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

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Hospital

Warm Springs Rehab Hospital Of San Antonio Llc

San Antonio, TX · CCN 453035 · Rates published

15,107 distinct procedures filed
100 distinct payers
407,503 rate rows
2025-09-11 last MRF observed
Data quality

399,500 of 407,503 rate rows are consumer-grade (98.0%)

8,003 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 6,510
per-diem day rate — not a per-procedure price 1,370
template filing: same amount across many unrelated codes — excluded 51
percent-of-charges filed in the dollar field — excluded from medians 42
exceeds 10× this hospital's gross charge — excluded from medians 26
placeholder amount (≤ $0.02) — excluded from medians 4
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/11039/383743546_post-acute-medical-at-san-antonio-llc_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/WarmSpringsSanAntonio/11039
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint 4904ae00215a20cf… · 18,214,264 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 $4,377,500.00 $4,377,500.00 $4,377,500.00 nat. median
$4,505,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 1 $3,710,000.00 $3,710,000.00 $3,710,000.00 nat. median
$3,710,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 1 $3,685,266.67 $3,685,266.67 $3,685,266.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 1 $3,324,571.90 $3,324,571.90 $3,324,571.90 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 1 $3,261,355.00 $3,261,355.00 $3,261,355.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 1 $2,950,686.67 $2,950,686.67 $2,950,686.67 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 1 $2,452,115.60 $2,452,115.60 $2,452,115.60 nat. median
$2,469,189
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 1 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 1 $770,620.00 $770,620.00 $770,620.00 nat. median
$824,563
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 1 $578,324.58 $578,324.58 $578,324.58 nat. median
$754,974
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 1 $553,378.83 $553,378.83 $553,378.83 nat. median
$675,122
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 1 $541,635.66 $541,635.66 $541,635.66 nat. median
$674,188
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 1 $541,260.45 $541,260.45 $541,260.45 nat. median
$625,184
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 1 $489,720.00 $489,720.00 $489,720.00 nat. median
$620,080
0.8× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 2 $387,472.40 $533,076.48 $460,274.44 nat. median
$634,511
0.7× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 1 $270,375.00 $270,375.00 $270,375.00 nat. median
$324,450
0.8× median
1614
APR_DRG 		Implantable Heart Assist Systems 3 $152,022.84 $630,395.07 $155,823.41 nat. median
$207,730
0.8× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 3 $142,421.46 $590,580.92 $145,981.99 nat. median
$164,834
0.9× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 13 $128,475.86 $214,126.43 $145,657.73 nat. median
$202,986
0.7× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And… 13 $105,670.36 $176,117.27 $119,802.32 nat. median
$133,176
0.9× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 1 $109,306.00 $109,306.00 $109,306.00 nat. median
$111,989
1.0× median
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 $99,088.76 $410,892.62 $101,565.98 nat. median
$117,173
0.9× median
164
MS_DRG 		Major Chest Procedures With Cc 13 $87,208.95 $145,348.25 $98,871.94 nat. median
$25,707
outlier · 3.8×
165
MS_DRG 		Major Chest Procedures Without Cc/mcc 13 $87,208.95 $145,348.25 $98,871.94 nat. median
$19,862
outlier · 5.0×
163
MS_DRG 		Major Chest Procedures With Mcc 13 $87,208.95 $145,348.25 $98,871.94 nat. median
$44,938
outlier · 2.2×
140
MS_DRG 		Major Head And Neck Procedures With Mcc 13 $86,094.41 $143,490.69 $97,608.37 nat. median
$40,208
outlier · 2.4×
11
MS_DRG 		Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 13 $86,094.41 $143,490.69 $97,608.37 nat. median
$52,857
1.8× median
166
MS_DRG 		Other Respiratory System O.r. Procedures With Mcc 13 $86,094.41 $143,490.69 $97,608.37 nat. median
$37,476
outlier · 2.6×
981
MS_DRG 		Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 13 $86,083.38 $143,472.30 $97,595.86 nat. median
$46,084
outlier · 2.1×
2004
APR_DRG 		Cardiac Structural And Valvular Disorders 3 $92,080.74 $381,832.40 $94,382.76 nat. median
$32,636
outlier · 2.9×
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 1 $93,216.70 $93,216.70 $93,216.70 nat. median
$96,983
1.0× median
987
MS_DRG 		Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 13 $78,458.26 $130,763.76 $88,950.97 nat. median
$33,847
outlier · 2.6×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 13 $76,218.17 $127,030.28 $86,411.30 nat. median
$66,526
1.3× median
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 3 $83,400.59 $345,838.30 $85,485.60 nat. median
$105,658
0.8× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 3 $83,042.06 $344,351.60 $85,118.11 nat. median
$160,267
0.5× median
B0407
LOCAL 		Traumatic Spinal Cord Injury M <24.50 And A >=61.50 46 $72,407.14 $141,719.82 $82,183.04 nat. median
$79,920
1.0× median
8504
APR_DRG 		Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 3 $80,046.86 $331,931.37 $82,048.03 nat. median
$73,845
1.1× median
1613
APR_DRG 		Implantable Heart Assist Systems 3 $79,236.36 $328,570.42 $81,217.27 nat. median
$119,796
0.7× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support &gt;96 Hours 13 $71,528.33 $119,213.88 $81,094.26 nat. median
$62,134
1.3× median
C0407
LOCAL 		Traumatic Spinal Cord Injury M <24.50 And A >=61.50 46 $64,390.25 $126,028.67 $73,083.78 nat. median
$70,083
1.0× median
6814
APR_DRG 		Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 3 $70,600.49 $292,759.96 $72,365.50 nat. median
$73,428
1.0× median
1604
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly 3 $70,561.09 $292,596.57 $72,325.11 nat. median
$97,957
0.7× median
93
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 3 $69,971.36 $290,151.15 $71,720.64 nat. median
$79,160
0.9× median
B1904
LOCAL 		Guillain-barré M <38.50 46 $62,653.63 $122,629.64 $71,112.69 nat. median
$68,345
1.0× median
D0407
LOCAL 		Traumatic Spinal Cord Injury M <24.50 And A >=61.50 46 $62,506.34 $122,341.37 $70,945.52 nat. median
$67,662
1.0× median
2464
APR_DRG 		Gastrointestinal Vascular Insufficiency 3 $68,424.59 $283,737.13 $70,135.21 nat. median
$22,749
outlier · 3.1×
L8702
HCPCS 		Ewhf S/d Uprt Micro Sensor 1 $67,452.66 $67,452.66 $67,452.66 nat. median
$70,825
1.0× median
B1806
LOCAL 		Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 46 $58,935.48 $115,352.25 $66,892.54 nat. median
$64,290
1.0× median
12
MS_DRG 		Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 13 $58,017.92 $96,696.53 $65,777.01 nat. median
$40,916
1.6× median
168
MS_DRG 		Other Respiratory System O.r. Procedures Without Cc/mcc 13 $58,017.92 $96,696.53 $65,777.01 nat. median
$14,495
outlier · 4.5×

Other procedures at this hospital

Browse this hospital's 15,107 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 21 13 — — $86,094.41 $143,490.69 $97,608.37 2025-09-11
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 3 — — $56,307.35 $233,490.41 $57,715.04 2025-09-11
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 3 — — $99,088.76 $410,892.62 $101,565.98 2025-09-11
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 21 13 — — $58,017.92 $96,696.53 $65,777.01 2025-09-11
140 MS_DRG Major Head And Neck Procedures With Mcc 21 13 — — $86,094.41 $143,490.69 $97,608.37 2025-09-11
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 4 3 — — $70,561.09 $292,596.57 $72,325.11 2025-09-11
1611 APR_DRG Implantable Heart Assist Systems 4 3 — — $54,020.08 $224,005.77 $55,370.58 2025-09-11
1612 APR_DRG Implantable Heart Assist Systems 4 3 — — $56,958.62 $236,191.05 $58,382.59 2025-09-11
1613 APR_DRG Implantable Heart Assist Systems 4 3 — — $79,236.36 $328,570.42 $81,217.27 2025-09-11
1614 APR_DRG Implantable Heart Assist Systems 4 3 — — $152,022.84 $630,395.07 $155,823.41 2025-09-11
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 4 3 — — $61,552.69 $255,241.35 $63,091.51 2025-09-11
163 MS_DRG Major Chest Procedures With Mcc 21 13 — — $87,208.95 $145,348.25 $98,871.94 2025-09-11
164 MS_DRG Major Chest Procedures With Cc 21 13 — — $87,208.95 $145,348.25 $98,871.94 2025-09-11
165 MS_DRG Major Chest Procedures Without Cc/mcc 21 13 — — $87,208.95 $145,348.25 $98,871.94 2025-09-11
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 21 13 — — $86,094.41 $143,490.69 $97,608.37 2025-09-11
167 MS_DRG Other Respiratory System O.r. Procedures With Cc 21 13 — — $58,017.92 $96,696.53 $65,777.01 2025-09-11
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 4 3 — — $46,775.66 $193,965.22 $47,945.05 2025-09-11
168 MS_DRG Other Respiratory System O.r. Procedures Without Cc/mcc 21 13 — — $58,017.92 $96,696.53 $65,777.01 2025-09-11
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 21 13 — — $58,017.92 $96,696.53 $65,777.01 2025-09-11
1784 APR_DRG External Heart Assist Systems 4 3 — — $47,763.64 $198,062.09 $48,957.73 2025-09-11
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
2004 APR_DRG Cardiac Structural And Valvular Disorders 4 3 — — $92,080.74 $381,832.40 $94,382.76 2025-09-11
202 MS_DRG Bronchitis And Asthma With Cc/mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
205 MS_DRG Other Respiratory System Diagnoses With Mcc 21 13 — — $48,237.30 $80,395.50 $54,688.37 2025-09-11
207 MS_DRG Respiratory System Diagnosis With Ventilator Support &gt;96 Hours 21 13 — — $71,528.33 $119,213.88 $81,094.26 2025-09-11
208 MS_DRG Respiratory System Diagnosis With Ventilator Support &lt;=96 Hours 21 13 — — $43,433.43 $72,389.06 $49,242.05 2025-09-11
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
215 MS_DRG Other Heart Assist System Implant 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
228 MS_DRG Other Cardiothoracic Procedures With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
231 MS_DRG Coronary Bypass With Ptca With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
232 MS_DRG Coronary Bypass With Ptca Without Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
241 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc… 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
245 MS_DRG Aicd Generator Procedures 21 13 — — $46,736.55 $77,894.25 $52,986.92 2025-09-11
2464 APR_DRG Gastrointestinal Vascular Insufficiency 4 3 — — $68,424.59 $283,737.13 $70,135.21 2025-09-11
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
251 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
252 MS_DRG Other Vascular Procedures With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
253 MS_DRG Other Vascular Procedures With Cc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
254 MS_DRG Other Vascular Procedures Without Cc/mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
256 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Cc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
257 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders Without Cc/mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
263 MS_DRG Vein Ligation And Stripping 21 13 — — $46,736.55 $77,894.25 $52,986.92 2025-09-11
264 MS_DRG Other Circulatory System O.r. Procedures 21 13 — — $46,736.55 $77,894.25 $52,986.92 2025-09-11
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
271 MS_DRG Other Major Cardiovascular Procedures With Cc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
28 MS_DRG Spinal Procedures With Mcc 21 13 — — $44,102.88 $73,504.80 $50,001.04 2025-09-11
28730 CPT Fusion Of Foot Bones 153 66 $57,929.13 $57,929.13 $701.72 $49,239.76 $44,895.07 2025-09-11
288 MS_DRG Acute And Subacute Endocarditis With Mcc 21 13 — — $37,481.93 $62,469.89 $42,494.63 2025-09-11
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 21 13 — — $44,102.88 $73,504.80 $50,001.04 2025-09-11
3 MS_DRG Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 21 13 — — $128,475.86 $214,126.43 $145,657.73 2025-09-11
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 4 3 — — $43,425.51 $180,073.14 $44,511.15 2025-09-11
31 MS_DRG Ventricular Shunt Procedures With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
32 MS_DRG Ventricular Shunt Procedures With Cc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
33 MS_DRG Ventricular Shunt Procedures Without Cc/mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
34 MS_DRG Carotid Artery Stent Procedures With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
35 MS_DRG Carotid Artery Stent Procedures With Cc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 21 13 — — $51,341.79 $85,569.65 $58,208.05 2025-09-11
36 MS_DRG Carotid Artery Stent Procedures Without Cc/mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
37 MS_DRG Extracranial Procedures With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
38 MS_DRG Extracranial Procedures With Cc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
385 MS_DRG Inflammatory Bowel Disease With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
39 MS_DRG Extracranial Procedures Without Cc/mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
393 MS_DRG Other Digestive System Diagnoses With Mcc 21 13 — — $37,371.58 $62,285.97 $42,369.52 2025-09-11
4 MS_DRG Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And … 21 13 — — $105,670.36 $176,117.27 $119,802.32 2025-09-11
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 21 13 — — $54,034.31 $90,057.18 $61,260.66 2025-09-11
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
42 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 21 13 — — $39,104.06 $65,173.44 $44,333.70 2025-09-11
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 21 13 — — $39,104.06 $65,173.44 $44,333.70 2025-09-11
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 21 13 — — $39,104.06 $65,173.44 $44,333.70 2025-09-11
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 4 3 — — $53,622.15 $222,355.68 $54,962.71 2025-09-11
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 4 3 — — $46,071.63 $191,045.83 $47,223.42 2025-09-11
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 21 13 — — $38,537.60 $64,229.34 $43,691.48 2025-09-11
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 4 3 — — $83,400.59 $345,838.30 $85,485.60 2025-09-11
4414 APR_DRG Major Bladder Procedures 4 3 — — $50,996.23 $211,466.71 $52,271.14 2025-09-11
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 21 13 — — $39,104.06 $65,173.44 $44,333.70 2025-09-11
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 21 13 — — $39,104.06 $65,173.44 $44,333.70 2025-09-11
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 21 13 — — $46,387.11 $77,311.85 $52,590.75 2025-09-11
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
499 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur Without… 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
500 MS_DRG Soft Tissue Procedures With Mcc 21 13 — — $45,305.69 $75,509.48 $51,364.70 2025-09-11
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 21 13 — — $44,102.88 $73,504.80 $50,001.04 2025-09-11
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
519 MS_DRG Back And Neck Procedures Except Spinal Fusion With Cc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
52 MS_DRG Spinal Disorders And Injuries With Cc/mcc 21 13 — — $39,104.06 $65,173.44 $44,333.70 2025-09-11
53 MS_DRG Spinal Disorders And Injuries Without Cc/mcc 21 13 — — $39,104.06 $65,173.44 $44,333.70 2025-09-11
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 4 3 — — $53,640.39 $222,431.30 $54,981.40 2025-09-11
54 MS_DRG Nervous System Neoplasms With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
551 MS_DRG Medical Back Problems With Mcc 21 13 — — $48,034.99 $80,058.32 $54,459.02 2025-09-11
562 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
570 MS_DRG Skin Debridement With Mcc 21 13 — — $43,304.69 $72,174.48 $49,096.10 2025-09-11
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 21 13 — — $51,146.84 $85,244.73 $57,987.02 2025-09-11
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 21 13 — — $49,896.22 $83,160.36 $56,569.15 2025-09-11
580 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Cc 21 13 — — $41,005.75 $68,342.91 $46,489.70 2025-09-11
581 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures Without Cc/mcc 21 13 — — $41,005.75 $68,342.91 $46,489.70 2025-09-11
582 MS_DRG Mastectomy For Malignancy With Cc/mcc 21 13 — — $49,896.22 $83,160.36 $56,569.15 2025-09-11
583 MS_DRG Mastectomy For Malignancy Without Cc/mcc 21 13 — — $41,005.75 $68,342.91 $46,489.70 2025-09-11
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 21 13 — — $47,847.39 $79,745.66 $54,246.33 2025-09-11
619 MS_DRG O.r. Procedures For Obesity With Mcc 21 13 — — $48,097.52 $80,162.54 $54,529.91 2025-09-11
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 21 13 — — $48,097.52 $80,162.54 $54,529.91 2025-09-11
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 21 13 — — $47,847.39 $79,745.66 $54,246.33 2025-09-11
643 MS_DRG Endocrine Disorders With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
653 MS_DRG Major Bladder Procedures With Mcc 21 13 — — $44,033.00 $73,388.33 $49,921.81 2025-09-11
654 MS_DRG Major Bladder Procedures With Cc 21 13 — — $38,493.47 $64,155.78 $43,641.44 2025-09-11
665 MS_DRG Prostatectomy With Mcc 21 13 — — $44,033.00 $73,388.33 $49,921.81 2025-09-11
666 MS_DRG Prostatectomy With Cc 21 13 — — $38,493.47 $64,155.78 $43,641.44 2025-09-11
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 21 13 — — $44,033.00 $73,388.33 $49,921.81 2025-09-11
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 21 13 — — $38,493.47 $64,155.78 $43,641.44 2025-09-11
675 MS_DRG Other Kidney And Urinary Tract Procedures Without Cc/mcc 21 13 — — $38,493.47 $64,155.78 $43,641.44 2025-09-11
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 4 3 — — $52,238.53 $216,618.17 $53,544.49 2025-09-11
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 4 3 — — $70,600.49 $292,759.96 $72,365.50 2025-09-11
6904 APR_DRG Acute Leukemia 4 3 — — $46,355.59 $192,223.31 $47,514.48 2025-09-11
693 MS_DRG Urinary Stones With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
73 MS_DRG Cranial And Peripheral Nerve Disorders With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
735 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy Without Cc/mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
737 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
738 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy Without Cc/mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
740 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Cc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
741 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy Without… 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
742 MS_DRG Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
743 MS_DRG Uterine And Adnexa Procedures For Non-malignancy Without Cc/mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
744 MS_DRG D&amp;C, Conization, Laparoscopy And Tubal Interruption With Cc/mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
745 MS_DRG D&amp;C, Conization, Laparoscopy And Tubal Interruption Without Cc/mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
746 MS_DRG Vagina, Cervix And Vulva Procedures With Cc/mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
747 MS_DRG Vagina, Cervix And Vulva Procedures Without Cc/mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
748 MS_DRG Female Reproductive System Reconstructive Procedures 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
750 MS_DRG Other Female Reproductive System O.r. Procedures Without Cc/mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
754 MS_DRG Malignancy, Female Reproductive System With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
755 MS_DRG Malignancy, Female Reproductive System With Cc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
783 MS_DRG Cesarean Section With Sterilization With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
784 MS_DRG Cesarean Section With Sterilization With Cc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
786 MS_DRG Cesarean Section Without Sterilization With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
787 MS_DRG Cesarean Section Without Sterilization With Cc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
799 MS_DRG Splenic Procedures With Mcc 21 13 — — $51,341.79 $85,569.65 $58,208.05 2025-09-11
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
82 MS_DRG Traumatic Stupor And Coma &gt;1 Hour With Mcc 21 13 — — $39,464.54 $65,774.24 $44,742.38 2025-09-11
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
822 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures Without Cc/mcc 21 13 — — $46,251.01 $77,085.02 $52,436.45 2025-09-11
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
828 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 21 13 — — $46,251.01 $77,085.02 $52,436.45 2025-09-11
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 4 3 — — $83,042.06 $344,351.60 $85,118.11 2025-09-11
843 MS_DRG Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses… 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
850 MS_DRG Acute Leukemia With Other Procedures 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 4 3 — — $80,046.86 $331,931.37 $82,048.03 2025-09-11
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 21 13 — — $55,770.46 $92,950.77 $63,229.00 2025-09-11
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 21 13 — — $49,568.84 $82,614.74 $56,198.00 2025-09-11
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
870 MS_DRG Septicemia Or Severe Sepsis With Mv &gt;96 Hours 21 13 — — $76,218.17 $127,030.28 $86,411.30 2025-09-11
901 MS_DRG Wound Debridements For Injuries With Mcc 21 13 — — $47,196.33 $78,660.56 $53,508.20 2025-09-11
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 21 13 — — $46,251.01 $77,085.02 $52,436.45 2025-09-11
908 MS_DRG Other O.r. Procedures For Injuries With Cc 21 13 — — $46,251.01 $77,085.02 $52,436.45 2025-09-11
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 3 — — $44,630.04 $185,067.97 $45,745.79 2025-09-11
917 MS_DRG Poisoning And Toxic Effects Of Drugs With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
918 MS_DRG Poisoning And Toxic Effects Of Drugs Without Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
919 MS_DRG Complications Of Treatment With Mcc 21 13 — — $39,446.15 $65,743.58 $44,721.53 2025-09-11
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 3 — — $46,019.86 $190,831.13 $47,170.35 2025-09-11
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 3 — — $69,971.36 $290,151.15 $71,720.64 2025-09-11
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 21 13 — — $43,602.63 $72,671.06 $49,433.89 2025-09-11
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 3 — — $142,421.46 $590,580.92 $145,981.99 2025-09-11
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 21 13 — — $39,402.01 $65,670.02 $44,671.49 2025-09-11
955 MS_DRG Craniotomy For Multiple Significant Trauma 21 13 — — $46,251.01 $77,085.02 $52,436.45 2025-09-11
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 21 13 — — $46,251.01 $77,085.02 $52,436.45 2025-09-11
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 21 13 — — $46,251.01 $77,085.02 $52,436.45 2025-09-11
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 21 13 — — $46,251.01 $77,085.02 $52,436.45 2025-09-11
963 MS_DRG Other Multiple Significant Trauma With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 21 13 — — $46,431.25 $77,385.42 $52,640.79 2025-09-11
974 MS_DRG HIV With Major Related Condition With Mcc 21 13 — — $41,917.97 $69,863.28 $47,523.92 2025-09-11
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 21 13 — — $86,083.38 $143,472.30 $97,595.86 2025-09-11
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 21 13 — — $46,626.20 $77,710.34 $52,861.81 2025-09-11
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 21 13 — — $78,458.26 $130,763.76 $88,950.97 2025-09-11
A0106 LOCAL Stroke M <41.50 And A <84.50 86 46 — — $37,594.24 $73,581.81 $42,669.95 2025-09-11
A0404 LOCAL Traumatic Spinal Cord Injury M <31.50 And A <61.50 86 46 — — $40,942.45 $80,135.15 $46,470.22 2025-09-11
A0406 LOCAL Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 86 46 — — $41,545.31 $81,315.09 $47,154.46 2025-09-11
A0407 LOCAL Traumatic Spinal Cord Injury M <24.50 And A >=61.50 86 46 — — $56,796.39 $111,165.48 $64,464.64 2025-09-11
A1806 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 86 46 — — $41,384.32 $80,999.99 $46,971.74 2025-09-11
A1904 LOCAL Guillain-barré M <38.50 86 46 — — $44,169.07 $86,450.49 $50,132.47 2025-09-11
A5104 LOCAL Expired, Not Orthopedic, Length Of Stay Is 16 Days Or More 86 46 — — $40,819.14 $79,893.80 $46,330.26 2025-09-11
A9543 HCPCS Y90 Ibritumomab, Rx 1 1 — — $56,824.55 $56,824.55 $56,824.55 2025-09-11
B0105 LOCAL Stroke M <41.50 And A >=84.50 86 46 — — $43,763.18 $85,656.05 $49,671.77 2025-09-11
B0106 LOCAL Stroke M <41.50 And A <84.50 86 46 — — $49,776.27 $97,425.26 $56,496.71 2025-09-11
B0205 LOCAL Traumatic Brain Injury M <35.50 86 46 — — $45,188.09 $88,445.00 $51,289.08 2025-09-11
B0304 LOCAL Non-traumatic Brain Injury M <42.50 And A >=78.50 86 46 — — $37,029.06 $72,475.62 $42,028.47 2025-09-11
B0305 LOCAL Non-traumatic Brain Injury M <42.50 And A <78.50 86 46 — — $40,837.98 $79,930.68 $46,351.64 2025-09-11
B0404 LOCAL Traumatic Spinal Cord Injury M <31.50 And A <61.50 86 46 — — $52,194.52 $102,158.40 $59,241.46 2025-09-11
B0405 LOCAL Traumatic Spinal Cord Injury M >=31.50 And M <41.50 86 46 — — $41,507.63 $81,241.34 $47,111.69 2025-09-11
B0406 LOCAL Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 86 46 — — $52,963.50 $103,663.50 $60,114.26 2025-09-11
B0407 LOCAL Traumatic Spinal Cord Injury M <24.50 And A >=61.50 86 46 — — $72,407.14 $141,719.82 $82,183.04 2025-09-11
B0504 LOCAL Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50 86 46 — — $37,176.35 $72,763.89 $42,195.64 2025-09-11
B0505 LOCAL Non-traumatic Spinal Cord Injury M <39.50 86 46 — — $51,658.46 $101,109.20 $58,633.03 2025-09-11
B0604 LOCAL Neurological M <43.50 86 46 — — $42,651.67 $83,480.54 $48,410.20 2025-09-11
B0704 LOCAL Fracture Of Lower Extremity M <41.50 86 46 — — $39,858.35 $78,013.28 $45,239.75 2025-09-11
B1004 LOCAL Amputation Lower Extremity M <47.50 86 46 — — $39,409.64 $77,135.03 $44,730.45 2025-09-11
B1204 LOCAL Osteoarthritis M <49.50 And A <74.50 86 46 — — $37,398.99 $73,199.67 $42,448.34 2025-09-11
B1504 LOCAL Pulmonary M <45.50 86 46 — — $38,952.36 $76,240.02 $44,211.44 2025-09-11
B1604 LOCAL Pain Syndrome M <43.50 86 46 — — $40,204.30 $78,690.41 $45,632.41 2025-09-11
B1704 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50 86 46 — — $38,265.59 $74,895.83 $43,431.94 2025-09-11
B1705 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50 86 46 — — $44,905.51 $87,891.90 $50,968.34 2025-09-11
B1805 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50 86 46 — — $41,499.06 $81,224.58 $47,101.98 2025-09-11
B1806 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 86 46 — — $58,935.48 $115,352.25 $66,892.54 2025-09-11
B1903 LOCAL Guillain-barré M >=38.50 And M <51.50 86 46 — — $43,011.33 $84,184.49 $48,818.41 2025-09-11
B1904 LOCAL Guillain-barré M <38.50 86 46 — — $62,653.63 $122,629.64 $71,112.69 2025-09-11
B2005 LOCAL Miscellaneous M <46.50 And A <77.50 86 46 — — $38,041.23 $74,456.70 $43,177.30 2025-09-11
B2102 LOCAL Burns M <52.50 86 46 — — $39,692.23 $77,688.12 $45,051.19 2025-09-11
C0105 LOCAL Stroke M <41.50 And A >=84.50 86 46 — — $37,953.89 $74,285.75 $43,078.16 2025-09-11
C0106 LOCAL Stroke M <41.50 And A <84.50 86 46 — — $43,168.88 $84,492.87 $48,997.25 2025-09-11
C0205 LOCAL Traumatic Brain Injury M <35.50 86 46 — — $37,217.46 $72,844.35 $42,242.29 2025-09-11
C0404 LOCAL Traumatic Spinal Cord Injury M <31.50 And A <61.50 86 46 — — $46,416.06 $90,848.45 $52,682.83 2025-09-11
C0405 LOCAL Traumatic Spinal Cord Injury M >=31.50 And M <41.50 86 46 — — $36,912.60 $72,247.68 $41,896.28 2025-09-11
C0406 LOCAL Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 86 46 — — $47,099.40 $92,185.92 $53,458.44 2025-09-11
C0407 LOCAL Traumatic Spinal Cord Injury M <24.50 And A >=61.50 86 46 — — $64,390.25 $126,028.67 $73,083.78 2025-09-11
C0505 LOCAL Non-traumatic Spinal Cord Injury M <39.50 86 46 — — $40,188.89 $78,660.23 $45,614.91 2025-09-11
C1806 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 86 46 — — $47,015.48 $92,021.67 $53,363.19 2025-09-11
C1904 LOCAL Guillain-barré M <38.50 86 46 — — $48,168.10 $94,277.64 $54,671.42 2025-09-11
D0106 LOCAL Stroke M <41.50 And A <84.50 86 46 — — $39,449.03 $77,212.13 $44,775.16 2025-09-11
D0404 LOCAL Traumatic Spinal Cord Injury M <31.50 And A <61.50 86 46 — — $45,057.93 $88,190.24 $51,141.34 2025-09-11
D0406 LOCAL Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 86 46 — — $45,720.73 $89,487.50 $51,893.62 2025-09-11
D0407 LOCAL Traumatic Spinal Cord Injury M <24.50 And A >=61.50 86 46 — — $62,506.34 $122,341.37 $70,945.52 2025-09-11
D0505 LOCAL Non-traumatic Spinal Cord Injury M <39.50 86 46 — — $37,967.59 $74,312.57 $43,093.71 2025-09-11
D1806 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 86 46 — — $44,634.91 $87,362.27 $50,661.21 2025-09-11
D1904 LOCAL Guillain-barré M <38.50 86 46 — — $44,946.61 $87,972.35 $51,014.99 2025-09-11
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 1 1 — — $3,685,266.67 $3,685,266.67 $3,685,266.67 2025-09-11
J1413 HCPCS Inj Delandistrogene Mox Rokl 1 1 — — $3,324,571.90 $3,324,571.90 $3,324,571.90 2025-09-11
J1414 HCPCS Inj, Beqvez, Per Tx Dose 1 1 — — $3,710,000.00 $3,710,000.00 $3,710,000.00 2025-09-11
J3391 HCPCS Inj, Atidarsagene Autotemcel 1 1 — — $4,377,500.00 $4,377,500.00 $4,377,500.00 2025-09-11
J3392 HCPCS Inj, Exagamglogene Autotem 1 1 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2025-09-11
J3393 HCPCS Inj, Betibeglogene Autotemce 1 1 — — $2,950,686.67 $2,950,686.67 $2,950,686.67 2025-09-11
J3394 HCPCS Inj, Lovotibeglogene Autotem 1 1 — — $3,261,355.00 $3,261,355.00 $3,261,355.00 2025-09-11
J3399 HCPCS Inj Onase Abepar-xioi Treat 1 1 — — $2,452,115.60 $2,452,115.60 $2,452,115.60 2025-09-11
J9029 HCPCS Instill Adstiladrin, Tx Dose 1 1 — — $63,431.05 $63,431.05 $63,431.05 2025-09-11
J9226 HCPCS Supprelin La Implant 1 1 — — $45,560.39 $45,560.39 $45,560.39 2025-09-11
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 1 1 — — $93,216.70 $93,216.70 $93,216.70 2025-09-11
L7180 HCPCS Electronic Elbow Sequential 2 2 — — $40,925.01 $49,026.62 $44,975.82 2025-09-11
L7181 HCPCS Electronic Elbo Simultaneous 1 1 — — $48,628.26 $48,628.26 $48,628.26 2025-09-11
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 1 1 — — $67,452.66 $67,452.66 $67,452.66 2025-09-11
Q0480 HCPCS Driver Pneumatic Vad, Rep 1 1 — — $109,306.00 $109,306.00 $109,306.00 2025-09-11
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 2 2 — — $387,472.40 $533,076.48 $460,274.44 2025-09-11
Q2042 HCPCS Tisagenlecleucel Car-pos T 1 1 — — $578,324.58 $578,324.58 $578,324.58 2025-09-11
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 1 1 — — $55,945.97 $55,945.97 $55,945.97 2025-09-11
Q2053 HCPCS Brexucabtagene Car Pos T 1 1 — — $489,720.00 $489,720.00 $489,720.00 2025-09-11
Q2054 HCPCS Lisocabtagene Mara Car Pos T 1 1 — — $541,635.66 $541,635.66 $541,635.66 2025-09-11
Q2055 HCPCS Idecabtagene Vicleucel Car 1 1 — — $541,260.45 $541,260.45 $541,260.45 2025-09-11
Q2056 HCPCS Ciltacabtagene Car-pos T 1 1 — — $553,378.83 $553,378.83 $553,378.83 2025-09-11
Q2057 HCPCS Afamitresgene Autoleucel 1 1 — — $770,620.00 $770,620.00 $770,620.00 2025-09-11
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 1 1 — — $270,375.00 $270,375.00 $270,375.00 2025-09-11
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