Hospital

PORTSMOUTH REGIONAL HOSPITAL

Portsmouth, NH · CCN 300029 · Rates published

25,039 distinct procedures filed

30 distinct payers

572,369 rate rows

2025-11-01 last MRF observed

Data quality

263,766 of 572,369 rate rows are consumer-grade (46.1%)

308,603 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 — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	294,783
template filing: same amount across many unrelated codes — excluded	6,514
per-diem day rate — not a per-procedure price	5,772
placeholder amount (≤ $0.02) — excluded from medians	1,534

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/02-0364103_SEABROOK-EMERGENCY_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page	https://www.portsmouthhospital.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered via	CMS hospital list
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-06-18

Top 50 most expensive offerings

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

Code	Description	Payers	Min $	Max $	Avg median	vs national
J1411 HCPCS	Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose	1	$4,736,676.00	$4,736,676.00	$4,736,676.00	nat. median $3,710,000 1.3× median
J1414 HCPCS	Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose	1	$4,736,676.00	$4,736,676.00	$4,736,676.00	nat. median $3,710,000 1.3× median
J1413 HCPCS	Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose	1	$4,330,675.20	$4,763,481.60	$4,547,078.40	nat. median $3,325,455 1.4× median
845 OTHER	Inj, Atidarsagene Autotemc	13	$7,129.63	$4,685,200.00	$4,516,262.50	nat. median $9,966 outlier · 453.2×
J3393 HCPCS	Injection, Betibeglogene Autotemcel, Per Treatment	1	$3,789,340.80	$4,736,676.00	$4,452,361.20	nat. median $3,004,655 1.5× median
00845 OTHER	Inj, Atidarsagene Autotemc	3	$4,369,850.00	$4,505,000.00	$4,414,900.00	nat. median $4,505,000 1.0× median
J3394 HCPCS	Injection, Lovotibeglogene Autotemcel, Per Treatment	1	$4,195,341.60	$4,614,622.80	$4,404,982.20	nat. median $3,286,000 1.3× median
9138 OTHER	Inj, Hemgenix, Per Tx Dose	11	$3,685,267.00	$3,832,677.68	$3,758,972.34	nat. median $3,746,358 1.0× median
09138 OTHER	Inj, Hemgenix, Per Tx Dose	3	$3,574,708.99	$3,685,267.00	$3,611,561.66	nat. median $3,574,709 1.0× median
J3392 HCPCS	Injection, Exagamglogene Autotemcel, Per Treatment	1	$2,977,339.20	$3,721,674.00	$3,498,283.80	nat. median $2,448,600 1.4× median
J3399 HCPCS	Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge…	1	$2,847,644.50	$3,559,555.62	$3,345,896.44	nat. median $2,468,984 1.4× median
714 OTHER	Inj Delandistrogene Mox Ro	13	$8,007.02	$3,449,120.48	$3,324,753.16	nat. median $13,041 outlier · 254.9×
748 OTHER	Inj, Lovotibeglogene Autot	13	$14,801.97	$3,378,383.84	$3,256,567.12	nat. median $17,963 outlier · 181.3×
00714 OTHER	Inj Delandistrogene Mox Ro	3	$3,216,968.14	$3,316,462.00	$3,250,132.76	nat. median $3,228,024 1.0× median
00748 OTHER	Inj, Lovotibeglogene Autot	3	$3,150,992.62	$3,248,446.00	$3,183,477.08	nat. median $3,187,420 1.0× median
746 OTHER	Inj, Betibeglogene Autotem	13	$10,843.37	$3,063,569.60	$2,953,104.35	nat. median $21,896 outlier · 134.9×
00746 OTHER	Inj, Betibeglogene Autotem	3	$2,857,367.80	$2,945,740.00	$2,886,825.20	nat. median $2,878,960 1.0× median
9141 OTHER	Inj Onase Abepar-xioi Trea	12	$2,455,110.00	$4,291,286.77	$2,504,212.20	nat. median $2,588,981 1.0× median
09141 OTHER	Inj Onase Abepar-xioi Trea	3	$2,381,456.70	$2,455,110.00	$2,406,007.80	nat. median $2,457,321 1.0× median
824 OTHER	Inj, Exagamglogene Autotem	14	$20,240.53	$4,076,102.80	$2,343,660.00	nat. median $25,250 outlier · 92.8×
00824 OTHER	Inj, Exagamglogene Autotem	3	$2,262,040.00	$2,332,000.00	$2,285,360.00	nat. median $2,332,000 1.0× median
2067 OTHER	Afamitresgene Autoleucel	12	$770,620.00	$1,346,966.70	$786,032.40	nat. median $786,032 1.0× median
Q2042 HCPCS	Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka…	4	$561,407.87	$938,087.14	$750,469.71	nat. median $753,246 1.0× median
Q2056 HCPCS	Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige…	4	$536,573.93	$914,361.47	$731,489.17	nat. median $674,867 1.1× median
Q2055 HCPCS	Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (…	4	$511,793.34	$876,206.17	$700,964.93	nat. median $625,184 1.1× median
Q2054 HCPCS	Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi…	4	$500,948.74	$856,591.98	$685,273.58	nat. median $673,137 1.0× median
Q2041 HCPCS	Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via…	4	$487,755.77	$811,864.19	$649,491.35	nat. median $634,303 1.0× median
Q2053 HCPCS	Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V…	4	$474,717.03	$809,433.43	$647,546.74	nat. median $619,808 1.0× median
9194 OTHER	Tisagenlecleucel Car-pos T	12	$591,726.20	$1,034,278.22	$603,560.72	nat. median $566,531 1.1× median
09194 OTHER	Tisagenlecleucel Car-pos T	3	$573,974.41	$591,726.20	$579,891.68	nat. median $538,205 1.1× median
9498 OTHER	Ciltacabtagene Car-pos T	12	$565,868.90	$989,082.25	$577,186.28	nat. median $587,650 1.0× median
9413 OTHER	Lisocabtagene Car Pos T	12	$562,538.20	$983,260.52	$573,788.96	nat. median $562,201 1.0× median
9422 OTHER	Idecabtagene Vicleucel Car	12	$557,317.90	$974,135.96	$568,464.26	nat. median $558,082 1.0× median
09498 OTHER	Ciltacabtagene Car-pos T	3	$548,892.83	$565,868.90	$554,551.52	nat. median $554,552 1.0× median
09413 OTHER	Lisocabtagene Car Pos T	3	$545,662.05	$562,538.20	$551,287.44	nat. median $534,091 1.0× median
09422 OTHER	Idecabtagene Vicleucel Car	3	$540,598.36	$557,317.90	$546,171.54	nat. median $530,178 1.0× median
9035 OTHER	Axicabtagene Ciloleucel Ca	12	$533,230.20	$932,033.07	$543,894.80	nat. median $532,192 1.0× median
09035 OTHER	Axicabtagene Ciloleucel Ca	3	$517,233.29	$533,230.20	$522,565.60	nat. median $505,583 1.0× median
9391 OTHER	Brexucabtagene Car Pos T	12	$489,304.60	$855,255.51	$499,090.69	nat. median $489,450 1.0× median
09391 OTHER	Brexucabtagene Car Pos T	3	$474,625.46	$489,304.60	$479,518.51	nat. median $464,978 1.0× median
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	15	$23,229.00	$1,522,193.70	$401,281.04	nat. median $370,174 1.1× median
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	14	$199,181.97	$987,842.48	$313,587.44	nat. median $265,286 1.2× median
001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	3	$295,034.52	$304,159.30	$298,076.11	nat. median $263,894 1.1× median
018 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	3	$278,817.09	$287,440.30	$281,691.49	nat. median $424,868 0.7× median
831 OTHER	Obecbtge Autol Up To 400 M	14	$4,208.85	$486,353.17	$279,641.25	nat. median $12,362 outlier · 22.6×
00831 OTHER	Obecbtge Autol Up To 400 M	3	$269,902.50	$278,250.00	$272,685.00	nat. median $278,250 1.0× median
886 OTHER	No Description Found	14	$9,424.04	$359,438.16	$206,668.20	nat. median $17,985 outlier · 11.5×
003 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	3	$198,462.87	$204,600.90	$200,508.88	nat. median $218,232 0.9× median
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	15	$30,166.00	$252,185.70	$193,859.70	nat. median $206,474 0.9× median
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	15	$78,400.00	$250,705.69	$192,725.50	nat. median $202,976 0.9× median

Other procedures at this hospital

Browse this hospital's 25,039 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

J1411	HCPCS	Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose	1	1	—	—	$4,736,676.00	$4,736,676.00	$4,736,676.00	2025-11-01
J1414	HCPCS	Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose	1	1	—	—	$4,736,676.00	$4,736,676.00	$4,736,676.00	2025-11-01
J1413	HCPCS	Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose	2	1	—	—	$4,330,675.20	$4,763,481.60	$4,547,078.40	2025-11-01
845	OTHER	Inj, Atidarsagene Autotemc	14	13	—	—	$7,129.63	$4,685,200.00	$4,516,262.50	2025-11-01
J3393	HCPCS	Injection, Betibeglogene Autotemcel, Per Treatment	4	1	—	—	$3,789,340.80	$4,736,676.00	$4,452,361.20	2025-11-01
00845	OTHER	Inj, Atidarsagene Autotemc	3	3	—	—	$4,369,850.00	$4,505,000.00	$4,414,900.00	2025-11-01
J3394	HCPCS	Injection, Lovotibeglogene Autotemcel, Per Treatment	2	1	—	—	$4,195,341.60	$4,614,622.80	$4,404,982.20	2025-11-01
9138	OTHER	Inj, Hemgenix, Per Tx Dose	11	11	—	—	$3,685,267.00	$3,832,677.68	$3,758,972.34	2025-11-01
09138	OTHER	Inj, Hemgenix, Per Tx Dose	3	3	—	—	$3,574,708.99	$3,685,267.00	$3,611,561.66	2025-11-01
J3392	HCPCS	Injection, Exagamglogene Autotemcel, Per Treatment	4	1	—	—	$2,977,339.20	$3,721,674.00	$3,498,283.80	2025-11-01
J3399	HCPCS	Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge…	4	1	—	—	$2,847,644.50	$3,559,555.62	$3,345,896.44	2025-11-01
714	OTHER	Inj Delandistrogene Mox Ro	14	13	—	—	$8,007.02	$3,449,120.48	$3,324,753.16	2025-11-01
748	OTHER	Inj, Lovotibeglogene Autot	14	13	—	—	$14,801.97	$3,378,383.84	$3,256,567.12	2025-11-01
00714	OTHER	Inj Delandistrogene Mox Ro	3	3	—	—	$3,216,968.14	$3,316,462.00	$3,250,132.76	2025-11-01
00748	OTHER	Inj, Lovotibeglogene Autot	3	3	—	—	$3,150,992.62	$3,248,446.00	$3,183,477.08	2025-11-01
746	OTHER	Inj, Betibeglogene Autotem	14	13	—	—	$10,843.37	$3,063,569.60	$2,953,104.35	2025-11-01
00746	OTHER	Inj, Betibeglogene Autotem	3	3	—	—	$2,857,367.80	$2,945,740.00	$2,886,825.20	2025-11-01
9141	OTHER	Inj Onase Abepar-xioi Trea	12	12	—	—	$2,455,110.00	$4,291,286.77	$2,504,212.20	2025-11-01
09141	OTHER	Inj Onase Abepar-xioi Trea	3	3	—	—	$2,381,456.70	$2,455,110.00	$2,406,007.80	2025-11-01
824	OTHER	Inj, Exagamglogene Autotem	15	14	—	—	$20,240.53	$4,076,102.80	$2,343,660.00	2025-11-01
00824	OTHER	Inj, Exagamglogene Autotem	3	3	—	—	$2,262,040.00	$2,332,000.00	$2,285,360.00	2025-11-01
2067	OTHER	Afamitresgene Autoleucel	12	12	—	—	$770,620.00	$1,346,966.70	$786,032.40	2025-11-01
Q2042	HCPCS	Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka…	7	4	—	—	$561,407.87	$938,087.14	$750,469.71	2025-11-01
Q2056	HCPCS	Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige…	7	4	—	—	$536,573.93	$914,361.47	$731,489.17	2025-11-01
Q2055	HCPCS	Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (…	7	4	—	—	$511,793.34	$876,206.17	$700,964.93	2025-11-01
Q2054	HCPCS	Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi…	7	4	—	—	$500,948.74	$856,591.98	$685,273.58	2025-11-01
Q2041	HCPCS	Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via…	7	4	—	—	$487,755.77	$811,864.19	$649,491.35	2025-11-01
Q2053	HCPCS	Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V…	7	4	—	—	$474,717.03	$809,433.43	$647,546.74	2025-11-01
9194	OTHER	Tisagenlecleucel Car-pos T	12	12	—	—	$591,726.20	$1,034,278.22	$603,560.72	2025-11-01
09194	OTHER	Tisagenlecleucel Car-pos T	3	3	—	—	$573,974.41	$591,726.20	$579,891.68	2025-11-01
9498	OTHER	Ciltacabtagene Car-pos T	12	12	—	—	$565,868.90	$989,082.25	$577,186.28	2025-11-01
9413	OTHER	Lisocabtagene Car Pos T	12	12	—	—	$562,538.20	$983,260.52	$573,788.96	2025-11-01
9422	OTHER	Idecabtagene Vicleucel Car	12	12	—	—	$557,317.90	$974,135.96	$568,464.26	2025-11-01
09498	OTHER	Ciltacabtagene Car-pos T	3	3	—	—	$548,892.83	$565,868.90	$554,551.52	2025-11-01
09413	OTHER	Lisocabtagene Car Pos T	3	3	—	—	$545,662.05	$562,538.20	$551,287.44	2025-11-01
09422	OTHER	Idecabtagene Vicleucel Car	3	3	—	—	$540,598.36	$557,317.90	$546,171.54	2025-11-01
9035	OTHER	Axicabtagene Ciloleucel Ca	12	12	—	—	$533,230.20	$932,033.07	$543,894.80	2025-11-01
09035	OTHER	Axicabtagene Ciloleucel Ca	3	3	—	—	$517,233.29	$533,230.20	$522,565.60	2025-11-01
9391	OTHER	Brexucabtagene Car Pos T	12	12	—	—	$489,304.60	$855,255.51	$499,090.69	2025-11-01
09391	OTHER	Brexucabtagene Car Pos T	3	3	—	—	$474,625.46	$489,304.60	$479,518.51	2025-11-01
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	26	15	—	—	$23,229.00	$1,522,193.70	$401,281.04	2025-11-01
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	25	14	—	—	$199,181.97	$987,842.48	$313,587.44	2025-11-01
001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	3	3	—	—	$295,034.52	$304,159.30	$298,076.11	2025-11-01
018	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	3	3	—	—	$278,817.09	$287,440.30	$281,691.49	2025-11-01
831	OTHER	Obecbtge Autol Up To 400 M	15	14	—	—	$4,208.85	$486,353.17	$279,641.25	2025-11-01
00831	OTHER	Obecbtge Autol Up To 400 M	3	3	—	—	$269,902.50	$278,250.00	$272,685.00	2025-11-01
886	OTHER	No Description Found	15	14	—	—	$9,424.04	$359,438.16	$206,668.20	2025-11-01
003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	3	3	—	—	$198,462.87	$204,600.90	$200,508.88	2025-11-01
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	16	15	—	—	$30,166.00	$252,185.70	$193,859.70	2025-11-01
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	16	15	—	—	$78,400.00	$250,705.69	$192,725.50	2025-11-01
1908	OTHER	New Technology - Level 52	12	12	—	—	$166,088.30	$290,305.74	$169,410.07	2025-11-01
1907	OTHER	New Technology - Level 52	12	12	—	—	$166,088.30	$290,305.74	$169,410.07	2025-11-01
01907	OTHER	New Technology - Level 52	3	3	—	—	$161,105.65	$166,088.30	$162,766.53	2025-11-01
01908	OTHER	New Technology - Level 52	3	3	—	—	$161,105.65	$166,088.30	$162,766.53	2025-11-01
1906	OTHER	New Technology - Level 51	12	12	—	—	$149,751.80	$261,751.17	$152,746.84	2025-11-01
1905	OTHER	New Technology - Level 51	12	12	—	—	$149,751.80	$261,751.17	$152,746.84	2025-11-01
01905	OTHER	New Technology - Level 51	3	3	—	—	$145,259.25	$149,751.80	$146,756.76	2025-11-01
01906	OTHER	New Technology - Level 51	3	3	—	—	$145,259.25	$149,751.80	$146,756.76	2025-11-01
1903	OTHER	New Technology - Level 50	12	12	—	—	$133,415.30	$233,196.60	$136,083.61	2025-11-01
1904	OTHER	New Technology - Level 50	12	12	—	—	$133,415.30	$233,196.60	$136,083.61	2025-11-01
230	MS_DRG	Other Cardiothoracic Procedures Without Cc/mcc	2	1	—	—	$117,616.00	$147,431.00	$132,523.50	2025-11-01
01903	OTHER	New Technology - Level 50	3	3	—	—	$129,412.84	$133,415.30	$130,746.99	2025-11-01
01904	OTHER	New Technology - Level 50	3	3	—	—	$129,412.84	$133,415.30	$130,746.99	2025-11-01
004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	3	3	—	—	$127,341.60	$131,280.00	$128,654.40	2025-11-01
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	25	14	—	—	$77,927.09	$758,898.00	$126,802.84	2025-11-01
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	16	15	—	—	$99,915.57	$163,608.58	$125,975.10	2025-11-01
A9543	HCPCS	Y90 Ibritum Tiu Tx 40mci	18	4	$95,196.00	$95,196.00	$87,775.86	$254,234.45	$123,540.72	2025-11-01
7	MS_DRG	Lung Transplant	25	14	—	—	$30,166.00	$456,494.55	$121,351.61	2025-11-01
J7330	HCPCS	Autologous Cultured Chondrocytes, Implant	18	4	—	—	$42,332.27	$249,685.01	$121,330.00	2025-11-01
1901	OTHER	New Technology - Level 49	12	12	—	—	$117,078.80	$204,642.03	$119,420.38	2025-11-01
1902	OTHER	New Technology - Level 49	12	12	—	—	$117,078.80	$204,642.03	$119,420.38	2025-11-01
01902	OTHER	New Technology - Level 49	3	3	—	—	$113,566.44	$117,078.80	$114,737.22	2025-11-01
01901	OTHER	New Technology - Level 49	3	3	—	—	$113,566.44	$117,078.80	$114,737.22	2025-11-01
J9029	HCPCS	Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose	21	7	—	—	$61,338.53	$261,350.54	$114,298.79	2025-11-01
14	MS_DRG	Allogeneic Bone Marrow Transplant	25	14	—	—	$23,229.00	$423,630.97	$112,658.93	2025-11-01
209	MS_DRG	Complex Aortic Arch Procedures	23	12	—	—	$30,166.00	$398,987.70	$107,171.06	2025-11-01
Q0480	HCPCS	Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only	15	14	—	—	$102,937.37	$185,488.90	$106,651.60	2025-11-01
215	MS_DRG	Other Heart Assist System Implant	26	15	—	—	$74,918.11	$265,956.00	$105,979.77	2025-11-01
005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	3	3	—	—	$104,623.23	$107,859.00	$105,701.82	2025-11-01
1585	OTHER	New Technology - Level 48	12	12	—	—	$103,465.00	$180,846.47	$105,534.30	2025-11-01
1599	OTHER	New Technology - Level 48	12	12	—	—	$103,465.00	$180,846.47	$105,534.30	2025-11-01
651	OTHER	Kidney Transplant With Hemodialysis Without Mcc	3	3	—	—	$103,883.22	$107,096.10	$104,954.18	2025-11-01
C9150	HCPCS	Xenon Xe-129 Hyperpolarized Gas, Diagnostic, Per Study Dose	12	2	—	—	$93,600.00	$214,021.60	$104,000.00	2025-11-01
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	26	15	—	—	$74,121.85	$250,629.00	$102,863.98	2025-11-01
01585	OTHER	New Technology - Level 48	3	3	—	—	$100,361.05	$103,465.00	$101,395.70	2025-11-01
01599	OTHER	New Technology - Level 48	3	3	—	—	$100,361.05	$103,465.00	$101,395.70	2025-11-01
22634	CPT	Arthrodesis, Combined Posterior Or Posterolateral Technique With Posterior Inter…	2	1	—	—	$101,063.00	$101,063.00	$101,063.00	2025-11-01
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	30	16	—	—	$30,166.00	$383,312.03	$101,003.99	2025-11-01
020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	3	3	—	—	$99,971.40	$103,063.30	$101,002.03	2025-11-01
Q2043	HCPCS	Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm…	21	7	—	—	$55,306.59	$228,479.50	$99,923.00	2025-11-01
359	OTHER	Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc	3	3	—	—	$96,826.49	$99,821.12	$97,824.70	2025-11-01
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	30	16	—	—	$42,361.80	$262,922.00	$97,449.00	2025-11-01
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	25	14	—	—	$30,166.00	$363,445.13	$96,739.25	2025-11-01
002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	3	3	—	—	$93,894.20	$96,798.14	$94,862.18	2025-11-01
1584	OTHER	New Technology - Level 47	12	12	—	—	$92,574.05	$161,810.18	$94,425.53	2025-11-01
1598	OTHER	New Technology - Level 47	12	12	—	—	$92,574.05	$161,810.18	$94,425.53	2025-11-01
212	OTHER	Concomitant Aortic And Mitral Valve Procedures	3	3	—	—	$92,821.83	$95,692.61	$93,778.76	2025-11-01
K1007	HCPCS	Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin…	15	14	—	—	$90,420.20	$162,933.47	$93,682.78	2025-11-01
007	OTHER	Lung Transplant	3	3	—	—	$91,164.55	$93,984.07	$92,104.39	2025-11-01
014	OTHER	Allogeneic Bone Marrow Transplant	3	3	—	—	$90,158.97	$92,947.39	$91,088.44	2025-11-01
01598	OTHER	New Technology - Level 47	3	3	—	—	$89,796.83	$92,574.05	$90,722.57	2025-11-01
01584	OTHER	New Technology - Level 47	3	3	—	—	$89,796.83	$92,574.05	$90,722.57	2025-11-01
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	26	15	—	—	$58,977.27	$250,629.00	$89,515.60	2025-11-01
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	30	16	—	—	$68,243.92	$194,466.00	$89,144.66	2025-11-01
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	3	3	—	—	$88,102.52	$90,827.34	$89,010.79	2025-11-01
231	MS_DRG	Coronary Bypass With Ptca With Mcc	30	16	—	—	$59,920.63	$297,153.97	$83,597.32	2025-11-01
1597	OTHER	New Technology - Level 46	12	12	—	—	$81,683.05	$142,773.80	$83,316.71	2025-11-01
1583	OTHER	New Technology - Level 46	12	12	—	—	$81,683.05	$142,773.80	$83,316.71	2025-11-01
447	OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	3	3	—	—	$82,252.51	$84,796.40	$83,100.47	2025-11-01
215	OTHER	Other Heart Assist System Implant	3	3	—	—	$81,418.11	$83,936.20	$82,257.48	2025-11-01
356	MS_DRG	Other Digestive System O.r. Procedures With Mcc	48	24	—	—	$30,163.27	$154,846.20	$81,301.60	2025-11-01
850	MS_DRG	Acute Leukemia With Other Procedures	26	15	—	—	$30,166.00	$305,247.38	$80,950.54	2025-11-01
323	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	48	24	—	—	$30,119.42	$152,540.85	$80,148.93	2025-11-01
01597	OTHER	New Technology - Level 46	3	3	—	—	$79,232.56	$81,683.05	$80,049.39	2025-11-01
01583	OTHER	New Technology - Level 46	3	3	—	—	$79,232.56	$81,683.05	$80,049.39	2025-11-01
474	MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	48	24	—	—	$30,166.00	$151,324.73	$79,540.87	2025-11-01
J9226	HCPCS	Histrelin Implant (supprelin La), 50 Mg	21	7	—	—	$43,855.64	$181,746.53	$79,484.85	2025-11-01
22808	CPT	Arthrodesis, Anterior, For Spinal Deformity, With Or Without Cast; 2 To 3 Verteb…	12	3	—	—	$67,500.00	$123,521.00	$79,100.00	2025-11-01
22812	CPT	Arthrodesis, Anterior, For Spinal Deformity, With Or Without Cast; 8 Or More Ver…	12	3	—	—	$67,500.00	$123,521.00	$79,100.00	2025-11-01
22810	CPT	Arthrodesis, Anterior, For Spinal Deformity, With Or Without Cast; 4 To 7 Verteb…	12	3	—	—	$67,500.00	$123,521.00	$79,100.00	2025-11-01
22800	CPT	Arthrodesis, Posterior, For Spinal Deformity, With Or Without Cast; Up To 6 Vert…	12	3	—	—	$67,500.00	$123,521.00	$79,100.00	2025-11-01
22802	CPT	Arthrodesis, Posterior, For Spinal Deformity, With Or Without Cast; 7 To 12 Vert…	12	3	—	—	$67,500.00	$123,521.00	$79,100.00	2025-11-01
22633	CPT	Arthrodesis, Combined Posterior Or Posterolateral Technique With Posterior Inter…	12	3	—	—	$67,500.00	$101,063.00	$79,100.00	2025-11-01
22804	CPT	Arthrodesis, Posterior, For Spinal Deformity, With Or Without Cast; 13 Or More V…	12	3	—	—	$67,500.00	$123,521.00	$79,100.00	2025-11-01
140	MS_DRG	Major Head And Neck Procedures With Mcc	48	24	—	—	$29,905.87	$150,351.82	$79,054.41	2025-11-01
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	30	16	—	—	$42,069.75	$194,466.00	$78,526.74	2025-11-01
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	30	16	—	—	$45,664.25	$194,466.00	$78,526.74	2025-11-01
269	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	48	24	—	—	$29,420.75	$148,867.80	$78,312.40	2025-11-01
12	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	48	24	—	—	$29,017.67	$148,614.00	$78,185.50	2025-11-01
90288	CPT	Botulism Immune Globulin, Human, For Intravenous Use	6	2	—	—	$64,621.79	$80,777.24	$78,171.52	2025-11-01
958	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Cc	48	24	—	—	$29,060.81	$148,539.98	$78,148.49	2025-11-01
673	MS_DRG	Other Kidney And Urinary Tract Procedures With Mcc	48	24	—	—	$29,630.07	$148,106.40	$77,931.70	2025-11-01
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	30	16	—	—	$49,971.58	$284,913.00	$77,867.59	2025-11-01
901	MS_DRG	Wound Debridements For Injuries With Mcc	48	24	—	—	$30,166.00	$147,930.15	$77,843.57	2025-11-01
955	OTHER	Craniotomy For Multiple Significant Trauma	3	3	—	—	$76,837.74	$79,214.16	$77,629.88	2025-11-01
229	MS_DRG	Other Cardiothoracic Procedures Without Mcc	48	24	—	—	$21,965.15	$147,431.00	$77,594.00	2025-11-01
423	MS_DRG	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	48	24	—	—	$28,760.97	$146,393.25	$77,075.12	2025-11-01
22630	CPT	Arthrodesis, Posterior Interbody Technique, Including Laminectomy And/or Discect…	12	3	—	—	$67,375.00	$83,200.00	$75,000.00	2025-11-01
22612	CPT	Arthrodesis, Posterior Or Posterolateral Technique, Single Interspace; Lumbar (w…	12	3	—	—	$67,375.00	$83,200.00	$75,000.00	2025-11-01
22558	CPT	Arthrodesis, Anterior Interbody Technique, Including Minimal Discectomy To Prepa…	12	3	—	—	$67,375.00	$83,200.00	$75,000.00	2025-11-01
22610	CPT	Arthrodesis, Posterior Or Posterolateral Technique, Single Interspace; Thoracic …	12	3	—	—	$67,375.00	$83,200.00	$75,000.00	2025-11-01
22532	CPT	Arthrodesis, Lateral Extracavitary Technique, Including Minimal Discectomy To Pr…	12	3	—	—	$67,375.00	$83,200.00	$75,000.00	2025-11-01
22533	CPT	Arthrodesis, Lateral Extracavitary Technique, Including Minimal Discectomy To Pr…	12	3	—	—	$67,375.00	$83,200.00	$75,000.00	2025-11-01
22586	CPT	Arthrodesis, Pre-sacral Interbody Technique, Including Disc Space Preparation, D…	12	3	—	—	$67,375.00	$83,200.00	$75,000.00	2025-11-01
22556	CPT	Arthrodesis, Anterior Interbody Technique, Including Minimal Discectomy To Prepa…	12	3	—	—	$67,375.00	$83,200.00	$75,000.00	2025-11-01
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	26	15	—	—	$50,199.28	$254,455.65	$74,673.01	2025-11-01
850	OTHER	Acute Leukemia With Other Procedures	3	3	—	—	$73,629.09	$75,906.28	$74,388.15	2025-11-01
802	MS_DRG	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	48	24	—	—	$25,348.92	$140,439.52	$74,098.26	2025-11-01
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	26	15	—	—	$30,166.00	$277,375.20	$73,613.90	2025-11-01
13	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc	48	24	—	—	$18,738.37	$139,280.00	$73,518.50	2025-11-01
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	48	24	—	—	$36,426.00	$147,431.00	$73,456.07	2025-11-01
267	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	30	16	—	—	$33,267.71	$200,508.00	$73,170.50	2025-11-01
24	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	48	24	—	—	$26,882.04	$137,894.48	$72,825.74	2025-11-01
1582	OTHER	New Technology - Level 45	12	12	—	—	$70,792.05	$123,737.42	$72,207.89	2025-11-01
1596	OTHER	New Technology - Level 45	12	12	—	—	$70,792.05	$123,737.42	$72,207.89	2025-11-01
34	MS_DRG	Carotid Artery Stent Procedures With Mcc	48	24	—	—	$27,497.98	$136,442.17	$72,099.59	2025-11-01
40	MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	48	24	—	—	$26,672.72	$136,107.30	$71,932.15	2025-11-01
429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	3	3	—	—	$71,066.79	$73,264.73	$71,799.44	2025-11-01
488	MS_DRG	Knee Procedures Without Principal Diagnosis Of Infection With Cc/mcc	48	24	—	—	$13,897.84	$153,961.00	$71,606.36	2025-11-01
907	MS_DRG	Other O.r. Procedures For Injuries With Mcc	48	24	—	—	$28,169.78	$135,335.33	$71,546.16	2025-11-01
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	30	16	—	—	$54,615.00	$175,743.00	$71,495.84	2025-11-01
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	26	15	—	—	$30,166.00	$268,601.48	$71,304.43	2025-11-01
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	26	15	—	—	$47,147.88	$242,445.98	$71,163.04	2025-11-01
956	MS_DRG	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	48	24	—	—	$27,029.14	$132,645.75	$70,201.38	2025-11-01
143	MS_DRG	Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc	48	24	—	—	$23,348.35	$132,067.65	$69,912.32	2025-11-01
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	30	16	—	—	$51,422.00	$202,119.00	$69,794.33	2025-11-01
166	MS_DRG	Other Respiratory System O.r. Procedures With Mcc	48	24	—	—	$27,232.79	$131,753.92	$69,755.46	2025-11-01
628	MS_DRG	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	48	24	—	—	$27,906.71	$131,369.70	$69,563.35	2025-11-01
01582	OTHER	New Technology - Level 45	3	3	—	—	$68,668.29	$70,792.05	$69,376.21	2025-11-01
01596	OTHER	New Technology - Level 45	3	3	—	—	$68,668.29	$70,792.05	$69,376.21	2025-11-01
651	MS_DRG	Kidney Transplant With Hemodialysis Without Mcc	45	24	—	—	$24,554.07	$130,629.45	$69,193.23	2025-11-01
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	30	16	—	—	$43,195.55	$250,821.00	$68,808.74	2025-11-01
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	48	24	—	—	$40,584.00	$129,567.00	$68,662.00	2025-11-01
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	48	24	—	—	$59,886.69	$129,567.00	$68,662.00	2025-11-01
458	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	48	24	—	—	$30,533.12	$129,567.00	$68,662.00	2025-11-01
010	OTHER	Pancreas Transplant	3	3	—	—	$67,934.14	$70,035.20	$68,634.50	2025-11-01
904	MS_DRG	Skin Grafts For Injuries With Cc/mcc	48	24	—	—	$27,302.80	$129,476.77	$68,616.88	2025-11-01
019	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	3	3	—	—	$67,544.96	$69,633.98	$68,241.30	2025-11-01
939	MS_DRG	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	48	24	—	—	$22,443.90	$127,904.63	$67,830.82	2025-11-01
L8702	HCPCS	Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge…	15	14	—	—	$65,429.12	$117,900.57	$67,789.96	2025-11-01
495	MS_DRG	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	48	24	—	—	$24,894.21	$127,805.93	$67,781.46	2025-11-01
332	MS_DRG	Rectal Resection With Mcc	48	24	—	—	$24,527.90	$127,629.67	$67,693.34	2025-11-01
10	MS_DRG	Pancreas Transplant	25	14	—	—	$30,166.00	$252,943.42	$67,510.57	2025-11-01
279	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures	48	24	—	—	$22,658.88	$127,125.60	$67,441.30	2025-11-01
236	MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	48	24	—	—	$29,077.07	$146,618.00	$67,131.75	2025-11-01
739	MS_DRG	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	48	24	—	—	$28,149.98	$126,293.70	$67,025.35	2025-11-01
736	MS_DRG	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	48	24	—	—	$27,843.07	$126,001.13	$66,879.07	2025-11-01
335	MS_DRG	Peritoneal Adhesiolysis With Mcc	48	24	—	—	$25,626.83	$125,874.23	$66,815.62	2025-11-01
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	26	15	—	—	$30,166.00	$251,494.65	$66,801.49	2025-11-01
408	MS_DRG	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	48	24	—	—	$24,758.43	$125,687.40	$66,722.20	2025-11-01
414	MS_DRG	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	48	24	—	—	$24,776.12	$125,581.65	$66,669.32	2025-11-01
622	MS_DRG	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	48	24	—	—	$26,476.13	$125,461.80	$66,609.40	2025-11-01
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	26	15	—	—	$45,737.09	$226,823.18	$66,597.10	2025-11-01
5244	OTHER	Level 4 Blood Product Exch	12	12	—	—	$64,411.91	$112,585.58	$65,700.15	2025-11-01
616	MS_DRG	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	48	24	—	—	$27,331.08	$122,930.85	$65,343.93	2025-11-01
94	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System With Mcc	48	24	—	—	$23,229.00	$124,058.85	$65,195.43	2025-11-01
574	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Cc	48	24	—	—	$24,501.02	$122,366.85	$65,061.93	2025-11-01
477	MS_DRG	Biopsies Of Musculoskeletal System And Connective Tissue With Mcc	48	24	—	—	$24,317.87	$121,774.65	$64,765.82	2025-11-01
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	26	15	—	—	$23,229.00	$243,640.95	$64,734.21	2025-11-01
359	MS_DRG	Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc	45	21	—	—	$30,166.00	$121,210.65	$64,483.82	2025-11-01
987	MS_DRG	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	48	24	—	—	$24,771.87	$120,851.10	$64,304.05	2025-11-01
29	MS_DRG	Spinal Procedures With Cc Or Spinal Neurostimulators	48	24	—	—	$23,735.88	$120,258.90	$64,007.95	2025-11-01
420	MS_DRG	Hepatobiliary Diagnostic Procedures With Mcc	48	24	—	—	$24,957.15	$120,100.27	$63,928.64	2025-11-01
717	OTHER	Instill Adstiladrin, Tx Do	15	14	—	—	$14,597.02	$110,715.97	$63,658.99	2025-11-01
05244	OTHER	Level 4 Blood Product Exch	3	3	—	—	$62,479.55	$64,411.91	$63,123.67	2025-11-01
955	MS_DRG	Craniotomy For Multiple Significant Trauma	26	15	—	—	$30,166.00	$237,271.27	$63,057.55	2025-11-01
264	MS_DRG	Other Circulatory System O.r. Procedures	48	24	—	—	$24,714.59	$117,756.15	$62,756.57	2025-11-01
317	MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	26	15	—	—	$30,166.00	$235,699.13	$62,643.71	2025-11-01
411	MS_DRG	Cholecystectomy With C.d.e. With Mcc	48	24	—	—	$19,350.77	$116,441.33	$62,099.17	2025-11-01
00717	OTHER	Instill Adstiladrin, Tx Do	3	3	—	—	$61,442.01	$63,342.28	$62,075.43	2025-11-01
37	MS_DRG	Extracranial Procedures With Mcc	48	24	—	—	$23,482.71	$116,046.52	$61,901.76	2025-11-01
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	30	16	—	—	$37,453.40	$175,743.00	$61,533.21	2025-11-01
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	26	15	—	—	$38,682.44	$250,629.00	$61,512.02	2025-11-01
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	26	15	—	—	$30,166.00	$230,936.85	$61,390.18	2025-11-01
1595	OTHER	New Technology - Level 44	12	12	—	—	$59,901.04	$104,701.03	$61,099.06	2025-11-01
1581	OTHER	New Technology - Level 44	12	12	—	—	$59,901.04	$104,701.03	$61,099.06	2025-11-01
579	MS_DRG	Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc	48	24	—	—	$23,047.10	$114,157.13	$60,957.07	2025-11-01
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	3	3	—	—	$60,238.78	$62,101.83	$60,859.79	2025-11-01
485	MS_DRG	Knee Procedures With Principal Diagnosis Of Infection With Mcc	48	24	—	—	$22,796.06	$113,755.28	$60,756.14	2025-11-01
325	MS_DRG	Coronary Intravascular Lithotripsy Without Intraluminal Device	48	24	—	—	$20,238.97	$113,166.60	$60,461.80	2025-11-01
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	48	24	—	—	$47,409.53	$112,684.00	$60,220.50	2025-11-01
450	MS_DRG	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically	48	24	—	—	$36,416.70	$112,684.00	$60,220.50	2025-11-01
840	MS_DRG	Lymphoma And Non-acute Leukemia With Mcc	48	24	—	—	$22,554.21	$114,030.23	$60,181.11	2025-11-01
489	MS_DRG	Knee Procedures Without Principal Diagnosis Of Infection Without Cc/mcc	48	24	—	—	$8,758.90	$153,961.00	$60,113.10	2025-11-01
656	MS_DRG	Kidney And Ureter Procedures For Neoplasm With Mcc	48	24	—	—	$23,037.20	$112,228.95	$59,992.97	2025-11-01
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	48	24	—	—	$36,297.19	$112,209.00	$59,983.00	2025-11-01
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	26	15	—	—	$38,930.66	$250,629.00	$59,972.07	2025-11-01
22	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	48	24	—	—	$24,965.63	$112,003.35	$59,880.18	2025-11-01
500	MS_DRG	Soft Tissue Procedures With Mcc	48	24	—	—	$22,406.42	$111,559.20	$59,658.10	2025-11-01
829	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…	48	24	—	—	$21,806.03	$111,390.00	$59,573.50	2025-11-01
324	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc	48	24	—	—	$22,593.81	$111,072.75	$59,414.88	2025-11-01
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	3	3	—	—	$58,391.89	$60,197.82	$58,993.86	2025-11-01
665	MS_DRG	Prostatectomy With Mcc	48	24	—	—	$24,279.68	$110,022.30	$58,889.65	2025-11-01
464	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective	48	24	—	—	$20,851.37	$109,793.18	$58,775.09	2025-11-01
01595	OTHER	New Technology - Level 44	3	3	—	—	$58,104.01	$59,901.04	$58,703.02	2025-11-01
01581	OTHER	New Technology - Level 44	3	3	—	—	$58,104.01	$59,901.04	$58,703.02	2025-11-01
26	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Cc	48	24	—	—	$21,627.83	$109,599.30	$58,678.15	2025-11-01
1643	OTHER	Y90 Ibritumomab, Rx	12	12	—	—	$56,824.55	$99,323.63	$57,961.04	2025-11-01
662	MS_DRG	Minor Bladder Procedures With Mcc	48	24	—	—	$22,059.20	$107,917.88	$57,837.44	2025-11-01
263	MS_DRG	Vein Ligation And Stripping	48	24	—	—	$18,965.37	$107,773.35	$57,765.18	2025-11-01
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	30	16	—	—	$32,474.98	$175,743.00	$57,595.00	2025-11-01
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	26	15	—	—	$30,166.00	$215,775.82	$57,399.42	2025-11-01
625	MS_DRG	Thyroid, Parathyroid And Thyroglossal Procedures With Mcc	48	24	—	—	$20,273.62	$106,458.52	$57,107.76	2025-11-01
498	MS_DRG	Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…	48	24	—	—	$17,853.71	$106,342.20	$57,049.60	2025-11-01
405	MS_DRG	Pancreas, Liver And Shunt Procedures With Mcc	26	15	—	—	$38,387.56	$192,835.13	$56,663.68	2025-11-01
11	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	26	15	—	—	$38,155.61	$192,257.03	$56,494.72	2025-11-01
9273	OTHER	Sipuleucel-t Auto Cd54+	12	12	—	—	$55,272.32	$96,610.49	$56,377.77	2025-11-01
28	MS_DRG	Spinal Procedures With Mcc	26	15	—	—	$30,166.00	$211,792.58	$56,350.93	2025-11-01
173	MS_DRG	Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…	48	24	—	—	$21,698.55	$104,918.10	$56,337.55	2025-11-01
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	30	16	—	—	$34,555.00	$211,732.65	$56,335.14	2025-11-01
0715T	CPT	Percutaneous Transluminal Coronary Lithotripsy (list Separately In Addition To C…	2	1	—	—	$52,033.00	$59,838.00	$55,935.50	2025-11-01
93592	CPT	Percutaneous Transcatheter Closure Of Paravalvular Leak; Each Additional Occlusi…	2	1	—	—	$52,033.00	$59,838.00	$55,935.50	2025-11-01
92973	CPT	Percutaneous Transluminal Coronary Thrombectomy Mechanical (List Separately In A…	2	1	—	—	$52,033.00	$59,838.00	$55,935.50	2025-11-01
92974	CPT	Transcatheter Placement Of Radiation Delivery Device For Subsequent Coronary Int…	2	1	—	—	$52,033.00	$59,838.00	$55,935.50	2025-11-01
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	25	14	—	—	$23,229.00	$209,021.93	$55,892.94	2025-11-01
448	MS_DRG	Multiple Level Spinal Fusion Except Cervical Without Mcc	48	24	—	—	$28,874.82	$104,000.00	$55,878.50	2025-11-01
451	MS_DRG	Single Level Spinal Fusion Except Cervical Without Mcc	48	24	—	—	$21,821.60	$104,000.00	$55,878.50	2025-11-01
959	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc	48	24	—	—	$18,695.23	$103,779.53	$55,768.26	2025-11-01
570	MS_DRG	Skin Debridement With Mcc	48	24	—	—	$21,288.40	$103,673.78	$55,715.39	2025-11-01
01643	OTHER	Y90 Ibritumomab, Rx	3	3	—	—	$55,119.81	$56,824.55	$55,688.06	2025-11-01
317	OTHER	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	3	3	—	—	$54,936.08	$56,635.13	$55,502.43	2025-11-01
668	MS_DRG	Transurethral Procedures With Mcc	48	24	—	—	$20,621.54	$102,930.00	$55,343.50	2025-11-01
956	OTHER	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	3	3	—	—	$54,546.13	$56,233.12	$55,108.46	2025-11-01
353	MS_DRG	Hernia Procedures Except Inguinal And Femoral With Mcc	48	24	—	—	$20,739.63	$102,295.50	$55,026.25	2025-11-01
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	26	15	—	—	$30,166.00	$206,734.20	$55,019.43	2025-11-01
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	3	3	—	—	$54,447.11	$56,131.04	$55,008.42	2025-11-01
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	3	3	—	—	$53,886.74	$55,553.34	$54,442.27	2025-11-01
213	MS_DRG	Endovascular Abdominal Aorta With Iliac Branch Procedures	23	12	—	—	$30,166.00	$201,168.23	$54,338.04	2025-11-01
09273	OTHER	Sipuleucel-t Auto Cd54+	3	3	—	—	$53,614.15	$55,272.32	$54,166.87	2025-11-01
240	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc	48	24	—	—	$20,592.55	$100,480.13	$54,118.57	2025-11-01
974	MS_DRG	HIV With Major Related Condition With Mcc	48	24	—	—	$21,115.85	$101,731.50	$54,031.75	2025-11-01
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	26	15	—	—	$30,166.00	$201,993.07	$53,771.45	2025-11-01
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective	26	15	—	—	$30,166.00	$200,907.37	$53,485.67	2025-11-01
800	MS_DRG	Splenic Procedures With Cc	48	24	—	—	$20,603.86	$99,031.35	$53,394.18	2025-11-01
360	OTHER	Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc	3	3	—	—	$52,709.98	$54,340.19	$53,253.39	2025-11-01
654	MS_DRG	Major Bladder Procedures With Cc	48	24	—	—	$19,955.40	$98,675.32	$53,216.16	2025-11-01
277	MS_DRG	Cardiac Defibrillator Implant Without Mcc	30	16	—	—	$32,898.57	$228,130.00	$53,116.68	2025-11-01
503	MS_DRG	Foot Procedures With Mcc	48	24	—	—	$18,715.03	$98,386.28	$53,071.64	2025-11-01
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	3	3	—	—	$52,471.26	$54,094.08	$53,012.20	2025-11-01
8	MS_DRG	Simultaneous Pancreas And Kidney Transplant	25	14	—	—	$30,166.00	$197,562.15	$52,861.73	2025-11-01
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	3	3	—	—	$52,287.80	$53,904.95	$52,826.85	2025-11-01
232	OTHER	Coronary Bypass With Ptca Without Mcc	3	3	—	—	$52,049.83	$53,659.62	$52,586.43	2025-11-01
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	26	15	—	—	$43,396.39	$194,685.75	$52,576.37	2025-11-01
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures	26	15	—	—	$30,166.00	$196,208.55	$52,248.82	2025-11-01
27	MS_DRG	Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc	48	24	—	—	$17,449.92	$105,973.00	$52,189.50	2025-11-01
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	3	3	—	—	$51,622.27	$53,218.84	$52,154.46	2025-11-01
017	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	3	3	—	—	$51,428.83	$53,019.41	$51,959.02	2025-11-01
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	30	16	—	—	$37,620.29	$180,249.00	$51,788.85	2025-11-01
61	MS_DRG	Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…	48	24	—	—	$19,116.00	$97,187.77	$51,759.89	2025-11-01
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	3	3	—	—	$51,196.24	$52,779.63	$51,724.04	2025-11-01
834	MS_DRG	Acute Leukemia With Mcc	26	15	—	—	$23,229.00	$193,518.97	$51,540.85	2025-11-01
006	OTHER	Liver Transplant Without Mcc	3	3	—	—	$50,898.41	$52,472.59	$51,423.14	2025-11-01
255	MS_DRG	Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc	48	24	—	—	$18,501.47	$95,083.35	$51,420.18	2025-11-01
904	OTHER	Skin Grafts For Injuries With Cc/mcc	3	3	—	—	$50,871.54	$52,444.89	$51,395.99	2025-11-01
963	MS_DRG	Other Multiple Significant Trauma With Mcc	48	24	—	—	$19,210.76	$96,366.45	$51,349.22	2025-11-01
228	MS_DRG	Other Cardiothoracic Procedures With Mcc	26	15	—	—	$35,237.15	$174,395.85	$51,274.59	2025-11-01
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	25	14	—	—	$23,229.00	$191,488.57	$51,255.21	2025-11-01
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	3	3	—	—	$50,691.15	$52,258.92	$51,213.74	2025-11-01
011	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	3	3	—	—	$50,584.45	$52,148.92	$51,105.94	2025-11-01
849	MS_DRG	Radiotherapy	48	24	—	—	$18,887.58	$95,509.88	$50,920.94	2025-11-01

See an error in this hospital's data? Submit a correction