Hospital

THE MEDICAL CENTER OF AURORA & SOUTH HOSPITAL

Aurora, CO · CCN 060100 · Rates published

35,730 distinct procedures filed

37 distinct payers

1,023,511 rate rows

2026-07-17 last MRF observed

Data quality

986,589 of 1,023,511 rate rows are consumer-grade (96.4%)

36,922 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 — reason	Rows
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	12,402
per-diem day rate — not a per-procedure price	11,016
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	9,643
template filing: same amount across many unrelated codes — excluded	2,918
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings	527
placeholder amount (≤ $0.02) — excluded from medians	248
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	168

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/84-1321373_HCA-HEALTHONE-AURORA_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page	https://www.healthonecares.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered via	Discovered by HANK
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-09-21
Content fingerprint	9221f1e2106a5574… · 559,268,208 bytes · first seen 2026-05-08

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
J3393 HCPCS	Injection, Betibeglogene Autotemcel, Per Treatment	1	$4,850,948.67	$4,850,948.67	$4,850,948.67	nat. median $2,994,107 1.6× median
845 OTHER	Inj, Atidarsagene Autotem	14	$4,459,950.00	$4,730,250.00	$4,505,000.00	nat. median $17,146 outlier · 262.7×
J3392 HCPCS	Injection, Exagamglogene Autotemcel, Per Treatment	1	$3,847,800.00	$3,847,800.00	$3,847,800.00	nat. median $2,401,960 1.6× median
J3399 HCPCS	Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge…	3	$3,670,252.89	$4,271,819.03	$3,824,789.85	nat. median $2,466,282 1.6× median
9138 OTHER	Inj, Hemgenix, Per Tx Dos	14	$3,648,414.33	$3,869,530.35	$3,685,267.00	nat. median $3,758,972 1.0× median
908 OTHER	Topi Adm Prad Zami Per Tr	14	$3,302,461.80	$3,502,611.00	$3,335,820.00	nat. median $30,329 outlier · 110.0×
714 OTHER	Inj Delandistrogene Mox R	14	$3,294,581.40	$3,494,253.00	$3,327,860.00	nat. median $3,325,455 1.0× median
748 OTHER	Inj, Lovotibeglogene Auto	14	$3,219,982.92	$3,415,133.40	$3,252,508.00	nat. median $3,252,508 1.0× median
906 OTHER	Inj Elivaldogene Autoteme	14	$3,148,200.00	$3,339,000.00	$3,180,000.00	nat. median $24,952 outlier · 127.4×
746 OTHER	Inj, Betibeglogene Autote	14	$2,910,569.31	$3,086,967.45	$2,939,969.00	nat. median $2,939,969 1.0× median
9141 OTHER	Inj Onase Abepar-xioi Tre	14	$2,563,091.19	$2,718,430.05	$2,588,981.00	nat. median $2,588,981 1.0× median
824 OTHER	Inj, Exagamglogene Autote	14	$2,308,680.00	$2,448,600.00	$2,332,000.00	nat. median $2,262,040 1.0× median
Q2057 HCPCS	Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure…	2	$1,271,523.00	$2,311,860.00	$2,311,860.00	nat. median $809,217 outlier · 2.9×
Q2056 HCPCS	Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige…	5	$819,605.32	$1,762,948.71	$1,366,285.25	nat. median $646,415 outlier · 2.1×
Q2042 HCPCS	Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka…	5	$836,958.70	$1,699,593.90	$1,317,185.27	nat. median $738,272 1.8× median
Q2054 HCPCS	Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi…	5	$765,607.90	$1,686,603.72	$1,307,117.89	nat. median $640,950 outlier · 2.0×
Q2055 HCPCS	Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (…	5	$782,774.83	$1,674,245.19	$1,297,540.02	nat. median $622,245 outlier · 2.1×
Q2041 HCPCS	Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via…	5	$741,901.04	$1,596,576.72	$1,237,346.96	nat. median $608,101 outlier · 2.0×
Q2053 HCPCS	Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V…	5	$725,845.60	$1,468,350.60	$1,137,971.72	nat. median $591,650 1.9× median
Q2058 HCPCS	Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,…	2	$459,112.50	$834,750.00	$834,750.00	nat. median $319,951 outlier · 2.6×
2067 OTHER	Afamitresgene Autoleucel	14	$762,913.80	$809,151.00	$770,620.00	nat. median $789,886 1.0× median
J3402 HCPCS	Injection, Remestemcel-l-rknd, Per Therapeutic Dose	2	$332,753.88	$605,007.06	$605,007.06	nat. median $209,753 outlier · 2.9×
9498 OTHER	Ciltacabtagene Car-pos T	14	$581,773.10	$617,032.08	$587,649.60	nat. median $587,650 1.0× median
9194 OTHER	Tisagenlecleucel Car-pos	14	$560,865.99	$594,857.87	$566,531.30	nat. median $577,003 1.0× median
9413 OTHER	Lisocabtagene Car Pos T	14	$556,579.19	$590,311.26	$562,201.20	nat. median $562,201 1.0× median
9422 OTHER	Idecabtagene Vicleucel Ca	14	$552,500.98	$585,985.89	$558,081.80	nat. median $562,826 1.0× median
9035 OTHER	Axicabtagene Ciloleucel C	14	$526,870.28	$558,801.81	$532,192.20	nat. median $533,230 1.0× median
9391 OTHER	Brexucabtagene Car Pos T	14	$484,555.70	$513,922.71	$489,450.20	nat. median $492,768 1.0× median
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	17	$1,975.00	$616,909.48	$362,271.60	nat. median $359,358 1.0× median
C1822 HCPCS	Pulse Gen Imp	16	$78,789.96	$466,519.50	$331,747.20	nat. median $31,540 outlier · 10.5×
C1825 HCPCS	Generator Pulse Ipg	16	$71,374.79	$469,570.50	$328,699.70	nat. median $53,125 outlier · 6.2×
5834 APR_DRG	Neonate With Ecmo	2	$259,553.85	$390,081.55	$324,817.70	nat. median $307,273 1.1× median
772862 CDM	Valve Aor 15fr W/23mm	16	$73,294.86	$433,982.70	$308,609.92	nat. median $114,257 outlier · 2.7×
772856 CDM	Valve Aor 15f W/27mm	16	$73,294.86	$433,982.70	$308,609.92	nat. median $114,257 outlier · 2.7×
772861 CDM	Valve Aor 15f W25mm Edg	16	$73,294.86	$433,982.70	$308,609.92	nat. median $114,257 outlier · 2.7×
575012 CDM	Valve Tavr Sz 26mm	16	$67,975.92	$402,489.00	$286,214.40	nat. median $70,000 outlier · 4.1×
575010 CDM	Valve Tavr Size 34mm	16	$67,975.92	$402,489.00	$286,214.40	nat. median $75,000 outlier · 3.8×
575013 CDM	Valve Tavr Sz 23mm	16	$67,975.92	$402,489.00	$286,214.40	nat. median $59,527 outlier · 4.8×
575011 CDM	Valve Tavr Sz 29mm	16	$67,975.92	$402,489.00	$286,214.40	nat. median $70,000 outlier · 4.1×
831 OTHER	Obecbtge Autol Up To 400	14	$275,467.50	$292,162.50	$278,250.00	nat. median $23,568 outlier · 11.8×
5833 APR_DRG	Neonate With Ecmo	2	$205,571.85	$342,642.39	$274,107.12	nat. median $244,017 1.1× median
551582 CDM	Valve Heart Trnscth 20mm	16	$64,704.12	$383,116.50	$272,438.40	nat. median $60,938 outlier · 4.5×
871793 CDM	Vlv 26mm Sapn Xt Trnscth	16	$64,704.12	$383,116.50	$272,438.40	nat. median $127,706 outlier · 2.1×
873686 CDM	Kit Aor Vlv 14fr 29mm	16	$64,704.12	$383,116.50	$272,438.40	nat. median $37,781 outlier · 7.2×
777386 CDM	Valve Aor With Intro 25mm	16	$64,704.12	$383,116.50	$272,438.40	nat. median $127,706 outlier · 2.1×
871794 CDM	Valve 29mm Sapien Xt	16	$64,704.12	$383,116.50	$272,438.40	nat. median $437 outlier · 623.2×
775844 CDM	Valve Heart Trnscth 23mm	16	$64,704.12	$383,116.50	$272,438.40	nat. median $59,975 outlier · 4.5×
871795 CDM	Valve 29mm Sapien Xt Flx	16	$64,704.12	$383,116.50	$272,438.40	nat. median $463 outlier · 588.0×
775845 CDM	Valve Heart Trnscth 26mm	16	$64,704.12	$383,116.50	$272,438.40	nat. median $59,975 outlier · 4.5×
871796 CDM	Valve Xt Sapien 23mm Ta	16	$64,704.12	$383,116.50	$272,438.40	nat. median $272,438 1.0× median

Other procedures at this hospital

Browse this hospital's 35,730 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	40	19	—	—	$1,975.00	$400,349.44	$235,528.60	2026-03-01
114	APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	2	2	—	—	$133,914.44	$214,354.80	$174,134.62	2026-03-01
125245	CDM	Revsc Low Extr Ivl Angio	29	15	$413,193.00	$413,193.00	$62,805.34	$371,873.70	$206,596.50	2026-03-01
14	APR_DRG	Liver Transplant And/or Intestinal Transplant	2	2	—	—	$125,578.90	$164,450.82	$145,014.86	2026-03-01
14	MS_DRG	Allogeneic Bone Marrow Transplant	33	17	—	—	$3,100.00	$210,000.00	$101,703.00	2026-03-01
1585	OTHER	New Technology - Level 48	20	14	—	—	$97,109.01	$102,994.41	$98,089.91	2026-03-01
1599	OTHER	New Technology - Level 48	20	14	—	—	$97,109.01	$102,994.41	$98,089.91	2026-03-01
1604	APR_DRG	Major Cardiothoracic Repair Of Heart Anomaly	2	2	—	—	$86,136.24	$123,515.26	$104,825.75	2026-03-01
1611	APR_DRG	Implantable Heart Assist Systems	2	2	—	—	$118,952.83	$119,774.96	$119,363.90	2026-03-01
1612	APR_DRG	Implantable Heart Assist Systems	2	2	—	—	$125,214.52	$126,060.92	$125,637.72	2026-03-01
1613	APR_DRG	Implantable Heart Assist Systems	2	2	—	—	$155,337.18	$155,950.02	$155,643.60	2026-03-01
1614	APR_DRG	Implantable Heart Assist Systems	2	2	—	—	$203,562.46	$227,074.08	$215,318.27	2026-03-01
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	32	17	—	—	$1,975.00	$616,909.48	$362,271.60	2026-03-01
1901	OTHER	New Technology - Level 49	20	14	—	—	$109,886.44	$116,546.22	$110,996.40	2026-03-01
1902	OTHER	New Technology - Level 49	20	14	—	—	$109,886.44	$116,546.22	$110,996.40	2026-03-01
1903	OTHER	New Technology - Level 50	20	14	—	—	$125,219.36	$132,808.41	$126,484.20	2026-03-01
1904	OTHER	New Technology - Level 50	20	14	—	—	$125,219.36	$132,808.41	$126,484.20	2026-03-01
1905	OTHER	New Technology - Level 51	20	14	—	—	$140,552.28	$149,070.60	$141,972.00	2026-03-01
1906	OTHER	New Technology - Level 51	20	14	—	—	$140,552.28	$149,070.60	$141,972.00	2026-03-01
1907	OTHER	New Technology - Level 52	20	14	—	—	$155,885.20	$165,332.79	$157,459.80	2026-03-01
1908	OTHER	New Technology - Level 52	20	14	—	—	$155,885.20	$165,332.79	$157,459.80	2026-03-01
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	40	19	—	—	$1,975.00	$306,157.00	$95,966.59	2026-03-01
2067	OTHER	Afamitresgene Autoleucel	20	14	—	—	$762,913.80	$809,151.00	$770,620.00	2026-03-01
209	MS_DRG	Complex Aortic Arch Procedures	42	18	—	—	$1,975.00	$203,626.00	$95,857.90	2026-03-01
22	APR_DRG	Heart And/or Lung Transplant	2	2	—	—	$90,149.77	$114,919.11	$102,534.44	2026-03-01
23	APR_DRG	Heart And/or Lung Transplant	2	2	—	—	$121,477.89	$144,998.05	$133,237.97	2026-03-01
24	APR_DRG	Heart And/or Lung Transplant	2	2	—	—	$196,443.75	$267,232.31	$231,838.03	2026-03-01
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	31	19	—	—	$1,975.00	$560,173.00	$178,684.90	2026-03-01
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	31	19	—	—	$1,975.00	$239,323.00	$117,032.90	2026-03-01
44	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	2	2	—	—	$127,562.64	$156,275.14	$141,918.89	2026-03-01
453	MS_DRG	Combined Anterior And Posterior Spinal Fusion With Mcc	5	3	—	—	$103,412.00	$110,488.59	$106,024.41	2026-03-01
545929	CDM	Cage Spn D 13mm	23	16	$169,618.00	$169,618.00	$25,781.94	$152,656.20	$108,555.52	2026-03-01
551226	CDM	Cage Spn Szb 25mm	23	16	$159,642.00	$159,642.00	$24,265.58	$143,677.80	$102,170.88	2026-03-01
551227	CDM	Cage Spn Sz A 25mm	23	16	$169,618.00	$169,618.00	$25,781.94	$152,656.20	$108,555.52	2026-03-01
551582	CDM	Valve Heart Trnscth 20mm	23	16	$425,685.00	$425,685.00	$64,704.12	$383,116.50	$272,438.40	2026-03-01
556304	CDM	Graft Evas 45x45mm 15cm	23	16	$230,525.00	$230,525.00	$35,039.80	$207,472.50	$147,536.00	2026-03-01
557005	CDM	Cage Spnl 18mm 24d	23	16	$150,055.00	$150,055.00	$22,808.36	$135,049.50	$96,035.20	2026-03-01
557943	CDM	Graft Evas Alpha 142x34m	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
558473	CDM	Tag Conform Thoracic Sg	23	16	$230,525.00	$230,525.00	$35,039.80	$207,472.50	$147,536.00	2026-03-01
560738	CDM	Stent Thor 31x26mm 10cm	23	16	$262,364.00	$262,364.00	$39,879.33	$236,127.60	$167,912.96	2026-03-01
560987	CDM	Valve Aortic 29mm	23	16	$183,372.00	$183,372.00	$27,872.54	$165,034.80	$117,358.08	2026-03-01
562279	CDM	Graft Evasc 20x12mmx12cm	23	16	$158,945.00	$158,945.00	$24,159.64	$143,050.50	$101,724.80	2026-03-01
562607	CDM	Graft Endo Aaa 36x14mm	23	16	$176,484.00	$176,484.00	$26,825.57	$158,835.60	$112,949.76	2026-03-01
564638	CDM	Device Emb 4.25mm 16mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
565377	CDM	Graft Endo Aaa 32x14mm	23	16	$176,484.00	$176,484.00	$26,825.57	$158,835.60	$112,949.76	2026-03-01
566052	CDM	Device Embl 10mm 2.5mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566060	CDM	Device Embl 2.5mm 16mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566067	CDM	Device Embl 2.75mm 16mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566176	CDM	Device Embl 5.0x20mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566178	CDM	Device Embl 5.0x16mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566180	CDM	Device Embl 4.75mm 16mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566181	CDM	Device Embl 4.75mm 14mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566184	CDM	Device Embl 4.5mm 12mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566186	CDM	Device Embl 4.25mm 20mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566187	CDM	Device Embl 4.25mm 18mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566188	CDM	Device Embl 4mm 18mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566189	CDM	Device Embl 4mm 16mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566190	CDM	Device Embl 4mm 14mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566191	CDM	Device Embl 3.75mm 14mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566199	CDM	Device Embl 5.0x.0mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566212	CDM	Device Embl 4.75mm 20mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566214	CDM	Device Embl 4.5mm 20mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566215	CDM	Device Embl 4.5mm 18mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566216	CDM	Device Embl 4.50x16mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566219	CDM	Device Embl 4.25mm 14mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566220	CDM	Device Embl 4.25mm 12mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566224	CDM	Device Embl 4.00x2mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566232	CDM	Device Embl 3.5mm 14mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566235	CDM	Device Embl 3.25mm 16mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566237	CDM	Device Embl 5mm 35mm	23	16	$214,438.00	$214,438.00	$32,594.58	$192,994.20	$137,240.32	2026-03-01
566271	CDM	Occluder Cardiac Lt 34mm	23	16	$268,326.00	$268,326.00	$40,785.55	$241,493.40	$171,728.64	2026-03-01
566272	CDM	Occluder Cardiac Lt 31mm	23	16	$268,326.00	$268,326.00	$40,785.55	$241,493.40	$171,728.64	2026-03-01
566273	CDM	Occluder Cardiac Lt 28mm	23	16	$268,326.00	$268,326.00	$40,785.55	$241,493.40	$171,728.64	2026-03-01
566274	CDM	Occluder Cardiac Lt 25mm	23	16	$268,326.00	$268,326.00	$40,785.55	$241,493.40	$171,728.64	2026-03-01
566275	CDM	Occluder Cardiac Lt 22mm	23	16	$268,326.00	$268,326.00	$40,785.55	$241,493.40	$171,728.64	2026-03-01
566276	CDM	Occluder Cardiac Lt 20mm	23	16	$268,326.00	$268,326.00	$40,785.55	$241,493.40	$171,728.64	2026-03-01
566277	CDM	Occluder Cardiac Lt 18mm	23	16	$268,326.00	$268,326.00	$40,785.55	$241,493.40	$171,728.64	2026-03-01
566278	CDM	Occluder Cardiac Lt 16mm	23	16	$268,326.00	$268,326.00	$40,785.55	$241,493.40	$171,728.64	2026-03-01
566572	CDM	Gft Evs 15f 20x14.5x12mm	23	16	$176,484.00	$176,484.00	$26,825.57	$158,835.60	$112,949.76	2026-03-01
569793	CDM	Valve Aortic 23mm	23	16	$183,372.00	$183,372.00	$27,872.54	$165,034.80	$117,358.08	2026-03-01
571668	CDM	Cntr Piece Turq Spn 13mm	23	16	$156,348.00	$156,348.00	$23,764.90	$140,713.20	$100,062.72	2026-03-01
575010	CDM	Valve Tavr Size 34mm	23	16	$447,210.00	$447,210.00	$67,975.92	$402,489.00	$286,214.40	2026-03-01
575011	CDM	Valve Tavr Sz 29mm	23	16	$447,210.00	$447,210.00	$67,975.92	$402,489.00	$286,214.40	2026-03-01
575012	CDM	Valve Tavr Sz 26mm	23	16	$447,210.00	$447,210.00	$67,975.92	$402,489.00	$286,214.40	2026-03-01
575013	CDM	Valve Tavr Sz 23mm	23	16	$447,210.00	$447,210.00	$67,975.92	$402,489.00	$286,214.40	2026-03-01
576638	CDM	Valve Aortic 21mm	23	16	$183,372.00	$183,372.00	$27,872.54	$165,034.80	$117,358.08	2026-03-01
579495	CDM	Implant Cran Xl	23	16	$169,582.00	$169,582.00	$25,776.46	$152,623.80	$108,532.48	2026-03-01
5831	APR_DRG	Neonate With Ecmo	2	2	—	—	$131,000.65	$148,342.61	$139,671.63	2026-03-01
5832	APR_DRG	Neonate With Ecmo	2	2	—	—	$151,589.21	$235,856.24	$193,722.72	2026-03-01
5833	APR_DRG	Neonate With Ecmo	2	2	—	—	$205,571.85	$342,642.39	$274,107.12	2026-03-01
5834	APR_DRG	Neonate With Ecmo	2	2	—	—	$259,553.85	$390,081.55	$324,817.70	2026-03-01
584750	CDM	Transcth Aortic Vlv 29mm	23	16	$268,326.00	$268,326.00	$40,785.55	$241,493.40	$171,728.64	2026-03-01
584751	CDM	Transcth Aortic Vlv 27mm	23	16	$268,326.00	$268,326.00	$40,785.55	$241,493.40	$171,728.64	2026-03-01
584752	CDM	Transcth Aortic Vlv 23mm	23	16	$268,326.00	$268,326.00	$40,785.55	$241,493.40	$171,728.64	2026-03-01
584753	CDM	Transcth Aortic Vlv 25mm	23	16	$268,326.00	$268,326.00	$40,785.55	$241,493.40	$171,728.64	2026-03-01
587526	CDM	End Cap Spn 13mm 47-72mm	23	16	$167,947.00	$167,947.00	$25,527.94	$151,152.30	$107,486.08	2026-03-01
587988	CDM	Device Clsr 27mm	23	16	$253,419.00	$253,419.00	$38,519.69	$228,077.10	$162,188.16	2026-03-01
587989	CDM	Device Clsr 24mm	23	16	$253,419.00	$253,419.00	$38,519.69	$228,077.10	$162,188.16	2026-03-01
587990	CDM	Device Clsr 40mm	23	16	$253,419.00	$253,419.00	$38,519.69	$228,077.10	$162,188.16	2026-03-01
587991	CDM	Device Clsr 20mm	23	16	$253,419.00	$253,419.00	$38,519.69	$228,077.10	$162,188.16	2026-03-01
587992	CDM	Device Clsr 31mm	23	16	$253,419.00	$253,419.00	$38,519.69	$228,077.10	$162,188.16	2026-03-01
587993	CDM	Device Clsr 35mm	23	16	$253,419.00	$253,419.00	$38,519.69	$228,077.10	$162,188.16	2026-03-01
5881	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	2	2	—	—	$88,406.10	$197,085.00	$142,745.55	2026-03-01
5882	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	2	2	—	—	$134,307.76	$197,085.00	$165,696.38	2026-03-01
5883	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	2	2	—	—	$137,161.04	$205,887.53	$171,524.29	2026-03-01
5884	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	2	2	—	—	$212,904.99	$300,544.34	$256,724.67	2026-03-01
5891	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational	2	2	—	—	$96,445.65	$118,758.01	$107,601.83	2026-03-01
589161	CDM	Stent Vasc Vo3	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
5892	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational	2	2	—	—	$87,678.64	$114,461.64	$101,070.14	2026-03-01
590833	CDM	Impl Spn Mag 13x24-32mm	23	16	$156,348.00	$156,348.00	$23,764.90	$140,713.20	$100,062.72	2026-03-01
5913	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	2	2	—	—	$78,554.48	$137,036.42	$107,795.45	2026-03-01
5914	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	2	2	—	—	$134,086.76	$189,805.36	$161,946.06	2026-03-01
592870	CDM	Stent Vasc 16mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
592871	CDM	Stent Vasc 16mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
592902	CDM	Pump Pain Infn 20ml	23	16	$166,765.00	$166,765.00	$25,348.28	$150,088.50	$106,729.60	2026-03-01
592933	CDM	Stent Vasc 16mm 550mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
592934	CDM	Stent Vasc 20mm 300mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
592935	CDM	Stent Vasc 20mm 275mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
592936	CDM	Stent Vasc 20mm 250mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593012	CDM	Stent Vasc 450mm 16mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593013	CDM	Stent Vasc 350mm 14mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593014	CDM	Stent Vasc 350mm 16mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593015	CDM	Stent Vasc 325mm 16mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593016	CDM	Stent Vasc 300mm 14mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593017	CDM	Stent Vasc 250mm 16mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593018	CDM	Stent Vasc 500mm 14mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593019	CDM	Stent Vasc 450mm 14mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593020	CDM	Stent Vasc 275mm 14mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593021	CDM	Stent Vasc 500mm 16mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593022	CDM	Device Embl 400mm 16mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593023	CDM	Stent Vasc 300mm 16mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593024	CDM	Device Embl 2.5x14mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593025	CDM	Stent Vasc 400mm 14mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593026	CDM	Stent Vasc 325mm 14mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593110	CDM	Stent Vasc 350mm 25mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593111	CDM	Stent Vasc 550mm 25mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593112	CDM	Stent Vasc 450mm 20mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593113	CDM	Stent Vasc 450mm 12mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593114	CDM	Stent Vasc 400mm 25mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593115	CDM	Stent Vasc 350mm 20mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593116	CDM	Stent Vasc 275mm 12mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593117	CDM	Stent Vasc 600mm 50mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593118	CDM	Stent Vasc 600mm 30mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593119	CDM	Device Embl 5x40mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593120	CDM	Stent Vasc 450mm 40mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593121	CDM	Stent Vasc 350mm 12mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593122	CDM	Stent Vasc 325mm 12mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593123	CDM	Stent Vasc 300mm 12mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593124	CDM	Stent Vasc 250mm 12mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593125	CDM	Stent Vasc 400mm 30mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593126	CDM	Stent Vasc 500mm 20mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593127	CDM	Stent Vasc 400mm 20mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593128	CDM	Stent Vasc 325mm 20mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593129	CDM	Stent Vasc 600mm 40mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593130	CDM	Stent Vasc 550mm 40mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593131	CDM	Stent Vasc 450mm 30mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593132	CDM	Stent Vasc 400mm 12mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593133	CDM	Stent Vasc 250mm 10mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593134	CDM	Stent Vasc 550mm 50mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593136	CDM	Stent Vasc 500mm 30mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593137	CDM	Stent Vasc 500mm 25mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
593138	CDM	Stent Vasc 450mm 25mm	23	16	$203,019.00	$203,019.00	$30,858.89	$182,717.10	$129,932.16	2026-03-01
5933	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	2	2	—	—	$89,292.74	$119,568.94	$104,430.84	2026-03-01
5934	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	2	2	—	—	$138,854.06	$175,247.53	$157,050.79	2026-03-01
595762	CDM	Prost Bn Crnl	23	16	$157,642.00	$157,642.00	$23,961.58	$141,877.80	$100,890.88	2026-03-01
595979	CDM	Cage Ankle Cstm Sz M	23	16	$254,239.00	$254,239.00	$38,644.33	$228,815.10	$162,712.96	2026-03-01
597177	CDM	Cage Spn 6d 17-26mm 12mm	23	16	$165,584.00	$165,584.00	$25,168.77	$149,025.60	$105,973.76	2026-03-01
598832	CDM	Stent Evas 22fr 16cm	23	16	$379,842.00	$379,842.00	$57,735.98	$341,857.80	$243,098.88	2026-03-01
6024	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	2	2	—	—	$99,531.10	$129,939.46	$114,735.28	2026-03-01
6034	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	2	2	—	—	$111,615.09	$161,568.68	$136,591.89	2026-03-01
605845	CDM	Cage Spnl Exp 18mm	23	16	$196,975.00	$196,975.00	$29,940.20	$177,277.50	$126,064.00	2026-03-01
605873	CDM	Stent Evas 22fr 16cm	23	16	$379,842.00	$379,842.00	$57,735.98	$341,857.80	$243,098.88	2026-03-01
606035	CDM	Implant Spn Cerv Sys 4mm	23	16	$167,026.00	$167,026.00	$25,387.95	$150,323.40	$106,896.64	2026-03-01
6094	APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	2	2	—	—	$133,231.71	$184,979.66	$159,105.68	2026-03-01
6304	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	2	2	—	—	$154,534.56	$241,870.40	$198,202.48	2026-03-01
6314	APR_DRG	Neonate Birth Weight > 2499 Grams With Other Major Procedure	2	2	—	—	$127,907.95	$186,317.79	$157,112.87	2026-03-01
64	APR_DRG	Pancreas Transplant	2	2	—	—	$110,900.79	$126,246.35	$118,573.57	2026-03-01
647486	CDM	System Dlv Cath 1 Clip	36	17	$379,842.00	$379,842.00	$57,735.98	$341,857.80	$176,056.77	2026-03-01
647641	CDM	Stent Graft 15cm 40x34mm	23	16	$235,136.00	$235,136.00	$35,740.67	$211,622.40	$150,487.04	2026-03-01
7	MS_DRG	Lung Transplant	37	17	—	—	$1,975.00	$185,006.56	$109,498.00	2026-03-01
714	OTHER	Inj Delandistrogene Mox R	20	14	—	—	$3,294,581.40	$3,494,253.00	$3,327,860.00	2026-03-01
74	APR_DRG	Allogeneic Bone Marrow Transplant	2	2	—	—	$128,785.38	$185,485.48	$157,135.43	2026-03-01
746	OTHER	Inj, Betibeglogene Autote	20	14	—	—	$2,910,569.31	$3,086,967.45	$2,939,969.00	2026-03-01
748	OTHER	Inj, Lovotibeglogene Auto	20	14	—	—	$3,219,982.92	$3,415,133.40	$3,252,508.00	2026-03-01
771691	CDM	Valve Aortic 27mm	23	16	$183,372.00	$183,372.00	$27,872.54	$165,034.80	$117,358.08	2026-03-01
771873	CDM	Stent 20fr 31x31mm 10cm	23	16	$235,136.00	$235,136.00	$35,740.67	$211,622.40	$150,487.04	2026-03-01
772751	CDM	Valve Aortic 25mm	23	16	$183,372.00	$183,372.00	$27,872.54	$165,034.80	$117,358.08	2026-03-01
772856	CDM	Valve Aor 15f W/27mm	23	16	$482,203.00	$482,203.00	$73,294.86	$433,982.70	$308,609.92	2026-03-01
772861	CDM	Valve Aor 15f W25mm Edg	23	16	$482,203.00	$482,203.00	$73,294.86	$433,982.70	$308,609.92	2026-03-01
772862	CDM	Valve Aor 15fr W/23mm	23	16	$482,203.00	$482,203.00	$73,294.86	$433,982.70	$308,609.92	2026-03-01
772933	CDM	Stent Graft 10cm 21x21mm	23	16	$230,525.00	$230,525.00	$35,039.80	$207,472.50	$147,536.00	2026-03-01
773834	CDM	Cage Spn 12d 13x27x40mm	23	16	$150,055.00	$150,055.00	$22,808.36	$135,049.50	$96,035.20	2026-03-01
774168	CDM	Cage Spnl 40mm 16mm	23	16	$150,055.00	$150,055.00	$22,808.36	$135,049.50	$96,035.20	2026-03-01
774293	CDM	Cage Spnl 16deg 14mm	23	16	$150,055.00	$150,055.00	$22,808.36	$135,049.50	$96,035.20	2026-03-01
774713	CDM	Graft Evas 34x34x10cm	23	16	$230,525.00	$230,525.00	$35,039.80	$207,472.50	$147,536.00	2026-03-01
775018	CDM	Cage Spnl Cntrpc 13mm	23	16	$169,618.00	$169,618.00	$25,781.94	$152,656.20	$108,555.52	2026-03-01
775844	CDM	Valve Heart Trnscth 23mm	23	16	$425,685.00	$425,685.00	$64,704.12	$383,116.50	$272,438.40	2026-03-01
775845	CDM	Valve Heart Trnscth 26mm	23	16	$425,685.00	$425,685.00	$64,704.12	$383,116.50	$272,438.40	2026-03-01
775999	CDM	Stent 34mmx34mmx15cm	23	16	$262,364.00	$262,364.00	$39,879.33	$236,127.60	$167,912.96	2026-03-01
776775	CDM	Stent Graft 20cm 45x45mm	23	16	$230,525.00	$230,525.00	$35,039.80	$207,472.50	$147,536.00	2026-03-01
777080	CDM	Valve Aor Tavr 29mm	23	16	$392,940.00	$392,940.00	$59,726.88	$353,646.00	$251,481.60	2026-03-01
777081	CDM	Valve Aor Tavr 34mm	23	16	$392,940.00	$392,940.00	$59,726.88	$353,646.00	$251,481.60	2026-03-01
777082	CDM	Valve Aor Tavr 26mm	23	16	$392,940.00	$392,940.00	$59,726.88	$353,646.00	$251,481.60	2026-03-01
777083	CDM	Valve Aor Tavr 23mm	23	16	$392,940.00	$392,940.00	$59,726.88	$353,646.00	$251,481.60	2026-03-01
777384	CDM	Valve Aor With Intro 23mm	23	16	$425,685.00	$425,685.00	$64,704.12	$383,116.50	$272,438.40	2026-03-01
777386	CDM	Valve Aor With Intro 25mm	23	16	$425,685.00	$425,685.00	$64,704.12	$383,116.50	$272,438.40	2026-03-01
777390	CDM	Valve Aor With Intro 27mm	23	16	$425,685.00	$425,685.00	$64,704.12	$383,116.50	$272,438.40	2026-03-01
778313	CDM	Graft Evas 52mm 37mm 20f	23	16	$242,248.00	$242,248.00	$36,821.70	$218,023.20	$155,038.72	2026-03-01
780778	CDM	Cage Spn Szc 25mm	23	16	$169,618.00	$169,618.00	$25,781.94	$152,656.20	$108,555.52	2026-03-01
780835	CDM	Stent Eprsth 40x40x15cm	23	16	$230,525.00	$230,525.00	$35,039.80	$207,472.50	$147,536.00	2026-03-01
781540	CDM	Cage Spnl 25mm D Centerp	23	16	$169,618.00	$169,618.00	$25,781.94	$152,656.20	$108,555.52	2026-03-01
781685	CDM	Stent Eprsth 37x37x15cm	23	16	$230,525.00	$230,525.00	$35,039.80	$207,472.50	$147,536.00	2026-03-01
783155	CDM	Stent Graft 15cn 28x28mm	23	16	$230,525.00	$230,525.00	$35,039.80	$207,472.50	$147,536.00	2026-03-01
783358	CDM	Stnt Thorac 26x26mm 10cm	23	16	$235,136.00	$235,136.00	$35,740.67	$211,622.40	$150,487.04	2026-03-01
783359	CDM	Stnt Thorac 28x28mm 10cm	23	16	$230,525.00	$230,525.00	$35,039.80	$207,472.50	$147,536.00	2026-03-01
784085	CDM	Graft Bn Trchlea Lt Ost	23	16	$160,390.00	$160,390.00	$24,379.28	$144,351.00	$102,649.60	2026-03-01
786510	CDM	Cage Spn 20mm	23	16	$169,618.00	$169,618.00	$25,781.94	$152,656.20	$108,555.52	2026-03-01
794647	CDM	Cage Spnl C 30-45x20mm	23	16	$169,618.00	$169,618.00	$25,781.94	$152,656.20	$108,555.52	2026-03-01
796086	CDM	Graft Endo Aaa 23x12mm	23	16	$176,484.00	$176,484.00	$26,825.57	$158,835.60	$112,949.76	2026-03-01
796249	CDM	Graft Endo Aaa 28.5x12mm	23	16	$158,945.00	$158,945.00	$24,159.64	$143,050.50	$101,724.80	2026-03-01
798749	CDM	Graft Endo Aaa 26x12mm	23	16	$155,068.00	$155,068.00	$23,570.34	$139,561.20	$99,243.52	2026-03-01
824	OTHER	Inj, Exagamglogene Autote	20	14	—	—	$2,308,680.00	$2,448,600.00	$2,332,000.00	2026-03-01
831	OTHER	Obecbtge Autol Up To 400	20	14	—	—	$275,467.50	$292,162.50	$278,250.00	2026-03-01
8414	APR_DRG	Extensive Third Degree Burns With Skin Graft	2	2	—	—	$143,552.95	$226,153.03	$184,852.99	2026-03-01
845	OTHER	Inj, Atidarsagene Autotem	20	14	—	—	$4,459,950.00	$4,730,250.00	$4,505,000.00	2026-03-01
849531	CDM	Graft Hemi Cndyl Mdl Rt	23	16	$197,379.00	$197,379.00	$30,001.61	$177,641.10	$126,322.56	2026-03-01
862138	CDM	Graft Evas 23x14.5m14cm	23	16	$148,996.00	$148,996.00	$22,647.39	$134,096.40	$95,357.44	2026-03-01
862822	CDM	Graft Evas 35x14.5m 14cm	23	16	$153,468.00	$153,468.00	$23,327.14	$138,121.20	$98,219.52	2026-03-01
866765	CDM	Graft Evas 31x14.5m 15cm	23	16	$165,204.00	$165,204.00	$25,111.01	$148,683.60	$105,730.56	2026-03-01
867110	CDM	Graft Evas 14.5mm 12cm	23	16	$153,468.00	$153,468.00	$23,327.14	$138,121.20	$98,219.52	2026-03-01
871792	CDM	Valve 23mm Sapien Xt	23	16	$425,685.00	$425,685.00	$64,704.12	$383,116.50	$272,438.40	2026-03-01
871793	CDM	Vlv 26mm Sapn Xt Trnscth	23	16	$425,685.00	$425,685.00	$64,704.12	$383,116.50	$272,438.40	2026-03-01
871794	CDM	Valve 29mm Sapien Xt	23	16	$425,685.00	$425,685.00	$64,704.12	$383,116.50	$272,438.40	2026-03-01
871795	CDM	Valve 29mm Sapien Xt Flx	23	16	$425,685.00	$425,685.00	$64,704.12	$383,116.50	$272,438.40	2026-03-01
871796	CDM	Valve Xt Sapien 23mm Ta	23	16	$425,685.00	$425,685.00	$64,704.12	$383,116.50	$272,438.40	2026-03-01
871797	CDM	Valve Xt Sapien 26mm Ta	23	16	$425,685.00	$425,685.00	$64,704.12	$383,116.50	$272,438.40	2026-03-01
872005	CDM	Graft Evas 23x14.5m 12cm	23	16	$157,299.00	$157,299.00	$23,909.45	$141,569.10	$100,671.36	2026-03-01
873686	CDM	Kit Aor Vlv 14fr 29mm	23	16	$425,685.00	$425,685.00	$64,704.12	$383,116.50	$272,438.40	2026-03-01
876573	CDM	Valve Tavr 23mm	23	16	$392,940.00	$392,940.00	$59,726.88	$353,646.00	$251,481.60	2026-03-01
876574	CDM	Valve Transcth Aor 26mm	23	16	$392,940.00	$392,940.00	$59,726.88	$353,646.00	$251,481.60	2026-03-01
876575	CDM	Valve Tavr 29mm	23	16	$392,940.00	$392,940.00	$59,726.88	$353,646.00	$251,481.60	2026-03-01
876591	CDM	Vlv Aor 26-29mm 0-43mm	23	16	$392,940.00	$392,940.00	$59,726.88	$353,646.00	$251,481.60	2026-03-01
883402	CDM	Ins/repl Subq Imp Icd Sy	29	15	$302,605.20	$302,605.20	$45,995.99	$272,344.68	$151,302.60	2026-03-01
885940	CDM	Tavr	29	15	$309,074.66	$309,074.66	$46,979.35	$278,167.19	$154,537.33	2026-03-01
886	OTHER	Inj. Remestemcel-l-rknd/	20	14	—	—	$199,652.31	$211,752.45	$201,669.00	2026-03-01
888494	CDM	Tmvr Initial	29	15	$309,074.66	$309,074.66	$46,979.35	$278,167.19	$154,537.33	2026-03-01
893421	CDM	Valve Tavr 34mm	23	16	$392,940.00	$392,940.00	$59,726.88	$353,646.00	$251,481.60	2026-03-01
897	OTHER	Revakinagene, Per Implant	20	14	—	—	$262,350.00	$278,250.00	$265,000.00	2026-03-01
897592	CDM	Valve Tavr 23mm	23	16	$392,940.00	$392,940.00	$59,726.88	$353,646.00	$251,481.60	2026-03-01
897593	CDM	Valve Tavr 26mm	23	16	$392,940.00	$392,940.00	$59,726.88	$353,646.00	$251,481.60	2026-03-01
897594	CDM	Valve Tavr 29mm	23	16	$392,940.00	$392,940.00	$59,726.88	$353,646.00	$251,481.60	2026-03-01
9035	OTHER	Axicabtagene Ciloleucel C	20	14	—	—	$526,870.28	$558,801.81	$532,192.20	2026-03-01
906	OTHER	Inj Elivaldogene Autoteme	20	14	—	—	$3,148,200.00	$3,339,000.00	$3,180,000.00	2026-03-01
908	OTHER	Topi Adm Prad Zami Per Tr	20	14	—	—	$3,302,461.80	$3,502,611.00	$3,335,820.00	2026-03-01
9138	OTHER	Inj, Hemgenix, Per Tx Dos	20	14	—	—	$3,648,414.33	$3,869,530.35	$3,685,267.00	2026-03-01
9141	OTHER	Inj Onase Abepar-xioi Tre	20	14	—	—	$2,563,091.19	$2,718,430.05	$2,588,981.00	2026-03-01
9194	OTHER	Tisagenlecleucel Car-pos	20	14	—	—	$560,865.99	$594,857.87	$566,531.30	2026-03-01
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	29	19	—	—	$1,975.00	$328,654.12	$179,732.60	2026-03-01
9391	OTHER	Brexucabtagene Car Pos T	20	14	—	—	$484,555.70	$513,922.71	$489,450.20	2026-03-01
94	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	2	2	—	—	$124,886.96	$173,879.40	$149,383.18	2026-03-01
9413	OTHER	Lisocabtagene Car Pos T	20	14	—	—	$556,579.19	$590,311.26	$562,201.20	2026-03-01
9422	OTHER	Idecabtagene Vicleucel Ca	20	14	—	—	$552,500.98	$585,985.89	$558,081.80	2026-03-01
9498	OTHER	Ciltacabtagene Car-pos T	20	14	—	—	$581,773.10	$617,032.08	$587,649.60	2026-03-01
953000	CDM	Revasc Fem/pop Stnt/ath	29	15	$267,953.30	$267,953.30	$40,728.90	$241,157.97	$133,976.65	2026-03-01
953004	CDM	Revasc Tib Stnt/ath Init	29	15	$267,953.30	$267,953.30	$40,728.90	$241,157.97	$133,976.65	2026-03-01
953034	CDM	Revasc Fem/pop Stnt/ath	29	15	$267,953.30	$267,953.30	$40,728.90	$241,157.97	$133,976.65	2026-03-01
953038	CDM	Revasc Tib Stnt/ath Init	29	15	$267,953.30	$267,953.30	$40,728.90	$241,157.97	$133,976.65	2026-03-01
955643	CDM	Ins Icd Gen W Dual Lead	29	15	$419,169.11	$419,169.11	$63,713.70	$377,252.20	$209,584.55	2026-03-01
955644	CDM	Ins Icd Gen W Mult Lead	29	15	$419,169.11	$419,169.11	$63,713.70	$377,252.20	$209,584.55	2026-03-01
955645	CDM	Rmv Icd W Rplc Sgl Ld	29	15	$419,169.11	$419,169.11	$63,713.70	$377,252.20	$209,584.55	2026-03-01
955646	CDM	Rmv Icd W Rplc Dual Ld	29	15	$419,169.11	$419,169.11	$63,713.70	$377,252.20	$209,584.55	2026-03-01
955647	CDM	Rmv Icd W Rplc Mult Ld	29	15	$419,169.11	$419,169.11	$63,713.70	$377,252.20	$209,584.55	2026-03-01
959471	CDM	Perc Clsr Lt Atrl W/imp	29	15	$253,429.71	$253,429.71	$38,521.32	$228,086.74	$126,714.85	2026-03-01
975598	CDM	Graft Bn Hemi Condrl Rt	23	16	$175,715.00	$175,715.00	$26,708.68	$158,143.50	$112,457.60	2026-03-01
997676	CDM	Graft Hemi Cndyl Mdl Lt	23	16	$187,269.00	$187,269.00	$28,464.89	$168,542.10	$119,852.16	2026-03-01
997677	CDM	Graft Bn Fem Hemi Cndyl	23	16	$175,715.00	$175,715.00	$26,708.68	$158,143.50	$112,457.60	2026-03-01
999395	CDM	Nrstm Impl 60mm Fsn Spn	23	16	$192,759.00	$192,759.00	$29,299.37	$173,483.10	$123,365.76	2026-03-01
A9699	HCPCS	Radiopharmaceutical, Therapeutic, Not Otherwise Classified	3	2	—	—	$77,046.96	$140,085.39	$140,085.39	2026-03-01
C1767	HCPCS	Device Ipg Sleep 51mm	207	16	$271,681.00	$271,681.00	$18,981.00	$497,449.80	$154,032.30	2026-03-01
C1820	HCPCS	Generator Nrstm 18 Ch	115	16	$257,892.00	$257,892.00	$34,554.46	$358,702.20	$167,629.80	2026-03-01
C1822	HCPCS	Pulse Gen Imp	23	16	$518,355.00	$518,355.00	$78,789.96	$466,519.50	$331,747.20	2026-03-01
C1824	HCPCS	Gen Pls Card Mod Sys	46	16	$363,506.50	$363,506.50	$51,870.15	$347,185.80	$238,875.70	2026-03-01
C1825	HCPCS	Generator Pulse Ipg	46	16	$495,658.00	$495,658.00	$71,374.79	$469,570.50	$328,699.70	2026-03-01
C1882	HCPCS	Crt-d Crd 5.37x8.08x0.99	483	16	$205,241.00	$205,241.00	$20,647.83	$250,374.60	$131,354.24	2026-03-01
C2616	HCPCS	Brachytx Ns Yttrium 90	67	15	$268,252.00	$268,252.00	$8,688.00	$258,867.90	$171,681.28	2026-03-01
J3392	HCPCS	Injection, Exagamglogene Autotemcel, Per Treatment	1	1	—	—	$3,847,800.00	$3,847,800.00	$3,847,800.00	2026-03-01
J3393	HCPCS	Injection, Betibeglogene Autotemcel, Per Treatment	1	1	—	—	$4,850,948.67	$4,850,948.67	$4,850,948.67	2026-03-01
J3399	HCPCS	Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge…	4	3	—	—	$3,670,252.89	$4,271,819.03	$3,824,789.85	2026-03-01
J3402	HCPCS	Injection, Remestemcel-l-rknd, Per Therapeutic Dose	3	2	—	—	$332,753.88	$605,007.06	$605,007.06	2026-03-01
J7330	HCPCS	Autologous Cultured Chondrocytes, Implant	3	2	—	—	$138,148.31	$251,178.75	$251,178.75	2026-03-01
J9029	HCPCS	Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose	6	4	—	—	$102,561.22	$192,824.37	$106,879.59	2026-03-01
Q0480	HCPCS	Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only	20	14	—	—	$111,218.58	$117,959.10	$112,342.00	2026-03-01
Q2041	HCPCS	Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via…	9	5	—	—	$741,901.04	$1,596,576.72	$1,237,346.96	2026-03-01
Q2042	HCPCS	Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka…	9	5	—	—	$836,958.70	$1,699,593.90	$1,317,185.27	2026-03-01
Q2053	HCPCS	Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V…	9	5	—	—	$725,845.60	$1,468,350.60	$1,137,971.72	2026-03-01
Q2054	HCPCS	Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi…	9	5	—	—	$765,607.90	$1,686,603.72	$1,307,117.89	2026-03-01
Q2055	HCPCS	Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (…	9	5	—	—	$782,774.83	$1,674,245.19	$1,297,540.02	2026-03-01
Q2056	HCPCS	Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige…	9	5	—	—	$819,605.32	$1,762,948.71	$1,366,285.25	2026-03-01
Q2057	HCPCS	Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure…	3	2	—	—	$1,271,523.00	$2,311,860.00	$2,311,860.00	2026-03-01
Q2058	HCPCS	Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, …	3	2	—	—	$459,112.50	$834,750.00	$834,750.00	2026-03-01

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