Price Transparency 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

HILL COUNTRY MEMORIAL HOSPITAL

Fredericksburg, TX · CCN 450604 · Rates published

26,050 distinct procedures filed
22 distinct payers
684,972 rate rows
2025-01-01 last MRF observed · ⚠ 17 mo old
Data quality

480,177 of 684,972 rate rows are consumer-grade (70.1%)

204,795 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 185,732
per-diem day rate — not a per-procedure price 12,375
template filing: same amount across many unrelated codes — excluded 6,505
placeholder amount (≤ $0.02) — excluded from medians 171
exceeds 10× this hospital's gross charge — excluded from medians 12

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 17 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.hcadam.com/api/public/content/cc6810ad23a34ec5b29e13bd5237c339?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 · 2026-05-15
Content fingerprint 29627c7cfdfba2af… · 437,157,623 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
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $4,897,200.00 $4,897,200.00 $4,897,200.00 nat. median
$3,006,423
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
$2,469,189
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 11 $3,379,068.00 $4,003,461.00 $3,672,900.00 nat. median
$3,746,358
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 11 $3,316,600.00 $3,929,450.00 $3,605,000.00 nat. median
$3,605,000
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 13 $5,242.19 $4,655,637.00 $3,325,455.00 nat. median
$13,041
outlier · 255.0×
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
748
OTHER 		Inj, Lovotibeglogene Auto 13 $8,646.98 $4,600,400.00 $3,286,000.00 nat. median
$17,963
outlier · 182.9×
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
746
OTHER 		Inj, Betibeglogene Autote 13 $7,680.24 $4,600,400.00 $2,975,420.00 nat. median
$21,896
outlier · 135.9×
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
9141
OTHER 		Inj Onase Abepar-xioi Tre 12 $2,197,524.88 $3,702,351.70 $2,400,557.07 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
$2,457,321
1.0× median
5834
APR_DRG 		Neonate With Ecmo 3 $1,236,328.00 $1,434,140.48 $1,434,140.48 nat. median
$309,665
outlier · 4.6×
74
APR_DRG 		Allogeneic Bone Marrow Transplant 3 $1,202,701.00 $2,104,730.00 $1,407,160.00 nat. median
$187,294
outlier · 7.5×
5833
APR_DRG 		Neonate With Ecmo 3 $1,046,877.00 $1,214,377.32 $1,214,377.32 nat. median
$244,017
outlier · 5.0×
24
APR_DRG 		Heart And/or Lung Transplant 3 $1,007,066.00 $1,762,370.00 $1,178,270.00 nat. median
$234,738
outlier · 5.0×
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 3 $507,496.00 $1,912,768.20 $1,009,345.28 nat. median
$675,122
1.5× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 3 $484,690.00 $1,725,604.86 $948,073.04 nat. median
$625,184
1.5× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 3 $474,061.00 $1,687,760.84 $930,561.90 nat. median
$674,188
1.4× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $782,575.00 $907,787.00 $907,787.00 nat. median
$246,434
outlier · 3.7×
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 4 $25.48 $1,586,704.70 $863,696.72 nat. median
$754,974
1.1× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 3 $449,440.00 $1,534,328.04 $844,460.70 nat. median
$620,080
1.4× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 3 $711,938.00 $825,848.08 $825,848.08 nat. median
$164,834
outlier · 5.0×
1614
APR_DRG 		Implantable Heart Assist Systems 4 $759,934.00 $881,523.44 $820,729.23 nat. median
$207,730
outlier · 4.0×
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 4 $6.70 $1,463,465.50 $807,075.90 nat. median
$634,511
1.3× median
Q0480
HCPCS 		Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 1 $677,827.66 $677,827.66 $677,827.66 nat. median
$111,989
outlier · 6.1×
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 $582,288.00 $675,454.08 $675,454.08 nat. median
$150,721
outlier · 4.5×
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 $577,128.00 $669,468.48 $669,468.48 nat. median
$162,982
outlier · 4.1×
5832
APR_DRG 		Neonate With Ecmo 3 $521,635.00 $605,096.60 $605,096.60 nat. median
$156,126
outlier · 3.9×
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 $495,326.00 $574,578.16 $574,578.16 nat. median
$117,173
outlier · 4.9×
9194
OTHER 		Tisagenlecleucel Car-pos 13 $486,857.47 $1,148,348.59 $535,437.38 nat. median
$566,531
0.9× median
2004
APR_DRG 		Cardiac Structural And Valvular Disorders 3 $460,294.00 $533,941.04 $533,941.04 nat. median
$32,636
outlier · 16.4×
9498
OTHER 		Ciltacabtagene Car-pos T 13 $484,953.53 $1,143,857.78 $533,343.46 nat. median
$587,650
0.9× median
9422
OTHER 		Idecabtagene Vicleucel Ca 13 $484,460.59 $1,142,695.09 $532,801.33 nat. median
$558,082
1.0× median
5831
APR_DRG 		Neonate With Ecmo 3 $459,310.00 $532,799.60 $532,799.60 nat. median
$145,122
outlier · 3.7×
09194
OTHER 		Tisagenlecleucel Car-pos 1 $529,192.90 $529,192.90 $529,192.90 nat. median
$538,205
1.0× median
09498
OTHER 		Ciltacabtagene Car-pos T 1 $527,123.40 $527,123.40 $527,123.40 nat. median
$554,552
1.0× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $526,587.60 $526,587.60 $526,587.60 nat. median
$530,178
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 13 $475,388.01 $1,121,295.64 $522,823.47 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
$534,091
1.0× median
73
APR_DRG 		Allogeneic Bone Marrow Transplant 3 $424,387.00 $742,678.00 $496,533.00 nat. median
$89,273
outlier · 5.6×
9035
OTHER 		Axicabtagene Ciloleucel C 13 $450,299.52 $1,062,119.52 $495,231.58 nat. median
$532,192
0.9× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $489,456.00 $489,456.00 $489,456.00 nat. median
$505,583
1.0× median
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $419,904.00 $487,088.64 $487,088.64 nat. median
$182,736
outlier · 2.7×
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $417,985.00 $484,862.60 $484,862.60 nat. median
$145,336
outlier · 3.3×
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 3 $416,904.00 $483,608.64 $483,608.64 nat. median
$105,658
outlier · 4.6×
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 3 $415,112.00 $481,529.92 $481,529.92 nat. median
$160,267
outlier · 3.0×
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 3 $410,966.00 $476,720.56 $476,720.56 nat. median
$122,924
outlier · 3.9×

Other procedures at this hospital

Browse this hospital's 26,050 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 — — $3,884,946.48 $3,884,946.48 $3,884,946.48 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
9138 OTHER Inj, Hemgenix, Per Tx Dos 22 11 — — $3,379,068.00 $4,003,461.00 $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 22 11 — — $3,316,600.00 $3,929,450.00 $3,605,000.00 2025-01-01
00714 OTHER Inj Delandistrogene Mox R 1 1 — — $3,325,455.00 $3,325,455.00 $3,325,455.00 2025-01-01
714 OTHER Inj Delandistrogene Mox R 24 13 — — $5,242.19 $4,655,637.00 $3,325,455.00 2025-01-01
748 OTHER Inj, Lovotibeglogene Auto 24 13 — — $8,646.98 $4,600,400.00 $3,286,000.00 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
746 OTHER Inj, Betibeglogene Autote 26 13 — — $7,680.24 $4,600,400.00 $2,975,420.00 2025-01-01
00746 OTHER Inj, Betibeglogene Autote 1 1 — — $2,968,000.00 $2,968,000.00 $2,968,000.00 2025-01-01
9141 OTHER Inj Onase Abepar-xioi Tre 25 12 — — $2,197,524.88 $3,702,351.70 $2,400,557.07 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
5834 APR_DRG Neonate With Ecmo 12 3 — — $1,236,328.00 $1,434,140.48 $1,434,140.48 2025-01-01
74 APR_DRG Allogeneic Bone Marrow Transplant 12 3 — — $1,202,701.00 $2,104,730.00 $1,407,160.00 2025-01-01
5833 APR_DRG Neonate With Ecmo 12 3 — — $1,046,877.00 $1,214,377.32 $1,214,377.32 2025-01-01
24 APR_DRG Heart And/or Lung Transplant 12 3 — — $1,007,066.00 $1,762,370.00 $1,178,270.00 2025-01-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 10 3 — — $507,496.00 $1,912,768.20 $1,009,345.28 2025-01-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 10 3 — — $484,690.00 $1,725,604.86 $948,073.04 2025-01-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 10 3 — — $474,061.00 $1,687,760.84 $930,561.90 2025-01-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 12 3 — — $782,575.00 $907,787.00 $907,787.00 2025-01-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 12 4 — — $25.48 $1,586,704.70 $863,696.72 2025-01-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 10 3 — — $449,440.00 $1,534,328.04 $844,460.70 2025-01-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 12 3 — — $711,938.00 $825,848.08 $825,848.08 2025-01-01
1614 APR_DRG Implantable Heart Assist Systems 17 4 — — $759,934.00 $881,523.44 $820,729.23 2025-01-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 12 4 — — $6.70 $1,463,465.50 $807,075.90 2025-01-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 2 1 — — $677,827.66 $677,827.66 $677,827.66 2025-01-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 12 3 — — $582,288.00 $675,454.08 $675,454.08 2025-01-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 12 3 — — $577,128.00 $669,468.48 $669,468.48 2025-01-01
5832 APR_DRG Neonate With Ecmo 12 3 — — $521,635.00 $605,096.60 $605,096.60 2025-01-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 12 3 — — $495,326.00 $574,578.16 $574,578.16 2025-01-01
9194 OTHER Tisagenlecleucel Car-pos 26 13 — — $486,857.47 $1,148,348.59 $535,437.38 2025-01-01
2004 APR_DRG Cardiac Structural And Valvular Disorders 12 3 — — $460,294.00 $533,941.04 $533,941.04 2025-01-01
9498 OTHER Ciltacabtagene Car-pos T 26 13 — — $484,953.53 $1,143,857.78 $533,343.46 2025-01-01
9422 OTHER Idecabtagene Vicleucel Ca 26 13 — — $484,460.59 $1,142,695.09 $532,801.33 2025-01-01
5831 APR_DRG Neonate With Ecmo 12 3 — — $459,310.00 $532,799.60 $532,799.60 2025-01-01
09194 OTHER Tisagenlecleucel Car-pos 1 1 — — $529,192.90 $529,192.90 $529,192.90 2025-01-01
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
9413 OTHER Lisocabtagene Car Pos T 26 13 — — $475,388.01 $1,121,295.64 $522,823.47 2025-01-01
09413 OTHER Lisocabtagene Car Pos T 1 1 — — $516,726.10 $516,726.10 $516,726.10 2025-01-01
73 APR_DRG Allogeneic Bone Marrow Transplant 12 3 — — $424,387.00 $742,678.00 $496,533.00 2025-01-01
9035 OTHER Axicabtagene Ciloleucel C 26 13 — — $450,299.52 $1,062,119.52 $495,231.58 2025-01-01
09035 OTHER Axicabtagene Ciloleucel C 1 1 — — $489,456.00 $489,456.00 $489,456.00 2025-01-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 12 3 — — $419,904.00 $487,088.64 $487,088.64 2025-01-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 12 3 — — $417,985.00 $484,862.60 $484,862.60 2025-01-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 12 3 — — $416,904.00 $483,608.64 $483,608.64 2025-01-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 12 3 — — $415,112.00 $481,529.92 $481,529.92 2025-01-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 12 3 — — $410,966.00 $476,720.56 $476,720.56 2025-01-01
9391 OTHER Brexucabtagene Car Pos T 26 13 — — $423,687.97 $999,350.97 $465,964.66 2025-01-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 12 3 — — $400,139.00 $464,161.24 $464,161.24 2025-01-01
09391 OTHER Brexucabtagene Car Pos T 1 1 — — $460,530.40 $460,530.40 $460,530.40 2025-01-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 12 3 — — $396,555.00 $460,003.80 $460,003.80 2025-01-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 12 3 — — $393,994.00 $457,033.04 $457,033.04 2025-01-01
1613 APR_DRG Implantable Heart Assist Systems 17 4 — — $396,088.00 $459,462.08 $427,775.15 2025-01-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 12 3 — — $360,748.00 $631,310.00 $422,076.00 2025-01-01
84 APR_DRG Autologous Bone Marrow Transplant 12 3 — — $359,303.00 $628,781.00 $420,385.00 2025-01-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 12 3 — — $352,918.00 $409,384.88 $409,384.88 2025-01-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 12 3 — — $349,774.00 $405,737.84 $405,737.84 2025-01-01
2464 APR_DRG Gastrointestinal Vascular Insufficiency 12 3 — — $342,042.00 $396,768.72 $396,768.72 2025-01-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 12 3 — — $340,277.00 $394,721.32 $394,721.32 2025-01-01
64 APR_DRG Pancreas Transplant 12 3 — — $330,229.00 $577,901.00 $386,368.00 2025-01-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 12 3 — — $330,203.00 $383,035.48 $383,035.48 2025-01-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 12 3 — — $329,215.00 $381,889.40 $381,889.40 2025-01-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 17 4 — — $352,722.00 $409,157.52 $380,939.78 2025-01-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 12 3 — — $320,034.00 $371,239.44 $371,239.44 2025-01-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 12 3 — — $302,641.00 $351,063.56 $351,063.56 2025-01-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 12 3 — — $300,184.00 $348,213.44 $348,213.44 2025-01-01
72 APR_DRG Allogeneic Bone Marrow Transplant 12 3 — — $285,140.00 $498,996.00 $333,615.00 2025-01-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 12 3 — — $287,392.00 $333,374.72 $333,374.72 2025-01-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 17 4 — — $307,690.00 $356,920.40 $332,305.95 2025-01-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 12 3 — — $281,470.00 $326,505.20 $326,505.20 2025-01-01
8634 APR_DRG Neonatal Aftercare 12 3 — — $277,104.00 $321,440.64 $321,440.64 2025-01-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 12 3 — — $274,442.00 $318,352.72 $318,352.72 2025-01-01
4404 APR_DRG Kidney Transplant 12 3 — — $269,369.00 $471,396.00 $315,162.00 2025-01-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 12 3 — — $268,138.00 $311,040.08 $311,040.08 2025-01-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 12 3 — — $268,047.00 $310,934.52 $310,934.52 2025-01-01
1612 APR_DRG Implantable Heart Assist Systems 17 4 — — $284,725.00 $330,281.00 $307,503.82 2025-01-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 2 1 — — $304,023.47 $304,023.47 $304,023.47 2025-01-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 12 3 — — $261,130.00 $302,910.80 $302,910.80 2025-01-01
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 12 3 — — $261,130.00 $302,910.80 $302,910.80 2025-01-01
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 12 3 — — $260,390.00 $302,052.40 $302,052.40 2025-01-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 2 1 — — $301,553.20 $301,553.20 $301,553.20 2025-01-01
4414 APR_DRG Major Bladder Procedures 12 3 — — $254,920.00 $295,707.20 $295,707.20 2025-01-01
1611 APR_DRG Implantable Heart Assist Systems 17 4 — — $270,036.00 $313,241.76 $291,639.46 2025-01-01
23 APR_DRG Heart And/or Lung Transplant 12 3 — — $248,040.00 $434,070.00 $290,207.00 2025-01-01
83 APR_DRG Autologous Bone Marrow Transplant 12 3 — — $242,862.00 $425,009.00 $284,149.00 2025-01-01
1784 APR_DRG External Heart Assist Devices 12 3 — — $238,761.00 $276,962.76 $276,962.76 2025-01-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 12 3 — — $235,131.00 $272,751.96 $272,751.96 2025-01-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 12 3 — — $234,861.00 $272,438.76 $272,438.76 2025-01-01
6904 APR_DRG Acute Leukemia 12 3 — — $231,723.00 $268,798.68 $268,798.68 2025-01-01
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 12 3 — — $230,303.00 $267,151.48 $267,151.48 2025-01-01
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 12 3 — — $230,044.00 $266,851.04 $266,851.04 2025-01-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 16 8 — — $3,938.00 $478,617.86 $263,821.37 2025-01-01
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 12 3 — — $223,097.00 $258,792.52 $258,792.52 2025-01-01
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 12 3 — — $218,407.00 $253,352.12 $253,352.12 2025-01-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 44 18 — — $177,135.40 $387,181.20 $252,956.00 2025-01-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 17 4 — — $233,822.00 $271,233.52 $252,528.82 2025-01-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 12 3 — — $217,076.00 $251,808.16 $251,808.16 2025-01-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 12 3 — — $215,604.00 $250,100.64 $250,100.64 2025-01-01
63 APR_DRG Pancreas Transplant 12 3 — — $213,407.00 $373,463.00 $249,686.00 2025-01-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 12 3 — — $213,495.00 $247,654.20 $247,654.20 2025-01-01
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 12 3 — — $203,441.00 $235,991.56 $235,991.56 2025-01-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 12 3 — — $202,333.00 $234,706.28 $234,706.28 2025-01-01
4474 APR_DRG Other Kidney, Urinary Tract And Related Non-percutaneous Procedures 12 3 — — $201,859.00 $234,156.44 $234,156.44 2025-01-01
22 APR_DRG Heart And/or Lung Transplant 12 3 — — $199,258.00 $348,702.00 $233,132.00 2025-01-01
234 APR_DRG Spinal Procedures 12 3 — — $198,869.00 $230,688.04 $230,688.04 2025-01-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 12 3 — — $198,149.00 $229,852.84 $229,852.84 2025-01-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 12 3 — — $195,603.00 $226,899.48 $226,899.48 2025-01-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 12 3 — — $195,595.00 $226,890.20 $226,890.20 2025-01-01
62 APR_DRG Pancreas Transplant 12 3 — — $193,023.00 $337,792.00 $225,838.00 2025-01-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 12 3 — — $193,157.00 $224,062.12 $224,062.12 2025-01-01
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 12 3 — — $192,267.00 $223,029.72 $223,029.72 2025-01-01
61 APR_DRG Pancreas Transplant 12 3 — — $190,531.00 $333,431.00 $222,922.00 2025-01-01
71 APR_DRG Allogeneic Bone Marrow Transplant 12 3 — — $187,233.00 $327,659.00 $219,064.00 2025-01-01
13 APR_DRG Liver Transplant And/or Intestinal Transplant 12 3 — — $185,866.00 $325,266.00 $217,464.00 2025-01-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 12 3 — — $185,646.00 $215,349.36 $215,349.36 2025-01-01
264 APR_DRG Other Nervous System And Related Procedures 12 3 — — $185,534.00 $215,219.44 $215,219.44 2025-01-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 12 3 — — $184,733.00 $214,290.28 $214,290.28 2025-01-01
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 12 3 — — $183,638.00 $213,020.08 $213,020.08 2025-01-01
1824 APR_DRG Other Peripheral Vascular And Related Procedures 12 3 — — $183,489.00 $212,847.24 $212,847.24 2025-01-01
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 12 3 — — $180,379.00 $209,239.64 $209,239.64 2025-01-01
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 12 3 — — $180,335.00 $209,188.60 $209,188.60 2025-01-01
2054 APR_DRG Cardiomyopathy 12 3 — — $179,825.00 $208,597.00 $208,597.00 2025-01-01
6954 APR_DRG Chemotherapy For Acute Leukemia 12 3 — — $179,594.00 $208,329.04 $208,329.04 2025-01-01
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 12 3 — — $179,410.00 $208,115.60 $208,115.60 2025-01-01
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 12 3 — — $176,396.00 $204,619.36 $204,619.36 2025-01-01
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 12 3 — — $175,805.00 $203,933.80 $203,933.80 2025-01-01
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 12 3 — — $175,256.00 $203,296.96 $203,296.96 2025-01-01
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition… 12 3 — — $173,415.00 $201,161.40 $201,161.40 2025-01-01
214 APR_DRG Open Craniotomy Except Trauma 12 3 — — $172,710.00 $200,343.60 $200,343.60 2025-01-01
2304 APR_DRG Major Small Bowel Procedures 12 3 — — $172,087.00 $199,620.92 $199,620.92 2025-01-01
224 APR_DRG Ventricular Shunt Procedures 12 3 — — $171,408.00 $198,833.28 $198,833.28 2025-01-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 17 4 — — $183,380.00 $212,720.80 $198,051.34 2025-01-01
4424 APR_DRG Kidney And Urinary Tract Procedures For Malignancy 12 3 — — $170,469.00 $197,744.04 $197,744.04 2025-01-01
9524 APR_DRG Non-extensive O.r. Procedure Unrelated To Principal Diagnosis 12 3 — — $169,422.00 $196,529.52 $196,529.52 2025-01-01
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 12 3 — — $167,874.00 $194,733.84 $194,733.84 2025-01-01
4403 APR_DRG Kidney Transplant 12 3 — — $164,866.00 $288,516.00 $192,894.00 2025-01-01
3154 APR_DRG Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement 12 3 — — $164,854.00 $191,230.64 $191,230.64 2025-01-01
1204 APR_DRG Major Respiratory And Chest Procedures 12 3 — — $163,627.00 $189,807.32 $189,807.32 2025-01-01
4834 APR_DRG Penis, Testes And Scrotal Procedures 12 3 — — $163,005.00 $189,085.80 $189,085.80 2025-01-01
894 APR_DRG Major Cranial Or Facial Bone Procedures 12 3 — — $161,257.00 $187,058.12 $187,058.12 2025-01-01
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 17 4 — — $173,120.00 $200,819.20 $186,970.55 2025-01-01
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 12 3 — — $161,044.00 $186,811.04 $186,811.04 2025-01-01
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 12 3 — — $161,003.00 $186,763.48 $186,763.48 2025-01-01
L5856 HCPCS Addition To Lower Extremity Prosthesis, Endoskeletal Knee-shin System, Microproc… 2 1 — — $180,668.59 $180,668.59 $180,668.59 2025-01-01
21 APR_DRG Heart And/or Lung Transplant 12 3 — — $154,339.00 $270,094.00 $180,577.00 2025-01-01
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 12 3 — — $155,452.00 $180,324.32 $180,324.32 2025-01-01
L6880 HCPCS Electric Hand, Switch Or Myoelectric Controlled, Independently Articulating Digi… 2 1 — — $179,815.33 $179,815.33 $179,815.33 2025-01-01
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 12 3 — — $154,604.00 $179,340.64 $179,340.64 2025-01-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $177,688.60 $177,688.60 $177,688.60 2025-01-01
1694 APR_DRG Major Abdominal Vascular Procedures 17 4 — — $164,294.00 $190,581.04 $177,438.58 2025-01-01
1783 APR_DRG External Heart Assist Devices 12 3 — — $152,794.00 $177,241.04 $177,241.04 2025-01-01
1214 APR_DRG Other Respiratory And Chest Procedures 12 3 — — $152,706.00 $177,138.96 $177,138.96 2025-01-01
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 12 3 — — $152,148.00 $176,491.68 $176,491.68 2025-01-01
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 12 3 — — $150,919.00 $175,066.04 $175,066.04 2025-01-01
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 12 3 — — $150,484.00 $174,561.44 $174,561.44 2025-01-01
2244 APR_DRG Peritoneal Adhesiolysis 12 3 — — $148,819.00 $172,630.04 $172,630.04 2025-01-01
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 12 3 — — $147,782.00 $171,427.12 $171,427.12 2025-01-01
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 17 4 — — $158,605.00 $183,981.80 $171,294.30 2025-01-01
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 12 3 — — $147,369.00 $170,948.04 $170,948.04 2025-01-01
914 APR_DRG Other Major Head And Neck Procedures 12 3 — — $146,576.00 $170,028.16 $170,028.16 2025-01-01
204 APR_DRG Open Craniotomy For Trauma 12 3 — — $145,080.00 $168,292.80 $168,292.80 2025-01-01
51 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 12 3 — — $144,094.00 $167,149.04 $167,149.04 2025-01-01
12 APR_DRG Liver Transplant And/or Intestinal Transplant 12 3 — — $142,762.00 $249,834.00 $167,032.00 2025-01-01
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 12 3 — — $143,817.00 $166,827.72 $166,827.72 2025-01-01
1814 APR_DRG Lower Extremity Vascular Procedures 12 3 — — $142,703.00 $165,535.48 $165,535.48 2025-01-01
2274 APR_DRG Hernia Procedures Except Inguinal, Femoral And Umbilical 12 3 — — $142,267.00 $165,029.72 $165,029.72 2025-01-01
6604 APR_DRG Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula… 12 3 — — $141,800.00 $164,488.00 $164,488.00 2025-01-01
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 12 3 — — $141,771.00 $164,454.36 $164,454.36 2025-01-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 12 3 — — $141,611.00 $164,268.76 $164,268.76 2025-01-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 32 14 — — $3,938.00 $342,628.40 $163,299.70 2025-01-01
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 17 4 — — $149,057.00 $172,906.12 $160,981.76 2025-01-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 43 15 — — $3,938.00 $309,516.38 $160,962.04 2025-01-01
11 APR_DRG Liver Transplant And/or Intestinal Transplant 12 3 — — $137,402.00 $240,454.00 $160,761.00 2025-01-01
1834 APR_DRG Percutaneous Structural Cardiac Procedures 12 3 — — $138,001.00 $160,081.16 $160,081.16 2025-01-01
2614 APR_DRG Major Biliary Tract Procedures 12 3 — — $135,811.00 $157,540.76 $157,540.76 2025-01-01
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 12 3 — — $135,326.00 $156,978.16 $156,978.16 2025-01-01
1833 APR_DRG Percutaneous Structural Cardiac Procedures 12 3 — — $134,612.00 $156,149.92 $156,149.92 2025-01-01
9514 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 12 3 — — $134,084.00 $155,537.44 $155,537.44 2025-01-01
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 12 3 — — $133,238.00 $154,556.08 $154,556.08 2025-01-01
504 APR_DRG Non-bacterial Infections Of Nervous System Except Viral Meningitis 12 3 — — $131,892.00 $152,994.72 $152,994.72 2025-01-01
1782 APR_DRG External Heart Assist Devices 12 3 — — $131,138.00 $152,120.08 $152,120.08 2025-01-01
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 12 3 — — $130,915.00 $151,861.40 $151,861.40 2025-01-01
C2616 HCPCS Brachytherapy Source, Non-stranded, Yttrium-90, Per Source 9 2 — — $13,612.00 $211,935.47 $150,918.56 2025-01-01
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 12 3 — — $129,766.00 $150,528.56 $150,528.56 2025-01-01
2234 APR_DRG Other Small And Large Bowel Procedures 12 3 — — $127,780.00 $148,224.80 $148,224.80 2025-01-01
82 APR_DRG Autologous Bone Marrow Transplant 12 3 — — $126,422.00 $221,240.00 $147,915.00 2025-01-01
6914 APR_DRG Lymphoma, Myeloma And Non-acute Leukemia 12 3 — — $126,994.00 $147,313.04 $147,313.04 2025-01-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $146,619.30 $146,619.30 $146,619.30 2025-01-01
6944 APR_DRG Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior 12 3 — — $125,708.00 $145,821.28 $145,821.28 2025-01-01
7234 APR_DRG Viral Illness 12 3 — — $125,537.00 $145,622.92 $145,622.92 2025-01-01
L8614 HCPCS Battery Coclr Lf 2 1 $2,969.00 $2,969.00 $144,058.80 $144,058.80 $144,058.80 2025-01-01
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 12 3 — — $124,187.00 $144,056.92 $144,056.92 2025-01-01
L6975 HCPCS Interscapular-thoracic, External Power, Molded Inner Socket, Removable Shoulder … 2 1 — — $143,726.16 $143,726.16 $143,726.16 2025-01-01
L6970 HCPCS Interscapular-thoracic, External Power, Molded Inner Socket, Removable Shoulder … 2 1 — — $142,958.81 $142,958.81 $142,958.81 2025-01-01
1908 OTHER New Technology - Level 52 26 13 — — $129,845.30 $306,265.55 $142,801.60 2025-01-01
1907 OTHER New Technology - Level 52 26 13 — — $129,845.30 $306,265.55 $142,801.60 2025-01-01
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
Q0483 HCPCS Monitor/display Module For Use With Electric Ventricular Assist Device, Replacem… 2 1 — — $141,108.93 $141,108.93 $141,108.93 2025-01-01
6614 APR_DRG Coagulation And Platelet Disorders 12 3 — — $121,459.00 $140,892.44 $140,892.44 2025-01-01
L6965 HCPCS Shoulder Disarticulation, External Power, Molded Inner Socket, Removable Shoulde… 2 1 — — $140,647.81 $140,647.81 $140,647.81 2025-01-01
L5858 HCPCS Addition To Lower Extremity Prosthesis, Endoskeletal Knee Shin System, Microproc… 2 1 — — $139,872.75 $139,872.75 $139,872.75 2025-01-01
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 17 4 — — $129,271.00 $149,954.36 $139,613.05 2025-01-01
1781 APR_DRG External Heart Assist Devices 12 3 — — $120,212.00 $139,445.92 $139,445.92 2025-01-01
923 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 12 3 — — $119,782.00 $138,947.12 $138,947.12 2025-01-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 14 4 — — $99,549.12 $436,090.33 $136,948.70 2025-01-01
5134 APR_DRG Uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma 12 3 — — $117,388.00 $136,170.08 $136,170.08 2025-01-01
1794 APR_DRG Defibrillator Implants 12 3 — — $117,316.00 $136,086.56 $136,086.56 2025-01-01
3124 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 12 3 — — $117,157.00 $135,902.12 $135,902.12 2025-01-01
8412 APR_DRG Extensive Third Degree Burns With Skin Graft 12 3 — — $116,587.00 $135,240.92 $135,240.92 2025-01-01
8411 APR_DRG Extensive Third Degree Burns With Skin Graft 12 3 — — $115,680.00 $134,188.80 $134,188.80 2025-01-01
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures 12 3 — — $115,072.00 $133,483.52 $133,483.52 2025-01-01
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 17 4 — — $122,815.00 $142,465.40 $132,640.75 2025-01-01
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 17 4 — — $122,572.00 $142,183.52 $132,378.80 2025-01-01
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 12 3 — — $113,467.00 $131,621.72 $131,621.72 2025-01-01
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 12 3 — — $113,354.00 $131,490.64 $131,490.64 2025-01-01
4013 APR_DRG Adrenal Procedures 12 3 — — $112,929.00 $130,997.64 $130,997.64 2025-01-01
3043 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 12 3 — — $112,918.00 $130,984.88 $130,984.88 2025-01-01
3104 APR_DRG Vertebral And Intervertebral Spinal Procedures Including Disc Procedures 12 3 — — $111,722.00 $129,597.52 $129,597.52 2025-01-01
2334 APR_DRG Appendectomy With Complex Principal Diagnosis 12 3 — — $111,645.00 $129,508.20 $129,508.20 2025-01-01
L5973 HCPCS Endoskeletal Ankle Foot System, Microprocessor Controlled Feature, Dorsiflexion … 2 1 — — $129,483.03 $129,483.03 $129,483.03 2025-01-01
5114 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 12 3 — — $111,484.00 $129,321.44 $129,321.44 2025-01-01
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 12 3 — — $111,238.00 $129,036.08 $129,036.08 2025-01-01
6344 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 12 3 — — $111,074.00 $128,845.84 $128,845.84 2025-01-01
1906 OTHER New Technology - Level 51 26 13 — — $117,073.68 $276,141.18 $128,755.60 2025-01-01
1905 OTHER New Technology - Level 51 26 13 — — $117,073.68 $276,141.18 $128,755.60 2025-01-01
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 17 4 — — $119,076.00 $138,128.16 $128,602.58 2025-01-01
4804 APR_DRG Major Male Pelvic Procedures 12 3 — — $110,603.00 $128,299.48 $128,299.48 2025-01-01
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 12 3 — — $109,942.00 $127,532.72 $127,532.72 2025-01-01
01905 OTHER New Technology - Level 51 1 1 — — $127,254.00 $127,254.00 $127,254.00 2025-01-01
01906 OTHER New Technology - Level 51 1 1 — — $127,254.00 $127,254.00 $127,254.00 2025-01-01
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 12 3 — — $109,656.00 $127,200.96 $127,200.96 2025-01-01
1303 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 12 3 — — $109,322.00 $126,813.52 $126,813.52 2025-01-01
3464 APR_DRG Connective Tissue Disorders 12 3 — — $109,295.00 $126,782.20 $126,782.20 2025-01-01
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 12 3 — — $108,953.00 $126,385.48 $126,385.48 2025-01-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 3 1 — — $116,270.00 $134,750.00 $125,510.00 2025-01-01
4434 APR_DRG Kidney And Urinary Tract Procedures For Non-malignancy 12 3 — — $108,129.00 $125,429.64 $125,429.64 2025-01-01
1804 APR_DRG Other Circulatory System Procedures 12 3 — — $108,075.00 $125,367.00 $125,367.00 2025-01-01
294 APR_DRG Other Percutaneous Intracranial Procedures 12 3 — — $107,994.00 $125,273.04 $125,273.04 2025-01-01
1714 APR_DRG Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock 17 4 — — $115,970.00 $134,525.20 $125,248.28 2025-01-01
734 APR_DRG Orbit And Eye Procedures 12 3 — — $107,777.00 $125,021.32 $125,021.32 2025-01-01
4684 APR_DRG Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms 12 3 — — $107,234.00 $124,391.44 $124,391.44 2025-01-01
4402 APR_DRG Kidney Transplant 12 3 — — $106,039.00 $185,569.00 $124,066.00 2025-01-01
3134 APR_DRG Knee And Lower Leg Procedures Except Foot 12 3 — — $106,933.00 $124,042.28 $124,042.28 2025-01-01
81 APR_DRG Autologous Bone Marrow Transplant 12 3 — — $105,886.00 $185,301.00 $123,887.00 2025-01-01
1621 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 17 4 — — $114,700.00 $133,052.00 $123,877.02 2025-01-01
8154 APR_DRG Other Injury, Poisoning And Toxic Effect Diagnoses 12 3 — — $105,980.00 $122,936.80 $122,936.80 2025-01-01
Q0489 HCPCS Power Pack Base For Use With Electric/pneumatic Ventricular Assist Device, Repla… 2 1 — — $122,333.87 $122,333.87 $122,333.87 2025-01-01
913 APR_DRG Other Major Head And Neck Procedures 12 3 — — $105,166.00 $121,992.56 $121,992.56 2025-01-01
6924 APR_DRG Radiotherapy 12 3 — — $104,926.00 $121,714.16 $121,714.16 2025-01-01
984 APR_DRG Other Ear, Nose, Mouth, Throat, Craniofacial, And Neck Procedures 12 3 — — $104,789.00 $121,555.24 $121,555.24 2025-01-01
2314 APR_DRG Major Large Bowel Procedures 12 3 — — $104,390.00 $121,092.40 $121,092.40 2025-01-01
8104 APR_DRG Hemorrhage Or Hematoma Due To Complication 12 3 — — $104,239.00 $120,917.24 $120,917.24 2025-01-01
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 12 3 — — $103,944.00 $120,575.04 $120,575.04 2025-01-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 14 4 — — $97,356.45 $257,170.92 $120,116.70 2025-01-01
4844 APR_DRG Other Male Reproductive System And Related Procedures 12 3 — — $103,281.00 $119,805.96 $119,805.96 2025-01-01
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 12 3 — — $103,198.00 $119,709.68 $119,709.68 2025-01-01
494 APR_DRG Bacterial And Tuberculous Infections Of Nervous System 12 3 — — $103,003.00 $119,483.48 $119,483.48 2025-01-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $119,015.90 $119,015.90 $119,015.90 2025-01-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 13 4 — — $63,505.40 $660,800.00 $118,944.00 2025-01-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 15 5 — — $55,453.60 $334,251.46 $118,797.35 2025-01-01
6903 APR_DRG Acute Leukemia 12 3 — — $101,991.00 $118,309.56 $118,309.56 2025-01-01
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 12 3 — — $101,351.00 $117,567.16 $117,567.16 2025-01-01
4014 APR_DRG Adrenal Procedures 12 3 — — $100,986.00 $117,143.76 $117,143.76 2025-01-01
3254 APR_DRG Non-elective Or Complex Knee Joint Replacement 12 3 — — $100,775.00 $116,899.00 $116,899.00 2025-01-01
4401 APR_DRG Kidney Transplant 12 3 — — $99,399.00 $173,949.00 $116,298.00 2025-01-01
6613 APR_DRG Coagulation And Platelet Disorders 12 3 — — $99,583.00 $115,516.28 $115,516.28 2025-01-01
274 APR_DRG Other Open Craniotomy 12 3 — — $99,464.00 $115,378.24 $115,378.24 2025-01-01
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 12 3 — — $99,064.00 $114,914.24 $114,914.24 2025-01-01
1904 OTHER New Technology - Level 50 26 13 — — $104,302.06 $246,016.81 $114,709.59 2025-01-01
1903 OTHER New Technology - Level 50 26 13 — — $104,302.06 $246,016.81 $114,709.59 2025-01-01
213 APR_DRG Open Craniotomy Except Trauma 12 3 — — $98,846.00 $114,661.36 $114,661.36 2025-01-01
7934 APR_DRG Moderately Extensive O.r. Procedures For Other Complications Of Treatment 12 3 — — $98,217.00 $113,931.72 $113,931.72 2025-01-01
3214 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 12 3 — — $98,185.00 $113,894.60 $113,894.60 2025-01-01
3031 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 12 3 — — $98,152.00 $113,856.32 $113,856.32 2025-01-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 44 18 — — $70,185.72 $317,894.00 $113,677.86 2025-01-01
244 APR_DRG Open Extracranial Vascular Procedures 12 3 — — $97,985.00 $113,662.60 $113,662.60 2025-01-01
1801 APR_DRG Other Circulatory System Procedures 12 3 — — $97,913.00 $113,579.08 $113,579.08 2025-01-01
1754 APR_DRG Percutaneous Cardiac Intervention Without Ami 17 4 — — $104,999.00 $121,798.84 $113,399.23 2025-01-01
01903 OTHER New Technology - Level 50 1 1 — — $113,371.80 $113,371.80 $113,371.80 2025-01-01
01904 OTHER New Technology - Level 50 1 1 — — $113,371.80 $113,371.80 $113,371.80 2025-01-01
3084 APR_DRG Hip And Femur Fracture Repair 12 3 — — $97,584.00 $113,197.44 $113,197.44 2025-01-01
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 12 3 — — $97,361.00 $112,938.76 $112,938.76 2025-01-01
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 17 4 — — $104,279.00 $120,963.64 $112,622.19 2025-01-01
5144 APR_DRG Female Reproductive System Reconstructive Procedures 12 3 — — $96,839.00 $112,333.24 $112,333.24 2025-01-01
233 APR_DRG Spinal Procedures 12 3 — — $96,816.00 $112,306.56 $112,306.56 2025-01-01
2224 APR_DRG Other Stomach, Esophageal And Duodenal Procedures 12 3 — — $96,754.00 $112,234.64 $112,234.64 2025-01-01
5124 APR_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy 12 3 — — $96,640.00 $112,102.40 $112,102.40 2025-01-01
1602 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 17 4 — — $103,568.00 $120,138.88 $111,853.93 2025-01-01
4012 APR_DRG Adrenal Procedures 12 3 — — $96,233.00 $111,630.28 $111,630.28 2025-01-01
433 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 12 3 — — $95,846.00 $111,181.36 $111,181.36 2025-01-01
1302 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 12 3 — — $95,575.00 $110,867.00 $110,867.00 2025-01-01
6803 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 12 3 — — $95,525.00 $110,809.00 $110,809.00 2025-01-01
404 APR_DRG Spinal Disorders And Injuries 12 3 — — $95,523.00 $110,806.68 $110,806.68 2025-01-01
1704 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 17 4 — — $102,391.00 $118,773.56 $110,582.89 2025-01-01
293 APR_DRG Other Percutaneous Intracranial Procedures 12 3 — — $95,172.00 $110,399.52 $110,399.52 2025-01-01
1673 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 17 4 — — $101,567.00 $117,817.72 $109,693.33 2025-01-01
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