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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 HOSPITAL OF TROY, NEW YORK

Troy, NY · CCN 330180 · Rates published

18,492 distinct procedures filed
29 distinct payers
752,681 rate rows
2025-01-01 last MRF observed · ⚠ 17 mo old
Data quality

529,786 of 752,681 rate rows are consumer-grade (70.4%)

222,895 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 183,042
exceeds 10× this hospital's gross charge — excluded from medians 18,088
template filing: same amount across many unrelated codes — excluded 17,327
placeholder amount (≤ $0.02) — excluded from medians 4,138
percent-of-charges filed in the dollar field — excluded from medians 249
per-diem day rate — not a per-procedure price 51

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 17 months old.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/samaritanhospital
Found on page https://www.sphp.com/for-patients/billing-information/pricing-information/price-estimate-and-downloadable-list
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint e9f54fd14f27ba95… · 14,822,353 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
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 12 $313,695.43 $1,528,161.51 $543,954.40 nat. median
$370,174
1.5× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 12 $230,892.26 $1,123,995.73 $400,182.81 nat. median
$265,286
1.5× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 12 $224,604.76 $1,093,306.16 $389,265.79 nat. median
$206,474
1.9× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 12 $181,789.57 $884,323.40 $314,925.55 nat. median
$202,976
1.6× median
J2326
HCPCS 		Inj Nusinersen 0.1mg 23 $402.00 $372,332.19 $299,934.26 nat. median
$2,675
outlier · 112.1×
7
MS_DRG 		Lung Transplant 11 $104,851.56 $508,785.74 $243,144.58 nat. median
$122,708
2.0× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 11 $98,006.60 $475,375.21 $227,177.96 nat. median
$117,357
1.9× median
'002-4
APR_DRG 		Heart &/or Lung Transplant 6 $207,784.04 $467,514.09 $220,251.08 —
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 12 $125,531.75 $609,726.60 $217,244.80 nat. median
$133,161
1.6× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 11 $88,566.42 $429,297.30 $205,157.70 nat. median
$100,136
outlier · 2.0×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 12 $104,662.06 $507,860.78 $181,008.65 nat. median
$108,660
1.7× median
'583-4
APR_DRG 		Neonate W Ecmo 6 $153,045.00 $344,351.25 $162,227.70 —
'588-3
APR_DRG 		Neonate Bwt <1500g W Major Procedure 6 $150,360.87 $338,311.96 $159,382.52 —
'588-4
APR_DRG 		Neonate Bwt <1500g W Major Procedure 6 $150,360.87 $338,311.96 $159,382.52 —
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 12 $92,141.44 $446,747.09 $159,269.03 nat. median
$102,358
1.6× median
215
MS_DRG 		Other Heart Assist System Implant 12 $87,417.52 $423,689.47 $151,066.87 nat. median
$99,019
1.5× median
'161-4
APR_DRG 		Cardiac Defibrillator & Heart Assist Implant 6 $137,559.07 $309,507.91 $145,812.61 —
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 $83,087.91 $402,556.43 $143,549.34 nat. median
$93,672
1.5× median
'003-4
APR_DRG 		Bone Marrow Transplant 6 $133,573.01 $300,539.27 $141,587.39 —
453
MS_DRG 		Combined Anterior/posterior Spinal Fusion W Mcc 12 $75,916.64 $367,553.15 $131,097.82 nat. median
$87,428
1.5× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 12 $72,441.05 $350,588.65 $125,063.14 nat. median
$77,570
1.6× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 $72,245.60 $349,634.65 $124,723.77 nat. median
$81,118
1.5× median
'591-4
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 6 $115,525.42 $259,932.20 $122,456.95 —
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/mcc 11 $53,105.21 $256,209.61 $122,440.49 nat. median
$56,918
outlier · 2.2×
17
MS_DRG 		Autologous Bone Marrow Transplant Without Cc/mcc 11 $53,105.21 $256,209.61 $122,440.49 nat. median
$53,807
outlier · 2.3×
'588-2
APR_DRG 		Neonate Bwt <1500g W Major Procedure 6 $115,109.27 $258,995.86 $122,015.83 —
'588-1
APR_DRG 		Neonate Bwt <1500g W Major Procedure 6 $115,109.27 $258,995.86 $122,015.83 —
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 12 $69,575.60 $336,602.27 $120,087.83 nat. median
$79,312
1.5× median
'841-4
APR_DRG 		Extensive 3rd Degree Burns W Skin Graft 6 $111,743.85 $251,423.66 $118,448.48 —
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 12 $68,541.42 $331,554.39 $118,292.19 nat. median
$71,271
1.7× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization With Mcc 12 $66,893.70 $323,511.81 $115,431.25 nat. median
$73,807
1.6× median
'004-4
APR_DRG 		Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 6 $107,782.75 $242,511.19 $114,249.72 —
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 $66,142.49 $319,845.15 $114,126.93 nat. median
$74,915
1.5× median
'001-4
APR_DRG 		Liver Transplant &/or Intestinal Transplant 6 $104,413.77 $234,930.98 $110,678.60 —
'593-4
APR_DRG 		Neonate Birthwt 750-999g Without Major Procedure 6 $104,000.60 $234,001.35 $110,240.64 —
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 12 $62,074.61 $299,989.64 $107,063.84 nat. median
$72,135
1.5× median
8
MS_DRG 		Simultaneous Pancreas/kidney Transplant 11 $45,327.19 $218,244.79 $104,297.42 nat. median
$53,167
2.0× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 12 $60,403.10 $291,830.91 $104,161.58 nat. median
$68,886
1.5× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 12 $59,800.60 $288,890.12 $103,115.46 nat. median
$66,526
1.6× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 12 $59,416.50 $287,015.32 $102,448.55 nat. median
$64,023
1.6× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 12 $59,317.08 $286,530.02 $102,275.93 nat. median
$62,134
1.6× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 12 $59,016.26 $285,061.70 $101,753.61 nat. median
$60,185
1.7× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 12 $58,864.15 $284,319.25 $101,489.49 nat. median
$65,950
1.5× median
'609-4
APR_DRG 		Neonate Bwt 1500-2499g W Major Procedure 6 $95,251.46 $214,315.79 $100,966.55 —
461
MS_DRG 		Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 12 $58,556.53 $282,817.74 $100,955.38 nat. median
$55,736
1.8× median
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 12 $56,974.24 $275,094.54 $98,208.04 nat. median
$65,393
1.5× median
6
MS_DRG 		Liver Transplant Without Mcc 11 $41,717.34 $200,624.94 $95,877.03 nat. median
$46,260
outlier · 2.1×
'602-4
APR_DRG 		Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 6 $90,242.27 $203,045.11 $95,656.81 —
10
MS_DRG 		Pancreas Transplant 11 $41,519.34 $199,658.50 $95,415.18 nat. median
$68,884
1.4× median
'002-3
APR_DRG 		Heart &/or Lung Transplant 6 $89,928.38 $202,338.86 $95,324.08 —

Other procedures at this hospital

Browse this hospital's 18,492 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
             
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 22 12 — — $313,695.43 $1,528,161.51 $543,954.40 2025-01-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 22 12 — — $230,892.26 $1,123,995.73 $400,182.81 2025-01-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 22 12 — — $224,604.76 $1,093,306.16 $389,265.79 2025-01-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 22 12 — — $181,789.57 $884,323.40 $314,925.55 2025-01-01
J2326 HCPCS Inj Nusinersen 0.1mg 38 23 $413,702.43 $351,647.07 $402.00 $372,332.19 $299,934.26 2025-01-01
7 MS_DRG Lung Transplant 21 11 — — $104,851.56 $508,785.74 $243,144.58 2025-01-01
14 MS_DRG Allogeneic Bone Marrow Transplant 21 11 — — $98,006.60 $475,375.21 $227,177.96 2025-01-01
'002-4 APR_DRG Heart &/or Lung Transplant 15 6 — — $207,784.04 $467,514.09 $220,251.08 2025-01-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 22 12 — — $125,531.75 $609,726.60 $217,244.80 2025-01-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 21 11 — — $88,566.42 $429,297.30 $205,157.70 2025-01-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 22 12 — — $104,662.06 $507,860.78 $181,008.65 2025-01-01
'583-4 APR_DRG Neonate W Ecmo 15 6 — — $153,045.00 $344,351.25 $162,227.70 2025-01-01
'588-4 APR_DRG Neonate Bwt <1500g W Major Procedure 15 6 — — $150,360.87 $338,311.96 $159,382.52 2025-01-01
'588-3 APR_DRG Neonate Bwt <1500g W Major Procedure 15 6 — — $150,360.87 $338,311.96 $159,382.52 2025-01-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 22 12 — — $92,141.44 $446,747.09 $159,269.03 2025-01-01
215 MS_DRG Other Heart Assist System Implant 22 12 — — $87,417.52 $423,689.47 $151,066.87 2025-01-01
'161-4 APR_DRG Cardiac Defibrillator & Heart Assist Implant 15 6 — — $137,559.07 $309,507.91 $145,812.61 2025-01-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 22 12 — — $83,087.91 $402,556.43 $143,549.34 2025-01-01
'003-4 APR_DRG Bone Marrow Transplant 15 6 — — $133,573.01 $300,539.27 $141,587.39 2025-01-01
453 MS_DRG Combined Anterior/posterior Spinal Fusion W Mcc 22 12 — — $75,916.64 $367,553.15 $131,097.82 2025-01-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 22 12 — — $72,441.05 $350,588.65 $125,063.14 2025-01-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 22 12 — — $72,245.60 $349,634.65 $124,723.77 2025-01-01
'591-4 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 15 6 — — $115,525.42 $259,932.20 $122,456.95 2025-01-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 21 11 — — $53,105.21 $256,209.61 $122,440.49 2025-01-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 21 11 — — $53,105.21 $256,209.61 $122,440.49 2025-01-01
'588-1 APR_DRG Neonate Bwt <1500g W Major Procedure 15 6 — — $115,109.27 $258,995.86 $122,015.83 2025-01-01
'588-2 APR_DRG Neonate Bwt <1500g W Major Procedure 15 6 — — $115,109.27 $258,995.86 $122,015.83 2025-01-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 22 12 — — $69,575.60 $336,602.27 $120,087.83 2025-01-01
'841-4 APR_DRG Extensive 3rd Degree Burns W Skin Graft 15 6 — — $111,743.85 $251,423.66 $118,448.48 2025-01-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 22 12 — — $68,541.42 $331,554.39 $118,292.19 2025-01-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 22 12 — — $66,893.70 $323,511.81 $115,431.25 2025-01-01
'004-4 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 15 6 — — $107,782.75 $242,511.19 $114,249.72 2025-01-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 22 12 — — $66,142.49 $319,845.15 $114,126.93 2025-01-01
'001-4 APR_DRG Liver Transplant &/or Intestinal Transplant 15 6 — — $104,413.77 $234,930.98 $110,678.60 2025-01-01
'593-4 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 15 6 — — $104,000.60 $234,001.35 $110,240.64 2025-01-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 22 12 — — $62,074.61 $299,989.64 $107,063.84 2025-01-01
8 MS_DRG Simultaneous Pancreas/kidney Transplant 21 11 — — $45,327.19 $218,244.79 $104,297.42 2025-01-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 22 12 — — $60,403.10 $291,830.91 $104,161.58 2025-01-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 22 12 — — $59,800.60 $288,890.12 $103,115.46 2025-01-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 22 12 — — $59,416.50 $287,015.32 $102,448.55 2025-01-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 22 12 — — $59,317.08 $286,530.02 $102,275.93 2025-01-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 22 12 — — $59,016.26 $285,061.70 $101,753.61 2025-01-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 22 12 — — $58,864.15 $284,319.25 $101,489.49 2025-01-01
'609-4 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 15 6 — — $95,251.46 $214,315.79 $100,966.55 2025-01-01
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 22 12 — — $58,556.53 $282,817.74 $100,955.38 2025-01-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 22 12 — — $56,974.24 $275,094.54 $98,208.04 2025-01-01
6 MS_DRG Liver Transplant Without Mcc 21 11 — — $41,717.34 $200,624.94 $95,877.03 2025-01-01
'602-4 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 15 6 — — $90,242.27 $203,045.11 $95,656.81 2025-01-01
10 MS_DRG Pancreas Transplant 21 11 — — $41,519.34 $199,658.50 $95,415.18 2025-01-01
'002-3 APR_DRG Heart &/or Lung Transplant 15 6 — — $89,928.38 $202,338.86 $95,324.08 2025-01-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 22 12 — — $54,705.34 $264,019.91 $94,268.54 2025-01-01
'841-3 APR_DRG Extensive 3rd Degree Burns W Skin Graft 15 6 — — $87,396.43 $196,641.97 $92,640.22 2025-01-01
266 MS_DRG Endovascular Cardiac Valve Replacement W Mcc 22 12 — — $53,692.40 $259,075.74 $92,509.76 2025-01-01
'583-3 APR_DRG Neonate W Ecmo 15 6 — — $87,096.22 $195,966.50 $92,321.99 2025-01-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 22 12 — — $53,454.47 $257,914.35 $92,096.64 2025-01-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 22 12 — — $53,387.33 $257,586.68 $91,980.07 2025-01-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 22 12 — — $52,802.69 $254,732.99 $90,964.95 2025-01-01
'583-2 APR_DRG Neonate W Ecmo 15 6 — — $85,473.85 $192,316.16 $90,602.28 2025-01-01
'583-1 APR_DRG Neonate W Ecmo 15 6 — — $85,473.85 $192,316.16 $90,602.28 2025-01-01
454 MS_DRG Combined Anterior/posterior Spinal Fusion W Cc 22 12 — — $52,589.39 $253,691.89 $90,594.60 2025-01-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 22 12 — — $52,367.60 $252,609.32 $90,209.50 2025-01-01
27800000002-43 CDM Device Impella 5.5 Smartassist 24 13 $112,500.00 $95,625.00 $402.00 $101,250.00 $90,000.00 2025-01-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 22 12 — — $52,240.98 $251,991.29 $89,989.66 2025-01-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 22 12 — — $51,997.95 $250,805.02 $89,567.68 2025-01-01
28 MS_DRG Spinal Procedures With Mcc 22 12 — — $51,822.89 $249,950.58 $89,263.72 2025-01-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 22 12 — — $51,601.95 $248,872.15 $88,880.10 2025-01-01
'603-4 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 15 6 — — $83,157.11 $187,103.50 $88,146.54 2025-01-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 22 12 — — $51,164.32 $246,736.03 $88,120.24 2025-01-01
'005-4 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 15 6 — — $82,323.04 $185,226.84 $87,262.42 2025-01-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 22 12 — — $50,586.47 $243,915.53 $87,116.92 2025-01-01
'593-3 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 15 6 — — $81,303.49 $182,932.85 $86,181.70 2025-01-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 22 12 — — $49,023.73 $236,287.72 $84,403.52 2025-01-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 22 12 — — $48,908.16 $235,723.62 $84,202.86 2025-01-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 22 12 — — $48,786.64 $235,130.49 $83,991.86 2025-01-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 22 12 — — $48,743.30 $234,918.95 $83,916.61 2025-01-01
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 22 12 — — $48,193.49 $232,235.32 $82,961.98 2025-01-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 22 12 — — $47,396.40 $228,344.69 $81,577.99 2025-01-01
'002-2 APR_DRG Heart &/or Lung Transplant 15 6 — — $76,712.82 $172,603.85 $81,315.59 2025-01-01
653 MS_DRG Major Bladder Procedures With Mcc 22 12 — — $46,618.01 $224,545.30 $80,226.46 2025-01-01
27800000002-42 CDM Device Impella 5.5 Smartassist 24 13 $100,000.00 $85,000.00 $402.00 $90,000.00 $80,000.00 2025-01-01
A9542 HCPCS Indium In-111 Ibritumomab Tiuxetan Diagnostic Per Study Dose Up To 5 Millicuries 24 13 $97,800.00 $83,130.00 $402.00 $88,020.00 $78,240.00 2025-01-01
'607-4 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 15 6 — — $73,739.17 $165,913.13 $78,163.52 2025-01-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 22 12 — — $45,181.88 $217,535.52 $77,732.90 2025-01-01
'630-4 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 15 6 — — $73,048.96 $164,360.16 $77,431.90 2025-01-01
27800000002-547 CDM Coil Azur Cx Detach 13mmx24cm .035in Periph 1/bx 24 13 $96,382.50 $81,925.13 $402.00 $86,744.25 $77,106.00 2025-01-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 22 12 — — $44,785.04 $215,598.50 $77,043.86 2025-01-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 22 12 — — $44,689.01 $215,129.79 $76,877.13 2025-01-01
'589-1 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 15 6 — — $72,510.35 $163,148.29 $76,860.97 2025-01-01
'589-2 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 15 6 — — $72,510.35 $163,148.29 $76,860.97 2025-01-01
'002-1 APR_DRG Heart &/or Lung Transplant 15 6 — — $72,279.69 $162,629.30 $76,616.47 2025-01-01
11 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Mcc 22 12 — — $44,431.53 $213,873.01 $76,430.06 2025-01-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 22 12 — — $43,774.65 $210,666.76 $75,289.52 2025-01-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 22 12 — — $43,586.85 $209,750.10 $74,963.44 2025-01-01
'003-3 APR_DRG Bone Marrow Transplant 15 6 — — $70,632.95 $158,924.14 $74,870.93 2025-01-01
'591-3 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 15 6 — — $70,583.61 $158,813.12 $74,818.63 2025-01-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 22 12 — — $43,432.19 $208,995.20 $74,694.90 2025-01-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 22 12 — — $43,097.38 $207,360.97 $74,113.57 2025-01-01
799 MS_DRG Splenic Procedures With Mcc 22 12 — — $42,717.53 $205,506.90 $73,454.03 2025-01-01
471 MS_DRG Cervical Spinal Fusion With Mcc 22 12 — — $42,415.01 $204,030.28 $72,928.76 2025-01-01
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 22 12 — — $42,085.29 $202,420.94 $72,356.28 2025-01-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 22 12 — — $41,034.97 $200,919.43 $71,398.82 2025-01-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 22 12 — — $41,461.56 $199,376.45 $71,273.29 2025-01-01
'090-4 APR_DRG Major Larynx & Trachea Procedures 15 6 — — $67,109.39 $150,996.13 $71,135.95 2025-01-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 22 12 — — $41,254.21 $198,364.39 $70,913.26 2025-01-01
'602-3 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 15 6 — — $66,703.36 $150,082.56 $70,705.56 2025-01-01
'593-2 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 15 6 — — $66,584.46 $149,815.04 $70,579.53 2025-01-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 22 12 — — $40,897.30 $196,622.31 $70,293.57 2025-01-01
163 MS_DRG Major Chest Procedures With Mcc 22 12 — — $40,669.56 $195,510.70 $69,898.14 2025-01-01
'591-2 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 15 6 — — $65,869.88 $148,207.23 $69,822.07 2025-01-01
'303-4 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 15 6 — — $65,112.50 $146,503.13 $69,019.25 2025-01-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 22 12 — — $40,117.21 $192,814.63 $68,939.09 2025-01-01
'593-1 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 15 6 — — $64,567.35 $145,276.54 $68,441.39 2025-01-01
455 MS_DRG Combined Anterior/posterior Spinal Fusion Without Cc/mcc 22 12 — — $39,751.80 $191,031.08 $68,304.62 2025-01-01
27800000002-82 CDM Valve Sapien Thv Edwards Resilia 23mm 24 13 $85,000.00 $72,250.00 $402.00 $76,500.00 $68,000.00 2025-01-01
27800000002-83 CDM Valve Sapien Thv Edwards Resilia 29mm 24 13 $85,000.00 $72,250.00 $402.00 $76,500.00 $68,000.00 2025-01-01
27800000002-85 CDM Valve Sapien Thv Edwards Resilia 20mm 24 13 $85,000.00 $72,250.00 $402.00 $76,500.00 $68,000.00 2025-01-01
27800000002-84 CDM Valve Sapien Thv Edwards Resilia 26mm 24 13 $85,000.00 $72,250.00 $402.00 $76,500.00 $68,000.00 2025-01-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 22 12 — — $37,909.49 $191,947.74 $67,473.54 2025-01-01
245 MS_DRG Aicd Generator Procedures 22 12 — — $39,121.27 $187,953.41 $67,209.83 2025-01-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 22 12 — — $39,117.87 $187,936.82 $67,203.93 2025-01-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 22 12 — — $38,997.20 $187,347.83 $66,994.41 2025-01-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 22 12 — — $38,870.58 $186,729.81 $66,774.56 2025-01-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 22 12 — — $38,833.19 $186,547.31 $66,709.64 2025-01-01
'631-4 APR_DRG Neonate Birthwt >2499g W Other Major Procedure 15 6 — — $62,846.89 $141,405.50 $66,617.70 2025-01-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 22 12 — — $38,517.93 $185,008.47 $66,162.24 2025-01-01
'440-4 APR_DRG Kidney Transplant 15 6 — — $62,078.21 $139,675.97 $65,802.90 2025-01-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 22 12 — — $38,246.00 $183,681.18 $65,690.09 2025-01-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 22 12 — — $38,140.63 $183,166.85 $65,507.13 2025-01-01
27800000002-425 CDM Valve Sapien 3 Thv 23mm W/command System 24 13 $81,250.00 $69,062.50 $402.00 $73,125.00 $65,000.00 2025-01-01
27800000002-431 CDM Valve Thv Sapien 3 29mm W/certitudesystem 24 13 $81,250.00 $69,062.50 $402.00 $73,125.00 $65,000.00 2025-01-01
27800000002-426 CDM Valve Sapien 3 Thv 26mm W/command System 24 13 $81,250.00 $69,062.50 $402.00 $73,125.00 $65,000.00 2025-01-01
27800000002-429 CDM Valve Thv Sapien 3 23mm W/certitudesystem 24 13 $81,250.00 $69,062.50 $402.00 $73,125.00 $65,000.00 2025-01-01
27800000002-428 CDM Valve Sapien 3 Thv 29mm W/command System 24 13 $81,250.00 $69,062.50 $402.00 $73,125.00 $65,000.00 2025-01-01
27800000002-427 CDM Valve Sapien 3 Thv 29mm W/command System 24 13 $81,250.00 $69,062.50 $402.00 $73,125.00 $65,000.00 2025-01-01
27800000002-602 CDM Valve Sapien 3 Ultra Thv 23mm W/command System 24 13 $81,250.00 $69,062.50 $402.00 $73,125.00 $65,000.00 2025-01-01
27800000002-603 CDM Valve Sapien 3 Ultra Thv 23mm W/command System 24 13 $81,250.00 $69,062.50 $402.00 $73,125.00 $65,000.00 2025-01-01
27800000002-604 CDM Valve Sapien 3 Ultra Thv 26mm W/command System 24 13 $81,250.00 $69,062.50 $402.00 $73,125.00 $65,000.00 2025-01-01
27800000002-605 CDM Valve Sapien 3 Ultra Thv 26mm W/command System 24 13 $81,250.00 $69,062.50 $402.00 $73,125.00 $65,000.00 2025-01-01
27800000002-601 CDM Valve Sapien 3 Ultra Thv 20mm W/command System 24 13 $81,250.00 $69,062.50 $402.00 $73,125.00 $65,000.00 2025-01-01
27800000002-424 CDM Valve Sapien 3 Thv 20mm W/command System 24 13 $81,250.00 $69,062.50 $402.00 $73,125.00 $65,000.00 2025-01-01
27800000002-430 CDM Valve Thv Sapien 3 26mm W/certitudesystem 24 13 $81,250.00 $69,062.50 $402.00 $73,125.00 $65,000.00 2025-01-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 22 12 — — $37,680.90 $180,922.89 $64,708.90 2025-01-01
901 MS_DRG Wound Debridements For Injuries With Mcc 22 12 — — $37,391.12 $179,508.49 $64,205.76 2025-01-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 22 12 — — $37,178.68 $178,471.54 $63,836.90 2025-01-01
'004-3 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 15 6 — — $60,214.48 $135,482.58 $63,827.35 2025-01-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 22 12 — — $36,973.88 $177,471.92 $63,481.31 2025-01-01
'160-4 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 15 6 — — $59,461.25 $133,787.81 $63,028.93 2025-01-01
793 MS_DRG Full Term Neonate With Major Problems 22 12 — — $36,384.14 $174,593.35 $62,457.33 2025-01-01
'161-3 APR_DRG Cardiac Defibrillator & Heart Assist Implant 15 6 — — $58,841.20 $132,392.70 $62,371.67 2025-01-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 22 12 — — $35,953.30 $172,490.41 $61,709.26 2025-01-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 22 12 — — $35,795.24 $171,718.92 $61,434.82 2025-01-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 22 12 — — $35,596.39 $170,748.33 $61,089.57 2025-01-01
'361-4 APR_DRG Skin Graft For Skin & Subcutaneous Tissue Diagnoses 15 6 — — $57,419.77 $129,194.48 $60,864.96 2025-01-01
791 MS_DRG Prematurity With Major Problems 22 12 — — $35,435.78 $169,964.40 $60,810.70 2025-01-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 22 12 — — $35,096.72 $168,309.43 $60,221.99 2025-01-01
'602-2 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 15 6 — — $56,727.19 $127,636.18 $60,130.82 2025-01-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 22 12 — — $34,986.25 $167,770.21 $60,030.18 2025-01-01
27800000002-713 CDM Kit Mitraclip 1 Mbr0303 24 13 $75,000.00 $63,750.00 $402.00 $67,500.00 $60,000.00 2025-01-01
27800000002-470 CDM Valve Aortic Evolut Tm Pro 26mm 24 13 $75,000.00 $63,750.00 $402.00 $67,500.00 $60,000.00 2025-01-01
27800000002-76 CDM Valve Aortic 23mm Evolut Fx 24 13 $75,000.00 $63,750.00 $402.00 $67,500.00 $60,000.00 2025-01-01
27800000002-472 CDM Valve Aortic Evolut Tm Pro 34mm 24 13 $75,000.00 $63,750.00 $402.00 $67,500.00 $60,000.00 2025-01-01
27800000002-74 CDM Valve Aortic 29mm Evolut Fx 24 13 $75,000.00 $63,750.00 $402.00 $67,500.00 $60,000.00 2025-01-01
27800000002-75 CDM Valve Aortic 34mm Evolut Fx 24 13 $75,000.00 $63,750.00 $402.00 $67,500.00 $60,000.00 2025-01-01
27800000002-609 CDM Kit Mitraclip G4 Syst Cds0701nt/ntw/xt/xtw 24 13 $75,000.00 $63,750.00 $402.00 $67,500.00 $60,000.00 2025-01-01
27800000002-394 CDM Valve Aort 29mm Pro Perc 24 13 $75,000.00 $63,750.00 $402.00 $67,500.00 $60,000.00 2025-01-01
27800000002-73 CDM Valve Aortic 26mm Evolut Fx 24 13 $75,000.00 $63,750.00 $402.00 $67,500.00 $60,000.00 2025-01-01
27800000002-393 CDM Valve Aort 26mm Pro Perc 24 13 $75,000.00 $63,750.00 $402.00 $67,500.00 $60,000.00 2025-01-01
27800000002-471 CDM Valve Aortic Evolut Tm Pro 29mm 24 13 $75,000.00 $63,750.00 $402.00 $67,500.00 $60,000.00 2025-01-01
27800000002-292 CDM Kit Mitraclip 2 Mbr0302 24 13 $75,000.00 $63,750.00 $402.00 $67,500.00 $60,000.00 2025-01-01
27800000002-289 CDM Kit Mitraclip 1 Mbr0101 24 13 $75,000.00 $63,750.00 $402.00 $67,500.00 $60,000.00 2025-01-01
27800000002-745 CDM Kit Mitraclip 3 Mbr0103 24 13 $75,000.00 $63,750.00 $402.00 $67,500.00 $60,000.00 2025-01-01
27800000002-291 CDM Kit Mitraclip 2 Mbr0102 24 13 $75,000.00 $63,750.00 $402.00 $67,500.00 $60,000.00 2025-01-01
27800000002-290 CDM Kit Mitraclip 1 Mbr0301 24 13 $75,000.00 $63,750.00 $402.00 $67,500.00 $60,000.00 2025-01-01
27800000002-807 CDM Valve Aortic Evolut Tm Pro 23mm 24 13 $75,000.00 $63,750.00 $402.00 $67,500.00 $60,000.00 2025-01-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 22 12 — — $34,955.66 $167,620.89 $59,977.06 2025-01-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 22 12 — — $34,728.77 $166,513.43 $59,583.11 2025-01-01
652 MS_DRG Kidney Transplant 21 11 — — $26,145.17 $124,616.50 $59,553.22 2025-01-01
'162-4 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 15 6 — — $56,136.86 $126,307.94 $59,505.07 2025-01-01
12 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Cc 22 12 — — $34,647.19 $166,115.24 $59,441.47 2025-01-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 22 12 — — $34,246.09 $164,157.48 $58,745.04 2025-01-01
'005-3 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 15 6 — — $55,233.23 $124,274.77 $58,547.22 2025-01-01
'304-4 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 15 6 — — $54,933.01 $123,599.27 $58,228.99 2025-01-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 22 12 — — $33,848.40 $162,216.31 $58,054.52 2025-01-01
'607-3 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 15 6 — — $54,736.23 $123,156.52 $58,020.40 2025-01-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 22 12 — — $33,767.67 $161,822.27 $57,914.35 2025-01-01
273 MS_DRG Percutaneous Intracardiac Procedures W Mcc 22 12 — — $33,730.28 $161,639.77 $57,849.43 2025-01-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 22 12 — — $33,647.00 $161,233.28 $57,704.83 2025-01-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 22 12 — — $33,570.52 $160,859.98 $57,572.03 2025-01-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 22 12 — — $33,335.13 $159,711.04 $57,163.33 2025-01-01
'312-4 APR_DRG Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses 15 6 — — $53,863.52 $121,192.92 $57,095.33 2025-01-01
'603-3 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 15 6 — — $53,722.03 $120,874.57 $56,945.35 2025-01-01
'681-4 APR_DRG Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 15 6 — — $53,678.63 $120,776.92 $56,899.35 2025-01-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 22 12 — — $33,123.54 $158,678.24 $56,795.94 2025-01-01
'680-4 APR_DRG Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 15 6 — — $53,530.60 $120,443.85 $56,742.44 2025-01-01
'591-1 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 15 6 — — $53,192.34 $119,682.77 $56,383.88 2025-01-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 22 12 — — $32,810.82 $157,151.85 $56,252.96 2025-01-01
140 MS_DRG Major Head And Neck Procedures With Mcc 22 12 — — $32,719.89 $156,708.03 $56,095.08 2025-01-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 22 12 — — $30,158.67 $162,705.75 $56,068.32 2025-01-01
'690-4 APR_DRG Acute Leukemia 15 6 — — $52,382.04 $117,859.59 $55,524.96 2025-01-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 22 12 — — $32,323.90 $154,775.16 $55,407.52 2025-01-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 22 12 — — $32,244.87 $154,389.41 $55,270.30 2025-01-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 22 12 — — $32,221.92 $154,277.42 $55,230.46 2025-01-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 22 12 — — $32,039.22 $153,385.64 $54,913.24 2025-01-01
'842-4 APR_DRG Burns With Skin Graft Except Extensive 3rd Degree Burns 15 6 — — $51,696.00 $116,316.00 $54,797.76 2025-01-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 22 12 — — $31,698.46 $151,722.38 $54,321.57 2025-01-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 22 12 — — $31,646.63 $151,469.36 $54,231.57 2025-01-01
332 MS_DRG Rectal Resection With Mcc 22 12 — — $31,440.98 $151,573.06 $54,139.12 2025-01-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 22 12 — — $31,520.01 $150,851.34 $54,011.72 2025-01-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 22 12 — — $31,399.34 $150,262.35 $53,802.21 2025-01-01
'612-4 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 15 6 — — $50,720.44 $114,120.99 $53,763.67 2025-01-01
739 MS_DRG Uterine,adnexa Proc For Non-ovarian/adnexal Malig W Mcc 22 12 — — $31,344.95 $149,996.89 $53,707.77 2025-01-01
'405-4 APR_DRG Other Procedures For Endocrine, Nutritional & Metabolic Disorders 15 6 — — $50,212.15 $112,977.34 $53,224.88 2025-01-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 22 12 — — $31,046.68 $148,541.01 $53,189.89 2025-01-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 22 12 — — $30,994.00 $148,283.85 $53,098.40 2025-01-01
'001-3 APR_DRG Liver Transplant &/or Intestinal Transplant 15 6 — — $50,083.74 $112,688.42 $53,088.76 2025-01-01
265 MS_DRG Aicd Lead Procedures 22 12 — — $30,646.44 $146,587.40 $52,494.93 2025-01-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 22 12 — — $30,570.81 $146,218.25 $52,363.61 2025-01-01
'611-4 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 15 6 — — $49,175.35 $110,644.54 $52,125.87 2025-01-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 22 12 — — $30,240.24 $144,604.75 $51,789.65 2025-01-01
'950-4 APR_DRG Extensive Procedure Unrelated To Principal Diagnosis 15 6 — — $48,584.43 $109,314.97 $51,499.50 2025-01-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 22 12 — — $30,034.60 $143,600.98 $51,432.60 2025-01-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 22 12 — — $30,003.16 $143,447.52 $51,378.00 2025-01-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 22 12 — — $29,984.46 $143,356.26 $51,345.54 2025-01-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 22 12 — — $29,975.11 $143,310.64 $51,329.31 2025-01-01
'023-4 APR_DRG Spinal Procedures 15 6 — — $48,393.00 $108,884.25 $51,296.58 2025-01-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 22 12 — — $29,746.52 $142,194.88 $50,932.40 2025-01-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 22 12 — — $29,424.46 $142,302.72 $50,774.60 2025-01-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 22 12 — — $29,556.17 $141,265.77 $50,601.90 2025-01-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 22 12 — — $29,308.89 $140,058.76 $50,172.54 2025-01-01
37 MS_DRG Extracranial Procedures With Mcc 22 12 — — $29,299.54 $140,013.14 $50,156.31 2025-01-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 22 12 — — $29,243.45 $139,739.38 $50,058.93 2025-01-01
27800000002-825 CDM Set Pump Aic Impella 5.0 24 13 $62,500.00 $53,125.00 $402.00 $56,250.00 $50,000.00 2025-01-01
27800000002-824 CDM Set Pump Aic Impella 5.0 24 13 $62,500.00 $53,125.00 $402.00 $56,250.00 $50,000.00 2025-01-01
27800000002-331 CDM Set Pump Impella Cp 24 13 $62,500.00 $53,125.00 $402.00 $56,250.00 $50,000.00 2025-01-01
27800000002-335 CDM Set Pump Impella Rp 24 13 $62,500.00 $53,125.00 $402.00 $56,250.00 $50,000.00 2025-01-01
27800000002-332 CDM Set Pump Impella Cp 24 13 $62,500.00 $53,125.00 $402.00 $56,250.00 $50,000.00 2025-01-01
27800000002-77 CDM Impella Rp With Smart Assist 24 13 $62,500.00 $53,125.00 $402.00 $56,250.00 $50,000.00 2025-01-01
27200000002-6085 CDM Set Pump Cath Sys Rp Flex W/smart Assist 24 13 $62,500.00 $53,125.00 $402.00 $56,250.00 $50,000.00 2025-01-01
27800000002-334 CDM Set Pump Impella Rp 24 13 $62,500.00 $53,125.00 $402.00 $56,250.00 $50,000.00 2025-01-01
252 MS_DRG Other Vascular Procedures With Mcc 22 12 — — $29,114.29 $139,108.92 $49,834.65 2025-01-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 22 12 — — $29,015.71 $138,627.77 $49,663.50 2025-01-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan Therapeutic Per Treatment Dose Up To 40 Millic… 38 23 $55,035.00 $46,779.75 $402.00 $147,322.31 $49,531.50 2025-01-01
469 MS_DRG Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc 22 12 — — $28,910.34 $138,113.44 $49,480.54 2025-01-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 22 12 — — $28,874.65 $137,939.24 $49,418.57 2025-01-01
'003-2 APR_DRG Bone Marrow Transplant 15 6 — — $46,481.71 $104,583.85 $49,270.61 2025-01-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 22 12 — — $28,786.27 $137,507.87 $49,265.12 2025-01-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 22 12 — — $28,606.12 $136,628.53 $48,952.32 2025-01-01
264 MS_DRG Other Circulatory System O.r. Procedures 22 12 — — $28,368.18 $135,467.15 $48,539.19 2025-01-01
'006-4 APR_DRG Pancreas Transplant 15 6 — — $45,758.21 $102,955.97 $48,503.70 2025-01-01
'447-4 APR_DRG Other Kidney, Urinary Tract & Related Procedures 15 6 — — $45,708.87 $102,844.96 $48,451.40 2025-01-01
'850-4 APR_DRG Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service 15 6 — — $45,685.69 $102,792.80 $48,426.83 2025-01-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 22 12 — — $28,284.91 $135,060.66 $48,394.60 2025-01-01
500 MS_DRG Soft Tissue Procedures With Mcc 22 12 — — $28,171.04 $134,504.86 $48,196.89 2025-01-01
274 MS_DRG Percutaneous Intracardiac Procedures Without Mcc 22 12 — — $28,154.04 $134,421.90 $48,167.38 2025-01-01
'912-4 APR_DRG Musculoskeletal & Other Procedures For Multiple Significant Trauma 15 6 — — $45,387.85 $102,122.66 $48,111.12 2025-01-01
J9281 HCPCS mitoMYcin 40 Mg X 2 Kit 1 Each Kit 38 23 $66,330.00 $56,380.50 $300.59 $59,697.00 $48,089.25 2025-01-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 22 12 — — $27,939.05 $133,372.51 $47,794.08 2025-01-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 22 12 — — $27,937.35 $133,364.21 $47,791.13 2025-01-01
'512-4 APR_DRG Uterine & Adnexa Procedures For Non-ovarian & Non-adnexal Malig 15 6 — — $44,952.68 $101,143.53 $47,649.84 2025-01-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 22 12 — — $27,814.13 $132,762.78 $47,577.18 2025-01-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 22 12 — — $27,812.43 $132,754.49 $47,574.23 2025-01-01
'607-2 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 15 6 — — $44,804.05 $100,809.11 $47,492.29 2025-01-01
J9600 HCPCS Porfimer Per 75 Mg 38 23 $63,119.97 $53,651.97 $402.00 $56,807.97 $47,339.98 2025-01-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 22 12 — — $27,633.98 $131,883.45 $47,264.39 2025-01-01
'260-4 APR_DRG Major Pancreas, Liver & Shunt Procedures 15 6 — — $44,495.51 $100,114.90 $47,165.24 2025-01-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 22 12 — — $27,480.17 $131,132.70 $46,997.32 2025-01-01
'695-4 APR_DRG Chemotherapy For Acute Leukemia # 15 6 — — $44,259.50 $99,583.88 $46,915.07 2025-01-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 22 12 — — $27,414.73 $130,813.32 $46,883.71 2025-01-01
'092-4 APR_DRG Facial Bone Procedures Except Major Cranial/facial Bone Procedures 15 6 — — $44,060.94 $99,137.12 $46,704.60 2025-01-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 22 12 — — $27,277.07 $130,141.37 $46,644.68 2025-01-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 22 12 — — $27,171.70 $129,627.05 $46,461.72 2025-01-01
'006-3 APR_DRG Pancreas Transplant 15 6 — — $43,827.90 $98,612.78 $46,457.57 2025-01-01
'609-3 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 15 6 — — $43,643.01 $98,196.77 $46,261.59 2025-01-01
'021-4 APR_DRG Craniotomy Except For Trauma 15 6 — — $43,395.11 $97,639.00 $45,998.82 2025-01-01
665 MS_DRG Prostatectomy With Mcc 22 12 — — $26,864.93 $128,129.69 $45,929.08 2025-01-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 22 12 — — $26,745.11 $127,544.85 $45,721.04 2025-01-01
'004-1 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 15 6 — — $43,081.22 $96,932.75 $45,666.09 2025-01-01
'004-2 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 15 6 — — $43,081.22 $96,932.75 $45,666.09 2025-01-01
'169-4 APR_DRG Major Abdominal Vascular Procedures 15 6 — — $43,047.33 $96,856.49 $45,630.17 2025-01-01
'910-4 APR_DRG Craniotomy For Multiple Significant Trauma 15 6 — — $43,044.95 $96,851.14 $45,627.65 2025-01-01
'608-4 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 15 6 — — $43,044.36 $96,849.81 $45,627.02 2025-01-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 22 12 — — $26,379.70 $125,761.30 $45,086.58 2025-01-01
'220-4 APR_DRG Major Stomach, Esophageal & Duodenal Procedures 15 6 — — $42,481.37 $95,583.08 $45,030.25 2025-01-01
'841-2 APR_DRG Extensive 3rd Degree Burns W Skin Graft 15 6 — — $42,446.89 $95,505.50 $44,993.70 2025-01-01
'165-4 APR_DRG Coronary Bypass W Ami Or Complex Pdx 15 6 — — $42,415.39 $95,434.63 $44,960.31 2025-01-01
'321-4 APR_DRG Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp 15 6 — — $42,341.67 $95,268.76 $44,882.17 2025-01-01
'163-4 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Pdx 15 6 — — $42,239.42 $95,038.70 $44,773.79 2025-01-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 22 12 — — $26,119.67 $124,492.07 $44,635.08 2025-01-01
662 MS_DRG Minor Bladder Procedures With Mcc 22 12 — — $26,079.73 $124,297.12 $44,565.74 2025-01-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 22 12 — — $26,058.49 $124,193.43 $44,528.85 2025-01-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 22 12 — — $25,092.29 $126,109.71 $44,436.01 2025-01-01
'303-3 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 15 6 — — $41,888.67 $94,249.51 $44,401.99 2025-01-01
'401-4 APR_DRG Pituitary & Adrenal Procedures 15 6 — — $41,886.88 $94,245.48 $44,400.09 2025-01-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 22 12 — — $25,840.95 $123,131.59 $44,151.13 2025-01-01
472 MS_DRG Cervical Spinal Fusion With Cc 22 12 — — $25,728.77 $122,584.08 $43,956.37 2025-01-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 22 12 — — $25,709.23 $122,488.68 $43,922.43 2025-01-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 22 12 — — $25,673.54 $122,314.47 $43,860.47 2025-01-01
'603-2 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 15 6 — — $41,356.60 $93,052.35 $43,838.00 2025-01-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 22 12 — — $25,464.49 $121,294.12 $43,497.50 2025-01-01
'310-4 APR_DRG Intervertebral Disc Excision & Decompression 15 6 — — $41,021.90 $92,299.28 $43,483.21 2025-01-01
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