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

LEWISGALE MEDICAL CENTER

Salem, VA · CCN 490048 · Rates published

37,076 distinct procedures filed
50 distinct payers
738,894 rate rows
2024-10-01 last MRF observed · ⚠ 21 mo old
Data quality

231,272 of 738,894 rate rows are consumer-grade (31.3%)

507,622 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 504,958
per-diem day rate — not a per-procedure price 2,344
template filing: same amount across many unrelated codes — excluded 243
placeholder amount (≤ $0.02) — excluded from medians 62
exceeds 10× this hospital's gross charge — excluded from medians 15

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 21 months old.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://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1760148_LEWISGALE-MEDICAL-CENTER_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page https://www.hcavirginia.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-06-08

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
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 14 $3,672,900.00 $4,223,835.00 $3,764,722.50 nat. median
$3,746,358
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 14 $3,605,000.00 $4,145,750.00 $3,695,125.00 nat. median
$3,605,000
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 16 $5,150.11 $3,824,273.25 $3,363,365.19 nat. median
$13,041
outlier · 257.9×
748
OTHER 		Inj, Lovotibeglogene Auto 16 $8,495.09 $3,778,900.00 $3,323,460.40 nat. median
$17,963
outlier · 185.0×
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 2 $3,121,965.00 $3,562,713.00 $3,305,610.00 nat. median
$3,574,709
0.9× median
00773
OTHER 		Inj, Beqvez, Per Tx Dose 2 $3,064,250.00 $3,496,850.00 $3,244,500.00 nat. median
$3,496,850
0.9× median
746
OTHER 		Inj, Betibeglogene Autote 16 $7,545.33 $3,413,200.00 $3,001,835.20 nat. median
$21,896
outlier · 137.1×
00714
OTHER 		Inj Delandistrogene Mox R 2 $2,826,636.75 $3,225,691.35 $2,992,909.50 nat. median
$3,228,024
0.9× median
00748
OTHER 		Inj, Lovotibeglogene Auto 2 $2,793,100.00 $3,187,420.00 $2,957,400.00 nat. median
$3,187,420
0.9× median
00746
OTHER 		Inj, Betibeglogene Autote 2 $2,522,800.00 $2,878,960.00 $2,671,200.00 nat. median
$2,878,960
0.9× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 14 $2,388,614.00 $2,746,906.10 $2,448,329.35 nat. median
$2,588,981
0.9× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 2 $2,030,321.90 $2,316,955.58 $2,149,752.60 nat. median
$2,457,321
0.9× median
9194
OTHER 		Tisagenlecleucel Car-pos 14 $529,192.90 $608,571.83 $542,422.72 nat. median
$566,531
1.0× median
9498
OTHER 		Ciltacabtagene Car-pos T 14 $527,123.40 $606,191.91 $540,301.48 nat. median
$587,650
0.9× median
9422
OTHER 		Idecabtagene Vicleucel Ca 14 $526,587.60 $605,575.74 $539,752.29 nat. median
$558,082
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 14 $516,726.10 $594,235.01 $529,644.25 nat. median
$562,201
0.9× median
9035
OTHER 		Axicabtagene Ciloleucel C 14 $489,456.00 $562,874.40 $501,692.40 nat. median
$532,192
0.9× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 3 $440,504.85 $1,570,357.68 $484,555.34 nat. median
$753,246
0.6× median
5834
APR_DRG 		Neonate With Ecmo 7 $481,555.00 $520,079.40 $481,555.00 nat. median
$309,665
1.6× median
09194
OTHER 		Tisagenlecleucel Car-pos 2 $449,813.97 $513,317.11 $476,273.61 nat. median
$538,205
0.9× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 3 $431,371.60 $1,523,061.00 $474,508.76 nat. median
$674,867
0.7× median
09498
OTHER 		Ciltacabtagene Car-pos T 2 $448,054.89 $511,309.70 $474,411.06 nat. median
$554,552
0.9× median
09422
OTHER 		Idecabtagene Vicleucel Ca 2 $447,599.46 $510,789.97 $473,928.84 nat. median
$530,178
0.9× median
9391
OTHER 		Brexucabtagene Car Pos T 14 $460,530.40 $529,609.96 $472,043.66 nat. median
$489,450
1.0× median
09413
OTHER 		Lisocabtagene Car Pos T 2 $439,217.18 $501,224.32 $465,053.49 nat. median
$534,091
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 3 $411,986.50 $1,510,363.59 $453,185.15 nat. median
$625,184
0.7× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 3 $402,951.85 $1,489,170.63 $443,247.04 nat. median
$673,137
0.7× median
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 7 $441,020.00 $476,301.60 $441,020.00 nat. median
$93,370
outlier · 4.7×
09035
OTHER 		Axicabtagene Ciloleucel C 2 $416,037.60 $474,772.32 $440,510.40 nat. median
$505,583
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 3 $390,473.85 $1,467,410.73 $429,521.23 nat. median
$634,303
0.7× median
5892
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 7 $425,416.00 $459,449.28 $425,416.00 nat. median
$89,796
outlier · 4.7×
5833
APR_DRG 		Neonate With Ecmo 7 $422,976.00 $456,814.08 $422,976.00 nat. median
$244,017
1.7× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 3 $382,024.00 $1,348,320.00 $420,226.40 nat. median
$619,808
0.7× median
09391
OTHER 		Brexucabtagene Car Pos T 2 $391,450.84 $446,714.49 $414,477.36 nat. median
$464,978
0.9× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 7 $340,206.00 $367,422.48 $340,206.00 nat. median
$246,434
1.4× median
1614
APR_DRG 		Implantable Heart Assist Systems 7 $329,494.00 $355,853.52 $329,494.00 nat. median
$207,730
1.6× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 18 $12,503.00 $665,660.45 $314,536.58 nat. median
$370,174
0.8× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 7 $298,207.00 $322,063.56 $298,207.00 nat. median
$150,721
2.0× median
5832
APR_DRG 		Neonate With Ecmo 7 $291,035.00 $314,317.80 $291,035.00 nat. median
$156,126
1.9× median
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 7 $284,670.00 $307,443.60 $284,670.00 nat. median
$162,982
1.7× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 7 $279,223.00 $301,560.84 $279,223.00 nat. median
$160,267
1.7× median
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 7 $265,262.00 $286,482.96 $265,262.00 nat. median
$117,173
outlier · 2.3×
1604
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly 7 $264,654.00 $285,826.32 $264,654.00 nat. median
$97,957
outlier · 2.7×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 39 $23,576.00 $497,193.29 $261,790.64 nat. median
$265,286
1.0× median
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 7 $251,563.00 $271,688.04 $251,563.00 nat. median
$164,289
1.5× median
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 7 $237,859.00 $256,887.72 $237,859.00 nat. median
$122,924
1.9× median
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 7 $219,604.00 $237,172.32 $219,604.00 nat. median
$151,838
1.4× median
J7330
HCPCS 		Autologous Cultured Chondrocytes, Implant 1 $218,394.00 $218,394.00 $218,394.00 nat. median
$76,329
outlier · 2.9×
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 7 $199,298.00 $215,241.84 $199,298.00 nat. median
$164,834
1.2× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 18 $16,458.00 $418,754.87 $197,971.19 nat. median
$206,474
1.0× median

Other procedures at this hospital

Browse this hospital's 37,076 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
             
9138 OTHER Inj, Hemgenix, Per Tx Dos 14 14 — — $3,672,900.00 $4,223,835.00 $3,764,722.50 2024-10-01
773 OTHER Inj, Beqvez, Per Tx Dose 14 14 — — $3,605,000.00 $4,145,750.00 $3,695,125.00 2024-10-01
714 OTHER Inj Delandistrogene Mox R 17 16 — — $5,150.11 $3,824,273.25 $3,363,365.19 2024-10-01
748 OTHER Inj, Lovotibeglogene Auto 17 16 — — $8,495.09 $3,778,900.00 $3,323,460.40 2024-10-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 3 2 — — $3,121,965.00 $3,562,713.00 $3,305,610.00 2024-10-01
00773 OTHER Inj, Beqvez, Per Tx Dose 3 2 — — $3,064,250.00 $3,496,850.00 $3,244,500.00 2024-10-01
746 OTHER Inj, Betibeglogene Autote 17 16 — — $7,545.33 $3,413,200.00 $3,001,835.20 2024-10-01
00714 OTHER Inj Delandistrogene Mox R 3 2 — — $2,826,636.75 $3,225,691.35 $2,992,909.50 2024-10-01
00748 OTHER Inj, Lovotibeglogene Auto 3 2 — — $2,793,100.00 $3,187,420.00 $2,957,400.00 2024-10-01
00746 OTHER Inj, Betibeglogene Autote 3 2 — — $2,522,800.00 $2,878,960.00 $2,671,200.00 2024-10-01
9141 OTHER Inj Onase Abepar-xioi Tre 14 14 — — $2,388,614.00 $2,746,906.10 $2,448,329.35 2024-10-01
09141 OTHER Inj Onase Abepar-xioi Tre 3 2 — — $2,030,321.90 $2,316,955.58 $2,149,752.60 2024-10-01
9194 OTHER Tisagenlecleucel Car-pos 14 14 — — $529,192.90 $608,571.83 $542,422.72 2024-10-01
9498 OTHER Ciltacabtagene Car-pos T 14 14 — — $527,123.40 $606,191.91 $540,301.48 2024-10-01
9422 OTHER Idecabtagene Vicleucel Ca 14 14 — — $526,587.60 $605,575.74 $539,752.29 2024-10-01
9413 OTHER Lisocabtagene Car Pos T 14 14 — — $516,726.10 $594,235.01 $529,644.25 2024-10-01
9035 OTHER Axicabtagene Ciloleucel C 14 14 — — $489,456.00 $562,874.40 $501,692.40 2024-10-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 4 3 — — $440,504.85 $1,570,357.68 $484,555.34 2024-10-01
5834 APR_DRG Neonate With Ecmo 7 7 — — $481,555.00 $520,079.40 $481,555.00 2024-10-01
09194 OTHER Tisagenlecleucel Car-pos 3 2 — — $449,813.97 $513,317.11 $476,273.61 2024-10-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 4 3 — — $431,371.60 $1,523,061.00 $474,508.76 2024-10-01
09498 OTHER Ciltacabtagene Car-pos T 3 2 — — $448,054.89 $511,309.70 $474,411.06 2024-10-01
09422 OTHER Idecabtagene Vicleucel Ca 3 2 — — $447,599.46 $510,789.97 $473,928.84 2024-10-01
9391 OTHER Brexucabtagene Car Pos T 14 14 — — $460,530.40 $529,609.96 $472,043.66 2024-10-01
09413 OTHER Lisocabtagene Car Pos T 3 2 — — $439,217.18 $501,224.32 $465,053.49 2024-10-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 4 3 — — $411,986.50 $1,510,363.59 $453,185.15 2024-10-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 4 3 — — $402,951.85 $1,489,170.63 $443,247.04 2024-10-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 7 7 — — $441,020.00 $476,301.60 $441,020.00 2024-10-01
09035 OTHER Axicabtagene Ciloleucel C 3 2 — — $416,037.60 $474,772.32 $440,510.40 2024-10-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 4 3 — — $390,473.85 $1,467,410.73 $429,521.23 2024-10-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 7 7 — — $425,416.00 $459,449.28 $425,416.00 2024-10-01
5833 APR_DRG Neonate With Ecmo 7 7 — — $422,976.00 $456,814.08 $422,976.00 2024-10-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 4 3 — — $382,024.00 $1,348,320.00 $420,226.40 2024-10-01
09391 OTHER Brexucabtagene Car Pos T 3 2 — — $391,450.84 $446,714.49 $414,477.36 2024-10-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 7 7 — — $340,206.00 $367,422.48 $340,206.00 2024-10-01
1614 APR_DRG Implantable Heart Assist Systems 7 7 — — $329,494.00 $355,853.52 $329,494.00 2024-10-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 26 18 — — $12,503.00 $665,660.45 $314,536.58 2024-10-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 7 7 — — $298,207.00 $322,063.56 $298,207.00 2024-10-01
5832 APR_DRG Neonate With Ecmo 7 7 — — $291,035.00 $314,317.80 $291,035.00 2024-10-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 7 7 — — $284,670.00 $307,443.60 $284,670.00 2024-10-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 7 7 — — $279,223.00 $301,560.84 $279,223.00 2024-10-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 7 7 — — $265,262.00 $286,482.96 $265,262.00 2024-10-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 7 7 — — $264,654.00 $285,826.32 $264,654.00 2024-10-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 54 39 — — $23,576.00 $497,193.29 $261,790.64 2024-10-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 7 7 — — $251,563.00 $271,688.04 $251,563.00 2024-10-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 7 7 — — $237,859.00 $256,887.72 $237,859.00 2024-10-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 7 7 — — $219,604.00 $237,172.32 $219,604.00 2024-10-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 1 1 — — $218,394.00 $218,394.00 $218,394.00 2024-10-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 7 7 — — $199,298.00 $215,241.84 $199,298.00 2024-10-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 27 18 — — $16,458.00 $418,754.87 $197,971.19 2024-10-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 7 7 — — $197,713.00 $213,530.04 $197,713.00 2024-10-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 7 7 — — $196,456.00 $212,172.48 $196,456.00 2024-10-01
A9543 HCPCS Y90 Ibritum Tiu Tx 40mci 1 1 $199,929.00 $199,929.00 $196,429.74 $196,429.74 $196,429.74 2024-10-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 7 7 — — $191,263.00 $206,564.04 $191,263.00 2024-10-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 3 2 — — $174,567.39 $199,212.20 $184,836.06 2024-10-01
5831 APR_DRG Neonate With Ecmo 7 7 — — $182,168.00 $196,741.44 $182,168.00 2024-10-01
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 7 7 — — $163,774.00 $176,875.92 $163,774.00 2024-10-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 55 40 — — $23,576.00 $299,852.00 $160,022.50 2024-10-01
1613 APR_DRG Implantable Heart Assist Systems 7 7 — — $159,784.00 $172,566.72 $159,784.00 2024-10-01
1612 APR_DRG Implantable Heart Assist Systems 7 7 — — $155,996.00 $168,475.68 $155,996.00 2024-10-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 2 — — $144,043.80 $164,379.40 $152,516.97 2024-10-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 7 7 — — $151,415.00 $163,528.20 $151,415.00 2024-10-01
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 7 7 — — $150,761.00 $162,821.88 $150,761.00 2024-10-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 7 7 — — $150,735.00 $162,793.80 $150,735.00 2024-10-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 7 7 — — $148,821.00 $160,726.68 $148,821.00 2024-10-01
1611 APR_DRG Implantable Heart Assist Systems 7 7 — — $148,161.00 $160,013.88 $148,161.00 2024-10-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $148,157.00 $160,009.56 $148,157.00 2024-10-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 7 7 — — $147,715.00 $159,532.20 $147,715.00 2024-10-01
1908 OTHER New Technology - Level 52 14 14 — — $140,029.00 $161,033.35 $143,529.72 2024-10-01
1907 OTHER New Technology - Level 52 14 14 — — $140,029.00 $161,033.35 $143,529.72 2024-10-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 55 40 — — $23,576.00 $199,044.00 $142,475.09 2024-10-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 1 1 — — $139,609.77 $139,609.77 $139,609.77 2024-10-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 7 7 — — $139,408.00 $150,560.64 $139,408.00 2024-10-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 7 7 — — $137,614.00 $148,623.12 $137,614.00 2024-10-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 7 7 — — $137,527.00 $148,529.16 $137,527.00 2024-10-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $134,015.00 $144,736.20 $134,015.00 2024-10-01
33262 CPT Removal Of Implantable Defibrillator Pulse Generator With Replacement Of Implant… 6 4 — — $1,995.00 $141,902.00 $133,428.50 2024-10-01
33270 CPT Insertion Or Replacement Of Permanent Subcutaneous Implantable Defibrillator Sys… 6 4 — — $1,995.00 $141,902.00 $133,428.50 2024-10-01
33272 CPT Removal Of Subcutaneous Implantable Defibrillator Electrode 6 4 — — $1,995.00 $141,902.00 $133,428.50 2024-10-01
33264 CPT Removal Of Implantable Defibrillator Pulse Generator With Replacement Of Implant… 6 4 — — $1,995.00 $141,902.00 $133,428.50 2024-10-01
33271 CPT Insertion Of Subcutaneous Implantable Defibrillator Electrode 6 4 — — $1,995.00 $141,902.00 $133,428.50 2024-10-01
33263 CPT Removal Of Implantable Defibrillator Pulse Generator With Replacement Of Implant… 6 4 — — $1,995.00 $141,902.00 $133,428.50 2024-10-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 58 40 — — $16,458.00 $249,406.87 $132,932.43 2024-10-01
1905 OTHER New Technology - Level 51 14 14 — — $126,255.70 $145,194.05 $129,412.09 2024-10-01
1906 OTHER New Technology - Level 51 14 14 — — $126,255.70 $145,194.05 $129,412.09 2024-10-01
7 MS_DRG Lung Transplant 51 39 — — $23,576.00 $230,674.57 $128,531.29 2024-10-01
33230 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Dual … 9 6 — — $1,995.00 $141,902.00 $126,406.00 2024-10-01
33240 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Singl… 9 6 — — $4,250.00 $141,902.00 $126,406.00 2024-10-01
33231 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Multi… 9 6 — — $1,995.00 $141,902.00 $126,406.00 2024-10-01
33249 CPT Insertion Or Replacement Of Permanent Implantable Defibrillator System, With Tra… 9 6 — — $4,250.00 $141,902.00 $126,406.00 2024-10-01
01907 OTHER New Technology - Level 52 3 2 — — $119,024.65 $135,828.13 $126,026.10 2024-10-01
01908 OTHER New Technology - Level 52 3 2 — — $119,024.65 $135,828.13 $126,026.10 2024-10-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 7 7 — — $125,440.00 $135,475.20 $125,440.00 2024-10-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 3 2 — — $116,925.24 $133,432.33 $123,803.19 2024-10-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 7 7 — — $123,007.00 $132,847.56 $123,007.00 2024-10-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 7 7 — — $121,973.00 $131,730.84 $121,973.00 2024-10-01
14 MS_DRG Allogeneic Bone Marrow Transplant 52 40 — — $12,503.00 $231,257.09 $121,880.04 2024-10-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 7 7 — — $120,200.00 $129,816.00 $120,200.00 2024-10-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 7 7 — — $120,200.00 $129,816.00 $120,200.00 2024-10-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 55 40 — — $25,032.00 $211,094.00 $118,063.00 2024-10-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $116,206.00 $125,502.48 $116,206.00 2024-10-01
1904 OTHER New Technology - Level 50 14 14 — — $112,482.40 $129,354.76 $115,294.46 2024-10-01
1903 OTHER New Technology - Level 50 14 14 — — $112,482.40 $129,354.76 $115,294.46 2024-10-01
01906 OTHER New Technology - Level 51 3 2 — — $107,317.35 $122,468.03 $113,630.13 2024-10-01
01905 OTHER New Technology - Level 51 3 2 — — $107,317.35 $122,468.03 $113,630.13 2024-10-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 55 40 — — $23,576.00 $158,481.00 $113,444.94 2024-10-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 54 39 — — $23,576.00 $313,196.00 $110,453.87 2024-10-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 7 7 — — $110,101.00 $118,909.08 $110,101.00 2024-10-01
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $108,690.00 $117,385.20 $108,690.00 2024-10-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 58 40 — — $65,226.00 $149,487.73 $107,356.87 2024-10-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 51 39 — — $23,576.00 $187,969.09 $107,178.54 2024-10-01
215 MS_DRG Other Heart Assist System Implant 55 40 — — $26,388.00 $187,008.82 $106,698.41 2024-10-01
4404 APR_DRG Kidney Transplant 7 7 — — $105,412.00 $113,844.96 $105,412.00 2024-10-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 7 7 — — $104,752.00 $113,132.16 $104,752.00 2024-10-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 55 40 — — $16,458.00 $192,285.00 $104,371.50 2024-10-01
4403 APR_DRG Kidney Transplant 7 7 — — $102,978.00 $111,216.24 $102,978.00 2024-10-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 55 40 — — $26,388.00 $179,233.00 $102,810.50 2024-10-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 7 7 — — $102,611.00 $110,819.88 $102,611.00 2024-10-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 55 40 — — $23,576.00 $146,475.00 $102,371.11 2024-10-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 7 7 — — $102,160.00 $110,332.80 $102,160.00 2024-10-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 7 7 — — $102,132.00 $110,302.56 $102,132.00 2024-10-01
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 7 7 — — $101,921.00 $110,074.68 $101,921.00 2024-10-01
01904 OTHER New Technology - Level 50 3 2 — — $95,610.04 $109,107.93 $101,234.16 2024-10-01
01903 OTHER New Technology - Level 50 3 2 — — $95,610.04 $109,107.93 $101,234.16 2024-10-01
1901 OTHER New Technology - Level 49 14 14 — — $98,709.11 $113,515.48 $101,176.83 2024-10-01
1902 OTHER New Technology - Level 49 14 14 — — $98,709.11 $113,515.48 $101,176.83 2024-10-01
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $101,143.00 $109,234.44 $101,143.00 2024-10-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 17 16 — — $84,999.91 $114,999.88 $101,139.90 2024-10-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 58 40 — — $64,126.07 $137,964.50 $101,045.29 2024-10-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 55 40 — — $23,576.00 $146,475.00 $100,759.54 2024-10-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 7 7 — — $100,696.00 $108,751.68 $100,696.00 2024-10-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 55 40 — — $63,482.25 $136,573.52 $100,027.88 2024-10-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 55 40 — — $26,388.00 $170,348.86 $98,368.43 2024-10-01
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 7 7 — — $98,118.00 $105,967.44 $98,118.00 2024-10-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 4 2 — — $76,640.00 $146,475.00 $96,731.50 2024-10-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 7 7 — — $96,513.00 $104,234.04 $96,513.00 2024-10-01
652 MS_DRG Kidney Transplant 51 39 — — $23,576.00 $166,555.00 $95,958.37 2024-10-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 55 40 — — $23,576.00 $146,475.00 $95,861.51 2024-10-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 55 40 — — $23,576.00 $146,475.00 $95,718.12 2024-10-01
6904 APR_DRG Acute Leukemia 7 7 — — $95,352.00 $102,980.16 $95,352.00 2024-10-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 7 7 — — $95,233.00 $102,851.64 $95,233.00 2024-10-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 55 40 — — $23,576.00 $146,475.00 $94,409.25 2024-10-01
8634 APR_DRG Neonatal Aftercare 7 7 — — $94,228.00 $101,766.24 $94,228.00 2024-10-01
0208 RC — 5 4 — — $94,175.50 $94,175.50 $94,175.50 2024-10-01
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 7 7 — — $93,300.00 $100,764.00 $93,300.00 2024-10-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 7 7 — — $93,278.00 $100,740.24 $93,278.00 2024-10-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 7 7 — — $92,972.00 $100,409.76 $92,972.00 2024-10-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 55 40 — — $25,032.00 $159,140.00 $92,086.00 2024-10-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 17 16 — — $77,377.11 $104,686.68 $92,069.66 2024-10-01
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 7 7 — — $91,749.00 $99,088.92 $91,749.00 2024-10-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 55 40 — — $26,388.00 $156,309.00 $91,348.50 2024-10-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 55 40 — — $26,388.00 $156,309.00 $91,348.50 2024-10-01
3124 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 7 7 — — $90,411.00 $97,643.88 $90,411.00 2024-10-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 55 40 — — $23,576.00 $146,475.00 $90,052.49 2024-10-01
850 MS_DRG Acute Leukemia With Other Procedures 55 40 — — $16,458.00 $162,597.87 $89,527.93 2024-10-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 55 40 — — $23,576.00 $146,475.00 $89,423.38 2024-10-01
1585 OTHER New Technology - Level 48 14 14 — — $87,231.36 $100,316.06 $89,412.15 2024-10-01
1599 OTHER New Technology - Level 48 14 14 — — $87,231.36 $100,316.06 $89,412.15 2024-10-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 58 40 — — $43,734.07 $134,933.00 $89,333.54 2024-10-01
01902 OTHER New Technology - Level 49 3 2 — — $83,902.74 $95,747.84 $88,838.20 2024-10-01
01901 OTHER New Technology - Level 49 3 2 — — $83,902.74 $95,747.84 $88,838.20 2024-10-01
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 7 7 — — $88,469.00 $95,546.52 $88,469.00 2024-10-01
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 7 7 — — $88,057.00 $95,101.56 $88,057.00 2024-10-01
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 7 7 — — $88,034.00 $95,076.72 $88,034.00 2024-10-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 55 40 — — $26,388.00 $149,572.46 $87,980.23 2024-10-01
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 7 7 — — $87,942.00 $94,977.36 $87,942.00 2024-10-01
204 APR_DRG Open Craniotomy For Trauma 7 7 — — $87,789.00 $94,812.12 $87,789.00 2024-10-01
8904 APR_DRG HIV With Multiple Major HIV Related Conditions 7 7 — — $87,704.00 $94,720.32 $87,704.00 2024-10-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 3 2 — — $82,212.97 $93,819.51 $87,049.03 2024-10-01
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $86,541.00 $93,464.28 $86,541.00 2024-10-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 55 40 — — $43,541.25 $129,371.00 $86,456.12 2024-10-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 55 40 — — $23,576.00 $146,475.00 $85,978.01 2024-10-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 55 40 — — $26,388.00 $143,889.00 $85,138.50 2024-10-01
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 7 7 — — $84,578.00 $91,344.24 $84,578.00 2024-10-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 58 40 — — $26,388.00 $142,283.95 $84,335.98 2024-10-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 7 7 — — $83,819.00 $90,524.52 $83,819.00 2024-10-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 55 40 — — $37,789.43 $129,371.00 $83,580.21 2024-10-01
10 MS_DRG Pancreas Transplant 51 39 — — $23,576.00 $140,732.34 $83,560.17 2024-10-01
4402 APR_DRG Kidney Transplant 7 7 — — $83,362.00 $90,030.96 $83,362.00 2024-10-01
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 7 7 — — $83,297.00 $89,960.76 $83,297.00 2024-10-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 51 39 — — $23,576.00 $139,922.11 $83,155.05 2024-10-01
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 7 7 — — $81,138.00 $87,629.04 $81,138.00 2024-10-01
014 OTHER Allogeneic Bone Marrow Transplant 3 2 — — $76,389.99 $87,174.46 $80,883.52 2024-10-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 7 7 — — $80,204.00 $86,620.32 $80,204.00 2024-10-01
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 7 7 — — $80,021.00 $86,422.68 $80,021.00 2024-10-01
1598 OTHER New Technology - Level 47 14 14 — — $78,049.16 $89,756.53 $80,000.39 2024-10-01
1584 OTHER New Technology - Level 47 14 14 — — $78,049.16 $89,756.53 $80,000.39 2024-10-01
22810 CPT Arthrodesis, Anterior, For Spinal Deformity, With Or Without Cast; 4 To 7 Verteb… 7 5 — — $4,250.00 $111,327.00 $80,000.00 2024-10-01
22802 CPT Arthrodesis, Posterior, For Spinal Deformity, With Or Without Cast; 7 To 12 Vert… 7 5 — — $4,250.00 $111,327.00 $80,000.00 2024-10-01
22804 CPT Arthrodesis, Posterior, For Spinal Deformity, With Or Without Cast; 13 Or More V… 7 5 — — $4,250.00 $111,327.00 $80,000.00 2024-10-01
22808 CPT Arthrodesis, Anterior, For Spinal Deformity, With Or Without Cast; 2 To 3 Verteb… 7 5 — — $4,250.00 $111,327.00 $80,000.00 2024-10-01
22800 CPT Arthrodesis, Posterior, For Spinal Deformity, With Or Without Cast; Up To 6 Vert… 7 5 — — $4,250.00 $111,327.00 $80,000.00 2024-10-01
22812 CPT Arthrodesis, Anterior, For Spinal Deformity, With Or Without Cast; 8 Or More Ver… 7 5 — — $4,250.00 $111,327.00 $80,000.00 2024-10-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 7 7 — — $79,946.00 $86,341.68 $79,946.00 2024-10-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 58 40 — — $33,311.00 $126,000.00 $79,655.50 2024-10-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 58 40 — — $33,311.00 $126,000.00 $79,655.50 2024-10-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 55 40 — — $26,388.00 $132,015.00 $79,201.50 2024-10-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 55 40 — — $23,576.00 $131,749.23 $79,068.62 2024-10-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 3 2 — — $74,392.68 $84,895.18 $78,768.72 2024-10-01
1774 APR_DRG Cardiac Pacemaker And Defibrillator Revision Except Device Replacement 7 7 — — $78,763.00 $85,064.04 $78,763.00 2024-10-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 55 40 — — $26,388.00 $130,658.00 $78,523.00 2024-10-01
01599 OTHER New Technology - Level 48 3 2 — — $74,146.66 $84,614.42 $78,508.22 2024-10-01
01585 OTHER New Technology - Level 48 3 2 — — $74,146.66 $84,614.42 $78,508.22 2024-10-01
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 7 7 — — $78,240.00 $84,499.20 $78,240.00 2024-10-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 58 40 — — $26,388.00 $128,132.00 $77,260.00 2024-10-01
4414 APR_DRG Major Bladder Procedures 7 7 — — $76,808.00 $82,952.64 $76,808.00 2024-10-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 58 40 — — $33,863.65 $128,132.00 $76,801.00 2024-10-01
230 MS_DRG Other Cardiothoracic Procedures Without Cc/mcc 3 1 — — $76,801.00 $76,801.00 $76,801.00 2024-10-01
1834 APR_DRG Percutaneous Structural Cardiac Procedures 7 7 — — $75,828.00 $81,894.24 $75,828.00 2024-10-01
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 7 7 — — $75,541.00 $81,584.28 $75,541.00 2024-10-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 55 40 — — $19,270.00 $131,215.00 $75,242.50 2024-10-01
1694 APR_DRG Major Abdominal Vascular Procedures 7 7 — — $74,572.00 $80,537.76 $74,572.00 2024-10-01
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 7 7 — — $73,811.00 $79,715.88 $73,811.00 2024-10-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 55 40 — — $23,576.00 $120,526.09 $73,457.04 2024-10-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 4 2 — — $33,311.00 $146,475.00 $73,413.50 2024-10-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 4 2 — — $33,311.00 $146,475.00 $73,413.50 2024-10-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 4 2 — — $33,311.00 $146,475.00 $73,413.50 2024-10-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 7 7 — — $73,219.00 $79,076.52 $73,219.00 2024-10-01
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition… 7 7 — — $72,915.00 $78,748.20 $72,915.00 2024-10-01
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 7 7 — — $72,234.00 $78,012.72 $72,234.00 2024-10-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 55 40 — — $23,576.00 $116,826.00 $71,607.00 2024-10-01
234 APR_DRG Spinal Procedures 7 7 — — $71,446.00 $77,161.68 $71,446.00 2024-10-01
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $71,140.00 $76,831.20 $71,140.00 2024-10-01
1204 APR_DRG Major Respiratory And Chest Procedures 7 7 — — $71,079.00 $76,765.32 $71,079.00 2024-10-01
1784 APR_DRG External Heart Assist Devices 7 7 — — $70,835.00 $76,501.80 $70,835.00 2024-10-01
4014 APR_DRG Adrenal Procedures 7 7 — — $70,789.00 $76,452.12 $70,789.00 2024-10-01
2304 APR_DRG Major Small Bowel Procedures 7 7 — — $70,652.00 $76,304.16 $70,652.00 2024-10-01
1583 OTHER New Technology - Level 46 14 14 — — $68,866.96 $79,197.00 $70,588.64 2024-10-01
1597 OTHER New Technology - Level 46 14 14 — — $68,866.96 $79,197.00 $70,588.64 2024-10-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 1 1 — — $70,551.48 $70,551.48 $70,551.48 2024-10-01
914 APR_DRG Other Major Head And Neck Procedures 7 7 — — $70,544.00 $76,187.52 $70,544.00 2024-10-01
01598 OTHER New Technology - Level 47 3 2 — — $66,341.79 $75,707.69 $70,244.24 2024-10-01
01584 OTHER New Technology - Level 47 3 2 — — $66,341.79 $75,707.69 $70,244.24 2024-10-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 55 40 — — $26,388.00 $113,986.02 $70,187.01 2024-10-01
274 APR_DRG Other Open Craniotomy 7 7 — — $69,916.00 $75,509.28 $69,916.00 2024-10-01
007 OTHER Lung Transplant 3 2 — — $65,910.66 $75,215.69 $69,787.76 2024-10-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 2 — — $65,791.10 $75,079.25 $69,661.16 2024-10-01
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 7 7 — — $69,515.00 $75,076.20 $69,515.00 2024-10-01
214 APR_DRG Open Craniotomy Except Trauma 7 7 — — $69,148.00 $74,679.84 $69,148.00 2024-10-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 7 3 — — $61,439.00 $146,475.00 $68,266.00 2024-10-01
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 7 7 — — $68,134.00 $73,584.72 $68,134.00 2024-10-01
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 7 7 — — $67,546.00 $72,949.68 $67,546.00 2024-10-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 55 40 — — $12,212.00 $122,796.14 $67,504.07 2024-10-01
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 7 7 — — $67,376.00 $72,766.08 $67,376.00 2024-10-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 58 40 — — $26,388.00 $108,325.03 $67,356.51 2024-10-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 55 40 — — $26,388.00 $108,040.00 $67,214.00 2024-10-01
1783 APR_DRG External Heart Assist Devices 7 7 — — $67,192.00 $72,567.36 $67,192.00 2024-10-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 55 40 — — $16,458.00 $117,888.88 $67,173.44 2024-10-01
1643 OTHER Y90 Ibritumomab, Rx 14 14 — — $65,476.58 $75,298.07 $67,113.49 2024-10-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 17 16 — — $55,990.94 $75,752.45 $66,622.64 2024-10-01
894 APR_DRG Major Cranial Or Facial Bone Procedures 7 7 — — $66,008.00 $71,288.64 $66,008.00 2024-10-01
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 7 7 — — $65,864.00 $71,133.12 $65,864.00 2024-10-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 55 40 — — $26,388.00 $105,013.51 $65,700.76 2024-10-01
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 7 7 — — $65,431.00 $70,665.48 $65,431.00 2024-10-01
1782 APR_DRG External Heart Assist Devices 7 7 — — $65,351.00 $70,579.08 $65,351.00 2024-10-01
224 APR_DRG Ventricular Shunt Procedures 7 7 — — $64,895.00 $70,086.60 $64,895.00 2024-10-01
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 7 7 — — $64,831.00 $70,017.48 $64,831.00 2024-10-01
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 7 7 — — $64,665.00 $69,838.20 $64,665.00 2024-10-01
28 MS_DRG Spinal Procedures With Mcc 55 40 — — $21,744.00 $107,308.27 $64,526.14 2024-10-01
955 OTHER Craniotomy For Multiple Significant Trauma 3 2 — — $60,888.83 $69,484.90 $64,470.53 2024-10-01
64565 CPT HPercutaneous Implantation Of Neurostimulator Electrode Array; Neuromuscular 4 2 — — $52,082.00 $67,587.00 $64,207.50 2024-10-01
1214 APR_DRG Other Respiratory And Chest Procedures 7 7 — — $64,129.00 $69,259.32 $64,129.00 2024-10-01
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 7 7 — — $64,109.00 $69,237.72 $64,109.00 2024-10-01
717 OTHER Instill Adstiladrin, Tx D 17 16 — — $12,342.06 $72,857.99 $64,077.01 2024-10-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 55 40 — — $16,458.00 $111,629.48 $64,043.74 2024-10-01
22633 CPT Arthrodesis, Combined Posterior Or Posterolateral Technique With Posterior Inter… 7 5 — — $4,250.00 $80,000.00 $63,761.00 2024-10-01
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $63,642.00 $68,733.36 $63,642.00 2024-10-01
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 7 7 — — $63,620.00 $68,709.60 $63,620.00 2024-10-01
1794 APR_DRG Defibrillator Implants 7 7 — — $63,430.00 $68,504.40 $63,430.00 2024-10-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 55 40 — — $12,212.00 $114,167.84 $63,189.92 2024-10-01
264 APR_DRG Other Nervous System And Related Procedures 7 7 — — $62,746.00 $67,765.68 $62,746.00 2024-10-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 55 40 — — $16,458.00 $108,697.49 $62,577.75 2024-10-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 55 40 — — $19,270.00 $105,623.00 $62,446.50 2024-10-01
2614 APR_DRG Major Biliary Tract Procedures 7 7 — — $62,381.00 $67,371.48 $62,381.00 2024-10-01
01583 OTHER New Technology - Level 46 3 2 — — $58,536.92 $66,800.95 $61,980.26 2024-10-01
01597 OTHER New Technology - Level 46 3 2 — — $58,536.92 $66,800.95 $61,980.26 2024-10-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 58 40 — — $26,388.00 $97,567.90 $61,977.95 2024-10-01
2324 APR_DRG Gastric Fundoplication 7 7 — — $61,897.00 $66,848.76 $61,897.00 2024-10-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 55 40 — — $26,388.00 $97,277.00 $61,832.50 2024-10-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 58 40 — — $26,388.00 $97,091.00 $61,739.50 2024-10-01
4474 APR_DRG Other Kidney, Urinary Tract And Related Non-percutaneous Procedures 7 7 — — $61,718.00 $66,655.44 $61,718.00 2024-10-01
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 7 7 — — $61,393.00 $66,304.44 $61,393.00 2024-10-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 55 40 — — $25,257.16 $97,277.00 $61,267.08 2024-10-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 51 39 — — $23,576.00 $96,041.00 $61,214.50 2024-10-01
1582 OTHER New Technology - Level 45 14 14 — — $59,684.76 $68,637.47 $61,176.88 2024-10-01
1596 OTHER New Technology - Level 45 14 14 — — $59,684.76 $68,637.47 $61,176.88 2024-10-01
2294 APR_DRG Other Digestive System And Abdominal Procedures 7 7 — — $61,036.00 $65,918.88 $61,036.00 2024-10-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 55 40 — — $23,576.00 $95,333.16 $60,860.58 2024-10-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 58 40 — — $31,406.00 $89,924.58 $60,665.29 2024-10-01
8411 APR_DRG Extensive Third Degree Burns With Skin Graft 7 7 — — $60,629.00 $65,479.32 $60,629.00 2024-10-01
8412 APR_DRG Extensive Third Degree Burns With Skin Graft 7 7 — — $60,629.00 $65,479.32 $60,629.00 2024-10-01
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 7 7 — — $59,802.00 $64,586.16 $59,802.00 2024-10-01
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 7 7 — — $59,802.00 $64,586.16 $59,802.00 2024-10-01
1814 APR_DRG Lower Extremity Vascular Procedures 7 7 — — $59,671.00 $64,444.68 $59,671.00 2024-10-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 55 40 — — $16,458.00 $102,768.18 $59,613.09 2024-10-01
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 7 7 — — $59,571.00 $64,336.68 $59,571.00 2024-10-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 52 40 — — $12,503.00 $106,538.65 $59,520.82 2024-10-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 52 40 — — $12,503.00 $106,538.65 $59,520.82 2024-10-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 58 40 — — $23,665.61 $95,375.00 $59,520.31 2024-10-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 2 — — $56,117.27 $64,039.71 $59,418.29 2024-10-01
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