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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

UCHEALTH BROOMFIELD HOSPITAL

Broomfield, CO · CCN 060129 · Rates published

23,439 distinct procedures filed
19 distinct payers
566,741 rate rows
2025-11-01 last MRF observed
Data quality

564,536 of 566,741 rate rows are consumer-grade (99.6%)

2,205 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
per-diem day rate — not a per-procedure price 931
placeholder amount (≤ $0.02) — excluded from medians 736
template filing: same amount across many unrelated codes — excluded 331
exceeds 10× this hospital's gross charge — excluded from medians 157
percent-of-charges filed in the dollar field — excluded from medians 48
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/8085/473393862_uchealth-broomfield-hospital_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/BroomfieldHospital/8085
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 84feff50d616e105… · 270,145,741 bytes · first seen 2026-05-06

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 10 $4,505,000.00 $4,505,000.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 10 $3,685,266.67 $3,685,266.67 $3,685,266.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 10 $3,316,462.59 $3,316,462.59 $3,316,462.59 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 10 $3,248,445.72 $3,248,445.72 $3,248,445.72 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 10 $2,945,740.00 $2,945,740.00 $2,945,740.00 nat. median
$3,004,655
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 10 $186.59 $2,455,110.61 $2,455,110.61 nat. median
$2,468,984
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 10 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 10 $770,620.00 $770,620.00 $770,620.00 nat. median
$824,563
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 10 $468,441.50 $591,726.20 $591,726.20 nat. median
$753,246
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 10 $492,900.00 $3,450,300.00 $565,868.95 nat. median
$674,867
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 10 $434,918.00 $3,181,425.17 $562,538.19 nat. median
$673,137
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 10 $444,670.00 $557,317.93 $557,317.93 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 10 $449,245.86 $3,146,080.00 $533,230.17 nat. median
$634,303
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 10 $448,752.40 $3,146,080.00 $489,304.61 nat. median
$619,808
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 14 $312,945.75 $1,205,231.95 $342,310.06 nat. median
$370,174
0.9× median
E0194NU
HCPCS 		Other Outpatient 1 $259,670.40 $302,948.80 $281,309.60 —
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 10 $278,250.00 $278,250.00 $278,250.00 nat. median
$324,450
0.9× median
J3403
HCPCS 		Revakinagene, Per Implant 10 $257,500.00 $257,500.00 $257,500.00 nat. median
$265,000
1.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 15 $162,000.00 $782,147.05 $220,950.20 nat. median
$265,286
0.8× median
K0606NUKF
HCPCS 		Other Outpatient 1 $200,939.40 $234,429.30 $217,684.35 —
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 10 $205,640.00 $205,640.00 $205,640.00 nat. median
$209,753
1.0× median
5834
APR_DRG 		Neonate W Ecmo 1 $191,132.26 $191,132.26 $191,132.26 nat. median
$309,665
0.6× median
5884
APR_DRG 		Neonate Bwt <1500g W Major Procedure 1 $171,904.07 $171,904.07 $171,904.07 nat. median
$246,434
0.7× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 14 $154,727.07 $595,892.46 $169,245.41 nat. median
$206,474
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 14 $153,819.02 $592,395.33 $168,252.16 nat. median
$202,976
0.8× median
24
APR_DRG 		Heart &/or Lung Transplant 1 $149,739.33 $149,739.33 $149,739.33 nat. median
$234,729
0.6× median
1614
APR_DRG 		Cardiac Defibrillator & Heart Assist Implant 1 $149,355.70 $149,355.70 $149,355.70 nat. median
$207,730
0.7× median
34
APR_DRG 		Bone Marrow Transplant 1 $141,163.34 $141,163.34 $141,163.34 nat. median
$209,067
0.7× median
5833
APR_DRG 		Neonate W Ecmo 1 $137,458.28 $137,458.28 $137,458.28 nat. median
$244,017
0.6× median
7
MS_DRG 		Lung Transplant 15 $93,850.10 $361,440.08 $128,206.98 nat. median
$122,708
1.0× median
44
APR_DRG 		Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 1 $127,196.58 $127,196.58 $127,196.58 nat. median
$105,658
1.2× median
8414
APR_DRG 		Extensive 3rd Degree Burns W Skin Graft 1 $126,013.84 $126,013.84 $126,013.84 nat. median
$160,267
0.8× median
5832
APR_DRG 		Neonate W Ecmo 1 $124,961.67 $124,961.67 $124,961.67 nat. median
$156,126
0.8× median
14
APR_DRG 		Liver Transplant &/or Intestinal Transplant 1 $121,705.22 $121,705.22 $121,705.22 nat. median
$129,535
0.9× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 15 $87,093.72 $335,419.59 $118,977.21 nat. median
$117,357
1.0× median
5883
APR_DRG 		Neonate Bwt <1500g W Major Procedure 1 $113,384.15 $113,384.15 $113,384.15 nat. median
$182,665
0.6× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 15 $82,121.55 $316,270.54 $112,184.82 nat. median
$108,660
1.0× median
4
MS_DRG 		Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And… 14 $100,381.10 $386,592.57 $110,764.45 nat. median
$133,161
0.8× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 10 $110,139.19 $699,999.51 $110,139.19 nat. median
$111,989
1.0× median
C9150
HCPCS 		Other Radiology 1 $105,830.40 $105,830.40 $105,830.40 nat. median
$775
outlier · 136.6×
5914
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 1 $104,959.98 $104,959.98 $104,959.98 nat. median
$164,289
0.6× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 15 $74,720.19 $287,766.06 $102,073.95 nat. median
$100,136
1.0× median
E0766RRKF
HCPCS 		Other Outpatient 1 $91,736.64 $107,026.08 $99,381.36 —
E0766
HCPCS 		Elec Stim Cancer Treatment 1 $91,736.64 $107,026.08 $99,381.36 nat. median
$16,785
outlier · 5.9×
215
MS_DRG 		Other Heart Assist System Implant 15 $72,158.38 $277,899.87 $98,574.30 nat. median
$99,019
1.0× median
5934
APR_DRG 		Neonate Birthwt 750-999g Without Major Procedure 1 $97,158.74 $97,158.74 $97,158.74 nat. median
$151,838
0.6× median
E0764NUKF
HCPCS 		Other Outpatient 1 $88,303.20 $103,020.40 $95,661.80 —
6094
APR_DRG 		Neonate Bwt 1500-2499g W Major Procedure 1 $94,524.59 $94,524.59 $94,524.59 nat. median
$162,982
0.6× median
64
APR_DRG 		Pancreas Transplant 1 $93,578.65 $93,578.65 $93,578.65 nat. median
$91,009
1.0× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 10 $93,216.70 $93,216.70 $93,216.70 nat. median
$96,983
1.0× median

Other procedures at this hospital

Browse this hospital's 23,439 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
             
0266T CPT Outpatient Rates 22 14 — — $1,581.72 $61,071.00 $45,224.60 2025-11-01
0515T CPT Hb Radiant Ccl-insertion Wrls Car Stimulator Lv Pacg Compl Sys 66 19 $78,240.00 $27,384.00 65% off $3,606.00 $68,705.00 $39,902.40 2025-11-01
0520T CPT Hb Radiant Ccl-rmvl&rplcmt Pg Wcs Lv Pacg Battery Compnt Only 66 19 $78,240.00 $27,384.00 65% off $3,606.00 $68,705.00 $39,902.40 2025-11-01
0908T CPT Hb Open Impltj Int Neurostimulation Sys Vagus Nerve 47 19 $121,080.00 $42,378.00 65% off $2,766.00 $83,545.20 $61,750.80 2025-11-01
0909T CPT Hb Replacement Int Neurostimulation Sys Vagus Nerve 47 19 $121,083.00 $42,379.05 65% off $2,766.00 $83,547.27 $61,752.33 2025-11-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 25 15 — — $162,000.00 $782,147.05 $220,950.20 2025-11-01
10 MS_DRG Pancreas Transplant 24 15 — — $52,002.30 $200,273.79 $64,951.43 2025-11-01
11 APR_DRG Liver Transplant &/or Intestinal Transplant 1 1 — — $47,031.12 $47,031.12 $47,031.12 2025-11-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 23 14 — — $39,525.86 $152,223.93 $45,478.67 2025-11-01
12 APR_DRG Liver Transplant &/or Intestinal Transplant 1 1 — — $51,480.94 $51,480.94 $51,480.94 2025-11-01
1204 APR_DRG Major Respiratory & Chest Procedures 1 1 — — $42,084.59 $42,084.59 $42,084.59 2025-11-01
1214 APR_DRG Other Respiratory & Chest Procedures 1 1 — — $39,053.06 $39,053.06 $39,053.06 2025-11-01
13 APR_DRG Liver Transplant &/or Intestinal Transplant 1 1 — — $64,153.74 $64,153.74 $64,153.74 2025-11-01
1304 APR_DRG Respiratory System Diagnosis W Ventilator Support 96+ Hours 1 1 — — $42,027.73 $42,027.73 $42,027.73 2025-11-01
14 APR_DRG Liver Transplant &/or Intestinal Transplant 1 1 — — $121,705.22 $121,705.22 $121,705.22 2025-11-01
14 MS_DRG Allogeneic Bone Marrow Transplant 25 15 — — $87,093.72 $335,419.59 $118,977.21 2025-11-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 24 15 — — $42,972.54 $165,497.93 $53,940.15 2025-11-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 1 1 — — $73,248.31 $73,248.31 $73,248.31 2025-11-01
1613 APR_DRG Cardiac Defibrillator & Heart Assist Implant 1 1 — — $49,540.31 $49,540.31 $49,540.31 2025-11-01
1614 APR_DRG Cardiac Defibrillator & Heart Assist Implant 1 1 — — $149,355.70 $149,355.70 $149,355.70 2025-11-01
1623 APR_DRG Cardiac Valve Procedures W Cardiac Catheterization 1 1 — — $39,889.67 $39,889.67 $39,889.67 2025-11-01
1624 APR_DRG Cardiac Valve Procedures W Cardiac Catheterization 1 1 — — $72,313.61 $72,313.61 $72,313.61 2025-11-01
1634 APR_DRG Cardiac Valve Procedures Without Cardiac Catheterization 1 1 — — $67,295.23 $67,295.23 $67,295.23 2025-11-01
1654 APR_DRG Coronary Bypass W Cardiac Cath Or Percutaneous Cardiac Procedure 1 1 — — $40,125.22 $40,125.22 $40,125.22 2025-11-01
1664 APR_DRG Coronary Bypass Without Cardiac Cath Or Percutaneous Cardiac Procedure 1 1 — — $47,487.22 $47,487.22 $47,487.22 2025-11-01
1674 APR_DRG Other Cardiothoracic Procedures 1 1 — — $55,618.36 $55,618.36 $55,618.36 2025-11-01
1694 APR_DRG Major Thoracic & Abdominal Vascular Procedures 1 1 — — $50,574.98 $50,574.98 $50,574.98 2025-11-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 24 15 — — $39,367.88 $151,615.49 $49,544.47 2025-11-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 23 14 — — $312,945.75 $1,205,231.95 $342,310.06 2025-11-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 24 15 — — $51,704.45 $199,126.69 $64,588.22 2025-11-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 25 15 — — $82,121.55 $316,270.54 $112,184.82 2025-11-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 23 14 — — $57,025.19 $219,618.21 $64,252.04 2025-11-01
204 APR_DRG Craniotomy For Trauma 1 1 — — $48,638.73 $48,638.73 $48,638.73 2025-11-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support &gt;96 Hours 23 14 — — $46,632.27 $179,592.48 $53,102.46 2025-11-01
209 MS_DRG Complex Aortic Arch Procedures 23 14 — — $82,027.34 $315,907.71 $91,074.46 2025-11-01
21 APR_DRG Heart &/or Lung Transplant 1 1 — — $63,878.82 $63,878.82 $63,878.82 2025-11-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 23 14 — — $38,364.17 $147,749.96 $44,232.39 2025-11-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 23 14 — — $78,804.60 $303,496.13 $87,617.09 2025-11-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 23 14 — — $41,357.90 $159,279.58 $47,444.09 2025-11-01
214 APR_DRG Craniotomy Except For Trauma 1 1 — — $55,887.65 $55,887.65 $55,887.65 2025-11-01
215 MS_DRG Other Heart Assist System Implant 25 15 — — $72,158.38 $277,899.87 $98,574.30 2025-11-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 23 14 — — $70,895.95 $273,037.95 $79,132.65 2025-11-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 23 14 — — $47,651.20 $183,516.62 $54,195.57 2025-11-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 23 14 — — $47,651.20 $183,516.62 $54,195.57 2025-11-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 23 14 — — $55,644.64 $214,301.35 $62,770.97 2025-11-01
22 APR_DRG Heart &/or Lung Transplant 1 1 — — $71,136.49 $71,136.49 $71,136.49 2025-11-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 23 14 — — $38,646.80 $148,838.45 $44,535.61 2025-11-01
2204 APR_DRG Major Stomach, Esophageal & Duodenal Procedures 1 1 — — $46,823.69 $46,823.69 $46,823.69 2025-11-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 23 14 — — $36,526.33 $140,671.98 $42,260.75 2025-11-01
224 APR_DRG Ventricular Shunt Procedures 1 1 — — $50,799.28 $50,799.28 $50,799.28 2025-11-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 23 14 — — $35,853.81 $138,081.93 $41,539.27 2025-11-01
23 APR_DRG Heart &/or Lung Transplant 1 1 — — $91,762.35 $91,762.35 $91,762.35 2025-11-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 23 14 — — $41,527.48 $159,932.67 $47,626.01 2025-11-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 23 14 — — $61,091.49 $235,278.51 $68,614.37 2025-11-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 23 14 — — $43,935.66 $169,207.17 $50,209.52 2025-11-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 23 14 — — $55,404.76 $213,377.53 $62,513.63 2025-11-01
234 APR_DRG Spinal Procedures 1 1 — — $49,732.75 $49,732.75 $49,732.75 2025-11-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 23 14 — — $39,588.19 $152,463.96 $45,545.53 2025-11-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 23 14 — — $42,529.74 $163,792.63 $48,701.24 2025-11-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 23 14 — — $35,667.56 $137,364.65 $41,339.46 2025-11-01
24 APR_DRG Heart &/or Lung Transplant 1 1 — — $149,739.33 $149,739.33 $149,739.33 2025-11-01
244 APR_DRG Extracranial Vascular Procedures 1 1 — — $43,058.02 $43,058.02 $43,058.02 2025-11-01
245 MS_DRG Aicd Generator Procedures 23 14 — — $33,063.71 $127,336.58 $38,546.04 2025-11-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 23 14 — — $32,949.93 $126,898.40 $38,423.98 2025-11-01
2604 APR_DRG Major Pancreas, Liver & Shunt Procedures 1 1 — — $53,583.39 $53,583.39 $53,583.39 2025-11-01
264 APR_DRG Other Nervous System & Related Procedures 1 1 — — $41,334.20 $41,334.20 $41,334.20 2025-11-01
2644 APR_DRG Other Hepatobiliary, Pancreas & Abdominal Procedures 1 1 — — $43,788.41 $43,788.41 $43,788.41 2025-11-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 23 14 — — $44,412.51 $171,043.64 $50,721.10 2025-11-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 23 14 — — $34,501.52 $132,873.93 $40,088.53 2025-11-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 23 14 — — $49,844.14 $191,962.19 $56,548.16 2025-11-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 23 14 — — $38,237.35 $147,261.53 $44,096.34 2025-11-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 23 14 — — $51,674.01 $199,009.46 $58,511.26 2025-11-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 23 14 — — $43,529.83 $167,644.21 $49,774.14 2025-11-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 23 14 — — $33,470.27 $128,902.34 $38,982.20 2025-11-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 23 14 — — $40,338.25 $155,352.64 $46,350.20 2025-11-01
28 MS_DRG Spinal Procedures With Mcc 23 14 — — $43,542.15 $167,691.65 $49,787.36 2025-11-01
3 MS_DRG Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 23 14 — — $153,819.02 $592,395.33 $168,252.16 2025-11-01
3034 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 1 1 — — $74,421.68 $74,421.68 $74,421.68 2025-11-01
3044 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 1 1 — — $62,247.47 $62,247.47 $62,247.47 2025-11-01
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses 1 1 — — $64,476.13 $64,476.13 $64,476.13 2025-11-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 23 14 — — $48,457.07 $186,620.22 $55,060.10 2025-11-01
32 APR_DRG Bone Marrow Transplant 1 1 — — $45,232.32 $45,232.32 $45,232.32 2025-11-01
3214 APR_DRG Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp 1 1 — — $50,864.89 $50,864.89 $50,864.89 2025-11-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 23 14 — — $36,143.69 $139,198.33 $41,850.26 2025-11-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 23 14 — — $33,310.84 $128,288.32 $38,811.16 2025-11-01
33 APR_DRG Bone Marrow Transplant 1 1 — — $74,370.45 $74,370.45 $74,370.45 2025-11-01
33230 CPT Hb Insert Dfib Pulse Gen Only W Exist Dual Lead 64 19 $76,432.00 $26,751.20 65% off $2,210.04 $68,705.00 $38,980.32 2025-11-01
33263 CPT Hb Radiant Ccl-remv&replc Cvd Gen Dual Lead 66 19 $93,203.00 $32,621.05 65% off $1,307.33 $68,705.00 $45,669.47 2025-11-01
33264 CPT Hb Radiant Ccl-remv&replc Cvd Gen Mult Lead 66 19 $97,107.00 $33,987.45 65% off $1,361.68 $68,705.00 $47,582.43 2025-11-01
33270 CPT Hb Insert/replace S-icd W Subq Lead 66 19 $75,244.00 $26,335.40 65% off $1,886.09 $68,705.00 $38,374.44 2025-11-01
33276 CPT Hb Insertion Phrenic Nerve Stimulator System 57 19 $90,449.00 $31,657.15 65% off $3,478.00 $68,705.00 $46,128.99 2025-11-01
33287 CPT Hb Radiant-rmvl&rplcmt Phrenic Nrv Stimulator Pls Generator 57 19 $79,691.00 $27,891.85 65% off $3,478.00 $61,071.00 $40,642.41 2025-11-01
34 APR_DRG Bone Marrow Transplant 1 1 — — $141,163.34 $141,163.34 $141,163.34 2025-11-01
3614 APR_DRG Skin Graft For Skin & Subcutaneous Tissue Diagnoses 1 1 — — $40,020.25 $40,020.25 $40,020.25 2025-11-01
4 MS_DRG Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And … 23 14 — — $100,381.10 $386,592.57 $110,764.45 2025-11-01
4014 APR_DRG Pituitary & Adrenal Procedures 1 1 — — $53,788.95 $53,788.95 $53,788.95 2025-11-01
4034 APR_DRG Procedures For Obesity 1 1 — — $46,841.18 $46,841.18 $46,841.18 2025-11-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 23 14 — — $39,644.71 $152,681.66 $45,606.17 2025-11-01
4054 APR_DRG Other Procedures For Endocrine, Nutritional & Metabolic Disorders 1 1 — — $39,953.40 $39,953.40 $39,953.40 2025-11-01
41 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 1 1 — — $46,463.18 $46,463.18 $46,463.18 2025-11-01
42 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 1 1 — — $51,625.89 $51,625.89 $51,625.89 2025-11-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 23 14 — — $79,870.64 $307,601.69 $88,760.73 2025-11-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 23 14 — — $52,313.19 $201,471.13 $59,196.98 2025-11-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 23 14 — — $40,742.63 $156,910.02 $46,784.03 2025-11-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 23 14 — — $65,292.57 $251,457.94 $73,121.31 2025-11-01
43 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 1 1 — — $70,677.26 $70,677.26 $70,677.26 2025-11-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 23 14 — — $41,794.17 $160,959.76 $47,912.12 2025-11-01
44 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 1 1 — — $127,196.58 $127,196.58 $127,196.58 2025-11-01
4403 APR_DRG Kidney Transplant 1 1 — — $43,860.89 $43,860.89 $43,860.89 2025-11-01
4404 APR_DRG Kidney Transplant 1 1 — — $76,097.39 $76,097.39 $76,097.39 2025-11-01
4414 APR_DRG Major Bladder Procedures 1 1 — — $43,928.37 $43,928.37 $43,928.37 2025-11-01
4424 APR_DRG Kidney & Urinary Tract Procedures For Malignancy 1 1 — — $39,292.36 $39,292.36 $39,292.36 2025-11-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 23 14 — — $48,421.56 $186,483.46 $55,022.01 2025-11-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 23 14 — — $38,623.61 $148,749.14 $44,510.73 2025-11-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 23 14 — — $60,899.44 $234,538.89 $68,408.34 2025-11-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 23 14 — — $43,214.59 $166,430.12 $49,435.95 2025-11-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 23 14 — — $40,025.18 $154,146.93 $46,014.33 2025-11-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 23 14 — — $41,304.28 $159,073.05 $47,386.55 2025-11-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 23 14 — — $37,723.53 $145,282.71 $43,545.12 2025-11-01
471 MS_DRG Cervical Spinal Fusion With Mcc 23 14 — — $34,993.59 $134,769.02 $40,616.42 2025-11-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 25 15 — — $74,720.19 $287,766.06 $102,073.95 2025-11-01
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs 1 1 — — $44,508.18 $44,508.18 $44,508.18 2025-11-01
53 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 1 1 — — $49,355.37 $49,355.37 $49,355.37 2025-11-01
54 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 1 1 — — $89,576.81 $89,576.81 $89,576.81 2025-11-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 23 14 — — $47,478.00 $182,849.57 $54,009.75 2025-11-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 23 14 — — $35,519.00 $136,792.49 $41,180.09 2025-11-01
5831 APR_DRG Neonate W Ecmo 1 1 — — $79,137.04 $79,137.04 $79,137.04 2025-11-01
5832 APR_DRG Neonate W Ecmo 1 1 — — $124,961.67 $124,961.67 $124,961.67 2025-11-01
5833 APR_DRG Neonate W Ecmo 1 1 — — $137,458.28 $137,458.28 $137,458.28 2025-11-01
5834 APR_DRG Neonate W Ecmo 1 1 — — $191,132.26 $191,132.26 $191,132.26 2025-11-01
5881 APR_DRG Neonate Bwt <1500g W Major Procedure 1 1 — — $38,409.52 $38,409.52 $38,409.52 2025-11-01
5882 APR_DRG Neonate Bwt <1500g W Major Procedure 1 1 — — $55,567.12 $55,567.12 $55,567.12 2025-11-01
5883 APR_DRG Neonate Bwt <1500g W Major Procedure 1 1 — — $113,384.15 $113,384.15 $113,384.15 2025-11-01
5884 APR_DRG Neonate Bwt <1500g W Major Procedure 1 1 — — $171,904.07 $171,904.07 $171,904.07 2025-11-01
5891 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 1 1 — — $91,615.53 $91,615.53 $91,615.53 2025-11-01
5892 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 1 1 — — $83,287.58 $83,287.58 $83,287.58 2025-11-01
5893 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 1 1 — — $75,716.27 $75,716.27 $75,716.27 2025-11-01
5912 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 1 1 — — $44,172.04 $44,172.04 $44,172.04 2025-11-01
5913 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 1 1 — — $70,045.59 $70,045.59 $70,045.59 2025-11-01
5914 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 1 1 — — $104,959.98 $104,959.98 $104,959.98 2025-11-01
5932 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 1 1 — — $41,189.25 $41,189.25 $41,189.25 2025-11-01
5933 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 1 1 — — $65,696.37 $65,696.37 $65,696.37 2025-11-01
5934 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 1 1 — — $97,158.74 $97,158.74 $97,158.74 2025-11-01
6 MS_DRG Liver Transplant Without Mcc 25 15 — — $33,604.34 $194,000.00 $45,906.30 2025-11-01
6022 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $46,579.39 $46,579.39 $46,579.39 2025-11-01
6023 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $61,563.94 $61,563.94 $61,563.94 2025-11-01
6024 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $83,097.64 $83,097.64 $83,097.64 2025-11-01
6033 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 1 1 — — $52,038.88 $52,038.88 $52,038.88 2025-11-01
6034 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 1 1 — — $56,134.44 $56,134.44 $56,134.44 2025-11-01
6073 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $49,099.83 $49,099.83 $49,099.83 2025-11-01
6074 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 1 — — $63,084.08 $63,084.08 $63,084.08 2025-11-01
6083 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 1 1 — — $41,800.93 $41,800.93 $41,800.93 2025-11-01
6084 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 1 1 — — $47,942.08 $47,942.08 $47,942.08 2025-11-01
6093 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 1 1 — — $52,077.00 $52,077.00 $52,077.00 2025-11-01
6094 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 1 1 — — $94,524.59 $94,524.59 $94,524.59 2025-11-01
61 APR_DRG Pancreas Transplant 1 1 — — $44,707.49 $44,707.49 $44,707.49 2025-11-01
6114 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 1 1 — — $41,608.49 $41,608.49 $41,608.49 2025-11-01
6124 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 1 1 — — $49,427.85 $49,427.85 $49,427.85 2025-11-01
6134 APR_DRG Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 1 1 — — $38,740.66 $38,740.66 $38,740.66 2025-11-01
6144 APR_DRG Neonate Bwt 1500-1999g W Or Without Other Significant Condition 1 1 — — $40,307.66 $40,307.66 $40,307.66 2025-11-01
62 APR_DRG Pancreas Transplant 1 1 — — $58,561.79 $58,561.79 $58,561.79 2025-11-01
63 APR_DRG Pancreas Transplant 1 1 — — $60,359.96 $60,359.96 $60,359.96 2025-11-01
6303 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 1 1 — — $41,456.04 $41,456.04 $41,456.04 2025-11-01
6304 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 1 1 — — $88,920.77 $88,920.77 $88,920.77 2025-11-01
6314 APR_DRG Neonate Birthwt >2499g W Other Major Procedure 1 1 — — $76,426.66 $76,426.66 $76,426.66 2025-11-01
64 APR_DRG Pancreas Transplant 1 1 — — $93,578.65 $93,578.65 $93,578.65 2025-11-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 25 15 — — $34,071.05 $131,216.07 $46,543.86 2025-11-01
6504 APR_DRG Splenectomy 1 1 — — $38,825.63 $38,825.63 $38,825.63 2025-11-01
6514 APR_DRG Other Procedures Of Blood & Blood-forming Organs 1 1 — — $42,612.54 $42,612.54 $42,612.54 2025-11-01
653 MS_DRG Major Bladder Procedures With Mcc 23 14 — — $37,658.31 $145,031.52 $43,475.15 2025-11-01
6804 APR_DRG Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 1 1 — — $54,462.48 $54,462.48 $54,462.48 2025-11-01
6814 APR_DRG Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 1 1 — — $49,334.75 $49,334.75 $49,334.75 2025-11-01
6904 APR_DRG Acute Leukemia 1 1 — — $51,412.21 $51,412.21 $51,412.21 2025-11-01
6934 APR_DRG Chemotherapy 1 1 — — $41,722.20 $41,722.20 $41,722.20 2025-11-01
7 MS_DRG Lung Transplant 26 15 — — $93,850.10 $361,440.08 $128,206.98 2025-11-01
7114 APR_DRG Post-op, Post-trauma, Other Device Infections W O.r. Procedure 1 1 — — $42,757.49 $42,757.49 $42,757.49 2025-11-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 23 14 — — $5,377.00 $165,883.09 $49,283.57 2025-11-01
7914 APR_DRG O.r. Procedure For Other Complications Of Treatment 1 1 — — $39,901.54 $39,901.54 $39,901.54 2025-11-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 24 15 — — $40,616.54 $156,424.39 $51,067.15 2025-11-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 23 14 — — $42,502.21 $163,686.57 $48,671.69 2025-11-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 23 14 — — $33,226.05 $127,961.77 $38,720.20 2025-11-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 23 14 — — $33,900.02 $130,557.40 $39,443.23 2025-11-01
834 MS_DRG Acute Leukemia With Mcc 23 14 — — $39,785.31 $153,223.11 $45,756.99 2025-11-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 23 14 — — $34,816.76 $134,088.01 $40,426.72 2025-11-01
8413 APR_DRG Extensive 3rd Degree Burns W Skin Graft 1 1 — — $42,487.58 $42,487.58 $42,487.58 2025-11-01
8414 APR_DRG Extensive 3rd Degree Burns W Skin Graft 1 1 — — $126,013.84 $126,013.84 $126,013.84 2025-11-01
8424 APR_DRG Full Thickness Burns W Skin Graft 1 1 — — $69,552.00 $69,552.00 $69,552.00 2025-11-01
8444 APR_DRG Partial Thickness Burns W Or Without Skin Graft 1 1 — — $41,949.00 $41,949.00 $41,949.00 2025-11-01
850 MS_DRG Acute Leukemia With Other Procedures 23 14 — — $62,755.40 $241,686.65 $70,399.43 2025-11-01
8504 APR_DRG Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service 1 1 — — $42,819.97 $42,819.97 $42,819.97 2025-11-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 23 14 — — $35,790.03 $137,836.33 $41,470.84 2025-11-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 23 14 — — $32,964.43 $126,954.22 $38,439.53 2025-11-01
8634 APR_DRG Neonatal Aftercare 1 1 — — $65,551.41 $65,551.41 $65,551.41 2025-11-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv &gt;96 Hours 23 14 — — $50,089.81 $192,908.34 $56,811.73 2025-11-01
894 APR_DRG Major Cranial/facial Bone Procedures 1 1 — — $47,512.84 $47,512.84 $47,512.84 2025-11-01
90288 CPT Botulism Ig IV 2 2 — — $186.59 $126,145.95 $63,166.27 2025-11-01
904 APR_DRG Major Larynx & Trachea Procedures 1 1 — — $50,957.98 $50,957.98 $50,957.98 2025-11-01
9103 APR_DRG Craniotomy For Multiple Significant Trauma 1 1 — — $45,442.88 $45,442.88 $45,442.88 2025-11-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 1 1 — — $93,146.91 $93,146.91 $93,146.91 2025-11-01
9114 APR_DRG Extensive Abdominal/thoracic Procedures For Mult Significant Trauma 1 1 — — $77,886.82 $77,886.82 $77,886.82 2025-11-01
9124 APR_DRG Musculoskeletal & Other Procedures For Multiple Significant Trauma 1 1 — — $75,380.75 $75,380.75 $75,380.75 2025-11-01
914 APR_DRG Other Major Head & Neck Procedures 1 1 — — $44,205.15 $44,205.15 $44,205.15 2025-11-01
924 APR_DRG Facial Bone Procedures Except Major Cranial/facial Bone Procedures 1 1 — — $38,576.34 $38,576.34 $38,576.34 2025-11-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 23 14 — — $154,727.07 $595,892.46 $169,245.41 2025-11-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 23 14 — — $51,980.56 $200,190.06 $58,840.13 2025-11-01
9304 APR_DRG Multiple Significant Trauma Without O.r. Procedure 1 1 — — $43,730.31 $43,730.31 $43,730.31 2025-11-01
9504 APR_DRG Extensive Procedure Unrelated To Principal Diagnosis 1 1 — — $48,132.64 $48,132.64 $48,132.64 2025-11-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 23 14 — — $48,780.28 $187,865.00 $55,406.85 2025-11-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 23 14 — — $55,221.42 $212,671.41 $62,316.93 2025-11-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 23 14 — — $44,361.06 $170,845.48 $50,665.88 2025-11-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 23 14 — — $34,001.47 $130,948.14 $39,552.07 2025-11-01
C1767 HCPCS Hb Or-impl Pain Gen/stimulator (41) 576 19 $85,692.07 $29,992.22 65% off $8,271.65 $186,190.78 $39,332.65 2025-11-01
C1815 HCPCS Hb Or-impl Urinary Incont Male (40) 72 19 $88,646.96 $31,026.44 65% off $14,679.94 $79,782.26 $44,761.40 2025-11-01
C1882 HCPCS Hb Ep Defib(2) 504 19 $99,099.16 $34,684.71 65% off $10,571.66 $128,350.47 $42,701.33 2025-11-01
C2616 HCPCS Hb Brachy Tx Ns Spheres Yt-90 83 19 $169,668.05 $59,383.82 65% off $17,485.10 $152,701.25 $66,679.54 2025-11-01
C9150 HCPCS Other Radiology 1 1 — — $105,830.40 $105,830.40 $105,830.40 2025-11-01
E0193NU HCPCS Other Outpatient 2 1 — — $52,812.60 $61,614.70 $57,213.65 2025-11-01
E0194NU HCPCS Other Outpatient 2 1 — — $259,670.40 $302,948.80 $281,309.60 2025-11-01
E0302NU HCPCS Other Outpatient 2 1 — — $36,616.80 $42,719.60 $39,668.20 2025-11-01
E0304NU HCPCS Other Outpatient 2 1 — — $37,820.40 $44,123.80 $40,972.10 2025-11-01
E0483NU HCPCS Other Outpatient 2 1 — — $84,830.40 $98,968.80 $91,899.60 2025-11-01
E0636NU HCPCS Other Outpatient 2 1 — — $73,154.40 $85,346.80 $79,250.60 2025-11-01
E0652NU HCPCS Other Outpatient 2 1 — — $35,956.26 $41,948.97 $38,952.62 2025-11-01
E0764NUKF HCPCS Other Outpatient 2 1 — — $88,303.20 $103,020.40 $95,661.80 2025-11-01
E0766 HCPCS Elec Stim Cancer Treatment 2 1 — — $91,736.64 $107,026.08 $99,381.36 2025-11-01
E0766RRKF HCPCS Other Outpatient 2 1 — — $91,736.64 $107,026.08 $99,381.36 2025-11-01
E0783NUKF HCPCS Other Outpatient 2 1 — — $65,150.58 $76,009.01 $70,579.79 2025-11-01
E0783UEKF HCPCS Other Outpatient 2 1 — — $48,863.10 $57,006.95 $52,935.02 2025-11-01
E0786NUKF HCPCS Other Outpatient 2 1 — — $61,420.98 $71,657.81 $66,539.40 2025-11-01
E0786UEKF HCPCS Other Outpatient 2 1 — — $46,065.84 $53,743.48 $49,904.66 2025-11-01
E0986NU HCPCS Other Outpatient 2 1 — — $38,814.00 $45,283.00 $42,048.50 2025-11-01
E1005NU HCPCS Other Outpatient 2 1 — — $35,998.80 $41,998.60 $38,998.70 2025-11-01
E1005NUKE HCPCS Other Outpatient 2 1 — — $37,312.80 $43,531.60 $40,422.20 2025-11-01
E1005NUKU HCPCS Other Outpatient 2 1 — — $36,246.00 $42,287.00 $39,266.50 2025-11-01
E1006NU HCPCS Other Outpatient 2 1 — — $44,312.40 $51,697.80 $48,005.10 2025-11-01
E1006NUKE HCPCS Other Outpatient 2 1 — — $45,921.60 $53,575.20 $49,748.40 2025-11-01
E1006NUKU HCPCS Other Outpatient 2 1 — — $44,396.40 $51,795.80 $48,096.10 2025-11-01
E1007NU HCPCS Other Outpatient 2 1 — — $56,256.60 $65,632.70 $60,944.65 2025-11-01
E1007NUKE HCPCS Other Outpatient 2 1 — — $58,435.80 $68,175.10 $63,305.45 2025-11-01
E1007NUKU HCPCS Other Outpatient 2 1 — — $60,117.00 $70,136.50 $65,126.75 2025-11-01
E1008NU HCPCS Other Outpatient 2 1 — — $57,318.60 $66,871.70 $62,095.15 2025-11-01
E1008NUKE HCPCS Other Outpatient 2 1 — — $59,497.80 $69,414.10 $64,455.95 2025-11-01
E1008NUKU HCPCS Other Outpatient 2 1 — — $60,121.20 $70,141.40 $65,131.30 2025-11-01
E1035NU HCPCS Other Outpatient 2 1 — — $43,692.00 $50,974.00 $47,333.00 2025-11-01
E1036NU HCPCS Other Outpatient 2 1 — — $60,405.60 $70,473.20 $65,439.40 2025-11-01
E1841NU HCPCS Other Outpatient 2 1 — — $36,145.20 $42,169.40 $39,157.30 2025-11-01
E2402NU HCPCS Other Outpatient 2 1 — — $60,607.20 $70,708.40 $65,657.80 2025-11-01
E2510NU HCPCS Other Outpatient 2 1 — — $54,005.40 $63,006.30 $58,505.85 2025-11-01
E2510UE HCPCS Other Outpatient 2 1 — — $40,503.90 $47,254.55 $43,879.23 2025-11-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 10 10 — — $3,685,266.67 $3,685,266.67 $3,685,266.67 2025-11-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 10 10 — — $3,316,462.59 $3,316,462.59 $3,316,462.59 2025-11-01
J3357 HCPCS Ustekinumab 90 Mg/ml Subcutaneous Syringe 60 19 $124,898.32 $43,714.42 65% off $149.40 $86,179.84 $63,073.65 2025-11-01
J3391 HCPCS Inj, Atidarsagene Autotemcel 10 10 — — $4,505,000.00 $4,505,000.00 $4,505,000.00 2025-11-01
J3392 HCPCS Inj, Exagamglogene Autotem 10 10 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2025-11-01
J3393 HCPCS Inj, Betibeglogene Autotemce 10 10 — — $2,945,740.00 $2,945,740.00 $2,945,740.00 2025-11-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 10 10 — — $3,248,445.72 $3,248,445.72 $3,248,445.72 2025-11-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 11 10 — — $186.59 $2,455,110.61 $2,455,110.61 2025-11-01
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 10 10 — — $205,640.00 $205,640.00 $205,640.00 2025-11-01
J3403 HCPCS Revakinagene, Per Implant 10 10 — — $257,500.00 $257,500.00 $257,500.00 2025-11-01
J7330 HCPCS Hb Autologous Cultured Chondrocyctes, Implant 49 19 $182,777.50 $63,972.13 65% off $60,316.58 $155,324.32 $93,216.53 2025-11-01
J9029 HCPCS Instill Adstiladrin, Tx Dose 16 14 — — $63,342.28 $149,184.00 $63,342.28 2025-11-01
J9226 HCPCS Supprelin La Implant 21 14 — — $186.59 $302,890.14 $45,020.65 2025-11-01
K0606NUKF HCPCS Other Outpatient 2 1 — — $200,939.40 $234,429.30 $217,684.35 2025-11-01
K0826NU HCPCS Other Outpatient 2 1 — — $36,000.78 $42,000.91 $39,000.85 2025-11-01
K0828NU HCPCS Other Outpatient 2 1 — — $42,907.62 $50,058.89 $46,483.26 2025-11-01
K0829NU HCPCS Other Outpatient 2 1 — — $40,984.80 $47,815.60 $44,400.20 2025-11-01
K0840NU HCPCS Other Outpatient 2 1 — — $48,694.38 $56,810.11 $52,752.24 2025-11-01
K0848NU HCPCS Other Outpatient 2 1 — — $36,343.20 $42,400.40 $39,371.80 2025-11-01
K0850NU HCPCS Other Outpatient 2 1 — — $42,155.58 $49,181.51 $45,668.54 2025-11-01
K0851NU HCPCS Other Outpatient 2 1 — — $40,533.18 $47,288.71 $43,910.94 2025-11-01
K0852NU HCPCS Other Outpatient 2 1 — — $48,708.42 $56,826.49 $52,767.46 2025-11-01
K0853NU HCPCS Other Outpatient 2 1 — — $50,036.40 $58,375.80 $54,206.10 2025-11-01
K0854NU HCPCS Other Outpatient 2 1 — — $66,286.80 $77,334.60 $71,810.70 2025-11-01
K0855NU HCPCS Other Outpatient 2 1 — — $62,617.62 $73,053.89 $67,835.76 2025-11-01
K0856NU HCPCS Other Outpatient 2 1 — — $39,009.18 $45,510.71 $42,259.94 2025-11-01
K0857NU HCPCS Other Outpatient 2 1 — — $39,791.58 $46,423.51 $43,107.54 2025-11-01
K0858NU HCPCS Other Outpatient 2 1 — — $48,399.60 $56,466.20 $52,432.90 2025-11-01
K0859NU HCPCS Other Outpatient 2 1 — — $46,158.42 $53,851.49 $50,004.96 2025-11-01
K0860NU HCPCS Other Outpatient 2 1 — — $69,145.20 $80,669.40 $74,907.30 2025-11-01
K0861NU HCPCS Other Outpatient 2 1 — — $39,072.00 $45,584.00 $42,328.00 2025-11-01
K0862NU HCPCS Other Outpatient 2 1 — — $48,399.60 $56,466.20 $52,432.90 2025-11-01
K0863NU HCPCS Other Outpatient 2 1 — — $69,145.20 $80,669.40 $74,907.30 2025-11-01
K0864NU HCPCS Other Outpatient 2 1 — — $82,282.80 $95,996.60 $89,139.70 2025-11-01
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 10 10 — — $93,216.70 $93,216.70 $93,216.70 2025-11-01
K1014 HCPCS Other Outpatient 2 1 — — $44,446.14 $51,853.83 $48,149.99 2025-11-01
K1024NU HCPCS Other Outpatient 2 1 — — $35,956.20 $41,948.90 $38,952.55 2025-11-01
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 12 10 — — $39,482.40 $263,059.58 $39,482.40 2025-11-01
L7180 HCPCS Electronic Elbow Sequential 12 10 — — $42,853.91 $285,523.07 $42,853.91 2025-11-01
L7181 HCPCS Electronic Elbo Simultaneous 12 10 — — $48,901.12 $325,813.81 $48,901.12 2025-11-01
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 10 10 — — $67,452.66 $67,452.66 $67,452.66 2025-11-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 12 10 — — $110,139.19 $699,999.51 $110,139.19 2025-11-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 13 10 — — $449,245.86 $3,146,080.00 $533,230.17 2025-11-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 11 10 — — $468,441.50 $591,726.20 $591,726.20 2025-11-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 21 14 — — $53,630.37 $371,437.08 $55,272.32 2025-11-01
Q2053 HCPCS Brexucabtagene Car Pos T 13 10 — — $448,752.40 $3,146,080.00 $489,304.61 2025-11-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 13 10 — — $434,918.00 $3,181,425.17 $562,538.19 2025-11-01
Q2055 HCPCS Idecabtagene Vicleucel Car 11 10 — — $444,670.00 $557,317.93 $557,317.93 2025-11-01
Q2056 HCPCS Ciltacabtagene Car-pos T 13 10 — — $492,900.00 $3,450,300.00 $565,868.95 2025-11-01
Q2057 HCPCS Afamitresgene Autoleucel 10 10 — — $770,620.00 $770,620.00 $770,620.00 2025-11-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 10 10 — — $278,250.00 $278,250.00 $278,250.00 2025-11-01
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