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 HOSPITAL PULASKI

Pulaski, VA · CCN 490116 · Rates published

24,935 distinct procedures filed
46 distinct payers
697,180 rate rows
2026-03-07 last MRF observed
Data quality

530,742 of 697,180 rate rows are consumer-grade (76.1%)

166,438 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 162,409
per-diem day rate — not a per-procedure price 3,866
placeholder amount (≤ $0.02) — excluded from medians 147
exceeds 10× this hospital's gross charge — excluded from medians 16
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/54-0941129_LEWISGALE-HOSPITAL-PULASKI_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 not_modified · 2026-06-08
Content fingerprint 6e538acc08fbd920… · 272,233,350 bytes · first seen 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
845
OTHER 		Inj, Atidarsagene Autotem 18 $3,961.09 $4,820,350.00 $4,505,000.00 nat. median
$9,966
outlier · 452.1×
00845
OTHER 		Inj, Atidarsagene Autotem 3 $3,378,750.00 $4,054,500.00 $3,829,250.00 nat. median
$4,505,000
0.8× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 16 $3,672,900.00 $4,223,835.00 $3,736,818.52 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 19 $4,389.80 $3,824,273.25 $3,336,179.65 nat. median
$13,041
outlier · 255.8×
908
OTHER 		Topi Adm Prad Zami Per Tr 18 $8,061.65 $3,569,327.40 $3,335,820.00 nat. median
$22,747
outlier · 146.6×
748
OTHER 		Inj, Lovotibeglogene Auto 19 $7,240.96 $3,778,900.00 $3,286,000.00 nat. median
$17,963
outlier · 182.9×
906
OTHER 		Inj Elivaldogene Autoteme 18 $5,282.69 $3,402,600.00 $3,180,000.00 nat. median
$20,756
outlier · 153.2×
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 3 $2,754,675.00 $3,316,740.30 $3,127,220.98 nat. median
$3,574,709
0.9× median
00773
OTHER 		Inj, Beqvez, Per Tx Dose 2 $2,703,750.00 $3,244,500.00 $3,064,250.00 nat. median
$3,496,850
0.9× median
746
OTHER 		Inj, Betibeglogene Autote 19 $6,431.41 $3,413,200.00 $2,968,000.00 nat. median
$21,896
outlier · 135.6×
00908
OTHER 		Topi Adm Prad Zami Per Tr 3 $2,501,865.00 $3,002,238.00 $2,835,447.00 nat. median
$12,675
outlier · 223.7×
00714
OTHER 		Inj Delandistrogene Mox R 3 $2,494,091.25 $2,995,074.00 $2,827,658.88 nat. median
$3,228,024
0.9× median
00748
OTHER 		Inj, Lovotibeglogene Auto 3 $2,439,381.00 $2,957,400.00 $2,778,865.90 nat. median
$3,187,420
0.9× median
00906
OTHER 		Inj Elivaldogene Autoteme 3 $2,385,000.00 $2,862,000.00 $2,703,000.00 nat. median
$21
outlier · 130642.8×
9141
OTHER 		Inj Onase Abepar-xioi Tre 16 $2,388,614.00 $2,770,209.67 $2,588,981.00 nat. median
$2,588,981
1.0× median
00746
OTHER 		Inj, Betibeglogene Autote 3 $2,204,976.75 $2,671,200.00 $2,510,886.83 nat. median
$2,878,960
0.9× median
824
OTHER 		Inj, Exagamglogene Autote 18 $10,910.64 $2,495,240.00 $2,332,000.00 nat. median
$25,250
outlier · 92.4×
09141
OTHER 		Inj Onase Abepar-xioi Tre 3 $1,791,460.50 $2,330,082.90 $2,090,037.25 nat. median
$2,457,321
0.9× median
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 1 $2,042,143.00 $2,042,143.00 $2,042,143.00 nat. median
$824,563
outlier · 2.5×
00824
OTHER 		Inj, Exagamglogene Autote 3 $1,749,000.00 $2,098,800.00 $1,982,200.00 nat. median
$2,332,000
0.8× median
2067
OTHER 		Afamitresgene Autoleucel 15 $770,620.00 $824,563.40 $776,939.08 nat. median
$786,032
1.0× median
Q2058
HCPCS 		Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,… 1 $737,362.50 $737,362.50 $737,362.50 nat. median
$324,450
outlier · 2.3×
9498
OTHER 		Ciltacabtagene Car-pos T 15 $527,123.40 $628,785.07 $587,649.60 nat. median
$587,650
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos 16 $529,192.90 $608,571.83 $566,531.30 nat. median
$566,531
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 16 $516,726.10 $601,555.28 $562,201.20 nat. median
$562,201
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 15 $526,587.60 $605,575.74 $558,081.80 nat. median
$558,082
1.0× median
J3402
HCPCS 		Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 $534,422.90 $534,422.90 $534,422.90 nat. median
$209,753
outlier · 2.5×
9035
OTHER 		Axicabtagene Ciloleucel C 16 $489,456.00 $569,445.65 $532,192.20 nat. median
$532,192
1.0× median
9391
OTHER 		Brexucabtagene Car Pos T 16 $460,530.40 $529,609.96 $489,450.20 nat. median
$489,450
1.0× median
5834
APR_DRG 		Neonate With Ecmo 9 $470,282.90 $520,079.40 $481,555.00 nat. median
$309,665
1.6× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 4 $388,680.75 $1,501,307.95 $479,186.12 nat. median
$753,246
0.6× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 4 $380,622.00 $1,557,271.36 $463,470.03 nat. median
$674,867
0.7× median
09194
OTHER 		Tisagenlecleucel Car-pos 3 $396,894.68 $509,878.17 $463,043.79 nat. median
$538,205
0.9× median
09498
OTHER 		Ciltacabtagene Car-pos T 3 $395,342.55 $528,884.64 $461,232.97 nat. median
$554,552
0.8× median
09422
OTHER 		Idecabtagene Vicleucel Ca 3 $394,940.70 $502,273.62 $460,764.15 nat. median
$530,178
0.9× median
09413
OTHER 		Lisocabtagene Car Pos T 3 $387,544.57 $505,981.08 $452,135.33 nat. median
$534,091
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 4 $363,517.50 $1,478,916.58 $442,349.85 nat. median
$625,184
0.7× median
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 9 $430,696.39 $476,301.60 $441,020.00 nat. median
$93,370
outlier · 4.7×
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 4 $355,545.75 $1,489,833.29 $432,815.30 nat. median
$673,137
0.6× median
09035
OTHER 		Axicabtagene Ciloleucel C 3 $367,092.00 $478,972.98 $428,274.00 nat. median
$505,583
0.8× median
5892
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 9 $415,458.24 $459,449.28 $425,416.00 nat. median
$89,796
outlier · 4.7×
5833
APR_DRG 		Neonate With Ecmo 9 $413,074.95 $456,814.08 $422,976.00 nat. median
$244,017
1.7× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 4 $344,535.75 $1,410,309.44 $420,428.88 nat. median
$634,303
0.7× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 4 $337,080.00 $1,297,043.03 $410,242.58 nat. median
$619,808
0.7× median
09391
OTHER 		Brexucabtagene Car Pos T 3 $345,397.80 $440,505.18 $402,964.10 nat. median
$464,978
0.9× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 9 $332,243.00 $367,422.48 $340,206.00 nat. median
$246,434
1.4× median
1614
APR_DRG 		Implantable Heart Assist Systems 9 $321,781.57 $355,853.52 $329,494.00 nat. median
$207,730
1.6× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 9 $291,226.77 $322,063.56 $298,207.00 nat. median
$150,721
2.0× median
5832
APR_DRG 		Neonate With Ecmo 9 $284,222.51 $314,317.80 $291,035.00 nat. median
$156,126
1.9× median

Other procedures at this hospital

Browse this hospital's 24,935 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
             
845 OTHER Inj, Atidarsagene Autotem 22 18 — — $3,961.09 $4,820,350.00 $4,505,000.00 2026-03-07
00845 OTHER Inj, Atidarsagene Autotem 3 3 — — $3,378,750.00 $4,054,500.00 $3,829,250.00 2026-03-07
9138 OTHER Inj, Hemgenix, Per Tx Dos 30 16 — — $3,672,900.00 $4,223,835.00 $3,736,818.52 2026-03-07
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 36 19 — — $4,389.80 $3,824,273.25 $3,336,179.65 2026-03-07
908 OTHER Topi Adm Prad Zami Per Tr 22 18 — — $8,061.65 $3,569,327.40 $3,335,820.00 2026-03-07
748 OTHER Inj, Lovotibeglogene Auto 36 19 — — $7,240.96 $3,778,900.00 $3,286,000.00 2026-03-07
906 OTHER Inj Elivaldogene Autoteme 22 18 — — $5,282.69 $3,402,600.00 $3,180,000.00 2026-03-07
09138 OTHER Inj, Hemgenix, Per Tx Dos 6 3 — — $2,754,675.00 $3,316,740.30 $3,127,220.98 2026-03-07
00773 OTHER Inj, Beqvez, Per Tx Dose 3 2 — — $2,703,750.00 $3,244,500.00 $3,064,250.00 2024-10-01
746 OTHER Inj, Betibeglogene Autote 36 19 — — $6,431.41 $3,413,200.00 $2,968,000.00 2026-03-07
00908 OTHER Topi Adm Prad Zami Per Tr 3 3 — — $2,501,865.00 $3,002,238.00 $2,835,447.00 2026-03-07
00714 OTHER Inj Delandistrogene Mox R 6 3 — — $2,494,091.25 $2,995,074.00 $2,827,658.88 2026-03-07
00748 OTHER Inj, Lovotibeglogene Auto 6 3 — — $2,439,381.00 $2,957,400.00 $2,778,865.90 2026-03-07
00906 OTHER Inj Elivaldogene Autoteme 3 3 — — $2,385,000.00 $2,862,000.00 $2,703,000.00 2026-03-07
9141 OTHER Inj Onase Abepar-xioi Tre 30 16 — — $2,388,614.00 $2,770,209.67 $2,588,981.00 2026-03-07
00746 OTHER Inj, Betibeglogene Autote 6 3 — — $2,204,976.75 $2,671,200.00 $2,510,886.83 2026-03-07
824 OTHER Inj, Exagamglogene Autote 22 18 — — $10,910.64 $2,495,240.00 $2,332,000.00 2026-03-07
09141 OTHER Inj Onase Abepar-xioi Tre 6 3 — — $1,791,460.50 $2,330,082.90 $2,090,037.25 2026-03-07
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 1 1 — — $2,042,143.00 $2,042,143.00 $2,042,143.00 2026-03-07
00824 OTHER Inj, Exagamglogene Autote 3 3 — — $1,749,000.00 $2,098,800.00 $1,982,200.00 2026-03-07
2067 OTHER Afamitresgene Autoleucel 16 15 — — $770,620.00 $824,563.40 $776,939.08 2026-03-07
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 1 1 — — $737,362.50 $737,362.50 $737,362.50 2026-03-07
9498 OTHER Ciltacabtagene Car-pos T 29 15 — — $527,123.40 $628,785.07 $587,649.60 2026-03-07
9194 OTHER Tisagenlecleucel Car-pos 30 16 — — $529,192.90 $608,571.83 $566,531.30 2026-03-07
9413 OTHER Lisocabtagene Car Pos T 30 16 — — $516,726.10 $601,555.28 $562,201.20 2026-03-07
9422 OTHER Idecabtagene Vicleucel Ca 29 15 — — $526,587.60 $605,575.74 $558,081.80 2026-03-07
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 1 — — $534,422.90 $534,422.90 $534,422.90 2026-03-07
9035 OTHER Axicabtagene Ciloleucel C 30 16 — — $489,456.00 $569,445.65 $532,192.20 2026-03-07
9391 OTHER Brexucabtagene Car Pos T 30 16 — — $460,530.40 $529,609.96 $489,450.20 2026-03-07
5834 APR_DRG Neonate With Ecmo 14 9 — — $470,282.90 $520,079.40 $481,555.00 2026-03-07
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 8 4 — — $388,680.75 $1,501,307.95 $479,186.12 2026-03-07
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 8 4 — — $380,622.00 $1,557,271.36 $463,470.03 2026-03-07
09194 OTHER Tisagenlecleucel Car-pos 6 3 — — $396,894.68 $509,878.17 $463,043.79 2026-03-07
09498 OTHER Ciltacabtagene Car-pos T 6 3 — — $395,342.55 $528,884.64 $461,232.97 2026-03-07
09422 OTHER Idecabtagene Vicleucel Ca 6 3 — — $394,940.70 $502,273.62 $460,764.15 2026-03-07
09413 OTHER Lisocabtagene Car Pos T 6 3 — — $387,544.57 $505,981.08 $452,135.33 2026-03-07
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 8 4 — — $363,517.50 $1,478,916.58 $442,349.85 2026-03-07
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 14 9 — — $430,696.39 $476,301.60 $441,020.00 2026-03-07
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 8 4 — — $355,545.75 $1,489,833.29 $432,815.30 2026-03-07
09035 OTHER Axicabtagene Ciloleucel C 6 3 — — $367,092.00 $478,972.98 $428,274.00 2026-03-07
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 14 9 — — $415,458.24 $459,449.28 $425,416.00 2026-03-07
5833 APR_DRG Neonate With Ecmo 14 9 — — $413,074.95 $456,814.08 $422,976.00 2026-03-07
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 8 4 — — $344,535.75 $1,410,309.44 $420,428.88 2026-03-07
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 8 4 — — $337,080.00 $1,297,043.03 $410,242.58 2026-03-07
09391 OTHER Brexucabtagene Car Pos T 6 3 — — $345,397.80 $440,505.18 $402,964.10 2026-03-07
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 14 9 — — $332,243.00 $367,422.48 $340,206.00 2026-03-07
1614 APR_DRG Implantable Heart Assist Systems 14 9 — — $321,781.57 $355,853.52 $329,494.00 2026-03-07
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 14 9 — — $291,226.77 $322,063.56 $298,207.00 2026-03-07
5832 APR_DRG Neonate With Ecmo 14 9 — — $284,222.51 $314,317.80 $291,035.00 2026-03-07
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 45 18 — — $19,893.00 $786,617.88 $290,065.10 2026-03-07
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 14 9 — — $278,007.20 $307,443.60 $284,670.00 2026-03-07
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 14 9 — — $272,687.21 $301,560.84 $279,223.00 2026-03-07
831 OTHER Obecbtge Autol Up To 400 22 18 — — $2,436.48 $297,727.50 $278,250.00 2026-03-07
897 OTHER Revakinagene, Per Implant 16 15 — — $265,000.00 $283,550.00 $267,173.00 2026-03-07
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 14 9 — — $259,053.55 $286,482.96 $265,262.00 2026-03-07
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 14 9 — — $258,459.62 $285,826.32 $264,654.00 2026-03-07
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 93 36 — — $24,283.00 $510,483.36 $256,460.61 2026-03-07
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 14 9 — — $245,674.42 $271,688.04 $251,563.00 2026-03-07
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 14 9 — — $232,291.50 $256,887.72 $237,859.00 2026-03-07
00831 OTHER Obecbtge Autol Up To 400 3 3 — — $208,687.50 $250,425.00 $236,512.50 2026-03-07
00897 OTHER Revakinagene, Per Implant 3 3 — — $198,750.00 $238,500.00 $225,250.00 2026-03-07
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 14 9 — — $214,463.64 $237,172.32 $219,604.00 2026-03-07
886 OTHER Inj. Remestemcel-l-rknd/ 22 18 — — $4,594.45 $215,785.83 $201,669.00 2026-03-07
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 14 9 — — $194,633.66 $215,241.84 $199,298.00 2026-03-07
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 14 9 — — $193,084.90 $213,530.04 $197,713.00 2026-03-07
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 14 9 — — $191,857.79 $212,172.48 $196,456.00 2026-03-07
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 14 9 — — $186,786.01 $206,564.04 $191,263.00 2026-03-07
5831 APR_DRG Neonate With Ecmo 14 9 — — $177,903.74 $196,741.44 $182,168.00 2026-03-07
00886 OTHER Inj. Remestemcel-l-rknd/ 3 3 — — $151,251.75 $181,502.10 $171,418.65 2026-03-07
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 14 9 — — $159,940.38 $176,875.92 $163,774.00 2026-03-07
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 2 1 — — $150,585.06 $173,512.94 $162,049.00 2026-03-07
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 48 18 — — $11,750.00 $409,479.25 $161,750.50 2026-03-07
1613 APR_DRG Implantable Heart Assist Systems 14 9 — — $156,043.78 $172,566.72 $159,784.00 2026-03-07
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 6 3 — — $148,795.90 $169,074.54 $158,615.05 2026-03-07
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 71 36 — — $11,750.00 $386,638.24 $156,357.61 2026-03-07
1612 APR_DRG Implantable Heart Assist Systems 14 9 — — $152,344.74 $168,475.68 $155,996.00 2026-03-07
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 3 — — $122,778.59 $192,345.21 $155,830.11 2026-03-07
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 14 9 — — $147,870.67 $163,528.20 $151,415.00 2026-03-07
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 14 9 — — $147,232.43 $162,821.88 $150,761.00 2026-03-07
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 14 9 — — $147,207.10 $162,793.80 $150,735.00 2026-03-07
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 14 9 — — $145,337.95 $160,726.68 $148,821.00 2026-03-07
1611 APR_DRG Implantable Heart Assist Systems 14 9 — — $144,693.37 $160,013.88 $148,161.00 2026-03-07
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 14 9 — — $144,689.57 $160,009.56 $148,157.00 2026-03-07
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 14 9 — — $144,257.74 $159,532.20 $147,715.00 2026-03-07
1907 OTHER New Technology - Level 52 30 16 — — $140,029.00 $161,033.35 $145,638.00 2026-03-07
1908 OTHER New Technology - Level 52 30 16 — — $140,029.00 $161,033.35 $145,638.00 2026-03-07
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 14 9 — — $136,145.42 $150,560.64 $139,408.00 2026-03-07
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 14 9 — — $134,392.77 $148,623.12 $137,614.00 2026-03-07
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 14 9 — — $134,307.93 $148,529.16 $137,527.00 2026-03-07
33240 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Singl… 15 6 — — $4,250.00 $171,551.00 $136,146.00 2026-03-07
33271 CPT Insertion Of Subcutaneous Implantable Defibrillator Electrode 14 5 — — $1,995.00 $171,551.00 $136,146.00 2026-03-07
33249 CPT Insertion Or Replacement Of Permanent Implantable Defibrillator System, With Tra… 15 6 — — $4,250.00 $171,551.00 $136,146.00 2026-03-07
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 14 9 — — $130,878.62 $144,736.20 $134,015.00 2026-03-07
1906 OTHER New Technology - Level 51 30 16 — — $126,255.70 $145,194.05 $131,313.00 2026-03-07
1905 OTHER New Technology - Level 51 30 16 — — $126,255.70 $145,194.05 $131,313.00 2026-03-07
7 MS_DRG Lung Transplant 88 36 — — $24,283.00 $235,900.84 $126,153.01 2026-03-07
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 14 9 — — $122,504.16 $135,475.20 $125,440.00 2026-03-07
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 2 1 — — $123,321.96 $123,742.09 $123,532.02 2026-03-07
33263 CPT Removal Of Implantable Defibrillator Pulse Generator With Replacement Of Implant… 12 4 — — $1,995.00 $171,551.00 $123,519.50 2026-03-07
33270 CPT Insertion Or Replacement Of Permanent Subcutaneous Implantable Defibrillator Sys… 12 4 — — $1,995.00 $171,551.00 $123,519.50 2026-03-07
33264 CPT Removal Of Implantable Defibrillator Pulse Generator With Replacement Of Implant… 12 4 — — $1,995.00 $171,551.00 $123,519.50 2026-03-07
33262 CPT Removal Of Implantable Defibrillator Pulse Generator With Replacement Of Implant… 12 4 — — $1,995.00 $171,551.00 $123,519.50 2026-03-07
33272 CPT Removal Of Subcutaneous Implantable Defibrillator Electrode 12 4 — — $1,995.00 $171,551.00 $123,519.50 2026-03-07
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 14 9 — — $120,128.46 $132,847.56 $123,007.00 2026-03-07
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 14 9 — — $119,117.90 $131,730.84 $121,973.00 2026-03-07
01908 OTHER New Technology - Level 52 6 3 — — $105,021.75 $131,049.45 $121,396.79 2026-03-07
01907 OTHER New Technology - Level 52 6 3 — — $105,021.75 $131,049.45 $121,396.79 2026-03-07
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 14 9 — — $117,386.78 $129,816.00 $120,200.00 2026-03-07
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 14 9 — — $117,386.78 $129,816.00 $120,200.00 2026-03-07
14 MS_DRG Allogeneic Bone Marrow Transplant 88 36 — — $19,893.00 $226,134.63 $119,828.04 2026-03-07
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 95 36 — — $34,310.00 $200,762.18 $117,536.09 2026-03-07
209 MS_DRG Complex Aortic Arch Procedures 49 35 — — $27,878.00 $206,183.26 $117,030.63 2026-03-07
1903 OTHER New Technology - Level 50 30 16 — — $112,482.40 $129,354.76 $116,988.00 2026-03-07
1904 OTHER New Technology - Level 50 30 16 — — $112,482.40 $129,354.76 $116,988.00 2026-03-07
215 MS_DRG Other Heart Assist System Implant 95 36 — — $51,975.00 $182,866.49 $116,935.85 2026-03-07
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 14 9 — — $113,486.39 $125,502.48 $116,206.00 2026-03-07
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 95 36 — — $61,909.00 $178,203.48 $114,242.27 2026-03-07
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 95 36 — — $49,076.07 $186,850.00 $114,154.54 2026-03-07
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 14 9 — — $107,524.35 $118,909.08 $110,101.00 2026-03-07
01906 OTHER New Technology - Level 51 6 3 — — $94,691.77 $118,159.38 $109,456.16 2026-03-07
01905 OTHER New Technology - Level 51 6 3 — — $94,691.77 $118,159.38 $109,456.16 2026-03-07
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 6 3 — — $99,663.52 $119,167.11 $109,036.40 2026-03-07
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 14 9 — — $106,146.55 $117,385.20 $108,690.00 2026-03-07
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 93 36 — — $24,283.00 $249,977.00 $108,476.02 2026-03-07
4404 APR_DRG Kidney Transplant 14 9 — — $102,945.18 $113,844.96 $105,412.00 2026-03-07
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 88 36 — — $24,283.00 $187,816.07 $105,273.24 2026-03-07
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 14 9 — — $102,300.60 $113,132.16 $104,752.00 2026-03-07
4403 APR_DRG Kidney Transplant 14 9 — — $100,568.22 $111,216.24 $102,978.00 2026-03-07
1902 OTHER New Technology - Level 49 30 16 — — $98,709.11 $113,515.48 $102,663.00 2026-03-07
1901 OTHER New Technology - Level 49 30 16 — — $98,709.11 $113,515.48 $102,663.00 2026-03-07
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 14 9 — — $100,209.84 $110,819.88 $102,611.00 2026-03-07
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 95 36 — — $58,259.00 $153,076.33 $102,428.51 2026-03-07
231 MS_DRG Coronary Bypass With Ptca With Mcc 95 36 — — $51,290.00 $153,559.06 $102,424.53 2026-03-07
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 14 9 — — $99,769.14 $110,332.80 $102,160.00 2026-03-07
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 14 9 — — $99,741.28 $110,302.56 $102,132.00 2026-03-07
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 14 9 — — $99,536.13 $110,074.68 $101,921.00 2026-03-07
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 14 9 — — $98,776.31 $109,234.44 $101,143.00 2026-03-07
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 17 16 — — $74,999.92 $114,999.88 $101,139.90 2024-10-01
33231 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Multi… 13 5 — — $1,995.00 $171,551.00 $100,741.00 2026-03-07
33230 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Dual … 13 5 — — $1,995.00 $171,551.00 $100,741.00 2026-03-07
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 14 9 — — $98,339.42 $108,751.68 $100,696.00 2026-03-07
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 48 18 — — $11,750.00 $252,317.10 $99,959.78 2026-03-07
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 95 36 — — $11,750.00 $198,082.61 $99,887.90 2026-03-07
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 95 36 — — $34,310.00 $164,118.87 $99,214.43 2026-03-07
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 14 9 — — $95,821.89 $105,967.44 $98,118.00 2026-03-07
01904 OTHER New Technology - Level 50 6 3 — — $84,361.80 $105,269.31 $97,515.52 2026-03-07
01903 OTHER New Technology - Level 50 6 3 — — $84,361.80 $105,269.31 $97,515.52 2026-03-07
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 14 9 — — $94,254.13 $104,234.04 $96,513.00 2026-03-07
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 95 36 — — $25,783.00 $167,172.00 $96,477.50 2026-03-07
6904 APR_DRG Acute Leukemia 14 9 — — $93,120.74 $102,980.16 $95,352.00 2026-03-07
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 14 9 — — $93,004.23 $102,851.64 $95,233.00 2026-03-07
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 95 36 — — $53,086.44 $139,264.96 $94,558.66 2026-03-07
8634 APR_DRG Neonatal Aftercare 14 9 — — $92,022.80 $101,766.24 $94,228.00 2026-03-07
652 MS_DRG Kidney Transplant 88 36 — — $21,708.09 $173,634.00 $94,131.54 2026-03-07
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 95 36 — — $53,312.26 $139,867.91 $93,608.69 2026-03-07
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 14 9 — — $91,116.08 $100,764.00 $93,300.00 2026-03-07
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 14 9 — — $91,094.56 $100,740.24 $93,278.00 2026-03-07
9104 APR_DRG Craniotomy For Multiple Significant Trauma 14 9 — — $90,795.69 $100,409.76 $92,972.00 2026-03-07
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 17 16 — — $68,273.92 $104,686.68 $92,069.66 2024-10-01
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 14 9 — — $89,601.51 $99,088.92 $91,749.00 2026-03-07
1599 OTHER New Technology - Level 48 30 16 — — $87,231.36 $100,316.06 $90,725.48 2026-03-07
1585 OTHER New Technology - Level 48 30 16 — — $87,231.36 $100,316.06 $90,725.48 2026-03-07
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 95 36 — — $32,437.81 $155,071.00 $90,643.51 2026-03-07
3124 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 14 9 — — $88,294.63 $97,643.88 $90,411.00 2026-03-07
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 14 9 — — $86,398.88 $95,546.52 $88,469.00 2026-03-07
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 14 9 — — $85,996.18 $95,101.56 $88,057.00 2026-03-07
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 14 9 — — $85,973.38 $95,076.72 $88,034.00 2026-03-07
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 14 9 — — $85,883.47 $94,977.36 $87,942.00 2026-03-07
204 APR_DRG Open Craniotomy For Trauma 14 9 — — $85,734.04 $94,812.12 $87,789.00 2026-03-07
8904 APR_DRG HIV With Multiple Major HIV Related Conditions 14 9 — — $85,651.73 $94,720.32 $87,704.00 2026-03-07
232 MS_DRG Coronary Bypass With Ptca Without Mcc 95 36 — — $42,289.70 $136,211.00 $86,585.18 2026-03-07
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 14 9 — — $84,515.80 $93,464.28 $86,541.00 2026-03-07
01901 OTHER New Technology - Level 49 6 3 — — $74,031.83 $92,379.24 $85,574.90 2026-03-07
01902 OTHER New Technology - Level 49 6 3 — — $74,031.83 $92,379.24 $85,574.90 2026-03-07
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 95 36 — — $34,310.00 $136,107.00 $85,208.50 2026-03-07
850 MS_DRG Acute Leukemia With Other Procedures 95 36 — — $11,750.00 $158,996.25 $85,103.73 2026-03-07
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 14 9 — — $82,598.53 $91,344.24 $84,578.00 2026-03-07
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 95 36 — — $34,310.00 $136,107.00 $84,470.04 2026-03-07
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 95 36 — — $34,310.00 $136,107.00 $84,349.83 2026-03-07
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 14 9 — — $81,857.70 $90,524.52 $83,819.00 2026-03-07
4402 APR_DRG Kidney Transplant 14 9 — — $81,410.68 $90,030.96 $83,362.00 2026-03-07
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 95 36 — — $41,907.66 $124,762.00 $83,313.21 2026-03-07
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 14 9 — — $81,347.36 $89,960.76 $83,297.00 2026-03-07
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 95 36 — — $26,741.00 $143,338.06 $82,936.65 2026-03-07
1598 OTHER New Technology - Level 47 30 16 — — $78,049.16 $89,756.53 $81,175.48 2026-03-07
1584 OTHER New Technology - Level 47 30 16 — — $78,049.16 $89,756.53 $81,175.48 2026-03-07
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 95 36 — — $46,512.61 $121,712.03 $81,157.75 2026-03-07
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 14 9 — — $79,238.87 $87,629.04 $81,138.00 2026-03-07
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 6 3 — — $70,075.84 $93,060.09 $81,044.01 2026-03-07
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 14 9 — — $78,327.08 $86,620.32 $80,204.00 2026-03-07
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 14 9 — — $78,148.53 $86,422.68 $80,021.00 2026-03-07
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 14 9 — — $78,075.08 $86,341.68 $79,946.00 2026-03-07
10 MS_DRG Pancreas Transplant 88 36 — — $24,283.00 $137,615.05 $79,295.27 2026-03-07
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 95 36 — — $27,585.43 $136,107.00 $79,072.21 2026-03-07
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 49 35 — — $21,132.00 $136,721.00 $78,926.50 2026-03-07
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 89 36 — — $24,283.00 $136,822.77 $78,920.93 2026-03-07
1774 APR_DRG Cardiac Pacemaker And Defibrillator Revision Except Device Replacement 14 9 — — $76,920.15 $85,064.04 $78,763.00 2026-03-07
C1767 HCPCS Neurostm Vns Demipul 106 20 16 $99,999.00 $99,999.00 $14,999.85 $89,999.10 $78,499.21 2026-03-07
C1822 HCPCS Pulse Gen Imp 20 16 $99,999.00 $99,999.00 $14,999.85 $89,999.10 $78,499.21 2026-03-07
C1820 HCPCS Kit Generator Nrstm Ipg 20 16 $99,999.00 $99,999.00 $14,999.85 $89,999.10 $78,499.21 2026-03-07
376998 CDM Hip Hybrid Stryker Cap 20 16 $99,999.00 $99,999.00 $14,999.85 $89,999.10 $78,499.21 2026-03-07
230 MS_DRG Other Cardiothoracic Procedures Without Cc/mcc 6 1 — — $76,801.00 $80,065.00 $78,433.00 2026-03-07
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 14 9 — — $76,408.54 $84,499.20 $78,240.00 2026-03-07
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 95 36 — — $44,903.71 $119,775.66 $78,182.45 2026-03-07
4414 APR_DRG Major Bladder Procedures 14 9 — — $75,010.48 $82,952.64 $76,808.00 2026-03-07
476007 CDM Sys Reflux Mgmt Bead 14 20 16 $96,701.00 $96,701.00 $14,505.15 $87,030.90 $75,910.29 2026-03-07
476008 CDM Sys Reflux Mgmt Bead 15 20 16 $96,701.00 $96,701.00 $14,505.15 $87,030.90 $75,910.29 2026-03-07
476010 CDM Sys Reflux Mgmt Bead 17 20 16 $96,701.00 $96,701.00 $14,505.15 $87,030.90 $75,910.29 2026-03-07
476009 CDM Sys Reflux Mgmt Bead 16 20 16 $96,701.00 $96,701.00 $14,505.15 $87,030.90 $75,910.29 2026-03-07
476006 CDM System Gs Impl Anrflx 20 16 $96,701.00 $96,701.00 $14,505.15 $87,030.90 $75,910.29 2026-03-07
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 95 36 — — $25,783.00 $126,030.00 $75,906.50 2026-03-07
1834 APR_DRG Percutaneous Structural Cardiac Procedures 14 9 — — $74,053.11 $81,894.24 $75,828.00 2026-03-07
01585 OTHER New Technology - Level 48 6 3 — — $65,423.52 $81,637.54 $75,624.39 2026-03-07
01599 OTHER New Technology - Level 48 6 3 — — $65,423.52 $81,637.54 $75,624.39 2026-03-07
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 14 9 — — $73,773.24 $81,584.28 $75,541.00 2026-03-07
J7330 HCPCS Algrf Maci Fnl 1 Membran 29 20 $99,999.00 $99,999.00 $14,999.85 $221,874.56 $74,999.25 2026-03-07
1694 APR_DRG Major Abdominal Vascular Procedures 14 9 — — $72,827.27 $80,537.76 $74,572.00 2026-03-07
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 14 9 — — $72,083.91 $79,715.88 $73,811.00 2026-03-07
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 14 9 — — $71,505.19 $79,076.52 $73,219.00 2026-03-07
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 6 3 — — $63,410.06 $83,401.07 $72,953.87 2026-03-07
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition… 14 9 — — $71,208.86 $78,748.20 $72,915.00 2026-03-07
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 95 36 — — $41,421.83 $119,775.66 $72,583.41 2026-03-07
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 95 36 — — $37,111.78 $112,138.00 $72,338.89 2026-03-07
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 14 9 — — $70,544.02 $78,012.72 $72,234.00 2026-03-07
614030 CDM Probe Abltn Radio Disp 27 20 $99,999.00 $99,999.00 $14,999.85 $89,999.10 $71,999.28 2026-03-07
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 95 36 — — $34,310.00 $109,091.00 $71,700.50 2026-03-07
1597 OTHER New Technology - Level 46 30 16 — — $68,866.96 $79,197.00 $71,625.48 2026-03-07
1583 OTHER New Technology - Level 46 30 16 — — $68,866.96 $79,197.00 $71,625.48 2026-03-07
234 APR_DRG Spinal Procedures 14 9 — — $69,774.07 $77,161.68 $71,446.00 2026-03-07
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 95 36 — — $40,966.20 $106,902.42 $71,267.40 2026-03-07
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 14 9 — — $69,475.21 $76,831.20 $71,140.00 2026-03-07
1204 APR_DRG Major Respiratory And Chest Procedures 14 9 — — $69,415.69 $76,765.32 $71,079.00 2026-03-07
1784 APR_DRG External Heart Assist Devices 14 9 — — $69,177.61 $76,501.80 $70,835.00 2026-03-07
4014 APR_DRG Adrenal Procedures 14 9 — — $69,132.02 $76,452.12 $70,789.00 2026-03-07
2304 APR_DRG Major Small Bowel Procedures 14 9 — — $68,999.05 $76,304.16 $70,652.00 2026-03-07
914 APR_DRG Other Major Head And Neck Procedures 14 9 — — $68,892.68 $76,187.52 $70,544.00 2026-03-07
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 95 36 — — $36,950.12 $108,155.00 $70,347.56 2026-03-07
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 95 36 — — $11,750.00 $138,804.10 $70,290.46 2026-03-07
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 95 36 — — $26,741.00 $120,710.00 $70,226.00 2026-03-07
274 APR_DRG Other Open Craniotomy 14 9 — — $68,279.76 $75,509.28 $69,916.00 2026-03-07
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 95 36 — — $38,608.45 $105,925.58 $69,607.71 2026-03-07
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 14 9 — — $67,888.45 $75,076.20 $69,515.00 2026-03-07
214 APR_DRG Open Craniotomy Except Trauma 14 9 — — $67,530.07 $74,679.84 $69,148.00 2026-03-07
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 14 9 — — $66,539.78 $73,584.72 $68,134.00 2026-03-07
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 95 36 — — $32,127.69 $108,155.00 $67,936.35 2026-03-07
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 95 36 — — $35,945.91 $103,989.00 $67,847.96 2026-03-07
562943 CDM Filler Bn 5cc 20 16 $79,973.00 $79,973.00 $12,955.65 $77,733.90 $67,801.24 2026-03-07
01584 OTHER New Technology - Level 47 6 3 — — $58,536.87 $73,044.16 $67,663.97 2026-03-07
01598 OTHER New Technology - Level 47 6 3 — — $58,536.87 $73,044.16 $67,663.97 2026-03-07
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 14 9 — — $65,964.85 $72,949.68 $67,546.00 2026-03-07
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 95 36 — — $29,395.82 $109,091.00 $67,445.34 2026-03-07
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 14 9 — — $65,798.96 $72,766.08 $67,376.00 2026-03-07
1783 APR_DRG External Heart Assist Devices 14 9 — — $65,619.13 $72,567.36 $67,192.00 2026-03-07
22810 CPT Arthrodesis, Anterior, For Spinal Deformity, With Or Without Cast; 4 To 7 Verteb… 14 5 — — $4,250.00 $118,585.00 $66,776.50 2026-03-07
22800 CPT Arthrodesis, Posterior, For Spinal Deformity, With Or Without Cast; Up To 6 Vert… 14 5 — — $4,250.00 $118,585.00 $66,776.50 2026-03-07
22812 CPT Arthrodesis, Anterior, For Spinal Deformity, With Or Without Cast; 8 Or More Ver… 14 5 — — $4,250.00 $118,585.00 $66,776.50 2026-03-07
22808 CPT Arthrodesis, Anterior, For Spinal Deformity, With Or Without Cast; 2 To 3 Verteb… 14 5 — — $4,250.00 $118,585.00 $66,776.50 2026-03-07
22804 CPT Arthrodesis, Posterior, For Spinal Deformity, With Or Without Cast; 13 Or More V… 14 5 — — $4,250.00 $118,585.00 $66,776.50 2026-03-07
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 95 36 — — $26,741.00 $121,801.28 $66,758.77 2026-03-07
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 17 16 — — $49,403.77 $75,752.45 $66,622.64 2024-10-01
894 APR_DRG Major Cranial Or Facial Bone Procedures 14 9 — — $64,462.94 $71,288.64 $66,008.00 2026-03-07
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 14 9 — — $64,322.38 $71,133.12 $65,864.00 2026-03-07
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 14 9 — — $63,899.41 $70,665.48 $65,431.00 2026-03-07
1782 APR_DRG External Heart Assist Devices 14 9 — — $63,822.16 $70,579.08 $65,351.00 2026-03-07
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 95 36 — — $28,836.25 $102,272.00 $65,047.62 2026-03-07
224 APR_DRG Ventricular Shunt Procedures 14 9 — — $63,376.40 $70,086.60 $64,895.00 2026-03-07
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 14 9 — — $63,314.35 $70,017.48 $64,831.00 2026-03-07
955 MS_DRG Craniotomy For Multiple Significant Trauma 95 36 — — $11,750.00 $122,613.72 $64,803.19 2026-03-07
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 14 9 — — $63,152.26 $69,838.20 $64,665.00 2026-03-07
717 OTHER Instill Adstiladrin, Tx D 36 19 — — $9,988.21 $72,857.99 $64,274.79 2026-03-07
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 95 36 — — $8,216.00 $125,905.35 $64,146.07 2026-03-07
1214 APR_DRG Other Respiratory And Chest Procedures 14 9 — — $62,627.98 $69,259.32 $64,129.00 2026-03-07
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 14 9 — — $62,608.99 $69,237.72 $64,109.00 2026-03-07
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 14 9 — — $62,153.10 $68,733.36 $63,642.00 2026-03-07
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 14 9 — — $62,131.57 $68,709.60 $63,620.00 2026-03-07
007 OTHER Lung Transplant 6 3 — — $56,180.25 $71,523.06 $63,517.26 2026-03-07
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 95 36 — — $11,750.00 $130,657.90 $63,513.79 2026-03-07
1794 APR_DRG Defibrillator Implants 14 9 — — $61,945.41 $68,504.40 $63,430.00 2026-03-07
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 2 1 — — $62,320.47 $64,205.31 $63,262.89 2026-03-07
014 OTHER Allogeneic Bone Marrow Transplant 6 3 — — $57,659.87 $68,942.65 $63,082.07 2026-03-07
264 APR_DRG Other Nervous System And Related Procedures 14 9 — — $61,278.04 $67,765.68 $62,746.00 2026-03-07
2614 APR_DRG Major Biliary Tract Procedures 14 9 — — $60,920.92 $67,371.48 $62,381.00 2026-03-07
1596 OTHER New Technology - Level 45 30 16 — — $59,684.76 $68,637.47 $62,075.48 2026-03-07
1582 OTHER New Technology - Level 45 30 16 — — $59,684.76 $68,637.47 $62,075.48 2026-03-07
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 88 36 — — $19,893.00 $108,015.42 $62,035.89 2026-03-07
2324 APR_DRG Gastric Fundoplication 14 9 — — $60,448.57 $66,848.76 $61,897.00 2026-03-07
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 95 36 — — $19,848.00 $103,917.00 $61,882.50 2026-03-07
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 95 36 — — $35,566.41 $94,821.57 $61,749.56 2026-03-07
4474 APR_DRG Other Kidney, Urinary Tract And Related Non-percutaneous Procedures 14 9 — — $60,273.81 $66,655.44 $61,718.00 2026-03-07
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 14 9 — — $59,955.96 $66,304.44 $61,393.00 2026-03-07
5244 OTHER Level 4 Blood Product Exc 30 16 — — $47,808.20 $65,667.68 $61,371.66 2026-03-07
28 MS_DRG Spinal Procedures With Mcc 95 36 — — $17,679.00 $109,447.19 $61,305.18 2026-03-07
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 95 36 — — $26,741.00 $96,431.86 $61,073.86 2026-03-07
2294 APR_DRG Other Digestive System And Abdominal Procedures 14 9 — — $59,607.71 $65,918.88 $61,036.00 2026-03-07
1643 OTHER Y90 Ibritumomab, Rx 30 16 — — $56,824.55 $75,298.07 $60,802.27 2026-03-07
8411 APR_DRG Extensive Third Degree Burns With Skin Graft 14 9 — — $59,210.07 $65,479.32 $60,629.00 2026-03-07
8412 APR_DRG Extensive Third Degree Burns With Skin Graft 14 9 — — $59,210.07 $65,479.32 $60,629.00 2026-03-07
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 95 36 — — $11,750.00 $111,505.60 $60,453.42 2026-03-07
228 MS_DRG Other Cardiothoracic Procedures With Mcc 95 36 — — $34,681.63 $126,253.00 $60,406.58 2026-03-07
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