|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
22
|
9
|
—
|
—
|
$10,292.55
|
$303,464.65
|
$271,360.50
|
2026-03-06
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
22
|
9
|
—
|
—
|
$10,292.55
|
$76,707.09
|
$68,256.31
|
2026-03-06
|
|
11
|
APR_DRG
|
Apr-DRG 42.00: Liver Transplant And/or Intestinal Transplant
|
12
|
5
|
—
|
—
|
$48,924.20
|
$79,835.17
|
$61,980.96
|
2026-03-06
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$125,505.99
|
$53,595.62
|
2026-03-06
|
|
111
|
APR_DRG
|
Apr-DRG 42.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
12
|
5
|
—
|
—
|
$72,755.02
|
$118,644.49
|
$92,141.75
|
2026-03-06
|
|
112
|
APR_DRG
|
Apr-DRG 42.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
12
|
5
|
—
|
—
|
$147,719.52
|
$240,901.34
|
$187,085.29
|
2026-03-06
|
|
113
|
APR_DRG
|
Apr-DRG 42.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
12
|
5
|
—
|
—
|
$185,833.05
|
$303,025.07
|
$235,343.46
|
2026-03-06
|
|
114
|
APR_DRG
|
Apr-DRG 42.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
12
|
5
|
—
|
—
|
$249,671.24
|
$407,175.14
|
$316,210.21
|
2026-03-06
|
|
12
|
APR_DRG
|
Apr-DRG 42.00: Liver Transplant And/or Intestinal Transplant
|
12
|
5
|
—
|
—
|
$55,710.46
|
$90,873.98
|
$70,564.88
|
2026-03-06
|
|
12
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$102,044.96
|
$41,649.79
|
2026-03-06
|
|
1204
|
APR_DRG
|
Apr-DRG 42.00: Major Respiratory And Chest Procedures
|
12
|
5
|
—
|
—
|
$43,716.14
|
$71,246.86
|
$55,348.60
|
2026-03-06
|
|
1214
|
APR_DRG
|
Apr-DRG 42.00: Other Respiratory And Chest Procedures
|
12
|
5
|
—
|
—
|
$36,614.24
|
$59,720.48
|
$46,375.36
|
2026-03-06
|
|
13
|
APR_DRG
|
Apr-DRG 42.00: Liver Transplant And/or Intestinal Transplant
|
12
|
5
|
—
|
—
|
$72,123.74
|
$117,589.82
|
$91,332.59
|
2026-03-06
|
|
1304
|
APR_DRG
|
Apr-DRG 42.00: Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
12
|
5
|
—
|
—
|
$43,163.77
|
$70,408.89
|
$54,673.11
|
2026-03-06
|
|
14
|
APR_DRG
|
Apr-DRG 42.00: Liver Transplant And/or Intestinal Transplant
|
12
|
5
|
—
|
—
|
$138,881.60
|
$226,492.21
|
$175,893.60
|
2026-03-06
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
22
|
9
|
—
|
—
|
$10,292.55
|
$130,139.20
|
$116,926.48
|
2026-03-06
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$120,158.92
|
$42,125.48
|
2026-03-06
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
22
|
9
|
—
|
—
|
$10,292.55
|
$64,211.42
|
$58,184.46
|
2026-03-06
|
|
1602
|
APR_DRG
|
Apr-DRG 42.00: Major Cardiothoracic Repair Of Heart Anomaly
|
12
|
5
|
—
|
—
|
$37,087.70
|
$60,530.78
|
$46,989.62
|
2026-03-06
|
|
1603
|
APR_DRG
|
Apr-DRG 42.00: Major Cardiothoracic Repair Of Heart Anomaly
|
12
|
5
|
—
|
—
|
$49,555.48
|
$80,794.16
|
$62,753.46
|
2026-03-06
|
|
1604
|
APR_DRG
|
Apr-DRG 42.00: Major Cardiothoracic Repair Of Heart Anomaly
|
12
|
5
|
—
|
—
|
$106,923.05
|
$174,312.29
|
$135,394.71
|
2026-03-06
|
|
1611
|
APR_DRG
|
Apr-DRG 42.00: Implantable Heart Assist Systems
|
12
|
5
|
—
|
—
|
$107,317.60
|
$174,949.70
|
$135,892.10
|
2026-03-06
|
|
1612
|
APR_DRG
|
Apr-DRG 42.00: Implantable Heart Assist Systems
|
12
|
5
|
—
|
—
|
$107,317.60
|
$174,949.70
|
$135,892.10
|
2026-03-06
|
|
1613
|
APR_DRG
|
Apr-DRG 42.00: Implantable Heart Assist Systems
|
12
|
5
|
—
|
—
|
$145,825.68
|
$237,766.17
|
$184,668.86
|
2026-03-06
|
|
1614
|
APR_DRG
|
Apr-DRG 42.00: Implantable Heart Assist Systems
|
12
|
5
|
—
|
—
|
$186,227.60
|
$303,652.11
|
$235,836.87
|
2026-03-06
|
|
1621
|
APR_DRG
|
Apr-DRG 42.00: Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
12
|
5
|
—
|
—
|
$33,063.29
|
$53,981.50
|
$41,898.01
|
2026-03-06
|
|
1622
|
APR_DRG
|
Apr-DRG 42.00: Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
12
|
5
|
—
|
—
|
$39,691.73
|
$64,782.87
|
$50,289.68
|
2026-03-06
|
|
1623
|
APR_DRG
|
Apr-DRG 42.00: Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
12
|
5
|
—
|
—
|
$52,554.06
|
$85,691.72
|
$66,553.99
|
2026-03-06
|
|
1624
|
APR_DRG
|
Apr-DRG 42.00: Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
12
|
5
|
—
|
—
|
$71,808.10
|
$117,144.91
|
$90,959.60
|
2026-03-06
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$98,620.43
|
$44,214.37
|
2026-03-06
|
|
1632
|
APR_DRG
|
Apr-DRG 42.00: Cardiac Valve Procedures Without Ami Or Complex Principal Diagnos…
|
12
|
5
|
—
|
—
|
$33,378.93
|
$54,387.22
|
$42,255.99
|
2026-03-06
|
|
1633
|
APR_DRG
|
Apr-DRG 42.00: Cardiac Valve Procedures Without Ami Or Complex Principal Diagnos…
|
12
|
5
|
—
|
—
|
$45,215.43
|
$73,691.61
|
$57,247.32
|
2026-03-06
|
|
1634
|
APR_DRG
|
Apr-DRG 42.00: Cardiac Valve Procedures Without Ami Or Complex Principal Diagnos…
|
12
|
5
|
—
|
—
|
$62,891.27
|
$102,506.40
|
$79,629.38
|
2026-03-06
|
|
1652
|
APR_DRG
|
Apr-DRG 42.00: Coronary Bypass With Ami Or Complex Principal Diagnosis
|
12
|
5
|
—
|
—
|
$33,852.39
|
$55,180.24
|
$42,863.62
|
2026-03-06
|
|
1653
|
APR_DRG
|
Apr-DRG 42.00: Coronary Bypass With Ami Or Complex Principal Diagnosis
|
12
|
5
|
—
|
—
|
$41,980.12
|
$68,434.42
|
$53,157.11
|
2026-03-06
|
|
1654
|
APR_DRG
|
Apr-DRG 42.00: Coronary Bypass With Ami Or Complex Principal Diagnosis
|
12
|
5
|
—
|
—
|
$56,499.56
|
$92,091.17
|
$71,537.55
|
2026-03-06
|
|
1663
|
APR_DRG
|
Apr-DRG 42.00: Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
12
|
5
|
—
|
—
|
$36,929.88
|
$60,232.25
|
$46,773.97
|
2026-03-06
|
|
1664
|
APR_DRG
|
Apr-DRG 42.00: Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
12
|
5
|
—
|
—
|
$50,344.58
|
$82,098.95
|
$63,759.71
|
2026-03-06
|
|
1673
|
APR_DRG
|
Apr-DRG 42.00: Other Cardiothoracic And Thoracic Circulatory Procedures
|
12
|
5
|
—
|
—
|
$35,114.95
|
$57,274.58
|
$44,476.19
|
2026-03-06
|
|
1674
|
APR_DRG
|
Apr-DRG 42.00: Other Cardiothoracic And Thoracic Circulatory Procedures
|
12
|
5
|
—
|
—
|
$55,315.91
|
$90,231.96
|
$70,065.72
|
2026-03-06
|
|
1694
|
APR_DRG
|
Apr-DRG 42.00: Major Abdominal Vascular Procedures
|
12
|
5
|
—
|
—
|
$44,899.79
|
$73,197.12
|
$56,855.34
|
2026-03-06
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
22
|
9
|
—
|
—
|
$10,292.55
|
$58,328.36
|
$52,392.89
|
2026-03-06
|
|
1704
|
APR_DRG
|
Apr-DRG 42.00: Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Sh…
|
12
|
5
|
—
|
—
|
$37,008.79
|
$60,374.03
|
$46,878.93
|
2026-03-06
|
|
1754
|
APR_DRG
|
Apr-DRG 42.00: Percutaneous Cardiac Intervention Without Ami
|
12
|
5
|
—
|
—
|
$34,089.12
|
$55,570.98
|
$43,165.24
|
2026-03-06
|
|
1764
|
APR_DRG
|
Apr-DRG 42.00: Insertion, Revision And Replacements Of Pacemaker And Other Cardi…
|
12
|
5
|
—
|
—
|
$35,667.32
|
$58,133.30
|
$45,159.64
|
2026-03-06
|
|
1781
|
APR_DRG
|
Apr-DRG 42.00: External Heart Assist Devices
|
12
|
5
|
—
|
—
|
$35,351.68
|
$57,635.36
|
$44,766.32
|
2026-03-06
|
|
1782
|
APR_DRG
|
Apr-DRG 42.00: External Heart Assist Devices
|
12
|
5
|
—
|
—
|
$39,297.18
|
$64,039.41
|
$49,751.65
|
2026-03-06
|
|
1783
|
APR_DRG
|
Apr-DRG 42.00: External Heart Assist Devices
|
12
|
5
|
—
|
—
|
$48,214.01
|
$78,651.41
|
$61,071.71
|
2026-03-06
|
|
1784
|
APR_DRG
|
Apr-DRG 42.00: External Heart Assist Devices
|
12
|
5
|
—
|
—
|
$59,734.87
|
$97,475.14
|
$75,676.37
|
2026-03-06
|
|
1793
|
APR_DRG
|
Apr-DRG 42.00: Defibrillator Implants
|
12
|
5
|
—
|
—
|
$37,876.80
|
$61,706.48
|
$47,946.40
|
2026-03-06
|
|
1794
|
APR_DRG
|
Apr-DRG 42.00: Defibrillator Implants
|
12
|
5
|
—
|
—
|
$49,713.30
|
$81,028.15
|
$62,944.37
|
2026-03-06
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
22
|
9
|
—
|
—
|
$10,292.55
|
$467,617.04
|
$417,621.29
|
2026-03-06
|
|
1814
|
APR_DRG
|
Apr-DRG 42.00: Lower Extremity Vascular Procedures
|
12
|
5
|
—
|
—
|
$36,929.88
|
$60,240.32
|
$46,777.07
|
2026-03-06
|
|
1833
|
APR_DRG
|
Apr-DRG 42.00: Percutaneous Structural Cardiac Procedures
|
12
|
5
|
—
|
—
|
$39,060.45
|
$63,748.95
|
$49,488.48
|
2026-03-06
|
|
1834
|
APR_DRG
|
Apr-DRG 42.00: Percutaneous Structural Cardiac Procedures
|
12
|
5
|
—
|
—
|
$53,816.62
|
$87,728.43
|
$68,144.47
|
2026-03-06
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
22
|
9
|
—
|
—
|
$10,292.55
|
$76,273.81
|
$69,809.93
|
2026-03-06
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
22
|
9
|
—
|
—
|
$10,292.55
|
$122,709.57
|
$110,306.66
|
2026-03-06
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$230,765.21
|
$76,893.85
|
2026-03-06
|
|
204
|
APR_DRG
|
Apr-DRG 42.00: Open Craniotomy For Trauma
|
12
|
5
|
—
|
—
|
$42,453.58
|
$69,196.32
|
$53,752.82
|
2026-03-06
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
30
|
9
|
—
|
—
|
$10,292.55
|
$169,904.71
|
$63,056.94
|
2026-03-06
|
|
209
|
MS_DRG
|
Complex Aortic Arch Procedures
|
22
|
9
|
—
|
—
|
$10,292.55
|
$122,568.80
|
$110,181.21
|
2026-03-06
|
|
21
|
APR_DRG
|
Apr-DRG 42.00: Heart And/or Lung Transplant
|
12
|
5
|
—
|
—
|
$90,983.23
|
$148,344.51
|
$115,217.40
|
2026-03-06
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$174,500.79
|
$52,048.96
|
2026-03-06
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
30
|
9
|
—
|
—
|
$10,292.55
|
$324,489.16
|
$105,890.52
|
2026-03-06
|
|
213
|
MS_DRG
|
Endovascular Abdominal Aorta With Iliac Branch Procedures
|
22
|
9
|
—
|
—
|
$10,292.55
|
$61,798.76
|
$56,034.75
|
2026-03-06
|
|
213
|
APR_DRG
|
Apr-DRG 42.00: Open Craniotomy Except Trauma
|
12
|
5
|
—
|
—
|
$34,168.03
|
$55,740.42
|
$43,280.79
|
2026-03-06
|
|
214
|
APR_DRG
|
Apr-DRG 42.00: Open Craniotomy Except Trauma
|
12
|
5
|
—
|
—
|
$48,608.56
|
$79,205.83
|
$61,537.29
|
2026-03-06
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
30
|
9
|
—
|
—
|
$10,292.55
|
$160,712.56
|
$97,041.89
|
2026-03-06
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
30
|
9
|
—
|
—
|
$10,292.55
|
$206,012.47
|
$95,361.11
|
2026-03-06
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
30
|
9
|
—
|
—
|
$10,292.55
|
$135,148.75
|
$64,413.51
|
2026-03-06
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
30
|
9
|
—
|
—
|
$10,292.55
|
$122,742.34
|
$64,413.51
|
2026-03-06
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
30
|
9
|
—
|
—
|
$10,292.55
|
$142,358.28
|
$75,055.82
|
2026-03-06
|
|
22
|
APR_DRG
|
Apr-DRG 42.00: Heart And/or Lung Transplant
|
12
|
5
|
—
|
—
|
$102,898.64
|
$167,840.23
|
$130,332.70
|
2026-03-06
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
30
|
9
|
—
|
—
|
$10,292.55
|
$111,837.91
|
$52,425.26
|
2026-03-06
|
|
2204
|
APR_DRG
|
Apr-DRG 42.00: Major Stomach, Esophageal And Duodenal Procedures
|
12
|
5
|
—
|
—
|
$43,005.95
|
$70,177.21
|
$54,483.09
|
2026-03-06
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
30
|
9
|
—
|
—
|
$10,292.55
|
$88,887.56
|
$49,602.10
|
2026-03-06
|
|
224
|
APR_DRG
|
Apr-DRG 42.00: Ventricular Shunt Procedures
|
12
|
5
|
—
|
—
|
$37,955.71
|
$61,893.20
|
$48,068.59
|
2026-03-06
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$153,893.54
|
$48,706.71
|
2026-03-06
|
|
23
|
APR_DRG
|
Apr-DRG 42.00: Heart And/or Lung Transplant
|
12
|
5
|
—
|
—
|
$135,883.02
|
$221,648.83
|
$172,113.82
|
2026-03-06
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
30
|
9
|
—
|
—
|
$10,292.55
|
$128,570.04
|
$56,260.54
|
2026-03-06
|
|
2304
|
APR_DRG
|
Apr-DRG 42.00: Major Small Bowel Procedures
|
12
|
5
|
—
|
—
|
$36,377.51
|
$59,362.01
|
$46,086.12
|
2026-03-06
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$212,741.37
|
$82,307.65
|
2026-03-06
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$143,289.51
|
$59,466.72
|
2026-03-06
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$146,894.28
|
$74,736.45
|
2026-03-06
|
|
234
|
APR_DRG
|
Apr-DRG 42.00: Spinal Procedures
|
12
|
5
|
—
|
—
|
$44,268.51
|
$72,219.69
|
$56,075.78
|
2026-03-06
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$114,601.57
|
$53,678.58
|
2026-03-06
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$112,258.47
|
$57,594.92
|
2026-03-06
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$95,796.70
|
$48,458.74
|
2026-03-06
|
|
24
|
APR_DRG
|
Apr-DRG 42.00: Heart And/or Lung Transplant
|
12
|
5
|
—
|
—
|
$249,513.42
|
$406,905.42
|
$316,005.60
|
2026-03-06
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
30
|
9
|
—
|
—
|
$10,292.55
|
$144,641.30
|
$44,992.04
|
2026-03-06
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$94,144.51
|
$44,840.56
|
2026-03-06
|
|
2604
|
APR_DRG
|
Apr-DRG 42.00: Major Pancreas, Liver And Shunt Procedures
|
12
|
5
|
—
|
—
|
$45,294.34
|
$73,901.39
|
$57,378.34
|
2026-03-06
|
|
2614
|
APR_DRG
|
Apr-DRG 42.00: Major Biliary Tract Procedures
|
12
|
5
|
—
|
—
|
$42,137.94
|
$68,715.67
|
$53,366.13
|
2026-03-06
|
|
264
|
APR_DRG
|
Apr-DRG 42.00: Other Nervous System And Related Procedures
|
12
|
5
|
—
|
—
|
$34,483.67
|
$56,176.12
|
$43,650.26
|
2026-03-06
|
|
2644
|
APR_DRG
|
Apr-DRG 42.00: Other Hepatobiliary, Pancreas And Abdominal Procedures
|
12
|
5
|
—
|
—
|
$35,904.05
|
$58,581.67
|
$45,483.33
|
2026-03-06
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$133,646.76
|
$60,101.59
|
2026-03-06
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$120,369.20
|
$46,906.30
|
2026-03-06
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$165,428.79
|
$67,333.16
|
2026-03-06
|
|
269
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$87,896.25
|
$41,719.27
|
2026-03-06
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$106,911.40
|
$51,880.10
|
2026-03-06
|
|
274
|
APR_DRG
|
Apr-DRG 42.00: Other Open Craniotomy
|
12
|
5
|
—
|
—
|
$40,875.38
|
$66,661.67
|
$51,769.02
|
2026-03-06
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$186,006.01
|
$69,769.43
|
2026-03-06
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
30
|
9
|
—
|
—
|
$10,292.55
|
$160,292.00
|
$58,926.42
|
2026-03-06
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$123,703.61
|
$45,533.32
|
2026-03-06
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
30
|
9
|
—
|
—
|
$10,292.55
|
$138,062.60
|
$54,677.20
|
2026-03-06
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$122,712.30
|
$58,942.80
|
2026-03-06
|
|
294
|
APR_DRG
|
Apr-DRG 42.00: Other Percutaneous Intracranial Procedures
|
12
|
5
|
—
|
—
|
$34,641.49
|
$56,526.52
|
$43,885.79
|
2026-03-06
|
|
2992
|
APR_DRG
|
Apr-DRG 42.00: Multiple Level Combined Anterior And Posterior Spinal Fusion Exce…
|
12
|
5
|
—
|
—
|
$35,430.59
|
$57,763.30
|
$44,865.97
|
2026-03-06
|
|
2993
|
APR_DRG
|
Apr-DRG 42.00: Multiple Level Combined Anterior And Posterior Spinal Fusion Exce…
|
12
|
5
|
—
|
—
|
$48,135.10
|
$78,538.45
|
$60,977.81
|
2026-03-06
|
|
2994
|
APR_DRG
|
Apr-DRG 42.00: Multiple Level Combined Anterior And Posterior Spinal Fusion Exce…
|
12
|
5
|
—
|
—
|
$61,549.80
|
$100,438.57
|
$77,976.35
|
2026-03-06
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
30
|
9
|
—
|
—
|
$10,292.55
|
$448,463.13
|
$205,763.19
|
2026-03-06
|
|
3003
|
APR_DRG
|
Apr-DRG 42.00: Single Level Combined Anterior And Posterior Spinal Fusion Except…
|
12
|
5
|
—
|
—
|
$32,826.56
|
$53,574.61
|
$41,590.21
|
2026-03-06
|
|
3004
|
APR_DRG
|
Apr-DRG 42.00: Single Level Combined Anterior And Posterior Spinal Fusion Except…
|
12
|
5
|
—
|
—
|
$46,951.45
|
$76,622.76
|
$59,484.32
|
2026-03-06
|
|
3032
|
APR_DRG
|
Apr-DRG 42.00: Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
12
|
5
|
—
|
—
|
$36,061.87
|
$58,842.17
|
$45,684.41
|
2026-03-06
|
|
3033
|
APR_DRG
|
Apr-DRG 42.00: Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
12
|
5
|
—
|
—
|
$49,634.39
|
$80,904.81
|
$62,846.48
|
2026-03-06
|
|
3034
|
APR_DRG
|
Apr-DRG 42.00: Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
12
|
5
|
—
|
—
|
$71,492.46
|
$116,578.96
|
$90,540.23
|
2026-03-06
|
|
304
|
APR_DRG
|
Apr-DRG 42.00: Percutaneous Intracranial And Extracranial Vascular Procedures
|
12
|
5
|
—
|
—
|
$37,087.70
|
$60,420.13
|
$46,947.21
|
2026-03-06
|
|
3043
|
APR_DRG
|
Apr-DRG 42.00: Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
12
|
5
|
—
|
—
|
$37,166.61
|
$60,609.16
|
$47,070.29
|
2026-03-06
|
|
3044
|
APR_DRG
|
Apr-DRG 42.00: Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
12
|
5
|
—
|
—
|
$50,423.49
|
$82,216.52
|
$63,855.39
|
2026-03-06
|
|
31
|
MS_DRG
|
Ventricular Shunt Procedures With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$82,759.46
|
$44,201.83
|
2026-03-06
|
|
3124
|
APR_DRG
|
Apr-DRG 42.00: Skin Graft For Musculoskeletal And Connective Tissue Diagnoses
|
12
|
5
|
—
|
—
|
$43,558.32
|
$70,997.89
|
$55,151.95
|
2026-03-06
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
30
|
9
|
—
|
—
|
$10,292.55
|
$185,825.77
|
$65,486.46
|
2026-03-06
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$130,402.47
|
$44,032.01
|
2026-03-06
|
|
3214
|
APR_DRG
|
Apr-DRG 42.00: Spinal Fusion And Other Back And Neck Procedures Except For Disc …
|
12
|
5
|
—
|
—
|
$37,955.71
|
$61,933.55
|
$48,084.04
|
2026-03-06
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$117,275.11
|
$42,724.65
|
2026-03-06
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$109,795.21
|
$49,092.64
|
2026-03-06
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$86,514.42
|
$45,321.06
|
2026-03-06
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$83,840.89
|
$43,355.66
|
2026-03-06
|
|
3614
|
APR_DRG
|
Apr-DRG 42.00: Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
12
|
5
|
—
|
—
|
$42,374.67
|
$69,077.60
|
$53,656.71
|
2026-03-06
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
30
|
9
|
—
|
—
|
$10,292.55
|
$298,354.60
|
$134,617.03
|
2026-03-06
|
|
4014
|
APR_DRG
|
Apr-DRG 42.00: Adrenal Procedures
|
12
|
5
|
—
|
—
|
$40,086.28
|
$65,383.39
|
$50,772.93
|
2026-03-06
|
|
4034
|
APR_DRG
|
Apr-DRG 42.00: Procedures For Obesity
|
12
|
5
|
—
|
—
|
$35,430.59
|
$57,832.46
|
$44,892.47
|
2026-03-06
|
|
4044
|
APR_DRG
|
Apr-DRG 42.00: Thyroid, Parathyroid And Thyroglossal Procedures
|
12
|
5
|
—
|
—
|
$35,588.41
|
$57,994.98
|
$45,056.00
|
2026-03-06
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$130,162.15
|
$53,753.84
|
2026-03-06
|
|
4054
|
APR_DRG
|
Apr-DRG 42.00: Other Procedures For Endocrine, Nutritional And Metabolic Disorde…
|
12
|
5
|
—
|
—
|
$35,982.96
|
$58,696.94
|
$45,578.12
|
2026-03-06
|
|
41
|
APR_DRG
|
Apr-DRG 42.00: Tracheostomy With Mv >96 Hours With Extensive Procedure
|
12
|
5
|
—
|
—
|
$42,769.22
|
$69,746.13
|
$54,166.01
|
2026-03-06
|
|
42
|
APR_DRG
|
Apr-DRG 42.00: Tracheostomy With Mv >96 Hours With Extensive Procedure
|
12
|
5
|
—
|
—
|
$61,786.53
|
$100,809.72
|
$78,270.45
|
2026-03-06
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
30
|
9
|
—
|
—
|
$10,292.55
|
$154,914.89
|
$107,309.82
|
2026-03-06
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
30
|
9
|
—
|
—
|
$10,292.55
|
$120,939.95
|
$70,620.41
|
2026-03-06
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
30
|
9
|
—
|
—
|
$10,292.55
|
$106,370.68
|
$55,215.59
|
2026-03-06
|
|
4284
|
APR_DRG
|
Apr-DRG 42.00: Genetic Disorders
|
12
|
5
|
—
|
—
|
$42,295.76
|
$68,993.45
|
$53,573.83
|
2026-03-06
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$250,531.35
|
$87,900.89
|
2026-03-06
|
|
43
|
APR_DRG
|
Apr-DRG 42.00: Tracheostomy With Mv >96 Hours With Extensive Procedure
|
12
|
5
|
—
|
—
|
$96,743.66
|
$157,752.34
|
$122,518.18
|
2026-03-06
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$112,859.27
|
$56,615.58
|
2026-03-06
|
|
44
|
APR_DRG
|
Apr-DRG 42.00: Tracheostomy With Mv >96 Hours With Extensive Procedure
|
12
|
5
|
—
|
—
|
$140,301.98
|
$228,767.52
|
$177,676.76
|
2026-03-06
|
|
4401
|
APR_DRG
|
Apr-DRG 42.00: Kidney Transplant
|
12
|
5
|
—
|
—
|
$38,113.53
|
$62,196.35
|
$48,286.00
|
2026-03-06
|
|
4402
|
APR_DRG
|
Apr-DRG 42.00: Kidney Transplant
|
12
|
5
|
—
|
—
|
$40,717.56
|
$66,461.11
|
$51,590.92
|
2026-03-06
|
|
4403
|
APR_DRG
|
Apr-DRG 42.00: Kidney Transplant
|
12
|
5
|
—
|
—
|
$47,819.46
|
$77,987.49
|
$60,564.17
|
2026-03-06
|
|
4404
|
APR_DRG
|
Apr-DRG 42.00: Kidney Transplant
|
12
|
5
|
—
|
—
|
$70,308.81
|
$114,707.08
|
$89,063.53
|
2026-03-06
|
|
4414
|
APR_DRG
|
Apr-DRG 42.00: Major Bladder Procedures
|
12
|
5
|
—
|
—
|
$39,533.91
|
$64,484.33
|
$50,074.02
|
2026-03-06
|
|
4424
|
APR_DRG
|
Apr-DRG 42.00: Kidney And Urinary Tract Procedures For Malignancy
|
12
|
5
|
—
|
—
|
$33,615.66
|
$54,869.03
|
$42,592.49
|
2026-03-06
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
30
|
9
|
—
|
—
|
$10,292.55
|
$126,767.66
|
$65,439.17
|
2026-03-06
|
|
4474
|
APR_DRG
|
Apr-DRG 42.00: Other Kidney, Urinary Tract And Related Non-percutaneous Procedur…
|
12
|
5
|
—
|
—
|
$33,773.48
|
$55,041.92
|
$42,759.99
|
2026-03-06
|
|
448
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical Without Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$79,905.68
|
$41,889.07
|
2026-03-06
|
|
4484
|
APR_DRG
|
Apr-DRG 42.00: Other Kidney, Urinary Tract And Related Percutaneous Procedures
|
12
|
5
|
—
|
—
|
$33,457.84
|
$54,579.71
|
$42,380.38
|
2026-03-06
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
30
|
9
|
—
|
—
|
$10,292.55
|
$106,641.04
|
$52,394.39
|
2026-03-06
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
30
|
9
|
—
|
—
|
$10,292.55
|
$204,750.80
|
$82,051.96
|
2026-03-06
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
30
|
9
|
—
|
—
|
$10,292.55
|
$148,906.94
|
$58,506.70
|
2026-03-06
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$191,893.80
|
$54,260.40
|
2026-03-06
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
30
|
9
|
—
|
—
|
$10,292.55
|
$109,614.97
|
$55,963.35
|
2026-03-06
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$96,818.05
|
$51,196.04
|
2026-03-06
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$89,878.87
|
$47,561.44
|
2026-03-06
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
30
|
9
|
—
|
—
|
$10,292.55
|
$85,883.59
|
$42,391.76
|
2026-03-06
|
|
4844
|
APR_DRG
|
Apr-DRG 42.00: Other Male Reproductive System And Related Procedures
|
12
|
5
|
—
|
—
|
$34,641.49
|
$56,521.91
|
$43,884.01
|
2026-03-06
|
|
4854
|
APR_DRG
|
Apr-DRG 42.00: Prostatectomy Procedures
|
12
|
5
|
—
|
—
|
$34,562.58
|
$56,389.36
|
$43,782.60
|
2026-03-06
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
22
|
9
|
—
|
—
|
$10,292.55
|
$111,650.14
|
$100,452.64
|
2026-03-06
|
|
5114
|
APR_DRG
|
Apr-DRG 42.00: Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy
|
12
|
5
|
—
|
—
|
$38,271.35
|
$62,400.36
|
$48,465.43
|
2026-03-06
|
|
5124
|
APR_DRG
|
Apr-DRG 42.00: Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Mal…
|
12
|
5
|
—
|
—
|
$36,614.24
|
$59,696.27
|
$46,366.08
|
2026-03-06
|
|
52
|
APR_DRG
|
Apr-DRG 42.00: Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
12
|
5
|
—
|
—
|
$47,267.09
|
$77,119.55
|
$59,877.20
|
2026-03-06
|
|
5204
|
APR_DRG
|
Apr-DRG 42.00: Other GYN Procedures For Malignancy
|
12
|
5
|
—
|
—
|
$39,928.46
|
$65,142.49
|
$50,579.36
|
2026-03-06
|
|
53
|
APR_DRG
|
Apr-DRG 42.00: Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
12
|
5
|
—
|
—
|
$70,940.09
|
$115,658.00
|
$89,832.93
|
2026-03-06
|
|
54
|
APR_DRG
|
Apr-DRG 42.00: Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
12
|
5
|
—
|
—
|
$97,690.58
|
$159,368.34
|
$123,744.95
|
2026-03-06
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
28
|
8
|
—
|
—
|
$59,428.64
|
$175,912.66
|
$64,777.21
|
2026-03-06
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
28
|
8
|
—
|
—
|
$44,686.08
|
$164,407.44
|
$48,707.83
|
2026-03-06
|
|
5831
|
APR_DRG
|
Apr-DRG 42.00: Neonate With Ecmo
|
12
|
5
|
—
|
—
|
$171,155.79
|
$279,141.26
|
$216,774.74
|
2026-03-06
|
|
5832
|
APR_DRG
|
Apr-DRG 42.00: Neonate With Ecmo
|
12
|
5
|
—
|
—
|
$190,725.47
|
$310,978.27
|
$241,529.94
|
2026-03-06
|
|
5833
|
APR_DRG
|
Apr-DRG 42.00: Neonate With Ecmo
|
12
|
5
|
—
|
—
|
$248,329.77
|
$405,016.25
|
$314,522.28
|
2026-03-06
|
|
5834
|
APR_DRG
|
Apr-DRG 42.00: Neonate With Ecmo
|
12
|
5
|
—
|
—
|
$436,056.66
|
$711,138.46
|
$552,267.59
|
2026-03-06
|
|
5881
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight < 1500 Grams With Major Procedure
|
12
|
5
|
—
|
—
|
$130,674.96
|
$213,059.37
|
$165,481.02
|
2026-03-06
|
|
5882
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight < 1500 Grams With Major Procedure
|
12
|
5
|
—
|
—
|
$152,454.12
|
$248,568.69
|
$193,060.97
|
2026-03-06
|
|
5883
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight < 1500 Grams With Major Procedure
|
12
|
5
|
—
|
—
|
$177,863.14
|
$290,082.10
|
$225,270.49
|
2026-03-06
|
|
5884
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight < 1500 Grams With Major Procedure
|
12
|
5
|
—
|
—
|
$267,110.35
|
$435,558.85
|
$338,275.19
|
2026-03-06
|
|
5891
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams A…
|
12
|
5
|
—
|
—
|
$124,519.98
|
$203,030.27
|
$157,689.04
|
2026-03-06
|
|
5892
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams A…
|
12
|
5
|
—
|
—
|
$124,519.98
|
$203,030.27
|
$157,689.04
|
2026-03-06
|
|
5893
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams A…
|
12
|
5
|
—
|
—
|
$124,519.98
|
$203,030.27
|
$157,689.04
|
2026-03-06
|
|
5912
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 500-749 Grams Without Major Procedure
|
12
|
5
|
—
|
—
|
$113,314.76
|
$184,756.35
|
$143,497.58
|
2026-03-06
|
|
5913
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 500-749 Grams Without Major Procedure
|
12
|
5
|
—
|
—
|
$132,095.34
|
$215,406.14
|
$167,291.58
|
2026-03-06
|
|
5914
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 500-749 Grams Without Major Procedure
|
12
|
5
|
—
|
—
|
$175,101.29
|
$285,617.93
|
$221,787.92
|
2026-03-06
|
|
5931
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 750-999 Grams Without Major Procedure
|
12
|
5
|
—
|
—
|
$68,967.34
|
$112,445.60
|
$87,336.29
|
2026-03-06
|
|
5932
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 750-999 Grams Without Major Procedure
|
12
|
5
|
—
|
—
|
$90,588.68
|
$147,753.21
|
$114,737.69
|
2026-03-06
|
|
5933
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 750-999 Grams Without Major Procedure
|
12
|
5
|
—
|
—
|
$112,604.57
|
$183,697.07
|
$142,636.04
|
2026-03-06
|
|
5934
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 750-999 Grams Without Major Procedure
|
12
|
5
|
—
|
—
|
$153,953.41
|
$251,113.71
|
$194,998.12
|
2026-03-06
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
22
|
9
|
—
|
—
|
$10,292.55
|
$50,213.05
|
$45,711.82
|
2026-03-06
|
|
6021
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Sy…
|
12
|
5
|
—
|
—
|
$47,977.28
|
$78,182.28
|
$60,740.06
|
2026-03-06
|
|
6022
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Sy…
|
12
|
5
|
—
|
—
|
$64,390.56
|
$104,952.30
|
$81,528.54
|
2026-03-06
|
|
6023
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Sy…
|
12
|
5
|
—
|
—
|
$80,567.11
|
$131,345.41
|
$102,020.71
|
2026-03-06
|
|
6024
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Sy…
|
12
|
5
|
—
|
—
|
$115,997.70
|
$189,172.10
|
$146,910.98
|
2026-03-06
|
|
6032
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1000-1249 Grams With Or Without Significant …
|
12
|
5
|
—
|
—
|
$39,218.27
|
$63,926.46
|
$49,657.74
|
2026-03-06
|
|
6033
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1000-1249 Grams With Or Without Significant …
|
12
|
5
|
—
|
—
|
$48,056.19
|
$78,348.26
|
$60,854.29
|
2026-03-06
|
|
6034
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1000-1249 Grams With Or Without Significant …
|
12
|
5
|
—
|
—
|
$84,828.25
|
$138,362.67
|
$107,443.54
|
2026-03-06
|
|
6071
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Sy…
|
12
|
5
|
—
|
—
|
$32,826.56
|
$53,531.97
|
$41,573.87
|
2026-03-06
|
|
6072
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Sy…
|
12
|
5
|
—
|
—
|
$45,925.62
|
$74,882.28
|
$58,159.23
|
2026-03-06
|
|
6073
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Sy…
|
12
|
5
|
—
|
—
|
$61,470.89
|
$100,258.76
|
$77,856.82
|
2026-03-06
|
|
6074
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Sy…
|
12
|
5
|
—
|
—
|
$89,641.76
|
$146,230.57
|
$113,546.71
|
2026-03-06
|
|
6083
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1250-1499 Grams With Or Without Significant …
|
12
|
5
|
—
|
—
|
$44,110.69
|
$71,996.07
|
$55,888.84
|
2026-03-06
|
|
6084
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1250-1499 Grams With Or Without Significant …
|
12
|
5
|
—
|
—
|
$51,133.68
|
$83,404.89
|
$64,766.40
|
2026-03-06
|
|
6091
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
12
|
5
|
—
|
—
|
$33,852.39
|
$55,175.63
|
$42,861.85
|
2026-03-06
|
|
6092
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
12
|
5
|
—
|
—
|
$42,137.94
|
$68,689.16
|
$53,355.97
|
2026-03-06
|
|
6093
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
12
|
5
|
—
|
—
|
$64,548.38
|
$105,269.28
|
$81,751.26
|
2026-03-06
|
|
6094
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
12
|
5
|
—
|
—
|
$186,069.78
|
$303,465.38
|
$235,664.07
|
2026-03-06
|
|
61
|
APR_DRG
|
Apr-DRG 42.00: Pancreas Transplant
|
12
|
5
|
—
|
—
|
$41,901.21
|
$68,273.05
|
$53,044.65
|
2026-03-06
|
|
6113
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
12
|
5
|
—
|
—
|
$39,770.64
|
$64,861.25
|
$50,370.34
|
2026-03-06
|
|
6114
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
12
|
5
|
—
|
—
|
$74,569.95
|
$121,621.75
|
$94,447.04
|
2026-03-06
|
|
6123
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Sy…
|
12
|
5
|
—
|
—
|
$40,717.56
|
$66,344.69
|
$51,546.31
|
2026-03-06
|
|
6124
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Sy…
|
12
|
5
|
—
|
—
|
$58,709.04
|
$95,806.12
|
$74,378.66
|
2026-03-06
|
|
6133
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal…
|
12
|
5
|
—
|
—
|
$39,928.46
|
$65,117.13
|
$50,569.64
|
2026-03-06
|
|
6134
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal…
|
12
|
5
|
—
|
—
|
$73,859.76
|
$120,503.69
|
$93,562.96
|
2026-03-06
|
|
6143
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1500-1999 Grams With Or Without Other Signif…
|
12
|
5
|
—
|
—
|
$33,300.02
|
$54,304.23
|
$42,173.56
|
2026-03-06
|
|
6144
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 1500-1999 Grams With Or Without Other Signif…
|
12
|
5
|
—
|
—
|
$49,318.75
|
$80,404.57
|
$62,452.29
|
2026-03-06
|
|
62
|
APR_DRG
|
Apr-DRG 42.00: Pancreas Transplant
|
12
|
5
|
—
|
—
|
$60,287.24
|
$98,293.51
|
$76,344.35
|
2026-03-06
|
|
6214
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
12
|
5
|
—
|
—
|
$57,604.30
|
$93,954.98
|
$72,960.54
|
2026-03-06
|
|
6224
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Sy…
|
12
|
5
|
—
|
—
|
$38,113.53
|
$62,128.34
|
$48,259.94
|
2026-03-06
|
|
6234
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal…
|
12
|
5
|
—
|
—
|
$41,191.02
|
$67,116.96
|
$52,145.99
|
2026-03-06
|
|
6254
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight 2000-2499 Grams With Other Significant Condi…
|
12
|
5
|
—
|
—
|
$51,054.77
|
$83,283.86
|
$64,669.40
|
2026-03-06
|
|
63
|
APR_DRG
|
Apr-DRG 42.00: Pancreas Transplant
|
12
|
5
|
—
|
—
|
$69,914.26
|
$114,014.34
|
$88,544.94
|
2026-03-06
|
|
6302
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight > 2499 Grams With Major Cardiovascular Proce…
|
12
|
5
|
—
|
—
|
$40,796.47
|
$66,497.99
|
$51,655.68
|
2026-03-06
|
|
6303
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight > 2499 Grams With Major Cardiovascular Proce…
|
12
|
5
|
—
|
—
|
$89,483.94
|
$145,911.29
|
$113,323.10
|
2026-03-06
|
|
6304
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight > 2499 Grams With Major Cardiovascular Proce…
|
12
|
5
|
—
|
—
|
$162,317.87
|
$264,704.47
|
$205,572.46
|
2026-03-06
|
|
6313
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
12
|
5
|
—
|
—
|
$52,632.97
|
$85,787.39
|
$66,641.27
|
2026-03-06
|
|
6314
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
12
|
5
|
—
|
—
|
$178,967.88
|
$291,879.06
|
$226,667.85
|
2026-03-06
|
|
6334
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight > 2499 Grams With Major Anomaly
|
12
|
5
|
—
|
—
|
$58,630.13
|
$95,554.84
|
$74,231.73
|
2026-03-06
|
|
6344
|
APR_DRG
|
Apr-DRG 42.00: Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndr…
|
12
|
5
|
—
|
—
|
$35,509.50
|
$57,960.40
|
$44,992.13
|
2026-03-06
|
|
64
|
APR_DRG
|
Apr-DRG 42.00: Pancreas Transplant
|
12
|
5
|
—
|
—
|
$90,746.50
|
$147,944.55
|
$114,912.26
|
2026-03-06
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
20
|
8
|
—
|
—
|
$42,901.09
|
$50,910.43
|
$46,333.18
|
2026-03-06
|
|
6504
|
APR_DRG
|
Apr-DRG 42.00: Splenic Procedures
|
12
|
5
|
—
|
—
|
$33,300.02
|
$54,361.87
|
$42,195.65
|
2026-03-06
|
|
6514
|
APR_DRG
|
Apr-DRG 42.00: Other Procedures Of Blood And Blood-forming Organs
|
12
|
5
|
—
|
—
|
$37,482.25
|
$61,071.37
|
$47,449.90
|
2026-03-06
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
28
|
8
|
—
|
—
|
$47,323.32
|
$164,557.64
|
$51,582.42
|
2026-03-06
|
|
673
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Mcc
|
28
|
8
|
—
|
—
|
$38,435.97
|
$72,876.38
|
$41,895.21
|
2026-03-06
|
|
6804
|
APR_DRG
|
Apr-DRG 42.00: Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neopl…
|
12
|
5
|
—
|
—
|
$52,159.51
|
$85,022.04
|
$66,044.24
|
2026-03-06
|
|
6814
|
APR_DRG
|
Apr-DRG 42.00: Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neop…
|
12
|
5
|
—
|
—
|
$43,637.23
|
$71,131.60
|
$55,253.81
|
2026-03-06
|
|
6904
|
APR_DRG
|
Apr-DRG 42.00: Acute Leukemia
|
12
|
5
|
—
|
—
|
$46,635.81
|
$75,999.19
|
$59,042.86
|
2026-03-06
|
|
6954
|
APR_DRG
|
Apr-DRG 42.00: Chemotherapy For Acute Leukemia
|
12
|
5
|
—
|
—
|
$42,927.04
|
$69,947.84
|
$54,344.56
|
2026-03-06
|
|
7
|
MS_DRG
|
Lung Transplant
|
22
|
9
|
—
|
—
|
$10,292.55
|
$140,234.87
|
$125,921.78
|
2026-03-06
|
|
71
|
APR_DRG
|
Apr-DRG 42.00: Allogeneic Bone Marrow Transplant
|
12
|
5
|
—
|
—
|
$58,077.76
|
$94,718.03
|
$73,556.69
|
2026-03-06
|
|
7104
|
APR_DRG
|
Apr-DRG 42.00: Infectious And Parasitic Diseases Including HIV With O.r. Procedu…
|
12
|
5
|
—
|
—
|
$35,825.14
|
$58,370.74
|
$45,351.88
|
2026-03-06
|
|
7114
|
APR_DRG
|
Apr-DRG 42.00: Post-operative, Post-trauma, Other Device Infections With O.r. Pr…
|
12
|
5
|
—
|
—
|
$34,878.22
|
$56,908.04
|
$44,183.86
|
2026-03-06
|
|
72
|
APR_DRG
|
Apr-DRG 42.00: Allogeneic Bone Marrow Transplant
|
12
|
5
|
—
|
—
|
$65,810.94
|
$107,299.07
|
$83,339.10
|
2026-03-06
|
|
73
|
APR_DRG
|
Apr-DRG 42.00: Allogeneic Bone Marrow Transplant
|
12
|
5
|
—
|
—
|
$93,429.44
|
$152,369.52
|
$118,329.20
|
2026-03-06
|
|
74
|
APR_DRG
|
Apr-DRG 42.00: Allogeneic Bone Marrow Transplant
|
12
|
5
|
—
|
—
|
$146,930.42
|
$239,570.05
|
$186,068.87
|
2026-03-06
|
|
7404
|
APR_DRG
|
Apr-DRG 42.00: Mental Illness Diagnosis With O.r. Procedure
|
12
|
5
|
—
|
—
|
$44,189.60
|
$72,022.59
|
$55,949.62
|
2026-03-06
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
28
|
8
|
—
|
—
|
$53,997.76
|
$148,613.79
|
$58,857.56
|
2026-03-06
|
|
7924
|
APR_DRG
|
Apr-DRG 42.00: Extensive O.r. Procedures For Other Complications Of Treatment
|
12
|
5
|
—
|
—
|
$37,876.80
|
$61,708.78
|
$47,947.29
|
2026-03-06
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
28
|
8
|
—
|
—
|
$41,360.00
|
$90,750.02
|
$45,082.40
|
2026-03-06
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
22
|
9
|
—
|
—
|
$10,292.55
|
$60,690.98
|
$55,047.71
|
2026-03-06
|
|
82
|
APR_DRG
|
Apr-DRG 42.00: Autologous Bone Marrow Transplant
|
12
|
5
|
—
|
—
|
$36,061.87
|
$58,864.07
|
$45,692.81
|
2026-03-06
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
28
|
8
|
—
|
—
|
$53,294.68
|
$142,989.11
|
$58,091.20
|
2026-03-06
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
28
|
8
|
—
|
—
|
$41,859.42
|
$107,662.39
|
$45,626.76
|
2026-03-06
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
28
|
8
|
—
|
—
|
$42,690.25
|
$145,121.94
|
$46,532.38
|
2026-03-06
|
|
83
|
APR_DRG
|
Apr-DRG 42.00: Autologous Bone Marrow Transplant
|
12
|
5
|
—
|
—
|
$46,004.53
|
$74,997.54
|
$58,254.02
|
2026-03-06
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
28
|
8
|
—
|
—
|
$49,945.39
|
$204,540.52
|
$54,440.47
|
2026-03-06
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
28
|
8
|
—
|
—
|
$43,820.38
|
$94,745.31
|
$47,764.21
|
2026-03-06
|
|
84
|
APR_DRG
|
Apr-DRG 42.00: Autologous Bone Marrow Transplant
|
12
|
5
|
—
|
—
|
$65,337.48
|
$106,553.31
|
$82,749.57
|
2026-03-06
|
|
8411
|
APR_DRG
|
Apr-DRG 42.00: Extensive Third Degree Burns With Skin Graft
|
12
|
5
|
—
|
—
|
$35,272.77
|
$64,402.15
|
$44,685.66
|
2026-03-06
|
|
8412
|
APR_DRG
|
Apr-DRG 42.00: Extensive Third Degree Burns With Skin Graft
|
12
|
5
|
—
|
—
|
$35,272.77
|
$64,402.15
|
$44,685.66
|
2026-03-06
|
|
8413
|
APR_DRG
|
Apr-DRG 42.00: Extensive Third Degree Burns With Skin Graft
|
12
|
5
|
—
|
—
|
$53,895.53
|
$98,404.18
|
$68,238.38
|
2026-03-06
|
|
8414
|
APR_DRG
|
Apr-DRG 42.00: Extensive Third Degree Burns With Skin Graft
|
12
|
5
|
—
|
—
|
$165,632.09
|
$302,416.36
|
$209,768.52
|
2026-03-06
|
|
8423
|
APR_DRG
|
Apr-DRG 42.00: Burns With Skin Graft Except Extensive Third Degree Burns
|
12
|
5
|
—
|
—
|
$37,482.25
|
$68,436.29
|
$47,453.88
|
2026-03-06
|
|
8424
|
APR_DRG
|
Apr-DRG 42.00: Burns With Skin Graft Except Extensive Third Degree Burns
|
12
|
5
|
—
|
—
|
$92,719.25
|
$169,289.77
|
$117,433.20
|
2026-03-06
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
28
|
8
|
—
|
—
|
$78,261.98
|
$276,695.95
|
$85,305.56
|
2026-03-06
|
|
8504
|
APR_DRG
|
Apr-DRG 42.00: Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Co…
|
12
|
5
|
—
|
—
|
$48,608.56
|
$79,317.63
|
$61,580.14
|
2026-03-06
|
|
8513
|
APR_DRG
|
Apr-DRG 42.00: Gender Related Procedures
|
12
|
5
|
—
|
—
|
$85,538.44
|
$139,539.51
|
$108,350.14
|
2026-03-06
|
|
8514
|
APR_DRG
|
Apr-DRG 42.00: Gender Related Procedures
|
12
|
5
|
—
|
—
|
$85,538.44
|
$139,539.51
|
$108,350.14
|
2026-03-06
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
28
|
8
|
—
|
—
|
$45,020.20
|
$101,894.76
|
$49,072.02
|
2026-03-06
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
28
|
8
|
—
|
—
|
$41,536.90
|
$82,459.06
|
$45,275.22
|
2026-03-06
|
|
8633
|
APR_DRG
|
Apr-DRG 42.00: Neonatal Aftercare
|
12
|
5
|
—
|
—
|
$37,324.43
|
$60,850.07
|
$47,263.85
|
2026-03-06
|
|
8634
|
APR_DRG
|
Apr-DRG 42.00: Neonatal Aftercare
|
12
|
5
|
—
|
—
|
$72,912.84
|
$118,951.09
|
$92,360.49
|
2026-03-06
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
28
|
8
|
—
|
—
|
$62,648.37
|
$156,206.60
|
$68,286.73
|
2026-03-06
|
|
894
|
APR_DRG
|
Apr-DRG 42.00: Major Cranial Or Facial Bone Procedures
|
12
|
5
|
—
|
—
|
$42,374.67
|
$69,154.82
|
$53,686.30
|
2026-03-06
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
28
|
8
|
—
|
—
|
$38,391.32
|
$96,337.41
|
$41,846.54
|
2026-03-06
|
|
91
|
APR_DRG
|
Apr-DRG 42.00: Extracorporeal Membrane Oxygenation (ecmo)
|
12
|
5
|
—
|
—
|
$45,057.61
|
$73,526.78
|
$57,082.92
|
2026-03-06
|
|
9103
|
APR_DRG
|
Apr-DRG 42.00: Craniotomy For Multiple Significant Trauma
|
12
|
5
|
—
|
—
|
$34,641.49
|
$56,464.28
|
$43,861.93
|
2026-03-06
|
|
9104
|
APR_DRG
|
Apr-DRG 42.00: Craniotomy For Multiple Significant Trauma
|
12
|
5
|
—
|
—
|
$53,658.80
|
$87,470.24
|
$67,944.28
|
2026-03-06
|
|
9114
|
APR_DRG
|
Apr-DRG 42.00: Extensive Abdominal Or Thoracic Procedures For Multiple Significa…
|
12
|
5
|
—
|
—
|
$51,054.77
|
$83,197.41
|
$64,636.28
|
2026-03-06
|
|
9124
|
APR_DRG
|
Apr-DRG 42.00: Musculoskeletal And Other Procedures For Multiple Significant Tra…
|
12
|
5
|
—
|
—
|
$47,424.91
|
$77,355.84
|
$60,068.99
|
2026-03-06
|
|
913
|
APR_DRG
|
Apr-DRG 42.00: Other Major Head And Neck Procedures
|
12
|
5
|
—
|
—
|
$32,984.38
|
$53,825.89
|
$41,787.75
|
2026-03-06
|
|
914
|
APR_DRG
|
Apr-DRG 42.00: Other Major Head And Neck Procedures
|
12
|
5
|
—
|
—
|
$49,397.66
|
$80,555.56
|
$62,560.78
|
2026-03-06
|
|
92
|
APR_DRG
|
Apr-DRG 42.00: Extracorporeal Membrane Oxygenation (ecmo)
|
12
|
5
|
—
|
—
|
$61,549.80
|
$100,408.60
|
$77,964.86
|
2026-03-06
|
|
924
|
APR_DRG
|
Apr-DRG 42.00: Facial Bone Procedures Except Major Cranial Or Facial Bone Proced…
|
12
|
5
|
—
|
—
|
$40,401.92
|
$65,921.67
|
$51,181.71
|
2026-03-06
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
28
|
8
|
—
|
—
|
$191,640.87
|
$651,741.98
|
$206,972.14
|
2026-03-06
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
28
|
8
|
—
|
—
|
$42,371.65
|
$77,671.59
|
$69,202.82
|
2026-03-06
|
|
93
|
APR_DRG
|
Apr-DRG 42.00: Extracorporeal Membrane Oxygenation (ecmo)
|
12
|
5
|
—
|
—
|
$122,705.05
|
$200,057.61
|
$155,385.52
|
2026-03-06
|
|
94
|
APR_DRG
|
Apr-DRG 42.00: Extracorporeal Membrane Oxygenation (ecmo)
|
12
|
5
|
—
|
—
|
$182,518.83
|
$297,676.83
|
$231,167.72
|
2026-03-06
|
|
9504
|
APR_DRG
|
Apr-DRG 42.00: Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
12
|
5
|
—
|
—
|
$42,137.94
|
$68,705.29
|
$53,362.15
|
2026-03-06
|
|
9514
|
APR_DRG
|
Apr-DRG 42.00: Moderately Extensive O.r. Procedure Unrelated To Principal Diagno…
|
12
|
5
|
—
|
—
|
$33,063.29
|
$53,871.99
|
$41,856.04
|
2026-03-06
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
28
|
8
|
—
|
—
|
$61,034.03
|
$179,697.66
|
$66,527.09
|
2026-03-06
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
28
|
8
|
—
|
—
|
$68,974.40
|
$172,337.93
|
$75,182.10
|
2026-03-06
|
|
958
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
28
|
8
|
—
|
—
|
$38,545.85
|
$99,581.70
|
$42,014.97
|
2026-03-06
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
28
|
8
|
—
|
—
|
$55,586.20
|
$198,472.50
|
$60,588.96
|
2026-03-06
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
28
|
8
|
—
|
—
|
$42,815.31
|
$117,755.74
|
$46,668.68
|
2026-03-06
|
|
C1822
|
HCPCS
|
Kt Gen Neuro Stim Senza Nev
|
70
|
17
|
$94,686.00
|
$56,811.60
40% off
|
$22,724.64
|
$85,217.40
|
$42,608.70
|
2026-03-06
|