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

GEISINGER ST. LUKE'S HOSPITAL

Orwigsburg, PA · CCN 390332 · Rates published

19,721 distinct procedures filed
3 distinct payers
184,352 rate rows
2026-02-26 last MRF observed
Data quality

184,282 of 184,352 rate rows are consumer-grade (100.0%)

70 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 66
exceeds 10× this hospital's gross charge — excluded from medians 3
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.slhn.org/-/media/sluhn/billing/pdf/standard-charges/82-4432109_geisingerstlukeshospitalorwigsburgcamups_standardcharges.ashx
Found on page https://www.slhn.org/billpay/patient-billing/price-transparency
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-09-16
Content fingerprint d05e779cc7a27e65… · 282,406,813 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 1 $518,231.70 $518,231.70 $518,231.70 nat. median
$390,362
1.3× median
J0225
HCPCS 		Vutrisiran Sodium 25 Mg/0.5ml Sc Sosy 3 $5,203.79 $347,630.55 $344,726.27 nat. median
$6,067
outlier · 56.8×
18
MS_DRG 		Ms-DRG 43.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 $329,531.07 $342,205.34 $332,699.64 nat. median
$168,055
2.0× median
5884
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight < 1500 Grams With Major Procedure 1 $317,407.11 $317,407.11 $317,407.11 nat. median
$286,698
1.1× median
37660
CDM 		Bicol Collagen Sponge 2 $303,019.87 $308,968.03 $307,228.47 —
114
APR_DRG 		Apr-DRG 42.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $296,722.90 $296,722.90 $296,722.90 nat. median
$135,803
outlier · 2.2×
24
APR_DRG 		Apr-DRG 42.00: Heart And/or Lung Transplant 1 $296,526.34 $296,526.34 $296,526.34 nat. median
$225,531
1.3× median
5833
APR_DRG 		Apr-DRG 42.00: Neonate With Ecmo 1 $295,149.64 $295,149.64 $295,149.64 nat. median
$268,208
1.1× median
71459
CDM 		Heartmate Iii Kit Implant 2 $276,812.23 $282,245.96 $280,656.85 —
5832
APR_DRG 		Apr-DRG 42.00: Neonate With Ecmo 1 $226,620.85 $226,620.85 $226,620.85 nat. median
$201,678
1.1× median
1614
APR_DRG 		Apr-DRG 42.00: Implantable Heart Assist Systems 1 $221,282.01 $221,282.01 $221,282.01 nat. median
$202,242
1.1× median
6094
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight 1500-2499 Grams With Major Procedure 1 $221,145.94 $221,145.94 $221,145.94 nat. median
$198,578
1.1× median
113
APR_DRG 		Apr-DRG 42.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $220,825.07 $220,825.07 $220,825.07 nat. median
$68,335
outlier · 3.2×
94
APR_DRG 		Apr-DRG 42.00: Extracorporeal Membrane Oxygenation (ecmo) 1 $216,927.62 $216,927.62 $216,927.62 nat. median
$152,792
1.4× median
1
MS_DRG 		Ms-DRG 43.00: Heart Transplant Or Implant Of Heart Assist System With Mcc 3 $213,852.40 $222,077.49 $215,908.68 nat. median
$186,516
1.2× median
6314
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight > 2499 Grams With Other Major Procedure 1 $212,702.58 $212,702.58 $212,702.58 nat. median
$181,762
1.2× median
5883
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight < 1500 Grams With Major Procedure 1 $211,393.07 $211,393.07 $211,393.07 nat. median
$173,134
1.2× median
5914
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight 500-749 Grams Without Major Procedure 1 $208,139.87 $208,139.87 $208,139.87 nat. median
$171,497
1.2× median
5831
APR_DRG 		Apr-DRG 42.00: Neonate With Ecmo 1 $203,420.09 $203,420.09 $203,420.09 nat. median
$173,909
1.2× median
8414
APR_DRG 		Apr-DRG 42.00: Extensive Third Degree Burns With Skin Graft 1 $196,835.58 $196,835.58 $196,835.58 nat. median
$173,018
1.1× median
6304
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight > 2499 Grams With Major Cardiovascular Proce… 1 $192,899.49 $192,899.49 $192,899.49 nat. median
$187,567
1.0× median
5934
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight 750-999 Grams Without Major Procedure 1 $182,995.43 $182,995.43 $182,995.43 nat. median
$168,439
1.1× median
5882
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight < 1500 Grams With Major Procedure 1 $181,140.78 $181,140.78 $181,140.78 nat. median
$152,383
1.2× median
112
APR_DRG 		Apr-DRG 42.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $175,553.31 $175,553.31 $175,553.31 nat. median
$63,564
outlier · 2.8×
74
APR_DRG 		Apr-DRG 42.00: Allogeneic Bone Marrow Transplant 1 $174,583.15 $174,583.15 $174,583.15 nat. median
$149,836
1.2× median
1613
APR_DRG 		Apr-DRG 42.00: Implantable Heart Assist Systems 1 $173,268.60 $173,268.60 $173,268.60 nat. median
$155,539
1.1× median
44
APR_DRG 		Apr-DRG 42.00: Tracheostomy With Mv >96 Hours With Extensive Procedure 1 $166,710.97 $166,710.97 $166,710.97 nat. median
$135,630
1.2× median
14
APR_DRG 		Apr-DRG 42.00: Liver Transplant And/or Intestinal Transplant 1 $165,052.87 $165,052.87 $165,052.87 nat. median
$136,566
1.2× median
927
MS_DRG 		Ms-DRG 43.00: Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Ski… 3 $162,927.21 $169,193.64 $164,493.82 nat. median
$131,925
1.2× median
3
MS_DRG 		Ms-DRG 43.00: Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Exce… 3 $161,971.01 $168,200.67 $163,528.43 nat. median
$145,435
1.1× median
23
APR_DRG 		Apr-DRG 42.00: Heart And/or Lung Transplant 1 $161,523.33 $161,523.33 $161,523.33 nat. median
$117,894
1.4× median
5913
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight 500-749 Grams Without Major Procedure 1 $156,974.06 $156,974.06 $156,974.06 nat. median
$120,079
1.3× median
5881
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight < 1500 Grams With Major Procedure 1 $155,263.88 $155,263.88 $155,263.88 nat. median
$130,862
1.2× median
5892
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams A… 1 $147,955.32 $147,955.32 $147,955.32 nat. median
$96,548
1.5× median
5891
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams A… 1 $147,955.32 $147,955.32 $147,955.32 nat. median
$99,483
1.5× median
5893
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams A… 1 $147,955.32 $147,955.32 $147,955.32 nat. median
$77,096
1.9× median
J7330
HCPCS 		Maci Final Product Assembled 1 Membrane 2 $144,078.61 $146,906.82 $146,079.71 nat. median
$92,809
1.6× median
93
APR_DRG 		Apr-DRG 42.00: Extracorporeal Membrane Oxygenation (ecmo) 1 $145,789.05 $145,789.05 $145,789.05 nat. median
$73,618
2.0× median
6024
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Sy… 1 $137,856.39 $137,856.39 $137,856.39 nat. median
$124,731
1.1× median
5912
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight 500-749 Grams Without Major Procedure 1 $134,638.47 $134,638.47 $134,638.47 nat. median
$85,835
1.6× median
5933
APR_DRG 		Apr-DRG 42.00: Neonate Birth Weight 750-999 Grams Without Major Procedure 1 $133,866.54 $133,866.54 $133,866.54 nat. median
$114,205
1.2× median
1612
APR_DRG 		Apr-DRG 42.00: Implantable Heart Assist Systems 1 $127,492.02 $127,492.02 $127,492.02 nat. median
$109,992
1.2× median
1611
APR_DRG 		Apr-DRG 42.00: Implantable Heart Assist Systems 1 $127,492.02 $127,492.02 $127,492.02 nat. median
$108,954
1.2× median
1604
APR_DRG 		Apr-DRG 42.00: Major Cardiothoracic Repair Of Heart Anomaly 1 $127,027.52 $127,027.52 $127,027.52 nat. median
$106,926
1.2× median
22
APR_DRG 		Apr-DRG 42.00: Heart And/or Lung Transplant 1 $122,311.10 $122,311.10 $122,311.10 nat. median
$95,481
1.3× median
140985
CDM 		Dvc Heart Assist Impella 5.5 S2 2 $115,425.00 $117,690.75 $117,028.12 —
54
APR_DRG 		Apr-DRG 42.00: Tracheostomy With Mv >96 Hours Without Extensive Procedure 1 $116,137.34 $116,137.34 $116,137.34 nat. median
$91,350
1.3× median
43
APR_DRG 		Apr-DRG 42.00: Tracheostomy With Mv >96 Hours With Extensive Procedure 1 $114,959.70 $114,959.70 $114,959.70 nat. median
$85,032
1.4× median
156877
CDM 		Valve Tricuspid Evoque 48mm Rplcmnt Sys 2 $110,295.00 $112,460.05 $111,826.88 —
156876
CDM 		Valve Tricuspid Evoque 44mm Rplcmnt Sys 2 $110,295.00 $112,460.05 $111,826.88 —

Other procedures at this hospital

Browse this hospital's 19,721 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
             
5834 APR_DRG Apr-DRG 42.00: Neonate With Ecmo 1 1 — — $518,231.70 $518,231.70 $518,231.70 2026-02-26
J0225 HCPCS Vutrisiran Sodium 25 Mg/0.5ml Sc Sosy 9 3 $1,262,733.58 $1,048,068.87 $5,203.79 $347,630.55 $344,726.27 2026-02-26
18 MS_DRG Ms-DRG 43.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 3 — — $329,531.07 $342,205.34 $332,699.64 2026-02-26
5884 APR_DRG Apr-DRG 42.00: Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $317,407.11 $317,407.11 $317,407.11 2026-02-26
37660 CDM Bicol Collagen Sponge 6 2 $1,122,295.80 $931,505.51 $303,019.87 $308,968.03 $307,228.47 2026-02-26
114 APR_DRG Apr-DRG 42.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $296,722.90 $296,722.90 $296,722.90 2026-02-26
24 APR_DRG Apr-DRG 42.00: Heart And/or Lung Transplant 1 1 — — $296,526.34 $296,526.34 $296,526.34 2026-02-26
5833 APR_DRG Apr-DRG 42.00: Neonate With Ecmo 1 1 — — $295,149.64 $295,149.64 $295,149.64 2026-02-26
71459 CDM Heartmate Iii Kit Implant 6 2 $1,025,230.50 $850,941.32 $276,812.23 $282,245.96 $280,656.85 2026-02-26
5832 APR_DRG Apr-DRG 42.00: Neonate With Ecmo 1 1 — — $226,620.85 $226,620.85 $226,620.85 2026-02-26
1614 APR_DRG Apr-DRG 42.00: Implantable Heart Assist Systems 1 1 — — $221,282.01 $221,282.01 $221,282.01 2026-02-26
6094 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1500-2499 Grams With Major Procedure 1 1 — — $221,145.94 $221,145.94 $221,145.94 2026-02-26
113 APR_DRG Apr-DRG 42.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $220,825.07 $220,825.07 $220,825.07 2026-02-26
94 APR_DRG Apr-DRG 42.00: Extracorporeal Membrane Oxygenation (ecmo) 1 1 — — $216,927.62 $216,927.62 $216,927.62 2026-02-26
1 MS_DRG Ms-DRG 43.00: Heart Transplant Or Implant Of Heart Assist System With Mcc 3 3 — — $213,852.40 $222,077.49 $215,908.68 2026-02-26
6314 APR_DRG Apr-DRG 42.00: Neonate Birth Weight > 2499 Grams With Other Major Procedure 1 1 — — $212,702.58 $212,702.58 $212,702.58 2026-02-26
5883 APR_DRG Apr-DRG 42.00: Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $211,393.07 $211,393.07 $211,393.07 2026-02-26
5914 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $208,139.87 $208,139.87 $208,139.87 2026-02-26
5831 APR_DRG Apr-DRG 42.00: Neonate With Ecmo 1 1 — — $203,420.09 $203,420.09 $203,420.09 2026-02-26
8414 APR_DRG Apr-DRG 42.00: Extensive Third Degree Burns With Skin Graft 1 1 — — $196,835.58 $196,835.58 $196,835.58 2026-02-26
6304 APR_DRG Apr-DRG 42.00: Neonate Birth Weight > 2499 Grams With Major Cardiovascular Proce… 1 1 — — $192,899.49 $192,899.49 $192,899.49 2026-02-26
5934 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 750-999 Grams Without Major Procedure 1 1 — — $182,995.43 $182,995.43 $182,995.43 2026-02-26
5882 APR_DRG Apr-DRG 42.00: Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $181,140.78 $181,140.78 $181,140.78 2026-02-26
112 APR_DRG Apr-DRG 42.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $175,553.31 $175,553.31 $175,553.31 2026-02-26
74 APR_DRG Apr-DRG 42.00: Allogeneic Bone Marrow Transplant 1 1 — — $174,583.15 $174,583.15 $174,583.15 2026-02-26
1613 APR_DRG Apr-DRG 42.00: Implantable Heart Assist Systems 1 1 — — $173,268.60 $173,268.60 $173,268.60 2026-02-26
44 APR_DRG Apr-DRG 42.00: Tracheostomy With Mv >96 Hours With Extensive Procedure 1 1 — — $166,710.97 $166,710.97 $166,710.97 2026-02-26
14 APR_DRG Apr-DRG 42.00: Liver Transplant And/or Intestinal Transplant 1 1 — — $165,052.87 $165,052.87 $165,052.87 2026-02-26
927 MS_DRG Ms-DRG 43.00: Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Ski… 3 3 — — $162,927.21 $169,193.64 $164,493.82 2026-02-26
3 MS_DRG Ms-DRG 43.00: Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Exce… 3 3 — — $161,971.01 $168,200.67 $163,528.43 2026-02-26
23 APR_DRG Apr-DRG 42.00: Heart And/or Lung Transplant 1 1 — — $161,523.33 $161,523.33 $161,523.33 2026-02-26
5913 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $156,974.06 $156,974.06 $156,974.06 2026-02-26
5881 APR_DRG Apr-DRG 42.00: Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $155,263.88 $155,263.88 $155,263.88 2026-02-26
5892 APR_DRG Apr-DRG 42.00: Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams A… 1 1 — — $147,955.32 $147,955.32 $147,955.32 2026-02-26
5891 APR_DRG Apr-DRG 42.00: Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams A… 1 1 — — $147,955.32 $147,955.32 $147,955.32 2026-02-26
5893 APR_DRG Apr-DRG 42.00: Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams A… 1 1 — — $147,955.32 $147,955.32 $147,955.32 2026-02-26
J7330 HCPCS Maci Final Product Assembled 1 Membrane 6 2 $533,624.50 $442,908.34 $144,078.61 $146,906.82 $146,079.71 2026-02-26
93 APR_DRG Apr-DRG 42.00: Extracorporeal Membrane Oxygenation (ecmo) 1 1 — — $145,789.05 $145,789.05 $145,789.05 2026-02-26
6024 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Sy… 1 1 — — $137,856.39 $137,856.39 $137,856.39 2026-02-26
5912 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $134,638.47 $134,638.47 $134,638.47 2026-02-26
5933 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 750-999 Grams Without Major Procedure 1 1 — — $133,866.54 $133,866.54 $133,866.54 2026-02-26
1612 APR_DRG Apr-DRG 42.00: Implantable Heart Assist Systems 1 1 — — $127,492.02 $127,492.02 $127,492.02 2026-02-26
1611 APR_DRG Apr-DRG 42.00: Implantable Heart Assist Systems 1 1 — — $127,492.02 $127,492.02 $127,492.02 2026-02-26
1604 APR_DRG Apr-DRG 42.00: Major Cardiothoracic Repair Of Heart Anomaly 1 1 — — $127,027.52 $127,027.52 $127,027.52 2026-02-26
22 APR_DRG Apr-DRG 42.00: Heart And/or Lung Transplant 1 1 — — $122,311.10 $122,311.10 $122,311.10 2026-02-26
140985 CDM Dvc Heart Assist Impella 5.5 S2 6 2 $427,500.00 $354,825.00 $115,425.00 $117,690.75 $117,028.12 2026-02-26
54 APR_DRG Apr-DRG 42.00: Tracheostomy With Mv >96 Hours Without Extensive Procedure 1 1 — — $116,137.34 $116,137.34 $116,137.34 2026-02-26
43 APR_DRG Apr-DRG 42.00: Tracheostomy With Mv >96 Hours With Extensive Procedure 1 1 — — $114,959.70 $114,959.70 $114,959.70 2026-02-26
156878 CDM Valve Tricuspid Evoque 52mm Rplcmnt Sys 6 2 $408,500.00 $339,055.00 $110,295.00 $112,460.05 $111,826.88 2026-02-26
156877 CDM Valve Tricuspid Evoque 48mm Rplcmnt Sys 6 2 $408,500.00 $339,055.00 $110,295.00 $112,460.05 $111,826.88 2026-02-26
156876 CDM Valve Tricuspid Evoque 44mm Rplcmnt Sys 6 2 $408,500.00 $339,055.00 $110,295.00 $112,460.05 $111,826.88 2026-02-26
156879 CDM Valve Tricuspid Evoque 56mm Rplcmnt Sys 6 2 $408,500.00 $339,055.00 $110,295.00 $112,460.05 $111,826.88 2026-02-26
73 APR_DRG Apr-DRG 42.00: Allogeneic Bone Marrow Transplant 1 1 — — $111,037.05 $111,037.05 $111,037.05 2026-02-26
8424 APR_DRG Apr-DRG 42.00: Burns With Skin Graft Except Extensive Third Degree Burns 1 1 — — $110,199.60 $110,199.60 $110,199.60 2026-02-26
21 APR_DRG Apr-DRG 42.00: Heart And/or Lung Transplant 1 1 — — $108,103.88 $108,103.88 $108,103.88 2026-02-26
64 APR_DRG Apr-DRG 42.00: Pancreas Transplant 1 1 — — $107,812.41 $107,812.41 $107,812.41 2026-02-26
5932 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 750-999 Grams Without Major Procedure 1 1 — — $107,672.98 $107,672.98 $107,672.98 2026-02-26
4 MS_DRG Ms-DRG 43.00: Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face,… 3 3 — — $105,701.03 $109,766.46 $106,717.39 2026-02-26
6074 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Sy… 1 1 — — $106,563.38 $106,563.38 $106,563.38 2026-02-26
6303 APR_DRG Apr-DRG 42.00: Neonate Birth Weight > 2499 Grams With Major Cardiovascular Proce… 1 1 — — $106,330.71 $106,330.71 $106,330.71 2026-02-26
8513 APR_DRG Apr-DRG 42.00: Gender Related Procedures 1 1 — — $101,687.37 $101,687.37 $101,687.37 2026-02-26
8514 APR_DRG Apr-DRG 42.00: Gender Related Procedures 1 1 — — $101,687.37 $101,687.37 $101,687.37 2026-02-26
6034 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1000-1249 Grams With Or Without Significant … 1 1 — — $100,829.76 $100,829.76 $100,829.76 2026-02-26
7 MS_DRG Ms-DRG 43.00: Lung Transplant 3 3 — — $98,823.92 $102,624.84 $99,774.15 2026-02-26
6023 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Sy… 1 1 — — $95,716.03 $95,716.03 $95,716.03 2026-02-26
14 MS_DRG Ms-DRG 43.00: Allogeneic Bone Marrow Transplant 3 3 — — $91,709.46 $95,236.74 $92,591.28 2026-02-26
6114 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1500-1999 Grams With Major Anomaly 1 1 — — $88,630.06 $88,630.06 $88,630.06 2026-02-26
99053 CDM Valve Tavr Sapien 3 Ultra Resilia With Cmndr Dlv Sys 26mm 6 2 $323,000.00 $268,090.00 $87,210.00 $88,921.90 $88,421.25 2026-02-26
99051 CDM Valve Tavr Sapien 3 Ultra Resilia With Cmndr Dlv Sys 20mm 6 2 $323,000.00 $268,090.00 $87,210.00 $88,921.90 $88,421.25 2026-02-26
99052 CDM Valve Tavr Sapien 3 Ultra Resilia With Cmndr Dlv Sys 23mm 6 2 $323,000.00 $268,090.00 $87,210.00 $88,921.90 $88,421.25 2026-02-26
99054 CDM Valve Tavr Sapien 3 Ultra Resilia With Cmndr Dlv Sys 29mm 6 2 $323,000.00 $268,090.00 $87,210.00 $88,921.90 $88,421.25 2026-02-26
6134 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal… 1 1 — — $87,815.29 $87,815.29 $87,815.29 2026-02-26
2 MS_DRG Ms-DRG 43.00: Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 3 — — $86,473.78 $89,799.70 $87,305.26 2026-02-26
209 MS_DRG Ms-DRG 43.00: Complex Aortic Arch Procedures 3 3 — — $86,374.59 $89,696.69 $87,205.11 2026-02-26
8634 APR_DRG Apr-DRG 42.00: Neonatal Aftercare 1 1 — — $86,683.86 $86,683.86 $86,683.86 2026-02-26
111 APR_DRG Apr-DRG 42.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $86,460.43 $86,460.43 $86,460.43 2026-02-26
97297 CDM Cath Mitraclip G4 Mcg 6 2 $313,500.00 $260,205.00 $84,645.00 $86,306.55 $85,820.62 2026-02-26
13 APR_DRG Apr-DRG 42.00: Liver Transplant And/or Intestinal Transplant 1 1 — — $85,691.86 $85,691.86 $85,691.86 2026-02-26
1624 APR_DRG Apr-DRG 42.00: Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 1 1 — — $85,367.63 $85,367.63 $85,367.63 2026-02-26
3034 APR_DRG Apr-DRG 42.00: Dorsal And Lumbar Fusion Procedure For Curvature Of Back 1 1 — — $84,955.20 $84,955.20 $84,955.20 2026-02-26
426 MS_DRG Ms-DRG 43.00: Multiple Level Combined Anterior And Posterior Spinal Fusion Excep… 3 3 — — $84,103.58 $87,338.34 $84,912.27 2026-02-26
56945 CDM Tavr Sapien 3 Cmndr Dlv Sys 23mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
87092 CDM Valve Tavr Sapien 3 Ultra With Certitude Dlv Sys 23mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
37545 CDM Valve Transcatheter Sapien Xt W/nova Flex System 26mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
37544 CDM Valve Transcatheter Sapien Xt W/nova Flex System 23mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
64375 CDM Valve Tavr Sapien 3 Certitude Dlv Sys 26mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
56919 CDM Tavr Sapien 3 Cmndr Dlv Sys 29mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
67096 CDM Valve Tavr Sapien 3 Certitude Dlv Sys 20mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
87094 CDM Valve Tavr Sapien 3 Ultra With Certitude Dlv Sys 29mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
37546 CDM Valve Transcatheter Sapien Xt W/nova Flex System 29mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
87091 CDM Valve Tavr Sapien 3 Ultra With Certitude Dlv Sys 20mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
64627 CDM Valve Tavr Sapien 3 Certitude Dlv Sys 23mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
37172 CDM Tavr Sapien Retroflex 3 Dlv Sys 23mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
83623 CDM Valve Tavr Sapien 3 Ultra With Cmndr Dlv Sys 20mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
37541 CDM Tavr Sapien Xt W/ascendra System 23mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
87093 CDM Valve Tavr Sapien 3 Ultra With Certitude Dlv Sys 26mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
56918 CDM Tavr Sapien 3 Cmndr Dlv Sys 26mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
37543 CDM Tavr Sapien Xt W/ascendra System 29mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
83625 CDM Valve Tavr Sapien 3 Ultra With Cmndr Dlv Sys 26mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
66190 CDM Valve Tavr Sapien 3 Certitude Dlv Sys 29mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
37297 CDM Tavr Sapien 3 Transapical Dlv Sys 26mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
37542 CDM Tavr Sapien Xt W/ascendra System 26mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
37296 CDM Tavr Sapien 3 Transapical Dlv Sys 23mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
83624 CDM Valve Tavr Sapien 3 Ultra With Cmndr Dlv Sys 23mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
61735 CDM Valve Tavr Sapien 3 Cmndr Dlv Sys 20mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
37173 CDM Tavr Sapien Retroflex 3 Dlv Sys 26mm 6 2 $308,750.00 $256,262.50 $83,362.50 $84,998.88 $84,520.32 2026-02-26
53 APR_DRG Apr-DRG 42.00: Tracheostomy With Mv >96 Hours Without Extensive Procedure 1 1 — — $84,284.07 $84,284.07 $84,284.07 2026-02-26
212 MS_DRG Ms-DRG 43.00: Concomitant Aortic And Mitral Valve Procedures 3 3 — — $82,981.04 $86,172.62 $83,778.93 2026-02-26
4404 APR_DRG Apr-DRG 42.00: Kidney Transplant 1 1 — — $83,591.10 $83,591.10 $83,591.10 2026-02-26
180373 CDM Stent Tag Thoracic Endoproth 40 X 8mm X 15cm 26fr 6 2 $304,000.00 $252,320.00 $82,080.00 $83,691.20 $83,220.00 2026-02-26
122837 CDM Stent Tag Thoracic Endoproth 45 X 8mm X 15cm 26fr 6 2 $304,000.00 $252,320.00 $82,080.00 $83,691.20 $83,220.00 2026-02-26
136402 CDM Stent Tag Thoracic Endoproth 26 X 8mm X 10cm 20fr 6 2 $304,000.00 $252,320.00 $82,080.00 $83,691.20 $83,220.00 2026-02-26
146454 CDM Stent Tag Thoracic Endoproth 37 X 8mm X 15cm 24fr 6 2 $304,000.00 $252,320.00 $82,080.00 $83,691.20 $83,220.00 2026-02-26
63 APR_DRG Apr-DRG 42.00: Pancreas Transplant 1 1 — — $83,086.27 $83,086.27 $83,086.27 2026-02-26
172644 CDM Botulism Immune Globulin Human 100 Mg IV Solr 6 2 $303,117.00 $251,587.11 $81,841.59 $83,448.11 $82,978.28 2026-02-26
5931 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 750-999 Grams Without Major Procedure 1 1 — — $81,943.08 $81,943.08 $81,943.08 2026-02-26
104118 CDM Valve Trancath Aortic Evolut Fx 34mm 6 2 $299,250.00 $248,377.50 $80,797.50 $82,383.52 $81,919.69 2026-02-26
104117 CDM Valve Trancath Aortic Evolut Fx 29mm 6 2 $299,250.00 $248,377.50 $80,797.50 $82,383.52 $81,919.69 2026-02-26
156603 CDM Valve Trancath Aortic Evfxplus-26 6 2 $299,250.00 $248,377.50 $80,797.50 $82,383.52 $81,919.69 2026-02-26
104115 CDM Valve Trancath Aortic Evolut Fx 23mm 6 2 $299,250.00 $248,377.50 $80,797.50 $82,383.52 $81,919.69 2026-02-26
104116 CDM Valve Trancath Aortic Evolut Fx 26mm 6 2 $299,250.00 $248,377.50 $80,797.50 $82,383.52 $81,919.69 2026-02-26
156602 CDM Valve Trancath Aortic Evfxplus-23 6 2 $299,250.00 $248,377.50 $80,797.50 $82,383.52 $81,919.69 2026-02-26
156604 CDM Valve Trancath Aortic Evfxplus-29 6 2 $299,250.00 $248,377.50 $80,797.50 $82,383.52 $81,919.69 2026-02-26
156605 CDM Valve Trancath Aortic Evfxplus-34 6 2 $299,250.00 $248,377.50 $80,797.50 $82,383.52 $81,919.69 2026-02-26
132810 CDM Pascal Precision Sys W/pascal Imlant-guide Sheath-stabilizer 6 2 $290,700.00 $241,281.00 $78,489.00 $80,029.71 $79,579.12 2026-02-26
132811 CDM Pascal Precision Sys W/pascal Ace Imlant-guide Sheath-stabilizer 6 2 $290,700.00 $241,281.00 $78,489.00 $80,029.71 $79,579.12 2026-02-26
5 MS_DRG Ms-DRG 43.00: Liver Transplant With Mcc Or Intestinal Transplant 3 3 — — $78,680.17 $81,706.33 $79,436.71 2026-02-26
72 APR_DRG Apr-DRG 42.00: Allogeneic Bone Marrow Transplant 1 1 — — $78,192.62 $78,192.62 $78,192.62 2026-02-26
39358 CDM Tavr 29mm Corevalue Transcatheter 6 2 $285,000.00 $236,550.00 $76,950.00 $78,460.50 $78,018.75 2026-02-26
59204 CDM Tavr 23mm Corevalve Transcatheter 6 2 $285,000.00 $236,550.00 $76,950.00 $78,460.50 $78,018.75 2026-02-26
77739 CDM System Mitraclip Xtr/ntr W/one Clip 6 2 $285,000.00 $236,550.00 $76,950.00 $78,460.50 $78,018.75 2026-02-26
59205 CDM Tavr 31mm Corevalue Transcatheter 6 2 $285,000.00 $236,550.00 $76,950.00 $78,460.50 $78,018.75 2026-02-26
54439 CDM System Mitraclip Nt W/two Clips 6 2 $285,000.00 $236,550.00 $76,950.00 $78,460.50 $78,018.75 2026-02-26
39357 CDM Tavr 26mm Corevalue Transcatheter 6 2 $285,000.00 $236,550.00 $76,950.00 $78,460.50 $78,018.75 2026-02-26
54438 CDM System Mitraclip Nt W/one Clip 6 2 $285,000.00 $236,550.00 $76,950.00 $78,460.50 $78,018.75 2026-02-26
77579 CDM System Mitraclip Xtr W/three Clips 6 2 $285,000.00 $236,550.00 $76,950.00 $78,460.50 $78,018.75 2026-02-26
85655 CDM System Mitraclip Xtr W/two Clips 6 2 $285,000.00 $236,550.00 $76,950.00 $78,460.50 $78,018.75 2026-02-26
87817 CDM Cath Mitraclip G4 Sgc 6 2 $285,000.00 $236,550.00 $76,950.00 $78,460.50 $78,018.75 2026-02-26
77740 CDM System Mitraclip Xtr/ntr W/two Clips 6 2 $285,000.00 $236,550.00 $76,950.00 $78,460.50 $78,018.75 2026-02-26
77741 CDM System Mitraclip Xtr/ntr W/three Clips 6 2 $285,000.00 $236,550.00 $76,950.00 $78,460.50 $78,018.75 2026-02-26
54440 CDM System Mitraclip Nt W/three Clips 6 2 $285,000.00 $236,550.00 $76,950.00 $78,460.50 $78,018.75 2026-02-26
78682 CDM System Mitraclip Xtr W/one Clip 6 2 $285,000.00 $236,550.00 $76,950.00 $78,460.50 $78,018.75 2026-02-26
84 APR_DRG Apr-DRG 42.00: Autologous Bone Marrow Transplant 1 1 — — $77,649.16 $77,649.16 $77,649.16 2026-02-26
C1827 HCPCS Ipg Vivistim Paired Vns Model 1001 6 2 $280,250.00 $232,607.50 $75,667.50 $77,152.82 $76,718.43 2026-02-26
6093 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1500-2499 Grams With Major Procedure 1 1 — — $76,713.44 $76,713.44 $76,713.44 2026-02-26
215 MS_DRG Ms-DRG 43.00: Other Heart Assist System Implant 3 3 — — $75,982.59 $78,904.99 $76,713.19 2026-02-26
6022 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Sy… 1 1 — — $76,482.45 $76,482.45 $76,482.45 2026-02-26
179360 CDM Graft Endovascular Excluder Tambe 37 X 20 X160mm 22fr 6 2 $275,500.00 $228,665.00 $74,385.00 $75,845.15 $75,418.12 2026-02-26
179359 CDM Graft Endovascular Excluder Tambe 31 X 20 X 160mm 22fr 6 2 $275,500.00 $228,665.00 $74,385.00 $75,845.15 $75,418.12 2026-02-26
216 MS_DRG Ms-DRG 43.00: Cardiac Valve And Other Major Cardiothoracic Procedures With Cardi… 3 3 — — $74,653.25 $77,524.53 $75,371.07 2026-02-26
1634 APR_DRG Apr-DRG 42.00: Cardiac Valve Procedures Without Ami Or Complex Principal Diagnos… 1 1 — — $74,700.03 $74,700.03 $74,700.03 2026-02-26
42 APR_DRG Apr-DRG 42.00: Tracheostomy With Mv >96 Hours With Extensive Procedure 1 1 — — $73,463.60 $73,463.60 $73,463.60 2026-02-26
2994 APR_DRG Apr-DRG 42.00: Multiple Level Combined Anterior And Posterior Spinal Fusion Exce… 1 1 — — $73,193.13 $73,193.13 $73,193.13 2026-02-26
92 APR_DRG Apr-DRG 42.00: Extracorporeal Membrane Oxygenation (ecmo) 1 1 — — $73,171.29 $73,171.29 $73,171.29 2026-02-26
6073 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Sy… 1 1 — — $73,062.10 $73,062.10 $73,062.10 2026-02-26
62 APR_DRG Apr-DRG 42.00: Pancreas Transplant 1 1 — — $71,629.95 $71,629.95 $71,629.95 2026-02-26
1784 APR_DRG Apr-DRG 42.00: External Heart Assist Devices 1 1 — — $71,033.57 $71,033.57 $71,033.57 2026-02-26
6124 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Sy… 1 1 — — $69,817.30 $69,817.30 $69,817.30 2026-02-26
6334 APR_DRG Apr-DRG 42.00: Neonate Birth Weight > 2499 Grams With Major Anomaly 1 1 — — $69,634.19 $69,634.19 $69,634.19 2026-02-26
429 MS_DRG Ms-DRG 43.00: Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 3 3 — — $68,752.92 $71,397.27 $69,414.01 2026-02-26
71 APR_DRG Apr-DRG 42.00: Allogeneic Bone Marrow Transplant 1 1 — — $69,024.37 $69,024.37 $69,024.37 2026-02-26
6214 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 2000-2499 Grams With Major Anomaly 1 1 — — $68,468.31 $68,468.31 $68,468.31 2026-02-26
189332 CDM Hfx Iq Ipg Kit 6 2 $247,000.00 $205,010.00 $66,690.00 $67,999.10 $67,616.25 2026-02-26
1654 APR_DRG Apr-DRG 42.00: Coronary Bypass With Ami Or Complex Principal Diagnosis 1 1 — — $67,110.08 $67,110.08 $67,110.08 2026-02-26
850 MS_DRG Ms-DRG 43.00: Acute Leukemia With Other Procedures 3 3 — — $66,081.27 $68,622.85 $66,716.66 2026-02-26
12 APR_DRG Apr-DRG 42.00: Liver Transplant And/or Intestinal Transplant 1 1 — — $66,223.08 $66,223.08 $66,223.08 2026-02-26
1674 APR_DRG Apr-DRG 42.00: Other Cardiothoracic And Thoracic Circulatory Procedures 1 1 — — $65,755.21 $65,755.21 $65,755.21 2026-02-26
C1605 HCPCS Capit Aveir Dual Chamber Pacer System 6 2 $237,595.00 $197,203.85 $64,150.65 $65,409.90 $65,041.63 2026-02-26
185448 CDM Pump Set Impella Cp 6 2 $237,500.00 $197,125.00 $64,125.00 $65,383.75 $65,015.62 2026-02-26
C1604 HCPCS Capit Stent Graft Detour System 6 2 $237,500.00 $197,125.00 $64,125.00 $65,383.75 $65,015.62 2026-02-26
C1826 HCPCS Capit Neuro Inceptive Replacemnt Sys 18 2 $237,500.00 $197,125.00 $58,995.00 $70,614.45 $65,015.62 2026-02-26
66257 CDM Pump Set Impella Cp 6 2 $237,500.00 $197,125.00 $64,125.00 $65,383.75 $65,015.62 2026-02-26
149130 CDM Pump Set Impella Cp W/companion Sheath Bundle 6 2 $237,500.00 $197,125.00 $64,125.00 $65,383.75 $65,015.62 2026-02-26
231 MS_DRG Ms-DRG 43.00: Coronary Bypass With Ptca With Mcc 3 3 — — $64,329.17 $66,803.37 $64,947.72 2026-02-26
456 MS_DRG Ms-DRG 43.00: Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, I… 3 3 — — $64,126.97 $66,593.39 $64,743.58 2026-02-26
8413 APR_DRG Apr-DRG 42.00: Extensive Third Degree Burns With Skin Graft 1 1 — — $64,013.12 $64,013.12 $64,013.12 2026-02-26
1834 APR_DRG Apr-DRG 42.00: Percutaneous Structural Cardiac Procedures 1 1 — — $63,930.80 $63,930.80 $63,930.80 2026-02-26
9104 APR_DRG Apr-DRG 42.00: Craniotomy For Multiple Significant Trauma 1 1 — — $63,742.65 $63,742.65 $63,742.65 2026-02-26
C1824 HCPCS Ipg Optimizer Smart Mini 12 2 $232,750.00 $193,182.50 $58,995.00 $67,999.10 $63,421.53 2026-02-26
6313 APR_DRG Apr-DRG 42.00: Neonate Birth Weight > 2499 Grams With Other Major Procedure 1 1 — — $62,516.30 $62,516.30 $62,516.30 2026-02-26
1623 APR_DRG Apr-DRG 42.00: Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 1 1 — — $62,446.58 $62,446.58 $62,446.58 2026-02-26
6804 APR_DRG Apr-DRG 42.00: Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neopl… 1 1 — — $61,958.56 $61,958.56 $61,958.56 2026-02-26
C1822 HCPCS Capitated Neuro Senza 36 2 $223,250.00 $185,297.50 $192.38 $94,152.60 $60,856.53 2026-02-26
6084 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1250-1499 Grams With Or Without Significant … 1 1 — — $60,780.08 $60,780.08 $60,780.08 2026-02-26
6254 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 2000-2499 Grams With Other Significant Condi… 1 1 — — $60,691.89 $60,691.89 $60,691.89 2026-02-26
9114 APR_DRG Apr-DRG 42.00: Extensive Abdominal Or Thoracic Procedures For Multiple Significa… 1 1 — — $60,628.89 $60,628.89 $60,628.89 2026-02-26
20 MS_DRG Ms-DRG 43.00: Intracranial Vascular Procedures With Principal Diagnosis Hemorrha… 3 3 — — $60,047.36 $62,356.88 $60,624.74 2026-02-26
3044 APR_DRG Apr-DRG 42.00: Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 1 1 — — $59,914.08 $59,914.08 $59,914.08 2026-02-26
1664 APR_DRG Apr-DRG 42.00: Coronary Bypass Without Ami Or Complex Principal Diagnosis 1 1 — — $59,828.40 $59,828.40 $59,828.40 2026-02-26
J0223 HCPCS Givosiran Sodium 189 Mg/ml Sc Soln 9 3 $218,873.75 $181,665.21 $122.05 $60,255.94 $59,752.53 2026-02-26
219 MS_DRG Ms-DRG 43.00: Cardiac Valve And Other Major Cardiothoracic Procedures Without Ca… 3 3 — — $58,593.66 $60,847.26 $59,157.06 2026-02-26
1794 APR_DRG Apr-DRG 42.00: Defibrillator Implants 1 1 — — $59,048.07 $59,048.07 $59,048.07 2026-02-26
3033 APR_DRG Apr-DRG 42.00: Dorsal And Lumbar Fusion Procedure For Curvature Of Back 1 1 — — $58,958.19 $58,958.19 $58,958.19 2026-02-26
233 MS_DRG Ms-DRG 43.00: Coronary Bypass With Cardiac Catheterization Or Open Ablation With… 3 3 — — $58,341.08 $60,584.97 $58,902.05 2026-02-26
1603 APR_DRG Apr-DRG 42.00: Major Cardiothoracic Repair Of Heart Anomaly 1 1 — — $58,877.56 $58,877.56 $58,877.56 2026-02-26
957 MS_DRG Ms-DRG 43.00: Other O.r. Procedures For Multiple Significant Trauma With Mcc 3 3 — — $58,148.00 $60,384.46 $58,707.12 2026-02-26
914 APR_DRG Apr-DRG 42.00: Other Major Head And Neck Procedures 1 1 — — $58,703.68 $58,703.68 $58,703.68 2026-02-26
6144 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1500-1999 Grams With Or Without Other Signif… 1 1 — — $58,593.65 $58,593.65 $58,593.65 2026-02-26
J9274 HCPCS Tebentafusp-tebn 100 Mcg/0.5ml IV Soln 9 3 $214,350.80 $177,911.16 $225.77 $59,010.78 $58,517.77 2026-02-26
11 APR_DRG Apr-DRG 42.00: Liver Transplant And/or Intestinal Transplant 1 1 — — $58,178.70 $58,178.70 $58,178.70 2026-02-26
8504 APR_DRG Apr-DRG 42.00: Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Co… 1 1 — — $57,801.56 $57,801.56 $57,801.56 2026-02-26
214 APR_DRG Apr-DRG 42.00: Open Craniotomy Except Trauma 1 1 — — $57,720.08 $57,720.08 $57,720.08 2026-02-26
1783 APR_DRG Apr-DRG 42.00: External Heart Assist Devices 1 1 — — $57,316.06 $57,316.06 $57,316.06 2026-02-26
2993 APR_DRG Apr-DRG 42.00: Multiple Level Combined Anterior And Posterior Spinal Fusion Exce… 1 1 — — $57,233.74 $57,233.74 $57,233.74 2026-02-26
6033 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1000-1249 Grams With Or Without Significant … 1 1 — — $57,095.14 $57,095.14 $57,095.14 2026-02-26
6021 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Sy… 1 1 — — $56,974.19 $56,974.19 $56,974.19 2026-02-26
4403 APR_DRG Apr-DRG 42.00: Kidney Transplant 1 1 — — $56,832.23 $56,832.23 $56,832.23 2026-02-26
9124 APR_DRG Apr-DRG 42.00: Musculoskeletal And Other Procedures For Multiple Significant Tra… 1 1 — — $56,371.93 $56,371.93 $56,371.93 2026-02-26
52 APR_DRG Apr-DRG 42.00: Tracheostomy With Mv >96 Hours Without Extensive Procedure 1 1 — — $56,199.74 $56,199.74 $56,199.74 2026-02-26
87770 CDM Protekduo Ls Dl31 Kit 6 2 $204,250.00 $169,527.50 $55,147.50 $56,230.03 $55,913.44 2026-02-26
3004 APR_DRG Apr-DRG 42.00: Single Level Combined Anterior And Posterior Spinal Fusion Except… 1 1 — — $55,837.71 $55,837.71 $55,837.71 2026-02-26
427 MS_DRG Ms-DRG 43.00: Multiple Level Combined Anterior And Posterior Spinal Fusion Excep… 3 3 — — $55,085.66 $57,204.34 $55,615.33 2026-02-26
46610 CDM Restore Sensor System 6 2 $202,350.00 $167,950.50 $54,634.50 $55,706.96 $55,393.32 2026-02-26
6904 APR_DRG Apr-DRG 42.00: Acute Leukemia 1 1 — — $55,383.29 $55,383.29 $55,383.29 2026-02-26
10 MS_DRG Ms-DRG 43.00: Pancreas Transplant 3 3 — — $54,758.29 $56,864.38 $55,284.81 2026-02-26
928 MS_DRG Ms-DRG 43.00: Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/m… 3 3 — — $54,735.40 $56,840.61 $55,261.70 2026-02-26
C2624 HCPCS Cardiomems Hf System 12 2 $202,749.00 $168,281.67 $50,017.50 $60,634.27 $55,233.14 2026-02-26
19 MS_DRG Ms-DRG 43.00: Simultaneous Pancreas And Kidney Transplant With Hemodialysis 3 3 — — $54,444.64 $56,538.67 $54,968.15 2026-02-26
275 MS_DRG Ms-DRG 43.00: Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 3 3 — — $54,412.60 $56,505.39 $54,935.80 2026-02-26
83 APR_DRG Apr-DRG 42.00: Autologous Bone Marrow Transplant 1 1 — — $54,653.36 $54,653.36 $54,653.36 2026-02-26
189336 CDM Senza Omnia Ipg Kit 6 2 $199,500.00 $165,585.00 $53,865.00 $54,922.35 $54,613.12 2026-02-26
6072 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Sy… 1 1 — — $54,569.36 $54,569.36 $54,569.36 2026-02-26
2604 APR_DRG Apr-DRG 42.00: Major Pancreas, Liver And Shunt Procedures 1 1 — — $53,854.55 $53,854.55 $53,854.55 2026-02-26
1633 APR_DRG Apr-DRG 42.00: Cardiac Valve Procedures Without Ami Or Complex Principal Diagnos… 1 1 — — $53,701.67 $53,701.67 $53,701.67 2026-02-26
91 APR_DRG Apr-DRG 42.00: Extracorporeal Membrane Oxygenation (ecmo) 1 1 — — $53,581.56 $53,581.56 $53,581.56 2026-02-26
1694 APR_DRG Apr-DRG 42.00: Major Abdominal Vascular Procedures 1 1 — — $53,341.33 $53,341.33 $53,341.33 2026-02-26
870 MS_DRG Ms-DRG 43.00: Septicemia Or Severe Sepsis With Mv >96 Hours 3 3 — — $52,744.44 $54,773.07 $53,251.60 2026-02-26
268 MS_DRG Ms-DRG 43.00: Aortic And Heart Assist Procedures Except Pulsation Balloon With M… 3 3 — — $52,485.75 $54,504.44 $52,990.42 2026-02-26
234 APR_DRG Apr-DRG 42.00: Spinal Procedures 1 1 — — $52,629.04 $52,629.04 $52,629.04 2026-02-26
7404 APR_DRG Apr-DRG 42.00: Mental Illness Diagnosis With O.r. Procedure 1 1 — — $52,485.40 $52,485.40 $52,485.40 2026-02-26
6083 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1250-1499 Grams With Or Without Significant … 1 1 — — $52,466.08 $52,466.08 $52,466.08 2026-02-26
43040 CDM Cath Impella 9fr 2.5 Flow Rate 6 2 $190,000.00 $157,700.00 $51,300.00 $52,307.00 $52,012.50 2026-02-26
144719 CDM Stent Tag Conformable W/active Cntrl 21 X 21mm X 10cm 6 2 $189,715.00 $157,463.45 $51,223.05 $52,228.54 $51,934.48 2026-02-26
1204 APR_DRG Apr-DRG 42.00: Major Respiratory And Chest Procedures 1 1 — — $51,920.10 $51,920.10 $51,920.10 2026-02-26
955 MS_DRG Ms-DRG 43.00: Craniotomy For Multiple Significant Trauma 3 3 — — $51,365.50 $53,341.09 $51,859.39 2026-02-26
6814 APR_DRG Apr-DRG 42.00: Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neop… 1 1 — — $51,836.11 $51,836.11 $51,836.11 2026-02-26
3124 APR_DRG Apr-DRG 42.00: Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 1 1 — — $51,738.67 $51,738.67 $51,738.67 2026-02-26
317 MS_DRG Ms-DRG 43.00: Concomitant Left Atrial Appendage Closure And Cardiac Ablation 3 3 — — $51,025.16 $52,987.66 $51,515.78 2026-02-26
447 MS_DRG Ms-DRG 43.00: Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-ma… 3 3 — — $50,987.77 $52,948.84 $51,478.04 2026-02-26
1304 APR_DRG Apr-DRG 42.00: Respiratory System Diagnosis With Ventilator Support > 96 Hours 1 1 — — $51,309.45 $51,309.45 $51,309.45 2026-02-26
2204 APR_DRG Apr-DRG 42.00: Major Stomach, Esophageal And Duodenal Procedures 1 1 — — $51,140.61 $51,140.61 $51,140.61 2026-02-26
97220 CDM Implant Cranial Peek Custom Xlrg 6 2 $186,790.04 $155,035.73 $50,433.31 $51,423.30 $51,133.78 2026-02-26
6954 APR_DRG Apr-DRG 42.00: Chemotherapy For Acute Leukemia 1 1 — — $50,973.46 $50,973.46 $50,973.46 2026-02-26
41 APR_DRG Apr-DRG 42.00: Tracheostomy With Mv >96 Hours With Extensive Procedure 1 1 — — $50,826.46 $50,826.46 $50,826.46 2026-02-26
218 MS_DRG Ms-DRG 43.00: Cardiac Valve And Other Major Cardiothoracic Procedures With Cardi… 3 3 — — $50,176.59 $52,106.46 $50,659.06 2026-02-26
217 MS_DRG Ms-DRG 43.00: Cardiac Valve And Other Major Cardiothoracic Procedures With Cardi… 3 3 — — $50,176.59 $52,106.46 $50,659.06 2026-02-26
573 MS_DRG Ms-DRG 43.00: Skin Graft For Skin Ulcer Or Cellulitis With Mcc 3 3 — — $49,994.20 $51,917.06 $50,474.92 2026-02-26
204 APR_DRG Apr-DRG 42.00: Open Craniotomy For Trauma 1 1 — — $50,425.80 $50,425.80 $50,425.80 2026-02-26
894 APR_DRG Apr-DRG 42.00: Major Cranial Or Facial Bone Procedures 1 1 — — $50,395.56 $50,395.56 $50,395.56 2026-02-26
3614 APR_DRG Apr-DRG 42.00: Skin Graft For Skin And Subcutaneous Tissue Diagnoses 1 1 — — $50,339.28 $50,339.28 $50,339.28 2026-02-26
4284 APR_DRG Apr-DRG 42.00: Genetic Disorders 1 1 — — $50,277.96 $50,277.96 $50,277.96 2026-02-26
2614 APR_DRG Apr-DRG 42.00: Major Biliary Tract Procedures 1 1 — — $50,075.53 $50,075.53 $50,075.53 2026-02-26
9504 APR_DRG Apr-DRG 42.00: Extensive O.r. Procedure Unrelated To Principal Diagnosis 1 1 — — $50,067.97 $50,067.97 $50,067.97 2026-02-26
6092 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1500-2499 Grams With Major Procedure 1 1 — — $50,056.21 $50,056.21 $50,056.21 2026-02-26
C2616 HCPCS Microsphere Yttrium-90 Therasphere 3.0 Gbq 9 3 $183,302.50 $152,141.07 $18,102.68 $50,463.18 $50,041.58 2026-02-26
1653 APR_DRG Apr-DRG 42.00: Coronary Bypass With Ami Or Complex Principal Diagnosis 1 1 — — $49,870.58 $49,870.58 $49,870.58 2026-02-26
61 APR_DRG Apr-DRG 42.00: Pancreas Transplant 1 1 — — $49,752.98 $49,752.98 $49,752.98 2026-02-26
207 MS_DRG Ms-DRG 43.00: Respiratory System Diagnosis With Ventilator Support >96 Hours 3 3 — — $49,103.66 $50,992.26 $49,575.81 2026-02-26
6234 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal… 1 1 — — $48,910.50 $48,910.50 $48,910.50 2026-02-26
274 APR_DRG Apr-DRG 42.00: Other Open Craniotomy 1 1 — — $48,578.71 $48,578.71 $48,578.71 2026-02-26
6302 APR_DRG Apr-DRG 42.00: Neonate Birth Weight > 2499 Grams With Major Cardiovascular Proce… 1 1 — — $48,459.43 $48,459.43 $48,459.43 2026-02-26
4402 APR_DRG Apr-DRG 42.00: Kidney Transplant 1 1 — — $48,432.55 $48,432.55 $48,432.55 2026-02-26
6123 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Sy… 1 1 — — $48,347.72 $48,347.72 $48,347.72 2026-02-26
924 APR_DRG Apr-DRG 42.00: Facial Bone Procedures Except Major Cranial Or Facial Bone Proced… 1 1 — — $48,039.45 $48,039.45 $48,039.45 2026-02-26
4014 APR_DRG Apr-DRG 42.00: Adrenal Procedures 1 1 — — $47,647.18 $47,647.18 $47,647.18 2026-02-26
132134 CDM Graft Stent Thoracic Valiant Proximal Freeflo Str 28x28x150mm 6 2 $173,593.50 $144,082.60 $46,870.25 $47,790.29 $47,521.22 2026-02-26
132138 CDM Graft Stent Thoracic Valiant Proximal Freeflo Str 30x30x150mm 6 2 $173,593.50 $144,082.60 $46,870.25 $47,790.29 $47,521.22 2026-02-26
152433 CDM Graft Stent Thoracic Valiant Proximal Freeflo Str 30x26x150mm 6 2 $173,593.50 $144,082.60 $46,870.25 $47,790.29 $47,521.22 2026-02-26
144937 CDM Graft Stent Thoracic Valiant Proximal Freeflo Str 44x40x150mm 6 2 $173,593.50 $144,082.60 $46,870.25 $47,790.29 $47,521.22 2026-02-26
5204 APR_DRG Apr-DRG 42.00: Other GYN Procedures For Malignancy 1 1 — — $47,471.63 $47,471.63 $47,471.63 2026-02-26
6133 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal… 1 1 — — $47,453.15 $47,453.15 $47,453.15 2026-02-26
6113 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1500-1999 Grams With Major Anomaly 1 1 — — $47,266.68 $47,266.68 $47,266.68 2026-02-26
266 MS_DRG Ms-DRG 43.00: Endovascular Cardiac Valve Replacement And Supplement Procedures W… 3 3 — — $46,766.26 $48,564.96 $47,215.94 2026-02-26
1622 APR_DRG Apr-DRG 42.00: Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 1 1 — — $47,209.56 $47,209.56 $47,209.56 2026-02-26
969 MS_DRG Ms-DRG 43.00: HIV With Extensive O.r. Procedures With Mcc 3 3 — — $46,712.08 $48,508.70 $47,161.23 2026-02-26
4414 APR_DRG Apr-DRG 42.00: Major Bladder Procedures 1 1 — — $46,992.01 $46,992.01 $46,992.01 2026-02-26
232 MS_DRG Ms-DRG 43.00: Coronary Bypass With Ptca Without Mcc 3 3 — — $46,264.14 $48,043.53 $46,708.99 2026-02-26
1782 APR_DRG Apr-DRG 42.00: External Heart Assist Devices 1 1 — — $46,667.78 $46,667.78 $46,667.78 2026-02-26
6032 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 1000-1249 Grams With Or Without Significant … 1 1 — — $46,585.47 $46,585.47 $46,585.47 2026-02-26
1833 APR_DRG Apr-DRG 42.00: Percutaneous Structural Cardiac Procedures 1 1 — — $46,456.11 $46,456.11 $46,456.11 2026-02-26
28 MS_DRG Ms-DRG 43.00: Spinal Procedures With Mcc 3 3 — — $45,849.78 $47,613.24 $46,290.65 2026-02-26
276 MS_DRG Ms-DRG 43.00: Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimu… 3 3 — — $45,836.79 $47,599.75 $46,277.53 2026-02-26
457 MS_DRG Ms-DRG 43.00: Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, I… 3 3 — — $45,504.85 $47,255.03 $45,942.39 2026-02-26
790 MS_DRG Ms-DRG 43.00: Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 3 3 — — $45,355.28 $47,099.72 $45,791.39 2026-02-26
16 MS_DRG Ms-DRG 43.00: Autologous Bone Marrow Transplant With Cc/mcc 3 3 — — $45,249.97 $46,990.36 $45,685.07 2026-02-26
175826 CDM Graft Stent Thoracic Valiant Closed Web Str 34x34x150mm 6 2 $166,554.00 $138,239.82 $44,969.58 $45,852.32 $45,594.15 2026-02-26
5114 APR_DRG Apr-DRG 42.00: Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 1 1 — — $45,473.35 $45,473.35 $45,473.35 2026-02-26
71611 CDM Implant Peek Custom Cranial Large 6 2 $165,940.49 $137,730.61 $44,803.93 $45,683.42 $45,426.21 2026-02-26
4401 APR_DRG Apr-DRG 42.00: Kidney Transplant 1 1 — — $45,324.67 $45,324.67 $45,324.67 2026-02-26
6224 APR_DRG Apr-DRG 42.00: Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Sy… 1 1 — — $45,275.12 $45,275.12 $45,275.12 2026-02-26
235 MS_DRG Ms-DRG 43.00: Coronary Bypass Without Cardiac Catheterization With Mcc 3 3 — — $44,783.72 $46,506.17 $45,214.33 2026-02-26
820 MS_DRG Ms-DRG 43.00: Lymphoma And Leukemia With Major O.r. Procedures With Mcc 3 3 — — $44,754.73 $46,476.06 $45,185.06 2026-02-26
3214 APR_DRG Apr-DRG 42.00: Spinal Fusion And Other Back And Neck Procedures Except For Disc … 1 1 — — $45,133.16 $45,133.16 $45,133.16 2026-02-26
224 APR_DRG Apr-DRG 42.00: Ventricular Shunt Procedures 1 1 — — $45,103.76 $45,103.76 $45,103.76 2026-02-26
7924 APR_DRG Apr-DRG 42.00: Extensive O.r. Procedures For Other Complications Of Treatment 1 1 — — $44,969.37 $44,969.37 $44,969.37 2026-02-26
1793 APR_DRG Apr-DRG 42.00: Defibrillator Implants 1 1 — — $44,967.69 $44,967.69 $44,967.69 2026-02-26
8423 APR_DRG Apr-DRG 42.00: Burns With Skin Graft Except Extensive Third Degree Burns 1 1 — — $44,512.42 $44,512.42 $44,512.42 2026-02-26
6514 APR_DRG Apr-DRG 42.00: Other Procedures Of Blood And Blood-forming Organs 1 1 — — $44,504.86 $44,504.86 $44,504.86 2026-02-26
430 MS_DRG Ms-DRG 43.00: Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 3 3 — — $44,009.15 $45,701.81 $44,432.31 2026-02-26
8633 APR_DRG Apr-DRG 42.00: Neonatal Aftercare 1 1 — — $44,343.59 $44,343.59 $44,343.59 2026-02-26
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