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

Spalding Rehabilitation Hospital

Aurora, CO · CCN 063027 · Rates published

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You selected 27447 (CPT)

Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)

This hospital’s price: $20,678 across 6 payers · range $14,000-$28,422

Source: https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/84-1321505_HCA-HEALTHONE-SPALDING-REHABILITATION_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D · observed 2026-03-01

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.

20,448 distinct procedures filed
25 distinct payers
326,714 rate rows
2026-07-17 last MRF observed
Data quality

309,582 of 326,714 rate rows are consumer-grade (94.8%)

17,132 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
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 9,981
per-diem day rate — not a per-procedure price 3,956
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 2,978
placeholder amount (≤ $0.02) — excluded from medians 205
exceeds 10× this hospital's gross charge — excluded from medians 8
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 3
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/84-1321505_HCA-HEALTHONE-SPALDING-REHABILITATION_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 viaDiscovered by HANK
Last fetch not_modified · 2026-08-03
Content fingerprint bdfdaeef8ca1f17f… · 140,392,456 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
$2,997,086
1.6× median
845
OTHER 		Inj, Atidarsagene Autotem 15 $4,459,950.00 $4,730,250.00 $4,505,000.00 nat. median
$16,015
outlier · 281.3×
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 1 $3,847,800.00 $3,847,800.00 $3,847,800.00 nat. median
$2,405,851
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
$2,460,273
1.6× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 15 $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 15 $3,302,461.80 $3,502,611.00 $3,335,820.00 nat. median
$29,683
outlier · 112.4×
714
OTHER 		Inj Delandistrogene Mox R 15 $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 15 $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 15 $3,148,200.00 $3,339,000.00 $3,180,000.00 nat. median
$24,604
outlier · 129.2×
746
OTHER 		Inj, Betibeglogene Autote 15 $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 15 $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 15 $2,308,680.00 $2,448,600.00 $2,332,000.00 nat. median
$58,186
outlier · 40.1×
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
$809,151
outlier · 2.9×
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 4 $819,605.32 $1,762,948.71 $911,868.41 nat. median
$631,793
1.4× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 4 $836,958.70 $1,699,593.90 $903,487.86 nat. median
$691,418
1.3× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 4 $782,774.83 $1,674,245.19 $868,284.31 nat. median
$610,161
1.4× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 4 $765,607.90 $1,686,603.72 $862,738.04 nat. median
$624,417
1.4× 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
$302,242
outlier · 2.8×
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 4 $741,901.04 $1,596,576.72 $825,628.09 nat. median
$588,565
1.4× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 4 $725,845.60 $1,468,350.60 $782,000.18 nat. median
$577,541
1.4× median
2067
OTHER 		Afamitresgene Autoleucel 15 $762,913.80 $809,151.00 $770,620.00 nat. median
$786,032
1.0× median
J3402
HCPCS 		Injection, Remestemcel-l-rknd, Per Therapeutic Dose 2 $332,753.88 $605,007.06 $605,007.06 nat. median
$209,736
outlier · 2.9×
9498
OTHER 		Ciltacabtagene Car-pos T 15 $581,773.10 $617,032.08 $587,649.60 nat. median
$587,650
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos 15 $560,865.99 $594,857.87 $566,531.30 nat. median
$576,820
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 15 $556,579.19 $590,311.26 $562,201.20 nat. median
$562,201
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 15 $552,500.98 $585,985.89 $558,081.80 nat. median
$560,872
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 15 $526,870.28 $558,801.81 $532,192.20 nat. median
$533,230
1.0× median
9391
OTHER 		Brexucabtagene Car Pos T 15 $484,555.70 $513,922.71 $489,450.20 nat. median
$492,768
1.0× median
831
OTHER 		Obecbtge Autol Up To 400 15 $275,467.50 $292,162.50 $278,250.00 nat. median
$20,175
outlier · 13.8×
897
OTHER 		Revakinagene, Per Implant 15 $262,350.00 $278,250.00 $265,000.00 nat. median
$19,528
outlier · 13.6×
215
MS_DRG 		Other Heart Assist System Implant 2 $184,035.00 $258,231.00 $258,231.00 nat. median
$98,002
outlier · 2.6×
J7330
HCPCS 		Autologous Cultured Chondrocytes, Implant 2 $138,148.31 $251,178.75 $251,178.75 nat. median
$75,807
outlier · 3.3×
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 2 $189,492.00 $250,835.00 $250,835.00 nat. median
$59,257
outlier · 4.2×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 2 $189,492.00 $250,835.00 $250,835.00 nat. median
$79,040
outlier · 3.2×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 $153,188.00 $214,777.00 $214,777.00 nat. median
$77,385
outlier · 2.8×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 $156,788.00 $207,546.00 $207,546.00 nat. median
$68,581
outlier · 3.0×
21
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 2 $153,188.00 $202,620.00 $202,620.00 nat. median
$54,267
outlier · 3.7×
22
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 2 $153,188.00 $202,620.00 $202,620.00 nat. median
$34,270
outlier · 5.9×
886
OTHER 		Inj. Remestemcel-l-rknd/ 15 $199,652.31 $211,752.45 $201,669.00 nat. median
$200,661
1.0× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 $138,051.00 $193,554.00 $193,554.00 nat. median
$80,459
outlier · 2.4×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 $125,550.00 $178,565.00 $178,565.00 nat. median
$96,835
1.8× median
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 $125,502.00 $166,001.00 $166,001.00 nat. median
$57,394
outlier · 2.9×
458
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 $125,502.00 $166,001.00 $166,001.00 nat. median
$42,100
outlier · 3.9×
1907
OTHER 		New Technology - Level 52 15 $155,885.20 $165,332.79 $157,459.80 nat. median
$155,877
1.0× median
1908
OTHER 		New Technology - Level 52 15 $155,885.20 $165,332.79 $157,459.80 nat. median
$155,877
1.0× median
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 2 $107,043.00 $150,198.00 $150,198.00 nat. median
$60,162
outlier · 2.5×
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 $106,847.00 $149,922.00 $149,922.00 nat. median
$63,840
outlier · 2.3×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 $106,847.00 $149,922.00 $149,922.00 nat. median
$92,900
1.6× median
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 $106,847.00 $149,922.00 $149,922.00 nat. median
$60,895
outlier · 2.5×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 2 $99,965.00 $142,175.00 $142,175.00 nat. median
$81,124
1.8× median

Other procedures at this hospital

Browse this hospital's 20,448 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
             
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 1 1 — — $4,850,948.67 $4,850,948.67 $4,850,948.67 2026-03-01
845 OTHER Inj, Atidarsagene Autotem 21 15 — — $4,459,950.00 $4,730,250.00 $4,505,000.00 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
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
9138 OTHER Inj, Hemgenix, Per Tx Dos 21 15 — — $3,648,414.33 $3,869,530.35 $3,685,267.00 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 21 15 — — $3,302,461.80 $3,502,611.00 $3,335,820.00 2026-03-01
714 OTHER Inj Delandistrogene Mox R 21 15 — — $3,294,581.40 $3,494,253.00 $3,327,860.00 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 21 15 — — $3,219,982.92 $3,415,133.40 $3,252,508.00 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 21 15 — — $3,148,200.00 $3,339,000.00 $3,180,000.00 2026-03-01
746 OTHER Inj, Betibeglogene Autote 21 15 — — $2,910,569.31 $3,086,967.45 $2,939,969.00 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 21 15 — — $2,563,091.19 $2,718,430.05 $2,588,981.00 2026-03-01
824 OTHER Inj, Exagamglogene Autote 21 15 — — $2,308,680.00 $2,448,600.00 $2,332,000.00 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
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 6 4 — — $819,605.32 $1,762,948.71 $911,868.41 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 6 4 — — $836,958.70 $1,699,593.90 $903,487.86 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 6 4 — — $782,774.83 $1,674,245.19 $868,284.31 2026-03-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 6 4 — — $765,607.90 $1,686,603.72 $862,738.04 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
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 6 4 — — $741,901.04 $1,596,576.72 $825,628.09 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 6 4 — — $725,845.60 $1,468,350.60 $782,000.18 2026-03-01
2067 OTHER Afamitresgene Autoleucel 21 15 — — $762,913.80 $809,151.00 $770,620.00 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
9498 OTHER Ciltacabtagene Car-pos T 21 15 — — $581,773.10 $617,032.08 $587,649.60 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 21 15 — — $560,865.99 $594,857.87 $566,531.30 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 21 15 — — $556,579.19 $590,311.26 $562,201.20 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 21 15 — — $552,500.98 $585,985.89 $558,081.80 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 21 15 — — $526,870.28 $558,801.81 $532,192.20 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 21 15 — — $484,555.70 $513,922.71 $489,450.20 2026-03-01
831 OTHER Obecbtge Autol Up To 400 21 15 — — $275,467.50 $292,162.50 $278,250.00 2026-03-01
897 OTHER Revakinagene, Per Implant 21 15 — — $262,350.00 $278,250.00 $265,000.00 2026-03-01
215 MS_DRG Other Heart Assist System Implant 3 2 — — $184,035.00 $258,231.00 $258,231.00 2026-03-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 3 2 — — $138,148.31 $251,178.75 $251,178.75 2026-03-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 3 2 — — $189,492.00 $250,835.00 $250,835.00 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 3 2 — — $189,492.00 $250,835.00 $250,835.00 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 2 — — $153,188.00 $214,777.00 $214,777.00 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 3 2 — — $156,788.00 $207,546.00 $207,546.00 2026-03-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 3 2 — — $153,188.00 $202,620.00 $202,620.00 2026-03-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 3 2 — — $153,188.00 $202,620.00 $202,620.00 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 21 15 — — $199,652.31 $211,752.45 $201,669.00 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 2 — — $138,051.00 $193,554.00 $193,554.00 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 2 — — $125,550.00 $178,565.00 $178,565.00 2026-03-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 2 — — $125,502.00 $166,001.00 $166,001.00 2026-03-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 2 — — $125,502.00 $166,001.00 $166,001.00 2026-03-01
1908 OTHER New Technology - Level 52 21 15 — — $155,885.20 $165,332.79 $157,459.80 2026-03-01
1907 OTHER New Technology - Level 52 21 15 — — $155,885.20 $165,332.79 $157,459.80 2026-03-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 3 2 — — $107,043.00 $150,198.00 $150,198.00 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 2 — — $106,847.00 $149,922.00 $149,922.00 2026-03-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 2 — — $106,847.00 $149,922.00 $149,922.00 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 2 — — $106,847.00 $149,922.00 $149,922.00 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 3 2 — — $99,965.00 $142,175.00 $142,175.00 2026-03-01
1905 OTHER New Technology - Level 51 21 15 — — $140,552.28 $149,070.60 $141,972.00 2026-03-01
1906 OTHER New Technology - Level 51 21 15 — — $140,552.28 $149,070.60 $141,972.00 2026-03-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 3 2 — — $100,121.00 $140,484.00 $140,484.00 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 3 2 — — $77,046.96 $140,085.39 $140,085.39 2026-03-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 3 2 — — $100,121.00 $132,532.00 $132,532.00 2026-03-01
1903 OTHER New Technology - Level 50 21 15 — — $125,219.36 $132,808.41 $126,484.20 2026-03-01
1904 OTHER New Technology - Level 50 21 15 — — $125,219.36 $132,808.41 $126,484.20 2026-03-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 3 2 — — $88,375.00 $124,003.00 $124,003.00 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 2 — — $85,128.00 $121,074.00 $121,074.00 2026-03-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 3 2 — — $80,358.00 $114,289.00 $114,289.00 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 21 15 — — $111,218.58 $117,959.10 $112,342.00 2026-03-01
1901 OTHER New Technology - Level 49 21 15 — — $109,886.44 $116,546.22 $110,996.40 2026-03-01
1902 OTHER New Technology - Level 49 21 15 — — $109,886.44 $116,546.22 $110,996.40 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 6 4 — — $93,760.51 $170,473.65 $110,197.09 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
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 2 — — $72,671.00 $102,847.00 $102,847.00 2026-03-01
1585 OTHER New Technology - Level 48 21 15 — — $97,109.01 $102,994.41 $98,089.91 2026-03-01
1599 OTHER New Technology - Level 48 21 15 — — $97,109.01 $102,994.41 $98,089.91 2026-03-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 21 15 — — $94,130.19 $99,835.05 $95,081.00 2026-03-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 2 — — $65,968.00 $93,824.00 $93,824.00 2026-03-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 2 — — $66,063.00 $93,498.00 $93,498.00 2026-03-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 3 2 — — $66,593.00 $93,440.00 $93,440.00 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 3 2 — — $66,593.00 $93,440.00 $93,440.00 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 6 4 — — $89,557.51 $163,212.33 $93,328.35 2026-03-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 3 2 — — $65,566.00 $93,251.00 $93,251.00 2026-03-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 3 2 — — $61,725.00 $87,789.00 $87,789.00 2026-03-01
1584 OTHER New Technology - Level 47 21 15 — — $86,887.07 $92,152.96 $87,764.72 2026-03-01
1598 OTHER New Technology - Level 47 21 15 — — $86,887.07 $92,152.96 $87,764.72 2026-03-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 2 — — $58,126.00 $81,561.00 $81,561.00 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 2 — — $58,126.00 $81,561.00 $81,561.00 2026-03-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 2 — — $58,126.00 $81,561.00 $81,561.00 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 3 2 — — $58,126.00 $81,561.00 $81,561.00 2026-03-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 3 2 — — $56,792.00 $79,687.00 $79,687.00 2026-03-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 3 2 — — $56,792.00 $79,687.00 $79,687.00 2026-03-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 3 2 — — $56,640.00 $79,474.00 $79,474.00 2026-03-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 3 2 — — $56,640.00 $79,474.00 $79,474.00 2026-03-01
1583 OTHER New Technology - Level 46 21 15 — — $76,665.12 $81,311.50 $77,439.52 2026-03-01
1597 OTHER New Technology - Level 46 21 15 — — $76,665.12 $81,311.50 $77,439.52 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 6 4 — — $71,255.81 $129,556.02 $75,026.04 2026-03-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 3 2 — — $53,240.00 $74,645.00 $74,645.00 2026-03-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 3 2 — — $52,054.00 $72,982.00 $72,982.00 2026-03-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 3 2 — — $49,673.00 $69,642.00 $69,642.00 2026-03-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 3 2 — — $48,942.00 $69,608.00 $69,608.00 2026-03-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 21 15 — — $68,113.68 $72,241.79 $68,801.70 2026-03-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 3 2 — — $48,519.00 $68,722.00 $68,722.00 2026-03-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 3 2 — — $48,519.00 $68,722.00 $68,722.00 2026-03-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 3 2 — — $48,519.00 $68,080.00 $68,080.00 2026-03-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 3 2 — — $48,519.00 $68,080.00 $68,080.00 2026-03-01
1582 OTHER New Technology - Level 45 21 15 — — $66,443.17 $70,470.03 $67,114.31 2026-03-01
1596 OTHER New Technology - Level 45 21 15 — — $66,443.17 $70,470.03 $67,114.31 2026-03-01
C9608 HCPCS Percutaneous Transluminal Revascularization Of Chronic Total Occlusion, Coronary… 3 2 — — $46,040.00 $66,730.00 $66,730.00 2026-03-01
C9606 HCPCS Percutaneous Transluminal Revascularization Of Acute Total/subtotal Occlusion Du… 3 2 — — $46,040.00 $66,730.00 $66,730.00 2026-03-01
C9605 HCPCS Percutaneous Transluminal Revascularization Of Or Through Coronary Artery Bypass… 3 2 — — $46,040.00 $66,730.00 $66,730.00 2026-03-01
C9601 HCPCS Percutaneous Transcatheter Placement Of Drug-eluting Intracoronary Stent(s), Wit… 3 2 — — $46,040.00 $66,730.00 $66,730.00 2026-03-01
C9603 HCPCS Percutaneous Transluminal Coronary Atherectomy, With Drug-eluting Intracoronary … 3 2 — — $46,040.00 $66,730.00 $66,730.00 2026-03-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 2 — — $46,889.00 $66,688.00 $66,688.00 2026-03-01
5244 OTHER Level 4 Blood Product Exc 21 15 — — $65,689.84 $69,671.04 $66,353.37 2026-03-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 3 2 — — $46,883.00 $65,783.00 $65,783.00 2026-03-01
512 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures Without Cc/… 3 2 — — $49,307.00 $65,218.00 $65,218.00 2026-03-01
B0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 8 7 — — $62,654.01 $64,926.43 $64,926.43 2026-03-01
69930 CPT Cochlear Device Implantation, With Or Without Mastoidectomy 6 4 — — $51,601.51 $112,905.00 $64,479.10 2026-03-01
717 OTHER Instill Adstiladrin, Tx D 21 15 — — $63,632.04 $67,488.53 $64,274.79 2026-03-01
B0505 HCPCS Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 8 7 — — $61,622.43 $63,857.44 $63,857.44 2026-03-01
64565 CPT HPercutaneous Implantation Of Neurostimulator Electrode Array; Neuromuscular 3 2 — — $42,364.00 $63,617.00 $63,617.00 2026-03-01
33276 CPT Insertion Of Phrenic Nerve Stimulator System (pulse Generator And Stimulating Le… 6 4 — — $31,620.00 $75,735.84 $60,079.90 2026-03-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 3 2 — — $42,238.00 $59,779.00 $59,779.00 2026-03-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 3 2 — — $42,238.00 $59,779.00 $59,779.00 2026-03-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 3 2 — — $42,238.00 $59,779.00 $59,779.00 2026-03-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 3 2 — — $41,550.00 $58,301.00 $58,301.00 2026-03-01
33264 CPT Removal Of Implantable Defibrillator Pulse Generator With Replacement Of Implant… 6 4 — — $50,623.76 $103,634.00 $58,206.15 2026-03-01
33231 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Multi… 6 4 — — $50,623.76 $103,634.00 $58,206.15 2026-03-01
33249 CPT Insertion Or Replacement Of Permanent Implantable Defibrillator System, With Tra… 6 4 — — $50,623.76 $103,634.00 $58,206.15 2026-03-01
33270 CPT Insertion Or Replacement Of Permanent Subcutaneous Implantable Defibrillator Sys… 6 4 — — $50,623.76 $103,634.00 $58,206.15 2026-03-01
B0106 HCPCS Stroke; M > 30.05 & M < 34.25 8 7 — — $55,868.87 $57,895.20 $57,895.20 2026-03-01
1643 OTHER Y90 Ibritumomab, Rx 21 15 — — $56,256.30 $59,665.78 $56,824.55 2026-03-01
1581 OTHER New Technology - Level 44 21 15 — — $56,221.23 $59,628.58 $56,789.12 2026-03-01
1595 OTHER New Technology - Level 44 21 15 — — $56,221.23 $59,628.58 $56,789.12 2026-03-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 3 2 — — $39,933.00 $56,515.00 $56,515.00 2026-03-01
33225 CPT Insertion Of Pacing Electrode, Cardiac Venous System, For Left Ventricular Pacin… 3 2 — — $34,654.00 $56,455.00 $56,455.00 2026-03-01
B1903 HCPCS Guillian Barre; M < 18.05 8 7 — — $54,432.95 $56,407.20 $56,407.20 2026-03-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 3 2 — — $40,072.00 $56,181.00 $56,181.00 2026-03-01
B0205 HCPCS Traumatic Brain Injury; M > 28.75 & M < 40.65 8 7 — — $53,744.57 $55,693.86 $55,693.86 2026-03-01
9273 OTHER Sipuleucel-t Auto Cd54+ 21 15 — — $53,860.07 $57,124.32 $54,404.11 2026-03-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 3 2 — — $38,540.00 $54,035.00 $54,035.00 2026-03-01
505 MS_DRG Foot Procedures Without Cc/mcc 3 2 — — $40,764.00 $53,918.00 $53,918.00 2026-03-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 3 2 — — $37,999.00 $53,276.00 $53,276.00 2026-03-01
C0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 8 7 — — $51,211.98 $53,069.41 $53,069.41 2026-03-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 3 2 — — $36,987.00 $52,604.00 $52,604.00 2026-03-01
B2102 HCPCS Burns; M=12-45 8 7 — — $50,200.13 $52,020.86 $52,020.86 2026-03-01
D0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 8 7 — — $49,864.82 $51,673.39 $51,673.39 2026-03-01
B0405 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 8 7 — — $49,628.13 $51,428.11 $51,428.11 2026-03-01
C0106 HCPCS Stroke; M > 30.05 & M < 34.25 8 7 — — $49,612.35 $51,411.76 $51,411.76 2026-03-01
B0105 HCPCS Stroke; M > 34.25 & M < 38.85 8 7 — — $49,598.54 $51,397.45 $51,397.45 2026-03-01
33262 CPT Removal Of Implantable Defibrillator Pulse Generator With Replacement Of Implant… 6 4 — — $36,270.72 $103,634.00 $50,727.46 2026-03-01
33263 CPT Removal Of Implantable Defibrillator Pulse Generator With Replacement Of Implant… 6 4 — — $36,270.72 $103,634.00 $50,727.46 2026-03-01
33230 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Dual … 6 4 — — $36,270.72 $103,634.00 $50,727.46 2026-03-01
33240 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Singl… 6 4 — — $36,270.72 $103,634.00 $50,727.46 2026-03-01
B0604 HCPCS Neurological; M < 25.85 8 7 — — $48,320.41 $50,072.96 $50,072.96 2026-03-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 21 15 — — $49,380.31 $52,373.06 $49,879.10 2026-03-01
0268T CPT Implantation Or Replacement Of Carotid Sinus Baroreflex Activation Device; Pulse… 3 2 — — $47,781.86 $49,793.72 $49,793.72 2026-03-01
64568 CPT Open Implantation Of Cranial Nerve (eg, Vagus Nerve) Neurostimulator Electrode A… 6 4 — — $42,364.00 $63,617.00 $49,793.72 2026-03-01
63685 CPT Insertion Or Replacement Of Spinal Neurostimulator Pulse Generator Or Receiver, … 6 4 — — $42,364.00 $63,617.00 $49,793.72 2026-03-01
61886 CPT Insertion Or Replacement Of Cranial Neurostimulator Pulse Generator Or Receiver,… 6 4 — — $42,364.00 $63,617.00 $49,793.72 2026-03-01
C0505 HCPCS Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 8 7 — — $47,355.90 $49,073.47 $49,073.47 2026-03-01
0571T CPT Insertion Or Replacement Of Implantable Cardioverter-defibrillator System With S… 6 4 — — $31,620.00 $52,755.29 $49,053.88 2026-03-01
0408T CPT Insertion Or Replacement Of Permanent Cardiac Contractility Modulation System, I… 6 4 — — $31,620.00 $52,755.29 $49,053.88 2026-03-01
B1004 HCPCS Amputation, Lower Extremity; M=39-45 8 7 — — $46,616.24 $48,306.98 $48,306.98 2026-03-01
63620 CPT Stereotactic Radiosurgery (particle Beam, Gamma Ray, Or Linear Accelerator); 1 S… 3 2 — — $32,064.00 $48,152.00 $48,152.00 2026-03-01
61799 CPT Stereotactic Radiosurgery (particle Beam, Gamma Ray, Or Linear Accelerator); Eac… 3 2 — — $32,064.00 $48,152.00 $48,152.00 2026-03-01
61800 CPT Application Of Stereotactic Headframe For Stereotactic Radiosurgery (List Separa… 3 2 — — $32,064.00 $48,152.00 $48,152.00 2026-03-01
61798 CPT Stereotactic Radiosurgery (particle Beam, Gamma Ray, Or Linear Accelerator); 1 C… 3 2 — — $32,064.00 $48,152.00 $48,152.00 2026-03-01
61796 CPT Stereotactic Radiosurgery (particle Beam, Gamma Ray, Or Linear Accelerator); 1 S… 3 2 — — $32,064.00 $48,152.00 $48,152.00 2026-03-01
61797 CPT Stereotactic Radiosurgery (particle Beam, Gamma Ray, Or Linear Accelerator); Eac… 3 2 — — $32,064.00 $48,152.00 $48,152.00 2026-03-01
63621 CPT Stereotactic Radiosurgery (particle Beam, Gamma Ray, Or Linear Accelerator); Eac… 3 2 — — $32,064.00 $48,152.00 $48,152.00 2026-03-01
38240 CPT Hematopoietic Progenitor Cell (hpc); Allogeneic Transplantation Per Donor 6 4 — — $7,225.00 $87,627.37 $48,005.43 2026-03-01
B1504 HCPCS Pulmonary; M < 29.15 8 7 — — $46,204.00 $47,879.79 $47,879.79 2026-03-01
28 MS_DRG Spinal Procedures With Mcc 3 2 — — $33,599.00 $47,553.00 $47,553.00 2026-03-01
0923T CPT Removal And Replacement Of Permanent Cardiac Contractility Modulation-defibrilla… 3 2 — — $31,620.00 $47,484.00 $47,484.00 2026-03-01
0916T CPT Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 3 2 — — $31,620.00 $47,484.00 $47,484.00 2026-03-01
0915T CPT Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 3 2 — — $31,620.00 $47,484.00 $47,484.00 2026-03-01
0100T CPT Placement Of A Subconjunctival Retinal Prosthesis Receiver And Pulse Generator, … 3 2 — — $31,620.00 $47,484.00 $47,484.00 2026-03-01
64654 CPT Initial Open Implantation Of Baroreflex Activation Therapy (bat) Modulation Syst… 3 2 — — $31,620.00 $47,484.00 $47,484.00 2026-03-01
253 MS_DRG Other Vascular Procedures With Cc 3 2 — — $33,523.00 $47,483.00 $47,483.00 2026-03-01
30 MS_DRG Spinal Procedures Without Cc/mcc 3 2 — — $33,599.00 $47,109.00 $47,109.00 2026-03-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 3 2 — — $33,599.00 $47,109.00 $47,109.00 2026-03-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 3 2 — — $33,523.00 $47,040.00 $47,040.00 2026-03-01
254 MS_DRG Other Vascular Procedures Without Cc/mcc 3 2 — — $33,523.00 $47,040.00 $47,040.00 2026-03-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 3 2 — — $47,040.00 $48,925.00 $47,040.00 2026-03-01
252 MS_DRG Other Vascular Procedures With Mcc 3 2 — — $33,523.00 $47,040.00 $47,040.00 2026-03-01
B0704 HCPCS Fracture Of Lower Extremity; M < 28.15 8 7 — — $45,247.38 $46,888.47 $46,888.47 2026-03-01
B1304 HCPCS Rheumatoid, Other Arthritis; M=12-35 8 7 — — $45,192.15 $46,831.24 $46,831.24 2026-03-01
A0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 8 7 — — $45,123.11 $46,759.70 $46,759.70 2026-03-01
37215 CPT Transcatheter Placement Of Intravascular Stent(s), Cervical Carotid Artery, Open… 3 2 — — $31,041.00 $46,614.00 $46,614.00 2026-03-01
92941 CPT Percutaneous Transluminal Revascularization Of Acute Total/subtotal Occlusion Du… 3 2 — — $31,041.00 $46,614.00 $46,614.00 2026-03-01
37216 CPT Transcatheter Placement Of Intravascular Stent(s), Cervical Carotid Artery, Open… 3 2 — — $31,041.00 $46,614.00 $46,614.00 2026-03-01
33289 CPT Transcatheter Implantation Of Wireless Pulmonary Artery Pressure Sensor For Long… 6 4 — — $31,620.00 $47,484.00 $46,606.43 2026-03-01
D0106 HCPCS Stroke; M > 30.05 & M < 34.25 8 7 — — $44,949.54 $46,579.83 $46,579.83 2026-03-01
1594 OTHER New Technology - Level 43 21 15 — — $45,999.28 $48,787.12 $46,463.92 2026-03-01
1580 OTHER New Technology - Level 43 21 15 — — $45,999.28 $48,787.12 $46,463.92 2026-03-01
C9760 HCPCS Non-randomized, Non-blinded Procedure For Nyha Class Ii, Iii, IV Heart Failure; … 6 4 — — $31,620.00 $47,484.00 $46,283.34 2026-03-01
B0904 HCPCS Other Orthopedic; M < 24.15 8 7 — — $44,344.01 $45,952.34 $45,952.34 2026-03-01
D0505 HCPCS Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 8 7 — — $44,056.03 $45,653.92 $45,653.92 2026-03-01
C0105 HCPCS Stroke; M > 34.25 & M < 38.85 8 7 — — $44,044.20 $45,641.66 $45,641.66 2026-03-01
B2005 HCPCS Miscellaneous; M=12-32 And A Tm81 8 7 — — $43,626.04 $45,208.34 $45,208.34 2026-03-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 3 2 — — $32,220.00 $45,176.00 $45,176.00 2026-03-01
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 6 4 — — $41,637.06 $85,272.18 $45,144.95 2026-03-01
B0504 HCPCS Nontraumatic Spinal Cord Injury; M > 29.25 & M < 3 8 7 — — $43,371.60 $44,944.66 $44,944.66 2026-03-01
B1704 HCPCS Major Multiple Trauma,no Brain Or Spinal Cord Inju 8 7 — — $43,300.59 $44,871.08 $44,871.08 2026-03-01
A5104 HCPCS Expired, Not Orthopedic, Length Of Stay Is 16 Days 8 7 — — $43,158.58 $44,723.92 $44,723.92 2026-03-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 3 2 — — $31,672.00 $44,408.00 $44,408.00 2026-03-01
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 3 2 — — $31,369.00 $44,395.00 $44,395.00 2026-03-01
C0205 HCPCS Traumatic Brain Injury; M > 28.75 & M < 40.65 8 7 — — $42,732.54 $44,282.42 $44,282.42 2026-03-01
B0304 HCPCS Nontraumatic Brain Injury; M < 26.15 8 7 — — $42,673.36 $44,221.10 $44,221.10 2026-03-01
A0106 HCPCS Stroke; M > 30.05 & M < 34.25 8 7 — — $42,635.89 $44,182.27 $44,182.27 2026-03-01
B1404 HCPCS Cardiac; M < 31.15 8 7 — — $42,343.97 $43,879.76 $43,879.76 2026-03-01
B1204 HCPCS Osteoarthritis; M=39-47 8 7 — — $42,338.05 $43,873.63 $43,873.63 2026-03-01
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 3 2 — — $31,000.00 $43,873.00 $43,873.00 2026-03-01
C2102 HCPCS Burns; M=12-45 8 7 — — $42,203.93 $43,734.64 $43,734.64 2026-03-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 21 15 — — $43,273.89 $45,896.55 $43,711.00 2026-03-01
B0204 HCPCS Traumatic Brain Injury; M > 40.65 & M < 44.25 8 7 — — $41,892.28 $43,411.69 $43,411.69 2026-03-01
B2004 HCPCS Miscellaneous; M < 27.85 8 7 — — $41,679.26 $43,190.95 $43,190.95 2026-03-01
465 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 3 2 — — $30,803.00 $43,188.00 $43,188.00 2026-03-01
1142 OTHER Supprelin La Implant 21 15 — — $42,753.49 $45,344.61 $43,185.34 2026-03-01
B0805 HCPCS Replacement Of Lower Extremity Joint; M > 22.05 & 8 7 — — $41,243.36 $42,739.23 $42,739.23 2026-03-01
B1203 HCPCS Osteoarthritis; M < 30.75 8 7 — — $41,125.01 $42,616.59 $42,616.59 2026-03-01
B1804 HCPCS Major Multiple Trauma With Brain Or Spinal Code In 8 7 — — $40,760.11 $42,238.46 $42,238.46 2026-03-01
A0505 HCPCS Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 8 7 — — $40,600.35 $42,072.90 $42,072.90 2026-03-01
C0405 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 8 7 — — $40,564.84 $42,036.11 $42,036.11 2026-03-01
504 MS_DRG Foot Procedures With Cc 3 2 — — $29,767.00 $41,733.00 $41,733.00 2026-03-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 3 2 — — $29,601.00 $41,501.00 $41,501.00 2026-03-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 3 2 — — $29,601.00 $41,501.00 $41,501.00 2026-03-01
D0105 HCPCS Stroke; M > 34.25 & M < 38.85 8 7 — — $39,904.08 $41,351.38 $41,351.38 2026-03-01
33820 CPT Repair Of Patent Ductus Arteriosus; By Ligation 3 2 — — $27,464.00 $41,284.00 $41,284.00 2026-03-01
33824 CPT Repair Of Patent Ductus Arteriosus; By Division, 18 Years And Older 3 2 — — $27,464.00 $41,284.00 $41,284.00 2026-03-01
B0104 HCPCS Stroke; M > 38.85 & M < 44.45 8 7 — — $39,797.57 $41,241.01 $41,241.01 2026-03-01
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 3 2 — — $29,273.00 $41,074.00 $41,074.00 2026-03-01
244 MS_DRG Permanent Cardiac Pacemaker Implant Without Cc/mcc 3 2 — — $29,273.00 $41,074.00 $41,074.00 2026-03-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 3 2 — — $29,273.00 $41,074.00 $41,074.00 2026-03-01
265 MS_DRG Aicd Lead Procedures 3 2 — — $29,273.00 $41,074.00 $41,074.00 2026-03-01
245 MS_DRG Aicd Generator Procedures 3 2 — — $29,273.00 $41,074.00 $41,074.00 2026-03-01
D0405 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 8 7 — — $39,497.76 $40,930.32 $40,930.32 2026-03-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 3 2 — — $29,096.00 $40,793.00 $40,793.00 2026-03-01
D0205 HCPCS Traumatic Brain Injury; M > 28.75 & M < 40.65 8 7 — — $39,040.16 $40,456.13 $40,456.13 2026-03-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 3 2 — — $28,768.00 $40,366.00 $40,366.00 2026-03-01
92998 CPT Percutaneous Transluminal Pulmonary Artery Balloon Angioplasty; Each Additional … 3 2 — — $26,858.00 $40,335.00 $40,335.00 2026-03-01
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 21 15 — — $39,869.38 $42,285.71 $40,272.10 2026-03-01
C1004 HCPCS Amputation, Lower Extremity; M=39-45 8 7 — — $38,734.44 $40,139.31 $40,139.31 2026-03-01
B0403 HCPCS Traumatic Spinal Cord Injury; M > 16.05 & M < 30.3 8 7 — — $38,667.37 $40,069.82 $40,069.82 2026-03-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 3 2 — — $28,546.00 $40,053.00 $40,053.00 2026-03-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 3 2 — — $28,546.00 $40,053.00 $40,053.00 2026-03-01
B1902 HCPCS Guillian Barre; M > 18.05 & M < 35.95 8 7 — — $38,472.10 $39,867.46 $39,867.46 2026-03-01
C1903 HCPCS Guillian Barre; M < 18.05 8 7 — — $38,470.13 $39,865.42 $39,865.42 2026-03-01
93657 CPT Additional Linear Or Focal Intracardiac Catheter Ablation Of The Left Or Right A… 3 2 — — $25,557.00 $39,829.00 $39,829.00 2026-03-01
93655 CPT Intracardiac Catheter Ablation Of A Discrete Mechanism Of Arrhythmia Which Is Di… 3 2 — — $25,557.00 $39,829.00 $39,829.00 2026-03-01
93622 CPT Comprehensive Electrophysiologic Evaluation Including Insertion And Repositionin… 3 2 — — $11,556.00 $39,829.00 $39,829.00 2026-03-01
93623 CPT Programmed Stimulation And Pacing After Intravenous Drug Infusion (List Separate… 3 2 — — $11,556.00 $39,829.00 $39,829.00 2026-03-01
93613 CPT Intracardiac Electrophysiologic 3-dimensional Mapping (List Separately In Additi… 3 2 — — $11,556.00 $39,829.00 $39,829.00 2026-03-01
93609 CPT Intraventricular And/or Intra-atrial Mapping Of Tachycardia Site(s) With Cathete… 3 2 — — $11,556.00 $39,829.00 $39,829.00 2026-03-01
93621 CPT Comprehensive Electrophysiologic Evaluation Including Insertion And Repositionin… 3 2 — — $11,556.00 $39,829.00 $39,829.00 2026-03-01
93631 CPT Intra-operative Epicardial And Endocardial Pacing And Mapping To Localize The Si… 3 2 — — $11,556.00 $39,829.00 $39,829.00 2026-03-01
B0603 HCPCS Neurological; M > 25.85 & M < 37.35 8 7 — — $38,205.83 $39,591.53 $39,591.53 2026-03-01
B1103 HCPCS Amputation, Non-lower Extremity; M=12-37 8 7 — — $38,154.54 $39,538.39 $39,538.39 2026-03-01
0888T CPT Histotripsy (ie, Non-thermal Ablation Via Acoustic Energy Delivery) Of Malignant… 3 2 — — $29,750.85 $39,376.13 $39,376.13 2026-03-01
A0105 HCPCS Stroke; M > 34.25 & M < 38.85 8 7 — — $37,850.79 $39,223.62 $39,223.62 2026-03-01
B1703 HCPCS Maj Mult Trauma No Brain Or Spinal Cord Injury; M 8 7 — — $37,629.88 $38,994.69 $38,994.69 2026-03-01
64590 CPT Insertion Or Replacement Of Peripheral, Sacral, Or Gastric Neurostimulator Pulse… 6 4 — — $33,661.19 $63,617.00 $38,721.25 2026-03-01
61885 CPT Insertion Or Replacement Of Cranial Neurostimulator Pulse Generator Or Receiver,… 6 4 — — $33,661.19 $63,617.00 $38,721.25 2026-03-01
64580 CPT Open Implantation Of Neurostimulator Electrode Array; Neuromuscular 6 4 — — $33,661.19 $63,617.00 $38,721.25 2026-03-01
63655 CPT Laminectomy For Implantation Of Neurostimulator Electrodes, Plate/paddle, Epidur… 6 4 — — $33,661.19 $63,617.00 $38,721.25 2026-03-01
33271 CPT Insertion Of Subcutaneous Implantable Defibrillator Electrode 6 4 — — $13,072.80 $103,634.00 $38,640.12 2026-03-01
C1504 HCPCS Pulmonary; M < 29.15 8 7 — — $37,150.58 $38,498.01 $38,498.01 2026-03-01
B1503 HCPCS Pulmonary; M > 29.15 & M < 39.05 8 7 — — $36,844.86 $38,181.20 $38,181.20 2026-03-01
B0903 HCPCS Other Orthopedic; M > 24.15 & M < 34.35 8 7 — — $36,825.13 $38,160.76 $38,160.76 2026-03-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 3 2 — — $26,944.00 $38,134.00 $38,134.00 2026-03-01
39 MS_DRG Extracranial Procedures Without Cc/mcc 3 2 — — $28,827.00 $38,130.00 $38,130.00 2026-03-01
93656 CPT Comprehensive Electrophysiologic Evaluation With Transseptal Catheterizations, I… 6 4 — — $25,557.00 $39,829.00 $38,084.92 2026-03-01
93654 CPT Comprehensive Electrophysiologic Evaluation With Insertion And Repositioning Of … 6 4 — — $25,557.00 $39,829.00 $38,084.92 2026-03-01
93653 CPT Comprehensive Electrophysiologic Evaluation With Insertion And Repositioning Of … 6 4 — — $25,557.00 $39,829.00 $38,084.92 2026-03-01
A0205 HCPCS Traumatic Brain Injury; M > 28.75 & M < 40.65 8 7 — — $36,679.17 $38,009.50 $38,009.50 2026-03-01
B0703 HCPCS Fracture Of Lower Extremity; M > 28.15 & M < 34.15 8 7 — — $36,643.67 $37,972.71 $37,972.71 2026-03-01
264 MS_DRG Other Circulatory System O.r. Procedures 3 2 — — $27,044.00 $37,948.00 $37,948.00 2026-03-01
259 MS_DRG Cardiac Pacemaker Device Replacement Without Mcc 3 2 — — $27,044.00 $37,948.00 $37,948.00 2026-03-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 3 2 — — $27,044.00 $37,948.00 $37,948.00 2026-03-01
C0604 HCPCS Neurological; M < 25.85 8 7 — — $36,594.36 $37,921.61 $37,921.61 2026-03-01
0414T CPT Removal And Replacement Of Permanent Cardiac Contractility Modulation System Pul… 6 4 — — $31,620.00 $47,484.00 $37,797.91 2026-03-01
0614T CPT Removal And Replacement Of Substernal Implantable Defibrillator Pulse Generator 6 4 — — $31,620.00 $47,484.00 $37,797.91 2026-03-01
0409T CPT Insertion Or Replacement Of Permanent Cardiac Contractility Modulation System, I… 6 4 — — $31,620.00 $47,484.00 $37,797.91 2026-03-01
0515T CPT Insertion Of Wireless Cardiac Stimulator For Left Ventricular Pacing, Including … 6 4 — — $31,620.00 $47,484.00 $37,797.91 2026-03-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 3 2 — — $26,841.00 $37,661.00 $37,661.00 2026-03-01
B0503 HCPCS Nontraumatic Spinal Cord Injury; M > 31.25 & M < 4 8 7 — — $36,296.52 $37,612.98 $37,612.98 2026-03-01
C0704 HCPCS Fracture Of Lower Extremity; M < 28.15 8 7 — — $36,178.18 $37,490.34 $37,490.34 2026-03-01
C1304 HCPCS Rheumatoid, Other Arthritis; M=12-35 8 7 — — $36,130.84 $37,441.28 $37,441.28 2026-03-01
C1103 HCPCS Amputation, Non-lower Extremity; M=12-37 8 7 — — $36,120.98 $37,431.06 $37,431.06 2026-03-01
B0303 HCPCS Nontraumatic Brain Injury; M > 26.15 & M < 35.05 8 7 — — $36,020.38 $37,326.82 $37,326.82 2026-03-01
C9607 HCPCS Percutaneous Transluminal Revascularization Of Chronic Total Occlusion, Coronary… 6 4 — — $26,982.31 $66,730.00 $37,079.21 2026-03-01
C9602 HCPCS Percutaneous Transluminal Coronary Atherectomy, With Drug Eluting Intracoronary … 6 4 — — $26,982.31 $66,730.00 $37,079.21 2026-03-01
A0405 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 8 7 — — $35,742.27 $37,038.62 $37,038.62 2026-03-01
32 MS_DRG Ventricular Shunt Procedures With Cc 3 2 — — $26,392.00 $37,002.00 $37,002.00 2026-03-01
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 3 2 — — $26,310.00 $36,887.00 $36,887.00 2026-03-01
472 MS_DRG Cervical Spinal Fusion With Cc 3 2 — — $26,310.00 $36,887.00 $36,887.00 2026-03-01
37237 CPT Transcatheter Placement Of An Intravascular Stent(s) (except Lower Extremity Art… 3 2 — — $24,519.00 $36,821.00 $36,821.00 2026-03-01
37239 CPT Transcatheter Placement Of An Intravascular Stent(s), Open Or Percutaneous, Incl… 3 2 — — $24,519.00 $36,821.00 $36,821.00 2026-03-01
C0104 HCPCS Stroke; M > 38.85 & M < 44.45 8 7 — — $35,341.87 $36,623.70 $36,623.70 2026-03-01
D1004 HCPCS Amputation, Lower Extremity; M=39-45 8 7 — — $35,156.46 $36,431.57 $36,431.57 2026-03-01
B1003 HCPCS Amputation, Lower Extremity; M < 36.25 8 7 — — $35,046.01 $36,317.10 $36,317.10 2026-03-01
B1303 HCPCS Rheumatoid, Other Arthritis; M < 26.15 8 7 — — $35,014.45 $36,284.40 $36,284.40 2026-03-01
C2005 HCPCS Miscellaneous; M=12-32 And A Tm81 8 7 — — $34,986.83 $36,255.79 $36,255.79 2026-03-01
B1803 HCPCS Major Multiple Trauma With Brain Or Spinal Cord In 8 7 — — $34,900.05 $36,165.85 $36,165.85 2026-03-01
1593 OTHER New Technology - Level 42 21 15 — — $35,777.32 $37,945.65 $36,138.71 2026-03-01
1579 OTHER New Technology - Level 42 21 15 — — $35,777.32 $37,945.65 $36,138.71 2026-03-01
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