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

HIGHLAND HOSPITAL

Rochester, NY · CCN 330164 · Rates published

Your selected procedure

You selected 93306 (CPT)

Tte W or WO Fol Wcon,Doppler

This hospital’s price: $438 across 46 payers · range $153-$2,918

Source: https://www.urmc.rochester.edu/getmedia/5479e418-958b-4a8a-b3ab-610f5962d661/160743037-HIGHLAND-HOSPITAL-OF-ROCHESTER-standardcharges.csv · observed 2026-04-01

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.

22,133 distinct procedures filed
59 distinct payers
834,716 rate rows
2026-04-01 last MRF observed
Data quality

740,844 of 834,716 rate rows are consumer-grade (88.8%)

93,872 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 92,520
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 770
placeholder amount (≤ $0.02) — excluded from medians 434
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 148
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.urmc.rochester.edu/getmedia/5479e418-958b-4a8a-b3ab-610f5962d661/160743037-HIGHLAND-HOSPITAL-OF-ROCHESTER-standardcharges.csv
Found on page https://www.urmc.rochester.edu/pay-a-bill/cost-estimates-pricing
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-09-21
Content fingerprint 020592dabe89a1a7… · 445,250,856 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
0845
RC 		Inj, Atidarsagene Autotemcel 13 $4,505,000.00 $4,505,000.00 $4,505,000.00 nat. median
$965
outlier · 4668.4×
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 13 $4,505,000.00 $4,505,000.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dose 13 $3,685,266.67 $3,685,266.67 $3,685,266.67 nat. median
$3,758,972
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 13 $3,685,266.67 $3,685,266.67 $3,685,266.67 nat. median
$3,703,693
1.0× median
J3389
HCPCS 		Topi Adm Prad Zami Per Treat 13 $3,335,820.00 $3,335,820.00 $3,335,820.00 nat. median
$3,335,820
1.0× median
0908
OTHER 		Topi Adm Prad Zami Per Treat 13 $3,335,820.00 $3,335,820.00 $3,335,820.00 nat. median
$3,335,820
1.0× median
0714
OTHER 		Inj Delandistrogene Mox Rokl 13 $3,316,462.59 $3,316,462.59 $3,316,462.59 nat. median
$3,316,463
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 13 $3,316,462.59 $3,316,462.59 $3,316,462.59 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 13 $3,248,445.72 $3,248,445.72 $3,248,445.72 nat. median
$3,286,000
1.0× median
0748
OTHER 		Inj, Lovotibeglogene Autotem 13 $3,248,445.72 $3,248,445.72 $3,248,445.72 nat. median
$3,248,446
1.0× median
0906
RC 		Inj Elivaldogene Autotemecel 13 $3,090,000.00 $3,090,000.00 $3,090,000.00 nat. median
$242
outlier · 12768.6×
J3387
HCPCS 		Inj Elivaldogene Autotemecel 13 $3,090,000.00 $3,090,000.00 $3,090,000.00 nat. median
$3,180,000
1.0× median
0746
OTHER 		Inj, Betibeglogene Autotemce 13 $2,945,740.00 $2,945,740.00 $2,945,740.00 nat. median
$2,945,740
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 13 $2,945,740.00 $2,945,740.00 $2,945,740.00 nat. median
$2,994,107
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Treat 13 $2,455,110.61 $2,455,110.61 $2,455,110.61 nat. median
$2,588,981
0.9× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 13 $2,455,110.60 $2,455,110.60 $2,455,110.60 nat. median
$2,466,282
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 13 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,401,960
1.0× median
0824
RC 		Inj, Exagamglogene Autotem 13 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$1,200
outlier · 1943.3×
Q2057
HCPCS 		Afamitresgene Autoleucel 13 $770,620.00 $770,620.00 $770,620.00 nat. median
$809,217
1.0× median
2067
OTHER 		Afamitresgene Autoleucel 13 $770,620.00 $770,620.00 $770,620.00 nat. median
$789,886
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos T 13 $591,726.20 $591,726.20 $591,726.20 nat. median
$577,003
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 13 $591,726.20 $591,726.20 $591,726.20 nat. median
$738,272
0.8× median
9498
OTHER 		Ciltacabtagene Car-pos T 13 $565,868.95 $565,868.95 $565,868.95 nat. median
$587,650
1.0× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 13 $565,868.94 $565,868.94 $565,868.94 nat. median
$646,415
0.9× median
9413
OTHER 		Lisocabtagene Car Pos T 13 $562,538.19 $562,538.19 $562,538.19 nat. median
$562,201
1.0× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 13 $562,538.18 $562,538.18 $562,538.18 nat. median
$640,950
0.9× median
9422
OTHER 		Idecabtagene Vicleucel Car 13 $557,317.93 $557,317.93 $557,317.93 nat. median
$562,826
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 13 $557,317.93 $557,317.93 $557,317.93 nat. median
$622,245
0.9× median
9035
OTHER 		Axicabtagene Ciloleucel Car+ 13 $533,230.17 $533,230.17 $533,230.17 nat. median
$533,230
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 13 $533,230.17 $533,230.17 $533,230.17 nat. median
$608,101
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 13 $489,304.61 $489,304.61 $489,304.61 nat. median
$591,650
0.8× median
9391
OTHER 		Brexucabtagene Car Pos T 13 $489,304.61 $489,304.61 $489,304.61 nat. median
$492,768
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 12 $328,919.71 $461,639.03 $389,715.52 nat. median
$359,358
1.1× median
SUP-284765
CDM 		Console Ultrasonic Aspirator W/accessory Nexus 11 $353,528.55 $353,528.55 $353,528.55 nat. median
$353,529
1.0× median
24
APR_DRG 		Heart &/or Lung Transplant 16 $247,055.49 $679,158.53 $345,877.68 nat. median
$241,915
1.4× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 12 $242,044.14 $339,545.46 $286,782.32 nat. median
$249,124
1.2× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 12 $235,447.41 $330,274.51 $278,966.28 nat. median
$198,433
1.4× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 13 $278,250.00 $278,250.00 $278,250.00 nat. median
$319,951
0.9× median
0831
RC 		Obecbtge Autol Up To 400 Mil 13 $278,250.00 $278,250.00 $278,250.00 nat. median
$1,028
outlier · 270.7×
0897
OTHER 		Revakinagene, Per Implant 13 $257,500.00 $257,500.00 $257,500.00 nat. median
$260,075
1.0× median
J3403
HCPCS 		Revakinagene, Per Implant 13 $257,500.00 $257,500.00 $257,500.00 nat. median
$265,000
1.0× median
5834
APR_DRG 		Neonate W Ecmo 16 $182,050.96 $500,492.32 $254,871.35 nat. median
$307,273
0.8× median
5884
APR_DRG 		Neonate Bwt <1500g W Major Procedure 16 $178,863.47 $491,731.42 $250,408.85 nat. median
$247,214
1.0× median
5883
APR_DRG 		Neonate Bwt <1500g W Major Procedure 16 $178,863.47 $491,731.42 $250,408.85 nat. median
$175,429
1.4× median
1907
OTHER 		New Technology - Level 52 ($145,001-$160,000) 13 $162,105.50 $583,766.13 $245,953.17 nat. median
$155,877
1.6× median
1908
OTHER 		New Technology - Level 52 ($145,001-$160,000) 13 $162,105.50 $583,766.13 $245,953.17 nat. median
$155,833
1.6× median
1614
APR_DRG 		Cardiac Defibrillator & Heart Assist Implant 16 $163,660.89 $449,946.84 $229,125.24 nat. median
$202,993
1.1× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 12 $190,526.49 $267,143.36 $225,742.42 nat. median
$190,557
1.2× median
34
APR_DRG 		Bone Marrow Transplant 16 $158,927.30 $436,936.46 $222,498.21 nat. median
$241,408
0.9× median
1905
OTHER 		New Technology - Level 51 ($130,001-$145,000) 13 $146,160.75 $526,346.70 $221,761.14 nat. median
$140,530
1.6× median

Other procedures at this hospital

Browse this hospital's 22,133 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
             
0845 RC Inj, Atidarsagene Autotemcel 16 13 — — $4,505,000.00 $4,505,000.00 $4,505,000.00 2026-04-01
J3391 HCPCS Inj, Atidarsagene Autotemcel 16 13 — — $4,505,000.00 $4,505,000.00 $4,505,000.00 2026-04-01
9138 OTHER Inj, Hemgenix, Per Tx Dose 16 13 — — $3,685,266.67 $3,685,266.67 $3,685,266.67 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 16 13 — — $3,685,266.67 $3,685,266.67 $3,685,266.67 2026-04-01
J3389 HCPCS Topi Adm Prad Zami Per Treat 16 13 — — $3,335,820.00 $3,335,820.00 $3,335,820.00 2026-04-01
0908 OTHER Topi Adm Prad Zami Per Treat 16 13 — — $3,335,820.00 $3,335,820.00 $3,335,820.00 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 16 13 — — $3,316,462.59 $3,316,462.59 $3,316,462.59 2026-04-01
0714 OTHER Inj Delandistrogene Mox Rokl 16 13 — — $3,316,462.59 $3,316,462.59 $3,316,462.59 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 16 13 — — $3,248,445.72 $3,248,445.72 $3,248,445.72 2026-04-01
0748 OTHER Inj, Lovotibeglogene Autotem 16 13 — — $3,248,445.72 $3,248,445.72 $3,248,445.72 2026-04-01
J3387 HCPCS Inj Elivaldogene Autotemecel 16 13 — — $3,090,000.00 $3,090,000.00 $3,090,000.00 2026-04-01
0906 RC Inj Elivaldogene Autotemecel 16 13 — — $3,090,000.00 $3,090,000.00 $3,090,000.00 2026-04-01
0746 OTHER Inj, Betibeglogene Autotemce 16 13 — — $2,945,740.00 $2,945,740.00 $2,945,740.00 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 16 13 — — $2,945,740.00 $2,945,740.00 $2,945,740.00 2026-04-01
9141 OTHER Inj Onase Abepar-xioi Treat 16 13 — — $2,455,110.61 $2,455,110.61 $2,455,110.61 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 16 13 — — $2,455,110.60 $2,455,110.60 $2,455,110.60 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 16 13 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2026-04-01
0824 RC Inj, Exagamglogene Autotem 16 13 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 16 13 — — $770,620.00 $770,620.00 $770,620.00 2026-04-01
2067 OTHER Afamitresgene Autoleucel 16 13 — — $770,620.00 $770,620.00 $770,620.00 2026-04-01
9194 OTHER Tisagenlecleucel Car-pos T 16 13 — — $591,726.20 $591,726.20 $591,726.20 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 16 13 — — $591,726.20 $591,726.20 $591,726.20 2026-04-01
9498 OTHER Ciltacabtagene Car-pos T 16 13 — — $565,868.95 $565,868.95 $565,868.95 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 16 13 — — $565,868.94 $565,868.94 $565,868.94 2026-04-01
9413 OTHER Lisocabtagene Car Pos T 16 13 — — $562,538.19 $562,538.19 $562,538.19 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 16 13 — — $562,538.18 $562,538.18 $562,538.18 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 16 13 — — $557,317.93 $557,317.93 $557,317.93 2026-04-01
9422 OTHER Idecabtagene Vicleucel Car 16 13 — — $557,317.93 $557,317.93 $557,317.93 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 16 13 — — $533,230.17 $533,230.17 $533,230.17 2026-04-01
9035 OTHER Axicabtagene Ciloleucel Car+ 16 13 — — $533,230.17 $533,230.17 $533,230.17 2026-04-01
9391 OTHER Brexucabtagene Car Pos T 16 13 — — $489,304.61 $489,304.61 $489,304.61 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 16 13 — — $489,304.61 $489,304.61 $489,304.61 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 12 12 — — $328,919.71 $461,639.03 $389,715.52 2026-04-01
SUP-284765 CDM Console Ultrasonic Aspirator W/accessory Nexus 16 11 — — $353,528.55 $353,528.55 $353,528.55 2026-04-01
24 APR_DRG Heart &/or Lung Transplant 21 16 — — $247,055.49 $679,158.53 $345,877.68 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 12 12 — — $242,044.14 $339,545.46 $286,782.32 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 12 12 — — $235,447.41 $330,274.51 $278,966.28 2026-04-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 16 13 — — $278,250.00 $278,250.00 $278,250.00 2026-04-01
0831 RC Obecbtge Autol Up To 400 Mil 16 13 — — $278,250.00 $278,250.00 $278,250.00 2026-04-01
0897 OTHER Revakinagene, Per Implant 16 13 — — $257,500.00 $257,500.00 $257,500.00 2026-04-01
J3403 HCPCS Revakinagene, Per Implant 16 13 — — $257,500.00 $257,500.00 $257,500.00 2026-04-01
5834 APR_DRG Neonate W Ecmo 21 16 — — $182,050.96 $500,492.32 $254,871.35 2026-04-01
5883 APR_DRG Neonate Bwt <1500g W Major Procedure 21 16 — — $178,863.47 $491,731.42 $250,408.85 2026-04-01
5884 APR_DRG Neonate Bwt <1500g W Major Procedure 21 16 — — $178,863.47 $491,731.42 $250,408.85 2026-04-01
1908 OTHER New Technology - Level 52 ($145,001-$160,000) 16 13 — — $162,105.50 $583,766.13 $245,953.17 2026-04-01
1907 OTHER New Technology - Level 52 ($145,001-$160,000) 16 13 — — $162,105.50 $583,766.13 $245,953.17 2026-04-01
1614 APR_DRG Cardiac Defibrillator & Heart Assist Implant 21 16 — — $163,660.89 $449,946.84 $229,125.24 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 12 12 — — $190,526.49 $267,143.36 $225,742.42 2026-04-01
34 APR_DRG Bone Marrow Transplant 21 16 — — $158,927.30 $436,936.46 $222,498.21 2026-04-01
1905 OTHER New Technology - Level 51 ($130,001-$145,000) 16 13 — — $146,160.75 $526,346.70 $221,761.14 2026-04-01
1906 OTHER New Technology - Level 51 ($130,001-$145,000) 16 13 — — $146,160.75 $526,346.70 $221,761.14 2026-04-01
0886 OTHER Inj. Remestemcel-l-rknd/ Td 16 13 — — $205,640.00 $205,640.00 $205,640.00 2026-04-01
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 16 13 — — $205,640.00 $205,640.00 $205,640.00 2026-04-01
1903 OTHER New Technology - Level 50 ($115,001-$130,000) 16 13 — — $130,216.00 $468,927.27 $197,569.10 2026-04-01
1904 OTHER New Technology - Level 50 ($115,001-$130,000) 16 13 — — $130,216.00 $468,927.27 $197,569.10 2026-04-01
5914 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 21 16 — — $137,495.16 $378,029.80 $192,493.21 2026-04-01
5881 APR_DRG Neonate Bwt <1500g W Major Procedure 21 16 — — $137,000.97 $376,671.52 $191,801.35 2026-04-01
5882 APR_DRG Neonate Bwt <1500g W Major Procedure 21 16 — — $137,000.97 $376,671.52 $191,801.35 2026-04-01
8414 APR_DRG Extensive 3rd Degree Burns W Skin Graft 21 16 — — $133,004.42 $365,686.91 $186,206.18 2026-04-01
44 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 21 16 — — $128,300.47 $352,758.03 $179,620.66 2026-04-01
14 APR_DRG Liver Transplant &/or Intestinal Transplant 21 16 — — $124,299.68 $341,761.78 $174,019.55 2026-04-01
1901 OTHER New Technology - Level 49 ($100,001-$115,000) 16 13 — — $114,271.25 $411,507.84 $173,377.07 2026-04-01
1902 OTHER New Technology - Level 49 ($100,001-$115,000) 16 13 — — $114,271.25 $411,507.84 $173,377.07 2026-04-01
5934 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 21 16 — — $123,809.03 $340,413.20 $173,332.63 2026-04-01
6094 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 21 16 — — $113,419.12 $311,856.34 $158,786.76 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 12 12 — — $131,501.82 $184,191.00 $155,807.93 2026-04-01
1599 OTHER New Technology - Level 48 ($90,001-$100,000) 16 13 — — $100,983.95 $363,658.31 $153,217.03 2026-04-01
1585 OTHER New Technology - Level 48 ($90,001-$100,000) 16 13 — — $100,983.95 $363,658.31 $153,217.03 2026-04-01
6024 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 21 16 — — $107,470.53 $295,506.53 $150,458.74 2026-04-01
23 APR_DRG Heart &/or Lung Transplant 21 16 — — $107,097.77 $294,482.00 $149,936.88 2026-04-01
8413 APR_DRG Extensive 3rd Degree Burns W Skin Graft 21 16 — — $104,091.01 $286,217.83 $145,727.40 2026-04-01
5833 APR_DRG Neonate W Ecmo 21 16 — — $103,734.49 $285,237.93 $145,228.28 2026-04-01
5832 APR_DRG Neonate W Ecmo 21 16 — — $101,807.87 $279,942.58 $142,531.01 2026-04-01
5831 APR_DRG Neonate W Ecmo 21 16 — — $101,807.87 $279,942.58 $142,531.01 2026-04-01
6034 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 21 16 — — $99,056.66 $272,380.84 $138,679.32 2026-04-01
54 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 21 16 — — $98,066.17 $269,658.46 $137,292.64 2026-04-01
1584 OTHER New Technology - Level 47 ($80,001-$90,000) 16 13 — — $90,354.12 $325,378.69 $137,089.01 2026-04-01
1598 OTHER New Technology - Level 47 ($80,001-$90,000) 16 13 — — $90,354.12 $325,378.69 $137,089.01 2026-04-01
5933 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 21 16 — — $96,855.42 $266,330.67 $135,597.58 2026-04-01
L7181 HCPCS Hb Electronic Elbo Simultaneous 24 19 — — $37,769.02 $137,632.00 $131,078.00 2026-04-01
7 MS_DRG Lung Transplant 12 12 — — $109,804.55 $153,697.99 $130,100.25 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 12 12 — — $109,605.72 $153,418.57 $129,864.68 2026-04-01
22 APR_DRG Heart &/or Lung Transplant 21 16 — — $91,403.84 $251,346.90 $127,965.37 2026-04-01
6074 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 21 16 — — $87,872.53 $241,641.02 $123,021.53 2026-04-01
6304 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 21 16 — — $87,052.88 $239,388.22 $121,874.03 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 12 12 — — $102,622.94 $143,605.08 $121,591.23 2026-04-01
5891 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 21 16 — — $86,413.27 $237,630.22 $120,978.57 2026-04-01
5892 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 21 16 — — $86,413.27 $237,630.22 $120,978.57 2026-04-01
1583 OTHER New Technology - Level 46 ($70,001-$80,000) 16 13 — — $79,724.29 $287,099.07 $120,960.99 2026-04-01
1597 OTHER New Technology - Level 46 ($70,001-$80,000) 16 13 — — $79,724.29 $287,099.07 $120,960.99 2026-04-01
21 APR_DRG Heart &/or Lung Transplant 21 16 — — $86,139.35 $236,877.34 $120,595.08 2026-04-01
33 APR_DRG Bone Marrow Transplant 21 16 — — $84,183.78 $231,502.43 $117,857.29 2026-04-01
5913 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 21 16 — — $84,125.18 $231,341.38 $117,775.26 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 12 12 — — $96,469.32 $134,956.87 $114,300.21 2026-04-01
904 APR_DRG Major Larynx & Trachea Procedures 21 16 — — $79,999.44 $220,001.68 $111,999.21 2026-04-01
6023 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 21 16 — — $79,517.25 $218,676.39 $111,324.15 2026-04-01
5932 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 21 16 — — $79,376.06 $218,288.31 $111,126.48 2026-04-01
5912 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 21 16 — — $78,527.47 $215,955.95 $109,938.45 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 12 12 — — $92,718.48 $129,685.50 $109,856.08 2026-04-01
3034 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 21 16 — — $77,628.05 $213,483.88 $108,679.27 2026-04-01
215 MS_DRG Other Heart Assist System Implant 12 12 — — $91,513.07 $127,991.44 $108,427.88 2026-04-01
5931 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 21 16 — — $76,980.67 $211,704.53 $107,772.93 2026-04-01
6314 APR_DRG Neonate Birthwt >2499g W Other Major Procedure 21 16 — — $74,937.56 $206,089.01 $104,912.58 2026-04-01
1582 OTHER New Technology - Level 45 ($60,001-$70,000) 16 13 — — $69,094.45 $248,819.45 $104,832.96 2026-04-01
1596 OTHER New Technology - Level 45 ($60,001-$70,000) 16 13 — — $69,094.45 $248,819.45 $104,832.96 2026-04-01
5244 OTHER Level 4 Blood Product Exchange And Related Services 16 13 — — $68,311.05 $245,998.32 $103,644.36 2026-04-01
4404 APR_DRG Kidney Transplant 21 16 — — $74,024.73 $203,580.08 $103,634.62 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 12 — — $86,970.52 $121,607.41 $103,045.70 2026-04-01
43 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 21 16 — — $71,811.48 $197,496.92 $100,536.07 2026-04-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 21 16 — — $70,917.01 $195,038.44 $99,283.80 2026-04-01
1613 APR_DRG Cardiac Defibrillator & Heart Assist Implant 21 16 — — $70,180.67 $193,014.60 $98,252.93 2026-04-01
3614 APR_DRG Skin Graft For Skin & Subcutaneous Tissue Diagnoses 21 16 — — $68,492.67 $188,375.10 $95,889.73 2026-04-01
6022 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 21 16 — — $67,670.20 $186,114.54 $94,738.28 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 12 12 — — $79,446.55 $111,033.34 $94,131.04 2026-04-01
1624 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 21 16 — — $66,969.17 $184,187.72 $93,756.83 2026-04-01
53 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 21 16 — — $65,896.08 $181,238.31 $92,254.50 2026-04-01
3044 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 21 16 — — $65,539.56 $180,258.41 $91,755.37 2026-04-01
6073 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 21 16 — — $65,305.88 $179,616.14 $91,428.22 2026-04-01
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses 21 16 — — $64,269.50 $176,767.63 $89,977.29 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 12 12 — — $75,800.03 $105,908.57 $89,810.51 2026-04-01
6033 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 21 16 — — $64,101.47 $176,305.81 $89,742.06 2026-04-01
6814 APR_DRG Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 21 16 — — $64,049.94 $176,164.16 $89,669.91 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 12 — — $75,594.97 $105,620.38 $89,567.55 2026-04-01
6804 APR_DRG Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 21 16 — — $63,874.15 $175,681.01 $89,423.80 2026-04-01
5911 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 21 16 — — $63,472.45 $174,576.92 $88,861.42 2026-04-01
1595 OTHER New Technology - Level 44 ($50,001-$60,000) 16 13 — — $58,464.62 $210,539.83 $88,704.93 2026-04-01
1581 OTHER New Technology - Level 44 ($50,001-$60,000) 16 13 — — $58,464.62 $210,539.83 $88,704.93 2026-04-01
6904 APR_DRG Acute Leukemia 21 16 — — $62,510.20 $171,932.15 $87,514.27 2026-04-01
8424 APR_DRG Burns With Skin Graft Except Extensive 3rd Degree Burns 21 16 — — $61,695.49 $169,692.93 $86,373.69 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 12 12 — — $72,793.65 $101,683.46 $86,248.45 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 12 12 — — $71,708.61 $100,158.56 $84,962.86 2026-04-01
6124 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 21 16 — — $60,536.98 $166,508.73 $84,751.77 2026-04-01
4054 APR_DRG Other Procedures For Endocrine, Nutritional & Metabolic Disorders 21 16 — — $59,933.37 $164,849.69 $83,906.71 2026-04-01
13 APR_DRG Liver Transplant &/or Intestinal Transplant 21 16 — — $59,780.88 $164,430.57 $83,693.22 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 12 12 — — $69,979.85 $97,728.99 $82,914.56 2026-04-01
PX-81200005 CDM Hb Heart, Incoming 18 13 — — $13,239.13 $82,900.00 $82,900.00 2026-04-01
6114 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 21 16 — — $58,702.14 $161,465.63 $82,182.99 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 12 — — $69,191.70 $96,621.34 $81,980.74 2026-04-01
9504 APR_DRG Extensive Procedure Unrelated To Principal Diagnosis 21 16 — — $58,000.40 $159,536.88 $81,200.55 2026-04-01
234 APR_DRG Spinal Procedures 21 16 — — $57,773.07 $158,912.07 $80,882.29 2026-04-01
32 APR_DRG Bone Marrow Transplant 21 16 — — $55,503.34 $152,673.68 $77,704.68 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 12 12 — — $64,923.75 $90,623.22 $76,923.92 2026-04-01
64 APR_DRG Pancreas Transplant 21 16 — — $54,644.17 $150,312.22 $76,501.83 2026-04-01
4474 APR_DRG Other Kidney, Urinary Tract & Related Procedures 21 16 — — $54,585.57 $150,151.16 $76,419.79 2026-04-01
8504 APR_DRG Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service 21 16 — — $54,558.04 $150,075.49 $76,381.25 2026-04-01
9124 APR_DRG Musculoskeletal & Other Procedures For Multiple Significant Trauma 21 16 — — $54,204.34 $149,103.35 $75,886.07 2026-04-01
PX-81200007 CDM Hb Liver, Incoming 18 13 — — $12,025.41 $75,300.00 $75,300.00 2026-04-01
5124 APR_DRG Uterine & Adnexa Procedures For Non-ovarian & Non-adnexal Malig 21 16 — — $53,687.56 $147,682.97 $75,162.58 2026-04-01
6072 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 21 16 — — $53,511.07 $147,197.87 $74,915.49 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 12 12 — — $63,170.03 $88,158.57 $74,846.05 2026-04-01
2604 APR_DRG Major Pancreas, Liver & Shunt Procedures 21 16 — — $53,144.66 $146,190.81 $74,402.53 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 12 12 — — $62,537.91 $87,270.20 $74,097.09 2026-04-01
6954 APR_DRG Chemotherapy For Acute Leukemia # 21 16 — — $52,864.39 $145,420.47 $74,010.14 2026-04-01
924 APR_DRG Facial Bone Procedures Except Major Cranial/facial Bone Procedures 21 16 — — $52,628.59 $144,772.37 $73,680.03 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 12 12 — — $62,134.92 $86,703.84 $73,619.61 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 12 12 — — $62,030.60 $86,557.24 $73,496.02 2026-04-01
63 APR_DRG Pancreas Transplant 21 16 — — $52,351.85 $144,011.74 $73,292.58 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 12 12 — — $61,714.99 $86,113.68 $73,122.07 2026-04-01
6093 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 21 16 — — $52,132.29 $143,408.27 $72,985.20 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 12 12 — — $61,555.40 $85,889.39 $72,932.98 2026-04-01
1580 OTHER New Technology - Level 43 ($40,001-$50,000) 16 13 — — $47,834.78 $172,260.21 $72,576.91 2026-04-01
1594 OTHER New Technology - Level 43 ($40,001-$50,000) 16 13 — — $47,834.78 $172,260.21 $72,576.91 2026-04-01
214 APR_DRG Craniotomy Except For Trauma 21 16 — — $51,837.90 $142,599.13 $72,573.05 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 12 12 — — $61,232.65 $85,435.80 $72,550.57 2026-04-01
42 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 21 16 — — $51,465.14 $141,574.59 $72,051.19 2026-04-01
41 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 21 16 — — $51,465.14 $141,574.59 $72,051.19 2026-04-01
1694 APR_DRG Major Abdominal Vascular Procedures 21 16 — — $51,424.90 $141,463.99 $71,994.85 2026-04-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 21 16 — — $51,422.07 $141,456.23 $71,990.90 2026-04-01
6084 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 21 16 — — $51,421.37 $141,454.29 $71,989.91 2026-04-01
2204 APR_DRG Major Stomach, Esophageal & Duodenal Procedures 21 16 — — $50,752.80 $139,616.73 $71,053.92 2026-04-01
8412 APR_DRG Extensive 3rd Degree Burns W Skin Graft 21 16 — — $50,711.86 $139,504.19 $70,996.60 2026-04-01
1654 APR_DRG Coronary Bypass W Ami Or Complex Pdx 21 16 — — $50,674.44 $139,401.35 $70,944.21 2026-04-01
3214 APR_DRG Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp 21 16 — — $50,586.90 $139,160.74 $70,821.65 2026-04-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Pdx 21 16 — — $50,465.47 $138,826.99 $70,651.65 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 12 12 — — $59,572.54 $83,102.72 $70,583.62 2026-04-01
3033 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 21 16 — — $50,048.94 $137,682.15 $70,068.52 2026-04-01
4014 APR_DRG Pituitary & Adrenal Procedures 21 16 — — $50,046.82 $137,676.33 $70,065.55 2026-04-01
6032 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 21 16 — — $49,417.09 $135,945.49 $69,183.92 2026-04-01
3104 APR_DRG Intervertebral Disc Excision & Decompression 21 16 — — $49,019.62 $134,853.05 $68,627.47 2026-04-01
6083 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 21 16 — — $48,888.31 $134,492.13 $68,443.63 2026-04-01
894 APR_DRG Major Cranial/facial Bone Procedures 21 16 — — $48,853.01 $134,395.11 $68,394.21 2026-04-01
A9545 HCPCS Hb I131 Tositumomab, Rx 18 13 — — $11,347.48 $68,322.00 $68,322.00 2026-04-01
244 APR_DRG Extracranial Vascular Procedures 21 16 — — $48,676.52 $133,910.01 $68,147.12 2026-04-01
6214 APR_DRG Neonate Bwt 2000-2499g W Major Anomaly 21 16 — — $48,665.93 $133,880.91 $68,132.29 2026-04-01
4414 APR_DRG Major Bladder Procedures 21 16 — — $48,462.61 $133,322.07 $67,847.64 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 12 — — $57,192.05 $79,757.21 $67,763.13 2026-04-01
204 APR_DRG Craniotomy For Trauma 21 16 — — $47,945.12 $131,899.76 $67,123.17 2026-04-01
1674 APR_DRG Other Cardiothoracic & Thoracic Vascular Procedures 21 16 — — $47,530.01 $130,758.80 $66,542.00 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 12 12 — — $56,129.30 $78,263.63 $66,503.94 2026-04-01
31 APR_DRG Bone Marrow Transplant 21 16 — — $47,490.47 $130,650.14 $66,486.66 2026-04-01
1814 APR_DRG Lower Extremity Arterial Procedures # 21 16 — — $47,426.23 $130,473.57 $66,396.71 2026-04-01
7914 APR_DRG O.r. Procedure For Other Complications Of Treatment 21 16 — — $47,385.28 $130,361.02 $66,339.39 2026-04-01
2214 APR_DRG Major Small & Large Bowel Procedures 21 16 — — $47,368.34 $130,314.45 $66,315.67 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 12 12 — — $55,879.66 $77,912.79 $66,208.16 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc 12 12 — — $55,809.22 $77,813.81 $66,124.71 2026-04-01
4034 APR_DRG Procedures For Obesity 21 16 — — $47,145.25 $129,701.29 $66,003.34 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 12 12 — — $55,513.22 $77,397.81 $65,774.00 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 12 12 — — $55,513.22 $77,397.81 $65,774.00 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 12 12 — — $55,195.82 $76,951.74 $65,397.93 2026-04-01
6021 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 21 16 — — $46,552.22 $128,071.35 $65,173.11 2026-04-01
9114 APR_DRG Extensive Abdominal/thoracic Procedures For Mult Significant Trauma 21 16 — — $46,535.28 $128,024.78 $65,149.39 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 12 12 — — $54,972.04 $76,637.24 $65,132.78 2026-04-01
3134 APR_DRG Knee & Lower Leg Procedures Except Foot 21 16 — — $46,401.14 $127,656.11 $64,961.60 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 12 12 — — $54,739.34 $76,310.21 $64,857.07 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 12 — — $54,606.49 $76,123.51 $64,699.67 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 12 12 — — $54,351.50 $75,765.15 $64,397.55 2026-04-01
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs 21 16 — — $45,963.44 $126,453.06 $64,348.81 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 12 12 — — $54,167.84 $75,507.03 $64,179.94 2026-04-01
4424 APR_DRG Kidney & Urinary Tract Procedures For Malignancy 21 16 — — $45,727.64 $125,804.96 $64,018.69 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 12 12 — — $53,936.03 $75,181.25 $63,905.29 2026-04-01
6123 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 21 16 — — $45,495.37 $125,166.57 $63,693.52 2026-04-01
1774 APR_DRG Cardiac Pacemaker & Defibrillator Revision Except Device Replacement 21 16 — — $45,436.07 $125,003.58 $63,610.49 2026-04-01
6914 APR_DRG Lymphoma, Myeloma & Non-acute Leukemia 21 16 — — $45,423.36 $124,968.65 $63,592.70 2026-04-01
7104 APR_DRG Infectious & Parasitic Diseases Including HIV W O.r. Procedure 21 16 — — $45,335.82 $124,728.04 $63,470.14 2026-04-01
3174 APR_DRG Tendon, Muscle & Other Soft Tissue Procedures 21 16 — — $45,318.88 $124,681.47 $63,446.42 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 12 12 — — $53,476.87 $74,535.96 $63,361.26 2026-04-01
0717 OTHER Instill Adstiladrin, Tx Dose 16 13 — — $63,342.28 $63,342.28 $63,342.28 2026-04-01
J9029 HCPCS Instill Adstiladrin, Tx Dose 16 13 — — $63,342.28 $63,342.28 $63,342.28 2026-04-01
3054 APR_DRG Amputation Of Lower Limb Except Toes 21 16 — — $45,204.51 $124,367.13 $63,286.31 2026-04-01
264 APR_DRG Other Nervous System & Related Procedures 21 16 — — $45,021.66 $123,864.56 $63,030.32 2026-04-01
9514 APR_DRG Moderately Extensive Procedure Unrelated To Principal Diagnosis 21 16 — — $45,016.01 $123,849.04 $63,022.41 2026-04-01
1824 APR_DRG Other Peripheral Vascular Procedures # 21 16 — — $44,994.13 $123,788.89 $62,991.77 2026-04-01
6113 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 21 16 — — $44,950.35 $123,668.58 $62,930.49 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 12 12 — — $52,870.60 $73,683.92 $62,642.93 2026-04-01
1664 APR_DRG Coronary Bypass Without Ami Or Complex Pdx 21 16 — — $44,706.09 $122,997.20 $62,588.52 2026-04-01
5114 APR_DRG Uterine & Adnexa Procedures For Ovarian & Adnexal Malignancy 21 16 — — $44,672.20 $122,904.07 $62,541.07 2026-04-01
4444 APR_DRG Renal Dialysis Access Device Procedure Only 21 16 — — $44,386.28 $122,118.20 $62,140.78 2026-04-01
12 APR_DRG Liver Transplant &/or Intestinal Transplant 21 16 — — $44,226.73 $121,679.67 $61,917.41 2026-04-01
11 APR_DRG Liver Transplant &/or Intestinal Transplant 21 16 — — $44,226.73 $121,679.67 $61,917.41 2026-04-01
2644 APR_DRG Other Hepatobiliary, Pancreas & Abdominal Procedures 21 16 — — $44,165.31 $121,510.86 $61,831.42 2026-04-01
2614 APR_DRG Major Biliary Tract Procedures 21 16 — — $44,066.47 $121,239.20 $61,693.05 2026-04-01
1612 APR_DRG Cardiac Defibrillator & Heart Assist Implant 21 16 — — $43,974.69 $120,986.95 $61,564.56 2026-04-01
1204 APR_DRG Major Respiratory & Chest Procedures 21 16 — — $43,714.89 $120,272.88 $61,200.84 2026-04-01
1304 APR_DRG Respiratory System Diagnosis W Ventilator Support 96+ Hours 21 16 — — $43,587.81 $119,923.61 $61,022.93 2026-04-01
6903 APR_DRG Acute Leukemia 21 16 — — $43,517.92 $119,731.51 $60,925.09 2026-04-01
1214 APR_DRG Other Respiratory & Chest Procedures 21 16 — — $43,476.97 $119,618.97 $60,867.76 2026-04-01
3014 APR_DRG Hip Joint Replacement 21 16 — — $43,452.97 $119,552.99 $60,834.16 2026-04-01
2624 APR_DRG Cholecystectomy Except Laparoscopic 21 16 — — $43,452.27 $119,551.05 $60,833.17 2026-04-01
5194 APR_DRG Uterine & Adnexa Procedures For Leiomyoma 21 16 — — $43,418.38 $119,457.92 $60,785.73 2026-04-01
64654 CPT 1st Opn Implt Bat Modulj Sys 16 13 — — $52,642.48 $93,376.94 $60,742.57 2026-04-01
64568 CPT Opn Impltj Crnl Nrv Nea&pg 16 13 — — $52,642.48 $93,376.94 $60,742.57 2026-04-01
33276 CPT Insj Phrnc Nrv Stim Sys 16 13 — — $52,642.48 $93,376.94 $60,742.57 2026-04-01
6071 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 21 16 — — $43,364.72 $119,310.44 $60,710.61 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 12 — — $51,231.01 $71,379.65 $60,700.28 2026-04-01
7114 APR_DRG Post-op, Post-trauma, Other Device Infections W O.r. Procedure 21 16 — — $43,327.31 $119,207.60 $60,658.23 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 12 12 — — $51,109.75 $71,209.24 $60,556.61 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 12 12 — — $50,982.26 $71,030.06 $60,405.55 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 12 12 — — $50,936.79 $70,966.16 $60,351.68 2026-04-01
5184 APR_DRG Other Female Reproductive System & Related Procedures 21 16 — — $42,917.84 $118,082.17 $60,084.97 2026-04-01
494 APR_DRG Bacterial & Tuberculous Infections Of Nervous System 21 16 — — $42,844.42 $117,880.37 $59,982.18 2026-04-01
1714 APR_DRG Perm Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock 21 16 — — $42,818.30 $117,808.58 $59,945.61 2026-04-01
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 12 12 — — $50,359.94 $70,155.47 $59,668.21 2026-04-01
9524 APR_DRG Nonextensive Procedure Unrelated To Principal Diagnosis 21 16 — — $42,590.97 $117,183.77 $59,627.35 2026-04-01
6303 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 21 16 — — $42,547.90 $117,065.40 $59,567.06 2026-04-01
434 APR_DRG Multiple Sclerosis & Other Demyelinating Diseases 21 16 — — $42,492.84 $116,914.05 $59,489.97 2026-04-01
3814 APR_DRG Major Skin Disorders 21 16 — — $42,387.65 $116,624.93 $59,342.70 2026-04-01
52 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 21 16 — — $41,969.71 $115,476.21 $58,757.59 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 12 12 — — $49,523.65 $68,980.16 $58,677.34 2026-04-01
C1825 HCPCS Generator Pulse Legacy Implantable 7 5 — — $58,500.00 $58,500.00 $58,500.00 2026-04-01
2294 APR_DRG Other Digestive System & Abdominal Procedures 21 16 — — $41,568.71 $114,374.07 $58,196.19 2026-04-01
3084 APR_DRG Hip And Femur Fracture Repair 21 16 — — $41,441.63 $114,024.80 $58,018.28 2026-04-01
3094 APR_DRG Other Significant Hip And Femur Surgery 21 16 — — $41,274.32 $113,564.92 $57,784.04 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 12 12 — — $48,706.97 $67,832.41 $57,709.71 2026-04-01
1623 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 21 16 — — $41,215.01 $113,401.93 $57,701.02 2026-04-01
L6880 HCPCS Hb Electric Hand Ind Art Digits 24 19 — — $22,521.57 $82,069.00 $57,379.28 2026-04-01
6504 APR_DRG Splenectomy 21 16 — — $40,977.10 $112,748.01 $57,367.94 2026-04-01
0620T CPT Endovascular Venous Arterialization Tibl/Prnl Vn 29 14 — — $34,956.95 $129,266.18 $57,364.19 2026-04-01
51 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 21 16 — — $40,928.39 $112,614.12 $57,299.74 2026-04-01
6082 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 21 16 — — $40,857.08 $112,418.14 $57,199.91 2026-04-01
4403 APR_DRG Kidney Transplant 21 16 — — $40,761.07 $112,154.25 $57,065.49 2026-04-01
A9543 HCPCS Hb Y90 Ibritumomab, Rx 45 24 — — $56,824.55 $107,313.08 $56,824.55 2026-04-01
1643 OTHER Y90 Ibritumomab, Rx 16 13 — — $56,824.55 $56,824.55 $56,824.55 2026-04-01
1579 OTHER New Technology - Level 42 ($30,001-$40,000) 16 13 — — $37,204.95 $133,980.59 $56,448.89 2026-04-01
1593 OTHER New Technology - Level 42 ($30,001-$40,000) 16 13 — — $37,204.95 $133,980.59 $56,448.89 2026-04-01
2234 APR_DRG Other Small & Large Bowel Procedures 21 16 — — $40,098.15 $110,332.21 $56,137.41 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 12 12 — — $47,352.67 $65,929.10 $56,105.09 2026-04-01
2244 APR_DRG Peritoneal Adhesiolysis 21 16 — — $40,028.26 $110,140.11 $56,039.56 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 12 — — $47,200.21 $65,714.84 $55,924.46 2026-04-01
2224 APR_DRG Other Stomach, Esophageal & Duodenal Procedures 21 16 — — $39,783.99 $109,468.74 $55,697.59 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 12 12 — — $46,783.85 $65,129.69 $55,431.13 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 12 12 — — $46,683.10 $64,988.10 $55,311.76 2026-04-01
9273 OTHER Sipuleucel-t Auto Cd54+ 16 13 — — $55,272.32 $55,272.32 $55,272.32 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 16 13 — — $55,272.32 $55,272.32 $55,272.32 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 12 12 — — $46,412.96 $64,608.44 $54,991.69 2026-04-01
3024 APR_DRG Knee Joint Replacement 21 16 — — $39,140.14 $107,699.09 $54,796.19 2026-04-01
4234 APR_DRG Inborn Errors Of Metabolism 21 16 — — $39,108.37 $107,611.77 $54,751.71 2026-04-01
5166 OTHER Cochlear Implant Procedure 16 13 — — $35,807.96 $128,949.80 $54,329.31 2026-04-01
PX-81200011 CDM Hb Pancreas, Incoming 18 13 — — $8,671.71 $54,300.00 $54,300.00 2026-04-01
224 APR_DRG Ventricular Shunt Procedures 21 16 — — $38,749.73 $106,626.05 $54,249.62 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 12 12 — — $45,723.77 $63,639.87 $54,175.12 2026-04-01
8411 APR_DRG Extensive 3rd Degree Burns W Skin Graft 21 16 — — $38,603.59 $106,224.39 $54,045.03 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 12 12 — — $45,526.73 $63,362.96 $53,941.66 2026-04-01
6334 APR_DRG Neonate Birthwt >2499g W Major Anomaly 21 16 — — $38,512.52 $105,974.08 $53,917.53 2026-04-01
504 APR_DRG Non-bacterial Infections Of Nervous System Exc Viral Meningitis 21 16 — — $38,460.28 $105,830.49 $53,844.39 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 12 12 — — $45,364.47 $63,134.91 $53,749.40 2026-04-01
3043 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 21 16 — — $38,326.85 $105,463.75 $53,657.59 2026-04-01
3644 APR_DRG Other Skin, Subcutaneous Tissue & Related Procedures 21 16 — — $38,197.66 $105,108.66 $53,476.71 2026-04-01
8634 APR_DRG Neonatal Aftercare 21 16 — — $38,124.94 $104,908.80 $53,374.91 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 12 12 — — $45,013.19 $62,641.23 $53,333.19 2026-04-01
3032 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 21 16 — — $38,050.11 $104,703.11 $53,270.14 2026-04-01
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