|
845
|
OTHER
|
Inj, Atidarsagene Autotem
|
25
|
21
|
—
|
—
|
$4,946.44
|
$4,955,500.00
|
$4,595,100.00
|
2026-03-01
|
|
00845
|
OTHER
|
Inj, Atidarsagene Autotem
|
2
|
2
|
—
|
—
|
$4,369,850.00
|
$4,505,000.00
|
$4,437,425.00
|
2026-03-01
|
|
9138
|
OTHER
|
Inj, Hemgenix, Per Tx Dos
|
44
|
21
|
—
|
—
|
$3,672,900.00
|
$4,053,793.70
|
$3,856,545.00
|
2026-03-01
|
|
773
|
OTHER
|
Inj, Beqvez, Per Tx Dose
|
22
|
19
|
—
|
—
|
$3,605,000.00
|
$3,965,500.00
|
$3,749,200.00
|
2024-10-01
|
|
09138
|
OTHER
|
Inj, Hemgenix, Per Tx Dos
|
3
|
2
|
—
|
—
|
$3,562,713.00
|
$3,685,267.00
|
$3,574,708.99
|
2026-03-01
|
|
00773
|
OTHER
|
Inj, Beqvez, Per Tx Dose
|
1
|
1
|
—
|
—
|
$3,496,850.00
|
$3,496,850.00
|
$3,496,850.00
|
2024-10-01
|
|
714
|
OTHER
|
Inj Delandistrogene Mox R
|
47
|
23
|
—
|
—
|
$5,481.79
|
$3,660,646.00
|
$3,425,218.65
|
2026-03-01
|
|
908
|
OTHER
|
Topi Adm Prad Zami Per Tr
|
25
|
21
|
—
|
—
|
$10,067.05
|
$3,669,402.00
|
$3,402,536.40
|
2026-03-01
|
|
748
|
OTHER
|
Inj, Lovotibeglogene Auto
|
47
|
23
|
—
|
—
|
$9,042.20
|
$3,614,600.00
|
$3,384,580.00
|
2026-03-01
|
|
00908
|
OTHER
|
Topi Adm Prad Zami Per Tr
|
2
|
2
|
—
|
—
|
$3,235,745.40
|
$3,335,820.00
|
$3,285,782.70
|
2026-03-01
|
|
906
|
OTHER
|
Inj Elivaldogene Autoteme
|
25
|
21
|
—
|
—
|
$6,596.80
|
$3,498,000.00
|
$3,243,600.00
|
2026-03-01
|
|
00714
|
OTHER
|
Inj Delandistrogene Mox R
|
3
|
2
|
—
|
—
|
$3,225,691.35
|
$3,327,860.00
|
$3,228,024.20
|
2026-03-01
|
|
00748
|
OTHER
|
Inj, Lovotibeglogene Auto
|
3
|
2
|
—
|
—
|
$3,154,932.76
|
$3,252,508.00
|
$3,187,420.00
|
2026-03-01
|
|
00906
|
OTHER
|
Inj Elivaldogene Autoteme
|
2
|
2
|
—
|
—
|
$3,084,600.00
|
$3,180,000.00
|
$3,132,300.00
|
2026-03-01
|
|
746
|
OTHER
|
Inj, Betibeglogene Autote
|
47
|
23
|
—
|
—
|
$8,031.27
|
$3,264,800.00
|
$3,057,040.00
|
2026-03-01
|
|
00746
|
OTHER
|
Inj, Betibeglogene Autote
|
3
|
2
|
—
|
—
|
$2,851,769.93
|
$2,939,969.00
|
$2,878,960.00
|
2026-03-01
|
|
9141
|
OTHER
|
Inj Onase Abepar-xioi Tre
|
44
|
21
|
—
|
—
|
$2,388,614.00
|
$2,847,879.10
|
$2,588,981.00
|
2026-03-01
|
|
09141
|
OTHER
|
Inj Onase Abepar-xioi Tre
|
3
|
2
|
—
|
—
|
$2,316,955.58
|
$2,588,981.00
|
$2,511,311.57
|
2026-03-01
|
|
824
|
OTHER
|
Inj, Exagamglogene Autote
|
25
|
21
|
—
|
—
|
$14,221.02
|
$2,565,200.00
|
$2,378,640.00
|
2026-03-01
|
|
00824
|
OTHER
|
Inj, Exagamglogene Autote
|
2
|
2
|
—
|
—
|
$2,262,040.00
|
$2,332,000.00
|
$2,297,020.00
|
2026-03-01
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure…
|
1
|
1
|
—
|
—
|
$1,656,833.00
|
$1,656,833.00
|
$1,656,833.00
|
2026-03-01
|
|
2067
|
OTHER
|
Afamitresgene Autoleucel
|
22
|
19
|
—
|
—
|
$770,620.00
|
$847,682.00
|
$809,151.00
|
2026-03-01
|
|
Q2058
|
HCPCS
|
Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, …
|
1
|
1
|
—
|
—
|
$598,237.50
|
$598,237.50
|
$598,237.50
|
2026-03-01
|
|
9498
|
OTHER
|
Ciltacabtagene Car-pos T
|
44
|
21
|
—
|
—
|
$527,123.40
|
$646,414.56
|
$583,742.67
|
2026-03-01
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka…
|
12
|
4
|
—
|
—
|
$502,693.77
|
$1,218,042.30
|
$570,089.44
|
2026-03-01
|
|
09498
|
OTHER
|
Ciltacabtagene Car-pos T
|
3
|
2
|
—
|
—
|
$511,309.70
|
$587,649.60
|
$570,020.11
|
2026-03-01
|
|
9194
|
OTHER
|
Tisagenlecleucel Car-pos
|
44
|
21
|
—
|
—
|
$529,192.90
|
$623,184.43
|
$566,531.30
|
2026-03-01
|
|
9422
|
OTHER
|
Idecabtagene Vicleucel Ca
|
44
|
21
|
—
|
—
|
$526,587.60
|
$613,889.98
|
$563,448.73
|
2026-03-01
|
|
9413
|
OTHER
|
Lisocabtagene Car Pos T
|
44
|
21
|
—
|
—
|
$516,726.10
|
$618,421.32
|
$562,201.20
|
2026-03-01
|
|
09194
|
OTHER
|
Tisagenlecleucel Car-pos
|
3
|
2
|
—
|
—
|
$513,317.11
|
$566,531.30
|
$549,535.36
|
2026-03-01
|
|
09413
|
OTHER
|
Lisocabtagene Car Pos T
|
3
|
2
|
—
|
—
|
$501,224.32
|
$562,201.20
|
$545,335.16
|
2026-03-01
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige…
|
12
|
4
|
—
|
—
|
$492,271.12
|
$1,263,446.58
|
$544,871.46
|
2026-03-01
|
|
09422
|
OTHER
|
Idecabtagene Vicleucel Ca
|
3
|
2
|
—
|
—
|
$510,789.97
|
$558,081.80
|
$541,339.35
|
2026-03-01
|
|
9035
|
OTHER
|
Axicabtagene Ciloleucel C
|
44
|
21
|
—
|
—
|
$489,456.00
|
$585,411.42
|
$532,192.20
|
2026-03-01
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (…
|
8
|
4
|
—
|
—
|
$470,149.30
|
$1,199,875.72
|
$519,707.67
|
2026-03-01
|
|
09035
|
OTHER
|
Axicabtagene Ciloleucel C
|
3
|
2
|
—
|
—
|
$474,772.32
|
$532,192.20
|
$516,226.43
|
2026-03-01
|
|
Q2054
|
HCPCS
|
Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi…
|
12
|
4
|
—
|
—
|
$459,839.17
|
$1,208,732.67
|
$508,695.37
|
2026-03-01
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via…
|
12
|
4
|
—
|
—
|
$445,599.57
|
$1,144,213.32
|
$495,298.39
|
2026-03-01
|
|
9391
|
OTHER
|
Brexucabtagene Car Pos T
|
44
|
21
|
—
|
—
|
$460,530.40
|
$538,395.22
|
$492,767.53
|
2026-03-01
|
|
Q2053
|
HCPCS
|
Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V…
|
12
|
4
|
—
|
—
|
$435,956.80
|
$1,052,317.93
|
$482,058.02
|
2026-03-01
|
|
09391
|
OTHER
|
Brexucabtagene Car Pos T
|
3
|
2
|
—
|
—
|
$446,714.49
|
$489,450.20
|
$474,766.69
|
2026-03-01
|
|
J3402
|
HCPCS
|
Injection, Remestemcel-l-rknd, Per Therapeutic Dose
|
1
|
1
|
—
|
—
|
$433,588.39
|
$433,588.39
|
$433,588.39
|
2026-03-01
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
102
|
37
|
—
|
—
|
$6,771.00
|
$961,233.00
|
$290,527.43
|
2026-03-01
|
|
831
|
OTHER
|
Obecbtge Autol Up To 400
|
25
|
21
|
—
|
—
|
$3,042.58
|
$306,075.00
|
$283,815.00
|
2026-03-01
|
|
897
|
OTHER
|
Revakinagene, Per Implant
|
22
|
19
|
—
|
—
|
$265,000.00
|
$291,500.00
|
$278,250.00
|
2026-03-01
|
|
00831
|
OTHER
|
Obecbtge Autol Up To 400
|
2
|
2
|
—
|
—
|
$269,902.50
|
$278,250.00
|
$274,076.25
|
2026-03-01
|
|
00897
|
OTHER
|
Revakinagene, Per Implant
|
2
|
2
|
—
|
—
|
$257,050.00
|
$265,000.00
|
$261,025.00
|
2026-03-01
|
|
018
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
3
|
2
|
—
|
—
|
$153,320.72
|
$253,527.60
|
$245,921.77
|
2026-03-01
|
|
5834
|
APR_DRG
|
Neonate With Ecmo
|
33
|
14
|
—
|
—
|
$192,207.00
|
$312,391.65
|
$233,252.43
|
2026-03-01
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
104
|
37
|
—
|
—
|
$9,746.00
|
$717,961.54
|
$218,382.72
|
2026-03-01
|
|
001
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
3
|
2
|
—
|
—
|
$185,810.10
|
$222,854.80
|
$216,169.16
|
2026-03-01
|
|
886
|
OTHER
|
Inj. Remestemcel-l-rknd/
|
25
|
21
|
—
|
—
|
$5,737.36
|
$221,835.90
|
$205,702.38
|
2026-03-01
|
|
00886
|
OTHER
|
Inj. Remestemcel-l-rknd/
|
2
|
2
|
—
|
—
|
$195,618.93
|
$201,669.00
|
$198,643.96
|
2026-03-01
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
102
|
34
|
—
|
—
|
$9,000.00
|
$604,694.17
|
$176,502.55
|
2026-03-01
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
105
|
36
|
—
|
—
|
$9,000.00
|
$649,261.19
|
$173,729.40
|
2026-03-01
|
|
1907
|
OTHER
|
New Technology - Level 52
|
44
|
21
|
—
|
—
|
$147,339.90
|
$171,464.59
|
$157,653.69
|
2026-03-01
|
|
1908
|
OTHER
|
New Technology - Level 52
|
44
|
21
|
—
|
—
|
$147,339.90
|
$171,464.59
|
$157,653.69
|
2026-03-01
|
|
J7330
|
HCPCS
|
Autologous Cultured Chondrocytes, Implant
|
3
|
1
|
—
|
—
|
$156,515.70
|
$180,011.44
|
$156,515.70
|
2026-03-01
|
|
003
|
OTHER
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
3
|
2
|
—
|
—
|
$124,455.66
|
$157,072.60
|
$152,360.42
|
2026-03-01
|
|
5884
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
33
|
14
|
—
|
—
|
$125,393.00
|
$191,333.91
|
$150,471.60
|
2026-03-01
|
|
01907
|
OTHER
|
New Technology - Level 52
|
3
|
2
|
—
|
—
|
$142,919.70
|
$153,077.00
|
$148,484.69
|
2026-03-01
|
|
01908
|
OTHER
|
New Technology - Level 52
|
3
|
2
|
—
|
—
|
$142,919.70
|
$153,077.00
|
$148,484.69
|
2026-03-01
|
|
5833
|
APR_DRG
|
Neonate With Ecmo
|
33
|
14
|
—
|
—
|
$124,517.00
|
$186,775.50
|
$143,194.55
|
2026-03-01
|
|
1905
|
OTHER
|
New Technology - Level 51
|
44
|
21
|
—
|
—
|
$132,847.50
|
$154,599.28
|
$142,146.83
|
2026-03-01
|
|
1906
|
OTHER
|
New Technology - Level 51
|
44
|
21
|
—
|
—
|
$132,847.50
|
$154,599.28
|
$142,146.83
|
2026-03-01
|
|
A9543
|
HCPCS
|
Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil…
|
3
|
1
|
—
|
—
|
$122,172.78
|
$140,774.65
|
$140,774.65
|
2026-03-01
|
|
01905
|
OTHER
|
New Technology - Level 51
|
3
|
2
|
—
|
—
|
$128,862.07
|
$138,020.20
|
$133,879.59
|
2026-03-01
|
|
01906
|
OTHER
|
New Technology - Level 51
|
3
|
2
|
—
|
—
|
$128,862.07
|
$138,020.20
|
$133,879.59
|
2026-03-01
|
|
24
|
APR_DRG
|
Heart And/or Lung Transplant
|
33
|
14
|
—
|
—
|
$111,047.00
|
$178,746.99
|
$133,464.42
|
2026-03-01
|
|
114
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
33
|
14
|
—
|
—
|
$97,644.00
|
$178,865.04
|
$131,167.70
|
2026-03-01
|
|
1903
|
OTHER
|
New Technology - Level 50
|
44
|
21
|
—
|
—
|
$118,355.10
|
$137,733.97
|
$126,639.96
|
2026-03-01
|
|
1904
|
OTHER
|
New Technology - Level 50
|
44
|
21
|
—
|
—
|
$118,355.10
|
$137,733.97
|
$126,639.96
|
2026-03-01
|
|
01903
|
OTHER
|
New Technology - Level 50
|
3
|
2
|
—
|
—
|
$114,804.45
|
$122,963.60
|
$119,274.69
|
2026-03-01
|
|
01904
|
OTHER
|
New Technology - Level 50
|
3
|
2
|
—
|
—
|
$114,804.45
|
$122,963.60
|
$119,274.69
|
2026-03-01
|
|
004
|
OTHER
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
3
|
2
|
—
|
—
|
$87,507.74
|
$122,661.20
|
$118,981.36
|
2026-03-01
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
105
|
36
|
—
|
—
|
$9,000.00
|
$389,678.53
|
$113,374.50
|
2026-03-01
|
|
1901
|
OTHER
|
New Technology - Level 49
|
44
|
21
|
—
|
—
|
$103,862.70
|
$120,868.66
|
$111,133.09
|
2026-03-01
|
|
1902
|
OTHER
|
New Technology - Level 49
|
44
|
21
|
—
|
—
|
$103,862.70
|
$120,868.66
|
$111,133.09
|
2026-03-01
|
|
Q0480
|
HCPCS
|
Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only
|
47
|
23
|
—
|
—
|
$96,999.90
|
$122,653.30
|
$109,999.89
|
2026-03-01
|
|
5832
|
APR_DRG
|
Neonate With Ecmo
|
33
|
14
|
—
|
—
|
$95,607.00
|
$143,410.50
|
$109,948.05
|
2026-03-01
|
|
1614
|
APR_DRG
|
Implantable Heart Assist Systems
|
33
|
14
|
—
|
—
|
$95,167.00
|
$142,750.50
|
$109,442.05
|
2026-03-01
|
|
651
|
OTHER
|
Kidney Transplant With Hemodialysis Without Mcc
|
3
|
2
|
—
|
—
|
$79,183.81
|
$109,929.80
|
$106,631.91
|
2026-03-01
|
|
7
|
MS_DRG
|
Lung Transplant
|
102
|
37
|
—
|
—
|
$9,746.00
|
$333,100.77
|
$105,526.65
|
2026-03-01
|
|
6304
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
33
|
14
|
—
|
—
|
$85,272.22
|
$137,205.00
|
$105,190.50
|
2026-03-01
|
|
01901
|
OTHER
|
New Technology - Level 49
|
3
|
2
|
—
|
—
|
$100,746.82
|
$107,906.90
|
$104,669.69
|
2026-03-01
|
|
01902
|
OTHER
|
New Technology - Level 49
|
3
|
2
|
—
|
—
|
$100,746.82
|
$107,906.90
|
$104,669.69
|
2026-03-01
|
|
8414
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
33
|
14
|
—
|
—
|
$87,012.29
|
$135,325.50
|
$103,749.55
|
2026-03-01
|
|
224
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh…
|
3
|
1
|
—
|
—
|
$63,606.00
|
$102,063.00
|
$102,063.00
|
2024-10-01
|
|
223
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…
|
3
|
1
|
—
|
—
|
$63,606.00
|
$102,063.00
|
$102,063.00
|
2024-10-01
|
|
222
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…
|
3
|
1
|
—
|
—
|
$63,606.00
|
$102,063.00
|
$102,063.00
|
2024-10-01
|
|
225
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh…
|
3
|
1
|
—
|
—
|
$63,606.00
|
$102,063.00
|
$102,063.00
|
2024-10-01
|
|
226
|
MS_DRG
|
Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc
|
3
|
1
|
—
|
—
|
$62,579.00
|
$100,416.00
|
$100,416.00
|
2024-10-01
|
|
227
|
MS_DRG
|
Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc
|
3
|
1
|
—
|
—
|
$62,579.00
|
$100,416.00
|
$100,416.00
|
2024-10-01
|
|
A9699
|
HCPCS
|
Radiopharmaceutical, Therapeutic, Not Otherwise Classified
|
3
|
1
|
—
|
—
|
$100,053.67
|
$100,394.53
|
$100,053.67
|
2026-03-01
|
|
6094
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
33
|
14
|
—
|
—
|
$82,446.00
|
$133,307.22
|
$99,536.06
|
2026-03-01
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
102
|
37
|
—
|
—
|
$6,771.00
|
$365,494.91
|
$99,350.85
|
2026-03-01
|
|
1599
|
OTHER
|
New Technology - Level 48
|
44
|
21
|
—
|
—
|
$91,785.68
|
$106,814.19
|
$98,210.68
|
2026-03-01
|
|
1585
|
OTHER
|
New Technology - Level 48
|
44
|
21
|
—
|
—
|
$91,785.68
|
$106,814.19
|
$98,210.68
|
2026-03-01
|
|
5883
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
33
|
14
|
—
|
—
|
$81,552.00
|
$127,428.00
|
$97,862.40
|
2026-03-01
|
|
94
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
33
|
14
|
—
|
—
|
$75,232.00
|
$130,764.62
|
$97,637.58
|
2026-03-01
|
|
6314
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
33
|
14
|
—
|
—
|
$80,942.00
|
$128,217.69
|
$97,130.40
|
2026-03-01
|
|
K1007
|
HCPCS
|
Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin…
|
47
|
23
|
—
|
—
|
$88,300.94
|
$104,589.10
|
$96,982.62
|
2026-03-01
|
|
5914
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
33
|
14
|
—
|
—
|
$79,657.00
|
$125,467.54
|
$95,588.40
|
2026-03-01
|
|
209
|
MS_DRG
|
Complex Aortic Arch Procedures
|
57
|
34
|
—
|
—
|
$10,132.00
|
$366,683.84
|
$93,571.46
|
2026-03-01
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
104
|
37
|
—
|
—
|
$9,746.00
|
$418,187.01
|
$92,751.41
|
2026-03-01
|
|
01599
|
OTHER
|
New Technology - Level 48
|
3
|
2
|
—
|
—
|
$89,032.11
|
$95,359.60
|
$92,498.81
|
2026-03-01
|
|
01585
|
OTHER
|
New Technology - Level 48
|
3
|
2
|
—
|
—
|
$89,032.11
|
$95,359.60
|
$92,498.81
|
2026-03-01
|
|
007
|
OTHER
|
Lung Transplant
|
3
|
2
|
—
|
—
|
$70,155.51
|
$94,273.56
|
$91,445.35
|
2026-03-01
|
|
5831
|
APR_DRG
|
Neonate With Ecmo
|
33
|
14
|
—
|
—
|
$69,493.00
|
$122,622.00
|
$90,340.90
|
2026-03-01
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
109
|
38
|
—
|
—
|
$9,746.00
|
$339,361.06
|
$90,209.13
|
2026-03-01
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
109
|
38
|
—
|
—
|
$9,000.00
|
$348,927.60
|
$89,895.16
|
2026-03-01
|
|
5934
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
33
|
14
|
—
|
—
|
$73,863.00
|
$110,794.50
|
$88,248.00
|
2026-03-01
|
|
1584
|
OTHER
|
New Technology - Level 47
|
44
|
21
|
—
|
—
|
$82,124.09
|
$95,570.65
|
$87,872.78
|
2026-03-01
|
|
1598
|
OTHER
|
New Technology - Level 47
|
44
|
21
|
—
|
—
|
$82,124.09
|
$95,570.65
|
$87,872.78
|
2026-03-01
|
|
Q2043
|
HCPCS
|
Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm…
|
6
|
3
|
—
|
—
|
$53,789.99
|
$119,352.48
|
$86,992.97
|
2026-03-01
|
|
74
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
33
|
14
|
—
|
—
|
$75,611.00
|
$113,416.50
|
$86,952.65
|
2026-03-01
|
|
5882
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
33
|
14
|
—
|
—
|
$71,560.00
|
$109,192.05
|
$85,872.00
|
2026-03-01
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
113
|
39
|
—
|
—
|
$6,000.00
|
$377,345.37
|
$85,573.52
|
2026-03-01
|
|
113
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
33
|
14
|
—
|
—
|
$56,946.00
|
$133,113.71
|
$85,419.00
|
2026-03-01
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
102
|
37
|
—
|
—
|
$9,746.00
|
$371,491.41
|
$85,235.94
|
2026-03-01
|
|
01584
|
OTHER
|
New Technology - Level 47
|
3
|
2
|
—
|
—
|
$79,660.37
|
$85,321.80
|
$82,762.15
|
2026-03-01
|
|
01598
|
OTHER
|
New Technology - Level 47
|
3
|
2
|
—
|
—
|
$79,660.37
|
$85,321.80
|
$82,762.15
|
2026-03-01
|
|
002
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
3
|
2
|
—
|
—
|
$70,028.25
|
$83,554.20
|
$81,047.57
|
2026-03-01
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
113
|
39
|
—
|
—
|
$10,799.00
|
$236,979.98
|
$80,873.49
|
2026-03-01
|
|
014
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
3
|
2
|
—
|
—
|
$78,057.16
|
$81,309.75
|
$80,471.30
|
2026-03-01
|
|
44
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
33
|
14
|
—
|
—
|
$66,782.00
|
$100,494.24
|
$80,138.40
|
2026-03-01
|
|
14
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
33
|
14
|
—
|
—
|
$67,242.00
|
$100,863.00
|
$79,595.47
|
2026-03-01
|
|
1613
|
APR_DRG
|
Implantable Heart Assist Systems
|
33
|
14
|
—
|
—
|
$64,392.00
|
$104,446.96
|
$77,987.07
|
2026-03-01
|
|
1583
|
OTHER
|
New Technology - Level 46
|
44
|
21
|
—
|
—
|
$72,462.48
|
$84,327.11
|
$77,534.85
|
2026-03-01
|
|
1597
|
OTHER
|
New Technology - Level 46
|
44
|
21
|
—
|
—
|
$72,462.48
|
$84,327.11
|
$77,534.85
|
2026-03-01
|
|
005
|
OTHER
|
Liver Transplant With Mcc Or Intestinal Transplant
|
3
|
2
|
—
|
—
|
$57,563.21
|
$79,623.70
|
$77,234.99
|
2026-03-01
|
|
459
|
MS_DRG
|
Spinal Fusion Except Cervical With Mcc
|
5
|
2
|
—
|
—
|
$10,614.00
|
$75,435.00
|
$75,435.00
|
2026-03-01
|
|
6034
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
33
|
14
|
—
|
—
|
$44,572.04
|
$102,481.50
|
$75,153.10
|
2026-03-01
|
|
23
|
APR_DRG
|
Heart And/or Lung Transplant
|
33
|
14
|
—
|
—
|
$62,352.00
|
$97,366.79
|
$74,822.40
|
2026-03-01
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
109
|
38
|
—
|
—
|
$9,746.00
|
$270,202.08
|
$73,744.08
|
2026-03-01
|
|
5881
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
33
|
14
|
—
|
—
|
$61,338.00
|
$93,593.57
|
$73,605.60
|
2026-03-01
|
|
112
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
33
|
14
|
—
|
—
|
$48,895.00
|
$105,823.65
|
$73,342.50
|
2026-03-01
|
|
01583
|
OTHER
|
New Technology - Level 46
|
3
|
2
|
—
|
—
|
$70,288.61
|
$75,284.00
|
$73,025.48
|
2026-03-01
|
|
01597
|
OTHER
|
New Technology - Level 46
|
3
|
2
|
—
|
—
|
$70,288.61
|
$75,284.00
|
$73,025.48
|
2026-03-01
|
|
423
|
OTHER
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
3
|
2
|
—
|
—
|
$42,657.41
|
$74,621.06
|
$72,382.43
|
2026-03-01
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
111
|
39
|
—
|
—
|
$10,799.00
|
$238,726.12
|
$71,998.48
|
2026-03-01
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
109
|
38
|
—
|
—
|
$9,000.00
|
$298,428.71
|
$71,587.26
|
2026-03-01
|
|
5913
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
33
|
14
|
—
|
—
|
$59,125.00
|
$94,624.20
|
$70,950.00
|
2026-03-01
|
|
L8702
|
HCPCS
|
Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge…
|
47
|
23
|
—
|
—
|
$63,895.55
|
$75,681.87
|
$70,177.73
|
2026-03-01
|
|
474
|
OTHER
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
3
|
2
|
—
|
—
|
$24,609.07
|
$72,072.91
|
$69,910.72
|
2026-03-01
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
123
|
44
|
—
|
—
|
$10,614.00
|
$215,864.61
|
$69,470.12
|
2026-03-01
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
135
|
46
|
—
|
—
|
$10,799.00
|
$200,686.74
|
$68,208.27
|
2026-03-01
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
133
|
45
|
—
|
—
|
$10,799.00
|
$205,351.76
|
$67,918.17
|
2026-03-01
|
|
1596
|
OTHER
|
New Technology - Level 45
|
44
|
21
|
—
|
—
|
$62,800.88
|
$73,083.57
|
$67,196.94
|
2026-03-01
|
|
1582
|
OTHER
|
New Technology - Level 45
|
44
|
21
|
—
|
—
|
$62,800.88
|
$73,083.57
|
$67,196.94
|
2026-03-01
|
|
216
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
3
|
2
|
—
|
—
|
$51,704.25
|
$69,253.07
|
$67,175.48
|
2026-03-01
|
|
6024
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
33
|
14
|
—
|
—
|
$54,849.00
|
$83,100.26
|
$65,818.80
|
2026-03-01
|
|
717
|
OTHER
|
Instill Adstiladrin, Tx D
|
47
|
23
|
—
|
—
|
$13,136.93
|
$70,702.27
|
$65,560.29
|
2026-03-01
|
|
429
|
OTHER
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
2
|
2
|
—
|
—
|
$64,438.95
|
$66,431.91
|
$65,435.43
|
2026-03-01
|
|
5892
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational
|
33
|
14
|
—
|
—
|
$47,538.00
|
$89,188.07
|
$65,404.58
|
2026-03-01
|
|
5891
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational
|
33
|
14
|
—
|
—
|
$48,983.00
|
$89,188.07
|
$65,404.58
|
2026-03-01
|
|
5893
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational
|
33
|
14
|
—
|
—
|
$46,525.00
|
$89,188.07
|
$65,404.58
|
2026-03-01
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
109
|
38
|
—
|
—
|
$10,799.00
|
$233,915.32
|
$65,050.63
|
2026-03-01
|
|
1643
|
OTHER
|
Y90 Ibritumomab, Rx
|
44
|
21
|
—
|
—
|
$56,824.55
|
$72,024.24
|
$63,991.79
|
2026-03-01
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
33
|
14
|
—
|
—
|
$55,523.00
|
$83,284.50
|
$63,851.45
|
2026-03-01
|
|
020
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
3
|
2
|
—
|
—
|
$59,731.41
|
$65,666.66
|
$63,696.66
|
2026-03-01
|
|
01596
|
OTHER
|
New Technology - Level 45
|
3
|
2
|
—
|
—
|
$60,916.85
|
$65,246.20
|
$63,288.81
|
2026-03-01
|
|
01582
|
OTHER
|
New Technology - Level 45
|
3
|
2
|
—
|
—
|
$60,916.85
|
$65,246.20
|
$63,288.81
|
2026-03-01
|
|
460
|
MS_DRG
|
Spinal Fusion Except Cervical Without Mcc
|
5
|
2
|
—
|
—
|
$10,614.00
|
$62,710.00
|
$62,710.00
|
2026-03-01
|
|
05244
|
OTHER
|
Level 4 Blood Product Exc
|
3
|
2
|
—
|
—
|
$48,795.12
|
$64,506.44
|
$62,571.25
|
2026-03-01
|
|
00717
|
OTHER
|
Instill Adstiladrin, Tx D
|
3
|
2
|
—
|
—
|
$61,454.13
|
$64,274.79
|
$62,346.55
|
2026-03-01
|
|
J9029
|
HCPCS
|
Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose
|
12
|
4
|
—
|
—
|
$61,338.53
|
$138,190.80
|
$62,287.07
|
2026-03-01
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
122
|
45
|
—
|
—
|
$9,746.00
|
$227,931.78
|
$61,864.48
|
2026-03-01
|
|
1612
|
APR_DRG
|
Implantable Heart Assist Systems
|
33
|
14
|
—
|
—
|
$51,688.00
|
$77,532.00
|
$61,481.88
|
2026-03-01
|
|
5933
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
33
|
14
|
—
|
—
|
$51,226.00
|
$80,695.10
|
$61,471.20
|
2026-03-01
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
113
|
42
|
—
|
—
|
$9,746.00
|
$203,221.57
|
$60,832.02
|
2026-03-01
|
|
5244
|
OTHER
|
Level 4 Blood Product Exc
|
44
|
21
|
—
|
—
|
$50,304.25
|
$72,254.94
|
$60,510.49
|
2026-03-01
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
113
|
42
|
—
|
—
|
$9,746.00
|
$202,051.58
|
$60,481.79
|
2026-03-01
|
|
231
|
OTHER
|
Coronary Bypass With Ptca With Mcc
|
3
|
2
|
—
|
—
|
$46,413.62
|
$62,157.31
|
$60,292.59
|
2026-03-01
|
|
275
|
OTHER
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
3
|
2
|
—
|
—
|
$26,860.22
|
$61,956.70
|
$60,098.00
|
2026-03-01
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
108
|
38
|
—
|
—
|
$9,000.00
|
$190,249.71
|
$59,727.46
|
2026-03-01
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
121
|
43
|
—
|
—
|
$9,746.00
|
$216,496.15
|
$59,675.49
|
2026-03-01
|
|
5912
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
33
|
14
|
—
|
—
|
$44,835.00
|
$81,160.27
|
$59,517.54
|
2026-03-01
|
|
1611
|
APR_DRG
|
Implantable Heart Assist Systems
|
33
|
14
|
—
|
—
|
$49,247.00
|
$76,852.35
|
$59,096.40
|
2026-03-01
|
|
453
|
OTHER
|
Combined Anterior And Posterior Spinal Fusion With Mcc
|
1
|
1
|
—
|
—
|
$57,431.82
|
$57,431.82
|
$57,431.82
|
2024-10-01
|
|
9273
|
OTHER
|
Sipuleucel-t Auto Cd54+
|
44
|
21
|
—
|
—
|
$54,404.11
|
$60,516.75
|
$57,124.32
|
2026-03-01
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
118
|
41
|
—
|
—
|
$9,000.00
|
$170,234.96
|
$57,053.04
|
2026-03-01
|
|
1595
|
OTHER
|
New Technology - Level 44
|
44
|
21
|
—
|
—
|
$53,139.28
|
$61,840.03
|
$56,859.03
|
2026-03-01
|
|
1581
|
OTHER
|
New Technology - Level 44
|
44
|
21
|
—
|
—
|
$53,139.28
|
$61,840.03
|
$56,859.03
|
2026-03-01
|
|
01643
|
OTHER
|
Y90 Ibritumomab, Rx
|
3
|
2
|
—
|
—
|
$55,119.81
|
$63,512.28
|
$56,824.55
|
2026-03-01
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
122
|
43
|
—
|
—
|
$10,799.00
|
$115,135.00
|
$56,755.07
|
2026-03-01
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
113
|
39
|
—
|
—
|
$10,799.00
|
$236,979.98
|
$56,685.38
|
2026-03-01
|
|
689372
|
CDM
|
Insert Lv Lead
|
32
|
20
|
$237,085.71
|
$237,085.71
|
$11,143.03
|
$218,118.85
|
$55,715.15
|
2026-03-01
|
|
64
|
APR_DRG
|
Pancreas Transplant
|
33
|
14
|
—
|
—
|
$47,658.85
|
$72,558.00
|
$55,627.80
|
2026-03-01
|
|
246
|
MS_DRG
|
Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar…
|
3
|
1
|
—
|
—
|
$34,659.00
|
$55,615.00
|
$55,615.00
|
2024-10-01
|
|
247
|
MS_DRG
|
Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc
|
3
|
1
|
—
|
—
|
$34,659.00
|
$55,615.00
|
$55,615.00
|
2024-10-01
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
122
|
43
|
—
|
—
|
$9,746.00
|
$200,414.61
|
$55,276.67
|
2026-03-01
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
121
|
43
|
—
|
—
|
$9,746.00
|
$204,464.69
|
$55,236.16
|
2026-03-01
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
108
|
38
|
—
|
—
|
$9,000.00
|
$226,681.29
|
$55,094.43
|
2026-03-01
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
113
|
39
|
—
|
—
|
$10,799.00
|
$236,979.98
|
$55,087.90
|
2026-03-01
|
|
22
|
APR_DRG
|
Heart And/or Lung Transplant
|
33
|
14
|
—
|
—
|
$45,376.00
|
$73,729.74
|
$55,051.54
|
2026-03-01
|
|
957
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
3
|
2
|
—
|
—
|
$44,459.26
|
$56,302.41
|
$54,613.34
|
2026-03-01
|
|
707410
|
CDM
|
Insert Perc Vad/arterial
|
32
|
20
|
$229,727.94
|
$229,727.94
|
$10,797.21
|
$211,349.70
|
$53,986.07
|
2026-03-01
|
|
8514
|
APR_DRG
|
Gender Related Procedures
|
33
|
14
|
—
|
—
|
$44,951.52
|
$70,353.00
|
$53,937.30
|
2026-03-01
|
|
233
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
3
|
2
|
—
|
—
|
$38,803.31
|
$55,564.41
|
$53,897.48
|
2026-03-01
|
|
C2616
|
HCPCS
|
Brachytherapy Source, Non-stranded, Yttrium-90, Per Source
|
3
|
1
|
—
|
—
|
$40,208.00
|
$56,373.00
|
$53,804.00
|
2026-03-01
|
|
01595
|
OTHER
|
New Technology - Level 44
|
3
|
2
|
—
|
—
|
$51,545.10
|
$55,208.40
|
$53,552.15
|
2026-03-01
|
|
01581
|
OTHER
|
New Technology - Level 44
|
3
|
2
|
—
|
—
|
$51,545.10
|
$55,208.40
|
$53,552.15
|
2026-03-01
|
|
248
|
MS_DRG
|
Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4…
|
3
|
1
|
—
|
—
|
$33,290.00
|
$53,419.00
|
$53,419.00
|
2024-10-01
|
|
249
|
MS_DRG
|
Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc
|
3
|
1
|
—
|
—
|
$33,290.00
|
$53,419.00
|
$53,419.00
|
2024-10-01
|
|
09273
|
OTHER
|
Sipuleucel-t Auto Cd54+
|
3
|
2
|
—
|
—
|
$52,771.99
|
$54,404.11
|
$53,364.77
|
2026-03-01
|
|
447
|
OTHER
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
2
|
2
|
—
|
—
|
$52,412.26
|
$54,033.26
|
$53,222.76
|
2026-03-01
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
111
|
38
|
—
|
—
|
$10,799.00
|
$291,304.83
|
$53,170.97
|
2026-03-01
|
|
8424
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
33
|
14
|
—
|
—
|
$46,203.00
|
$69,304.50
|
$53,142.85
|
2026-03-01
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
135
|
46
|
—
|
—
|
$10,799.00
|
$165,154.81
|
$52,357.95
|
2026-03-01
|
|
54
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
33
|
14
|
—
|
—
|
$43,560.00
|
$70,007.73
|
$52,272.44
|
2026-03-01
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
121
|
43
|
—
|
—
|
$9,746.00
|
$157,885.06
|
$52,114.22
|
2026-03-01
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
111
|
39
|
—
|
—
|
$10,799.00
|
$238,726.12
|
$52,103.86
|
2026-03-01
|
|
43
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
33
|
14
|
—
|
—
|
$41,876.00
|
$69,298.37
|
$51,742.78
|
2026-03-01
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
135
|
46
|
—
|
—
|
$10,614.00
|
$164,374.06
|
$51,736.80
|
2026-03-01
|
|
217
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
3
|
2
|
—
|
—
|
$50,984.39
|
$52,561.23
|
$51,416.74
|
2026-03-01
|
|
010
|
OTHER
|
Pancreas Transplant
|
3
|
2
|
—
|
—
|
$27,530.57
|
$52,909.31
|
$51,322.03
|
2026-03-01
|
|
6303
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
33
|
14
|
—
|
—
|
$43,677.00
|
$65,515.50
|
$51,276.94
|
2026-03-01
|
|
019
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
3
|
2
|
—
|
—
|
$45,717.51
|
$52,606.40
|
$51,028.21
|
2026-03-01
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
133
|
46
|
—
|
—
|
$8,000.00
|
$79,140.11
|
$50,895.00
|
2026-03-01
|
|
C1825
|
HCPCS
|
System Gen Neo2
|
15
|
9
|
$101,710.00
|
$101,710.00
|
$7,017.99
|
$93,573.20
|
$50,855.00
|
2026-03-01
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
121
|
43
|
—
|
—
|
$6,771.00
|
$164,861.67
|
$50,786.78
|
2026-03-01
|
|
L7181
|
HCPCS
|
Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi…
|
47
|
23
|
—
|
—
|
$46,068.21
|
$54,565.94
|
$50,597.51
|
2026-03-01
|
|
J9600
|
HCPCS
|
Injection, Porfimer Sodium, 75 Mg
|
3
|
1
|
—
|
—
|
$50,561.89
|
$52,091.10
|
$50,561.89
|
2026-03-01
|
|
213
|
MS_DRG
|
Endovascular Abdominal Aorta With Iliac Branch Procedures
|
70
|
39
|
—
|
—
|
$10,132.00
|
$184,880.73
|
$50,557.03
|
2026-03-01
|
|
6074
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
33
|
14
|
—
|
—
|
$42,035.00
|
$64,236.87
|
$50,442.00
|
2026-03-01
|
|
5932
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
33
|
14
|
—
|
—
|
$41,957.00
|
$64,905.25
|
$50,348.40
|
2026-03-01
|
|
360
|
OTHER
|
Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc
|
2
|
2
|
—
|
—
|
$49,558.46
|
$51,091.20
|
$50,324.83
|
2026-03-01
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
122
|
43
|
—
|
—
|
$9,000.00
|
$161,196.21
|
$50,103.18
|
2026-03-01
|
|
21
|
APR_DRG
|
Heart And/or Lung Transplant
|
33
|
14
|
—
|
—
|
$41,730.00
|
$65,165.07
|
$50,076.00
|
2026-03-01
|
|
956
|
OTHER
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
3
|
2
|
—
|
—
|
$44,991.00
|
$51,396.76
|
$49,854.86
|
2026-03-01
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
135
|
46
|
—
|
—
|
$10,799.00
|
$145,412.80
|
$49,716.99
|
2026-03-01
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
122
|
43
|
—
|
—
|
$10,799.00
|
$154,956.26
|
$49,178.27
|
2026-03-01
|
|
73
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
33
|
14
|
—
|
—
|
$36,953.00
|
$66,933.09
|
$49,084.27
|
2026-03-01
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
122
|
43
|
—
|
—
|
$9,000.00
|
$156,962.32
|
$49,037.58
|
2026-03-01
|
|
011
|
OTHER
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
3
|
2
|
—
|
—
|
$30,082.62
|
$50,521.91
|
$49,006.25
|
2026-03-01
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
135
|
46
|
—
|
—
|
$10,799.00
|
$152,902.64
|
$48,736.63
|
2026-03-01
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
102
|
37
|
—
|
—
|
$6,771.00
|
$365,494.91
|
$48,734.30
|
2026-03-01
|
|
93
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
33
|
14
|
—
|
—
|
$32,422.00
|
$87,882.00
|
$48,633.00
|
2026-03-01
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
135
|
46
|
—
|
—
|
$10,799.00
|
$156,424.48
|
$48,187.65
|
2026-03-01
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
133
|
45
|
—
|
—
|
$10,799.00
|
$205,351.76
|
$48,014.19
|
2026-03-01
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
121
|
43
|
—
|
—
|
$9,746.00
|
$166,827.11
|
$47,676.08
|
2026-03-01
|
|
976232
|
CDM
|
Kit Aor Vlv 14fr 29mm
|
15
|
9
|
$94,445.00
|
$94,445.00
|
$6,516.70
|
$86,889.40
|
$47,222.50
|
2026-03-01
|
|
218
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
3
|
2
|
—
|
—
|
$32,581.09
|
$48,482.60
|
$47,028.12
|
2026-03-01
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
122
|
43
|
—
|
—
|
$9,000.00
|
$148,400.23
|
$46,985.44
|
2026-03-01
|
|
573
|
OTHER
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
3
|
2
|
—
|
—
|
$35,563.39
|
$48,306.57
|
$46,857.37
|
2026-03-01
|
|
1594
|
OTHER
|
New Technology - Level 43
|
44
|
21
|
—
|
—
|
$43,477.68
|
$50,596.49
|
$46,521.12
|
2026-03-01
|
|
1580
|
OTHER
|
New Technology - Level 43
|
44
|
21
|
—
|
—
|
$43,477.68
|
$50,596.49
|
$46,521.12
|
2026-03-01
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
121
|
43
|
—
|
—
|
$9,746.00
|
$167,897.59
|
$46,476.54
|
2026-03-01
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
113
|
42
|
—
|
—
|
$9,746.00
|
$189,192.64
|
$46,332.70
|
2026-03-01
|
|
1142
|
OTHER
|
Supprelin La Implant
|
44
|
21
|
—
|
—
|
$43,185.34
|
$49,885.23
|
$46,208.31
|
2026-03-01
|
|
6023
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
33
|
14
|
—
|
—
|
$38,906.00
|
$58,359.00
|
$46,158.30
|
2026-03-01
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures
|
122
|
43
|
—
|
—
|
$9,746.00
|
$144,499.12
|
$46,015.26
|
2026-03-01
|
|
3034
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
33
|
14
|
—
|
—
|
$37,554.87
|
$59,817.00
|
$45,859.70
|
2026-03-01
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
109
|
38
|
—
|
—
|
$10,799.00
|
$233,915.32
|
$45,496.55
|
2026-03-01
|
|
0294T
|
CPT
|
HInsertion Of Left Atrial Hemodynamic Monitor; Pressure Sensor Lead At Time Of I…
|
7
|
2
|
—
|
—
|
$19,926.00
|
$52,079.00
|
$45,326.00
|
2026-03-01
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
102
|
37
|
—
|
—
|
$6,771.00
|
$365,494.91
|
$45,157.47
|
2026-03-01
|
|
215
|
OTHER
|
Other Heart Assist System Implant
|
3
|
2
|
—
|
—
|
$43,702.66
|
$53,413.86
|
$45,054.29
|
2026-03-01
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
122
|
43
|
—
|
—
|
$9,000.00
|
$144,495.88
|
$44,995.21
|
2026-03-01
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
133
|
45
|
—
|
—
|
$10,799.00
|
$205,351.76
|
$44,967.21
|
2026-03-01
|
|
955
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
3
|
2
|
—
|
—
|
$43,429.46
|
$64,810.26
|
$44,772.64
|
2026-03-01
|
|
834
|
OTHER
|
Acute Leukemia With Mcc
|
3
|
2
|
—
|
—
|
$43,654.43
|
$45,966.33
|
$44,587.34
|
2026-03-01
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
131
|
45
|
—
|
—
|
$10,799.00
|
$154,862.60
|
$44,544.21
|
2026-03-01
|
|
J9226
|
HCPCS
|
Histrelin Implant (supprelin La), 50 Mg
|
12
|
4
|
—
|
—
|
$43,241.44
|
$94,940.24
|
$44,533.82
|
2026-03-01
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
103
|
39
|
—
|
—
|
$11,098.00
|
$60,809.85
|
$44,480.35
|
2026-03-01
|
|
704895
|
CDM
|
Revas Tib Stnt/ath/ang 1
|
32
|
20
|
$188,303.23
|
$188,303.23
|
$8,850.25
|
$173,238.97
|
$44,251.26
|
2026-03-01
|
|
704891
|
CDM
|
Revas Fempp Stnt/ath/ang
|
32
|
20
|
$188,303.23
|
$188,303.23
|
$8,850.25
|
$173,238.97
|
$44,251.26
|
2026-03-01
|
|
219
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
3
|
2
|
—
|
—
|
$39,395.34
|
$45,522.60
|
$44,156.92
|
2026-03-01
|
|
023
|
OTHER
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
3
|
2
|
—
|
—
|
$32,019.98
|
$45,427.61
|
$44,064.78
|
2026-03-01
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically
|
121
|
43
|
—
|
—
|
$9,746.00
|
$157,055.55
|
$44,059.30
|
2026-03-01
|
|
01594
|
OTHER
|
New Technology - Level 43
|
3
|
2
|
—
|
—
|
$42,173.35
|
$45,170.60
|
$43,815.48
|
2026-03-01
|
|
01580
|
OTHER
|
New Technology - Level 43
|
3
|
2
|
—
|
—
|
$42,173.35
|
$45,170.60
|
$43,815.48
|
2026-03-01
|
|
969
|
OTHER
|
HIV With Extensive O.r. Procedures With Mcc
|
3
|
2
|
—
|
—
|
$39,306.71
|
$45,134.66
|
$43,780.62
|
2026-03-01
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
122
|
43
|
—
|
—
|
$9,000.00
|
$137,533.84
|
$43,658.31
|
2026-03-01
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
122
|
43
|
—
|
—
|
$10,799.00
|
$107,289.07
|
$43,618.68
|
2026-03-01
|
|
976660
|
CDM
|
Valve Tavr 23mm
|
15
|
9
|
$87,180.00
|
$87,180.00
|
$6,015.42
|
$80,205.60
|
$43,590.00
|
2026-03-01
|
|
912729
|
CDM
|
Valve Aor Tavr 26mm
|
15
|
9
|
$87,180.00
|
$87,180.00
|
$6,015.42
|
$80,205.60
|
$43,590.00
|
2026-03-01
|
|
912731
|
CDM
|
Valve Aor Tavr 34mm
|
15
|
9
|
$87,180.00
|
$87,180.00
|
$6,015.42
|
$80,205.60
|
$43,590.00
|
2026-03-01
|
|
912730
|
CDM
|
Valve Aor Tavr 29mm
|
15
|
9
|
$87,180.00
|
$87,180.00
|
$6,015.42
|
$80,205.60
|
$43,590.00
|
2026-03-01
|
|
976664
|
CDM
|
Valve Tavr 29mm
|
15
|
9
|
$87,180.00
|
$87,180.00
|
$6,015.42
|
$80,205.60
|
$43,590.00
|
2026-03-01
|
|
986887
|
CDM
|
Valve Tavr 34mm
|
15
|
9
|
$87,180.00
|
$87,180.00
|
$6,015.42
|
$80,205.60
|
$43,590.00
|
2026-03-01
|
|
976663
|
CDM
|
Valve Tavr 26mm
|
15
|
9
|
$87,180.00
|
$87,180.00
|
$6,015.42
|
$80,205.60
|
$43,590.00
|
2026-03-01
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
33
|
14
|
—
|
—
|
$37,737.10
|
$56,856.00
|
$43,589.60
|
2026-03-01
|
|
456
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
3
|
2
|
—
|
—
|
$31,536.15
|
$44,771.31
|
$43,428.17
|
2026-03-01
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
121
|
43
|
—
|
—
|
$6,771.00
|
$140,880.68
|
$43,399.27
|
2026-03-01
|
|
232
|
OTHER
|
Coronary Bypass With Ptca Without Mcc
|
3
|
2
|
—
|
—
|
$39,398.94
|
$44,702.22
|
$43,361.15
|
2026-03-01
|
|
01142
|
OTHER
|
Supprelin La Implant
|
3
|
2
|
—
|
—
|
$41,889.78
|
$43,989.70
|
$43,185.34
|
2026-03-01
|
|
84
|
APR_DRG
|
Autologous Bone Marrow Transplant
|
33
|
14
|
—
|
—
|
$34,325.35
|
$56,214.00
|
$43,097.40
|
2026-03-01
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective
|
122
|
43
|
—
|
—
|
$9,746.00
|
$137,663.84
|
$43,008.43
|
2026-03-01
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
122
|
43
|
—
|
—
|
$9,000.00
|
$142,086.36
|
$42,958.15
|
2026-03-01
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
122
|
43
|
—
|
—
|
$10,799.00
|
$80,429.55
|
$42,606.49
|
2026-03-01
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
124
|
43
|
—
|
—
|
$10,799.00
|
$218,728.07
|
$42,474.48
|
2026-03-01
|
|
207
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
3
|
2
|
—
|
—
|
$34,055.75
|
$43,557.68
|
$42,250.95
|
2026-03-01
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
121
|
43
|
—
|
—
|
$10,799.00
|
$79,119.00
|
$41,894.57
|
2026-03-01
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
33
|
14
|
—
|
—
|
$35,009.00
|
$52,513.50
|
$41,802.50
|
2026-03-01
|
|
213
|
OTHER
|
Endovascular Abdominal Aorta With Iliac Branch Procedures
|
2
|
2
|
—
|
—
|
$40,817.29
|
$42,079.68
|
$41,448.49
|
2026-03-01
|
|
0923T
|
CPT
|
Removal And Replacement Of Permanent Cardiac Contractility Modulation-defibrilla…
|
1
|
1
|
—
|
—
|
$41,326.00
|
$41,326.00
|
$41,326.00
|
2026-03-01
|
|
0915T
|
CPT
|
Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co…
|
1
|
1
|
—
|
—
|
$41,326.00
|
$41,326.00
|
$41,326.00
|
2026-03-01
|
|
0916T
|
CPT
|
Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co…
|
1
|
1
|
—
|
—
|
$41,326.00
|
$41,326.00
|
$41,326.00
|
2026-03-01
|
|
6134
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
33
|
14
|
—
|
—
|
$34,228.00
|
$52,935.54
|
$41,073.60
|
2026-03-01
|