Hospital

HCA FLORIDA FORT WALTON-DESTIN HOSPITAL

Fort Walton Beach, FL · CCN 100223 · Rates published

34,208 distinct procedures filed

40 distinct payers

1,830,585 rate rows

2026-07-30 last MRF observed

Data quality

1,739,379 of 1,830,585 rate rows are consumer-grade (95.0%)

91,206 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	26,015
template filing: same amount across many unrelated codes — excluded	24,741
per-diem day rate — not a per-procedure price	16,994
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	14,225
exceeds 10× this hospital's gross charge — excluded from medians	7,843
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	663
percent-of-charges filed in the dollar field — excluded from medians	316
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings	279
placeholder amount (≤ $0.02) — excluded from medians	130

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

Source MRF file	https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/61-1259833_HCA-FLORIDA-FORT-WALTON-DESTIN-HOSPITAL_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page	https://www.hcafloridahealthcare.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered via	CMS hospital list
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-10-10
Content fingerprint	2a268ef733cec4bc… · 370,628,638 bytes · first seen 2026-06-08

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
845 OTHER	Inj, Atidarsagene Autotem	18	$4,764.90	$4,955,500.00	$4,595,100.00	nat. median $4,505,000 1.0× median
00845 OTHER	Inj, Atidarsagene Autotem	1	$4,369,850.00	$4,369,850.00	$4,369,850.00	—
9138 OTHER	Inj, Hemgenix, Per Tx Dos	20	$3,599,442.00	$4,422,320.40	$3,761,847.42	nat. median $3,765,001 1.0× median
773 OTHER	Inj, Beqvez, Per Tx Dose	18	$3,532,900.00	$4,326,000.00	$3,677,100.00	nat. median $3,677,100 1.0× median
09138 OTHER	Inj, Hemgenix, Per Tx Dos	1	$3,562,713.00	$3,574,708.99	$3,568,711.00	nat. median $3,562,713 1.0× median
00773 OTHER	Inj, Beqvez, Per Tx Dose	1	$3,496,850.00	$3,496,850.00	$3,496,850.00	nat. median $3,496,850 1.0× median
908 OTHER	Topi Adm Prad Zami Per Tr	20	$9,697.57	$4,002,984.00	$3,402,536.40	nat. median $8,800 outlier · 386.6×
714 OTHER	Inj Delandistrogene Mox R	20	$5,280.60	$3,993,432.00	$3,394,417.20	nat. median $3,391,964 1.0× median
748 OTHER	Inj, Lovotibeglogene Auto	20	$8,710.34	$3,943,200.00	$3,342,770.35	nat. median $3,351,720 1.0× median
906 OTHER	Inj Elivaldogene Autoteme	20	$6,354.69	$3,816,000.00	$3,243,600.00	nat. median $2,726 outlier · 1189.7×
00908 OTHER	Topi Adm Prad Zami Per Tr	1	$3,235,745.40	$3,235,745.40	$3,235,745.40	—
00714 OTHER	Inj Delandistrogene Mox R	1	$3,225,691.35	$3,228,024.20	$3,226,857.78	nat. median $3,225,691 1.0× median
00748 OTHER	Inj, Lovotibeglogene Auto	1	$3,154,932.76	$3,187,420.00	$3,171,176.38	nat. median $3,187,420 1.0× median
00906 OTHER	Inj Elivaldogene Autoteme	1	$3,084,600.00	$3,084,600.00	$3,084,600.00	—
746 OTHER	Inj, Betibeglogene Autote	20	$7,736.51	$3,561,600.00	$3,020,414.11	nat. median $3,001,835 1.0× median
00746 OTHER	Inj, Betibeglogene Autote	1	$2,851,769.93	$2,878,960.00	$2,865,364.96	nat. median $2,878,960 1.0× median
9141 OTHER	Inj Onase Abepar-xioi Tre	20	$2,340,841.72	$3,106,777.20	$2,588,981.00	nat. median $2,508,045 1.0× median
09141 OTHER	Inj Onase Abepar-xioi Tre	1	$2,316,955.58	$2,511,311.57	$2,414,133.58	nat. median $2,316,956 1.0× median
824 OTHER	Inj, Exagamglogene Autote	20	$13,699.09	$2,798,400.00	$2,378,640.00	nat. median $28,063 outlier · 84.8×
00824 OTHER	Inj, Exagamglogene Autote	1	$2,262,040.00	$2,262,040.00	$2,262,040.00	—
Q2057 HCPCS	Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure…	1	$2,042,143.00	$2,042,143.00	$2,042,143.00	nat. median $813,967 outlier · 2.5×
2067 OTHER	Afamitresgene Autoleucel	20	$755,207.60	$924,744.00	$789,885.50	nat. median $838,386 0.9× median
Q2058 HCPCS	Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,…	1	$737,362.50	$737,362.50	$737,362.50	nat. median $286,598 outlier · 2.6×
9498 OTHER	Ciltacabtagene Car-pos T	20	$516,580.93	$705,179.52	$587,649.60	nat. median $553,480 1.1× median
9194 OTHER	Tisagenlecleucel Car-pos	20	$518,609.04	$679,837.56	$566,531.30	nat. median $555,653 1.0× median
9413 OTHER	Lisocabtagene Car Pos T	20	$506,391.58	$674,641.44	$562,201.20	nat. median $542,562 1.0× median
Q2042 HCPCS	Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka…	3	$502,693.77	$1,501,307.95	$561,407.87	nat. median $621,313 0.9× median
9422 OTHER	Idecabtagene Vicleucel Ca	20	$516,055.85	$669,698.16	$560,815.79	nat. median $552,917 1.0× median
09498 OTHER	Ciltacabtagene Car-pos T	1	$511,309.70	$570,020.11	$540,664.91	nat. median $511,310 1.1× median
Q2056 HCPCS	Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige…	3	$492,271.12	$1,557,271.36	$536,573.93	nat. median $599,737 0.9× median
J3402 HCPCS	Injection, Remestemcel-l-rknd, Per Therapeutic Dose	1	$534,422.90	$534,422.90	$534,422.90	nat. median $207,733 outlier · 2.6×
9035 OTHER	Axicabtagene Ciloleucel C	20	$479,666.88	$638,630.64	$532,192.20	nat. median $513,929 1.0× median
09194 OTHER	Tisagenlecleucel Car-pos	1	$513,317.11	$549,535.36	$531,426.23	nat. median $513,317 1.0× median
09422 OTHER	Idecabtagene Vicleucel Ca	1	$510,789.97	$541,339.35	$526,064.66	nat. median $510,790 1.0× median
09413 OTHER	Lisocabtagene Car Pos T	1	$501,224.32	$545,335.16	$523,279.74	nat. median $501,224 1.0× median
Q2054 HCPCS	Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi…	3	$459,839.17	$1,489,833.29	$500,948.74	nat. median $579,571 0.9× median
09035 OTHER	Axicabtagene Ciloleucel C	1	$474,772.32	$516,226.43	$495,499.38	nat. median $474,772 1.0× median
9391 OTHER	Brexucabtagene Car Pos T	20	$451,319.79	$587,340.24	$491,108.86	nat. median $483,557 1.0× median
Q2041 HCPCS	Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via…	3	$445,599.57	$1,410,309.44	$487,755.77	nat. median $562,501 0.9× median
Q2053 HCPCS	Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V…	3	$435,956.80	$1,297,043.03	$474,717.03	nat. median $513,770 0.9× median
Q2055 HCPCS	Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (…	3	$470,149.30	$1,478,916.58	$470,149.30	nat. median $574,037 0.8× median
09391 OTHER	Brexucabtagene Car Pos T	1	$446,714.49	$474,766.69	$460,740.59	nat. median $446,714 1.0× median
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	25	$2,701.00	$1,936,748.58	$288,251.60	nat. median $168,055 1.7× median
831 OTHER	Obecbtge Autol Up To 400	20	$2,930.91	$333,900.00	$283,815.00	nat. median $278,250 1.0× median
897 OTHER	Revakinagene, Per Implant	20	$259,700.00	$318,000.00	$271,625.00	nat. median $269,427 1.0× median
00831 OTHER	Obecbtge Autol Up To 400	1	$269,902.50	$269,902.50	$269,902.50	—
00897 OTHER	Revakinagene, Per Implant	1	$257,050.00	$257,050.00	$257,050.00	—
5834 APR_DRG	Neonate With Ecmo	14	$192,207.00	$312,391.65	$230,648.40	nat. median $390,362 0.6× median
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	24	$2,837.00	$1,256,871.92	$218,708.46	nat. median $186,516 1.2× median
J7330 HCPCS	Autologous Cultured Chondrocytes, Implant	1	$192,914.70	$221,874.56	$207,394.63	nat. median $92,809 outlier · 2.2×

Other procedures at this hospital

Browse this hospital's 34,208 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

845	OTHER	Inj, Atidarsagene Autotem	23	18	—	—	$4,764.90	$4,955,500.00	$4,595,100.00	2026-03-01
00845	OTHER	Inj, Atidarsagene Autotem	1	1	—	—	$4,369,850.00	$4,369,850.00	$4,369,850.00	2026-03-01
9138	OTHER	Inj, Hemgenix, Per Tx Dos	44	20	—	—	$3,599,442.00	$4,422,320.40	$3,761,847.42	2026-03-01
773	OTHER	Inj, Beqvez, Per Tx Dose	21	18	—	—	$3,532,900.00	$4,326,000.00	$3,677,100.00	2024-10-01
09138	OTHER	Inj, Hemgenix, Per Tx Dos	2	1	—	—	$3,562,713.00	$3,574,708.99	$3,568,711.00	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
908	OTHER	Topi Adm Prad Zami Per Tr	25	20	—	—	$9,697.57	$4,002,984.00	$3,402,536.40	2026-03-01
714	OTHER	Inj Delandistrogene Mox R	46	20	—	—	$5,280.60	$3,993,432.00	$3,394,417.20	2026-03-01
748	OTHER	Inj, Lovotibeglogene Auto	46	20	—	—	$8,710.34	$3,943,200.00	$3,342,770.35	2026-03-01
906	OTHER	Inj Elivaldogene Autoteme	25	20	—	—	$6,354.69	$3,816,000.00	$3,243,600.00	2026-03-01
00908	OTHER	Topi Adm Prad Zami Per Tr	1	1	—	—	$3,235,745.40	$3,235,745.40	$3,235,745.40	2026-03-01
00714	OTHER	Inj Delandistrogene Mox R	2	1	—	—	$3,225,691.35	$3,228,024.20	$3,226,857.78	2026-03-01
00748	OTHER	Inj, Lovotibeglogene Auto	2	1	—	—	$3,154,932.76	$3,187,420.00	$3,171,176.38	2026-03-01
00906	OTHER	Inj Elivaldogene Autoteme	1	1	—	—	$3,084,600.00	$3,084,600.00	$3,084,600.00	2026-03-01
746	OTHER	Inj, Betibeglogene Autote	46	20	—	—	$7,736.51	$3,561,600.00	$3,020,414.11	2026-03-01
00746	OTHER	Inj, Betibeglogene Autote	2	1	—	—	$2,851,769.93	$2,878,960.00	$2,865,364.96	2026-03-01
9141	OTHER	Inj Onase Abepar-xioi Tre	44	20	—	—	$2,340,841.72	$3,106,777.20	$2,588,981.00	2026-03-01
09141	OTHER	Inj Onase Abepar-xioi Tre	2	1	—	—	$2,316,955.58	$2,511,311.57	$2,414,133.58	2026-03-01
824	OTHER	Inj, Exagamglogene Autote	25	20	—	—	$13,699.09	$2,798,400.00	$2,378,640.00	2026-03-01
00824	OTHER	Inj, Exagamglogene Autote	1	1	—	—	$2,262,040.00	$2,262,040.00	$2,262,040.00	2026-03-01
Q2057	HCPCS	Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure…	1	1	—	—	$2,042,143.00	$2,042,143.00	$2,042,143.00	2026-03-01
2067	OTHER	Afamitresgene Autoleucel	23	20	—	—	$755,207.60	$924,744.00	$789,885.50	2026-03-01
Q2058	HCPCS	Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, …	1	1	—	—	$737,362.50	$737,362.50	$737,362.50	2026-03-01
9498	OTHER	Ciltacabtagene Car-pos T	44	20	—	—	$516,580.93	$705,179.52	$587,649.60	2026-03-01
9194	OTHER	Tisagenlecleucel Car-pos	44	20	—	—	$518,609.04	$679,837.56	$566,531.30	2026-03-01
9413	OTHER	Lisocabtagene Car Pos T	44	20	—	—	$506,391.58	$674,641.44	$562,201.20	2026-03-01
Q2042	HCPCS	Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka…	10	3	—	—	$502,693.77	$1,501,307.95	$561,407.87	2026-03-01
9422	OTHER	Idecabtagene Vicleucel Ca	44	20	—	—	$516,055.85	$669,698.16	$560,815.79	2026-03-01
09498	OTHER	Ciltacabtagene Car-pos T	2	1	—	—	$511,309.70	$570,020.11	$540,664.91	2026-03-01
Q2056	HCPCS	Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige…	10	3	—	—	$492,271.12	$1,557,271.36	$536,573.93	2026-03-01
J3402	HCPCS	Injection, Remestemcel-l-rknd, Per Therapeutic Dose	1	1	—	—	$534,422.90	$534,422.90	$534,422.90	2026-03-01
9035	OTHER	Axicabtagene Ciloleucel C	44	20	—	—	$479,666.88	$638,630.64	$532,192.20	2026-03-01
09194	OTHER	Tisagenlecleucel Car-pos	2	1	—	—	$513,317.11	$549,535.36	$531,426.23	2026-03-01
09422	OTHER	Idecabtagene Vicleucel Ca	2	1	—	—	$510,789.97	$541,339.35	$526,064.66	2026-03-01
09413	OTHER	Lisocabtagene Car Pos T	2	1	—	—	$501,224.32	$545,335.16	$523,279.74	2026-03-01
Q2054	HCPCS	Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi…	10	3	—	—	$459,839.17	$1,489,833.29	$500,948.74	2026-03-01
09035	OTHER	Axicabtagene Ciloleucel C	2	1	—	—	$474,772.32	$516,226.43	$495,499.38	2026-03-01
9391	OTHER	Brexucabtagene Car Pos T	44	20	—	—	$451,319.79	$587,340.24	$491,108.86	2026-03-01
Q2041	HCPCS	Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via…	10	3	—	—	$445,599.57	$1,410,309.44	$487,755.77	2026-03-01
Q2053	HCPCS	Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V…	10	3	—	—	$435,956.80	$1,297,043.03	$474,717.03	2026-03-01
Q2055	HCPCS	Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (…	7	3	—	—	$470,149.30	$1,478,916.58	$470,149.30	2026-03-01
09391	OTHER	Brexucabtagene Car Pos T	2	1	—	—	$446,714.49	$474,766.69	$460,740.59	2026-03-01
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	89	25	—	—	$2,701.00	$1,936,748.58	$288,251.60	2026-03-01
831	OTHER	Obecbtge Autol Up To 400	25	20	—	—	$2,930.91	$333,900.00	$283,815.00	2026-03-01
897	OTHER	Revakinagene, Per Implant	23	20	—	—	$259,700.00	$318,000.00	$271,625.00	2026-03-01
00831	OTHER	Obecbtge Autol Up To 400	1	1	—	—	$269,902.50	$269,902.50	$269,902.50	2026-03-01
00897	OTHER	Revakinagene, Per Implant	1	1	—	—	$257,050.00	$257,050.00	$257,050.00	2026-03-01
5834	APR_DRG	Neonate With Ecmo	31	14	—	—	$192,207.00	$312,391.65	$230,648.40	2026-03-01
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	90	24	—	—	$2,837.00	$1,256,871.92	$218,708.46	2026-03-01
J7330	HCPCS	Autologous Cultured Chondrocytes, Implant	2	1	—	—	$192,914.70	$221,874.56	$207,394.63	2026-03-01
886	OTHER	Inj. Remestemcel-l-rknd/	25	20	—	—	$5,526.79	$242,002.80	$205,702.38	2026-03-01
00886	OTHER	Inj. Remestemcel-l-rknd/	1	1	—	—	$195,618.93	$195,618.93	$195,618.93	2026-03-01
001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	2	1	—	—	$178,990.51	$208,395.96	$193,693.23	2026-03-01
018	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	2	1	—	—	$147,693.56	$237,078.77	$192,386.16	2026-03-01
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	93	24	—	—	$2,837.00	$1,043,115.24	$174,663.80	2026-03-01
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	93	24	—	—	$2,837.00	$951,950.22	$165,531.72	2026-03-01
A9543	HCPCS	Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil…	2	1	—	—	$150,585.06	$173,512.94	$162,049.00	2026-03-01
455	MS_DRG	Combined Anterior And Posterior Spinal Fusion Without Cc/mcc	2	1	—	—	$137,848.00	$184,270.00	$161,059.00	2024-10-01
1907	OTHER	New Technology - Level 52	44	20	—	—	$144,393.10	$187,052.28	$156,916.99	2026-03-01
1908	OTHER	New Technology - Level 52	44	20	—	—	$144,393.10	$187,052.28	$156,916.99	2026-03-01
5884	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	31	14	—	—	$125,393.00	$191,333.91	$150,471.60	2026-03-01
01907	OTHER	New Technology - Level 52	2	1	—	—	$142,919.70	$148,484.69	$145,702.20	2026-03-01
01908	OTHER	New Technology - Level 52	2	1	—	—	$142,919.70	$148,484.69	$145,702.20	2026-03-01
5833	APR_DRG	Neonate With Ecmo	31	14	—	—	$118,611.62	$186,775.50	$142,333.94	2026-03-01
1906	OTHER	New Technology - Level 51	44	20	—	—	$130,190.55	$168,653.76	$141,482.59	2026-03-01
1905	OTHER	New Technology - Level 51	44	20	—	—	$130,190.55	$168,653.76	$141,482.59	2026-03-01
003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	2	1	—	—	$119,887.93	$146,881.67	$133,384.80	2026-03-01
24	APR_DRG	Heart And/or Lung Transplant	31	14	—	—	$111,047.00	$178,746.99	$133,256.40	2026-03-01
806531	CDM	Insert/repos Of Leads Pa	61	20	$265,791.05	$265,791.05	$12,757.97	$292,370.15	$132,895.52	2026-03-01
01905	OTHER	New Technology - Level 51	2	1	—	—	$128,862.07	$133,879.59	$131,370.83	2026-03-01
01906	OTHER	New Technology - Level 51	2	1	—	—	$128,862.07	$133,879.59	$131,370.83	2026-03-01
1904	OTHER	New Technology - Level 50	44	20	—	—	$115,988.00	$150,255.24	$126,048.18	2026-03-01
1903	OTHER	New Technology - Level 50	44	20	—	—	$115,988.00	$150,255.24	$126,048.18	2026-03-01
A9699	HCPCS	Radiopharmaceutical, Therapeutic, Not Otherwise Classified	2	1	—	—	$123,321.96	$123,742.09	$123,532.02	2026-03-01
114	APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	31	14	—	—	$97,644.00	$178,865.04	$119,243.36	2026-03-01
460	MS_DRG	Spinal Fusion Except Cervical Without Mcc	6	2	—	—	$74,602.00	$118,877.00	$118,877.00	2026-03-01
459	MS_DRG	Spinal Fusion Except Cervical With Mcc	6	2	—	—	$93,485.00	$122,984.00	$118,877.00	2026-03-01
01903	OTHER	New Technology - Level 50	2	1	—	—	$114,804.45	$119,274.69	$117,039.57	2026-03-01
01904	OTHER	New Technology - Level 50	2	1	—	—	$114,804.45	$119,274.69	$117,039.57	2026-03-01
Q0480	HCPCS	Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only	46	20	—	—	$96,999.90	$133,803.60	$111,503.00	2026-03-01
1901	OTHER	New Technology - Level 49	44	20	—	—	$101,785.45	$131,856.72	$110,613.77	2026-03-01
1902	OTHER	New Technology - Level 49	44	20	—	—	$101,785.45	$131,856.72	$110,613.77	2026-03-01
816307	CDM	Aicd Insertion	61	20	$220,888.70	$220,888.70	$10,602.66	$242,977.55	$110,444.35	2026-03-01
5832	APR_DRG	Neonate With Ecmo	31	14	—	—	$91,071.80	$143,410.50	$109,286.16	2026-03-01
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	93	24	—	—	$2,837.00	$621,270.66	$108,436.71	2026-03-01
454	MS_DRG	Combined Anterior And Posterior Spinal Fusion With Cc	2	1	—	—	$105,575.00	$110,589.00	$108,082.00	2024-10-01
1614	APR_DRG	Implantable Heart Assist Systems	31	14	—	—	$88,926.10	$142,750.50	$106,711.32	2026-03-01
641826	CDM	Ins Icd Gen Only Sgl Ld	28	16	$220,888.70	$220,888.70	$10,602.66	$220,888.70	$104,922.13	2026-03-01
825819	CDM	Tavr/tavi Op Axl Art Apr	61	20	$209,095.45	$209,095.45	$10,036.58	$230,005.00	$104,547.73	2026-03-01
825813	CDM	Tavr/tavi Transaortic	61	20	$209,095.45	$209,095.45	$10,036.58	$230,005.00	$104,547.73	2026-03-01
825818	CDM	Tavr Pros Valve Faa	61	20	$209,095.45	$209,095.45	$10,036.58	$230,005.00	$104,547.73	2026-03-01
825814	CDM	Tavr/tavi/trans Exposure	61	20	$209,095.45	$209,095.45	$10,036.58	$230,005.00	$104,547.73	2026-03-01
825822	CDM	Tavr/tavi Opn Ili Art	61	20	$209,095.45	$209,095.45	$10,036.58	$230,005.00	$104,547.73	2026-03-01
825812	CDM	Tavr/tavi Perc Fem Aprch	61	20	$209,095.45	$209,095.45	$10,036.58	$230,005.00	$104,547.73	2026-03-01
01901	OTHER	New Technology - Level 49	2	1	—	—	$100,746.82	$104,669.69	$102,708.26	2026-03-01
01902	OTHER	New Technology - Level 49	2	1	—	—	$100,746.82	$104,669.69	$102,708.26	2026-03-01
7	MS_DRG	Lung Transplant	89	25	—	—	$2,837.00	$580,816.47	$101,458.77	2026-03-01
6304	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	31	14	—	—	$77,520.20	$137,205.00	$100,617.00	2026-03-01
Q2043	HCPCS	Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm…	4	2	—	—	$53,789.99	$147,108.87	$99,738.74	2026-03-01
004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	2	1	—	—	$84,296.07	$114,702.99	$99,499.53	2026-03-01
8414	APR_DRG	Extensive Third Degree Burns With Skin Graft	31	14	—	—	$79,102.08	$135,325.50	$99,238.70	2026-03-01
6094	APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	31	14	—	—	$82,446.00	$133,307.22	$98,935.20	2026-03-01
14	MS_DRG	Allogeneic Bone Marrow Transplant	89	25	—	—	$2,701.00	$576,059.67	$97,935.69	2026-03-01
5883	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	31	14	—	—	$81,552.00	$127,428.00	$97,862.40	2026-03-01
1599	OTHER	New Technology - Level 48	44	20	—	—	$89,949.97	$116,524.57	$97,751.75	2026-03-01
1585	OTHER	New Technology - Level 48	44	20	—	—	$89,949.97	$116,524.57	$97,751.75	2026-03-01
6314	APR_DRG	Neonate Birth Weight > 2499 Grams With Other Major Procedure	31	14	—	—	$80,942.00	$128,217.69	$97,130.40	2026-03-01
223	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…	3	1	—	—	$68,358.00	$96,349.00	$96,349.00	2024-10-01
222	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…	3	1	—	—	$68,358.00	$96,349.00	$96,349.00	2024-10-01
K1007	HCPCS	Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin…	46	20	—	—	$88,300.94	$114,097.20	$96,038.65	2026-03-01
5914	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	31	14	—	—	$79,657.00	$125,467.54	$95,588.40	2026-03-01
225	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh…	3	1	—	—	$66,124.00	$93,198.00	$93,198.00	2024-10-01
224	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh…	3	1	—	—	$66,124.00	$93,198.00	$93,198.00	2024-10-01
818438	CDM	Prc D-el Cor Stnt Ath Sl	59	19	$183,062.25	$183,062.25	$8,786.99	$197,707.25	$91,531.13	2026-03-01
818443	CDM	Prc D-el Cor Stnt Ath Ad	59	19	$183,062.25	$183,062.25	$8,786.99	$197,707.25	$91,531.13	2026-03-01
01585	OTHER	New Technology - Level 48	2	1	—	—	$89,032.11	$92,498.81	$90,765.46	2026-03-01
01599	OTHER	New Technology - Level 48	2	1	—	—	$89,032.11	$92,498.81	$90,765.46	2026-03-01
94	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	31	14	—	—	$75,232.00	$130,764.62	$90,278.40	2026-03-01
209	MS_DRG	Complex Aortic Arch Procedures	49	26	—	—	$2,968.00	$311,561.29	$89,697.77	2026-03-01
651	OTHER	Kidney Transplant With Hemodialysis Without Mcc	2	1	—	—	$76,277.63	$102,797.59	$89,537.61	2026-03-01
246	MS_DRG	Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar…	3	1	—	—	$63,181.00	$89,052.00	$89,052.00	2024-10-01
247	MS_DRG	Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc	3	1	—	—	$63,181.00	$89,052.00	$89,052.00	2024-10-01
227	MS_DRG	Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc	3	1	—	—	$62,687.00	$88,354.00	$88,354.00	2024-10-01
226	MS_DRG	Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc	3	1	—	—	$62,687.00	$88,354.00	$88,354.00	2024-10-01
5934	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	31	14	—	—	$73,540.00	$110,794.50	$88,248.00	2026-03-01
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	90	24	—	—	$2,837.00	$508,231.23	$87,731.55	2026-03-01
1584	OTHER	New Technology - Level 47	44	20	—	—	$80,481.61	$104,258.89	$87,462.16	2026-03-01
1598	OTHER	New Technology - Level 47	44	20	—	—	$80,481.61	$104,258.89	$87,462.16	2026-03-01
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	92	26	—	—	$2,837.00	$487,703.39	$86,011.44	2026-03-01
817829	CDM	Rem/repl Aicd Mult Ld	32	20	$171,976.35	$171,976.35	$8,254.86	$180,575.17	$85,988.18	2024-10-01
821299	CDM	Ins/repos Dual Icd+lead	32	20	$171,976.35	$171,976.35	$8,254.86	$180,575.17	$85,988.18	2024-10-01
5882	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	31	14	—	—	$71,560.00	$109,192.05	$85,872.00	2026-03-01
113	APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	31	14	—	—	$56,946.00	$133,113.71	$85,419.00	2026-03-01
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	92	26	—	—	$10,799.00	$494,300.82	$85,130.57	2026-03-01
215	MS_DRG	Other Heart Assist System Implant	92	26	—	—	$10,799.00	$465,837.57	$84,380.21	2026-03-01
74	APR_DRG	Allogeneic Bone Marrow Transplant	31	14	—	—	$70,159.56	$113,416.50	$84,191.47	2026-03-01
5831	APR_DRG	Neonate With Ecmo	31	14	—	—	$69,493.00	$122,622.00	$83,391.60	2026-03-01
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	89	25	—	—	$2,837.00	$468,229.59	$81,814.00	2026-03-01
01598	OTHER	New Technology - Level 47	2	1	—	—	$79,660.37	$82,762.15	$81,211.26	2026-03-01
01584	OTHER	New Technology - Level 47	2	1	—	—	$79,660.37	$82,762.15	$81,211.26	2026-03-01
640686	CDM	Ins/repl Sq Icd With Elec	28	16	$169,636.85	$169,636.85	$8,142.57	$169,636.85	$80,577.51	2026-03-01
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	84	25	—	—	$68,786.70	$201,355.44	$80,327.87	2026-03-01
44	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	31	14	—	—	$66,782.00	$100,494.24	$80,138.40	2026-03-01
14	APR_DRG	Liver Transplant And/or Intestinal Transplant	31	14	—	—	$66,329.56	$100,863.00	$79,595.47	2026-03-01
834413	CDM	Ins Perm Subq Defib	32	20	$157,071.15	$157,071.15	$7,539.42	$164,924.71	$78,535.57	2024-10-01
007	OTHER	Lung Transplant	2	1	—	—	$67,580.69	$88,157.09	$77,868.89	2026-03-01
1613	APR_DRG	Implantable Heart Assist Systems	31	14	—	—	$64,392.00	$104,446.96	$77,270.40	2026-03-01
1583	OTHER	New Technology - Level 46	44	20	—	—	$71,013.23	$91,993.21	$77,172.54	2026-03-01
1597	OTHER	New Technology - Level 46	44	20	—	—	$71,013.23	$91,993.21	$77,172.54	2026-03-01
014	OTHER	Allogeneic Bone Marrow Transplant	2	1	—	—	$75,250.33	$78,325.54	$76,787.93	2026-03-01
641817	CDM	Ptca Stent W Ath Sgl	28	16	$160,978.90	$160,978.90	$7,726.99	$160,978.90	$76,464.98	2026-03-01
641815	CDM	Ptca Stent W Ath Addl	28	16	$160,978.90	$160,978.90	$7,726.99	$160,978.90	$76,464.98	2026-03-01
0207	RC	—	24	11	—	—	$11,700.00	$75,519.50	$75,194.50	2026-03-01
23	APR_DRG	Heart And/or Lung Transplant	31	14	—	—	$62,352.00	$97,366.79	$74,822.40	2026-03-01
5881	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	31	14	—	—	$61,338.00	$93,593.57	$73,605.60	2026-03-01
638199	CDM	Ins Leadless Ppm Dual	28	16	$153,422.75	$153,422.75	$7,364.29	$153,422.75	$72,875.81	2026-03-01
002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	2	1	—	—	$67,458.10	$78,133.21	$72,795.65	2026-03-01
818675	CDM	Ptca Stent W Ath Sgl	67	22	$173,857.20	$173,857.20	$7,726.99	$173,857.20	$72,440.51	2026-03-01
818679	CDM	Ptca Stent W Ath Addl	67	22	$173,857.20	$173,857.20	$7,726.99	$173,857.20	$72,440.51	2026-03-01
01597	OTHER	New Technology - Level 46	2	1	—	—	$70,288.61	$73,025.48	$71,657.04	2026-03-01
01583	OTHER	New Technology - Level 46	2	1	—	—	$70,288.61	$73,025.48	$71,657.04	2026-03-01
231	MS_DRG	Coronary Bypass With Ptca With Mcc	88	25	—	—	$60,499.45	$378,081.02	$71,344.93	2026-03-01
818598	CDM	Ins/rep Spin Stim	61	20	$141,913.65	$141,913.65	$6,811.86	$156,105.00	$70,956.82	2026-03-01
5913	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	31	14	—	—	$59,125.00	$94,624.20	$70,950.00	2026-03-01
816911	CDM	Stent Fem Pop	61	20	$141,855.60	$141,855.60	$6,809.07	$156,041.15	$70,927.80	2026-03-01
816999	CDM	Stent Ather Fem Pop	61	20	$141,855.60	$141,855.60	$6,809.07	$156,041.15	$70,927.80	2026-03-01
112	APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	31	14	—	—	$48,895.00	$105,823.65	$70,549.10	2026-03-01
811668	CDM	Cth Plc/inj R&lhc/grafts	59	19	$140,585.70	$140,585.70	$6,748.11	$151,832.55	$70,292.85	2026-03-01
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	92	26	—	—	$10,799.00	$404,080.56	$70,251.33	2026-03-01
850	MS_DRG	Acute Leukemia With Other Procedures	96	26	—	—	$2,837.00	$405,030.07	$69,651.17	2026-03-01
L8702	HCPCS	Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge…	46	20	—	—	$63,895.55	$82,562.04	$69,494.64	2026-03-01
6034	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	31	14	—	—	$40,520.04	$102,481.50	$68,321.00	2026-03-01
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	86	25	—	—	$13,318.00	$376,892.49	$67,638.47	2026-03-01
1582	OTHER	New Technology - Level 45	44	20	—	—	$61,544.86	$79,727.53	$66,882.93	2026-03-01
1596	OTHER	New Technology - Level 45	44	20	—	—	$61,544.86	$79,727.53	$66,882.93	2026-03-01
6024	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	31	14	—	—	$54,849.00	$83,100.26	$65,818.80	2026-03-01
717	OTHER	Instill Adstiladrin, Tx D	46	20	—	—	$12,654.78	$77,129.75	$65,560.29	2026-03-01
5244	OTHER	Level 4 Blood Product Exc	44	20	—	—	$49,298.17	$78,823.57	$65,029.44	2026-03-01
005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	2	1	—	—	$55,450.54	$74,457.71	$64,954.12	2026-03-01
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	88	25	—	—	$55,869.29	$177,434.00	$64,822.28	2026-03-01
1643	OTHER	Y90 Ibritumomab, Rx	44	20	—	—	$55,688.06	$78,571.90	$64,757.64	2026-03-01
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	92	26	—	—	$10,799.00	$354,428.25	$64,486.87	2026-03-01
641805	CDM	Revsc Fem/pop W Stnt/ath	29	17	$141,855.60	$141,855.60	$6,809.07	$141,855.60	$63,835.02	2026-03-01
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	86	25	—	—	$13,318.00	$177,444.00	$63,759.81	2026-03-01
811680	CDM	Stent Fem Pop	61	20	$126,740.10	$126,740.10	$6,083.52	$139,414.10	$63,370.05	2026-03-01
811681	CDM	Stent Ather Fem Pop	61	20	$126,740.10	$126,740.10	$6,083.52	$139,414.10	$63,370.05	2026-03-01
J9600	HCPCS	Injection, Porfimer Sodium, 75 Mg	2	1	—	—	$62,320.47	$64,205.31	$63,262.89	2026-03-01
811667	CDM	Cth Plc/inj R&lhc/l Vent	59	19	$126,183.80	$126,183.80	$6,056.82	$136,278.50	$63,091.90	2026-03-01
811666	CDM	Cth Plc/inj Lhc W Graft	59	19	$125,605.25	$125,605.25	$6,029.05	$135,653.65	$62,802.63	2026-03-01
429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	1	1	—	—	$62,121.81	$62,121.81	$62,121.81	2026-03-01
01582	OTHER	New Technology - Level 45	2	1	—	—	$60,916.85	$63,288.81	$62,102.83	2026-03-01
01596	OTHER	New Technology - Level 45	2	1	—	—	$60,916.85	$63,288.81	$62,102.83	2026-03-01
817750	CDM	Rem/repl Aicd Sing Ld	32	20	$123,934.75	$123,934.75	$5,948.87	$130,131.49	$61,967.38	2024-10-01
817819	CDM	Rem/repl Aicd Dual Ld	61	20	$123,934.75	$123,934.75	$5,948.87	$136,328.25	$61,967.38	2026-03-01
00717	OTHER	Instill Adstiladrin, Tx D	2	1	—	—	$61,454.13	$62,346.55	$61,900.34	2026-03-01
J9029	HCPCS	Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose	10	3	—	—	$61,338.53	$170,328.19	$61,600.24	2026-03-01
1612	APR_DRG	Implantable Heart Assist Systems	31	14	—	—	$51,234.90	$77,532.00	$61,481.88	2026-03-01
5933	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	31	14	—	—	$51,226.00	$80,695.10	$61,471.20	2026-03-01
93640	CPT	Aicd Lead Test Init	110	26	$211,684.90	$211,684.90	$242.10	$228,617.55	$61,388.62	2026-03-01
1604	APR_DRG	Major Cardiothoracic Repair Of Heart Anomaly	31	14	—	—	$51,048.39	$83,284.50	$61,258.07	2026-03-01
249	MS_DRG	Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc	3	1	—	—	$42,484.00	$59,879.00	$59,879.00	2024-10-01
248	MS_DRG	Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4…	3	1	—	—	$42,484.00	$59,879.00	$59,879.00	2024-10-01
10	MS_DRG	Pancreas Transplant	89	25	—	—	$2,837.00	$350,563.19	$59,806.97	2026-03-01
817001	CDM	Stent Ather Tibperoneal	61	20	$119,067.35	$119,067.35	$5,715.23	$130,974.10	$59,533.68	2026-03-01
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	96	26	—	—	$2,837.00	$341,752.52	$59,521.15	2026-03-01
020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	2	1	—	—	$57,539.16	$61,406.22	$59,472.69	2026-03-01
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	91	26	—	—	$2,837.00	$348,544.93	$59,471.57	2026-03-01
5893	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational	31	14	—	—	$46,525.00	$89,188.07	$59,458.71	2026-03-01
5891	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational	31	14	—	—	$48,983.00	$89,188.07	$59,458.71	2026-03-01
5892	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational	31	14	—	—	$47,538.00	$89,188.07	$59,458.71	2026-03-01
01643	OTHER	Y90 Ibritumomab, Rx	2	1	—	—	$55,119.81	$63,512.28	$59,316.04	2026-03-01
1611	APR_DRG	Implantable Heart Assist Systems	31	14	—	—	$49,247.00	$76,852.35	$59,096.40	2026-03-01
641799	CDM	Revsc Tib/per Stnt Addl	29	17	$130,420.25	$130,420.25	$6,260.17	$130,420.25	$58,689.11	2026-03-01
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	86	25	—	—	$13,318.00	$319,798.44	$58,331.49	2026-03-01
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	91	26	—	—	$10,799.00	$323,754.21	$58,161.00	2026-03-01
638694	CDM	Ins Leadless Ppm Atrial	28	16	$121,685.15	$121,685.15	$5,840.89	$121,685.15	$57,800.44	2026-03-01
921340	CDM	Ins/rep Ccm System	32	20	$115,378.55	$115,378.55	$5,538.17	$121,147.48	$57,689.28	2024-10-01
817682	CDM	Insrt Aicd Only Mult Ld	61	20	$115,378.55	$115,378.55	$5,538.17	$126,916.40	$57,689.28	2026-03-01
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	90	25	—	—	$13,318.00	$177,434.00	$57,376.78	2026-03-01
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	2	1	—	—	$49,806.62	$64,759.94	$57,283.28	2026-03-01
1581	OTHER	New Technology - Level 44	44	20	—	—	$52,076.49	$67,461.85	$56,593.33	2026-03-01
1595	OTHER	New Technology - Level 44	44	20	—	—	$52,076.49	$67,461.85	$56,593.33	2026-03-01
9273	OTHER	Sipuleucel-t Auto Cd54+	44	20	—	—	$53,316.03	$66,018.28	$56,115.53	2026-03-01
05244	OTHER	Level 4 Blood Product Exc	2	1	—	—	$48,795.12	$62,571.25	$55,683.18	2026-03-01
811665	CDM	Cth Plc/inj Lhc & L Vent	59	19	$111,202.00	$111,202.00	$5,337.70	$120,098.15	$55,601.00	2026-03-01
423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	2	1	—	—	$41,091.81	$69,779.65	$55,435.73	2026-03-01
453	OTHER	Combined Anterior And Posterior Spinal Fusion With Mcc	1	1	—	—	$55,323.98	$55,323.98	$55,323.98	2024-10-01
641827	CDM	Ins Icd Gen Only Mult Ld	28	16	$115,378.55	$115,378.55	$5,538.17	$115,378.55	$54,804.82	2026-03-01
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	86	25	—	—	$13,318.00	$201,355.44	$54,779.74	2026-03-01
B0404	HCPCS	Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5	10	4	—	—	$44,083.60	$57,517.55	$54,497.40	2026-03-01
22	APR_DRG	Heart And/or Lung Transplant	31	14	—	—	$45,376.00	$73,729.74	$54,451.20	2026-03-01
816277	CDM	Insrt Lv Lead New Aicd	32	20	$108,877.55	$108,877.55	$5,226.12	$114,321.43	$54,438.78	2024-10-01
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	93	24	—	—	$2,837.00	$321,695.59	$54,221.33	2026-03-01
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	86	25	—	—	$13,318.00	$201,355.44	$54,141.28	2026-03-01
5912	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	31	14	—	—	$44,835.00	$81,160.27	$54,106.85	2026-03-01
816290	CDM	Insert/replace Aicd	32	20	$107,885.35	$107,885.35	$5,178.50	$113,279.62	$53,942.68	2024-10-01
B0505	HCPCS	Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2	10	4	—	—	$43,630.84	$56,570.54	$53,767.37	2026-03-01
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	89	25	—	—	$13,318.00	$164,024.96	$53,741.64	2026-03-01
641804	CDM	Revsc Tib/per St/ath Ini	29	17	$119,067.35	$119,067.35	$5,715.23	$119,067.35	$53,580.31	2026-03-01
955	MS_DRG	Craniotomy For Multiple Significant Trauma	96	26	—	—	$2,837.00	$301,889.83	$53,504.67	2026-03-01
64	APR_DRG	Pancreas Transplant	31	14	—	—	$43,326.23	$72,558.00	$53,209.20	2026-03-01
811688	CDM	Stent Ather Tibperoneal	61	20	$106,382.85	$106,382.85	$5,106.38	$117,021.15	$53,191.43	2026-03-01
8424	APR_DRG	Burns With Skin Graft Except Extensive Third Degree Burns	31	14	—	—	$44,285.71	$69,304.50	$53,142.85	2026-03-01
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	91	26	—	—	$10,799.00	$92,215.00	$53,136.77	2026-03-01
09273	OTHER	Sipuleucel-t Auto Cd54+	2	1	—	—	$52,771.99	$53,364.77	$53,068.38	2026-03-01
01581	OTHER	New Technology - Level 44	2	1	—	—	$51,545.10	$53,552.15	$52,548.62	2026-03-01
01595	OTHER	New Technology - Level 44	2	1	—	—	$51,545.10	$53,552.15	$52,548.62	2026-03-01
54	APR_DRG	Tracheostomy With Mv >96 Hours Without Extensive Procedure	31	14	—	—	$43,560.00	$70,007.73	$52,272.00	2026-03-01
317	MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	96	26	—	—	$2,837.00	$299,889.52	$52,204.00	2026-03-01
955	OTHER	Craniotomy For Multiple Significant Trauma	2	1	—	—	$41,867.79	$62,431.63	$52,149.71	2026-03-01
816912	CDM	Iliac Stent Additional	61	20	$103,420.25	$103,420.25	$4,964.17	$113,762.30	$51,710.13	2026-03-01
816913	CDM	Iliac Stent Initial	61	20	$103,420.25	$103,420.25	$4,964.17	$113,762.30	$51,710.13	2026-03-01
817000	CDM	Atherectomy Tibia	61	20	$103,420.25	$103,420.25	$4,964.17	$113,762.30	$51,710.13	2026-03-01
817003	CDM	Stent Ather Tibperon Add	61	20	$103,420.25	$103,420.25	$4,964.17	$113,762.30	$51,710.13	2026-03-01
816908	CDM	Stent Tibioperoneal	61	20	$103,420.25	$103,420.25	$4,964.17	$113,762.30	$51,710.13	2026-03-01
816910	CDM	Stent Tibioperoneal Add	61	20	$103,420.25	$103,420.25	$4,964.17	$113,762.30	$51,710.13	2026-03-01
8514	APR_DRG	Gender Related Procedures	31	14	—	—	$40,865.02	$70,353.00	$51,592.20	2026-03-01
231	OTHER	Coronary Bypass With Ptca With Mcc	2	1	—	—	$44,710.16	$58,124.54	$51,417.35	2026-03-01
6303	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	31	14	—	—	$42,730.78	$65,515.50	$51,276.94	2026-03-01
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	88	26	—	—	$10,799.00	$247,513.79	$50,783.67	2026-03-01
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	92	26	—	—	$10,799.00	$271,907.61	$50,723.55	2026-03-01
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	96	26	—	—	$2,701.00	$288,596.30	$50,590.93	2026-03-01
447	OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	1	1	—	—	$50,527.58	$50,527.58	$50,527.58	2026-03-01
806141	CDM	Ins Icd/lead Sgl	32	20	$100,913.65	$100,913.65	$4,843.86	$105,959.33	$50,456.82	2024-10-01
6074	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	31	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	31	14	—	—	$41,957.00	$64,905.25	$50,348.40	2026-03-01
28	MS_DRG	Spinal Procedures With Mcc	92	26	—	—	$10,799.00	$269,472.26	$50,280.44	2026-03-01
43	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	31	14	—	—	$41,876.00	$69,298.37	$50,251.20	2026-03-01
L7181	HCPCS	Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi…	46	20	—	—	$46,068.21	$59,526.48	$50,105.12	2026-03-01
21	APR_DRG	Heart And/or Lung Transplant	31	14	—	—	$41,730.00	$65,165.07	$50,076.00	2026-03-01
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	91	26	—	—	$11,736.00	$293,830.29	$49,877.35	2026-03-01
817196	CDM	Iliac Artery Atherectomy	61	20	$99,651.85	$99,651.85	$4,783.29	$109,617.05	$49,825.93	2026-03-01
B0106	HCPCS	Stroke; M > 30.05 & M < 34.25	10	4	—	—	$40,030.18	$53,865.21	$49,537.35	2026-03-01
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	91	26	—	—	$10,799.00	$272,356.37	$49,491.91	2026-03-01
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	2	1	—	—	$49,151.06	$49,529.65	$49,340.35	2026-03-01
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	92	26	—	—	$10,799.00	$177,434.00	$49,140.42	2026-03-01
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	88	26	—	—	$10,799.00	$267,445.03	$48,840.08	2026-03-01
958870	CDM	Kit Aor Vlv 14fr 29mm	48	19	$97,500.00	$97,500.00	$4,680.00	$102,375.00	$48,750.00	2026-03-01
C1604	HCPCS	System Graft Stent Case	17	13	$75,000.00	$75,000.00	$15,450.00	$75,000.00	$48,750.00	2026-03-01
837208	CDM	Valve Heart Trnscth 23mm	48	19	$97,500.00	$97,500.00	$4,680.00	$102,375.00	$48,750.00	2026-03-01
504635	CDM	Valve Heart Trnscth 20mm	48	19	$97,500.00	$97,500.00	$4,680.00	$102,375.00	$48,750.00	2026-03-01
837209	CDM	Valve Heart Trnscth 26mm	48	19	$97,500.00	$97,500.00	$4,680.00	$102,375.00	$48,750.00	2026-03-01
521250	CDM	Valve Aor 23mm	48	19	$97,500.00	$97,500.00	$4,680.00	$102,375.00	$48,750.00	2026-03-01
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	96	26	—	—	$2,837.00	$278,068.21	$48,721.55	2026-03-01
133	MS_DRG	Other Ear, Nose, Mouth & Throat O.r. Procedures W Cc/mcc	3	1	—	—	$20,167.00	$48,710.00	$48,710.00	2024-10-01
93	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	31	14	—	—	$32,422.00	$87,882.00	$48,633.00	2026-03-01
837680	CDM	Valve Tavor Aor 26mm	27	19	$97,200.00	$97,200.00	$4,665.60	$102,060.00	$48,600.00	2024-10-01
837409	CDM	Valve Tavor Aor 34mm	27	19	$97,200.00	$97,200.00	$4,665.60	$102,060.00	$48,600.00	2024-10-01
836938	CDM	Valve Tavor Aor 29mm	27	19	$97,200.00	$97,200.00	$4,665.60	$102,060.00	$48,600.00	2024-10-01
837679	CDM	Valve Tavor Aor 23mm	27	19	$97,200.00	$97,200.00	$4,665.60	$102,060.00	$48,600.00	2024-10-01
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	92	26	—	—	$10,799.00	$269,836.84	$48,584.36	2026-03-01
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	92	26	—	—	$10,799.00	$257,003.95	$48,011.83	2026-03-01
834588	CDM	Implnt Spinal Neuroel	61	20	$95,915.70	$95,915.70	$4,603.95	$105,507.25	$47,957.85	2026-03-01
360	OTHER	Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc	1	1	—	—	$47,776.40	$47,776.40	$47,776.40	2026-03-01
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	2	1	—	—	$42,827.53	$52,649.51	$47,738.52	2026-03-01
816672	CDM	Per Cl Con Int Com W/imp	59	19	$95,401.40	$95,401.40	$4,579.27	$103,033.50	$47,700.70	2026-03-01
834400	CDM	Closure Lt Atr Appendage	32	20	$95,338.40	$95,338.40	$4,576.24	$100,105.32	$47,669.20	2024-10-01
824556	CDM	Closure Lt Atr Appendage	61	20	$95,338.40	$95,338.40	$4,576.24	$104,872.25	$47,669.20	2026-03-01
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	89	25	—	—	$2,701.00	$310,551.08	$47,330.24	2026-03-01
535829	CDM	Valve Tavr 29mm	48	19	$94,500.00	$94,500.00	$4,176.00	$99,225.00	$47,250.00	2026-03-01

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