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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

SAUK PRAIRIE HOSPITAL

Prairie Du Sac, WI · CCN 520095 · Rates published

15,660 distinct procedures filed
7 distinct payers
248,218 rate rows
2026-01-29 last MRF observed
Data quality

186,148 of 248,218 rate rows are consumer-grade (75.0%)

62,070 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
professional (physician) fee — not the facility price 55,453
per-diem day rate — not a per-procedure price 5,343
exceeds 10× this hospital's gross charge — excluded from medians 709
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 522
placeholder amount (≤ $0.02) — excluded from medians 37
percent-of-charges filed in the dollar field — excluded from medians 6
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/9451/390872080_sauk-prairie-healthcare_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/SaukPrairieHealthcare/9451
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint a99217467e81cb78… · 138,292,215 bytes · first seen 2026-05-08

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 5 $4,505,000.00 $4,505,000.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 5 $3,685,266.67 $3,685,266.67 $3,685,266.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 5 $3,316,462.59 $3,316,462.59 $3,316,462.59 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 5 $3,248,445.72 $3,248,445.72 $3,248,445.72 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 5 $2,945,740.00 $2,945,740.00 $2,945,740.00 nat. median
$3,004,655
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 6 $2,455,110.61 $4,173,688.02 $2,455,110.61 nat. median
$2,468,984
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 6 $2,332,000.00 $3,964,400.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 6 $770,620.00 $2,102,174.30 $770,620.00 nat. median
$824,563
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 6 $591,726.20 $1,614,169.90 $591,726.20 nat. median
$753,246
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 6 $565,868.95 $1,543,633.90 $565,868.95 nat. median
$674,867
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 6 $562,538.19 $1,534,547.91 $562,538.19 nat. median
$673,137
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 6 $557,317.93 $1,520,307.59 $557,317.93 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 6 $533,230.17 $1,454,598.58 $533,230.17 nat. median
$634,303
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 6 $489,304.61 $1,334,774.04 $489,304.61 nat. median
$619,808
0.8× median
5834
APR_DRG 		Neonate With Ecmo 6 $416,100.49 $416,100.49 $416,100.49 nat. median
$309,665
1.3× median
5833
APR_DRG 		Neonate With Ecmo 6 $365,483.81 $365,483.81 $365,483.81 nat. median
$244,017
1.5× median
24
APR_DRG 		Heart And/or Lung Transplant 6 $329,119.21 $329,119.21 $329,119.21 nat. median
$234,729
1.4× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 6 $316,893.84 $316,893.84 $316,893.84 nat. median
$246,434
1.3× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 7 $155,458.08 $906,838.80 $305,222.33 nat. median
$370,174
0.8× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 6 $278,250.00 $759,038.18 $278,250.00 nat. median
$324,450
0.9× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 6 $257,674.28 $257,674.28 $257,674.28 nat. median
$150,721
1.7× median
J3403
HCPCS 		Revakinagene, Per Implant 6 $257,500.00 $702,434.25 $257,500.00 nat. median
$265,000
1.0× median
5832
APR_DRG 		Neonate With Ecmo 6 $251,476.51 $251,476.51 $251,476.51 nat. median
$156,126
1.6× median
1614
APR_DRG 		Implantable Heart Assist Systems 6 $223,795.68 $223,795.68 $223,795.68 nat. median
$207,730
1.1× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 6 $222,711.25 $222,711.25 $222,711.25 nat. median
$160,267
1.4× median
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 6 $216,571.70 $216,571.70 $216,571.70 nat. median
$182,665
1.2× median
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 $211,575.95 $211,575.95 $211,575.95 nat. median
$117,173
1.8× median
5881
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 6 $207,523.57 $207,523.57 $207,523.57 nat. median
$124,573
1.7× median
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 6 $207,523.57 $207,523.57 $207,523.57 nat. median
$145,336
1.4× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 6 $205,640.00 $560,965.36 $205,640.00 nat. median
$209,753
1.0× median
14
APR_DRG 		Liver Transplant And/or Intestinal Transplant 6 $202,558.88 $202,558.88 $202,558.88 nat. median
$129,535
1.6× median
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 6 $199,404.53 $199,404.53 $199,404.53 nat. median
$164,289
1.2× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 7 $100,886.04 $588,501.90 $198,077.01 nat. median
$265,286
0.7× median
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 6 $196,760.31 $196,760.31 $196,760.31 nat. median
$122,924
1.6× median
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 6 $194,779.73 $194,779.73 $194,779.73 nat. median
$162,982
1.2× median
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 6 $183,747.26 $183,747.26 $183,747.26 nat. median
$151,838
1.2× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 6 $182,099.34 $182,099.34 $182,099.34 nat. median
$187,061
1.0× median
23
APR_DRG 		Heart And/or Lung Transplant 6 $178,641.66 $178,641.66 $178,641.66 nat. median
$93,528
1.9× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 6 $171,626.16 $171,626.16 $171,626.16 nat. median
$164,834
1.0× median
6034
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 6 $169,753.33 $169,753.33 $169,753.33 nat. median
$109,499
1.6× median
5831
APR_DRG 		Neonate With Ecmo 6 $157,407.68 $157,407.68 $157,407.68 nat. median
$144,745
1.1× median
64
APR_DRG 		Pancreas Transplant 6 $155,460.85 $155,460.85 $155,460.85 nat. median
$91,009
1.7× median
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 6 $153,320.47 $153,320.47 $153,320.47 nat. median
$105,658
1.5× median
1613
APR_DRG 		Implantable Heart Assist Systems 6 $153,081.51 $153,081.51 $153,081.51 nat. median
$119,796
1.3× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 7 $76,861.80 $448,360.50 $150,908.44 nat. median
$206,474
0.7× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 7 $76,410.72 $445,729.20 $150,022.81 nat. median
$202,976
0.7× median
5913
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 6 $143,754.52 $143,754.52 $143,754.52 nat. median
$102,919
1.4× median
22
APR_DRG 		Heart And/or Lung Transplant 6 $141,912.10 $141,912.10 $141,912.10 nat. median
$77,804
1.8× median
6024
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 $135,699.49 $135,699.49 $135,699.49 nat. median
$118,620
1.1× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 6 $129,537.54 $395,089.50 $129,537.54 nat. median
$111,989
1.2× median

Other procedures at this hospital

Browse this hospital's 15,660 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
             
0266T CPT Outpatient Services 7 6 — — $43,450.68 $118,529.12 $43,450.68 2026-01-29
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 10 7 — — $100,886.04 $588,501.90 $198,077.01 2026-01-29
10 MS_DRG Pancreas Transplant 10 7 — — $25,832.52 $150,689.70 $50,718.89 2026-01-29
11 APR_DRG Liver Transplant And/or Intestinal Transplant 6 6 — — $66,406.68 $66,406.68 $66,406.68 2026-01-29
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 10 7 — — $19,634.76 $114,536.10 $38,550.38 2026-01-29
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 6 — — $47,514.68 $47,514.68 $47,514.68 2026-01-29
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 6 — — $83,551.69 $83,551.69 $83,551.69 2026-01-29
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 6 — — $120,228.24 $120,228.24 $120,228.24 2026-01-29
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 6 — — $211,575.95 $211,575.95 $211,575.95 2026-01-29
12 APR_DRG Liver Transplant And/or Intestinal Transplant 6 6 — — $75,896.45 $75,896.45 $75,896.45 2026-01-29
1204 APR_DRG Major Respiratory And Chest Procedures 6 6 — — $54,649.44 $54,649.44 $54,649.44 2026-01-29
1214 APR_DRG Other Respiratory And Chest Procedures 6 6 — — $44,440.41 $44,440.41 $44,440.41 2026-01-29
13 APR_DRG Liver Transplant And/or Intestinal Transplant 6 6 — — $94,341.60 $94,341.60 $94,341.60 2026-01-29
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 6 6 — — $49,388.95 $49,388.95 $49,388.95 2026-01-29
14 APR_DRG Liver Transplant And/or Intestinal Transplant 6 6 — — $202,558.88 $202,558.88 $202,558.88 2026-01-29
14 MS_DRG Allogeneic Bone Marrow Transplant 10 7 — — $43,264.44 $252,375.90 $84,944.27 2026-01-29
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 10 7 — — $21,346.92 $124,523.70 $41,911.99 2026-01-29
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 6 6 — — $55,472.31 $55,472.31 $55,472.31 2026-01-29
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 6 6 — — $121,457.78 $121,457.78 $121,457.78 2026-01-29
1611 APR_DRG Implantable Heart Assist Systems 6 6 — — $118,174.97 $118,174.97 $118,174.97 2026-01-29
1612 APR_DRG Implantable Heart Assist Systems 6 6 — — $124,424.29 $124,424.29 $124,424.29 2026-01-29
1613 APR_DRG Implantable Heart Assist Systems 6 6 — — $153,081.51 $153,081.51 $153,081.51 2026-01-29
1614 APR_DRG Implantable Heart Assist Systems 6 6 — — $223,795.68 $223,795.68 $223,795.68 2026-01-29
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 6 6 — — $43,963.37 $43,963.37 $43,963.37 2026-01-29
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 6 6 — — $58,125.15 $58,125.15 $58,125.15 2026-01-29
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 6 6 — — $90,693.41 $90,693.41 $90,693.41 2026-01-29
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 6 6 — — $48,252.40 $48,252.40 $48,252.40 2026-01-29
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 6 6 — — $76,612.44 $76,612.44 $76,612.44 2026-01-29
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 6 6 — — $47,623.29 $47,623.29 $47,623.29 2026-01-29
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 6 6 — — $70,340.53 $70,340.53 $70,340.53 2026-01-29
1663 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 6 6 — — $39,138.22 $39,138.22 $39,138.22 2026-01-29
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 6 6 — — $62,355.08 $62,355.08 $62,355.08 2026-01-29
1673 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 6 6 — — $43,680.97 $43,680.97 $43,680.97 2026-01-29
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 6 6 — — $78,722.20 $78,722.20 $78,722.20 2026-01-29
1694 APR_DRG Major Abdominal Vascular Procedures 6 6 — — $58,271.13 $58,271.13 $58,271.13 2026-01-29
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 10 7 — — $19,556.28 $114,078.30 $38,396.28 2026-01-29
1704 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 6 6 — — $41,459.99 $41,459.99 $41,459.99 2026-01-29
1754 APR_DRG Percutaneous Cardiac Intervention Without Ami 6 6 — — $38,091.16 $38,091.16 $38,091.16 2026-01-29
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 6 6 — — $46,292.97 $46,292.97 $46,292.97 2026-01-29
1781 APR_DRG External Heart Assist Systems 6 6 — — $41,834.50 $41,834.50 $41,834.50 2026-01-29
1782 APR_DRG External Heart Assist Systems 6 6 — — $52,125.20 $52,125.20 $52,125.20 2026-01-29
1783 APR_DRG External Heart Assist Systems 6 6 — — $53,592.82 $53,592.82 $53,592.82 2026-01-29
1784 APR_DRG External Heart Assist Systems 6 6 — — $74,686.90 $74,686.90 $74,686.90 2026-01-29
1793 APR_DRG Defibrillator Implants 6 6 — — $42,972.79 $42,972.79 $42,972.79 2026-01-29
1794 APR_DRG Defibrillator Implants 6 6 — — $59,021.01 $59,021.01 $59,021.01 2026-01-29
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 10 7 — — $155,458.08 $906,838.80 $305,222.33 2026-01-29
1814 APR_DRG Lower Extremity Arterial Procedures 6 6 — — $50,111.90 $50,111.90 $50,111.90 2026-01-29
1824 APR_DRG Other Peripheral Vascular And Related Procedures 6 6 — — $44,544.68 $44,544.68 $44,544.68 2026-01-29
1833 APR_DRG Percutaneous Structural Cardiac Procedures 6 6 — — $42,814.65 $42,814.65 $42,814.65 2026-01-29
1834 APR_DRG Percutaneous Structural Cardiac Procedures 6 6 — — $63,322.20 $63,322.20 $63,322.20 2026-01-29
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 10 7 — — $25,684.56 $149,826.60 $50,428.40 2026-01-29
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 10 7 — — $40,794.48 $237,967.80 $80,094.81 2026-01-29
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 10 7 — — $28,327.68 $165,244.80 $55,617.82 2026-01-29
204 APR_DRG Open Craniotomy For Trauma 6 6 — — $54,241.04 $54,241.04 $54,241.04 2026-01-29
207 MS_DRG Respiratory System Diagnosis With Ventilator Support &gt;96 Hours 10 7 — — $23,164.92 $135,128.70 $45,481.39 2026-01-29
209 MS_DRG Complex Aortic Arch Procedures 10 7 — — $40,747.68 $237,694.80 $80,002.93 2026-01-29
21 APR_DRG Heart And/or Lung Transplant 6 6 — — $123,605.98 $123,605.98 $123,605.98 2026-01-29
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 10 7 — — $39,146.76 $228,356.10 $76,859.72 2026-01-29
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 10 7 — — $20,544.84 $119,844.90 $40,337.21 2026-01-29
214 APR_DRG Open Craniotomy Except Trauma 6 6 — — $63,191.86 $63,191.86 $63,191.86 2026-01-29
215 MS_DRG Other Heart Assist System Implant 10 7 — — $35,845.20 $209,097.00 $70,377.53 2026-01-29
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 7 — — $35,218.08 $205,438.80 $69,146.25 2026-01-29
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 7 — — $23,671.08 $138,081.30 $46,475.17 2026-01-29
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 7 — — $23,671.08 $138,081.30 $46,475.17 2026-01-29
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 10 7 — — $27,641.88 $161,244.30 $54,271.34 2026-01-29
22 APR_DRG Heart And/or Lung Transplant 6 6 — — $141,912.10 $141,912.10 $141,912.10 2026-01-29
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 6 6 — — $56,192.65 $56,192.65 $56,192.65 2026-01-29
2224 APR_DRG Other Stomach, Esophageal And Duodenal Procedures 6 6 — — $42,353.25 $42,353.25 $42,353.25 2026-01-29
2234 APR_DRG Other Small And Large Bowel Procedures 6 6 — — $39,520.55 $39,520.55 $39,520.55 2026-01-29
224 APR_DRG Ventricular Shunt Procedures 6 6 — — $51,761.99 $51,761.99 $51,761.99 2026-01-29
2274 APR_DRG Hernia Procedures Except Inguinal, Femoral And Umbilical 6 6 — — $38,062.49 $38,062.49 $38,062.49 2026-01-29
2294 APR_DRG Other Digestive System And Abdominal Procedures 6 6 — — $39,906.35 $39,906.35 $39,906.35 2026-01-29
23 APR_DRG Heart And/or Lung Transplant 6 6 — — $178,641.66 $178,641.66 $178,641.66 2026-01-29
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 10 7 — — $20,629.08 $120,336.30 $40,502.60 2026-01-29
2304 APR_DRG Major Small Bowel Procedures 6 6 — — $48,624.30 $48,624.30 $48,624.30 2026-01-29
231 MS_DRG Coronary Bypass With Ptca With Mcc 10 7 — — $30,347.64 $177,027.90 $59,583.77 2026-01-29
2314 APR_DRG Major Large Bowel Procedures 6 6 — — $41,189.76 $41,189.76 $41,189.76 2026-01-29
232 MS_DRG Coronary Bypass With Ptca Without Mcc 10 7 — — $21,825.36 $127,314.60 $42,851.34 2026-01-29
2324 APR_DRG Gastric Fundoplication 6 6 — — $49,369.84 $49,369.84 $49,369.84 2026-01-29
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 10 7 — — $27,522.72 $160,549.20 $54,037.38 2026-01-29
234 APR_DRG Spinal Procedures 6 6 — — $57,874.90 $57,874.90 $57,874.90 2026-01-29
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 10 7 — — $19,665.72 $114,716.70 $38,611.17 2026-01-29
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 10 7 — — $21,126.96 $123,240.60 $41,480.12 2026-01-29
24 APR_DRG Heart And/or Lung Transplant 6 6 — — $329,119.21 $329,119.21 $329,119.21 2026-01-29
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 6 6 — — $60,184.50 $60,184.50 $60,184.50 2026-01-29
2614 APR_DRG Major Biliary Tract Procedures 6 6 — — $49,755.64 $49,755.64 $49,755.64 2026-01-29
264 APR_DRG Other Nervous System And Related Procedures 6 6 — — $47,665.00 $47,665.00 $47,665.00 2026-01-29
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures 6 6 — — $47,970.86 $47,970.86 $47,970.86 2026-01-29
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 10 7 — — $22,062.24 $128,696.40 $43,316.42 2026-01-29
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 10 7 — — $24,760.44 $144,435.90 $48,614.00 2026-01-29
274 APR_DRG Other Open Craniotomy 6 6 — — $55,766.01 $55,766.01 $55,766.01 2026-01-29
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 10 7 — — $25,669.44 $149,738.40 $50,398.71 2026-01-29
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 10 7 — — $21,623.76 $126,138.60 $42,455.52 2026-01-29
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 10 7 — — $20,038.32 $116,890.20 $39,342.72 2026-01-29
28 MS_DRG Spinal Procedures With Mcc 10 7 — — $21,629.88 $126,174.30 $42,467.53 2026-01-29
294 APR_DRG Other Percutaneous Intracranial Procedures 6 6 — — $43,136.15 $43,136.15 $43,136.15 2026-01-29
3 MS_DRG Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 10 7 — — $76,410.72 $445,729.20 $150,022.81 2026-01-29
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 6 6 — — $46,548.43 $46,548.43 $46,548.43 2026-01-29
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 6 6 — — $67,569.52 $67,569.52 $67,569.52 2026-01-29
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 6 6 — — $95,208.35 $95,208.35 $95,208.35 2026-01-29
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 6 6 — — $45,754.23 $45,754.23 $45,754.23 2026-01-29
3043 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 6 6 — — $44,228.39 $44,228.39 $44,228.39 2026-01-29
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 6 6 — — $68,913.75 $68,913.75 $68,913.75 2026-01-29
3054 APR_DRG Amputation Of Lower Limb Except Toes 6 6 — — $38,673.34 $38,673.34 $38,673.34 2026-01-29
3094 APR_DRG Other Significant Hip And Femur Surgery 6 6 — — $39,176.45 $39,176.45 $39,176.45 2026-01-29
3104 APR_DRG Vertebral And Intervertebral Spinal Procedures Including Disc Procedures 6 6 — — $38,292.75 $38,292.75 $38,292.75 2026-01-29
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 6 6 — — $72,112.27 $72,112.27 $72,112.27 2026-01-29
3134 APR_DRG Knee And Lower Leg Procedures Except Foot 6 6 — — $38,716.79 $38,716.79 $38,716.79 2026-01-29
3154 APR_DRG Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement 6 6 — — $38,910.56 $38,910.56 $38,910.56 2026-01-29
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 10 7 — — $24,071.40 $140,416.50 $47,261.16 2026-01-29
3214 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 6 6 — — $45,319.77 $45,319.77 $45,319.77 2026-01-29
3254 APR_DRG Non-elective Or Complex Knee Joint Replacement 6 6 — — $42,303.72 $42,303.72 $42,303.72 2026-01-29
33276 CPT Insj Phrnc Nrv Stim Sys 7 6 — — $43,450.68 $118,529.12 $43,450.68 2026-01-29
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 6 6 — — $64,715.96 $64,715.96 $64,715.96 2026-01-29
38240 CPT Transplt Allo Hct/donor 7 6 — — $57,105.47 $155,778.01 $57,105.47 2026-01-29
4 MS_DRG Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And … 10 7 — — $49,865.04 $290,879.40 $97,903.72 2026-01-29
4014 APR_DRG Adrenal Procedures 6 6 — — $56,462.02 $56,462.02 $56,462.02 2026-01-29
4034 APR_DRG Procedures For Obesity 6 6 — — $39,351.11 $39,351.11 $39,351.11 2026-01-29
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 6 6 — — $51,710.73 $51,710.73 $51,710.73 2026-01-29
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 10 7 — — $19,693.80 $114,880.50 $38,666.28 2026-01-29
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 6 6 — — $45,456.19 $45,456.19 $45,456.19 2026-01-29
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 6 6 — — $54,344.44 $54,344.44 $54,344.44 2026-01-29
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 6 6 — — $70,235.39 $70,235.39 $70,235.39 2026-01-29
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 10 7 — — $39,676.32 $231,445.20 $77,899.45 2026-01-29
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 10 7 — — $25,986.96 $151,590.60 $51,022.12 2026-01-29
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 10 7 — — $20,239.20 $118,062.00 $39,737.12 2026-01-29
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 10 7 — — $32,434.56 $189,201.60 $63,681.16 2026-01-29
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 6 6 — — $101,314.30 $101,314.30 $101,314.30 2026-01-29
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 10 7 — — $20,761.56 $121,109.10 $40,762.70 2026-01-29
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 6 6 — — $153,320.47 $153,320.47 $153,320.47 2026-01-29
4401 APR_DRG Kidney Transplant 6 6 — — $50,348.90 $50,348.90 $50,348.90 2026-01-29
4402 APR_DRG Kidney Transplant 6 6 — — $55,519.02 $55,519.02 $55,519.02 2026-01-29
4403 APR_DRG Kidney Transplant 6 6 — — $65,208.64 $65,208.64 $65,208.64 2026-01-29
4404 APR_DRG Kidney Transplant 6 6 — — $105,097.83 $105,097.83 $105,097.83 2026-01-29
4414 APR_DRG Major Bladder Procedures 6 6 — — $56,459.41 $56,459.41 $56,459.41 2026-01-29
4424 APR_DRG Kidney And Urinary Tract Procedures For Malignancy 6 6 — — $39,640.46 $39,640.46 $39,640.46 2026-01-29
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 10 7 — — $24,053.76 $140,313.60 $47,226.52 2026-01-29
4474 APR_DRG Other Kidney, Urinary Tract And Related Procedures 6 6 — — $42,800.75 $42,800.75 $42,800.75 2026-01-29
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 7 — — $30,252.24 $176,471.40 $59,396.46 2026-01-29
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 7 — — $21,467.16 $125,225.10 $42,148.06 2026-01-29
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 10 7 — — $19,882.80 $115,983.00 $39,037.37 2026-01-29
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 10 7 — — $20,518.20 $119,689.50 $40,284.90 2026-01-29
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 10 7 — — $37,117.80 $216,520.50 $72,876.11 2026-01-29
504 APR_DRG Non-bacterial Infections Of Nervous System Except Viral Meningitis 6 6 — — $41,136.75 $41,136.75 $41,136.75 2026-01-29
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 6 6 — — $44,908.76 $44,908.76 $44,908.76 2026-01-29
5114 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 6 6 — — $44,920.06 $44,920.06 $44,920.06 2026-01-29
5124 APR_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy 6 6 — — $38,417.88 $38,417.88 $38,417.88 2026-01-29
5144 APR_DRG Female Reproductive System Reconstructive Procedures 6 6 — — $39,846.39 $39,846.39 $39,846.39 2026-01-29
5184 APR_DRG Other Female Reproductive System And Related Procedures 6 6 — — $41,643.34 $41,643.34 $41,643.34 2026-01-29
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 6 6 — — $53,739.67 $53,739.67 $53,739.67 2026-01-29
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 6 6 — — $71,652.61 $71,652.61 $71,652.61 2026-01-29
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 6 6 — — $99,043.80 $99,043.80 $99,043.80 2026-01-29
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 10 7 — — $23,585.04 $137,579.40 $46,306.25 2026-01-29
5831 APR_DRG Neonate With Ecmo 6 6 — — $157,407.68 $157,407.68 $157,407.68 2026-01-29
5832 APR_DRG Neonate With Ecmo 6 6 — — $251,476.51 $251,476.51 $251,476.51 2026-01-29
5833 APR_DRG Neonate With Ecmo 6 6 — — $365,483.81 $365,483.81 $365,483.81 2026-01-29
5834 APR_DRG Neonate With Ecmo 6 6 — — $416,100.49 $416,100.49 $416,100.49 2026-01-29
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 6 — — $207,523.57 $207,523.57 $207,523.57 2026-01-29
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 6 — — $207,523.57 $207,523.57 $207,523.57 2026-01-29
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 6 — — $216,571.70 $216,571.70 $216,571.70 2026-01-29
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 6 — — $316,893.84 $316,893.84 $316,893.84 2026-01-29
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 6 6 — — $124,631.24 $124,631.24 $124,631.24 2026-01-29
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 6 6 — — $120,222.02 $120,222.02 $120,222.02 2026-01-29
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 6 6 — — $114,455.38 $114,455.38 $114,455.38 2026-01-29
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 6 6 — — $75,988.55 $75,988.55 $75,988.55 2026-01-29
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 6 6 — — $105,394.06 $105,394.06 $105,394.06 2026-01-29
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 6 6 — — $143,754.52 $143,754.52 $143,754.52 2026-01-29
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 6 6 — — $199,404.53 $199,404.53 $199,404.53 2026-01-29
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 6 6 — — $110,298.43 $110,298.43 $110,298.43 2026-01-29
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 6 6 — — $124,840.22 $124,840.22 $124,840.22 2026-01-29
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 6 6 — — $183,747.26 $183,747.26 $183,747.26 2026-01-29
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $80,935.28 $80,935.28 $80,935.28 2026-01-29
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $100,867.17 $100,867.17 $100,867.17 2026-01-29
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $135,699.49 $135,699.49 $135,699.49 2026-01-29
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 6 6 — — $46,679.06 $46,679.06 $46,679.06 2026-01-29
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 6 6 — — $84,781.59 $84,781.59 $84,781.59 2026-01-29
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 6 6 — — $169,753.33 $169,753.33 $169,753.33 2026-01-29
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $57,883.80 $57,883.80 $57,883.80 2026-01-29
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $74,438.17 $74,438.17 $74,438.17 2026-01-29
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $106,234.68 $106,234.68 $106,234.68 2026-01-29
6082 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 6 6 — — $42,922.18 $42,922.18 $42,922.18 2026-01-29
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 6 6 — — $56,212.93 $56,212.93 $56,212.93 2026-01-29
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 6 6 — — $71,974.69 $71,974.69 $71,974.69 2026-01-29
6091 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 6 6 — — $47,692.88 $47,692.88 $47,692.88 2026-01-29
6092 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 6 6 — — $47,692.88 $47,692.88 $47,692.88 2026-01-29
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 6 6 — — $90,025.78 $90,025.78 $90,025.78 2026-01-29
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 6 6 — — $194,779.73 $194,779.73 $194,779.73 2026-01-29
61 APR_DRG Pancreas Transplant 6 6 — — $60,302.46 $60,302.46 $60,302.46 2026-01-29
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 6 6 — — $54,359.43 $54,359.43 $54,359.43 2026-01-29
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 6 6 — — $94,040.59 $94,040.59 $94,040.59 2026-01-29
6122 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $39,017.51 $39,017.51 $39,017.51 2026-01-29
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $49,819.36 $49,819.36 $49,819.36 2026-01-29
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $76,114.69 $76,114.69 $76,114.69 2026-01-29
6133 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 6 6 — — $51,131.59 $51,131.59 $51,131.59 2026-01-29
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 6 6 — — $95,136.30 $95,136.30 $95,136.30 2026-01-29
6143 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 6 6 — — $44,025.43 $44,025.43 $44,025.43 2026-01-29
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 6 6 — — $63,004.68 $63,004.68 $63,004.68 2026-01-29
62 APR_DRG Pancreas Transplant 6 6 — — $87,201.19 $87,201.19 $87,201.19 2026-01-29
6213 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 6 6 — — $39,549.37 $39,549.37 $39,549.37 2026-01-29
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 6 6 — — $74,425.93 $74,425.93 $74,425.93 2026-01-29
6224 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $51,512.83 $51,512.83 $51,512.83 2026-01-29
6233 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 6 6 — — $43,502.99 $43,502.99 $43,502.99 2026-01-29
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 6 6 — — $53,048.15 $53,048.15 $53,048.15 2026-01-29
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 6 6 — — $76,068.57 $76,068.57 $76,068.57 2026-01-29
63 APR_DRG Pancreas Transplant 6 6 — — $99,766.96 $99,766.96 $99,766.96 2026-01-29
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 6 6 — — $79,277.59 $79,277.59 $79,277.59 2026-01-29
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 6 6 — — $106,288.33 $106,288.33 $106,288.33 2026-01-29
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 6 6 — — $257,674.28 $257,674.28 $257,674.28 2026-01-29
6312 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 6 6 — — $43,354.25 $43,354.25 $43,354.25 2026-01-29
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 6 6 — — $68,559.51 $68,559.51 $68,559.51 2026-01-29
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 6 6 — — $196,760.31 $196,760.31 $196,760.31 2026-01-29
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 6 6 — — $69,760.66 $69,760.66 $69,760.66 2026-01-29
6344 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 6 6 — — $47,114.90 $47,114.90 $47,114.90 2026-01-29
64 APR_DRG Pancreas Transplant 6 6 — — $155,460.85 $155,460.85 $155,460.85 2026-01-29
6504 APR_DRG Splenectomy 6 6 — — $42,915.45 $42,915.45 $42,915.45 2026-01-29
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 6 6 — — $62,404.61 $62,404.61 $62,404.61 2026-01-29
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 6 6 — — $73,997.84 $73,997.84 $73,997.84 2026-01-29
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 6 6 — — $66,359.97 $66,359.97 $66,359.97 2026-01-29
6903 APR_DRG Acute Leukemia 6 6 — — $40,047.99 $40,047.99 $40,047.99 2026-01-29
6904 APR_DRG Acute Leukemia 6 6 — — $67,732.88 $67,732.88 $67,732.88 2026-01-29
6954 APR_DRG Chemotherapy For Acute Leukemia 6 6 — — $61,444.45 $61,444.45 $61,444.45 2026-01-29
7 MS_DRG Lung Transplant 10 7 — — $46,620.72 $271,954.20 $91,533.91 2026-01-29
71 APR_DRG Allogeneic Bone Marrow Transplant 6 6 — — $56,024.08 $56,024.08 $56,024.08 2026-01-29
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 6 6 — — $45,398.84 $45,398.84 $45,398.84 2026-01-29
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 6 6 — — $45,493.55 $45,493.55 $45,493.55 2026-01-29
72 APR_DRG Allogeneic Bone Marrow Transplant 6 6 — — $72,982.93 $72,982.93 $72,982.93 2026-01-29
73 APR_DRG Allogeneic Bone Marrow Transplant 6 6 — — $92,030.69 $92,030.69 $92,030.69 2026-01-29
734 APR_DRG Orbit And Eye Procedures 6 6 — — $40,047.12 $40,047.12 $40,047.12 2026-01-29
74 APR_DRG Allogeneic Bone Marrow Transplant 6 6 — — $182,099.34 $182,099.34 $182,099.34 2026-01-29
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 6 6 — — $71,981.93 $71,981.93 $71,981.93 2026-01-29
7504 APR_DRG Schizophrenia 6 6 — — $41,360.50 $41,360.50 $41,360.50 2026-01-29
7574 APR_DRG Organic Mental Health Disturbances 6 6 — — $41,007.28 $41,007.28 $41,007.28 2026-01-29
7584 APR_DRG Behavioral Disorders 6 6 — — $68,023.97 $68,023.97 $68,023.97 2026-01-29
7594 APR_DRG Eating Disorders 6 6 — — $98,356.48 $98,356.48 $98,356.48 2026-01-29
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 9 7 — — $21,396.60 $99,218.35 $42,009.52 2026-01-29
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 6 6 — — $50,469.03 $50,469.03 $50,469.03 2026-01-29
7934 APR_DRG Moderately Extensive O.r. Procedures For Other Complications Of Treatment 6 6 — — $40,947.33 $40,947.33 $40,947.33 2026-01-29
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 10 7 — — $20,176.56 $117,696.60 $39,614.14 2026-01-29
82 APR_DRG Autologous Bone Marrow Transplant 6 6 — — $41,464.34 $41,464.34 $41,464.34 2026-01-29
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 10 7 — — $21,113.28 $123,160.80 $41,453.26 2026-01-29
83 APR_DRG Autologous Bone Marrow Transplant 6 6 — — $49,082.22 $49,082.22 $49,082.22 2026-01-29
834 MS_DRG Acute Leukemia With Mcc 10 7 — — $19,763.64 $115,287.90 $38,803.41 2026-01-29
84 APR_DRG Autologous Bone Marrow Transplant 6 6 — — $91,257.34 $91,257.34 $91,257.34 2026-01-29
8411 APR_DRG Extensive Third Degree Burns With Skin Graft 6 6 — — $48,358.41 $48,358.41 $48,358.41 2026-01-29
8412 APR_DRG Extensive Third Degree Burns With Skin Graft 6 6 — — $48,358.41 $48,358.41 $48,358.41 2026-01-29
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 6 6 — — $74,417.53 $74,417.53 $74,417.53 2026-01-29
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 6 6 — — $222,711.25 $222,711.25 $222,711.25 2026-01-29
8423 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 6 6 — — $41,431.32 $41,431.32 $41,431.32 2026-01-29
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 6 6 — — $100,533.14 $100,533.14 $100,533.14 2026-01-29
850 MS_DRG Acute Leukemia With Other Procedures 10 7 — — $31,174.20 $181,849.50 $61,206.61 2026-01-29
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 6 6 — — $59,734.40 $59,734.40 $59,734.40 2026-01-29
8633 APR_DRG Neonatal Aftercare 6 6 — — $48,127.78 $48,127.78 $48,127.78 2026-01-29
8634 APR_DRG Neonatal Aftercare 6 6 — — $81,420.07 $81,420.07 $81,420.07 2026-01-29
870 MS_DRG Septicemia Or Severe Sepsis With Mv &gt;96 Hours 10 7 — — $24,882.48 $145,147.80 $48,853.62 2026-01-29
894 APR_DRG Major Cranial Or Facial Bone Procedures 6 6 — — $51,752.44 $51,752.44 $51,752.44 2026-01-29
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 6 6 — — $47,698.89 $47,698.89 $47,698.89 2026-01-29
9103 APR_DRG Craniotomy For Multiple Significant Trauma 6 6 — — $39,156.47 $39,156.47 $39,156.47 2026-01-29
9104 APR_DRG Craniotomy For Multiple Significant Trauma 6 6 — — $66,425.14 $66,425.14 $66,425.14 2026-01-29
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 6 6 — — $66,834.40 $66,834.40 $66,834.40 2026-01-29
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 6 6 — — $59,153.96 $59,153.96 $59,153.96 2026-01-29
914 APR_DRG Other Major Head And Neck Procedures 6 6 — — $56,266.51 $56,266.51 $56,266.51 2026-01-29
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 6 6 — — $47,698.89 $47,698.89 $47,698.89 2026-01-29
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 6 6 — — $53,875.22 $53,875.22 $53,875.22 2026-01-29
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 10 7 — — $76,861.80 $448,360.50 $150,908.44 2026-01-29
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 10 7 — — $25,821.72 $150,626.70 $50,697.69 2026-01-29
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 6 6 — — $76,980.00 $76,980.00 $76,980.00 2026-01-29
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 6 6 — — $171,626.16 $171,626.16 $171,626.16 2026-01-29
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 6 6 — — $55,517.50 $55,517.50 $55,517.50 2026-01-29
9514 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 6 6 — — $40,994.25 $40,994.25 $40,994.25 2026-01-29
955 MS_DRG Craniotomy For Multiple Significant Trauma 10 7 — — $24,231.96 $141,353.10 $47,576.40 2026-01-29
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 10 7 — — $27,431.64 $160,017.90 $53,858.57 2026-01-29
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 10 7 — — $22,036.68 $128,547.30 $43,266.24 2026-01-29
A9543 HCPCS Y90 Ibritumomab, Rx 7 6 — — $56,824.55 $155,011.69 $56,824.55 2026-01-29
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 5 5 — — $3,685,266.67 $3,685,266.67 $3,685,266.67 2026-01-29
J1413 HCPCS Inj Delandistrogene Mox Rokl 5 5 — — $3,316,462.59 $3,316,462.59 $3,316,462.59 2026-01-29
J2350 HCPCS Ocrelizumab (300 Mg/10 Ml) Vial 27 7 $50,217.53 $27,468.99 45% off $59.41 $47,706.65 $43,940.33 2026-01-29
J3391 HCPCS Inj, Atidarsagene Autotemcel 5 5 — — $4,505,000.00 $4,505,000.00 $4,505,000.00 2026-01-29
J3392 HCPCS Inj, Exagamglogene Autotem 6 6 — — $2,332,000.00 $3,964,400.00 $2,332,000.00 2026-01-29
J3393 HCPCS Inj, Betibeglogene Autotemce 5 5 — — $2,945,740.00 $2,945,740.00 $2,945,740.00 2026-01-29
J3394 HCPCS Inj, Lovotibeglogene Autotem 5 5 — — $3,248,445.72 $3,248,445.72 $3,248,445.72 2026-01-29
J3399 HCPCS Inj Onase Abepar-xioi Treat 6 6 — — $2,455,110.61 $4,173,688.02 $2,455,110.61 2026-01-29
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 7 6 — — $205,640.00 $560,965.36 $205,640.00 2026-01-29
J3403 HCPCS Revakinagene, Per Implant 7 6 — — $257,500.00 $702,434.25 $257,500.00 2026-01-29
J9029 HCPCS Instill Adstiladrin, Tx Dose 8 6 — — $63,342.28 $172,791.41 $63,342.28 2026-01-29
J9226 HCPCS Supprelin La Implant 8 6 — — $45,020.65 $122,811.83 $45,020.65 2026-01-29
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 7 6 — — $89,488.03 $305,143.00 $111,860.04 2026-01-29
L7180 HCPCS Electronic Elbow Sequential 7 6 — — $52,277.90 $159,447.60 $52,277.90 2026-01-29
L7181 HCPCS Electronic Elbo Simultaneous 7 6 — — $57,614.51 $175,724.26 $57,614.51 2026-01-29
L8701 HCPCS Ewh S/d Uprt Micro Sensor 7 6 — — $41,141.33 $125,481.06 $41,141.33 2026-01-29
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 7 6 — — $80,943.19 $246,876.73 $80,943.19 2026-01-29
Q0480 HCPCS Driver Pneumatic Vad, Rep 7 6 — — $129,537.54 $395,089.50 $129,537.54 2026-01-29
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 8 6 — — $533,230.17 $1,454,598.58 $533,230.17 2026-01-29
Q2042 HCPCS Tisagenlecleucel Car-pos T 8 6 — — $591,726.20 $1,614,169.90 $591,726.20 2026-01-29
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 8 6 — — $55,272.32 $150,777.37 $55,272.32 2026-01-29
Q2053 HCPCS Brexucabtagene Car Pos T 8 6 — — $489,304.61 $1,334,774.04 $489,304.61 2026-01-29
Q2054 HCPCS Lisocabtagene Mara Car Pos T 8 6 — — $562,538.19 $1,534,547.91 $562,538.19 2026-01-29
Q2055 HCPCS Idecabtagene Vicleucel Car 8 6 — — $557,317.93 $1,520,307.59 $557,317.93 2026-01-29
Q2056 HCPCS Ciltacabtagene Car-pos T 8 6 — — $565,868.95 $1,543,633.90 $565,868.95 2026-01-29
Q2057 HCPCS Afamitresgene Autoleucel 7 6 — — $770,620.00 $2,102,174.30 $770,620.00 2026-01-29
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 7 6 — — $278,250.00 $759,038.18 $278,250.00 2026-01-29
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