Price Transparency 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 →

Export CSV
Hospital

SAINT ALPHONSUS MEDICAL CENTER ONTARIO

Ontario, OR · CCN 380052 · Rates published

15,677 distinct procedures filed
58 distinct payers
2,457,258 rate rows
2025-01-01 last MRF observed · ⚠ 17 mo old
Data quality

2,288,770 of 2,457,258 rate rows are consumer-grade (93.1%)

168,488 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 151,760
template filing: same amount across many unrelated codes — excluded 12,102
percent-of-charges filed in the dollar field — excluded from medians 2,300
exceeds 10× this hospital's gross charge — excluded from medians 2,178
per-diem day rate — not a per-procedure price 120
placeholder amount (≤ $0.02) — excluded from medians 28

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 17 months old.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/saintalphonsusmedical-ontario
Found on page https://www.saintalphonsus.org/for-patients/before-your-visit/price-estimator
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-18
Content fingerprint c59279f6ab3e1a84… · 18,240,428 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
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 11 $284,173.96 $685,569.68 $473,257.46 nat. median
$370,174
1.3× median
J2326
HCPCS 		Inj Nusinersen 0.1mg 58 $350.00 $661,923.89 $368,195.17 nat. median
$2,677
outlier · 137.5×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 11 $209,077.39 $504,399.21 $348,130.54 nat. median
$265,286
1.3× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 11 $203,375.07 $490,642.36 $338,629.26 nat. median
$206,368
1.6× median
'583-4
APR_DRG 		Neonate, Transferred < 5 Days Old, Born Here 1 $296,334.89 $296,334.89 $296,334.89 —
'002-4
APR_DRG 		Heart And/or Lung Transplant 1 $295,762.07 $295,762.07 $295,762.07 —
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 11 $164,544.75 $396,964.21 $273,929.65 nat. median
$202,986
1.3× median
'583-3
APR_DRG 		Neonate, Transferred < 5 Days Old, Born Here 1 $248,452.48 $248,452.48 $248,452.48 —
'588-4
APR_DRG 		Neonate With Ecmo 1 $219,820.51 $219,820.51 $219,820.51 —
'161-4
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly 1 $208,852.94 $208,852.94 $208,852.94 —
'001-4
APR_DRG 		Liver Transplant And/or Intestinal Transplant 1 $191,632.02 $191,632.02 $191,632.02 —
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 11 $113,522.93 $273,874.06 $188,916.39 nat. median
$133,176
1.4× median
'006-4
APR_DRG 		Pancreas Transplant 1 $177,975.86 $177,975.86 $177,975.86 —
'002-3
APR_DRG 		Heart And/or Lung Transplant 1 $169,280.32 $169,280.32 $169,280.32 —
7
MS_DRG 		Lung Transplant 11 $94,767.47 $228,626.53 $157,665.79 nat. median
$122,708
1.3× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 11 $94,595.61 $228,211.90 $157,379.43 nat. median
$108,660
1.4× median
'161-3
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly 1 $155,855.91 $155,855.91 $155,855.91 —
14
MS_DRG 		Allogeneic Bone Marrow Transplant 11 $88,559.58 $213,650.00 $147,322.12 nat. median
$117,303
1.3× median
'841-4
APR_DRG 		Intentional Self-harm And Attempted Suicide 1 $147,132.67 $147,132.67 $147,132.67 —
'591-4
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 1 $145,029.99 $145,029.99 $145,029.99 —
'630-4
APR_DRG 		Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Probl… 1 $140,427.39 $140,427.39 $140,427.39 —
J1747
HCPCS 		Injection Spesolimab-sbzo 1 Mg 58 $18.05 $250,347.17 $139,255.61 nat. median
$94
outlier · 1484.9×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 11 $83,240.30 $200,817.21 $138,459.05 nat. median
$102,358
1.4× median
'593-4
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 1 $136,981.20 $136,981.20 $136,981.20 —
'007-4
APR_DRG 		Allogeneic Bone Marrow Transplant 1 $135,603.03 $135,603.03 $135,603.03 —
'002-2
APR_DRG 		Heart And/or Lung Transplant 1 $133,743.67 $133,743.67 $133,743.67 —
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 11 $79,998.02 $192,995.21 $133,056.73 nat. median
$100,136
1.3× median
'588-3
APR_DRG 		Neonate With Ecmo 1 $132,872.11 $132,872.11 $132,872.11 —
'609-4
APR_DRG 		Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 1 $132,860.57 $132,860.57 $132,860.57 —
215
MS_DRG 		Other Heart Assist System Implant 11 $78,956.05 $190,481.47 $131,320.58 nat. median
$99,019
1.3× median
'004-4
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 1 $130,238.20 $130,238.20 $130,238.20 —
'009-4
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 1 $128,069.32 $128,069.32 $128,069.32 —
'583-2
APR_DRG 		Neonate, Transferred < 5 Days Old, Born Here 1 $126,206.11 $126,206.11 $126,206.11 —
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 11 $75,029.39 $181,008.41 $124,777.93 nat. median
$93,672
1.3× median
'583-1
APR_DRG 		Neonate, Transferred < 5 Days Old, Born Here 1 $123,161.82 $123,161.82 $123,161.82 —
'631-4
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 1 $120,261.51 $120,261.51 $120,261.51 —
'002-1
APR_DRG 		Heart And/or Lung Transplant 1 $115,812.12 $115,812.12 $115,812.12 —
453
MS_DRG 		Combined Anterior/posterior Spinal Fusion W Mcc 11 $68,525.56 $165,317.91 $113,941.16 nat. median
$87,411
1.3× median
'006-3
APR_DRG 		Pancreas Transplant 1 $113,650.93 $113,650.93 $113,650.93 —
'440-4
APR_DRG 		Thyroid Disorders 1 $109,644.24 $109,644.24 $109,644.24 —
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 11 $65,373.45 $157,713.44 $108,689.07 nat. median
$77,576
1.4× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 11 $65,196.19 $157,285.81 $108,393.72 nat. median
$81,118
1.3× median
'603-4
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 $108,271.47 $108,271.47 $108,271.47 —
'001-3
APR_DRG 		Liver Transplant And/or Intestinal Transplant 1 $107,078.85 $107,078.85 $107,078.85 —
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 11 $62,774.69 $151,443.93 $104,358.98 nat. median
$79,312
1.3× median
'602-4
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 1 $103,358.57 $103,358.57 $103,358.57 —
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 11 $61,836.77 $149,181.20 $102,796.20 nat. median
$71,240
1.4× median
'006-2
APR_DRG 		Pancreas Transplant 1 $102,323.03 $102,323.03 $102,323.03 —
C9081
HCPCS 		Idecabtagene Car Pos T 1 $102,175.83 $102,175.83 $102,175.83 nat. median
$30,475
outlier · 3.4×
C9076
HCPCS 		Lisocabtagene Car Pos T 1 $102,175.83 $102,175.83 $102,175.83 nat. median
$30,475
outlier · 3.4×

Other procedures at this hospital

Browse this hospital's 15,677 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
             
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 24 11 — — $284,173.96 $685,569.68 $473,257.46 2025-01-01
J2326 HCPCS Inj Nusinersen 0.1mg 160 58 $413,702.43 $289,591.70 30% off $350.00 $661,923.89 $368,195.17 2025-01-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 24 11 — — $209,077.39 $504,399.21 $348,130.54 2025-01-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 24 11 — — $203,375.07 $490,642.36 $338,629.26 2025-01-01
'583-4 APR_DRG Neonate, Transferred < 5 Days Old, Born Here 2 1 — — $296,334.89 $296,334.89 $296,334.89 2025-01-01
'002-4 APR_DRG Heart And/or Lung Transplant 2 1 — — $295,762.07 $295,762.07 $295,762.07 2025-01-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 24 11 — — $164,544.75 $396,964.21 $273,929.65 2025-01-01
'583-3 APR_DRG Neonate, Transferred < 5 Days Old, Born Here 2 1 — — $248,452.48 $248,452.48 $248,452.48 2025-01-01
'588-4 APR_DRG Neonate With Ecmo 2 1 — — $219,820.51 $219,820.51 $219,820.51 2025-01-01
'161-4 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 2 1 — — $208,852.94 $208,852.94 $208,852.94 2025-01-01
'001-4 APR_DRG Liver Transplant And/or Intestinal Transplant 2 1 — — $191,632.02 $191,632.02 $191,632.02 2025-01-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 24 11 — — $113,522.93 $273,874.06 $188,916.39 2025-01-01
'006-4 APR_DRG Pancreas Transplant 2 1 — — $177,975.86 $177,975.86 $177,975.86 2025-01-01
'002-3 APR_DRG Heart And/or Lung Transplant 2 1 — — $169,280.32 $169,280.32 $169,280.32 2025-01-01
7 MS_DRG Lung Transplant 24 11 — — $94,767.47 $228,626.53 $157,665.79 2025-01-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 24 11 — — $94,595.61 $228,211.90 $157,379.43 2025-01-01
'161-3 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 2 1 — — $155,855.91 $155,855.91 $155,855.91 2025-01-01
14 MS_DRG Allogeneic Bone Marrow Transplant 24 11 — — $88,559.58 $213,650.00 $147,322.12 2025-01-01
'841-4 APR_DRG Intentional Self-harm And Attempted Suicide 2 1 — — $147,132.67 $147,132.67 $147,132.67 2025-01-01
'591-4 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 2 1 — — $145,029.99 $145,029.99 $145,029.99 2025-01-01
'630-4 APR_DRG Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Probl… 2 1 — — $140,427.39 $140,427.39 $140,427.39 2025-01-01
J1747 HCPCS Injection Spesolimab-sbzo 1 Mg 160 58 $156,466.98 $109,526.89 30% off $18.05 $250,347.17 $139,255.61 2025-01-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 24 11 — — $83,240.30 $200,817.21 $138,459.05 2025-01-01
'593-4 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 1 — — $136,981.20 $136,981.20 $136,981.20 2025-01-01
'007-4 APR_DRG Allogeneic Bone Marrow Transplant 2 1 — — $135,603.03 $135,603.03 $135,603.03 2025-01-01
'002-2 APR_DRG Heart And/or Lung Transplant 2 1 — — $133,743.67 $133,743.67 $133,743.67 2025-01-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 24 11 — — $79,998.02 $192,995.21 $133,056.73 2025-01-01
'588-3 APR_DRG Neonate With Ecmo 2 1 — — $132,872.11 $132,872.11 $132,872.11 2025-01-01
'609-4 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 2 1 — — $132,860.57 $132,860.57 $132,860.57 2025-01-01
215 MS_DRG Other Heart Assist System Implant 24 11 — — $78,956.05 $190,481.47 $131,320.58 2025-01-01
'004-4 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 1 — — $130,238.20 $130,238.20 $130,238.20 2025-01-01
'009-4 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 2 1 — — $128,069.32 $128,069.32 $128,069.32 2025-01-01
'583-2 APR_DRG Neonate, Transferred < 5 Days Old, Born Here 2 1 — — $126,206.11 $126,206.11 $126,206.11 2025-01-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 24 11 — — $75,029.39 $181,008.41 $124,777.93 2025-01-01
'583-1 APR_DRG Neonate, Transferred < 5 Days Old, Born Here 2 1 — — $123,161.82 $123,161.82 $123,161.82 2025-01-01
'631-4 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 1 — — $120,261.51 $120,261.51 $120,261.51 2025-01-01
'002-1 APR_DRG Heart And/or Lung Transplant 2 1 — — $115,812.12 $115,812.12 $115,812.12 2025-01-01
453 MS_DRG Combined Anterior/posterior Spinal Fusion W Mcc 24 11 — — $68,525.56 $165,317.91 $113,941.16 2025-01-01
'006-3 APR_DRG Pancreas Transplant 2 1 — — $113,650.93 $113,650.93 $113,650.93 2025-01-01
'440-4 APR_DRG Thyroid Disorders 2 1 — — $109,644.24 $109,644.24 $109,644.24 2025-01-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 24 11 — — $65,373.45 $157,713.44 $108,689.07 2025-01-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 24 11 — — $65,196.19 $157,285.81 $108,393.72 2025-01-01
'603-4 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 1 — — $108,271.47 $108,271.47 $108,271.47 2025-01-01
'001-3 APR_DRG Liver Transplant And/or Intestinal Transplant 2 1 — — $107,078.85 $107,078.85 $107,078.85 2025-01-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 24 11 — — $62,774.69 $151,443.93 $104,358.98 2025-01-01
'602-4 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 1 — — $103,358.57 $103,358.57 $103,358.57 2025-01-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 24 11 — — $61,836.77 $149,181.20 $102,796.20 2025-01-01
'006-2 APR_DRG Pancreas Transplant 2 1 — — $102,323.03 $102,323.03 $102,323.03 2025-01-01
C9076 HCPCS Lisocabtagene Car Pos T 2 1 — — $102,175.83 $102,175.83 $102,175.83 2025-01-01
C9098 HCPCS Ciltacabtagene Car Pos T 2 1 — — $102,175.83 $102,175.83 $102,175.83 2025-01-01
Q2040 HCPCS Tisagenlecleucel Car-pos T 2 1 — — $102,175.83 $102,175.83 $102,175.83 2025-01-01
C9073 HCPCS Brexucabtagene Autoleucel Ca 2 1 — — $102,175.83 $102,175.83 $102,175.83 2025-01-01
C9081 HCPCS Idecabtagene Car Pos T 2 1 — — $102,175.83 $102,175.83 $102,175.83 2025-01-01
'161-2 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 2 1 — — $100,382.05 $100,382.05 $100,382.05 2025-01-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 24 11 — — $60,342.40 $145,576.04 $100,306.27 2025-01-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 24 11 — — $59,661.11 $143,932.43 $99,171.10 2025-01-01
C9031 HCPCS Lutetium Lu 177 Dotatate, Tx 2 1 — — $96,265.60 $96,265.60 $96,265.60 2025-01-01
'161-1 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 2 1 — — $95,339.81 $95,339.81 $95,339.81 2025-01-01
J9600 HCPCS Porfimer Per 75 Mg 158 58 $105,199.95 $73,639.97 30% off $350.00 $168,319.92 $94,679.96 2025-01-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 24 11 — — $55,971.83 $135,032.04 $93,023.96 2025-01-01
'588-1 APR_DRG Neonate With Ecmo 2 1 — — $91,278.46 $91,278.46 $91,278.46 2025-01-01
'588-2 APR_DRG Neonate With Ecmo 2 1 — — $91,278.46 $91,278.46 $91,278.46 2025-01-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 24 11 — — $54,455.89 $131,374.83 $90,498.09 2025-01-01
'160-4 APR_DRG Acute Bronchitis And Related Symptoms 2 1 — — $90,075.83 $90,075.83 $90,075.83 2025-01-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 24 11 — — $53,909.47 $130,056.60 $89,587.64 2025-01-01
'004-3 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 1 — — $89,360.58 $89,360.58 $89,360.58 2025-01-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 24 11 — — $53,561.12 $129,216.20 $89,007.21 2025-01-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 24 11 — — $53,470.95 $128,998.67 $88,856.96 2025-01-01
'593-3 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 1 — — $88,536.75 $88,536.75 $88,536.75 2025-01-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 24 11 — — $53,198.13 $128,340.48 $88,402.38 2025-01-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 24 11 — — $53,060.18 $128,007.67 $88,172.52 2025-01-01
A9542 HCPCS Indium In-111 Ibritumomab Tiuxetan Diagnostic Per Study Dose Up To 5 Millicuries 148 56 $97,800.00 $68,460.00 30% off $350.00 $156,480.00 $88,020.00 2025-01-01
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 24 11 — — $52,781.18 $127,334.61 $87,707.67 2025-01-01
'001-2 APR_DRG Liver Transplant And/or Intestinal Transplant 2 1 — — $87,698.30 $87,698.30 $87,698.30 2025-01-01
'005-4 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 1 — — $85,840.48 $85,840.48 $85,840.48 2025-01-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 24 11 — — $51,346.17 $123,872.63 $85,316.62 2025-01-01
A9604 HCPCS Samarium Sm-153 Lexidronam Therapeutic Per 150 Millicuries 160 58 $95,760.00 $67,032.00 30% off $350.00 $153,216.00 $85,226.40 2025-01-01
0454T HCPCS Insj/rplcmt Subq Electrode 2 1 — — $84,056.53 $84,056.53 $84,056.53 2025-01-01
0459T HCPCS Relocaj Rplcmt Aortic Ventr 2 1 — — $84,056.53 $84,056.53 $84,056.53 2025-01-01
0453T HCPCS Insj/rplcmt Mech-elec Ntrfce 2 1 — — $84,056.53 $84,056.53 $84,056.53 2025-01-01
33983 HCPCS Replace Vad Intra W/bp 2 1 — — $84,056.53 $84,056.53 $84,056.53 2025-01-01
33975 HCPCS Implant Ventricular Device 2 1 — — $84,056.53 $84,056.53 $84,056.53 2025-01-01
0452T HCPCS Insj/rplcmt Dev Vasc Seal 2 1 — — $84,056.53 $84,056.53 $84,056.53 2025-01-01
33995 HCPCS Insj Perq Vad R Hrt Venous 2 1 — — $84,056.53 $84,056.53 $84,056.53 2025-01-01
33990 HCPCS Insj Perq Vad L Hrt Arterial 2 1 — — $84,056.53 $84,056.53 $84,056.53 2025-01-01
0451T HCPCS Insj/rplcmt Aortic Ventr Sys 2 1 — — $84,056.53 $84,056.53 $84,056.53 2025-01-01
33976 HCPCS Implant Ventricular Device 2 1 — — $84,056.53 $84,056.53 $84,056.53 2025-01-01
33982 HCPCS Replace Vad Intra Without Bp 2 1 — — $84,056.53 $84,056.53 $84,056.53 2025-01-01
33979 HCPCS Insert Intracorporeal Device 2 1 — — $84,056.53 $84,056.53 $84,056.53 2025-01-01
33981 HCPCS Replace Vad Pump Ext 2 1 — — $84,056.53 $84,056.53 $84,056.53 2025-01-01
33991 HCPCS Insj Perq Vad L Hrt Artl&ven 2 1 — — $84,056.53 $84,056.53 $84,056.53 2025-01-01
'162-4 APR_DRG Implantable Heart Assist Systems 2 1 — — $82,677.63 $82,677.63 $82,677.63 2025-01-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 24 11 — — $49,288.43 $118,908.34 $81,887.99 2025-01-01
'001-1 APR_DRG Liver Transplant And/or Intestinal Transplant 2 1 — — $80,983.79 $80,983.79 $80,983.79 2025-01-01
'007-3 APR_DRG Allogeneic Bone Marrow Transplant 2 1 — — $80,744.34 $80,744.34 $80,744.34 2025-01-01
'303-4 APR_DRG Disorders Of Gallbladder And Biliary Tract 2 1 — — $80,504.89 $80,504.89 $80,504.89 2025-01-01
266 MS_DRG Endovascular Cardiac Valve Replacement W Mcc 24 11 — — $48,369.77 $116,692.07 $80,357.31 2025-01-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 24 11 — — $48,153.98 $116,171.47 $79,997.75 2025-01-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 24 11 — — $48,093.10 $116,024.59 $79,896.30 2025-01-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 24 11 — — $47,837.22 $115,407.30 $79,469.98 2025-01-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 24 11 — — $47,837.22 $115,407.30 $79,469.98 2025-01-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 24 11 — — $47,562.86 $114,745.41 $79,012.83 2025-01-01
454 MS_DRG Combined Anterior/posterior Spinal Fusion W Cc 24 11 — — $47,369.42 $114,278.72 $78,690.51 2025-01-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 24 11 — — $47,168.27 $113,793.46 $78,355.35 2025-01-01
'607-4 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 1 — — $78,238.23 $78,238.23 $78,238.23 2025-01-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 24 11 — — $47,053.43 $113,516.40 $78,164.01 2025-01-01
'602-3 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 1 — — $78,134.30 $78,134.30 $78,134.30 2025-01-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 24 11 — — $46,833.02 $112,984.65 $77,796.75 2025-01-01
J9298 HCPCS Opdualag Per 1 Each 160 58 $87,194.88 $61,036.42 30% off $56.10 $139,511.81 $77,603.44 2025-01-01
'006-1 APR_DRG Pancreas Transplant 2 1 — — $77,551.46 $77,551.46 $77,551.46 2025-01-01
28 MS_DRG Spinal Procedures With Mcc 24 11 — — $46,674.26 $112,601.64 $77,532.22 2025-01-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 24 11 — — $46,473.88 $112,118.24 $77,198.35 2025-01-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 24 11 — — $46,076.98 $111,160.70 $76,537.02 2025-01-01
'842-4 APR_DRG Extensive Third Degree Burns With Skin Graft 2 1 — — $76,374.24 $76,374.24 $76,374.24 2025-01-01
A9606 HCPCS Radium Ra-223 Dichloride Therapeutic Per Microcurie 160 58 $85,076.88 $59,553.82 30% off $48.53 $136,123.01 $75,718.42 2025-01-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 24 11 — — $45,552.90 $109,896.38 $75,663.81 2025-01-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 24 11 — — $44,135.62 $106,477.17 $73,302.30 2025-01-01
'759-4 APR_DRG Behavioral Disorders 2 1 — — $73,210.63 $73,210.63 $73,210.63 2025-01-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 24 11 — — $44,030.80 $106,224.31 $73,127.66 2025-01-01
'591-3 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 2 1 — — $73,021.99 $73,021.99 $73,021.99 2025-01-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 24 11 — — $43,920.59 $105,958.43 $72,944.02 2025-01-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 24 11 — — $43,881.29 $105,863.61 $72,878.54 2025-01-01
'008-4 APR_DRG Autologous Bone Marrow Transplant 2 1 — — $72,683.23 $72,683.23 $72,683.23 2025-01-01
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 24 11 — — $43,382.65 $104,660.64 $72,047.70 2025-01-01
'593-2 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 1 — — $71,857.87 $71,857.87 $71,857.87 2025-01-01
'163-4 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 2 1 — — $71,624.58 $71,624.58 $71,624.58 2025-01-01
'440-3 APR_DRG Thyroid Disorders 2 1 — — $71,500.62 $71,500.62 $71,500.62 2025-01-01
'178-4 APR_DRG Cardiac Pacemaker And Defibrillator Revision Except Device Replacement 2 1 — — $70,973.99 $70,973.99 $70,973.99 2025-01-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 24 11 — — $42,659.74 $102,916.63 $70,843.18 2025-01-01
'630-3 APR_DRG Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Probl… 2 1 — — $69,761.36 $69,761.36 $69,761.36 2025-01-01
653 MS_DRG Major Bladder Procedures With Mcc 24 11 — — $41,953.80 $101,213.54 $69,666.93 2025-01-01
27800000002-25809 CDM Device Impella 5.5 Smartassist 146 56 $77,355.00 $54,148.50 30% off $350.00 $123,768.00 $69,619.50 2025-01-01
27800000002-25808 CDM Device Impella 5.5 Smartassist 146 56 $77,355.00 $54,148.50 30% off $350.00 $123,768.00 $69,619.50 2025-01-01
J3357 HCPCS Ustekinumab Sub Cu Inj 1 Mg 160 58 $76,829.58 $53,780.71 30% off $45.77 $122,927.33 $68,378.32 2025-01-01
'609-3 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 2 1 — — $67,739.54 $67,739.54 $67,739.54 2025-01-01
8 MS_DRG Simultaneous Pancreas/kidney Transplant 24 11 — — $40,783.12 $98,389.28 $67,716.33 2025-01-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 24 11 — — $40,651.34 $98,071.35 $67,496.75 2025-01-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 24 11 — — $40,291.42 $97,203.06 $66,897.05 2025-01-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 24 11 — — $40,204.34 $96,992.96 $66,751.95 2025-01-01
11 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Mcc 24 11 — — $39,970.82 $96,429.59 $66,362.86 2025-01-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 24 11 — — $39,375.07 $94,992.36 $65,370.22 2025-01-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 24 11 — — $39,204.75 $94,581.46 $65,086.43 2025-01-01
'007-2 APR_DRG Allogeneic Bone Marrow Transplant 2 1 — — $64,997.83 $64,997.83 $64,997.83 2025-01-01
'165-4 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 2 1 — — $64,927.00 $64,927.00 $64,927.00 2025-01-01
S2235 HCPCS Implant Auditory Brain Imp 2 1 — — $64,859.47 $64,859.47 $64,859.47 2025-01-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 24 11 — — $39,064.49 $94,243.08 $64,852.72 2025-01-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 24 11 — — $38,760.84 $93,510.53 $64,346.78 2025-01-01
C9149 HCPCS Inj, Teplizumab-mzwv, 5 Mcg 2 1 — — $63,940.39 $63,940.39 $63,940.39 2025-01-01
J9376 HCPCS Inj Pozelimab-bbfg, 1 Mg 2 1 — — $63,940.39 $63,940.39 $63,940.39 2025-01-01
C9052 HCPCS Injection, Ravulizumab-cwv 2 1 — — $63,940.39 $63,940.39 $63,940.39 2025-01-01
C9146 HCPCS Inj, Elahere, 1 Mg 2 1 — — $63,940.39 $63,940.39 $63,940.39 2025-01-01
Q9995 HCPCS Inj. Emicizumab-kxwh, 0.5 Mg 2 1 — — $63,940.39 $63,940.39 $63,940.39 2025-01-01
C9085 HCPCS Inj Avalglucosid Alfa-ngpt 2 1 — — $63,940.39 $63,940.39 $63,940.39 2025-01-01
799 MS_DRG Splenic Procedures With Mcc 24 11 — — $38,416.34 $92,679.43 $63,772.77 2025-01-01
'167-4 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 2 1 — — $63,699.74 $63,699.74 $63,699.74 2025-01-01
471 MS_DRG Cervical Spinal Fusion With Mcc 24 11 — — $38,141.98 $92,017.52 $63,315.62 2025-01-01
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 24 11 — — $37,842.95 $91,296.12 $62,817.38 2025-01-01
'005-3 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 1 — — $62,263.06 $62,263.06 $62,263.06 2025-01-01
6 MS_DRG Liver Transplant Without Mcc 24 11 — — $37,509.24 $90,491.04 $62,261.35 2025-01-01
10 MS_DRG Pancreas Transplant 24 11 — — $37,329.67 $90,057.83 $61,962.14 2025-01-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 24 11 — — $36,890.38 $88,998.03 $61,918.90 2025-01-01
'183-4 APR_DRG Other Peripheral Vascular And Related Procedures 2 1 — — $61,890.41 $61,890.41 $61,890.41 2025-01-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 24 11 — — $37,277.26 $89,931.40 $61,874.82 2025-01-01
'690-4 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 2 1 — — $61,741.05 $61,741.05 $61,741.05 2025-01-01
'009-3 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 2 1 — — $61,721.80 $61,721.80 $61,721.80 2025-01-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 24 11 — — $37,089.22 $89,477.73 $61,561.49 2025-01-01
'303-3 APR_DRG Disorders Of Gallbladder And Biliary Tract 2 1 — — $61,359.94 $61,359.94 $61,359.94 2025-01-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 24 11 — — $36,765.53 $88,696.84 $61,022.16 2025-01-01
'004-2 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 1 — — $60,945.72 $60,945.72 $60,945.72 2025-01-01
163 MS_DRG Major Chest Procedures With Mcc 24 11 — — $36,558.98 $88,198.55 $60,678.01 2025-01-01
'611-4 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 1 — — $60,589.25 $60,589.25 $60,589.25 2025-01-01
'440-2 APR_DRG Thyroid Disorders 2 1 — — $60,443.73 $60,443.73 $60,443.73 2025-01-01
'695-4 APR_DRG Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior 2 1 — — $60,398.30 $60,398.30 $60,398.30 2025-01-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 24 11 — — $17,099.48 $86,990.02 $59,843.34 2025-01-01
'602-2 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 1 — — $59,733.09 $59,733.09 $59,733.09 2025-01-01
G0448 HCPCS Place Perm Pacing Cardiovert 2 1 — — $59,702.19 $59,702.19 $59,702.19 2025-01-01
C9741 HCPCS Impl Pressure Sensor W/angio 2 1 — — $59,702.19 $59,702.19 $59,702.19 2025-01-01
'304-4 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 2 1 — — $59,484.41 $59,484.41 $59,484.41 2025-01-01
'863-4 APR_DRG Signs, Symptoms And Other Factors Influencing Health Status 2 1 — — $59,479.78 $59,479.78 $59,479.78 2025-01-01
455 MS_DRG Combined Anterior/posterior Spinal Fusion Without Cc/mcc 24 11 — — $35,726.64 $86,190.52 $59,291.15 2025-01-01
'607-3 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 1 — — $58,857.68 $58,857.68 $58,857.68 2025-01-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 24 11 — — $34,055.79 $82,159.60 $58,389.69 2025-01-01
245 MS_DRG Aicd Generator Procedures 24 11 — — $35,154.79 $84,810.94 $58,338.32 2025-01-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 24 11 — — $35,151.71 $84,803.51 $58,333.19 2025-01-01
'608-4 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 2 1 — — $58,331.83 $58,331.83 $58,331.83 2025-01-01
'166-4 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 2 1 — — $58,248.67 $58,248.67 $58,248.67 2025-01-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 24 11 — — $35,042.27 $84,539.48 $58,150.85 2025-01-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 24 11 — — $34,927.44 $84,262.45 $57,959.51 2025-01-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 24 11 — — $34,893.53 $84,180.64 $57,903.01 2025-01-01
'179-4 APR_DRG External Heart Assist Systems 2 1 — — $57,770.55 $57,770.55 $57,770.55 2025-01-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 24 11 — — $34,607.60 $83,490.84 $57,426.60 2025-01-01
'613-4 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 2 1 — — $57,130.74 $57,130.74 $57,130.74 2025-01-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 24 11 — — $34,360.98 $82,895.87 $57,015.68 2025-01-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 24 11 — — $34,265.42 $82,665.32 $56,856.44 2025-01-01
'162-3 APR_DRG Implantable Heart Assist Systems 2 1 — — $56,462.45 $56,462.45 $56,462.45 2025-01-01
'680-4 APR_DRG Other Anemia And Disorders Of Blood And Blood-forming Organs 2 1 — — $56,209.91 $56,209.91 $56,209.91 2025-01-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 24 11 — — $33,848.47 $81,659.44 $56,161.72 2025-01-01
'910-4 APR_DRG HIV With Multiple Significant HIV Related Conditions 2 1 — — $56,123.68 $56,123.68 $56,123.68 2025-01-01
901 MS_DRG Wound Debridements For Injuries With Mcc 24 11 — — $33,585.67 $81,025.43 $55,723.84 2025-01-01
'612-4 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 2 1 — — $55,411.50 $55,411.50 $55,411.50 2025-01-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 24 11 — — $33,393.00 $80,560.61 $55,402.81 2025-01-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 24 11 — — $33,207.26 $80,112.52 $55,093.33 2025-01-01
'911-4 APR_DRG HIV With One Significant HIV Condition Or Without Significant Related Conditions 2 1 — — $55,041.16 $55,041.16 $55,041.16 2025-01-01
'603-3 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 1 — — $54,865.62 $54,865.62 $54,865.62 2025-01-01
'169-4 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 2 1 — — $54,122.65 $54,122.65 $54,122.65 2025-01-01
'091-4 APR_DRG Major Cranial Or Facial Bone Procedures 2 1 — — $53,729.98 $53,729.98 $53,729.98 2025-01-01
'312-4 APR_DRG Vertebral And Intervertebral Spinal Procedures Including Disc Procedures 2 1 — — $53,700.73 $53,700.73 $53,700.73 2025-01-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 24 11 — — $32,281.66 $77,879.51 $53,551.09 2025-01-01
'912-4 APR_DRG Craniotomy For Multiple Significant Trauma 2 1 — — $53,549.05 $53,549.05 $53,549.05 2025-01-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 24 11 — — $32,138.32 $77,533.70 $53,312.24 2025-01-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 24 11 — — $31,957.98 $77,098.62 $53,011.76 2025-01-01
791 MS_DRG Prematurity With Major Problems 24 11 — — $31,812.32 $76,747.22 $52,769.06 2025-01-01
J2350 HCPCS Injection Ocrelizumab 1 Mg 160 58 $59,143.14 $41,400.20 30% off $17.63 $94,629.02 $52,637.40 2025-01-01
27800000002-25879 CDM Valve Sapien Thv Edwards Resilia 29mm 146 56 $58,446.00 $40,912.20 30% off $350.00 $93,513.60 $52,601.40 2025-01-01
27800000002-25878 CDM Valve Sapien Thv Edwards Resilia 23mm 146 56 $58,446.00 $40,912.20 30% off $350.00 $93,513.60 $52,601.40 2025-01-01
27800000002-25880 CDM Valve Sapien Thv Edwards Resilia 26mm 146 56 $58,446.00 $40,912.20 30% off $350.00 $93,513.60 $52,601.40 2025-01-01
27800000002-25881 CDM Valve Sapien Thv Edwards Resilia 20mm 146 56 $58,446.00 $40,912.20 30% off $350.00 $93,513.60 $52,601.40 2025-01-01
'440-1 APR_DRG Thyroid Disorders 2 1 — — $52,393.39 $52,393.39 $52,393.39 2025-01-01
'178-3 APR_DRG Cardiac Pacemaker And Defibrillator Revision Except Device Replacement 2 1 — — $52,307.16 $52,307.16 $52,307.16 2025-01-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 24 11 — — $31,504.82 $76,005.37 $52,256.69 2025-01-01
'441-4 APR_DRG Kidney Transplant 2 1 — — $52,225.55 $52,225.55 $52,225.55 2025-01-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 24 11 — — $31,404.62 $75,763.66 $52,089.75 2025-01-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 24 11 — — $31,376.88 $75,696.72 $52,043.52 2025-01-01
'260-4 APR_DRG Other Digestive System Diagnoses 2 1 — — $52,023.83 $52,023.83 $52,023.83 2025-01-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 24 11 — — $31,171.10 $75,200.29 $51,700.66 2025-01-01
0466T HCPCS Insj Ch Wal Respir Eltrd/ra 2 1 — — $51,631.90 $51,631.90 $51,631.90 2025-01-01
0431T HCPCS Rmvl/rplc Nstim Apnea Pls Gn 2 1 — — $51,631.90 $51,631.90 $51,631.90 2025-01-01
0424T HCPCS Insj/rplc Nstim Apnea Compl 2 1 — — $51,631.90 $51,631.90 $51,631.90 2025-01-01
61870 HCPCS Implant Neuroelectrodes 2 1 — — $51,631.90 $51,631.90 $51,631.90 2025-01-01
61889 HCPCS Ins Sk-mnt Crnl Nstm Pg/rcvr 2 1 — — $51,631.90 $51,631.90 $51,631.90 2025-01-01
0427T HCPCS Insj/rplc Nstim Apnea Pls Gn 2 1 — — $51,631.90 $51,631.90 $51,631.90 2025-01-01
61867 HCPCS Implant Neuroelectrode 2 1 — — $51,631.90 $51,631.90 $51,631.90 2025-01-01
0316T HCPCS Replc Vagus Nerve Pls Gen 2 1 — — $51,631.90 $51,631.90 $51,631.90 2025-01-01
61868 HCPCS Implant Neuroelectrde Addl 2 1 — — $51,631.90 $51,631.90 $51,631.90 2025-01-01
0312T HCPCS Laps Impltj Nstim Vagus 2 1 — — $51,631.90 $51,631.90 $51,631.90 2025-01-01
61860 HCPCS Implant Neuroelectrodes 2 1 — — $51,631.90 $51,631.90 $51,631.90 2025-01-01
61850 HCPCS Implant Neuroelectrodes 2 1 — — $51,631.90 $51,631.90 $51,631.90 2025-01-01
61863 HCPCS Implant Neuroelectrode 2 1 — — $51,631.90 $51,631.90 $51,631.90 2025-01-01
61864 HCPCS Implant Neuroelectrde Addl 2 1 — — $51,631.90 $51,631.90 $51,631.90 2025-01-01
12 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Cc 24 11 — — $31,097.12 $75,021.80 $51,577.38 2025-01-01
'752-4 APR_DRG Major Depressive Disorders And Other Or Unspecified Psychoses 2 1 — — $51,010.61 $51,010.61 $51,010.61 2025-01-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 24 11 — — $30,733.36 $74,144.23 $50,971.27 2025-01-01
27800000002-26188 CDM Implant Gammatile Therapy Device 6pk 146 56 $56,108.16 $39,275.71 30% off $350.00 $89,773.06 $50,497.34 2025-01-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 24 11 — — $30,372.67 $73,274.07 $50,370.30 2025-01-01
27800000002-26240 CDM Valve Sapien 3 Ultra Thv 23mm W/command System 146 56 $55,867.50 $39,107.25 30% off $350.00 $89,388.00 $50,280.75 2025-01-01
27800000002-26140 CDM Valve Sapien 3 Thv 29mm W/command System 146 56 $55,867.50 $39,107.25 30% off $350.00 $89,388.00 $50,280.75 2025-01-01
27800000002-26239 CDM Valve Sapien 3 Ultra Thv 20mm W/command System 146 56 $55,867.50 $39,107.25 30% off $350.00 $89,388.00 $50,280.75 2025-01-01
27800000002-26241 CDM Valve Sapien 3 Ultra Thv 26mm W/command System 146 56 $55,867.50 $39,107.25 30% off $350.00 $89,388.00 $50,280.75 2025-01-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 24 11 — — $30,299.46 $73,097.44 $50,248.31 2025-01-01
273 MS_DRG Percutaneous Intracardiac Procedures W Mcc 24 11 — — $30,265.55 $73,015.64 $50,191.81 2025-01-01
'021-4 APR_DRG Open Craniotomy For Trauma 2 1 — — $50,135.20 $50,135.20 $50,135.20 2025-01-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 24 11 — — $30,190.02 $72,833.43 $50,065.96 2025-01-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 24 11 — — $30,120.66 $72,666.08 $49,950.38 2025-01-01
'023-4 APR_DRG Ventricular Shunt Procedures 2 1 — — $49,736.38 $49,736.38 $49,736.38 2025-01-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 24 11 — — $29,907.18 $72,151.06 $49,594.68 2025-01-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan Therapeutic Per Treatment Dose Up To 40 Millic… 160 58 $55,035.00 $38,524.50 30% off $350.00 $278,930.23 $49,531.50 2025-01-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 24 11 — — $29,715.28 $71,688.11 $49,274.94 2025-01-01
'007-1 APR_DRG Allogeneic Bone Marrow Transplant 2 1 — — $49,199.74 $49,199.74 $49,199.74 2025-01-01
'005-2 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 1 — — $48,928.73 $48,928.73 $48,928.73 2025-01-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 24 11 — — $29,431.66 $71,003.89 $48,802.38 2025-01-01
140 MS_DRG Major Head And Neck Procedures With Mcc 24 11 — — $29,349.20 $70,804.95 $48,664.98 2025-01-01
'841-3 APR_DRG Intentional Self-harm And Attempted Suicide 2 1 — — $48,656.18 $48,656.18 $48,656.18 2025-01-01
'608-3 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 2 1 — — $48,529.14 $48,529.14 $48,529.14 2025-01-01
'681-4 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 2 1 — — $48,414.42 $48,414.42 $48,414.42 2025-01-01
'591-2 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 2 1 — — $48,357.45 $48,357.45 $48,357.45 2025-01-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 24 11 — — $28,990.06 $69,938.53 $48,066.57 2025-01-01
'178-2 APR_DRG Cardiac Pacemaker And Defibrillator Revision Except Device Replacement 2 1 — — $48,025.60 $48,025.60 $48,025.60 2025-01-01
'165-3 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 2 1 — — $47,970.94 $47,970.94 $47,970.94 2025-01-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 24 11 — — $28,918.38 $69,765.60 $47,947.15 2025-01-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 24 11 — — $28,897.58 $69,715.40 $47,912.47 2025-01-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 24 11 — — $27,026.35 $68,890.46 $47,802.86 2025-01-01
'950-4 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 2 1 — — $47,689.15 $47,689.15 $47,689.15 2025-01-01
'020-4 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 1 — — $47,667.60 $47,667.60 $47,667.60 2025-01-01
'220-4 APR_DRG Other Circulatory System Diagnoses 2 1 — — $47,656.04 $47,656.04 $47,656.04 2025-01-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 24 11 — — $28,731.88 $69,315.66 $47,636.39 2025-01-01
'160-3 APR_DRG Acute Bronchitis And Related Symptoms 2 1 — — $47,309.58 $47,309.58 $47,309.58 2025-01-01
'163-3 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 2 1 — — $47,130.18 $47,130.18 $47,130.18 2025-01-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 24 11 — — $28,422.83 $68,570.08 $47,121.45 2025-01-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 24 11 — — $28,375.82 $68,456.68 $47,043.12 2025-01-01
332 MS_DRG Rectal Resection With Mcc 24 11 — — $28,189.32 $68,006.73 $46,942.76 2025-01-01
'850-4 APR_DRG Partial Thickness Burns Without Skin Graft 2 1 — — $46,923.07 $46,923.07 $46,923.07 2025-01-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 24 11 — — $28,260.99 $68,179.64 $46,851.79 2025-01-01
J9309 HCPCS Polatuzumab Per 140 Mg 160 58 $52,629.12 $36,840.38 30% off $37.21 $84,206.59 $46,839.92 2025-01-01
C2616 HCPCS Brachytherapy Source Non-stranded Yttrium-90 Per Source 160 58 $51,900.00 $36,330.00 30% off $350.00 $83,040.00 $46,710.00 2025-01-01
'120-4 APR_DRG Other Ear, Nose, Mouth, Throat And Cranial Or Facial Diagnoses 2 1 — — $46,702.88 $46,702.88 $46,702.88 2025-01-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 24 11 — — $28,151.55 $67,915.62 $46,669.43 2025-01-01
739 MS_DRG Uterine,adnexa Proc For Non-ovarian/adnexal Malig W Mcc 24 11 — — $28,102.23 $67,796.63 $46,587.26 2025-01-01
27800000002-26244 CDM Kit Mitraclip G4 Syst Cds0701nt/ntw/xt/xtw 146 56 $51,570.00 $36,099.00 30% off $350.00 $82,512.00 $46,413.00 2025-01-01
27800000002-25864 CDM Valve Aortic 26mm Evolut Fx 146 56 $51,570.00 $36,099.00 30% off $350.00 $82,512.00 $46,413.00 2025-01-01
27800000002-25866 CDM Valve Mitral Tendyne 33mm Lp 146 56 $51,570.00 $36,099.00 30% off $350.00 $82,512.00 $46,413.00 2025-01-01
'607-2 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 1 — — $46,368.73 $46,368.73 $46,368.73 2025-01-01
'027-4 APR_DRG Other Nervous System And Related Procedures 2 1 — — $46,341.78 $46,341.78 $46,341.78 2025-01-01
'181-4 APR_DRG Other Circulatory System Procedures 2 1 — — $46,227.06 $46,227.06 $46,227.06 2025-01-01
'089-4 APR_DRG Eye Infections And Other Eye Disorders 2 1 — — $46,178.56 $46,178.56 $46,178.56 2025-01-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 24 11 — — $27,831.72 $67,144.02 $46,136.52 2025-01-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 24 11 — — $27,783.94 $67,028.75 $46,056.91 2025-01-01
265 MS_DRG Aicd Lead Procedures 24 11 — — $27,468.73 $66,268.31 $45,531.71 2025-01-01
'004-1 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 1 — — $45,487.93 $45,487.93 $45,487.93 2025-01-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 24 11 — — $27,400.14 $66,102.83 $45,417.42 2025-01-01
93609 HCPCS Map Tachycardia Add-on 2 1 — — $45,327.71 $45,327.71 $45,327.71 2025-01-01
See an error in this hospital's data? Submit a correction