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

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Hospital

PERMIAN REGIONAL MEDICAL CENTER ANDREWS COUNTY HO

Andrews, TX · CCN 450144 · Rates published

17,519 distinct procedures filed
8 distinct payers
231,137 rate rows
2025-12-03 last MRF observed
Data quality

229,836 of 231,137 rate rows are consumer-grade (99.4%)

1,301 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
per-diem day rate — not a per-procedure price 1,100
placeholder amount (≤ $0.02) — excluded from medians 96
percent-of-charges filed in the dollar field — excluded from medians 53
exceeds 10× this hospital's gross charge — excluded from medians 26
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 26
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/7829/751997880_andrews-county-hospital-district_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/permianregionalmedicalcenter/7829
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint a2aadf573662e6dc… · 117,342,772 bytes · first seen 2026-05-08

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 3 $4,377,500.00 $4,596,375.00 $4,377,500.00 nat. median
$4,505,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 3 $3,710,000.00 $3,895,500.00 $3,710,000.00 nat. median
$3,710,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 3 $3,685,266.67 $3,869,530.00 $3,685,266.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 3 $3,324,571.90 $3,490,800.50 $3,324,571.90 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 3 $3,261,355.00 $3,424,422.75 $3,261,355.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 3 $2,950,686.67 $3,098,221.00 $2,950,686.67 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 4 $2,452,115.60 $4,291,202.29 $2,452,115.60 nat. median
$2,469,189
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 4 $2,332,000.00 $4,081,000.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 4 $770,620.00 $1,348,585.00 $770,620.00 nat. median
$824,563
0.9× median
5834
APR_DRG 		Neonate With Ecmo 3 $738,706.47 $790,415.92 $738,706.47 nat. median
$309,665
outlier · 2.4×
74
APR_DRG 		Allogeneic Bone Marrow Transplant 3 $718,614.34 $768,917.34 $718,614.34 nat. median
$187,294
outlier · 3.8×
5833
APR_DRG 		Neonate With Ecmo 3 $625,509.49 $669,295.15 $625,509.49 nat. median
$244,017
outlier · 2.6×
24
APR_DRG 		Heart And/or Lung Transplant 3 $601,722.42 $643,842.99 $601,722.42 nat. median
$234,738
outlier · 2.6×
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 4 $338,087.20 $1,012,068.01 $578,324.58 nat. median
$754,974
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 4 $407,563.20 $968,412.95 $553,378.83 nat. median
$675,122
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 4 $359,619.74 $947,862.40 $541,635.66 nat. median
$674,188
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 4 $367,683.36 $947,205.78 $541,260.45 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $311,828.00 $932,883.83 $533,076.48 nat. median
$634,511
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 4 $326,927.04 $857,010.00 $489,720.00 nat. median
$620,080
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 $196,106.56 $849,588.71 $485,479.26 nat. median
$370,174
1.3× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $467,589.08 $500,320.32 $467,589.08 nat. median
$246,434
1.9× median
1614
APR_DRG 		Implantable Heart Assist Systems 3 $454,061.07 $485,845.34 $454,061.07 nat. median
$207,730
outlier · 2.2×
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 3 $425,383.73 $455,160.59 $425,383.73 nat. median
$164,834
outlier · 2.6×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 5 $146,475.16 $634,571.58 $362,612.33 nat. median
$265,286
1.4× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 $347,917.44 $372,271.66 $347,917.44 nat. median
$150,721
outlier · 2.3×
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 $344,834.28 $368,972.68 $344,834.28 nat. median
$162,982
outlier · 2.1×
5832
APR_DRG 		Neonate With Ecmo 3 $311,677.10 $333,494.50 $311,677.10 nat. median
$156,126
2.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 5 $123,358.56 $534,423.96 $305,385.12 nat. median
$206,368
1.5× median
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 $295,957.81 $316,674.86 $295,957.81 nat. median
$117,173
outlier · 2.5×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 5 $111,444.32 $482,808.13 $275,890.36 nat. median
$202,986
1.4× median
2004
APR_DRG 		Cardiac Structural And Valvular Disorders 3 $275,026.31 $294,278.15 $275,026.31 nat. median
$32,636
outlier · 8.4×
5831
APR_DRG 		Neonate With Ecmo 3 $274,437.88 $293,648.53 $274,437.88 nat. median
$145,122
1.9× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 4 $270,375.00 $473,156.25 $270,375.00 nat. median
$324,450
0.8× median
73
APR_DRG 		Allogeneic Bone Marrow Transplant 3 $253,571.55 $271,321.56 $253,571.55 nat. median
$89,273
outlier · 2.8×
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $250,892.99 $268,455.50 $250,892.99 nat. median
$182,736
1.4× median
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $249,746.28 $267,228.52 $249,746.28 nat. median
$145,336
1.7× median
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 3 $249,100.47 $266,537.50 $249,100.47 nat. median
$105,658
outlier · 2.4×
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 3 $248,029.63 $265,391.70 $248,029.63 nat. median
$160,267
1.5× median
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 3 $245,552.40 $262,741.07 $245,552.40 nat. median
$122,924
2.0× median
8504
APR_DRG 		Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 3 $239,083.58 $255,819.43 $239,083.58 nat. median
$73,845
outlier · 3.2×
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 3 $236,941.90 $253,527.83 $236,941.90 nat. median
$164,279
1.4× median
1613
APR_DRG 		Implantable Heart Assist Systems 3 $236,662.76 $253,229.15 $236,662.76 nat. median
$119,796
2.0× median
5881
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $235,411.99 $251,890.83 $235,411.99 nat. median
$124,573
1.9× median
14
APR_DRG 		Liver Transplant And/or Intestinal Transplant 3 $215,547.44 $230,635.76 $215,547.44 nat. median
$129,535
1.7× median
84
APR_DRG 		Autologous Bone Marrow Transplant Or T-cell Immunotherapy 3 $214,683.76 $229,711.62 $214,683.76 nat. median
$79,774
outlier · 2.7×
6814
APR_DRG 		Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 3 $210,869.20 $225,630.04 $210,869.20 nat. median
$73,428
outlier · 2.9×
1604
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly 3 $210,751.51 $225,504.12 $210,751.51 nat. median
$97,957
outlier · 2.2×
93
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 3 $208,990.12 $223,619.43 $208,990.12 nat. median
$79,160
outlier · 2.6×
2464
APR_DRG 		Gastrointestinal Vascular Insufficiency 3 $204,370.23 $218,676.15 $204,370.23 nat. median
$22,749
outlier · 9.0×
6034
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 3 $203,315.92 $217,548.03 $203,315.92 nat. median
$109,499
1.9× median

Other procedures at this hospital

Browse this hospital's 17,519 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
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
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
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 8 5 — — $123,358.56 $534,423.96 $305,385.12 2025-12-03
3 MS_DRG Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 11 5 — — $111,444.32 $482,808.13 $275,890.36 2025-12-03
4 MS_DRG Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And … 11 5 — — $73,476.00 $318,318.70 $181,896.40 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
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
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 8 5 — — $56,648.28 $245,416.26 $140,237.86 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
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
850 MS_DRG Acute Leukemia With Other Procedures 8 5 — — $47,901.88 $207,524.40 $118,585.37 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
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
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
10 MS_DRG Pancreas Transplant 8 5 — — $41,459.60 $179,614.66 $102,636.95 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
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
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
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
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
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
870 MS_DRG Septicemia Or Severe Sepsis With Mv &gt;96 Hours 11 5 — — $36,173.80 $156,715.04 $89,551.45 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
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
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
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
207 MS_DRG Respiratory System Diagnosis With Ventilator Support &gt;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
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
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
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
232 MS_DRG Coronary Bypass With Ptca Without Mcc 11 5 — — $31,765.24 $137,615.96 $78,637.69 2025-12-03
28 MS_DRG Spinal Procedures With Mcc 11 5 — — $31,613.40 $136,958.15 $78,261.80 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
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
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 11 5 — — $30,597.84 $132,558.48 $75,747.70 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
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
653 MS_DRG Major Bladder Procedures With Mcc 11 5 — — $28,987.92 $125,583.82 $71,762.18 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
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
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 8 5 — — $28,293.72 $122,576.34 $70,043.62 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
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
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
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
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 11 5 — — $26,691.60 $115,635.50 $66,077.43 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
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 11 5 — — $26,410.80 $114,419.03 $65,382.30 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
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
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
245 MS_DRG Aicd Generator Procedures 11 5 — — $25,411.36 $110,089.16 $62,908.09 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
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
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
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
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 6 4 — — $270,375.00 $473,156.25 $270,375.00 2025-12-03
Q0480 HCPCS Driver Pneumatic Vad, Rep 6 4 — — $129,537.50 $226,690.63 $129,537.50 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
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 6 4 — — $80,943.19 $141,650.58 $80,943.19 2025-12-03
J9029 HCPCS Instill Adstiladrin, Tx Dose 6 4 — — $63,431.05 $111,004.34 $63,431.05 2025-12-03
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
224 APR_DRG Ventricular Shunt Procedures 4 3 — — $102,416.60 $109,585.76 $102,416.60 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
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
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
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
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
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
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
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
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
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
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
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
2614 APR_DRG Major Biliary Tract Procedures 4 3 — — $81,147.60 $86,827.93 $81,147.60 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
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
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
1782 APR_DRG External Heart Assist Systems 4 3 — — $78,355.25 $83,840.12 $78,355.25 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
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
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
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
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
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
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
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
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
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
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
8412 APR_DRG Extensive Third Degree Burns With Skin Graft 4 3 — — $69,661.10 $74,537.38 $69,661.10 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
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
4804 APR_DRG Major Male Pelvic Procedures 4 3 — — $66,085.80 $70,711.81 $66,085.80 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
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 4 3 — — $65,519.74 $70,106.12 $65,519.74 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
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
734 APR_DRG Orbit And Eye Procedures 4 3 — — $64,397.35 $68,905.16 $64,397.35 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
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
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
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
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
453 MS_DRG Inpatient Ms-DRG 3 1 — — $66,903.28 $76,900.32 $73,055.30 2025-12-03
222 MS_DRG Inpatient Ms-DRG 3 1 — — $55,954.43 $64,315.44 $61,099.67 2025-12-03
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