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

CHILDRENS HOSPITAL OF WISCONSIN FOX VALLEY

Neenah, WI · CCN 523302 · Rates published

12,428 distinct procedures filed
39 distinct payers
105,449 rate rows
2026-03-24 last MRF observed
Data quality

100,624 of 105,449 rate rows are consumer-grade (95.4%)

4,825 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 2,698
template filing: same amount across many unrelated codes — excluded 2,002
placeholder amount (≤ $0.02) — excluded from medians 55
percent-of-charges filed in the dollar field — excluded from medians 48
per-diem day rate — not a per-procedure price 21
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://7pgcgohua4yc5gik.public.blob.vercel-storage.com/390812532-1881780302_Childrens-Hospital-of-Wisconsin_standardcharges.csv
Found on page https://childrenswi.org/family-resources/insurance-billing-payments/price-transparency
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-17
Content fingerprint e68384cf71d79bc8… · 2,647,824 bytes · first seen 2026-05-17

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
Q2057
HCPCS 		Afamitresgene Autoleucel Per Therapeutic Dose 1 $1,656,833.00 $1,656,833.00 $1,656,833.00 nat. median
$824,563
outlier · 2.0×
Q2056
HCPCS 		Cilta Cel To 100 M Auto Bcma Dir Car-pos Tc Dose 1 $1,263,446.58 $1,263,446.58 $1,263,446.58 nat. median
$675,122
1.9× median
Q2042
HCPCS 		Tisagenlecleucel To 600 M Car-pos Vi T Ce Per Td 1 $1,218,042.30 $1,218,042.30 $1,218,042.30 nat. median
$754,974
1.6× median
Q2054
HCPCS 		Lm >=110 Mil Autol Anti-cd19 Car-pos Viabl Tc 1 $1,208,732.67 $1,208,732.67 $1,208,732.67 nat. median
$674,188
1.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Auto Bcma Dir Car-pos Tc 1 $1,199,875.72 $1,199,875.72 $1,199,875.72 nat. median
$625,184
1.9× median
Q2041
HCPCS 		Kte-c19 To 200 M Auto Anti-cd19 Car T Cell P Inf 1 $1,144,213.32 $1,144,213.32 $1,144,213.32 nat. median
$634,511
1.8× median
Q2053
HCPCS 		Brexucabtagene Autolcl Au Anti-cd19 Car P V T C 1 $1,052,317.93 $1,052,317.93 $1,052,317.93 nat. median
$620,080
1.7× median
5834
APR_DRG 		7 $572,597.86 $715,747.32 $624,131.66 nat. median
$309,665
outlier · 2.0×
Q2058
HCPCS 		Obecabtagene Autoleucel 10 Up To 400 Mil Cd19 1 $598,237.50 $598,237.50 $598,237.50 nat. median
$324,450
1.8× median
J3402
HCPCS 		Injection Remestemcel-l-rknd Per Ther Dose 1 $433,588.39 $433,588.39 $433,588.39 nat. median
$209,753
outlier · 2.1×
0024
APR_DRG 		7 $378,040.17 $472,550.22 $412,063.79 nat. median
$372,987
1.1× median
5884
APR_DRG 		7 $350,705.71 $438,382.13 $382,269.22 nat. median
$246,434
1.6× median
5833
APR_DRG 		7 $326,113.20 $407,641.49 $355,463.38 nat. median
$244,017
1.5× median
0114
APR_DRG 		7 $252,193.22 $315,241.53 $274,890.61 nat. median
$197,700
1.4× median
5832
APR_DRG 		7 $250,395.39 $312,994.24 $272,930.97 nat. median
$156,126
1.7× median
6094
APR_DRG 		7 $244,345.13 $305,431.41 $266,336.19 nat. median
$162,982
1.6× median
6314
APR_DRG 		7 $235,016.14 $293,770.17 $256,167.59 nat. median
$122,924
outlier · 2.1×
5883
APR_DRG 		7 $233,569.99 $291,962.49 $254,591.29 nat. median
$182,736
1.4× median
5914
APR_DRG 		7 $229,975.26 $287,469.08 $250,673.04 nat. median
$164,279
1.5× median
5831
APR_DRG 		7 $224,760.28 $280,950.36 $244,988.71 nat. median
$145,122
1.7× median
6304
APR_DRG 		7 $213,135.78 $266,419.72 $232,318.00 nat. median
$150,721
1.5× median
0014
APR_DRG 		7 $210,424.86 $263,031.08 $229,363.10 nat. median
$190,591
1.2× median
0023
APR_DRG 		7 $205,924.10 $257,405.12 $224,457.26 nat. median
$167,082
1.3× median
5934
APR_DRG 		7 $202,192.58 $252,740.72 $220,389.91 nat. median
$151,838
1.5× median
5882
APR_DRG 		7 $200,143.62 $250,179.52 $218,156.55 nat. median
$145,336
1.5× median
1614
APR_DRG 		7 $188,073.91 $235,092.39 $205,000.56 nat. median
$207,730
1.0× median
0113
APR_DRG 		7 $187,685.30 $234,606.63 $204,576.98 nat. median
$128,705
1.6× median
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$60,691
outlier · 3.3×
215
MS_DRG 		Other Heart Assist System Implant 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$99,019
outlier · 2.0×
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$72,138
outlier · 2.8×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$133,176
1.5× median
850
MS_DRG 		Acute Leukemia With Other Procedures 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$83,442
outlier · 2.4×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$68,887
outlier · 2.9×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$68,090
outlier · 3.0×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$93,672
outlier · 2.2×
209
MS_DRG 		Complex Aortic Arch Procedures 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$98,017
outlier · 2.1×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$74,915
outlier · 2.7×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$79,312
outlier · 2.5×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$98,905
outlier · 2.0×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$66,526
outlier · 3.0×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$370,174
0.5× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$73,807
outlier · 2.7×
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$63,738
outlier · 3.2×
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$64,027
outlier · 3.2×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$77,576
outlier · 2.6×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$102,358
2.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$202,986
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$206,368
1.0× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$82,712
outlier · 2.4×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $202,006.00 $202,006.00 $202,006.00 nat. median
$81,118
outlier · 2.5×

Other procedures at this hospital

Browse this hospital's 12,428 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
             
0011 APR_DRG — 8 7 — — $74,170.95 $92,713.68 $80,846.33 2026-03-24
0012 APR_DRG — 8 7 — — $84,427.73 $105,534.66 $92,026.23 2026-03-24
0013 APR_DRG — 8 7 — — $109,246.98 $136,558.73 $119,079.21 2026-03-24
0014 APR_DRG — 8 7 — — $210,424.86 $263,031.08 $229,363.10 2026-03-24
0021 APR_DRG — 8 7 — — $137,820.36 $172,275.45 $150,224.19 2026-03-24
0022 APR_DRG — 8 7 — — $155,933.75 $194,917.19 $169,967.79 2026-03-24
0023 APR_DRG — 8 7 — — $205,924.10 $257,405.12 $224,457.26 2026-03-24
0024 APR_DRG — 8 7 — — $378,040.17 $472,550.22 $412,063.79 2026-03-24
0043 APR_DRG — 8 7 — — $97,707.86 $122,134.83 $106,501.57 2026-03-24
0044 APR_DRG — 8 7 — — $141,692.93 $177,116.16 $154,445.29 2026-03-24
0053 APR_DRG — 8 7 — — $71,636.07 $89,545.09 $78,083.32 2026-03-24
0054 APR_DRG — 8 7 — — $98,708.81 $123,386.01 $107,592.60 2026-03-24
0062 APR_DRG — 8 7 — — $91,320.55 $114,150.68 $99,539.40 2026-03-24
0063 APR_DRG — 8 7 — — $105,925.98 $132,407.48 $115,459.32 2026-03-24
0064 APR_DRG — 8 7 — — $137,448.78 $171,810.98 $149,819.17 2026-03-24
0072 APR_DRG — 8 7 — — $66,458.72 $83,073.40 $72,440.00 2026-03-24
0073 APR_DRG — 8 7 — — $94,373.70 $117,967.13 $102,867.33 2026-03-24
0074 APR_DRG — 8 7 — — $148,383.70 $185,479.62 $161,738.23 2026-03-24
0084 APR_DRG — 8 7 — — $65,996.56 $82,495.70 $71,936.25 2026-03-24
0093 APR_DRG — 8 7 — — $123,910.48 $154,888.10 $135,062.42 2026-03-24
0094 APR_DRG — 8 7 — — $184,372.82 $230,466.02 $200,966.37 2026-03-24
0111 APR_DRG — 8 7 — — $73,485.46 $91,856.82 $80,099.15 2026-03-24
0112 APR_DRG — 8 7 — — $149,207.37 $186,509.21 $162,636.03 2026-03-24
0113 APR_DRG — 8 7 — — $187,685.30 $234,606.63 $204,576.98 2026-03-24
0114 APR_DRG — 8 7 — — $252,193.22 $315,241.53 $274,890.61 2026-03-24
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 1 1 — — $165,504.66 $165,504.66 $165,504.66 2026-03-24
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 1 1 — — $127,934.52 $127,934.52 $127,934.52 2026-03-24
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 1 1 — — $87,448.22 $87,448.22 $87,448.22 2026-03-24
140 MS_DRG Major Head And Neck Procedures With Mcc 1 1 — — $129,430.53 $129,430.53 $129,430.53 2026-03-24
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 1 1 — — $113,690.58 $113,690.58 $113,690.58 2026-03-24
1604 APR_DRG — 8 7 — — $107,964.26 $134,955.32 $117,681.04 2026-03-24
1611 APR_DRG — 8 7 — — $108,359.06 $135,448.83 $118,111.38 2026-03-24
1612 APR_DRG — 8 7 — — $108,359.06 $135,448.83 $118,111.38 2026-03-24
1613 APR_DRG — 8 7 — — $147,265.86 $184,082.32 $160,519.79 2026-03-24
1614 APR_DRG — 8 7 — — $188,073.91 $235,092.39 $205,000.56 2026-03-24
1624 APR_DRG — 8 7 — — $72,556.51 $90,695.63 $79,086.59 2026-03-24
163 MS_DRG Major Chest Procedures With Mcc 1 1 — — $136,000.22 $136,000.22 $136,000.22 2026-03-24
164 MS_DRG Major Chest Procedures With Cc 1 1 — — $76,590.78 $76,590.78 $76,590.78 2026-03-24
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 1 1 — — $113,420.51 $113,420.51 $113,420.51 2026-03-24
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 1 1 — — $90,318.86 $90,318.86 $90,318.86 2026-03-24
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 1 1 — — $195,260.97 $195,260.97 $195,260.97 2026-03-24
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 1 1 — — $83,409.30 $83,409.30 $83,409.30 2026-03-24
209 MS_DRG Complex Aortic Arch Procedures 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 1 — — $160,640.36 $160,640.36 $160,640.36 2026-03-24
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 1 1 — — $173,175.88 $173,175.88 $173,175.88 2026-03-24
215 MS_DRG Other Heart Assist System Implant 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $199,527.48 $199,527.48 $199,527.48 2026-03-24
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $199,527.48 $199,527.48 $199,527.48 2026-03-24
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 1 1 — — $96,418.20 $96,418.20 $96,418.20 2026-03-24
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $161,823.82 $161,823.82 $161,823.82 2026-03-24
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $152,944.87 $152,944.87 $152,944.87 2026-03-24
228 MS_DRG Other Cardiothoracic Procedures With Mcc 1 1 — — $150,128.85 $150,128.85 $150,128.85 2026-03-24
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 1 1 — — $95,571.58 $95,571.58 $95,571.58 2026-03-24
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 1 1 — — $173,885.95 $173,885.95 $173,885.95 2026-03-24
231 MS_DRG Coronary Bypass With Ptca With Mcc 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
232 MS_DRG Coronary Bypass With Ptca Without Mcc 1 1 — — $183,969.60 $183,969.60 $183,969.60 2026-03-24
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 1 1 — — $165,765.63 $165,765.63 $165,765.63 2026-03-24
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 1 1 — — $178,082.67 $178,082.67 $178,082.67 2026-03-24
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 1 1 — — $127,109.14 $127,109.14 $127,109.14 2026-03-24
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 1 1 — — $149,348.99 $149,348.99 $149,348.99 2026-03-24
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 1 1 — — $118,706.61 $118,706.61 $118,706.61 2026-03-24
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 1 1 — — $86,498.42 $86,498.42 $86,498.42 2026-03-24
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 1 1 — — $96,885.52 $96,885.52 $96,885.52 2026-03-24
245 MS_DRG Aicd Generator Procedures 1 1 — — $138,446.03 $138,446.03 $138,446.03 2026-03-24
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 1 1 — — $137,969.61 $137,969.61 $137,969.61 2026-03-24
252 MS_DRG Other Vascular Procedures With Mcc 1 1 — — $105,852.46 $105,852.46 $105,852.46 2026-03-24
253 MS_DRG Other Vascular Procedures With Cc 1 1 — — $78,763.48 $78,763.48 $78,763.48 2026-03-24
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 1 1 — — $81,852.60 $81,852.60 $81,852.60 2026-03-24
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 1 1 — — $95,347.02 $95,347.02 $95,347.02 2026-03-24
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 1 1 — — $94,348.67 $94,348.67 $94,348.67 2026-03-24
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 1 1 — — $98,706.22 $98,706.22 $98,706.22 2026-03-24
263 MS_DRG Vein Ligation And Stripping 1 1 — — $92,776.80 $92,776.80 $92,776.80 2026-03-24
264 MS_DRG Other Circulatory System O.r. Procedures 1 1 — — $101,370.51 $101,370.51 $101,370.51 2026-03-24
265 MS_DRG Aicd Lead Procedures 1 1 — — $109,794.28 $109,794.28 $109,794.28 2026-03-24
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 1 1 — — $185,966.30 $185,966.30 $185,966.30 2026-03-24
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 1 1 — — $144,466.48 $144,466.48 $144,466.48 2026-03-24
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 1 1 — — $128,153.00 $128,153.00 $128,153.00 2026-03-24
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 1 1 — — $76,557.40 $76,557.40 $76,557.40 2026-03-24
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 1 1 — — $160,109.32 $160,109.32 $160,109.32 2026-03-24
271 MS_DRG Other Major Cardiovascular Procedures With Cc 1 1 — — $107,915.92 $107,915.92 $107,915.92 2026-03-24
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 1 1 — — $77,470.79 $77,470.79 $77,470.79 2026-03-24
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 1 1 — — $125,188.30 $125,188.30 $125,188.30 2026-03-24
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 1 1 — — $99,886.64 $99,886.64 $99,886.64 2026-03-24
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 1 1 — — $182,270.28 $182,270.28 $182,270.28 2026-03-24
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 1 1 — — $140,148.38 $140,148.38 $140,148.38 2026-03-24
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 1 1 — — $168,906.34 $168,906.34 $168,906.34 2026-03-24
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 1 1 — — $109,436.21 $109,436.21 $109,436.21 2026-03-24
28 MS_DRG Spinal Procedures With Mcc 1 1 — — $182,321.86 $182,321.86 $182,321.86 2026-03-24
288 MS_DRG Acute And Subacute Endocarditis With Mcc 1 1 — — $82,119.64 $82,119.64 $82,119.64 2026-03-24
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 1 1 — — $103,525.00 $103,525.00 $103,525.00 2026-03-24
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
3034 APR_DRG — 8 7 — — $72,205.83 $90,257.29 $78,704.35 2026-03-24
31 MS_DRG Ventricular Shunt Procedures With Mcc 1 1 — — $135,960.77 $135,960.77 $135,960.77 2026-03-24
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 1 1 — — $73,501.66 $73,501.66 $73,501.66 2026-03-24
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 1 1 — — $135,426.70 $135,426.70 $135,426.70 2026-03-24
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 1 1 — — $72,988.83 $72,988.83 $72,988.83 2026-03-24
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 1 1 — — $82,562.68 $82,562.68 $82,562.68 2026-03-24
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 1 1 — — $131,314.95 $131,314.95 $131,314.95 2026-03-24
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 1 1 — — $95,617.10 $95,617.10 $95,617.10 2026-03-24
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 1 1 — — $97,419.59 $97,419.59 $97,419.59 2026-03-24
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 1 1 — — $151,342.65 $151,342.65 $151,342.65 2026-03-24
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 1 1 — — $74,169.25 $74,169.25 $74,169.25 2026-03-24
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 1 1 — — $139,480.79 $139,480.79 $139,480.79 2026-03-24
330 MS_DRG Major Small And Large Bowel Procedures With Cc 1 1 — — $72,743.03 $72,743.03 $72,743.03 2026-03-24
332 MS_DRG Rectal Resection With Mcc 1 1 — — $109,870.14 $109,870.14 $109,870.14 2026-03-24
335 MS_DRG Peritoneal Adhesiolysis With Mcc 1 1 — — $108,358.96 $108,358.96 $108,358.96 2026-03-24
34 MS_DRG Carotid Artery Stent Procedures With Mcc 1 1 — — $117,456.39 $117,456.39 $117,456.39 2026-03-24
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 1 1 — — $78,375.07 $78,375.07 $78,375.07 2026-03-24
35 MS_DRG Carotid Artery Stent Procedures With Cc 1 1 — — $72,539.72 $72,539.72 $72,539.72 2026-03-24
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 1 1 — — $75,616.71 $75,616.71 $75,616.71 2026-03-24
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 1 1 — — $88,061.19 $88,061.19 $88,061.19 2026-03-24
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 1 1 — — $133,299.52 $133,299.52 $133,299.52 2026-03-24
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 1 1 — — $104,344.32 $104,344.32 $104,344.32 2026-03-24
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 1 1 — — $73,261.93 $73,261.93 $73,261.93 2026-03-24
37 MS_DRG Extracranial Procedures With Mcc 1 1 — — $99,898.77 $99,898.77 $99,898.77 2026-03-24
397 MS_DRG Appendix Procedures With Mcc 1 1 — — $72,673.24 $72,673.24 $72,673.24 2026-03-24
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 1 1 — — $117,168.11 $117,168.11 $117,168.11 2026-03-24
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 1 1 — — $122,002.07 $122,002.07 $122,002.07 2026-03-24
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 1 1 — — $166,002.32 $166,002.32 $166,002.32 2026-03-24
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 1 1 — — $88,006.57 $88,006.57 $88,006.57 2026-03-24
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 1 1 — — $108,198.13 $108,198.13 $108,198.13 2026-03-24
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 1 1 — — $100,238.64 $100,238.64 $100,238.64 2026-03-24
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 1 1 — — $108,107.10 $108,107.10 $108,107.10 2026-03-24
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 1 1 — — $72,415.31 $72,415.31 $72,415.31 2026-03-24
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 1 1 — — $103,388.45 $103,388.45 $103,388.45 2026-03-24
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $126,022.79 $126,022.79 $126,022.79 2026-03-24
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 1 — — $170,599.59 $170,599.59 $170,599.59 2026-03-24
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 1 1 — — $175,002.65 $175,002.65 $175,002.65 2026-03-24
4403 APR_DRG — 8 7 — — $72,454.71 $90,568.39 $78,975.63 2026-03-24
4404 APR_DRG — 8 7 — — $106,570.44 $133,213.05 $116,161.78 2026-03-24
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 1 1 — — $128,687.08 $128,687.08 $128,687.08 2026-03-24
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 1 1 — — $161,726.71 $161,726.71 $161,726.71 2026-03-24
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 1 1 — — $98,026.49 $98,026.49 $98,026.49 2026-03-24
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $180,950.27 $180,950.27 $180,950.27 2026-03-24
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $126,617.55 $126,617.55 $126,617.55 2026-03-24
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 1 1 — — $167,595.44 $167,595.44 $167,595.44 2026-03-24
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 1 1 — — $80,717.70 $80,717.70 $80,717.70 2026-03-24
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 1 1 — — $172,951.33 $172,951.33 $172,951.33 2026-03-24
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 1 1 — — $94,515.57 $94,515.57 $94,515.57 2026-03-24
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 1 1 — — $157,957.86 $157,957.86 $157,957.86 2026-03-24
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 1 1 — — $107,014.68 $107,014.68 $107,014.68 2026-03-24
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 1 1 — — $83,388.06 $83,388.06 $83,388.06 2026-03-24
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 1 1 — — $92,042.45 $92,042.45 $92,042.45 2026-03-24
471 MS_DRG Cervical Spinal Fusion With Mcc 1 1 — — $146,526.90 $146,526.90 $146,526.90 2026-03-24
472 MS_DRG Cervical Spinal Fusion With Cc 1 1 — — $89,399.40 $89,399.40 $89,399.40 2026-03-24
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 1 1 — — $74,081.25 $74,081.25 $74,081.25 2026-03-24
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 1 1 — — $130,268.05 $130,268.05 $130,268.05 2026-03-24
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 1 1 — — $104,829.84 $104,829.84 $104,829.84 2026-03-24
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 1 1 — — $74,624.42 $74,624.42 $74,624.42 2026-03-24
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 1 1 — — $88,373.74 $88,373.74 $88,373.74 2026-03-24
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 1 1 — — $84,113.31 $84,113.31 $84,113.31 2026-03-24
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 1 1 — — $97,926.35 $97,926.35 $97,926.35 2026-03-24
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 1 1 — — $111,414.70 $111,414.70 $111,414.70 2026-03-24
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 1 1 — — $76,957.95 $76,957.95 $76,957.95 2026-03-24
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 1 1 — — $110,021.87 $110,021.87 $110,021.87 2026-03-24
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 1 1 — — $91,544.80 $91,544.80 $91,544.80 2026-03-24
500 MS_DRG Soft Tissue Procedures With Mcc 1 1 — — $96,035.86 $96,035.86 $96,035.86 2026-03-24
503 MS_DRG Foot Procedures With Mcc 1 1 — — $84,695.93 $84,695.93 $84,695.93 2026-03-24
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 1 1 — — $91,657.07 $91,657.07 $91,657.07 2026-03-24
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 1 1 — — $96,706.48 $96,706.48 $96,706.48 2026-03-24
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 1 1 — — $113,408.37 $113,408.37 $113,408.37 2026-03-24
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 1 1 — — $87,096.22 $87,096.22 $87,096.22 2026-03-24
545 MS_DRG Connective Tissue Disorders With Mcc 1 1 — — $75,307.19 $75,307.19 $75,307.19 2026-03-24
570 MS_DRG Skin Debridement With Mcc 1 1 — — $89,247.68 $89,247.68 $89,247.68 2026-03-24
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 1 1 — — $198,802.23 $198,802.23 $198,802.23 2026-03-24
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 1 1 — — $105,339.63 $105,339.63 $105,339.63 2026-03-24
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 1 1 — — $148,726.91 $148,726.91 $148,726.91 2026-03-24
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 1 1 — — $80,435.49 $80,435.49 $80,435.49 2026-03-24
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 1 1 — — $98,272.28 $98,272.28 $98,272.28 2026-03-24
5831 APR_DRG — 8 7 — — $224,760.28 $280,950.36 $244,988.71 2026-03-24
5832 APR_DRG — 8 7 — — $250,395.39 $312,994.24 $272,930.97 2026-03-24
5833 APR_DRG — 8 7 — — $326,113.20 $407,641.49 $355,463.38 2026-03-24
5834 APR_DRG — 8 7 — — $572,597.86 $715,747.32 $624,131.66 2026-03-24
5881 APR_DRG — 8 7 — — $171,551.82 $214,439.77 $186,991.48 2026-03-24
5882 APR_DRG — 8 7 — — $200,143.62 $250,179.52 $218,156.55 2026-03-24
5883 APR_DRG — 8 7 — — $233,569.99 $291,962.49 $254,591.29 2026-03-24
5884 APR_DRG — 8 7 — — $350,705.71 $438,382.13 $382,269.22 2026-03-24
5891 APR_DRG — 8 7 — — $163,477.76 $204,347.20 $178,190.76 2026-03-24
5892 APR_DRG — 8 7 — — $163,477.76 $204,347.20 $178,190.76 2026-03-24
5893 APR_DRG — 8 7 — — $163,477.76 $204,347.20 $178,190.76 2026-03-24
5912 APR_DRG — 8 7 — — $148,762.71 $185,953.39 $162,151.35 2026-03-24
5913 APR_DRG — 8 7 — — $173,441.77 $216,802.21 $189,051.53 2026-03-24
5914 APR_DRG — 8 7 — — $229,975.26 $287,469.08 $250,673.04 2026-03-24
5931 APR_DRG — 8 7 — — $90,539.53 $113,174.41 $98,688.09 2026-03-24
5932 APR_DRG — 8 7 — — $118,968.30 $148,710.38 $129,675.45 2026-03-24
5933 APR_DRG — 8 7 — — $147,909.31 $184,886.64 $161,221.15 2026-03-24
5934 APR_DRG — 8 7 — — $202,192.58 $252,740.72 $220,389.91 2026-03-24
6022 APR_DRG — 8 7 — — $84,506.38 $105,632.98 $92,111.96 2026-03-24
6023 APR_DRG — 8 7 — — $105,756.76 $132,195.95 $115,274.87 2026-03-24
6024 APR_DRG — 8 7 — — $152,318.19 $190,397.74 $166,026.83 2026-03-24
6034 APR_DRG — 8 7 — — $111,407.49 $139,259.36 $121,434.17 2026-03-24
6073 APR_DRG — 8 7 — — $80,726.48 $100,908.10 $87,991.86 2026-03-24
6074 APR_DRG — 8 7 — — $117,742.55 $147,178.19 $128,339.38 2026-03-24
6084 APR_DRG — 8 7 — — $67,156.67 $83,945.84 $73,200.77 2026-03-24
6093 APR_DRG — 8 7 — — $84,760.99 $105,951.24 $92,389.48 2026-03-24
6094 APR_DRG — 8 7 — — $244,345.13 $305,431.41 $266,336.19 2026-03-24
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 1 1 — — $83,664.20 $83,664.20 $83,664.20 2026-03-24
6114 APR_DRG — 8 7 — — $97,928.26 $122,410.32 $106,741.80 2026-03-24
6124 APR_DRG — 8 7 — — $77,140.80 $96,426.01 $84,083.48 2026-03-24
6134 APR_DRG — 8 7 — — $97,027.56 $121,284.45 $105,760.04 2026-03-24
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 1 1 — — $105,825.15 $105,825.15 $105,825.15 2026-03-24
619 MS_DRG O.r. Procedures For Obesity With Mcc 1 1 — — $87,618.15 $87,618.15 $87,618.15 2026-03-24
6214 APR_DRG — 8 7 — — $75,651.39 $94,564.23 $82,460.01 2026-03-24
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 1 1 — — $108,003.92 $108,003.92 $108,003.92 2026-03-24
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 1 1 — — $91,644.93 $91,644.93 $91,644.93 2026-03-24
6254 APR_DRG — 8 7 — — $67,058.05 $83,822.56 $73,093.27 2026-03-24
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 1 1 — — $113,089.75 $113,089.75 $113,089.75 2026-03-24
6303 APR_DRG — 8 7 — — $117,485.93 $146,857.41 $128,059.66 2026-03-24
6304 APR_DRG — 8 7 — — $213,135.78 $266,419.72 $232,318.00 2026-03-24
6313 APR_DRG — 8 7 — — $69,074.80 $86,343.50 $75,291.53 2026-03-24
6314 APR_DRG — 8 7 — — $235,016.14 $293,770.17 $256,167.59 2026-03-24
6334 APR_DRG — 8 7 — — $76,938.53 $96,173.16 $83,862.99 2026-03-24
653 MS_DRG Major Bladder Procedures With Mcc 1 1 — — $157,684.76 $157,684.76 $157,684.76 2026-03-24
654 MS_DRG Major Bladder Procedures With Cc 1 1 — — $84,944.76 $84,944.76 $84,944.76 2026-03-24
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 1 1 — — $96,612.41 $96,612.41 $96,612.41 2026-03-24
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 1 1 — — $77,103.61 $77,103.61 $77,103.61 2026-03-24
662 MS_DRG Minor Bladder Procedures With Mcc 1 1 — — $92,901.22 $92,901.22 $92,901.22 2026-03-24
665 MS_DRG Prostatectomy With Mcc 1 1 — — $94,712.81 $94,712.81 $94,712.81 2026-03-24
668 MS_DRG Transurethral Procedures With Mcc 1 1 — — $88,607.40 $88,607.40 $88,607.40 2026-03-24
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 1 1 — — $127,497.55 $127,497.55 $127,497.55 2026-03-24
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 1 1 — — $108,468.20 $108,468.20 $108,468.20 2026-03-24
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 1 1 — — $108,720.07 $108,720.07 $108,720.07 2026-03-24
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 1 1 — — $77,913.82 $77,913.82 $77,913.82 2026-03-24
783 MS_DRG Cesarean Section With Sterilization With Mcc 1 1 — — $74,500.01 $74,500.01 $74,500.01 2026-03-24
799 MS_DRG Splenic Procedures With Mcc 1 1 — — $137,429.47 $137,429.47 $137,429.47 2026-03-24
800 MS_DRG Splenic Procedures With Cc 1 1 — — $85,251.24 $85,251.24 $85,251.24 2026-03-24
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 1 1 — — $120,897.51 $120,897.51 $120,897.51 2026-03-24
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 1 1 — — $177,967.36 $177,967.36 $177,967.36 2026-03-24
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 1 1 — — $139,125.76 $139,125.76 $139,125.76 2026-03-24
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 1 1 — — $141,947.84 $141,947.84 $141,947.84 2026-03-24
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 1 1 — — $95,890.20 $95,890.20 $95,890.20 2026-03-24
834 MS_DRG Acute Leukemia With Mcc 1 1 — — $166,591.02 $166,591.02 $166,591.02 2026-03-24
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 1 1 — — $145,786.48 $145,786.48 $145,786.48 2026-03-24
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 1 1 — — $98,163.04 $98,163.04 $98,163.04 2026-03-24
8414 APR_DRG — 8 7 — — $167,296.37 $209,120.46 $182,353.04 2026-03-24
8424 APR_DRG — 8 7 — — $93,661.50 $117,076.88 $102,091.04 2026-03-24
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 1 1 — — $78,669.41 $78,669.41 $78,669.41 2026-03-24
849 MS_DRG Radiotherapy 1 1 — — $82,219.78 $82,219.78 $82,219.78 2026-03-24
850 MS_DRG Acute Leukemia With Other Procedures 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
8513 APR_DRG — 8 7 — — $86,426.52 $108,033.15 $94,204.91 2026-03-24
8514 APR_DRG — 8 7 — — $86,426.52 $108,033.15 $94,204.91 2026-03-24
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 1 1 — — $149,861.82 $149,861.82 $149,861.82 2026-03-24
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 1 1 — — $138,030.30 $138,030.30 $138,030.30 2026-03-24
8634 APR_DRG — 8 7 — — $95,777.66 $119,722.07 $104,397.64 2026-03-24
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 1 1 — — $117,280.39 $117,280.39 $117,280.39 2026-03-24
901 MS_DRG Wound Debridements For Injuries With Mcc 1 1 — — $127,345.83 $127,345.83 $127,345.83 2026-03-24
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 1 1 — — $111,460.22 $111,460.22 $111,460.22 2026-03-24
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 1 1 — — $116,503.56 $116,503.56 $116,503.56 2026-03-24
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 1 1 — — $97,735.18 $97,735.18 $97,735.18 2026-03-24
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 1 1 — — $118,169.50 $118,169.50 $118,169.50 2026-03-24
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 1 1 — — $110,106.83 $110,106.83 $110,106.83 2026-03-24
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 1 1 — — $106,796.19 $106,796.19 $106,796.19 2026-03-24
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 1 1 — — $78,265.82 $78,265.82 $78,265.82 2026-03-24
955 MS_DRG Craniotomy For Multiple Significant Trauma 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 1 — — $114,188.24 $114,188.24 $114,188.24 2026-03-24
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $202,006.00 $202,006.00 $202,006.00 2026-03-24
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 1 1 — — $127,870.80 $127,870.80 $127,870.80 2026-03-24
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 1 1 — — $89,338.71 $89,338.71 $89,338.71 2026-03-24
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 1 1 — — $78,265.82 $78,265.82 $78,265.82 2026-03-24
963 MS_DRG Other Multiple Significant Trauma With Mcc 1 1 — — $82,957.16 $82,957.16 $82,957.16 2026-03-24
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 1 1 — — $185,750.85 $185,750.85 $185,750.85 2026-03-24
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 1 1 — — $109,600.07 $109,600.07 $109,600.07 2026-03-24
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 1 1 — — $80,031.90 $80,031.90 $80,031.90 2026-03-24
974 MS_DRG HIV With Major Related Condition With Mcc 1 1 — — $87,575.67 $87,575.67 $87,575.67 2026-03-24
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 1 1 — — $142,372.67 $142,372.67 $142,372.67 2026-03-24
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 1 1 — — $74,603.18 $74,603.18 $74,603.18 2026-03-24
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 1 1 — — $104,034.80 $104,034.80 $104,034.80 2026-03-24
A9543 HCPCS Y-90 Ibritumomb Tiuxtn Tx To 40 Mci 1 1 — — $122,172.78 $122,172.78 $122,172.78 2026-03-24
A9699 HCPCS Radiopharmaceutical Therapeutic Noc 1 1 — — $100,394.53 $100,394.53 $100,394.53 2026-03-24
J3402 HCPCS Injection Remestemcel-l-rknd Per Ther Dose 1 1 — — $433,588.39 $433,588.39 $433,588.39 2026-03-24
J7330 HCPCS Autol Culturd Chondrocytes Impl 1 1 — — $180,011.44 $180,011.44 $180,011.44 2026-03-24
J9029 HCPCS Ives Instal Nadofaragn Firadenovc-vncg Per Thr D 1 1 — — $138,190.80 $138,190.80 $138,190.80 2026-03-24
J9226 HCPCS Histrelin Impl Supprelin La 50 Mg 1 1 — — $92,848.48 $92,848.48 $92,848.48 2026-03-24
Q2041 HCPCS Kte-c19 To 200 M Auto Anti-cd19 Car T Cell P Inf 1 1 — — $1,144,213.32 $1,144,213.32 $1,144,213.32 2026-03-24
Q2042 HCPCS Tisagenlecleucel To 600 M Car-pos Vi T Ce Per Td 1 1 — — $1,218,042.30 $1,218,042.30 $1,218,042.30 2026-03-24
Q2043 HCPCS Sipuleucel-t Including Leukapheresis Per Infus 1 1 — — $116,968.84 $116,968.84 $116,968.84 2026-03-24
Q2053 HCPCS Brexucabtagene Autolcl Au Anti-cd19 Car P V T C 1 1 — — $1,052,317.93 $1,052,317.93 $1,052,317.93 2026-03-24
Q2054 HCPCS Lm >=110 Mil Autol Anti-cd19 Car-pos Viabl Tc 1 1 — — $1,208,732.67 $1,208,732.67 $1,208,732.67 2026-03-24
Q2055 HCPCS Idecabtagene Vicleucel Auto Bcma Dir Car-pos Tc 1 1 — — $1,199,875.72 $1,199,875.72 $1,199,875.72 2026-03-24
Q2056 HCPCS Cilta Cel To 100 M Auto Bcma Dir Car-pos Tc Dose 1 1 — — $1,263,446.58 $1,263,446.58 $1,263,446.58 2026-03-24
Q2057 HCPCS Afamitresgene Autoleucel Per Therapeutic Dose 1 1 — — $1,656,833.00 $1,656,833.00 $1,656,833.00 2026-03-24
Q2058 HCPCS Obecabtagene Autoleucel 10 Up To 400 Mil Cd19 1 1 — — $598,237.50 $598,237.50 $598,237.50 2026-03-24
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