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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

CHILDRENS MEDICAL CENTER PLANO

Plano, TX · CCN 453316 · Rates published

12,461 distinct procedures filed
39 distinct payers
457,061 rate rows
2026-01-27 last MRF observed
Data quality

456,586 of 457,061 rate rows are consumer-grade (99.9%)

475 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 413
placeholder amount (≤ $0.02) — excluded from medians 56
exceeds 10× this hospital's gross charge — excluded from medians 4
per-diem day rate — not a per-procedure price 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/10175/750800628-1720480627_childrens-medical-center_standardcharges.csv
Found on page https://www.childrens.com/cms-hpt.txt
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-05-18
Content fingerprint f34a5919e45707ad… · 347,042,929 bytes · first seen 2026-05-14

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
$3,004,655
0.9× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 4 $2,200,000.00 $2,200,000.00 $2,200,000.00 nat. median
$2,448,600
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
$2,468,984
0.9× median
5834
APR_DRG 		Neonate With Ecmo 9 $952,201.22 $1,095,031.40 $1,037,899.33 nat. median
$309,665
outlier · 3.4×
74
APR_DRG 		Allogeneic Bone Marrow Transplant 13 $118,800.00 $1,065,247.55 $926,302.22 nat. median
$187,061
outlier · 5.0×
5833
APR_DRG 		Neonate With Ecmo 9 $806,289.00 $927,232.35 $878,855.01 nat. median
$244,017
outlier · 3.6×
24
APR_DRG 		Heart And/or Lung Transplant 14 $77,000.00 $891,971.26 $787,261.59 nat. median
$234,729
outlier · 3.4×
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 9 $602,727.75 $693,136.91 $675,055.08 nat. median
$246,434
outlier · 2.7×
1614
APR_DRG 		Implantable Heart Assist Systems 9 $585,289.99 $673,083.49 $637,966.09 nat. median
$207,730
outlier · 3.1×
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 9 $548,324.56 $630,573.24 $614,123.51 nat. median
$164,834
outlier · 3.7×
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 5 $511,072.00 $591,726.20 $591,726.20 nat. median
$753,246
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 4 $557,317.93 $557,317.93 $557,317.93 nat. median
$625,184
0.9× median
Q2024
HCPCS 		Non Risk Drugs - Q2024 With Mod U1 1 $511,072.00 $511,072.00 $511,072.00 nat. median
$4
outlier · 113824.5×
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 9 $444,495.38 $511,169.69 $497,834.83 nat. median
$162,982
outlier · 3.1×
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 9 $448,469.62 $515,740.06 $488,831.89 nat. median
$150,721
outlier · 3.2×
J3398
HCPCS 		Inj Luxturna 1 Billion Vec G 5 $2,890.00 $456,875.00 $456,875.00 nat. median
$3,491
outlier · 130.9×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 1 $449,440.00 $449,440.00 $449,440.00 nat. median
$634,303
0.7× median
5832
APR_DRG 		Neonate With Ecmo 9 $401,755.39 $462,018.70 $437,913.38 nat. median
$156,126
outlier · 2.8×
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 9 $381,493.05 $438,717.01 $415,827.42 nat. median
$117,173
outlier · 3.5×
2004
APR_DRG 		Cardiac Structural And Valvular Disorders 9 $354,512.10 $407,688.92 $386,418.19 nat. median
$32,541
outlier · 11.9×
5831
APR_DRG 		Neonate With Ecmo 9 $353,753.61 $406,816.65 $385,591.43 nat. median
$144,745
outlier · 2.7×
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 9 $321,093.40 $369,257.41 $362,835.54 nat. median
$105,658
outlier · 3.4×
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 9 $316,519.89 $363,997.87 $354,502.28 nat. median
$122,924
outlier · 2.9×
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 9 $323,403.97 $371,914.57 $352,510.33 nat. median
$182,665
1.9× median
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 9 $321,925.86 $370,214.74 $350,899.19 nat. median
$145,336
outlier · 2.4×
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 9 $319,713.07 $367,670.03 $348,487.25 nat. median
$160,267
outlier · 2.2×
8504
APR_DRG 		Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 9 $308,181.51 $354,408.74 $335,917.85 nat. median
$73,845
outlier · 4.5×
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 9 $305,420.86 $351,233.99 $332,908.74 nat. median
$164,289
outlier · 2.0×
1613
APR_DRG 		Implantable Heart Assist Systems 9 $305,061.04 $350,820.20 $332,516.53 nat. median
$119,796
outlier · 2.8×
5881
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 9 $303,448.78 $348,966.10 $330,759.17 nat. median
$124,573
outlier · 2.7×
73
APR_DRG 		Allogeneic Bone Marrow Transplant 13 $118,800.00 $375,885.17 $326,856.67 nat. median
$89,273
outlier · 3.7×
1604
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly 9 $271,661.14 $312,410.31 $304,260.48 nat. median
$97,957
outlier · 3.1×
6814
APR_DRG 		Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 9 $271,812.84 $312,584.77 $296,276.00 nat. median
$73,288
outlier · 4.0×
93
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 9 $269,390.69 $309,799.29 $293,635.85 nat. median
$78,990
outlier · 3.7×
2464
APR_DRG 		Gastrointestinal Vascular Insufficiency 9 $263,435.60 $302,950.94 $287,144.80 nat. median
$22,749
outlier · 12.6×
6034
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 9 $262,076.58 $301,388.07 $285,663.47 nat. median
$109,499
outlier · 2.6×
14
APR_DRG 		Liver Transplant And/or Intestinal Transplant 14 $97,500.00 $319,519.62 $277,843.15 nat. median
$129,535
outlier · 2.1×
64
APR_DRG 		Pancreas Transplant 9 $254,337.47 $292,488.09 $277,227.84 nat. median
$91,009
outlier · 3.0×
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 9 $254,317.41 $292,465.02 $277,205.98 nat. median
$93,370
outlier · 3.0×
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 9 $253,556.42 $291,589.88 $276,376.50 nat. median
$151,838
1.8× median
5892
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 9 $246,485.53 $283,458.36 $268,669.23 nat. median
$89,796
outlier · 3.0×
6024
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 9 $233,089.72 $268,053.18 $261,060.49 nat. median
$118,620
outlier · 2.2×
1624
APR_DRG 		Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 9 $236,978.70 $272,525.51 $258,306.78 nat. median
$81,781
outlier · 3.2×
5893
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 9 $231,197.88 $265,877.56 $252,005.69 nat. median
$69,788
outlier · 3.6×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 5 $94,500.00 $250,680.43 $250,680.43 nat. median
$265,286
0.9× 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 9 $221,345.03 $254,546.78 $247,906.43 nat. median
$69,160
outlier · 3.6×
1612
APR_DRG 		Implantable Heart Assist Systems 9 $219,291.46 $252,185.18 $239,027.69 nat. median
$85,444
outlier · 2.8×

Other procedures at this hospital

Browse this hospital's 12,461 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
             
J1414 HCPCS Inj, Beqvez, Per Tx Dose 4 4 — — $3,500,000.00 $3,500,000.00 $3,500,000.00 2026-01-27
J3394 HCPCS Inj, Lovotibeglogene Autotem 4 4 — — $3,100,000.00 $3,100,000.00 $3,100,000.00 2026-01-27
J3393 HCPCS Inj, Betibeglogene Autotemce 4 4 — — $2,800,000.00 $2,800,000.00 $2,800,000.00 2026-01-27
J3392 HCPCS Inj, Exagamglogene Autotem 4 4 — — $2,200,000.00 $2,200,000.00 $2,200,000.00 2026-01-27
J3399 HCPCS Inj Onase Abepar-xioi Treat 5 5 — — $2,125,000.00 $2,368,485.25 $2,125,000.00 2026-01-27
5834 APR_DRG Neonate With Ecmo 9 9 — — $952,201.22 $1,095,031.40 $1,037,899.33 2026-01-27
74 APR_DRG Allogeneic Bone Marrow Transplant 17 13 — — $118,800.00 $1,065,247.55 $926,302.22 2026-01-27
5833 APR_DRG Neonate With Ecmo 9 9 — — $806,289.00 $927,232.35 $878,855.01 2026-01-27
24 APR_DRG Heart And/or Lung Transplant 14 14 — — $77,000.00 $891,971.26 $787,261.59 2026-01-27
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 9 9 — — $602,727.75 $693,136.91 $675,055.08 2026-01-27
1614 APR_DRG Implantable Heart Assist Systems 9 9 — — $585,289.99 $673,083.49 $637,966.09 2026-01-27
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 9 9 — — $548,324.56 $630,573.24 $614,123.51 2026-01-27
Q2042 HCPCS Tisagenlecleucel Car-pos T 5 5 — — $511,072.00 $591,726.20 $591,726.20 2026-01-27
Q2055 HCPCS Idecabtagene Vicleucel Car 4 4 — — $557,317.93 $557,317.93 $557,317.93 2026-01-27
Q2024 HCPCS Non Risk Drugs - Q2024 With Mod U1 1 1 — — $511,072.00 $511,072.00 $511,072.00 2026-01-27
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 9 9 — — $444,495.38 $511,169.69 $497,834.83 2026-01-27
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 9 9 — — $448,469.62 $515,740.06 $488,831.89 2026-01-27
J3398 HCPCS Inj Luxturna 1 Billion Vec G 5 5 — — $2,890.00 $456,875.00 $456,875.00 2026-01-27
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 1 1 — — $449,440.00 $449,440.00 $449,440.00 2026-01-27
5832 APR_DRG Neonate With Ecmo 9 9 — — $401,755.39 $462,018.70 $437,913.38 2026-01-27
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 9 9 — — $381,493.05 $438,717.01 $415,827.42 2026-01-27
2004 APR_DRG Cardiac Structural And Valvular Disorders 9 9 — — $354,512.10 $407,688.92 $386,418.19 2026-01-27
5831 APR_DRG Neonate With Ecmo 9 9 — — $353,753.61 $406,816.65 $385,591.43 2026-01-27
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 9 9 — — $321,093.40 $369,257.41 $362,835.54 2026-01-27
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 9 9 — — $316,519.89 $363,997.87 $354,502.28 2026-01-27
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 9 9 — — $323,403.97 $371,914.57 $352,510.33 2026-01-27
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 9 9 — — $321,925.86 $370,214.74 $350,899.19 2026-01-27
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 9 9 — — $319,713.07 $367,670.03 $348,487.25 2026-01-27
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 9 9 — — $308,181.51 $354,408.74 $335,917.85 2026-01-27
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 9 9 — — $305,420.86 $351,233.99 $332,908.74 2026-01-27
1613 APR_DRG Implantable Heart Assist Systems 9 9 — — $305,061.04 $350,820.20 $332,516.53 2026-01-27
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 9 9 — — $303,448.78 $348,966.10 $330,759.17 2026-01-27
73 APR_DRG Allogeneic Bone Marrow Transplant 17 13 — — $118,800.00 $375,885.17 $326,856.67 2026-01-27
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 9 9 — — $271,661.14 $312,410.31 $304,260.48 2026-01-27
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 9 9 — — $271,812.84 $312,584.77 $296,276.00 2026-01-27
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 9 9 — — $269,390.69 $309,799.29 $293,635.85 2026-01-27
2464 APR_DRG Gastrointestinal Vascular Insufficiency 9 9 — — $263,435.60 $302,950.94 $287,144.80 2026-01-27
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 9 9 — — $262,076.58 $301,388.07 $285,663.47 2026-01-27
14 APR_DRG Liver Transplant And/or Intestinal Transplant 16 14 — — $97,500.00 $319,519.62 $277,843.15 2026-01-27
64 APR_DRG Pancreas Transplant 9 9 — — $254,337.47 $292,488.09 $277,227.84 2026-01-27
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 9 9 — — $254,317.41 $292,465.02 $277,205.98 2026-01-27
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 9 9 — — $253,556.42 $291,589.88 $276,376.50 2026-01-27
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 9 9 — — $246,485.53 $283,458.36 $268,669.23 2026-01-27
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 9 9 — — $233,089.72 $268,053.18 $261,060.49 2026-01-27
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 9 9 — — $236,978.70 $272,525.51 $258,306.78 2026-01-27
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 9 9 — — $231,197.88 $265,877.56 $252,005.69 2026-01-27
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 5 5 — — $94,500.00 $250,680.43 $250,680.43 2026-01-27
J3403 HCPCS Revakinagene, Per Implant 4 4 — — $250,000.00 $250,000.00 $250,000.00 2026-01-27
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 9 9 — — $221,345.03 $254,546.78 $247,906.43 2026-01-27
1612 APR_DRG Implantable Heart Assist Systems 9 9 — — $219,291.46 $252,185.18 $239,027.69 2026-01-27
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 9 9 — — $216,784.05 $249,301.66 $236,294.61 2026-01-27
84 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 18 14 — — $50,000.00 $318,239.34 $234,564.93 2026-01-27
8634 APR_DRG Neonatal Aftercare 9 9 — — $213,421.62 $245,434.86 $232,629.57 2026-01-27
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 9 9 — — $211,371.82 $243,077.59 $230,395.28 2026-01-27
1611 APR_DRG Implantable Heart Assist Systems 9 9 — — $207,978.04 $239,174.75 $226,696.06 2026-01-27
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 9 9 — — $206,516.23 $237,493.66 $225,102.69 2026-01-27
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 9 9 — — $206,446.02 $237,412.92 $225,026.16 2026-01-27
72 APR_DRG Allogeneic Bone Marrow Transplant 17 13 — — $118,800.00 $252,552.82 $219,611.15 2026-01-27
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 9 9 — — $201,119.04 $231,286.90 $219,219.75 2026-01-27
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 9 9 — — $201,119.04 $231,286.90 $219,219.75 2026-01-27
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 9 9 — — $200,548.60 $230,630.89 $218,597.97 2026-01-27
4414 APR_DRG Major Bladder Procedures 9 9 — — $196,336.16 $225,786.58 $214,006.41 2026-01-27
4404 APR_DRG Kidney Transplant 16 14 — — $38,000.00 $238,583.63 $207,464.03 2026-01-27
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 4 4 — — $205,640.00 $205,640.00 $205,640.00 2026-01-27
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 9 9 — — $180,086.91 $207,099.95 $201,697.34 2026-01-27
1784 APR_DRG External Heart Assist Systems 9 9 — — $183,890.65 $211,474.25 $200,440.81 2026-01-27
J1823 HCPCS Inebilizumab-cdon 10 mg/mL Soln 10 Ml Vial 58 39 $298,473.81 $223,855.36 25% off $495.55 $289,519.60 $199,977.45 2026-01-27
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 9 9 — — $181,094.89 $208,259.12 $197,393.43 2026-01-27
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 9 9 — — $180,886.78 $208,019.80 $197,166.59 2026-01-27
J9226 HCPCS Histrelin (supprelin La) 50 Mg (65 Mcg/day) Kit 1 Each Kit 58 39 $292,062.03 $219,046.53 25% off $45,020.65 $283,300.17 $195,681.56 2026-01-27
6904 APR_DRG Acute Leukemia 9 9 — — $178,469.64 $205,240.09 $194,531.91 2026-01-27
J0802 HCPCS Corticotropin 80 unit/mL Gel 5 Ml Vial 58 39 $289,245.74 $216,934.31 25% off $3,534.60 $280,568.37 $193,794.64 2026-01-27
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 9 9 — — $177,376.41 $203,982.87 $193,340.29 2026-01-27
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 9 9 — — $177,177.07 $203,753.63 $193,123.01 2026-01-27
23 APR_DRG Heart And/or Lung Transplant 14 14 — — $77,000.00 $219,692.27 $191,036.76 2026-01-27
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 9 9 — — $168,214.35 $193,446.50 $188,400.07 2026-01-27
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 9 9 — — $171,826.26 $197,600.20 $187,290.62 2026-01-27
83 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 18 14 — — $50,000.00 $215,106.04 $187,048.73 2026-01-27
C9293 HCPCS Glucarpidase 1,000 unit/mL Solr 1 Each Vial 54 39 $276,024.47 $207,018.36 25% off $55,066.88 $267,743.74 $184,936.39 2026-01-27
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 9 9 — — $167,188.82 $192,267.14 $182,235.81 2026-01-27
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 9 9 — — $166,055.47 $190,963.79 $181,000.46 2026-01-27
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 9 9 — — $164,430.67 $189,095.27 $179,229.43 2026-01-27
63 APR_DRG Pancreas Transplant 9 9 — — $164,362.97 $189,017.42 $179,155.64 2026-01-27
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 9 9 — — $156,687.80 $180,190.97 $170,789.70 2026-01-27
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 9 9 — — $155,834.03 $179,209.13 $169,859.09 2026-01-27
4474 APR_DRG Other Kidney, Urinary Tract And Related Procedures 9 9 — — $155,469.20 $178,789.58 $169,461.43 2026-01-27
234 APR_DRG Spinal Procedures 9 9 — — $153,166.15 $176,141.07 $166,951.10 2026-01-27
9104 APR_DRG Craniotomy For Multiple Significant Trauma 9 9 — — $152,612.01 $175,503.81 $166,347.09 2026-01-27
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 9 9 — — $148,081.13 $170,293.30 $165,850.87 2026-01-27
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 9 9 — — $150,651.22 $173,248.90 $164,209.83 2026-01-27
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 9 9 — — $150,644.95 $173,241.69 $164,203.00 2026-01-27
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 9 9 — — $148,766.91 $171,081.95 $162,155.93 2026-01-27
62 APR_DRG Pancreas Transplant 9 9 — — $148,664.10 $170,963.72 $162,043.87 2026-01-27
61 APR_DRG Pancreas Transplant 9 9 — — $146,744.68 $168,756.38 $159,951.70 2026-01-27
1824 APR_DRG Other Peripheral Vascular Procedures 9 9 — — $141,321.16 $162,519.33 $158,279.70 2026-01-27
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 9 9 — — $142,982.32 $164,429.67 $155,850.73 2026-01-27
22 APR_DRG Heart And/or Lung Transplant 14 14 — — $77,000.00 $176,485.65 $155,767.77 2026-01-27
264 APR_DRG Other Nervous System And Related Procedures 9 9 — — $142,895.81 $164,330.18 $155,756.43 2026-01-27
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 9 9 — — $142,278.99 $163,620.84 $155,084.10 2026-01-27
6954 APR_DRG Chemotherapy For Acute Leukemia 9 9 — — $138,321.05 $159,069.21 $154,919.58 2026-01-27
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 9 9 — — $141,435.25 $162,650.54 $154,164.42 2026-01-27
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 9 9 — — $141,237.17 $162,422.75 $153,948.52 2026-01-27
0812 RC Acquisition Of Body Components-cadaver Donor 92 39 $228,087.00 $171,065.25 25% off $42,797.94 $221,244.39 $152,818.29 2026-01-27
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 9 9 — — $138,925.34 $159,764.14 $151,428.62 2026-01-27
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 9 9 — — $138,891.49 $159,725.21 $151,391.72 2026-01-27
2054 APR_DRG Cardiomyopathy 9 9 — — $138,499.08 $159,273.94 $150,964.00 2026-01-27
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 9 9 — — $138,179.38 $158,906.29 $150,615.52 2026-01-27
214 APR_DRG Open Craniotomy Except Trauma 9 9 — — $133,019.14 $152,972.01 $148,981.44 2026-01-27
2304 APR_DRG Major Small Bowel Procedures 9 9 — — $132,538.97 $152,419.82 $148,443.65 2026-01-27
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 9 9 — — $135,857.53 $156,236.16 $148,084.71 2026-01-27
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 9 9 — — $135,402.43 $155,712.79 $147,588.65 2026-01-27
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 9 9 — — $134,979.93 $155,226.92 $147,128.12 2026-01-27
9524 APR_DRG Non-extensive O.r. Procedure Unrelated To Principal Diagnosis 9 9 — — $130,486.66 $150,059.66 $146,145.06 2026-01-27
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 9 9 — — $133,562.00 $153,596.30 $145,582.58 2026-01-27
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 9 9 — — $133,335.08 $153,335.34 $145,335.24 2026-01-27
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 2026-01-27
71 APR_DRG Allogeneic Bone Marrow Transplant 17 13 — — $118,800.00 $170,000.00 $144,204.68 2026-01-27
224 APR_DRG Ventricular Shunt Procedures 9 9 — — $132,016.18 $151,818.61 $143,897.64 2026-01-27
13 APR_DRG Liver Transplant And/or Intestinal Transplant 16 14 — — $97,500.00 $164,624.31 $143,151.57 2026-01-27
4424 APR_DRG Kidney And Urinary Tract Procedures For Malignancy 9 9 — — $131,292.79 $150,986.71 $143,109.14 2026-01-27
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 4 4 — — $141,625.29 $141,625.29 $141,625.29 2026-01-27
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 9 9 — — $129,294.39 $148,688.55 $140,930.89 2026-01-27
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 9 9 — — $124,002.51 $142,602.89 $138,882.81 2026-01-27
3154 APR_DRG Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement 9 9 — — $126,968.77 $146,014.09 $138,395.96 2026-01-27
1694 APR_DRG Major Abdominal Vascular Procedures 9 9 — — $126,537.50 $145,518.13 $137,925.88 2026-01-27
1204 APR_DRG Major Respiratory And Chest Procedures 9 9 — — $126,023.48 $144,927.00 $137,365.59 2026-01-27
4834 APR_DRG Penis, Testes And Scrotal Procedures 9 9 — — $125,544.56 $144,376.24 $136,843.57 2026-01-27
894 APR_DRG Major Cranial Or Facial Bone Procedures 9 9 — — $124,198.09 $142,827.80 $135,375.92 2026-01-27
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 9 9 — — $124,033.85 $142,638.93 $135,196.90 2026-01-27
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 9 9 — — $122,155.81 $140,479.18 $133,149.83 2026-01-27
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 9 9 — — $119,727.38 $137,686.49 $130,502.84 2026-01-27
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 9 9 — — $119,074.20 $136,935.33 $129,790.88 2026-01-27
0N14 LOCAL Less Than 750 Grams - Discharged Alive 4 4 — — $128,683.02 $128,683.02 $128,683.02 2026-01-27
1783 APR_DRG External Heart Assist Systems 9 9 — — $117,680.09 $135,332.10 $128,271.30 2026-01-27
1214 APR_DRG Other Respiratory And Chest Procedures 9 9 — — $117,612.39 $135,254.25 $128,197.51 2026-01-27
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 9 9 — — $117,182.37 $134,759.73 $127,728.78 2026-01-27
4403 APR_DRG Kidney Transplant 16 14 — — $38,000.00 $155,740.00 $126,977.55 2026-01-27
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 9 9 — — $116,235.82 $133,671.19 $126,697.04 2026-01-27
21 APR_DRG Heart And/or Lung Transplant 14 14 — — $77,000.00 $160,000.00 $126,440.00 2026-01-27
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 9 9 — — $115,901.08 $133,286.24 $126,332.18 2026-01-27
204 APR_DRG Open Craniotomy For Trauma 9 9 — — $111,738.79 $128,499.61 $125,147.44 2026-01-27
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 9 9 — — $114,801.58 $132,021.82 $125,133.72 2026-01-27
2244 APR_DRG Peritoneal Adhesiolysis 9 9 — — $114,618.54 $131,811.32 $124,934.21 2026-01-27
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 9 9 — — $113,819.93 $130,892.92 $124,063.72 2026-01-27
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 9 9 — — $113,501.49 $130,526.71 $123,716.62 2026-01-27
14 MS_DRG Allogeneic Bone Marrow Transplant 5 5 — — $123,536.85 $123,536.85 $123,536.85 2026-01-27
914 APR_DRG Other Major Head And Neck Procedures 9 9 — — $112,890.94 $129,824.58 $123,051.12 2026-01-27
6604 APR_DRG Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula… 9 9 — — $109,212.58 $125,594.47 $122,318.09 2026-01-27
51 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 9 9 — — $110,979.04 $127,625.90 $120,967.15 2026-01-27
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 9 9 — — $110,765.91 $127,380.80 $120,734.84 2026-01-27
1814 APR_DRG Lower Extremity Arterial Procedures 9 9 — — $109,908.38 $126,394.64 $119,800.13 2026-01-27
2274 APR_DRG Hernia Procedures Except Inguinal, Femoral And Umbilical 9 9 — — $109,572.39 $126,008.25 $119,433.91 2026-01-27
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 9 9 — — $109,190.01 $125,568.51 $119,017.11 2026-01-27
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 9 9 — — $109,067.15 $125,427.22 $118,883.19 2026-01-27
12 APR_DRG Liver Transplant And/or Intestinal Transplant 16 14 — — $97,500.00 $130,875.00 $117,674.67 2026-01-27
J1951 HCPCS Leuprolide 45 Mg Syrg 1 Each Syringe 58 39 $175,221.56 $131,416.17 25% off $140.99 $169,964.91 $117,398.45 2026-01-27
0811 RC Acquisition Of Body Components-living Donor 92 39 $173,955.00 $130,466.25 25% off $31,897.06 $168,736.35 $116,549.85 2026-01-27
1834 APR_DRG Percutaneous Structural Cardiac Procedures 9 9 — — $106,286.43 $122,229.39 $115,852.21 2026-01-27
11 APR_DRG Liver Transplant And/or Intestinal Transplant 16 14 — — $97,500.00 $130,875.00 $115,424.67 2026-01-27
2614 APR_DRG Major Biliary Tract Procedures 9 9 — — $104,600.20 $120,290.23 $114,014.22 2026-01-27
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 9 9 — — $104,226.60 $119,860.59 $113,606.99 2026-01-27
1833 APR_DRG Percutaneous Structural Cardiac Procedures 9 9 — — $103,676.22 $119,227.65 $113,007.08 2026-01-27
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 9 9 — — $100,829.06 $115,953.42 $112,928.55 2026-01-27
9514 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 9 9 — — $103,270.02 $118,760.52 $112,564.32 2026-01-27
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 9 9 — — $102,618.10 $118,010.82 $111,853.73 2026-01-27
504 APR_DRG Non-bacterial Infections Of Nervous System Except Viral Meningitis 9 9 — — $101,581.29 $116,818.48 $110,723.61 2026-01-27
1782 APR_DRG External Heart Assist Systems 9 9 — — $101,000.82 $116,150.94 $110,090.89 2026-01-27
33270 CPT Ins/Rplcmnt Perm Subq Impltbl Dfb W/Subq Eltrd 59 39 $163,106.00 $122,329.50 25% off $472.07 $158,212.82 $109,281.02 2026-01-27
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 9 9 — — $99,943.95 $114,935.54 $108,938.91 2026-01-27
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 9 9 — — $99,562.82 $114,497.24 $108,523.47 2026-01-27
82 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 18 14 — — $50,000.00 $192,400.00 $107,592.57 2026-01-27
2234 APR_DRG Other Small And Large Bowel Procedures 9 9 — — $98,414.43 $113,176.59 $107,271.73 2026-01-27
6914 APR_DRG Lymphoma, Myeloma And Non-acute Leukemia 9 9 — — $97,808.89 $112,480.22 $106,611.69 2026-01-27
6944 APR_DRG Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior 9 9 — — $96,818.47 $111,341.24 $105,532.13 2026-01-27
7234 APR_DRG Viral Illness 9 9 — — $96,686.83 $111,189.85 $105,388.64 2026-01-27
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 9 9 — — $95,647.51 $109,994.64 $104,255.79 2026-01-27
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 9 9 — — $94,590.64 $108,779.24 $103,103.80 2026-01-27
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 9 9 — — $94,403.84 $108,564.42 $102,900.19 2026-01-27
33289 CPT Tcat Impl Wrls P-art S Snr L-t Hemodyn Mntr 54 39 $152,884.00 $114,663.00 25% off $30,500.36 $148,297.48 $102,432.28 2026-01-27
6614 APR_DRG Coagulation And Platelet Disorders 9 9 — — $93,546.30 $107,578.25 $101,965.47 2026-01-27
1781 APR_DRG External Heart Assist Systems 9 9 — — $92,585.97 $106,473.87 $100,918.71 2026-01-27
923 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 9 9 — — $92,254.99 $106,093.24 $100,557.94 2026-01-27
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 9 9 — — $91,710.88 $105,467.51 $99,964.86 2026-01-27
5134 APR_DRG Uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma 9 9 — — $90,410.79 $103,972.41 $98,547.76 2026-01-27
1794 APR_DRG Defibrillator Implants 9 9 — — $90,355.63 $103,908.97 $98,487.64 2026-01-27
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 9 9 — — $90,232.77 $103,767.69 $98,353.72 2026-01-27
8412 APR_DRG Extensive Third Degree Burns With Skin Graft 9 9 — — $89,793.97 $103,263.07 $97,875.43 2026-01-27
0N24 LOCAL Less Than 1000 Grams - Discharged Alive 4 4 — — $97,622.32 $97,622.32 $97,622.32 2026-01-27
1714 APR_DRG Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock 9 9 — — $89,318.82 $102,716.64 $97,357.51 2026-01-27
8411 APR_DRG Extensive Third Degree Burns With Skin Graft 9 9 — — $89,095.66 $102,460.01 $97,114.27 2026-01-27
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures 9 9 — — $88,626.77 $101,920.79 $96,603.18 2026-01-27
1621 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 9 9 — — $88,340.93 $101,592.07 $96,291.61 2026-01-27
J3316 HCPCS Triptorelin 22.5 Mg Susr 1 Each Vial 58 39 $142,373.33 $106,780.00 25% off $3,817.28 $138,102.13 $95,390.13 2026-01-27
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 9 9 — — $87,390.62 $100,499.21 $95,255.78 2026-01-27
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 9 9 — — $87,304.12 $100,399.74 $95,161.49 2026-01-27
4013 APR_DRG Adrenal Procedures 9 9 — — $86,976.90 $100,023.44 $94,804.82 2026-01-27
3043 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 9 9 — — $86,968.12 $100,013.34 $94,795.25 2026-01-27
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 2026-01-27
3104 APR_DRG Intervertebral Disc Excision And Decompression 9 9 — — $86,046.65 $98,953.65 $93,790.85 2026-01-27
2334 APR_DRG Appendectomy With Complex Principal Diagnosis 9 9 — — $85,987.73 $98,885.89 $93,726.63 2026-01-27
5114 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 9 9 — — $85,863.61 $98,743.15 $93,591.33 2026-01-27
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 9 9 — — $85,674.30 $98,525.45 $93,384.99 2026-01-27
6344 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 9 9 — — $85,547.68 $98,379.83 $93,246.97 2026-01-27
81 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 18 14 — — $50,000.00 $192,400.00 $92,969.43 2026-01-27
4804 APR_DRG Major Male Pelvic Procedures 9 9 — — $85,185.36 $97,963.16 $92,852.04 2026-01-27
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 9 9 — — $84,676.35 $97,377.80 $92,297.22 2026-01-27
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 9 9 — — $84,455.70 $97,124.06 $92,056.71 2026-01-27
1303 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 9 9 — — $84,198.69 $96,828.49 $91,776.57 2026-01-27
3464 APR_DRG Connective Tissue Disorders 9 9 — — $84,177.38 $96,803.99 $91,753.34 2026-01-27
0N80 LOCAL 2500 And Greater Grams - O.r. Performed 4 4 — — $91,535.45 $91,535.45 $91,535.45 2026-01-27
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 9 9 — — $83,914.10 $96,501.22 $91,466.37 2026-01-27
4434 APR_DRG Kidney And Urinary Tract Procedures For Non-malignancy 9 9 — — $83,279.73 $95,771.69 $90,774.91 2026-01-27
1804 APR_DRG Other Circulatory System Procedures 9 9 — — $83,238.36 $95,724.11 $90,729.81 2026-01-27
294 APR_DRG Other Percutaneous Intracranial Procedures 9 9 — — $83,175.67 $95,652.02 $90,661.48 2026-01-27
734 APR_DRG Orbit And Eye Procedures 9 9 — — $83,008.93 $95,460.27 $90,479.73 2026-01-27
984 APR_DRG Other Ear, Nose, Mouth And Throat Procedures 9 9 — — $80,707.13 $92,813.20 $90,391.99 2026-01-27
4684 APR_DRG Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms 9 9 — — $82,590.19 $94,978.72 $90,023.31 2026-01-27
3134 APR_DRG Knee And Lower Leg Procedures Except Foot 9 9 — — $82,358.26 $94,712.00 $89,770.50 2026-01-27
8154 APR_DRG Other Injury, Poisoning And Toxic Effect Diagnoses 9 9 — — $81,624.84 $93,868.57 $88,971.08 2026-01-27
J2350 HCPCS Ocrelizumab 30 mg/mL Soln 10 Ml Vial 58 39 $131,796.88 $98,847.66 25% off $59.41 $127,842.97 $88,303.91 2026-01-27
913 APR_DRG Other Major Head And Neck Procedures 9 9 — — $80,997.99 $93,147.69 $88,287.81 2026-01-27
1754 APR_DRG Percutaneous Cardiac Intervention Without Ami 9 9 — — $80,868.86 $92,999.19 $88,147.06 2026-01-27
6924 APR_DRG Radiotherapy 9 9 — — $80,812.44 $92,934.31 $88,085.56 2026-01-27
6903 APR_DRG Acute Leukemia 9 9 — — $78,552.02 $90,334.82 $87,978.26 2026-01-27
2314 APR_DRG Major Large Bowel Procedures 9 9 — — $80,399.97 $92,459.97 $87,635.97 2026-01-27
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 9 9 — — $80,314.72 $92,361.93 $87,543.04 2026-01-27
8104 APR_DRG Hemorrhage Or Hematoma Due To Complication 9 9 — — $80,283.38 $92,325.89 $87,508.88 2026-01-27
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 9 9 — — $80,056.46 $92,064.93 $87,261.54 2026-01-27
1602 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 9 9 — — $79,766.85 $91,731.88 $86,945.87 2026-01-27
4844 APR_DRG Other Male Reproductive System And Related Procedures 9 9 — — $79,546.20 $91,478.13 $86,705.36 2026-01-27
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 9 9 — — $79,482.26 $91,404.60 $86,635.66 2026-01-27
494 APR_DRG Bacterial And Tuberculous Infections Of Nervous System 9 9 — — $79,331.82 $91,231.59 $86,471.68 2026-01-27
1704 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 9 9 — — $78,860.43 $90,689.49 $85,957.87 2026-01-27
1673 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 9 9 — — $78,226.05 $89,959.96 $85,266.39 2026-01-27
213 APR_DRG Open Craniotomy Except Trauma 9 9 — — $76,129.86 $87,549.34 $85,265.44 2026-01-27
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 9 9 — — $78,059.31 $89,768.21 $85,084.65 2026-01-27
4014 APR_DRG Adrenal Procedures 9 9 — — $77,778.48 $89,445.25 $84,778.54 2026-01-27
3254 APR_DRG Non-elective Or Complex Knee Joint Replacement 9 9 — — $77,615.50 $89,257.83 $84,600.90 2026-01-27
6613 APR_DRG Coagulation And Platelet Disorders 9 9 — — $76,697.79 $88,202.46 $83,600.59 2026-01-27
274 APR_DRG Other Open Craniotomy 9 9 — — $76,606.27 $88,097.21 $83,500.83 2026-01-27
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 9 9 — — $76,297.86 $87,742.54 $83,164.67 2026-01-27
7934 APR_DRG Moderately Extensive O.r. Procedures For Other Complications Of Treatment 9 9 — — $75,645.93 $86,992.82 $82,454.06 2026-01-27
3214 APR_DRG Cervical Spinal Fusion And Other Back Or Neck Procedures Except Disc Excision Or… 9 9 — — $75,620.86 $86,963.99 $82,426.74 2026-01-27
3031 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 9 9 — — $75,595.78 $86,935.15 $82,399.40 2026-01-27
244 APR_DRG Open Extracranial Vascular Procedures 9 9 — — $75,466.65 $86,786.65 $82,258.65 2026-01-27
1801 APR_DRG Other Circulatory System Procedures 9 9 — — $75,411.49 $86,723.21 $82,198.52 2026-01-27
3084 APR_DRG Hip And Femur Fracture Repair 9 9 — — $75,158.24 $86,431.98 $81,922.48 2026-01-27
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 9 9 — — $74,986.48 $86,234.45 $81,735.26 2026-01-27
4402 APR_DRG Kidney Transplant 16 14 — — $38,000.00 $155,740.00 $81,669.97 2026-01-27
5144 APR_DRG Female Reproductive System Reconstructive Procedures 9 9 — — $74,584.05 $85,771.66 $81,296.61 2026-01-27
233 APR_DRG Spinal Procedures 9 9 — — $74,566.49 $85,751.46 $81,277.47 2026-01-27
2224 APR_DRG Other Stomach, Esophageal And Duodenal Procedures 9 9 — — $74,518.85 $85,696.68 $81,225.55 2026-01-27
5124 APR_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy 9 9 — — $74,431.09 $85,595.75 $81,129.89 2026-01-27
4012 APR_DRG Adrenal Procedures 9 9 — — $74,117.67 $85,235.32 $80,788.26 2026-01-27
433 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 9 9 — — $73,819.29 $84,892.18 $80,463.03 2026-01-27
1302 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 9 9 — — $73,611.17 $84,652.85 $80,236.18 2026-01-27
6803 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 9 9 — — $73,572.31 $84,608.16 $80,193.82 2026-01-27
404 APR_DRG Spinal Disorders And Injuries 9 9 — — $73,571.05 $84,606.71 $80,192.44 2026-01-27
293 APR_DRG Other Percutaneous Intracranial Procedures 9 9 — — $73,300.25 $84,295.29 $79,897.27 2026-01-27
7923 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 9 9 — — $72,440.21 $83,306.24 $78,959.83 2026-01-27
6813 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 9 9 — — $72,163.14 $82,987.61 $78,657.82 2026-01-27
4444 APR_DRG Renal Dialysis Access Device Procedures And Vessel Repair 9 9 — — $71,664.17 $82,413.80 $78,113.95 2026-01-27
2824 APR_DRG Disorders Of Pancreas Except Malignancy 9 9 — — $69,665.77 $80,115.64 $78,025.66 2026-01-27
2454 APR_DRG Inflammatory Bowel Disease 9 9 — — $71,561.37 $82,295.58 $78,001.89 2026-01-27
7594 APR_DRG Eating Disorders 9 9 — — $69,447.62 $79,864.76 $77,781.33 2026-01-27
J9210 HCPCS Emapalumab-lzsg 5 mg/mL Soln 10 Ml Vial 58 39 $115,945.67 $86,959.26 25% off $384.85 $112,467.30 $77,683.60 2026-01-27
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 9 9 — — $70,845.50 $81,472.33 $77,221.60 2026-01-27
J3357 HCPCS Ustekinumab 90 mg/mL Syrg 1 Ml Syringe 96 39 $186,127.92 $139,595.94 25% off $155.88 $180,544.08 $76,788.13 2026-01-27
203 APR_DRG Open Craniotomy For Trauma 9 9 — — $70,249.99 $80,787.49 $76,572.49 2026-01-27
4401 APR_DRG Kidney Transplant 16 14 — — $38,000.00 $155,740.00 $76,556.12 2026-01-27
3224 APR_DRG Shoulder And Elbow Joint Replacement 9 9 — — $70,075.73 $80,587.09 $76,382.55 2026-01-27
1632 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 9 9 — — $70,026.83 $80,530.85 $76,329.24 2026-01-27
4624 APR_DRG Nephritis And Nephrosis 9 9 — — $69,507.80 $79,933.97 $75,763.50 2026-01-27
273 APR_DRG Other Open Craniotomy 9 9 — — $69,468.94 $79,889.28 $75,721.14 2026-01-27
594 APR_DRG Anoxic And Other Severe Brain Damage 9 9 — — $69,396.22 $79,805.65 $75,641.88 2026-01-27
6504 APR_DRG Splenectomy 9 9 — — $69,285.90 $79,678.79 $75,521.63 2026-01-27
1793 APR_DRG Defibrillator Implants 9 9 — — $69,283.39 $79,675.90 $75,518.90 2026-01-27
2634 APR_DRG Cholecystectomy 9 9 — — $69,248.29 $79,635.53 $75,480.64 2026-01-27
2613 APR_DRG Major Biliary Tract Procedures 9 9 — — $69,140.47 $79,511.54 $75,363.11 2026-01-27
2264 APR_DRG Anal Procedures 9 9 — — $69,046.44 $79,403.41 $75,260.62 2026-01-27
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 4 4 — — $74,752.09 $74,752.09 $74,752.09 2026-01-27
2074 APR_DRG Other Circulatory System Diagnoses 9 9 — — $68,448.42 $78,715.68 $74,608.78 2026-01-27
3054 APR_DRG Amputation Of Lower Limb Except Toes 9 9 — — $68,402.04 $78,662.35 $74,558.22 2026-01-27
1934 APR_DRG Acute And Subacute Endocarditis 9 9 — — $67,857.93 $78,036.62 $73,965.14 2026-01-27
A9543 HCPCS Y90 Ibritumomab, Rx 4 4 — — $73,939.13 $73,939.13 $73,939.13 2026-01-27
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 9 9 — — $67,738.83 $77,899.65 $73,835.32 2026-01-27
4454 APR_DRG Other Bladder Procedures 9 9 — — $67,689.93 $77,843.42 $73,782.02 2026-01-27
1314 APR_DRG Cystic Fibrosis - Pulmonary Disease 9 9 — — $65,577.44 $75,414.06 $73,446.73 2026-01-27
1832 APR_DRG Percutaneous Structural Cardiac Procedures 9 9 — — $67,307.55 $77,403.68 $73,365.23 2026-01-27
J9118 HCPCS CALaspargase Pegol-mknl 750 unit/mL Soln 5 Ml Vial 58 39 $109,458.13 $82,093.60 25% off $50.01 $106,174.39 $73,336.95 2026-01-27
1663 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 9 9 — — $67,127.02 $77,196.07 $73,168.45 2026-01-27
6902 APR_DRG Acute Leukemia 9 9 — — $67,120.75 $77,188.86 $73,161.62 2026-01-27
0N38 LOCAL Less Than 1500 Grams - O.r. Performed 4 4 — — $72,970.66 $72,970.66 $72,970.66 2026-01-27
3814 APR_DRG Major Skin Disorders 9 9 — — $66,938.96 $76,979.80 $72,963.47 2026-01-27
3164 APR_DRG Hand And Wrist Procedures 9 9 — — $66,839.92 $76,865.91 $72,855.51 2026-01-27
0N37 LOCAL Less Than 1500 Grams - Discharged Dead 4 4 — — $72,301.83 $72,301.83 $72,301.83 2026-01-27
1652 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 9 9 — — $66,239.40 $76,175.31 $72,200.95 2026-01-27
6213 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 9 9 — — $66,179.22 $76,106.10 $72,135.35 2026-01-27
893 APR_DRG Major Cranial Or Facial Bone Procedures 9 9 — — $66,096.48 $76,010.95 $72,045.16 2026-01-27
5184 APR_DRG Other Female Reproductive System And Related Procedures 9 9 — — $65,984.90 $75,882.64 $71,923.54 2026-01-27
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