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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

ORLANDO HEALTH SOUTH LAKE HOSPITAL

Clermont, FL · CCN 100051 · Rates published

12,311 distinct procedures filed
43 distinct payers
299,190 rate rows
2026-04-01 last MRF observed
Data quality

223,222 of 299,190 rate rows are consumer-grade (74.6%)

75,968 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 66,799
template filing: same amount across many unrelated codes — excluded 9,111
placeholder amount (≤ $0.02) — excluded from medians 58
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://hospitalpricedisclosure.com/download.aspx?pi=bMxquK2F0SAP1VuYiDuxgw*-*&f=p22CpYLrWLxCnt4HoK7iZA*-*
Found on page https://www.orlandohealth.com/patients-and-visitors/patient-financial-resources/financial-information-prior-to-care/pricing-transparency-guide
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-16
Content fingerprint 3922b2a73fa6d5ad… · 70,579,849 bytes · first seen 2026-05-09

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 7 $4,279,750.00 $4,820,350.00 $4,640,150.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 7 $3,501,003.33 $4,238,056.67 $3,832,677.33 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 7 $3,150,639.46 $3,813,931.98 $3,449,121.10 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 7 $3,086,023.43 $3,735,712.57 $3,378,383.54 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 8 $2,798,453.00 $4,868,633.01 $3,107,755.70 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 11 $2,332,355.07 $4,934,772.32 $2,823,377.20 nat. median
$2,469,189
1.1× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 11 $2,215,400.00 $4,687,320.00 $2,681,800.00 nat. median
$2,448,600
1.1× median
Q2057
HCPCS 		Afamitresgene Autoleucel 12 $732,089.00 $2,465,984.00 $1,078,868.00 nat. median
$824,563
1.3× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 12 $562,139.89 $1,893,523.84 $817,360.34 nat. median
$754,974
1.1× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 12 $537,575.50 $1,810,780.62 $781,912.18 nat. median
$675,122
1.2× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 12 $534,411.28 $1,800,122.19 $770,308.88 nat. median
$674,188
1.1× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 12 $529,452.04 $1,783,417.39 $766,997.68 nat. median
$625,184
1.2× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 12 $506,568.66 $1,706,336.55 $746,395.44 nat. median
$634,511
1.2× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 12 $464,839.38 $1,565,774.75 $685,369.15 nat. median
$620,080
1.1× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 28 $110,095.49 $1,305,761.51 $407,522.17 nat. median
$370,174
1.1× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 12 $264,337.50 $890,400.00 $383,053.12 nat. median
$324,450
1.2× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 28 $202,709.88 $847,386.69 $350,298.75 nat. median
$265,286
1.3× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 28 $122,128.85 $641,807.60 $265,315.00 nat. median
$202,986
1.3× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 28 $154,670.32 $645,596.42 $252,292.55 nat. median
$206,368
1.2× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 28 $100,686.82 $418,838.63 $173,142.50 nat. median
$133,176
1.3× median
7
MS_DRG 		Lung Transplant 28 $94,199.39 $391,588.15 $153,323.54 nat. median
$122,708
1.2× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 28 $87,488.07 $363,397.26 $150,223.75 nat. median
$117,303
1.3× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 1 $149,749.00 $149,749.00 $149,749.00 nat. median
$87,411
1.7× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 28 $82,549.06 $615,011.66 $142,078.11 nat. median
$108,660
1.3× median
209
MS_DRG 		Complex Aortic Arch Procedures 28 $82,455.49 $343,910.42 $141,915.11 nat. median
$98,017
1.4× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 28 $79,860.60 $333,259.05 $137,765.00 nat. median
$98,905
1.4× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 28 $79,254.23 $328,811.04 $136,339.46 nat. median
$102,358
1.3× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 2 $82,553.84 $130,327.56 $130,327.56 nat. median
$76,377
1.7× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 28 $75,197.07 $333,652.78 $129,273.05 nat. median
$100,136
1.3× median
215
MS_DRG 		Other Heart Assist System Implant 28 $31,177.36 $353,909.79 $124,462.50 nat. median
$99,019
1.3× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 28 $71,398.33 $295,812.31 $122,285.00 nat. median
$93,672
1.3× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 28 $65,832.33 $272,432.28 $112,962.36 nat. median
$82,712
1.4× median
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 1 $112,127.00 $112,127.00 $112,127.00 nat. median
$62,270
1.8× median
850
MS_DRG 		Acute Leukemia With Other Procedures 28 $63,312.08 $279,894.37 $108,572.81 nat. median
$83,442
1.3× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 28 $61,659.27 $254,903.32 $105,373.75 nat. median
$79,312
1.3× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 28 $60,911.46 $254,102.01 $105,042.50 nat. median
$81,118
1.3× median
5055
OTHER 		Level 5 Skin Procedures 1 $103,843.44 $103,843.44 $103,843.44 nat. median
$3,738
outlier · 27.8×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 28 $57,620.09 $237,936.77 $98,593.49 nat. median
$77,576
1.3× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 28 $56,248.75 $232,176.44 $95,978.75 nat. median
$74,915
1.3× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 28 $4,104.66 $231,175.56 $95,565.00 nat. median
$73,807
1.3× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 28 $55,828.35 $230,410.54 $95,201.38 nat. median
$72,138
1.3× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 13 $53,983.32 $181,838.56 $93,760.51 nat. median
$62,507
1.5× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 28 $2,147.64 $262,624.32 $90,506.80 nat. median
$68,090
1.3× median
10
MS_DRG 		Pancreas Transplant 28 $52,630.70 $216,978.82 $89,696.25 nat. median
$68,882
1.3× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 28 $51,395.17 $268,663.37 $89,400.96 nat. median
$68,887
1.3× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 28 $52,334.84 $215,736.03 $89,182.50 nat. median
$71,240
1.3× median
0100T
HCPCS 		Prosth Retina Receive&Gen 1 $88,839.00 $89,169.00 $89,004.00 nat. median
$11,210
outlier · 7.9×
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 13 $60,175.17 $202,695.30 $88,305.00 nat. median
$69,774
1.3× median
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 2 $85,000.00 $90,480.00 $87,740.00 nat. median
$65,381
1.3× median
455
MS_DRG 		Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 1 $87,629.00 $87,629.00 $87,629.00 nat. median
$48,483
1.8× median

Other procedures at this hospital

Browse this hospital's 12,311 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
             
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 74 28 — — $9,476.89 $149,333.39 $58,934.04 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 65 29 — — $8,722.64 $90,634.21 $34,010.00 2026-04-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 61 29 — — $17,999.78 $72,159.96 $29,830.00 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 60 28 — — $28,975.33 $132,913.69 $53,010.00 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 59 28 — — $22,208.53 $237,223.10 $60,236.36 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 59 28 — — $32,701.04 $138,988.97 $57,456.25 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 59 28 — — $12,787.01 $141,870.65 $57,274.61 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 58 28 — — $2,147.64 $262,624.32 $90,506.80 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 58 29 — — $135.00 $99,032.00 $36,826.25 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 57 29 — — $39,658.63 $193,888.94 $70,275.00 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 57 28 — — $29,549.44 $244,694.09 $56,858.75 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 57 29 — — $11,243.44 $118,757.44 $40,380.00 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 57 28 — — $3,665.03 $105,479.22 $40,090.59 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 57 28 — — $21,848.15 $95,279.94 $39,387.50 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 57 28 — — $4,193.54 $94,059.75 $32,445.00 2026-04-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 57 28 — — $17,574.59 $151,400.03 $29,965.00 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 56 29 — — $12,525.97 $162,026.58 $65,953.75 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 56 28 — — $28,340.27 $139,998.84 $52,252.82 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 56 28 — — $26,816.82 $127,047.98 $41,208.80 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 56 28 — — $20,080.46 $99,534.42 $35,609.21 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 56 28 — — $2,802.91 $126,080.36 $34,252.98 2026-04-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 56 28 — — $18,462.13 $76,831.73 $31,761.25 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 56 29 — — $17,569.47 $73,820.03 $30,516.25 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 55 28 — — $30,938.56 $130,851.92 $54,092.50 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 55 28 — — $33,238.22 $135,520.67 $52,249.08 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 55 28 — — $25,299.33 $126,324.52 $44,453.75 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 55 28 — — $19,456.75 $136,042.41 $34,358.75 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 55 28 — — $11,309.81 $179,669.22 $31,550.00 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 54 28 — — $2,032.52 $172,341.48 $51,574.46 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 54 29 — — $21,750.59 $87,730.32 $36,075.00 2026-04-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 54 28 — — $140.00 $117,756.23 $30,731.25 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 53 28 — — $4,199.78 $194,572.46 $73,680.00 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 53 29 — — $7,642.99 $113,008.48 $46,716.25 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 53 28 — — $9,873.48 $96,543.89 $39,910.00 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 53 28 — — $23,913.61 $103,667.96 $39,427.91 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 53 28 — — $14,029.44 $97,925.76 $37,327.02 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 52 28 — — $51,395.17 $268,663.37 $89,400.96 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 52 28 — — $44,684.01 $203,715.60 $83,520.00 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 52 28 — — $33,902.14 $157,916.86 $57,906.76 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 52 28 — — $20,097.15 $148,822.36 $53,321.06 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 52 28 — — $24,767.38 $107,976.87 $44,636.25 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 52 28 — — $27,513.15 $116,092.75 $40,776.13 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 52 28 — — $22,521.52 $101,013.06 $38,398.43 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 52 28 — — $18,680.33 $77,197.61 $31,912.50 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 52 28 — — $2,560.48 $91,717.90 $31,653.72 2026-04-01
215 MS_DRG Other Heart Assist System Implant 51 28 — — $31,177.36 $353,909.79 $124,462.50 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 51 28 — — $26,151.54 $150,809.00 $62,342.50 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 51 28 — — $350.00 $113,785.59 $47,037.50 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 51 28 — — $28,712.94 $124,746.87 $43,912.60 2026-04-01
791 MS_DRG Prematurity With Major Problems 51 28 — — $15,094.80 $122,736.04 $41,807.70 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 51 28 — — $21,213.48 $111,021.84 $37,817.48 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 51 28 — — $11,479.60 $97,816.91 $37,287.19 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 51 28 — — $16,238.82 $86,193.42 $35,631.25 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 51 28 — — $272.39 $95,697.22 $34,214.74 2026-04-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 51 28 — — $17,574.59 $74,361.29 $30,926.90 2026-04-01
545 MS_DRG Connective Tissue Disorders With Mcc 51 28 — — $13,842.24 $411,516.17 $29,459.71 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 50 28 — — $37,931.18 $256,401.70 $73,700.89 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 50 28 — — $3,881.22 $157,400.89 $53,516.69 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 50 29 — — $31,820.91 $146,010.23 $52,471.14 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 50 28 — — $26,357.87 $134,389.65 $45,147.50 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 50 28 — — $25,195.40 $106,637.33 $44,082.50 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 50 28 — — $19,709.87 $103,159.96 $42,645.00 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 50 28 — — $1,978.15 $103,023.89 $42,588.75 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 50 28 — — $21,688.03 $97,243.99 $38,933.75 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 50 28 — — $22,401.35 $93,430.80 $37,205.00 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 50 28 — — $149.89 $96,365.48 $35,426.26 2026-04-01
570 MS_DRG Skin Debridement With Mcc 50 28 — — $20,653.92 $88,932.98 $35,400.28 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 50 28 — — $18,638.96 $87,750.68 $33,668.69 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 50 28 — — $18,104.36 $86,789.11 $32,614.64 2026-04-01
397 MS_DRG Appendix Procedures With Mcc 50 28 — — $18,215.33 $72,416.99 $30,884.10 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 49 28 — — $122,128.85 $641,807.60 $265,315.00 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 49 28 — — $100,686.82 $418,838.63 $173,142.50 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 49 28 — — $60,911.46 $254,102.01 $105,042.50 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 49 28 — — $44,214.75 $181,627.57 $75,082.50 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 49 28 — — $36,589.91 $168,099.48 $61,842.50 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 49 28 — — $31,313.08 $132,829.49 $53,161.00 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 49 28 — — $30,764.22 $127,701.12 $48,220.95 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 49 28 — — $26,892.97 $116,754.97 $44,216.07 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 49 28 — — $14,118.50 $112,690.98 $43,777.49 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 49 28 — — $3,054.03 $128,974.14 $43,718.34 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 49 28 — — $19,947.58 $101,655.75 $34,991.25 2026-04-01
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 49 28 — — $18,354.99 $73,356.09 $33,044.52 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 49 28 — — $19,449.08 $83,816.71 $32,164.91 2026-04-01
665 MS_DRG Prostatectomy With Mcc 49 28 — — $17,776.68 $94,378.85 $32,148.36 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 49 28 — — $8,102.87 $82,664.64 $31,882.42 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 48 28 — — $79,860.60 $333,259.05 $137,765.00 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 48 28 — — $2,320.80 $179,719.55 $74,293.75 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 48 28 — — $3,835.15 $165,181.12 $68,283.75 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 48 28 — — $37,227.26 $161,156.44 $66,620.00 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 48 28 — — $33,092.57 $138,635.18 $54,765.71 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 48 28 — — $31,012.40 $154,165.38 $52,316.06 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 48 28 — — $7,937.26 $125,578.41 $51,951.97 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 48 28 — — $27,881.69 $113,020.57 $46,721.25 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 48 28 — — $26,621.21 $107,725.90 $44,532.50 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 48 28 — — $24,423.08 $117,042.23 $42,034.79 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 48 28 — — $26,079.88 $105,452.00 $41,836.57 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 48 28 — — $25,745.56 $107,623.09 $41,489.82 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 48 28 — — $25,383.78 $104,460.19 $40,834.38 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 48 28 — — $21,897.30 $97,581.05 $40,338.75 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 48 28 — — $4,672.33 $92,573.64 $37,311.09 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 48 28 — — $5,230.93 $83,369.19 $34,463.75 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 48 28 — — $2,219.46 $83,094.02 $34,350.00 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 48 28 — — $20,123.70 $91,355.57 $33,351.08 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 48 28 — — $8,965.44 $98,358.17 $33,287.80 2026-04-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 48 28 — — $18,139.64 $132,228.13 $30,552.50 2026-04-01
35 MS_DRG Carotid Artery Stent Procedures With Cc 48 28 — — $16,977.39 $72,283.94 $29,464.75 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 47 28 — — $71,398.33 $295,812.31 $122,285.00 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 47 28 — — $4,104.66 $231,175.56 $95,565.00 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 47 28 — — $50,486.94 $207,973.94 $85,973.75 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 47 28 — — $48,308.62 $238,243.98 $82,690.97 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 47 28 — — $41,816.52 $230,249.02 $75,103.75 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 47 28 — — $43,901.60 $180,312.22 $74,538.75 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 47 28 — — $40,237.48 $164,921.08 $68,176.25 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 47 28 — — $34,263.95 $141,447.32 $58,472.50 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 47 28 — — $28,154.16 $198,101.23 $57,155.85 2026-04-01
245 MS_DRG Aicd Generator Procedures 47 28 — — $10,732.93 $137,957.85 $57,030.00 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 47 28 — — $31,020.04 $137,483.11 $56,833.75 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 47 28 — — $33,577.28 $136,944.88 $56,611.25 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 47 28 — — $22,987.32 $148,202.49 $50,482.36 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 47 28 — — $29,135.70 $135,448.83 $48,898.75 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 47 28 — — $26,603.42 $129,808.71 $48,147.39 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 47 28 — — $28,477.17 $126,896.79 $47,926.68 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 47 28 — — $26,936.51 $109,050.32 $45,080.00 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 47 28 — — $26,460.99 $107,816.61 $44,570.00 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 47 28 — — $26,248.82 $106,419.62 $43,992.50 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 47 28 — — $24,952.77 $120,471.22 $43,670.00 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 47 29 — — $25,964.69 $104,968.19 $43,392.50 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 47 28 — — $21,760.16 $97,076.08 $40,130.00 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 47 28 — — $23,647.44 $168,099.48 $39,608.11 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 47 28 — — $22,351.82 $95,552.08 $39,500.00 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 47 28 — — $3,209.87 $113,289.69 $38,589.98 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 47 28 — — $16,373.76 $109,718.58 $36,348.38 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 47 29 — — $21,760.67 $87,309.20 $36,092.50 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 47 28 — — $19,625.79 $95,010.82 $35,519.14 2026-04-01
800 MS_DRG Splenic Procedures With Cc 47 28 — — $21,199.17 $102,977.45 $35,331.01 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 47 28 — — $20,270.84 $81,563.98 $33,717.50 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 47 28 — — $19,961.01 $157,890.46 $33,167.94 2026-04-01
503 MS_DRG Foot Procedures With Mcc 47 28 — — $15,280.17 $84,397.28 $32,377.32 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 47 28 — — $2,901.38 $78,098.71 $32,285.00 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 47 28 — — $19,136.76 $99,395.18 $31,727.99 2026-04-01
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 47 28 — — $18,411.86 $73,596.12 $30,277.50 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 47 28 — — $15,556.64 $88,294.96 $30,076.00 2026-04-01
333 MS_DRG Rectal Resection With Cc 47 28 — — $17,835.96 $84,358.14 $29,455.51 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 46 28 — — $110,095.49 $1,305,761.51 $407,522.17 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 46 28 — — $202,709.88 $847,386.69 $350,298.75 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 46 28 — — $154,670.32 $645,596.42 $252,292.55 2026-04-01
7 MS_DRG Lung Transplant 46 28 — — $94,199.39 $391,588.15 $153,323.54 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 46 28 — — $87,488.07 $363,397.26 $150,223.75 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 46 28 — — $82,549.06 $615,011.66 $142,078.11 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 46 28 — — $82,455.49 $343,910.42 $141,915.11 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 46 28 — — $79,254.23 $328,811.04 $136,339.46 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 46 28 — — $75,197.07 $333,652.78 $129,273.05 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 46 28 — — $65,832.33 $272,432.28 $112,962.36 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 46 28 — — $63,312.08 $279,894.37 $108,572.81 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 46 28 — — $61,659.27 $254,903.32 $105,373.75 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 46 28 — — $57,620.09 $237,936.77 $98,593.49 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 46 28 — — $56,248.75 $232,176.44 $95,978.75 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 46 28 — — $55,828.35 $230,410.54 $95,201.38 2026-04-01
10 MS_DRG Pancreas Transplant 46 28 — — $52,630.70 $216,978.82 $89,696.25 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 46 28 — — $52,334.84 $215,736.03 $89,182.50 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 46 28 — — $52,609.11 $216,888.10 $85,255.32 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 46 28 — — $49,430.17 $203,535.00 $84,138.75 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 46 28 — — $49,109.12 $202,186.39 $83,835.33 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 46 28 — — $48,308.62 $238,243.98 $82,191.25 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 46 28 — — $45,091.54 $273,212.93 $76,837.88 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 46 28 — — $45,040.43 $185,095.87 $76,516.25 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 46 28 — — $44,617.87 $226,044.81 $76,012.88 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 46 28 — — $43,661.16 $244,402.82 $74,346.58 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 46 28 — — $43,221.32 $177,454.73 $73,357.50 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 46 28 — — $43,193.97 $177,339.82 $73,066.52 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 46 28 — — $42,225.75 $173,272.81 $71,628.75 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 46 28 — — $42,057.31 $173,398.45 $71,553.11 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 46 28 — — $41,320.88 $177,442.56 $70,270.48 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 46 28 — — $41,044.46 $168,310.76 $69,577.50 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 46 28 — — $40,495.19 $166,003.60 $68,623.75 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 46 28 — — $40,355.54 $165,416.98 $68,381.25 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 46 28 — — $40,080.55 $244,402.82 $67,903.75 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 46 28 — — $40,733.47 $167,004.47 $66,864.83 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 46 28 — — $39,364.29 $172,568.97 $66,862.64 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 46 28 — — $39,083.53 $219,387.67 $66,373.67 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 46 28 — — $38,382.38 $157,128.74 $64,955.00 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 46 28 — — $37,257.96 $172,568.97 $63,194.03 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 46 28 — — $35,559.79 $148,535.22 $60,236.32 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 46 28 — — $35,246.65 $205,143.65 $59,690.91 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 46 28 — — $34,819.05 $142,160.93 $58,767.50 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 46 28 — — $34,355.46 $333,652.78 $58,138.71 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 46 28 — — $33,102.17 $134,949.17 $55,786.25 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 46 28 — — $30,835.44 $135,481.36 $53,437.05 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 46 28 — — $31,309.70 $160,694.90 $52,833.88 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 46 28 — — $31,324.82 $127,483.41 $52,700.00 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 46 28 — — $31,129.01 $126,660.93 $52,360.00 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 46 28 — — $28,797.37 $116,866.85 $47,760.62 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 46 28 — — $27,652.06 $112,055.98 $46,322.50 2026-04-01
332 MS_DRG Rectal Resection With Mcc 46 28 — — $27,039.45 $109,482.73 $45,258.75 2026-04-01
265 MS_DRG Aicd Lead Procedures 46 28 — — $27,021.46 $109,407.13 $45,227.50 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 46 28 — — $26,706.88 $108,085.73 $44,681.25 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 46 28 — — $26,459.71 $111,067.20 $43,590.04 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 46 28 — — $25,728.57 $104,478.42 $43,113.17 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 46 28 — — $20,522.29 $117,752.82 $41,630.13 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 46 28 — — $24,754.60 $99,885.19 $41,416.78 2026-04-01
652 MS_DRG Kidney Transplant 46 28 — — $24,223.34 $101,111.88 $40,491.47 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 46 28 — — $24,889.81 $109,633.92 $40,368.77 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 46 28 — — $23,848.29 $219,387.67 $39,838.24 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 46 28 — — $23,894.35 $96,271.74 $39,797.50 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 46 28 — — $20,964.38 $108,336.71 $39,538.90 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 46 28 — — $22,827.18 $99,546.52 $39,535.62 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 46 28 — — $23,357.34 $102,922.76 $38,983.15 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 46 28 — — $24,160.70 $97,390.55 $38,557.18 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 46 28 — — $22,168.84 $160,694.90 $36,801.25 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 46 28 — — $21,852.81 $140,371.04 $36,362.71 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 46 28 — — $21,720.36 $117,230.59 $36,022.50 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 46 28 — — $20,456.27 $81,830.08 $33,930.33 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 46 28 — — $18,611.58 $91,222.00 $33,192.81 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 46 28 — — $20,056.75 $80,151.87 $32,368.38 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 46 28 — — $19,542.04 $84,358.14 $32,338.01 2026-04-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 46 28 — — $19,542.04 $84,358.14 $32,240.00 2026-04-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/Mcc 46 28 — — $19,458.54 $77,639.09 $32,095.00 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 46 28 — — $13,102.57 $91,321.78 $30,096.81 2026-04-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 46 28 — — $18,290.20 $72,731.46 $30,066.25 2026-04-01
22630 HCPCS Lumbar Spine Fusion 23 13 — — $9,674.00 $90,673.57 $29,752.26 2026-04-01
22558 HCPCS Lumbar Spine Fusion 23 13 — — $9,674.00 $90,673.57 $29,752.26 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 22 12 — — $9,674.00 $210,196.21 $66,671.60 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 22 12 — — $9,674.00 $104,891.94 $34,581.57 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 22 12 — — $9,674.00 $104,891.94 $34,581.57 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 22 12 — — $9,674.00 $104,891.94 $34,581.57 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 22 12 — — $9,674.00 $104,891.94 $34,581.57 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 22 12 — — $9,674.00 $103,116.95 $33,996.37 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 22 12 — — $9,674.00 $103,116.95 $33,996.37 2026-04-01
61886 HCPCS Implant Neurostim Arrays 22 12 — — $9,674.00 $103,116.95 $33,996.37 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 22 12 — — $9,674.00 $103,116.95 $33,996.37 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 22 12 — — $9,674.00 $103,116.95 $33,996.37 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 22 12 — — $9,674.00 $103,116.95 $33,996.37 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 22 12 — — $9,674.00 $95,850.96 $31,600.86 2026-04-01
22633 HCPCS Lumbar Spine Fusion Combined 22 12 — — $9,674.00 $90,673.57 $29,893.94 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 20 11 — — $9,674.00 $103,116.95 $33,513.01 2026-04-01
5213 OTHER Level 3 Electrophysiologic Procedures 18 11 — — $6,500.00 $94,434.44 $47,591.01 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 17 13 — — $53,983.32 $181,838.56 $93,760.51 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 17 13 — — $60,175.17 $202,695.30 $88,305.00 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 17 13 — — $52,508.71 $176,871.44 $80,144.86 2026-04-01
J9226 HCPCS Supprelin La Implant 17 13 — — $42,769.62 $144,066.08 $52,223.95 2026-04-01
J9266 HCPCS Pegaspargase Injection 17 13 — — $27,002.86 $90,956.99 $41,214.89 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 17 13 — — $23,017.00 $77,530.94 $34,494.72 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 16 12 — — $732,089.00 $2,465,984.00 $1,078,868.00 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 16 12 — — $562,139.89 $1,893,523.84 $817,360.34 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 16 12 — — $537,575.50 $1,810,780.62 $781,912.18 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 16 12 — — $534,411.28 $1,800,122.19 $770,308.88 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 16 12 — — $529,452.04 $1,783,417.39 $766,997.68 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 16 12 — — $506,568.66 $1,706,336.55 $746,395.44 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 16 12 — — $464,839.38 $1,565,774.75 $685,369.15 2026-04-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 16 12 — — $264,337.50 $890,400.00 $383,053.12 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 16 12 — — $43,696.97 $147,189.80 $66,695.38 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 16 12 — — $43,696.97 $147,189.80 $66,695.38 2026-04-01
69930 HCPCS Implant Cochlear Device 16 12 — — $32,710.49 $110,182.70 $49,926.54 2026-04-01
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 16 12 — — $36,100.00 $147,189.80 $48,986.60 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 16 12 — — $31,139.80 $104,891.94 $47,529.16 2026-04-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 16 12 — — $31,139.80 $104,891.94 $47,529.16 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 16 12 — — $31,139.80 $104,891.94 $47,529.16 2026-04-01
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 16 12 — — $30,612.84 $103,116.95 $46,724.87 2026-04-01
0956T HCPCS Prt Crn Ch Cr&tun Elt S-sclp 16 12 — — $26,918.71 $90,673.57 $41,086.46 2026-04-01
0960T HCPCS Rpl S-sclp Eltr Ra Rcvr&tlmt 16 12 — — $26,918.71 $90,673.57 $41,086.46 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 16 12 — — $26,703.89 $89,949.96 $40,758.57 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 16 12 — — $25,930.46 $87,344.69 $39,578.07 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 16 12 — — $25,930.46 $87,344.69 $39,578.07 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 16 12 — — $25,930.46 $87,344.69 $39,578.07 2026-04-01
0686T HCPCS Histotripsy Mal Hepatcel Tis 16 12 — — $28,126.13 $114,481.32 $38,100.82 2026-04-01
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 16 12 — — $22,067.07 $89,169.00 $33,681.32 2026-04-01
0916T HCPCS Insj Perm Ccm-d Sys Pg Only 16 12 — — $22,067.07 $89,169.00 $33,681.32 2026-04-01
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 16 12 — — $22,067.07 $89,169.00 $33,681.32 2026-04-01
0515T HCPCS Insj Wcs Lv Compl Sys 16 12 — — $22,067.07 $89,169.00 $33,681.32 2026-04-01
0409T HCPCS Insj/rplc Car Modulj Pls Gn 16 12 — — $22,067.07 $89,169.00 $33,681.32 2026-04-01
0923T HCPCS Rmvl&rplcmt Perm Ccm-d Pg 16 12 — — $22,067.07 $89,169.00 $33,681.32 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 15 11 — — $2,332,355.07 $4,934,772.32 $2,823,377.20 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 15 11 — — $2,215,400.00 $4,687,320.00 $2,681,800.00 2026-04-01
5232 OTHER Level 2 Icd And Similar Procedures 15 9 — — $14,642.86 $114,260.58 $33,750.45 2026-04-01
5465 OTHER Level 5 Neurostimulator And Related Procedures 15 8 — — $29,982.91 $72,604.39 $32,529.43 2026-04-01
0909T HCPCS Rplcmt Int Nstim Sys Vgs Nrv 14 11 — — $30,612.84 $103,116.95 $35,768.69 2026-04-01
0908T HCPCS Opn Imp Int Nstm Sys Vgs Nrv 14 11 — — $30,612.84 $103,116.95 $35,768.69 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 10 8 — — $2,798,453.00 $4,868,633.01 $3,107,755.70 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 8 7 — — $3,501,003.33 $4,238,056.67 $3,832,677.33 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 8 7 — — $3,150,639.46 $3,813,931.98 $3,449,121.10 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 8 7 — — $3,086,023.43 $3,735,712.57 $3,378,383.54 2026-04-01
5231 OTHER Level 1 Icd And Similar Procedures 8 4 — — $15,098.85 $127,394.95 $31,770.01 2026-04-01
J3391 HCPCS Inj, Atidarsagene Autotemcel 7 7 — — $4,279,750.00 $4,820,350.00 $4,640,150.00 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 3 2 — — $82,553.84 $130,327.56 $130,327.56 2026-04-01
0100T HCPCS Prosth Retina Receive&Gen 2 1 — — $88,839.00 $89,169.00 $89,004.00 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 2 2 — — $85,000.00 $90,480.00 $87,740.00 2026-04-01
A9699 HCPCS Radiopharm Rx Agent Noc 2 1 — — $74,614.73 $74,614.73 $74,614.73 2026-04-01
0268T HCPCS Implt/rpl Crtd Sns Dev Gen 2 1 — — $61,909.00 $62,139.00 $62,024.00 2026-04-01
0266T HCPCS Implt/rpl Crtd Sns Dev Total 2 1 — — $61,909.00 $62,139.00 $62,024.00 2026-04-01
33225 HCPCS L Ventric Pacing Lead Add-on 2 1 — — $51,860.00 $52,053.00 $51,956.50 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 2 2 — — $48,000.00 $55,082.00 $51,541.00 2026-04-01
5094 OTHER Level 4 Breast/Lymphatic Surgery And Related Procedures 2 2 — — $19,218.75 $80,466.11 $49,842.43 2026-04-01
37233 HCPCS Tibper Revasc W/ather Add-on 2 1 — — $36,100.00 $36,234.00 $36,167.00 2026-04-01
92925 HCPCS Prq Card Angio/athrect Addl 2 1 — — $36,100.00 $36,234.00 $36,167.00 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $149,749.00 $149,749.00 $149,749.00 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 1 1 — — $112,127.00 $112,127.00 $112,127.00 2026-04-01
5055 OTHER Level 5 Skin Procedures 1 1 — — $103,843.44 $103,843.44 $103,843.44 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 1 1 — — $87,629.00 $87,629.00 $87,629.00 2026-04-01
90288 HCPCS Botulism Ig IV 1 1 — — $56,497.80 $56,497.80 $56,497.80 2026-04-01
5471 OTHER Implantation Of Drug Infusion Device 1 1 — — $36,563.94 $36,563.94 $36,563.94 2026-04-01
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