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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

SAMARITAN MEDICAL CENTER

Watertown, NY · CCN 330157 · Rates published

16,292 distinct procedures filed
11 distinct payers
442,903 rate rows
2026-02-02 last MRF observed
Data quality

330,526 of 442,903 rate rows are consumer-grade (74.6%)

112,377 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
professional (physician) fee — not the facility price 111,993
exceeds 10× this hospital's gross charge — excluded from medians 140
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 82
per-diem day rate — not a per-procedure price 75
percent-of-charges filed in the dollar field — excluded from medians 64
placeholder amount (≤ $0.02) — excluded from medians 23
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/8502/150533577_samaritan-medical-center_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/SamaritanMedicalCenter/8502
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-16
Content fingerprint 2794b15551d67ff6… · 355,917,538 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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 7 $4,505,000.00 $4,730,250.00 $4,550,050.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 7 $3,685,266.67 $4,238,056.67 $3,758,972.00 nat. median
$3,710,000
1.0× median
J3389
HCPCS 		Topi Adm Prad Zami Per Treat 7 $3,335,820.00 $3,836,193.00 $3,402,536.40 nat. median
$3,335,820
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 7 $3,316,462.59 $3,813,931.98 $3,382,791.84 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 7 $3,248,445.72 $4,920,420.72 $3,329,656.86 nat. median
$3,286,000
1.0× median
J3387
HCPCS 		Inj Elivaldogene Autotemecel 7 $3,090,000.00 $4,680,423.00 $3,167,250.00 nat. median
$3,180,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 7 $2,945,740.00 $4,461,912.38 $3,019,383.50 nat. median
$3,004,655
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 7 $2,455,110.61 $3,718,756.03 $2,516,488.37 nat. median
$2,468,984
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 7 $2,332,000.00 $3,532,280.40 $2,390,300.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 7 $770,620.00 $3,537,145.80 $793,738.60 nat. median
$824,563
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 7 $591,726.20 $2,716,023.26 $609,477.99 nat. median
$753,246
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 7 $565,868.95 $2,597,338.46 $582,845.01 nat. median
$674,867
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 7 $562,538.19 $2,582,050.27 $579,414.33 nat. median
$673,137
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 7 $557,317.93 $2,558,089.32 $574,037.47 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 7 $533,230.17 $2,447,526.48 $549,227.08 nat. median
$634,303
0.9× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 9 $398,836.34 $612,208.81 $532,355.49 nat. median
$370,174
1.4× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 7 $489,304.61 $2,245,908.15 $503,983.75 nat. median
$619,808
0.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 9 $258,828.74 $397,325.30 $345,500.26 nat. median
$265,286
1.3× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 7 $278,250.00 $1,277,167.50 $286,597.50 nat. median
$324,450
0.9× median
J3403
HCPCS 		Revakinagene, Per Implant 7 $257,500.00 $1,181,925.00 $265,225.00 nat. median
$265,000
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 9 $197,193.22 $302,727.16 $263,241.01 nat. median
$206,474
1.3× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 9 $196,035.95 $300,951.00 $261,696.52 nat. median
$202,976
1.3× median
24
APR_DRG 		Heart &/or Lung Transplant 5 $149,430.29 $458,324.81 $257,767.25 nat. median
$234,729
1.1× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 7 $205,640.00 $943,887.60 $211,809.20 nat. median
$209,753
1.0× median
5834
APR_DRG 		Neonate W Ecmo 5 $109,998.50 $337,381.67 $189,747.42 nat. median
$309,665
0.6× median
5884
APR_DRG 		Neonate Bwt <1500g W Major Procedure 5 $108,064.96 $331,451.22 $186,412.05 nat. median
$246,434
0.8× median
5883
APR_DRG 		Neonate Bwt <1500g W Major Procedure 5 $108,064.96 $331,451.22 $186,412.05 nat. median
$182,665
1.0× median
J0225
HCPCS 		Vutrisiran Sodium 25mg/0.5ml Syringe 11 $5,003.64 $194,785.08 $183,327.14 nat. median
$8,223
outlier · 22.3×
4
MS_DRG 		Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And… 9 $127,931.53 $196,424.39 $170,803.82 nat. median
$133,161
1.3× median
1614
APR_DRG 		Cardiac Defibrillator & Heart Assist Implant 5 $98,843.06 $303,166.31 $170,504.28 nat. median
$207,730
0.8× median
34
APR_DRG 		Bone Marrow Transplant 5 $95,971.66 $294,359.29 $165,551.11 nat. median
$209,067
0.8× median
7
MS_DRG 		Lung Transplant 9 $119,608.05 $183,649.53 $159,695.24 nat. median
$122,708
1.3× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 9 $110,997.32 $170,433.78 $148,203.29 nat. median
$117,357
1.3× median
5914
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 5 $82,970.91 $254,484.06 $143,124.82 nat. median
$164,289
0.9× median
5882
APR_DRG 		Neonate Bwt <1500g W Major Procedure 5 $82,671.14 $253,564.61 $142,607.72 nat. median
$145,336
1.0× median
5881
APR_DRG 		Neonate Bwt <1500g W Major Procedure 5 $82,671.14 $253,564.61 $142,607.72 nat. median
$124,573
1.1× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 9 $104,660.50 $160,708.04 $139,746.12 nat. median
$108,660
1.3× median
209
MS_DRG 		Complex Aortic Arch Procedures 8 $104,540.44 $160,523.77 $139,585.89 nat. median
$98,047
1.4× median
8414
APR_DRG 		Extensive 3rd Degree Burns W Skin Graft 5 $80,246.82 $246,128.88 $138,425.77 nat. median
$160,267
0.9× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 $101,791.80 $156,305.17 $135,917.54 nat. median
$98,894
1.4× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 9 $100,433.19 $154,219.96 $134,104.31 nat. median
$102,358
1.3× median
44
APR_DRG 		Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 5 $77,393.41 $237,377.03 $133,503.63 nat. median
$105,658
1.3× median
14
APR_DRG 		Liver Transplant &/or Intestinal Transplant 5 $74,966.53 $229,933.43 $129,317.26 nat. median
$129,535
1.0× median
5934
APR_DRG 		Neonate Birthwt 750-999g Without Major Procedure 5 $74,668.89 $229,020.55 $128,803.83 nat. median
$151,838
0.8× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 9 $95,227.78 $146,230.71 $127,157.14 nat. median
$100,136
1.3× median
215
MS_DRG 		Other Heart Assist System Implant 9 $91,962.85 $141,219.69 $122,799.73 nat. median
$99,019
1.2× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 9 $90,353.94 $138,750.36 $120,652.49 nat. median
$93,672
1.3× median
6094
APR_DRG 		Neonate Bwt 1500-2499g W Major Procedure 5 $68,366.37 $209,689.77 $117,931.98 nat. median
$162,982
0.7× median
A9543
HCPCS 		Zevalin Yttrium-90 Upto 40mCi 11 $56,824.55 $260,824.68 $113,311.60 nat. median
$62,507
1.8× median
6024
APR_DRG 		Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 5 $64,757.95 $198,622.22 $111,707.46 nat. median
$118,620
0.9× median

Other procedures at this hospital

Browse this hospital's 16,292 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
             
0620T CPT Evasc Ven Artlz Tibl/prnl Vn 12 7 — — $11,220.00 $252,369.73 $56,357.07 2026-02-02
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 13 9 — — $258,828.74 $397,325.30 $345,500.26 2026-02-02
10 MS_DRG Pancreas Transplant 13 9 — — $54,437.00 $101,793.64 $88,516.21 2026-02-02
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 13 9 — — $50,374.07 $77,389.28 $67,295.03 2026-02-02
11 APR_DRG Liver Transplant &/or Intestinal Transplant 12 5 — — $26,394.21 $80,954.95 $45,530.01 2026-02-02
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 13 9 — — $38,938.98 $59,838.69 $52,033.64 2026-02-02
12 APR_DRG Liver Transplant &/or Intestinal Transplant 12 5 — — $26,394.21 $80,954.95 $45,530.01 2026-02-02
1204 APR_DRG Major Respiratory & Chest Procedures 12 5 — — $26,083.73 $80,002.66 $44,994.43 2026-02-02
1214 APR_DRG Other Respiratory & Chest Procedures 12 5 — — $25,939.41 $79,560.01 $44,745.48 2026-02-02
13 APR_DRG Liver Transplant &/or Intestinal Transplant 12 5 — — $35,829.37 $109,893.98 $61,805.66 2026-02-02
1304 APR_DRG Respiratory System Diagnosis W Ventilator Support 96+ Hours 12 5 — — $26,006.64 $79,766.23 $44,861.46 2026-02-02
14 MS_DRG Allogeneic Bone Marrow Transplant 13 9 — — $110,997.32 $170,433.78 $148,203.29 2026-02-02
14 APR_DRG Liver Transplant &/or Intestinal Transplant 12 5 — — $74,966.53 $229,933.43 $129,317.26 2026-02-02
140 MS_DRG Major Head And Neck Procedures With Mcc 13 9 — — $39,394.31 $60,537.55 $52,641.35 2026-02-02
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 13 9 — — $34,603.60 $53,184.77 $46,247.63 2026-02-02
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 13 9 — — $54,766.71 $84,131.09 $73,157.47 2026-02-02
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 12 5 — — $42,584.55 $130,613.13 $73,458.35 2026-02-02
1612 APR_DRG Cardiac Defibrillator & Heart Assist Implant 12 5 — — $26,241.32 $80,486.03 $45,266.28 2026-02-02
1613 APR_DRG Cardiac Defibrillator & Heart Assist Implant 12 5 — — $42,137.89 $129,243.15 $72,687.86 2026-02-02
1614 APR_DRG Cardiac Defibrillator & Heart Assist Implant 12 5 — — $98,843.06 $303,166.31 $170,504.28 2026-02-02
1624 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 12 5 — — $40,189.79 $123,268.03 $69,327.39 2026-02-02
163 MS_DRG Major Chest Procedures With Mcc 13 9 — — $41,393.90 $63,606.55 $55,310.04 2026-02-02
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Pdx 12 5 — — $30,178.64 $92,562.35 $52,058.15 2026-02-02
1654 APR_DRG Coronary Bypass W Ami Or Complex Pdx 12 5 — — $30,305.40 $92,951.14 $52,276.82 2026-02-02
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 13 9 — — $34,521.40 $53,058.61 $46,137.92 2026-02-02
1664 APR_DRG Coronary Bypass Without Ami Or Complex Pdx 12 5 — — $26,684.99 $81,846.81 $46,031.61 2026-02-02
1674 APR_DRG Other Cardiothoracic & Thoracic Vascular Procedures 12 5 — — $28,397.98 $87,100.81 $48,986.52 2026-02-02
1694 APR_DRG Major Abdominal Vascular Procedures 12 5 — — $30,760.63 $94,347.39 $53,062.09 2026-02-02
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 13 9 — — $50,172.72 $77,080.25 $67,026.30 2026-02-02
1774 APR_DRG Cardiac Pacemaker & Defibrillator Revision Except Device Replacement 12 5 — — $27,127.80 $83,204.97 $46,795.46 2026-02-02
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 9 — — $398,836.34 $612,208.81 $532,355.49 2026-02-02
1814 APR_DRG Lower Extremity Arterial Procedures # 12 5 — — $28,335.03 $86,907.73 $48,877.93 2026-02-02
1824 APR_DRG Other Peripheral Vascular Procedures # 12 5 — — $26,859.71 $82,382.72 $46,333.00 2026-02-02
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 13 9 — — $65,895.17 $101,211.03 $88,009.59 2026-02-02
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 13 9 — — $104,660.50 $160,708.04 $139,746.12 2026-02-02
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 13 9 — — $72,676.24 $111,618.63 $97,059.68 2026-02-02
204 APR_DRG Craniotomy For Trauma 12 5 — — $28,649.79 $87,873.15 $49,420.89 2026-02-02
207 MS_DRG Respiratory System Diagnosis With Ventilator Support &gt;96 Hours 13 9 — — $59,430.89 $91,289.67 $79,382.32 2026-02-02
209 MS_DRG Complex Aortic Arch Procedures 12 8 — — $104,540.44 $160,523.77 $139,585.89 2026-02-02
21 APR_DRG Heart &/or Lung Transplant 12 5 — — $51,818.44 $158,934.81 $89,386.81 2026-02-02
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 13 9 — — $48,893.54 $75,116.98 $65,319.11 2026-02-02
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 13 9 — — $100,433.19 $154,219.96 $134,104.31 2026-02-02
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 12 8 — — $52,708.93 $80,972.82 $70,411.15 2026-02-02
214 APR_DRG Craniotomy Except For Trauma 12 5 — — $31,011.15 $95,115.79 $53,494.24 2026-02-02
215 MS_DRG Other Heart Assist System Implant 13 9 — — $91,962.85 $141,219.69 $122,799.73 2026-02-02
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 13 9 — — $90,353.94 $138,750.36 $120,652.49 2026-02-02
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 13 9 — — $60,729.47 $93,282.74 $81,115.43 2026-02-02
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 13 9 — — $60,729.47 $93,282.74 $81,115.43 2026-02-02
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 13 9 — — $70,916.78 $108,918.20 $94,711.48 2026-02-02
22 APR_DRG Heart &/or Lung Transplant 12 5 — — $55,011.88 $168,729.58 $94,895.49 2026-02-02
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 13 9 — — $49,253.74 $75,669.80 $65,799.83 2026-02-02
2204 APR_DRG Major Stomach, Esophageal & Duodenal Procedures 12 5 — — $30,352.93 $93,096.94 $52,358.80 2026-02-02
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 13 9 — — $46,551.29 $71,522.10 $62,193.13 2026-02-02
2214 APR_DRG Major Small & Large Bowel Procedures 12 5 — — $28,299.91 $86,800.02 $48,817.35 2026-02-02
228 MS_DRG Other Cardiothoracic Procedures With Mcc 13 9 — — $45,694.19 $70,206.59 $61,049.21 2026-02-02
23 APR_DRG Heart &/or Lung Transplant 12 5 — — $64,531.83 $197,928.69 $111,317.41 2026-02-02
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 13 9 — — $52,925.05 $81,304.53 $70,699.59 2026-02-02
231 MS_DRG Coronary Bypass With Ptca With Mcc 13 9 — — $77,858.56 $119,572.43 $103,976.03 2026-02-02
232 MS_DRG Coronary Bypass With Ptca Without Mcc 13 9 — — $55,994.17 $86,015.01 $74,795.66 2026-02-02
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 13 9 — — $70,611.07 $108,448.98 $94,303.46 2026-02-02
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 13 9 — — $50,453.50 $77,511.17 $67,401.02 2026-02-02
234 APR_DRG Spinal Procedures 12 5 — — $34,611.43 $106,158.38 $59,704.72 2026-02-02
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 13 9 — — $54,202.39 $83,264.98 $72,404.33 2026-02-02
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 13 9 — — $38,687.76 $59,453.15 $51,698.39 2026-02-02
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 13 9 — — $45,456.82 $69,842.28 $60,732.42 2026-02-02
24 APR_DRG Heart &/or Lung Transplant 12 5 — — $149,430.29 $458,324.81 $257,767.25 2026-02-02
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 13 9 — — $36,130.31 $55,527.97 $48,285.19 2026-02-02
244 APR_DRG Extracranial Vascular Procedures 12 5 — — $29,093.46 $89,233.94 $50,186.22 2026-02-02
245 MS_DRG Aicd Generator Procedures 13 9 — — $42,138.33 $64,749.07 $56,303.54 2026-02-02
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 13 9 — — $41,993.32 $64,526.51 $56,110.01 2026-02-02
2604 APR_DRG Major Pancreas, Liver & Shunt Procedures 12 5 — — $31,803.84 $97,547.08 $54,861.62 2026-02-02
2614 APR_DRG Major Biliary Tract Procedures 12 5 — — $26,297.00 $80,656.78 $45,362.32 2026-02-02
2624 APR_DRG Cholecystectomy Except Laparoscopic 12 5 — — $25,924.42 $79,514.04 $44,719.62 2026-02-02
264 APR_DRG Other Nervous System & Related Procedures 12 5 — — $26,876.42 $82,433.95 $46,361.82 2026-02-02
2644 APR_DRG Other Hepatobiliary, Pancreas & Abdominal Procedures 12 5 — — $26,356.95 $80,840.67 $45,465.74 2026-02-02
265 MS_DRG Aicd Lead Procedures 13 9 — — $33,417.70 $51,364.65 $44,664.91 2026-02-02
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 13 9 — — $56,601.90 $86,947.74 $75,606.73 2026-02-02
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 13 9 — — $43,970.75 $67,561.47 $58,749.10 2026-02-02
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 13 9 — — $63,524.28 $97,572.23 $84,845.42 2026-02-02
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 13 9 — — $39,005.48 $59,940.79 $52,122.43 2026-02-02
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 13 9 — — $48,731.91 $74,868.90 $65,103.39 2026-02-02
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 13 9 — — $38,103.12 $58,555.84 $50,918.12 2026-02-02
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 13 9 — — $65,856.37 $101,151.49 $87,957.82 2026-02-02
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 13 9 — — $55,476.96 $85,221.18 $74,105.37 2026-02-02
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 13 9 — — $42,656.47 $65,544.32 $56,995.06 2026-02-02
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 13 9 — — $50,442.66 $78,978.35 $68,676.83 2026-02-02
28 MS_DRG Spinal Procedures With Mcc 13 9 — — $55,492.66 $85,245.29 $74,126.34 2026-02-02
3 MS_DRG Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 13 9 — — $196,035.95 $300,951.00 $261,696.52 2026-02-02
3014 APR_DRG Hip Joint Replacement 12 5 — — $25,924.85 $79,515.35 $44,720.37 2026-02-02
3033 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 12 5 — — $29,925.97 $91,787.38 $51,622.29 2026-02-02
3034 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 12 5 — — $46,655.48 $143,099.26 $80,480.71 2026-02-02
3044 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 12 5 — — $39,322.59 $120,608.20 $67,831.47 2026-02-02
3054 APR_DRG Amputation Of Lower Limb Except Toes 12 5 — — $26,987.33 $82,774.14 $46,553.14 2026-02-02
31 MS_DRG Ventricular Shunt Procedures With Mcc 13 9 — — $41,381.90 $63,588.11 $55,294.01 2026-02-02
31 APR_DRG Bone Marrow Transplant 12 5 — — $28,374.00 $87,027.26 $48,945.15 2026-02-02
3104 APR_DRG Intervertebral Disc Excision & Decompression 12 5 — — $29,301.58 $89,872.30 $50,545.23 2026-02-02
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses 12 5 — — $38,552.17 $118,245.21 $66,502.49 2026-02-02
3134 APR_DRG Knee & Lower Leg Procedures Except Foot 12 5 — — $27,713.21 $85,000.53 $47,805.29 2026-02-02
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 12 8 — — $61,756.51 $94,859.04 $82,486.12 2026-02-02
3174 APR_DRG Tendon, Muscle & Other Soft Tissue Procedures 12 5 — — $27,056.71 $82,986.93 $46,672.82 2026-02-02
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 13 9 — — $41,219.34 $63,338.63 $55,077.07 2026-02-02
32 APR_DRG Bone Marrow Transplant 12 5 — — $33,234.61 $101,935.48 $57,329.70 2026-02-02
3214 APR_DRG Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp 12 5 — — $30,252.30 $92,788.27 $52,185.22 2026-02-02
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 13 9 — — $39,967.87 $61,417.84 $53,406.82 2026-02-02
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 13 9 — — $46,063.63 $70,773.61 $61,542.27 2026-02-02
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 13 9 — — $42,453.27 $65,232.45 $56,723.87 2026-02-02
33 APR_DRG Bone Marrow Transplant 12 5 — — $50,632.19 $155,296.42 $87,340.53 2026-02-02
332 MS_DRG Rectal Resection With Mcc 13 9 — — $33,440.79 $51,400.09 $44,695.73 2026-02-02
33276 CPT Insj Phrnc Nrv Stim Sys 11 7 — — $54,982.51 $252,369.73 $56,631.99 2026-02-02
34 APR_DRG Bone Marrow Transplant 12 5 — — $95,971.66 $294,359.29 $165,551.11 2026-02-02
34 MS_DRG Carotid Artery Stent Procedures With Mcc 13 9 — — $35,749.79 $54,943.94 $47,777.34 2026-02-02
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 13 9 — — $40,571.90 $62,344.93 $54,212.98 2026-02-02
3614 APR_DRG Skin Graft For Skin & Subcutaneous Tissue Diagnoses 12 5 — — $41,113.95 $126,102.57 $70,921.57 2026-02-02
38240 CPT Transplt Allo Hct/donor 12 7 — — $13,260.00 $360,399.70 $80,481.42 2026-02-02
4 MS_DRG Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And … 13 9 — — $127,931.53 $196,424.39 $170,803.82 2026-02-02
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 13 9 — — $35,662.04 $54,809.28 $47,660.24 2026-02-02
4014 APR_DRG Pituitary & Adrenal Procedures 12 5 — — $29,924.69 $91,783.44 $51,620.09 2026-02-02
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 12 8 — — $37,133.34 $57,067.40 $49,623.83 2026-02-02
4034 APR_DRG Procedures For Obesity 12 5 — — $28,164.59 $86,384.95 $48,583.92 2026-02-02
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 13 9 — — $50,525.54 $77,621.77 $67,497.19 2026-02-02
4054 APR_DRG Other Procedures For Endocrine, Nutritional & Metabolic Disorders 12 5 — — $35,921.87 $110,177.69 $61,965.23 2026-02-02
41 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 12 5 — — $30,785.04 $94,422.26 $53,104.19 2026-02-02
42 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 12 5 — — $30,785.04 $94,422.26 $53,104.19 2026-02-02
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 13 9 — — $38,357.11 $58,945.67 $51,257.10 2026-02-02
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 8 — — $101,791.80 $156,305.17 $135,917.54 2026-02-02
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 8 — — $66,670.99 $102,401.76 $89,045.01 2026-02-02
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 8 — — $51,924.79 $79,769.32 $69,364.63 2026-02-02
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 12 8 — — $83,212.67 $127,789.93 $111,121.68 2026-02-02
43 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 12 5 — — $43,127.14 $132,277.33 $74,394.32 2026-02-02
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 12 8 — — $53,264.94 $81,826.19 $71,153.21 2026-02-02
44 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 12 5 — — $77,393.41 $237,377.03 $133,503.63 2026-02-02
4404 APR_DRG Kidney Transplant 12 5 — — $44,469.70 $136,395.15 $76,710.24 2026-02-02
4414 APR_DRG Major Bladder Procedures 12 5 — — $28,963.70 $88,835.95 $49,962.39 2026-02-02
4424 APR_DRG Kidney & Urinary Tract Procedures For Malignancy 12 5 — — $27,304.66 $83,747.45 $47,100.54 2026-02-02
4444 APR_DRG Renal Dialysis Access Device Procedure Only 12 5 — — $26,490.99 $81,251.80 $45,696.96 2026-02-02
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 12 8 — — $61,711.26 $94,789.59 $82,425.73 2026-02-02
4474 APR_DRG Other Kidney, Urinary Tract & Related Procedures 12 5 — — $32,677.89 $100,227.93 $56,369.36 2026-02-02
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 12 8 — — $39,168.03 $60,190.25 $52,339.35 2026-02-02
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 12 8 — — $49,224.19 $75,624.45 $65,760.39 2026-02-02
453 MS_DRG Inpatient Ms-DRG 1 1 — — $100,213.57 $100,213.57 $100,213.57 2026-02-02
454 MS_DRG Inpatient Ms-DRG 1 1 — — $69,169.24 $69,169.24 $69,169.24 2026-02-02
455 MS_DRG Inpatient Ms-DRG 1 1 — — $52,084.73 $52,084.73 $52,084.73 2026-02-02
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 13 9 — — $77,613.80 $119,196.78 $103,649.37 2026-02-02
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 13 9 — — $55,075.19 $84,604.57 $73,569.19 2026-02-02
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 13 9 — — $38,538.13 $59,223.51 $51,498.70 2026-02-02
459 MS_DRG Inpatient Ms-DRG 1 1 — — $75,004.68 $75,004.68 $75,004.68 2026-02-02
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 13 9 — — $51,010.43 $78,365.97 $68,144.32 2026-02-02
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 13 9 — — $52,640.58 $80,867.94 $70,319.95 2026-02-02
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 13 9 — — $48,077.07 $73,863.86 $64,229.44 2026-02-02
471 MS_DRG Cervical Spinal Fusion With Mcc 13 9 — — $44,597.87 $68,523.98 $59,586.07 2026-02-02
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 13 9 — — $39,649.22 $60,928.79 $52,981.56 2026-02-02
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 13 9 — — $33,910.90 $52,121.62 $45,323.15 2026-02-02
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 13 9 — — $33,486.97 $51,470.96 $44,757.36 2026-02-02
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 13 9 — — $95,227.78 $146,230.71 $127,157.14 2026-02-02
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs 12 5 — — $27,447.70 $84,186.16 $47,347.29 2026-02-02
5114 APR_DRG Uterine & Adnexa Procedures For Ovarian & Adnexal Malignancy 12 5 — — $26,664.43 $81,783.76 $45,996.15 2026-02-02
5124 APR_DRG Uterine & Adnexa Procedures For Non-ovarian & Non-adnexal Malig 12 5 — — $32,133.16 $98,557.16 $55,429.70 2026-02-02
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 13 9 — — $34,517.70 $53,052.95 $46,133.00 2026-02-02
5194 APR_DRG Uterine & Adnexa Procedures For Leiomyoma 12 5 — — $25,903.87 $79,450.99 $44,684.18 2026-02-02
53 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 12 5 — — $39,538.85 $121,271.51 $68,204.51 2026-02-02
54 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 12 5 — — $59,053.26 $181,125.08 $101,866.88 2026-02-02
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 13 9 — — $60,508.73 $92,943.95 $80,820.83 2026-02-02
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 13 9 — — $45,267.48 $69,551.68 $60,479.72 2026-02-02
5831 APR_DRG Neonate W Ecmo 12 5 — — $61,322.97 $188,086.63 $105,782.12 2026-02-02
5832 APR_DRG Neonate W Ecmo 12 5 — — $61,322.97 $188,086.63 $105,782.12 2026-02-02
5833 APR_DRG Neonate W Ecmo 12 5 — — $62,491.66 $191,671.17 $107,798.11 2026-02-02
5834 APR_DRG Neonate W Ecmo 12 5 — — $109,998.50 $337,381.67 $189,747.42 2026-02-02
5881 APR_DRG Neonate Bwt <1500g W Major Procedure 12 5 — — $82,671.14 $253,564.61 $142,607.72 2026-02-02
5882 APR_DRG Neonate Bwt <1500g W Major Procedure 12 5 — — $82,671.14 $253,564.61 $142,607.72 2026-02-02
5883 APR_DRG Neonate Bwt <1500g W Major Procedure 12 5 — — $108,064.96 $331,451.22 $186,412.05 2026-02-02
5884 APR_DRG Neonate Bwt <1500g W Major Procedure 12 5 — — $108,064.96 $331,451.22 $186,412.05 2026-02-02
5891 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 12 5 — — $51,984.60 $159,444.45 $89,673.43 2026-02-02
5892 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 12 5 — — $51,984.60 $159,444.45 $89,673.43 2026-02-02
5911 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 12 5 — — $38,068.68 $116,762.27 $65,668.48 2026-02-02
5912 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 12 5 — — $47,201.07 $144,772.66 $81,421.85 2026-02-02
5913 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 12 5 — — $50,596.64 $155,187.40 $87,279.21 2026-02-02
5914 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 12 5 — — $82,970.91 $254,484.06 $143,124.82 2026-02-02
5931 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 12 5 — — $46,262.77 $141,894.78 $79,803.27 2026-02-02
5932 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 12 5 — — $47,715.82 $146,351.48 $82,309.79 2026-02-02
5933 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 12 5 — — $58,318.81 $178,872.43 $100,599.95 2026-02-02
5934 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 12 5 — — $74,668.89 $229,020.55 $128,803.83 2026-02-02
6 MS_DRG Liver Transplant Without Mcc 13 9 — — $42,827.33 $65,806.57 $57,223.10 2026-02-02
6021 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 12 5 — — $27,804.86 $85,281.61 $47,963.39 2026-02-02
6022 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 12 5 — — $40,615.04 $124,572.34 $70,060.95 2026-02-02
6023 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 12 5 — — $47,801.47 $146,614.18 $82,457.54 2026-02-02
6024 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 12 5 — — $64,757.95 $198,622.22 $111,707.46 2026-02-02
6032 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 12 5 — — $29,542.69 $90,611.80 $50,961.14 2026-02-02
6033 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 12 5 — — $38,450.25 $117,932.60 $66,326.68 2026-02-02
6034 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 12 5 — — $59,654.09 $182,967.92 $102,903.31 2026-02-02
6071 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 12 5 — — $25,871.32 $79,351.16 $44,628.03 2026-02-02
6072 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 12 5 — — $32,026.10 $98,228.78 $55,245.02 2026-02-02
6073 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 12 5 — — $39,180.84 $120,173.43 $67,586.95 2026-02-02
6074 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 12 5 — — $52,869.79 $162,159.46 $91,200.39 2026-02-02
6083 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 12 5 — — $29,221.93 $89,627.99 $50,407.83 2026-02-02
6084 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 12 5 — — $30,758.48 $94,340.82 $53,058.38 2026-02-02
6093 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 12 5 — — $31,189.73 $95,663.52 $53,802.29 2026-02-02
6094 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 12 5 — — $68,366.37 $209,689.77 $117,931.98 2026-02-02
6113 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 12 5 — — $26,833.16 $82,301.28 $46,287.20 2026-02-02
6114 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 12 5 — — $35,175.01 $107,886.95 $60,676.89 2026-02-02
6123 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 12 5 — — $27,163.77 $83,315.31 $46,857.50 2026-02-02
6124 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 12 5 — — $36,288.02 $111,300.74 $62,596.84 2026-02-02
6214 APR_DRG Neonate Bwt 2000-2499g W Major Anomaly 12 5 — — $29,087.03 $89,214.23 $50,175.13 2026-02-02
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 13 9 — — $34,420.72 $52,904.12 $46,003.58 2026-02-02
63 APR_DRG Pancreas Transplant 12 5 — — $31,322.92 $96,072.02 $54,032.04 2026-02-02
6304 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 12 5 — — $52,372.59 $160,634.48 $90,342.72 2026-02-02
6314 APR_DRG Neonate Birthwt >2499g W Other Major Procedure 12 5 — — $45,023.43 $138,093.51 $77,665.42 2026-02-02
64 APR_DRG Pancreas Transplant 12 5 — — $32,713.44 $100,336.95 $56,430.68 2026-02-02
64568 CPT Opn Impltj Crnl Nrv Nea&pg 12 7 — — $3,978.00 $252,369.73 $56,357.07 2026-02-02
64654 CPT 1st Opn Implt Bat Modulj Sys 11 7 — — $54,982.51 $252,369.73 $56,631.99 2026-02-02
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 13 9 — — $43,422.13 $66,719.46 $58,016.92 2026-02-02
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 13 9 — — $34,226.77 $52,606.41 $45,744.70 2026-02-02
653 MS_DRG Major Bladder Procedures With Mcc 13 9 — — $47,993.95 $73,736.29 $64,118.51 2026-02-02
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 13 9 — — $38,805.98 $59,634.60 $51,856.17 2026-02-02
6804 APR_DRG Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 12 5 — — $38,312.35 $117,509.65 $66,088.80 2026-02-02
6814 APR_DRG Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 12 5 — — $38,418.98 $117,836.71 $66,272.74 2026-02-02
6903 APR_DRG Acute Leukemia 12 5 — — $25,964.25 $79,636.19 $44,788.33 2026-02-02
6904 APR_DRG Acute Leukemia 12 5 — — $37,484.98 $114,971.97 $64,661.60 2026-02-02
6914 APR_DRG Lymphoma, Myeloma & Non-acute Leukemia 12 5 — — $27,120.09 $83,181.33 $46,782.15 2026-02-02
6954 APR_DRG Chemotherapy For Acute Leukemia # 12 5 — — $31,633.82 $97,025.62 $54,568.34 2026-02-02
7 MS_DRG Lung Transplant 13 9 — — $119,608.05 $183,649.53 $159,695.24 2026-02-02
7104 APR_DRG Infectious & Parasitic Diseases Including HIV W O.r. Procedure 12 5 — — $27,066.99 $83,018.45 $46,690.56 2026-02-02
7114 APR_DRG Post-op, Post-trauma, Other Device Infections W O.r. Procedure 12 5 — — $25,848.62 $79,281.55 $44,588.87 2026-02-02
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 11 7 — — $69,717.26 $84,326.73 $73,327.59 2026-02-02
791 MS_DRG Prematurity With Major Problems 11 7 — — $47,612.07 $57,613.17 $50,098.41 2026-02-02
7914 APR_DRG O.r. Procedure For Other Complications Of Treatment 12 5 — — $28,310.19 $86,831.54 $48,835.08 2026-02-02
793 MS_DRG Full Term Neonate With Major Problems 11 7 — — $48,909.41 $59,180.98 $51,461.72 2026-02-02
799 MS_DRG Splenic Procedures With Mcc 13 9 — — $41,828.92 $64,274.18 $55,890.59 2026-02-02
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 13 9 — — $51,764.09 $79,522.66 $69,150.14 2026-02-02
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 13 9 — — $36,797.15 $56,551.42 $49,175.15 2026-02-02
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 13 9 — — $54,167.29 $83,211.14 $72,357.51 2026-02-02
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 13 9 — — $42,345.21 $65,066.60 $56,579.65 2026-02-02
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 13 9 — — $43,204.16 $66,384.90 $57,726.00 2026-02-02
834 MS_DRG Acute Leukemia With Mcc 13 9 — — $50,704.72 $77,896.75 $67,736.30 2026-02-02
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 13 9 — — $44,372.51 $68,178.11 $59,285.31 2026-02-02
8412 APR_DRG Extensive 3rd Degree Burns W Skin Graft 12 5 — — $30,328.10 $93,020.76 $52,315.97 2026-02-02
8413 APR_DRG Extensive 3rd Degree Burns W Skin Graft 12 5 — — $62,707.93 $192,334.49 $108,171.18 2026-02-02
8414 APR_DRG Extensive 3rd Degree Burns W Skin Graft 12 5 — — $80,246.82 $246,128.88 $138,425.77 2026-02-02
8424 APR_DRG Burns With Skin Graft Except Extensive 3rd Degree Burns 12 5 — — $36,990.78 $113,456.19 $63,809.10 2026-02-02
850 MS_DRG Acute Leukemia With Other Procedures 12 8 — — $79,979.14 $122,827.13 $106,806.20 2026-02-02
8504 APR_DRG Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service 12 5 — — $32,661.19 $100,176.70 $56,340.55 2026-02-02
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 13 9 — — $45,612.91 $70,081.86 $60,940.75 2026-02-02
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 13 9 — — $42,011.79 $64,554.86 $56,134.66 2026-02-02
870 MS_DRG Septicemia Or Severe Sepsis With Mv &gt;96 Hours 13 9 — — $63,837.38 $98,052.77 $85,263.28 2026-02-02
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 13 9 — — $35,696.22 $54,861.70 $47,705.83 2026-02-02
894 APR_DRG Major Cranial/facial Bone Procedures 12 5 — — $29,200.52 $89,562.31 $50,370.90 2026-02-02
901 MS_DRG Wound Debridements For Injuries With Mcc 13 9 — — $38,759.80 $59,563.72 $51,794.54 2026-02-02
904 APR_DRG Major Larynx & Trachea Procedures 12 5 — — $48,093.96 $147,511.30 $82,962.08 2026-02-02
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 13 9 — — $33,924.75 $52,142.87 $45,341.63 2026-02-02
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 13 9 — — $35,459.77 $54,498.85 $47,390.30 2026-02-02
9104 APR_DRG Craniotomy For Multiple Significant Trauma 12 5 — — $30,758.91 $94,342.14 $53,059.12 2026-02-02
9114 APR_DRG Extensive Abdominal/thoracic Procedures For Mult Significant Trauma 12 5 — — $27,794.58 $85,250.09 $47,945.65 2026-02-02
9124 APR_DRG Musculoskeletal & Other Procedures For Multiple Significant Trauma 12 5 — — $32,446.64 $99,518.64 $55,970.46 2026-02-02
924 APR_DRG Facial Bone Procedures Except Major Cranial/facial Bone Procedures 12 5 — — $31,490.79 $96,586.91 $54,321.61 2026-02-02
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 13 9 — — $197,193.22 $302,727.16 $263,241.01 2026-02-02
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 13 9 — — $66,247.06 $101,751.13 $88,479.24 2026-02-02
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours Without Skin Graft 13 9 — — $34,288.89 $55,277.07 $48,067.02 2026-02-02
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 13 9 — — $33,512.83 $51,510.66 $44,791.88 2026-02-02
9504 APR_DRG Extensive Procedure Unrelated To Principal Diagnosis 12 5 — — $34,749.33 $106,581.33 $59,942.60 2026-02-02
9514 APR_DRG Moderately Extensive Procedure Unrelated To Principal Diagnosis 12 5 — — $26,872.99 $82,423.44 $46,355.91 2026-02-02
955 MS_DRG Craniotomy For Multiple Significant Trauma 13 9 — — $62,168.44 $95,491.27 $83,035.89 2026-02-02
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 13 9 — — $34,755.07 $53,417.27 $46,449.80 2026-02-02
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 13 9 — — $70,377.40 $108,090.36 $93,991.62 2026-02-02
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 13 9 — — $38,919.58 $59,808.95 $52,007.78 2026-02-02
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 13 9 — — $56,536.33 $86,847.11 $75,519.23 2026-02-02
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 13 9 — — $33,358.58 $51,273.93 $44,586.03 2026-02-02
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 13 9 — — $43,333.46 $66,583.38 $57,898.59 2026-02-02
A9543 HCPCS Zevalin Yttrium-90 Upto 40mCi 45 11 $141,639.50 $141,639.50 $56,824.55 $260,824.68 $113,311.60 2026-02-02
J0225 HCPCS Vutrisiran Sodium 25mg/0.5ml Syringe 44 11 $229,158.92 $229,158.92 $5,003.64 $194,785.08 $183,327.14 2026-02-02
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 9 7 — — $3,685,266.67 $4,238,056.67 $3,758,972.00 2026-02-02
J1413 HCPCS Inj Delandistrogene Mox Rokl 9 7 — — $3,316,462.59 $3,813,931.98 $3,382,791.84 2026-02-02
J2350 HCPCS Ocrelizumab 300 Mg/10 Ml 44 11 $56,972.05 $56,972.05 $59.41 $48,426.24 $45,577.64 2026-02-02
J2507 HCPCS Pegloticase 8 Mg/ml 1 Ml Vial 44 11 $56,370.37 $56,370.37 $3,660.83 $47,914.81 $45,096.29 2026-02-02
J3387 HCPCS Inj Elivaldogene Autotemecel 10 7 — — $3,090,000.00 $4,680,423.00 $3,167,250.00 2026-02-02
J3389 HCPCS Topi Adm Prad Zami Per Treat 9 7 — — $3,335,820.00 $3,836,193.00 $3,402,536.40 2026-02-02
J3391 HCPCS Inj, Atidarsagene Autotemcel 8 7 — — $4,505,000.00 $4,730,250.00 $4,550,050.00 2026-02-02
J3392 HCPCS Inj, Exagamglogene Autotem 10 7 — — $2,332,000.00 $3,532,280.40 $2,390,300.00 2026-02-02
J3393 HCPCS Inj, Betibeglogene Autotemce 10 7 — — $2,945,740.00 $4,461,912.38 $3,019,383.50 2026-02-02
J3394 HCPCS Inj, Lovotibeglogene Autotem 10 7 — — $3,248,445.72 $4,920,420.72 $3,329,656.86 2026-02-02
J3399 HCPCS Inj Onase Abepar-xioi Treat 10 7 — — $2,455,110.61 $3,718,756.03 $2,516,488.37 2026-02-02
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 11 7 — — $205,640.00 $943,887.60 $211,809.20 2026-02-02
J3403 HCPCS Revakinagene, Per Implant 11 7 — — $257,500.00 $1,181,925.00 $265,225.00 2026-02-02
J7330 HCPCS Carticel Cultured Chondrocytes 35 11 $76,550.50 $76,550.50 $49,757.83 $65,067.93 $61,240.40 2026-02-02
J9029 HCPCS Instill Adstiladrin, Tx Dose 11 7 — — $63,342.28 $290,741.07 $65,242.55 2026-02-02
J9226 HCPCS Supprelin La Implant 11 7 — — $45,020.65 $206,644.78 $46,371.27 2026-02-02
J9228 HCPCS Ipilimumab 200mg/40ml 51 11 $69,550.27 $69,550.28 $183.48 $59,117.73 $55,640.22 2026-02-02
J9347 HCPCS Tremelimumab-actl 300mg/15ml Vial 44 11 $79,473.25 $79,473.25 $140.90 $67,552.26 $63,578.60 2026-02-02
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 11 7 — — $95,081.03 $436,421.93 $97,933.46 2026-02-02
L7180 HCPCS Electronic Elbow Sequential 11 7 — — $44,008.89 $202,000.81 $45,329.16 2026-02-02
L7181 HCPCS Electronic Elbo Simultaneous 11 7 — — $48,155.50 $221,033.75 $49,600.17 2026-02-02
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 11 7 — — $68,801.71 $315,799.85 $70,865.76 2026-02-02
Q0480 HCPCS Driver Pneumatic Vad, Rep 11 7 — — $108,243.35 $496,836.98 $111,490.65 2026-02-02
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 11 7 — — $533,230.17 $2,447,526.48 $549,227.08 2026-02-02
Q2042 HCPCS Tisagenlecleucel Car-pos T 11 7 — — $591,726.20 $2,716,023.26 $609,477.99 2026-02-02
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 11 7 — — $55,272.32 $253,699.97 $56,930.49 2026-02-02
Q2053 HCPCS Brexucabtagene Car Pos T 11 7 — — $489,304.61 $2,245,908.15 $503,983.75 2026-02-02
Q2054 HCPCS Lisocabtagene Mara Car Pos T 11 7 — — $562,538.19 $2,582,050.27 $579,414.33 2026-02-02
Q2055 HCPCS Idecabtagene Vicleucel Car 11 7 — — $557,317.93 $2,558,089.32 $574,037.47 2026-02-02
Q2056 HCPCS Ciltacabtagene Car-pos T 11 7 — — $565,868.95 $2,597,338.46 $582,845.01 2026-02-02
Q2057 HCPCS Afamitresgene Autoleucel 11 7 — — $770,620.00 $3,537,145.80 $793,738.60 2026-02-02
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 11 7 — — $278,250.00 $1,277,167.50 $286,597.50 2026-02-02
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