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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.

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
             
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
10 MS_DRG Pancreas Transplant 27 18 — — $51,030.07 $223,329.31 $131,387.07 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
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
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
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
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
12 APR_DRG Liver Transplant And/or Intestinal Transplant 10 10 — — $53,669.51 $56,352.99 $54,474.56 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
14 MS_DRG Allogeneic Bone Marrow Transplant 27 18 — — $85,465.43 $374,033.10 $220,047.75 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
140 MS_DRG Major Head And Neck Procedures With Mcc 27 18 — — $30,332.73 $132,748.93 $78,097.64 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
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 27 18 — — $42,169.13 $184,550.05 $108,572.81 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
1611 APR_DRG Implantable Heart Assist Systems 10 10 — — $104,593.94 $109,823.64 $106,162.85 2025-12-31
1612 APR_DRG Implantable Heart Assist Systems 10 10 — — $109,779.78 $115,268.77 $111,426.48 2025-12-31
1613 APR_DRG Implantable Heart Assist Systems 10 10 — — $136,760.47 $143,598.49 $138,811.88 2025-12-31
1614 APR_DRG Implantable Heart Assist Systems 10 10 — — $202,120.88 $212,226.92 $205,152.70 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
163 MS_DRG Major Chest Procedures With Mcc 27 18 — — $31,872.38 $139,487.06 $82,061.76 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
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
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
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
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 10 10 — — $67,515.54 $70,891.32 $68,528.27 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
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
1784 APR_DRG External Heart Assist Systems 10 10 — — $64,263.78 $67,476.97 $65,227.74 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
1834 APR_DRG Percutaneous Structural Cardiac Procedures 10 10 — — $56,004.42 $58,804.64 $56,844.49 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
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
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
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
209 MS_DRG Complex Aortic Arch Procedures 27 18 — — $80,493.78 $352,275.01 $207,247.23 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
21 APR_DRG Heart And/or Lung Transplant 10 10 — — $88,630.15 $93,061.66 $89,959.60 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
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 27 18 — — $40,584.69 $177,615.85 $104,493.34 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
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
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
22 APR_DRG Heart And/or Lung Transplant 10 10 — — $96,374.27 $101,192.98 $97,819.89 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
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
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
228 MS_DRG Other Cardiothoracic Procedures With Mcc 27 18 — — $35,183.48 $153,977.93 $90,586.89 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
23 APR_DRG Heart And/or Lung Transplant 10 10 — — $132,427.65 $139,049.03 $134,414.07 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
231 MS_DRG Coronary Bypass With Ptca With Mcc 27 18 — — $59,949.33 $262,363.78 $154,351.47 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
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
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
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 27 18 — — $41,734.62 $182,648.44 $107,454.07 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
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
24 APR_DRG Heart And/or Lung Transplant 10 10 — — $235,848.68 $247,641.11 $239,386.41 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
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 27 18 — — $22,705.63 $99,369.51 $58,460.17 2025-12-31
245 MS_DRG Aicd Generator Procedures 27 18 — — $32,445.55 $141,995.58 $83,537.54 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
252 MS_DRG Other Vascular Procedures With Mcc 27 18 — — $24,807.08 $108,566.36 $63,870.77 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
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 27 18 — — $22,111.11 $96,767.63 $56,929.45 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
263 MS_DRG Vein Ligation And Stripping 27 18 — — $21,742.73 $95,155.46 $55,980.99 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
265 MS_DRG Aicd Lead Procedures 27 18 — — $25,730.87 $112,609.24 $66,249.24 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
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
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
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
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 27 18 — — $37,522.47 $164,214.28 $96,609.05 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
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 27 18 — — $29,338.55 $128,397.94 $75,537.91 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
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
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
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 27 18 — — $32,844.52 $143,741.58 $84,564.74 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
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
28 MS_DRG Spinal Procedures With Mcc 27 18 — — $42,728.10 $186,996.32 $110,011.97 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
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
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
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
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
31 MS_DRG Ventricular Shunt Procedures With Mcc 27 18 — — $31,863.13 $139,446.60 $82,037.96 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
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
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 27 18 — — $31,737.97 $138,898.84 $81,715.70 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
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
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 27 18 — — $22,830.79 $99,917.28 $58,782.42 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
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
332 MS_DRG Rectal Resection With Mcc 27 18 — — $25,748.66 $112,687.05 $66,295.02 2025-12-31
335 MS_DRG Peritoneal Adhesiolysis With Mcc 27 18 — — $25,394.49 $111,137.12 $65,383.18 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
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
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
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
37 MS_DRG Extracranial Procedures With Mcc 27 18 — — $23,411.81 $102,460.03 $60,278.35 2025-12-31
38240 CPT Transplt Allo Hct/donor 19 13 — — $8,391.64 $59,151.24 $57,428.39 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
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
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
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 27 18 — — $38,903.53 $170,258.37 $100,164.86 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
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 27 18 — — $23,491.45 $102,808.61 $60,483.42 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
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
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 27 18 — — $24,229.63 $106,039.17 $62,384.00 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
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
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
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
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
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
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
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
4404 APR_DRG Kidney Transplant 10 10 — — $75,233.20 $78,994.86 $76,361.70 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
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
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
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
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
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
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
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
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
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
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
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
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
471 MS_DRG Cervical Spinal Fusion With Mcc 27 18 — — $34,339.36 $150,283.63 $88,413.50 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
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
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
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
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
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
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 27 18 — — $73,323.24 $320,893.69 $188,785.26 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
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
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
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
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
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
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
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
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
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
5831 APR_DRG Neonate With Ecmo 10 10 — — $147,594.46 $154,974.18 $149,808.38 2025-12-31
5832 APR_DRG Neonate With Ecmo 10 10 — — $203,055.62 $213,208.40 $206,101.46 2025-12-31
5833 APR_DRG Neonate With Ecmo 10 10 — — $264,458.36 $277,681.28 $268,425.23 2025-12-31
5834 APR_DRG Neonate With Ecmo 10 10 — — $408,221.23 $428,632.29 $414,344.55 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
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
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
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
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
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
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
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
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
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
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
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
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
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
6 MS_DRG Liver Transplant Without Mcc 27 18 — — $32,976.07 $144,317.35 $84,903.47 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
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
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
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
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
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
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
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
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
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
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
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
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
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
62 APR_DRG Pancreas Transplant 10 10 — — $58,438.96 $61,360.91 $59,315.54 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
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
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 27 18 — — $21,477.48 $93,994.57 $55,298.03 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
63 APR_DRG Pancreas Transplant 10 10 — — $72,985.46 $76,634.73 $74,080.24 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
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
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
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
64 APR_DRG Pancreas Transplant 10 10 — — $102,736.13 $107,872.94 $104,277.17 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
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 27 18 — — $26,353.84 $115,335.61 $67,853.20 2025-12-31
652 MS_DRG Kidney Transplant 27 18 — — $22,966.63 $100,511.73 $59,132.15 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
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
662 MS_DRG Minor Bladder Procedures With Mcc 27 18 — — $21,771.90 $95,283.06 $56,056.07 2025-12-31
665 MS_DRG Prostatectomy With Mcc 27 18 — — $22,196.45 $97,141.11 $57,149.17 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
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
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
6904 APR_DRG Acute Leukemia 10 10 — — $55,241.68 $58,003.76 $56,070.31 2025-12-31
7 MS_DRG Lung Transplant 27 18 — — $92,095.50 $403,049.07 $237,118.16 2025-12-31
71 APR_DRG Allogeneic Bone Marrow Transplant 10 10 — — $59,789.31 $62,778.78 $60,686.15 2025-12-31
72 APR_DRG Allogeneic Bone Marrow Transplant 10 10 — — $62,936.00 $66,082.80 $63,880.04 2025-12-31
73 APR_DRG Allogeneic Bone Marrow Transplant 10 10 — — $78,484.95 $82,409.20 $79,662.23 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
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
74 APR_DRG Allogeneic Bone Marrow Transplant 10 10 — — $160,587.46 $168,616.83 $162,996.27 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
799 MS_DRG Splenic Procedures With Mcc 27 18 — — $32,207.33 $140,952.95 $82,924.16 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
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
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
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
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
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
834 MS_DRG Acute Leukemia With Mcc 27 18 — — $39,041.49 $170,862.16 $100,520.07 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
84 APR_DRG Autologous Bone Marrow Transplant 10 10 — — $79,594.04 $83,573.74 $80,787.95 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
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 10 10 — — $61,318.68 $64,384.61 $62,238.46 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
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
850 MS_DRG Acute Leukemia With Other Procedures 27 18 — — $61,582.15 $269,509.62 $158,555.45 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
8514 APR_DRG Gender Related Procedures 10 10 — — $99,615.13 $104,595.89 $101,109.36 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
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
8634 APR_DRG Neonatal Aftercare 10 10 — — $74,354.49 $78,072.21 $75,469.80 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
901 MS_DRG Wound Debridements For Injuries With Mcc 27 18 — — $29,844.18 $130,610.78 $76,839.75 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
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
9104 APR_DRG Craniotomy For Multiple Significant Trauma 10 10 — — $56,690.89 $59,525.43 $57,541.26 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
914 APR_DRG Other Major Head And Neck Procedures 10 10 — — $53,720.10 $56,406.11 $54,525.90 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
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
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
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 10 10 — — $68,861.22 $72,304.28 $69,894.14 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
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
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 10 10 — — $159,782.70 $167,771.84 $162,179.44 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
955 MS_DRG Craniotomy For Multiple Significant Trauma 27 18 — — $47,868.30 $209,492.03 $123,246.44 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
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
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
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
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
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
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
A9543 HCPCS Y90 Ibritumomab, Rx 12 12 — — $56,824.55 $58,529.29 $56,824.55 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
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
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
J1414 HCPCS Inj, Beqvez, Per Tx Dose 6 3 — — $3,539,340.00 $3,932,600.00 $3,932,600.00 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
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
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
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
J3391 HCPCS Inj, Atidarsagene Autotemcel 12 12 — — $4,505,000.00 $4,640,150.00 $4,505,000.00 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
J3393 HCPCS Inj, Betibeglogene Autotemce 18 13 — — $2,831,472.00 $3,146,080.00 $2,945,740.00 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
J3399 HCPCS Inj Onase Abepar-xioi Treat 12 12 — — $2,455,110.61 $2,528,763.92 $2,455,110.61 2025-12-31
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 12 12 — — $205,640.00 $211,809.20 $205,640.00 2025-12-31
J3403 HCPCS Revakinagene, Per Implant 12 12 — — $257,500.00 $265,225.00 $257,500.00 2025-12-31
J7330 HCPCS Cultured Chondrocytes Implnt 6 3 — — $69,449.29 $77,165.88 $77,165.88 2025-12-31
J9029 HCPCS Instill Adstiladrin, Tx Dose 20 13 — — $60,485.54 $317,155.25 $63,342.28 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
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
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
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
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
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
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 12 12 — — $93,216.70 $96,013.20 $93,216.70 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
Q0480 HCPCS Driver Pneumatic Vad, Rep 12 12 — — $108,727.22 $111,989.04 $108,727.22 2025-12-31
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 16 13 — — $466,999.36 $2,665,382.40 $533,230.17 2025-12-31
Q2042 HCPCS Tisagenlecleucel Car-pos T 16 13 — — $539,605.14 $2,891,622.90 $591,726.20 2025-12-31
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 20 13 — — $52,981.82 $279,729.85 $55,272.32 2025-12-31
Q2053 HCPCS Brexucabtagene Car Pos T 16 13 — — $465,601.14 $2,448,600.00 $489,304.61 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
Q2056 HCPCS Ciltacabtagene Car-pos T 16 13 — — $525,957.70 $2,766,894.15 $565,868.95 2025-12-31
Q2057 HCPCS Afamitresgene Autoleucel 13 12 — — $770,620.00 $3,853,100.00 $770,620.00 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
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