|
J3391
|
HCPCS
|
Inj, Atidarsagene Autotemcel
|
5
|
3
|
—
|
—
|
$4,377,500.00
|
$4,596,375.00
|
$4,377,500.00
|
2025-12-03
|
|
J1414
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
5
|
3
|
—
|
—
|
$3,710,000.00
|
$3,895,500.00
|
$3,710,000.00
|
2025-12-03
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
5
|
3
|
—
|
—
|
$3,685,266.67
|
$3,869,530.00
|
$3,685,266.67
|
2025-12-03
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
5
|
3
|
—
|
—
|
$3,324,571.90
|
$3,490,800.50
|
$3,324,571.90
|
2025-12-03
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
5
|
3
|
—
|
—
|
$3,261,355.00
|
$3,424,422.75
|
$3,261,355.00
|
2025-12-03
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
5
|
3
|
—
|
—
|
$2,950,686.67
|
$3,098,221.00
|
$2,950,686.67
|
2025-12-03
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
6
|
4
|
—
|
—
|
$2,452,115.60
|
$4,291,202.29
|
$2,452,115.60
|
2025-12-03
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
6
|
4
|
—
|
—
|
$2,332,000.00
|
$4,081,000.00
|
$2,332,000.00
|
2025-12-03
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
6
|
4
|
—
|
—
|
$770,620.00
|
$1,348,585.00
|
$770,620.00
|
2025-12-03
|
|
5834
|
APR_DRG
|
Neonate With Ecmo
|
4
|
3
|
—
|
—
|
$738,706.47
|
$790,415.92
|
$738,706.47
|
2025-12-03
|
|
74
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
4
|
3
|
—
|
—
|
$718,614.34
|
$768,917.34
|
$718,614.34
|
2025-12-03
|
|
5833
|
APR_DRG
|
Neonate With Ecmo
|
4
|
3
|
—
|
—
|
$625,509.49
|
$669,295.15
|
$625,509.49
|
2025-12-03
|
|
24
|
APR_DRG
|
Heart And/or Lung Transplant
|
4
|
3
|
—
|
—
|
$601,722.42
|
$643,842.99
|
$601,722.42
|
2025-12-03
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel Car-pos T
|
9
|
4
|
—
|
—
|
$338,087.20
|
$1,012,068.01
|
$578,324.58
|
2025-12-03
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
9
|
4
|
—
|
—
|
$407,563.20
|
$968,412.95
|
$553,378.83
|
2025-12-03
|
|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
9
|
4
|
—
|
—
|
$359,619.74
|
$947,862.40
|
$541,635.66
|
2025-12-03
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel Car
|
9
|
4
|
—
|
—
|
$367,683.36
|
$947,205.78
|
$541,260.45
|
2025-12-03
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Car+
|
9
|
4
|
—
|
—
|
$311,828.00
|
$932,883.83
|
$533,076.48
|
2025-12-03
|
|
Q2053
|
HCPCS
|
Brexucabtagene Car Pos T
|
9
|
4
|
—
|
—
|
$326,927.04
|
$857,010.00
|
$489,720.00
|
2025-12-03
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
11
|
5
|
—
|
—
|
$196,106.56
|
$849,588.71
|
$485,479.26
|
2025-12-03
|
|
5884
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
4
|
3
|
—
|
—
|
$467,589.08
|
$500,320.32
|
$467,589.08
|
2025-12-03
|
|
1614
|
APR_DRG
|
Implantable Heart Assist Systems
|
4
|
3
|
—
|
—
|
$454,061.07
|
$485,845.34
|
$454,061.07
|
2025-12-03
|
|
94
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
4
|
3
|
—
|
—
|
$425,383.73
|
$455,160.59
|
$425,383.73
|
2025-12-03
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
8
|
5
|
—
|
—
|
$146,475.16
|
$634,571.58
|
$362,612.33
|
2025-12-03
|
|
6304
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
4
|
3
|
—
|
—
|
$347,917.44
|
$372,271.66
|
$347,917.44
|
2025-12-03
|
|
6094
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
4
|
3
|
—
|
—
|
$344,834.28
|
$368,972.68
|
$344,834.28
|
2025-12-03
|
|
5832
|
APR_DRG
|
Neonate With Ecmo
|
4
|
3
|
—
|
—
|
$311,677.10
|
$333,494.50
|
$311,677.10
|
2025-12-03
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
8
|
5
|
—
|
—
|
$123,358.56
|
$534,423.96
|
$305,385.12
|
2025-12-03
|
|
114
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
4
|
3
|
—
|
—
|
$295,957.81
|
$316,674.86
|
$295,957.81
|
2025-12-03
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…
|
11
|
5
|
—
|
—
|
$111,444.32
|
$482,808.13
|
$275,890.36
|
2025-12-03
|
|
2004
|
APR_DRG
|
Cardiac Structural And Valvular Disorders
|
4
|
3
|
—
|
—
|
$275,026.31
|
$294,278.15
|
$275,026.31
|
2025-12-03
|
|
5831
|
APR_DRG
|
Neonate With Ecmo
|
4
|
3
|
—
|
—
|
$274,437.88
|
$293,648.53
|
$274,437.88
|
2025-12-03
|
|
Q2058
|
HCPCS
|
Obecbtge Autol Up To 400 Mil
|
6
|
4
|
—
|
—
|
$270,375.00
|
$473,156.25
|
$270,375.00
|
2025-12-03
|
|
73
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
4
|
3
|
—
|
—
|
$253,571.55
|
$271,321.56
|
$253,571.55
|
2025-12-03
|
|
5883
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
4
|
3
|
—
|
—
|
$250,892.99
|
$268,455.50
|
$250,892.99
|
2025-12-03
|
|
5882
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
4
|
3
|
—
|
—
|
$249,746.28
|
$267,228.52
|
$249,746.28
|
2025-12-03
|
|
44
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
4
|
3
|
—
|
—
|
$249,100.47
|
$266,537.50
|
$249,100.47
|
2025-12-03
|
|
8414
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
4
|
3
|
—
|
—
|
$248,029.63
|
$265,391.70
|
$248,029.63
|
2025-12-03
|
|
6314
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
4
|
3
|
—
|
—
|
$245,552.40
|
$262,741.07
|
$245,552.40
|
2025-12-03
|
|
8504
|
APR_DRG
|
Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…
|
4
|
3
|
—
|
—
|
$239,083.58
|
$255,819.43
|
$239,083.58
|
2025-12-03
|
|
5914
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
4
|
3
|
—
|
—
|
$236,941.90
|
$253,527.83
|
$236,941.90
|
2025-12-03
|
|
1613
|
APR_DRG
|
Implantable Heart Assist Systems
|
4
|
3
|
—
|
—
|
$236,662.76
|
$253,229.15
|
$236,662.76
|
2025-12-03
|
|
5881
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
4
|
3
|
—
|
—
|
$235,411.99
|
$251,890.83
|
$235,411.99
|
2025-12-03
|
|
14
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
4
|
3
|
—
|
—
|
$215,547.44
|
$230,635.76
|
$215,547.44
|
2025-12-03
|
|
84
|
APR_DRG
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
4
|
3
|
—
|
—
|
$214,683.76
|
$229,711.62
|
$214,683.76
|
2025-12-03
|
|
6814
|
APR_DRG
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
4
|
3
|
—
|
—
|
$210,869.20
|
$225,630.04
|
$210,869.20
|
2025-12-03
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
4
|
3
|
—
|
—
|
$210,751.51
|
$225,504.12
|
$210,751.51
|
2025-12-03
|
|
93
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
4
|
3
|
—
|
—
|
$208,990.12
|
$223,619.43
|
$208,990.12
|
2025-12-03
|
|
2464
|
APR_DRG
|
Gastrointestinal Vascular Insufficiency
|
4
|
3
|
—
|
—
|
$204,370.23
|
$218,676.15
|
$204,370.23
|
2025-12-03
|
|
6034
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
4
|
3
|
—
|
—
|
$203,315.92
|
$217,548.03
|
$203,315.92
|
2025-12-03
|
|
64
|
APR_DRG
|
Pancreas Transplant
|
4
|
3
|
—
|
—
|
$197,312.01
|
$211,123.85
|
$197,312.01
|
2025-12-03
|
|
5891
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
4
|
3
|
—
|
—
|
$197,296.45
|
$211,107.20
|
$197,296.45
|
2025-12-03
|
|
5934
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
4
|
3
|
—
|
—
|
$196,706.08
|
$210,475.51
|
$196,706.08
|
2025-12-03
|
|
5892
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
4
|
3
|
—
|
—
|
$191,220.57
|
$204,606.01
|
$191,220.57
|
2025-12-03
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
4
|
3
|
—
|
—
|
$183,845.28
|
$196,714.45
|
$183,845.28
|
2025-12-03
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …
|
11
|
5
|
—
|
—
|
$73,476.00
|
$318,318.70
|
$181,896.40
|
2025-12-03
|
|
6024
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
4
|
3
|
—
|
—
|
$180,828.25
|
$193,486.23
|
$180,828.25
|
2025-12-03
|
|
5893
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
4
|
3
|
—
|
—
|
$179,360.59
|
$191,915.83
|
$179,360.59
|
2025-12-03
|
|
6214
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
4
|
3
|
—
|
—
|
$171,716.86
|
$183,737.04
|
$171,716.86
|
2025-12-03
|
|
72
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
4
|
3
|
—
|
—
|
$170,371.74
|
$182,297.76
|
$170,371.74
|
2025-12-03
|
|
1612
|
APR_DRG
|
Implantable Heart Assist Systems
|
4
|
3
|
—
|
—
|
$170,123.73
|
$182,032.39
|
$170,123.73
|
2025-12-03
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
8
|
5
|
—
|
—
|
$68,129.36
|
$295,155.56
|
$168,660.32
|
2025-12-03
|
|
7
|
MS_DRG
|
Lung Transplant
|
8
|
5
|
—
|
—
|
$67,957.76
|
$294,412.13
|
$168,235.50
|
2025-12-03
|
|
113
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
4
|
3
|
—
|
—
|
$168,178.51
|
$179,951.01
|
$168,178.51
|
2025-12-03
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
4
|
3
|
—
|
—
|
$165,569.98
|
$177,159.88
|
$165,569.98
|
2025-12-03
|
|
6303
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
4
|
3
|
—
|
—
|
$163,979.76
|
$175,458.34
|
$163,979.76
|
2025-12-03
|
|
1611
|
APR_DRG
|
Implantable Heart Assist Systems
|
4
|
3
|
—
|
—
|
$161,346.91
|
$172,641.19
|
$161,346.91
|
2025-12-03
|
|
4404
|
APR_DRG
|
Kidney Transplant
|
4
|
3
|
—
|
—
|
$160,948.14
|
$172,214.51
|
$160,948.14
|
2025-12-03
|
|
54
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
4
|
3
|
—
|
—
|
$160,212.85
|
$171,427.75
|
$160,212.85
|
2025-12-03
|
|
43
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
4
|
3
|
—
|
—
|
$160,158.39
|
$171,369.48
|
$160,158.39
|
2025-12-03
|
|
6804
|
APR_DRG
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
4
|
3
|
—
|
—
|
$156,025.78
|
$166,947.58
|
$156,025.78
|
2025-12-03
|
|
5913
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
4
|
3
|
—
|
—
|
$156,025.78
|
$166,947.58
|
$156,025.78
|
2025-12-03
|
|
6084
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
4
|
3
|
—
|
—
|
$155,583.24
|
$166,474.07
|
$155,583.24
|
2025-12-03
|
|
4414
|
APR_DRG
|
Major Bladder Procedures
|
4
|
3
|
—
|
—
|
$152,315.28
|
$162,977.35
|
$152,315.28
|
2025-12-03
|
|
23
|
APR_DRG
|
Heart And/or Lung Transplant
|
4
|
3
|
—
|
—
|
$148,204.06
|
$158,578.34
|
$148,204.06
|
2025-12-03
|
|
0100T
|
CPT
|
Prosth Retina Receive&gen
|
5
|
3
|
—
|
—
|
$1,350.00
|
$160,125.52
|
$147,925.48
|
2025-12-03
|
|
83
|
APR_DRG
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
4
|
3
|
—
|
—
|
$145,110.20
|
$155,267.91
|
$145,110.20
|
2025-12-03
|
|
1784
|
APR_DRG
|
External Heart Assist Systems
|
4
|
3
|
—
|
—
|
$142,660.20
|
$152,646.41
|
$142,660.20
|
2025-12-03
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
8
|
5
|
—
|
—
|
$57,302.44
|
$248,250.28
|
$141,857.30
|
2025-12-03
|
|
5933
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
4
|
3
|
—
|
—
|
$140,491.28
|
$150,325.67
|
$140,491.28
|
2025-12-03
|
|
6114
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
4
|
3
|
—
|
—
|
$140,329.83
|
$150,152.92
|
$140,329.83
|
2025-12-03
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
8
|
5
|
—
|
—
|
$56,648.28
|
$245,416.26
|
$140,237.86
|
2025-12-03
|
|
1674
|
APR_DRG
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
4
|
3
|
—
|
—
|
$139,709.30
|
$149,488.95
|
$139,709.30
|
2025-12-03
|
|
6904
|
APR_DRG
|
Acute Leukemia
|
4
|
3
|
—
|
—
|
$138,454.64
|
$148,146.46
|
$138,454.64
|
2025-12-03
|
|
434
|
APR_DRG
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
4
|
3
|
—
|
—
|
$137,606.53
|
$147,238.99
|
$137,606.53
|
2025-12-03
|
|
92
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
4
|
3
|
—
|
—
|
$137,451.88
|
$147,073.51
|
$137,451.88
|
2025-12-03
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
8
|
5
|
—
|
—
|
$55,376.88
|
$239,908.24
|
$137,090.42
|
2025-12-03
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
11
|
5
|
—
|
—
|
$55,092.96
|
$238,678.20
|
$136,387.54
|
2025-12-03
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
8
|
5
|
—
|
—
|
$54,472.08
|
$235,988.36
|
$134,850.49
|
2025-12-03
|
|
91
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
4
|
3
|
—
|
—
|
$133,300.79
|
$142,631.85
|
$133,300.79
|
2025-12-03
|
|
6334
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
4
|
3
|
—
|
—
|
$130,498.71
|
$139,633.62
|
$130,498.71
|
2025-12-03
|
|
3034
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
4
|
3
|
—
|
—
|
$129,703.11
|
$138,782.33
|
$129,703.11
|
2025-12-03
|
|
Q0480
|
HCPCS
|
Driver Pneumatic Vad, Rep
|
6
|
4
|
—
|
—
|
$129,537.50
|
$226,690.63
|
$129,537.50
|
2025-12-03
|
|
5912
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
4
|
3
|
—
|
—
|
$128,823.87
|
$137,841.54
|
$128,823.87
|
2025-12-03
|
|
6074
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
4
|
3
|
—
|
—
|
$127,563.37
|
$136,492.81
|
$127,563.37
|
2025-12-03
|
|
63
|
APR_DRG
|
Pancreas Transplant
|
4
|
3
|
—
|
—
|
$127,510.85
|
$136,436.61
|
$127,510.85
|
2025-12-03
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
11
|
5
|
—
|
—
|
$50,185.72
|
$217,418.62
|
$124,239.21
|
2025-12-03
|
|
2204
|
APR_DRG
|
Major Stomach, Esophageal And Duodenal Procedures
|
4
|
3
|
—
|
—
|
$121,556.55
|
$130,065.51
|
$121,556.55
|
2025-12-03
|
|
6134
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
4
|
3
|
—
|
—
|
$120,894.20
|
$129,356.79
|
$120,894.20
|
2025-12-03
|
|
4474
|
APR_DRG
|
Other Kidney, Urinary Tract And Related Procedures
|
4
|
3
|
—
|
—
|
$120,611.17
|
$129,053.95
|
$120,611.17
|
2025-12-03
|
|
22
|
APR_DRG
|
Heart And/or Lung Transplant
|
4
|
3
|
—
|
—
|
$119,056.95
|
$127,390.94
|
$119,056.95
|
2025-12-03
|
|
234
|
APR_DRG
|
Spinal Procedures
|
4
|
3
|
—
|
—
|
$118,824.49
|
$127,142.20
|
$118,824.49
|
2025-12-03
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
8
|
5
|
—
|
—
|
$47,901.88
|
$207,524.40
|
$118,585.37
|
2025-12-03
|
|
9104
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
4
|
3
|
—
|
—
|
$118,394.60
|
$126,682.22
|
$118,394.60
|
2025-12-03
|
|
112
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
4
|
3
|
—
|
—
|
$116,873.44
|
$125,054.58
|
$116,873.44
|
2025-12-03
|
|
6023
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
4
|
3
|
—
|
—
|
$116,868.58
|
$125,049.38
|
$116,868.58
|
2025-12-03
|
|
53
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
4
|
3
|
—
|
—
|
$115,411.61
|
$123,490.42
|
$115,411.61
|
2025-12-03
|
|
62
|
APR_DRG
|
Pancreas Transplant
|
4
|
3
|
—
|
—
|
$115,331.86
|
$123,405.09
|
$115,331.86
|
2025-12-03
|
|
9504
|
APR_DRG
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
4
|
3
|
—
|
—
|
$114,879.59
|
$122,921.16
|
$114,879.59
|
2025-12-03
|
|
61
|
APR_DRG
|
Pancreas Transplant
|
4
|
3
|
—
|
—
|
$113,842.79
|
$121,811.79
|
$113,842.79
|
2025-12-03
|
|
71
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
4
|
3
|
—
|
—
|
$111,872.29
|
$119,703.35
|
$111,872.29
|
2025-12-03
|
|
K1007
|
HCPCS
|
Bil Hkaf Pc S/d Micro Sensor
|
9
|
4
|
—
|
—
|
$67,760.00
|
$195,755.00
|
$111,860.00
|
2025-12-03
|
|
13
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
4
|
3
|
—
|
—
|
$111,055.30
|
$118,829.17
|
$111,055.30
|
2025-12-03
|
|
6093
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
4
|
3
|
—
|
—
|
$110,924.00
|
$118,688.68
|
$110,924.00
|
2025-12-03
|
|
264
|
APR_DRG
|
Other Nervous System And Related Procedures
|
4
|
3
|
—
|
—
|
$110,856.89
|
$118,616.87
|
$110,856.89
|
2025-12-03
|
|
5932
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
4
|
3
|
—
|
—
|
$110,378.36
|
$118,104.85
|
$110,378.36
|
2025-12-03
|
|
3033
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
4
|
3
|
—
|
—
|
$109,723.80
|
$117,404.47
|
$109,723.80
|
2025-12-03
|
|
1824
|
APR_DRG
|
Other Peripheral Vascular Procedures
|
4
|
3
|
—
|
—
|
$109,635.29
|
$117,309.76
|
$109,635.29
|
2025-12-03
|
|
1634
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
4
|
3
|
—
|
—
|
$109,570.13
|
$117,240.04
|
$109,570.13
|
2025-12-03
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
11
|
5
|
—
|
—
|
$44,064.28
|
$190,898.84
|
$109,085.05
|
2025-12-03
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
11
|
5
|
—
|
—
|
$44,039.84
|
$190,792.98
|
$109,024.56
|
2025-12-03
|
|
7924
|
APR_DRG
|
Extensive O.r. Procedures For Other Complications Of Treatment
|
4
|
3
|
—
|
—
|
$107,776.64
|
$115,321.00
|
$107,776.64
|
2025-12-03
|
|
3044
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
4
|
3
|
—
|
—
|
$107,750.38
|
$115,292.91
|
$107,750.38
|
2025-12-03
|
|
2054
|
APR_DRG
|
Cardiomyopathy
|
4
|
3
|
—
|
—
|
$107,445.95
|
$114,967.17
|
$107,445.95
|
2025-12-03
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
8
|
5
|
—
|
—
|
$43,371.12
|
$187,895.87
|
$107,369.07
|
2025-12-03
|
|
6954
|
APR_DRG
|
Chemotherapy For Acute Leukemia
|
4
|
3
|
—
|
—
|
$107,307.84
|
$114,819.39
|
$107,307.84
|
2025-12-03
|
|
8413
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
4
|
3
|
—
|
—
|
$107,197.94
|
$114,701.80
|
$107,197.94
|
2025-12-03
|
|
52
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
4
|
3
|
—
|
—
|
$105,396.67
|
$112,774.44
|
$105,396.67
|
2025-12-03
|
|
6514
|
APR_DRG
|
Other Procedures Of Blood And Blood-forming Organs
|
4
|
3
|
—
|
—
|
$105,043.61
|
$112,396.66
|
$105,043.61
|
2025-12-03
|
|
42
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
4
|
3
|
—
|
—
|
$104,715.84
|
$112,045.95
|
$104,715.84
|
2025-12-03
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
11
|
5
|
—
|
—
|
$41,917.72
|
$181,599.36
|
$103,771.06
|
2025-12-03
|
|
6144
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
4
|
3
|
—
|
—
|
$103,615.82
|
$110,868.93
|
$103,615.82
|
2025-12-03
|
|
1623
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
4
|
3
|
—
|
—
|
$103,439.78
|
$110,680.56
|
$103,439.78
|
2025-12-03
|
|
214
|
APR_DRG
|
Open Craniotomy Except Trauma
|
4
|
3
|
—
|
—
|
$103,194.68
|
$110,418.31
|
$103,194.68
|
2025-12-03
|
|
2304
|
APR_DRG
|
Major Small Bowel Procedures
|
4
|
3
|
—
|
—
|
$102,822.17
|
$110,019.72
|
$102,822.17
|
2025-12-03
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
8
|
5
|
—
|
—
|
$41,459.60
|
$179,614.66
|
$102,636.95
|
2025-12-03
|
|
224
|
APR_DRG
|
Ventricular Shunt Procedures
|
4
|
3
|
—
|
—
|
$102,416.60
|
$109,585.76
|
$102,416.60
|
2025-12-03
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
8
|
5
|
—
|
—
|
$41,221.96
|
$178,585.12
|
$102,048.64
|
2025-12-03
|
|
4424
|
APR_DRG
|
Kidney And Urinary Tract Procedures For Malignancy
|
4
|
3
|
—
|
—
|
$101,855.40
|
$108,985.28
|
$101,855.40
|
2025-12-03
|
|
9524
|
APR_DRG
|
Non-extensive O.r. Procedure Unrelated To Principal Diagnosis
|
4
|
3
|
—
|
—
|
$101,230.01
|
$108,316.11
|
$101,230.01
|
2025-12-03
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
11
|
5
|
—
|
—
|
$40,645.28
|
$176,086.80
|
$100,621.03
|
2025-12-03
|
|
9114
|
APR_DRG
|
Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma
|
4
|
3
|
—
|
—
|
$100,305.06
|
$107,326.41
|
$100,305.06
|
2025-12-03
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
11
|
5
|
—
|
—
|
$40,235.00
|
$174,309.31
|
$99,605.32
|
2025-12-03
|
|
4403
|
APR_DRG
|
Kidney Transplant
|
4
|
3
|
—
|
—
|
$98,507.68
|
$105,403.22
|
$98,507.68
|
2025-12-03
|
|
3154
|
APR_DRG
|
Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement
|
4
|
3
|
—
|
—
|
$98,500.88
|
$105,395.94
|
$98,500.88
|
2025-12-03
|
|
1694
|
APR_DRG
|
Major Abdominal Vascular Procedures
|
4
|
3
|
—
|
—
|
$98,166.30
|
$105,037.94
|
$98,166.30
|
2025-12-03
|
|
1204
|
APR_DRG
|
Major Respiratory And Chest Procedures
|
4
|
3
|
—
|
—
|
$97,767.53
|
$104,611.26
|
$97,767.53
|
2025-12-03
|
|
4834
|
APR_DRG
|
Penis, Testes And Scrotal Procedures
|
4
|
3
|
—
|
—
|
$97,395.99
|
$104,213.71
|
$97,395.99
|
2025-12-03
|
|
894
|
APR_DRG
|
Major Cranial Or Facial Bone Procedures
|
4
|
3
|
—
|
—
|
$96,351.41
|
$103,096.01
|
$96,351.41
|
2025-12-03
|
|
9124
|
APR_DRG
|
Musculoskeletal And Other Procedures For Multiple Significant Trauma
|
4
|
3
|
—
|
—
|
$96,224.00
|
$102,959.68
|
$96,224.00
|
2025-12-03
|
|
1304
|
APR_DRG
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
4
|
3
|
—
|
—
|
$96,199.68
|
$102,933.66
|
$96,199.68
|
2025-12-03
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
11
|
5
|
—
|
—
|
$38,813.84
|
$168,152.46
|
$96,087.12
|
2025-12-03
|
|
1654
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
4
|
3
|
—
|
—
|
$94,767.03
|
$101,400.72
|
$94,767.03
|
2025-12-03
|
|
5911
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
4
|
3
|
—
|
—
|
$92,883.09
|
$99,384.91
|
$92,883.09
|
2025-12-03
|
|
2604
|
APR_DRG
|
Major Pancreas, Liver And Shunt Procedures
|
4
|
3
|
—
|
—
|
$92,376.36
|
$98,842.71
|
$92,376.36
|
2025-12-03
|
|
21
|
APR_DRG
|
Heart And/or Lung Transplant
|
4
|
3
|
—
|
—
|
$92,217.83
|
$98,673.08
|
$92,217.83
|
2025-12-03
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
8
|
5
|
—
|
—
|
$36,934.04
|
$160,008.63
|
$91,433.50
|
2025-12-03
|
|
1783
|
APR_DRG
|
External Heart Assist Systems
|
4
|
3
|
—
|
—
|
$91,294.82
|
$97,685.46
|
$91,294.82
|
2025-12-03
|
|
1214
|
APR_DRG
|
Other Respiratory And Chest Procedures
|
4
|
3
|
—
|
—
|
$91,242.30
|
$97,629.26
|
$91,242.30
|
2025-12-03
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
8
|
5
|
—
|
—
|
$36,748.40
|
$159,204.40
|
$90,973.94
|
2025-12-03
|
|
6313
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
4
|
3
|
—
|
—
|
$90,908.70
|
$97,272.31
|
$90,908.70
|
2025-12-03
|
|
6254
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
4
|
3
|
—
|
—
|
$90,174.38
|
$96,486.59
|
$90,174.38
|
2025-12-03
|
|
6124
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
4
|
3
|
—
|
—
|
$89,914.69
|
$96,208.72
|
$89,914.69
|
2025-12-03
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
11
|
5
|
—
|
—
|
$36,173.80
|
$156,715.04
|
$89,551.45
|
2025-12-03
|
|
1603
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
4
|
3
|
—
|
—
|
$89,061.71
|
$95,296.03
|
$89,061.71
|
2025-12-03
|
|
2244
|
APR_DRG
|
Peritoneal Adhesiolysis
|
4
|
3
|
—
|
—
|
$88,919.71
|
$95,144.09
|
$88,919.71
|
2025-12-03
|
|
6022
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
4
|
3
|
—
|
—
|
$88,300.16
|
$94,481.17
|
$88,300.16
|
2025-12-03
|
|
3614
|
APR_DRG
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
4
|
3
|
—
|
—
|
$88,053.12
|
$94,216.84
|
$88,053.12
|
2025-12-03
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
11
|
5
|
—
|
—
|
$35,507.16
|
$153,827.01
|
$87,901.15
|
2025-12-03
|
|
914
|
APR_DRG
|
Other Major Head And Neck Procedures
|
4
|
3
|
—
|
—
|
$87,579.46
|
$93,710.02
|
$87,579.46
|
2025-12-03
|
|
204
|
APR_DRG
|
Open Craniotomy For Trauma
|
4
|
3
|
—
|
—
|
$86,685.63
|
$92,753.62
|
$86,685.63
|
2025-12-03
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
8
|
5
|
—
|
—
|
$34,864.44
|
$151,042.54
|
$86,310.02
|
2025-12-03
|
|
51
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
4
|
3
|
—
|
—
|
$86,096.23
|
$92,122.97
|
$86,096.23
|
2025-12-03
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
8
|
5
|
—
|
—
|
$34,730.28
|
$150,461.36
|
$85,977.92
|
2025-12-03
|
|
41
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
4
|
3
|
—
|
—
|
$85,930.89
|
$91,946.05
|
$85,930.89
|
2025-12-03
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
11
|
5
|
—
|
—
|
$34,671.52
|
$150,206.79
|
$85,832.45
|
2025-12-03
|
|
12
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
4
|
3
|
—
|
—
|
$85,300.64
|
$91,271.68
|
$85,300.64
|
2025-12-03
|
|
1814
|
APR_DRG
|
Lower Extremity Arterial Procedures
|
4
|
3
|
—
|
—
|
$85,265.63
|
$91,234.22
|
$85,265.63
|
2025-12-03
|
|
2274
|
APR_DRG
|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
4
|
3
|
—
|
—
|
$85,004.97
|
$90,955.32
|
$85,004.97
|
2025-12-03
|
|
6604
|
APR_DRG
|
Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula…
|
4
|
3
|
—
|
—
|
$84,725.83
|
$90,656.64
|
$84,725.83
|
2025-12-03
|
|
6234
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
4
|
3
|
—
|
—
|
$84,708.32
|
$90,637.90
|
$84,708.32
|
2025-12-03
|
|
8424
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
4
|
3
|
—
|
—
|
$84,613.01
|
$90,535.92
|
$84,613.01
|
2025-12-03
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
11
|
5
|
—
|
—
|
$33,629.44
|
$145,692.19
|
$83,252.68
|
2025-12-03
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
11
|
5
|
—
|
—
|
$33,581.08
|
$145,482.68
|
$83,132.96
|
2025-12-03
|
|
1834
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
4
|
3
|
—
|
—
|
$82,455.76
|
$88,227.66
|
$82,455.76
|
2025-12-03
|
|
11
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
4
|
3
|
—
|
—
|
$82,097.84
|
$87,844.69
|
$82,097.84
|
2025-12-03
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
11
|
5
|
—
|
—
|
$32,886.36
|
$142,472.93
|
$81,413.10
|
2025-12-03
|
|
2614
|
APR_DRG
|
Major Biliary Tract Procedures
|
4
|
3
|
—
|
—
|
$81,147.60
|
$86,827.93
|
$81,147.60
|
2025-12-03
|
|
L8702
|
HCPCS
|
Ewhf S/d Uprt Micro Sensor
|
6
|
4
|
—
|
—
|
$80,943.19
|
$141,650.58
|
$80,943.19
|
2025-12-03
|
|
6073
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
4
|
3
|
—
|
—
|
$80,857.77
|
$86,517.81
|
$80,857.77
|
2025-12-03
|
|
1833
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
4
|
3
|
—
|
—
|
$80,430.79
|
$86,060.95
|
$80,430.79
|
2025-12-03
|
|
9514
|
APR_DRG
|
Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
4
|
3
|
—
|
—
|
$80,115.67
|
$85,723.77
|
$80,115.67
|
2025-12-03
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
8
|
5
|
—
|
—
|
$32,210.88
|
$139,546.58
|
$79,740.90
|
2025-12-03
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
8
|
5
|
—
|
—
|
$32,169.28
|
$139,366.34
|
$79,637.91
|
2025-12-03
|
|
3032
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
4
|
3
|
—
|
—
|
$79,609.91
|
$85,182.60
|
$79,609.91
|
2025-12-03
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
11
|
5
|
—
|
—
|
$32,022.64
|
$138,731.06
|
$79,274.89
|
2025-12-03
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
11
|
5
|
—
|
—
|
$31,910.84
|
$138,246.73
|
$78,998.13
|
2025-12-03
|
|
504
|
APR_DRG
|
Non-bacterial Infections Of Nervous System Except Viral Meningitis
|
4
|
3
|
—
|
—
|
$78,805.56
|
$84,321.95
|
$78,805.56
|
2025-12-03
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
11
|
5
|
—
|
—
|
$31,765.24
|
$137,615.96
|
$78,637.69
|
2025-12-03
|
|
1782
|
APR_DRG
|
External Heart Assist Systems
|
4
|
3
|
—
|
—
|
$78,355.25
|
$83,840.12
|
$78,355.25
|
2025-12-03
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
11
|
5
|
—
|
—
|
$31,613.40
|
$136,958.15
|
$78,261.80
|
2025-12-03
|
|
7104
|
APR_DRG
|
Infectious And Parasitic Diseases Including HIV With O.r. Procedure
|
4
|
3
|
—
|
—
|
$78,222.00
|
$83,697.54
|
$78,222.00
|
2025-12-03
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
8
|
5
|
—
|
—
|
$31,386.68
|
$135,975.91
|
$77,700.52
|
2025-12-03
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
8
|
5
|
—
|
—
|
$31,386.68
|
$135,975.91
|
$77,700.52
|
2025-12-03
|
|
6033
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
4
|
3
|
—
|
—
|
$77,535.34
|
$82,962.81
|
$77,535.34
|
2025-12-03
|
|
1622
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
4
|
3
|
—
|
—
|
$77,239.66
|
$82,646.44
|
$77,239.66
|
2025-12-03
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
11
|
5
|
—
|
—
|
$31,152.16
|
$134,959.91
|
$77,119.95
|
2025-12-03
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
11
|
5
|
—
|
—
|
$30,936.36
|
$134,025.03
|
$76,585.73
|
2025-12-03
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
8
|
5
|
—
|
—
|
$30,912.96
|
$133,923.60
|
$76,527.77
|
2025-12-03
|
|
2234
|
APR_DRG
|
Other Small And Large Bowel Procedures
|
4
|
3
|
—
|
—
|
$76,348.76
|
$81,693.17
|
$76,348.76
|
2025-12-03
|
|
6914
|
APR_DRG
|
Lymphoma, Myeloma And Non-acute Leukemia
|
4
|
3
|
—
|
—
|
$75,878.99
|
$81,190.52
|
$75,878.99
|
2025-12-03
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
11
|
5
|
—
|
—
|
$30,597.84
|
$132,558.48
|
$75,747.70
|
2025-12-03
|
|
82
|
APR_DRG
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
4
|
3
|
—
|
—
|
$75,537.60
|
$80,825.23
|
$75,537.60
|
2025-12-03
|
|
6944
|
APR_DRG
|
Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior
|
4
|
3
|
—
|
—
|
$75,110.63
|
$80,368.37
|
$75,110.63
|
2025-12-03
|
|
7234
|
APR_DRG
|
Viral Illness
|
4
|
3
|
—
|
—
|
$75,008.50
|
$80,259.10
|
$75,008.50
|
2025-12-03
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
11
|
5
|
—
|
—
|
$30,275.96
|
$131,163.95
|
$74,950.83
|
2025-12-03
|
|
924
|
APR_DRG
|
Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures
|
4
|
3
|
—
|
—
|
$74,202.21
|
$79,396.36
|
$74,202.21
|
2025-12-03
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
11
|
5
|
—
|
—
|
$29,844.88
|
$129,296.39
|
$73,883.65
|
2025-12-03
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
11
|
5
|
—
|
—
|
$29,666.52
|
$128,523.71
|
$73,442.12
|
2025-12-03
|
|
1633
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
4
|
3
|
—
|
—
|
$73,382.30
|
$78,519.06
|
$73,382.30
|
2025-12-03
|
|
1664
|
APR_DRG
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
4
|
3
|
—
|
—
|
$73,237.38
|
$78,364.00
|
$73,237.38
|
2025-12-03
|
|
453
|
MS_DRG
|
Inpatient Ms-DRG
|
3
|
1
|
—
|
—
|
$66,903.28
|
$76,900.32
|
$73,055.30
|
2025-12-03
|
|
6614
|
APR_DRG
|
Coagulation And Platelet Disorders
|
4
|
3
|
—
|
—
|
$72,572.12
|
$77,652.17
|
$72,572.12
|
2025-12-03
|
|
1781
|
APR_DRG
|
External Heart Assist Systems
|
4
|
3
|
—
|
—
|
$71,827.10
|
$76,855.00
|
$71,827.10
|
2025-12-03
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
11
|
5
|
—
|
—
|
$28,987.92
|
$125,583.82
|
$71,762.18
|
2025-12-03
|
|
923
|
APR_DRG
|
Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures
|
4
|
3
|
—
|
—
|
$71,570.33
|
$76,580.25
|
$71,570.33
|
2025-12-03
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
11
|
5
|
—
|
—
|
$28,741.96
|
$124,518.26
|
$71,153.29
|
2025-12-03
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
11
|
5
|
—
|
—
|
$28,741.96
|
$124,518.26
|
$71,153.29
|
2025-12-03
|
|
1764
|
APR_DRG
|
Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices
|
4
|
3
|
—
|
—
|
$71,148.22
|
$76,128.60
|
$71,148.22
|
2025-12-03
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
8
|
5
|
—
|
—
|
$28,621.32
|
$123,995.60
|
$70,854.63
|
2025-12-03
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
8
|
5
|
—
|
—
|
$28,446.60
|
$123,238.68
|
$70,422.10
|
2025-12-03
|
|
5134
|
APR_DRG
|
Uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma
|
4
|
3
|
—
|
—
|
$70,139.63
|
$75,049.40
|
$70,139.63
|
2025-12-03
|
|
1794
|
APR_DRG
|
Defibrillator Implants
|
4
|
3
|
—
|
—
|
$70,096.83
|
$75,003.61
|
$70,096.83
|
2025-12-03
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
8
|
5
|
—
|
—
|
$28,293.72
|
$122,576.34
|
$70,043.62
|
2025-12-03
|
|
3124
|
APR_DRG
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
4
|
3
|
—
|
—
|
$70,001.52
|
$74,901.63
|
$70,001.52
|
2025-12-03
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
11
|
5
|
—
|
—
|
$28,229.24
|
$122,297.00
|
$69,884.00
|
2025-12-03
|
|
8412
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
4
|
3
|
—
|
—
|
$69,661.10
|
$74,537.38
|
$69,661.10
|
2025-12-03
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
11
|
5
|
—
|
—
|
$28,085.20
|
$121,672.99
|
$69,527.42
|
2025-12-03
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
11
|
5
|
—
|
—
|
$28,058.68
|
$121,558.08
|
$69,461.76
|
2025-12-03
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
11
|
5
|
—
|
—
|
$28,055.56
|
$121,544.55
|
$69,454.03
|
2025-12-03
|
|
1714
|
APR_DRG
|
Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock
|
4
|
3
|
—
|
—
|
$69,292.48
|
$74,142.95
|
$69,292.48
|
2025-12-03
|
|
8411
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
4
|
3
|
—
|
—
|
$69,119.36
|
$73,957.72
|
$69,119.36
|
2025-12-03
|
|
2644
|
APR_DRG
|
Other Hepatobiliary, Pancreas And Abdominal Procedures
|
4
|
3
|
—
|
—
|
$68,755.60
|
$73,568.49
|
$68,755.60
|
2025-12-03
|
|
1621
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
4
|
3
|
—
|
—
|
$68,533.85
|
$73,331.22
|
$68,533.85
|
2025-12-03
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
11
|
5
|
—
|
—
|
$27,665.04
|
$119,852.72
|
$68,487.27
|
2025-12-03
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
11
|
5
|
—
|
—
|
$27,542.84
|
$119,323.33
|
$68,184.76
|
2025-12-03
|
|
5104
|
APR_DRG
|
Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…
|
4
|
3
|
—
|
—
|
$67,796.61
|
$72,542.37
|
$67,796.61
|
2025-12-03
|
|
7404
|
APR_DRG
|
Mental Illness Diagnosis With O.r. Procedure
|
4
|
3
|
—
|
—
|
$67,729.50
|
$72,470.57
|
$67,729.50
|
2025-12-03
|
|
4013
|
APR_DRG
|
Adrenal Procedures
|
4
|
3
|
—
|
—
|
$67,475.65
|
$72,198.95
|
$67,475.65
|
2025-12-03
|
|
3043
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
4
|
3
|
—
|
—
|
$67,468.84
|
$72,191.66
|
$67,468.84
|
2025-12-03
|
|
3104
|
APR_DRG
|
Intervertebral Disc Excision And Decompression
|
4
|
3
|
—
|
—
|
$66,753.98
|
$71,426.76
|
$66,753.98
|
2025-12-03
|
|
2334
|
APR_DRG
|
Appendectomy With Complex Principal Diagnosis
|
4
|
3
|
—
|
—
|
$66,708.26
|
$71,377.84
|
$66,708.26
|
2025-12-03
|
|
5114
|
APR_DRG
|
Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy
|
4
|
3
|
—
|
—
|
$66,611.98
|
$71,274.82
|
$66,611.98
|
2025-12-03
|
|
111
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
4
|
3
|
—
|
—
|
$66,465.11
|
$71,117.67
|
$66,465.11
|
2025-12-03
|
|
6344
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…
|
4
|
3
|
—
|
—
|
$66,366.88
|
$71,012.56
|
$66,366.88
|
2025-12-03
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
8
|
5
|
—
|
—
|
$26,780.52
|
$116,020.73
|
$66,297.56
|
2025-12-03
|
|
4804
|
APR_DRG
|
Major Male Pelvic Procedures
|
4
|
3
|
—
|
—
|
$66,085.80
|
$70,711.81
|
$66,085.80
|
2025-12-03
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
11
|
5
|
—
|
—
|
$26,691.60
|
$115,635.50
|
$66,077.43
|
2025-12-03
|
|
7114
|
APR_DRG
|
Post-operative, Post-trauma, Other Device Infections With O.r. Procedure
|
4
|
3
|
—
|
—
|
$65,690.92
|
$70,289.28
|
$65,690.92
|
2025-12-03
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
11
|
5
|
—
|
—
|
$26,491.92
|
$114,770.46
|
$65,583.12
|
2025-12-03
|
|
304
|
APR_DRG
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
4
|
3
|
—
|
—
|
$65,519.74
|
$70,106.12
|
$65,519.74
|
2025-12-03
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
11
|
5
|
—
|
—
|
$26,410.80
|
$114,419.03
|
$65,382.30
|
2025-12-03
|
|
1303
|
APR_DRG
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
4
|
3
|
—
|
—
|
$65,320.35
|
$69,892.77
|
$65,320.35
|
2025-12-03
|
|
3464
|
APR_DRG
|
Connective Tissue Disorders
|
4
|
3
|
—
|
—
|
$65,303.82
|
$69,875.09
|
$65,303.82
|
2025-12-03
|
|
4044
|
APR_DRG
|
Thyroid, Parathyroid And Thyroglossal Procedures
|
4
|
3
|
—
|
—
|
$65,099.57
|
$69,656.54
|
$65,099.57
|
2025-12-03
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
11
|
5
|
—
|
—
|
$26,191.88
|
$113,470.58
|
$64,840.33
|
2025-12-03
|
|
4434
|
APR_DRG
|
Kidney And Urinary Tract Procedures For Non-malignancy
|
4
|
3
|
—
|
—
|
$64,607.43
|
$69,129.95
|
$64,607.43
|
2025-12-03
|
|
1804
|
APR_DRG
|
Other Circulatory System Procedures
|
4
|
3
|
—
|
—
|
$64,575.34
|
$69,095.61
|
$64,575.34
|
2025-12-03
|
|
294
|
APR_DRG
|
Other Percutaneous Intracranial Procedures
|
4
|
3
|
—
|
—
|
$64,526.71
|
$69,043.58
|
$64,526.71
|
2025-12-03
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
11
|
5
|
—
|
—
|
$26,037.44
|
$112,801.50
|
$64,458.00
|
2025-12-03
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
8
|
5
|
—
|
—
|
$26,017.16
|
$112,713.67
|
$64,407.81
|
2025-12-03
|
|
734
|
APR_DRG
|
Orbit And Eye Procedures
|
4
|
3
|
—
|
—
|
$64,397.35
|
$68,905.16
|
$64,397.35
|
2025-12-03
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
11
|
5
|
—
|
—
|
$26,006.76
|
$112,668.59
|
$64,382.05
|
2025-12-03
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
11
|
5
|
—
|
—
|
$25,913.16
|
$112,263.10
|
$64,150.34
|
2025-12-03
|
|
4684
|
APR_DRG
|
Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms
|
4
|
3
|
—
|
—
|
$64,072.50
|
$68,557.58
|
$64,072.50
|
2025-12-03
|
|
3134
|
APR_DRG
|
Knee And Lower Leg Procedures Except Foot
|
4
|
3
|
—
|
—
|
$63,892.56
|
$68,365.04
|
$63,892.56
|
2025-12-03
|
|
J9029
|
HCPCS
|
Instill Adstiladrin, Tx Dose
|
6
|
4
|
—
|
—
|
$63,431.05
|
$111,004.34
|
$63,431.05
|
2025-12-03
|
|
4402
|
APR_DRG
|
Kidney Transplant
|
4
|
3
|
—
|
—
|
$63,358.60
|
$67,793.70
|
$63,358.60
|
2025-12-03
|
|
8154
|
APR_DRG
|
Other Injury, Poisoning And Toxic Effect Diagnoses
|
4
|
3
|
—
|
—
|
$63,323.59
|
$67,756.24
|
$63,323.59
|
2025-12-03
|
|
81
|
APR_DRG
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
4
|
3
|
—
|
—
|
$63,267.18
|
$67,695.88
|
$63,267.18
|
2025-12-03
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
11
|
5
|
—
|
—
|
$25,411.36
|
$110,089.16
|
$62,908.09
|
2025-12-03
|
|
913
|
APR_DRG
|
Other Major Head And Neck Procedures
|
4
|
3
|
—
|
—
|
$62,837.29
|
$67,235.90
|
$62,837.29
|
2025-12-03
|
|
1754
|
APR_DRG
|
Percutaneous Cardiac Intervention Without Ami
|
4
|
3
|
—
|
—
|
$62,737.11
|
$67,128.71
|
$62,737.11
|
2025-12-03
|
|
6924
|
APR_DRG
|
Radiotherapy
|
4
|
3
|
—
|
—
|
$62,693.34
|
$67,081.87
|
$62,693.34
|
2025-12-03
|
|
984
|
APR_DRG
|
Other Ear, Nose, Mouth And Throat Procedures
|
4
|
3
|
—
|
—
|
$62,611.64
|
$66,994.45
|
$62,611.64
|
2025-12-03
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
11
|
5
|
—
|
—
|
$25,257.96
|
$109,424.60
|
$62,528.34
|
2025-12-03
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
8
|
5
|
—
|
—
|
$25,215.84
|
$109,242.09
|
$62,424.05
|
2025-12-03
|
|
2314
|
APR_DRG
|
Major Large Bowel Procedures
|
4
|
3
|
—
|
—
|
$62,373.35
|
$66,739.48
|
$62,373.35
|
2025-12-03
|
|
1653
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
4
|
3
|
—
|
—
|
$62,307.21
|
$66,668.71
|
$62,307.21
|
2025-12-03
|
|
8104
|
APR_DRG
|
Hemorrhage Or Hematoma Due To Complication
|
4
|
3
|
—
|
—
|
$62,282.90
|
$66,642.70
|
$62,282.90
|
2025-12-03
|
|
6032
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
4
|
3
|
—
|
—
|
$62,106.86
|
$66,454.34
|
$62,106.86
|
2025-12-03
|
|
1602
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
4
|
3
|
—
|
—
|
$61,882.18
|
$66,213.93
|
$61,882.18
|
2025-12-03
|
|
4844
|
APR_DRG
|
Other Male Reproductive System And Related Procedures
|
4
|
3
|
—
|
—
|
$61,711.00
|
$66,030.77
|
$61,711.00
|
2025-12-03
|
|
6083
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
4
|
3
|
—
|
—
|
$61,661.40
|
$65,977.70
|
$61,661.40
|
2025-12-03
|
|
494
|
APR_DRG
|
Bacterial And Tuberculous Infections Of Nervous System
|
4
|
3
|
—
|
—
|
$61,544.69
|
$65,852.82
|
$61,544.69
|
2025-12-03
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
11
|
5
|
—
|
—
|
$24,832.60
|
$107,581.79
|
$61,475.31
|
2025-12-03
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
11
|
5
|
—
|
—
|
$24,724.96
|
$107,115.47
|
$61,208.84
|
2025-12-03
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
11
|
5
|
—
|
—
|
$24,720.28
|
$107,095.21
|
$61,197.26
|
2025-12-03
|
|
1704
|
APR_DRG
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
4
|
3
|
—
|
—
|
$61,178.99
|
$65,461.52
|
$61,178.99
|
2025-12-03
|
|
222
|
MS_DRG
|
Inpatient Ms-DRG
|
3
|
1
|
—
|
—
|
$55,954.43
|
$64,315.44
|
$61,099.67
|
2025-12-03
|