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

ST LUKE'S HOSPITAL - MONROE CAMPUS

Stroudsburg, PA · CCN 390330 · Rates published

20,685 distinct procedures filed
14 distinct payers
436,443 rate rows
2026-02-27 last MRF observed
Data quality

435,511 of 436,443 rate rows are consumer-grade (99.8%)

932 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 550
per-diem day rate — not a per-procedure price 137
template filing: same amount across many unrelated codes — excluded 101
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 88
exceeds 10× this hospital's gross charge — excluded from medians 56
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.slhn.org/-/media/sluhn/billing/pdf/standard-charges/46-5143606_stlukeshospitalmonroecampus_standardcharges.ashx
Found on page https://www.slhn.org/billpay/patient-billing/price-transparency
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 5209ee97d01fa11c… · 259,393,549 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
5834
APR_DRG 		Apr-DRG 42.00: Neonate With Ecmo 5 $442,589.20 $555,248.42 $462,706.61 nat. median
$309,665
1.5× median
18
MS_DRG 		Ms-DRG 43.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 9 $327,997.21 $882,296.72 $342,757.08 nat. median
$370,174
0.9× median
37660
CDM 		Bicol Collagen Sponge 9 $181,811.92 $832,070.11 $315,477.35 nat. median
$0
5884
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight < 1500 Grams With Major Procedure 5 $271,077.51 $340,079.15 $283,399.04 nat. median
$246,434
1.1× median
71459
CDM 		Heartmate Iii Kit Implant 11 $107,956.77 $760,105.89 $281,015.68 nat. median
$107,957
outlier · 2.6×
114
APR_DRG 		Apr-DRG 42.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 $253,412.42 $317,917.49 $264,931.01 nat. median
$117,173
outlier · 2.3×
24
APR_DRG 		Apr-DRG 42.00: Heart And/or Lung Transplant 5 $253,244.56 $317,706.90 $264,755.51 nat. median
$234,729
1.1× median
5833
APR_DRG 		Apr-DRG 42.00: Neonate With Ecmo 5 $252,068.80 $316,231.85 $263,526.31 nat. median
$244,017
1.1× median
1
MS_DRG 		Ms-DRG 43.00: Heart Transplant Or Implant Of Heart Assist System With Mcc 10 $213,057.83 $572,575.08 $223,710.72 nat. median
$265,286
0.8× median
5832
APR_DRG 		Apr-DRG 42.00: Neonate With Ecmo 5 $193,542.66 $242,808.13 $202,339.93 nat. median
$156,126
1.3× median
1614
APR_DRG 		Apr-DRG 42.00: Implantable Heart Assist Systems 5 $188,983.09 $237,087.94 $197,573.11 nat. median
$207,730
1.0× median
6094
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 $188,866.88 $236,942.15 $197,451.61 nat. median
$162,982
1.2× median
113
APR_DRG 		Apr-DRG 42.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 $188,592.84 $236,598.36 $197,165.13 nat. median
$60,831
outlier · 3.2×
94
APR_DRG 		Apr-DRG 42.00: Extracorporeal Membrane Oxygenation (ecmo) 5 $185,264.27 $232,422.52 $193,685.26 nat. median
$164,834
1.2× median
6314
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight > 2499 Grams With Other Major Procedure 5 $181,655.93 $227,895.69 $189,912.91 nat. median
$122,924
1.5× median
5883
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight < 1500 Grams With Major Procedure 5 $180,537.56 $226,492.64 $188,743.70 nat. median
$182,665
1.0× median
5914
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight 500-749 Grams Without Major Procedure 5 $177,759.21 $223,007.07 $185,839.06 nat. median
$164,289
1.1× median
5831
APR_DRG 		Apr-DRG 42.00: Neonate With Ecmo 5 $173,728.34 $217,950.17 $181,624.98 nat. median
$144,745
1.3× median
8414
APR_DRG 		Apr-DRG 42.00: Extensive Third Degree Burns With Skin Graft 5 $168,104.93 $210,895.33 $175,745.95 nat. median
$160,267
1.1× median
927
MS_DRG 		Ms-DRG 43.00: Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Ski… 10 $162,458.05 $376,559.76 $173,017.82 nat. median
$206,474
0.8× median
6304
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight > 2499 Grams With Major Cardiovascular Proce… 5 $164,743.36 $206,678.09 $172,231.59 nat. median
$150,721
1.1× median
3
MS_DRG 		Ms-DRG 43.00: Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Exce… 10 $161,508.00 $433,666.28 $172,006.02 nat. median
$202,976
0.8× median
5934
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight 750-999 Grams Without Major Procedure 5 $156,284.92 $196,066.59 $163,388.68 nat. median
$151,838
1.1× median
5882
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight < 1500 Grams With Major Procedure 5 $154,700.98 $194,079.47 $161,732.75 nat. median
$145,336
1.1× median
112
APR_DRG 		Apr-DRG 42.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 $149,929.08 $188,092.89 $156,743.94 nat. median
$58,674
outlier · 2.7×
74
APR_DRG 		Apr-DRG 42.00: Allogeneic Bone Marrow Transplant 5 $149,100.52 $187,053.43 $155,877.72 nat. median
$187,061
0.8× median
1613
APR_DRG 		Apr-DRG 42.00: Implantable Heart Assist Systems 5 $147,977.85 $185,644.99 $154,704.02 nat. median
$119,796
1.3× median
44
APR_DRG 		Apr-DRG 42.00: Tracheostomy With Mv >96 Hours With Extensive Procedure 5 $142,377.39 $178,618.95 $148,848.99 nat. median
$105,658
1.4× median
14
APR_DRG 		Apr-DRG 42.00: Liver Transplant And/or Intestinal Transplant 5 $140,961.31 $176,842.42 $147,368.55 nat. median
$129,535
1.1× median
23
APR_DRG 		Apr-DRG 42.00: Heart And/or Lung Transplant 5 $137,946.95 $173,060.76 $144,217.17 nat. median
$93,528
1.5× median
5913
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight 500-749 Grams Without Major Procedure 5 $134,061.70 $168,186.55 $140,155.33 nat. median
$102,919
1.4× median
5881
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight < 1500 Grams With Major Procedure 5 $132,601.15 $166,354.22 $138,628.39 nat. median
$124,573
1.1× median
5892
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams A… 5 $126,359.36 $158,523.61 $132,102.89 nat. median
$89,796
1.5× median
5893
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams A… 5 $126,359.36 $158,523.61 $132,102.89 nat. median
$69,788
1.9× median
5891
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams A… 5 $126,359.36 $158,523.61 $132,102.89 nat. median
$93,370
1.4× median
93
APR_DRG 		Apr-DRG 42.00: Extracorporeal Membrane Oxygenation (ecmo) 5 $124,509.28 $156,202.60 $130,168.72 nat. median
$78,990
1.6× median
453
MS_DRG 		Combined Anterior/posterior Spinal Fusion W Mcc 1 $126,423.52 $126,423.52 $126,423.52 nat. median
$87,428
1.4× median
6024
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Sy… 5 $117,734.50 $147,703.32 $123,085.99 nat. median
$118,620
1.0× median
5912
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight 500-749 Grams Without Major Procedure 5 $114,986.28 $144,255.55 $120,212.85 nat. median
$81,294
1.5× median
5933
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight 750-999 Grams Without Major Procedure 5 $114,327.02 $143,428.48 $119,523.63 nat. median
$108,996
1.1× median
140985
CDM 		Dvc Heart Assist Impella 5.5 S2 11 $45,015.75 $316,948.50 $117,177.75 nat. median
$116,878
1.0× median
1611
APR_DRG 		Apr-DRG 42.00: Implantable Heart Assist Systems 5 $108,882.94 $136,598.64 $113,832.10 nat. median
$76,806
1.5× median
1612
APR_DRG 		Apr-DRG 42.00: Implantable Heart Assist Systems 5 $108,882.94 $136,598.64 $113,832.10 nat. median
$85,444
1.3× median
1604
APR_DRG 		Apr-DRG 42.00: Major Cardiothoracic Repair Of Heart Anomaly 5 $108,486.24 $136,100.96 $113,417.36 nat. median
$97,957
1.2× median
4
MS_DRG 		Ms-DRG 43.00: Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face,… 10 $105,597.60 $283,007.23 $112,461.45 nat. median
$133,161
0.8× median
156878
CDM 		Valve Tricuspid Evoque 52mm Rplcmnt Sys 11 $43,015.05 $302,861.90 $111,969.85 nat. median
$111,806
1.0× median
156879
CDM 		Valve Tricuspid Evoque 56mm Rplcmnt Sys 11 $43,015.05 $302,861.90 $111,969.85 nat. median
$111,806
1.0× median
156876
CDM 		Valve Tricuspid Evoque 44mm Rplcmnt Sys 11 $43,015.05 $302,861.90 $111,969.85 nat. median
$111,806
1.0× median
156877
CDM 		Valve Tricuspid Evoque 48mm Rplcmnt Sys 11 $43,015.05 $302,861.90 $111,969.85 nat. median
$111,806
1.0× median
222
MS_DRG 		Cardiac Defib Implant W Cardiac Cath W Ami/hf/shock W Mcc 1 $110,215.26 $110,215.26 $110,215.26 nat. median
$63,570
1.7× median

Other procedures at this hospital

Browse this hospital's 20,685 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
             
0915T CPT Hb Insj Perm Ccm-d Sys Pg&dual Transvns Eltrds/lds 22 12 $201,311.00 $167,088.13 $13,448.00 $149,251.98 $43,844.71 2026-02-27
1 MS_DRG Ms-DRG 43.00: Heart Transplant Or Implant Of Heart Assist System With Mcc 15 10 — — $213,057.83 $572,575.08 $223,710.72 2026-02-27
10 MS_DRG Ms-DRG 43.00: Pancreas Transplant 14 10 — — $46,475.22 $62,723.18 $55,805.10 2026-02-27
104115 CDM Valve Trancath Aortic Evolut Fx 23mm 15 11 $299,250.00 $248,377.50 $31,511.03 $221,863.95 $82,024.43 2026-02-27
104116 CDM Valve Trancath Aortic Evolut Fx 26mm 15 11 $299,250.00 $248,377.50 $31,511.03 $221,863.95 $82,024.43 2026-02-27
104117 CDM Valve Trancath Aortic Evolut Fx 29mm 15 11 $299,250.00 $248,377.50 $31,511.03 $221,863.95 $82,024.43 2026-02-27
104118 CDM Valve Trancath Aortic Evolut Fx 34mm 15 11 $299,250.00 $248,377.50 $31,511.03 $221,863.95 $82,024.43 2026-02-27
11 APR_DRG Apr-DRG 42.00: Liver Transplant And/or Intestinal Transplant 5 5 — — $49,686.78 $62,334.35 $51,945.24 2026-02-27
11 MS_DRG Ms-DRG 43.00: Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Wi… 16 10 — — $41,926.71 $111,436.37 $44,651.95 2026-02-27
111 APR_DRG Apr-DRG 42.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 5 — — $73,840.43 $92,636.20 $77,196.76 2026-02-27
112 APR_DRG Apr-DRG 42.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 5 — — $149,929.08 $188,092.89 $156,743.94 2026-02-27
113 APR_DRG Apr-DRG 42.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 5 — — $188,592.84 $236,598.36 $197,165.13 2026-02-27
114 APR_DRG Apr-DRG 42.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 5 — — $253,412.42 $317,917.49 $264,931.01 2026-02-27
12 APR_DRG Apr-DRG 42.00: Liver Transplant And/or Intestinal Transplant 5 5 — — $56,556.98 $70,953.32 $59,127.71 2026-02-27
1204 APR_DRG Apr-DRG 42.00: Major Respiratory And Chest Procedures 5 5 — — $44,341.70 $55,628.70 $46,357.21 2026-02-27
122837 CDM Stent Tag Thoracic Endoproth 45 X 8mm X 15cm 26fr 15 11 $304,000.00 $252,320.00 $32,011.20 $225,385.60 $83,326.40 2026-02-27
13 APR_DRG Apr-DRG 42.00: Liver Transplant And/or Intestinal Transplant 5 5 — — $73,184.04 $91,812.73 $76,510.54 2026-02-27
1304 APR_DRG Apr-DRG 42.00: Respiratory System Diagnosis With Ventilator Support > 96 Hours 5 5 — — $43,820.18 $54,974.42 $45,811.98 2026-02-27
132134 CDM Graft Stent Thoracic Valiant Proximal Freeflo Str 28x28x150mm 15 11 $173,593.50 $144,082.60 $18,279.40 $128,702.22 $47,581.98 2026-02-27
132138 CDM Graft Stent Thoracic Valiant Proximal Freeflo Str 30x30x150mm 15 11 $173,593.50 $144,082.60 $18,279.40 $128,702.22 $47,581.98 2026-02-27
132810 CDM Pascal Precision Sys W/pascal Imlant-guide Sheath-stabilizer 15 11 $290,700.00 $241,281.00 $30,610.71 $215,524.98 $79,680.87 2026-02-27
132811 CDM Pascal Precision Sys W/pascal Ace Imlant-guide Sheath-stabilizer 15 11 $290,700.00 $241,281.00 $30,610.71 $215,524.98 $79,680.87 2026-02-27
136402 CDM Stent Tag Thoracic Endoproth 26 X 8mm X 10cm 20fr 15 11 $304,000.00 $252,320.00 $32,011.20 $225,385.60 $83,326.40 2026-02-27
14 APR_DRG Apr-DRG 42.00: Liver Transplant And/or Intestinal Transplant 5 5 — — $140,961.31 $176,842.42 $147,368.55 2026-02-27
14 MS_DRG Ms-DRG 43.00: Allogeneic Bone Marrow Transplant 14 10 — — $91,695.45 $245,545.77 $95,821.74 2026-02-27
140985 CDM Dvc Heart Assist Impella 5.5 S2 15 11 $427,500.00 $354,825.00 $45,015.75 $316,948.50 $117,177.75 2026-02-27
142606 CDM Device Emb 5 X 25mm Pipeline Vantage 15 11 $159,676.00 $132,531.08 $16,813.88 $118,383.79 $43,767.19 2026-02-27
144719 CDM Stent Tag Conformable W/active Cntrl 21 X 21mm X 10cm 15 11 $189,715.00 $157,463.45 $19,976.99 $140,654.70 $52,000.88 2026-02-27
144937 CDM Graft Stent Thoracic Valiant Proximal Freeflo Str 44x40x150mm 15 11 $173,593.50 $144,082.60 $18,279.40 $128,702.22 $47,581.98 2026-02-27
146454 CDM Stent Tag Thoracic Endoproth 37 X 8mm X 15cm 24fr 15 11 $304,000.00 $252,320.00 $32,011.20 $225,385.60 $83,326.40 2026-02-27
149130 CDM Pump Set Impella Cp W/companion Sheath Bundle 15 11 $237,500.00 $197,125.00 $25,008.75 $176,082.50 $65,098.75 2026-02-27
152433 CDM Graft Stent Thoracic Valiant Proximal Freeflo Str 30x26x150mm 15 11 $173,593.50 $144,082.60 $18,279.40 $128,702.22 $47,581.98 2026-02-27
154798 CDM Device Emb 5 X 40mm Pipeline Vantage 15 11 $159,676.00 $132,531.08 $16,813.88 $118,383.79 $43,767.19 2026-02-27
156602 CDM Valve Trancath Aortic Evfxplus-23 15 11 $299,250.00 $248,377.50 $31,511.03 $221,863.95 $82,024.43 2026-02-27
156603 CDM Valve Trancath Aortic Evfxplus-26 15 11 $299,250.00 $248,377.50 $31,511.03 $221,863.95 $82,024.43 2026-02-27
156604 CDM Valve Trancath Aortic Evfxplus-29 15 11 $299,250.00 $248,377.50 $31,511.03 $221,863.95 $82,024.43 2026-02-27
156605 CDM Valve Trancath Aortic Evfxplus-34 15 11 $299,250.00 $248,377.50 $31,511.03 $221,863.95 $82,024.43 2026-02-27
156876 CDM Valve Tricuspid Evoque 44mm Rplcmnt Sys 15 11 $408,500.00 $339,055.00 $43,015.05 $302,861.90 $111,969.85 2026-02-27
156877 CDM Valve Tricuspid Evoque 48mm Rplcmnt Sys 15 11 $408,500.00 $339,055.00 $43,015.05 $302,861.90 $111,969.85 2026-02-27
156878 CDM Valve Tricuspid Evoque 52mm Rplcmnt Sys 15 11 $408,500.00 $339,055.00 $43,015.05 $302,861.90 $111,969.85 2026-02-27
156879 CDM Valve Tricuspid Evoque 56mm Rplcmnt Sys 15 11 $408,500.00 $339,055.00 $43,015.05 $302,861.90 $111,969.85 2026-02-27
16 MS_DRG Ms-DRG 43.00: Autologous Bone Marrow Transplant With Cc/mcc 14 10 — — $45,532.86 $121,153.67 $47,581.83 2026-02-27
1603 APR_DRG Apr-DRG 42.00: Major Cardiothoracic Repair Of Heart Anomaly 5 5 — — $50,283.63 $63,083.12 $52,569.22 2026-02-27
1604 APR_DRG Apr-DRG 42.00: Major Cardiothoracic Repair Of Heart Anomaly 5 5 — — $108,486.24 $136,100.96 $113,417.36 2026-02-27
1611 APR_DRG Apr-DRG 42.00: Implantable Heart Assist Systems 5 5 — — $108,882.94 $136,598.64 $113,832.10 2026-02-27
1612 APR_DRG Apr-DRG 42.00: Implantable Heart Assist Systems 5 5 — — $108,882.94 $136,598.64 $113,832.10 2026-02-27
1613 APR_DRG Apr-DRG 42.00: Implantable Heart Assist Systems 5 5 — — $147,977.85 $185,644.99 $154,704.02 2026-02-27
1614 APR_DRG Apr-DRG 42.00: Implantable Heart Assist Systems 5 5 — — $188,983.09 $237,087.94 $197,573.11 2026-02-27
1623 APR_DRG Apr-DRG 42.00: Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 5 5 — — $53,331.71 $66,907.07 $55,755.84 2026-02-27
1624 APR_DRG Apr-DRG 42.00: Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 5 5 — — $72,907.14 $91,465.34 $76,221.05 2026-02-27
1633 APR_DRG Apr-DRG 42.00: Cardiac Valve Procedures Without Ami Or Complex Principal Diagnos… 5 5 — — $45,863.23 $57,537.53 $47,947.90 2026-02-27
1634 APR_DRG Apr-DRG 42.00: Cardiac Valve Procedures Without Ami Or Complex Principal Diagnos… 5 5 — — $63,796.62 $80,035.78 $66,696.42 2026-02-27
1653 APR_DRG Apr-DRG 42.00: Coronary Bypass With Ami Or Complex Principal Diagnosis 5 5 — — $42,591.34 $53,432.78 $44,527.28 2026-02-27
1654 APR_DRG Apr-DRG 42.00: Coronary Bypass With Ami Or Complex Principal Diagnosis 5 5 — — $57,314.51 $71,903.68 $59,919.68 2026-02-27
1664 APR_DRG Apr-DRG 42.00: Coronary Bypass Without Ami Or Complex Principal Diagnosis 5 5 — — $51,095.69 $64,101.88 $53,418.18 2026-02-27
1674 APR_DRG Apr-DRG 42.00: Other Cardiothoracic And Thoracic Circulatory Procedures 5 5 — — $56,157.41 $70,452.04 $58,709.98 2026-02-27
1694 APR_DRG Apr-DRG 42.00: Major Abdominal Vascular Procedures 5 5 — — $45,555.48 $57,151.44 $47,626.16 2026-02-27
172644 CDM Botulism Immune Globulin Human 100 Mg IV Solr 13 9 $303,117.00 $251,587.11 $49,104.95 $224,730.94 $85,206.19 2026-02-27
175826 CDM Graft Stent Thoracic Valiant Closed Web Str 34x34x150mm 15 11 $166,554.00 $138,239.82 $17,538.14 $123,483.14 $45,652.45 2026-02-27
1783 APR_DRG Apr-DRG 42.00: External Heart Assist Devices 5 5 — — $48,950.05 $61,410.08 $51,175.02 2026-02-27
1784 APR_DRG Apr-DRG 42.00: External Heart Assist Devices 5 5 — — $60,665.32 $76,107.42 $63,422.80 2026-02-27
179359 CDM Graft Endovascular Excluder Tambe 31 X 20 X 160mm 22fr 15 11 $275,500.00 $228,665.00 $29,010.15 $204,255.70 $75,514.55 2026-02-27
179360 CDM Graft Endovascular Excluder Tambe 37 X 20 X160mm 22fr 15 11 $275,500.00 $228,665.00 $29,010.15 $204,255.70 $75,514.55 2026-02-27
1794 APR_DRG Apr-DRG 42.00: Defibrillator Implants 5 5 — — $50,429.25 $63,265.81 $52,721.46 2026-02-27
18 MS_DRG Ms-DRG 43.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 14 9 — — $327,997.21 $882,296.72 $342,757.08 2026-02-27
180373 CDM Stent Tag Thoracic Endoproth 40 X 8mm X 15cm 26fr 15 11 $304,000.00 $252,320.00 $32,011.20 $225,385.60 $83,326.40 2026-02-27
1834 APR_DRG Apr-DRG 42.00: Percutaneous Structural Cardiac Procedures 5 5 — — $54,599.29 $68,497.31 $57,081.04 2026-02-27
185448 CDM Pump Set Impella Cp 15 11 $237,500.00 $197,125.00 $25,008.75 $176,082.50 $65,098.75 2026-02-27
189332 CDM Hfx Iq Ipg Kit 13 9 $247,000.00 $205,010.00 $40,014.00 $183,125.80 $69,431.70 2026-02-27
189336 CDM Senza Omnia Ipg Kit 13 9 $199,500.00 $165,585.00 $32,319.00 $147,909.30 $56,079.45 2026-02-27
19 MS_DRG Ms-DRG 43.00: Simultaneous Pancreas And Kidney Transplant With Hemodialysis 13 9 — — $54,668.78 $135,404.76 $56,855.53 2026-02-27
2 MS_DRG Ms-DRG 43.00: Heart Transplant Or Implant Of Heart Assist System Without Mcc 15 10 — — $86,493.22 $231,527.60 $90,817.88 2026-02-27
20 MS_DRG Ms-DRG 43.00: Intracranial Vascular Procedures With Principal Diagnosis Hemorrha… 16 10 — — $60,235.72 $179,068.75 $64,151.04 2026-02-27
204 APR_DRG Apr-DRG 42.00: Open Craniotomy For Trauma 5 5 — — $43,065.51 $54,027.66 $45,023.01 2026-02-27
207 MS_DRG Ms-DRG 43.00: Respiratory System Diagnosis With Ventilator Support >96 Hours 16 10 — — $49,361.92 $131,471.67 $52,570.44 2026-02-27
209 MS_DRG Ms-DRG 43.00: Complex Aortic Arch Procedures 15 9 — — $86,394.65 $245,661.64 $90,714.38 2026-02-27
21 APR_DRG Apr-DRG 42.00: Heart And/or Lung Transplant 5 5 — — $92,324.75 $115,825.62 $96,521.27 2026-02-27
212 MS_DRG Ms-DRG 43.00: Concomitant Aortic And Mitral Valve Procedures 15 9 — — $83,022.80 $230,149.83 $87,173.94 2026-02-27
213 MS_DRG Ms-DRG 43.00: Endovascular Abdominal Aorta With Iliac Branch Procedures 15 9 — — $43,843.51 $116,601.50 $46,035.69 2026-02-27
214 APR_DRG Apr-DRG 42.00: Open Craniotomy Except Trauma 5 5 — — $49,295.10 $61,842.96 $51,535.76 2026-02-27
215 MS_DRG Ms-DRG 43.00: Other Heart Assist System Implant 16 10 — — $76,069.06 $264,577.72 $81,013.54 2026-02-27
216 MS_DRG Ms-DRG 43.00: Cardiac Valve And Other Major Cardiothoracic Procedures With Cardi… 16 10 — — $74,748.23 $217,990.08 $79,606.86 2026-02-27
217 MS_DRG Ms-DRG 43.00: Cardiac Valve And Other Major Cardiothoracic Procedures With Cardi… 16 10 — — $50,427.99 $150,951.61 $53,705.81 2026-02-27
218 MS_DRG Ms-DRG 43.00: Cardiac Valve And Other Major Cardiothoracic Procedures With Cardi… 16 10 — — $50,427.99 $134,344.36 $53,705.81 2026-02-27
219 MS_DRG Ms-DRG 43.00: Cardiac Valve And Other Major Cardiothoracic Procedures Without Ca… 16 10 — — $58,791.28 $173,473.36 $62,612.71 2026-02-27
22 APR_DRG Apr-DRG 42.00: Heart And/or Lung Transplant 5 5 — — $104,458.24 $131,047.65 $109,206.28 2026-02-27
2204 APR_DRG Apr-DRG 42.00: Major Stomach, Esophageal And Duodenal Procedures 5 5 — — $43,675.99 $54,793.53 $45,661.23 2026-02-27
222 MS_DRG Cardiac Defib Implant W Cardiac Cath W Ami/hf/shock W Mcc 1 1 — — $110,215.26 $110,215.26 $110,215.26 2026-02-27
223 MS_DRG Cardiac Defib Implant W Cardiac Cath W Ami/hf/shock Without Mcc 1 1 — — $83,846.35 $83,846.35 $83,846.35 2026-02-27
224 MS_DRG Cardiac Defib Implant W Cardiac Cath Without Ami/hf/shock W Mcc 1 1 — — $95,449.86 $95,449.86 $95,449.86 2026-02-27
225 MS_DRG Cardiac Defib Implant W Cardiac Cath Without Ami/hf/shock Without Mcc 1 1 — — $73,769.59 $73,769.59 $73,769.59 2026-02-27
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Cath W Mcc 1 1 — — $88,431.75 $88,431.75 $88,431.75 2026-02-27
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Cath Without Mcc 1 1 — — $70,461.86 $70,461.86 $70,461.86 2026-02-27
23 APR_DRG Apr-DRG 42.00: Heart And/or Lung Transplant 5 5 — — $137,946.95 $173,060.76 $144,217.17 2026-02-27
23 MS_DRG Ms-DRG 43.00: Craniotomy With Major Device Implant Or Acute Complex Cns Principa… 16 10 — — $44,020.94 $117,079.60 $46,882.31 2026-02-27
231 MS_DRG Ms-DRG 43.00: Coronary Bypass With Ptca With Mcc 16 10 — — $64,490.14 $172,236.93 $68,682.00 2026-02-27
232 MS_DRG Ms-DRG 43.00: Coronary Bypass With Ptca Without Mcc 16 10 — — $46,540.55 $123,869.04 $49,565.68 2026-02-27
233 MS_DRG Ms-DRG 43.00: Coronary Bypass With Cardiac Catheterization Or Open Ablation With… 16 10 — — $58,540.29 $156,204.20 $62,345.40 2026-02-27
234 APR_DRG Apr-DRG 42.00: Spinal Procedures 5 5 — — $44,947.16 $56,388.27 $46,990.18 2026-02-27
234 MS_DRG Ms-DRG 43.00: Coronary Bypass With Cardiac Catheterization Or Open Ablation With… 16 10 — — $41,991.92 $111,612.08 $44,721.39 2026-02-27
235 MS_DRG Ms-DRG 43.00: Coronary Bypass Without Cardiac Catheterization With Mcc 16 10 — — $45,069.57 $122,471.63 $47,999.10 2026-02-27
24 APR_DRG Apr-DRG 42.00: Heart And/or Lung Transplant 5 5 — — $253,244.56 $317,706.90 $264,755.51 2026-02-27
2604 APR_DRG Apr-DRG 42.00: Major Pancreas, Liver And Shunt Procedures 5 5 — — $45,993.79 $57,701.32 $48,084.39 2026-02-27
2614 APR_DRG Apr-DRG 42.00: Major Biliary Tract Procedures 5 5 — — $42,766.37 $53,652.37 $44,710.27 2026-02-27
266 MS_DRG Ms-DRG 43.00: Endovascular Cardiac Valve Replacement And Supplement Procedures W… 16 10 — — $47,039.46 $198,502.54 $50,097.03 2026-02-27
268 MS_DRG Ms-DRG 43.00: Aortic And Heart Assist Procedures Except Pulsation Balloon With M… 16 10 — — $52,722.39 $140,526.98 $56,149.35 2026-02-27
275 MS_DRG Ms-DRG 43.00: Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 15 9 — — $54,636.92 $175,578.35 $57,368.77 2026-02-27
276 MS_DRG Ms-DRG 43.00: Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimu… 15 9 — — $46,115.94 $140,623.42 $48,421.74 2026-02-27
278 MS_DRG Ms-DRG 43.00: Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascul… 15 9 — — $42,776.68 $113,726.76 $44,915.51 2026-02-27
28 MS_DRG Ms-DRG 43.00: Spinal Procedures With Mcc 16 10 — — $46,128.82 $122,759.60 $49,127.19 2026-02-27
2993 APR_DRG Apr-DRG 42.00: Multiple Level Combined Anterior And Posterior Spinal Fusion Exce… 5 5 — — $48,879.75 $61,321.88 $51,101.52 2026-02-27
2994 APR_DRG Apr-DRG 42.00: Multiple Level Combined Anterior And Posterior Spinal Fusion Exce… 5 5 — — $62,509.66 $78,421.24 $65,350.97 2026-02-27
3 MS_DRG Ms-DRG 43.00: Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Exce… 16 10 — — $161,508.00 $433,666.28 $172,006.02 2026-02-27
3004 APR_DRG Apr-DRG 42.00: Single Level Combined Anterior And Posterior Spinal Fusion Except… 5 5 — — $47,687.49 $59,826.14 $49,855.07 2026-02-27
3033 APR_DRG Apr-DRG 42.00: Dorsal And Lumbar Fusion Procedure For Curvature Of Back 5 5 — — $50,352.50 $63,169.51 $52,641.21 2026-02-27
3034 APR_DRG Apr-DRG 42.00: Dorsal And Lumbar Fusion Procedure For Curvature Of Back 5 5 — — $72,554.91 $91,023.46 $75,852.82 2026-02-27
3044 APR_DRG Apr-DRG 42.00: Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 5 5 — — $51,168.86 $64,193.67 $53,494.68 2026-02-27
3124 APR_DRG Apr-DRG 42.00: Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 5 5 — — $44,186.75 $55,434.31 $46,195.21 2026-02-27
317 MS_DRG Ms-DRG 43.00: Concomitant Left Atrial Appendage Closure And Cardiac Ablation 15 9 — — $51,271.13 $154,933.73 $53,834.69 2026-02-27
3614 APR_DRG Apr-DRG 42.00: Skin Graft For Skin And Subcutaneous Tissue Diagnoses 5 5 — — $42,991.62 $53,934.96 $44,945.76 2026-02-27
37172 CDM Tavr Sapien Retroflex 3 Dlv Sys 23mm 15 11 $308,750.00 $256,262.50 $32,511.38 $228,907.25 $84,628.38 2026-02-27
37173 CDM Tavr Sapien Retroflex 3 Dlv Sys 26mm 15 11 $308,750.00 $256,262.50 $32,511.38 $228,907.25 $84,628.38 2026-02-27
37296 CDM Tavr Sapien 3 Transapical Dlv Sys 23mm 15 11 $308,750.00 $256,262.50 $32,511.38 $228,907.25 $84,628.38 2026-02-27
37297 CDM Tavr Sapien 3 Transapical Dlv Sys 26mm 15 11 $308,750.00 $256,262.50 $32,511.38 $228,907.25 $84,628.38 2026-02-27
37541 CDM Tavr Sapien Xt W/ascendra System 23mm 15 11 $308,750.00 $256,262.50 $32,511.38 $228,907.25 $84,628.38 2026-02-27
37542 CDM Tavr Sapien Xt W/ascendra System 26mm 15 11 $308,750.00 $256,262.50 $32,511.38 $228,907.25 $84,628.38 2026-02-27
37543 CDM Tavr Sapien Xt W/ascendra System 29mm 15 11 $308,750.00 $256,262.50 $32,511.38 $228,907.25 $84,628.38 2026-02-27
37544 CDM Valve Transcatheter Sapien Xt W/nova Flex System 23mm 13 9 $308,750.00 $256,262.50 $50,017.50 $228,907.25 $86,789.62 2026-02-27
37545 CDM Valve Transcatheter Sapien Xt W/nova Flex System 26mm 13 9 $308,750.00 $256,262.50 $50,017.50 $228,907.25 $86,789.62 2026-02-27
37546 CDM Valve Transcatheter Sapien Xt W/nova Flex System 29mm 13 9 $308,750.00 $256,262.50 $50,017.50 $228,907.25 $86,789.62 2026-02-27
37660 CDM Bicol Collagen Sponge 13 9 $1,122,295.80 $931,505.51 $181,811.92 $832,070.11 $315,477.35 2026-02-27
39357 CDM Tavr 26mm Corevalue Transcatheter 15 11 $285,000.00 $236,550.00 $30,010.50 $211,299.00 $78,118.50 2026-02-27
39358 CDM Tavr 29mm Corevalue Transcatheter 15 11 $285,000.00 $236,550.00 $30,010.50 $211,299.00 $78,118.50 2026-02-27
4 MS_DRG Ms-DRG 43.00: Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face,… 16 10 — — $105,597.60 $283,007.23 $112,461.45 2026-02-27
405 MS_DRG Ms-DRG 43.00: Pancreas, Liver And Shunt Procedures With Mcc 16 10 — — $42,051.06 $121,808.63 $44,784.38 2026-02-27
41 APR_DRG Apr-DRG 42.00: Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $43,407.70 $54,456.94 $45,380.75 2026-02-27
42 APR_DRG Apr-DRG 42.00: Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $62,740.66 $78,711.03 $65,592.46 2026-02-27
426 MS_DRG Ms-DRG 43.00: Multiple Level Combined Anterior And Posterior Spinal Fusion Excep… 15 9 — — $84,138.15 $254,235.83 $88,345.06 2026-02-27
427 MS_DRG Ms-DRG 43.00: Multiple Level Combined Anterior And Posterior Spinal Fusion Excep… 15 9 — — $55,305.68 $172,182.11 $58,070.96 2026-02-27
428 MS_DRG Ms-DRG 43.00: Multiple Level Combined Anterior And Posterior Spinal Fusion Excep… 15 9 — — $43,199.77 $133,531.06 $45,359.76 2026-02-27
4284 APR_DRG Apr-DRG 42.00: Genetic Disorders 5 5 — — $42,939.26 $53,869.26 $44,891.01 2026-02-27
429 MS_DRG Ms-DRG 43.00: Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 15 9 — — $68,885.59 $202,290.38 $72,329.87 2026-02-27
43 APR_DRG Apr-DRG 42.00: Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $98,179.87 $123,171.15 $102,642.53 2026-02-27
430 MS_DRG Ms-DRG 43.00: Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 15 9 — — $44,299.96 $132,679.69 $46,514.96 2026-02-27
43040 CDM Cath Impella 9fr 2.5 Flow Rate 15 11 $190,000.00 $157,700.00 $20,007.00 $140,866.00 $52,079.00 2026-02-27
44 APR_DRG Apr-DRG 42.00: Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $142,377.39 $178,618.95 $148,848.99 2026-02-27
4403 APR_DRG Apr-DRG 42.00: Kidney Transplant 5 5 — — $48,536.85 $60,891.70 $50,743.04 2026-02-27
4404 APR_DRG Apr-DRG 42.00: Kidney Transplant 5 5 — — $71,389.91 $89,561.92 $74,634.86 2026-02-27
447 MS_DRG Ms-DRG 43.00: Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-ma… 15 9 — — $51,233.98 $162,613.34 $53,795.68 2026-02-27
453 MS_DRG Combined Anterior/posterior Spinal Fusion W Mcc 1 1 — — $126,423.52 $126,423.52 $126,423.52 2026-02-27
454 MS_DRG Combined Anterior/posterior Spinal Fusion W Cc 1 1 — — $84,553.58 $84,553.58 $84,553.58 2026-02-27
455 MS_DRG Combined Anterior/posterior Spinal Fusion Without Cc/mcc 1 1 — — $66,245.57 $66,245.57 $66,245.57 2026-02-27
456 MS_DRG Ms-DRG 43.00: Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, I… 16 10 — — $64,289.20 $183,366.22 $68,468.00 2026-02-27
457 MS_DRG Ms-DRG 43.00: Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, I… 16 10 — — $45,786.10 $121,925.22 $48,762.19 2026-02-27
459 MS_DRG Spinal Fusion Except Cervical W Mcc 1 1 — — $78,633.74 $78,633.74 $78,633.74 2026-02-27
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 1 1 — — $52,522.95 $52,522.95 $52,522.95 2026-02-27
461 MS_DRG Ms-DRG 43.00: Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Wi… 16 10 — — $42,449.14 $109,526.01 $45,208.33 2026-02-27
463 MS_DRG Ms-DRG 43.00: Wound Debridement And Skin Graft Except Hand For Musculoskeletal A… 16 10 — — $43,787.40 $116,450.30 $46,633.58 2026-02-27
46610 CDM Restore Sensor System 13 9 $202,350.00 $167,950.50 $32,780.70 $150,022.29 $56,880.58 2026-02-27
5 MS_DRG Ms-DRG 43.00: Liver Transplant With Mcc Or Intestinal Transplant 14 10 — — $78,749.43 $210,660.73 $82,293.15 2026-02-27
52 APR_DRG Apr-DRG 42.00: Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 5 — — $47,996.67 $60,214.03 $50,178.31 2026-02-27
53 APR_DRG Apr-DRG 42.00: Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 5 — — $71,981.74 $90,304.39 $75,253.59 2026-02-27
54 APR_DRG Apr-DRG 42.00: Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 5 — — $99,185.62 $124,432.90 $103,693.99 2026-02-27
54438 CDM System Mitraclip Nt W/one Clip 15 11 $285,000.00 $236,550.00 $30,010.50 $211,299.00 $78,118.50 2026-02-27
54439 CDM System Mitraclip Nt W/two Clips 15 11 $285,000.00 $236,550.00 $30,010.50 $211,299.00 $78,118.50 2026-02-27
54440 CDM System Mitraclip Nt W/three Clips 15 11 $285,000.00 $236,550.00 $30,010.50 $211,299.00 $78,118.50 2026-02-27
56918 CDM Tavr Sapien 3 Cmndr Dlv Sys 26mm 15 11 $308,750.00 $256,262.50 $32,511.38 $228,907.25 $84,628.38 2026-02-27
56919 CDM Tavr Sapien 3 Cmndr Dlv Sys 29mm 15 11 $308,750.00 $256,262.50 $32,511.38 $228,907.25 $84,628.38 2026-02-27
56945 CDM Tavr Sapien 3 Cmndr Dlv Sys 23mm 15 11 $308,750.00 $256,262.50 $32,511.38 $228,907.25 $84,628.38 2026-02-27
573 MS_DRG Ms-DRG 43.00: Skin Graft For Skin Ulcer Or Cellulitis With Mcc 16 10 — — $50,246.78 $133,856.04 $52,954.64 2026-02-27
5831 APR_DRG Apr-DRG 42.00: Neonate With Ecmo 5 5 — — $173,728.34 $217,950.17 $181,624.98 2026-02-27
5832 APR_DRG Apr-DRG 42.00: Neonate With Ecmo 5 5 — — $193,542.66 $242,808.13 $202,339.93 2026-02-27
5833 APR_DRG Apr-DRG 42.00: Neonate With Ecmo 5 5 — — $252,068.80 $316,231.85 $263,526.31 2026-02-27
5834 APR_DRG Apr-DRG 42.00: Neonate With Ecmo 5 5 — — $442,589.20 $555,248.42 $462,706.61 2026-02-27
5881 APR_DRG Apr-DRG 42.00: Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $132,601.15 $166,354.22 $138,628.39 2026-02-27
5882 APR_DRG Apr-DRG 42.00: Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $154,700.98 $194,079.47 $161,732.75 2026-02-27
5883 APR_DRG Apr-DRG 42.00: Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $180,537.56 $226,492.64 $188,743.70 2026-02-27
5884 APR_DRG Apr-DRG 42.00: Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $271,077.51 $340,079.15 $283,399.04 2026-02-27
5891 APR_DRG Apr-DRG 42.00: Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams A… 5 5 — — $126,359.36 $158,523.61 $132,102.89 2026-02-27
5892 APR_DRG Apr-DRG 42.00: Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams A… 5 5 — — $126,359.36 $158,523.61 $132,102.89 2026-02-27
5893 APR_DRG Apr-DRG 42.00: Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams A… 5 5 — — $126,359.36 $158,523.61 $132,102.89 2026-02-27
5912 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 500-749 Grams Without Major Procedure 5 5 — — $114,986.28 $144,255.55 $120,212.85 2026-02-27
5913 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 500-749 Grams Without Major Procedure 5 5 — — $134,061.70 $168,186.55 $140,155.33 2026-02-27
5914 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 500-749 Grams Without Major Procedure 5 5 — — $177,759.21 $223,007.07 $185,839.06 2026-02-27
59204 CDM Tavr 23mm Corevalve Transcatheter 15 11 $285,000.00 $236,550.00 $30,010.50 $211,299.00 $78,118.50 2026-02-27
59205 CDM Tavr 31mm Corevalue Transcatheter 15 11 $285,000.00 $236,550.00 $30,010.50 $211,299.00 $78,118.50 2026-02-27
5931 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 750-999 Grams Without Major Procedure 5 5 — — $69,982.45 $87,796.18 $73,163.42 2026-02-27
5932 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 750-999 Grams Without Major Procedure 5 5 — — $91,956.74 $115,363.94 $96,136.53 2026-02-27
5933 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 750-999 Grams Without Major Procedure 5 5 — — $114,327.02 $143,428.48 $119,523.63 2026-02-27
5934 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 750-999 Grams Without Major Procedure 5 5 — — $156,284.92 $196,066.59 $163,388.68 2026-02-27
6021 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Sy… 5 5 — — $48,658.08 $61,043.79 $50,869.78 2026-02-27
6022 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Sy… 5 5 — — $65,318.86 $81,945.50 $68,287.86 2026-02-27
6023 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Sy… 5 5 — — $81,745.06 $102,552.93 $85,460.70 2026-02-27
6024 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Sy… 5 5 — — $117,734.50 $147,703.32 $123,085.99 2026-02-27
6033 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1000-1249 Grams With Or Without Significant … 5 5 — — $48,761.38 $61,173.39 $50,977.78 2026-02-27
6034 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1000-1249 Grams With Or Without Significant … 5 5 — — $86,112.37 $108,031.92 $90,026.52 2026-02-27
6072 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Sy… 5 5 — — $46,604.27 $58,467.19 $48,722.62 2026-02-27
6073 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Sy… 5 5 — — $62,397.76 $78,280.84 $65,233.98 2026-02-27
6074 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Sy… 5 5 — — $91,009.10 $114,175.09 $95,145.82 2026-02-27
6083 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1250-1499 Grams With Or Without Significant … 5 5 — — $44,807.99 $56,213.68 $46,844.69 2026-02-27
6084 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1250-1499 Grams With Or Without Significant … 5 5 — — $51,908.46 $65,121.54 $54,267.90 2026-02-27
6092 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 5 — — $42,749.87 $53,631.67 $44,693.02 2026-02-27
6093 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 5 — — $65,516.14 $82,192.99 $68,494.10 2026-02-27
6094 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 5 — — $188,866.88 $236,942.15 $197,451.61 2026-02-27
61 APR_DRG Apr-DRG 42.00: Pancreas Transplant 5 5 — — $42,490.90 $53,306.79 $44,422.28 2026-02-27
6114 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1500-1999 Grams With Major Anomaly 5 5 — — $75,693.38 $94,960.81 $79,133.94 2026-02-27
6124 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Sy… 5 5 — — $59,626.58 $74,804.27 $62,336.84 2026-02-27
6134 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal… 5 5 — — $74,997.54 $94,087.85 $78,406.47 2026-02-27
6144 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1500-1999 Grams With Or Without Other Signif… 5 5 — — $50,041.16 $62,778.93 $52,315.73 2026-02-27
61735 CDM Valve Tavr Sapien 3 Cmndr Dlv Sys 20mm 15 11 $308,750.00 $256,262.50 $32,511.38 $228,907.25 $84,628.38 2026-02-27
62 APR_DRG Apr-DRG 42.00: Pancreas Transplant 5 5 — — $61,174.65 $76,746.40 $63,955.28 2026-02-27
6214 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 2000-2499 Grams With Major Anomaly 5 5 — — $58,474.49 $73,358.93 $61,132.39 2026-02-27
6254 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 2000-2499 Grams With Other Significant Condi… 5 5 — — $51,833.14 $65,027.04 $54,189.15 2026-02-27
63 APR_DRG Apr-DRG 42.00: Pancreas Transplant 5 5 — — $70,958.78 $89,021.04 $74,184.13 2026-02-27
6303 APR_DRG Apr-DRG 42.00: Neonate Birth Weight > 2499 Grams With Major Cardiovascular Proce… 5 5 — — $90,810.39 $113,925.80 $94,938.08 2026-02-27
6304 APR_DRG Apr-DRG 42.00: Neonate Birth Weight > 2499 Grams With Major Cardiovascular Proce… 5 5 — — $164,743.36 $206,678.09 $172,231.59 2026-02-27
6313 APR_DRG Apr-DRG 42.00: Neonate Birth Weight > 2499 Grams With Other Major Procedure 5 5 — — $53,391.25 $66,981.77 $55,818.09 2026-02-27
6314 APR_DRG Apr-DRG 42.00: Neonate Birth Weight > 2499 Grams With Other Major Procedure 5 5 — — $181,655.93 $227,895.69 $189,912.91 2026-02-27
6334 APR_DRG Apr-DRG 42.00: Neonate Birth Weight > 2499 Grams With Major Anomaly 5 5 — — $59,470.19 $74,608.08 $62,173.35 2026-02-27
64 APR_DRG Apr-DRG 42.00: Pancreas Transplant 5 5 — — $92,075.82 $115,513.34 $96,261.03 2026-02-27
64375 CDM Valve Tavr Sapien 3 Certitude Dlv Sys 26mm 15 11 $308,750.00 $256,262.50 $32,511.38 $228,907.25 $84,628.38 2026-02-27
64627 CDM Valve Tavr Sapien 3 Certitude Dlv Sys 23mm 15 11 $308,750.00 $256,262.50 $32,511.38 $228,907.25 $84,628.38 2026-02-27
66190 CDM Valve Tavr Sapien 3 Certitude Dlv Sys 29mm 15 11 $308,750.00 $256,262.50 $32,511.38 $228,907.25 $84,628.38 2026-02-27
66257 CDM Pump Set Impella Cp 15 11 $237,500.00 $197,125.00 $25,008.75 $176,082.50 $65,098.75 2026-02-27
67096 CDM Valve Tavr Sapien 3 Certitude Dlv Sys 20mm 15 11 $308,750.00 $256,262.50 $32,511.38 $228,907.25 $84,628.38 2026-02-27
6804 APR_DRG Apr-DRG 42.00: Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neopl… 5 5 — — $52,914.92 $66,384.19 $55,320.11 2026-02-27
6814 APR_DRG Apr-DRG 42.00: Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neop… 5 5 — — $44,269.97 $55,538.70 $46,282.21 2026-02-27
6904 APR_DRG Apr-DRG 42.00: Acute Leukemia 5 5 — — $47,299.40 $59,339.26 $49,449.34 2026-02-27
6954 APR_DRG Apr-DRG 42.00: Chemotherapy For Acute Leukemia 5 5 — — $43,533.23 $54,614.44 $45,511.99 2026-02-27
7 MS_DRG Ms-DRG 43.00: Lung Transplant 14 10 — — $98,764.42 $264,594.21 $103,208.82 2026-02-27
71 APR_DRG Apr-DRG 42.00: Allogeneic Bone Marrow Transplant 5 5 — — $58,949.39 $73,954.71 $61,628.87 2026-02-27
71459 CDM Heartmate Iii Kit Implant 15 11 $1,025,230.50 $850,941.32 $107,956.77 $760,105.89 $281,015.68 2026-02-27
71611 CDM Implant Peek Custom Cranial Large 15 11 $165,940.49 $137,730.61 $17,473.53 $123,028.28 $45,484.29 2026-02-27
72 APR_DRG Apr-DRG 42.00: Allogeneic Bone Marrow Transplant 5 5 — — $66,779.41 $83,777.83 $69,814.80 2026-02-27
73 APR_DRG Apr-DRG 42.00: Allogeneic Bone Marrow Transplant 5 5 — — $94,829.78 $118,968.31 $99,140.17 2026-02-27
73592 CDM Capit Watchman Laa Procedure Device 15 11 $161,500.00 $134,045.00 $17,005.95 $119,736.10 $44,267.15 2026-02-27
74 APR_DRG Apr-DRG 42.00: Allogeneic Bone Marrow Transplant 5 5 — — $149,100.52 $187,053.43 $155,877.72 2026-02-27
7404 APR_DRG Apr-DRG 42.00: Mental Illness Diagnosis With O.r. Procedure 5 5 — — $44,824.49 $56,234.38 $46,861.94 2026-02-27
77579 CDM System Mitraclip Xtr W/three Clips 15 11 $285,000.00 $236,550.00 $30,010.50 $211,299.00 $78,118.50 2026-02-27
77739 CDM System Mitraclip Xtr/ntr W/one Clip 15 11 $285,000.00 $236,550.00 $30,010.50 $211,299.00 $78,118.50 2026-02-27
77740 CDM System Mitraclip Xtr/ntr W/two Clips 15 11 $285,000.00 $236,550.00 $30,010.50 $211,299.00 $78,118.50 2026-02-27
77741 CDM System Mitraclip Xtr/ntr W/three Clips 15 11 $285,000.00 $236,550.00 $30,010.50 $211,299.00 $78,118.50 2026-02-27
78682 CDM System Mitraclip Xtr W/one Clip 15 11 $285,000.00 $236,550.00 $30,010.50 $211,299.00 $78,118.50 2026-02-27
790 MS_DRG Ms-DRG 43.00: Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 13 8 — — $45,637.48 $121,435.63 $47,201.29 2026-02-27
8 MS_DRG Ms-DRG 43.00: Simultaneous Pancreas And Kidney Transplant 14 10 — — $43,067.85 $114,511.34 $45,005.90 2026-02-27
820 MS_DRG Ms-DRG 43.00: Lymphoma And Leukemia With Major O.r. Procedures With Mcc 16 10 — — $45,040.76 $121,609.97 $47,968.41 2026-02-27
83 APR_DRG Apr-DRG 42.00: Autologous Bone Marrow Transplant 5 5 — — $46,676.01 $58,557.19 $48,797.61 2026-02-27
834 MS_DRG Ms-DRG 43.00: Acute Leukemia With Mcc 16 10 — — $42,198.14 $112,167.83 $44,941.02 2026-02-27
83623 CDM Valve Tavr Sapien 3 Ultra With Cmndr Dlv Sys 20mm 15 11 $308,750.00 $256,262.50 $32,511.38 $228,907.25 $84,628.38 2026-02-27
83624 CDM Valve Tavr Sapien 3 Ultra With Cmndr Dlv Sys 23mm 15 11 $308,750.00 $256,262.50 $32,511.38 $228,907.25 $84,628.38 2026-02-27
83625 CDM Valve Tavr Sapien 3 Ultra With Cmndr Dlv Sys 26mm 15 11 $308,750.00 $256,262.50 $32,511.38 $228,907.25 $84,628.38 2026-02-27
84 APR_DRG Apr-DRG 42.00: Autologous Bone Marrow Transplant 5 5 — — $66,315.28 $83,195.56 $69,329.57 2026-02-27
8413 APR_DRG Apr-DRG 42.00: Extensive Third Degree Burns With Skin Graft 5 5 — — $54,669.59 $68,585.51 $57,154.54 2026-02-27
8414 APR_DRG Apr-DRG 42.00: Extensive Third Degree Burns With Skin Graft 5 5 — — $168,104.93 $210,895.33 $175,745.95 2026-02-27
8424 APR_DRG Apr-DRG 42.00: Burns With Skin Graft Except Extensive Third Degree Burns 5 5 — — $94,114.57 $118,071.04 $98,392.45 2026-02-27
850 MS_DRG Ms-DRG 43.00: Acute Leukemia With Other Procedures 15 9 — — $66,231.04 $192,508.50 $69,542.59 2026-02-27
8504 APR_DRG Apr-DRG 42.00: Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Co… 5 5 — — $49,364.69 $61,930.26 $51,608.50 2026-02-27
8513 APR_DRG Apr-DRG 42.00: Gender Related Procedures 5 5 — — $86,844.80 $108,950.78 $90,792.24 2026-02-27
8514 APR_DRG Apr-DRG 42.00: Gender Related Procedures 5 5 — — $86,844.80 $108,950.78 $90,792.24 2026-02-27
85655 CDM System Mitraclip Xtr W/two Clips 15 11 $285,000.00 $236,550.00 $30,010.50 $211,299.00 $78,118.50 2026-02-27
8634 APR_DRG Apr-DRG 42.00: Neonatal Aftercare 5 5 — — $74,031.25 $92,875.59 $77,396.26 2026-02-27
870 MS_DRG Ms-DRG 43.00: Septicemia Or Severe Sepsis With Mv >96 Hours 16 10 — — $52,979.44 $141,219.62 $56,423.11 2026-02-27
87091 CDM Valve Tavr Sapien 3 Ultra With Certitude Dlv Sys 20mm 15 11 $308,750.00 $256,262.50 $32,511.38 $228,907.25 $84,628.38 2026-02-27
87092 CDM Valve Tavr Sapien 3 Ultra With Certitude Dlv Sys 23mm 15 11 $308,750.00 $256,262.50 $32,511.38 $228,907.25 $84,628.38 2026-02-27
87093 CDM Valve Tavr Sapien 3 Ultra With Certitude Dlv Sys 26mm 15 11 $308,750.00 $256,262.50 $32,511.38 $228,907.25 $84,628.38 2026-02-27
87094 CDM Valve Tavr Sapien 3 Ultra With Certitude Dlv Sys 29mm 15 11 $308,750.00 $256,262.50 $32,511.38 $228,907.25 $84,628.38 2026-02-27
87769 CDM Tandemlife Ls V24/a17 Kit 13 9 $156,750.00 $130,102.50 $25,393.50 $116,214.45 $44,062.43 2026-02-27
87770 CDM Protekduo Ls Dl31 Kit 13 9 $204,250.00 $169,527.50 $33,088.50 $151,430.95 $57,414.68 2026-02-27
87817 CDM Cath Mitraclip G4 Sgc 15 11 $285,000.00 $236,550.00 $30,010.50 $211,299.00 $78,118.50 2026-02-27
894 APR_DRG Apr-DRG 42.00: Major Cranial Or Facial Bone Procedures 5 5 — — $43,039.69 $53,995.26 $44,996.01 2026-02-27
89604 CDM Capit Watchman Flx Laa Procedure Device 15 11 $161,500.00 $134,045.00 $17,005.95 $119,736.10 $44,267.15 2026-02-27
91 APR_DRG Apr-DRG 42.00: Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $45,760.65 $57,408.83 $47,840.65 2026-02-27
9104 APR_DRG Apr-DRG 42.00: Craniotomy For Multiple Significant Trauma 5 5 — — $54,438.60 $68,295.72 $56,913.05 2026-02-27
9114 APR_DRG Apr-DRG 42.00: Extensive Abdominal Or Thoracic Procedures For Multiple Significa… 5 5 — — $51,779.33 $64,959.55 $54,132.91 2026-02-27
9124 APR_DRG Apr-DRG 42.00: Musculoskeletal And Other Procedures For Multiple Significant Tra… 5 5 — — $48,143.73 $60,398.52 $50,332.05 2026-02-27
914 APR_DRG Apr-DRG 42.00: Other Major Head And Neck Procedures 5 5 — — $50,135.14 $62,896.82 $52,413.97 2026-02-27
92 APR_DRG Apr-DRG 42.00: Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $62,491.01 $78,397.84 $65,331.47 2026-02-27
927 MS_DRG Ms-DRG 43.00: Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Ski… 16 10 — — $162,458.05 $376,559.76 $173,017.82 2026-02-27
928 MS_DRG Ms-DRG 43.00: Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/m… 16 10 — — $54,957.66 $146,550.24 $58,529.90 2026-02-27
93 APR_DRG Apr-DRG 42.00: Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $124,509.28 $156,202.60 $130,168.72 2026-02-27
94 APR_DRG Apr-DRG 42.00: Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $185,264.27 $232,422.52 $193,685.26 2026-02-27
9504 APR_DRG Apr-DRG 42.00: Extensive O.r. Procedure Unrelated To Principal Diagnosis 5 5 — — $42,759.92 $53,644.27 $44,703.52 2026-02-27
955 MS_DRG Ms-DRG 43.00: Craniotomy For Multiple Significant Trauma 16 10 — — $51,609.32 $137,527.61 $54,963.93 2026-02-27
957 MS_DRG Ms-DRG 43.00: Other O.r. Procedures For Multiple Significant Trauma With Mcc 16 10 — — $58,348.47 $155,687.28 $62,141.12 2026-02-27
969 MS_DRG Ms-DRG 43.00: HIV With Extensive O.r. Procedures With Mcc 16 10 — — $46,985.62 $125,068.38 $50,039.68 2026-02-27
97220 CDM Implant Cranial Peek Custom Xlrg 15 11 $186,790.04 $155,035.73 $19,668.99 $138,486.14 $51,199.15 2026-02-27
97297 CDM Cath Mitraclip G4 Mcg 15 11 $313,500.00 $260,205.00 $33,011.55 $232,428.90 $85,930.35 2026-02-27
99051 CDM Valve Tavr Sapien 3 Ultra Resilia With Cmndr Dlv Sys 20mm 15 11 $323,000.00 $268,090.00 $34,011.90 $239,472.20 $88,534.30 2026-02-27
99052 CDM Valve Tavr Sapien 3 Ultra Resilia With Cmndr Dlv Sys 23mm 15 11 $323,000.00 $268,090.00 $34,011.90 $239,472.20 $88,534.30 2026-02-27
99053 CDM Valve Tavr Sapien 3 Ultra Resilia With Cmndr Dlv Sys 26mm 15 11 $323,000.00 $268,090.00 $34,011.90 $239,472.20 $88,534.30 2026-02-27
99054 CDM Valve Tavr Sapien 3 Ultra Resilia With Cmndr Dlv Sys 29mm 15 11 $323,000.00 $268,090.00 $34,011.90 $239,472.20 $88,534.30 2026-02-27
A9543 CPT Hb Y90 Ibritumomab, Rx 22 12 $240,839.00 $199,896.37 $40,942.63 $137,782.49 $64,171.55 2026-02-27
C1604 HCPCS Capit Stent Graft Detour System 15 11 $237,500.00 $197,125.00 $25,008.75 $176,082.50 $65,098.75 2026-02-27
C1605 HCPCS Capit Aveir Dual Chamber Pacer System 14 10 $237,595.00 $197,203.85 $25,018.75 $176,152.93 $65,077.27 2026-02-27
C1822 HCPCS Stylet Kit (w/0.016) 50cm Length 75 11 $218,500.00 $181,355.00 $74.81 $253,558.80 $56,700.75 2026-02-27
C1824 HCPCS Optimizer Smart Generator 28 11 $218,500.00 $181,355.00 $23,008.05 $183,125.80 $62,294.35 2026-02-27
C1826 HCPCS Capit Neuro Inceptive Replacemnt Sys 41 11 $237,500.00 $197,125.00 $23,008.05 $190,169.10 $64,932.50 2026-02-27
C1827 HCPCS Ipg Vivistim Paired Vns Model 1001 15 11 $280,250.00 $232,607.50 $29,510.33 $207,777.35 $76,816.52 2026-02-27
C2624 HCPCS Impl Cardiomems Hf Sys Pa Sensor And Delivery Sys 28 11 $185,250.00 $153,757.50 $19,506.83 $163,291.87 $52,814.78 2026-02-27
J7330 HCPCS Maci Final Product Assembled 1 Membrane 15 11 $533,624.50 $442,908.34 $56,190.66 $154,217.48 $105,204.07 2026-02-27
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