Price Transparency 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

GUNDERSEN MOUNDVIEW HOSPITAL AND CLINICS

Friendship, WI · CCN 521309 · Rates published

20,408 distinct procedures filed
17 distinct payers
171,649 rate rows
2025-06-27 last MRF observed · ⚠ 12 mo old
Data quality

143,650 of 171,649 rate rows are consumer-grade (83.7%)

27,999 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 24,884
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
per-diem day rate — not a per-procedure price 2

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 12 months old.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 · 2026-05-17
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 		4 $411,851.82 $831,412.76 $831,412.76 nat. median
$309,665
outlier · 2.7×
5884
APR_DRG 		4 $268,686.28 $542,401.87 $542,401.87 nat. median
$246,434
outlier · 2.2×
5833
APR_DRG 		4 $266,810.37 $538,614.95 $538,614.95 nat. median
$244,017
outlier · 2.2×
0024
APR_DRG 		4 $237,946.25 $480,346.42 $480,346.42 nat. median
$372,987
1.3× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 6 $16,507.81 $4,747,210.00 $449,440.00 nat. median
$620,080
0.7× median
0114
APR_DRG 		4 $209,226.61 $422,369.56 $422,369.56 nat. median
$197,700
outlier · 2.1×
5832
APR_DRG 		4 $204,861.54 $413,557.71 $413,557.71 nat. median
$156,126
outlier · 2.6×
1614
APR_DRG 		4 $203,918.48 $411,653.94 $411,653.94 nat. median
$207,730
2.0× median
6304
APR_DRG 		4 $195,997.12 $395,662.95 $395,662.95 nat. median
$150,721
outlier · 2.6×
8414
APR_DRG 		4 $193,312.43 $390,243.32 $390,243.32 nat. median
$160,267
outlier · 2.4×
6094
APR_DRG 		4 $176,662.50 $356,631.80 $356,631.80 nat. median
$162,982
outlier · 2.2×
5883
APR_DRG 		4 $174,746.55 $352,764.04 $352,764.04 nat. median
$182,736
1.9× median
6314
APR_DRG 		4 $173,438.36 $350,123.18 $350,123.18 nat. median
$122,924
outlier · 2.8×
5914
APR_DRG 		4 $170,686.93 $344,568.81 $344,568.81 nat. median
$164,279
outlier · 2.1×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 4 $269,344.82 $690,785.36 $342,695.08 nat. median
$370,174
0.9× median
0074
APR_DRG 		4 $162,015.68 $327,064.00 $327,064.00 nat. median
$178,275
1.8× median
0094
APR_DRG 		4 $161,203.76 $325,424.95 $325,424.95 nat. median
$166,008
2.0× median
5934
APR_DRG 		4 $158,270.15 $319,502.83 $319,502.83 nat. median
$151,838
outlier · 2.1×
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 5 $16,507.81 $578,771.12 $314,701.72 nat. median
$754,974
outlier · 0.4×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 5 $16,507.81 $553,169.30 $312,763.43 nat. median
$675,122
outlier · 0.5×
5882
APR_DRG 		4 $153,336.58 $309,543.34 $309,543.34 nat. median
$145,336
outlier · 2.1×
Q2055
HCPCS 		Idecabtagene Vicleucel Car 5 $16,507.81 $527,622.46 $301,510.62 nat. median
$625,184
outlier · 0.5×
5831
APR_DRG 		4 $148,907.12 $300,601.51 $300,601.51 nat. median
$145,122
outlier · 2.1×
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 5 $16,507.81 $516,442.29 $296,092.23 nat. median
$674,188
outlier · 0.4×
6034
APR_DRG 		4 $146,394.39 $295,529.03 $295,529.03 nat. median
$109,499
outlier · 2.7×
0014
APR_DRG 		4 $144,084.26 $290,865.51 $290,865.51 nat. median
$190,591
1.5× median
0044
APR_DRG 		4 $143,096.45 $288,871.40 $288,871.40 nat. median
$195,681
1.5× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 5 $16,507.81 $502,840.73 $283,885.47 nat. median
$634,511
outlier · 0.4×
1613
APR_DRG 		4 $137,976.77 $278,536.22 $278,536.22 nat. median
$119,796
outlier · 2.3×
0023
APR_DRG 		4 $133,605.42 $269,711.69 $269,711.69 nat. median
$167,082
1.6× median
5881
APR_DRG 		4 $131,431.13 $265,322.41 $265,322.41 nat. median
$124,573
outlier · 2.1×
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
$265,286
1.0× median
5913
APR_DRG 		4 $126,689.93 $255,751.27 $255,751.27 nat. median
$102,636
outlier · 2.5×
0113
APR_DRG 		4 $122,020.98 $246,325.97 $246,325.97 nat. median
$128,705
1.9× median
1604
APR_DRG 		4 $118,972.73 $240,172.42 $240,172.42 nat. median
$97,957
outlier · 2.5×
6024
APR_DRG 		4 $117,527.92 $237,255.74 $237,255.74 nat. median
$118,620
outlier · 2.0×
1612
APR_DRG 		4 $110,756.13 $223,585.41 $223,585.41 nat. median
$85,406
outlier · 2.6×
5933
APR_DRG 		4 $109,765.96 $221,586.53 $221,586.53 nat. median
$108,996
outlier · 2.0×
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
$206,368
1.0× median
1611
APR_DRG 		4 $105,524.17 $213,023.55 $213,023.55 nat. median
$76,806
outlier · 2.8×
5891
APR_DRG 		4 $104,959.59 $211,883.83 $211,883.83 nat. median
$93,260
outlier · 2.3×
0112
APR_DRG 		4 $104,771.13 $211,503.39 $211,503.39 nat. median
$93,442
outlier · 2.3×
0064
APR_DRG 		4 $103,649.83 $209,239.80 $209,239.80 nat. median
$98,565
outlier · 2.1×
5892
APR_DRG 		4 $101,863.44 $205,633.58 $205,633.58 nat. median
$89,790
outlier · 2.3×
8514
APR_DRG 		4 $100,501.08 $202,883.35 $202,883.35 nat. median
$70,353
outlier · 2.9×
5893
APR_DRG 		4 $99,693.08 $201,252.23 $201,252.23 nat. median
$69,788
outlier · 2.9×
8424
APR_DRG 		4 $99,002.08 $199,857.30 $199,857.30 nat. median
$80,494
outlier · 2.5×
0022
APR_DRG 		4 $97,231.39 $196,282.78 $196,282.78 nat. median
$140,623
1.4× median
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
$202,986
1.0× median
5912
APR_DRG 		4 $96,071.62 $193,941.52 $193,941.52 nat. median
$81,294
outlier · 2.4×

Other procedures at this hospital

Browse this hospital's 20,408 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
             
81416 HCPCS Exome Sequence Analysis 9 5 — — $833.23 $192,000.00 $108,000.00 2025-06-27
0315U HCPCS Onc Cutan Sq Cll Ca Mrna 40 9 5 — — $833.23 $136,000.00 $76,500.00 2025-06-27
0211U HCPCS Onc Pan-tum Dna&rna Gnrj Seq 9 5 — — $833.23 $135,280.00 $76,095.00 2025-06-27
81552 HCPCS Onc Uveal Mlnma Mrna 15 Gene 9 5 — — $833.23 $124,416.00 $69,984.00 2025-06-27
33270 HCPCS Ins/rep Subq Defibrillator 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
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
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
0409T HCPCS Insj/rplc Car Modulj Pls Gn 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
C9741 HCPCS Impl Pressure Sensor W/angio 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
0294T HCPCS Ins Lt Atrl Mont Pres Lead 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
G0448 HCPCS Place Perm Pacing Cardiovert 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
0520T HCPCS Rmvl&rplcmt Pg Wcs New Eltrd 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
33240 HCPCS Insrt Pulse Gen W/singl Lead 4 4 — — $9,645.65 $69,141.79 $69,141.79 2025-06-27
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 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
C9085 HCPCS Inj Avalglucosid Alfa-ngpt 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
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
J9600 HCPCS Porfimer Sodium Injection 4 4 — — $10,330.37 $74,049.96 $74,049.96 2025-06-27
J2326 HCPCS Inj, Nusinersen, 0.1mg 4 4 — — $10,330.37 $74,049.96 $74,049.96 2025-06-27
S2235 HCPCS Implant Auditory Brain Imp 4 4 — — $10,478.87 $75,114.42 $75,114.42 2025-06-27
69930 HCPCS Implant Cochlear Device 4 4 — — $10,478.87 $75,114.42 $75,114.42 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
33983 HCPCS Replace Vad Intra W/bp 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
33981 HCPCS Replace Vad Pump Ext 4 4 — — $13,580.40 $97,346.79 $97,346.79 2025-06-27
0453T HCPCS Insj/rplcmt Mech-elec Ntrfce 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
0452T HCPCS Insj/rplcmt Dev Vasc Seal 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
33976 HCPCS Implant Ventricular Device 4 4 — — $13,580.40 $97,346.79 $97,346.79 2025-06-27
0454T HCPCS Insj/rplcmt Subq Electrode 4 4 — — $13,580.40 $97,346.79 $97,346.79 2025-06-27
0459T HCPCS Relocaj Rplcmt Aortic Ventr 4 4 — — $13,580.40 $97,346.79 $97,346.79 2025-06-27
0451T HCPCS Insj/rplcmt Aortic Ventr Sys 4 4 — — $13,580.40 $97,346.79 $97,346.79 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
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
A9607 HCPCS Lutetium Lu 177 Vipivotide 4 4 — — $15,552.92 $111,486.12 $111,486.12 2025-06-27
C9031 HCPCS Lutetium Lu 177 Dotatate, Tx 4 4 — — $15,552.92 $111,486.12 $111,486.12 2025-06-27
Q2053 HCPCS Brexucabtagene Car Pos T 9 6 — — $16,507.81 $4,747,210.00 $449,440.00 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
Q2055 HCPCS Idecabtagene Vicleucel Car 8 5 — — $16,507.81 $527,622.46 $301,510.62 2025-06-27
Q2054 HCPCS Lisocabtagene Mara Car Pos T 8 5 — — $16,507.81 $516,442.29 $296,092.23 2025-06-27
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 8 5 — — $16,507.81 $502,840.73 $283,885.47 2025-06-27
C9081 HCPCS Idecabtagene 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
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
2234 APR_DRG — 4 4 — — $33,399.59 $67,424.36 $67,424.36 2025-06-27
5194 APR_DRG — 4 4 — — $33,610.81 $67,850.76 $67,850.76 2025-06-27
2224 APR_DRG — 4 4 — — $33,674.42 $67,979.16 $67,979.16 2025-06-27
6312 APR_DRG — 4 4 — — $33,821.25 $68,275.58 $68,275.58 2025-06-27
0913 APR_DRG — 4 4 — — $33,897.42 $68,429.34 $68,429.34 2025-06-27
6082 APR_DRG — 4 4 — — $33,935.90 $68,507.01 $68,507.01 2025-06-27
3094 APR_DRG — 4 4 — — $33,986.15 $68,608.46 $68,608.46 2025-06-27
3134 APR_DRG — 4 4 — — $34,062.32 $68,762.22 $68,762.22 2025-06-27
2294 APR_DRG — 4 4 — — $34,213.08 $69,066.57 $69,066.57 2025-06-27
3204 APR_DRG — 4 4 — — $34,249.99 $69,141.07 $69,141.07 2025-06-27
0082 APR_DRG — 4 4 — — $34,517.75 $69,681.61 $69,681.61 2025-06-27
6091 APR_DRG — 4 4 — — $34,573.50 $69,794.15 $69,794.15 2025-06-27
6233 APR_DRG — 4 4 — — $34,604.91 $69,857.56 $69,857.56 2025-06-27
3104 APR_DRG — 4 4 — — $34,699.92 $70,049.36 $70,049.36 2025-06-27
4804 APR_DRG — 4 4 — — $34,757.24 $70,165.08 $70,165.08 2025-06-27
0244 APR_DRG — 4 4 — — $34,759.60 $70,169.84 $70,169.84 2025-06-27
2314 APR_DRG — 4 4 — — $34,899.37 $70,451.99 $70,451.99 2025-06-27
0504 APR_DRG — 4 4 — — $35,058.77 $70,773.78 $70,773.78 2025-06-27
0294 APR_DRG — 4 4 — — $35,072.90 $70,802.31 $70,802.31 2025-06-27
3154 APR_DRG — 4 4 — — $35,094.11 $70,845.11 $70,845.11 2025-06-27
1754 APR_DRG — 4 4 — — $35,251.94 $71,163.72 $71,163.72 2025-06-27
7934 APR_DRG — 4 4 — — $35,253.51 $71,166.89 $71,166.89 2025-06-27
9514 APR_DRG — 4 4 — — $35,383.07 $71,428.44 $71,428.44 2025-06-27
1663 APR_DRG — 4 4 — — $35,544.04 $71,753.40 $71,753.40 2025-06-27
1704 APR_DRG — 4 4 — — $35,763.12 $72,195.66 $72,195.66 2025-06-27
4424 APR_DRG — 4 4 — — $35,879.33 $72,430.26 $72,430.26 2025-06-27
5124 APR_DRG — 4 4 — — $35,904.46 $72,480.98 $72,480.98 2025-06-27
6032 APR_DRG — 4 4 — — $36,055.22 $72,785.33 $72,785.33 2025-06-27
6143 APR_DRG — 4 4 — — $36,059.15 $72,793.26 $72,793.26 2025-06-27
4474 APR_DRG — 4 4 — — $36,293.15 $73,265.63 $73,265.63 2025-06-27
6344 APR_DRG — 4 4 — — $36,379.52 $73,440.00 $73,440.00 2025-06-27
6092 APR_DRG — 4 4 — — $36,392.87 $73,466.95 $73,466.95 2025-06-27
8423 APR_DRG — 4 4 — — $36,556.20 $73,796.66 $73,796.66 2025-06-27
7114 APR_DRG — 4 4 — — $36,561.69 $73,807.75 $73,807.75 2025-06-27
3254 APR_DRG — 4 4 — — $36,613.52 $73,912.37 $73,912.37 2025-06-27
6504 APR_DRG — 4 4 — — $36,796.48 $74,281.71 $74,281.71 2025-06-27
4401 APR_DRG — 4 4 — — $37,090.94 $74,876.15 $74,876.15 2025-06-27
1833 APR_DRG — 4 4 — — $37,840.83 $76,389.96 $76,389.96 2025-06-27
1793 APR_DRG — 4 4 — — $38,029.28 $76,770.40 $76,770.40 2025-06-27
7104 APR_DRG — 4 4 — — $38,034.78 $76,781.50 $76,781.50 2025-06-27
4034 APR_DRG — 4 4 — — $38,315.89 $77,348.98 $77,348.98 2025-06-27
9103 APR_DRG — 4 4 — — $38,354.36 $77,426.65 $77,426.65 2025-06-27
4014 APR_DRG — 4 4 — — $38,401.48 $77,521.76 $77,521.76 2025-06-27
6224 APR_DRG — 4 4 — — $38,443.09 $77,605.77 $77,605.77 2025-06-27
3043 APR_DRG — 4 4 — — $38,534.18 $77,789.65 $77,789.65 2025-06-27
1622 APR_DRG — 4 4 — — $38,593.86 $77,910.12 $77,910.12 2025-06-27
1824 APR_DRG — 4 4 — — $38,750.12 $78,225.57 $78,225.57 2025-06-27
8633 APR_DRG — 4 4 — — $38,858.48 $78,444.32 $78,444.32 2025-06-27
1781 APR_DRG — 4 4 — — $38,947.99 $78,625.03 $78,625.03 2025-06-27
4054 APR_DRG — 4 4 — — $38,950.35 $78,629.78 $78,629.78 2025-06-27
1673 APR_DRG — 4 4 — — $39,141.16 $79,014.97 $79,014.97 2025-06-27
0304 APR_DRG — 4 4 — — $39,313.91 $79,363.71 $79,363.71 2025-06-27
5184 APR_DRG — 4 4 — — $39,684.54 $80,111.90 $80,111.90 2025-06-27
0091 APR_DRG — 4 4 — — $39,818.03 $80,381.37 $80,381.37 2025-06-27
6123 APR_DRG — 4 4 — — $40,081.86 $80,913.98 $80,913.98 2025-06-27
4402 APR_DRG — 4 4 — — $40,205.93 $81,164.44 $81,164.44 2025-06-27
2304 APR_DRG — 4 4 — — $40,463.48 $81,684.36 $81,684.36 2025-06-27
3214 APR_DRG — 4 4 — — $40,472.12 $81,701.80 $81,701.80 2025-06-27
4044 APR_DRG — 4 4 — — $40,504.31 $81,766.79 $81,766.79 2025-06-27
1214 APR_DRG — 4 4 — — $40,536.51 $81,831.78 $81,831.78 2025-06-27
0264 APR_DRG — 4 4 — — $40,553.00 $81,865.07 $81,865.07 2025-06-27
5114 APR_DRG — 4 4 — — $40,589.90 $81,939.57 $81,939.57 2025-06-27
3634 APR_DRG — 4 4 — — $40,666.07 $82,093.33 $82,093.33 2025-06-27
2644 APR_DRG — 4 4 — — $40,819.19 $82,402.44 $82,402.44 2025-06-27
3032 APR_DRG — 4 4 — — $40,860.81 $82,486.45 $82,486.45 2025-06-27
0083 APR_DRG — 4 4 — — $40,972.31 $82,711.54 $82,711.54 2025-06-27
7584 APR_DRG — 4 4 — — $40,980.94 $82,728.98 $82,728.98 2025-06-27
0224 APR_DRG — 4 4 — — $41,313.10 $83,399.50 $83,399.50 2025-06-27
0092 APR_DRG — 4 4 — — $41,913.01 $84,610.55 $84,610.55 2025-06-27
8412 APR_DRG — 4 4 — — $41,974.26 $84,734.19 $84,734.19 2025-06-27
8411 APR_DRG — 4 4 — — $41,974.26 $84,734.19 $84,734.19 2025-06-27
6514 APR_DRG — 4 4 — — $42,239.66 $85,269.97 $85,269.97 2025-06-27
1653 APR_DRG — 4 4 — — $42,285.21 $85,361.91 $85,361.91 2025-06-27
1814 APR_DRG — 4 4 — — $42,447.75 $85,690.04 $85,690.04 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
0052 APR_DRG — 4 4 — — $42,571.81 $85,940.49 $85,940.49 2025-06-27
5104 APR_DRG — 4 4 — — $42,598.51 $85,994.39 $85,994.39 2025-06-27
7924 APR_DRG — 4 4 — — $42,680.17 $86,159.24 $86,159.24 2025-06-27
5144 APR_DRG — 4 4 — — $42,768.90 $86,338.37 $86,338.37 2025-06-27
1304 APR_DRG — 4 4 — — $43,090.06 $86,986.69 $86,986.69 2025-06-27
1633 APR_DRG — 4 4 — — $43,175.65 $87,159.47 $87,159.47 2025-06-27
6234 APR_DRG — 4 4 — — $43,296.58 $87,403.59 $87,403.59 2025-06-27
1764 APR_DRG — 4 4 — — $43,650.71 $88,118.49 $88,118.49 2025-06-27
2614 APR_DRG — 4 4 — — $43,975.80 $88,774.74 $88,774.74 2025-06-27
0061 APR_DRG — 4 4 — — $44,092.80 $89,010.93 $89,010.93 2025-06-27
0894 APR_DRG — 4 4 — — $44,391.18 $89,613.28 $89,613.28 2025-06-27
6133 APR_DRG — 4 4 — — $44,513.68 $89,860.57 $89,860.57 2025-06-27
4414 APR_DRG — 4 4 — — $44,823.06 $90,485.12 $90,485.12 2025-06-27
6113 APR_DRG — 4 4 — — $45,101.03 $91,046.26 $91,046.26 2025-06-27
6083 APR_DRG — 4 4 — — $45,312.25 $91,472.67 $91,472.67 2025-06-27
1782 APR_DRG — 4 4 — — $45,909.02 $92,677.38 $92,677.38 2025-06-27
0924 APR_DRG — 4 4 — — $45,971.06 $92,802.61 $92,802.61 2025-06-27
4403 APR_DRG — 4 4 — — $45,999.32 $92,859.67 $92,859.67 2025-06-27
6072 APR_DRG — 4 4 — — $46,050.36 $92,962.71 $92,962.71 2025-06-27
0011 APR_DRG — 4 4 — — $47,079.80 $95,040.84 $95,040.84 2025-06-27
9504 APR_DRG — 4 4 — — $47,144.18 $95,170.82 $95,170.82 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
1783 APR_DRG — 4 4 — — $47,757.45 $96,408.82 $96,408.82 2025-06-27
0204 APR_DRG — 4 4 — — $47,763.73 $96,421.50 $96,421.50 2025-06-27
0111 APR_DRG — 4 4 — — $47,775.51 $96,445.28 $96,445.28 2025-06-27
1603 APR_DRG — 4 4 — — $48,185.39 $97,272.73 $97,272.73 2025-06-27
1694 APR_DRG — 4 4 — — $48,761.75 $98,436.23 $98,436.23 2025-06-27
0234 APR_DRG — 4 4 — — $48,947.06 $98,810.33 $98,810.33 2025-06-27
2204 APR_DRG — 4 4 — — $49,082.12 $99,082.97 $99,082.97 2025-06-27
0041 APR_DRG — 4 4 — — $49,136.30 $99,192.35 $99,192.35 2025-06-27
6954 APR_DRG — 4 4 — — $49,389.93 $99,704.35 $99,704.35 2025-06-27
2324 APR_DRG — 4 4 — — $49,634.14 $100,197.33 $100,197.33 2025-06-27
0274 APR_DRG — 4 4 — — $49,973.35 $100,882.12 $100,882.12 2025-06-27
9124 APR_DRG — 4 4 — — $50,161.81 $101,262.55 $101,262.55 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
2604 APR_DRG — 4 4 — — $50,733.45 $102,416.54 $102,416.54 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
1204 APR_DRG — 4 4 — — $51,144.13 $103,245.57 $103,245.57 2025-06-27
6254 APR_DRG — 4 4 — — $51,388.33 $103,738.56 $103,738.56 2025-06-27
1623 APR_DRG — 4 4 — — $51,886.95 $104,745.13 $104,745.13 2025-06-27
6313 APR_DRG — 4 4 — — $52,079.33 $105,133.49 $105,133.49 2025-06-27
6144 APR_DRG — 4 4 — — $52,526.91 $106,037.02 $106,037.02 2025-06-27
1794 APR_DRG — 4 4 — — $52,544.18 $106,071.90 $106,071.90 2025-06-27
7594 APR_DRG — 4 4 — — $52,614.85 $106,214.56 $106,214.56 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
0214 APR_DRG — 4 4 — — $53,312.92 $107,623.76 $107,623.76 2025-06-27
6302 APR_DRG — 4 4 — — $53,556.34 $108,115.16 $108,115.16 2025-06-27
9114 APR_DRG — 4 4 — — $53,639.57 $108,283.18 $108,283.18 2025-06-27
0012 APR_DRG — 4 4 — — $54,146.83 $109,307.19 $109,307.19 2025-06-27
0914 APR_DRG — 4 4 — — $54,197.87 $109,410.22 $109,410.22 2025-06-27
3614 APR_DRG — 4 4 — — $54,360.41 $109,738.35 $109,738.35 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
1664 APR_DRG — 4 4 — — $55,330.95 $111,697.59 $111,697.59 2025-06-27
0042 APR_DRG — 4 4 — — $55,370.21 $111,776.85 $111,776.85 2025-06-27
6904 APR_DRG — 4 4 — — $55,732.99 $112,509.19 $112,509.19 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
7404 APR_DRG — 4 4 — — $56,031.37 $113,111.55 $113,111.55 2025-06-27
3124 APR_DRG — 4 4 — — $56,105.97 $113,262.14 $113,262.14 2025-06-27
6814 APR_DRG — 4 4 — — $56,261.44 $113,576.00 $113,576.00 2025-06-27
1834 APR_DRG — 4 4 — — $56,502.51 $114,062.64 $114,062.64 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
6084 APR_DRG — 4 4 — — $56,907.68 $114,880.58 $114,880.58 2025-06-27
10 MS_DRG Pancreas Transplant 7 4 — — $56,943.17 $146,041.44 $72,450.41 2025-06-27
9104 APR_DRG — 4 4 — — $57,195.08 $115,460.74 $115,460.74 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
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
5911 APR_DRG — 4 4 — — $57,751.02 $116,583.03 $116,583.03 2025-06-27
3033 APR_DRG — 4 4 — — $58,230.79 $117,551.55 $117,551.55 2025-06-27
0062 APR_DRG — 4 4 — — $58,958.69 $119,020.99 $119,020.99 2025-06-27
3044 APR_DRG — 4 4 — — $59,911.17 $120,943.77 $120,943.77 2025-06-27
0071 APR_DRG — 4 4 — — $60,321.06 $121,771.22 $121,771.22 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
231 MS_DRG Coronary Bypass With Ptca With Mcc 7 4 — — $60,520.59 $155,216.43 $77,002.08 2025-06-27
6334 APR_DRG — 4 4 — — $61,174.60 $123,494.28 $123,494.28 2025-06-27
6804 APR_DRG — 4 4 — — $61,744.68 $124,645.10 $124,645.10 2025-06-27
6214 APR_DRG — 4 4 — — $61,797.29 $124,751.31 $124,751.31 2025-06-27
8413 APR_DRG — 4 4 — — $61,864.03 $124,886.04 $124,886.04 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
6073 APR_DRG — 4 4 — — $62,350.87 $125,868.84 $125,868.84 2025-06-27
1654 APR_DRG — 4 4 — — $63,184.00 $127,550.68 $127,550.68 2025-06-27
0072 APR_DRG — 4 4 — — $63,495.73 $128,179.98 $128,179.98 2025-06-27
8504 APR_DRG — 4 4 — — $63,749.36 $128,691.99 $128,691.99 2025-06-27
6124 APR_DRG — 4 4 — — $64,337.49 $129,879.27 $129,879.27 2025-06-27
0053 APR_DRG — 4 4 — — $64,474.91 $130,156.67 $130,156.67 2025-06-27
6033 APR_DRG — 4 4 — — $64,664.15 $130,538.69 $130,538.69 2025-06-27
1784 APR_DRG — 4 4 — — $64,835.33 $130,884.25 $130,884.25 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
6093 APR_DRG — 4 4 — — $65,962.12 $133,158.94 $133,158.94 2025-06-27
6022 APR_DRG — 4 4 — — $66,668.83 $134,585.58 $134,585.58 2025-06-27
0013 APR_DRG — 4 4 — — $67,403.01 $136,067.69 $136,067.69 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
1634 APR_DRG — 4 4 — — $67,655.86 $136,578.11 $136,578.11 2025-06-27
1674 APR_DRG — 4 4 — — $68,116.00 $137,507.01 $137,507.01 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
0093 APR_DRG — 4 4 — — $69,473.66 $140,247.73 $140,247.73 2025-06-27
6114 APR_DRG — 4 4 — — $73,000.89 $147,368.23 $147,368.23 2025-06-27
6134 APR_DRG — 4 4 — — $73,344.03 $148,060.94 $148,060.94 2025-06-27
0063 APR_DRG — 4 4 — — $73,634.57 $148,647.44 $148,647.44 2025-06-27
8634 APR_DRG — 4 4 — — $75,015.78 $151,435.72 $151,435.72 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
4404 APR_DRG — 4 4 — — $75,902.30 $153,225.35 $153,225.35 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
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
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 7 4 — — $77,804.23 $199,543.57 $98,992.54 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
0073 APR_DRG — 4 4 — — $79,182.98 $159,848.11 $159,848.11 2025-06-27
0084 APR_DRG — 4 4 — — $80,301.92 $162,106.95 $162,106.95 2025-06-27
1624 APR_DRG — 4 4 — — $81,220.64 $163,961.58 $163,961.58 2025-06-27
6023 APR_DRG — 4 4 — — $83,366.66 $168,293.79 $168,293.79 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
3034 APR_DRG — 4 4 — — $85,449.08 $172,497.61 $172,497.61 2025-06-27
0021 APR_DRG — 4 4 — — $89,418.40 $180,510.54 $180,510.54 2025-06-27
0043 APR_DRG — 4 4 — — $89,730.92 $181,141.43 $181,141.43 2025-06-27
5932 APR_DRG — 4 4 — — $89,903.67 $181,490.16 $181,490.16 2025-06-27
6074 APR_DRG — 4 4 — — $90,070.92 $181,827.80 $181,827.80 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
7 MS_DRG Lung Transplant 7 4 — — $93,337.37 $239,381.21 $118,755.79 2025-06-27
0054 APR_DRG — 4 4 — — $93,338.24 $188,423.61 $188,423.61 2025-06-27
14 MS_DRG Allogeneic Bone Marrow Transplant 7 4 — — $93,573.06 $239,985.67 $119,055.66 2025-06-27
6303 APR_DRG — 4 4 — — $93,588.73 $188,929.27 $188,929.27 2025-06-27
5912 APR_DRG — 4 4 — — $96,071.62 $193,941.52 $193,941.52 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
0022 APR_DRG — 4 4 — — $97,231.39 $196,282.78 $196,282.78 2025-06-27
8424 APR_DRG — 4 4 — — $99,002.08 $199,857.30 $199,857.30 2025-06-27
5893 APR_DRG — 4 4 — — $99,693.08 $201,252.23 $201,252.23 2025-06-27
Q0480 HCPCS Driver Pneumatic Vad, Rep 3 1 — — $99,999.95 $99,999.95 $99,999.95 2025-06-27
8514 APR_DRG — 4 4 — — $100,501.08 $202,883.35 $202,883.35 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
5892 APR_DRG — 4 4 — — $101,863.44 $205,633.58 $205,633.58 2025-06-27
0064 APR_DRG — 4 4 — — $103,649.83 $209,239.80 $209,239.80 2025-06-27
0112 APR_DRG — 4 4 — — $104,771.13 $211,503.39 $211,503.39 2025-06-27
5891 APR_DRG — 4 4 — — $104,959.59 $211,883.83 $211,883.83 2025-06-27
1611 APR_DRG — 4 4 — — $105,524.17 $213,023.55 $213,023.55 2025-06-27
5933 APR_DRG — 4 4 — — $109,765.96 $221,586.53 $221,586.53 2025-06-27
1612 APR_DRG — 4 4 — — $110,756.13 $223,585.41 $223,585.41 2025-06-27
6024 APR_DRG — 4 4 — — $117,527.92 $237,255.74 $237,255.74 2025-06-27
1604 APR_DRG — 4 4 — — $118,972.73 $240,172.42 $240,172.42 2025-06-27
0113 APR_DRG — 4 4 — — $122,020.98 $246,325.97 $246,325.97 2025-06-27
5913 APR_DRG — 4 4 — — $126,689.93 $255,751.27 $255,751.27 2025-06-27
5881 APR_DRG — 4 4 — — $131,431.13 $265,322.41 $265,322.41 2025-06-27
0023 APR_DRG — 4 4 — — $133,605.42 $269,711.69 $269,711.69 2025-06-27
1613 APR_DRG — 4 4 — — $137,976.77 $278,536.22 $278,536.22 2025-06-27
0044 APR_DRG — 4 4 — — $143,096.45 $288,871.40 $288,871.40 2025-06-27
0014 APR_DRG — 4 4 — — $144,084.26 $290,865.51 $290,865.51 2025-06-27
6034 APR_DRG — 4 4 — — $146,394.39 $295,529.03 $295,529.03 2025-06-27
5831 APR_DRG — 4 4 — — $148,907.12 $300,601.51 $300,601.51 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
5882 APR_DRG — 4 4 — — $153,336.58 $309,543.34 $309,543.34 2025-06-27
5934 APR_DRG — 4 4 — — $158,270.15 $319,502.83 $319,502.83 2025-06-27
0094 APR_DRG — 4 4 — — $161,203.76 $325,424.95 $325,424.95 2025-06-27
0074 APR_DRG — 4 4 — — $162,015.68 $327,064.00 $327,064.00 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
5914 APR_DRG — 4 4 — — $170,686.93 $344,568.81 $344,568.81 2025-06-27
6314 APR_DRG — 4 4 — — $173,438.36 $350,123.18 $350,123.18 2025-06-27
5883 APR_DRG — 4 4 — — $174,746.55 $352,764.04 $352,764.04 2025-06-27
6094 APR_DRG — 4 4 — — $176,662.50 $356,631.80 $356,631.80 2025-06-27
8414 APR_DRG — 4 4 — — $193,312.43 $390,243.32 $390,243.32 2025-06-27
6304 APR_DRG — 4 4 — — $195,997.12 $395,662.95 $395,662.95 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
1614 APR_DRG — 4 4 — — $203,918.48 $411,653.94 $411,653.94 2025-06-27
5832 APR_DRG — 4 4 — — $204,861.54 $413,557.71 $413,557.71 2025-06-27
0114 APR_DRG — 4 4 — — $209,226.61 $422,369.56 $422,369.56 2025-06-27
0024 APR_DRG — 4 4 — — $237,946.25 $480,346.42 $480,346.42 2025-06-27
5833 APR_DRG — 4 4 — — $266,810.37 $538,614.95 $538,614.95 2025-06-27
5884 APR_DRG — 4 4 — — $268,686.28 $542,401.87 $542,401.87 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
5834 APR_DRG — 4 4 — — $411,851.82 $831,412.76 $831,412.76 2025-06-27
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