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

SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL

Santa Monica, CA · CCN 050112 · Rates published

19,281 distinct procedures filed
113 distinct payers
1,148,630 rate rows
2026-03-29 last MRF observed
Data quality

1,111,023 of 1,148,630 rate rows are consumer-grade (96.7%)

37,607 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 19,934
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 9,784
percent-of-charges filed in the dollar field — excluded from medians 4,788
per-diem day rate — not a per-procedure price 2,201
placeholder amount (≤ $0.02) — excluded from medians 582
template filing: same amount across many unrelated codes — excluded 232
exceeds 10× this hospital's gross charge — excluded from medians 54
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 20
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 12
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.uclahealth.org/sites/default/files/cms-hpt/954541687_santa-monica-ucla-medical-center-and-orthopaedic-hospital_standardcharges.json
Found on page https://www.uclahealth.org/patient-resources/billing-insurance/price-transparency/machine-readable-files
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-09-20
Content fingerprint 5abda4012a4104ed… · 450,464,364 bytes · first seen 2026-05-09

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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 7 $4,335,000.00 $4,505,000.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
71894013909
NDC 		Onasemnogene Abeparvovec-xioi 2x5.5ml & 7x8.3ml IV Kit 85 $11,961.00 $4,961,662.50 $4,462,500.00 —
71894012705
NDC 		Onasemnogene Abeparvovec-xioi 2x5.5ml & 3x8.3ml IV Kit 85 $11,961.00 $4,961,662.50 $4,462,500.00 —
71894013006
NDC 		Onasemnogene Abeparvovec-xioi 2x5.5ml & 4x8.3ml IV Kit 85 $11,961.00 $4,961,662.50 $4,462,500.00 —
71894012103
NDC 		Onasemnogene Abeparvovec-xioi 2x5.5ml & 1x8.3ml IV Kit 85 $11,961.00 $4,961,662.50 $4,462,500.00 —
71894012504
NDC 		Onasemnogene Abeparvovec-xioi 1x5.5ml & 3x8.3ml IV Kit 85 $11,961.00 $4,961,662.50 $4,462,500.00 —
71894013507
NDC 		Onasemnogene Abeparvovec-xioi 7x8.3 Ml IV Kit 85 $11,961.00 $4,961,662.50 $4,462,500.00 —
71894014109
NDC 		Onasemnogene Abeparvovec-xioi 9x8.3 Ml IV Kit 85 $11,961.00 $4,961,662.50 $4,462,500.00 —
71894012905
NDC 		Onasemnogene Abeparvovec-xioi 5x8.3 Ml IV Kit 85 $11,961.00 $4,961,662.50 $4,462,500.00 —
71894012404
NDC 		Onasemnogene Abeparvovec-xioi 2x5.5ml & 2x8.3ml IV Kit 85 $11,961.00 $4,961,662.50 $4,462,500.00 —
71894013808
NDC 		Onasemnogene Abeparvovec-xioi 8x8.3 Ml IV Kit 85 $11,961.00 $4,961,662.50 $4,462,500.00 —
71894013307
NDC 		Onasemnogene Abeparvovec-xioi 2x5.5ml & 5x8.3ml IV Kit 92 $1,785,000.00 $4,961,662.50 $4,398,431.25 —
71894013407
NDC 		Onasemnogene Abeparvovec-xioi 1x5.5ml & 6x8.3ml IV Kit 92 $1,785,000.00 $4,961,662.50 $4,398,431.25 —
71894013206
NDC 		Onasemnogene Abeparvovec-xioi 6x8.3 Ml IV Kit 92 $1,785,000.00 $4,961,662.50 $4,398,431.25 —
71894012203
NDC 		Onasemnogene Abeparvovec-xioi 1x5.5ml & 2x8.3ml IV Kit 92 $1,785,000.00 $4,961,662.50 $4,398,431.25 —
71894012604
NDC 		Onasemnogene Abeparvovec-xioi 4x8.3 Ml IV Kit 92 $1,785,000.00 $4,961,662.50 $4,398,431.25 —
71894012303
NDC 		Onasemnogene Abeparvovec-xioi 3x8.3 Ml IV Kit 92 $1,785,000.00 $4,961,662.50 $4,398,431.25 —
71894013106
NDC 		Onasemnogene Abeparvovec-xioi 1x5.5ml & 5x8.3ml IV Kit 92 $1,785,000.00 $4,961,662.50 $4,398,431.25 —
71894013608
NDC 		Onasemnogene Abeparvovec-xioi 2x5.5ml & 6x8.3ml IV Kit 92 $1,785,000.00 $4,961,662.50 $4,398,431.25 —
71894014009
NDC 		Onasemnogene Abeparvovec-xioi 1x5.5ml & 8x8.3ml IV Kit 92 $1,785,000.00 $4,961,662.50 $4,398,431.25 —
71894012805
NDC 		Onasemnogene Abeparvovec-xioi 1x5.5ml & 4x8.3ml IV Kit 92 $1,785,000.00 $4,961,662.50 $4,398,431.25 —
71894013708
NDC 		Onasemnogene Abeparvovec-xioi 1x5.5ml & 7x8.3ml IV Kit 92 $1,785,000.00 $4,961,662.50 $4,398,431.25 —
71894012002
NDC 		Onasemnogene Abeparvovec-xioi 2x8.3 Ml IV Kit 92 $1,785,000.00 $4,961,662.50 $4,398,431.25 —
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 17 $3,570,000.00 $4,958,415.00 $3,685,266.66 nat. median
$3,685,267
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 9 $3,570,000.00 $4,866,750.00 $3,657,500.00 nat. median
$3,508,750
1.0× median
RRUCLASM-6362339400-J3394-0892-SM45018-1000-12400000
CDM 		Hb Lyfgenia Lovotibeglogene Autotemcel 73554111101 27 $11,961.00 $4,960,000.00 $3,379,000.00 —
60923051423
NDC 		Delandistrogene Moxeparvo-rokl 23 X 10 Ml IV Kit 17 $11,961.00 $4,848,000.00 $3,360,000.00 —
60923052433
NDC 		Delandistrogene Moxeparvo-rokl 33 X 10 Ml IV Kit 17 $11,961.00 $4,848,000.00 $3,360,000.00 —
60923050615
NDC 		Delandistrogene Moxeparvo-rokl 15 X 10 Ml IV Kit 17 $11,961.00 $4,848,000.00 $3,360,000.00 —
60923051524
NDC 		Delandistrogene Moxeparvo-rokl 24 X 10 Ml IV Kit 17 $11,961.00 $4,848,000.00 $3,360,000.00 —
60923051524_2
NDC 		Delandistrogene Moxeparvo-rokl 24 X 10 Ml IV Kit|discarded Drug Not Administered 17 $11,961.00 $4,848,000.00 $3,360,000.00 —
60923051120
NDC 		Delandistrogene Moxeparvo-rokl 20 X 10 Ml IV Kit 17 $11,961.00 $4,848,000.00 $3,360,000.00 —
60923055463
NDC 		Delandistrogene Moxeparvo-rokl 63 X 10 Ml IV Kit 29 $2,688,000.00 $4,848,000.00 $3,343,929.86 —
60923051827_2
NDC 		Delandistrogene Moxeparvo-rokl 27 X 10 Ml IV Kit|discarded Drug Not Administered 29 $2,688,000.00 $4,848,000.00 $3,343,929.86 —
60923052130
NDC 		Delandistrogene Moxeparvo-rokl 30 X 10 Ml IV Kit 29 $2,688,000.00 $4,848,000.00 $3,343,929.86 —
60923051827
NDC 		Delandistrogene Moxeparvo-rokl 27 X 10 Ml IV Kit 29 $2,688,000.00 $4,848,000.00 $3,343,929.86 —
60923051322
NDC 		Delandistrogene Moxeparvo-rokl 22 X 10 Ml IV Kit 29 $2,688,000.00 $4,848,000.00 $3,343,929.86 —
60923053847
NDC 		Delandistrogene Moxeparvo-rokl 47 X 10 Ml IV Kit 29 $2,688,000.00 $4,848,000.00 $3,343,929.86 —
60923050918
NDC 		Delandistrogene Moxeparvo-rokl 18 X 10 Ml IV Kit 29 $2,688,000.00 $4,848,000.00 $3,343,929.86 —
60923053544
NDC 		Delandistrogene Moxeparvo-rokl 44 X 10 Ml IV Kit 29 $2,688,000.00 $4,848,000.00 $3,343,929.86 —
60923053241
NDC 		Delandistrogene Moxeparvo-rokl 41 X 10 Ml IV Kit 29 $2,688,000.00 $4,848,000.00 $3,343,929.86 —
J3389
HCPCS 		Topi Adm Prad Zami Per Treat 8 $3,209,940.00 $4,002,984.00 $3,335,820.00 nat. median
$3,335,820
1.0× median
J3387
HCPCS 		Inj Elivaldogene Autotemecel 8 $3,060,000.00 $3,816,000.00 $3,180,000.00 nat. median
$3,180,000
1.0× median
RRUCLASM-6362339300-J3393-0892-SM45018-1000-11200000
CDM 		Hb Zynteglo Betibeglogene Autotemcel 73554311101 27 $11,961.00 $4,524,800.00 $3,136,000.00 —
J3392
HCPCS 		Inj, Exagamglogene Autotem 16 $2,244,000.00 $3,148,200.00 $2,332,000.00 nat. median
$2,332,000
1.0× median
RRUCLASM-8918205800-Q2058-0891-SM45018-1000-2100000
CDM 		Hb Aucatzyl Obecabtagene Autoleucel 83047041004 101 $11,961.00 $1,890,000.00 $1,470,000.00 —
RRUCLASM-6363939925-C9399-0891-SM45018-1000-2248000
CDM 		Hb Amtagvi Lifileucel 73776000111 98 $566.24 $2,151,336.00 $1,378,305.00 —
RRUCLASM-6368204200-Q2042-0891-SM45018-1000-1780600
CDM 		Hb Kymriah All 00078084619 105 $11,961.00 $1,625,944.83 $1,246,420.00 —
RRUCLASM-6368205400-Q2054-0891-SM45018-1000-1673754
CDM 		Hb Breyanzi Dlbcl 73153090001 105 $11,961.00 $1,613,517.56 $1,171,627.80 —
RRUCLASM-6368204100-Q2041-0891-SM45018-1000-1646700
CDM 		Hb Yescarta 71287011901 105 $11,961.00 $1,527,391.73 $1,152,690.00 —

Other procedures at this hospital

Browse this hospital's 19,281 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
             
J3391 HCPCS Inj, Atidarsagene Autotemcel 9 7 — — $4,335,000.00 $4,505,000.00 $4,505,000.00 2026-03-29
71894012404 NDC Onasemnogene Abeparvovec-xioi 2x5.5ml & 2x8.3ml IV Kit 96 85 — $3,506,250.00 $11,961.00 $4,961,662.50 $4,462,500.00 2026-03-29
71894012103 NDC Onasemnogene Abeparvovec-xioi 2x5.5ml & 1x8.3ml IV Kit 96 85 — $3,506,250.00 $11,961.00 $4,961,662.50 $4,462,500.00 2026-03-29
71894013507 NDC Onasemnogene Abeparvovec-xioi 7x8.3 Ml IV Kit 96 85 — $3,506,250.00 $11,961.00 $4,961,662.50 $4,462,500.00 2026-03-29
71894013909 NDC Onasemnogene Abeparvovec-xioi 2x5.5ml & 7x8.3ml IV Kit 96 85 — $3,506,250.00 $11,961.00 $4,961,662.50 $4,462,500.00 2026-03-29
71894012905 NDC Onasemnogene Abeparvovec-xioi 5x8.3 Ml IV Kit 96 85 — $3,506,250.00 $11,961.00 $4,961,662.50 $4,462,500.00 2026-03-29
71894013006 NDC Onasemnogene Abeparvovec-xioi 2x5.5ml & 4x8.3ml IV Kit 96 85 — $3,506,250.00 $11,961.00 $4,961,662.50 $4,462,500.00 2026-03-29
71894012504 NDC Onasemnogene Abeparvovec-xioi 1x5.5ml & 3x8.3ml IV Kit 96 85 — $3,506,250.00 $11,961.00 $4,961,662.50 $4,462,500.00 2026-03-29
71894014109 NDC Onasemnogene Abeparvovec-xioi 9x8.3 Ml IV Kit 96 85 — $3,506,250.00 $11,961.00 $4,961,662.50 $4,462,500.00 2026-03-29
71894012705 NDC Onasemnogene Abeparvovec-xioi 2x5.5ml & 3x8.3ml IV Kit 96 85 — $3,506,250.00 $11,961.00 $4,961,662.50 $4,462,500.00 2026-03-29
71894013808 NDC Onasemnogene Abeparvovec-xioi 8x8.3 Ml IV Kit 96 85 — $3,506,250.00 $11,961.00 $4,961,662.50 $4,462,500.00 2026-03-29
71894012303 NDC Onasemnogene Abeparvovec-xioi 3x8.3 Ml IV Kit 104 92 — $3,506,250.00 $1,785,000.00 $4,961,662.50 $4,398,431.25 2026-03-29
71894012203 NDC Onasemnogene Abeparvovec-xioi 1x5.5ml & 2x8.3ml IV Kit 104 92 — $3,506,250.00 $1,785,000.00 $4,961,662.50 $4,398,431.25 2026-03-29
71894013307 NDC Onasemnogene Abeparvovec-xioi 2x5.5ml & 5x8.3ml IV Kit 104 92 — $3,506,250.00 $1,785,000.00 $4,961,662.50 $4,398,431.25 2026-03-29
71894012805 NDC Onasemnogene Abeparvovec-xioi 1x5.5ml & 4x8.3ml IV Kit 104 92 — $3,506,250.00 $1,785,000.00 $4,961,662.50 $4,398,431.25 2026-03-29
71894014009 NDC Onasemnogene Abeparvovec-xioi 1x5.5ml & 8x8.3ml IV Kit 104 92 — $3,506,250.00 $1,785,000.00 $4,961,662.50 $4,398,431.25 2026-03-29
71894013708 NDC Onasemnogene Abeparvovec-xioi 1x5.5ml & 7x8.3ml IV Kit 104 92 — $3,506,250.00 $1,785,000.00 $4,961,662.50 $4,398,431.25 2026-03-29
71894013206 NDC Onasemnogene Abeparvovec-xioi 6x8.3 Ml IV Kit 104 92 — $3,506,250.00 $1,785,000.00 $4,961,662.50 $4,398,431.25 2026-03-29
71894012604 NDC Onasemnogene Abeparvovec-xioi 4x8.3 Ml IV Kit 104 92 — $3,506,250.00 $1,785,000.00 $4,961,662.50 $4,398,431.25 2026-03-29
71894012002 NDC Onasemnogene Abeparvovec-xioi 2x8.3 Ml IV Kit 104 92 — $3,506,250.00 $1,785,000.00 $4,961,662.50 $4,398,431.25 2026-03-29
71894013407 NDC Onasemnogene Abeparvovec-xioi 1x5.5ml & 6x8.3ml IV Kit 104 92 — $3,506,250.00 $1,785,000.00 $4,961,662.50 $4,398,431.25 2026-03-29
71894013608 NDC Onasemnogene Abeparvovec-xioi 2x5.5ml & 6x8.3ml IV Kit 104 92 — $3,506,250.00 $1,785,000.00 $4,961,662.50 $4,398,431.25 2026-03-29
71894013106 NDC Onasemnogene Abeparvovec-xioi 1x5.5ml & 5x8.3ml IV Kit 104 92 — $3,506,250.00 $1,785,000.00 $4,961,662.50 $4,398,431.25 2026-03-29
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 19 17 — — $3,570,000.00 $4,958,415.00 $3,685,266.66 2026-03-29
J1414 HCPCS Inj, Beqvez, Per Tx Dose 10 9 — — $3,570,000.00 $4,866,750.00 $3,657,500.00 2026-03-29
RRUCLASM-6362339400-J3394-0892-SM45018-1000-12400000 CDM Hb Lyfgenia Lovotibeglogene Autotemcel 73554111101 30 27 — — $11,961.00 $4,960,000.00 $3,379,000.00 2026-03-29
60923051524_2 NDC Delandistrogene Moxeparvo-rokl 24 X 10 Ml IV Kit|discarded Drug Not Administered 22 17 — — $11,961.00 $4,848,000.00 $3,360,000.00 2026-03-29
60923052433 NDC Delandistrogene Moxeparvo-rokl 33 X 10 Ml IV Kit 22 17 — — $11,961.00 $4,848,000.00 $3,360,000.00 2026-03-29
60923050615 NDC Delandistrogene Moxeparvo-rokl 15 X 10 Ml IV Kit 22 17 — — $11,961.00 $4,848,000.00 $3,360,000.00 2026-03-29
60923051120 NDC Delandistrogene Moxeparvo-rokl 20 X 10 Ml IV Kit 22 17 — — $11,961.00 $4,848,000.00 $3,360,000.00 2026-03-29
60923051524 NDC Delandistrogene Moxeparvo-rokl 24 X 10 Ml IV Kit 22 17 — — $11,961.00 $4,848,000.00 $3,360,000.00 2026-03-29
60923051423 NDC Delandistrogene Moxeparvo-rokl 23 X 10 Ml IV Kit 22 17 — — $11,961.00 $4,848,000.00 $3,360,000.00 2026-03-29
60923051827_2 NDC Delandistrogene Moxeparvo-rokl 27 X 10 Ml IV Kit|discarded Drug Not Administered 34 29 — — $2,688,000.00 $4,848,000.00 $3,343,929.86 2026-03-29
60923051827 NDC Delandistrogene Moxeparvo-rokl 27 X 10 Ml IV Kit 34 29 — — $2,688,000.00 $4,848,000.00 $3,343,929.86 2026-03-29
60923052130 NDC Delandistrogene Moxeparvo-rokl 30 X 10 Ml IV Kit 34 29 — — $2,688,000.00 $4,848,000.00 $3,343,929.86 2026-03-29
60923050918 NDC Delandistrogene Moxeparvo-rokl 18 X 10 Ml IV Kit 34 29 — — $2,688,000.00 $4,848,000.00 $3,343,929.86 2026-03-29
60923051322 NDC Delandistrogene Moxeparvo-rokl 22 X 10 Ml IV Kit 34 29 — — $2,688,000.00 $4,848,000.00 $3,343,929.86 2026-03-29
60923053847 NDC Delandistrogene Moxeparvo-rokl 47 X 10 Ml IV Kit 34 29 — — $2,688,000.00 $4,848,000.00 $3,343,929.86 2026-03-29
60923053241 NDC Delandistrogene Moxeparvo-rokl 41 X 10 Ml IV Kit 34 29 — — $2,688,000.00 $4,848,000.00 $3,343,929.86 2026-03-29
60923053544 NDC Delandistrogene Moxeparvo-rokl 44 X 10 Ml IV Kit 34 29 — — $2,688,000.00 $4,848,000.00 $3,343,929.86 2026-03-29
60923055463 NDC Delandistrogene Moxeparvo-rokl 63 X 10 Ml IV Kit 34 29 — — $2,688,000.00 $4,848,000.00 $3,343,929.86 2026-03-29
J3389 HCPCS Topi Adm Prad Zami Per Treat 9 8 — — $3,209,940.00 $4,002,984.00 $3,335,820.00 2026-03-29
J3387 HCPCS Inj Elivaldogene Autotemecel 9 8 — — $3,060,000.00 $3,816,000.00 $3,180,000.00 2026-03-29
RRUCLASM-6362339300-J3393-0892-SM45018-1000-11200000 CDM Hb Zynteglo Betibeglogene Autotemcel 73554311101 31 27 — — $11,961.00 $4,524,800.00 $3,136,000.00 2026-03-29
J3392 HCPCS Inj, Exagamglogene Autotem 18 16 — — $2,244,000.00 $3,148,200.00 $2,332,000.00 2026-03-29
RRUCLASM-8918205800-Q2058-0891-SM45018-1000-2100000 CDM Hb Aucatzyl Obecabtagene Autoleucel 83047041004 118 101 $2,100,000.00 $1,155,000.00 45% off $11,961.00 $1,890,000.00 $1,470,000.00 2026-03-29
RRUCLASM-6363939925-C9399-0891-SM45018-1000-2248000 CDM Hb Amtagvi Lifileucel 73776000111 224 98 $2,248,000.00 $1,236,400.00 45% off $566.24 $2,151,336.00 $1,378,305.00 2026-03-29
RRUCLASM-6368204200-Q2042-0891-SM45018-1000-1780600 CDM Hb Kymriah All 00078084619 123 105 $1,780,600.00 $979,330.00 45% off $11,961.00 $1,625,944.83 $1,246,420.00 2026-03-29
RRUCLASM-6368205400-Q2054-0891-SM45018-1000-1673754 CDM Hb Breyanzi Dlbcl 73153090001 123 105 $1,673,754.00 $920,564.70 45% off $11,961.00 $1,613,517.56 $1,171,627.80 2026-03-29
RRUCLASM-6368204100-Q2041-0891-SM45018-1000-1646700 CDM Hb Yescarta 71287011901 123 105 $1,646,700.00 $905,685.00 45% off $11,961.00 $1,527,391.73 $1,152,690.00 2026-03-29
RRUCLASM-6368205502-Q2055-0891-SM45018-1000-1632485 CDM Hb Abecma Mm 50 Ml 59572051501 123 105 $1,632,485.00 $897,866.75 45% off $11,961.00 $1,601,694.54 $1,142,739.50 2026-03-29
RRUCLASM-6368205500-Q2055-0891-SM45018-1000-1632485 CDM Hb Abecma Mm 500 Ml 59572051503 123 105 $1,632,485.00 $897,866.75 45% off $11,961.00 $1,601,694.54 $1,142,739.50 2026-03-29
RRUCLASM-6368205501-Q2055-0891-SM45018-1000-1632485 CDM Hb Abecma Mm 250 Ml 59572051502 123 105 $1,632,485.00 $897,866.75 45% off $11,961.00 $1,601,694.54 $1,142,739.50 2026-03-29
RRUCLASM-6368205302-Q2053-0891-SM45018-1000-1510740 CDM Hb Tecartus All 71287022001 123 105 $1,510,740.00 $830,907.00 45% off $11,961.00 $1,404,722.07 $1,057,518.00 2026-03-29
RRUCLASM-6368205300-Q2053-0891-SM45018-1000-1510740 CDM Hb Tecartus Mcl 71287021901 123 105 $1,510,740.00 $830,907.00 45% off $11,961.00 $1,404,722.07 $1,057,518.00 2026-03-29
RRUCLASM-6368204201-Q2042-0891-SM45018-1000-1466781 CDM Hb Kymriah Dlbcl 00078095819 123 105 $1,466,781.00 $806,729.55 45% off $11,961.00 $1,625,944.83 $1,026,746.70 2026-03-29
999-HL OTHER Heart-lung Adult 1 1 — — $903,260.00 $903,260.00 $903,260.00 2026-03-29
Q2057 HCPCS Afamitresgene Autoleucel 13 11 — — $741,540.00 $2,211,679.40 $770,620.00 2026-03-29
999-LB OTHER Liver Small Bowel 3 2 — — $678,338.00 $947,082.00 $718,699.11 2026-03-29
999-SB OTHER Small Bowel 1 1 — — $699,458.00 $699,458.00 $699,458.00 2026-03-29
Q2056 HCPCS Ciltacabtagene Car-pos T 24 22 — — $99,409.39 $1,686,554.27 $587,649.57 2026-03-29
999-LK OTHER Liver-kidney 3 2 — — $554,309.00 $703,058.00 $587,290.39 2026-03-29
999-CB OTHER Cord Blood Related Or Unrelated (single Or Multiple Units) 1 1 — — $541,826.00 $541,826.00 $541,826.00 2026-03-29
7-D OTHER Lung (Double) 7 6 — — $115,000.00 $908,558.00 $534,618.00 2026-03-29
005-I OTHER Intestinal - Adult & Pediatric 1 1 — — $533,493.00 $533,493.00 $533,493.00 2026-03-29
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 19 18 — — $427,262.01 $1,076,407.72 $495,274.50 2026-03-29
007-D OTHER Lung (Double) - Adult 1 1 — — $436,420.00 $436,420.00 $436,420.00 2026-03-29
005-C OTHER Liver Transplant - Cadaveric 1 1 — — $422,070.00 $422,070.00 $422,070.00 2026-03-29
75833060102 NDC Melphalan Hcl 50 Mg Ia Solr 112 96 $547,500.00 $301,125.00 45% off $11,961.00 $492,750.00 $383,250.00 2026-03-29
005-L OTHER Liver (Live Donor) - Adult & Pediatric 2 2 — — $297,460.00 $423,940.00 $360,700.00 2026-03-29
014-U OTHER Allogeneic Unrelated Bmt ? Adult & Pediatric 2 2 — — $288,536.00 $431,443.00 $359,989.50 2026-03-29
007-S OTHER Lung (Single) - Adult 1 1 — — $349,135.00 $349,135.00 $349,135.00 2026-03-29
005-LK OTHER Liver/Kidney Transplant 2 2 — — $130,000.00 $543,998.00 $336,999.00 2026-03-29
014-R OTHER Allogeneic Related Bmt ? Adult & Pediatric 2 2 — — $288,536.00 $384,553.00 $336,544.50 2026-03-29
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 46 30 — — $17,500.00 $698,545.31 $319,429.15 2026-03-29
64406005801_2 NDC Nusinersen 12 Mg/5ml It Soln 112 96 $426,183.49 $234,400.92 45% off $11,961.00 $383,565.14 $298,328.44 2026-03-29
64406005801 NDC Nusinersen 12 Mg/5ml It Soln|discarded Drug Not Administered 112 96 $426,113.49 $234,362.42 45% off $11,961.00 $383,502.14 $298,279.44 2026-03-29
005-D OTHER Liver (Deceased Donor) - Adult & Pediatri 1 1 — — $297,460.00 $297,460.00 $297,460.00 2026-03-29
7-S OTHER Lung (Single) 8 7 — — $90,000.00 $619,177.00 $296,155.00 2026-03-29
016-P OTHER Pediatric Bmt Autologous Transplant 1 1 — — $284,199.00 $284,199.00 $284,199.00 2026-03-29
016-A OTHER Adult Bmt Autologous Transplant 1 1 — — $271,999.00 $271,999.00 $271,999.00 2026-03-29
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 19 19 — — $34,020.00 $532,199.00 $268,889.39 2026-03-29
C9301 HCPCS Obecabtagene Car Pos T 2 1 — — $267,750.00 $267,750.00 $267,750.00 2026-03-29
J3403 HCPCS Revakinagene, Per Implant 13 11 — — $255,000.00 $760,550.00 $265,000.00 2026-03-29
999-F OTHER Small Bowel Transplant 4 4 — — $160,000.00 $590,901.00 $258,050.00 2026-03-29
650-C OTHER Kidney Transplant - Cadaveric 1 1 — — $253,239.00 $253,239.00 $253,239.00 2026-03-29
71336100301 NDC Vutrisiran Sodium 25 Mg/0.5ml Sc Sosy 123 105 $358,053.00 $196,929.15 45% off $4,917.75 $322,247.70 $250,637.10 2026-03-29
650C OTHER Kidney Transplant - Cadaveric Donor 2 1 — — $244,518.00 $244,518.00 $244,518.00 2026-03-29
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 21 20 — — $28,623.00 $529,075.68 $243,648.42 2026-03-29
650L OTHER Kidney Transplant - Live Donor 2 1 — — $233,859.00 $233,859.00 $233,859.00 2026-03-29
999-BM OTHER Tandem Bone Marrow Transplant Autologous/Autologous 1 1 — — $226,030.00 $226,030.00 $226,030.00 2026-03-29
999-S OTHER Sequential Autologous Transplants (3 Or 4 Autologous Transplants) 1 1 — — $226,030.00 $226,030.00 $226,030.00 2026-03-29
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 13 11 — — $197,880.00 $578,790.09 $201,669.02 2026-03-29
4LT OTHER Liver Transplant 7 4 — — $165,000.00 $539,641.00 $192,160.00 2026-03-29
999-D OTHER Liver /Kidney Transplant 3 3 — — $80,000.00 $259,200.00 $181,900.00 2026-03-29
Q0480 HCPCS Driver Pneumatic Vad, Rep 1 1 — — $176,288.09 $176,288.09 $176,288.09 2026-03-29
14 MS_DRG Allogeneic Bone Marrow Transplant 27 22 — — $126,577.81 $553,724.37 $163,520.78 2026-03-29
LOR OTHER Allogeneic (Related Donor) 1 1 — — $163,500.00 $163,500.00 $163,500.00 2026-03-29
LOU OTHER Allogeneic (Unrelated Donor) 1 1 — — $163,500.00 $163,500.00 $163,500.00 2026-03-29
7 MS_DRG Lung Transplant 26 25 — — $115,000.00 $322,806.66 $163,109.85 2026-03-29
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 19 18 — — $145,889.04 $345,270.66 $160,294.90 2026-03-29
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 1 1 — — $154,851.58 $154,851.58 $154,851.58 2026-03-29
RRUCLASM-4810240000--0481-SM45700-1000-211050 CDM Hb Cath Lab Ir Hours 24.00 114 97 $211,050.00 $116,077.50 45% off $6,200.00 $189,945.00 $147,735.00 2026-03-29
RRUCLASM-4810237500--0481-SM45700-1000-208950 CDM Hb Cath Lab Ir Hours 23.75 114 97 $208,950.00 $114,922.50 45% off $6,200.00 $188,055.00 $146,265.00 2026-03-29
RRUCLASM-4810235000--0481-SM45700-1000-206850 CDM Hb Cath Lab Ir Hours 23.50 114 97 $206,850.00 $113,767.50 45% off $6,200.00 $186,165.00 $144,795.00 2026-03-29
RRUCLASM-4810232500--0481-SM45700-1000-204750 CDM Hb Cath Lab Ir Hours 23.25 114 97 $204,750.00 $112,612.50 45% off $6,200.00 $184,275.00 $143,325.00 2026-03-29
RRUCLASM-4810230000--0481-SM45700-1000-202650 CDM Hb Cath Lab Ir Hours 23.00 114 97 $202,650.00 $111,457.50 45% off $6,200.00 $182,385.00 $141,855.00 2026-03-29
RRUCLASM-4810227500--0481-SM45700-1000-200550 CDM Hb Cath Lab Ir Hours 22.75 114 97 $200,550.00 $110,302.50 45% off $6,200.00 $180,495.00 $140,385.00 2026-03-29
RRUCLASM-4810225000--0481-SM45700-1000-198450 CDM Hb Cath Lab Ir Hours 22.50 114 97 $198,450.00 $109,147.50 45% off $6,200.00 $178,605.00 $138,915.00 2026-03-29
RRUCLASM-4810222500--0481-SM45700-1000-196350 CDM Hb Cath Lab Ir Hours 22.25 114 97 $196,350.00 $107,992.50 45% off $6,200.00 $176,715.00 $137,445.00 2026-03-29
RRUCLASM-4810220000--0481-SM45700-1000-194250 CDM Hb Cath Lab Ir Hours 22.00 114 97 $194,250.00 $106,837.50 45% off $6,200.00 $174,825.00 $135,975.00 2026-03-29
999-E OTHER Heart/Lung Transplant 5 3 — — $128,000.00 $299,600.00 $135,000.00 2026-03-29
RRUCLASM-4810217500--0481-SM45700-1000-192150 CDM Hb Cath Lab Ir Hours 21.75 114 97 $192,150.00 $105,682.50 45% off $6,200.00 $172,935.00 $134,505.00 2026-03-29
RRUCLASM-4810215000--0481-SM45700-1000-190050 CDM Hb Cath Lab Ir Hours 21.50 114 97 $190,050.00 $104,527.50 45% off $6,200.00 $171,045.00 $133,035.00 2026-03-29
RRUCLASM-4810212500--0481-SM45700-1000-187950 CDM Hb Cath Lab Ir Hours 21.25 114 97 $187,950.00 $103,372.50 45% off $6,200.00 $169,155.00 $131,565.00 2026-03-29
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 27 22 — — $17,500.00 $282,465.17 $130,273.66 2026-03-29
RRUCLASM-4810210000--0481-SM45700-1000-185850 CDM Hb Cath Lab Ir Hours 21.00 114 97 $185,850.00 $102,217.50 45% off $6,200.00 $167,265.00 $130,095.00 2026-03-29
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 23 20 — — $108,594.72 $628,857.00 $129,932.92 2026-03-29
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 18 — — $116,080.13 $274,722.92 $128,764.97 2026-03-29
RRUCLASM-4810207500--0481-SM45700-1000-183750 CDM Hb Cath Lab Ir Hours 20.75 114 97 $183,750.00 $101,062.50 45% off $6,200.00 $165,375.00 $128,625.00 2026-03-29
RRUCLASM-4810205000--0481-SM45700-1000-181650 CDM Hb Cath Lab Ir Hours 20.50 114 97 $181,650.00 $99,907.50 45% off $6,200.00 $163,485.00 $127,155.00 2026-03-29
RRUCLASM-4810202500--0481-SM45700-1000-179550 CDM Hb Cath Lab Ir Hours 20.25 114 97 $179,550.00 $98,752.50 45% off $6,200.00 $161,595.00 $125,685.00 2026-03-29
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 19 19 — — $73,818.00 $271,056.19 $125,028.59 2026-03-29
999-B OTHER Bone Marrow Transplant - Autologous 7 6 — — $80,000.00 $429,373.00 $125,000.00 2026-03-29
RRUCLASM-4810200000--0481-SM45700-1000-177450 CDM Hb Cath Lab Ir Hours 20.00 114 97 $177,450.00 $97,597.50 45% off $6,200.00 $159,705.00 $124,215.00 2026-03-29
RRUCLASM-4810197500--0481-SM45700-1000-175350 CDM Hb Cath Lab Ir Hours 19.75 114 97 $175,350.00 $96,442.50 45% off $6,200.00 $157,815.00 $122,745.00 2026-03-29
999-A OTHER Bone Marrow Transplant - Allogeneic 9 9 — — $75,000.00 $862,894.00 $121,980.00 2026-03-29
RRUCLASM-4810195000--0481-SM45700-1000-173250 CDM Hb Cath Lab Ir Hours 19.50 114 97 $173,250.00 $95,287.50 45% off $6,200.00 $155,925.00 $121,275.00 2026-03-29
RRUCLASM-4810192500--0481-SM45700-1000-171150 CDM Hb Cath Lab Ir Hours 19.25 114 97 $171,150.00 $94,132.50 45% off $6,200.00 $154,035.00 $119,805.00 2026-03-29
RRUCLASM-4810190000--0481-SM45700-1000-169050 CDM Hb Cath Lab Ir Hours 19.00 114 97 $169,050.00 $92,977.50 45% off $6,200.00 $152,145.00 $118,335.00 2026-03-29
RRUCLASM-4810187500--0481-SM45700-1000-166950 CDM Hb Cath Lab Ir Hours 18.75 114 97 $166,950.00 $91,822.50 45% off $6,200.00 $150,255.00 $116,865.00 2026-03-29
RRUCLASM-4810185000--0481-SM45700-1000-164850 CDM Hb Cath Lab Ir Hours 18.50 114 97 $164,850.00 $90,667.50 45% off $6,200.00 $148,365.00 $115,395.00 2026-03-29
215 MS_DRG Other Heart Assist System Implant 24 20 — — $17,500.00 $248,195.85 $114,518.96 2026-03-29
0-L OTHER Kidney Transplant - Living 4 3 — — $39,000.00 $217,599.00 $114,347.00 2026-03-29
RRUCLASM-4810182500--0481-SM45700-1000-162750 CDM Hb Cath Lab Ir Hours 18.25 114 97 $162,750.00 $89,512.50 45% off $6,200.00 $146,475.00 $113,925.00 2026-03-29
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 35 28 — — $17,500.00 $243,853.61 $112,522.69 2026-03-29
RRUCLASM-4810180000--0481-SM45700-1000-160650 CDM Hb Cath Lab Ir Hours 18.00 114 97 $160,650.00 $88,357.50 45% off $6,200.00 $144,585.00 $112,455.00 2026-03-29
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 1 1 — — $112,052.36 $112,052.36 $112,052.36 2026-03-29
69488000301 NDC Lutetium Lu 177 Dotatate 370 Mbq/ml IV Soln 112 96 $159,780.00 $87,879.00 45% off $11,961.00 $143,802.00 $111,846.00 2026-03-29
RRUCLASM-4810177500--0481-SM45700-1000-158550 CDM Hb Cath Lab Ir Hours 17.75 114 97 $158,550.00 $87,202.50 45% off $6,200.00 $142,695.00 $110,985.00 2026-03-29
RRUCLASM-4810175000--0481-SM45700-1000-156450 CDM Hb Cath Lab Ir Hours 17.50 114 97 $156,450.00 $86,047.50 45% off $6,200.00 $140,805.00 $109,515.00 2026-03-29
RRUCLASM-4810172500--0481-SM45700-1000-154350 CDM Hb Cath Lab Ir Hours 17.25 114 97 $154,350.00 $84,892.50 45% off $6,200.00 $138,915.00 $108,045.00 2026-03-29
RRUCLASM-4810170000--0481-SM45700-1000-152250 CDM Hb Cath Lab Ir Hours 17.00 114 97 $152,250.00 $83,737.50 45% off $6,200.00 $137,025.00 $106,575.00 2026-03-29
850 MS_DRG Acute Leukemia With Other Procedures 18 18 — — $91,205.66 $215,853.36 $105,513.26 2026-03-29
RRUCLASM-4810167500--0481-SM45700-1000-150150 CDM Hb Cath Lab Ir Hours 16.75 114 97 $150,150.00 $82,582.50 45% off $6,200.00 $135,135.00 $105,105.00 2026-03-29
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 18 18 — — $94,756.48 $224,580.23 $103,947.12 2026-03-29
RRUCLASM-4810165000--0481-SM45700-1000-148050 CDM Hb Cath Lab Ir Hours 16.50 114 97 $148,050.00 $81,427.50 45% off $6,200.00 $133,245.00 $103,635.00 2026-03-29
UTO OTHER Autologous 3 3 — — $71,155.00 $129,500.00 $102,600.00 2026-03-29
RRUCLASM-4810162500--0481-SM45700-1000-145950 CDM Hb Cath Lab Ir Hours 16.25 114 97 $145,950.00 $80,272.50 45% off $6,200.00 $131,355.00 $102,165.00 2026-03-29
RRUCLASM-4810160000--0481-SM45700-1000-143850 CDM Hb Cath Lab Ir Hours 16.00 114 97 $143,850.00 $79,117.50 45% off $6,200.00 $129,465.00 $100,695.00 2026-03-29
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 18 18 — — $88,508.31 $209,469.62 $99,987.45 2026-03-29
10 MS_DRG Pancreas Transplant 29 24 — — $40,108.00 $484,786.00 $99,654.61 2026-03-29
RRUCLASM-4810157500--0481-SM45700-1000-141750 CDM Hb Cath Lab Ir Hours 15.75 114 97 $141,750.00 $77,962.50 45% off $6,200.00 $127,575.00 $99,225.00 2026-03-29
RRUCLASM-4810155000--0481-SM45700-1000-139650 CDM Hb Cath Lab Ir Hours 15.50 114 97 $139,650.00 $76,807.50 45% off $6,200.00 $125,685.00 $97,755.00 2026-03-29
231 MS_DRG Coronary Bypass With Ptca With Mcc 34 27 — — $17,500.00 $210,130.18 $97,018.95 2026-03-29
RRUCLASM-4810152500--0481-SM45700-1000-137550 CDM Hb Cath Lab Ir Hours 15.25 124 106 $137,550.00 $75,652.50 45% off $6,200.00 $123,795.00 $96,285.00 2026-03-29
67979000201 NDC Histrelin Acetate (cpp) 50 Mg Sc Kit 126 107 $135,537.57 $74,545.66 45% off $11,961.00 $123,941.90 $94,876.30 2026-03-29
RRUCLASM-4810150000--0481-SM45700-1000-135450 CDM Hb Cath Lab Ir Hours 15.00 124 106 $135,450.00 $74,497.50 45% off $6,200.00 $121,905.00 $94,815.00 2026-03-29
RRUCLASM-4810147500--0481-SM45700-1000-133350 CDM Hb Cath Lab Ir Hours 14.75 124 106 $133,350.00 $73,342.50 45% off $6,200.00 $120,015.00 $93,345.00 2026-03-29
RRUCLASM-4810145000--0481-SM45700-1000-131250 CDM Hb Cath Lab Ir Hours 14.50 124 106 $131,250.00 $72,187.50 45% off $6,200.00 $118,125.00 $91,875.00 2026-03-29
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 34 29 — — $25,000.00 $196,143.77 $91,090.68 2026-03-29
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 18 18 — — $80,256.14 $189,939.49 $90,527.72 2026-03-29
RRUCLASM-4810142500--0481-SM45700-1000-129150 CDM Hb Cath Lab Ir Hours 14.25 124 106 $129,150.00 $71,032.50 45% off $6,200.00 $116,235.00 $90,405.00 2026-03-29
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 20 19 — — $75,144.75 $177,842.53 $90,077.75 2026-03-29
69488001061 NDC Lutetium Lu 177 Vipivotide Tet 1000 Mbq/ml IV Soln 122 104 $127,500.00 $70,125.00 45% off $216.75 $114,750.00 $89,250.00 2026-03-29
RRUCLASM-2744749911-L7499-0274-SM47704-1000-127280 CDM Hb Prsth Partl Hand Myoelectric I-digits Custom Fab 110 96 $127,280.00 $70,004.00 45% off $1,685.00 $114,552.00 $89,096.00 2026-03-29
RRUCLASM-4810140000--0481-SM45700-1000-127050 CDM Hb Cath Lab Ir Hours 14.00 124 106 $127,050.00 $69,877.50 45% off $6,200.00 $114,345.00 $88,935.00 2026-03-29
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 35 28 — — $17,500.00 $191,395.22 $88,405.89 2026-03-29
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 34 27 — — $17,500.00 $190,570.14 $88,026.57 2026-03-29
RRUCLASM-4810137500--0481-SM45700-1000-124950 CDM Hb Cath Lab Ir Hours 13.75 124 106 $124,950.00 $68,722.50 45% off $6,200.00 $112,455.00 $87,465.00 2026-03-29
RRUCLASM-4810135000--0481-SM45700-1000-122850 CDM Hb Cath Lab Ir Hours 13.50 124 106 $122,850.00 $67,567.50 45% off $6,200.00 $110,565.00 $85,995.00 2026-03-29
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 18 — — $76,029.47 $179,936.38 $85,919.45 2026-03-29
8 MS_DRG Simultaneous Pancreas/kidney Transplant 36 29 — — $59,030.11 $656,064.00 $85,414.25 2026-03-29
RRUCLASM-4810132500--0481-SM45700-1000-120750 CDM Hb Cath Lab Ir Hours 13.25 124 106 $120,750.00 $66,412.50 45% off $6,200.00 $108,675.00 $84,525.00 2026-03-29
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 26 23 — — $40,574.00 $171,443.83 $83,956.85 2026-03-29
00310453530 NDC Tremelimumab-actl 300 Mg/15ml IV Soln 123 104 $119,340.00 $65,637.00 45% off $135.45 $107,406.00 $83,538.00 2026-03-29
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 18 18 — — $75,546.03 $178,792.24 $83,075.89 2026-03-29
00003712511_2 NDC Nivolumab-relatlimab-rmbw 240-80 Mg/20ml IV Soln 112 96 $118,654.96 $65,260.23 45% off $11,961.00 $106,789.46 $83,058.47 2026-03-29
RRUCLASM-4810130000--0481-SM45700-1000-118650 CDM Hb Cath Lab Ir Hours 13.00 124 106 $118,650.00 $65,257.50 45% off $6,200.00 $106,785.00 $83,055.00 2026-03-29
00003712511 NDC Nivolumab-relatlimab-rmbw 240-80 Mg/20ml IV Soln|discarded Drug Not Administered 112 96 $118,584.96 $65,221.73 45% off $11,961.00 $106,726.46 $83,009.47 2026-03-29
RRUCLASM-2744718100-L7181-0274-SM47704-1000-117770 CDM Hb Electronic Elbow Microprocessor Simul Control 110 96 $117,770.00 $64,773.50 45% off $1,685.00 $105,993.00 $82,439.00 2026-03-29
RRUCLASM-2744599901-L5999-0274-SM47704-1000-117540 CDM Hb Prosth Knee System Genium Ottobock 110 96 $117,540.00 $64,647.00 45% off $1,685.00 $105,786.00 $82,278.00 2026-03-29
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 18 18 — — $72,798.12 $172,288.85 $82,276.58 2026-03-29
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 20 20 — — $40,574.00 $177,737.84 $82,127.15 2026-03-29
24338005008 NDC Carmustine In Polifeprosan 7.7 Mg Il Wafr 112 96 $117,011.71 $64,356.44 45% off $11,961.00 $105,310.54 $81,908.20 2026-03-29
38240 HCPCS Transplt Allo Hct/donor 21 21 — — $75,146.24 $232,186.86 $81,879.58 2026-03-29
RRUCLASM-4810127500--0481-SM45700-1000-116550 CDM Hb Cath Lab Ir Hours 12.75 124 106 $116,550.00 $64,102.50 45% off $6,200.00 $104,895.00 $81,585.00 2026-03-29
RRUCLASM-4810125000--0481-SM45700-1000-114450 CDM Hb Cath Lab Ir Hours 12.50 124 106 $114,450.00 $62,947.50 45% off $6,200.00 $103,005.00 $80,115.00 2026-03-29
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 18 18 — — $70,373.55 $166,550.71 $79,543.25 2026-03-29
RRUCLASM-4810122500--0481-SM45700-1000-112350 CDM Hb Cath Lab Ir Hours 12.25 124 106 $112,350.00 $61,792.50 45% off $6,200.00 $101,115.00 $78,645.00 2026-03-29
RRUCLASM-2744200600-L2006-0274-SM47704-1000-111810 CDM Hb Kafo Stance Microprocessor Control Cust 110 96 $111,810.00 $61,495.50 45% off $1,685.00 $100,629.00 $78,267.00 2026-03-29
955 MS_DRG Craniotomy For Multiple Significant Trauma 23 22 — — $29,106.00 $167,784.58 $77,636.62 2026-03-29
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 18 18 — — $70,370.04 $166,672.85 $77,223.64 2026-03-29
RRUCLASM-4810120000--0481-SM45700-1000-110250 CDM Hb Cath Lab Ir Hours 12.00 124 106 $110,250.00 $60,637.50 45% off $6,200.00 $99,225.00 $77,175.00 2026-03-29
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 18 18 — — $67,773.09 $160,396.29 $76,611.62 2026-03-29
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 18 18 — — $69,002.23 $163,305.24 $76,273.96 2026-03-29
RRUCLASM-2744718000-L7180-0274-SM47704-1000-108480 CDM Hb Electronic Elbow Microprocessor Seq Control 110 96 $108,480.00 $59,664.00 45% off $1,685.00 $97,632.00 $75,936.00 2026-03-29
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 35 28 — — $17,500.00 $163,900.99 $75,765.91 2026-03-29
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 35 28 — — $17,500.00 $163,900.99 $75,765.91 2026-03-29
RRUCLASM-4810117500--0481-SM45700-1000-108150 CDM Hb Cath Lab Ir Hours 11.75 124 106 $108,150.00 $59,482.50 45% off $6,200.00 $97,335.00 $75,705.00 2026-03-29
81481080301 NDC Nogapendekin Alfa Inbakic-pmln 400 Mcg/0.4ml Is Soln 112 96 $107,400.00 $59,070.00 45% off $11,961.00 $96,660.00 $75,180.00 2026-03-29
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 24 21 — — $62,454.21 $300,499.63 $75,129.51 2026-03-29
999-C OTHER Stem Cell For Breast Cancer 3 3 — — $70,000.00 $95,000.00 $75,000.00 2026-03-29
RRUCLASM-4810115000--0481-SM45700-1000-106050 CDM Hb Cath Lab Ir Hours 11.50 124 106 $106,050.00 $58,327.50 45% off $6,200.00 $95,445.00 $74,235.00 2026-03-29
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 18 18 — — $64,472.22 $152,584.24 $73,574.34 2026-03-29
RRUCLASM-4810112500--0481-SM45700-1000-103950 CDM Hb Cath Lab Ir Hours 11.25 124 106 $103,950.00 $57,172.50 45% off $6,200.00 $93,555.00 $72,765.00 2026-03-29
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 20 20 — — $40,574.00 $149,725.14 $72,134.37 2026-03-29
232 MS_DRG Coronary Bypass With Ptca Without Mcc 34 27 — — $17,500.00 $154,581.00 $71,854.27 2026-03-29
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 27 24 — — $25,000.00 $142,837.87 $71,413.68 2026-03-29
RRUCLASM-4810110000--0481-SM45700-1000-101850 CDM Hb Cath Lab Ir Hours 11.00 124 106 $101,850.00 $56,017.50 45% off $6,200.00 $91,665.00 $71,295.00 2026-03-29
J7330 HCPCS Cultured Chondrocytes Implnt 2 1 — — $71,167.10 $71,167.10 $71,167.10 2026-03-29
66658051001 NDC Emapalumab-lzsg 100 Mg/20ml IV Soln 123 104 $101,310.30 $55,720.67 45% off $370.42 $96,953.96 $70,917.21 2026-03-29
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 18 18 — — $62,599.56 $148,152.26 $70,779.24 2026-03-29
266 MS_DRG Endovascular Cardiac Valve Replacement W Mcc 32 25 — — $17,500.00 $152,761.22 $70,644.60 2026-03-29
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 18 18 — — $62,805.99 $148,640.82 $70,295.56 2026-03-29
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 34 27 — — $17,500.00 $154,581.00 $69,889.90 2026-03-29
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 18 18 — — $61,770.65 $146,190.52 $69,844.78 2026-03-29
RRUCLASM-4810107500--0481-SM45700-1000-99750 CDM Hb Cath Lab Ir Hours 10.75 124 106 $99,750.00 $54,862.50 45% off $6,200.00 $89,775.00 $69,825.00 2026-03-29
50633021011 NDC Glucarpidase 1000 Units IV Solr 112 96 $99,723.00 $54,847.65 45% off $11,961.00 $89,750.70 $69,806.10 2026-03-29
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 18 18 — — $58,170.67 $137,670.55 $69,704.14 2026-03-29
28 MS_DRG Spinal Procedures With Mcc 19 18 — — $63,282.06 $149,767.51 $69,268.30 2026-03-29
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 20 19 — — $57,215.37 $135,409.69 $68,666.32 2026-03-29
RRUCLASM-4810105000--0481-SM45700-1000-97650 CDM Hb Cath Lab Ir Hours 10.50 124 106 $97,650.00 $53,707.50 45% off $6,200.00 $87,885.00 $68,355.00 2026-03-29
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 18 18 — — $60,741.63 $143,755.18 $67,498.28 2026-03-29
RRUCLASM-4810102500--0481-SM45700-1000-95550 CDM Hb Cath Lab Ir Hours 10.25 124 106 $95,550.00 $52,552.50 45% off $6,200.00 $85,995.00 $66,885.00 2026-03-29
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 18 — — $59,213.38 $140,138.30 $66,876.09 2026-03-29
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 18 18 — — $60,029.64 $142,070.13 $66,678.23 2026-03-29
RRUCLASM-4810100000--0481-SM45700-1000-93450 CDM Hb Cath Lab Ir Hours 10.00 124 106 $93,450.00 $51,397.50 45% off $6,200.00 $84,105.00 $65,415.00 2026-03-29
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 18 18 — — $57,822.04 $136,845.47 $65,393.32 2026-03-29
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 18 18 — — $57,617.71 $136,361.90 $65,162.97 2026-03-29
72187040101 NDC Tagraxofusp-erzs 1000 Mcg/ml IV Soln 112 96 $92,738.04 $51,005.92 45% off $11,961.00 $83,464.24 $64,916.63 2026-03-29
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 34 27 — — $17,500.00 $154,581.00 $64,818.32 2026-03-29
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 34 29 — — $25,000.00 $131,957.34 $64,546.68 2026-03-29
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 29 26 — — $12,497.00 $131,521.12 $64,289.63 2026-03-29
J9029 HCPCS Instill Adstiladrin, Tx Dose 24 22 — — $15,000.00 $184,468.65 $64,274.79 2026-03-29
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 18 18 — — $56,976.86 $138,747.39 $64,201.99 2026-03-29
RRUCLASM-4810097500--0481-SM45700-1000-91350 CDM Hb Cath Lab Ir Hours 9.75 124 106 $91,350.00 $50,242.50 45% off $6,200.00 $82,215.00 $63,945.00 2026-03-29
653 MS_DRG Major Bladder Procedures With Mcc 18 18 — — $54,730.77 $129,529.47 $63,648.37 2026-03-29
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 18 18 — — $56,133.69 $132,849.71 $62,996.60 2026-03-29
11 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Mcc 19 18 — — $57,444.98 $135,953.10 $62,917.37 2026-03-29
RRUCLASM-4810095000--0481-SM45700-1000-89250 CDM Hb Cath Lab Ir Hours 9.50 124 106 $89,250.00 $49,087.50 45% off $6,200.00 $80,325.00 $62,475.00 2026-03-29
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 18 18 — — $54,825.56 $129,753.81 $61,939.40 2026-03-29
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 35 28 — — $17,500.00 $154,581.00 $61,527.31 2026-03-29
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 18 18 — — $51,621.59 $122,171.09 $61,414.46 2026-03-29
RRUCLASM-4810092500--0481-SM45700-1000-87150 CDM Hb Cath Lab Ir Hours 9.25 124 106 $87,150.00 $47,932.50 45% off $6,200.00 $78,435.00 $61,005.00 2026-03-29
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 18 18 — — $52,529.49 $124,319.77 $59,559.09 2026-03-29
RRUCLASM-4810090000--0481-SM45700-1000-85050 CDM Hb Cath Lab Ir Hours 9.00 124 106 $85,050.00 $46,777.50 45% off $6,200.00 $76,545.00 $59,535.00 2026-03-29
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 26 23 — — $47,670.00 $118,671.37 $59,475.92 2026-03-29
228 MS_DRG Other Cardiothoracic Procedures With Mcc 34 27 — — $17,500.00 $154,581.00 $58,951.82 2026-03-29
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 18 18 — — $51,837.51 $122,682.08 $58,917.14 2026-03-29
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 18 18 — — $52,015.51 $123,103.35 $58,847.32 2026-03-29
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 36 29 — — $9,031.00 $154,581.00 $58,174.22 2026-03-29
RRUCLASM-4810087500--0481-SM45700-1000-82950 CDM Hb Cath Lab Ir Hours 8.75 124 106 $82,950.00 $45,622.50 45% off $6,200.00 $74,655.00 $58,065.00 2026-03-29
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 18 18 — — $50,601.00 $119,755.68 $58,027.74 2026-03-29
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 21 21 — — $49,517.21 $271,081.00 $57,743.37 2026-03-29
471 MS_DRG Cervical Spinal Fusion With Mcc 18 18 — — $50,857.99 $120,363.89 $57,542.40 2026-03-29
0266T OTHER Implt/rpl Crtd Sns Dev Total 11 11 — — $45,000.50 $82,615.34 $57,177.64 2026-03-29
33276 HCPCS Insj Phrnc Nrv Stim Sys 21 21 — — $45,000.50 $162,588.74 $57,177.64 2026-03-29
L8701 HCPCS Ewh S/d Uprt Micro Sensor 1 1 — — $56,953.31 $56,953.31 $56,953.31 2026-03-29
64654 HCPCS 1st Opn Implt Bat Modulj Sys 10 10 — — $56,651.13 $162,588.74 $56,914.38 2026-03-29
A9543 HCPCS Y90 Ibritumomab, Rx 22 22 — — $14,774.74 $163,086.43 $56,824.54 2026-03-29
00003232822 NDC Ipilimumab 200 Mg/40ml IV Soln 123 104 $81,107.46 $44,609.10 45% off $173.02 $72,996.71 $56,775.22 2026-03-29
0620T OTHER Evasc Ven Artlz Tibl/prnl Vn 21 21 — — $35,000.50 $162,588.74 $56,651.13 2026-03-29
RRUCLASM-4810085000--0481-SM45700-1000-80850 CDM Hb Cath Lab Ir Hours 8.50 124 106 $80,850.00 $44,467.50 45% off $6,200.00 $72,765.00 $56,595.00 2026-03-29
6 MS_DRG Liver Transplant Without Mcc 20 19 — — $48,838.92 $115,585.43 $56,105.54 2026-03-29
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 34 29 — — $25,000.00 $130,239.00 $56,062.29 2026-03-29
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 18 18 — — $49,416.10 $116,951.42 $56,034.89 2026-03-29
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 18 18 — — $49,268.65 $116,602.44 $55,939.06 2026-03-29
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 24 22 — — $53,477.33 $156,139.77 $55,536.50 2026-03-29
RRUCLASM-4810082500--0481-SM45700-1000-78750 CDM Hb Cath Lab Ir Hours 8.25 124 106 $78,750.00 $43,312.50 45% off $6,200.00 $70,875.00 $55,125.00 2026-03-29
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 22 21 — — $47,005.23 $111,245.68 $55,072.32 2026-03-29
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 20 20 — — $40,574.00 $115,124.29 $55,046.54 2026-03-29
799 MS_DRG Splenic Procedures With Mcc 18 18 — — $47,700.37 $112,890.85 $54,907.07 2026-03-29
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 18 18 — — $48,289.13 $114,284.26 $54,824.29 2026-03-29
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 18 18 — — $48,412.36 $114,575.90 $54,785.32 2026-03-29
64568 HCPCS Opn Impltj Crnl Nrv Nea&pg 21 21 — — $38,719.74 $162,588.74 $54,316.76 2026-03-29
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 18 18 — — $47,908.91 $113,384.40 $54,217.75 2026-03-29
31 MS_DRG Ventricular Shunt Procedures With Mcc 34 29 — — $25,000.00 $130,239.00 $53,805.05 2026-03-29
00597003510 NDC Spesolimab-sbzo 450 Mg/7.5ml IV Soln 122 104 $76,699.50 $42,184.73 45% off $61.43 $69,029.55 $53,689.65 2026-03-29
RRUCLASM-4810080000--0481-SM45700-1000-76650 CDM Hb Cath Lab Ir Hours 8.00 124 106 $76,650.00 $42,157.50 45% off $6,200.00 $68,985.00 $53,655.00 2026-03-29
57894006103 NDC Ustekinumab 90 Mg/ml Sc Sosy 123 106 $75,651.81 $41,608.50 45% off $11,961.00 $68,086.63 $52,956.27 2026-03-29
245 MS_DRG Aicd Generator Procedures 34 27 — — $17,500.00 $131,258.00 $52,698.81 2026-03-29
72694051501 NDC Calaspargase Pegol-mknl 3750 Unit/5ml IV Soln 118 100 $75,099.36 $41,304.65 45% off $77.34 $67,589.42 $52,569.55 2026-03-29
163 MS_DRG Major Chest Procedures With Mcc 31 26 — — $17,500.00 $154,581.00 $52,515.48 2026-03-29
RRUCLASM-4810077500--0481-SM45700-1000-74550 CDM Hb Cath Lab Ir Hours 7.75 124 106 $74,550.00 $41,002.50 45% off $6,200.00 $67,095.00 $52,185.00 2026-03-29
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 26 23 — — $40,574.00 $131,258.00 $52,182.11 2026-03-29
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 18 18 — — $46,266.90 $109,498.32 $52,122.43 2026-03-29
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 18 18 — — $45,214.71 $107,008.13 $51,928.28 2026-03-29
72493010303 NDC Mitomycin 80 (2 X 40) Mg Ul Solr 112 96 $73,440.00 $40,392.00 45% off $11,961.00 $66,096.00 $51,408.00 2026-03-29
901 MS_DRG Wound Debridements For Injuries With Mcc 18 18 — — $44,200.44 $104,607.68 $51,029.83 2026-03-29
140 MS_DRG Major Head And Neck Procedures With Mcc 18 18 — — $44,924.02 $106,320.15 $50,852.74 2026-03-29
RRUCLASM-4810075000--0481-SM45700-1000-72450 CDM Hb Cath Lab Ir Hours 7.50 124 106 $72,450.00 $39,847.50 45% off $6,200.00 $65,205.00 $50,715.00 2026-03-29
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 18 18 — — $43,947.66 $104,009.44 $50,245.60 2026-03-29
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 18 18 — — $44,382.65 $105,038.92 $50,126.71 2026-03-29
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 18 18 — — $44,665.97 $105,709.45 $50,117.08 2026-03-29
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 18 18 — — $44,253.10 $104,732.32 $50,096.38 2026-03-29
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 21 19 — — $27,247.00 $107,868.10 $50,005.79 2026-03-29
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 33 29 — — $25,000.00 $130,239.00 $49,978.02 2026-03-29
793 MS_DRG Full Term Neonate With Major Problems 18 18 — — $43,916.06 $103,934.66 $49,716.42 2026-03-29
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 18 18 — — $43,741.22 $103,520.88 $49,513.76 2026-03-29
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