Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

MERCY CATHOLIC MEDICAL CENTER- MERCY FITZGERALD

Darby, PA · CCN 390156 · Rates published

14,360 distinct procedures filed
29 distinct payers
688,371 rate rows
2025-01-01 last MRF observed · ⚠ 17 mo old
Data quality

416,395 of 688,371 rate rows are consumer-grade (60.5%)

271,976 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 219,395
template filing: same amount across many unrelated codes — excluded 36,901
exceeds 10× this hospital's gross charge — excluded from medians 15,553
percent-of-charges filed in the dollar field — excluded from medians 118
placeholder amount (≤ $0.02) — excluded from medians 6
per-diem day rate — not a per-procedure price 3

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 17 months old.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/mercyfitzgeraldhospital
Found on page https://www.trinityhealthma.org/patients-visitors/billing-insurance/pricing-transparency
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-18
Content fingerprint b4be1dfff6e78643… · 17,404,065 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
'583-4
APR_DRG 		Neonate With Ecmo 3 $414,464.65 $626,579.35 $542,571.87 —
'583-3
APR_DRG 		Neonate With Ecmo 3 $347,859.41 $525,886.88 $455,379.56 —
'588-4
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $321,042.37 $485,345.43 $420,273.63 —
'002-4
APR_DRG 		Heart And/or Lung Transplant 3 $303,766.99 $459,228.84 $397,658.58 —
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 20 $286,163.15 $822,090.67 $376,334.84 nat. median
$370,174
1.0× median
'161-4
APR_DRG 		Implantable Heart Assist Systems 3 $255,103.34 $385,660.12 $333,953.45 —
'841-4
APR_DRG 		Extensive Third Degree Burns With Skin Graft 3 $237,828.84 $359,544.88 $311,339.56 —
'583-2
APR_DRG 		Neonate With Ecmo 3 $225,734.12 $341,260.32 $295,506.47 —
'588-3
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $216,613.85 $327,472.48 $283,567.20 —
'630-4
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 $214,483.92 $324,252.49 $280,778.94 —
'591-4
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 3 $213,668.68 $323,020.02 $279,711.71 —
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 20 $210,479.16 $605,442.24 $277,158.00 nat. median
$265,286
1.0× median
'007-4
APR_DRG 		Allogeneic Bone Marrow Transplant 3 $206,288.00 $311,862.07 $270,049.74 —
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 21 $204,732.24 $588,991.46 $269,627.20 nat. median
$206,474
1.3× median
'009-4
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 3 $189,379.88 $286,300.71 $247,915.46 —
'631-4
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 3 $187,701.48 $283,763.34 $245,718.29 —
'609-4
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 $187,659.79 $283,700.31 $245,663.71 —
'593-4
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 3 $182,126.06 $275,334.53 $238,419.56 —
'001-4
APR_DRG 		Liver Transplant And/or Intestinal Transplant 3 $181,914.04 $275,014.01 $238,142.01 —
'583-1
APR_DRG 		Neonate With Ecmo 3 $178,356.77 $269,636.20 $233,485.22 —
'161-3
APR_DRG 		Implantable Heart Assist Systems 3 $170,328.52 $257,499.24 $222,975.50 —
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 21 $165,598.18 $476,968.66 $222,585.37 nat. median
$202,976
1.1× median
'004-4
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 3 $168,131.17 $254,177.34 $220,098.98 —
'588-1
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $164,139.22 $248,142.39 $214,873.15 —
'588-2
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $164,139.22 $248,142.39 $214,873.15 —
'002-3
APR_DRG 		Heart And/or Lung Transplant 3 $152,144.74 $230,009.37 $199,171.29 —
J7330
HCPCS 		Membrane Collgn Porcine Maci W/autologous Cult Chondrocytes 12 $211.00 $281,638.28 $187,663.06 nat. median
$76,329
outlier · 2.5×
'603-4
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 3 $141,589.14 $214,051.62 $185,353.05 —
'602-4
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 $140,306.39 $212,112.39 $183,673.81 —
'006-4
APR_DRG 		Pancreas Transplant 3 $138,776.14 $209,799.00 $181,670.58 —
'591-3
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 3 $136,548.64 $206,431.49 $178,754.57 —
'589-1
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 3 $133,890.89 $202,413.56 $175,275.33 —
'160-4
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly 3 $130,715.07 $197,612.42 $171,117.90 —
'002-2
APR_DRG 		Heart And/or Lung Transplant 3 $129,171.51 $195,278.91 $169,097.25 —
'589-2
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 3 $129,153.77 $195,252.09 $169,074.02 —
'161-2
APR_DRG 		Implantable Heart Assist Systems 3 $124,796.34 $188,664.60 $163,369.74 —
27800000002-52209
CDM 		Device Impella 5.5 Smartassist 12 $211.00 $242,550.00 $161,617.50 nat. median
$148,252
1.1× median
'589-3
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 3 $122,958.26 $185,885.84 $160,963.54 —
'593-3
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 3 $122,410.92 $185,058.38 $160,247.02 —
'161-1
APR_DRG 		Implantable Heart Assist Systems 3 $118,528.09 $179,188.39 $155,164.03 —
'008-4
APR_DRG 		Autologous Bone Marrow Transplant Or T-cell Immunotherapy 3 $117,165.50 $177,128.46 $153,380.29 —
'842-4
APR_DRG 		Burns With Skin Graft Except Extensive Third Degree Burns 3 $116,100.98 $175,519.14 $151,986.73 —
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 21 $114,177.25 $329,774.18 $150,963.29 nat. median
$133,161
1.1× median
'004-3
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 3 $114,792.51 $173,541.02 $150,273.82 —
'591-2
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 3 $112,675.00 $170,339.81 $147,501.81 —
'005-4
APR_DRG 		Tracheostomy With Mv >96 Hours Without Extensive Procedure 3 $110,302.90 $166,753.71 $144,396.51 —
'593-2
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 3 $110,242.57 $166,662.52 $144,317.54 —
'607-4
APR_DRG 		Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 3 $109,406.93 $165,399.20 $143,223.60 —
'007-3
APR_DRG 		Allogeneic Bone Marrow Transplant 3 $106,392.56 $160,842.14 $139,277.53 —
'002-1
APR_DRG 		Heart And/or Lung Transplant 3 $105,322.72 $159,224.77 $137,877.00 —

Other procedures at this hospital

Browse this hospital's 14,360 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
             
'001-1 APR_DRG Liver Transplant And/or Intestinal Transplant 3 3 — — $68,509.84 $103,571.81 $89,685.61 2025-01-01
'001-2 APR_DRG Liver Transplant And/or Intestinal Transplant 3 3 — — $68,509.84 $103,571.81 $89,685.61 2025-01-01
'001-3 APR_DRG Liver Transplant And/or Intestinal Transplant 3 3 — — $84,291.35 $127,429.98 $110,345.04 2025-01-01
'001-4 APR_DRG Liver Transplant And/or Intestinal Transplant 3 3 — — $181,914.04 $275,014.01 $238,142.01 2025-01-01
'002-1 APR_DRG Heart And/or Lung Transplant 3 3 — — $105,322.72 $159,224.77 $137,877.00 2025-01-01
'002-2 APR_DRG Heart And/or Lung Transplant 3 3 — — $129,171.51 $195,278.91 $169,097.25 2025-01-01
'002-3 APR_DRG Heart And/or Lung Transplant 3 3 — — $152,144.74 $230,009.37 $199,171.29 2025-01-01
'002-4 APR_DRG Heart And/or Lung Transplant 3 3 — — $303,766.99 $459,228.84 $397,658.58 2025-01-01
'004-1 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 3 3 — — $72,798.97 $110,056.03 $95,300.47 2025-01-01
'004-2 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 3 3 — — $83,607.40 $126,395.99 $109,449.68 2025-01-01
'004-3 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 3 3 — — $114,792.51 $173,541.02 $150,273.82 2025-01-01
'004-4 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 3 3 — — $168,131.17 $254,177.34 $220,098.98 2025-01-01
'005-2 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 3 3 — — $62,515.71 $94,509.99 $81,838.74 2025-01-01
'005-3 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 3 3 — — $77,559.15 $117,252.37 $101,531.97 2025-01-01
'005-4 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 3 3 — — $110,302.90 $166,753.71 $144,396.51 2025-01-01
'006-1 APR_DRG Pancreas Transplant 3 3 — — $55,874.88 $84,470.52 $73,145.29 2025-01-01
'006-2 APR_DRG Pancreas Transplant 3 3 — — $80,798.84 $122,150.07 $105,773.02 2025-01-01
'006-3 APR_DRG Pancreas Transplant 3 3 — — $88,419.03 $133,670.11 $115,748.54 2025-01-01
'006-4 APR_DRG Pancreas Transplant 3 3 — — $138,776.14 $209,799.00 $181,670.58 2025-01-01
'007-1 APR_DRG Allogeneic Bone Marrow Transplant 3 3 — — $67,217.34 $101,617.82 $87,993.60 2025-01-01
'007-2 APR_DRG Allogeneic Bone Marrow Transplant 3 3 — — $87,564.75 $132,378.63 $114,630.21 2025-01-01
'007-3 APR_DRG Allogeneic Bone Marrow Transplant 3 3 — — $106,392.56 $160,842.14 $139,277.53 2025-01-01
'007-4 APR_DRG Allogeneic Bone Marrow Transplant 3 3 — — $206,288.00 $311,862.07 $270,049.74 2025-01-01
'008-2 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 3 3 — — $48,771.87 $73,732.33 $63,846.80 2025-01-01
'008-3 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 3 3 — — $61,284.41 $92,648.55 $80,226.86 2025-01-01
'008-4 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 3 3 — — $117,165.50 $177,128.46 $153,380.29 2025-01-01
'009-1 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 3 3 — — $55,856.25 $84,442.36 $73,120.90 2025-01-01
'009-2 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 3 3 — — $55,856.25 $84,442.36 $73,120.90 2025-01-01
'009-3 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 3 3 — — $89,456.05 $135,237.86 $117,106.09 2025-01-01
'009-4 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 3 3 — — $189,379.88 $286,300.71 $247,915.46 2025-01-01
'020-4 APR_DRG Open Craniotomy For Trauma 3 3 — — $60,983.68 $92,193.91 $79,833.18 2025-01-01
'021-4 APR_DRG Open Craniotomy Except Trauma 3 3 — — $69,577.91 $105,186.49 $91,083.80 2025-01-01
'022-4 APR_DRG Ventricular Shunt Procedures 3 3 — — $61,012.96 $92,238.17 $79,871.51 2025-01-01
'023-4 APR_DRG Spinal Procedures 3 3 — — $62,266.43 $94,133.15 $81,512.42 2025-01-01
'026-4 APR_DRG Other Nervous System And Related Procedures 3 3 — — $52,872.93 $79,932.24 $69,215.47 2025-01-01
'027-4 APR_DRG Other Open Craniotomy 3 3 — — $63,892.49 $96,591.38 $83,641.07 2025-01-01
'029-4 APR_DRG Other Percutaneous Intracranial Procedures 3 3 — — $48,691.14 $73,610.29 $63,741.13 2025-01-01
'030-4 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 3 3 — — $52,997.12 $80,119.99 $69,378.05 2025-01-01
'073-4 APR_DRG Orbit And Eye Procedures 3 3 — — $46,509.76 $70,312.53 $60,885.50 2025-01-01
'089-4 APR_DRG Major Cranial Or Facial Bone Procedures 3 3 — — $59,347.87 $89,720.93 $77,691.76 2025-01-01
'091-4 APR_DRG Other Major Head And Neck Procedures 3 3 — — $63,563.37 $96,093.83 $83,210.23 2025-01-01
'092-4 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 3 3 — — $52,552.69 $79,448.10 $68,796.24 2025-01-01
'120-4 APR_DRG Major Respiratory And Chest Procedures 3 3 — — $57,621.58 $87,111.15 $75,431.88 2025-01-01
'121-4 APR_DRG Other Respiratory And Chest Procedures 3 3 — — $48,708.88 $73,637.11 $63,764.35 2025-01-01
'130-4 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 3 3 — — $54,616.08 $82,567.50 $71,497.41 2025-01-01
'160-3 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 3 3 — — $59,071.98 $89,303.84 $77,330.59 2025-01-01
'160-4 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 3 3 — — $130,715.07 $197,612.42 $171,117.90 2025-01-01
'161-1 APR_DRG Implantable Heart Assist Systems 3 3 — — $118,528.09 $179,188.39 $155,164.03 2025-01-01
'161-2 APR_DRG Implantable Heart Assist Systems 3 3 — — $124,796.34 $188,664.60 $163,369.74 2025-01-01
'161-3 APR_DRG Implantable Heart Assist Systems 3 3 — — $170,328.52 $257,499.24 $222,975.50 2025-01-01
'161-4 APR_DRG Implantable Heart Assist Systems 3 3 — — $255,103.34 $385,660.12 $333,953.45 2025-01-01
'162-2 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 3 3 — — $49,089.45 $74,212.45 $64,262.55 2025-01-01
'162-3 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 3 3 — — $64,323.62 $97,243.16 $84,205.46 2025-01-01
'162-4 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 3 3 — — $99,841.33 $150,938.12 $130,701.37 2025-01-01
'163-3 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 3 3 — — $54,181.40 $81,910.36 $70,928.38 2025-01-01
'163-4 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 3 3 — — $85,983.05 $129,987.45 $112,559.62 2025-01-01
'165-3 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 3 3 — — $53,816.80 $81,359.17 $70,451.09 2025-01-01
'165-4 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 3 3 — — $77,552.94 $117,242.98 $101,523.84 2025-01-01
'166-4 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 3 3 — — $67,421.37 $101,926.28 $88,260.70 2025-01-01
'167-3 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 3 3 — — $48,157.11 $72,802.95 $63,042.03 2025-01-01
'167-4 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 3 3 — — $87,255.15 $131,910.59 $114,224.92 2025-01-01
'169-4 APR_DRG Major Abdominal Vascular Procedures 3 3 — — $64,670.47 $97,767.53 $84,659.52 2025-01-01
'170-4 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 3 3 — — $47,066.86 $71,154.74 $61,614.80 2025-01-01
'176-4 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 3 3 — — $51,569.78 $77,962.16 $67,509.53 2025-01-01
'178-1 APR_DRG External Heart Assist Systems 3 3 — — $45,825.81 $69,278.54 $59,990.15 2025-01-01
'178-2 APR_DRG External Heart Assist Systems 3 3 — — $54,482.13 $82,364.99 $71,322.06 2025-01-01
'178-3 APR_DRG External Heart Assist Systems 3 3 — — $58,616.01 $88,614.52 $76,733.69 2025-01-01
'178-4 APR_DRG External Heart Assist Systems 3 3 — — $83,669.49 $126,489.86 $109,530.97 2025-01-01
'179-3 APR_DRG Defibrillator Implants 3 3 — — $48,890.74 $73,912.04 $64,002.42 2025-01-01
'179-4 APR_DRG Defibrillator Implants 3 3 — — $66,122.65 $99,962.91 $86,560.56 2025-01-01
'181-4 APR_DRG Lower Extremity Arterial Procedures 3 3 — — $57,086.65 $86,302.46 $74,731.62 2025-01-01
'182-4 APR_DRG Other Peripheral Vascular And Related Procedures 3 3 — — $49,344.93 $74,598.68 $64,597.00 2025-01-01
'183-3 APR_DRG Percutaneous Structural Cardiac Procedures 3 3 — — $49,189.69 $74,363.99 $64,393.77 2025-01-01
'183-4 APR_DRG Percutaneous Structural Cardiac Procedures 3 3 — — $72,170.02 $109,105.19 $94,477.11 2025-01-01
'220-4 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 3 3 — — $61,624.17 $93,162.19 $80,671.64 2025-01-01
'222-4 APR_DRG Other Stomach, Esophageal And Duodenal Procedures 3 3 — — $46,119.44 $69,722.44 $60,374.53 2025-01-01
'230-4 APR_DRG Major Small Bowel Procedures 3 3 — — $53,185.19 $80,404.30 $69,624.24 2025-01-01
'231-4 APR_DRG Major Large Bowel Procedures 3 3 — — $46,608.23 $70,461.39 $61,014.41 2025-01-01
'232-4 APR_DRG Gastric Fundoplication 3 3 — — $63,182.81 $95,518.50 $82,712.03 2025-01-01
'260-4 APR_DRG Major Pancreas, Liver And Shunt Procedures 3 3 — — $68,453.07 $103,485.98 $89,611.28 2025-01-01
'261-4 APR_DRG Major Biliary Tract Procedures 3 3 — — $56,274.96 $85,075.36 $73,669.03 2025-01-01
'303-2 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 3 3 — — $51,853.65 $78,391.31 $67,881.14 2025-01-01
'303-3 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 3 3 — — $77,515.68 $117,186.65 $101,475.07 2025-01-01
'303-4 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 3 3 — — $104,823.28 $158,469.74 $137,223.20 2025-01-01
'304-3 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 3 3 — — $50,153.97 $75,821.77 $65,656.10 2025-01-01
'304-4 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 3 3 — — $74,098.57 $112,020.74 $97,001.76 2025-01-01
'309-4 APR_DRG Other Significant Hip And Femur Surgery 3 3 — — $45,645.73 $69,006.30 $59,754.40 2025-01-01
'312-4 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 3 3 — — $74,191.72 $112,161.55 $97,123.70 2025-01-01
'321-4 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 3 3 — — $52,081.64 $78,735.98 $68,179.59 2025-01-01
'361-4 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 3 3 — — $69,528.23 $105,111.39 $91,018.77 2025-01-01
'401-4 APR_DRG Adrenal Procedures 3 3 — — $66,350.64 $100,307.57 $86,859.02 2025-01-01
'403-4 APR_DRG Procedures For Obesity 3 3 — — $45,744.19 $69,155.16 $59,883.31 2025-01-01
'404-4 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 3 3 — — $55,894.39 $84,500.02 $73,170.84 2025-01-01
'405-4 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 3 3 — — $51,371.96 $77,663.10 $67,250.56 2025-01-01
'440-2 APR_DRG Kidney Transplant 3 3 — — $49,218.96 $74,408.25 $64,432.10 2025-01-01
'440-3 APR_DRG Kidney Transplant 3 3 — — $58,115.69 $87,858.14 $76,078.72 2025-01-01
'440-4 APR_DRG Kidney Transplant 3 3 — — $91,930.17 $138,978.19 $120,344.94 2025-01-01
'441-4 APR_DRG Major Bladder Procedures 3 3 — — $62,497.08 $94,481.83 $81,814.35 2025-01-01
'447-4 APR_DRG Other Kidney, Urinary Tract And Related Procedures 3 3 — — $46,939.12 $70,961.62 $61,447.57 2025-01-01
'510-4 APR_DRG Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 3 3 — — $52,581.07 $79,491.02 $68,833.40 2025-01-01
'511-4 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 3 3 — — $48,555.41 $73,405.10 $63,563.45 2025-01-01
'514-4 APR_DRG Female Reproductive System Reconstructive Procedures 3 3 — — $46,386.45 $70,126.11 $60,724.08 2025-01-01
'583-1 APR_DRG Neonate With Ecmo 3 3 — — $178,356.77 $269,636.20 $233,485.22 2025-01-01
'583-2 APR_DRG Neonate With Ecmo 3 3 — — $225,734.12 $341,260.32 $295,506.47 2025-01-01
'583-3 APR_DRG Neonate With Ecmo 3 3 — — $347,859.41 $525,886.88 $455,379.56 2025-01-01
'583-4 APR_DRG Neonate With Ecmo 3 3 — — $414,464.65 $626,579.35 $542,571.87 2025-01-01
'588-1 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 — — $164,139.22 $248,142.39 $214,873.15 2025-01-01
'588-2 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 — — $164,139.22 $248,142.39 $214,873.15 2025-01-01
'588-3 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 — — $216,613.85 $327,472.48 $283,567.20 2025-01-01
'588-4 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 — — $321,042.37 $485,345.43 $420,273.63 2025-01-01
'589-1 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 3 3 — — $133,890.89 $202,413.56 $175,275.33 2025-01-01
'589-2 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 3 3 — — $129,153.77 $195,252.09 $169,074.02 2025-01-01
'589-3 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 3 3 — — $122,958.26 $185,885.84 $160,963.54 2025-01-01
'591-1 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 3 3 — — $81,238.84 $122,815.25 $106,349.02 2025-01-01
'591-2 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 3 3 — — $112,675.00 $170,339.81 $147,501.81 2025-01-01
'591-3 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 3 3 — — $136,548.64 $206,431.49 $178,754.57 2025-01-01
'591-4 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 3 3 — — $213,668.68 $323,020.02 $279,711.71 2025-01-01
'593-2 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 3 3 — — $110,242.57 $166,662.52 $144,317.54 2025-01-01
'593-3 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 3 3 — — $122,410.92 $185,058.38 $160,247.02 2025-01-01
'593-4 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 3 3 — — $182,126.06 $275,334.53 $238,419.56 2025-01-01
'602-2 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $81,821.66 $123,696.35 $107,111.99 2025-01-01
'602-3 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $100,852.62 $152,466.97 $132,025.24 2025-01-01
'602-4 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $140,306.39 $212,112.39 $183,673.81 2025-01-01
'603-2 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 3 3 — — $51,065.91 $77,200.42 $66,849.91 2025-01-01
'603-3 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 3 3 — — $84,138.77 $127,199.31 $110,145.29 2025-01-01
'603-4 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 3 3 — — $141,589.14 $214,051.62 $185,353.05 2025-01-01
'607-2 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $60,044.25 $90,773.69 $78,603.37 2025-01-01
'607-3 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $74,611.31 $112,795.89 $97,672.99 2025-01-01
'607-4 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $109,406.93 $165,399.20 $143,223.60 2025-01-01
'608-3 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 3 3 — — $59,170.45 $89,452.71 $77,459.50 2025-01-01
'608-4 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 3 3 — — $93,767.35 $141,755.61 $122,749.98 2025-01-01
'609-1 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 3 — — $55,793.26 $84,347.14 $73,038.45 2025-01-01
'609-2 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 3 — — $55,793.26 $84,347.14 $73,038.45 2025-01-01
'609-3 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 3 — — $90,257.98 $136,450.21 $118,155.90 2025-01-01
'609-4 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 3 — — $187,659.79 $283,700.31 $245,663.71 2025-01-01
'611-3 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 3 3 — — $52,929.70 $80,018.07 $69,289.79 2025-01-01
'611-4 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 3 3 — — $97,612.93 $147,569.27 $127,784.19 2025-01-01
'612-3 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $51,181.23 $77,374.76 $67,000.88 2025-01-01
'612-4 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $75,270.43 $113,792.33 $98,535.83 2025-01-01
'613-3 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 3 3 — — $48,469.36 $73,275.02 $63,450.80 2025-01-01
'613-4 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 3 3 — — $90,184.36 $136,338.90 $118,059.51 2025-01-01
'614-3 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 3 3 — — $45,477.18 $68,751.49 $59,533.76 2025-01-01
'614-4 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 3 3 — — $65,594.83 $99,164.95 $85,869.59 2025-01-01
'621-4 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 3 3 — — $71,300.66 $107,790.91 $93,339.04 2025-01-01
'622-4 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $56,248.34 $85,035.12 $73,634.19 2025-01-01
'623-4 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 3 3 — — $53,580.84 $81,002.44 $70,142.18 2025-01-01
'625-4 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 3 3 — — $85,317.72 $128,981.63 $111,688.65 2025-01-01
'630-2 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 3 — — $61,336.75 $92,727.67 $80,295.38 2025-01-01
'630-3 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 3 — — $100,338.10 $151,689.13 $131,351.69 2025-01-01
'630-4 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 3 — — $214,483.92 $324,252.49 $280,778.94 2025-01-01
'631-3 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 3 3 — — $64,915.31 $98,137.67 $84,980.04 2025-01-01
'631-4 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 3 3 — — $187,701.48 $283,763.34 $245,718.29 2025-01-01
'633-4 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 3 3 — — $69,262.99 $104,710.40 $90,671.55 2025-01-01
'634-4 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 3 3 — — $47,411.05 $71,675.08 $62,065.38 2025-01-01
'651-4 APR_DRG Other Procedures Of Blood And Blood-forming Organs 3 3 — — $76,346.48 $115,419.08 $99,944.48 2025-01-01
'680-4 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 3 3 — — $81,355.05 $122,990.93 $106,501.15 2025-01-01
'681-4 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 3 3 — — $72,425.50 $109,491.42 $94,811.56 2025-01-01
'690-3 APR_DRG Acute Leukemia 3 3 — — $45,896.77 $69,385.83 $60,083.05 2025-01-01
'690-4 APR_DRG Acute Leukemia 3 3 — — $75,526.80 $114,179.91 $98,871.45 2025-01-01
'695-4 APR_DRG Chemotherapy For Acute Leukemia 3 3 — — $69,481.22 $105,040.31 $90,957.22 2025-01-01
'710-4 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 3 3 — — $51,206.07 $77,412.31 $67,033.40 2025-01-01
'711-4 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 3 3 — — $51,230.91 $77,449.86 $67,065.91 2025-01-01
'740-4 APR_DRG Mental Illness Diagnosis With O.r. Procedure 3 3 — — $51,317.84 $77,581.29 $67,179.72 2025-01-01
'758-4 APR_DRG Behavioral Disorders 3 3 — — $53,875.35 $81,447.68 $70,527.73 2025-01-01
'759-4 APR_DRG Eating Disorders 3 3 — — $63,106.51 $95,403.17 $82,612.16 2025-01-01
'792-4 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 3 3 — — $56,211.09 $84,978.80 $73,585.42 2025-01-01
'841-1 APR_DRG Extensive Third Degree Burns With Skin Graft 3 3 — — $53,147.93 $80,347.98 $69,575.47 2025-01-01
'841-2 APR_DRG Extensive Third Degree Burns With Skin Graft 3 3 — — $53,147.93 $80,347.98 $69,575.47 2025-01-01
'841-3 APR_DRG Extensive Third Degree Burns With Skin Graft 3 3 — — $81,786.18 $123,642.71 $107,065.54 2025-01-01
'841-4 APR_DRG Extensive Third Degree Burns With Skin Graft 3 3 — — $237,828.84 $359,544.88 $311,339.56 2025-01-01
'842-4 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 3 3 — — $116,100.98 $175,519.14 $151,986.73 2025-01-01
'850-4 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 3 3 — — $71,594.29 $108,234.81 $93,723.43 2025-01-01
'863-3 APR_DRG Neonatal Aftercare 3 3 — — $46,876.13 $70,866.40 $61,365.12 2025-01-01
'863-4 APR_DRG Neonatal Aftercare 3 3 — — $81,170.53 $122,711.99 $106,259.60 2025-01-01
'910-4 APR_DRG Craniotomy For Multiple Significant Trauma 3 3 — — $72,823.81 $110,093.58 $95,332.98 2025-01-01
'911-4 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 3 3 — — $74,828.65 $113,124.46 $97,957.51 2025-01-01
'912-4 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 3 3 — — $67,459.51 $101,983.94 $88,310.63 2025-01-01
'950-4 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 3 3 — — $61,422.80 $92,857.76 $80,408.02 2025-01-01
'951-4 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 3 3 — — $46,163.79 $69,789.50 $60,432.60 2025-01-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 23 20 — — $210,479.16 $605,442.24 $277,158.00 2025-01-01
14 MS_DRG Allogeneic Bone Marrow Transplant 22 19 — — $89,018.64 $257,756.67 $118,568.07 2025-01-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 22 19 — — $47,977.75 $140,275.46 $64,526.71 2025-01-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 22 19 — — $47,977.75 $140,275.46 $64,526.71 2025-01-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 23 20 — — $286,163.15 $822,090.67 $376,334.84 2025-01-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 23 20 — — $62,086.79 $180,663.17 $82,703.58 2025-01-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 23 20 — — $95,101.88 $275,170.19 $125,966.80 2025-01-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 27 21 — — $65,651.14 $190,866.26 $89,070.92 2025-01-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 27 21 — — $53,655.54 $156,528.36 $71,655.20 2025-01-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 27 21 — — $47,701.24 $139,483.94 $65,092.50 2025-01-01
212 MS_DRG Concomitant Aortic And Mitral Valve?procedures 25 21 — — $83,657.75 $242,410.88 $112,047.70 2025-01-01
215 MS_DRG Other Heart Assist System Implant 27 21 — — $79,339.99 $230,051.12 $107,357.19 2025-01-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 27 21 — — $75,382.62 $218,723.00 $102,070.73 2025-01-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 27 21 — — $49,440.30 $144,462.08 $67,415.64 2025-01-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 27 21 — — $44,247.18 $129,596.56 $60,478.39 2025-01-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 27 21 — — $59,894.12 $174,386.57 $81,380.40 2025-01-01
222 MS_DRG Cardiac Defib Implant W Cardiac Cath W Ami/hf/shock W Mcc 2 1 — — $108,767.00 $108,767.00 $108,767.00 2025-01-01
223 MS_DRG Cardiac Defib Implant W Cardiac Cath W Ami/hf/shock Without Mcc 2 1 — — $77,677.00 $77,677.00 $77,677.00 2025-01-01
224 MS_DRG Cardiac Defib Implant W Cardiac Cath Without Ami/hf/shock W Mcc 2 1 — — $97,639.00 $97,639.00 $97,639.00 2025-01-01
225 MS_DRG Cardiac Defib Implant W Cardiac Cath Without Ami/hf/shock Without Mcc 2 1 — — $73,276.00 $73,276.00 $73,276.00 2025-01-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Cath W Mcc 2 1 — — $85,677.00 $85,677.00 $85,677.00 2025-01-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Cath Without Mcc 2 1 — — $66,000.00 $66,000.00 $66,000.00 2025-01-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 27 21 — — $44,030.48 $128,976.23 $60,188.91 2025-01-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 27 21 — — $63,032.06 $183,369.02 $85,572.21 2025-01-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 27 21 — — $46,203.73 $135,197.26 $63,092.05 2025-01-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 27 21 — — $60,580.74 $176,352.03 $82,297.61 2025-01-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 27 21 — — $45,675.56 $133,685.35 $62,386.50 2025-01-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 27 21 — — $48,514.46 $141,811.81 $66,178.84 2025-01-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 27 21 — — $53,241.55 $155,343.31 $71,112.71 2025-01-01
27200000002-17907 CDM Introducer Lotus 23 Edge 15 12 $178,750.00 $101,351.25 43% off $211.00 $175,175.00 $116,723.75 2025-01-01
27200000002-17908 CDM Introducer Lotus 25 Edge 15 12 $178,750.00 $101,351.25 43% off $211.00 $175,175.00 $116,723.75 2025-01-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 25 21 — — $54,648.18 $159,369.84 $73,664.28 2025-01-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc 25 21 — — $48,235.62 $141,013.62 $65,179.63 2025-01-01
27800000002-52188 CDM Device Clsur Watchman Flx Laa 20mm 15 12 $93,500.00 $61,055.50 35% off $211.00 $91,630.00 $61,055.50 2025-01-01
27800000002-52209 CDM Device Impella 5.5 Smartassist 15 12 $247,500.00 $140,332.50 43% off $211.00 $242,550.00 $161,617.50 2025-01-01
27800000002-52368 CDM Valve Aort 23mm Evolutr 15 12 $165,000.00 $107,745.00 35% off $211.00 $161,700.00 $107,745.00 2025-01-01
27800000002-52372 CDM Valve Aortic 26mm Evolut Fx 15 12 $165,000.00 $107,745.00 35% off $211.00 $161,700.00 $107,745.00 2025-01-01
27800000002-52373 CDM Valve Aortic 26mm Evolut Fx 15 12 $117,000.00 $76,401.00 35% off $211.00 $114,660.00 $76,401.00 2025-01-01
27800000002-52374 CDM Valve Aortic 29mm Evolut Fx 15 12 $165,000.00 $107,745.00 35% off $211.00 $161,700.00 $107,745.00 2025-01-01
27800000002-52375 CDM Valve Aortic 29mm Evolut Fx 15 12 $117,000.00 $76,401.00 35% off $211.00 $114,660.00 $76,401.00 2025-01-01
27800000002-52376 CDM Valve Aortic 34mm Evolut Fx 15 12 $165,000.00 $107,745.00 35% off $211.00 $161,700.00 $107,745.00 2025-01-01
27800000002-52377 CDM Valve Aortic 23mm Evolut Fx 15 12 $165,000.00 $107,745.00 35% off $211.00 $161,700.00 $107,745.00 2025-01-01
27800000002-52378 CDM Valve Aortic 23mm Evolut Fx 15 12 $117,000.00 $66,339.00 43% off $211.00 $114,660.00 $76,401.00 2025-01-01
27800000002-52400 CDM Valve Sapien Thv Edwards Resilia 23mm 15 12 $187,000.00 $122,111.00 35% off $211.00 $183,260.00 $122,111.00 2025-01-01
27800000002-52401 CDM Valve Sapien Thv Edwards Resilia 29mm 15 12 $187,000.00 $122,111.00 35% off $211.00 $183,260.00 $122,111.00 2025-01-01
27800000002-52402 CDM Valve Sapien Thv Edwards Resilia 29mm 15 12 $132,600.00 $86,587.80 35% off $211.00 $129,948.00 $86,587.80 2025-01-01
27800000002-52403 CDM Valve Sapien Thv Edwards Resilia 26mm 15 12 $187,000.00 $106,029.00 43% off $211.00 $183,260.00 $122,111.00 2025-01-01
27800000002-52836 CDM Kit Mitraclip 1 Mbr0101 15 12 $165,000.00 $107,745.00 35% off $211.00 $161,700.00 $107,745.00 2025-01-01
27800000002-52837 CDM Kit Mitraclip 1 Mbr0201 15 12 $165,000.00 $107,745.00 35% off $211.00 $161,700.00 $107,745.00 2025-01-01
27800000002-52838 CDM Kit Mitraclip 1 Mbr0301 15 12 $165,000.00 $107,745.00 35% off $211.00 $161,700.00 $107,745.00 2025-01-01
27800000002-52839 CDM Kit Mitraclip 2 Mbr0102 15 12 $165,000.00 $107,745.00 35% off $211.00 $161,700.00 $107,745.00 2025-01-01
27800000002-52840 CDM Kit Mitraclip 2 Mbr0302 15 12 $165,000.00 $107,745.00 35% off $211.00 $161,700.00 $107,745.00 2025-01-01
27800000002-52890 CDM Set Pump Impella Cp 15 12 $137,500.00 $89,787.50 35% off $211.00 $134,750.00 $89,787.50 2025-01-01
27800000002-52891 CDM Set Pump Impella Cp 15 12 $137,500.00 $89,787.50 35% off $211.00 $134,750.00 $89,787.50 2025-01-01
27800000002-52892 CDM Set Pump Impella Cp 15 12 $137,500.00 $89,787.50 35% off $211.00 $134,750.00 $89,787.50 2025-01-01
27800000002-52893 CDM Set Pump Impella Cp 15 12 $137,500.00 $89,787.50 35% off $211.00 $134,750.00 $89,787.50 2025-01-01
27800000002-52894 CDM Set Pump Impella Cp 15 12 $100,000.00 $65,300.00 35% off $211.00 $98,000.00 $65,300.00 2025-01-01
27800000002-52895 CDM Set Pump Impella Cp 15 12 $97,500.00 $63,667.50 35% off $211.00 $95,550.00 $63,667.50 2025-01-01
27800000002-52896 CDM Set Pump Impella Rp 15 12 $137,500.00 $89,787.50 35% off $211.00 $134,750.00 $89,787.50 2025-01-01
27800000002-52897 CDM Set Pump Impella Rp 15 12 $97,500.00 $63,667.50 35% off $211.00 $95,550.00 $63,667.50 2025-01-01
27800000002-53067 CDM Valve Aort 26mm Evolutr 15 12 $165,000.00 $107,745.00 35% off $211.00 $161,700.00 $107,745.00 2025-01-01
27800000002-53068 CDM Valve Aort 26mm Pro Perc 15 12 $165,000.00 $107,745.00 35% off $211.00 $161,700.00 $107,745.00 2025-01-01
27800000002-53070 CDM Valve Aort 29mm Pro Perc 15 12 $165,000.00 $93,555.00 43% off $211.00 $161,700.00 $107,745.00 2025-01-01
27800000002-53071 CDM Valve Aort 34mm Evolutr 15 12 $165,000.00 $107,745.00 35% off $211.00 $161,700.00 $107,745.00 2025-01-01
27800000002-53126 CDM Valve Sapien 3 Thv 23mm W/command System 15 12 $178,750.00 $101,351.25 43% off $211.00 $175,175.00 $116,723.75 2025-01-01
27800000002-53127 CDM Valve Sapien 3 Thv 26mm W/command System 15 12 $178,750.00 $116,723.75 35% off $211.00 $175,175.00 $116,723.75 2025-01-01
27800000002-53128 CDM Valve Sapien 3 Thv 29mm W/command System 15 12 $178,750.00 $116,723.75 35% off $211.00 $175,175.00 $116,723.75 2025-01-01
27800000002-53129 CDM Valve Sapien 3 Thv 29mm W/command System 15 12 $126,750.00 $71,867.25 43% off $211.00 $124,215.00 $82,767.75 2025-01-01
27800000002-53130 CDM Valve Sapien 3 Thv 29mm W/command System 15 12 $126,750.00 $82,767.75 35% off $211.00 $124,215.00 $82,767.75 2025-01-01
27800000002-53133 CDM Valve Thv Sapien 3 23mm W/certitudesystem 15 12 $178,750.00 $101,351.25 43% off $211.00 $175,175.00 $116,723.75 2025-01-01
27800000002-53134 CDM Valve Thv Sapien 3 26mm W/certitudesystem 15 12 $178,750.00 $101,351.25 43% off $211.00 $175,175.00 $116,723.75 2025-01-01
27800000002-53326 CDM Valve Sapien 3 Ultra Thv 20mm W/command System 15 12 $178,750.00 $101,351.25 43% off $211.00 $175,175.00 $116,723.75 2025-01-01
27800000002-53327 CDM Valve Sapien 3 Ultra Thv 20mm W/command System 15 12 $126,750.00 $71,867.25 43% off $211.00 $124,215.00 $82,767.75 2025-01-01
27800000002-53328 CDM Valve Sapien 3 Ultra Thv 20mm W/command System 15 12 $126,750.00 $71,867.25 43% off $211.00 $124,215.00 $82,767.75 2025-01-01
27800000002-53329 CDM Valve Sapien 3 Ultra Thv 23mm W/command System 15 12 $178,750.00 $101,351.25 43% off $211.00 $175,175.00 $116,723.75 2025-01-01
27800000002-53330 CDM Valve Sapien 3 Ultra Thv 23mm W/command System 15 12 $126,750.00 $71,867.25 43% off $211.00 $124,215.00 $82,767.75 2025-01-01
27800000002-53331 CDM Valve Sapien 3 Ultra Thv 23mm W/command System 15 12 $126,750.00 $71,867.25 43% off $211.00 $124,215.00 $82,767.75 2025-01-01
27800000002-53332 CDM Valve Sapien 3 Ultra Thv 23mm W/command System 15 12 $126,750.00 $71,867.25 43% off $211.00 $124,215.00 $82,767.75 2025-01-01
27800000002-53333 CDM Valve Sapien 3 Ultra Thv 26mm W/command System 15 12 $178,750.00 $101,351.25 43% off $211.00 $175,175.00 $116,723.75 2025-01-01
27800000002-53334 CDM Valve Sapien 3 Ultra Thv 26mm W/command System 15 12 $126,750.00 $71,867.25 43% off $211.00 $124,215.00 $82,767.75 2025-01-01
27800000002-53335 CDM Valve Sapien 3 Ultra Thv 26mm W/command System 15 12 $126,750.00 $71,867.25 43% off $211.00 $124,215.00 $82,767.75 2025-01-01
27800000002-53336 CDM Valve Sapien 3 Ultra Thv 26mm W/command System 15 12 $126,750.00 $71,867.25 43% off $211.00 $124,215.00 $82,767.75 2025-01-01
27800000002-53339 CDM Kit Mitraclip G4 Syst Cds0701nt/ntw/xt/xtw 15 12 $165,000.00 $93,555.00 43% off $211.00 $161,700.00 $107,745.00 2025-01-01
27800000002-53340 CDM Kit Mitraclip G4 Syst Cds0701nt/ntw/xt/xtw 15 12 $117,000.00 $66,339.00 43% off $211.00 $114,660.00 $76,401.00 2025-01-01
27800000002-53341 CDM Kit Mitraclip G4 Syst Cds0701nt/ntw/xt/xtw 15 12 $117,000.00 $76,401.00 35% off $211.00 $114,660.00 $76,401.00 2025-01-01
27800000002-53374 CDM Stent Valiant Navion Vnmc2828c90tu Coveredseal 100mm 15 12 $91,550.25 $51,908.99 43% off $211.00 $89,719.25 $59,782.31 2025-01-01
27800000002-53375 CDM Stent Graft Prox 28x28x150mm Valiant Captivia Free Flo Str 15 12 $91,550.25 $51,908.99 43% off $211.00 $89,719.25 $59,782.31 2025-01-01
27800000002-53431 CDM Stent Valiant 42x38x150 15 12 $91,550.25 $59,782.31 35% off $211.00 $89,719.25 $59,782.31 2025-01-01
27800000002-53456 CDM Kit Mitraclip 3 Mbr0103 15 12 $165,000.00 $107,745.00 35% off $211.00 $161,700.00 $107,745.00 2025-01-01
27800000002-53472 CDM Kit Mitraclip G4 Delivery Sys Ntw 15 12 $165,000.00 $107,745.00 35% off $211.00 $161,700.00 $107,745.00 2025-01-01
27800000002-53501 CDM Stent Valiant Navion Vnmf4040c183tu Freeflo 175mm 15 12 $98,975.25 $64,630.84 35% off $211.00 $96,995.75 $64,630.84 2025-01-01
27800000002-53517 CDM Kit Mitraclip 2 Mbr0202 15 12 $165,000.00 $107,745.00 35% off $211.00 $161,700.00 $107,745.00 2025-01-01
27800000002-53528 CDM Stent Graft Confrm Thor 45x45x20 24f 15 12 $100,595.00 $65,688.54 35% off $211.00 $98,583.10 $65,688.54 2025-01-01
28 MS_DRG Spinal Procedures With Mcc 27 21 — — $46,805.68 $136,920.38 $63,896.18 2025-01-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 27 21 — — $165,598.18 $476,968.66 $222,585.37 2025-01-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 27 21 — — $114,177.25 $329,774.18 $150,963.29 2025-01-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 27 21 — — $68,827.91 $199,959.89 $93,314.61 2025-01-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 27 21 — — $47,506.28 $138,925.87 $64,832.07 2025-01-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 27 21 — — $65,472.50 $190,354.88 $88,832.28 2025-01-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 27 21 — — $47,187.83 $138,014.28 $64,406.66 2025-01-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 27 21 — — $51,514.14 $150,398.51 $70,185.97 2025-01-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 27 21 — — $52,960.38 $154,538.44 $70,744.26 2025-01-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 27 21 — — $43,990.86 $128,862.86 $60,136.00 2025-01-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 22 19 — — $80,390.11 $233,057.14 $107,206.29 2025-01-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 27 21 — — $45,331.00 $141,189.28 $64,633.31 2025-01-01
7 MS_DRG Lung Transplant 22 19 — — $95,275.09 $275,666.00 $126,806.36 2025-01-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 27 21 — — $46,603.74 $136,342.31 $62,414.48 2025-01-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 27 21 — — $46,965.69 $137,378.39 $64,109.91 2025-01-01
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 27 21 — — $43,488.33 $127,424.32 $59,464.68 2025-01-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 27 21 — — $54,097.49 $157,793.47 $73,636.95 2025-01-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 27 21 — — $204,732.24 $588,991.46 $269,627.20 2025-01-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 27 21 — — $53,746.42 $156,788.51 $71,774.29 2025-01-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 27 21 — — $47,303.56 $138,345.57 $64,561.27 2025-01-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 27 21 — — $56,175.98 $163,743.23 $76,413.51 2025-01-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 27 21 — — $53,380.58 $155,741.29 $71,294.90 2025-01-01
A9542 HCPCS Indium In-111 Ibritumomab Tiuxetan Diagnostic Per Study Dose Up To 5 Millicuries 15 12 $130,400.00 $85,151.20 35% off $211.00 $127,792.00 $85,151.20 2025-01-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan Therapeutic Per Treatment Dose Up To 40 Millic… 34 27 $73,380.00 $47,917.14 35% off $211.00 $147,322.31 $67,440.88 2025-01-01
C1822 HCPCS Sable 10x22mm 6-12mm 8deg 54 12 $104,000.00 $58,968.00 43% off $211.00 $140,140.00 $65,467.03 2025-01-01
C1824 HCPCS Kit Ipg Optimizer Smart Mini 28 12 $143,000.00 $81,081.00 43% off $211.00 $140,140.00 $84,740.50 2025-01-01
C2624 HCPCS System Cardiomems Pa Sensor And Delivery 15 12 $93,500.00 $61,055.50 35% off $211.00 $91,630.00 $61,055.50 2025-01-01
J7330 HCPCS Membrane Collgn Porcine Maci W/autologous Cult Chondrocytes 15 12 $287,386.00 $162,947.86 43% off $211.00 $281,638.28 $187,663.06 2025-01-01
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