Hospital

ST MARY MEDICAL CENTER

Langhorne, PA · CCN 390258 · Rates published

14,663 distinct procedures filed

26 distinct payers

693,383 rate rows

2025-01-01 last MRF observed · ⚠ 19 mo old

Data quality

420,658 of 693,383 rate rows are consumer-grade (60.7%)

272,725 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 — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	217,157
template filing: same amount across many unrelated codes — excluded	31,744
exceeds 10× this hospital's gross charge — excluded from medians	22,785
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	772
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	169
percent-of-charges filed in the dollar field — excluded from medians	84
placeholder amount (≤ $0.02) — excluded from medians	9
per-diem day rate — not a per-procedure price	5

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 19 months old.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/stmarycenter
Found on page	https://www.trinityhealthma.org/patients-visitors/billing-insurance/pricing-transparency
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-08-18
Content fingerprint	95fedb7fa395d2a3… · 16,942,144 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 OTHER	Neonate With Ecmo	3	$445,253.98	$516,130.20	$462,073.65	nat. median $221,551 outlier · 2.1×
'583-3 OTHER	Neonate With Ecmo	3	$373,700.84	$433,187.11	$387,817.55	nat. median $195,630 2.0× median
'588-4 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	3	$344,891.65	$399,792.03	$357,920.08	nat. median $202,324 1.8× median
'002-4 OTHER	Heart And/or Lung Transplant	3	$326,332.93	$378,279.10	$338,660.30	nat. median $205,014 1.7× median
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	19	$231,849.27	$636,546.56	$294,225.96	nat. median $370,165 0.8× median
'161-4 OTHER	Implantable Heart Assist Systems	3	$274,054.21	$317,678.57	$284,406.73	nat. median $182,608 1.6× median
'841-4 OTHER	Extensive Third Degree Burns With Skin Graft	3	$255,496.44	$296,166.75	$265,147.93	nat. median $138,284 1.9× median
'583-2 OTHER	Neonate With Ecmo	3	$242,503.23	$281,105.27	$251,663.90	nat. median $119,004 outlier · 2.1×
'588-3 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	3	$232,705.44	$269,747.85	$241,495.99	nat. median $131,074 1.8× median
'630-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	3	$230,417.29	$267,095.47	$239,121.40	nat. median $127,072 1.9× median
'591-4 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	3	$229,541.48	$266,080.25	$238,212.51	nat. median $119,104 outlier · 2.0×
'007-4 OTHER	Allogeneic Bone Marrow Transplant	3	$221,612.52	$256,889.14	$229,984.03	nat. median $131,941 1.7× median
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	20	$165,873.98	$487,635.95	$216,665.04	nat. median $205,166 1.1× median
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	19	$170,530.13	$468,373.93	$216,492.84	nat. median $261,939 0.8× median
'009-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	3	$203,448.34	$235,833.56	$211,133.69	nat. median $89,522 outlier · 2.4×
'631-4 OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	3	$201,645.27	$233,743.47	$209,262.51	nat. median $112,354 1.9× median
'609-4 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	3	$201,600.47	$233,691.55	$209,216.02	nat. median $130,670 1.6× median
'593-4 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	3	$195,655.66	$226,800.43	$203,046.64	nat. median $115,906 1.8× median
'001-4 OTHER	Liver Transplant And/or Intestinal Transplant	3	$195,427.89	$226,536.41	$202,810.27	nat. median $107,546 1.9× median
'583-1 OTHER	Neonate With Ecmo	3	$191,606.36	$222,106.56	$198,844.38	nat. median $105,798 1.9× median
'161-3 OTHER	Implantable Heart Assist Systems	3	$182,981.71	$212,109.02	$189,893.93	nat. median $114,612 1.7× median
'004-4 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	3	$180,621.13	$209,372.68	$187,444.18	nat. median $101,809 1.8× median
'588-1 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	3	$176,332.63	$204,401.53	$182,993.68	nat. median $98,245 1.9× median
'588-2 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	3	$176,332.63	$204,401.53	$182,993.68	nat. median $110,776 1.7× median
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	20	$134,167.58	$394,425.55	$175,312.00	nat. median $199,832 0.9× median
'002-3 OTHER	Heart And/or Lung Transplant	3	$163,447.12	$189,464.88	$169,621.41	nat. median $89,928 1.9× median
222 MS_DRG	Cardiac Defib Implant W Cardiac Cath W Ami/hf/shock W Mcc	1	$146,858.00	$181,568.00	$164,213.00	nat. median $58,534 outlier · 2.8×
'603-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	3	$152,107.37	$176,320.06	$157,853.30	nat. median $102,933 1.5× median
'602-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	3	$150,729.33	$174,722.66	$156,423.20	nat. median $66,108 outlier · 2.4×
'006-4 OTHER	Pancreas Transplant	3	$149,085.41	$172,817.05	$154,717.18	nat. median $56,683 outlier · 2.7×
'591-3 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	3	$146,692.43	$170,043.15	$152,233.80	nat. median $84,666 1.8× median
'589-1 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	3	$143,837.24	$166,733.47	$149,270.75	nat. median $78,851 1.9× median
224 MS_DRG	Cardiac Defib Implant W Cardiac Cath Without Ami/hf/shock W Mcc	1	$131,834.00	$162,990.00	$147,412.00	nat. median $51,048 outlier · 2.9×
'160-4 OTHER	Major Cardiothoracic Repair Of Heart Anomaly	3	$140,425.50	$162,778.64	$145,730.13	nat. median $82,416 1.8× median
'002-2 OTHER	Heart And/or Lung Transplant	3	$138,767.28	$160,856.47	$144,009.27	nat. median $76,713 1.9× median
'589-2 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	3	$138,748.22	$160,834.37	$143,989.49	nat. median $77,835 1.8× median
'161-2 OTHER	Implantable Heart Assist Systems	3	$134,067.08	$155,408.09	$139,131.53	nat. median $86,952 1.6× median
'589-3 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	3	$132,092.47	$153,119.15	$137,082.32	nat. median $46,281 outlier · 3.0×
'593-3 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	3	$131,504.47	$152,437.55	$136,472.11	nat. median $82,229 1.7× median
'161-1 OTHER	Implantable Heart Assist Systems	3	$127,333.18	$147,602.28	$132,143.25	nat. median $70,718 1.9× median
'008-4 OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	3	$125,869.38	$145,905.46	$130,624.15	nat. median $56,082 outlier · 2.3×
'842-4 OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	3	$124,725.78	$144,579.82	$129,437.35	nat. median $80,075 1.6× median
226 MS_DRG	Cardiac Defibrillator Implant Without Cardiac Cath W Mcc	1	$115,683.00	$143,022.00	$129,352.50	nat. median $46,826 outlier · 2.8×
'004-3 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	3	$123,320.10	$142,950.38	$127,978.57	nat. median $62,886 outlier · 2.0×
'591-2 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	3	$121,045.29	$140,313.47	$125,617.83	nat. median $68,201 1.8× median
'005-4 OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	3	$118,496.97	$137,359.50	$122,973.24	nat. median $61,783 2.0× median
'593-2 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	3	$118,432.16	$137,284.38	$122,905.99	nat. median $55,163 outlier · 2.2×
'607-4 OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	3	$117,534.44	$136,243.75	$121,974.35	nat. median $64,930 1.9× median
4 MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	20	$92,506.37	$271,950.00	$120,975.40	nat. median $132,706 0.9× median
J7330 HCPCS	Membrane Collgn Porcine Maci W/autologous Cult Chondrocytes	11	$223.00	$273,016.70	$118,690.42	nat. median $75,807 1.6× median

Other procedures at this hospital

Browse this hospital's 14,663 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

'583-4	OTHER	Neonate With Ecmo	3	3	—	—	$445,253.98	$516,130.20	$462,073.65	2025-01-01
'583-3	OTHER	Neonate With Ecmo	3	3	—	—	$373,700.84	$433,187.11	$387,817.55	2025-01-01
'588-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	3	3	—	—	$344,891.65	$399,792.03	$357,920.08	2025-01-01
'002-4	OTHER	Heart And/or Lung Transplant	3	3	—	—	$326,332.93	$378,279.10	$338,660.30	2025-01-01
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	21	19	—	—	$231,849.27	$636,546.56	$294,225.96	2025-01-01
'161-4	OTHER	Implantable Heart Assist Systems	3	3	—	—	$274,054.21	$317,678.57	$284,406.73	2025-01-01
'841-4	OTHER	Extensive Third Degree Burns With Skin Graft	3	3	—	—	$255,496.44	$296,166.75	$265,147.93	2025-01-01
'583-2	OTHER	Neonate With Ecmo	3	3	—	—	$242,503.23	$281,105.27	$251,663.90	2025-01-01
'588-3	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	3	3	—	—	$232,705.44	$269,747.85	$241,495.99	2025-01-01
'630-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	3	3	—	—	$230,417.29	$267,095.47	$239,121.40	2025-01-01
'591-4	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	3	3	—	—	$229,541.48	$266,080.25	$238,212.51	2025-01-01
'007-4	OTHER	Allogeneic Bone Marrow Transplant	3	3	—	—	$221,612.52	$256,889.14	$229,984.03	2025-01-01
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	25	20	—	$281,719.00	$165,873.98	$487,635.95	$216,665.04	2025-01-01
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	21	19	—	—	$170,530.13	$468,373.93	$216,492.84	2025-01-01
'009-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	3	3	—	—	$203,448.34	$235,833.56	$211,133.69	2025-01-01
'631-4	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	3	3	—	—	$201,645.27	$233,743.47	$209,262.51	2025-01-01
'609-4	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	3	3	—	—	$201,600.47	$233,691.55	$209,216.02	2025-01-01
'593-4	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	3	3	—	—	$195,655.66	$226,800.43	$203,046.64	2025-01-01
'001-4	OTHER	Liver Transplant And/or Intestinal Transplant	3	3	—	—	$195,427.89	$226,536.41	$202,810.27	2025-01-01
'583-1	OTHER	Neonate With Ecmo	3	3	—	—	$191,606.36	$222,106.56	$198,844.38	2025-01-01
'161-3	OTHER	Implantable Heart Assist Systems	3	3	—	—	$182,981.71	$212,109.02	$189,893.93	2025-01-01
'004-4	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	3	3	—	—	$180,621.13	$209,372.68	$187,444.18	2025-01-01
'588-1	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	3	3	—	—	$176,332.63	$204,401.53	$182,993.68	2025-01-01
'588-2	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	3	3	—	—	$176,332.63	$204,401.53	$182,993.68	2025-01-01
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	25	20	—	$304,634.00	$134,167.58	$394,425.55	$175,312.00	2025-01-01
'002-3	OTHER	Heart And/or Lung Transplant	3	3	—	—	$163,447.12	$189,464.88	$169,621.41	2025-01-01
222	MS_DRG	Cardiac Defib Implant W Cardiac Cath W Ami/hf/shock W Mcc	2	1	—	$146,858.00	$146,858.00	$181,568.00	$164,213.00	2025-01-01
'603-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	3	3	—	—	$152,107.37	$176,320.06	$157,853.30	2025-01-01
'602-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	3	3	—	—	$150,729.33	$174,722.66	$156,423.20	2025-01-01
'006-4	OTHER	Pancreas Transplant	3	3	—	—	$149,085.41	$172,817.05	$154,717.18	2025-01-01
'591-3	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	3	3	—	—	$146,692.43	$170,043.15	$152,233.80	2025-01-01
'589-1	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	3	3	—	—	$143,837.24	$166,733.47	$149,270.75	2025-01-01
224	MS_DRG	Cardiac Defib Implant W Cardiac Cath Without Ami/hf/shock W Mcc	2	1	—	$131,834.00	$131,834.00	$162,990.00	$147,412.00	2025-01-01
'160-4	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	3	3	—	—	$140,425.50	$162,778.64	$145,730.13	2025-01-01
'002-2	OTHER	Heart And/or Lung Transplant	3	3	—	—	$138,767.28	$160,856.47	$144,009.27	2025-01-01
'589-2	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	3	3	—	—	$138,748.22	$160,834.37	$143,989.49	2025-01-01
'161-2	OTHER	Implantable Heart Assist Systems	3	3	—	—	$134,067.08	$155,408.09	$139,131.53	2025-01-01
'589-3	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	3	3	—	—	$132,092.47	$153,119.15	$137,082.32	2025-01-01
'593-3	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	3	3	—	—	$131,504.47	$152,437.55	$136,472.11	2025-01-01
'161-1	OTHER	Implantable Heart Assist Systems	3	3	—	—	$127,333.18	$147,602.28	$132,143.25	2025-01-01
'008-4	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	3	3	—	—	$125,869.38	$145,905.46	$130,624.15	2025-01-01
'842-4	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	3	3	—	—	$124,725.78	$144,579.82	$129,437.35	2025-01-01
226	MS_DRG	Cardiac Defibrillator Implant Without Cardiac Cath W Mcc	2	1	—	$115,683.00	$115,683.00	$143,022.00	$129,352.50	2025-01-01
'004-3	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	3	3	—	—	$123,320.10	$142,950.38	$127,978.57	2025-01-01
'591-2	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	3	3	—	—	$121,045.29	$140,313.47	$125,617.83	2025-01-01
'005-4	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	3	3	—	—	$118,496.97	$137,359.50	$122,973.24	2025-01-01
'593-2	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	3	3	—	—	$118,432.16	$137,284.38	$122,905.99	2025-01-01
'607-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	3	3	—	—	$117,534.44	$136,243.75	$121,974.35	2025-01-01
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	25	20	—	$186,924.00	$92,506.37	$271,950.00	$120,975.40	2025-01-01
J7330	HCPCS	Membrane Collgn Porcine Maci W/autologous Cult Chondrocytes	15	11	$287,386.00	$181,627.95 37% off	$223.00	$273,016.70	$118,690.42	2025-01-01
'007-3	OTHER	Allogeneic Bone Marrow Transplant	3	3	—	—	$114,296.14	$132,489.98	$118,613.73	2025-01-01
'002-1	OTHER	Heart And/or Lung Transplant	3	3	—	—	$113,146.83	$131,157.71	$117,421.00	2025-01-01
223	MS_DRG	Cardiac Defib Implant W Cardiac Cath W Ami/hf/shock Without Mcc	2	1	—	$104,880.00	$104,880.00	$129,668.00	$117,274.00	2025-01-01
'303-4	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	3	3	—	—	$112,610.29	$130,535.77	$116,864.19	2025-01-01
'602-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	3	3	—	—	$108,344.66	$125,591.13	$112,437.43	2025-01-01
'630-3	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	3	3	—	—	$107,791.92	$124,950.40	$111,863.81	2025-01-01
'162-4	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	3	3	—	—	$107,258.24	$124,331.77	$111,309.97	2025-01-01
225	MS_DRG	Cardiac Defib Implant W Cardiac Cath Without Ami/hf/shock Without Mcc	2	1	—	$98,938.00	$98,938.00	$122,321.00	$110,629.50	2025-01-01
'611-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	3	3	—	—	$104,864.30	$121,556.76	$108,825.60	2025-01-01
'608-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	3	3	—	—	$100,733.05	$116,767.89	$104,538.28	2025-01-01
'440-4	OTHER	Kidney Transplant	3	3	—	—	$98,759.39	$114,480.06	$102,490.07	2025-01-01
27800000002-52209	CDM	Device Impella 5.5 Smartassist	15	11	$247,500.00	$156,420.00 37% off	$223.00	$235,125.00	$102,217.50	2025-01-01
'609-3	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	3	3	—	—	$96,962.98	$112,397.70	$100,625.80	2025-01-01
'613-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	3	3	—	—	$96,883.88	$112,306.01	$100,543.71	2025-01-01
'009-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	3	3	—	—	$96,101.47	$111,399.05	$99,731.74	2025-01-01
227	MS_DRG	Cardiac Defibrillator Implant Without Cardiac Cath Without Mcc	2	1	—	$89,114.00	$89,114.00	$110,175.00	$99,644.50	2025-01-01
'006-3	OTHER	Pancreas Transplant	3	3	—	—	$94,987.41	$110,107.65	$98,575.60	2025-01-01
7	MS_DRG	Lung Transplant	21	19	—	—	$77,191.84	$212,386.23	$98,169.64	2025-01-01
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	21	19	—	—	$77,051.51	$212,001.35	$97,991.73	2025-01-01
'007-2	OTHER	Allogeneic Bone Marrow Transplant	3	3	—	—	$94,069.67	$109,043.83	$97,623.20	2025-01-01
'167-4	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	3	3	—	—	$93,737.08	$108,658.29	$97,278.04	2025-01-01
'163-4	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	3	3	—	—	$92,370.47	$107,074.15	$95,859.81	2025-01-01
'625-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	3	3	—	—	$91,655.72	$106,245.62	$95,118.06	2025-01-01
'001-3	OTHER	Liver Transplant And/or Intestinal Transplant	3	3	—	—	$90,553.10	$104,967.48	$93,973.79	2025-01-01
'603-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	3	3	—	—	$90,389.19	$104,777.48	$93,803.68	2025-01-01
'178-4	OTHER	External Heart Assist Systems	3	3	—	—	$89,885.05	$104,193.09	$93,280.50	2025-01-01
'004-2	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	3	3	—	—	$89,818.34	$104,115.76	$93,211.27	2025-01-01
14	MS_DRG	Allogeneic Bone Marrow Transplant	21	19	—	—	$72,122.87	$198,484.16	$91,743.79	2025-01-01
'602-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	3	3	—	—	$87,899.95	$101,892.00	$91,220.41	2025-01-01
'841-3	OTHER	Extensive Third Degree Burns With Skin Graft	3	3	—	—	$87,861.83	$101,847.81	$91,180.85	2025-01-01
'680-4	OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	3	3	—	—	$87,398.67	$101,310.93	$90,700.20	2025-01-01
'591-1	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	3	3	—	—	$87,273.83	$101,166.21	$90,570.64	2025-01-01
'863-4	OTHER	Neonatal Aftercare	3	3	—	—	$87,200.45	$101,081.15	$90,494.48	2025-01-01
'006-2	OTHER	Pancreas Transplant	3	3	—	—	$86,801.14	$100,618.28	$90,080.09	2025-01-01
212	MS_DRG	Concomitant Aortic And Mitral Valve?procedures	23	20	—	—	$67,779.48	$199,257.95	$87,066.96	2025-01-01
27200000002-17908	CDM	Introducer Lotus 25 Edge	15	11	$178,750.00	$112,970.00 37% off	$223.00	$169,812.50	$86,515.00	2025-01-01
27200000002-17907	CDM	Introducer Lotus 23 Edge	15	11	$178,750.00	$112,970.00 37% off	$223.00	$169,812.50	$86,515.00	2025-01-01
'005-3	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	3	3	—	—	$83,320.79	$96,583.92	$86,468.27	2025-01-01
'165-4	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	3	3	—	—	$83,314.11	$96,576.18	$86,461.34	2025-01-01
'303-3	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	3	3	—	—	$83,274.09	$96,529.79	$86,419.80	2025-01-01
'651-4	OTHER	Other Procedures Of Blood And Blood-forming Organs	3	3	—	—	$82,018.03	$95,073.79	$85,116.30	2025-01-01
'690-4	OTHER	Acute Leukemia	3	3	—	—	$81,137.46	$94,053.05	$84,202.47	2025-01-01
215	MS_DRG	Other Heart Assist System Implant	25	20	—	$242,234.00	$64,281.23	$299,480.00	$84,162.79	2025-01-01
'612-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	3	3	—	—	$80,862.05	$93,733.79	$83,916.65	2025-01-01
'911-4	OTHER	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	3	3	—	—	$80,387.45	$93,183.65	$83,424.12	2025-01-01
'607-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	3	3	—	—	$80,153.97	$92,913.00	$83,181.82	2025-01-01
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	21	19	—	—	$65,132.03	$179,311.23	$82,881.64	2025-01-01
'312-4	OTHER	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses	3	3	—	—	$79,703.20	$92,390.47	$82,714.02	2025-01-01
'304-4	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	3	3	—	—	$79,603.13	$92,274.48	$82,610.18	2025-01-01
'910-4	OTHER	Craniotomy For Multiple Significant Trauma	3	3	—	—	$78,233.67	$90,687.03	$81,188.98	2025-01-01
'004-1	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	3	3	—	—	$78,206.99	$90,656.10	$81,161.29	2025-01-01
'681-4	OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	3	3	—	—	$77,805.77	$90,191.02	$80,744.92	2025-01-01
'183-4	OTHER	Percutaneous Structural Cardiac Procedures	3	3	—	—	$77,531.31	$89,872.86	$80,460.09	2025-01-01
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	25	20	—	$163,491.00	$61,074.97	$202,127.00	$79,981.03	2025-01-01
'850-4	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	3	3	—	—	$76,912.81	$89,155.91	$79,818.23	2025-01-01
'621-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	3	3	—	—	$76,597.37	$88,790.26	$79,490.87	2025-01-01
'021-4	OTHER	Open Craniotomy Except Trauma	3	3	—	—	$74,746.64	$86,644.93	$77,570.23	2025-01-01
'361-4	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	3	3	—	—	$74,693.28	$86,583.07	$77,514.85	2025-01-01
'695-4	OTHER	Chemotherapy For Acute Leukemia	3	3	—	—	$74,642.77	$86,524.52	$77,462.43	2025-01-01
27800000002-52401	CDM	Valve Sapien Thv Edwards Resilia 29mm	15	11	$187,000.00	$118,184.00 37% off	$223.00	$177,650.00	$77,231.00	2025-01-01
27800000002-52400	CDM	Valve Sapien Thv Edwards Resilia 23mm	15	11	$187,000.00	$118,184.00 37% off	$223.00	$177,650.00	$77,231.00	2025-01-01
27800000002-52403	CDM	Valve Sapien Thv Edwards Resilia 26mm	15	11	$187,000.00	$118,184.00 37% off	$223.00	$177,650.00	$77,231.00	2025-01-01
'633-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	3	3	—	—	$74,408.33	$86,252.76	$77,219.14	2025-01-01
'001-1	OTHER	Liver Transplant And/or Intestinal Transplant	3	3	—	—	$73,599.23	$85,314.87	$76,379.48	2025-01-01
'001-2	OTHER	Liver Transplant And/or Intestinal Transplant	3	3	—	—	$73,599.23	$85,314.87	$76,379.48	2025-01-01
'260-4	OTHER	Major Pancreas, Liver And Shunt Procedures	3	3	—	—	$73,538.24	$85,244.17	$76,316.18	2025-01-01
'912-4	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	3	3	—	—	$72,470.88	$84,006.91	$75,208.50	2025-01-01
'166-4	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	3	3	—	—	$72,429.90	$83,959.40	$75,165.97	2025-01-01
'007-1	OTHER	Allogeneic Bone Marrow Transplant	3	3	—	—	$72,210.71	$83,705.32	$74,938.50	2025-01-01
'401-4	OTHER	Adrenal Procedures	3	3	—	—	$71,279.63	$82,626.03	$73,972.25	2025-01-01
27800000002-53127	CDM	Valve Sapien 3 Thv 26mm W/command System	15	11	$178,750.00	$112,970.00 37% off	$223.00	$169,812.50	$73,823.75	2025-01-01
27800000002-53329	CDM	Valve Sapien 3 Ultra Thv 23mm W/command System	15	11	$178,750.00	$112,970.00 37% off	$223.00	$169,812.50	$73,823.75	2025-01-01
27800000002-53126	CDM	Valve Sapien 3 Thv 23mm W/command System	15	11	$178,750.00	$112,970.00 37% off	$223.00	$169,812.50	$73,823.75	2025-01-01
27800000002-53326	CDM	Valve Sapien 3 Ultra Thv 20mm W/command System	15	11	$178,750.00	$112,970.00 37% off	$223.00	$169,812.50	$73,823.75	2025-01-01
27800000002-53333	CDM	Valve Sapien 3 Ultra Thv 26mm W/command System	15	11	$178,750.00	$112,970.00 37% off	$223.00	$169,812.50	$73,823.75	2025-01-01
27800000002-53128	CDM	Valve Sapien 3 Thv 29mm W/command System	15	11	$178,750.00	$112,970.00 37% off	$223.00	$169,812.50	$73,823.75	2025-01-01
27800000002-53134	CDM	Valve Thv Sapien 3 26mm W/certitudesystem	15	11	$178,750.00	$112,970.00 37% off	$223.00	$169,812.50	$73,823.75	2025-01-01
27800000002-53133	CDM	Valve Thv Sapien 3 23mm W/certitudesystem	15	11	$178,750.00	$112,970.00 37% off	$223.00	$169,812.50	$73,823.75	2025-01-01
'179-4	OTHER	Defibrillator Implants	3	3	—	—	$71,034.71	$82,342.12	$73,718.08	2025-01-01
'614-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	3	3	—	—	$70,467.67	$81,684.83	$73,129.62	2025-01-01
453	MS_DRG	Combined Anterior And Posterior Spinal Fusion With Mcc	25	20	—	$181,976.00	$55,764.35	$224,982.00	$73,054.66	2025-01-01
'631-3	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	3	3	—	—	$69,737.68	$80,838.63	$72,372.05	2025-01-01
'169-4	OTHER	Major Abdominal Vascular Procedures	3	3	—	—	$69,474.65	$80,533.73	$72,099.08	2025-01-01
'162-3	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	3	3	—	—	$69,102.03	$80,101.79	$71,712.39	2025-01-01
'027-4	OTHER	Other Open Craniotomy	3	3	—	—	$68,638.87	$79,564.91	$71,231.73	2025-01-01
'091-4	OTHER	Other Major Head And Neck Procedures	3	3	—	—	$68,285.30	$79,155.06	$70,864.81	2025-01-01
'232-4	OTHER	Gastric Fundoplication	3	3	—	—	$67,876.47	$78,681.15	$70,440.53	2025-01-01
'759-4	OTHER	Eating Disorders	3	3	—	—	$67,794.51	$78,586.14	$70,355.48	2025-01-01
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	25	20	—	$156,323.00	$53,190.53	$193,266.00	$69,697.76	2025-01-01
'005-2	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	3	3	—	—	$67,159.81	$77,850.41	$69,696.80	2025-01-01
'441-4	OTHER	Major Bladder Procedures	3	3	—	—	$67,139.80	$77,827.21	$69,676.03	2025-01-01
984	MS_DRG	Prostatic O.r. Procedure Unrelated To Principal Diagnosis W Mcc	2	1	—	$62,203.00	$62,203.00	$76,903.00	$69,553.00	2025-01-01
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	25	20	—	$163,517.00	$53,045.79	$202,160.00	$69,508.99	2025-01-01
'023-4	OTHER	Spinal Procedures	3	3	—	—	$66,892.02	$77,539.99	$69,418.89	2025-01-01
'220-4	OTHER	Major Stomach, Esophageal And Duodenal Procedures	3	3	—	—	$66,202.05	$76,740.19	$68,702.86	2025-01-01
'950-4	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis	3	3	—	—	$65,985.72	$76,489.42	$68,478.36	2025-01-01
'630-2	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	3	3	—	—	$65,893.27	$76,382.27	$68,382.42	2025-01-01
'008-3	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	3	3	—	—	$65,837.05	$76,317.09	$68,324.07	2025-01-01
27800000002-53517	CDM	Kit Mitraclip 2 Mbr0202	15	11	$165,000.00	$104,280.00 37% off	$223.00	$156,750.00	$68,145.00	2025-01-01
27800000002-52836	CDM	Kit Mitraclip 1 Mbr0101	15	11	$165,000.00	$104,280.00 37% off	$223.00	$156,750.00	$68,145.00	2025-01-01
27800000002-53456	CDM	Kit Mitraclip 3 Mbr0103	15	11	$165,000.00	$104,280.00 37% off	$223.00	$156,750.00	$68,145.00	2025-01-01
27800000002-52838	CDM	Kit Mitraclip 1 Mbr0301	15	11	$165,000.00	$104,280.00 37% off	$223.00	$156,750.00	$68,145.00	2025-01-01
27800000002-53070	CDM	Valve Aort 29mm Pro Perc	15	11	$165,000.00	$104,280.00 37% off	$223.00	$156,750.00	$68,145.00	2025-01-01
27800000002-53071	CDM	Valve Aort 34mm Evolutr	15	11	$165,000.00	$104,280.00 37% off	$223.00	$156,750.00	$68,145.00	2025-01-01
27800000002-53067	CDM	Valve Aort 26mm Evolutr	15	11	$165,000.00	$104,280.00 37% off	$223.00	$156,750.00	$68,145.00	2025-01-01
27800000002-53472	CDM	Kit Mitraclip G4 Delivery Sys Ntw	15	11	$165,000.00	$104,280.00 37% off	$223.00	$156,750.00	$68,145.00	2025-01-01
27800000002-53068	CDM	Valve Aort 26mm Pro Perc	15	11	$165,000.00	$104,280.00 37% off	$223.00	$156,750.00	$68,145.00	2025-01-01
27800000002-52368	CDM	Valve Aort 23mm Evolutr	15	11	$165,000.00	$104,280.00 37% off	$223.00	$156,750.00	$68,145.00	2025-01-01
27800000002-52376	CDM	Valve Aortic 34mm Evolut Fx	15	11	$165,000.00	$104,280.00 37% off	$223.00	$156,750.00	$68,145.00	2025-01-01
27800000002-52374	CDM	Valve Aortic 29mm Evolut Fx	15	11	$165,000.00	$104,280.00 37% off	$223.00	$156,750.00	$68,145.00	2025-01-01
27800000002-53339	CDM	Kit Mitraclip G4 Syst Cds0701nt/ntw/xt/xtw	15	11	$165,000.00	$104,280.00 37% off	$223.00	$156,750.00	$68,145.00	2025-01-01
27800000002-52377	CDM	Valve Aortic 23mm Evolut Fx	15	11	$165,000.00	$104,280.00 37% off	$223.00	$156,750.00	$68,145.00	2025-01-01
27800000002-52372	CDM	Valve Aortic 26mm Evolut Fx	15	11	$165,000.00	$104,280.00 37% off	$223.00	$156,750.00	$68,145.00	2025-01-01
27800000002-52837	CDM	Kit Mitraclip 1 Mbr0201	15	11	$165,000.00	$104,280.00 37% off	$223.00	$156,750.00	$68,145.00	2025-01-01
27800000002-52840	CDM	Kit Mitraclip 2 Mbr0302	15	11	$165,000.00	$104,280.00 37% off	$223.00	$156,750.00	$68,145.00	2025-01-01
27800000002-52839	CDM	Kit Mitraclip 2 Mbr0102	15	11	$165,000.00	$104,280.00 37% off	$223.00	$156,750.00	$68,145.00	2025-01-01
'022-4	OTHER	Ventricular Shunt Procedures	3	3	—	—	$65,545.43	$75,979.05	$68,021.44	2025-01-01
'020-4	OTHER	Open Craniotomy For Trauma	3	3	—	—	$65,513.98	$75,942.60	$67,988.80	2025-01-01
A9543	HCPCS	Yttrium Y-90 Ibritumomab Tiuxetan Therapeutic Per Treatment Dose Up To 40 Millic…	32	25	$73,380.00	$46,376.16 37% off	$223.00	$147,322.31	$67,440.88	2025-01-01
'607-2	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	3	3	—	—	$64,504.75	$74,772.72	$66,941.45	2025-01-01
231	MS_DRG	Coronary Bypass With Ptca With Mcc	25	20	—	$129,324.00	$51,068.55	$159,890.00	$66,930.17	2025-01-01
'089-4	OTHER	Major Cranial Or Facial Bone Procedures	3	3	—	—	$63,756.65	$73,905.53	$66,165.08	2025-01-01
'608-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	3	3	—	—	$63,566.05	$73,684.59	$65,967.28	2025-01-01
'160-3	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	3	3	—	—	$63,460.27	$73,561.97	$65,857.51	2025-01-01
'178-3	OTHER	External Heart Assist Systems	3	3	—	—	$62,970.42	$72,994.15	$65,349.16	2025-01-01
'440-3	OTHER	Kidney Transplant	3	3	—	—	$62,432.93	$72,371.10	$64,791.36	2025-01-01
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	25	20	—	$124,163.00	$49,082.49	$153,508.00	$64,339.86	2025-01-01
'120-4	OTHER	Major Respiratory And Chest Procedures	3	3	—	—	$61,902.11	$71,755.78	$64,240.49	2025-01-01
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	21	19	—	—	$50,302.70	$138,640.59	$64,082.76	2025-01-01
'181-4	OTHER	Lower Extremity Arterial Procedures	3	3	—	—	$61,327.45	$71,089.65	$63,644.12	2025-01-01
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	25	20	—	$134,637.00	$48,526.20	$166,456.00	$63,614.30	2025-01-01
A9542	HCPCS	Indium In-111 Ibritumomab Tiuxetan Diagnostic Per Study Dose Up To 5 Millicuries	15	11	$130,400.00	$82,412.80 37% off	$223.00	$123,880.00	$63,113.60	2025-01-01
'261-4	OTHER	Major Biliary Tract Procedures	3	3	—	—	$60,455.46	$70,078.85	$62,739.19	2025-01-01
'622-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…	3	3	—	—	$60,426.87	$70,045.71	$62,709.52	2025-01-01
'792-4	OTHER	Extensive O.r. Procedures For Other Complications Of Treatment	3	3	—	—	$60,386.84	$69,999.31	$62,667.98	2025-01-01
'404-4	OTHER	Thyroid, Parathyroid And Thyroglossal Procedures	3	3	—	—	$60,046.62	$69,604.93	$62,314.91	2025-01-01
'006-1	OTHER	Pancreas Transplant	3	3	—	—	$60,025.65	$69,580.63	$62,293.15	2025-01-01
'009-2	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	3	3	—	—	$60,005.64	$69,557.43	$62,272.38	2025-01-01
'009-1	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	3	3	—	—	$60,005.64	$69,557.43	$62,272.38	2025-01-01
'609-2	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	3	3	—	—	$59,937.98	$69,479.00	$62,202.16	2025-01-01
'609-1	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	3	3	—	—	$59,937.98	$69,479.00	$62,202.16	2025-01-01
338	MS_DRG	Appendectomy W Complicated Principal Diag W Mcc	2	1	—	$54,974.00	$54,974.00	$67,966.00	$61,470.00	2025-01-01
'130-4	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	3	3	—	—	$58,673.35	$68,013.06	$60,889.76	2025-01-01
'178-2	OTHER	External Heart Assist Systems	3	3	—	—	$58,529.44	$67,846.25	$60,740.42	2025-01-01
246	MS_DRG	Perc Cardiovasc Proc W Drug-eluting Stent W Mcc Or 4+ Vessels/stents	2	1	—	$54,214.00	$54,214.00	$67,028.00	$60,621.00	2025-01-01
'163-3	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	3	3	—	—	$58,206.38	$67,471.76	$60,405.15	2025-01-01
'758-4	OTHER	Behavioral Disorders	3	3	—	—	$57,877.59	$67,090.64	$60,063.94	2025-01-01
'165-3	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	3	3	—	—	$57,814.69	$67,017.73	$59,998.67	2025-01-01
'623-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	3	3	—	—	$57,561.20	$66,723.88	$59,735.60	2025-01-01
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	25	20	—	$110,237.00	$45,513.76	$136,287.00	$59,685.34	2025-01-01
'230-4	OTHER	Major Small Bowel Procedures	3	3	—	—	$57,136.16	$66,231.18	$59,294.50	2025-01-01
'841-2	OTHER	Extensive Third Degree Burns With Skin Graft	3	3	—	—	$57,096.13	$66,184.78	$59,252.96	2025-01-01
'841-1	OTHER	Extensive Third Degree Burns With Skin Graft	3	3	—	—	$57,096.13	$66,184.78	$59,252.96	2025-01-01
'030-4	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	3	3	—	—	$56,934.12	$65,996.98	$59,084.83	2025-01-01
'611-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	3	3	—	—	$56,861.69	$65,913.03	$59,009.67	2025-01-01
'026-4	OTHER	Other Nervous System And Related Procedures	3	3	—	—	$56,800.70	$65,842.32	$58,946.37	2025-01-01
'510-4	OTHER	Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…	3	3	—	—	$56,487.16	$65,478.88	$58,620.99	2025-01-01
'092-4	OTHER	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	3	3	—	—	$56,456.67	$65,443.53	$58,589.34	2025-01-01
'321-4	OTHER	Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures	3	3	—	—	$55,950.63	$64,856.93	$58,064.19	2025-01-01
'303-2	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	3	3	—	—	$55,705.70	$64,573.02	$57,810.01	2025-01-01
248	MS_DRG	Perc Cardiovasc Proc W Non-drug-eluting Stent W Mcc Or 4+ Ves/stents	2	1	—	$51,531.00	$51,531.00	$63,710.00	$57,620.50	2025-01-01
'176-4	OTHER	Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices	3	3	—	—	$55,400.74	$64,219.52	$57,493.53	2025-01-01
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	25	20	—	$100,302.00	$43,829.77	$128,850.65	$57,488.99	2025-01-01
'405-4	OTHER	Other Procedures For Endocrine, Nutritional And Metabolic Disorders	3	3	—	—	$55,188.23	$63,973.17	$57,272.99	2025-01-01
'740-4	OTHER	Mental Illness Diagnosis With O.r. Procedure	3	3	—	—	$55,130.09	$63,905.79	$57,212.66	2025-01-01
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	25	20	—	$82,302.00	$43,545.33	$128,014.45	$57,118.01	2025-01-01
'711-4	OTHER	Post-operative, Post-trauma, Other Device Infections With O.r. Procedure	3	3	—	—	$55,036.70	$63,797.52	$57,115.73	2025-01-01
'710-4	OTHER	Infectious And Parasitic Diseases Including HIV With O.r. Procedure	3	3	—	—	$55,010.01	$63,766.59	$57,088.04	2025-01-01
'612-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	3	3	—	—	$54,983.33	$63,735.66	$57,060.35	2025-01-01
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	25	20	—	$92,092.00	$43,471.70	$127,798.00	$57,021.98	2025-01-01
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	23	20	—	—	$44,275.94	$130,162.30	$56,985.47	2025-01-01
'603-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	3	3	—	—	$54,859.44	$63,592.05	$56,931.78	2025-01-01
27800000002-52890	CDM	Set Pump Impella Cp	15	11	$137,500.00	$86,900.00 37% off	$223.00	$130,625.00	$56,787.50	2025-01-01
27800000002-52891	CDM	Set Pump Impella Cp	15	11	$137,500.00	$86,900.00 37% off	$223.00	$130,625.00	$56,787.50	2025-01-01
27800000002-52892	CDM	Set Pump Impella Cp	15	11	$137,500.00	$86,900.00 37% off	$223.00	$130,625.00	$56,787.50	2025-01-01
27800000002-52893	CDM	Set Pump Impella Cp	15	11	$137,500.00	$86,900.00 37% off	$223.00	$130,625.00	$56,787.50	2025-01-01
27800000002-52896	CDM	Set Pump Impella Rp	15	11	$137,500.00	$86,900.00 37% off	$223.00	$130,625.00	$56,787.50	2025-01-01
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	25	20	—	$94,147.00	$43,248.93	$127,143.10	$56,731.43	2025-01-01
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	25	20	—	$87,884.00	$43,136.28	$126,811.95	$56,584.52	2025-01-01
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	25	20	—	$84,265.00	$42,908.48	$126,142.25	$56,287.40	2025-01-01
'304-3	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	3	3	—	—	$53,879.76	$62,456.42	$55,915.09	2025-01-01
'182-4	OTHER	Other Peripheral Vascular And Related Procedures	3	3	—	—	$53,010.62	$61,448.93	$55,013.12	2025-01-01
'440-2	OTHER	Kidney Transplant	3	3	—	—	$52,875.29	$61,292.07	$54,872.68	2025-01-01
'183-3	OTHER	Percutaneous Structural Cardiac Procedures	3	3	—	—	$52,843.85	$61,255.61	$54,840.05	2025-01-01
27800000002-52402	CDM	Valve Sapien Thv Edwards Resilia 29mm	15	11	$132,600.00	$83,803.20 37% off	$223.00	$125,970.00	$54,763.80	2025-01-01
459	MS_DRG	Spinal Fusion Except Cervical With Mcc	25	20	—	$112,309.00	$41,736.73	$138,852.00	$54,759.15	2025-01-01
'162-2	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	3	3	—	—	$52,736.16	$61,130.78	$54,728.29	2025-01-01
C1824	HCPCS	Kit Ipg Optimizer Smart Mini	28	11	$143,000.00	$90,376.00 37% off	$223.00	$135,850.00	$54,697.50	2025-01-01
'179-3	OTHER	Defibrillator Implants	3	3	—	—	$52,522.68	$60,883.33	$54,506.75	2025-01-01
'008-2	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	3	3	—	—	$52,394.98	$60,735.30	$54,374.23	2025-01-01
'121-4	OTHER	Other Respiratory And Chest Procedures	3	3	—	—	$52,327.32	$60,656.86	$54,304.01	2025-01-01
'029-4	OTHER	Other Percutaneous Intracranial Procedures	3	3	—	—	$52,308.26	$60,634.77	$54,284.23	2025-01-01
'511-4	OTHER	Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy	3	3	—	—	$52,162.45	$60,465.75	$54,132.91	2025-01-01
'613-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	3	3	—	—	$52,070.01	$60,358.59	$54,036.98	2025-01-01
'167-3	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	3	3	—	—	$51,734.55	$59,969.74	$53,688.85	2025-01-01
'634-4	OTHER	Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…	3	3	—	—	$50,933.08	$59,040.69	$52,857.10	2025-01-01
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	25	20	—	$109,054.00	$40,056.51	$134,829.00	$52,567.73	2025-01-01
'170-4	OTHER	Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock	3	3	—	—	$50,563.32	$58,612.06	$52,473.37	2025-01-01
27800000002-53327	CDM	Valve Sapien 3 Ultra Thv 20mm W/command System	15	11	$126,750.00	$80,106.00 37% off	$223.00	$120,412.50	$52,347.75	2025-01-01
27800000002-53336	CDM	Valve Sapien 3 Ultra Thv 26mm W/command System	15	11	$126,750.00	$80,106.00 37% off	$223.00	$120,412.50	$52,347.75	2025-01-01
27800000002-53334	CDM	Valve Sapien 3 Ultra Thv 26mm W/command System	15	11	$126,750.00	$80,106.00 37% off	$223.00	$120,412.50	$52,347.75	2025-01-01
27800000002-53332	CDM	Valve Sapien 3 Ultra Thv 23mm W/command System	15	11	$126,750.00	$80,106.00 37% off	$223.00	$120,412.50	$52,347.75	2025-01-01
27800000002-53331	CDM	Valve Sapien 3 Ultra Thv 23mm W/command System	15	11	$126,750.00	$80,106.00 37% off	$223.00	$120,412.50	$52,347.75	2025-01-01
27800000002-53130	CDM	Valve Sapien 3 Thv 29mm W/command System	15	11	$126,750.00	$80,106.00 37% off	$223.00	$120,412.50	$52,347.75	2025-01-01
27800000002-53335	CDM	Valve Sapien 3 Ultra Thv 26mm W/command System	15	11	$126,750.00	$80,106.00 37% off	$223.00	$120,412.50	$52,347.75	2025-01-01
27800000002-53328	CDM	Valve Sapien 3 Ultra Thv 20mm W/command System	15	11	$126,750.00	$80,106.00 37% off	$223.00	$120,412.50	$52,347.75	2025-01-01
27800000002-53129	CDM	Valve Sapien 3 Thv 29mm W/command System	15	11	$126,750.00	$80,106.00 37% off	$223.00	$120,412.50	$52,347.75	2025-01-01
27800000002-53330	CDM	Valve Sapien 3 Ultra Thv 23mm W/command System	15	11	$126,750.00	$80,106.00 37% off	$223.00	$120,412.50	$52,347.75	2025-01-01
'447-4	OTHER	Other Kidney, Urinary Tract And Related Procedures	3	3	—	—	$50,426.08	$58,452.99	$52,330.95	2025-01-01
'863-3	OTHER	Neonatal Aftercare	3	3	—	—	$50,358.42	$58,374.55	$52,260.73	2025-01-01
'231-4	OTHER	Major Large Bowel Procedures	3	3	—	—	$50,070.62	$58,040.93	$51,962.06	2025-01-01
'073-4	OTHER	Orbit And Eye Procedures	3	3	—	—	$49,964.83	$57,918.31	$51,852.28	2025-01-01
'514-4	OTHER	Female Reproductive System Reconstructive Procedures	3	3	—	—	$49,832.37	$57,764.76	$51,714.81	2025-01-01
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	25	20	—	$112,628.00	$39,306.39	$139,243.00	$51,589.39	2025-01-01
'951-4	OTHER	Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis	3	3	—	—	$49,593.16	$57,487.48	$51,466.57	2025-01-01
'222-4	OTHER	Other Stomach, Esophageal And Duodenal Procedures	3	3	—	—	$49,545.51	$57,432.24	$51,417.12	2025-01-01
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	25	20	—	$61,207.00	$39,130.19	$115,034.85	$51,359.57	2025-01-01
'690-3	OTHER	Acute Leukemia	3	3	—	—	$49,306.31	$57,154.96	$51,168.88	2025-01-01
'178-1	OTHER	External Heart Assist Systems	3	3	—	—	$49,230.07	$57,066.59	$51,089.76	2025-01-01
'403-4	OTHER	Procedures For Obesity	3	3	—	—	$49,142.39	$56,964.96	$50,998.77	2025-01-01
'309-4	OTHER	Other Significant Hip And Femur Surgery	3	3	—	—	$49,036.61	$56,842.33	$50,888.99	2025-01-01
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	25	20	—	$114,043.00	$38,647.52	$140,998.00	$50,730.06	2025-01-01
'614-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	3	3	—	—	$48,855.54	$56,632.44	$50,701.08	2025-01-01
454	MS_DRG	Combined Anterior And Posterior Spinal Fusion With Cc	25	20	—	$133,930.00	$38,489.57	$165,583.00	$50,524.04	2025-01-01
276	MS_DRG	Cardiac Defibrillator Implant With Mcc	23	20	—	—	$39,080.48	$114,888.70	$50,335.96	2025-01-01
'325-4	OTHER	Non-elective Or Complex Knee Joint Replacement	3	3	—	—	$48,490.54	$56,209.34	$50,322.29	2025-01-01
955	MS_DRG	Craniotomy For Multiple Significant Trauma	25	20	—	$93,038.00	$38,325.32	$115,026.00	$50,309.83	2025-01-01
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	25	20	—	$110,215.00	$38,231.56	$136,262.00	$50,187.54	2025-01-01
'650-4	OTHER	Splenectomy	3	3	—	—	$48,265.63	$55,948.63	$50,088.89	2025-01-01
'315-4	OTHER	Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement	3	3	—	—	$48,248.48	$55,928.75	$50,071.09	2025-01-01
'264-4	OTHER	Other Hepatobiliary, Pancreas And Abdominal Procedures	3	3	—	—	$48,146.51	$55,810.54	$49,965.26	2025-01-01
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	25	20	—	$98,291.00	$38,051.58	$121,519.00	$49,952.80	2025-01-01
28	MS_DRG	Spinal Procedures With Mcc	25	20	—	$96,230.00	$37,921.95	$118,972.00	$49,783.72	2025-01-01
'440-1	OTHER	Kidney Transplant	3	3	—	—	$47,851.08	$55,468.09	$49,658.67	2025-01-01
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	21	19	—	—	$38,871.55	$107,289.77	$49,591.71	2025-01-01
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	21	19	—	—	$38,871.55	$107,289.77	$49,591.71	2025-01-01
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	23	19	—	$85,168.00	$46,327.41	$111,001.85	$49,570.33	2025-01-01
'050-4	OTHER	Non-bacterial Infections Of Nervous System Except Viral Meningitis	3	3	—	—	$47,759.59	$55,362.04	$49,563.73	2025-01-01
'636-4	OTHER	Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection	3	3	—	—	$47,571.85	$55,144.41	$49,368.90	2025-01-01
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	25	20	—	$98,160.00	$37,434.24	$121,357.00	$49,147.64	2025-01-01
'842-3	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	3	3	—	—	$47,293.57	$54,821.84	$49,080.11	2025-01-01
'623-3	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	3	3	—	—	$47,203.99	$54,718.00	$48,987.14	2025-01-01
'166-3	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	3	3	—	—	$47,112.50	$54,611.94	$48,892.20	2025-01-01
'310-4	OTHER	Vertebral And Intervertebral Spinal Procedures Including Disc Procedures	3	3	—	—	$46,994.33	$54,474.96	$48,769.56	2025-01-01
'229-4	OTHER	Other Digestive System And Abdominal Procedures	3	3	—	—	$46,940.96	$54,413.10	$48,714.18	2025-01-01
'793-4	OTHER	Moderately Extensive O.r. Procedures For Other Complications Of Treatment	3	3	—	—	$46,903.80	$54,370.01	$48,675.61	2025-01-01
'024-4	OTHER	Open Extracranial Vascular Procedures	3	3	—	—	$46,871.39	$54,332.46	$48,641.98	2025-01-01
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	25	20	—	$99,641.00	$37,006.32	$123,190.00	$48,589.52	2025-01-01
'444-4	OTHER	Renal Dialysis Access Device Procedures	3	3	—	—	$46,763.71	$54,207.62	$48,530.23	2025-01-01
'305-4	OTHER	Amputation Of Lower Limb Except Toes	3	3	—	—	$46,704.62	$54,139.13	$48,468.91	2025-01-01

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