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

JACOBI MEDICAL CENTER

Bronx, NY · CCN 330127 · Rates published

Your selected procedure

You selected 29916 (HCPCS)

HIP ARTHRO W/LABRAL REPAIR

This hospital’s price: $4,230 across 19 payers · range $1,081-$16,907

Source: https://nychh.pt.panaceainc.com/MRFDownload/nychh/jacobi · observed 2025-09-05

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

53,440 distinct procedures filed
28 distinct payers
3,942,712 rate rows
2025-09-05 last MRF observed · ⚠ 14 mo old

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 14 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://nychh.pt.panaceainc.com/MRFDownload/nychh/jacobi
Found on page https://www.nychealthandhospitals.org/paying-for-your-health-care/facility-charges/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-11-05
Content fingerprint 85537a02a2d98825… · 45,595,071 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
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 5 $3,605,000.00 $4,565,876.22 $4,390,265.60 nat. median
$3,710,000
1.2× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 5 $3,672,900.00 $4,535,437.05 $4,360,997.17 nat. median
$3,705,478
1.2× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 6 $3,325,454.76 $4,722,145.76 $3,934,165.40 nat. median
$3,324,572
1.2× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 6 $3,286,000.00 $4,666,120.00 $3,859,357.05 nat. median
$3,286,000
1.2× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 6 $2,968,000.00 $4,214,560.00 $3,491,724.58 nat. median
$2,994,107
1.2× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 8 $2,388,614.23 $4,352,603.27 $2,901,735.52 nat. median
$2,467,989
1.2× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 8 $2,332,000.00 $4,139,393.28 $2,759,595.52 nat. median
$2,401,965
1.1× median
Q2057
HCPCS 		Afamitresgene Autoleucel 16 $755,207.60 $1,823,841.77 $911,920.88 nat. median
$813,967
1.1× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 16 $529,192.86 $1,368,732.35 $684,366.18 nat. median
$739,658
0.9× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 16 $527,123.43 $1,309,692.74 $654,846.37 nat. median
$646,415
1.0× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 16 $516,726.08 $1,281,899.95 $640,949.97 nat. median
$640,950
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 16 $526,587.59 $1,281,011.93 $640,505.97 nat. median
$623,527
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 16 $489,455.96 $1,261,642.77 $630,821.38 nat. median
$608,239
1.0× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 16 $460,530.40 $1,159,030.12 $579,515.06 nat. median
$592,235
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 21 $17,861.00 $1,234,867.92 $475,027.85 nat. median
$359,244
1.3× median
24
APR_DRG 		Heart &/or Lung Transplant 12 $264,199.63 $1,984,153.60 $410,285.95 nat. median
$241,734
1.7× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 21 $17,861.00 $922,342.82 $356,571.81 nat. median
$248,541
1.4× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 7 $319,950.96 $639,901.92 $326,349.98 nat. median
$319,951
1.0× median
5834
APR_DRG 		Neonate W Ecmo 12 $194,702.56 $626,202.46 $303,526.01 nat. median
$307,273
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 20 $17,861.00 $776,779.36 $301,399.06 nat. median
$198,115
1.5× median
5883
APR_DRG 		Neonate Bwt <1500g W Major Procedure 12 $191,294.76 $618,190.17 $298,291.03 nat. median
$175,429
1.7× median
5884
APR_DRG 		Neonate Bwt <1500g W Major Procedure 12 $191,294.76 $826,479.29 $298,291.03 nat. median
$247,815
1.2× median
1614
APR_DRG 		Cardiac Defibrillator & Heart Assist Implant 12 $175,041.53 $824,634.72 $273,323.14 nat. median
$202,649
1.3× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 21 $17,861.00 $701,756.31 $272,963.15 nat. median
$190,359
1.4× median
1734
APR_DRG 		Other Vascular Procedures 1 $267,221.37 $267,221.37 $267,221.37 nat. median
$46,745
outlier · 5.7×
34
APR_DRG 		Bone Marrow Transplant 12 $169,980.78 $1,879,152.60 $265,548.93 nat. median
$241,408
1.1× median
6934
APR_DRG 		Chemotherapy 1 $247,134.81 $247,134.81 $247,134.81 nat. median
$41,538
outlier · 5.9×
5914
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 12 $147,067.44 $475,838.09 $230,349.93 nat. median
$163,528
1.4× median
5881
APR_DRG 		Neonate Bwt <1500g W Major Procedure 12 $146,539.11 $601,822.52 $229,538.31 nat. median
$120,763
1.9× median
5882
APR_DRG 		Neonate Bwt <1500g W Major Procedure 12 $146,539.11 $601,822.52 $229,538.31 nat. median
$145,061
1.6× median
8414
APR_DRG 		Extensive 3rd Degree Burns W Skin Graft 12 $142,266.34 $1,355,034.20 $222,974.58 nat. median
$158,104
1.4× median
44
APR_DRG 		Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 12 $137,237.30 $666,745.24 $215,249.08 nat. median
$122,016
1.8× median
14
APR_DRG 		Liver Transplant &/or Intestinal Transplant 12 $132,960.01 $1,552,577.00 $208,678.39 nat. median
$137,051
1.5× median
5934
APR_DRG 		Neonate Birthwt 750-999g Without Major Procedure 12 $132,435.44 $450,880.17 $207,872.57 nat. median
$151,838
1.4× median
6094
APR_DRG 		Neonate Bwt 1500-2499g W Major Procedure 12 $121,327.48 $561,891.20 $190,808.74 nat. median
$165,000
1.2× median
C1833
HCPCS 		Cardiac Monitor Sys 1 $187,725.00 $187,725.00 $187,725.00 nat. median
$10,762
outlier · 17.4×
E0766NU
OTHER 		Elec Stim Cancer Treatment 1 $185,002.22 $185,002.22 $185,002.22 nat. median
$185,002
1.0× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 21 $17,861.00 $462,672.72 $182,343.57 nat. median
$126,461
1.4× median
6024
APR_DRG 		Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 12 $114,967.77 $378,708.72 $181,039.09 nat. median
$118,883
1.5× median
23
APR_DRG 		Heart &/or Lung Transplant 12 $114,569.26 $1,234,204.40 $180,426.90 nat. median
$110,771
1.6× median
8413
APR_DRG 		Extensive 3rd Degree Burns W Skin Graft 12 $111,354.69 $485,529.20 $175,488.74 nat. median
$61,016
outlier · 2.9×
5833
APR_DRG 		Neonate W Ecmo 12 $110,973.53 $449,016.10 $174,903.21 nat. median
$244,017
0.7× median
5831
APR_DRG 		Neonate W Ecmo 12 $108,913.76 $447,089.50 $171,739.04 nat. median
$147,206
1.2× median
5832
APR_DRG 		Neonate W Ecmo 12 $108,913.76 $447,089.50 $171,739.04 nat. median
$159,249
1.1× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 21 $17,861.00 $429,005.34 $169,582.66 nat. median
$110,084
1.5× median
7
MS_DRG 		Lung Transplant 21 $17,861.00 $427,924.79 $169,173.10 nat. median
$117,977
1.4× median
6034
APR_DRG 		Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 12 $105,972.41 $346,420.85 $167,220.60 nat. median
$107,442
1.6× median
5933
APR_DRG 		Neonate Birthwt 750-999g Without Major Procedure 12 $103,619.04 $365,259.70 $163,605.40 nat. median
$108,900
1.5× median
22
APR_DRG 		Heart &/or Lung Transplant 12 $97,790.69 $758,498.00 $154,652.01 nat. median
$92,158
1.7× median
54
APR_DRG 		Tracheostomy W Mv 96+ Hours Without Extensive Procedure 12 $2,548.00 $490,752.21 $153,550.69 nat. median
$81,052
1.9× median

Other procedures at this hospital

Browse this hospital's 53,440 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
             
J1414 HCPCS Inj, Beqvez, Per Tx Dose 12 5 — — $3,605,000.00 $4,565,876.22 $4,390,265.60 2025-09-05
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 12 5 — — $3,672,900.00 $4,535,437.05 $4,360,997.17 2025-09-05
J1413 HCPCS Inj Delandistrogene Mox Rokl 14 6 — — $3,325,454.76 $4,722,145.76 $3,934,165.40 2025-09-05
J3394 HCPCS Inj, Lovotibeglogene Autotem 14 6 — — $3,286,000.00 $4,666,120.00 $3,859,357.05 2025-09-05
J3393 HCPCS Inj, Betibeglogene Autotemce 14 6 — — $2,968,000.00 $4,214,560.00 $3,491,724.58 2025-09-05
J3399 HCPCS Inj Onase Abepar-xioi Treat 18 8 — — $2,388,614.23 $4,352,603.27 $2,901,735.52 2025-09-05
J3392 HCPCS Inj, Exagamglogene Autotem 18 8 — — $2,332,000.00 $4,139,393.28 $2,759,595.52 2025-09-05
Q2057 HCPCS Afamitresgene Autoleucel 60 16 — — $755,207.60 $1,823,841.77 $911,920.88 2025-09-05
Q2042 HCPCS Tisagenlecleucel Car-pos T 62 16 — — $529,192.86 $1,368,732.35 $684,366.18 2025-09-05
Q2056 HCPCS Ciltacabtagene Car-pos T 62 16 — — $527,123.43 $1,309,692.74 $654,846.37 2025-09-05
Q2054 HCPCS Lisocabtagene Mara Car Pos T 62 16 — — $516,726.08 $1,281,899.95 $640,949.97 2025-09-05
Q2055 HCPCS Idecabtagene Vicleucel Car 62 16 — — $526,587.59 $1,281,011.93 $640,505.97 2025-09-05
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 62 16 — — $489,455.96 $1,261,642.77 $630,821.38 2025-09-05
Q2053 HCPCS Brexucabtagene Car Pos T 62 16 — — $460,530.40 $1,159,030.12 $579,515.06 2025-09-05
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 68 21 — — $17,861.00 $1,234,867.92 $475,027.85 2025-09-05
24 APR_DRG Heart &/or Lung Transplant 110 12 — — $264,199.63 $1,984,153.60 $410,285.95 2025-09-05
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 68 21 — — $17,861.00 $922,342.82 $356,571.81 2025-09-05
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 16 7 — — $319,950.96 $639,901.92 $326,349.98 2025-09-05
5834 APR_DRG Neonate W Ecmo 110 12 — — $194,702.56 $626,202.46 $303,526.01 2025-09-05
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 66 20 — — $17,861.00 $776,779.36 $301,399.06 2025-09-05
5883 APR_DRG Neonate Bwt <1500g W Major Procedure 110 12 — — $191,294.76 $618,190.17 $298,291.03 2025-09-05
5884 APR_DRG Neonate Bwt <1500g W Major Procedure 110 12 — — $191,294.76 $826,479.29 $298,291.03 2025-09-05
1614 APR_DRG Cardiac Defibrillator & Heart Assist Implant 110 12 — — $175,041.53 $824,634.72 $273,323.14 2025-09-05
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 68 21 — — $17,861.00 $701,756.31 $272,963.15 2025-09-05
1734 APR_DRG Other Vascular Procedures 2 1 — — $267,221.37 $267,221.37 $267,221.37 2025-09-05
34 APR_DRG Bone Marrow Transplant 110 12 — — $169,980.78 $1,879,152.60 $265,548.93 2025-09-05
6934 APR_DRG Chemotherapy 2 1 — — $247,134.81 $247,134.81 $247,134.81 2025-09-05
5914 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 110 12 — — $147,067.44 $475,838.09 $230,349.93 2025-09-05
5881 APR_DRG Neonate Bwt <1500g W Major Procedure 110 12 — — $146,539.11 $601,822.52 $229,538.31 2025-09-05
5882 APR_DRG Neonate Bwt <1500g W Major Procedure 110 12 — — $146,539.11 $601,822.52 $229,538.31 2025-09-05
8414 APR_DRG Extensive 3rd Degree Burns W Skin Graft 110 12 — — $142,266.34 $1,355,034.20 $222,974.58 2025-09-05
44 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 110 12 — — $137,237.30 $666,745.24 $215,249.08 2025-09-05
14 APR_DRG Liver Transplant &/or Intestinal Transplant 110 12 — — $132,960.01 $1,552,577.00 $208,678.39 2025-09-05
5934 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 110 12 — — $132,435.44 $450,880.17 $207,872.57 2025-09-05
6094 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 110 12 — — $121,327.48 $561,891.20 $190,808.74 2025-09-05
C1833 HCPCS Cardiac Monitor Sys 2 1 — — $187,725.00 $187,725.00 $187,725.00 2025-09-05
E0766NU OTHER Elec Stim Cancer Treatment 6 1 — — $185,002.22 $185,002.22 $185,002.22 2025-09-05
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 68 21 — — $17,861.00 $462,672.72 $182,343.57 2025-09-05
6024 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 110 12 — — $114,967.77 $378,708.72 $181,039.09 2025-09-05
23 APR_DRG Heart &/or Lung Transplant 110 12 — — $114,569.26 $1,234,204.40 $180,426.90 2025-09-05
8413 APR_DRG Extensive 3rd Degree Burns W Skin Graft 110 12 — — $111,354.69 $485,529.20 $175,488.74 2025-09-05
5833 APR_DRG Neonate W Ecmo 110 12 — — $110,973.53 $449,016.10 $174,903.21 2025-09-05
5831 APR_DRG Neonate W Ecmo 110 12 — — $108,913.76 $447,089.50 $171,739.04 2025-09-05
5832 APR_DRG Neonate W Ecmo 110 12 — — $108,913.76 $447,089.50 $171,739.04 2025-09-05
14 MS_DRG Allogeneic Bone Marrow Transplant 68 21 — — $17,861.00 $429,005.34 $169,582.66 2025-09-05
7 MS_DRG Lung Transplant 68 21 — — $17,861.00 $427,924.79 $169,173.10 2025-09-05
6034 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 110 12 — — $105,972.41 $346,420.85 $167,220.60 2025-09-05
5933 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 110 12 — — $103,619.04 $365,259.70 $163,605.40 2025-09-05
22 APR_DRG Heart &/or Lung Transplant 110 12 — — $97,790.69 $758,498.00 $154,652.01 2025-09-05
54 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 130 12 — — $2,548.00 $490,752.21 $153,550.69 2025-09-05
6074 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 110 12 — — $94,015.33 $354,854.37 $148,852.37 2025-09-05
6304 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 110 12 — — $93,139.04 $418,513.29 $147,506.24 2025-09-05
5891 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 110 12 — — $92,455.22 $303,947.33 $146,455.77 2025-09-05
5892 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 110 12 — — $92,455.22 $303,947.33 $146,455.77 2025-09-05
21 APR_DRG Heart &/or Lung Transplant 110 12 — — $92,162.37 $725,875.80 $146,005.89 2025-09-05
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 68 21 — — $17,861.00 $360,829.06 $143,741.88 2025-09-05
33 APR_DRG Bone Marrow Transplant 110 12 — — $90,071.65 $940,849.00 $142,794.18 2025-09-05
5913 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 110 12 — — $90,009.00 $350,480.65 $142,697.94 2025-09-05
212 MS_DRG Concomitant Aortic And Mitral Valve?procedures 68 21 — — $17,861.00 $356,709.86 $142,180.59 2025-09-05
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 68 21 — — $17,861.00 $348,703.95 $139,146.11 2025-09-05
215 MS_DRG Other Heart Assist System Implant 68 21 — — $17,861.00 $346,916.13 $138,468.48 2025-09-05
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 58 18 — — $127,397.55 $343,006.50 $136,986.61 2025-09-05
904 APR_DRG Major Larynx & Trachea Procedures 110 12 — — $85,598.12 $282,401.06 $135,922.04 2025-09-05
6023 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 110 12 — — $85,082.61 $325,749.19 $135,130.13 2025-09-05
5932 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 110 12 — — $84,931.65 $339,855.62 $134,898.24 2025-09-05
5912 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 110 12 — — $84,024.42 $277,456.21 $133,504.56 2025-09-05
3034 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 110 12 — — $83,062.84 $393,024.39 $132,027.40 2025-09-05
5931 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 110 12 — — $82,370.72 $337,569.05 $130,964.17 2025-09-05
1733 APR_DRG Other Vascular Procedures 2 1 — — $128,979.24 $128,979.24 $128,979.24 2025-09-05
6314 APR_DRG Neonate Birthwt >2499g W Other Major Procedure 110 12 — — $80,186.41 $329,703.79 $127,608.68 2025-09-05
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 72 22 — — $17,861.00 $316,015.62 $126,756.29 2025-09-05
4404 APR_DRG Kidney Transplant 110 12 — — $79,210.49 $819,101.40 $126,109.50 2025-09-05
B0407 HCPCS Traumatic Spinal Cord Injury M <24.50 And A >=61.50 34 11 — — $122,323.14 $177,243.73 $124,819.53 2025-09-05
43 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 110 12 — — $76,844.28 $394,875.46 $122,474.57 2025-09-05
850 MS_DRG Acute Leukemia With Other Procedures 58 18 — — $112,814.04 $301,634.45 $121,305.42 2025-09-05
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 110 12 — — $75,887.99 $389,725.64 $121,005.53 2025-09-05
1613 APR_DRG Cardiac Defibrillator & Heart Assist Implant 110 12 — — $75,100.76 $401,325.93 $119,796.22 2025-09-05
3614 APR_DRG Skin Graft For Skin & Subcutaneous Tissue Diagnoses 110 12 — — $73,296.10 $627,632.20 $117,023.94 2025-09-05
6022 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 110 12 — — $72,416.80 $258,936.73 $115,673.16 2025-09-05
B1904 HCPCS Guillain-barr? M <38.50 34 11 — — $113,073.69 $163,841.47 $115,381.32 2025-09-05
1624 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 110 12 — — $71,667.31 $404,045.98 $114,521.81 2025-09-05
3044 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 110 12 — — $70,138.90 $346,549.71 $112,173.90 2025-09-05
231 MS_DRG Coronary Bypass With Ptca With Mcc 72 22 — — $17,861.00 $277,469.38 $112,146.16 2025-09-05
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 68 21 — — $17,861.00 $277,315.48 $112,087.82 2025-09-05
6073 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 110 12 — — $69,889.07 $252,678.66 $111,790.12 2025-09-05
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 58 18 — — $102,757.36 $273,104.61 $110,491.78 2025-09-05
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses 110 12 — — $68,781.06 $802,386.00 $110,088.02 2025-09-05
6033 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 110 12 — — $68,601.43 $276,904.81 $109,812.08 2025-09-05
6814 APR_DRG Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 110 12 — — $68,546.33 $301,430.35 $109,727.43 2025-09-05
6804 APR_DRG Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 110 12 — — $68,358.39 $400,434.32 $109,438.73 2025-09-05
5911 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 110 12 — — $67,928.92 $226,881.18 $108,778.99 2025-09-05
6904 APR_DRG Acute Leukemia 110 12 — — $66,900.17 $338,387.66 $107,198.64 2025-09-05
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 68 21 — — $17,861.00 $263,952.66 $107,022.93 2025-09-05
10 MS_DRG Pancreas Transplant 68 21 — — $17,861.00 $261,067.91 $105,929.52 2025-09-05
8424 APR_DRG Burns With Skin Graft Except Extensive 3rd Degree Burns 110 12 — — $66,029.17 $617,528.60 $105,860.62 2025-09-05
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 68 21 — — $17,861.00 $259,571.51 $105,362.35 2025-09-05
53 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 130 12 — — $2,548.00 $343,200.07 $104,558.74 2025-09-05
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 72 22 — — $17,861.00 $255,940.20 $103,985.97 2025-09-05
6124 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 110 12 — — $64,790.59 $246,515.23 $103,957.94 2025-09-05
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 72 22 — — $17,861.00 $253,356.70 $103,006.75 2025-09-05
4054 APR_DRG Other Procedures For Endocrine, Nutritional & Metabolic Disorders 110 12 — — $64,145.25 $290,393.68 $102,966.60 2025-09-05
13 APR_DRG Liver Transplant &/or Intestinal Transplant 110 12 — — $63,982.22 $791,393.20 $102,716.15 2025-09-05
6114 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 110 12 — — $62,828.93 $317,427.63 $100,944.49 2025-09-05
C0407 HCPCS Traumatic Spinal Cord Injury M <24.50 And A >=61.50 34 11 — — $97,890.31 $141,841.06 $99,888.07 2025-09-05
9504 APR_DRG Extensive Procedure Unrelated To Principal Diagnosis 110 12 — — $62,078.69 $301,952.50 $99,791.99 2025-09-05
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 66 20 — — $17,861.00 $244,407.76 $99,614.85 2025-09-05
234 APR_DRG Spinal Procedures 110 12 — — $61,835.66 $313,662.12 $99,418.64 2025-09-05
SUP90411 CDM Hc Supply Revenue Code 278 W/wo HCPCS 86 19 $122,496.62 — $24,499.32 $122,496.62 $97,997.30 2025-09-05
Q0480 HCPCS Driver Pneumatic Vad, Rep 16 3 — — $35,858.53 $122,219.08 $97,904.99 2025-09-05
D0407 HCPCS Traumatic Spinal Cord Injury M <24.50 And A >=61.50 34 11 — — $95,348.70 $138,158.32 $97,294.59 2025-09-05
B1806 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 34 11 — — $93,819.50 $135,942.54 $95,734.18 2025-09-05
4604 APR_DRG Renal Failure 2 1 — — $95,703.01 $95,703.01 $95,703.01 2025-09-05
32 APR_DRG Bone Marrow Transplant 110 12 — — $59,409.07 $701,461.80 $95,690.97 2025-09-05
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 58 18 — — $88,469.32 $232,570.81 $95,128.30 2025-09-05
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 68 21 — — $17,861.00 $231,401.85 $94,685.23 2025-09-05
64 APR_DRG Pancreas Transplant 110 12 — — $58,490.51 $665,160.60 $94,279.90 2025-09-05
4474 APR_DRG Other Kidney, Urinary Tract & Related Procedures 110 12 — — $58,427.87 $260,273.26 $94,183.66 2025-09-05
8504 APR_DRG Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service 110 12 — — $58,398.43 $247,074.49 $94,138.44 2025-09-05
9124 APR_DRG Musculoskeletal & Other Procedures For Multiple Significant Trauma 110 12 — — $58,020.29 $269,225.13 $93,557.55 2025-09-05
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 68 21 — — $17,861.00 $227,783.64 $93,313.82 2025-09-05
5124 APR_DRG Uterine & Adnexa Procedures For Non-ovarian & Non-adnexal Malig 110 12 — — $57,467.80 $195,685.62 $92,708.83 2025-09-05
6072 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 110 12 — — $57,279.10 $206,039.73 $92,418.95 2025-09-05
2604 APR_DRG Major Pancreas, Liver & Shunt Procedures 110 12 — — $56,887.38 $286,048.75 $91,817.20 2025-09-05
955 MS_DRG Craniotomy For Multiple Significant Trauma 66 20 — — $17,861.00 $223,585.86 $91,722.74 2025-09-05
6954 APR_DRG Chemotherapy For Acute Leukemia # 108 12 — — $56,587.74 $191,245.07 $91,356.89 2025-09-05
B0406 HCPCS Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 34 11 — — $89,393.55 $129,529.43 $91,217.91 2025-09-05
924 APR_DRG Facial Bone Procedures Except Major Cranial/facial Bone Procedures 110 12 — — $56,335.64 $190,452.94 $90,969.63 2025-09-05
63 APR_DRG Pancreas Transplant 110 12 — — $56,039.77 $599,294.80 $90,515.12 2025-09-05
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 58 18 — — $83,875.54 $219,538.70 $90,188.75 2025-09-05
6093 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 110 12 — — $55,805.03 $227,242.47 $90,154.53 2025-09-05
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 66 20 — — $17,861.00 $218,693.90 $89,868.55 2025-09-05
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 4 1 — — $67,727.85 $111,750.95 $89,739.40 2025-09-05
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 68 21 — — $17,861.00 $218,323.89 $89,728.31 2025-09-05
214 APR_DRG Craniotomy Except For Trauma 110 12 — — $55,490.30 $284,864.97 $89,671.03 2025-09-05
42 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 110 12 — — $55,091.77 $282,165.65 $89,058.83 2025-09-05
41 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 110 12 — — $55,091.77 $281,709.48 $89,058.83 2025-09-05
1694 APR_DRG Major Abdominal Vascular Procedures 110 12 — — $55,048.76 $273,715.20 $88,992.74 2025-09-05
9104 APR_DRG Craniotomy For Multiple Significant Trauma 110 12 — — $55,045.74 $257,907.59 $88,988.11 2025-09-05
6084 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 110 12 — — $55,044.99 $229,045.70 $88,986.94 2025-09-05
B0404 HCPCS Traumatic Spinal Cord Injury M <31.50 And A <61.50 34 11 — — $86,510.06 $125,351.31 $88,275.57 2025-09-05
2204 APR_DRG Major Stomach, Esophageal & Duodenal Procedures 110 12 — — $54,330.22 $279,023.36 $87,888.93 2025-09-05
8412 APR_DRG Extensive 3rd Degree Burns W Skin Graft 110 12 — — $54,286.44 $481,683.80 $87,821.68 2025-09-05
A0407 HCPCS Traumatic Spinal Cord Injury M <24.50 And A >=61.50 34 11 — — $86,043.61 $124,675.43 $87,799.60 2025-09-05
1654 APR_DRG Coronary Bypass W Ami Or Complex Pdx 110 12 — — $54,246.43 $314,595.19 $87,760.23 2025-09-05
3214 APR_DRG Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp 110 12 — — $54,152.84 $295,818.71 $87,616.46 2025-09-05
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Pdx 110 12 — — $54,023.02 $376,487.28 $87,417.03 2025-09-05
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 72 22 — — $17,861.00 $211,457.48 $87,334.47 2025-09-05
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 68 21 — — $17,861.00 $211,762.00 $87,241.16 2025-09-05
3033 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 110 12 — — $53,577.71 $245,817.20 $86,732.94 2025-09-05
4014 APR_DRG Pituitary & Adrenal Procedures 110 12 — — $53,575.44 $327,613.00 $86,729.47 2025-09-05
1732 APR_DRG Other Vascular Procedures 2 1 — — $86,308.50 $86,308.50 $86,308.50 2025-09-05
6032 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 110 12 — — $52,902.18 $215,160.66 $85,695.23 2025-09-05
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 66 20 — — $17,861.00 $207,082.88 $85,467.64 2025-09-05
3104 APR_DRG Intervertebral Disc Excision & Decompression 110 12 — — $52,477.25 $218,181.21 $85,042.45 2025-09-05
6083 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 110 12 — — $52,336.86 $213,183.36 $84,826.79 2025-09-05
6214 APR_DRG Neonate Bwt 2000-2499g W Major Anomaly 110 12 — — $52,099.11 $191,652.76 $84,461.55 2025-09-05
4414 APR_DRG Major Bladder Procedures 110 12 — — $51,881.73 $284,974.30 $84,127.63 2025-09-05
B0505 HCPCS Non-traumatic Spinal Cord Injury M <39.50 34 11 — — $82,367.69 $119,349.10 $84,048.66 2025-09-05
276 MS_DRG Cardiac Defibrillator Implant With Mcc 68 21 — — $17,861.00 $202,829.43 $83,855.46 2025-09-05
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 58 18 — — $77,893.24 $202,567.48 $83,756.17 2025-09-05
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 68 21 — — $17,861.00 $201,644.10 $83,406.18 2025-09-05
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 68 21 — — $17,861.00 $200,940.10 $83,139.35 2025-09-05
232 MS_DRG Coronary Bypass With Ptca Without Mcc 68 21 — — $17,861.00 $200,023.27 $82,791.84 2025-09-05
1674 APR_DRG Other Cardiothoracic & Thoracic Vascular Procedures 110 12 — — $50,884.68 $252,857.67 $82,595.98 2025-09-05
31 APR_DRG Bone Marrow Transplant 110 12 — — $50,842.41 $618,833.80 $82,531.05 2025-09-05
28 MS_DRG Spinal Procedures With Mcc 68 21 — — $17,861.00 $199,067.15 $82,429.44 2025-09-05
1814 APR_DRG Lower Extremity Arterial Procedures # 108 12 — — $50,773.73 $172,976.40 $82,425.54 2025-09-05
7914 APR_DRG O.r. Procedure For Other Complications Of Treatment 110 12 — — $50,729.95 $239,870.02 $82,358.29 2025-09-05
2214 APR_DRG Major Small & Large Bowel Procedures 110 12 — — $50,711.84 $243,383.66 $82,330.46 2025-09-05
4034 APR_DRG Procedures For Obesity 110 12 — — $50,473.33 $263,240.25 $81,964.07 2025-09-05
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 68 21 — — $17,861.00 $197,639.51 $81,888.33 2025-09-05
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 68 21 — — $17,861.00 $197,639.51 $81,888.33 2025-09-05
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 68 21 — — $17,861.00 $196,162.76 $81,328.60 2025-09-05
6021 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 110 12 — — $49,839.33 $254,645.82 $80,990.12 2025-09-05
9114 APR_DRG Extensive Abdominal/thoracic Procedures For Mult Significant Trauma 110 12 — — $49,821.21 $246,701.26 $80,962.30 2025-09-05
C1904 HCPCS Guillain-barr? M <38.50 34 11 — — $79,309.27 $114,917.52 $80,927.83 2025-09-05
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 68 21 — — $17,861.00 $194,803.88 $80,813.54 2025-09-05
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 58 19 — — $17,861.00 $132,462.03 $80,757.69 2025-09-05
3134 APR_DRG Knee & Lower Leg Procedures Except Foot 110 12 — — $49,677.80 $261,703.98 $80,742.00 2025-09-05
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs 110 12 — — $49,209.85 $205,304.78 $80,023.13 2025-09-05
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 72 22 — — $17,861.00 $192,672.24 $80,005.59 2025-09-05
4424 APR_DRG Kidney & Urinary Tract Procedures For Malignancy 110 12 — — $48,957.76 $240,648.53 $79,635.86 2025-09-05
6123 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 110 12 — — $48,709.44 $177,478.73 $79,254.41 2025-09-05
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 68 21 — — $17,861.00 $190,645.39 $79,237.36 2025-09-05
1774 APR_DRG Cardiac Pacemaker & Defibrillator Revision Except Device Replacement 110 12 — — $48,646.03 $264,578.60 $79,157.01 2025-09-05
6914 APR_DRG Lymphoma, Myeloma & Non-acute Leukemia 110 12 — — $48,632.45 $223,093.52 $79,136.15 2025-09-05
7104 APR_DRG Infectious & Parasitic Diseases Including HIV W O.r. Procedure 110 12 — — $48,538.85 $250,982.10 $78,992.36 2025-09-05
3174 APR_DRG Tendon, Muscle & Other Soft Tissue Procedures 110 12 — — $48,520.74 $255,636.16 $78,964.53 2025-09-05
6933 APR_DRG Chemotherapy 2 1 — — $78,919.30 $78,919.30 $78,919.30 2025-09-05
3054 APR_DRG Amputation Of Lower Limb Except Toes 110 12 — — $48,398.46 $263,811.41 $78,776.71 2025-09-05
C1806 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 34 11 — — $77,141.36 $111,776.25 $78,715.67 2025-09-05
894 APR_DRG Major Cranial/facial Bone Procedures 130 12 — — $2,548.00 $227,029.40 $78,603.81 2025-09-05
264 APR_DRG Other Nervous System & Related Procedures 110 12 — — $48,202.98 $244,177.25 $78,476.41 2025-09-05
9514 APR_DRG Moderately Extensive Procedure Unrelated To Principal Diagnosis 110 12 — — $48,196.94 $245,455.28 $78,467.13 2025-09-05
1824 APR_DRG Other Peripheral Vascular Procedures # 108 12 — — $48,173.54 $164,806.13 $78,431.19 2025-09-05
6113 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 110 12 — — $48,126.75 $181,800.06 $78,359.30 2025-09-05
244 APR_DRG Extracranial Vascular Procedures 130 12 — — $2,548.00 $259,228.97 $78,335.02 2025-09-05
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 68 21 — — $17,861.00 $187,930.91 $78,208.49 2025-09-05
1664 APR_DRG Coronary Bypass Without Ami Or Complex Pdx 110 12 — — $47,865.60 $330,774.15 $77,958.12 2025-09-05
5114 APR_DRG Uterine & Adnexa Procedures For Ovarian & Adnexal Malignancy 110 12 — — $47,829.37 $216,982.35 $77,902.47 2025-09-05
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 68 21 — — $17,861.00 $186,807.79 $77,782.80 2025-09-05
4444 APR_DRG Renal Dialysis Access Device Procedure Only 110 12 — — $47,523.68 $236,835.17 $77,432.88 2025-09-05
204 APR_DRG Craniotomy For Trauma 130 12 — — $2,548.00 $248,765.34 $77,221.18 2025-09-05
12 APR_DRG Liver Transplant &/or Intestinal Transplant 110 12 — — $47,353.11 $784,539.60 $77,170.85 2025-09-05
11 APR_DRG Liver Transplant &/or Intestinal Transplant 110 12 — — $47,353.11 $770,174.60 $77,170.85 2025-09-05
2644 APR_DRG Other Hepatobiliary, Pancreas & Abdominal Procedures 110 12 — — $47,287.45 $266,753.89 $77,069.97 2025-09-05
2614 APR_DRG Major Biliary Tract Procedures 110 12 — — $47,181.78 $213,664.75 $76,907.66 2025-09-05
B0106 HCPCS Stroke M <41.50 And A <84.50 34 11 — — $75,257.02 $109,045.89 $76,792.88 2025-09-05
1612 APR_DRG Cardiac Defibrillator & Heart Assist Implant 110 12 — — $47,083.65 $242,305.44 $76,756.92 2025-09-05
1204 APR_DRG Major Respiratory & Chest Procedures 110 12 — — $46,805.90 $244,744.63 $76,330.23 2025-09-05
653 MS_DRG Major Bladder Procedures With Mcc 68 21 — — $17,861.00 $182,534.70 $76,163.17 2025-09-05
1304 APR_DRG Respiratory System Diagnosis W Ventilator Support 96+ Hours 110 12 — — $46,670.04 $224,467.69 $76,121.53 2025-09-05
6903 APR_DRG Acute Leukemia 110 12 — — $46,595.32 $192,895.82 $76,006.74 2025-09-05
1214 APR_DRG Other Respiratory & Chest Procedures 110 12 — — $46,551.54 $233,289.49 $75,939.50 2025-09-05
3014 APR_DRG Hip Joint Replacement 110 12 — — $46,525.88 $205,031.45 $75,900.08 2025-09-05
2624 APR_DRG Cholecystectomy Except Laparoscopic 110 12 — — $46,525.12 $185,949.60 $75,898.92 2025-09-05
5194 APR_DRG Uterine & Adnexa Procedures For Leiomyoma 110 12 — — $46,488.90 $159,512.65 $75,843.26 2025-09-05
6071 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 110 12 — — $46,431.54 $176,623.59 $75,755.14 2025-09-05
7114 APR_DRG Post-op, Post-trauma, Other Device Infections W O.r. Procedure 110 12 — — $46,391.53 $249,396.81 $75,693.70 2025-09-05
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 68 21 — — $17,861.00 $180,985.91 $75,576.13 2025-09-05
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 68 21 — — $17,861.00 $180,985.91 $75,576.13 2025-09-05
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 58 18 — — $70,018.03 $180,226.25 $75,288.20 2025-09-05
B1903 HCPCS Guillain-barr? M >=38.50 And M <51.50 34 11 — — $71,185.19 $106,714.89 $75,151.33 2025-09-05
J9029 HCPCS Instill Adstiladrin, Tx Dose 64 17 — — $62,162.43 $150,123.53 $75,061.77 2025-09-05
5184 APR_DRG Other Female Reproductive System & Related Procedures 110 12 — — $45,953.76 $163,938.45 $75,021.20 2025-09-05
69930 CPT Implant Cochlear Device 10 3 — — $33,293.55 $74,910.49 $74,910.49 2025-09-05
494 APR_DRG Bacterial & Tuberculous Infections Of Nervous System 110 12 — — $45,875.26 $188,901.51 $74,900.62 2025-09-05
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 58 18 — — $69,630.21 $179,126.05 $74,871.19 2025-09-05
1714 APR_DRG Perm Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock 110 12 — — $45,847.34 $219,915.41 $74,857.72 2025-09-05
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 68 21 — — $17,861.00 $178,163.38 $74,506.31 2025-09-05
9524 APR_DRG Nonextensive Procedure Unrelated To Principal Diagnosis 110 12 — — $45,604.30 $221,623.22 $74,484.37 2025-09-05
6303 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 110 12 — — $45,558.27 $196,286.74 $74,413.65 2025-09-05
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 68 21 — — $17,861.00 $177,757.35 $74,352.42 2025-09-05
434 APR_DRG Multiple Sclerosis & Other Demyelinating Diseases 110 12 — — $45,499.39 $156,403.44 $74,323.21 2025-09-05
3814 APR_DRG Major Skin Disorders 110 12 — — $45,386.92 $156,050.08 $74,150.45 2025-09-05
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 68 21 — — $17,861.00 $176,850.34 $74,008.63 2025-09-05
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 68 21 — — $17,861.00 $176,683.35 $73,945.34 2025-09-05
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 68 21 — — $17,861.00 $176,663.70 $73,937.89 2025-09-05
B0205 HCPCS Traumatic Brain Injury M <35.50 34 11 — — $72,023.69 $104,360.86 $73,493.56 2025-09-05
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 72 22 — — $17,861.00 $173,435.14 $73,044.46 2025-09-05
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 72 22 — — $17,861.00 $174,204.63 $73,005.83 2025-09-05
C0406 HCPCS Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 34 11 — — $71,538.69 $103,658.10 $72,998.66 2025-09-05
2294 APR_DRG Other Digestive System & Abdominal Procedures 110 12 — — $44,511.40 $221,589.29 $72,805.47 2025-09-05
3084 APR_DRG Hip And Femur Fracture Repair 110 12 — — $44,375.54 $175,928.94 $72,596.77 2025-09-05
3094 APR_DRG Other Significant Hip And Femur Surgery 110 12 — — $44,196.65 $208,784.49 $72,321.98 2025-09-05
1623 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 110 12 — — $44,133.26 $213,052.13 $72,224.58 2025-09-05
D1806 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 34 11 — — $70,568.69 $102,252.60 $72,008.87 2025-09-05
6504 APR_DRG Splenectomy 110 12 — — $43,878.89 $244,427.95 $71,833.84 2025-09-05
51 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 110 12 — — $43,826.82 $227,649.57 $71,753.84 2025-09-05
6082 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 110 12 — — $43,750.59 $175,803.94 $71,636.73 2025-09-05
4403 APR_DRG Kidney Transplant 110 12 — — $43,647.94 $563,672.20 $71,479.05 2025-09-05
D0406 HCPCS Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 34 11 — — $69,680.85 $100,966.13 $71,102.91 2025-09-05
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 58 18 — — $65,932.10 $168,634.87 $70,894.73 2025-09-05
D1904 HCPCS Guillain-barr? M <38.50 34 11 — — $69,402.57 $100,562.91 $70,818.95 2025-09-05
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 68 21 — — $17,861.00 $168,074.95 $70,682.51 2025-09-05
C0404 HCPCS Traumatic Spinal Cord Injury M <31.50 And A <61.50 34 11 — — $69,230.31 $100,313.30 $70,643.17 2025-09-05
2234 APR_DRG Other Small & Large Bowel Procedures 110 12 — — $42,939.20 $220,358.39 $70,390.31 2025-09-05
A1904 HCPCS Guillain-barr? M <38.50 34 11 — — $68,933.47 $99,883.20 $70,340.28 2025-09-05
2244 APR_DRG Peritoneal Adhesiolysis 110 12 — — $42,864.48 $165,389.90 $70,275.51 2025-09-05
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 68 21 — — $17,861.00 $166,817.58 $70,205.93 2025-09-05
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 68 21 — — $17,861.00 $166,306.78 $70,012.32 2025-09-05
A9543 HCPCS Y90 Ibritumomab, Rx 30 11 — — $14,774.74 $134,487.80 $69,933.66 2025-09-05
2224 APR_DRG Other Stomach, Esophageal & Duodenal Procedures 110 12 — — $42,603.33 $189,397.26 $69,874.34 2025-09-05
B0405 HCPCS Traumatic Spinal Cord Injury M >=31.50 And M <41.50 34 11 — — $68,339.82 $99,023.00 $69,734.51 2025-09-05
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 68 21 — — $17,861.00 $164,928.25 $69,489.82 2025-09-05
228 MS_DRG Other Cardiothoracic Procedures With Mcc 72 22 — — $17,861.00 $163,173.18 $69,340.77 2025-09-05
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 68 21 — — $17,861.00 $163,955.76 $69,121.21 2025-09-05
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 68 21 — — $17,861.00 $163,828.06 $69,072.81 2025-09-05
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 68 21 — — $17,861.00 $163,762.57 $69,047.99 2025-09-05
B1705 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50 34 11 — — $67,454.63 $97,740.38 $68,831.25 2025-09-05
3024 APR_DRG Knee Joint Replacement 110 12 — — $41,914.98 $222,946.49 $68,816.91 2025-09-05
D0404 HCPCS Traumatic Spinal Cord Injury M <31.50 And A <61.50 34 11 — — $67,433.43 $97,709.66 $68,809.62 2025-09-05
4234 APR_DRG Inborn Errors Of Metabolism 110 12 — — $41,881.02 $147,469.40 $68,764.74 2025-09-05
224 APR_DRG Ventricular Shunt Procedures 110 12 — — $41,497.60 $267,134.66 $68,175.72 2025-09-05
52 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 130 12 — — $2,548.00 $234,203.71 $68,121.20 2025-09-05
B0105 HCPCS Stroke M <41.50 And A >=84.50 34 11 — — $66,707.25 $96,657.44 $68,068.62 2025-09-05
C0106 HCPCS Stroke M <41.50 And A <84.50 34 11 — — $66,641.00 $96,561.45 $68,001.02 2025-09-05
8411 APR_DRG Extensive 3rd Degree Burns W Skin Graft 110 12 — — $41,341.36 $481,683.80 $67,935.71 2025-09-05
6334 APR_DRG Neonate Birthwt >2499g W Major Anomaly 110 12 — — $41,243.99 $162,512.09 $67,786.15 2025-09-05
504 APR_DRG Non-bacterial Infections Of Nervous System Exc Viral Meningitis 110 12 — — $41,188.13 $160,269.46 $67,700.35 2025-09-05
A1806 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 34 11 — — $66,293.81 $96,058.37 $67,646.74 2025-09-05
245 MS_DRG Aicd Generator Procedures 72 22 — — $17,861.00 $160,013.38 $67,626.94 2025-09-05
3043 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 110 12 — — $41,045.48 $202,175.68 $67,481.21 2025-09-05
3644 APR_DRG Other Skin, Subcutaneous Tissue & Related Procedures 110 12 — — $40,907.36 $143,014.56 $67,269.03 2025-09-05
471 MS_DRG Cervical Spinal Fusion With Mcc 68 21 — — $17,861.00 $159,047.43 $67,260.82 2025-09-05
6 MS_DRG Liver Transplant Without Mcc 68 21 — — $17,861.00 $158,782.20 $67,160.29 2025-09-05
8634 APR_DRG Neonatal Aftercare 110 12 — — $40,829.62 $196,243.58 $67,149.60 2025-09-05
B1805 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50 34 11 — — $65,726.65 $95,236.57 $67,068.01 2025-09-05
3032 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 110 12 — — $40,749.61 $187,250.25 $67,026.70 2025-09-05
1731 APR_DRG Other Vascular Procedures 2 1 — — $67,019.29 $67,019.29 $67,019.29 2025-09-05
B2102 HCPCS Burns M <52.50 34 11 — — $65,625.95 $95,090.66 $66,965.25 2025-09-05
2274 APR_DRG Hernia Procedures Except Inguinal, Femoral & Umbilical 110 12 — — $40,638.66 $204,153.04 $66,856.26 2025-09-05
B0604 HCPCS Neurological M <43.50 34 11 — — $64,931.58 $94,084.53 $66,256.71 2025-09-05
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 68 21 — — $17,861.00 $156,368.97 $66,245.60 2025-09-05
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 68 17 — — $54,827.05 $132,408.45 $66,204.22 2025-09-05
799 MS_DRG Splenic Procedures With Mcc 68 21 — — $17,861.00 $155,691.17 $65,988.70 2025-09-05
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 66 20 — — $17,861.00 $155,661.70 $65,977.53 2025-09-05
6134 APR_DRG Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 110 12 — — $39,917.10 $173,047.55 $65,747.81 2025-09-05
6031 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 110 12 — — $39,887.67 $180,682.97 $65,702.59 2025-09-05
6224 APR_DRG Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond 110 12 — — $39,848.42 $161,905.38 $65,642.30 2025-09-05
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