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

Saint Francis Hospital

Charleston, WV · CCN 510031 · Rates published

Your selected procedure

You selected G0121 (HCPCS)

HC COLORECTAL CANCER SCRN, COLONOSCOPY NOT HIGH RISK - G0121 - 75000071

This hospital’s price: $1,021 across 32 payers · range $184-$2,193

Source: https://saintfrancisevanston.org/wp-content/uploads/2026/09/0006470_SaintFrancisHospital_standardcharges.json · observed 2026-09-01

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.

18,665 distinct procedures filed
52 distinct payers
389,001 rate rows
2026-09-01 last MRF observed
Data quality

349,941 of 389,001 rate rows are consumer-grade (90.0%)

39,060 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 39,008
placeholder amount (≤ $0.02) — excluded from medians 32
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 12
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 6
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://saintfrancis.com/finance/sfh-cms-hpt
Found on page https://www.saintfrancis.com/patients-and-guests/billing-and-insurance/standard-hospital-charges
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-10-22
Content fingerprint 5d9bd000bedffa21… · 34,889,316 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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 3 $4,505,000.00 $4,990,350.00 $4,640,150.00 nat. median
$4,505,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 1 $4,229,400.00 $4,229,400.00 $4,229,400.00 nat. median
$3,710,000
1.1× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 3 $3,685,266.67 $4,201,204.00 $3,795,824.67 nat. median
$3,705,478
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 3 $3,316,462.59 $3,790,011.97 $3,415,956.47 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 3 $3,248,445.72 $3,717,944.70 $3,345,899.09 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 3 $2,945,740.00 $3,363,782.80 $3,034,112.20 nat. median
$2,994,107
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 3 $2,455,110.60 $2,795,411.78 $2,528,763.92 nat. median
$2,467,386
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 3 $2,332,000.00 $2,658,480.00 $2,401,960.00 nat. median
$2,401,965
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 4 $770,620.00 $1,849,488.00 $1,267,669.90 nat. median
$813,967
1.6× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 4 $591,726.20 $1,420,142.88 $951,823.96 nat. median
$739,258
1.3× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 4 $565,868.94 $1,358,085.47 $910,082.94 nat. median
$646,415
1.4× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 4 $557,317.93 $1,337,563.04 $875,712.60 nat. median
$622,450
1.4× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 4 $562,538.19 $1,350,091.64 $863,907.78 nat. median
$640,950
1.3× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $533,230.17 $1,279,752.41 $844,407.38 nat. median
$608,239
1.4× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 4 $489,304.61 $1,174,331.06 $805,244.49 nat. median
$591,721
1.4× median
C9301
HCPCS 		Obecabtagene Car Pos T 1 $598,237.50 $598,237.50 $598,237.50 nat. median
$459,112
1.3× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 30 $317,303.10 $844,482.84 $371,597.93 nat. median
$359,454
1.0× median
8414
APR_DRG 		Extensive 3rd Degree Burns W Skin Graft - Soi : 4 7 $328,418.79 $344,839.73 $328,418.79 nat. median
$155,939
outlier · 2.1×
24
APR_DRG 		Heart &or Lung Transplant - Soi : 4 7 $325,869.50 $342,162.98 $325,869.50 nat. median
$241,437
1.3× median
5834
APR_DRG 		Neonate W Ecmo - Soi : 4 7 $314,247.56 $329,959.94 $314,247.56 nat. median
$307,206
1.0× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 3 $278,250.00 $667,800.00 $308,227.50 nat. median
$319,951
1.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 33 $33,000.00 $898,819.08 $268,175.47 nat. median
$249,036
1.1× median
5884
APR_DRG 		Neonate Bwt <1500g W Major Procedure - Soi : 4 7 $257,768.22 $270,656.63 $257,768.22 nat. median
$247,214
1.0× median
5833
APR_DRG 		Neonate W Ecmo - Soi : 3 7 $227,879.86 $239,273.85 $227,879.86 nat. median
$244,017
0.9× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant- Soi : 4 7 $213,634.82 $224,316.56 $213,634.82 nat. median
$170,082
1.3× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 36 $4,555.79 $737,889.25 $209,377.61 nat. median
$190,559
1.1× median
14
APR_DRG 		Liver Transplant &or Intestinal Transplant - Soi : 4 7 $208,315.93 $218,731.73 $208,315.93 nat. median
$136,566
1.5× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 33 $157,417.02 $417,530.38 $204,642.13 nat. median
$198,418
1.0× median
23
APR_DRG 		Heart &or Lung Transplant - Soi : 3 7 $201,512.93 $211,588.58 $201,512.93 nat. median
$110,944
1.8× median
6304
APR_DRG 		Neonate Birthwt >2499g W Major Cardiovascular Procedure - Soi : 4 7 $187,097.74 $196,452.63 $187,097.74 nat. median
$154,011
1.2× median
64
APR_DRG 		Pancreas Transplant - Soi : 4 7 $183,967.17 $193,165.53 $183,967.17 nat. median
$91,106
outlier · 2.0×
5832
APR_DRG 		Neonate W Ecmo - Soi : 2 7 $170,423.10 $178,944.25 $170,423.10 nat. median
$159,249
1.1× median
5934
APR_DRG 		Neonate Birthwt 750-999g Wo Major Procedure - Soi : 4 7 $168,113.95 $176,519.64 $168,113.95 nat. median
$151,838
1.1× median
8424
APR_DRG 		Burns With Skin Graft Except Extensive 3rd Degree Burns - Soi : 4 7 $165,973.92 $174,272.61 $165,973.92 nat. median
$82,180
outlier · 2.0×
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 3 $111,492.17 $267,581.21 $163,959.00 nat. median
$111,503
1.5× median
5914
APR_DRG 		Neonate Birthwt 500-749g Wo Major Procedure - Soi : 4 7 $162,341.78 $170,458.87 $162,341.78 nat. median
$162,342
1.0× median
6094
APR_DRG 		Neonate Bwt 1500-2499g W Major Procedure - Soi : 4 7 $161,306.22 $169,371.53 $161,306.22 nat. median
$165,000
1.0× median
1614
APR_DRG 		Implantable Heart Assist Systems- Soi : 4 7 $160,037.03 $168,038.88 $160,037.03 nat. median
$202,993
0.8× median
6314
APR_DRG 		Neonate Birthwt >2499g W Other Major Procedure - Soi : 4 7 $154,861.09 $162,604.15 $154,861.09 nat. median
$133,164
1.2× median
5883
APR_DRG 		Neonate Bwt <1500g W Major Procedure - Soi : 3 7 $152,045.70 $159,647.99 $152,045.70 nat. median
$175,204
0.9× median
5882
APR_DRG 		Neonate Bwt <1500g W Major Procedure - Soi : 2 7 $150,994.10 $158,543.81 $150,994.10 nat. median
$145,061
1.0× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 1 $146,886.05 $200,432.87 $149,730.45 nat. median
$70,732
outlier · 2.1×
22
APR_DRG 		Heart &or Lung Transplant - Soi : 2 7 $149,544.46 $157,021.68 $149,544.46 nat. median
$92,229
1.6× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 1 $139,825.05 $139,825.05 $139,825.05 nat. median
$96,983
1.4× median
5831
APR_DRG 		Neonate W Ecmo - Soi : 1 7 $139,037.11 $145,988.96 $139,037.11 nat. median
$146,500
0.9× median
6034
APR_DRG 		Neonate Birthwt 1000-1249g W Or Wo Other Significant Condition - Soi : 4 7 $135,135.40 $141,892.17 $135,135.40 nat. median
$107,681
1.3× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 35 $2,568.53 $359,111.64 $133,247.82 nat. median
$126,695
1.1× median
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 $127,948.33 $174,591.48 $130,426.01 nat. median
$47,543
outlier · 2.7×
63
APR_DRG 		Pancreas Transplant - Soi : 3 7 $129,356.02 $135,823.82 $129,356.02 nat. median
$73,580
1.8× median
9104
APR_DRG 		Craniotomy For Multiple Significant Trauma - Soi : 4 7 $128,700.05 $135,135.05 $128,700.05 nat. median
$57,768
outlier · 2.2×

Other procedures at this hospital

Browse this hospital's 18,665 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
             
J3391 HCPCS Inj, Atidarsagene Autotemcel 3 3 — — $4,505,000.00 $4,990,350.00 $4,640,150.00 2026-04-01
J1414 HCPCS Inj, Beqvez, Per Tx Dose 1 1 — — $4,229,400.00 $4,229,400.00 $4,229,400.00 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 3 3 — — $3,685,266.67 $4,201,204.00 $3,795,824.67 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 3 3 — — $3,316,462.59 $3,790,011.97 $3,415,956.47 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 3 3 — — $3,248,445.72 $3,717,944.70 $3,345,899.09 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 3 3 — — $2,945,740.00 $3,363,782.80 $3,034,112.20 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 3 3 — — $2,455,110.60 $2,795,411.78 $2,528,763.92 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 3 3 — — $2,332,000.00 $2,658,480.00 $2,401,960.00 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 6 4 — — $770,620.00 $1,849,488.00 $1,267,669.90 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 6 4 — — $591,726.20 $1,420,142.88 $951,823.96 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 6 4 — — $565,868.94 $1,358,085.47 $910,082.94 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 6 4 — — $557,317.93 $1,337,563.04 $875,712.60 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 6 4 — — $562,538.19 $1,350,091.64 $863,907.78 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 6 4 — — $533,230.17 $1,279,752.41 $844,407.38 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 6 4 — — $489,304.61 $1,174,331.06 $805,244.49 2026-04-01
C9301 HCPCS Obecabtagene Car Pos T 1 1 — — $598,237.50 $598,237.50 $598,237.50 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 90 30 — $425,102.00 $317,303.10 $844,482.84 $371,597.93 2026-09-01
8414 APR_DRG Extensive 3rd Degree Burns W Skin Graft - Soi : 4 14 7 — — $328,418.79 $344,839.73 $328,418.79 2026-09-01
24 APR_DRG Heart &or Lung Transplant - Soi : 4 14 7 — — $325,869.50 $342,162.98 $325,869.50 2026-09-01
5834 APR_DRG Neonate W Ecmo - Soi : 4 14 7 — — $314,247.56 $329,959.94 $314,247.56 2026-09-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 5 3 — — $278,250.00 $667,800.00 $308,227.50 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 105 33 — $276,172.00 $33,000.00 $898,819.08 $268,175.47 2026-09-01
5884 APR_DRG Neonate Bwt <1500g W Major Procedure - Soi : 4 14 7 — — $257,768.22 $270,656.63 $257,768.22 2026-09-01
5833 APR_DRG Neonate W Ecmo - Soi : 3 14 7 — — $227,879.86 $239,273.85 $227,879.86 2026-09-01
74 APR_DRG Allogeneic Bone Marrow Transplant- Soi : 4 14 7 — — $213,634.82 $224,316.56 $213,634.82 2026-09-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 113 36 — $209,377.00 $4,555.79 $737,889.25 $209,377.61 2026-09-01
14 APR_DRG Liver Transplant &or Intestinal Transplant - Soi : 4 14 7 — — $208,315.93 $218,731.73 $208,315.93 2026-09-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 99 33 — $210,608.00 $157,417.02 $417,530.38 $204,642.13 2026-09-01
23 APR_DRG Heart &or Lung Transplant - Soi : 3 14 7 — — $201,512.93 $211,588.58 $201,512.93 2026-09-01
6304 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure - Soi : 4 14 7 — — $187,097.74 $196,452.63 $187,097.74 2026-09-01
64 APR_DRG Pancreas Transplant - Soi : 4 14 7 — — $183,967.17 $193,165.53 $183,967.17 2026-09-01
5832 APR_DRG Neonate W Ecmo - Soi : 2 14 7 — — $170,423.10 $178,944.25 $170,423.10 2026-09-01
5934 APR_DRG Neonate Birthwt 750-999g Wo Major Procedure - Soi : 4 14 7 — — $168,113.95 $176,519.64 $168,113.95 2026-09-01
8424 APR_DRG Burns With Skin Graft Except Extensive 3rd Degree Burns - Soi : 4 14 7 — — $165,973.92 $174,272.61 $165,973.92 2026-09-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 5 3 — — $111,492.17 $267,581.21 $163,959.00 2026-04-01
5914 APR_DRG Neonate Birthwt 500-749g Wo Major Procedure - Soi : 4 14 7 — — $162,341.78 $170,458.87 $162,341.78 2026-09-01
6094 APR_DRG Neonate Bwt 1500-2499g W Major Procedure - Soi : 4 14 7 — — $161,306.22 $169,371.53 $161,306.22 2026-09-01
1614 APR_DRG Implantable Heart Assist Systems- Soi : 4 14 7 — — $160,037.03 $168,038.88 $160,037.03 2026-09-01
6314 APR_DRG Neonate Birthwt >2499g W Other Major Procedure - Soi : 4 14 7 — — $154,861.09 $162,604.15 $154,861.09 2026-09-01
5883 APR_DRG Neonate Bwt <1500g W Major Procedure - Soi : 3 14 7 — — $152,045.70 $159,647.99 $152,045.70 2026-09-01
5882 APR_DRG Neonate Bwt <1500g W Major Procedure - Soi : 2 14 7 — — $150,994.10 $158,543.81 $150,994.10 2026-09-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 3 1 — — $146,886.05 $200,432.87 $149,730.45 2026-04-01
22 APR_DRG Heart &or Lung Transplant - Soi : 2 14 7 — — $149,544.46 $157,021.68 $149,544.46 2026-09-01
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 1 1 — — $139,825.05 $139,825.05 $139,825.05 2026-04-01
5831 APR_DRG Neonate W Ecmo - Soi : 1 14 7 — — $139,037.11 $145,988.96 $139,037.11 2026-09-01
6034 APR_DRG Neonate Birthwt 1000-1249g W Or Wo Other Significant Condition - Soi : 4 14 7 — — $135,135.40 $141,892.17 $135,135.40 2026-09-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 108 35 — $136,932.00 $2,568.53 $359,111.64 $133,247.82 2026-09-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 3 1 — — $127,948.33 $174,591.48 $130,426.01 2026-04-01
63 APR_DRG Pancreas Transplant - Soi : 3 14 7 — — $129,356.02 $135,823.82 $129,356.02 2026-09-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma - Soi : 4 14 7 — — $128,700.05 $135,135.05 $128,700.05 2026-09-01
21 APR_DRG Heart &or Lung Transplant - Soi : 1 14 7 — — $128,199.25 $134,609.21 $128,199.25 2026-09-01
73 APR_DRG Allogeneic Bone Marrow Transplant- Soi : 3 14 7 — — $125,900.68 $132,195.71 $125,900.68 2026-09-01
7 MS_DRG Lung Transplant 99 33 — $128,078.00 $95,898.49 $253,254.11 $124,668.04 2026-09-01
1613 APR_DRG Implantable Heart Assist Systems- Soi : 3 14 7 — — $122,604.81 $128,735.05 $122,604.81 2026-09-01
4404 APR_DRG Kidney Transplant - Soi : 4 14 7 — — $122,395.95 $128,515.75 $122,395.95 2026-09-01
9114 APR_DRG Extensive Abdominalthoracic Procedures For Mult Significant Trauma - Soi : 4 14 7 — — $121,588.44 $127,667.86 $121,588.44 2026-09-01
8413 APR_DRG Extensive 3rd Degree Burns W Skin Graft - Soi : 3 14 7 — — $120,526.09 $126,552.39 $120,526.09 2026-09-01
6024 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Syndoth Maj Resp Or Maj Anom - Soi : 4 14 7 — — $120,504.40 $126,529.62 $120,504.40 2026-09-01
13 APR_DRG Liver Transplant &or Intestinal Transplant - Soi : 3 14 7 — — $120,433.57 $126,455.25 $120,433.57 2026-09-01
J7330 HCPCS Cultured Chondrocytes Implnt 2 2 — — $69,113.10 $169,820.76 $119,466.93 2026-04-01
9124 APR_DRG Musculoskeletal & Other Procedures For Multiple Significant Trauma - Soi : 4 14 7 — — $118,133.66 $124,040.34 $118,133.66 2026-09-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 3 1 — — $110,696.45 $151,050.47 $112,840.05 2026-04-01
62 APR_DRG Pancreas Transplant - Soi : 2 14 7 — — $112,293.78 $117,908.47 $112,293.78 2026-09-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 99 33 — $112,178.00 $84,046.35 $395,913.32 $109,260.26 2026-09-01
209 MS_DRG Complex Aortic Arch Procedures 15 7 — — $83,951.14 $221,350.45 $109,136.48 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 93 30 — $118,919.00 $89,070.91 $239,407.93 $108,116.91 2026-09-01
84 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy- Soi : 4 14 7 — — $108,069.03 $113,472.48 $108,069.03 2026-09-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 19 8 — — $2,382.98 $215,530.59 $106,303.22 2026-04-01
204 APR_DRG Open Craniotomy For Trauma- Soi : 4 14 7 — — $104,978.89 $110,227.83 $104,978.89 2026-09-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 3 1 — — $102,496.49 $139,861.24 $104,481.30 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 6 4 — — $63,342.28 $152,021.48 $104,133.98 2026-04-01
L8702 HCPCS Pow Ue Rom Dev Ewhf Uprt Cus 5 3 — — $68,801.71 $165,124.10 $101,178.99 2026-04-01
12 APR_DRG Liver Transplant &or Intestinal Transplant - Soi : 2 14 7 — — $100,937.80 $105,984.69 $100,937.80 2026-09-01
44 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure - Soi : 4 14 7 — — $100,287.33 $105,301.70 $100,287.33 2026-09-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 3 1 — — $97,965.25 $133,678.16 $99,862.31 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 99 33 — $102,144.00 $76,566.99 $351,213.20 $99,537.09 2026-09-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 3 1 — — $97,138.92 $132,550.59 $99,019.98 2026-04-01
5933 APR_DRG Neonate Birthwt 750-999g Wo Major Procedure - Soi : 3 14 7 — — $98,982.06 $103,931.16 $98,982.06 2026-09-01
72 APR_DRG Allogeneic Bone Marrow Transplant- Soi : 2 14 7 — — $98,480.41 $103,404.43 $98,480.41 2026-09-01
1612 APR_DRG Implantable Heart Assist Systems- Soi : 2 14 7 — — $98,441.06 $103,363.11 $98,441.06 2026-09-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo)- Soi : 4 14 7 — — $98,183.88 $103,093.07 $98,183.88 2026-09-01
215 MS_DRG Other Heart Assist System Implant 102 34 — $98,671.00 $73,978.17 $294,808.80 $97,421.73 2026-09-01
212 MS_DRG Concomitant Aortic And Mitral Valveâ Procedures 96 31 — $107,681.00 $78,181.44 $221,617.92 $97,387.57 2026-09-01
A9699 HCPCS Radiopharm Rx Agent Noc 1 1 — — $97,225.26 $97,225.26 $97,225.26 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 104 34 — $96,960.00 $2,004.81 $230,315.95 $95,736.77 2026-09-01
5881 APR_DRG Neonate Bwt <1500g W Major Procedure - Soi : 1 14 7 — — $93,829.52 $98,521.00 $93,829.52 2026-09-01
1611 APR_DRG Implantable Heart Assist Systems- Soi : 1 14 7 — — $93,518.65 $98,194.58 $93,518.65 2026-09-01
A9543 HCPCS Y90 Ibritumomab, Rx 6 4 — — $56,824.55 $136,378.92 $93,476.38 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 6 4 — — $55,272.32 $132,653.58 $93,182.59 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 3 1 — — $91,048.51 $124,239.95 $92,811.64 2026-04-01
6074 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Syndoth Maj Resp Or Maj Anom - Soi : 4 14 7 — — $92,558.08 $97,185.99 $92,558.08 2026-09-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 16 8 — — $67,040.01 $176,191.74 $91,509.61 2026-04-01
11 APR_DRG Liver Transplant &or Intestinal Transplant - Soi : 1 14 7 — — $89,619.74 $94,100.73 $89,619.74 2026-09-01
61 APR_DRG Pancreas Transplant - Soi : 1 14 7 — — $88,267.95 $92,681.35 $88,267.95 2026-09-01
71 APR_DRG Allogeneic Bone Marrow Transplant- Soi : 1 14 7 — — $87,689.13 $92,073.59 $87,689.13 2026-09-01
5913 APR_DRG Neonate Birthwt 500-749g Wo Major Procedure - Soi : 3 14 7 — — $87,079.09 $91,433.04 $87,079.09 2026-09-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 3 1 — — $85,365.23 $116,484.85 $87,018.31 2026-04-01
6023 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Syndoth Maj Resp Or Maj Anom - Soi : 3 14 7 — — $86,999.50 $91,349.47 $86,999.50 2026-09-01
38240 HCPCS Transplt Allo Hct/donor 6 4 — — $11,050.00 $145,191.34 $84,383.74 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 21 10 — — $34,700.99 $169,345.18 $83,818.93 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 3 1 — — $81,500.49 $111,211.22 $83,078.72 2026-04-01
6303 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure - Soi : 3 14 7 — — $82,770.05 $86,908.55 $82,770.05 2026-09-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 107 33 — $83,408.00 $1,540.45 $189,389.73 $81,380.75 2026-09-01
4403 APR_DRG Kidney Transplant - Soi : 3 14 7 — — $80,677.88 $84,711.77 $80,677.88 2026-09-01
5932 APR_DRG Neonate Birthwt 750-999g Wo Major Procedure - Soi : 2 14 7 — — $79,565.54 $83,543.82 $79,565.54 2026-09-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 3 1 — — $76,574.18 $104,489.04 $78,057.01 2026-04-01
9103 APR_DRG Craniotomy For Multiple Significant Trauma - Soi : 3 14 7 — — $76,685.80 $80,520.09 $76,685.80 2026-09-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 108 33 — $76,284.00 $2,291.55 $156,531.92 $76,284.47 2026-09-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 114 35 — $75,959.00 $2,583.20 $151,101.91 $75,959.27 2026-09-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 95 30 — $83,668.00 $62,794.65 $166,918.68 $75,552.40 2026-09-01
J9226 HCPCS Supprelin La Implant 6 4 — — $45,020.65 $108,049.56 $74,572.37 2026-04-01
1580 OTHER New Technology - Level 43 ($40,001-$50,000) 2 2 — — $43,065.71 $104,986.52 $74,026.12 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 112 36 — $75,710.00 $1,956.83 $150,272.70 $73,921.54 2026-09-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 108 34 — $78,156.00 $144.04 $205,741.48 $73,701.76 2026-09-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 26 10 — — $1,521.26 $141,166.94 $73,606.05 2026-04-01
6093 APR_DRG Neonate Bwt 1500-2499g W Major Procedure - Soi : 3 14 7 — — $73,579.40 $77,258.37 $73,579.40 2026-09-01
L7180 HCPCS Electronic Elbow Sequential 5 3 — — $50,007.15 $120,017.16 $73,539.93 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 5 3 — — $49,600.83 $119,041.99 $72,942.39 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 21 10 — — $1,315.73 $130,761.19 $71,538.72 2026-04-01
64654 HCPCS 1st Opn Implt Bat Modulj Sys 4 2 — — $42,362.57 $101,670.17 $70,533.68 2026-04-01
6114 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly - Soi : 4 14 7 — — $70,336.90 $73,853.74 $70,336.90 2026-09-01
4402 APR_DRG Kidney Transplant - Soi : 2 14 7 — — $69,194.81 $72,654.55 $69,194.81 2026-09-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 114 36 — $68,753.00 $1,157.63 $283,624.31 $68,753.90 2026-09-01
43 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure - Soi : 3 14 7 — — $68,629.36 $72,060.83 $68,629.36 2026-09-01
8423 APR_DRG Burns With Skin Graft Except Extensive 3rd Degree Burns - Soi : 3 14 7 — — $68,447.36 $71,869.73 $68,447.36 2026-09-01
9102 APR_DRG Craniotomy For Multiple Significant Trauma - Soi : 2 14 7 — — $68,115.13 $71,520.88 $68,115.13 2026-09-01
83 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy- Soi : 3 14 7 — — $68,049.53 $71,452.01 $68,049.53 2026-09-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly - Soi : 4 14 7 — — $67,718.56 $71,104.49 $67,718.56 2026-09-01
6022 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Syndoth Maj Resp Or Maj Anom - Soi : 2 14 7 — — $67,325.10 $70,691.36 $67,325.10 2026-09-01
6124 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Syndoth Maj Resp Cond - Soi : 4 14 7 — — $67,259.87 $70,622.86 $67,259.87 2026-09-01
10 MS_DRG Pancreas Transplant 99 33 — $71,346.00 $53,609.68 $158,242.26 $67,205.09 2026-09-01
203 APR_DRG Open Craniotomy For Trauma- Soi : 3 14 7 — — $67,150.14 $70,507.65 $67,150.14 2026-09-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 103 33 — $66,978.00 $50,353.71 $172,536.56 $66,978.59 2026-09-01
9123 APR_DRG Musculoskeletal & Other Procedures For Multiple Significant Trauma - Soi : 3 14 7 — — $66,533.16 $69,859.82 $66,533.16 2026-09-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 6 4 — — $42,362.57 $101,670.17 $66,258.45 2026-04-01
54 APR_DRG Tracheostomy W Mv 96+ Hours Wo Extensive Procedure - Soi : 4 14 7 — — $66,091.42 $69,395.99 $66,091.42 2026-09-01
6134 APR_DRG Neonate Birthwt 1500-1999g W Congenitalperinatal Infection - Soi : 4 14 7 — — $65,989.91 $69,289.40 $65,989.91 2026-09-01
6073 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Syndoth Maj Resp Or Maj Anom - Soi : 3 14 7 — — $65,926.52 $69,222.85 $65,926.52 2026-09-01
69930 HCPCS Implant Cochlear Device 6 4 — — $31,711.59 $132,697.00 $65,095.37 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 23 9 — — $1,430.27 $131,375.50 $64,988.56 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Ccmcc 99 33 — $71,317.00 $43,875.30 $140,269.32 $64,904.07 2026-09-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 101 31 — $70,901.00 $2,426.57 $355,975.83 $64,526.77 2026-09-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 102 33 — $65,447.00 $1,317.84 $129,276.95 $64,030.49 2026-09-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 99 33 — $65,447.00 $49,212.72 $128,586.57 $63,976.54 2026-09-01
1624 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx - Soi : 4 14 7 — — $63,823.62 $67,014.80 $63,823.62 2026-09-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 6 4 — — $30,188.86 $110,345.00 $63,572.61 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 6 4 — — $30,188.86 $110,345.00 $63,572.61 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 6 4 — — $30,188.86 $110,345.00 $63,572.61 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 6 4 — — $30,188.86 $110,345.00 $63,572.61 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 99 33 — $65,213.00 $49,037.70 $128,119.18 $62,460.06 2026-09-01
0266T OTHER Implt/rpl Crtd Sns Dev Total 2 2 — — $43,535.00 $81,000.90 $62,267.95 2026-04-01
4401 APR_DRG Kidney Transplant - Soi : 1 14 7 — — $61,785.63 $64,874.91 $61,785.63 2026-09-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 3 1 — — $60,540.68 $82,610.58 $61,713.03 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 90 30 — $70,942.00 $53,308.69 $139,524.24 $61,629.54 2026-09-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 20 10 — — $20,713.47 $222,880.77 $61,116.42 2026-04-01
3034 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back - Soi : 4 14 7 — — $61,017.21 $64,068.07 $61,017.21 2026-09-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 100 34 — $60,987.00 $45,887.91 $119,708.14 $60,320.91 2026-09-01
6033 APR_DRG Neonate Birthwt 1000-1249g W Or Wo Other Significant Condition - Soi : 3 14 7 — — $60,210.00 $63,220.50 $60,210.00 2026-09-01
3084 APR_DRG Hip & Femur Fracture Repair - Soi : 4 14 7 — — $60,161.43 $63,169.50 $60,161.43 2026-09-01
9101 APR_DRG Craniotomy For Multiple Significant Trauma - Soi : 1 14 7 — — $59,544.45 $62,521.67 $59,544.45 2026-09-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 100 31 — $68,420.00 $2,409.02 $134,504.21 $59,444.18 2026-09-01
63685 HCPCS Insrt/redo Spine N Generator 6 4 — — $29,678.00 $71,227.21 $59,267.23 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 110 35 — $59,433.00 $580.54 $176,743.40 $58,790.72 2026-09-01
6084 APR_DRG Neonate Bwt 1250-1499g W Or Wo Other Significant Condition - Soi : 4 14 7 — — $58,603.88 $61,534.08 $58,603.88 2026-09-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 116 35 — $58,504.00 $400.00 $177,709.29 $58,504.85 2026-09-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 108 35 — $64,066.00 $1,100.31 $134,182.50 $58,322.11 2026-09-01
5232 OTHER Level 2 Icd And Similar Procedures 16 9 — — $211.50 $112,667.66 $58,043.85 2026-04-01
9113 APR_DRG Extensive Abdominalthoracic Procedures For Mult Significant Trauma - Soi : 3 14 7 — — $57,220.17 $60,081.18 $57,220.17 2026-09-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 113 35 — $57,146.00 $466.54 $182,187.00 $57,146.11 2026-09-01
82 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy- Soi : 2 14 7 — — $56,935.29 $59,782.05 $56,935.29 2026-09-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 107 34 — $56,843.00 $2,045.70 $315,725.13 $56,843.51 2026-09-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 19 10 — — $28,423.15 $112,781.41 $56,282.16 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 15 7 — — $42,853.11 $111,604.14 $55,709.04 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 106 33 — $59,877.00 $1,101.40 $117,498.31 $55,605.54 2026-09-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 104 33 — $58,467.00 $2,233.37 $203,845.04 $55,225.82 2026-09-01
6214 APR_DRG Neonate Bwt 2000-2499g W Major Anomaly - Soi : 4 14 7 — — $55,180.39 $57,939.41 $55,180.39 2026-09-01
C9605 HCPCS Hc Add'l Pci, Des Through Bypapss Graft - Lc 1 1 — — $55,148.00 $55,148.00 $55,148.00 2026-04-01
C9603 HCPCS Hc Atherect W Balloon And/Or Stent Ea Addtl Ld (Des) 1 1 — — $55,148.00 $55,148.00 $55,148.00 2026-04-01
C9608 HCPCS Hc Perc D-e Cor Revasc Chro Add - Lc 1 1 — — $55,148.00 $55,148.00 $55,148.00 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 95 30 — $60,410.00 $45,458.03 $120,172.07 $55,003.41 2026-09-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 99 33 — $55,911.00 $42,103.93 $197,626.46 $54,735.11 2026-09-01
0915T OTHER Insj Perm Ccm-d Sys Pg&eltrd 6 4 — — $30,188.86 $72,453.27 $54,613.42 2026-04-01
9304 APR_DRG Multiple Significant Trauma Wo O.r. Procedure - Soi : 4 14 7 — — $54,608.68 $57,339.12 $54,608.68 2026-09-01
6313 APR_DRG Neonate Birthwt >2499g W Other Major Procedure - Soi : 3 14 7 — — $54,450.45 $57,172.97 $54,450.45 2026-09-01
1634 APR_DRG Cardiac Valve Procedures Wo Ami Or Complex Pdx - Soi : 4 14 7 — — $54,310.00 $57,025.50 $54,310.00 2026-09-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 100 33 — $55,109.00 $41,506.34 $108,007.79 $53,958.24 2026-09-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 106 34 — $54,517.00 $1,916.33 $136,382.67 $53,950.60 2026-09-01
1784 APR_DRG External Heart Assist Systems- Soi : 4 14 7 — — $53,947.44 $56,644.81 $53,947.44 2026-09-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 115 35 — $59,240.00 $0.70 $169,643.07 $53,941.14 2026-09-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 110 34 — $54,432.00 $2,155.86 $137,476.61 $53,867.42 2026-09-01
16 MS_DRG Autologous Bone Marrow Transplant With Ccmcc 93 30 — $59,105.00 $44,484.75 $132,593.80 $53,818.16 2026-09-01
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 107 34 — $54,784.00 $865.48 $166,912.52 $53,643.12 2026-09-01
2046 OTHER Pmkr, Dual, Leadless 1 1 — — $53,576.44 $53,576.44 $53,576.44 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 98 30 — $61,057.00 $1,324.00 $159,515.44 $53,568.80 2026-09-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 104 33 — $54,593.00 $32,312.90 $127,489.32 $53,458.42 2026-09-01
0620T OTHER Evasc Ven Artlz Tibl/prnl Vn 6 4 — — $24,065.00 $101,670.17 $53,317.18 2026-04-01
6302 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure - Soi : 2 14 7 — — $53,259.56 $55,922.54 $53,259.56 2026-09-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 113 35 — $53,240.00 $654.00 $134,649.55 $53,240.82 2026-09-01
64568 HCPCS Inc For Vagus N Elect Impl 6 4 — — $42,362.57 $101,670.17 $53,184.23 2026-04-01
61886 HCPCS Implant Neurostim Arrays 6 4 — — $29,678.00 $71,227.21 $53,184.23 2026-04-01
6144 APR_DRG Neonate Bwt 1500-1999g W Or Wo Other Significant Condition - Soi : 4 14 7 — — $53,030.72 $55,682.25 $53,030.72 2026-09-01
5166 OTHER Cochlear Implant Procedure 13 7 — — $211.50 $105,375.90 $52,471.71 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 102 33 — $52,857.00 $2,204.74 $155,066.91 $52,316.92 2026-09-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 22 10 — — $6,539.58 $104,991.51 $52,117.00 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc 97 32 — $59,860.00 $22,657.08 $127,781.08 $52,026.56 2026-09-01
6072 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Syndoth Maj Resp Or Maj Anom - Soi : 2 14 7 — — $51,772.95 $54,361.60 $51,772.95 2026-09-01
0571T OTHER Insj/rplcmt Icds Ss Eltrd 5 3 — — $30,188.86 $72,453.27 $51,516.00 2026-04-01
0100T OTHER Prosth Retina Receive&Gen 1 1 — — $51,516.00 $51,516.00 $51,516.00 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 5 3 — — $25,888.42 $62,132.21 $51,516.00 2026-04-01
0408T OTHER Insj/rplc Cardiac Modulj Sys 5 3 — — $30,188.86 $72,453.27 $51,516.00 2026-04-01
L8701 HCPCS Pow Ue Rom Dev Ewh Uprt Cust 5 3 — — $34,970.13 $83,928.31 $51,426.66 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 6 4 — — $27,586.78 $66,208.28 $51,343.49 2026-04-01
6083 APR_DRG Neonate Bwt 1250-1499g W Or Wo Other Significant Condition - Soi : 3 14 7 — — $51,101.32 $53,656.38 $51,101.32 2026-09-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 103 33 — $51,989.00 $782.64 $103,764.77 $50,934.57 2026-09-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 102 33 — $50,366.00 $37,970.61 $98,566.15 $50,366.14 2026-09-01
6334 APR_DRG Neonate Birthwt >2499g W Major Anomaly - Soi : 4 14 7 — — $50,153.33 $52,661.00 $50,153.33 2026-09-01
1654 APR_DRG Coronary Bypass W Ami Or Complex Pdx - Soi : 4 14 7 — — $49,665.27 $52,148.53 $49,665.27 2026-09-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 4 2 — — $29,678.00 $71,227.21 $49,413.88 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Ccmcc 93 30 — $54,218.00 $40,842.11 $106,234.06 $49,381.97 2026-09-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 3 1 — — $48,408.11 $66,055.13 $49,345.52 2026-04-01
0923T OTHER Rmvl&rplcmt Perm Ccm-d Pg 5 3 — — $21,393.20 $51,516.00 $49,204.36 2026-04-01
0515T OTHER Insj Wcs Lv Compl Sys 5 3 — — $21,393.20 $51,516.00 $49,204.36 2026-04-01
0409T OTHER Insj/rplc Car Modulj Pls Gn 5 3 — — $21,393.20 $51,516.00 $49,204.36 2026-04-01
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 5 3 — — $21,393.20 $51,516.00 $49,204.36 2026-04-01
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 5 3 — — $21,393.20 $51,516.00 $49,204.36 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 6 4 — — $29,678.00 $71,227.21 $49,193.73 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 6 4 — — $29,678.00 $71,227.21 $49,193.73 2026-04-01
0268T OTHER Implt/rpl Crtd Sns Dev Gen 2 2 — — $43,535.00 $54,852.46 $49,193.73 2026-04-01
L6700 HCPCS Ue Add Ext Power Myoel 4 2 — — $29,510.19 $70,824.46 $49,134.47 2026-04-01
202 APR_DRG Open Craniotomy For Trauma- Soi : 2 14 7 — — $49,076.63 $51,530.46 $49,076.63 2026-09-01
1674 APR_DRG Other Cardiothoracic & Thoracic Vascular Procedures - Soi : 4 14 7 — — $48,852.32 $51,294.94 $48,852.32 2026-09-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 108 33 — $49,201.00 $19,840.71 $122,791.63 $48,717.77 2026-09-01
53 APR_DRG Tracheostomy W Mv 96+ Hours Wo Extensive Procedure - Soi : 3 14 7 — — $48,668.74 $51,102.18 $48,668.74 2026-09-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 100 33 — $49,000.00 $36,952.67 $95,847.87 $48,519.49 2026-09-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 102 33 — $49,454.00 $982.80 $194,585.98 $48,478.31 2026-09-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 119 38 — $49,367.00 $909.13 $135,979.90 $48,394.53 2026-09-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 98 30 — $55,533.00 $26,559.30 $108,852.61 $48,277.22 2026-09-01
471 MS_DRG Cervical Spinal Fusion With Mcc 108 36 — $48,288.00 $1,565.45 $101,207.17 $47,818.24 2026-09-01
653 MS_DRG Major Bladder Procedures With Mcc 103 33 — $51,900.00 $29,592.25 $117,946.20 $47,278.00 2026-09-01
42 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure - Soi : 2 14 7 — — $47,182.94 $49,542.09 $47,182.94 2026-09-01
5912 APR_DRG Neonate Birthwt 500-749g Wo Major Procedure - Soi : 2 14 7 — — $46,994.33 $49,344.05 $46,994.33 2026-09-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 112 36 — $46,943.00 $864.15 $134,978.35 $46,943.24 2026-09-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 106 30 — $52,685.00 $750.00 $298,771.74 $46,900.00 2026-09-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 3 1 — — $45,954.76 $62,707.42 $46,844.66 2026-04-01
3044 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back - Soi : 4 14 7 — — $46,833.76 $49,175.45 $46,833.76 2026-09-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 100 33 — $46,805.00 $35,316.62 $287,535.73 $46,358.65 2026-09-01
3033 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back - Soi : 3 14 7 — — $46,200.22 $48,510.23 $46,200.22 2026-09-01
1834 APR_DRG Percutaneous Structural Cardiac Procedures- Soi : 4 14 7 — — $46,035.87 $48,337.66 $46,035.87 2026-09-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 116 37 — $46,006.00 $1,029.21 $265,154.01 $46,006.96 2026-09-01
8444 APR_DRG Partial Thickness Burns Wo Skin Graft - Soi : 4 14 7 — — $45,581.69 $47,860.77 $45,581.69 2026-09-01
554 APR_DRG Head Trauma W Coma >1 Hr Or Hemorrhage - Soi : 4 14 7 — — $45,565.86 $47,844.15 $45,565.86 2026-09-01
6 MS_DRG Liver Transplant Without Mcc 99 33 — $46,404.00 $35,017.83 $246,350.90 $45,523.18 2026-09-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 113 37 — $49,847.00 $289.82 $121,170.83 $45,414.05 2026-09-01
J9266 HCPCS Pegaspargase Injection 6 4 — — $28,424.06 $68,217.74 $45,302.54 2026-04-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo)- Soi : 3 14 7 — — $45,252.20 $47,514.81 $45,252.20 2026-09-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 116 36 — $45,517.00 $1,832.22 $154,253.18 $45,090.59 2026-09-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 108 33 — $45,892.00 $200.00 $116,385.47 $45,026.22 2026-09-01
163 MS_DRG Major Chest Procedures With Mcc 120 38 — $44,880.00 $1,896.72 $148,788.45 $44,880.07 2026-09-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 6 4 — — $21,393.20 $110,345.00 $44,803.75 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 6 4 — — $21,393.20 $110,345.00 $44,803.75 2026-04-01
0916T OTHER Insj Perm Ccm-d Sys Pg Only 6 4 — — $21,393.20 $51,516.00 $44,803.75 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 6 4 — — $21,393.20 $110,345.00 $44,803.75 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 6 4 — — $21,393.20 $110,345.00 $44,803.75 2026-04-01
92929 HCPCS Hc Prq Trluml Coronary Stent W/Angio Addl Art/Brnch 1 1 — — $44,779.00 $44,779.00 $44,779.00 2026-04-01
92938 HCPCS Hc Prq Trluml Coronary Byp Grft Revasc Addl Vessel - Lc 1 1 — — $44,779.00 $44,779.00 $44,779.00 2026-04-01
92944 HCPCS Hc Prq Card Revasc Chronic Addl - Rc 1 1 — — $44,779.00 $44,779.00 $44,779.00 2026-04-01
92941 HCPCS Hc Prq Card Revasc Mi 1 Vsl - Lc 1 1 — — $44,779.00 $44,779.00 $44,779.00 2026-04-01
92934 HCPCS Prq Card Stent/ath/angio 1 1 — — $44,779.00 $44,779.00 $44,779.00 2026-04-01
8634 APR_DRG Neonatal Aftercare - Soi : 4 14 7 — — $44,776.31 $47,015.13 $44,776.31 2026-09-01
1664 APR_DRG Coronary Bypass Wo Ami Or Complex Pdx - Soi : 4 14 7 — — $44,768.79 $47,007.23 $44,768.79 2026-09-01
5891 APR_DRG Neo Bwt<500g Or 500-999g & Ga<24wks Or 500-749g W Maj Anom Or Wout Life Sustaini… 14 7 — — $44,148.50 $46,355.92 $44,148.50 2026-09-01
1794 APR_DRG Defibrillator Implants- Soi : 4 14 7 — — $43,952.50 $46,150.13 $43,952.50 2026-09-01
2616 OTHER Brachytx, Non-str,yttrium-90 8 5 — — $1,417.90 $67,015.01 $43,938.84 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 26 11 — — $1,068.58 $80,605.60 $43,922.38 2026-04-01
6804 APR_DRG Major O.r. Procedures For Lymphatichematopoieticother Neoplasms - Soi : 4 14 7 — — $43,770.17 $45,958.68 $43,770.17 2026-09-01
1623 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx - Soi : 3 14 7 — — $43,713.71 $45,899.40 $43,713.71 2026-09-01
L5856 HCPCS Elec Knee-shin Swing/stance 5 3 — — $29,717.20 $71,321.28 $43,701.77 2026-04-01
6224 APR_DRG Neonate Bwt 2000-2499g W Resp Dist Syndoth Maj Resp Cond - Soi : 4 14 7 — — $43,553.63 $45,731.31 $43,553.63 2026-09-01
33967 HCPCS Hc Insertion Intra-aortic Balloon Assist Dev Prq 1 1 — — $43,535.00 $43,535.00 $43,535.00 2026-04-01
33968 HCPCS Hc Removal Intra-aortic Balloon Assist Device Prq 1 1 — — $43,535.00 $43,535.00 $43,535.00 2026-04-01
0674T OTHER Laps Insj Nw/rpcmt Prm Isdss 5 3 — — $29,678.00 $71,227.21 $43,535.00 2026-04-01
0956T OTHER Prt Crn Ch Cr&tun Elt S-sclp 5 3 — — $26,096.68 $62,632.04 $43,535.00 2026-04-01
L6880 HCPCS Elec Hand Ind Art Digits 5 3 — — $29,576.84 $70,984.42 $43,495.35 2026-04-01
6123 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Syndoth Maj Resp Cond - Soi : 3 14 7 — — $43,309.29 $45,474.76 $43,309.29 2026-09-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 112 34 — $45,537.00 $733.03 $117,860.69 $43,091.94 2026-09-01
799 MS_DRG Splenic Procedures With Mcc 102 35 — $45,342.00 $17,774.89 $100,347.09 $42,909.41 2026-09-01
81 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy- Soi : 1 14 7 — — $42,784.85 $44,924.09 $42,784.85 2026-09-01
245 MS_DRG Aicd Generator Procedures 103 33 — $45,671.00 $25,941.37 $112,188.58 $42,582.22 2026-09-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 3 1 — — $41,676.85 $56,870.01 $42,483.91 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 98 30 — $46,223.00 $1,060.19 $98,402.66 $42,123.95 2026-09-01
0960T OTHER Rpl S-sclp Eltr Ra Rcvr&tlmt 6 4 — — $26,096.68 $62,632.04 $42,017.95 2026-04-01
9112 APR_DRG Extensive Abdominalthoracic Procedures For Mult Significant Trauma - Soi : 2 14 7 — — $42,005.18 $44,105.44 $42,005.18 2026-09-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 113 36 — $42,248.00 $23,488.15 $112,220.30 $41,977.96 2026-09-01
9122 APR_DRG Musculoskeletal & Other Procedures For Multiple Significant Trauma - Soi : 2 14 7 — — $41,957.72 $44,055.60 $41,957.72 2026-09-01
6113 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly - Soi : 3 14 7 — — $41,945.47 $44,042.74 $41,945.47 2026-09-01
1694 APR_DRG Major Abdominal Vascular Procedures - Soi : 4 14 7 — — $41,902.15 $43,997.26 $41,902.15 2026-09-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 100 31 — $48,048.00 $784.04 $173,698.21 $41,790.95 2026-09-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 103 33 — $41,649.00 $30,367.20 $126,512.31 $41,649.74 2026-09-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 110 33 — $42,001.00 $1,580.91 $84,071.70 $41,628.80 2026-09-01
3083 APR_DRG Hip & Femur Fracture Repair - Soi : 3 14 7 — — $41,623.07 $43,704.22 $41,623.07 2026-09-01
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