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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

CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS

Sulphur Springs, TX · CCN 450236 · Rates published

18,789 distinct procedures filed
25 distinct payers
665,251 rate rows
2026-01-12 last MRF observed
Data quality

484,454 of 665,251 rate rows are consumer-grade (72.8%)

180,797 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 172,907
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 5,307
per-diem day rate — not a per-procedure price 2,022
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 487
placeholder amount (≤ $0.02) — excluded from medians 61
template filing: same amount across many unrelated codes — excluded 13
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.christushealth.org/-/media/christus-health/plan-care/files/bill-pay/machine-readable-files/811708177_motherfranceshospitalsulphursprings_standardcharges.json
Found on page https://www.christushealth.org/plan-care/bill-pay/pricing-transparency
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-22
Content fingerprint 31190e4ab64333e6… · 141,491,469 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
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 17 $3,821,307.87 $4,203,438.66 $3,821,307.87 nat. median
$3,705,478
1.0× median
J1414
HCPCS 		Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose 17 $3,821,307.87 $4,203,438.66 $3,821,307.87 nat. median
$3,710,000
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 25 $2,475,567.61 $4,951,135.22 $3,713,351.42 nat. median
$2,467,386
1.5× median
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 25 $2,401,964.94 $4,803,929.88 $3,602,947.41 nat. median
$2,401,965
1.5× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 17 $3,421,442.00 $4,790,018.80 $3,421,442.00 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Injection, Lovotibeglogene Autotemcel, Per Treatment 17 $3,288,796.77 $4,604,315.48 $3,288,796.77 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 17 $3,057,046.29 $4,279,864.81 $3,057,046.29 nat. median
$2,994,107
1.0× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 25 $567,859.06 $1,847,928.60 $1,207,893.83 nat. median
$646,415
1.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 25 $544,162.92 $1,667,109.78 $1,105,636.35 nat. median
$622,450
1.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 25 $531,981.64 $1,630,548.61 $1,081,265.12 nat. median
$640,950
1.7× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 25 $582,593.75 $1,532,918.10 $1,057,755.93 nat. median
$739,258
1.4× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 25 $502,694.09 $1,482,316.92 $992,505.51 nat. median
$591,721
1.7× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 25 $504,203.70 $1,413,856.50 $959,030.10 nat. median
$608,239
1.6× median
5834
APR_DRG 		Neonate With Ecmo, Severe 5 $726,579.36 $762,908.29 $762,908.29 nat. median
$307,206
outlier · 2.5×
74
APR_DRG 		Allogeneic Bone Marrow Transplant, Severe 5 $706,817.07 $742,157.89 $742,157.89 nat. median
$170,082
outlier · 4.4×
5833
APR_DRG 		Neonate With Ecmo, Major 5 $615,240.70 $646,002.70 $646,002.70 nat. median
$244,017
outlier · 2.6×
24
APR_DRG 		Heart And/Or Lung Transplant, Severe 5 $591,844.13 $621,436.31 $621,436.31 nat. median
$241,437
outlier · 2.6×
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure, Severe 5 $459,912.81 $482,908.43 $482,908.43 nat. median
$247,214
2.0× median
1614
APR_DRG 		Implantable Heart Assist Systems, Severe 5 $446,606.89 $468,937.22 $468,937.22 nat. median
$202,993
outlier · 2.3×
94
APR_DRG 		Extracorporeal Membrane Oxygenation (Ecmo), Severe 5 $418,400.33 $439,320.33 $439,320.33 nat. median
$163,587
outlier · 2.7×
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure, Severe 5 $342,205.79 $359,316.06 $359,316.06 nat. median
$154,011
outlier · 2.3×
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure, Severe 5 $339,173.24 $356,131.88 $356,131.88 nat. median
$165,000
outlier · 2.2×
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 25 $65,304.24 $638,400.00 $351,852.12 nat. median
$68,423
outlier · 5.1×
5832
APR_DRG 		Neonate With Ecmo, Moderate 5 $306,560.39 $321,888.40 $321,888.40 nat. median
$159,249
outlier · 2.0×
100T
OTHER 		Prosth Retina Receive&gen 17 $231,800.76 $343,126.13 $287,463.45 nat. median
$6,525
outlier · 44.1×
2004
APR_DRG 		Cardiac Structural And Valvular Disorders, Severe 5 $270,511.29 $284,036.84 $284,036.84 nat. median
$28,457
outlier · 10.0×
5831
APR_DRG 		Neonate With Ecmo, Minor 5 $269,932.52 $283,429.13 $283,429.13 nat. median
$146,500
1.9× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 19 $243,454.46 $589,416.06 $266,478.64 nat. median
$359,454
0.7× median
73
APR_DRG 		Allogeneic Bone Marrow Transplant, Major 5 $249,408.75 $261,879.17 $261,879.17 nat. median
$89,273
outlier · 2.9×
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure, Major 5 $246,774.16 $259,112.85 $259,112.85 nat. median
$175,204
1.5× median
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure, Moderate 5 $245,646.28 $257,928.58 $257,928.58 nat. median
$145,061
1.8× median
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure, Severe 5 $245,011.07 $257,261.61 $257,261.61 nat. median
$122,016
outlier · 2.1×
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft, Severe 5 $243,957.80 $256,155.68 $256,155.68 nat. median
$155,939
1.6× median
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure, Severe 5 $241,521.24 $253,597.29 $253,597.29 nat. median
$133,164
1.9× median
8504
APR_DRG 		Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 5 $235,158.62 $246,916.54 $246,916.54 nat. median
$66,667
outlier · 3.7×
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure, Severe 5 $233,052.10 $244,704.69 $244,704.69 nat. median
$162,342
1.5× median
1613
APR_DRG 		Implantable Heart Assist Systems, Major 5 $232,777.54 $244,416.41 $244,416.41 nat. median
$120,517
outlier · 2.0×
5881
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure, Minor 5 $231,547.30 $243,124.65 $243,124.65 nat. median
$120,208
outlier · 2.0×
14
APR_DRG 		Liver Transplant And/Or Intestinal Transplant, Severe 5 $212,008.87 $222,609.30 $222,609.30 nat. median
$136,566
1.6× median
84
APR_DRG 		Autologous Bone Marrow Transplant Or T-cell Immunotherapy, Severe 5 $211,159.37 $221,717.33 $221,717.33 nat. median
$78,130
outlier · 2.8×
6814
APR_DRG 		Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms, Severe 5 $207,407.42 $217,777.78 $217,777.78 nat. median
$68,030
outlier · 3.2×
1604
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly, Severe 5 $207,291.67 $217,656.24 $217,656.24 nat. median
$98,624
outlier · 2.2×
93
APR_DRG 		Extracorporeal Membrane Oxygenation (Ecmo), Major 5 $205,559.19 $215,837.14 $215,837.14 nat. median
$78,893
outlier · 2.7×
2464
APR_DRG 		Gastrointestinal Vascular Insufficiency, Severe 5 $201,015.15 $211,065.89 $211,065.89 nat. median
$20,493
outlier · 10.3×
6034
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition, Seve… 5 $199,978.15 $209,977.04 $209,977.04 nat. median
$107,681
1.9× median
64
APR_DRG 		Pancreas Transplant, Severe 5 $194,072.80 $203,776.43 $203,776.43 nat. median
$91,106
outlier · 2.2×
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 5 $194,057.50 $203,760.36 $203,760.36 nat. median
$93,998
outlier · 2.2×
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure, Severe 5 $193,476.82 $203,150.65 $203,150.65 nat. median
$151,838
1.3× median
5892
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 5 $188,081.36 $197,485.42 $197,485.42 nat. median
$89,188
outlier · 2.2×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 18 $181,840.07 $440,244.38 $197,152.92 nat. median
$249,036
0.8× median

Other procedures at this hospital

Browse this hospital's 18,789 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
             
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 18 17 — — $3,821,307.87 $4,203,438.66 $3,821,307.87 2026-01-12
J1414 HCPCS Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose 18 17 — — $3,821,307.87 $4,203,438.66 $3,821,307.87 2026-01-12
J3399 HCPCS Inj Onase Abepar-xioi Treat 45 25 — — $2,475,567.61 $4,951,135.22 $3,713,351.42 2026-01-12
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 45 25 — — $2,401,964.94 $4,803,929.88 $3,602,947.41 2026-01-12
J1413 HCPCS Inj Delandistrogene Mox Rokl 19 17 — — $3,421,442.00 $4,790,018.80 $3,421,442.00 2026-01-12
J3394 HCPCS Injection, Lovotibeglogene Autotemcel, Per Treatment 19 17 — — $3,288,796.77 $4,604,315.48 $3,288,796.77 2026-01-12
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 19 17 — — $3,057,046.29 $4,279,864.81 $3,057,046.29 2026-01-12
Q2056 HCPCS Ciltacabtagene Car-pos T 44 25 — — $567,859.06 $1,847,928.60 $1,207,893.83 2026-01-12
Q2055 HCPCS Idecabtagene Vicleucel Car 44 25 — — $544,162.92 $1,667,109.78 $1,105,636.35 2026-01-12
Q2054 HCPCS Lisocabtagene Mara Car Pos T 44 25 — — $531,981.64 $1,630,548.61 $1,081,265.12 2026-01-12
Q2042 HCPCS Tisagenlecleucel Car-pos T 44 25 — — $582,593.75 $1,532,918.10 $1,057,755.93 2026-01-12
Q2053 HCPCS Brexucabtagene Car Pos T 44 25 — — $502,694.09 $1,482,316.92 $992,505.51 2026-01-12
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 44 25 — — $504,203.70 $1,413,856.50 $959,030.10 2026-01-12
5834 APR_DRG Neonate With Ecmo, Severe 10 5 — — $726,579.36 $762,908.29 $762,908.29 2026-01-12
74 APR_DRG Allogeneic Bone Marrow Transplant, Severe 10 5 — — $706,817.07 $742,157.89 $742,157.89 2026-01-12
5833 APR_DRG Neonate With Ecmo, Major 10 5 — — $615,240.70 $646,002.70 $646,002.70 2026-01-12
24 APR_DRG Heart And/Or Lung Transplant, Severe 10 5 — — $591,844.13 $621,436.31 $621,436.31 2026-01-12
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure, Severe 10 5 — — $459,912.81 $482,908.43 $482,908.43 2026-01-12
1614 APR_DRG Implantable Heart Assist Systems, Severe 10 5 — — $446,606.89 $468,937.22 $468,937.22 2026-01-12
94 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo), Severe 10 5 — — $418,400.33 $439,320.33 $439,320.33 2026-01-12
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure, Severe 10 5 — — $342,205.79 $359,316.06 $359,316.06 2026-01-12
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure, Severe 10 5 — — $339,173.24 $356,131.88 $356,131.88 2026-01-12
J9029 HCPCS Instill Adstiladrin, Tx Dose 45 25 — — $65,304.24 $638,400.00 $351,852.12 2026-01-12
5832 APR_DRG Neonate With Ecmo, Moderate 10 5 — — $306,560.39 $321,888.40 $321,888.40 2026-01-12
100T OTHER Prosth Retina Receive&gen 33 17 — — $231,800.76 $343,126.13 $287,463.45 2026-01-12
2004 APR_DRG Cardiac Structural And Valvular Disorders, Severe 10 5 — — $270,511.29 $284,036.84 $284,036.84 2026-01-12
5831 APR_DRG Neonate With Ecmo, Minor 10 5 — — $269,932.52 $283,429.13 $283,429.13 2026-01-12
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 25 19 — — $243,454.46 $589,416.06 $266,478.64 2026-01-12
73 APR_DRG Allogeneic Bone Marrow Transplant, Major 10 5 — — $249,408.75 $261,879.17 $261,879.17 2026-01-12
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure, Major 10 5 — — $246,774.16 $259,112.85 $259,112.85 2026-01-12
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure, Moderate 10 5 — — $245,646.28 $257,928.58 $257,928.58 2026-01-12
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure, Severe 10 5 — — $245,011.07 $257,261.61 $257,261.61 2026-01-12
8414 APR_DRG Extensive Third Degree Burns With Skin Graft, Severe 10 5 — — $243,957.80 $256,155.68 $256,155.68 2026-01-12
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure, Severe 10 5 — — $241,521.24 $253,597.29 $253,597.29 2026-01-12
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 10 5 — — $235,158.62 $246,916.54 $246,916.54 2026-01-12
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure, Severe 10 5 — — $233,052.10 $244,704.69 $244,704.69 2026-01-12
1613 APR_DRG Implantable Heart Assist Systems, Major 10 5 — — $232,777.54 $244,416.41 $244,416.41 2026-01-12
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure, Minor 10 5 — — $231,547.30 $243,124.65 $243,124.65 2026-01-12
14 APR_DRG Liver Transplant And/Or Intestinal Transplant, Severe 10 5 — — $212,008.87 $222,609.30 $222,609.30 2026-01-12
84 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy, Severe 10 5 — — $211,159.37 $221,717.33 $221,717.33 2026-01-12
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms, Severe 10 5 — — $207,407.42 $217,777.78 $217,777.78 2026-01-12
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly, Severe 10 5 — — $207,291.67 $217,656.24 $217,656.24 2026-01-12
93 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo), Major 10 5 — — $205,559.19 $215,837.14 $215,837.14 2026-01-12
2464 APR_DRG Gastrointestinal Vascular Insufficiency, Severe 10 5 — — $201,015.15 $211,065.89 $211,065.89 2026-01-12
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition, Seve… 10 5 — — $199,978.15 $209,977.04 $209,977.04 2026-01-12
64 APR_DRG Pancreas Transplant, Severe 10 5 — — $194,072.80 $203,776.43 $203,776.43 2026-01-12
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 10 5 — — $194,057.50 $203,760.36 $203,760.36 2026-01-12
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure, Severe 10 5 — — $193,476.82 $203,150.65 $203,150.65 2026-01-12
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 10 5 — — $188,081.36 $197,485.42 $197,485.42 2026-01-12
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 19 18 — — $181,840.07 $440,244.38 $197,152.92 2026-01-12
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis, Severe 10 5 — — $180,827.15 $189,868.50 $189,868.50 2026-01-12
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 10 5 — — $177,859.65 $186,752.62 $186,752.62 2026-01-12
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 10 5 — — $176,416.08 $185,236.87 $185,236.87 2026-01-12
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly, Severe 10 5 — — $168,897.84 $177,342.72 $177,342.72 2026-01-12
72 APR_DRG Allogeneic Bone Marrow Transplant, Moderate 10 5 — — $167,574.80 $175,953.54 $175,953.54 2026-01-12
1612 APR_DRG Implantable Heart Assist Systems, Moderate 10 5 — — $167,330.86 $175,697.39 $175,697.39 2026-01-12
8634 APR_DRG Neonatal Aftercare, Severe 10 5 — — $162,851.87 $170,994.45 $170,994.45 2026-01-12
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure, Major 10 5 — — $161,287.76 $169,352.14 $169,352.14 2026-01-12
1611 APR_DRG Implantable Heart Assist Systems, Minor 10 5 — — $158,698.13 $166,633.03 $166,633.03 2026-01-12
4404 APR_DRG Kidney Transplant, Severe 10 5 — — $158,305.91 $166,221.20 $166,221.20 2026-01-12
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure, Severe 10 5 — — $157,582.69 $165,461.81 $165,461.81 2026-01-12
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure, Major 10 5 — — $157,529.12 $165,405.56 $165,405.56 2026-01-12
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 21 19 — — $153,142.21 $370,765.36 $162,814.35 2026-01-12
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure, Major 10 5 — — $153,464.35 $161,137.56 $161,137.56 2026-01-12
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms, Severe 10 5 — — $153,464.35 $161,137.56 $161,137.56 2026-01-12
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition, Seve… 10 5 — — $153,029.08 $160,680.52 $160,680.52 2026-01-12
4414 APR_DRG Major Bladder Procedures, Severe 10 5 — — $149,814.76 $157,305.49 $157,305.49 2026-01-12
23 APR_DRG Heart And/Or Lung Transplant, Major 10 5 — — $145,771.04 $153,059.59 $153,059.59 2026-01-12
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 26 19 — — $138,351.40 $334,956.02 $150,718.86 2026-01-12
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 44 25 — — $57,202.71 $242,943.88 $150,073.30 2026-01-12
83 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy, Major 10 5 — — $142,727.97 $149,864.36 $149,864.36 2026-01-12
1784 APR_DRG External Heart Assist Systems, Severe 10 5 — — $140,318.19 $147,334.09 $147,334.09 2026-01-12
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure, Major 10 5 — — $138,184.88 $145,094.12 $145,094.12 2026-01-12
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly, Severe 10 5 — — $138,026.08 $144,927.37 $144,927.37 2026-01-12
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures, Severe 10 5 — — $137,415.74 $144,286.52 $144,286.52 2026-01-12
6904 APR_DRG Acute Leukemia, Severe 10 5 — — $136,181.67 $142,990.75 $142,990.75 2026-01-12
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies, S… 10 5 — — $135,347.48 $142,114.85 $142,114.85 2026-01-12
92 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo), Moderate 10 5 — — $135,195.38 $141,955.14 $141,955.14 2026-01-12
A9543 HCPCS Y90 Ibritumomab, Rx 45 25 — — $58,529.41 $217,595.89 $138,062.65 2026-01-12
91 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo), Minor 10 5 — — $131,112.43 $137,668.05 $137,668.05 2026-01-12
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly, Severe 10 5 — — $128,356.35 $134,774.16 $134,774.16 2026-01-12
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back, Severe 10 5 — — $127,573.82 $133,952.50 $133,952.50 2026-01-12
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure, Moderate 10 5 — — $126,709.01 $133,044.46 $133,044.46 2026-01-12
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 10 5 — — $125,469.21 $131,742.66 $131,742.66 2026-01-12
63 APR_DRG Pancreas Transplant, Major 10 5 — — $125,417.55 $131,688.42 $131,688.42 2026-01-12
J7330 HCPCS Cultured Chondrocytes Implnt 33 17 — — $105,755.83 $152,334.21 $129,045.02 2026-01-12
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures, Severe 10 5 — — $119,560.99 $125,539.04 $125,539.04 2026-01-12
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection, Sev… 10 5 — — $118,909.52 $124,854.99 $124,854.99 2026-01-12
4474 APR_DRG Other Kidney, Urinary Tract And Related Procedures, Severe 10 5 — — $118,631.14 $124,562.69 $124,562.69 2026-01-12
22 APR_DRG Heart And/Or Lung Transplant, Moderate 10 5 — — $117,102.42 $122,957.54 $122,957.54 2026-01-12
234 APR_DRG Spinal Procedures, Severe 10 5 — — $116,873.79 $122,717.47 $122,717.47 2026-01-12
9104 APR_DRG Craniotomy For Multiple Significant Trauma, Severe 10 5 — — $116,450.95 $122,273.49 $122,273.49 2026-01-12
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 10 5 — — $114,949.98 $120,697.48 $120,697.48 2026-01-12
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure, Major 10 5 — — $113,516.93 $119,192.78 $119,192.78 2026-01-12
62 APR_DRG Pancreas Transplant, Moderate 10 5 — — $113,438.49 $119,110.41 $119,110.41 2026-01-12
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis, Severe 10 5 — — $112,993.65 $118,643.33 $118,643.33 2026-01-12
61 APR_DRG Pancreas Transplant, Minor 10 5 — — $111,973.87 $117,572.56 $117,572.56 2026-01-12
71 APR_DRG Allogeneic Bone Marrow Transplant, Minor 10 5 — — $110,035.72 $115,537.50 $115,537.50 2026-01-12
13 APR_DRG Liver Transplant And/Or Intestinal Transplant, Major 10 5 — — $109,232.14 $114,693.74 $114,693.74 2026-01-12
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure, Major 10 5 — — $109,102.99 $114,558.14 $114,558.14 2026-01-12
264 APR_DRG Other Nervous System And Related Procedures, Severe 10 5 — — $109,036.98 $114,488.83 $114,488.83 2026-01-12
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure, Moderate 10 5 — — $108,566.32 $113,994.63 $113,994.63 2026-01-12
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back, Major 10 5 — — $107,922.50 $113,318.62 $113,318.62 2026-01-12
1824 APR_DRG Other Peripheral Vascular And Related Procedures, Severe 10 5 — — $107,835.44 $113,227.21 $113,227.21 2026-01-12
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis, Severe 10 5 — — $107,771.35 $113,159.91 $113,159.91 2026-01-12
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment, Severe 10 5 — — $106,007.30 $111,307.66 $111,307.66 2026-01-12
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back, Severe 10 5 — — $105,981.47 $111,280.54 $111,280.54 2026-01-12
2054 APR_DRG Cardiomyopathy, Severe 10 5 — — $105,682.04 $110,966.14 $110,966.14 2026-01-12
6954 APR_DRG Chemotherapy For Acute Leukemia, Severe 10 5 — — $105,546.20 $110,823.51 $110,823.51 2026-01-12
8413 APR_DRG Extensive Third Degree Burns With Skin Graft, Major 10 5 — — $105,438.10 $110,710.00 $110,710.00 2026-01-12
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure, Moderate 10 5 — — $103,666.40 $108,849.72 $108,849.72 2026-01-12
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs, Severe 10 5 — — $103,319.14 $108,485.09 $108,485.09 2026-01-12
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure, Moderate 10 5 — — $102,996.75 $108,146.59 $108,146.59 2026-01-12
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition… 10 5 — — $101,914.79 $107,010.53 $107,010.53 2026-01-12
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis, Major 10 5 — — $101,741.64 $106,828.72 $106,828.72 2026-01-12
214 APR_DRG Open Craniotomy Except Trauma, Severe 10 5 — — $101,500.57 $106,575.59 $106,575.59 2026-01-12
2304 APR_DRG Major Small Bowel Procedures, Severe 10 5 — — $101,134.17 $106,190.88 $106,190.88 2026-01-12
224 APR_DRG Ventricular Shunt Procedures, Severe 10 5 — — $100,735.25 $105,772.01 $105,772.01 2026-01-12
4424 APR_DRG Kidney And Urinary Tract Procedures For Malignancy, Severe 10 5 — — $100,183.27 $105,192.43 $105,192.43 2026-01-12
9524 APR_DRG Non-extensive O.r. Procedure Unrelated To Principal Diagnosis, Severe 10 5 — — $99,568.15 $104,546.55 $104,546.55 2026-01-12
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma, Seve… 10 5 — — $98,658.39 $103,591.30 $103,591.30 2026-01-12
4403 APR_DRG Kidney Transplant, Major 10 5 — — $96,890.51 $101,735.03 $101,735.03 2026-01-12
3154 APR_DRG Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement, Severe 10 5 — — $96,883.82 $101,728.00 $101,728.00 2026-01-12
1694 APR_DRG Major Abdominal Vascular Procedures, Severe 10 5 — — $96,554.73 $101,382.46 $101,382.46 2026-01-12
1204 APR_DRG Major Respiratory And Chest Procedures, Severe 10 5 — — $96,162.51 $100,970.63 $100,970.63 2026-01-12
4834 APR_DRG Penis, Testes And Scrotal Procedures, Severe 10 5 — — $95,797.07 $100,586.92 $100,586.92 2026-01-12
894 APR_DRG Major Cranial Or Facial Bone Procedures, Severe 10 5 — — $94,769.64 $99,508.12 $99,508.12 2026-01-12
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma, Severe 10 5 — — $94,644.32 $99,376.53 $99,376.53 2026-01-12
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 26 19 — — $91,216.02 $220,838.78 $99,369.98 2026-01-12
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours, Severe 10 5 — — $94,620.40 $99,351.42 $99,351.42 2026-01-12
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis, Severe 10 5 — — $93,211.27 $97,871.83 $97,871.83 2026-01-12
J9226 HCPCS Supprelin La Implant 45 25 — — $46,619.75 $146,628.59 $96,624.17 2026-01-12
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure, Minor 10 5 — — $91,358.26 $95,926.17 $95,926.17 2026-01-12
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures, Severe 10 5 — — $90,859.85 $95,402.84 $95,402.84 2026-01-12
21 APR_DRG Heart And/Or Lung Transplant, Minor 10 5 — — $90,703.92 $95,239.11 $95,239.11 2026-01-12
1783 APR_DRG External Heart Assist Systems, Major 10 5 — — $89,796.06 $94,285.86 $94,285.86 2026-01-12
1214 APR_DRG Other Respiratory And Chest Procedures, Severe 10 5 — — $89,744.41 $94,231.62 $94,231.62 2026-01-12
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure, Major 10 5 — — $89,416.28 $93,887.09 $93,887.09 2026-01-12
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition, Severe 10 5 — — $88,694.01 $93,128.71 $93,128.71 2026-01-12
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 10 5 — — $88,438.59 $92,860.52 $92,860.52 2026-01-12
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly, Major 10 5 — — $87,599.62 $91,979.59 $91,979.59 2026-01-12
2244 APR_DRG Peritoneal Adhesiolysis, Severe 10 5 — — $87,459.95 $91,832.94 $91,832.94 2026-01-12
14 MS_DRG Allogeneic Bone Marrow Transplant 19 18 — — $84,578.49 $204,768.98 $91,700.89 2026-01-12
7 MS_DRG Lung Transplant 19 18 — — $84,365.46 $204,253.23 $91,469.92 2026-01-12
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 10 5 — — $86,850.57 $91,193.09 $91,193.09 2026-01-12
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses, Severe 10 5 — — $86,607.58 $90,937.95 $90,937.95 2026-01-12
914 APR_DRG Other Major Head And Neck Procedures, Severe 10 5 — — $86,141.70 $90,448.78 $90,448.78 2026-01-12
204 APR_DRG Open Craniotomy For Trauma, Severe 10 5 — — $85,262.54 $89,525.67 $89,525.67 2026-01-12
51 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure, Minor 10 5 — — $84,682.82 $88,916.95 $88,916.95 2026-01-12
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure, Minor 10 5 — — $84,520.19 $88,746.19 $88,746.19 2026-01-12
12 APR_DRG Liver Transplant And/Or Intestinal Transplant, Moderate 10 5 — — $83,900.29 $88,095.30 $88,095.30 2026-01-12
1814 APR_DRG Lower Extremity Arterial Procedures, Severe 10 5 — — $83,865.85 $88,059.13 $88,059.13 2026-01-12
2274 APR_DRG Hernia Procedures Except Inguinal, Femoral And Umbilical, Severe 10 5 — — $83,609.47 $87,789.94 $87,789.94 2026-01-12
6604 APR_DRG Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula… 10 5 — — $83,334.91 $87,501.65 $87,501.65 2026-01-12
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection, Sev… 10 5 — — $83,317.69 $87,483.57 $87,483.57 2026-01-12
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns, Severe 10 5 — — $83,223.94 $87,385.13 $87,385.13 2026-01-12
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 33 17 — — $71,610.00 $102,410.00 $87,010.00 2026-01-12
E0767 HCPCS Intrabuccal, Systemic Delivery Of Amplitude-modulated, Radiofrequency Electromag… 33 17 — — $71,093.11 $101,670.79 $86,381.95 2026-01-12
1834 APR_DRG Percutaneous Structural Cardiac Procedures, Severe 10 5 — — $81,102.11 $85,157.21 $85,157.21 2026-01-12
11 APR_DRG Liver Transplant And/Or Intestinal Transplant, Minor 10 5 — — $80,750.07 $84,787.57 $84,787.57 2026-01-12
38240 CPT Transplt Allo Hct/donor 45 25 — — $56,902.54 $121,833.46 $84,230.73 2026-01-12
2614 APR_DRG Major Biliary Tract Procedures, Severe 10 5 — — $79,815.43 $83,806.20 $83,806.20 2026-01-12
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 10 5 — — $79,530.35 $83,506.86 $83,506.86 2026-01-12
1833 APR_DRG Percutaneous Structural Cardiac Procedures, Major 10 5 — — $79,110.38 $83,065.90 $83,065.90 2026-01-12
9514 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis, Severe 10 5 — — $78,800.43 $82,740.45 $82,740.45 2026-01-12
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back, Moderate 10 5 — — $78,302.98 $82,218.12 $82,218.12 2026-01-12
504 APR_DRG Non-bacterial Infections Of Nervous System Except Viral Meningitis, Severe 10 5 — — $77,511.84 $81,387.42 $81,387.42 2026-01-12
1782 APR_DRG External Heart Assist Systems, Moderate 10 5 — — $77,068.91 $80,922.35 $80,922.35 2026-01-12
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure, Severe 10 5 — — $76,937.85 $80,784.74 $80,784.74 2026-01-12
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition, Majo… 10 5 — — $76,262.46 $80,075.58 $80,075.58 2026-01-12
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis, Moderate 10 5 — — $75,971.65 $79,770.22 $79,770.22 2026-01-12
2234 APR_DRG Other Small And Large Bowel Procedures, Severe 10 5 — — $75,095.36 $78,850.13 $78,850.13 2026-01-12
6914 APR_DRG Lymphoma, Myeloma And Non-acute Leukemia, Severe 10 5 — — $74,633.30 $78,364.97 $78,364.97 2026-01-12
82 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy, Moderate 10 5 — — $74,297.52 $78,012.40 $78,012.40 2026-01-12
6944 APR_DRG Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior, Severe 10 5 — — $73,877.56 $77,571.43 $77,571.43 2026-01-12
7234 APR_DRG Viral Illness, Severe 10 5 — — $73,777.11 $77,465.96 $77,465.96 2026-01-12
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 19 18 — — $71,137.52 $172,227.68 $77,128.05 2026-01-12
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures, Severe 10 5 — — $72,984.06 $76,633.25 $76,633.25 2026-01-12
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 26 19 — — $70,325.42 $170,261.55 $76,611.93 2026-01-12
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis, Major 10 5 — — $72,177.61 $75,786.48 $75,786.48 2026-01-12
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis, Severe 10 5 — — $72,035.07 $75,636.82 $75,636.82 2026-01-12
6614 APR_DRG Coagulation And Platelet Disorders, Severe 10 5 — — $71,380.72 $74,949.76 $74,949.76 2026-01-12
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 19 18 — — $68,747.05 $166,440.24 $74,536.28 2026-01-12
215 MS_DRG Other Heart Assist System Implant 26 19 — — $68,394.59 $165,586.89 $74,508.49 2026-01-12
1781 APR_DRG External Heart Assist Systems, Minor 10 5 — — $70,647.94 $74,180.33 $74,180.33 2026-01-12
923 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures, Major 10 5 — — $70,395.38 $73,915.15 $73,915.15 2026-01-12
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 26 19 — — $67,623.80 $163,720.79 $73,668.81 2026-01-12
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices, Sev… 10 5 — — $69,980.20 $73,479.21 $73,479.21 2026-01-12
5134 APR_DRG Uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma, Severe 10 5 — — $68,988.17 $72,437.57 $72,437.57 2026-01-12
1794 APR_DRG Defibrillator Implants, Severe 10 5 — — $68,946.07 $72,393.37 $72,393.37 2026-01-12
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses, Se… 10 5 — — $68,852.32 $72,294.94 $72,294.94 2026-01-12
8412 APR_DRG Extensive Third Degree Burns With Skin Graft, Moderate 10 5 — — $68,517.50 $71,943.37 $71,943.37 2026-01-12
1714 APR_DRG Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock, Severe 10 5 — — $68,154.93 $71,562.67 $71,562.67 2026-01-12
8411 APR_DRG Extensive Third Degree Burns With Skin Graft, Minor 10 5 — — $67,984.65 $71,383.88 $71,383.88 2026-01-12
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures, Severe 10 5 — — $67,626.87 $71,008.21 $71,008.21 2026-01-12
1621 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis, Minor 10 5 — — $67,408.75 $70,779.19 $70,779.19 2026-01-12
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 10 5 — — $66,683.62 $70,017.79 $70,017.79 2026-01-12
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure, Severe 10 5 — — $66,617.61 $69,948.49 $69,948.49 2026-01-12
4013 APR_DRG Adrenal Procedures, Major 10 5 — — $66,367.93 $69,686.32 $69,686.32 2026-01-12
3043 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back, Major 10 5 — — $66,361.23 $69,679.29 $69,679.29 2026-01-12
3104 APR_DRG Vertebral And Intervertebral Spinal Procedures Including Disc Procedures, Severe 10 5 — — $65,658.10 $68,941.00 $68,941.00 2026-01-12
2334 APR_DRG Appendectomy With Complex Principal Diagnosis, Severe 10 5 — — $65,613.14 $68,893.79 $68,893.79 2026-01-12
5114 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy, Severe 10 5 — — $65,518.43 $68,794.35 $68,794.35 2026-01-12
6344 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 10 5 — — $65,277.36 $68,541.22 $68,541.22 2026-01-12
4804 APR_DRG Major Male Pelvic Procedures, Severe 10 5 — — $65,000.89 $68,250.93 $68,250.93 2026-01-12
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 26 19 — — $62,302.54 $150,837.73 $67,871.87 2026-01-12
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure, Severe 10 5 — — $64,612.49 $67,843.11 $67,843.11 2026-01-12
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures, Severe 10 5 — — $64,444.12 $67,666.32 $67,666.32 2026-01-12
1303 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours, Major 10 5 — — $64,248.01 $67,460.41 $67,460.41 2026-01-12
3464 APR_DRG Connective Tissue Disorders, Severe 10 5 — — $64,231.75 $67,443.33 $67,443.33 2026-01-12
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures, Severe 10 5 — — $64,030.85 $67,232.39 $67,232.39 2026-01-12
4434 APR_DRG Kidney And Urinary Tract Procedures For Non-malignancy, Severe 10 5 — — $63,546.79 $66,724.13 $66,724.13 2026-01-12
1804 APR_DRG Other Circulatory System Procedures, Severe 10 5 — — $63,515.22 $66,690.98 $66,690.98 2026-01-12
294 APR_DRG Other Percutaneous Intracranial Procedures, Severe 10 5 — — $63,467.39 $66,640.76 $66,640.76 2026-01-12
734 APR_DRG Orbit And Eye Procedures, Severe 10 5 — — $63,340.16 $66,507.16 $66,507.16 2026-01-12
4684 APR_DRG Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms, Severe 10 5 — — $63,020.64 $66,171.67 $66,171.67 2026-01-12
3134 APR_DRG Knee And Lower Leg Procedures Except Foot, Severe 10 5 — — $62,843.66 $65,985.84 $65,985.84 2026-01-12
4402 APR_DRG Kidney Transplant, Moderate 10 5 — — $62,318.46 $65,434.38 $65,434.38 2026-01-12
8154 APR_DRG Other Injury, Poisoning And Toxic Effect Diagnoses, Severe 10 5 — — $62,284.03 $65,398.22 $65,398.22 2026-01-12
81 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy, Minor 10 5 — — $62,228.54 $65,339.96 $65,339.96 2026-01-12
913 APR_DRG Other Major Head And Neck Procedures, Major 10 5 — — $61,805.71 $64,895.99 $64,895.99 2026-01-12
266T OTHER Implt/rpl Crtd Sns Dev Total 45 25 — — $44,260.48 $92,701.22 $64,890.85 2026-01-12
1754 APR_DRG Percutaneous Cardiac Intervention Without Ami, Severe 10 5 — — $61,707.17 $64,792.53 $64,792.53 2026-01-12
6924 APR_DRG Radiotherapy, Severe 10 5 — — $61,664.12 $64,747.33 $64,747.33 2026-01-12
984 APR_DRG Other Ear, Nose, Mouth And Throat Procedures, Severe 10 5 — — $61,583.76 $64,662.95 $64,662.95 2026-01-12
2314 APR_DRG Major Large Bowel Procedures, Severe 10 5 — — $61,349.39 $64,416.85 $64,416.85 2026-01-12
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis, Major 10 5 — — $61,284.34 $64,348.55 $64,348.55 2026-01-12
8104 APR_DRG Hemorrhage Or Hematoma Due To Complication, Severe 10 5 — — $61,260.42 $64,323.44 $64,323.44 2026-01-12
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition, Mode… 10 5 — — $61,087.27 $64,141.63 $64,141.63 2026-01-12
1602 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly, Moderate 10 5 — — $60,866.28 $63,909.59 $63,909.59 2026-01-12
4844 APR_DRG Other Male Reproductive System And Related Procedures, Severe 10 5 — — $60,697.91 $63,732.81 $63,732.81 2026-01-12
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition, Majo… 10 5 — — $60,649.13 $63,681.58 $63,681.58 2026-01-12
494 APR_DRG Bacterial And Tuberculous Infections Of Nervous System, Severe 10 5 — — $60,534.33 $63,561.04 $63,561.04 2026-01-12
1704 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock, Severe 10 5 — — $60,174.63 $63,183.36 $63,183.36 2026-01-12
6903 APR_DRG Acute Leukemia, Major 10 5 — — $59,939.30 $62,936.26 $62,936.26 2026-01-12
1673 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures, Major 10 5 — — $59,690.57 $62,675.10 $62,675.10 2026-01-12
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders, Severe 10 5 — — $59,563.34 $62,541.50 $62,541.50 2026-01-12
4014 APR_DRG Adrenal Procedures, Severe 10 5 — — $59,349.05 $62,316.50 $62,316.50 2026-01-12
3254 APR_DRG Non-elective Or Complex Knee Joint Replacement, Severe 10 5 — — $59,224.69 $62,185.92 $62,185.92 2026-01-12
6613 APR_DRG Coagulation And Platelet Disorders, Major 10 5 — — $58,524.43 $61,450.64 $61,450.64 2026-01-12
274 APR_DRG Other Open Craniotomy, Severe 10 5 — — $58,454.59 $61,377.32 $61,377.32 2026-01-12
4401 APR_DRG Kidney Transplant, Minor 10 5 — — $58,416.33 $61,337.14 $61,337.14 2026-01-12
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure, Moderate 10 5 — — $58,219.26 $61,130.22 $61,130.22 2026-01-12
213 APR_DRG Open Craniotomy Except Trauma, Major 10 5 — — $58,091.07 $60,995.62 $60,995.62 2026-01-12
7934 APR_DRG Moderately Extensive O.r. Procedures For Other Complications Of Treatment, Sever… 10 5 — — $57,721.80 $60,607.89 $60,607.89 2026-01-12
3214 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures, Sev… 10 5 — — $57,702.67 $60,587.80 $60,587.80 2026-01-12
3031 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back, Minor 10 5 — — $57,683.54 $60,567.71 $60,567.71 2026-01-12
244 APR_DRG Open Extracranial Vascular Procedures, Severe 10 5 — — $57,585.00 $60,464.25 $60,464.25 2026-01-12
1801 APR_DRG Other Circulatory System Procedures, Minor 10 5 — — $57,542.91 $60,420.06 $60,420.06 2026-01-12
3084 APR_DRG Hip And Femur Fracture Repair, Severe 10 5 — — $57,349.67 $60,217.15 $60,217.15 2026-01-12
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 10 5 — — $57,218.61 $60,079.54 $60,079.54 2026-01-12
5144 APR_DRG Female Reproductive System Reconstructive Procedures, Severe 10 5 — — $56,911.53 $59,757.10 $59,757.10 2026-01-12
233 APR_DRG Spinal Procedures, Major 10 5 — — $56,898.14 $59,743.04 $59,743.04 2026-01-12
2224 APR_DRG Other Stomach, Esophageal And Duodenal Procedures, Severe 10 5 — — $56,861.78 $59,704.87 $59,704.87 2026-01-12
5124 APR_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy, Severe 10 5 — — $56,794.82 $59,634.56 $59,634.56 2026-01-12
231 MS_DRG Coronary Bypass With Ptca With Mcc 26 19 — — $54,703.15 $132,439.20 $59,593.15 2026-01-12
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 26 19 — — $54,672.80 $132,365.74 $59,560.10 2026-01-12
4012 APR_DRG Adrenal Procedures, Moderate 10 5 — — $56,555.66 $59,383.44 $59,383.44 2026-01-12
433 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies, M… 10 5 — — $56,327.98 $59,144.37 $59,144.37 2026-01-12
1302 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours, Moderate 10 5 — — $56,169.18 $58,977.63 $58,977.63 2026-01-12
6803 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms, Major 10 5 — — $56,139.52 $58,946.49 $58,946.49 2026-01-12
404 APR_DRG Spinal Disorders And Injuries, Severe 10 5 — — $56,138.56 $58,945.49 $58,945.49 2026-01-12
293 APR_DRG Other Percutaneous Intracranial Procedures, Major 10 5 — — $55,931.93 $58,728.52 $58,728.52 2026-01-12
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 26 19 — — $53,842.63 $130,355.84 $58,655.71 2026-01-12
E0738 HCPCS Upper Extremity Rehab 33 17 — — $48,169.35 $68,887.35 $58,528.35 2026-01-12
E0739 HCPCS Rehab Sys Active Assist Rt 33 17 — — $48,169.35 $68,887.35 $58,528.35 2026-01-12
7923 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment, Major 10 5 — — $55,275.67 $58,039.45 $58,039.45 2026-01-12
6813 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms, Major 10 5 — — $55,064.26 $57,817.47 $57,817.47 2026-01-12
4444 APR_DRG Renal Dialysis Access Device Procedures, Severe 10 5 — — $54,683.51 $57,417.69 $57,417.69 2026-01-12
2454 APR_DRG Inflammatory Bowel Disease, Severe 10 5 — — $54,605.07 $57,335.32 $57,335.32 2026-01-12
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly, Major 10 5 — — $54,058.83 $56,761.76 $56,761.76 2026-01-12
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 26 19 — — $52,038.32 $125,987.51 $56,690.12 2026-01-12
203 APR_DRG Open Craniotomy For Trauma, Major 10 5 — — $53,604.42 $56,284.64 $56,284.64 2026-01-12
3224 APR_DRG Shoulder And Elbow Joint Replacement, Severe 10 5 — — $53,471.45 $56,145.02 $56,145.02 2026-01-12
1632 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis, Moderate 10 5 — — $53,434.14 $56,105.84 $56,105.84 2026-01-12
2824 APR_DRG Disorders Of Pancreas Except Malignancy, Severe 10 5 — — $53,158.63 $55,816.56 $55,816.56 2026-01-12
10 MS_DRG Pancreas Transplant 19 18 — — $51,469.59 $124,610.60 $55,803.88 2026-01-12
J9600 HCPCS Porfimer Sodium Injection 45 25 — — $24,955.32 $86,468.09 $55,711.71 2026-01-12
4624 APR_DRG Nephritis And Nephrosis, Severe 10 5 — — $53,038.09 $55,689.99 $55,689.99 2026-01-12
273 APR_DRG Other Open Craniotomy, Major 10 5 — — $53,008.43 $55,658.85 $55,658.85 2026-01-12
7594 APR_DRG Eating Disorders, Severe 10 5 — — $52,992.17 $55,641.78 $55,641.78 2026-01-12
594 APR_DRG Anoxic And Other Severe Brain Damage, Severe 10 5 — — $52,952.95 $55,600.59 $55,600.59 2026-01-12
6504 APR_DRG Splenectomy, Severe 10 5 — — $52,868.76 $55,512.20 $55,512.20 2026-01-12
1793 APR_DRG Defibrillator Implants, Major 10 5 — — $52,866.85 $55,510.19 $55,510.19 2026-01-12
2634 APR_DRG Cholecystectomy, Severe 10 5 — — $52,840.07 $55,482.07 $55,482.07 2026-01-12
2613 APR_DRG Major Biliary Tract Procedures, Major 10 5 — — $52,757.79 $55,395.68 $55,395.68 2026-01-12
2264 APR_DRG Anal And Perineal Procedures, Severe 10 5 — — $52,686.05 $55,320.35 $55,320.35 2026-01-12
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 26 19 — — $50,458.66 $122,163.07 $54,969.24 2026-01-12
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 20 19 — — $51,174.57 $123,896.33 $54,945.33 2026-01-12
2074 APR_DRG Other Circulatory System Diagnoses, Severe 10 5 — — $52,229.73 $54,841.21 $54,841.21 2026-01-12
3054 APR_DRG Amputation Of Lower Limb Except Toes, Severe 10 5 — — $52,194.33 $54,804.05 $54,804.05 2026-01-12
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 26 19 — — $49,949.33 $120,929.95 $54,414.38 2026-01-12
1934 APR_DRG Acute And Subacute Endocarditis, Severe 10 5 — — $51,779.15 $54,368.11 $54,368.11 2026-01-12
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 10 5 — — $51,688.27 $54,272.68 $54,272.68 2026-01-12
4454 APR_DRG Other Bladder Procedures, Severe 10 5 — — $51,650.96 $54,233.51 $54,233.51 2026-01-12
1832 APR_DRG Percutaneous Structural Cardiac Procedures, Moderate 10 5 — — $51,359.19 $53,927.14 $53,927.14 2026-01-12
J7310 HCPCS Ganciclovir Long Act Implant 33 17 — — $44,142.72 $63,584.64 $53,863.68 2026-01-12
1663 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis, Major 10 5 — — $51,221.43 $53,782.50 $53,782.50 2026-01-12
6902 APR_DRG Acute Leukemia, Moderate 10 5 — — $51,216.65 $53,777.48 $53,777.48 2026-01-12
3814 APR_DRG Major Skin Disorders, Severe 10 5 — — $51,077.93 $53,631.83 $53,631.83 2026-01-12
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