Price Transparency 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

29,322 distinct procedures filed
55 distinct payers
920,011 rate rows
2024-10-01 last MRF observed · ⚠ 20 mo old
Data quality

823,197 of 920,011 rate rows are consumer-grade (89.5%)

96,814 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 58,898
per-diem day rate — not a per-procedure price 26,488
template filing: same amount across many unrelated codes — excluded 6,409
exceeds 10× this hospital's gross charge — excluded from medians 4,756
placeholder amount (≤ $0.02) — excluded from medians 263

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 20 months old.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 · 2026-05-18
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 3 $3,994,116.00 $4,200,000.00 $4,111,590.00 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
$3,325,455
1.1× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 19 $3,232,152.00 $4,223,835.00 $3,709,629.00 nat. median
$3,746,358
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 19 $3,172,400.00 $4,145,750.00 $3,641,050.00 nat. median
$3,605,000
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 23 $4,461.14 $4,888,418.85 $3,358,709.55 nat. median
$13,041
outlier · 257.5×
748
OTHER 		Inj, Lovotibeglogene Auto 23 $7,358.63 $4,830,420.00 $3,318,860.00 nat. median
$17,963
outlier · 184.8×
746
OTHER 		Inj, Betibeglogene Autote 23 $6,535.93 $4,362,960.00 $2,997,680.00 nat. median
$21,896
outlier · 136.9×
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 2 $2,648,347.96 $2,649,861.29 $2,649,104.62 nat. median
$2,469,189
1.1× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 22 $2,101,980.32 $3,511,262.58 $2,436,386.28 nat. median
$2,588,981
0.9× 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
$754,974
1.8× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 4 $579,360.22 $1,345,370.55 $1,345,370.55 nat. median
$675,122
2.0× median
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
$625,184
outlier · 2.1×
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 4 $556,654.68 $1,315,434.06 $1,315,434.06 nat. median
$674,188
2.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 4 $549,504.00 $1,296,212.81 $1,296,212.81 nat. median
$634,511
outlier · 2.0×
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 4 $512,890.14 $1,191,016.00 $1,191,016.00 nat. median
$620,080
1.9× median
9194
OTHER 		Tisagenlecleucel Car-pos 22 $465,689.75 $777,913.56 $539,776.76 nat. median
$566,531
1.0× median
9498
OTHER 		Ciltacabtagene Car-pos T 22 $463,868.59 $774,871.40 $537,665.87 nat. median
$587,650
0.9× median
9422
OTHER 		Idecabtagene Vicleucel Ca 22 $463,397.09 $774,083.77 $537,119.35 nat. median
$558,082
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 22 $454,718.97 $759,587.37 $527,060.62 nat. median
$562,201
0.9× median
9035
OTHER 		Axicabtagene Ciloleucel C 22 $430,721.28 $719,500.32 $499,245.12 nat. median
$532,192
0.9× median
9391
OTHER 		Brexucabtagene Car Pos T 22 $405,266.75 $676,979.69 $469,741.01 nat. median
$489,450
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 28 $1,854.72 $1,249,829.16 $265,763.86 nat. median
$370,174
0.7× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 28 $2,253.12 $933,519.00 $198,818.30 nat. median
$265,286
0.7× median
1614
APR_DRG 		Implantable Heart Assist Systems 1 $198,774.36 $198,774.36 $198,774.36 nat. median
$207,730
1.0× median
J7330
HCPCS 		Autologous Cultured Chondrocytes, Implant 2 $87,248.40 $192,914.70 $192,914.70 nat. median
$76,377
outlier · 2.5×
5834
APR_DRG 		Neonate With Ecmo 1 $189,844.81 $189,844.81 $189,844.81 nat. median
$309,665
0.6× median
A9543
HCPCS 		Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 3 $74,124.43 $173,512.94 $173,512.94 nat. median
$62,507
outlier · 2.8×
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 1 $171,129.43 $171,129.43 $171,129.43 nat. median
$164,834
1.0× median
J9029
HCPCS 		Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 4 $72,000.00 $168,273.22 $168,273.22 nat. median
$69,774
outlier · 2.4×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 30 $2,253.12 $786,244.76 $167,648.32 nat. median
$206,368
0.8× median
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 2 $151,214.00 $182,499.66 $166,856.83 nat. median
$263,894
0.6× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 30 $2,253.12 $710,261.12 $151,566.80 nat. median
$202,986
0.7× median
5833
APR_DRG 		Neonate With Ecmo 1 $150,334.58 $150,334.58 $150,334.58 nat. median
$244,017
0.6× median
1613
APR_DRG 		Implantable Heart Assist Systems 1 $145,563.99 $145,563.99 $145,563.99 nat. median
$119,796
1.2× median
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 1 $143,239.86 $143,239.86 $143,239.86 nat. median
$105,658
1.4× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 1 $143,117.54 $143,117.54 $143,117.54 nat. median
$150,721
0.9× median
1908
OTHER 		New Technology - Level 52 22 $122,380.02 $204,430.25 $141,849.56 nat. median
$152,962
0.9× median
1907
OTHER 		New Technology - Level 52 22 $122,380.02 $204,430.25 $141,849.56 nat. median
$153,199
0.9× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 1 $140,304.12 $140,304.12 $140,304.12 nat. median
$246,434
0.6× median
018
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $124,773.83 $150,589.11 $137,681.47 nat. median
$424,868
outlier · 0.3×
1905
OTHER 		New Technology - Level 51 22 $110,342.76 $184,322.57 $127,897.29 nat. median
$137,903
0.9× median
1906
OTHER 		New Technology - Level 51 22 $110,342.76 $184,322.57 $127,897.29 nat. median
$138,020
0.9× median
A9699
HCPCS 		Radiopharmaceutical, Therapeutic, Not Otherwise Classified 1 $123,321.96 $123,321.96 $123,321.96 nat. median
$21,806
outlier · 5.7×
1903
OTHER 		New Technology - Level 50 22 $98,305.42 $164,214.73 $113,944.91 nat. median
$119,935
1.0× median
1904
OTHER 		New Technology - Level 50 22 $98,305.42 $164,214.73 $113,944.91 nat. median
$120,174
0.9× median
24
APR_DRG 		Heart And/or Lung Transplant 1 $112,842.68 $112,842.68 $112,842.68 nat. median
$234,738
outlier · 0.5×
Q2043
HCPCS 		Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 5 $62,762.43 $147,108.87 $112,690.95 nat. median
$66,682
1.7× median
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
$218,232
0.5× median
5832
APR_DRG 		Neonate With Ecmo 1 $110,885.51 $110,885.51 $110,885.51 nat. median
$156,126
0.7× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 1 $105,014.02 $105,014.02 $105,014.02 nat. median
$160,267
0.7× median

Other procedures at this hospital

Browse this hospital's 29,322 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 3 3 — — $3,994,116.00 $4,200,000.00 $4,111,590.00 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
9138 OTHER Inj, Hemgenix, Per Tx Dos 28 19 — — $3,232,152.00 $4,223,835.00 $3,709,629.00 2024-10-01
773 OTHER Inj, Beqvez, Per Tx Dose 28 19 — — $3,172,400.00 $4,145,750.00 $3,641,050.00 2024-10-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 2 2 — — $2,648,347.96 $2,649,861.29 $2,649,104.62 2024-10-01
9141 OTHER Inj Onase Abepar-xioi Tre 31 22 — — $2,101,980.32 $3,511,262.58 $2,436,386.28 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… 7 4 — — $579,360.22 $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… 7 4 — — $556,654.68 $1,315,434.06 $1,315,434.06 2024-10-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 7 4 — — $549,504.00 $1,296,212.81 $1,296,212.81 2024-10-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 7 4 — — $512,890.14 $1,191,016.00 $1,191,016.00 2024-10-01
9194 OTHER Tisagenlecleucel Car-pos 31 22 — — $465,689.75 $777,913.56 $539,776.76 2024-10-01
9498 OTHER Ciltacabtagene Car-pos T 31 22 — — $463,868.59 $774,871.40 $537,665.87 2024-10-01
9422 OTHER Idecabtagene Vicleucel Ca 31 22 — — $463,397.09 $774,083.77 $537,119.35 2024-10-01
9413 OTHER Lisocabtagene Car Pos T 31 22 — — $454,718.97 $759,587.37 $527,060.62 2024-10-01
9035 OTHER Axicabtagene Ciloleucel C 31 22 — — $430,721.28 $719,500.32 $499,245.12 2024-10-01
9391 OTHER Brexucabtagene Car Pos T 31 22 — — $405,266.75 $676,979.69 $469,741.01 2024-10-01
1614 APR_DRG Implantable Heart Assist Systems 1 1 — — $198,774.36 $198,774.36 $198,774.36 2024-10-01
5834 APR_DRG Neonate With Ecmo 1 1 — — $189,844.81 $189,844.81 $189,844.81 2024-10-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 1 1 — — $171,129.43 $171,129.43 $171,129.43 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
1613 APR_DRG Implantable Heart Assist Systems 1 1 — — $145,563.99 $145,563.99 $145,563.99 2024-10-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 1 1 — — $143,239.86 $143,239.86 $143,239.86 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
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
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $124,773.83 $150,589.11 $137,681.47 2024-10-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 4 1 — — $123,321.96 $123,321.96 $123,321.96 2024-10-01
1908 OTHER New Technology - Level 52 31 22 — — $122,380.02 $204,430.25 $141,849.56 2024-10-01
1907 OTHER New Technology - Level 52 31 22 — — $122,380.02 $204,430.25 $141,849.56 2024-10-01
24 APR_DRG Heart And/or Lung Transplant 1 1 — — $112,842.68 $112,842.68 $112,842.68 2024-10-01
5832 APR_DRG Neonate With Ecmo 1 1 — — $110,885.51 $110,885.51 $110,885.51 2024-10-01
1905 OTHER New Technology - Level 51 31 22 — — $110,342.76 $184,322.57 $127,897.29 2024-10-01
1906 OTHER New Technology - Level 51 31 22 — — $110,342.76 $184,322.57 $127,897.29 2024-10-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 1 1 — — $105,014.02 $105,014.02 $105,014.02 2024-10-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $102,812.22 $102,812.22 $102,812.22 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
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $100,304.60 $100,304.60 $100,304.60 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
1903 OTHER New Technology - Level 50 31 22 — — $98,305.42 $164,214.73 $113,944.91 2024-10-01
1904 OTHER New Technology - Level 50 31 22 — — $98,305.42 $164,214.73 $113,944.91 2024-10-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $98,225.12 $98,225.12 $98,225.12 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
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 1 1 — — $97,430.02 $97,430.02 $97,430.02 2024-10-01
5831 APR_DRG Neonate With Ecmo 1 1 — — $95,839.82 $95,839.82 $95,839.82 2024-10-01
1612 APR_DRG Implantable Heart Assist Systems 1 1 — — $91,558.53 $91,558.53 $91,558.53 2024-10-01
74 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $90,396.46 $90,396.46 $90,396.46 2024-10-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 31 22 — — $87,999.91 $146,999.85 $101,999.90 2024-10-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 5 2 — — $87,248.40 $192,914.70 $192,914.70 2024-10-01
1611 APR_DRG Implantable Heart Assist Systems 1 1 — — $86,971.43 $86,971.43 $86,971.43 2024-10-01
1901 OTHER New Technology - Level 49 31 22 — — $86,268.04 $144,106.83 $99,992.50 2024-10-01
1902 OTHER New Technology - Level 49 31 22 — — $86,268.04 $144,106.83 $99,992.50 2024-10-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 1 1 — — $85,136.59 $85,136.59 $85,136.59 2024-10-01
30243U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30243X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Central Vein, Per… 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30240G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Central Vein, Open Approach… 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30230G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Peripheral Vein, Open Approac… 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30230U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30240Y3 OTHER Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Central Vein, … 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30240U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30233G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Peripheral Vein, Percutaneous… 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30240X2 OTHER Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Central Vein, Open … 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30240G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Central Vein, Open Approach 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30230Y3 OTHER Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Peripheral Vei… 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30243Y3 OTHER Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Central Vein, … 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30243G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Central Vein, Percutaneous Ap… 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30233Y3 OTHER Transfusion Of Allogeneic Unrelated Hamatopoietic Stem Cells Into Peripheral Vei… 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30240X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Central Vein, Ope… 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30233G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Peripheral Vein, Percutaneo… 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30233Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Peripheral Vein,… 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30243Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Central Vein, Pe… 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30230X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Peripheral Vein, … 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30230U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30233U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30240Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Central Vein, Op… 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30240U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30233X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Peripheral Vein, … 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30243X2 OTHER Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Central Vein, Percu… 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30233U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30243G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Central Vein, Percutaneous … 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30230Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Peripheral Vein,… 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30230G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Peripheral Vein, Open Appro… 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30243U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30230X2 OTHER Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Peripheral Vein, Op… 1 1 — — $83,298.00 $83,298.00 $83,298.00 2024-10-01
30233X2 OTHER Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Peripheral Vein, Pe… 1 1 — — $83,298.00 $83,298.00 $83,298.00 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
64 APR_DRG Pancreas Transplant 1 1 — — $81,099.94 $81,099.94 $81,099.94 2024-10-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 31 22 — — $80,108.07 $133,816.89 $92,852.54 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
1585 OTHER New Technology - Level 48 31 22 — — $76,236.92 $127,350.30 $88,365.52 2024-10-01
1599 OTHER New Technology - Level 48 31 22 — — $76,236.92 $127,350.30 $88,365.52 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
C9150 HCPCS Xenon Xe-129 Hyperpolarized Gas, Diagnostic, Per Study Dose 1 1 — — $74,786.40 $74,786.40 $74,786.40 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
12 APR_DRG Liver Transplant And/or Intestinal Transplant 1 1 — — $74,555.68 $74,555.68 $74,555.68 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
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 6 3 — — $74,124.43 $173,512.94 $173,512.94 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
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 7 4 — — $72,000.00 $168,273.22 $168,273.22 2024-10-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 2 — — $71,214.65 $85,948.72 $78,581.68 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
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 1 1 — — $70,335.54 $70,335.54 $70,335.54 2024-10-01
90288 CPT Botulism Immune Globulin, Human, For Intravenous Use 1 1 — — $68,674.05 $68,674.05 $68,674.05 2024-10-01
1584 OTHER New Technology - Level 47 31 22 — — $68,212.02 $113,945.08 $79,063.93 2024-10-01
1598 OTHER New Technology - Level 47 31 22 — — $68,212.02 $113,945.08 $79,063.93 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
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 1 1 — — $67,705.61 $67,705.61 $67,705.61 2024-10-01
014 OTHER Allogeneic Bone Marrow Transplant 2 2 — — $66,170.66 $79,861.14 $73,015.90 2024-10-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $64,647.54 $64,647.54 $64,647.54 2024-10-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 2 2 — — $64,440.54 $77,773.07 $71,106.81 2024-10-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 1 1 — — $64,280.57 $64,280.57 $64,280.57 2024-10-01
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 1 1 — — $63,913.60 $63,913.60 $63,913.60 2024-10-01
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 1 1 — — $62,873.86 $62,873.86 $62,873.86 2024-10-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 8 5 — — $62,762.43 $147,108.87 $112,690.95 2024-10-01
6344 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 1 1 — — $62,384.57 $62,384.57 $62,384.57 2024-10-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $60,243.92 $60,243.92 $60,243.92 2024-10-01
1583 OTHER New Technology - Level 46 31 22 — — $60,187.12 $100,539.84 $69,762.34 2024-10-01
1597 OTHER New Technology - Level 46 31 22 — — $60,187.12 $100,539.84 $69,762.34 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
9104 APR_DRG Craniotomy For Multiple Significant Trauma 1 1 — — $57,980.95 $57,980.95 $57,980.95 2024-10-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 31 22 — — $57,967.10 $96,831.40 $67,189.13 2024-10-01
1643 OTHER Y90 Ibritumomab, Rx 31 22 — — $57,619.39 $96,250.57 $66,786.11 2024-10-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $57,430.50 $57,430.50 $57,430.50 2024-10-01
007 OTHER Lung Transplant 2 2 — — $57,093.24 $68,905.63 $62,999.43 2024-10-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 2 — — $56,989.66 $68,780.63 $62,885.15 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
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $54,250.11 $54,250.11 $54,250.11 2024-10-01
22 APR_DRG Heart And/or Lung Transplant 1 1 — — $53,944.30 $53,944.30 $53,944.30 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
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 1 1 — — $53,393.85 $53,393.85 $53,393.85 2024-10-01
955 OTHER Craniotomy For Multiple Significant Trauma 2 2 — — $52,743.22 $63,655.61 $58,199.42 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
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 1 1 — — $52,537.59 $52,537.59 $52,537.59 2024-10-01
B0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 3 1 — — $52,409.09 $52,409.09 $52,409.09 2024-10-01
1596 OTHER New Technology - Level 45 31 22 — — $52,162.23 $87,134.63 $60,460.77 2024-10-01
1582 OTHER New Technology - Level 45 31 22 — — $52,162.23 $87,134.63 $60,460.77 2024-10-01
B0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 3 1 — — $51,870.83 $51,870.83 $51,870.83 2024-10-01
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 1 1 — — $51,375.53 $51,375.53 $51,375.53 2024-10-01
214 APR_DRG Open Craniotomy Except Trauma 1 1 — — $51,192.04 $51,192.04 $51,192.04 2024-10-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 8 5 — — $50,392.33 $117,019.36 $89,641.24 2024-10-01
B0106 OTHER Stroke; M > 30.05 & M < 34.25 3 1 — — $49,980.90 $49,980.90 $49,980.90 2024-10-01
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $49,907.66 $49,907.66 $49,907.66 2024-10-01
73 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $49,663.01 $49,663.01 $49,663.01 2024-10-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 2 — — $48,609.99 $58,667.23 $53,638.61 2024-10-01
9273 OTHER Sipuleucel-t Auto Cd54+ 31 22 — — $48,413.40 $80,872.39 $56,115.53 2024-10-01
84 APR_DRG Autologous Bone Marrow Transplant 1 1 — — $48,378.62 $48,378.62 $48,378.62 2024-10-01
83 APR_DRG Autologous Bone Marrow Transplant 1 1 — — $48,378.62 $48,378.62 $48,378.62 2024-10-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $48,195.14 $48,195.14 $48,195.14 2024-10-01
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 1 1 — — $47,216.56 $47,216.56 $47,216.56 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
C0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 3 1 — — $46,606.88 $46,606.88 $46,606.88 2024-10-01
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 1 1 — — $46,299.14 $46,299.14 $46,299.14 2024-10-01
1784 APR_DRG External Heart Assist Devices 1 1 — — $46,115.65 $46,115.65 $46,115.65 2024-10-01
B0205 OTHER Traumatic Brain Injury; M > 28.75 & M < 40.65 3 1 — — $45,373.86 $45,373.86 $45,373.86 2024-10-01
D0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 3 1 — — $45,243.17 $45,243.17 $45,243.17 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
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 1 1 — — $44,280.81 $44,280.81 $44,280.81 2024-10-01
1581 OTHER New Technology - Level 44 31 22 — — $44,137.32 $73,729.39 $51,159.17 2024-10-01
1595 OTHER New Technology - Level 44 31 22 — — $44,137.32 $73,729.39 $51,159.17 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
B0105 OTHER Stroke; M > 34.25 & M < 38.85 3 1 — — $43,943.09 $43,943.09 $43,943.09 2024-10-01
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 1 1 — — $43,669.20 $43,669.20 $43,669.20 2024-10-01
215 OTHER Other Heart Assist System Implant 2 2 — — $43,468.72 $52,462.25 $47,965.49 2024-10-01
C0106 OTHER Stroke; M > 30.05 & M < 34.25 3 1 — — $43,346.36 $43,346.36 $43,346.36 2024-10-01
B1903 OTHER Guillian Barre; M < 18.05 3 1 — — $43,188.15 $43,188.15 $43,188.15 2024-10-01
4404 APR_DRG Kidney Transplant 1 1 — — $43,179.91 $43,179.91 $43,179.91 2024-10-01
B0604 OTHER Neurological; M < 25.85 3 1 — — $42,827.01 $42,827.01 $42,827.01 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
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 1 1 — — $42,507.13 $42,507.13 $42,507.13 2024-10-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 1 1 — — $42,507.13 $42,507.13 $42,507.13 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
3033 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
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
3031 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
63 APR_DRG Pancreas Transplant 1 1 — — $42,201.33 $42,201.33 $42,201.33 2024-10-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 1 1 — — $42,079.00 $42,079.00 $42,079.00 2024-10-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 — — $42,077.42 $50,783.09 $46,430.25 2024-10-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 1 1 — — $41,895.52 $41,895.52 $41,895.52 2024-10-01
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 — — $41,843.44 $50,500.71 $46,172.07 2024-10-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 31 22 — — $41,793.84 $69,814.71 $48,442.86 2024-10-01
5244 OTHER Level 4 Blood Product Exc 31 22 — — $41,782.56 $69,795.86 $48,429.78 2024-10-01
B0405 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 3 1 — — $41,678.26 $41,678.26 $41,678.26 2024-10-01
8634 APR_DRG Neonatal Aftercare 1 1 — — $41,650.87 $41,650.87 $41,650.87 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
1794 APR_DRG Defibrillator Implants 1 1 — — $41,345.07 $41,345.07 $41,345.07 2024-10-01
4403 APR_DRG Kidney Transplant 1 1 — — $41,283.91 $41,283.91 $41,283.91 2024-10-01
1824 APR_DRG Other Peripheral Vascular And Related Procedures 1 1 — — $41,161.58 $41,161.58 $41,161.58 2024-10-01
A0404 OTHER 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
A5104 OTHER Expired, Not Orthopedic, Length Of Stay Is 16 Days 3 1 — — $40,986.95 $40,986.95 $40,986.95 2024-10-01
72 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $40,672.29 $40,672.29 $40,672.29 2024-10-01
914 APR_DRG Other Major Head And Neck Procedures 1 1 — — $40,488.81 $40,488.81 $40,488.81 2024-10-01
C0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 3 1 — — $40,354.11 $40,354.11 $40,354.11 2024-10-01
B0704 OTHER Fracture Of Lower Extremity; M < 28.15 3 1 — — $40,022.21 $40,022.21 $40,022.21 2024-10-01
913 APR_DRG Other Major Head And Neck Procedures 1 1 — — $39,999.52 $39,999.52 $39,999.52 2024-10-01
1142 OTHER Supprelin La Implant 31 22 — — $39,908.18 $66,664.81 $46,257.21 2024-10-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 1 1 — — $39,877.19 $39,877.19 $39,877.19 2024-10-01
B2102 OTHER Burns; M=12-45 3 1 — — $39,855.40 $39,855.40 $39,855.40 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
D0106 OTHER Stroke; M > 30.05 & M < 34.25 3 1 — — $39,611.20 $39,611.20 $39,611.20 2024-10-01
B1004 OTHER Amputation, Lower Extremity; M=39-45 3 1 — — $39,571.65 $39,571.65 $39,571.65 2024-10-01
11 APR_DRG Liver Transplant And/or Intestinal Transplant 1 1 — — $39,510.23 $39,510.23 $39,510.23 2024-10-01
1834 APR_DRG Percutaneous Structural Cardiac Procedures 1 1 — — $39,449.07 $39,449.07 $39,449.07 2024-10-01
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 1 1 — — $39,326.74 $39,326.74 $39,326.74 2024-10-01
B1504 OTHER Pulmonary; M < 29.15 3 1 — — $39,112.49 $39,112.49 $39,112.49 2024-10-01
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $38,959.77 $38,959.77 $38,959.77 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
71 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $38,653.97 $38,653.97 $38,653.97 2024-10-01
1833 APR_DRG Percutaneous Structural Cardiac Procedures 1 1 — — $38,653.97 $38,653.97 $38,653.97 2024-10-01
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 1 1 — — $38,531.65 $38,531.65 $38,531.65 2024-10-01
894 APR_DRG Major Cranial Or Facial Bone Procedures 1 1 — — $38,470.48 $38,470.48 $38,470.48 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 OTHER Major Multiple Trauma,no Brain Or Spinal Cord Inju 3 1 — — $38,422.90 $38,422.90 $38,422.90 2024-10-01
B2005 OTHER Miscellaneous; M=12-32 And A Tm81 3 1 — — $38,197.62 $38,197.62 $38,197.62 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
D0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 3 1 — — $38,123.68 $38,123.68 $38,123.68 2024-10-01
C0105 OTHER Stroke; M > 34.25 & M < 38.85 3 1 — — $38,109.92 $38,109.92 $38,109.92 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
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 2 — — $37,205.35 $44,903.01 $41,054.18 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
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
1580 OTHER New Technology - Level 43 31 22 — — $36,112.44 $60,324.18 $41,857.60 2024-10-01
1594 OTHER New Technology - Level 43 31 22 — — $36,112.44 $60,324.18 $41,857.60 2024-10-01
834 OTHER Acute Leukemia With Mcc 2 2 — — $35,526.40 $42,876.69 $39,201.54 2024-10-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 2 — — $34,715.01 $41,897.43 $38,306.22 2024-10-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 31 22 — — $33,694.76 $56,285.57 $39,055.29 2024-10-01
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 31 22 — — $33,177.32 $55,421.21 $38,455.53 2024-10-01
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 8 5 — — $30,286.51 $71,589.38 $54,840.17 2024-10-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 6 3 — — $26,766.00 $62,320.47 $62,320.47 2024-10-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 51 27 — — $21,031.00 $347,391.67 $74,767.16 2024-10-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 51 27 — — $21,031.00 $276,412.62 $59,744.79 2024-10-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 51 27 — — $21,031.00 $235,272.21 $51,037.62 2024-10-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 51 27 — — $21,031.00 $222,197.30 $48,270.37 2024-10-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 51 27 — — $21,031.00 $205,022.60 $44,635.42 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
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 51 27 — — $19,389.48 $182,458.84 $39,859.92 2024-10-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 51 27 — — $19,265.86 $181,295.52 $39,613.70 2024-10-01
850 MS_DRG Acute Leukemia With Other Procedures 51 27 — — $11,050.00 $305,290.12 $65,856.58 2024-10-01
717 OTHER Instill Adstiladrin, Tx D 33 23 — — $10,690.96 $93,131.51 $63,988.32 2024-10-01
748 OTHER Inj, Lovotibeglogene Auto 33 23 — — $7,358.63 $4,830,420.00 $3,318,860.00 2024-10-01
746 OTHER Inj, Betibeglogene Autote 33 23 — — $6,535.93 $4,362,960.00 $2,997,680.00 2024-10-01
714 OTHER Inj Delandistrogene Mox R 33 23 — — $4,461.14 $4,888,418.85 $3,358,709.55 2024-10-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 53 28 — — $2,253.12 $933,519.00 $198,818.30 2024-10-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 50 30 — — $2,253.12 $786,244.76 $167,648.32 2024-10-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 57 30 — — $2,253.12 $710,261.12 $151,566.80 2024-10-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 58 30 — — $2,253.12 $468,280.76 $100,352.77 2024-10-01
7 MS_DRG Lung Transplant 48 29 — — $2,253.12 $433,109.41 $92,908.92 2024-10-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 53 28 — — $2,253.12 $676,929.00 $78,541.70 2024-10-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 58 30 — — $2,253.12 $361,030.01 $77,653.66 2024-10-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 48 29 — — $2,253.12 $352,926.55 $75,938.60 2024-10-01
215 MS_DRG Other Heart Assist System Implant 58 30 — — $2,253.12 $559,326.00 $75,927.38 2024-10-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 7 4 — — $2,253.12 $92,326.93 $74,471.21 2024-10-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 59 30 — — $2,253.12 $319,843.21 $68,936.67 2024-10-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 59 30 — — $2,253.12 $190,941.52 $61,241.43 2024-10-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 59 30 — — $2,253.12 $280,833.90 $60,680.52 2024-10-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 58 30 — — $2,253.12 $267,149.15 $57,784.21 2024-10-01
10 MS_DRG Pancreas Transplant 48 29 — — $2,253.12 $264,235.88 $57,167.63 2024-10-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 49 29 — — $2,253.12 $262,714.62 $56,845.67 2024-10-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 59 30 — — $2,253.12 $259,039.06 $56,067.76 2024-10-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 7 4 — — $2,253.12 $69,101.93 $55,737.85 2024-10-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 59 30 — — $2,253.12 $256,427.39 $55,515.01 2024-10-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 58 30 — — $2,253.12 $247,369.41 $53,597.93 2024-10-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 7 4 — — $2,253.12 $63,725.73 $51,401.39 2024-10-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 58 30 — — $2,253.12 $320,043.00 $51,060.82 2024-10-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 58 30 — — $2,253.12 $226,297.09 $49,138.07 2024-10-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 50 30 — — $2,253.12 $221,345.53 $48,090.09 2024-10-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 59 30 — — $2,253.12 $220,971.01 $48,010.83 2024-10-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 59 30 — — $2,253.12 $214,017.61 $46,539.17 2024-10-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 58 30 — — $2,253.12 $209,593.02 $45,602.73 2024-10-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 58 30 — — $2,253.12 $208,125.00 $44,910.62 2024-10-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 58 30 — — $2,253.12 $204,087.97 $44,437.62 2024-10-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 58 30 — — $2,253.12 $203,388.65 $44,289.60 2024-10-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 59 30 — — $2,253.12 $272,490.00 $44,090.40 2024-10-01
28 MS_DRG Spinal Procedures With Mcc 58 30 — — $2,253.12 $201,479.61 $43,885.57 2024-10-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 58 30 — — $2,253.12 $208,820.00 $43,475.44 2024-10-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 59 30 — — $2,253.12 $197,171.02 $42,973.67 2024-10-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 59 30 — — $2,253.12 $195,006.78 $42,515.62 2024-10-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 56 30 — — $2,253.12 $314,996.79 $42,081.43 2024-10-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 59 30 — — $2,253.12 $135,581.00 $41,906.78 2024-10-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 58 30 — — $2,253.12 $189,070.87 $41,461.57 2024-10-01
653 MS_DRG Major Bladder Procedures With Mcc 58 30 — — $2,253.12 $184,745.71 $40,343.92 2024-10-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 58 30 — — $2,253.12 $183,191.30 $40,211.09 2024-10-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 48 29 — — $2,253.12 $180,324.43 $39,408.17 2024-10-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 58 30 — — $2,253.12 $179,913.46 $39,321.19 2024-10-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 58 30 — — $2,253.12 $178,995.40 $39,318.69 2024-10-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 58 30 — — $2,253.12 $178,826.37 $39,091.11 2024-10-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 58 30 — — $2,253.12 $178,803.17 $39,086.21 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
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 59 30 — — $2,253.12 $176,317.45 $38,560.12 2024-10-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 59 30 — — $2,253.12 $175,535.27 $38,394.57 2024-10-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 47 28 — — $1,854.72 $1,249,829.16 $265,763.86 2024-10-01
14 MS_DRG Allogeneic Bone Marrow Transplant 48 29 — — $1,854.72 $434,203.13 $93,140.40 2024-10-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 58 30 — — $1,854.72 $230,559.28 $50,040.14 2024-10-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 58 30 — — $1,854.72 $214,358.98 $46,611.43 2024-10-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 48 29 — — $1,854.72 $200,034.58 $43,579.73 2024-10-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 48 29 — — $1,854.72 $200,034.58 $43,579.73 2024-10-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 45 26 — — $1,854.72 $134,041.92 $42,944.92 2024-10-01
834 MS_DRG Acute Leukemia With Mcc 58 30 — — $1,854.72 $183,178.05 $40,012.13 2024-10-01
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