Price Transparencybeta Hospital negotiated rates

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

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Hospital

METHODIST HOSPITAL ATASCOSA

Jourdanton, TX · CCN 450165 · Rates published

Your selected procedure

You selected 807 (MS_DRG)

VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC

This hospital’s price: $7,111 across 27 payers · range $4,800-$12,335

Source: https://www.hcadam.com/api/public/content/df7f8f5a3ee84a5d9cdc24cc848a8467?download=true · observed 2025-01-01

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

35,252 distinct procedures filed
33 distinct payers
1,194,648 rate rows
2026-07-17 last MRF observed
Data quality

1,140,716 of 1,194,648 rate rows are consumer-grade (95.5%)

53,932 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 25,399
per-diem day rate — not a per-procedure price 14,372
template filing: same amount across many unrelated codes — excluded 6,289
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 5,862
percent-of-charges filed in the dollar field — excluded from medians 1,153
placeholder amount (≤ $0.02) — excluded from medians 399
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 354
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 73
exceeds 10× this hospital's gross charge — excluded from medians 31
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.hcadam.com/api/public/content/df7f8f5a3ee84a5d9cdc24cc848a8467?download=true
Found on page https://sahealth.com/about/legal/pricing-transparency-cms-required-file-of-standard-charges.dot
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-08-04
Content fingerprint df27fae1915d1410… · 567,516,180 bytes · first seen 2026-05-06

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
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $4,897,200.00 $4,897,200.00 $4,897,200.00 nat. median
$2,997,086
1.6× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 $3,884,946.48 $3,884,946.48 $3,884,946.48 nat. median
$2,460,273
1.6× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 1 $3,672,900.00 $3,672,900.00 $3,672,900.00 nat. median
$3,574,709
1.0× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 16 $3,379,068.00 $3,893,274.00 $3,672,900.00 nat. median
$3,758,972
1.0× median
00773
OTHER 		Inj, Beqvez, Per Tx Dose 1 $3,605,000.00 $3,605,000.00 $3,605,000.00 nat. median
$3,496,850
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 16 $3,316,600.00 $3,821,300.00 $3,605,000.00 nat. median
$3,646,097
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 17 $3,059,418.60 $4,655,637.00 $3,325,455.00 nat. median
$3,325,455
1.0× median
00714
OTHER 		Inj Delandistrogene Mox R 1 $3,325,455.00 $3,325,455.00 $3,325,455.00 nat. median
$3,228,024
1.0× median
00748
OTHER 		Inj, Lovotibeglogene Auto 1 $3,286,000.00 $3,286,000.00 $3,286,000.00 nat. median
$3,187,420
1.0× median
748
OTHER 		Inj, Lovotibeglogene Auto 17 $3,023,120.00 $4,600,400.00 $3,286,000.00 nat. median
$3,252,508
1.0× median
00746
OTHER 		Inj, Betibeglogene Autote 1 $2,968,000.00 $2,968,000.00 $2,968,000.00 nat. median
$2,878,960
1.0× median
746
OTHER 		Inj, Betibeglogene Autote 17 $2,730,560.00 $4,155,200.00 $2,968,000.00 nat. median
$2,939,969
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 17 $2,197,524.88 $3,344,059.60 $2,388,614.00 nat. median
$2,588,981
0.9× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 1 $2,388,614.00 $2,388,614.00 $2,388,614.00 nat. median
$2,511,312
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 3 $484,690.00 $4,967,903.58 $1,600,258.26 nat. median
$610,161
outlier · 2.6×
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 3 $474,061.00 $4,858,953.13 $1,565,163.20 nat. median
$624,417
outlier · 2.5×
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 3 $449,440.00 $4,777,592.88 $1,480,459.38 nat. median
$577,541
outlier · 2.6×
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 4 $25.48 $4,940,683.40 $1,167,572.21 nat. median
$691,418
1.7× median
5834
APR_DRG 		Neonate With Ecmo 4 $963,403.00 $1,204,253.75 $1,117,547.48 nat. median
$311,018
outlier · 3.6×
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 4 $6.70 $4,556,941.00 $1,082,118.20 nat. median
$588,565
1.8× median
5833
APR_DRG 		Neonate With Ecmo 4 $815,774.00 $1,019,717.50 $946,297.84 nat. median
$250,089
outlier · 3.8×
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 3 $507,496.00 $4,909,284.00 $837,683.55 nat. median
$631,793
1.3× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 4 $609,818.00 $762,272.50 $707,388.88 nat. median
$254,667
outlier · 2.8×
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 4 $554,775.00 $693,468.75 $643,539.00 nat. median
$165,599
outlier · 3.9×
1614
APR_DRG 		Implantable Heart Assist Systems 5 $592,175.00 $740,218.75 $639,549.59 nat. median
$209,486
outlier · 3.1×
9194
OTHER 		Tisagenlecleucel Car-pos 18 $486,857.47 $1,148,348.59 $530,515.88 nat. median
$576,820
0.9× median
09194
OTHER 		Tisagenlecleucel Car-pos 1 $529,192.90 $529,192.90 $529,192.90 nat. median
$549,535
1.0× median
9498
OTHER 		Ciltacabtagene Car-pos T 18 $484,953.53 $1,143,857.78 $528,441.21 nat. median
$587,650
0.9× median
9422
OTHER 		Idecabtagene Vicleucel Ca 18 $484,460.59 $1,142,695.09 $527,904.07 nat. median
$560,872
0.9× median
09498
OTHER 		Ciltacabtagene Car-pos T 1 $527,123.40 $527,123.40 $527,123.40 nat. median
$570,020
0.9× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $526,587.60 $526,587.60 $526,587.60 nat. median
$541,339
1.0× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 4 $453,745.00 $567,181.25 $526,344.20 nat. median
$160,171
outlier · 3.3×
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 $449,724.00 $562,155.00 $521,679.84 nat. median
$168,174
outlier · 3.1×
9413
OTHER 		Lisocabtagene Car Pos T 18 $475,388.01 $1,121,295.64 $518,017.91 nat. median
$562,201
0.9× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $516,726.10 $516,726.10 $516,726.10 nat. median
$545,335
0.9× median
9035
OTHER 		Axicabtagene Ciloleucel C 18 $450,299.52 $1,062,119.52 $490,679.64 nat. median
$533,230
0.9× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $489,456.00 $489,456.00 $489,456.00 nat. median
$516,226
0.9× median
5832
APR_DRG 		Neonate With Ecmo 4 $406,481.00 $508,101.25 $471,517.96 nat. median
$169,230
outlier · 2.8×
9391
OTHER 		Brexucabtagene Car Pos T 18 $423,687.97 $999,350.97 $461,681.72 nat. median
$492,768
0.9× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $460,530.40 $460,530.40 $460,530.40 nat. median
$474,767
1.0× median
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 $385,981.00 $482,476.25 $447,737.96 nat. median
$119,243
outlier · 3.8×
2004
APR_DRG 		Cardiac Structural And Valvular Disorders 4 $358,682.00 $448,352.50 $416,071.12 nat. median
$28,828
outlier · 14.4×
5831
APR_DRG 		Neonate With Ecmo 4 $357,915.00 $447,393.75 $415,181.40 nat. median
$154,685
outlier · 2.7×
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 4 $327,208.00 $409,010.00 $379,561.28 nat. median
$180,995
outlier · 2.1×
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 4 $325,713.00 $407,141.25 $377,827.08 nat. median
$147,847
outlier · 2.6×
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 4 $324,870.00 $406,087.50 $376,849.20 nat. median
$127,600
outlier · 3.0×
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 4 $323,474.00 $404,342.50 $375,229.84 nat. median
$165,646
outlier · 2.3×
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 4 $320,243.00 $400,303.75 $371,481.88 nat. median
$147,677
outlier · 2.5×
8504
APR_DRG 		Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 4 $311,807.00 $389,758.75 $361,696.12 nat. median
$67,813
outlier · 5.3×
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 4 $309,013.00 $386,266.25 $358,455.08 nat. median
$168,361
outlier · 2.1×

Other procedures at this hospital

Browse this hospital's 35,252 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
             
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 4 1 — — $4,897,200.00 $4,897,200.00 $4,897,200.00 2025-01-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 4 1 $4,463,735.93 — $3,884,946.48 $3,884,946.48 $3,884,946.48 2026-07-17
9138 OTHER Inj, Hemgenix, Per Tx Dos 36 16 — — $3,379,068.00 $3,893,274.00 $3,672,900.00 2025-01-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 1 1 — — $3,672,900.00 $3,672,900.00 $3,672,900.00 2025-01-01
00773 OTHER Inj, Beqvez, Per Tx Dose 1 1 — — $3,605,000.00 $3,605,000.00 $3,605,000.00 2025-01-01
773 OTHER Inj, Beqvez, Per Tx Dose 36 16 — — $3,316,600.00 $3,821,300.00 $3,605,000.00 2025-01-01
714 OTHER Inj Delandistrogene Mox R 37 17 $13,669.68 — $3,059,418.60 $4,655,637.00 $3,325,455.00 2026-07-17
00714 OTHER Inj Delandistrogene Mox R 1 1 — — $3,325,455.00 $3,325,455.00 $3,325,455.00 2025-01-01
00748 OTHER Inj, Lovotibeglogene Auto 1 1 — — $3,286,000.00 $3,286,000.00 $3,286,000.00 2025-01-01
748 OTHER Inj, Lovotibeglogene Auto 37 17 $20,217.78 — $3,023,120.00 $4,600,400.00 $3,286,000.00 2026-07-17
00746 OTHER Inj, Betibeglogene Autote 1 1 — — $2,968,000.00 $2,968,000.00 $2,968,000.00 2025-01-01
746 OTHER Inj, Betibeglogene Autote 37 17 $22,303.46 — $2,730,560.00 $4,155,200.00 $2,968,000.00 2026-07-17
9141 OTHER Inj Onase Abepar-xioi Tre 37 17 — — $2,197,524.88 $3,344,059.60 $2,388,614.00 2025-01-01
09141 OTHER Inj Onase Abepar-xioi Tre 1 1 — — $2,388,614.00 $2,388,614.00 $2,388,614.00 2025-01-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 11 3 — — $484,690.00 $4,967,903.58 $1,600,258.26 2026-07-17
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 11 3 $4,940,684.89 — $474,061.00 $4,858,953.13 $1,565,163.20 2026-07-17
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 12 3 $4,491,531.72 — $449,440.00 $4,777,592.88 $1,480,459.38 2026-07-17
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 14 4 $4,644,857.10 — $25.48 $4,940,683.40 $1,167,572.21 2026-07-17
5834 APR_DRG Neonate With Ecmo 13 4 — — $963,403.00 $1,204,253.75 $1,117,547.48 2025-01-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 14 4 $4,284,091.50 — $6.70 $4,556,941.00 $1,082,118.20 2026-07-17
5833 APR_DRG Neonate With Ecmo 13 4 — — $815,774.00 $1,019,717.50 $946,297.84 2025-01-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 9 3 — — $507,496.00 $4,909,284.00 $837,683.55 2026-07-17
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 13 4 — — $609,818.00 $762,272.50 $707,388.88 2025-01-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 13 4 — — $554,775.00 $693,468.75 $643,539.00 2025-01-01
1614 APR_DRG Implantable Heart Assist Systems 18 5 — — $592,175.00 $740,218.75 $639,549.59 2025-01-01
9194 OTHER Tisagenlecleucel Car-pos 38 18 $889,558.93 — $486,857.47 $1,148,348.59 $530,515.88 2026-07-17
09194 OTHER Tisagenlecleucel Car-pos 1 1 — — $529,192.90 $529,192.90 $529,192.90 2025-01-01
9498 OTHER Ciltacabtagene Car-pos T 38 18 $938,742.00 — $484,953.53 $1,143,857.78 $528,441.21 2026-07-17
9422 OTHER Idecabtagene Vicleucel Ca 38 18 $871,553.20 — $484,460.59 $1,142,695.09 $527,904.07 2026-07-17
09498 OTHER Ciltacabtagene Car-pos T 1 1 — — $527,123.40 $527,123.40 $527,123.40 2025-01-01
09422 OTHER Idecabtagene Vicleucel Ca 1 1 — — $526,587.60 $526,587.60 $526,587.60 2025-01-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 13 4 — — $453,745.00 $567,181.25 $526,344.20 2025-01-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 13 4 — — $449,724.00 $562,155.00 $521,679.84 2025-01-01
9413 OTHER Lisocabtagene Car Pos T 38 18 $852,439.28 — $475,388.01 $1,121,295.64 $518,017.91 2026-07-17
09413 OTHER Lisocabtagene Car Pos T 1 1 — — $516,726.10 $516,726.10 $516,726.10 2025-01-01
9035 OTHER Axicabtagene Ciloleucel C 38 18 $828,854.15 — $450,299.52 $1,062,119.52 $490,679.64 2026-07-17
09035 OTHER Axicabtagene Ciloleucel C 1 1 — — $489,456.00 $489,456.00 $489,456.00 2025-01-01
5832 APR_DRG Neonate With Ecmo 13 4 — — $406,481.00 $508,101.25 $471,517.96 2025-01-01
9391 OTHER Brexucabtagene Car Pos T 38 18 $828,962.40 — $423,687.97 $999,350.97 $461,681.72 2026-07-17
09391 OTHER Brexucabtagene Car Pos T 1 1 — — $460,530.40 $460,530.40 $460,530.40 2025-01-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 4 — — $385,981.00 $482,476.25 $447,737.96 2025-01-01
2004 APR_DRG Cardiac Structural And Valvular Disorders 13 4 — — $358,682.00 $448,352.50 $416,071.12 2025-01-01
5831 APR_DRG Neonate With Ecmo 13 4 — — $357,915.00 $447,393.75 $415,181.40 2025-01-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 13 4 — — $327,208.00 $409,010.00 $379,561.28 2025-01-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 13 4 — — $325,713.00 $407,141.25 $377,827.08 2025-01-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 13 4 — — $324,870.00 $406,087.50 $376,849.20 2025-01-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 13 4 — — $323,474.00 $404,342.50 $375,229.84 2025-01-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 13 4 — — $320,243.00 $400,303.75 $371,481.88 2025-01-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 13 4 — — $311,807.00 $389,758.75 $361,696.12 2025-01-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 13 4 — — $309,013.00 $386,266.25 $358,455.08 2025-01-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 13 4 — — $307,018.00 $383,772.50 $356,140.88 2025-01-01
1613 APR_DRG Implantable Heart Assist Systems 18 5 — — $308,649.00 $385,811.25 $333,341.88 2025-01-01
74 APR_DRG Allogeneic Bone Marrow Transplant 13 4 — — $321,106.00 $1,171,498.75 $321,106.00 2025-01-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 13 4 — — $275,010.00 $343,762.50 $319,011.60 2025-01-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 13 4 — — $272,559.00 $340,698.75 $316,168.44 2025-01-01
2464 APR_DRG Gastrointestinal Vascular Insufficiency 13 4 — — $266,534.00 $333,167.50 $309,179.44 2025-01-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 13 4 — — $265,159.00 $331,448.75 $307,584.44 2025-01-01
645277 CDM Lvas Heartmate Ii 10 9 $569,100.00 $569,100.00 $142,275.00 $483,735.00 $302,192.10 2025-01-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 13 4 — — $257,309.00 $321,636.25 $298,478.44 2025-01-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 13 4 — — $256,539.00 $320,673.75 $297,585.24 2025-01-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 18 5 — — $274,857.00 $343,571.25 $296,845.62 2025-01-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 13 4 — — $249,385.00 $311,731.25 $289,286.60 2025-01-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 13 4 — — $235,831.00 $294,788.75 $273,563.96 2025-01-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 13 4 — — $233,917.00 $292,396.25 $271,343.72 2025-01-01
24 APR_DRG Heart And/or Lung Transplant 13 4 — — $268,874.00 $980,938.75 $268,874.00 2025-01-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 45 19 — — $3,938.00 $516,177.22 $268,207.47 2025-01-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 13 4 — — $223,949.00 $279,936.25 $259,780.84 2025-01-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 18 5 — — $239,766.00 $299,707.50 $258,947.93 2025-01-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 4 — — $219,334.00 $274,167.50 $254,427.44 2025-01-01
8634 APR_DRG Neonatal Aftercare 13 4 — — $215,932.00 $269,915.00 $250,481.12 2025-01-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 13 4 — — $213,858.00 $267,322.50 $248,075.28 2025-01-01
134663 CDM Valve Tavr 31mm 10 9 $467,145.00 $467,145.00 $116,786.25 $397,073.25 $248,053.99 2025-01-01
134434 CDM Valve Tavr 29mm 10 9 $467,145.00 $467,145.00 $116,786.25 $397,073.25 $248,053.99 2025-01-01
134662 CDM Valve Tavr 23mm 10 9 $467,145.00 $467,145.00 $116,786.25 $397,073.25 $248,053.99 2025-01-01
134664 CDM Valve Tavr 26mm 10 9 $467,145.00 $467,145.00 $116,786.25 $397,073.25 $248,053.99 2025-01-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 13 4 — — $208,945.00 $261,181.25 $242,376.20 2025-01-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 13 4 — — $208,874.00 $261,092.50 $242,293.84 2025-01-01
1612 APR_DRG Implantable Heart Assist Systems 18 5 — — $221,871.00 $277,338.75 $239,620.98 2025-01-01
111426 CDM Valve Tavr Sz 29mm 10 9 $444,900.00 $444,900.00 $111,225.00 $378,165.00 $236,241.90 2025-01-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 13 4 — — $203,485.00 $254,356.25 $236,042.60 2025-01-01
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 13 4 — — $203,485.00 $254,356.25 $236,042.60 2025-01-01
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 13 4 — — $202,907.00 $253,633.75 $235,372.12 2025-01-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 17 5 $736,138.22 — $55,453.60 $783,022.12 $233,201.77 2026-07-17
4414 APR_DRG Major Bladder Procedures 13 4 — — $198,645.00 $248,306.25 $230,428.20 2025-01-01
1611 APR_DRG Implantable Heart Assist Systems 18 5 — — $210,424.00 $263,030.00 $227,258.75 2025-01-01
1784 APR_DRG External Heart Assist Devices 13 4 — — $186,054.00 $232,567.50 $215,822.64 2025-01-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 13 4 — — $183,225.00 $229,031.25 $212,541.00 2025-01-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 13 4 — — $183,014.00 $228,767.50 $212,296.24 2025-01-01
6904 APR_DRG Acute Leukemia 13 4 — — $180,569.00 $225,711.25 $209,460.04 2025-01-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 78 29 — — $137,695.00 $394,103.40 $208,874.80 2025-01-01
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 13 4 — — $179,463.00 $224,328.75 $208,177.08 2025-01-01
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 13 4 — — $179,261.00 $224,076.25 $207,942.76 2025-01-01
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 13 4 — — $173,847.00 $217,308.75 $201,662.52 2025-01-01
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 13 4 — — $170,193.00 $212,741.25 $197,423.88 2025-01-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 18 5 — — $182,205.00 $227,756.25 $196,781.96 2025-01-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 13 4 — — $169,155.00 $211,443.75 $196,219.80 2025-01-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 13 4 — — $168,009.00 $210,011.25 $194,890.44 2025-01-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 13 4 — — $166,365.00 $207,956.25 $192,983.40 2025-01-01
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 13 4 — — $158,531.00 $198,163.75 $183,895.96 2025-01-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 13 4 — — $157,667.00 $197,083.75 $182,893.72 2025-01-01
4474 APR_DRG Other Kidney, Urinary Tract And Related Non-percutaneous Procedures 13 4 — — $157,298.00 $196,622.50 $182,465.68 2025-01-01
234 APR_DRG Spinal Procedures 13 4 — — $154,968.00 $193,710.00 $179,762.88 2025-01-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 13 4 — — $154,407.00 $193,008.75 $179,112.12 2025-01-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 4 — — $152,423.00 $190,528.75 $176,810.68 2025-01-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 13 4 — — $152,417.00 $190,521.25 $176,803.72 2025-01-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 13 4 — — $150,517.00 $188,146.25 $174,599.72 2025-01-01
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 13 4 — — $149,823.00 $187,278.75 $173,794.68 2025-01-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 53 22 — — $3,938.00 $342,628.40 $169,697.40 2025-01-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 13 4 — — $144,664.00 $180,830.00 $167,810.24 2025-01-01
264 APR_DRG Other Nervous System And Related Procedures 13 4 — — $144,576.00 $180,720.00 $167,708.16 2025-01-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 13 4 — — $143,952.00 $179,940.00 $166,984.32 2025-01-01
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 13 4 — — $143,099.00 $178,873.75 $165,994.84 2025-01-01
1824 APR_DRG Other Peripheral Vascular And Related Procedures 13 4 — — $142,983.00 $178,728.75 $165,860.28 2025-01-01
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 13 4 — — $140,559.00 $175,698.75 $163,048.44 2025-01-01
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 13 4 — — $140,525.00 $175,656.25 $163,009.00 2025-01-01
2054 APR_DRG Cardiomyopathy 13 4 — — $140,128.00 $175,160.00 $162,548.48 2025-01-01
6954 APR_DRG Chemotherapy For Acute Leukemia 13 4 — — $139,948.00 $174,935.00 $162,339.68 2025-01-01
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 13 4 — — $139,804.00 $174,755.00 $162,172.64 2025-01-01
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 13 4 — — $137,455.00 $171,818.75 $159,447.80 2025-01-01
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 13 4 — — $136,995.00 $171,243.75 $158,914.20 2025-01-01
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 13 4 — — $136,567.00 $170,708.75 $158,417.72 2025-01-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 21 5 $262,004.81 — $37,032.96 $278,691.63 $157,862.30 2026-07-17
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition… 13 4 — — $135,133.00 $168,916.25 $156,754.28 2025-01-01
214 APR_DRG Open Craniotomy Except Trauma 13 4 — — $134,584.00 $168,230.00 $156,117.44 2025-01-01
2304 APR_DRG Major Small Bowel Procedures 13 4 — — $134,098.00 $167,622.50 $155,553.68 2025-01-01
224 APR_DRG Ventricular Shunt Procedures 13 4 — — $133,569.00 $166,961.25 $154,940.04 2025-01-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 18 5 — — $142,898.00 $178,622.50 $154,330.63 2025-01-01
4424 APR_DRG Kidney And Urinary Tract Procedures For Malignancy 13 4 — — $132,837.00 $166,046.25 $154,090.92 2025-01-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 62 24 — — $3,938.00 $339,625.81 $153,551.21 2025-01-01
9524 APR_DRG Non-extensive O.r. Procedure Unrelated To Principal Diagnosis 13 4 — — $132,021.00 $165,026.25 $153,144.36 2025-01-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 16 4 $461,584.11 — $97,767.71 $490,981.94 $152,143.32 2026-07-17
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 13 4 — — $130,815.00 $163,518.75 $151,745.40 2025-01-01
3154 APR_DRG Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement 13 4 — — $128,462.00 $160,577.50 $149,015.92 2025-01-01
1204 APR_DRG Major Respiratory And Chest Procedures 13 4 — — $127,506.00 $159,382.50 $147,906.96 2025-01-01
4834 APR_DRG Penis, Testes And Scrotal Procedures 13 4 — — $127,021.00 $158,776.25 $147,344.36 2025-01-01
894 APR_DRG Major Cranial Or Facial Bone Procedures 13 4 — — $125,659.00 $157,073.75 $145,764.44 2025-01-01
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 18 5 — — $134,903.00 $168,628.75 $145,695.97 2025-01-01
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 13 4 — — $125,493.00 $156,866.25 $145,571.88 2025-01-01
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 13 4 — — $125,461.00 $156,826.25 $145,534.76 2025-01-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 15 4 — — $63,505.40 $2,057,600.00 $143,808.00 2025-01-01
1908 OTHER New Technology - Level 52 38 18 $270,385.83 — $129,845.30 $306,265.55 $141,489.04 2026-07-17
1907 OTHER New Technology - Level 52 38 18 $270,385.83 — $129,845.30 $306,265.55 $141,489.04 2026-07-17
01908 OTHER New Technology - Level 52 1 1 — — $141,136.20 $141,136.20 $141,136.20 2025-01-01
01907 OTHER New Technology - Level 52 1 1 — — $141,136.20 $141,136.20 $141,136.20 2025-01-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 17 5 $444,295.65 — $44,578.80 $472,592.40 $140,748.75 2026-07-17
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 13 4 — — $121,135.00 $151,418.75 $140,516.60 2025-01-01
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 13 4 — — $120,475.00 $150,593.75 $139,751.00 2025-01-01
1694 APR_DRG Major Abdominal Vascular Procedures 18 5 — — $128,026.00 $160,032.50 $138,268.22 2025-01-01
1783 APR_DRG External Heart Assist Devices 13 4 — — $119,064.00 $148,830.00 $138,114.24 2025-01-01
1214 APR_DRG Other Respiratory And Chest Procedures 13 4 — — $118,996.00 $148,745.00 $138,035.36 2025-01-01
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 13 4 — — $118,560.00 $148,200.00 $137,529.60 2025-01-01
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 13 4 — — $117,603.00 $147,003.75 $136,419.48 2025-01-01
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 13 4 — — $117,264.00 $146,580.00 $136,026.24 2025-01-01
2244 APR_DRG Peritoneal Adhesiolysis 13 4 — — $115,966.00 $144,957.50 $134,520.56 2025-01-01
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 13 4 — — $115,158.00 $143,947.50 $133,583.28 2025-01-01
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 18 5 — — $123,592.00 $154,490.00 $133,480.32 2025-01-01
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 13 4 — — $114,836.00 $143,545.00 $133,209.76 2025-01-01
914 APR_DRG Other Major Head And Neck Procedures 13 4 — — $114,219.00 $142,773.75 $132,494.04 2025-01-01
204 APR_DRG Open Craniotomy For Trauma 13 4 — — $113,053.00 $141,316.25 $131,141.48 2025-01-01
51 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 13 4 — — $112,284.00 $140,355.00 $130,249.44 2025-01-01
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 13 4 — — $112,069.00 $140,086.25 $130,000.04 2025-01-01
1814 APR_DRG Lower Extremity Vascular Procedures 13 4 — — $111,201.00 $139,001.25 $128,993.16 2025-01-01
2274 APR_DRG Hernia Procedures Except Inguinal, Femoral And Umbilical 13 4 — — $110,861.00 $138,576.25 $128,598.76 2025-01-01
6604 APR_DRG Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula… 13 4 — — $110,497.00 $138,121.25 $128,176.52 2025-01-01
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 13 4 — — $110,474.00 $138,092.50 $128,149.84 2025-01-01
439515 CDM Cord Blood Acquisition 49 20 $384,659.63 $384,659.63 $23,079.58 $326,960.69 $128,091.66 2025-01-01
107794 CDM Cord Blood Acquisition 49 20 $384,659.63 $384,659.63 $23,079.58 $326,960.69 $128,091.66 2025-01-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 13 4 — — $110,350.00 $137,937.50 $128,006.00 2025-01-01
1906 OTHER New Technology - Level 51 38 18 $243,790.59 — $117,073.68 $276,141.18 $127,572.14 2026-07-17
1905 OTHER New Technology - Level 51 38 18 $243,790.59 — $117,073.68 $276,141.18 $127,572.14 2026-07-17
01906 OTHER New Technology - Level 51 1 1 — — $127,254.00 $127,254.00 $127,254.00 2025-01-01
01905 OTHER New Technology - Level 51 1 1 — — $127,254.00 $127,254.00 $127,254.00 2025-01-01
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 18 5 — — $116,152.00 $145,190.00 $125,444.32 2025-01-01
1834 APR_DRG Percutaneous Structural Cardiac Procedures 13 4 — — $107,536.00 $134,420.00 $124,741.76 2025-01-01
2614 APR_DRG Major Biliary Tract Procedures 13 4 — — $105,830.00 $132,287.50 $122,762.80 2025-01-01
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 13 4 — — $105,452.00 $131,815.00 $122,324.32 2025-01-01
1833 APR_DRG Percutaneous Structural Cardiac Procedures 13 4 — — $104,895.00 $131,118.75 $121,678.20 2025-01-01
9514 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 13 4 — — $104,484.00 $130,605.00 $121,201.44 2025-01-01
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 13 4 — — $103,825.00 $129,781.25 $120,437.00 2025-01-01
504 APR_DRG Non-bacterial Infections Of Nervous System Except Viral Meningitis 13 4 — — $102,776.00 $128,470.00 $119,220.16 2025-01-01
1782 APR_DRG External Heart Assist Devices 13 4 — — $102,189.00 $127,736.25 $118,539.24 2025-01-01
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 13 4 — — $102,015.00 $127,518.75 $118,337.40 2025-01-01
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 13 4 — — $101,119.00 $126,398.75 $117,298.04 2025-01-01
2234 APR_DRG Other Small And Large Bowel Procedures 13 4 — — $99,572.00 $124,465.00 $115,503.52 2025-01-01
6914 APR_DRG Lymphoma, Myeloma And Non-acute Leukemia 13 4 — — $98,959.00 $123,698.75 $114,792.44 2025-01-01
1903 OTHER New Technology - Level 50 38 18 $217,195.35 — $104,302.06 $246,016.81 $113,655.23 2026-07-17
1904 OTHER New Technology - Level 50 38 18 $217,195.35 — $104,302.06 $246,016.81 $113,655.23 2026-07-17
6944 APR_DRG Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior 13 4 — — $97,957.00 $122,446.25 $113,630.12 2025-01-01
7234 APR_DRG Viral Illness 13 4 — — $97,824.00 $122,280.00 $113,475.84 2025-01-01
01904 OTHER New Technology - Level 50 1 1 — — $113,371.80 $113,371.80 $113,371.80 2025-01-01
01903 OTHER New Technology - Level 50 1 1 — — $113,371.80 $113,371.80 $113,371.80 2025-01-01
73 APR_DRG Allogeneic Bone Marrow Transplant 13 4 — — $113,306.00 $413,376.25 $113,306.00 2025-01-01
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 13 4 — — $96,772.00 $120,965.00 $112,255.52 2025-01-01
6614 APR_DRG Coagulation And Platelet Disorders 13 4 — — $94,646.00 $118,307.50 $109,789.36 2025-01-01
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 18 5 — — $100,734.00 $125,917.50 $108,792.84 2025-01-01
1781 APR_DRG External Heart Assist Devices 13 4 — — $93,675.00 $117,093.75 $108,663.00 2025-01-01
923 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 13 4 — — $93,340.00 $116,675.00 $108,274.40 2025-01-01
5134 APR_DRG Uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma 13 4 — — $91,474.00 $114,342.50 $106,109.84 2025-01-01
L5969 HCPCS Addition, Endoskeletal Ankle-foot Or Ankle System, Power Assist, Includes Any Ty… 2 1 $100,565.67 — $106,097.82 $106,097.82 $106,097.82 2026-07-17
1794 APR_DRG Defibrillator Implants 13 4 — — $91,418.00 $114,272.50 $106,044.88 2025-01-01
3124 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 13 4 — — $91,294.00 $114,117.50 $105,901.04 2025-01-01
8412 APR_DRG Extensive Third Degree Burns With Skin Graft 13 4 — — $90,850.00 $113,562.50 $105,386.00 2025-01-01
8411 APR_DRG Extensive Third Degree Burns With Skin Graft 13 4 — — $90,143.00 $112,678.75 $104,565.88 2025-01-01
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures 13 4 — — $89,669.00 $112,086.25 $104,016.04 2025-01-01
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 18 5 — — $95,703.00 $119,628.75 $103,359.71 2025-01-01
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 18 5 — — $95,514.00 $119,392.50 $103,155.59 2025-01-01
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 13 4 — — $88,418.00 $110,522.50 $102,564.88 2025-01-01
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 13 4 — — $88,331.00 $110,413.75 $102,463.96 2025-01-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 62 24 — — $3,938.00 $223,917.98 $102,131.27 2025-01-01
4013 APR_DRG Adrenal Procedures 13 4 — — $88,000.00 $110,000.00 $102,080.00 2025-01-01
3043 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 13 4 — — $87,991.00 $109,988.75 $102,069.56 2025-01-01
3104 APR_DRG Vertebral And Intervertebral Spinal Procedures Including Disc Procedures 13 4 — — $87,058.00 $108,822.50 $100,987.28 2025-01-01
2334 APR_DRG Appendectomy With Complex Principal Diagnosis 13 4 — — $86,999.00 $108,748.75 $100,918.84 2025-01-01
5114 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 13 4 — — $86,873.00 $108,591.25 $100,772.68 2025-01-01
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 4 — — $86,682.00 $108,352.50 $100,551.12 2025-01-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 41 19 $642,484.33 — $92,000.00 $677,827.66 $100,500.00 2026-07-17
6344 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 13 4 — — $86,554.00 $108,192.50 $100,402.64 2025-01-01
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 18 5 — — $92,789.00 $115,986.25 $100,212.98 2025-01-01
4804 APR_DRG Major Male Pelvic Procedures 13 4 — — $86,187.00 $107,733.75 $99,976.92 2025-01-01
107792 CDM Bone Marrow Acquisition 49 20 $299,740.03 $299,740.03 $17,984.40 $254,779.03 $99,813.43 2025-01-01
439525 CDM Donor Leuk Acquisition 49 20 $299,740.03 $299,740.03 $17,984.40 $254,779.03 $99,813.43 2025-01-01
439505 CDM Stemcell/bm Acquisition 49 20 $299,740.03 $299,740.03 $17,984.40 $254,779.03 $99,813.43 2025-01-01
107799 CDM Stemcell/bm Acquisition 49 20 $299,740.03 $299,740.03 $17,984.40 $254,779.03 $99,813.43 2025-01-01
107796 CDM Donor Leuk Acquisition 49 20 $299,740.03 $299,740.03 $17,984.40 $254,779.03 $99,813.43 2025-01-01
439555 CDM Bone Marrow Acquisition 49 20 $299,740.03 $299,740.03 $17,984.40 $254,779.03 $99,813.43 2025-01-01
1902 OTHER New Technology - Level 49 38 18 $190,600.11 — $91,530.40 $215,892.35 $99,738.29 2026-07-17
1901 OTHER New Technology - Level 49 38 18 $190,600.11 — $91,530.40 $215,892.35 $99,738.29 2026-07-17
01901 OTHER New Technology - Level 49 1 1 — — $99,489.56 $99,489.56 $99,489.56 2025-01-01
01902 OTHER New Technology - Level 49 1 1 — — $99,489.56 $99,489.56 $99,489.56 2025-01-01
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 13 4 — — $85,672.00 $107,090.00 $99,379.52 2025-01-01
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 13 4 — — $85,449.00 $106,811.25 $99,120.84 2025-01-01
1303 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 13 4 — — $85,189.00 $106,486.25 $98,819.24 2025-01-01
3464 APR_DRG Connective Tissue Disorders 13 4 — — $85,167.00 $106,458.75 $98,793.72 2025-01-01
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 13 4 — — $84,901.00 $106,126.25 $98,485.16 2025-01-01
4434 APR_DRG Kidney And Urinary Tract Procedures For Non-malignancy 13 4 — — $84,259.00 $105,323.75 $97,740.44 2025-01-01
1804 APR_DRG Other Circulatory System Procedures 13 4 — — $84,217.00 $105,271.25 $97,691.72 2025-01-01
294 APR_DRG Other Percutaneous Intracranial Procedures 13 4 — — $84,154.00 $105,192.50 $97,618.64 2025-01-01
1714 APR_DRG Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock 18 5 — — $90,369.00 $112,961.25 $97,599.16 2025-01-01
734 APR_DRG Orbit And Eye Procedures 13 4 — — $83,985.00 $104,981.25 $97,422.60 2025-01-01
4684 APR_DRG Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms 13 4 — — $83,561.00 $104,451.25 $96,930.76 2025-01-01
3134 APR_DRG Knee And Lower Leg Procedures Except Foot 13 4 — — $83,327.00 $104,158.75 $96,659.32 2025-01-01
1621 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 18 5 — — $89,380.00 $111,725.00 $96,530.62 2025-01-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 13 4 — — $96,315.40 $351,388.75 $96,315.40 2025-01-01
84 APR_DRG Autologous Bone Marrow Transplant 13 4 — — $95,929.50 $349,981.25 $95,929.50 2025-01-01
8154 APR_DRG Other Injury, Poisoning And Toxic Effect Diagnoses 13 4 — — $82,585.00 $103,231.25 $95,798.60 2025-01-01
913 APR_DRG Other Major Head And Neck Procedures 13 4 — — $81,950.00 $102,437.50 $95,062.00 2025-01-01
14 MS_DRG Allogeneic Bone Marrow Transplant 49 21 — — $85,121.79 $186,058.56 $94,889.87 2025-01-01
6924 APR_DRG Radiotherapy 13 4 — — $81,763.00 $102,203.75 $94,845.08 2025-01-01
984 APR_DRG Other Ear, Nose, Mouth, Throat, Craniofacial, And Neck Procedures 13 4 — — $81,656.00 $102,070.00 $94,720.96 2025-01-01
7 MS_DRG Lung Transplant 50 22 — — $3,938.00 $207,100.08 $94,657.46 2025-01-01
2314 APR_DRG Major Large Bowel Procedures 13 4 — — $81,345.00 $101,681.25 $94,360.20 2025-01-01
8104 APR_DRG Hemorrhage Or Hematoma Due To Complication 13 4 — — $81,227.00 $101,533.75 $94,223.32 2025-01-01
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 13 4 — — $80,998.00 $101,247.50 $93,957.68 2025-01-01
4844 APR_DRG Other Male Reproductive System And Related Procedures 13 4 — — $80,482.00 $100,602.50 $93,359.12 2025-01-01
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 13 4 — — $80,417.00 $100,521.25 $93,283.72 2025-01-01
494 APR_DRG Bacterial And Tuberculous Infections Of Nervous System 13 4 — — $80,265.00 $100,331.25 $93,107.40 2025-01-01
6903 APR_DRG Acute Leukemia 13 4 — — $79,476.00 $99,345.00 $92,192.16 2025-01-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 42 19 $127,050.00 — $83,749.35 $197,539.22 $92,106.07 2026-07-17
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 13 4 — — $78,977.00 $98,721.25 $91,613.32 2025-01-01
4014 APR_DRG Adrenal Procedures 13 4 — — $78,693.00 $98,366.25 $91,283.88 2025-01-01
3254 APR_DRG Non-elective Or Complex Knee Joint Replacement 13 4 — — $78,528.00 $98,160.00 $91,092.48 2025-01-01
6613 APR_DRG Coagulation And Platelet Disorders 13 4 — — $77,600.00 $97,000.00 $90,016.00 2025-01-01
274 APR_DRG Other Open Craniotomy 13 4 — — $77,507.00 $96,883.75 $89,908.12 2025-01-01
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 13 4 — — $77,195.00 $96,493.75 $89,546.20 2025-01-01
213 APR_DRG Open Craniotomy Except Trauma 13 4 — — $77,025.00 $96,281.25 $89,349.00 2025-01-01
7934 APR_DRG Moderately Extensive O.r. Procedures For Other Complications Of Treatment 13 4 — — $76,535.00 $95,668.75 $88,780.60 2025-01-01
3214 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 13 4 — — $76,510.00 $95,637.50 $88,751.60 2025-01-01
3031 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 13 4 — — $76,485.00 $95,606.25 $88,722.60 2025-01-01
244 APR_DRG Open Extracranial Vascular Procedures 13 4 — — $76,354.00 $95,442.50 $88,570.64 2025-01-01
1801 APR_DRG Other Circulatory System Procedures 13 4 — — $76,298.00 $95,372.50 $88,505.68 2025-01-01
1754 APR_DRG Percutaneous Cardiac Intervention Without Ami 18 5 — — $81,820.00 $102,275.00 $88,365.85 2025-01-01
3084 APR_DRG Hip And Femur Fracture Repair 13 4 — — $76,042.00 $95,052.50 $88,208.72 2025-01-01
64 APR_DRG Pancreas Transplant 13 4 — — $88,167.10 $321,661.25 $88,167.10 2025-01-01
1585 OTHER New Technology - Level 48 38 18 $168,437.41 — $80,887.38 $190,788.70 $88,140.86 2026-07-17
1599 OTHER New Technology - Level 48 38 18 $168,437.41 — $80,887.38 $190,788.70 $88,140.86 2026-07-17
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 13 4 — — $75,868.00 $94,835.00 $88,006.88 2025-01-01
A9543 HCPCS Y90 Ibritum Tiu Tx 40mci 51 18 $218,286.62 $218,286.62 $13,097.20 $701,324.09 $87,969.51 2026-07-17
01585 OTHER New Technology - Level 48 1 1 — — $87,921.06 $87,921.06 $87,921.06 2025-01-01
01599 OTHER New Technology - Level 48 1 1 — — $87,921.06 $87,921.06 $87,921.06 2025-01-01
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 18 5 — — $81,259.00 $101,573.75 $87,760.34 2025-01-01
5144 APR_DRG Female Reproductive System Reconstructive Procedures 13 4 — — $75,461.00 $94,326.25 $87,534.76 2025-01-01
233 APR_DRG Spinal Procedures 13 4 — — $75,443.00 $94,303.75 $87,513.88 2025-01-01
2224 APR_DRG Other Stomach, Esophageal And Duodenal Procedures 13 4 — — $75,395.00 $94,243.75 $87,458.20 2025-01-01
5124 APR_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy 13 4 — — $75,306.00 $94,132.50 $87,354.96 2025-01-01
1602 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 18 5 — — $80,705.00 $100,881.25 $87,161.68 2025-01-01
4012 APR_DRG Adrenal Procedures 13 4 — — $74,989.00 $93,736.25 $86,987.24 2025-01-01
433 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 13 4 — — $74,687.00 $93,358.75 $86,636.92 2025-01-01
1302 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 13 4 — — $74,477.00 $93,096.25 $86,393.32 2025-01-01
6803 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 13 4 — — $74,437.00 $93,046.25 $86,346.92 2025-01-01
404 APR_DRG Spinal Disorders And Injuries 13 4 — — $74,436.00 $93,045.00 $86,345.76 2025-01-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 7 1 — — $72,447.38 $113,775.00 $86,266.13 2025-01-01
90288 CPT Botulism Immune Globulin, Human, For Intravenous Use 3 1 — — $76,953.90 $104,228.70 $86,207.85 2025-01-01
1704 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 18 5 — — $79,788.00 $99,735.00 $86,171.22 2025-01-01
293 APR_DRG Other Percutaneous Intracranial Procedures 13 4 — — $74,162.00 $92,702.50 $86,027.92 2025-01-01
J7699 HCPCS Ribavirin 6 Gm Inh 23 9 $227,836.20 $227,836.20 $13,670.17 $193,660.77 $85,666.41 2025-01-01
1673 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 18 5 — — $79,146.00 $98,932.50 $85,478.04 2025-01-01
7923 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 13 4 — — $73,292.00 $91,615.00 $85,018.72 2025-01-01
6813 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 13 4 — — $73,012.00 $91,265.00 $84,693.92 2025-01-01
4444 APR_DRG Renal Dialysis Access Device Procedures 13 4 — — $72,507.00 $90,633.75 $84,108.12 2025-01-01
2454 APR_DRG Inflammatory Bowel Disease 13 4 — — $72,403.00 $90,503.75 $83,987.48 2025-01-01
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