|
1614
|
APR_DRG
|
Implantable Heart Assist Systems
|
6
|
3
|
—
|
—
|
$163,244.49
|
$163,244.49
|
$163,244.49
|
2025-09-11
|
|
94
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
6
|
3
|
—
|
—
|
$152,934.38
|
$152,934.38
|
$152,934.38
|
2025-09-11
|
|
114
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
6
|
3
|
—
|
—
|
$106,403.05
|
$106,403.05
|
$106,403.05
|
2025-09-11
|
|
2004
|
APR_DRG
|
Cardiac Structural And Valvular Disorders
|
6
|
3
|
—
|
—
|
$98,877.73
|
$98,877.73
|
$98,877.73
|
2025-09-11
|
|
44
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
6
|
3
|
—
|
—
|
$89,556.85
|
$89,556.85
|
$89,556.85
|
2025-09-11
|
|
8414
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
6
|
3
|
—
|
—
|
$89,171.86
|
$89,171.86
|
$89,171.86
|
2025-09-11
|
|
8504
|
APR_DRG
|
Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…
|
6
|
3
|
—
|
—
|
$85,955.57
|
$85,955.57
|
$85,955.57
|
2025-09-11
|
|
1613
|
APR_DRG
|
Implantable Heart Assist Systems
|
6
|
3
|
—
|
—
|
$85,085.23
|
$85,085.23
|
$85,085.23
|
2025-09-11
|
|
B0407
|
LOCAL
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
50
|
21
|
—
|
—
|
$70,928.27
|
$118,213.79
|
$78,809.19
|
2025-09-11
|
|
6814
|
APR_DRG
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
6
|
3
|
—
|
—
|
$75,811.90
|
$75,811.90
|
$75,811.90
|
2025-09-11
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
6
|
3
|
—
|
—
|
$75,769.59
|
$75,769.59
|
$75,769.59
|
2025-09-11
|
|
93
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
6
|
3
|
—
|
—
|
$75,136.34
|
$75,136.34
|
$75,136.34
|
2025-09-11
|
|
2464
|
APR_DRG
|
Gastrointestinal Vascular Insufficiency
|
6
|
3
|
—
|
—
|
$73,475.39
|
$73,475.39
|
$73,475.39
|
2025-09-11
|
|
C0407
|
LOCAL
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
50
|
21
|
—
|
—
|
$63,075.12
|
$105,125.21
|
$70,083.47
|
2025-09-11
|
|
B1904
|
LOCAL
|
Guillain-barré M <38.50
|
50
|
21
|
—
|
—
|
$61,373.98
|
$102,289.97
|
$68,193.31
|
2025-09-11
|
|
D0407
|
LOCAL
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
50
|
21
|
—
|
—
|
$61,229.70
|
$102,049.50
|
$68,033.00
|
2025-09-11
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
6
|
3
|
—
|
—
|
$66,096.24
|
$66,096.24
|
$66,096.24
|
2025-09-11
|
|
B1806
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
50
|
21
|
—
|
—
|
$57,731.77
|
$96,219.62
|
$64,146.41
|
2025-09-11
|
|
A0407
|
LOCAL
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
50
|
21
|
—
|
—
|
$55,636.36
|
$92,727.27
|
$61,818.18
|
2025-09-11
|
|
1612
|
APR_DRG
|
Implantable Heart Assist Systems
|
6
|
3
|
—
|
—
|
$61,163.05
|
$61,163.05
|
$61,163.05
|
2025-09-11
|
|
113
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
6
|
3
|
—
|
—
|
$60,463.71
|
$60,463.71
|
$60,463.71
|
2025-09-11
|
|
1611
|
APR_DRG
|
Implantable Heart Assist Systems
|
6
|
3
|
—
|
—
|
$58,007.60
|
$58,007.60
|
$58,007.60
|
2025-09-11
|
|
B0406
|
LOCAL
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
50
|
21
|
—
|
—
|
$51,881.75
|
$86,469.59
|
$57,646.39
|
2025-09-11
|
|
54
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
6
|
3
|
—
|
—
|
$57,599.88
|
$57,599.88
|
$57,599.88
|
2025-09-11
|
|
43
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
6
|
3
|
—
|
—
|
$57,580.30
|
$57,580.30
|
$57,580.30
|
2025-09-11
|
|
B0404
|
LOCAL
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
50
|
21
|
—
|
—
|
$51,128.48
|
$85,214.13
|
$56,809.42
|
2025-09-11
|
|
B0505
|
LOCAL
|
Non-traumatic Spinal Cord Injury M <39.50
|
50
|
21
|
—
|
—
|
$50,603.37
|
$84,338.96
|
$56,225.97
|
2025-09-11
|
|
6804
|
APR_DRG
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
6
|
3
|
—
|
—
|
$56,094.54
|
$56,094.54
|
$56,094.54
|
2025-09-11
|
|
4414
|
APR_DRG
|
Major Bladder Procedures
|
6
|
3
|
—
|
—
|
$54,760.54
|
$54,760.54
|
$54,760.54
|
2025-09-11
|
|
B0106
|
LOCAL
|
Stroke M <41.50 And A <84.50
|
50
|
21
|
—
|
—
|
$48,759.62
|
$81,266.04
|
$54,177.36
|
2025-09-11
|
|
C1904
|
LOCAL
|
Guillain-barré M <38.50
|
50
|
21
|
—
|
—
|
$47,184.29
|
$78,640.49
|
$52,426.99
|
2025-09-11
|
|
1784
|
APR_DRG
|
External Heart Assist Systems
|
6
|
3
|
—
|
—
|
$51,289.34
|
$51,289.34
|
$51,289.34
|
2025-09-11
|
|
C0406
|
LOCAL
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
50
|
21
|
—
|
—
|
$46,137.43
|
$76,895.72
|
$51,263.81
|
2025-09-11
|
|
C1806
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
50
|
21
|
—
|
—
|
$46,055.22
|
$76,758.71
|
$51,172.47
|
2025-09-11
|
|
C0404
|
LOCAL
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
50
|
21
|
—
|
—
|
$45,468.05
|
$75,780.08
|
$50,520.05
|
2025-09-11
|
|
1674
|
APR_DRG
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
6
|
3
|
—
|
—
|
$50,228.43
|
$50,228.43
|
$50,228.43
|
2025-09-11
|
|
6904
|
APR_DRG
|
Acute Leukemia
|
6
|
3
|
—
|
—
|
$49,777.35
|
$49,777.35
|
$49,777.35
|
2025-09-11
|
|
D0406
|
LOCAL
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
50
|
21
|
—
|
—
|
$44,786.92
|
$74,644.86
|
$49,763.24
|
2025-09-11
|
|
434
|
APR_DRG
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
6
|
3
|
—
|
—
|
$49,472.44
|
$49,472.44
|
$49,472.44
|
2025-09-11
|
|
92
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
6
|
3
|
—
|
—
|
$49,416.84
|
$49,416.84
|
$49,416.84
|
2025-09-11
|
|
B0205
|
LOCAL
|
Traumatic Brain Injury M <35.50
|
50
|
21
|
—
|
—
|
$44,265.16
|
$73,775.27
|
$49,183.51
|
2025-09-11
|
|
D0404
|
LOCAL
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
50
|
21
|
—
|
—
|
$44,137.66
|
$73,562.76
|
$49,041.84
|
2025-09-11
|
|
D1904
|
LOCAL
|
Guillain-barré M <38.50
|
50
|
21
|
—
|
—
|
$44,028.61
|
$73,381.02
|
$48,920.68
|
2025-09-11
|
|
B1705
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
50
|
21
|
—
|
—
|
$43,988.35
|
$73,313.91
|
$48,875.94
|
2025-09-11
|
|
D1806
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
50
|
21
|
—
|
—
|
$43,723.28
|
$72,872.13
|
$48,581.42
|
2025-09-11
|
|
A1904
|
LOCAL
|
Guillain-barré M <38.50
|
50
|
21
|
—
|
—
|
$43,266.95
|
$72,111.59
|
$48,074.39
|
2025-09-11
|
|
91
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
6
|
3
|
—
|
—
|
$47,924.43
|
$47,924.43
|
$47,924.43
|
2025-09-11
|
|
B0105
|
LOCAL
|
Stroke M <41.50 And A >=84.50
|
50
|
21
|
—
|
—
|
$42,869.34
|
$71,448.90
|
$47,632.60
|
2025-09-11
|
|
C0106
|
LOCAL
|
Stroke M <41.50 And A <84.50
|
50
|
21
|
—
|
—
|
$42,287.19
|
$70,478.66
|
$46,985.77
|
2025-09-11
|
|
B1903
|
LOCAL
|
Guillain-barré M >=38.50 And M <51.50
|
50
|
21
|
—
|
—
|
$42,132.85
|
$70,221.42
|
$46,814.28
|
2025-09-11
|
|
3034
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
6
|
3
|
—
|
—
|
$46,630.99
|
$46,630.99
|
$46,630.99
|
2025-09-11
|
|
B0604
|
LOCAL
|
Neurological M <43.50
|
50
|
21
|
—
|
—
|
$41,780.54
|
$69,634.23
|
$46,422.82
|
2025-09-11
|
|
A0406
|
LOCAL
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
50
|
21
|
—
|
—
|
$40,696.77
|
$67,827.95
|
$45,218.63
|
2025-09-11
|
|
B0405
|
LOCAL
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
50
|
21
|
—
|
—
|
$40,659.86
|
$67,766.43
|
$45,177.62
|
2025-09-11
|
|
B1805
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
50
|
21
|
—
|
—
|
$40,651.47
|
$67,752.45
|
$45,168.30
|
2025-09-11
|
|
A1806
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
50
|
21
|
—
|
—
|
$40,539.07
|
$67,565.12
|
$45,043.41
|
2025-09-11
|
|
A0404
|
LOCAL
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
50
|
21
|
—
|
—
|
$40,106.23
|
$66,843.72
|
$44,562.48
|
2025-09-11
|
|
B0305
|
LOCAL
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
50
|
21
|
—
|
—
|
$40,003.89
|
$66,673.16
|
$44,448.77
|
2025-09-11
|
|
A5104
|
LOCAL
|
Expired, Not Orthopedic, Length Of Stay Is 16 Days Or More
|
50
|
21
|
—
|
—
|
$39,985.44
|
$66,642.41
|
$44,428.27
|
2025-09-11
|
|
B1604
|
LOCAL
|
Pain Syndrome M <43.50
|
50
|
21
|
—
|
—
|
$39,383.15
|
$65,638.59
|
$43,759.06
|
2025-09-11
|
|
C0505
|
LOCAL
|
Non-traumatic Spinal Cord Injury M <39.50
|
50
|
21
|
—
|
—
|
$39,368.06
|
$65,613.44
|
$43,742.29
|
2025-09-11
|
|
2204
|
APR_DRG
|
Major Stomach, Esophageal And Duodenal Procedures
|
6
|
3
|
—
|
—
|
$43,702.13
|
$43,702.13
|
$43,702.13
|
2025-09-11
|
|
B0704
|
LOCAL
|
Fracture Of Lower Extremity M <41.50
|
50
|
21
|
—
|
—
|
$39,044.27
|
$65,073.78
|
$43,382.52
|
2025-09-11
|
|
4474
|
APR_DRG
|
Other Kidney, Urinary Tract And Related Procedures
|
6
|
3
|
—
|
—
|
$43,362.25
|
$43,362.25
|
$43,362.25
|
2025-09-11
|
|
B2102
|
LOCAL
|
Burns M <52.50
|
50
|
21
|
—
|
—
|
$38,881.54
|
$64,802.57
|
$43,201.71
|
2025-09-11
|
|
D0106
|
LOCAL
|
Stroke M <41.50 And A <84.50
|
50
|
21
|
—
|
—
|
$38,643.31
|
$64,405.52
|
$42,937.01
|
2025-09-11
|
|
B1004
|
LOCAL
|
Amputation Lower Extremity M <47.50
|
50
|
21
|
—
|
—
|
$38,604.73
|
$64,341.21
|
$42,894.14
|
2025-09-11
|
|
234
|
APR_DRG
|
Spinal Procedures
|
6
|
3
|
—
|
—
|
$42,719.90
|
$42,719.90
|
$42,719.90
|
2025-09-11
|
|
9104
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
6
|
3
|
—
|
—
|
$42,565.34
|
$42,565.34
|
$42,565.34
|
2025-09-11
|
|
B1504
|
LOCAL
|
Pulmonary M <45.50
|
50
|
21
|
—
|
—
|
$38,156.79
|
$63,594.65
|
$42,396.43
|
2025-09-11
|
|
112
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
6
|
3
|
—
|
—
|
$42,018.46
|
$42,018.46
|
$42,018.46
|
2025-09-11
|
|
B1704
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
50
|
21
|
—
|
—
|
$37,484.05
|
$62,473.41
|
$41,648.94
|
2025-09-11
|
|
53
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
6
|
3
|
—
|
—
|
$41,492.90
|
$41,492.90
|
$41,492.90
|
2025-09-11
|
|
B2005
|
LOCAL
|
Miscellaneous M <46.50 And A <77.50
|
50
|
21
|
—
|
—
|
$37,264.27
|
$62,107.11
|
$41,404.74
|
2025-09-11
|
|
D0505
|
LOCAL
|
Non-traumatic Spinal Cord Injury M <39.50
|
50
|
21
|
—
|
—
|
$37,192.13
|
$61,986.89
|
$41,324.59
|
2025-09-11
|
|
C0105
|
LOCAL
|
Stroke M <41.50 And A >=84.50
|
50
|
21
|
—
|
—
|
$37,178.71
|
$61,964.52
|
$41,309.68
|
2025-09-11
|
|
9504
|
APR_DRG
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
6
|
3
|
—
|
—
|
$41,301.63
|
$41,301.63
|
$41,301.63
|
2025-09-11
|
|
A0106
|
LOCAL
|
Stroke M <41.50 And A <84.50
|
50
|
21
|
—
|
—
|
$36,826.40
|
$61,377.33
|
$40,918.22
|
2025-09-11
|
|
B1204
|
LOCAL
|
Osteoarthritis M <49.50 And A <74.50
|
50
|
21
|
—
|
—
|
$36,635.15
|
$61,058.58
|
$40,705.72
|
2025-09-11
|
|
C0205
|
LOCAL
|
Traumatic Brain Injury M <35.50
|
50
|
21
|
—
|
—
|
$36,457.31
|
$60,762.18
|
$40,508.12
|
2025-09-11
|
|
B0504
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
50
|
21
|
—
|
—
|
$36,417.05
|
$60,695.09
|
$40,463.39
|
2025-09-11
|
|
B0304
|
LOCAL
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
50
|
21
|
—
|
—
|
$36,272.77
|
$60,454.62
|
$40,303.08
|
2025-09-11
|
|
C0405
|
LOCAL
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
50
|
21
|
—
|
—
|
$36,158.69
|
$60,264.48
|
$40,176.32
|
2025-09-11
|
|
B1404
|
LOCAL
|
Cardiac M <45.50
|
50
|
21
|
—
|
—
|
$35,999.31
|
$59,998.85
|
$39,999.23
|
2025-09-11
|
|
B0904
|
LOCAL
|
Other Orthopedic M <44.5
|
50
|
21
|
—
|
—
|
$35,928.85
|
$59,881.41
|
$39,920.94
|
2025-09-11
|
|
B1304
|
LOCAL
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
50
|
21
|
—
|
—
|
$35,928.85
|
$59,881.41
|
$39,920.94
|
2025-09-11
|
|
264
|
APR_DRG
|
Other Nervous System And Related Procedures
|
6
|
3
|
—
|
—
|
$39,855.38
|
$39,855.38
|
$39,855.38
|
2025-09-11
|
|
3033
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
6
|
3
|
—
|
—
|
$39,448.01
|
$39,448.01
|
$39,448.01
|
2025-09-11
|
|
1824
|
APR_DRG
|
Other Peripheral Vascular Procedures
|
6
|
3
|
—
|
—
|
$39,416.19
|
$39,416.19
|
$39,416.19
|
2025-09-11
|
|
1634
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
6
|
3
|
—
|
—
|
$39,392.76
|
$39,392.76
|
$39,392.76
|
2025-09-11
|
|
B2004
|
LOCAL
|
Miscellaneous M <46.50 And A >=77.50
|
50
|
21
|
—
|
—
|
$35,353.41
|
$58,922.36
|
$39,281.57
|
2025-09-11
|
|
D0405
|
LOCAL
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
50
|
21
|
—
|
—
|
$35,100.08
|
$58,500.14
|
$39,000.09
|
2025-09-11
|
|
B1203
|
LOCAL
|
Osteoarthritis M <49.50 And A >=74.50
|
50
|
21
|
—
|
—
|
$34,935.67
|
$58,226.12
|
$38,817.41
|
2025-09-11
|
|
7924
|
APR_DRG
|
Extensive O.r. Procedures For Other Complications Of Treatment
|
6
|
3
|
—
|
—
|
$38,747.96
|
$38,747.96
|
$38,747.96
|
2025-09-11
|
|
3044
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
6
|
3
|
—
|
—
|
$38,738.52
|
$38,738.52
|
$38,738.52
|
2025-09-11
|
|
2054
|
APR_DRG
|
Cardiomyopathy
|
6
|
3
|
—
|
—
|
$38,629.08
|
$38,629.08
|
$38,629.08
|
2025-09-11
|
|
6954
|
APR_DRG
|
Chemotherapy For Acute Leukemia
|
6
|
3
|
—
|
—
|
$38,579.42
|
$38,579.42
|
$38,579.42
|
2025-09-11
|
|
8413
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
6
|
3
|
—
|
—
|
$38,539.91
|
$38,539.91
|
$38,539.91
|
2025-09-11
|
|
B0805
|
LOCAL
|
Replacement Of Lower-extremity Joint M <42.50
|
50
|
21
|
—
|
—
|
$34,581.68
|
$57,636.14
|
$38,424.09
|
2025-09-11
|
|
B0204
|
LOCAL
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
50
|
21
|
—
|
—
|
$34,556.52
|
$57,594.20
|
$38,396.13
|
2025-09-11
|
|
B1305
|
LOCAL
|
Rheumatoid Other Arthritis M <51.50 And A <64.50
|
50
|
21
|
—
|
—
|
$34,407.21
|
$57,345.35
|
$38,230.23
|
2025-09-11
|
|
B0104
|
LOCAL
|
Stroke M >=41.50 And M <50.50
|
50
|
21
|
—
|
—
|
$34,283.06
|
$57,138.44
|
$38,092.29
|
2025-09-11
|
|
A0505
|
LOCAL
|
Non-traumatic Spinal Cord Injury M <39.50
|
50
|
21
|
—
|
—
|
$34,272.99
|
$57,121.65
|
$38,081.10
|
2025-09-11
|
|
C1705
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
50
|
21
|
—
|
—
|
$34,192.47
|
$56,987.45
|
$37,991.63
|
2025-09-11
|
|
52
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
6
|
3
|
—
|
—
|
$37,892.31
|
$37,892.31
|
$37,892.31
|
2025-09-11
|
|
6514
|
APR_DRG
|
Other Procedures Of Blood And Blood-forming Organs
|
6
|
3
|
—
|
—
|
$37,765.38
|
$37,765.38
|
$37,765.38
|
2025-09-11
|
|
D0105
|
LOCAL
|
Stroke M <41.50 And A >=84.50
|
50
|
21
|
—
|
—
|
$33,974.37
|
$56,623.95
|
$37,749.30
|
2025-09-11
|
|
42
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
6
|
3
|
—
|
—
|
$37,647.54
|
$37,647.54
|
$37,647.54
|
2025-09-11
|
|
B1103
|
LOCAL
|
Amputation Non-lower Extremity M <52.50
|
50
|
21
|
—
|
—
|
$33,647.23
|
$56,078.72
|
$37,385.81
|
2025-09-11
|
|
B1804
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50
|
50
|
21
|
—
|
—
|
$33,529.79
|
$55,882.98
|
$37,255.32
|
2025-09-11
|
|
1623
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
6
|
3
|
—
|
—
|
$37,188.77
|
$37,188.77
|
$37,188.77
|
2025-09-11
|
|
214
|
APR_DRG
|
Open Craniotomy Except Trauma
|
6
|
3
|
—
|
—
|
$37,100.65
|
$37,100.65
|
$37,100.65
|
2025-09-11
|
|
B0603
|
LOCAL
|
Neurological M >=43.50 And M <52.50
|
50
|
21
|
—
|
—
|
$33,315.05
|
$55,525.08
|
$37,016.72
|
2025-09-11
|
|
2304
|
APR_DRG
|
Major Small Bowel Procedures
|
6
|
3
|
—
|
—
|
$36,966.73
|
$36,966.73
|
$36,966.73
|
2025-09-11
|
|
224
|
APR_DRG
|
Ventricular Shunt Procedures
|
6
|
3
|
—
|
—
|
$36,820.92
|
$36,820.92
|
$36,820.92
|
2025-09-11
|
|
B1703
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50
|
50
|
21
|
—
|
—
|
$33,117.08
|
$55,195.14
|
$36,796.76
|
2025-09-11
|
|
D0205
|
LOCAL
|
Traumatic Brain Injury M <35.50
|
50
|
21
|
—
|
—
|
$33,113.73
|
$55,189.55
|
$36,793.03
|
2025-09-11
|
|
4424
|
APR_DRG
|
Kidney And Urinary Tract Procedures For Malignancy
|
6
|
3
|
—
|
—
|
$36,619.16
|
$36,619.16
|
$36,619.16
|
2025-09-11
|
|
9524
|
APR_DRG
|
Non-extensive O.r. Procedure Unrelated To Principal Diagnosis
|
6
|
3
|
—
|
—
|
$36,394.32
|
$36,394.32
|
$36,394.32
|
2025-09-11
|
|
B0403
|
LOCAL
|
Traumatic Spinal Cord Injury M >=41.50 And M <47.50
|
50
|
21
|
—
|
—
|
$32,746.32
|
$54,577.20
|
$36,384.80
|
2025-09-11
|
|
9114
|
APR_DRG
|
Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma
|
6
|
3
|
—
|
—
|
$36,061.78
|
$36,061.78
|
$36,061.78
|
2025-09-11
|
|
C1805
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
50
|
21
|
—
|
—
|
$32,429.24
|
$54,048.74
|
$36,032.49
|
2025-09-11
|
|
C1903
|
LOCAL
|
Guillain-barré M >=38.50 And M <51.50
|
50
|
21
|
—
|
—
|
$32,390.66
|
$53,984.43
|
$35,989.62
|
2025-09-11
|
|
A0105
|
LOCAL
|
Stroke M <41.50 And A >=84.50
|
50
|
21
|
—
|
—
|
$32,378.91
|
$53,964.86
|
$35,976.57
|
2025-09-11
|
|
C0305
|
LOCAL
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
50
|
21
|
—
|
—
|
$32,004.79
|
$53,341.32
|
$35,560.88
|
2025-09-11
|
|
B0703
|
LOCAL
|
Fracture Of Lower Extremity M >=41.50 And M <52.50
|
50
|
21
|
—
|
—
|
$31,961.17
|
$53,268.62
|
$35,512.41
|
2025-09-11
|
|
C1004
|
LOCAL
|
Amputation Lower Extremity M <47.50
|
50
|
21
|
—
|
—
|
$31,927.62
|
$53,212.70
|
$35,475.13
|
2025-09-11
|
|
A0405
|
LOCAL
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
50
|
21
|
—
|
—
|
$31,894.07
|
$53,156.78
|
$35,437.85
|
2025-09-11
|
|
3154
|
APR_DRG
|
Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement
|
6
|
3
|
—
|
—
|
$35,413.13
|
$35,413.13
|
$35,413.13
|
2025-09-11
|
|
B1603
|
LOCAL
|
Pain Syndrome M >=43.50 And M <58.50
|
50
|
21
|
—
|
—
|
$31,786.70
|
$52,977.83
|
$35,318.55
|
2025-09-11
|
|
1694
|
APR_DRG
|
Major Abdominal Vascular Procedures
|
6
|
3
|
—
|
—
|
$35,292.85
|
$35,292.85
|
$35,292.85
|
2025-09-11
|
|
D1705
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
50
|
21
|
—
|
—
|
$31,665.91
|
$52,776.51
|
$35,184.34
|
2025-09-11
|
|
1204
|
APR_DRG
|
Major Respiratory And Chest Procedures
|
6
|
3
|
—
|
—
|
$35,149.48
|
$35,149.48
|
$35,149.48
|
2025-09-11
|
|
4834
|
APR_DRG
|
Penis, Testes And Scrotal Procedures
|
6
|
3
|
—
|
—
|
$35,015.90
|
$35,015.90
|
$35,015.90
|
2025-09-11
|
|
B0303
|
LOCAL
|
Non-traumatic Brain Injury M >=42.50 And M <52.50
|
50
|
21
|
—
|
—
|
$31,285.07
|
$52,141.79
|
$34,761.19
|
2025-09-11
|
|
C0604
|
LOCAL
|
Neurological M <43.50
|
50
|
21
|
—
|
—
|
$31,280.04
|
$52,133.40
|
$34,755.60
|
2025-09-11
|
|
894
|
APR_DRG
|
Major Cranial Or Facial Bone Procedures
|
6
|
3
|
—
|
—
|
$34,640.36
|
$34,640.36
|
$34,640.36
|
2025-09-11
|
|
A0205
|
LOCAL
|
Traumatic Brain Injury M <35.50
|
50
|
21
|
—
|
—
|
$31,176.03
|
$51,960.05
|
$34,640.03
|
2025-09-11
|
|
9124
|
APR_DRG
|
Musculoskeletal And Other Procedures For Multiple Significant Trauma
|
6
|
3
|
—
|
—
|
$34,594.55
|
$34,594.55
|
$34,594.55
|
2025-09-11
|
|
1304
|
APR_DRG
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
6
|
3
|
—
|
—
|
$34,585.81
|
$34,585.81
|
$34,585.81
|
2025-09-11
|
|
C1504
|
LOCAL
|
Pulmonary M <45.50
|
50
|
21
|
—
|
—
|
$30,969.68
|
$51,616.13
|
$34,410.75
|
2025-09-11
|
|
B1503
|
LOCAL
|
Pulmonary M >=45.50 And M <56.50
|
50
|
21
|
—
|
—
|
$30,811.98
|
$51,353.30
|
$34,235.53
|
2025-09-11
|
|
D1805
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
50
|
21
|
—
|
—
|
$30,786.81
|
$51,311.36
|
$34,207.57
|
2025-09-11
|
|
1654
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
6
|
3
|
—
|
—
|
$34,070.74
|
$34,070.74
|
$34,070.74
|
2025-09-11
|
|
B1803
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50
|
50
|
21
|
—
|
—
|
$30,660.98
|
$51,101.64
|
$34,067.76
|
2025-09-11
|
|
B0503
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50
|
50
|
21
|
—
|
—
|
$30,635.82
|
$51,059.70
|
$34,039.80
|
2025-09-11
|
|
D1903
|
LOCAL
|
Guillain-barré M >=38.50 And M <51.50
|
50
|
21
|
—
|
—
|
$30,224.79
|
$50,374.65
|
$33,583.10
|
2025-09-11
|
|
C0704
|
LOCAL
|
Fracture Of Lower Extremity M <41.50
|
50
|
21
|
—
|
—
|
$30,202.98
|
$50,338.31
|
$33,558.87
|
2025-09-11
|
|
B1003
|
LOCAL
|
Amputation Lower Extremity M >=47.50 And M <55.50
|
50
|
21
|
—
|
—
|
$30,154.33
|
$50,257.22
|
$33,504.81
|
2025-09-11
|
|
A5102
|
LOCAL
|
Expired, Orthopedic, Length Of Stay Is 14 Days Or More
|
50
|
21
|
—
|
—
|
$30,073.81
|
$50,123.01
|
$33,415.34
|
2025-09-11
|
|
B0903
|
LOCAL
|
Other Orthopedic M >=44.50 And M <51.50
|
50
|
21
|
—
|
—
|
$29,984.89
|
$49,974.81
|
$33,316.54
|
2025-09-11
|
|
2604
|
APR_DRG
|
Major Pancreas, Liver And Shunt Procedures
|
6
|
3
|
—
|
—
|
$33,211.24
|
$33,211.24
|
$33,211.24
|
2025-09-11
|
|
C2005
|
LOCAL
|
Miscellaneous M <46.50 And A <77.50
|
50
|
21
|
—
|
—
|
$29,765.12
|
$49,608.53
|
$33,072.35
|
2025-09-11
|
|
C0104
|
LOCAL
|
Stroke M >=41.50 And M <50.50
|
50
|
21
|
—
|
—
|
$29,731.55
|
$49,552.59
|
$33,035.06
|
2025-09-11
|
|
C1304
|
LOCAL
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
50
|
21
|
—
|
—
|
$29,706.39
|
$49,510.65
|
$33,007.10
|
2025-09-11
|
|
A1903
|
LOCAL
|
Guillain-barré M >=38.50 And M <51.50
|
50
|
21
|
—
|
—
|
$29,701.36
|
$49,502.27
|
$33,001.51
|
2025-09-11
|
|
B2003
|
LOCAL
|
Miscellaneous M >=46.50 And M <55.50
|
50
|
21
|
—
|
—
|
$29,568.83
|
$49,281.38
|
$32,854.25
|
2025-09-11
|
|
D2102
|
LOCAL
|
Burns M <52.50
|
50
|
21
|
—
|
—
|
$29,545.34
|
$49,242.23
|
$32,828.15
|
2025-09-11
|
|
C2102
|
LOCAL
|
Burns M <52.50
|
50
|
21
|
—
|
—
|
$29,545.34
|
$49,242.23
|
$32,828.15
|
2025-09-11
|
|
1783
|
APR_DRG
|
External Heart Assist Systems
|
6
|
3
|
—
|
—
|
$32,822.41
|
$32,822.41
|
$32,822.41
|
2025-09-11
|
|
1214
|
APR_DRG
|
Other Respiratory And Chest Procedures
|
6
|
3
|
—
|
—
|
$32,803.52
|
$32,803.52
|
$32,803.52
|
2025-09-11
|
|
D0305
|
LOCAL
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
50
|
21
|
—
|
—
|
$29,399.38
|
$48,998.97
|
$32,665.98
|
2025-09-11
|
|
B1403
|
LOCAL
|
Cardiac M >=45.50 And M <55.50
|
50
|
21
|
—
|
—
|
$29,379.25
|
$48,965.42
|
$32,643.61
|
2025-09-11
|
|
C1604
|
LOCAL
|
Pain Syndrome M <43.50
|
50
|
21
|
—
|
—
|
$29,251.75
|
$48,752.91
|
$32,501.94
|
2025-09-11
|
|
33276
|
CPT
|
Insj Phrnc Nrv Stim Sys
|
2
|
1
|
—
|
—
|
$32,454.62
|
$32,454.62
|
$32,454.62
|
2025-09-11
|
|
D0604
|
LOCAL
|
Neurological M <43.50
|
50
|
21
|
—
|
—
|
$29,201.42
|
$48,669.03
|
$32,446.02
|
2025-09-11
|
|
D1004
|
LOCAL
|
Amputation Lower Extremity M <47.50
|
50
|
21
|
—
|
—
|
$29,164.51
|
$48,607.52
|
$32,405.01
|
2025-09-11
|
|
C1704
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
50
|
21
|
—
|
—
|
$29,135.99
|
$48,559.98
|
$32,373.32
|
2025-09-11
|
|
D1504
|
LOCAL
|
Pulmonary M <45.50
|
50
|
21
|
—
|
—
|
$29,125.92
|
$48,543.20
|
$32,362.13
|
2025-09-11
|
|
C0403
|
LOCAL
|
Traumatic Spinal Cord Injury M >=41.50 And M <47.50
|
50
|
21
|
—
|
—
|
$29,120.89
|
$48,534.81
|
$32,356.54
|
2025-09-11
|
|
C0304
|
LOCAL
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
50
|
21
|
—
|
—
|
$29,020.23
|
$48,367.05
|
$32,244.70
|
2025-09-11
|
|
B0804
|
LOCAL
|
Replacement Of Lower-extremity Joint M >=42.50 And M <51.50
|
50
|
21
|
—
|
—
|
$28,834.01
|
$48,056.69
|
$32,037.79
|
2025-09-11
|
|
1603
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
6
|
3
|
—
|
—
|
$32,019.56
|
$32,019.56
|
$32,019.56
|
2025-09-11
|
|
C0904
|
LOCAL
|
Other Orthopedic M <44.5
|
50
|
21
|
—
|
—
|
$28,776.97
|
$47,961.62
|
$31,974.41
|
2025-09-11
|
|
2244
|
APR_DRG
|
Peritoneal Adhesiolysis
|
6
|
3
|
—
|
—
|
$31,968.50
|
$31,968.50
|
$31,968.50
|
2025-09-11
|
|
A1705
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
50
|
21
|
—
|
—
|
$28,728.32
|
$47,880.53
|
$31,920.35
|
2025-09-11
|
|
D0704
|
LOCAL
|
Fracture Of Lower Extremity M <41.50
|
50
|
21
|
—
|
—
|
$28,610.88
|
$47,684.81
|
$31,789.87
|
2025-09-11
|
|
A1805
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
50
|
21
|
—
|
—
|
$28,545.45
|
$47,575.76
|
$31,717.17
|
2025-09-11
|
|
3614
|
APR_DRG
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
6
|
3
|
—
|
—
|
$31,656.95
|
$31,656.95
|
$31,656.95
|
2025-09-11
|
|
C0204
|
LOCAL
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
50
|
21
|
—
|
—
|
$28,463.25
|
$47,438.75
|
$31,625.83
|
2025-09-11
|
|
B1303
|
LOCAL
|
Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50
|
50
|
21
|
—
|
—
|
$28,449.82
|
$47,416.37
|
$31,610.91
|
2025-09-11
|
|
C1305
|
LOCAL
|
Rheumatoid Other Arthritis M <51.50 And A <64.50
|
50
|
21
|
—
|
—
|
$28,448.15
|
$47,413.58
|
$31,609.05
|
2025-09-11
|
|
C1404
|
LOCAL
|
Cardiac M <45.50
|
50
|
21
|
—
|
—
|
$28,359.23
|
$47,265.38
|
$31,510.25
|
2025-09-11
|
|
D1304
|
LOCAL
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
50
|
21
|
—
|
—
|
$28,355.88
|
$47,259.80
|
$31,506.53
|
2025-09-11
|
|
914
|
APR_DRG
|
Other Major Head And Neck Procedures
|
6
|
3
|
—
|
—
|
$31,486.65
|
$31,486.65
|
$31,486.65
|
2025-09-11
|
|
C0504
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
50
|
21
|
—
|
—
|
$28,330.71
|
$47,217.86
|
$31,478.57
|
2025-09-11
|
|
B0602
|
LOCAL
|
Neurological M >=52.50 And M <64.50
|
50
|
21
|
—
|
—
|
$28,273.67
|
$47,122.79
|
$31,415.19
|
2025-09-11
|
|
D0403
|
LOCAL
|
Traumatic Spinal Cord Injury M >=41.50 And M <47.50
|
50
|
21
|
—
|
—
|
$28,268.63
|
$47,114.39
|
$31,409.59
|
2025-09-11
|
|
C2004
|
LOCAL
|
Miscellaneous M <46.50 And A >=77.50
|
50
|
21
|
—
|
—
|
$28,238.44
|
$47,064.06
|
$31,376.04
|
2025-09-11
|
|
204
|
APR_DRG
|
Open Craniotomy For Trauma
|
6
|
3
|
—
|
—
|
$31,165.31
|
$31,165.31
|
$31,165.31
|
2025-09-11
|
|
B1902
|
LOCAL
|
Guillain-barré M >=51.50 And M <66.50
|
50
|
21
|
—
|
—
|
$27,924.71
|
$46,541.19
|
$31,027.46
|
2025-09-11
|
|
B1702
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50
|
50
|
21
|
—
|
—
|
$27,869.36
|
$46,448.93
|
$30,965.95
|
2025-09-11
|
|
B0203
|
LOCAL
|
Traumatic Brain Injury M >=49.50 And M <61.50
|
50
|
21
|
—
|
—
|
$27,862.64
|
$46,437.74
|
$30,958.49
|
2025-09-11
|
|
51
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
6
|
3
|
—
|
—
|
$30,953.40
|
$30,953.40
|
$30,953.40
|
2025-09-11
|
|
C1204
|
LOCAL
|
Osteoarthritis M <49.50 And A <74.50
|
50
|
21
|
—
|
—
|
$27,852.58
|
$46,420.97
|
$30,947.31
|
2025-09-11
|
|
D2005
|
LOCAL
|
Miscellaneous M <46.50 And A <77.50
|
50
|
21
|
—
|
—
|
$27,805.60
|
$46,342.67
|
$30,895.11
|
2025-09-11
|
|
41
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
6
|
3
|
—
|
—
|
$30,893.96
|
$30,893.96
|
$30,893.96
|
2025-09-11
|
|
C0805
|
LOCAL
|
Replacement Of Lower-extremity Joint M <42.50
|
50
|
21
|
—
|
—
|
$27,748.56
|
$46,247.60
|
$30,831.73
|
2025-09-11
|
|
A0305
|
LOCAL
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
50
|
21
|
—
|
—
|
$27,709.97
|
$46,183.29
|
$30,788.86
|
2025-09-11
|
|
1814
|
APR_DRG
|
Lower Extremity Arterial Procedures
|
6
|
3
|
—
|
—
|
$30,654.78
|
$30,654.78
|
$30,654.78
|
2025-09-11
|
|
2274
|
APR_DRG
|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
6
|
3
|
—
|
—
|
$30,561.07
|
$30,561.07
|
$30,561.07
|
2025-09-11
|
|
6604
|
APR_DRG
|
Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula…
|
6
|
3
|
—
|
—
|
$30,460.71
|
$30,460.71
|
$30,460.71
|
2025-09-11
|
|
8424
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
6
|
3
|
—
|
—
|
$30,420.15
|
$30,420.15
|
$30,420.15
|
2025-09-11
|
|
A1504
|
LOCAL
|
Pulmonary M <45.50
|
50
|
21
|
—
|
—
|
$27,245.26
|
$45,408.77
|
$30,272.51
|
2025-09-11
|
|
D0104
|
LOCAL
|
Stroke M >=41.50 And M <50.50
|
50
|
21
|
—
|
—
|
$27,169.77
|
$45,282.95
|
$30,188.63
|
2025-09-11
|
|
D1305
|
LOCAL
|
Rheumatoid Other Arthritis M <51.50 And A <64.50
|
50
|
21
|
—
|
—
|
$27,154.67
|
$45,257.78
|
$30,171.85
|
2025-09-11
|
|
B1502
|
LOCAL
|
Pulmonary M >=56.50 And M <68.50
|
50
|
21
|
—
|
—
|
$27,111.05
|
$45,185.09
|
$30,123.39
|
2025-09-11
|
|
C1103
|
LOCAL
|
Amputation Non-lower Extremity M <52.50
|
50
|
21
|
—
|
—
|
$27,047.30
|
$45,078.83
|
$30,052.55
|
2025-09-11
|
|
D1103
|
LOCAL
|
Amputation Non-lower Extremity M <52.50
|
50
|
21
|
—
|
—
|
$27,047.30
|
$45,078.83
|
$30,052.55
|
2025-09-11
|
|
D1704
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
50
|
21
|
—
|
—
|
$26,983.55
|
$44,972.58
|
$29,981.72
|
2025-09-11
|
|
B1102
|
LOCAL
|
Amputation Non-lower Extremity M >=52.50 And M <58.50
|
50
|
21
|
—
|
—
|
$26,981.87
|
$44,969.78
|
$29,979.85
|
2025-09-11
|
|
B1202
|
LOCAL
|
Osteoarthritis M >=49.50 And M <61.50
|
50
|
21
|
—
|
—
|
$26,966.77
|
$44,944.62
|
$29,963.08
|
2025-09-11
|
|
B0103
|
LOCAL
|
Stroke M >=50.50 And M <63.50
|
50
|
21
|
—
|
—
|
$26,862.75
|
$44,771.25
|
$29,847.50
|
2025-09-11
|
|
D0904
|
LOCAL
|
Other Orthopedic M <44.5
|
50
|
21
|
—
|
—
|
$26,822.49
|
$44,704.16
|
$29,802.77
|
2025-09-11
|
|
D0504
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
50
|
21
|
—
|
—
|
$26,765.45
|
$44,609.09
|
$29,739.39
|
2025-09-11
|
|
C1804
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50
|
50
|
21
|
—
|
—
|
$26,748.68
|
$44,581.13
|
$29,720.75
|
2025-09-11
|
|
B0502
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50
|
50
|
21
|
—
|
—
|
$26,726.86
|
$44,544.77
|
$29,696.51
|
2025-09-11
|
|
1834
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
6
|
3
|
—
|
—
|
$29,644.58
|
$29,644.58
|
$29,644.58
|
2025-09-11
|
|
D0304
|
LOCAL
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
50
|
21
|
—
|
—
|
$26,658.08
|
$44,430.14
|
$29,620.09
|
2025-09-11
|
|
C1203
|
LOCAL
|
Osteoarthritis M <49.50 And A >=74.50
|
50
|
21
|
—
|
—
|
$26,559.10
|
$44,265.17
|
$29,510.11
|
2025-09-11
|
|
A1103
|
LOCAL
|
Amputation Non-lower Extremity M <52.50
|
50
|
21
|
—
|
—
|
$26,500.37
|
$44,167.29
|
$29,444.86
|
2025-09-11
|
|
D1604
|
LOCAL
|
Pain Syndrome M <43.50
|
50
|
21
|
—
|
—
|
$26,439.98
|
$44,066.64
|
$29,377.76
|
2025-09-11
|
|
A0704
|
LOCAL
|
Fracture Of Lower Extremity M <41.50
|
50
|
21
|
—
|
—
|
$26,433.27
|
$44,055.45
|
$29,370.30
|
2025-09-11
|
|
A1304
|
LOCAL
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
50
|
21
|
—
|
—
|
$26,379.59
|
$43,965.98
|
$29,310.65
|
2025-09-11
|
|
D2004
|
LOCAL
|
Miscellaneous M <46.50 And A >=77.50
|
50
|
21
|
—
|
—
|
$26,379.59
|
$43,965.98
|
$29,310.65
|
2025-09-11
|
|
D1404
|
LOCAL
|
Cardiac M <45.50
|
50
|
21
|
—
|
—
|
$26,367.84
|
$43,946.40
|
$29,297.60
|
2025-09-11
|
|
A0604
|
LOCAL
|
Neurological M <43.50
|
50
|
21
|
—
|
—
|
$26,335.97
|
$43,893.29
|
$29,262.19
|
2025-09-11
|
|
2614
|
APR_DRG
|
Major Biliary Tract Procedures
|
6
|
3
|
—
|
—
|
$29,174.27
|
$29,174.27
|
$29,174.27
|
2025-09-11
|
|
A1004
|
LOCAL
|
Amputation Lower Extremity M <47.50
|
50
|
21
|
—
|
—
|
$26,129.61
|
$43,549.35
|
$29,032.90
|
2025-09-11
|
|
D1204
|
LOCAL
|
Osteoarthritis M <49.50 And A <74.50
|
50
|
21
|
—
|
—
|
$26,114.52
|
$43,524.20
|
$29,016.13
|
2025-09-11
|
|
B0402
|
LOCAL
|
Traumatic Spinal Cord Injury M >=47.50 And M <56.50
|
50
|
21
|
—
|
—
|
$26,094.38
|
$43,490.64
|
$28,993.76
|
2025-09-11
|
|
1833
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
6
|
3
|
—
|
—
|
$28,916.56
|
$28,916.56
|
$28,916.56
|
2025-09-11
|
|
B0302
|
LOCAL
|
Non-traumatic Brain Injury M >=52.50 And M <65.50
|
50
|
21
|
—
|
—
|
$26,000.43
|
$43,334.06
|
$28,889.37
|
2025-09-11
|
|
B0702
|
LOCAL
|
Fracture Of Lower Extremity M >=52.50 And M <61.50
|
50
|
21
|
—
|
—
|
$25,990.37
|
$43,317.29
|
$28,878.19
|
2025-09-11
|
|
9514
|
APR_DRG
|
Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
6
|
3
|
—
|
—
|
$28,803.26
|
$28,803.26
|
$28,803.26
|
2025-09-11
|
|
A0104
|
LOCAL
|
Stroke M >=41.50 And M <50.50
|
50
|
21
|
—
|
—
|
$25,893.06
|
$43,155.11
|
$28,770.07
|
2025-09-11
|
|
D0204
|
LOCAL
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
50
|
21
|
—
|
—
|
$25,851.12
|
$43,085.21
|
$28,723.47
|
2025-09-11
|
|
3032
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
6
|
3
|
—
|
—
|
$28,621.43
|
$28,621.43
|
$28,621.43
|
2025-09-11
|
|
C1703
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50
|
50
|
21
|
—
|
—
|
$25,742.07
|
$42,903.45
|
$28,602.30
|
2025-09-11
|
|
B0803
|
LOCAL
|
Replacement Of Lower-extremity Joint M >=51.50 And M <57.50
|
50
|
21
|
—
|
—
|
$25,737.04
|
$42,895.07
|
$28,596.71
|
2025-09-11
|
|
B1002
|
LOCAL
|
Amputation Lower Extremity M >=55.50 And M <64.50
|
50
|
21
|
—
|
—
|
$25,737.04
|
$42,895.07
|
$28,596.71
|
2025-09-11
|
|
A0403
|
LOCAL
|
Traumatic Spinal Cord Injury M >=41.50 And M <47.50
|
50
|
21
|
—
|
—
|
$25,686.71
|
$42,811.19
|
$28,540.79
|
2025-09-11
|
|
504
|
APR_DRG
|
Non-bacterial Infections Of Nervous System Except Viral Meningitis
|
6
|
3
|
—
|
—
|
$28,332.25
|
$28,332.25
|
$28,332.25
|
2025-09-11
|
|
D1804
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50
|
50
|
21
|
—
|
—
|
$25,393.12
|
$42,321.87
|
$28,214.58
|
2025-09-11
|
|
1782
|
APR_DRG
|
External Heart Assist Systems
|
6
|
3
|
—
|
—
|
$28,170.36
|
$28,170.36
|
$28,170.36
|
2025-09-11
|
|
7104
|
APR_DRG
|
Infectious And Parasitic Diseases Including HIV With O.r. Procedure
|
6
|
3
|
—
|
—
|
$28,122.45
|
$28,122.45
|
$28,122.45
|
2025-09-11
|
|
A2005
|
LOCAL
|
Miscellaneous M <46.50 And A <77.50
|
50
|
21
|
—
|
—
|
$25,309.23
|
$42,182.06
|
$28,121.37
|
2025-09-11
|
|
D0805
|
LOCAL
|
Replacement Of Lower-extremity Joint M <42.50
|
50
|
21
|
—
|
—
|
$25,299.17
|
$42,165.29
|
$28,110.19
|
2025-09-11
|
|
A1305
|
LOCAL
|
Rheumatoid Other Arthritis M <51.50 And A <64.50
|
50
|
21
|
—
|
—
|
$25,262.26
|
$42,103.77
|
$28,069.18
|
2025-09-11
|
|
B2101
|
LOCAL
|
Burns M >=52.50
|
50
|
21
|
—
|
—
|
$25,247.16
|
$42,078.60
|
$28,052.40
|
2025-09-11
|
|
A2102
|
LOCAL
|
Burns M <52.50
|
50
|
21
|
—
|
—
|
$25,232.07
|
$42,053.45
|
$28,035.63
|
2025-09-11
|
|
B1602
|
LOCAL
|
Pain Syndrome M >=58.50 And M <65.50
|
50
|
21
|
—
|
—
|
$25,169.99
|
$41,949.99
|
$27,966.66
|
2025-09-11
|
|
A0304
|
LOCAL
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
50
|
21
|
—
|
—
|
$25,126.37
|
$41,877.29
|
$27,918.19
|
2025-09-11
|
|
B0902
|
LOCAL
|
Other Orthopedic M >=51.50 And M <63.50
|
50
|
21
|
—
|
—
|
$25,109.60
|
$41,849.33
|
$27,899.55
|
2025-09-11
|
|
C0303
|
LOCAL
|
Non-traumatic Brain Injury M >=42.50 And M <52.50
|
50
|
21
|
—
|
—
|
$25,029.06
|
$41,715.11
|
$27,810.07
|
2025-09-11
|
|
B1302
|
LOCAL
|
Rheumatoid Other Arthritis M >=51.50 And M <62.50
|
50
|
21
|
—
|
—
|
$25,007.26
|
$41,678.76
|
$27,785.84
|
2025-09-11
|
|
C1503
|
LOCAL
|
Pulmonary M >=45.50 And M <56.50
|
50
|
21
|
—
|
—
|
$25,007.26
|
$41,678.76
|
$27,785.84
|
2025-09-11
|
|
1622
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
6
|
3
|
—
|
—
|
$27,769.28
|
$27,769.28
|
$27,769.28
|
2025-09-11
|
|
C0603
|
LOCAL
|
Neurological M >=43.50 And M <52.50
|
50
|
21
|
—
|
—
|
$24,941.83
|
$41,569.71
|
$27,713.14
|
2025-09-11
|
|
C1003
|
LOCAL
|
Amputation Lower Extremity M >=47.50 And M <55.50
|
50
|
21
|
—
|
—
|
$24,938.47
|
$41,564.12
|
$27,709.41
|
2025-09-11
|
|
D1203
|
LOCAL
|
Osteoarthritis M <49.50 And A >=74.50
|
50
|
21
|
—
|
—
|
$24,903.24
|
$41,505.41
|
$27,670.27
|
2025-09-11
|
|
C0703
|
LOCAL
|
Fracture Of Lower Extremity M >=41.50 And M <52.50
|
50
|
21
|
—
|
—
|
$24,723.73
|
$41,206.22
|
$27,470.81
|
2025-09-11
|
|
2234
|
APR_DRG
|
Other Small And Large Bowel Procedures
|
6
|
3
|
—
|
—
|
$27,448.98
|
$27,448.98
|
$27,448.98
|
2025-09-11
|
|
B2002
|
LOCAL
|
Miscellaneous M >=55.50 And M <66.50
|
50
|
21
|
—
|
—
|
$24,691.86
|
$41,153.10
|
$27,435.40
|
2025-09-11
|
|
A0504
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
50
|
21
|
—
|
—
|
$24,665.01
|
$41,108.36
|
$27,405.57
|
2025-09-11
|
|
6914
|
APR_DRG
|
Lymphoma, Myeloma And Non-acute Leukemia
|
6
|
3
|
—
|
—
|
$27,280.09
|
$27,280.09
|
$27,280.09
|
2025-09-11
|
|
A0904
|
LOCAL
|
Other Orthopedic M <44.5
|
50
|
21
|
—
|
—
|
$24,540.87
|
$40,901.45
|
$27,267.63
|
2025-09-11
|
|
A1704
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
50
|
21
|
—
|
—
|
$24,480.47
|
$40,800.78
|
$27,200.52
|
2025-09-11
|
|
A1604
|
LOCAL
|
Pain Syndrome M <43.50
|
50
|
21
|
—
|
—
|
$24,475.44
|
$40,792.40
|
$27,194.93
|
2025-09-11
|
|
C1803
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50
|
50
|
21
|
—
|
—
|
$24,460.34
|
$40,767.23
|
$27,178.15
|
2025-09-11
|
|
A0204
|
LOCAL
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
50
|
21
|
—
|
—
|
$24,339.55
|
$40,565.91
|
$27,043.94
|
2025-09-11
|
|
6944
|
APR_DRG
|
Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior
|
6
|
3
|
—
|
—
|
$27,003.85
|
$27,003.85
|
$27,003.85
|
2025-09-11
|
|
7234
|
APR_DRG
|
Viral Illness
|
6
|
3
|
—
|
—
|
$26,967.13
|
$26,967.13
|
$26,967.13
|
2025-09-11
|
|
A1404
|
LOCAL
|
Cardiac M <45.50
|
50
|
21
|
—
|
—
|
$24,262.37
|
$40,437.29
|
$26,958.19
|
2025-09-11
|
|
C0903
|
LOCAL
|
Other Orthopedic M >=44.50 And M <51.50
|
50
|
21
|
—
|
—
|
$24,015.75
|
$40,026.26
|
$26,684.17
|
2025-09-11
|
|
B1402
|
LOCAL
|
Cardiac M >=55.50 And M <68.50
|
50
|
21
|
—
|
—
|
$24,010.72
|
$40,017.87
|
$26,678.58
|
2025-09-11
|
|
A2004
|
LOCAL
|
Miscellaneous M <46.50 And A >=77.50
|
50
|
21
|
—
|
—
|
$24,010.72
|
$40,017.87
|
$26,678.58
|
2025-09-11
|
|
924
|
APR_DRG
|
Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures
|
6
|
3
|
—
|
—
|
$26,677.25
|
$26,677.25
|
$26,677.25
|
2025-09-11
|
|
A1204
|
LOCAL
|
Osteoarthritis M <49.50 And A <74.50
|
50
|
21
|
—
|
—
|
$23,874.83
|
$39,791.39
|
$26,527.59
|
2025-09-11
|
|
B1802
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=55.50 And M <67.50
|
50
|
21
|
—
|
—
|
$23,864.77
|
$39,774.62
|
$26,516.41
|
2025-09-11
|
|
D1703
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50
|
50
|
21
|
—
|
—
|
$23,841.28
|
$39,735.47
|
$26,490.31
|
2025-09-11
|
|
C0503
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50
|
50
|
21
|
—
|
—
|
$23,832.89
|
$39,721.49
|
$26,480.99
|
2025-09-11
|
|
1633
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
6
|
3
|
—
|
—
|
$26,382.48
|
$26,382.48
|
$26,382.48
|
2025-09-11
|
|
1664
|
APR_DRG
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
6
|
3
|
—
|
—
|
$26,330.38
|
$26,330.38
|
$26,330.38
|
2025-09-11
|
|
C2003
|
LOCAL
|
Miscellaneous M >=46.50 And M <55.50
|
50
|
21
|
—
|
—
|
$23,618.15
|
$39,363.59
|
$26,242.39
|
2025-09-11
|
|
C1603
|
LOCAL
|
Pain Syndrome M >=43.50 And M <58.50
|
50
|
21
|
—
|
—
|
$23,609.76
|
$39,349.61
|
$26,233.07
|
2025-09-11
|
|
A0805
|
LOCAL
|
Replacement Of Lower-extremity Joint M <42.50
|
50
|
21
|
—
|
—
|
$23,596.34
|
$39,327.24
|
$26,218.16
|
2025-09-11
|
|
A1804
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50
|
50
|
21
|
—
|
—
|
$23,544.33
|
$39,240.56
|
$26,160.37
|
2025-09-11
|
|
C1303
|
LOCAL
|
Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50
|
50
|
21
|
—
|
—
|
$23,524.20
|
$39,207.00
|
$26,138.00
|
2025-09-11
|
|
D1503
|
LOCAL
|
Pulmonary M >=45.50 And M <56.50
|
50
|
21
|
—
|
—
|
$23,519.17
|
$39,198.62
|
$26,132.41
|
2025-09-11
|
|
6614
|
APR_DRG
|
Coagulation And Platelet Disorders
|
6
|
3
|
—
|
—
|
$26,091.20
|
$26,091.20
|
$26,091.20
|
2025-09-11
|
|
D0703
|
LOCAL
|
Fracture Of Lower Extremity M >=41.50 And M <52.50
|
50
|
21
|
—
|
—
|
$23,420.19
|
$39,033.65
|
$26,022.43
|
2025-09-11
|
|
69930
|
CPT
|
Implant Cochlear Device
|
2
|
1
|
—
|
—
|
$25,960.08
|
$25,960.08
|
$25,960.08
|
2025-09-11
|
|
C0103
|
LOCAL
|
Stroke M >=50.50 And M <63.50
|
50
|
21
|
—
|
—
|
$23,297.72
|
$38,829.53
|
$25,886.35
|
2025-09-11
|
|
D0603
|
LOCAL
|
Neurological M >=43.50 And M <52.50
|
50
|
21
|
—
|
—
|
$23,284.30
|
$38,807.16
|
$25,871.44
|
2025-09-11
|
|
1781
|
APR_DRG
|
External Heart Assist Systems
|
6
|
3
|
—
|
—
|
$25,823.35
|
$25,823.35
|
$25,823.35
|
2025-09-11
|
|
D1803
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50
|
50
|
21
|
—
|
—
|
$23,222.22
|
$38,703.71
|
$25,802.47
|
2025-09-11
|
|
C0402
|
LOCAL
|
Traumatic Spinal Cord Injury M >=47.50 And M <56.50
|
50
|
21
|
—
|
—
|
$23,205.45
|
$38,675.75
|
$25,783.83
|
2025-09-11
|
|
923
|
APR_DRG
|
Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures
|
6
|
3
|
—
|
—
|
$25,731.04
|
$25,731.04
|
$25,731.04
|
2025-09-11
|
|
C1403
|
LOCAL
|
Cardiac M >=45.50 And M <55.50
|
50
|
21
|
—
|
—
|
$23,145.05
|
$38,575.08
|
$25,716.72
|
2025-09-11
|