Hospital

HENDRICK MEDICAL CENTER BROWNWOOD

Brownwood, TX · CCN 450587 · Rates published

15,391 distinct procedures filed

10 distinct payers

173,224 rate rows

2025-12-08 last MRF observed

Data quality

171,837 of 173,224 rate rows are consumer-grade (99.2%)

1,387 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 — reason	Rows
template filing: same amount across many unrelated codes — excluded	1,277
exceeds 10× this hospital's gross charge — excluded from medians	70
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	18
placeholder amount (≤ $0.02) — excluded from medians	17
per-diem day rate — not a per-procedure price	5

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://sthpiprd.blob.core.windows.net/machine-readable-files/8819/851941193-1184233785_hendrick-medical-center_standardcharges.csv
Found on page	https://search.hospitalpriceindex.com/hpi2/machineReadable/HendrickMedicalCenterBrownwood/8819
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-07-31
Content fingerprint	5001033bf76f1643… · 121,658,505 bytes · first seen 2026-05-09

Top 50 most expensive offerings

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

Code	Description	Payers	Min $	Max $	Avg median	vs national
J3391 HCPCS	Inj, Atidarsagene Autotemcel	1	$4,505,000.00	$4,505,000.00	$4,505,000.00	nat. median $4,505,000 1.0× median
J1411 HCPCS	Inj, Hemgenix, Per Tx Dose	4	$3,685,266.67	$4,284,000.00	$4,016,250.00	nat. median $3,710,000 1.1× median
J1413 HCPCS	Inj Delandistrogene Mox Rokl	4	$3,316,462.59	$3,916,800.00	$3,672,000.00	nat. median $3,324,572 1.1× median
J3394 HCPCS	Inj, Lovotibeglogene Autotem	4	$3,248,445.72	$3,794,400.00	$3,557,250.00	nat. median $3,286,000 1.1× median
J3393 HCPCS	Inj, Betibeglogene Autotemce	4	$2,945,740.00	$3,427,200.00	$3,213,000.00	nat. median $2,997,086 1.1× median
J3399 HCPCS	Inj Onase Abepar-xioi Treat	4	$2,455,110.61	$2,927,447.77	$2,744,482.29	nat. median $2,460,273 1.1× median
J3392 HCPCS	Inj, Exagamglogene Autotem	4	$2,332,000.00	$2,692,800.00	$2,524,500.00	nat. median $2,405,851 1.0× median
Q2057 HCPCS	Afamitresgene Autoleucel	5	$770,620.00	$1,749,307.40	$1,046,880.00	nat. median $809,151 1.3× median
5834 APR_DRG	Neonate With Ecmo	3	$810,332.46	$926,094.24	$926,094.24	nat. median $311,018 outlier · 3.0×
74 APR_DRG	Allogeneic Bone Marrow Transplant	3	$788,292.16	$900,905.33	$900,905.33	nat. median $175,480 outlier · 5.1×
5833 APR_DRG	Neonate With Ecmo	3	$686,159.74	$784,182.56	$784,182.56	nat. median $250,089 outlier · 3.1×
24 APR_DRG	Heart And/or Lung Transplant	3	$660,066.25	$754,361.42	$754,361.42	nat. median $243,231 outlier · 3.1×
Q2042 HCPCS	Tisagenlecleucel Car-pos T	5	$591,726.20	$1,343,218.48	$678,748.61	nat. median $691,418 1.0× median
Q2056 HCPCS	Ciltacabtagene Car-pos T	5	$565,868.95	$1,284,522.51	$661,582.01	nat. median $631,793 1.0× median
Q2055 HCPCS	Idecabtagene Vicleucel Car	5	$554,728.05	$1,265,111.71	$633,974.92	nat. median $610,161 1.0× median
Q2054 HCPCS	Lisocabtagene Mara Car Pos T	5	$542,310.27	$1,276,961.68	$619,783.16	nat. median $624,417 1.0× median
Q2041 HCPCS	Axicabtagene Ciloleucel Car+	5	$513,993.01	$1,210,432.49	$587,420.58	nat. median $588,565 1.0× median
5884 APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	3	$512,927.15	$586,202.46	$586,202.46	nat. median $254,667 outlier · 2.3×
Q2053 HCPCS	Brexucabtagene Car Pos T	5	$489,304.61	$1,110,721.46	$585,661.81	nat. median $577,541 1.0× median
1614 APR_DRG	Implantable Heart Assist Systems	3	$498,087.45	$569,242.80	$569,242.80	nat. median $209,486 outlier · 2.7×
94 APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	3	$466,629.51	$533,290.87	$533,290.87	nat. median $165,599 outlier · 3.2×
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	2	$310,449.91	$704,721.30	$507,585.60	nat. median $370,165 1.4× median
Q2058 HCPCS	Obecbtge Autol Up To 400 Mil	2	$278,250.00	$631,627.50	$454,938.75	nat. median $302,242 1.5× median
6304 APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	3	$381,651.99	$436,173.71	$436,173.71	nat. median $160,171 outlier · 2.7×
6094 APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	3	$378,269.88	$432,308.44	$432,308.44	nat. median $168,174 outlier · 2.6×
J3403 HCPCS	Revakinagene, Per Implant	2	$257,500.00	$584,525.00	$421,012.50	nat. median $265,000 1.6× median
5832 APR_DRG	Neonate With Ecmo	3	$341,897.73	$390,740.27	$390,740.27	nat. median $169,230 outlier · 2.3×
114 APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	3	$324,654.28	$371,033.46	$371,033.46	nat. median $119,243 outlier · 3.1×
2004 APR_DRG	Cardiac Structural And Valvular Disorders	3	$301,693.23	$344,792.27	$344,792.27	nat. median $28,828 outlier · 12.0×
5831 APR_DRG	Neonate With Ecmo	3	$301,047.76	$344,054.58	$344,054.58	nat. median $154,685 outlier · 2.2×
J3402 HCPCS	Inj. Remestemcel-l-rknd/ Td	2	$205,640.00	$466,802.80	$336,221.40	nat. median $209,736 1.6× median
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	2	$202,049.58	$458,652.55	$330,351.07	nat. median $261,939 1.3× median
73 APR_DRG	Allogeneic Bone Marrow Transplant	3	$278,158.20	$317,895.08	$317,895.08	nat. median $89,814 outlier · 3.5×
5883 APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	3	$275,219.91	$314,537.04	$314,537.04	nat. median $180,995 1.7× median
5882 APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	3	$273,962.02	$313,099.45	$313,099.45	nat. median $147,847 outlier · 2.1×
44 APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	3	$273,253.60	$312,289.82	$312,289.82	nat. median $127,600 outlier · 2.4×
8414 APR_DRG	Extensive Third Degree Burns With Skin Graft	3	$272,078.92	$310,947.34	$310,947.34	nat. median $165,646 1.9× median
6314 APR_DRG	Neonate Birth Weight > 2499 Grams With Other Major Procedure	3	$269,361.49	$307,841.70	$307,841.70	nat. median $147,677 outlier · 2.1×
8504 APR_DRG	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	3	$262,265.45	$299,731.94	$299,731.94	nat. median $67,813 outlier · 4.4×
5914 APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	3	$259,916.11	$297,046.98	$297,046.98	nat. median $168,361 1.8× median
1613 APR_DRG	Implantable Heart Assist Systems	3	$259,609.91	$296,697.04	$296,697.04	nat. median $127,938 outlier · 2.3×
5881 APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	3	$258,237.85	$295,128.97	$295,128.97	nat. median $120,928 outlier · 2.4×
14 APR_DRG	Liver Transplant And/or Intestinal Transplant	3	$236,447.21	$270,225.38	$270,225.38	nat. median $137,901 2.0× median
84 APR_DRG	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	3	$235,499.80	$269,142.62	$269,142.62	nat. median $79,228 outlier · 3.4×
6814 APR_DRG	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	3	$231,315.36	$264,360.41	$264,360.41	nat. median $69,072 outlier · 3.8×
1604 APR_DRG	Major Cardiothoracic Repair Of Heart Anomaly	3	$231,186.26	$264,212.87	$264,212.87	nat. median $101,315 outlier · 2.6×
93 APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	3	$229,254.08	$262,004.66	$262,004.66	nat. median $80,413 outlier · 3.3×
2464 APR_DRG	Gastrointestinal Vascular Insufficiency	3	$224,186.25	$256,212.85	$256,212.85	nat. median $20,493 outlier · 12.5×
6034 APR_DRG	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	3	$223,029.71	$254,891.10	$254,891.10	nat. median $109,499 outlier · 2.3×
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	2	$154,328.52	$350,325.74	$252,327.13	nat. median $205,166 1.2× median

Other procedures at this hospital

Browse this hospital's 15,391 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

6904	APR_DRG	Acute Leukemia	3	3	—	—	$151,879.39	$173,576.45	$173,576.45	2025-12-08
6903	APR_DRG	Acute Leukemia	3	3	—	—	$66,848.52	$76,398.31	$76,398.31	2025-12-08
850	MS_DRG	Acute Leukemia With Other Procedures	2	2	—	—	$63,576.00	$144,317.52	$103,946.76	2025-12-08
4013	APR_DRG	Adrenal Procedures	3	3	—	—	$74,018.19	$84,592.21	$84,592.21	2025-12-08
4014	APR_DRG	Adrenal Procedures	3	3	—	—	$66,190.24	$75,645.98	$75,645.98	2025-12-08
4012	APR_DRG	Adrenal Procedures	3	3	—	—	$63,074.85	$72,085.55	$72,085.55	2025-12-08
Q2057	HCPCS	Afamitresgene Autoleucel	5	5	—	—	$770,620.00	$1,749,307.40	$1,046,880.00	2025-12-08
74	APR_DRG	Allogeneic Bone Marrow Transplant	3	3	—	—	$788,292.16	$900,905.33	$900,905.33	2025-12-08
73	APR_DRG	Allogeneic Bone Marrow Transplant	3	3	—	—	$278,158.20	$317,895.08	$317,895.08	2025-12-08
72	APR_DRG	Allogeneic Bone Marrow Transplant	3	3	—	—	$186,891.22	$213,589.97	$213,589.97	2025-12-08
14	MS_DRG	Allogeneic Bone Marrow Transplant	2	2	—	—	$87,591.70	$198,833.16	$143,212.43	2025-12-08
71	APR_DRG	Allogeneic Bone Marrow Transplant	3	3	—	—	$122,719.58	$140,250.95	$140,250.95	2025-12-08
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	2	2	—	—	$50,835.89	$115,397.47	$83,116.68	2025-12-08
2334	APR_DRG	Appendectomy With Complex Principal Diagnosis	3	3	—	—	$73,176.39	$83,630.16	$83,630.16	2025-12-08
84	APR_DRG	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	3	3	—	—	$235,499.80	$269,142.62	$269,142.62	2025-12-08
83	APR_DRG	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	3	3	—	—	$159,180.28	$181,920.32	$181,920.32	2025-12-08
82	APR_DRG	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	3	3	—	—	$82,861.83	$94,699.24	$94,699.24	2025-12-08
81	APR_DRG	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	3	3	—	—	$69,401.65	$79,316.17	$79,316.17	2025-12-08
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	2	2	—	—	$44,055.37	$100,005.69	$72,030.53	2025-12-08
Q2041	HCPCS	Axicabtagene Ciloleucel Car+	5	5	—	—	$513,993.01	$1,210,432.49	$587,420.58	2025-12-08
494	APR_DRG	Bacterial And Tuberculous Infections Of Nervous System	3	3	—	—	$67,512.14	$77,156.74	$77,156.74	2025-12-08
K1007	HCPCS	Bil Hkaf Pc S/d Micro Sensor	2	2	—	—	$111,860.04	$253,922.29	$182,891.16	2025-12-08
Q2053	HCPCS	Brexucabtagene Car Pos T	5	5	—	—	$489,304.61	$1,110,721.46	$585,661.81	2025-12-08
8424	APR_DRG	Burns With Skin Graft Except Extensive Third Degree Burns	3	3	—	—	$92,817.20	$106,076.80	$106,076.80	2025-12-08
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	2	2	—	—	$52,641.50	$119,496.21	$86,068.86	2025-12-08
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	2	2	—	—	$44,605.29	$101,254.01	$72,929.65	2025-12-08
2004	APR_DRG	Cardiac Structural And Valvular Disorders	3	3	—	—	$301,693.23	$344,792.27	$344,792.27	2025-12-08
1624	APR_DRG	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	3	3	—	—	$201,671.17	$230,481.34	$230,481.34	2025-12-08
1623	APR_DRG	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	3	3	—	—	$113,469.44	$129,679.36	$129,679.36	2025-12-08
1622	APR_DRG	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	3	3	—	—	$84,728.93	$96,833.06	$96,833.06	2025-12-08
1621	APR_DRG	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	3	3	—	—	$75,178.98	$85,918.84	$85,918.84	2025-12-08
1634	APR_DRG	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	3	3	—	—	$120,194.19	$137,364.79	$137,364.79	2025-12-08
1633	APR_DRG	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	3	3	—	—	$80,497.55	$91,997.20	$91,997.20	2025-12-08
2054	APR_DRG	Cardiomyopathy	3	3	—	—	$117,864.05	$134,701.78	$134,701.78	2025-12-08
33289	CPT	Cc-imp Press Sen Ang	20	10	$137,712.69	$137,712.69	$4,353.00	$123,941.42	$93,231.49	2025-12-08
3214	APR_DRG	Cervical Spinal Fusion And Other Back Or Neck Procedures Except Disc Excision Or…	3	3	—	—	$64,354.08	$73,547.52	$73,547.52	2025-12-08
C1822	HCPCS	Charger Kit (l54705)	15	10	$212,445.35	$212,445.35	$96,450.19	$191,200.82	$150,836.20	2025-12-08
6954	APR_DRG	Chemotherapy For Acute Leukemia	3	3	—	—	$117,712.56	$134,528.64	$134,528.64	2025-12-08
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	2	2	—	—	$310,449.91	$704,721.30	$507,585.60	2025-12-08
114	APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	3	3	—	—	$324,654.28	$371,033.46	$371,033.46	2025-12-08
113	APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	3	3	—	—	$184,485.33	$210,840.37	$210,840.37	2025-12-08
112	APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	3	3	—	—	$128,205.65	$146,520.74	$146,520.74	2025-12-08
111	APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	3	3	—	—	$72,909.66	$83,325.32	$83,325.32	2025-12-08
Q2056	HCPCS	Ciltacabtagene Car-pos T	5	5	—	—	$565,868.95	$1,284,522.51	$661,582.01	2025-12-08
6614	APR_DRG	Coagulation And Platelet Disorders	3	3	—	—	$79,608.81	$90,981.49	$90,981.49	2025-12-08
6613	APR_DRG	Coagulation And Platelet Disorders	3	3	—	—	$65,270.56	$74,594.93	$74,594.93	2025-12-08
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	2	2	—	—	$66,079.54	$150,000.56	$108,040.05	2025-12-08
209	MS_DRG	Complex Aortic Arch Procedures	2	2	—	—	$82,592.48	$187,484.93	$135,038.70	2025-12-08
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	2	2	—	—	$79,412.46	$180,266.28	$129,839.37	2025-12-08
317	MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	2	2	—	—	$49,467.20	$112,290.54	$80,878.87	2025-12-08
3464	APR_DRG	Connective Tissue Disorders	3	3	—	—	$71,635.77	$81,869.45	$81,869.45	2025-12-08
1654	APR_DRG	Coronary Bypass With Ami Or Complex Principal Diagnosis	3	3	—	—	$103,955.78	$118,806.60	$118,806.60	2025-12-08
1653	APR_DRG	Coronary Bypass With Ami Or Complex Principal Diagnosis	3	3	—	—	$68,348.61	$78,112.69	$78,112.69	2025-12-08
1664	APR_DRG	Coronary Bypass Without Ami Or Complex Principal Diagnosis	3	3	—	—	$80,338.58	$91,815.52	$91,815.52	2025-12-08
9104	APR_DRG	Craniotomy For Multiple Significant Trauma	3	3	—	—	$129,874.30	$148,427.77	$148,427.77	2025-12-08
1794	APR_DRG	Defibrillator Implants	3	3	—	—	$76,893.52	$87,878.30	$87,878.30	2025-12-08
3044	APR_DRG	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	3	3	—	—	$118,198.00	$135,083.42	$135,083.42	2025-12-08
3043	APR_DRG	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	3	3	—	—	$74,010.72	$84,583.68	$84,583.68	2025-12-08
3034	APR_DRG	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	3	3	—	—	$142,279.31	$162,604.92	$162,604.92	2025-12-08
3033	APR_DRG	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	3	3	—	—	$120,362.77	$137,557.45	$137,557.45	2025-12-08
3032	APR_DRG	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	3	3	—	—	$87,328.99	$99,804.56	$99,804.56	2025-12-08
3031	APR_DRG	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	3	3	—	—	$64,332.74	$73,523.14	$73,523.14	2025-12-08
Q0480	HCPCS	Driver Pneumatic Vad, Rep	2	2	—	—	$129,537.54	$294,050.22	$211,793.88	2025-12-08
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	6	3	—	—	$97,902.51	$348,291.78	$100,569.86	2025-12-08
L7181	HCPCS	Electronic Elbo Simultaneous	2	2	—	—	$57,614.51	$130,784.94	$94,199.73	2025-12-08
L7180	HCPCS	Electronic Elbow Sequential	2	2	—	—	$52,277.90	$118,670.83	$85,474.36	2025-12-08
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	2	2	—	—	$45,476.27	$103,231.13	$74,353.70	2025-12-08
L8702	HCPCS	Ewhf S/d Uprt Micro Sensor	2	2	—	—	$80,943.19	$183,741.04	$132,342.11	2025-12-08
9114	APR_DRG	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	3	3	—	—	$110,030.78	$125,749.46	$125,749.46	2025-12-08
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	2	2	—	—	$154,328.52	$350,325.74	$252,327.13	2025-12-08
9504	APR_DRG	Extensive O.r. Procedure Unrelated To Principal Diagnosis	3	3	—	—	$126,018.48	$144,021.12	$144,021.12	2025-12-08
7924	APR_DRG	Extensive O.r. Procedures For Other Complications Of Treatment	3	3	—	—	$118,226.81	$135,116.35	$135,116.35	2025-12-08
7923	APR_DRG	Extensive O.r. Procedures For Other Complications Of Treatment	3	3	—	—	$61,647.33	$70,454.09	$70,454.09	2025-12-08
8414	APR_DRG	Extensive Third Degree Burns With Skin Graft	3	3	—	—	$272,078.92	$310,947.34	$310,947.34	2025-12-08
8413	APR_DRG	Extensive Third Degree Burns With Skin Graft	3	3	—	—	$117,592.00	$134,390.86	$134,390.86	2025-12-08
8412	APR_DRG	Extensive Third Degree Burns With Skin Graft	3	3	—	—	$76,415.54	$87,332.04	$87,332.04	2025-12-08
8411	APR_DRG	Extensive Third Degree Burns With Skin Graft	3	3	—	—	$75,821.27	$86,652.88	$86,652.88	2025-12-08
1784	APR_DRG	External Heart Assist Systems	3	3	—	—	$156,492.72	$178,848.83	$178,848.83	2025-12-08
1783	APR_DRG	External Heart Assist Systems	3	3	—	—	$100,146.89	$114,453.59	$114,453.59	2025-12-08
1782	APR_DRG	External Heart Assist Systems	3	3	—	—	$85,952.67	$98,231.63	$98,231.63	2025-12-08
1781	APR_DRG	External Heart Assist Systems	3	3	—	—	$78,791.56	$90,047.50	$90,047.50	2025-12-08
94	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	3	3	—	—	$466,629.51	$533,290.87	$533,290.87	2025-12-08
93	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	3	3	—	—	$229,254.08	$262,004.66	$262,004.66	2025-12-08
92	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	3	3	—	—	$150,779.40	$172,319.32	$172,319.32	2025-12-08
91	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	3	3	—	—	$146,225.81	$167,115.22	$167,115.22	2025-12-08
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	2	2	—	—	$44,154.06	$100,229.72	$72,191.89	2025-12-08
924	APR_DRG	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	3	3	—	—	$81,396.96	$93,025.09	$93,025.09	2025-12-08
923	APR_DRG	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	3	3	—	—	$78,509.89	$89,725.58	$89,725.58	2025-12-08
5144	APR_DRG	Female Reproductive System Reconstructive Procedures	3	3	—	—	$63,471.74	$72,539.14	$72,539.14	2025-12-08
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	2	2	—	—	$52,943.99	$120,182.86	$86,563.42	2025-12-08
2464	APR_DRG	Gastrointestinal Vascular Insufficiency	3	3	—	—	$224,186.25	$256,212.85	$256,212.85	2025-12-08
C1767	HCPCS	Generator C - Implant-nonrecharg	85	10	$164,954.88	$164,954.88	$3,550.32	$297,079.48	$129,863.13	2025-12-08
C1820	HCPCS	Generator Restore And Recharger Sys	35	10	$192,924.61	$192,924.61	$57,206.48	$175,315.24	$135,047.23	2025-12-08
C1882	HCPCS	Generator, Cardiac Resynch	155	10	$201,228.27	$201,228.27	$50,995.88	$229,954.96	$148,908.92	2025-12-08
24	APR_DRG	Heart And/or Lung Transplant	3	3	—	—	$660,066.25	$754,361.42	$754,361.42	2025-12-08
23	APR_DRG	Heart And/or Lung Transplant	3	3	—	—	$162,574.13	$185,799.00	$185,799.00	2025-12-08
22	APR_DRG	Heart And/or Lung Transplant	3	3	—	—	$130,600.87	$149,258.14	$149,258.14	2025-12-08
21	APR_DRG	Heart And/or Lung Transplant	3	3	—	—	$101,159.39	$115,610.74	$115,610.74	2025-12-08
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	2	2	—	—	$202,049.58	$458,652.55	$330,351.07	2025-12-08
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	2	2	—	—	$82,685.46	$187,695.99	$135,190.73	2025-12-08
8104	APR_DRG	Hemorrhage Or Hematoma Due To Complication	3	3	—	—	$68,321.94	$78,082.21	$78,082.21	2025-12-08
2274	APR_DRG	Hernia Procedures Except Inguinal, Femoral And Umbilical	3	3	—	—	$93,247.16	$106,568.18	$106,568.18	2025-12-08
3084	APR_DRG	Hip And Femur Fracture Repair	3	3	—	—	$63,960.39	$73,097.59	$73,097.59	2025-12-08
C1721	HCPCS	Icd-dual St-j Ellipse- (41271,41326)	115	10	$163,158.06	$163,158.06	$50,583.15	$170,337.01	$121,824.68	2025-12-08
C1722	HCPCS	Icd-single Medtronic-(45551-45553)	105	10	$157,115.17	$157,115.17	$44,677.47	$170,337.01	$112,483.78	2025-12-08
Q2055	HCPCS	Idecabtagene Vicleucel Car	5	5	—	—	$554,728.05	$1,265,111.71	$633,974.92	2025-12-08
1614	APR_DRG	Implantable Heart Assist Systems	3	3	—	—	$498,087.45	$569,242.80	$569,242.80	2025-12-08
1613	APR_DRG	Implantable Heart Assist Systems	3	3	—	—	$259,609.91	$296,697.04	$296,697.04	2025-12-08
1612	APR_DRG	Implantable Heart Assist Systems	3	3	—	—	$186,619.16	$213,279.04	$213,279.04	2025-12-08
1611	APR_DRG	Implantable Heart Assist Systems	3	3	—	—	$176,991.33	$202,275.80	$202,275.80	2025-12-08
7104	APR_DRG	Infectious And Parasitic Diseases Including HIV With O.r. Procedure	3	3	—	—	$85,806.51	$98,064.59	$98,064.59	2025-12-08
J1413	HCPCS	Inj Delandistrogene Mox Rokl	4	4	—	—	$3,316,462.59	$3,916,800.00	$3,672,000.00	2025-12-08
J3399	HCPCS	Inj Onase Abepar-xioi Treat	4	4	—	—	$2,455,110.61	$2,927,447.77	$2,744,482.29	2025-12-08
J1412	HCPCS	Inj Roctavian Ml 2x10^13vc G	5	5	—	—	$12,553.71	$114,254.28	$99,972.50	2025-12-08
J3391	HCPCS	Inj, Atidarsagene Autotemcel	1	1	—	—	$4,505,000.00	$4,505,000.00	$4,505,000.00	2025-12-08
J3393	HCPCS	Inj, Betibeglogene Autotemce	4	4	—	—	$2,945,740.00	$3,427,200.00	$3,213,000.00	2025-12-08
J3392	HCPCS	Inj, Exagamglogene Autotem	4	4	—	—	$2,332,000.00	$2,692,800.00	$2,524,500.00	2025-12-08
J1411	HCPCS	Inj, Hemgenix, Per Tx Dose	4	4	—	—	$3,685,266.67	$4,284,000.00	$4,016,250.00	2025-12-08
J3394	HCPCS	Inj, Lovotibeglogene Autotem	4	4	—	—	$3,248,445.72	$3,794,400.00	$3,557,250.00	2025-12-08
J3402	HCPCS	Inj. Remestemcel-l-rknd/ Td	2	2	—	—	$205,640.00	$466,802.80	$336,221.40	2025-12-08
33240	CPT	Insert Icd Dual (cath Lab)	20	10	$106,468.53	$106,468.53	$4,353.00	$95,821.68	$72,079.20	2025-12-08
33249	CPT	Insert Icd Single System (cath Lab)	20	10	$151,748.40	$151,748.40	$4,353.00	$136,573.56	$102,733.66	2025-12-08
1764	APR_DRG	Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices	3	3	—	—	$78,046.85	$89,196.40	$89,196.40	2025-12-08
J9029	HCPCS	Instill Adstiladrin, Tx Dose	2	2	—	—	$63,342.28	$143,786.98	$103,564.63	2025-12-08
3104	APR_DRG	Intervertebral Disc Excision And Decompression	3	3	—	—	$73,226.54	$83,687.47	$83,687.47	2025-12-08
4424	APR_DRG	Kidney And Urinary Tract Procedures For Malignancy	3	3	—	—	$111,731.43	$127,693.07	$127,693.07	2025-12-08
4434	APR_DRG	Kidney And Urinary Tract Procedures For Non-malignancy	3	3	—	—	$70,871.86	$80,996.41	$80,996.41	2025-12-08
4404	APR_DRG	Kidney Transplant	3	3	—	—	$176,553.90	$201,775.88	$201,775.88	2025-12-08
4403	APR_DRG	Kidney Transplant	3	3	—	—	$108,059.12	$123,496.14	$123,496.14	2025-12-08
4402	APR_DRG	Kidney Transplant	3	3	—	—	$69,501.94	$79,430.78	$79,430.78	2025-12-08
4401	APR_DRG	Kidney Transplant	3	3	—	—	$65,150.00	$74,457.14	$74,457.14	2025-12-08
3134	APR_DRG	Knee And Lower Leg Procedures Except Foot	3	3	—	—	$70,087.68	$80,100.20	$80,100.20	2025-12-08
Q2054	HCPCS	Lisocabtagene Mara Car Pos T	5	5	—	—	$542,310.27	$1,276,961.68	$619,783.16	2025-12-08
14	APR_DRG	Liver Transplant And/or Intestinal Transplant	3	3	—	—	$236,447.21	$270,225.38	$270,225.38	2025-12-08
13	APR_DRG	Liver Transplant And/or Intestinal Transplant	3	3	—	—	$121,823.37	$139,226.71	$139,226.71	2025-12-08
12	APR_DRG	Liver Transplant And/or Intestinal Transplant	3	3	—	—	$93,571.51	$106,938.86	$106,938.86	2025-12-08
11	APR_DRG	Liver Transplant And/or Intestinal Transplant	3	3	—	—	$90,058.16	$102,923.62	$102,923.62	2025-12-08
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	2	2	—	—	$75,382.19	$171,117.57	$123,249.88	2025-12-08
1814	APR_DRG	Lower Extremity Arterial Procedures	3	3	—	—	$93,533.10	$106,894.97	$106,894.97	2025-12-08
7	MS_DRG	Lung Transplant	2	2	—	—	$94,258.52	$213,966.84	$154,112.68	2025-12-08
6944	APR_DRG	Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior	3	3	—	—	$82,393.46	$94,163.95	$94,163.95	2025-12-08
6914	APR_DRG	Lymphoma, Myeloma And Non-acute Leukemia	3	3	—	—	$83,236.31	$95,127.22	$95,127.22	2025-12-08
1694	APR_DRG	Major Abdominal Vascular Procedures	3	3	—	—	$107,684.64	$123,068.16	$123,068.16	2025-12-08
2614	APR_DRG	Major Biliary Tract Procedures	3	3	—	—	$89,015.79	$101,732.33	$101,732.33	2025-12-08
4414	APR_DRG	Major Bladder Procedures	3	3	—	—	$167,083.97	$190,953.11	$190,953.11	2025-12-08
1604	APR_DRG	Major Cardiothoracic Repair Of Heart Anomaly	3	3	—	—	$231,186.26	$264,212.87	$264,212.87	2025-12-08
1603	APR_DRG	Major Cardiothoracic Repair Of Heart Anomaly	3	3	—	—	$97,697.26	$111,654.01	$111,654.01	2025-12-08
1602	APR_DRG	Major Cardiothoracic Repair Of Heart Anomaly	3	3	—	—	$67,882.36	$77,579.84	$77,579.84	2025-12-08
894	APR_DRG	Major Cranial Or Facial Bone Procedures	3	3	—	—	$105,693.78	$120,792.89	$120,792.89	2025-12-08
6604	APR_DRG	Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula…	3	3	—	—	$92,940.96	$106,218.24	$106,218.24	2025-12-08
2314	APR_DRG	Major Large Bowel Procedures	3	3	—	—	$68,421.16	$78,195.61	$78,195.61	2025-12-08
4804	APR_DRG	Major Male Pelvic Procedures	3	3	—	—	$72,493.56	$82,849.79	$82,849.79	2025-12-08
6804	APR_DRG	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	3	3	—	—	$171,154.25	$195,604.86	$195,604.86	2025-12-08
6803	APR_DRG	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	3	3	—	—	$62,610.74	$71,555.14	$71,555.14	2025-12-08
2604	APR_DRG	Major Pancreas, Liver And Shunt Procedures	3	3	—	—	$101,333.31	$115,809.49	$115,809.49	2025-12-08
1204	APR_DRG	Major Respiratory And Chest Procedures	3	3	—	—	$107,247.20	$122,568.23	$122,568.23	2025-12-08
2304	APR_DRG	Major Small Bowel Procedures	3	3	—	—	$112,791.96	$128,905.09	$128,905.09	2025-12-08
2204	APR_DRG	Major Stomach, Esophageal And Duodenal Procedures	3	3	—	—	$133,342.84	$152,391.82	$152,391.82	2025-12-08
7404	APR_DRG	Mental Illness Diagnosis With O.r. Procedure	3	3	—	—	$74,296.65	$84,910.45	$84,910.45	2025-12-08
Q4130	HCPCS	Mesh Strattice Impl Per Sq Cm [20x25] Lawson 37931	55	10	$126,819.36	$126,819.36	$9,338.63	$178,351.07	$101,455.49	2025-12-08
9514	APR_DRG	Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis	3	3	—	—	$87,883.79	$100,438.62	$100,438.62	2025-12-08
7934	APR_DRG	Moderately Extensive O.r. Procedures For Other Complications Of Treatment	3	3	—	—	$64,375.42	$73,571.90	$73,571.90	2025-12-08
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	2	2	—	—	$80,464.38	$182,654.14	$131,559.26	2025-12-08
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	2	2	—	—	$53,272.22	$120,927.94	$87,100.08	2025-12-08
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	2	2	—	—	$49,432.15	$112,210.98	$80,821.57	2025-12-08
434	APR_DRG	Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies	3	3	—	—	$150,949.04	$172,513.19	$172,513.19	2025-12-08
433	APR_DRG	Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies	3	3	—	—	$62,820.93	$71,795.35	$71,795.35	2025-12-08
9124	APR_DRG	Musculoskeletal And Other Procedures For Multiple Significant Trauma	3	3	—	—	$105,554.01	$120,633.16	$120,633.16	2025-12-08
8634	APR_DRG	Neonatal Aftercare	3	3	—	—	$181,623.87	$207,570.13	$207,570.13	2025-12-08
6034	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	3	3	—	—	$223,029.71	$254,891.10	$254,891.10	2025-12-08
6033	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	3	3	—	—	$85,053.27	$97,203.73	$97,203.73	2025-12-08
6032	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	3	3	—	—	$68,128.82	$77,861.51	$77,861.51	2025-12-08
6024	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	3	3	—	—	$198,361.61	$226,698.98	$226,698.98	2025-12-08
6023	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	3	3	—	—	$128,200.32	$146,514.65	$146,514.65	2025-12-08
6022	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	3	3	—	—	$96,861.87	$110,699.28	$110,699.28	2025-12-08
6084	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	3	3	—	—	$170,668.81	$195,050.06	$195,050.06	2025-12-08
6083	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	3	3	—	—	$67,640.17	$77,303.05	$77,303.05	2025-12-08
6074	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	3	3	—	—	$139,932.09	$159,922.39	$159,922.39	2025-12-08
6073	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	3	3	—	—	$88,697.85	$101,368.97	$101,368.97	2025-12-08
6072	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	3	3	—	—	$63,814.22	$72,930.54	$72,930.54	2025-12-08
6134	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	3	3	—	—	$132,616.27	$151,561.45	$151,561.45	2025-12-08
6114	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	3	3	—	—	$153,936.39	$175,927.31	$175,927.31	2025-12-08
6144	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	3	3	—	—	$113,662.55	$129,900.06	$129,900.06	2025-12-08
6124	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	3	3	—	—	$98,632.95	$112,723.37	$112,723.37	2025-12-08
6094	APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	3	3	—	—	$378,269.88	$432,308.44	$432,308.44	2025-12-08
6093	APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	3	3	—	—	$121,679.34	$139,062.11	$139,062.11	2025-12-08
6234	APR_DRG	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	3	3	—	—	$92,921.76	$106,196.29	$106,196.29	2025-12-08
6214	APR_DRG	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	3	3	—	—	$188,366.77	$215,276.30	$215,276.30	2025-12-08
6254	APR_DRG	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	3	3	—	—	$98,917.81	$113,048.93	$113,048.93	2025-12-08
5914	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	3	3	—	—	$259,916.11	$297,046.98	$297,046.98	2025-12-08
5913	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	3	3	—	—	$171,154.25	$195,604.86	$195,604.86	2025-12-08
5912	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	3	3	—	—	$141,314.82	$161,502.65	$161,502.65	2025-12-08
5911	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	3	3	—	—	$101,889.17	$116,444.76	$116,444.76	2025-12-08
5934	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	3	3	—	—	$215,778.97	$246,604.54	$246,604.54	2025-12-08
5933	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	3	3	—	—	$154,113.51	$176,129.72	$176,129.72	2025-12-08
5932	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	3	3	—	—	$121,080.80	$138,378.06	$138,378.06	2025-12-08
5884	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	3	3	—	—	$512,927.15	$586,202.46	$586,202.46	2025-12-08
5883	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	3	3	—	—	$275,219.91	$314,537.04	$314,537.04	2025-12-08
5882	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	3	3	—	—	$273,962.02	$313,099.45	$313,099.45	2025-12-08
5881	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	3	3	—	—	$258,237.85	$295,128.97	$295,128.97	2025-12-08
5891	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	3	3	—	—	$216,426.59	$247,344.67	$247,344.67	2025-12-08
5892	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	3	3	—	—	$209,761.58	$239,727.52	$239,727.52	2025-12-08
5893	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	3	3	—	—	$196,751.64	$224,859.01	$224,859.01	2025-12-08
6334	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Anomaly	3	3	—	—	$143,152.03	$163,602.32	$163,602.32	2025-12-08
6304	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	3	3	—	—	$381,651.99	$436,173.71	$436,173.71	2025-12-08
6303	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	3	3	—	—	$179,879.47	$205,576.54	$205,576.54	2025-12-08
6302	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	3	3	—	—	$64,930.22	$74,205.96	$74,205.96	2025-12-08
6314	APR_DRG	Neonate Birth Weight > 2499 Grams With Other Major Procedure	3	3	—	—	$269,361.49	$307,841.70	$307,841.70	2025-12-08
6313	APR_DRG	Neonate Birth Weight > 2499 Grams With Other Major Procedure	3	3	—	—	$99,723.33	$113,969.52	$113,969.52	2025-12-08
6344	APR_DRG	Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…	3	3	—	—	$72,801.91	$83,202.18	$83,202.18	2025-12-08
5834	APR_DRG	Neonate With Ecmo	3	3	—	—	$810,332.46	$926,094.24	$926,094.24	2025-12-08
5833	APR_DRG	Neonate With Ecmo	3	3	—	—	$686,159.74	$784,182.56	$784,182.56	2025-12-08
5832	APR_DRG	Neonate With Ecmo	3	3	—	—	$341,897.73	$390,740.27	$390,740.27	2025-12-08
5831	APR_DRG	Neonate With Ecmo	3	3	—	—	$301,047.76	$344,054.58	$344,054.58	2025-12-08
504	APR_DRG	Non-bacterial Infections Of Nervous System Except Viral Meningitis	3	3	—	—	$86,446.66	$98,796.18	$98,796.18	2025-12-08
3254	APR_DRG	Non-elective Or Complex Knee Joint Replacement	3	3	—	—	$66,051.54	$75,487.48	$75,487.48	2025-12-08
9524	APR_DRG	Non-extensive O.r. Procedure Unrelated To Principal Diagnosis	3	3	—	—	$111,045.42	$126,909.05	$126,909.05	2025-12-08
Q2058	HCPCS	Obecbtge Autol Up To 400 Mil	2	2	—	—	$278,250.00	$631,627.50	$454,938.75	2025-12-08
214	APR_DRG	Open Craniotomy Except Trauma	3	3	—	—	$113,200.57	$129,372.08	$129,372.08	2025-12-08
213	APR_DRG	Open Craniotomy Except Trauma	3	3	—	—	$64,787.25	$74,042.57	$74,042.57	2025-12-08
204	APR_DRG	Open Craniotomy For Trauma	3	3	—	—	$95,090.79	$108,675.19	$108,675.19	2025-12-08
244	APR_DRG	Open Extracranial Vascular Procedures	3	3	—	—	$64,222.85	$73,397.54	$73,397.54	2025-12-08
734	APR_DRG	Orbit And Eye Procedures	3	3	—	—	$70,641.41	$80,733.04	$80,733.04	2025-12-08
6814	APR_DRG	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	3	3	—	—	$231,315.36	$264,360.41	$264,360.41	2025-12-08
6813	APR_DRG	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	3	3	—	—	$61,411.54	$70,184.62	$70,184.62	2025-12-08
1674	APR_DRG	Other Cardiothoracic And Thoracic Vascular Procedures	3	3	—	—	$153,255.71	$175,149.38	$175,149.38	2025-12-08
1673	APR_DRG	Other Cardiothoracic And Thoracic Vascular Procedures	3	3	—	—	$66,571.12	$76,081.28	$76,081.28	2025-12-08
1804	APR_DRG	Other Circulatory System Procedures	3	3	—	—	$70,836.64	$80,956.16	$80,956.16	2025-12-08
1801	APR_DRG	Other Circulatory System Procedures	3	3	—	—	$64,175.91	$73,343.89	$73,343.89	2025-12-08
984	APR_DRG	Other Ear, Nose, Mouth And Throat Procedures	3	3	—	—	$68,682.55	$78,494.34	$78,494.34	2025-12-08
215	MS_DRG	Other Heart Assist System Implant	6	3	—	—	$72,854.33	$165,379.33	$122,168.71	2025-12-08
2644	APR_DRG	Other Hepatobiliary, Pancreas And Abdominal Procedures	3	3	—	—	$75,422.25	$86,196.85	$86,196.85	2025-12-08
8154	APR_DRG	Other Injury, Poisoning And Toxic Effect Diagnoses	3	3	—	—	$69,463.53	$79,386.89	$79,386.89	2025-12-08
4684	APR_DRG	Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms	3	3	—	—	$70,285.06	$80,325.78	$80,325.78	2025-12-08
4474	APR_DRG	Other Kidney, Urinary Tract And Related Procedures	3	3	—	—	$132,305.80	$151,206.62	$151,206.62	2025-12-08
914	APR_DRG	Other Major Head And Neck Procedures	3	3	—	—	$96,071.28	$109,795.75	$109,795.75	2025-12-08
913	APR_DRG	Other Major Head And Neck Procedures	3	3	—	—	$68,930.07	$78,777.23	$78,777.23	2025-12-08
4844	APR_DRG	Other Male Reproductive System And Related Procedures	3	3	—	—	$67,694.59	$77,365.25	$77,365.25	2025-12-08
264	APR_DRG	Other Nervous System And Related Procedures	3	3	—	—	$121,605.72	$138,977.96	$138,977.96	2025-12-08
274	APR_DRG	Other Open Craniotomy	3	3	—	—	$65,192.67	$74,505.91	$74,505.91	2025-12-08
294	APR_DRG	Other Percutaneous Intracranial Procedures	3	3	—	—	$70,783.30	$80,895.20	$80,895.20	2025-12-08
293	APR_DRG	Other Percutaneous Intracranial Procedures	3	3	—	—	$62,379.23	$71,290.55	$71,290.55	2025-12-08
1824	APR_DRG	Other Peripheral Vascular Procedures	3	3	—	—	$120,265.68	$137,446.49	$137,446.49	2025-12-08
4054	APR_DRG	Other Procedures For Endocrine, Nutritional And Metabolic Disorders	3	3	—	—	$66,429.23	$75,919.12	$75,919.12	2025-12-08
6514	APR_DRG	Other Procedures Of Blood And Blood-forming Organs	3	3	—	—	$115,228.79	$131,690.04	$131,690.04	2025-12-08
1214	APR_DRG	Other Respiratory And Chest Procedures	3	3	—	—	$100,089.28	$114,387.74	$114,387.74	2025-12-08
2234	APR_DRG	Other Small And Large Bowel Procedures	3	3	—	—	$83,751.63	$95,716.15	$95,716.15	2025-12-08
2224	APR_DRG	Other Stomach, Esophageal And Duodenal Procedures	3	3	—	—	$63,416.26	$72,475.73	$72,475.73	2025-12-08
64	APR_DRG	Pancreas Transplant	3	3	—	—	$216,443.65	$247,364.17	$247,364.17	2025-12-08
63	APR_DRG	Pancreas Transplant	3	3	—	—	$139,874.48	$159,856.55	$159,856.55	2025-12-08
62	APR_DRG	Pancreas Transplant	3	3	—	—	$126,514.59	$144,588.11	$144,588.11	2025-12-08
61	APR_DRG	Pancreas Transplant	3	3	—	—	$124,881.15	$142,721.32	$142,721.32	2025-12-08
10	MS_DRG	Pancreas Transplant	2	2	—	—	$52,965.44	$120,231.55	$86,598.49	2025-12-08
5104	APR_DRG	Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…	3	3	—	—	$74,370.26	$84,994.58	$84,994.58	2025-12-08
4834	APR_DRG	Penis, Testes And Scrotal Procedures	3	3	—	—	$106,839.64	$122,102.45	$122,102.45	2025-12-08
1754	APR_DRG	Percutaneous Cardiac Intervention Without Ami	3	3	—	—	$68,820.18	$78,651.64	$78,651.64	2025-12-08
304	APR_DRG	Percutaneous Intracranial And Extracranial Vascular Procedures	3	3	—	—	$71,872.63	$82,140.14	$82,140.14	2025-12-08
1834	APR_DRG	Percutaneous Structural Cardiac Procedures	3	3	—	—	$90,450.78	$103,372.32	$103,372.32	2025-12-08
1833	APR_DRG	Percutaneous Structural Cardiac Procedures	3	3	—	—	$88,229.47	$100,833.68	$100,833.68	2025-12-08
2244	APR_DRG	Peritoneal Adhesiolysis	3	3	—	—	$97,541.49	$111,475.99	$111,475.99	2025-12-08
1704	APR_DRG	Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock	3	3	—	—	$67,110.99	$76,698.28	$76,698.28	2025-12-08
1714	APR_DRG	Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock	3	3	—	—	$76,011.18	$86,869.92	$86,869.92	2025-12-08
C1605	HCPCS	Pmkr, Dual, Leadless [cath]	15	10	$214,748.31	$214,748.31	$97,495.73	$193,273.48	$152,471.30	2025-12-08
7114	APR_DRG	Post-operative, Post-trauma, Other Device Infections With O.r. Procedure	3	3	—	—	$72,060.40	$82,354.74	$82,354.74	2025-12-08
8504	APR_DRG	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	3	3	—	—	$262,265.45	$299,731.94	$299,731.94	2025-12-08
C1772	HCPCS	Pump Medtronic	25	10	$135,465.07	$135,465.07	$31,332.87	$121,918.56	$91,709.85	2025-12-08
6924	APR_DRG	Radiotherapy	3	3	—	—	$68,772.18	$78,596.77	$78,596.77	2025-12-08
33264	CPT	Remv&replc Cvd Gen Mult Lead - Cl	20	10	$151,748.40	$151,748.40	$4,353.00	$136,573.56	$102,733.66	2025-12-08
33262	CPT	Remv&replc Cvd Gen Sing Lead - Cl	20	10	$106,468.53	$106,468.53	$4,353.00	$95,821.68	$72,079.20	2025-12-08
1304	APR_DRG	Respiratory System Diagnosis With Ventilator Support > 96 Hours	3	3	—	—	$105,527.34	$120,602.68	$120,602.68	2025-12-08
1303	APR_DRG	Respiratory System Diagnosis With Ventilator Support > 96 Hours	3	3	—	—	$71,653.90	$81,890.17	$81,890.17	2025-12-08
1302	APR_DRG	Respiratory System Diagnosis With Ventilator Support > 96 Hours	3	3	—	—	$62,643.82	$71,592.94	$71,592.94	2025-12-08
J3403	HCPCS	Revakinagene, Per Implant	2	2	—	—	$257,500.00	$584,525.00	$421,012.50	2025-12-08
3154	APR_DRG	Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement	3	3	—	—	$108,051.66	$123,487.61	$123,487.61	2025-12-08
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	2	2	—	—	$52,671.54	$119,564.40	$86,117.97	2025-12-08
Q2043	HCPCS	Sipuleucel-t Premixed In Lr Total Vol 250ml [8900-06]	16	10	$162,219.15	$162,219.15	$55,272.32	$145,997.24	$114,364.51	2025-12-08
C2616	HCPCS	Sir Spheres Y-90 Resin Microsphrs Yttrium-90 Per Source	17	10	$183,918.59	$183,918.59	$17,485.10	$165,526.73	$128,743.01	2025-12-08
3614	APR_DRG	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	3	3	—	—	$96,590.88	$110,389.57	$110,389.57	2025-12-08
3124	APR_DRG	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses	3	3	—	—	$76,788.96	$87,758.81	$87,758.81	2025-12-08
404	APR_DRG	Spinal Disorders And Injuries	3	3	—	—	$62,609.68	$71,553.92	$71,553.92	2025-12-08
234	APR_DRG	Spinal Procedures	3	3	—	—	$130,345.88	$148,966.72	$148,966.72	2025-12-08
233	APR_DRG	Spinal Procedures	3	3	—	—	$63,456.81	$72,522.07	$72,522.07	2025-12-08
J9226	HCPCS	Supprelin La Implant	2	2	—	—	$45,020.65	$102,196.88	$73,608.76	2025-12-08
4044	APR_DRG	Thyroid, Parathyroid And Thyroglossal Procedures	3	3	—	—	$71,411.72	$81,613.39	$81,613.39	2025-12-08
Q2042	HCPCS	Tisagenlecleucel Car-pos T	5	5	—	—	$591,726.20	$1,343,218.48	$678,748.61	2025-12-08
44	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	3	3	—	—	$273,253.60	$312,289.82	$312,289.82	2025-12-08
43	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	3	3	—	—	$175,687.56	$200,785.79	$200,785.79	2025-12-08
42	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	3	3	—	—	$114,869.23	$131,279.12	$131,279.12	2025-12-08
41	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	3	3	—	—	$94,262.87	$107,728.99	$107,728.99	2025-12-08
54	APR_DRG	Tracheostomy With Mv >96 Hours Without Extensive Procedure	3	3	—	—	$175,747.31	$200,854.07	$200,854.07	2025-12-08
53	APR_DRG	Tracheostomy With Mv >96 Hours Without Extensive Procedure	3	3	—	—	$126,602.08	$144,688.09	$144,688.09	2025-12-08
52	APR_DRG	Tracheostomy With Mv >96 Hours Without Extensive Procedure	3	3	—	—	$115,616.07	$132,132.65	$132,132.65	2025-12-08
51	APR_DRG	Tracheostomy With Mv >96 Hours Without Extensive Procedure	3	3	—	—	$94,444.25	$107,936.28	$107,936.28	2025-12-08
5134	APR_DRG	Uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma	3	3	—	—	$76,940.46	$87,931.96	$87,931.96	2025-12-08
5124	APR_DRG	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy	3	3	—	—	$63,341.59	$72,390.38	$72,390.38	2025-12-08
5114	APR_DRG	Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy	3	3	—	—	$73,070.76	$83,509.44	$83,509.44	2025-12-08
224	APR_DRG	Ventricular Shunt Procedures	3	3	—	—	$112,347.05	$128,396.63	$128,396.63	2025-12-08
7234	APR_DRG	Viral Illness	3	3	—	—	$82,281.43	$94,035.92	$94,035.92	2025-12-08
C2624	HCPCS	Wireless Press Sens	15	10	$207,232.20	$207,232.20	$94,083.42	$186,508.98	$147,134.86	2025-12-08
A9543	HCPCS	Y90 Ibritumomab Rx =< 40 Mci	16	10	$125,216.85	$125,216.85	$56,824.55	$128,991.73	$88,277.88	2025-12-08

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