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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 THIEF RIVER FALLS MEDICAL CENTER

Thief River Falls, MN · CCN 241381 · Rates published

8,020 distinct procedures filed
15 distinct payers
204,405 rate rows
2026-03-04 last MRF observed
Data quality

204,079 of 204,405 rate rows are consumer-grade (99.8%)

326 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 252
per-diem day rate — not a per-procedure price 64
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 10
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/8386/450409348_sanford-thief-river-falls-medical-center_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/SanfordThiefRiverFallsMedicalCenter/8386
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-21
Content fingerprint de2d023e4a8f85ba… · 153,908,630 bytes · first seen 2026-05-09

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
5834
APR_DRG 		Neonate With Ecmo 2 $182,097.58 $182,097.58 $182,097.58 nat. median
$307,273
0.6× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $115,092.49 $115,092.49 $115,092.49 nat. median
$247,815
outlier · 0.5×
5833
APR_DRG 		Neonate With Ecmo 2 $109,945.81 $109,945.81 $109,945.81 nat. median
$244,017
outlier · 0.5×
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $103,131.42 $103,131.42 $103,131.42 nat. median
$123,836
0.8× median
24
APR_DRG 		Heart And/or Lung Transplant 2 $93,658.59 $93,658.59 $93,658.59 nat. median
$241,734
outlier · 0.4×
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 $80,933.59 $80,933.59 $80,933.59 nat. median
$165,000
outlier · 0.5×
113
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $80,494.01 $80,494.01 $80,494.01 nat. median
$67,440
1.2× median
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 2 $79,190.61 $79,190.61 $79,190.61 nat. median
$163,528
outlier · 0.5×
1614
APR_DRG 		Implantable Heart Assist Systems 2 $77,875.22 $77,875.22 $77,875.22 nat. median
$202,649
outlier · 0.4×
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 2 $74,947.39 $74,947.39 $74,947.39 nat. median
$163,718
outlier · 0.5×
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $74,503.48 $74,503.48 $74,503.48 nat. median
$175,429
outlier · 0.4×
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $71,854.05 $71,854.05 $71,854.05 nat. median
$145,061
outlier · 0.5×
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 2 $69,902.28 $69,902.28 $69,902.28 nat. median
$151,838
outlier · 0.5×
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 2 $69,076.41 $69,076.41 $69,076.41 nat. median
$134,402
0.5× median
5832
APR_DRG 		Neonate With Ecmo 2 $68,993.49 $68,993.49 $68,993.49 nat. median
$159,249
outlier · 0.4×
112
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $68,020.43 $68,020.43 $68,020.43 nat. median
$68,020
1.0× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 2 $66,622.12 $66,622.12 $66,622.12 nat. median
$158,104
outlier · 0.4×
1613
APR_DRG 		Implantable Heart Assist Systems 2 $62,664.29 $62,664.29 $62,664.29 nat. median
$120,841
0.5× median
38240
CPT 		Transplt Allo Hct/donor 2 $62,099.45 $62,099.45 $62,099.45 nat. median
$12,874
outlier · 4.8×
5892
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 2 $61,127.11 $61,127.11 $61,127.11 nat. median
$89,331
0.7× median
5893
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 2 $61,127.11 $61,127.11 $61,127.11 nat. median
$71,350
0.9× median
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 2 $61,127.11 $61,127.11 $61,127.11 nat. median
$94,264
0.6× median
5913
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 2 $60,170.37 $60,170.37 $60,170.37 nat. median
$101,865
0.6× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 2 $58,743.27 $58,743.27 $58,743.27 nat. median
$65,720
0.9× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 $58,696.47 $58,696.47 $58,696.47 nat. median
$154,116
outlier · 0.4×
5831
APR_DRG 		Neonate With Ecmo 2 $58,213.27 $58,213.27 $58,213.27 nat. median
$147,206
outlier · 0.4×
74
APR_DRG 		Allogeneic Bone Marrow Transplant 2 $57,695.77 $57,695.77 $57,695.77 nat. median
$170,172
outlier · 0.3×
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 2 $57,255.86 $57,255.86 $57,255.86 nat. median
$122,016
outlier · 0.5×
14
APR_DRG 		Liver Transplant And/or Intestinal Transplant 2 $53,099.89 $53,099.89 $53,099.89 nat. median
$137,051
outlier · 0.4×
6024
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 $51,055.87 $51,055.87 $51,055.87 nat. median
$118,883
outlier · 0.4×
23
APR_DRG 		Heart And/or Lung Transplant 2 $50,647.26 $50,647.26 $50,647.26 nat. median
$110,771
outlier · 0.5×
5933
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 2 $49,936.95 $49,936.95 $49,936.95 nat. median
$108,900
outlier · 0.5×
5912
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 2 $48,857.66 $48,857.66 $48,857.66 nat. median
$82,966
0.6× median
5881
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $47,791.03 $47,791.03 $47,791.03 nat. median
$120,763
outlier · 0.4×
93
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 2 $42,399.26 $42,399.26 $42,399.26 nat. median
$78,990
0.5× median
1611
APR_DRG 		Implantable Heart Assist Systems 2 $42,353.30 $42,353.30 $42,353.30 nat. median
$77,028
0.5× median
1612
APR_DRG 		Implantable Heart Assist Systems 2 $42,353.30 $42,353.30 $42,353.30 nat. median
$85,271
outlier · 0.5×
1604
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly 2 $41,172.78 $41,172.78 $41,172.78 nat. median
$98,831
outlier · 0.4×
54
APR_DRG 		Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 $40,728.87 $40,728.87 $40,728.87 nat. median
$81,052
0.5× median
22
APR_DRG 		Heart And/or Lung Transplant 2 $39,092.79 $39,092.79 $39,092.79 nat. median
$92,158
outlier · 0.4×
5932
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 2 $38,826.72 $38,826.72 $38,826.72 nat. median
$86,187
outlier · 0.5×
6074
APR_DRG 		Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 2 $38,003.85 $38,003.85 $38,003.85 nat. median
$96,883
outlier · 0.4×
43
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 2 $37,953.90 $37,953.90 $37,953.90 nat. median
$74,628
0.5× median
6034
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 $36,926.56 $36,926.56 $36,926.56 nat. median
$107,442
outlier · 0.3×
J9347
HCPCS 		Tremelimumab-actl Soln For IV Infusion 300 Mg/15ml 15 $16,946.63 $46,671.07 $36,552.43 nat. median
$2,840
outlier · 12.9×
64
APR_DRG 		Pancreas Transplant 2 $35,808.31 $35,808.31 $35,808.31 nat. median
$91,239
outlier · 0.4×
8424
APR_DRG 		Burns With Skin Graft Except Extensive Third Degree Burns 2 $35,627.48 $35,627.48 $35,627.48 nat. median
$82,410
outlier · 0.4×
6023
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 $35,589.19 $35,589.19 $35,589.19 nat. median
$88,855
outlier · 0.4×
73
APR_DRG 		Allogeneic Bone Marrow Transplant 2 $34,375.36 $34,375.36 $34,375.36 nat. median
$89,273
outlier · 0.4×
33270
CPT 		Ins/rep Subq Defibrillator 2 $33,664.66 $33,664.66 $33,664.66 nat. median
$32,114
1.0× median

Other procedures at this hospital

Browse this hospital's 8,020 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
5834 APR_DRG Neonate With Ecmo 2 2 — — $182,097.58 $182,097.58 $182,097.58 2026-03-04
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $115,092.49 $115,092.49 $115,092.49 2026-03-04
5833 APR_DRG Neonate With Ecmo 2 2 — — $109,945.81 $109,945.81 $109,945.81 2026-03-04
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $103,131.42 $103,131.42 $103,131.42 2026-03-04
24 APR_DRG Heart And/or Lung Transplant 2 2 — — $93,658.59 $93,658.59 $93,658.59 2026-03-04
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 2 — — $80,933.59 $80,933.59 $80,933.59 2026-03-04
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $80,494.01 $80,494.01 $80,494.01 2026-03-04
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $79,190.61 $79,190.61 $79,190.61 2026-03-04
1614 APR_DRG Implantable Heart Assist Systems 2 2 — — $77,875.22 $77,875.22 $77,875.22 2026-03-04
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 2 2 — — $74,947.39 $74,947.39 $74,947.39 2026-03-04
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $74,503.48 $74,503.48 $74,503.48 2026-03-04
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $71,854.05 $71,854.05 $71,854.05 2026-03-04
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $69,902.28 $69,902.28 $69,902.28 2026-03-04
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 2 2 — — $69,076.41 $69,076.41 $69,076.41 2026-03-04
5832 APR_DRG Neonate With Ecmo 2 2 — — $68,993.49 $68,993.49 $68,993.49 2026-03-04
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $68,020.43 $68,020.43 $68,020.43 2026-03-04
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 2 2 — — $66,622.12 $66,622.12 $66,622.12 2026-03-04
1613 APR_DRG Implantable Heart Assist Systems 2 2 — — $62,664.29 $62,664.29 $62,664.29 2026-03-04
38240 CPT Transplt Allo Hct/donor 2 2 — — $62,099.45 $62,099.45 $62,099.45 2026-03-04
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 2 2 — — $61,127.11 $61,127.11 $61,127.11 2026-03-04
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 2 2 — — $61,127.11 $61,127.11 $61,127.11 2026-03-04
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 2 2 — — $61,127.11 $61,127.11 $61,127.11 2026-03-04
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $60,170.37 $60,170.37 $60,170.37 2026-03-04
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 2 2 — — $58,743.27 $58,743.27 $58,743.27 2026-03-04
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 2 — — $58,696.47 $58,696.47 $58,696.47 2026-03-04
5831 APR_DRG Neonate With Ecmo 2 2 — — $58,213.27 $58,213.27 $58,213.27 2026-03-04
74 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $57,695.77 $57,695.77 $57,695.77 2026-03-04
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $57,255.86 $57,255.86 $57,255.86 2026-03-04
14 APR_DRG Liver Transplant And/or Intestinal Transplant 2 2 — — $53,099.89 $53,099.89 $53,099.89 2026-03-04
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $51,055.87 $51,055.87 $51,055.87 2026-03-04
23 APR_DRG Heart And/or Lung Transplant 2 2 — — $50,647.26 $50,647.26 $50,647.26 2026-03-04
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $49,936.95 $49,936.95 $49,936.95 2026-03-04
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $48,857.66 $48,857.66 $48,857.66 2026-03-04
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $47,791.03 $47,791.03 $47,791.03 2026-03-04
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 2 2 — — $42,399.26 $42,399.26 $42,399.26 2026-03-04
1611 APR_DRG Implantable Heart Assist Systems 2 2 — — $42,353.30 $42,353.30 $42,353.30 2026-03-04
1612 APR_DRG Implantable Heart Assist Systems 2 2 — — $42,353.30 $42,353.30 $42,353.30 2026-03-04
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 2 2 — — $41,172.78 $41,172.78 $41,172.78 2026-03-04
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 2 — — $40,728.87 $40,728.87 $40,728.87 2026-03-04
22 APR_DRG Heart And/or Lung Transplant 2 2 — — $39,092.79 $39,092.79 $39,092.79 2026-03-04
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $38,826.72 $38,826.72 $38,826.72 2026-03-04
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $38,003.85 $38,003.85 $38,003.85 2026-03-04
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $37,953.90 $37,953.90 $37,953.90 2026-03-04
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 2 — — $36,926.56 $36,926.56 $36,926.56 2026-03-04
J9347 HCPCS Tremelimumab-actl Soln For IV Infusion 300 Mg/15ml 39 15 $49,335.17 $39,468.14 $16,946.63 $46,671.07 $36,552.43 2026-03-04
64 APR_DRG Pancreas Transplant 2 2 — — $35,808.31 $35,808.31 $35,808.31 2026-03-04
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 2 2 — — $35,627.48 $35,627.48 $35,627.48 2026-03-04
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $35,589.19 $35,589.19 $35,589.19 2026-03-04
73 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $34,375.36 $34,375.36 $34,375.36 2026-03-04
33270 CPT Ins/rep Subq Defibrillator 2 2 — — $33,664.66 $33,664.66 $33,664.66 2026-03-04
33264 CPT Rmvl & Rplcmt Dfb Gen Mlt Ld 2 2 — — $33,664.66 $33,664.66 $33,664.66 2026-03-04
33249 CPT Insj/rplcmt Defib W/lead(s) 2 2 — — $33,664.66 $33,664.66 $33,664.66 2026-03-04
33231 CPT Insrt Pulse Gen W/mult Leads 2 2 — — $33,664.66 $33,664.66 $33,664.66 2026-03-04
69930 CPT Implant Cochlear Device 2 2 — — $33,398.21 $33,398.21 $33,398.21 2026-03-04
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 2 2 — — $32,025.64 $32,025.64 $32,025.64 2026-03-04
64568 CPT Opn Impltj Crnl Nrv Nea&pg 2 2 — — $31,997.27 $31,997.27 $31,997.27 2026-03-04
61886 CPT Implant Neurostim Arrays 2 2 — — $31,997.27 $31,997.27 $31,997.27 2026-03-04
63685 CPT Ins/rplc Spi Npg/rcvr Pocket 2 2 — — $31,997.27 $31,997.27 $31,997.27 2026-03-04
64582 CPT Opn Mpltj Hpglsl Nstm Ary Pg 2 2 — — $31,997.27 $31,997.27 $31,997.27 2026-03-04
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 2 — — $31,878.12 $31,878.12 $31,878.12 2026-03-04
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 2 2 — — $31,101.53 $31,101.53 $31,101.53 2026-03-04
8634 APR_DRG Neonatal Aftercare 2 2 — — $30,555.40 $30,555.40 $30,555.40 2026-03-04
63 APR_DRG Pancreas Transplant 2 2 — — $30,475.47 $30,475.47 $30,475.47 2026-03-04
21 APR_DRG Heart And/or Lung Transplant 2 2 — — $29,967.30 $29,967.30 $29,967.30 2026-03-04
33289 CPT Tcat Impl Wrls P-art Prs Snr 2 2 — — $29,849.75 $29,849.75 $29,849.75 2026-03-04
4404 APR_DRG Kidney Transplant 2 2 — — $29,609.65 $29,609.65 $29,609.65 2026-03-04
C1722 HCPCS Icd Dynagen Mini Vr Df4 39 15 $39,732.00 $31,785.60 20% off $13,647.94 $37,586.47 $29,437.44 2026-03-04
13 APR_DRG Liver Transplant And/or Intestinal Transplant 2 2 — — $29,324.26 $29,324.26 $29,324.26 2026-03-04
C9760 HCPCS Non-blind Interatrial Shunt 2 2 — — $28,875.53 $28,875.53 $28,875.53 2026-03-04
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $28,735.49 $28,735.49 $28,735.49 2026-03-04
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 2 — — $28,734.49 $28,734.49 $28,734.49 2026-03-04
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 2 2 — — $28,512.04 $28,512.04 $28,512.04 2026-03-04
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 2 2 — — $27,341.51 $27,341.51 $27,341.51 2026-03-04
8514 APR_DRG Gender Related Procedures 2 2 — — $26,802.03 $26,802.03 $26,802.03 2026-03-04
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $26,689.14 $26,689.14 $26,689.14 2026-03-04
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $26,017.46 $26,017.46 $26,017.46 2026-03-04
2994 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 2 — — $25,796.01 $25,796.01 $25,796.01 2026-03-04
62 APR_DRG Pancreas Transplant 2 2 — — $25,770.37 $25,770.37 $25,770.37 2026-03-04
93656 CPT Compre Ep Eval Abltj Atr Fib 2 2 — — $25,758.92 $25,758.92 $25,758.92 2026-03-04
93654 CPT Compre Ep Eval Tx Vt 2 2 — — $25,758.92 $25,758.92 $25,758.92 2026-03-04
93653 CPT Compre Ep Eval Tx Svt 2 2 — — $25,758.92 $25,758.92 $25,758.92 2026-03-04
72 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $25,585.55 $25,585.55 $25,585.55 2026-03-04
1784 APR_DRG External Heart Assist Devices 2 2 — — $25,501.96 $25,501.96 $25,501.96 2026-03-04
84 APR_DRG Autologous Bone Marrow Transplant 2 2 — — $25,070.38 $25,070.38 $25,070.38 2026-03-04
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 2 — — $24,853.92 $24,853.92 $24,853.92 2026-03-04
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 2 2 — — $24,512.58 $24,512.58 $24,512.58 2026-03-04
J2350 HCPCS Ocrelizumab Soln For IV Infusion 300 Mg/10ml 40 15 $32,695.53 $26,156.43 $60.94 $30,929.97 $24,224.12 2026-03-04
J0638 HCPCS Canakinumab Subcutaneous Inj 150 Mg/ml 40 15 $32,069.85 $25,655.88 $130.24 $30,338.08 $23,760.56 2026-03-04
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $23,669.07 $23,669.07 $23,669.07 2026-03-04
12 APR_DRG Liver Transplant And/or Intestinal Transplant 2 2 — — $23,660.41 $23,660.41 $23,660.41 2026-03-04
33262 CPT Rmvl& Replc Pulse Gen 1 Lead 2 2 — — $23,568.50 $23,568.50 $23,568.50 2026-03-04
33240 CPT Insrt Pulse Gen W/singl Lead 2 2 — — $23,568.50 $23,568.50 $23,568.50 2026-03-04
33263 CPT Rmvl & Rplcmt Dfb Gen 2 Lead 2 2 — — $23,568.50 $23,568.50 $23,568.50 2026-03-04
33230 CPT Insrt Pulse Gen W/dual Leads 2 2 — — $23,568.50 $23,568.50 $23,568.50 2026-03-04
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $23,469.60 $23,469.60 $23,469.60 2026-03-04
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 2 2 — — $23,266.79 $23,266.79 $23,266.79 2026-03-04
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 2 2 — — $22,974.74 $22,974.74 $22,974.74 2026-03-04
1834 APR_DRG Percutaneous Structural Cardiac Procedures 2 2 — — $22,629.41 $22,629.41 $22,629.41 2026-03-04
64580 CPT Opn Impltj Nea Neuromuscular 2 2 — — $22,516.61 $22,516.61 $22,516.61 2026-03-04
61885 CPT Insrt/redo Neurostim 1 Array 2 2 — — $22,516.61 $22,516.61 $22,516.61 2026-03-04
64590 CPT Ins/rpl Prph Sac/gstr Npg/r 2 2 — — $22,516.61 $22,516.61 $22,516.61 2026-03-04
63655 CPT Implant Neuroelectrodes 2 2 — — $22,516.61 $22,516.61 $22,516.61 2026-03-04
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 2 2 — — $22,277.08 $22,277.08 $22,277.08 2026-03-04
9104 APR_DRG Craniotomy For Multiple Significant Trauma 2 2 — — $21,944.07 $21,944.07 $21,944.07 2026-03-04
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 2 2 — — $21,926.76 $21,926.76 $21,926.76 2026-03-04
C1767 HCPCS Ipg Spectra*nlu* 93 15 $28,000.00 $22,400.00 20% off $9,317.44 $27,977.95 $21,912.12 2026-03-04
71 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $21,297.37 $21,297.37 $21,297.37 2026-03-04
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 2 2 — — $21,196.13 $21,196.13 $21,196.13 2026-03-04
1794 APR_DRG Defibrillator Implants 2 2 — — $21,175.48 $21,175.48 $21,175.48 2026-03-04
54401 CPT Insert Self-contd Prosthesis 2 2 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
54405 CPT Insert Multi-comp Penis Pros 2 2 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
54410 CPT Remove/replace Penis Prosth 2 2 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
54411 CPT Remov/replc Penis Pros Comp 2 2 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
54416 CPT Remv/repl Penis Contain Pros 2 2 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
53444 CPT Insert Tandem Cuff 2 2 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
53445 CPT Insert Uro/ves Nck Sphincter 2 2 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
53447 CPT Remove/replace Ur Sphincter 2 2 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 2 2 — — $21,069.92 $21,069.92 $21,069.92 2026-03-04
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 2 2 — — $20,957.36 $20,957.36 $20,957.36 2026-03-04
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 2 2 — — $20,804.51 $20,804.51 $20,804.51 2026-03-04
61 APR_DRG Pancreas Transplant 2 2 — — $20,795.52 $20,795.52 $20,795.52 2026-03-04
914 APR_DRG Other Major Head And Neck Procedures 2 2 — — $20,733.91 $20,733.91 $20,733.91 2026-03-04
1783 APR_DRG External Heart Assist Devices 2 2 — — $20,679.63 $20,679.63 $20,679.63 2026-03-04
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 2 2 — — $20,440.53 $20,440.53 $20,440.53 2026-03-04
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 2 2 — — $20,405.23 $20,405.23 $20,405.23 2026-03-04
2993 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 2 — — $20,224.07 $20,224.07 $20,224.07 2026-03-04
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 2 2 — — $20,146.48 $20,146.48 $20,146.48 2026-03-04
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 2 2 — — $20,114.85 $20,114.85 $20,114.85 2026-03-04
C1820 HCPCS Stim Restor Sens Surscan*obs* 120 15 $28,525.00 $22,820.00 20% off $9,317.44 $30,461.20 $20,096.92 2026-03-04
33274 CPT Tcat Insj/rpl Perm Ldls Pm 2 2 — — $20,024.72 $20,024.72 $20,024.72 2026-03-04
33229 CPT Remv&replc Pm Gen Mult Leads 2 2 — — $20,024.72 $20,024.72 $20,024.72 2026-03-04
33221 CPT Insert Pulse Gen Mult Leads 2 2 — — $20,024.72 $20,024.72 $20,024.72 2026-03-04
4403 APR_DRG Kidney Transplant 2 2 — — $19,710.57 $19,710.57 $19,710.57 2026-03-04
3004 APR_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 2 — — $19,505.44 $19,505.44 $19,505.44 2026-03-04
11 APR_DRG Liver Transplant And/or Intestinal Transplant 2 2 — — $19,441.83 $19,441.83 $19,441.83 2026-03-04
22633 CPT Arthrd Cmbn 1ntrspc Lumbar 2 2 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
22856 CPT Tot Disc Arthrp 1ntrspc Crv 2 2 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
22612 CPT Arthrd Pst Tq 1ntrspc Lumbar 2 2 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
23616 CPT Optx Prx Hmrl Fx Fix Rpr Rpl 2 2 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
22630 CPT Arthrd Pst Tq 1ntrspc Lum 2 2 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
23472 CPT Reconstruct Shoulder Joint 2 2 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
20696 CPT App Mltpln Uni Xtrnl Fix 1st 2 2 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
27702 CPT Reconstruct Ankle Joint 2 2 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
28705 CPT Arthrodesis Pantalar 2 2 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
C8003 HCPCS Imp Extar Knee Shck Absrb 2 2 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
24371 CPT Revise Reconst Elbow Joint 2 2 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
27279 CPT Arthrd Si Jt Plmt Tartclr Dv 2 2 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
24363 CPT Replace Elbow Joint 2 2 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
25446 CPT Arthrp W/prostc Dst Rds&crps 2 2 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
21243 CPT Reconstruction Of Jaw Joint 2 2 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
25442 CPT Arthrp W/prostc Dstl Ulna 2 2 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
24361 CPT Reconstruct Elbow Joint 2 2 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
5931 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $19,247.35 $19,247.35 $19,247.35 2026-03-04
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 2 — — $19,242.36 $19,242.36 $19,242.36 2026-03-04
1694 APR_DRG Major Abdominal Vascular Procedures 2 2 — — $19,138.12 $19,138.12 $19,138.12 2026-03-04
214 APR_DRG Open Craniotomy Except Trauma 2 2 — — $19,114.81 $19,114.81 $19,114.81 2026-03-04
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 2 2 — — $19,103.49 $19,103.49 $19,103.49 2026-03-04
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 2 2 — — $19,034.56 $19,034.56 $19,034.56 2026-03-04
C9607 HCPCS Perc D-e Cor Revasc Chro Sin 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9602 HCPCS Perc D-e Cor Stent Ather S 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9606 HCPCS Perc D-e Cor Revasc W Ami S 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9765 HCPCS Revasc Intra Lithotrip-stent 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9766 HCPCS Revasc Intra Lithotrip-ather 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
93590 CPT Perq Transcath Cls Mitral 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
93581 CPT Transcath Closure Of Vsd 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
93591 CPT Perq Transcath Cls Aortic 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
92933 CPT Prq Trlml C Athrc St Angiop1 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9767 HCPCS Revasc Lithotrip-stent-ather 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
93582 CPT Perq Transcath Closure Pda 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9775 HCPCS Revasc Lith-sten-ath Tib/per 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9773 HCPCS Revasc Lithotr-stent Tib/per 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9774 HCPCS Revasc Lithotr-ather Tib/per 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
93580 CPT Transcath Closure Of Asd 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37242 CPT Vasc Embolize/occlude Artery 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37230 CPT Outpatient Services - Cpt/hcpcs 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37231 CPT Outpatient Services - Cpt/hcpcs 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37227 CPT Outpatient Services - Cpt/hcpcs 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37225 CPT Outpatient Services - Cpt/hcpcs 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
36906 CPT Thrmbc/nfs Dialysis Circuit 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
33902 CPT Perq P-art Revsc 1 Abnor Uni 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
36836 CPT Prq Av Fstl Crtj Uxtr 1 Acs 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
36837 CPT Prq Av Fstl Crt Uxtr Sep Acs 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37229 CPT Outpatient Services - Cpt/hcpcs 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37184 CPT Prim Art M-thrmbc 1st Vsl 2 2 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 2 2 — — $18,824.76 $18,824.76 $18,824.76 2026-03-04
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 2 2 — — $18,689.89 $18,689.89 $18,689.89 2026-03-04
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 2 2 — — $18,610.30 $18,610.30 $18,610.30 2026-03-04
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 2 2 — — $18,610.30 $18,610.30 $18,610.30 2026-03-04
62362 CPT Implant Spine Infusion Pump 2 2 — — $18,557.83 $18,557.83 $18,557.83 2026-03-04
62360 CPT Insert Spine Infusion Device 2 2 — — $18,557.83 $18,557.83 $18,557.83 2026-03-04
62361 CPT Implant Spine Infusion Pump 2 2 — — $18,557.83 $18,557.83 $18,557.83 2026-03-04
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 2 2 — — $18,459.12 $18,459.12 $18,459.12 2026-03-04
234 APR_DRG Spinal Procedures 2 2 — — $18,443.13 $18,443.13 $18,443.13 2026-03-04
C9758 HCPCS Blind Interatrial Shunt Ide 2 2 — — $18,375.53 $18,375.53 $18,375.53 2026-03-04
C8005 HCPCS Pef Bronch Ablt 3d Nav Ebus 2 2 — — $18,375.53 $18,375.53 $18,375.53 2026-03-04
19357 CPT Tiss Xpndr Plmt Brst Rcnstj 2 2 — — $18,268.26 $18,268.26 $18,268.26 2026-03-04
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $18,178.72 $18,178.72 $18,178.72 2026-03-04
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 2 2 — — $18,159.41 $18,159.41 $18,159.41 2026-03-04
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 2 2 — — $18,097.13 $18,097.13 $18,097.13 2026-03-04
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 2 2 — — $18,082.81 $18,082.81 $18,082.81 2026-03-04
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 2 2 — — $18,071.49 $18,071.49 $18,071.49 2026-03-04
894 APR_DRG Major Cranial Or Facial Bone Procedures 2 2 — — $17,649.90 $17,649.90 $17,649.90 2026-03-04
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 2 2 — — $17,576.97 $17,576.97 $17,576.97 2026-03-04
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 2 2 — — $17,533.35 $17,533.35 $17,533.35 2026-03-04
4014 APR_DRG Adrenal Procedures 2 2 — — $17,441.10 $17,441.10 $17,441.10 2026-03-04
6904 APR_DRG Acute Leukemia 2 2 — — $17,357.85 $17,357.85 $17,357.85 2026-03-04
1204 APR_DRG Major Respiratory And Chest Procedures 2 2 — — $17,324.55 $17,324.55 $17,324.55 2026-03-04
66683 CPT Implantation Iris Prosthesis 2 2 — — $17,237.25 $17,237.25 $17,237.25 2026-03-04
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 2 2 — — $17,229.31 $17,229.31 $17,229.31 2026-03-04
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 2 2 — — $17,048.82 $17,048.82 $17,048.82 2026-03-04
4402 APR_DRG Kidney Transplant 2 2 — — $17,013.18 $17,013.18 $17,013.18 2026-03-04
204 APR_DRG Open Craniotomy For Trauma 2 2 — — $16,936.26 $16,936.26 $16,936.26 2026-03-04
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $16,769.42 $16,769.42 $16,769.42 2026-03-04
3124 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 2 2 — — $16,740.45 $16,740.45 $16,740.45 2026-03-04
4414 APR_DRG Major Bladder Procedures 2 2 — — $16,732.46 $16,732.46 $16,732.46 2026-03-04
1782 APR_DRG External Heart Assist Devices 2 2 — — $16,670.52 $16,670.52 $16,670.52 2026-03-04
5204 APR_DRG Other GYN Procedures For Malignancy 2 2 — — $16,549.63 $16,549.63 $16,549.63 2026-03-04
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 2 2 — — $16,494.35 $16,494.35 $16,494.35 2026-03-04
83 APR_DRG Autologous Bone Marrow Transplant 2 2 — — $16,444.07 $16,444.07 $16,444.07 2026-03-04
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $16,239.27 $16,239.27 $16,239.27 2026-03-04
67027 CPT Implant Eye Drug System 2 2 — — $16,133.07 $16,133.07 $16,133.07 2026-03-04
2614 APR_DRG Major Biliary Tract Procedures 2 2 — — $16,017.48 $16,017.48 $16,017.48 2026-03-04
4854 APR_DRG Prostatectomy Procedures 2 2 — — $15,968.86 $15,968.86 $15,968.86 2026-03-04
1833 APR_DRG Percutaneous Structural Cardiac Procedures 2 2 — — $15,944.89 $15,944.89 $15,944.89 2026-03-04
6092 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 2 — — $15,914.91 $15,914.91 $15,914.91 2026-03-04
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 2 2 — — $15,763.06 $15,763.06 $15,763.06 2026-03-04
1793 APR_DRG Defibrillator Implants 2 2 — — $15,632.52 $15,632.52 $15,632.52 2026-03-04
4401 APR_DRG Kidney Transplant 2 2 — — $15,543.27 $15,543.27 $15,543.27 2026-03-04
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 2 2 — — $15,472.68 $15,472.68 $15,472.68 2026-03-04
3214 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 2 2 — — $15,429.72 $15,429.72 $15,429.72 2026-03-04
1663 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 2 2 — — $15,387.43 $15,387.43 $15,387.43 2026-03-04
1781 APR_DRG External Heart Assist Devices 2 2 — — $15,294.85 $15,294.85 $15,294.85 2026-03-04
6021 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $15,256.22 $15,256.22 $15,256.22 2026-03-04
2992 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 2 — — $15,152.32 $15,152.32 $15,152.32 2026-03-04
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 2 — — $15,113.02 $15,113.02 $15,113.02 2026-03-04
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 2 2 — — $15,087.38 $15,087.38 $15,087.38 2026-03-04
6133 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 2 2 — — $15,073.06 $15,073.06 $15,073.06 2026-03-04
2304 APR_DRG Major Small Bowel Procedures 2 2 — — $15,033.10 $15,033.10 $15,033.10 2026-03-04
6954 APR_DRG Chemotherapy For Acute Leukemia 2 2 — — $15,027.11 $15,027.11 $15,027.11 2026-03-04
274 APR_DRG Other Open Craniotomy 2 2 — — $15,016.12 $15,016.12 $15,016.12 2026-03-04
65770 CPT Keratoprosthesis 2 2 — — $15,003.78 $15,003.78 $15,003.78 2026-03-04
1814 APR_DRG Lower Extremity Vascular Procedures 2 2 — — $15,003.13 $15,003.13 $15,003.13 2026-03-04
3043 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 2 2 — — $14,969.83 $14,969.83 $14,969.83 2026-03-04
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 2 2 — — $14,920.21 $14,920.21 $14,920.21 2026-03-04
1652 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 2 2 — — $14,850.28 $14,850.28 $14,850.28 2026-03-04
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 2 2 — — $14,833.96 $14,833.96 $14,833.96 2026-03-04
5114 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 2 2 — — $14,761.70 $14,761.70 $14,761.70 2026-03-04
5124 APR_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy 2 2 — — $14,689.43 $14,689.43 $14,689.43 2026-03-04
1621 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 2 2 — — $14,648.81 $14,648.81 $14,648.81 2026-03-04
1214 APR_DRG Other Respiratory And Chest Procedures 2 2 — — $14,647.48 $14,647.48 $14,647.48 2026-03-04
J9272 HCPCS Dostarlimab-gxly IV Soln 500 Mg/10ml (50 Mg/ml) 40 15 $19,493.48 $15,594.79 $283.24 $18,440.83 $14,442.72 2026-03-04
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 2 2 — — $14,427.02 $14,427.02 $14,427.02 2026-03-04
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 2 2 — — $14,227.22 $14,227.22 $14,227.22 2026-03-04
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 2 2 — — $14,209.23 $14,209.23 $14,209.23 2026-03-04
1632 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 2 2 — — $14,205.24 $14,205.24 $14,205.24 2026-03-04
8633 APR_DRG Neonatal Aftercare 2 2 — — $14,144.63 $14,144.63 $14,144.63 2026-03-04
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 2 2 — — $14,143.63 $14,143.63 $14,143.63 2026-03-04
1602 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 2 2 — — $14,127.98 $14,127.98 $14,127.98 2026-03-04
1704 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 2 2 — — $14,044.73 $14,044.73 $14,044.73 2026-03-04
4284 APR_DRG Genetic Disorders 2 2 — — $14,037.40 $14,037.40 $14,037.40 2026-03-04
4034 APR_DRG Procedures For Obesity 2 2 — — $14,034.74 $14,034.74 $14,034.74 2026-03-04
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 2 2 — — $13,922.18 $13,922.18 $13,922.18 2026-03-04
1754 APR_DRG Percutaneous Cardiac Intervention Without Ami 2 2 — — $13,884.22 $13,884.22 $13,884.22 2026-03-04
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures 2 2 — — $13,836.26 $13,836.26 $13,836.26 2026-03-04
1303 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 2 2 — — $13,804.29 $13,804.29 $13,804.29 2026-03-04
294 APR_DRG Other Percutaneous Intracranial Procedures 2 2 — — $13,793.64 $13,793.64 $13,793.64 2026-03-04
224 APR_DRG Ventricular Shunt Procedures 2 2 — — $13,783.31 $13,783.31 $13,783.31 2026-03-04
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 2 2 — — $13,737.02 $13,737.02 $13,737.02 2026-03-04
6224 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $13,707.05 $13,707.05 $13,707.05 2026-03-04
54400 CPT Insert Semi-rigid Prosthesis 2 2 — — $13,642.04 $13,642.04 $13,642.04 2026-03-04
53451 CPT Tprnl Balo Cntnc Dev Bi 2 2 — — $13,642.04 $13,642.04 $13,642.04 2026-03-04
54417 CPT Remv/replc Penis Pros Compl 2 2 — — $13,642.04 $13,642.04 $13,642.04 2026-03-04
53440 CPT Male Sling Procedure 2 2 — — $13,642.04 $13,642.04 $13,642.04 2026-03-04
1651 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 2 2 — — $13,557.53 $13,557.53 $13,557.53 2026-03-04
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 2 2 — — $13,546.88 $13,546.88 $13,546.88 2026-03-04
C9757 HCPCS Spine Device Implant Surgery 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
25391 CPT Lengthen Radius Or Ulna 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27709 CPT Osteotomy Tibia & Fibula 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
25365 CPT Revise Radius & Ulna 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
23680 CPT Optx Sho Dislc Neck Fx Fixj 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24346 CPT Reconstruct Elbow Med Ligmnt 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
23802 CPT Arthrd Glenohumeral Jt W/grf 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
69730 CPT Rplc Oi Implt Sk Tc Esp>=100 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
69729 CPT Impl Oi Implt Sk Tc Esp>=100 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
69714 CPT Impl Oi Implt Skull Perq Esp 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
69716 CPT Impl Oi Implt Sk Tc Esp<100 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
25810 CPT Arthrd Wrst Iliac/oth Agrft 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
69719 CPT Rplcm Oi Implt Sk Tc Esp<100 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
23615 CPT Optx Prox Humrl Fx W/int Fix 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24666 CPT Optx Radial Head/nck Fx Rplc 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
23491 CPT Reinforce Shoulder Bones 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24802 CPT Arthrd Elbow Jt Autog Graft 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24587 CPT Optx Partclr Fx&/dslc Elbw W 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24586 CPT Optx Partclr Fx&/dislc Elbow 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
22551 CPT Arthrd Ant Ntrbdy Cervical 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
22554 CPT Arthrd Ant Ntrbd Min Dsc Crv 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
64628 CPT Trml Dstrj Ios Bvn 1st 2 L/s 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27441 CPT Revision Of Knee Joint 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
23470 CPT Reconstruct Shoulder Joint 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24545 CPT Optx Hum Fx Wo Ntrcndylr Xtn 2 2 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
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