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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

PALOMAR HEALTH DOWNTOWN CAMPUS

Escondido, CA · CCN 050115 · Rates published

10,739 distinct procedures filed
116 distinct payers
125,919 rate rows
2026-04-01 last MRF observed
Data quality

72,682 of 125,919 rate rows are consumer-grade (57.7%)

53,237 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 43,518
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 9,407
placeholder amount (≤ $0.02) — excluded from medians 269
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 43
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://hospitalpricedisclosure.com/Download.aspx?pxi=6zygLFNJwULWEO0nVbhl5Q*-*
Found on page https://HospitalPriceDisclosure.com/Default.aspx?ci=tWKNrFY5HZER1VRkXeC4JQ*-*
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-09
Content fingerprint abb83494e73d385f… · 39,888,675 bytes · first seen 2026-09-28

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 2 $4,414,900.00 $4,505,000.00 $4,459,950.00 nat. median
$4,505,000
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 5 $2,626,436.64 $4,941,988.93 $4,154,057.94 nat. median
$2,455,111
1.7× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 4 $2,871,655.14 $4,688,416.55 $3,736,081.94 nat. median
$2,968,000
1.3× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 2 $3,617,621.00 $3,691,450.00 $3,654,535.50 nat. median
$3,685,267
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 5 $2,254,888.53 $4,242,871.89 $3,566,405.33 nat. median
$2,332,000
1.5× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 2 $3,250,559.18 $3,316,897.12 $3,283,728.15 nat. median
$3,325,455
1.0× median
J3389
HCPCS 		Topi Adm Prad Zami Per Treat 2 $3,220,067.05 $3,285,782.70 $3,252,924.88 nat. median
$3,335,820
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 2 $3,170,597.90 $3,235,303.98 $3,202,950.94 nat. median
$3,248,446
1.0× median
J3387
HCPCS 		Inj Elivaldogene Autotemecel 3 $3,116,400.00 $4,929,000.00 $3,180,000.00 nat. median
$3,180,000
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 5 $797,688.03 $1,500,955.84 $1,261,649.43 nat. median
$813,967
1.5× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 5 $599,459.31 $1,127,962.21 $948,124.42 nat. median
$621,313
1.5× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 5 $576,218.20 $1,084,230.98 $911,365.52 nat. median
$599,737
1.5× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 5 $567,979.20 $1,068,728.21 $898,334.45 nat. median
$579,571
1.6× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 5 $556,618.22 $1,047,351.03 $880,365.56 nat. median
$574,037
1.5× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 5 $551,250.87 $1,037,251.64 $871,876.38 nat. median
$562,501
1.6× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 5 $499,901.84 $940,631.63 $790,661.07 nat. median
$513,770
1.5× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 5 $272,685.00 $513,093.00 $431,287.50 nat. median
$286,598
1.5× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 15 $419,615.01 $816,765.79 $423,853.55 nat. median
$168,055
outlier · 2.5×
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 5 $199,586.57 $375,548.60 $315,672.63 nat. median
$207,733
1.5× median
J3403
HCPCS 		Revakinagene, Per Implant 6 $202,975.00 $482,352.88 $287,750.00 nat. median
$264,195
1.1× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 15 $173,423.00 $530,714.59 $275,409.75 nat. median
$186,516
1.5× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 15 $207,959.77 $404,786.33 $210,060.37 nat. median
$131,925
1.6× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 15 $98,265.12 $914,780.96 $208,833.36 nat. median
$145,435
1.4× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 5 $106,078.48 $199,600.74 $167,777.19 nat. median
$108,243
1.6× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 16 $71,531.72 $263,276.95 $136,625.30 nat. median
$97,418
1.4× median
J3404
HCPCS 		Inj Zopapogene Per Ther Dose 6 $93,368.50 $224,783.60 $132,365.00 nat. median
$128,604
1.0× median
7
MS_DRG 		Lung Transplant 15 $126,522.28 $246,271.14 $127,800.28 nat. median
$70,649
1.8× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 15 $117,484.01 $228,678.48 $118,670.72 nat. median
$72,715
1.6× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 15 $65,744.84 $215,731.64 $111,952.07 nat. median
$65,418
1.7× median
209
MS_DRG 		Complex Aortic Arch Procedures 15 $110,706.52 $215,486.33 $111,824.77 nat. median
$2,110
outlier · 53.0×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 15 $107,821.40 $209,870.55 $108,910.51 nat. median
$2,736
outlier · 39.8×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 15 $106,395.34 $207,094.77 $107,470.04 nat. median
$74,509
1.4× median
L8702
HCPCS 		Pow Ue Rom Dev Ewhf Uprt Cus 5 $67,425.68 $126,870.35 $106,642.65 nat. median
$68,802
1.6× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 15 $100,931.46 $196,459.52 $101,950.97 nat. median
$69,922
1.5× median
J9183
HCPCS 		Gemcitabine Intravesical Sys 7 $59,340.36 $172,132.65 $98,625.08 nat. median
$78,093
1.3× median
215
MS_DRG 		Other Heart Assist System Implant 15 $13,563.00 $189,788.92 $98,489.32 nat. median
$73,023
1.3× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 $1,925.70 $186,501.73 $96,783.46 nat. median
$69,822
1.4× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 15 $88,319.77 $171,911.31 $89,211.89 nat. median
$2,596
outlier · 34.4×
850
MS_DRG 		Acute Leukemia With Other Procedures 15 $84,925.69 $165,304.86 $85,783.53 nat. median
$2,633
outlier · 32.6×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 15 $38,970.06 $391,319.99 $83,535.16 nat. median
$60,505
1.4× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Or Infection Wi… 15 $82,442.90 $160,472.20 $83,275.66 nat. median
$59,651
1.4× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 6 $55,052.27 $104,784.47 $78,045.52 nat. median
$65,477
1.2× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 15 $16,992.29 $150,384.20 $78,040.58 nat. median
$56,428
1.4× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 15 $57,853.90 $709,348.41 $76,175.11 nat. median
$55,923
1.4× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 16 $47,036.99 $146,164.84 $75,850.98 nat. median
$55,935
1.4× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 7 $45,684.96 $131,916.10 $75,730.55 nat. median
$63,499
1.2× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 16 $10,928.65 $661,808.97 $75,603.22 nat. median
$52,327
1.4× median
L7181
HCPCS 		Electronic Elbo Simultaneous 5 $47,192.39 $88,798.74 $74,641.02 nat. median
$48,410
1.5× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 6 $52,190.80 $118,627.50 $73,988.93 nat. median
$66,211
1.1× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 15 $70,956.76 $138,114.82 $71,673.49 nat. median
$9,905
outlier · 7.2×

Other procedures at this hospital

Browse this hospital's 10,739 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
834 MS_DRG Acute Leukemia With Mcc 18 15 — — $54,197.71 $105,493.92 $54,745.16 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 18 15 — — $84,925.69 $165,304.86 $85,783.53 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 5 5 — — $797,688.03 $1,500,955.84 $1,261,649.43 2026-04-01
245 MS_DRG Aicd Generator Procedures 19 15 — — $25,569.01 $87,991.83 $45,662.60 2026-04-01
265 MS_DRG Aicd Lead Procedures 18 15 — — $36,052.34 $70,174.61 $36,416.51 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 18 15 — — $117,484.01 $228,678.48 $118,670.72 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 21 15 — — $24,090.68 $94,771.88 $49,181.05 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc O… 20 15 — — $24,090.68 $1,022,871.92 $43,023.52 2026-04-01
27290 HCPCS Amputation Of Leg At Hip 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
27295 HCPCS Amputation Of Leg At Hip 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 19 15 — — $34,784.29 $67,706.40 $35,135.65 2026-04-01
22808 HCPCS Ant Fusion 2-3 Vert Seg 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
22810 HCPCS Ant Fusion 4-7 Vert Seg 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
22812 HCPCS Ant Fusion 8/> Vert Seg 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
22837 HCPCS Ant Thrc Vrt Body Tethrg 8+ 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
22836 HCPCS Ant Thrc Vrt Body Tethrg <7 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 20 15 — — $64,477.21 $131,685.75 $68,337.18 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 21 15 — — $1,632.00 $81,591.07 $42,340.98 2026-04-01
27278 HCPCS Arthrd Si Jt Prq Wo Tfxj Dev 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
27279 HCPCS Arthrodesis Sacroiliac Joint 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 18 15 — — $58,461.39 $113,793.03 $59,051.91 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 18 15 — — $53,639.30 $104,407.00 $54,181.11 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 5 5 — — $551,250.87 $1,037,251.64 $871,876.38 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 20 15 — — $23,523.00 $156,981.66 $37,582.80 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 19 15 — — $15,618.46 $68,310.24 $35,449.01 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 18 15 — — $54,518.60 $106,118.52 $55,069.29 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 18 15 — — $35,542.41 $69,182.04 $35,901.42 2026-04-01
2616 OTHER Brachytx, Non-str,yttrium-90 1 1 — — $48,391.94 $48,391.94 $48,391.94 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 5 5 — — $499,901.84 $940,631.63 $790,661.07 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 18 15 — — $70,101.69 $136,450.47 $70,809.79 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 18 15 — — $59,206.91 $115,244.16 $59,804.96 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 19 16 — — $43,199.85 $89,050.45 $46,211.96 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 22 16 — — $1,925.70 $186,501.73 $96,783.46 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 18 15 — — $64,720.22 $125,975.62 $65,373.96 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 16 — — $62,191.14 $125,975.62 $65,373.96 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 22 15 — — $57,853.90 $709,348.41 $76,175.11 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 22 15 — — $26,537.88 $712,891.79 $53,206.76 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 18 15 — — $49,838.06 $97,008.01 $50,341.47 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 18 15 — — $38,500.23 $74,939.33 $38,889.12 2026-04-01
22856 HCPCS Cerv Artific Diskectomy 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 20 15 — — $44,544.95 $93,016.96 $48,270.35 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 18 15 — — $47,551.10 $92,556.53 $48,031.41 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 18 15 — — $419,615.01 $816,765.79 $423,853.55 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 18 15 — — $35,513.32 $69,125.42 $35,872.04 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 5 5 — — $576,218.20 $1,084,230.98 $911,365.52 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 18 15 — — $88,319.77 $171,911.31 $89,211.89 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 18 15 — — $56,885.05 $110,724.75 $57,459.65 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 4 4 — — $12,584.00 $136,829.67 $60,707.46 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 18 15 — — $110,706.52 $215,486.33 $111,824.77 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 18 15 — — $106,395.34 $207,094.77 $107,470.04 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 18 15 — — $65,798.26 $128,073.99 $66,462.89 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 21 16 — — $47,036.99 $146,164.84 $75,850.98 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 22 15 — — $38,702.97 $130,608.00 $54,478.81 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 22 15 — — $38,970.06 $391,319.99 $83,535.16 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 19 15 — — $59,749.81 $135,430.00 $60,353.34 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 20 15 — — $51,624.86 $112,640.07 $58,453.59 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 19 16 — — $39,873.22 $80,941.94 $42,004.12 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 18 15 — — $42,927.75 $83,557.34 $43,361.36 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 25 16 — — $32,041.83 $87,695.57 $45,508.86 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 19 15 — — $66,230.63 $128,915.59 $66,899.63 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 25 17 — — $38,542.15 $350,273.00 $57,099.28 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 24 16 — — $21,615.45 $75,716.78 $39,292.57 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 2 1 — — $56,647.89 $80,307.57 $68,477.73 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 5 5 — — $106,078.48 $199,600.74 $167,777.19 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 23 15 — — $98,265.12 $914,780.96 $208,833.36 2026-04-01
L6880 HCPCS Elec Hand Ind Art Digits 5 5 — — $28,140.70 $52,950.46 $44,508.25 2026-04-01
L5856 HCPCS Elec Knee-shin Swing/stance 5 5 — — $28,274.21 $53,201.67 $44,719.41 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 5 5 — — $47,192.39 $88,798.74 $74,641.02 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 5 5 — — $43,469.71 $81,794.03 $68,753.12 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 18 15 — — $56,301.44 $109,588.76 $56,870.14 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 21 15 — — $57,743.15 $117,542.53 $60,997.68 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 21 15 — — $17,436.00 $91,735.68 $47,605.44 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 5 5 — — $32,945.30 $61,990.95 $52,107.36 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 5 5 — — $32,945.30 $61,990.95 $52,107.36 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 18 15 — — $207,959.77 $404,786.33 $210,060.37 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 18 15 — — $38,728.05 $75,382.78 $39,119.24 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 22 16 — — $17,978.25 $246,322.33 $46,929.75 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 18 15 — — $58,595.18 $114,053.45 $59,187.05 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 21 15 — — $2,515.31 $80,579.62 $41,816.10 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 18 15 — — $70,511.77 $137,248.67 $71,224.01 2026-04-01
28705 HCPCS Fusion Of Foot Bones 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
27280 HCPCS Fusion Of Sacroiliac Joint 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
J9183 HCPCS Gemcitabine Intravesical Sys 8 7 — — $59,340.36 $172,132.65 $98,625.08 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 22 15 — — $173,423.00 $530,714.59 $275,409.75 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 19 15 — — $65,744.84 $215,731.64 $111,952.07 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 18 15 — — $60,318.88 $117,408.56 $60,928.16 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 5 5 — — $556,618.22 $1,047,351.03 $880,365.56 2026-04-01
C8003 HCPCS Imp Extar Knee Shck Absrb 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 32 16 — — $1,676.00 $353,080.04 $49,346.55 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 2 2 — — $3,250,559.18 $3,316,897.12 $3,283,728.15 2026-04-01
J3387 HCPCS Inj Elivaldogene Autotemecel 3 3 — — $3,116,400.00 $4,929,000.00 $3,180,000.00 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 5 5 — — $2,626,436.64 $4,941,988.93 $4,154,057.94 2026-04-01
J3404 HCPCS Inj Zopapogene Per Ther Dose 7 6 — — $93,368.50 $224,783.60 $132,365.00 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 7 6 — — $52,190.80 $118,627.50 $73,988.93 2026-04-01
J3391 HCPCS Inj, Atidarsagene Autotemcel 2 2 — — $4,414,900.00 $4,505,000.00 $4,459,950.00 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 4 4 — — $2,871,655.14 $4,688,416.55 $3,736,081.94 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 5 5 — — $2,254,888.53 $4,242,871.89 $3,566,405.33 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 2 2 — — $3,617,621.00 $3,691,450.00 $3,654,535.50 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 2 2 — — $3,170,597.90 $3,235,303.98 $3,202,950.94 2026-04-01
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 5 5 — — $199,586.57 $375,548.60 $315,672.63 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 5 5 — — $39,563.90 $74,444.72 $62,575.55 2026-04-01
37182 HCPCS Insert Hepatic Shunt (tips) 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
54405 HCPCS Insert Multi-comp Penis Pros 5 5 — — $26,124.11 $49,155.98 $41,318.75 2026-04-01
33221 HCPCS Insert Pulse Gen Mult Leads 5 5 — — $24,278.28 $45,682.80 $38,399.32 2026-04-01
54401 HCPCS Insert Self-contd Prosthesis 5 5 — — $26,124.11 $49,155.98 $41,318.75 2026-04-01
53444 HCPCS Insert Tandem Cuff 5 5 — — $26,124.11 $49,155.98 $41,318.75 2026-04-01
53445 HCPCS Insert Uro/ves Nck Sphincter 5 5 — — $26,124.11 $49,155.98 $41,318.75 2026-04-01
0916T OTHER Insj Perm Ccm-d Sys Pg Only 5 5 — — $28,036.78 $52,754.91 $44,343.88 2026-04-01
0915T OTHER Insj Perm Ccm-d Sys Pg&eltrd 5 5 — — $39,563.90 $74,444.72 $62,575.55 2026-04-01
22867 HCPCS Insj Stablj Dev W/dcmprn 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
0515T OTHER Insj Wcs Lv Compl Sys 5 5 — — $28,036.78 $52,754.91 $44,343.88 2026-04-01
0409T OTHER Insj/rplc Car Modulj Pls Gn 5 5 — — $28,036.78 $52,754.91 $44,343.88 2026-04-01
0408T OTHER Insj/rplc Cardiac Modulj Sys 5 5 — — $39,563.90 $74,444.72 $62,575.55 2026-04-01
0525T OTHER Insj/rplcmt Compl Iims 5 5 — — $24,278.28 $45,682.80 $38,399.32 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 5 5 — — $39,563.90 $74,444.72 $62,575.55 2026-04-01
0571T OTHER Insj/rplcmt Icds Ss Eltrd 5 5 — — $39,563.90 $74,444.72 $62,575.55 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 5 5 — — $28,036.78 $52,754.91 $44,343.88 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 5 5 — — $39,563.90 $74,444.72 $62,575.55 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 5 5 — — $28,036.78 $52,754.91 $44,343.88 2026-04-01
L6975 HCPCS Interscap-thor Myoelectronic 5 5 — — $22,292.31 $41,945.95 $35,258.25 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 19 15 — — $52,296.60 $101,793.49 $52,824.85 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 19 15 — — $16,992.29 $150,384.20 $78,040.58 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 18 15 — — $46,553.52 $90,614.79 $47,023.76 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 18 15 — — $36,901.59 $71,827.63 $37,274.33 2026-04-01
22818 HCPCS Kyphectomy 1-2 Segments 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
22819 HCPCS Kyphectomy 3 Or More 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
22533 HCPCS Lat Lumbar Spine Fusion 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
5342 OTHER Level 2 Abdominal/Peritoneal/Biliary And Related Procedures 1 1 — — $40,104.67 $40,104.67 $40,104.67 2026-04-01
5378 OTHER Level 8 Urology And Related Services 1 1 — — $55,684.89 $55,684.89 $55,684.89 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 25 16 — — $14,444.83 $393,777.67 $37,834.46 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 5 5 — — $567,979.20 $1,068,728.21 $898,334.45 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 18 15 — — $100,931.46 $196,459.52 $101,950.97 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 18 15 — — $45,929.19 $89,399.54 $46,393.12 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 19 15 — — $36,125.05 $70,316.13 $36,489.95 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc Or In… 27 15 — — $250.00 $248,035.32 $36,939.43 2026-04-01
22857 HCPCS Lumbar Artif Diskectomy 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
22612 HCPCS Lumbar Spine Fusion 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
7 MS_DRG Lung Transplant 18 15 — — $126,522.28 $246,271.14 $127,800.28 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 18 15 — — $57,832.22 $112,568.36 $58,416.38 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 19 16 — — $45,270.26 $88,414.52 $45,881.95 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 18 15 — — $51,352.35 $99,955.53 $51,871.06 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 21 15 — — $9,450.80 $86,470.91 $44,873.33 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 18 15 — — $42,325.72 $82,385.51 $42,753.25 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 28 16 — — $39,205.00 $101,291.00 $45,996.53 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 15 — — $107,821.40 $209,870.55 $108,910.51 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 15 — — $70,956.76 $138,114.82 $71,673.49 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 15 — — $55,478.36 $107,986.67 $56,038.75 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc 18 15 — — $65,750.76 $127,981.53 $66,414.91 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 18 15 — — $42,088.20 $81,923.19 $42,513.33 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 18 15 — — $46,324.73 $90,169.46 $46,792.66 2026-04-01
22600 HCPCS Neck Spine Fusion 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 20 15 — — $10,751.26 $70,053.83 $36,353.83 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 19 15 — — $31,725.77 $70,368.97 $36,517.37 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 18 15 — — $38,444.00 $74,829.88 $38,832.32 2026-04-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 5 5 — — $272,685.00 $513,093.00 $431,287.50 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 20 16 — — $47,742.80 $175,619.83 $49,432.72 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 20 16 — — $22,223.49 $84,791.45 $44,001.79 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 18 15 — — $37,297.13 $72,597.55 $37,673.87 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc Or Insertion… 19 15 — — $19,118.20 $72,223.90 $37,479.97 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 18 15 — — $44,241.37 $86,114.26 $44,688.25 2026-04-01
215 MS_DRG Other Heart Assist System Implant 20 15 — — $13,563.00 $189,788.92 $98,489.32 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 21 15 — — $12,618.41 $124,287.98 $41,653.55 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 24 15 — — $6,054.24 $81,183.47 $42,129.46 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 22 15 — — $21,103.99 $122,067.00 $35,810.35 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 27 17 — — $25,402.86 $148,066.68 $52,653.48 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 24 15 — — $17,352.62 $74,346.80 $38,581.63 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 24 15 — — $27,696.89 $543,230.25 $42,249.91 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 26 16 — — $10,928.65 $661,808.97 $75,603.22 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 19 15 — — $33,634.00 $77,079.21 $39,999.59 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 20 15 — — $6,167.56 $72,429.59 $37,586.71 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 23 15 — — $2,125.00 $67,723.37 $35,144.46 2026-04-01
10 MS_DRG Pancreas Or Islet Cell Transplant 18 15 — — $70,540.86 $137,305.28 $71,253.39 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 20 15 — — $19,186.37 $105,127.85 $54,555.19 2026-04-01
J9266 HCPCS Pegaspargase Injection 8 7 — — $23,077.49 $69,962.18 $39,347.62 2026-04-01
C9607 HCPCS Perc D-e Cor Revasc Chro Sin 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
C9602 HCPCS Perc D-e Cor Stent Ather S 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 18 15 — — $40,970.41 $79,747.45 $41,384.25 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 19 16 — — $38,408.13 $74,760.07 $38,796.09 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 20 15 — — $13,955.56 $69,282.05 $35,953.32 2026-04-01
33902 HCPCS Perq P-art Revsc 1 Abnor Uni 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
0632T OTHER Perq Tcat US Abltj Nrv P-art 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
93582 HCPCS Perq Transcath Closure Pda 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
93591 HCPCS Perq Transcath Cls Aortic 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
93590 HCPCS Perq Transcath Cls Mitral 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
22804 HCPCS Post Fusion 13/> Vert Seg 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
22802 HCPCS Post Fusion 7-12 Vert Seg 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
22800 HCPCS Post Fusion <=6 Vert Seg 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 20 15 — — $26,546.21 $87,733.30 $45,528.44 2026-04-01
L8701 HCPCS Pow Ue Rom Dev Ewh Uprt Cust 5 5 — — $34,270.73 $64,484.92 $54,203.70 2026-04-01
L8702 HCPCS Pow Ue Rom Dev Ewhf Uprt Cus 5 5 — — $67,425.68 $126,870.35 $106,642.65 2026-04-01
791 MS_DRG Prematurity With Major Problems 18 15 — — $40,325.72 $78,492.59 $40,733.05 2026-04-01
22586 HCPCS Prescrl Fuse With Instr L5-s1 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
37184 HCPCS Prim Art M-thrmbc 1st Vsl 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
36837 HCPCS Prq Av Fstl Crt Uxtr Sep Acs 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
36836 HCPCS Prq Av Fstl Crtj Uxtr 1 Acs 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
92933 HCPCS Prq Card Stent/ath/angio 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
92930 HCPCS Prq Tcat Plmt Ntrac St 2+les 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
0793T OTHER Prq Tcat Thrm Ablt Nrv P-art 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
23472 HCPCS Reconstruct Shoulder Joint 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
25442 HCPCS Reconstruct Wrist Joint 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
27703 HCPCS Reconstruction Ankle Joint 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
332 MS_DRG Rectal Resection With Mcc 18 15 — — $36,076.58 $70,221.79 $36,440.99 2026-04-01
54411 HCPCS Remov/replc Penis Pros Comp 5 5 — — $26,124.11 $49,155.98 $41,318.75 2026-04-01
54410 HCPCS Remove/replace Penis Prosth 5 5 — — $26,124.11 $49,155.98 $41,318.75 2026-04-01
53447 HCPCS Remove/replace Ur Sphincter 5 5 — — $26,124.11 $49,155.98 $41,318.75 2026-04-01
33229 HCPCS Remv&replc Pm Gen Mult Leads 5 5 — — $24,278.28 $45,682.80 $38,399.32 2026-04-01
54416 HCPCS Remv/repl Penis Contain Pros 5 5 — — $26,124.11 $49,155.98 $41,318.75 2026-04-01
54417 HCPCS Remv/replc Penis Pros Compl 5 5 — — $26,124.11 $49,155.98 $41,318.75 2026-04-01
20805 HCPCS Replant Forearm Complete 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
20802 HCPCS Replantation Arm Complete 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
20838 HCPCS Replantation Foot Complete 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
20808 HCPCS Replantation Hand Complete 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 26 15 — — $35,190.66 $354,073.00 $63,997.13 2026-04-01
22838 HCPCS Rev Rplc/rmv Thrc Vrt Tethrg 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
J3403 HCPCS Revakinagene, Per Implant 7 6 — — $202,975.00 $482,352.88 $287,750.00 2026-04-01
C9766 HCPCS Revasc Intra Lithotrip-ather 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
C9765 HCPCS Revasc Intra Lithotrip-stent 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
C9775 HCPCS Revasc Lith-sten-ath Tib/per 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
C9774 HCPCS Revasc Lithotr-ather Tib/per 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
C9773 HCPCS Revasc Lithotr-stent Tib/per 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
C9767 HCPCS Revasc Lithotrip-stent-ather 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
22861 HCPCS Revise Cerv Artific Disc 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
22862 HCPCS Revise Lumbar Artif Disc 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
27487 HCPCS Revise/replace Knee Joint 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 22 15 — — $21,821.64 $68,446.10 $35,519.51 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 19 15 — — $29,022.75 $100,125.36 $51,959.19 2026-04-01
0790T OTHER Revj Rplcmt/rmvl Vrt Tethrg 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
37286 HCPCS Revsc Evasc Tpvt St Cplx 1st 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
37284 HCPCS Revsc Evasc Tpvt St Sf 1st 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
37273 HCPCS Revsc Evsc Fpvt Athrc Cplx 1 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
37271 HCPCS Revsc Evsc Fpvt Athrc Sf 1st 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
37290 HCPCS Revsc Evsc Tpvt Athrc Cplx 1 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
37288 HCPCS Revsc Evsc Tpvt Athrc Sf 1st 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 5 5 — — $28,036.78 $52,754.91 $44,343.88 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 5 5 — — $28,036.78 $52,754.91 $44,343.88 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 5 5 — — $39,563.90 $74,444.72 $62,575.55 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 5 5 — — $28,036.78 $52,754.91 $44,343.88 2026-04-01
0923T OTHER Rmvl&rplcmt Perm Ccm-d Pg 5 5 — — $28,036.78 $52,754.91 $44,343.88 2026-04-01
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 5 5 — — $28,036.78 $52,754.91 $44,343.88 2026-04-01
37277 HCPCS Rvsc Evsc Fpvt St Athr Cpx 1 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
37275 HCPCS Rvsc Evsc Fpvt St Athrc Sf 1 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
37294 HCPCS Rvsc Evsc Tpvt St Athr Cpx 1 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
37292 HCPCS Rvsc Evsc Tpvt St Athrc Sf 1 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 27 17 — — $17,452.71 $185,786.72 $68,669.14 2026-04-01
8 MS_DRG Simultaneous Pancreas, Islet Cell And Kidney Transplant 18 15 — — $55,309.68 $107,658.33 $55,868.36 2026-04-01
19 MS_DRG Simultaneous Pancreas, Islet Cell And Kidney Transplant With Hemodialysis 18 15 — — $70,142.41 $136,529.72 $70,850.92 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 18 15 — — $39,952.48 $77,766.09 $40,356.04 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc 18 15 — — $52,643.67 $102,469.03 $53,175.42 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 8 7 — — $45,684.96 $131,916.10 $75,730.55 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 19 15 — — $15,908.32 $94,385.06 $48,980.31 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 20 15 — — $8,488.23 $67,404.48 $34,978.97 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 19 15 — — $59,609.23 $125,524.63 $65,139.92 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 19 15 — — $14,210.79 $69,061.27 $35,838.75 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 20 15 — — $11,492.35 $81,572.93 $36,954.12 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 6 5 — — $29,021.11 $298,278.00 $58,683.24 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Or Infection Wi… 18 15 — — $82,442.90 $160,472.20 $83,275.66 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Or Infection Wi… 19 15 — — $47,504.00 $114,423.29 $59,378.98 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Or Infection Wi… 19 15 — — $41,427.03 $216,818.00 $41,845.48 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 21 15 — — $39,672.00 $115,276.22 $59,821.60 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 20 15 — — $44,881.20 $332,045.45 $45,334.55 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 21 15 — — $12,005.64 $96,011.66 $49,824.42 2026-04-01
J9226 HCPCS Supprelin La Implant 8 7 — — $33,428.71 $88,424.48 $52,751.59 2026-04-01
0981T OTHER Tcat Impl Wrls Ivc Snr 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
0645T OTHER Tcat Impltj C Sins Rdctj Dev 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
0823T OTHER Tcat Ins 1chmbr Ldls Pm Ra 5 5 — — $24,278.28 $45,682.80 $38,399.32 2026-04-01
0795T OTHER Tcat Ins 2chmbr Ldls Pm Cmpl 5 5 — — $24,278.28 $45,682.80 $38,399.32 2026-04-01
0796T OTHER Tcat Ins 2chmbr Ldls Pm Ra 5 5 — — $24,278.28 $45,682.80 $38,399.32 2026-04-01
0797T OTHER Tcat Ins 2chmbr Ldls Pm Rv 5 5 — — $24,278.28 $45,682.80 $38,399.32 2026-04-01
33274 HCPCS Tcat Insj/rpl Perm Ldls Pm 5 5 — — $24,278.28 $45,682.80 $38,399.32 2026-04-01
0801T OTHER Tcat Rmv&rpl 2chmbr Ldls Pm 5 5 — — $24,278.28 $45,682.80 $38,399.32 2026-04-01
0825T OTHER Tcat Rmv&rpl1chmb Ldls Pm Ra 5 5 — — $24,278.28 $45,682.80 $38,399.32 2026-04-01
0802T OTHER Tcat Rmv&rpl2chmb Ldls Pm Ra 5 5 — — $24,278.28 $45,682.80 $38,399.32 2026-04-01
0803T OTHER Tcat Rmv&rpl2chmb Ldls Pm Rv 5 5 — — $24,278.28 $45,682.80 $38,399.32 2026-04-01
22610 HCPCS Thorax Spine Fusion 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
22556 HCPCS Thorax Spine Fusion 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
36906 HCPCS Thrmbc/nfs Dialysis Circuit 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 5 5 — — $599,459.31 $1,127,962.21 $948,124.42 2026-04-01
J3389 HCPCS Topi Adm Prad Zami Per Treat 2 2 — — $3,220,067.05 $3,285,782.70 $3,252,924.88 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 18 15 — — $41,847.77 $81,455.20 $42,270.47 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 18 15 — — $53,850.64 $104,818.37 $54,394.59 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 26 16 — — $71,531.72 $263,276.95 $136,625.30 2026-04-01
93580 HCPCS Transcath Closure Of Asd 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
93581 HCPCS Transcath Closure Of Vsd 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
61624 HCPCS Transcath Occlusion Cns 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
23616 HCPCS Treat Humerus Fracture 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
0238T OTHER Trluml Perip Athrc Iliac Art 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 5 5 — — $32,945.30 $61,990.95 $52,107.36 2026-04-01
L6700 HCPCS Ue Add Ext Power Myoel 5 5 — — $28,919.99 $54,416.79 $45,740.79 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 18 15 — — $54,937.41 $106,933.72 $55,492.33 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 21 15 — — $23,523.00 $69,951.95 $36,300.96 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 18 15 — — $35,709.15 $69,506.60 $36,069.85 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 18 15 — — $35,628.68 $69,349.97 $35,988.57 2026-04-01
C9797 HCPCS Vasc Emb/occ W/prs Cath 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
37242 HCPCS Vasc Embolize/occlude Artery 5 5 — — $23,106.00 $43,477.00 $36,545.20 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 19 15 — — $13,564.21 $86,446.36 $44,860.59 2026-04-01
0656T OTHER Vrt Bdy Tethering Ant 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
463 MS_DRG Wound Debridement Or Skin Graft Except Hand For Musculoskeletal And Connective T… 21 15 — — $32,255.65 $120,014.24 $56,797.67 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 20 15 — — $855.51 $81,089.12 $42,080.50 2026-04-01
25446 HCPCS Wrist Replacement 5 5 — — $22,100.39 $41,584.82 $34,954.70 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 7 6 — — $55,052.27 $104,784.47 $78,045.52 2026-04-01
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