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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

OUR LADY OF FATIMA HOSPITAL

North Providence, RI · CCN 410005 · Rates published

18,880 distinct procedures filed
8 distinct payers
159,348 rate rows
2026-01-01 last MRF observed
Data quality

156,702 of 159,348 rate rows are consumer-grade (98.3%)

2,646 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 1,500
per-diem day rate — not a per-procedure price 1,108
percent-of-charges filed in the dollar field — excluded from medians 23
exceeds 10× this hospital's gross charge — excluded from medians 15
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/7916/464661337_prospect-chartercare-sjhsri,-llc_standardcharges.csv
Found on page https://www.chartercare.org/cms-hpt.txt
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-05-18
Content fingerprint a06e670e1ea8c74b… · 65,517,502 bytes · first seen 2026-05-14

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 $4,505,000.00 $4,505,000.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 3 $3,685,266.67 $3,685,266.67 $3,685,266.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 3 $3,316,462.59 $3,316,462.59 $3,316,462.59 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 3 $3,248,445.72 $3,248,445.72 $3,248,445.72 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 3 $2,945,740.00 $2,945,740.00 $2,945,740.00 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 3 $2,455,110.61 $4,352,911.10 $2,455,110.61 nat. median
$2,469,189
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 3 $2,332,000.00 $4,134,636.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
Q2056
HCPCS 		Ciltacabtagene Autolucel Bag 8 $502,083.28 $1,651,770.90 $1,465,852.97 nat. median
$675,122
outlier · 2.2×
Q2041
HCPCS 		Axicabtagene Ciloleucel Bag 8 $470,944.44 $1,497,898.71 $1,329,300.13 nat. median
$634,511
outlier · 2.1×
Q2057
HCPCS 		Afamitresgene Autoleucel 3 $770,620.00 $1,366,309.26 $770,620.00 nat. median
$824,563
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 3 $591,726.20 $1,049,130.55 $591,726.20 nat. median
$754,974
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 3 $562,538.19 $997,380.20 $562,538.19 nat. median
$674,188
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 3 $557,317.93 $988,124.70 $557,317.93 nat. median
$625,184
0.9× median
5834
APR_DRG 		Neonate W Ecmo 1 $533,683.55 $533,683.55 $533,683.55 nat. median
$309,665
1.7× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 3 $489,304.61 $867,537.07 $489,304.61 nat. median
$620,080
0.8× median
5884
APR_DRG 		Neonate Bwt <1500g W Major Procedure 1 $480,257.90 $480,257.90 $480,257.90 nat. median
$246,434
1.9× median
5914
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 1 $385,008.42 $385,008.42 $385,008.42 nat. median
$164,279
outlier · 2.3×
34
APR_DRG 		Bone Marrow Transplant 1 $354,786.41 $354,786.41 $354,786.41 nat. median
$209,067
1.7× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 $309,001.44 $656,306.01 $354,359.45 nat. median
$370,174
1.0× median
24
APR_DRG 		Heart &/or Lung Transplant 1 $354,213.48 $354,213.48 $354,213.48 nat. median
$234,738
1.5× median
5883
APR_DRG 		Neonate Bwt <1500g W Major Procedure 1 $329,434.29 $329,434.29 $329,434.29 nat. median
$182,736
1.8× median
1614
APR_DRG 		Cardiac Defibrillator & Heart Assist Implant 1 $313,535.50 $313,535.50 $313,535.50 nat. median
$207,730
1.5× median
5934
APR_DRG 		Neonate Birthwt 750-999g Without Major Procedure 1 $290,475.10 $290,475.10 $290,475.10 nat. median
$151,838
1.9× median
8414
APR_DRG 		Extensive 3rd Degree Burns W Skin Graft 1 $280,592.08 $280,592.08 $280,592.08 nat. median
$160,267
1.8× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 3 $278,250.00 $493,337.25 $278,250.00 nat. median
$324,450
0.9× median
14
APR_DRG 		Liver Transplant &/or Intestinal Transplant 1 $276,581.57 $276,581.57 $276,581.57 nat. median
$129,535
outlier · 2.1×
6304
APR_DRG 		Neonate Birthwt >2499g W Major Cardiovascular Procedure 1 $276,151.87 $276,151.87 $276,151.87 nat. median
$150,721
1.8× median
5833
APR_DRG 		Neonate W Ecmo 1 $271,138.74 $271,138.74 $271,138.74 nat. median
$244,017
1.1× median
6094
APR_DRG 		Neonate Bwt 1500-2499g W Major Procedure 1 $258,247.84 $258,247.84 $258,247.84 nat. median
$162,982
1.6× median
J3403
HCPCS 		Revakinagene, Per Implant 3 $257,500.00 $456,547.50 $257,500.00 nat. median
$265,000
1.0× median
5891
APR_DRG 		Neonate Bwt <500g Or Ga <24 Weeks 1 $250,656.53 $250,656.53 $250,656.53 nat. median
$93,260
outlier · 2.7×
6314
APR_DRG 		Neonate Birthwt >2499g W Other Major Procedure 1 $242,205.82 $242,205.82 $242,205.82 nat. median
$122,924
2.0× 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
$105,658
outlier · 2.2×
5913
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 1 $233,898.35 $233,898.35 $233,898.35 nat. median
$102,636
outlier · 2.3×
6024
APR_DRG 		Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 $233,468.65 $233,468.65 $233,468.65 nat. median
$118,620
2.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 4 $200,762.15 $425,916.20 $230,231.82 nat. median
$265,286
0.9× median
23
APR_DRG 		Heart &/or Lung Transplant 1 $229,601.38 $229,601.38 $229,601.38 nat. median
$93,528
outlier · 2.5×
5892
APR_DRG 		Neonate Bwt <500g Or Ga <24 Weeks 1 $227,882.59 $227,882.59 $227,882.59 nat. median
$89,790
outlier · 2.5×
6034
APR_DRG 		Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 1 $222,439.76 $222,439.76 $222,439.76 nat. median
$109,499
outlier · 2.0×
5832
APR_DRG 		Neonate W Ecmo 1 $213,845.82 $213,845.82 $213,845.82 nat. median
$156,126
1.4× median
5933
APR_DRG 		Neonate Birthwt 750-999g Without Major Procedure 1 $208,116.53 $208,116.53 $208,116.53 nat. median
$108,996
1.9× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 3 $205,640.00 $364,599.72 $205,640.00 nat. median
$209,753
1.0× median
33
APR_DRG 		Bone Marrow Transplant 1 $201,814.31 $201,814.31 $201,814.31 nat. median
$113,142
1.8× median
5831
APR_DRG 		Neonate W Ecmo 1 $192,504.21 $192,504.21 $192,504.21 nat. median
$145,122
1.3× median
64
APR_DRG 		Pancreas Transplant 1 $191,358.35 $191,358.35 $191,358.35 nat. median
$91,748
outlier · 2.1×
6074
APR_DRG 		Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 $188,207.24 $188,207.24 $188,207.24 nat. median
$95,507
2.0× median
8424
APR_DRG 		Full Thickness Burns W Skin Graft 1 $178,610.68 $178,610.68 $178,610.68 nat. median
$80,494
outlier · 2.2×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 4 $153,111.99 $324,491.73 $175,587.14 nat. median
$206,368
0.9× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 4 $152,217.31 $322,587.38 $174,561.14 nat. median
$202,986
0.9× median
5893
APR_DRG 		Neonate Bwt <500g Or Ga <24 Weeks 1 $174,170.48 $174,170.48 $174,170.48 nat. median
$69,788
outlier · 2.5×

Other procedures at this hospital

Browse this hospital's 18,880 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
             
Q2056 HCPCS Ciltacabtagene Autolucel Bag 31 8 $2,498,896.98 $1,249,448.49 50% off $502,083.28 $1,651,770.90 $1,465,852.97 2026-01-01
Q2041 HCPCS Axicabtagene Ciloleucel Bag 31 8 $2,266,110.00 $1,133,055.00 50% off $470,944.44 $1,497,898.71 $1,329,300.13 2026-01-01
J9228 HCPCS Ipilimumab 200 Mg/40 Ml 34 8 $156,656.12 $78,328.06 50% off $183.48 $91,894.48 $64,698.98 2026-01-01
J3391 HCPCS Inj, Atidarsagene Autotemcel 4 3 — — $4,505,000.00 $4,505,000.00 $4,505,000.00 2026-01-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 4 3 — — $3,685,266.67 $3,685,266.67 $3,685,266.67 2026-01-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 4 3 — — $3,316,462.59 $3,316,462.59 $3,316,462.59 2026-01-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 4 3 — — $3,248,445.72 $3,248,445.72 $3,248,445.72 2026-01-01
J3393 HCPCS Inj, Betibeglogene Autotemce 4 3 — — $2,945,740.00 $2,945,740.00 $2,945,740.00 2026-01-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 5 3 — — $2,455,110.61 $4,352,911.10 $2,455,110.61 2026-01-01
J3392 HCPCS Inj, Exagamglogene Autotem 5 3 — — $2,332,000.00 $4,134,636.00 $2,332,000.00 2026-01-01
Q2057 HCPCS Afamitresgene Autoleucel 5 3 — — $770,620.00 $1,366,309.26 $770,620.00 2026-01-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 5 3 — — $591,726.20 $1,049,130.55 $591,726.20 2026-01-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 5 3 — — $562,538.19 $997,380.20 $562,538.19 2026-01-01
Q2055 HCPCS Idecabtagene Vicleucel Car 5 3 — — $557,317.93 $988,124.70 $557,317.93 2026-01-01
5834 APR_DRG Neonate W Ecmo 1 1 — — $533,683.55 $533,683.55 $533,683.55 2026-01-01
Q2053 HCPCS Brexucabtagene Car Pos T 5 3 — — $489,304.61 $867,537.07 $489,304.61 2026-01-01
5884 APR_DRG Neonate Bwt <1500g W Major Procedure 1 1 — — $480,257.90 $480,257.90 $480,257.90 2026-01-01
5914 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 1 1 — — $385,008.42 $385,008.42 $385,008.42 2026-01-01
34 APR_DRG Bone Marrow Transplant 1 1 — — $354,786.41 $354,786.41 $354,786.41 2026-01-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 4 — — $309,001.44 $656,306.01 $354,359.45 2026-01-01
24 APR_DRG Heart &/or Lung Transplant 1 1 — — $354,213.48 $354,213.48 $354,213.48 2026-01-01
5883 APR_DRG Neonate Bwt <1500g W Major Procedure 1 1 — — $329,434.29 $329,434.29 $329,434.29 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
5934 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 1 1 — — $290,475.10 $290,475.10 $290,475.10 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
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 5 3 — — $278,250.00 $493,337.25 $278,250.00 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
6304 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 1 1 — — $276,151.87 $276,151.87 $276,151.87 2026-01-01
5833 APR_DRG Neonate W Ecmo 1 1 — — $271,138.74 $271,138.74 $271,138.74 2026-01-01
6094 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 1 1 — — $258,247.84 $258,247.84 $258,247.84 2026-01-01
J3403 HCPCS Revakinagene, Per Implant 5 3 — — $257,500.00 $456,547.50 $257,500.00 2026-01-01
5891 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 1 1 — — $250,656.53 $250,656.53 $250,656.53 2026-01-01
6314 APR_DRG Neonate Birthwt >2499g W Other Major Procedure 1 1 — — $242,205.82 $242,205.82 $242,205.82 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
5913 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 1 1 — — $233,898.35 $233,898.35 $233,898.35 2026-01-01
6024 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $233,468.65 $233,468.65 $233,468.65 2026-01-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 8 4 — — $200,762.15 $425,916.20 $230,231.82 2026-01-01
23 APR_DRG Heart &/or Lung Transplant 1 1 — — $229,601.38 $229,601.38 $229,601.38 2026-01-01
5892 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 1 1 — — $227,882.59 $227,882.59 $227,882.59 2026-01-01
6034 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 1 1 — — $222,439.76 $222,439.76 $222,439.76 2026-01-01
5832 APR_DRG Neonate W Ecmo 1 1 — — $213,845.82 $213,845.82 $213,845.82 2026-01-01
5933 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 1 1 — — $208,116.53 $208,116.53 $208,116.53 2026-01-01
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 5 3 — — $205,640.00 $364,599.72 $205,640.00 2026-01-01
33 APR_DRG Bone Marrow Transplant 1 1 — — $201,814.31 $201,814.31 $201,814.31 2026-01-01
5831 APR_DRG Neonate W Ecmo 1 1 — — $192,504.21 $192,504.21 $192,504.21 2026-01-01
64 APR_DRG Pancreas Transplant 1 1 — — $191,358.35 $191,358.35 $191,358.35 2026-01-01
6074 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $188,207.24 $188,207.24 $188,207.24 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
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 8 4 — — $153,111.99 $324,491.73 $175,587.14 2026-01-01
3 MS_DRG Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 8 4 — — $152,217.31 $322,587.38 $174,561.14 2026-01-01
5893 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 1 1 — — $174,170.48 $174,170.48 $174,170.48 2026-01-01
6114 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 1 1 — — $173,740.78 $173,740.78 $173,740.78 2026-01-01
8634 APR_DRG Neonatal Aftercare 1 1 — — $172,165.22 $172,165.22 $172,165.22 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
5882 APR_DRG Neonate Bwt <1500g W Major Procedure 1 1 — — $160,133.71 $160,133.71 $160,133.71 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
6134 APR_DRG Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 1 1 — — $157,698.76 $157,698.76 $157,698.76 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
6084 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 1 1 — — $152,972.10 $152,972.10 $152,972.10 2026-01-01
6023 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $150,250.68 $150,250.68 $150,250.68 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
5881 APR_DRG Neonate Bwt <1500g W Major Procedure 1 1 — — $144,091.69 $144,091.69 $144,091.69 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
6033 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 1 1 — — $140,510.89 $140,510.89 $140,510.89 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
5932 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 1 1 — — $135,927.45 $135,927.45 $135,927.45 2026-01-01
6303 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 1 1 — — $135,927.45 $135,927.45 $135,927.45 2026-01-01
6093 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 1 1 — — $133,206.04 $133,206.04 $133,206.04 2026-01-01
8504 APR_DRG Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service 1 1 — — $129,625.23 $129,625.23 $129,625.23 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
6124 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 1 1 — — $127,619.98 $127,619.98 $127,619.98 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
32 APR_DRG Bone Marrow Transplant 1 1 — — $122,893.31 $122,893.31 $122,893.31 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
1634 APR_DRG Cardiac Valve Procedures Without Cardiac Catheterization 1 1 — — $119,598.97 $119,598.97 $119,598.97 2026-01-01
6214 APR_DRG Neonate Bwt 2000-2499g W Major Anomaly 1 1 — — $118,309.88 $118,309.88 $118,309.88 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
224 APR_DRG Ventricular Shunt Procedures 1 1 — — $115,588.47 $115,588.47 $115,588.47 2026-01-01
6073 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $115,445.23 $115,445.23 $115,445.23 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
4 MS_DRG Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And … 8 4 — — $99,566.06 $210,518.01 $114,181.26 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
6904 APR_DRG Acute Leukemia 1 1 — — $111,864.43 $111,864.43 $111,864.43 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
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
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
6083 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 1 1 — — $110,002.41 $110,002.41 $110,002.41 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
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
6364 APR_DRG Neonate Birthwt >2499g W Congenital/perinatal Infection 1 1 — — $108,570.08 $108,570.08 $108,570.08 2026-01-01
6022 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $108,140.39 $108,140.39 $108,140.39 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
6334 APR_DRG Neonate Birthwt >2499g W Major Anomaly 1 1 — — $107,567.46 $107,567.46 $107,567.46 2026-01-01
7 MS_DRG Lung Transplant 8 4 — — $93,131.21 $196,821.28 $106,801.85 2026-01-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 5 3 — — $58,956.36 $188,152.41 $106,120.93 2026-01-01
6344 APR_DRG Neonate, Birthwt >2499g W Resp Dist Synd/oth Maj Resp Cond 1 1 — — $105,132.51 $105,132.51 $105,132.51 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
6144 APR_DRG Neonate Bwt 1500-1999g W Or Without Other Significant Condition 1 1 — — $102,984.02 $102,984.02 $102,984.02 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
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
14 MS_DRG Allogeneic Bone Marrow Transplant 8 4 — — $86,474.30 $182,651.89 $99,167.77 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
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
4014 APR_DRG Pituitary & Adrenal Procedures 1 1 — — $95,106.25 $95,106.25 $95,106.25 2026-01-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 8 4 — — $81,575.33 $172,224.32 $93,549.69 2026-01-01
209 MS_DRG Complex Aortic Arch Procedures 8 4 — — $81,482.51 $172,026.74 $93,443.24 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
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 5 3 — — $50,067.65 $165,273.21 $93,216.70 2026-01-01
6313 APR_DRG Neonate Birthwt >2499g W Other Major Procedure 1 1 — — $92,098.37 $92,098.37 $92,098.37 2026-01-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 4 — — $79,357.55 $167,503.72 $91,006.37 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
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
7404 APR_DRG Mental Illness Diagnosis W O.r. Procedure 1 1 — — $90,379.58 $90,379.58 $90,379.58 2026-01-01
6224 APR_DRG Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond 1 1 — — $90,093.12 $90,093.12 $90,093.12 2026-01-01
4403 APR_DRG Kidney Transplant 1 1 — — $89,806.65 $89,806.65 $89,806.65 2026-01-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 8 4 — — $78,307.21 $165,268.05 $89,801.85 2026-01-01
61 APR_DRG Pancreas Transplant 1 1 — — $89,663.42 $89,663.42 $89,663.42 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
5912 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 1 1 — — $87,801.40 $87,801.40 $87,801.40 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
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
6113 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 1 1 — — $85,652.92 $85,652.92 $85,652.92 2026-01-01
6254 APR_DRG Neonate Bwt 2000-2499g W Other Significant Condition 1 1 — — $85,652.92 $85,652.92 $85,652.92 2026-01-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 8 4 — — $74,282.93 $156,702.28 $85,186.85 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
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
6032 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 1 1 — — $84,507.06 $84,507.06 $84,507.06 2026-01-01
6072 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $83,790.90 $83,790.90 $83,790.90 2026-01-01
1214 APR_DRG Other Respiratory & Chest Procedures 1 1 — — $82,931.50 $82,931.50 $82,931.50 2026-01-01
6504 APR_DRG Splenectomy 1 1 — — $82,931.50 $82,931.50 $82,931.50 2026-01-01
6123 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 1 1 — — $82,788.27 $82,788.27 $82,788.27 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
6133 APR_DRG Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 1 1 — — $82,358.57 $82,358.57 $82,358.57 2026-01-01
215 MS_DRG Other Heart Assist System Implant 8 4 — — $71,758.82 $151,329.67 $82,292.22 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
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 4 — — $70,514.99 $148,682.12 $80,865.81 2026-01-01
6234 APR_DRG Neonate Bwt 2000-2499g W Congenital/perinatal Infection 1 1 — — $80,353.32 $80,353.32 $80,353.32 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 — — $79,846.28 $79,846.28 $79,846.28 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
5464 APR_DRG Other O.r. Proc For Obstetric Diagnoses Except Delivery Diagnoses 1 1 — — $77,918.37 $77,918.37 $77,918.37 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
4474 APR_DRG Other Kidney, Urinary Tract & Related Procedures 1 1 — — $77,345.44 $77,345.44 $77,345.44 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
6092 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 1 1 — — $76,486.05 $76,486.05 $76,486.05 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
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 8 4 — — $64,994.09 $136,930.78 $74,534.51 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
6954 APR_DRG Chemotherapy For Acute Leukemia 1 1 — — $73,515.41 $73,515.41 $73,515.41 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
9514 APR_DRG Moderately Extensive Procedure Unrelated To Principal Diagnosis 1 1 — — $71,759.38 $71,759.38 $71,759.38 2026-01-01
6082 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 1 1 — — $71,759.38 $71,759.38 $71,759.38 2026-01-01
850 MS_DRG Acute Leukemia With Other Procedures 8 4 — — $62,494.28 $131,609.85 $71,667.75 2026-01-01
4402 APR_DRG Kidney Transplant 1 1 — — $71,472.92 $71,472.92 $71,472.92 2026-01-01
6394 APR_DRG Neonate Birthwt >2499g W Other Significant Condition 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
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 — — $70,042.03 $70,042.03 $70,042.03 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
5114 APR_DRG Uterine & Adnexa Procedures For Ovarian & Adnexal Malignancy 1 1 — — $70,040.59 $70,040.59 $70,040.59 2026-01-01
6143 APR_DRG Neonate Bwt 1500-1999g W Or Without Other Significant Condition 1 1 — — $70,040.59 $70,040.59 $70,040.59 2026-01-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 8 4 — — $60,854.86 $128,120.32 $69,787.68 2026-01-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 8 4 — — $60,665.63 $127,717.56 $69,570.68 2026-01-01
8633 APR_DRG Neonatal Aftercare 1 1 — — $69,324.43 $69,324.43 $69,324.43 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
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
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 5 3 — — $52,038.74 $119,593.57 $67,452.66 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
1622 APR_DRG Cardiac Valve Procedures W Cardiac Catheterization 1 1 — — $66,459.79 $66,459.79 $66,459.79 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
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
6302 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 1 1 — — $66,030.09 $66,030.09 $66,030.09 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
6091 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 1 1 — — $65,600.39 $65,600.39 $65,600.39 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
4401 APR_DRG Kidney Transplant 1 1 — — $65,313.93 $65,313.93 $65,313.93 2026-01-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 8 4 — — $56,848.43 $119,592.54 $65,193.15 2026-01-01
2624 APR_DRG Cholecystectomy Except Laparoscopic 1 1 — — $64,884.23 $64,884.23 $64,884.23 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 — — $64,454.54 $64,454.54 $64,454.54 2026-01-01
6021 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $64,311.30 $64,311.30 $64,311.30 2026-01-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 4 — — $55,488.19 $116,697.26 $63,633.24 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
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 8 4 — — $55,251.85 $116,194.20 $63,362.21 2026-01-01
J9029 HCPCS Instill Adstiladrin, Tx Dose 5 3 — — $63,342.28 $112,305.87 $63,342.28 2026-01-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 8 4 — — $55,071.20 $115,809.68 $63,155.05 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
4444 APR_DRG Renal Dialysis Access Device Procedure Only 1 1 — — $62,592.52 $62,592.52 $62,592.52 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
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
4044 APR_DRG Thyroid, Parathyroid & Thyroglossal Procedures 1 1 — — $62,306.05 $62,306.05 $62,306.05 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
1804 APR_DRG Other Circulatory System Procedures 1 1 — — $61,876.35 $61,876.35 $61,876.35 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
1764 APR_DRG Cardiac Pacemaker & Defibrillator Device Replacement 1 1 — — $61,589.89 $61,589.89 $61,589.89 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
4804 APR_DRG Major Male Pelvic Procedures 1 1 — — $60,587.26 $60,587.26 $60,587.26 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
1621 APR_DRG Cardiac Valve Procedures W Cardiac Catheterization 1 1 — — $59,871.10 $59,871.10 $59,871.10 2026-01-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 4 — — $52,205.79 $109,710.59 $59,869.03 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
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
4834 APR_DRG Testes & Scrotal Procedures 1 1 — — $59,584.64 $59,584.64 $59,584.64 2026-01-01
10 MS_DRG Pancreas Transplant 8 4 — — $51,899.48 $109,058.58 $59,517.75 2026-01-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 8 4 — — $51,878.06 $109,012.99 $59,493.19 2026-01-01
6071 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $59,441.40 $59,441.40 $59,441.40 2026-01-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 8 4 — — $51,606.01 $108,433.93 $59,181.20 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
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 8 4 — — $51,576.03 $108,370.10 $59,146.82 2026-01-01
1673 APR_DRG Other Cardiothoracic Procedures 1 1 — — $58,868.48 $58,868.48 $58,868.48 2026-01-01
8503 APR_DRG Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service 1 1 — — $58,725.24 $58,725.24 $58,725.24 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
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
870 MS_DRG Septicemia Or Severe Sepsis With Mv &gt;96 Hours 8 4 — — $50,015.14 $105,047.75 $57,356.81 2026-01-01
J7330 HCPCS Cultured Chondrocytes Implnt 1 1 — — $57,294.42 $57,294.42 $57,294.42 2026-01-01
3624 APR_DRG Mastectomy Procedures 1 1 — — $57,149.69 $57,149.69 $57,149.69 2026-01-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 8 4 — — $49,773.09 $104,532.53 $57,079.23 2026-01-01
6031 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 1 1 — — $57,006.46 $57,006.46 $57,006.46 2026-01-01
A9543 HCPCS Y90 Ibritumomab, Rx 5 3 — — $56,824.55 $100,749.93 $56,824.55 2026-01-01
6122 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 1 1 — — $56,433.53 $56,433.53 $56,433.53 2026-01-01
223 APR_DRG Ventricular Shunt Procedures 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
955 MS_DRG Craniotomy For Multiple Significant Trauma 8 4 — — $48,724.90 $102,301.41 $55,877.18 2026-01-01
6213 APR_DRG Neonate Bwt 2000-2499g W Major Anomaly 1 1 — — $55,860.60 $55,860.60 $55,860.60 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
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 8 4 — — $48,406.43 $101,623.57 $55,511.96 2026-01-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 8 4 — — $48,371.44 $101,549.09 $55,471.84 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
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
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
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 5 3 — — $55,272.32 $97,997.83 $55,272.32 2026-01-01
233 APR_DRG Spinal Procedures 1 1 — — $55,001.20 $55,001.20 $55,001.20 2026-01-01
7594 APR_DRG Eating Disorders 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
6132 APR_DRG Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 1 1 — — $54,857.97 $54,857.97 $54,857.97 2026-01-01
3224 APR_DRG Shoulder & Elbow Joint Replacement 1 1 — — $54,792.08 $54,792.08 $54,792.08 2026-01-01
6903 APR_DRG Acute Leukemia 1 1 — — $54,714.74 $54,714.74 $54,714.74 2026-01-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 4 — — $47,612.42 $99,933.51 $54,601.40 2026-01-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 4 — — $47,612.42 $99,933.51 $54,601.40 2026-01-01
913 APR_DRG Other Major Head & Neck Procedures 1 1 — — $54,571.51 $54,571.51 $54,571.51 2026-01-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 8 4 — — $47,441.79 $99,570.27 $54,405.72 2026-01-01
1714 APR_DRG Perm Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock 1 1 — — $54,285.04 $54,285.04 $54,285.04 2026-01-01
1652 APR_DRG Coronary Bypass W Cardiac Cath Or Percutaneous Cardiac Procedure 1 1 — — $54,141.81 $54,141.81 $54,141.81 2026-01-01
6924 APR_DRG Radiotherapy 1 1 — — $53,998.58 $53,998.58 $53,998.58 2026-01-01
1754 APR_DRG Percutaneous Cardiovascular Procedures Without Ami 1 1 — — $53,855.34 $53,855.34 $53,855.34 2026-01-01
6914 APR_DRG Lymphoma, Myeloma & Non-acute Leukemia 1 1 — — $53,855.34 $53,855.34 $53,855.34 2026-01-01
6233 APR_DRG Neonate Bwt 2000-2499g W Congenital/perinatal Infection 1 1 — — $53,855.34 $53,855.34 $53,855.34 2026-01-01
203 APR_DRG Craniotomy For Trauma 1 1 — — $53,712.11 $53,712.11 $53,712.11 2026-01-01
1632 APR_DRG Cardiac Valve Procedures Without Cardiac Catheterization 1 1 — — $53,712.11 $53,712.11 $53,712.11 2026-01-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support &gt;96 Hours 8 4 — — $46,608.50 $97,796.63 $53,450.12 2026-01-01
6614 APR_DRG Coagulation & Platelet Disorders 1 1 — — $53,425.65 $53,425.65 $53,425.65 2026-01-01
4454 APR_DRG Other Bladder Procedures 1 1 — — $53,282.42 $53,282.42 $53,282.42 2026-01-01
903 APR_DRG Major Larynx & Trachea Procedures 1 1 — — $52,995.95 $52,995.95 $52,995.95 2026-01-01
6223 APR_DRG Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond 1 1 — — $52,852.72 $52,852.72 $52,852.72 2026-01-01
5424 APR_DRG Vaginal Delivery W Complicating Procedures Exc Sterilization &/or D&c 1 1 — — $52,709.49 $52,709.49 $52,709.49 2026-01-01
434 APR_DRG Multiple Sclerosis & Other Demyelinating Diseases 1 1 — — $52,709.49 $52,709.49 $52,709.49 2026-01-01
2254 APR_DRG Appendectomy 1 1 — — $52,423.02 $52,423.02 $52,423.02 2026-01-01
1663 APR_DRG Coronary Bypass Without Cardiac Cath Or Percutaneous Cardiac Procedure 1 1 — — $51,850.09 $51,850.09 $51,850.09 2026-01-01
6112 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 1 1 — — $51,706.86 $51,706.86 $51,706.86 2026-01-01
3014 APR_DRG Hip Joint Replacement 1 1 — — $51,563.63 $51,563.63 $51,563.63 2026-01-01
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