Hospital

MARY BRIDGE CHILDREN'S HOSPITAL

Tacoma, WA · CCN 503301 · Rates published

Your selected procedure

You selected 93350 (CPT)

HC ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST WO/ CONTRAST

This hospital’s price: $2,546 across 17 payers · range $328-$4,873

Source: https://sthpiprd.blob.core.windows.net/machine-readable-files/8057/911352172-1306952726_mary-bridge-childrens-hospital_standardcharges.csv · observed 2025-07-29

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

16,029 distinct procedures filed

17 distinct payers

592,011 rate rows

2025-07-29 last MRF observed · ⚠ 15 mo old

Data quality

586,817 of 592,011 rate rows are consumer-grade (99.1%)

5,194 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 — reason	Rows
per-diem day rate — not a per-procedure price	2,818
template filing: same amount across many unrelated codes — excluded	1,144
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	623
exceeds 10× this hospital's gross charge — excluded from medians	212
percent-of-charges filed in the dollar field — excluded from medians	205
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	155
placeholder amount (≤ $0.02) — excluded from medians	32
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	5

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 15 months old.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://sthpiprd.blob.core.windows.net/machine-readable-files/8057/911352172-1306952726_mary-bridge-childrens-hospital_standardcharges.csv
Found on page	https://search.hospitalpriceindex.com/hpi2/machineReadable/MaryBridgeChildrensHospital/8057
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-10-03
Content fingerprint	e54e2e4e69f73b04… · 1,391,817,320 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
J1414 HCPCS	Inj, Beqvez, Per Tx Dose	6	$3,744,874.00	$3,999,380.00	$3,799,411.00	nat. median $3,710,000 1.0× median
J1411 HCPCS	Inj, Hemgenix, Per Tx Dose	6	$3,719,908.17	$3,972,717.47	$3,774,081.59	nat. median $3,705,478 1.0× median
J1413 HCPCS	Inj Delandistrogene Mox Rokl	6	$3,353,704.54	$3,581,626.21	$3,402,544.90	nat. median $3,324,572 1.0× median
J3394 HCPCS	Inj, Lovotibeglogene Autotem	6	$3,316,888.40	$3,542,308.00	$3,365,192.60	nat. median $3,286,000 1.0× median
J3393 HCPCS	Inj, Betibeglogene Autotemce	6	$2,975,926.54	$3,178,173.97	$3,019,265.27	nat. median $2,994,107 1.0× median
J3392 HCPCS	Inj, Exagamglogene Autotem	6	$2,353,920.80	$4,227,916.00	$2,399,628.00	nat. median $2,401,965 1.0× median
J3399 HCPCS	Onasemnogene Abeparvovec-xioi 4x8.3 Ml Kit	17	$866,362.50	$4,393,136.92	$1,647,780.00	nat. median $2,467,386 0.7× median
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	9	$337,950.15	$2,149,481.40	$873,798.32	nat. median $359,454 outlier · 2.4×
Q2057 HCPCS	Afamitresgene Autoleucel	6	$777,863.83	$1,397,134.06	$792,967.98	nat. median $813,967 1.0× median
Q2056 HCPCS	Ciltacabtagene Car-pos T	7	$558,369.09	$4,256,177.56	$692,478.25	nat. median $646,415 1.1× median
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	10	$252,661.51	$1,605,484.80	$642,697.50	nat. median $249,036 outlier · 2.6×
Q2054 HCPCS	Lisocabtagene Mara Car Pos T	7	$521,296.84	$4,958,265.28	$626,296.79	nat. median $640,950 1.0× median
Q2042 HCPCS	Tisagenlecleucel Car-pos T	7	$584,211.57	$1,431,002.99	$623,915.27	nat. median $739,258 0.8× median
Q2041 HCPCS	Axicabtagene Ciloleucel Car+	7	$507,567.43	$4,699,364.65	$618,997.57	nat. median $608,239 1.0× median
Q2053 HCPCS	Brexucabtagene Car Pos T	7	$493,999.51	$4,685,164.79	$612,599.14	nat. median $591,721 1.0× median
Q2055 HCPCS	Idecabtagene Vicleucel Car	7	$532,582.11	$1,357,132.84	$568,777.01	nat. median $622,450 0.9× median
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	10	$192,463.07	$1,221,521.40	$502,313.84	nat. median $190,559 outlier · 2.6×
5834 APR_DRG	Neonate With Ecmo	6	$423,060.57	$1,430,347.65	$423,060.57	nat. median $307,206 1.4× median
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	9	$212,936.99	$1,352,199.60	$369,086.32	nat. median $198,418 1.9× median
5833 APR_DRG	Neonate With Ecmo	6	$339,864.91	$1,149,067.09	$339,864.91	nat. median $244,017 1.4× median
5884 APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	6	$335,114.87	$1,133,007.41	$335,114.87	nat. median $247,214 1.4× median
4 MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And…	10	$127,216.75	$805,358.70	$331,178.94	nat. median $126,695 outlier · 2.6×
7 MS_DRG	Lung Transplant	10	$117,733.98	$744,870.30	$290,922.21	nat. median $117,974 outlier · 2.5×
C9301 HCPCS	Apc	6	$280,865.55	$504,467.25	$286,319.25	nat. median $459,112 0.6× median
C2624 HCPCS	Hc Kit Impl Hrtmt 3 Str Lf	17	$37,526.62	$345,516.32	$281,461.32	nat. median $32,662 outlier · 8.6×
14 MS_DRG	Allogeneic Bone Marrow Transplant	10	$118,028.86	$746,751.30	$271,818.17	nat. median $110,307 outlier · 2.5×
C9741 HCPCS	Fee Schedule	1	$270,085.77	$270,085.77	$270,085.77	nat. median $12,039 outlier · 22.4×
L6700 HCPCS	Ue Add Ext Power Myoel	1	$264,723.77	$264,723.77	$264,723.77	nat. median $30,378 outlier · 8.7×
1614 APR_DRG	Implantable Heart Assist Systems	6	$259,459.24	$877,219.33	$259,459.24	nat. median $202,993 1.3× median
2 MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	10	$99,423.43	$628,122.90	$259,425.78	nat. median $104,013 outlier · 2.5×
212 MS_DRG	Concomitant Aortic And Mitral Valve Procedures	9	$98,299.30	$620,906.70	$255,448.69	nat. median $97,323 outlier · 2.6×
0424T CPT	Fee Schedule	1	$247,481.06	$247,481.06	$247,481.06	nat. median $22,771 outlier · 10.9×
0312T CPT	Fee Schedule	1	$247,481.06	$247,481.06	$247,481.06	nat. median $9,552 outlier · 25.9×
5 MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	10	$96,114.47	$606,970.20	$245,470.95	nat. median $95,038 outlier · 2.6×
215 MS_DRG	Other Heart Assist System Implant	10	$95,626.57	$603,869.40	$242,264.41	nat. median $93,901 outlier · 2.6×
8414 APR_DRG	Extensive Third Degree Burns With Skin Graft	6	$233,572.39	$789,697.12	$233,572.39	nat. median $155,939 1.5× median
5832 APR_DRG	Neonate With Ecmo	6	$230,603.32	$779,658.85	$230,603.32	nat. median $159,249 1.4× median
5914 APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	6	$228,798.59	$773,557.13	$228,798.59	nat. median $162,342 1.4× median
216 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	10	$87,193.77	$550,072.80	$226,202.48	nat. median $90,551 outlier · 2.5×
6094 APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	6	$224,131.26	$757,777.10	$224,131.26	nat. median $165,000 1.4× median
453 MS_DRG	DRG	5	$137,339.28	$294,195.20	$210,165.82	nat. median $70,732 outlier · 3.0×
5883 APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	6	$204,273.20	$690,637.95	$204,273.20	nat. median $175,204 1.2× median
94 APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	6	$201,739.46	$682,071.51	$201,739.46	nat. median $163,587 1.2× median
0775T CPT	Fee Schedule	1	$200,363.31	$200,363.31	$200,363.31	nat. median $9,762 outlier · 20.5×
0809T CPT	Fee Schedule	1	$200,363.31	$200,363.31	$200,363.31	nat. median $9,875 outlier · 20.3×
6314 APR_DRG	Neonate Birth Weight > 2499 Grams With Other Major Procedure	6	$199,825.96	$675,602.06	$199,825.96	nat. median $133,164 1.5× median
456 MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	10	$76,632.44	$482,710.20	$198,501.11	nat. median $77,632 outlier · 2.6×
231 MS_DRG	Coronary Bypass With Ptca With Mcc	10	$76,674.44	$482,983.80	$192,468.20	nat. median $77,028 outlier · 2.5×
6304 APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	6	$192,455.11	$650,681.58	$192,455.11	nat. median $154,011 1.2× median
5934 APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	6	$189,950.99	$642,215.27	$189,950.99	nat. median $151,838 1.3× median

Other procedures at this hospital

Browse this hospital's 16,029 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

J1414	HCPCS	Inj, Beqvez, Per Tx Dose	6	6	—	—	$3,744,874.00	$3,999,380.00	$3,799,411.00	2025-07-29
J1411	HCPCS	Inj, Hemgenix, Per Tx Dose	6	6	—	—	$3,719,908.17	$3,972,717.47	$3,774,081.59	2025-07-29
J1413	HCPCS	Inj Delandistrogene Mox Rokl	6	6	—	—	$3,353,704.54	$3,581,626.21	$3,402,544.90	2025-07-29
J3394	HCPCS	Inj, Lovotibeglogene Autotem	6	6	—	—	$3,316,888.40	$3,542,308.00	$3,365,192.60	2025-07-29
J3393	HCPCS	Inj, Betibeglogene Autotemce	6	6	—	—	$2,975,926.54	$3,178,173.97	$3,019,265.27	2025-07-29
J3392	HCPCS	Inj, Exagamglogene Autotem	7	6	—	—	$2,353,920.80	$4,227,916.00	$2,399,628.00	2025-07-29
J3399	HCPCS	Onasemnogene Abeparvovec-xioi 4x8.3 Ml Kit	63	17	$2,175,000.00	$870,000.00 60% off	$866,362.50	$4,393,136.92	$1,647,780.00	2025-07-29
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	19	9	—	—	$337,950.15	$2,149,481.40	$873,798.32	2025-07-29
Q2057	HCPCS	Afamitresgene Autoleucel	7	6	—	—	$777,863.83	$1,397,134.06	$792,967.98	2025-07-29
Q2056	HCPCS	Ciltacabtagene Car-pos T	12	7	—	—	$558,369.09	$4,256,177.56	$692,478.25	2025-07-29
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	21	10	—	—	$252,661.51	$1,605,484.80	$642,697.50	2025-07-29
Q2054	HCPCS	Lisocabtagene Mara Car Pos T	12	7	—	—	$521,296.84	$4,958,265.28	$626,296.79	2025-07-29
Q2042	HCPCS	Tisagenlecleucel Car-pos T	11	7	—	—	$584,211.57	$1,431,002.99	$623,915.27	2025-07-29
Q2041	HCPCS	Axicabtagene Ciloleucel Car+	12	7	—	—	$507,567.43	$4,699,364.65	$618,997.57	2025-07-29
Q2053	HCPCS	Brexucabtagene Car Pos T	12	7	—	—	$493,999.51	$4,685,164.79	$612,599.14	2025-07-29
Q2055	HCPCS	Idecabtagene Vicleucel Car	11	7	—	—	$532,582.11	$1,357,132.84	$568,777.01	2025-07-29
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	21	10	—	—	$192,463.07	$1,221,521.40	$502,313.84	2025-07-29
5834	APR_DRG	Neonate With Ecmo	7	6	—	—	$423,060.57	$1,430,347.65	$423,060.57	2025-07-29
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	16	9	—	—	$212,936.99	$1,352,199.60	$369,086.32	2025-07-29
5833	APR_DRG	Neonate With Ecmo	7	6	—	—	$339,864.91	$1,149,067.09	$339,864.91	2025-07-29
5884	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	7	6	—	—	$335,114.87	$1,133,007.41	$335,114.87	2025-07-29
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …	21	10	—	—	$127,216.75	$805,358.70	$331,178.94	2025-07-29
7	MS_DRG	Lung Transplant	21	10	—	—	$117,733.98	$744,870.30	$290,922.21	2025-07-29
C9301	HCPCS	Apc	7	6	—	—	$280,865.55	$504,467.25	$286,319.25	2025-07-29
C2624	HCPCS	Hc Kit Impl Hrtmt 3 Str Lf	64	17	$413,792.00	$165,516.80 60% off	$37,526.62	$345,516.32	$281,461.32	2025-07-29
14	MS_DRG	Allogeneic Bone Marrow Transplant	21	10	—	—	$118,028.86	$746,751.30	$271,818.17	2025-07-29
C9741	HCPCS	Fee Schedule	1	1	—	—	$270,085.77	$270,085.77	$270,085.77	2025-07-29
L6700	HCPCS	Ue Add Ext Power Myoel	1	1	—	—	$264,723.77	$264,723.77	$264,723.77	2025-07-29
1614	APR_DRG	Implantable Heart Assist Systems	7	6	—	—	$259,459.24	$877,219.33	$259,459.24	2025-07-29
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	21	10	—	—	$99,423.43	$628,122.90	$259,425.78	2025-07-29
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	19	9	—	—	$98,299.30	$620,906.70	$255,448.69	2025-07-29
0424T	CPT	Fee Schedule	1	1	—	—	$247,481.06	$247,481.06	$247,481.06	2025-07-29
0312T	CPT	Fee Schedule	1	1	—	—	$247,481.06	$247,481.06	$247,481.06	2025-07-29
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	21	10	—	—	$96,114.47	$606,970.20	$245,470.95	2025-07-29
215	MS_DRG	Other Heart Assist System Implant	21	10	—	—	$95,626.57	$603,869.40	$242,264.41	2025-07-29
8414	APR_DRG	Extensive Third Degree Burns With Skin Graft	7	6	—	—	$233,572.39	$789,697.12	$233,572.39	2025-07-29
5832	APR_DRG	Neonate With Ecmo	7	6	—	—	$230,603.32	$779,658.85	$230,603.32	2025-07-29
5914	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	7	6	—	—	$228,798.59	$773,557.13	$228,798.59	2025-07-29
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	21	10	—	—	$87,193.77	$550,072.80	$226,202.48	2025-07-29
6094	APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	7	6	—	—	$224,131.26	$757,777.10	$224,131.26	2025-07-29
453	MS_DRG	DRG	9	5	—	—	$137,339.28	$294,195.20	$210,165.82	2025-07-29
5883	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	7	6	—	—	$204,273.20	$690,637.95	$204,273.20	2025-07-29
94	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	7	6	—	—	$201,739.46	$682,071.51	$201,739.46	2025-07-29
0775T	CPT	Fee Schedule	1	1	—	—	$200,363.31	$200,363.31	$200,363.31	2025-07-29
0809T	CPT	Fee Schedule	1	1	—	—	$200,363.31	$200,363.31	$200,363.31	2025-07-29
6314	APR_DRG	Neonate Birth Weight > 2499 Grams With Other Major Procedure	7	6	—	—	$199,825.96	$675,602.06	$199,825.96	2025-07-29
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	21	10	—	—	$76,632.44	$482,710.20	$198,501.11	2025-07-29
231	MS_DRG	Coronary Bypass With Ptca With Mcc	21	10	—	—	$76,674.44	$482,983.80	$192,468.20	2025-07-29
6304	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	7	6	—	—	$192,455.11	$650,681.58	$192,455.11	2025-07-29
5934	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	7	6	—	—	$189,950.99	$642,215.27	$189,950.99	2025-07-29
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	21	10	—	—	$72,985.70	$459,448.50	$189,774.42	2025-07-29
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	19	9	—	—	$71,790.08	$451,821.90	$186,624.50	2025-07-29
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	21	10	—	—	$70,799.08	$445,500.60	$183,200.78	2025-07-29
5831	APR_DRG	Neonate With Ecmo	7	6	—	—	$182,204.70	$616,025.43	$182,204.70	2025-07-29
J9226	HCPCS	Histrelin 50 Mg Kit	66	17	$240,347.99	$96,139.20 60% off	$20,166.02	$434,513.24	$182,087.64	2025-07-29
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	21	10	—	—	$70,094.04	$441,009.00	$181,351.52	2025-07-29
1613	APR_DRG	Implantable Heart Assist Systems	7	6	—	—	$180,889.59	$611,579.08	$180,889.59	2025-07-29
6034	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	7	6	—	—	$177,945.48	$601,625.18	$177,945.48	2025-07-29
44	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	7	6	—	—	$177,126.67	$598,856.82	$177,126.67	2025-07-29
222	MS_DRG	DRG	3	2	—	—	$119,632.41	$269,475.20	$174,404.80	2025-07-29
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	13	8	—	—	$94,559.63	$597,451.20	$173,203.28	2025-07-29
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	19	9	—	—	$64,102.53	$402,790.50	$166,371.31	2025-07-29
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	21	10	—	—	$63,115.11	$396,520.50	$163,046.45	2025-07-29
0316T	CPT	Fee Schedule	1	1	—	—	$162,900.93	$162,900.93	$162,900.93	2025-07-29
0431T	CPT	Fee Schedule	1	1	—	—	$162,900.93	$162,900.93	$162,900.93	2025-07-29
0426T	CPT	Fee Schedule	1	1	—	—	$162,900.93	$162,900.93	$162,900.93	2025-07-29
0427T	CPT	Fee Schedule	1	1	—	—	$162,900.93	$162,900.93	$162,900.93	2025-07-29
Q0480	HCPCS	Driver Pneumatic Vad, Rep	15	8	—	—	$99,999.91	$309,999.72	$161,612.00	2025-07-29
459	MS_DRG	DRG	9	5	—	—	$85,130.87	$215,417.60	$157,298.26	2025-07-29
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	21	10	—	—	$60,533.53	$380,030.40	$156,275.21	2025-07-29
0302T	CPT	Fee Schedule	1	1	—	—	$153,416.77	$153,416.77	$153,416.77	2025-07-29
850	MS_DRG	Acute Leukemia With Other Procedures	13	8	—	—	$83,269.13	$525,044.10	$152,522.65	2025-07-29
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	21	10	—	—	$58,742.78	$368,658.90	$151,578.23	2025-07-29
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	21	10	—	—	$58,659.67	$368,071.80	$150,965.82	2025-07-29
224	MS_DRG	DRG	3	2	—	—	$103,501.80	$235,590.40	$150,888.97	2025-07-29
0548T	CPT	Fee Schedule	1	1	—	—	$149,323.88	$149,323.88	$149,323.88	2025-07-29
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	21	10	—	—	$57,465.84	$360,462.30	$148,228.94	2025-07-29
6024	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	7	6	—	—	$146,993.25	$496,977.19	$146,993.25	2025-07-29
G2171	HCPCS	Fee Schedule	1	1	—	—	$145,850.73	$145,850.73	$145,850.73	2025-07-29
G2170	HCPCS	Fee Schedule	1	1	—	—	$145,850.73	$145,850.73	$145,850.73	2025-07-29
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	19	9	—	—	$56,305.06	$353,058.00	$145,828.56	2025-07-29
454	MS_DRG	DRG	9	5	—	—	$91,598.06	$195,139.20	$145,060.29	2025-07-29
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	21	10	—	—	$55,981.58	$350,994.60	$144,335.89	2025-07-29
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	21	10	—	—	$55,789.46	$349,791.90	$143,831.97	2025-07-29
28	MS_DRG	Spinal Procedures With Mcc	21	10	—	—	$55,278.33	$346,508.70	$142,491.32	2025-07-29
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	21	10	—	—	$54,888.73	$344,023.50	$141,469.42	2025-07-29
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	21	10	—	—	$54,888.73	$344,023.50	$141,469.42	2025-07-29
5891	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	7	6	—	—	$141,311.53	$477,767.55	$141,311.53	2025-07-29
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	21	10	—	—	$55,539.26	$348,173.10	$141,082.95	2025-07-29
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	21	10	—	—	$54,485.72	$341,452.80	$141,035.41	2025-07-29
226	MS_DRG	DRG	3	2	—	—	$95,834.79	$211,577.60	$139,711.70	2025-07-29
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	13	8	—	—	$75,483.28	$475,380.00	$138,261.45	2025-07-29
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	21	10	—	—	$53,533.15	$335,376.60	$137,913.88	2025-07-29
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	21	10	—	—	$52,980.02	$331,848.30	$136,463.07	2025-07-29
5892	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	7	6	—	—	$136,312.27	$460,865.30	$136,312.27	2025-07-29
5913	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	7	6	—	—	$135,976.80	$459,731.10	$135,976.80	2025-07-29
0387T	CPT	Fee Schedule	1	1	—	—	$135,256.58	$135,256.58	$135,256.58	2025-07-29
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	21	10	—	—	$52,239.23	$327,123.00	$135,116.95	2025-07-29
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	21	10	—	—	$54,114.88	$339,098.70	$135,108.63	2025-07-29
69715	CPT	Fee Schedule	1	1	—	—	$134,542.79	$134,542.79	$134,542.79	2025-07-29
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	21	10	—	—	$51,932.73	$325,167.90	$133,716.13	2025-07-29
223	MS_DRG	DRG	3	2	—	—	$90,825.44	$198,787.20	$132,408.87	2025-07-29
5933	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	7	6	—	—	$131,545.27	$444,748.29	$131,545.27	2025-07-29
C9746	HCPCS	Fee Schedule	1	1	—	—	$131,427.03	$131,427.03	$131,427.03	2025-07-29
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	16	9	—	—	$67,651.86	$425,430.90	$130,894.96	2025-07-29
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	21	10	—	—	$50,343.93	$315,056.10	$130,123.70	2025-07-29
834	MS_DRG	Acute Leukemia With Mcc	21	10	—	—	$50,343.93	$315,033.30	$129,548.86	2025-07-29
653	MS_DRG	Major Bladder Procedures With Mcc	21	10	—	—	$50,766.60	$317,729.40	$128,394.35	2025-07-29
405	MS_DRG	Pancreas, Liver And Shunt Procedures With Mcc	21	10	—	—	$49,462.85	$309,418.80	$127,237.87	2025-07-29
1612	APR_DRG	Implantable Heart Assist Systems	7	6	—	—	$126,694.88	$428,349.36	$126,694.88	2025-07-29
1611	APR_DRG	Implantable Heart Assist Systems	7	6	—	—	$126,694.88	$428,349.36	$126,694.88	2025-07-29
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	21	10	—	—	$49,215.33	$307,839.90	$126,588.64	2025-07-29
576	MS_DRG	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	21	10	—	—	$49,164.39	$307,509.30	$126,455.04	2025-07-29
33903	CPT	Hc Percutaneous Pulmonary Artery Revascularization By Stent Placement Initial Ab…	66	17	$167,118.00	$66,847.20 60% off	$6,077.00	$139,543.53	$125,137.96	2025-07-29
8	MS_DRG	Simultaneous Pancreas And Kidney Transplant	21	10	—	—	$49,573.66	$310,125.60	$124,791.74	2025-07-29
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	21	10	—	—	$48,283.31	$301,889.10	$124,144.05	2025-07-29
5893	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	7	6	—	—	$123,920.49	$418,969.28	$123,920.49	2025-07-29
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	21	10	—	—	$48,493.31	$303,234.30	$123,278.59	2025-07-29
5912	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	7	6	—	—	$123,011.39	$415,895.65	$123,011.39	2025-07-29
1604	APR_DRG	Major Cardiothoracic Repair Of Heart Anomaly	7	6	—	—	$122,623.58	$414,584.48	$122,623.58	2025-07-29
6074	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	7	6	—	—	$122,543.42	$414,313.47	$122,543.42	2025-07-29
11	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	21	10	—	—	$49,169.75	$307,549.20	$122,291.97	2025-07-29
43	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	7	6	—	—	$121,117.25	$409,491.66	$121,117.25	2025-07-29
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	21	10	—	—	$46,820.51	$292,569.60	$119,934.50	2025-07-29
466	MS_DRG	Revision Of Hip Or Knee Replacement With Mcc	21	10	—	—	$46,477.37	$290,375.10	$119,407.23	2025-07-29
326	MS_DRG	Stomach, Esophageal And Duodenal Procedures With Mcc	21	10	—	—	$46,337.97	$289,485.90	$119,041.60	2025-07-29
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	13	8	—	—	$64,421.54	$404,625.90	$117,999.85	2025-07-29
228	MS_DRG	Other Cardiothoracic Procedures With Mcc	21	10	—	—	$45,482.80	$284,025.30	$117,316.85	2025-07-29
853	MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	21	10	—	—	$45,643.65	$285,085.50	$117,220.47	2025-07-29
8634	APR_DRG	Neonatal Aftercare	7	6	—	—	$116,822.97	$394,972.90	$116,822.97	2025-07-29
225	MS_DRG	DRG	3	2	—	—	$79,816.98	$180,057.60	$116,360.30	2025-07-29
33902	CPT	Hc Percutaneous Pulmonary Artery Revascularization By Stent Placement Initial Ab…	66	17	$153,475.00	$61,390.00 60% off	$6,077.00	$157,175.04	$116,272.66	2025-07-29
54	APR_DRG	Tracheostomy With Mv >96 Hours Without Extensive Procedure	7	6	—	—	$116,250.84	$393,038.54	$116,250.84	2025-07-29
8424	APR_DRG	Burns With Skin Graft Except Extensive Third Degree Burns	7	6	—	—	$116,154.03	$392,711.24	$116,154.03	2025-07-29
837	MS_DRG	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	21	10	—	—	$45,696.37	$285,387.60	$114,885.15	2025-07-29
955	MS_DRG	Craniotomy For Multiple Significant Trauma	16	9	—	—	$61,969.53	$389,190.30	$114,803.01	2025-07-29
10	MS_DRG	Pancreas Transplant	21	10	—	—	$61,643.43	$454,438.20	$114,164.15	2025-07-29
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	16	9	—	—	$60,634.51	$380,674.50	$114,145.44	2025-07-29
239	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	21	10	—	—	$45,961.77	$287,080.50	$114,002.88	2025-07-29
5932	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	7	6	—	—	$113,951.44	$385,264.40	$113,951.44	2025-07-29
471	MS_DRG	Cervical Spinal Fusion With Mcc	21	10	—	—	$44,356.88	$276,849.00	$113,845.40	2025-07-29
6	MS_DRG	Liver Transplant Without Mcc	21	10	—	—	$44,284.50	$276,387.30	$113,655.55	2025-07-29
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	13	8	—	—	$60,865.05	$382,139.40	$111,485.49	2025-07-29
799	MS_DRG	Splenic Procedures With Mcc	21	10	—	—	$43,440.95	$271,006.50	$111,443.00	2025-07-29
981	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	21	10	—	—	$43,432.91	$270,995.10	$111,421.91	2025-07-29
227	MS_DRG	DRG	3	2	—	—	$76,203.41	$168,060.80	$111,092.31	2025-07-29
267	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	21	10	—	—	$42,993.26	$268,150.80	$110,758.05	2025-07-29
826	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	21	10	—	—	$43,625.92	$272,186.40	$109,755.16	2025-07-29
277	MS_DRG	Cardiac Defibrillator Implant Without Mcc	19	9	—	—	$42,521.45	$265,175.40	$109,515.03	2025-07-29
455	MS_DRG	DRG	9	5	—	—	$71,597.29	$153,312.00	$109,231.02	2025-07-29
6084	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	7	6	—	—	$108,552.87	$367,012.10	$108,552.87	2025-07-29
K1007	HCPCS	Bil Hkaf Pc S/d Micro Sensor	3	3	—	—	$91,031.93	$198,551.57	$108,131.37	2025-07-29
163	MS_DRG	Major Chest Procedures With Mcc	21	10	—	—	$42,139.88	$262,707.30	$108,030.43	2025-07-29
3034	APR_DRG	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	7	6	—	—	$107,657.45	$363,984.71	$107,657.45	2025-07-29
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	21	10	—	—	$41,991.55	$261,761.10	$107,641.36	2025-07-29
245	MS_DRG	Aicd Generator Procedures	21	10	—	—	$44,620.49	$278,530.50	$107,471.21	2025-07-29
329	MS_DRG	Major Small And Large Bowel Procedures With Mcc	21	10	—	—	$41,985.29	$261,726.90	$107,124.95	2025-07-29
1624	APR_DRG	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	7	6	—	—	$106,988.03	$361,721.43	$106,988.03	2025-07-29
823	MS_DRG	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	21	10	—	—	$42,768.08	$266,714.40	$106,771.56	2025-07-29
650	MS_DRG	Kidney Transplant With Hemodialysis With Mcc	19	9	—	—	$42,122.91	$262,599.00	$106,667.21	2025-07-29
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	19	9	—	—	$45,661.52	$285,165.30	$105,787.31	2025-07-29
856	MS_DRG	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	21	10	—	—	$41,267.74	$257,144.10	$105,028.36	2025-07-29
25	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Mcc	21	10	—	—	$40,916.56	$254,904.00	$104,734.27	2025-07-29
319	MS_DRG	Other Endovascular Cardiac Valve Procedures With Mcc	19	9	—	—	$40,206.16	$250,372.50	$103,415.30	2025-07-29
317	MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	13	8	—	—	$56,233.58	$352,602.00	$103,002.10	2025-07-29
901	MS_DRG	Wound Debridements For Injuries With Mcc	21	10	—	—	$40,543.04	$252,521.40	$102,642.43	2025-07-29
474	MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	21	10	—	—	$41,027.37	$255,610.80	$102,049.51	2025-07-29
458	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	21	10	—	—	$39,537.75	$246,108.90	$101,654.36	2025-07-29
6023	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	7	6	—	—	$100,216.11	$338,825.88	$100,216.11	2025-07-29
356	MS_DRG	Other Digestive System O.r. Procedures With Mcc	21	10	—	—	$39,070.41	$243,127.80	$99,979.48	2025-07-29
J9029	HCPCS	Instill Adstiladrin, Tx Dose	13	7	—	—	$63,830.02	$489,463.77	$98,880.00	2025-07-29
6114	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	7	6	—	—	$98,766.15	$333,923.66	$98,766.15	2025-07-29
5881	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	7	6	—	—	$98,616.47	$333,417.60	$98,616.47	2025-07-29
5882	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	7	6	—	—	$98,616.47	$333,417.60	$98,616.47	2025-07-29
323	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	19	9	—	—	$39,014.11	$242,774.40	$98,188.38	2025-07-29
C9752	HCPCS	Fee Schedule	1	1	—	—	$98,032.00	$98,032.00	$98,032.00	2025-07-29
31	MS_DRG	Ventricular Shunt Procedures With Mcc	21	10	—	—	$38,399.32	$238,847.10	$97,633.40	2025-07-29
269	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	21	10	—	—	$38,132.14	$237,142.80	$97,518.49	2025-07-29
33901	CPT	Hc Percutaneous Pulmonary Artery Revascularization By Stent Placement Initial No…	66	17	$128,552.00	$51,420.80 60% off	$6,077.00	$107,340.92	$97,281.63	2025-07-29
6303	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	7	6	—	—	$96,090.62	$324,877.83	$96,090.62	2025-07-29
236	MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	21	10	—	—	$37,697.85	$234,372.60	$95,845.14	2025-07-29
12	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	21	10	—	—	$37,622.79	$233,893.80	$94,984.21	2025-07-29
8413	APR_DRG	Extensive Third Degree Burns With Skin Graft	7	6	—	—	$92,784.61	$313,700.36	$92,784.61	2025-07-29
423	MS_DRG	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	21	10	—	—	$37,298.42	$231,824.70	$92,754.82	2025-07-29
628	MS_DRG	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	21	10	—	—	$36,210.92	$224,939.10	$92,479.32	2025-07-29
736	MS_DRG	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	21	10	—	—	$36,138.54	$224,426.10	$92,192.72	2025-07-29
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	13	8	—	—	$50,136.62	$313,796.40	$91,834.40	2025-07-29
273	MS_DRG	Percutaneous And Other Intracardiac Procedures With Mcc	21	10	—	—	$35,894.59	$222,870.00	$91,649.61	2025-07-29
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	13	8	—	—	$49,836.37	$311,795.70	$91,284.44	2025-07-29
34	MS_DRG	Carotid Artery Stent Procedures With Mcc	21	10	—	—	$35,701.57	$221,644.50	$91,143.35	2025-07-29
93581	CPT	Hc Percutaneous Transcatheter Closure Congenital Ventricular Septal Defect W/imp…	66	17	$120,281.00	$48,112.40 60% off	$7,141.83	$154,886.08	$91,124.89	2025-07-29
616	MS_DRG	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	21	10	—	—	$35,489.79	$220,299.30	$90,587.87	2025-07-29
22862	CPT	Rev Rplcm Rthrp 1ntrspc Lmbr	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
22819	CPT	Kyphectomy 3 Or More	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
22532	CPT	Arthrd Lat Xtrcvtry Tq Thrc	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
22533	CPT	Arthrd Lat Xtrcvtry Tq Lmbr	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
22548	CPT	Arthrd Ant Toral/xoral C1-c2	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
27295	CPT	Amputation Of Leg At Hip	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
27591	CPT	Amputate Leg At Thigh	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
27280	CPT	Arthr Si Jt Opn B1grf Instrm	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
27284	CPT	Arthrodesis Hip Joint	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
22861	CPT	Rev Rplcm Arthrp 1ntrspc Crv	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
27592	CPT	Amputate Leg At Thigh	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
20808	CPT	Replantation Hand Complete	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
22810	CPT	Arthrd Ant Dfrm 4-7 Vrt Sgm	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
27286	CPT	Arthrd Hip Jt Sbtrchc Osteot	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
22818	CPT	Kyphectomy 1-2 Segments	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
22610	CPT	Arthrd Pst Tq 1ntrspc Thrc	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
27290	CPT	Amputation Of Leg At Hip	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
27880	CPT	Amputation Of Lower Leg	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
22849	CPT	Reinsert Spinal Fixation	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
27590	CPT	Amputate Leg At Thigh	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
22812	CPT	Arthrd Ant Dfrm 8+ Vrt Sgm	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
22590	CPT	Arthrd Pst Tq Craniocervical	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
22804	CPT	Arthrd Pst Dfrm 13+ Vrt Sgm	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
22800	CPT	Arthrd Pst Dfrm<6 Vrt Sgm	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
20802	CPT	Replantation Arm Complete	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
22802	CPT	Arthrd Pst Dfrm 7-12 Vrt Sgm	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
20838	CPT	Replantation Foot Complete	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
22595	CPT	Arthrd Pst Tq Atlas-axis	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
22808	CPT	Arthrd Ant Dfrm 2-3 Vrt Sgm	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
22857	CPT	Tot Disc Arthrp 1ntrspc Lmbr	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
22556	CPT	Arthrd Ant Ntrbd Min Dsc Thc	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
20805	CPT	Replant Forearm Complete	3	3	—	—	$41,021.76	$145,193.39	$90,281.73	2025-07-29
166	MS_DRG	Other Respiratory System O.r. Procedures With Mcc	21	10	—	—	$35,358.43	$219,507.00	$90,243.33	2025-07-29
1784	APR_DRG	External Heart Assist Systems	7	6	—	—	$89,892.95	$303,923.79	$89,892.95	2025-07-29
6022	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	7	6	—	—	$89,818.52	$303,672.15	$89,818.52	2025-07-29
6093	APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	7	6	—	—	$89,631.92	$303,041.26	$89,631.92	2025-07-29
140	MS_DRG	Major Head And Neck Procedures With Mcc	19	9	—	—	$38,744.25	$241,053.00	$89,605.20	2025-07-29
93	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	7	6	—	—	$89,288.27	$301,879.39	$89,288.27	2025-07-29
C9750	HCPCS	Fee Schedule	1	1	—	—	$89,194.11	$89,194.11	$89,194.11	2025-07-29
24	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	21	10	—	—	$34,924.15	$216,679.80	$89,104.24	2025-07-29
1634	APR_DRG	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	7	6	—	—	$88,998.89	$300,901.02	$88,998.89	2025-07-29
5911	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	7	6	—	—	$88,691.21	$299,860.77	$88,691.21	2025-07-29
C9755	HCPCS	Fee Schedule	1	1	—	—	$88,471.72	$88,471.72	$88,471.72	2025-07-29
C9754	HCPCS	Fee Schedule	1	1	—	—	$88,471.72	$88,471.72	$88,471.72	2025-07-29
40	MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	21	10	—	—	$34,659.65	$214,992.60	$88,410.48	2025-07-29
907	MS_DRG	Other O.r. Procedures For Injuries With Mcc	21	10	—	—	$36,550.48	$227,059.50	$88,215.38	2025-07-29
673	MS_DRG	Other Kidney And Urinary Tract Procedures With Mcc	21	10	—	—	$38,390.38	$238,830.00	$87,705.47	2025-07-29
622	MS_DRG	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	21	10	—	—	$34,390.68	$213,408.00	$87,705.00	2025-07-29
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	21	10	—	—	$54,074.67	$338,865.00	$86,771.10	2025-07-29
460	MS_DRG	DRG	9	5	—	—	$56,605.87	$125,846.40	$86,754.41	2025-07-29
C9775	HCPCS	Hc Revascularization,endovascular,open/percutaneous,tibial/peroneal Artery(ies),…	59	17	$114,169.00	$45,667.60 60% off	$20,544.18	$154,886.08	$86,494.43	2025-07-29
C9773	HCPCS	Hc Revascularization,endovascular,open Or Percutaneous,tibial/peroneal Artery(ie…	59	17	$114,169.00	$45,667.60 60% off	$20,544.18	$154,886.08	$86,494.43	2025-07-29
C9774	HCPCS	Hc Revascularization,endovascular, Open Or Percutaneous,tibial/peroneal Artery(i…	59	17	$114,169.00	$45,667.60 60% off	$20,544.18	$154,886.08	$86,494.43	2025-07-29
0304T	CPT	Fee Schedule	1	1	—	—	$86,134.90	$86,134.90	$86,134.90	2025-07-29
1674	APR_DRG	Other Cardiothoracic And Thoracic Vascular Procedures	7	6	—	—	$86,133.16	$291,212.13	$86,133.16	2025-07-29
450	MS_DRG	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	13	8	—	—	$46,973.31	$293,532.90	$86,040.22	2025-07-29
6033	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	7	6	—	—	$85,787.89	$290,044.78	$85,787.89	2025-07-29
739	MS_DRG	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	21	10	—	—	$36,525.46	$226,899.90	$85,767.79	2025-07-29
94	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System With Mcc	21	10	—	—	$33,556.96	$207,958.80	$85,518.23	2025-07-29
42	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	7	6	—	—	$84,837.03	$286,829.96	$84,837.03	2025-07-29
335	MS_DRG	Peritoneal Adhesiolysis With Mcc	21	10	—	—	$33,330.88	$206,562.30	$84,788.28	2025-07-29
0266T	CPT	Apc	13	8	—	—	$51,484.82	$256,030.34	$84,301.34	2025-07-29
33276	CPT	Insj Phrnc Nrv Stim Sys	13	8	—	—	$51,484.82	$411,754.58	$84,301.34	2025-07-29
36836	CPT	Hc Percutaneous Fistula Creation Upper Extremity Single Access Artery And Vein I…	66	17	$110,918.00	$44,367.20 60% off	$2,492.96	$157,175.04	$84,031.48	2025-07-29
0620T	CPT	Hc Endovascular Venous Arterialization Tibial Or Peroneal Vein Intravascular Ste…	59	17	$110,918.00	$44,367.20 60% off	$27,500.50	$168,669.88	$84,031.48	2025-07-29
36837	CPT	Hc Percutaneous Fistula Creation Upper Extremity Separate Access Artery And Vei…	66	17	$110,918.00	$44,367.20 60% off	$2,492.96	$157,175.04	$84,031.48	2025-07-29
97	MS_DRG	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	21	10	—	—	$32,984.17	$204,333.60	$84,015.85	2025-07-29
518	MS_DRG	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	21	10	—	—	$32,978.81	$204,276.60	$84,001.79	2025-07-29
6254	APR_DRG	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	7	6	—	—	$83,655.41	$282,834.97	$83,655.41	2025-07-29
265	MS_DRG	Aicd Lead Procedures	21	10	—	—	$32,828.68	$203,313.30	$83,608.03	2025-07-29
33900	CPT	Hc Percutaneous Pulmonary Artery Revascularization By Stent Placement Initial No…	66	17	$110,187.00	$44,074.80 60% off	$6,077.00	$97,172.26	$83,477.68	2025-07-29
22	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	21	10	—	—	$32,499.84	$201,232.80	$83,112.68	2025-07-29
6804	APR_DRG	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	7	6	—	—	$82,968.73	$280,513.31	$82,968.73	2025-07-29
3033	APR_DRG	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	7	6	—	—	$82,673.45	$279,515.00	$82,673.45	2025-07-29
495	MS_DRG	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	21	10	—	—	$32,412.27	$200,657.10	$82,515.82	2025-07-29
1654	APR_DRG	Coronary Bypass With Ami Or Complex Principal Diagnosis	7	6	—	—	$82,137.51	$277,703.01	$82,137.51	2025-07-29
414	MS_DRG	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	21	10	—	—	$32,262.15	$199,705.20	$82,122.06	2025-07-29
492	MS_DRG	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc	21	10	—	—	$32,685.71	$202,407.00	$82,110.63	2025-07-29
408	MS_DRG	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	21	10	—	—	$32,239.81	$199,562.70	$82,063.47	2025-07-29
651	MS_DRG	Kidney Transplant With Hemodialysis Without Mcc	19	9	—	—	$31,982.45	$197,915.40	$81,749.60	2025-07-29
53	APR_DRG	Tracheostomy With Mv >96 Hours Without Extensive Procedure	7	6	—	—	$81,714.20	$276,271.80	$81,714.20	2025-07-29
6134	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	7	6	—	—	$81,475.90	$275,466.15	$81,475.90	2025-07-29
802	MS_DRG	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	21	10	—	—	$32,985.95	$204,322.20	$81,368.28	2025-07-29
332	MS_DRG	Rectal Resection With Mcc	21	10	—	—	$31,948.50	$197,704.50	$81,299.39	2025-07-29
9104	APR_DRG	Craniotomy For Multiple Significant Trauma	7	6	—	—	$81,187.87	$274,492.31	$81,187.87	2025-07-29
93591	CPT	C Percutaneous Transcatheter Closure Paravalvular Leal:initial Occlusion Device,…	59	17	$107,090.00	$42,836.00 60% off	$20,544.18	$154,886.08	$81,131.38	2025-07-29
0238T	CPT	C Transluminal Peripheral Atherectomy,open Or Percutaneous,iliac Artery Ea Vesse…	66	17	$107,019.00	$42,807.60 60% off	$7,751.71	$154,886.08	$81,077.60	2025-07-29
6124	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	7	6	—	—	$81,071.86	$274,100.11	$81,071.86	2025-07-29
574	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Cc	21	10	—	—	$31,914.54	$197,487.90	$80,775.36	2025-07-29
271	MS_DRG	Other Major Cardiovascular Procedures With Cc	21	10	—	—	$31,731.36	$196,330.80	$80,729.85	2025-07-29
93590	CPT	C Percutaneous Transcatheter Closure Paravalvular Leak,intial Occlusion Device, …	59	17	$106,222.00	$42,488.80 60% off	$20,544.18	$154,886.08	$80,473.79	2025-07-29
467	MS_DRG	Revision Of Hip Or Knee Replacement With Cc	21	10	—	—	$31,559.79	$195,219.30	$80,279.84	2025-07-29
987	MS_DRG	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	21	10	—	—	$32,252.32	$199,671.00	$80,085.19	2025-07-29
477	MS_DRG	Biopsies Of Musculoskeletal System And Connective Tissue With Mcc	21	10	—	—	$31,683.10	$196,011.60	$79,902.57	2025-07-29
9114	APR_DRG	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	7	6	—	—	$79,698.53	$269,456.92	$79,698.53	2025-07-29
252	MS_DRG	Other Vascular Procedures With Mcc	21	10	—	—	$31,606.25	$195,521.40	$79,542.07	2025-07-29
242	MS_DRG	Permanent Cardiac Pacemaker Implant With Mcc	21	10	—	—	$31,263.11	$193,344.00	$79,501.70	2025-07-29
1834	APR_DRG	Percutaneous Structural Cardiac Procedures	7	6	—	—	$79,231.09	$267,876.53	$79,231.09	2025-07-29
29	MS_DRG	Spinal Procedures With Cc Or Spinal Neurostimulators	21	10	—	—	$30,947.68	$191,320.50	$78,674.33	2025-07-29
260	MS_DRG	Cardiac Pacemaker Revision Except Device Replacement With Mcc	21	10	—	—	$31,390.00	$194,187.60	$78,626.60	2025-07-29
6073	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	7	6	—	—	$78,610.73	$265,779.14	$78,610.73	2025-07-29
6904	APR_DRG	Acute Leukemia	7	6	—	—	$78,584.42	$265,690.19	$78,584.42	2025-07-29
37	MS_DRG	Extracranial Procedures With Mcc	21	10	—	—	$30,627.77	$189,279.90	$77,835.25	2025-07-29
143	MS_DRG	Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc	19	9	—	—	$30,457.99	$188,196.90	$77,733.33	2025-07-29
264	MS_DRG	Other Circulatory System O.r. Procedures	21	10	—	—	$32,184.41	$199,209.30	$77,459.72	2025-07-29
L7181	HCPCS	Electronic Elbo Simultaneous	16	9	—	—	$46,104.76	$344,192.62	$77,443.42	2025-07-29
904	MS_DRG	Skin Grafts For Injuries With Cc/mcc	21	10	—	—	$35,454.94	$220,071.30	$77,227.30	2025-07-29
3044	APR_DRG	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	7	6	—	—	$77,099.72	$260,670.50	$77,099.72	2025-07-29

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