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 PALMS WEST HOSPITAL

Loxahatchee, FL · CCN 100269 · Rates published

32,495 distinct procedures filed
56 distinct payers
1,853,029 rate rows
2026-07-31 last MRF observed
Data quality

1,782,706 of 1,853,029 rate rows are consumer-grade (96.2%)

70,323 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 31,406
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 16,241
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 14,280
template filing: same amount across many unrelated codes — excluded 4,940
exceeds 10× this hospital's gross charge — excluded from medians 1,563
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 867
percent-of-charges filed in the dollar field — excluded from medians 685
placeholder amount (≤ $0.02) — excluded from medians 281
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 60
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1694178_HCA-FLORIDA-PALMS-WEST-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 442913fb5967a284… · 401,948,433 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 $4,897,200.00 nat. median
$2,997,086
1.6× median
845
OTHER 		Inj, Atidarsagene Autotem 19 $5,022.21 $4,955,500.00 $4,595,100.00 nat. median
$16,015
outlier · 286.9×
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 $3,884,946.48 nat. median
$2,460,273
1.6× 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
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 22 $3,636,171.00 $4,422,320.40 $3,826,185.00 nat. median
$3,758,972
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 21 $3,568,950.00 $4,326,000.00 $3,713,150.00 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 23 $10,221.24 $4,836,939.00 $3,469,252.80 nat. median
$29,683
outlier · 116.9×
714
OTHER 		Inj Delandistrogene Mox R 24 $5,565.76 $4,825,397.00 $3,427,695.80 nat. median
$3,325,455
1.0× median
748
OTHER 		Inj, Lovotibeglogene Auto 24 $9,180.70 $4,716,136.60 $3,384,580.00 nat. median
$3,252,508
1.0× median
906
OTHER 		Inj Elivaldogene Autoteme 23 $6,697.84 $4,611,000.00 $3,307,200.00 nat. median
$24,604
outlier · 134.4×
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 24 $8,154.28 $4,262,955.05 $3,057,040.00 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 23 $2,364,727.86 $3,754,022.45 $2,588,981.00 nat. median
$2,588,981
1.0× median
824
OTHER 		Inj, Exagamglogene Autote 23 $14,438.84 $3,381,400.00 $2,425,280.00 nat. median
$58,186
outlier · 41.7×
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 22 $762,913.80 $1,117,399.00 $809,151.00 nat. median
$786,032
1.0× median
9498
OTHER 		Ciltacabtagene Car-pos T 23 $521,852.17 $852,091.92 $587,649.60 nat. median
$587,650
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos 23 $523,900.97 $821,470.39 $566,531.30 nat. median
$576,820
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 23 $521,321.72 $809,218.61 $563,448.73 nat. median
$560,872
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 23 $511,558.84 $815,191.74 $562,201.20 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
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
9035
OTHER 		Axicabtagene Ciloleucel C 23 $484,561.44 $771,678.69 $532,192.20 nat. median
$533,230
1.0× 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
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 3 $470,149.30 $920,834.85 $511,793.34 nat. median
$610,161
0.8× 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
09035
OTHER 		Axicabtagene Ciloleucel C 1 $474,772.32 $516,226.43 $495,499.38 nat. median
$516,226
1.0× median
9391
OTHER 		Brexucabtagene Car Pos T 23 $455,925.10 $709,702.79 $492,767.53 nat. median
$492,768
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
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
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 34 $1,870.00 $725,393.41 $312,120.10 nat. median
$370,165
0.8× median
831
OTHER 		Obecbtge Autol Up To 400 23 $3,089.18 $403,462.50 $289,380.00 nat. median
$20,175
outlier · 14.3×
897
OTHER 		Revakinagene, Per Implant 22 $262,350.00 $384,250.00 $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 32,495 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
             
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 2 1 — — $188,656.08 $220,378.76 $204,517.42 2026-03-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 1 — — $71,100.84 $82,625.86 $76,863.35 2026-03-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 1 — — $126,361.80 $155,327.36 $140,844.58 2026-03-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 1 — — $88,848.05 $121,298.40 $105,073.23 2026-03-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 2 1 — — $58,444.88 $78,739.03 $68,591.96 2026-03-01
007 OTHER Lung Transplant 2 1 — — $71,230.05 $93,226.13 $82,228.09 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
00717 OTHER Instill Adstiladrin, Tx D 2 1 — — $61,454.13 $62,346.55 $61,900.34 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
00748 OTHER Inj, Lovotibeglogene Auto 2 1 — — $3,154,932.76 $3,187,420.00 $3,171,176.38 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
00824 OTHER Inj, Exagamglogene Autote 1 1 — — $2,262,040.00 $2,262,040.00 $2,262,040.00 2026-03-01
00831 OTHER Obecbtge Autol Up To 400 1 1 — — $269,902.50 $269,902.50 $269,902.50 2026-03-01
00845 OTHER Inj, Atidarsagene Autotem 1 1 — — $4,369,850.00 $4,369,850.00 $4,369,850.00 2026-03-01
00886 OTHER Inj. Remestemcel-l-rknd/ 1 1 — — $195,618.93 $195,618.93 $195,618.93 2026-03-01
00897 OTHER Revakinagene, Per Implant 1 1 — — $257,050.00 $257,050.00 $257,050.00 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
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
010 OTHER Pancreas Transplant 2 1 — — $27,952.24 $52,321.46 $40,136.85 2026-03-01
011 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 2 1 — — $30,543.38 $49,960.59 $40,251.99 2026-03-01
01142 OTHER Supprelin La Implant 2 1 — — $41,889.78 $43,989.70 $42,939.74 2026-03-01
014 OTHER Allogeneic Bone Marrow Transplant 2 1 — — $79,577.23 $82,555.13 $81,066.18 2026-03-01
01580 OTHER New Technology - Level 43 2 1 — — $42,173.35 $43,815.48 $42,994.42 2026-03-01
01581 OTHER New Technology - Level 44 2 1 — — $51,545.10 $53,552.15 $52,548.62 2026-03-01
01582 OTHER New Technology - Level 45 2 1 — — $60,916.85 $63,288.81 $62,102.83 2026-03-01
01583 OTHER New Technology - Level 46 2 1 — — $70,288.61 $73,025.48 $71,657.04 2026-03-01
01584 OTHER New Technology - Level 47 2 1 — — $79,660.37 $82,762.15 $81,211.26 2026-03-01
01585 OTHER New Technology - Level 48 2 1 — — $89,032.11 $92,498.81 $90,765.46 2026-03-01
01594 OTHER New Technology - Level 43 2 1 — — $42,173.35 $43,815.48 $42,994.42 2026-03-01
01595 OTHER New Technology - Level 44 2 1 — — $51,545.10 $53,552.15 $52,548.62 2026-03-01
01596 OTHER New Technology - Level 45 2 1 — — $60,916.85 $63,288.81 $62,102.83 2026-03-01
01597 OTHER New Technology - Level 46 2 1 — — $70,288.61 $73,025.48 $71,657.04 2026-03-01
01598 OTHER New Technology - Level 47 2 1 — — $79,660.37 $82,762.15 $81,211.26 2026-03-01
01599 OTHER New Technology - Level 48 2 1 — — $89,032.11 $92,498.81 $90,765.46 2026-03-01
01643 OTHER Y90 Ibritumomab, Rx 2 1 — — $55,119.81 $63,512.28 $59,316.04 2026-03-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 1 — — $155,668.99 $250,710.76 $203,189.88 2026-03-01
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 1 — — $46,417.74 $52,021.91 $49,219.82 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
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
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
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
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 1 — — $60,646.27 $64,937.08 $62,791.68 2026-03-01
021 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 2 1 — — $39,097.57 $47,586.97 $43,342.27 2026-03-01
0515T CPT Insertion Of Wireless Cardiac Stimulator For Left Ventricular Pacing, Including … 3 1 — — $44,716.00 $78,780.00 $78,356.00 2026-03-01
0520T CPT Removal And Replacement Of Pulse Generator For Wireless Cardiac Stimulator For L… 3 1 — — $44,716.00 $78,780.00 $78,356.00 2026-03-01
05244 OTHER Level 4 Blood Product Exc 2 1 — — $48,795.12 $62,571.25 $55,683.18 2026-03-01
0571T CPT Insertion Or Replacement Of Implantable Cardioverter-defibrillator System With S… 3 1 — — $44,716.00 $78,780.00 $78,356.00 2026-03-01
0614T CPT Removal And Replacement Of Substernal Implantable Defibrillator Pulse Generator 3 1 — — $44,716.00 $78,780.00 $78,356.00 2026-03-01
09035 OTHER Axicabtagene Ciloleucel C 2 1 — — $474,772.32 $516,226.43 $495,499.38 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
09141 OTHER Inj Onase Abepar-xioi Tre 2 1 — — $2,316,955.58 $2,511,311.57 $2,414,133.58 2026-03-01
0915T CPT Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 1 1 — — $78,780.00 $78,780.00 $78,780.00 2026-03-01
0916T CPT Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 1 1 — — $78,780.00 $78,780.00 $78,780.00 2026-03-01
09194 OTHER Tisagenlecleucel Car-pos 2 1 — — $513,317.11 $549,535.36 $531,426.23 2026-03-01
0923T CPT Removal And Replacement Of Permanent Cardiac Contractility Modulation-defibrilla… 1 1 — — $78,780.00 $78,780.00 $78,780.00 2026-03-01
09273 OTHER Sipuleucel-t Auto Cd54+ 2 1 — — $52,771.99 $53,364.77 $53,068.38 2026-03-01
09391 OTHER Brexucabtagene Car Pos T 2 1 — — $446,714.49 $474,766.69 $460,740.59 2026-03-01
09413 OTHER Lisocabtagene Car Pos T 2 1 — — $501,224.32 $545,335.16 $523,279.74 2026-03-01
09422 OTHER Idecabtagene Vicleucel Ca 2 1 — — $510,789.97 $541,339.35 $526,064.66 2026-03-01
09498 OTHER Ciltacabtagene Car-pos T 2 1 — — $511,309.70 $570,020.11 $540,664.91 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 122 36 — — $1,870.00 $541,808.87 $228,616.29 2026-03-01
10 MS_DRG Pancreas Transplant 116 36 — — $1,870.00 $172,444.62 $64,074.24 2026-03-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 125 37 — — $1,870.00 $103,789.76 $45,339.87 2026-03-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 27 12 — — $48,895.00 $105,823.65 $70,549.10 2026-03-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 27 12 — — $56,946.00 $133,113.71 $85,419.00 2026-03-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 27 12 — — $97,644.00 $178,865.04 $119,243.36 2026-03-01
1142 OTHER Supprelin La Implant 52 23 — — $42,753.49 $62,618.74 $45,992.38 2026-03-01
121710 CDM Ins Icd Lead/generator 63 25 $263,805.00 $263,805.00 $550.00 $352,031.00 $58,037.10 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 114 35 — — $1,870.00 $336,522.48 $105,786.30 2026-03-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 27 12 — — $66,329.56 $100,863.00 $78,000.72 2026-03-01
1580 OTHER New Technology - Level 43 52 23 — — $43,042.90 $66,695.37 $46,521.12 2026-03-01
1581 OTHER New Technology - Level 44 52 23 — — $52,607.89 $81,516.40 $56,859.03 2026-03-01
1582 OTHER New Technology - Level 45 52 23 — — $62,172.87 $96,337.43 $67,196.94 2026-03-01
1583 OTHER New Technology - Level 46 52 23 — — $71,737.86 $111,158.46 $77,534.85 2026-03-01
1584 OTHER New Technology - Level 47 52 23 — — $81,302.85 $125,979.49 $87,872.78 2026-03-01
1585 OTHER New Technology - Level 48 52 23 — — $90,867.82 $140,800.52 $98,210.68 2026-03-01
1594 OTHER New Technology - Level 43 52 23 — — $43,042.90 $66,695.37 $46,521.12 2026-03-01
1595 OTHER New Technology - Level 44 52 23 — — $52,607.89 $81,516.40 $56,859.03 2026-03-01
1596 OTHER New Technology - Level 45 52 23 — — $62,172.87 $96,337.43 $67,196.94 2026-03-01
1597 OTHER New Technology - Level 46 52 23 — — $71,737.86 $111,158.46 $77,534.85 2026-03-01
1598 OTHER New Technology - Level 47 52 23 — — $81,302.85 $125,979.49 $87,872.78 2026-03-01
1599 OTHER New Technology - Level 48 52 23 — — $90,867.82 $140,800.52 $98,210.68 2026-03-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 114 35 — — $1,870.00 $336,522.48 $51,056.73 2026-03-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 27 12 — — $51,048.39 $83,284.50 $61,258.07 2026-03-01
1611 APR_DRG Implantable Heart Assist Systems 27 12 — — $49,247.00 $76,852.35 $58,920.13 2026-03-01
1612 APR_DRG Implantable Heart Assist Systems 27 12 — — $51,234.90 $77,532.00 $59,958.08 2026-03-01
1613 APR_DRG Implantable Heart Assist Systems 27 12 — — $64,392.00 $104,446.96 $77,270.40 2026-03-01
1614 APR_DRG Implantable Heart Assist Systems 27 12 — — $88,926.10 $142,750.50 $106,711.32 2026-03-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 27 12 — — $34,306.45 $56,856.00 $41,167.74 2026-03-01
1643 OTHER Y90 Ibritumomab, Rx 52 23 — — $56,256.30 $82,395.60 $65,476.58 2026-03-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 114 35 — — $1,870.00 $336,522.48 $49,218.33 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 112 34 — — $1,870.00 $725,393.41 $312,120.10 2026-03-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 116 36 — — $1,870.00 $174,195.52 $63,857.74 2026-03-01
1901 OTHER New Technology - Level 49 52 23 — — $102,824.07 $159,326.87 $111,133.09 2026-03-01
1902 OTHER New Technology - Level 49 52 23 — — $102,824.07 $159,326.87 $111,133.09 2026-03-01
1903 OTHER New Technology - Level 50 52 23 — — $117,171.55 $181,558.41 $126,639.96 2026-03-01
1904 OTHER New Technology - Level 50 52 23 — — $117,171.55 $181,558.41 $126,639.96 2026-03-01
1905 OTHER New Technology - Level 51 52 23 — — $131,519.02 $203,789.96 $142,146.83 2026-03-01
1906 OTHER New Technology - Level 51 52 23 — — $131,519.02 $203,789.96 $142,146.83 2026-03-01
1907 OTHER New Technology - Level 52 52 23 — — $145,866.50 $226,021.50 $157,653.69 2026-03-01
1908 OTHER New Technology - Level 52 52 23 — — $145,866.50 $226,021.50 $157,653.69 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 122 36 — — $1,870.00 $385,037.72 $92,727.48 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 121 36 — — $1,870.00 $215,373.07 $67,940.55 2026-03-01
2067 OTHER Afamitresgene Autoleucel 26 22 — — $762,913.80 $1,117,399.00 $809,151.00 2026-03-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 123 36 — — $1,870.00 $124,412.68 $53,326.26 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 66 36 — — $1,984.00 $337,617.17 $96,128.67 2026-03-01
21 APR_DRG Heart And/or Lung Transplant 27 12 — — $41,730.00 $65,165.07 $49,959.89 2026-03-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 121 36 — — $1,870.00 $215,373.07 $47,213.00 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 131 38 — — $1,870.00 $321,268.44 $90,794.21 2026-03-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 66 36 — — $1,984.00 $170,225.41 $49,680.41 2026-03-01
213 OTHER Endovascular Abdominal Aorta With Iliac Branch Procedures 1 1 — — $41,612.15 $41,612.15 $41,612.15 2026-03-01
215 MS_DRG Other Heart Assist System Implant 132 38 — — $1,870.00 $347,433.56 $88,934.21 2026-03-01
215 OTHER Other Heart Assist System Implant 2 1 — — $44,553.71 $54,231.97 $49,392.84 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 132 38 — — $1,870.00 $220,000.00 $82,686.86 2026-03-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $52,496.18 $68,483.63 $60,489.90 2026-03-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 132 38 — — $1,870.00 $220,000.00 $57,154.95 2026-03-01
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $51,977.25 $52,204.26 $52,090.76 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 132 38 — — $1,870.00 $220,000.00 $57,015.21 2026-03-01
218 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $33,080.11 $47,943.93 $40,512.02 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 128 37 — — $1,870.00 $189,073.73 $66,714.10 2026-03-01
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $39,998.73 $45,016.82 $42,507.78 2026-03-01
22 APR_DRG Heart And/or Lung Transplant 27 12 — — $45,376.00 $73,729.74 $54,451.20 2026-03-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 128 37 — — $1,870.00 $189,073.73 $46,634.65 2026-03-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 128 37 — — $1,870.00 $189,073.73 $44,049.23 2026-03-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 128 37 — — $1,870.00 $142,586.79 $43,435.49 2026-03-01
23 APR_DRG Heart And/or Lung Transplant 27 12 — — $62,352.00 $97,366.79 $74,647.87 2026-03-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 121 36 — — $1,870.00 $132,970.24 $49,878.05 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 132 38 — — $1,870.00 $219,802.53 $72,992.86 2026-03-01
231 OTHER Coronary Bypass With Ptca With Mcc 2 1 — — $47,124.50 $61,466.71 $54,295.60 2026-03-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 132 38 — — $1,870.00 $219,802.53 $53,459.54 2026-03-01
232 OTHER Coronary Bypass With Ptca Without Mcc 2 1 — — $40,002.39 $44,205.56 $42,103.97 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 132 38 — — $1,870.00 $184,778.49 $67,347.08 2026-03-01
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 1 — — $39,397.64 $54,947.06 $47,172.35 2026-03-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 132 38 — — $1,870.00 $140,782.19 $47,992.23 2026-03-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 126 37 — — $1,870.00 $152,063.14 $52,047.08 2026-03-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 125 37 — — $1,870.00 $96,882.11 $41,779.07 2026-03-01
24 APR_DRG Heart And/or Lung Transplant 27 12 — — $111,047.00 $178,746.99 $133,256.40 2026-03-01
245 MS_DRG Aicd Generator Procedures 124 36 — — $1,425.00 $93,996.71 $40,188.44 2026-03-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 4 2 — — $6,300.00 $51,722.00 $44,082.00 2024-10-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 4 2 — — $6,300.00 $51,722.00 $44,082.00 2024-10-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 4 2 — — $6,300.00 $51,638.00 $40,213.00 2024-10-01
249 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc 4 2 — — $6,300.00 $51,638.00 $40,213.00 2024-10-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 131 38 — — $1,870.00 $268,213.38 $53,501.53 2026-03-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 131 38 — — $1,870.00 $201,389.71 $42,506.76 2026-03-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 127 37 — — $1,870.00 $145,000.00 $58,403.01 2026-03-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 127 37 — — $1,870.00 $109,000.00 $46,269.11 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 125 37 — — $1,870.00 $209,863.84 $62,913.65 2026-03-01
275 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 1 — — $27,271.63 $61,268.33 $44,269.98 2026-03-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 123 37 — — $1,870.00 $138,361.61 $53,142.47 2026-03-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 123 37 — — $1,870.00 $138,361.61 $40,593.25 2026-03-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 121 36 — — $1,870.00 $133,044.81 $44,518.47 2026-03-01
28 MS_DRG Spinal Procedures With Mcc 123 36 — — $1,870.00 $116,937.57 $51,681.79 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 125 36 — — $1,870.00 $597,794.88 $176,631.38 2026-03-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 27 12 — — $34,140.79 $59,817.00 $40,968.95 2026-03-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 125 37 — — $1,870.00 $184,527.94 $53,580.86 2026-03-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 125 37 — — $1,870.00 $97,693.87 $42,119.56 2026-03-01
360 OTHER Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 1 1 — — $50,523.55 $50,523.55 $50,523.55 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 125 36 — — $1,870.00 $358,789.08 $116,279.90 2026-03-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 125 37 — — $1,870.00 $133,041.83 $45,830.92 2026-03-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 1 — — $43,310.77 $73,791.97 $58,551.37 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 125 37 — — $1,870.00 $312,460.23 $89,931.17 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 123 37 — — $1,870.00 $196,811.46 $61,309.23 2026-03-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 123 37 — — $1,870.00 $152,631.67 $48,963.32 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 125 37 — — $1,870.00 $248,783.42 $71,820.07 2026-03-01
429 OTHER Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 1 1 — — $65,693.81 $65,693.81 $65,693.81 2026-03-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 27 12 — — $41,876.00 $69,298.37 $50,251.20 2026-03-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 123 37 — — $1,870.00 $151,658.52 $50,188.88 2026-03-01
430 OTHER Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 1 1 — — $40,634.03 $40,634.03 $40,634.03 2026-03-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 27 12 — — $66,782.00 $100,494.24 $77,715.55 2026-03-01
4404 APR_DRG Kidney Transplant 27 12 — — $33,592.77 $53,133.00 $40,311.32 2026-03-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 123 37 — — $1,870.00 $185,873.95 $55,781.27 2026-03-01
447 OTHER Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 1 1 — — $53,432.92 $53,432.92 $53,432.92 2026-03-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 123 37 — — $1,870.00 $142,775.43 $44,805.88 2026-03-01
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $58,311.47 $58,311.47 $58,311.47 2024-10-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 121 36 — — $1,870.00 $162,901.99 $71,328.89 2026-03-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 121 36 — — $1,870.00 $151,344.29 $51,336.08 2026-03-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 127 37 — — $1,870.00 $118,045.56 $50,014.46 2026-03-01
461 OTHER Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 2 1 — — $39,594.34 $40,270.77 $39,932.55 2026-03-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 125 37 — — $1,870.00 $103,887.87 $45,160.26 2026-03-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 125 37 — — $1,870.00 $74,053.98 $44,336.77 2026-03-01
471 MS_DRG Cervical Spinal Fusion With Mcc 125 37 — — $1,870.00 $70,676.00 $41,848.48 2026-03-01
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 2 1 — — $24,986.00 $71,272.14 $48,129.07 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 122 37 — — $1,870.00 $342,043.64 $87,808.11 2026-03-01
5244 OTHER Level 4 Blood Product Exc 52 23 — — $49,801.21 $95,245.15 $65,029.45 2026-03-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 27 12 — — $43,560.00 $70,007.73 $52,272.00 2026-03-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 131 38 — — $1,870.00 $118,451.44 $51,329.15 2026-03-01
573 OTHER Skin Graft For Skin Ulcer Or Cellulitis With Mcc 2 1 — — $36,108.09 $47,769.85 $41,938.97 2026-03-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 125 37 — — $1,870.00 $103,776.30 $42,454.85 2026-03-01
5831 APR_DRG Neonate With Ecmo 27 12 — — $69,493.00 $122,622.00 $83,391.60 2026-03-01
5832 APR_DRG Neonate With Ecmo 27 12 — — $91,071.80 $143,410.50 $109,286.16 2026-03-01
5833 APR_DRG Neonate With Ecmo 27 12 — — $118,611.62 $186,775.50 $142,333.94 2026-03-01
5834 APR_DRG Neonate With Ecmo 27 12 — — $192,207.00 $312,391.65 $230,648.40 2026-03-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 27 12 — — $61,338.00 $93,593.57 $72,379.02 2026-03-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 27 12 — — $71,560.00 $109,192.05 $84,441.85 2026-03-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 27 12 — — $81,552.00 $127,428.00 $97,694.80 2026-03-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 27 12 — — $125,393.00 $191,333.91 $147,964.89 2026-03-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 27 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 27 12 — — $47,538.00 $89,188.07 $59,458.71 2026-03-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 27 12 — — $46,525.00 $89,188.07 $59,458.71 2026-03-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 27 12 — — $44,835.00 $81,160.27 $54,106.85 2026-03-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 27 12 — — $59,125.00 $94,624.20 $70,950.00 2026-03-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 27 12 — — $79,657.00 $125,467.54 $95,588.40 2026-03-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 27 12 — — $41,957.00 $64,905.25 $49,928.83 2026-03-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 27 12 — — $51,226.00 $80,695.10 $61,471.20 2026-03-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 27 12 — — $73,540.00 $110,794.50 $85,681.08 2026-03-01
595882 CDM Rem/replace Icd Dual Ld 28 23 $188,954.00 $188,954.00 $550.00 $273,983.30 $49,411.47 2024-10-01
6 MS_DRG Liver Transplant Without Mcc 122 37 — — $1,870.00 $342,043.64 $40,454.57 2026-03-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 27 12 — — $38,465.25 $58,359.00 $45,130.96 2026-03-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 27 12 — — $54,849.00 $83,100.26 $64,264.20 2026-03-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 27 12 — — $40,520.04 $102,481.50 $68,321.00 2026-03-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 27 12 — — $42,035.00 $64,236.87 $49,676.51 2026-03-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 27 12 — — $82,446.00 $133,307.22 $98,935.20 2026-03-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 27 12 — — $34,068.00 $53,426.60 $40,881.60 2026-03-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 27 12 — — $34,228.00 $52,935.54 $40,731.32 2026-03-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 27 12 — — $42,730.78 $65,515.50 $50,665.32 2026-03-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 27 12 — — $77,520.20 $137,205.00 $93,024.24 2026-03-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 27 12 — — $80,942.00 $128,217.69 $97,130.40 2026-03-01
64 APR_DRG Pancreas Transplant 27 12 — — $43,326.23 $72,558.00 $51,991.48 2026-03-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 2 1 — — $80,396.63 $108,708.38 $94,552.51 2026-03-01
653 MS_DRG Major Bladder Procedures With Mcc 125 37 — — $1,870.00 $107,225.31 $45,652.70 2026-03-01
7 MS_DRG Lung Transplant 122 37 — — $1,870.00 $283,876.06 $108,423.43 2026-03-01
714 OTHER Inj Delandistrogene Mox R 53 24 — — $5,565.76 $4,825,397.00 $3,427,695.80 2026-03-01
717 OTHER Instill Adstiladrin, Tx D 53 24 — — $13,338.14 $93,198.45 $66,203.03 2026-03-01
73 APR_DRG Allogeneic Bone Marrow Transplant 27 12 — — $36,953.00 $66,933.09 $44,622.06 2026-03-01
74 APR_DRG Allogeneic Bone Marrow Transplant 27 12 — — $70,159.56 $113,416.50 $84,191.47 2026-03-01
746 OTHER Inj, Betibeglogene Autote 53 24 — — $8,154.28 $4,262,955.05 $3,057,040.00 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 53 24 — — $9,180.70 $4,716,136.60 $3,384,580.00 2026-03-01
773 OTHER Inj, Beqvez, Per Tx Dose 25 21 — — $3,568,950.00 $4,326,000.00 $3,713,150.00 2024-10-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 80 30 — — $4,345.00 $63,331.88 $50,567.70 2026-03-01
791316 CDM Ep Eval Sq Defib 28 23 $160,385.00 $160,385.00 $550.00 $232,558.25 $41,940.68 2024-10-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 122 37 — — $1,870.00 $174,195.52 $46,378.89 2026-03-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 125 37 — — $1,870.00 $111,990.07 $48,592.22 2026-03-01
824 OTHER Inj, Exagamglogene Autote 28 23 — — $14,438.84 $3,381,400.00 $2,425,280.00 2026-03-01
831 OTHER Obecbtge Autol Up To 400 28 23 — — $3,089.18 $403,462.50 $289,380.00 2026-03-01
834 MS_DRG Acute Leukemia With Mcc 123 36 — — $1,870.00 $106,315.45 $45,735.71 2026-03-01
834 OTHER Acute Leukemia With Mcc 2 1 — — $44,323.06 $45,455.62 $44,889.34 2026-03-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 123 36 — — $1,870.00 $96,310.80 $41,539.45 2026-03-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 27 12 — — $79,102.08 $135,325.50 $94,922.50 2026-03-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 27 12 — — $44,285.71 $69,304.50 $53,133.45 2026-03-01
845 OTHER Inj, Atidarsagene Autotem 24 19 — — $5,022.21 $4,955,500.00 $4,595,100.00 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 125 37 — — $1,870.00 $274,772.55 $74,714.99 2026-03-01
8514 APR_DRG Gender Related Procedures 27 12 — — $40,865.02 $70,353.00 $49,038.02 2026-03-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 125 37 — — $1,870.00 $99,288.46 $41,907.55 2026-03-01
8634 APR_DRG Neonatal Aftercare 27 12 — — $34,835.42 $52,513.50 $40,610.44 2026-03-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 121 36 — — $1,870.00 $74,889.35 $56,702.96 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 28 23 — — $5,825.24 $292,420.05 $209,735.76 2026-03-01
897 OTHER Revakinagene, Per Implant 26 22 — — $262,350.00 $384,250.00 $278,250.00 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 51 23 — — $484,561.44 $771,678.69 $532,192.20 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 28 23 — — $6,697.84 $4,611,000.00 $3,307,200.00 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 28 23 — — $10,221.24 $4,836,939.00 $3,469,252.80 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 50 22 — — $3,636,171.00 $4,422,320.40 $3,826,185.00 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 51 23 — — $2,364,727.86 $3,754,022.45 $2,588,981.00 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 51 23 — — $523,900.97 $821,470.39 $566,531.30 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 119 35 — — $1,870.00 $456,331.78 $185,376.57 2026-03-01
9273 OTHER Sipuleucel-t Auto Cd54+ 51 23 — — $53,860.07 $78,885.96 $57,124.32 2026-03-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 119 35 — — $1,870.00 $128,467.63 $56,661.50 2026-03-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 27 12 — — $32,422.00 $87,882.00 $48,633.00 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 51 23 — — $455,925.10 $709,702.79 $492,767.53 2026-03-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 27 12 — — $75,232.00 $130,764.62 $90,278.40 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 51 23 — — $511,558.84 $815,191.74 $562,201.20 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 51 23 — — $521,321.72 $809,218.61 $563,448.73 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 51 23 — — $521,852.17 $852,091.92 $587,649.60 2026-03-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 124 37 — — $1,870.00 $208,712.48 $57,187.40 2026-03-01
955 OTHER Craniotomy For Multiple Significant Trauma 2 1 — — $44,275.18 $65,802.93 $55,039.05 2026-03-01
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 2 1 — — $45,680.10 $50,825.71 $48,252.90 2026-03-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 124 37 — — $1,870.00 $147,955.83 $62,610.89 2026-03-01
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 1 — — $45,140.21 $55,676.87 $50,408.54 2026-03-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 125 37 — — $1,870.00 $134,458.66 $52,659.19 2026-03-01
969 OTHER HIV With Extensive O.r. Procedures With Mcc 2 1 — — $39,908.75 $44,633.19 $42,270.97 2026-03-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 125 37 — — $1,870.00 $107,983.33 $40,224.04 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 3 1 — — $93,760.51 $108,036.36 $108,036.36 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 3 1 — — $76,785.37 $77,046.96 $76,785.37 2026-03-01
C2616 HCPCS Brachytherapy Source, Non-stranded, Yttrium-90, Per Source 3 1 — — $27,959.00 $47,788.00 $40,000.00 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
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 3 1 — — $4,850,948.67 $4,897,200.00 $4,897,200.00 2026-03-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 3 1 — — $3,884,946.48 $4,271,819.03 $3,884,946.48 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
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 3 1 — — $120,116.70 $138,148.31 $120,116.70 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 11 3 — — $61,338.53 $106,053.40 $61,600.24 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 11 3 — — $43,241.44 $72,861.11 $43,855.64 2026-03-01
J9999 HCPCS Carmustine 7.7mg Implant 69 26 $222,230.00 $222,230.00 $550.00 $295,627.67 $48,890.60 2026-03-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 54 24 — — $88,300.94 $137,867.45 $96,738.21 2026-03-01
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 54 24 — — $36,570.46 $57,098.68 $40,064.78 2026-03-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 54 24 — — $37,140.82 $57,989.27 $40,689.66 2026-03-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 54 24 — — $46,068.21 $71,927.83 $50,470.04 2026-03-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 54 24 — — $63,895.55 $99,762.46 $70,000.86 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 54 24 — — $96,999.90 $161,679.35 $110,945.49 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 11 3 — — $445,599.57 $878,117.20 $487,755.77 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 11 3 — — $502,693.77 $934,776.65 $561,407.87 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 5 2 — — $53,789.99 $91,596.09 $89,766.78 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 11 3 — — $435,956.80 $807,592.83 $474,717.03 2026-03-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 11 3 — — $459,839.17 $927,632.05 $500,948.74 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 7 3 — — $470,149.30 $920,834.85 $511,793.34 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 11 3 — — $492,271.12 $969,621.79 $536,573.93 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
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
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