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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

LEHIGH VALLEY HOSPITAL - POCONO

East Stroudsburg, PA · CCN 390201 · Rates published

22,220 distinct procedures filed
20 distinct payers
866,223 rate rows
2025-08-01 last MRF observed
Data quality

716,724 of 866,223 rate rows are consumer-grade (82.7%)

149,499 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
placeholder amount (≤ $0.02) — excluded from medians 146,547
template filing: same amount across many unrelated codes — excluded 2,046
exceeds 10× this hospital's gross charge — excluded from medians 683
per-diem day rate — not a per-procedure price 117
percent-of-charges filed in the dollar field — excluded from medians 99
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 7
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://lvhn.pt.panaceainc.com/MRFDownload/lvhn/pocono
Found on page https://www.lvhn.org/get-price-quote
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint bf6b525e80a5de82… · 507,717,559 bytes · first seen 2026-05-08

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
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 14 $3,570,000.00 $4,683,875.00 $3,895,500.00 nat. median
$3,710,000
1.1× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 14 $3,570,000.00 $4,652,649.17 $3,869,530.00 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 14 $3,264,000.00 $4,194,622.54 $3,488,596.97 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 14 $3,162,000.00 $4,148,575.00 $3,450,300.00 nat. median
$3,286,000
1.1× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 14 $2,856,000.00 $3,722,119.33 $3,095,624.00 nat. median
$3,004,655
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 14 $2,368,485.25 $4,938,583.76 $2,568,519.10 nat. median
$2,468,984
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 14 $2,244,000.00 $4,752,849.20 $2,471,920.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 15 $819,941.84 $4,687,736.12 $949,565.00 nat. median
$824,563
1.2× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 8 $537,784.53 $1,140,020.23 $681,411.46 nat. median
$370,174
1.8× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 16 $565,623.84 $3,375,103.79 $636,648.23 nat. median
$753,246
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 16 $551,318.34 $3,225,806.77 $608,486.23 nat. median
$674,867
0.9× median
5957251501
NDC 		Idecabtagene Vicleucel 300 X 10exp6 To 460 X 10exp6 Cell IV Suspension 18 $527,622.46 $3,076,830.38 $580,384.71 nat. median
$606,766
1.0× median
7315390001
NDC 		Lisocabtagene Maraleucel 1.5 X 10exp6 To 70 X 10exp6 Cell/ml IV Susp 18 $516,442.29 $3,011,633.21 $568,086.52 nat. median
$593,909
1.0× median
7128711901
NDC 		Axicabtagene Ciloleucel Intravenous Suspension 18 $489,517.15 $2,932,315.72 $553,124.80 nat. median
$578,267
1.0× median
7128722001
NDC 		Brexucabtagene Autoleucel 1x 10exp6 To 1x 10exp8 Cell IV Suspension 18 $488,051.51 $2,853,931.20 $538,339.08 nat. median
$637,006
0.8× median
7128721901
NDC 		Brexucabtagene Autoleucel 2x 10exp6 To 2x 10exp8 Cell IV Suspension 18 $488,051.51 $2,853,931.20 $538,339.08 nat. median
$562,809
1.0× median
C9098
HCPCS 		Ciltacabtagene Car Pos T 1 $335,983.43 $335,983.43 $335,983.43 nat. median
$57,174
outlier · 5.9×
C9301
HCPCS 		Obecabtagene Car Pos T 15 $283,815.00 $1,622,614.88 $328,682.82 nat. median
$459,112
0.7× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 16 $224,720.80 $851,499.54 $313,135.24 nat. median
$265,286
1.2× median
5063321011
NDC 		Glucarpidase 1000 Unit Intravenous Solution 9 $1,574.93 $426,764.40 $266,727.75 nat. median
$56,116
outlier · 4.8×
5831
APR_DRG 		8 $141,506.98 $484,571.75 $247,292.65 nat. median
$144,745
1.7× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 14 $189,337.69 $717,116.52 $234,351.80 nat. median
$206,474
1.1× median
0-D
MS_DRG 		Kidney Transplant With Hemodialysis With Mcc - Deceased Donor 2 $145,141.00 $291,282.00 $218,211.50 —
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 15 $22,511.00 $647,855.84 $196,472.97 nat. median
$202,976
1.0× median
1-D
MS_DRG 		Kidney Transplant With Hemodialysis Without Mcc - Deceased Donor 2 $145,141.00 $238,389.00 $191,765.00 —
0-L
MS_DRG 		Kidney Transplant With Hemodialysis With Mcc - Living Donor 2 $122,004.00 $243,226.00 $182,615.00 —
2-D
MS_DRG 		Kidney Transplant - Deceased Donor 2 $145,141.00 $201,892.00 $173,516.50 —
5881
APR_DRG 		8 $124,900.26 $316,127.86 $170,016.21 nat. median
$124,573
1.4× median
1-L
MS_DRG 		Kidney Transplant With Hemodialysis Without Mcc - Living Donor 2 $122,004.00 $199,061.00 $160,532.50 —
J7330
HCPCS 		Cultured Chondrocytes Implnt 2 $61,878.30 $232,043.63 $146,960.97 nat. median
$76,329
1.9× median
2-L
MS_DRG 		Kidney Transplant - Living Donor 2 $122,004.00 $171,483.00 $146,743.50 —
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 16 $22,511.00 $427,135.77 $139,847.44 nat. median
$133,161
1.1× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 16 $88,229.82 $359,854.05 $133,173.47 nat. median
$108,660
1.2× median
1611
APR_DRG 		8 $100,280.52 $239,924.76 $130,716.29 nat. median
$76,806
1.7× median
7
MS_DRG 		Lung Transplant 15 $104,539.23 $395,056.76 $129,392.92 nat. median
$122,708
1.1× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 15 $83,897.56 $316,660.87 $126,611.49 nat. median
$98,894
1.3× median
270006206-10806601-10094
CDM 		Hb Kit Protek Duo Dl31 9 $48,240.08 $149,438.03 $123,502.50 nat. median
$123,502
1.0× median
5024255401
NDC 		Ocrelizumab 920 Mg-hyaluronidase-ocsq 23000 Unit/23 Ml Subcut Soln 9 $40,225.67 $160,902.69 $122,113.65 nat. median
$14,568
outlier · 8.4×
0021
APR_DRG 		8 $84,974.85 $279,960.14 $120,682.88 nat. median
$128,074
0.9× median
5911
APR_DRG 		8 $54,880.49 $200,824.52 $116,714.60 nat. median
$40,526
outlier · 2.9×
270006205-10806601-10095
CDM 		Hb Kit Protek Duo Dl29 9 $45,508.81 $140,977.10 $116,510.00 nat. median
$116,510
1.0× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 16 $63,616.45 $338,268.00 $113,043.30 nat. median
$71,271
1.6× median
850
MS_DRG 		Acute Leukemia With Other Procedures 15 $73,840.98 $278,466.53 $111,379.00 nat. median
$83,470
1.3× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 15 $95,081.03 $543,593.19 $110,112.23 nat. median
$96,983
1.1× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 16 $52,470.33 $583,149.48 $109,999.90 nat. median
$111,989
1.0× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve?procedures 16 $87,228.53 $329,311.70 $107,966.69 nat. median
$102,358
1.1× median
0071
APR_DRG 		18 $57,323.70 $396,054.31 $107,370.57 nat. median
$75,827
1.4× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 $77,336.71 $291,743.10 $107,246.00 nat. median
$93,672
1.1× median
0111
APR_DRG 		17 $35,223.87 $703,817.24 $106,902.11 nat. median
$85,731
1.2× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 15 $85,282.49 $321,920.71 $105,557.98 nat. median
$100,136
1.1× median

Other procedures at this hospital

Browse this hospital's 22,220 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
J1414 HCPCS Inj, Beqvez, Per Tx Dose 15 14 — — $3,570,000.00 $4,683,875.00 $3,895,500.00 2025-08-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 15 14 — — $3,570,000.00 $4,652,649.17 $3,869,530.00 2025-08-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 15 14 — — $3,264,000.00 $4,194,622.54 $3,488,596.97 2025-08-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 15 14 — — $3,162,000.00 $4,148,575.00 $3,450,300.00 2025-08-01
J3393 HCPCS Inj, Betibeglogene Autotemce 15 14 — — $2,856,000.00 $3,722,119.33 $3,095,624.00 2025-08-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 18 14 — — $2,368,485.25 $4,938,583.76 $2,568,519.10 2025-08-01
J3392 HCPCS Inj, Exagamglogene Autotem 18 14 — — $2,244,000.00 $4,752,849.20 $2,471,920.00 2025-08-01
Q2057 HCPCS Afamitresgene Autoleucel 26 15 — — $819,941.84 $4,687,736.12 $949,565.00 2025-08-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 12 8 — — $537,784.53 $1,140,020.23 $681,411.46 2025-08-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 32 16 — — $565,623.84 $3,375,103.79 $636,648.23 2025-08-01
Q2056 HCPCS Ciltacabtagene Car-pos T 32 16 — — $551,318.34 $3,225,806.77 $608,486.23 2025-08-01
5957251501 NDC Idecabtagene Vicleucel 300 X 10exp6 To 460 X 10exp6 Cell IV Suspension 36 18 $3,962,343.23 $1,981,171.62 50% off $527,622.46 $3,076,830.38 $580,384.71 2025-08-01
7315390001 NDC Lisocabtagene Maraleucel 1.5 X 10exp6 To 70 X 10exp6 Cell/ml IV Susp 36 18 $3,985,128.00 $1,992,564.00 50% off $516,442.29 $3,011,633.21 $568,086.52 2025-08-01
7128711901 NDC Axicabtagene Ciloleucel Intravenous Suspension 36 18 $3,776,850.00 $1,888,425.00 50% off $489,517.15 $2,932,315.72 $553,124.80 2025-08-01
7128722001 NDC Brexucabtagene Autoleucel 1x 10exp6 To 1x 10exp8 Cell IV Suspension 36 18 $3,465,000.00 $1,732,500.00 50% off $488,051.51 $2,853,931.20 $538,339.08 2025-08-01
7128721901 NDC Brexucabtagene Autoleucel 2x 10exp6 To 2x 10exp8 Cell IV Suspension 36 18 $3,465,000.00 $1,732,500.00 50% off $488,051.51 $2,853,931.20 $538,339.08 2025-08-01
C9098 HCPCS Ciltacabtagene Car Pos T 2 1 — — $335,983.43 $335,983.43 $335,983.43 2025-08-01
C9301 HCPCS Obecabtagene Car Pos T 26 15 — — $283,815.00 $1,622,614.88 $328,682.82 2025-08-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 28 16 — — $224,720.80 $851,499.54 $313,135.24 2025-08-01
5063321011 NDC Glucarpidase 1000 Unit Intravenous Solution 14 9 $762,079.28 $381,039.64 50% off $1,574.93 $426,764.40 $266,727.75 2025-08-01
5831 APR_DRG — 36 8 — — $141,506.98 $484,571.75 $247,292.65 2025-08-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 27 14 — — $189,337.69 $717,116.52 $234,351.80 2025-08-01
0-D MS_DRG Kidney Transplant With Hemodialysis With Mcc - Deceased Donor 2 2 — — $145,141.00 $291,282.00 $218,211.50 2025-08-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 28 15 — — $22,511.00 $647,855.84 $196,472.97 2025-08-01
1-D MS_DRG Kidney Transplant With Hemodialysis Without Mcc - Deceased Donor 2 2 — — $145,141.00 $238,389.00 $191,765.00 2025-08-01
0-L MS_DRG Kidney Transplant With Hemodialysis With Mcc - Living Donor 2 2 — — $122,004.00 $243,226.00 $182,615.00 2025-08-01
2-D MS_DRG Kidney Transplant - Deceased Donor 2 2 — — $145,141.00 $201,892.00 $173,516.50 2025-08-01
5881 APR_DRG — 36 8 — — $124,900.26 $316,127.86 $170,016.21 2025-08-01
1-L MS_DRG Kidney Transplant With Hemodialysis Without Mcc - Living Donor 2 2 — — $122,004.00 $199,061.00 $160,532.50 2025-08-01
J7330 HCPCS Cultured Chondrocytes Implnt 2 2 — — $61,878.30 $232,043.63 $146,960.97 2025-08-01
2-L MS_DRG Kidney Transplant - Living Donor 2 2 — — $122,004.00 $171,483.00 $146,743.50 2025-08-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 29 16 — — $22,511.00 $427,135.77 $139,847.44 2025-08-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 28 16 — — $88,229.82 $359,854.05 $133,173.47 2025-08-01
1611 APR_DRG — 36 8 — — $100,280.52 $239,924.76 $130,716.29 2025-08-01
7 MS_DRG Lung Transplant 27 15 — — $104,539.23 $395,056.76 $129,392.92 2025-08-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 28 15 — — $83,897.56 $316,660.87 $126,611.49 2025-08-01
270006206-10806601-10094 CDM Hb Kit Protek Duo Dl31 12 9 $247,005.00 $123,502.50 50% off $48,240.08 $149,438.03 $123,502.50 2025-08-01
5024255401 NDC Ocrelizumab 920 Mg-hyaluronidase-ocsq 23000 Unit/23 Ml Subcut Soln 12 9 $287,326.24 $143,663.12 50% off $40,225.67 $160,902.69 $122,113.65 2025-08-01
0021 APR_DRG — 36 8 — — $84,974.85 $279,960.14 $120,682.88 2025-08-01
5911 APR_DRG — 36 8 — — $54,880.49 $200,824.52 $116,714.60 2025-08-01
270006205-10806601-10095 CDM Hb Kit Protek Duo Dl29 12 9 $233,020.00 $116,510.00 50% off $45,508.81 $140,977.10 $116,510.00 2025-08-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 29 16 — — $63,616.45 $338,268.00 $113,043.30 2025-08-01
850 MS_DRG Acute Leukemia With Other Procedures 28 15 — — $73,840.98 $278,466.53 $111,379.00 2025-08-01
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 26 15 — — $95,081.03 $543,593.19 $110,112.23 2025-08-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 27 16 — — $52,470.33 $583,149.48 $109,999.90 2025-08-01
212 MS_DRG Concomitant Aortic And Mitral Valve?procedures 29 16 — — $87,228.53 $329,311.70 $107,966.69 2025-08-01
0071 APR_DRG — 64 18 — — $57,323.70 $396,054.31 $107,370.57 2025-08-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 29 16 — — $77,336.71 $291,743.10 $107,246.00 2025-08-01
0111 APR_DRG — 52 17 — — $35,223.87 $703,817.24 $106,902.11 2025-08-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 27 15 — — $85,282.49 $321,920.71 $105,557.98 2025-08-01
5931 APR_DRG — 36 8 — — $18,489.11 $186,215.34 $105,044.61 2025-08-01
5891 APR_DRG — 36 8 — — $14,791.42 $123,492.17 $101,232.80 2025-08-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 28 15 — — $66,906.03 $252,128.00 $100,874.79 2025-08-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 29 16 — — $56,769.06 $213,628.34 $100,775.42 2025-08-01
215 MS_DRG Other Heart Assist System Implant 29 16 — — $84,847.90 $320,270.21 $98,718.95 2025-08-01
8 MS_DRG Simultaneous Pancreas/kidney Transplant 12 8 — — $77,590.09 $275,556.00 $98,647.28 2025-08-01
810000002-10806601-5451 CDM Hb Organ Processing - Lrd 11 8 $191,370.00 $95,685.00 50% off $37,374.56 $115,778.85 $95,685.00 2025-08-01
810000001-10806601-5452 CDM Hb Organ Processing 11 8 $191,370.00 $95,685.00 50% off $37,374.56 $115,778.85 $95,685.00 2025-08-01
6872790001 NDC Asparaginase Erwinia Chrysanthemi-rywn 10 Mg/0.5 Ml IM Solution 28 9 $277,162.55 $138,581.28 50% off $25,868.51 $206,948.04 $93,773.33 2025-08-01
810000003-10806601-5450 CDM Hb Pancreas Organ Processing 11 8 $184,995.00 $92,497.50 50% off $36,129.52 $111,921.98 $92,497.50 2025-08-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc 29 16 — — $49,823.77 $187,250.52 $88,332.14 2025-08-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 28 15 — — $57,053.21 $214,707.52 $85,950.92 2025-08-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 29 16 — — $67,967.01 $256,157.52 $84,125.83 2025-08-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 29 16 — — $22,511.00 $256,015.45 $84,079.53 2025-08-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 29 16 — — $62,105.78 $233,896.89 $83,317.85 2025-08-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 28 15 — — $53,885.41 $202,676.38 $81,152.71 2025-08-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 29 16 — — $22,511.00 $243,678.99 $80,059.10 2025-08-01
270006137-10806601-10163 CDM Hb Set Usa Hls Advanced 7.0 12 9 $160,030.00 $80,015.00 50% off $31,253.86 $96,818.15 $80,015.00 2025-08-01
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 26 15 — — $68,801.71 $393,350.19 $79,678.45 2025-08-01
6021 APR_DRG — 36 8 — — $18,804.79 $138,279.39 $78,832.33 2025-08-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 29 16 — — $48,203.25 $181,095.89 $77,837.79 2025-08-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 29 16 — — $62,733.76 $236,281.96 $77,648.41 2025-08-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 29 16 — — $51,921.05 $195,215.86 $77,104.79 2025-08-01
A0407 OTHER Traumatic Spinal Cord Injury M <24.50 And A >=61.50 28 7 — — $67,866.78 $89,040.29 $76,902.95 2025-08-01
270006272-10806601-10028 CDM Hb Protek Duo Cannula Veno-venous 29fr 12 9 $152,290.00 $76,145.00 50% off $29,742.24 $92,135.45 $76,145.00 2025-08-01
270006273-10806601-10027 CDM Hb Protek Duo Cannula Veno-venous 31fr 12 9 $152,290.00 $76,145.00 50% off $29,742.24 $92,135.45 $76,145.00 2025-08-01
6301 APR_DRG — 36 8 — — $24,284.20 $230,604.13 $75,975.67 2025-08-01
0041 APR_DRG — 36 8 — — $46,694.22 $168,363.35 $75,209.52 2025-08-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 28 15 — — $49,760.10 $187,008.69 $74,904.19 2025-08-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 29 16 — — $22,511.00 $225,635.30 $74,178.68 2025-08-01
0061 APR_DRG — 65 19 — — $41,902.30 $241,015.82 $73,307.42 2025-08-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 29 16 — — $49,141.65 $184,659.89 $73,021.00 2025-08-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 29 16 — — $40,184.26 $150,640.18 $71,061.86 2025-08-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 29 16 — — $47,872.95 $179,841.39 $69,670.06 2025-08-01
J9029 HCPCS Instill Adstiladrin, Tx Dose 34 17 — — $56,912.05 $368,758.46 $69,559.17 2025-08-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 29 16 — — $14,754.00 $210,288.04 $69,177.02 2025-08-01
7995211001 NDC Loncastuximab Tesirine-lpyl 10 Mg Intravenous Solution 14 9 $194,364.80 $97,182.40 50% off $27,211.07 $108,844.29 $68,027.68 2025-08-01
560000237-10806601-7467 CDM Hb Trnsplj Allogeneic Hematopoietic Cells Per Donor 31 16 $180,430.00 $90,215.00 50% off $130.04 $359,766.99 $67,863.10 2025-08-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 29 16 — — $37,966.79 $142,218.38 $67,089.02 2025-08-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 28 15 — — $44,329.46 $166,383.44 $66,678.52 2025-08-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 29 16 — — $37,546.54 $140,622.29 $66,336.09 2025-08-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 29 16 — — $22,511.00 $201,554.88 $66,330.90 2025-08-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 28 15 — — $44,062.02 $165,367.74 $66,273.44 2025-08-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 29 16 — — $42,865.74 $160,824.33 $66,109.77 2025-08-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 29 16 — — $47,354.80 $177,873.48 $65,027.72 2025-08-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 29 16 — — $42,678.70 $160,113.94 $64,661.22 2025-08-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 29 16 — — $14,754.00 $195,496.99 $64,356.64 2025-08-01
0011 APR_DRG — 36 8 — — $44,740.62 $169,524.82 $63,880.47 2025-08-01
J7310 HCPCS Ganciclovir Long Act Implant 1 1 — — $63,600.00 $63,600.00 $63,600.00 2025-08-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 29 16 — — $22,511.00 $191,177.26 $62,948.84 2025-08-01
3023789006 NDC Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension 36 18 $511,574.00 $255,787.00 50% off $55,536.50 $332,495.22 $62,718.81 2025-08-01
A9543 HCPCS Y90 Ibritumomab, Rx 29 15 — — $41,945.39 $331,372.36 $62,507.01 2025-08-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 28 15 — — $41,511.87 $155,682.37 $62,410.77 2025-08-01
8411 APR_DRG — 27 8 — — $39,888.43 $227,445.24 $61,589.29 2025-08-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 29 16 — — $22,511.00 $186,156.23 $61,312.50 2025-08-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 29 16 — — $22,511.00 $185,506.30 $61,100.69 2025-08-01
28 MS_DRG Spinal Procedures With Mcc 29 16 — — $22,511.00 $183,777.21 $60,537.18 2025-08-01
7598713015 NDC Teprotumumab-trbw 500 Mg Intravenous Solution 28 9 $162,387.20 $81,193.60 50% off $16,582.21 $115,544.83 $60,110.50 2025-08-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 27 15 — — $47,837.12 $179,705.36 $59,210.16 2025-08-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 29 16 — — $22,511.00 $176,002.31 $58,003.35 2025-08-01
0091 APR_DRG — 36 8 — — $37,839.64 $189,667.56 $57,667.21 2025-08-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 29 16 — — $22,511.00 $173,496.32 $57,186.65 2025-08-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 29 16 — — $22,511.00 $172,459.47 $56,848.75 2025-08-01
6071 APR_DRG — 36 8 — — $24,260.92 $105,974.22 $56,716.74 2025-08-01
A1904 OTHER Guillain-barr? M <38.50 28 7 — — $52,778.23 $77,046.24 $56,414.16 2025-08-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 29 16 — — $34,422.51 $128,757.40 $56,368.00 2025-08-01
A0406 OTHER Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 28 7 — — $49,643.04 $65,130.11 $56,251.64 2025-08-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 27 14 — — $41,222.62 $201,896.47 $55,785.15 2025-08-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 29 16 — — $31,643.92 $118,204.46 $55,760.88 2025-08-01
0051 APR_DRG — 36 8 — — $31,411.15 $109,818.96 $55,679.57 2025-08-01
653 MS_DRG Major Bladder Procedures With Mcc 29 16 — — $22,511.00 $168,514.58 $55,563.10 2025-08-01
A1806 OTHER Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 28 7 — — $49,450.68 $72,473.96 $55,533.88 2025-08-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 26 15 — — $47,880.66 $273,741.22 $55,450.03 2025-08-01
A0404 OTHER Traumatic Spinal Cord Injury M <31.50 And A <61.50 28 7 — — $48,922.69 $64,184.48 $55,435.84 2025-08-01
9101 APR_DRG — 65 19 — — $19,882.59 $206,412.68 $55,407.11 2025-08-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 28 15 — — $48,562.22 $182,459.22 $55,309.27 2025-08-01
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 29 16 — — $22,511.00 $191,140.22 $55,097.13 2025-08-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 29 16 — — $22,511.00 $167,084.75 $55,097.13 2025-08-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 29 16 — — $22,511.00 $164,104.17 $54,125.76 2025-08-01
270006248-10806601-10052 CDM Hb Centrimag Blood Pump 18 12 $154,070.00 $77,035.00 50% off $14,390.14 $86,279.20 $53,924.50 2025-08-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 29 16 — — $22,511.00 $163,266.83 $53,852.87 2025-08-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 29 16 — — $22,511.00 $163,112.66 $53,802.62 2025-08-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 29 16 — — $22,511.00 $163,094.52 $53,796.72 2025-08-01
0003712511 NDC Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution 28 9 $157,850.70 $78,925.35 50% off $14,732.73 $117,861.86 $53,406.15 2025-08-01
6091 APR_DRG — 36 8 — — $32,855.30 $207,855.27 $52,751.32 2025-08-01
6031 APR_DRG — 36 8 — — $15,795.28 $172,243.71 $51,936.32 2025-08-01
L7181 HCPCS Electronic Elbo Simultaneous 27 16 — — $23,653.04 $275,312.52 $51,932.40 2025-08-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 29 16 — — $37,074.55 $138,829.71 $51,920.95 2025-08-01
3031 APR_DRG — 36 8 — — $30,914.02 $100,537.31 $51,706.53 2025-08-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 29 16 — — $22,511.00 $155,165.46 $51,212.64 2025-08-01
0266T HCPCS Implt/rpl Crtd Sns Dev Total 28 15 — — $21,089.53 $273,741.22 $51,166.58 2025-08-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 29 16 — — $37,488.00 $154,004.66 $50,834.35 2025-08-01
5024210501 NDC Polatuzumab Vedotin-piiq 140 Mg Intravenous Solution 28 9 $137,300.23 $68,650.12 50% off $18,135.21 $81,235.40 $50,772.12 2025-08-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 29 16 — — $33,250.10 $124,304.67 $50,716.73 2025-08-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 29 16 — — $22,511.00 $153,533.09 $50,680.66 2025-08-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 28 15 — — $43,159.83 $182,459.22 $50,466.62 2025-08-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 29 16 — — $22,511.00 $152,260.45 $50,265.91 2025-08-01
A0106 OTHER Stroke M <41.50 And A <84.50 28 7 — — $44,921.86 $61,210.72 $50,047.11 2025-08-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 29 16 — — $14,754.00 $151,362.65 $49,973.31 2025-08-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 29 16 — — $39,990.00 $151,244.76 $49,934.89 2025-08-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 29 16 — — $22,511.00 $151,184.30 $49,915.18 2025-08-01
A5104 OTHER Expired, Not Orthopedic, Length Of Stay Is 16 Days Or More 7 7 — — $48,775.35 $50,195.99 $49,722.45 2025-08-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 28 15 — — $33,022.47 $123,440.12 $49,552.06 2025-08-01
6797900201 NDC Histrelin 50 Mg (65 Mcg/day) Implant Kit 37 19 $207,261.33 $103,630.67 50% off $40,478.14 $263,654.01 $48,829.00 2025-08-01
245 MS_DRG Aicd Generator Procedures 29 16 — — $39,416.18 $147,723.08 $48,787.18 2025-08-01
471 MS_DRG Cervical Spinal Fusion With Mcc 29 16 — — $22,511.00 $146,831.32 $48,496.56 2025-08-01
6 MS_DRG Liver Transplant Without Mcc 27 15 — — $39,116.91 $146,586.47 $48,416.76 2025-08-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 29 16 — — $22,511.00 $144,358.59 $47,690.70 2025-08-01
1781 APR_DRG — 36 8 — — $37,012.46 $76,282.78 $47,544.73 2025-08-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 28 15 — — $31,659.04 $118,261.89 $47,486.90 2025-08-01
799 MS_DRG Splenic Procedures With Mcc 29 16 — — $22,511.00 $143,732.85 $47,486.77 2025-08-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 29 16 — — $22,511.00 $143,705.64 $47,477.90 2025-08-01
1621 APR_DRG — 36 8 — — $31,547.42 $95,561.61 $47,358.65 2025-08-01
A0505 OTHER Non-traumatic Spinal Cord Injury M <39.50 28 7 — — $41,807.14 $63,525.28 $47,355.82 2025-08-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 28 15 — — $34,959.77 $130,797.86 $46,863.11 2025-08-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 29 16 — — $22,511.00 $141,456.61 $46,744.95 2025-08-01
L7180 HCPCS Electronic Elbow Sequential 27 16 — — $20,995.68 $244,381.90 $46,097.93 2025-08-01
163 MS_DRG Major Chest Procedures With Mcc 29 16 — — $22,511.00 $139,331.51 $46,052.38 2025-08-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 27 15 — — $37,191.56 $139,274.07 $46,033.67 2025-08-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 29 16 — — $22,511.00 $138,808.55 $45,881.95 2025-08-01
560000345-10806601-7361 CDM Hb Nmdp Unreltd Donr Marrow Fee & Cryo 11 8 $91,695.00 $45,847.50 50% off $17,908.03 $55,475.48 $45,847.50 2025-08-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 29 16 — — $25,951.42 $96,584.68 $45,562.13 2025-08-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 29 16 — — $22,511.00 $136,381.16 $45,090.87 2025-08-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 29 16 — — $22,511.00 $135,568.00 $44,825.86 2025-08-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 29 16 — — $22,511.00 $135,193.16 $44,703.70 2025-08-01
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 26 15 — — $38,584.77 $220,595.21 $44,684.57 2025-08-01
6311 APR_DRG — 36 8 — — $6,325.78 $204,062.25 $44,642.18 2025-08-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 29 16 — — $25,361.64 $94,344.71 $44,505.46 2025-08-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 29 16 — — $25,244.63 $93,900.34 $44,295.84 2025-08-01
901 MS_DRG Wound Debridements For Injuries With Mcc 29 16 — — $22,511.00 $133,929.58 $44,291.90 2025-08-01
A0405 OTHER Traumatic Spinal Cord Injury M >=31.50 And M <41.50 28 7 — — $38,905.26 $51,042.63 $44,085.25 2025-08-01
A0105 OTHER Stroke M <41.50 And A >=84.50 28 7 — — $39,496.69 $53,816.32 $44,000.79 2025-08-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 29 16 — — $21,439.00 $132,789.95 $43,920.49 2025-08-01
4401 APR_DRG — 63 18 — — $24,966.86 $107,923.64 $43,798.16 2025-08-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 29 16 — — $22,511.00 $130,528.82 $43,183.60 2025-08-01
A0205 OTHER Traumatic Brain Injury M <35.50 28 7 — — $38,029.38 $55,568.56 $43,020.59 2025-08-01
481000335-10806601-8046 CDM Hb 37231-50 Revasc Tibial/peroneal With Stent & Atherect Bilateral 21 14 $122,810.00 $61,405.00 50% off $700.94 $77,370.30 $42,983.50 2025-08-01
560000344-10806601-7362 CDM Hb Nmdp Unreltd Donr Marrow Fee 11 8 $85,695.00 $42,847.50 50% off $16,736.23 $51,845.48 $42,847.50 2025-08-01
560000347-10806601-7359 CDM Hb Nmdp Unreltd Donr Primary Pbsc Fee &cryo 11 8 $85,685.00 $42,842.50 50% off $16,734.28 $51,839.43 $42,842.50 2025-08-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 29 16 — — $22,511.00 $128,947.85 $42,668.36 2025-08-01
140 MS_DRG Major Head And Neck Procedures With Mcc 29 16 — — $22,511.00 $127,844.49 $42,308.77 2025-08-01
7289300803 NDC Vincristine Sulfate Liposomal 5 Mg/31 Ml(0.16 Mg/ml)(final Conc)iv Kit 14 9 $119,883.26 $59,941.63 50% off $3,933.90 $67,134.63 $41,959.14 2025-08-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 29 16 — — $22,511.00 $125,773.80 $41,633.94 2025-08-01
6081 APR_DRG — 36 8 — — $13,876.59 $66,955.36 $41,494.73 2025-08-01
481000334-10806601-8047 CDM Hb 37230-50 Revasc Tibial/peroneal With Stent Bilateral 21 14 $118,545.00 $59,272.50 50% off $644.90 $74,683.35 $41,490.75 2025-08-01
481000331-10806601-8050 CDM Hb 37227-50 Revasc Femoral/popliteal With Stent & Atherect Bilater 21 14 $118,545.00 $59,272.50 50% off $690.34 $74,683.35 $41,490.75 2025-08-01
481000333-10806601-8048 CDM Hb 37229 -50 Revasc Tibial/peroneal With Atherectomy Bilateral 21 14 $118,545.00 $59,272.50 50% off $669.43 $74,683.35 $41,490.75 2025-08-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 29 16 — — $22,511.00 $124,235.14 $41,132.49 2025-08-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 29 16 — — $22,511.00 $124,050.75 $41,072.39 2025-08-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 29 16 — — $23,300.97 $86,518.42 $40,813.55 2025-08-01
A1705 OTHER Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50 28 7 — — $35,043.60 $55,221.06 $40,730.46 2025-08-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 29 16 — — $22,511.00 $122,953.43 $40,714.78 2025-08-01
1601 APR_DRG — 36 8 — — $22,522.32 $139,980.06 $40,625.85 2025-08-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 29 16 — — $23,179.19 $86,055.92 $40,595.37 2025-08-01
L8701 HCPCS Ewh S/d Uprt Micro Sensor 26 15 — — $34,970.13 $199,929.71 $40,498.49 2025-08-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 29 16 — — $27,518.60 $102,536.77 $39,990.00 2025-08-01
265 MS_DRG Aicd Lead Procedures 29 16 — — $28,913.07 $107,832.89 $39,990.00 2025-08-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 29 16 — — $26,025.44 $96,865.81 $39,990.00 2025-08-01
560000346-10806601-7360 CDM Hb Nmdp Unreltd Donr Primary Pbsc Fee 11 8 $79,865.00 $39,932.50 50% off $15,597.63 $48,318.33 $39,932.50 2025-08-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 29 16 — — $22,511.00 $120,423.27 $39,890.20 2025-08-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 29 16 — — $22,511.00 $120,338.63 $39,862.62 2025-08-01
560000348-10806601-7358 CDM Hb Nmdp Unreltd Donr Total Sec. Pbsc 11 8 $79,685.00 $39,842.50 50% off $15,562.48 $48,209.43 $39,842.50 2025-08-01
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 28 15 — — $11,506.22 $212,910.51 $39,796.35 2025-08-01
0081 APR_DRG — 36 8 — — $23,009.87 $94,480.67 $39,774.68 2025-08-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 29 16 — — $22,511.00 $126,677.65 $39,739.16 2025-08-01
1631 APR_DRG — 36 8 — — $27,030.76 $79,601.90 $39,586.93 2025-08-01
1651 APR_DRG — 36 8 — — $27,999.01 $74,340.49 $39,541.86 2025-08-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 29 16 — — $22,511.00 $119,274.57 $39,515.85 2025-08-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 29 16 — — $22,511.00 $119,029.71 $39,436.04 2025-08-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 29 16 — — $22,511.00 $126,647.42 $39,425.02 2025-08-01
7347531023 NDC Efgartigimod Alfa 1008 Mg-hyaluron-qvfc 11200 Unit/5.6 Ml Subcut Soln 14 9 $112,619.21 $56,309.61 50% off $15,766.69 $63,066.76 $39,416.72 2025-08-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 29 16 — — $22,511.00 $118,787.88 $39,357.24 2025-08-01
A1805 OTHER Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50 28 7 — — $34,820.53 $51,032.10 $39,103.26 2025-08-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 29 16 — — $22,511.00 $117,551.51 $38,954.31 2025-08-01
A1903 OTHER Guillain-barr? M >=38.50 And M <51.50 28 7 — — $36,230.54 $52,891.75 $38,726.96 2025-08-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 29 16 — — $22,511.00 $116,835.09 $38,720.82 2025-08-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 29 16 — — $22,511.00 $116,717.19 $38,682.41 2025-08-01
6630201401 NDC Dinutuximab 3.5 Mg/ml Intravenous Solution 14 9 $110,391.40 $55,195.70 50% off $15,454.80 $61,819.18 $38,636.99 2025-08-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 29 16 — — $22,511.00 $116,390.72 $38,576.00 2025-08-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 29 16 — — $22,511.00 $128,666.69 $38,301.14 2025-08-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 29 16 — — $22,511.00 $114,921.59 $38,097.21 2025-08-01
A0305 OTHER Non-traumatic Brain Injury M <42.50 And A <78.50 28 7 — — $33,801.40 $50,219.15 $37,973.52 2025-08-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 29 16 — — $22,511.00 $114,026.81 $37,805.61 2025-08-01
A1004 OTHER Amputation Lower Extremity M <47.50 28 7 — — $31,873.63 $48,462.69 $37,779.03 2025-08-01
6121 APR_DRG — 36 8 — — $19,579.93 $75,697.80 $37,678.36 2025-08-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 26 15 — — $32,423.98 $185,373.00 $37,549.83 2025-08-01
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 26 15 — — $32,423.98 $185,373.00 $37,549.83 2025-08-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 28 15 — — $25,083.05 $93,286.69 $37,526.40 2025-08-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 29 16 — — $26,537.22 $98,809.53 $37,488.00 2025-08-01
A0604 OTHER Neurological M <43.50 28 7 — — $32,125.34 $52,449.48 $37,407.23 2025-08-01
A5102 OTHER Expired, Orthopedic, Length Of Stay Is 14 Days Or More 7 7 — — $36,684.85 $37,753.34 $37,397.18 2025-08-01
A1504 OTHER Pulmonary M <45.50 28 7 — — $33,234.53 $47,900.37 $37,170.54 2025-08-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 29 16 — — $27,782.85 $103,540.37 $36,946.77 2025-08-01
481000211-10806621-8143 CDM Hb 33270 Insert Subq Defib W/eltrd 31 16 $116,270.00 $58,135.00 50% off $22,707.53 $195,032.88 $36,789.19 2025-08-01
481000370-10806601-8018 CDM Hb 0915t Insj Perm Ccm-d Sys Pg&dual Transvns Eltrds/lds 31 16 $161,270.00 $80,635.00 50% off $31,496.03 $195,032.88 $36,789.19 2025-08-01
481000034-10806621-8304 CDM Hb Icd Removal/rplcmnt Pace With Mult Lead 33264 31 16 $157,220.00 $78,610.00 50% off $892.40 $195,032.88 $36,789.19 2025-08-01
A2102 OTHER Burns M <52.50 21 7 — — $30,778.77 $48,810.20 $36,740.03 2025-08-01
0074501501 NDC Risankizumab-rzaa 60 Mg/ml Intravenous Solution 28 9 $108,292.59 $54,146.29 50% off $10,107.31 $80,858.47 $36,638.99 2025-08-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 29 16 — — $14,754.00 $110,296.55 $36,589.93 2025-08-01
6111 APR_DRG — 36 8 — — $12,242.76 $85,890.83 $36,462.87 2025-08-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 28 15 — — $23,533.24 $195,032.88 $36,454.75 2025-08-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 28 15 — — $16,520.92 $195,032.88 $36,454.75 2025-08-01
A0704 OTHER Fracture Of Lower Extremity M <41.50 28 7 — — $32,244.04 $49,014.48 $36,379.65 2025-08-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 29 16 — — $22,511.00 $109,531.76 $36,340.68 2025-08-01
1831 APR_DRG — 36 8 — — $28,233.20 $66,478.89 $36,307.59 2025-08-01
1791 APR_DRG — 36 8 — — $25,884.47 $61,821.97 $36,304.04 2025-08-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 29 16 — — $22,511.00 $108,364.92 $35,960.41 2025-08-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 29 16 — — $14,754.00 $108,358.87 $35,958.44 2025-08-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 29 16 — — $22,511.00 $108,340.74 $35,952.53 2025-08-01
A1304 OTHER Rheumatoid Other Arthritis M <44.50 And A >=64.50 28 7 — — $32,178.55 $45,103.52 $35,916.71 2025-08-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 29 16 — — $22,511.00 $107,349.22 $35,629.39 2025-08-01
A2005 OTHER Miscellaneous M <46.50 And A <77.50 28 7 — — $30,872.91 $46,779.95 $35,607.12 2025-08-01
A0403 OTHER Traumatic Spinal Cord Injury M >=41.50 And M <47.50 28 7 — — $31,333.36 $41,108.31 $35,504.84 2025-08-01
481000031-10806621-8307 CDM Hb Icd Insert Generator, Leads Single/dual 33249 31 16 $41,735.00 $20,867.50 50% off $892.40 $195,032.88 $35,451.40 2025-08-01
481000024-10806621-8314 CDM Hb Icd Gen Insertion With Multiple Lead 33231 31 16 $47,045.00 $23,522.50 50% off $892.40 $195,032.88 $35,451.40 2025-08-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 29 16 — — $22,511.00 $115,987.36 $35,424.47 2025-08-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 29 16 — — $22,511.00 $106,693.26 $35,415.61 2025-08-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 29 16 — — $22,511.00 $106,424.22 $35,327.93 2025-08-01
A0104 OTHER Stroke M >=41.50 And M <50.50 28 7 — — $31,585.07 $43,037.46 $35,187.57 2025-08-01
69930 HCPCS Implant Cochlear Device 35 18 — — $853.60 $193,489.23 $35,170.81 2025-08-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 29 16 — — $22,511.00 $105,916.37 $35,162.43 2025-08-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 29 16 — — $22,511.00 $105,883.12 $35,151.59 2025-08-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 29 16 — — $22,511.00 $105,840.80 $35,137.80 2025-08-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 29 16 — — $22,221.69 $82,419.37 $35,061.91 2025-08-01
6131 APR_DRG — 36 8 — — $16,192.44 $86,293.53 $34,874.85 2025-08-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 27 15 — — $28,159.33 $104,970.20 $34,854.08 2025-08-01
332 MS_DRG Rectal Resection With Mcc 29 16 — — $22,511.00 $104,855.33 $34,816.63 2025-08-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 29 16 — — $22,511.00 $104,740.46 $34,779.20 2025-08-01
A1704 OTHER Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50 28 7 — — $29,861.96 $47,055.84 $34,707.43 2025-08-01
793 MS_DRG Full Term Neonate With Major Problems 27 15 — — $8,743.00 $126,070.04 $34,706.54 2025-08-01
791 MS_DRG Prematurity With Major Problems 27 15 — — $32,834.63 $122,726.72 $34,679.78 2025-08-01
0268T HCPCS Implt/rpl Crtd Sns Dev Gen 28 15 — — $21,089.53 $185,373.00 $34,649.16 2025-08-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 28 15 — — $21,089.53 $185,373.00 $34,649.16 2025-08-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 29 16 — — $22,511.00 $104,120.77 $34,577.24 2025-08-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 29 16 — — $22,511.00 $103,957.53 $34,524.05 2025-08-01
665 MS_DRG Prostatectomy With Mcc 29 16 — — $22,511.00 $103,794.29 $34,470.85 2025-08-01
252 MS_DRG Other Vascular Procedures With Mcc 29 16 — — $22,511.00 $103,697.56 $34,439.32 2025-08-01
A1604 OTHER Pain Syndrome M <43.50 28 7 — — $29,855.82 $49,439.91 $34,436.85 2025-08-01
A0304 OTHER Non-traumatic Brain Injury M <42.50 And A >=78.50 28 7 — — $30,649.84 $45,535.26 $34,432.54 2025-08-01
A1305 OTHER Rheumatoid Other Arthritis M <51.50 And A <64.50 28 7 — — $30,815.60 $43,193.31 $34,395.31 2025-08-01
A0904 OTHER Other Orthopedic M <44.5 28 7 — — $29,935.63 $45,103.52 $34,387.37 2025-08-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 29 16 — — $22,511.00 $102,966.02 $34,200.91 2025-08-01
L6700 HCPCS Ue Add Ext Power Myoel 26 15 — — $29,510.19 $168,714.39 $34,175.40 2025-08-01
A0504 OTHER Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50 28 7 — — $30,087.06 $45,716.38 $34,079.39 2025-08-01
A1404 OTHER Cardiac M <45.50 28 7 — — $29,595.92 $45,191.98 $33,847.21 2025-08-01
3041 APR_DRG — 36 8 — — $20,288.65 $70,488.96 $33,797.20 2025-08-01
A2004 OTHER Miscellaneous M <46.50 And A >=77.50 28 7 — — $29,288.95 $44,381.14 $33,780.90 2025-08-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 29 16 — — $22,511.00 $101,469.68 $33,713.26 2025-08-01
761001320-10806601-5871 CDM Hb 63685 Insj/rplcmt Spi Npg Rcvr With Pocket 38 19 $136,325.00 $68,162.50 50% off $331.10 $185,373.00 $33,695.51 2025-08-01
61886 HCPCS Implant Neurostim Arrays 37 18 — — $853.60 $185,373.00 $33,695.51 2025-08-01
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