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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

ADENA FAYETTE MEDICAL CENTER

Washington Ch, OH · CCN 361331 · Rates published

6,946 distinct procedures filed
24 distinct payers
399,113 rate rows
2025-10-03 last MRF observed
Data quality

398,351 of 399,113 rate rows are consumer-grade (99.8%)

762 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
placeholder amount (≤ $0.02) — excluded from medians 630
per-diem day rate — not a per-procedure price 121
exceeds 10× this hospital's gross charge — excluded from medians 11
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/10269/852985806_adena-fayette-medical-center_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/machineReadable/AdenaFayetteMedicalCenter/10269
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-19
Content fingerprint df96a2e67bd57216… · 459,215,336 bytes · first seen 2026-05-14

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
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $437,857.80 $459,750.69 $459,750.69 nat. median
$246,434
1.9× median
5834
APR_DRG 		Neonate With Ecmo 3 $423,563.08 $444,741.23 $444,741.23 nat. median
$309,665
1.4× median
5833
APR_DRG 		Neonate With Ecmo 3 $423,563.08 $444,741.23 $444,741.23 nat. median
$244,017
1.8× median
5832
APR_DRG 		Neonate With Ecmo 3 $402,894.59 $423,039.32 $423,039.32 nat. median
$156,126
outlier · 2.7×
5831
APR_DRG 		Neonate With Ecmo 3 $402,894.59 $423,039.32 $423,039.32 nat. median
$145,122
outlier · 2.9×
1614
APR_DRG 		Implantable Heart Assist Systems 3 $401,333.68 $421,400.36 $421,400.36 nat. median
$207,730
outlier · 2.0×
24
APR_DRG 		Heart And/or Lung Transplant 3 $352,968.24 $370,616.65 $370,616.65 nat. median
$234,738
1.6× median
1611
APR_DRG 		Implantable Heart Assist Systems 3 $310,603.32 $326,133.49 $326,133.49 nat. median
$76,806
outlier · 4.2×
1612
APR_DRG 		Implantable Heart Assist Systems 3 $310,603.32 $326,133.49 $326,133.49 nat. median
$85,406
outlier · 3.8×
1613
APR_DRG 		Implantable Heart Assist Systems 3 $310,603.32 $326,133.49 $326,133.49 nat. median
$119,796
outlier · 2.7×
74
APR_DRG 		Allogeneic Bone Marrow Transplant 3 $301,721.79 $316,807.88 $316,807.88 nat. median
$187,294
1.7× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 3 $280,852.42 $294,895.04 $294,895.04 nat. median
$160,267
1.8× median
8413
APR_DRG 		Extensive Third Degree Burns With Skin Graft 3 $280,852.42 $294,895.04 $294,895.04 nat. median
$66,693
outlier · 4.4×
8412
APR_DRG 		Extensive Third Degree Burns With Skin Graft 3 $280,852.42 $294,895.04 $294,895.04 nat. median
$35,675
outlier · 8.3×
8411
APR_DRG 		Extensive Third Degree Burns With Skin Graft 3 $280,852.42 $294,895.04 $294,895.04 nat. median
$34,396
outlier · 8.6×
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 $280,831.50 $294,873.08 $294,873.08 nat. median
$162,982
1.8× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 $272,544.80 $286,172.04 $286,172.04 nat. median
$150,721
1.9× median
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 3 $240,570.05 $252,598.55 $252,598.55 nat. median
$122,924
outlier · 2.1×
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $221,185.26 $232,244.52 $232,244.52 nat. median
$182,736
1.3× median
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $210,392.14 $220,911.75 $220,911.75 nat. median
$145,336
1.5× median
5881
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $210,392.14 $220,911.75 $220,911.75 nat. median
$124,573
1.8× median
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 3 $203,894.30 $214,089.02 $214,089.02 nat. median
$151,838
1.4× median
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 3 $189,284.19 $198,748.40 $198,748.40 nat. median
$164,279
1.2× median
1604
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly 3 $174,117.93 $182,823.83 $182,823.83 nat. median
$97,957
1.9× median
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 2 $180,000.00 $180,000.00 $180,000.00 nat. median
$69,774
outlier · 2.6×
23
APR_DRG 		Heart And/or Lung Transplant 3 $156,454.40 $164,277.12 $164,277.12 nat. median
$93,528
1.8× median
21
APR_DRG 		Heart And/or Lung Transplant 3 $156,454.40 $164,277.12 $164,277.12 nat. median
$65,130
outlier · 2.5×
22
APR_DRG 		Heart And/or Lung Transplant 3 $156,454.40 $164,277.12 $164,277.12 nat. median
$78,029
outlier · 2.1×
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 3 $156,202.48 $164,012.60 $164,012.60 nat. median
$164,834
1.0× median
C9150
HCPCS 		Drugs 2 $156,000.00 $156,000.00 $156,000.00 nat. median
$775
outlier · 201.3×
73
APR_DRG 		Allogeneic Bone Marrow Transplant 3 $147,256.92 $154,619.77 $154,619.77 nat. median
$89,273
1.7× median
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 3 $141,852.13 $148,944.74 $148,944.74 nat. median
$105,658
1.4× median
6024
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 $139,554.03 $146,531.73 $146,531.73 nat. median
$118,620
1.2× median
6074
APR_DRG 		Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 3 $138,017.79 $144,918.68 $144,918.68 nat. median
$95,507
1.5× median
8504
APR_DRG 		Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 3 $133,643.52 $140,325.70 $140,325.70 nat. median
$73,845
1.9× median
3034
APR_DRG 		Dorsal And Lumbar Fusion Procedure For Curvature Of Back 3 $129,590.84 $136,070.38 $136,070.38 nat. median
$84,162
1.6× median
8514
APR_DRG 		Gender Related Procedures 3 $129,334.21 $135,800.92 $135,800.92 nat. median
$70,353
1.9× median
5933
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 3 $127,581.09 $133,960.14 $133,960.14 nat. median
$108,996
1.2× median
14
APR_DRG 		Liver Transplant And/or Intestinal Transplant 3 $124,500.05 $130,725.05 $130,725.05 nat. median
$129,535
1.0× median
6303
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 $120,385.99 $126,405.29 $126,405.29 nat. median
$72,936
1.7× median
84
APR_DRG 		Autologous Bone Marrow Transplant 3 $118,173.83 $124,082.52 $124,082.52 nat. median
$79,774
1.6× median
72
APR_DRG 		Allogeneic Bone Marrow Transplant 3 $117,880.67 $123,774.70 $123,774.70 nat. median
$66,666
1.9× median
71
APR_DRG 		Allogeneic Bone Marrow Transplant 3 $117,880.67 $123,774.70 $123,774.70 nat. median
$50,717
outlier · 2.4×
6334
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Anomaly 3 $117,376.35 $123,245.17 $123,245.17 nat. median
$57,983
outlier · 2.1×
03060
EAPG 		Ventricular Assist Device Procedures 3 $117,333.20 $123,197.78 $123,197.78 nat. median
$76,683
1.6× median
8424
APR_DRG 		Burns With Skin Graft Except Extensive Third Degree Burns 3 $117,265.50 $123,128.78 $123,128.78 nat. median
$80,494
1.5× median
Q2043
HCPCS 		Sipuleucel-t 50000000 Cells IV Susp 24 $58,569.88 $197,451.79 $122,752.12 nat. median
$66,682
1.8× median
90288
CPT 		Botulism Ig IV 2 $121,762.50 $121,762.50 $121,762.50 nat. median
$55,037
outlier · 2.2×
6093
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 $114,136.49 $119,843.31 $119,843.31 nat. median
$66,386
1.8× median
6023
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 $112,823.94 $118,465.14 $118,465.14 nat. median
$86,492
1.4× median

Other procedures at this hospital

Browse this hospital's 6,946 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 5 3 — — $437,857.80 $459,750.69 $459,750.69 2025-10-03
5833 APR_DRG Neonate With Ecmo 5 3 — — $423,563.08 $444,741.23 $444,741.23 2025-10-03
5834 APR_DRG Neonate With Ecmo 5 3 — — $423,563.08 $444,741.23 $444,741.23 2025-10-03
5831 APR_DRG Neonate With Ecmo 5 3 — — $402,894.59 $423,039.32 $423,039.32 2025-10-03
5832 APR_DRG Neonate With Ecmo 5 3 — — $402,894.59 $423,039.32 $423,039.32 2025-10-03
1614 APR_DRG Implantable Heart Assist Systems 5 3 — — $401,333.68 $421,400.36 $421,400.36 2025-10-03
24 APR_DRG Heart And/or Lung Transplant 5 3 — — $352,968.24 $370,616.65 $370,616.65 2025-10-03
1611 APR_DRG Implantable Heart Assist Systems 5 3 — — $310,603.32 $326,133.49 $326,133.49 2025-10-03
1613 APR_DRG Implantable Heart Assist Systems 5 3 — — $310,603.32 $326,133.49 $326,133.49 2025-10-03
1612 APR_DRG Implantable Heart Assist Systems 5 3 — — $310,603.32 $326,133.49 $326,133.49 2025-10-03
74 APR_DRG Allogeneic Bone Marrow Transplant 5 3 — — $301,721.79 $316,807.88 $316,807.88 2025-10-03
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 5 3 — — $280,852.42 $294,895.04 $294,895.04 2025-10-03
8411 APR_DRG Extensive Third Degree Burns With Skin Graft 5 3 — — $280,852.42 $294,895.04 $294,895.04 2025-10-03
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 5 3 — — $280,852.42 $294,895.04 $294,895.04 2025-10-03
8412 APR_DRG Extensive Third Degree Burns With Skin Graft 5 3 — — $280,852.42 $294,895.04 $294,895.04 2025-10-03
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 3 — — $280,831.50 $294,873.08 $294,873.08 2025-10-03
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 5 3 — — $272,544.80 $286,172.04 $286,172.04 2025-10-03
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 5 3 — — $240,570.05 $252,598.55 $252,598.55 2025-10-03
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 5 3 — — $221,185.26 $232,244.52 $232,244.52 2025-10-03
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 5 3 — — $210,392.14 $220,911.75 $220,911.75 2025-10-03
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 5 3 — — $210,392.14 $220,911.75 $220,911.75 2025-10-03
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 5 3 — — $203,894.30 $214,089.02 $214,089.02 2025-10-03
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 5 3 — — $189,284.19 $198,748.40 $198,748.40 2025-10-03
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 5 3 — — $174,117.93 $182,823.83 $182,823.83 2025-10-03
J9029 HCPCS Instill Adstiladrin, Tx Dose 2 2 — — $180,000.00 $180,000.00 $180,000.00 2025-10-03
22 APR_DRG Heart And/or Lung Transplant 5 3 — — $156,454.40 $164,277.12 $164,277.12 2025-10-03
21 APR_DRG Heart And/or Lung Transplant 5 3 — — $156,454.40 $164,277.12 $164,277.12 2025-10-03
23 APR_DRG Heart And/or Lung Transplant 5 3 — — $156,454.40 $164,277.12 $164,277.12 2025-10-03
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 3 — — $156,202.48 $164,012.60 $164,012.60 2025-10-03
C9150 HCPCS Drugs 2 2 — — $156,000.00 $156,000.00 $156,000.00 2025-10-03
73 APR_DRG Allogeneic Bone Marrow Transplant 5 3 — — $147,256.92 $154,619.77 $154,619.77 2025-10-03
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 5 3 — — $141,852.13 $148,944.74 $148,944.74 2025-10-03
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 5 3 — — $139,554.03 $146,531.73 $146,531.73 2025-10-03
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 5 3 — — $138,017.79 $144,918.68 $144,918.68 2025-10-03
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 5 3 — — $133,643.52 $140,325.70 $140,325.70 2025-10-03
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 5 3 — — $129,590.84 $136,070.38 $136,070.38 2025-10-03
8514 APR_DRG Gender Related Procedures 5 3 — — $129,334.21 $135,800.92 $135,800.92 2025-10-03
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 5 3 — — $127,581.09 $133,960.14 $133,960.14 2025-10-03
14 APR_DRG Liver Transplant And/or Intestinal Transplant 5 3 — — $124,500.05 $130,725.05 $130,725.05 2025-10-03
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 5 3 — — $120,385.99 $126,405.29 $126,405.29 2025-10-03
84 APR_DRG Autologous Bone Marrow Transplant 5 3 — — $118,173.83 $124,082.52 $124,082.52 2025-10-03
71 APR_DRG Allogeneic Bone Marrow Transplant 5 3 — — $117,880.67 $123,774.70 $123,774.70 2025-10-03
72 APR_DRG Allogeneic Bone Marrow Transplant 5 3 — — $117,880.67 $123,774.70 $123,774.70 2025-10-03
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 5 3 — — $117,376.35 $123,245.17 $123,245.17 2025-10-03
03060 EAPG Ventricular Assist Device Procedures 5 3 — — $117,333.20 $123,197.78 $123,197.78 2025-10-03
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 5 3 — — $117,265.50 $123,128.78 $123,128.78 2025-10-03
Q2043 HCPCS Sipuleucel-t 50000000 Cells IV Susp 49 24 $174,736.10 $87,368.05 50% off $58,569.88 $197,451.79 $122,752.12 2025-10-03
90288 CPT Botulism Ig IV 2 2 — — $121,762.50 $121,762.50 $121,762.50 2025-10-03
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 3 — — $114,136.49 $119,843.31 $119,843.31 2025-10-03
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 5 3 — — $112,823.94 $118,465.14 $118,465.14 2025-10-03
6091 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 3 — — $108,567.01 $113,995.36 $113,995.36 2025-10-03
6092 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 3 — — $108,567.01 $113,995.36 $113,995.36 2025-10-03
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 5 3 — — $108,196.38 $113,606.20 $113,606.20 2025-10-03
1834 APR_DRG Percutaneous Structural Cardiac Procedures 5 3 — — $107,694.89 $113,079.63 $113,079.63 2025-10-03
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 5 3 — — $107,487.01 $112,861.36 $112,861.36 2025-10-03
8634 APR_DRG Neonatal Aftercare 5 3 — — $107,330.26 $112,696.77 $112,696.77 2025-10-03
1784 APR_DRG External Heart Assist Systems 5 3 — — $107,294.47 $112,659.19 $112,659.19 2025-10-03
6904 APR_DRG Acute Leukemia 5 3 — — $106,874.90 $112,218.65 $112,218.65 2025-10-03
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 5 3 — — $106,241.85 $111,553.94 $111,553.94 2025-10-03
0624 RC Hc Cch Watchman Closure Delivery 45 24 $157,657.50 $78,828.75 50% off $53,603.55 $178,152.98 $110,754.40 2025-10-03
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 5 3 — — $104,852.59 $110,095.22 $110,095.22 2025-10-03
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 5 3 — — $101,141.46 $106,198.53 $106,198.53 2025-10-03
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 3 — — $100,142.13 $105,149.24 $105,149.24 2025-10-03
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 5 3 — — $97,198.19 $102,058.10 $102,058.10 2025-10-03
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 5 3 — — $96,988.86 $101,838.30 $101,838.30 2025-10-03
5894 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 5 3 — — $95,659.88 $100,442.87 $100,442.87 2025-10-03
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 5 3 — — $95,659.88 $100,442.87 $100,442.87 2025-10-03
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 5 3 — — $94,091.56 $98,796.14 $98,796.14 2025-10-03
6954 APR_DRG Chemotherapy For Acute Leukemia 5 3 — — $93,555.68 $98,233.46 $98,233.46 2025-10-03
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 5 3 — — $92,788.96 $97,428.41 $97,428.41 2025-10-03
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 5 3 — — $91,742.20 $96,329.31 $96,329.31 2025-10-03
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 5 3 — — $91,301.29 $95,866.35 $95,866.35 2025-10-03
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 5 3 — — $90,991.99 $95,541.59 $95,541.59 2025-10-03
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 5 3 — — $90,991.99 $95,541.59 $95,541.59 2025-10-03
224 APR_DRG Ventricular Shunt Procedures 5 3 — — $89,219.91 $93,680.91 $93,680.91 2025-10-03
83 APR_DRG Autologous Bone Marrow Transplant 5 3 — — $88,765.46 $93,203.73 $93,203.73 2025-10-03
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 3 — — $87,923.11 $92,319.27 $92,319.27 2025-10-03
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 3 — — $87,923.11 $92,319.27 $92,319.27 2025-10-03
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 3 — — $87,923.11 $92,319.27 $92,319.27 2025-10-03
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 3 — — $87,923.11 $92,319.27 $92,319.27 2025-10-03
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 5 3 — — $86,352.86 $90,670.50 $90,670.50 2025-10-03
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 5 3 — — $83,917.84 $88,113.73 $88,113.73 2025-10-03
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 5 3 — — $82,547.43 $86,674.80 $86,674.80 2025-10-03
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 5 3 — — $81,229.51 $85,290.99 $85,290.99 2025-10-03
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 5 3 — — $81,229.51 $85,290.99 $85,290.99 2025-10-03
8633 APR_DRG Neonatal Aftercare 5 3 — — $81,088.51 $85,142.94 $85,142.94 2025-10-03
5931 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 5 3 — — $80,711.28 $84,746.84 $84,746.84 2025-10-03
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 5 3 — — $80,711.28 $84,746.84 $84,746.84 2025-10-03
J0223 HCPCS Givosiran Sodium 189 Mg/ml Sc Soln 49 24 $118,949.78 $59,474.89 50% off $119.15 $134,413.25 $83,264.85 2025-10-03
914 APR_DRG Other Major Head And Neck Procedures 5 3 — — $79,253.48 $83,216.15 $83,216.15 2025-10-03
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 5 3 — — $79,102.56 $83,057.69 $83,057.69 2025-10-03
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 5 3 — — $79,102.56 $83,057.69 $83,057.69 2025-10-03
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 5 3 — — $78,881.72 $82,825.81 $82,825.81 2025-10-03
6301 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 5 3 — — $78,881.72 $82,825.81 $82,825.81 2025-10-03
2004 APR_DRG Cardiac Structural And Valvular Disorders 5 3 — — $77,320.41 $81,186.43 $81,186.43 2025-10-03
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 5 3 — — $76,772.57 $80,611.20 $80,611.20 2025-10-03
9104 APR_DRG Craniotomy For Multiple Significant Trauma 5 3 — — $76,302.82 $80,117.96 $80,117.96 2025-10-03
J9347 HCPCS Tremelimumab-actl 300 Mg/15ml IV Soln 47 24 $113,254.62 $56,627.31 50% off $340.78 $127,977.72 $79,561.37 2025-10-03
1833 APR_DRG Percutaneous Structural Cardiac Procedures 5 3 — — $75,741.40 $79,528.47 $79,528.47 2025-10-03
1794 APR_DRG Defibrillator Implants 5 3 — — $73,690.77 $77,375.31 $77,375.31 2025-10-03
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 5 3 — — $73,207.43 $76,867.80 $76,867.80 2025-10-03
214 APR_DRG Open Craniotomy Except Trauma 5 3 — — $73,075.58 $76,729.36 $76,729.36 2025-10-03
1204 APR_DRG Major Respiratory And Chest Procedures 5 3 — — $72,661.47 $76,294.54 $76,294.54 2025-10-03
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 3 — — $72,474.82 $76,098.56 $76,098.56 2025-10-03
6604 APR_DRG Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula… 5 3 — — $72,449.87 $76,072.36 $76,072.36 2025-10-03
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 5 3 — — $71,380.89 $74,949.93 $74,949.93 2025-10-03
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 5 3 — — $69,979.21 $73,478.17 $73,478.17 2025-10-03
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 5 3 — — $68,347.85 $71,765.24 $71,765.24 2025-10-03
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 5 3 — — $68,347.85 $71,765.24 $71,765.24 2025-10-03
6344 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 5 3 — — $68,144.53 $71,551.76 $71,551.76 2025-10-03
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 5 3 — — $68,139.14 $71,546.10 $71,546.10 2025-10-03
1832 APR_DRG Percutaneous Structural Cardiac Procedures 5 3 — — $68,007.64 $71,408.02 $71,408.02 2025-10-03
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 5 3 — — $67,777.63 $71,166.51 $71,166.51 2025-10-03
6903 APR_DRG Acute Leukemia 5 3 — — $67,717.04 $71,102.89 $71,102.89 2025-10-03
6224 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 5 3 — — $67,336.54 $70,703.37 $70,703.37 2025-10-03
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 5 3 — — $66,888.43 $70,232.85 $70,232.85 2025-10-03
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 5 3 — — $66,502.52 $69,827.65 $69,827.65 2025-10-03
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 5 3 — — $66,386.01 $69,705.31 $69,705.31 2025-10-03
1831 APR_DRG Percutaneous Structural Cardiac Procedures 5 3 — — $66,095.98 $69,400.78 $69,400.78 2025-10-03
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 5 3 — — $65,561.60 $68,839.68 $68,839.68 2025-10-03
264 APR_DRG Other Nervous System And Related Procedures 5 3 — — $65,114.93 $68,370.68 $68,370.68 2025-10-03
92941 CPT Hc Revascularize Acute Occl During Ami With Or Without Des Atherectomy Angioplasty Asp… 45 24 $96,868.23 $48,434.12 50% off $32,935.20 $109,461.10 $68,049.93 2025-10-03
0620T CPT Hc Cch Endovascular Venous Arterialization Tibl/prnl Vn 45 24 $96,251.75 $48,125.88 50% off $32,725.60 $108,764.48 $67,616.85 2025-10-03
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 3 — — $64,053.39 $67,256.06 $67,256.06 2025-10-03
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 3 — — $64,053.39 $67,256.06 $67,256.06 2025-10-03
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 3 — — $64,053.39 $67,256.06 $67,256.06 2025-10-03
234 APR_DRG Spinal Procedures 5 3 — — $63,777.83 $66,966.72 $66,966.72 2025-10-03
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 5 3 — — $63,726.40 $66,912.72 $66,912.72 2025-10-03
1781 APR_DRG External Heart Assist Systems 5 3 — — $63,647.77 $66,830.16 $66,830.16 2025-10-03
1782 APR_DRG External Heart Assist Systems 5 3 — — $63,647.77 $66,830.16 $66,830.16 2025-10-03
1783 APR_DRG External Heart Assist Systems 5 3 — — $63,647.77 $66,830.16 $66,830.16 2025-10-03
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 5 3 — — $63,003.79 $66,153.98 $66,153.98 2025-10-03
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 5 3 — — $62,792.24 $65,931.85 $65,931.85 2025-10-03
2304 APR_DRG Major Small Bowel Procedures 5 3 — — $61,826.92 $64,918.27 $64,918.27 2025-10-03
204 APR_DRG Open Craniotomy For Trauma 5 3 — — $61,656.01 $64,738.81 $64,738.81 2025-10-03
8423 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 5 3 — — $61,621.40 $64,702.47 $64,702.47 2025-10-03
894 APR_DRG Major Cranial Or Facial Bone Procedures 5 3 — — $61,221.58 $64,282.66 $64,282.66 2025-10-03
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 5 3 — — $61,178.92 $64,237.87 $64,237.87 2025-10-03
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 5 3 — — $60,938.58 $63,985.51 $63,985.51 2025-10-03
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 5 3 — — $60,384.97 $63,404.22 $63,404.22 2025-10-03
274 APR_DRG Other Open Craniotomy 5 3 — — $60,317.62 $63,333.50 $63,333.50 2025-10-03
1694 APR_DRG Major Abdominal Vascular Procedures 5 3 — — $60,215.82 $63,226.61 $63,226.61 2025-10-03
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 5 3 — — $59,145.07 $62,102.32 $62,102.32 2025-10-03
294 APR_DRG Other Percutaneous Intracranial Procedures 5 3 — — $58,693.81 $61,628.50 $61,628.50 2025-10-03
504 APR_DRG Non-bacterial Infections Of Nervous System Except Viral Meningitis 5 3 — — $58,675.88 $61,609.67 $61,609.67 2025-10-03
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 5 3 — — $58,480.69 $61,404.72 $61,404.72 2025-10-03
1814 APR_DRG Lower Extremity Arterial Procedures 5 3 — — $58,418.12 $61,339.03 $61,339.03 2025-10-03
3214 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 5 3 — — $58,015.56 $60,916.34 $60,916.34 2025-10-03
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 5 3 — — $57,619.23 $60,500.19 $60,500.19 2025-10-03
1824 APR_DRG Other Peripheral Vascular And Related Procedures 5 3 — — $57,360.45 $60,228.47 $60,228.47 2025-10-03
J9298 HCPCS Nivolumab-relatlimab-rmbw 240-80 Mg/20ml IV Soln 49 24 $84,403.56 $42,201.78 50% off $195.71 $95,376.02 $59,082.49 2025-10-03
C1822 HCPCS Hc Cch Nevro Replacement Generator Nipg2500 Senza Omnia 219 24 $115,500.00 $57,750.00 50% off $24,380.39 $152,800.44 $59,029.22 2025-10-03
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 5 3 — — $56,123.16 $58,929.32 $58,929.32 2025-10-03
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 5 3 — — $56,123.16 $58,929.32 $58,929.32 2025-10-03
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures 5 3 — — $56,095.53 $58,900.31 $58,900.31 2025-10-03
J2507 HCPCS Pegloticase 8 Mg/ml IV Soln 49 24 $83,798.66 $41,899.33 50% off $3,466.55 $94,692.49 $58,659.06 2025-10-03
6213 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 5 3 — — $55,719.40 $58,505.37 $58,505.37 2025-10-03
3043 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 5 3 — — $55,668.18 $58,451.59 $58,451.59 2025-10-03
2294 APR_DRG Other Digestive System And Abdominal Procedures 5 3 — — $55,633.39 $58,415.06 $58,415.06 2025-10-03
4474 APR_DRG Other Kidney, Urinary Tract And Related Procedures 5 3 — — $55,545.45 $58,322.72 $58,322.72 2025-10-03
9514 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 5 3 — — $55,219.94 $57,980.94 $57,980.94 2025-10-03
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 5 3 — — $54,996.64 $57,746.47 $57,746.47 2025-10-03
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 5 3 — — $54,992.64 $57,742.27 $57,742.27 2025-10-03
92943 CPT Hc Revascularize Chronic Total Occl With Or Without Des Atherectomy Angioplasty Sgl Ve… 45 24 $81,889.00 $40,944.50 50% off $27,842.26 $92,534.57 $57,527.03 2025-10-03
92937 CPT Hc Revascularize Cabg With Or Without Non-des Atherectomy Angioplasty Distal Protect S… 45 24 $81,889.00 $40,944.50 50% off $27,842.26 $92,534.57 $57,527.03 2025-10-03
1324 APR_DRG Bpd And Other Chronic Respiratory Diseases Arising In Perinatal Period 5 3 — — $54,532.47 $57,259.09 $57,259.09 2025-10-03
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 5 3 — — $54,278.74 $56,992.68 $56,992.68 2025-10-03
1793 APR_DRG Defibrillator Implants 5 3 — — $54,171.89 $56,880.48 $56,880.48 2025-10-03
J7330 HCPCS Cultured Chondrocytes Implnt 5 4 — — $56,693.42 $168,513.00 $56,693.42 2025-10-03
81 APR_DRG Autologous Bone Marrow Transplant 5 3 — — $53,906.12 $56,601.43 $56,601.43 2025-10-03
82 APR_DRG Autologous Bone Marrow Transplant 5 3 — — $53,906.12 $56,601.43 $56,601.43 2025-10-03
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 5 3 — — $53,645.50 $56,327.78 $56,327.78 2025-10-03
3031 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 5 3 — — $53,630.22 $56,311.73 $56,311.73 2025-10-03
1214 APR_DRG Other Respiratory And Chest Procedures 5 3 — — $52,930.34 $55,576.86 $55,576.86 2025-10-03
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 5 3 — — $52,776.31 $55,415.13 $55,415.13 2025-10-03
13 APR_DRG Liver Transplant And/or Intestinal Transplant 5 3 — — $52,607.30 $55,237.67 $55,237.67 2025-10-03
8503 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 5 3 — — $52,507.85 $55,133.24 $55,133.24 2025-10-03
37184 CPT Hc Primary Percutaneous Arterial Thrombectomy With Fluoro Initial Vessel 45 24 $78,022.52 $39,011.26 50% off $26,527.66 $88,165.45 $54,810.82 2025-10-03
J9359 HCPCS Loncastuximab Tesirine-lpyl 10 Mg IV Solr 49 24 $77,501.58 $38,750.79 50% off $205.04 $87,576.79 $54,251.11 2025-10-03
3254 APR_DRG Non-elective Or Complex Knee Joint Replacement 5 3 — — $51,666.99 $54,250.34 $54,250.34 2025-10-03
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 5 3 — — $51,665.69 $54,248.97 $54,248.97 2025-10-03
6122 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 5 3 — — $51,655.61 $54,238.39 $54,238.39 2025-10-03
9524 APR_DRG Non-extensive O.r. Procedure Unrelated To Principal Diagnosis 5 3 — — $51,631.43 $54,213.00 $54,213.00 2025-10-03
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 5 3 — — $50,903.36 $53,448.53 $53,448.53 2025-10-03
6143 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 5 3 — — $50,903.36 $53,448.53 $53,448.53 2025-10-03
4414 APR_DRG Major Bladder Procedures 5 3 — — $50,895.98 $53,440.78 $53,440.78 2025-10-03
6071 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 5 3 — — $50,372.73 $52,891.37 $52,891.37 2025-10-03
93580 CPT Hc Transcath Closure Asd With Implant 45 24 $75,276.04 $37,638.02 50% off $25,593.85 $85,061.93 $52,881.42 2025-10-03
7504 APR_DRG Schizophrenia 5 3 — — $49,761.18 $52,249.24 $52,249.24 2025-10-03
C2616 HCPCS Hc Yttrim 90 Bt Source 45 24 $74,023.12 $37,011.56 50% off $25,167.86 $83,646.13 $52,001.24 2025-10-03
1602 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 5 3 — — $49,229.21 $51,690.67 $51,690.67 2025-10-03
2244 APR_DRG Peritoneal Adhesiolysis 5 3 — — $49,202.90 $51,663.05 $51,663.05 2025-10-03
1303 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 5 3 — — $48,583.81 $51,013.00 $51,013.00 2025-10-03
6021 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 5 3 — — $48,340.31 $50,757.33 $50,757.33 2025-10-03
8624 APR_DRG Other Aftercare And Convalescence 5 3 — — $48,262.07 $50,675.17 $50,675.17 2025-10-03
6964 APR_DRG Other Chemotherapy 5 3 — — $48,120.65 $50,526.68 $50,526.68 2025-10-03
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 5 3 — — $48,104.48 $50,509.70 $50,509.70 2025-10-03
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 5 3 — — $47,564.83 $49,943.07 $49,943.07 2025-10-03
1792 APR_DRG Defibrillator Implants 5 3 — — $47,378.37 $49,747.29 $49,747.29 2025-10-03
734 APR_DRG Orbit And Eye Procedures 5 3 — — $47,277.88 $49,641.77 $49,641.77 2025-10-03
3234 APR_DRG Non-elective Or Complex Hip Joint Replacement 5 3 — — $47,236.83 $49,598.67 $49,598.67 2025-10-03
1714 APR_DRG Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock 5 3 — — $47,175.39 $49,534.16 $49,534.16 2025-10-03
6312 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 5 3 — — $46,790.71 $49,130.25 $49,130.25 2025-10-03
6311 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 5 3 — — $46,790.71 $49,130.25 $49,130.25 2025-10-03
1673 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 5 3 — — $46,648.30 $48,980.72 $48,980.72 2025-10-03
9103 APR_DRG Craniotomy For Multiple Significant Trauma 5 3 — — $46,265.17 $48,578.43 $48,578.43 2025-10-03
213 APR_DRG Open Craniotomy Except Trauma 5 3 — — $46,100.23 $48,405.24 $48,405.24 2025-10-03
J7310 HCPCS Drugs 2 2 — — $48,000.00 $48,000.00 $48,000.00 2025-10-03
4404 APR_DRG Kidney Transplant 5 3 — — $45,681.74 $47,965.83 $47,965.83 2025-10-03
4403 APR_DRG Kidney Transplant 5 3 — — $45,681.74 $47,965.83 $47,965.83 2025-10-03
33229 CPT Hc Replacement Pm Multi Lead Generator Only 45 24 $68,227.67 $34,113.84 50% off $23,197.41 $77,097.27 $47,929.94 2025-10-03
2234 APR_DRG Other Small And Large Bowel Procedures 5 3 — — $45,488.26 $47,762.67 $47,762.67 2025-10-03
494 APR_DRG Bacterial And Tuberculous Infections Of Nervous System 5 3 — — $45,427.32 $47,698.69 $47,698.69 2025-10-03
1791 APR_DRG Defibrillator Implants 5 3 — — $45,296.25 $47,561.06 $47,561.06 2025-10-03
8632 APR_DRG Neonatal Aftercare 5 3 — — $45,190.28 $47,449.79 $47,449.79 2025-10-03
2614 APR_DRG Major Biliary Tract Procedures 5 3 — — $44,835.19 $47,076.95 $47,076.95 2025-10-03
J9226 HCPCS Supprelin La Implant 5 4 — — $47,007.19 $111,737.75 $47,007.19 2025-10-03
J1303 HCPCS Ravulizumab-cwvz 1100 Mg/11ml IV Soln 49 24 $66,851.92 $33,425.96 50% off $241.61 $75,542.67 $46,796.34 2025-10-03
C1882 HCPCS G447-defibrillator Cardiac W5.37xh8.18cm D0.99cm Is-4 Df-4 Connector Resonate X4 451 24 $76,543.74 $38,271.87 50% off $15,236.76 $130,635.75 $46,632.06 2025-10-03
2274 APR_DRG Hernia Procedures Except Inguinal, Femoral And Umbilical 5 3 — — $44,293.33 $46,508.00 $46,508.00 2025-10-03
3094 APR_DRG Other Significant Hip And Femur Surgery 5 3 — — $44,288.22 $46,502.63 $46,502.63 2025-10-03
6082 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 5 3 — — $44,275.94 $46,489.74 $46,489.74 2025-10-03
244 APR_DRG Open Extracranial Vascular Procedures 5 3 — — $44,047.90 $46,250.30 $46,250.30 2025-10-03
2484 APR_DRG Major Gastrointestinal And Peritoneal Infections 5 3 — — $44,003.10 $46,203.26 $46,203.26 2025-10-03
2613 APR_DRG Major Biliary Tract Procedures 5 3 — — $43,745.36 $45,932.63 $45,932.63 2025-10-03
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 3 — — $43,603.09 $45,783.24 $45,783.24 2025-10-03
51 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 3 — — $43,603.09 $45,783.24 $45,783.24 2025-10-03
2314 APR_DRG Major Large Bowel Procedures 5 3 — — $43,569.02 $45,747.47 $45,747.47 2025-10-03
J9600 HCPCS Porfimer Sodium 75 Mg IV Solr 49 24 $65,099.16 $32,549.58 50% off $22,133.71 $73,562.05 $45,732.16 2025-10-03
6914 APR_DRG Lymphoma, Myeloma And Non-acute Leukemia 5 3 — — $43,460.75 $45,633.79 $45,633.79 2025-10-03
3613 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 5 3 — — $43,435.20 $45,606.96 $45,606.96 2025-10-03
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 5 3 — — $43,435.20 $45,606.96 $45,606.96 2025-10-03
6614 APR_DRG Coagulation And Platelet Disorders 5 3 — — $43,383.66 $45,552.84 $45,552.84 2025-10-03
1601 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 5 3 — — $43,379.08 $45,548.03 $45,548.03 2025-10-03
8154 APR_DRG Other Injury, Poisoning And Toxic Effect Diagnoses 5 3 — — $43,344.33 $45,511.55 $45,511.55 2025-10-03
893 APR_DRG Major Cranial Or Facial Bone Procedures 5 3 — — $43,308.96 $45,474.41 $45,474.41 2025-10-03
4034 APR_DRG Procedures For Obesity 5 3 — — $43,085.99 $45,240.29 $45,240.29 2025-10-03
6112 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 5 3 — — $43,013.51 $45,164.19 $45,164.19 2025-10-03
36223 CPT Hc Place Cath Common Carotid/innominate With Angio Ipsilateral Intracranial Caroti… 45 24 $63,993.45 $31,996.73 50% off $21,757.77 $72,312.60 $44,955.40 2025-10-03
984 APR_DRG Other Ear, Nose, Mouth, Throat, Craniofacial, And Neck Procedures 5 3 — — $42,813.48 $44,954.15 $44,954.15 2025-10-03
6333 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 5 3 — — $42,745.21 $44,882.47 $44,882.47 2025-10-03
37221 CPT Hc Insertion Stent Iliac Artery Initial Vessel 45 24 $63,746.30 $31,873.15 50% off $21,673.74 $72,033.32 $44,781.78 2025-10-03
J9229 HCPCS Inotuzumab Ozogamicin 0.9 Mg IV Solr 49 24 $63,940.81 $31,970.41 50% off $2,688.22 $72,253.12 $44,758.57 2025-10-03
1754 APR_DRG Percutaneous Cardiac Intervention Without Ami 5 3 — — $42,621.26 $44,752.32 $44,752.32 2025-10-03
233 APR_DRG Spinal Procedures 5 3 — — $42,599.18 $44,729.14 $44,729.14 2025-10-03
1632 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 5 3 — — $42,248.52 $44,360.95 $44,360.95 2025-10-03
37230 CPT Hc Insertion Stent Tibial/peroneal Artery Initial Vessel 45 24 $63,127.68 $31,563.84 50% off $21,463.41 $71,334.28 $44,347.19 2025-10-03
37227 CPT Hc Atherectomy & Stent Insertion Fem/pop Artery Each Vessel 45 24 $63,127.68 $31,563.84 50% off $21,463.41 $71,334.28 $44,347.19 2025-10-03
2224 APR_DRG Other Stomach, Esophageal And Duodenal Procedures 5 3 — — $42,188.16 $44,297.57 $44,297.57 2025-10-03
A9543 HCPCS Ibritumomab Tiuxetan For Y-90 3.2 Mg/2ml IV Kit (non-oncology) Ade 49 24 $63,009.76 $31,504.88 50% off $21,423.32 $185,311.08 $44,264.36 2025-10-03
36906 CPT Hc Percutaneous Thrombectomy Any Method Dialysis Circuit Transcath Plcmt IV Sten… 45 24 $62,848.52 $31,424.26 50% off $21,368.50 $71,018.83 $44,151.08 2025-10-03
1763 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 5 3 — — $41,893.12 $43,987.78 $43,987.78 2025-10-03
913 APR_DRG Other Major Head And Neck Procedures 5 3 — — $41,868.77 $43,962.21 $43,962.21 2025-10-03
1663 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 5 3 — — $41,683.84 $43,768.03 $43,768.03 2025-10-03
7934 APR_DRG Moderately Extensive O.r. Procedures For Other Complications Of Treatment 5 3 — — $41,385.03 $43,454.28 $43,454.28 2025-10-03
C9765 HCPCS Hc Revasc Intravascular Lithotripsy W Stent 45 24 $61,399.37 $30,699.69 50% off $20,875.79 $69,381.29 $43,133.06 2025-10-03
C9766 HCPCS Hc Revasc Intravascular Lithotripsy And Arthectomy 45 24 $61,399.37 $30,699.69 50% off $20,875.79 $69,381.29 $43,133.06 2025-10-03
C9775 HCPCS Hc Revasc Lower Extremity Artery Tibial/peroneal Intravascular Lithotripsy & Art… 45 24 $61,399.37 $30,699.69 50% off $20,875.79 $69,381.29 $43,133.06 2025-10-03
C9774 HCPCS Hc Revasc Lower Extremity Artery Tibial/peroneal Intravascular Lithotripsy & Art… 45 24 $61,399.37 $30,699.69 50% off $20,875.79 $69,381.29 $43,133.06 2025-10-03
C9773 HCPCS Hc Revasc Lower Extremity Artery Tibial/peroneal Intravascular Lithotripsy W Ste… 45 24 $61,399.37 $30,699.69 50% off $20,875.79 $69,381.29 $43,133.06 2025-10-03
37225 CPT Hc Atherectomy Fem/pop Artery Each Vessel 45 24 $61,399.37 $30,699.69 50% off $20,875.79 $69,381.29 $43,133.06 2025-10-03
37229 CPT Hc Atherectomy Tibial/peroneal Artery Initial Vessel 45 24 $61,399.37 $30,699.69 50% off $20,875.79 $69,381.29 $43,133.06 2025-10-03
37231 CPT Hc Atherectomy & Stent Insertion Tibial/peroneal Artery Initial Vessel 45 24 $61,399.37 $30,699.69 50% off $20,875.79 $69,381.29 $43,133.06 2025-10-03
1804 APR_DRG Other Circulatory System Procedures 5 3 — — $41,074.36 $43,128.08 $43,128.08 2025-10-03
1314 APR_DRG Cystic Fibrosis - Pulmonary Disease 5 3 — — $40,800.22 $42,840.23 $42,840.23 2025-10-03
3464 APR_DRG Connective Tissue Disorders 5 3 — — $40,691.86 $42,726.45 $42,726.45 2025-10-03
C1767 HCPCS 222pp5ctrsy33 Ipg Proclaim Plus With Controller 393 24 $84,199.50 $42,099.75 50% off $48.08 $117,463.50 $42,714.21 2025-10-03
3104 APR_DRG Vertebral And Intervertebral Spinal Procedures Including Disc Procedures 5 3 — — $40,584.77 $42,614.01 $42,614.01 2025-10-03
303 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 5 3 — — $40,575.59 $42,604.37 $42,604.37 2025-10-03
8513 APR_DRG Gender Related Procedures 5 3 — — $40,542.07 $42,569.17 $42,569.17 2025-10-03
4424 APR_DRG Kidney And Urinary Tract Procedures For Malignancy 5 3 — — $40,373.78 $42,392.47 $42,392.47 2025-10-03
1652 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 5 3 — — $40,192.63 $42,202.26 $42,202.26 2025-10-03
1651 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 5 3 — — $40,192.63 $42,202.26 $42,202.26 2025-10-03
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 5 3 — — $40,066.47 $42,069.79 $42,069.79 2025-10-03
92928 CPT Hc Insertion Non-des With Or Without Angioplasty Single Major Artery/branch 45 24 $59,874.51 $29,937.26 50% off $20,357.33 $67,658.20 $42,061.84 2025-10-03
1693 APR_DRG Major Abdominal Vascular Procedures 5 3 — — $39,838.10 $41,830.01 $41,830.01 2025-10-03
3174 APR_DRG Tendon, Muscle And Other Soft Tissue Procedures 5 3 — — $39,367.35 $41,335.72 $41,335.72 2025-10-03
4444 APR_DRG Renal Dialysis Access Device Procedures 5 3 — — $39,204.17 $41,164.38 $41,164.38 2025-10-03
3134 APR_DRG Knee And Lower Leg Procedures Except Foot 5 3 — — $39,117.58 $41,073.46 $41,073.46 2025-10-03
3042 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 5 3 — — $39,025.24 $40,976.50 $40,976.50 2025-10-03
3084 APR_DRG Hip And Femur Fracture Repair 5 3 — — $38,796.85 $40,736.69 $40,736.69 2025-10-03
3204 APR_DRG Other Musculoskeletal System And Connective Tissue Procedures 5 3 — — $38,556.41 $40,484.23 $40,484.23 2025-10-03
3253 APR_DRG Non-elective Or Complex Knee Joint Replacement 5 3 — — $38,526.86 $40,453.20 $40,453.20 2025-10-03
424 APR_DRG Degenerative Nervous System Disorders Except Multiple Sclerosis 5 3 — — $38,461.22 $40,384.28 $40,384.28 2025-10-03
J2350 HCPCS Ocrelizumab 300 Mg/10ml IV Soln 49 24 $57,613.04 $28,806.52 50% off $64.72 $65,102.74 $40,329.13 2025-10-03
7584 APR_DRG Behavioral Disorders 5 3 — — $38,398.19 $40,318.10 $40,318.10 2025-10-03
404 APR_DRG Spinal Disorders And Injuries 5 3 — — $38,360.28 $40,278.29 $40,278.29 2025-10-03
403 APR_DRG Spinal Disorders And Injuries 5 3 — — $38,360.28 $40,278.29 $40,278.29 2025-10-03
1631 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 5 3 — — $38,325.98 $40,242.28 $40,242.28 2025-10-03
8604 APR_DRG Rehabilitation 5 3 — — $38,296.37 $40,211.19 $40,211.19 2025-10-03
7944 APR_DRG Non-extensive O.r. Procedures For Other Complications Of Treatment 5 3 — — $38,219.98 $40,130.98 $40,130.98 2025-10-03
7583 APR_DRG Behavioral Disorders 5 3 — — $38,104.41 $40,009.63 $40,009.63 2025-10-03
11 APR_DRG Liver Transplant And/or Intestinal Transplant 5 3 — — $37,869.82 $39,763.31 $39,763.31 2025-10-03
12 APR_DRG Liver Transplant And/or Intestinal Transplant 5 3 — — $37,869.82 $39,763.31 $39,763.31 2025-10-03
3154 APR_DRG Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement 5 3 — — $37,649.59 $39,532.07 $39,532.07 2025-10-03
00097 EAPG Aicd And Related Cardiac Device Insertion Or Replacement 5 3 — — $37,562.48 $39,439.94 $39,439.94 2025-10-03
9304 APR_DRG Multiple Significant Trauma Without O.r. Procedure 5 3 — — $37,481.30 $39,355.37 $39,355.37 2025-10-03
1302 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 5 3 — — $37,414.97 $39,285.72 $39,285.72 2025-10-03
1301 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 5 3 — — $37,414.97 $39,285.72 $39,285.72 2025-10-03
4214 APR_DRG Malnutrition, Failure To Thrive And Other Nutritional Disorders 5 3 — — $37,365.46 $39,233.73 $39,233.73 2025-10-03
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