Price Transparency Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

Export CSV
Hospital

BELLIN MEMORIAL HOSPITAL

Green Bay, WI · CCN 520049 · Rates published

20,023 distinct procedures filed
23 distinct payers
371,876 rate rows
2025-06-27 last MRF observed · ⚠ 12 mo old
Data quality

295,809 of 371,876 rate rows are consumer-grade (79.5%)

76,067 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 59,907
per-diem day rate — not a per-procedure price 11,272
template filing: same amount across many unrelated codes — excluded 4,434
exceeds 10× this hospital's gross charge — excluded from medians 286
percent-of-charges filed in the dollar field — excluded from medians 85
placeholder amount (≤ $0.02) — excluded from medians 83

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 12 months old.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://bellin-ghs.pt.panaceainc.com/MRFDownload/bellin-ghs/bellin-memorial
Found on page https://bellin.org/patients-visitors/billing-insurance-services
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 52cc7f358dfbf396… · 4,713,216 bytes · first seen 2026-05-08

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
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 4 $3,339,000.00 $3,710,000.00 $3,710,000.00 nat. median
$3,710,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 6 $3,339,000.00 $3,672,900.00 $3,654,350.00 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 6 $2,989,603.36 $3,339,578.18 $3,339,578.18 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 4 $2,873,700.00 $3,286,000.00 $3,193,000.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 4 $2,671,200.00 $2,968,000.00 $2,968,000.00 nat. median
$3,006,423
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 4 $2,098,800.00 $2,332,000.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 6 $2,163,112.88 $2,388,614.23 $2,272,602.41 nat. median
$2,469,189
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 7 $509,061.46 $1,351,749.25 $518,240.68 nat. median
$754,974
0.7× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 7 $496,186.51 $1,611,772.38 $507,495.55 nat. median
$675,122
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 7 $475,481.19 $1,540,253.79 $484,690.30 nat. median
$625,184
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 12 $233,502.20 $775,601.44 $480,966.42 nat. median
$370,174
1.3× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 7 $464,837.37 $1,505,816.54 $474,060.62 nat. median
$674,188
0.7× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 7 $440,565.44 $1,188,735.81 $459,381.45 nat. median
$634,511
0.7× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 7 $439,246.36 $1,428,235.02 $449,440.00 nat. median
$620,080
0.7× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 12 $174,406.56 $579,309.26 $359,241.60 nat. median
$265,286
1.4× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 12 $146,881.85 $487,883.10 $302,546.35 nat. median
$206,368
1.5× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 3 $119,999.94 $274,999.86 $274,999.86 nat. median
$111,989
outlier · 2.5×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 12 $132,695.68 $440,762.29 $273,325.77 nat. median
$202,986
1.3× median
L8702
HCPCS 		Ewhf S/d Uprt Micro Sensor 2 $181,147.29 $181,147.29 $181,147.29 nat. median
$70,825
outlier · 2.6×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 12 $87,487.17 $290,597.58 $180,205.54 nat. median
$133,176
1.4× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 12 $81,120.97 $269,451.62 $167,092.50 nat. median
$117,303
1.4× median
7
MS_DRG 		Lung Transplant 12 $80,916.65 $268,772.94 $166,671.64 nat. median
$122,708
1.4× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 12 $68,229.46 $226,631.15 $140,538.65 nat. median
$108,660
1.3× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 12 $67,450.56 $224,043.95 $138,934.26 nat. median
$102,358
1.4× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 12 $65,936.72 $219,015.56 $135,816.06 nat. median
$100,136
1.4× median
215
MS_DRG 		Other Heart Assist System Implant 12 $65,598.66 $217,892.66 $135,119.73 nat. median
$99,019
1.4× median
A9543RR
HCPCS 		Y90 Ibritumomab, Rx 2 $130,953.16 $130,953.16 $130,953.16 —
L7181
HCPCS 		Electronic Elbo Simultaneous 3 $56,684.48 $129,901.94 $129,901.94 nat. median
$50,598
outlier · 2.6×
L7180
HCPCS 		Electronic Elbow Sequential 3 $55,055.14 $126,168.02 $126,168.02 nat. median
$49,027
outlier · 2.6×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 $59,755.65 $198,484.52 $123,084.34 nat. median
$93,672
1.3× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 12 $52,466.91 $174,274.23 $108,071.04 nat. median
$79,312
1.4× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 $52,437.81 $174,177.57 $108,011.10 nat. median
$81,118
1.3× median
L2006
HCPCS 		Kaf Sng/dbl Swg/stn Mcpr Cus 3 $45,424.97 $104,098.89 $104,098.89 nat. median
$39,823
outlier · 2.6×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 12 $49,911.03 $165,784.58 $102,806.43 nat. median
$77,576
1.3× median
10
MS_DRG 		Pancreas Transplant 12 $49,365.55 $163,972.72 $101,682.86 nat. median
$68,882
1.5× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 12 $49,082.59 $163,032.85 $101,100.03 nat. median
$71,240
1.4× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization With Mcc 12 $48,395.94 $160,752.08 $99,685.68 nat. median
$73,807
1.4× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 $47,907.43 $159,129.43 $98,679.43 nat. median
$74,915
1.3× median
0915T
HCPCS 		Insj Perm Ccm-d Sys Pg&eltrd 3 $30,443.75 $120,812.06 $95,283.32 nat. median
$32,560
outlier · 2.9×
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 12 $46,215.27 $153,508.74 $95,193.93 nat. median
$72,138
1.3× median
L8701
HCPCS 		Ewh S/d Uprt Micro Sensor 2 $92,072.48 $92,072.48 $92,072.48 nat. median
$35,999
outlier · 2.6×
0674T
HCPCS 		Laps Insj Nw/rpcmt Prm Isdss 3 $28,935.89 $114,828.30 $90,563.99 nat. median
$25,200
outlier · 3.6×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 12 $43,755.97 $145,339.92 $90,128.28 nat. median
$68,887
1.3× median
69930
HCPCS 		Hc Implant Cochlear Device 23 $4,047.26 $115,025.40 $89,336.39 nat. median
$29,663
outlier · 3.0×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 12 $43,071.80 $143,067.38 $88,719.02 nat. median
$66,526
1.3× median
33264
HCPCS 		Hc Remv&replc Cvd Gen Mult Lead (33264) 23 $1,321.73 $112,845.60 $87,643.42 nat. median
$31,873
outlier · 2.7×
33231
HCPCS 		Hc Insrt Pulse Gen W/mult Leads 23 $1,314.97 $112,845.60 $87,643.42 nat. median
$30,121
outlier · 2.9×
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 12 $42,278.03 $140,430.82 $87,084.04 nat. median
$64,732
1.3× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 12 $41,353.01 $137,358.26 $85,178.68 nat. median
$64,027
1.3× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 12 $41,283.05 $137,125.86 $85,034.57 nat. median
$65,950
1.3× median

Other procedures at this hospital

Browse this hospital's 20,023 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
             
J1414 HCPCS Inj, Beqvez, Per Tx Dose 5 4 — — $3,339,000.00 $3,710,000.00 $3,710,000.00 2025-06-27
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 7 6 — — $3,339,000.00 $3,672,900.00 $3,654,350.00 2025-06-27
J1413 HCPCS Inj Delandistrogene Mox Rokl 7 6 — — $2,989,603.36 $3,339,578.18 $3,339,578.18 2025-06-27
J3394 HCPCS Inj, Lovotibeglogene Autotem 5 4 — — $2,873,700.00 $3,286,000.00 $3,193,000.00 2025-06-27
J3393 HCPCS Inj, Betibeglogene Autotemce 5 4 — — $2,671,200.00 $2,968,000.00 $2,968,000.00 2025-06-27
J3392 HCPCS Inj, Exagamglogene Autotem 5 4 — — $2,098,800.00 $2,332,000.00 $2,332,000.00 2025-06-27
J3399 HCPCS Inj Onase Abepar-xioi Treat 7 6 — — $2,163,112.88 $2,388,614.23 $2,272,602.41 2025-06-27
Q2042 HCPCS Tisagenlecleucel Car-pos T 8 7 — — $509,061.46 $1,351,749.25 $518,240.68 2025-06-27
Q2056 HCPCS Ciltacabtagene Car-pos T 8 7 — — $496,186.51 $1,611,772.38 $507,495.55 2025-06-27
Q2055 HCPCS Idecabtagene Vicleucel Car 8 7 — — $475,481.19 $1,540,253.79 $484,690.30 2025-06-27
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 16 12 — — $233,502.20 $775,601.44 $480,966.42 2025-06-27
Q2054 HCPCS Lisocabtagene Mara Car Pos T 8 7 — — $464,837.37 $1,505,816.54 $474,060.62 2025-06-27
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 8 7 — — $440,565.44 $1,188,735.81 $459,381.45 2025-06-27
Q2053 HCPCS Brexucabtagene Car Pos T 8 7 — — $439,246.36 $1,428,235.02 $449,440.00 2025-06-27
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 16 12 — — $174,406.56 $579,309.26 $359,241.60 2025-06-27
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 16 12 — — $146,881.85 $487,883.10 $302,546.35 2025-06-27
Q0480 HCPCS Driver Pneumatic Vad, Rep 4 3 — — $119,999.94 $274,999.86 $274,999.86 2025-06-27
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 16 12 — — $132,695.68 $440,762.29 $273,325.77 2025-06-27
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 3 2 — — $181,147.29 $181,147.29 $181,147.29 2025-06-27
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 16 12 — — $87,487.17 $290,597.58 $180,205.54 2025-06-27
14 MS_DRG Allogeneic Bone Marrow Transplant 16 12 — — $81,120.97 $269,451.62 $167,092.50 2025-06-27
7 MS_DRG Lung Transplant 16 12 — — $80,916.65 $268,772.94 $166,671.64 2025-06-27
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 16 12 — — $68,229.46 $226,631.15 $140,538.65 2025-06-27
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 16 12 — — $67,450.56 $224,043.95 $138,934.26 2025-06-27
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 16 12 — — $65,936.72 $219,015.56 $135,816.06 2025-06-27
215 MS_DRG Other Heart Assist System Implant 16 12 — — $65,598.66 $217,892.66 $135,119.73 2025-06-27
A9543RR HCPCS Y90 Ibritumomab, Rx 3 2 — — $130,953.16 $130,953.16 $130,953.16 2025-06-27
L7181 HCPCS Electronic Elbo Simultaneous 4 3 — — $56,684.48 $129,901.94 $129,901.94 2025-06-27
L7180 HCPCS Electronic Elbow Sequential 4 3 — — $55,055.14 $126,168.02 $126,168.02 2025-06-27
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 12 — — $59,755.65 $198,484.52 $123,084.34 2025-06-27
231 MS_DRG Coronary Bypass With Ptca With Mcc 16 12 — — $52,466.91 $174,274.23 $108,071.04 2025-06-27
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 16 12 — — $52,437.81 $174,177.57 $108,011.10 2025-06-27
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 4 3 — — $45,424.97 $104,098.89 $104,098.89 2025-06-27
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 16 12 — — $49,911.03 $165,784.58 $102,806.43 2025-06-27
10 MS_DRG Pancreas Transplant 16 12 — — $49,365.55 $163,972.72 $101,682.86 2025-06-27
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 16 12 — — $49,082.59 $163,032.85 $101,100.03 2025-06-27
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 16 12 — — $48,395.94 $160,752.08 $99,685.68 2025-06-27
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 16 12 — — $47,907.43 $159,129.43 $98,679.43 2025-06-27
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 4 3 — — $30,443.75 $120,812.06 $95,283.32 2025-06-27
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 16 12 — — $46,215.27 $153,508.74 $95,193.93 2025-06-27
L8701 HCPCS Ewh S/d Uprt Micro Sensor 3 2 — — $92,072.48 $92,072.48 $92,072.48 2025-06-27
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 4 3 — — $28,935.89 $114,828.30 $90,563.99 2025-06-27
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 16 12 — — $43,755.97 $145,339.92 $90,128.28 2025-06-27
69930 HCPCS Hc Implant Cochlear Device 27 23 $127,806.00 $83,073.90 35% off $4,047.26 $115,025.40 $89,336.39 2025-06-27
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 16 12 — — $43,071.80 $143,067.38 $88,719.02 2025-06-27
33231 HCPCS Hc Insrt Pulse Gen W/mult Leads 27 23 $125,384.00 $81,499.60 35% off $1,314.97 $112,845.60 $87,643.42 2025-06-27
33264 HCPCS Hc Remv&replc Cvd Gen Mult Lead (33264) 27 23 $125,384.00 $81,499.60 35% off $1,321.73 $112,845.60 $87,643.42 2025-06-27
955 MS_DRG Craniotomy For Multiple Significant Trauma 16 12 — — $42,278.03 $140,430.82 $87,084.04 2025-06-27
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 16 12 — — $41,353.01 $137,358.26 $85,178.68 2025-06-27
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 16 12 — — $41,283.05 $137,125.86 $85,034.57 2025-06-27
33249 HCPCS Hc Insert/repl Defib Lead/gener Othr 27 23 $118,682.00 $77,143.30 35% off $2,998.52 $106,813.80 $82,958.72 2025-06-27
64568 HCPCS Hc Inc For Vagus N Elect Impl 27 23 $118,346.00 $76,924.90 35% off $2,017.29 $106,511.40 $82,723.85 2025-06-27
63685 HCPCS Implant Neurostim/receiver 27 23 $118,346.00 $76,924.90 35% off $1,136.27 $106,511.40 $82,723.85 2025-06-27
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 16 12 — — $40,042.25 $133,004.44 $82,478.79 2025-06-27
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 12 — — $39,984.67 $132,813.17 $82,360.18 2025-06-27
33270 HCPCS Hc Ins/rplcmnt Perm Subq Impltbl Dfb With Subq Eltrd 27 23 $117,548.00 $76,406.20 35% off $1,842.36 $105,793.20 $82,166.05 2025-06-27
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 16 12 — — $39,157.47 $130,065.55 $80,656.33 2025-06-27
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 16 12 — — $38,353.19 $127,394.03 $78,999.66 2025-06-27
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 16 12 — — $38,129.05 $126,649.54 $78,537.99 2025-06-27
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 16 12 — — $37,995.93 $126,207.37 $78,263.79 2025-06-27
232 MS_DRG Coronary Bypass With Ptca Without Mcc 16 12 — — $37,822.57 $125,631.52 $77,906.70 2025-06-27
L5856 HCPCS Elec Knee-shin Swing/stance 4 3 — — $33,961.15 $77,827.64 $77,827.64 2025-06-27
28 MS_DRG Spinal Procedures With Mcc 16 12 — — $37,641.77 $125,031.00 $77,534.29 2025-06-27
L6880 HCPCS Elec Hand Ind Art Digits 4 3 — — $33,800.78 $77,460.13 $77,460.13 2025-06-27
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 16 12 — — $37,371.82 $124,134.32 $76,978.25 2025-06-27
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 16 12 — — $37,371.82 $124,134.32 $76,978.25 2025-06-27
266 MS_DRG Endovascular Cardiac Valve Replacement W Mcc 16 12 — — $37,092.58 $123,206.79 $76,403.07 2025-06-27
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 12 — — $36,835.63 $122,353.30 $75,873.80 2025-06-27
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 16 12 — — $36,432.55 $121,014.46 $75,043.56 2025-06-27
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 16 12 — — $36,049.29 $119,741.42 $74,254.12 2025-06-27
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 16 12 — — $35,536.01 $118,036.50 $73,196.86 2025-06-27
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 16 12 — — $35,323.64 $117,331.09 $72,759.42 2025-06-27
653 MS_DRG Major Bladder Procedures With Mcc 16 12 — — $34,515.64 $114,647.22 $71,095.10 2025-06-27
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 16 12 — — $34,222.78 $113,674.45 $70,491.87 2025-06-27
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 16 12 — — $34,222.78 $113,674.45 $70,491.87 2025-06-27
8 MS_DRG Simultaneous Pancreas/kidney Transplant 16 12 — — $33,689.06 $111,901.66 $69,392.52 2025-06-27
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 16 12 — — $33,612.28 $111,646.64 $69,234.38 2025-06-27
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 16 12 — — $33,440.78 $111,076.97 $68,881.11 2025-06-27
11 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Mcc 16 12 — — $33,409.20 $110,972.08 $68,816.07 2025-06-27
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 16 12 — — $33,405.49 $110,959.74 $68,808.42 2025-06-27
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 16 12 — — $32,940.50 $109,415.23 $67,850.64 2025-06-27
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 16 12 — — $32,794.99 $108,931.93 $67,550.93 2025-06-27
0916T HCPCS Insj Perm Ccm-d Sys Pg Only 4 3 — — $21,313.56 $84,580.07 $66,707.50 2025-06-27
0923T HCPCS Rmvl&rplcmt Perm Ccm-d Pg 4 3 — — $21,313.56 $84,580.07 $66,707.50 2025-06-27
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 16 12 — — $31,781.43 $105,565.28 $65,463.20 2025-06-27
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 16 12 — — $31,543.67 $104,775.54 $64,973.47 2025-06-27
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 16 12 — — $31,447.09 $104,454.71 $64,774.51 2025-06-27
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 16 12 — — $31,186.42 $103,588.89 $64,237.60 2025-06-27
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 16 12 — — $31,002.53 $102,978.08 $63,858.82 2025-06-27
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 16 12 — — $30,978.38 $102,897.87 $63,809.09 2025-06-27
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 16 12 — — $30,966.00 $102,856.74 $63,783.58 2025-06-27
0680T HCPCS Insj/rplcmt Pg Only Isdss 4 3 — — $20,362.31 $80,805.14 $63,730.24 2025-06-27
228 MS_DRG Other Cardiothoracic Procedures With Mcc 16 12 — — $30,854.55 $102,486.55 $63,554.01 2025-06-27
J9029 HCPCS Instill Adstiladrin, Tx Dose 10 8 — — $57,061.84 $127,010.80 $63,505.40 2025-06-27
L8614 HCPCS Cochlear Device 4 3 — — $27,699.70 $63,478.47 $63,478.47 2025-06-27
93654 HCPCS Hc Comp Eps & Vt Ablation 27 23 $90,517.00 $58,836.05 35% off $3,331.43 $81,465.30 $63,271.38 2025-06-27
33263 HCPCS Hc Remv&replc Cvd Gen Dual Lead (33263) 27 23 $89,835.00 $58,392.75 35% off $1,268.55 $80,851.50 $62,794.67 2025-06-27
33230 HCPCS Hc Insertion/replacement Of Dual Chamber Icd Generator 27 23 $89,835.00 $58,392.75 35% off $1,230.24 $80,851.50 $62,794.67 2025-06-27
33262 HCPCS Hc Remv&replc Cvd Gen Sing Lead (33262) 27 23 $89,835.00 $58,392.75 35% off $1,219.65 $80,851.50 $62,794.67 2025-06-27
J2350 HCPCS Ocrevus 300 Mg/10ml Intravenous Soln 28 23 $88,983.90 $57,839.54 35% off $52.89 $80,085.51 $62,466.70 2025-06-27
245 MS_DRG Aicd Generator Procedures 16 12 — — $30,257.06 $100,501.93 $62,323.32 2025-06-27
471 MS_DRG Cervical Spinal Fusion With Mcc 16 12 — — $30,074.41 $99,895.23 $61,947.09 2025-06-27
6 MS_DRG Liver Transplant Without Mcc 16 12 — — $30,024.26 $99,728.65 $61,843.79 2025-06-27
A9543 HCPCS Y90 Ibritumomab, Rx 10 8 — — $14,774.74 $65,476.58 $61,150.57 2025-06-27
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 16 12 — — $29,567.94 $98,212.93 $60,903.86 2025-06-27
Q0483 HCPCS Monitor Elec Vad, Rep 4 3 — — $26,524.96 $60,786.36 $60,786.36 2025-06-27
799 MS_DRG Splenic Procedures With Mcc 16 12 — — $29,439.77 $97,787.22 $60,639.87 2025-06-27
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 16 12 — — $29,434.20 $97,768.71 $60,628.38 2025-06-27
L5858 HCPCS Stance Phase Only 4 3 — — $26,292.56 $60,253.79 $60,253.79 2025-06-27
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 16 12 — — $29,129.57 $96,756.86 $60,000.92 2025-06-27
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 16 12 — — $28,973.55 $96,238.60 $59,679.54 2025-06-27
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 16 12 — — $28,802.66 $95,670.98 $59,327.54 2025-06-27
163 MS_DRG Major Chest Procedures With Mcc 16 12 — — $28,538.28 $94,792.81 $58,782.97 2025-06-27
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 16 12 — — $28,526.51 $94,753.73 $58,758.74 2025-06-27
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 16 12 — — $28,435.50 $94,451.41 $58,571.26 2025-06-27
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 16 12 — — $28,431.16 $94,437.02 $58,562.33 2025-06-27
63655 HCPCS Surg Implnt Neuroelect,epidural 26 23 $83,372.00 $54,191.80 35% off $2,864.24 $75,034.80 $58,527.15 2025-06-27
64590 HCPCS Implant Neurostim/receiver 27 23 $83,372.00 $54,191.80 35% off $1,012.11 $75,034.80 $58,277.03 2025-06-27
61885 HCPCS Implant Cranial Neurostim/recvr 27 23 $83,372.00 $54,191.80 35% off $1,818.22 $75,034.80 $58,277.03 2025-06-27
25442 HCPCS Hc Reconstruct Dist Ulna W Prosthesis 26 23 $82,116.00 $53,375.40 35% off $2,714.03 $93,552.95 $58,220.24 2025-06-27
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 16 12 — — $27,933.98 $92,785.57 $57,538.24 2025-06-27
L6975 HCPCS Interscap-thor Myoelectronic 4 3 — — $25,085.26 $57,487.05 $57,487.05 2025-06-27
93653 HCPCS Hc Comp Eps & Svt Ablation 27 23 $82,068.00 $53,344.20 35% off $2,764.08 $73,861.20 $57,365.53 2025-06-27
L5973 HCPCS Ank-foot Sys Dors-plant Flex 4 3 — — $24,976.46 $57,237.73 $57,237.73 2025-06-27
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 16 12 — — $27,767.42 $92,232.34 $57,195.17 2025-06-27
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 16 12 — — $27,690.65 $91,977.32 $57,037.04 2025-06-27
J1300 HCPCS Soliris 300 Mg/30ml Intravenous Soln 28 23 $80,947.10 $52,615.62 35% off $201.74 $72,852.39 $56,824.86 2025-06-27
901 MS_DRG Wound Debridements For Injuries With Mcc 16 12 — — $27,431.84 $91,117.66 $56,503.94 2025-06-27
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 16 12 — — $27,198.42 $90,342.32 $56,023.13 2025-06-27
93656 HCPCS Hc Comp Eps & Afib Ablation 27 23 $79,748.00 $51,836.20 35% off $3,133.38 $71,773.20 $55,743.85 2025-06-27
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 13 11 — — $49,982.85 $129,981.48 $55,453.57 2025-06-27
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 16 12 — — $26,790.39 $88,987.03 $55,182.69 2025-06-27
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 16 12 — — $26,735.29 $88,803.99 $55,069.18 2025-06-27
C8003 HCPCS Imp Extar Knee Shck Absrb 4 3 — — $17,462.09 $69,296.00 $54,653.10 2025-06-27
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 16 12 — — $26,411.47 $87,728.39 $54,402.18 2025-06-27
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 16 12 — — $26,372.46 $87,598.82 $54,321.83 2025-06-27
140 MS_DRG Major Head And Neck Procedures With Mcc 16 12 — — $26,185.47 $86,977.73 $53,936.68 2025-06-27
53445 HCPCS Correct Urin Incontin,sphinc Ctrl 27 23 $76,878.00 $49,970.70 35% off $2,609.61 $69,190.20 $53,737.72 2025-06-27
54405 HCPCS Insert Multi-compon Penile Prosthe 27 23 $76,878.00 $49,970.70 35% off $2,800.82 $69,190.20 $53,737.72 2025-06-27
54410 HCPCS Remove/replace Penis Prosth 27 23 $76,878.00 $49,970.70 35% off $2,983.92 $69,190.20 $53,737.72 2025-06-27
53447 HCPCS Hc Removal Artificial Sphincter 27 23 $76,878.00 $49,970.70 35% off $2,787.32 $69,190.20 $53,737.72 2025-06-27
54401 HCPCS Hc Insert Self-contd Penile Prosthesis 27 23 $76,878.00 $49,970.70 35% off $2,272.85 $69,190.20 $53,737.72 2025-06-27
31 MS_DRG Ventricular Shunt Procedures With Mcc 16 12 — — $25,946.48 $86,183.88 $53,444.40 2025-06-27
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 16 12 — — $25,940.29 $86,163.31 $53,431.64 2025-06-27
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 16 12 — — $25,761.35 $85,568.96 $53,063.07 2025-06-27
Q0489 HCPCS Pwr Pck Base Combo Vad, Rep 4 3 — — $22,995.71 $52,698.50 $52,698.50 2025-06-27
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 16 12 — — $25,460.44 $84,569.45 $52,443.26 2025-06-27
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 16 12 — — $25,446.20 $84,522.15 $52,413.92 2025-06-27
12 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Cc 16 12 — — $25,408.43 $84,396.69 $52,336.13 2025-06-27
L6970 HCPCS Interscapular-thor Switch CT 4 3 — — $22,758.53 $52,154.96 $52,154.96 2025-06-27
33221 HCPCS Hc Insert Pulse Gen Mult Leads 26 23 $74,262.00 $48,270.30 35% off $1,169.41 $66,835.80 $52,131.93 2025-06-27
33229 HCPCS Hc Remove/replace Pcmkr Mult 26 23 $74,262.00 $48,270.30 35% off $1,219.87 $66,835.80 $52,131.93 2025-06-27
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 16 12 — — $25,183.67 $83,650.15 $51,873.18 2025-06-27
38240 HCPCS Transplt Allo Hct/donor 10 8 — — $2,113.30 $222,855.73 $51,005.58 2025-06-27
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 16 12 — — $24,665.44 $81,928.77 $50,805.72 2025-06-27
739 MS_DRG Uterine,adnexa Proc For Non-ovarian/adnexal Malig W Mcc 16 12 — — $24,648.10 $81,871.19 $50,770.01 2025-06-27
27279 HCPCS Hc Arthrodesis Sacroilliac Joint Percutaneous 26 23 $71,026.00 $46,166.90 35% off $2,694.23 $100,443.66 $50,357.43 2025-06-27
24363 HCPCS Hc Arthroplasty,elbow,total,proth Repl 26 23 $71,025.00 $46,166.25 35% off $4,859.09 $96,870.51 $50,356.73 2025-06-27
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 16 12 — — $24,430.16 $81,147.27 $50,321.09 2025-06-27
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 16 12 — — $24,380.00 $80,980.68 $50,217.79 2025-06-27
C2616 HCPCS Hc Rad Sup Brachytx Seed, Yttrium-90 27 23 $68,709.00 $44,660.85 35% off $16,477.22 $65,886.07 $50,130.09 2025-06-27
22856 HCPCS Hc Tot Disc Arthrp Art Disc Ant Appro 1 Ntrspc Crv 27 23 $71,026.00 $46,166.90 35% off $5,446.60 $91,263.54 $50,073.33 2025-06-27
22867 HCPCS Hc Insj Stablj Dev W/dcmprn Lumbar Single Level 27 23 $71,025.00 $46,166.25 35% off $3,547.47 $92,996.23 $50,072.63 2025-06-27
273 MS_DRG Percutaneous Intracardiac Procedures W Mcc 16 12 — — $24,210.97 $80,419.23 $49,869.62 2025-06-27
34 MS_DRG Carotid Artery Stent Procedures With Mcc 16 12 — — $24,077.24 $79,975.00 $49,594.15 2025-06-27
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 16 12 — — $23,930.50 $79,487.59 $49,291.90 2025-06-27
33274 HCPCS Hc Tcat Insj/rpl Perm Leadless Pacemaker Rv W/img 27 23 $69,913.00 $45,443.45 35% off $1,571.38 $62,921.70 $49,288.67 2025-06-27
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 16 12 — — $23,906.35 $79,407.38 $49,242.15 2025-06-27
C9767 HCPCS Hc Pr Revasc Lithotrip-stent-ather 26 23 $66,829.00 $43,438.85 35% off $16,026.65 $67,663.18 $49,105.95 2025-06-27
C9766 HCPCS Hc Pr Revasc Intra Lithotrip-ather 26 23 $66,829.00 $43,438.85 35% off $16,026.65 $67,663.18 $49,105.95 2025-06-27
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 16 12 — — $23,839.48 $79,185.27 $49,104.42 2025-06-27
66683 HCPCS Implantation Iris Prosthesis 4 3 — — $15,588.07 $61,859.21 $48,787.77 2025-06-27
C9773 HCPCS Hc Revasc, Endovascular, Open Or Perc, Tibial/peroneal Artery(i 27 23 $66,829.00 $43,438.85 35% off $16,026.65 $67,663.18 $48,785.17 2025-06-27
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 16 12 — — $23,666.73 $78,611.48 $48,748.60 2025-06-27
L6965 HCPCS Shldr Disartic Myoelectronic 4 3 — — $21,261.91 $48,725.22 $48,725.22 2025-06-27
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 16 12 — — $23,538.57 $78,185.76 $48,484.60 2025-06-27
70272176-38430 CDM Device Card Ventr Assist W/smartassist Strl Lf Impella 22 20 $66,000.00 $42,900.00 35% off $19,800.00 $59,400.00 $48,166.80 2025-06-27
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 16 12 — — $23,355.30 $77,577.01 $48,107.10 2025-06-27
62362 HCPCS Insert Infusn Pump,programmable 27 23 $67,970.00 $44,180.50 35% off $1,281.06 $61,173.00 $47,918.85 2025-06-27
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 16 12 — — $23,168.93 $76,957.97 $47,723.22 2025-06-27
37231 HCPCS Hc Tib/per Revasc Stent & Ather 27 23 $66,830.00 $43,439.50 35% off $2,505.83 $60,147.00 $47,115.15 2025-06-27
37227 HCPCS Hc Fem/popl Revasc Stnt & Ather 27 23 $66,830.00 $43,439.50 35% off $2,404.74 $60,147.00 $47,115.15 2025-06-27
36906 HCPCS Hc Perq Thrmbc/nfs Dial Circuit Tcat Plmt IV Stent 27 23 $66,830.00 $43,439.50 35% off $1,756.84 $60,147.00 $47,115.15 2025-06-27
36836 HCPCS Hc Perc Av Fistula Creation, Upper Extremity, Single Access Incl 27 23 $66,830.00 $43,439.50 35% off $1,230.24 $60,147.00 $47,115.15 2025-06-27
93591 HCPCS Hc Perc Transcath Closure Of Paravalvular Leak; Initial Occlusio 27 23 $66,829.00 $43,438.85 35% off $3,102.72 $60,146.10 $47,114.45 2025-06-27
93590 HCPCS Hc Perq Transcath Cls Paravalvr Leak 1 Mitral Valve 27 23 $66,829.00 $43,438.85 35% off $3,747.12 $60,146.10 $47,114.45 2025-06-27
93582 HCPCS Hc Percutan Transcath Closure Pat Duct Arteriosus 27 23 $66,829.00 $43,438.85 35% off $2,198.63 $60,146.10 $47,114.45 2025-06-27
Q0481 HCPCS Microprcsr Cu Elec Vad, Rep 4 3 — — $20,556.92 $47,109.62 $47,109.62 2025-06-27
L5859 HCPCS Knee-shin Pro Flex/ext Cont 4 3 — — $20,526.35 $47,039.55 $47,039.55 2025-06-27
19357 HCPCS Breast Reconstruc W Tiss Expandr 27 23 $67,161.00 $43,654.65 35% off $3,843.48 $60,444.90 $46,945.54 2025-06-27
21243 HCPCS Hc Arthroplasty Tmj+prosthesis 27 23 $66,587.00 $43,281.55 35% off $5,488.07 $96,944.29 $46,943.84 2025-06-27
37229 HCPCS Hc Tib/per Revasc W/ather 26 23 $66,830.00 $43,439.50 35% off $2,336.15 $60,147.00 $46,914.66 2025-06-27
37230 HCPCS Hc Tib/per Revasc W/stent 26 23 $66,830.00 $43,439.50 35% off $2,324.08 $60,147.00 $46,914.66 2025-06-27
39503 HCPCS Repair Of Diaphragm Hernia 1 1 — — $46,649.50 $46,649.50 $46,649.50 2025-06-27
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 16 12 — — $22,591.25 $75,039.16 $46,533.33 2025-06-27
0238T HCPCS Hc Trluml Perip Athrc Iliac Art (0238t) 26 23 $63,128.00 $41,033.20 35% off $16,026.65 $67,663.18 $46,386.46 2025-06-27
C9765 HCPCS Hc Revasc Intra Lithotrip-stent 26 23 $63,128.00 $41,033.20 35% off $16,026.65 $67,663.18 $46,386.46 2025-06-27
335 MS_DRG Peritoneal Adhesiolysis With Mcc 16 12 — — $22,434.61 $74,518.84 $46,210.67 2025-06-27
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 16 12 — — $22,195.61 $73,725.00 $45,718.39 2025-06-27
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 16 12 — — $22,194.37 $73,720.88 $45,715.84 2025-06-27
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 16 12 — — $22,190.66 $73,708.54 $45,708.18 2025-06-27
265 MS_DRG Aicd Lead Procedures 16 12 — — $22,086.64 $73,363.04 $45,493.93 2025-06-27
J9226 HCPCS Supprelin La Implant 13 11 — — $40,735.62 $141,653.85 $45,350.22 2025-06-27
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 16 12 — — $21,987.57 $73,033.98 $45,289.87 2025-06-27
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 16 12 — — $21,858.79 $72,606.21 $45,024.60 2025-06-27
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 16 12 — — $21,853.22 $72,587.70 $45,013.12 2025-06-27
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 16 12 — — $21,798.11 $72,404.66 $44,899.62 2025-06-27
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 16 12 — — $21,694.09 $72,059.15 $44,685.36 2025-06-27
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 16 12 — — $21,687.28 $72,036.53 $44,671.33 2025-06-27
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 16 12 — — $21,678.61 $72,007.74 $44,653.48 2025-06-27
264 MS_DRG Other Circulatory System O.r. Procedures 16 12 — — $21,640.23 $71,880.23 $44,574.41 2025-06-27
93580 HCPCS Hc Transcath Closure Of Asd 27 23 $63,128.00 $41,033.20 35% off $3,241.51 $56,815.20 $44,505.24 2025-06-27
47135 HCPCS Transplantation Of Liver 1 1 — — $44,387.57 $44,387.57 $44,387.57 2025-06-27
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 16 12 — — $21,500.30 $71,415.44 $44,286.18 2025-06-27
332 MS_DRG Rectal Resection With Mcc 16 12 — — $21,476.77 $71,337.28 $44,237.72 2025-06-27
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 16 12 — — $21,453.24 $71,259.13 $44,189.25 2025-06-27
92933 HCPCS Hc Des Stent & Atherectomy W Or Without Ptca 27 23 $63,128.00 $41,033.20 35% off $2,195.35 $56,815.20 $44,126.47 2025-06-27
271 MS_DRG Other Major Cardiovascular Procedures With Cc 16 12 — — $21,326.31 $70,837.53 $43,927.81 2025-06-27
70278101-18684 CDM Gen Nrstm Vagus Nerv Eplp 22 20 $60,184.50 $39,119.93 35% off $18,055.35 $54,166.05 $43,922.65 2025-06-27
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 16 12 — — $21,292.88 $70,726.47 $43,858.94 2025-06-27
665 MS_DRG Prostatectomy With Mcc 16 12 — — $21,259.44 $70,615.42 $43,790.07 2025-06-27
252 MS_DRG Other Vascular Procedures With Mcc 16 12 — — $21,239.63 $70,549.61 $43,749.26 2025-06-27
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 16 12 — — $21,207.43 $70,442.66 $43,682.95 2025-06-27
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 16 12 — — $21,089.79 $70,051.91 $43,440.63 2025-06-27
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 16 12 — — $21,001.87 $69,759.87 $43,259.53 2025-06-27
0266T HCPCS Implt/rpl Crtd Sns Dev Total 9 8 — — $42,729.77 $45,000.50 $43,167.18 2025-06-27
33276 HCPCS Insj Phrnc Nrv Stim Sys 10 8 — — $4,734.94 $45,000.50 $43,167.18 2025-06-27
E0766 HCPCS Elec Stim Cancer Treatment 4 3 — — $18,824.36 $43,139.17 $43,139.17 2025-06-27
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 16 12 — — $20,783.31 $69,033.89 $42,809.34 2025-06-27
37 MS_DRG Extracranial Procedures With Mcc 16 12 — — $20,561.65 $68,297.63 $42,352.76 2025-06-27
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 16 12 — — $20,444.01 $67,906.88 $42,110.45 2025-06-27
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 16 12 — — $20,180.87 $67,032.82 $41,568.43 2025-06-27
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 16 12 — — $20,172.20 $67,004.03 $41,550.58 2025-06-27
L6960 HCPCS Shldr Disartic Switch Contro 4 3 — — $17,947.76 $41,130.29 $41,130.29 2025-06-27
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 16 12 — — $19,932.59 $66,208.12 $41,057.02 2025-06-27
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 16 12 — — $19,840.33 $65,901.69 $40,866.99 2025-06-27
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 16 12 — — $19,782.75 $65,710.43 $40,748.39 2025-06-27
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 16 12 — — $19,744.98 $65,584.97 $40,670.59 2025-06-27
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 16 12 — — $19,691.73 $65,408.11 $40,560.91 2025-06-27
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 16 12 — — $19,652.11 $65,276.48 $40,479.29 2025-06-27
500 MS_DRG Soft Tissue Procedures With Mcc 16 12 — — $19,619.29 $65,167.48 $40,411.70 2025-06-27
49605 HCPCS Repair Umbilical Lesion 1 1 — — $40,049.94 $40,049.94 $40,049.94 2025-06-27
43116 HCPCS Partial Removal Of Esophagus 1 1 — — $39,875.56 $39,875.56 $39,875.56 2025-06-27
274 MS_DRG Percutaneous Intracardiac Procedures Without Mcc 16 12 — — $19,323.95 $64,186.49 $39,803.37 2025-06-27
662 MS_DRG Minor Bladder Procedures With Mcc 16 12 — — $19,315.28 $64,157.69 $39,785.51 2025-06-27
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 16 12 — — $19,232.94 $63,884.17 $39,615.88 2025-06-27
33935 HCPCS Transplantation Heart/lung 1 1 — — $39,591.68 $39,591.68 $39,591.68 2025-06-27
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 16 12 — — $19,146.87 $63,598.30 $39,438.61 2025-06-27
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 16 12 — — $19,093.63 $63,421.43 $39,328.93 2025-06-27
652 MS_DRG Kidney Transplant 16 12 — — $19,016.85 $63,166.41 $39,170.79 2025-06-27
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 16 12 — — $18,999.51 $63,108.83 $39,135.08 2025-06-27
33945 HCPCS Transplantation Of Heart 1 1 — — $39,106.64 $39,106.64 $39,106.64 2025-06-27
L6955 HCPCS Above Elbow Myoelectronic CT 4 3 — — $17,061.24 $39,098.68 $39,098.68 2025-06-27
70278101-19257 CDM Gen Nrstm Vns Aspiresr Pls Mdl 106 103 Strl Lf 22 20 $53,494.50 $34,771.43 35% off $16,048.35 $48,145.05 $39,040.29 2025-06-27
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 16 12 — — $18,937.60 $62,903.17 $39,007.55 2025-06-27
32854 HCPCS Lung Transplant With Bypass 1 1 — — $38,972.53 $38,972.53 $38,972.53 2025-06-27
Q0479 HCPCS Power Module Combo Vad, Rep 4 3 — — $16,981.73 $38,916.46 $38,916.46 2025-06-27
55882 HCPCS Ablt Trurl Prst8 Tis Trnsdcr 4 3 — — $12,336.82 $48,957.08 $38,611.99 2025-06-27
47142 HCPCS Partial Removal Donor Liver 1 1 — — $38,582.37 $38,582.37 $38,582.37 2025-06-27
570 MS_DRG Skin Debridement With Mcc 16 12 — — $18,637.92 $61,907.77 $38,390.29 2025-06-27
0737T HCPCS Xenograft Impltj Artclr Surf 4 3 — — $12,217.56 $48,483.79 $38,238.71 2025-06-27
974 MS_DRG HIV With Major Related Condition With Mcc 16 12 — — $18,489.33 $61,414.19 $38,084.21 2025-06-27
34848 HCPCS Hc Viscer And Infrarenal Abdom Aorta 4+ Prosthesis 21 19 $51,962.00 $33,775.30 35% off $15,588.60 $46,765.80 $37,911.48 2025-06-27
L6945 HCPCS Elbow Disart Myoelectronic C 4 3 — — $16,443.59 $37,683.22 $37,683.22 2025-06-27
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 16 12 — — $18,256.52 $60,640.91 $37,604.68 2025-06-27
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 16 12 — — $18,209.47 $60,484.61 $37,507.75 2025-06-27
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 16 12 — — $18,159.93 $60,320.08 $37,405.72 2025-06-27
668 MS_DRG Transurethral Procedures With Mcc 16 12 — — $18,056.53 $59,976.63 $37,192.74 2025-06-27
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 16 12 — — $18,046.63 $59,943.72 $37,172.33 2025-06-27
800 MS_DRG Splenic Procedures With Cc 16 12 — — $18,041.05 $59,925.21 $37,160.85 2025-06-27
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 16 12 — — $18,031.15 $59,892.31 $37,140.45 2025-06-27
61715 HCPCS Mrgfus Strtctc Ablt Trgt Icr 4 3 — — $11,841.06 $46,989.70 $37,060.33 2025-06-27
0675T HCPCS Laps Insj Nw/rpcmt Isdss 1ld 4 3 — — $11,841.06 $46,989.70 $37,060.33 2025-06-27
472 MS_DRG Cervical Spinal Fusion With Cc 16 12 — — $17,938.27 $59,583.82 $36,949.15 2025-06-27
32853 HCPCS Lung Transplant Double 1 1 — — $36,813.79 $36,813.79 $36,813.79 2025-06-27
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 10 9 — — $36,807.76 $93,594.93 $36,807.76 2025-06-27
61698 HCPCS Brain Aneurysm Repr Complx 1 1 — — $36,571.99 $36,571.99 $36,571.99 2025-06-27
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 16 12 — — $17,751.91 $58,964.78 $36,565.27 2025-06-27
462 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity Without Mcc 16 12 — — $17,731.48 $58,896.91 $36,523.18 2025-06-27
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 16 12 — — $17,720.95 $58,861.95 $36,501.51 2025-06-27
54400 HCPCS Hc Insert Semi-rigid Penile Prosthesis 26 23 $51,970.00 $33,780.50 35% off $1,837.36 $46,773.00 $36,482.94 2025-06-27
510 MS_DRG Shoulder,elbow Or Forearm Proc,exc Major Joint Proc W Mcc 16 12 — — $17,696.18 $58,779.68 $36,450.49 2025-06-27
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mmc Or 4+ A… 16 12 — — $17,626.22 $58,547.29 $36,306.38 2025-06-27
61888 HCPCS Hc Revis/remov Cranial Neurorcvr 27 23 $51,916.00 $33,745.40 35% off $1,370.19 $46,724.40 $36,289.28 2025-06-27
33305 HCPCS Hc Repair Heart Wnd W Cp Bypass 21 19 $49,704.00 $32,307.60 35% off $13,638.43 $44,733.60 $36,264.04 2025-06-27
L7191 HCPCS Elbow Child Myoelectronic CT 4 3 — — $15,820.04 $36,254.27 $36,254.27 2025-06-27
43123 HCPCS Partial Removal Of Esophagus 1 1 — — $36,224.30 $36,224.30 $36,224.30 2025-06-27
654 MS_DRG Major Bladder Procedures With Cc 16 12 — — $17,473.29 $58,039.31 $35,991.37 2025-06-27
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 16 12 — — $17,388.46 $57,757.55 $35,816.65 2025-06-27
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 16 12 — — $17,370.51 $57,697.91 $35,779.66 2025-06-27
43108 HCPCS Removal Of Esophagus 1 1 — — $35,684.31 $35,684.31 $35,684.31 2025-06-27
24366 HCPCS Hc Reconstruct Radial Head W Implant 26 23 $50,160.00 $32,604.00 35% off $2,283.68 $66,067.03 $35,563.44 2025-06-27
61686 HCPCS Intracranial Vessel Surgery 1 1 — — $35,523.65 $35,523.65 $35,523.65 2025-06-27
27438 HCPCS Hc Arthroplasty Patella With Implant 27 23 $50,160.00 $32,604.00 35% off $2,813.33 $58,265.91 $35,362.80 2025-06-27
24545 HCPCS Hc Open Rx Humeral Supracondylar Fx 27 23 $50,160.00 $32,604.00 35% off $3,106.59 $61,386.39 $35,362.80 2025-06-27
27428 HCPCS Ligmt Revision,knee,intra-artic 27 23 $50,160.00 $32,604.00 35% off $3,725.65 $45,144.00 $35,362.80 2025-06-27
24575 HCPCS Hc Open Rx Humeral Epicondylar Fx 27 23 $50,160.00 $32,604.00 35% off $2,450.09 $45,144.00 $35,362.80 2025-06-27
28320 HCPCS Hc Repair Non/malunion Tarsal Bone(s) 27 23 $50,160.00 $32,604.00 35% off $2,094.62 $60,306.25 $35,362.80 2025-06-27
24515 HCPCS Open Fixatn Mid Humerus Fracture 27 23 $50,160.00 $32,604.00 35% off $2,937.39 $57,709.85 $35,362.80 2025-06-27
27828 HCPCS Open Rx Weightbear Tib,fix Tib/fib 27 23 $50,160.00 $32,604.00 35% off $4,395.16 $58,561.99 $35,362.80 2025-06-27
See an error in this hospital's data? Submit a correction