Price Transparency 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 POINCIANA HOSPITAL

Kissimmee, FL · CCN 100320 · Rates published

44,804 distinct procedures filed
43 distinct payers
1,300,553 rate rows
2024-10-01 last MRF observed · ⚠ 20 mo old
Data quality

1,218,606 of 1,300,553 rate rows are consumer-grade (93.7%)

81,947 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 48,196
exceeds 10× this hospital's gross charge — excluded from medians 17,676
per-diem day rate — not a per-procedure price 8,409
template filing: same amount across many unrelated codes — excluded 7,578
placeholder amount (≤ $0.02) — excluded from medians 88

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 20 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/90-0811360_HCA-FLORIDA-POINCIANA-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 success · 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 $4,897,200.00 $4,897,200.00 $4,897,200.00 nat. median
$3,006,423
1.6× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 $3,884,946.48 $3,884,946.48 $3,884,946.48 nat. median
$2,469,189
1.6× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 19 $3,672,900.00 $4,407,480.00 $3,856,545.00 nat. median
$3,746,358
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 19 $3,605,000.00 $4,326,000.00 $3,785,250.00 nat. median
$3,605,000
1.1× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 1 $3,562,713.00 $3,562,713.00 $3,562,713.00 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
714
OTHER 		Inj Delandistrogene Mox R 20 $5,280.60 $4,821,909.75 $3,491,727.75 nat. median
$13,041
outlier · 267.7×
748
OTHER 		Inj, Lovotibeglogene Auto 20 $8,710.34 $4,764,700.00 $3,450,300.00 nat. median
$17,963
outlier · 192.1×
00714
OTHER 		Inj Delandistrogene Mox R 1 $3,225,691.35 $3,225,691.35 $3,225,691.35 nat. median
$3,228,024
1.0× median
00748
OTHER 		Inj, Lovotibeglogene Auto 1 $3,187,420.00 $3,187,420.00 $3,187,420.00 nat. median
$3,187,420
1.0× median
746
OTHER 		Inj, Betibeglogene Autote 20 $7,736.51 $4,303,600.00 $3,116,400.00 nat. median
$21,896
outlier · 142.3×
00746
OTHER 		Inj, Betibeglogene Autote 1 $2,878,960.00 $2,878,960.00 $2,878,960.00 nat. median
$2,878,960
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 20 $2,388,614.00 $3,463,490.30 $2,519,987.77 nat. median
$2,588,981
1.0× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 1 $2,316,955.58 $2,316,955.58 $2,316,955.58 nat. median
$2,457,321
0.9× median
9194
OTHER 		Tisagenlecleucel Car-pos 20 $529,192.90 $1,587,578.70 $560,944.47 nat. median
$566,531
1.0× median
9498
OTHER 		Ciltacabtagene Car-pos T 20 $527,123.40 $1,581,370.20 $558,750.80 nat. median
$587,650
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 20 $526,587.60 $1,579,762.80 $558,182.86 nat. median
$558,082
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 20 $516,726.10 $1,550,178.30 $547,729.67 nat. median
$562,201
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 20 $489,456.00 $1,468,368.00 $518,823.36 nat. median
$532,192
1.0× median
09194
OTHER 		Tisagenlecleucel Car-pos 1 $513,317.11 $513,317.11 $513,317.11 nat. median
$538,205
1.0× median
09498
OTHER 		Ciltacabtagene Car-pos T 1 $511,309.70 $511,309.70 $511,309.70 nat. median
$554,552
0.9× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $510,789.97 $510,789.97 $510,789.97 nat. median
$530,178
1.0× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 3 $502,693.77 $863,696.72 $502,693.77 nat. median
$754,974
0.7× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $501,224.32 $501,224.32 $501,224.32 nat. median
$534,091
0.9× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 3 $492,271.12 $837,683.55 $492,271.12 nat. median
$675,122
0.7× median
9391
OTHER 		Brexucabtagene Car Pos T 20 $460,530.40 $1,381,591.20 $488,162.22 nat. median
$489,450
1.0× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $474,772.32 $474,772.32 $474,772.32 nat. median
$505,583
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 3 $470,149.30 $830,699.97 $470,149.30 nat. median
$625,184
0.8× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 3 $459,839.17 $819,043.85 $459,839.17 nat. median
$674,188
0.7× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $446,714.49 $446,714.49 $446,714.49 nat. median
$464,978
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 3 $445,599.57 $807,075.90 $445,599.57 nat. median
$634,511
0.7× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 3 $435,956.80 $741,576.00 $435,956.80 nat. median
$620,080
0.7× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 29 $1,426.00 $669,846.28 $282,944.67 nat. median
$370,174
0.8× median
5834
APR_DRG 		Neonate With Ecmo 10 $192,207.00 $288,310.50 $230,648.40 nat. median
$309,665
0.7× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 30 $2,837.00 $500,319.76 $216,722.49 nat. median
$265,286
0.8× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 29 $2,837.00 $436,445.08 $181,815.50 nat. median
$206,368
0.9× median
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $178,990.51 $178,990.51 $178,990.51 nat. median
$263,894
0.7× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 29 $2,837.00 $619,680.09 $164,446.26 nat. median
$202,986
0.8× median
1908
OTHER 		New Technology - Level 52 20 $147,339.90 $442,019.70 $156,180.29 nat. median
$152,962
1.0× median
1907
OTHER 		New Technology - Level 52 20 $147,339.90 $442,019.70 $156,180.29 nat. median
$153,199
1.0× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 10 $125,393.00 $188,089.50 $150,471.60 nat. median
$246,434
0.6× median
5833
APR_DRG 		Neonate With Ecmo 10 $124,517.00 $186,775.50 $149,420.40 nat. median
$244,017
0.6× median
018
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $147,693.56 $147,693.56 $147,693.56 nat. median
$424,868
outlier · 0.3×
01907
OTHER 		New Technology - Level 52 1 $142,919.70 $142,919.70 $142,919.70 nat. median
$84,819
1.7× median
01908
OTHER 		New Technology - Level 52 1 $142,919.70 $142,919.70 $142,919.70 nat. median
$82,736
1.7× median
1905
OTHER 		New Technology - Level 51 20 $132,847.50 $398,542.50 $140,818.35 nat. median
$137,903
1.0× median
1906
OTHER 		New Technology - Level 51 20 $132,847.50 $398,542.50 $140,818.35 nat. median
$138,020
1.0× median
24
APR_DRG 		Heart And/or Lung Transplant 10 $111,047.00 $166,570.50 $133,256.40 nat. median
$234,738
0.6× median
01905
OTHER 		New Technology - Level 51 1 $128,862.07 $128,862.07 $128,862.07 nat. median
$82,736
1.6× median
01906
OTHER 		New Technology - Level 51 1 $128,862.07 $128,862.07 $128,862.07 nat. median
$82,736
1.6× median

Other procedures at this hospital

Browse this hospital's 44,804 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 — 12 10 — — $11,700.00 $44,738.50 $44,738.50 2024-10-01
0208 RC — 22 17 — — $6,000.00 $41,888.50 $41,888.50 2024-10-01
834 MS_DRG Acute Leukemia With Mcc 66 33 — — $1,426.00 $98,174.32 $44,381.87 2024-10-01
834 OTHER Acute Leukemia With Mcc 1 1 — — $42,052.24 $42,052.24 $42,052.24 2024-10-01
850 MS_DRG Acute Leukemia With Other Procedures 54 30 — — $2,837.00 $284,813.40 $72,218.59 2024-10-01
245 MS_DRG Aicd Generator Procedures 62 33 — — $9,599.00 $101,849.00 $41,457.57 2024-10-01
14 MS_DRG Allogeneic Bone Marrow Transplant 53 30 — — $1,426.00 $348,842.53 $102,315.99 2024-10-01
74 APR_DRG Allogeneic Bone Marrow Transplant 12 10 — — $75,611.00 $113,416.50 $90,733.20 2024-10-01
014 OTHER Allogeneic Bone Marrow Transplant 1 1 — — $78,325.54 $78,325.54 $78,325.54 2024-10-01
73 APR_DRG Allogeneic Bone Marrow Transplant 12 10 — — $36,953.00 $55,429.50 $44,343.60 2024-10-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 65 33 — — $2,837.00 $89,463.35 $41,017.72 2024-10-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 65 33 — — $2,837.00 $79,656.40 $36,407.71 2024-10-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 62 33 — — $10,799.00 $102,400.86 $55,617.35 2024-10-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 62 33 — — $10,799.00 $88,840.00 $38,776.46 2024-10-01
84 APR_DRG Autologous Bone Marrow Transplant 12 10 — — $37,476.00 $56,214.00 $44,971.20 2024-10-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 62 33 — — $1,426.00 $348,842.53 $48,731.93 2024-10-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 62 33 — — $1,426.00 $348,842.53 $48,731.93 2024-10-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 1 1 — — $120,116.70 $120,116.70 $120,116.70 2024-10-01
9035 OTHER Axicabtagene Ciloleucel C 23 20 — — $489,456.00 $1,468,368.00 $518,823.36 2024-10-01
09035 OTHER Axicabtagene Ciloleucel C 1 1 — — $474,772.32 $474,772.32 $474,772.32 2024-10-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 5 3 — — $445,599.57 $807,075.90 $445,599.57 2024-10-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 24 20 — — $88,300.94 $273,095.70 $96,038.65 2024-10-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 62 33 — — $10,799.00 $114,376.17 $51,682.89 2024-10-01
461 OTHER Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 1 1 — — $37,565.78 $37,565.78 $37,565.78 2024-10-01
C2616 HCPCS Brachytherapy Source, Non-stranded, Yttrium-90, Per Source 1 1 — — $57,469.00 $57,469.00 $57,469.00 2024-10-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 5 3 — — $435,956.80 $741,576.00 $435,956.80 2024-10-01
9391 OTHER Brexucabtagene Car Pos T 23 20 — — $460,530.40 $1,381,591.20 $488,162.22 2024-10-01
09391 OTHER Brexucabtagene Car Pos T 1 1 — — $446,714.49 $446,714.49 $446,714.49 2024-10-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 12 10 — — $46,203.00 $69,304.50 $55,443.60 2024-10-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 52 30 — — $9,599.00 $217,546.94 $57,228.07 2024-10-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 3 1 — — $78,794.00 $96,685.00 $96,685.00 2024-10-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 3 1 — — $78,794.00 $96,685.00 $96,685.00 2024-10-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 3 1 — — $77,361.00 $94,927.00 $94,927.00 2024-10-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 3 1 — — $77,361.00 $94,927.00 $94,927.00 2024-10-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 62 33 — — $9,599.00 $154,306.26 $51,369.70 2024-10-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 4 2 — — $71,631.00 $87,894.00 $79,978.00 2024-10-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 4 2 — — $71,631.00 $87,894.00 $79,978.00 2024-10-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 62 33 — — $9,599.00 $154,306.26 $39,127.07 2024-10-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 52 30 — — $10,799.00 $226,182.89 $77,730.53 2024-10-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 52 30 — — $10,799.00 $226,182.89 $53,461.22 2024-10-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $49,806.62 $49,806.62 $49,806.62 2024-10-01
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $49,529.65 $49,529.65 $49,529.65 2024-10-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 52 30 — — $10,799.00 $226,182.89 $49,425.08 2024-10-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 60 33 — — $10,799.00 $195,995.70 $65,810.67 2024-10-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 60 33 — — $10,799.00 $195,995.70 $48,706.29 2024-10-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 60 33 — — $10,799.00 $195,995.70 $42,552.05 2024-10-01
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $37,949.46 $37,949.46 $37,949.46 2024-10-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 12 10 — — $37,904.00 $56,856.00 $45,484.80 2024-10-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 12 10 — — $31,574.00 $47,361.00 $37,888.80 2024-10-01
471 MS_DRG Cervical Spinal Fusion With Mcc 62 33 — — $10,799.00 $75,357.00 $40,753.29 2024-10-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 66 33 — — $1,426.00 $88,935.79 $40,788.39 2024-10-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 52 29 — — $1,426.00 $669,846.28 $282,944.67 2024-10-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $147,693.56 $147,693.56 $147,693.56 2024-10-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 12 10 — — $97,644.00 $146,466.00 $117,172.80 2024-10-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 12 10 — — $56,946.00 $85,419.00 $68,335.20 2024-10-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 12 10 — — $48,895.00 $73,342.50 $58,674.00 2024-10-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 5 3 — — $492,271.12 $837,683.55 $492,271.12 2024-10-01
9498 OTHER Ciltacabtagene Car-pos T 23 20 — — $527,123.40 $1,581,370.20 $558,750.80 2024-10-01
09498 OTHER Ciltacabtagene Car-pos T 1 1 — — $511,309.70 $511,309.70 $511,309.70 2024-10-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 52 30 — — $10,799.00 $257,872.80 $66,527.11 2024-10-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 62 33 — — $10,799.00 $169,135.49 $44,993.77 2024-10-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 3 2 — — $79,747.00 $138,351.00 $95,081.00 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 3 2 — — $79,747.00 $138,351.00 $94,719.00 2024-10-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 54 30 — — $2,837.00 $333,030.04 $85,428.36 2024-10-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 65 33 — — $2,837.00 $191,271.12 $50,364.78 2024-10-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 62 33 — — $10,799.00 $191,543.22 $70,731.26 2024-10-01
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 1 — — $37,379.15 $37,379.15 $37,379.15 2024-10-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 62 33 — — $10,799.00 $145,936.22 $53,381.31 2024-10-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 52 30 — — $10,799.00 $227,849.48 $68,513.21 2024-10-01
231 OTHER Coronary Bypass With Ptca With Mcc 1 1 — — $44,710.16 $44,710.16 $44,710.16 2024-10-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 52 30 — — $10,799.00 $227,849.48 $50,689.20 2024-10-01
232 OTHER Coronary Bypass With Ptca Without Mcc 1 1 — — $37,952.93 $37,952.93 $37,952.93 2024-10-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 62 33 — — $10,799.00 $157,630.16 $50,389.29 2024-10-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 62 33 — — $10,799.00 $119,858.00 $40,940.80 2024-10-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 62 33 — — $10,799.00 $117,839.21 $38,993.10 2024-10-01
955 OTHER Craniotomy For Multiple Significant Trauma 1 1 — — $62,431.63 $62,431.63 $62,431.63 2024-10-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 54 30 — — $2,837.00 $216,353.42 $54,074.59 2024-10-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 62 33 — — $10,799.00 $137,838.27 $49,404.12 2024-10-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 62 33 — — $10,799.00 $137,838.27 $36,734.54 2024-10-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 12 10 — — $39,878.00 $59,817.00 $47,853.60 2024-10-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 24 20 — — $96,999.90 $299,999.70 $105,499.89 2024-10-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 53 29 — — $2,837.00 $619,680.09 $164,446.26 2024-10-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $119,887.93 $119,887.93 $119,887.93 2024-10-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 24 20 — — $37,140.82 $114,868.50 $40,395.42 2024-10-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 24 20 — — $46,068.21 $142,479.00 $50,105.12 2024-10-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 52 30 — — $10,799.00 $278,032.64 $49,753.02 2024-10-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 62 33 — — $10,799.00 $208,762.56 $50,301.86 2024-10-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 53 29 — — $2,837.00 $436,445.08 $181,815.50 2024-10-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 65 33 — — $2,837.00 $111,936.58 $38,838.59 2024-10-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 12 10 — — $90,217.00 $135,325.50 $108,260.40 2024-10-01
1784 APR_DRG External Heart Assist Devices 12 10 — — $30,258.00 $45,387.00 $36,309.60 2024-10-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 12 10 — — $75,232.00 $112,848.00 $90,278.40 2024-10-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 12 10 — — $32,422.00 $48,633.00 $38,906.40 2024-10-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 37 26 — — $43,139.16 $171,726.59 $48,033.09 2024-10-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 65 33 — — $2,837.00 $131,341.98 $53,697.13 2024-10-01
8514 APR_DRG Gender Related Procedures 12 10 — — $46,902.00 $70,353.00 $56,282.40 2024-10-01
24 APR_DRG Heart And/or Lung Transplant 12 10 — — $111,047.00 $166,570.50 $133,256.40 2024-10-01
23 APR_DRG Heart And/or Lung Transplant 12 10 — — $62,352.00 $93,528.00 $74,822.40 2024-10-01
22 APR_DRG Heart And/or Lung Transplant 12 10 — — $45,376.00 $68,064.00 $54,451.20 2024-10-01
21 APR_DRG Heart And/or Lung Transplant 12 10 — — $41,730.00 $62,595.00 $50,076.00 2024-10-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 53 30 — — $2,837.00 $500,319.76 $216,722.49 2024-10-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $178,990.51 $178,990.51 $178,990.51 2024-10-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 53 30 — — $2,837.00 $449,458.00 $86,396.72 2024-10-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $67,458.10 $67,458.10 $67,458.10 2024-10-01
0294T CPT HInsertion Of Left Atrial Hemodynamic Monitor; Pressure Sensor Lead At Time Of I… 4 2 — — $25,658.00 $45,611.00 $36,519.00 2024-10-01
0888T CPT Histotripsy (ie, Non-thermal Ablation Via Acoustic Energy Delivery) Of Malignant… 1 1 — — $39,376.13 $39,376.13 $39,376.13 2024-10-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 5 3 — — $43,241.44 $72,861.11 $43,241.44 2024-10-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 65 33 — — $2,837.00 $139,381.18 $50,958.93 2024-10-01
969 OTHER HIV With Extensive O.r. Procedures With Mcc 1 1 — — $37,864.09 $37,864.09 $37,864.09 2024-10-01
9422 OTHER Idecabtagene Vicleucel Ca 23 20 — — $526,587.60 $1,579,762.80 $558,182.86 2024-10-01
09422 OTHER Idecabtagene Vicleucel Ca 1 1 — — $510,789.97 $510,789.97 $510,789.97 2024-10-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 5 3 — — $470,149.30 $830,699.97 $470,149.30 2024-10-01
1614 APR_DRG Implantable Heart Assist Systems 12 10 — — $95,167.00 $142,750.50 $114,200.40 2024-10-01
1613 APR_DRG Implantable Heart Assist Systems 12 10 — — $64,392.00 $96,588.00 $77,270.40 2024-10-01
1612 APR_DRG Implantable Heart Assist Systems 12 10 — — $51,688.00 $77,532.00 $62,025.60 2024-10-01
1611 APR_DRG Implantable Heart Assist Systems 12 10 — — $49,247.00 $73,870.50 $59,096.40 2024-10-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 65 33 — — $2,837.00 $102,923.40 $40,747.46 2024-10-01
714 OTHER Inj Delandistrogene Mox R 23 20 — — $5,280.60 $4,821,909.75 $3,491,727.75 2024-10-01
00714 OTHER Inj Delandistrogene Mox R 1 1 — — $3,225,691.35 $3,225,691.35 $3,225,691.35 2024-10-01
9141 OTHER Inj Onase Abepar-xioi Tre 22 20 — — $2,388,614.00 $3,463,490.30 $2,519,987.77 2024-10-01
09141 OTHER Inj Onase Abepar-xioi Tre 1 1 — — $2,316,955.58 $2,316,955.58 $2,316,955.58 2024-10-01
773 OTHER Inj, Beqvez, Per Tx Dose 21 19 — — $3,605,000.00 $4,326,000.00 $3,785,250.00 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 23 20 — — $7,736.51 $4,303,600.00 $3,116,400.00 2024-10-01
00746 OTHER Inj, Betibeglogene Autote 1 1 — — $2,878,960.00 $2,878,960.00 $2,878,960.00 2024-10-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 21 19 — — $3,672,900.00 $4,407,480.00 $3,856,545.00 2024-10-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 1 1 — — $3,562,713.00 $3,562,713.00 $3,562,713.00 2024-10-01
748 OTHER Inj, Lovotibeglogene Auto 23 20 — — $8,710.34 $4,764,700.00 $3,450,300.00 2024-10-01
00748 OTHER Inj, Lovotibeglogene Auto 1 1 — — $3,187,420.00 $3,187,420.00 $3,187,420.00 2024-10-01
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 1 1 — — $4,897,200.00 $4,897,200.00 $4,897,200.00 2024-10-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 1 — — $3,884,946.48 $3,884,946.48 $3,884,946.48 2024-10-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 1 1 — — $38,803.31 $38,803.31 $38,803.31 2024-10-01
0515T CPT Insertion Of Wireless Cardiac Stimulator For Left Ventricular Pacing, Including … 1 1 — — $36,292.00 $36,292.00 $36,292.00 2024-10-01
0571T CPT Insertion Or Replacement Of Implantable Cardioverter-defibrillator System With S… 1 1 — — $36,292.00 $36,292.00 $36,292.00 2024-10-01
717 OTHER Instill Adstiladrin, Tx D 24 20 — — $12,654.78 $190,064.31 $66,839.29 2024-10-01
00717 OTHER Instill Adstiladrin, Tx D 1 1 — — $61,454.13 $61,454.13 $61,454.13 2024-10-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 52 30 — — $10,799.00 $223,257.86 $45,441.71 2024-10-01
021 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 1 — — $45,148.93 $45,148.93 $45,148.93 2024-10-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 52 30 — — $10,799.00 $223,257.86 $64,368.83 2024-10-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $57,539.16 $57,539.16 $57,539.16 2024-10-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 5 3 — — $61,600.24 $104,773.89 $61,600.24 2024-10-01
4404 APR_DRG Kidney Transplant 12 10 — — $35,422.00 $53,133.00 $42,506.40 2024-10-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 61 33 — — $2,837.00 $143,057.56 $37,701.16 2024-10-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $76,277.63 $76,277.63 $76,277.63 2024-10-01
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 24 20 — — $36,570.46 $113,104.50 $39,775.08 2024-10-01
5244 OTHER Level 4 Blood Product Exc 23 20 — — $50,304.25 $150,912.75 $53,322.51 2024-10-01
05244 OTHER Level 4 Blood Product Exc 1 1 — — $48,795.12 $48,795.12 $48,795.12 2024-10-01
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 1 — — $43,339.76 $43,339.76 $43,339.76 2024-10-01
9413 OTHER Lisocabtagene Car Pos T 23 20 — — $516,726.10 $1,550,178.30 $547,729.67 2024-10-01
09413 OTHER Lisocabtagene Car Pos T 1 1 — — $501,224.32 $501,224.32 $501,224.32 2024-10-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 5 3 — — $459,839.17 $819,043.85 $459,839.17 2024-10-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 12 10 — — $67,242.00 $100,863.00 $80,690.40 2024-10-01
13 APR_DRG Liver Transplant And/or Intestinal Transplant 12 10 — — $31,456.00 $47,184.00 $37,747.20 2024-10-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 52 30 — — $2,837.00 $354,565.82 $83,558.16 2024-10-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $55,450.54 $55,450.54 $55,450.54 2024-10-01
6 MS_DRG Liver Transplant Without Mcc 52 30 — — $2,837.00 $354,565.82 $39,195.80 2024-10-01
7 MS_DRG Lung Transplant 52 30 — — $2,837.00 $294,268.73 $102,063.57 2024-10-01
007 OTHER Lung Transplant 1 1 — — $67,580.69 $67,580.69 $67,580.69 2024-10-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 65 33 — — $2,837.00 $104,651.83 $47,082.53 2024-10-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 65 33 — — $2,837.00 $83,116.63 $37,897.74 2024-10-01
653 MS_DRG Major Bladder Procedures With Mcc 65 33 — — $2,837.00 $103,449.04 $45,169.80 2024-10-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 12 10 — — $55,523.00 $83,284.50 $66,627.60 2024-10-01
163 MS_DRG Major Chest Procedures With Mcc 65 33 — — $2,837.00 $92,067.39 $37,715.83 2024-10-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 65 33 — — $2,837.00 $90,907.89 $37,937.57 2024-10-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 52 30 — — $10,799.00 $324,091.07 $82,280.75 2024-10-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 52 30 — — $10,799.00 $219,491.80 $56,941.88 2024-10-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 62 33 — — $10,799.00 $170,220.78 $45,268.65 2024-10-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 62 33 — — $10,799.00 $207,293.86 $54,658.26 2024-10-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. 65 33 — — $2,837.00 $84,821.88 $38,999.99 2024-10-01
8634 APR_DRG Neonatal Aftercare 12 10 — — $35,009.00 $52,513.50 $42,010.80 2024-10-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 12 10 — — $68,321.00 $102,481.50 $81,985.20 2024-10-01
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 12 10 — — $30,178.00 $45,267.00 $36,213.60 2024-10-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 12 10 — — $54,849.00 $82,273.50 $65,818.80 2024-10-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 12 10 — — $38,906.00 $58,359.00 $46,687.20 2024-10-01
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 12 10 — — $31,113.00 $46,669.50 $37,335.60 2024-10-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 12 10 — — $42,035.00 $63,052.50 $50,442.00 2024-10-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 12 10 — — $34,228.00 $51,342.00 $41,073.60 2024-10-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 12 10 — — $34,068.00 $51,102.00 $40,881.60 2024-10-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 12 10 — — $82,446.00 $123,669.00 $98,935.20 2024-10-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 12 10 — — $30,783.00 $46,174.50 $36,939.60 2024-10-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 12 10 — — $79,657.00 $119,485.50 $95,588.40 2024-10-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 12 10 — — $59,125.00 $88,687.50 $70,950.00 2024-10-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 12 10 — — $44,835.00 $67,252.50 $53,802.00 2024-10-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 12 10 — — $73,863.00 $110,794.50 $88,635.60 2024-10-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 12 10 — — $51,226.00 $76,839.00 $61,471.20 2024-10-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 12 10 — — $41,957.00 $62,935.50 $50,348.40 2024-10-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 12 10 — — $125,393.00 $188,089.50 $150,471.60 2024-10-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 12 10 — — $81,552.00 $122,328.00 $97,862.40 2024-10-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 12 10 — — $71,560.00 $107,340.00 $85,872.00 2024-10-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 12 10 — — $61,338.00 $92,007.00 $73,605.60 2024-10-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 12 10 — — $48,983.00 $73,474.50 $58,779.60 2024-10-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 12 10 — — $47,538.00 $71,307.00 $57,045.60 2024-10-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 12 10 — — $46,525.00 $69,787.50 $55,830.00 2024-10-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 12 10 — — $91,470.00 $137,205.00 $109,764.00 2024-10-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 12 10 — — $43,677.00 $65,515.50 $52,412.40 2024-10-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 12 10 — — $80,942.00 $121,413.00 $97,130.40 2024-10-01
5834 APR_DRG Neonate With Ecmo 12 10 — — $192,207.00 $288,310.50 $230,648.40 2024-10-01
5833 APR_DRG Neonate With Ecmo 12 10 — — $124,517.00 $186,775.50 $149,420.40 2024-10-01
5832 APR_DRG Neonate With Ecmo 12 10 — — $95,607.00 $143,410.50 $114,728.40 2024-10-01
5831 APR_DRG Neonate With Ecmo 12 10 — — $69,493.00 $104,239.50 $83,391.60 2024-10-01
1580 OTHER New Technology - Level 43 23 20 — — $43,477.68 $130,433.04 $46,086.34 2024-10-01
1594 OTHER New Technology - Level 43 23 20 — — $43,477.68 $130,433.04 $46,086.34 2024-10-01
01580 OTHER New Technology - Level 43 1 1 — — $42,173.35 $42,173.35 $42,173.35 2024-10-01
01594 OTHER New Technology - Level 43 1 1 — — $42,173.35 $42,173.35 $42,173.35 2024-10-01
1581 OTHER New Technology - Level 44 23 20 — — $53,139.28 $159,417.84 $56,327.64 2024-10-01
1595 OTHER New Technology - Level 44 23 20 — — $53,139.28 $159,417.84 $56,327.64 2024-10-01
01581 OTHER New Technology - Level 44 1 1 — — $51,545.10 $51,545.10 $51,545.10 2024-10-01
01595 OTHER New Technology - Level 44 1 1 — — $51,545.10 $51,545.10 $51,545.10 2024-10-01
1582 OTHER New Technology - Level 45 23 20 — — $62,800.88 $188,402.64 $66,568.93 2024-10-01
1596 OTHER New Technology - Level 45 23 20 — — $62,800.88 $188,402.64 $66,568.93 2024-10-01
01582 OTHER New Technology - Level 45 1 1 — — $60,916.85 $60,916.85 $60,916.85 2024-10-01
01596 OTHER New Technology - Level 45 1 1 — — $60,916.85 $60,916.85 $60,916.85 2024-10-01
1583 OTHER New Technology - Level 46 23 20 — — $72,462.48 $217,387.44 $76,810.23 2024-10-01
1597 OTHER New Technology - Level 46 23 20 — — $72,462.48 $217,387.44 $76,810.23 2024-10-01
01583 OTHER New Technology - Level 46 1 1 — — $70,288.61 $70,288.61 $70,288.61 2024-10-01
01597 OTHER New Technology - Level 46 1 1 — — $70,288.61 $70,288.61 $70,288.61 2024-10-01
1584 OTHER New Technology - Level 47 23 20 — — $82,124.09 $246,372.27 $87,051.54 2024-10-01
1598 OTHER New Technology - Level 47 23 20 — — $82,124.09 $246,372.27 $87,051.54 2024-10-01
01598 OTHER New Technology - Level 47 1 1 — — $79,660.37 $79,660.37 $79,660.37 2024-10-01
01584 OTHER New Technology - Level 47 1 1 — — $79,660.37 $79,660.37 $79,660.37 2024-10-01
1585 OTHER New Technology - Level 48 23 20 — — $91,785.68 $275,357.04 $97,292.82 2024-10-01
1599 OTHER New Technology - Level 48 23 20 — — $91,785.68 $275,357.04 $97,292.82 2024-10-01
01599 OTHER New Technology - Level 48 1 1 — — $89,032.11 $89,032.11 $89,032.11 2024-10-01
01585 OTHER New Technology - Level 48 1 1 — — $89,032.11 $89,032.11 $89,032.11 2024-10-01
1901 OTHER New Technology - Level 49 23 20 — — $103,862.70 $311,588.10 $110,094.46 2024-10-01
1902 OTHER New Technology - Level 49 23 20 — — $103,862.70 $311,588.10 $110,094.46 2024-10-01
01902 OTHER New Technology - Level 49 1 1 — — $100,746.82 $100,746.82 $100,746.82 2024-10-01
01901 OTHER New Technology - Level 49 1 1 — — $100,746.82 $100,746.82 $100,746.82 2024-10-01
1904 OTHER New Technology - Level 50 23 20 — — $118,355.10 $355,065.30 $125,456.41 2024-10-01
1903 OTHER New Technology - Level 50 23 20 — — $118,355.10 $355,065.30 $125,456.41 2024-10-01
01904 OTHER New Technology - Level 50 1 1 — — $114,804.45 $114,804.45 $114,804.45 2024-10-01
01903 OTHER New Technology - Level 50 1 1 — — $114,804.45 $114,804.45 $114,804.45 2024-10-01
1906 OTHER New Technology - Level 51 23 20 — — $132,847.50 $398,542.50 $140,818.35 2024-10-01
1905 OTHER New Technology - Level 51 23 20 — — $132,847.50 $398,542.50 $140,818.35 2024-10-01
01906 OTHER New Technology - Level 51 1 1 — — $128,862.07 $128,862.07 $128,862.07 2024-10-01
01905 OTHER New Technology - Level 51 1 1 — — $128,862.07 $128,862.07 $128,862.07 2024-10-01
1907 OTHER New Technology - Level 52 23 20 — — $147,339.90 $442,019.70 $156,180.29 2024-10-01
1908 OTHER New Technology - Level 52 23 20 — — $147,339.90 $442,019.70 $156,180.29 2024-10-01
01907 OTHER New Technology - Level 52 1 1 — — $142,919.70 $142,919.70 $142,919.70 2024-10-01
01908 OTHER New Technology - Level 52 1 1 — — $142,919.70 $142,919.70 $142,919.70 2024-10-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 12 10 — — $31,789.00 $47,683.50 $38,146.80 2024-10-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 60 33 — — $10,799.00 $147,806.88 $45,966.60 2024-10-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 62 33 — — $10,799.00 $129,629.00 $36,384.85 2024-10-01
215 MS_DRG Other Heart Assist System Implant 52 30 — — $10,799.00 $402,640.00 $85,121.61 2024-10-01
215 OTHER Other Heart Assist System Implant 1 1 — — $51,453.49 $51,453.49 $51,453.49 2024-10-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $41,091.81 $41,091.81 $41,091.81 2024-10-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 62 33 — — $10,799.00 $102,400.86 $37,165.07 2024-10-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 62 33 — — $10,799.00 $102,400.86 $47,083.04 2024-10-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 65 33 — — $2,837.00 $153,372.48 $59,760.38 2024-10-01
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $42,827.53 $42,827.53 $42,827.53 2024-10-01
10 MS_DRG Pancreas Transplant 61 33 — — $2,837.00 $178,757.80 $63,690.07 2024-10-01
64 APR_DRG Pancreas Transplant 12 10 — — $48,372.00 $72,558.00 $58,046.40 2024-10-01
63 APR_DRG Pancreas Transplant 12 10 — — $34,364.00 $51,546.00 $41,236.80 2024-10-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 65 33 — — $2,837.00 $137,912.48 $44,043.94 2024-10-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 4 2 — — $32,234.00 $41,507.00 $38,638.00 2024-10-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 3 1 — — $32,234.00 $38,638.00 $38,638.00 2024-10-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 65 33 — — $2,837.00 $102,923.40 $36,962.17 2024-10-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 24 20 — — $63,895.55 $197,615.10 $69,494.64 2024-10-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 1 1 — — $76,785.37 $76,785.37 $76,785.37 2024-10-01
0520T CPT Removal And Replacement Of Pulse Generator For Wireless Cardiac Stimulator For L… 1 1 — — $36,292.00 $36,292.00 $36,292.00 2024-10-01
0614T CPT Removal And Replacement Of Substernal Implantable Defibrillator Pulse Generator 1 1 — — $36,292.00 $36,292.00 $36,292.00 2024-10-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 66 33 — — $1,426.00 $114,885.76 $52,069.34 2024-10-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 62 33 — — $10,799.00 $76,765.08 $42,050.81 2024-10-01
466 OTHER Revision Of Hip Or Knee Replacement With Mcc 1 1 — — $37,802.54 $37,802.54 $37,802.54 2024-10-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 62 33 — — $8,477.00 $102,260.55 $53,868.21 2024-10-01
870 OTHER Septicemia Or Severe Sepsis With Mv >96 Hours 1 1 — — $37,248.13 $37,248.13 $37,248.13 2024-10-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 61 33 — — $2,837.00 $180,572.80 $44,139.70 2024-10-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 61 33 — — $2,837.00 $180,572.80 $63,335.64 2024-10-01
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 1 — — $44,039.60 $44,039.60 $44,039.60 2024-10-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 65 33 — — $2,837.00 $159,228.72 $42,682.26 2024-10-01
9273 OTHER Sipuleucel-t Auto Cd54+ 23 20 — — $55,015.23 $165,045.69 $58,316.14 2024-10-01
09273 OTHER Sipuleucel-t Auto Cd54+ 1 1 — — $53,364.77 $53,364.77 $53,364.77 2024-10-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 2 2 — — $53,789.99 $91,596.09 $72,693.04 2024-10-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 65 33 — — $2,837.00 $95,829.61 $42,959.12 2024-10-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 65 33 — — $2,837.00 $109,381.00 $49,207.67 2024-10-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 5 3 — — $48,042.00 $83,345.00 $76,850.00 2024-10-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 62 33 — — $10,799.00 $156,884.99 $69,464.04 2024-10-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 62 33 — — $10,799.00 $156,884.99 $48,817.99 2024-10-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 62 33 — — $10,799.00 $156,884.99 $39,295.78 2024-10-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 5 3 — — $42,278.00 $73,342.00 $63,887.00 2024-10-01
28 MS_DRG Spinal Procedures With Mcc 62 33 — — $10,799.00 $107,983.05 $49,762.97 2024-10-01
799 MS_DRG Splenic Procedures With Mcc 65 33 — — $2,837.00 $100,452.90 $38,840.14 2024-10-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 65 33 — — $2,837.00 $90,212.95 $41,343.59 2024-10-01
1142 OTHER Supprelin La Implant 23 20 — — $45,350.21 $136,050.63 $48,071.22 2024-10-01
01142 OTHER Supprelin La Implant 1 1 — — $43,989.70 $43,989.70 $43,989.70 2024-10-01
9194 OTHER Tisagenlecleucel Car-pos 23 20 — — $529,192.90 $1,587,578.70 $560,944.47 2024-10-01
09194 OTHER Tisagenlecleucel Car-pos 1 1 — — $513,317.11 $513,317.11 $513,317.11 2024-10-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 5 3 — — $502,693.77 $863,696.72 $502,693.77 2024-10-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 65 33 — — $2,837.00 $100,984.72 $43,790.67 2024-10-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 53 29 — — $2,837.00 $371,924.31 $109,131.46 2024-10-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $84,296.07 $84,296.07 $84,296.07 2024-10-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 12 10 — — $66,782.00 $100,173.00 $80,138.40 2024-10-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 12 10 — — $41,876.00 $62,814.00 $50,251.20 2024-10-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 12 10 — — $43,560.00 $65,340.00 $52,272.00 2024-10-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 62 33 — — $9,599.00 $137,915.57 $42,392.45 2024-10-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 65 33 — — $2,837.00 $95,932.63 $43,416.56 2024-10-01
1643 OTHER Y90 Ibritumomab, Rx 23 20 — — $65,476.58 $196,429.74 $69,405.17 2024-10-01
01643 OTHER Y90 Ibritumomab, Rx 1 1 — — $63,512.28 $63,512.28 $63,512.28 2024-10-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 1 1 — — $108,036.36 $108,036.36 $108,036.36 2024-10-01
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