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 →

Export CSV
Hospital

MOUNTAIN VIEW HOSPITAL

Payson, UT · CCN 460013 · Rates published

21,528 distinct procedures filed
39 distinct payers
469,442 rate rows
2024-10-01 last MRF observed · ⚠ 21 mo old
Data quality

263,034 of 469,442 rate rows are consumer-grade (56.0%)

206,408 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 202,835
per-diem day rate — not a per-procedure price 3,212
template filing: same amount across many unrelated codes — excluded 256
placeholder amount (≤ $0.02) — excluded from medians 98
exceeds 10× this hospital's gross charge — excluded from medians 7

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 21 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.hcadam.com/api/public/content/ed92b53525bd4968b7a7fc42d1e3b85d?download=true
Found on page https://www.mountainstar.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-16
Content fingerprint 237e9cbaa980e2b2… · 280,100,199 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
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 1 $3,672,900.00 $3,672,900.00 $3,672,900.00 nat. median
$3,574,709
1.0× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 10 $2,754,675.00 $3,709,629.00 $3,672,900.00 nat. median
$3,746,358
1.0× median
00773
OTHER 		Inj, Beqvez, Per Tx Dose 1 $3,605,000.00 $3,605,000.00 $3,605,000.00 nat. median
$3,496,850
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 10 $2,703,750.00 $3,641,050.00 $3,605,000.00 nat. median
$3,605,000
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 11 $5,166.40 $3,358,709.55 $3,325,455.00 nat. median
$13,041
outlier · 255.0×
00714
OTHER 		Inj Delandistrogene Mox R 1 $3,325,455.00 $3,325,455.00 $3,325,455.00 nat. median
$3,228,024
1.0× median
00748
OTHER 		Inj, Lovotibeglogene Auto 1 $3,286,000.00 $3,286,000.00 $3,286,000.00 nat. median
$3,187,420
1.0× median
748
OTHER 		Inj, Lovotibeglogene Auto 11 $8,521.96 $3,318,860.00 $3,286,000.00 nat. median
$17,963
outlier · 182.9×
746
OTHER 		Inj, Betibeglogene Autote 11 $7,569.19 $2,997,680.00 $2,968,000.00 nat. median
$21,896
outlier · 135.6×
00746
OTHER 		Inj, Betibeglogene Autote 1 $2,968,000.00 $2,968,000.00 $2,968,000.00 nat. median
$2,878,960
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 10 $1,791,460.50 $2,412,500.14 $2,388,614.00 nat. median
$2,588,981
0.9× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 1 $2,388,614.00 $2,388,614.00 $2,388,614.00 nat. median
$2,457,321
1.0× median
09194
OTHER 		Tisagenlecleucel Car-pos 1 $529,192.90 $529,192.90 $529,192.90 nat. median
$538,205
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos 10 $396,894.68 $534,484.83 $529,192.90 nat. median
$566,531
0.9× median
9498
OTHER 		Ciltacabtagene Car-pos T 10 $395,342.55 $532,394.63 $527,123.40 nat. median
$587,650
0.9× median
09498
OTHER 		Ciltacabtagene Car-pos T 1 $527,123.40 $527,123.40 $527,123.40 nat. median
$554,552
1.0× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $526,587.60 $526,587.60 $526,587.60 nat. median
$530,178
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 10 $394,940.70 $531,853.48 $526,587.60 nat. median
$558,082
0.9× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 1 $518,241.00 $518,241.00 $518,241.00 nat. median
$753,246
0.7× median
9413
OTHER 		Lisocabtagene Car Pos T 10 $387,544.57 $521,893.36 $516,726.10 nat. median
$562,201
0.9× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $516,726.10 $516,726.10 $516,726.10 nat. median
$534,091
1.0× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 1 $507,496.00 $507,496.00 $507,496.00 nat. median
$674,867
0.8× median
9035
OTHER 		Axicabtagene Ciloleucel C 10 $367,092.00 $494,350.56 $489,456.00 nat. median
$532,192
0.9× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $489,456.00 $489,456.00 $489,456.00 nat. median
$505,583
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 1 $484,690.00 $484,690.00 $484,690.00 nat. median
$625,184
0.8× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 1 $474,061.00 $474,061.00 $474,061.00 nat. median
$673,137
0.7× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $460,530.40 $460,530.40 $460,530.40 nat. median
$464,978
1.0× median
9391
OTHER 		Brexucabtagene Car Pos T 10 $345,397.80 $465,135.70 $460,530.40 nat. median
$489,450
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 1 $459,381.00 $459,381.00 $459,381.00 nat. median
$634,303
0.7× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 1 $449,440.00 $449,440.00 $449,440.00 nat. median
$619,808
0.7× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 25 $235,461.70 $1,026,253.41 $425,929.17 nat. median
$370,174
1.2× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 24 $173,187.15 $546,266.94 $258,963.00 nat. median
$265,286
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 25 $136,258.04 $593,876.96 $244,721.48 nat. median
$202,976
1.2× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 23 $146,105.99 $734,221.59 $223,682.81 nat. median
$206,474
1.1× median
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $175,119.46 $175,119.46 $175,119.46 nat. median
$263,894
0.7× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 24 $76,517.61 $277,022.82 $158,369.00 nat. median
$108,660
1.5× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 25 $93,947.70 $409,468.50 $148,190.27 nat. median
$133,161
1.1× median
1907
OTHER 		New Technology - Level 52 10 $109,283.40 $147,168.31 $145,711.20 nat. median
$153,199
1.0× median
1908
OTHER 		New Technology - Level 52 10 $109,283.40 $147,168.31 $145,711.20 nat. median
$152,962
1.0× median
01908
OTHER 		New Technology - Level 52 1 $145,711.20 $145,711.20 $145,711.20 nat. median
$82,736
1.8× median
01907
OTHER 		New Technology - Level 52 1 $145,711.20 $145,711.20 $145,711.20 nat. median
$84,819
1.7× median
018
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $144,499.39 $144,499.39 $144,499.39 nat. median
$424,868
outlier · 0.3×
7
MS_DRG 		Lung Transplant 25 $78,394.56 $234,367.95 $143,490.00 nat. median
$122,708
1.2× median
A9543
HCPCS 		Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 1 $103,453.00 $168,274.81 $136,846.05 nat. median
$62,507
outlier · 2.2×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 25 $66,146.85 $225,151.15 $134,129.67 nat. median
$100,136
1.3× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 24 $73,246.61 $252,136.89 $131,567.00 nat. median
$117,357
1.1× median
01906
OTHER 		New Technology - Level 51 1 $131,379.00 $131,379.00 $131,379.00 nat. median
$82,736
1.6× median
1906
OTHER 		New Technology - Level 51 10 $98,534.25 $132,692.79 $131,379.00 nat. median
$138,020
1.0× median
01905
OTHER 		New Technology - Level 51 1 $131,379.00 $131,379.00 $131,379.00 nat. median
$82,736
1.6× median
1905
OTHER 		New Technology - Level 51 10 $98,534.25 $132,692.79 $131,379.00 nat. median
$137,903
1.0× median

Other procedures at this hospital

Browse this hospital's 21,528 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
             
09138 OTHER Inj, Hemgenix, Per Tx Dos 1 1 — — $3,672,900.00 $3,672,900.00 $3,672,900.00 2024-10-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 13 10 — — $2,754,675.00 $3,709,629.00 $3,672,900.00 2024-10-01
00773 OTHER Inj, Beqvez, Per Tx Dose 1 1 — — $3,605,000.00 $3,605,000.00 $3,605,000.00 2024-10-01
773 OTHER Inj, Beqvez, Per Tx Dose 13 10 — — $2,703,750.00 $3,641,050.00 $3,605,000.00 2024-10-01
00714 OTHER Inj Delandistrogene Mox R 1 1 — — $3,325,455.00 $3,325,455.00 $3,325,455.00 2024-10-01
714 OTHER Inj Delandistrogene Mox R 14 11 — — $5,166.40 $3,358,709.55 $3,325,455.00 2024-10-01
00748 OTHER Inj, Lovotibeglogene Auto 1 1 — — $3,286,000.00 $3,286,000.00 $3,286,000.00 2024-10-01
748 OTHER Inj, Lovotibeglogene Auto 14 11 — — $8,521.96 $3,318,860.00 $3,286,000.00 2024-10-01
746 OTHER Inj, Betibeglogene Autote 14 11 — — $7,569.19 $2,997,680.00 $2,968,000.00 2024-10-01
00746 OTHER Inj, Betibeglogene Autote 1 1 — — $2,968,000.00 $2,968,000.00 $2,968,000.00 2024-10-01
9141 OTHER Inj Onase Abepar-xioi Tre 13 10 — — $1,791,460.50 $2,412,500.14 $2,388,614.00 2024-10-01
09141 OTHER Inj Onase Abepar-xioi Tre 1 1 — — $2,388,614.00 $2,388,614.00 $2,388,614.00 2024-10-01
09194 OTHER Tisagenlecleucel Car-pos 1 1 — — $529,192.90 $529,192.90 $529,192.90 2024-10-01
9194 OTHER Tisagenlecleucel Car-pos 13 10 — — $396,894.68 $534,484.83 $529,192.90 2024-10-01
9498 OTHER Ciltacabtagene Car-pos T 13 10 — — $395,342.55 $532,394.63 $527,123.40 2024-10-01
09498 OTHER Ciltacabtagene Car-pos T 1 1 — — $527,123.40 $527,123.40 $527,123.40 2024-10-01
9422 OTHER Idecabtagene Vicleucel Ca 13 10 — — $394,940.70 $531,853.48 $526,587.60 2024-10-01
09422 OTHER Idecabtagene Vicleucel Ca 1 1 — — $526,587.60 $526,587.60 $526,587.60 2024-10-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 1 1 — — $518,241.00 $518,241.00 $518,241.00 2024-10-01
09413 OTHER Lisocabtagene Car Pos T 1 1 — — $516,726.10 $516,726.10 $516,726.10 2024-10-01
9413 OTHER Lisocabtagene Car Pos T 13 10 — — $387,544.57 $521,893.36 $516,726.10 2024-10-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 1 1 — — $507,496.00 $507,496.00 $507,496.00 2024-10-01
9035 OTHER Axicabtagene Ciloleucel C 13 10 — — $367,092.00 $494,350.56 $489,456.00 2024-10-01
09035 OTHER Axicabtagene Ciloleucel C 1 1 — — $489,456.00 $489,456.00 $489,456.00 2024-10-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 1 1 — — $484,690.00 $484,690.00 $484,690.00 2024-10-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 1 1 — — $474,061.00 $474,061.00 $474,061.00 2024-10-01
9391 OTHER Brexucabtagene Car Pos T 13 10 — — $345,397.80 $465,135.70 $460,530.40 2024-10-01
09391 OTHER Brexucabtagene Car Pos T 1 1 — — $460,530.40 $460,530.40 $460,530.40 2024-10-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 1 1 — — $459,381.00 $459,381.00 $459,381.00 2024-10-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 1 1 — — $449,440.00 $449,440.00 $449,440.00 2024-10-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 44 25 — — $235,461.70 $1,026,253.41 $425,929.17 2024-10-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 39 24 — — $173,187.15 $546,266.94 $258,963.00 2024-10-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 44 25 — — $136,258.04 $593,876.96 $244,721.48 2024-10-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 36 23 — — $146,105.99 $734,221.59 $223,682.81 2024-10-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $175,119.46 $175,119.46 $175,119.46 2024-10-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 39 24 — — $76,517.61 $277,022.82 $158,369.00 2024-10-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 44 25 — — $93,947.70 $409,468.50 $148,190.27 2024-10-01
01907 OTHER New Technology - Level 52 1 1 — — $145,711.20 $145,711.20 $145,711.20 2024-10-01
1907 OTHER New Technology - Level 52 13 10 — — $109,283.40 $147,168.31 $145,711.20 2024-10-01
01908 OTHER New Technology - Level 52 1 1 — — $145,711.20 $145,711.20 $145,711.20 2024-10-01
1908 OTHER New Technology - Level 52 13 10 — — $109,283.40 $147,168.31 $145,711.20 2024-10-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $144,499.39 $144,499.39 $144,499.39 2024-10-01
7 MS_DRG Lung Transplant 42 25 — — $78,394.56 $234,367.95 $143,490.00 2024-10-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 7 1 — — $103,453.00 $168,274.81 $136,846.05 2024-10-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 42 25 — — $66,146.85 $225,151.15 $134,129.67 2024-10-01
14 MS_DRG Allogeneic Bone Marrow Transplant 38 24 — — $73,246.61 $252,136.89 $131,567.00 2024-10-01
01906 OTHER New Technology - Level 51 1 1 — — $131,379.00 $131,379.00 $131,379.00 2024-10-01
1906 OTHER New Technology - Level 51 13 10 — — $98,534.25 $132,692.79 $131,379.00 2024-10-01
01905 OTHER New Technology - Level 51 1 1 — — $131,379.00 $131,379.00 $131,379.00 2024-10-01
1905 OTHER New Technology - Level 51 13 10 — — $98,534.25 $132,692.79 $131,379.00 2024-10-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 31 14 — — $56,633.21 $246,834.30 $121,410.04 2024-10-01
215 MS_DRG Other Heart Assist System Implant 41 25 — — $65,282.79 $284,533.25 $121,108.00 2024-10-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $117,295.01 $117,295.01 $117,295.01 2024-10-01
1903 OTHER New Technology - Level 50 13 10 — — $87,785.10 $118,217.27 $117,046.80 2024-10-01
01903 OTHER New Technology - Level 50 1 1 — — $117,046.80 $117,046.80 $117,046.80 2024-10-01
1904 OTHER New Technology - Level 50 13 10 — — $87,785.10 $118,217.27 $117,046.80 2024-10-01
01904 OTHER New Technology - Level 50 1 1 — — $117,046.80 $117,046.80 $117,046.80 2024-10-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 19 8 — — $58,932.85 $164,956.05 $116,066.40 2024-10-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 45 26 — — $62,026.57 $270,341.13 $115,082.55 2024-10-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 45 26 — — $54,019.29 $235,441.60 $109,901.77 2024-10-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 19 8 — — $54,565.57 $146,208.08 $107,465.18 2024-10-01
01901 OTHER New Technology - Level 49 1 1 — — $102,714.60 $102,714.60 $102,714.60 2024-10-01
1902 OTHER New Technology - Level 49 13 10 — — $77,035.95 $103,741.75 $102,714.60 2024-10-01
1901 OTHER New Technology - Level 49 13 10 — — $77,035.95 $103,741.75 $102,714.60 2024-10-01
01902 OTHER New Technology - Level 49 1 1 — — $102,714.60 $102,714.60 $102,714.60 2024-10-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 21 12 — — $74,999.92 $100,999.90 $99,999.90 2024-10-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 45 26 — — $51,864.24 $226,048.90 $98,657.00 2024-10-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 45 26 — — $49,282.28 $214,795.48 $97,528.00 2024-10-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 19 8 — — $49,267.73 $132,202.45 $97,031.24 2024-10-01
0424T CPT Insertion Or Replacement Of Neurostimulator System For Treatment Of Central Slee… 11 2 — — $4,180.00 $141,351.29 $96,800.88 2024-10-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 45 26 — — $53,872.30 $179,517.16 $94,694.60 2024-10-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 11 3 — — $55,453.60 $136,370.47 $93,389.89 2024-10-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 26 18 — — $68,835.54 $300,017.85 $91,311.74 2024-10-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 14 11 — — $68,273.92 $91,942.22 $91,031.90 2024-10-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 31 14 — — $42,387.03 $184,742.72 $90,869.14 2024-10-01
1599 OTHER New Technology - Level 48 13 10 — — $68,078.31 $91,678.79 $90,771.08 2024-10-01
01599 OTHER New Technology - Level 48 1 1 — — $90,771.08 $90,771.08 $90,771.08 2024-10-01
1585 OTHER New Technology - Level 48 13 10 — — $68,078.31 $91,678.79 $90,771.08 2024-10-01
01585 OTHER New Technology - Level 48 1 1 — — $90,771.08 $90,771.08 $90,771.08 2024-10-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 34 24 — — $46,222.91 $201,461.29 $88,769.08 2024-10-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 45 26 — — $49,847.24 $217,257.86 $88,495.27 2024-10-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 44 25 — — $51,086.46 $222,658.94 $85,008.75 2024-10-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 31 14 — — $33,877.00 $170,369.54 $83,799.43 2024-10-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 45 26 — — $44,512.68 $194,007.29 $83,080.00 2024-10-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $82,472.97 $82,472.97 $82,472.97 2024-10-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 45 26 — — $43,922.79 $191,436.27 $81,935.14 2024-10-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 45 26 — — $43,808.39 $190,937.67 $81,721.73 2024-10-01
01598 OTHER New Technology - Level 47 1 1 — — $81,216.28 $81,216.28 $81,216.28 2024-10-01
1584 OTHER New Technology - Level 47 13 10 — — $60,912.21 $82,028.44 $81,216.28 2024-10-01
01584 OTHER New Technology - Level 47 1 1 — — $81,216.28 $81,216.28 $81,216.28 2024-10-01
1598 OTHER New Technology - Level 47 13 10 — — $60,912.21 $82,028.44 $81,216.28 2024-10-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 45 26 — — $38,819.60 $171,068.70 $80,203.02 2024-10-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 19 8 — — $40,168.33 $118,665.33 $79,110.27 2024-10-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 45 26 — — $44,149.03 $192,422.34 $77,941.00 2024-10-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 45 26 — — $39,918.83 $173,985.12 $77,604.43 2024-10-01
834 MS_DRG Acute Leukemia With Mcc 45 26 — — $16,243.00 $155,960.15 $76,711.90 2024-10-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 19 8 — — $38,929.12 $111,665.48 $76,669.67 2024-10-01
014 OTHER Allogeneic Bone Marrow Transplant 1 1 — — $76,631.57 $76,631.57 $76,631.57 2024-10-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 34 24 — — $38,922.47 $169,642.52 $76,514.29 2024-10-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 19 8 — — $38,644.33 $103,370.83 $76,108.79 2024-10-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 14 — — $1,663.00 $113,368.99 $75,858.61 2024-10-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 45 26 — — $43,002.32 $189,929.32 $75,784.03 2024-10-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 45 26 — — $40,680.63 $177,305.43 $74,999.13 2024-10-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $74,627.95 $74,627.95 $74,627.95 2024-10-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 36 23 — — $46,721.05 $192,748.24 $72,956.93 2024-10-01
1597 OTHER New Technology - Level 46 13 10 — — $53,746.11 $72,378.09 $71,661.48 2024-10-01
01597 OTHER New Technology - Level 46 1 1 — — $71,661.48 $71,661.48 $71,661.48 2024-10-01
01583 OTHER New Technology - Level 46 1 1 — — $71,661.48 $71,661.48 $71,661.48 2024-10-01
1583 OTHER New Technology - Level 46 13 10 — — $53,746.11 $72,378.09 $71,661.48 2024-10-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 38 24 — — $39,477.21 $136,106.63 $71,518.00 2024-10-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 45 26 — — $37,582.91 $163,804.11 $70,408.00 2024-10-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 45 26 — — $36,407.61 $158,681.58 $69,806.00 2024-10-01
28 MS_DRG Spinal Procedures With Mcc 45 26 — — $38,512.81 $167,857.02 $69,432.43 2024-10-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 45 26 — — $38,017.50 $165,698.25 $69,198.27 2024-10-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 45 26 — — $33,219.78 $144,787.50 $67,340.00 2024-10-01
850 MS_DRG Acute Leukemia With Other Procedures 18 14 — — $1,663.00 $99,629.42 $66,776.40 2024-10-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 45 26 — — $39,739.88 $173,205.18 $66,733.00 2024-10-01
007 OTHER Lung Transplant 1 1 — — $66,119.11 $66,119.11 $66,119.11 2024-10-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $65,999.16 $65,999.16 $65,999.16 2024-10-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 14 11 — — $49,403.77 $66,530.42 $65,871.70 2024-10-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 45 26 — — $38,827.24 $128,754.91 $65,835.00 2024-10-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 42 25 — — $33,627.52 $111,019.06 $65,720.00 2024-10-01
1643 OTHER Y90 Ibritumomab, Rx 13 10 — — $49,107.43 $66,131.35 $65,476.58 2024-10-01
01643 OTHER Y90 Ibritumomab, Rx 1 1 — — $65,476.58 $65,476.58 $65,476.58 2024-10-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 45 26 — — $35,183.73 $153,347.35 $65,467.71 2024-10-01
653 MS_DRG Major Bladder Procedures With Mcc 45 26 — — $34,598.32 $150,795.83 $65,316.00 2024-10-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 1 1 — — $63,505.40 $63,505.40 $63,505.40 2024-10-01
717 OTHER Instill Adstiladrin, Tx D 14 11 — — $12,381.09 $63,988.32 $63,354.77 2024-10-01
00717 OTHER Instill Adstiladrin, Tx D 1 1 — — $63,354.77 $63,354.77 $63,354.77 2024-10-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 45 26 — — $30,958.00 $134,929.62 $63,265.00 2024-10-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 31 14 — — $28,534.00 $128,288.99 $63,101.33 2024-10-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 45 26 — — $38,644.46 $168,430.83 $62,969.67 2024-10-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 45 26 — — $33,518.24 $146,088.33 $62,719.00 2024-10-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 45 26 — — $36,229.30 $157,904.42 $62,453.29 2024-10-01
01582 OTHER New Technology - Level 45 1 1 — — $62,106.68 $62,106.68 $62,106.68 2024-10-01
1582 OTHER New Technology - Level 45 13 10 — — $46,580.01 $62,727.75 $62,106.68 2024-10-01
1596 OTHER New Technology - Level 45 13 10 — — $46,580.01 $62,727.75 $62,106.68 2024-10-01
01596 OTHER New Technology - Level 45 1 1 — — $62,106.68 $62,106.68 $62,106.68 2024-10-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 45 26 — — $36,196.71 $157,762.36 $61,920.06 2024-10-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 45 26 — — $33,147.56 $144,472.74 $61,834.65 2024-10-01
0268T CPT Implantation Or Replacement Of Carotid Sinus Baroreflex Activation Device; Pulse… 7 1 — — $46,386.40 $75,451.29 $61,359.22 2024-10-01
0266T CPT Implantation Or Replacement Of Carotid Sinus Baroreflex Activation Device; Total… 7 1 — — $46,386.40 $75,451.29 $61,359.22 2024-10-01
799 MS_DRG Splenic Procedures With Mcc 45 26 — — $31,664.85 $138,010.38 $61,213.00 2024-10-01
955 OTHER Craniotomy For Multiple Significant Trauma 1 1 — — $61,081.39 $61,081.39 $61,081.39 2024-10-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 45 26 — — $32,953.91 $143,628.74 $61,017.57 2024-10-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 18 14 — — $1,663.00 $90,205.44 $60,546.91 2024-10-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. 45 26 — — $29,575.63 $128,904.58 $60,440.00 2024-10-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 45 26 — — $32,318.65 $140,859.95 $60,288.36 2024-10-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 45 26 — — $6,248.00 $141,475.54 $60,168.00 2024-10-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 26 18 — — $44,965.80 $195,982.21 $59,411.05 2024-10-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 45 26 — — $32,202.33 $140,352.99 $58,691.93 2024-10-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 45 26 — — $36,320.69 $158,302.75 $58,351.24 2024-10-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 45 26 — — $31,189.36 $135,937.97 $58,181.74 2024-10-01
10 MS_DRG Pancreas Transplant 42 25 — — $30,763.72 $86,231.64 $57,920.12 2024-10-01
245 MS_DRG Aicd Generator Procedures 45 26 — — $28,960.18 $126,222.15 $57,601.57 2024-10-01
163 MS_DRG Major Chest Procedures With Mcc 45 26 — — $30,124.62 $131,297.33 $56,935.00 2024-10-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 45 26 — — $28,222.66 $123,007.68 $56,532.00 2024-10-01
6 MS_DRG Liver Transplant Without Mcc 42 25 — — $30,912.63 $96,307.72 $56,530.00 2024-10-01
0571T CPT Insertion Or Replacement Of Implantable Cardioverter-defibrillator System With S… 11 2 — — $5,948.00 $82,436.17 $56,454.34 2024-10-01
0408T CPT Insertion Or Replacement Of Permanent Cardiac Contractility Modulation System, I… 11 2 — — $9,243.00 $82,436.17 $56,454.34 2024-10-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $56,294.75 $56,294.75 $56,294.75 2024-10-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 45 26 — — $29,709.20 $129,486.75 $55,617.00 2024-10-01
471 MS_DRG Cervical Spinal Fusion With Mcc 45 26 — — $31,437.33 $137,018.74 $55,271.92 2024-10-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 45 26 — — $28,957.62 $97,905.00 $55,138.68 2024-10-01
09273 OTHER Sipuleucel-t Auto Cd54+ 1 1 — — $55,015.23 $55,015.23 $55,015.23 2024-10-01
9273 OTHER Sipuleucel-t Auto Cd54+ 13 10 — — $41,261.42 $55,565.38 $55,015.23 2024-10-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 45 26 — — $30,720.26 $133,893.41 $54,932.29 2024-10-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 45 26 — — $31,950.53 $139,255.50 $54,747.37 2024-10-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 44 25 — — $28,743.52 $125,277.86 $54,586.00 2024-10-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $54,251.30 $54,251.30 $54,251.30 2024-10-01
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $54,127.47 $54,127.47 $54,127.47 2024-10-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 45 26 — — $28,866.87 $125,815.46 $53,801.95 2024-10-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 4 2 — — $44,578.80 $65,181.79 $53,617.28 2024-10-01
131 MS_DRG Cranial/facial Procedures W Cc/mcc 1 1 — — $53,162.08 $53,162.08 $53,162.08 2024-10-01
1595 OTHER New Technology - Level 44 13 10 — — $39,413.91 $53,077.40 $52,551.88 2024-10-01
01581 OTHER New Technology - Level 44 1 1 — — $52,551.88 $52,551.88 $52,551.88 2024-10-01
01595 OTHER New Technology - Level 44 1 1 — — $52,551.88 $52,551.88 $52,551.88 2024-10-01
1581 OTHER New Technology - Level 44 13 10 — — $39,413.91 $53,077.40 $52,551.88 2024-10-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 26 18 — — $39,689.39 $172,985.12 $52,137.40 2024-10-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 45 26 — — $28,301.90 $123,353.08 $52,128.34 2024-10-01
901 MS_DRG Wound Debridements For Injuries With Mcc 45 26 — — $27,658.97 $120,550.87 $51,703.00 2024-10-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 14 — — $1,663.00 $76,779.54 $51,672.04 2024-10-01
0431T CPT Removal And Replacement Of Neurostimulator System For Treatment Of Central Sleep… 11 2 — — $4,180.00 $75,451.29 $51,670.92 2024-10-01
0427T CPT Insertion Or Replacement Of Neurostimulator System For Treatment Of Central Slee… 11 2 — — $1,737.00 $75,451.29 $51,670.92 2024-10-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 31 14 — — $23,377.64 $101,890.80 $51,511.82 2024-10-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 38 24 — — $33,636.66 $88,092.11 $51,496.42 2024-10-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 45 26 — — $25,069.98 $109,266.81 $51,488.16 2024-10-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 45 26 — — $30,295.90 $132,043.84 $51,422.51 2024-10-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 45 26 — — $28,771.64 $125,400.42 $51,108.27 2024-10-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 45 26 — — $27,876.90 $121,500.72 $50,874.10 2024-10-01
33264 CPT Removal Of Implantable Defibrillator Pulse Generator With Replacement Of Implant… 23 10 — — $1,348.00 $82,436.17 $50,680.60 2024-10-01
33270 CPT Insertion Or Replacement Of Permanent Subcutaneous Implantable Defibrillator Sys… 23 10 — — $1,348.00 $82,436.17 $50,680.60 2024-10-01
33231 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Multi… 23 10 — — $1,568.00 $82,436.17 $50,680.60 2024-10-01
33249 CPT Insertion Or Replacement Of Permanent Implantable Defibrillator System, With Tra… 23 10 — — $1,568.00 $82,436.17 $50,680.60 2024-10-01
215 OTHER Other Heart Assist System Implant 1 1 — — $50,340.69 $50,340.69 $50,340.69 2024-10-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 45 26 — — $26,577.61 $115,837.80 $50,265.00 2024-10-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 45 26 — — $24,843.10 $108,277.96 $50,135.00 2024-10-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 45 26 — — $25,827.31 $112,567.63 $49,929.00 2024-10-01
05244 OTHER Level 4 Blood Product Exc 1 1 — — $49,748.18 $49,748.18 $49,748.18 2024-10-01
5244 OTHER Level 4 Blood Product Exc 13 10 — — $37,311.14 $50,245.66 $49,748.18 2024-10-01
140 MS_DRG Major Head And Neck Procedures With Mcc 44 25 — — $24,145.84 $105,238.98 $48,855.00 2024-10-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 18 14 — — $1,663.00 $72,512.63 $48,851.51 2024-10-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $48,729.44 $48,729.44 $48,729.44 2024-10-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 45 26 — — $26,309.19 $114,667.89 $48,681.19 2024-10-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 45 26 — — $27,499.19 $119,854.49 $48,503.27 2024-10-01
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $48,458.47 $48,458.47 $48,458.47 2024-10-01
C9760 HCPCS Non-randomized, Non-blinded Procedure For Nyha Class Ii, Iii, IV Heart Failure; … 11 2 — — $9,243.00 $70,676.28 $48,400.88 2024-10-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 45 26 — — $24,905.73 $108,550.93 $47,849.00 2024-10-01
332 MS_DRG Rectal Resection With Mcc 45 26 — — $23,354.63 $101,790.53 $47,726.00 2024-10-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 45 26 — — $27,345.17 $119,183.19 $47,433.19 2024-10-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 45 26 — — $24,933.85 $108,673.50 $47,011.00 2024-10-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 7 1 — — $35,534.23 $57,799.35 $47,004.14 2024-10-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 21 12 — — $35,816.25 $48,232.55 $46,799.90 2024-10-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 45 26 — — $24,994.56 $108,938.12 $46,448.08 2024-10-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 45 26 — — $24,214.22 $105,537.02 $46,415.00 2024-10-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 45 26 — — $25,595.32 $111,556.49 $46,182.76 2024-10-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 45 26 — — $23,111.77 $100,732.04 $45,869.00 2024-10-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 45 26 — — $23,243.43 $101,305.85 $45,703.00 2024-10-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 19 8 — — $23,166.43 $61,211.61 $45,625.56 2024-10-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 45 26 — — $23,771.32 $103,606.67 $45,439.00 2024-10-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 19 8 — — $23,055.59 $62,719.91 $45,407.27 2024-10-01
01142 OTHER Supprelin La Implant 1 1 — — $45,350.21 $45,350.21 $45,350.21 2024-10-01
1142 OTHER Supprelin La Implant 13 10 — — $34,012.66 $45,803.71 $45,350.21 2024-10-01
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 11 3 — — $25,781.50 $66,209.52 $45,341.93 2024-10-01
129 MS_DRG Major Head & Neck Procedures W Cc/mcc Or Major Device 1 1 — — $45,254.88 $45,254.88 $45,254.88 2024-10-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 18 14 — — $1,663.00 $66,907.78 $45,146.55 2024-10-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 45 26 — — $21,926.24 $95,564.93 $44,808.00 2024-10-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 45 26 — — $24,608.55 $107,255.68 $44,753.65 2024-10-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 45 26 — — $25,293.66 $110,241.73 $44,471.25 2024-10-01
021 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 1 — — $44,172.48 $44,172.48 $44,172.48 2024-10-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 45 26 — — $23,633.92 $103,007.79 $44,087.56 2024-10-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 45 26 — — $18,351.00 $101,720.89 $43,817.00 2024-10-01
231 OTHER Coronary Bypass With Ptca With Mcc 1 1 — — $43,743.20 $43,743.20 $43,743.20 2024-10-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 45 26 — — $22,887.45 $99,754.33 $43,660.00 2024-10-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 35 16 — — $2,826.00 $94,189.57 $43,423.49 2024-10-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 45 26 — — $23,788.58 $103,681.88 $43,347.66 2024-10-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 45 26 — — $25,933.40 $113,030.02 $43,304.44 2024-10-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 45 26 — — $22,847.83 $99,581.63 $43,300.00 2024-10-01
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 1 — — $43,087.14 $43,087.14 $43,087.14 2024-10-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 45 26 — — $25,656.67 $111,823.90 $43,056.21 2024-10-01
01580 OTHER New Technology - Level 43 1 1 — — $42,997.08 $42,997.08 $42,997.08 2024-10-01
01594 OTHER New Technology - Level 43 1 1 — — $42,997.08 $42,997.08 $42,997.08 2024-10-01
1580 OTHER New Technology - Level 43 13 10 — — $32,247.81 $43,427.05 $42,997.08 2024-10-01
1594 OTHER New Technology - Level 43 13 10 — — $32,247.81 $43,427.05 $42,997.08 2024-10-01
93623 CPT Programmed Stimulation And Pacing After Intravenous Drug Infusion (List Separate… 7 4 — — $8,300.00 $71,218.00 $42,855.00 2024-10-01
93621 CPT Comprehensive Electrophysiologic Evaluation Including Insertion And Repositionin… 7 4 — — $8,300.00 $71,218.00 $42,855.00 2024-10-01
93622 CPT Comprehensive Electrophysiologic Evaluation Including Insertion And Repositionin… 7 4 — — $8,300.00 $71,218.00 $42,855.00 2024-10-01
93613 CPT Intracardiac Electrophysiologic 3-dimensional Mapping (List Separately In Additi… 7 4 — — $8,300.00 $71,218.00 $42,855.00 2024-10-01
93609 CPT Intraventricular And/or Intra-atrial Mapping Of Tachycardia Site(s) With Cathete… 7 4 — — $8,300.00 $71,218.00 $42,855.00 2024-10-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 45 26 — — $24,449.41 $106,562.09 $42,775.81 2024-10-01
133 MS_DRG Other Ear, Nose, Mouth & Throat O.r. Procedures W Cc/mcc 1 1 — — $42,439.92 $42,439.92 $42,439.92 2024-10-01
93654 CPT Comprehensive Electrophysiologic Evaluation With Insertion And Repositioning Of … 20 9 — — $3,280.00 $63,349.00 $42,438.54 2024-10-01
93656 CPT Comprehensive Electrophysiologic Evaluation With Transseptal Catheterizations, I… 20 9 — — $3,280.00 $63,349.00 $42,438.54 2024-10-01
93653 CPT Comprehensive Electrophysiologic Evaluation With Insertion And Repositioning Of … 20 9 — — $3,280.00 $63,349.00 $42,438.54 2024-10-01
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 1 — — $42,402.43 $42,402.43 $42,402.43 2024-10-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 45 26 — — $23,152.68 $100,910.31 $42,214.02 2024-10-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 26 18 — — $28,506.42 $124,244.44 $42,207.72 2024-10-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 45 26 — — $20,155.94 $87,849.10 $42,046.08 2024-10-01
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $41,901.28 $41,901.28 $41,901.28 2024-10-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 45 26 — — $20,810.37 $90,701.45 $41,759.49 2024-10-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 45 26 — — $22,529.55 $98,194.45 $41,755.74 2024-10-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 44 25 — — $22,102.63 $96,333.73 $41,684.00 2024-10-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 45 26 — — $22,126.28 $96,436.80 $41,178.87 2024-10-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 45 26 — — $22,088.57 $96,272.45 $41,154.75 2024-10-01
834 OTHER Acute Leukemia With Mcc 1 1 — — $41,142.76 $41,142.76 $41,142.76 2024-10-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 45 26 — — $21,187.44 $92,344.90 $41,124.00 2024-10-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 45 26 — — $22,081.54 $96,241.81 $41,044.60 2024-10-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 21 12 — — $31,387.13 $42,268.00 $41,012.51 2024-10-01
652 MS_DRG Kidney Transplant 42 25 — — $19,201.12 $66,912.70 $40,733.51 2024-10-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 14 — — $1,663.00 $59,544.24 $40,279.07 2024-10-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 19 8 — — $20,447.08 $57,526.86 $40,269.88 2024-10-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $40,203.11 $40,203.11 $40,203.11 2024-10-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 45 26 — — $21,531.28 $93,843.50 $40,165.22 2024-10-01
0409T CPT Insertion Or Replacement Of Permanent Cardiac Contractility Modulation System, I… 11 2 — — $5,948.00 $58,643.08 $40,160.24 2024-10-01
0515T CPT Insertion Of Wireless Cardiac Stimulator For Left Ventricular Pacing, Including … 11 2 — — $4,245.00 $58,643.08 $40,160.24 2024-10-01
0414T CPT Removal And Replacement Of Permanent Cardiac Contractility Modulation System Pul… 11 2 — — $5,948.00 $58,643.08 $40,160.24 2024-10-01
0520T CPT Removal And Replacement Of Pulse Generator For Wireless Cardiac Stimulator For L… 11 2 — — $4,245.00 $58,643.08 $40,160.24 2024-10-01
0614T CPT Removal And Replacement Of Substernal Implantable Defibrillator Pulse Generator 11 2 — — $6,090.00 $58,643.08 $40,160.24 2024-10-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 18 14 — — $1,663.00 $59,164.60 $40,028.12 2024-10-01
265 MS_DRG Aicd Lead Procedures 45 26 — — $22,586.43 $98,442.36 $39,953.77 2024-10-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 45 26 — — $19,431.20 $84,690.34 $39,906.54 2024-10-01
37 MS_DRG Extracranial Procedures With Mcc 45 26 — — $21,573.46 $94,027.34 $39,845.23 2024-10-01
252 MS_DRG Other Vascular Procedures With Mcc 45 26 — — $21,434.14 $93,420.10 $39,495.49 2024-10-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 45 26 — — $20,711.95 $90,272.48 $39,489.00 2024-10-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 45 26 — — $22,280.94 $97,110.89 $39,391.85 2024-10-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 26 18 — — $30,564.32 $133,213.75 $39,284.10 2024-10-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 45 26 — — $21,580.49 $94,057.98 $39,201.03 2024-10-01
264 MS_DRG Other Circulatory System O.r. Procedures 45 26 — — $20,873.01 $90,974.43 $38,937.25 2024-10-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 45 26 — — $20,052.40 $87,397.85 $38,852.00 2024-10-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 45 26 — — $20,320.82 $88,567.76 $38,800.00 2024-10-01
0809T CPT Arthrodesis, Sacroiliac Joint, Percutaneous Or Minimally Invasive, With Image Gu… 11 2 — — $6,090.00 $56,276.91 $38,539.83 2024-10-01
22633 CPT Arthrodesis, Combined Posterior Or Posterolateral Technique With Posterior Inter… 17 6 — — $4,000.00 $56,276.91 $38,539.83 2024-10-01
0775T CPT Arthrodesis, Sacroiliac Joint, Percutaneous, With Image Guidance, Includes Place… 11 2 — — $4,283.00 $56,276.91 $38,539.83 2024-10-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 45 26 — — $20,456.31 $89,158.28 $38,524.66 2024-10-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 45 26 — — $21,051.95 $91,754.37 $38,404.06 2024-10-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 45 26 — — $21,280.75 $92,751.58 $38,171.91 2024-10-01
500 MS_DRG Soft Tissue Procedures With Mcc 45 26 — — $20,724.73 $90,328.19 $37,855.33 2024-10-01
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 21 12 — — $28,917.75 $38,942.57 $37,785.86 2024-10-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 18 14 — — $1,663.00 $55,699.16 $37,737.37 2024-10-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 28 20 — — $23,848.02 $61,365.76 $37,570.00 2024-10-01
See an error in this hospital's data? Submit a correction