Hospital

ST JOSEPH'S HOSPITAL HEALTH CENTER

Syracuse, NY · CCN 330140 · Rates published

16,669 distinct procedures filed

29 distinct payers

1,150,778 rate rows

2025-01-01 last MRF observed · ⚠ 21 mo old

Data quality

876,802 of 1,150,778 rate rows are consumer-grade (76.2%)

273,976 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	219,244
template filing: same amount across many unrelated codes — excluded	22,084
exceeds 10× this hospital's gross charge — excluded from medians	14,462
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	10,700
placeholder amount (≤ $0.02) — excluded from medians	6,740
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	342
percent-of-charges filed in the dollar field — excluded from medians	336
per-diem day rate — not a per-procedure price	68

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 21 months old.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://trinityhealth.pt.panaceainc.com/MRFDownload/trinityhealth/stjosephshospitalhealthcenter
Found on page	https://www.sjhsyr.org/for-patients/billing-and-insurance/price-estimates-lists
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-10-13
Content fingerprint	22d5e831c60381dc… · 8,316,756 bytes · first seen 2026-05-09

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
'002-4 OTHER	Heart &/or Lung Transplant	9	$257,052.98	$586,245.71	$463,629.09	—
'583-4 OTHER	Neonate W Ecmo	9	$189,359.72	$432,117.12	$341,737.37	—
'588-3 OTHER	Neonate Bwt <1500g W Major Procedure	9	$186,040.38	$424,559.42	$335,760.40	—
'588-4 OTHER	Neonate Bwt <1500g W Major Procedure	9	$186,040.38	$424,559.42	$335,760.40	—
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	15	$323,620.49	$669,247.65	$328,474.80	nat. median $168,055 2.0× median
'161-4 OTHER	Cardiac Defibrillator & Heart Assist Implant	9	$170,208.99	$388,513.45	$307,253.65	—
'003-4 OTHER	Bone Marrow Transplant	9	$165,279.60	$377,289.88	$298,377.56	—
'591-4 OTHER	Neonate Birthwt 500-749g Without Major Procedure	9	$142,960.98	$326,473.33	$258,189.58	—
'588-1 OTHER	Neonate Bwt <1500g W Major Procedure	9	$142,446.35	$325,301.59	$257,262.92	—
'588-2 OTHER	Neonate Bwt <1500g W Major Procedure	9	$142,446.35	$325,301.59	$257,262.92	—
'841-4 OTHER	Extensive 3rd Degree Burns W Skin Graft	9	$138,284.49	$315,825.59	$249,768.87	—
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	15	$238,094.17	$492,246.07	$241,665.58	nat. median $186,516 1.3× median
'004-4 OTHER	Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo	9	$133,385.98	$304,672.33	$240,948.38	—
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	15	$231,599.89	$478,805.79	$235,073.89	nat. median $131,925 1.8× median
'001-4 OTHER	Liver Transplant &/or Intestinal Transplant	9	$129,219.71	$295,186.28	$233,446.40	—
'593-4 OTHER	Neonate Birthwt 750-999g Without Major Procedure	9	$128,708.76	$294,022.91	$232,526.35	—
J2326 HCPCS	Inj Nusinersen 0.1mg	23	$121.13	$413,702.43	$225,467.83	nat. median $1,667 outlier · 135.3×
'609-4 OTHER	Neonate Bwt 1500-2499g W Major Procedure	9	$117,889.10	$269,387.98	$213,043.96	—
'602-4 OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	9	$111,694.47	$255,283.62	$201,889.60	—
'002-3 OTHER	Heart &/or Lung Transplant	9	$111,306.29	$254,399.80	$201,190.64	—
'841-3 OTHER	Extensive 3rd Degree Burns W Skin Graft	9	$108,175.15	$247,270.61	$195,552.56	—
'583-3 OTHER	Neonate W Ecmo	9	$107,803.89	$246,425.29	$194,884.04	—
'583-2 OTHER	Neonate W Ecmo	9	$105,797.58	$241,857.19	$191,271.39	—
'583-1 OTHER	Neonate W Ecmo	9	$105,797.58	$241,857.19	$191,271.39	—
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	15	$187,376.64	$387,283.25	$190,187.29	nat. median $145,435 1.3× median
'603-4 OTHER	Neonate Birthwt 1000-1249g W Or Without Other Significant Condition	9	$102,932.58	$235,333.96	$186,112.53	—
'005-4 OTHER	Tracheostomy W Mv 96+ Hours Without Extensive Procedure	9	$101,901.12	$232,985.47	$184,255.24	—
'593-3 OTHER	Neonate Birthwt 750-999g Without Major Procedure	9	$100,640.28	$230,114.71	$181,984.92	—
'002-2 OTHER	Heart &/or Lung Transplant	9	$94,963.22	$217,188.78	$171,762.52	—
'607-4 OTHER	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	9	$91,285.84	$208,815.89	$165,140.86	—
'630-4 OTHER	Neonate Birthwt >2499g W Major Cardiovascular Procedure	9	$90,432.30	$206,872.48	$163,603.93	—
'589-2 OTHER	Neonate Bwt <500g Or Ga <24 Weeks	9	$89,766.22	$205,355.91	$162,404.56	—
'589-1 OTHER	Neonate Bwt <500g Or Ga <24 Weeks	9	$89,766.22	$205,355.91	$162,404.56	—
'002-1 OTHER	Heart &/or Lung Transplant	9	$89,480.97	$204,706.44	$161,890.93	—
'003-3 OTHER	Bone Marrow Transplant	9	$87,444.52	$200,069.71	$158,223.99	—
'591-3 OTHER	Neonate Birthwt 500-749g Without Major Procedure	9	$87,383.50	$199,930.77	$158,114.12	—
'090-4 OTHER	Major Larynx & Trachea Procedures	9	$83,087.10	$190,148.44	$150,377.82	—
'602-3 OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	9	$82,584.97	$189,005.16	$149,473.66	—
'593-2 OTHER	Neonate Birthwt 750-999g Without Major Procedure	9	$82,437.94	$188,670.38	$149,208.90	—
'591-2 OTHER	Neonate Birthwt 500-749g Without Major Procedure	9	$81,554.25	$186,658.34	$147,617.69	—
'303-4 OTHER	Dorsal & Lumbar Fusion Proc For Curvature Of Back	9	$80,617.63	$184,525.78	$145,931.17	—
'593-1 OTHER	Neonate Birthwt 750-999g Without Major Procedure	9	$79,943.47	$182,990.81	$144,717.24	—
'631-4 OTHER	Neonate Birthwt >2499g W Other Major Procedure	9	$77,815.85	$178,146.51	$140,886.16	—
'440-4 OTHER	Kidney Transplant	9	$76,865.27	$175,982.14	$139,174.48	—
'004-3 OTHER	Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo	9	$74,560.47	$170,734.44	$135,024.36	—
'160-4 OTHER	Major Cardiothoracic Repair Of Heart Anomaly	9	$73,629.00	$168,613.59	$133,347.11	—
'161-3 OTHER	Cardiac Defibrillator & Heart Assist Implant	9	$72,862.20	$166,867.71	$131,966.38	—
4 MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	15	$129,268.67	$267,025.50	$131,207.70	nat. median $97,418 1.3× median
'361-4 OTHER	Skin Graft For Skin & Subcutaneous Tissue Diagnoses	9	$71,104.39	$162,865.39	$128,801.17	—
'602-2 OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	9	$70,247.90	$160,915.28	$127,258.94	—

Other procedures at this hospital

Browse this hospital's 16,669 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

'002-4	OTHER	Heart &/or Lung Transplant	42	9	—	—	$257,052.98	$586,245.71	$463,629.09	2025-01-01
'583-4	OTHER	Neonate W Ecmo	42	9	—	—	$189,359.72	$432,117.12	$341,737.37	2025-01-01
'588-3	OTHER	Neonate Bwt <1500g W Major Procedure	42	9	—	—	$186,040.38	$424,559.42	$335,760.40	2025-01-01
'588-4	OTHER	Neonate Bwt <1500g W Major Procedure	42	9	—	—	$186,040.38	$424,559.42	$335,760.40	2025-01-01
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	36	15	—	—	$323,620.49	$669,247.65	$328,474.80	2025-01-01
'161-4	OTHER	Cardiac Defibrillator & Heart Assist Implant	42	9	—	—	$170,208.99	$388,513.45	$307,253.65	2025-01-01
'003-4	OTHER	Bone Marrow Transplant	42	9	—	—	$165,279.60	$377,289.88	$298,377.56	2025-01-01
'591-4	OTHER	Neonate Birthwt 500-749g Without Major Procedure	42	9	—	—	$142,960.98	$326,473.33	$258,189.58	2025-01-01
'588-2	OTHER	Neonate Bwt <1500g W Major Procedure	42	9	—	—	$142,446.35	$325,301.59	$257,262.92	2025-01-01
'588-1	OTHER	Neonate Bwt <1500g W Major Procedure	42	9	—	—	$142,446.35	$325,301.59	$257,262.92	2025-01-01
'841-4	OTHER	Extensive 3rd Degree Burns W Skin Graft	42	9	—	—	$138,284.49	$315,825.59	$249,768.87	2025-01-01
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	36	15	—	—	$238,094.17	$492,246.07	$241,665.58	2025-01-01
'004-4	OTHER	Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo	42	9	—	—	$133,385.98	$304,672.33	$240,948.38	2025-01-01
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	36	15	—	—	$231,599.89	$478,805.79	$235,073.89	2025-01-01
'001-4	OTHER	Liver Transplant &/or Intestinal Transplant	42	9	—	—	$129,219.71	$295,186.28	$233,446.40	2025-01-01
'593-4	OTHER	Neonate Birthwt 750-999g Without Major Procedure	42	9	—	—	$128,708.76	$294,022.91	$232,526.35	2025-01-01
J2326	HCPCS	Inj Nusinersen 0.1mg	76	23	$413,702.43	$268,906.58 35% off	$121.13	$413,702.43	$225,467.83	2025-01-01
'609-4	OTHER	Neonate Bwt 1500-2499g W Major Procedure	42	9	—	—	$117,889.10	$269,387.98	$213,043.96	2025-01-01
'602-4	OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	42	9	—	—	$111,694.47	$255,283.62	$201,889.60	2025-01-01
'002-3	OTHER	Heart &/or Lung Transplant	42	9	—	—	$111,306.29	$254,399.80	$201,190.64	2025-01-01
'841-3	OTHER	Extensive 3rd Degree Burns W Skin Graft	42	9	—	—	$108,175.15	$247,270.61	$195,552.56	2025-01-01
'583-3	OTHER	Neonate W Ecmo	42	9	—	—	$107,803.89	$246,425.29	$194,884.04	2025-01-01
'583-2	OTHER	Neonate W Ecmo	42	9	—	—	$105,797.58	$241,857.19	$191,271.39	2025-01-01
'583-1	OTHER	Neonate W Ecmo	42	9	—	—	$105,797.58	$241,857.19	$191,271.39	2025-01-01
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	36	15	—	—	$187,376.64	$387,283.25	$190,187.29	2025-01-01
'603-4	OTHER	Neonate Birthwt 1000-1249g W Or Without Other Significant Condition	42	9	—	—	$102,932.58	$235,333.96	$186,112.53	2025-01-01
'005-4	OTHER	Tracheostomy W Mv 96+ Hours Without Extensive Procedure	42	9	—	—	$101,901.12	$232,985.47	$184,255.24	2025-01-01
'593-3	OTHER	Neonate Birthwt 750-999g Without Major Procedure	42	9	—	—	$100,640.28	$230,114.71	$181,984.92	2025-01-01
'002-2	OTHER	Heart &/or Lung Transplant	42	9	—	—	$94,963.22	$217,188.78	$171,762.52	2025-01-01
'607-4	OTHER	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	42	9	—	—	$91,285.84	$208,815.89	$165,140.86	2025-01-01
'630-4	OTHER	Neonate Birthwt >2499g W Major Cardiovascular Procedure	42	9	—	—	$90,432.30	$206,872.48	$163,603.93	2025-01-01
'589-2	OTHER	Neonate Bwt <500g Or Ga <24 Weeks	42	9	—	—	$89,766.22	$205,355.91	$162,404.56	2025-01-01
'589-1	OTHER	Neonate Bwt <500g Or Ga <24 Weeks	42	9	—	—	$89,766.22	$205,355.91	$162,404.56	2025-01-01
'002-1	OTHER	Heart &/or Lung Transplant	42	9	—	—	$89,480.97	$204,706.44	$161,890.93	2025-01-01
'003-3	OTHER	Bone Marrow Transplant	42	9	—	—	$87,444.52	$200,069.71	$158,223.99	2025-01-01
'591-3	OTHER	Neonate Birthwt 500-749g Without Major Procedure	42	9	—	—	$87,383.50	$199,930.77	$158,114.12	2025-01-01
'090-4	OTHER	Major Larynx & Trachea Procedures	42	9	—	—	$83,087.10	$190,148.44	$150,377.82	2025-01-01
'602-3	OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	42	9	—	—	$82,584.97	$189,005.16	$149,473.66	2025-01-01
'593-2	OTHER	Neonate Birthwt 750-999g Without Major Procedure	42	9	—	—	$82,437.94	$188,670.38	$149,208.90	2025-01-01
'591-2	OTHER	Neonate Birthwt 500-749g Without Major Procedure	42	9	—	—	$81,554.25	$186,658.34	$147,617.69	2025-01-01
'303-4	OTHER	Dorsal & Lumbar Fusion Proc For Curvature Of Back	42	9	—	—	$80,617.63	$184,525.78	$145,931.17	2025-01-01
'593-1	OTHER	Neonate Birthwt 750-999g Without Major Procedure	42	9	—	—	$79,943.47	$182,990.81	$144,717.24	2025-01-01
'631-4	OTHER	Neonate Birthwt >2499g W Other Major Procedure	42	9	—	—	$77,815.85	$178,146.51	$140,886.16	2025-01-01
'440-4	OTHER	Kidney Transplant	42	9	—	—	$76,865.27	$175,982.14	$139,174.48	2025-01-01
'004-3	OTHER	Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo	42	9	—	—	$74,560.47	$170,734.44	$135,024.36	2025-01-01
'160-4	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	42	9	—	—	$73,629.00	$168,613.59	$133,347.11	2025-01-01
'161-3	OTHER	Cardiac Defibrillator & Heart Assist Implant	42	9	—	—	$72,862.20	$166,867.71	$131,966.38	2025-01-01
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	36	15	—	—	$129,268.67	$267,025.50	$131,207.70	2025-01-01
'361-4	OTHER	Skin Graft For Skin & Subcutaneous Tissue Diagnoses	42	9	—	—	$71,104.39	$162,865.39	$128,801.17	2025-01-01
'602-2	OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	42	9	—	—	$70,247.90	$160,915.28	$127,258.94	2025-01-01
'162-4	OTHER	Cardiac Valve Procedures W Ami Or Complex Pdx	42	9	—	—	$69,517.87	$159,253.09	$125,944.41	2025-01-01
'005-3	OTHER	Tracheostomy W Mv 96+ Hours Without Extensive Procedure	42	9	—	—	$68,400.39	$156,708.75	$123,932.23	2025-01-01
'304-4	OTHER	Dorsal & Lumbar Fusion Proc Except For Curvature Of Back	42	9	—	—	$68,029.12	$155,863.42	$123,263.71	2025-01-01
'607-3	OTHER	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	42	9	—	—	$67,785.78	$155,309.36	$122,825.53	2025-01-01
'312-4	OTHER	Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses	42	9	—	—	$66,706.53	$152,852.06	$120,882.19	2025-01-01
'603-3	OTHER	Neonate Birthwt 1000-1249g W Or Without Other Significant Condition	42	9	—	—	$66,531.56	$152,453.67	$120,567.12	2025-01-01
'681-4	OTHER	Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms	42	9	—	—	$66,477.89	$152,331.47	$120,470.49	2025-01-01
'680-4	OTHER	Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms	42	9	—	—	$66,294.83	$151,914.67	$120,140.86	2025-01-01
'591-1	OTHER	Neonate Birthwt 500-749g Without Major Procedure	42	9	—	—	$65,876.51	$150,962.22	$119,387.61	2025-01-01
'690-4	OTHER	Acute Leukemia	42	9	—	—	$64,874.46	$148,680.68	$117,583.27	2025-01-01
'842-4	OTHER	Burns With Skin Graft Except Extensive 3rd Degree Burns	42	9	—	—	$64,026.06	$146,748.98	$116,055.61	2025-01-01
'612-4	OTHER	Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond	42	9	—	—	$62,819.63	$144,002.10	$113,883.25	2025-01-01
'405-4	OTHER	Other Procedures For Endocrine, Nutritional & Metabolic Disorders	42	9	—	—	$62,191.05	$142,570.91	$112,751.40	2025-01-01
'001-3	OTHER	Liver Transplant &/or Intestinal Transplant	42	9	—	—	$62,032.25	$142,209.34	$112,465.45	2025-01-01
'611-4	OTHER	Neonate Birthwt 1500-1999g W Major Anomaly	42	9	—	—	$60,908.90	$139,651.61	$110,442.68	2025-01-01
7	MS_DRG	Lung Transplant	34	14	—	—	$107,908.38	$222,819.16	$110,066.55	2025-01-01
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	36	15	—	—	$107,712.65	$222,414.08	$109,328.34	2025-01-01
'950-4	OTHER	Extensive Procedure Unrelated To Principal Diagnosis	42	9	—	—	$60,178.13	$137,987.74	$109,126.83	2025-01-01
'023-4	OTHER	Spinal Procedures	42	9	—	—	$59,941.40	$137,448.74	$108,700.56	2025-01-01
'003-2	OTHER	Bone Marrow Transplant	42	9	—	—	$57,577.79	$132,067.12	$104,444.54	2025-01-01
14	MS_DRG	Allogeneic Bone Marrow Transplant	34	14	—	—	$100,838.31	$208,187.25	$102,855.08	2025-01-01
'006-4	OTHER	Pancreas Transplant	42	9	—	—	$56,683.08	$130,029.97	$102,833.47	2025-01-01
'447-4	OTHER	Other Kidney, Urinary Tract & Related Procedures	42	9	—	—	$56,622.06	$129,891.04	$102,723.60	2025-01-01
'850-4	OTHER	Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service	42	9	—	—	$56,593.38	$129,825.76	$102,671.97	2025-01-01
'912-4	OTHER	Musculoskeletal & Other Procedures For Multiple Significant Trauma	42	9	—	—	$56,225.06	$128,987.13	$102,008.74	2025-01-01
'512-4	OTHER	Uterine & Adnexa Procedures For Non-ovarian & Non-adnexal Malig	42	9	—	—	$55,686.91	$127,761.83	$101,039.72	2025-01-01
'607-2	OTHER	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	42	9	—	—	$55,503.11	$127,343.35	$100,708.77	2025-01-01
'260-4	OTHER	Major Pancreas, Liver & Shunt Procedures	42	9	—	—	$55,121.55	$126,474.59	$100,021.72	2025-01-01
'695-4	OTHER	Chemotherapy For Acute Leukemia #	42	9	—	—	$54,829.69	$125,810.05	$99,496.17	2025-01-01
'092-4	OTHER	Facial Bone Procedures Except Major Cranial/facial Bone Procedures	42	9	—	—	$54,584.13	$125,250.96	$99,054.02	2025-01-01
'006-3	OTHER	Pancreas Transplant	42	9	—	—	$54,295.94	$124,594.79	$98,535.09	2025-01-01
'609-3	OTHER	Neonate Bwt 1500-2499g W Major Procedure	42	9	—	—	$54,067.30	$124,074.20	$98,123.38	2025-01-01
'021-4	OTHER	Craniotomy Except For Trauma	42	9	—	—	$53,760.73	$123,376.18	$97,571.36	2025-01-01
'004-2	OTHER	Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo	42	9	—	—	$53,372.56	$122,492.36	$96,872.39	2025-01-01
'004-1	OTHER	Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo	42	9	—	—	$53,372.56	$122,492.36	$96,872.39	2025-01-01
'169-4	OTHER	Major Abdominal Vascular Procedures	42	9	—	—	$53,330.65	$122,396.95	$96,796.93	2025-01-01
'910-4	OTHER	Craniotomy For Multiple Significant Trauma	42	9	—	—	$53,327.71	$122,390.25	$96,791.64	2025-01-01
'608-4	OTHER	Neonate Bwt 1250-1499g W Or Without Other Significant Condition	42	9	—	—	$53,326.98	$122,388.58	$96,790.31	2025-01-01
212	MS_DRG	Concomitant Aortic And Mitral Valve?procedures	36	15	—	—	$94,780.26	$195,649.77	$96,201.96	2025-01-01
'220-4	OTHER	Major Stomach, Esophageal & Duodenal Procedures	42	9	—	—	$52,630.76	$120,803.38	$95,536.67	2025-01-01
'841-2	OTHER	Extensive 3rd Degree Burns W Skin Graft	42	9	—	—	$52,588.12	$120,706.30	$95,459.89	2025-01-01
'165-4	OTHER	Coronary Bypass W Ami Or Complex Pdx	42	9	—	—	$52,549.15	$120,617.58	$95,389.73	2025-01-01
'321-4	OTHER	Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp	42	9	—	—	$52,457.99	$120,410.01	$95,225.58	2025-01-01
'163-4	OTHER	Cardiac Valve Procedures Without Ami Or Complex Pdx	42	9	—	—	$52,331.54	$120,122.10	$94,997.89	2025-01-01
'303-3	OTHER	Dorsal & Lumbar Fusion Proc For Curvature Of Back	42	9	—	—	$51,897.78	$119,134.49	$94,216.84	2025-01-01
'401-4	OTHER	Pituitary & Adrenal Procedures	42	9	—	—	$51,895.58	$119,129.47	$94,212.87	2025-01-01
'603-2	OTHER	Neonate Birthwt 1000-1249g W Or Without Other Significant Condition	42	9	—	—	$51,239.80	$117,636.35	$93,032.04	2025-01-01
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	34	14	—	—	$91,087.67	$188,007.75	$92,909.42	2025-01-01
'310-4	OTHER	Intervertebral Disc Excision & Decompression	42	9	—	—	$50,825.89	$116,693.93	$92,286.74	2025-01-01
'608-3	OTHER	Neonate Bwt 1250-1499g W Or Without Other Significant Condition	42	9	—	—	$50,689.15	$116,382.59	$92,040.51	2025-01-01
'089-4	OTHER	Major Cranial/facial Bone Procedures	42	9	—	—	$50,652.39	$116,298.89	$91,974.32	2025-01-01
'024-4	OTHER	Extracranial Vascular Procedures	42	9	—	—	$50,468.59	$115,880.41	$91,643.37	2025-01-01
'621-4	OTHER	Neonate Bwt 2000-2499g W Major Anomaly	42	9	—	—	$50,457.56	$115,855.31	$91,623.52	2025-01-01
215	MS_DRG	Other Heart Assist System Implant	36	15	—	—	$89,900.99	$185,551.84	$91,249.51	2025-01-01
'441-4	OTHER	Major Bladder Procedures	42	9	—	—	$50,245.83	$115,373.22	$91,242.26	2025-01-01
'020-4	OTHER	Craniotomy For Trauma	42	9	—	—	$49,706.94	$114,146.24	$90,271.91	2025-01-01
'167-4	OTHER	Other Cardiothoracic & Thoracic Vascular Procedures	42	9	—	—	$49,274.66	$113,161.98	$89,493.52	2025-01-01
'003-1	OTHER	Bone Marrow Transplant	42	9	—	—	$49,233.49	$113,068.25	$89,419.39	2025-01-01
'181-4	OTHER	Lower Extremity Arterial Procedures #	42	9	—	—	$49,166.59	$112,915.92	$89,298.92	2025-01-01
'791-4	OTHER	O.r. Procedure For Other Complications Of Treatment	42	9	—	—	$49,123.95	$112,818.83	$89,222.14	2025-01-01
'221-4	OTHER	Major Small & Large Bowel Procedures	42	9	—	—	$49,106.30	$112,778.66	$89,190.37	2025-01-01
'403-4	OTHER	Procedures For Obesity	42	9	—	—	$48,873.98	$112,249.70	$88,772.05	2025-01-01
27800000002-9354	CDM	Device Impella 5.5 Smartassist	50	16	$123,750.00	$80,437.50 35% off	$57,234.38	$123,750.00	$88,481.25	2025-01-01
27800000002-9353	CDM	Device Impella 5.5 Smartassist	50	16	$123,750.00	$80,437.50 35% off	$57,234.38	$123,750.00	$88,481.25	2025-01-01
'602-1	OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	42	9	—	—	$48,256.43	$110,843.62	$87,660.05	2025-01-01
'911-4	OTHER	Extensive Abdominal/thoracic Procedures For Mult Significant Trauma	42	9	—	—	$48,238.79	$110,803.45	$87,628.28	2025-01-01
'313-4	OTHER	Knee & Lower Leg Procedures Except Foot	42	9	—	—	$48,099.10	$110,485.40	$87,376.76	2025-01-01
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	36	15	—	—	$85,428.99	$176,296.77	$86,710.43	2025-01-01
'510-4	OTHER	Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs	42	9	—	—	$47,643.29	$109,447.58	$86,556.00	2025-01-01
'442-4	OTHER	Kidney & Urinary Tract Procedures For Malignancy	42	9	—	—	$47,397.74	$108,888.49	$86,113.85	2025-01-01
'612-3	OTHER	Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond	42	9	—	—	$47,155.87	$108,337.78	$85,678.32	2025-01-01
'177-4	OTHER	Cardiac Pacemaker & Defibrillator Revision Except Device Replacement	42	9	—	—	$47,094.11	$108,197.17	$85,567.12	2025-01-01
'691-4	OTHER	Lymphoma, Myeloma & Non-acute Leukemia	42	9	—	—	$47,080.88	$108,167.04	$85,543.29	2025-01-01
'710-4	OTHER	Infectious & Parasitic Diseases Including HIV W O.r. Procedure	42	9	—	—	$46,989.71	$107,959.47	$85,379.14	2025-01-01
'317-4	OTHER	Tendon, Muscle & Other Soft Tissue Procedures	42	9	—	—	$46,972.07	$107,919.30	$85,347.37	2025-01-01
J1747	HCPCS	Injection Spesolimab-sbzo 1 Mg	76	23	$156,466.98	$101,703.54 35% off	$6.14	$156,466.98	$85,274.51	2025-01-01
'305-4	OTHER	Amputation Of Lower Limb Except Toes	42	9	—	—	$46,852.97	$107,648.13	$85,132.91	2025-01-01
'026-4	OTHER	Other Nervous System & Related Procedures	42	9	—	—	$46,662.56	$107,214.58	$84,790.05	2025-01-01
'951-4	OTHER	Moderately Extensive Procedure Unrelated To Principal Diagnosis	42	9	—	—	$46,656.68	$107,201.19	$84,779.46	2025-01-01
'182-4	OTHER	Other Peripheral Vascular Procedures #	42	9	—	—	$46,633.89	$107,149.30	$84,738.42	2025-01-01
'611-3	OTHER	Neonate Birthwt 1500-1999g W Major Anomaly	42	9	—	—	$46,588.31	$107,045.52	$84,656.35	2025-01-01
'166-4	OTHER	Coronary Bypass Without Ami Or Complex Pdx	42	9	—	—	$46,333.93	$106,466.35	$84,198.31	2025-01-01
'511-4	OTHER	Uterine & Adnexa Procedures For Ovarian & Adnexal Malignancy	42	9	—	—	$46,298.64	$106,386.00	$84,134.77	2025-01-01
0310453530	NDC	Injection Tremelimumab-actl 1 Mg	50	16	$117,000.00	$76,050.00 35% off	$54,112.50	$117,000.00	$83,655.00	2025-01-01
'444-4	OTHER	Renal Dialysis Access Device Procedure Only	42	9	—	—	$46,000.90	$105,708.06	$83,598.63	2025-01-01
'001-1	OTHER	Liver Transplant &/or Intestinal Transplant	42	9	—	—	$45,834.75	$105,329.76	$83,299.45	2025-01-01
'001-2	OTHER	Liver Transplant &/or Intestinal Transplant	42	9	—	—	$45,834.75	$105,329.76	$83,299.45	2025-01-01
'264-4	OTHER	Other Hepatobiliary, Pancreas & Abdominal Procedures	42	9	—	—	$45,770.78	$105,184.13	$83,184.28	2025-01-01
'261-4	OTHER	Major Biliary Tract Procedures	42	9	—	—	$45,667.86	$104,949.78	$82,998.95	2025-01-01
'161-2	OTHER	Cardiac Defibrillator & Heart Assist Implant	42	9	—	—	$45,572.29	$104,732.18	$82,826.85	2025-01-01
'120-4	OTHER	Major Respiratory & Chest Procedures	42	9	—	—	$45,301.74	$104,116.18	$82,339.69	2025-01-01
'130-4	OTHER	Respiratory System Diagnosis W Ventilator Support 96+ Hours	42	9	—	—	$45,169.41	$103,814.87	$82,101.41	2025-01-01
'690-3	OTHER	Acute Leukemia	42	9	—	—	$45,096.62	$103,649.16	$81,970.35	2025-01-01
'121-4	OTHER	Other Respiratory & Chest Procedures	42	9	—	—	$45,053.98	$103,552.07	$81,893.57	2025-01-01
'262-4	OTHER	Cholecystectomy Except Laparoscopic	42	9	—	—	$45,028.25	$103,493.48	$81,847.24	2025-01-01
'519-4	OTHER	Uterine & Adnexa Procedures For Leiomyoma	42	9	—	—	$44,992.96	$103,413.13	$81,783.70	2025-01-01
'607-1	OTHER	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	42	9	—	—	$44,937.09	$103,285.92	$81,683.09	2025-01-01
'711-4	OTHER	Post-op, Post-trauma, Other Device Infections W O.r. Procedure	42	9	—	—	$44,898.12	$103,197.20	$81,612.92	2025-01-01
'518-4	OTHER	Other Female Reproductive System & Related Procedures	42	9	—	—	$44,471.72	$102,226.33	$80,845.12	2025-01-01
'049-4	OTHER	Bacterial & Tuberculous Infections Of Nervous System	42	9	—	—	$44,395.26	$102,052.25	$80,707.44	2025-01-01
'171-4	OTHER	Perm Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock	42	9	—	—	$44,368.06	$101,990.31	$80,658.46	2025-01-01
'952-4	OTHER	Nonextensive Procedure Unrelated To Principal Diagnosis	42	9	—	—	$44,131.33	$101,451.31	$80,232.20	2025-01-01
'630-3	OTHER	Neonate Birthwt >2499g W Major Cardiovascular Procedure	42	9	—	—	$44,086.49	$101,349.20	$80,151.45	2025-01-01
'043-4	OTHER	Multiple Sclerosis & Other Demyelinating Diseases	42	9	—	—	$44,029.14	$101,218.64	$80,048.19	2025-01-01
'381-4	OTHER	Major Skin Disorders	42	9	—	—	$43,919.60	$100,969.23	$79,850.94	2025-01-01
453	MS_DRG	Combined Anterior And Posterior Spinal Fusion With Mcc	36	15	—	—	$78,021.87	$160,967.33	$79,192.20	2025-01-01
'005-2	OTHER	Tracheostomy W Mv 96+ Hours Without Extensive Procedure	42	9	—	—	$43,484.37	$99,978.27	$79,067.25	2025-01-01
27800000002-9352	CDM	Device Impella 5.5 Smartassist	50	16	$110,000.00	$71,500.00 35% off	$50,875.00	$110,000.00	$78,650.00	2025-01-01
'229-4	OTHER	Other Digestive System & Abdominal Procedures	42	9	—	—	$43,066.79	$99,027.49	$78,315.33	2025-01-01
'308-4	OTHER	Hip And Femur Fracture Repair	42	9	—	—	$42,934.46	$98,726.19	$78,077.05	2025-01-01
'309-4	OTHER	Other Significant Hip And Femur Surgery	42	9	—	—	$42,760.22	$98,329.47	$77,763.31	2025-01-01
'162-3	OTHER	Cardiac Valve Procedures W Ami Or Complex Pdx	42	9	—	—	$42,698.46	$98,188.86	$77,652.11	2025-01-01
'650-4	OTHER	Splenectomy	42	9	—	—	$42,450.71	$97,624.75	$77,205.99	2025-01-01
'005-1	OTHER	Tracheostomy W Mv 96+ Hours Without Extensive Procedure	42	9	—	—	$42,399.98	$97,509.25	$77,114.65	2025-01-01
'608-2	OTHER	Neonate Bwt 1250-1499g W Or Without Other Significant Condition	42	9	—	—	$42,325.73	$97,340.19	$76,980.94	2025-01-01
'440-3	OTHER	Kidney Transplant	42	9	—	—	$42,225.74	$97,112.54	$76,800.90	2025-01-01
'223-4	OTHER	Other Small & Large Bowel Procedures	42	9	—	—	$41,535.41	$95,540.74	$75,557.85	2025-01-01
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	36	15	—	—	$74,431.98	$153,537.85	$75,548.46	2025-01-01
'224-4	OTHER	Peritoneal Adhesiolysis	42	9	—	—	$41,462.62	$95,375.02	$75,426.80	2025-01-01
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	36	15	—	—	$74,230.11	$153,120.05	$75,343.56	2025-01-01
'222-4	OTHER	Other Stomach, Esophageal & Duodenal Procedures	42	9	—	—	$41,208.25	$94,795.85	$74,968.76	2025-01-01
'423-4	OTHER	Inborn Errors Of Metabolism	42	9	—	—	$40,504.68	$93,193.92	$73,701.88	2025-01-01
'022-4	OTHER	Ventricular Shunt Procedures	42	9	—	—	$40,131.21	$92,343.57	$73,029.39	2025-01-01
'841-1	OTHER	Extensive 3rd Degree Burns W Skin Graft	42	9	—	—	$39,979.03	$91,997.07	$72,755.37	2025-01-01
'633-4	OTHER	Neonate Birthwt >2499g W Major Anomaly	42	9	—	—	$39,884.19	$91,781.14	$72,584.60	2025-01-01
231	MS_DRG	Coronary Bypass With Ptca With Mcc	36	15	—	—	$71,472.30	$147,412.61	$72,544.39	2025-01-01
'050-4	OTHER	Non-bacterial Infections Of Nervous System Exc Viral Meningitis	42	9	—	—	$39,829.79	$91,657.27	$72,486.63	2025-01-01
'304-3	OTHER	Dorsal & Lumbar Fusion Proc Except For Curvature Of Back	42	9	—	—	$39,690.84	$91,340.90	$72,236.44	2025-01-01
'364-4	OTHER	Other Skin, Subcutaneous Tissue & Related Procedures	42	9	—	—	$39,556.30	$91,034.57	$71,994.18	2025-01-01
'863-4	OTHER	Neonatal Aftercare	42	9	—	—	$39,480.58	$90,862.16	$71,857.83	2025-01-01
'303-2	OTHER	Dorsal & Lumbar Fusion Proc For Curvature Of Back	42	9	—	—	$39,402.65	$90,684.72	$71,717.50	2025-01-01
'227-4	OTHER	Hernia Procedures Except Inguinal, Femoral & Umbilical	42	9	—	—	$39,294.58	$90,438.66	$71,522.91	2025-01-01
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	36	15	—	—	$70,404.11	$145,201.93	$71,460.17	2025-01-01
'613-4	OTHER	Neonate Birthwt 1500-1999g W Congenital/perinatal Infection	42	9	—	—	$38,591.74	$88,838.40	$70,257.35	2025-01-01
'603-1	OTHER	Neonate Birthwt 1000-1249g W Or Without Other Significant Condition	42	9	—	—	$38,563.07	$88,773.12	$70,205.72	2025-01-01
'622-4	OTHER	Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond	42	9	—	—	$38,524.84	$88,686.08	$70,136.89	2025-01-01
A9542	HCPCS	Indium In-111 Ibritumomab Tiuxetan Diagnostic Per Study Dose Up To 5 Millicuries	50	16	$97,800.00	$63,570.00 35% off	$45,232.50	$97,800.00	$69,927.00	2025-01-01
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	36	15	—	—	$68,702.20	$141,679.73	$69,732.73	2025-01-01
'315-4	OTHER	Shoulder, Upper Arm & Forearm Procedures Except Joint Replacement	42	9	—	—	$38,263.12	$88,090.16	$69,665.61	2025-01-01
'844-4	OTHER	Partial Thickness Burns Without Skin Graft	42	9	—	—	$37,868.32	$87,191.27	$68,954.73	2025-01-01
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	36	15	—	—	$67,926.29	$140,073.95	$68,945.18	2025-01-01
'443-4	OTHER	Kidney & Urinary Tract Procedures For Nonmalignancy	42	9	—	—	$37,780.84	$86,992.08	$68,797.20	2025-01-01
'006-1	OTHER	Pancreas Transplant	42	9	—	—	$37,689.68	$86,784.51	$68,633.05	2025-01-01
'006-2	OTHER	Pancreas Transplant	42	9	—	—	$37,689.68	$86,784.51	$68,633.05	2025-01-01
'613-3	OTHER	Neonate Birthwt 1500-1999g W Congenital/perinatal Infection	42	9	—	—	$37,633.07	$86,655.62	$68,531.11	2025-01-01
'614-4	OTHER	Neonate Bwt 1500-1999g W Or Without Other Significant Condition	42	9	—	—	$37,547.79	$86,461.45	$68,377.55	2025-01-01
'614-3	OTHER	Neonate Bwt 1500-1999g W Or Without Other Significant Condition	42	9	—	—	$37,547.79	$86,461.45	$68,377.55	2025-01-01
'320-4	OTHER	Other Musculoskeletal System & Connective Tissue Procedures	42	9	—	—	$37,308.85	$85,917.43	$67,947.32	2025-01-01
'660-4	OTHER	Major Hematologic/immunologic Diag Exc Sickle Cell Crisis & Coagul	42	9	—	—	$37,120.65	$85,488.91	$67,608.42	2025-01-01
27800000002-9396	CDM	Valve Sapien Thv Edwards Resilia 26mm	50	16	$93,500.00	$60,775.00 35% off	$43,243.75	$93,500.00	$66,852.50	2025-01-01
27800000002-9397	CDM	Valve Sapien Thv Edwards Resilia 20mm	50	16	$93,500.00	$60,775.00 35% off	$43,243.75	$93,500.00	$66,852.50	2025-01-01
27800000002-9394	CDM	Valve Sapien Thv Edwards Resilia 23mm	50	16	$93,500.00	$60,775.00 35% off	$43,243.75	$93,500.00	$66,852.50	2025-01-01
27800000002-9395	CDM	Valve Sapien Thv Edwards Resilia 29mm	50	16	$93,500.00	$60,775.00 35% off	$43,243.75	$93,500.00	$66,852.50	2025-01-01
'175-4	OTHER	Percutaneous Coronary Intervention Without Ami	42	9	—	—	$36,625.87	$84,362.37	$66,717.50	2025-01-01
'631-3	OTHER	Neonate Birthwt >2499g W Other Major Procedure	42	9	—	—	$36,370.76	$83,781.52	$66,258.15	2025-01-01
'346-4	OTHER	Connective Tissue Disorders	42	9	—	—	$36,359.73	$83,756.41	$66,238.29	2025-01-01
'165-3	OTHER	Coronary Bypass W Ami Or Complex Pdx	42	9	—	—	$36,263.42	$83,537.13	$66,064.87	2025-01-01
'180-4	OTHER	Other Circulatory System Procedures	42	9	—	—	$35,952.44	$82,829.07	$65,504.90	2025-01-01
'170-4	OTHER	Permanent Cardiac Pacemaker Implant W Ami, Heart Failure Or Shock	42	9	—	—	$35,903.92	$82,718.59	$65,417.53	2025-01-01
'513-4	OTHER	Uterine & Adnexa Procedures For Non-malignancy Except Leiomyoma	42	9	—	—	$35,823.79	$82,536.13	$65,273.24	2025-01-01
'160-3	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	42	9	—	—	$35,665.72	$82,176.24	$64,988.62	2025-01-01
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	36	15	—	—	$63,724.63	$131,378.36	$64,680.50	2025-01-01
27800000002-9680	CDM	Valve Sapien 3 Ultra Thv 20mm W/command System	50	16	$89,375.00	$58,093.75 35% off	$41,335.94	$89,375.00	$63,903.13	2025-01-01
27800000002-9617	CDM	Valve Thv Sapien 3 26mm W/certitudesystem	50	16	$89,375.00	$58,093.75 35% off	$41,335.94	$89,375.00	$63,903.13	2025-01-01
27800000002-9613	CDM	Valve Sapien 3 Thv 26mm W/command System	50	16	$89,375.00	$58,093.75 35% off	$41,335.94	$89,375.00	$63,903.13	2025-01-01
27800000002-9618	CDM	Valve Thv Sapien 3 29mm W/certitudesystem	50	16	$89,375.00	$58,093.75 35% off	$41,335.94	$89,375.00	$63,903.13	2025-01-01
27800000002-9684	CDM	Valve Sapien 3 Ultra Thv 26mm W/command System	50	16	$89,375.00	$58,093.75 35% off	$41,335.94	$89,375.00	$63,903.13	2025-01-01
27800000002-9681	CDM	Valve Sapien 3 Ultra Thv 23mm W/command System	50	16	$89,375.00	$58,093.75 35% off	$41,335.94	$89,375.00	$63,903.13	2025-01-01
27800000002-9612	CDM	Valve Sapien 3 Thv 23mm W/command System	50	16	$89,375.00	$58,093.75 35% off	$41,335.94	$89,375.00	$63,903.13	2025-01-01
27800000002-9682	CDM	Valve Sapien 3 Ultra Thv 23mm W/command System	50	16	$89,375.00	$58,093.75 35% off	$41,335.94	$89,375.00	$63,903.13	2025-01-01
27800000002-9616	CDM	Valve Thv Sapien 3 23mm W/certitudesystem	50	16	$89,375.00	$58,093.75 35% off	$41,335.94	$89,375.00	$63,903.13	2025-01-01
27800000002-9611	CDM	Valve Sapien 3 Thv 20mm W/command System	50	16	$89,375.00	$58,093.75 35% off	$41,335.94	$89,375.00	$63,903.13	2025-01-01
27800000002-9615	CDM	Valve Sapien 3 Thv 29mm W/command System	50	16	$89,375.00	$58,093.75 35% off	$41,335.94	$89,375.00	$63,903.13	2025-01-01
27800000002-9614	CDM	Valve Sapien 3 Thv 29mm W/command System	50	16	$89,375.00	$58,093.75 35% off	$41,335.94	$89,375.00	$63,903.13	2025-01-01
27800000002-9774	CDM	Valve Transcath Sapien 3 26mm W/certitude	50	16	$89,375.00	$58,093.75 35% off	$41,335.94	$89,375.00	$63,903.13	2025-01-01
27800000002-9683	CDM	Valve Sapien 3 Ultra Thv 26mm W/command System	50	16	$89,375.00	$58,093.75 35% off	$41,335.94	$89,375.00	$63,903.13	2025-01-01
'440-2	OTHER	Kidney Transplant	42	9	—	—	$34,675.43	$79,921.48	$63,205.46	2025-01-01
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	34	14	—	—	$61,998.14	$127,805.31	$62,618.12	2025-01-01
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	36	15	—	—	$61,375.84	$126,517.41	$62,296.48	2025-01-01
'661-4	OTHER	Coagulation & Platelet Disorders	42	9	—	—	$34,092.43	$78,594.07	$62,155.68	2025-01-01
'612-2	OTHER	Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond	42	9	—	—	$33,974.81	$78,326.25	$61,943.87	2025-01-01
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	36	15	—	—	$60,979.10	$125,696.35	$61,893.79	2025-01-01
'163-3	OTHER	Cardiac Valve Procedures Without Ami Or Complex Pdx	42	9	—	—	$33,941.72	$78,250.92	$61,884.30	2025-01-01
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	36	15	—	—	$60,876.41	$125,483.82	$61,789.56	2025-01-01
'312-3	OTHER	Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses	42	9	—	—	$33,810.13	$77,951.29	$61,647.34	2025-01-01
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	36	15	—	—	$60,565.70	$124,840.78	$61,474.18	2025-01-01
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	36	15	—	—	$60,408.58	$124,515.63	$61,314.71	2025-01-01
'162-2	OTHER	Cardiac Valve Procedures W Ami Or Complex Pdx	42	9	—	—	$33,474.88	$77,187.99	$61,043.69	2025-01-01
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	36	15	—	—	$60,090.85	$123,858.05	$60,992.21	2025-01-01
'193-4	OTHER	Acute & Subacute Endocarditis	42	9	—	—	$33,343.29	$76,888.36	$60,806.73	2025-01-01
'228-4	OTHER	Inguinal, Femoral & Umbilical Hernia Procedures	42	9	—	—	$33,281.53	$76,747.75	$60,695.53	2025-01-01
'303-1	OTHER	Dorsal & Lumbar Fusion Proc For Curvature Of Back	42	9	—	—	$33,016.86	$76,145.14	$60,218.96	2025-01-01
'589-3	OTHER	Neonate Bwt <500g Or Ga <24 Weeks	42	9	—	—	$32,870.56	$75,812.04	$59,955.52	2025-01-01
'696-4	OTHER	Other Chemotherapy #	42	9	—	—	$32,830.13	$75,719.97	$59,882.72	2025-01-01
'842-3	OTHER	Burns With Skin Graft Except Extensive 3rd Degree Burns	42	9	—	—	$32,602.96	$75,202.73	$59,473.66	2025-01-01
459	MS_DRG	Spinal Fusion Except Cervical With Mcc	36	15	—	—	$58,456.53	$120,475.73	$59,333.38	2025-01-01
'021-3	OTHER	Craniotomy Except For Trauma	42	9	—	—	$32,370.64	$74,673.78	$59,055.34	2025-01-01
27800000002-9481	CDM	Kit Mitraclip 2 Mbr0102	50	16	$82,500.00	$53,625.00 35% off	$38,156.25	$82,500.00	$58,987.50	2025-01-01
27800000002-9389	CDM	Valve Aortic 34mm Evolut Fx	50	16	$82,500.00	$53,625.00 35% off	$38,156.25	$82,500.00	$58,987.50	2025-01-01
27800000002-9390	CDM	Valve Aortic 23mm Evolut Fx	50	16	$82,500.00	$53,625.00 35% off	$38,156.25	$82,500.00	$58,987.50	2025-01-01
27800000002-9581	CDM	Valve Aort 26mm Evolutr	50	16	$82,500.00	$53,625.00 35% off	$38,156.25	$82,500.00	$58,987.50	2025-01-01
27800000002-9387	CDM	Valve Aortic 26mm Evolut Fx	50	16	$82,500.00	$53,625.00 35% off	$38,156.25	$82,500.00	$58,987.50	2025-01-01
27800000002-9692	CDM	Kit Mitraclip G4 Syst Cds0701nt/ntw/xt/xtw	50	16	$82,500.00	$53,625.00 35% off	$38,156.25	$82,500.00	$58,987.50	2025-01-01
27800000002-9479	CDM	Kit Mitraclip 1 Mbr0101	50	16	$82,500.00	$53,625.00 35% off	$38,156.25	$82,500.00	$58,987.50	2025-01-01
27800000002-9633	CDM	Valve Aortic Evolut Tm Pro 29mm	50	16	$82,500.00	$53,625.00 35% off	$38,156.25	$82,500.00	$58,987.50	2025-01-01
27800000002-9719	CDM	Kit Mitraclip 3 Mbr0103	50	16	$82,500.00	$53,625.00 35% off	$38,156.25	$82,500.00	$58,987.50	2025-01-01
27800000002-9388	CDM	Valve Aortic 29mm Evolut Fx	50	16	$82,500.00	$53,625.00 35% off	$38,156.25	$82,500.00	$58,987.50	2025-01-01
27800000002-9691	CDM	Kit Mitraclip G4 Syst Cds0701nt/ntw/xt/xtw	50	16	$82,500.00	$53,625.00 35% off	$38,156.25	$82,500.00	$58,987.50	2025-01-01
27800000002-9384	CDM	Valve Aort 23mm Evolutr	50	16	$82,500.00	$53,625.00 35% off	$38,156.25	$82,500.00	$58,987.50	2025-01-01
27800000002-9728	CDM	Kit Mitraclip G4 Delivery Sys Ntw	50	16	$82,500.00	$53,625.00 35% off	$38,156.25	$82,500.00	$58,987.50	2025-01-01
27800000002-9386	CDM	Valve Aortic 26mm Evolut Fx	50	16	$82,500.00	$53,625.00 35% off	$38,156.25	$82,500.00	$58,987.50	2025-01-01
27800000002-9582	CDM	Valve Aort 29mm Evolutr	50	16	$82,500.00	$53,625.00 35% off	$38,156.25	$82,500.00	$58,987.50	2025-01-01
27800000002-9482	CDM	Kit Mitraclip 3 Mbr0203	50	16	$82,500.00	$53,625.00 35% off	$38,156.25	$82,500.00	$58,987.50	2025-01-01
27800000002-9480	CDM	Kit Mitraclip 1 Mbr0201	50	16	$82,500.00	$53,625.00 35% off	$38,156.25	$82,500.00	$58,987.50	2025-01-01
27800000002-9738	CDM	Kit Mitraclip 2 Mbr0202	50	16	$82,500.00	$53,625.00 35% off	$38,156.25	$82,500.00	$58,987.50	2025-01-01
'546-4	OTHER	Other O.r. Proc For Obstetric Diagnoses Except Delivery Diagnoses	42	9	—	—	$32,192.73	$74,268.69	$58,734.98	2025-01-01
'023-3	OTHER	Spinal Procedures	42	9	—	—	$32,109.65	$74,079.54	$58,585.39	2025-01-01
'130-3	OTHER	Respiratory System Diagnosis W Ventilator Support 96+ Hours	42	9	—	—	$31,984.67	$73,794.97	$58,360.34	2025-01-01
'483-4	OTHER	Testes & Scrotal Procedures	42	9	—	—	$31,974.38	$73,771.54	$58,341.81	2025-01-01
'608-1	OTHER	Neonate Bwt 1250-1499g W Or Without Other Significant Condition	42	9	—	—	$31,727.36	$73,209.11	$57,897.01	2025-01-01
J9600	HCPCS	Porfimer Per 75 Mg	76	23	$105,199.95	$68,379.97 35% off	$2,351.72	$105,199.95	$57,333.97	2025-01-01
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	36	15	—	—	$56,113.00	$115,625.67	$56,954.69	2025-01-01
'098-4	OTHER	Other Ear, Nose, Mouth & Throat Procedures	42	9	—	—	$31,117.89	$71,821.44	$56,799.58	2025-01-01
'863-3	OTHER	Neonatal Aftercare	42	9	—	—	$31,044.37	$71,654.04	$56,667.20	2025-01-01
'091-4	OTHER	Other Major Head & Neck Procedures	42	9	—	—	$30,979.68	$71,506.74	$56,550.71	2025-01-01
'192-4	OTHER	Cardiac Catheterization For Other Non-coronary Conditions	42	9	—	—	$30,792.94	$71,081.57	$56,214.46	2025-01-01
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	36	15	—	—	$55,066.76	$113,460.41	$55,892.76	2025-01-01
'181-3	OTHER	Lower Extremity Arterial Procedures #	42	9	—	—	$30,594.44	$70,629.61	$55,857.03	2025-01-01
'090-3	OTHER	Major Larynx & Trachea Procedures	42	9	—	—	$30,567.24	$70,567.68	$55,808.05	2025-01-01
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	36	15	—	—	$54,820.99	$112,951.79	$55,643.31	2025-01-01
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	34	14	—	—	$54,460.25	$112,205.21	$55,549.46	2025-01-01
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	34	14	—	—	$54,460.25	$112,205.21	$55,549.46	2025-01-01
'225-4	OTHER	Appendectomy	42	9	—	—	$30,387.86	$70,159.24	$55,485.04	2025-01-01
276	MS_DRG	Cardiac Defibrillator Implant With Mcc	34	14	—	—	$54,751.65	$112,808.28	$55,299.17	2025-01-01
'611-2	OTHER	Neonate Birthwt 1500-1999g W Major Anomaly	42	9	—	—	$30,187.15	$69,702.27	$55,123.65	2025-01-01
'634-4	OTHER	Neonate, Birthwt >2499g W Resp Dist Synd/oth Maj Resp Cond	42	9	—	—	$30,176.86	$69,678.83	$55,105.11	2025-01-01
'613-2	OTHER	Neonate Birthwt 1500-1999g W Congenital/perinatal Infection	42	9	—	—	$30,133.48	$69,580.07	$55,027.01	2025-01-01
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	36	15	—	—	$54,147.78	$111,558.53	$54,960.00	2025-01-01
'462-4	OTHER	Nephritis & Nephrosis	42	9	—	—	$30,063.64	$69,421.05	$54,901.25	2025-01-01
'166-3	OTHER	Coronary Bypass Without Ami Or Complex Pdx	42	9	—	—	$30,046.73	$69,382.55	$54,870.80	2025-01-01
'161-1	OTHER	Cardiac Defibrillator & Heart Assist Implant	42	9	—	—	$30,035.71	$69,357.44	$54,850.94	2025-01-01
454	MS_DRG	Combined Anterior And Posterior Spinal Fusion With Cc	36	15	—	—	$53,927.47	$111,102.59	$54,736.38	2025-01-01
'950-3	OTHER	Extensive Procedure Unrelated To Principal Diagnosis	42	9	—	—	$29,889.40	$69,024.33	$54,587.51	2025-01-01
955	MS_DRG	Craniotomy For Multiple Significant Trauma	36	15	—	—	$53,698.38	$110,628.48	$54,503.85	2025-01-01
'621-3	OTHER	Neonate Bwt 2000-2499g W Major Anomaly	42	9	—	—	$29,771.04	$68,754.83	$54,374.37	2025-01-01
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	36	15	—	—	$53,567.60	$110,357.82	$54,371.11	2025-01-01
'097-4	OTHER	Tonsil & Adenoid Procedures	42	9	—	—	$29,740.90	$68,686.20	$54,320.10	2025-01-01
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	36	15	—	—	$53,316.57	$109,838.31	$54,116.32	2025-01-01
'165-2	OTHER	Coronary Bypass W Ami Or Complex Pdx	42	9	—	—	$29,540.93	$68,230.90	$53,960.02	2025-01-01
28	MS_DRG	Spinal Procedures With Mcc	36	15	—	—	$53,135.76	$109,464.11	$53,932.80	2025-01-01

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