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

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Hospital

ROGER WILLIAMS MEDICAL CENTER

Providence, RI · CCN 410004 · Rates published

20,511 distinct procedures filed
8 distinct payers
178,444 rate rows
2026-01-01 last MRF observed
Data quality

175,962 of 178,444 rate rows are consumer-grade (98.6%)

2,482 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 1,731
per-diem day rate — not a per-procedure price 555
template filing: same amount across many unrelated codes — excluded 123
exceeds 10× this hospital's gross charge — excluded from medians 29
percent-of-charges filed in the dollar field — excluded from medians 27
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 11
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 6
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/7917/464648465_prospect-chartercare-rwmc,-llc_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/CharterCAREHealthPartnersatRogerWilliams/7917
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-09-11
Content fingerprint a0b27d500a70c954… · 75,510,646 bytes · first seen 2026-05-17

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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 3 $4,180,640.00 $4,505,000.00 $4,423,910.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 3 $3,419,927.47 $3,685,266.67 $3,618,931.87 nat. median
$3,685,267
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 3 $3,077,677.28 $3,316,462.59 $3,256,766.26 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 3 $3,014,557.62 $3,248,445.72 $3,189,973.69 nat. median
$3,248,446
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 3 $2,733,646.72 $2,945,740.00 $2,892,716.68 nat. median
$2,968,000
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 3 $2,278,342.64 $2,455,110.61 $2,410,918.62 nat. median
$2,455,111
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 3 $2,164,096.00 $2,332,000.00 $2,290,024.00 nat. median
$2,332,000
1.0× median
Q2056
HCPCS 		Ciltacabtagene Autolucel Bag 8 $501,412.76 $1,954,637.22 $871,480.85 nat. median
$599,737
1.5× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Bag 8 $470,315.49 $1,772,551.24 $800,721.15 nat. median
$562,501
1.4× median
Q2057
HCPCS 		Afamitresgene Autoleucel 3 $715,135.36 $770,620.00 $756,748.84 nat. median
$813,967
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 3 $549,121.91 $591,726.20 $581,075.13 nat. median
$621,313
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 3 $522,035.44 $562,538.19 $552,412.50 nat. median
$579,571
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 3 $517,191.04 $557,317.93 $547,286.21 nat. median
$574,037
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 $363,901.46 $704,349.90 $484,166.38 nat. median
$168,055
outlier · 2.9×
Q2053
HCPCS 		Brexucabtagene Car Pos T 3 $454,074.68 $489,304.61 $480,497.13 nat. median
$513,770
0.9× median
5834
APR_DRG 		Neonate W Ecmo 1 $426,975.49 $426,975.49 $426,975.49 nat. median
$390,362
1.1× median
5884
APR_DRG 		Neonate Bwt <1500g W Major Procedure 1 $384,149.03 $384,149.03 $384,149.03 nat. median
$286,698
1.3× median
34
APR_DRG 		Bone Marrow Transplant 1 $354,786.41 $354,786.41 $354,786.41 nat. median
$187,752
1.9× median
24
APR_DRG 		Heart &/or Lung Transplant 1 $354,213.48 $354,213.48 $354,213.48 nat. median
$225,531
1.6× median
1614
APR_DRG 		Cardiac Defibrillator & Heart Assist Implant 1 $313,535.50 $313,535.50 $313,535.50 nat. median
$202,242
1.6× median
5914
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 1 $307,949.44 $307,949.44 $307,949.44 nat. median
$171,497
1.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 4 $204,633.54 $457,094.75 $300,633.52 nat. median
$186,516
1.6× median
8414
APR_DRG 		Extensive 3rd Degree Burns W Skin Graft 1 $280,592.08 $280,592.08 $280,592.08 nat. median
$173,018
1.6× median
14
APR_DRG 		Liver Transplant &/or Intestinal Transplant 1 $276,581.57 $276,581.57 $276,581.57 nat. median
$136,566
outlier · 2.0×
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 3 $258,216.00 $278,250.00 $273,241.50 nat. median
$286,598
1.0× median
5883
APR_DRG 		Neonate Bwt <1500g W Major Procedure 1 $263,547.43 $263,547.43 $263,547.43 nat. median
$173,134
1.5× median
J3403
HCPCS 		Revakinagene, Per Implant 3 $238,960.00 $257,500.00 $252,865.00 nat. median
$264,195
1.0× median
44
APR_DRG 		Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 1 $236,046.83 $236,046.83 $236,046.83 nat. median
$135,630
1.7× median
5934
APR_DRG 		Neonate Birthwt 750-999g Without Major Procedure 1 $232,322.79 $232,322.79 $232,322.79 nat. median
$168,439
1.4× median
23
APR_DRG 		Heart &/or Lung Transplant 1 $229,601.38 $229,601.38 $229,601.38 nat. median
$117,894
1.9× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 4 $155,151.62 $346,201.90 $227,805.76 nat. median
$145,435
1.6× median
14
MS_DRG 		Autologous Stem Cell Transplant 5 $101,274.84 $383,387.00 $223,363.37 nat. median
$72,715
outlier · 3.1×
6304
APR_DRG 		Neonate Birthwt >2499g W Major Cardiovascular Procedure 1 $220,864.21 $220,864.21 $220,864.21 nat. median
$187,567
1.2× median
5833
APR_DRG 		Neonate W Ecmo 1 $216,853.70 $216,853.70 $216,853.70 nat. median
$268,208
0.8× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 4 $155,311.30 $300,612.96 $211,828.00 nat. median
$131,925
1.6× median
6094
APR_DRG 		Neonate Bwt 1500-2499g W Major Procedure 1 $206,540.98 $206,540.98 $206,540.98 nat. median
$198,578
1.0× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 3 $190,833.92 $205,640.00 $201,938.48 nat. median
$207,733
1.0× median
33
APR_DRG 		Bone Marrow Transplant 1 $201,814.31 $201,814.31 $201,814.31 nat. median
$104,474
1.9× median
5891
APR_DRG 		Neonate Bwt <500g Or Ga <24 Weeks 1 $200,525.22 $200,525.22 $200,525.22 nat. median
$99,483
outlier · 2.0×
6314
APR_DRG 		Neonate Birthwt >2499g W Other Major Procedure 1 $193,793.30 $193,793.30 $193,793.30 nat. median
$181,762
1.1× median
64
APR_DRG 		Pancreas Transplant 1 $191,358.35 $191,358.35 $191,358.35 nat. median
$92,994
outlier · 2.1×
5913
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 1 $187,061.38 $187,061.38 $187,061.38 nat. median
$120,079
1.6× median
6024
APR_DRG 		Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 $186,774.92 $186,774.92 $186,774.92 nat. median
$124,731
1.5× median
5892
APR_DRG 		Neonate Bwt <500g Or Ga <24 Weeks 1 $182,334.72 $182,334.72 $182,334.72 nat. median
$96,548
1.9× median
8424
APR_DRG 		Full Thickness Burns W Skin Graft 1 $178,610.68 $178,610.68 $178,610.68 nat. median
$91,950
1.9× median
6034
APR_DRG 		Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 1 $177,894.52 $177,894.52 $177,894.52 nat. median
$115,963
1.5× median
5832
APR_DRG 		Neonate W Ecmo 1 $171,019.37 $171,019.37 $171,019.37 nat. median
$201,678
0.8× median
5933
APR_DRG 		Neonate Birthwt 750-999g Without Major Procedure 1 $166,435.93 $166,435.93 $166,435.93 nat. median
$114,205
1.5× median
54
APR_DRG 		Tracheostomy W Mv 96+ Hours Without Extensive Procedure 1 $164,287.45 $164,287.45 $164,287.45 nat. median
$91,350
1.8× median
22
APR_DRG 		Heart &/or Lung Transplant 1 $162,711.89 $162,711.89 $162,711.89 nat. median
$95,481
1.7× median

Other procedures at this hospital

Browse this hospital's 20,511 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J3391 HCPCS Inj, Atidarsagene Autotemcel 4 3 — — $4,180,640.00 $4,505,000.00 $4,423,910.00 2026-01-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 4 3 — — $3,419,927.47 $3,685,266.67 $3,618,931.87 2026-01-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 4 3 — — $3,077,677.28 $3,316,462.59 $3,256,766.26 2026-01-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 4 3 — — $3,014,557.62 $3,248,445.72 $3,189,973.69 2026-01-01
J3393 HCPCS Inj, Betibeglogene Autotemce 4 3 — — $2,733,646.72 $2,945,740.00 $2,892,716.68 2026-01-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 4 3 — — $2,278,342.64 $2,455,110.61 $2,410,918.62 2026-01-01
J3392 HCPCS Inj, Exagamglogene Autotem 4 3 — — $2,164,096.00 $2,332,000.00 $2,290,024.00 2026-01-01
Q2056 HCPCS Ciltacabtagene Autolucel Bag 34 8 $2,498,896.98 $1,249,448.49 50% off $501,412.76 $1,954,637.22 $871,480.85 2026-01-01
Q2041 HCPCS Axicabtagene Ciloleucel Bag 34 8 $2,266,110.00 $1,133,055.00 50% off $470,315.49 $1,772,551.24 $800,721.15 2026-01-01
Q2057 HCPCS Afamitresgene Autoleucel 4 3 — — $715,135.36 $770,620.00 $756,748.84 2026-01-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 4 3 — — $549,121.91 $591,726.20 $581,075.13 2026-01-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 4 3 — — $522,035.44 $562,538.19 $552,412.50 2026-01-01
Q2055 HCPCS Idecabtagene Vicleucel Car 4 3 — — $517,191.04 $557,317.93 $547,286.21 2026-01-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 9 4 — — $363,901.46 $704,349.90 $484,166.38 2026-01-01
Q2053 HCPCS Brexucabtagene Car Pos T 4 3 — — $454,074.68 $489,304.61 $480,497.13 2026-01-01
5834 APR_DRG Neonate W Ecmo 1 1 — — $426,975.49 $426,975.49 $426,975.49 2026-01-01
5884 APR_DRG Neonate Bwt <1500g W Major Procedure 1 1 — — $384,149.03 $384,149.03 $384,149.03 2026-01-01
34 APR_DRG Bone Marrow Transplant 1 1 — — $354,786.41 $354,786.41 $354,786.41 2026-01-01
24 APR_DRG Heart &/or Lung Transplant 1 1 — — $354,213.48 $354,213.48 $354,213.48 2026-01-01
1614 APR_DRG Cardiac Defibrillator & Heart Assist Implant 1 1 — — $313,535.50 $313,535.50 $313,535.50 2026-01-01
5914 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 1 1 — — $307,949.44 $307,949.44 $307,949.44 2026-01-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 8 4 — — $204,633.54 $457,094.75 $300,633.52 2026-01-01
8414 APR_DRG Extensive 3rd Degree Burns W Skin Graft 1 1 — — $280,592.08 $280,592.08 $280,592.08 2026-01-01
14 APR_DRG Liver Transplant &/or Intestinal Transplant 1 1 — — $276,581.57 $276,581.57 $276,581.57 2026-01-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 4 3 — — $258,216.00 $278,250.00 $273,241.50 2026-01-01
5883 APR_DRG Neonate Bwt <1500g W Major Procedure 1 1 — — $263,547.43 $263,547.43 $263,547.43 2026-01-01
J3403 HCPCS Revakinagene, Per Implant 4 3 — — $238,960.00 $257,500.00 $252,865.00 2026-01-01
44 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 1 1 — — $236,046.83 $236,046.83 $236,046.83 2026-01-01
5934 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 1 1 — — $232,322.79 $232,322.79 $232,322.79 2026-01-01
23 APR_DRG Heart &/or Lung Transplant 1 1 — — $229,601.38 $229,601.38 $229,601.38 2026-01-01
3 MS_DRG Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 8 4 — — $155,151.62 $346,201.90 $227,805.76 2026-01-01
14 MS_DRG Autologous Stem Cell Transplant 12 5 — — $101,274.84 $383,387.00 $223,363.37 2026-01-01
6304 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 1 1 — — $220,864.21 $220,864.21 $220,864.21 2026-01-01
5833 APR_DRG Neonate W Ecmo 1 1 — — $216,853.70 $216,853.70 $216,853.70 2026-01-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 8 4 — — $155,311.30 $300,612.96 $211,828.00 2026-01-01
6094 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 1 1 — — $206,540.98 $206,540.98 $206,540.98 2026-01-01
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 4 3 — — $190,833.92 $205,640.00 $201,938.48 2026-01-01
33 APR_DRG Bone Marrow Transplant 1 1 — — $201,814.31 $201,814.31 $201,814.31 2026-01-01
5891 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 1 1 — — $200,525.22 $200,525.22 $200,525.22 2026-01-01
6314 APR_DRG Neonate Birthwt >2499g W Other Major Procedure 1 1 — — $193,793.30 $193,793.30 $193,793.30 2026-01-01
64 APR_DRG Pancreas Transplant 1 1 — — $191,358.35 $191,358.35 $191,358.35 2026-01-01
5913 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 1 1 — — $187,061.38 $187,061.38 $187,061.38 2026-01-01
6024 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $186,774.92 $186,774.92 $186,774.92 2026-01-01
5892 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 1 1 — — $182,334.72 $182,334.72 $182,334.72 2026-01-01
8424 APR_DRG Full Thickness Burns W Skin Graft 1 1 — — $178,610.68 $178,610.68 $178,610.68 2026-01-01
6034 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 1 1 — — $177,894.52 $177,894.52 $177,894.52 2026-01-01
5832 APR_DRG Neonate W Ecmo 1 1 — — $171,019.37 $171,019.37 $171,019.37 2026-01-01
5933 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 1 1 — — $166,435.93 $166,435.93 $166,435.93 2026-01-01
54 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 1 1 — — $164,287.45 $164,287.45 $164,287.45 2026-01-01
22 APR_DRG Heart &/or Lung Transplant 1 1 — — $162,711.89 $162,711.89 $162,711.89 2026-01-01
3034 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 1 1 — — $158,128.46 $158,128.46 $158,128.46 2026-01-01
43 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 1 1 — — $154,547.65 $154,547.65 $154,547.65 2026-01-01
5831 APR_DRG Neonate W Ecmo 1 1 — — $153,974.72 $153,974.72 $153,974.72 2026-01-01
6074 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $150,537.15 $150,537.15 $150,537.15 2026-01-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 1 1 — — $149,820.99 $149,820.99 $149,820.99 2026-01-01
4 MS_DRG Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And … 8 4 — — $101,484.03 $225,928.66 $148,817.52 2026-01-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 1 1 — — $143,948.46 $143,948.46 $143,948.46 2026-01-01
13 APR_DRG Liver Transplant &/or Intestinal Transplant 1 1 — — $141,513.51 $141,513.51 $141,513.51 2026-01-01
5893 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 1 1 — — $139,365.03 $139,365.03 $139,365.03 2026-01-01
7 MS_DRG Lung Transplant 8 4 — — $94,924.96 $211,229.29 $139,163.85 2026-01-01
6114 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 1 1 — — $138,935.33 $138,935.33 $138,935.33 2026-01-01
1624 APR_DRG Cardiac Valve Procedures W Cardiac Catheterization 1 1 — — $137,359.78 $137,359.78 $137,359.78 2026-01-01
4404 APR_DRG Kidney Transplant 1 1 — — $136,786.85 $136,786.85 $136,786.85 2026-01-01
21 APR_DRG Heart &/or Lung Transplant 1 1 — — $136,500.38 $136,500.38 $136,500.38 2026-01-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 11 5 — — $49,969.58 $289,058.36 $134,407.80 2026-01-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 11 5 — — $40,772.35 $289,058.36 $130,893.22 2026-01-01
5882 APR_DRG Neonate Bwt <1500g W Major Procedure 1 1 — — $128,049.68 $128,049.68 $128,049.68 2026-01-01
42 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 1 1 — — $128,049.68 $128,049.68 $128,049.68 2026-01-01
6134 APR_DRG Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 1 1 — — $126,187.66 $126,187.66 $126,187.66 2026-01-01
3044 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 1 1 — — $125,614.73 $125,614.73 $125,614.73 2026-01-01
63 APR_DRG Pancreas Transplant 1 1 — — $125,471.49 $125,471.49 $125,471.49 2026-01-01
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses 1 1 — — $125,328.26 $125,328.26 $125,328.26 2026-01-01
J7330 HCPCS Cultured Chondrocytes Implnt 1 1 — — $125,216.95 $125,216.95 $125,216.95 2026-01-01
32 APR_DRG Bone Marrow Transplant 1 1 — — $122,893.31 $122,893.31 $122,893.31 2026-01-01
6084 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 1 1 — — $122,320.38 $122,320.38 $122,320.38 2026-01-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 8 4 — — $83,146.02 $184,831.74 $121,827.53 2026-01-01
209 MS_DRG Complex Aortic Arch Procedures 8 4 — — $83,051.40 $184,619.70 $121,688.27 2026-01-01
6804 APR_DRG Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 1 1 — — $120,888.06 $120,888.06 $120,888.06 2026-01-01
6023 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $120,171.90 $120,171.90 $120,171.90 2026-01-01
1634 APR_DRG Cardiac Valve Procedures Without Cardiac Catheterization 1 1 — — $119,598.97 $119,598.97 $119,598.97 2026-01-01
8634 APR_DRG Neonatal Aftercare 1 1 — — $118,739.58 $118,739.58 $118,739.58 2026-01-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 4 — — $80,885.43 $179,765.58 $118,500.38 2026-01-01
1613 APR_DRG Cardiac Defibrillator & Heart Assist Implant 1 1 — — $118,166.65 $118,166.65 $118,166.65 2026-01-01
214 APR_DRG Craniotomy Except For Trauma 1 1 — — $117,880.18 $117,880.18 $117,880.18 2026-01-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 8 4 — — $79,814.81 $177,366.25 $116,924.64 2026-01-01
224 APR_DRG Ventricular Shunt Procedures 1 1 — — $115,588.47 $115,588.47 $115,588.47 2026-01-01
5881 APR_DRG Neonate Bwt <1500g W Major Procedure 1 1 — — $115,302.00 $115,302.00 $115,302.00 2026-01-01
2604 APR_DRG Major Pancreas, Liver & Shunt Procedures 1 1 — — $115,015.54 $115,015.54 $115,015.54 2026-01-01
9114 APR_DRG Extensive Abdominal/thoracic Procedures For Mult Significant Trauma 1 1 — — $113,726.45 $113,726.45 $113,726.45 2026-01-01
6033 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 1 1 — — $112,437.36 $112,437.36 $112,437.36 2026-01-01
6904 APR_DRG Acute Leukemia 1 1 — — $111,864.43 $111,864.43 $111,864.43 2026-01-01
3033 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 1 1 — — $111,148.26 $111,148.26 $111,148.26 2026-01-01
53 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 1 1 — — $111,148.26 $111,148.26 $111,148.26 2026-01-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 8 4 — — $75,712.85 $168,173.43 $110,887.35 2026-01-01
904 APR_DRG Major Larynx & Trachea Procedures 1 1 — — $110,861.80 $110,861.80 $110,861.80 2026-01-01
12 APR_DRG Liver Transplant &/or Intestinal Transplant 1 1 — — $110,718.57 $110,718.57 $110,718.57 2026-01-01
9124 APR_DRG Musculoskeletal & Other Procedures For Multiple Significant Trauma 1 1 — — $109,429.48 $109,429.48 $109,429.48 2026-01-01
1674 APR_DRG Other Cardiothoracic Procedures 1 1 — — $109,286.24 $109,286.24 $109,286.24 2026-01-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 5 3 — — $98,480.22 $128,849.12 $109,138.43 2026-01-01
62 APR_DRG Pancreas Transplant 1 1 — — $108,713.32 $108,713.32 $108,713.32 2026-01-01
234 APR_DRG Spinal Procedures 1 1 — — $108,713.32 $108,713.32 $108,713.32 2026-01-01
6303 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 1 1 — — $108,713.32 $108,713.32 $108,713.32 2026-01-01
5932 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 1 1 — — $108,713.32 $108,713.32 $108,713.32 2026-01-01
894 APR_DRG Major Cranial/facial Bone Procedures 1 1 — — $107,567.46 $107,567.46 $107,567.46 2026-01-01
215 MS_DRG Other Heart Assist System Implant 8 4 — — $73,140.02 $162,407.53 $107,100.65 2026-01-01
6093 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 1 1 — — $106,564.83 $106,564.83 $106,564.83 2026-01-01
90288 CPT Botulism Ig IV 1 1 — — $106,444.78 $106,444.78 $106,444.78 2026-01-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 4 — — $71,872.17 $159,566.17 $105,234.62 2026-01-01
1654 APR_DRG Coronary Bypass W Cardiac Cath Or Percutaneous Cardiac Procedure 1 1 — — $103,127.26 $103,127.26 $103,127.26 2026-01-01
41 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 1 1 — — $102,697.56 $102,697.56 $102,697.56 2026-01-01
6124 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 1 1 — — $102,124.63 $102,124.63 $102,124.63 2026-01-01
11 APR_DRG Liver Transplant &/or Intestinal Transplant 1 1 — — $101,408.47 $101,408.47 $101,408.47 2026-01-01
1694 APR_DRG Major Thoracic & Abdominal Vascular Procedures 1 1 — — $100,835.54 $100,835.54 $100,835.54 2026-01-01
204 APR_DRG Craniotomy For Trauma 1 1 — — $100,549.07 $100,549.07 $100,549.07 2026-01-01
4034 APR_DRG Procedures For Obesity 1 1 — — $99,259.98 $99,259.98 $99,259.98 2026-01-01
2204 APR_DRG Major Stomach, Esophageal & Duodenal Procedures 1 1 — — $98,400.59 $98,400.59 $98,400.59 2026-01-01
9504 APR_DRG Extensive Procedure Unrelated To Principal Diagnosis 1 1 — — $98,114.13 $98,114.13 $98,114.13 2026-01-01
8413 APR_DRG Extensive 3rd Degree Burns W Skin Graft 1 1 — — $97,970.89 $97,970.89 $97,970.89 2026-01-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 8 4 — — $66,244.71 $146,954.59 $96,952.10 2026-01-01
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 5 3 — — $86,505.10 $109,422.85 $95,115.61 2026-01-01
4014 APR_DRG Pituitary & Adrenal Procedures 1 1 — — $95,106.25 $95,106.25 $95,106.25 2026-01-01
6814 APR_DRG Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 1 1 — — $95,106.25 $95,106.25 $95,106.25 2026-01-01
6214 APR_DRG Neonate Bwt 2000-2499g W Major Anomaly 1 1 — — $94,676.55 $94,676.55 $94,676.55 2026-01-01
2644 APR_DRG Other Hepatobiliary, Pancreas & Abdominal Procedures 1 1 — — $93,244.23 $93,244.23 $93,244.23 2026-01-01
850 MS_DRG Acute Leukemia With Other Procedures 8 4 — — $63,696.63 $141,244.15 $93,201.82 2026-01-01
6073 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $92,384.83 $92,384.83 $92,384.83 2026-01-01
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs 1 1 — — $90,952.51 $90,952.51 $90,952.51 2026-01-01
734 APR_DRG Eye Procedures Except Orbit 1 1 — — $90,809.28 $90,809.28 $90,809.28 2026-01-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 8 4 — — $62,025.57 $137,499.17 $90,742.34 2026-01-01
3214 APR_DRG Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp 1 1 — — $90,522.81 $90,522.81 $90,522.81 2026-01-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 8 4 — — $61,832.69 $137,066.93 $90,458.47 2026-01-01
4403 APR_DRG Kidney Transplant 1 1 — — $89,806.65 $89,806.65 $89,806.65 2026-01-01
61 APR_DRG Pancreas Transplant 1 1 — — $89,663.42 $89,663.42 $89,663.42 2026-01-01
8504 APR_DRG Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service 1 1 — — $89,376.96 $89,376.96 $89,376.96 2026-01-01
4414 APR_DRG Major Bladder Procedures 1 1 — — $89,090.49 $89,090.49 $89,090.49 2026-01-01
1204 APR_DRG Major Respiratory & Chest Procedures 1 1 — — $88,947.26 $88,947.26 $88,947.26 2026-01-01
1664 APR_DRG Coronary Bypass Without Cardiac Cath Or Percutaneous Cardiac Procedure 1 1 — — $88,517.56 $88,517.56 $88,517.56 2026-01-01
3614 APR_DRG Skin Graft For Skin & Subcutaneous Tissue Diagnoses 1 1 — — $88,231.10 $88,231.10 $88,231.10 2026-01-01
8412 APR_DRG Extensive 3rd Degree Burns W Skin Graft 1 1 — — $88,087.86 $88,087.86 $88,087.86 2026-01-01
6083 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 1 1 — — $87,944.63 $87,944.63 $87,944.63 2026-01-01
31 APR_DRG Bone Marrow Transplant 1 1 — — $87,801.40 $87,801.40 $87,801.40 2026-01-01
7104 APR_DRG Infectious & Parasitic Diseases Including HIV W O.r. Procedure 1 1 — — $87,228.47 $87,228.47 $87,228.47 2026-01-01
6364 APR_DRG Neonate Birthwt >2499g W Congenital/perinatal Infection 1 1 — — $86,798.77 $86,798.77 $86,798.77 2026-01-01
6022 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $86,512.31 $86,512.31 $86,512.31 2026-01-01
6334 APR_DRG Neonate Birthwt >2499g W Major Anomaly 1 1 — — $86,082.61 $86,082.61 $86,082.61 2026-01-01
52 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 1 1 — — $86,082.61 $86,082.61 $86,082.61 2026-01-01
2214 APR_DRG Major Small & Large Bowel Procedures 1 1 — — $85,796.15 $85,796.15 $85,796.15 2026-01-01
1623 APR_DRG Cardiac Valve Procedures W Cardiac Catheterization 1 1 — — $85,079.99 $85,079.99 $85,079.99 2026-01-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 8 4 — — $57,941.80 $128,347.13 $84,731.83 2026-01-01
7114 APR_DRG Post-op, Post-trauma, Other Device Infections W O.r. Procedure 1 1 — — $84,650.29 $84,650.29 $84,650.29 2026-01-01
244 APR_DRG Extracranial Vascular Procedures 1 1 — — $84,650.29 $84,650.29 $84,650.29 2026-01-01
6344 APR_DRG Neonate, Birthwt >2499g W Resp Dist Synd/oth Maj Resp Cond 1 1 — — $84,077.36 $84,077.36 $84,077.36 2026-01-01
6504 APR_DRG Splenectomy 1 1 — — $82,931.50 $82,931.50 $82,931.50 2026-01-01
1214 APR_DRG Other Respiratory & Chest Procedures 1 1 — — $82,931.50 $82,931.50 $82,931.50 2026-01-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 4 — — $56,555.31 $125,239.91 $82,691.19 2026-01-01
7914 APR_DRG O.r. Procedure For Other Complications Of Treatment 1 1 — — $82,645.04 $82,645.04 $82,645.04 2026-01-01
4054 APR_DRG Other Procedures For Endocrine, Nutritional & Metabolic Disorders 1 1 — — $82,358.57 $82,358.57 $82,358.57 2026-01-01
6144 APR_DRG Neonate Bwt 1500-1999g W Or Without Other Significant Condition 1 1 — — $82,358.57 $82,358.57 $82,358.57 2026-01-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 8 4 — — $56,314.41 $124,700.02 $82,336.62 2026-01-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 8 4 — — $56,130.27 $124,287.35 $82,065.61 2026-01-01
264 APR_DRG Other Nervous System & Related Procedures 1 1 — — $81,355.95 $81,355.95 $81,355.95 2026-01-01
914 APR_DRG Other Major Head & Neck Procedures 1 1 — — $81,212.71 $81,212.71 $81,212.71 2026-01-01
6514 APR_DRG Other Procedures Of Blood & Blood-forming Organs 1 1 — — $81,069.48 $81,069.48 $81,069.48 2026-01-01
8444 APR_DRG Partial Thickness Burns W Or Without Skin Graft 1 1 — — $79,923.62 $79,923.62 $79,923.62 2026-01-01
1814 APR_DRG Lower Extremity Arterial Procedures 1 1 — — $79,846.15 $79,846.15 $79,846.15 2026-01-01
8411 APR_DRG Extensive 3rd Degree Burns W Skin Graft 1 1 — — $79,350.69 $79,350.69 $79,350.69 2026-01-01
J9029 HCPCS Instill Adstiladrin, Tx Dose 5 3 — — $58,781.64 $144,328.91 $78,627.48 2026-01-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 4 — — $53,209.55 $117,741.79 $77,766.88 2026-01-01
4474 APR_DRG Other Kidney, Urinary Tract & Related Procedures 1 1 — — $77,345.44 $77,345.44 $77,345.44 2026-01-01
51 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 1 1 — — $77,345.44 $77,345.44 $77,345.44 2026-01-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 8 4 — — $52,875.49 $116,993.12 $77,275.20 2026-01-01
1304 APR_DRG Respiratory System Diagnosis W Ventilator Support 96+ Hours 1 1 — — $77,202.21 $77,202.21 $77,202.21 2026-01-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 8 4 — — $52,567.62 $116,303.17 $76,822.08 2026-01-01
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 5 3 — — $62,596.07 $113,730.67 $75,736.94 2026-01-01
924 APR_DRG Facial Bone Procedures Except Major Cranial/facial Bone Procedures 1 1 — — $75,483.42 $75,483.42 $75,483.42 2026-01-01
3032 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 1 1 — — $75,483.42 $75,483.42 $75,483.42 2026-01-01
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 1 1 — — $75,053.73 $75,053.73 $75,053.73 2026-01-01
2224 APR_DRG Other Stomach, Esophageal & Duodenal Procedures 1 1 — — $74,767.26 $74,767.26 $74,767.26 2026-01-01
2234 APR_DRG Other Small & Large Bowel Procedures 1 1 — — $74,480.80 $74,480.80 $74,480.80 2026-01-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv &gt;96 Hours 8 4 — — $50,976.62 $112,737.61 $74,480.43 2026-01-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 8 4 — — $50,729.89 $112,184.67 $74,117.30 2026-01-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 8 4 — — $52,598.19 $108,095.53 $73,857.74 2026-01-01
6313 APR_DRG Neonate Birthwt >2499g W Other Major Procedure 1 1 — — $73,621.40 $73,621.40 $73,621.40 2026-01-01
6954 APR_DRG Chemotherapy For Acute Leukemia 1 1 — — $73,515.89 $73,515.89 $73,515.89 2026-01-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 8 4 — — $49,661.45 $109,790.23 $72,544.77 2026-01-01
1612 APR_DRG Cardiac Defibrillator & Heart Assist Implant 1 1 — — $72,332.31 $72,332.31 $72,332.31 2026-01-01
A9543 HCPCS Y90 Ibritumomab, Rx 5 3 — — $52,733.18 $137,699.11 $72,181.19 2026-01-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 8 4 — — $49,336.85 $109,062.77 $72,067.02 2026-01-01
6224 APR_DRG Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond 1 1 — — $72,045.85 $72,045.85 $72,045.85 2026-01-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 8 4 — — $49,301.19 $108,982.84 $72,014.53 2026-01-01
9514 APR_DRG Moderately Extensive Procedure Unrelated To Principal Diagnosis 1 1 — — $71,759.38 $71,759.38 $71,759.38 2026-01-01
4402 APR_DRG Kidney Transplant 1 1 — — $71,472.92 $71,472.92 $71,472.92 2026-01-01
9103 APR_DRG Craniotomy For Multiple Significant Trauma 1 1 — — $71,329.69 $71,329.69 $71,329.69 2026-01-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 4 — — $48,527.52 $107,249.00 $70,875.84 2026-01-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 4 — — $48,527.52 $107,249.00 $70,875.84 2026-01-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 8 4 — — $48,353.57 $106,859.16 $70,619.82 2026-01-01
5912 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 1 1 — — $70,183.83 $70,183.83 $70,183.83 2026-01-01
3174 APR_DRG Tendon, Muscle & Other Soft Tissue Procedures 1 1 — — $70,183.83 $70,183.83 $70,183.83 2026-01-01
1824 APR_DRG Other Peripheral Vascular Procedures 1 1 — — $70,042.46 $70,042.46 $70,042.46 2026-01-01
5114 APR_DRG Uterine & Adnexa Procedures For Ovarian & Adnexal Malignancy 1 1 — — $70,040.59 $70,040.59 $70,040.59 2026-01-01
2294 APR_DRG Other Digestive System & Abdominal Procedures 1 1 — — $70,040.59 $70,040.59 $70,040.59 2026-01-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 9 4 — — $44,071.84 $110,711.00 $69,472.73 2026-01-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support &gt;96 Hours 8 4 — — $47,504.21 $104,955.68 $69,369.73 2026-01-01
3043 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 1 1 — — $69,181.20 $69,181.20 $69,181.20 2026-01-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 5 3 — — $51,292.72 $126,176.13 $68,657.16 2026-01-01
6113 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 1 1 — — $68,465.04 $68,465.04 $68,465.04 2026-01-01
6254 APR_DRG Neonate Bwt 2000-2499g W Other Significant Condition 1 1 — — $68,465.04 $68,465.04 $68,465.04 2026-01-01
2244 APR_DRG Peritoneal Adhesiolysis 1 1 — — $68,321.81 $68,321.81 $68,321.81 2026-01-01
934 APR_DRG Sinus & Mastoid Procedures 1 1 — — $68,178.57 $68,178.57 $68,178.57 2026-01-01
1633 APR_DRG Cardiac Valve Procedures Without Cardiac Catheterization 1 1 — — $67,748.88 $67,748.88 $67,748.88 2026-01-01
5464 APR_DRG Other O.r. Proc For Obstetric Diagnoses Except Delivery Diagnoses 1 1 — — $67,748.88 $67,748.88 $67,748.88 2026-01-01
6032 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 1 1 — — $67,605.65 $67,605.65 $67,605.65 2026-01-01
8434 APR_DRG Extensive 3rd Degree Or Full Thickness Burns Without Skin Graft 1 1 — — $67,319.18 $67,319.18 $67,319.18 2026-01-01
2614 APR_DRG Major Biliary Tract Procedures 1 1 — — $67,175.95 $67,175.95 $67,175.95 2026-01-01
6072 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $67,032.72 $67,032.72 $67,032.72 2026-01-01
1622 APR_DRG Cardiac Valve Procedures W Cardiac Catheterization 1 1 — — $66,459.79 $66,459.79 $66,459.79 2026-01-01
6123 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 1 1 — — $66,173.32 $66,173.32 $66,173.32 2026-01-01
1653 APR_DRG Coronary Bypass W Cardiac Cath Or Percutaneous Cardiac Procedure 1 1 — — $66,173.32 $66,173.32 $66,173.32 2026-01-01
3204 APR_DRG Other Musculoskeletal System & Connective Tissue Procedures 1 1 — — $66,173.32 $66,173.32 $66,173.32 2026-01-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 8 4 — — $45,274.92 $99,959.66 $66,088.64 2026-01-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 8 4 — — $45,223.24 $99,843.85 $66,012.59 2026-01-01
6133 APR_DRG Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 1 1 — — $65,886.86 $65,886.86 $65,886.86 2026-01-01
3031 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 1 1 — — $65,600.39 $65,600.39 $65,600.39 2026-01-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 8 4 — — $44,796.02 $98,886.40 $65,383.79 2026-01-01
4401 APR_DRG Kidney Transplant 1 1 — — $65,313.93 $65,313.93 $65,313.93 2026-01-01
3094 APR_DRG Hip & Femur Procedures For Non-trauma Except Joint Replacement 1 1 — — $65,313.93 $65,313.93 $65,313.93 2026-01-01
2624 APR_DRG Cholecystectomy Except Laparoscopic 1 1 — — $64,884.23 $64,884.23 $64,884.23 2026-01-01
28 MS_DRG Spinal Procedures With Mcc 8 4 — — $44,400.82 $98,000.72 $64,802.13 2026-01-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 8 4 — — $44,388.44 $97,972.99 $64,783.92 2026-01-01
1704 APR_DRG Permanent Cardiac Pacemaker Implant W Ami, Heart Failure Or Shock 1 1 — — $64,741.00 $64,741.00 $64,741.00 2026-01-01
213 APR_DRG Craniotomy Except For Trauma 1 1 — — $64,454.53 $64,454.53 $64,454.53 2026-01-01
6234 APR_DRG Neonate Bwt 2000-2499g W Congenital/perinatal Infection 1 1 — — $64,311.30 $64,311.30 $64,311.30 2026-01-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 8 4 — — $43,929.19 $96,943.77 $64,107.99 2026-01-01
9524 APR_DRG Nonextensive Procedure Unrelated To Principal Diagnosis 1 1 — — $63,451.91 $63,451.91 $63,451.91 2026-01-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 8 4 — — $43,384.06 $95,722.09 $63,305.66 2026-01-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 8 4 — — $43,356.40 $95,660.11 $63,264.96 2026-01-01
3134 APR_DRG Knee & Lower Leg Procedures Except Foot 1 1 — — $63,022.21 $63,022.21 $63,022.21 2026-01-01
4424 APR_DRG Kidney & Urinary Tract Procedures For Malignancy 1 1 — — $62,735.75 $62,735.75 $62,735.75 2026-01-01
9304 APR_DRG Multiple Significant Trauma Without O.r. Procedure 1 1 — — $62,592.52 $62,592.52 $62,592.52 2026-01-01
4444 APR_DRG Renal Dialysis Access Device Procedure Only 1 1 — — $62,592.52 $62,592.52 $62,592.52 2026-01-01
1774 APR_DRG Cardiac Pacemaker & Defibrillator Revision Except Device Replacement 1 1 — — $62,449.28 $62,449.28 $62,449.28 2026-01-01
4814 APR_DRG Penis Procedures 1 1 — — $62,306.05 $62,306.05 $62,306.05 2026-01-01
7404 APR_DRG Mental Illness Diagnosis W O.r. Procedure 1 1 — — $62,306.05 $62,306.05 $62,306.05 2026-01-01
4044 APR_DRG Thyroid, Parathyroid & Thyroglossal Procedures 1 1 — — $62,306.05 $62,306.05 $62,306.05 2026-01-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 8 4 — — $42,645.32 $94,066.53 $62,218.39 2026-01-01
8423 APR_DRG Full Thickness Burns W Skin Graft 1 1 — — $62,019.59 $62,019.59 $62,019.59 2026-01-01
494 APR_DRG Bacterial & Tuberculous Infections Of Nervous System 1 1 — — $61,876.35 $61,876.35 $61,876.35 2026-01-01
1804 APR_DRG Other Circulatory System Procedures 1 1 — — $61,876.35 $61,876.35 $61,876.35 2026-01-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 8 4 — — $42,377.49 $93,466.29 $61,824.19 2026-01-01
1764 APR_DRG Cardiac Pacemaker & Defibrillator Device Replacement 1 1 — — $61,589.89 $61,589.89 $61,589.89 2026-01-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 8 4 — — $42,207.18 $93,084.62 $61,573.53 2026-01-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 8 4 — — $42,153.32 $92,963.92 $61,494.26 2026-01-01
6092 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 1 1 — — $61,160.19 $61,160.19 $61,160.19 2026-01-01
4434 APR_DRG Kidney & Urinary Tract Procedures For Nonmalignancy 1 1 — — $60,873.73 $60,873.73 $60,873.73 2026-01-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 4 — — $41,589.27 $91,699.82 $60,664.08 2026-01-01
4804 APR_DRG Major Male Pelvic Procedures 1 1 — — $60,587.26 $60,587.26 $60,587.26 2026-01-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 8 4 — — $41,462.62 $91,416.01 $60,477.69 2026-01-01
3154 APR_DRG Shoulder, Upper Arm & Forearm Procedures 1 1 — — $60,157.57 $60,157.57 $60,157.57 2026-01-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 8 4 — — $41,183.15 $90,789.68 $60,066.35 2026-01-01
1621 APR_DRG Cardiac Valve Procedures W Cardiac Catheterization 1 1 — — $59,871.10 $59,871.10 $59,871.10 2026-01-01
3054 APR_DRG Amputation Of Lower Limb Except Toes 1 1 — — $59,727.87 $59,727.87 $59,727.87 2026-01-01
4834 APR_DRG Testes & Scrotal Procedures 1 1 — — $59,584.64 $59,584.64 $59,584.64 2026-01-01
5124 APR_DRG Uterine & Adnexa Procedures For Non-ovarian & Non-adnexal Malig 1 1 — — $59,584.64 $59,584.64 $59,584.64 2026-01-01
834 MS_DRG Acute Leukemia With Mcc 8 4 — — $40,627.82 $89,545.16 $59,249.02 2026-01-01
1744 APR_DRG Percutaneous Cardiovascular Procedures W Ami 1 1 — — $59,154.94 $59,154.94 $59,154.94 2026-01-01
504 APR_DRG Non-bacterial Infections Of Nervous System Exc Viral Meningitis 1 1 — — $59,154.94 $59,154.94 $59,154.94 2026-01-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 8 4 — — $40,486.63 $89,228.72 $59,041.21 2026-01-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 8 4 — — $40,429.85 $89,101.50 $58,957.65 2026-01-01
1673 APR_DRG Other Cardiothoracic Procedures 1 1 — — $58,868.48 $58,868.48 $58,868.48 2026-01-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 8 4 — — $40,367.26 $88,961.23 $58,865.53 2026-01-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 8 4 — — $40,868.73 $87,436.16 $58,640.41 2026-01-01
2274 APR_DRG Hernia Procedures Except Inguinal, Femoral & Umbilical 1 1 — — $58,295.55 $58,295.55 $58,295.55 2026-01-01
704 APR_DRG Orbital Procedures 1 1 — — $58,009.08 $58,009.08 $58,009.08 2026-01-01
3024 APR_DRG Knee Joint Replacement 1 1 — — $57,722.62 $57,722.62 $57,722.62 2026-01-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 4 — — $39,484.43 $86,982.71 $57,566.17 2026-01-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 8 4 — — $39,461.13 $86,930.52 $57,531.88 2026-01-01
6082 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 1 1 — — $57,436.15 $57,436.15 $57,436.15 2026-01-01
984 APR_DRG Other Ear, Nose, Mouth & Throat Procedures 1 1 — — $57,436.15 $57,436.15 $57,436.15 2026-01-01
3644 APR_DRG Other Skin, Subcutaneous Tissue & Related Procedures 1 1 — — $57,436.15 $57,436.15 $57,436.15 2026-01-01
1611 APR_DRG Cardiac Defibrillator & Heart Assist Implant 1 1 — — $57,436.15 $57,436.15 $57,436.15 2026-01-01
6394 APR_DRG Neonate Birthwt >2499g W Other Significant Condition 1 1 — — $57,149.69 $57,149.69 $57,149.69 2026-01-01
3624 APR_DRG Mastectomy Procedures 1 1 — — $57,149.69 $57,149.69 $57,149.69 2026-01-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 8 4 — — $39,200.58 $86,346.59 $57,148.40 2026-01-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 8 4 — — $39,073.21 $86,061.15 $56,960.93 2026-01-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 8 4 — — $38,557.19 $84,904.71 $56,201.45 2026-01-01
653 MS_DRG Major Bladder Procedures With Mcc 8 4 — — $38,491.69 $84,757.91 $56,105.05 2026-01-01
223 APR_DRG Ventricular Shunt Procedures 1 1 — — $56,003.83 $56,003.83 $56,003.83 2026-01-01
6143 APR_DRG Neonate Bwt 1500-1999g W Or Without Other Significant Condition 1 1 — — $56,003.83 $56,003.83 $56,003.83 2026-01-01
8904 APR_DRG HIV W Multiple Major HIV Related Conditions 1 1 — — $56,003.83 $56,003.83 $56,003.83 2026-01-01
6604 APR_DRG Major Hematologic/immunologic Diag Exc Sickle Cell Crisis & Coagul 1 1 — — $55,574.13 $55,574.13 $55,574.13 2026-01-01
J9226 HCPCS Supprelin La Implant 5 3 — — $41,779.16 $100,368.17 $55,441.86 2026-01-01
1303 APR_DRG Respiratory System Diagnosis W Ventilator Support 96+ Hours 1 1 — — $55,430.90 $55,430.90 $55,430.90 2026-01-01
5184 APR_DRG Other Female Reproductive System & Related Procedures 1 1 — — $55,287.67 $55,287.67 $55,287.67 2026-01-01
9102 APR_DRG Craniotomy For Multiple Significant Trauma 1 1 — — $55,287.67 $55,287.67 $55,287.67 2026-01-01
3123 APR_DRG Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses 1 1 — — $55,287.67 $55,287.67 $55,287.67 2026-01-01
233 APR_DRG Spinal Procedures 1 1 — — $55,001.20 $55,001.20 $55,001.20 2026-01-01
9123 APR_DRG Musculoskeletal & Other Procedures For Multiple Significant Trauma 1 1 — — $54,857.97 $54,857.97 $54,857.97 2026-01-01
3224 APR_DRG Shoulder & Elbow Joint Replacement 1 1 — — $54,791.86 $54,791.86 $54,791.86 2026-01-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 9 4 — — $34,125.53 $95,443.02 $54,763.81 2026-01-01
6903 APR_DRG Acute Leukemia 1 1 — — $54,714.74 $54,714.74 $54,714.74 2026-01-01
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