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

METHODIST HOSPITAL STONE OAK

San Antonio, TX · CCN 670055 · Rates published

33,629 distinct procedures filed
57 distinct payers
1,778,682 rate rows
2025-01-01 last MRF observed · ⚠ 17 mo old
Data quality

862,837 of 1,778,682 rate rows are consumer-grade (48.5%)

915,845 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 878,844
per-diem day rate — not a per-procedure price 30,226
template filing: same amount across many unrelated codes — excluded 6,503
placeholder amount (≤ $0.02) — excluded from medians 240
exceeds 10× this hospital's gross charge — excluded from medians 32

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 17 months old.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://www.hcadam.com/api/public/content/e131399d17f645799531eb7f1f536aa2?download=true
Found on page https://sahealth.com/about/legal/pricing-transparency-cms-required-file-of-standard-charges.dot
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 015288a626f49185… · 908,263,007 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
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $4,897,200.00 $4,897,200.00 $4,897,200.00 nat. median
$3,004,655
1.6× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 $3,884,946.48 $3,884,946.48 $3,884,946.48 nat. median
$2,468,984
1.6× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 20 $3,379,068.00 $4,003,461.00 $3,672,900.00 nat. median
$3,746,358
1.0× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 2 $3,562,713.00 $3,672,900.00 $3,617,806.50 nat. median
$3,574,709
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 20 $3,316,600.00 $3,929,450.00 $3,605,000.00 nat. median
$3,605,000
1.0× median
00773
OTHER 		Inj, Beqvez, Per Tx Dose 2 $3,496,850.00 $3,605,000.00 $3,550,925.00 nat. median
$3,496,850
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 23 $5,050.58 $4,655,637.00 $3,325,455.00 nat. median
$13,041
outlier · 255.0×
748
OTHER 		Inj, Lovotibeglogene Auto 23 $8,330.92 $4,600,400.00 $3,286,000.00 nat. median
$17,963
outlier · 182.9×
00714
OTHER 		Inj Delandistrogene Mox R 2 $3,225,691.35 $3,325,455.00 $3,275,573.17 nat. median
$3,228,024
1.0× median
00748
OTHER 		Inj, Lovotibeglogene Auto 2 $3,187,420.00 $3,286,000.00 $3,236,710.00 nat. median
$3,187,420
1.0× median
746
OTHER 		Inj, Betibeglogene Autote 23 $7,399.52 $4,600,400.00 $2,968,000.00 nat. median
$21,896
outlier · 135.6×
00746
OTHER 		Inj, Betibeglogene Autote 2 $2,878,960.00 $2,968,000.00 $2,923,480.00 nat. median
$2,878,960
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 22 $2,197,524.88 $3,702,351.70 $2,400,557.07 nat. median
$2,588,981
0.9× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 2 $2,316,955.58 $2,388,614.00 $2,352,784.79 nat. median
$2,457,321
1.0× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 4 $492,271.12 $2,663,055.00 $1,653,409.80 nat. median
$674,867
outlier · 2.4×
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 4 $470,149.30 $2,402,476.50 $1,491,624.54 nat. median
$625,184
outlier · 2.4×
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 4 $459,839.17 $2,349,788.10 $1,458,911.92 nat. median
$673,137
outlier · 2.2×
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 4 $435,956.80 $2,136,171.00 $1,326,283.56 nat. median
$619,808
outlier · 2.1×
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 4 $25.48 $2,209,092.50 $863,696.72 nat. median
$753,246
1.1× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 4 $6.70 $2,037,512.50 $807,075.90 nat. median
$634,303
1.3× median
9194
OTHER 		Tisagenlecleucel Car-pos 23 $486,857.47 $1,148,348.59 $535,437.38 nat. median
$566,531
0.9× median
9498
OTHER 		Ciltacabtagene Car-pos T 23 $484,953.53 $1,143,857.78 $533,343.46 nat. median
$587,650
0.9× median
9422
OTHER 		Idecabtagene Vicleucel Ca 23 $484,460.59 $1,142,695.09 $532,801.33 nat. median
$558,082
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 23 $475,388.01 $1,121,295.64 $522,823.47 nat. median
$562,201
0.9× median
09194
OTHER 		Tisagenlecleucel Car-pos 2 $513,317.11 $529,192.90 $521,255.01 nat. median
$538,205
1.0× median
09498
OTHER 		Ciltacabtagene Car-pos T 2 $511,309.70 $527,123.40 $519,216.55 nat. median
$554,552
0.9× median
09422
OTHER 		Idecabtagene Vicleucel Ca 2 $510,789.97 $526,587.60 $518,688.78 nat. median
$530,178
1.0× median
09413
OTHER 		Lisocabtagene Car Pos T 2 $501,224.32 $516,726.10 $508,975.21 nat. median
$534,091
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 23 $450,299.52 $1,062,119.52 $495,231.58 nat. median
$532,192
0.9× median
09035
OTHER 		Axicabtagene Ciloleucel C 2 $474,772.32 $489,456.00 $482,114.16 nat. median
$505,583
1.0× median
9391
OTHER 		Brexucabtagene Car Pos T 23 $423,687.97 $999,350.97 $465,964.66 nat. median
$489,450
1.0× median
09391
OTHER 		Brexucabtagene Car Pos T 2 $446,714.49 $460,530.40 $453,622.45 nat. median
$464,978
1.0× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 7 $253,775.00 $444,107.00 $296,917.00 nat. median
$187,061
1.6× median
5834
APR_DRG 		Neonate With Ecmo 7 $260,870.00 $326,087.50 $273,913.50 nat. median
$309,665
0.9× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 24 $3,938.00 $516,177.22 $271,829.37 nat. median
$370,174
0.7× median
24
APR_DRG 		Heart And/or Lung Transplant 7 $212,495.00 $371,867.00 $248,620.00 nat. median
$234,729
1.1× median
5833
APR_DRG 		Neonate With Ecmo 7 $220,895.00 $276,118.75 $231,939.75 nat. median
$244,017
1.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 28 $137,695.00 $385,541.68 $203,169.03 nat. median
$265,286
0.8× median
A9543
HCPCS 		Y90 Ibritum Tiu Tx 40mci 4 $99,549.12 $436,090.33 $202,598.68 nat. median
$62,507
outlier · 3.2×
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 2 $171,193.85 $176,488.50 $173,841.17 nat. median
$263,894
0.7× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 7 $165,126.00 $206,407.50 $173,382.30 nat. median
$246,434
0.7× median
1614
APR_DRG 		Implantable Heart Assist Systems 8 $160,349.00 $200,436.25 $173,177.52 nat. median
$207,730
0.8× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 28 $3,938.00 $342,628.40 $169,585.50 nat. median
$206,474
0.8× median
Q2043
HCPCS 		Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 5 $53,789.99 $350,107.09 $168,084.10 nat. median
$66,682
outlier · 2.5×
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 7 $150,222.00 $187,777.50 $157,733.10 nat. median
$164,834
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 30 $3,938.00 $411,167.00 $154,707.11 nat. median
$202,976
0.8× median
018
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $141,260.13 $145,629.00 $143,444.57 nat. median
$424,868
outlier · 0.3×
1908
OTHER 		New Technology - Level 52 23 $129,845.30 $306,265.55 $142,801.60 nat. median
$152,962
0.9× median
1907
OTHER 		New Technology - Level 52 23 $129,845.30 $306,265.55 $142,801.60 nat. median
$153,199
0.9× median
J7330
HCPCS 		Autologous Cultured Chondrocytes, Implant 4 $97,767.71 $257,170.92 $141,834.98 nat. median
$76,329
1.9× median

Other procedures at this hospital

Browse this hospital's 33,629 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
             
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 4 1 — — $4,897,200.00 $4,897,200.00 $4,897,200.00 2025-01-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 4 1 — — $3,884,946.48 $3,884,946.48 $3,884,946.48 2025-01-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 41 20 — — $3,379,068.00 $4,003,461.00 $3,672,900.00 2025-01-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 2 2 — — $3,562,713.00 $3,672,900.00 $3,617,806.50 2025-01-01
773 OTHER Inj, Beqvez, Per Tx Dose 41 20 — — $3,316,600.00 $3,929,450.00 $3,605,000.00 2025-01-01
00773 OTHER Inj, Beqvez, Per Tx Dose 2 2 — — $3,496,850.00 $3,605,000.00 $3,550,925.00 2025-01-01
714 OTHER Inj Delandistrogene Mox R 45 23 — — $5,050.58 $4,655,637.00 $3,325,455.00 2025-01-01
748 OTHER Inj, Lovotibeglogene Auto 45 23 — — $8,330.92 $4,600,400.00 $3,286,000.00 2025-01-01
00714 OTHER Inj Delandistrogene Mox R 2 2 — — $3,225,691.35 $3,325,455.00 $3,275,573.17 2025-01-01
00748 OTHER Inj, Lovotibeglogene Auto 2 2 — — $3,187,420.00 $3,286,000.00 $3,236,710.00 2025-01-01
746 OTHER Inj, Betibeglogene Autote 47 23 — — $7,399.52 $4,600,400.00 $2,968,000.00 2025-01-01
00746 OTHER Inj, Betibeglogene Autote 2 2 — — $2,878,960.00 $2,968,000.00 $2,923,480.00 2025-01-01
9141 OTHER Inj Onase Abepar-xioi Tre 45 22 — — $2,197,524.88 $3,702,351.70 $2,400,557.07 2025-01-01
09141 OTHER Inj Onase Abepar-xioi Tre 2 2 — — $2,316,955.58 $2,388,614.00 $2,352,784.79 2025-01-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 13 4 — — $492,271.12 $2,663,055.00 $1,653,409.80 2025-01-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 13 4 — — $470,149.30 $2,402,476.50 $1,491,624.54 2025-01-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 13 4 — — $459,839.17 $2,349,788.10 $1,458,911.92 2025-01-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 13 4 — — $435,956.80 $2,136,171.00 $1,326,283.56 2025-01-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 15 4 — — $25.48 $2,209,092.50 $863,696.72 2025-01-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 15 4 — — $6.70 $2,037,512.50 $807,075.90 2025-01-01
9194 OTHER Tisagenlecleucel Car-pos 46 23 — — $486,857.47 $1,148,348.59 $535,437.38 2025-01-01
9498 OTHER Ciltacabtagene Car-pos T 46 23 — — $484,953.53 $1,143,857.78 $533,343.46 2025-01-01
9422 OTHER Idecabtagene Vicleucel Ca 46 23 — — $484,460.59 $1,142,695.09 $532,801.33 2025-01-01
9413 OTHER Lisocabtagene Car Pos T 46 23 — — $475,388.01 $1,121,295.64 $522,823.47 2025-01-01
09194 OTHER Tisagenlecleucel Car-pos 2 2 — — $513,317.11 $529,192.90 $521,255.01 2025-01-01
09498 OTHER Ciltacabtagene Car-pos T 2 2 — — $511,309.70 $527,123.40 $519,216.55 2025-01-01
09422 OTHER Idecabtagene Vicleucel Ca 2 2 — — $510,789.97 $526,587.60 $518,688.78 2025-01-01
09413 OTHER Lisocabtagene Car Pos T 2 2 — — $501,224.32 $516,726.10 $508,975.21 2025-01-01
9035 OTHER Axicabtagene Ciloleucel C 46 23 — — $450,299.52 $1,062,119.52 $495,231.58 2025-01-01
09035 OTHER Axicabtagene Ciloleucel C 2 2 — — $474,772.32 $489,456.00 $482,114.16 2025-01-01
9391 OTHER Brexucabtagene Car Pos T 46 23 — — $423,687.97 $999,350.97 $465,964.66 2025-01-01
09391 OTHER Brexucabtagene Car Pos T 2 2 — — $446,714.49 $460,530.40 $453,622.45 2025-01-01
74 APR_DRG Allogeneic Bone Marrow Transplant 20 7 — — $253,775.00 $444,107.00 $296,917.00 2025-01-01
5834 APR_DRG Neonate With Ecmo 20 7 — — $260,870.00 $326,087.50 $273,913.50 2025-01-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 52 24 — — $3,938.00 $516,177.22 $271,829.37 2025-01-01
24 APR_DRG Heart And/or Lung Transplant 20 7 — — $212,495.00 $371,867.00 $248,620.00 2025-01-01
5833 APR_DRG Neonate With Ecmo 20 7 — — $220,895.00 $276,118.75 $231,939.75 2025-01-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 65 28 — — $137,695.00 $385,541.68 $203,169.03 2025-01-01
A9543 HCPCS Y90 Ibritum Tiu Tx 40mci 16 4 $218,286.62 $218,286.62 $99,549.12 $436,090.33 $202,598.68 2025-01-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 2 2 — — $171,193.85 $176,488.50 $173,841.17 2025-01-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 20 7 — — $165,126.00 $206,407.50 $173,382.30 2025-01-01
1614 APR_DRG Implantable Heart Assist Systems 25 8 — — $160,349.00 $200,436.25 $173,177.52 2025-01-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 63 28 — — $3,938.00 $342,628.40 $169,585.50 2025-01-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 18 5 — — $53,789.99 $350,107.09 $168,084.10 2025-01-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 20 7 — — $150,222.00 $187,777.50 $157,733.10 2025-01-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 72 30 — — $3,938.00 $411,167.00 $154,707.11 2025-01-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $141,260.13 $145,629.00 $143,444.57 2025-01-01
1908 OTHER New Technology - Level 52 46 23 — — $129,845.30 $306,265.55 $142,801.60 2025-01-01
1907 OTHER New Technology - Level 52 46 23 — — $129,845.30 $306,265.55 $142,801.60 2025-01-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 16 4 — — $97,767.71 $257,170.92 $141,834.98 2025-01-01
01907 OTHER New Technology - Level 52 2 2 — — $136,902.11 $141,136.20 $139,019.15 2025-01-01
01908 OTHER New Technology - Level 52 2 2 — — $136,902.11 $141,136.20 $139,019.15 2025-01-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 16 5 — — $61,600.24 $920,000.00 $131,376.00 2025-01-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 20 7 — — $122,865.00 $153,581.25 $129,008.25 2025-01-01
1905 OTHER New Technology - Level 51 46 23 — — $117,073.68 $276,141.18 $128,755.60 2025-01-01
1906 OTHER New Technology - Level 51 46 23 — — $117,073.68 $276,141.18 $128,755.60 2025-01-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 20 7 — — $121,776.00 $152,220.00 $127,864.80 2025-01-01
01905 OTHER New Technology - Level 51 2 2 — — $123,436.38 $127,254.00 $125,345.19 2025-01-01
01906 OTHER New Technology - Level 51 2 2 — — $123,436.38 $127,254.00 $125,345.19 2025-01-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 2 — — $114,665.64 $118,212.00 $116,438.82 2025-01-01
5832 APR_DRG Neonate With Ecmo 20 7 — — $110,067.00 $137,583.75 $115,570.35 2025-01-01
1903 OTHER New Technology - Level 50 46 23 — — $104,302.06 $246,016.81 $114,709.59 2025-01-01
1904 OTHER New Technology - Level 50 46 23 — — $104,302.06 $246,016.81 $114,709.59 2025-01-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 18 5 — — $43,241.44 $245,072.58 $112,846.32 2025-01-01
01903 OTHER New Technology - Level 50 2 2 — — $109,970.65 $113,371.80 $111,671.23 2025-01-01
01904 OTHER New Technology - Level 50 2 2 — — $109,970.65 $113,371.80 $111,671.23 2025-01-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 20 7 — — $104,516.00 $130,645.00 $109,741.80 2025-01-01
L5969 HCPCS Addition, Endoskeletal Ankle-foot Or Ankle System, Power Assist, Includes Any Ty… 2 1 — — $106,097.82 $106,097.82 $106,097.82 2025-01-01
73 APR_DRG Allogeneic Bone Marrow Transplant 20 7 — — $89,547.00 $156,708.00 $104,771.00 2025-01-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 72 30 — — $3,938.00 $204,066.59 $102,181.24 2025-01-01
2004 APR_DRG Cardiac Structural And Valvular Disorders 20 7 — — $97,124.00 $121,405.00 $101,980.20 2025-01-01
5831 APR_DRG Neonate With Ecmo 20 7 — — $96,916.00 $121,145.00 $101,761.80 2025-01-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 50 24 — — $92,000.00 $677,827.66 $101,180.00 2025-01-01
1902 OTHER New Technology - Level 49 46 23 — — $91,530.40 $215,892.35 $100,663.54 2025-01-01
1901 OTHER New Technology - Level 49 46 23 — — $91,530.40 $215,892.35 $100,663.54 2025-01-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 21 5 — — $37,032.96 $161,968.67 $99,500.82 2025-01-01
01902 OTHER New Technology - Level 49 2 2 — — $96,504.87 $99,489.56 $97,997.21 2025-01-01
01901 OTHER New Technology - Level 49 2 2 — — $96,504.87 $99,489.56 $97,997.21 2025-01-01
14 MS_DRG Allogeneic Bone Marrow Transplant 56 26 — — $81,818.37 $179,325.12 $94,784.12 2025-01-01
7 MS_DRG Lung Transplant 57 27 — — $3,938.00 $183,904.56 $94,546.72 2025-01-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 20 7 — — $88,601.00 $110,751.25 $93,031.05 2025-01-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 51 24 — — $83,749.35 $197,539.22 $92,725.09 2025-01-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 20 7 — — $88,196.00 $110,245.00 $92,605.80 2025-01-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 20 7 — — $87,968.00 $109,960.00 $92,366.40 2025-01-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 20 7 — — $87,590.00 $109,487.50 $91,969.50 2025-01-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 20 7 — — $86,715.00 $108,393.75 $91,050.75 2025-01-01
1613 APR_DRG Implantable Heart Assist Systems 25 8 — — $83,576.00 $104,470.00 $90,262.46 2025-01-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 20 7 — — $76,119.00 $133,209.00 $89,059.90 2025-01-01
1599 OTHER New Technology - Level 48 46 23 — — $80,887.38 $190,788.70 $88,958.53 2025-01-01
1585 OTHER New Technology - Level 48 46 23 — — $80,887.38 $190,788.70 $88,958.53 2025-01-01
84 APR_DRG Autologous Bone Marrow Transplant 20 7 — — $75,814.00 $132,676.00 $88,703.10 2025-01-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 20 7 — — $84,431.00 $105,538.75 $88,652.55 2025-01-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 20 7 — — $83,674.00 $104,592.50 $87,857.70 2025-01-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 20 7 — — $83,134.00 $103,917.50 $87,290.70 2025-01-01
01585 OTHER New Technology - Level 48 2 2 — — $85,283.43 $87,921.06 $86,602.24 2025-01-01
01599 OTHER New Technology - Level 48 2 2 — — $85,283.43 $87,921.06 $86,602.24 2025-01-01
90288 CPT Botulism Immune Globulin, Human, For Intravenous Use 3 1 — — $76,953.90 $104,228.70 $86,207.85 2025-01-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 2 — — $80,624.20 $83,117.73 $81,870.96 2025-01-01
64 APR_DRG Pancreas Transplant 20 7 — — $69,679.00 $121,940.00 $81,525.40 2025-01-01
215 MS_DRG Other Heart Assist System Implant 85 33 — — $3,938.00 $317,917.00 $81,094.68 2025-01-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 25 8 — — $74,425.00 $93,031.25 $80,379.99 2025-01-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 65 28 — — $68,893.86 $317,894.00 $79,811.47 2025-01-01
1598 OTHER New Technology - Level 47 46 23 — — $72,372.97 $170,705.81 $79,594.53 2025-01-01
1584 OTHER New Technology - Level 47 46 23 — — $72,372.97 $170,705.81 $79,594.53 2025-01-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 7 1 — — $66,521.12 $104,476.75 $79,209.75 2025-01-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 70 32 — — $3,938.00 $157,329.04 $78,900.68 2025-01-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 20 7 — — $74,467.00 $93,083.75 $78,190.35 2025-01-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 20 7 — — $73,803.00 $92,253.75 $77,493.15 2025-01-01
01598 OTHER New Technology - Level 47 2 2 — — $76,306.28 $78,666.27 $77,486.27 2025-01-01
01584 OTHER New Technology - Level 47 2 2 — — $76,306.28 $78,666.27 $77,486.27 2025-01-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 60 26 — — $66,589.28 $145,758.04 $77,141.68 2025-01-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 4 1 — — $76,785.37 $76,785.37 $76,785.37 2025-01-01
014 OTHER Allogeneic Bone Marrow Transplant 2 2 — — $74,913.74 $77,230.66 $76,072.20 2025-01-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 69 31 — — $3,938.00 $182,164.00 $75,940.24 2025-01-01
2464 APR_DRG Gastrointestinal Vascular Insufficiency 20 7 — — $72,172.00 $90,215.00 $75,780.60 2025-01-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 20 7 — — $71,800.00 $89,750.00 $75,390.00 2025-01-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 2 2 — — $72,955.04 $75,211.38 $74,083.21 2025-01-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 90 34 — — $41,756.00 $176,731.84 $73,695.21 2025-01-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 20 7 — — $69,674.00 $87,092.50 $73,157.70 2025-01-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 20 7 — — $69,465.00 $86,831.25 $72,938.25 2025-01-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 20 7 — — $67,528.00 $84,410.00 $70,904.40 2025-01-01
72 APR_DRG Allogeneic Bone Marrow Transplant 20 7 — — $60,165.00 $105,290.00 $70,394.20 2025-01-01
J9266 HCPCS Pegaspargase Singl Vial 23 6 $144,077.09 $144,077.09 $25,008.06 $115,694.02 $70,351.04 2025-01-01
1597 OTHER New Technology - Level 46 46 23 — — $63,858.54 $150,622.87 $70,230.51 2025-01-01
1583 OTHER New Technology - Level 46 46 23 — — $63,858.54 $150,622.87 $70,230.51 2025-01-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 25 8 — — $64,924.00 $81,155.00 $70,118.04 2025-01-01
01597 OTHER New Technology - Level 46 2 2 — — $67,329.12 $69,411.46 $68,370.29 2025-01-01
01583 OTHER New Technology - Level 46 2 2 — — $67,329.12 $69,411.46 $68,370.29 2025-01-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 20 7 — — $63,858.00 $79,822.50 $67,050.90 2025-01-01
850 MS_DRG Acute Leukemia With Other Procedures 69 31 — — $3,938.00 $133,038.81 $66,801.39 2025-01-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 20 7 — — $63,340.00 $79,175.00 $66,507.00 2025-01-01
4404 APR_DRG Kidney Transplant 20 7 — — $56,838.00 $99,466.70 $66,500.60 2025-01-01
1643 OTHER Y90 Ibritumomab, Rx 46 23 — — $60,238.45 $142,084.18 $66,249.20 2025-01-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 48 24 — — $60,601.96 $142,941.59 $66,036.38 2025-01-01
007 OTHER Lung Transplant 2 2 — — $64,636.94 $66,636.02 $65,636.48 2025-01-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 2 — — $64,519.68 $66,515.13 $65,517.40 2025-01-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 89 33 — — $42,293.00 $153,434.70 $64,973.48 2025-01-01
1612 APR_DRG Implantable Heart Assist Systems 25 8 — — $60,078.00 $75,097.50 $64,884.68 2025-01-01
01643 OTHER Y90 Ibritumomab, Rx 2 2 — — $63,512.28 $65,476.58 $64,494.43 2025-01-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 20 7 — — $60,641.00 $75,801.25 $63,673.05 2025-01-01
717 OTHER Instill Adstiladrin, Tx D 48 24 — — $12,103.55 $137,479.85 $63,513.15 2025-01-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 76 31 — — $3,938.00 $122,311.99 $63,487.51 2025-01-01
00717 OTHER Instill Adstiladrin, Tx D 2 2 — — $61,454.13 $63,354.77 $62,404.45 2025-01-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 20 7 — — $59,391.00 $74,238.75 $62,360.55 2025-01-01
1611 APR_DRG Implantable Heart Assist Systems 25 8 — — $56,978.00 $71,222.50 $61,537.23 2025-01-01
8634 APR_DRG Neonatal Aftercare 20 7 — — $58,470.00 $73,087.50 $61,393.50 2025-01-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 76 31 — — $3,938.00 $135,094.00 $61,282.74 2025-01-01
23 APR_DRG Heart And/or Lung Transplant 20 7 — — $52,337.00 $91,590.80 $61,235.00 2025-01-01
1596 OTHER New Technology - Level 45 46 23 — — $55,344.13 $130,539.95 $60,866.51 2025-01-01
1582 OTHER New Technology - Level 45 46 23 — — $55,344.13 $130,539.95 $60,866.51 2025-01-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 20 7 — — $57,908.00 $72,385.00 $60,803.40 2025-01-01
955 OTHER Craniotomy For Multiple Significant Trauma 2 2 — — $59,712.15 $61,558.92 $60,635.54 2025-01-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 69 31 — — $3,938.00 $145,041.00 $60,533.05 2025-01-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 90 34 — — $37,019.00 $112,883.60 $59,974.76 2025-01-01
83 APR_DRG Autologous Bone Marrow Transplant 20 7 — — $51,244.00 $89,678.70 $59,956.60 2025-01-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 20 7 — — $56,578.00 $70,722.50 $59,406.90 2025-01-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 20 7 — — $56,559.00 $70,698.75 $59,386.95 2025-01-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 90 34 — — $39,896.00 $141,845.99 $59,375.77 2025-01-01
01596 OTHER New Technology - Level 45 2 2 — — $58,351.96 $60,156.66 $59,254.31 2025-01-01
01582 OTHER New Technology - Level 45 2 2 — — $58,351.96 $60,156.66 $59,254.31 2025-01-01
J7310 HCPCS Ganciclovir, 4.5 Mg, Long-acting Implant 16 4 — — $6,969.90 $130,561.47 $59,202.24 2025-01-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 7 1 — — $48,750.54 $76,566.63 $58,049.50 2025-01-01
10 MS_DRG Pancreas Transplant 60 26 — — $49,970.99 $109,226.20 $57,889.89 2025-01-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 20 7 — — $55,099.00 $68,873.75 $57,853.95 2025-01-01
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 20 7 — — $55,099.00 $68,873.75 $57,853.95 2025-01-01
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 20 7 — — $54,943.00 $68,678.75 $57,690.15 2025-01-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 60 28 — — $3,938.00 $114,485.33 $57,559.67 2025-01-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 79 32 — — $3,938.00 $197,568.00 $57,298.29 2025-01-01
C2616 HCPCS Brachytherapy Source, Non-stranded, Yttrium-90, Per Source 11 2 — — $13,612.00 $81,014.04 $56,744.01 2025-01-01
4414 APR_DRG Major Bladder Procedures 20 7 — — $53,789.00 $67,236.25 $56,478.45 2025-01-01
A9604 HCPCS Sm153 Lexidron Tx 150mci 16 4 $45,387.69 $45,387.69 $26,241.49 $116,182.08 $56,307.40 2025-01-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 2 — — $55,032.80 $56,734.85 $55,883.82 2025-01-01
9273 OTHER Sipuleucel-t Auto Cd54+ 46 23 — — $50,614.01 $119,383.05 $55,664.41 2025-01-01
09273 OTHER Sipuleucel-t Auto Cd54+ 2 2 — — $53,364.77 $55,015.23 $54,190.00 2025-01-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 2 2 — — $53,035.17 $54,675.43 $53,855.30 2025-01-01
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 2 2 — — $52,914.11 $54,550.63 $53,732.37 2025-01-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 25 8 — — $49,337.00 $61,671.25 $53,284.71 2025-01-01
1784 APR_DRG External Heart Assist Devices 20 7 — — $50,379.00 $62,973.75 $52,897.95 2025-01-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 73 33 — — $3,938.00 $160,698.00 $52,825.08 2025-01-01
63 APR_DRG Pancreas Transplant 20 7 — — $45,029.00 $78,802.30 $52,684.90 2025-01-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 7 1 — — $44,114.04 $69,284.64 $52,528.62 2025-01-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 20 7 — — $49,613.00 $62,016.25 $52,093.65 2025-01-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 20 7 — — $49,556.00 $61,945.00 $52,033.80 2025-01-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 69 31 — — $3,938.00 $123,514.00 $51,602.84 2025-01-01
1595 OTHER New Technology - Level 44 46 23 — — $46,829.71 $110,457.04 $51,502.50 2025-01-01
1581 OTHER New Technology - Level 44 46 23 — — $46,829.71 $110,457.04 $51,502.50 2025-01-01
6904 APR_DRG Acute Leukemia 20 7 — — $48,894.00 $61,117.50 $51,338.70 2025-01-01
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 20 7 — — $48,595.00 $60,743.75 $51,024.75 2025-01-01
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 20 7 — — $48,540.00 $60,675.00 $50,967.00 2025-01-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 76 31 — — $3,938.00 $100,472.73 $50,579.82 2025-01-01
01595 OTHER New Technology - Level 44 2 2 — — $49,374.80 $50,901.86 $50,138.33 2025-01-01
01581 OTHER New Technology - Level 44 2 2 — — $49,374.80 $50,901.86 $50,138.33 2025-01-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 79 32 — — $3,938.00 $98,615.36 $50,138.30 2025-01-01
B0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 13 9 — — $45,243.17 $52,860.38 $50,099.78 2025-01-01
215 OTHER Other Heart Assist System Implant 2 2 — — $49,212.21 $50,734.24 $49,973.22 2025-01-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 90 34 — — $40,561.41 $166,046.00 $49,648.94 2025-01-01
B0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 13 9 — — $44,778.50 $52,317.48 $49,585.24 2025-01-01
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 20 7 — — $47,074.00 $58,842.50 $49,427.70 2025-01-01
22 APR_DRG Heart And/or Lung Transplant 20 7 — — $42,044.00 $73,577.70 $49,192.00 2025-01-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 69 31 — — $3,938.00 $116,593.00 $48,764.71 2025-01-01
5244 OTHER Level 4 Blood Product Exc 46 23 — — $44,331.30 $104,564.05 $48,754.79 2025-01-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 85 33 — — $3,938.00 $122,581.93 $48,498.52 2025-01-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 50 24 — — $44,047.39 $304,023.47 $48,442.56 2025-01-01
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 20 7 — — $46,085.00 $57,606.25 $48,389.25 2025-01-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 — — $47,637.08 $49,110.39 $48,373.74 2025-01-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 63 28 — — $3,938.00 $96,457.58 $48,121.52 2025-01-01
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 — — $47,372.18 $48,837.30 $48,104.74 2025-01-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 20 7 — — $45,804.00 $57,255.00 $48,094.20 2025-01-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 50 24 — — $43,689.42 $301,553.20 $48,048.87 2025-01-01
B0106 OTHER Stroke; M > 30.05 & M < 34.25 13 9 — — $43,146.98 $50,411.28 $47,778.58 2025-01-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 20 7 — — $45,493.00 $56,866.25 $47,767.65 2025-01-01
62 APR_DRG Pancreas Transplant 20 7 — — $40,728.00 $71,275.60 $47,652.80 2025-01-01
05244 OTHER Level 4 Blood Product Exc 2 2 — — $46,740.61 $48,186.20 $47,463.40 2025-01-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 20 7 — — $45,048.00 $56,310.00 $47,300.40 2025-01-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 76 31 — — $3,938.00 $93,412.99 $47,063.27 2025-01-01
61 APR_DRG Pancreas Transplant 20 7 — — $40,203.00 $70,355.30 $47,037.60 2025-01-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 89 33 — — $38,393.45 $134,564.00 $46,995.26 2025-01-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 73 33 — — $3,938.00 $147,791.00 $46,370.45 2025-01-01
71 APR_DRG Allogeneic Bone Marrow Transplant 20 7 — — $39,507.00 $69,137.60 $46,223.40 2025-01-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 76 31 — — $3,938.00 $95,180.00 $46,157.32 2025-01-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 76 31 — — $3,938.00 $91,336.09 $46,028.74 2025-01-01
13 APR_DRG Liver Transplant And/or Intestinal Transplant 20 7 — — $39,218.00 $68,632.70 $45,885.80 2025-01-01
1142 OTHER Supprelin La Implant 46 23 — — $41,722.19 $98,409.96 $45,885.34 2025-01-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 90 34 — — $37,404.80 $166,046.00 $45,785.11 2025-01-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 76 31 — — $3,938.00 $180,102.00 $45,687.46 2025-01-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 90 34 — — $26,835.00 $94,097.00 $45,288.73 2025-01-01
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 20 7 — — $42,927.00 $53,658.75 $45,073.35 2025-01-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 69 31 — — $3,938.00 $95,409.00 $45,036.65 2025-01-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 76 31 — — $3,938.00 $88,937.11 $44,833.78 2025-01-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 20 7 — — $42,693.00 $53,366.25 $44,827.65 2025-01-01
D926JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Salivary Glands 6 2 — — $27,872.00 $53,489.00 $44,788.00 2025-01-01
D925JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Tongue 6 2 — — $27,872.00 $53,489.00 $44,788.00 2025-01-01
DB26JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Mediastinum 6 2 — — $27,872.00 $53,489.00 $44,788.00 2025-01-01
DB25JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Pleura 6 2 — — $27,872.00 $53,489.00 $44,788.00 2025-01-01
D92BJZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Larynx 6 2 — — $27,872.00 $53,489.00 $44,788.00 2025-01-01
DB20JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Trachea 6 2 — — $27,872.00 $53,489.00 $44,788.00 2025-01-01
D921JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Nose 6 2 — — $27,872.00 $53,489.00 $44,788.00 2025-01-01
D927JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Sinuses 6 2 — — $27,872.00 $53,489.00 $44,788.00 2025-01-01
D92CJZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Pharynx 6 2 — — $27,872.00 $53,489.00 $44,788.00 2025-01-01
D928JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Hard Palate 6 2 — — $27,872.00 $53,489.00 $44,788.00 2025-01-01
DB27JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Chest Wall 6 2 — — $27,872.00 $53,489.00 $44,788.00 2025-01-01
D026JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Spinal Cord 6 2 — — $27,872.00 $53,489.00 $44,788.00 2025-01-01
D929JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Soft Palate 6 2 — — $27,872.00 $53,489.00 $44,788.00 2025-01-01
DB22JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Lung 6 2 — — $27,872.00 $53,489.00 $44,788.00 2025-01-01
D924JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Mouth 6 2 — — $27,872.00 $53,489.00 $44,788.00 2025-01-01
DG25JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Thyroid 6 2 — — $27,872.00 $53,489.00 $44,788.00 2025-01-01
DB21JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Bronchus 6 2 — — $27,872.00 $53,489.00 $44,788.00 2025-01-01
DF20JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Liver 6 2 — — $27,872.00 $53,489.00 $44,788.00 2025-01-01
4474 APR_DRG Other Kidney, Urinary Tract And Related Non-percutaneous Procedures 20 7 — — $42,593.00 $53,241.25 $44,722.65 2025-01-01
01142 OTHER Supprelin La Implant 2 2 — — $43,989.70 $45,350.21 $44,669.96 2025-01-01
C0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 13 9 — — $40,234.29 $47,008.20 $44,553.23 2025-01-01
28 MS_DRG Spinal Procedures With Mcc 76 31 — — $3,938.00 $87,800.44 $44,267.59 2025-01-01
D92CHZZ OTHER Stereotactic Particulate Radiosurgery Of Pharynx 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D027HZZ OTHER Stereotactic Particulate Radiosurgery Of Peripheral Nerve 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D723JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Neck Lymphatics 7 3 — — $27,292.00 $53,489.00 $44,111.00 2025-01-01
D929HZZ OTHER Stereotactic Particulate Radiosurgery Of Soft Palate 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D027JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Peripheral Nerve 7 3 — — $27,292.00 $53,489.00 $44,111.00 2025-01-01
D722JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Spleen 7 3 — — $27,292.00 $53,489.00 $44,111.00 2025-01-01
D927HZZ OTHER Stereotactic Particulate Radiosurgery Of Sinuses 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
DB21HZZ OTHER Stereotactic Particulate Radiosurgery Of Bronchus 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
DB22HZZ OTHER Stereotactic Particulate Radiosurgery Of Lung 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D724JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Axillary Lymphatics 7 3 — — $27,292.00 $53,489.00 $44,111.00 2025-01-01
D728HZZ OTHER Stereotactic Particulate Radiosurgery Of Inguinal Lymphatics 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D020JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Brain 7 3 — — $27,292.00 $53,489.00 $44,111.00 2025-01-01
D925HZZ OTHER Stereotactic Particulate Radiosurgery Of Tongue 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D92BHZZ OTHER Stereotactic Particulate Radiosurgery Of Larynx 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D020HZZ OTHER Stereotactic Particulate Radiosurgery Of Brain 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D924HZZ OTHER Stereotactic Particulate Radiosurgery Of Mouth 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D926HZZ OTHER Stereotactic Particulate Radiosurgery Of Salivary Glands 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
DB20HZZ OTHER Stereotactic Particulate Radiosurgery Of Trachea 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
DB25HZZ OTHER Stereotactic Particulate Radiosurgery Of Pleura 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D721HZZ OTHER Stereotactic Particulate Radiosurgery Of Thymus 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D725HZZ OTHER Stereotactic Particulate Radiosurgery Of Thorax Lymphatics 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D920HZZ OTHER Stereotactic Particulate Radiosurgery Of Ear 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D021HZZ OTHER Stereotactic Particulate Radiosurgery Of Brain Stem 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
DD20HZZ OTHER Stereotactic Particulate Radiosurgery Of Esophagus 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D921HZZ OTHER Stereotactic Particulate Radiosurgery Of Nose 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D720JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Bone Marrow 7 3 — — $27,292.00 $53,489.00 $44,111.00 2025-01-01
D727HZZ OTHER Stereotactic Particulate Radiosurgery Of Pelvis Lymphatics 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D724HZZ OTHER Stereotactic Particulate Radiosurgery Of Axillary Lymphatics 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D92DJZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Nasopharynx 7 3 — — $27,292.00 $53,489.00 $44,111.00 2025-01-01
DB26HZZ OTHER Stereotactic Particulate Radiosurgery Of Mediastinum 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D021JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Brain Stem 7 3 — — $27,292.00 $53,489.00 $44,111.00 2025-01-01
D722HZZ OTHER Stereotactic Particulate Radiosurgery Of Spleen 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D727JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Pelvis Lymphatics 7 3 — — $27,292.00 $53,489.00 $44,111.00 2025-01-01
D928HZZ OTHER Stereotactic Particulate Radiosurgery Of Hard Palate 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D726HZZ OTHER Stereotactic Particulate Radiosurgery Of Abdomen Lymphatics 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D728JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Inguinal Lymphatics 7 3 — — $27,292.00 $53,489.00 $44,111.00 2025-01-01
D026HZZ OTHER Stereotactic Particulate Radiosurgery Of Spinal Cord 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D720HZZ OTHER Stereotactic Particulate Radiosurgery Of Bone Marrow 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D723HZZ OTHER Stereotactic Particulate Radiosurgery Of Neck Lymphatics 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D721JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Thymus 7 3 — — $27,292.00 $53,489.00 $44,111.00 2025-01-01
D820JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Eye 7 3 — — $27,292.00 $53,489.00 $44,111.00 2025-01-01
D92DHZZ OTHER Stereotactic Particulate Radiosurgery Of Nasopharynx 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D725JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Thorax Lymphatics 7 3 — — $27,292.00 $53,489.00 $44,111.00 2025-01-01
D820HZZ OTHER Stereotactic Particulate Radiosurgery Of Eye 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
D726JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Abdomen Lymphatics 7 3 — — $27,292.00 $53,489.00 $44,111.00 2025-01-01
D920JZZ OTHER Stereotactic Gamma Beam Radiosurgery Of Ear 7 3 — — $27,292.00 $53,489.00 $44,111.00 2025-01-01
DB27HZZ OTHER Stereotactic Particulate Radiosurgery Of Chest Wall 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
DB28HZZ OTHER Stereotactic Particulate Radiosurgery Of Diaphragm 5 1 — — $27,872.00 $53,489.00 $44,111.00 2025-01-01
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