Price Transparencybeta Hospital negotiated rates

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

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Hospital

TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH

Fort Worth, TX · CCN 450677 · Rates published

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You selected 93306 (CPT)

HC TTE W/DOPPLER COMPLETE - TRANSTHORACIC ECHO (TTE) COMPLETE

This hospital’s price: $828 across 12 payers · range $186-$2,705

Source: https://www.adventhealth.com/sites/default/files/CDM/2025/452694620_Texas-Health-Huguley_standardcharges.json · observed 2026-04-01

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

27,502 distinct procedures filed
26 distinct payers
573,126 rate rows
2026-04-01 last MRF observed
Data quality

540,042 of 573,126 rate rows are consumer-grade (94.2%)

33,084 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 27,867
per-diem day rate — not a per-procedure price 1,922
template filing: same amount across many unrelated codes — excluded 1,544
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 802
exceeds 10× this hospital's gross charge — excluded from medians 704
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 195
placeholder amount (≤ $0.02) — excluded from medians 50
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://HospitalPriceDisclosure.com/download.aspx?pi=2VSkC7fOUM8I3j2TiNK4ZA*-*
Found on page https://HospitalPriceDisclosure.com/Default.aspx?ci=RsbcVwMa5jfnDZuYpIqAxQ*-*
Discovered viaCMS hospital list
Last fetch success · 2026-10-12
Content fingerprint 48739c4d12f49a1a… · 21,290,666 bytes · first seen 2026-09-11

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
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 4 $2,680,037.38 $4,910,221.21 $4,467,936.34 nat. median
$2,466,282
1.8× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 1 $3,691,450.00 $3,691,450.00 $3,691,450.00 nat. median
$3,703,693
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 1 $3,316,897.12 $3,316,897.12 $3,316,897.12 nat. median
$3,324,572
1.0× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 5 $587,977.76 $3,564,325.44 $997,736.25 nat. median
$646,415
1.5× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 5 $468,805.05 $2,727,077.60 $903,143.93 nat. median
$608,101
1.5× median
Q2055
HCPCS 		Idecabtagene Vicleucel 460000000 Cells IV Susp 16 $503,455.00 $3,215,558.11 $887,797.00 nat. median
$622,245
1.4× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 5 $491,505.08 $2,859,125.57 $883,599.04 nat. median
$591,650
1.5× median
Q2054
HCPCS 		Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp 16 $496,390.00 $3,145,038.12 $868,333.00 nat. median
$640,950
1.4× median
Q2042
HCPCS 		Tisagenlecleucel IV Infusion (wrapped) 16 $421,729.00 $2,956,726.24 $777,216.37 nat. median
$738,272
1.1× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 19 $248,134.00 $1,979,545.00 $641,999.54 nat. median
$359,358
1.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 18 $185,705.00 $1,478,554.00 $418,167.30 nat. median
$249,124
1.7× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 19 $141,642.00 $1,124,945.00 $328,318.74 nat. median
$190,557
1.7× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 18 $156,628.00 $1,245,210.00 $319,629.66 nat. median
$198,433
1.6× median
5834
APR_DRG 		Neonate With Ecmo 3 $267,255.00 $293,981.00 $277,945.50 nat. median
$307,273
0.9× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 5 $66,818.13 $424,436.00 $276,963.06 nat. median
$71,201
outlier · 3.9×
74
APR_DRG 		Allogeneic Bone Marrow Transplant 3 $259,986.00 $285,985.00 $270,385.50 nat. median
$170,172
1.6× median
0100T
OTHER 		Prosth Retina Receive&Gen 4 $59,420.00 $1,053,168.45 $245,068.30 nat. median
$5,128
outlier · 47.8×
5833
APR_DRG 		Neonate With Ecmo 3 $226,302.00 $248,932.00 $235,354.00 nat. median
$244,017
1.0× median
24
APR_DRG 		Heart And/or Lung Transplant 3 $217,696.00 $239,466.00 $226,404.00 nat. median
$241,915
0.9× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 19 $93,884.00 $741,684.00 $226,381.20 nat. median
$126,722
1.8× median
215
MS_DRG 		Other Heart Assist System Implant 19 $70,761.00 $434,299.75 $202,730.61 nat. median
$93,917
outlier · 2.2×
7
MS_DRG 		Lung Transplant 18 $86,943.00 $685,981.00 $195,593.10 nat. median
$117,894
1.7× median
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 6 $29,844.47 $312,935.68 $191,164.96 nat. median
$49,639
outlier · 3.9×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 19 $64,589.00 $412,475.25 $190,327.95 nat. median
$90,581
outlier · 2.1×
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 $86,109.33 $320,139.06 $187,492.53 nat. median
$47,579
outlier · 3.9×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 19 $56,889.00 $350,937.00 $184,889.59 nat. median
$77,043
outlier · 2.4×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Or Infection Wi… 19 $56,858.00 $337,955.00 $184,784.85 nat. median
$77,696
outlier · 2.4×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 18 $87,159.00 $687,713.00 $181,827.00 nat. median
$110,192
1.7× median
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 $81,431.85 $302,749.04 $177,307.90 nat. median
$39,629
outlier · 4.5×
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $169,168.00 $186,085.00 $175,935.00 nat. median
$247,214
0.7× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 18 $72,718.00 $571,821.00 $172,075.62 nat. median
$97,414
1.8× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 18 $73,540.00 $578,424.00 $171,696.24 nat. median
$103,967
1.7× median
1614
APR_DRG 		Implantable Heart Assist Systems 3 $164,274.00 $180,701.00 $170,845.00 nat. median
$202,993
0.8× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 20 $52,588.00 $331,483.00 $170,540.76 nat. median
$71,758
outlier · 2.4×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 $69,980.00 $549,854.00 $167,110.00 nat. median
$93,270
1.8× median
C1831
HCPCS 		Kit Imp Aprevo Spine Lvl 1 11 $64,097.00 $305,129.00 $166,329.50 nat. median
$7,534
outlier · 22.1×
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 3 $153,899.00 $169,289.00 $160,055.00 nat. median
$163,587
1.0× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 18 $71,118.00 $558,987.00 $156,616.00 nat. median
$94,964
1.6× median
226
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 1 $71,098.95 $264,333.16 $154,809.27 nat. median
$38,225
outlier · 4.0×
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 3 $66,809.79 $353,441.42 $153,822.51 nat. median
$52,841
outlier · 2.9×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 19 $54,189.00 $352,677.77 $151,307.00 nat. median
$74,460
outlier · 2.0×
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 19 $45,074.00 $291,324.75 $145,478.30 nat. median
$63,896
outlier · 2.3×
455
MS_DRG 		Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 7 $27,565.71 $182,899.07 $143,948.03 nat. median
$38,944
outlier · 3.7×
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 19 $43,703.00 $270,525.25 $140,900.47 nat. median
$62,038
outlier · 2.3×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 19 $52,072.00 $327,726.00 $140,154.41 nat. median
$72,473
1.9× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 18 $56,017.00 $437,798.00 $137,209.68 nat. median
$78,037
1.8× median
223
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 $62,798.84 $233,474.83 $136,736.79 nat. median
$32,619
outlier · 4.2×
461
MS_DRG 		Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 19 $41,602.00 $369,393.00 $133,897.00 nat. median
$53,342
outlier · 2.5×
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 19 $41,419.00 $252,815.50 $133,007.89 nat. median
$57,804
outlier · 2.3×
225
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 $60,840.77 $226,195.10 $132,473.34 nat. median
$34,024
outlier · 3.9×

Other procedures at this hospital

Browse this hospital's 27,502 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
             
J3399 HCPCS Inj Onase Abepar-xioi Treat 5 4 — — $2,680,037.38 $4,910,221.21 $4,467,936.34 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 1 1 — — $3,691,450.00 $3,691,450.00 $3,691,450.00 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 1 1 — — $3,316,897.12 $3,316,897.12 $3,316,897.12 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 11 5 — — $587,977.76 $3,564,325.44 $997,736.25 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 11 5 — — $468,805.05 $2,727,077.60 $903,143.93 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel 460000000 Cells IV Susp 29 16 $1,624,811.86 $812,405.93 50% off $503,455.00 $3,215,558.11 $887,797.00 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 11 5 — — $491,505.08 $2,859,125.57 $883,599.04 2026-04-01
Q2054 HCPCS Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp 29 16 $1,589,189.84 $794,594.92 50% off $496,390.00 $3,145,038.12 $868,333.00 2026-04-01
Q2042 HCPCS Tisagenlecleucel IV Infusion (wrapped) 29 16 $1,392,190.32 $696,095.16 50% off $421,729.00 $2,956,726.24 $777,216.37 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 36 19 $0.01 — $248,134.00 $1,979,545.00 $641,999.54 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 32 18 $0.01 — $185,705.00 $1,478,554.00 $418,167.30 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 36 19 $0.01 — $141,642.00 $1,124,945.00 $328,318.74 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 31 18 $0.01 — $156,628.00 $1,245,210.00 $319,629.66 2026-04-01
5834 APR_DRG Neonate With Ecmo 4 3 $0.01 — $267,255.00 $293,981.00 $277,945.50 2024-12-15
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 13 5 — — $66,818.13 $424,436.00 $276,963.06 2026-04-01
74 APR_DRG Allogeneic Bone Marrow Transplant 4 3 $0.01 — $259,986.00 $285,985.00 $270,385.50 2024-12-15
0100T OTHER Prosth Retina Receive&Gen 8 4 — — $59,420.00 $1,053,168.45 $245,068.30 2026-04-01
5833 APR_DRG Neonate With Ecmo 4 3 $0.01 — $226,302.00 $248,932.00 $235,354.00 2024-12-15
24 APR_DRG Heart And/or Lung Transplant 4 3 $0.01 — $217,696.00 $239,466.00 $226,404.00 2024-12-15
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 41 19 $0.01 — $93,884.00 $741,684.00 $226,381.20 2026-04-01
215 MS_DRG Other Heart Assist System Implant 44 19 $0.01 — $70,761.00 $434,299.75 $202,730.61 2026-04-01
7 MS_DRG Lung Transplant 31 18 $0.01 — $86,943.00 $685,981.00 $195,593.10 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 17 6 — — $29,844.47 $312,935.68 $191,164.96 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 44 19 $0.01 — $64,589.00 $412,475.25 $190,327.95 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 4 1 — — $86,109.33 $320,139.06 $187,492.53 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 39 19 $0.01 — $56,889.00 $350,937.00 $184,889.59 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Or Infection Wi… 39 19 $0.01 — $56,858.00 $337,955.00 $184,784.85 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 31 18 $0.01 — $87,159.00 $687,713.00 $181,827.00 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 4 1 — — $81,431.85 $302,749.04 $177,307.90 2026-04-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 4 3 $0.01 — $169,168.00 $186,085.00 $175,935.00 2024-12-15
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 34 18 $0.01 — $72,718.00 $571,821.00 $172,075.62 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 31 18 $0.01 — $73,540.00 $578,424.00 $171,696.24 2026-04-01
1614 APR_DRG Implantable Heart Assist Systems 4 3 $0.01 — $164,274.00 $180,701.00 $170,845.00 2024-12-15
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 49 20 $0.01 — $52,588.00 $331,483.00 $170,540.76 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 31 18 $0.01 — $69,980.00 $549,854.00 $167,110.00 2026-04-01
C1831 HCPCS Kit Imp Aprevo Spine Lvl 1 54 11 $302,750.00 $151,375.00 50% off $64,097.00 $305,129.00 $166,329.50 2024-12-15
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 3 $0.01 — $153,899.00 $169,289.00 $160,055.00 2024-12-15
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 31 18 $0.01 — $71,118.00 $558,987.00 $156,616.00 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 4 1 — — $71,098.95 $264,333.16 $154,809.27 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 8 3 — — $66,809.79 $353,441.42 $153,822.51 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 39 19 $0.01 — $54,189.00 $352,677.77 $151,307.00 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 39 19 $0.01 — $45,074.00 $291,324.75 $145,478.30 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 13 7 — — $27,565.71 $182,899.07 $143,948.03 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 39 19 $0.01 — $43,703.00 $270,525.25 $140,900.47 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 42 19 $0.01 — $52,072.00 $327,726.00 $140,154.41 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 31 18 $0.01 — $56,017.00 $437,798.00 $137,209.68 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 4 1 — — $62,798.84 $233,474.83 $136,736.79 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 39 19 $0.01 — $41,602.00 $369,393.00 $133,897.00 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 39 19 $0.01 — $41,419.00 $252,815.50 $133,007.89 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 4 1 — — $60,840.77 $226,195.10 $132,473.34 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 31 18 $0.01 — $61,716.00 $483,533.00 $132,237.78 2026-04-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 4 3 $0.01 — $125,872.00 $138,460.00 $130,907.00 2024-12-15
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 39 19 $0.01 — $40,648.00 $283,776.65 $130,710.53 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 39 19 $0.01 — $40,376.00 $245,984.86 $129,809.36 2026-04-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 3 $0.01 — $124,757.00 $137,233.00 $129,747.00 2024-12-15
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 11 5 — — $64,331.61 $1,231,360.00 $128,663.23 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 45 19 $0.01 — $39,950.00 $249,925.50 $128,384.52 2026-04-01
C1827 HCPCS Generator Imp Vivistim Vns Ipg 1001 27 11 $255,175.00 $127,587.50 50% off $13,005.00 $180,026.00 $126,375.50 2024-12-15
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Or Infection Wi… 39 19 $0.01 — $39,003.00 $248,487.66 $125,224.98 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 4 1 — — $56,447.04 $209,859.99 $122,906.53 2026-04-01
5232 OTHER Level 2 Icd And Similar Procedures 9 7 — — $30,638.21 $222,153.51 $122,857.88 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 16 6 — — $1,282.64 $191,227.60 $121,134.01 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 36 19 $0.01 — $50,285.00 $391,796.00 $119,840.05 2026-04-01
5832 APR_DRG Neonate With Ecmo 4 3 $0.01 — $112,761.00 $124,037.00 $117,271.50 2024-12-15
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 42 19 $0.01 — $36,108.00 $222,895.50 $115,565.27 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 11 5 — — $56,824.55 $419,703.75 $113,649.10 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 45 20 $0.01 — $38,453.09 $365,147.00 $113,506.69 2026-04-01
C1824 HCPCS Generator Pul Implantable Optimizer Smt F/hrt Fail 27 11 $224,900.00 $112,450.00 50% off $52,018.00 $158,667.00 $111,382.00 2024-12-15
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 3 $0.01 — $107,074.00 $117,781.00 $111,357.00 2024-12-15
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 31 18 $0.01 — $47,920.00 $372,821.00 $110,961.82 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 11 5 — — $55,932.43 $468,595.51 $110,544.65 2026-04-01
10 MS_DRG Pancreas Or Islet Cell Transplant 31 18 $0.01 — $53,613.00 $418,503.00 $110,328.38 2026-04-01
C1825 HCPCS System Neo Barostim Includes 2102 Ipg 1036 Csl Kit 27 11 $196,560.00 $98,280.00 50% off $56,020.00 $170,872.00 $109,975.00 2024-12-15
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 31 18 $0.01 — $45,148.00 $350,575.00 $109,874.68 2026-04-01
19 MS_DRG Simultaneous Pancreas, Islet Cell And Kidney Transplant With Hemodialysis 31 18 $0.01 — $53,314.00 $416,104.00 $109,721.50 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 39 18 $0.01 — $47,687.00 $370,947.00 $109,659.50 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 36 19 $0.01 — $46,126.00 $358,417.00 $107,315.66 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 42 19 $0.01 — $33,234.00 $193,826.00 $105,980.37 2026-04-01
C1822 HCPCS Construct Neuromod Nevro Pain Mgmt Omnia With Ipg Rm 36 11 $184,785.62 $92,392.81 50% off $50,538.00 $158,667.00 $104,617.00 2024-12-15
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 44 20 $0.01 — $40,514.76 $339,463.00 $103,761.29 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 39 19 $0.01 — $37,616.00 $257,369.13 $103,747.00 2026-04-01
2004 APR_DRG Cardiac Structural And Valvular Disorders 4 3 $0.01 — $99,501.00 $109,451.00 $103,481.00 2024-12-15
5831 APR_DRG Neonate With Ecmo 4 3 $0.01 — $99,288.00 $109,217.00 $103,259.50 2024-12-15
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc 31 18 $0.01 — $45,317.00 $351,930.00 $103,032.64 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 39 19 $0.01 — $32,236.00 $225,397.87 $102,650.01 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 44 19 $0.01 — $36,261.00 $220,910.75 $101,801.61 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 31 18 $0.01 — $41,927.00 $324,724.00 $101,772.07 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 39 19 $0.01 — $41,743.00 $323,244.00 $101,308.13 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 40 19 $0.01 — $34,786.00 $321,779.07 $101,060.03 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 39 19 $0.01 — $39,546.00 $305,613.00 $100,333.29 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 39 19 $0.01 — $31,502.00 $197,565.50 $100,203.99 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 41 19 $0.01 — $25,918.03 $319,113.00 $100,013.35 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 36 19 $0.01 — $42,829.00 $331,963.00 $98,958.35 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 39 19 $0.01 — $37,925.00 $292,611.00 $96,234.78 2026-04-01
5464 OTHER Level 4 Neurostimulator And Related Procedures 3 2 — — $23,125.45 $95,756.46 $95,756.46 2026-04-01
73 APR_DRG Allogeneic Bone Marrow Transplant 4 3 $0.01 — $91,739.00 $100,913.00 $95,408.50 2024-12-15
228 MS_DRG Other Cardiothoracic Procedures With Mcc 44 19 $0.01 — $34,058.00 $214,619.20 $95,352.77 2026-04-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 4 3 $0.01 — $90,770.00 $99,847.00 $94,401.00 2024-12-15
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Or Infection Wi… 39 19 $0.01 — $29,706.00 $191,555.72 $94,212.21 2026-04-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 4 3 $0.01 — $90,355.00 $99,391.00 $93,969.50 2024-12-15
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 4 3 $0.01 — $90,122.00 $99,134.00 $93,726.50 2024-12-15
463 MS_DRG Wound Debridement Or Skin Graft Except Hand For Musculoskeletal And Connective T… 44 20 $0.01 — $1,475.00 $325,108.00 $93,726.04 2026-04-01
245 MS_DRG Aicd Generator Procedures 40 19 $0.01 — $33,427.00 $218,142.30 $93,508.07 2026-04-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 4 3 $0.01 — $89,734.00 $98,708.00 $93,323.50 2024-12-15
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 40 19 $0.01 — $585.73 $325,144.00 $93,065.76 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 40 19 $0.01 — $36,971.00 $301,166.62 $92,502.52 2026-04-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 4 3 $0.01 — $88,838.00 $97,722.00 $92,391.50 2024-12-15
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 31 18 $0.01 — $40,943.00 $316,824.00 $91,930.28 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 36 19 $0.01 — $38,779.00 $299,461.00 $91,419.86 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 42 19 $0.01 — $28,677.00 $176,740.50 $90,779.93 2026-04-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 4 3 $0.01 — $86,498.00 $95,147.00 $89,957.50 2024-12-15
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 31 18 $0.01 — $37,244.00 $287,147.00 $89,529.36 2026-04-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 4 3 $0.01 — $85,723.00 $94,295.00 $89,152.00 2024-12-15
1613 APR_DRG Implantable Heart Assist Systems 4 3 $0.01 — $85,622.00 $94,184.00 $89,047.00 2024-12-15
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 40 19 $0.01 — $36,753.00 $283,199.00 $89,009.89 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 39 19 $0.01 — $36,757.00 $283,231.00 $88,768.41 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 52 20 $0.01 — $34,176.00 $262,518.00 $88,689.26 2026-04-01
C1823 HCPCS Generator Implantable Remede Pul Cent Sleep Apnea 27 11 $179,010.00 $89,505.00 50% off $18,006.00 $126,292.00 $88,655.00 2024-12-15
33276 HCPCS Insj Phrnc Nrv Stim Sys 11 5 — — $44,320.09 $310,773.45 $88,640.18 2026-04-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 4 3 $0.01 — $85,169.00 $93,686.00 $88,576.00 2024-12-15
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 39 19 $0.01 — $34,214.00 $299,156.26 $88,267.00 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 42 19 $0.01 — $37,616.00 $317,679.98 $88,182.43 2026-04-01
C1816 HCPCS System Stim Nerv Stimq-4 8 Elect Dl Transm Kt 36 11 $166,512.50 $83,256.25 50% off $4,931.00 $125,103.00 $87,820.50 2024-12-15
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 31 18 $0.01 — $37,464.00 $288,910.00 $87,386.86 2026-04-01
52427-273-75 NDC Naproxen Sodium ER 500 Mg Po Tb24 18 11 $150,524.45 $75,262.23 50% off $47,265.00 $127,494.00 $87,379.50 2024-12-15
8 MS_DRG Simultaneous Pancreas, Islet Cell And Kidney Transplant 31 18 $0.01 — $37,052.00 $285,603.00 $87,129.94 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 44 19 $0.01 — $34,684.00 $279,052.59 $86,543.89 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc O… 40 19 $0.01 — $27,523.86 $269,952.00 $86,213.22 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 9 8 — — $85,752.14 $171,504.28 $85,752.14 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 31 18 $0.01 — $40,943.00 $316,824.00 $84,585.80 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 36 18 $0.01 — $34,189.00 $262,623.00 $84,435.33 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 39 19 $0.01 — $32,699.00 $264,785.81 $84,183.00 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 39 19 $0.01 — $32,563.00 $270,187.03 $83,818.00 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc 31 18 $0.01 — $35,149.00 $270,329.00 $83,069.36 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 41 19 $0.01 — $34,408.00 $206,392.00 $82,860.50 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 47 20 $0.01 — $35,037.00 $220,065.92 $82,282.34 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 39 19 $0.01 — $31,890.00 $244,178.00 $82,004.00 2026-04-01
C1767 HCPCS Stimulator Proclaim Elite 7 Rechrg-free Scs 243 11 $142,725.00 $71,362.50 50% off $25,281.00 $238,885.00 $81,334.00 2024-12-15
14 APR_DRG Liver Transplant And/or Intestinal Transplant 4 3 $0.01 — $77,982.00 $85,781.00 $81,101.50 2024-12-15
38240 HCPCS Transplt Allo Hct/donor 11 5 — — $13,172.00 $258,532.19 $80,786.63 2026-04-01
84 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 4 3 $0.01 — $77,670.00 $85,437.00 $80,777.00 2024-12-15
5094 OTHER Level 4 Breast/Lymphatic Surgery And Related Procedures 9 6 — — $14,812.96 $149,588.13 $79,401.50 2026-04-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 4 3 $0.01 — $76,290.00 $83,919.00 $79,341.50 2024-12-15
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 4 3 $0.01 — $76,247.00 $83,872.00 $79,297.00 2024-12-15
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 40 19 $0.01 — $28,360.00 $171,751.00 $78,683.40 2026-04-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 3 $0.01 — $75,610.00 $83,171.00 $78,634.50 2024-12-15
163 MS_DRG Major Chest Procedures With Mcc 52 20 $0.01 — $5,077.00 $262,806.93 $78,538.31 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 40 19 $0.01 — $24,905.00 $143,016.00 $78,198.52 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 5 2 — — $50,510.82 $293,825.58 $77,236.12 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 41 20 $0.01 — $32,071.00 $245,627.00 $76,982.20 2026-04-01
2464 APR_DRG Gastrointestinal Vascular Insufficiency 4 3 $0.01 — $73,939.00 $81,333.00 $76,896.50 2024-12-15
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 39 19 $0.01 — $24,491.00 $219,220.53 $76,812.95 2026-04-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 4 3 $0.01 — $73,557.00 $80,913.00 $76,499.50 2024-12-15
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 39 19 $0.01 — $30,196.00 $230,578.00 $76,115.94 2026-04-01
58468-0132-1 NDC Sevelamer Carbonate 0.8 G Po Pack 18 11 $130,545.57 $65,272.79 50% off $40,991.00 $110,572.00 $75,781.50 2024-12-15
58468-0132-2 NDC Sevelamer Carbonate 0.8 G Po Pack 18 11 $130,545.57 $65,272.79 50% off $40,991.00 $110,572.00 $75,781.50 2024-12-15
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 48 20 $0.01 — $27,040.00 $187,770.82 $75,303.07 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 39 19 $0.01 — $30,442.00 $232,557.00 $75,248.64 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 46 20 $0.01 — $23,992.00 $146,888.50 $75,156.81 2026-04-01
J9226 HCPCS Supprelin La Implant 11 5 — — $37,491.97 $282,820.46 $74,983.95 2026-04-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 4 1 — — $34,246.63 $127,322.82 $74,567.84 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 42 19 $0.01 — $24,324.00 $143,215.00 $74,472.07 2026-04-01
64 APR_DRG Pancreas Transplant 4 3 $0.01 — $71,385.00 $78,524.00 $74,240.50 2024-12-15
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 4 3 $0.01 — $71,380.00 $78,517.00 $74,235.00 2024-12-15
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 41 19 $0.01 — $30,973.00 $244,808.11 $74,219.91 2026-04-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 4 3 $0.01 — $71,166.00 $78,283.00 $74,012.50 2024-12-15
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 46 19 $0.01 — $29,065.22 $256,476.64 $73,893.62 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 31 18 $0.01 — $31,599.00 $241,837.00 $73,793.52 2026-04-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 4 1 — — $33,836.17 $125,796.82 $73,674.11 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 45 20 $0.01 — $32,557.00 $249,532.00 $73,651.78 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 31 18 $0.01 — $33,181.00 $254,535.00 $72,842.62 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 36 19 $0.01 — $30,716.00 $236,068.53 $72,541.31 2026-04-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 4 3 $0.01 — $69,181.00 $76,099.00 $71,948.50 2024-12-15
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 44 19 $0.01 — $22,843.00 $196,756.00 $71,319.33 2026-04-01
68382-395-04 NDC Ribavirin 6 G In Solr 18 11 $121,890.62 $60,945.31 50% off $38,274.00 $103,241.00 $70,757.50 2024-12-15
68382-395-01 NDC Ribavirin 6 G In Solr 18 11 $121,890.62 $60,945.31 50% off $38,274.00 $103,241.00 $70,757.50 2024-12-15
31 MS_DRG Ventricular Shunt Procedures With Mcc 36 19 $0.01 — $28,873.00 $229,470.53 $70,531.78 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 42 19 $0.01 — $22,520.00 $205,237.46 $70,243.50 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 39 19 $0.01 — $29,125.00 $221,991.00 $70,122.42 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 11 5 — — $30,749.39 $201,094.02 $69,826.74 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 42 20 $0.01 — $29,364.00 $226,116.42 $69,705.59 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 47 20 $0.01 — $27,520.00 $209,104.00 $69,598.87 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 44 19 $0.01 — $28,067.00 $219,717.89 $69,472.04 2026-04-01
38240 CPT Hc Trnsplj Allogeneic Hematopoietic Cells Per Donor 18 11 $177,055.20 $88,527.60 50% off $13,172.00 $149,966.00 $69,421.00 2024-12-15
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 39 19 $0.01 — $27,218.00 $223,644.14 $69,412.00 2026-04-01
C2624 HCPCS System Cardiomems Hrt Failure Ptnt 18 11 $140,049.00 $70,024.50 50% off $39,914.00 $98,805.00 $69,359.50 2024-12-15
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 4 3 $0.01 — $66,513.00 $73,164.00 $69,173.50 2024-12-15
34 MS_DRG Carotid Artery Stent Procedures With Mcc 40 19 $0.01 — $26,898.00 $135,724.82 $68,482.30 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 35 18 $0.01 — $29,323.00 $223,576.00 $68,271.14 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 46 19 $0.01 — $7,925.70 $137,734.00 $68,095.86 2026-04-01
59385-027-60 NDC Buprenorphine Hcl 900 Mcg Bu Film 18 11 $117,243.60 $58,621.80 50% off $36,814.00 $99,305.00 $68,059.50 2024-12-15
59385-027-01 NDC Buprenorphine Hcl 900 Mcg Bu Film 18 11 $117,243.60 $58,621.80 50% off $36,814.00 $99,305.00 $68,059.50 2024-12-15
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 4 3 $0.01 — $65,422.00 $71,964.00 $68,038.50 2024-12-15
472 MS_DRG Cervical Spinal Fusion With Cc 46 19 $0.01 — $20,413.00 $116,813.19 $67,938.33 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 40 19 $0.01 — $23,867.00 $215,344.04 $67,803.03 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 39 19 $0.01 — $28,305.00 $215,403.00 $67,564.60 2026-04-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 4 3 $0.01 — $64,891.00 $71,380.00 $67,486.50 2024-12-15
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 39 19 $0.01 — $27,501.00 $208,957.00 $67,409.47 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 36 19 $0.01 — $28,344.00 $220,757.19 $67,102.37 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 31 18 $0.01 — $28,172.00 $214,343.00 $66,992.44 2026-04-01
265 MS_DRG Aicd Lead Procedures 40 19 $0.01 — $24,795.00 $150,199.25 $66,933.96 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc Or Insertion O… 40 19 $0.01 — $23,957.00 $207,007.00 $66,776.31 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 42 19 $0.01 — $25,163.00 $205,419.62 $66,430.09 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 51 20 $0.01 — $489.30 $219,912.00 $66,413.62 2026-04-01
69930 HCPCS Implant Cochlear Device 11 5 — — $33,176.94 $228,646.06 $66,353.89 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 39 19 $0.01 — $24,555.00 $165,226.65 $66,266.00 2026-04-01
999 MS_DRG Ungroupable 3 3 $0.01 — $9,105.36 $65,553.20 $65,553.20 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 40 19 $0.01 — $23,742.00 $143,633.77 $65,185.83 2026-04-01
C1882 HCPCS System Defib Crdc Viva Quad Xt Crt-d 549 11 $112,811.40 $56,405.70 50% off $9.00 $161,411.00 $65,011.00 2024-12-15
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 44 20 $0.01 — $23,650.00 $150,088.09 $64,909.09 2026-04-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 4 3 $0.01 — $62,125.00 $68,338.00 $64,610.00 2024-12-15
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 41 19 $0.01 — $25,329.00 $191,520.00 $64,319.00 2026-04-01
72 APR_DRG Allogeneic Bone Marrow Transplant 4 3 $0.01 — $61,638.00 $67,802.00 $64,104.00 2024-12-15
1612 APR_DRG Implantable Heart Assist Systems 4 3 $0.01 — $61,549.00 $67,704.00 $64,011.00 2024-12-15
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 31 18 $0.01 — $27,052.00 $205,351.00 $63,739.54 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 41 19 $0.01 — $26,718.00 $202,669.00 $63,519.53 2026-04-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 3 $0.01 — $60,845.00 $66,929.00 $63,279.00 2024-12-15
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 42 19 $0.01 — $24,911.00 $194,827.13 $63,197.54 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 11 5 — — $31,583.85 $222,943.91 $63,167.70 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 11 5 — — $31,583.85 $222,943.91 $63,167.70 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 11 5 — — $31,583.85 $222,943.91 $63,167.70 2026-04-01
0571T OTHER Insj/rplcmt Icds Ss Eltrd 11 5 — — $31,583.85 $222,943.91 $63,167.70 2026-04-01
0915T OTHER Insj Perm Ccm-d Sys Pg&eltrd 3 2 — — $31,583.85 $63,167.70 $63,167.70 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 11 5 — — $31,583.85 $222,943.91 $63,167.70 2026-04-01
C2616 HCPCS Microsphere Gl Therasphere Y-90 3 Gbq 35 14 $128,781.90 $64,390.95 50% off $16,749.74 $99,848.95 $62,845.70 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 39 19 $0.01 — $20,195.00 $189,093.43 $62,483.75 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 39 19 $0.01 — $20,157.00 $172,040.00 $62,361.00 2026-04-01
8634 APR_DRG Neonatal Aftercare 4 3 $0.01 — $59,901.00 $65,891.00 $62,297.00 2024-12-15
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 38 20 $0.01 — $24,009.20 $206,758.11 $62,135.98 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 11 5 — — $10,179.00 $207,618.39 $62,098.77 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 11 5 — — $10,179.00 $204,322.92 $62,098.77 2026-04-01
61886 HCPCS Implant Neurostim Arrays 11 5 — — $30,749.39 $201,094.02 $62,098.77 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 11 5 — — $10,179.00 $201,094.02 $62,098.77 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 41 19 $0.01 — $820.83 $131,859.25 $62,053.65 2026-04-01
C1820 HCPCS Stimulator Neurostim Gastric Enterra Ii 171 11 $107,581.50 $53,790.75 50% off $2,330.00 $155,951.00 $62,030.00 2024-12-15
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 31 18 $0.01 — $29,764.00 $227,119.00 $61,874.64 2026-04-01
5231 OTHER Level 1 Icd And Similar Procedures 4 2 — — $23,755.55 $65,354.19 $61,815.80 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 39 19 $0.01 — $24,381.00 $190,449.47 $61,765.00 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 39 19 $0.01 — $24,364.00 $196,989.72 $61,721.00 2026-04-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 4 3 $0.01 — $59,326.00 $65,259.00 $61,699.00 2024-12-15
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 35 18 $0.01 — $27,166.00 $206,265.00 $61,442.00 2026-04-01
0008-0423-03 NDC Antivenin Micrurus Fulvius IV Solr 18 11 $105,554.39 $52,777.20 50% off $33,144.00 $89,405.00 $61,274.50 2024-12-15
0008-0423-01 NDC Antivenin Micrurus Fulvius IV Solr 18 11 $105,554.39 $52,777.20 50% off $33,144.00 $89,405.00 $61,274.50 2024-12-15
332 MS_DRG Rectal Resection With Mcc 39 19 $0.01 — $24,151.00 $218,437.14 $61,146.00 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 40 19 $0.01 — $12,052.74 $197,383.40 $61,083.07 2026-04-01
1611 APR_DRG Implantable Heart Assist Systems 4 3 $0.01 — $58,373.00 $64,211.00 $60,708.00 2024-12-15
5116 OTHER Level 6 Musculoskeletal Procedures 6 5 — — $17,987.55 $81,937.92 $60,698.43 2026-04-01
4404 APR_DRG Kidney Transplant 4 3 $0.01 — $58,229.00 $64,052.00 $60,558.00 2024-12-15
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 4 3 $0.01 — $57,963.00 $63,759.00 $60,281.50 2024-12-15
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 4 3 $0.01 — $57,943.00 $63,738.00 $60,261.00 2024-12-15
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 40 19 $0.01 — $24,549.00 $185,263.00 $60,025.63 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 37 19 $0.01 — $25,702.53 $202,086.50 $59,937.36 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc Or In… 42 20 $0.01 — $20,892.99 $213,761.00 $59,736.26 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 11 5 — — $28,861.53 $196,969.69 $59,420.00 2026-04-01
0408T OTHER Insj/rplc Cardiac Modulj Sys 11 5 — — $23,984.81 $156,855.22 $59,420.00 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc Or Insertion… 44 19 $0.01 — $10,216.12 $207,110.00 $59,402.84 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 46 20 $0.01 — $10,227.49 $196,418.00 $59,262.21 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 42 19 $0.01 — $24,126.00 $181,873.00 $59,154.15 2026-04-01
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 4 3 $0.01 — $56,448.00 $62,093.00 $58,706.00 2024-12-15
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 4 3 $0.01 — $56,448.00 $62,093.00 $58,706.00 2024-12-15
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 4 3 $0.01 — $56,288.00 $61,917.00 $58,539.50 2024-12-15
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 39 19 $0.01 — $23,060.00 $173,317.00 $58,365.34 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 37 19 $0.01 — $22,422.00 $168,199.00 $57,625.06 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 39 19 $0.01 — $22,773.00 $172,429.65 $57,432.00 2026-04-01
4414 APR_DRG Major Bladder Procedures 4 3 $0.01 — $55,106.00 $60,616.00 $57,310.00 2024-12-15
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 42 19 $0.01 — $18,622.00 $168,687.67 $57,238.11 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 31 18 $0.01 — $24,176.00 $182,272.00 $57,124.63 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 36 19 $0.01 — $22,224.00 $177,132.75 $56,951.19 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 44 19 $0.01 — $26,743.00 $208,185.84 $56,775.79 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 40 19 $0.01 — $23,419.00 $176,193.00 $56,668.57 2026-04-01
665 MS_DRG Prostatectomy With Mcc 39 19 $0.01 — $23,922.00 $180,230.00 $56,486.30 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 49 20 $0.01 — $23,901.00 $142,536.50 $56,433.65 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 38 19 $0.01 — $19,813.00 $127,560.38 $55,991.57 2026-04-01
23 APR_DRG Heart And/or Lung Transplant 4 3 $0.01 — $53,618.00 $58,980.00 $55,763.00 2024-12-15
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 44 20 $0.01 — $193.93 $119,391.00 $55,105.01 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 39 19 $0.01 — $17,978.00 $155,523.24 $55,088.95 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 43 19 $0.01 — $17,643.46 $183,857.00 $54,996.76 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 41 19 $0.01 — $17,962.49 $113,302.00 $54,632.16 2026-04-01
83 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 4 3 $0.01 — $52,499.00 $57,749.00 $54,599.00 2024-12-15
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 39 19 $0.01 — $17,830.00 $108,241.71 $54,593.64 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 11 5 — — $22,381.75 $156,855.22 $54,465.51 2026-04-01
0409T OTHER Insj/rplc Car Modulj Pls Gn 11 5 — — $22,381.75 $156,855.22 $54,465.51 2026-04-01
0515T OTHER Insj Wcs Lv Compl Sys 11 5 — — $22,381.75 $156,855.22 $54,465.51 2026-04-01
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 11 5 — — $22,381.75 $156,855.22 $54,465.51 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 11 5 — — $22,381.75 $156,855.22 $54,465.51 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 11 5 — — $22,381.75 $156,855.22 $54,465.51 2026-04-01
0520T OTHER Rmvl&rplcmt Pg Wcs New Eltrd 11 5 — — $10,516.92 $156,855.22 $54,465.51 2026-04-01
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 11 5 — — $22,381.75 $156,855.22 $54,465.51 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 11 5 — — $22,381.75 $156,855.22 $54,465.51 2026-04-01
0187-0007-14 NDC Ribavirin 6 G In Solr 18 11 $93,484.99 $46,742.49 50% off $29,354.00 $79,182.00 $54,268.00 2024-12-15
500 MS_DRG Soft Tissue Procedures With Mcc 42 19 $0.01 — $18,158.85 $191,988.76 $54,095.76 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 44 20 $0.01 — $16,286.40 $171,086.00 $53,686.42 2026-04-01
1784 APR_DRG External Heart Assist Systems 4 3 $0.01 — $51,613.00 $56,774.00 $53,677.50 2024-12-15
24338-050-08 NDC Carmustine In Polifeprosan 7.7 Mg Il Wafr 18 11 $92,097.04 $46,048.52 50% off $28,918.00 $78,006.00 $53,462.00 2024-12-15
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 41 20 $0.01 — $21,690.00 $189,045.28 $53,440.45 2026-04-01
0781-5893-31 NDC Nevirapine ER 400 Mg Po Tb24 18 11 $91,654.60 $45,827.30 50% off $28,780.00 $77,631.00 $53,205.50 2024-12-15
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 39 19 $0.01 — $19,361.00 $197,021.22 $53,149.56 2026-04-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 4 3 $0.01 — $50,828.00 $55,911.00 $52,861.00 2024-12-15
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 4 3 $0.01 — $50,770.00 $55,847.00 $52,800.50 2024-12-15
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 40 19 $0.01 — $21,634.00 $168,408.92 $52,697.32 2026-04-01
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