Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

BOYS TOWN NATIONAL RESEARCH HOSPITAL

Boys Town, NE · CCN 283300 · Rates published

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You selected 93350 (HCPCS)

Stress tte only

This hospital’s price: $878 across 4 payers · range $439-$878

Source: https://media.boystown.org/raw/upload/v1776093630/cost-estimates-spreadsheet-2026_xlc7uv.zip · observed 2025-12-29

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

17,944 distinct procedures filed
15 distinct payers
153,652 rate rows
2025-12-29 last MRF observed
Data quality

130,239 of 153,652 rate rows are consumer-grade (84.8%)

23,413 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 10,418
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 10,308
placeholder amount (≤ $0.02) — excluded from medians 1,495
template filing: same amount across many unrelated codes — excluded 1,036
exceeds 10× this hospital's gross charge — excluded from medians 54
percent-of-charges filed in the dollar field — excluded from medians 51
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 18
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 17
per-diem day rate — not a per-procedure price 16
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://media.boystown.org/raw/upload/v1776093630/cost-estimates-spreadsheet-2026_xlc7uv.zip
Found on page https://www.boystownhospital.org/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-09-21
Content fingerprint 6c8e6a66b35a11e7… · 1,672,718 bytes · first seen 2026-05-14

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
J3399
HCPCS 		Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspensionkit 12 $35,185.25 $2,435,952.24 $1,946,250.50 nat. median
$2,466,282
0.8× median
5834
APR_DRG 		Neonate With Ecmo 3 $567,534.58 $567,534.58 $567,534.58 nat. median
$307,273
1.8× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $347,604.58 $347,604.58 $347,604.58 nat. median
$247,214
1.4× median
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 $324,952.04 $324,952.04 $324,952.04 nat. median
$124,042
outlier · 2.6×
5833
APR_DRG 		Neonate With Ecmo 3 $323,229.76 $323,229.76 $323,229.76 nat. median
$244,017
1.3× median
5832
APR_DRG 		Neonate With Ecmo 3 $248,180.71 $248,180.71 $248,180.71 nat. median
$159,249
1.6× median
1614
APR_DRG 		Implantable Heart Assist Systems 3 $242,334.00 $242,334.00 $242,334.00 nat. median
$202,993
1.2× median
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 $242,185.09 $242,185.09 $242,185.09 nat. median
$165,000
1.5× median
113
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 $241,833.85 $241,833.85 $241,833.85 nat. median
$67,766
outlier · 3.6×
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 3 $237,565.64 $237,565.64 $237,565.64 nat. median
$163,587
1.5× median
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 3 $232,937.98 $232,937.98 $232,937.98 nat. median
$133,164
1.7× median
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $231,504.29 $231,504.29 $231,504.29 nat. median
$175,429
1.3× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 1 $229,570.40 $229,570.40 $229,570.40 nat. median
$359,358
0.6× median
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 3 $227,941.62 $227,941.62 $227,941.62 nat. median
$162,514
1.4× median
5831
APR_DRG 		Neonate With Ecmo 3 $222,772.73 $222,772.73 $222,772.73 nat. median
$146,591
1.5× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 3 $215,562.17 $215,562.17 $215,562.17 nat. median
$156,153
1.4× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 $211,250.82 $211,250.82 $211,250.82 nat. median
$154,011
1.4× median
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 3 $200,404.67 $200,404.67 $200,404.67 nat. median
$151,838
1.3× median
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $198,374.29 $198,374.29 $198,374.29 nat. median
$145,061
1.4× median
112
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 $192,254.40 $192,254.40 $192,254.40 nat. median
$68,020
outlier · 2.8×
1613
APR_DRG 		Implantable Heart Assist Systems 3 $189,752.63 $189,752.63 $189,752.63 nat. median
$120,517
1.6× median
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 3 $182,571.84 $182,571.84 $182,571.84 nat. median
$122,016
1.5× median
5913
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 3 $171,907.48 $171,907.48 $171,907.48 nat. median
$101,541
1.7× median
5881
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $170,035.26 $170,035.26 $170,035.26 nat. median
$120,505
1.4× median
5892
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 3 $162,031.84 $162,031.84 $162,031.84 nat. median
$89,188
1.8× median
5893
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 3 $162,031.84 $162,031.84 $162,031.84 nat. median
$71,350
outlier · 2.3×
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 3 $162,031.84 $162,031.84 $162,031.84 nat. median
$93,998
1.7× median
93
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 3 $159,659.47 $159,659.47 $159,659.47 nat. median
$78,898
outlier · 2.0×
6024
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 $150,972.08 $150,972.08 $150,972.08 nat. median
$118,589
1.3× median
5912
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 3 $147,447.42 $147,447.42 $147,447.42 nat. median
$82,224
1.8× median
5933
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 3 $146,602.20 $146,602.20 $146,602.20 nat. median
$108,798
1.3× median
1611
APR_DRG 		Implantable Heart Assist Systems 3 $139,620.65 $139,620.65 $139,620.65 nat. median
$76,852
1.8× median
1612
APR_DRG 		Implantable Heart Assist Systems 3 $139,620.65 $139,620.65 $139,620.65 nat. median
$84,808
1.6× median
1604
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly 3 $139,112.29 $139,112.29 $139,112.29 nat. median
$98,624
1.4× median
54
APR_DRG 		Tracheostomy With Mv >96 Hours Without Extensive Procedure 3 $127,186.76 $127,186.76 $127,186.76 nat. median
$81,668
1.6× median
43
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 3 $125,896.85 $125,896.85 $125,896.85 nat. median
$74,757
1.7× median
8424
APR_DRG 		Burns With Skin Graft Except Extensive Third Degree Burns 3 $120,683.80 $120,683.80 $120,683.80 nat. median
$82,002
1.5× median
5932
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 3 $117,916.03 $117,916.03 $117,916.03 nat. median
$85,523
1.4× median
6074
APR_DRG 		Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 3 $116,702.12 $116,702.12 $116,702.12 nat. median
$96,883
1.2× median
6303
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 $116,446.40 $116,446.40 $116,446.40 nat. median
$75,282
1.5× median
8514
APR_DRG 		Gender Related Procedures 3 $111,361.72 $111,361.72 $111,361.72 nat. median
$69,605
1.6× median
8513
APR_DRG 		Gender Related Procedures 3 $111,361.72 $111,361.72 $111,361.72 nat. median
$40,865
outlier · 2.7×
6034
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 3 $110,422.01 $110,422.01 $110,422.01 nat. median
$107,657
1.0× median
6023
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 $104,821.78 $104,821.78 $104,821.78 nat. median
$88,157
1.2× median
6114
APR_DRG 		Neonate Birth Weight 1500-1999 Grams With Major Anomaly 3 $97,061.77 $97,061.77 $97,061.77 nat. median
$74,798
1.3× median
6134
APR_DRG 		Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 3 $96,170.33 $96,170.33 $96,170.33 nat. median
$56,159
1.7× median
8634
APR_DRG 		Neonatal Aftercare 3 $94,930.75 $94,930.75 $94,930.75 nat. median
$71,102
1.3× median
111
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 $94,686.32 $94,686.32 $94,686.32 nat. median
$34,378
outlier · 2.8×
1624
APR_DRG 		Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 3 $93,488.84 $93,488.84 $93,488.84 nat. median
$80,771
1.2× median
3034
APR_DRG 		Dorsal And Lumbar Fusion Procedure For Curvature Of Back 3 $93,036.96 $93,036.96 $93,036.96 nat. median
$82,615
1.1× median

Other procedures at this hospital

Browse this hospital's 17,944 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
             
J3399 HCPCS Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspensionkit 20 12 $2,511,290.97 $2,009,032.78 $35,185.25 $2,435,952.24 $1,946,250.50 2025-12-29
5834 APR_DRG Neonate With Ecmo 3 3 — — $567,534.58 $567,534.58 $567,534.58 2025-12-29
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 — — $347,604.58 $347,604.58 $347,604.58 2025-12-29
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 3 — — $324,952.04 $324,952.04 $324,952.04 2025-12-29
5833 APR_DRG Neonate With Ecmo 3 3 — — $323,229.76 $323,229.76 $323,229.76 2025-12-29
5832 APR_DRG Neonate With Ecmo 3 3 — — $248,180.71 $248,180.71 $248,180.71 2025-12-29
1614 APR_DRG Implantable Heart Assist Systems 3 3 — — $242,334.00 $242,334.00 $242,334.00 2025-12-29
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 3 — — $242,185.09 $242,185.09 $242,185.09 2025-12-29
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 3 — — $241,833.85 $241,833.85 $241,833.85 2025-12-29
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 3 3 — — $237,565.64 $237,565.64 $237,565.64 2025-12-29
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 3 3 — — $232,937.98 $232,937.98 $232,937.98 2025-12-29
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 — — $231,504.29 $231,504.29 $231,504.29 2025-12-29
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 1 1 — — $229,570.40 $229,570.40 $229,570.40 2025-12-29
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 3 3 — — $227,941.62 $227,941.62 $227,941.62 2025-12-29
5831 APR_DRG Neonate With Ecmo 3 3 — — $222,772.73 $222,772.73 $222,772.73 2025-12-29
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 3 3 — — $215,562.17 $215,562.17 $215,562.17 2025-12-29
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 3 — — $211,250.82 $211,250.82 $211,250.82 2025-12-29
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 3 3 — — $200,404.67 $200,404.67 $200,404.67 2025-12-29
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 — — $198,374.29 $198,374.29 $198,374.29 2025-12-29
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 3 — — $192,254.40 $192,254.40 $192,254.40 2025-12-29
1613 APR_DRG Implantable Heart Assist Systems 3 3 — — $189,752.63 $189,752.63 $189,752.63 2025-12-29
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 3 3 — — $182,571.84 $182,571.84 $182,571.84 2025-12-29
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 3 3 — — $171,907.48 $171,907.48 $171,907.48 2025-12-29
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 — — $170,035.26 $170,035.26 $170,035.26 2025-12-29
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 3 3 — — $162,031.84 $162,031.84 $162,031.84 2025-12-29
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 3 3 — — $162,031.84 $162,031.84 $162,031.84 2025-12-29
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 3 3 — — $162,031.84 $162,031.84 $162,031.84 2025-12-29
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 3 3 — — $159,659.47 $159,659.47 $159,659.47 2025-12-29
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $150,972.08 $150,972.08 $150,972.08 2025-12-29
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 3 3 — — $147,447.42 $147,447.42 $147,447.42 2025-12-29
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 3 3 — — $146,602.20 $146,602.20 $146,602.20 2025-12-29
1612 APR_DRG Implantable Heart Assist Systems 3 3 — — $139,620.65 $139,620.65 $139,620.65 2025-12-29
1611 APR_DRG Implantable Heart Assist Systems 3 3 — — $139,620.65 $139,620.65 $139,620.65 2025-12-29
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 3 3 — — $139,112.29 $139,112.29 $139,112.29 2025-12-29
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 3 3 — — $127,186.76 $127,186.76 $127,186.76 2025-12-29
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 3 3 — — $125,896.85 $125,896.85 $125,896.85 2025-12-29
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 3 3 — — $120,683.80 $120,683.80 $120,683.80 2025-12-29
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 3 3 — — $117,916.03 $117,916.03 $117,916.03 2025-12-29
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $116,702.12 $116,702.12 $116,702.12 2025-12-29
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 3 — — $116,446.40 $116,446.40 $116,446.40 2025-12-29
8514 APR_DRG Gender Related Procedures 3 3 — — $111,361.72 $111,361.72 $111,361.72 2025-12-29
8513 APR_DRG Gender Related Procedures 3 3 — — $111,361.72 $111,361.72 $111,361.72 2025-12-29
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 3 3 — — $110,422.01 $110,422.01 $110,422.01 2025-12-29
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $104,821.78 $104,821.78 $104,821.78 2025-12-29
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 3 3 — — $97,061.77 $97,061.77 $97,061.77 2025-12-29
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 3 3 — — $96,170.33 $96,170.33 $96,170.33 2025-12-29
8634 APR_DRG Neonatal Aftercare 3 3 — — $94,930.75 $94,930.75 $94,930.75 2025-12-29
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 3 — — $94,686.32 $94,686.32 $94,686.32 2025-12-29
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 3 3 — — $93,488.84 $93,488.84 $93,488.84 2025-12-29
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 3 3 — — $93,036.96 $93,036.96 $93,036.96 2025-12-29
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 3 3 — — $92,302.65 $92,302.65 $92,302.65 2025-12-29
Q2055 HCPCS Idecabtagene Vicleucel Car 3 3 — — $90,961.77 $90,961.77 $90,961.77 2025-12-29
C9073 HCPCS Brexucabtagene Autoleucel Ca 3 3 — — $90,961.77 $90,961.77 $90,961.77 2025-12-29
C9081 HCPCS Idecabtagene Car Pos T 3 3 — — $90,961.77 $90,961.77 $90,961.77 2025-12-29
C9076 HCPCS Lisocabtagene Car Pos T 3 3 — — $90,961.77 $90,961.77 $90,961.77 2025-12-29
Q2056 HCPCS Ciltacabtagene Car-pos T 3 3 — — $90,961.77 $90,961.77 $90,961.77 2025-12-29
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 3 3 — — $90,961.77 $90,961.77 $90,961.77 2025-12-29
Q2054 HCPCS Lisocabtagene Mara Car Pos T 3 3 — — $90,961.77 $90,961.77 $90,961.77 2025-12-29
Q2042 HCPCS Tisagenlecleucel Car-pos T 3 3 — — $90,961.77 $90,961.77 $90,961.77 2025-12-29
Q2053 HCPCS Brexucabtagene Car Pos T 3 3 — — $90,961.77 $90,961.77 $90,961.77 2025-12-29
Q2040 HCPCS Tisagenlecleucel Car-pos T 3 3 — — $90,961.77 $90,961.77 $90,961.77 2025-12-29
C9098 HCPCS Ciltacabtagene Car Pos T 3 3 — — $90,961.77 $90,961.77 $90,961.77 2025-12-29
5931 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 3 3 — — $89,738.23 $89,738.23 $89,738.23 2025-12-29
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 3 — — $84,011.68 $84,011.68 $84,011.68 2025-12-29
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $83,759.04 $83,759.04 $83,759.04 2025-12-29
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 3 3 — — $81,806.71 $81,806.71 $81,806.71 2025-12-29
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 3 3 — — $80,453.13 $80,453.13 $80,453.13 2025-12-29
2994 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 3 — — $80,156.32 $80,156.32 $80,156.32 2025-12-29
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 3 3 — — $80,132.70 $80,132.70 $80,132.70 2025-12-29
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $80,012.54 $80,012.54 $80,012.54 2025-12-29
1784 APR_DRG External Heart Assist Devices 3 3 — — $77,791.14 $77,791.14 $77,791.14 2025-12-29
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $76,459.12 $76,459.12 $76,459.12 2025-12-29
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 3 3 — — $76,258.86 $76,258.86 $76,258.86 2025-12-29
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 3 3 — — $74,982.30 $74,982.30 $74,982.30 2025-12-29
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 3 3 — — $73,495.20 $73,495.20 $73,495.20 2025-12-29
A9543 HCPCS Y90 Ibritumomab, Rx 3 3 — — $72,980.82 $72,980.82 $72,980.82 2025-12-29
C9031 HCPCS Lutetium Lu 177 Dotatate, Tx 3 3 — — $72,980.82 $72,980.82 $72,980.82 2025-12-29
A9607 HCPCS Lutetium Lu 177 Vipivotide 3 3 — — $72,980.82 $72,980.82 $72,980.82 2025-12-29
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 3 3 — — $72,011.19 $72,011.19 $72,011.19 2025-12-29
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 3 3 — — $70,104.05 $70,104.05 $70,104.05 2025-12-29
1834 APR_DRG Percutaneous Structural Cardiac Procedures 3 3 — — $70,013.67 $70,013.67 $70,013.67 2025-12-29
9104 APR_DRG Craniotomy For Multiple Significant Trauma 3 3 — — $69,807.24 $69,807.24 $69,807.24 2025-12-29
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $68,670.80 $68,670.80 $68,670.80 2025-12-29
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 3 3 — — $68,463.93 $68,463.93 $68,463.93 2025-12-29
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 3 3 — — $68,386.90 $68,386.90 $68,386.90 2025-12-29
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 3 3 — — $67,852.86 $67,852.86 $67,852.86 2025-12-29
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 3 3 — — $66,562.95 $66,562.95 $66,562.95 2025-12-29
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 3 3 — — $66,465.39 $66,465.39 $66,465.39 2025-12-29
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 3 3 — — $66,396.58 $66,396.58 $66,396.58 2025-12-29
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 3 3 — — $65,614.00 $65,614.00 $65,614.00 2025-12-29
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 3 3 — — $65,520.55 $65,520.55 $65,520.55 2025-12-29
1794 APR_DRG Defibrillator Implants 3 3 — — $64,666.08 $64,666.08 $64,666.08 2025-12-29
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 3 3 — — $64,567.49 $64,567.49 $64,567.49 2025-12-29
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 3 3 — — $64,478.14 $64,478.14 $64,478.14 2025-12-29
914 APR_DRG Other Major Head And Neck Procedures 3 3 — — $64,289.17 $64,289.17 $64,289.17 2025-12-29
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 3 3 — — $64,167.99 $64,167.99 $64,167.99 2025-12-29
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 3 3 — — $63,301.20 $63,301.20 $63,301.20 2025-12-29
214 APR_DRG Open Craniotomy Except Trauma 3 3 — — $63,211.85 $63,211.85 $63,211.85 2025-12-29
1783 APR_DRG External Heart Assist Devices 3 3 — — $62,769.21 $62,769.21 $62,769.21 2025-12-29
2993 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 3 — — $62,678.84 $62,678.84 $62,678.84 2025-12-29
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 3 3 — — $62,527.87 $62,527.87 $62,527.87 2025-12-29
6021 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $62,394.36 $62,394.36 $62,394.36 2025-12-29
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 3 3 — — $61,735.02 $61,735.02 $61,735.02 2025-12-29
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 3 3 — — $61,546.06 $61,546.06 $61,546.06 2025-12-29
3004 APR_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 3 — — $61,150.66 $61,150.66 $61,150.66 2025-12-29
6904 APR_DRG Acute Leukemia 3 3 — — $60,651.54 $60,651.54 $60,651.54 2025-12-29
33991 HCPCS Insj Perq Vad L Hrt Artl&ven 3 3 — — $59,850.35 $59,850.35 $59,850.35 2025-12-29
33995 HCPCS Insj Perq Vad R Hrt Venous 3 3 — — $59,850.35 $59,850.35 $59,850.35 2025-12-29
0451T OTHER Insj/rplcmt Aortic Ventr Sys 3 3 — — $59,850.35 $59,850.35 $59,850.35 2025-12-29
33983 HCPCS Replace Vad Intra W/bp 3 3 — — $59,850.35 $59,850.35 $59,850.35 2025-12-29
33982 HCPCS Replace Vad Intra Without Bp 3 3 — — $59,850.35 $59,850.35 $59,850.35 2025-12-29
33981 HCPCS Replace Vad Pump Ext 3 3 — — $59,850.35 $59,850.35 $59,850.35 2025-12-29
33979 HCPCS Insert Intracorporeal Device 3 3 — — $59,850.35 $59,850.35 $59,850.35 2025-12-29
33990 HCPCS Insj Perq Vad L Hrt Arterial 3 3 — — $59,850.35 $59,850.35 $59,850.35 2025-12-29
33975 HCPCS Implant Ventricular Device 3 3 — — $59,850.35 $59,850.35 $59,850.35 2025-12-29
0452T OTHER Insj/rplcmt Dev Vasc Seal 3 3 — — $59,850.35 $59,850.35 $59,850.35 2025-12-29
33976 HCPCS Implant Ventricular Device 3 3 — — $59,850.35 $59,850.35 $59,850.35 2025-12-29
0453T OTHER Insj/rplcmt Mech-elec Ntrfce 3 3 — — $59,850.35 $59,850.35 $59,850.35 2025-12-29
0454T OTHER Insj/rplcmt Subq Electrode 3 3 — — $59,850.35 $59,850.35 $59,850.35 2025-12-29
0459T OTHER Relocaj Rplcmt Aortic Ventr 3 3 — — $59,850.35 $59,850.35 $59,850.35 2025-12-29
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $59,761.13 $59,761.13 $59,761.13 2025-12-29
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 1 1 — — $59,648.73 $59,648.73 $59,648.73 2025-12-29
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 3 3 — — $58,978.56 $58,978.56 $58,978.56 2025-12-29
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 3 3 — — $58,811.16 $58,811.16 $58,811.16 2025-12-29
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 3 3 — — $58,679.70 $58,679.70 $58,679.70 2025-12-29
1694 APR_DRG Major Abdominal Vascular Procedures 3 3 — — $58,415.76 $58,415.76 $58,415.76 2025-12-29
234 APR_DRG Spinal Procedures 3 3 — — $57,635.24 $57,635.24 $57,635.24 2025-12-29
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 3 3 — — $57,479.14 $57,479.14 $57,479.14 2025-12-29
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 3 3 — — $57,457.57 $57,457.57 $57,457.57 2025-12-29
1204 APR_DRG Major Respiratory And Chest Procedures 3 3 — — $56,859.86 $56,859.86 $56,859.86 2025-12-29
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 3 3 — — $56,767.43 $56,767.43 $56,767.43 2025-12-29
3124 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 3 3 — — $56,660.62 $56,660.62 $56,660.62 2025-12-29
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 3 3 — — $56,191.28 $56,191.28 $56,191.28 2025-12-29
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 3 3 — — $56,005.39 $56,005.39 $56,005.39 2025-12-29
6954 APR_DRG Chemotherapy For Acute Leukemia 3 3 — — $55,822.59 $55,822.59 $55,822.59 2025-12-29
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 3 3 — — $55,661.35 $55,661.35 $55,661.35 2025-12-29
204 APR_DRG Open Craniotomy For Trauma 3 3 — — $55,222.82 $55,222.82 $55,222.82 2025-12-29
894 APR_DRG Major Cranial Or Facial Bone Procedures 3 3 — — $55,189.95 $55,189.95 $55,189.95 2025-12-29
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 3 3 — — $55,128.33 $55,128.33 $55,128.33 2025-12-29
4284 APR_DRG Genetic Disorders 3 3 — — $55,061.58 $55,061.58 $55,061.58 2025-12-29
2614 APR_DRG Major Biliary Tract Procedures 3 3 — — $54,839.75 $54,839.75 $54,839.75 2025-12-29
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 3 3 — — $54,831.53 $54,831.53 $54,831.53 2025-12-29
6092 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 3 — — $54,818.18 $54,818.18 $54,818.18 2025-12-29
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 3 3 — — $54,615.86 $54,615.86 $54,615.86 2025-12-29
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 3 3 — — $53,563.19 $53,563.19 $53,563.19 2025-12-29
274 APR_DRG Other Open Craniotomy 3 3 — — $53,200.65 $53,200.65 $53,200.65 2025-12-29
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 3 — — $53,070.23 $53,070.23 $53,070.23 2025-12-29
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $52,948.01 $52,948.01 $52,948.01 2025-12-29
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 3 3 — — $52,610.13 $52,610.13 $52,610.13 2025-12-29
7907 OTHER Level 3: Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 1 1 — — $52,306.38 $52,306.38 $52,306.38 2025-12-29
4014 APR_DRG Adrenal Procedures 3 3 — — $52,179.82 $52,179.82 $52,179.82 2025-12-29
5204 APR_DRG Other GYN Procedures For Malignancy 3 3 — — $51,987.77 $51,987.77 $51,987.77 2025-12-29
6133 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 3 3 — — $51,968.25 $51,968.25 $51,968.25 2025-12-29
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 3 3 — — $51,763.88 $51,763.88 $51,763.88 2025-12-29
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 3 3 — — $51,701.23 $51,701.23 $51,701.23 2025-12-29
4414 APR_DRG Major Bladder Procedures 3 3 — — $51,462.97 $51,462.97 $51,462.97 2025-12-29
1782 APR_DRG External Heart Assist Devices 3 3 — — $51,107.63 $51,107.63 $51,107.63 2025-12-29
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 3 3 — — $51,018.28 $51,018.28 $51,018.28 2025-12-29
1833 APR_DRG Percutaneous Structural Cardiac Procedures 3 3 — — $50,875.53 $50,875.53 $50,875.53 2025-12-29
5114 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 3 3 — — $49,799.23 $49,799.23 $49,799.23 2025-12-29
6224 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $49,582.53 $49,582.53 $49,582.53 2025-12-29
3214 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 3 3 — — $49,427.46 $49,427.46 $49,427.46 2025-12-29
224 APR_DRG Ventricular Shunt Procedures 3 3 — — $49,395.62 $49,395.62 $49,395.62 2025-12-29
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 3 3 — — $49,247.73 $49,247.73 $49,247.73 2025-12-29
1793 APR_DRG Defibrillator Implants 3 3 — — $49,245.68 $49,245.68 $49,245.68 2025-12-29
8423 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 3 3 — — $48,747.58 $48,747.58 $48,747.58 2025-12-29
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 3 3 — — $48,739.37 $48,739.37 $48,739.37 2025-12-29
8633 APR_DRG Neonatal Aftercare 3 3 — — $48,562.72 $48,562.72 $48,562.72 2025-12-29
3043 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 3 3 — — $48,370.67 $48,370.67 $48,370.67 2025-12-29
1602 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 3 3 — — $48,307.00 $48,307.00 $48,307.00 2025-12-29
S2235 HCPCS Implant Auditory Brain Imp 3 3 — — $48,255.81 $48,255.81 $48,255.81 2025-12-29
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 3 3 — — $48,219.70 $48,219.70 $48,219.70 2025-12-29
1704 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 3 3 — — $48,182.73 $48,182.73 $48,182.73 2025-12-29
1814 APR_DRG Lower Extremity Vascular Procedures 3 3 — — $48,075.92 $48,075.92 $48,075.92 2025-12-29
1663 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 3 3 — — $48,068.74 $48,068.74 $48,068.74 2025-12-29
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 5 4 — — $47,914.10 $107,778.77 $47,914.10 2025-12-29
Q9995 HCPCS Inj. Emicizumab-kxwh, 0.5 Mg 3 3 — — $47,914.10 $47,914.10 $47,914.10 2025-12-29
J9600 HCPCS Porfimer Sodium Injection 3 3 — — $47,914.10 $47,914.10 $47,914.10 2025-12-29
J9226 HCPCS Supprelin La Implant 5 4 — — $47,914.10 $89,317.42 $47,914.10 2025-12-29
C9085 HCPCS Inj Avalglucosid Alfa-ngpt 3 3 — — $47,914.10 $47,914.10 $47,914.10 2025-12-29
C9052 HCPCS Injection, Ravulizumab-cwv 3 3 — — $47,914.10 $47,914.10 $47,914.10 2025-12-29
1214 APR_DRG Other Respiratory And Chest Procedures 3 3 — — $47,661.02 $47,661.02 $47,661.02 2025-12-29
5124 APR_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy 3 3 — — $47,641.50 $47,641.50 $47,641.50 2025-12-29
2304 APR_DRG Major Small Bowel Procedures 3 3 — — $47,375.51 $47,375.51 $47,375.51 2025-12-29
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 3 3 — — $46,959.58 $46,959.58 $46,959.58 2025-12-29
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 3 3 — — $46,843.52 $46,843.52 $46,843.52 2025-12-29
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures 3 3 — — $46,752.12 $46,752.12 $46,752.12 2025-12-29
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 3 3 — — $46,583.69 $46,583.69 $46,583.69 2025-12-29
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 3 3 — — $46,393.70 $46,393.70 $46,393.70 2025-12-29
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 3 3 — — $46,283.81 $46,283.81 $46,283.81 2025-12-29
6344 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 3 3 — — $46,256.08 $46,256.08 $46,256.08 2025-12-29
4034 APR_DRG Procedures For Obesity 3 3 — — $46,154.41 $46,154.41 $46,154.41 2025-12-29
2992 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 3 — — $46,098.95 $46,098.95 $46,098.95 2025-12-29
1781 APR_DRG External Heart Assist Devices 3 3 — — $45,996.25 $45,996.25 $45,996.25 2025-12-29
8412 APR_DRG Extensive Third Degree Burns With Skin Graft 3 3 — — $45,933.60 $45,933.60 $45,933.60 2025-12-29
8411 APR_DRG Extensive Third Degree Burns With Skin Graft 3 3 — — $45,933.60 $45,933.60 $45,933.60 2025-12-29
1673 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 3 3 — — $45,708.69 $45,708.69 $45,708.69 2025-12-29
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 3 3 — — $45,417.02 $45,417.02 $45,417.02 2025-12-29
294 APR_DRG Other Percutaneous Intracranial Procedures 3 3 — — $45,112.00 $45,112.00 $45,112.00 2025-12-29
4844 APR_DRG Other Male Reproductive System And Related Procedures 3 3 — — $45,107.89 $45,107.89 $45,107.89 2025-12-29
9103 APR_DRG Craniotomy For Multiple Significant Trauma 3 3 — — $45,061.68 $45,061.68 $45,061.68 2025-12-29
4854 APR_DRG Prostatectomy Procedures 3 3 — — $45,003.14 $45,003.14 $45,003.14 2025-12-29
0294T OTHER Ins Lt Atrl Mont Pres Lead 3 3 — — $44,959.19 $44,959.19 $44,959.19 2025-12-29
G0448 HCPCS Place Perm Pacing Cardiovert 3 3 — — $44,959.19 $44,959.19 $44,959.19 2025-12-29
0409T OTHER Insj/rplc Car Modulj Pls Gn 4 4 — — $19,932.20 $44,959.19 $44,959.19 2025-12-29
C9741 HCPCS Impl Pressure Sensor W/angio 3 3 — — $44,959.19 $44,959.19 $44,959.19 2025-12-29
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 4 4 — — $19,932.20 $44,959.19 $44,959.19 2025-12-29
33270 HCPCS Ins/rep Subq Defibrillator 4 4 — — $28,019.23 $44,959.19 $44,959.19 2025-12-29
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 4 4 — — $28,019.23 $44,959.19 $44,959.19 2025-12-29
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 4 4 — — $19,932.20 $44,959.19 $44,959.19 2025-12-29
33240 HCPCS Insrt Pulse Gen W/singl Lead 4 4 — — $19,932.20 $44,959.19 $44,959.19 2025-12-29
33249 HCPCS Insj/rplcmt Defib W/lead(s) 4 4 — — $28,019.23 $44,959.19 $44,959.19 2025-12-29
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 4 4 — — $19,932.20 $44,959.19 $44,959.19 2025-12-29
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 4 4 — — $23,851.54 $44,959.19 $44,959.19 2025-12-29
0520T OTHER Rmvl&rplcmt Pg Wcs New Eltrd 4 4 — — $19,932.20 $44,959.19 $44,959.19 2025-12-29
0571T OTHER Insj/rplcmt Icds Ss Eltrd 4 4 — — $28,019.23 $44,959.19 $44,959.19 2025-12-29
33231 HCPCS Insrt Pulse Gen W/mult Leads 4 4 — — $28,019.23 $44,959.19 $44,959.19 2025-12-29
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 4 4 — — $19,932.20 $44,959.19 $44,959.19 2025-12-29
33230 HCPCS Insrt Pulse Gen W/dual Leads 4 4 — — $19,932.20 $44,959.19 $44,959.19 2025-12-29
264 APR_DRG Other Nervous System And Related Procedures 3 3 — — $44,831.63 $44,831.63 $44,831.63 2025-12-29
213 APR_DRG Open Craniotomy Except Trauma 3 3 — — $44,484.51 $44,484.51 $44,484.51 2025-12-29
1754 APR_DRG Percutaneous Cardiac Intervention Without Ami 3 3 — — $44,348.94 $44,348.94 $44,348.94 2025-12-29
1652 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 3 3 — — $44,036.73 $44,036.73 $44,036.73 2025-12-29
6091 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 3 — — $44,033.65 $44,033.65 $44,033.65 2025-12-29
4474 APR_DRG Other Kidney, Urinary Tract And Related Non-percutaneous Procedures 3 3 — — $43,926.84 $43,926.84 $43,926.84 2025-12-29
4424 APR_DRG Kidney And Urinary Tract Procedures For Malignancy 3 3 — — $43,789.23 $43,789.23 $43,789.23 2025-12-29
4484 APR_DRG Other Kidney, Urinary Tract And Related Percutaneous Procedures 3 3 — — $43,558.15 $43,558.15 $43,558.15 2025-12-29
1632 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 3 3 — — $43,405.13 $43,405.13 $43,405.13 2025-12-29
6504 APR_DRG Splenic Procedures 3 3 — — $43,384.59 $43,384.59 $43,384.59 2025-12-29
6143 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 3 3 — — $43,338.37 $43,338.37 $43,338.37 2025-12-29
1621 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 3 3 — — $43,080.60 $43,080.60 $43,080.60 2025-12-29
9514 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 3 3 — — $42,993.30 $42,993.30 $42,993.30 2025-12-29
913 APR_DRG Other Major Head And Neck Procedures 3 3 — — $42,956.33 $42,956.33 $42,956.33 2025-12-29
3003 APR_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 3 — — $42,756.06 $42,756.06 $42,756.06 2025-12-29
6071 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $42,721.15 $42,721.15 $42,721.15 2025-12-29
1303 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 3 3 — — $42,390.45 $42,390.45 $42,390.45 2025-12-29
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 3 3 — — $42,332.94 $42,332.94 $42,332.94 2025-12-29
5144 APR_DRG Female Reproductive System Reconstructive Procedures 3 3 — — $42,118.30 $42,118.30 $42,118.30 2025-12-29
2314 APR_DRG Major Large Bowel Procedures 3 3 — — $41,820.47 $41,820.47 $41,820.47 2025-12-29
1824 APR_DRG Other Peripheral Vascular And Related Procedures 3 3 — — $41,593.50 $41,593.50 $41,593.50 2025-12-29
2224 APR_DRG Other Stomach, Esophageal And Duodenal Procedures 3 3 — — $41,538.04 $41,538.04 $41,538.04 2025-12-29
2294 APR_DRG Other Digestive System And Abdominal Procedures 3 3 — — $41,239.19 $41,239.19 $41,239.19 2025-12-29
5184 APR_DRG Other Female Reproductive System And Related Procedures 3 3 — — $41,172.43 $41,172.43 $41,172.43 2025-12-29
893 APR_DRG Major Cranial Or Facial Bone Procedures 3 3 — — $41,153.94 $41,153.94 $41,153.94 2025-12-29
4444 APR_DRG Renal Dialysis Access Device Procedures 3 3 — — $41,135.46 $41,135.46 $41,135.46 2025-12-29
6903 APR_DRG Acute Leukemia 3 3 — — $40,971.14 $40,971.14 $40,971.14 2025-12-29
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 1 — — $40,970.07 $40,970.07 $40,970.07 2025-12-29
4834 APR_DRG Penis, Testes And Scrotal Procedures 3 3 — — $40,948.54 $40,948.54 $40,948.54 2025-12-29
1693 APR_DRG Major Abdominal Vascular Procedures 3 3 — — $40,833.52 $40,833.52 $40,833.52 2025-12-29
1832 APR_DRG Percutaneous Structural Cardiac Procedures 3 3 — — $40,781.14 $40,781.14 $40,781.14 2025-12-29
3134 APR_DRG Knee And Lower Leg Procedures Except Foot 3 3 — — $40,720.55 $40,720.55 $40,720.55 2025-12-29
1792 APR_DRG Defibrillator Implants 3 3 — — $40,715.42 $40,715.42 $40,715.42 2025-12-29
3031 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 3 3 — — $40,706.17 $40,706.17 $40,706.17 2025-12-29
3094 APR_DRG Other Significant Hip And Femur Surgery 3 3 — — $40,615.80 $40,615.80 $40,615.80 2025-12-29
5194 APR_DRG Uterine And Adnexa Procedures For Leiomyoma 3 3 — — $40,323.10 $40,323.10 $40,323.10 2025-12-29
6233 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 3 3 — — $40,285.10 $40,285.10 $40,285.10 2025-12-29
5134 APR_DRG Uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma 3 3 — — $40,177.27 $40,177.27 $40,177.27 2025-12-29
3154 APR_DRG Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement 3 3 — — $39,996.52 $39,996.52 $39,996.52 2025-12-29
3254 APR_DRG Non-elective Or Complex Knee Joint Replacement 3 3 — — $39,941.06 $39,941.06 $39,941.06 2025-12-29
984 APR_DRG Other Ear, Nose, Mouth, Throat, Craniofacial, And Neck Procedures 3 3 — — $39,847.60 $39,847.60 $39,847.60 2025-12-29
2324 APR_DRG Gastric Fundoplication 3 3 — — $39,833.22 $39,833.22 $39,833.22 2025-12-29
2274 APR_DRG Hernia Procedures Except Inguinal, Femoral And Umbilical 3 3 — — $39,809.60 $39,809.60 $39,809.60 2025-12-29
J9266 HCPCS Pegaspargase Injection 4 3 — — $35,185.25 $44,329.51 $39,757.38 2025-12-29
233 APR_DRG Spinal Procedures 3 3 — — $39,697.66 $39,697.66 $39,697.66 2025-12-29
6082 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 3 3 — — $39,694.58 $39,694.58 $39,694.58 2025-12-29
2234 APR_DRG Other Small And Large Bowel Procedures 3 3 — — $39,687.39 $39,687.39 $39,687.39 2025-12-29
1804 APR_DRG Other Circulatory System Procedures 3 3 — — $39,524.10 $39,524.10 $39,524.10 2025-12-29
1651 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 3 3 — — $39,460.42 $39,460.42 $39,460.42 2025-12-29
6312 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 3 3 — — $39,436.80 $39,436.80 $39,436.80 2025-12-29
1744 APR_DRG Percutaneous Cardiac Intervention With Ami 3 3 — — $39,418.31 $39,418.31 $39,418.31 2025-12-29
3054 APR_DRG Amputation Of Lower Limb Except Toes 3 3 — — $39,195.46 $39,195.46 $39,195.46 2025-12-29
1714 APR_DRG Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock 3 3 — — $39,182.10 $39,182.10 $39,182.10 2025-12-29
9524 APR_DRG Non-extensive O.r. Procedure Unrelated To Principal Diagnosis 3 3 — — $39,159.51 $39,159.51 $39,159.51 2025-12-29
9123 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 3 3 — — $39,158.48 $39,158.48 $39,158.48 2025-12-29
504 APR_DRG Non-bacterial Infections Of Nervous System Except Viral Meningitis 3 3 — — $39,088.65 $39,088.65 $39,088.65 2025-12-29
2244 APR_DRG Peritoneal Adhesiolysis 3 3 — — $39,074.27 $39,074.27 $39,074.27 2025-12-29
4234 APR_DRG Inborn Errors Of Metabolism 3 3 — — $38,974.65 $38,974.65 $38,974.65 2025-12-29
7934 APR_DRG Moderately Extensive O.r. Procedures For Other Complications Of Treatment 3 3 — — $38,865.79 $38,865.79 $38,865.79 2025-12-29
1662 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 3 3 — — $38,490.93 $38,490.93 $38,490.93 2025-12-29
9113 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 3 3 — — $38,422.12 $38,422.12 $38,422.12 2025-12-29
2991 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 3 — — $38,345.10 $38,345.10 $38,345.10 2025-12-29
244 APR_DRG Open Extracranial Vascular Procedures 3 3 — — $38,320.45 $38,320.45 $38,320.45 2025-12-29
0266T OTHER Implt/rpl Crtd Sns Dev Total 4 4 — — $25,645.15 $38,276.36 $38,276.36 2025-12-29
0268T OTHER Implt/rpl Crtd Sns Dev Gen 4 4 — — $25,645.15 $38,276.36 $38,276.36 2025-12-29
0312T OTHER Laps Impltj Nstim Vagus 3 3 — — $38,276.36 $38,276.36 $38,276.36 2025-12-29
0424T OTHER Insj/rplc Nstim Apnea Compl 3 3 — — $38,276.36 $38,276.36 $38,276.36 2025-12-29
0316T OTHER Replc Vagus Nerve Pls Gen 3 3 — — $38,276.36 $38,276.36 $38,276.36 2025-12-29
0431T OTHER Rmvl/rplc Nstim Apnea Pls Gn 4 4 — — $25,645.15 $38,276.36 $38,276.36 2025-12-29
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 4 4 — — $25,645.15 $38,276.36 $38,276.36 2025-12-29
64575 HCPCS Opn Impltj Nea Perph Nerve 4 4 — — $10,440.79 $38,276.36 $38,276.36 2025-12-29
64590 HCPCS Insrt/redo Pn/gastr Stimul 4 4 — — $18,794.04 $38,276.36 $38,276.36 2025-12-29
64553 HCPCS Implant Neuroelectrodes 4 4 — — $10,440.79 $38,276.36 $38,276.36 2025-12-29
64569 HCPCS Revise/repl Vagus N Eltrd 4 4 — — $10,440.79 $38,276.36 $38,276.36 2025-12-29
63685 HCPCS Insrt/redo Spine N Generator 4 4 — — $25,645.15 $38,276.36 $38,276.36 2025-12-29
64568 HCPCS Opn Impltj Crnl Nrv Nea&pg 4 4 — — $25,645.15 $38,276.36 $38,276.36 2025-12-29
63664 HCPCS Revise Spine Eltrd Plate 4 4 — — $10,440.79 $38,276.36 $38,276.36 2025-12-29
61870 HCPCS Implant Neuroelectrodes 3 3 — — $38,276.36 $38,276.36 $38,276.36 2025-12-29
64580 HCPCS Opn Impltj Nea Neuromuscular 4 4 — — $18,794.04 $38,276.36 $38,276.36 2025-12-29
61868 HCPCS Implant Neuroelectrde Addl 3 3 — — $38,276.36 $38,276.36 $38,276.36 2025-12-29
61886 HCPCS Implant Neurostim Arrays 4 4 — — $25,645.15 $38,276.36 $38,276.36 2025-12-29
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