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

RIVERVIEW MEDICAL CENTER

Red Bank, NJ · CCN 310034 · Rates published

101,014 distinct procedures filed
43 distinct payers
6,449,713 rate rows
2026-07-31 last MRF observed
Data quality

5,482,574 of 6,449,713 rate rows are consumer-grade (85.0%)

967,139 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 941,862
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 6,168
exceeds 10× this hospital's gross charge — excluded from medians 5,616
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 5,317
per-diem day rate — not a per-procedure price 3,050
placeholder amount (≤ $0.02) — excluded from medians 2,729
percent-of-charges filed in the dollar field — excluded from medians 1,673
template filing: same amount across many unrelated codes — excluded 722
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.hackensackmeridianhealth.org/-/media/project/hmh/hmh/public/files/cdm/20250101/rmc/221487576-1760599336_hackensack-meridian-health_standardcharges.csv
Found on page https://www.hackensackmeridianhealth.org/en/pay-bill/price-transparency
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-08-14
Content fingerprint 1032be7859c0f246… · 1,638,285,915 bytes · first seen 2026-07-31

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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 5 $4,377,500.00 $4,771,475.00 $4,377,500.00 nat. median
$4,505,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 6 $3,710,000.00 $4,452,000.00 $3,710,000.00 nat. median
$3,710,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 11 $3,685,266.67 $4,422,320.00 $3,710,000.00 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 11 $3,324,571.90 $3,989,486.28 $3,327,159.88 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 11 $3,261,355.00 $3,913,626.00 $3,286,000.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 11 $2,950,686.67 $3,540,824.00 $2,968,000.00 nat. median
$2,997,086
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 11 $2,354,513.02 $2,942,538.72 $2,452,115.60 nat. median
$2,460,273
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 6 $2,332,000.00 $2,798,400.00 $2,332,000.00 nat. median
$2,405,851
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 7 $655,027.00 $924,744.00 $770,620.00 nat. median
$809,151
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 16 $491,575.89 $922,082.02 $578,324.58 nat. median
$691,418
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 13 $470,372.01 $664,054.60 $553,378.83 nat. median
$631,793
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 16 $460,390.31 $933,986.41 $541,635.66 nat. median
$624,417
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 16 $460,071.38 $954,928.83 $541,260.45 nat. median
$610,161
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 16 $453,115.01 $884,589.61 $533,076.48 nat. median
$588,565
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 16 $416,262.00 $878,671.10 $489,720.00 nat. median
$577,541
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 24 $13,307.00 $1,138,247.73 $299,704.70 nat. median
$370,165
0.8× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 6 $270,375.00 $324,450.00 $270,375.00 nat. median
$302,242
0.9× median
'583-4
OTHER 		Neonate W Ecmo 2 $263,700.81 $263,700.81 $263,700.81 nat. median
$221,551
1.2× median
5834
APR_DRG 		Neonate W Ecmo 1 $263,700.81 $263,700.81 $263,700.81 nat. median
$311,018
0.8× median
'588-4
OTHER 		Neonate Bwt <1500g W Major Procedure 2 $252,297.48 $252,297.48 $252,297.48 nat. median
$202,324
1.2× median
5884
APR_DRG 		Neonate Bwt <1500g W Major Procedure 1 $252,297.48 $252,297.48 $252,297.48 nat. median
$254,667
1.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 28 $14,547.00 $1,064,846.24 $244,734.99 nat. median
$261,939
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 30 $14,547.00 $920,920.26 $224,848.46 nat. median
$205,166
1.1× median
'002-4
OTHER 		Heart &/or Lung Transplant 2 $217,484.20 $217,484.20 $217,484.20 nat. median
$205,014
1.1× median
24
APR_DRG 		Heart &/or Lung Transplant 1 $217,484.20 $217,484.20 $217,484.20 nat. median
$243,231
0.9× median
5914
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 1 $211,881.29 $211,881.29 $211,881.29 nat. median
$168,361
1.3× median
'591-4
OTHER 		Neonate Birthwt 500-749g Without Major Procedure 2 $211,881.29 $211,881.29 $211,881.29 nat. median
$119,104
1.8× median
'161-4
OTHER 		Cardiac Defibrillator & Heart Assist Implant 2 $206,769.43 $206,769.43 $206,769.43 nat. median
$182,608
1.1× median
1614
APR_DRG 		Cardiac Defibrillator & Heart Assist Implant 1 $206,769.43 $206,769.43 $206,769.43 nat. median
$209,486
1.0× median
8414
APR_DRG 		Extensive 3rd Degree Burns W Skin Graft 1 $200,628.89 $200,628.89 $200,628.89 nat. median
$165,646
1.2× median
'841-4
OTHER 		Extensive 3rd Degree Burns W Skin Graft 2 $200,628.89 $200,628.89 $200,628.89 nat. median
$138,284
1.5× median
34
APR_DRG 		Bone Marrow Transplant 1 $193,574.88 $193,574.88 $193,574.88 nat. median
$241,408
0.8× median
'003-4
OTHER 		Bone Marrow Transplant 2 $193,574.88 $193,574.88 $193,574.88 nat. median
$193,377
1.0× median
5883
APR_DRG 		Neonate Bwt <1500g W Major Procedure 1 $188,495.69 $188,495.69 $188,495.69 nat. median
$180,995
1.0× median
'588-3
OTHER 		Neonate Bwt <1500g W Major Procedure 2 $188,495.69 $188,495.69 $188,495.69 nat. median
$131,074
1.4× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 30 $14,547.00 $810,178.77 $188,274.05 nat. median
$199,832
0.9× median
'583-3
OTHER 		Neonate W Ecmo 2 $176,349.22 $176,349.22 $176,349.22 nat. median
$195,630
0.9× median
5833
APR_DRG 		Neonate W Ecmo 1 $176,349.22 $176,349.22 $176,349.22 nat. median
$250,089
0.7× median
5934
APR_DRG 		Neonate Birthwt 750-999g Without Major Procedure 1 $174,064.66 $174,064.66 $174,064.66 nat. median
$156,285
1.1× median
'593-4
OTHER 		Neonate Birthwt 750-999g Without Major Procedure 2 $174,064.66 $174,064.66 $174,064.66 nat. median
$115,906
1.5× median
14
APR_DRG 		Liver Transplant &/or Intestinal Transplant 1 $162,740.13 $162,740.13 $162,740.13 nat. median
$137,901
1.2× median
'001-4
OTHER 		Liver Transplant &/or Intestinal Transplant 2 $162,740.13 $162,740.13 $162,740.13 nat. median
$107,546
1.5× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 3 $130,249.99 $270,421.41 $159,873.55 nat. median
$111,503
1.4× median
5913
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 1 $150,089.36 $150,089.36 $150,089.36 nat. median
$108,751
1.4× median
'591-3
OTHER 		Neonate Birthwt 500-749g Without Major Procedure 2 $150,089.36 $150,089.36 $150,089.36 nat. median
$84,666
1.8× median
64
APR_DRG 		Pancreas Transplant 1 $149,325.21 $149,325.21 $149,325.21 nat. median
$92,994
1.6× median
'006-4
OTHER 		Pancreas Transplant 2 $149,325.21 $149,325.21 $149,325.21 nat. median
$56,683
outlier · 2.6×
'004-4
OTHER 		Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 2 $148,223.13 $148,223.13 $148,223.13 nat. median
$101,809
1.5× median
44
APR_DRG 		Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 1 $148,223.13 $148,223.13 $148,223.13 nat. median
$127,600
1.2× median
6094
APR_DRG 		Neonate Bwt 1500-2499g W Major Procedure 1 $146,310.46 $146,310.46 $146,310.46 nat. median
$168,174
0.9× median

Other procedures at this hospital

Browse this hospital's 101,014 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
             
131 MS_DRG Cranial/facial Procedures W Cc/mcc 6 3 — — $49,845.00 $82,752.54 $56,951.00 2024-12-31
D0406 HCPCS Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 12 6 — — $55,417.33 $64,842.94 $57,182.73 2025-12-31
B0205 HCPCS Traumatic Brain Injury M <35.50 12 6 — — $54,771.73 $69,290.56 $57,236.46 2025-12-31
2214 APR_DRG Major Small & Large Bowel Procedures 2 1 — — $57,372.14 $57,372.14 $57,372.14 2025-12-31
'221-4 OTHER Major Small & Large Bowel Procedures 2 2 — — $57,372.14 $57,372.14 $57,372.14 2024-12-31
Sx00000189430 CDM Implant Gamma Tile 9 Count 34 17 $116,560.00 — $20,980.80 $99,076.00 $57,405.80 2024-12-31
C0404 HCPCS Traumatic Spinal Cord Injury M <31.50 And A <61.50 12 6 — — $56,260.13 $65,093.97 $57,718.24 2025-12-31
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 38 13 — $56,879.19 $14,547.00 $253,457.77 $57,722.96 2025-12-31
'361-4 OTHER Skin Graft For Skin & Subcutaneous Tissue Diagnoses 2 2 — — $57,798.17 $57,798.17 $57,798.17 2024-12-31
3614 APR_DRG Skin Graft For Skin & Subcutaneous Tissue Diagnoses 2 1 — — $57,798.17 $57,798.17 $57,798.17 2025-12-31
'003-1 OTHER Bone Marrow Transplant 2 2 — — $57,800.22 $57,800.22 $57,800.22 2024-12-31
31 APR_DRG Bone Marrow Transplant 2 1 — — $57,800.22 $57,800.22 $57,800.22 2025-12-31
E0194NU OTHER Air Fluidized Bed 3 2 — — $51,609.55 $57,835.69 $57,835.69 2025-12-31
459 MS_DRG Spinal Fusion Except Cervical With Mcc 34 18 — $56,264.98 $48,465.66 $231,719.29 $57,853.80 2025-12-31
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 86 30 — $52,060.57 $14,547.00 $238,224.75 $58,164.61 2025-12-31
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 34 17 — $55,945.97 $47,554.07 $112,575.34 $58,515.85 2025-12-31
914 APR_DRG Other Major Head & Neck Procedures 2 1 — — $58,781.28 $58,781.28 $58,781.28 2025-12-31
'091-4 OTHER Other Major Head & Neck Procedures 2 2 — — $58,781.28 $58,781.28 $58,781.28 2024-12-31
C0406 HCPCS Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 12 6 — — $57,088.40 $66,762.46 $58,890.78 2025-12-31
'440-3 OTHER Kidney Transplant 2 2 — — $59,027.41 $59,027.41 $59,027.41 2024-12-31
4403 APR_DRG Kidney Transplant 2 1 — — $59,027.41 $59,027.41 $59,027.41 2025-12-31
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 88 30 — $56,564.45 $14,547.00 $252,055.28 $59,388.64 2025-12-31
Sx00000076504 CDM Ligasure Kit Lf1744/gen 31 16 $79,401.17 — $11,195.56 $74,637.10 $59,550.88 2024-12-31
C1806 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 12 6 — — $56,986.68 $76,177.52 $59,551.08 2025-12-31
955 MS_DRG Craniotomy For Multiple Significant Trauma 86 30 — $57,927.75 $14,547.00 $258,130.22 $59,865.73 2025-12-31
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 86 30 — $53,652.07 $14,547.00 $240,114.89 $59,942.71 2025-12-31
'006-1 OTHER Pancreas Transplant 2 2 — — $60,029.49 $60,029.49 $60,029.49 2024-12-31
61 APR_DRG Pancreas Transplant 2 1 — — $60,029.49 $60,029.49 $60,029.49 2025-12-31
1814 APR_DRG Lower Extremity Arterial Procedures 2 1 — — $60,202.85 $60,202.85 $60,202.85 2025-12-31
'181-4 OTHER Lower Extremity Arterial Procedures 2 2 — — $60,202.85 $60,202.85 $60,202.85 2024-12-31
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 86 30 — $54,864.36 $13,307.00 $244,479.56 $60,258.74 2025-12-31
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 78 28 — $50,432.59 $13,307.00 $224,731.27 $60,313.99 2025-12-31
128788 CDM Cadaver Kidney/pancreas Acquis 32 16 $80,453.00 — $11,343.87 $75,625.82 $60,339.75 2024-12-31
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 86 30 — $56,660.31 $14,547.00 $252,482.46 $60,360.79 2025-12-31
C1904 HCPCS Guillain-barr? M <38.50 12 6 — — $58,383.74 $76,879.91 $61,011.01 2025-12-31
'483-4 OTHER Testes & Scrotal Procedures 2 2 — — $61,065.84 $61,065.84 $61,065.84 2024-12-31
4834 APR_DRG Testes & Scrotal Procedures 2 1 — — $61,065.84 $61,065.84 $61,065.84 2025-12-31
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 38 13 — $60,255.61 $14,547.00 $268,503.37 $61,149.47 2025-12-31
C1605 HCPCS System Leadless Pacemaker Aveir Dr 66 15 $118,965.00 — $21,413.70 $101,120.25 $61,266.98 2025-12-31
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 86 30 — $59,015.33 $13,307.00 $262,976.57 $61,307.25 2025-12-31
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 58 25 — $59,952.75 $14,547.00 $267,153.80 $61,373.54 2025-12-31
'403-4 OTHER Procedures For Obesity 2 2 — — $61,677.07 $61,677.07 $61,677.07 2024-12-31
4034 APR_DRG Procedures For Obesity 2 1 — — $61,677.07 $61,677.07 $61,677.07 2025-12-31
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 17 7 — — $54,906.00 $256,191.60 $61,741.15 2025-12-31
Sx00000076504-72659 CDM Ligasure Kit Lf1744/gen 60 14 $79,401.17 — $11,195.56 $77,773.45 $62,405.35 2025-12-31
4414 APR_DRG Major Bladder Procedures 2 1 — — $62,422.19 $62,422.19 $62,422.19 2025-12-31
'441-4 OTHER Major Bladder Procedures 2 2 — — $62,422.19 $62,422.19 $62,422.19 2024-12-31
B0106 HCPCS Stroke M <41.50 And A <84.50 12 6 — — $60,332.98 $73,591.11 $63,047.96 2025-12-31
8010000023-108081 CDM Cadaver Kidney/pancreas Acquis 62 14 $80,453.00 — $11,343.87 $78,803.71 $63,469.37 2025-12-31
J9029 HCPCS Instill Adstiladrin, Tx Dose 24 12 — $63,431.05 $53,916.39 $76,117.26 $63,499.33 2025-12-31
'024-4 OTHER Extracranial Vascular Procedures 2 2 — — $63,665.98 $63,665.98 $63,665.98 2024-12-31
244 APR_DRG Extracranial Vascular Procedures 2 1 — — $63,665.98 $63,665.98 $63,665.98 2025-12-31
'220-4 OTHER Major Stomach, Esophageal & Duodenal Procedures 2 2 — — $64,483.36 $64,483.36 $64,483.36 2024-12-31
2204 APR_DRG Major Stomach, Esophageal & Duodenal Procedures 2 1 — — $64,483.36 $64,483.36 $64,483.36 2025-12-31
'162-3 OTHER Cardiac Valve Procedures W Ami Or Complex Pdx 2 2 — — $65,316.51 $65,316.51 $65,316.51 2024-12-31
1623 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 2 1 — — $65,316.51 $65,316.51 $65,316.51 2025-12-31
Sx00000075430 CDM Ligasure Kit 31 16 $87,094.62 — $12,280.34 $81,868.94 $65,320.96 2024-12-31
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs 2 1 — — $65,389.67 $65,389.67 $65,389.67 2025-12-31
'510-4 OTHER Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs 2 2 — — $65,389.67 $65,389.67 $65,389.67 2024-12-31
L7181 HCPCS Electronic Elbo Simultaneous 7 5 — — $37,355.19 $120,305.46 $65,394.88 2025-12-31
B0505 HCPCS Non-traumatic Spinal Cord Injury M <39.50 12 6 — — $62,614.35 $76,400.66 $65,431.99 2025-12-31
'695-4 OTHER Chemotherapy For Acute Leukemia 2 2 — — $65,438.74 $65,438.74 $65,438.74 2024-12-31
6954 APR_DRG Chemotherapy For Acute Leukemia 2 1 — — $65,438.74 $65,438.74 $65,438.74 2025-12-31
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 86 30 — $63,322.39 $14,547.00 $282,169.15 $65,440.85 2025-12-31
'089-4 OTHER Major Cranial/facial Bone Procedures 2 2 — — $65,617.60 $65,617.60 $65,617.60 2024-12-31
894 APR_DRG Major Cranial/facial Bone Procedures 2 1 — — $65,617.60 $65,617.60 $65,617.60 2025-12-31
'022-4 OTHER Ventricular Shunt Procedures 2 2 — — $65,639.90 $65,639.90 $65,639.90 2024-12-31
224 APR_DRG Ventricular Shunt Procedures 2 1 — — $65,639.90 $65,639.90 $65,639.90 2025-12-31
'950-4 OTHER Extensive Procedure Unrelated To Principal Diagnosis 2 2 — — $65,683.46 $65,683.46 $65,683.46 2024-12-31
9504 APR_DRG Extensive Procedure Unrelated To Principal Diagnosis 2 1 — — $65,683.46 $65,683.46 $65,683.46 2025-12-31
128782 CDM Live Donor Kidney Acquisition 32 16 $88,000.00 — $12,408.00 $82,720.00 $66,000.00 2024-12-31
B0404 HCPCS Traumatic Spinal Cord Injury M <31.50 And A <61.50 12 6 — — $63,264.10 $82,620.74 $66,110.99 2025-12-31
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 66 27 — $67,251.09 $14,547.00 $299,675.72 $66,151.17 2025-12-31
1694 APR_DRG Major Abdominal Vascular Procedures 2 1 — — $66,523.20 $66,523.20 $66,523.20 2025-12-31
'169-4 OTHER Major Abdominal Vascular Procedures 2 2 — — $66,523.20 $66,523.20 $66,523.20 2024-12-31
204 APR_DRG Craniotomy For Trauma 2 1 — — $67,081.58 $67,081.58 $67,081.58 2025-12-31
'020-4 OTHER Craniotomy For Trauma 2 2 — — $67,081.58 $67,081.58 $67,081.58 2024-12-31
B0406 HCPCS Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 12 6 — — $64,196.16 $84,740.59 $67,084.99 2025-12-31
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 89 30 — $65,640.93 $14,547.00 $292,500.71 $67,265.08 2025-12-31
'260-4 OTHER Major Pancreas, Liver & Shunt Procedures 2 2 — — $67,604.46 $67,604.46 $67,604.46 2024-12-31
2604 APR_DRG Major Pancreas, Liver & Shunt Procedures 2 1 — — $67,604.46 $67,604.46 $67,604.46 2025-12-31
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 89 30 — $66,310.27 $14,547.00 $295,483.37 $68,036.19 2025-12-31
6083 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 2 1 — — $68,126.13 $68,126.13 $68,126.13 2025-12-31
'608-3 OTHER Neonate Bwt 1250-1499g W Or Without Other Significant Condition 2 2 — — $68,126.13 $68,126.13 $68,126.13 2024-12-31
C1827 HCPCS Generator Neurostimulator Vagal Nerve Stimulator Permanent Pulse 100 32 $136,290.00 — $24,532.20 $115,846.50 $68,145.00 2025-12-31
53 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 2 1 — — $68,179.05 $68,179.05 $68,179.05 2025-12-31
'005-3 OTHER Tracheostomy W Mv 96+ Hours Without Extensive Procedure 2 2 — — $68,179.05 $68,179.05 $68,179.05 2024-12-31
'166-4 OTHER Coronary Bypass Without Ami Or Complex Pdx 2 2 — — $68,426.46 $68,426.46 $68,426.46 2024-12-31
1664 APR_DRG Coronary Bypass Without Ami Or Complex Pdx 2 1 — — $68,426.46 $68,426.46 $68,426.46 2025-12-31
3214 APR_DRG Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp 2 1 — — $68,449.71 $68,449.71 $68,449.71 2025-12-31
'321-4 OTHER Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp 2 2 — — $68,449.71 $68,449.71 $68,449.71 2024-12-31
Sx00000075430-72848 CDM Ligasure Kit 60 14 $87,094.62 — $12,280.34 $85,309.18 $68,452.02 2025-12-31
10 MS_DRG Pancreas Transplant 78 27 — $67,638.79 $14,547.00 $240,641.09 $68,642.16 2025-12-31
6814 APR_DRG Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 2 1 — — $69,072.03 $69,072.03 $69,072.03 2025-12-31
'681-4 OTHER Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 2 2 — — $69,072.03 $69,072.03 $69,072.03 2024-12-31
8010000020-108084 CDM Live Donor Kidney Acquisition 62 14 $88,000.00 — $12,408.00 $86,196.00 $69,423.20 2025-12-31
128784 CDM Cadaver Donor Kidney Acquisit 32 16 $93,500.00 — $13,183.50 $87,890.00 $70,125.00 2024-12-31
'004-2 OTHER Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 2 2 — — $71,018.46 $71,018.46 $71,018.46 2024-12-31
42 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 2 1 — — $71,018.46 $71,018.46 $71,018.46 2025-12-31
6214 APR_DRG Neonate Bwt 2000-2499g W Major Anomaly 2 1 — — $71,101.74 $71,101.74 $71,101.74 2025-12-31
'621-4 OTHER Neonate Bwt 2000-2499g W Major Anomaly 2 2 — — $71,101.74 $71,101.74 $71,101.74 2024-12-31
A0407 HCPCS Traumatic Spinal Cord Injury M <24.50 And A >=61.50 12 6 — — $68,841.95 $81,106.93 $71,287.76 2025-12-31
32 APR_DRG Bone Marrow Transplant 2 1 — — $71,432.12 $71,432.12 $71,432.12 2025-12-31
'003-2 OTHER Bone Marrow Transplant 2 2 — — $71,432.12 $71,432.12 $71,432.12 2024-12-31
'023-4 OTHER Spinal Procedures 2 2 — — $71,718.22 $71,718.22 $71,718.22 2024-12-31
234 APR_DRG Spinal Procedures 2 1 — — $71,718.22 $71,718.22 $71,718.22 2025-12-31
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 38 13 — $70,757.31 $14,547.00 $315,299.70 $71,806.95 2025-12-31
'401-4 OTHER Pituitary & Adrenal Procedures 2 2 — — $72,817.49 $72,817.49 $72,817.49 2024-12-31
4014 APR_DRG Pituitary & Adrenal Procedures 2 1 — — $72,817.49 $72,817.49 $72,817.49 2025-12-31
'602-2 OTHER Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 2 2 — — $72,941.45 $72,941.45 $72,941.45 2024-12-31
6022 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 2 1 — — $72,941.45 $72,941.45 $72,941.45 2025-12-31
'680-4 OTHER Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 2 2 — — $73,073.87 $73,073.87 $73,073.87 2024-12-31
6804 APR_DRG Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 2 1 — — $73,073.87 $73,073.87 $73,073.87 2025-12-31
5893 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 2 1 — — $73,197.70 $73,197.70 $73,197.70 2025-12-31
'589-3 OTHER Neonate Bwt <500g Or Ga <24 Weeks 2 2 — — $73,197.70 $73,197.70 $73,197.70 2024-12-31
'912-4 OTHER Musculoskeletal & Other Procedures For Multiple Significant Trauma 2 2 — — $73,375.09 $73,375.09 $73,375.09 2024-12-31
9124 APR_DRG Musculoskeletal & Other Procedures For Multiple Significant Trauma 2 1 — — $73,375.09 $73,375.09 $73,375.09 2025-12-31
231 MS_DRG Coronary Bypass With Ptca With Mcc 89 30 — $71,888.16 $14,547.00 $320,338.84 $73,623.88 2025-12-31
11 APR_DRG Liver Transplant &/or Intestinal Transplant 2 1 — — $73,702.97 $73,702.97 $73,702.97 2025-12-31
'001-1 OTHER Liver Transplant &/or Intestinal Transplant 2 2 — — $73,702.97 $73,702.97 $73,702.97 2024-12-31
'613-4 OTHER Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 2 2 — — $73,712.19 $73,712.19 $73,712.19 2024-12-31
6134 APR_DRG Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 2 1 — — $73,712.19 $73,712.19 $73,712.19 2025-12-31
8010000021-108083 CDM Cadaver Donor Kidney Acquisit 62 14 $93,500.00 — $13,183.50 $91,583.25 $73,762.15 2025-12-31
9114 APR_DRG Extensive Abdominal/thoracic Procedures For Mult Significant Trauma 2 1 — — $73,781.77 $73,781.77 $73,781.77 2025-12-31
'911-4 OTHER Extensive Abdominal/thoracic Procedures For Mult Significant Trauma 2 2 — — $73,781.77 $73,781.77 $73,781.77 2024-12-31
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 86 30 — $71,848.29 $14,547.00 $320,161.17 $74,419.25 2025-12-31
B1806 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 12 6 — — $71,434.71 $91,057.02 $74,649.27 2025-12-31
'021-4 OTHER Craniotomy Except For Trauma 2 2 — — $74,949.77 $74,949.77 $74,949.77 2024-12-31
214 APR_DRG Craniotomy Except For Trauma 2 1 — — $74,949.77 $74,949.77 $74,949.77 2025-12-31
904 APR_DRG Major Larynx & Trachea Procedures 2 1 — — $75,795.15 $75,795.15 $75,795.15 2025-12-31
'090-4 OTHER Major Larynx & Trachea Procedures 2 2 — — $75,795.15 $75,795.15 $75,795.15 2024-12-31
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 86 30 — $68,386.18 $14,547.00 $354,491.48 $76,034.23 2025-12-31
6073 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 2 1 — — $76,571.53 $76,571.53 $76,571.53 2025-12-31
'607-3 OTHER Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 2 2 — — $76,571.53 $76,571.53 $76,571.53 2024-12-31
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 34 18 — $75,175.51 $64,754.86 $309,599.59 $77,298.31 2025-12-31
D0407 HCPCS Traumatic Spinal Cord Injury M <24.50 And A >=61.50 12 6 — — $75,762.89 $87,020.18 $77,436.07 2025-12-31
8413 APR_DRG Extensive 3rd Degree Burns W Skin Graft 2 1 — — $77,546.57 $77,546.57 $77,546.57 2025-12-31
'841-3 OTHER Extensive 3rd Degree Burns W Skin Graft 2 2 — — $77,546.57 $77,546.57 $77,546.57 2024-12-31
12 APR_DRG Liver Transplant &/or Intestinal Transplant 2 1 — — $78,039.67 $78,039.67 $78,039.67 2025-12-31
'001-2 OTHER Liver Transplant &/or Intestinal Transplant 2 2 — — $78,039.67 $78,039.67 $78,039.67 2024-12-31
1654 APR_DRG Coronary Bypass W Ami Or Complex Pdx 2 1 — — $78,201.62 $78,201.62 $78,201.62 2025-12-31
'165-4 OTHER Coronary Bypass W Ami Or Complex Pdx 2 2 — — $78,201.62 $78,201.62 $78,201.62 2024-12-31
6904 APR_DRG Acute Leukemia 2 1 — — $78,823.04 $78,823.04 $78,823.04 2025-12-31
'690-4 OTHER Acute Leukemia 2 2 — — $78,823.04 $78,823.04 $78,823.04 2024-12-31
'609-3 OTHER Neonate Bwt 1500-2499g W Major Procedure 2 2 — — $78,903.37 $78,903.37 $78,903.37 2024-12-31
6093 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 2 1 — — $78,903.37 $78,903.37 $78,903.37 2025-12-31
'603-3 OTHER Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 2 2 — — $79,182.43 $79,182.43 $79,182.43 2024-12-31
6033 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 2 1 — — $79,182.43 $79,182.43 $79,182.43 2025-12-31
850 MS_DRG Acute Leukemia With Other Procedures 38 13 — $78,148.97 $14,547.00 $348,237.46 $79,308.26 2025-12-31
B1904 HCPCS Guillain-barr? M <38.50 12 6 — — $75,941.42 $107,655.71 $79,358.79 2025-12-31
Sx00000066257 CDM Controller Impella Packaged 34 17 $161,200.00 — $29,016.00 $137,020.00 $79,391.00 2024-12-31
1674 APR_DRG Other Cardiothoracic & Thoracic Vascular Procedures 2 1 — — $79,431.83 $79,431.83 $79,431.83 2025-12-31
'167-4 OTHER Other Cardiothoracic & Thoracic Vascular Procedures 2 2 — — $79,431.83 $79,431.83 $79,431.83 2024-12-31
C0407 HCPCS Traumatic Spinal Cord Injury M <24.50 And A >=61.50 12 6 — — $78,046.35 $89,596.45 $79,748.84 2025-12-31
3033 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 2 1 — — $81,846.38 $81,846.38 $81,846.38 2025-12-31
'303-3 OTHER Dorsal & Lumbar Fusion Proc For Curvature Of Back 2 2 — — $81,846.38 $81,846.38 $81,846.38 2024-12-31
'612-4 OTHER Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 2 2 — — $82,929.75 $82,929.75 $82,929.75 2024-12-31
6124 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 2 1 — — $82,929.75 $82,929.75 $82,929.75 2025-12-31
5881 APR_DRG Neonate Bwt <1500g W Major Procedure 2 1 — — $83,082.22 $83,082.22 $83,082.22 2025-12-31
'588-1 OTHER Neonate Bwt <1500g W Major Procedure 2 2 — — $83,082.22 $83,082.22 $83,082.22 2024-12-31
'312-4 OTHER Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses 2 2 — — $84,333.89 $84,333.89 $84,333.89 2024-12-31
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses 2 1 — — $84,333.89 $84,333.89 $84,333.89 2025-12-31
'006-2 OTHER Pancreas Transplant 2 2 — — $84,402.89 $84,402.89 $84,402.89 2024-12-31
62 APR_DRG Pancreas Transplant 2 1 — — $84,402.89 $84,402.89 $84,402.89 2025-12-31
'583-1 OTHER Neonate W Ecmo 2 2 — — $84,656.77 $84,656.77 $84,656.77 2024-12-31
5831 APR_DRG Neonate W Ecmo 2 1 — — $84,656.77 $84,656.77 $84,656.77 2025-12-31
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 89 30 — $81,874.91 $14,547.00 $364,840.53 $84,659.68 2025-12-31
3044 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 2 1 — — $84,775.16 $84,775.16 $84,775.16 2025-12-31
'304-4 OTHER Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 2 2 — — $84,775.16 $84,775.16 $84,775.16 2024-12-31
Sx00000069838 CDM Jts Implant Set 34 17 $172,360.00 — $31,024.80 $146,506.00 $84,887.30 2024-12-31
1613 APR_DRG Cardiac Defibrillator & Heart Assist Implant 2 1 — — $86,171.67 $86,171.67 $86,171.67 2025-12-31
'161-3 OTHER Cardiac Defibrillator & Heart Assist Implant 2 2 — — $86,171.67 $86,171.67 $86,171.67 2024-12-31
Sx00000069838-74793 CDM Jts Implant Set 66 15 $172,360.00 — $31,024.80 $146,506.00 $86,180.00 2025-12-31
6114 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 2 1 — — $86,306.97 $86,306.97 $86,306.97 2025-12-31
'611-4 OTHER Neonate Birthwt 1500-1999g W Major Anomaly 2 2 — — $86,306.97 $86,306.97 $86,306.97 2024-12-31
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Pdx 2 1 — — $87,115.71 $87,115.71 $87,115.71 2025-12-31
'163-4 OTHER Cardiac Valve Procedures Without Ami Or Complex Pdx 2 2 — — $87,115.71 $87,115.71 $87,115.71 2024-12-31
'591-1 OTHER Neonate Birthwt 500-749g Without Major Procedure 2 2 — — $87,118.91 $87,118.91 $87,118.91 2024-12-31
5911 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 2 1 — — $87,118.91 $87,118.91 $87,118.91 2025-12-31
21 APR_DRG Heart &/or Lung Transplant 2 1 — — $89,049.08 $89,049.08 $89,049.08 2025-12-31
'002-1 OTHER Heart &/or Lung Transplant 2 2 — — $89,049.08 $89,049.08 $89,049.08 2024-12-31
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 38 13 — $88,867.85 $14,547.00 $396,001.55 $90,186.14 2025-12-31
'593-2 OTHER Neonate Birthwt 750-999g Without Major Procedure 2 2 — — $91,513.46 $91,513.46 $91,513.46 2024-12-31
5932 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 2 1 — — $91,513.46 $91,513.46 $91,513.46 2025-12-31
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 80 27 — $90,343.97 $14,547.00 $348,683.76 $91,684.17 2025-12-31
B0407 HCPCS Traumatic Spinal Cord Injury M <24.50 And A >=61.50 12 6 — — $87,763.48 $113,723.64 $91,712.83 2025-12-31
'001-3 OTHER Liver Transplant &/or Intestinal Transplant 2 2 — — $91,727.50 $91,727.50 $91,727.50 2024-12-31
13 APR_DRG Liver Transplant &/or Intestinal Transplant 2 1 — — $91,727.50 $91,727.50 $91,727.50 2025-12-31
'588-2 OTHER Neonate Bwt <1500g W Major Procedure 2 2 — — $92,313.61 $92,313.61 $92,313.61 2024-12-31
5882 APR_DRG Neonate Bwt <1500g W Major Procedure 2 1 — — $92,313.61 $92,313.61 $92,313.61 2025-12-31
4404 APR_DRG Kidney Transplant 2 1 — — $93,448.69 $93,448.69 $93,448.69 2025-12-31
'440-4 OTHER Kidney Transplant 2 2 — — $93,448.69 $93,448.69 $93,448.69 2024-12-31
215 MS_DRG Other Heart Assist System Implant 89 30 — $89,880.77 $14,547.00 $438,166.06 $93,724.58 2025-12-31
212 MS_DRG Concomitant Aortic And Mitral Valve?procedures 58 25 — $92,418.18 $14,547.00 $411,822.10 $93,953.21 2025-12-31
5832 APR_DRG Neonate W Ecmo 2 1 — — $94,063.12 $94,063.12 $94,063.12 2025-12-31
'583-2 OTHER Neonate W Ecmo 2 2 — — $94,063.12 $94,063.12 $94,063.12 2024-12-31
'006-3 OTHER Pancreas Transplant 2 2 — — $94,371.46 $94,371.46 $94,371.46 2024-12-31
63 APR_DRG Pancreas Transplant 2 1 — — $94,371.46 $94,371.46 $94,371.46 2025-12-31
C1842 HCPCS Retinal Prosth, Add-on 1 1 — — $94,381.74 $94,381.74 $94,381.74 2024-12-31
C1841 HCPCS Retinal Prosth Int/ext Comp 1 1 — — $94,381.74 $94,381.74 $94,381.74 2024-12-31
'863-4 OTHER Neonatal Aftercare 2 2 — — $95,498.84 $95,498.84 $95,498.84 2024-12-31
8634 APR_DRG Neonatal Aftercare 2 1 — — $95,498.84 $95,498.84 $95,498.84 2025-12-31
6023 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 2 1 — — $96,830.97 $96,830.97 $96,830.97 2025-12-31
'602-3 OTHER Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 2 2 — — $96,830.97 $96,830.97 $96,830.97 2024-12-31
A9543 HCPCS Y-90 Yttrium Ibrit To 40 Mci Tx 113 38 $129,984.00 $56,824.55 56% off $18,327.74 $129,984.00 $97,488.00 2025-12-31
54 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 2 1 — — $99,581.27 $99,581.27 $99,581.27 2025-12-31
'005-4 OTHER Tracheostomy W Mv 96+ Hours Without Extensive Procedure 2 2 — — $99,581.27 $99,581.27 $99,581.27 2024-12-31
6314 APR_DRG Neonate Birthwt >2499g W Other Major Procedure 2 1 — — $99,707.29 $99,707.29 $99,707.29 2025-12-31
'631-4 OTHER Neonate Birthwt >2499g W Other Major Procedure 2 2 — — $99,707.29 $99,707.29 $99,707.29 2024-12-31
6084 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 2 1 — — $99,872.51 $99,872.51 $99,872.51 2025-12-31
'608-4 OTHER Neonate Bwt 1250-1499g W Or Without Other Significant Condition 2 2 — — $99,872.51 $99,872.51 $99,872.51 2024-12-31
9104 APR_DRG Craniotomy For Multiple Significant Trauma 2 1 — — $100,740.12 $100,740.12 $100,740.12 2025-12-31
'910-4 OTHER Craniotomy For Multiple Significant Trauma 2 2 — — $100,740.12 $100,740.12 $100,740.12 2024-12-31
5892 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 2 1 — — $102,326.58 $102,326.58 $102,326.58 2025-12-31
'589-2 OTHER Neonate Bwt <500g Or Ga <24 Weeks 2 2 — — $102,326.58 $102,326.58 $102,326.58 2024-12-31
'162-4 OTHER Cardiac Valve Procedures W Ami Or Complex Pdx 2 2 — — $102,733.00 $102,733.00 $102,733.00 2024-12-31
1624 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 2 1 — — $102,733.00 $102,733.00 $102,733.00 2025-12-31
43 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 2 1 — — $103,021.79 $103,021.79 $103,021.79 2025-12-31
'004-3 OTHER Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 2 2 — — $103,021.79 $103,021.79 $103,021.79 2024-12-31
8424 APR_DRG Burns With Skin Graft Except Extensive 3rd Degree Burns 2 1 — — $105,141.01 $105,141.01 $105,141.01 2025-12-31
'842-4 OTHER Burns With Skin Graft Except Extensive 3rd Degree Burns 2 2 — — $105,141.01 $105,141.01 $105,141.01 2024-12-31
6074 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 2 1 — — $107,049.45 $107,049.45 $107,049.45 2025-12-31
'607-4 OTHER Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 2 2 — — $107,049.45 $107,049.45 $107,049.45 2024-12-31
'303-4 OTHER Dorsal & Lumbar Fusion Proc For Curvature Of Back 2 2 — — $111,181.99 $111,181.99 $111,181.99 2024-12-31
3034 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 2 1 — — $111,181.99 $111,181.99 $111,181.99 2025-12-31
'630-4 OTHER Neonate Birthwt >2499g W Major Cardiovascular Procedure 2 2 — — $112,312.06 $112,312.06 $112,312.06 2024-12-31
6304 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 2 1 — — $112,312.06 $112,312.06 $112,312.06 2025-12-31
7 MS_DRG Lung Transplant 80 27 — $110,868.90 $14,547.00 $394,442.52 $112,513.57 2025-12-31
14 MS_DRG Allogeneic Bone Marrow Transplant 78 27 — $111,148.86 $13,307.00 $406,346.05 $113,315.10 2025-12-31
'002-2 OTHER Heart &/or Lung Transplant 2 2 — — $114,790.35 $114,790.35 $114,790.35 2024-12-31
22 APR_DRG Heart &/or Lung Transplant 2 1 — — $114,790.35 $114,790.35 $114,790.35 2025-12-31
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 84 28 — $93,485.40 $14,547.00 $456,412.07 $116,801.63 2025-12-31
33 APR_DRG Bone Marrow Transplant 2 1 — — $117,474.67 $117,474.67 $117,474.67 2025-12-31
'003-3 OTHER Bone Marrow Transplant 2 2 — — $117,474.67 $117,474.67 $117,474.67 2024-12-31
'160-4 OTHER Major Cardiothoracic Repair Of Heart Anomaly 2 2 — — $120,599.67 $120,599.67 $120,599.67 2024-12-31
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 2 1 — — $120,599.67 $120,599.67 $120,599.67 2025-12-31
5912 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 2 1 — — $120,867.52 $120,867.52 $120,867.52 2025-12-31
'591-2 OTHER Neonate Birthwt 500-749g Without Major Procedure 2 2 — — $120,867.52 $120,867.52 $120,867.52 2024-12-31
'593-3 OTHER Neonate Birthwt 750-999g Without Major Procedure 2 2 — — $121,880.62 $121,880.62 $121,880.62 2024-12-31
5933 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 2 1 — — $121,880.62 $121,880.62 $121,880.62 2025-12-31
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 86 30 — $119,871.57 $14,547.00 $534,156.39 $128,228.63 2025-12-31
6024 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 2 1 — — $134,052.13 $134,052.13 $134,052.13 2025-12-31
'602-4 OTHER Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 2 2 — — $134,052.13 $134,052.13 $134,052.13 2024-12-31
'603-4 OTHER Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 2 2 — — $137,867.36 $137,867.36 $137,867.36 2024-12-31
6034 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 2 1 — — $137,867.36 $137,867.36 $137,867.36 2025-12-31
'002-3 OTHER Heart &/or Lung Transplant 2 2 — — $137,941.74 $137,941.74 $137,941.74 2024-12-31
23 APR_DRG Heart &/or Lung Transplant 2 1 — — $137,941.74 $137,941.74 $137,941.74 2025-12-31
5891 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 2 1 — — $145,878.54 $145,878.54 $145,878.54 2025-12-31
'589-1 OTHER Neonate Bwt <500g Or Ga <24 Weeks 2 2 — — $145,878.54 $145,878.54 $145,878.54 2024-12-31
6094 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 2 1 — — $146,310.46 $146,310.46 $146,310.46 2025-12-31
'609-4 OTHER Neonate Bwt 1500-2499g W Major Procedure 2 2 — — $146,310.46 $146,310.46 $146,310.46 2024-12-31
'004-4 OTHER Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 2 2 — — $148,223.13 $148,223.13 $148,223.13 2024-12-31
44 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 2 1 — — $148,223.13 $148,223.13 $148,223.13 2025-12-31
64 APR_DRG Pancreas Transplant 2 1 — — $149,325.21 $149,325.21 $149,325.21 2025-12-31
'006-4 OTHER Pancreas Transplant 2 2 — — $149,325.21 $149,325.21 $149,325.21 2024-12-31
5913 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 2 1 — — $150,089.36 $150,089.36 $150,089.36 2025-12-31
'591-3 OTHER Neonate Birthwt 500-749g Without Major Procedure 2 2 — — $150,089.36 $150,089.36 $150,089.36 2024-12-31
Q0480 HCPCS Driver Pneumatic Vad, Rep 4 3 — — $130,249.99 $270,421.41 $159,873.55 2025-12-31
'001-4 OTHER Liver Transplant &/or Intestinal Transplant 2 2 — — $162,740.13 $162,740.13 $162,740.13 2024-12-31
14 APR_DRG Liver Transplant &/or Intestinal Transplant 2 1 — — $162,740.13 $162,740.13 $162,740.13 2025-12-31
5934 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 2 1 — — $174,064.66 $174,064.66 $174,064.66 2025-12-31
'593-4 OTHER Neonate Birthwt 750-999g Without Major Procedure 2 2 — — $174,064.66 $174,064.66 $174,064.66 2024-12-31
5833 APR_DRG Neonate W Ecmo 2 1 — — $176,349.22 $176,349.22 $176,349.22 2025-12-31
'583-3 OTHER Neonate W Ecmo 2 2 — — $176,349.22 $176,349.22 $176,349.22 2024-12-31
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 86 30 — $181,814.55 $14,547.00 $810,178.77 $188,274.05 2025-12-31
5883 APR_DRG Neonate Bwt <1500g W Major Procedure 2 1 — — $188,495.69 $188,495.69 $188,495.69 2025-12-31
'588-3 OTHER Neonate Bwt <1500g W Major Procedure 2 2 — — $188,495.69 $188,495.69 $188,495.69 2024-12-31
34 APR_DRG Bone Marrow Transplant 2 1 — — $193,574.88 $193,574.88 $193,574.88 2025-12-31
'003-4 OTHER Bone Marrow Transplant 2 2 — — $193,574.88 $193,574.88 $193,574.88 2024-12-31
'841-4 OTHER Extensive 3rd Degree Burns W Skin Graft 2 2 — — $200,628.89 $200,628.89 $200,628.89 2024-12-31
8414 APR_DRG Extensive 3rd Degree Burns W Skin Graft 2 1 — — $200,628.89 $200,628.89 $200,628.89 2025-12-31
1614 APR_DRG Cardiac Defibrillator & Heart Assist Implant 2 1 — — $206,769.43 $206,769.43 $206,769.43 2025-12-31
'161-4 OTHER Cardiac Defibrillator & Heart Assist Implant 2 2 — — $206,769.43 $206,769.43 $206,769.43 2024-12-31
5914 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 2 1 — — $211,881.29 $211,881.29 $211,881.29 2025-12-31
'591-4 OTHER Neonate Birthwt 500-749g Without Major Procedure 2 2 — — $211,881.29 $211,881.29 $211,881.29 2024-12-31
24 APR_DRG Heart &/or Lung Transplant 2 1 — — $217,484.20 $217,484.20 $217,484.20 2025-12-31
'002-4 OTHER Heart &/or Lung Transplant 2 2 — — $217,484.20 $217,484.20 $217,484.20 2024-12-31
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 86 30 — $201,251.90 $14,547.00 $920,920.26 $224,848.46 2025-12-31
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 84 28 — $238,965.21 $14,547.00 $1,064,846.24 $244,734.99 2025-12-31
'588-4 OTHER Neonate Bwt <1500g W Major Procedure 2 2 — — $252,297.48 $252,297.48 $252,297.48 2024-12-31
5884 APR_DRG Neonate Bwt <1500g W Major Procedure 2 1 — — $252,297.48 $252,297.48 $252,297.48 2025-12-31
'583-4 OTHER Neonate W Ecmo 2 2 — — $263,700.81 $263,700.81 $263,700.81 2024-12-31
5834 APR_DRG Neonate W Ecmo 2 1 — — $263,700.81 $263,700.81 $263,700.81 2025-12-31
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 14 6 — $270,375.00 $270,375.00 $324,450.00 $270,375.00 2025-12-31
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 60 24 — $319,935.78 $13,307.00 $1,138,247.73 $299,704.70 2025-12-31
Q2053 HCPCS Brexucabtagene Car Pos T 33 16 — $489,720.00 $416,262.00 $878,671.10 $489,720.00 2025-12-31
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 33 16 — $533,076.48 $453,115.01 $884,589.61 $533,076.48 2025-12-31
Q2055 HCPCS Idecabtagene Vicleucel Car 33 16 — $541,260.45 $460,071.38 $954,928.83 $541,260.45 2025-12-31
Q2054 HCPCS Lisocabtagene Mara Car Pos T 33 16 — $541,635.66 $460,390.31 $933,986.41 $541,635.66 2025-12-31
Q2056 HCPCS Ciltacabtagene Car-pos T 27 13 — $553,378.83 $470,372.01 $664,054.60 $553,378.83 2025-12-31
Q2042 HCPCS Tisagenlecleucel Car-pos T 33 16 — $578,324.58 $491,575.89 $922,082.02 $578,324.58 2025-12-31
Q2057 HCPCS Afamitresgene Autoleucel 16 7 — $770,620.00 $655,027.00 $924,744.00 $770,620.00 2025-12-31
J3392 HCPCS Inj, Exagamglogene Autotem 14 6 — $2,332,000.00 $2,332,000.00 $2,798,400.00 $2,332,000.00 2025-12-31
J3399 HCPCS Inj Onase Abepar-xioi Treat 22 11 — $2,452,115.60 $2,354,513.02 $2,942,538.72 $2,452,115.60 2025-12-31
J3393 HCPCS Inj, Betibeglogene Autotemce 22 11 — $2,950,686.67 $2,950,686.67 $3,540,824.00 $2,968,000.00 2025-12-31
J3394 HCPCS Inj, Lovotibeglogene Autotem 22 11 — $3,261,355.00 $3,261,355.00 $3,913,626.00 $3,286,000.00 2025-12-31
J1413 HCPCS Inj Delandistrogene Mox Rokl 22 11 — $3,324,571.90 $3,324,571.90 $3,989,486.28 $3,327,159.88 2025-12-31
J1414 HCPCS Inj, Beqvez, Per Tx Dose 14 6 — $3,710,000.00 $3,710,000.00 $4,452,000.00 $3,710,000.00 2025-12-31
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 22 11 — $3,685,266.67 $3,685,266.67 $4,422,320.00 $3,710,000.00 2025-12-31
J3391 HCPCS Inj, Atidarsagene Autotemcel 12 5 — $4,377,500.00 $4,377,500.00 $4,771,475.00 $4,377,500.00 2025-12-31
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