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

PARKRIDGE MEDICAL CENTER

Chattanooga, TN · CCN 440156 · Rates published

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You selected 59400 (CPT)

Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care

This hospital’s price: $6,285 across 1 payer

Source: https://www.hcadam.com/api/public/content/d2ba7ca479e14040a78e2b72ff8b9a87?download=true · observed 2024-10-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

11,714 distinct procedures filed
22 distinct payers
57,955 rate rows
2024-10-01 last MRF observed · ⚠ 22 mo old
Data quality

54,288 of 57,955 rate rows are consumer-grade (93.7%)

3,667 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
template filing: same amount across many unrelated codes — excluded 2,783
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 420
per-diem day rate — not a per-procedure price 288
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 108
placeholder amount (≤ $0.02) — excluded from medians 66
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 2

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 22 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.hcadam.com/api/public/content/d2ba7ca479e14040a78e2b72ff8b9a87?download=true
Found on page https://www.parkridgehealth.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-08-05
Content fingerprint ad241a5b59d7b5db… · 563,654,505 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
J1411
HCPCS 		Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 2 $3,994,116.00 $4,200,000.00 $4,097,058.00 nat. median
$3,710,000
1.1× median
J1413
HCPCS 		Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 2 $3,651,763.20 $3,840,000.00 $3,745,881.60 nat. median
$3,324,572
1.1× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 $2,648,347.96 $2,648,347.96 $2,648,347.96 nat. median
$2,460,273
1.1× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 3 $629,386.80 $1,387,149.28 $1,387,149.28 nat. median
$691,418
outlier · 2.0×
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 2 $620,118.79 $1,345,370.55 $1,345,370.55 nat. median
$631,793
outlier · 2.1×
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 4 $569,385.09 $1,334,154.50 $1,334,154.50 nat. median
$610,161
outlier · 2.2×
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 3 $556,654.68 $1,315,434.06 $1,315,434.06 nat. median
$624,417
outlier · 2.1×
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 3 $512,890.14 $1,191,016.00 $1,191,016.00 nat. median
$577,541
outlier · 2.1×
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 3 $549,504.00 $588,126.48 $556,289.86 nat. median
$588,565
0.9× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 2 $235,595.23 $676,929.00 $507,647.25 nat. median
$261,939
1.9× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 $106,450.21 $676,929.00 $439,905.00 nat. median
$108,240
outlier · 4.1×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $320,310.43 $383,864.09 $352,087.26 nat. median
$370,165
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 $185,358.69 $222,136.21 $203,747.45 nat. median
$199,832
1.0× median
J7330
HCPCS 		Autologous Cultured Chondrocytes, Implant 1 $192,914.70 $192,914.70 $192,914.70 nat. median
$75,807
outlier · 2.5×
A9543
HCPCS 		Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 2 $74,124.43 $173,512.94 $173,512.94 nat. median
$63,643
outlier · 2.7×
J9029
HCPCS 		Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 2 $72,000.00 $168,273.22 $168,273.22 nat. median
$69,291
outlier · 2.4×
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 2 $151,214.00 $182,499.66 $166,856.83 nat. median
$214,447
0.8× median
5833
APR_DRG 		Neonate With Ecmo 1 $150,334.58 $150,334.58 $150,334.58 nat. median
$250,089
0.6× median
Q2043
HCPCS 		Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 3 $63,349.85 $147,108.87 $147,108.87 nat. median
$65,655
outlier · 2.2×
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 1 $143,117.54 $143,117.54 $143,117.54 nat. median
$160,171
0.9× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 $127,801.80 $153,159.30 $140,480.55 nat. median
$132,706
1.1× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 1 $140,304.12 $140,304.12 $140,304.12 nat. median
$254,667
0.6× median
927
OTHER 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 2 $122,685.23 $148,068.38 $135,376.80 nat. median
$2
outlier · 79633.4×
A9699
HCPCS 		Radiopharmaceutical, Therapeutic, Not Otherwise Classified 1 $123,321.96 $123,321.96 $123,321.96 nat. median
$4,125
outlier · 29.9×
7
MS_DRG 		Lung Transplant 1 $106,644.08 $127,803.62 $117,223.85 nat. median
$122,690
1.0× median
J9226
HCPCS 		Histrelin Implant (supprelin La), 50 Mg 2 $54,500.39 $117,019.36 $117,019.36 nat. median
$55,200
outlier · 2.1×
003
OTHER 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 $101,283.23 $122,238.38 $111,760.80 nat. median
$163,765
0.7× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 1 $99,641.06 $119,411.12 $109,526.09 nat. median
$114,305
1.0× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 1 $93,640.47 $112,219.92 $102,930.20 nat. median
$100,978
1.0× median
54
APR_DRG 		Tracheostomy With Mv >96 Hours Without Extensive Procedure 1 $99,326.02 $99,326.02 $99,326.02 nat. median
$88,000
1.1× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 1 $89,982.90 $107,836.65 $98,909.77 nat. median
$99,646
1.0× median
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $97,919.31 $97,919.31 $97,919.31 nat. median
$119,243
0.8× median
215
MS_DRG 		Other Heart Assist System Implant 1 $88,807.47 $106,428.00 $97,617.74 nat. median
$98,002
1.0× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $84,377.88 $101,119.52 $92,748.70 nat. median
$92,900
1.0× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 1 $90,396.46 $90,396.46 $90,396.46 nat. median
$175,480
0.5× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 1 $77,041.01 $92,326.93 $84,683.97 nat. median
$83,623
1.0× median
6034
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 1 $81,650.39 $81,650.39 $81,650.39 nat. median
$109,499
0.7× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 $73,485.17 $88,065.56 $80,775.36 nat. median
$77,385
1.0× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $73,285.20 $87,825.92 $80,555.56 nat. median
$80,459
1.0× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 1 $70,553.55 $84,552.27 $77,552.91 nat. median
$79,040
1.0× median
53
APR_DRG 		Tracheostomy With Mv >96 Hours Without Extensive Procedure 1 $77,552.58 $77,552.58 $77,552.58 nat. median
$52,271
1.5× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 $69,495.49 $83,284.28 $76,389.89 nat. median
$69,153
1.1× median
6303
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 1 $75,595.42 $75,595.42 $75,595.42 nat. median
$80,447
0.9× median
13
APR_DRG 		Liver Transplant And/or Intestinal Transplant 1 $74,555.68 $74,555.68 $74,555.68 nat. median
$74,748
1.0× median
14
APR_DRG 		Liver Transplant And/or Intestinal Transplant 1 $74,555.68 $74,555.68 $74,555.68 nat. median
$137,901
0.5× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 $67,809.72 $81,264.03 $74,536.88 nat. median
$73,475
1.0× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 $67,041.17 $80,342.99 $73,692.08 nat. median
$74,472
1.0× median
5933
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 1 $73,515.93 $73,515.93 $73,515.93 nat. median
$112,711
0.7× median
014
OTHER 		Allogeneic Bone Marrow Transplant 2 $66,170.66 $79,861.14 $73,015.90 nat. median
$85,837
0.9× median
J9266
HCPCS 		Injection, Pegaspargase, Per Single Dose Vial 3 $30,828.70 $71,589.38 $71,589.38 nat. median
$32,688
outlier · 2.2×

Other procedures at this hospital

Browse this hospital's 11,714 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
             
J1411 HCPCS Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 2 2 — — $3,994,116.00 $4,200,000.00 $4,097,058.00 2024-10-01
J1413 HCPCS Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 2 2 — — $3,651,763.20 $3,840,000.00 $3,745,881.60 2024-10-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 1 — — $2,648,347.96 $2,648,347.96 $2,648,347.96 2024-10-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 6 3 — — $629,386.80 $1,387,149.28 $1,387,149.28 2024-10-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 5 2 — — $620,118.79 $1,345,370.55 $1,345,370.55 2024-10-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 7 4 — — $569,385.09 $1,334,154.50 $1,334,154.50 2024-10-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 6 3 — — $556,654.68 $1,315,434.06 $1,315,434.06 2024-10-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 6 3 — — $512,890.14 $1,191,016.00 $1,191,016.00 2024-10-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 3 3 — — $549,504.00 $588,126.48 $556,289.86 2024-10-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 8 2 — — $235,595.23 $676,929.00 $507,647.25 2024-10-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 6 2 — — $106,450.21 $676,929.00 $439,905.00 2024-10-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 1 — — $320,310.43 $383,864.09 $352,087.26 2024-10-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 1 — — $185,358.69 $222,136.21 $203,747.45 2024-10-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 4 1 — — $192,914.70 $192,914.70 $192,914.70 2024-10-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 5 2 — — $74,124.43 $173,512.94 $173,512.94 2024-10-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 5 2 — — $72,000.00 $168,273.22 $168,273.22 2024-10-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 2 2 — — $151,214.00 $182,499.66 $166,856.83 2024-10-01
5833 APR_DRG Neonate With Ecmo 1 1 — — $150,334.58 $150,334.58 $150,334.58 2024-10-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 6 3 — — $63,349.85 $147,108.87 $147,108.87 2024-10-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 1 1 — — $143,117.54 $143,117.54 $143,117.54 2024-10-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 1 — — $127,801.80 $153,159.30 $140,480.55 2024-10-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $140,304.12 $140,304.12 $140,304.12 2024-10-01
927 OTHER Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 2 2 — — $122,685.23 $148,068.38 $135,376.80 2024-10-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 4 1 — — $123,321.96 $123,321.96 $123,321.96 2024-10-01
7 MS_DRG Lung Transplant 2 1 — — $106,644.08 $127,803.62 $117,223.85 2024-10-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 5 2 — — $54,500.39 $117,019.36 $117,019.36 2024-10-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 2 — — $101,283.23 $122,238.38 $111,760.80 2024-10-01
14 MS_DRG Allogeneic Bone Marrow Transplant 2 1 — — $99,641.06 $119,411.12 $109,526.09 2024-10-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 2 1 — — $93,640.47 $112,219.92 $102,930.20 2024-10-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 1 1 — — $99,326.02 $99,326.02 $99,326.02 2024-10-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 2 1 — — $89,982.90 $107,836.65 $98,909.77 2024-10-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $97,919.31 $97,919.31 $97,919.31 2024-10-01
215 MS_DRG Other Heart Assist System Implant 2 1 — — $88,807.47 $106,428.00 $97,617.74 2024-10-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $84,377.88 $101,119.52 $92,748.70 2024-10-01
74 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $90,396.46 $90,396.46 $90,396.46 2024-10-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 2 1 — — $77,041.01 $92,326.93 $84,683.97 2024-10-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 1 1 — — $81,650.39 $81,650.39 $81,650.39 2024-10-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 1 — — $73,485.17 $88,065.56 $80,775.36 2024-10-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 1 — — $73,285.20 $87,825.92 $80,555.56 2024-10-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 2 1 — — $70,553.55 $84,552.27 $77,552.91 2024-10-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 1 1 — — $77,552.58 $77,552.58 $77,552.58 2024-10-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 1 — — $69,495.49 $83,284.28 $76,389.89 2024-10-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 1 1 — — $75,595.42 $75,595.42 $75,595.42 2024-10-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 1 1 — — $74,555.68 $74,555.68 $74,555.68 2024-10-01
13 APR_DRG Liver Transplant And/or Intestinal Transplant 1 1 — — $74,555.68 $74,555.68 $74,555.68 2024-10-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 1 — — $67,809.72 $81,264.03 $74,536.88 2024-10-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $67,041.17 $80,342.99 $73,692.08 2024-10-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 1 1 — — $73,515.93 $73,515.93 $73,515.93 2024-10-01
014 OTHER Allogeneic Bone Marrow Transplant 2 2 — — $66,170.66 $79,861.14 $73,015.90 2024-10-01
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 6 3 — — $30,828.70 $71,589.38 $71,589.38 2024-10-01
23 APR_DRG Heart And/or Lung Transplant 1 1 — — $70,580.19 $70,580.19 $70,580.19 2024-10-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 1 — — $62,879.35 $75,355.42 $69,117.38 2024-10-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 1 1 — — $68,194.90 $68,194.90 $68,194.90 2024-10-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 1 — — $61,169.25 $73,306.00 $67,237.62 2024-10-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 2 1 — — $60,552.84 $72,567.29 $66,560.07 2024-10-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 2 1 — — $60,058.15 $71,974.45 $66,016.30 2024-10-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 2 1 — — $59,594.76 $71,419.12 $65,506.94 2024-10-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 2 1 — — $59,280.04 $71,041.95 $65,160.99 2024-10-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 2 1 — — $57,661.22 $69,101.93 $63,381.57 2024-10-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 6 3 — — $26,766.00 $62,320.47 $62,320.47 2024-10-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $55,339.92 $66,320.06 $60,829.99 2024-10-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 2 1 — — $54,303.59 $65,078.12 $59,690.85 2024-10-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 2 1 — — $54,060.16 $64,786.38 $59,423.27 2024-10-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 2 1 — — $53,991.48 $64,704.07 $59,347.78 2024-10-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 2 1 — — $53,702.84 $64,358.16 $59,030.50 2024-10-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 2 1 — — $53,702.84 $64,358.16 $59,030.50 2024-10-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 2 1 — — $53,393.33 $63,987.25 $58,690.29 2024-10-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 1 1 — — $58,531.40 $58,531.40 $58,531.40 2024-10-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 2 1 — — $53,175.11 $63,725.73 $58,450.42 2024-10-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 2 1 — — $52,948.20 $63,453.79 $58,200.99 2024-10-01
955 OTHER Craniotomy For Multiple Significant Trauma 2 2 — — $52,743.22 $63,655.61 $58,199.42 2024-10-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 1 — — $52,818.66 $63,298.55 $58,058.61 2024-10-01
28 MS_DRG Spinal Procedures With Mcc 2 1 — — $52,390.91 $62,785.94 $57,588.43 2024-10-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 2 1 — — $52,164.87 $62,515.04 $57,339.96 2024-10-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 2 1 — — $51,717.13 $61,978.46 $56,847.79 2024-10-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 2 1 — — $51,125.94 $61,269.97 $56,197.96 2024-10-01
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 1 1 — — $54,494.76 $54,494.76 $54,494.76 2024-10-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $49,527.11 $59,353.92 $54,440.51 2024-10-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 2 1 — — $49,408.87 $59,212.22 $54,310.54 2024-10-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 2 1 — — $49,284.55 $59,063.23 $54,173.89 2024-10-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 2 1 — — $49,240.21 $59,010.09 $54,125.15 2024-10-01
21 APR_DRG Heart And/or Lung Transplant 1 1 — — $53,944.30 $53,944.30 $53,944.30 2024-10-01
834 MS_DRG Acute Leukemia With Mcc 2 1 — — $48,677.71 $58,335.98 $53,506.85 2024-10-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 1 1 — — $52,659.92 $52,659.92 $52,659.92 2024-10-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 2 1 — — $47,862.21 $57,358.68 $52,610.44 2024-10-01
B0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 3 1 — — $52,409.09 $52,409.09 $52,409.09 2024-10-01
B0505 HCPCS Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 3 1 — — $51,870.83 $51,870.83 $51,870.83 2024-10-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 2 2 — — $46,845.50 $56,537.67 $51,691.58 2024-10-01
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 2 2 — — $46,738.57 $56,408.63 $51,573.60 2024-10-01
214 APR_DRG Open Craniotomy Except Trauma 1 1 — — $51,192.04 $51,192.04 $51,192.04 2024-10-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $45,596.55 $54,643.49 $50,120.02 2024-10-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 2 1 — — $45,190.54 $54,156.92 $49,673.73 2024-10-01
73 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $49,663.01 $49,663.01 $49,663.01 2024-10-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 2 1 — — $45,092.30 $54,039.19 $49,565.75 2024-10-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 2 1 — — $44,828.87 $53,723.49 $49,276.18 2024-10-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 2 1 — — $44,156.83 $52,918.10 $48,537.46 2024-10-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 2 1 — — $43,964.69 $52,687.84 $48,326.26 2024-10-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 2 1 — — $43,806.46 $52,498.22 $48,152.34 2024-10-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 2 1 — — $43,463.91 $52,087.71 $47,775.81 2024-10-01
799 MS_DRG Splenic Procedures With Mcc 2 1 — — $43,075.29 $51,621.98 $47,348.64 2024-10-01
471 MS_DRG Cervical Spinal Fusion With Mcc 2 1 — — $42,765.79 $51,251.06 $47,008.43 2024-10-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 2 1 — — $42,428.46 $50,846.80 $46,637.63 2024-10-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 2 1 — — $42,113.74 $50,469.64 $46,291.69 2024-10-01
6 MS_DRG Liver Transplant Without Mcc 2 1 — — $42,052.01 $50,395.66 $46,223.84 2024-10-01
1784 APR_DRG External Heart Assist Devices 1 1 — — $46,115.65 $46,115.65 $46,115.65 2024-10-01
10 MS_DRG Pancreas Transplant 2 1 — — $41,849.44 $50,152.90 $46,001.17 2024-10-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 2 1 — — $41,790.32 $50,082.05 $45,936.18 2024-10-01
A9604 HCPCS Samarium Sm-153 Lexidronam, Therapeutic, Per Treatment Dose, Up To 150 Millicuri… 6 3 — — $19,539.46 $45,738.60 $45,738.60 2024-10-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 2 1 — — $41,578.19 $49,827.83 $45,703.01 2024-10-01
163 MS_DRG Major Chest Procedures With Mcc 2 1 — — $40,980.04 $49,111.00 $45,045.52 2024-10-01
1303 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 1 1 — — $44,708.94 $44,708.94 $44,708.94 2024-10-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $40,414.93 $48,433.76 $44,424.35 2024-10-01
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 1 1 — — $44,036.17 $44,036.17 $44,036.17 2024-10-01
C0106 HCPCS Stroke; M > 30.05 & M < 34.25 3 1 — — $43,346.36 $43,346.36 $43,346.36 2024-10-01
245 MS_DRG Aicd Generator Procedures 2 1 — — $39,395.99 $47,212.66 $43,304.32 2024-10-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 1 — — $39,392.51 $47,208.49 $43,300.50 2024-10-01
B1903 HCPCS Guillian Barre; M < 18.05 3 1 — — $43,188.15 $43,188.15 $43,188.15 2024-10-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 2 1 — — $39,269.06 $47,060.54 $43,164.80 2024-10-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 2 1 — — $39,101.26 $46,859.45 $42,980.35 2024-10-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $42,629.46 $42,629.46 $42,629.46 2024-10-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 2 1 — — $38,778.72 $46,472.91 $42,625.82 2024-10-01
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 1 1 — — $42,507.13 $42,507.13 $42,507.13 2024-10-01
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 1 1 — — $42,384.81 $42,384.81 $42,384.81 2024-10-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 2 1 — — $38,500.51 $46,139.50 $42,320.01 2024-10-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 2 1 — — $38,392.70 $46,010.30 $42,201.50 2024-10-01
63 APR_DRG Pancreas Transplant 1 1 — — $42,201.33 $42,201.33 $42,201.33 2024-10-01
021 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 2 2 — — $38,142.53 $46,034.09 $42,088.31 2024-10-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 2 1 — — $37,922.36 $45,446.64 $41,684.50 2024-10-01
231 OTHER Coronary Bypass With Ptca With Mcc 2 2 — — $37,771.85 $45,586.72 $41,679.29 2024-10-01
B0405 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 3 1 — — $41,678.26 $41,678.26 $41,678.26 2024-10-01
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 1 1 — — $41,406.23 $41,406.23 $41,406.23 2024-10-01
901 MS_DRG Wound Debridements For Injuries With Mcc 2 1 — — $37,625.89 $45,091.35 $41,358.62 2024-10-01
1794 APR_DRG Defibrillator Implants 1 1 — — $41,345.07 $41,345.07 $41,345.07 2024-10-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 2 1 — — $37,408.54 $44,830.87 $41,119.71 2024-10-01
A0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 3 1 — — $41,110.77 $41,110.77 $41,110.77 2024-10-01
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 1 1 — — $41,039.26 $41,039.26 $41,039.26 2024-10-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 2 1 — — $37,199.02 $44,579.78 $40,889.40 2024-10-01
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 2 2 — — $36,614.11 $44,189.44 $40,401.78 2024-10-01
793 MS_DRG Full Term Neonate With Major Problems 2 1 — — $36,595.65 $43,856.70 $40,226.18 2024-10-01
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 2 — — $36,181.38 $43,667.18 $39,924.28 2024-10-01
620 MS_DRG O.r. Procedures For Obesity With Cc 6 2 — — $14,103.41 $61,360.00 $39,875.00 2024-10-01
621 MS_DRG O.r. Procedures For Obesity Without Cc/mcc 6 2 — — $13,191.41 $61,360.00 $39,875.00 2024-10-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 6 2 — — $22,626.14 $61,360.00 $39,875.00 2024-10-01
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 1 1 — — $39,754.87 $39,754.87 $39,754.87 2024-10-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 2 1 — — $36,154.87 $43,328.45 $39,741.66 2024-10-01
D0106 HCPCS Stroke; M > 30.05 & M < 34.25 3 1 — — $39,611.20 $39,611.20 $39,611.20 2024-10-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 2 1 — — $35,789.72 $42,890.86 $39,340.29 2024-10-01
834 OTHER Acute Leukemia With Mcc 2 2 — — $35,526.40 $42,876.69 $39,201.54 2024-10-01
791 MS_DRG Prematurity With Major Problems 2 1 — — $35,625.40 $42,693.94 $39,159.67 2024-10-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 2 1 — — $35,278.51 $42,278.22 $38,778.37 2024-10-01
3124 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 1 1 — — $38,715.13 $38,715.13 $38,715.13 2024-10-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 7 4 — — $2,253.12 $47,985.75 $38,705.46 2024-10-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 2 1 — — $35,165.49 $42,142.77 $38,654.13 2024-10-01
71 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $38,653.97 $38,653.97 $38,653.97 2024-10-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 2 1 — — $35,134.19 $42,105.26 $38,619.73 2024-10-01
893 APR_DRG Major Cranial Or Facial Bone Procedures 1 1 — — $38,470.48 $38,470.48 $38,470.48 2024-10-01
B1704 HCPCS Major Multiple Trauma,no Brain Or Spinal Cord Inju 3 1 — — $38,422.90 $38,422.90 $38,422.90 2024-10-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 2 1 — — $34,902.06 $41,827.08 $38,364.57 2024-10-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 2 1 — — $34,818.60 $41,727.05 $38,272.82 2024-10-01
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 1 1 — — $38,042.35 $38,042.35 $38,042.35 2024-10-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 2 1 — — $34,408.24 $41,235.28 $37,821.76 2024-10-01
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 1 1 — — $37,614.23 $37,614.23 $37,614.23 2024-10-01
62 APR_DRG Pancreas Transplant 1 1 — — $37,491.90 $37,491.90 $37,491.90 2024-10-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 2 1 — — $34,103.95 $40,870.61 $37,487.28 2024-10-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 1 — — $34,001.36 $40,747.67 $37,374.51 2024-10-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 2 1 — — $33,918.77 $40,648.69 $37,283.73 2024-10-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 2 1 — — $33,880.52 $40,602.84 $37,241.68 2024-10-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 2 1 — — $33,795.32 $40,500.74 $37,148.03 2024-10-01
C0405 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 3 1 — — $37,064.35 $37,064.35 $37,064.35 2024-10-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 2 1 — — $33,476.25 $40,118.36 $36,797.31 2024-10-01
1302 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 1 1 — — $36,635.64 $36,635.64 $36,635.64 2024-10-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 2 1 — — $33,259.77 $39,858.93 $36,559.35 2024-10-01
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 1 1 — — $36,452.16 $36,452.16 $36,452.16 2024-10-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 2 1 — — $32,939.83 $39,475.51 $36,207.67 2024-10-01
140 MS_DRG Major Head And Neck Procedures With Mcc 2 1 — — $32,846.80 $39,364.02 $36,105.41 2024-10-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 2 1 — — $32,360.81 $38,781.60 $35,571.21 2024-10-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 2 1 — — $32,337.33 $38,753.47 $35,545.40 2024-10-01
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 1 1 — — $35,473.58 $35,473.58 $35,473.58 2024-10-01
232 OTHER Coronary Bypass With Ptca Without Mcc 2 2 — — $32,063.24 $38,697.02 $35,380.13 2024-10-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 2 1 — — $32,150.41 $38,529.46 $35,339.93 2024-10-01
461 OTHER Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 2 2 — — $31,736.17 $38,302.28 $35,019.22 2024-10-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 2 1 — — $31,801.78 $38,111.66 $34,956.72 2024-10-01
332 MS_DRG Rectal Resection With Mcc 2 1 — — $31,770.48 $38,074.15 $34,922.32 2024-10-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 2 1 — — $31,748.75 $38,048.10 $34,898.43 2024-10-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 2 1 — — $31,619.21 $37,892.86 $34,756.04 2024-10-01
870 OTHER Septicemia Or Severe Sepsis With Mv >96 Hours 2 2 — — $31,467.80 $37,978.38 $34,723.09 2024-10-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 2 1 — — $31,495.75 $37,744.91 $34,620.33 2024-10-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 2 1 — — $31,440.11 $37,678.23 $34,559.17 2024-10-01
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $34,372.67 $34,372.67 $34,372.67 2024-10-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 2 1 — — $31,134.95 $37,312.52 $34,223.74 2024-10-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 2 1 — — $31,081.05 $37,247.93 $34,164.49 2024-10-01
B1703 HCPCS Maj Mult Trauma No Brain Or Spinal Cord Injury; M 3 1 — — $33,946.56 $33,946.56 $33,946.56 2024-10-01
1782 APR_DRG External Heart Assist Devices 1 1 — — $33,944.54 $33,944.54 $33,944.54 2024-10-01
265 MS_DRG Aicd Lead Procedures 2 1 — — $30,725.47 $36,821.79 $33,773.63 2024-10-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 2 1 — — $30,648.09 $36,729.06 $33,688.57 2024-10-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 1 1 — — $33,332.93 $33,332.93 $33,332.93 2024-10-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 2 1 — — $30,309.89 $36,323.76 $33,316.82 2024-10-01
A0105 HCPCS Stroke; M > 34.25 & M < 38.85 3 1 — — $33,189.90 $33,189.90 $33,189.90 2024-10-01
7594 APR_DRG Eating Disorders 1 1 — — $33,149.45 $33,149.45 $33,149.45 2024-10-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 2 1 — — $30,099.50 $36,071.62 $33,085.56 2024-10-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 2 1 — — $30,067.33 $36,033.07 $33,050.20 2024-10-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 2 1 — — $30,048.20 $36,010.15 $33,029.18 2024-10-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 2 1 — — $30,038.64 $35,998.69 $33,018.67 2024-10-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 2 1 — — $29,827.38 $35,745.51 $32,786.44 2024-10-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 2 1 — — $29,804.77 $35,718.42 $32,761.60 2024-10-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 2 1 — — $29,610.03 $35,485.03 $32,547.53 2024-10-01
1673 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 1 1 — — $32,476.67 $32,476.67 $32,476.67 2024-10-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 2 1 — — $29,357.03 $35,181.84 $32,269.43 2024-10-01
37 MS_DRG Extracranial Procedures With Mcc 2 1 — — $29,347.47 $35,170.38 $32,258.92 2024-10-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 2 1 — — $29,290.09 $35,101.61 $32,195.85 2024-10-01
B0303 HCPCS Nontraumatic Brain Injury; M > 26.15 & M < 35.05 3 1 — — $32,068.67 $32,068.67 $32,068.67 2024-10-01
252 MS_DRG Other Vascular Procedures With Mcc 2 1 — — $29,157.94 $34,943.24 $32,050.59 2024-10-01
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 1 1 — — $31,987.38 $31,987.38 $31,987.38 2024-10-01
A0205 HCPCS Traumatic Brain Injury; M > 28.75 & M < 40.65 3 1 — — $31,956.89 $31,956.89 $31,956.89 2024-10-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 2 1 — — $29,057.09 $34,822.38 $31,939.74 2024-10-01
573 OTHER Skin Graft For Skin Ulcer Or Cellulitis With Mcc 2 2 — — $28,941.83 $34,929.79 $31,935.81 2024-10-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 2 1 — — $28,949.28 $34,693.19 $31,821.24 2024-10-01
J1412 HCPCS Injection, Valoctocogene Roxaparvovec-rvox, Per Ml, Containing Nominal 2 X 10°13… 5 2 — — $13,593.76 $31,820.70 $31,820.70 2024-10-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 2 1 — — $28,912.77 $34,649.43 $31,781.10 2024-10-01
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 1 1 — — $31,742.74 $31,742.74 $31,742.74 2024-10-01
017 OTHER Autologous Bone Marrow Transplant Without Cc/mcc 2 2 — — $28,750.62 $34,699.02 $31,724.82 2024-10-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 2 1 — — $28,822.35 $34,541.07 $31,681.71 2024-10-01
405 OTHER Pancreas, Liver And Shunt Procedures With Mcc 2 2 — — $28,705.33 $34,644.36 $31,674.85 2024-10-01
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 1 1 — — $31,559.25 $31,559.25 $31,559.25 2024-10-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 2 1 — — $28,638.04 $34,320.19 $31,479.12 2024-10-01
6954 APR_DRG Chemotherapy For Acute Leukemia 1 1 — — $31,436.93 $31,436.93 $31,436.93 2024-10-01
264 MS_DRG Other Circulatory System O.r. Procedures 2 1 — — $28,394.60 $34,028.45 $31,211.52 2024-10-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 2 1 — — $28,309.40 $33,926.35 $31,117.88 2024-10-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 2 1 — — $28,175.52 $33,765.90 $30,970.71 2024-10-01
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 1 1 — — $30,886.48 $30,886.48 $30,886.48 2024-10-01
1781 APR_DRG External Heart Assist Devices 1 1 — — $30,825.32 $30,825.32 $30,825.32 2024-10-01
64565 CPT HPercutaneous Implantation Of Neurostimulator Electrode Array; Neuromuscular 6 3 — — $3,686.00 $47,359.00 $30,742.00 2024-10-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 2 1 — — $27,953.82 $33,500.21 $30,727.01 2024-10-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 2 1 — — $27,826.02 $33,347.05 $30,586.54 2024-10-01
207 OTHER Respiratory System Diagnosis With Ventilator Support >96 Hours 2 2 — — $27,714.90 $33,449.02 $30,581.96 2024-10-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $30,580.67 $30,580.67 $30,580.67 2024-10-01
A1903 HCPCS Guillian Barre; M < 18.05 3 1 — — $30,445.29 $30,445.29 $30,445.29 2024-10-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 1 1 — — $30,397.19 $30,397.19 $30,397.19 2024-10-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 2 1 — — $27,643.44 $33,128.25 $30,385.85 2024-10-01
B2003 HCPCS Miscellaneous; M > 27.85 & M < 38.75 3 1 — — $30,309.43 $30,309.43 $30,309.43 2024-10-01
D2102 HCPCS Burns; M=12-45 3 1 — — $30,285.36 $30,285.36 $30,285.36 2024-10-01
1792 APR_DRG Defibrillator Implants 1 1 — — $30,152.54 $30,152.54 $30,152.54 2024-10-01
1214 APR_DRG Other Respiratory And Chest Procedures 1 1 — — $29,907.90 $29,907.90 $29,907.90 2024-10-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 2 1 — — $27,170.49 $32,561.46 $29,865.97 2024-10-01
B0804 HCPCS Replacement Of Lower Ext Joint; M > 28.65 & M < 37 3 1 — — $29,556.21 $29,556.21 $29,556.21 2024-10-01
665 MS_DRG Prostatectomy With Mcc 2 1 — — $26,856.64 $32,185.33 $29,520.99 2024-10-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 2 1 — — $26,734.05 $32,038.43 $29,386.24 2024-10-01
D0704 HCPCS Fracture Of Lower Extremity; M < 28.15 3 1 — — $29,327.49 $29,327.49 $29,327.49 2024-10-01
218 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 — — $26,514.81 $32,000.63 $29,257.72 2024-10-01
C1404 HCPCS Cardiac; M < 31.15 3 1 — — $29,069.54 $29,069.54 $29,069.54 2024-10-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 2 1 — — $26,433.24 $31,677.93 $29,055.58 2024-10-01
B0602 HCPCS Neurological; M > 37.35 & M < 47.75 3 1 — — $28,981.84 $28,981.84 $28,981.84 2024-10-01
023 OTHER Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 2 2 — — $26,058.17 $31,449.52 $28,753.85 2024-10-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 2 1 — — $26,094.17 $31,271.59 $28,682.88 2024-10-01
662 MS_DRG Minor Bladder Procedures With Mcc 2 1 — — $26,053.31 $31,222.62 $28,637.97 2024-10-01
B1902 HCPCS Guillian Barre; M > 18.05 & M < 35.95 3 1 — — $28,624.14 $28,624.14 $28,624.14 2024-10-01
235 OTHER Coronary Bypass Without Cardiac Catheterization With Mcc 2 2 — — $25,915.60 $31,277.45 $28,596.53 2024-10-01
3154 APR_DRG Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement 1 1 — — $28,440.02 $28,440.02 $28,440.02 2024-10-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 2 1 — — $25,809.01 $30,929.84 $28,369.42 2024-10-01
3054 APR_DRG Amputation Of Lower Limb Except Toes 1 1 — — $28,317.70 $28,317.70 $28,317.70 2024-10-01
472 MS_DRG Cervical Spinal Fusion With Cc 2 1 — — $25,694.25 $30,792.31 $28,243.28 2024-10-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 2 1 — — $25,674.25 $30,768.35 $28,221.30 2024-10-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 2 1 — — $25,637.74 $30,724.59 $28,181.17 2024-10-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 2 1 — — $25,423.86 $30,468.28 $27,946.07 2024-10-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 2 1 — — $25,396.91 $30,435.98 $27,916.44 2024-10-01
5114 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 1 1 — — $27,889.57 $27,889.57 $27,889.57 2024-10-01
974 MS_DRG HIV With Major Related Condition With Mcc 2 1 — — $25,356.05 $30,387.01 $27,871.53 2024-10-01
D1704 HCPCS Major Multiple Trauma,no Brain Or Spinal Cord Inju 3 1 — — $27,659.40 $27,659.40 $27,659.40 2024-10-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 2 1 — — $25,103.06 $30,083.82 $27,593.44 2024-10-01
B0103 HCPCS Stroke; M > 44.45 & M < 51.05 & C < 18.5 3 1 — — $27,535.58 $27,535.58 $27,535.58 2024-10-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 2 1 — — $24,992.64 $29,951.50 $27,472.07 2024-10-01
1704 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 1 1 — — $27,461.44 $27,461.44 $27,461.44 2024-10-01
B0502 HCPCS Nontraumatic Spinal Cord Injury; M > 40.15 & M < 5 3 1 — — $27,396.29 $27,396.29 $27,396.29 2024-10-01
D0304 HCPCS Nontraumatic Brain Injury; M < 26.15 3 1 — — $27,325.78 $27,325.78 $27,325.78 2024-10-01
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 1 1 — — $27,277.96 $27,277.96 $27,277.96 2024-10-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 2 1 — — $24,745.73 $29,655.60 $27,200.67 2024-10-01
A1103 HCPCS Amputation, Non-lower Extremity; M=12-37 3 1 — — $27,164.13 $27,164.13 $27,164.13 2024-10-01
A0704 HCPCS Fracture Of Lower Extremity; M < 28.15 3 1 — — $27,095.34 $27,095.34 $27,095.34 2024-10-01
D2004 HCPCS Miscellaneous; M < 27.85 3 1 — — $27,040.31 $27,040.31 $27,040.31 2024-10-01
263 MS_DRG Vein Ligation And Stripping 2 1 — — $24,562.29 $29,435.76 $26,999.03 2024-10-01
3084 APR_DRG Hip And Femur Fracture Repair 1 1 — — $26,972.15 $26,972.15 $26,972.15 2024-10-01
668 MS_DRG Transurethral Procedures With Mcc 2 1 — — $24,499.69 $29,360.74 $26,930.22 2024-10-01
800 MS_DRG Splenic Procedures With Cc 2 1 — — $24,497.08 $29,357.62 $26,927.35 2024-10-01
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 2 1 — — $24,489.26 $29,348.24 $26,918.75 2024-10-01
264 APR_DRG Other Nervous System And Related Procedures 1 1 — — $26,910.99 $26,910.99 $26,910.99 2024-10-01
G0340 HCPCS Image-guided Robotic Linear Accelerator-based Stereotactic Radiosurgery, Deliver… 1 1 — — $26,882.00 $26,882.00 $26,882.00 2024-10-01
G0173 HCPCS Linear Accelerator Based Stereotactic Radiosurgery, Complete Course Of Therapy I… 1 1 — — $26,882.00 $26,882.00 $26,882.00 2024-10-01
G0251 HCPCS Linear Accelerator Based Stereotactic Radiosurgery, Delivery Including Collimato… 1 1 — — $26,882.00 $26,882.00 $26,882.00 2024-10-01
G0339 HCPCS Image-guided Robotic Linear Accelerator-based Stereotactic Radiosurgery, Complet… 1 1 — — $26,882.00 $26,882.00 $26,882.00 2024-10-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 2 1 — — $24,423.18 $29,269.05 $26,846.11 2024-10-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 2 1 — — $24,367.54 $29,202.37 $26,784.96 2024-10-01
D1204 HCPCS Osteoarthritis; M=39-47 3 1 — — $26,768.60 $26,768.60 $26,768.60 2024-10-01
B0402 HCPCS Traumatic Spinal Cord Injury; M > 30.35 & M < 48.4 3 1 — — $26,747.97 $26,747.97 $26,747.97 2024-10-01
3094 APR_DRG Other Significant Hip And Femur Surgery 1 1 — — $26,605.18 $26,605.18 $26,605.18 2024-10-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 2 1 — — $24,165.84 $28,960.65 $26,563.25 2024-10-01
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures 1 1 — — $26,544.02 $26,544.02 $26,544.02 2024-10-01
A0403 HCPCS Traumatic Spinal Cord Injury; M > 16.05 & M < 30.3 3 1 — — $26,330.08 $26,330.08 $26,330.08 2024-10-01
4402 APR_DRG Kidney Transplant 1 1 — — $26,299.38 $26,299.38 $26,299.38 2024-10-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 2 1 — — $23,885.90 $28,625.16 $26,255.53 2024-10-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 2 1 — — $23,825.04 $28,552.23 $26,188.64 2024-10-01
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