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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

ST JOSEPHS COMMUNITY HOSPITAL WEST BEND

West Bend, WI · CCN 520063 · Rates published

16,433 distinct procedures filed
31 distinct payers
512,679 rate rows
2025-12-31 last MRF observed
Data quality

511,718 of 512,679 rate rows are consumer-grade (99.8%)

961 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
percent-of-charges filed in the dollar field — excluded from medians 334
per-diem day rate — not a per-procedure price 261
exceeds 10× this hospital's gross charge — excluded from medians 147
placeholder amount (≤ $0.02) — excluded from medians 145
template filing: same amount across many unrelated codes — excluded 68
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 6
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/8142/390806302_st-josephs-community-hospital-of-west-bend-inc_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/FroedtertStJosephsHospital/8142
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-16
Content fingerprint 3a33a35c069b227b… · 328,296,216 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 12 $4,505,000.00 $4,640,150.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 3 $3,539,340.00 $3,932,600.00 $3,932,600.00 nat. median
$3,710,000
1.1× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 13 $3,539,340.00 $3,932,600.00 $3,685,266.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 13 $3,168,979.56 $3,521,088.40 $3,316,462.59 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 13 $3,046,122.00 $3,384,580.00 $3,248,445.72 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 13 $2,831,472.00 $3,146,080.00 $2,945,740.00 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 12 $2,455,110.61 $2,528,763.92 $2,455,110.61 nat. median
$2,469,189
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 13 $2,224,728.00 $2,471,920.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 18 $307,095.00 $1,343,978.28 $790,677.07 nat. median
$370,174
outlier · 2.1×
Q2057
HCPCS 		Afamitresgene Autoleucel 12 $770,620.00 $3,853,100.00 $770,620.00 nat. median
$824,563
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 13 $539,605.14 $2,891,622.90 $591,726.20 nat. median
$754,974
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 13 $525,957.70 $2,766,894.15 $565,868.95 nat. median
$675,122
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 13 $492,727.62 $2,708,178.30 $562,538.19 nat. median
$674,188
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 13 $504,010.06 $2,706,302.25 $557,317.93 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 13 $466,999.36 $2,665,382.40 $533,230.17 nat. median
$634,511
0.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 18 $199,292.30 $872,187.84 $513,117.61 nat. median
$265,286
1.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 13 $465,601.14 $2,448,600.00 $489,304.61 nat. median
$620,080
0.8× median
5834
APR_DRG 		Neonate With Ecmo 10 $408,221.23 $428,632.29 $414,344.55 nat. median
$309,665
1.3× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 18 $151,834.34 $664,491.61 $390,927.66 nat. median
$206,368
1.9× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 18 $150,943.26 $660,591.90 $388,633.41 nat. median
$202,986
1.9× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 12 $278,250.00 $286,597.50 $278,250.00 nat. median
$324,450
0.9× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 10 $266,317.73 $279,633.62 $270,312.49 nat. median
$246,434
1.1× median
5833
APR_DRG 		Neonate With Ecmo 10 $264,458.36 $277,681.28 $268,425.23 nat. median
$244,017
1.1× median
J3403
HCPCS 		Revakinagene, Per Implant 12 $257,500.00 $265,225.00 $257,500.00 nat. median
$265,000
1.0× median
4
MS_DRG 		Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And… 18 $98,504.40 $431,097.12 $253,619.13 nat. median
$133,176
1.9× median
24
APR_DRG 		Heart And/or Lung Transplant 10 $235,848.68 $247,641.11 $239,386.41 nat. median
$234,738
1.0× median
7
MS_DRG 		Lung Transplant 18 $92,095.50 $403,049.07 $237,118.16 nat. median
$122,708
1.9× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 18 $85,465.43 $374,033.10 $220,047.75 nat. median
$117,303
1.9× median
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 10 $207,382.21 $217,751.32 $210,492.95 nat. median
$117,173
1.8× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 18 $80,586.23 $352,679.61 $207,485.26 nat. median
$108,660
1.9× median
209
MS_DRG 		Complex Aortic Arch Procedures 18 $80,493.78 $352,275.01 $207,247.23 nat. median
$98,017
outlier · 2.1×
5832
APR_DRG 		Neonate With Ecmo 10 $203,055.62 $213,208.40 $206,101.46 nat. median
$156,126
1.3× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 12 $205,640.00 $211,809.20 $205,640.00 nat. median
$209,753
1.0× median
1614
APR_DRG 		Implantable Heart Assist Systems 10 $202,120.88 $212,226.92 $205,152.70 nat. median
$207,730
1.0× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 $78,377.40 $343,012.81 $201,798.17 nat. median
$98,905
outlier · 2.0×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 18 $77,331.29 $338,434.61 $199,104.77 nat. median
$102,358
1.9× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 10 $194,269.35 $203,982.82 $197,183.39 nat. median
$150,721
1.3× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 10 $191,608.33 $201,188.75 $194,482.45 nat. median
$160,267
1.2× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 18 $73,323.24 $320,893.69 $188,785.26 nat. median
$100,136
1.9× median
215
MS_DRG 		Other Heart Assist System Implant 18 $70,809.33 $309,891.71 $182,312.67 nat. median
$99,019
1.8× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 18 $69,570.50 $304,470.08 $179,123.07 nat. median
$93,672
1.9× median
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 10 $175,105.17 $183,860.43 $177,731.75 nat. median
$162,982
1.1× median
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 10 $173,206.11 $181,866.42 $175,804.20 nat. median
$182,736
1.0× median
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 10 $171,909.45 $180,504.92 $174,488.09 nat. median
$122,924
1.4× median
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 10 $169,182.28 $177,641.39 $171,720.02 nat. median
$164,279
1.0× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 18 $64,071.88 $280,405.78 $164,965.78 nat. median
$82,712
2.0× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 10 $160,587.46 $168,616.83 $162,996.27 nat. median
$187,294
0.9× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 10 $159,782.70 $167,771.84 $162,179.44 nat. median
$164,834
1.0× median
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 10 $156,874.95 $164,718.70 $159,228.08 nat. median
$151,838
1.0× median
850
MS_DRG 		Acute Leukemia With Other Procedures 18 $61,582.15 $269,509.62 $158,555.45 nat. median
$83,442
1.9× median

Other procedures at this hospital

Browse this hospital's 16,433 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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 12 12 — — $4,505,000.00 $4,640,150.00 $4,505,000.00 2025-12-31
J1414 HCPCS Inj, Beqvez, Per Tx Dose 6 3 — — $3,539,340.00 $3,932,600.00 $3,932,600.00 2025-12-31
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 18 13 — — $3,539,340.00 $3,932,600.00 $3,685,266.67 2025-12-31
J1413 HCPCS Inj Delandistrogene Mox Rokl 18 13 — — $3,168,979.56 $3,521,088.40 $3,316,462.59 2025-12-31
J3394 HCPCS Inj, Lovotibeglogene Autotem 18 13 — — $3,046,122.00 $3,384,580.00 $3,248,445.72 2025-12-31
J3393 HCPCS Inj, Betibeglogene Autotemce 18 13 — — $2,831,472.00 $3,146,080.00 $2,945,740.00 2025-12-31
J3399 HCPCS Inj Onase Abepar-xioi Treat 12 12 — — $2,455,110.61 $2,528,763.92 $2,455,110.61 2025-12-31
J3392 HCPCS Inj, Exagamglogene Autotem 18 13 — — $2,224,728.00 $2,471,920.00 $2,332,000.00 2025-12-31
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 27 18 — — $307,095.00 $1,343,978.28 $790,677.07 2025-12-31
Q2057 HCPCS Afamitresgene Autoleucel 13 12 — — $770,620.00 $3,853,100.00 $770,620.00 2025-12-31
Q2042 HCPCS Tisagenlecleucel Car-pos T 16 13 — — $539,605.14 $2,891,622.90 $591,726.20 2025-12-31
Q2056 HCPCS Ciltacabtagene Car-pos T 16 13 — — $525,957.70 $2,766,894.15 $565,868.95 2025-12-31
Q2054 HCPCS Lisocabtagene Mara Car Pos T 16 13 — — $492,727.62 $2,708,178.30 $562,538.19 2025-12-31
Q2055 HCPCS Idecabtagene Vicleucel Car 16 13 — — $504,010.06 $2,706,302.25 $557,317.93 2025-12-31
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 16 13 — — $466,999.36 $2,665,382.40 $533,230.17 2025-12-31
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 27 18 — — $199,292.30 $872,187.84 $513,117.61 2025-12-31
Q2053 HCPCS Brexucabtagene Car Pos T 16 13 — — $465,601.14 $2,448,600.00 $489,304.61 2025-12-31
5834 APR_DRG Neonate With Ecmo 10 10 — — $408,221.23 $428,632.29 $414,344.55 2025-12-31
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 27 18 — — $151,834.34 $664,491.61 $390,927.66 2025-12-31
3 MS_DRG Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 27 18 — — $150,943.26 $660,591.90 $388,633.41 2025-12-31
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 12 12 — — $278,250.00 $286,597.50 $278,250.00 2025-12-31
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 10 10 — — $266,317.73 $279,633.62 $270,312.49 2025-12-31
5833 APR_DRG Neonate With Ecmo 10 10 — — $264,458.36 $277,681.28 $268,425.23 2025-12-31
J3403 HCPCS Revakinagene, Per Implant 12 12 — — $257,500.00 $265,225.00 $257,500.00 2025-12-31
4 MS_DRG Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And … 27 18 — — $98,504.40 $431,097.12 $253,619.13 2025-12-31
24 APR_DRG Heart And/or Lung Transplant 10 10 — — $235,848.68 $247,641.11 $239,386.41 2025-12-31
7 MS_DRG Lung Transplant 27 18 — — $92,095.50 $403,049.07 $237,118.16 2025-12-31
14 MS_DRG Allogeneic Bone Marrow Transplant 27 18 — — $85,465.43 $374,033.10 $220,047.75 2025-12-31
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 10 10 — — $207,382.21 $217,751.32 $210,492.95 2025-12-31
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 27 18 — — $80,586.23 $352,679.61 $207,485.26 2025-12-31
209 MS_DRG Complex Aortic Arch Procedures 27 18 — — $80,493.78 $352,275.01 $207,247.23 2025-12-31
5832 APR_DRG Neonate With Ecmo 10 10 — — $203,055.62 $213,208.40 $206,101.46 2025-12-31
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 12 12 — — $205,640.00 $211,809.20 $205,640.00 2025-12-31
1614 APR_DRG Implantable Heart Assist Systems 10 10 — — $202,120.88 $212,226.92 $205,152.70 2025-12-31
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 27 18 — — $78,377.40 $343,012.81 $201,798.17 2025-12-31
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 27 18 — — $77,331.29 $338,434.61 $199,104.77 2025-12-31
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 10 10 — — $194,269.35 $203,982.82 $197,183.39 2025-12-31
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 10 10 — — $191,608.33 $201,188.75 $194,482.45 2025-12-31
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 27 18 — — $73,323.24 $320,893.69 $188,785.26 2025-12-31
215 MS_DRG Other Heart Assist System Implant 27 18 — — $70,809.33 $309,891.71 $182,312.67 2025-12-31
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 27 18 — — $69,570.50 $304,470.08 $179,123.07 2025-12-31
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 10 10 — — $175,105.17 $183,860.43 $177,731.75 2025-12-31
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 10 10 — — $173,206.11 $181,866.42 $175,804.20 2025-12-31
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 10 10 — — $171,909.45 $180,504.92 $174,488.09 2025-12-31
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 10 10 — — $169,182.28 $177,641.39 $171,720.02 2025-12-31
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 27 18 — — $64,071.88 $280,405.78 $164,965.78 2025-12-31
74 APR_DRG Allogeneic Bone Marrow Transplant 10 10 — — $160,587.46 $168,616.83 $162,996.27 2025-12-31
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 10 10 — — $159,782.70 $167,771.84 $162,179.44 2025-12-31
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 10 10 — — $156,874.95 $164,718.70 $159,228.08 2025-12-31
850 MS_DRG Acute Leukemia With Other Procedures 27 18 — — $61,582.15 $269,509.62 $158,555.45 2025-12-31
231 MS_DRG Coronary Bypass With Ptca With Mcc 27 18 — — $59,949.33 $262,363.78 $154,351.47 2025-12-31
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 10 10 — — $151,984.87 $159,584.11 $154,264.65 2025-12-31
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 27 18 — — $59,760.87 $261,539.02 $153,866.25 2025-12-31
5831 APR_DRG Neonate With Ecmo 10 10 — — $147,594.46 $154,974.18 $149,808.38 2025-12-31
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 10 10 — — $145,103.88 $152,359.07 $147,280.44 2025-12-31
14 APR_DRG Liver Transplant And/or Intestinal Transplant 10 10 — — $142,814.11 $149,954.82 $144,956.32 2025-12-31
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 27 18 — — $55,959.06 $244,900.66 $144,077.73 2025-12-31
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 10 10 — — $141,835.01 $148,926.76 $143,962.54 2025-12-31
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 27 18 — — $54,604.33 $238,971.73 $140,589.67 2025-12-31
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 27 18 — — $54,368.94 $237,941.56 $139,983.61 2025-12-31
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 27 18 — — $54,189.00 $237,154.15 $139,520.37 2025-12-31
1613 APR_DRG Implantable Heart Assist Systems 10 10 — — $136,760.47 $143,598.49 $138,811.88 2025-12-31
23 APR_DRG Heart And/or Lung Transplant 10 10 — — $132,427.65 $139,049.03 $134,414.07 2025-12-31
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 10 10 — — $130,272.52 $136,786.15 $132,226.61 2025-12-31
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 27 18 — — $51,335.16 $224,664.49 $132,172.57 2025-12-31
10 MS_DRG Pancreas Transplant 27 18 — — $51,030.07 $223,329.31 $131,387.07 2025-12-31
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 27 18 — — $51,008.74 $223,235.94 $131,332.14 2025-12-31
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 27 18 — — $50,737.79 $222,050.16 $130,634.53 2025-12-31
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 27 18 — — $50,707.93 $221,919.44 $130,557.62 2025-12-31
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 10 10 — — $125,573.12 $131,851.78 $127,456.71 2025-12-31
J2351 HCPCS Ocrelizumab-hyaluronidase-ocsq 920-23000 Mg-unit/23 Ml Solution 23 Ml Vial 77 31 $175,458.15 $96,501.99 45% off $47.23 $166,685.24 $127,207.16 2025-12-31
870 MS_DRG Septicemia Or Severe Sepsis With Mv &gt;96 Hours 27 18 — — $49,153.34 $215,115.95 $126,555.06 2025-12-31
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 27 18 — — $48,912.27 $214,060.88 $125,934.35 2025-12-31
955 MS_DRG Craniotomy For Multiple Significant Trauma 27 18 — — $47,868.30 $209,492.03 $123,246.44 2025-12-31
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 10 10 — — $120,945.33 $126,992.60 $122,759.51 2025-12-31
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 27 18 — — $47,551.11 $208,103.94 $122,429.82 2025-12-31
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 27 18 — — $47,516.27 $207,951.44 $122,340.10 2025-12-31
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 27 18 — — $46,760.32 $204,643.06 $120,393.74 2025-12-31
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 27 18 — — $46,760.32 $204,643.06 $120,393.74 2025-12-31
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 27 18 — — $46,590.36 $203,899.22 $119,956.13 2025-12-31
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 10 10 — — $117,923.95 $123,820.15 $119,692.81 2025-12-31
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 10 10 — — $116,491.87 $122,316.46 $118,239.25 2025-12-31
207 MS_DRG Respiratory System Diagnosis With Ventilator Support &gt;96 Hours 27 18 — — $45,760.44 $200,267.17 $117,819.36 2025-12-31
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 27 18 — — $43,582.19 $190,734.19 $112,211.00 2025-12-31
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 27 18 — — $43,531.70 $190,513.22 $112,081.00 2025-12-31
1612 APR_DRG Implantable Heart Assist Systems 10 10 — — $109,779.78 $115,268.77 $111,426.48 2025-12-31
232 MS_DRG Coronary Bypass With Ptca Without Mcc 27 18 — — $43,114.25 $188,686.30 $111,006.21 2025-12-31
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 10 10 — — $108,798.34 $114,238.26 $110,430.32 2025-12-31
28 MS_DRG Spinal Procedures With Mcc 27 18 — — $42,728.10 $186,996.32 $110,011.97 2025-12-31
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 27 18 — — $42,716.01 $186,943.41 $109,980.85 2025-12-31
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 27 18 — — $42,406.66 $185,589.56 $109,184.36 2025-12-31
Q0480 HCPCS Driver Pneumatic Vad, Rep 12 12 — — $108,727.22 $111,989.04 $108,727.22 2025-12-31
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 27 18 — — $42,169.13 $184,550.05 $108,572.81 2025-12-31
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 27 18 — — $41,734.62 $182,648.44 $107,454.07 2025-12-31
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 27 18 — — $41,707.60 $182,530.17 $107,384.49 2025-12-31
1611 APR_DRG Implantable Heart Assist Systems 10 10 — — $104,593.94 $109,823.64 $106,162.85 2025-12-31
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 27 18 — — $41,012.80 $179,489.45 $105,595.60 2025-12-31
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 10 10 — — $104,034.34 $109,236.06 $105,594.85 2025-12-31
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 10 10 — — $103,847.55 $109,039.93 $105,405.26 2025-12-31
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 27 18 — — $40,751.09 $178,344.13 $104,921.79 2025-12-31
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 27 18 — — $40,584.69 $177,615.85 $104,493.34 2025-12-31
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 27 18 — — $40,532.06 $177,385.54 $104,357.85 2025-12-31
64 APR_DRG Pancreas Transplant 10 10 — — $102,736.13 $107,872.94 $104,277.17 2025-12-31
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 27 18 — — $39,980.92 $174,973.51 $102,938.82 2025-12-31
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 27 18 — — $39,857.18 $174,431.97 $102,620.23 2025-12-31
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 10 10 — — $100,965.49 $106,013.76 $102,479.97 2025-12-31
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 27 18 — — $39,584.10 $173,236.84 $101,917.12 2025-12-31
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 27 18 — — $39,276.88 $171,892.33 $101,126.13 2025-12-31
8514 APR_DRG Gender Related Procedures 10 10 — — $99,615.13 $104,595.89 $101,109.36 2025-12-31
834 MS_DRG Acute Leukemia With Mcc 27 18 — — $39,041.49 $170,862.16 $100,520.07 2025-12-31
J9269 HCPCS Tagraxofusp-erzs 1000 Mcg/ml Solution 1 Ml Vial 77 31 $138,417.27 $76,129.50 45% off $323.30 $131,496.41 $100,352.52 2025-12-31
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 10 10 — — $98,814.25 $103,754.96 $100,296.46 2025-12-31
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 27 18 — — $38,903.53 $170,258.37 $100,164.86 2025-12-31
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 27 18 — — $38,848.06 $170,015.61 $100,022.04 2025-12-31
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 27 18 — — $38,786.90 $169,747.95 $99,864.57 2025-12-31
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 10 10 — — $98,129.35 $103,035.82 $99,601.29 2025-12-31
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 27 18 — — $38,631.87 $169,069.47 $99,465.41 2025-12-31
22 APR_DRG Heart And/or Lung Transplant 10 10 — — $96,374.27 $101,192.98 $97,819.89 2025-12-31
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 27 18 — — $37,924.26 $165,972.73 $97,643.57 2025-12-31
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 27 18 — — $37,901.51 $165,873.14 $97,584.98 2025-12-31
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 27 18 — — $37,646.92 $164,758.94 $96,929.48 2025-12-31
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 10 10 — — $95,224.72 $99,985.96 $96,653.09 2025-12-31
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 27 18 — — $37,522.47 $164,214.28 $96,609.05 2025-12-31
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 27 18 — — $37,018.27 $162,007.66 $95,310.87 2025-12-31
653 MS_DRG Major Bladder Procedures With Mcc 27 18 — — $36,954.27 $161,727.56 $95,146.08 2025-12-31
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 10 10 — — $92,763.72 $97,401.91 $94,155.18 2025-12-31
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 10 10 — — $92,515.44 $97,141.21 $93,903.17 2025-12-31
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 12 12 — — $93,216.70 $96,013.20 $93,216.70 2025-12-31
J2507 HCPCS Pegloticase 8 Mg/ml Solution 1 Ml Vial 77 31 $127,605.41 $70,182.98 45% off $3,386.75 $121,225.14 $92,513.93 2025-12-31
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 27 18 — — $35,843.44 $156,866.14 $92,286.06 2025-12-31
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 27 18 — — $35,467.96 $155,222.85 $91,319.29 2025-12-31
J0202 HCPCS Alemtuzumab 12 Mg/1.2ml Solution 1.2 Ml Vial 77 31 $125,171.40 $68,844.27 45% off $2,302.34 $118,912.83 $90,749.26 2025-12-31
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 10 10 — — $89,276.92 $93,740.77 $90,616.07 2025-12-31
228 MS_DRG Other Cardiothoracic Procedures With Mcc 27 18 — — $35,183.48 $153,977.93 $90,586.89 2025-12-31
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 10 10 — — $89,111.14 $93,566.70 $90,447.80 2025-12-31
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 27 18 — — $35,120.90 $153,704.05 $90,425.77 2025-12-31
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 10 10 — — $88,939.91 $93,386.91 $90,274.01 2025-12-31
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 27 18 — — $35,000.73 $153,178.07 $90,116.33 2025-12-31
21 APR_DRG Heart And/or Lung Transplant 10 10 — — $88,630.15 $93,061.66 $89,959.60 2025-12-31
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 27 18 — — $34,854.94 $152,540.05 $89,740.97 2025-12-31
471 MS_DRG Cervical Spinal Fusion With Mcc 27 18 — — $34,339.36 $150,283.63 $88,413.50 2025-12-31
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 27 18 — — $34,165.84 $149,524.23 $87,966.73 2025-12-31
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 27 18 — — $33,856.49 $148,170.38 $87,170.25 2025-12-31
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 27 18 — — $33,434.06 $146,321.67 $86,082.63 2025-12-31
J1747 HCPCS Spesolimab-sbzo 450 Mg/7.5ml Solution 7.5 Ml Vial 77 31 $118,598.93 $65,229.42 45% off $58.61 $112,668.98 $85,984.23 2025-12-31
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 10 10 — — $84,695.82 $88,930.61 $85,966.26 2025-12-31
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 27 18 — — $33,365.79 $146,022.89 $85,906.86 2025-12-31
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 27 18 — — $33,266.23 $145,587.17 $85,650.52 2025-12-31
6 MS_DRG Liver Transplant Without Mcc 27 18 — — $32,976.07 $144,317.35 $84,903.47 2025-12-31
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 27 18 — — $32,844.52 $143,741.58 $84,564.74 2025-12-31
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 27 18 — — $32,688.06 $143,056.87 $84,161.92 2025-12-31
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 27 18 — — $32,604.85 $142,692.73 $83,947.69 2025-12-31
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 10 10 — — $82,631.76 $86,763.35 $83,871.24 2025-12-31
245 MS_DRG Aicd Generator Procedures 27 18 — — $32,445.55 $141,995.58 $83,537.54 2025-12-31
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 27 18 — — $32,348.14 $141,569.19 $83,286.70 2025-12-31
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 27 18 — — $32,333.92 $141,506.94 $83,250.08 2025-12-31
799 MS_DRG Splenic Procedures With Mcc 27 18 — — $32,207.33 $140,952.95 $82,924.16 2025-12-31
J9359 HCPCS Loncastuximab Tesirine-lpyl 10 Mg/2 Ml Recon Soln 1 Each Vial 77 31 $113,857.24 $62,621.49 45% off $202.37 $108,164.38 $82,546.50 2025-12-31
163 MS_DRG Major Chest Procedures With Mcc 27 18 — — $31,872.38 $139,487.06 $82,061.76 2025-12-31
31 MS_DRG Ventricular Shunt Procedures With Mcc 27 18 — — $31,863.13 $139,446.60 $82,037.96 2025-12-31
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 27 18 — — $31,737.97 $138,898.84 $81,715.70 2025-12-31
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 10 10 — — $80,504.65 $84,529.88 $81,712.22 2025-12-31
84 APR_DRG Autologous Bone Marrow Transplant 10 10 — — $79,594.04 $83,573.74 $80,787.95 2025-12-31
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 27 18 — — $31,239.45 $136,717.11 $80,432.17 2025-12-31
73 APR_DRG Allogeneic Bone Marrow Transplant 10 10 — — $78,484.95 $82,409.20 $79,662.23 2025-12-31
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 27 18 — — $30,774.36 $134,681.67 $79,234.69 2025-12-31
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 27 18 — — $30,529.01 $133,607.93 $78,603.00 2025-12-31
140 MS_DRG Major Head And Neck Procedures With Mcc 27 18 — — $30,332.73 $132,748.93 $78,097.64 2025-12-31
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 27 18 — — $30,158.51 $131,986.42 $77,649.05 2025-12-31
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 27 18 — — $30,033.34 $131,438.65 $77,326.79 2025-12-31
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 27 18 — — $29,982.13 $131,214.57 $77,194.96 2025-12-31
J7330 HCPCS Cultured Chondrocytes Implnt 6 3 — — $69,449.29 $77,165.88 $77,165.88 2025-12-31
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 27 18 — — $29,967.21 $131,149.21 $77,156.51 2025-12-31
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 27 18 — — $29,879.72 $130,766.40 $76,931.30 2025-12-31
901 MS_DRG Wound Debridements For Injuries With Mcc 27 18 — — $29,844.18 $130,610.78 $76,839.75 2025-12-31
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 27 18 — — $29,788.70 $130,368.02 $76,696.93 2025-12-31
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 27 18 — — $29,673.49 $129,863.83 $76,400.31 2025-12-31
4404 APR_DRG Kidney Transplant 10 10 — — $75,233.20 $78,994.86 $76,361.70 2025-12-31
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 27 18 — — $29,534.10 $129,253.82 $76,041.43 2025-12-31
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 27 18 — — $29,338.55 $128,397.94 $75,537.91 2025-12-31
8634 APR_DRG Neonatal Aftercare 10 10 — — $74,354.49 $78,072.21 $75,469.80 2025-12-31
63 APR_DRG Pancreas Transplant 10 10 — — $72,985.46 $76,634.73 $74,080.24 2025-12-31
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 10 10 — — $72,697.49 $76,332.36 $73,787.95 2025-12-31
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 27 18 — — $28,591.84 $125,130.02 $73,615.36 2025-12-31
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 10 10 — — $72,357.37 $75,975.24 $73,442.73 2025-12-31
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 27 18 — — $28,332.97 $123,997.14 $72,948.87 2025-12-31
J9228 HCPCS Ipilimumab 200 Mg/40ml Solution 40 Ml Vial 101 31 $145,600.75 $80,080.42 45% off $171.77 $138,320.71 $72,800.38 2025-12-31
J9281 HCPCS mitoMYcin 80 (2 X 40) Mg Recon Soln 1 Each Box 77 31 $100,383.00 $55,210.65 45% off $297.04 $95,363.85 $72,777.68 2025-12-31
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 27 18 — — $27,819.52 $121,750.06 $71,626.89 2025-12-31
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours Without Skin Graft 27 18 — — $27,693.65 $121,199.19 $71,302.80 2025-12-31
34 MS_DRG Carotid Artery Stent Procedures With Mcc 27 18 — — $27,526.52 $120,467.80 $70,872.52 2025-12-31
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 27 18 — — $27,458.96 $120,172.13 $70,698.57 2025-12-31
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 27 18 — — $27,303.24 $119,490.53 $70,297.58 2025-12-31
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 10 10 — — $68,861.22 $72,304.28 $69,894.14 2025-12-31
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 27 18 — — $26,760.62 $117,115.85 $68,900.53 2025-12-31
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 27 18 — — $26,644.00 $116,605.43 $68,600.25 2025-12-31
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 10 10 — — $67,515.54 $70,891.32 $68,528.27 2025-12-31
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 27 18 — — $26,580.70 $116,328.44 $68,437.29 2025-12-31
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 27 18 — — $26,577.85 $116,315.99 $68,429.96 2025-12-31
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 27 18 — — $26,503.18 $115,989.20 $68,237.71 2025-12-31
J9229 HCPCS Inotuzumab Ozogamicin 0.25 Mg/ml Recon Soln 1 Each Vial 77 31 $93,937.80 $51,665.79 45% off $2,535.86 $89,240.91 $68,104.90 2025-12-31
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 10 10 — — $67,059.45 $70,412.42 $68,065.34 2025-12-31
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 27 18 — — $26,353.84 $115,335.61 $67,853.20 2025-12-31
13 APR_DRG Liver Transplant And/or Intestinal Transplant 10 10 — — $66,808.84 $70,149.28 $67,810.98 2025-12-31
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 12 12 — — $67,452.66 $69,476.24 $67,452.66 2025-12-31
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 27 18 — — $26,121.29 $114,317.89 $67,254.46 2025-12-31
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 27 18 — — $26,110.63 $114,271.21 $67,227.00 2025-12-31
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 10 10 — — $66,081.12 $69,385.18 $67,072.33 2025-12-31
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 27 18 — — $25,804.13 $112,929.81 $66,437.84 2025-12-31
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 27 18 — — $25,784.20 $112,842.66 $66,386.57 2025-12-31
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 10 10 — — $65,380.65 $68,649.68 $66,361.36 2025-12-31
332 MS_DRG Rectal Resection With Mcc 27 18 — — $25,748.66 $112,687.05 $66,295.02 2025-12-31
265 MS_DRG Aicd Lead Procedures 27 18 — — $25,730.87 $112,609.24 $66,249.24 2025-12-31
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 27 18 — — $25,685.36 $112,410.05 $66,132.06 2025-12-31
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 27 18 — — $25,646.96 $112,241.99 $66,033.18 2025-12-31
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 27 18 — — $25,479.12 $111,507.48 $65,601.07 2025-12-31
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 27 18 — — $25,420.10 $111,249.16 $65,449.10 2025-12-31
335 MS_DRG Peritoneal Adhesiolysis With Mcc 27 18 — — $25,394.49 $111,137.12 $65,383.18 2025-12-31
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 27 18 — — $25,356.80 $110,972.17 $65,286.14 2025-12-31
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 27 18 — — $25,335.47 $110,878.80 $65,231.21 2025-12-31
1784 APR_DRG External Heart Assist Systems 10 10 — — $64,263.78 $67,476.97 $65,227.74 2025-12-31
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 27 18 — — $25,311.30 $110,772.98 $65,168.95 2025-12-31
271 MS_DRG Other Major Cardiovascular Procedures With Cc 27 18 — — $25,290.66 $110,682.72 $65,115.85 2025-12-31
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 10 10 — — $64,094.11 $67,298.82 $65,055.52 2025-12-31
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 10 10 — — $63,906.54 $67,101.87 $64,865.14 2025-12-31
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 10 10 — — $63,770.34 $66,958.86 $64,726.89 2025-12-31
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 27 18 — — $25,079.47 $109,758.37 $64,572.05 2025-12-31
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 27 18 — — $25,028.25 $109,534.29 $64,440.21 2025-12-31
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 10 10 — — $63,187.39 $66,346.76 $64,135.20 2025-12-31
72 APR_DRG Allogeneic Bone Marrow Transplant 10 10 — — $62,936.00 $66,082.80 $63,880.04 2025-12-31
252 MS_DRG Other Vascular Procedures With Mcc 27 18 — — $24,807.08 $108,566.36 $63,870.77 2025-12-31
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 27 18 — — $24,800.68 $108,538.35 $63,854.29 2025-12-31
J2350 HCPCS Ocrelizumab 300 Mg/10ml Solution 10 Ml Vial 77 31 $87,734.08 $48,253.75 45% off $56.07 $83,347.38 $63,607.21 2025-12-31
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 10 10 — — $62,627.01 $65,758.36 $63,566.42 2025-12-31
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 27 18 — — $24,686.91 $108,040.38 $63,561.33 2025-12-31
J9029 HCPCS Instill Adstiladrin, Tx Dose 20 13 — — $60,485.54 $317,155.25 $63,342.28 2025-12-31
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 27 18 — — $24,567.43 $107,517.52 $63,253.73 2025-12-31
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 27 18 — — $24,453.65 $107,019.55 $62,960.77 2025-12-31
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 27 18 — — $24,381.12 $106,702.09 $62,774.00 2025-12-31
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 10 10 — — $61,801.23 $64,891.29 $62,728.25 2025-12-31
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 27 18 — — $24,261.63 $106,179.23 $62,466.40 2025-12-31
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 27 18 — — $24,229.63 $106,039.17 $62,384.00 2025-12-31
J0638 HCPCS Canakinumab 150 mg/mL Solution 1 Ml Vial 77 31 $85,951.84 $47,273.52 45% off $129.63 $81,654.25 $62,315.08 2025-12-31
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 10 10 — — $61,318.68 $64,384.61 $62,238.46 2025-12-31
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 10 10 — — $61,252.52 $64,315.15 $62,171.31 2025-12-31
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 10 10 — — $61,200.38 $64,260.40 $62,118.38 2025-12-31
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 10 10 — — $60,635.33 $63,667.10 $61,544.86 2025-12-31
264 MS_DRG Other Circulatory System O.r. Procedures 27 18 — — $23,756.72 $103,969.49 $61,166.39 2025-12-31
J9274 HCPCS Tebentafusp-tebn 100 Mcg/0.5ml Solution 0.5 Ml Vial 77 31 $83,983.00 $46,190.65 45% off $204.89 $79,783.85 $60,887.68 2025-12-31
71 APR_DRG Allogeneic Bone Marrow Transplant 10 10 — — $59,789.31 $62,778.78 $60,686.15 2025-12-31
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 27 18 — — $23,491.45 $102,808.61 $60,483.42 2025-12-31
37 MS_DRG Extracranial Procedures With Mcc 27 18 — — $23,411.81 $102,460.03 $60,278.35 2025-12-31
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 10 10 — — $59,383.04 $62,352.19 $60,273.79 2025-12-31
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 27 18 — — $23,408.97 $102,447.58 $60,271.03 2025-12-31
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 27 18 — — $23,132.33 $101,236.89 $59,558.77 2025-12-31
62 APR_DRG Pancreas Transplant 10 10 — — $58,438.96 $61,360.91 $59,315.54 2025-12-31
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 27 18 — — $23,030.64 $100,791.84 $59,296.94 2025-12-31
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 27 18 — — $23,005.03 $100,679.79 $59,231.02 2025-12-31
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 27 18 — — $22,973.03 $100,539.74 $59,148.62 2025-12-31
652 MS_DRG Kidney Transplant 27 18 — — $22,966.63 $100,511.73 $59,132.15 2025-12-31
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 27 18 — — $22,949.57 $100,437.03 $59,088.20 2025-12-31
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 27 18 — — $22,904.75 $100,240.96 $58,972.85 2025-12-31
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 27 18 — — $22,830.79 $99,917.28 $58,782.42 2025-12-31
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 10 10 — — $57,717.47 $60,603.34 $58,583.23 2025-12-31
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 27 18 — — $22,705.63 $99,369.51 $58,460.17 2025-12-31
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 27 18 — — $22,663.68 $99,185.89 $58,352.14 2025-12-31
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 27 18 — — $22,641.62 $99,089.41 $58,295.38 2025-12-31
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 27 18 — — $22,596.13 $98,890.22 $58,178.19 2025-12-31
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 10 10 — — $57,241.92 $60,104.02 $58,100.55 2025-12-31
500 MS_DRG Soft Tissue Procedures With Mcc 27 18 — — $22,506.51 $98,498.07 $57,947.49 2025-12-31
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 27 18 — — $22,472.38 $98,348.68 $57,859.60 2025-12-31
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 27 18 — — $22,408.38 $98,068.57 $57,694.81 2025-12-31
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 27 18 — — $22,397.70 $98,021.89 $57,667.35 2025-12-31
9104 APR_DRG Craniotomy For Multiple Significant Trauma 10 10 — — $56,690.89 $59,525.43 $57,541.26 2025-12-31
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 27 18 — — $22,345.09 $97,791.58 $57,531.85 2025-12-31
38240 CPT Transplt Allo Hct/donor 19 13 — — $8,391.64 $59,151.24 $57,428.39 2025-12-31
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 10 10 — — $56,406.03 $59,226.33 $57,252.12 2025-12-31
665 MS_DRG Prostatectomy With Mcc 27 18 — — $22,196.45 $97,141.11 $57,149.17 2025-12-31
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 27 18 — — $22,150.23 $96,938.81 $57,030.16 2025-12-31
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 27 18 — — $22,111.11 $96,767.63 $56,929.45 2025-12-31
1834 APR_DRG Percutaneous Structural Cardiac Procedures 10 10 — — $56,004.42 $58,804.64 $56,844.49 2025-12-31
A9543 HCPCS Y90 Ibritumomab, Rx 12 12 — — $56,824.55 $58,529.29 $56,824.55 2025-12-31
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 10 10 — — $55,765.48 $58,553.75 $56,601.96 2025-12-31
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 10 10 — — $55,611.38 $58,391.95 $56,445.55 2025-12-31
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 10 10 — — $55,537.44 $58,314.31 $56,370.50 2025-12-31
6904 APR_DRG Acute Leukemia 10 10 — — $55,241.68 $58,003.76 $56,070.31 2025-12-31
662 MS_DRG Minor Bladder Procedures With Mcc 27 18 — — $21,771.90 $95,283.06 $56,056.07 2025-12-31
263 MS_DRG Vein Ligation And Stripping 27 18 — — $21,742.73 $95,155.46 $55,980.99 2025-12-31
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 10 10 — — $54,882.11 $57,626.22 $55,705.34 2025-12-31
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 10 10 — — $54,843.19 $57,585.35 $55,665.84 2025-12-31
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 27 18 — — $21,570.64 $94,402.28 $55,537.89 2025-12-31
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 27 18 — — $21,480.33 $94,007.02 $55,305.36 2025-12-31
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 27 18 — — $21,477.48 $93,994.57 $55,298.03 2025-12-31
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 20 13 — — $52,981.82 $279,729.85 $55,272.32 2025-12-31
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 27 18 — — $21,454.01 $93,891.87 $55,237.61 2025-12-31
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 10 10 — — $53,881.21 $56,575.27 $54,689.43 2025-12-31
914 APR_DRG Other Major Head And Neck Procedures 10 10 — — $53,720.10 $56,406.11 $54,525.90 2025-12-31
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 27 18 — — $21,166.71 $92,634.50 $54,497.88 2025-12-31
12 APR_DRG Liver Transplant And/or Intestinal Transplant 10 10 — — $53,669.51 $56,352.99 $54,474.56 2025-12-31
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 10 10 — — $53,166.72 $55,825.06 $53,964.22 2025-12-31
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