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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

Jeanes Hospital

Philadelphia, PA · CCN 390080 · Rates published

21,619 distinct procedures filed
80 distinct payers
897,597 rate rows
2026-07-31 last MRF observed
Data quality

887,375 of 897,597 rate rows are consumer-grade (98.9%)

10,222 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
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 4,378
per-diem day rate — not a per-procedure price 3,214
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 668
exceeds 3× this hospital's gross charge for a DRG stay — excluded 549
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 512
exceeds 10× this hospital's gross charge — excluded from medians 320
placeholder amount (≤ $0.02) — excluded from medians 311
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 198
percent-of-charges filed in the dollar field — excluded from medians 72
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.templehealth.org/sites/default/files/file/2025-04/232825878_Temple_University%20Hosp_Jeanes_standardcharges.csv
Found on page https://www.templehealth.org/pricing-disclaimer
Discovered viaCMS hospital list
Last fetch not_modified · 2026-08-17
Content fingerprint a8d55c4d61756dfc… · 227,095,908 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
C9399
HCPCS 		Omidubicel-onlv Intravenous Suspension 19 $298,061.92 $4,593,420.00 $1,275,950.00 nat. median
$1,984
outlier · 643.0×
Q2056
HCPCS 		Ciltacabtagene Autoleucel 0.5 X 10exp6 To 1x 10exp8 Cell IV Suspension 14 $551,318.34 $4,706,255.40 $1,235,405.11 nat. median
$631,793
2.0× median
Q2054
HCPCS 		Lisocabtagene Maraleucel 1.5 X 10exp6 To 70 X 10exp6 Cell/ml IV Susp 13 $516,485.97 $4,822,004.88 $1,174,961.86 nat. median
$624,417
1.9× median
Q2053
HCPCS 		Brexucabtagene Autoleucel 2x 10exp6 To 2x 10exp8 Cell IV Suspension 14 $488,051.51 $4,527,600.00 $1,170,708.00 nat. median
$577,541
outlier · 2.0×
Q2055
HCPCS 		Idecabtagene Vicleucel 300 X 10exp6 To 460 X 10exp6 Cell IV Suspension 13 $528,312.43 $4,758,298.73 $1,159,438.79 nat. median
$610,161
1.9× median
49749880
OTHER 		Tisagenlecleucel Ped (kymriah) 20 $304,000.00 $3,800,000.00 $877,800.00 nat. median
$950,000
0.9× median
49751837
OTHER 		Brexucabtagene (tecartus) 20 $10.35 $3,192,000.00 $737,352.00 nat. median
$798,000
0.9× median
49749914
OTHER 		Axicabtagene Dlbcl (yescarta) 20 $245,394.70 $3,192,000.00 $718,200.00 nat. median
$798,000
0.9× median
49749898
OTHER 		Tisagenlecleucel Dlbcl-kymriah 20 $238,720.00 $2,984,000.00 $689,304.00 nat. median
$746,000
0.9× median
SUP-HT-LU
CDM 		Organ Heart Lung 40 $77,505.75 $598,500.00 $598,500.00 nat. median
$598,500
1.0× median
Q2042
HCPCS 		Tisagenlecleucel 0.2 X10exp6 To 2.5x10exp8 Cell Intravenous Suspension 40 $37,410.68 $4,189,120.00 $589,036.59 nat. median
$691,418
0.9× median
C9293
HCPCS 		Glucarpidase 1,000 Unit Intravenous Solution 40 $41,998.00 $561,039.40 $561,039.40 nat. median
$24,377
outlier · 23.0×
SUP-LU-EB
CDM 		Organ Double Lung 40 $71,095.50 $549,000.00 $549,000.00 nat. median
$549,000
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Intravenous Suspension 36 $489,455.96 $4,155,200.00 $538,401.55 nat. median
$588,565
0.9× median
SUP-LU
CDM 		Organ 1 Lung 40 $67,599.00 $522,000.00 $522,000.00 nat. median
$522,000
1.0× median
SUP-PN
CDM 		Organ Pancreas 40 $62,937.00 $486,000.00 $486,000.00 nat. median
$486,000
1.0× median
SUP-LI
CDM 		Organ Liver 40 $57,692.25 $445,500.00 $445,500.00 nat. median
$445,500
1.0× median
SUP-KI
CDM 		Organ Kidney 40 $54,195.75 $418,500.00 $418,500.00 nat. median
$418,500
1.0× median
SUP-HT
CDM 		Organ Heart 40 $50,699.25 $391,500.00 $391,500.00 nat. median
$391,500
1.0× median
SUP-1000100
CDM 		Impella 5.5 Pump Set 40 $66,789.00 $369,000.00 $369,000.00 nat. median
$92,796
outlier · 4.0×
J9118
HCPCS 		Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution 40 $28,697.25 $327,025.44 $327,025.44 nat. median
$190
outlier · 1719.6×
5834
APR_DRG 		7 $273,957.06 $454,843.38 $318,486.04 nat. median
$311,018
1.0× median
J1162
HCPCS 		Digoxin Immune Fab 40 Mg Intravenous Solution 40 $24,440.50 $317,729.75 $317,729.75 nat. median
$7,100
outlier · 44.8×
SUP-106
CDM 		Generator Aspire Sr 40 $23,798.41 $313,137.00 $313,137.00 nat. median
$297,480
1.1× median
5833
APR_DRG 		7 $249,051.66 $413,493.64 $289,532.53 nat. median
$250,089
1.2× median
SUP-MCG40100
CDM 		Mitraclip G4 System 40 $20,520.00 $270,000.00 $270,000.00 nat. median
$50,972
outlier · 5.3×
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 39 $37.71 $4,168,263.36 $263,571.23 nat. median
$370,165
0.7× median
5884
APR_DRG 		7 $218,492.14 $362,756.50 $254,005.86 nat. median
$254,667
1.0× median
G0339
HCPCS 		Hc Stereo Rad,Sgl Tx,(image-guid) 40 $2,362.01 $248,801.00 $248,801.00 nat. median
$7,799
outlier · 31.9×
SUP-103
CDM 		Demipulse Model 103 Generator Single Pin 8cc 40 $18,529.56 $243,810.00 $243,810.00 nat. median
$6
outlier · 42328.1×
PX-38301206
CDM 		Hc Tmr Laser 40 $1,093.00 $238,966.00 $238,966.00 nat. median
$238,966
1.0× median
SUP-2540002
CDM 		Tissue Matrix Strtice 25x40cm 40 $17,758.01 $233,658.00 $233,658.00 nat. median
$38,770
outlier · 6.0×
1614
APR_DRG 		7 $194,372.88 $322,711.96 $225,966.25 nat. median
$209,486
1.1× median
SUP-0046-0035
CDM 		Impella Rp US Pump Set 40 $17,100.00 $225,000.00 $225,000.00 nat. median
$66,320
outlier · 3.4×
SUP-005062
CDM 		Impella 5.0 Pump Set 40 $17,100.00 $225,000.00 $225,000.00 nat. median
$67,990
outlier · 3.3×
SUP-0048-0003
CDM 		Impella Cp 40 $17,100.00 $225,000.00 $225,000.00 nat. median
$61,875
outlier · 3.6×
24
APR_DRG 		7 $187,964.36 $312,072.07 $218,516.09 nat. median
$243,231
0.9× median
5914
APR_DRG 		7 $187,622.69 $311,504.81 $218,118.89 nat. median
$168,361
1.3× median
74
APR_DRG 		7 $179,003.92 $297,195.30 $208,099.22 nat. median
$175,480
1.2× median
6094
APR_DRG 		7 $172,846.36 $286,972.07 $200,940.81 nat. median
$168,174
1.2× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With McC 40 $28.17 $2,586,342.27 $196,865.62 nat. median
$261,939
0.8× median
5891
APR_DRG 		7 $165,437.79 $274,671.81 $192,328.05 nat. median
$96,420
2.0× median
5934
APR_DRG 		7 $164,222.30 $272,653.77 $190,914.99 nat. median
$156,285
1.2× median
1613
APR_DRG 		7 $155,280.00 $257,807.12 $180,519.22 nat. median
$127,938
1.4× median
SUP-005042
CDM 		Catheter Ventricular Assist Device Left Impella 2.5 40 $32,580.00 $180,000.00 $180,000.00 nat. median
$42,344
outlier · 4.3×
0823T
CPT 		Hc Pr Tcat Insj Perm 1chmbr Ldls Pacemaker R Atrial 40 $3,012.00 $177,020.00 $177,020.00 nat. median
$21,679
outlier · 8.2×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 62 $23.72 $1,564,801.98 $175,243.61 nat. median
$205,166
0.9× median
5913
APR_DRG 		7 $150,182.97 $249,344.66 $174,593.71 nat. median
$108,751
1.6× median
5883
APR_DRG 		7 $149,897.24 $248,870.27 $174,261.54 nat. median
$180,995
1.0× median
SUP-ZTA-P-38-117-W
CDM 		Graft Thoracic Distal 18fr 33-34mm 38dx117l 40 $13,032.94 $171,486.00 $171,486.00 nat. median
$162,912
1.1× median

Other procedures at this hospital

Browse this hospital's 21,619 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
             
C9399 HCPCS Omidubicel-onlv Intravenous Suspension 19 19 — — $298,061.92 $4,593,420.00 $1,275,950.00 2025-01-01
Q2056 HCPCS Ciltacabtagene Autoleucel 0.5 X 10exp6 To 1x 10exp8 Cell IV Suspension 14 14 — — $551,318.34 $4,706,255.40 $1,235,405.11 2025-01-01
Q2054 HCPCS Lisocabtagene Maraleucel 1.5 X 10exp6 To 70 X 10exp6 Cell/ml IV Susp 13 13 — — $516,485.97 $4,822,004.88 $1,174,961.86 2025-01-01
Q2053 HCPCS Brexucabtagene Autoleucel 2x 10exp6 To 2x 10exp8 Cell IV Suspension 14 14 — — $488,051.51 $4,527,600.00 $1,170,708.00 2025-01-01
Q2055 HCPCS Idecabtagene Vicleucel 300 X 10exp6 To 460 X 10exp6 Cell IV Suspension 13 13 — — $528,312.43 $4,758,298.73 $1,159,438.79 2025-01-01
49749880 OTHER Tisagenlecleucel Ped (kymriah) 20 20 $3,952,000.00 — $304,000.00 $3,800,000.00 $877,800.00 2026-07-31
49751837 OTHER Brexucabtagene (tecartus) 20 20 $3,319,680.00 — $10.35 $3,192,000.00 $737,352.00 2026-07-31
49749914 OTHER Axicabtagene Dlbcl (yescarta) 20 20 $3,319,680.00 — $245,394.70 $3,192,000.00 $718,200.00 2026-07-31
49749898 OTHER Tisagenlecleucel Dlbcl-kymriah 20 20 $3,103,360.00 — $238,720.00 $2,984,000.00 $689,304.00 2026-07-31
SUP-HT-LU CDM Organ Heart Lung 40 40 $598,500.00 $598,500.00 $77,505.75 $598,500.00 $598,500.00 2025-01-01
Q2042 HCPCS Tisagenlecleucel 0.2 X10exp6 To 2.5x10exp8 Cell Intravenous Suspension 76 40 $4,189,120.00 $4,189,120.00 $37,410.68 $4,189,120.00 $589,036.59 2025-01-01
C9293 HCPCS Glucarpidase 1,000 Unit Intravenous Solution 40 40 $561,039.40 $561,039.40 $41,998.00 $561,039.40 $561,039.40 2025-01-01
SUP-LU-EB CDM Organ Double Lung 40 40 $549,000.00 $549,000.00 $71,095.50 $549,000.00 $549,000.00 2025-01-01
Q2041 HCPCS Axicabtagene Ciloleucel Intravenous Suspension 36 36 — $489,455.96 $489,455.96 $4,155,200.00 $538,401.55 2025-01-01
SUP-LU CDM Organ 1 Lung 40 40 $522,000.00 $522,000.00 $67,599.00 $522,000.00 $522,000.00 2025-01-01
SUP-PN CDM Organ Pancreas 40 40 $486,000.00 $486,000.00 $62,937.00 $486,000.00 $486,000.00 2025-01-01
SUP-LI CDM Organ Liver 40 40 $445,500.00 $445,500.00 $57,692.25 $445,500.00 $445,500.00 2025-01-01
SUP-KI CDM Organ Kidney 40 40 $418,500.00 $418,500.00 $54,195.75 $418,500.00 $418,500.00 2025-01-01
SUP-HT CDM Organ Heart 40 40 $391,500.00 $391,500.00 $50,699.25 $391,500.00 $391,500.00 2025-01-01
SUP-1000100 CDM Impella 5.5 Pump Set 40 40 $369,000.00 $369,000.00 $66,789.00 $369,000.00 $369,000.00 2025-01-01
J9118 HCPCS Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution 40 40 $327,025.44 $327,025.44 $28,697.25 $327,025.44 $327,025.44 2025-01-01
5834 APR_DRG — 7 7 — — $273,957.06 $454,843.38 $318,486.04 2026-07-31
J1162 HCPCS Digoxin Immune Fab 40 Mg Intravenous Solution 40 40 $317,729.75 $317,729.75 $24,440.50 $317,729.75 $317,729.75 2025-01-01
SUP-106 CDM Generator Aspire Sr 40 40 $313,137.00 $313,137.00 $23,798.41 $313,137.00 $313,137.00 2025-01-01
5833 APR_DRG — 7 7 — — $249,051.66 $413,493.64 $289,532.53 2026-07-31
SUP-MCG40100 CDM Mitraclip G4 System 40 40 $270,000.00 $270,000.00 $20,520.00 $270,000.00 $270,000.00 2025-01-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 39 39 $117,786.28 $626,763.51 $37.71 $4,168,263.36 $263,571.23 2026-07-31
5884 APR_DRG — 7 7 — — $218,492.14 $362,756.50 $254,005.86 2026-07-31
G0339 HCPCS Hc Stereo Rad,Sgl Tx,(image-guid) 40 40 $248,801.00 $248,801.00 $2,362.01 $248,801.00 $248,801.00 2025-01-01
SUP-103 CDM Demipulse Model 103 Generator Single Pin 8cc 40 40 $243,810.00 $243,810.00 $18,529.56 $243,810.00 $243,810.00 2025-01-01
PX-38301206 CDM Hc Tmr Laser 40 40 $238,966.00 $238,966.00 $1,093.00 $238,966.00 $238,966.00 2025-01-01
SUP-2540002 CDM Tissue Matrix Strtice 25x40cm 40 40 $233,658.00 $233,658.00 $17,758.01 $233,658.00 $233,658.00 2025-01-01
1614 APR_DRG — 7 7 — — $194,372.88 $322,711.96 $225,966.25 2026-07-31
SUP-005062 CDM Impella 5.0 Pump Set 40 40 $225,000.00 $225,000.00 $17,100.00 $225,000.00 $225,000.00 2025-01-01
SUP-0048-0003 CDM Impella Cp 40 40 $225,000.00 $225,000.00 $17,100.00 $225,000.00 $225,000.00 2025-01-01
SUP-0046-0035 CDM Impella Rp US Pump Set 40 40 $225,000.00 $225,000.00 $17,100.00 $225,000.00 $225,000.00 2025-01-01
24 APR_DRG — 7 7 — — $187,964.36 $312,072.07 $218,516.09 2026-07-31
5914 APR_DRG — 7 7 — — $187,622.69 $311,504.81 $218,118.89 2026-07-31
74 APR_DRG — 7 7 — — $179,003.92 $297,195.30 $208,099.22 2026-07-31
6094 APR_DRG — 7 7 — — $172,846.36 $286,972.07 $200,940.81 2026-07-31
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With McC 40 40 $2,873,713.64 $303,151.53 89% off $28.17 $2,586,342.27 $196,865.62 2026-07-31
5891 APR_DRG — 7 7 — — $165,437.79 $274,671.81 $192,328.05 2026-07-31
5934 APR_DRG — 7 7 — — $164,222.30 $272,653.77 $190,914.99 2026-07-31
1613 APR_DRG — 7 7 — — $155,280.00 $257,807.12 $180,519.22 2026-07-31
SUP-005042 CDM Catheter Ventricular Assist Device Left Impella 2.5 40 40 $180,000.00 $180,000.00 $32,580.00 $180,000.00 $180,000.00 2025-01-01
0823T CPT Hc Pr Tcat Insj Perm 1chmbr Ldls Pacemaker R Atrial 40 40 $177,020.00 $177,020.00 $3,012.00 $177,020.00 $177,020.00 2025-01-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 62 62 $1,593,635.00 $255,416.83 84% off $23.72 $1,564,801.98 $175,243.61 2026-07-31
5913 APR_DRG — 7 7 — — $150,182.97 $249,344.66 $174,593.71 2026-07-31
5883 APR_DRG — 7 7 — — $149,897.24 $248,870.27 $174,261.54 2026-07-31
SUP-ZTA-P-38-117-W CDM Graft Thoracic Distal 18fr 33-34mm 38dx117l 40 40 $171,486.00 $171,486.00 $13,032.94 $171,486.00 $171,486.00 2025-01-01
5832 APR_DRG — 7 7 — — $147,152.56 $244,313.36 $171,070.75 2026-07-31
5831 APR_DRG — 7 7 — — $146,835.84 $243,787.52 $170,702.54 2026-07-31
5912 APR_DRG — 7 7 — — $145,507.73 $241,582.48 $169,158.55 2026-07-31
6304 APR_DRG — 7 7 — — $141,407.72 $234,775.36 $164,392.14 2026-07-31
14 APR_DRG — 7 7 — — $140,006.29 $232,448.59 $162,762.91 2026-07-31
6024 APR_DRG — 7 7 — — $138,642.64 $230,184.57 $161,177.62 2026-07-31
J9042 HCPCS Brentuximab Vedotin 50 Mg Intravenous Solution 40 40 $159,997.20 $159,997.20 $19,679.66 $159,997.20 $159,997.20 2025-01-01
94 APR_DRG — 7 7 — — $135,376.40 $224,761.72 $157,380.48 2026-07-31
5882 APR_DRG — 7 7 — — $135,120.90 $224,337.53 $157,083.46 2026-07-31
23 APR_DRG — 7 7 — — $133,951.53 $222,396.04 $155,724.01 2026-07-31
8414 APR_DRG — 7 7 — — $133,537.29 $221,708.30 $155,242.45 2026-07-31
6314 APR_DRG — 7 7 — — $131,936.30 $219,050.21 $153,381.23 2026-07-31
SUP-WMFLXPROPERPROC CDM Watchman Flx Pro Procedure - Device 40 40 $153,000.00 $153,000.00 $27,693.00 $153,000.00 $153,000.00 2025-01-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 19 19 $59,582.17 $120,771.13 $941.60 $167,793.63 $152,539.66 2026-07-31
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 56 56 $1,164,732.13 $230,814.49 80% off $21.43 $1,048,258.91 $151,827.39 2026-07-31
5933 APR_DRG — 7 7 — — $125,785.54 $208,838.28 $146,230.72 2026-07-31
44 APR_DRG — 7 7 — — $125,584.47 $208,504.45 $145,996.97 2026-07-31
J1640 HCPCS Hemin 350 Mg Intravenous Powder For Solution 40 40 $145,724.18 $145,724.18 $11,270.00 $145,724.18 $145,724.18 2025-01-01
J9153 HCPCS Daunorubicin 44 Mg And Cytarabine 100 Mg In Liposome IV Solution 40 40 $142,460.46 $142,460.46 $10,670.00 $142,460.46 $142,460.46 2025-01-01
5881 APR_DRG — 7 7 — — $121,609.19 $201,904.40 $141,375.55 2026-07-31
J9266 HCPCS Pegaspargase 750 Unit/ml Injection Solution 40 40 $277,162.38 $135,352.67 51% off $34,090.97 $835,125.85 $138,736.48 2025-01-01
64 APR_DRG — 7 7 — — $117,611.99 $195,267.96 $136,728.65 2026-07-31
5892 APR_DRG — 7 7 — — $116,046.52 $192,668.86 $134,908.73 2026-07-31
73 APR_DRG — 7 7 — — $115,165.14 $191,205.53 $133,884.09 2026-07-31
J2267 HCPCS Mirikizumab-mrkz 100 Mg/ml Subcutaneous Pen Injector 80 40 $134,183.79 $134,183.79 $7,908.00 $137,649.78 $130,717.80 2025-01-01
1612 APR_DRG — 7 7 — — $112,083.34 $186,088.89 $130,301.37 2026-07-31
6074 APR_DRG — 7 7 — — $112,026.65 $185,994.77 $130,235.46 2026-07-31
PX-43500438 CDM Hc Implant-pulse Generator 40 40 $126,895.00 $126,895.00 $22,968.00 $126,895.00 $126,895.00 2025-01-01
6034 APR_DRG — 7 7 — — $108,486.01 $180,116.35 $126,119.33 2026-07-31
1611 APR_DRG — 7 7 — — $107,924.38 $179,183.88 $125,466.41 2026-07-31
5932 APR_DRG — 7 7 — — $107,847.28 $179,055.87 $125,376.77 2026-07-31
SUP-BEA22-40/I13-40 CDM Afx2 Bifurcated Stent Graft 22mm X13mm X 80mm 40 40 $124,650.00 $124,650.00 $9,473.40 $124,650.00 $124,650.00 2025-01-01
6084 APR_DRG — 7 7 — — $105,689.94 $175,474.10 $122,868.78 2026-07-31
5893 APR_DRG — 7 7 — — $105,496.43 $175,152.82 $122,643.82 2026-07-31
5911 APR_DRG — 7 7 — — $104,910.61 $174,180.20 $121,962.78 2026-07-31
1604 APR_DRG — 7 7 — — $104,319.49 $173,198.79 $121,275.58 2026-07-31
92986 CPT Hc Valvuloplasty Aortic Perc 40 40 $120,559.00 $120,559.00 $2,540.91 $120,559.00 $120,559.00 2025-01-01
92987 CPT Hc Valvuloplasty Mitral Perc 40 40 $120,559.00 $120,559.00 $2,540.91 $120,559.00 $120,559.00 2025-01-01
92990 CPT Hc Valvuloplasty Pulmon Perc 40 40 $120,559.00 $120,559.00 $2,540.91 $120,559.00 $120,559.00 2025-01-01
22 APR_DRG — 7 7 — — $103,106.27 $171,184.51 $119,865.17 2026-07-31
38301743 OTHER Heart/lung Sgl 20 20 $472,500.00 — $1,670.00 $472,500.00 $118,125.00 2026-07-31
38301750 OTHER Lung, Double 20 20 $501,428.57 — $1,670.00 $468,000.00 $117,000.00 2026-07-31
6114 APR_DRG — 7 7 — — $97,962.37 $162,644.24 $113,885.18 2026-07-31
6023 APR_DRG — 7 7 — — $97,688.74 $162,189.93 $113,567.07 2026-07-31
38300414 OTHER Lung 20 20 $445,500.00 — $1,670.00 $445,894.74 $111,473.68 2026-07-31
84 APR_DRG — 7 7 — — $95,709.03 $158,903.08 $111,265.58 2026-07-31
Q3025 HCPCS Interferon Beta-1a 30 Mcg/0.5 Ml Intramuscular Syringe Kit 40 40 $109,818.28 $109,818.28 $14,221.47 $109,818.28 $109,818.28 2025-01-01
43 APR_DRG — 7 7 — — $90,695.91 $150,579.92 $105,437.62 2026-07-31
8634 APR_DRG — 7 7 — — $90,654.33 $150,510.90 $105,389.29 2026-07-31
SUP-RLT311417 CDM Device Trunk 40 40 $105,201.00 $105,201.00 $7,995.28 $105,201.00 $105,201.00 2025-01-01
1624 APR_DRG — 7 7 — — $90,432.10 $150,141.93 $105,130.93 2026-07-31
5 MS_DRG Liver Transplant With McC Or Intestinal Transplant 57 57 $1,231,196.44 $115,037.86 91% off $10.65 $1,108,076.79 $104,556.16 2026-07-31
J3101 HCPCS Tenecteplase 50 Mg Intravenous Solution 40 40 $103,995.87 $103,995.87 $7,886.00 $103,995.87 $103,995.87 2025-01-01
38203584 OTHER Pancreas 20 20 $409,500.00 — $1,670.00 $409,500.00 $102,375.00 2026-07-31
6214 APR_DRG — 7 7 — — $87,938.38 $146,001.68 $102,231.89 2026-07-31
37195 CPT Hc Thrombolysis, Cerebral, By IV Infusion 40 40 $101,156.00 $101,156.00 $88.72 $101,156.00 $101,156.00 2025-01-01
C1882 HCPCS Crt D Bi Polar Dynagen Df4 G150 480 40 $119,691.00 $119,691.00 $6,634.80 $276,210.00 $99,666.00 2025-01-01
6093 APR_DRG — 7 7 — — $85,280.64 $141,589.10 $99,142.15 2026-07-31
3034 APR_DRG — 7 7 — — $84,984.33 $141,097.14 $98,797.68 2026-07-31
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 40 40 $1,173,781.14 $152,411.69 87% off $14.13 $1,056,403.02 $98,753.25 2026-07-31
SUP-MC-SPK20 CDM Accushape Cranial Implant Medium 40 40 $98,604.00 $98,604.00 $7,493.90 $98,604.00 $98,604.00 2025-01-01
4404 APR_DRG — 7 7 — — $84,592.77 $140,447.05 $98,342.48 2026-07-31
6134 APR_DRG — 7 7 — — $84,485.43 $140,268.84 $98,217.69 2026-07-31
54 APR_DRG — 7 7 — — $84,390.94 $140,111.97 $98,107.85 2026-07-31
6033 APR_DRG — 7 7 — — $84,262.44 $139,898.62 $97,958.46 2026-07-31
72 APR_DRG — 7 7 — — $83,539.04 $138,697.58 $97,117.48 2026-07-31
7 MS_DRG Lung Transplant 51 51 $1,892,709.56 $141,016.80 93% off $13.07 $1,703,438.60 $96,775.29 2026-07-31
8424 APR_DRG — 7 7 — — $83,124.81 $138,009.84 $96,635.92 2026-07-31
63 APR_DRG — 7 7 — — $81,925.95 $136,019.41 $95,242.20 2026-07-31
6303 APR_DRG — 7 7 — — $80,621.27 $133,853.28 $93,725.45 2026-07-31
SUP-ETBF2816C145E CDM Endurant Aaa Bifurcated 28mm X 16mm X 145mm 40 40 $93,366.00 $93,366.00 $7,095.82 $93,366.00 $93,366.00 2025-01-01
SUP-ETBF3616C145E CDM Stent Graft Ii Bifurcated 40 40 $93,366.00 $93,366.00 $7,095.82 $93,366.00 $93,366.00 2025-01-01
21 APR_DRG — 7 7 — — $80,024.11 $132,861.83 $93,031.23 2026-07-31
38301198 OTHER Septal Defect Implant,intracr 22 22 $881,343.00 — $66,622.36 $832,779.50 $92,605.08 2026-07-31
215 MS_DRG Other Heart Assist System Implant 52 52 $723,588.62 $114,451.59 84% off $10.59 $651,229.76 $92,054.89 2026-07-31
14 MS_DRG Allogeneic Bone Marrow Transplant 43 43 $1,098,593.04 $141,371.14 87% off $13.10 $988,733.73 $91,567.26 2026-07-31
6022 APR_DRG — 7 7 — — $77,941.60 $129,404.31 $90,610.23 2026-07-31
6144 APR_DRG — 7 7 — — $77,584.06 $128,810.69 $90,194.58 2026-07-31
1784 APR_DRG — 7 7 — — $76,834.21 $127,565.73 $89,322.85 2026-07-31
93 APR_DRG — 7 7 — — $76,722.34 $127,379.99 $89,192.79 2026-07-31
71 APR_DRG — 7 7 — — $76,683.03 $127,314.73 $89,147.09 2026-07-31
13 APR_DRG — 7 7 — — $76,361.77 $126,781.36 $88,773.62 2026-07-31
1634 APR_DRG — 7 7 — — $76,096.45 $126,340.85 $88,465.17 2026-07-31
0075T CPT Hc Trnscth Plcmnt Ex-cran Init'l 40 40 $87,705.00 $87,705.00 $3,012.00 $87,705.00 $87,705.00 2025-01-01
6334 APR_DRG — 7 7 — — $75,240.02 $124,918.94 $87,469.53 2026-07-31
38203147 OTHER Liver 20 20 $347,850.00 — $1,670.00 $347,850.00 $86,962.50 2026-07-31
62 APR_DRG — 7 7 — — $74,266.42 $123,302.50 $86,337.68 2026-07-31
1674 APR_DRG — 7 7 — — $73,707.05 $122,373.80 $85,687.40 2026-07-31
12 APR_DRG — 7 7 — — $73,145.42 $121,441.33 $85,034.48 2026-07-31
61 APR_DRG — 7 7 — — $72,412.20 $120,223.98 $84,182.08 2026-07-31
6124 APR_DRG — 7 7 — — $71,889.87 $119,356.78 $83,574.85 2026-07-31
1834 APR_DRG — 7 7 — — $71,877.02 $119,335.44 $83,559.91 2026-07-31
C1767 HCPCS Interstim X Ins 280 40 $96,876.00 $96,876.00 $6,151.21 $352,305.00 $83,458.80 2025-01-01
6073 APR_DRG — 7 7 — — $71,505.87 $118,719.24 $83,128.44 2026-07-31
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 61 61 $434,556.64 $91,627.41 79% off $8.47 $391,100.97 $82,970.25 2026-07-31
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 19 19 $32,755.87 $64,242.89 $941.60 $89,552.18 $81,411.07 2026-07-31
6514 APR_DRG — 7 7 — — $69,858.77 $115,984.59 $81,213.61 2026-07-31
42 APR_DRG — 7 7 — — $69,558.67 $115,486.36 $80,864.74 2026-07-31
SUP-DTP001-01 CDM Neuroblate Laser Probe 00 40 40 $80,667.00 $80,667.00 $14,600.73 $80,667.00 $80,667.00 2025-01-01
SUP-DTP000-01 CDM Neuroblate Laser Probe 000 40 40 $80,667.00 $80,667.00 $14,600.73 $80,667.00 $80,667.00 2025-01-01
SUP-M003UZAS40240 CDM Nf Atlas Stent 4.0x24mm No Tip 40 40 $79,958.97 $79,958.97 $6,076.88 $79,958.97 $79,958.97 2025-01-01
SUP-M003UZAS30210 CDM Nf Atlas Stent 3.0x21mm No Tip 40 40 $79,958.97 $79,958.97 $6,076.88 $79,958.97 $79,958.97 2025-01-01
SUP-M003UZAS45210 CDM Nf Atlas Stent 4.5x21mm No Tip 40 40 $79,958.97 $79,958.97 $6,076.88 $79,958.97 $79,958.97 2025-01-01
SUP-M003UZAS30150 CDM Nf Atlas Stent 3.0x15mm No Tip 40 40 $79,958.97 $79,958.97 $6,076.88 $79,958.97 $79,958.97 2025-01-01
SUP-M003UZAS40210 CDM Nf Atlas Stent 4.0x21mm No Tip 40 40 $79,958.97 $79,958.97 $6,076.88 $79,958.97 $79,958.97 2025-01-01
3033 APR_DRG — 7 7 — — $68,473.96 $113,685.43 $79,603.72 2026-07-31
11 APR_DRG — 7 7 — — $67,816.32 $112,593.58 $78,839.19 2026-07-31
3044 APR_DRG — 7 7 — — $67,111.83 $111,423.92 $78,020.18 2026-07-31
1654 APR_DRG — 7 7 — — $66,677.18 $110,702.30 $77,514.89 2026-07-31
6804 APR_DRG — 7 7 — — $66,061.88 $109,680.73 $76,799.58 2026-07-31
8504 APR_DRG — 7 7 — — $66,008.97 $109,592.88 $76,738.07 2026-07-31
53 APR_DRG — 7 7 — — $65,794.29 $109,236.46 $76,488.50 2026-07-31
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 33 33 $2,965,799.90 $231,697.07 92% off $10.89 $2,669,219.91 $76,136.45 2025-01-01
33418 CPT Hc Tmvr Percutaneous - Initial 40 40 $75,900.00 $75,900.00 $3,012.00 $75,900.00 $75,900.00 2025-01-01
SUP-80052 CDM Cath Trevo Pro 4x20 40 40 $75,323.43 $75,323.43 $13,633.54 $75,323.43 $75,323.43 2025-01-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With McC 59 59 $743,975.65 $84,617.81 89% off $7.82 $669,578.09 $75,298.49 2026-07-31
SUP-90312 CDM Retriever 3.0x20mm 40 40 $74,832.03 $74,832.03 $13,544.60 $74,832.03 $74,832.03 2025-01-01
SUP-90315 CDM 6x25mm Trevo Xp Provue Rtrvr 40 40 $74,832.03 $74,832.03 $13,544.60 $74,832.03 $74,832.03 2025-01-01
SUP-90314 CDM Retriever 4.0x30mm 40 40 $74,832.03 $74,832.03 $13,544.60 $74,832.03 $74,832.03 2025-01-01
SUP-M003UZAS45300 CDM Nf Atlas Stent 4.5x30mm No Tip 40 40 $74,572.83 $74,572.83 $5,667.54 $74,572.83 $74,572.83 2025-01-01
SUP-M003UZAS30240 CDM Nf Atlas Stent 3.0x24mm No Tip 40 40 $74,572.83 $74,572.83 $5,667.54 $74,572.83 $74,572.83 2025-01-01
9104 APR_DRG — 7 7 — — $63,944.60 $106,165.47 $74,338.16 2026-07-31
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With McC 63 63 $490,964.16 $80,835.97 84% off $7.46 $533,907.81 $73,727.50 2026-07-31
8413 APR_DRG — 7 7 — — $63,155.45 $104,855.25 $73,420.73 2026-07-31
38202362 OTHER Kidney 20 20 $305,100.00 — $1,670.00 $291,348.00 $72,837.00 2026-07-31
6814 APR_DRG — 7 7 — — $62,440.36 $103,668.02 $72,589.42 2026-07-31
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With McC 62 62 $560,649.28 $65,014.96 88% off $5.99 $504,584.35 $72,259.44 2026-07-31
914 APR_DRG — 7 7 — — $62,147.07 $103,181.08 $72,248.46 2026-07-31
SUP-MC-SPK10 CDM Accushape Cranial Implant Small 40 40 $72,247.50 $72,247.50 $5,490.81 $72,247.50 $72,247.50 2025-01-01
6904 APR_DRG — 7 7 — — $61,994.38 $102,927.57 $72,070.95 2026-07-31
SUP-FR995-27 CDM Valve Aortic Freestyle27mm 40 40 $72,000.00 $72,000.00 $5,472.00 $72,000.00 $72,000.00 2025-01-01
SUP-FR995-19 CDM Valve Aortic Freestyle19mm 40 40 $72,000.00 $72,000.00 $5,472.00 $72,000.00 $72,000.00 2025-01-01
SUP-FR995-23 CDM Valve Aortic Freestyle23mm 40 40 $72,000.00 $72,000.00 $5,472.00 $72,000.00 $72,000.00 2025-01-01
SUP-FR995-21 CDM Valve Aortic Freestyle21mm 40 40 $72,000.00 $72,000.00 $5,472.00 $72,000.00 $72,000.00 2025-01-01
SUP-FR995-25 CDM Valve Aortic Freestyle25mm 40 40 $72,000.00 $72,000.00 $5,472.00 $72,000.00 $72,000.00 2025-01-01
2604 APR_DRG — 7 7 — — $61,787.27 $102,583.70 $71,830.17 2026-07-31
1794 APR_DRG — 7 7 — — $61,507.58 $102,119.35 $71,505.03 2026-07-31
C1815 HCPCS Prosthesis Penile Cuff 4cm 40 40 $71,100.00 $71,100.00 $5,403.60 $71,100.00 $71,100.00 2025-01-01
SUP-CV71-80 CDM Saphens Ndecell 71-80cm 3mm 40 40 $71,100.00 $71,100.00 $5,403.60 $71,100.00 $71,100.00 2025-01-01
6954 APR_DRG — 7 7 — — $60,807.62 $100,957.22 $70,691.29 2026-07-31
1664 APR_DRG — 7 7 — — $60,616.38 $100,639.71 $70,468.96 2026-07-31
6313 APR_DRG — 7 7 — — $60,556.66 $100,540.56 $70,399.54 2026-07-31
J9039 HCPCS Blinatumomab 35 Mcg Intravenous Kit 40 40 $70,101.31 $70,101.31 $5,326.30 $70,101.31 $70,101.31 2025-01-01
33025 CPT Hc Pericardial Window 40 40 $70,070.00 $70,070.00 $1,093.00 $70,070.00 $70,070.00 2025-01-01
83 APR_DRG — 7 7 — — $60,259.59 $100,047.35 $70,054.19 2026-07-31
49744097 OTHER Sipuleucel-t 50 Million 250ml 23 23 $416,938.00 — $32,072.16 $400,902.00 $69,837.13 2026-07-31
38300406 OTHER Heart 20 20 $279,000.00 — $1,670.00 $279,000.00 $69,750.00 2026-07-31
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 57 57 $1,411,513.30 $104,318.37 93% off $9.65 $1,270,361.96 $69,598.00 2026-07-31
1623 APR_DRG — 7 7 — — $59,855.19 $99,375.92 $69,584.05 2026-07-31
PX-38300026 CDM Hc Cardiac, Cabg 40 40 $69,575.00 $69,575.00 $1,093.00 $69,575.00 $69,575.00 2025-01-01
1694 APR_DRG — 7 7 — — $59,621.61 $98,988.13 $69,312.51 2026-07-31
214 APR_DRG — 7 7 — — $59,577.01 $98,914.08 $69,260.66 2026-07-31
459 MS_DRG Spinal Fusion Except Cervical With Mcc 25 25 $85,686.44 $55,964.15 35% off $941.60 $141,627.00 $69,073.45 2026-07-31
6083 APR_DRG — 7 7 — — $58,603.42 $97,297.64 $68,128.82 2026-07-31
C1722 HCPCS Defibrillator Cardiac W5.37xh7.79cm D0.99cm 320 40 $90,589.50 $90,589.50 $3,933.00 $153,000.00 $68,013.00 2025-01-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With McC 63 63 $759,233.52 $72,282.27 90% off $6.67 $683,310.17 $68,003.00 2026-07-31
C1721 HCPCS Azure Xt Dr MRI Device 400 40 $90,534.92 $90,534.92 $2,748.31 $120,312.00 $67,500.00 2025-01-01
4414 APR_DRG — 7 7 — — $58,024.40 $96,336.31 $67,455.68 2026-07-31
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 26 26 $57,160.00 $50,623.98 $941.60 $158,550.43 $67,365.94 2026-07-31
6224 APR_DRG — 7 7 — — $57,849.78 $96,046.41 $67,252.69 2026-07-31
894 APR_DRG — 7 7 — — $57,830.89 $96,015.03 $67,230.72 2026-07-31
924 APR_DRG — 7 7 — — $56,871.65 $94,422.44 $66,115.57 2026-07-31
4234 APR_DRG — 7 7 — — $56,264.66 $93,414.67 $65,409.92 2026-07-31
SUP-7510600 CDM Graft Lmbr Lg 8ml Tpr Fsn 40 40 $65,383.76 $65,383.76 $4,969.17 $65,383.76 $65,383.76 2025-01-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/McC 61 61 $400,714.73 $65,499.22 84% off $6.04 $360,643.26 $65,139.66 2026-07-31
6113 APR_DRG — 7 7 — — $55,943.40 $92,881.30 $65,036.44 2026-07-31
3124 APR_DRG — 7 7 — — $55,938.87 $92,873.77 $65,031.17 2026-07-31
41 APR_DRG — 7 7 — — $55,651.63 $92,396.87 $64,697.24 2026-07-31
2644 APR_DRG — 7 7 — — $55,388.57 $91,960.13 $64,391.43 2026-07-31
1204 APR_DRG — 7 7 — — $55,014.40 $91,338.90 $63,956.44 2026-07-31
6072 APR_DRG — 7 7 — — $54,855.66 $91,075.35 $63,771.90 2026-07-31
9114 APR_DRG — 7 7 — — $54,798.21 $90,979.97 $63,705.12 2026-07-31
6032 APR_DRG — 7 7 — — $54,775.54 $90,942.32 $63,678.75 2026-07-31
955 MS_DRG Craniotomy For Multiple Significant Trauma 62 62 $426,332.33 $74,007.83 83% off $6.83 $488,991.15 $63,607.42 2026-07-31
4403 APR_DRG — 7 7 — — $54,681.81 $90,786.70 $63,569.79 2026-07-31
SUP-D140 CDM Icd Sc Inogen El Vr Df4 D140 40 40 $63,513.00 $63,513.00 $4,826.99 $63,513.00 $63,513.00 2025-01-01
7404 APR_DRG — 7 7 — — $54,371.13 $90,270.90 $63,208.62 2026-07-31
92 APR_DRG — 7 7 — — $54,314.44 $90,176.77 $63,142.71 2026-07-31
234 APR_DRG — 7 7 — — $54,057.43 $89,750.07 $62,843.93 2026-07-31
224 APR_DRG — 7 7 — — $53,858.63 $89,420.01 $62,612.81 2026-07-31
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 23 23 $52,862.60 $46,757.29 $941.60 $116,199.30 $62,583.90 2026-07-31
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 27 27 $98,648.01 $46,592.45 53% off $941.60 $164,075.30 $62,468.38 2026-07-31
SUP-823832 CDM Device Vlv Siphonguard Program 40 40 $62,410.68 $62,410.68 $4,743.21 $62,410.68 $62,410.68 2025-01-01
2204 APR_DRG — 7 7 — — $53,597.85 $88,987.03 $62,309.64 2026-07-31
1783 APR_DRG — 7 7 — — $53,538.13 $88,887.89 $62,240.22 2026-07-31
PX-38301651 CDM Hc Cardiac/Thoracic, Case Cx. 40 40 $62,047.00 $62,047.00 $1,093.00 $62,047.00 $62,047.00 2025-01-01
PX-38300018 CDM Hc Cardiac, Valve 40 40 $62,047.00 $62,047.00 $1,093.00 $62,047.00 $62,047.00 2025-01-01
9124 APR_DRG — 7 7 — — $53,305.31 $88,501.35 $61,969.56 2026-07-31
4034 APR_DRG — 7 7 — — $53,174.54 $88,284.23 $61,817.53 2026-07-31
1603 APR_DRG — 7 7 — — $53,070.98 $88,112.30 $61,697.14 2026-07-31
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With McC 50 50 $496,688.36 $87,245.33 82% off $8.06 $447,019.53 $61,309.29 2026-07-31
SUP-LITNG12XTORQ100 CDM Indigo Catheter 12 Dynamic Aspiration Tubing 40 40 $61,290.00 $61,290.00 $11,093.49 $61,290.00 $61,290.00 2025-01-01
SUP-LITNG12HTORQ115 CDM Indigo Catheter 12 + Dynamic Aspiration Tubing 40 40 $61,290.00 $61,290.00 $11,093.49 $61,290.00 $61,290.00 2025-01-01
2324 APR_DRG — 7 7 — — $52,690.01 $87,479.78 $61,254.24 2026-07-31
232 MS_DRG Coronary Bypass With Ptca Without Mcc 22 22 $37,445.50 $45,253.36 $941.60 $107,938.89 $61,172.30 2026-07-31
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 52 52 $999,692.61 $83,770.59 92% off $7.74 $899,723.35 $61,146.85 2026-07-31
2614 APR_DRG — 7 7 — — $52,361.19 $86,933.85 $60,871.98 2026-07-31
38240 CPT Hc Hpc Allo Transplant, Per Donor 40 40 $60,820.00 $60,820.00 $1,254.91 $60,820.00 $60,820.00 2025-01-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 24 24 $54,061.65 $47,615.39 $941.60 $133,638.00 $60,815.10 2026-07-31
52 APR_DRG — 7 7 — — $52,300.72 $86,833.45 $60,801.68 2026-07-31
274 APR_DRG — 7 7 — — $52,209.26 $86,681.60 $60,695.35 2026-07-31
SUP-ETLW1610C156E CDM Endurant Aaa Contra Limb 16mm X 10mm X 156mm 40 40 $59,904.00 $59,904.00 $4,552.70 $59,904.00 $59,904.00 2025-01-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 57 57 $255,857.10 $60,038.01 77% off $5.53 $230,271.38 $59,849.38 2026-07-31
SUP-407137 CDM Pacemaker Cardiac Resynchronization Therapy Permanent Tripl 40 40 $59,700.42 $59,700.42 $4,537.23 $59,700.42 $59,700.42 2025-01-01
6021 APR_DRG — 7 7 — — $51,102.62 $84,844.28 $59,408.84 2026-07-31
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 6 6 $23,075.70 $56,272.37 $941.60 $63,048.00 $59,367.35 2026-07-31
231 MS_DRG Coronary Bypass With Ptca With McC 46 46 $733,480.92 $91,677.88 88% off $8.47 $660,132.82 $59,223.30 2026-07-31
35371 CPT Hc Endarterect,Incl Patch,Com Fem 40 40 $59,043.00 $59,043.00 $1,093.00 $59,043.00 $59,043.00 2025-01-01
204 APR_DRG — 7 7 — — $50,616.58 $84,037.31 $58,843.79 2026-07-31
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With McC 61 61 $528,786.72 $60,038.01 89% off $5.53 $475,908.05 $58,699.54 2026-07-31
6344 APR_DRG — 7 7 — — $50,315.73 $83,537.82 $58,494.05 2026-07-31
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 59 59 $804,586.75 $64,521.02 92% off $5.94 $724,128.07 $58,317.67 2026-07-31
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 60 60 $375,661.99 $75,384.40 80% off $6.96 $338,095.79 $58,203.37 2026-07-31
1304 APR_DRG — 7 7 — — $49,690.60 $82,499.94 $57,767.31 2026-07-31
7924 APR_DRG — 7 7 — — $49,676.99 $82,477.35 $57,751.49 2026-07-31
969 MS_DRG HIV With Extensive O.r. Procedures With McC 63 63 $344,233.19 $68,596.00 80% off $6.32 $309,809.86 $57,744.18 2026-07-31
6123 APR_DRG — 7 7 — — $49,618.03 $82,379.46 $57,682.95 2026-07-31
6234 APR_DRG — 7 7 — — $49,472.90 $82,138.50 $57,514.23 2026-07-31
6092 APR_DRG — 7 7 — — $49,471.39 $82,135.99 $57,512.47 2026-07-31
9504 APR_DRG — 7 7 — — $49,424.52 $82,058.18 $57,457.98 2026-07-31
6302 APR_DRG — 7 7 — — $49,372.36 $81,971.58 $57,397.35 2026-07-31
91 APR_DRG — 7 7 — — $48,883.30 $81,159.60 $56,828.79 2026-07-31
6133 APR_DRG — 7 7 — — $48,791.08 $81,006.49 $56,721.58 2026-07-31
4054 APR_DRG — 7 7 — — $48,758.57 $80,952.52 $56,683.79 2026-07-31
1833 APR_DRG — 7 7 — — $48,642.92 $80,760.51 $56,549.34 2026-07-31
2304 APR_DRG — 7 7 — — $48,617.98 $80,719.09 $56,520.34 2026-07-31
Q4105 HCPCS Hc Integra Drt Per 1 Cm 134 40 $57,260.61 $57,260.61 $15.49 $146,062.62 $56,304.71 2025-01-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without McC 62 62 $431,541.93 $51,205.15 88% off $4.70 $388,387.75 $56,187.58 2026-07-31
653 MS_DRG Major Bladder Procedures With McC 58 58 $354,096.47 $59,953.31 83% off $5.57 $318,686.83 $56,160.23 2026-07-31
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 62 62 $325,967.66 $54,453.31 83% off $5.01 $293,370.89 $56,118.10 2026-07-31
SUP-615.10.01S CDM Cement Bone Nrn Crs Fst St 10ml 40 40 $56,016.00 $56,016.00 $4,257.22 $56,016.00 $56,016.00 2025-01-01
4402 APR_DRG — 7 7 — — $48,083.55 $79,831.81 $55,899.06 2026-07-31
1764 APR_DRG — 7 7 — — $48,026.11 $79,736.43 $55,832.27 2026-07-31
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 26 26 $44,127.89 $40,387.79 $941.60 $132,250.79 $55,802.47 2026-07-31
J7504 HCPCS Lymphocyte,anti-thymo Immune Globulin 50 Mg/ml Intravenous Solution 40 40 $55,687.60 $55,687.60 $3,968.45 $55,687.60 $55,687.60 2025-01-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With McC 61 61 $305,990.61 $55,551.71 82% off $5.43 $275,391.55 $55,655.22 2026-07-31
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 36 36 $2,263,969.99 $109,132.86 95% off $7.93 $2,037,573.00 $55,403.16 2025-01-01
1814 APR_DRG — 7 7 — — $47,652.69 $79,116.46 $55,398.16 2026-07-31
1633 APR_DRG — 7 7 — — $47,623.97 $79,068.77 $55,364.77 2026-07-31
SUP-3300TFX21MM CDM Valve Aortic Bio Magne Ease 21mm 40 40 $55,350.00 $55,350.00 $4,206.60 $55,350.00 $55,350.00 2025-01-01
SUP-7300TFX29 CDM Valve Mitral Magna Ease 29mm 40 40 $55,350.00 $55,350.00 $4,206.60 $55,350.00 $55,350.00 2025-01-01
SUP-3300TFX29MM CDM Valve Aortic Bio Magne Ease 29mm 40 40 $55,350.00 $55,350.00 $4,206.60 $55,350.00 $55,350.00 2025-01-01
SUP-3300TFX27MM CDM Valve Aortic Bio Magne Ease 27mm 40 40 $55,350.00 $55,350.00 $4,206.60 $55,350.00 $55,350.00 2025-01-01
SUP-3300TFX25MM CDM Valve Aortic Bio Magne Ease 25mm 40 40 $55,350.00 $55,350.00 $4,206.60 $55,350.00 $55,350.00 2025-01-01
SUP-7300TFX27 CDM Valve Mitral Magna Ease 27mm 40 40 $55,350.00 $55,350.00 $4,206.60 $55,350.00 $55,350.00 2025-01-01
SUP-7300TFX25 CDM Valve Mitral Magna Ease 25mm 40 40 $55,350.00 $55,350.00 $4,206.60 $55,350.00 $55,350.00 2025-01-01
SUP-3300TFX23MM CDM Valve Aortic Bio Magne Ease 23mm 40 40 $55,350.00 $55,350.00 $4,206.60 $55,350.00 $55,350.00 2025-01-01
SUP-7300TFX31 CDM Valve Mitral Magna Ease 31mm 40 40 $55,350.00 $55,350.00 $4,206.60 $55,350.00 $55,350.00 2025-01-01
SUP-3300TFX19MM CDM Valve Aortic Bio Magne Ease 19mm 40 40 $55,350.00 $55,350.00 $4,206.60 $55,350.00 $55,350.00 2025-01-01
SUP-7510400 CDM Graft Bn Lmbr Tpr Fsn Dev 5.6 40 40 $55,224.00 $55,224.00 $4,197.02 $55,224.00 $55,224.00 2025-01-01
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