Price Transparency 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

NYACK HOSPITAL

Nyack, NY · CCN 330104 · Rates published

81,899 distinct procedures filed
31 distinct payers
1,799,957 rate rows
2026-04-01 last MRF observed
Data quality

1,607,054 of 1,799,957 rate rows are consumer-grade (89.3%)

192,903 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 180,762
per-diem day rate — not a per-procedure price 6,972
template filing: same amount across many unrelated codes — excluded 4,114
placeholder amount (≤ $0.02) — excluded from medians 934
exceeds 10× this hospital's gross charge — excluded from medians 121
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.montefiorenyack.org/sites/default/files/131740119_nyack-hospital_standardcharges.csv
Discovered viaDiscovered by HANK (automated)
Last fetch success · 2026-05-26
Content fingerprint 1fd08bc3f2333cd2… · 310,421,522 bytes · first seen 2026-05-26

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 		Inj Hemgenix Per Tx Dose 17 $3,500,000.00 $4,780,514.42 $4,345,922.20 nat. median
$3,710,000
1.2× median
J1414
HCPCS 		Inj Beqvez Per Tx Dose 15 $4,137,612.79 $4,692,138.22 $4,265,580.20 nat. median
$3,710,000
1.1× median
J3389
HCPCS 		Topi Adm Prad Zami Per Treat 2 $4,198,044.74 $4,279,560.17 $4,198,044.74 nat. median
$3,335,820
1.3× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 16 $3,816,766.76 $4,721,773.31 $3,934,811.09 nat. median
$3,325,455
1.2× median
J3387
HCPCS 		Inj Elivaldogene Autotemecel 2 $3,888,686.51 $3,964,194.99 $3,888,686.51 nat. median
$3,180,000
1.2× median
J3394
HCPCS 		Inj Lovotibeglogene Autotem 16 $3,720,000.00 $4,665,751.97 $3,888,126.64 nat. median
$3,286,000
1.2× median
J3393
HCPCS 		Inj Betibeglogene Autotemce 17 $3,360,000.00 $4,846,361.72 $3,511,856.32 nat. median
$3,006,423
1.2× median
J3399
HCPCS 		Inj Onase Abepar Xioi Treat 17 $2,741,514.78 $3,900,299.38 $2,882,829.98 nat. median
$2,469,189
1.2× median
J3392
HCPCS 		Inj Exagamglogene Autotem 17 $2,640,000.00 $3,807,855.64 $2,759,315.68 nat. median
$2,448,600
1.1× median
Q2057
HCPCS 		Afamitresgene Autoleucel 17 $872,400.00 $2,532,793.52 $941,558.93 nat. median
$824,563
1.1× median
Q2056
HCPCS 		Ciltacabtagene Car Pos T 7 $497,024.65 $748,456.24 $666,372.50 nat. median
$675,122
1.0× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 7 $473,458.43 $733,693.15 $637,620.44 nat. median
$674,188
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 7 $483,453.66 $747,695.40 $633,974.94 nat. median
$625,184
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car Pos T 7 $484,623.49 $759,132.06 $626,162.15 nat. median
$754,974
0.8× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car 7 $449,341.85 $694,972.64 $604,296.00 nat. median
$634,511
1.0× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 7 $449,440.00 $653,901.59 $554,400.00 nat. median
$620,080
0.9× median
C9098
HCPCS 		HCPCS C9098 1 $478,950.00 $478,950.00 $478,950.00 nat. median
$57,174
outlier · 8.4×
C9081
HCPCS 		HCPCS C9081 1 $432,085.00 $432,085.00 $432,085.00 nat. median
$30,475
outlier · 14.2×
18
MS_DRG 		Chimeric Antigen Receptor Car T Cell And Other Immunotherapies 27 $238,630.15 $3,016,816.00 $373,752.72 nat. median
$370,174
1.0× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 17 $336,571.71 $914,523.12 $350,170.56 nat. median
$324,450
1.1× median
J3403
HCPCS 		Revakinagene Per Implant 2 $324,057.21 $330,349.58 $324,057.21 nat. median
$265,000
1.2× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 27 $178,236.98 $2,253,312.00 $279,162.37 nat. median
$265,286
1.1× median
24
APR_DRG 		Heart Or Lung Transplant 13 $127,919.28 $1,217,989.02 $262,994.95 nat. median
$234,738
1.1× median
J3402
HCPCS 		Inj Remestemcel L Rknd Td 2 $258,792.71 $263,817.81 $258,792.71 nat. median
$209,753
1.2× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns W Mv 96 Hours W Skin Graft 27 $150,117.88 $1,897,824.00 $235,121.03 nat. median
$206,368
1.1× median
3
MS_DRG 		Ecmo Or Trach W Mv 96 Hrs Or Pdx Exc Face Mouth Neck W Maj O R 27 $135,610.31 $1,714,416.00 $212,398.65 nat. median
$202,986
1.0× median
5834
APR_DRG 		Neonate W Ecmo 13 $94,230.28 $896,585.04 $193,595.62 nat. median
$309,665
0.6× median
5883
APR_DRG 		Neonate Bwt 1500g W Major Procedure 13 $171,727.32 $880,824.99 $190,711.37 nat. median
$182,736
1.0× median
5884
APR_DRG 		Neonate Bwt 1500g W Major Procedure 13 $92,578.34 $880,824.99 $190,192.62 nat. median
$246,434
0.8× median
C1833
HCPCS 		HCPCS C1833 1 $187,725.00 $187,725.00 $187,725.00 nat. median
$9,621
outlier · 19.5×
1614
APR_DRG 		Cardiac Defibrillator Heart Assist Implant 13 $84,699.51 $805,658.40 $173,962.23 nat. median
$207,730
0.8× median
34
APR_DRG 		Bone Marrow Transplant 13 $82,246.30 $782,253.93 $168,908.61 nat. median
$209,067
0.8× median
48109150
CDM 		Hc Insj Perm Ccm D Sys Pg Eltrd 3 $122,699.40 $173,824.15 $158,486.73 nat. median
$123,229
1.3× median
5914
APR_DRG 		Neonate Birthwt 500 749g W O Major Procedure 13 $71,138.96 $676,286.30 $146,027.49 nat. median
$164,279
0.9× median
5882
APR_DRG 		Neonate Bwt 1500g W Major Procedure 13 $131,373.70 $673,842.88 $146,018.65 nat. median
$145,336
1.0× median
5881
APR_DRG 		Neonate Bwt 1500g W Major Procedure 13 $131,373.70 $673,842.88 $146,018.65 nat. median
$124,573
1.2× median
8414
APR_DRG 		Extensive 3rd Degree Burns W Skin Graft 13 $68,811.60 $654,082.59 $141,233.15 nat. median
$160,267
0.9× median
4
MS_DRG 		Trach W Mv 96 Hrs Or Pdx Exc Face Mouth Neck W O Maj O R 27 $89,408.94 $1,130,328.00 $140,036.10 nat. median
$133,176
1.1× median
44
APR_DRG 		Tracheostomy W Mv 96 Hours W Extensive Procedure Or Ecmo 13 $66,373.76 $630,824.72 $136,211.18 nat. median
$105,658
1.3× median
14
APR_DRG 		Liver Transplant Or Intestinal Transplant 13 $64,300.32 $611,043.49 $131,939.90 nat. median
$129,535
1.0× median
5934
APR_DRG 		Neonate Birthwt 750 999g W O Major Procedure 13 $64,046.04 $608,617.53 $131,416.07 nat. median
$151,838
0.9× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 27 $82,902.50 $1,048,072.00 $129,845.42 nat. median
$117,303
1.1× median
7
MS_DRG 		Lung Transplant 27 $82,693.67 $1,045,432.00 $129,518.36 nat. median
$122,708
1.1× median
6094
APR_DRG 		Neonate Bwt 1500 2499g W Major Procedure 13 $58,661.40 $557,246.37 $120,323.73 nat. median
$162,982
0.7× median
23
APR_DRG 		Heart Or Lung Transplant 13 $102,548.31 $525,991.53 $114,093.77 nat. median
$93,528
1.2× median
6024
APR_DRG 		Neonate Bwt 1000 1249g W Resp Dist Synd Oth Maj Resp Or Maj Anom 13 $55,578.51 $527,834.57 $113,972.97 nat. median
$118,620
1.0× median
48109160
CDM 		Hc Insj Perm Ccm D Sys Pg Only 3 $85,901.40 $121,693.65 $110,955.98 nat. median
$86,272
1.3× median
48109230
CDM 		Hc Rmvl Rplcmt Perm Ccm D Pg 3 $85,901.40 $121,693.65 $110,955.98 nat. median
$86,272
1.3× median
8413
APR_DRG 		Extensive 3rd Degree Burns W Skin Graft 13 $99,649.92 $511,125.07 $110,883.72 nat. median
$66,693
1.7× median
5833
APR_DRG 		Neonate W Ecmo 13 $99,306.25 $509,362.31 $110,503.10 nat. median
$244,017
outlier · 0.5×

Other procedures at this hospital

Browse this hospital's 81,899 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
             
36137236 CDM Hc Open Perq Place Stent 1st 8 3 $57,264.97 $12,402.50 78% off $34,358.98 $48,675.23 $44,380.36 2025-06-27
3043 APR_DRG Dorsal Lumbar Fusion Proc Except For Curvature Of Back 98 13 — $39,488.74 $36,256.13 $185,965.21 $40,673.40 2026-04-01
8411 APR_DRG Extensive 3rd Degree Burns W Skin Graft 98 13 — $39,775.58 $36,522.90 $187,333.52 $40,968.85 2026-04-01
224 APR_DRG Ventricular Shunt Procedures 104 13 — $39,927.06 $19,963.53 $188,056.08 $40,606.11 2026-04-01
4234 APR_DRG Inborn Errors Of Metabolism 104 13 — $40,298.79 $20,149.40 $189,829.30 $40,989.00 2026-04-01
3024 APR_DRG Knee Joint Replacement 104 13 — $40,331.72 $20,165.86 $189,986.38 $41,022.91 2026-04-01
2224 APR_DRG Other Stomach Esophageal Duodenal Procedures 104 13 — $40,999.08 $20,499.54 $193,169.80 $41,710.30 2026-04-01
2244 APR_DRG Peritoneal Adhesiolysis 104 13 — $41,252.27 $20,626.14 $194,377.55 $41,971.09 2026-04-01
2234 APR_DRG Other Small Large Bowel Procedures 104 13 — $41,324.71 $20,662.36 $194,723.12 $42,045.70 2026-04-01
4403 APR_DRG Kidney Transplant 98 13 — $42,011.83 $38,602.62 $198,000.79 $43,272.18 2026-04-01
6082 APR_DRG Neonate Bwt 1250 1499g W Or W O Other Significant Condition 98 13 — $42,111.35 $38,695.17 $198,475.52 $43,374.69 2026-04-01
51 APR_DRG Tracheostomy W Mv 96 Hours W O Extensive Procedure 98 13 — $42,185.26 $38,763.91 $198,828.07 $43,450.82 2026-04-01
6504 APR_DRG Splenectomy 104 13 — $42,235.75 $21,117.88 $199,068.92 $42,984.07 2026-04-01
1623 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 98 13 — $42,482.35 $39,040.20 $200,245.25 $43,756.82 2026-04-01
3094 APR_DRG Other Significant Hip And Femur Surgery 104 13 — $42,543.82 $21,271.91 $200,538.46 $43,301.39 2026-04-01
3084 APR_DRG Hip And Femur Fracture Repair 104 13 — $42,717.25 $21,358.63 $201,365.73 $43,480.01 2026-04-01
2294 APR_DRG Other Digestive System Abdominal Procedures 104 13 — $42,848.96 $21,424.48 $201,994.04 $43,615.68 2026-04-01
52 APR_DRG Tracheostomy W Mv 96 Hours W O Extensive Procedure 98 13 — $43,264.60 $39,767.69 $203,976.70 $44,562.54 2026-04-01
3814 APR_DRG Major Skin Disorders 104 13 — $43,697.80 $21,848.90 $206,043.14 $44,489.98 2026-04-01
434 APR_DRG Multiple Sclerosis Other Demyelinating Diseases 104 13 — $43,806.83 $21,903.42 $206,563.24 $44,602.29 2026-04-01
6303 APR_DRG Neonate Birthwt 2499g W Major Cardiovascular Procedure 98 13 — $43,863.91 $40,325.05 $206,835.50 $45,179.83 2026-04-01
9524 APR_DRG Nonextensive Procedure Unrelated To Principal Diagnosis 104 13 — $43,908.55 $21,954.28 $207,048.43 $44,707.05 2026-04-01
1714 APR_DRG Perm Cardiac Pacemaker Implant W O Ami Heart Failure Or Shock 104 13 — $44,144.17 $22,072.09 $208,172.40 $44,949.75 2026-04-01
494 APR_DRG Bacterial Tuberculous Infections Of Nervous System 104 13 — $44,171.25 $22,085.63 $208,301.56 $44,977.63 2026-04-01
5184 APR_DRG Other Female Reproductive System Related Procedures 104 13 — $44,247.35 $22,123.68 $208,664.58 $45,056.02 2026-04-01
7114 APR_DRG Post Op Post Trauma Other Device Infections W O R Procedure 104 13 — $44,671.77 $22,335.89 $210,689.13 $45,493.17 2026-04-01
6071 APR_DRG Neonate Bwt 1250 1499g W Resp Dist Synd Oth Maj Resp Or Maj Anom 98 13 — $44,710.55 $41,112.43 $210,874.13 $46,051.87 2026-04-01
5194 APR_DRG Uterine Adnexa Procedures For Leiomyoma 104 13 — $44,766.17 $22,383.09 $211,139.41 $45,590.40 2026-04-01
2624 APR_DRG Cholecystectomy Except Laparoscopic 104 13 — $44,801.29 $22,400.65 $211,306.96 $45,626.58 2026-04-01
3014 APR_DRG Hip Joint Replacement 104 13 — $44,802.02 $22,401.01 $211,310.45 $45,627.33 2026-04-01
1214 APR_DRG Other Respiratory Chest Procedures 104 13 — $44,826.90 $22,413.45 $211,429.13 $45,652.96 2026-04-01
6903 APR_DRG Acute Leukemia 98 13 — $44,869.35 $41,260.10 $211,631.59 $46,215.43 2026-04-01
1304 APR_DRG Respiratory System Diagnosis W Ventilator Support 96 Hours 104 13 — $44,941.79 $22,470.90 $211,977.16 $45,771.28 2026-04-01
1204 APR_DRG Major Respiratory Chest Procedures 104 13 — $45,073.51 $22,536.76 $212,605.46 $45,906.96 2026-04-01
1612 APR_DRG Cardiac Defibrillator Heart Assist Implant 98 13 — $45,342.79 $41,700.41 $213,890.01 $46,703.07 2026-04-01
2614 APR_DRG Major Biliary Tract Procedures 104 13 — $45,437.92 $22,718.96 $214,343.78 $46,282.31 2026-04-01
2644 APR_DRG Other Hepatobiliary Pancreas Abdominal Procedures 104 13 — $45,540.37 $22,770.19 $214,832.47 $46,387.82 2026-04-01
12 APR_DRG Liver Transplant Or Intestinal Transplant 98 13 — $45,604.03 $41,943.35 $215,136.15 $46,972.15 2026-04-01
11 APR_DRG Liver Transplant Or Intestinal Transplant 98 13 — $45,604.03 $41,943.35 $215,136.15 $46,972.15 2026-04-01
4444 APR_DRG Renal Dialysis Access Device Procedure Only 104 13 — $45,769.41 $22,884.71 $215,925.03 $46,623.73 2026-04-01
5114 APR_DRG Uterine Adnexa Procedures For Ovarian Adnexal Malignancy 104 13 — $46,065.77 $23,032.89 $217,338.72 $46,928.98 2026-04-01
1664 APR_DRG Coronary Bypass W O Ami Or Complex Pdx 104 13 — $46,100.89 $23,050.45 $217,506.27 $46,965.17 2026-04-01
6113 APR_DRG Neonate Birthwt 1500 1999g W Major Anomaly 98 13 — $46,354.08 $42,640.91 $218,714.01 $47,744.70 2026-04-01
1824 APR_DRG Other Peripheral Vascular Procedures 90 13 — $46,399.45 $42,683.09 $218,930.43 $46,836.06 2026-04-01
9514 APR_DRG Moderately Extensive Procedure Unrelated To Principal Diagnosis 104 13 — $46,422.13 $23,211.07 $219,038.64 $47,296.04 2026-04-01
264 APR_DRG Other Nervous System Related Procedures 104 13 — $46,427.99 $23,214.00 $219,066.57 $47,302.07 2026-04-01
3054 APR_DRG Amputation Of Lower Limb Except Toes 104 13 — $46,617.51 $23,308.76 $219,970.63 $47,497.29 2026-04-01
3174 APR_DRG Tendon Muscle Other Soft Tissue Procedures 104 13 — $46,736.06 $23,368.03 $220,536.11 $47,619.38 2026-04-01
7104 APR_DRG Infectious Parasitic Diseases Including HIV W O R Procedure 104 13 — $46,753.62 $23,376.81 $220,619.88 $47,637.47 2026-04-01
6914 APR_DRG Lymphoma Myeloma Non Acute Leukemia 104 13 — $46,844.36 $23,422.18 $221,052.72 $47,730.93 2026-04-01
1774 APR_DRG Cardiac Pacemaker Defibrillator Revision Except Device Replacement 104 13 — $46,857.53 $23,428.77 $221,115.55 $47,744.50 2026-04-01
6123 APR_DRG Neonate Bwt 1500 1999g W Resp Dist Synd Oth Maj Resp Cond 98 13 — $46,919.00 $43,166.28 $221,408.76 $48,326.57 2026-04-01
4424 APR_DRG Kidney Urinary Tract Procedures For Malignancy 104 13 — $47,159.74 $23,579.87 $222,557.17 $48,055.78 2026-04-01
5104 APR_DRG Pelvic Evisceration Radical Hysterectomy Other Radical GYN Procs 104 13 — $47,404.15 $23,702.08 $223,723.03 $48,307.53 2026-04-01
3134 APR_DRG Knee Lower Leg Procedures Except Foot 104 13 — $47,857.84 $23,928.92 $225,887.20 $48,774.83 2026-04-01
9114 APR_DRG Extensive Abdominal Thoracic Procedures For Mult Significant Trauma 104 13 — $47,996.87 $23,998.44 $226,550.41 $48,918.03 2026-04-01
6021 APR_DRG Neonate Bwt 1000 1249g W Resp Dist Synd Oth Maj Resp Or Maj Anom 98 13 — $48,014.44 $44,185.03 $226,634.19 $49,454.87 2026-04-01
4034 APR_DRG Procedures For Obesity 104 13 — $48,629.11 $24,314.56 $229,566.29 $49,569.23 2026-04-01
2214 APR_DRG Major Small Large Bowel Procedures 104 13 — $48,860.35 $24,430.18 $230,669.32 $49,807.40 2026-04-01
7914 APR_DRG O R Procedure For Other Complications Of Treatment 104 13 — $48,877.91 $24,438.96 $230,753.09 $49,825.49 2026-04-01
1814 APR_DRG Lower Extremity Arterial Procedures 90 13 — $48,920.35 $45,027.54 $230,955.55 $49,394.78 2026-04-01
31 APR_DRG Bone Marrow Transplant 98 13 — $48,986.94 $45,089.47 $231,273.19 $50,456.55 2026-04-01
1674 APR_DRG Other Cardiothoracic Thoracic Vascular Procedures 104 13 — $49,027.92 $24,513.96 $231,468.67 $49,980.01 2026-04-01
204 APR_DRG Craniotomy For Trauma 104 13 — $49,458.19 $24,729.10 $233,521.14 $50,423.19 2026-04-01
4414 APR_DRG Major Bladder Procedures 104 13 — $49,994.57 $24,997.29 $236,079.75 $50,975.66 2026-04-01
6214 APR_DRG Neonate Bwt 2000 2499g W Major Anomaly 104 13 — $50,205.32 $25,102.66 $237,085.04 $51,192.72 2026-04-01
244 APR_DRG Extracranial Vascular Procedures 104 13 — $50,216.29 $25,108.15 $237,137.40 $51,204.03 2026-04-01
894 APR_DRG Major Cranial Facial Bone Procedures 104 13 — $50,399.23 $25,199.62 $238,010.05 $51,392.46 2026-04-01
6083 APR_DRG Neonate Bwt 1250 1499g W Or W O Other Significant Condition 98 13 — $50,435.82 $46,436.93 $238,184.58 $51,948.89 2026-04-01
3104 APR_DRG Intervertebral Disc Excision Decompression 104 13 — $50,571.93 $25,285.97 $238,833.83 $51,570.33 2026-04-01
6032 APR_DRG Neonate Birthwt 1000 1249g W Or W O Other Significant Condition 98 13 — $50,983.91 $46,946.64 $240,799.04 $52,513.43 2026-04-01
4014 APR_DRG Pituitary Adrenal Procedures 104 13 — $51,636.63 $25,818.32 $243,912.66 $52,666.98 2026-04-01
3033 APR_DRG Dorsal Lumbar Fusion Proc For Curvature Of Back 98 13 — $51,638.83 $47,555.72 $243,923.13 $53,187.99 2026-04-01
1634 APR_DRG Cardiac Valve Procedures W O Ami Or Complex Pdx 104 13 — $52,070.57 $26,035.29 $245,982.58 $53,113.93 2026-04-01
3214 APR_DRG Cervical Spinal Fusion Other Back Neck Proc Exc Disc Excis Decomp 104 13 — $52,196.43 $26,098.22 $246,582.97 $53,243.56 2026-04-01
1654 APR_DRG Coronary Bypass W Ami Or Complex Pdx 104 13 — $52,287.17 $26,143.59 $247,015.80 $53,337.03 2026-04-01
8412 APR_DRG Extensive 3rd Degree Burns W Skin Graft 98 13 — $52,325.95 $48,194.74 $247,200.80 $53,895.73 2026-04-01
2204 APR_DRG Major Stomach Esophageal Duodenal Procedures 104 13 — $52,368.39 $26,184.20 $247,403.26 $53,420.69 2026-04-01
6084 APR_DRG Neonate Bwt 1250 1499g W Or W O Other Significant Condition 104 13 — $53,061.36 $26,530.68 $250,708.85 $54,134.45 2026-04-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 104 13 — $53,062.10 $26,531.05 $250,712.35 $54,135.20 2026-04-01
1694 APR_DRG Major Abdominal Vascular Procedures 104 13 — $53,065.02 $26,532.51 $250,726.31 $54,138.22 2026-04-01
41 APR_DRG Tracheostomy W Mv 96 Hours W Extensive Procedure Or Ecmo 98 13 — $53,106.73 $48,920.87 $250,925.27 $54,699.93 2026-04-01
42 APR_DRG Tracheostomy W Mv 96 Hours W Extensive Procedure Or Ecmo 98 13 — $53,106.73 $48,920.87 $250,925.27 $54,699.93 2026-04-01
214 APR_DRG Craniotomy Except For Trauma 104 13 — $53,493.10 $26,746.55 $252,768.31 $54,579.14 2026-04-01
6093 APR_DRG Neonate Bwt 1500 2499g W Major Procedure 98 13 — $53,798.24 $49,563.98 $254,223.89 $55,412.19 2026-04-01
63 APR_DRG Pancreas Transplant 98 13 — $54,025.82 $49,775.63 $255,309.47 $55,646.59 2026-04-01
924 APR_DRG Facial Bone Procedures Except Major Cranial Facial Bone Procedures 104 13 — $54,312.67 $27,156.34 $256,677.78 $55,423.29 2026-04-01
6954 APR_DRG Chemotherapy For Acute Leukemia 90 13 — $54,557.08 $50,269.69 $257,843.64 $55,116.06 2026-04-01
2604 APR_DRG Major Pancreas Liver Shunt Procedures 104 13 — $54,847.58 $27,423.79 $259,229.41 $55,974.26 2026-04-01
64654 CPT 1st Opn Implt Bat Modulj Sys 26 18 — $54,982.51 $12,966.00 $147,902.95 $54,982.51 2026-04-01
33276 CPT Insj Phrnc Nrv Stim Sys 93 22 — $54,982.51 $673.58 $147,902.95 $53,246.39 2026-04-01
J9226 HCPCS Supprelin La Implant 52 19 — $55,007.13 $44,695.10 $144,345.91 $55,963.67 2026-04-01
6072 APR_DRG Neonate Bwt 1250 1499g W Resp Dist Synd Oth Maj Resp Or Maj Anom 98 13 — $55,227.37 $50,893.06 $261,041.03 $56,884.19 2026-04-01
5124 APR_DRG Uterine Adnexa Procedures For Non Ovarian Non Adnexal Malig 104 13 — $55,410.30 $27,705.15 $261,913.68 $56,553.86 2026-04-01
9124 APR_DRG Musculoskeletal Other Procedures For Multiple Significant Trauma 104 13 — $55,945.95 $27,972.98 $264,468.80 $57,105.58 2026-04-01
8504 APR_DRG Procedure W Diag Of Rehab Aftercare Or Oth Contact W Health Service 104 13 — $56,312.56 $28,156.28 $266,217.59 $57,483.19 2026-04-01
4474 APR_DRG Other Kidney Urinary Tract Related Procedures 104 13 — $56,341.10 $28,170.55 $266,353.72 $57,512.57 2026-04-01
64 APR_DRG Pancreas Transplant 104 13 — $56,401.84 $28,200.92 $266,643.44 $57,575.14 2026-04-01
32 APR_DRG Bone Marrow Transplant 98 13 — $57,292.38 $52,813.53 $270,891.50 $59,011.15 2026-04-01
234 APR_DRG Spinal Procedures 104 13 — $59,644.98 $29,822.49 $282,113.78 $60,915.58 2026-04-01
9504 APR_DRG Extensive Procedure Unrelated To Principal Diagnosis 104 13 — $59,880.61 $29,940.31 $283,237.76 $61,158.27 2026-04-01
6114 APR_DRG Neonate Birthwt 1500 1999g W Major Anomaly 104 13 — $60,607.97 $30,303.99 $286,707.41 $61,907.46 2026-04-01
13 APR_DRG Liver Transplant Or Intestinal Transplant 98 13 — $61,726.10 $56,936.88 $292,041.05 $63,577.88 2026-04-01
4054 APR_DRG Other Procedures For Endocrine Nutritional Metabolic Disorders 104 13 — $61,884.16 $30,942.08 $292,795.02 $63,221.93 2026-04-01
6124 APR_DRG Neonate Bwt 1500 1999g W Resp Dist Synd Oth Maj Resp Cond 104 13 — $62,509.81 $31,254.91 $295,779.48 $63,866.36 2026-04-01
8424 APR_DRG Burns With Skin Graft Except Extensive 3rd Degree Burns 104 13 — $63,710.62 $31,855.31 $301,507.56 $65,103.19 2026-04-01
6904 APR_DRG Acute Leukemia 104 13 — $64,555.07 $32,277.54 $305,535.71 $65,972.97 2026-04-01
5911 APR_DRG Neonate Birthwt 500 749g W O Major Procedure 98 13 — $65,552.46 $60,495.39 $310,293.40 $67,519.03 2026-04-01
6804 APR_DRG Major O R Procedures For Lymphatic Hematopoietic Other Neoplasms 104 13 — $65,968.83 $32,984.42 $312,279.55 $67,429.14 2026-04-01
6814 APR_DRG Other O R Procedures For Lymphatic Hematopoietic Other Neoplasms 104 13 — $66,151.03 $33,075.52 $313,148.71 $67,616.81 2026-04-01
6033 APR_DRG Neonate Birthwt 1000 1249g W Or W O Other Significant Condition 98 13 — $66,204.45 $61,101.75 $313,403.52 $68,190.58 2026-04-01
3124 APR_DRG Skin Graft Except Hand For Musculoskeletal Connective Tissue Diagnoses 104 13 — $66,378.61 $33,189.31 $314,234.28 $67,851.22 2026-04-01
6073 APR_DRG Neonate Bwt 1250 1499g W Resp Dist Synd Oth Maj Resp Or Maj Anom 98 13 — $67,452.83 $62,262.74 $319,358.48 $69,476.41 2026-04-01
Q2043 HCPCS Sipuleucel T Auto Cd54 105 24 — $67,532.83 $42,911.88 $113,331.37 $58,316.14 2026-04-01
3044 APR_DRG Dorsal Lumbar Fusion Proc Except For Curvature Of Back 104 13 — $67,695.04 $33,847.52 $320,513.87 $69,207.14 2026-04-01
53 APR_DRG Tracheostomy W Mv 96 Hours W O Extensive Procedure 98 13 — $68,064.58 $62,831.66 $322,276.63 $70,106.52 2026-04-01
1624 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 104 13 — $69,176.85 $34,588.43 $327,582.34 $70,733.40 2026-04-01
A9543 HCPCS Y90 Ibritumomab Rx 76 21 — $69,429.37 $24,521.62 $291,398.54 $77,474.51 2026-04-01
6022 APR_DRG Neonate Bwt 1000 1249g W Resp Dist Synd Oth Maj Resp Or Maj Anom 98 13 — $69,903.48 $64,541.85 $331,048.50 $72,000.58 2026-04-01
3614 APR_DRG Skin Graft For Skin Subcutaneous Tissue Diagnoses 104 13 — $70,755.98 $35,377.99 $335,115.05 $72,359.91 2026-04-01
1613 APR_DRG Cardiac Defibrillator Heart Assist Implant 98 13 — $72,505.61 $66,961.83 $343,461.08 $74,680.78 2026-04-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 104 13 — $73,268.83 $36,634.42 $347,101.77 $74,948.15 2026-04-01
43 APR_DRG Tracheostomy W Mv 96 Hours W Extensive Procedure Or Ecmo 98 13 — $74,195.97 $68,533.87 $351,524.36 $76,421.85 2026-04-01
4404 APR_DRG Kidney Transplant 104 13 — $76,490.03 $38,245.02 $362,467.39 $78,265.97 2026-04-01
J9029 HCPCS Instill Adstiladrin Tx Dose 50 19 — $77,392.87 $72,000.00 $201,652.89 $74,963.90 2026-04-01
6314 APR_DRG Neonate Birthwt 2499g W Other Major Procedure 104 13 — $77,436.19 $38,718.10 $366,980.74 $79,240.53 2026-04-01
5931 APR_DRG Neonate Birthwt 750 999g W O Major Procedure 98 13 — $79,553.90 $73,516.73 $377,082.54 $81,940.52 2026-04-01
3034 APR_DRG Dorsal Lumbar Fusion Proc For Curvature Of Back 104 13 — $80,224.92 $40,112.46 $380,283.42 $82,112.91 2026-04-01
5912 APR_DRG Neonate Birthwt 500 749g W O Major Procedure 98 13 — $81,157.17 $75,007.78 $384,730.44 $83,591.89 2026-04-01
5932 APR_DRG Neonate Birthwt 750 999g W O Major Procedure 98 13 — $82,036.75 $75,825.78 $388,926.14 $84,497.85 2026-04-01
6023 APR_DRG Neonate Bwt 1000 1249g W Resp Dist Synd Oth Maj Resp Or Maj Anom 98 13 — $82,183.10 $75,961.89 $389,624.26 $84,648.59 2026-04-01
904 APR_DRG Major Larynx Trachea Procedures 104 13 — $82,682.89 $41,341.45 $392,008.34 $84,644.62 2026-04-01
5913 APR_DRG Neonate Birthwt 500 749g W O Major Procedure 98 13 — $86,959.28 $80,403.74 $412,407.41 $89,568.06 2026-04-01
33 APR_DRG Bone Marrow Transplant 98 13 — $87,020.01 $80,460.22 $412,697.13 $89,630.61 2026-04-01
21 APR_DRG Heart Or Lung Transplant 98 13 — $89,046.98 $82,345.30 $422,366.09 $91,718.39 2026-04-01
5892 APR_DRG Neonate Bwt 500g Or Ga 24 Weeks 98 13 — $89,330.90 $82,609.35 $423,720.44 $92,010.83 2026-04-01
5891 APR_DRG Neonate Bwt 500g Or Ga 24 Weeks 104 13 — $89,330.90 $44,665.45 $423,720.44 $91,492.08 2026-04-01
6304 APR_DRG Neonate Birthwt 2499g W Major Cardiovascular Procedure 104 13 — $89,993.87 $44,996.94 $426,882.93 $92,174.94 2026-04-01
6074 APR_DRG Neonate Bwt 1250 1499g W Resp Dist Synd Oth Maj Resp Or Maj Anom 104 13 — $90,843.44 $45,421.72 $430,935.51 $93,049.99 2026-04-01
22 APR_DRG Heart Or Lung Transplant 98 13 — $94,503.69 $87,420.05 $448,395.49 $97,338.80 2026-04-01
5933 APR_DRG Neonate Birthwt 750 999g W O Major Procedure 98 13 — $100,154.32 $92,675.12 $475,349.91 $103,158.95 2026-04-01
54 APR_DRG Tracheostomy W Mv 96 Hours W O Extensive Procedure 104 13 — $101,409.28 $50,704.64 $481,336.29 $103,932.81 2026-04-01
6034 APR_DRG Neonate Birthwt 1000 1249g W Or W O Other Significant Condition 104 13 — $102,435.94 $51,217.97 $486,233.60 $104,990.26 2026-04-01
5832 APR_DRG Neonate W Ecmo 98 13 — $105,287.59 $97,449.07 $499,836.47 $108,446.22 2026-04-01
5831 APR_DRG Neonate W Ecmo 98 13 — $105,287.59 $97,449.07 $499,836.47 $108,446.22 2026-04-01
5833 APR_DRG Neonate W Ecmo 98 13 — $107,284.56 $99,306.25 $509,362.31 $110,503.10 2026-04-01
8413 APR_DRG Extensive 3rd Degree Burns W Skin Graft 98 13 — $107,654.10 $99,649.92 $511,125.07 $110,883.72 2026-04-01
23 APR_DRG Heart Or Lung Transplant 98 13 — $110,770.65 $102,548.31 $525,991.53 $114,093.77 2026-04-01
6024 APR_DRG Neonate Bwt 1000 1249g W Resp Dist Synd Oth Maj Resp Or Maj Anom 104 13 — $111,157.02 $55,578.51 $527,834.57 $113,972.97 2026-04-01
6094 APR_DRG Neonate Bwt 1500 2499g W Major Procedure 104 13 — $117,322.80 $58,661.40 $557,246.37 $120,323.73 2026-04-01
5934 APR_DRG Neonate Birthwt 750 999g W O Major Procedure 104 13 — $128,092.07 $64,046.04 $608,617.53 $131,416.07 2026-04-01
14 APR_DRG Liver Transplant Or Intestinal Transplant 104 13 — $128,600.64 $64,300.32 $611,043.49 $131,939.90 2026-04-01
44 APR_DRG Tracheostomy W Mv 96 Hours W Extensive Procedure Or Ecmo 104 13 — $132,747.51 $66,373.76 $630,824.72 $136,211.18 2026-04-01
8414 APR_DRG Extensive 3rd Degree Burns W Skin Graft 104 13 — $137,623.20 $68,811.60 $654,082.59 $141,233.15 2026-04-01
5882 APR_DRG Neonate Bwt 1500g W Major Procedure 98 13 — $141,765.68 $131,373.70 $673,842.88 $146,018.65 2026-04-01
5881 APR_DRG Neonate Bwt 1500g W Major Procedure 98 13 — $141,765.68 $131,373.70 $673,842.88 $146,018.65 2026-04-01
5914 APR_DRG Neonate Birthwt 500 749g W O Major Procedure 104 13 — $142,277.91 $71,138.96 $676,286.30 $146,027.49 2026-04-01
34 APR_DRG Bone Marrow Transplant 104 13 — $164,492.59 $82,246.30 $782,253.93 $168,908.61 2026-04-01
1614 APR_DRG Cardiac Defibrillator Heart Assist Implant 104 13 — $169,399.02 $84,699.51 $805,658.40 $173,962.23 2026-04-01
5883 APR_DRG Neonate Bwt 1500g W Major Procedure 98 13 — $185,156.67 $171,727.32 $880,824.99 $190,711.37 2026-04-01
5884 APR_DRG Neonate Bwt 1500g W Major Procedure 104 13 — $185,156.67 $92,578.34 $880,824.99 $190,192.62 2026-04-01
5834 APR_DRG Neonate W Ecmo 104 13 — $188,460.56 $94,230.28 $896,585.04 $193,595.62 2026-04-01
J3402 HCPCS Inj Remestemcel L Rknd Td 3 2 — $251,255.06 $258,792.71 $263,817.81 $258,792.71 2026-04-01
24 APR_DRG Heart Or Lung Transplant 104 13 — $255,838.55 $127,919.28 $1,217,989.02 $262,994.95 2026-04-01
J3403 HCPCS Revakinagene Per Implant 3 2 — $314,618.65 $324,057.21 $330,349.58 $324,057.21 2026-04-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 22 17 — $339,971.42 $336,571.71 $914,523.12 $350,170.56 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 20 7 — $597,842.16 $449,440.00 $653,901.59 $554,400.00 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car 20 7 — $651,511.29 $449,341.85 $694,972.64 $604,296.00 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 20 7 — $680,942.20 $483,453.66 $747,695.40 $633,974.94 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 20 7 — $687,320.41 $473,458.43 $733,693.15 $637,620.44 2026-04-01
Q2056 HCPCS Ciltacabtagene Car Pos T 20 7 — $691,389.99 $497,024.65 $748,456.24 $666,372.50 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car Pos T 20 7 — $722,982.91 $484,623.49 $759,132.06 $626,162.15 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 22 17 — $941,558.93 $872,400.00 $2,532,793.52 $941,558.93 2026-04-01
J3392 HCPCS Inj Exagamglogene Autotem 45 17 — $2,849,284.24 $2,640,000.00 $3,807,855.64 $2,759,315.68 2026-04-01
J3399 HCPCS Inj Onase Abepar Xioi Treat 45 17 — $2,999,703.24 $2,741,514.78 $3,900,299.38 $2,882,829.98 2026-04-01
J3393 HCPCS Inj Betibeglogene Autotemce 45 17 — $3,599,164.05 $3,360,000.00 $4,846,361.72 $3,511,856.32 2026-04-01
J3387 HCPCS Inj Elivaldogene Autotemecel 3 2 — $3,775,423.80 $3,888,686.51 $3,964,194.99 $3,888,686.51 2026-04-01
J3394 HCPCS Inj Lovotibeglogene Autotem 43 16 — $3,969,015.94 $3,720,000.00 $4,665,751.97 $3,888,126.64 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 43 16 — $4,052,120.32 $3,816,766.76 $4,721,773.31 $3,934,811.09 2026-04-01
J3389 HCPCS Topi Adm Prad Zami Per Treat 3 2 — $4,075,771.59 $4,198,044.74 $4,279,560.17 $4,198,044.74 2026-04-01
J1411 HCPCS Inj Hemgenix Per Tx Dose 44 17 — $4,502,732.52 $3,500,000.00 $4,780,514.42 $4,345,922.20 2026-04-01
J1414 HCPCS Inj Beqvez Per Tx Dose 38 15 — — $4,137,612.79 $4,692,138.22 $4,265,580.20 2026-04-01
C9098 HCPCS HCPCS C9098 1 1 — — $478,950.00 $478,950.00 $478,950.00 2026-04-01
C9081 HCPCS HCPCS C9081 1 1 — — $432,085.00 $432,085.00 $432,085.00 2026-04-01
18 MS_DRG Chimeric Antigen Receptor Car T Cell And Other Immunotherapies 97 27 — — $238,630.15 $3,016,816.00 $373,752.72 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 97 27 — — $178,236.98 $2,253,312.00 $279,162.37 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns W Mv 96 Hours W Skin Graft 97 27 — — $150,117.88 $1,897,824.00 $235,121.03 2026-04-01
3 MS_DRG Ecmo Or Trach W Mv 96 Hrs Or Pdx Exc Face Mouth Neck W Maj O R 97 27 — — $135,610.31 $1,714,416.00 $212,398.65 2026-04-01
C1833 HCPCS HCPCS C1833 1 1 — — $187,725.00 $187,725.00 $187,725.00 2026-04-01
48109150 CDM Hc Insj Perm Ccm D Sys Pg Eltrd 8 3 $204,499.00 — $122,699.40 $173,824.15 $158,486.73 2025-06-27
4 MS_DRG Trach W Mv 96 Hrs Or Pdx Exc Face Mouth Neck W O Maj O R 97 27 — — $89,408.94 $1,130,328.00 $140,036.10 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 97 27 — — $82,902.50 $1,048,072.00 $129,845.42 2026-04-01
7 MS_DRG Lung Transplant 97 27 — — $82,693.67 $1,045,432.00 $129,518.36 2026-04-01
48109230 CDM Hc Rmvl Rplcmt Perm Ccm D Pg 8 3 $143,169.00 — $85,901.40 $121,693.65 $110,955.98 2025-06-27
48109160 CDM Hc Insj Perm Ccm D Sys Pg Only 8 3 $143,169.00 — $85,901.40 $121,693.65 $110,955.98 2025-06-27
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 97 27 — — $69,732.66 $881,576.00 $109,218.27 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 97 27 — — $68,931.54 $871,448.00 $107,963.51 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 97 27 — — $67,384.34 $851,888.00 $105,540.23 2026-04-01
215 MS_DRG Other Heart Assist System Implant 97 27 — — $67,040.10 $847,536.00 $105,001.07 2026-04-01
426 MS_DRG Mult Lvl Comb Ant Pst Spin Fsn Exc Cerv W Mcc Or Cust Anat Des Fus Dev 97 27 — — $66,327.56 $838,528.00 $103,885.07 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad Rep 10 2 — — $103,633.72 $106,120.93 $103,633.72 2026-04-01
216 MS_DRG Cardiac Valve Oth Maj Cardiothoracic Proc W Cardiac Cath W Mcc 97 27 — — $61,067.73 $772,032.00 $95,646.89 2026-04-01
K1007 HCPCS HCPCS K1007 4 2 — — $93,216.70 $93,216.70 $93,216.70 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 97 27 — — $58,289.11 $736,904.00 $91,294.89 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 97 27 — — $53,619.68 $677,872.00 $83,981.42 2026-04-01
456 MS_DRG Spinal Fusion Exc Cerv W Spinal Curv Malig Infec Ext Fusion W Mcc 97 27 — — $53,589.30 $677,488.00 $83,933.85 2026-04-01
429 MS_DRG Combine Anterior And Posterior Cervical Spinal Fusion With Mcc 97 27 — — $52,775.52 $667,200.00 $82,659.27 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Pdx Hemorrhage W Mcc 97 27 — — $51,006.84 $644,840.00 $79,889.10 2026-04-01
10 MS_DRG Pancreas Transplant 97 27 — — $50,450.61 $637,808.00 $79,017.90 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 97 27 — — $50,160.16 $634,136.00 $78,562.98 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Cath Or Open Ablation With Mcc 97 27 — — $49,458.38 $625,264.00 $77,463.83 2026-04-01
219 MS_DRG Cardiac Valve Oth Maj Cardiothoracic Proc W O Cardiac Cath W Mcc 97 27 — — $48,959.74 $618,960.00 $76,682.83 2026-04-01
957 MS_DRG Other O R Procedures For Multiple Significant Trauma With Mcc 97 27 — — $47,230.29 $597,096.00 $73,974.10 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 11 3 — — $31,905.54 $78,986.40 $72,798.00 2026-04-01
427 MS_DRG Multiple Level Comb Ant Pst Spinal Fusion Except Cervical With Cc 97 27 — — $44,920.57 $567,896.00 $70,356.52 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 97 27 — — $44,716.81 $565,320.00 $70,037.38 2026-04-01
36166683 CDM Hc Implantation Iris Prosthesis 8 3 $89,247.00 — $53,548.20 $75,859.95 $69,166.43 2025-06-27
870 MS_DRG Septicemia Or Severe Sepsis With Mv 96 Hours 97 27 — — $44,020.73 $556,520.00 $68,947.15 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 97 27 — — $43,206.95 $546,232.00 $67,672.57 2026-04-01
L8702 HCPCS HCPCS L8702 4 2 — — $67,452.66 $67,452.66 $67,452.66 2026-04-01
447 MS_DRG Mult Lvl Spin Fus Exc Cerv W Mcc Or Vust Anatom Des Interbody Fus Dev 97 27 — — $42,424.18 $536,336.00 $66,446.55 2026-04-01
928 MS_DRG Full Thickness Burn W Skin Graft Or Inhalation Injury W Cc Mcc 97 27 — — $42,261.55 $534,280.00 $66,191.84 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon W Mcc 97 27 — — $42,190.04 $533,376.00 $66,079.85 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support 96 Hours 97 27 — — $40,927.61 $517,416.00 $64,102.56 2026-04-01
217 MS_DRG Cardiac Valve Oth Maj Cardiothoracic Proc W Cardiac Cath W Cc 97 27 — — $40,862.43 $516,592.00 $64,000.48 2026-04-01
969 MS_DRG HIV With Extensive O R Procedures With Mcc 97 27 — — $40,017.64 $505,912.00 $62,677.34 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulators 97 27 — — $39,195.63 $495,520.00 $61,389.87 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 97 27 — — $39,145.01 $494,880.00 $61,310.58 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 97 27 — — $38,966.56 $492,624.00 $61,031.09 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 97 27 — — $38,833.04 $490,936.00 $60,821.96 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 97 27 — — $38,653.32 $488,664.00 $60,540.48 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 97 27 — — $38,468.54 $486,328.00 $60,251.08 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc Mcc 97 27 — — $38,192.64 $482,840.00 $59,818.95 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc Mcc 97 27 — — $38,192.64 $482,840.00 $59,818.95 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement Supplement Procedure W Mcc 97 27 — — $37,907.25 $479,232.00 $59,371.96 2026-04-01
218 MS_DRG Cardiac Valve Oth Maj Cardiothoracic Proc W Card Cath W O Cc Mcc 97 27 — — $37,645.90 $475,928.00 $58,962.62 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 97 27 — — $37,232.69 $470,704.00 $58,315.43 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O R Procedures With Mcc 97 27 — — $36,840.98 $465,752.00 $57,701.92 2026-04-01
90288 CPT Botulism Ig IV 8 2 — — $57,300.00 $57,300.00 $57,300.00 2026-04-01
457 MS_DRG Spinal Fusion Exc Cerv W Spinal Curv Malig Infec Ext Fusion W Cc 97 27 — — $36,316.39 $459,120.00 $56,880.29 2026-04-01
23 MS_DRG Craniot W Maj Dev Impl Acute Cns Pdx W Mcc Or Chemo Epilep W Neuros 97 27 — — $36,099.34 $456,376.00 $56,540.33 2026-04-01
36109470 CDM Hc Mrgfus Strtctc Bl Br Disrpj 8 3 $72,305.00 — $43,383.00 $61,459.25 $56,036.38 2025-06-27
653 MS_DRG Major Bladder Procedures With Mcc 97 27 — — $35,273.54 $445,936.00 $55,246.92 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Pdx Hemorrhage W Cc 97 27 — — $34,976.75 $442,184.00 $54,782.08 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 97 27 — — $34,974.22 $442,152.00 $54,778.12 2026-04-01
36155882 CDM Hc Ablt Trurl Prst8 Tis Trnsdcr 8 3 $70,632.00 — $42,379.20 $60,037.20 $54,739.80 2025-06-27
428 MS_DRG Multiple Level Comb Ant Pst Spinal Fusion Except Cervical W O Cc Mcc 97 27 — — $34,836.91 $440,416.00 $54,563.05 2026-04-01
430 MS_DRG Combine Anterior And Posterior Cervical Spinal Fusion Without Mcc 97 27 — — $34,614.79 $437,608.00 $54,215.17 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 97 27 — — $34,429.38 $435,264.00 $53,924.77 2026-04-01
405 MS_DRG Pancreas Liver And Shunt Procedures With Mcc 97 27 — — $34,350.92 $434,272.00 $53,801.86 2026-04-01
463 MS_DRG Wnd Debride Skn Grft Exc Hand For Musculoskel Conn Tis Dis W Mcc 97 27 — — $34,175.63 $432,056.00 $53,527.33 2026-04-01
11 MS_DRG Tracheostomy For Face Mouth Neck Diagnoses Or Laryngectomy W Mcc 97 27 — — $34,143.36 $431,648.00 $53,476.79 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 97 27 — — $34,138.93 $431,592.00 $53,469.84 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Cath Or Open Ablation Without Mcc 97 27 — — $33,664.33 $425,592.00 $52,726.51 2026-04-01
36161715 CDM Hc Mrgfus Strtctc Ablt Trgt Icr 8 3 $67,794.00 — $40,676.40 $57,624.90 $52,540.35 2025-06-27
220 MS_DRG Cardiac Valve Oth Maj Cardiothoracic Proc W O Cardiac Cath W Cc 97 27 — — $33,514.99 $423,704.00 $52,492.60 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome Neonate 74 23 — — $37,619.96 $196,714.11 $51,794.33 2026-04-01
450 MS_DRG Sing Lvl Spin Fus Exc Cerv W Mcc Or Cust Anatom Design Inter Fus Dev 97 27 — — $32,587.30 $411,976.00 $51,039.63 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 97 27 — — $32,480.36 $410,624.00 $50,872.13 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 97 27 — — $32,236.73 $407,544.00 $50,490.54 2026-04-01
326 MS_DRG Stomach Esophageal And Duodenal Procedures With Mcc 97 27 — — $32,138.01 $406,296.00 $50,335.93 2026-04-01
239 MS_DRG Amputation For Circulatory Sys Disorders Exc Upper Limb Toe W Mcc 97 27 — — $31,870.97 $402,920.00 $49,917.68 2026-04-01
837 MS_DRG Chemo W Acute Leukemia As Sdx Or W High Dose Chemo Agent W Mcc 97 27 — — $31,683.03 $400,544.00 $49,623.31 2026-04-01
278 MS_DRG US Accelerated Other Thrombolysis Of Peripheral Vasc Structures W Mcc 97 27 — — $31,658.35 $400,232.00 $49,584.66 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O R Procedures With Mcc 97 27 — — $31,649.49 $400,120.00 $49,570.79 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 97 27 — — $31,531.79 $398,632.00 $49,386.43 2026-04-01
245 MS_DRG Aicd Generator Procedures 97 27 — — $30,921.77 $390,920.00 $48,431.00 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 97 27 — — $30,735.10 $388,560.00 $48,138.62 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 97 27 — — $30,683.84 $387,912.00 $48,058.33 2026-04-01
826 MS_DRG Myeloprolif Disord Or Poorly Diff Neopl W Maj O R Proc W Mcc 97 27 — — $30,217.47 $382,016.00 $47,327.89 2026-04-01
L7181 HCPCS HCPCS L7181 4 2 — — $47,211.27 $47,211.27 $47,211.27 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 97 27 — — $30,086.48 $380,360.00 $47,122.73 2026-04-01
981 MS_DRG Extensive O R Procedures Unrelated To Principal Diagnosis W Mcc 97 27 — — $30,085.21 $380,344.00 $47,120.74 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replace Supplement Procedure W O Mcc 97 27 — — $29,769.44 $376,352.00 $46,626.17 2026-04-01
823 MS_DRG Lymphoma And Non Acute Leukemia With Other Procedures With Mcc 97 27 — — $29,609.98 $374,336.00 $46,376.41 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 97 27 — — $29,439.12 $372,176.00 $46,108.80 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 97 27 — — $29,165.12 $368,712.00 $45,679.65 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 97 27 — — $29,153.10 $368,560.00 $45,660.82 2026-04-01
221 MS_DRG Cardiac Valve Oth Maj Cardiothorac Proc W O Card Cath W O Cc Mcc 97 27 — — $29,060.07 $367,384.00 $45,515.13 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 97 27 — — $29,056.28 $367,336.00 $45,509.18 2026-04-01
856 MS_DRG Postoperative Or Post Traumatic Infections W O R Procedures W Mcc 97 27 — — $28,547.51 $360,904.00 $44,712.32 2026-04-01
474 MS_DRG Amputation For Musculoskeletal Syst Connective Tissue Dis W Mcc 97 27 — — $28,377.28 $358,752.00 $44,445.72 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 97 27 — — $28,298.82 $357,760.00 $44,322.81 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 97 27 — — $28,034.31 $354,416.00 $43,908.52 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 97 27 — — $27,795.74 $351,400.00 $43,534.87 2026-04-01
L7180 HCPCS HCPCS L7180 4 2 — — $43,145.97 $43,145.97 $43,145.97 2026-04-01
933 MS_DRG Extensive Burns Or Full Thick Burns W Mv 96 Hours W O Skin Graft 97 27 — — $27,379.36 $346,136.00 $42,882.72 2026-04-01
458 MS_DRG Spinal Fus Exc Cerv W Spinal Curv Malig Infec Ext Fusion W O Cc Mcc 97 27 — — $27,322.41 $345,416.00 $42,793.52 2026-04-01
356 MS_DRG Other Digestive System O R Procedures With Mcc 97 27 — — $26,991.45 $341,232.00 $42,275.16 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 97 27 — — $26,952.22 $340,736.00 $42,213.72 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 97 27 — — $26,761.11 $338,320.00 $41,914.39 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 97 27 — — $26,516.22 $335,224.00 $41,530.84 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 97 27 — — $26,514.32 $335,200.00 $41,527.86 2026-04-01
0620T HCPCS Evasc Ven Artlz Tibl Prnl Vn 103 22 — — $1,341.41 $147,902.95 $41,413.99 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon W O Mcc 97 27 — — $26,327.01 $332,832.00 $41,234.49 2026-04-01
48109180 CDM Hc Insj Perm Ccm D Sys Dual Ld 8 3 $52,787.00 — $31,672.20 $44,868.95 $40,909.93 2025-06-27
48109170 CDM Hc Insj Perm Ccm D Sys 1 Lead 8 3 $52,787.00 — $31,672.20 $44,868.95 $40,909.93 2025-06-27
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 97 27 — — $26,019.47 $328,944.00 $40,752.81 2026-04-01
958 MS_DRG Other O R Procedures For Multiple Significant Trauma With Cc 97 27 — — $26,004.92 $328,760.00 $40,730.01 2026-04-01
12 MS_DRG Tracheostomy For Face Mouth Neck Diagnoses Or Laryngectomy W Cc 97 27 — — $25,966.32 $328,272.00 $40,669.54 2026-04-01
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