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

CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR

Plattsburgh, NY · CCN 330250 · Rates published

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You selected 93350 (CPT)

This facility hasn’t published a payer-negotiated rate for this exact code. See its full rate list below.

30,658 distinct procedures filed
39 distinct payers
2,016,888 rate rows
2026-10-12 last MRF observed
Data quality

1,389,825 of 2,016,888 rate rows are consumer-grade (68.9%)

627,063 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 620,643
per-diem day rate — not a per-procedure price 2,703
placeholder amount (≤ $0.02) — excluded from medians 1,683
exceeds 10× this hospital's gross charge — excluded from medians 1,265
template filing: same amount across many unrelated codes — excluded 423
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 170
percent-of-charges filed in the dollar field — excluded from medians 92
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 72
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 12
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.cvph.org/data/files/141338471_champlain-valley-physicians-hospital_standardcharges.csv
Found on page https://www.cvph.org/Patients-and-Visitors/Patients/Price-Transparency
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-22
Content fingerprint 5ede56a902f67b69… · 32,349,750 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
Q2054
HCPCS 		Lisocabtagene Maraleucel(cd8) 1.5x To 70x 10exp6 Cell/ml IV Susp(1of2) 17 $421,042.06 $1,479,060.60 $636,835.68 nat. median
$640,950
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel 300 X 10exp6 To 510 X 10exp6 Cell IV Suspension 17 $418,634.77 $1,470,604.14 $630,925.96 nat. median
$622,450
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Intravenous Suspension 17 $399,036.79 $1,401,759.25 $603,656.80 nat. median
$608,239
1.0× median
Q2053
HCPCS 		Brexucabtagene Autoleucel 1x 10exp6 To 1x 10exp8 Cell IV Suspension 17 $366,088.80 $1,286,017.66 $553,929.74 nat. median
$591,721
0.9× median
24
APR_DRG 		Heart &/or Lung Transplant 7 $229,325.68 $972,062.04 $515,017.16 nat. median
$241,437
outlier · 2.1×
3
OTHER 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 12 $343,817.04 $747,428.36 $511,004.95 nat. median
$204,908
outlier · 2.5×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 $380,332.57 $1,530,355.25 $421,125.57 nat. median
$359,454
1.2× median
5834
APR_DRG 		Neonate W Ecmo 7 $168,974.64 $1,698,802.92 $379,114.00 nat. median
$307,206
1.2× median
5883
APR_DRG 		Neonate Bwt <1500g W Major Procedure 7 $166,015.32 $692,924.68 $372,449.98 nat. median
$175,204
outlier · 2.1×
5884
APR_DRG 		Neonate Bwt <1500g W Major Procedure 7 $166,015.32 $1,040,616.70 $372,449.98 nat. median
$247,214
1.5× median
018
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $361,515.21 $361,515.21 $361,515.21 nat. median
$297,123
1.2× median
1614
APR_DRG 		Cardiac Defibrillator & Heart Assist Implant 7 $151,901.06 $725,511.20 $340,666.38 nat. median
$202,993
1.7× median
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $317,777.65 $317,777.65 $317,777.65 nat. median
$214,523
1.5× median
612
OTHER 		Neonate, Birth Weight <750 Grams, Discharged Alive 1 $302,797.47 $302,797.47 $302,797.47 nat. median
$1,883
outlier · 160.8×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 13 $273,293.56 $993,138.99 $300,482.91 nat. median
$249,036
1.2× median
5914
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 7 $127,608.45 $682,164.98 $285,962.39 nat. median
$162,342
1.8× median
5882
APR_DRG 		Neonate Bwt <1500g W Major Procedure 7 $127,149.64 $593,935.44 $284,929.21 nat. median
$145,061
2.0× median
5881
APR_DRG 		Neonate Bwt <1500g W Major Procedure 7 $127,149.64 $509,087.52 $284,929.21 nat. median
$120,208
outlier · 2.4×
8414
APR_DRG 		Extensive 3rd Degree Burns W Skin Graft 7 $123,439.19 $645,274.58 $277,155.95 nat. median
$155,939
1.8× median
44
APR_DRG 		Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 7 $119,071.98 $546,592.76 $266,739.32 nat. median
$122,016
outlier · 2.2×
633
OTHER 		Neonate, Birth Weight 1000-1499 Grams, With Significant O.r. Procedures, Dischar… 1 $262,342.95 $262,342.95 $262,342.95 nat. median
$6,194
outlier · 42.4×
14
APR_DRG 		Liver Transplant &/or Intestinal Transplant 7 $115,357.60 $541,059.20 $258,374.98 nat. median
$136,566
1.9× median
5934
APR_DRG 		Neonate Birthwt 750-999g Without Major Procedure 7 $114,902.07 $599,776.42 $257,349.18 nat. median
$151,838
1.7× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 13 $208,213.49 $756,640.37 $253,060.92 nat. median
$198,418
1.3× median
631
OTHER 		Neonate, Birth Weight 750-999 Grams, Discharged Alive 1 $237,939.91 $237,939.91 $237,939.91 nat. median
$5,376
outlier · 44.3×
6094
APR_DRG 		Neonate Bwt 1500-2499g W Major Procedure 7 $105,255.94 $724,896.36 $235,627.28 nat. median
$165,000
1.4× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 13 $206,991.55 $752,199.86 $228,619.74 nat. median
$190,559
1.2× median
927
OTHER 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 1 $224,480.96 $224,480.96 $224,480.96 nat. median
$2
outlier · 132829.0×
003
OTHER 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 $223,976.09 $223,976.09 $223,976.09 nat. median
$165,355
1.4× median
6024
APR_DRG 		Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 7 $99,733.20 $451,907.40 $223,190.73 nat. median
$118,620
1.9× median
23
APR_DRG 		Heart &/or Lung Transplant 7 $99,387.12 $529,377.24 $222,411.42 nat. median
$110,944
outlier · 2.0×
5833
APR_DRG 		Neonate W Ecmo 7 $96,264.60 $967,450.74 $215,379.88 nat. median
$244,017
0.9× median
5831
APR_DRG 		Neonate W Ecmo 7 $94,475.90 $666,793.98 $211,351.95 nat. median
$146,500
1.4× median
5832
APR_DRG 		Neonate W Ecmo 7 $94,475.90 $743,034.14 $211,351.95 nat. median
$159,249
1.3× median
6034
APR_DRG 		Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 7 $91,921.65 $330,476.50 $205,600.09 nat. median
$107,681
1.9× median
54
APR_DRG 		Tracheostomy W Mv 96+ Hours Without Extensive Procedure 7 $91,002.07 $380,585.96 $203,529.30 nat. median
$81,521
outlier · 2.5×
950
OTHER 		Extensive Procedure Unrelated To Principal Diagnosis 13 $24,291.28 $1,057,179.99 $201,839.33 nat. median
$5,983
outlier · 33.7×
5933
APR_DRG 		Neonate Birthwt 750-999g Without Major Procedure 7 $89,877.99 $438,688.34 $200,998.00 nat. median
$108,695
1.8× median
22
APR_DRG 		Heart &/or Lung Transplant 7 $84,816.67 $400,875.68 $189,600.54 nat. median
$92,229
outlier · 2.1×
6074
APR_DRG 		Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 7 $81,538.15 $349,229.12 $182,217.72 nat. median
$96,883
1.9× median
6304
APR_DRG 		Neonate Birthwt >2499g W Major Cardiovascular Procedure 7 $80,777.19 $632,362.94 $180,504.12 nat. median
$154,011
1.2× median
5892
APR_DRG 		Neonate Bwt <500g Or Ga <24 Weeks 7 $80,183.36 $485,108.76 $179,166.89 nat. median
$89,188
outlier · 2.0×
5891
APR_DRG 		Neonate Bwt <500g Or Ga <24 Weeks 7 $80,183.36 $485,108.76 $179,166.89 nat. median
$93,998
1.9× median
21
APR_DRG 		Heart &/or Lung Transplant 7 $79,929.05 $354,455.26 $178,594.21 nat. median
$73,922
outlier · 2.4×
004
OTHER 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 $174,907.62 $174,907.62 $174,907.62 nat. median
$118,265
1.5× median
5913
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 7 $78,059.07 $514,621.08 $174,383.26 nat. median
$101,406
1.7× median
6023
APR_DRG 		Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 7 $73,781.01 $313,875.82 $164,749.58 nat. median
$88,008
1.9× median
5932
APR_DRG 		Neonate Birthwt 750-999g Without Major Procedure 7 $73,649.92 $352,918.16 $164,454.39 nat. median
$85,331
1.9× median
870
OTHER 		Septicemia Or Severe Sepsis With Mv >96 Hours 13 $74,897.08 $211,881.35 $164,015.42 nat. median
$724
outlier · 226.4×
5912
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 7 $72,862.08 $441,455.12 $162,680.27 nat. median
$82,129
2.0× median

Other procedures at this hospital

Browse this hospital's 30,658 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
             
Q2054 HCPCS Lisocabtagene Maraleucel(cd8) 1.5x To 70x 10exp6 Cell/ml IV Susp(1of2) 30 17 $1,503,721.63 $1,503,721.63 $421,042.06 $1,479,060.60 $636,835.68 2026-10-12
Q2055 HCPCS Idecabtagene Vicleucel 300 X 10exp6 To 510 X 10exp6 Cell IV Suspension 30 17 $1,495,124.18 $1,495,124.18 $418,634.77 $1,470,604.14 $630,925.96 2026-10-12
Q2041 HCPCS Axicabtagene Ciloleucel Intravenous Suspension 30 17 $1,425,131.40 $1,425,131.40 $399,036.79 $1,401,759.25 $603,656.80 2026-10-12
Q2053 HCPCS Brexucabtagene Autoleucel 1x 10exp6 To 1x 10exp8 Cell IV Suspension 30 17 $1,307,460.00 $1,307,460.00 $366,088.80 $1,286,017.66 $553,929.74 2026-10-12
24 APR_DRG Heart &/or Lung Transplant 33 7 — — $229,325.68 $972,062.04 $515,017.16 2026-10-12
3 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 26 12 $879,327.48 — $343,817.04 $747,428.36 $511,004.95 2026-05-23
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 44 13 — — $380,332.57 $1,530,355.25 $421,125.57 2026-10-12
5834 APR_DRG Neonate W Ecmo 33 7 — — $168,974.64 $1,698,802.92 $379,114.00 2026-10-12
5883 APR_DRG Neonate Bwt <1500g W Major Procedure 33 7 — — $166,015.32 $692,924.68 $372,449.98 2026-10-12
5884 APR_DRG Neonate Bwt <1500g W Major Procedure 33 7 — — $166,015.32 $1,040,616.70 $372,449.98 2026-10-12
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $361,515.21 $361,515.21 $361,515.21 2026-10-12
1614 APR_DRG Cardiac Defibrillator & Heart Assist Implant 33 7 — — $151,901.06 $725,511.20 $340,666.38 2026-10-12
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $317,777.65 $317,777.65 $317,777.65 2026-10-12
612 OTHER Neonate, Birth Weight <750 Grams, Discharged Alive 1 1 — — $302,797.47 $302,797.47 $302,797.47 2026-10-12
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 42 13 — — $273,293.56 $993,138.99 $300,482.91 2026-10-12
5914 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 33 7 — — $127,608.45 $682,164.98 $285,962.39 2026-10-12
5881 APR_DRG Neonate Bwt <1500g W Major Procedure 33 7 — — $127,149.64 $509,087.52 $284,929.21 2026-10-12
5882 APR_DRG Neonate Bwt <1500g W Major Procedure 33 7 — — $127,149.64 $593,935.44 $284,929.21 2026-10-12
8414 APR_DRG Extensive 3rd Degree Burns W Skin Graft 32 7 — — $123,439.19 $645,274.58 $277,155.95 2026-10-12
44 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 33 7 — — $119,071.98 $546,592.76 $266,739.32 2026-10-12
633 OTHER Neonate, Birth Weight 1000-1499 Grams, With Significant O.r. Procedures, Dischar… 1 1 — — $262,342.95 $262,342.95 $262,342.95 2026-10-12
14 APR_DRG Liver Transplant &/or Intestinal Transplant 33 7 — — $115,357.60 $541,059.20 $258,374.98 2026-10-12
5934 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 33 7 — — $114,902.07 $599,776.42 $257,349.18 2026-10-12
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 44 13 — — $208,213.49 $756,640.37 $253,060.92 2026-10-12
631 OTHER Neonate, Birth Weight 750-999 Grams, Discharged Alive 1 1 — — $237,939.91 $237,939.91 $237,939.91 2026-10-12
6094 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 33 7 — — $105,255.94 $724,896.36 $235,627.28 2026-10-12
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 44 13 — — $206,991.55 $752,199.86 $228,619.74 2026-10-12
927 OTHER Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 1 1 — — $224,480.96 $224,480.96 $224,480.96 2026-10-12
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $223,976.09 $223,976.09 $223,976.09 2026-10-12
6024 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 33 7 — — $99,733.20 $451,907.40 $223,190.73 2026-10-12
23 APR_DRG Heart &/or Lung Transplant 33 7 — — $99,387.12 $529,377.24 $222,411.42 2026-10-12
5833 APR_DRG Neonate W Ecmo 33 7 — — $96,264.60 $967,450.74 $215,379.88 2026-10-12
5831 APR_DRG Neonate W Ecmo 33 7 — — $94,475.90 $666,793.98 $211,351.95 2026-10-12
5832 APR_DRG Neonate W Ecmo 33 7 — — $94,475.90 $743,034.14 $211,351.95 2026-10-12
6034 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 33 7 — — $91,921.65 $330,476.50 $205,600.09 2026-10-12
54 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 33 7 — — $91,002.07 $380,585.96 $203,529.30 2026-10-12
950 OTHER Extensive Procedure Unrelated To Principal Diagnosis 27 13 $1,243,741.16 — $24,291.28 $1,057,179.99 $201,839.33 2026-10-12
5933 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 33 7 — — $89,877.99 $438,688.34 $200,998.00 2026-10-12
22 APR_DRG Heart &/or Lung Transplant 33 7 — — $84,816.67 $400,875.68 $189,600.54 2026-10-12
6074 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 33 7 — — $81,538.15 $349,229.12 $182,217.72 2026-10-12
6304 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 33 7 — — $80,777.19 $632,362.94 $180,504.12 2026-10-12
5891 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 33 7 — — $80,183.36 $485,108.76 $179,166.89 2026-10-12
5892 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 33 7 — — $80,183.36 $485,108.76 $179,166.89 2026-10-12
21 APR_DRG Heart &/or Lung Transplant 33 7 — — $79,929.05 $354,455.26 $178,594.21 2026-10-12
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $174,907.62 $174,907.62 $174,907.62 2026-10-12
5913 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 33 7 — — $78,059.07 $514,621.08 $174,383.26 2026-10-12
6023 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 33 7 — — $73,781.01 $313,875.82 $164,749.58 2026-10-12
5932 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 33 7 — — $73,649.92 $352,918.16 $164,454.39 2026-10-12
870 OTHER Septicemia Or Severe Sepsis With Mv >96 Hours 27 13 $249,272.17 — $74,897.08 $211,881.35 $164,015.42 2026-10-12
5912 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 33 7 — — $72,862.08 $441,455.12 $162,680.27 2026-10-12
3034 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 33 7 — — $72,027.05 $278,522.52 $160,799.88 2026-10-12
5931 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 33 7 — — $71,426.01 $268,685.08 $159,446.41 2026-10-12
636 OTHER Neonate, Birth Weight 1500-1999 Grams, With Significant O.r. Procedures, With Mu… 1 1 — — $159,218.93 $159,218.93 $159,218.93 2026-10-12
34 APR_DRG Bone Marrow Transplant 24 6 — — $147,506.32 $363,040.36 $158,116.45 2026-10-12
8413 APR_DRG Extensive 3rd Degree Burns W Skin Graft 32 7 — — $96,595.60 $237,210.73 $157,809.27 2026-10-12
651 OTHER Neonate, Birth Weight 2000-2499 Grams, With Significant O.r. Procedures, With Mu… 1 1 — — $156,753.33 $156,753.33 $156,753.33 2026-10-12
6314 APR_DRG Neonate Birthwt >2499g W Other Major Procedure 33 7 — — $69,529.16 $697,228.56 $155,174.95 2026-10-12
4404 APR_DRG Kidney Transplant 33 7 — — $68,681.68 $273,911.22 $153,266.51 2026-10-12
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 44 13 — — $135,081.07 $490,879.76 $150,730.56 2026-10-12
43 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 33 7 — — $66,626.87 $376,896.92 $148,639.34 2026-10-12
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 33 7 — — $65,796.43 $416,554.10 $146,769.28 2026-10-12
1613 APR_DRG Cardiac Defibrillator & Heart Assist Implant 33 7 — — $65,112.80 $568,112.16 $145,229.84 2026-10-12
6022 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 33 7 — — $62,782.05 $250,854.72 $139,981.28 2026-10-12
14 MS_DRG Allogeneic Bone Marrow Transplant 44 13 — — $117,200.48 $425,902.36 $139,762.32 2026-10-12
7 MS_DRG Lung Transplant 42 13 — — $126,292.42 $458,942.14 $139,410.31 2026-10-12
1624 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 33 7 — — $62,131.20 $279,752.20 $138,515.64 2026-10-12
209 MS_DRG Complex Aortic Arch Procedures 16 11 — — $110,382.75 $401,126.95 $137,978.44 2026-10-12
53 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 33 7 — — $61,134.93 $276,370.58 $136,272.16 2026-10-12
276 OTHER Cardiac Defibrillator Implant With Mcc 27 13 $164,913.99 — $34,984.36 $181,648.35 $135,382.36 2026-10-12
6073 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 33 7 — — $60,586.98 $239,480.18 $135,038.25 2026-10-12
007 OTHER Lung Transplant 1 1 — — $134,428.47 $134,428.47 $134,428.47 2026-10-12
6804 APR_DRG Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 32 7 — — $59,257.75 $203,204.62 $129,843.16 2026-10-12
7404 APR_DRG Mental Illness Diagnosis W O.r. Procedure 12 6 — — $21,786.81 $172,155.20 $129,389.74 2026-10-12
8424 APR_DRG Burns With Skin Graft Except Extensive 3rd Degree Burns 32 7 — — $57,235.06 $361,218.50 $128,134.50 2026-10-12
981 OTHER Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 27 13 $401,144.42 — $46,351.87 $340,972.76 $127,915.31 2026-10-12
J7330 HCPCS Graft Cartilage Membrane Collagen Maci 3 X 5cm St 16 11 $158,963.93 $158,963.93 $44,509.90 $156,484.09 $125,422.54 2026-10-12
6124 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 33 7 — — $56,159.48 $228,720.48 $125,068.05 2026-10-12
3044 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 33 7 — — $60,803.93 $196,441.38 $124,648.06 2026-10-12
13 APR_DRG Liver Transplant &/or Intestinal Transplant 33 7 — — $55,457.50 $280,981.88 $123,487.28 2026-10-12
365 OTHER Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 1 — — $122,797.64 $122,797.64 $122,797.64 2026-10-12
6033 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 33 7 — — $59,468.80 $187,218.78 $121,911.04 2026-10-12
6814 APR_DRG Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 32 7 — — $59,420.95 $170,003.26 $121,251.55 2026-10-12
6114 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 33 7 — — $54,455.99 $290,511.90 $121,231.99 2026-10-12
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses 33 7 — — $59,624.80 $169,695.84 $120,471.90 2026-10-12
6904 APR_DRG Acute Leukemia 32 7 — — $57,991.44 $181,685.22 $119,559.85 2026-10-12
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $119,143.29 $119,143.29 $119,143.29 2026-10-12
853 OTHER Infectious And Parasitic Diseases With O.r. Procedures With Mcc 27 13 $199,218.85 — $40,934.76 $169,336.02 $118,379.19 2026-10-12
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 42 13 — — $110,509.53 $401,587.66 $117,551.70 2026-10-12
356 OTHER Other Digestive System O.r. Procedures With Mcc 27 13 $310,534.61 — $31,479.68 $263,954.42 $117,508.35 2026-10-12
3614 APR_DRG Skin Graft For Skin & Subcutaneous Tissue Diagnoses 33 7 — — $63,545.64 $165,084.54 $117,198.21 2026-10-12
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 44 13 — — $106,045.96 $385,367.23 $116,209.75 2026-10-12
207 OTHER Other Circulatory System Diagnoses 27 13 $254,269.70 — $62,110.65 $216,129.24 $114,983.66 2026-10-12
014 OTHER Allogeneic Bone Marrow Transplant 1 1 — — $114,747.28 $114,747.28 $114,747.28 2026-10-12
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 42 13 — — $100,549.65 $365,393.81 $113,601.55 2026-10-12
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $113,538.63 $113,538.63 $113,538.63 2026-10-12
8504 APR_DRG Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service 32 7 — — $50,608.55 $189,370.72 $113,218.64 2026-10-12
215 MS_DRG Other Heart Assist System Implant 44 13 — — $97,102.26 $352,866.12 $113,019.12 2026-10-12
64 APR_DRG Pancreas Transplant 33 7 — — $50,688.51 $353,533.00 $112,748.10 2026-10-12
9124 APR_DRG Musculoskeletal & Other Procedures For Multiple Significant Trauma 32 7 — — $50,280.17 $184,759.42 $112,479.48 2026-10-12
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 44 13 — — $105,644.12 $390,580.31 $111,745.42 2026-10-12
6072 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 33 7 — — $49,636.53 $178,918.44 $110,379.16 2026-10-12
9504 APR_DRG Extensive Procedure Unrelated To Principal Diagnosis 32 7 — — $53,804.48 $164,162.28 $110,299.18 2026-10-12
329 OTHER Major Small And Large Bowel Procedures With Mcc 27 13 $143,565.82 — $33,967.06 $134,564.00 $110,264.27 2026-10-12
234 APR_DRG Spinal Procedures 33 7 — — $53,593.43 $172,462.62 $109,866.53 2026-10-12
634 OTHER Neonate, Birth Weight 1000-1499 Grams, Without Significant O.r. Procedures, Disc… 1 1 — — $109,767.78 $109,767.78 $109,767.78 2026-10-12
2604 APR_DRG Major Pancreas, Liver & Shunt Procedures 33 7 — — $49,296.36 $176,459.08 $109,613.13 2026-10-12
710 OTHER Infectious & Parasitic Diseases Including HIV W O.r. Procedure 27 13 $177,849.91 — $14,076.53 $151,172.43 $109,201.86 2026-10-12
163 OTHER Major Chest Procedures With Mcc 27 13 $135,048.46 — $41,018.11 $140,156.06 $108,038.76 2026-10-12
63 APR_DRG Pancreas Transplant 33 7 — — $48,560.30 $272,374.12 $107,955.62 2026-10-12
6093 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 33 7 — — $48,356.45 $251,469.56 $107,496.59 2026-10-12
6954 APR_DRG Chemotherapy For Acute Leukemia # 32 7 — — $49,036.15 $167,236.48 $107,037.71 2026-10-12
214 APR_DRG Craniotomy Except For Trauma 33 7 — — $48,083.13 $189,370.72 $106,881.11 2026-10-12
9104 APR_DRG Craniotomy For Multiple Significant Trauma 32 7 — — $47,697.08 $209,045.60 $106,665.10 2026-10-12
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $106,405.17 $106,405.17 $106,405.17 2026-10-12
A9699 HCPCS Hc - Lu-177 Pluvicto (lutetium Lu 177 Vipvotide Tetraxtean) 16 11 $132,904.00 $132,904.00 $37,213.12 $130,830.70 $106,190.29 2026-10-12
42 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 33 7 — — $47,737.06 $240,709.86 $106,101.80 2026-10-12
1694 APR_DRG Major Abdominal Vascular Procedures 33 7 — — $47,699.70 $174,921.98 $106,017.66 2026-10-12
6084 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 33 7 — — $47,696.42 $199,208.16 $106,010.28 2026-10-12
41 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 33 7 — — $47,737.06 $166,621.64 $104,662.04 2026-10-12
2204 APR_DRG Major Stomach, Esophageal & Duodenal Procedures 33 7 — — $47,075.72 $167,543.90 $104,612.54 2026-10-12
1654 APR_DRG Coronary Bypass W Ami Or Complex Pdx 33 7 — — $47,002.97 $220,112.72 $104,448.71 2026-10-12
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Pdx 33 7 — — $46,808.96 $245,013.74 $104,011.82 2026-10-12
901 OTHER Wound Debridements For Injuries With Mcc 27 13 $222,542.30 — $44,123.08 $189,160.96 $103,728.71 2026-10-12
802 OTHER Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 1 1 — — $103,543.64 $103,543.64 $103,543.64 2026-10-12
3033 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 33 7 — — $46,422.25 $193,367.18 $103,140.99 2026-10-12
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 44 13 — — $95,403.43 $346,692.65 $102,952.27 2026-10-12
632 OTHER Neonate, Birth Weight 750-999 Grams, Died 1 1 — — $101,694.68 $101,694.68 $101,694.68 2026-10-12
5124 APR_DRG Uterine & Adnexa Procedures For Non-ovarian & Non-adnexal Malig 33 7 — — $49,800.39 $142,642.88 $101,266.24 2026-10-12
6083 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 33 7 — — $45,344.70 $171,847.78 $100,714.49 2026-10-12
894 APR_DRG Major Cranial/facial Bone Procedures 33 7 — — $45,311.93 $165,084.54 $100,640.69 2026-10-12
6240000051 CDM Intrepid Transcatheter Valve Replacement Bioprosthesis 42mm 18 13 $127,350.00 $127,350.00 $35,658.00 $125,363.34 $100,479.15 2026-10-12
6214 APR_DRG Neonate Bwt 2000-2499g W Major Anomaly 33 7 — — $45,138.24 $224,416.60 $100,249.56 2026-10-12
924 APR_DRG Facial Bone Procedures Except Major Cranial/facial Bone Procedures 33 7 — — $48,817.23 $157,399.04 $100,075.32 2026-10-12
4054 APR_DRG Other Procedures For Endocrine, Nutritional & Metabolic Disorders 33 7 — — $55,599.08 $140,183.52 $99,520.27 2026-10-12
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $98,750.74 $98,750.74 $98,750.74 2026-10-12
204 APR_DRG Craniotomy For Trauma 33 7 — — $44,469.03 $165,391.96 $98,742.59 2026-10-12
850 MS_DRG Acute Leukemia With Other Procedures 44 13 — — $84,448.83 $306,884.02 $98,267.15 2026-10-12
4014 APR_DRG Pituitary & Adrenal Procedures 33 7 — — $46,420.28 $156,169.36 $98,096.53 2026-10-12
1674 APR_DRG Other Cardiothoracic & Thoracic Vascular Procedures 33 7 — — $44,083.63 $215,501.42 $97,874.72 2026-10-12
4414 APR_DRG Major Bladder Procedures 33 7 — — $44,949.47 $154,017.42 $96,744.80 2026-10-12
9114 APR_DRG Extensive Abdominal/thoracic Procedures For Mult Significant Trauma 32 7 — — $43,160.12 $198,900.74 $96,452.68 2026-10-12
8412 APR_DRG Extensive 3rd Degree Burns W Skin Graft 32 7 — — $47,037.71 $137,416.74 $96,427.31 2026-10-12
3214 APR_DRG Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp 33 7 — — $46,921.69 $147,869.02 $96,189.46 2026-10-12
6032 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 33 7 — — $45,835.63 $152,787.74 $95,972.39 2026-10-12
6021 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 33 7 — — $43,175.85 $186,911.36 $95,830.50 2026-10-12
429 OTHER Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 1 1 — — $94,727.93 $94,727.93 $94,727.93 2026-10-12
8120000001 CDM Hc - Cadaver Kidney Acquisitio 18 13 $120,000.00 $120,000.00 $33,600.00 $118,128.00 $94,680.00 2026-10-12
8110000001 CDM Hc - Live Kidney Acquisition 18 13 $120,000.00 $120,000.00 $33,600.00 $118,128.00 $94,680.00 2026-10-12
166 OTHER Other Respiratory System O.r. Procedures With Mcc 27 13 $233,658.23 — $38,288.24 $198,609.49 $94,125.53 2026-10-12
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $93,636.74 $93,636.74 $93,636.74 2026-10-12
6123 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 33 7 — — $42,194.65 $158,628.72 $93,620.97 2026-10-12
4474 APR_DRG Other Kidney, Urinary Tract & Related Procedures 33 7 — — $50,634.11 $131,575.76 $93,409.37 2026-10-12
6113 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 33 7 — — $41,688.65 $154,939.68 $92,481.52 2026-10-12
270 OTHER Other Major Cardiovascular Procedures With Mcc 27 13 $57,943.42 — $4,248.25 $149,427.18 $92,041.87 2026-10-12
1664 APR_DRG Coronary Bypass Without Ami Or Complex Pdx 33 7 — — $41,461.87 $196,133.96 $91,970.83 2026-10-12
5114 APR_DRG Uterine & Adnexa Procedures For Ovarian & Adnexal Malignancy 33 7 — — $41,430.41 $149,098.70 $91,899.98 2026-10-12
11 APR_DRG Liver Transplant &/or Intestinal Transplant 33 7 — — $41,016.83 $190,600.40 $90,968.64 2026-10-12
12 APR_DRG Liver Transplant &/or Intestinal Transplant 33 7 — — $41,016.83 $217,038.52 $90,968.64 2026-10-12
2614 APR_DRG Major Biliary Tract Procedures 33 7 — — $40,868.04 $164,162.28 $90,633.60 2026-10-12
1612 APR_DRG Cardiac Defibrillator & Heart Assist Implant 33 7 — — $40,782.83 $418,091.20 $90,441.72 2026-10-12
231 MS_DRG Coronary Bypass With Ptca With Mcc 44 13 — — $82,209.73 $298,747.23 $90,394.61 2026-10-12
1814 APR_DRG Lower Extremity Arterial Procedures # 33 7 — — $43,987.28 $143,872.56 $90,372.39 2026-10-12
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 44 13 — — $81,951.30 $297,808.09 $90,344.46 2026-10-12
7104 APR_DRG Infectious & Parasitic Diseases Including HIV W O.r. Procedure 32 7 — — $42,046.52 $139,568.68 $90,016.96 2026-10-12
1204 APR_DRG Major Respiratory & Chest Procedures 33 7 — — $40,541.63 $170,310.68 $89,898.56 2026-10-12
4034 APR_DRG Procedures For Obesity 33 7 — — $43,726.42 $138,031.58 $89,639.16 2026-10-12
1304 APR_DRG Respiratory System Diagnosis W Ventilator Support 96+ Hours 33 7 — — $40,423.65 $168,158.74 $89,632.89 2026-10-12
L8688 HCPCS Generator Neurostimulator Sentiva Duo Epilepsy Vagus Nerve Permanent Ti MRI Comp… 16 11 $113,548.09 $113,548.09 $31,793.47 $111,776.74 $89,589.45 2026-10-12
876 OTHER O.r. Procedures With Principal Diagnosis Of Mental Illness 27 13 $183,946.40 — $40,652.49 $156,354.44 $89,436.59 2026-10-12
1214 APR_DRG Other Respiratory & Chest Procedures 33 7 — — $40,320.75 $142,642.88 $89,401.16 2026-10-12
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 44 13 — — $84,114.71 $319,291.21 $88,972.62 2026-10-12
J2326 HCPCS Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution 28 17 $233,288.60 $233,288.60 $1,296.18 $229,649.30 $88,649.67 2026-10-12
231 OTHER Coronary Bypass With Ptca With Mcc 1 1 — — $88,632.61 $88,632.61 $88,632.61 2026-10-12
275 OTHER Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 1 1 — — $88,346.56 $88,346.56 $88,346.56 2026-10-12
2644 APR_DRG Other Hepatobiliary, Pancreas & Abdominal Procedures 33 7 — — $40,959.80 $139,876.10 $87,862.05 2026-10-12
6303 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 33 7 — — $39,458.19 $348,614.28 $87,458.78 2026-10-12
7114 APR_DRG Post-op, Post-trauma, Other Device Infections W O.r. Procedure 32 7 — — $40,181.79 $135,879.64 $87,219.98 2026-10-12
4424 APR_DRG Kidney & Urinary Tract Procedures For Malignancy 33 7 — — $42,410.29 $130,960.92 $86,941.09 2026-10-12
3134 APR_DRG Knee & Lower Leg Procedures Except Foot 33 7 — — $43,035.58 $122,045.74 $86,643.74 2026-10-12
52 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 33 7 — — $38,921.38 $184,144.58 $86,249.96 2026-10-12
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 44 13 — — $76,737.80 $278,862.40 $85,991.08 2026-10-12
673 OTHER Other Kidney And Urinary Tract Procedures With Mcc 27 13 $127,209.57 — $37,798.53 $108,128.13 $85,699.98 2026-10-12
264 APR_DRG Other Nervous System & Related Procedures 33 7 — — $41,754.85 $134,342.54 $85,597.44 2026-10-12
9514 APR_DRG Moderately Extensive Procedure Unrelated To Principal Diagnosis 32 7 — — $41,749.61 $128,808.98 $85,586.70 2026-10-12
1824 APR_DRG Other Peripheral Vascular Procedures # 33 7 — — $41,729.29 $124,505.10 $85,545.04 2026-10-12
10 MS_DRG Pancreas Transplant 42 13 — — $69,978.57 $254,299.63 $85,051.30 2026-10-12
1623 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 33 7 — — $38,220.71 $204,741.72 $84,672.14 2026-10-12
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 42 13 — — $69,577.76 $252,843.09 $84,563.80 2026-10-12
4444 APR_DRG Renal Dialysis Access Device Procedure Only 33 7 — — $41,164.95 $123,275.42 $84,388.15 2026-10-12
6914 APR_DRG Lymphoma, Myeloma & Non-acute Leukemia 32 7 — — $42,127.80 $114,360.24 $83,774.79 2026-10-12
4403 APR_DRG Kidney Transplant 33 7 — — $37,799.27 $186,296.52 $83,723.09 2026-10-12
33 APR_DRG Bone Marrow Transplant 24 6 — — $78,113.47 $191,530.79 $83,571.96 2026-10-12
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 44 13 — — $74,557.21 $270,938.24 $83,380.78 2026-10-12
3054 APR_DRG Amputation Of Lower Limb Except Toes 33 7 — — $41,924.61 $117,434.44 $83,370.05 2026-10-12
6504 APR_DRG Splenectomy 32 7 — — $37,999.83 $129,731.24 $82,832.18 2026-10-12
6903 APR_DRG Acute Leukemia 32 7 — — $40,358.76 $122,660.58 $82,735.46 2026-10-12
5194 APR_DRG Uterine & Adnexa Procedures For Leiomyoma 33 7 — — $40,266.35 $120,816.06 $82,546.02 2026-10-12
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 44 13 — — $74,880.01 $272,111.27 $82,539.12 2026-10-12
6071 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 33 7 — — $40,216.53 $127,886.72 $82,443.89 2026-10-12
5184 APR_DRG Other Female Reproductive System & Related Procedures 33 7 — — $39,801.64 $123,275.42 $81,593.36 2026-10-12
244 APR_DRG Extracranial Vascular Procedures 33 7 — — $45,148.07 $114,667.66 $81,405.83 2026-10-12
1714 APR_DRG Perm Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock 33 7 — — $39,709.22 $117,434.44 $81,403.90 2026-10-12
9524 APR_DRG Nonextensive Procedure Unrelated To Principal Diagnosis 32 7 — — $39,498.17 $117,127.02 $80,971.25 2026-10-12
434 APR_DRG Multiple Sclerosis & Other Demyelinating Diseases 33 7 — — $39,407.06 $126,657.04 $80,784.47 2026-10-12
3104 APR_DRG Intervertebral Disc Excision & Decompression 33 7 — — $45,466.61 $113,437.98 $80,532.85 2026-10-12
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $80,283.88 $80,283.88 $80,283.88 2026-10-12
8411 APR_DRG Extensive 3rd Degree Burns W Skin Graft 32 7 — — $35,796.24 $137,416.74 $79,877.03 2026-10-12
987 OTHER Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 27 13 $124,542.93 — $35,426.71 $105,861.49 $79,768.30 2026-10-12
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 44 13 — — $74,310.48 $270,041.64 $79,623.70 2026-10-12
224 APR_DRG Ventricular Shunt Procedures 33 7 — — $35,931.91 $147,869.02 $79,518.05 2026-10-12
904 APR_DRG Major Larynx & Trachea Procedures 24 6 — — $74,228.68 $181,929.22 $79,398.76 2026-10-12
467 OTHER Revision Of Hip Or Knee Replacement With Cc 27 13 $99,203.75 — $36,549.16 $105,377.03 $79,363.00 2026-10-12
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 1 — — $79,231.53 $79,231.53 $79,231.53 2026-10-12
2294 APR_DRG Other Digestive System & Abdominal Procedures 33 7 — — $38,549.09 $123,582.84 $79,025.63 2026-10-12
6334 APR_DRG Neonate Birthwt >2499g W Major Anomaly 33 7 — — $35,711.69 $228,413.06 $79,022.12 2026-10-12
8634 APR_DRG Neonatal Aftercare 32 7 — — $35,351.85 $284,056.08 $78,876.74 2026-10-12
1774 APR_DRG Cardiac Pacemaker & Defibrillator Revision Except Device Replacement 33 7 — — $42,139.60 $110,978.62 $78,786.88 2026-10-12
3043 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 33 7 — — $35,539.30 $144,794.82 $78,633.94 2026-10-12
3094 APR_DRG Other Significant Hip And Femur Surgery 33 7 — — $38,275.77 $121,430.90 $78,465.33 2026-10-12
7594 APR_DRG Eating Disorders 12 6 — — $15,232.04 $104,215.38 $78,327.00 2026-10-12
3032 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 33 7 — — $35,282.37 $140,490.94 $78,055.36 2026-10-12
2224 APR_DRG Other Stomach, Esophageal & Duodenal Procedures 33 7 — — $36,892.13 $124,197.68 $78,013.77 2026-10-12
579 OTHER Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 27 13 $112,388.42 — $18,914.90 $95,530.16 $77,822.90 2026-10-12
6082 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 33 7 — — $37,888.41 $118,971.54 $77,671.24 2026-10-12
850 OTHER Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service 27 13 $99,069.59 — $38,736.21 $94,691.03 $77,591.61 2026-10-12
269 OTHER Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 27 13 $91,199.87 — $4,598.72 $124,316.73 $77,519.89 2026-10-12
449 OTHER Endovascular Abdominal Aorta With Iliac Branch Procedures 1 1 — — $77,308.68 $77,308.68 $77,308.68 2026-10-12
447 OTHER Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 1 1 — — $77,048.20 $77,048.20 $77,048.20 2026-10-12
3174 APR_DRG Tendon, Muscle & Other Soft Tissue Procedures 33 7 — — $42,030.79 $108,519.26 $77,040.91 2026-10-12
6134 APR_DRG Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 33 7 — — $34,559.42 $287,745.12 $76,427.36 2026-10-12
6224 APR_DRG Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond 33 7 — — $34,499.78 $148,483.86 $76,293.04 2026-10-12
2234 APR_DRG Other Small & Large Bowel Procedures 33 7 — — $37,183.81 $118,664.12 $76,226.81 2026-10-12
2244 APR_DRG Peritoneal Adhesiolysis 33 7 — — $37,118.92 $116,819.60 $76,093.79 2026-10-12
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 44 13 — — $70,396.94 $255,819.97 $75,767.44 2026-10-12
242 OTHER Major Esophageal Disorders 27 13 $147,299.09 — $33,601.43 $125,204.23 $75,620.59 2026-10-12
010 OTHER Pancreas Transplant 1 1 — — $75,445.52 $75,445.52 $75,445.52 2026-10-12
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 44 13 — — $69,536.80 $252,694.25 $75,386.60 2026-10-12
3154 APR_DRG Shoulder, Upper Arm & Forearm Procedures Except Joint Replacement 33 7 — — $34,266.44 $119,586.38 $75,117.22 2026-10-12
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 1 — — $75,013.59 $75,013.59 $75,013.59 2026-10-12
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $74,949.18 $74,949.18 $74,949.18 2026-10-12
2274 APR_DRG Hernia Procedures Except Inguinal, Femoral & Umbilical 33 7 — — $35,186.02 $119,278.96 $74,924.12 2026-10-12
840 OTHER Lymphoma And Non-acute Leukemia With Mcc 27 13 $141,148.85 — $37,995.56 $119,976.52 $74,643.06 2026-10-12
61 APR_DRG Pancreas Transplant 33 7 — — $33,755.19 $163,240.02 $74,616.34 2026-10-12
62 APR_DRG Pancreas Transplant 33 7 — — $33,755.19 $234,868.88 $74,616.34 2026-10-12
6133 APR_DRG Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 33 7 — — $33,704.73 $155,554.52 $74,502.69 2026-10-12
4234 APR_DRG Inborn Errors Of Metabolism 33 7 — — $36,264.88 $116,819.60 $74,343.00 2026-10-12
6143 APR_DRG Neonate Bwt 1500-1999g W Or Without Other Significant Condition 33 7 — — $33,628.69 $129,731.24 $74,331.48 2026-10-12
6144 APR_DRG Neonate Bwt 1500-1999g W Or Without Other Significant Condition 33 7 — — $33,628.69 $192,137.50 $74,331.48 2026-10-12
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 44 13 — — $67,404.98 $244,947.28 $74,207.87 2026-10-12
7584 APR_DRG Behavioral Disorders 12 6 — — $8,142.33 $98,681.82 $74,168.04 2026-10-12
37 OTHER Extracranial Procedures With Mcc 26 12 $89,342.78 — $34,933.03 $98,736.30 $73,588.08 2026-05-23
504 APR_DRG Non-bacterial Infections Of Nervous System Exc Viral Meningitis 33 7 — — $35,663.18 $117,127.02 $73,572.40 2026-10-12
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 1 — — $73,288.71 $73,288.71 $73,288.71 2026-10-12
360 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 1 1 — — $72,852.99 $72,852.99 $72,852.99 2026-10-12
955 MS_DRG Craniotomy For Multiple Significant Trauma 44 13 — — $65,642.76 $238,543.45 $72,840.30 2026-10-12
1754 APR_DRG Percutaneous Coronary Intervention Without Ami 33 7 — — $32,806.77 $132,805.44 $72,480.61 2026-10-12
616 OTHER Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 27 13 $57,693.84 — $22,558.29 $112,937.18 $72,087.47 2026-10-12
011 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 1 1 — — $72,041.23 $72,041.23 $72,041.23 2026-10-12
6313 APR_DRG Neonate Birthwt >2499g W Other Major Procedure 33 7 — — $32,579.33 $205,049.14 $71,968.44 2026-10-12
1653 APR_DRG Coronary Bypass W Ami Or Complex Pdx 33 7 — — $32,483.64 $163,547.44 $71,752.95 2026-10-12
647 OTHER Neonate, Birth Weight 1500-1999 Grams, Without Significant O.r. Procedures, With… 1 1 — — $71,712.55 $71,712.55 $71,712.55 2026-10-12
464 OTHER Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 27 13 $93,331.23 — $34,087.35 $87,514.05 $71,710.66 2026-10-12
659 OTHER Kidney And Ureter Procedures For Non-neoplasm With Mcc 27 13 $269,807.92 — $16,810.19 $229,336.73 $71,673.59 2026-10-12
494 APR_DRG Bacterial & Tuberculous Infections Of Nervous System 33 7 — — $39,733.47 $100,833.76 $71,584.75 2026-10-12
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 44 13 — — $65,160.03 $236,789.22 $71,521.82 2026-10-12
3204 APR_DRG Other Musculoskeletal System & Connective Tissue Procedures 33 7 — — $33,415.68 $113,437.98 $71,255.15 2026-10-12
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 44 13 — — $67,356.53 $254,193.32 $71,246.59 2026-10-12
1804 APR_DRG Other Circulatory System Procedures 33 7 — — $32,206.39 $118,356.70 $71,128.61 2026-10-12
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 44 13 — — $67,074.38 $243,745.90 $71,126.05 2026-10-12
1704 APR_DRG Permanent Cardiac Pacemaker Implant W Ami, Heart Failure Or Shock 33 7 — — $32,163.13 $144,179.98 $71,031.20 2026-10-12
169 OTHER Major Abdominal Vascular Procedures 27 13 $128,072.37 — $4,216.05 $108,861.51 $70,998.73 2026-10-12
5134 APR_DRG Uterine & Adnexa Procedures For Non-malignancy Except Leiomyoma 33 7 — — $32,091.69 $120,201.22 $70,870.32 2026-10-12
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 33 7 — — $31,950.77 $193,059.76 $70,552.99 2026-10-12
4434 APR_DRG Kidney & Urinary Tract Procedures For Nonmalignancy 33 7 — — $33,836.47 $111,900.88 $70,289.64 2026-10-12
480 OTHER Hip And Femur Procedures Except Major Joint With Mcc 27 13 $87,242.45 — $34,111.80 $86,672.14 $69,793.96 2026-10-12
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 16 11 — — $55,654.60 $202,246.83 $69,568.25 2026-10-12
366 OTHER Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 1 — — $69,287.68 $69,287.68 $69,287.68 2026-10-12
218 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $69,133.29 $69,133.29 $69,133.29 2026-10-12
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 44 13 — — $62,752.22 $228,039.33 $68,988.31 2026-10-12
321 OTHER Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 27 13 $99,831.00 — $27,432.24 $84,856.35 $68,900.81 2026-10-12
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 44 13 — — $64,123.38 $233,022.06 $68,889.08 2026-10-12
573 OTHER Skin Graft For Skin Ulcer Or Cellulitis With Mcc 1 1 — — $68,882.28 $68,882.28 $68,882.28 2026-10-12
51 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 33 7 — — $37,954.60 $96,837.30 $68,747.55 2026-10-12
4402 APR_DRG Kidney Transplant 33 7 — — $31,067.89 $158,628.72 $68,564.85 2026-10-12
846 OTHER Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 27 13 $314,247.44 — $22,178.99 $267,110.32 $67,913.87 2026-10-12
3084 APR_DRG Hip And Femur Fracture Repair 33 7 — — $38,431.11 $95,607.62 $67,874.57 2026-10-12
2780000040 CDM Clip Mitra G4 Clip System Must Be Ordered With 1 Or 2 Or 3 Delivery System St 35 13 $84,900.00 $84,900.00 $23,772.00 $91,933.12 $67,614.36 2026-10-12
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 44 13 — — $59,695.90 $216,932.75 $67,463.93 2026-10-12
3644 APR_DRG Other Skin, Subcutaneous Tissue & Related Procedures 33 7 — — $35,419.36 $94,685.36 $67,219.83 2026-10-12
6122 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 33 7 — — $30,443.25 $110,978.62 $67,158.25 2026-10-12
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Pdx 33 7 — — $30,413.76 $176,151.66 $67,091.83 2026-10-12
7574 APR_DRG Organic Mental Health Disturbances 12 6 — — $6,938.51 $89,151.80 $67,005.40 2026-10-12
5911 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 33 7 — — $58,884.80 $144,005.70 $66,565.09 2026-10-12
3464 APR_DRG Connective Tissue Disorders 33 7 — — $32,569.50 $93,455.68 $66,346.84 2026-10-12
1622 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 33 7 — — $29,997.55 $154,632.26 $66,154.59 2026-10-12
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 44 13 — — $58,577.32 $212,867.90 $66,078.22 2026-10-12
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 44 13 — — $62,389.66 $236,962.87 $65,992.87 2026-10-12
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 44 13 — — $62,105.27 $232,175.06 $65,692.06 2026-10-12
C2699 HCPCS Civasheet Large 5 X 15cm - Trial Item 41 17 $113,200.00 $113,200.00 $35.11 $111,434.08 $65,565.44 2026-10-12
834 OTHER Acute Leukemia Age >17 With Mcc 1 1 — — $65,545.25 $65,545.25 $65,545.25 2026-10-12
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