Price Transparencybeta Hospital negotiated rates

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

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Hospital

FOUNDATION SURGICAL HOSPITAL OF SAN ANTONIO

San Antonio, TX · CCN 670054 · Rates published

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You selected 93306 (CPT)

TTE W/DOPPLER COMPLETE

This hospital’s price: $316 across 3 payers · range $186-$1,168

Source: https://mrfs.hyvehealthcare.com/USPI/203793927_FoundationSurgicalHospitalofSanAntonio_standardcharges.json · observed 2026-04-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

15,259 distinct procedures filed
3 distinct payers
70,806 rate rows
2026-04-01 last MRF observed
Data quality

70,675 of 70,806 rate rows are consumer-grade (99.8%)

131 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 124
placeholder amount (≤ $0.02) — excluded from medians 7
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://mrfs.hyvehealthcare.com/USPI/203793927_FoundationSurgicalHospitalofSanAntonio_standardcharges.json
Found on page https://fshsanantonio.com/Hospital-Pricing-Information
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-20
Content fingerprint 316ff98e511e6289… · 13,702,134 bytes · first seen 2026-05-08

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 1 $3,605,207.34 $3,605,207.34 $3,605,207.34 nat. median
$3,703,693
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 1 $3,202,901.18 $3,202,901.18 $3,202,901.18 nat. median
$3,324,572
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 1 $2,237,740.22 $2,237,740.22 $2,237,740.22 nat. median
$2,466,282
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 1 $496,636.74 $1,135,169.69 $815,903.21 nat. median
$738,272
1.1× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 1 $492,869.66 $1,126,559.23 $809,714.45 nat. median
$646,415
1.3× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 1 $470,999.74 $1,076,570.83 $773,785.29 nat. median
$622,245
1.2× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 1 $460,469.05 $1,052,500.68 $756,484.86 nat. median
$640,950
1.2× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 1 $436,745.12 $998,274.55 $717,509.83 nat. median
$591,650
1.2× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 1 $436,745.12 $998,274.55 $717,509.83 nat. median
$608,101
1.2× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 $249,598.81 $891,462.18 $430,133.12 nat. median
$359,358
1.2× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $183,585.31 $419,623.56 $301,604.43 nat. median
$249,124
1.2× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 1 $178,572.69 $408,166.15 $293,369.42 nat. median
$198,433
1.5× median
5834
APR_DRG 		Neonate With Ecmo, Severe 1 $279,016.83 $279,016.83 $279,016.83 nat. median
$307,273
0.9× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant, Severe 1 $271,427.83 $271,427.83 $271,427.83 nat. median
$170,172
1.6× median
5833
APR_DRG 		Neonate With Ecmo, Major 1 $236,261.19 $236,261.19 $236,261.19 nat. median
$244,017
1.0× median
24
APR_DRG 		Heart And/Or Lung Transplant, Severe 1 $227,276.58 $227,276.58 $227,276.58 nat. median
$241,915
0.9× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 3 $140,692.90 $454,787.32 $219,436.22 nat. median
$190,557
1.2× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure, Severe 1 $176,613.07 $176,613.07 $176,613.07 nat. median
$247,214
0.7× median
Q0480
HCPCS 		Dme Pos 1 $104,999.96 $239,999.90 $172,499.93 nat. median
$111,503
1.5× median
1614
APR_DRG 		Implantable Heart Assist Systems, Severe 1 $171,503.41 $171,503.41 $171,503.41 nat. median
$202,993
0.8× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (Ecmo), Severe 1 $160,671.69 $160,671.69 $160,671.69 nat. median
$163,587
1.0× median
100T
OTHER 		Prosth Retina Receive&gen 2 $131,150.43 $292,800.96 $141,062.97 nat. median
$6,463
outlier · 21.8×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 3 $87,797.29 $283,803.19 $136,935.88 nat. median
$126,722
1.1× median
7
MS_DRG 		Lung Transplant 1 $83,101.37 $189,945.98 $136,523.67 nat. median
$117,894
1.2× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 $82,950.29 $189,600.67 $136,275.48 nat. median
$103,967
1.3× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure, Severe 1 $131,411.90 $131,411.90 $131,411.90 nat. median
$154,011
0.9× median
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure, Severe 1 $130,247.36 $130,247.36 $130,247.36 nat. median
$165,000
0.8× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 1 $77,644.34 $177,472.78 $127,558.56 nat. median
$110,192
1.2× median
215
MS_DRG 		Other Heart Assist System Implant 3 $69,202.36 $251,332.15 $121,268.51 nat. median
$93,917
1.3× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 1 $72,968.43 $166,784.98 $119,876.71 nat. median
$97,414
1.2× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 $57,262.60 $246,061.95 $118,725.61 nat. median
$74,460
1.6× median
5832
APR_DRG 		Neonate With Ecmo, Moderate 1 $117,723.56 $117,723.56 $117,723.56 nat. median
$159,249
0.7× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 $65,750.64 $238,975.50 $115,306.38 nat. median
$90,581
1.3× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 1 $70,118.31 $160,270.42 $115,194.37 nat. median
$94,964
1.2× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 3 $60,033.47 $218,711.15 $105,528.77 nat. median
$71,201
1.5× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 1 $63,627.13 $145,433.45 $104,530.29 nat. median
$63,643
1.6× median
2004
APR_DRG 		Cardiac Structural And Valvular Disorders, Severe 1 $103,880.19 $103,880.19 $103,880.19 nat. median
$28,699
outlier · 3.6×
5831
APR_DRG 		Neonate With Ecmo, Minor 1 $103,657.93 $103,657.93 $103,657.93 nat. median
$146,591
0.7× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 3 $54,978.17 $207,473.28 $100,106.47 nat. median
$77,043
1.3× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 $57,106.79 $204,714.40 $98,775.30 nat. median
$77,696
1.3× median
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 1 $60,054.39 $137,267.18 $98,660.79 nat. median
$68,423
1.4× median
73
APR_DRG 		Allogeneic Bone Marrow Transplant, Major 1 $95,776.51 $95,776.51 $95,776.51 nat. median
$89,273
1.1× median
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure, Major 1 $94,764.79 $94,764.79 $94,764.79 nat. median
$175,429
0.5× median
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure, Moderate 1 $94,331.67 $94,331.67 $94,331.67 nat. median
$145,061
0.7× median
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure, Severe 1 $94,087.74 $94,087.74 $94,087.74 nat. median
$122,016
0.8× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft, Severe 1 $93,683.27 $93,683.27 $93,683.27 nat. median
$156,153
0.6× median
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure, Severe 1 $92,747.60 $92,747.60 $92,747.60 nat. median
$133,164
0.7× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 $52,241.19 $191,803.11 $92,545.57 nat. median
$72,473
1.3× median
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 $58,551.16 $189,265.60 $91,321.21 nat. median
$47,579
1.9× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 3 $52,840.07 $188,582.43 $90,991.58 nat. median
$71,758
1.3× median

Other procedures at this hospital

Browse this hospital's 15,259 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
             
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 1 1 — — $3,605,207.34 $3,605,207.34 $3,605,207.34 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 1 1 — — $3,202,901.18 $3,202,901.18 $3,202,901.18 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 1 1 — — $2,237,740.22 $2,237,740.22 $2,237,740.22 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 2 1 — — $496,636.74 $1,135,169.69 $815,903.21 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 2 1 — — $492,869.66 $1,126,559.23 $809,714.45 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 2 1 — — $470,999.74 $1,076,570.83 $773,785.29 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 2 1 — — $460,469.05 $1,052,500.68 $756,484.86 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 2 1 — — $436,745.12 $998,274.55 $717,509.83 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 2 1 — — $436,745.12 $998,274.55 $717,509.83 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 3 — — $249,598.81 $891,462.18 $430,133.12 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 2 1 — — $183,585.31 $419,623.56 $301,604.43 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 2 1 — — $178,572.69 $408,166.15 $293,369.42 2026-04-01
5834 APR_DRG Neonate With Ecmo, Severe 1 1 — — $279,016.83 $279,016.83 $279,016.83 2026-04-01
74 APR_DRG Allogeneic Bone Marrow Transplant, Severe 1 1 — — $271,427.83 $271,427.83 $271,427.83 2026-04-01
5833 APR_DRG Neonate With Ecmo, Major 1 1 — — $236,261.19 $236,261.19 $236,261.19 2026-04-01
24 APR_DRG Heart And/Or Lung Transplant, Severe 1 1 — — $227,276.58 $227,276.58 $227,276.58 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 6 3 — — $140,692.90 $454,787.32 $219,436.22 2026-04-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure, Severe 1 1 — — $176,613.07 $176,613.07 $176,613.07 2026-04-01
Q0480 HCPCS Dme Pos 2 1 — — $104,999.96 $239,999.90 $172,499.93 2026-04-01
1614 APR_DRG Implantable Heart Assist Systems, Severe 1 1 — — $171,503.41 $171,503.41 $171,503.41 2026-04-01
94 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo), Severe 1 1 — — $160,671.69 $160,671.69 $160,671.69 2026-04-01
100T OTHER Prosth Retina Receive&gen 4 2 — — $131,150.43 $292,800.96 $141,062.97 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 6 3 — — $87,797.29 $283,803.19 $136,935.88 2026-04-01
7 MS_DRG Lung Transplant 2 1 — — $83,101.37 $189,945.98 $136,523.67 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 1 — — $82,950.29 $189,600.67 $136,275.48 2026-04-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure, Severe 1 1 — — $131,411.90 $131,411.90 $131,411.90 2026-04-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure, Severe 1 1 — — $130,247.36 $130,247.36 $130,247.36 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 2 1 — — $77,644.34 $177,472.78 $127,558.56 2026-04-01
215 MS_DRG Other Heart Assist System Implant 6 3 — — $69,202.36 $251,332.15 $121,268.51 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 2 1 — — $72,968.43 $166,784.98 $119,876.71 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 6 3 — — $57,262.60 $246,061.95 $118,725.61 2026-04-01
5832 APR_DRG Neonate With Ecmo, Moderate 1 1 — — $117,723.56 $117,723.56 $117,723.56 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 3 — — $65,750.64 $238,975.50 $115,306.38 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 2 1 — — $70,118.31 $160,270.42 $115,194.37 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 6 3 — — $60,033.47 $218,711.15 $105,528.77 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 2 1 — — $63,627.13 $145,433.45 $104,530.29 2026-04-01
2004 APR_DRG Cardiac Structural And Valvular Disorders, Severe 1 1 — — $103,880.19 $103,880.19 $103,880.19 2026-04-01
5831 APR_DRG Neonate With Ecmo, Minor 1 1 — — $103,657.93 $103,657.93 $103,657.93 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 6 3 — — $54,978.17 $207,473.28 $100,106.47 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 6 3 — — $57,106.79 $204,714.40 $98,775.30 2026-04-01
J9029 HCPCS Instill Adstiladrin, Tx Dose 2 1 — — $60,054.39 $137,267.18 $98,660.79 2026-04-01
73 APR_DRG Allogeneic Bone Marrow Transplant, Major 1 1 — — $95,776.51 $95,776.51 $95,776.51 2026-04-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure, Major 1 1 — — $94,764.79 $94,764.79 $94,764.79 2026-04-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure, Moderate 1 1 — — $94,331.67 $94,331.67 $94,331.67 2026-04-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure, Severe 1 1 — — $94,087.74 $94,087.74 $94,087.74 2026-04-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft, Severe 1 1 — — $93,683.27 $93,683.27 $93,683.27 2026-04-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure, Severe 1 1 — — $92,747.60 $92,747.60 $92,747.60 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 6 3 — — $52,241.19 $191,803.11 $92,545.57 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 4 2 — — $58,551.16 $189,265.60 $91,321.21 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 6 3 — — $52,840.07 $188,582.43 $90,991.58 2026-04-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 1 1 — — $90,304.26 $90,304.26 $90,304.26 2026-04-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure, Severe 1 1 — — $89,495.33 $89,495.33 $89,495.33 2026-04-01
1613 APR_DRG Implantable Heart Assist Systems, Major 1 1 — — $89,389.89 $89,389.89 $89,389.89 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 1 — — $54,153.69 $123,779.86 $88,966.77 2026-04-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure, Minor 1 1 — — $88,917.46 $88,917.46 $88,917.46 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 6 3 — — $41,606.24 $179,565.47 $86,640.87 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 4 2 — — $55,370.65 $178,984.66 $86,360.62 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 2 1 — — $51,917.57 $118,668.72 $85,293.14 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 6 3 — — $48,998.13 $176,647.10 $85,232.74 2026-04-01
L7180 HCPCS Dme Pos 2 1 — — $50,271.44 $114,906.14 $82,588.79 2026-04-01
L7181 HCPCS Dme Pos 2 1 — — $49,862.97 $113,972.50 $81,917.74 2026-04-01
14 APR_DRG Liver Transplant And/Or Intestinal Transplant, Severe 1 1 — — $81,414.42 $81,414.42 $81,414.42 2026-04-01
84 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy, Severe 1 1 — — $81,088.21 $81,088.21 $81,088.21 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 6 3 — — $42,315.55 $167,768.21 $80,948.66 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 6 3 — — $46,438.64 $165,754.39 $79,976.99 2026-04-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms, Severe 1 1 — — $79,647.40 $79,647.40 $79,647.40 2026-04-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly, Severe 1 1 — — $79,602.95 $79,602.95 $79,602.95 2026-04-01
93 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo), Major 1 1 — — $78,937.66 $78,937.66 $78,937.66 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 1 — — $47,665.55 $108,949.82 $78,307.68 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 6 3 — — $44,931.95 $160,284.23 $77,337.61 2026-04-01
2464 APR_DRG Gastrointestinal Vascular Insufficiency, Severe 1 1 — — $77,192.68 $77,192.68 $77,192.68 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 2 1 — — $46,879.00 $107,152.01 $77,015.51 2026-04-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition, Seve… 1 1 — — $76,794.46 $76,794.46 $76,794.46 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 4 2 — — $48,344.66 $156,273.26 $75,402.31 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 6 3 — — $41,158.43 $154,628.40 $74,608.66 2026-04-01
64 APR_DRG Pancreas Transplant, Severe 1 1 — — $74,526.72 $74,526.72 $74,526.72 2026-04-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 1 1 — — $74,520.84 $74,520.84 $74,520.84 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 3 — — $43,123.10 $154,333.23 $74,466.24 2026-04-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure, Severe 1 1 — — $74,297.85 $74,297.85 $74,297.85 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 6 3 — — $47,185.22 $153,273.96 $73,955.13 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 6 3 — — $41,259.37 $149,710.50 $72,235.76 2026-04-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 1 1 — — $72,225.92 $72,225.92 $72,225.92 2026-04-01
J9226 HCPCS Supprelin La Implant 2 1 — — $43,316.85 $99,009.94 $71,163.40 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 3 — — $38,593.53 $145,425.78 $70,168.36 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 6 3 — — $39,839.39 $145,302.00 $70,108.64 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 6 3 — — $41,436.19 $145,040.15 $69,982.30 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 6 3 — — $44,785.64 $144,768.79 $69,851.36 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 6 3 — — $37,931.63 $144,066.57 $69,512.54 2026-04-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis, Severe 1 1 — — $69,440.20 $69,440.20 $69,440.20 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 2 1 — — $42,072.33 $96,165.34 $69,118.83 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 2 1 — — $41,847.41 $95,651.23 $68,749.32 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 2 1 — — $41,847.41 $95,651.23 $68,749.32 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 6 3 — — $40,300.07 $141,724.26 $68,382.37 2026-04-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $68,300.64 $68,300.64 $68,300.64 2026-04-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 1 1 — — $67,746.29 $67,746.29 $67,746.29 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 6 3 — — $43,093.39 $139,298.63 $67,211.99 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 6 3 — — $40,825.11 $138,613.07 $66,881.21 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 2 1 — — $40,648.98 $92,911.94 $66,780.46 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 4 2 — — $42,700.89 $138,029.87 $66,599.82 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 6 3 — — $37,296.17 $136,577.83 $65,899.21 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 6 3 — — $42,240.64 $136,542.12 $65,881.98 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 6 3 — — $32,224.62 $135,666.14 $65,459.31 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 6 3 — — $40,964.67 $135,485.23 $65,372.02 2026-04-01
L2006 HCPCS Dme Pos 2 1 — — $39,734.49 $90,821.69 $65,278.09 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 6 3 — — $38,404.51 $135,013.91 $65,144.61 2026-04-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly, Severe 1 1 — — $64,859.18 $64,859.18 $64,859.18 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 4 2 — — $41,369.48 $133,726.11 $64,523.24 2026-04-01
72 APR_DRG Allogeneic Bone Marrow Transplant, Moderate 1 1 — — $64,351.11 $64,351.11 $64,351.11 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 6 3 — — $33,061.97 $133,254.79 $64,295.83 2026-04-01
1612 APR_DRG Implantable Heart Assist Systems, Moderate 1 1 — — $64,257.43 $64,257.43 $64,257.43 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 6 3 — — $40,789.93 $131,852.74 $63,619.33 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 6 3 — — $36,675.60 $129,950.80 $62,701.64 2026-04-01
8634 APR_DRG Neonatal Aftercare, Severe 1 1 — — $62,537.44 $62,537.44 $62,537.44 2026-04-01
245 MS_DRG Aicd Generator Procedures 6 3 — — $30,698.94 $128,965.31 $62,226.15 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 6 3 — — $35,530.68 $128,667.76 $62,082.57 2026-04-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure, Major 1 1 — — $61,936.80 $61,936.80 $61,936.80 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 6 3 — — $38,369.96 $127,834.62 $61,680.58 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 6 3 — — $35,137.74 $127,249.04 $61,398.04 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 6 3 — — $35,214.29 $127,018.14 $61,286.62 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 6 3 — — $34,135.76 $126,882.46 $61,221.16 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 6 3 — — $34,408.78 $126,549.21 $61,060.36 2026-04-01
1611 APR_DRG Implantable Heart Assist Systems, Minor 1 1 — — $60,942.34 $60,942.34 $60,942.34 2026-04-01
4404 APR_DRG Kidney Transplant, Severe 1 1 — — $60,791.72 $60,791.72 $60,791.72 2026-04-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure, Severe 1 1 — — $60,514.00 $60,514.00 $60,514.00 2026-04-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure, Major 1 1 — — $60,493.43 $60,493.43 $60,493.43 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 4 2 — — $38,381.90 $124,068.83 $59,863.57 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 6 3 — — $34,259.06 $123,471.35 $59,575.29 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 6 3 — — $33,566.00 $122,528.71 $59,120.46 2026-04-01
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms, Severe 1 1 — — $58,932.50 $58,932.50 $58,932.50 2026-04-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure, Major 1 1 — — $58,932.50 $58,932.50 $58,932.50 2026-04-01
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition, Seve… 1 1 — — $58,765.35 $58,765.35 $58,765.35 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 2 1 — — $35,646.52 $81,477.77 $58,562.15 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 6 3 — — $37,289.09 $120,536.31 $58,159.13 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 6 3 — — $29,732.87 $120,079.28 $57,938.60 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 6 3 — — $34,932.46 $119,529.41 $57,673.29 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 6 3 — — $33,324.83 $119,488.94 $57,653.76 2026-04-01
4414 APR_DRG Major Bladder Procedures, Severe 1 1 — — $57,531.00 $57,531.00 $57,531.00 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 6 3 — — $30,696.24 $119,200.91 $57,514.79 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 6 3 — — $31,933.30 $119,181.87 $57,505.60 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 6 3 — — $33,868.83 $118,253.51 $57,057.67 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 6 3 — — $30,600.03 $116,311.10 $56,120.45 2026-04-01
23 APR_DRG Heart And/Or Lung Transplant, Major 1 1 — — $55,978.16 $55,978.16 $55,978.16 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 6 3 — — $32,564.70 $114,640.06 $55,314.17 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 6 3 — — $31,201.63 $113,814.07 $54,915.62 2026-04-01
83 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy, Major 1 1 — — $54,809.57 $54,809.57 $54,809.57 2026-04-01
1784 APR_DRG External Heart Assist Systems, Severe 1 1 — — $53,884.18 $53,884.18 $53,884.18 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 2 1 — — $32,768.62 $74,899.70 $53,834.16 2026-04-01
10 MS_DRG Pancreas Transplant 2 1 — — $32,610.77 $74,538.91 $53,574.84 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 6 3 — — $30,001.15 $111,019.48 $53,567.22 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 6 3 — — $23,553.65 $115,278.01 $53,316.57 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 2 1 — — $32,399.40 $74,055.77 $53,227.59 2026-04-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure, Major 1 1 — — $53,064.96 $53,064.96 $53,064.96 2026-04-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly, Severe 1 1 — — $53,003.98 $53,003.98 $53,003.98 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 6 3 — — $32,114.86 $109,843.56 $52,999.84 2026-04-01
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures, Severe 1 1 — — $52,769.60 $52,769.60 $52,769.60 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 6 3 — — $31,492.94 $109,019.94 $52,602.44 2026-04-01
6904 APR_DRG Acute Leukemia, Severe 1 1 — — $52,295.70 $52,295.70 $52,295.70 2026-04-01
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies, S… 1 1 — — $51,975.36 $51,975.36 $51,975.36 2026-04-01
92 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo), Moderate 1 1 — — $51,916.95 $51,916.95 $51,916.95 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 6 3 — — $30,499.09 $107,160.85 $51,705.42 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 6 3 — — $29,917.15 $107,056.11 $51,654.89 2026-04-01
91 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo), Minor 1 1 — — $50,349.04 $50,349.04 $50,349.04 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 6 3 — — $27,888.80 $104,063.95 $50,211.16 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 2 1 — — $30,469.28 $69,644.06 $50,056.67 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 2 1 — — $30,217.94 $69,069.58 $49,643.76 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 6 3 — — $29,550.63 $102,783.29 $49,593.24 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 6 3 — — $28,173.33 $102,716.64 $49,561.08 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 6 3 — — $28,986.97 $102,542.87 $49,477.24 2026-04-01
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly, Severe 1 1 — — $49,290.67 $49,290.67 $49,290.67 2026-04-01
L5856 HCPCS Dme Pos 2 1 — — $29,874.25 $68,284.01 $49,079.13 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 6 3 — — $29,319.61 $101,612.13 $49,028.15 2026-04-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back, Severe 1 1 — — $48,990.16 $48,990.16 $48,990.16 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 6 3 — — $26,334.67 $101,421.70 $48,936.27 2026-04-01
L6880 HCPCS Dme Pos 2 1 — — $29,733.15 $67,961.50 $48,847.32 2026-04-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure, Moderate 1 1 — — $48,658.07 $48,658.07 $48,658.07 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 6 3 — — $27,402.36 $100,112.48 $48,304.57 2026-04-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $48,181.96 $48,181.96 $48,181.96 2026-04-01
63 APR_DRG Pancreas Transplant, Major 1 1 — — $48,162.13 $48,162.13 $48,162.13 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 6 3 — — $26,495.24 $99,641.16 $48,077.15 2026-04-01
332 MS_DRG Rectal Resection With Mcc 6 3 — — $24,575.95 $99,060.35 $47,796.90 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 6 3 — — $27,377.98 $97,524.99 $47,056.09 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 2 1 — — $28,516.81 $65,181.29 $46,849.05 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 6 3 — — $29,150.25 $97,027.48 $46,816.04 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 2 1 — — $28,047.33 $64,108.18 $46,077.76 2026-04-01
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures, Severe 1 1 — — $45,913.12 $45,913.12 $45,913.12 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 6 3 — — $26,430.87 $94,694.69 $45,690.47 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 6 3 — — $25,595.56 $94,689.93 $45,688.18 2026-04-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection, Sev… 1 1 — — $45,662.95 $45,662.95 $45,662.95 2026-04-01
791 MS_DRG Prematurity With Major Problems 2 1 — — $27,760.75 $63,453.14 $45,606.94 2026-04-01
4474 APR_DRG Other Kidney, Urinary Tract And Related Procedures, Severe 1 1 — — $45,556.05 $45,556.05 $45,556.05 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 6 3 — — $26,812.30 $94,411.42 $45,553.79 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 6 3 — — $25,198.55 $93,982.95 $45,347.06 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 6 3 — — $25,668.04 $93,763.96 $45,241.39 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 6 3 — — $24,781.23 $93,566.38 $45,146.06 2026-04-01
22 APR_DRG Heart And/Or Lung Transplant, Moderate 1 1 — — $44,969.00 $44,969.00 $44,969.00 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 6 3 — — $24,219.60 $93,156.95 $44,948.51 2026-04-01
234 APR_DRG Spinal Procedures, Severe 1 1 — — $44,881.20 $44,881.20 $44,881.20 2026-04-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma, Severe 1 1 — — $44,718.82 $44,718.82 $44,718.82 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 6 3 — — $26,086.04 $91,997.70 $44,389.16 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 6 3 — — $26,273.70 $91,645.40 $44,219.18 2026-04-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $44,142.43 $44,142.43 $44,142.43 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 6 3 — — $27,132.06 $91,235.97 $44,021.62 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 6 3 — — $26,401.06 $91,090.77 $43,951.56 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 6 3 — — $24,499.41 $91,026.50 $43,920.56 2026-04-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure, Major 1 1 — — $43,592.12 $43,592.12 $43,592.12 2026-04-01
62 APR_DRG Pancreas Transplant, Moderate 1 1 — — $43,562.00 $43,562.00 $43,562.00 2026-04-01
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis, Severe 1 1 — — $43,391.17 $43,391.17 $43,391.17 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 6 3 — — $24,638.96 $89,512.56 $43,190.07 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 6 3 — — $25,216.84 $89,334.03 $43,103.93 2026-04-01
38240 CPT Transplt Allo Hct/donor 6 3 — — $32,194.86 $115,646.88 $43,079.80 2026-04-01
61 APR_DRG Pancreas Transplant, Minor 1 1 — — $42,999.56 $42,999.56 $42,999.56 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 6 3 — — $23,407.32 $88,731.79 $42,813.35 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 6 3 — — $22,059.83 $88,717.51 $42,806.46 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 6 3 — — $27,419.85 $88,634.19 $42,766.26 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 6 3 — — $19,514.57 $89,348.31 $42,762.69 2026-04-01
33276 CPT Insj Phrnc Nrv Stim Sys 7 3 — — $32,454.62 $99,952.94 $42,750.48 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 6 3 — — $22,968.32 $88,353.31 $42,630.73 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 6 3 — — $27,095.10 $87,584.44 $42,259.75 2026-04-01
71 APR_DRG Allogeneic Bone Marrow Transplant, Minor 1 1 — — $42,255.28 $42,255.28 $42,255.28 2026-04-01
13 APR_DRG Liver Transplant And/Or Intestinal Transplant, Major 1 1 — — $41,946.70 $41,946.70 $41,946.70 2026-04-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure, Major 1 1 — — $41,897.10 $41,897.10 $41,897.10 2026-04-01
264 APR_DRG Other Nervous System And Related Procedures, Severe 1 1 — — $41,871.76 $41,871.76 $41,871.76 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 6 3 — — $24,261.62 $86,691.79 $41,829.04 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 6 3 — — $24,542.76 $86,596.57 $41,783.10 2026-04-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure, Moderate 1 1 — — $41,691.01 $41,691.01 $41,691.01 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 6 3 — — $23,882.23 $86,368.05 $41,672.84 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 2 1 — — $25,279.85 $57,782.52 $41,531.18 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 6 3 — — $25,917.35 $86,049.08 $41,518.93 2026-04-01
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back, Major 1 1 — — $41,443.78 $41,443.78 $41,443.78 2026-04-01
1824 APR_DRG Other Peripheral Vascular And Related Procedures, Severe 1 1 — — $41,410.35 $41,410.35 $41,410.35 2026-04-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis, Severe 1 1 — — $41,385.73 $41,385.73 $41,385.73 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 6 3 — — $24,739.91 $85,382.57 $41,197.34 2026-04-01
J9266 HCPCS Pegaspargase Injection 2 1 — — $25,053.23 $57,264.53 $41,158.88 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 6 3 — — $23,618.69 $85,158.81 $41,089.38 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 6 3 — — $22,459.54 $84,916.01 $40,972.22 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 6 3 — — $23,414.77 $84,870.78 $40,950.40 2026-04-01
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment, Severe 1 1 — — $40,708.31 $40,708.31 $40,708.31 2026-04-01
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back, Severe 1 1 — — $40,698.40 $40,698.40 $40,698.40 2026-04-01
2054 APR_DRG Cardiomyopathy, Severe 1 1 — — $40,583.41 $40,583.41 $40,583.41 2026-04-01
6954 APR_DRG Chemotherapy For Acute Leukemia, Severe 1 1 — — $40,531.25 $40,531.25 $40,531.25 2026-04-01
8413 APR_DRG Extensive Third Degree Burns With Skin Graft, Major 1 1 — — $40,489.73 $40,489.73 $40,489.73 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 6 3 — — $21,684.51 $83,706.77 $40,388.76 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 6 3 — — $23,454.74 $82,599.88 $39,854.68 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 6 3 — — $25,052.90 $82,559.41 $39,835.16 2026-04-01
823T OTHER Tcat Ins 1chmbr Ldls Pm Ra 6 3 — — $18,040.95 $71,847.90 $39,822.68 2026-04-01
825T OTHER Tcat Rmv&rpl1chmb Ldls Pm Ra 6 3 — — $18,040.95 $71,847.90 $39,822.68 2026-04-01
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure, Moderate 1 1 — — $39,809.38 $39,809.38 $39,809.38 2026-04-01
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs, Severe 1 1 — — $39,676.02 $39,676.02 $39,676.02 2026-04-01
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure, Moderate 1 1 — — $39,552.22 $39,552.22 $39,552.22 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 6 3 — — $21,540.89 $81,914.32 $39,523.90 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 6 3 — — $22,315.91 $81,162.12 $39,160.96 2026-04-01
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition… 1 1 — — $39,136.73 $39,136.73 $39,136.73 2026-04-01
L8614 HCPCS Dme Pos 2 1 — — $23,820.68 $54,447.26 $39,133.97 2026-04-01
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis, Major 1 1 — — $39,070.24 $39,070.24 $39,070.24 2026-04-01
L6975 HCPCS Dme Pos 2 1 — — $23,765.67 $54,321.53 $39,043.60 2026-04-01
214 APR_DRG Open Craniotomy Except Trauma, Severe 1 1 — — $38,977.66 $38,977.66 $38,977.66 2026-04-01
2304 APR_DRG Major Small Bowel Procedures, Severe 1 1 — — $38,836.96 $38,836.96 $38,836.96 2026-04-01
L6970 HCPCS Dme Pos 2 1 — — $23,638.80 $54,031.54 $38,835.17 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 6 3 — — $21,782.74 $80,328.98 $38,758.97 2026-04-01
224 APR_DRG Ventricular Shunt Procedures, Severe 1 1 — — $38,683.77 $38,683.77 $38,683.77 2026-04-01
265 MS_DRG Aicd Lead Procedures 6 3 — — $23,942.52 $80,112.36 $38,654.45 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 6 3 — — $22,824.02 $79,955.26 $38,578.65 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 2 1 — — $23,429.68 $53,553.55 $38,491.62 2026-04-01
4424 APR_DRG Kidney And Urinary Tract Procedures For Malignancy, Severe 1 1 — — $38,471.80 $38,471.80 $38,471.80 2026-04-01
Q0483 HCPCS Dme Pos 2 1 — — $23,332.90 $53,332.34 $38,332.62 2026-04-01
9524 APR_DRG Non-extensive O.r. Procedure Unrelated To Principal Diagnosis, Severe 1 1 — — $38,235.59 $38,235.59 $38,235.59 2026-04-01
L6965 HCPCS Dme Pos 2 1 — — $23,256.64 $53,158.03 $38,207.33 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 6 3 — — $22,721.04 $79,164.96 $38,197.32 2026-04-01
L5858 HCPCS Dme Pos 2 1 — — $23,128.50 $52,865.14 $37,996.82 2026-04-01
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma, Seve… 1 1 — — $37,886.23 $37,886.23 $37,886.23 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 6 3 — — $23,225.08 $78,477.03 $37,865.40 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 6 3 — — $21,955.50 $78,234.23 $37,748.25 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 6 3 — — $21,256.35 $78,196.14 $37,729.87 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 6 3 — — $22,868.73 $78,019.99 $37,644.88 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 6 3 — — $22,876.18 $77,979.52 $37,625.35 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 6 3 — — $22,126.22 $77,448.69 $37,369.22 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 6 3 — — $23,073.33 $77,279.69 $37,287.68 2026-04-01
4403 APR_DRG Kidney Transplant, Major 1 1 — — $37,207.34 $37,207.34 $37,207.34 2026-04-01
3154 APR_DRG Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement, Severe 1 1 — — $37,204.77 $37,204.77 $37,204.77 2026-04-01
1694 APR_DRG Major Abdominal Vascular Procedures, Severe 1 1 — — $37,078.39 $37,078.39 $37,078.39 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 6 3 — — $21,172.34 $76,660.78 $36,989.05 2026-04-01
1204 APR_DRG Major Respiratory And Chest Procedures, Severe 1 1 — — $36,927.77 $36,927.77 $36,927.77 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 6 3 — — $21,366.09 $76,372.75 $36,850.08 2026-04-01
4834 APR_DRG Penis, Testes And Scrotal Procedures, Severe 1 1 — — $36,787.44 $36,787.44 $36,787.44 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 6 3 — — $21,969.05 $75,922.86 $36,633.01 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 2 1 — — $22,183.36 $50,704.82 $36,444.09 2026-04-01
793T OTHER Prq Tcat Thrm Ablt Nrv P-art 6 3 — — $16,235.39 $66,477.31 $36,419.44 2026-04-01
894 APR_DRG Major Cranial Or Facial Bone Procedures, Severe 1 1 — — $36,392.89 $36,392.89 $36,392.89 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 6 3 — — $18,350.00 $75,413.45 $36,387.21 2026-04-01
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma, Severe 1 1 — — $36,344.77 $36,344.77 $36,344.77 2026-04-01
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours, Severe 1 1 — — $36,335.58 $36,335.58 $36,335.58 2026-04-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 4 2 — — $23,286.44 $75,273.01 $36,319.44 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 6 3 — — $22,642.45 $74,861.20 $36,120.75 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 6 3 — — $19,282.87 $74,777.89 $36,080.55 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 6 3 — — $21,418.27 $74,758.84 $36,071.36 2026-04-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 4 2 — — $23,007.35 $74,370.84 $35,884.15 2026-04-01
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis, Severe 1 1 — — $35,794.46 $35,794.46 $35,794.46 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 2 1 — — $21,784.10 $49,792.22 $35,788.16 2026-04-01
266T OTHER Implt/rpl Crtd Sns Dev Total 6 3 — — $25,042.12 $99,952.94 $35,696.11 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 2 1 — — $21,683.15 $49,561.49 $35,622.32 2026-04-01
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