|
0266T
|
CPT
|
Outpatient Services
|
4
|
4
|
—
|
—
|
$45,347.18
|
$86,159.64
|
$45,347.18
|
2025-09-26
|
|
0620T
|
CPT
|
Evasc Ven Artlz Tibl/prnl Vn
|
4
|
4
|
—
|
—
|
$35,270.14
|
$67,013.27
|
$35,270.14
|
2025-09-26
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
10
|
10
|
—
|
—
|
$98,011.35
|
$495,216.11
|
$180,413.81
|
2025-09-26
|
|
104
|
EAPG
|
Major Open Coronary Artery Procedures Including Cabg
|
1
|
1
|
—
|
—
|
$34,826.43
|
$34,826.43
|
$34,826.43
|
2025-09-26
|
|
11
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
1
|
1
|
—
|
—
|
$46,804.46
|
$46,804.46
|
$46,804.46
|
2025-09-26
|
|
111
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
1
|
1
|
—
|
—
|
$41,862.10
|
$41,862.10
|
$41,862.10
|
2025-09-26
|
|
112
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
1
|
1
|
—
|
—
|
$73,610.47
|
$73,610.47
|
$73,610.47
|
2025-09-26
|
|
113
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
1
|
1
|
—
|
—
|
$105,923.90
|
$105,923.90
|
$105,923.90
|
2025-09-26
|
|
114
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
1
|
1
|
—
|
—
|
$186,403.31
|
$186,403.31
|
$186,403.31
|
2025-09-26
|
|
12
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
1
|
1
|
—
|
—
|
$53,493.18
|
$53,493.18
|
$53,493.18
|
2025-09-26
|
|
120
|
EAPG
|
Car T-cell Immunotherapy
|
1
|
1
|
—
|
—
|
$89,523.36
|
$89,523.36
|
$89,523.36
|
2025-09-26
|
|
1204
|
APR_DRG
|
Major Respiratory And Chest Procedures
|
1
|
1
|
—
|
—
|
$48,147.09
|
$48,147.09
|
$48,147.09
|
2025-09-26
|
|
1214
|
APR_DRG
|
Other Respiratory And Chest Procedures
|
1
|
1
|
—
|
—
|
$39,153.25
|
$39,153.25
|
$39,153.25
|
2025-09-26
|
|
13
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
1
|
1
|
—
|
—
|
$66,493.63
|
$66,493.63
|
$66,493.63
|
2025-09-26
|
|
1304
|
APR_DRG
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
1
|
1
|
—
|
—
|
$43,513.23
|
$43,513.23
|
$43,513.23
|
2025-09-26
|
|
14
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
1
|
1
|
—
|
—
|
$142,767.31
|
$142,767.31
|
$142,767.31
|
2025-09-26
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
10
|
10
|
—
|
—
|
$36,936.45
|
$230,348.04
|
$86,116.72
|
2025-09-26
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
10
|
10
|
—
|
—
|
$19,908.00
|
$106,129.97
|
$39,772.38
|
2025-09-26
|
|
1603
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
1
|
1
|
—
|
—
|
$48,872.70
|
$48,872.70
|
$48,872.70
|
2025-09-26
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
1
|
1
|
—
|
—
|
$107,007.60
|
$107,007.60
|
$107,007.60
|
2025-09-26
|
|
1611
|
APR_DRG
|
Implantable Heart Assist Systems
|
1
|
1
|
—
|
—
|
$104,114.59
|
$104,114.59
|
$104,114.59
|
2025-09-26
|
|
1612
|
APR_DRG
|
Implantable Heart Assist Systems
|
1
|
1
|
—
|
—
|
$109,621.23
|
$109,621.23
|
$109,621.23
|
2025-09-26
|
|
1613
|
APR_DRG
|
Implantable Heart Assist Systems
|
1
|
1
|
—
|
—
|
$134,868.19
|
$134,868.19
|
$134,868.19
|
2025-09-26
|
|
1614
|
APR_DRG
|
Implantable Heart Assist Systems
|
1
|
1
|
—
|
—
|
$197,169.47
|
$197,169.47
|
$197,169.47
|
2025-09-26
|
|
1622
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
1
|
1
|
—
|
—
|
$38,732.99
|
$38,732.99
|
$38,732.99
|
2025-09-26
|
|
1623
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
1
|
1
|
—
|
—
|
$51,210.09
|
$51,210.09
|
$51,210.09
|
2025-09-26
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
1
|
1
|
—
|
—
|
$79,903.32
|
$79,903.32
|
$79,903.32
|
2025-09-26
|
|
1633
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
1
|
1
|
—
|
—
|
$42,511.38
|
$42,511.38
|
$42,511.38
|
2025-09-26
|
|
1634
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
1
|
1
|
—
|
—
|
$67,497.06
|
$67,497.06
|
$67,497.06
|
2025-09-26
|
|
1653
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
1
|
1
|
—
|
—
|
$41,957.33
|
$41,957.33
|
$41,957.33
|
2025-09-26
|
|
1654
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
1
|
1
|
—
|
—
|
$61,972.32
|
$61,972.32
|
$61,972.32
|
2025-09-26
|
|
1664
|
APR_DRG
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
1
|
1
|
—
|
—
|
$54,935.75
|
$54,935.75
|
$54,935.75
|
2025-09-26
|
|
1673
|
APR_DRG
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
1
|
1
|
—
|
—
|
$38,484.30
|
$38,484.30
|
$38,484.30
|
2025-09-26
|
|
1674
|
APR_DRG
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
1
|
1
|
—
|
—
|
$69,355.95
|
$69,355.95
|
$69,355.95
|
2025-09-26
|
|
1694
|
APR_DRG
|
Major Abdominal Vascular Procedures
|
1
|
1
|
—
|
—
|
$51,338.37
|
$51,338.37
|
$51,338.37
|
2025-09-26
|
|
1704
|
APR_DRG
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
1
|
1
|
—
|
—
|
$36,527.03
|
$36,527.03
|
$36,527.03
|
2025-09-26
|
|
1764
|
APR_DRG
|
Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices
|
1
|
1
|
—
|
—
|
$40,784.70
|
$40,784.70
|
$40,784.70
|
2025-09-26
|
|
1781
|
APR_DRG
|
External Heart Assist Systems
|
1
|
1
|
—
|
—
|
$36,857.57
|
$36,857.57
|
$36,857.57
|
2025-09-26
|
|
1782
|
APR_DRG
|
External Heart Assist Systems
|
1
|
1
|
—
|
—
|
$45,923.81
|
$45,923.81
|
$45,923.81
|
2025-09-26
|
|
1783
|
APR_DRG
|
External Heart Assist Systems
|
1
|
1
|
—
|
—
|
$47,216.85
|
$47,216.85
|
$47,216.85
|
2025-09-26
|
|
1784
|
APR_DRG
|
External Heart Assist Systems
|
1
|
1
|
—
|
—
|
$65,801.07
|
$65,801.07
|
$65,801.07
|
2025-09-26
|
|
1793
|
APR_DRG
|
Defibrillator Implants
|
1
|
1
|
—
|
—
|
$37,860.21
|
$37,860.21
|
$37,860.21
|
2025-09-26
|
|
1794
|
APR_DRG
|
Defibrillator Implants
|
1
|
1
|
—
|
—
|
$51,998.66
|
$51,998.66
|
$51,998.66
|
2025-09-26
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
10
|
10
|
—
|
—
|
$118,772.55
|
$663,007.83
|
$229,570.41
|
2025-09-26
|
|
1814
|
APR_DRG
|
Lower Extremity Arterial Procedures
|
1
|
1
|
—
|
—
|
$44,149.91
|
$44,149.91
|
$44,149.91
|
2025-09-26
|
|
1824
|
APR_DRG
|
Other Peripheral Vascular And Related Procedures
|
1
|
1
|
—
|
—
|
$39,244.54
|
$39,244.54
|
$39,244.54
|
2025-09-26
|
|
1833
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
1
|
1
|
—
|
—
|
$37,720.12
|
$37,720.12
|
$37,720.12
|
2025-09-26
|
|
1834
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
1
|
1
|
—
|
—
|
$55,788.86
|
$55,788.86
|
$55,788.86
|
2025-09-26
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
10
|
10
|
—
|
—
|
$28,902.15
|
$139,380.71
|
$40,970.08
|
2025-09-26
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
10
|
10
|
—
|
—
|
$44,295.30
|
$193,744.86
|
$89,682.76
|
2025-09-26
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
10
|
10
|
—
|
—
|
$35,869.95
|
$141,732.89
|
$52,448.41
|
2025-09-26
|
|
204
|
APR_DRG
|
Open Craniotomy For Trauma
|
1
|
1
|
—
|
—
|
$47,787.43
|
$47,787.43
|
$47,787.43
|
2025-09-26
|
|
21
|
APR_DRG
|
Heart And/or Lung Transplant
|
1
|
1
|
—
|
—
|
$87,120.11
|
$87,120.11
|
$87,120.11
|
2025-09-26
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
10
|
10
|
—
|
—
|
$26,058.15
|
$97,188.82
|
$41,303.93
|
2025-09-26
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
7
|
7
|
—
|
—
|
$47,388.15
|
$191,533.30
|
$100,807.00
|
2025-09-26
|
|
214
|
APR_DRG
|
Open Craniotomy Except Trauma
|
1
|
1
|
—
|
—
|
$55,673.17
|
$55,673.17
|
$55,673.17
|
2025-09-26
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
10
|
10
|
—
|
—
|
$44,970.75
|
$186,275.16
|
$50,601.45
|
2025-09-26
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
10
|
10
|
—
|
—
|
$42,695.55
|
$169,684.97
|
$68,670.81
|
2025-09-26
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
10
|
10
|
—
|
—
|
$28,013.40
|
$113,548.73
|
$35,494.98
|
2025-09-26
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
10
|
10
|
—
|
—
|
$33,950.25
|
$136,043.99
|
$36,068.01
|
2025-09-26
|
|
22
|
APR_DRG
|
Heart And/or Lung Transplant
|
1
|
1
|
—
|
—
|
$100,022.19
|
$100,022.19
|
$100,022.19
|
2025-09-26
|
|
2204
|
APR_DRG
|
Major Stomach, Esophageal And Duodenal Procedures
|
1
|
1
|
—
|
—
|
$49,507.02
|
$49,507.02
|
$49,507.02
|
2025-09-26
|
|
222
|
MS_DRG
|
Inpatient Ms-DRG
|
3
|
3
|
—
|
—
|
$45,748.57
|
$45,748.57
|
$45,748.57
|
2025-09-26
|
|
2224
|
APR_DRG
|
Other Stomach, Esophageal And Duodenal Procedures
|
1
|
1
|
—
|
—
|
$37,314.03
|
$37,314.03
|
$37,314.03
|
2025-09-26
|
|
2234
|
APR_DRG
|
Other Small And Large Bowel Procedures
|
1
|
1
|
—
|
—
|
$34,818.45
|
$34,818.45
|
$34,818.45
|
2025-09-26
|
|
224
|
MS_DRG
|
Inpatient Ms-DRG
|
3
|
3
|
—
|
—
|
$49,560.54
|
$49,560.54
|
$49,560.54
|
2025-09-26
|
|
224
|
APR_DRG
|
Ventricular Shunt Procedures
|
1
|
1
|
—
|
—
|
$45,603.50
|
$45,603.50
|
$45,603.50
|
2025-09-26
|
|
224
|
EAPG
|
Level Ii Neurostimulator And Related Device Implantation
|
1
|
1
|
—
|
—
|
$37,671.08
|
$37,671.08
|
$37,671.08
|
2025-09-26
|
|
226
|
MS_DRG
|
Inpatient Ms-DRG
|
3
|
3
|
—
|
—
|
$36,755.39
|
$36,755.39
|
$36,755.39
|
2025-09-26
|
|
2294
|
APR_DRG
|
Other Digestive System And Abdominal Procedures
|
1
|
1
|
—
|
—
|
$35,158.44
|
$35,158.44
|
$35,158.44
|
2025-09-26
|
|
23
|
APR_DRG
|
Heart And/or Lung Transplant
|
1
|
1
|
—
|
—
|
$125,909.77
|
$125,909.77
|
$125,909.77
|
2025-09-26
|
|
2304
|
APR_DRG
|
Major Small Bowel Procedures
|
1
|
1
|
—
|
—
|
$42,839.56
|
$42,839.56
|
$42,839.56
|
2025-09-26
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
10
|
10
|
—
|
—
|
$35,727.75
|
$148,989.87
|
$39,111.44
|
2025-09-26
|
|
2314
|
APR_DRG
|
Major Large Bowel Procedures
|
1
|
1
|
—
|
—
|
$36,289.36
|
$36,289.36
|
$36,289.36
|
2025-09-26
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
10
|
10
|
—
|
—
|
$26,164.80
|
$107,409.83
|
$38,117.25
|
2025-09-26
|
|
2324
|
APR_DRG
|
Gastric Fundoplication
|
1
|
1
|
—
|
—
|
$43,495.92
|
$43,495.92
|
$43,495.92
|
2025-09-26
|
|
234
|
APR_DRG
|
Spinal Procedures
|
1
|
1
|
—
|
—
|
$50,988.94
|
$50,988.94
|
$50,988.94
|
2025-09-26
|
|
24
|
APR_DRG
|
Heart And/or Lung Transplant
|
1
|
1
|
—
|
—
|
$231,969.04
|
$231,969.04
|
$231,969.04
|
2025-09-26
|
|
246
|
EAPG
|
Class IV Therapeutic Radiopharmaceuticals
|
1
|
1
|
—
|
—
|
$71,826.75
|
$71,826.75
|
$71,826.75
|
2025-09-26
|
|
250
|
EAPG
|
Cochlear Device Implantation
|
1
|
1
|
—
|
—
|
$47,492.72
|
$47,492.72
|
$47,492.72
|
2025-09-26
|
|
2604
|
APR_DRG
|
Major Pancreas, Liver And Shunt Procedures
|
1
|
1
|
—
|
—
|
$53,024.12
|
$53,024.12
|
$53,024.12
|
2025-09-26
|
|
2614
|
APR_DRG
|
Major Biliary Tract Procedures
|
1
|
1
|
—
|
—
|
$43,835.90
|
$43,835.90
|
$43,835.90
|
2025-09-26
|
|
264
|
APR_DRG
|
Other Nervous System And Related Procedures
|
1
|
1
|
—
|
—
|
$41,994.32
|
$41,994.32
|
$41,994.32
|
2025-09-26
|
|
2644
|
APR_DRG
|
Other Hepatobiliary, Pancreas And Abdominal Procedures
|
1
|
1
|
—
|
—
|
$42,263.47
|
$42,263.47
|
$42,263.47
|
2025-09-26
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
10
|
10
|
—
|
—
|
$32,812.65
|
$105,337.12
|
$38,116.63
|
2025-09-26
|
|
274
|
APR_DRG
|
Other Open Craniotomy
|
1
|
1
|
—
|
—
|
$49,130.84
|
$49,130.84
|
$49,130.84
|
2025-09-26
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
7
|
7
|
—
|
—
|
$30,964.05
|
$124,256.66
|
$65,398.24
|
2025-09-26
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
7
|
7
|
—
|
—
|
$27,337.95
|
$108,916.40
|
$57,324.42
|
2025-09-26
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
7
|
7
|
—
|
—
|
$21,045.60
|
$81,799.37
|
$43,052.30
|
2025-09-26
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
7
|
7
|
—
|
—
|
$19,623.60
|
$87,976.95
|
$46,303.66
|
2025-09-26
|
|
294
|
APR_DRG
|
Other Percutaneous Intracranial Procedures
|
1
|
1
|
—
|
—
|
$38,004.23
|
$38,004.23
|
$38,004.23
|
2025-09-26
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…
|
10
|
10
|
—
|
—
|
$77,107.95
|
$376,785.37
|
$95,176.30
|
2025-09-26
|
|
3032
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
1
|
1
|
—
|
—
|
$41,010.57
|
$41,010.57
|
$41,010.57
|
2025-09-26
|
|
3033
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
1
|
1
|
—
|
—
|
$59,530.25
|
$59,530.25
|
$59,530.25
|
2025-09-26
|
|
3034
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
1
|
1
|
—
|
—
|
$83,880.82
|
$83,880.82
|
$83,880.82
|
2025-09-26
|
|
304
|
APR_DRG
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
1
|
1
|
—
|
—
|
$40,310.93
|
$40,310.93
|
$40,310.93
|
2025-09-26
|
|
3043
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
1
|
1
|
—
|
—
|
$38,966.73
|
$38,966.73
|
$38,966.73
|
2025-09-26
|
|
3044
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
1
|
1
|
—
|
—
|
$60,714.69
|
$60,714.69
|
$60,714.69
|
2025-09-26
|
|
3060
|
EAPG
|
Ventricular Assist Device Procedures
|
1
|
1
|
—
|
—
|
$58,903.92
|
$58,903.92
|
$58,903.92
|
2025-09-26
|
|
3094
|
APR_DRG
|
Other Significant Hip And Femur Surgery
|
1
|
1
|
—
|
—
|
$34,515.46
|
$34,515.46
|
$34,515.46
|
2025-09-26
|
|
3124
|
APR_DRG
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
1
|
1
|
—
|
—
|
$63,532.94
|
$63,532.94
|
$63,532.94
|
2025-09-26
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
7
|
7
|
—
|
—
|
$27,231.30
|
$108,775.74
|
$57,250.39
|
2025-09-26
|
|
3214
|
APR_DRG
|
Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures
|
1
|
1
|
—
|
—
|
$39,927.66
|
$39,927.66
|
$39,927.66
|
2025-09-26
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
7
|
7
|
—
|
—
|
$18,237.15
|
$74,899.24
|
$39,420.65
|
2025-09-26
|
|
3254
|
APR_DRG
|
Non-elective Or Complex Knee Joint Replacement
|
1
|
1
|
—
|
—
|
$37,270.75
|
$37,270.75
|
$37,270.75
|
2025-09-26
|
|
33276
|
CPT
|
Insj Phrnc Nrv Stim Sys
|
4
|
4
|
—
|
—
|
$45,347.18
|
$86,159.64
|
$45,347.18
|
2025-09-26
|
|
3614
|
APR_DRG
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
1
|
1
|
—
|
—
|
$57,016.58
|
$57,016.58
|
$57,016.58
|
2025-09-26
|
|
38240
|
CPT
|
Transplt Allo Hct/donor
|
4
|
4
|
—
|
—
|
$59,597.96
|
$113,236.12
|
$59,597.96
|
2025-09-26
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …
|
10
|
10
|
—
|
—
|
$53,147.25
|
$248,423.75
|
$62,389.05
|
2025-09-26
|
|
4014
|
APR_DRG
|
Adrenal Procedures
|
1
|
1
|
—
|
—
|
$49,744.70
|
$49,744.70
|
$49,744.70
|
2025-09-26
|
|
402
|
MS_DRG
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
7
|
7
|
—
|
—
|
$17,739.45
|
$68,795.49
|
$36,208.15
|
2025-09-26
|
|
4034
|
APR_DRG
|
Procedures For Obesity
|
1
|
1
|
—
|
—
|
$34,669.71
|
$34,669.71
|
$34,669.71
|
2025-09-26
|
|
4044
|
APR_DRG
|
Thyroid, Parathyroid And Thyroglossal Procedures
|
1
|
1
|
—
|
—
|
$45,558.64
|
$45,558.64
|
$45,558.64
|
2025-09-26
|
|
4054
|
APR_DRG
|
Other Procedures For Endocrine, Nutritional And Metabolic Disorders
|
1
|
1
|
—
|
—
|
$40,048.07
|
$40,048.07
|
$40,048.07
|
2025-09-26
|
|
41
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
1
|
1
|
—
|
—
|
$47,878.72
|
$47,878.72
|
$47,878.72
|
2025-09-26
|
|
42
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
1
|
1
|
—
|
—
|
$61,878.66
|
$61,878.66
|
$61,878.66
|
2025-09-26
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
7
|
7
|
—
|
—
|
$47,352.60
|
$184,176.10
|
$96,934.79
|
2025-09-26
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
7
|
7
|
—
|
—
|
$32,066.10
|
$124,884.28
|
$65,728.57
|
2025-09-26
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
7
|
7
|
—
|
—
|
$24,885.00
|
$96,780.98
|
$50,937.36
|
2025-09-26
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
7
|
7
|
—
|
—
|
$37,683.00
|
$146,646.48
|
$77,182.36
|
2025-09-26
|
|
43
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
1
|
1
|
—
|
—
|
$89,259.97
|
$89,259.97
|
$89,259.97
|
2025-09-26
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
7
|
7
|
—
|
—
|
$24,707.25
|
$96,190.31
|
$50,626.48
|
2025-09-26
|
|
44
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
1
|
1
|
—
|
—
|
$135,079.11
|
$135,079.11
|
$135,079.11
|
2025-09-26
|
|
4401
|
APR_DRG
|
Kidney Transplant
|
1
|
1
|
—
|
—
|
$35,486.62
|
$35,486.62
|
$35,486.62
|
2025-09-26
|
|
4402
|
APR_DRG
|
Kidney Transplant
|
1
|
1
|
—
|
—
|
$39,131.21
|
$39,131.21
|
$39,131.21
|
2025-09-26
|
|
4403
|
APR_DRG
|
Kidney Transplant
|
1
|
1
|
—
|
—
|
$45,960.01
|
$45,960.01
|
$45,960.01
|
2025-09-26
|
|
4404
|
APR_DRG
|
Kidney Transplant
|
1
|
1
|
—
|
—
|
$74,074.80
|
$74,074.80
|
$74,074.80
|
2025-09-26
|
|
4414
|
APR_DRG
|
Major Bladder Procedures
|
1
|
1
|
—
|
—
|
$49,742.34
|
$49,742.34
|
$49,742.34
|
2025-09-26
|
|
4424
|
APR_DRG
|
Kidney And Urinary Tract Procedures For Malignancy
|
1
|
1
|
—
|
—
|
$34,923.91
|
$34,923.91
|
$34,923.91
|
2025-09-26
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
7
|
7
|
—
|
—
|
$30,288.60
|
$117,887.44
|
$62,046.02
|
2025-09-26
|
|
4474
|
APR_DRG
|
Other Kidney, Urinary Tract And Related Procedures
|
1
|
1
|
—
|
—
|
$37,709.10
|
$37,709.10
|
$37,709.10
|
2025-09-26
|
|
448
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical Without Mcc
|
7
|
7
|
—
|
—
|
$18,450.45
|
$71,806.93
|
$37,793.12
|
2025-09-26
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
7
|
7
|
—
|
—
|
$23,285.25
|
$90,557.71
|
$47,661.95
|
2025-09-26
|
|
453
|
MS_DRG
|
Inpatient Ms-DRG
|
3
|
3
|
—
|
—
|
$39,779.14
|
$39,779.14
|
$39,779.14
|
2025-09-26
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
10
|
10
|
—
|
—
|
$38,109.60
|
$148,907.28
|
$44,486.31
|
2025-09-26
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
10
|
10
|
—
|
—
|
$30,821.85
|
$107,902.05
|
$37,358.54
|
2025-09-26
|
|
465
|
EAPG
|
Class Xiii Combined Chemotherapy And Pharmacotherapy
|
1
|
1
|
—
|
—
|
$34,628.85
|
$34,628.85
|
$34,628.85
|
2025-09-26
|
|
466
|
EAPG
|
Class Xiv Combined Chemotherapy And Pharmacotherapy
|
1
|
1
|
—
|
—
|
$47,156.42
|
$47,156.42
|
$47,156.42
|
2025-09-26
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
10
|
10
|
—
|
—
|
$37,434.15
|
$187,235.03
|
$98,544.75
|
2025-09-26
|
|
504
|
APR_DRG
|
Non-bacterial Infections Of Nervous System Except Viral Meningitis
|
1
|
1
|
—
|
—
|
$36,242.92
|
$36,242.92
|
$36,242.92
|
2025-09-26
|
|
5104
|
APR_DRG
|
Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…
|
1
|
1
|
—
|
—
|
$39,565.64
|
$39,565.64
|
$39,565.64
|
2025-09-26
|
|
5114
|
APR_DRG
|
Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy
|
1
|
1
|
—
|
—
|
$39,575.87
|
$39,575.87
|
$39,575.87
|
2025-09-26
|
|
5144
|
APR_DRG
|
Female Reproductive System Reconstructive Procedures
|
1
|
1
|
—
|
—
|
$35,105.71
|
$35,105.71
|
$35,105.71
|
2025-09-26
|
|
5184
|
APR_DRG
|
Other Female Reproductive System And Related Procedures
|
1
|
1
|
—
|
—
|
$36,689.15
|
$36,689.15
|
$36,689.15
|
2025-09-26
|
|
52
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
1
|
1
|
—
|
—
|
$47,345.92
|
$47,345.92
|
$47,345.92
|
2025-09-26
|
|
53
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
1
|
1
|
—
|
—
|
$63,127.63
|
$63,127.63
|
$63,127.63
|
2025-09-26
|
|
54
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
1
|
1
|
—
|
—
|
$87,260.20
|
$87,260.20
|
$87,260.20
|
2025-09-26
|
|
5831
|
APR_DRG
|
Neonate With Ecmo
|
1
|
1
|
—
|
—
|
$128,011.85
|
$128,011.85
|
$128,011.85
|
2025-09-26
|
|
5832
|
APR_DRG
|
Neonate With Ecmo
|
1
|
1
|
—
|
—
|
$204,513.76
|
$204,513.76
|
$204,513.76
|
2025-09-26
|
|
5833
|
APR_DRG
|
Neonate With Ecmo
|
1
|
1
|
—
|
—
|
$297,231.01
|
$297,231.01
|
$297,231.01
|
2025-09-26
|
|
5834
|
APR_DRG
|
Neonate With Ecmo
|
1
|
1
|
—
|
—
|
$338,395.05
|
$338,395.05
|
$338,395.05
|
2025-09-26
|
|
5881
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
1
|
1
|
—
|
—
|
$168,769.00
|
$168,769.00
|
$168,769.00
|
2025-09-26
|
|
5882
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
1
|
1
|
—
|
—
|
$168,769.00
|
$168,769.00
|
$168,769.00
|
2025-09-26
|
|
5883
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
1
|
1
|
—
|
—
|
$176,127.45
|
$176,127.45
|
$176,127.45
|
2025-09-26
|
|
5884
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
1
|
1
|
—
|
—
|
$257,714.17
|
$257,714.17
|
$257,714.17
|
2025-09-26
|
|
5891
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
1
|
1
|
—
|
—
|
$101,356.94
|
$101,356.94
|
$101,356.94
|
2025-09-26
|
|
5892
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
1
|
1
|
—
|
—
|
$97,771.37
|
$97,771.37
|
$97,771.37
|
2025-09-26
|
|
5893
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
1
|
1
|
—
|
—
|
$93,081.64
|
$93,081.64
|
$93,081.64
|
2025-09-26
|
|
5911
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
1
|
1
|
—
|
—
|
$61,797.60
|
$61,797.60
|
$61,797.60
|
2025-09-26
|
|
5912
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
1
|
1
|
—
|
—
|
$85,712.17
|
$85,712.17
|
$85,712.17
|
2025-09-26
|
|
5913
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
1
|
1
|
—
|
—
|
$116,908.85
|
$116,908.85
|
$116,908.85
|
2025-09-26
|
|
5914
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
1
|
1
|
—
|
—
|
$162,166.07
|
$162,166.07
|
$162,166.07
|
2025-09-26
|
|
5932
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
1
|
1
|
—
|
—
|
$89,700.69
|
$89,700.69
|
$89,700.69
|
2025-09-26
|
|
5933
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
1
|
1
|
—
|
—
|
$101,526.94
|
$101,526.94
|
$101,526.94
|
2025-09-26
|
|
5934
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
1
|
1
|
—
|
—
|
$149,432.41
|
$149,432.41
|
$149,432.41
|
2025-09-26
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
10
|
10
|
—
|
—
|
$17,490.60
|
$85,267.90
|
$44,877.84
|
2025-09-26
|
|
6022
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
1
|
1
|
—
|
—
|
$65,820.74
|
$65,820.74
|
$65,820.74
|
2025-09-26
|
|
6023
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
1
|
1
|
—
|
—
|
$82,030.58
|
$82,030.58
|
$82,030.58
|
2025-09-26
|
|
6024
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
1
|
1
|
—
|
—
|
$110,357.86
|
$110,357.86
|
$110,357.86
|
2025-09-26
|
|
6032
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
1
|
1
|
—
|
—
|
$37,961.73
|
$37,961.73
|
$37,961.73
|
2025-09-26
|
|
6033
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
1
|
1
|
—
|
—
|
$68,949.07
|
$68,949.07
|
$68,949.07
|
2025-09-26
|
|
6034
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
1
|
1
|
—
|
—
|
$138,052.39
|
$138,052.39
|
$138,052.39
|
2025-09-26
|
|
6072
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
1
|
1
|
—
|
—
|
$47,073.62
|
$47,073.62
|
$47,073.62
|
2025-09-26
|
|
6073
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
1
|
1
|
—
|
—
|
$60,537.61
|
$60,537.61
|
$60,537.61
|
2025-09-26
|
|
6074
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
1
|
1
|
—
|
—
|
$86,395.29
|
$86,395.29
|
$86,395.29
|
2025-09-26
|
|
6082
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
1
|
1
|
—
|
—
|
$34,906.60
|
$34,906.60
|
$34,906.60
|
2025-09-26
|
|
6083
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
1
|
1
|
—
|
—
|
$45,715.26
|
$45,715.26
|
$45,715.26
|
2025-09-26
|
|
6084
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
1
|
1
|
—
|
—
|
$58,533.91
|
$58,533.91
|
$58,533.91
|
2025-09-26
|
|
6091
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
1
|
1
|
—
|
—
|
$38,786.51
|
$38,786.51
|
$38,786.51
|
2025-09-26
|
|
6092
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
1
|
1
|
—
|
—
|
$38,786.51
|
$38,786.51
|
$38,786.51
|
2025-09-26
|
|
6093
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
1
|
1
|
—
|
—
|
$73,213.82
|
$73,213.82
|
$73,213.82
|
2025-09-26
|
|
6094
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
1
|
1
|
—
|
—
|
$158,405.00
|
$158,405.00
|
$158,405.00
|
2025-09-26
|
|
61
|
APR_DRG
|
Pancreas Transplant
|
1
|
1
|
—
|
—
|
$42,501.94
|
$42,501.94
|
$42,501.94
|
2025-09-26
|
|
6113
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
1
|
1
|
—
|
—
|
$44,208.15
|
$44,208.15
|
$44,208.15
|
2025-09-26
|
|
6114
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
1
|
1
|
—
|
—
|
$76,478.30
|
$76,478.30
|
$76,478.30
|
2025-09-26
|
|
6123
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
1
|
1
|
—
|
—
|
$40,515.55
|
$40,515.55
|
$40,515.55
|
2025-09-26
|
|
6124
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
1
|
1
|
—
|
—
|
$61,900.70
|
$61,900.70
|
$61,900.70
|
2025-09-26
|
|
6133
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
1
|
1
|
—
|
—
|
$41,582.72
|
$41,582.72
|
$41,582.72
|
2025-09-26
|
|
6134
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
1
|
1
|
—
|
—
|
$77,369.97
|
$77,369.97
|
$77,369.97
|
2025-09-26
|
|
6143
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
1
|
1
|
—
|
—
|
$35,803.78
|
$35,803.78
|
$35,803.78
|
2025-09-26
|
|
6144
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
1
|
1
|
—
|
—
|
$51,238.42
|
$51,238.42
|
$51,238.42
|
2025-09-26
|
|
62
|
APR_DRG
|
Pancreas Transplant
|
1
|
1
|
—
|
—
|
$61,461.55
|
$61,461.55
|
$61,461.55
|
2025-09-26
|
|
6214
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
1
|
1
|
—
|
—
|
$60,527.38
|
$60,527.38
|
$60,527.38
|
2025-09-26
|
|
6224
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…
|
1
|
1
|
—
|
—
|
$41,892.80
|
$41,892.80
|
$41,892.80
|
2025-09-26
|
|
6233
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
1
|
1
|
—
|
—
|
$35,378.80
|
$35,378.80
|
$35,378.80
|
2025-09-26
|
|
6234
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
1
|
1
|
—
|
—
|
$43,141.77
|
$43,141.77
|
$43,141.77
|
2025-09-26
|
|
6254
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
1
|
1
|
—
|
—
|
$61,862.92
|
$61,862.92
|
$61,862.92
|
2025-09-26
|
|
63
|
APR_DRG
|
Pancreas Transplant
|
1
|
1
|
—
|
—
|
$70,317.66
|
$70,317.66
|
$70,317.66
|
2025-09-26
|
|
6302
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
1
|
1
|
—
|
—
|
$64,472.61
|
$64,472.61
|
$64,472.61
|
2025-09-26
|
|
6303
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
1
|
1
|
—
|
—
|
$86,439.36
|
$86,439.36
|
$86,439.36
|
2025-09-26
|
|
6304
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
1
|
1
|
—
|
—
|
$209,553.70
|
$209,553.70
|
$209,553.70
|
2025-09-26
|
|
6312
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
1
|
1
|
—
|
—
|
$35,257.60
|
$35,257.60
|
$35,257.60
|
2025-09-26
|
|
6313
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
1
|
1
|
—
|
—
|
$55,756.59
|
$55,756.59
|
$55,756.59
|
2025-09-26
|
|
6314
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
1
|
1
|
—
|
—
|
$160,015.99
|
$160,015.99
|
$160,015.99
|
2025-09-26
|
|
6334
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
1
|
1
|
—
|
—
|
$56,733.26
|
$56,733.26
|
$56,733.26
|
2025-09-26
|
|
6344
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…
|
1
|
1
|
—
|
—
|
$38,315.88
|
$38,315.88
|
$38,315.88
|
2025-09-26
|
|
64
|
APR_DRG
|
Pancreas Transplant
|
1
|
1
|
—
|
—
|
$109,571.65
|
$109,571.65
|
$109,571.65
|
2025-09-26
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
10
|
10
|
—
|
—
|
$19,339.20
|
$81,015.30
|
$42,639.63
|
2025-09-26
|
|
6504
|
APR_DRG
|
Splenectomy
|
1
|
1
|
—
|
—
|
$37,809.84
|
$37,809.84
|
$37,809.84
|
2025-09-26
|
|
6514
|
APR_DRG
|
Other Procedures Of Blood And Blood-forming Organs
|
1
|
1
|
—
|
—
|
$54,979.82
|
$54,979.82
|
$54,979.82
|
2025-09-26
|
|
6804
|
APR_DRG
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
1
|
1
|
—
|
—
|
$65,193.51
|
$65,193.51
|
$65,193.51
|
2025-09-26
|
|
6814
|
APR_DRG
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
1
|
1
|
—
|
—
|
$58,464.66
|
$58,464.66
|
$58,464.66
|
2025-09-26
|
|
6903
|
APR_DRG
|
Acute Leukemia
|
1
|
1
|
—
|
—
|
$35,282.78
|
$35,282.78
|
$35,282.78
|
2025-09-26
|
|
6904
|
APR_DRG
|
Acute Leukemia
|
1
|
1
|
—
|
—
|
$59,674.27
|
$59,674.27
|
$59,674.27
|
2025-09-26
|
|
6954
|
APR_DRG
|
Chemotherapy For Acute Leukemia
|
1
|
1
|
—
|
—
|
$54,133.80
|
$54,133.80
|
$54,133.80
|
2025-09-26
|
|
7
|
MS_DRG
|
Lung Transplant
|
10
|
10
|
—
|
—
|
$44,366.40
|
$229,767.89
|
$94,702.27
|
2025-09-26
|
|
71
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
1
|
1
|
—
|
—
|
$49,358.28
|
$49,358.28
|
$49,358.28
|
2025-09-26
|
|
7104
|
APR_DRG
|
Infectious And Parasitic Diseases Including HIV With O.r. Procedure
|
1
|
1
|
—
|
—
|
$39,997.70
|
$39,997.70
|
$39,997.70
|
2025-09-26
|
|
7114
|
APR_DRG
|
Post-operative, Post-trauma, Other Device Infections With O.r. Procedure
|
1
|
1
|
—
|
—
|
$40,081.12
|
$40,081.12
|
$40,081.12
|
2025-09-26
|
|
72
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
1
|
1
|
—
|
—
|
$64,299.47
|
$64,299.47
|
$64,299.47
|
2025-09-26
|
|
73
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
1
|
1
|
—
|
—
|
$81,081.46
|
$81,081.46
|
$81,081.46
|
2025-09-26
|
|
734
|
APR_DRG
|
Orbit And Eye Procedures
|
1
|
1
|
—
|
—
|
$35,282.00
|
$35,282.00
|
$35,282.00
|
2025-09-26
|
|
74
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
1
|
1
|
—
|
—
|
$160,433.88
|
$160,433.88
|
$160,433.88
|
2025-09-26
|
|
7404
|
APR_DRG
|
Mental Illness Diagnosis With O.r. Procedure
|
1
|
1
|
—
|
—
|
$63,417.25
|
$63,417.25
|
$63,417.25
|
2025-09-26
|
|
7584
|
APR_DRG
|
Behavioral Disorders
|
1
|
1
|
—
|
—
|
$39,953.63
|
$39,953.63
|
$39,953.63
|
2025-09-26
|
|
7594
|
APR_DRG
|
Eating Disorders
|
1
|
1
|
—
|
—
|
$57,769.73
|
$57,769.73
|
$57,769.73
|
2025-09-26
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
7
|
7
|
—
|
—
|
$23,641.60
|
$104,528.50
|
$55,015.00
|
2025-09-26
|
|
791
|
MS_DRG
|
Prematurity With Major Problems
|
7
|
7
|
—
|
—
|
$5,843.38
|
$71,392.08
|
$37,574.78
|
2025-09-26
|
|
7924
|
APR_DRG
|
Extensive O.r. Procedures For Other Complications Of Treatment
|
1
|
1
|
—
|
—
|
$44,464.71
|
$44,464.71
|
$44,464.71
|
2025-09-26
|
|
7934
|
APR_DRG
|
Moderately Extensive O.r. Procedures For Other Complications Of Treatment
|
1
|
1
|
—
|
—
|
$36,075.29
|
$36,075.29
|
$36,075.29
|
2025-09-26
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
10
|
10
|
—
|
—
|
$19,019.25
|
$95,673.44
|
$50,354.44
|
2025-09-26
|
|
82
|
APR_DRG
|
Autologous Bone Marrow Transplant
|
1
|
1
|
—
|
—
|
$36,530.97
|
$36,530.97
|
$36,530.97
|
2025-09-26
|
|
82
|
EAPG
|
Comprehensive Cardiac Electrophysiologic Procedures With Ablation
|
1
|
1
|
—
|
—
|
$34,891.70
|
$34,891.70
|
$34,891.70
|
2025-09-26
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
10
|
10
|
—
|
—
|
$24,387.30
|
$102,374.95
|
$34,976.68
|
2025-09-26
|
|
83
|
APR_DRG
|
Autologous Bone Marrow Transplant
|
1
|
1
|
—
|
—
|
$43,242.50
|
$43,242.50
|
$43,242.50
|
2025-09-26
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
10
|
10
|
—
|
—
|
$17,455.05
|
$97,188.82
|
$38,298.62
|
2025-09-26
|
|
84
|
APR_DRG
|
Autologous Bone Marrow Transplant
|
1
|
1
|
—
|
—
|
$80,399.92
|
$80,399.92
|
$80,399.92
|
2025-09-26
|
|
8411
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
1
|
1
|
—
|
—
|
$42,605.03
|
$42,605.03
|
$42,605.03
|
2025-09-26
|
|
8412
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
1
|
1
|
—
|
—
|
$42,605.03
|
$42,605.03
|
$42,605.03
|
2025-09-26
|
|
8413
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
1
|
1
|
—
|
—
|
$65,563.40
|
$65,563.40
|
$65,563.40
|
2025-09-26
|
|
8414
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
1
|
1
|
—
|
—
|
$196,214.05
|
$196,214.05
|
$196,214.05
|
2025-09-26
|
|
8423
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
1
|
1
|
—
|
—
|
$36,501.85
|
$36,501.85
|
$36,501.85
|
2025-09-26
|
|
8424
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
1
|
1
|
—
|
—
|
$88,572.13
|
$88,572.13
|
$88,572.13
|
2025-09-26
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
7
|
7
|
—
|
—
|
$37,149.75
|
$161,963.87
|
$85,244.14
|
2025-09-26
|
|
8504
|
APR_DRG
|
Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…
|
1
|
1
|
—
|
—
|
$63,152.81
|
$63,152.81
|
$63,152.81
|
2025-09-26
|
|
8633
|
APR_DRG
|
Neonatal Aftercare
|
1
|
1
|
—
|
—
|
$39,139.87
|
$39,139.87
|
$39,139.87
|
2025-09-26
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
1
|
1
|
—
|
—
|
$66,215.03
|
$66,215.03
|
$66,215.03
|
2025-09-26
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
10
|
10
|
—
|
—
|
$29,328.75
|
$122,314.10
|
$38,585.75
|
2025-09-26
|
|
894
|
APR_DRG
|
Major Cranial Or Facial Bone Procedures
|
1
|
1
|
—
|
—
|
$45,594.84
|
$45,594.84
|
$45,594.84
|
2025-09-26
|
|
91
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
1
|
1
|
—
|
—
|
$42,023.44
|
$42,023.44
|
$42,023.44
|
2025-09-26
|
|
9103
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
1
|
1
|
—
|
—
|
$34,497.36
|
$34,497.36
|
$34,497.36
|
2025-09-26
|
|
9104
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
1
|
1
|
—
|
—
|
$58,522.11
|
$58,522.11
|
$58,522.11
|
2025-09-26
|
|
9114
|
APR_DRG
|
Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma
|
1
|
1
|
—
|
—
|
$58,882.55
|
$58,882.55
|
$58,882.55
|
2025-09-26
|
|
9124
|
APR_DRG
|
Musculoskeletal And Other Procedures For Multiple Significant Trauma
|
1
|
1
|
—
|
—
|
$52,115.93
|
$52,115.93
|
$52,115.93
|
2025-09-26
|
|
914
|
APR_DRG
|
Other Major Head And Neck Procedures
|
1
|
1
|
—
|
—
|
$49,572.34
|
$49,572.34
|
$49,572.34
|
2025-09-26
|
|
92
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
1
|
1
|
—
|
—
|
$42,023.44
|
$42,023.44
|
$42,023.44
|
2025-09-26
|
|
924
|
APR_DRG
|
Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures
|
1
|
1
|
—
|
—
|
$47,465.54
|
$47,465.54
|
$47,465.54
|
2025-09-26
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
10
|
10
|
—
|
—
|
$106,294.50
|
$417,064.54
|
$129,338.32
|
2025-09-26
|
|
93
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
1
|
1
|
—
|
—
|
$67,820.51
|
$67,820.51
|
$67,820.51
|
2025-09-26
|
|
93581
|
CPT
|
Hc Prq Tcat Clsr Cgen Ventr Septal Dfct W/implt
|
37
|
25
|
$62,000.00
|
$52,700.00
|
$18,095.06
|
$110,360.00
|
$40,300.00
|
2025-09-26
|
|
93582
|
CPT
|
Hc Percutan Transcath Closure Pat Duct Arteriosus
|
40
|
25
|
$62,000.00
|
$52,700.00
|
$12,751.98
|
$110,360.00
|
$40,300.00
|
2025-09-26
|
|
94
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
1
|
1
|
—
|
—
|
$151,206.31
|
$151,206.31
|
$151,206.31
|
2025-09-26
|
|
9504
|
APR_DRG
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
1
|
1
|
—
|
—
|
$48,912.05
|
$48,912.05
|
$48,912.05
|
2025-09-26
|
|
9514
|
APR_DRG
|
Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
1
|
1
|
—
|
—
|
$36,117.00
|
$36,117.00
|
$36,117.00
|
2025-09-26
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
10
|
10
|
—
|
—
|
$26,484.75
|
$131,239.40
|
$36,393.87
|
2025-09-26
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
10
|
10
|
—
|
—
|
$27,729.00
|
$111,200.05
|
$35,592.13
|
2025-09-26
|
|
97
|
EAPG
|
Aicd And Related Cardiac Device Insertion Or Replacement
|
1
|
1
|
—
|
—
|
$44,248.23
|
$44,248.23
|
$44,248.23
|
2025-09-26
|
|
993
|
MS_DRG
|
Inpatient Ms-DRG
|
3
|
3
|
—
|
—
|
$55,849.05
|
$55,849.05
|
$55,849.05
|
2025-09-26
|
|
A9543
|
HCPCS
|
Y90 Ibritumomab, Rx
|
4
|
4
|
—
|
—
|
$56,824.55
|
$107,966.64
|
$56,824.55
|
2025-09-26
|
|
C1767
|
HCPCS
|
Controller Proclai Plus 7 Ipg
|
261
|
25
|
$47,500.00
|
$40,375.00
|
$390.00
|
$178,547.35
|
$38,637.00
|
2025-09-26
|
|
C1822
|
HCPCS
|
Kit Ipg Hfxd
|
109
|
25
|
$61,250.00
|
$52,062.50
|
$1,000.00
|
$120,150.00
|
$46,305.00
|
2025-09-26
|
|
C1826
|
HCPCS
|
Neurostimultr Inceptiv 977119
|
33
|
25
|
$55,000.00
|
$46,750.00
|
$22,000.00
|
$97,900.00
|
$41,580.00
|
2025-09-26
|
|
C1827
|
HCPCS
|
Generator Vivistim Pair Vns
|
33
|
25
|
$73,750.00
|
$62,687.50
|
$29,500.00
|
$131,275.00
|
$55,755.00
|
2025-09-26
|
|
C1882
|
HCPCS
|
Biv Unify Crtd40 Cd325740
|
622
|
25
|
$42,477.50
|
$36,105.88
|
$10,961.00
|
$142,422.25
|
$35,591.50
|
2025-09-26
|
|
J0202
|
HCPCS
|
Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution
|
43
|
25
|
$81,216.34
|
$69,033.89
|
$2,400.56
|
$144,565.09
|
$52,790.62
|
2025-09-26
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
6
|
6
|
—
|
—
|
$35,448.00
|
$3,685,266.67
|
$1,860,357.33
|
2025-09-26
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
3
|
3
|
—
|
—
|
$3,324,571.90
|
$3,324,571.90
|
$3,324,571.90
|
2025-09-26
|
|
J1414
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
3
|
3
|
—
|
—
|
$3,710,000.00
|
$3,710,000.00
|
$3,710,000.00
|
2025-09-26
|
|
J3391
|
HCPCS
|
Inj, Atidarsagene Autotemcel
|
3
|
3
|
—
|
—
|
$4,377,500.00
|
$4,377,500.00
|
$4,377,500.00
|
2025-09-26
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
4
|
4
|
—
|
—
|
$2,332,000.00
|
$4,430,800.00
|
$2,332,000.00
|
2025-09-26
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
6
|
6
|
—
|
—
|
$2,950,686.67
|
$2,968,000.00
|
$2,959,343.33
|
2025-09-26
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
3
|
3
|
—
|
—
|
$3,261,355.00
|
$3,261,355.00
|
$3,261,355.00
|
2025-09-26
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
7
|
7
|
—
|
—
|
$2,222,890.60
|
$4,659,019.63
|
$2,452,115.60
|
2025-09-26
|
|
J9029
|
HCPCS
|
Instill Adstiladrin, Tx Dose
|
10
|
10
|
—
|
—
|
$60,768.00
|
$120,519.00
|
$63,402.04
|
2025-09-26
|
|
J9226
|
HCPCS
|
Supprelin La Implant
|
10
|
10
|
—
|
—
|
$45,261.80
|
$86,564.74
|
$45,560.39
|
2025-09-26
|
|
K1007
|
HCPCS
|
Bil Hkaf Pc S/d Micro Sensor
|
4
|
4
|
—
|
—
|
$93,216.70
|
$177,111.73
|
$93,216.70
|
2025-09-26
|
|
L2006
|
HCPCS
|
Kaf Sng/dbl Swg/stn Mcpr Cus
|
4
|
4
|
—
|
—
|
$38,629.63
|
$73,396.30
|
$38,629.63
|
2025-09-26
|
|
L7180
|
HCPCS
|
Electronic Elbow Sequential
|
7
|
7
|
—
|
—
|
$29,785.66
|
$82,408.64
|
$43,372.97
|
2025-09-26
|
|
L7181
|
HCPCS
|
Electronic Elbo Simultaneous
|
7
|
7
|
—
|
—
|
$33,054.59
|
$91,452.85
|
$48,133.08
|
2025-09-26
|
|
L8702
|
HCPCS
|
Ewhf S/d Uprt Micro Sensor
|
4
|
4
|
—
|
—
|
$67,452.66
|
$128,160.05
|
$67,452.66
|
2025-09-26
|
|
Q0480
|
HCPCS
|
Driver Pneumatic Vad, Rep
|
10
|
10
|
—
|
—
|
$79,999.95
|
$205,566.70
|
$90,900.76
|
2025-09-26
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Car+
|
7
|
7
|
—
|
—
|
$489,517.15
|
$1,012,845.30
|
$533,076.48
|
2025-09-26
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel Car-pos T
|
7
|
7
|
—
|
—
|
$565,623.84
|
$1,098,816.70
|
$578,324.58
|
2025-09-26
|
|
Q2043
|
HCPCS
|
Sipuleucel-t Auto Cd54+
|
7
|
7
|
—
|
—
|
$55,536.50
|
$106,297.34
|
$55,945.97
|
2025-09-26
|
|
Q2053
|
HCPCS
|
Brexucabtagene Car Pos T
|
7
|
7
|
—
|
—
|
$488,051.51
|
$930,468.00
|
$489,720.00
|
2025-09-26
|
|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
7
|
7
|
—
|
—
|
$516,485.97
|
$1,029,107.75
|
$541,635.66
|
2025-09-26
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel Car
|
7
|
7
|
—
|
—
|
$528,312.43
|
$1,028,394.85
|
$541,260.45
|
2025-09-26
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
7
|
7
|
—
|
—
|
$551,318.34
|
$1,051,419.78
|
$553,378.83
|
2025-09-26
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
4
|
4
|
—
|
—
|
$770,620.00
|
$1,464,178.00
|
$770,620.00
|
2025-09-26
|
|
Q2058
|
HCPCS
|
Obecbtge Autol Up To 400 Mil
|
4
|
4
|
—
|
—
|
$270,375.00
|
$513,712.50
|
$270,375.00
|
2025-09-26
|