APR-DRG 021

Open skull surgery, not for trauma

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

CRANIOTOMY EXCEPT FOR TRAUMA,MINOR

Payers reporting APR-DRG 021

24 payers file a negotiated rate for this code. Each is shown once, under the terms the most hospitals file it under; rates under different terms (billing class, payment method, setting) are never blended, so open a payer to see them all. Figures are hospital-level averages; the median is across hospitals.

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1	Molina facility · case rate · inpatient · +7 other terms	16	$37,562	$30,492	$9,384 – $93,837
2	UnitedHealthcare facility · case rate · inpatient · +6 other terms	15	$44,312	$45,903	$12,347 – $136,525
3	Humana facility · case rate · inpatient · +5 other terms	13	$29,209	$26,365	$8,935 – $50,151
4	Aetna case rate · inpatient · +7 other terms	9	$115,471	$93,640	$37,377 – $138,569
5	Blue Cross Blue Shield facility · case rate · inpatient · +4 other terms	9	$23,682	$68,273	$11,268 – $148,358
6	Highmark fee schedule · inpatient · +2 other terms	9	$33,186	$35,491	$19,678 – $61,816
7	Wellmark case rate · inpatient · +1 other terms	9	$114,003	$109,209	$85,352 – $137,130
8	Aetna Better Health facility · case rate · inpatient · +1 other terms	6	$15,826	$24,344	$9,384 – $165,851
9	Anthem facility · case rate · inpatient · +5 other terms	6	$74,675	$72,828	$16,786 – $136,525
10	Kaiser case rate · inpatient · +2 other terms	5	$70,730	$74,661	$69,440 – $85,747
11	Caresource facility · case rate · inpatient · +3 other terms	4	$81,644	$81,834	$16,786 – $136,525
12	Amerihealth Caritas case rate · inpatient · +1 other terms	3	$91,485	$91,485	$91,485 – $91,485
13	Carefirst facility · case rate · inpatient	3	$64,319	$72,574	$30,185 – $118,248
14	Excellus facility · case rate · inpatient · +2 other terms	3	$64,319	$72,574	$30,185 – $118,248
15	Medicaid case rate · inpatient · +2 other terms	3	$110,039	$110,039	$110,039 – $110,039
16	Premera facility · case rate · inpatient	3	$64,319	$72,574	$30,185 – $118,248
17	Regence facility · case rate · inpatient	3	$64,319	$72,574	$30,185 – $118,248
18	Medical Mutual per diem · both · +4 other terms	2	$3,906	$3,906	$3,588 – $4,224
19	WellCare case rate · inpatient · +1 other terms	2	$30,333	$27,767	$12,228 – $46,750
20	Bcbs Ny case rate · inpatient · +1 other terms	1	$76,637	$76,637	$35,964 – $137,496
21	Cigna case rate · inpatient · +3 other terms	1	$64,494	$64,494	$30,266 – $115,710
22	Sanford Health Plan case rate · inpatient	1	$60,066	$60,066	$51,579 – $69,192
23	Superior Healthplan facility · case rate · inpatient	1	$33,321	$33,321	$16,192 – $60,480
24	Ucare facility · case rate · inpatient	1	$31,148	$31,148	$17,506 – $51,805