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 RAULERSON HOSPITAL

Okeechobee, FL · CCN 100252 · Rates published

Your selected procedure

You selected 70551 (CPT)

MRI BRAIN W/O CONTRAST

This hospital’s price: $3,134 across 17 payers · range $518-$12,921

Source: https://www.hcadam.com/api/public/content/c26ebb8914cf4f3391a41d908df5c7ce?download=true · observed 2026-03-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

25,225 distinct procedures filed
46 distinct payers
1,109,852 rate rows
2026-07-31 last MRF observed
Data quality

1,045,753 of 1,109,852 rate rows are consumer-grade (94.2%)

64,099 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 26,150
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 13,874
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 13,646
template filing: same amount across many unrelated codes — excluded 9,674
percent-of-charges filed in the dollar field — excluded from medians 304
placeholder amount (≤ $0.02) — excluded from medians 170
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 110
exceeds 10× this hospital's gross charge — excluded from medians 101
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 70
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/59-1833934_HCA-FLORIDA-RAULERSON-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 Latest re-check couldn't be parsed — showing last good data · 2026-10-11
Content fingerprint c60ab23487c7f9a2… · 295,297,872 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
$2,968,000
1.6× median
845
OTHER 		Inj, Atidarsagene Autotem 17 $4,912.27 $4,955,500.00 $4,595,100.00 nat. median
$4,505,000
1.0× median
00845
OTHER 		Inj, Atidarsagene Autotem 1 $4,459,950.00 $4,459,950.00 $4,459,950.00 —
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
$2,455,111
1.7× median
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 1 $3,847,800.00 $3,847,800.00 $3,847,800.00 nat. median
$2,332,000
1.6× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 18 $3,672,900.00 $4,422,320.40 $3,758,972.34 nat. median
$3,765,001
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 18 $3,605,000.00 $4,326,000.00 $3,677,100.00 nat. median
$3,677,100
1.0× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 1 $3,636,171.00 $3,648,414.33 $3,642,292.67 nat. median
$3,562,713
1.0× median
00773
OTHER 		Inj, Beqvez, Per Tx Dose 1 $3,568,950.00 $3,568,950.00 $3,568,950.00 nat. median
$3,496,850
1.0× median
908
OTHER 		Topi Adm Prad Zami Per Tr 20 $9,997.49 $4,836,939.00 $3,402,536.40 nat. median
$8,800
outlier · 386.6×
714
OTHER 		Inj Delandistrogene Mox R 20 $5,443.92 $4,825,397.00 $3,394,417.20 nat. median
$3,391,964
1.0× median
748
OTHER 		Inj, Lovotibeglogene Auto 20 $8,979.73 $4,716,136.60 $3,350,083.24 nat. median
$3,351,720
1.0× median
00908
OTHER 		Topi Adm Prad Zami Per Tr 1 $3,302,461.80 $3,302,461.80 $3,302,461.80 —
00714
OTHER 		Inj Delandistrogene Mox R 1 $3,292,200.45 $3,294,581.40 $3,293,390.92 nat. median
$3,225,691
1.0× median
906
OTHER 		Inj Elivaldogene Autoteme 20 $6,551.23 $4,611,000.00 $3,243,600.00 nat. median
$2,726
outlier · 1189.7×
00748
OTHER 		Inj, Lovotibeglogene Auto 1 $3,219,982.92 $3,253,140.00 $3,236,561.46 nat. median
$3,187,420
1.0× median
00906
OTHER 		Inj Elivaldogene Autoteme 1 $3,148,200.00 $3,148,200.00 $3,148,200.00 —
746
OTHER 		Inj, Betibeglogene Autote 20 $7,975.79 $4,262,955.05 $3,027,360.00 nat. median
$3,001,835
1.0× median
00746
OTHER 		Inj, Betibeglogene Autote 1 $2,910,569.31 $2,938,320.00 $2,924,444.66 nat. median
$2,878,960
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 19 $2,388,614.00 $3,754,022.45 $2,588,981.00 nat. median
$2,508,045
1.0× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 1 $2,364,727.86 $2,563,091.19 $2,463,909.52 nat. median
$2,316,956
1.1× median
824
OTHER 		Inj, Exagamglogene Autote 20 $14,122.77 $3,381,400.00 $2,378,640.00 nat. median
$28,063
outlier · 84.8×
00824
OTHER 		Inj, Exagamglogene Autote 1 $2,308,680.00 $2,308,680.00 $2,308,680.00 —
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
$813,967
1.6× median
2067
OTHER 		Afamitresgene Autoleucel 19 $770,620.00 $1,117,399.00 $786,032.40 nat. median
$838,386
0.9× median
9498
OTHER 		Ciltacabtagene Car-pos T 19 $527,123.40 $852,091.92 $587,649.60 nat. median
$553,480
1.1× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 3 $513,058.59 $934,776.65 $572,983.29 nat. median
$621,313
0.9× median
9194
OTHER 		Tisagenlecleucel Car-pos 19 $529,192.90 $821,470.39 $566,531.30 nat. median
$555,653
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 19 $516,726.10 $815,191.74 $562,201.20 nat. median
$542,562
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 19 $526,587.60 $809,218.61 $558,081.80 nat. median
$552,917
1.0× median
09498
OTHER 		Ciltacabtagene Car-pos T 1 $521,852.17 $581,773.10 $551,812.64 nat. median
$511,310
1.1× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 3 $502,421.04 $969,621.79 $547,637.31 nat. median
$599,737
0.9× median
09194
OTHER 		Tisagenlecleucel Car-pos 1 $523,900.97 $560,865.99 $542,383.48 nat. median
$513,317
1.1× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $521,321.72 $552,500.98 $536,911.35 nat. median
$510,790
1.1× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $511,558.84 $556,579.19 $534,069.02 nat. median
$501,224
1.1× median
9035
OTHER 		Axicabtagene Ciloleucel C 19 $489,456.00 $771,678.69 $532,192.20 nat. median
$513,929
1.0× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 3 $469,320.39 $927,632.05 $511,277.58 nat. median
$579,571
0.9× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $484,561.44 $526,870.28 $505,715.86 nat. median
$474,772
1.1× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 3 $479,843.10 $920,834.85 $501,094.44 nat. median
$574,037
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 3 $454,787.19 $878,117.20 $497,812.59 nat. median
$562,501
0.9× median
9391
OTHER 		Brexucabtagene Car Pos T 19 $460,530.40 $709,702.79 $489,450.20 nat. median
$483,557
1.0× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 3 $444,945.60 $807,592.83 $484,505.01 nat. median
$513,770
0.9× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $455,925.10 $484,555.70 $470,240.40 nat. median
$446,714
1.1× 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
$286,598
1.6× median
J3402
HCPCS 		Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 $332,753.88 $332,753.88 $332,753.88 nat. median
$207,733
1.6× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 26 $5,348.00 $1,159,814.91 $294,677.17 nat. median
$168,055
1.8× median
831
OTHER 		Obecbtge Autol Up To 400 20 $3,021.56 $403,462.50 $283,815.00 nat. median
$278,250
1.0× median
00831
OTHER 		Obecbtge Autol Up To 400 1 $275,467.50 $275,467.50 $275,467.50 —
897
OTHER 		Revakinagene, Per Implant 19 $265,000.00 $384,250.00 $270,300.00 nat. median
$269,427
1.0× median
00897
OTHER 		Revakinagene, Per Implant 1 $262,350.00 $262,350.00 $262,350.00 —

Other procedures at this hospital

Browse this hospital's 25,225 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 2 1 — — $4,850,948.67 $4,897,200.00 $4,874,074.33 2026-03-01
845 OTHER Inj, Atidarsagene Autotem 22 17 — — $4,912.27 $4,955,500.00 $4,595,100.00 2026-03-01
00845 OTHER Inj, Atidarsagene Autotem 1 1 — — $4,459,950.00 $4,459,950.00 $4,459,950.00 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
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 1 1 — — $3,847,800.00 $3,847,800.00 $3,847,800.00 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 44 18 — — $3,672,900.00 $4,422,320.40 $3,758,972.34 2026-03-01
773 OTHER Inj, Beqvez, Per Tx Dose 22 18 — — $3,605,000.00 $4,326,000.00 $3,677,100.00 2024-10-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 2 1 — — $3,636,171.00 $3,648,414.33 $3,642,292.67 2026-03-01
00773 OTHER Inj, Beqvez, Per Tx Dose 1 1 — — $3,568,950.00 $3,568,950.00 $3,568,950.00 2024-10-01
908 OTHER Topi Adm Prad Zami Per Tr 25 20 — — $9,997.49 $4,836,939.00 $3,402,536.40 2026-03-01
714 OTHER Inj Delandistrogene Mox R 47 20 — — $5,443.92 $4,825,397.00 $3,394,417.20 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 47 20 — — $8,979.73 $4,716,136.60 $3,350,083.24 2026-03-01
00908 OTHER Topi Adm Prad Zami Per Tr 1 1 — — $3,302,461.80 $3,302,461.80 $3,302,461.80 2026-03-01
00714 OTHER Inj Delandistrogene Mox R 2 1 — — $3,292,200.45 $3,294,581.40 $3,293,390.92 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 25 20 — — $6,551.23 $4,611,000.00 $3,243,600.00 2026-03-01
00748 OTHER Inj, Lovotibeglogene Auto 2 1 — — $3,219,982.92 $3,253,140.00 $3,236,561.46 2026-03-01
00906 OTHER Inj Elivaldogene Autoteme 1 1 — — $3,148,200.00 $3,148,200.00 $3,148,200.00 2026-03-01
746 OTHER Inj, Betibeglogene Autote 47 20 — — $7,975.79 $4,262,955.05 $3,027,360.00 2026-03-01
00746 OTHER Inj, Betibeglogene Autote 2 1 — — $2,910,569.31 $2,938,320.00 $2,924,444.66 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 45 19 — — $2,388,614.00 $3,754,022.45 $2,588,981.00 2026-03-01
09141 OTHER Inj Onase Abepar-xioi Tre 2 1 — — $2,364,727.86 $2,563,091.19 $2,463,909.52 2026-03-01
824 OTHER Inj, Exagamglogene Autote 25 20 — — $14,122.77 $3,381,400.00 $2,378,640.00 2026-03-01
00824 OTHER Inj, Exagamglogene Autote 1 1 — — $2,308,680.00 $2,308,680.00 $2,308,680.00 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
2067 OTHER Afamitresgene Autoleucel 23 19 — — $770,620.00 $1,117,399.00 $786,032.40 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 45 19 — — $527,123.40 $852,091.92 $587,649.60 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 10 3 — — $513,058.59 $934,776.65 $572,983.29 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 45 19 — — $529,192.90 $821,470.39 $566,531.30 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 45 19 — — $516,726.10 $815,191.74 $562,201.20 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 45 19 — — $526,587.60 $809,218.61 $558,081.80 2026-03-01
09498 OTHER Ciltacabtagene Car-pos T 2 1 — — $521,852.17 $581,773.10 $551,812.64 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 10 3 — — $502,421.04 $969,621.79 $547,637.31 2026-03-01
09194 OTHER Tisagenlecleucel Car-pos 2 1 — — $523,900.97 $560,865.99 $542,383.48 2026-03-01
09422 OTHER Idecabtagene Vicleucel Ca 2 1 — — $521,321.72 $552,500.98 $536,911.35 2026-03-01
09413 OTHER Lisocabtagene Car Pos T 2 1 — — $511,558.84 $556,579.19 $534,069.02 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 45 19 — — $489,456.00 $771,678.69 $532,192.20 2026-03-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 10 3 — — $469,320.39 $927,632.05 $511,277.58 2026-03-01
09035 OTHER Axicabtagene Ciloleucel C 2 1 — — $484,561.44 $526,870.28 $505,715.86 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 6 3 — — $479,843.10 $920,834.85 $501,094.44 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 10 3 — — $454,787.19 $878,117.20 $497,812.59 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 45 19 — — $460,530.40 $709,702.79 $489,450.20 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 10 3 — — $444,945.60 $807,592.83 $484,505.01 2026-03-01
09391 OTHER Brexucabtagene Car Pos T 2 1 — — $455,925.10 $484,555.70 $470,240.40 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
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 1 — — $332,753.88 $332,753.88 $332,753.88 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 101 26 — — $5,348.00 $1,159,814.91 $294,677.17 2026-03-01
831 OTHER Obecbtge Autol Up To 400 25 20 — — $3,021.56 $403,462.50 $283,815.00 2026-03-01
00831 OTHER Obecbtge Autol Up To 400 1 1 — — $275,467.50 $275,467.50 $275,467.50 2026-03-01
897 OTHER Revakinagene, Per Implant 23 19 — — $265,000.00 $384,250.00 $270,300.00 2026-03-01
00897 OTHER Revakinagene, Per Implant 1 1 — — $262,350.00 $262,350.00 $262,350.00 2026-03-01
5834 APR_DRG Neonate With Ecmo 28 12 — — $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 110 27 — — $7,000.00 $866,285.80 $214,049.81 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 25 20 — — $5,697.72 $292,420.05 $205,702.38 2026-03-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 2 1 — — $184,526.30 $214,841.20 $199,683.75 2026-03-01
00886 OTHER Inj. Remestemcel-l-rknd/ 1 1 — — $199,652.31 $199,652.31 $199,652.31 2026-03-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 1 — — $152,261.40 $244,411.10 $198,336.25 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 104 25 — — $8,403.00 $729,618.44 $169,419.46 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 110 26 — — $7,000.00 $823,000.09 $161,328.23 2026-03-01
1908 OTHER New Technology - Level 52 45 19 — — $147,339.90 $226,021.50 $155,876.90 2026-03-01
1907 OTHER New Technology - Level 52 45 19 — — $147,339.90 $226,021.50 $155,876.90 2026-03-01
01907 OTHER New Technology - Level 52 2 1 — — $145,866.50 $151,546.23 $148,706.36 2026-03-01
01908 OTHER New Technology - Level 52 2 1 — — $145,866.50 $151,546.23 $148,706.36 2026-03-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 28 12 — — $125,393.00 $191,333.91 $147,327.11 2026-03-01
5833 APR_DRG Neonate With Ecmo 28 12 — — $118,611.62 $186,775.50 $142,333.94 2026-03-01
1905 OTHER New Technology - Level 51 45 19 — — $132,847.50 $203,789.96 $140,544.80 2026-03-01
1906 OTHER New Technology - Level 51 45 19 — — $132,847.50 $203,789.96 $140,544.80 2026-03-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 1 — — $123,595.80 $151,424.40 $137,510.10 2026-03-01
01906 OTHER New Technology - Level 51 2 1 — — $131,519.02 $136,640.00 $134,079.51 2026-03-01
01905 OTHER New Technology - Level 51 2 1 — — $131,519.02 $136,640.00 $134,079.51 2026-03-01
24 APR_DRG Heart And/or Lung Transplant 28 12 — — $111,047.00 $178,746.99 $133,256.40 2026-03-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 2 1 — — $120,116.70 $138,148.31 $129,132.51 2026-03-01
1904 OTHER New Technology - Level 50 45 19 — — $118,355.10 $181,558.41 $125,212.70 2026-03-01
1903 OTHER New Technology - Level 50 45 19 — — $118,355.10 $181,558.41 $125,212.70 2026-03-01
01904 OTHER New Technology - Level 50 2 1 — — $117,171.55 $121,733.96 $119,452.76 2026-03-01
01903 OTHER New Technology - Level 50 2 1 — — $117,171.55 $121,733.96 $119,452.76 2026-03-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 28 12 — — $97,644.00 $178,865.04 $119,243.36 2026-03-01
1902 OTHER New Technology - Level 49 45 19 — — $103,862.70 $159,326.87 $109,880.60 2026-03-01
1901 OTHER New Technology - Level 49 45 19 — — $103,862.70 $159,326.87 $109,880.60 2026-03-01
5832 APR_DRG Neonate With Ecmo 28 12 — — $91,071.80 $143,410.50 $109,286.16 2026-03-01
1614 APR_DRG Implantable Heart Assist Systems 28 12 — — $88,926.10 $142,750.50 $106,711.32 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 110 26 — — $7,000.00 $493,954.46 $106,074.89 2026-03-01
01901 OTHER New Technology - Level 49 2 1 — — $102,824.07 $106,827.83 $104,825.95 2026-03-01
01902 OTHER New Technology - Level 49 2 1 — — $102,824.07 $106,827.83 $104,825.95 2026-03-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 1 — — $86,903.16 $118,250.50 $102,576.83 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
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 28 12 — — $82,446.00 $133,307.22 $98,935.20 2026-03-01
7 MS_DRG Lung Transplant 109 28 — — $7,000.00 $401,916.33 $98,902.21 2026-03-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 28 12 — — $81,552.00 $127,428.00 $97,694.80 2026-03-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 28 12 — — $80,942.00 $128,217.69 $97,130.40 2026-03-01
1599 OTHER New Technology - Level 48 45 19 — — $91,785.68 $140,800.52 $97,103.81 2026-03-01
1585 OTHER New Technology - Level 48 45 19 — — $91,785.68 $140,800.52 $97,103.81 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 103 27 — — $5,348.00 $463,299.44 $95,779.68 2026-03-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 28 12 — — $79,657.00 $125,467.54 $95,588.40 2026-03-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 28 12 — — $79,102.08 $135,325.50 $94,922.50 2026-03-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 28 12 — — $77,520.20 $137,205.00 $93,024.24 2026-03-01
01599 OTHER New Technology - Level 48 2 1 — — $90,867.82 $94,406.00 $92,636.91 2026-03-01
01585 OTHER New Technology - Level 48 2 1 — — $90,867.82 $94,406.00 $92,636.91 2026-03-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 2 1 — — $78,636.73 $105,976.90 $92,306.82 2026-03-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 28 12 — — $75,232.00 $130,764.62 $90,278.40 2026-03-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 28 12 — — $56,946.00 $133,113.71 $87,080.74 2026-03-01
1584 OTHER New Technology - Level 47 45 19 — — $82,124.09 $125,979.49 $86,882.41 2026-03-01
1598 OTHER New Technology - Level 47 45 19 — — $82,124.09 $125,979.49 $86,882.41 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 58 28 — — $7,000.00 $464,806.52 $86,232.18 2026-03-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 28 12 — — $73,540.00 $110,794.50 $85,493.74 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 110 27 — — $7,000.00 $530,091.66 $84,552.51 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 113 28 — — $7,000.00 $442,298.80 $84,369.63 2026-03-01
74 APR_DRG Allogeneic Bone Marrow Transplant 28 12 — — $70,159.56 $113,416.50 $84,191.47 2026-03-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 28 12 — — $71,560.00 $109,192.05 $84,077.88 2026-03-01
5831 APR_DRG Neonate With Ecmo 28 12 — — $69,493.00 $122,622.00 $83,391.60 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 107 27 — — $11,098.00 $430,172.30 $82,938.45 2026-03-01
01598 OTHER New Technology - Level 47 2 1 — — $81,302.85 $84,468.58 $82,885.71 2026-03-01
01584 OTHER New Technology - Level 47 2 1 — — $81,302.85 $84,468.58 $82,885.71 2026-03-01
215 MS_DRG Other Heart Assist System Implant 115 28 — — $7,000.00 $478,321.01 $82,054.58 2026-03-01
007 OTHER Lung Transplant 2 1 — — $69,670.81 $90,883.60 $80,277.21 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 109 28 — — $7,000.00 $470,900.57 $79,894.84 2026-03-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 4 1 — — $72,221.00 $87,033.00 $79,627.00 2026-03-01
014 OTHER Allogeneic Bone Marrow Transplant 2 1 — — $77,577.66 $80,747.98 $79,162.82 2026-03-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 28 12 — — $66,329.56 $100,863.00 $77,664.51 2026-03-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 28 12 — — $66,782.00 $100,494.24 $77,591.33 2026-03-01
1613 APR_DRG Implantable Heart Assist Systems 28 12 — — $64,392.00 $104,446.96 $77,270.40 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 107 27 — — $26,750.00 $300,394.58 $77,263.56 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 2 1 — — $76,785.37 $77,046.96 $76,916.17 2026-03-01
1597 OTHER New Technology - Level 46 45 19 — — $72,462.48 $111,158.46 $76,661.01 2026-03-01
1583 OTHER New Technology - Level 46 45 19 — — $72,462.48 $111,158.46 $76,661.01 2026-03-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 1 — — $69,544.43 $80,549.70 $75,047.07 2026-03-01
23 APR_DRG Heart And/or Lung Transplant 28 12 — — $62,352.00 $97,366.79 $74,647.87 2026-03-01
01583 OTHER New Technology - Level 46 2 1 — — $71,737.86 $74,531.16 $73,134.51 2026-03-01
01597 OTHER New Technology - Level 46 2 1 — — $71,737.86 $74,531.16 $73,134.51 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 4 2 — — $54,899.06 $91,596.09 $73,106.85 2026-03-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 28 12 — — $61,338.00 $93,593.57 $72,067.05 2026-03-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 28 12 — — $59,125.00 $94,624.20 $70,950.00 2026-03-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 28 12 — — $48,895.00 $105,823.65 $70,549.10 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 107 27 — — $26,000.00 $302,607.98 $69,090.89 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 107 27 — — $8,403.00 $378,286.67 $67,746.64 2026-03-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 4 1 — — $61,112.00 $74,071.00 $67,591.50 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 107 27 — — $11,098.00 $342,506.74 $66,991.00 2026-03-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 2 1 — — $57,165.51 $76,760.53 $66,963.02 2026-03-01
1582 OTHER New Technology - Level 45 45 19 — — $62,800.88 $96,337.43 $66,439.61 2026-03-01
1596 OTHER New Technology - Level 45 45 19 — — $62,800.88 $96,337.43 $66,439.61 2026-03-01
5244 OTHER Level 4 Blood Product Exc 45 19 — — $50,304.25 $95,245.15 $65,686.31 2026-03-01
717 OTHER Instill Adstiladrin, Tx D 47 20 — — $13,046.17 $93,198.45 $65,560.29 2026-03-01
1643 OTHER Y90 Ibritumomab, Rx 45 19 — — $56,824.55 $82,395.60 $65,476.58 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 104 27 — — $18,371.00 $260,460.26 $65,354.13 2026-03-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 28 12 — — $40,520.04 $102,481.50 $64,550.53 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 107 27 — — $11,098.00 $296,509.83 $64,180.86 2026-03-01
429 OTHER Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 1 1 — — $64,043.10 $64,043.10 $64,043.10 2026-03-01
0916T CPT Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 1 1 — — $64,000.00 $64,000.00 $64,000.00 2026-03-01
0923T CPT Removal And Replacement Of Permanent Cardiac Contractility Modulation-defibrilla… 1 1 — — $64,000.00 $64,000.00 $64,000.00 2026-03-01
0915T CPT Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 1 1 — — $64,000.00 $64,000.00 $64,000.00 2026-03-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 28 12 — — $54,849.00 $83,100.26 $63,987.20 2026-03-01
01582 OTHER New Technology - Level 45 2 1 — — $62,172.87 $64,593.74 $63,383.31 2026-03-01
01596 OTHER New Technology - Level 45 2 1 — — $62,172.87 $64,593.74 $63,383.31 2026-03-01
00717 OTHER Instill Adstiladrin, Tx D 2 1 — — $62,721.22 $63,632.04 $63,176.63 2026-03-01
0614T CPT Removal And Replacement Of Substernal Implantable Defibrillator Pulse Generator 2 1 — — $61,780.00 $64,000.00 $62,890.00 2026-03-01
0515T CPT Insertion Of Wireless Cardiac Stimulator For Left Ventricular Pacing, Including … 2 1 — — $61,780.00 $64,000.00 $62,890.00 2026-03-01
0520T CPT Removal And Replacement Of Pulse Generator For Wireless Cardiac Stimulator For L… 2 1 — — $61,780.00 $64,000.00 $62,890.00 2026-03-01
0571T CPT Insertion Or Replacement Of Implantable Cardioverter-defibrillator System With S… 2 1 — — $61,780.00 $64,000.00 $62,890.00 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 10 3 — — $62,603.24 $106,053.40 $62,870.35 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 107 27 — — $25,000.00 $254,389.46 $62,659.54 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 103 26 — — $25,750.00 $260,302.82 $61,605.03 2026-03-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 28 12 — — $51,226.00 $80,695.10 $61,471.20 2026-03-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 1 — — $59,318.72 $63,305.38 $61,312.05 2026-03-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 28 12 — — $51,048.39 $83,284.50 $61,258.07 2026-03-01
01643 OTHER Y90 Ibritumomab, Rx 2 1 — — $56,256.30 $64,821.81 $60,539.06 2026-03-01
1612 APR_DRG Implantable Heart Assist Systems 28 12 — — $51,234.90 $77,532.00 $59,699.64 2026-03-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 28 12 — — $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 28 12 — — $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 28 12 — — $47,538.00 $89,188.07 $59,458.71 2026-03-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $51,347.03 $66,762.82 $59,054.93 2026-03-01
1611 APR_DRG Implantable Heart Assist Systems 28 12 — — $49,247.00 $76,852.35 $58,920.13 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 105 27 — — $26,121.00 $288,925.13 $58,440.27 2026-03-01
10 MS_DRG Pancreas Transplant 103 27 — — $8,403.00 $245,205.29 $58,287.07 2026-03-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 103 27 — — $8,403.00 $243,793.59 $57,951.50 2026-03-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 106 27 — — $8,403.00 $229,553.56 $57,305.16 2026-03-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 1 — — $42,362.69 $71,937.78 $57,150.24 2026-03-01
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $57,035.03 $57,035.03 $57,035.03 2024-10-01
0674T CPT Laparoscopic Insertion Of New Or Replacement Of Permanent Implantable Synchroniz… 1 1 — — $57,000.00 $57,000.00 $57,000.00 2026-03-01
0960T CPT Replacement Of Sub-scalp Implanted Electrode Array, Receiver, And Telemetry Unit… 1 1 — — $57,000.00 $57,000.00 $57,000.00 2026-03-01
0956T CPT Partial Craniectomy, Channel Creation, And Tunneling Of Electrode For Sub-scalp … 1 1 — — $57,000.00 $57,000.00 $57,000.00 2026-03-01
05244 OTHER Level 4 Blood Product Exc 2 1 — — $49,801.21 $63,861.38 $56,831.29 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 105 27 — — $11,098.00 $264,121.33 $56,522.63 2026-03-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 107 28 — — $13,000.00 $190,000.00 $56,370.80 2026-03-01
1595 OTHER New Technology - Level 44 45 19 — — $53,139.28 $81,516.40 $56,218.21 2026-03-01
1581 OTHER New Technology - Level 44 45 19 — — $53,139.28 $81,516.40 $56,218.21 2026-03-01
9273 OTHER Sipuleucel-t Auto Cd54+ 45 19 — — $54,404.11 $78,885.96 $56,115.53 2026-03-01
C9782 HCPCS Blinded Procedure For New York Heart Association (nyha) Class Ii Or Iii Heart Fa… 2 1 — — $54,105.00 $57,000.00 $55,552.50 2026-03-01
22 APR_DRG Heart And/or Lung Transplant 28 12 — — $45,376.00 $73,729.74 $54,451.20 2026-03-01
09273 OTHER Sipuleucel-t Auto Cd54+ 2 1 — — $53,860.07 $54,465.08 $54,162.57 2026-03-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 28 12 — — $44,835.00 $81,160.27 $54,106.85 2026-03-01
0266T CPT Implantation Or Replacement Of Carotid Sinus Baroreflex Activation Device; Total… 1 1 — — $54,105.00 $54,105.00 $54,105.00 2024-10-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 109 28 — — $13,000.00 $300,394.58 $53,890.71 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 109 28 — — $13,000.00 $300,394.58 $53,828.49 2026-03-01
955 OTHER Craniotomy For Multiple Significant Trauma 2 1 — — $43,162.67 $64,362.50 $53,762.58 2026-03-01
01581 OTHER New Technology - Level 44 2 1 — — $52,607.89 $54,656.32 $53,632.10 2026-03-01
01595 OTHER New Technology - Level 44 2 1 — — $52,607.89 $54,656.32 $53,632.10 2026-03-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 28 12 — — $32,422.00 $87,882.00 $53,610.50 2026-03-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 28 12 — — $44,285.71 $69,304.50 $53,133.45 2026-03-01
231 OTHER Coronary Bypass With Ptca With Mcc 2 1 — — $46,092.95 $59,922.21 $53,007.58 2026-03-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 28 12 — — $43,560.00 $70,007.73 $52,272.00 2026-03-01
447 OTHER Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 1 1 — — $52,090.29 $52,090.29 $52,090.29 2026-03-01
64 APR_DRG Pancreas Transplant 28 12 — — $43,326.23 $72,558.00 $51,991.48 2026-03-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 106 27 — — $8,403.00 $287,340.02 $51,895.22 2026-03-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 104 25 — — $8,403.00 $205,403.95 $51,839.41 2026-03-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 105 27 — — $9,535.00 $97,836.53 $51,498.77 2026-03-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 102 27 — — $18,371.00 $249,443.17 $51,234.25 2026-03-01
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $50,671.20 $51,061.50 $50,866.35 2026-03-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 28 12 — — $42,730.78 $65,515.50 $50,446.93 2026-03-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 107 27 — — $8,403.00 $254,044.52 $50,318.29 2026-03-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 28 12 — — $41,876.00 $69,298.37 $50,251.20 2026-03-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 111 28 — — $11,000.00 $369,256.48 $50,227.95 2026-03-01
0207 RC — 35 9 — — $7,500.00 $50,045.00 $50,045.00 2026-03-01
21 APR_DRG Heart And/or Lung Transplant 28 12 — — $41,730.00 $65,165.07 $49,959.89 2026-03-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 28 12 — — $41,957.00 $64,905.25 $49,844.76 2026-03-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 113 28 — — $11,000.00 $302,607.98 $49,688.66 2026-03-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 28 12 — — $42,035.00 $64,236.87 $49,462.39 2026-03-01
0208 RC — 60 16 — — $6,000.00 $49,295.00 $49,295.00 2026-03-01
360 OTHER Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 1 1 — — $49,254.02 $49,254.02 $49,254.02 2026-03-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 105 27 — — $11,098.00 $190,502.66 $49,229.69 2026-03-01
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 1 — — $44,152.09 $54,277.85 $49,214.97 2026-03-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 107 27 — — $5,348.00 $198,920.58 $49,157.53 2026-03-01
8514 APR_DRG Gender Related Procedures 28 12 — — $40,865.02 $70,353.00 $49,038.02 2026-03-01
28 MS_DRG Spinal Procedures With Mcc 107 27 — — $11,098.00 $186,968.80 $48,404.18 2026-03-01
215 OTHER Other Heart Assist System Implant 2 1 — — $43,434.19 $53,044.83 $48,239.51 2026-03-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 109 27 — — $11,098.00 $209,349.37 $48,098.64 2026-03-01
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 1 — — $45,401.65 $50,714.74 $48,058.19 2026-03-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 109 28 — — $11,000.00 $189,389.30 $47,693.61 2026-03-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 107 27 — — $8,403.00 $194,497.87 $47,606.82 2026-03-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 113 28 — — $7,000.00 $188,740.35 $47,323.68 2026-03-01
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 2 1 — — $44,680.16 $49,548.60 $47,114.38 2026-03-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 107 27 — — $11,098.00 $183,063.66 $46,965.15 2026-03-01
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 2 1 — — $24,439.05 $69,481.26 $46,960.15 2026-03-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 106 27 — — $11,098.00 $226,552.00 $46,873.81 2026-03-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 5 2 — — $6,300.00 $115,429.00 $46,865.00 2026-03-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 5 2 — — $6,300.00 $115,429.00 $46,865.00 2026-03-01
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 1 — — $38,535.21 $53,566.38 $46,050.79 2026-03-01
1594 OTHER New Technology - Level 43 45 19 — — $43,477.68 $66,695.37 $45,996.81 2026-03-01
1580 OTHER New Technology - Level 43 45 19 — — $43,477.68 $66,695.37 $45,996.81 2026-03-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 103 27 — — $5,348.00 $463,299.44 $45,872.61 2026-03-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 68 22 — — $10,959.00 $78,437.00 $45,615.10 2026-03-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 105 27 — — $11,098.00 $226,552.00 $45,534.86 2026-03-01
1142 OTHER Supprelin La Implant 45 19 — — $43,185.34 $62,618.74 $45,350.21 2026-03-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 28 12 — — $38,465.25 $58,359.00 $44,936.43 2026-03-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 113 28 — — $11,000.00 $193,818.59 $44,771.91 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 10 3 — — $44,133.01 $72,861.11 $44,759.88 2026-03-01
73 APR_DRG Allogeneic Bone Marrow Transplant 28 12 — — $36,953.00 $66,933.09 $44,622.06 2026-03-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 56 28 — — $11,000.00 $234,353.85 $44,434.69 2026-03-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 105 27 — — $11,098.00 $226,552.00 $44,401.98 2026-03-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 107 27 — — $8,403.00 $179,058.36 $44,249.15 2026-03-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 103 27 — — $5,348.00 $463,299.44 $44,125.08 2026-03-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 107 27 — — $11,098.00 $296,509.83 $44,010.53 2026-03-01
01594 OTHER New Technology - Level 43 2 1 — — $43,042.90 $44,718.89 $43,880.90 2026-03-01
01580 OTHER New Technology - Level 43 2 1 — — $43,042.90 $44,718.89 $43,880.90 2026-03-01
834 OTHER Acute Leukemia With Mcc 2 1 — — $43,352.82 $44,313.44 $43,833.13 2026-03-01
01142 OTHER Supprelin La Implant 2 1 — — $42,753.49 $44,896.71 $43,825.10 2026-03-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 109 27 — — $11,000.00 $260,302.82 $43,707.27 2026-03-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 111 28 — — $11,000.00 $147,000.00 $43,244.20 2026-03-01
275 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 1 — — $26,674.64 $59,728.82 $43,201.73 2026-03-01
249 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc 5 2 — — $6,300.00 $54,530.00 $43,072.00 2026-03-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 5 2 — — $6,300.00 $54,530.00 $43,072.00 2026-03-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 107 27 — — $8,403.00 $166,103.93 $42,890.77 2026-03-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 107 27 — — $11,098.00 $183,166.33 $42,889.00 2026-03-01
021 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 2 1 — — $38,115.14 $46,545.29 $42,330.21 2026-03-01
834 MS_DRG Acute Leukemia With Mcc 107 27 — — $5,348.00 $169,985.34 $42,007.01 2026-03-01
0918T CPT Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 1 1 — — $42,000.00 $42,000.00 $42,000.00 2026-03-01
0917T CPT Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 1 1 — — $42,000.00 $42,000.00 $42,000.00 2026-03-01
1013T CPT Laparoscopy, Surgical, Implantation Or Replacement Of Lower Esophageal Sphincter… 1 1 — — $42,000.00 $42,000.00 $42,000.00 2026-03-01
1014T CPT Laparoscopic Revision Or Removal, Lower Esophageal Sphincter Neurostimulator Ele… 1 1 — — $42,000.00 $42,000.00 $42,000.00 2026-03-01
0675T CPT Laparoscopic Insertion Of New Or Replacement Of Diaphragmatic Lead(s), Permanent… 1 1 — — $42,000.00 $42,000.00 $42,000.00 2026-03-01
0680T CPT Insertion Or Replacement Of Pulse Generator Only, Permanent Implantable Synchron… 1 1 — — $42,000.00 $42,000.00 $42,000.00 2026-03-01
C8003 HCPCS Implantation Of Medial Knee Extraarticular Implantable Shock Absorber Spanning T… 1 1 — — $42,000.00 $42,000.00 $42,000.00 2026-03-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 109 28 — — $7,000.00 $239,819.60 $41,759.02 2026-03-01
0802T CPT Transcatheter Removal And Replacement Of Permanent Dual-chamber Leadless Pacemak… 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
0803T CPT Transcatheter Removal And Replacement Of Permanent Dual-chamber Leadless Pacemak… 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
C9792 HCPCS Blinded Or Nonblinded Procedure For Symptomatic New York Heart Association (nyha… 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
C9780 HCPCS Insertion Of Central Venous Catheter Through Central Venous Occlusion Via Inferi… 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
C9797 HCPCS Vascular Embolization Or Occlusion Procedure With Use Of A Pressure-generating C… 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
0505T CPT Endovenous Femoral-popliteal Arterial Revascularization, With Transcatheter Plac… 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
0801T CPT Transcatheter Removal And Replacement Of Permanent Dual-chamber Leadless Pacemak… 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
0796T CPT Transcatheter Insertion Of Permanent Dual-chamber Leadless Pacemaker, Including … 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
0797T CPT Transcatheter Insertion Of Permanent Dual-chamber Leadless Pacemaker, Including … 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
0795T CPT Transcatheter Insertion Of Permanent Dual-chamber Leadless Pacemaker, Including … 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
0620T CPT Endovascular Venous Arterialization, Tibial Or Peroneal Vein, With Transcatheter… 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
C9783 HCPCS Blinded Procedure For Transcatheter Implantation Of Coronary Sinus Reduction Dev… 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
0516T CPT Insertion Of Wireless Cardiac Stimulator For Left Ventricular Pacing, Including … 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
0526T CPT Insertion Or Replacement Of Intracardiac Ischemia Monitoring System, Including T… 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
0517T CPT Insertion Of Wireless Cardiac Stimulator For Left Ventricular Pacing, Including … 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
C9775 HCPCS Revascularization, Endovascular, Open Or Percutaneous, Tibial/peroneal Artery(ie… 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
0572T CPT Insertion Of Substernal Implantable Defibrillator Electrode 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
C9774 HCPCS Revascularization, Endovascular, Open Or Percutaneous, Tibial/peroneal Artery(ie… 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
C9766 HCPCS Revascularization, Endovascular, Open Or Percutaneous, Lower Extremity Artery(ie… 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
C9767 HCPCS Revascularization, Endovascular, Open Or Percutaneous, Lower Extremity Artery(ie… 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
0816T CPT Open Insertion Or Replacement Of Integrated Neurostimulation System For Bladder … 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
0823T CPT Transcatheter Insertion Of Permanent Single-chamber Leadless Pacemaker, Right At… 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
C9765 HCPCS Revascularization, Endovascular, Open Or Percutaneous, Lower Extremity Artery(ie… 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
0645T CPT Transcatheter Implantation Of Coronary Sinus Reduction Device Including Vascular… 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
0817T CPT Open Insertion Or Replacement Of Integrated Neurostimulation System For Bladder … 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
0527T CPT Insertion Or Replacement Of Intracardiac Ischemia Monitoring System, Including T… 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
C9772 HCPCS Revascularization, Endovascular, Open Or Percutaneous, Tibial/peroneal Artery(ie… 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
0825T CPT Transcatheter Removal And Replacement Of Permanent Single-chamber Leadless Pacem… 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
0525T CPT Insertion Or Replacement Of Intracardiac Ischemia Monitoring System, Including T… 2 1 — — $41,512.00 $42,000.00 $41,756.00 2026-03-01
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