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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

GUNDERSEN MOUNDVIEW HOSPITAL AND CLINICS

Friendship, WI · CCN 521309 · Rates published

20,407 distinct procedures filed
17 distinct payers
171,649 rate rows
2025-06-27 last MRF observed · ⚠ 16 mo old
Data quality

143,607 of 171,649 rate rows are consumer-grade (83.7%)

28,042 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 16,415
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 8,469
template filing: same amount across many unrelated codes — excluded 2,536
exceeds 10× this hospital's gross charge — excluded from medians 472
placeholder amount (≤ $0.02) — excluded from medians 57
percent-of-charges filed in the dollar field — excluded from medians 48
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 43
per-diem day rate — not a per-procedure price 2

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 16 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://bellin-ghs.pt.panaceainc.com/MRFDownload/bellin-ghs/gundersen-moundview
Found on page https://www.gundersenhealth.org/cost-estimates/charges
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-15
Content fingerprint 2850586d8855fac9… · 1,946,081 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
5834
APR_DRG 		Neonate With Ecmo 4 $411,851.82 $831,412.76 $831,412.76 nat. median
$390,362
outlier · 2.1×
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 4 $268,686.28 $542,401.87 $542,401.87 nat. median
$286,698
1.9× median
5833
APR_DRG 		Neonate With Ecmo 4 $266,810.37 $538,614.95 $538,614.95 nat. median
$268,208
outlier · 2.0×
24
APR_DRG 		Heart And/or Lung Transplant 4 $237,946.25 $480,346.42 $480,346.42 nat. median
$225,531
outlier · 2.1×
Q2053
HCPCS 		Brexucabtagene Car Pos T 6 $16,507.81 $4,747,210.00 $449,440.00 nat. median
$513,770
0.9× median
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 $209,226.61 $422,369.56 $422,369.56 nat. median
$135,803
outlier · 3.1×
5832
APR_DRG 		Neonate With Ecmo 4 $204,861.54 $413,557.71 $413,557.71 nat. median
$201,678
outlier · 2.1×
1614
APR_DRG 		Implantable Heart Assist Systems 4 $203,918.48 $411,653.94 $411,653.94 nat. median
$202,242
outlier · 2.0×
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 4 $195,997.12 $395,662.95 $395,662.95 nat. median
$187,567
outlier · 2.1×
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 4 $193,312.43 $390,243.32 $390,243.32 nat. median
$173,018
outlier · 2.3×
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 $176,662.50 $356,631.80 $356,631.80 nat. median
$198,578
1.8× median
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 4 $174,746.55 $352,764.04 $352,764.04 nat. median
$173,134
outlier · 2.0×
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 4 $173,438.36 $350,123.18 $350,123.18 nat. median
$181,762
1.9× median
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 4 $170,686.93 $344,568.81 $344,568.81 nat. median
$171,497
outlier · 2.0×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 4 $269,344.82 $690,785.36 $342,695.08 nat. median
$168,055
outlier · 2.0×
74
APR_DRG 		Allogeneic Bone Marrow Transplant 4 $162,015.68 $327,064.00 $327,064.00 nat. median
$149,836
outlier · 2.2×
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 4 $161,203.76 $325,424.95 $325,424.95 nat. median
$152,792
outlier · 2.1×
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 4 $158,270.15 $319,502.83 $319,502.83 nat. median
$168,439
1.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 5 $16,507.81 $578,771.12 $314,701.72 nat. median
$621,313
0.5× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 5 $16,507.81 $553,169.30 $312,763.43 nat. median
$599,737
0.5× median
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 4 $153,336.58 $309,543.34 $309,543.34 nat. median
$152,383
outlier · 2.0×
Q2055
HCPCS 		Idecabtagene Vicleucel Car 5 $16,507.81 $527,622.46 $301,510.62 nat. median
$574,037
0.5× median
5831
APR_DRG 		Neonate With Ecmo 4 $148,907.12 $300,601.51 $300,601.51 nat. median
$173,909
1.7× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 5 $16,507.81 $516,442.29 $296,092.23 nat. median
$579,571
0.5× median
6034
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 4 $146,394.39 $295,529.03 $295,529.03 nat. median
$115,963
outlier · 2.5×
14
APR_DRG 		Liver Transplant And/or Intestinal Transplant 4 $144,084.26 $290,865.51 $290,865.51 nat. median
$136,566
outlier · 2.1×
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 4 $143,096.45 $288,871.40 $288,871.40 nat. median
$135,630
outlier · 2.1×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 5 $16,507.81 $502,840.73 $283,885.47 nat. median
$562,501
0.5× median
1613
APR_DRG 		Implantable Heart Assist Systems 4 $137,976.77 $278,536.22 $278,536.22 nat. median
$155,539
1.8× median
23
APR_DRG 		Heart And/or Lung Transplant 4 $133,605.42 $269,711.69 $269,711.69 nat. median
$117,894
outlier · 2.3×
5881
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 4 $131,431.13 $265,322.41 $265,322.41 nat. median
$130,862
outlier · 2.0×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 4 $201,178.00 $515,958.75 $255,964.50 nat. median
$186,516
1.4× median
5913
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 4 $126,689.93 $255,751.27 $255,751.27 nat. median
$120,079
outlier · 2.1×
113
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 $122,020.98 $246,325.97 $246,325.97 nat. median
$68,335
outlier · 3.6×
1604
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly 4 $118,972.73 $240,172.42 $240,172.42 nat. median
$106,926
outlier · 2.2×
6024
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 4 $117,527.92 $237,255.74 $237,255.74 nat. median
$124,731
1.9× median
1612
APR_DRG 		Implantable Heart Assist Systems 4 $110,756.13 $223,585.41 $223,585.41 nat. median
$109,992
outlier · 2.0×
5933
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 4 $109,765.96 $221,586.53 $221,586.53 nat. median
$114,205
1.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 4 $169,428.24 $434,530.53 $215,568.37 nat. median
$131,925
1.6× median
1611
APR_DRG 		Implantable Heart Assist Systems 4 $105,524.17 $213,023.55 $213,023.55 nat. median
$108,954
2.0× median
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 4 $104,959.59 $211,883.83 $211,883.83 nat. median
$99,483
outlier · 2.1×
112
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 $104,771.13 $211,503.39 $211,503.39 nat. median
$63,564
outlier · 3.3×
64
APR_DRG 		Pancreas Transplant 4 $103,649.83 $209,239.80 $209,239.80 nat. median
$92,994
outlier · 2.3×
5892
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 4 $101,863.44 $205,633.58 $205,633.58 nat. median
$96,548
outlier · 2.1×
8514
APR_DRG 		Gender Related Procedures 4 $100,501.08 $202,883.35 $202,883.35 nat. median
$56,282
outlier · 3.6×
5893
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 4 $99,693.08 $201,252.23 $201,252.23 nat. median
$77,096
outlier · 2.6×
8424
APR_DRG 		Burns With Skin Graft Except Extensive Third Degree Burns 4 $99,002.08 $199,857.30 $199,857.30 nat. median
$91,950
outlier · 2.2×
22
APR_DRG 		Heart And/or Lung Transplant 4 $97,231.39 $196,282.78 $196,282.78 nat. median
$95,481
outlier · 2.1×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 4 $153,064.49 $392,562.62 $194,748.31 nat. median
$145,435
1.3× median
5912
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 4 $96,071.62 $193,941.52 $193,941.52 nat. median
$85,835
outlier · 2.3×

Other procedures at this hospital

Browse this hospital's 20,407 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
5834 APR_DRG Neonate With Ecmo 4 4 — — $411,851.82 $831,412.76 $831,412.76 2025-06-27
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 4 4 — — $268,686.28 $542,401.87 $542,401.87 2025-06-27
5833 APR_DRG Neonate With Ecmo 4 4 — — $266,810.37 $538,614.95 $538,614.95 2025-06-27
24 APR_DRG Heart And/or Lung Transplant 4 4 — — $237,946.25 $480,346.42 $480,346.42 2025-06-27
Q2053 HCPCS Brexucabtagene Car Pos T 9 6 — — $16,507.81 $4,747,210.00 $449,440.00 2025-06-27
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 4 — — $209,226.61 $422,369.56 $422,369.56 2025-06-27
5832 APR_DRG Neonate With Ecmo 4 4 — — $204,861.54 $413,557.71 $413,557.71 2025-06-27
1614 APR_DRG Implantable Heart Assist Systems 4 4 — — $203,918.48 $411,653.94 $411,653.94 2025-06-27
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 4 4 — — $195,997.12 $395,662.95 $395,662.95 2025-06-27
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 4 4 — — $193,312.43 $390,243.32 $390,243.32 2025-06-27
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 4 — — $176,662.50 $356,631.80 $356,631.80 2025-06-27
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 4 4 — — $174,746.55 $352,764.04 $352,764.04 2025-06-27
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 4 4 — — $173,438.36 $350,123.18 $350,123.18 2025-06-27
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 4 4 — — $170,686.93 $344,568.81 $344,568.81 2025-06-27
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 7 4 — — $269,344.82 $690,785.36 $342,695.08 2025-06-27
74 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $162,015.68 $327,064.00 $327,064.00 2025-06-27
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 4 — — $161,203.76 $325,424.95 $325,424.95 2025-06-27
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 4 4 — — $158,270.15 $319,502.83 $319,502.83 2025-06-27
Q2042 HCPCS Tisagenlecleucel Car-pos T 8 5 — — $16,507.81 $578,771.12 $314,701.72 2025-06-27
Q2056 HCPCS Ciltacabtagene Car-pos T 8 5 — — $16,507.81 $553,169.30 $312,763.43 2025-06-27
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 4 4 — — $153,336.58 $309,543.34 $309,543.34 2025-06-27
Q2055 HCPCS Idecabtagene Vicleucel Car 8 5 — — $16,507.81 $527,622.46 $301,510.62 2025-06-27
5831 APR_DRG Neonate With Ecmo 4 4 — — $148,907.12 $300,601.51 $300,601.51 2025-06-27
Q2054 HCPCS Lisocabtagene Mara Car Pos T 8 5 — — $16,507.81 $516,442.29 $296,092.23 2025-06-27
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 4 4 — — $146,394.39 $295,529.03 $295,529.03 2025-06-27
14 APR_DRG Liver Transplant And/or Intestinal Transplant 4 4 — — $144,084.26 $290,865.51 $290,865.51 2025-06-27
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 4 4 — — $143,096.45 $288,871.40 $288,871.40 2025-06-27
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 8 5 — — $16,507.81 $502,840.73 $283,885.47 2025-06-27
1613 APR_DRG Implantable Heart Assist Systems 4 4 — — $137,976.77 $278,536.22 $278,536.22 2025-06-27
23 APR_DRG Heart And/or Lung Transplant 4 4 — — $133,605.42 $269,711.69 $269,711.69 2025-06-27
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 4 4 — — $131,431.13 $265,322.41 $265,322.41 2025-06-27
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 7 4 — — $201,178.00 $515,958.75 $255,964.50 2025-06-27
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 4 4 — — $126,689.93 $255,751.27 $255,751.27 2025-06-27
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 4 — — $122,020.98 $246,325.97 $246,325.97 2025-06-27
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 4 4 — — $118,972.73 $240,172.42 $240,172.42 2025-06-27
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $117,527.92 $237,255.74 $237,255.74 2025-06-27
1612 APR_DRG Implantable Heart Assist Systems 4 4 — — $110,756.13 $223,585.41 $223,585.41 2025-06-27
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 4 4 — — $109,765.96 $221,586.53 $221,586.53 2025-06-27
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 7 4 — — $169,428.24 $434,530.53 $215,568.37 2025-06-27
1611 APR_DRG Implantable Heart Assist Systems 4 4 — — $105,524.17 $213,023.55 $213,023.55 2025-06-27
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 4 4 — — $104,959.59 $211,883.83 $211,883.83 2025-06-27
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 4 — — $104,771.13 $211,503.39 $211,503.39 2025-06-27
64 APR_DRG Pancreas Transplant 4 4 — — $103,649.83 $209,239.80 $209,239.80 2025-06-27
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 4 4 — — $101,863.44 $205,633.58 $205,633.58 2025-06-27
8514 APR_DRG Gender Related Procedures 4 4 — — $100,501.08 $202,883.35 $202,883.35 2025-06-27
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 4 4 — — $99,693.08 $201,252.23 $201,252.23 2025-06-27
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 4 4 — — $99,002.08 $199,857.30 $199,857.30 2025-06-27
22 APR_DRG Heart And/or Lung Transplant 4 4 — — $97,231.39 $196,282.78 $196,282.78 2025-06-27
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 7 4 — — $153,064.49 $392,562.62 $194,748.31 2025-06-27
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 4 4 — — $96,071.62 $193,941.52 $193,941.52 2025-06-27
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 4 4 — — $93,588.73 $188,929.27 $188,929.27 2025-06-27
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 4 4 — — $93,338.24 $188,423.61 $188,423.61 2025-06-27
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $90,070.92 $181,827.80 $181,827.80 2025-06-27
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 4 4 — — $89,903.67 $181,490.16 $181,490.16 2025-06-27
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 4 4 — — $89,730.92 $181,141.43 $181,141.43 2025-06-27
21 APR_DRG Heart And/or Lung Transplant 4 4 — — $89,418.40 $180,510.54 $180,510.54 2025-06-27
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 4 4 — — $85,449.08 $172,497.61 $172,497.61 2025-06-27
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $83,366.66 $168,293.79 $168,293.79 2025-06-27
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 4 4 — — $81,220.64 $163,961.58 $163,961.58 2025-06-27
84 APR_DRG Autologous Bone Marrow Transplant 4 4 — — $80,301.92 $162,106.95 $162,106.95 2025-06-27
73 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $79,182.98 $159,848.11 $159,848.11 2025-06-27
4404 APR_DRG Kidney Transplant 4 4 — — $75,902.30 $153,225.35 $153,225.35 2025-06-27
8634 APR_DRG Neonatal Aftercare 4 4 — — $75,015.78 $151,435.72 $151,435.72 2025-06-27
63 APR_DRG Pancreas Transplant 4 4 — — $73,634.57 $148,647.44 $148,647.44 2025-06-27
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 4 4 — — $73,344.03 $148,060.94 $148,060.94 2025-06-27
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 4 4 — — $73,000.89 $147,368.23 $147,368.23 2025-06-27
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 2 — — $97,106.96 $191,877.90 $144,492.43 2025-06-27
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 4 — — $69,473.66 $140,247.73 $140,247.73 2025-06-27
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 4 4 — — $68,116.00 $137,507.01 $137,507.01 2025-06-27
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 4 4 — — $67,655.86 $136,578.11 $136,578.11 2025-06-27
13 APR_DRG Liver Transplant And/or Intestinal Transplant 4 4 — — $67,403.01 $136,067.69 $136,067.69 2025-06-27
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $66,668.83 $134,585.58 $134,585.58 2025-06-27
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 4 — — $65,962.12 $133,158.94 $133,158.94 2025-06-27
1784 APR_DRG External Heart Assist Systems 4 4 — — $64,835.33 $130,884.25 $130,884.25 2025-06-27
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 4 4 — — $64,664.15 $130,538.69 $130,538.69 2025-06-27
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 4 4 — — $64,474.91 $130,156.67 $130,156.67 2025-06-27
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $64,337.49 $129,879.27 $129,879.27 2025-06-27
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 4 4 — — $63,749.36 $128,691.99 $128,691.99 2025-06-27
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 7 4 — — $100,916.46 $258,819.21 $128,398.89 2025-06-27
72 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $63,495.73 $128,179.98 $128,179.98 2025-06-27
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 4 4 — — $63,184.00 $127,550.68 $127,550.68 2025-06-27
850 MS_DRG Acute Leukemia With Other Procedures 2 2 — — $85,394.31 $168,734.37 $127,064.34 2025-06-27
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $62,350.87 $125,868.84 $125,868.84 2025-06-27
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 4 4 — — $61,864.03 $124,886.04 $124,886.04 2025-06-27
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 4 4 — — $61,797.29 $124,751.31 $124,751.31 2025-06-27
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 4 4 — — $61,744.68 $124,645.10 $124,645.10 2025-06-27
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 4 4 — — $61,174.60 $123,494.28 $123,494.28 2025-06-27
71 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $60,321.06 $121,771.22 $121,771.22 2025-06-27
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 4 4 — — $59,911.17 $120,943.77 $120,943.77 2025-06-27
14 MS_DRG Allogeneic Bone Marrow Transplant 7 4 — — $93,573.06 $239,985.67 $119,055.66 2025-06-27
62 APR_DRG Pancreas Transplant 4 4 — — $58,958.69 $119,020.99 $119,020.99 2025-06-27
7 MS_DRG Lung Transplant 7 4 — — $93,337.37 $239,381.21 $118,755.79 2025-06-27
C9081 HCPCS Idecabtagene Car Pos T 4 4 — — $16,507.81 $118,330.95 $118,330.95 2025-06-27
C9098 HCPCS Ciltacabtagene Car Pos T 4 4 — — $16,507.81 $118,330.95 $118,330.95 2025-06-27
Q2040 HCPCS Tisagenlecleucel Car-pos T 4 4 — — $16,507.81 $118,330.95 $118,330.95 2025-06-27
C9076 HCPCS Lisocabtagene Car Pos T 4 4 — — $16,507.81 $118,330.95 $118,330.95 2025-06-27
C9073 HCPCS Brexucabtagene Autoleucel Ca 4 4 — — $16,507.81 $118,330.95 $118,330.95 2025-06-27
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 4 4 — — $58,230.79 $117,551.55 $117,551.55 2025-06-27
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 4 4 — — $57,751.02 $116,583.03 $116,583.03 2025-06-27
9104 APR_DRG Craniotomy For Multiple Significant Trauma 4 4 — — $57,195.08 $115,460.74 $115,460.74 2025-06-27
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 2 2 — — $77,317.36 $152,774.77 $115,046.07 2025-06-27
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 4 4 — — $56,907.68 $114,880.58 $114,880.58 2025-06-27
1834 APR_DRG Percutaneous Structural Cardiac Procedures 4 4 — — $56,502.51 $114,062.64 $114,062.64 2025-06-27
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 4 4 — — $56,261.44 $113,576.00 $113,576.00 2025-06-27
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 4 4 — — $56,105.97 $113,262.14 $113,262.14 2025-06-27
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 4 4 — — $56,031.37 $113,111.55 $113,111.55 2025-06-27
6904 APR_DRG Acute Leukemia 4 4 — — $55,732.99 $112,509.19 $112,509.19 2025-06-27
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 4 4 — — $55,370.21 $111,776.85 $111,776.85 2025-06-27
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 4 4 — — $55,330.95 $111,697.59 $111,697.59 2025-06-27
C9031 HCPCS Lutetium Lu 177 Dotatate, Tx 4 4 — — $15,552.92 $111,486.12 $111,486.12 2025-06-27
A9607 HCPCS Lutetium Lu 177 Vipivotide 4 4 — — $15,552.92 $111,486.12 $111,486.12 2025-06-27
A9543 HCPCS Y90 Ibritumomab, Rx 4 4 — — $15,552.92 $111,486.12 $111,486.12 2025-06-27
A9513 HCPCS Lutetium Lu 177 Dotatat Ther 4 4 — — $15,552.92 $111,486.12 $111,486.12 2025-06-27
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 4 4 — — $54,360.41 $109,738.35 $109,738.35 2025-06-27
914 APR_DRG Other Major Head And Neck Procedures 4 4 — — $54,197.87 $109,410.22 $109,410.22 2025-06-27
12 APR_DRG Liver Transplant And/or Intestinal Transplant 4 4 — — $54,146.83 $109,307.19 $109,307.19 2025-06-27
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 4 4 — — $53,639.57 $108,283.18 $108,283.18 2025-06-27
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 4 4 — — $53,556.34 $108,115.16 $108,115.16 2025-06-27
81416 HCPCS Exome Sequence Analysis 9 5 — — $833.23 $192,000.00 $108,000.00 2025-06-27
214 APR_DRG Open Craniotomy Except Trauma 4 4 — — $53,312.92 $107,623.76 $107,623.76 2025-06-27
7594 APR_DRG Eating Disorders 4 4 — — $52,614.85 $106,214.56 $106,214.56 2025-06-27
1794 APR_DRG Defibrillator Implants 4 4 — — $52,544.18 $106,071.90 $106,071.90 2025-06-27
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 4 4 — — $52,526.91 $106,037.02 $106,037.02 2025-06-27
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 4 4 — — $52,079.33 $105,133.49 $105,133.49 2025-06-27
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 4 4 — — $51,886.95 $104,745.13 $104,745.13 2025-06-27
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 4 4 — — $51,388.33 $103,738.56 $103,738.56 2025-06-27
1204 APR_DRG Major Respiratory And Chest Procedures 4 4 — — $51,144.13 $103,245.57 $103,245.57 2025-06-27
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 4 4 — — $50,733.45 $102,416.54 $102,416.54 2025-06-27
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 4 4 — — $50,161.81 $101,262.55 $101,262.55 2025-06-27
274 APR_DRG Other Open Craniotomy 4 4 — — $49,973.35 $100,882.12 $100,882.12 2025-06-27
2324 APR_DRG Gastric Fundoplication 4 4 — — $49,634.14 $100,197.33 $100,197.33 2025-06-27
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 7 4 — — $78,702.70 $201,847.84 $100,135.68 2025-06-27
Q0480 HCPCS Driver Pneumatic Vad, Rep 3 1 — — $99,999.95 $99,999.95 $99,999.95 2025-06-27
6954 APR_DRG Chemotherapy For Acute Leukemia 4 4 — — $49,389.93 $99,704.35 $99,704.35 2025-06-27
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 4 4 — — $49,136.30 $99,192.35 $99,192.35 2025-06-27
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 4 4 — — $49,082.12 $99,082.97 $99,082.97 2025-06-27
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 7 4 — — $77,804.23 $199,543.57 $98,992.54 2025-06-27
234 APR_DRG Spinal Procedures 4 4 — — $48,947.06 $98,810.33 $98,810.33 2025-06-27
1694 APR_DRG Major Abdominal Vascular Procedures 4 4 — — $48,761.75 $98,436.23 $98,436.23 2025-06-27
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 2 — — $65,842.03 $130,100.16 $97,971.10 2025-06-27
33991 HCPCS Insj Perq Vad L Hrt Artl&ven 4 4 — — $13,580.40 $97,346.79 $97,346.79 2025-06-27
33983 HCPCS Replace Vad Intra W/bp 4 4 — — $13,580.40 $97,346.79 $97,346.79 2025-06-27
33975 HCPCS Implant Ventricular Device 4 4 — — $13,580.40 $97,346.79 $97,346.79 2025-06-27
0454T OTHER Insj/rplcmt Subq Electrode 4 4 — — $13,580.40 $97,346.79 $97,346.79 2025-06-27
0453T OTHER Insj/rplcmt Mech-elec Ntrfce 4 4 — — $13,580.40 $97,346.79 $97,346.79 2025-06-27
0459T OTHER Relocaj Rplcmt Aortic Ventr 4 4 — — $13,580.40 $97,346.79 $97,346.79 2025-06-27
33976 HCPCS Implant Ventricular Device 4 4 — — $13,580.40 $97,346.79 $97,346.79 2025-06-27
0451T OTHER Insj/rplcmt Aortic Ventr Sys 4 4 — — $13,580.40 $97,346.79 $97,346.79 2025-06-27
33990 HCPCS Insj Perq Vad L Hrt Arterial 4 4 — — $13,580.40 $97,346.79 $97,346.79 2025-06-27
33995 HCPCS Insj Perq Vad R Hrt Venous 4 4 — — $13,580.40 $97,346.79 $97,346.79 2025-06-27
0452T OTHER Insj/rplcmt Dev Vasc Seal 4 4 — — $13,580.40 $97,346.79 $97,346.79 2025-06-27
33982 HCPCS Replace Vad Intra Without Bp 4 4 — — $13,580.40 $97,346.79 $97,346.79 2025-06-27
33981 HCPCS Replace Vad Pump Ext 4 4 — — $13,580.40 $97,346.79 $97,346.79 2025-06-27
33979 HCPCS Insert Intracorporeal Device 4 4 — — $13,580.40 $97,346.79 $97,346.79 2025-06-27
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 4 4 — — $48,185.39 $97,272.73 $97,272.73 2025-06-27
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 7 4 — — $76,058.01 $195,065.06 $96,770.78 2025-06-27
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 4 — — $47,775.51 $96,445.28 $96,445.28 2025-06-27
204 APR_DRG Open Craniotomy For Trauma 4 4 — — $47,763.73 $96,421.50 $96,421.50 2025-06-27
1783 APR_DRG External Heart Assist Systems 4 4 — — $47,757.45 $96,408.82 $96,408.82 2025-06-27
215 MS_DRG Other Heart Assist System Implant 7 4 — — $75,668.06 $194,064.95 $96,274.63 2025-06-27
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 4 4 — — $47,144.18 $95,170.82 $95,170.82 2025-06-27
11 APR_DRG Liver Transplant And/or Intestinal Transplant 4 4 — — $47,079.80 $95,040.84 $95,040.84 2025-06-27
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 2 1 — — $93,216.70 $93,216.70 $93,216.70 2025-06-27
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $46,050.36 $92,962.71 $92,962.71 2025-06-27
4403 APR_DRG Kidney Transplant 4 4 — — $45,999.32 $92,859.67 $92,859.67 2025-06-27
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 4 4 — — $45,971.06 $92,802.61 $92,802.61 2025-06-27
1782 APR_DRG External Heart Assist Systems 4 4 — — $45,909.02 $92,677.38 $92,677.38 2025-06-27
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 2 2 — — $62,152.57 $122,809.99 $92,481.28 2025-06-27
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 4 4 — — $45,312.25 $91,472.67 $91,472.67 2025-06-27
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 4 4 — — $45,101.03 $91,046.26 $91,046.26 2025-06-27
4414 APR_DRG Major Bladder Procedures 4 4 — — $44,823.06 $90,485.12 $90,485.12 2025-06-27
6133 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 4 4 — — $44,513.68 $89,860.57 $89,860.57 2025-06-27
894 APR_DRG Major Cranial Or Facial Bone Procedures 4 4 — — $44,391.18 $89,613.28 $89,613.28 2025-06-27
61 APR_DRG Pancreas Transplant 4 4 — — $44,092.80 $89,010.93 $89,010.93 2025-06-27
2614 APR_DRG Major Biliary Tract Procedures 4 4 — — $43,975.80 $88,774.74 $88,774.74 2025-06-27
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 4 4 — — $43,650.71 $88,118.49 $88,118.49 2025-06-27
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 7 4 — — $68,928.16 $176,779.20 $87,699.26 2025-06-27
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 4 4 — — $43,296.58 $87,403.59 $87,403.59 2025-06-27
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 4 4 — — $43,175.65 $87,159.47 $87,159.47 2025-06-27
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 4 4 — — $43,090.06 $86,986.69 $86,986.69 2025-06-27
5144 APR_DRG Female Reproductive System Reconstructive Procedures 4 4 — — $42,768.90 $86,338.37 $86,338.37 2025-06-27
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 4 4 — — $42,680.17 $86,159.24 $86,159.24 2025-06-27
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 4 4 — — $42,598.51 $85,994.39 $85,994.39 2025-06-27
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 4 4 — — $42,571.81 $85,940.49 $85,940.49 2025-06-27
1814 APR_DRG Lower Extremity Arterial Procedures 4 4 — — $42,447.75 $85,690.04 $85,690.04 2025-06-27
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 4 4 — — $42,285.21 $85,361.91 $85,361.91 2025-06-27
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 2 2 — — $57,347.93 $113,316.29 $85,332.11 2025-06-27
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 4 4 — — $42,239.66 $85,269.97 $85,269.97 2025-06-27
8412 APR_DRG Extensive Third Degree Burns With Skin Graft 4 4 — — $41,974.26 $84,734.19 $84,734.19 2025-06-27
8411 APR_DRG Extensive Third Degree Burns With Skin Graft 4 4 — — $41,974.26 $84,734.19 $84,734.19 2025-06-27
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 4 — — $41,913.01 $84,610.55 $84,610.55 2025-06-27
224 APR_DRG Ventricular Shunt Procedures 4 4 — — $41,313.10 $83,399.50 $83,399.50 2025-06-27
7584 APR_DRG Behavioral Disorders 4 4 — — $40,980.94 $82,728.98 $82,728.98 2025-06-27
83 APR_DRG Autologous Bone Marrow Transplant 4 4 — — $40,972.31 $82,711.54 $82,711.54 2025-06-27
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 4 4 — — $40,860.81 $82,486.45 $82,486.45 2025-06-27
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures 4 4 — — $40,819.19 $82,402.44 $82,402.44 2025-06-27
3634 APR_DRG Breast Procedures Except Mastectomy 4 4 — — $40,666.07 $82,093.33 $82,093.33 2025-06-27
5114 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 4 4 — — $40,589.90 $81,939.57 $81,939.57 2025-06-27
264 APR_DRG Other Nervous System And Related Procedures 4 4 — — $40,553.00 $81,865.07 $81,865.07 2025-06-27
1214 APR_DRG Other Respiratory And Chest Procedures 4 4 — — $40,536.51 $81,831.78 $81,831.78 2025-06-27
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 4 4 — — $40,504.31 $81,766.79 $81,766.79 2025-06-27
3214 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 4 4 — — $40,472.12 $81,701.80 $81,701.80 2025-06-27
2304 APR_DRG Major Small Bowel Procedures 4 4 — — $40,463.48 $81,684.36 $81,684.36 2025-06-27
4402 APR_DRG Kidney Transplant 4 4 — — $40,205.93 $81,164.44 $81,164.44 2025-06-27
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $40,081.86 $80,913.98 $80,913.98 2025-06-27
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 4 — — $39,818.03 $80,381.37 $80,381.37 2025-06-27
5184 APR_DRG Other Female Reproductive System And Related Procedures 4 4 — — $39,684.54 $80,111.90 $80,111.90 2025-06-27
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 4 4 — — $39,313.91 $79,363.71 $79,363.71 2025-06-27
1673 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 4 4 — — $39,141.16 $79,014.97 $79,014.97 2025-06-27
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 4 4 — — $38,950.35 $78,629.78 $78,629.78 2025-06-27
1781 APR_DRG External Heart Assist Systems 4 4 — — $38,947.99 $78,625.03 $78,625.03 2025-06-27
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 4 3 — — $42,457.76 $108,890.90 $78,501.08 2025-06-27
8633 APR_DRG Neonatal Aftercare 4 4 — — $38,858.48 $78,444.32 $78,444.32 2025-06-27
1824 APR_DRG Other Peripheral Vascular And Related Procedures 4 4 — — $38,750.12 $78,225.57 $78,225.57 2025-06-27
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 4 4 — — $38,593.86 $77,910.12 $77,910.12 2025-06-27
3043 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 4 4 — — $38,534.18 $77,789.65 $77,789.65 2025-06-27
6224 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $38,443.09 $77,605.77 $77,605.77 2025-06-27
4014 APR_DRG Adrenal Procedures 4 4 — — $38,401.48 $77,521.76 $77,521.76 2025-06-27
9103 APR_DRG Craniotomy For Multiple Significant Trauma 4 4 — — $38,354.36 $77,426.65 $77,426.65 2025-06-27
4034 APR_DRG Procedures For Obesity 4 4 — — $38,315.89 $77,348.98 $77,348.98 2025-06-27
231 MS_DRG Coronary Bypass With Ptca With Mcc 7 4 — — $60,520.59 $155,216.43 $77,002.08 2025-06-27
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 7 4 — — $60,487.03 $155,130.34 $76,959.37 2025-06-27
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 4 4 — — $38,034.78 $76,781.50 $76,781.50 2025-06-27
1793 APR_DRG Defibrillator Implants 4 4 — — $38,029.28 $76,770.40 $76,770.40 2025-06-27
0315U OTHER Onc Cutan Sq Cll Ca Mrna 40 9 5 — — $833.23 $136,000.00 $76,500.00 2025-06-27
1833 APR_DRG Percutaneous Structural Cardiac Procedures 4 4 — — $37,840.83 $76,389.96 $76,389.96 2025-06-27
0211U OTHER Onc Pan-tum Dna&rna Gnrj Seq 9 5 — — $833.23 $135,280.00 $76,095.00 2025-06-27
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 2 — — $51,023.01 $100,818.60 $75,920.81 2025-06-27
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 2 2 — — $50,711.54 $100,203.15 $75,457.35 2025-06-27
69930 HCPCS Implant Cochlear Device 4 4 — — $10,478.87 $75,114.42 $75,114.42 2025-06-27
S2235 HCPCS Implant Auditory Brain Imp 4 4 — — $10,478.87 $75,114.42 $75,114.42 2025-06-27
4401 APR_DRG Kidney Transplant 4 4 — — $37,090.94 $74,876.15 $74,876.15 2025-06-27
6504 APR_DRG Splenic Procedures 4 4 — — $36,796.48 $74,281.71 $74,281.71 2025-06-27
J2326 HCPCS Inj, Nusinersen, 0.1mg 4 4 — — $10,330.37 $74,049.96 $74,049.96 2025-06-27
C9085 HCPCS Inj Avalglucosid Alfa-ngpt 4 4 — — $10,330.37 $74,049.96 $74,049.96 2025-06-27
C9052 HCPCS Injection, Ravulizumab-cwv 4 4 — — $10,330.37 $74,049.96 $74,049.96 2025-06-27
J2840 HCPCS Inj Sebelipase Alfa 1 Mg 4 4 — — $10,330.37 $74,049.96 $74,049.96 2025-06-27
Q9995 HCPCS Inj. Emicizumab-kxwh, 0.5 Mg 4 4 — — $10,330.37 $74,049.96 $74,049.96 2025-06-27
J9600 HCPCS Porfimer Sodium Injection 4 4 — — $10,330.37 $74,049.96 $74,049.96 2025-06-27
3254 APR_DRG Non-elective Or Complex Knee Joint Replacement 4 4 — — $36,613.52 $73,912.37 $73,912.37 2025-06-27
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 4 4 — — $36,561.69 $73,807.75 $73,807.75 2025-06-27
8423 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 4 4 — — $36,556.20 $73,796.66 $73,796.66 2025-06-27
6092 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 4 — — $36,392.87 $73,466.95 $73,466.95 2025-06-27
6344 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 4 4 — — $36,379.52 $73,440.00 $73,440.00 2025-06-27
4474 APR_DRG Other Kidney, Urinary Tract And Related Procedures 4 4 — — $36,293.15 $73,265.63 $73,265.63 2025-06-27
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 7 4 — — $57,572.38 $147,655.17 $73,250.97 2025-06-27
6143 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 4 4 — — $36,059.15 $72,793.26 $72,793.26 2025-06-27
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 4 4 — — $36,055.22 $72,785.33 $72,785.33 2025-06-27
5124 APR_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy 4 4 — — $35,904.46 $72,480.98 $72,480.98 2025-06-27
10 MS_DRG Pancreas Transplant 7 4 — — $56,943.17 $146,041.44 $72,450.41 2025-06-27
4424 APR_DRG Kidney And Urinary Tract Procedures For Malignancy 4 4 — — $35,879.33 $72,430.26 $72,430.26 2025-06-27
1704 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 4 4 — — $35,763.12 $72,195.66 $72,195.66 2025-06-27
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 7 4 — — $56,616.78 $145,204.35 $72,035.14 2025-06-27
1663 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 4 4 — — $35,544.04 $71,753.40 $71,753.40 2025-06-27
9514 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 4 4 — — $35,383.07 $71,428.44 $71,428.44 2025-06-27
7934 APR_DRG Moderately Extensive O.r. Procedures For Other Complications Of Treatment 4 4 — — $35,253.51 $71,166.89 $71,166.89 2025-06-27
1754 APR_DRG Percutaneous Cardiac Intervention Without Ami 4 4 — — $35,251.94 $71,163.72 $71,163.72 2025-06-27
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 2 2 — — $47,741.43 $94,334.38 $71,037.90 2025-06-27
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 7 4 — — $55,824.73 $143,173.00 $71,027.39 2025-06-27
3154 APR_DRG Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement 4 4 — — $35,094.11 $70,845.11 $70,845.11 2025-06-27
294 APR_DRG Other Percutaneous Intracranial Procedures 4 4 — — $35,072.90 $70,802.31 $70,802.31 2025-06-27
504 APR_DRG Non-bacterial Infections Of Nervous System Except Viral Meningitis 4 4 — — $35,058.77 $70,773.78 $70,773.78 2025-06-27
2314 APR_DRG Major Large Bowel Procedures 4 4 — — $34,899.37 $70,451.99 $70,451.99 2025-06-27
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 7 4 — — $55,261.23 $141,727.79 $70,310.43 2025-06-27
244 APR_DRG Open Extracranial Vascular Procedures 4 4 — — $34,759.60 $70,169.84 $70,169.84 2025-06-27
4804 APR_DRG Major Male Pelvic Procedures 4 4 — — $34,757.24 $70,165.08 $70,165.08 2025-06-27
3104 APR_DRG Vertebral And Intervertebral Spinal Procedures Including Disc Procedures 4 4 — — $34,699.92 $70,049.36 $70,049.36 2025-06-27
81552 HCPCS Onc Uveal Mlnma Mrna 15 Gene 9 5 — — $833.23 $124,416.00 $69,984.00 2025-06-27
6233 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 4 4 — — $34,604.91 $69,857.56 $69,857.56 2025-06-27
6091 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 4 — — $34,573.50 $69,794.15 $69,794.15 2025-06-27
82 APR_DRG Autologous Bone Marrow Transplant 4 4 — — $34,517.75 $69,681.61 $69,681.61 2025-06-27
G0448 HCPCS Place Perm Pacing Cardiovert 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
33270 HCPCS Ins/rep Subq Defibrillator 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
0571T OTHER Insj/rplcmt Icds Ss Eltrd 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
33249 HCPCS Insj/rplcmt Defib W/lead(s) 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
33240 HCPCS Insrt Pulse Gen W/singl Lead 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
33230 HCPCS Insrt Pulse Gen W/dual Leads 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
33231 HCPCS Insrt Pulse Gen W/mult Leads 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
C9741 HCPCS Impl Pressure Sensor W/angio 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
0294T OTHER Ins Lt Atrl Mont Pres Lead 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
0409T OTHER Insj/rplc Car Modulj Pls Gn 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
0520T OTHER Rmvl&rplcmt Pg Wcs New Eltrd 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
3204 APR_DRG Other Musculoskeletal System And Connective Tissue Procedures 4 4 — — $34,249.99 $69,141.07 $69,141.07 2025-06-27
2294 APR_DRG Other Digestive System And Abdominal Procedures 4 4 — — $34,213.08 $69,066.57 $69,066.57 2025-06-27
3134 APR_DRG Knee And Lower Leg Procedures Except Foot 4 4 — — $34,062.32 $68,762.22 $68,762.22 2025-06-27
3094 APR_DRG Other Significant Hip And Femur Surgery 4 4 — — $33,986.15 $68,608.46 $68,608.46 2025-06-27
6082 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 4 4 — — $33,935.90 $68,507.01 $68,507.01 2025-06-27
913 APR_DRG Other Major Head And Neck Procedures 4 4 — — $33,897.42 $68,429.34 $68,429.34 2025-06-27
6312 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 4 4 — — $33,821.25 $68,275.58 $68,275.58 2025-06-27
2224 APR_DRG Other Stomach, Esophageal And Duodenal Procedures 4 4 — — $33,674.42 $67,979.16 $67,979.16 2025-06-27
5194 APR_DRG Uterine And Adnexa Procedures For Leiomyoma 4 4 — — $33,610.81 $67,850.76 $67,850.76 2025-06-27
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 7 4 — — $53,309.32 $136,721.75 $67,826.96 2025-06-27
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 2 1 — — $67,452.66 $67,452.66 $67,452.66 2025-06-27
2234 APR_DRG Other Small And Large Bowel Procedures 4 4 — — $33,399.59 $67,424.36 $67,424.36 2025-06-27
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