Price Transparencybeta Hospital negotiated rates

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

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Hospital

FORT MEMORIAL HOSPITAL

Fort Atkinson, WI · CCN 520071 · Rates published

29,437 distinct procedures filed
18 distinct payers
523,654 rate rows
2025-07-22 last MRF observed · ⚠ 13 mo old
Data quality

387,604 of 523,654 rate rows are consumer-grade (74.0%)

136,050 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 97,207
professional (physician) fee — not the facility price 26,143
template filing: same amount across many unrelated codes — excluded 8,014
placeholder amount (≤ $0.02) — excluded from medians 3,827
percent-of-charges filed in the dollar field — excluded from medians 481
exceeds 10× this hospital's gross charge — excluded from medians 145
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 122
per-diem day rate — not a per-procedure price 111

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 13 months old.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://fortmemorial.pt.panaceainc.com/MRFDownload/fortmemorial/fortmemorial
Found on page https://www.forthealthcare.com/patient-info/financial-aid-pricing/estimate-costs-of-care/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-08-13
Content fingerprint 0520b0a6237dd58d… · 189,953,609 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 7 $4,218,596.75 $4,218,596.75 $4,218,596.75 nat. median
$4,505,000
0.9× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 9 $9,926.25 $3,575,327.00 $3,575,327.00 nat. median
$3,710,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 11 $9,170.40 $4,637,500.00 $3,551,491.49 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 11 $9,170.40 $4,158,949.85 $3,203,889.94 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 10 $15,862.03 $4,107,500.00 $3,142,967.81 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 10 $15,862.03 $3,710,000.00 $2,843,576.74 nat. median
$2,997,086
0.9× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 11 $6,800.06 $2,943,141.28 $2,358,808.41 nat. median
$2,460,273
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 9 $15,862.03 $2,247,348.40 $2,247,348.40 nat. median
$2,405,851
0.9× median
Q2057
HCPCS 		Afamitresgene Autoleucel 9 $15,862.03 $742,646.49 $742,646.49 nat. median
$809,151
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 13 $15,862.03 $1,425,161.87 $557,331.40 nat. median
$691,418
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 13 $15,862.03 $1,395,612.77 $533,291.18 nat. median
$631,793
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 13 $15,862.03 $1,332,898.33 $521,612.70 nat. median
$610,161
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 13 $15,862.03 $1,303,666.71 $519,208.29 nat. median
$624,417
0.8× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 13 $15,862.03 $1,263,298.98 $502,840.73 nat. median
$588,565
0.9× median
5834
APR_DRG 		Neonate With Ecmo 8 $311,760.04 $536,955.61 $492,619.83 nat. median
$311,018
1.6× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 13 $15,862.03 $1,235,960.00 $471,943.16 nat. median
$577,541
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 10 $306,043.27 $476,165.58 $339,566.05 nat. median
$370,165
0.9× median
24
APR_DRG 		Heart And/or Lung Transplant 8 $213,711.33 $357,951.49 $328,395.86 nat. median
$243,231
1.4× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 8 $237,430.23 $350,302.22 $321,378.18 nat. median
$254,667
1.3× median
5833
APR_DRG 		Neonate With Ecmo 8 $273,835.89 $347,856.49 $319,134.39 nat. median
$250,089
1.3× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 7 $260,560.39 $260,560.39 $260,560.39 nat. median
$302,242
0.9× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 10 $225,200.42 $355,655.77 $253,627.37 nat. median
$261,939
1.0× median
A9543TC
OTHER 		Y90 Ibritumomab, Rx 1 $246,923.66 $246,923.66 $246,923.66 nat. median
$247,293
1.0× median
5832
APR_DRG 		Neonate With Ecmo 8 $188,416.81 $267,090.12 $245,036.81 nat. median
$169,230
1.4× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 8 $193,060.44 $255,533.05 $234,433.99 nat. median
$160,171
1.5× median
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 $171,731.76 $251,797.96 $231,007.30 nat. median
$119,243
1.9× median
1614
APR_DRG 		Implantable Heart Assist Systems 8 $181,650.26 $245,409.78 $225,146.59 nat. median
$209,486
1.1× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 10 $196,537.07 $299,526.45 $219,061.77 nat. median
$205,166
1.1× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 8 $180,770.05 $232,645.72 $213,436.44 nat. median
$165,646
1.3× median
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 8 $145,937.19 $230,325.36 $211,307.67 nat. median
$168,174
1.3× median
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 8 $162,264.65 $227,827.43 $209,015.99 nat. median
$180,995
1.2× median
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 8 $147,421.12 $226,121.86 $207,451.25 nat. median
$147,677
1.4× median
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 8 $149,402.28 $222,534.66 $204,160.24 nat. median
$168,361
1.2× median
14
APR_DRG 		Liver Transplant And/or Intestinal Transplant 8 $131,530.23 $216,751.36 $198,854.46 nat. median
$137,901
1.4× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 10 $177,260.21 $270,597.52 $192,970.13 nat. median
$199,832
1.0× median
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 8 $137,671.19 $206,346.17 $189,308.41 nat. median
$156,285
1.2× median
23
APR_DRG 		Heart And/or Lung Transplant 8 $115,999.75 $200,987.65 $184,392.34 nat. median
$116,111
1.6× median
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 8 $155,485.41 $199,913.98 $183,407.32 nat. median
$147,847
1.2× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 8 $147,806.21 $194,981.02 $178,881.67 nat. median
$175,480
1.0× median
5831
APR_DRG 		Neonate With Ecmo 8 $117,936.47 $194,139.03 $178,109.20 nat. median
$154,685
1.2× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 8 $139,305.35 $194,003.89 $177,985.22 nat. median
$165,599
1.1× median
6034
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 8 $127,186.35 $190,863.04 $175,103.71 nat. median
$109,499
1.6× median
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 8 $124,447.00 $172,212.28 $157,992.92 nat. median
$127,600
1.2× median
5881
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 8 $155,485.41 $171,354.54 $157,206.00 nat. median
$120,928
1.3× median
1613
APR_DRG 		Implantable Heart Assist Systems 8 $124,253.05 $166,050.91 $152,340.28 nat. median
$127,938
1.2× median
5913
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 8 $107,706.95 $165,173.17 $151,535.02 nat. median
$108,751
1.4× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 2 $54,619.16 $233,041.75 $143,830.46 nat. median
$97,404
1.5× median
64
APR_DRG 		Pancreas Transplant 8 $100,947.45 $155,924.34 $143,049.85 nat. median
$92,994
1.5× median
6024
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 8 $101,671.78 $153,228.10 $140,576.24 nat. median
$123,690
1.1× median
113
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 $97,586.74 $146,848.59 $134,723.48 nat. median
$67,603
2.0× median

Other procedures at this hospital

Browse this hospital's 29,437 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J3391 HCPCS Inj, Atidarsagene Autotemcel 8 7 — — $4,218,596.75 $4,218,596.75 $4,218,596.75 2025-07-22
J1414 HCPCS Inj, Beqvez, Per Tx Dose 14 9 — — $9,926.25 $3,575,327.00 $3,575,327.00 2025-07-22
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 20 11 — — $9,170.40 $4,637,500.00 $3,551,491.49 2025-07-22
J1413 HCPCS Inj Delandistrogene Mox Rokl 19 11 — — $9,170.40 $4,158,949.85 $3,203,889.94 2025-07-22
J3394 HCPCS Inj, Lovotibeglogene Autotem 17 10 — — $15,862.03 $4,107,500.00 $3,142,967.81 2025-07-22
J3393 HCPCS Inj, Betibeglogene Autotemce 17 10 — — $15,862.03 $3,710,000.00 $2,843,576.74 2025-07-22
J3399 HCPCS Inj Onase Abepar-xioi Treat 20 11 — — $6,800.06 $2,943,141.28 $2,358,808.41 2025-07-22
J3392 HCPCS Inj, Exagamglogene Autotem 14 9 — — $15,862.03 $2,247,348.40 $2,247,348.40 2025-07-22
Q2057 HCPCS Afamitresgene Autoleucel 14 9 — — $15,862.03 $742,646.49 $742,646.49 2025-07-22
Q2042 HCPCS Tisagenlecleucel Car-pos T 27 13 — — $15,862.03 $1,425,161.87 $557,331.40 2025-07-22
Q2056 HCPCS Ciltacabtagene Car-pos T 26 13 — — $15,862.03 $1,395,612.77 $533,291.18 2025-07-22
Q2055 HCPCS Idecabtagene Vicleucel Car 26 13 — — $15,862.03 $1,332,898.33 $521,612.70 2025-07-22
Q2054 HCPCS Lisocabtagene Mara Car Pos T 26 13 — — $15,862.03 $1,303,666.71 $519,208.29 2025-07-22
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 27 13 — — $15,862.03 $1,263,298.98 $502,840.73 2025-07-22
5834 APR_DRG Neonate With Ecmo 8 8 — — $311,760.04 $536,955.61 $492,619.83 2025-07-22
Q2053 HCPCS Brexucabtagene Car Pos T 27 13 — — $15,862.03 $1,235,960.00 $471,943.16 2025-07-22
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 19 10 — — $306,043.27 $476,165.58 $339,566.05 2025-07-22
24 APR_DRG Heart And/or Lung Transplant 8 8 — — $213,711.33 $357,951.49 $328,395.86 2025-07-22
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 8 8 — — $237,430.23 $350,302.22 $321,378.18 2025-07-22
5833 APR_DRG Neonate With Ecmo 8 8 — — $273,835.89 $347,856.49 $319,134.39 2025-07-22
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 8 7 — — $260,560.39 $260,560.39 $260,560.39 2025-07-22
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 19 10 — — $225,200.42 $355,655.77 $253,627.37 2025-07-22
A9543TC OTHER Y90 Ibritumomab, Rx 1 1 — — $246,923.66 $246,923.66 $246,923.66 2025-07-22
5832 APR_DRG Neonate With Ecmo 8 8 — — $188,416.81 $267,090.12 $245,036.81 2025-07-22
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 8 8 — — $193,060.44 $255,533.05 $234,433.99 2025-07-22
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 8 — — $171,731.76 $251,797.96 $231,007.30 2025-07-22
1614 APR_DRG Implantable Heart Assist Systems 8 8 — — $181,650.26 $245,409.78 $225,146.59 2025-07-22
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 19 10 — — $196,537.07 $299,526.45 $219,061.77 2025-07-22
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 8 8 — — $180,770.05 $232,645.72 $213,436.44 2025-07-22
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 8 8 — — $145,937.19 $230,325.36 $211,307.67 2025-07-22
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 8 8 — — $162,264.65 $227,827.43 $209,015.99 2025-07-22
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 8 8 — — $147,421.12 $226,121.86 $207,451.25 2025-07-22
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 8 8 — — $149,402.28 $222,534.66 $204,160.24 2025-07-22
14 APR_DRG Liver Transplant And/or Intestinal Transplant 8 8 — — $131,530.23 $216,751.36 $198,854.46 2025-07-22
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 19 10 — — $177,260.21 $270,597.52 $192,970.13 2025-07-22
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 8 8 — — $137,671.19 $206,346.17 $189,308.41 2025-07-22
23 APR_DRG Heart And/or Lung Transplant 8 8 — — $115,999.75 $200,987.65 $184,392.34 2025-07-22
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 8 8 — — $155,485.41 $199,913.98 $183,407.32 2025-07-22
74 APR_DRG Allogeneic Bone Marrow Transplant 8 8 — — $147,806.21 $194,981.02 $178,881.67 2025-07-22
5831 APR_DRG Neonate With Ecmo 8 8 — — $117,936.47 $194,139.03 $178,109.20 2025-07-22
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 8 8 — — $139,305.35 $194,003.89 $177,985.22 2025-07-22
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 8 8 — — $127,186.35 $190,863.04 $175,103.71 2025-07-22
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 8 8 — — $124,447.00 $172,212.28 $157,992.92 2025-07-22
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 8 8 — — $155,485.41 $171,354.54 $157,206.00 2025-07-22
1613 APR_DRG Implantable Heart Assist Systems 8 8 — — $124,253.05 $166,050.91 $152,340.28 2025-07-22
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 8 8 — — $107,706.95 $165,173.17 $151,535.02 2025-07-22
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 2 2 — — $54,619.16 $233,041.75 $143,830.46 2025-07-22
64 APR_DRG Pancreas Transplant 8 8 — — $100,947.45 $155,924.34 $143,049.85 2025-07-22
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $101,671.78 $153,228.10 $140,576.24 2025-07-22
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 8 — — $97,586.74 $146,848.59 $134,723.48 2025-07-22
22 APR_DRG Heart And/or Lung Transplant 8 8 — — $92,149.66 $146,268.83 $134,191.59 2025-07-22
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 8 8 — — $98,584.73 $143,180.12 $131,357.91 2025-07-22
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 8 8 — — $93,535.55 $143,108.38 $131,292.09 2025-07-22
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 19 10 — — $117,328.75 $178,406.79 $127,226.52 2025-07-22
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 8 8 — — $93,378.98 $136,842.03 $125,543.15 2025-07-22
21 APR_DRG Heart And/or Lung Transplant 8 8 — — $80,262.70 $134,515.45 $123,408.67 2025-07-22
1612 APR_DRG Implantable Heart Assist Systems 8 8 — — $100,992.59 $133,291.67 $122,285.94 2025-07-22
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 8 8 — — $90,075.40 $132,805.40 $121,839.82 2025-07-22
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 8 8 — — $85,754.80 $129,975.76 $119,243.82 2025-07-22
14 MS_DRG Allogeneic Bone Marrow Transplant 19 10 — — $95,460.77 $165,424.64 $117,968.61 2025-07-22
7 MS_DRG Lung Transplant 19 10 — — $102,143.68 $165,007.98 $117,671.48 2025-07-22
1611 APR_DRG Implantable Heart Assist Systems 8 8 — — $95,920.14 $126,995.17 $116,509.33 2025-07-22
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 8 — — $67,817.15 $126,088.92 $115,677.91 2025-07-22
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 8 8 — — $78,965.67 $125,254.25 $114,912.16 2025-07-22
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 8 8 — — $79,635.70 $122,017.17 $111,942.36 2025-07-22
8514 APR_DRG Gender Related Procedures 7 7 — — $110,963.33 $120,950.03 $110,963.33 2025-07-22
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 8 8 — — $81,600.64 $119,146.04 $109,308.29 2025-07-22
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $79,595.50 $117,430.79 $107,734.67 2025-07-22
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 8 8 — — $82,640.23 $117,212.72 $107,534.61 2025-07-22
4404 APR_DRG Kidney Transplant 8 8 — — $68,244.56 $114,182.68 $104,754.75 2025-07-22
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 2 2 — — $39,523.04 $168,631.65 $104,077.35 2025-07-22
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 8 8 — — $80,391.77 $112,329.78 $103,054.84 2025-07-22
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 19 10 — — $91,646.82 $139,135.83 $101,958.66 2025-07-22
63 APR_DRG Pancreas Transplant 8 8 — — $64,783.00 $110,771.24 $101,624.99 2025-07-22
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $75,573.93 $108,690.05 $99,715.64 2025-07-22
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 8 8 — — $82,234.69 $107,988.47 $99,071.99 2025-07-22
212 MS_DRG Concomitant Aortic And Mitral Valve?procedures 19 10 — — $89,734.46 $137,547.47 $98,088.68 2025-07-22
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 19 10 — — $86,244.08 $134,460.39 $95,887.20 2025-07-22
215 MS_DRG Other Heart Assist System Implant 19 10 — — $85,122.38 $133,771.00 $95,395.58 2025-07-22
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 8 8 — — $77,278.62 $102,835.41 $94,344.41 2025-07-22
13 APR_DRG Liver Transplant And/or Intestinal Transplant 8 8 — — $61,260.07 $101,396.88 $93,024.66 2025-07-22
Q0480 HCPCS Driver Pneumatic Vad, Rep 6 5 — — $54,242.82 $271,818.05 $92,999.95 2025-07-22
8634 APR_DRG Neonatal Aftercare 8 8 — — $61,003.35 $97,802.52 $89,727.08 2025-07-22
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 8 8 — — $73,613.93 $97,746.60 $89,675.78 2025-07-22
84 APR_DRG Autologous Bone Marrow Transplant 8 8 — — $74,071.67 $96,640.96 $88,661.43 2025-07-22
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 8 8 — — $71,280.13 $95,622.95 $87,727.48 2025-07-22
73 APR_DRG Allogeneic Bone Marrow Transplant 8 8 — — $74,699.37 $95,294.34 $87,426.00 2025-07-22
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 8 8 — — $70,459.17 $95,175.58 $87,317.05 2025-07-22
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 9 7 — — $87,152.50 $94,320.50 $87,152.50 2025-07-22
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 19 10 — — $80,346.21 $121,855.75 $86,898.50 2025-07-22
62 APR_DRG Pancreas Transplant 8 8 — — $56,623.50 $88,693.78 $81,370.44 2025-07-22
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $60,640.12 $86,920.10 $79,743.21 2025-07-22
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 8 8 — — $67,451.11 $85,998.72 $78,897.91 2025-07-22
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 8 8 — — $63,521.94 $84,306.48 $77,345.39 2025-07-22
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $57,028.33 $83,880.59 $76,954.67 2025-07-22
850 MS_DRG Acute Leukemia With Other Procedures 9 7 — — $76,719.70 $82,943.95 $76,719.70 2025-07-22
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 8 8 — — $62,483.05 $83,609.46 $76,705.93 2025-07-22
231 MS_DRG Coronary Bypass With Ptca With Mcc 19 10 — — $67,702.86 $106,992.31 $76,299.00 2025-07-22
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 19 10 — — $70,309.65 $106,932.97 $76,256.68 2025-07-22
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 8 8 — — $63,897.15 $81,975.56 $75,206.94 2025-07-22
12 APR_DRG Liver Transplant And/or Intestinal Transplant 8 8 — — $49,282.84 $81,455.10 $74,729.45 2025-07-22
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 8 8 — — $62,184.71 $81,421.79 $74,698.89 2025-07-22
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $55,772.21 $81,290.52 $74,578.46 2025-07-22
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 8 8 — — $55,763.04 $80,568.78 $73,916.31 2025-07-22
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 8 8 — — $52,267.63 $79,756.95 $73,171.51 2025-07-22
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 19 10 — — $67,217.48 $101,780.25 $72,582.14 2025-07-22
L6700 HCPCS Ue Add Ext Power Myoel 1 1 — — $72,328.90 $72,328.90 $72,328.90 2025-07-22
1784 APR_DRG External Heart Assist Systems 8 8 — — $60,621.79 $78,027.37 $71,584.74 2025-07-22
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 19 10 — — $66,112.69 $100,090.88 $71,377.41 2025-07-22
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 8 8 — — $58,158.91 $77,593.61 $71,186.80 2025-07-22
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 19 10 — — $65,084.45 $98,690.65 $70,378.87 2025-07-22
72 APR_DRG Allogeneic Bone Marrow Transplant 8 8 — — $59,238.71 $76,415.20 $70,105.69 2025-07-22
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 8 8 — — $57,093.93 $76,040.05 $69,761.51 2025-07-22
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 19 10 — — $64,351.03 $97,694.45 $69,668.45 2025-07-22
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 9 7 — — $69,525.33 $75,098.76 $69,525.33 2025-07-22
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 8 8 — — $56,933.82 $75,293.42 $69,076.53 2025-07-22
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 8 8 — — $60,403.15 $74,451.50 $68,304.13 2025-07-22
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 8 8 — — $60,062.49 $74,307.86 $68,172.35 2025-07-22
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 8 8 — — $53,926.47 $74,193.91 $68,067.81 2025-07-22
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 19 10 — — $60,379.45 $94,243.74 $67,207.66 2025-07-22
71 APR_DRG Allogeneic Bone Marrow Transplant 8 8 — — $45,473.57 $72,594.59 $66,600.54 2025-07-22
10 MS_DRG Pancreas Transplant 19 10 — — $40,310.82 $100,667.90 $66,490.03 2025-07-22
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 8 8 — — $55,935.84 $72,101.30 $66,147.98 2025-07-22
11 APR_DRG Liver Transplant And/or Intestinal Transplant 8 8 — — $43,120.72 $70,823.91 $64,976.06 2025-07-22
E0766NU OTHER Elec Stim Cancer Treatment 1 1 — — $64,643.95 $64,643.95 $64,643.95 2025-07-22
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 8 8 — — $54,844.76 $70,079.01 $64,292.67 2025-07-22
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 8 8 — — $59,398.11 $69,824.57 $64,059.24 2025-07-22
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 19 10 — — $58,747.51 $89,228.65 $63,631.27 2025-07-22
4403 APR_DRG Kidney Transplant 8 8 — — $42,342.79 $69,198.51 $63,484.87 2025-07-22
9104 APR_DRG Craniotomy For Multiple Significant Trauma 8 8 — — $53,915.89 $68,832.56 $63,149.14 2025-07-22
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 8 8 — — $47,205.76 $68,482.43 $62,827.92 2025-07-22
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 19 10 — — $58,096.73 $87,833.46 $62,636.33 2025-07-22
1834 APR_DRG Percutaneous Structural Cardiac Procedures 8 8 — — $51,397.30 $67,999.07 $62,384.47 2025-07-22
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 8 8 — — $51,367.68 $67,898.90 $62,292.57 2025-07-22
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 8 8 — — $53,862.99 $67,708.96 $62,118.31 2025-07-22
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 8 8 — — $58,532.01 $67,521.85 $61,946.65 2025-07-22
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 8 8 — — $58,426.22 $67,432.08 $61,864.29 2025-07-22
6904 APR_DRG Acute Leukemia 8 8 — — $54,977.35 $67,072.98 $61,534.84 2025-07-22
955 MS_DRG Craniotomy For Multiple Significant Trauma 19 10 — — $50,902.25 $86,214.80 $61,482.01 2025-07-22
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 8 8 — — $56,993.77 $66,998.01 $61,466.06 2025-07-22
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 8 8 — — $57,008.59 $66,636.39 $61,134.30 2025-07-22
J9029 HCPCS Instill Adstiladrin, Tx Dose 26 13 — — $9,170.40 $174,639.85 $61,128.50 2025-07-22
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 8 8 — — $50,612.31 $66,589.14 $61,090.95 2025-07-22
61 APR_DRG Pancreas Transplant 8 8 — — $39,156.99 $66,330.45 $60,853.62 2025-07-22
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 19 10 — — $55,804.57 $84,328.46 $60,136.82 2025-07-22
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 19 10 — — $55,711.27 $84,185.78 $60,035.07 2025-07-22
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 8 8 — — $52,528.58 $65,421.12 $60,019.38 2025-07-22
914 APR_DRG Other Major Head And Neck Procedures 8 8 — — $45,670.34 $65,225.51 $59,839.92 2025-07-22
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 9 7 — — $59,303.92 $63,952.71 $59,303.92 2025-07-22
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 8 8 — — $54,248.08 $64,553.62 $59,223.50 2025-07-22
214 APR_DRG Open Craniotomy Except Trauma 8 8 — — $51,291.50 $64,160.50 $58,862.84 2025-07-22
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 8 8 — — $58,182.19 $63,933.70 $58,654.77 2025-07-22
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 19 10 — — $54,056.55 $81,655.51 $58,230.67 2025-07-22
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 19 10 — — $53,184.64 $81,538.09 $58,146.93 2025-07-22
1794 APR_DRG Defibrillator Implants 8 8 — — $47,906.11 $63,235.35 $58,014.08 2025-07-22
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 19 10 — — $52,876.62 $79,851.24 $57,393.51 2025-07-22
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 8 8 — — $47,178.96 $62,444.39 $57,288.43 2025-07-22
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 19 10 — — $51,327.60 $77,482.59 $56,944.66 2025-07-22
1204 APR_DRG Major Respiratory And Chest Procedures 8 8 — — $44,357.80 $61,550.41 $56,468.27 2025-07-22
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 9 7 — — $56,017.61 $60,369.12 $56,017.61 2025-07-22
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 8 8 — — $48,850.50 $61,056.19 $56,014.85 2025-07-22
276 MS_DRG Cardiac Defibrillator Implant With Mcc 19 10 — — $51,804.03 $78,211.11 $55,774.38 2025-07-22
4402 APR_DRG Kidney Transplant 8 8 — — $36,050.89 $60,483.28 $55,489.25 2025-07-22
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 19 10 — — $51,505.12 $77,754.05 $55,448.43 2025-07-22
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 8 8 — — $48,014.02 $60,368.23 $55,383.70 2025-07-22
274 APR_DRG Other Open Craniotomy 8 8 — — $45,264.10 $60,141.43 $55,175.62 2025-07-22
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $43,368.98 $60,038.58 $55,081.27 2025-07-22
232 MS_DRG Coronary Bypass With Ptca Without Mcc 19 10 — — $49,727.45 $77,129.06 $55,002.73 2025-07-22
2324 APR_DRG Gastric Fundoplication 8 8 — — $40,072.46 $59,733.19 $54,801.09 2025-07-22
A9543 HCPCS Y90 Ibritumomab, Rx 24 12 — — $958.93 $246,923.66 $54,761.82 2025-07-22
28 MS_DRG Spinal Procedures With Mcc 19 10 — — $50,370.44 $76,760.37 $54,739.82 2025-07-22
6954 APR_DRG Chemotherapy For Acute Leukemia 8 8 — — $49,873.17 $59,439.30 $54,531.47 2025-07-22
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 19 10 — — $50,495.28 $76,209.88 $54,347.24 2025-07-22
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 19 10 — — $50,495.28 $76,209.88 $54,347.24 2025-07-22
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 8 8 — — $44,110.24 $59,134.06 $54,251.43 2025-07-22
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 8 8 — — $42,117.09 $59,076.27 $54,198.41 2025-07-22
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 8 8 — — $45,610.39 $59,068.85 $54,191.61 2025-07-22
234 APR_DRG Spinal Procedures 8 8 — — $46,975.84 $58,906.33 $54,042.50 2025-07-22
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 8 8 — — $40,728.38 $58,800.88 $53,945.76 2025-07-22
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 19 10 — — $50,122.89 $75,640.44 $53,941.16 2025-07-22
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 26 13 — — $9,170.40 $152,497.31 $53,915.13 2025-07-22
1694 APR_DRG Major Abdominal Vascular Procedures 8 8 — — $47,297.45 $58,683.30 $53,837.89 2025-07-22
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 19 10 — — $47,637.54 $75,116.46 $53,567.50 2025-07-22
6133 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 8 8 — — $38,309.94 $58,035.11 $53,243.22 2025-07-22
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 8 8 — — $45,025.71 $57,989.68 $53,201.54 2025-07-22
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 19 10 — — $49,163.29 $74,294.50 $52,981.34 2025-07-22
L8701 HCPCS Ewh S/d Uprt Micro Sensor 2 2 — — $20,088.54 $85,711.10 $52,899.82 2025-07-22
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 8 — — $38,566.66 $57,496.39 $52,748.98 2025-07-22
204 APR_DRG Open Craniotomy For Trauma 8 8 — — $44,026.31 $57,482.21 $52,735.97 2025-07-22
1783 APR_DRG External Heart Assist Systems 8 8 — — $43,500.17 $57,474.65 $52,729.04 2025-07-22
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 19 10 — — $48,731.58 $73,512.94 $52,423.99 2025-07-22
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 8 8 — — $45,062.38 $56,736.60 $52,051.93 2025-07-22
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 8 8 — — $39,745.91 $56,448.31 $51,787.44 2025-07-22
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 9 7 — — $51,737.97 $55,702.35 $51,737.97 2025-07-22
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 19 10 — — $48,047.07 $72,466.24 $51,677.56 2025-07-22
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 19 10 — — $47,406.07 $72,033.16 $51,368.72 2025-07-22
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 19 10 — — $46,295.74 $69,788.24 $51,327.04 2025-07-22
4401 APR_DRG Kidney Transplant 8 8 — — $32,693.71 $55,797.29 $51,190.17 2025-07-22
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 8 8 — — $43,729.39 $55,324.78 $50,756.68 2025-07-22
1782 APR_DRG External Heart Assist Systems 8 8 — — $42,308.93 $55,250.13 $50,688.19 2025-07-22
38240 HCPCS Transplt Allo Hct/donor 23 13 — — $237.22 $126,479.14 $50,591.66 2025-07-22
653 MS_DRG Major Bladder Procedures With Mcc 19 10 — — $45,288.78 $70,385.46 $50,193.70 2025-07-22
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 19 10 — — $46,295.74 $69,788.24 $49,767.81 2025-07-22
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 14 9 — — $49,743.07 $75,059.64 $49,743.07 2025-07-22
4414 APR_DRG Major Bladder Procedures 8 8 — — $45,826.92 $53,943.21 $49,489.18 2025-07-22
894 APR_DRG Major Cranial Or Facial Bone Procedures 8 8 — — $42,006.36 $53,423.45 $49,012.34 2025-07-22
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 19 10 — — $44,028.52 $68,699.87 $48,991.66 2025-07-22
7594 APR_DRG Eating Disorders 8 8 — — $48,410.09 $53,222.59 $48,894.19 2025-07-22
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 19 10 — — $45,481.60 $68,543.31 $48,880.01 2025-07-22
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 19 10 — — $45,252.88 $68,193.57 $48,630.60 2025-07-22
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 19 10 — — $43,154.06 $68,129.17 $48,584.68 2025-07-22
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 19 10 — — $45,205.81 $68,121.60 $48,579.28 2025-07-22
2614 APR_DRG Major Biliary Tract Procedures 8 8 — — $40,385.61 $52,923.55 $48,553.72 2025-07-22
E0766UE OTHER Elec Stim Cancer Treatment 1 1 — — $48,483.07 $48,483.07 $48,483.07 2025-07-22
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 8 8 — — $37,575.03 $52,532.32 $48,194.79 2025-07-22
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $37,326.76 $52,257.10 $47,942.29 2025-07-22
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 19 10 — — $43,499.20 $67,173.38 $47,903.08 2025-07-22
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 19 10 — — $43,886.65 $66,876.66 $47,691.49 2025-07-22
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 8 8 — — $39,165.45 $51,960.59 $47,670.27 2025-07-22
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 8 8 — — $40,087.97 $51,857.59 $47,575.77 2025-07-22
J7330 HCPCS Cultured Chondrocytes Implnt 3 3 — — $33,406.63 $57,856.13 $47,475.75 2025-07-22
5144 APR_DRG Female Reproductive System Reconstructive Procedures 8 8 — — $32,342.48 $51,471.09 $47,221.18 2025-07-22
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 8 8 — — $40,964.65 $51,364.31 $47,123.22 2025-07-22
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 8 8 — — $46,636.85 $50,834.17 $47,103.22 2025-07-22
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 8 8 — — $36,451.50 $51,266.02 $47,033.05 2025-07-22
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 8 8 — — $43,619.36 $51,233.90 $47,003.58 2025-07-22
1814 APR_DRG Lower Extremity Arterial Procedures 8 8 — — $40,674.77 $51,084.58 $46,866.59 2025-07-22
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 8 8 — — $38,654.82 $50,888.97 $46,687.13 2025-07-22
8633 APR_DRG Neonatal Aftercare 8 8 — — $36,059.36 $50,662.10 $46,478.99 2025-07-22
8411 APR_DRG Extensive Third Degree Burns With Skin Graft 8 8 — — $39,251.50 $50,514.75 $46,343.81 2025-07-22
8412 APR_DRG Extensive Third Degree Burns With Skin Graft 8 8 — — $39,251.50 $50,514.75 $46,343.81 2025-07-22
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 8 8 — — $38,716.18 $50,441.05 $46,276.19 2025-07-22
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 19 10 — — $42,329.38 $64,809.77 $46,217.53 2025-07-22
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 9 7 — — $46,104.18 $49,558.92 $46,104.18 2025-07-22
6224 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $38,595.58 $50,120.53 $45,982.14 2025-07-22
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 19 10 — — $42,722.91 $64,324.93 $45,871.78 2025-07-22
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 9 7 — — $45,826.74 $49,256.38 $45,826.74 2025-07-22
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 19 10 — — $42,512.74 $64,127.96 $45,731.32 2025-07-22
224 APR_DRG Ventricular Shunt Procedures 8 8 — — $42,014.12 $49,719.06 $45,613.82 2025-07-22
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 19 10 — — $40,254.40 $63,596.40 $45,352.25 2025-07-22
83 APR_DRG Autologous Bone Marrow Transplant 8 8 — — $39,839.01 $49,308.94 $45,237.56 2025-07-22
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 8 8 — — $37,782.38 $49,174.75 $45,114.45 2025-07-22
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 19 10 — — $39,837.91 $63,221.41 $45,084.83 2025-07-22
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures 8 8 — — $38,936.94 $49,124.67 $45,068.50 2025-07-22
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 19 10 — — $37,380.46 $63,172.17 $45,049.71 2025-07-22
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 19 10 — — $41,851.50 $63,146.91 $45,031.71 2025-07-22
3634 APR_DRG Breast Procedures Except Mastectomy 8 8 — — $30,135.63 $48,940.39 $44,899.44 2025-07-22
228 MS_DRG Other Cardiothoracic Procedures With Mcc 19 10 — — $41,803.90 $62,919.64 $44,869.63 2025-07-22
5114 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 8 8 — — $36,460.67 $48,848.73 $44,815.35 2025-07-22
264 APR_DRG Other Nervous System And Related Procedures 8 8 — — $38,688.68 $48,804.31 $44,774.60 2025-07-22
1214 APR_DRG Other Respiratory And Chest Procedures 8 8 — — $36,071.35 $48,784.47 $44,756.39 2025-07-22
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 8 8 — — $41,972.51 $48,745.73 $44,720.85 2025-07-22
3214 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 8 8 — — $36,785.10 $48,706.98 $44,685.30 2025-07-22
2304 APR_DRG Major Small Bowel Procedures 8 8 — — $39,467.32 $48,696.58 $44,675.76 2025-07-22
245 MS_DRG Aicd Generator Procedures 19 10 — — $37,969.52 $61,701.23 $44,000.75 2025-07-22
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 8 8 — — $38,716.18 $47,919.80 $43,963.12 2025-07-22
J9226 HCPCS Supprelin La Implant 26 13 — — $9,170.40 $122,591.57 $43,906.55 2025-07-22
5184 APR_DRG Other Female Reproductive System And Related Procedures 8 8 — — $33,801.02 $47,759.15 $43,815.73 2025-07-22
471 MS_DRG Cervical Spinal Fusion With Mcc 19 10 — — $40,763.51 $61,328.76 $43,735.13 2025-07-22
6 MS_DRG Liver Transplant Without Mcc 19 10 — — $40,504.13 $61,226.48 $43,662.20 2025-07-22
6092 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 8 8 — — $35,733.51 $47,447.54 $43,529.85 2025-07-22
6344 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 8 8 — — $35,300.46 $47,430.13 $43,513.88 2025-07-22
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 8 8 — — $37,137.75 $47,313.11 $43,406.52 2025-07-22
0266T OTHER Implt/rpl Crtd Sns Dev Total 23 12 — — $114.92 $109,315.21 $43,366.98 2025-07-22
33276 HCPCS Insj Phrnc Nrv Stim Sys 21 12 — — $683.08 $109,315.21 $43,366.98 2025-07-22
1673 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 8 8 — — $35,454.92 $47,105.21 $43,215.79 2025-07-22
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 9 7 — — $43,181.18 $46,371.50 $43,181.18 2025-07-22
L7181 HCPCS Electronic Elbo Simultaneous 6 5 — — $24,131.64 $120,926.90 $43,142.81 2025-07-22
6143 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 8 8 — — $32,985.70 $47,012.44 $43,130.68 2025-07-22
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 8 8 — — $34,973.92 $47,007.33 $43,125.99 2025-07-22
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 8 8 — — $36,895.83 $46,875.58 $43,005.12 2025-07-22
1781 APR_DRG External Heart Assist Systems 8 8 — — $33,956.18 $46,872.74 $43,002.51 2025-07-22
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 19 10 — — $36,786.43 $60,295.94 $42,998.60 2025-07-22
4014 APR_DRG Adrenal Procedures 8 8 — — $42,399.10 $46,215.02 $42,823.09 2025-07-22
799 MS_DRG Splenic Procedures With Mcc 19 10 — — $39,917.17 $60,034.58 $42,812.22 2025-07-22
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 19 10 — — $39,703.51 $60,023.22 $42,804.12 2025-07-22
1824 APR_DRG Other Peripheral Vascular And Related Procedures 8 8 — — $36,155.98 $46,634.60 $42,784.04 2025-07-22
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 8 8 — — $35,684.14 $46,446.55 $42,611.51 2025-07-22
3043 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 8 8 — — $35,899.26 $46,374.73 $42,545.62 2025-07-22
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 19 10 — — $39,503.49 $59,402.01 $42,361.12 2025-07-22
9103 APR_DRG Craniotomy For Multiple Significant Trauma 8 8 — — $31,782.48 $46,158.33 $42,347.09 2025-07-22
4034 APR_DRG Procedures For Obesity 8 8 — — $31,940.46 $46,112.01 $42,304.60 2025-07-22
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 19 10 — — $37,724.77 $59,083.83 $42,134.22 2025-07-22
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 8 8 — — $36,849.28 $45,773.71 $41,994.23 2025-07-22
1793 APR_DRG Defibrillator Implants 8 8 — — $34,880.11 $45,767.09 $41,988.16 2025-07-22
L7180 HCPCS Electronic Elbow Sequential 6 5 — — $23,438.00 $117,450.95 $41,902.70 2025-07-22
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 19 10 — — $39,067.51 $58,735.35 $41,885.71 2025-07-22
1833 APR_DRG Percutaneous Structural Cardiac Procedures 8 8 — — $34,751.75 $45,540.30 $41,780.09 2025-07-22
163 MS_DRG Major Chest Procedures With Mcc 19 10 — — $38,714.94 $58,196.22 $41,501.24 2025-07-22
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 19 10 — — $37,688.27 $58,172.23 $41,484.13 2025-07-22
6233 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 8 8 — — $32,594.27 $45,116.46 $41,391.25 2025-07-22
6091 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 8 8 — — $35,733.51 $45,075.51 $41,353.68 2025-07-22
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 19 10 — — $38,577.87 $57,986.63 $41,351.77 2025-07-22
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 19 10 — — $37,848.39 $57,977.79 $41,345.47 2025-07-22
6504 APR_DRG Splenic Procedures 8 8 — — $34,833.56 $44,283.45 $40,627.02 2025-07-22
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 19 10 — — $37,114.97 $56,963.91 $40,622.45 2025-07-22
6082 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 8 8 — — $32,159.10 $44,244.23 $40,591.04 2025-07-22
6312 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 8 8 — — $32,482.83 $44,094.77 $40,453.92 2025-07-22
3254 APR_DRG Non-elective Or Complex Knee Joint Replacement 8 8 — — $34,337.04 $44,063.27 $40,425.02 2025-07-22
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 19 10 — — $36,072.92 $56,624.27 $40,380.24 2025-07-22
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