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

CHILDRENS MEDICAL CTR OF DALLAS

Dallas, TX · CCN 453302 · Rates published

12,465 distinct procedures filed
35 distinct payers
406,246 rate rows
2026-08-01 last MRF observed
Data quality

405,834 of 406,246 rate rows are consumer-grade (99.9%)

412 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
percent-of-charges filed in the dollar field — excluded from medians 340
placeholder amount (≤ $0.02) — excluded from medians 56
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 8
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 4
exceeds 10× this hospital's gross charge — excluded from medians 2
per-diem day rate — not a per-procedure price 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://assets.childrens.com/m/21bace01055291fc/original/DALLAS-Price-Transparency-CSV-Cost-Estimates.csv
Found on page https://www.childrens.com/patient-families/billing-and-insurance/cost-estimates
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-08-14
Content fingerprint ab813864affb2fe3… · 120,809,212 bytes · first seen 2026-07-31

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
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 4 $3,500,000.00 $3,500,000.00 $3,500,000.00 nat. median
$3,710,000
0.9× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 4 $3,100,000.00 $3,100,000.00 $3,100,000.00 nat. median
$3,286,000
0.9× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 4 $2,800,000.00 $2,800,000.00 $2,800,000.00 nat. median
$2,997,086
0.9× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 4 $2,200,000.00 $2,200,000.00 $2,200,000.00 nat. median
$2,405,851
0.9× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 5 $2,125,000.00 $2,368,485.25 $2,125,000.00 nat. median
$2,460,273
0.9× median
5834
APR_DRG 		Neonate With Ecmo 8 $950,562.19 $1,093,146.52 $1,059,876.84 nat. median
$311,018
outlier · 3.4×
74
APR_DRG 		Allogeneic Bone Marrow Transplant 11 $118,800.00 $1,063,413.95 $924,707.78 nat. median
$175,480
outlier · 5.3×
5833
APR_DRG 		Neonate With Ecmo 8 $804,901.13 $925,636.30 $897,464.76 nat. median
$250,089
outlier · 3.6×
24
APR_DRG 		Heart And/or Lung Transplant 11 $77,000.00 $890,435.90 $797,520.85 nat. median
$243,231
outlier · 3.3×
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 8 $601,690.27 $691,943.81 $670,884.65 nat. median
$254,667
outlier · 2.6×
1614
APR_DRG 		Implantable Heart Assist Systems 8 $584,282.53 $671,924.91 $651,475.02 nat. median
$209,486
outlier · 3.1×
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 8 $547,380.73 $629,487.84 $610,329.52 nat. median
$165,599
outlier · 3.7×
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 5 $511,072.00 $591,726.20 $591,726.20 nat. median
$691,418
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 4 $557,317.93 $557,317.93 $557,317.93 nat. median
$610,161
0.9× median
Q2024
HCPCS 		Non Risk Drugs - Q2024 With Mod U1 1 $511,072.00 $511,072.00 $511,072.00 nat. median
$58
outlier · 8842.1×
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 8 $443,730.27 $510,289.81 $499,196.56 nat. median
$168,174
outlier · 3.0×
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 8 $447,697.67 $514,852.32 $499,182.90 nat. median
$160,171
outlier · 3.1×
J3398
HCPCS 		Inj Luxturna 1 Billion Vec G 5 $2,890.00 $456,875.00 $456,875.00 nat. median
$3,393
outlier · 134.7×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 1 $449,440.00 $449,440.00 $449,440.00 nat. median
$588,565
0.8× median
5832
APR_DRG 		Neonate With Ecmo 8 $401,063.85 $461,223.43 $447,186.19 nat. median
$169,230
outlier · 2.6×
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 $380,836.38 $437,961.84 $424,632.57 nat. median
$119,243
outlier · 3.6×
2004
APR_DRG 		Cardiac Structural And Valvular Disorders 8 $353,901.88 $406,987.16 $394,600.60 nat. median
$28,828
outlier · 13.7×
5831
APR_DRG 		Neonate With Ecmo 8 $353,144.70 $406,116.41 $393,756.34 nat. median
$154,685
outlier · 2.5×
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 8 $320,540.70 $368,621.81 $360,608.29 nat. median
$127,600
outlier · 2.8×
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 8 $322,847.30 $371,274.40 $359,974.74 nat. median
$180,995
2.0× median
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 8 $321,371.73 $369,577.49 $358,329.48 nat. median
$147,847
outlier · 2.4×
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 8 $319,162.75 $367,037.16 $355,866.47 nat. median
$165,646
outlier · 2.1×
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 8 $315,975.06 $363,371.32 $352,312.20 nat. median
$147,677
outlier · 2.4×
8504
APR_DRG 		Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 8 $307,651.04 $353,798.70 $343,030.91 nat. median
$67,813
outlier · 5.1×
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 8 $304,895.14 $350,629.41 $339,958.08 nat. median
$168,361
outlier · 2.0×
1613
APR_DRG 		Implantable Heart Assist Systems 8 $304,535.94 $350,216.33 $339,557.57 nat. median
$127,938
outlier · 2.7×
5881
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 8 $302,926.45 $348,365.42 $337,762.99 nat. median
$120,928
outlier · 2.8×
73
APR_DRG 		Allogeneic Bone Marrow Transplant 11 $118,800.00 $375,238.16 $326,294.05 nat. median
$89,814
outlier · 3.6×
1604
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly 8 $271,193.53 $311,872.56 $305,092.72 nat. median
$101,315
outlier · 3.0×
6814
APR_DRG 		Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 8 $271,344.97 $312,046.72 $302,549.65 nat. median
$69,072
outlier · 4.4×
93
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 8 $268,926.98 $309,266.03 $299,853.58 nat. median
$80,413
outlier · 3.7×
2464
APR_DRG 		Gastrointestinal Vascular Insufficiency 8 $262,982.14 $302,429.46 $293,225.09 nat. median
$20,493
outlier · 14.3×
6034
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 8 $261,625.47 $300,869.29 $291,712.40 nat. median
$109,499
outlier · 2.7×
64
APR_DRG 		Pancreas Transplant 8 $253,899.68 $291,984.63 $283,098.14 nat. median
$92,994
outlier · 3.0×
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 8 $253,879.66 $291,961.61 $283,075.82 nat. median
$96,420
outlier · 2.9×
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 8 $253,119.97 $291,087.97 $282,228.77 nat. median
$156,285
1.8× median
14
APR_DRG 		Liver Transplant And/or Intestinal Transplant 11 $108,000.00 $318,969.64 $281,525.38 nat. median
$137,901
outlier · 2.0×
84
APR_DRG 		Autologous Bone Marrow Transplant Or T-cell Immunotherapy 11 $50,000.00 $317,691.56 $280,397.34 nat. median
$79,228
outlier · 3.5×
5892
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 8 $246,061.26 $282,970.45 $274,358.30 nat. median
$89,188
outlier · 3.1×
1624
APR_DRG 		Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 8 $236,570.79 $272,056.41 $263,776.43 nat. median
$82,636
outlier · 3.2×
6024
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 8 $232,688.50 $267,591.78 $259,447.68 nat. median
$123,690
outlier · 2.1×
5893
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 8 $230,799.92 $265,419.91 $257,341.91 nat. median
$71,350
outlier · 3.6×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 6 $94,500.00 $250,680.43 $250,680.43 nat. median
$261,939
1.0× median
J3403
HCPCS 		Revakinagene, Per Implant 4 $250,000.00 $250,000.00 $250,000.00 nat. median
$265,000
0.9× median
6214
APR_DRG 		Neonate Birth Weight 2000-2499 Grams With Major Anomaly 8 $220,964.02 $254,108.62 $246,374.88 nat. median
$69,851
outlier · 3.5×

Other procedures at this hospital

Browse this hospital's 12,465 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
             
0811 RC Acquisition Of Body Components-living Donor 77 34 $173,955.00 $130,466.25 25% off $33,575.85 $168,736.35 $116,549.85 2026-08-01
0812 RC Acquisition Of Body Components-cadaver Donor 78 35 $228,087.00 $171,065.25 25% off $45,050.46 $221,244.39 $152,818.29 2026-08-01
0N14 LOCAL Less Than 750 Grams - Discharged Alive 4 4 — — $128,683.02 $128,683.02 $128,683.02 2026-08-01
0N24 LOCAL Less Than 1000 Grams - Discharged Alive 4 4 — — $97,622.32 $97,622.32 $97,622.32 2026-08-01
0N80 LOCAL 2500 And Greater Grams - O.r. Performed 4 4 — — $91,535.45 $91,535.45 $91,535.45 2026-08-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 6 6 — — $94,500.00 $250,680.43 $250,680.43 2026-08-01
11 APR_DRG Liver Transplant And/or Intestinal Transplant 14 12 — — $97,500.00 $130,875.00 $116,381.82 2026-08-01
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 8 — — $85,526.83 $98,355.85 $95,362.42 2026-08-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 8 — — $150,391.90 $172,950.69 $167,686.97 2026-08-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 8 — — $216,410.90 $248,872.54 $241,298.15 2026-08-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 8 — — $380,836.38 $437,961.84 $424,632.57 2026-08-01
12 APR_DRG Liver Transplant And/or Intestinal Transplant 12 11 — — $108,000.00 $126,228.89 $117,810.00 2026-08-01
1204 APR_DRG Major Respiratory And Chest Procedures 8 8 — — $125,806.55 $144,677.53 $140,274.30 2026-08-01
1214 APR_DRG Other Respiratory And Chest Procedures 8 8 — — $117,409.94 $135,021.43 $130,912.08 2026-08-01
13 APR_DRG Liver Transplant And/or Intestinal Transplant 12 11 — — $108,000.00 $164,340.93 $145,048.73 2026-08-01
1302 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 8 8 — — $73,484.46 $84,507.13 $81,935.18 2026-08-01
1303 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 8 8 — — $84,053.76 $96,661.82 $93,719.94 2026-08-01
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 8 8 — — $123,789.06 $142,357.42 $138,024.80 2026-08-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 12 11 — — $108,000.00 $318,969.64 $281,525.38 2026-08-01
14 MS_DRG Allogeneic Bone Marrow Transplant 5 5 — — $123,536.85 $123,536.85 $123,536.85 2026-08-01
1602 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 8 8 — — $79,629.55 $91,573.98 $88,786.95 2026-08-01
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 8 8 — — $114,603.98 $131,794.58 $127,783.44 2026-08-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 8 8 — — $271,193.53 $311,872.56 $305,092.72 2026-08-01
1611 APR_DRG Implantable Heart Assist Systems 8 8 — — $207,620.05 $238,763.06 $231,496.36 2026-08-01
1612 APR_DRG Implantable Heart Assist Systems 8 8 — — $218,913.99 $251,751.09 $244,089.10 2026-08-01
1613 APR_DRG Implantable Heart Assist Systems 8 8 — — $304,535.94 $350,216.33 $339,557.57 2026-08-01
1614 APR_DRG Implantable Heart Assist Systems 8 8 — — $584,282.53 $671,924.91 $651,475.02 2026-08-01
1621 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 8 8 — — $88,188.87 $101,417.20 $98,330.59 2026-08-01
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 8 8 — — $99,391.45 $114,300.17 $110,821.46 2026-08-01
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 8 8 — — $133,105.57 $153,071.41 $148,412.71 2026-08-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 8 8 — — $236,570.79 $272,056.41 $263,776.43 2026-08-01
1632 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 8 8 — — $69,906.30 $80,392.25 $77,945.52 2026-08-01
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 8 8 — — $94,427.82 $108,591.99 $105,287.02 2026-08-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 8 8 — — $140,994.05 $162,143.16 $157,208.37 2026-08-01
1652 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 8 8 — — $66,125.38 $76,044.19 $73,729.80 2026-08-01
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 8 8 — — $80,176.48 $92,202.95 $89,396.77 2026-08-01
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 8 8 — — $121,945.54 $140,237.37 $135,969.27 2026-08-01
1663 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 8 8 — — $67,011.47 $77,063.19 $74,717.79 2026-08-01
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 8 8 — — $94,241.34 $108,377.54 $105,079.10 2026-08-01
1673 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 8 8 — — $78,091.40 $89,805.11 $87,071.91 2026-08-01
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 8 8 — — $179,776.93 $206,743.47 $202,249.04 2026-08-01
1694 APR_DRG Major Abdominal Vascular Procedures 8 8 — — $126,319.69 $145,267.64 $140,846.45 2026-08-01
1704 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 8 8 — — $78,724.68 $90,533.38 $87,778.01 2026-08-01
1714 APR_DRG Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock 8 8 — — $89,165.07 $102,539.83 $99,419.05 2026-08-01
1754 APR_DRG Percutaneous Cardiac Intervention Without Ami 8 8 — — $80,729.66 $92,839.11 $90,013.57 2026-08-01
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 8 8 — — $91,553.02 $105,285.97 $102,081.62 2026-08-01
1781 APR_DRG External Heart Assist Systems 8 8 — — $92,426.60 $106,290.59 $103,055.66 2026-08-01
1782 APR_DRG External Heart Assist Systems 8 8 — — $100,826.97 $115,951.02 $112,422.08 2026-08-01
1783 APR_DRG External Heart Assist Systems 8 8 — — $117,477.52 $135,099.15 $130,987.43 2026-08-01
1784 APR_DRG External Heart Assist Systems 8 8 — — $183,574.12 $211,110.24 $204,685.14 2026-08-01
1793 APR_DRG Defibrillator Implants 8 8 — — $69,164.13 $79,538.75 $77,118.01 2026-08-01
1794 APR_DRG Defibrillator Implants 8 8 — — $90,200.10 $103,730.12 $100,573.11 2026-08-01
1801 APR_DRG Other Circulatory System Procedures 8 8 — — $75,281.68 $86,573.93 $83,939.07 2026-08-01
1804 APR_DRG Other Circulatory System Procedures 8 8 — — $83,095.08 $95,559.34 $92,651.01 2026-08-01
1814 APR_DRG Lower Extremity Arterial Procedures 8 8 — — $109,719.20 $126,177.08 $122,336.90 2026-08-01
1824 APR_DRG Other Peripheral Vascular Procedures 8 8 — — $141,077.91 $162,239.60 $157,301.87 2026-08-01
1832 APR_DRG Percutaneous Structural Cardiac Procedures 8 8 — — $67,191.70 $77,270.46 $74,918.74 2026-08-01
1833 APR_DRG Percutaneous Structural Cardiac Procedures 8 8 — — $103,497.77 $119,022.44 $115,400.01 2026-08-01
1834 APR_DRG Percutaneous Structural Cardiac Procedures 8 8 — — $106,103.48 $122,019.00 $118,305.38 2026-08-01
1934 APR_DRG Acute And Subacute Endocarditis 8 8 — — $67,741.12 $77,902.29 $75,531.35 2026-08-01
2004 APR_DRG Cardiac Structural And Valvular Disorders 8 8 — — $353,901.88 $406,987.16 $394,600.60 2026-08-01
203 APR_DRG Open Craniotomy For Trauma 8 8 — — $70,129.07 $80,648.43 $78,193.92 2026-08-01
204 APR_DRG Open Craniotomy For Trauma 8 8 — — $111,546.45 $128,278.42 $124,374.29 2026-08-01
2054 APR_DRG Cardiomyopathy 8 8 — — $138,260.68 $158,999.78 $154,160.65 2026-08-01
2074 APR_DRG Other Circulatory System Diagnoses 8 8 — — $68,330.60 $78,580.19 $76,188.62 2026-08-01
21 APR_DRG Heart And/or Lung Transplant 11 11 — — $77,000.00 $136,465.03 $126,000.00 2026-08-01
213 APR_DRG Open Craniotomy Except Trauma 8 8 — — $75,998.82 $87,398.64 $85,498.67 2026-08-01
214 APR_DRG Open Craniotomy Except Trauma 8 8 — — $132,790.18 $152,708.71 $148,061.05 2026-08-01
22 APR_DRG Heart And/or Lung Transplant 11 11 — — $77,000.00 $176,181.86 $157,797.67 2026-08-01
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 8 8 — — $156,418.09 $179,880.80 $174,406.17 2026-08-01
2224 APR_DRG Other Stomach, Esophageal And Duodenal Procedures 8 8 — — $74,390.58 $85,549.17 $82,945.49 2026-08-01
2234 APR_DRG Other Small And Large Bowel Procedures 8 8 — — $98,245.03 $112,981.78 $109,543.20 2026-08-01
224 APR_DRG Ventricular Shunt Procedures 8 8 — — $131,788.94 $151,557.28 $146,944.66 2026-08-01
2244 APR_DRG Peritoneal Adhesiolysis 8 8 — — $114,421.25 $131,584.44 $127,579.70 2026-08-01
2264 APR_DRG Anal Procedures 8 8 — — $68,927.59 $79,266.73 $76,854.26 2026-08-01
2274 APR_DRG Hernia Procedures Except Inguinal, Femoral And Umbilical 8 8 — — $109,383.78 $125,791.35 $121,962.92 2026-08-01
2294 APR_DRG Other Digestive System And Abdominal Procedures 8 8 — — $65,823.76 $75,697.32 $73,393.49 2026-08-01
23 APR_DRG Heart And/or Lung Transplant 12 12 — — $77,000.00 $219,314.11 $193,568.54 2026-08-01
2304 APR_DRG Major Small Bowel Procedures 8 8 — — $132,310.83 $152,157.45 $147,526.58 2026-08-01
2314 APR_DRG Major Large Bowel Procedures 8 8 — — $80,261.58 $92,300.82 $89,491.66 2026-08-01
233 APR_DRG Spinal Procedures 8 8 — — $74,438.14 $85,603.86 $82,998.53 2026-08-01
2334 APR_DRG Appendectomy With Complex Principal Diagnosis 8 8 — — $85,839.72 $98,715.68 $95,711.29 2026-08-01
234 APR_DRG Spinal Procedures 8 8 — — $152,902.50 $175,837.88 $170,486.29 2026-08-01
24 APR_DRG Heart And/or Lung Transplant 11 11 — — $77,000.00 $890,435.90 $797,520.85 2026-08-01
244 APR_DRG Open Extracranial Vascular Procedures 8 8 — — $75,336.75 $86,637.26 $84,000.48 2026-08-01
2454 APR_DRG Inflammatory Bowel Disease 8 8 — — $71,438.19 $82,153.92 $79,653.58 2026-08-01
2464 APR_DRG Gastrointestinal Vascular Insufficiency 8 8 — — $262,982.14 $302,429.46 $293,225.09 2026-08-01
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 8 8 — — $118,869.24 $136,699.63 $132,539.20 2026-08-01
2613 APR_DRG Major Biliary Tract Procedures 8 8 — — $69,021.46 $79,374.68 $76,958.93 2026-08-01
2614 APR_DRG Major Biliary Tract Procedures 8 8 — — $104,420.15 $120,083.17 $116,428.47 2026-08-01
2634 APR_DRG Cholecystectomy 8 8 — — $69,129.09 $79,498.45 $77,078.93 2026-08-01
264 APR_DRG Other Nervous System And Related Procedures 8 8 — — $142,649.85 $164,047.33 $159,054.58 2026-08-01
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures 8 8 — — $88,474.22 $101,745.35 $98,648.76 2026-08-01
273 APR_DRG Other Open Craniotomy 8 8 — — $69,349.36 $79,751.76 $77,324.54 2026-08-01
274 APR_DRG Other Open Craniotomy 8 8 — — $76,474.41 $87,945.57 $85,268.97 2026-08-01
2824 APR_DRG Disorders Of Pancreas Except Malignancy 8 8 — — $69,545.85 $79,977.73 $77,543.62 2026-08-01
293 APR_DRG Other Percutaneous Intracranial Procedures 8 8 — — $73,174.08 $84,150.19 $81,589.10 2026-08-01
294 APR_DRG Other Percutaneous Intracranial Procedures 8 8 — — $83,032.50 $95,487.38 $92,581.24 2026-08-01
3 MS_DRG Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 4 4 — — $144,767.20 $144,767.20 $144,767.20 2026-08-01
3031 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 8 8 — — $75,465.66 $86,785.51 $84,144.21 2026-08-01
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 8 8 — — $102,441.46 $117,807.68 $114,222.23 2026-08-01
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 8 8 — — $141,191.80 $162,370.57 $157,428.86 2026-08-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 8 8 — — $166,901.04 $191,936.20 $186,094.65 2026-08-01
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 8 8 — — $84,310.33 $96,956.88 $94,006.02 2026-08-01
3043 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 8 8 — — $86,818.43 $99,841.19 $96,802.55 2026-08-01
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 8 8 — — $138,652.41 $159,450.27 $154,597.44 2026-08-01
3054 APR_DRG Amputation Of Lower Limb Except Toes 8 8 — — $68,284.30 $78,526.95 $76,136.99 2026-08-01
3084 APR_DRG Hip And Femur Fracture Repair 8 8 — — $75,028.87 $86,283.20 $83,657.19 2026-08-01
3104 APR_DRG Intervertebral Disc Excision And Decompression 8 8 — — $85,898.54 $98,783.32 $95,776.87 2026-08-01
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 8 8 — — $90,077.45 $103,589.07 $100,436.36 2026-08-01
3134 APR_DRG Knee And Lower Leg Procedures Except Foot 8 8 — — $82,216.49 $94,548.96 $91,671.39 2026-08-01
3154 APR_DRG Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement 8 8 — — $126,750.22 $145,762.75 $141,326.49 2026-08-01
3164 APR_DRG Hand And Wrist Procedures 8 8 — — $66,724.87 $76,733.60 $74,398.23 2026-08-01
3214 APR_DRG Cervical Spinal Fusion And Other Back Or Neck Procedures Except Disc Excision Or… 8 8 — — $75,490.69 $86,814.29 $84,172.12 2026-08-01
3224 APR_DRG Shoulder And Elbow Joint Replacement 8 8 — — $69,955.11 $80,448.38 $77,999.95 2026-08-01
3254 APR_DRG Non-elective Or Complex Knee Joint Replacement 8 8 — — $77,481.90 $89,104.19 $86,392.32 2026-08-01
33270 CPT Ins/Rplcmnt Perm Subq Impltbl Dfb W/Subq Eltrd 51 34 $163,106.00 $122,329.50 25% off $472.07 $158,212.82 $109,281.02 2026-08-01
33289 CPT Tcat Impl Wrls P-art S Snr L-t Hemodyn Mntr 46 34 $152,884.00 $114,663.00 25% off $32,105.64 $148,297.48 $102,432.28 2026-08-01
3464 APR_DRG Connective Tissue Disorders 8 8 — — $84,032.49 $96,637.36 $93,696.23 2026-08-01
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 8 8 — — $113,306.12 $130,302.04 $126,336.32 2026-08-01
3814 APR_DRG Major Skin Disorders 8 8 — — $66,823.74 $76,847.30 $74,508.47 2026-08-01
4 MS_DRG Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And … 4 4 — — $94,690.95 $94,690.95 $94,690.95 2026-08-01
4012 APR_DRG Adrenal Procedures 8 8 — — $73,990.09 $85,088.60 $82,498.95 2026-08-01
4013 APR_DRG Adrenal Procedures 8 8 — — $86,827.19 $99,851.27 $96,812.32 2026-08-01
4014 APR_DRG Adrenal Procedures 8 8 — — $77,644.60 $89,291.29 $86,573.73 2026-08-01
404 APR_DRG Spinal Disorders And Injuries 8 8 — — $73,444.42 $84,461.08 $81,890.53 2026-08-01
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 8 8 — — $83,769.66 $96,335.11 $93,403.17 2026-08-01
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 8 8 — — $77,924.95 $89,613.69 $86,886.32 2026-08-01
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 8 8 — — $110,575.25 $127,161.54 $123,291.40 2026-08-01
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 8 8 — — $134,747.59 $154,959.73 $150,243.56 2026-08-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 8 8 — — $206,090.66 $237,004.26 $229,791.09 2026-08-01
433 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 8 8 — — $73,692.22 $84,746.05 $82,166.82 2026-08-01
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 8 8 — — $177,071.09 $203,631.75 $197,434.27 2026-08-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 8 8 — — $320,540.70 $368,621.81 $360,608.29 2026-08-01
4401 APR_DRG Kidney Transplant 12 11 — — $38,000.00 $87,887.99 $77,570.71 2026-08-01
4402 APR_DRG Kidney Transplant 12 11 — — $38,000.00 $93,758.81 $82,752.34 2026-08-01
4403 APR_DRG Kidney Transplant 12 11 — — $38,000.00 $145,772.83 $128,660.36 2026-08-01
4404 APR_DRG Kidney Transplant 12 11 — — $38,000.00 $238,172.96 $210,213.53 2026-08-01
4414 APR_DRG Major Bladder Procedures 8 8 — — $195,998.20 $225,397.93 $218,537.99 2026-08-01
4424 APR_DRG Kidney And Urinary Tract Procedures For Malignancy 8 8 — — $131,066.80 $150,726.82 $146,139.48 2026-08-01
4434 APR_DRG Kidney And Urinary Tract Procedures For Non-malignancy 8 8 — — $83,136.38 $95,606.84 $92,697.07 2026-08-01
4444 APR_DRG Renal Dialysis Access Device Procedures And Vessel Repair 8 8 — — $71,540.82 $82,271.94 $79,768.01 2026-08-01
4454 APR_DRG Other Bladder Procedures 8 8 — — $67,573.42 $77,709.43 $75,344.36 2026-08-01
4474 APR_DRG Other Kidney, Urinary Tract And Related Procedures 8 8 — — $155,201.59 $178,481.83 $173,049.77 2026-08-01
4624 APR_DRG Nephritis And Nephrosis 8 8 — — $69,388.16 $79,796.38 $77,367.80 2026-08-01
4684 APR_DRG Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms 8 8 — — $82,448.03 $94,815.23 $91,929.55 2026-08-01
4804 APR_DRG Major Male Pelvic Procedures 8 8 — — $85,038.73 $97,794.54 $94,818.18 2026-08-01
4834 APR_DRG Penis, Testes And Scrotal Procedures 8 8 — — $125,328.46 $144,127.73 $139,741.23 2026-08-01
4844 APR_DRG Other Male Reproductive System And Related Procedures 8 8 — — $79,409.28 $91,320.67 $88,541.35 2026-08-01
494 APR_DRG Bacterial And Tuberculous Infections Of Nervous System 8 8 — — $79,195.26 $91,074.55 $88,302.71 2026-08-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 5 5 — — $141,625.29 $141,625.29 $141,625.29 2026-08-01
504 APR_DRG Non-bacterial Infections Of Nervous System Except Viral Meningitis 8 8 — — $101,406.43 $116,617.39 $113,068.17 2026-08-01
51 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 8 8 — — $110,788.01 $127,406.21 $123,528.63 2026-08-01
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 8 8 — — $87,240.20 $100,326.23 $97,272.82 2026-08-01
5114 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 8 8 — — $85,715.81 $98,573.18 $95,573.13 2026-08-01
5124 APR_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy 8 8 — — $74,302.98 $85,448.43 $82,847.82 2026-08-01
5134 APR_DRG Uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma 8 8 — — $90,255.17 $103,793.45 $100,634.51 2026-08-01
5144 APR_DRG Female Reproductive System Reconstructive Procedures 8 8 — — $74,455.66 $85,624.01 $83,018.06 2026-08-01
5184 APR_DRG Other Female Reproductive System And Related Procedures 8 8 — — $65,871.32 $75,752.02 $73,446.52 2026-08-01
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 8 8 — — $135,623.67 $155,967.22 $151,220.39 2026-08-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 8 8 — — $148,510.83 $170,787.45 $165,589.58 2026-08-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 8 8 — — $206,160.75 $237,084.86 $229,869.23 2026-08-01
5831 APR_DRG Neonate With Ecmo 8 8 — — $353,144.70 $406,116.41 $393,756.34 2026-08-01
5832 APR_DRG Neonate With Ecmo 8 8 — — $401,063.85 $461,223.43 $447,186.19 2026-08-01
5833 APR_DRG Neonate With Ecmo 8 8 — — $804,901.13 $925,636.30 $897,464.76 2026-08-01
5834 APR_DRG Neonate With Ecmo 8 8 — — $950,562.19 $1,093,146.52 $1,059,876.84 2026-08-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 8 8 — — $302,926.45 $348,365.42 $337,762.99 2026-08-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 8 8 — — $321,371.73 $369,577.49 $358,329.48 2026-08-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 8 8 — — $322,847.30 $371,274.40 $359,974.74 2026-08-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 8 8 — — $601,690.27 $691,943.81 $670,884.65 2026-08-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 8 8 — — $253,879.66 $291,961.61 $283,075.82 2026-08-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 8 8 — — $246,061.26 $282,970.45 $274,358.30 2026-08-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 8 8 — — $230,799.92 $265,419.91 $257,341.91 2026-08-01
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 8 8 — — $119,521.30 $137,449.50 $133,266.25 2026-08-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 8 8 — — $165,769.64 $190,635.09 $184,833.15 2026-08-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 8 8 — — $200,772.85 $230,888.78 $223,861.72 2026-08-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 8 8 — — $304,895.14 $350,629.41 $339,958.08 2026-08-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 8 8 — — $142,034.09 $163,339.20 $158,368.01 2026-08-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 8 8 — — $180,783.17 $207,900.65 $201,573.23 2026-08-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 8 8 — — $253,119.97 $291,087.97 $282,228.77 2026-08-01
594 APR_DRG Anoxic And Other Severe Brain Damage 8 8 — — $69,276.77 $79,668.29 $77,243.60 2026-08-01
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $113,624.02 $130,667.62 $126,690.78 2026-08-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $150,385.65 $172,943.50 $167,680.00 2026-08-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $232,688.50 $267,591.78 $259,447.68 2026-08-01
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 8 8 — — $79,918.66 $91,906.46 $89,109.30 2026-08-01
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 8 8 — — $99,771.92 $114,737.71 $111,245.69 2026-08-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 8 8 — — $261,625.47 $300,869.29 $291,712.40 2026-08-01
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $74,857.41 $86,086.02 $83,466.01 2026-08-01
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $104,047.19 $119,654.27 $116,012.62 2026-08-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $164,147.64 $188,769.79 $183,024.62 2026-08-01
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 8 8 — — $79,345.45 $91,247.27 $88,470.17 2026-08-01
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 8 8 — — $200,203.40 $230,233.91 $223,226.79 2026-08-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 8 8 — — $142,736.20 $164,146.63 $159,150.86 2026-08-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 8 8 — — $443,730.27 $510,289.81 $499,196.56 2026-08-01
61 APR_DRG Pancreas Transplant 8 8 — — $146,492.09 $168,465.90 $163,338.68 2026-08-01
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 8 8 — — $70,723.56 $81,332.09 $78,856.77 2026-08-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 8 8 — — $180,575.42 $207,661.73 $201,341.60 2026-08-01
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $67,622.23 $77,765.56 $75,398.79 2026-08-01
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $115,701.58 $133,056.82 $129,007.26 2026-08-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 8 8 — — $155,565.79 $178,900.66 $173,455.85 2026-08-01
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 8 8 — — $133,332.10 $153,331.92 $148,665.29 2026-08-01
62 APR_DRG Pancreas Transplant 8 8 — — $148,408.21 $170,669.44 $165,475.15 2026-08-01
6213 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 8 8 — — $66,065.31 $75,975.11 $73,662.82 2026-08-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 8 8 — — $220,964.02 $254,108.62 $246,374.88 2026-08-01
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 8 8 — — $109,002.06 $125,352.37 $121,537.30 2026-08-01
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 8 8 — — $116,035.74 $133,441.10 $129,379.85 2026-08-01
63 APR_DRG Pancreas Transplant 8 8 — — $164,080.05 $188,692.06 $182,949.26 2026-08-01
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 8 8 — — $76,166.53 $87,591.51 $84,925.68 2026-08-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 8 8 — — $211,007.98 $242,659.18 $235,273.90 2026-08-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 8 8 — — $447,697.67 $514,852.32 $499,182.90 2026-08-01
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 8 8 — — $116,980.66 $134,527.76 $130,433.43 2026-08-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 8 8 — — $315,975.06 $363,371.32 $352,312.20 2026-08-01
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 8 8 — — $167,924.80 $193,113.52 $187,236.15 2026-08-01
6344 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 8 8 — — $85,400.42 $98,210.48 $95,221.47 2026-08-01
64 APR_DRG Pancreas Transplant 8 8 — — $253,899.68 $291,984.63 $283,098.14 2026-08-01
6504 APR_DRG Splenectomy 8 8 — — $69,166.63 $79,541.62 $77,120.80 2026-08-01
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 8 8 — — $135,169.36 $155,444.76 $150,713.83 2026-08-01
6604 APR_DRG Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula… 8 8 — — $109,024.59 $125,378.28 $121,562.41 2026-08-01
6613 APR_DRG Coagulation And Platelet Disorders 8 8 — — $76,565.77 $88,050.64 $85,370.83 2026-08-01
6614 APR_DRG Coagulation And Platelet Disorders 8 8 — — $93,385.28 $107,393.07 $104,124.58 2026-08-01
6803 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 8 8 — — $73,445.67 $84,462.52 $81,891.92 2026-08-01
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 8 8 — — $200,772.85 $230,888.78 $223,861.72 2026-08-01
6813 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 8 8 — — $72,038.93 $82,844.77 $80,323.40 2026-08-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 8 8 — — $271,344.97 $312,046.72 $302,549.65 2026-08-01
6902 APR_DRG Acute Leukemia 8 8 — — $67,005.22 $77,056.00 $74,710.82 2026-08-01
6903 APR_DRG Acute Leukemia 8 8 — — $78,416.80 $90,179.32 $87,434.74 2026-08-01
6904 APR_DRG Acute Leukemia 8 8 — — $178,162.44 $204,886.81 $198,651.12 2026-08-01
6914 APR_DRG Lymphoma, Myeloma And Non-acute Leukemia 8 8 — — $97,640.53 $112,286.61 $108,869.19 2026-08-01
6924 APR_DRG Radiotherapy 8 8 — — $80,673.34 $92,774.34 $89,950.77 2026-08-01
6944 APR_DRG Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior 8 8 — — $96,651.81 $111,149.58 $107,766.77 2026-08-01
6954 APR_DRG Chemotherapy For Acute Leukemia 8 8 — — $138,082.96 $158,795.40 $155,343.33 2026-08-01
71 APR_DRG Allogeneic Bone Marrow Transplant 12 10 — — $118,800.00 $165,549.93 $146,115.80 2026-08-01
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 8 8 — — $100,655.51 $115,753.84 $112,230.89 2026-08-01
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 8 8 — — $84,530.60 $97,210.19 $94,251.62 2026-08-01
72 APR_DRG Allogeneic Bone Marrow Transplant 12 10 — — $118,800.00 $252,118.11 $222,521.64 2026-08-01
7234 APR_DRG Viral Illness 8 8 — — $96,520.40 $110,998.46 $107,620.24 2026-08-01
73 APR_DRG Allogeneic Bone Marrow Transplant 14 11 — — $118,800.00 $375,238.16 $326,294.05 2026-08-01
734 APR_DRG Orbit And Eye Procedures 8 8 — — $82,866.05 $95,295.96 $92,395.65 2026-08-01
74 APR_DRG Allogeneic Bone Marrow Transplant 14 11 — — $118,800.00 $1,063,413.95 $924,707.78 2026-08-01
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 8 8 — — $87,153.84 $100,226.92 $97,176.53 2026-08-01
7594 APR_DRG Eating Disorders 8 8 — — $69,328.08 $79,727.29 $77,300.81 2026-08-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 4 4 — — $74,752.09 $74,752.09 $74,752.09 2026-08-01
7923 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 8 8 — — $72,315.52 $83,162.85 $80,631.80 2026-08-01
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 8 8 — — $138,686.20 $159,489.13 $154,635.11 2026-08-01
7934 APR_DRG Moderately Extensive O.r. Procedures For Other Complications Of Treatment 8 8 — — $75,515.72 $86,843.08 $84,200.03 2026-08-01
81 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 13 12 — — $50,000.00 $165,000.00 $91,181.16 2026-08-01
8104 APR_DRG Hemorrhage Or Hematoma Due To Complication 8 8 — — $80,145.19 $92,166.97 $89,361.89 2026-08-01
8154 APR_DRG Other Injury, Poisoning And Toxic Effect Diagnoses 8 8 — — $81,484.34 $93,706.99 $90,855.04 2026-08-01
82 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 12 11 — — $50,000.00 $165,000.00 $104,005.33 2026-08-01
83 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 12 11 — — $50,000.00 $214,735.77 $189,527.66 2026-08-01
84 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 12 11 — — $50,000.00 $317,691.56 $280,397.34 2026-08-01
8411 APR_DRG Extensive Third Degree Burns With Skin Graft 8 8 — — $88,942.30 $102,283.65 $99,170.67 2026-08-01
8412 APR_DRG Extensive Third Degree Burns With Skin Graft 8 8 — — $89,639.41 $103,085.32 $99,947.95 2026-08-01
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 8 8 — — $137,941.54 $158,632.77 $153,804.82 2026-08-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 8 8 — — $319,162.75 $367,037.16 $355,866.47 2026-08-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 8 8 — — $108,879.41 $125,211.32 $121,400.54 2026-08-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 8 8 — — $307,651.04 $353,798.70 $343,030.91 2026-08-01
8634 APR_DRG Neonatal Aftercare 8 8 — — $213,054.26 $245,012.40 $237,555.50 2026-08-01
893 APR_DRG Major Cranial Or Facial Bone Procedures 8 8 — — $65,982.70 $75,880.11 $73,570.71 2026-08-01
894 APR_DRG Major Cranial Or Facial Bone Procedures 8 8 — — $123,984.31 $142,581.96 $138,242.51 2026-08-01
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 8 8 — — $171,530.50 $197,260.08 $191,256.51 2026-08-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 8 8 — — $152,349.32 $175,201.72 $169,869.49 2026-08-01
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 8 8 — — $129,071.84 $148,432.62 $143,915.10 2026-08-01
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 8 8 — — $123,820.35 $142,393.40 $138,059.69 2026-08-01
913 APR_DRG Other Major Head And Neck Procedures 8 8 — — $80,858.57 $92,987.36 $90,157.30 2026-08-01
914 APR_DRG Other Major Head And Neck Procedures 8 8 — — $112,696.62 $129,601.11 $125,656.73 2026-08-01
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 8 8 — — $176,872.09 $203,402.90 $197,212.38 2026-08-01
923 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 8 8 — — $92,096.19 $105,910.62 $102,687.25 2026-08-01
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 8 8 — — $95,482.87 $109,805.30 $106,463.40 2026-08-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 8 8 — — $268,926.98 $309,266.03 $299,853.58 2026-08-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 8 8 — — $547,380.73 $629,487.84 $610,329.52 2026-08-01
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 8 8 — — $147,826.24 $170,000.18 $164,826.26 2026-08-01
9514 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 8 8 — — $103,092.26 $118,556.10 $114,947.87 2026-08-01
9524 APR_DRG Non-extensive O.r. Procedure Unrelated To Principal Diagnosis 8 8 — — $130,262.06 $149,801.37 $145,242.20 2026-08-01
984 APR_DRG Other Ear, Nose, Mouth And Throat Procedures 8 8 — — $80,568.21 $92,653.44 $89,833.55 2026-08-01
A9543 HCPCS Y90 Ibritumomab, Rx 4 4 — — $73,939.13 $73,939.13 $73,939.13 2026-08-01
C9293 HCPCS Glucarpidase 1,000 unit/mL Solr 1 Each Vial 46 34 $276,024.47 $207,018.36 25% off $57,965.14 $267,743.74 $184,936.39 2026-08-01
J0638 HCPCS Canakinumab (pf) 150 mg/mL Soln 1 Ml Vial 50 34 $136,542.69 $102,407.02 25% off $141.60 $132,446.41 $91,483.60 2026-08-01
J0802 HCPCS Corticotropin 80 unit/mL Gel 5 Ml Vial 82 35 $222,220.12 $166,665.09 25% off $3,534.60 $280,568.37 $148,887.48 2026-08-01
J1305 HCPCS Evinacumab-dgnb 150 mg/mL Soln 8 Ml Vial 82 35 $285,690.44 $214,267.83 25% off $193.76 $277,119.73 $102,848.55 2026-08-01
J1414 HCPCS Inj, Beqvez, Per Tx Dose 4 4 — — $3,500,000.00 $3,500,000.00 $3,500,000.00 2026-08-01
J1823 HCPCS Inebilizumab-cdon 10 mg/mL Soln 10 Ml Vial 50 34 $298,473.81 $223,855.36 25% off $495.55 $289,519.60 $199,977.45 2026-08-01
J1951 HCPCS Leuprolide 45 Mg Syrg 1 Each Syringe 51 35 $175,221.56 $131,416.17 25% off $140.99 $169,964.91 $117,398.45 2026-08-01
J2350 HCPCS Ocrelizumab 30 mg/mL Soln 10 Ml Vial 50 34 $131,796.88 $98,847.66 25% off $59.41 $127,842.97 $88,303.91 2026-08-01
J3316 HCPCS Triptorelin 22.5 Mg Susr 1 Each Vial 50 34 $142,373.33 $106,780.00 25% off $3,817.28 $138,102.13 $95,390.13 2026-08-01
J3392 HCPCS Inj, Exagamglogene Autotem 4 4 — — $2,200,000.00 $2,200,000.00 $2,200,000.00 2026-08-01
J3393 HCPCS Inj, Betibeglogene Autotemce 4 4 — — $2,800,000.00 $2,800,000.00 $2,800,000.00 2026-08-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 4 4 — — $3,100,000.00 $3,100,000.00 $3,100,000.00 2026-08-01
J3398 HCPCS Inj Luxturna 1 Billion Vec G 5 5 — — $2,890.00 $456,875.00 $456,875.00 2026-08-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 5 5 — — $2,125,000.00 $2,368,485.25 $2,125,000.00 2026-08-01
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 4 4 — — $205,640.00 $205,640.00 $205,640.00 2026-08-01
J3403 HCPCS Revakinagene, Per Implant 4 4 — — $250,000.00 $250,000.00 $250,000.00 2026-08-01
J9118 HCPCS CALaspargase Pegol-mknl 750 unit/mL Soln 5 Ml Vial 51 35 $109,458.13 $82,093.60 25% off $82.08 $106,174.39 $73,336.95 2026-08-01
J9210 HCPCS Emapalumab-lzsg 5 mg/mL Soln 10 Ml Vial 50 34 $115,945.67 $86,959.26 25% off $384.85 $112,467.30 $77,683.60 2026-08-01
J9226 HCPCS Histrelin (supprelin La) 50 Mg (65 Mcg/day) Kit 1 Each Kit 50 34 $292,062.03 $219,046.53 25% off $45,020.65 $283,300.17 $195,681.56 2026-08-01
J9348 HCPCS Naxitamab 4 mg/mL Soln 10 Ml Vial 50 34 $166,429.71 $124,822.29 25% off $686.00 $161,436.82 $111,507.90 2026-08-01
Q2024 HCPCS Non Risk Drugs - Q2024 With Mod U1 1 1 — — $511,072.00 $511,072.00 $511,072.00 2026-08-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 1 1 — — $449,440.00 $449,440.00 $449,440.00 2026-08-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 5 5 — — $511,072.00 $591,726.20 $591,726.20 2026-08-01
Q2055 HCPCS Idecabtagene Vicleucel Car 4 4 — — $557,317.93 $557,317.93 $557,317.93 2026-08-01
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