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

VALLEY CHILDREN'S HOSPITAL

Madera, CA · CCN 053300 · Rates published

Your selected procedure

You selected 93306 (HCPCS)

HC TTE W/DOPPLER COMPLETE - TTE COMPLETE

This hospital’s price: $2,865 across 35 payers · range $240-$5,178

Source: https://share.valleychildrens.org/link/1da4f783-fbd1-4c47-b93c-18c815cfc45e · observed 2026-04-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

33,559 distinct procedures filed
58 distinct payers
865,881 rate rows
2026-05-08 last MRF observed
Data quality

801,177 of 865,881 rate rows are consumer-grade (92.5%)

64,704 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 52,227
template filing: same amount across many unrelated codes — excluded 6,287
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 3,891
per-diem day rate — not a per-procedure price 1,138
placeholder amount (≤ $0.02) — excluded from medians 588
exceeds 10× this hospital's gross charge — excluded from medians 292
percent-of-charges filed in the dollar field — excluded from medians 145
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 136
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://share.valleychildrens.org/link/1da4f783-fbd1-4c47-b93c-18c815cfc45e
Found on page https://www.valleychildrens.org/your-visit/billing-and-insurance/financial-assistance/cost-estimates
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-18
Content fingerprint 1c44c239d8a609e0… · 308,825,493 bytes · first seen 2026-05-18

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 $4,335,000.00 $4,335,000.00 $4,335,000.00 nat. median
$4,505,000
1.0× median
60923054352
OTHER 		Delandistrogene Moxeparvo-rokl 52 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923053342
OTHER 		Delandistrogene Moxeparvo-rokl 42 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923054756
OTHER 		Delandistrogene Moxeparvo-rokl 56 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923054150
OTHER 		Delandistrogene Moxeparvo-rokl 50 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923054049
OTHER 		Delandistrogene Moxeparvo-rokl 49 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923054251
OTHER 		Delandistrogene Moxeparvo-rokl 51 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923054453
OTHER 		Delandistrogene Moxeparvo-rokl 53 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923052736
OTHER 		Delandistrogene Moxeparvo-rokl 36 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923054655
OTHER 		Delandistrogene Moxeparvo-rokl 55 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923053948
OTHER 		Delandistrogene Moxeparvo-rokl 48 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923053645
OTHER 		Delandistrogene Moxeparvo-rokl 45 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923052938
OTHER 		Delandistrogene Moxeparvo-rokl 38 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923053746
OTHER 		Delandistrogene Moxeparvo-rokl 46 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923054554
OTHER 		Delandistrogene Moxeparvo-rokl 54 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923052635
OTHER 		Delandistrogene Moxeparvo-rokl 35 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923053443
OTHER 		Delandistrogene Moxeparvo-rokl 43 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923053544
OTHER 		Delandistrogene Moxeparvo-rokl 44 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923052231
OTHER 		Delandistrogene Moxeparvo-rokl 31 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$4,272
outlier · 862.9×
60923052534
OTHER 		Delandistrogene Moxeparvo-rokl 34 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923052029
OTHER 		Delandistrogene Moxeparvo-rokl 29 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$4,272
outlier · 862.9×
60923053847
OTHER 		Delandistrogene Moxeparvo-rokl 47 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923052130
OTHER 		Delandistrogene Moxeparvo-rokl 30 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$4,272
outlier · 862.9×
60923050817
OTHER 		Delandistrogene Moxeparvo-rokl 17 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923051726
OTHER 		Delandistrogene Moxeparvo-rokl 26 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923054857
OTHER 		Delandistrogene Moxeparvo-rokl 57 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923050312
OTHER 		Delandistrogene Moxeparvo-rokl 12 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923051120
OTHER 		Delandistrogene Moxeparvo-rokl 20 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923050716
OTHER 		Delandistrogene Moxeparvo-rokl 16 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923051827
OTHER 		Delandistrogene Moxeparvo-rokl 27 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923053241
OTHER 		Delandistrogene Moxeparvo-rokl 41 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923051322
OTHER 		Delandistrogene Moxeparvo-rokl 22 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$4,272
outlier · 862.9×
60923052433
OTHER 		Delandistrogene Moxeparvo-rokl 33 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$4,272
outlier · 862.9×
60923051221
OTHER 		Delandistrogene Moxeparvo-rokl 21 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923052837
OTHER 		Delandistrogene Moxeparvo-rokl 37 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923053140
OTHER 		Delandistrogene Moxeparvo-rokl 40 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923053039
OTHER 		Delandistrogene Moxeparvo-rokl 39 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923051625
OTHER 		Delandistrogene Moxeparvo-rokl 25 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$4,272
outlier · 862.9×
60923050413
OTHER 		Delandistrogene Moxeparvo-rokl 13 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923050918
OTHER 		Delandistrogene Moxeparvo-rokl 18 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$4,272
outlier · 862.9×
60923051524
OTHER 		Delandistrogene Moxeparvo-rokl 24 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923052332
OTHER 		Delandistrogene Moxeparvo-rokl 32 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$4,272
outlier · 862.9×
60923051423
OTHER 		Delandistrogene Moxeparvo-rokl 23 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$4,272
outlier · 862.9×
60923050514
OTHER 		Delandistrogene Moxeparvo-rokl 14 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923050211
OTHER 		Delandistrogene Moxeparvo-rokl 11 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923051928
OTHER 		Delandistrogene Moxeparvo-rokl 28 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$4,272
outlier · 862.9×
60923051019
OTHER 		Delandistrogene Moxeparvo-rokl 19 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$4,272
outlier · 862.9×
60923050110
OTHER 		Delandistrogene Moxeparvo-rokl 10 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923050615
OTHER 		Delandistrogene Moxeparvo-rokl 15 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median
60923054958
OTHER 		Delandistrogene Moxeparvo-rokl 58 X 10 Ml Kit 1 Each Box 22 $1,979,577.60 $4,108,800.00 $3,686,400.00 nat. median
$3,686,400
1.0× median

Other procedures at this hospital

Browse this hospital's 33,559 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 3 2 — — $4,335,000.00 $4,335,000.00 $4,335,000.00 2026-04-01
60923050615 OTHER Delandistrogene Moxeparvo-rokl 15 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923051120 OTHER Delandistrogene Moxeparvo-rokl 20 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923055160 OTHER Delandistrogene Moxeparvo-rokl 60 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923053847 OTHER Delandistrogene Moxeparvo-rokl 47 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923050312 OTHER Delandistrogene Moxeparvo-rokl 12 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923055362 OTHER Delandistrogene Moxeparvo-rokl 62 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923054554 OTHER Delandistrogene Moxeparvo-rokl 54 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923054251 OTHER Delandistrogene Moxeparvo-rokl 51 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923052635 OTHER Delandistrogene Moxeparvo-rokl 35 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923056170 OTHER Delandistrogene Moxeparvo-rokl 70 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923054756 OTHER Delandistrogene Moxeparvo-rokl 56 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923051322 OTHER Delandistrogene Moxeparvo-rokl 22 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923055261 OTHER Delandistrogene Moxeparvo-rokl 61 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923053443 OTHER Delandistrogene Moxeparvo-rokl 43 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923054655 OTHER Delandistrogene Moxeparvo-rokl 55 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923052029 OTHER Delandistrogene Moxeparvo-rokl 29 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923052837 OTHER Delandistrogene Moxeparvo-rokl 37 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923055867 OTHER Delandistrogene Moxeparvo-rokl 67 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923051928 OTHER Delandistrogene Moxeparvo-rokl 28 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923052938 OTHER Delandistrogene Moxeparvo-rokl 38 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923051019 OTHER Delandistrogene Moxeparvo-rokl 19 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923055564 OTHER Delandistrogene Moxeparvo-rokl 64 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923052736 OTHER Delandistrogene Moxeparvo-rokl 36 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923053241 OTHER Delandistrogene Moxeparvo-rokl 41 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923050918 OTHER Delandistrogene Moxeparvo-rokl 18 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923054352 OTHER Delandistrogene Moxeparvo-rokl 52 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923054857 OTHER Delandistrogene Moxeparvo-rokl 57 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923053140 OTHER Delandistrogene Moxeparvo-rokl 40 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923053746 OTHER Delandistrogene Moxeparvo-rokl 46 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923050413 OTHER Delandistrogene Moxeparvo-rokl 13 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923051625 OTHER Delandistrogene Moxeparvo-rokl 25 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923051423 OTHER Delandistrogene Moxeparvo-rokl 23 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923051726 OTHER Delandistrogene Moxeparvo-rokl 26 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923054958 OTHER Delandistrogene Moxeparvo-rokl 58 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923050514 OTHER Delandistrogene Moxeparvo-rokl 14 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923055968 OTHER Delandistrogene Moxeparvo-rokl 68 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923055463 OTHER Delandistrogene Moxeparvo-rokl 63 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923050110 OTHER Delandistrogene Moxeparvo-rokl 10 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923053342 OTHER Delandistrogene Moxeparvo-rokl 42 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923052231 OTHER Delandistrogene Moxeparvo-rokl 31 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923050211 OTHER Delandistrogene Moxeparvo-rokl 11 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923055766 OTHER Delandistrogene Moxeparvo-rokl 66 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923054150 OTHER Delandistrogene Moxeparvo-rokl 50 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923053544 OTHER Delandistrogene Moxeparvo-rokl 44 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923050716 OTHER Delandistrogene Moxeparvo-rokl 16 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923051827 OTHER Delandistrogene Moxeparvo-rokl 27 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923052534 OTHER Delandistrogene Moxeparvo-rokl 34 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923052433 OTHER Delandistrogene Moxeparvo-rokl 33 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923053039 OTHER Delandistrogene Moxeparvo-rokl 39 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923055665 OTHER Delandistrogene Moxeparvo-rokl 65 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923054049 OTHER Delandistrogene Moxeparvo-rokl 49 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923053645 OTHER Delandistrogene Moxeparvo-rokl 45 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923050817 OTHER Delandistrogene Moxeparvo-rokl 17 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923053948 OTHER Delandistrogene Moxeparvo-rokl 48 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923052332 OTHER Delandistrogene Moxeparvo-rokl 32 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923051221 OTHER Delandistrogene Moxeparvo-rokl 21 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923054453 OTHER Delandistrogene Moxeparvo-rokl 53 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923051524 OTHER Delandistrogene Moxeparvo-rokl 24 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923052130 OTHER Delandistrogene Moxeparvo-rokl 30 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
60923055059 OTHER Delandistrogene Moxeparvo-rokl 59 X 10 Ml Kit 1 Each Box 23 22 $3,296,000.00 $3,296,000.00 $1,979,577.60 $4,108,800.00 $3,686,400.00 2026-05-08
J1414 HCPCS Inj, Beqvez, Per Tx Dose 3 2 — — $3,570,000.00 $3,570,000.00 $3,570,000.00 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 3 2 — — $3,570,000.00 $3,570,000.00 $3,570,000.00 2026-04-01
C9172 HCPCS Inj, Beqvez, Per Tx Dose 3 2 — — $3,570,000.00 $3,570,000.00 $3,570,000.00 2026-04-01
J3389 HCPCS Topi Adm Prad Zami Per Treat 3 2 — — $3,209,940.00 $3,209,940.00 $3,209,940.00 2026-04-01
J1413 HCPCS Delandistrogene Moxeparvo-rokl 70 X 10 Ml Kit 1 Each Box 12 7 $3,296,000.00 — $3,200,000.00 $3,296,000.00 $3,200,620.00 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 3 2 — — $3,162,000.00 $3,162,000.00 $3,162,000.00 2026-04-01
J3387 HCPCS Inj Elivaldogene Autotemecel 3 2 — — $3,060,000.00 $3,060,000.00 $3,060,000.00 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 5 3 — — $2,856,000.00 $4,864,551.99 $2,856,000.00 2026-04-01
J3399 HCPCS Onasemnogene Abeparvovec-xioi 9 X 8.3 Ml Kit 1 Each Box 9 7 $2,664,228.59 — $2,392,705.69 $2,664,228.59 $2,586,629.70 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 5 3 — — $2,244,000.00 $3,847,800.00 $2,244,000.00 2026-04-01
5834 APR_DRG Neonate With Ecmo 7 7 — — $1,440,003.12 $2,424,369.39 $1,647,562.19 2026-04-01
71894013307 OTHER Onasemnogene Abeparvovec-xioi 2 X 5.5 Ml & 5 X 8.3 Ml Kit 1 Each Box 16 16 $2,463,456.86 $2,463,456.86 $225,000.00 $2,323,044.36 $1,274,022.18 2026-05-08
71894013608 OTHER Onasemnogene Abeparvovec-xioi 2 X 5.5 Ml & 6 X 8.3 Ml Kit 1 Each Box 16 16 $2,463,456.86 $2,463,456.86 $225,000.00 $2,323,044.36 $1,274,022.18 2026-05-08
71894013106 OTHER Onasemnogene Abeparvovec-xioi 1 X 5.5 Ml & 5 X 8.3 Ml Kit 1 Each Box 16 16 $2,463,456.86 $2,463,456.86 $225,000.00 $2,323,044.36 $1,274,022.18 2026-05-08
71894013808 OTHER Onasemnogene Abeparvovec-xioi 8 X 8.3 Ml Kit 1 Each Box 16 16 $2,463,456.86 $2,463,456.86 $225,000.00 $2,323,044.36 $1,274,022.18 2026-05-08
71894013006 OTHER Onasemnogene Abeparvovec-xioi 2 X 5.5 Ml & 4 X 8.3 Ml Kit 1 Each Box 16 16 $2,463,456.86 $2,463,456.86 $225,000.00 $2,323,044.36 $1,274,022.18 2026-05-08
71894013407 OTHER Onasemnogene Abeparvovec-xioi 1 X 5.5 Ml & 6 X 8.3 Ml Kit 1 Each Box 16 16 $2,463,456.86 $2,463,456.86 $225,000.00 $2,323,044.36 $1,274,022.18 2026-05-08
71894012805 OTHER Onasemnogene Abeparvovec-xioi 1 X 5.5 Ml & 4 X 8.3 Ml Kit 1 Each Box 16 16 $2,463,456.86 $2,463,456.86 $225,000.00 $2,323,044.36 $1,274,022.18 2026-05-08
71894014109 OTHER Onasemnogene Abeparvovec-xioi 9 X 8.3 Ml Kit 1 Each Box 16 16 $2,463,456.86 $2,463,456.86 $225,000.00 $2,323,044.36 $1,274,022.18 2026-05-08
71894012002 OTHER Onasemnogene Abeparvovec-xioi 2 X 8.3 Ml Kit 1 Each Box 16 16 $2,463,456.86 $2,463,456.86 $225,000.00 $2,323,044.36 $1,274,022.18 2026-05-08
71894013708 OTHER Onasemnogene Abeparvovec-xioi 1 X 5.5 Ml & 7 X 8.3 Ml Kit 1 Each Box 16 16 $2,463,456.86 $2,463,456.86 $225,000.00 $2,323,044.36 $1,274,022.18 2026-05-08
71894012504 OTHER Onasemnogene Abeparvovec-xioi 1 X 5.5 Ml & 3 X 8.3 Ml Kit 1 Each Box 16 16 $2,463,456.86 $2,463,456.86 $225,000.00 $2,323,044.36 $1,274,022.18 2026-05-08
71894014009 OTHER Onasemnogene Abeparvovec-xioi 1 X 5.5 Ml & 8 X 8.3 Ml Kit 1 Each Box 16 16 $2,463,456.86 $2,463,456.86 $225,000.00 $2,323,044.36 $1,274,022.18 2026-05-08
71894013507 OTHER Onasemnogene Abeparvovec-xioi 7 X 8.3 Ml Kit 1 Each Box 16 16 $2,463,456.86 $2,463,456.86 $225,000.00 $2,323,044.36 $1,274,022.18 2026-05-08
71894012103 OTHER Onasemnogene Abeparvovec-xioi 2 X 5.5 Ml & 1 X 8.3 Ml Kit 1 Each Box 16 16 $2,463,456.86 $2,463,456.86 $225,000.00 $2,323,044.36 $1,274,022.18 2026-05-08
71894012303 OTHER Onasemnogene Abeparvovec-xioi 3 X 8.3 Ml Kit 1 Each Box 16 16 $2,463,456.86 $2,463,456.86 $225,000.00 $2,323,044.36 $1,274,022.18 2026-05-08
71894012705 OTHER Onasemnogene Abeparvovec-xioi 2 X 5.5 Ml & 3 X 8.3 Ml Kit 1 Each Box 16 16 $2,463,456.86 $2,463,456.86 $225,000.00 $2,323,044.36 $1,274,022.18 2026-05-08
71894013909 OTHER Onasemnogene Abeparvovec-xioi 2 X 5.5 Ml & 7 X 8.3 Ml Kit 1 Each Box 16 16 $2,463,456.86 $2,463,456.86 $225,000.00 $2,323,044.36 $1,274,022.18 2026-05-08
71894012905 OTHER Onasemnogene Abeparvovec-xioi 5 X 8.3 Ml Kit 1 Each Box 16 16 $2,463,456.86 $2,463,456.86 $225,000.00 $2,323,044.36 $1,274,022.18 2026-05-08
71894013206 OTHER Onasemnogene Abeparvovec-xioi 6 X 8.3 Ml Kit 1 Each Box 16 16 $2,463,456.86 $2,463,456.86 $225,000.00 $2,323,044.36 $1,274,022.18 2026-05-08
71894012604 OTHER Onasemnogene Abeparvovec-xioi 4 X 8.3 Ml Kit 1 Each Box 16 16 $2,463,456.86 $2,463,456.86 $225,000.00 $2,323,044.36 $1,274,022.18 2026-05-08
71894012203 OTHER Onasemnogene Abeparvovec-xioi 1 X 5.5 Ml & 2 X 8.3 Ml Kit 1 Each Box 16 16 $2,463,456.86 $2,463,456.86 $225,000.00 $2,323,044.36 $1,274,022.18 2026-05-08
71894012404 OTHER Onasemnogene Abeparvovec-xioi 2 X 5.5 Ml & 2 X 8.3 Ml Kit 1 Each Box 16 16 $2,463,456.86 $2,463,456.86 $225,000.00 $2,323,044.36 $1,274,022.18 2026-05-08
583-4 OTHER Neonate With Ecmo 7 7 — — $1,011,367.21 $1,738,696.93 $1,124,113.29 2026-05-08
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 7 7 — — $910,135.87 $1,532,292.20 $1,041,320.97 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 1 1 — — $979,602.30 $979,602.30 $979,602.30 2026-04-01
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 1 1 — — $860,483.36 $860,483.36 $860,483.36 2026-04-01
588-4 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 7 7 — — $754,348.99 $1,296,842.78 $838,442.96 2026-05-08
5833 APR_DRG Neonate With Ecmo 7 7 — — $724,530.98 $1,219,810.37 $828,963.38 2026-04-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 7 7 — — $679,624.06 $1,144,205.70 $777,583.67 2026-04-01
583-3 OTHER Neonate With Ecmo 7 7 — — $670,151.05 $1,152,093.48 $744,858.74 2026-05-08
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 7 7 — — $640,013.22 $1,077,517.44 $732,263.41 2026-04-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 7 7 — — $626,229.64 $1,054,311.58 $716,493.08 2026-04-01
24 APR_DRG Heart And/or Lung Transplant 7 7 — — $617,199.84 $1,039,109.13 $706,161.74 2026-04-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 7 7 — — $552,779.63 $930,652.16 $632,456.14 2026-04-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 7 7 — — $546,246.15 $919,652.48 $624,980.94 2026-04-01
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 1 1 — — $622,655.50 $622,655.50 $622,655.50 2026-04-01
1614 APR_DRG Implantable Heart Assist Systems 7 7 — — $513,188.16 $863,996.51 $587,158.04 2026-04-01
630-4 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 7 7 — — $512,728.89 $881,460.39 $569,887.32 2026-05-08
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 7 7 — — $493,895.45 $831,515.56 $565,084.52 2026-04-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 7 7 — — $490,968.72 $826,588.17 $561,735.94 2026-04-01
593-4 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 7 7 — — $495,900.95 $852,530.56 $551,183.43 2026-05-08
591-4 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 7 7 — — $490,954.90 $844,027.54 $545,686.00 2026-05-08
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 7 7 — — $473,510.59 $797,195.90 $541,761.43 2026-04-01
631-4 OTHER Neonate Birth Weight > 2499 Grams With Other Major Procedure 7 7 — — $482,312.12 $829,169.25 $536,079.73 2026-05-08
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 7 7 — — $464,164.44 $781,460.86 $531,068.15 2026-04-01
609-4 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 7 7 — — $476,797.55 $819,688.85 $529,950.40 2026-05-08
5832 APR_DRG Neonate With Ecmo 7 7 — — $454,659.06 $765,457.72 $520,192.67 2026-04-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 7 7 — — $439,032.83 $739,149.61 $502,314.11 2026-04-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 7 7 — — $409,202.14 $688,927.07 $468,183.69 2026-04-01
583-2 OTHER Neonate With Ecmo 7 7 — — $420,536.27 $722,966.99 $467,417.18 2026-05-08
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $403,742.67 $679,735.59 $461,937.30 2026-04-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 7 7 — — $402,819.99 $678,182.18 $460,881.63 2026-04-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 7 7 — — $402,819.99 $678,182.18 $460,881.63 2026-04-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 7 7 — — $402,819.99 $678,182.18 $460,881.63 2026-04-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 7 7 — — $396,517.32 $667,571.09 $453,670.50 2026-04-01
5831 APR_DRG Neonate With Ecmo 7 7 — — $383,618.74 $645,855.22 $438,912.75 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 1 1 — — $435,807.23 $435,807.23 $435,807.23 2026-04-01
74 APR_DRG Allogeneic Bone Marrow Transplant 7 7 — — $380,207.82 $640,112.64 $435,010.19 2026-04-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 7 7 — — $377,310.69 $635,235.08 $431,695.47 2026-04-01
603-4 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 7 7 — — $371,998.20 $639,522.53 $413,468.13 2026-05-08
588-3 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 7 7 — — $368,122.38 $632,859.40 $409,160.24 2026-05-08
14 APR_DRG Liver Transplant And/or Intestinal Transplant 7 7 — — $349,923.76 $589,126.81 $400,361.05 2026-04-01
588-2 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 7 7 — — $358,332.61 $616,029.28 $398,279.13 2026-05-08
602-4 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $357,833.74 $615,171.63 $397,724.64 2026-05-08
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 7 7 — — $345,789.84 $582,167.00 $395,631.27 2026-04-01
009-4 OTHER Extracorporeal Membrane Oxygenation (Ecmo) 7 7 — — $341,717.87 $587,465.97 $379,812.20 2026-05-08
583-1 OTHER Neonate With Ecmo 7 7 — — $340,556.68 $585,469.70 $378,521.56 2026-05-08
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 7 7 — — $329,078.92 $554,032.73 $376,511.68 2026-04-01
004-4 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 7 7 — — $335,398.87 $576,602.63 $372,788.76 2026-05-08
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 7 7 — — $321,966.56 $542,058.45 $368,374.15 2026-04-01
1613 APR_DRG Implantable Heart Assist Systems 7 7 — — $318,561.85 $536,326.34 $364,478.70 2026-04-01
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 1 1 — — $361,439.90 $361,439.90 $361,439.90 2026-04-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 7 7 — — $314,937.56 $530,224.54 $360,332.01 2026-04-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $300,530.45 $505,968.92 $343,848.29 2026-04-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 7 7 — — $292,011.74 $491,626.95 $334,101.71 2026-04-01
L8701 HCPCS Ewh S/d Uprt Micro Sensor 1 1 — — $316,479.67 $316,479.67 $316,479.67 2026-04-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 7 7 — — $271,324.54 $456,798.25 $310,432.69 2026-04-01
607-4 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $278,162.58 $478,204.57 $309,171.83 2026-05-08
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 7 7 — — $268,397.81 $451,870.86 $307,084.12 2026-04-01
23 APR_DRG Heart And/or Lung Transplant 7 7 — — $257,471.63 $433,475.68 $294,583.06 2026-04-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 7 7 — — $255,865.09 $430,770.93 $292,744.95 2026-04-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 7 7 — — $253,253.10 $426,373.43 $289,756.48 2026-04-01
593-3 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 7 7 — — $254,145.82 $436,916.04 $282,477.71 2026-05-08
8634 APR_DRG Neonatal Aftercare 7 7 — — $241,629.04 $406,803.33 $276,456.95 2026-04-01
591-3 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 7 7 — — $244,565.00 $420,445.12 $271,828.83 2026-05-08
64 APR_DRG Pancreas Transplant 7 7 — — $235,972.51 $397,280.06 $269,985.10 2026-04-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 7 7 — — $234,780.84 $395,273.78 $268,621.66 2026-04-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $234,527.97 $394,848.06 $268,332.35 2026-04-01
160-4 OTHER Major Cardiothoracic Repair Of Heart Anomaly 7 7 — — $241,391.28 $414,989.01 $268,301.31 2026-05-08
C9301 HCPCS Obecabtagene Car Pos T 5 3 — — $267,750.00 $459,112.50 $267,750.00 2026-04-01
L6700 HCPCS Ue Add Ext Power Myoel 1 1 — — $267,067.23 $267,067.23 $267,067.23 2026-04-01
588-1 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 7 7 — — $238,331.27 $409,728.37 $264,900.17 2026-05-08
L6880 HCPCS Elec Hand Ind Art Digits 1 1 — — $259,870.74 $259,870.74 $259,870.74 2026-04-01
005-4 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 7 7 — — $230,288.26 $395,901.19 $255,960.53 2026-05-08
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 7 7 — — $215,541.24 $362,882.26 $246,608.91 2026-04-01
1611 APR_DRG Implantable Heart Assist Systems 7 7 — — $215,308.82 $362,490.96 $246,342.99 2026-04-01
1612 APR_DRG Implantable Heart Assist Systems 7 7 — — $215,308.82 $362,490.96 $246,342.99 2026-04-01
863-4 OTHER Neonatal Aftercare 7 7 — — $221,574.40 $380,920.72 $246,275.26 2026-05-08
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 7 7 — — $210,073.16 $353,676.27 $240,352.67 2026-04-01
630-3 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 7 7 — — $211,326.98 $363,303.83 $234,885.48 2026-05-08
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 7 7 — — $204,956.76 $345,062.37 $234,498.80 2026-04-01
611-4 OTHER Neonate Birth Weight 1500-1999 Grams With Major Anomaly 7 7 — — $210,970.24 $362,690.52 $234,488.96 2026-05-08
303-4 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 7 7 — — $209,683.99 $360,479.26 $233,059.32 2026-05-08
162-4 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 7 7 — — $206,432.10 $354,888.77 $229,444.92 2026-05-08
602-3 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $205,675.98 $353,588.88 $228,604.51 2026-05-08
22 APR_DRG Heart And/or Lung Transplant 7 7 — — $198,732.56 $334,583.40 $227,377.46 2026-04-01
612-4 OTHER Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $202,785.10 $348,619.01 $225,391.36 2026-05-08
64406005801 OTHER Injection, Nusinersen, 0.1 Mg 3 3 $295,797.20 $295,797.20 $1,149.17 $225,000.00 $225,000.00 2026-05-08
4404 APR_DRG Kidney Transplant 7 7 — — $195,124.80 $328,509.43 $223,249.69 2026-04-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 7 7 — — $192,942.90 $324,836.01 $220,753.29 2026-04-01
593-2 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 7 7 — — $197,605.96 $339,715.27 $219,634.85 2026-05-08
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 7 7 — — $187,891.38 $316,331.33 $214,973.65 2026-04-01
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $185,594.11 $312,463.69 $212,345.26 2026-04-01
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 7 7 — — $181,681.78 $305,876.94 $207,869.02 2026-04-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 7 7 — — $180,176.45 $303,342.58 $206,146.71 2026-04-01
Q0483 HCPCS Monitor Elec Vad, Rep 1 1 — — $203,931.99 $203,931.99 $203,931.99 2026-04-01
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $175,877.82 $296,105.48 $201,228.49 2026-04-01
73 APR_DRG Allogeneic Bone Marrow Transplant 7 7 — — $174,752.17 $294,210.35 $199,940.59 2026-04-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 7 7 — — $173,395.50 $291,926.26 $198,388.36 2026-04-01
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $171,452.77 $288,655.52 $196,165.62 2026-04-01
2994 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 7 7 — — $169,992.10 $286,196.35 $194,494.41 2026-04-01
163-4 OTHER Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 7 7 — — $174,658.01 $300,264.18 $194,128.69 2026-05-08
1784 APR_DRG External Heart Assist Devices 7 7 — — $168,055.29 $282,935.57 $192,278.43 2026-04-01
613-4 OTHER Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 7 7 — — $171,880.83 $295,489.78 $191,041.91 2026-05-08
84 APR_DRG Autologous Bone Marrow Transplant 7 7 — — $165,211.96 $278,148.57 $189,025.27 2026-04-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 7 7 — — $163,783.58 $275,743.77 $187,391.00 2026-04-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 7 7 — — $161,642.33 $272,138.80 $184,941.12 2026-04-01
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 7 7 — — $161,534.73 $271,957.64 $184,818.01 2026-04-01
621-4 OTHER Neonate Birth Weight 2000-2499 Grams With Major Anomaly 7 7 — — $164,780.12 $283,282.56 $183,149.63 2026-05-08
167-4 OTHER Other Cardiothoracic And Thoracic Vascular Procedures 7 7 — — $161,478.50 $277,606.55 $179,479.94 2026-05-08
602-2 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $159,561.20 $274,310.42 $177,348.90 2026-05-08
63 APR_DRG Pancreas Transplant 7 7 — — $154,926.24 $260,831.67 $177,256.98 2026-04-01
607-3 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $159,266.99 $273,804.63 $177,021.89 2026-05-08
Q0489 HCPCS Pwr Pck Base Combo Vad, Rep 1 1 — — $176,797.84 $176,797.84 $176,797.84 2026-04-01
004-3 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 7 7 — — $158,340.32 $272,211.55 $175,991.92 2026-05-08
609-3 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 7 7 — — $158,232.30 $272,025.85 $175,871.86 2026-05-08
21 APR_DRG Heart And/or Lung Transplant 7 7 — — $152,342.67 $256,482.02 $174,301.03 2026-04-01
633-4 OTHER Neonate Birth Weight > 2499 Grams With Major Anomaly 7 7 — — $155,064.27 $266,579.50 $172,350.66 2026-05-08
1834 APR_DRG Percutaneous Structural Cardiac Procedures 7 7 — — $149,125.74 $251,066.04 $170,620.42 2026-04-01
13 APR_DRG Liver Transplant And/or Intestinal Transplant 7 7 — — $149,074.33 $250,979.48 $170,561.59 2026-04-01
304-4 OTHER Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 7 7 — — $152,299.88 $261,827.10 $169,278.10 2026-05-08
608-4 OTHER Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 7 7 — — $151,913.30 $261,162.51 $168,848.43 2026-05-08
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 7 7 — — $147,167.95 $247,769.94 $168,380.44 2026-04-01
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 7 7 — — $146,079.89 $245,938.08 $167,135.54 2026-04-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 7 7 — — $146,075.74 $245,931.10 $167,130.80 2026-04-01
183-4 OTHER Percutaneous Structural Cardiac Procedures 7 7 — — $150,031.52 $257,927.43 $166,756.86 2026-05-08
9104 APR_DRG Craniotomy For Multiple Significant Trauma 7 7 — — $144,609.23 $243,462.10 $165,452.90 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 20 18 — — $97,860.92 $807,508.61 $163,623.46 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 20 18 — — $96,327.50 $1,271,523.00 $161,059.58 2026-04-01
591-2 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 7 7 — — $144,565.29 $248,530.13 $160,681.26 2026-05-08
614-4 OTHER Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 7 7 — — $143,947.03 $247,467.25 $159,994.09 2026-05-08
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 7 7 — — $139,681.14 $235,165.24 $159,814.49 2026-04-01
1794 APR_DRG Defibrillator Implants 7 7 — — $139,543.94 $234,934.25 $159,657.51 2026-04-01
910-4 OTHER Craniotomy For Multiple Significant Trauma 7 7 — — $143,554.76 $246,792.87 $159,558.08 2026-05-08
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 7 7 — — $138,847.23 $233,761.28 $158,860.38 2026-04-01
Q0481 HCPCS Microprcsr Cu Elec Vad, Rep 1 1 — — $158,047.18 $158,047.18 $158,047.18 2026-04-01
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 7 7 — — $138,107.48 $232,515.85 $158,014.01 2026-04-01
L5859 HCPCS Knee-shin Pro Flex/ext Cont 1 1 — — $157,812.99 $157,812.99 $157,812.99 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 20 18 — — $94,311.49 $912,729.35 $157,688.81 2026-04-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 7 7 — — $137,098.73 $230,817.54 $156,859.86 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 20 18 — — $93,756.37 $852,129.78 $156,760.65 2026-04-01
914 APR_DRG Other Major Head And Neck Procedures 7 7 — — $136,633.36 $230,034.03 $156,327.40 2026-04-01
680-4 OTHER Major O.r. Procedures For Lymphatic Hematopoietic Or Other Neoplasms 7 7 — — $140,500.44 $241,542.02 $156,163.27 2026-05-08
Q2055 HCPCS Idecabtagene Vicleucel Car 20 18 — — $92,886.32 $870,577.06 $155,305.93 2026-04-01
091-4 OTHER Other Major Head And Neck Procedures 7 7 — — $138,887.29 $238,768.77 $154,370.29 2026-05-08
Q2042 HCPCS Tisagenlecleucel Car-pos T 18 17 — — $98,621.03 $954,972.35 $154,341.92 2026-04-01
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 7 7 — — $134,467.91 $226,388.32 $153,849.84 2026-04-01
603-3 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 7 7 — — $136,672.94 $234,961.96 $151,909.09 2026-05-08
589-1 OTHER Neonate Birth Weight < 500 Grams Or Birth Weight 500-999 Grams And Gestational … 7 7 — — $136,563.50 $234,773.82 $151,787.45 2026-05-08
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 7 7 — — $132,555.32 $223,168.30 $151,661.57 2026-04-01
62 APR_DRG Pancreas Transplant 7 7 — — $131,006.02 $220,559.93 $149,888.96 2026-04-01
72 APR_DRG Allogeneic Bone Marrow Transplant 7 7 — — $130,068.06 $218,980.79 $148,815.80 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 20 18 — — $88,871.70 $829,687.20 $148,593.48 2026-04-01
E0766RR OTHER Elec Stim Cancer Treatment 1 1 — — $148,281.80 $148,281.80 $148,281.80 2026-04-01
3004 APR_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 7 7 — — $128,539.14 $216,406.72 $147,066.50 2026-04-01
5931 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 7 7 — — $126,839.05 $213,544.48 $145,121.37 2026-04-01
1694 APR_DRG Major Abdominal Vascular Procedures 7 7 — — $126,118.13 $212,330.74 $144,296.54 2026-04-01
214 APR_DRG Open Craniotomy Except Trauma 7 7 — — $125,964.81 $212,072.61 $144,121.11 2026-04-01
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 7 7 — — $125,889.48 $211,945.79 $144,034.93 2026-04-01
912-4 OTHER Musculoskeletal And Other Procedures For Multiple Significant Trauma 7 7 — — $128,084.16 $220,196.51 $142,362.83 2026-05-08
169-4 OTHER Major Abdominal Vascular Procedures 7 7 — — $127,646.40 $219,443.94 $141,876.28 2026-05-08
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 7 7 — — $122,639.96 $206,474.94 $140,317.03 2026-04-01
120-4 OTHER Major Respiratory And Chest Procedures 7 7 — — $126,070.20 $216,734.20 $140,124.36 2026-05-08
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 7 7 — — $122,357.51 $205,999.42 $139,993.87 2026-04-01
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 7 7 — — $121,644.66 $204,799.27 $139,178.27 2026-04-01
234 APR_DRG Spinal Procedures 7 7 — — $121,537.06 $204,618.11 $139,055.16 2026-04-01
021-4 OTHER Open Craniotomy Except Trauma 7 7 — — $124,958.76 $214,823.48 $138,889.03 2026-05-08
023-4 OTHER Spinal Procedures 7 7 — — $124,282.23 $213,660.42 $138,137.08 2026-05-08
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 7 7 — — $120,325.25 $202,577.93 $137,668.68 2026-04-01
12 APR_DRG Liver Transplant And/or Intestinal Transplant 7 7 — — $120,281.68 $202,504.57 $137,618.83 2026-04-01
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $119,796.62 $201,687.94 $137,063.86 2026-04-01
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 7 7 — — $119,164.48 $200,623.67 $136,340.60 2026-04-01
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 7 7 — — $118,279.15 $199,133.15 $135,327.67 2026-04-01
681-4 OTHER Other O.r. Procedures For Lymphatic Hematopoietic Or Other Neoplasms 7 7 — — $120,399.30 $206,985.05 $133,821.28 2026-05-08
220-4 OTHER Major Stomach Esophageal And Duodenal Procedures 7 7 — — $120,362.35 $206,921.53 $133,780.21 2026-05-08
631-3 OTHER Neonate Birth Weight > 2499 Grams With Other Major Procedure 7 7 — — $120,349.56 $206,899.54 $133,765.99 2026-05-08
894 APR_DRG Major Cranial Or Facial Bone Procedures 7 7 — — $116,310.39 $195,818.56 $133,075.13 2026-04-01
690-4 OTHER Acute Leukemia 7 7 — — $119,481.16 $205,406.62 $132,800.78 2026-05-08
260-4 OTHER Major Pancreas Liver And Shunt Procedures 7 7 — — $119,458.42 $205,367.54 $132,775.51 2026-05-08
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 7 7 — — $115,831.57 $195,012.43 $132,527.29 2026-04-01
4014 APR_DRG Adrenal Procedures 7 7 — — $114,935.79 $193,504.31 $131,502.39 2026-04-01
089-4 OTHER Major Cranial Or Facial Bone Procedures 7 7 — — $117,832.48 $202,572.29 $130,968.31 2026-05-08
6904 APR_DRG Acute Leukemia 7 7 — — $114,387.03 $192,580.43 $130,874.54 2026-04-01
130-4 OTHER Respiratory System Diagnosis With Ventilator Support > 96 Hours 7 7 — — $117,586.59 $202,149.57 $130,695.01 2026-05-08
1204 APR_DRG Major Respiratory And Chest Procedures 7 7 — — $114,166.45 $192,209.05 $130,622.16 2026-04-01
312-4 OTHER Skin Graft Except Hand For Musculoskeletal And Connective Tissue Diagnoses 7 7 — — $117,468.63 $201,946.78 $130,563.90 2026-05-08
950-4 OTHER Extensive O.r. Procedure Unrelated To Principal Diagnosis 7 7 — — $117,391.88 $201,814.83 $130,478.60 2026-05-08
020-4 OTHER Open Craniotomy For Trauma 7 7 — — $117,374.83 $201,785.52 $130,459.64 2026-05-08
J3403 HCPCS Revakinagene, Per Implant 20 18 — — $83,333.33 $315,050.00 $130,416.66 2026-04-01
Q0479 HCPCS Power Module Combo Vad, Rep 1 1 — — $130,200.58 $130,200.58 $130,200.58 2026-04-01
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 7 7 — — $113,539.68 $191,153.85 $129,905.06 2026-04-01
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 7 7 — — $113,249.00 $190,664.46 $129,572.48 2026-04-01
005-3 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 7 7 — — $116,480.84 $200,248.61 $129,465.99 2026-05-08
361-4 OTHER Skin Graft For Skin And Subcutaneous Tissue Diagnoses 7 7 — — $115,926.54 $199,295.69 $128,849.90 2026-05-08
607-2 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $115,869.69 $199,197.94 $128,786.71 2026-05-08
441-4 OTHER Major Bladder Procedures 7 7 — — $115,588.27 $198,714.14 $128,473.92 2026-05-08
204 APR_DRG Open Craniotomy For Trauma 7 7 — — $111,608.25 $187,902.12 $127,695.24 2026-04-01
622-4 OTHER Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $113,568.65 $195,242.10 $126,229.15 2026-05-08
3124 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 7 7 — — $110,317.06 $185,728.28 $126,217.93 2026-04-01
4414 APR_DRG Major Bladder Procedures 7 7 — — $110,265.95 $185,642.23 $126,159.45 2026-04-01
608-3 OTHER Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 7 7 — — $113,010.08 $194,281.83 $125,608.31 2026-05-08
5204 APR_DRG Other GYN Procedures For Malignancy 7 7 — — $109,060.82 $183,613.30 $124,780.62 2026-04-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 7 7 — — $108,694.99 $182,997.38 $124,362.06 2026-04-01
6224 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $108,393.17 $182,489.25 $124,016.74 2026-04-01
71 APR_DRG Allogeneic Bone Marrow Transplant 7 7 — — $108,268.66 $182,279.62 $123,874.28 2026-04-01
027-4 OTHER Other Open Craniotomy 7 7 — — $110,782.93 $190,453.03 $123,132.89 2026-05-08
009-3 OTHER Extracorporeal Membrane Oxygenation (Ecmo) 7 7 — — $110,532.79 $190,022.98 $122,854.86 2026-05-08
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 7 7 — — $107,013.73 $180,166.83 $122,438.46 2026-04-01
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