|
J3393
|
HCPCS
|
Injection, Betibeglogene Autotemcel, Per Treatment
|
3
|
1
|
—
|
—
|
$4,850,948.67
|
$4,897,200.00
|
$4,897,200.00
|
2026-03-01
|
|
845
|
OTHER
|
Inj, Atidarsagene Autotem
|
19
|
15
|
—
|
—
|
$4,459,950.00
|
$4,955,500.00
|
$4,640,150.00
|
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
|
|
9138
|
OTHER
|
Inj, Hemgenix, Per Tx Dos
|
41
|
18
|
—
|
—
|
$3,636,171.00
|
$4,422,320.40
|
$3,856,545.00
|
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
|
|
773
|
OTHER
|
Inj, Beqvez, Per Tx Dose
|
19
|
16
|
—
|
—
|
$3,568,950.00
|
$4,326,000.00
|
$3,785,250.00
|
2024-10-01
|
|
908
|
OTHER
|
Topi Adm Prad Zami Per Tr
|
23
|
19
|
—
|
—
|
$3,302,461.80
|
$4,836,939.00
|
$3,502,611.00
|
2026-03-01
|
|
714
|
OTHER
|
Inj Delandistrogene Mox R
|
42
|
19
|
—
|
—
|
$3,292,200.45
|
$4,825,397.00
|
$3,492,990.38
|
2026-03-01
|
|
748
|
OTHER
|
Inj, Lovotibeglogene Auto
|
42
|
19
|
—
|
—
|
$3,219,982.92
|
$4,716,136.60
|
$3,431,395.94
|
2026-03-01
|
|
906
|
OTHER
|
Inj Elivaldogene Autoteme
|
23
|
19
|
—
|
—
|
$3,148,200.00
|
$4,611,000.00
|
$3,339,000.00
|
2026-03-01
|
|
746
|
OTHER
|
Inj, Betibeglogene Autote
|
42
|
19
|
—
|
—
|
$2,910,569.31
|
$4,262,955.05
|
$3,101,667.29
|
2026-03-01
|
|
9141
|
OTHER
|
Inj Onase Abepar-xioi Tre
|
42
|
19
|
—
|
—
|
$2,364,727.86
|
$3,754,022.45
|
$2,608,228.20
|
2026-03-01
|
|
824
|
OTHER
|
Inj, Exagamglogene Autote
|
23
|
19
|
—
|
—
|
$2,308,680.00
|
$3,381,400.00
|
$2,448,600.00
|
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
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka…
|
3
|
1
|
—
|
—
|
$863,696.72
|
$934,776.65
|
$863,696.72
|
2026-03-01
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige…
|
3
|
1
|
—
|
—
|
$837,683.55
|
$969,621.79
|
$837,683.55
|
2026-03-01
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (…
|
3
|
1
|
—
|
—
|
$830,699.97
|
$920,834.85
|
$830,699.97
|
2026-03-01
|
|
Q2054
|
HCPCS
|
Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi…
|
3
|
1
|
—
|
—
|
$819,043.85
|
$927,632.05
|
$819,043.85
|
2026-03-01
|
|
2067
|
OTHER
|
Afamitresgene Autoleucel
|
23
|
19
|
—
|
—
|
$762,913.80
|
$1,117,399.00
|
$809,151.00
|
2026-03-01
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via…
|
3
|
1
|
—
|
—
|
$807,075.90
|
$878,117.20
|
$807,075.90
|
2026-03-01
|
|
Q2053
|
HCPCS
|
Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V…
|
3
|
1
|
—
|
—
|
$741,576.00
|
$807,592.83
|
$741,576.00
|
2026-03-01
|
|
9498
|
OTHER
|
Ciltacabtagene Car-pos T
|
42
|
19
|
—
|
—
|
$521,852.17
|
$852,091.92
|
$587,649.60
|
2026-03-01
|
|
9194
|
OTHER
|
Tisagenlecleucel Car-pos
|
42
|
19
|
—
|
—
|
$523,900.97
|
$821,470.39
|
$572,196.61
|
2026-03-01
|
|
9422
|
OTHER
|
Idecabtagene Vicleucel Ca
|
42
|
19
|
—
|
—
|
$521,321.72
|
$809,218.61
|
$566,346.08
|
2026-03-01
|
|
9413
|
OTHER
|
Lisocabtagene Car Pos T
|
42
|
19
|
—
|
—
|
$511,558.84
|
$815,191.74
|
$565,299.95
|
2026-03-01
|
|
9035
|
OTHER
|
Axicabtagene Ciloleucel C
|
42
|
19
|
—
|
—
|
$484,561.44
|
$771,678.69
|
$535,296.90
|
2026-03-01
|
|
9391
|
OTHER
|
Brexucabtagene Car Pos T
|
42
|
19
|
—
|
—
|
$455,925.10
|
$709,702.79
|
$496,003.36
|
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
|
88
|
28
|
—
|
—
|
$1,870.00
|
$725,393.41
|
$317,426.95
|
2026-03-01
|
|
831
|
OTHER
|
Obecbtge Autol Up To 400
|
23
|
19
|
—
|
—
|
$275,467.50
|
$403,462.50
|
$292,162.50
|
2026-03-01
|
|
897
|
OTHER
|
Revakinagene, Per Implant
|
23
|
19
|
—
|
—
|
$262,350.00
|
$384,250.00
|
$278,250.00
|
2026-03-01
|
|
5834
|
APR_DRG
|
Neonate With Ecmo
|
24
|
10
|
—
|
—
|
$192,207.00
|
$312,391.65
|
$235,074.33
|
2026-03-01
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
96
|
29
|
—
|
—
|
$1,870.00
|
$541,808.87
|
$228,914.28
|
2026-03-01
|
|
886
|
OTHER
|
Inj. Remestemcel-l-rknd/
|
23
|
19
|
—
|
—
|
$199,652.31
|
$292,420.05
|
$211,752.45
|
2026-03-01
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
91
|
27
|
—
|
—
|
$1,870.00
|
$456,331.78
|
$183,881.80
|
2026-03-01
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
97
|
28
|
—
|
—
|
$1,870.00
|
$597,794.88
|
$177,649.25
|
2026-03-01
|
|
1908
|
OTHER
|
New Technology - Level 52
|
43
|
19
|
—
|
—
|
$145,866.50
|
$226,021.50
|
$158,994.44
|
2026-03-01
|
|
1907
|
OTHER
|
New Technology - Level 52
|
43
|
19
|
—
|
—
|
$145,866.50
|
$226,021.50
|
$158,994.44
|
2026-03-01
|
|
5884
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
24
|
10
|
—
|
—
|
$125,393.00
|
$191,333.91
|
$149,844.64
|
2026-03-01
|
|
1906
|
OTHER
|
New Technology - Level 51
|
43
|
19
|
—
|
—
|
$131,519.02
|
$203,789.96
|
$143,355.70
|
2026-03-01
|
|
1905
|
OTHER
|
New Technology - Level 51
|
43
|
19
|
—
|
—
|
$131,519.02
|
$203,789.96
|
$143,355.70
|
2026-03-01
|
|
5833
|
APR_DRG
|
Neonate With Ecmo
|
24
|
10
|
—
|
—
|
$118,611.62
|
$186,775.50
|
$142,764.24
|
2026-03-01
|
|
24
|
APR_DRG
|
Heart And/or Lung Transplant
|
24
|
10
|
—
|
—
|
$111,047.00
|
$178,746.99
|
$135,147.88
|
2026-03-01
|
|
114
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
24
|
10
|
—
|
—
|
$97,644.00
|
$178,865.04
|
$127,972.48
|
2026-03-01
|
|
1904
|
OTHER
|
New Technology - Level 50
|
43
|
19
|
—
|
—
|
$117,171.55
|
$181,558.41
|
$127,716.95
|
2026-03-01
|
|
1903
|
OTHER
|
New Technology - Level 50
|
43
|
19
|
—
|
—
|
$117,171.55
|
$181,558.41
|
$127,716.95
|
2026-03-01
|
|
J7330
|
HCPCS
|
Autologous Cultured Chondrocytes, Implant
|
3
|
1
|
—
|
—
|
$120,116.70
|
$138,148.31
|
$120,116.70
|
2026-03-01
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
97
|
28
|
—
|
—
|
$1,870.00
|
$358,789.08
|
$117,131.29
|
2026-03-01
|
|
1902
|
OTHER
|
New Technology - Level 49
|
43
|
19
|
—
|
—
|
$102,824.07
|
$159,326.87
|
$112,078.21
|
2026-03-01
|
|
1901
|
OTHER
|
New Technology - Level 49
|
43
|
19
|
—
|
—
|
$102,824.07
|
$159,326.87
|
$112,078.21
|
2026-03-01
|
|
Q0480
|
HCPCS
|
Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only
|
43
|
19
|
—
|
—
|
$98,999.90
|
$161,679.35
|
$111,503.00
|
2026-03-01
|
|
5832
|
APR_DRG
|
Neonate With Ecmo
|
24
|
10
|
—
|
—
|
$91,071.80
|
$143,410.50
|
$109,617.11
|
2026-03-01
|
|
7
|
MS_DRG
|
Lung Transplant
|
96
|
30
|
—
|
—
|
$1,870.00
|
$283,876.06
|
$108,971.50
|
2026-03-01
|
|
1614
|
APR_DRG
|
Implantable Heart Assist Systems
|
24
|
10
|
—
|
—
|
$88,926.10
|
$142,750.50
|
$108,076.68
|
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
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
90
|
29
|
—
|
—
|
$1,870.00
|
$336,522.48
|
$106,047.85
|
2026-03-01
|
|
J9029
|
HCPCS
|
Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose
|
3
|
1
|
—
|
—
|
$104,773.89
|
$106,053.40
|
$104,773.89
|
2026-03-01
|
|
6094
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
24
|
10
|
—
|
—
|
$82,446.00
|
$133,307.22
|
$100,568.70
|
2026-03-01
|
|
8414
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
24
|
10
|
—
|
—
|
$79,102.08
|
$135,325.50
|
$99,336.02
|
2026-03-01
|
|
6304
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
24
|
10
|
—
|
—
|
$77,520.20
|
$137,205.00
|
$99,107.37
|
2026-03-01
|
|
1585
|
OTHER
|
New Technology - Level 48
|
43
|
19
|
—
|
—
|
$90,867.82
|
$140,800.52
|
$99,045.89
|
2026-03-01
|
|
1599
|
OTHER
|
New Technology - Level 48
|
43
|
19
|
—
|
—
|
$90,867.82
|
$140,800.52
|
$99,045.89
|
2026-03-01
|
|
5883
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
24
|
10
|
—
|
—
|
$81,552.00
|
$127,428.00
|
$97,862.40
|
2026-03-01
|
|
6314
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
24
|
10
|
—
|
—
|
$80,942.00
|
$128,217.69
|
$97,715.32
|
2026-03-01
|
|
K1007
|
HCPCS
|
Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin…
|
43
|
19
|
—
|
—
|
$90,121.58
|
$137,867.45
|
$97,404.13
|
2026-03-01
|
|
209
|
MS_DRG
|
Complex Aortic Arch Procedures
|
53
|
29
|
—
|
—
|
$2,017.00
|
$337,617.17
|
$96,345.81
|
2026-03-01
|
|
5914
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
24
|
10
|
—
|
—
|
$79,657.00
|
$125,467.54
|
$95,890.09
|
2026-03-01
|
|
94
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
24
|
10
|
—
|
—
|
$75,232.00
|
$130,764.62
|
$95,265.63
|
2026-03-01
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
96
|
29
|
—
|
—
|
$1,870.00
|
$385,037.72
|
$93,625.63
|
2026-03-01
|
|
J9226
|
HCPCS
|
Supprelin La 50 Mg Imp
|
44
|
10
|
$363,354.00
|
$363,354.00
|
$31,248.44
|
$526,863.30
|
$93,200.30
|
2026-03-01
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
103
|
30
|
—
|
—
|
$1,870.00
|
$321,268.44
|
$91,693.06
|
2026-03-01
|
|
Q2043
|
HCPCS
|
Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm…
|
3
|
1
|
—
|
—
|
$89,766.78
|
$91,596.09
|
$91,596.09
|
2026-03-01
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
97
|
29
|
—
|
—
|
$1,870.00
|
$312,460.23
|
$91,168.31
|
2026-03-01
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
96
|
30
|
—
|
—
|
$1,870.00
|
$342,043.64
|
$88,797.27
|
2026-03-01
|
|
5831
|
APR_DRG
|
Neonate With Ecmo
|
24
|
10
|
—
|
—
|
$69,493.00
|
$122,622.00
|
$88,700.90
|
2026-03-01
|
|
1584
|
OTHER
|
New Technology - Level 47
|
43
|
19
|
—
|
—
|
$81,302.85
|
$125,979.49
|
$88,620.06
|
2026-03-01
|
|
1598
|
OTHER
|
New Technology - Level 47
|
43
|
19
|
—
|
—
|
$81,302.85
|
$125,979.49
|
$88,620.06
|
2026-03-01
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
103
|
30
|
—
|
—
|
$1,870.00
|
$347,433.56
|
$88,476.86
|
2026-03-01
|
|
5934
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
24
|
10
|
—
|
—
|
$73,540.00
|
$110,794.50
|
$87,704.79
|
2026-03-01
|
|
113
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
24
|
10
|
—
|
—
|
$56,946.00
|
$133,113.71
|
$87,080.74
|
2026-03-01
|
|
74
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
24
|
10
|
—
|
—
|
$70,159.56
|
$113,416.50
|
$85,572.06
|
2026-03-01
|
|
5882
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
24
|
10
|
—
|
—
|
$71,560.00
|
$109,192.05
|
$85,514.20
|
2026-03-01
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
92
|
28
|
—
|
—
|
$19,995.00
|
$220,000.00
|
$83,624.88
|
2026-03-01
|
|
44
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
24
|
10
|
—
|
—
|
$66,782.00
|
$100,494.24
|
$79,598.01
|
2026-03-01
|
|
14
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
24
|
10
|
—
|
—
|
$66,329.56
|
$100,863.00
|
$79,263.82
|
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
|
|
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
|
|
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
|
|
0571T
|
CPT
|
Insertion Or Replacement Of Implantable Cardioverter-defibrillator System With S…
|
3
|
1
|
—
|
—
|
$67,069.00
|
$78,780.00
|
$78,713.00
|
2026-03-01
|
|
0515T
|
CPT
|
Insertion Of Wireless Cardiac Stimulator For Left Ventricular Pacing, Including …
|
3
|
1
|
—
|
—
|
$67,069.00
|
$78,780.00
|
$78,713.00
|
2026-03-01
|
|
0614T
|
CPT
|
Removal And Replacement Of Substernal Implantable Defibrillator Pulse Generator
|
3
|
1
|
—
|
—
|
$67,069.00
|
$78,780.00
|
$78,713.00
|
2026-03-01
|
|
0520T
|
CPT
|
Removal And Replacement Of Pulse Generator For Wireless Cardiac Stimulator For L…
|
3
|
1
|
—
|
—
|
$67,069.00
|
$78,780.00
|
$78,713.00
|
2026-03-01
|
|
1613
|
APR_DRG
|
Implantable Heart Assist Systems
|
24
|
10
|
—
|
—
|
$64,392.00
|
$104,446.96
|
$78,673.20
|
2026-03-01
|
|
1597
|
OTHER
|
New Technology - Level 46
|
43
|
19
|
—
|
—
|
$71,737.86
|
$111,158.46
|
$78,194.23
|
2026-03-01
|
|
1583
|
OTHER
|
New Technology - Level 46
|
43
|
19
|
—
|
—
|
$71,737.86
|
$111,158.46
|
$78,194.23
|
2026-03-01
|
|
A9699
|
HCPCS
|
Radiopharmaceutical, Therapeutic, Not Otherwise Classified
|
3
|
1
|
—
|
—
|
$76,785.37
|
$77,046.96
|
$76,785.37
|
2026-03-01
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
97
|
29
|
—
|
—
|
$1,870.00
|
$274,772.55
|
$76,087.18
|
2026-03-01
|
|
23
|
APR_DRG
|
Heart And/or Lung Transplant
|
24
|
10
|
—
|
—
|
$62,352.00
|
$97,366.79
|
$74,822.40
|
2026-03-01
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
93
|
28
|
—
|
—
|
$16,602.00
|
$219,802.53
|
$74,751.76
|
2026-03-01
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$248,783.42
|
$73,482.73
|
2026-03-01
|
|
5881
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
24
|
10
|
—
|
—
|
$61,338.00
|
$93,593.57
|
$73,298.91
|
2026-03-01
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
89
|
28
|
—
|
—
|
$13,883.00
|
$162,901.99
|
$71,950.96
|
2026-03-01
|
|
5913
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
24
|
10
|
—
|
—
|
$59,125.00
|
$94,624.20
|
$71,747.61
|
2026-03-01
|
|
112
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
24
|
10
|
—
|
—
|
$48,895.00
|
$105,823.65
|
$70,549.10
|
2026-03-01
|
|
L8702
|
HCPCS
|
Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge…
|
43
|
19
|
—
|
—
|
$65,212.98
|
$99,762.46
|
$70,482.72
|
2026-03-01
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
93
|
28
|
—
|
—
|
$1,870.00
|
$215,373.07
|
$68,483.66
|
2026-03-01
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
94
|
29
|
—
|
—
|
$13,883.00
|
$184,778.49
|
$68,186.62
|
2026-03-01
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
90
|
28
|
—
|
—
|
$13,883.00
|
$189,073.73
|
$68,080.95
|
2026-03-01
|
|
1596
|
OTHER
|
New Technology - Level 45
|
43
|
19
|
—
|
—
|
$62,172.87
|
$96,337.43
|
$67,768.40
|
2026-03-01
|
|
1582
|
OTHER
|
New Technology - Level 45
|
43
|
19
|
—
|
—
|
$62,172.87
|
$96,337.43
|
$67,768.40
|
2026-03-01
|
|
717
|
OTHER
|
Instill Adstiladrin, Tx D
|
42
|
19
|
—
|
—
|
$62,721.22
|
$93,198.45
|
$66,839.29
|
2026-03-01
|
|
6024
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
24
|
10
|
—
|
—
|
$54,849.00
|
$83,100.26
|
$65,544.55
|
2026-03-01
|
|
5244
|
OTHER
|
Level 4 Blood Product Exc
|
43
|
19
|
—
|
—
|
$49,801.21
|
$95,245.15
|
$65,395.53
|
2026-03-01
|
|
1643
|
OTHER
|
Y90 Ibritumomab, Rx
|
43
|
19
|
—
|
—
|
$56,256.30
|
$82,395.60
|
$64,821.81
|
2026-03-01
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
90
|
29
|
—
|
—
|
$1,870.00
|
$172,444.62
|
$64,682.34
|
2026-03-01
|
|
6034
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
24
|
10
|
—
|
—
|
$40,520.04
|
$102,481.50
|
$64,550.53
|
2026-03-01
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
90
|
29
|
—
|
—
|
$1,870.00
|
$174,195.52
|
$64,413.39
|
2026-03-01
|
|
5891
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational
|
24
|
10
|
—
|
—
|
$48,983.00
|
$89,188.07
|
$63,918.12
|
2026-03-01
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
94
|
29
|
—
|
—
|
$12,867.00
|
$209,863.84
|
$63,475.10
|
2026-03-01
|
|
5892
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational
|
24
|
10
|
—
|
—
|
$47,538.00
|
$89,188.07
|
$63,005.96
|
2026-03-01
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
96
|
29
|
—
|
—
|
$1,870.00
|
$147,955.83
|
$62,825.97
|
2026-03-01
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
24
|
10
|
—
|
—
|
$51,048.39
|
$83,284.50
|
$62,554.76
|
2026-03-01
|
|
5893
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational
|
24
|
10
|
—
|
—
|
$46,525.00
|
$89,188.07
|
$62,296.85
|
2026-03-01
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
95
|
29
|
—
|
—
|
$1,870.00
|
$196,811.46
|
$61,987.34
|
2026-03-01
|
|
5933
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
24
|
10
|
—
|
—
|
$51,226.00
|
$80,695.10
|
$61,668.72
|
2026-03-01
|
|
1612
|
APR_DRG
|
Implantable Heart Assist Systems
|
24
|
10
|
—
|
—
|
$51,234.90
|
$77,532.00
|
$61,225.71
|
2026-03-01
|
|
1611
|
APR_DRG
|
Implantable Heart Assist Systems
|
24
|
10
|
—
|
—
|
$49,247.00
|
$76,852.35
|
$59,096.40
|
2026-03-01
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
97
|
30
|
—
|
—
|
$12,867.00
|
$220,000.00
|
$59,087.44
|
2026-03-01
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
97
|
30
|
—
|
—
|
$12,867.00
|
$220,000.00
|
$58,530.01
|
2026-03-01
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
93
|
29
|
—
|
—
|
$12,867.00
|
$145,000.00
|
$58,219.39
|
2026-03-01
|
|
5912
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
24
|
10
|
—
|
—
|
$44,835.00
|
$81,160.27
|
$58,164.86
|
2026-03-01
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
91
|
27
|
—
|
—
|
$1,870.00
|
$128,467.63
|
$57,792.68
|
2026-03-01
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
96
|
29
|
—
|
—
|
$1,870.00
|
$208,712.48
|
$57,514.12
|
2026-03-01
|
|
9273
|
OTHER
|
Sipuleucel-t Auto Cd54+
|
42
|
19
|
—
|
—
|
$53,860.07
|
$78,885.96
|
$57,396.34
|
2026-03-01
|
|
1581
|
OTHER
|
New Technology - Level 44
|
43
|
19
|
—
|
—
|
$52,607.89
|
$81,516.40
|
$57,342.57
|
2026-03-01
|
|
1595
|
OTHER
|
New Technology - Level 44
|
43
|
19
|
—
|
—
|
$52,607.89
|
$81,516.40
|
$57,342.57
|
2026-03-01
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
95
|
29
|
—
|
—
|
$1,870.00
|
$73,451.70
|
$56,289.70
|
2026-03-01
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
90
|
29
|
—
|
—
|
$12,867.00
|
$185,873.95
|
$55,905.44
|
2026-03-01
|
|
22
|
APR_DRG
|
Heart And/or Lung Transplant
|
24
|
10
|
—
|
—
|
$45,376.00
|
$73,729.74
|
$55,488.66
|
2026-03-01
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
99
|
30
|
—
|
—
|
$11,000.00
|
$268,213.38
|
$55,312.82
|
2026-03-01
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
97
|
29
|
—
|
—
|
$1,870.00
|
$184,527.94
|
$54,930.05
|
2026-03-01
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
99
|
30
|
—
|
—
|
$11,000.00
|
$219,802.53
|
$54,757.07
|
2026-03-01
|
|
64
|
APR_DRG
|
Pancreas Transplant
|
24
|
10
|
—
|
—
|
$43,326.23
|
$72,558.00
|
$53,809.64
|
2026-03-01
|
|
93
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
24
|
10
|
—
|
—
|
$32,422.00
|
$87,882.00
|
$53,610.50
|
2026-03-01
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
92
|
29
|
—
|
—
|
$11,768.00
|
$138,361.61
|
$53,429.95
|
2026-03-01
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
97
|
29
|
—
|
—
|
$1,870.00
|
$124,412.68
|
$53,424.48
|
2026-03-01
|
|
8424
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
24
|
10
|
—
|
—
|
$44,285.71
|
$69,304.50
|
$53,142.85
|
2026-03-01
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
95
|
29
|
—
|
—
|
$12,867.00
|
$152,063.14
|
$53,118.51
|
2026-03-01
|
|
54
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
24
|
10
|
—
|
—
|
$43,560.00
|
$70,007.73
|
$52,972.29
|
2026-03-01
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$134,458.66
|
$52,734.16
|
2026-03-01
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
90
|
28
|
—
|
—
|
$12,867.00
|
$151,344.29
|
$52,263.57
|
2026-03-01
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
94
|
30
|
—
|
—
|
$11,000.00
|
$118,451.44
|
$51,833.51
|
2026-03-01
|
|
43
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
24
|
10
|
—
|
—
|
$41,876.00
|
$69,298.37
|
$51,689.97
|
2026-03-01
|
|
213
|
MS_DRG
|
Endovascular Abdominal Aorta With Iliac Branch Procedures
|
50
|
29
|
—
|
—
|
$10,745.00
|
$170,225.41
|
$51,508.65
|
2026-03-01
|
|
8514
|
APR_DRG
|
Gender Related Procedures
|
24
|
10
|
—
|
—
|
$40,865.02
|
$70,353.00
|
$51,487.66
|
2026-03-01
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
90
|
29
|
—
|
—
|
$1,870.00
|
$336,522.48
|
$51,191.74
|
2026-03-01
|
|
6303
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
24
|
10
|
—
|
—
|
$42,730.78
|
$65,515.50
|
$51,063.29
|
2026-03-01
|
|
L7181
|
HCPCS
|
Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi…
|
43
|
19
|
—
|
—
|
$47,018.07
|
$71,927.83
|
$50,817.51
|
2026-03-01
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$116,937.57
|
$50,692.81
|
2026-03-01
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
99
|
29
|
—
|
—
|
$1,870.00
|
$118,045.56
|
$50,673.08
|
2026-03-01
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
95
|
29
|
—
|
—
|
$1,870.00
|
$151,658.52
|
$50,289.10
|
2026-03-01
|
|
5932
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
24
|
10
|
—
|
—
|
$41,957.00
|
$64,905.25
|
$50,270.90
|
2026-03-01
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
93
|
28
|
—
|
—
|
$1,870.00
|
$132,970.24
|
$50,235.06
|
2026-03-01
|
|
6074
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
24
|
10
|
—
|
—
|
$42,035.00
|
$64,236.87
|
$50,231.82
|
2026-03-01
|
|
21
|
APR_DRG
|
Heart And/or Lung Transplant
|
24
|
10
|
—
|
—
|
$41,730.00
|
$65,165.07
|
$50,076.00
|
2026-03-01
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
99
|
30
|
—
|
—
|
$11,000.00
|
$140,782.19
|
$49,690.19
|
2026-03-01
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
90
|
29
|
—
|
—
|
$1,870.00
|
$336,522.48
|
$49,643.93
|
2026-03-01
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
66
|
23
|
—
|
—
|
$4,345.00
|
$63,385.76
|
$49,634.51
|
2026-03-01
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
95
|
29
|
—
|
—
|
$1,870.00
|
$152,631.67
|
$49,109.80
|
2026-03-01
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$111,990.07
|
$49,006.05
|
2026-03-01
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
95
|
29
|
—
|
—
|
$11,000.00
|
$189,073.73
|
$48,593.03
|
2026-03-01
|
|
73
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
24
|
10
|
—
|
—
|
$36,953.00
|
$66,933.09
|
$47,968.71
|
2026-03-01
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
93
|
28
|
—
|
—
|
$1,870.00
|
$215,373.07
|
$47,808.32
|
2026-03-01
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
95
|
29
|
—
|
—
|
$11,000.00
|
$109,000.00
|
$47,661.89
|
2026-03-01
|
|
246
|
MS_DRG
|
Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar…
|
3
|
1
|
—
|
—
|
$37,976.00
|
$51,722.00
|
$47,374.00
|
2024-10-01
|
|
247
|
MS_DRG
|
Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc
|
3
|
1
|
—
|
—
|
$37,976.00
|
$51,722.00
|
$47,374.00
|
2024-10-01
|
|
1580
|
OTHER
|
New Technology - Level 43
|
43
|
19
|
—
|
—
|
$43,042.90
|
$66,695.37
|
$46,916.75
|
2026-03-01
|
|
1594
|
OTHER
|
New Technology - Level 43
|
43
|
19
|
—
|
—
|
$43,042.90
|
$66,695.37
|
$46,916.75
|
2026-03-01
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures
|
93
|
28
|
—
|
—
|
$1,870.00
|
$133,044.81
|
$46,748.20
|
2026-03-01
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
96
|
30
|
—
|
—
|
$1,870.00
|
$174,195.52
|
$46,567.96
|
2026-03-01
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
93
|
29
|
—
|
—
|
$9,339.00
|
$107,225.31
|
$46,482.52
|
2026-03-01
|
|
1142
|
OTHER
|
Supprelin La Implant
|
43
|
19
|
—
|
—
|
$42,753.49
|
$62,618.74
|
$46,208.31
|
2026-03-01
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
93
|
29
|
—
|
—
|
$9,339.00
|
$133,041.83
|
$46,120.80
|
2026-03-01
|
|
6023
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
24
|
10
|
—
|
—
|
$38,465.25
|
$58,359.00
|
$45,965.98
|
2026-03-01
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$106,315.45
|
$45,681.44
|
2026-03-01
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically
|
92
|
29
|
—
|
—
|
$11,768.00
|
$142,775.43
|
$45,595.18
|
2026-03-01
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective
|
97
|
29
|
—
|
—
|
$1,870.00
|
$103,887.87
|
$45,460.59
|
2026-03-01
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$103,789.76
|
$45,417.66
|
2026-03-01
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
95
|
29
|
—
|
—
|
$11,000.00
|
$189,073.73
|
$45,251.45
|
2026-03-01
|
|
J9266
|
HCPCS
|
Injection, Pegaspargase, Per Single Dose Vial
|
3
|
1
|
—
|
—
|
$44,574.52
|
$46,899.70
|
$44,574.52
|
2026-03-01
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
99
|
29
|
—
|
—
|
$1,870.00
|
$142,586.79
|
$44,482.43
|
2026-03-01
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
99
|
30
|
—
|
—
|
$11,000.00
|
$201,389.71
|
$43,761.80
|
2026-03-01
|
|
3034
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
24
|
10
|
—
|
—
|
$34,140.79
|
$59,817.00
|
$43,414.32
|
2026-03-01
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$74,053.98
|
$43,282.21
|
2026-03-01
|
|
249
|
MS_DRG
|
Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc
|
3
|
1
|
—
|
—
|
$34,652.00
|
$51,638.00
|
$43,208.00
|
2024-10-01
|
|
248
|
MS_DRG
|
Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4…
|
3
|
1
|
—
|
—
|
$34,652.00
|
$51,638.00
|
$43,208.00
|
2024-10-01
|
|
594884
|
CDM
|
Revas Tib Stnt/ath/ang 1
|
42
|
14
|
$175,000.00
|
$175,000.00
|
$11,931.83
|
$230,681.95
|
$42,954.57
|
2026-03-01
|
|
594797
|
CDM
|
Revas Fempp Stnt/ath/ang
|
42
|
14
|
$175,000.00
|
$175,000.00
|
$11,931.83
|
$230,681.95
|
$42,954.57
|
2026-03-01
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$103,776.30
|
$42,440.90
|
2026-03-01
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
24
|
10
|
—
|
—
|
$34,306.45
|
$56,856.00
|
$42,378.67
|
2026-03-01
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
94
|
29
|
—
|
—
|
$8,706.00
|
$97,693.87
|
$42,350.60
|
2026-03-01
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$99,288.46
|
$42,100.31
|
2026-03-01
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
97
|
29
|
—
|
—
|
$1,870.00
|
$96,310.80
|
$41,631.33
|
2026-03-01
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$96,882.11
|
$41,602.49
|
2026-03-01
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
93
|
29
|
—
|
—
|
$9,882.00
|
$138,361.61
|
$41,559.00
|
2026-03-01
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
24
|
10
|
—
|
—
|
$34,835.42
|
$52,513.50
|
$41,557.43
|
2026-03-01
|
|
C2616
|
HCPCS
|
Brachytherapy Source, Non-stranded, Yttrium-90, Per Source
|
3
|
1
|
—
|
—
|
$40,000.00
|
$47,471.00
|
$41,459.00
|
2026-03-01
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
93
|
29
|
—
|
—
|
$11,000.00
|
$70,676.00
|
$41,266.07
|
2026-03-01
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
93
|
28
|
—
|
—
|
$1,870.00
|
$93,996.71
|
$41,132.29
|
2026-03-01
|
|
6134
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
24
|
10
|
—
|
—
|
$34,228.00
|
$52,935.54
|
$41,005.21
|
2026-03-01
|
|
L7180
|
HCPCS
|
Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device…
|
43
|
19
|
—
|
—
|
$37,906.61
|
$57,989.27
|
$40,969.76
|
2026-03-01
|
|
6114
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
24
|
10
|
—
|
—
|
$34,068.00
|
$53,426.60
|
$40,920.99
|
2026-03-01
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
96
|
30
|
—
|
—
|
$1,870.00
|
$342,043.64
|
$40,815.79
|
2026-03-01
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
93
|
28
|
—
|
—
|
$1,870.00
|
$113,677.49
|
$40,568.22
|
2026-03-01
|
|
4404
|
APR_DRG
|
Kidney Transplant
|
24
|
10
|
—
|
—
|
$33,592.77
|
$53,133.00
|
$40,523.31
|
2026-03-01
|
|
L2006
|
HCPCS
|
Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance…
|
43
|
19
|
—
|
—
|
$37,324.49
|
$57,098.68
|
$40,340.61
|
2026-03-01
|
|
84
|
APR_DRG
|
Autologous Bone Marrow Transplant
|
24
|
10
|
—
|
—
|
$31,204.86
|
$56,214.00
|
$40,286.70
|
2026-03-01
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
90
|
29
|
—
|
—
|
$1,870.00
|
$138,005.21
|
$40,112.24
|
2026-03-01
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$107,983.33
|
$40,097.77
|
2026-03-01
|
|
63
|
APR_DRG
|
Pancreas Transplant
|
24
|
10
|
—
|
—
|
$33,389.74
|
$51,546.00
|
$39,964.96
|
2026-03-01
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
95
|
29
|
—
|
—
|
$8,403.00
|
$96,905.21
|
$39,831.28
|
2026-03-01
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r.
|
97
|
29
|
—
|
—
|
$1,870.00
|
$91,855.75
|
$39,819.76
|
2026-03-01
|
|
0888T
|
CPT
|
Histotripsy (ie, Non-thermal Ablation Via Acoustic Energy Delivery) Of Malignant…
|
3
|
1
|
—
|
—
|
$39,376.13
|
$39,376.13
|
$39,376.13
|
2026-03-01
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
95
|
29
|
—
|
—
|
$8,403.00
|
$88,325.94
|
$39,012.02
|
2026-03-01
|
|
236
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
95
|
29
|
—
|
—
|
$12,867.00
|
$107,831.20
|
$38,930.58
|
2026-03-01
|
|
J9600
|
HCPCS
|
Injection, Porfimer Sodium, 75 Mg
|
3
|
1
|
—
|
—
|
$38,803.31
|
$39,976.89
|
$38,803.31
|
2026-03-01
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$90,009.09
|
$38,685.86
|
2026-03-01
|
|
13
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
24
|
10
|
—
|
—
|
$31,456.00
|
$51,654.79
|
$38,674.60
|
2026-03-01
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
103
|
30
|
—
|
—
|
$1,870.00
|
$88,815.85
|
$38,433.00
|
2026-03-01
|
|
460
|
MS_DRG
|
Spinal Fusion Except Cervical Without Mcc
|
4
|
1
|
—
|
—
|
$35,664.00
|
$41,013.00
|
$38,338.50
|
2026-03-01
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$99,288.46
|
$38,328.93
|
2026-03-01
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$123,487.92
|
$38,209.65
|
2026-03-01
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$93,000.00
|
$38,132.80
|
2026-03-01
|
|
458
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
89
|
28
|
—
|
—
|
$8,706.00
|
$140,673.88
|
$38,042.74
|
2026-03-01
|
|
269
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
95
|
29
|
—
|
—
|
$11,000.00
|
$91,501.00
|
$37,741.08
|
2026-03-01
|
|
595878
|
CDM
|
Rem/replace Pm Multi Ld
|
42
|
14
|
$152,973.00
|
$152,973.00
|
$10,429.95
|
$201,645.70
|
$37,547.82
|
2026-03-01
|
|
53
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
24
|
10
|
—
|
—
|
$30,089.00
|
$50,806.90
|
$37,529.38
|
2026-03-01
|
|
31
|
MS_DRG
|
Ventricular Shunt Procedures With Mcc
|
93
|
28
|
—
|
—
|
$1,870.00
|
$70,676.00
|
$37,260.00
|
2026-03-01
|
|
448
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical Without Mcc
|
93
|
29
|
—
|
—
|
$8,706.00
|
$133,560.00
|
$37,141.30
|
2026-03-01
|
|
273
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures With Mcc
|
93
|
29
|
—
|
—
|
$12,867.00
|
$62,866.00
|
$36,911.29
|
2026-03-01
|
|
6022
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
24
|
10
|
—
|
—
|
$30,735.91
|
$46,669.50
|
$36,729.41
|
2026-03-01
|
|
6093
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
24
|
10
|
—
|
—
|
$30,783.00
|
$46,242.93
|
$36,658.91
|
2026-03-01
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$85,219.33
|
$36,594.34
|
2026-03-01
|
|
1579
|
OTHER
|
New Technology - Level 42
|
43
|
19
|
—
|
—
|
$33,477.92
|
$51,874.34
|
$36,490.92
|
2026-03-01
|
|
1593
|
OTHER
|
New Technology - Level 42
|
43
|
19
|
—
|
—
|
$33,477.92
|
$51,874.34
|
$36,490.92
|
2026-03-01
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
103
|
30
|
—
|
—
|
$1,870.00
|
$86,261.92
|
$36,429.75
|
2026-03-01
|
|
1634
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
24
|
10
|
—
|
—
|
$30,019.36
|
$47,361.00
|
$36,166.67
|
2026-03-01
|
|
402
|
MS_DRG
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
101
|
30
|
—
|
—
|
$1,870.00
|
$137,813.00
|
$36,093.64
|
2026-03-01
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$85,731.64
|
$35,930.44
|
2026-03-01
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
103
|
30
|
—
|
—
|
$1,870.00
|
$82,358.09
|
$35,904.16
|
2026-03-01
|
|
24
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
93
|
28
|
—
|
—
|
$1,870.00
|
$132,970.24
|
$35,901.41
|
2026-03-01
|
|
72
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
24
|
10
|
—
|
—
|
$29,633.00
|
$47,135.02
|
$35,848.22
|
2026-03-01
|
|
L8701
|
HCPCS
|
Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand With S…
|
43
|
19
|
—
|
—
|
$33,146.09
|
$50,706.64
|
$35,824.56
|
2026-03-01
|
|
958
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
96
|
29
|
—
|
—
|
$1,870.00
|
$147,955.83
|
$35,763.76
|
2026-03-01
|
|
12
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$97,418.25
|
$35,724.55
|
2026-03-01
|
|
673
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Mcc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$82,730.94
|
$35,599.10
|
2026-03-01
|
|
793
|
MS_DRG
|
Full Term Neonate With Major Problems
|
66
|
23
|
—
|
—
|
$3,075.00
|
$45,789.00
|
$35,476.75
|
2026-03-01
|
|
423
|
MS_DRG
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
95
|
29
|
—
|
—
|
$8,403.00
|
$80,908.45
|
$35,194.82
|
2026-03-01
|
|
0207
|
RC
|
—
|
30
|
11
|
—
|
—
|
$7,500.00
|
$34,956.50
|
$34,956.50
|
2026-03-01
|
|
933
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
91
|
27
|
—
|
—
|
$1,870.00
|
$83,228.40
|
$34,888.47
|
2026-03-01
|
|
6073
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
24
|
10
|
—
|
—
|
$29,098.00
|
$44,042.07
|
$34,772.11
|
2026-03-01
|
|
791
|
MS_DRG
|
Prematurity With Major Problems
|
66
|
23
|
—
|
—
|
$3,945.00
|
$45,789.00
|
$34,621.92
|
2026-03-01
|
|
2994
|
APR_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
12
|
10
|
—
|
—
|
$29,413.84
|
$44,120.76
|
$34,561.26
|
2026-03-01
|
|
1784
|
APR_DRG
|
External Heart Assist Devices
|
24
|
10
|
—
|
—
|
$28,546.00
|
$45,387.00
|
$34,525.95
|
2026-03-01
|
|
5166
|
OTHER
|
Cochlear Implant Procedur
|
43
|
19
|
—
|
—
|
$30,561.46
|
$49,926.53
|
$34,432.09
|
2026-03-01
|
|
0208
|
RC
|
—
|
44
|
17
|
—
|
—
|
$6,000.00
|
$34,206.50
|
$34,206.50
|
2026-03-01
|
|
1674
|
APR_DRG
|
Other Cardiothoracic And Thoracic Circulatory Procedures
|
24
|
10
|
—
|
—
|
$26,425.10
|
$47,683.50
|
$34,173.18
|
2026-03-01
|
|
6124
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
24
|
10
|
—
|
—
|
$28,057.28
|
$45,037.50
|
$34,098.74
|
2026-03-01
|
|
111
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
24
|
10
|
—
|
—
|
$22,296.00
|
$52,118.37
|
$34,094.79
|
2026-03-01
|
|
34
|
MS_DRG
|
Carotid Artery Stent Procedures With Mcc
|
93
|
28
|
—
|
—
|
$1,870.00
|
$100,000.00
|
$33,649.30
|
2026-03-01
|
|
876
|
MS_DRG
|
O.r. Procedures With Principal Diagnosis Of Mental Illness
|
73
|
25
|
—
|
—
|
$9,339.00
|
$65,958.66
|
$33,598.49
|
2026-03-01
|
|
271
|
MS_DRG
|
Other Major Cardiovascular Procedures With Cc
|
91
|
28
|
—
|
—
|
$12,867.00
|
$98,784.37
|
$33,588.35
|
2026-03-01
|
|
6334
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
24
|
10
|
—
|
—
|
$27,983.61
|
$42,823.50
|
$33,440.42
|
2026-03-01
|
|
5232
|
OTHER
|
Level 2 Icd And Similar P
|
43
|
19
|
—
|
—
|
$29,982.38
|
$47,529.16
|
$33,313.75
|
2026-03-01
|
|
71
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
24
|
10
|
—
|
—
|
$27,738.54
|
$42,226.50
|
$33,147.56
|
2026-03-01
|
|
1654
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
24
|
10
|
—
|
—
|
$26,969.52
|
$44,230.50
|
$33,136.74
|
2026-03-01
|
|
6214
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
24
|
10
|
—
|
—
|
$27,515.38
|
$43,260.00
|
$33,092.23
|
2026-03-01
|
|
62
|
APR_DRG
|
Pancreas Transplant
|
24
|
10
|
—
|
—
|
$27,515.00
|
$43,179.07
|
$33,060.98
|
2026-03-01
|
|
518
|
MS_DRG
|
Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…
|
101
|
30
|
—
|
—
|
$7,000.00
|
$91,357.20
|
$33,051.00
|
2026-03-01
|
|
628
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$75,911.03
|
$33,045.69
|
2026-03-01
|
|
907
|
MS_DRG
|
Other O.r. Procedures For Injuries With Mcc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$76,626.61
|
$32,923.84
|
2026-03-01
|
|
279
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures
|
93
|
28
|
—
|
—
|
$1,870.00
|
$95,467.50
|
$32,728.06
|
2026-03-01
|
|
252
|
MS_DRG
|
Other Vascular Procedures With Mcc
|
95
|
29
|
—
|
—
|
$12,867.00
|
$92,338.54
|
$32,702.55
|
2026-03-01
|
|
40
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
103
|
30
|
—
|
—
|
$1,870.00
|
$70,676.00
|
$32,639.43
|
2026-03-01
|
|
739
|
MS_DRG
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…
|
97
|
29
|
—
|
—
|
$1,870.00
|
$76,572.75
|
$32,568.22
|
2026-03-01
|
|
42
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
24
|
10
|
—
|
—
|
$25,840.00
|
$44,284.10
|
$32,479.57
|
2026-03-01
|
|
956
|
MS_DRG
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
96
|
29
|
—
|
—
|
$1,870.00
|
$97,301.92
|
$32,474.20
|
2026-03-01
|
|
121709
|
CDM
|
Ins/repos Sgl Icd+lead
|
42
|
14
|
$132,220.00
|
$132,220.00
|
$9,015.00
|
$174,290.00
|
$32,454.00
|
2026-03-01
|
|
166
|
MS_DRG
|
Other Respiratory System O.r. Procedures With Mcc
|
101
|
30
|
—
|
—
|
$7,000.00
|
$76,547.60
|
$32,415.93
|
2026-03-01
|
|
467
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Cc
|
95
|
29
|
—
|
—
|
$1,870.00
|
$68,832.86
|
$32,393.98
|
2026-03-01
|
|
359
|
MS_DRG
|
Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc
|
53
|
29
|
—
|
—
|
$2,017.00
|
$102,566.56
|
$32,286.74
|
2026-03-01
|
|
616
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
97
|
29
|
—
|
—
|
$1,870.00
|
$97,594.23
|
$32,228.89
|
2026-03-01
|
|
5465
|
OTHER
|
Level 5 Neurostimulator A
|
43
|
19
|
—
|
—
|
$28,299.24
|
$46,724.87
|
$32,224.05
|
2026-03-01
|
|
736
|
MS_DRG
|
Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$75,737.90
|
$32,213.14
|
2026-03-01
|
|
29
|
MS_DRG
|
Spinal Procedures With Cc Or Spinal Neurostimulators
|
97
|
29
|
—
|
—
|
$1,870.00
|
$91,130.51
|
$32,060.85
|
2026-03-01
|
|
8413
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
24
|
10
|
—
|
—
|
$25,725.07
|
$43,306.50
|
$32,035.87
|
2026-03-01
|
|
651
|
MS_DRG
|
Kidney Transplant With Hemodialysis Without Mcc
|
90
|
29
|
—
|
—
|
$1,870.00
|
$138,005.21
|
$31,892.01
|
2026-03-01
|
|
904
|
MS_DRG
|
Skin Grafts For Injuries With Cc/mcc
|
97
|
29
|
—
|
—
|
$1,870.00
|
$74,268.27
|
$31,891.80
|
2026-03-01
|
|
265
|
MS_DRG
|
Aicd Lead Procedures
|
99
|
29
|
—
|
—
|
$1,870.00
|
$92,487.68
|
$31,536.74
|
2026-03-01
|