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

RARITAN BAY MEDICAL CENTER

Perth Amboy, NJ · CCN 310039 · Rates published

103,842 distinct procedures filed
41 distinct payers
4,876,717 rate rows
2026-07-30 last MRF observed
Data quality

3,840,659 of 4,876,717 rate rows are consumer-grade (78.8%)

1,036,058 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 1,015,235
placeholder amount (≤ $0.02) — excluded from medians 8,440
exceeds 10× this hospital's gross charge — excluded from medians 3,995
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 3,791
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 1,542
percent-of-charges filed in the dollar field — excluded from medians 1,447
per-diem day rate — not a per-procedure price 1,273
template filing: same amount across many unrelated codes — excluded 271
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 64
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.hackensackmeridianhealth.org/-/media/project/hmh/hmh/public/files/cdm/20250101/rbmc/221487576-1770569832_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 58d8d27f1efd4316… · 1,860,267,949 bytes · first seen 2026-05-08

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 6 $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 7 $3,710,000.00 $4,452,000.00 $3,802,750.00 nat. median
$3,710,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 13 $3,672,900.00 $4,422,320.00 $3,685,266.67 nat. median
$3,710,000
1.0× median
C9172
HCPCS 		Inj, Beqvez, Per Tx Dose 6 $3,605,000.00 $3,965,500.00 $3,605,000.00 nat. median
$3,605,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 13 $3,324,571.90 $3,989,486.28 $3,325,454.76 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 13 $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 13 $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 13 $2,388,614.23 $2,942,538.72 $2,452,115.60 nat. median
$2,460,273
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 7 $2,332,000.00 $2,798,400.00 $2,390,300.00 nat. median
$2,405,851
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 8 $655,027.00 $924,744.00 $770,620.00 nat. median
$809,151
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 17 $468,441.50 $922,082.02 $578,324.58 nat. median
$691,418
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 15 $470,372.01 $674,570.57 $553,378.83 nat. median
$631,793
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 17 $434,918.00 $933,986.41 $541,635.66 nat. median
$624,417
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 17 $444,670.00 $954,928.83 $541,260.45 nat. median
$610,161
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 17 $453,115.01 $884,589.61 $533,076.48 nat. median
$588,565
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 17 $416,262.00 $878,671.10 $492,767.53 nat. median
$577,541
0.9× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 24 $4,529.00 $1,303,203.52 $335,407.02 nat. median
$370,165
0.9× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 7 $270,375.00 $324,450.00 $277,134.38 nat. median
$302,242
0.9× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 28 $5,095.00 $1,064,226.54 $273,269.94 nat. median
$261,939
1.0× median
'583-4
OTHER 		Neonate W Ecmo 1 $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
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 29 $5,095.00 $922,080.04 $255,356.76 nat. median
$205,166
1.2× median
'588-4
OTHER 		Neonate Bwt <1500g W Major Procedure 1 $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
'002-4
OTHER 		Heart &/or Lung Transplant 1 $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
'591-4
OTHER 		Neonate Birthwt 500-749g Without Major Procedure 1 $211,881.29 $211,881.29 $211,881.29 nat. median
$119,104
1.8× 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
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 29 $5,095.00 $809,707.28 $210,015.23 nat. median
$199,832
1.1× median
'161-4
OTHER 		Cardiac Defibrillator & Heart Assist Implant 1 $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 1 $200,628.89 $200,628.89 $200,628.89 nat. median
$138,284
1.5× median
'003-4
OTHER 		Bone Marrow Transplant 1 $193,574.88 $193,574.88 $193,574.88 nat. median
$193,377
1.0× median
34
APR_DRG 		Bone Marrow Transplant 1 $193,574.88 $193,574.88 $193,574.88 nat. median
$241,408
0.8× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 3 $132,999.99 $270,421.41 $191,689.93 nat. median
$111,503
1.7× 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 1 $188,495.69 $188,495.69 $188,495.69 nat. median
$131,074
1.4× median
5833
APR_DRG 		Neonate W Ecmo 1 $176,349.22 $176,349.22 $176,349.22 nat. median
$250,089
0.7× median
'583-3
OTHER 		Neonate W Ecmo 1 $176,349.22 $176,349.22 $176,349.22 nat. median
$195,630
0.9× 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 1 $174,064.66 $174,064.66 $174,064.66 nat. median
$115,906
1.5× median
'001-4
OTHER 		Liver Transplant &/or Intestinal Transplant 1 $162,740.13 $162,740.13 $162,740.13 nat. median
$107,546
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
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 1 $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 1 $149,325.21 $149,325.21 $149,325.21 nat. median
$56,683
outlier · 2.6×
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
'004-4
OTHER 		Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 1 $148,223.13 $148,223.13 $148,223.13 nat. median
$101,809
1.5× median

Other procedures at this hospital

Browse this hospital's 103,842 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
J3391 HCPCS Inj, Atidarsagene Autotemcel 7 6 — $4,377,500.00 $4,377,500.00 $4,771,475.00 $4,377,500.00 2025-12-31
J1414 HCPCS Inj, Beqvez, Per Tx Dose 8 7 — $3,710,000.00 $3,710,000.00 $4,452,000.00 $3,802,750.00 2025-12-31
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 15 13 — $3,685,266.67 $3,672,900.00 $4,422,320.00 $3,685,266.67 2025-12-31
C9172 HCPCS Inj, Beqvez, Per Tx Dose 7 6 — — $3,605,000.00 $3,965,500.00 $3,605,000.00 2024-12-31
J1413 HCPCS Inj Delandistrogene Mox Rokl 15 13 — $3,324,571.90 $3,324,571.90 $3,989,486.28 $3,325,454.76 2025-12-31
J3394 HCPCS Inj, Lovotibeglogene Autotem 15 13 — $3,261,355.00 $3,261,355.00 $3,913,626.00 $3,286,000.00 2025-12-31
J3393 HCPCS Inj, Betibeglogene Autotemce 15 13 — $2,950,686.67 $2,950,686.67 $3,540,824.00 $2,968,000.00 2025-12-31
J3399 HCPCS Inj Onase Abepar-xioi Treat 15 13 — $2,452,115.60 $2,388,614.23 $2,942,538.72 $2,452,115.60 2025-12-31
J3392 HCPCS Inj, Exagamglogene Autotem 8 7 — $2,332,000.00 $2,332,000.00 $2,798,400.00 $2,390,300.00 2025-12-31
Q2057 HCPCS Afamitresgene Autoleucel 9 8 — $770,620.00 $655,027.00 $924,744.00 $770,620.00 2025-12-31
Q2042 HCPCS Tisagenlecleucel Car-pos T 25 17 — $468,441.50 $468,441.50 $922,082.02 $578,324.58 2025-12-31
Q2056 HCPCS Ciltacabtagene Car-pos T 17 15 — $553,378.83 $470,372.01 $674,570.57 $553,378.83 2025-12-31
Q2054 HCPCS Lisocabtagene Mara Car Pos T 25 17 — $434,918.00 $434,918.00 $933,986.41 $541,635.66 2025-12-31
Q2055 HCPCS Idecabtagene Vicleucel Car 25 17 — $444,670.00 $444,670.00 $954,928.83 $541,260.45 2025-12-31
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 21 17 — $533,076.48 $453,115.01 $884,589.61 $533,076.48 2025-12-31
Q2053 HCPCS Brexucabtagene Car Pos T 21 17 — $489,720.00 $416,262.00 $878,671.10 $492,767.53 2025-12-31
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 43 24 — $318,681.25 $4,529.00 $1,303,203.52 $335,407.02 2025-12-31
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 8 7 — $270,375.00 $270,375.00 $324,450.00 $277,134.38 2025-12-31
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 59 28 — $234,396.93 $5,095.00 $1,064,226.54 $273,269.94 2025-12-31
'583-4 OTHER Neonate W Ecmo 1 1 — — $263,700.81 $263,700.81 $263,700.81 2024-12-31
5834 APR_DRG Neonate W Ecmo 1 1 — — $263,700.81 $263,700.81 $263,700.81 2025-12-31
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 61 29 — $205,197.00 $5,095.00 $922,080.04 $255,356.76 2025-12-31
'588-4 OTHER Neonate Bwt <1500g W Major Procedure 1 1 — — $252,297.48 $252,297.48 $252,297.48 2024-12-31
5884 APR_DRG Neonate Bwt <1500g W Major Procedure 1 1 — — $252,297.48 $252,297.48 $252,297.48 2025-12-31
24 APR_DRG Heart &/or Lung Transplant 1 1 — — $217,484.20 $217,484.20 $217,484.20 2025-12-31
'002-4 OTHER Heart &/or Lung Transplant 1 1 — — $217,484.20 $217,484.20 $217,484.20 2024-12-31
5914 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 1 1 — — $211,881.29 $211,881.29 $211,881.29 2025-12-31
'591-4 OTHER Neonate Birthwt 500-749g Without Major Procedure 1 1 — — $211,881.29 $211,881.29 $211,881.29 2024-12-31
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 61 29 — $184,415.90 $5,095.00 $809,707.28 $210,015.23 2025-12-31
'161-4 OTHER Cardiac Defibrillator & Heart Assist Implant 1 1 — — $206,769.43 $206,769.43 $206,769.43 2024-12-31
1614 APR_DRG Cardiac Defibrillator & Heart Assist Implant 1 1 — — $206,769.43 $206,769.43 $206,769.43 2025-12-31
8414 APR_DRG Extensive 3rd Degree Burns W Skin Graft 1 1 — — $200,628.89 $200,628.89 $200,628.89 2025-12-31
'841-4 OTHER Extensive 3rd Degree Burns W Skin Graft 1 1 — — $200,628.89 $200,628.89 $200,628.89 2024-12-31
34 APR_DRG Bone Marrow Transplant 1 1 — — $193,574.88 $193,574.88 $193,574.88 2025-12-31
'003-4 OTHER Bone Marrow Transplant 1 1 — — $193,574.88 $193,574.88 $193,574.88 2024-12-31
Q0480 HCPCS Driver Pneumatic Vad, Rep 3 3 — — $132,999.99 $270,421.41 $191,689.93 2025-12-31
'588-3 OTHER Neonate Bwt <1500g W Major Procedure 1 1 — — $188,495.69 $188,495.69 $188,495.69 2024-12-31
5883 APR_DRG Neonate Bwt <1500g W Major Procedure 1 1 — — $188,495.69 $188,495.69 $188,495.69 2025-12-31
5833 APR_DRG Neonate W Ecmo 1 1 — — $176,349.22 $176,349.22 $176,349.22 2025-12-31
'583-3 OTHER Neonate W Ecmo 1 1 — — $176,349.22 $176,349.22 $176,349.22 2024-12-31
'593-4 OTHER Neonate Birthwt 750-999g Without Major Procedure 1 1 — — $174,064.66 $174,064.66 $174,064.66 2024-12-31
5934 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 1 1 — — $174,064.66 $174,064.66 $174,064.66 2025-12-31
14 APR_DRG Liver Transplant &/or Intestinal Transplant 1 1 — — $162,740.13 $162,740.13 $162,740.13 2025-12-31
'001-4 OTHER Liver Transplant &/or Intestinal Transplant 1 1 — — $162,740.13 $162,740.13 $162,740.13 2024-12-31
5913 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 1 1 — — $150,089.36 $150,089.36 $150,089.36 2025-12-31
'591-3 OTHER Neonate Birthwt 500-749g Without Major Procedure 1 1 — — $150,089.36 $150,089.36 $150,089.36 2024-12-31
'006-4 OTHER Pancreas Transplant 1 1 — — $149,325.21 $149,325.21 $149,325.21 2024-12-31
64 APR_DRG Pancreas Transplant 1 1 — — $149,325.21 $149,325.21 $149,325.21 2025-12-31
44 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 1 1 — — $148,223.13 $148,223.13 $148,223.13 2025-12-31
'004-4 OTHER Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 1 1 — — $148,223.13 $148,223.13 $148,223.13 2024-12-31
'609-4 OTHER Neonate Bwt 1500-2499g W Major Procedure 1 1 — — $146,310.46 $146,310.46 $146,310.46 2024-12-31
6094 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 1 1 — — $146,310.46 $146,310.46 $146,310.46 2025-12-31
5891 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 1 1 — — $145,878.54 $145,878.54 $145,878.54 2025-12-31
'589-1 OTHER Neonate Bwt <500g Or Ga <24 Weeks 1 1 — — $145,878.54 $145,878.54 $145,878.54 2024-12-31
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 61 29 — $127,151.77 $5,095.00 $533,845.53 $143,969.32 2025-12-31
'002-3 OTHER Heart &/or Lung Transplant 1 1 — — $137,941.74 $137,941.74 $137,941.74 2024-12-31
23 APR_DRG Heart &/or Lung Transplant 1 1 — — $137,941.74 $137,941.74 $137,941.74 2025-12-31
6034 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 1 1 — — $137,867.36 $137,867.36 $137,867.36 2025-12-31
'603-4 OTHER Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 1 1 — — $137,867.36 $137,867.36 $137,867.36 2024-12-31
'602-4 OTHER Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $134,052.13 $134,052.13 $134,052.13 2024-12-31
6024 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $134,052.13 $134,052.13 $134,052.13 2025-12-31
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 59 28 — $105,908.77 $5,095.00 $515,244.00 $128,325.80 2025-12-31
7 MS_DRG Lung Transplant 57 27 — $106,101.66 $5,095.00 $451,605.45 $124,878.67 2025-12-31
222 MS_DRG Cardiac Defib Implant W Cardiac Cath W Ami/hf/shock W Mcc 14 6 — — $54,906.00 $274,842.00 $124,532.40 2025-12-31
14 MS_DRG Allogeneic Bone Marrow Transplant 56 27 — $99,134.26 $4,529.00 $458,724.00 $124,022.00 2025-12-31
'593-3 OTHER Neonate Birthwt 750-999g Without Major Procedure 1 1 — — $121,880.62 $121,880.62 $121,880.62 2024-12-31
5933 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 1 1 — — $121,880.62 $121,880.62 $121,880.62 2025-12-31
5912 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 1 1 — — $120,867.52 $120,867.52 $120,867.52 2025-12-31
'591-2 OTHER Neonate Birthwt 500-749g Without Major Procedure 1 1 — — $120,867.52 $120,867.52 $120,867.52 2024-12-31
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 1 1 — — $120,599.67 $120,599.67 $120,599.67 2025-12-31
'160-4 OTHER Major Cardiothoracic Repair Of Heart Anomaly 1 1 — — $120,599.67 $120,599.67 $120,599.67 2024-12-31
'003-3 OTHER Bone Marrow Transplant 1 1 — — $117,474.67 $117,474.67 $117,474.67 2024-12-31
33 APR_DRG Bone Marrow Transplant 1 1 — — $117,474.67 $117,474.67 $117,474.67 2025-12-31
22 APR_DRG Heart &/or Lung Transplant 1 1 — — $114,790.35 $114,790.35 $114,790.35 2025-12-31
'002-2 OTHER Heart &/or Lung Transplant 1 1 — — $114,790.35 $114,790.35 $114,790.35 2024-12-31
224 MS_DRG Cardiac Defib Implant W Cardiac Cath Without Ami/hf/shock W Mcc 14 6 — — $54,906.00 $250,777.00 $112,333.13 2025-12-31
'630-4 OTHER Neonate Birthwt >2499g W Major Cardiovascular Procedure 1 1 — — $112,312.06 $112,312.06 $112,312.06 2024-12-31
6304 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 1 1 — — $112,312.06 $112,312.06 $112,312.06 2025-12-31
'303-4 OTHER Dorsal & Lumbar Fusion Proc For Curvature Of Back 1 1 — — $111,181.99 $111,181.99 $111,181.99 2024-12-31
3034 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 1 1 — — $111,181.99 $111,181.99 $111,181.99 2025-12-31
'607-4 OTHER Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $107,049.45 $107,049.45 $107,049.45 2024-12-31
6074 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $107,049.45 $107,049.45 $107,049.45 2025-12-31
212 MS_DRG Concomitant Aortic And Mitral Valve?procedures 40 24 — $94,229.84 $5,095.00 $411,582.44 $105,668.39 2025-12-31
8424 APR_DRG Burns With Skin Graft Except Extensive 3rd Degree Burns 1 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 1 1 — — $105,141.01 $105,141.01 $105,141.01 2024-12-31
B0407 HCPCS Traumatic Spinal Cord Injury M <24.50 And A >=61.50 5 3 — — $103,385.13 $113,723.64 $103,385.13 2024-12-31
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Cath W Mcc 14 6 — — $53,258.71 $230,292.00 $103,380.50 2025-12-31
215 MS_DRG Other Heart Assist System Implant 63 29 — $91,642.69 $5,095.00 $494,646.00 $103,281.91 2025-12-31
'004-3 OTHER Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 1 1 — — $103,021.79 $103,021.79 $103,021.79 2024-12-31
43 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 1 1 — — $103,021.79 $103,021.79 $103,021.79 2025-12-31
'162-4 OTHER Cardiac Valve Procedures W Ami Or Complex Pdx 1 1 — — $102,733.00 $102,733.00 $102,733.00 2024-12-31
1624 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 1 1 — — $102,733.00 $102,733.00 $102,733.00 2025-12-31
5892 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 1 1 — — $102,326.58 $102,326.58 $102,326.58 2025-12-31
'589-2 OTHER Neonate Bwt <500g Or Ga <24 Weeks 1 1 — — $102,326.58 $102,326.58 $102,326.58 2024-12-31
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 57 27 — $89,525.22 $5,095.00 $393,629.00 $101,905.28 2025-12-31
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 22 14 — $90,609.91 $5,095.00 $395,771.09 $101,190.02 2025-12-31
9104 APR_DRG Craniotomy For Multiple Significant Trauma 1 1 — — $100,740.12 $100,740.12 $100,740.12 2025-12-31
'910-4 OTHER Craniotomy For Multiple Significant Trauma 1 1 — — $100,740.12 $100,740.12 $100,740.12 2024-12-31
'608-4 OTHER Neonate Bwt 1250-1499g W Or Without Other Significant Condition 1 1 — — $99,872.51 $99,872.51 $99,872.51 2024-12-31
6084 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 1 1 — — $99,872.51 $99,872.51 $99,872.51 2025-12-31
'631-4 OTHER Neonate Birthwt >2499g W Other Major Procedure 1 1 — — $99,707.29 $99,707.29 $99,707.29 2024-12-31
6314 APR_DRG Neonate Birthwt >2499g W Other Major Procedure 1 1 — — $99,707.29 $99,707.29 $99,707.29 2025-12-31
54 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 1 1 — — $99,581.27 $99,581.27 $99,581.27 2025-12-31
'005-4 OTHER Tracheostomy W Mv 96+ Hours Without Extensive Procedure 1 1 — — $99,581.27 $99,581.27 $99,581.27 2024-12-31
223 MS_DRG Cardiac Defib Implant W Cardiac Cath W Ami/hf/shock Without Mcc 14 6 — — $50,039.09 $214,687.00 $98,235.50 2025-12-31
B1904 HCPCS Guillain-barr? M <38.50 5 3 — — $97,868.83 $107,655.71 $97,868.83 2024-12-31
6023 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 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 1 1 — — $96,830.97 $96,830.97 $96,830.97 2024-12-31
'863-4 OTHER Neonatal Aftercare 1 1 — — $95,498.84 $95,498.84 $95,498.84 2024-12-31
8634 APR_DRG Neonatal Aftercare 1 1 — — $95,498.84 $95,498.84 $95,498.84 2025-12-31
C1842 HCPCS Retinal Prosth, Add-on 1 1 — — $95,473.91 $95,473.91 $95,473.91 2024-12-31
C1841 HCPCS Retinal Prosth Int/ext Comp 1 1 — — $95,473.91 $95,473.91 $95,473.91 2024-12-31
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 63 29 — $83,479.89 $5,095.00 $376,985.00 $95,283.38 2025-12-31
63 APR_DRG Pancreas Transplant 1 1 — — $94,371.46 $94,371.46 $94,371.46 2025-12-31
'006-3 OTHER Pancreas Transplant 1 1 — — $94,371.46 $94,371.46 $94,371.46 2024-12-31
5832 APR_DRG Neonate W Ecmo 1 1 — — $94,063.12 $94,063.12 $94,063.12 2025-12-31
'583-2 OTHER Neonate W Ecmo 1 1 — — $94,063.12 $94,063.12 $94,063.12 2024-12-31
4404 APR_DRG Kidney Transplant 1 1 — — $93,448.69 $93,448.69 $93,448.69 2025-12-31
'440-4 OTHER Kidney Transplant 1 1 — — $93,448.69 $93,448.69 $93,448.69 2024-12-31
'588-2 OTHER Neonate Bwt <1500g W Major Procedure 1 1 — — $92,313.61 $92,313.61 $92,313.61 2024-12-31
5882 APR_DRG Neonate Bwt <1500g W Major Procedure 1 1 — — $92,313.61 $92,313.61 $92,313.61 2025-12-31
13 APR_DRG Liver Transplant &/or Intestinal Transplant 1 1 — — $91,727.50 $91,727.50 $91,727.50 2025-12-31
'001-3 OTHER Liver Transplant &/or Intestinal Transplant 1 1 — — $91,727.50 $91,727.50 $91,727.50 2024-12-31
5932 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 1 1 — — $91,513.46 $91,513.46 $91,513.46 2025-12-31
'593-2 OTHER Neonate Birthwt 750-999g Without Major Procedure 1 1 — — $91,513.46 $91,513.46 $91,513.46 2024-12-31
225 MS_DRG Cardiac Defib Implant W Cardiac Cath Without Ami/hf/shock Without Mcc 14 6 — — $45,324.44 $193,178.00 $91,144.00 2025-12-31
850 MS_DRG Acute Leukemia With Other Procedures 22 14 — $79,680.91 $5,095.00 $348,034.79 $89,080.33 2025-12-31
'002-1 OTHER Heart &/or Lung Transplant 1 1 — — $89,049.08 $89,049.08 $89,049.08 2024-12-31
21 APR_DRG Heart &/or Lung Transplant 1 1 — — $89,049.08 $89,049.08 $89,049.08 2025-12-31
5911 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 1 1 — — $87,118.91 $87,118.91 $87,118.91 2025-12-31
'591-1 OTHER Neonate Birthwt 500-749g Without Major Procedure 1 1 — — $87,118.91 $87,118.91 $87,118.91 2024-12-31
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Pdx 1 1 — — $87,115.71 $87,115.71 $87,115.71 2025-12-31
'163-4 OTHER Cardiac Valve Procedures Without Ami Or Complex Pdx 1 1 — — $87,115.71 $87,115.71 $87,115.71 2024-12-31
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Cath Without Mcc 14 6 — — $42,304.58 $179,577.00 $86,660.00 2025-12-31
6114 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 1 1 — — $86,306.97 $86,306.97 $86,306.97 2025-12-31
'611-4 OTHER Neonate Birthwt 1500-1999g W Major Anomaly 1 1 — — $86,306.97 $86,306.97 $86,306.97 2024-12-31
Sx00000069838-74891 CDM Jts Implant Set 32 14 $172,360.00 — $26,715.80 $167,689.04 $86,180.00 2025-12-31
Sx00000069838 CDM Jts Implant Set 35 16 $172,360.00 — $82.15 $189,596.00 $86,180.00 2024-12-31
1613 APR_DRG Cardiac Defibrillator & Heart Assist Implant 1 1 — — $86,171.67 $86,171.67 $86,171.67 2025-12-31
'161-3 OTHER Cardiac Defibrillator & Heart Assist Implant 1 1 — — $86,171.67 $86,171.67 $86,171.67 2024-12-31
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 35 18 — $76,649.16 $42,400.00 $320,767.00 $85,847.12 2025-12-31
3044 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 1 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 1 1 — — $84,775.16 $84,775.16 $84,775.16 2024-12-31
5831 APR_DRG Neonate W Ecmo 1 1 — — $84,656.77 $84,656.77 $84,656.77 2025-12-31
'583-1 OTHER Neonate W Ecmo 1 1 — — $84,656.77 $84,656.77 $84,656.77 2024-12-31
'006-2 OTHER Pancreas Transplant 1 1 — — $84,402.89 $84,402.89 $84,402.89 2024-12-31
62 APR_DRG Pancreas Transplant 1 1 — — $84,402.89 $84,402.89 $84,402.89 2025-12-31
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses 1 1 — — $84,333.89 $84,333.89 $84,333.89 2025-12-31
'312-4 OTHER Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses 1 1 — — $84,333.89 $84,333.89 $84,333.89 2024-12-31
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 61 29 — $73,111.40 $5,095.00 $400,186.00 $83,129.44 2025-12-31
5881 APR_DRG Neonate Bwt <1500g W Major Procedure 1 1 — — $83,082.22 $83,082.22 $83,082.22 2025-12-31
'588-1 OTHER Neonate Bwt <1500g W Major Procedure 1 1 — — $83,082.22 $83,082.22 $83,082.22 2024-12-31
'612-4 OTHER Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 1 1 — — $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 1 1 — — $82,929.75 $82,929.75 $82,929.75 2025-12-31
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 67 33 — $73,256.72 $5,095.00 $350,280.00 $82,846.51 2025-12-31
B1806 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 5 3 — — $82,779.11 $91,057.02 $82,779.11 2024-12-31
231 MS_DRG Coronary Bypass With Ptca With Mcc 63 29 — $73,297.37 $5,095.00 $322,400.00 $82,766.50 2025-12-31
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 1 1 — — $82,339.68 $82,339.68 $82,339.68 2025-12-31
3033 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 1 1 — — $81,846.38 $81,846.38 $81,846.38 2025-12-31
'303-3 OTHER Dorsal & Lumbar Fusion Proc For Curvature Of Back 1 1 — — $81,846.38 $81,846.38 $81,846.38 2024-12-31
C0407 HCPCS Traumatic Spinal Cord Injury M <24.50 And A >=61.50 5 3 — — $81,451.32 $89,596.45 $81,451.32 2024-12-31
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 22 14 — $72,144.36 $5,095.00 $315,116.21 $80,729.59 2025-12-31
Sx00000066257 CDM Controller Impella Packaged 35 16 $161,200.00 — $82.15 $177,320.00 $80,600.00 2024-12-31
'167-4 OTHER Other Cardiothoracic & Thoracic Vascular Procedures 1 1 — — $79,431.83 $79,431.83 $79,431.83 2024-12-31
1674 APR_DRG Other Cardiothoracic & Thoracic Vascular Procedures 1 1 — — $79,431.83 $79,431.83 $79,431.83 2025-12-31
'603-3 OTHER Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 1 1 — — $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 1 1 — — $79,182.43 $79,182.43 $79,182.43 2025-12-31
D0407 HCPCS Traumatic Spinal Cord Injury M <24.50 And A >=61.50 5 3 — — $79,109.25 $87,020.18 $79,109.25 2024-12-31
6093 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 1 1 — — $78,903.37 $78,903.37 $78,903.37 2025-12-31
'609-3 OTHER Neonate Bwt 1500-2499g W Major Procedure 1 1 — — $78,903.37 $78,903.37 $78,903.37 2024-12-31
6904 APR_DRG Acute Leukemia 1 1 — — $78,823.04 $78,823.04 $78,823.04 2025-12-31
'690-4 OTHER Acute Leukemia 1 1 — — $78,823.04 $78,823.04 $78,823.04 2024-12-31
'165-4 OTHER Coronary Bypass W Ami Or Complex Pdx 1 1 — — $78,201.62 $78,201.62 $78,201.62 2024-12-31
1654 APR_DRG Coronary Bypass W Ami Or Complex Pdx 1 1 — — $78,201.62 $78,201.62 $78,201.62 2025-12-31
12 APR_DRG Liver Transplant &/or Intestinal Transplant 1 1 — — $78,039.67 $78,039.67 $78,039.67 2025-12-31
'001-2 OTHER Liver Transplant &/or Intestinal Transplant 1 1 — — $78,039.67 $78,039.67 $78,039.67 2024-12-31
'841-3 OTHER Extensive 3rd Degree Burns W Skin Graft 1 1 — — $77,546.57 $77,546.57 $77,546.57 2024-12-31
8413 APR_DRG Extensive 3rd Degree Burns W Skin Graft 1 1 — — $77,546.57 $77,546.57 $77,546.57 2025-12-31
B0406 HCPCS Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 5 3 — — $77,036.90 $84,740.59 $77,036.90 2024-12-31
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 63 29 — $67,610.14 $5,095.00 $295,311.41 $76,707.52 2025-12-31
6073 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 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 1 1 — — $76,571.53 $76,571.53 $76,571.53 2024-12-31
8010000021-108126 CDM Cadaver Donor Kidney Acquisit 29 13 $93,500.00 — $12,435.50 $90,966.15 $76,137.05 2025-12-31
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 63 29 — $66,927.67 $5,095.00 $295,250.00 $75,845.85 2025-12-31
904 APR_DRG Major Larynx & Trachea Procedures 1 1 — — $75,795.15 $75,795.15 $75,795.15 2025-12-31
'090-4 OTHER Major Larynx & Trachea Procedures 1 1 — — $75,795.15 $75,795.15 $75,795.15 2024-12-31
B0404 HCPCS Traumatic Spinal Cord Injury M <31.50 And A <61.50 5 3 — — $75,109.76 $82,620.74 $75,109.76 2024-12-31
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 47 26 — $69,142.02 $5,095.00 $299,501.32 $75,024.96 2025-12-31
214 APR_DRG Craniotomy Except For Trauma 1 1 — — $74,949.77 $74,949.77 $74,949.77 2025-12-31
'021-4 OTHER Craniotomy Except For Trauma 1 1 — — $74,949.77 $74,949.77 $74,949.77 2024-12-31
128784 CDM Cadaver Donor Kidney Acquisit 33 15 $93,500.00 — $82.15 $102,850.00 $73,799.55 2024-12-31
'911-4 OTHER Extensive Abdominal/thoracic Procedures For Mult Significant Trauma 1 1 — — $73,781.77 $73,781.77 $73,781.77 2024-12-31
9114 APR_DRG Extensive Abdominal/thoracic Procedures For Mult Significant Trauma 1 1 — — $73,781.77 $73,781.77 $73,781.77 2025-12-31
A0407 HCPCS Traumatic Spinal Cord Injury M <24.50 And A >=61.50 5 3 — — $73,733.57 $81,106.93 $73,733.57 2024-12-31
'613-4 OTHER Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 1 1 — — $73,712.19 $73,712.19 $73,712.19 2024-12-31
6134 APR_DRG Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 1 1 — — $73,712.19 $73,712.19 $73,712.19 2025-12-31
11 APR_DRG Liver Transplant &/or Intestinal Transplant 1 1 — — $73,702.97 $73,702.97 $73,702.97 2025-12-31
'001-1 OTHER Liver Transplant &/or Intestinal Transplant 1 1 — — $73,702.97 $73,702.97 $73,702.97 2024-12-31
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 61 29 — $64,563.69 $5,095.00 $291,676.00 $73,669.42 2025-12-31
9124 APR_DRG Musculoskeletal & Other Procedures For Multiple Significant Trauma 1 1 — — $73,375.09 $73,375.09 $73,375.09 2025-12-31
'912-4 OTHER Musculoskeletal & Other Procedures For Multiple Significant Trauma 1 1 — — $73,375.09 $73,375.09 $73,375.09 2024-12-31
10 MS_DRG Pancreas Transplant 56 27 — $41,636.58 $5,095.00 $275,514.99 $73,274.61 2025-12-31
'589-3 OTHER Neonate Bwt <500g Or Ga <24 Weeks 1 1 — — $73,197.70 $73,197.70 $73,197.70 2024-12-31
5893 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 1 1 — — $73,197.70 $73,197.70 $73,197.70 2025-12-31
Sx00000075430-72942 CDM Ligasure Kit 27 12 $87,094.62 — $11,583.58 $84,734.36 $73,185.61 2025-12-31
'680-4 OTHER Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 1 1 — — $73,073.87 $73,073.87 $73,073.87 2024-12-31
6804 APR_DRG Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 1 1 — — $73,073.87 $73,073.87 $73,073.87 2025-12-31
6022 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $72,941.45 $72,941.45 $72,941.45 2025-12-31
'602-2 OTHER Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $72,941.45 $72,941.45 $72,941.45 2024-12-31
'401-4 OTHER Pituitary & Adrenal Procedures 1 1 — — $72,817.49 $72,817.49 $72,817.49 2024-12-31
4014 APR_DRG Pituitary & Adrenal Procedures 1 1 — — $72,817.49 $72,817.49 $72,817.49 2025-12-31
'023-4 OTHER Spinal Procedures 1 1 — — $71,718.22 $71,718.22 $71,718.22 2024-12-31
234 APR_DRG Spinal Procedures 1 1 — — $71,718.22 $71,718.22 $71,718.22 2025-12-31
8010000020-108127 CDM Live Donor Kidney Acquisition 29 13 $88,000.00 — $11,704.00 $85,615.20 $71,658.40 2025-12-31
32 APR_DRG Bone Marrow Transplant 1 1 — — $71,432.12 $71,432.12 $71,432.12 2025-12-31
'003-2 OTHER Bone Marrow Transplant 1 1 — — $71,432.12 $71,432.12 $71,432.12 2024-12-31
6214 APR_DRG Neonate Bwt 2000-2499g W Major Anomaly 1 1 — — $71,101.74 $71,101.74 $71,101.74 2025-12-31
'621-4 OTHER Neonate Bwt 2000-2499g W Major Anomaly 1 1 — — $71,101.74 $71,101.74 $71,101.74 2024-12-31
'004-2 OTHER Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 1 1 — — $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 1 1 — — $71,018.46 $71,018.46 $71,018.46 2025-12-31
Sx00000075430 CDM Ligasure Kit 30 14 $87,094.62 — $82.15 $95,804.08 $70,873.25 2024-12-31
C1904 HCPCS Guillain-barr? M <38.50 5 3 — — $69,890.83 $76,879.91 $69,890.83 2024-12-31
128782 CDM Live Donor Kidney Acquisition 33 15 $88,000.00 — $82.15 $96,800.00 $69,458.40 2024-12-31
B0505 HCPCS Non-traumatic Spinal Cord Injury M <39.50 5 3 — — $69,455.15 $76,400.66 $69,455.15 2024-12-31
C1806 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 5 3 — — $69,252.29 $76,177.52 $69,252.29 2024-12-31
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 40 24 — $61,128.00 $5,095.00 $266,998.33 $69,209.98 2025-12-31
6814 APR_DRG Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 1 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 1 1 — — $69,072.03 $69,072.03 $69,072.03 2024-12-31
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 22 14 — $61,436.79 $5,095.00 $268,347.11 $68,865.27 2025-12-31
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 61 29 — $60,172.19 $4,529.00 $262,823.53 $68,713.39 2025-12-31
'321-4 OTHER Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp 1 1 — — $68,449.71 $68,449.71 $68,449.71 2024-12-31
3214 APR_DRG Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp 1 1 — — $68,449.71 $68,449.71 $68,449.71 2025-12-31
1664 APR_DRG Coronary Bypass Without Ami Or Complex Pdx 1 1 — — $68,426.46 $68,426.46 $68,426.46 2025-12-31
'166-4 OTHER Coronary Bypass Without Ami Or Complex Pdx 1 1 — — $68,426.46 $68,426.46 $68,426.46 2024-12-31
53 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 1 1 — — $68,179.05 $68,179.05 $68,179.05 2025-12-31
'005-3 OTHER Tracheostomy W Mv 96+ Hours Without Extensive Procedure 1 1 — — $68,179.05 $68,179.05 $68,179.05 2024-12-31
C1827 HCPCS Generator Neurostimulator Vagal Nerve Stimulator Permanent Pulse 67 30 $136,290.00 — $82.15 $149,919.00 $68,145.00 2025-12-31
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 61 29 — $57,771.02 $5,095.00 $252,335.52 $68,130.68 2025-12-31
'608-3 OTHER Neonate Bwt 1250-1499g W Or Without Other Significant Condition 1 1 — — $68,126.13 $68,126.13 $68,126.13 2024-12-31
6083 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 1 1 — — $68,126.13 $68,126.13 $68,126.13 2025-12-31
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 61 29 — $55,939.86 $4,529.00 $244,337.28 $68,016.64 2025-12-31
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 61 29 — $54,703.80 $5,095.00 $240,417.29 $67,671.57 2025-12-31
D1904 HCPCS Guillain-barr? M <38.50 5 3 — — $67,670.94 $74,438.03 $67,670.94 2024-12-31
'260-4 OTHER Major Pancreas, Liver & Shunt Procedures 1 1 — — $67,604.46 $67,604.46 $67,604.46 2024-12-31
2604 APR_DRG Major Pancreas, Liver & Shunt Procedures 1 1 — — $67,604.46 $67,604.46 $67,604.46 2025-12-31
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 62 29 — $57,673.27 $5,095.00 $257,328.00 $67,294.19 2025-12-31
204 APR_DRG Craniotomy For Trauma 1 1 — — $67,081.58 $67,081.58 $67,081.58 2025-12-31
'020-4 OTHER Craniotomy For Trauma 1 1 — — $67,081.58 $67,081.58 $67,081.58 2024-12-31
B0106 HCPCS Stroke M <41.50 And A <84.50 5 3 — — $66,901.01 $73,591.11 $66,901.01 2024-12-31
955 MS_DRG Craniotomy For Multiple Significant Trauma 61 29 — $59,063.29 $5,095.00 $257,980.00 $66,848.64 2025-12-31
Sx00000076504-72753 CDM Ligasure Kit Lf1744/gen 27 12 $79,401.17 — $10,560.36 $77,249.40 $66,720.80 2025-12-31
'169-4 OTHER Major Abdominal Vascular Procedures 1 1 — — $66,523.20 $66,523.20 $66,523.20 2024-12-31
1694 APR_DRG Major Abdominal Vascular Procedures 1 1 — — $66,523.20 $66,523.20 $66,523.20 2025-12-31
L7181 HCPCS Electronic Elbo Simultaneous 5 5 — — $37,355.19 $120,305.46 $66,151.62 2025-12-31
9504 APR_DRG Extensive Procedure Unrelated To Principal Diagnosis 1 1 — — $65,683.46 $65,683.46 $65,683.46 2025-12-31
'950-4 OTHER Extensive Procedure Unrelated To Principal Diagnosis 1 1 — — $65,683.46 $65,683.46 $65,683.46 2024-12-31
224 APR_DRG Ventricular Shunt Procedures 1 1 — — $65,639.90 $65,639.90 $65,639.90 2025-12-31
'022-4 OTHER Ventricular Shunt Procedures 1 1 — — $65,639.90 $65,639.90 $65,639.90 2024-12-31
'089-4 OTHER Major Cranial/facial Bone Procedures 1 1 — — $65,617.60 $65,617.60 $65,617.60 2024-12-31
894 APR_DRG Major Cranial/facial Bone Procedures 1 1 — — $65,617.60 $65,617.60 $65,617.60 2025-12-31
8010000023-108124 CDM Cadaver Kidney/pancreas Acquis 29 13 $80,453.00 — $10,700.25 $78,272.72 $65,512.88 2025-12-31
'695-4 OTHER Chemotherapy For Acute Leukemia 1 1 — — $65,438.74 $65,438.74 $65,438.74 2024-12-31
6954 APR_DRG Chemotherapy For Acute Leukemia 1 1 — — $65,438.74 $65,438.74 $65,438.74 2025-12-31
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs 1 1 — — $65,389.67 $65,389.67 $65,389.67 2025-12-31
'510-4 OTHER Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs 1 1 — — $65,389.67 $65,389.67 $65,389.67 2024-12-31
459 MS_DRG Spinal Fusion Except Cervical With Mcc 35 18 — $57,367.94 $42,400.00 $232,011.11 $65,329.24 2025-12-31
'162-3 OTHER Cardiac Valve Procedures W Ami Or Complex Pdx 1 1 — — $65,316.51 $65,316.51 $65,316.51 2024-12-31
1623 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 1 1 — — $65,316.51 $65,316.51 $65,316.51 2025-12-31
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 22 14 — $57,994.18 $5,095.00 $253,310.27 $65,050.75 2025-12-31
A1904 HCPCS Guillain-barr? M <38.50 5 3 — — $64,976.18 $71,473.80 $64,976.18 2024-12-31
Sx00000076504 CDM Ligasure Kit Lf1744/gen 30 14 $79,401.17 — $82.15 $87,341.29 $64,612.71 2024-12-31
'220-4 OTHER Major Stomach, Esophageal & Duodenal Procedures 1 1 — — $64,483.36 $64,483.36 $64,483.36 2024-12-31
2204 APR_DRG Major Stomach, Esophageal & Duodenal Procedures 1 1 — — $64,483.36 $64,483.36 $64,483.36 2025-12-31
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 55 27 — $51,421.21 $4,529.00 $224,600.49 $64,186.32 2025-12-31
D1806 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 5 3 — — $63,897.35 $70,287.09 $63,897.35 2024-12-31
338 MS_DRG Appendectomy W Complicated Principal Diag W Mcc 13 5 — — $22,544.61 $96,761.00 $63,805.00 2025-12-31
244 APR_DRG Extracranial Vascular Procedures 1 1 — — $63,665.98 $63,665.98 $63,665.98 2025-12-31
'024-4 OTHER Extracranial Vascular Procedures 1 1 — — $63,665.98 $63,665.98 $63,665.98 2024-12-31
128788 CDM Cadaver Kidney/pancreas Acquis 33 15 $80,453.00 — $82.15 $88,498.30 $63,501.55 2024-12-31
131 MS_DRG Cranial/facial Procedures W Cc/mcc 7 3 — — $58,540.00 $88,777.00 $63,450.00 2024-12-31
J9029 HCPCS Instill Adstiladrin, Tx Dose 16 14 — $63,431.05 $53,916.39 $76,117.26 $63,431.05 2025-12-31
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 63 29 — $55,859.41 $5,095.00 $244,242.00 $63,265.78 2025-12-31
B0205 HCPCS Traumatic Brain Injury M <35.50 5 3 — — $62,991.42 $69,290.56 $62,991.42 2024-12-31
4414 APR_DRG Major Bladder Procedures 1 1 — — $62,422.19 $62,422.19 $62,422.19 2025-12-31
'441-4 OTHER Major Bladder Procedures 1 1 — — $62,422.19 $62,422.19 $62,422.19 2024-12-31
4034 APR_DRG Procedures For Obesity 1 1 — — $61,677.07 $61,677.07 $61,677.07 2025-12-31
'403-4 OTHER Procedures For Obesity 1 1 — — $61,677.07 $61,677.07 $61,677.07 2024-12-31
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 61 29 — $51,819.10 $5,095.00 $276,053.00 $61,564.76 2025-12-31
B0405 HCPCS Traumatic Spinal Cord Injury M >=31.50 And M <41.50 5 3 — — $61,347.82 $67,482.60 $61,347.82 2024-12-31
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 61 29 — $53,267.08 $5,095.00 $232,662.95 $61,291.82 2025-12-31
4834 APR_DRG Testes & Scrotal Procedures 1 1 — — $61,065.84 $61,065.84 $61,065.84 2025-12-31
'483-4 OTHER Testes & Scrotal Procedures 1 1 — — $61,065.84 $61,065.84 $61,065.84 2024-12-31
C1605 HCPCS System Leadless Pacemaker Aveir Dr 32 14 $118,965.00 — $18,439.58 $115,741.05 $61,058.79 2025-12-31
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 69 33 — $53,081.10 $5,095.00 $238,524.76 $61,040.21 2025-12-31
276 MS_DRG Cardiac Defibrillator Implant With Mcc 40 24 — $53,580.20 $5,095.00 $234,030.63 $60,965.88 2025-12-31
Sx00000046460-81225 CDM Kit Starter Stapler Endowrist 45 27 12 $72,354.00 — $9,623.08 $70,393.21 $60,799.07 2025-12-31
C0406 HCPCS Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 5 3 — — $60,693.15 $66,762.46 $60,693.15 2024-12-31
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 61 29 — $53,121.76 $5,095.00 $303,464.00 $60,667.79 2025-12-31
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 56 27 — $53,429.69 $4,529.00 $208,576.56 $60,326.99 2025-12-31
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 56 27 — $53,429.69 $4,529.00 $251,021.00 $60,326.99 2025-12-31
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