Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

HCA FLORIDA PUTNAM HOSPITAL

Palatka, FL · CCN 100232 · Rates published

24,993 distinct procedures filed
40 distinct payers
956,277 rate rows
2026-07-31 last MRF observed
Data quality

904,381 of 956,277 rate rows are consumer-grade (94.6%)

51,896 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
per-diem day rate — not a per-procedure price 16,733
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 14,453
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 14,318
exceeds 10× this hospital's gross charge — excluded from medians 3,457
template filing: same amount across many unrelated codes — excluded 2,091
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 321
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 283
placeholder amount (≤ $0.02) — excluded from medians 186
percent-of-charges filed in the dollar field — excluded from medians 54
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/47-2762362_HCA-FLORIDA-PUTNAM-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 viaCMS hospital list
Last fetch not_modified · 2026-08-11
Content fingerprint 8f10217f368fa818… · 237,563,267 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
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $4,850,948.67 $4,897,200.00 $4,874,074.33 nat. median
$2,997,086
1.6× median
845
OTHER 		Inj, Atidarsagene Autotem 17 $4,764.90 $4,955,500.00 $4,606,362.50 nat. median
$16,015
outlier · 287.6×
00845
OTHER 		Inj, Atidarsagene Autotem 1 $4,369,850.00 $4,369,850.00 $4,369,850.00 nat. median
$4,414,900
1.0× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 $3,884,946.48 $4,271,819.03 $4,078,382.75 nat. median
$2,460,273
1.7× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 19 $3,672,900.00 $4,422,320.40 $3,863,037.67 nat. median
$3,758,972
1.0× median
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 1 $3,847,800.00 $3,847,800.00 $3,847,800.00 nat. median
$2,405,851
1.6× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 17 $3,605,000.00 $4,326,000.00 $3,740,187.50 nat. median
$3,646,097
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
$3,574,709
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 19 $9,697.57 $4,002,984.00 $3,460,913.25 nat. median
$29,683
outlier · 116.6×
714
OTHER 		Inj Delandistrogene Mox R 19 $5,280.60 $3,993,432.00 $3,451,392.12 nat. median
$3,325,455
1.0× median
748
OTHER 		Inj, Lovotibeglogene Auto 19 $8,710.34 $3,943,200.00 $3,391,641.70 nat. median
$3,252,508
1.0× median
906
OTHER 		Inj Elivaldogene Autoteme 19 $6,354.69 $3,816,000.00 $3,299,250.00 nat. median
$24,604
outlier · 134.1×
00908
OTHER 		Topi Adm Prad Zami Per Tr 1 $3,235,745.40 $3,235,745.40 $3,235,745.40 nat. median
$14,170
outlier · 228.4×
00714
OTHER 		Inj Delandistrogene Mox R 1 $3,225,691.35 $3,228,024.20 $3,226,857.78 nat. median
$3,228,024
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 nat. median
$3,084,600
1.0× median
746
OTHER 		Inj, Betibeglogene Autote 19 $7,736.51 $3,561,600.00 $3,064,583.73 nat. median
$2,939,969
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 19 $2,388,614.00 $3,106,777.20 $2,627,475.40 nat. median
$2,588,981
1.0× median
824
OTHER 		Inj, Exagamglogene Autote 19 $13,699.09 $2,798,400.00 $2,419,450.00 nat. median
$58,186
outlier · 41.6×
09141
OTHER 		Inj Onase Abepar-xioi Tre 1 $2,316,955.58 $2,511,311.57 $2,414,133.58 nat. median
$2,511,312
1.0× median
00824
OTHER 		Inj, Exagamglogene Autote 1 $2,262,040.00 $2,262,040.00 $2,262,040.00 nat. median
$2,285,360
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 1 $1,271,523.00 $1,271,523.00 $1,271,523.00 nat. median
$809,151
1.6× median
2067
OTHER 		Afamitresgene Autoleucel 19 $770,620.00 $924,744.00 $809,151.00 nat. median
$786,032
1.0× median
9498
OTHER 		Ciltacabtagene Car-pos T 19 $527,123.40 $705,179.52 $587,649.60 nat. median
$587,650
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos 19 $529,192.90 $679,837.56 $577,861.93 nat. median
$576,820
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 19 $526,587.60 $669,698.16 $569,243.44 nat. median
$560,872
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 19 $516,726.10 $674,641.44 $568,398.71 nat. median
$562,201
1.0× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 3 $502,693.77 $934,776.65 $561,407.87 nat. median
$691,418
0.8× median
09498
OTHER 		Ciltacabtagene Car-pos T 1 $511,309.70 $570,020.11 $540,664.91 nat. median
$570,020
0.9× median
9035
OTHER 		Axicabtagene Ciloleucel C 19 $489,456.00 $638,630.64 $538,401.60 nat. median
$533,230
1.0× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 3 $492,271.12 $969,621.79 $536,573.93 nat. median
$631,793
0.8× median
09194
OTHER 		Tisagenlecleucel Car-pos 1 $513,317.11 $549,535.36 $531,426.23 nat. median
$549,535
1.0× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $510,789.97 $541,339.35 $526,064.66 nat. median
$541,339
1.0× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $501,224.32 $545,335.16 $523,279.74 nat. median
$545,335
1.0× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 3 $459,839.17 $927,632.05 $500,948.74 nat. median
$624,417
0.8× median
9391
OTHER 		Brexucabtagene Car Pos T 19 $460,530.40 $587,340.24 $499,239.20 nat. median
$492,768
1.0× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $474,772.32 $516,226.43 $495,499.38 nat. median
$516,226
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 3 $445,599.57 $878,117.20 $487,755.77 nat. median
$588,565
0.8× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 3 $435,956.80 $807,592.83 $474,717.03 nat. median
$577,541
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 3 $470,149.30 $920,834.85 $470,149.30 nat. median
$610,161
0.8× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $446,714.49 $474,766.69 $460,740.59 nat. median
$474,767
1.0× median
Q2058
HCPCS 		Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,… 1 $459,112.50 $459,112.50 $459,112.50 nat. median
$302,242
1.5× median
J3402
HCPCS 		Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 $332,753.88 $332,753.88 $332,753.88 nat. median
$209,736
1.6× median
831
OTHER 		Obecbtge Autol Up To 400 19 $2,930.91 $333,900.00 $288,684.38 nat. median
$20,175
outlier · 14.3×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 25 $2,701.00 $1,893,263.50 $287,178.57 nat. median
$370,165
0.8× median
897
OTHER 		Revakinagene, Per Implant 19 $265,000.00 $318,000.00 $278,250.00 nat. median
$19,528
outlier · 14.2×
00831
OTHER 		Obecbtge Autol Up To 400 1 $269,902.50 $269,902.50 $269,902.50 nat. median
$272,685
1.0× median
00897
OTHER 		Revakinagene, Per Implant 1 $257,050.00 $257,050.00 $257,050.00 nat. median
$259,700
1.0× median

Other procedures at this hospital

Browse this hospital's 24,993 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
0207 RC — 23 10 — — $11,700.00 $55,706.00 $55,381.00 2026-03-01
834 OTHER Acute Leukemia With Mcc 2 1 — — $42,052.24 $42,984.04 $42,518.14 2026-03-01
834 MS_DRG Acute Leukemia With Mcc 94 26 — — $2,701.00 $240,693.69 $41,609.91 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 94 26 — — $2,837.00 $395,929.31 $69,084.32 2026-03-01
2067 OTHER Afamitresgene Autoleucel 22 19 — — $770,620.00 $924,744.00 $809,151.00 2026-03-01
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 1 1 — — $1,271,523.00 $1,271,523.00 $1,271,523.00 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 89 26 — — $2,701.00 $563,115.98 $97,470.91 2026-03-01
74 APR_DRG Allogeneic Bone Marrow Transplant 25 11 — — $70,159.56 $113,416.50 $84,191.47 2026-03-01
014 OTHER Allogeneic Bone Marrow Transplant 2 1 — — $75,250.33 $78,325.54 $76,787.93 2026-03-01
73 APR_DRG Allogeneic Bone Marrow Transplant 25 11 — — $36,953.00 $66,933.09 $48,038.90 2026-03-01
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 2 1 — — $23,705.88 $67,396.82 $45,551.35 2026-03-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 86 26 — — $10,799.00 $177,434.00 $53,839.54 2026-03-01
84 APR_DRG Autologous Bone Marrow Transplant 25 11 — — $31,204.86 $56,214.00 $40,566.32 2026-03-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 89 26 — — $2,701.00 $308,644.41 $47,139.89 2026-03-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 89 26 — — $2,701.00 $308,644.41 $45,001.17 2026-03-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 2 1 — — $120,116.70 $138,148.31 $129,132.51 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 42 19 — — $489,456.00 $638,630.64 $538,401.60 2026-03-01
09035 OTHER Axicabtagene Ciloleucel C 2 1 — — $474,772.32 $516,226.43 $495,499.38 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 10 3 — — $445,599.57 $878,117.20 $487,755.77 2026-03-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 90 26 — — $10,799.00 $263,773.78 $46,683.35 2026-03-01
C9782 HCPCS Blinded Procedure For New York Heart Association (nyha) Class Ii Or Iii Heart Fa… 2 1 — — $47,446.00 $50,174.00 $48,810.00 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 10 3 — — $435,956.80 $807,592.83 $474,717.03 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 42 19 — — $460,530.40 $587,340.24 $499,239.20 2026-03-01
09391 OTHER Brexucabtagene Car Pos T 2 1 — — $446,714.49 $474,766.69 $460,740.59 2026-03-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 25 11 — — $44,285.71 $69,304.50 $53,142.85 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 90 26 — — $10,799.00 $312,618.13 $57,604.39 2026-03-01
275 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 1 — — $25,874.40 $57,936.96 $41,905.68 2026-03-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 3 1 — — $71,038.00 $87,168.00 $87,168.00 2024-10-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 3 1 — — $71,038.00 $87,168.00 $87,168.00 2024-10-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 3 1 — — $69,717.00 $85,547.00 $85,547.00 2024-10-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 3 1 — — $69,717.00 $85,547.00 $85,547.00 2024-10-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 89 26 — — $9,905.00 $266,236.70 $48,710.88 2026-03-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 3 1 — — $65,187.00 $79,989.00 $79,989.00 2024-10-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 3 1 — — $65,187.00 $79,989.00 $79,989.00 2024-10-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 90 26 — — $10,799.00 $200,119.19 $78,965.64 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
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 90 26 — — $10,799.00 $200,119.19 $54,844.61 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 90 26 — — $10,799.00 $200,119.19 $54,639.18 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
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 86 26 — — $10,799.00 $177,444.00 $62,736.05 2026-03-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 86 26 — — $10,799.00 $177,444.00 $43,583.18 2026-03-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 86 26 — — $10,799.00 $177,444.00 $41,256.68 2026-03-01
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $37,949.46 $42,569.09 $40,259.27 2026-03-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 25 11 — — $34,306.45 $56,856.00 $41,694.40 2026-03-01
471 MS_DRG Cervical Spinal Fusion With Mcc 89 26 — — $10,799.00 $93,302.00 $39,389.23 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 87 25 — — $2,701.00 $1,893,263.50 $287,178.57 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
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 25 11 — — $97,644.00 $178,865.04 $126,937.20 2026-03-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 25 11 — — $56,946.00 $133,113.71 $88,742.47 2026-03-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 25 11 — — $48,895.00 $105,823.65 $70,549.10 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 10 3 — — $492,271.12 $969,621.79 $536,573.93 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 42 19 — — $527,123.40 $705,179.52 $587,649.60 2026-03-01
09498 OTHER Ciltacabtagene Car-pos T 2 1 — — $511,309.70 $570,020.11 $540,664.91 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 90 26 — — $9,905.00 $395,007.89 $69,057.29 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
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 89 26 — — $9,905.00 $252,846.97 $46,373.87 2026-03-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 2 1 — — $80,323.00 $102,075.00 $91,199.00 2024-10-01
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $55,323.98 $55,323.98 $55,323.98 2024-10-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 2 1 — — $112,982.00 $143,579.00 $128,280.50 2024-10-01
209 MS_DRG Complex Aortic Arch Procedures 48 26 — — $2,968.00 $309,648.41 $89,894.34 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 94 26 — — $2,837.00 $476,753.17 $86,408.29 2026-03-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 94 26 — — $2,837.00 $293,156.22 $50,686.64 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 86 26 — — $10,799.00 $177,434.00 $63,349.25 2026-03-01
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 1 — — $37,379.15 $51,959.39 $44,669.27 2026-03-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 86 26 — — $10,799.00 $177,434.00 $44,616.04 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 90 26 — — $10,799.00 $369,592.11 $69,821.50 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
232 MS_DRG Coronary Bypass With Ptca Without Mcc 90 26 — — $10,799.00 $265,802.57 $50,383.89 2026-03-01
232 OTHER Coronary Bypass With Ptca Without Mcc 2 1 — — $37,952.93 $41,801.95 $39,877.44 2026-03-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 86 26 — — $10,799.00 $177,434.00 $47,998.52 2026-03-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 94 26 — — $2,837.00 $295,111.62 $52,734.83 2026-03-01
955 OTHER Craniotomy For Multiple Significant Trauma 2 1 — — $41,867.79 $62,431.63 $52,149.71 2026-03-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 90 26 — — $10,799.00 $251,233.54 $47,470.40 2026-03-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 25 11 — — $34,140.79 $59,817.00 $43,865.80 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 91 24 — — $2,837.00 $930,576.44 $165,134.01 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
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 48 26 — — $2,968.00 $177,434.00 $45,901.95 2026-03-01
213 OTHER Endovascular Abdominal Aorta With Iliac Branch Procedures 1 1 — — $39,349.54 $39,349.54 $39,349.54 2026-03-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 90 26 — — $10,799.00 $245,994.14 $51,158.48 2026-03-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 90 26 — — $10,799.00 $184,706.26 $39,878.23 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 91 24 — — $2,837.00 $1,019,677.11 $170,139.22 2026-03-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 25 11 — — $79,102.08 $135,325.50 $99,238.70 2026-03-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 25 11 — — $75,232.00 $130,764.62 $95,894.05 2026-03-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 25 11 — — $32,422.00 $87,882.00 $58,588.00 2026-03-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 59 20 — — $24,177.00 $136,409.34 $46,884.41 2026-03-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 91 24 — — $2,837.00 $314,472.69 $52,068.22 2026-03-01
8514 APR_DRG Gender Related Procedures 25 11 — — $40,865.02 $70,353.00 $51,592.20 2026-03-01
8513 APR_DRG Gender Related Procedures 25 11 — — $13,656.00 $61,297.53 $40,865.02 2026-03-01
24 APR_DRG Heart And/or Lung Transplant 25 11 — — $111,047.00 $178,746.99 $133,256.40 2026-03-01
23 APR_DRG Heart And/or Lung Transplant 25 11 — — $62,352.00 $97,366.79 $74,822.40 2026-03-01
22 APR_DRG Heart And/or Lung Transplant 25 11 — — $45,376.00 $73,729.74 $54,451.20 2026-03-01
21 APR_DRG Heart And/or Lung Transplant 25 11 — — $41,730.00 $65,165.07 $50,076.00 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 90 25 — — $2,837.00 $1,228,651.85 $213,486.17 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
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 90 25 — — $2,837.00 $496,820.11 $87,639.21 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
0888T CPT Histotripsy (ie, Non-thermal Ablation Via Acoustic Energy Delivery) Of Malignant… 2 1 — — $39,376.13 $39,376.13 $39,376.13 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 10 3 — — $43,241.44 $72,861.11 $43,855.64 2026-03-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 94 26 — — $2,837.00 $271,820.19 $48,884.79 2026-03-01
969 OTHER HIV With Extensive O.r. Procedures With Mcc 2 1 — — $37,864.09 $42,206.33 $40,035.21 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 42 19 — — $526,587.60 $669,698.16 $569,243.44 2026-03-01
09422 OTHER Idecabtagene Vicleucel Ca 2 1 — — $510,789.97 $541,339.35 $526,064.66 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 7 3 — — $470,149.30 $920,834.85 $470,149.30 2026-03-01
1614 APR_DRG Implantable Heart Assist Systems 25 11 — — $88,926.10 $142,750.50 $106,711.32 2026-03-01
1613 APR_DRG Implantable Heart Assist Systems 25 11 — — $64,392.00 $104,446.96 $77,270.40 2026-03-01
1612 APR_DRG Implantable Heart Assist Systems 25 11 — — $51,234.90 $77,532.00 $61,481.88 2026-03-01
1611 APR_DRG Implantable Heart Assist Systems 25 11 — — $49,247.00 $76,852.35 $59,096.40 2026-03-01
0266T CPT Implantation Or Replacement Of Carotid Sinus Baroreflex Activation Device; Total… 1 1 — — $47,446.00 $47,446.00 $47,446.00 2024-10-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 94 26 — — $2,837.00 $216,523.04 $38,844.75 2026-03-01
714 OTHER Inj Delandistrogene Mox R 44 19 — — $5,280.60 $3,993,432.00 $3,451,392.12 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
906 OTHER Inj Elivaldogene Autoteme 24 19 — — $6,354.69 $3,816,000.00 $3,299,250.00 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
9141 OTHER Inj Onase Abepar-xioi Tre 42 19 — — $2,388,614.00 $3,106,777.20 $2,627,475.40 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
845 OTHER Inj, Atidarsagene Autotem 22 17 — — $4,764.90 $4,955,500.00 $4,606,362.50 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
773 OTHER Inj, Beqvez, Per Tx Dose 20 17 — — $3,605,000.00 $4,326,000.00 $3,740,187.50 2024-10-01
00773 OTHER Inj, Beqvez, Per Tx Dose 1 1 — — $3,496,850.00 $3,496,850.00 $3,496,850.00 2024-10-01
746 OTHER Inj, Betibeglogene Autote 44 19 — — $7,736.51 $3,561,600.00 $3,064,583.73 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
824 OTHER Inj, Exagamglogene Autote 24 19 — — $13,699.09 $2,798,400.00 $2,419,450.00 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
9138 OTHER Inj, Hemgenix, Per Tx Dos 42 19 — — $3,672,900.00 $4,422,320.40 $3,863,037.67 2026-03-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 2 1 — — $3,562,713.00 $3,574,708.99 $3,568,711.00 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 44 19 — — $8,710.34 $3,943,200.00 $3,391,641.70 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
886 OTHER Inj. Remestemcel-l-rknd/ 24 19 — — $5,526.79 $242,002.80 $209,231.59 2026-03-01
00886 OTHER Inj. Remestemcel-l-rknd/ 1 1 — — $195,618.93 $195,618.93 $195,618.93 2026-03-01
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 2 1 — — $4,850,948.67 $4,897,200.00 $4,874,074.33 2026-03-01
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 1 1 — — $3,847,800.00 $3,847,800.00 $3,847,800.00 2026-03-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 2 1 — — $3,884,946.48 $4,271,819.03 $4,078,382.75 2026-03-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 2 1 — — $38,803.31 $39,976.89 $39,390.10 2026-03-01
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 1 — — $332,753.88 $332,753.88 $332,753.88 2026-03-01
C000033701 CDM Ins Icd Lead/generator 42 12 $228,262.62 $228,262.62 $14,705.38 $230,457.41 $52,500.40 2026-03-01
0916T CPT Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 1 1 — — $66,896.00 $66,896.00 $66,896.00 2026-03-01
0915T CPT Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 1 1 — — $66,896.00 $66,896.00 $66,896.00 2026-03-01
0515T CPT Insertion Of Wireless Cardiac Stimulator For Left Ventricular Pacing, Including … 2 1 — — $63,259.00 $66,896.00 $65,077.50 2026-03-01
0571T CPT Insertion Or Replacement Of Implantable Cardioverter-defibrillator System With S… 2 1 — — $63,259.00 $66,896.00 $65,077.50 2026-03-01
717 OTHER Instill Adstiladrin, Tx D 44 19 — — $12,654.78 $77,129.75 $66,202.08 2026-03-01
00717 OTHER Instill Adstiladrin, Tx D 2 1 — — $61,454.13 $62,346.55 $61,900.34 2026-03-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 90 26 — — $10,799.00 $237,579.94 $44,876.62 2026-03-01
021 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 2 1 — — $36,971.69 $45,148.93 $41,060.31 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 90 26 — — $10,799.00 $346,464.47 $63,447.92 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
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 10 3 — — $61,338.53 $106,053.40 $61,600.24 2026-03-01
4404 APR_DRG Kidney Transplant 25 11 — — $33,592.77 $53,133.00 $40,311.32 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
5244 OTHER Level 4 Blood Product Exc 42 19 — — $50,304.25 $78,823.57 $65,686.31 2026-03-01
05244 OTHER Level 4 Blood Product Exc 2 1 — — $48,795.12 $62,571.25 $55,683.18 2026-03-01
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 2 1 — — $43,339.76 $48,062.14 $45,700.95 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 42 19 — — $516,726.10 $674,641.44 $568,398.71 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 $927,632.05 $500,948.74 2026-03-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 25 11 — — $66,329.56 $100,863.00 $79,595.47 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 89 26 — — $2,837.00 $457,708.77 $81,990.15 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
7 MS_DRG Lung Transplant 89 26 — — $2,837.00 $567,775.62 $101,040.38 2026-03-01
007 OTHER Lung Transplant 2 1 — — $67,580.69 $88,157.09 $77,868.89 2026-03-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 94 26 — — $2,837.00 $257,130.43 $45,073.47 2026-03-01
653 MS_DRG Major Bladder Procedures With Mcc 94 26 — — $2,837.00 $239,595.84 $41,723.75 2026-03-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 25 11 — — $51,048.39 $83,284.50 $61,258.07 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 90 26 — — $9,905.00 $483,202.47 $84,665.34 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 89 26 — — $9,905.00 $316,485.08 $57,636.05 2026-03-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 89 26 — — $9,905.00 $246,485.35 $45,236.40 2026-03-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 91 26 — — $2,968.00 $164,661.86 $52,267.92 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
8634 APR_DRG Neonatal Aftercare 25 11 — — $34,835.42 $52,513.50 $41,802.50 2026-03-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 25 11 — — $40,520.04 $102,481.50 $60,780.06 2026-03-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 25 11 — — $54,849.00 $83,100.26 $65,818.80 2026-03-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 25 11 — — $38,465.25 $58,359.00 $46,158.30 2026-03-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 25 11 — — $42,035.00 $64,236.87 $50,442.00 2026-03-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 25 11 — — $34,228.00 $52,935.54 $41,073.60 2026-03-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 25 11 — — $34,068.00 $53,426.60 $40,881.60 2026-03-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 25 11 — — $82,446.00 $133,307.22 $98,935.20 2026-03-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 25 11 — — $79,657.00 $125,467.54 $95,588.40 2026-03-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 25 11 — — $59,125.00 $94,624.20 $70,950.00 2026-03-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 25 11 — — $44,835.00 $81,160.27 $58,285.50 2026-03-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 25 11 — — $73,540.00 $110,794.50 $88,248.00 2026-03-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 25 11 — — $51,226.00 $80,695.10 $61,471.20 2026-03-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 25 11 — — $41,957.00 $64,905.25 $50,348.40 2026-03-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 25 11 — — $125,393.00 $191,333.91 $150,471.60 2026-03-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 25 11 — — $81,552.00 $127,428.00 $97,862.40 2026-03-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 25 11 — — $71,560.00 $109,192.05 $85,872.00 2026-03-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 25 11 — — $61,338.00 $93,593.57 $73,605.60 2026-03-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 25 11 — — $48,983.00 $89,188.07 $63,677.90 2026-03-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 25 11 — — $47,538.00 $89,188.07 $61,799.40 2026-03-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 25 11 — — $46,525.00 $89,188.07 $60,482.50 2026-03-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 25 11 — — $77,520.20 $137,205.00 $100,617.00 2026-03-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 25 11 — — $42,730.78 $65,515.50 $51,276.94 2026-03-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 25 11 — — $80,942.00 $128,217.69 $97,130.40 2026-03-01
5834 APR_DRG Neonate With Ecmo 25 11 — — $192,207.00 $312,391.65 $230,648.40 2026-03-01
5833 APR_DRG Neonate With Ecmo 25 11 — — $118,611.62 $186,775.50 $142,333.94 2026-03-01
5832 APR_DRG Neonate With Ecmo 25 11 — — $91,071.80 $143,410.50 $109,286.16 2026-03-01
5831 APR_DRG Neonate With Ecmo 25 11 — — $69,493.00 $122,622.00 $89,922.80 2026-03-01
1594 OTHER New Technology - Level 43 42 19 — — $43,477.68 $55,196.17 $46,916.75 2026-03-01
1580 OTHER New Technology - Level 43 42 19 — — $43,477.68 $55,196.17 $46,916.75 2026-03-01
01594 OTHER New Technology - Level 43 2 1 — — $42,173.35 $43,815.48 $42,994.42 2026-03-01
01580 OTHER New Technology - Level 43 2 1 — — $42,173.35 $43,815.48 $42,994.42 2026-03-01
1581 OTHER New Technology - Level 44 42 19 — — $53,139.28 $67,461.85 $57,342.57 2026-03-01
1595 OTHER New Technology - Level 44 42 19 — — $53,139.28 $67,461.85 $57,342.57 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
1582 OTHER New Technology - Level 45 42 19 — — $62,800.88 $79,727.53 $67,768.40 2026-03-01
1596 OTHER New Technology - Level 45 42 19 — — $62,800.88 $79,727.53 $67,768.40 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
1597 OTHER New Technology - Level 46 42 19 — — $72,462.48 $91,993.21 $78,194.23 2026-03-01
1583 OTHER New Technology - Level 46 42 19 — — $72,462.48 $91,993.21 $78,194.23 2026-03-01
01583 OTHER New Technology - Level 46 2 1 — — $70,288.61 $73,025.48 $71,657.04 2026-03-01
01597 OTHER New Technology - Level 46 2 1 — — $70,288.61 $73,025.48 $71,657.04 2026-03-01
1598 OTHER New Technology - Level 47 42 19 — — $82,124.09 $104,258.89 $88,620.06 2026-03-01
1584 OTHER New Technology - Level 47 42 19 — — $82,124.09 $104,258.89 $88,620.06 2026-03-01
01584 OTHER New Technology - Level 47 2 1 — — $79,660.37 $82,762.15 $81,211.26 2026-03-01
01598 OTHER New Technology - Level 47 2 1 — — $79,660.37 $82,762.15 $81,211.26 2026-03-01
1599 OTHER New Technology - Level 48 42 19 — — $91,785.68 $116,524.57 $99,045.89 2026-03-01
1585 OTHER New Technology - Level 48 42 19 — — $91,785.68 $116,524.57 $99,045.89 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
1902 OTHER New Technology - Level 49 42 19 — — $103,862.70 $131,856.72 $112,078.21 2026-03-01
1901 OTHER New Technology - Level 49 42 19 — — $103,862.70 $131,856.72 $112,078.21 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
1903 OTHER New Technology - Level 50 42 19 — — $118,355.10 $150,255.24 $127,716.95 2026-03-01
1904 OTHER New Technology - Level 50 42 19 — — $118,355.10 $150,255.24 $127,716.95 2026-03-01
01904 OTHER New Technology - Level 50 2 1 — — $114,804.45 $119,274.69 $117,039.57 2026-03-01
01903 OTHER New Technology - Level 50 2 1 — — $114,804.45 $119,274.69 $117,039.57 2026-03-01
1906 OTHER New Technology - Level 51 42 19 — — $132,847.50 $168,653.76 $143,355.70 2026-03-01
1905 OTHER New Technology - Level 51 42 19 — — $132,847.50 $168,653.76 $143,355.70 2026-03-01
01906 OTHER New Technology - Level 51 2 1 — — $128,862.07 $133,879.59 $131,370.83 2026-03-01
01905 OTHER New Technology - Level 51 2 1 — — $128,862.07 $133,879.59 $131,370.83 2026-03-01
1908 OTHER New Technology - Level 52 42 19 — — $147,339.90 $187,052.28 $158,994.44 2026-03-01
1907 OTHER New Technology - Level 52 42 19 — — $147,339.90 $187,052.28 $158,994.44 2026-03-01
01908 OTHER New Technology - Level 52 2 1 — — $142,919.70 $148,484.69 $145,702.20 2026-03-01
01907 OTHER New Technology - Level 52 2 1 — — $142,919.70 $148,484.69 $145,702.20 2026-03-01
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 1 1 — — $459,112.50 $459,112.50 $459,112.50 2026-03-01
831 OTHER Obecbtge Autol Up To 400 24 19 — — $2,930.91 $333,900.00 $288,684.38 2026-03-01
00831 OTHER Obecbtge Autol Up To 400 1 1 — — $269,902.50 $269,902.50 $269,902.50 2026-03-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 86 26 — — $10,799.00 $177,434.00 $40,730.86 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
215 MS_DRG Other Heart Assist System Implant 90 26 — — $10,799.00 $455,370.50 $84,273.22 2026-03-01
215 OTHER Other Heart Assist System Implant 2 1 — — $42,131.16 $51,453.49 $46,792.32 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
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 86 26 — — $10,799.00 $177,434.00 $42,526.43 2026-03-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 94 26 — — $2,837.00 $334,079.28 $58,086.46 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
10 MS_DRG Pancreas Transplant 89 26 — — $2,837.00 $342,686.27 $59,443.50 2026-03-01
64 APR_DRG Pancreas Transplant 25 11 — — $43,326.23 $72,558.00 $53,209.20 2026-03-01
63 APR_DRG Pancreas Transplant 25 11 — — $33,389.74 $51,546.00 $40,067.69 2026-03-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 94 26 — — $2,837.00 $239,843.13 $42,638.47 2026-03-01
0956T CPT Partial Craniectomy, Channel Creation, And Tunneling Of Electrode For Sub-scalp … 1 1 — — $50,174.00 $50,174.00 $50,174.00 2026-03-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 3 1 — — $31,488.00 $38,638.00 $38,638.00 2024-10-01
360 OTHER Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 1 1 — — $47,776.40 $47,776.40 $47,776.40 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 2 1 — — $76,785.37 $77,046.96 $76,916.17 2026-03-01
C000033901 CDM Rem/replace Icd Gen Dual 42 12 $169,735.75 $169,735.75 $10,934.90 $171,367.88 $39,039.22 2026-03-01
C000034001 CDM Rem/replace Icd Gen Mult 42 12 $228,262.62 $228,262.62 $14,705.38 $230,457.41 $52,500.40 2026-03-01
C000033801 CDM Rem/replace Icd Gen Sgl 42 12 $169,735.75 $169,735.75 $10,934.90 $171,367.88 $39,039.22 2026-03-01
0923T CPT Removal And Replacement Of Permanent Cardiac Contractility Modulation-defibrilla… 1 1 — — $66,896.00 $66,896.00 $66,896.00 2026-03-01
0520T CPT Removal And Replacement Of Pulse Generator For Wireless Cardiac Stimulator For L… 2 1 — — $63,259.00 $66,896.00 $65,077.50 2026-03-01
0614T CPT Removal And Replacement Of Substernal Implantable Defibrillator Pulse Generator 2 1 — — $63,259.00 $66,896.00 $65,077.50 2026-03-01
0960T CPT Replacement Of Sub-scalp Implanted Electrode Array, Receiver, And Telemetry Unit… 1 1 — — $50,174.00 $50,174.00 $50,174.00 2026-03-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 94 26 — — $2,701.00 $282,116.55 $49,641.28 2026-03-01
897 OTHER Revakinagene, Per Implant 22 19 — — $265,000.00 $318,000.00 $278,250.00 2026-03-01
00897 OTHER Revakinagene, Per Implant 1 1 — — $257,050.00 $257,050.00 $257,050.00 2026-03-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 90 26 — — $10,799.00 $99,260.00 $40,771.47 2026-03-01
I000004602 CDM Revsc Fem/pop W Stnt/ath 44 13 $190,914.62 $190,914.62 $12,182.17 $190,914.67 $39,910.24 2026-03-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 89 26 — — $10,799.00 $112,019.54 $51,657.50 2026-03-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 89 26 — — $2,837.00 $245,722.48 $43,811.44 2026-03-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 89 26 — — $2,837.00 $340,713.35 $59,103.03 2026-03-01
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 1 — — $44,039.60 $49,193.30 $46,616.45 2026-03-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 91 26 — — $2,837.00 $130,889.00 $42,063.58 2026-03-01
9273 OTHER Sipuleucel-t Auto Cd54+ 42 19 — — $54,404.11 $66,018.28 $57,124.32 2026-03-01
09273 OTHER Sipuleucel-t Auto Cd54+ 2 1 — — $52,771.99 $53,364.77 $53,068.38 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 4 2 — — $53,789.99 $91,596.09 $72,536.68 2026-03-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 94 26 — — $2,837.00 $287,233.03 $47,623.71 2026-03-01
573 OTHER Skin Graft For Skin Ulcer Or Cellulitis With Mcc 2 1 — — $34,258.15 $45,172.43 $39,715.29 2026-03-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 6 2 — — $79,174.00 $100,617.00 $83,213.00 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 88 26 — — $2,968.00 $368,430.27 $65,305.96 2026-03-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 88 26 — — $2,968.00 $261,440.19 $47,910.33 2026-03-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 6 2 — — $44,812.00 $83,213.00 $83,213.00 2026-03-01
28 MS_DRG Spinal Procedures With Mcc 90 26 — — $10,799.00 $263,421.90 $48,264.67 2026-03-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 94 26 — — $2,837.00 $218,662.58 $38,909.58 2026-03-01
1142 OTHER Supprelin La Implant 42 19 — — $43,185.34 $54,420.25 $46,208.31 2026-03-01
01142 OTHER Supprelin La Implant 2 1 — — $41,889.78 $43,989.70 $42,939.74 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 42 19 — — $529,192.90 $679,837.56 $577,861.93 2026-03-01
09194 OTHER Tisagenlecleucel Car-pos 2 1 — — $513,317.11 $549,535.36 $531,426.23 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 10 3 — — $502,693.77 $934,776.65 $561,407.87 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 24 19 — — $9,697.57 $4,002,984.00 $3,460,913.25 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
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 94 26 — — $2,837.00 $239,124.11 $41,836.87 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 91 24 — — $2,837.00 $607,311.11 $109,174.06 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
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 25 11 — — $66,782.00 $100,494.24 $80,138.40 2026-03-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 25 11 — — $41,876.00 $69,298.37 $50,818.80 2026-03-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 25 11 — — $43,560.00 $70,007.73 $52,272.00 2026-03-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 86 26 — — $10,799.00 $244,038.91 $44,413.99 2026-03-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 94 26 — — $2,837.00 $249,883.18 $41,875.59 2026-03-01
1643 OTHER Y90 Ibritumomab, Rx 42 19 — — $56,824.55 $78,571.90 $65,412.40 2026-03-01
01643 OTHER Y90 Ibritumomab, Rx 2 1 — — $55,119.81 $63,512.28 $59,316.04 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 2 1 — — $93,760.51 $108,036.36 $100,898.43 2026-03-01
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