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

Lake City Medical Center Suwannee Campus

Lake City, FL · CCN 101301 · Rates published

21,930 distinct procedures filed
41 distinct payers
524,785 rate rows
2026-03-01 last MRF observed
Data quality

469,378 of 524,785 rate rows are consumer-grade (89.4%)

55,407 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
template filing: same amount across many unrelated codes — excluded 27,353
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 17,378
per-diem day rate — not a per-procedure price 8,600
exceeds 10× this hospital's gross charge — excluded from medians 1,964
placeholder amount (≤ $0.02) — excluded from medians 112
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/95-4176924_HCA-FLORIDA-LAKE-CITY-HOSPITAL_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page https://hcafloridahealthcare.com/cms-hpt.txt
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-05-17
Content fingerprint 6f1b43cd80f3b49e… · 244,366,261 bytes · first seen 2026-05-11

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 $4,850,948.67 $4,850,948.67 nat. median
$3,004,655
1.6× median
845
OTHER 		Inj, Atidarsagene Autotem 15 $4,505,000.00 $4,955,500.00 $4,673,937.50 nat. median
$9,966
outlier · 469.0×
00845
OTHER 		Inj, Atidarsagene Autotem 1 $4,369,850.00 $4,369,850.00 $4,369,850.00 nat. median
$4,505,000
1.0× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 $4,271,819.03 $4,271,819.03 $4,271,819.03 nat. median
$2,468,984
1.7× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 17 $3,685,267.00 $4,422,320.40 $3,869,530.35 nat. median
$3,746,358
1.0× median
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 1 $3,847,800.00 $3,847,800.00 $3,847,800.00 nat. median
$2,448,600
1.6× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 1 $3,574,708.99 $3,574,708.99 $3,574,708.99 nat. median
$3,574,709
1.0× median
908
OTHER 		Topi Adm Prad Zami Per Tr 17 $3,335,820.00 $4,002,984.00 $3,502,611.00 nat. median
$22,747
outlier · 154.0×
714
OTHER 		Inj Delandistrogene Mox R 17 $3,327,860.00 $3,993,432.00 $3,494,253.00 nat. median
$13,041
outlier · 267.9×
748
OTHER 		Inj, Lovotibeglogene Auto 17 $3,252,508.00 $3,903,009.60 $3,415,133.40 nat. median
$17,963
outlier · 190.1×
906
OTHER 		Inj Elivaldogene Autoteme 17 $3,180,000.00 $3,816,000.00 $3,339,000.00 nat. median
$20,756
outlier · 160.9×
00908
OTHER 		Topi Adm Prad Zami Per Tr 1 $3,235,745.40 $3,235,745.40 $3,235,745.40 nat. median
$12,675
outlier · 255.3×
00714
OTHER 		Inj Delandistrogene Mox R 1 $3,228,024.20 $3,228,024.20 $3,228,024.20 nat. median
$3,228,024
1.0× median
00748
OTHER 		Inj, Lovotibeglogene Auto 1 $3,154,932.76 $3,154,932.76 $3,154,932.76 nat. median
$3,187,420
1.0× median
746
OTHER 		Inj, Betibeglogene Autote 17 $2,939,969.00 $3,527,962.80 $3,086,967.45 nat. median
$21,896
outlier · 141.0×
00906
OTHER 		Inj Elivaldogene Autoteme 1 $3,084,600.00 $3,084,600.00 $3,084,600.00 nat. median
$21
outlier · 149086.5×
00746
OTHER 		Inj, Betibeglogene Autote 1 $2,851,769.93 $2,851,769.93 $2,851,769.93 nat. median
$2,878,960
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 17 $2,588,981.00 $3,106,777.20 $2,718,430.05 nat. median
$2,588,981
1.0× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 1 $2,511,311.57 $2,511,311.57 $2,511,311.57 nat. median
$2,457,321
1.0× median
824
OTHER 		Inj, Exagamglogene Autote 17 $2,332,000.00 $2,798,400.00 $2,448,600.00 nat. median
$25,250
outlier · 97.0×
00824
OTHER 		Inj, Exagamglogene Autote 1 $2,262,040.00 $2,262,040.00 $2,262,040.00 nat. median
$2,332,000
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
$824,563
1.5× median
2067
OTHER 		Afamitresgene Autoleucel 18 $693,558.00 $924,744.00 $809,151.00 nat. median
$786,032
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 2 $511,793.34 $920,834.85 $716,314.09 nat. median
$625,184
1.1× median
9498
OTHER 		Ciltacabtagene Car-pos T 17 $587,649.60 $705,179.52 $617,032.08 nat. median
$587,650
1.1× median
9194
OTHER 		Tisagenlecleucel Car-pos 17 $566,531.30 $679,837.56 $594,857.87 nat. median
$566,531
1.1× median
9413
OTHER 		Lisocabtagene Car Pos T 17 $562,201.20 $674,641.44 $590,311.26 nat. median
$562,201
1.1× median
9422
OTHER 		Idecabtagene Vicleucel Ca 17 $558,081.80 $669,698.16 $585,985.89 nat. median
$558,082
1.1× median
09498
OTHER 		Ciltacabtagene Car-pos T 1 $570,020.11 $570,020.11 $570,020.11 nat. median
$554,552
1.0× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 3 $561,407.87 $934,776.65 $561,407.87 nat. median
$753,246
0.7× median
9035
OTHER 		Axicabtagene Ciloleucel C 17 $532,192.20 $638,630.64 $558,801.81 nat. median
$532,192
1.1× median
09194
OTHER 		Tisagenlecleucel Car-pos 1 $549,535.36 $549,535.36 $549,535.36 nat. median
$538,205
1.0× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $545,335.16 $545,335.16 $545,335.16 nat. median
$534,091
1.0× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $541,339.35 $541,339.35 $541,339.35 nat. median
$530,178
1.0× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 3 $536,573.93 $969,621.79 $536,573.93 nat. median
$674,867
0.8× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $516,226.43 $516,226.43 $516,226.43 nat. median
$505,583
1.0× median
9391
OTHER 		Brexucabtagene Car Pos T 17 $489,450.20 $587,340.24 $513,922.71 nat. median
$489,450
1.1× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 3 $500,948.74 $927,632.05 $500,948.74 nat. median
$673,137
0.7× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 3 $487,755.77 $878,117.20 $487,755.77 nat. median
$634,303
0.8× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $474,766.69 $474,766.69 $474,766.69 nat. median
$464,978
1.0× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 3 $474,717.03 $807,592.83 $474,717.03 nat. median
$619,808
0.8× 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
$324,450
1.4× median
J3402
HCPCS 		Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 $332,753.88 $332,753.88 $332,753.88 nat. median
$209,753
1.6× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 23 $1,636.00 $1,929,752.97 $322,045.92 nat. median
$370,174
0.9× median
831
OTHER 		Obecbtge Autol Up To 400 17 $278,250.00 $333,900.00 $292,162.50 nat. median
$12,362
outlier · 23.6×
897
OTHER 		Revakinagene, Per Implant 17 $265,000.00 $318,000.00 $278,250.00 nat. median
$9,577
outlier · 29.1×
00831
OTHER 		Obecbtge Autol Up To 400 1 $269,902.50 $269,902.50 $269,902.50 nat. median
$278,250
1.0× median
00897
OTHER 		Revakinagene, Per Implant 1 $257,050.00 $257,050.00 $257,050.00 nat. median
$265,000
1.0× median
5834
APR_DRG 		Neonate With Ecmo 11 $208,261.10 $312,391.65 $249,913.32 nat. median
$309,665
0.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 23 $2,968.00 $1,252,332.04 $220,735.78 nat. median
$265,286
0.8× median

Other procedures at this hospital

Browse this hospital's 21,930 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
             
00714 OTHER Inj Delandistrogene Mox R 1 1 — — $3,228,024.20 $3,228,024.20 $3,228,024.20 2026-03-01
00717 OTHER Instill Adstiladrin, Tx D 1 1 — — $62,346.55 $62,346.55 $62,346.55 2026-03-01
00746 OTHER Inj, Betibeglogene Autote 1 1 — — $2,851,769.93 $2,851,769.93 $2,851,769.93 2026-03-01
00748 OTHER Inj, Lovotibeglogene Auto 1 1 — — $3,154,932.76 $3,154,932.76 $3,154,932.76 2026-03-01
00824 OTHER Inj, Exagamglogene Autote 1 1 — — $2,262,040.00 $2,262,040.00 $2,262,040.00 2026-03-01
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
01142 OTHER Supprelin La Implant 1 1 — — $41,889.78 $41,889.78 $41,889.78 2026-03-01
01580 OTHER New Technology - Level 43 1 1 — — $43,815.48 $43,815.48 $43,815.48 2026-03-01
01581 OTHER New Technology - Level 44 1 1 — — $53,552.15 $53,552.15 $53,552.15 2026-03-01
01582 OTHER New Technology - Level 45 1 1 — — $63,288.81 $63,288.81 $63,288.81 2026-03-01
01583 OTHER New Technology - Level 46 1 1 — — $73,025.48 $73,025.48 $73,025.48 2026-03-01
01584 OTHER New Technology - Level 47 1 1 — — $82,762.15 $82,762.15 $82,762.15 2026-03-01
01585 OTHER New Technology - Level 48 1 1 — — $92,498.81 $92,498.81 $92,498.81 2026-03-01
01594 OTHER New Technology - Level 43 1 1 — — $43,815.48 $43,815.48 $43,815.48 2026-03-01
01595 OTHER New Technology - Level 44 1 1 — — $53,552.15 $53,552.15 $53,552.15 2026-03-01
01596 OTHER New Technology - Level 45 1 1 — — $63,288.81 $63,288.81 $63,288.81 2026-03-01
01597 OTHER New Technology - Level 46 1 1 — — $73,025.48 $73,025.48 $73,025.48 2026-03-01
01598 OTHER New Technology - Level 47 1 1 — — $82,762.15 $82,762.15 $82,762.15 2026-03-01
01599 OTHER New Technology - Level 48 1 1 — — $92,498.81 $92,498.81 $92,498.81 2026-03-01
01643 OTHER Y90 Ibritumomab, Rx 1 1 — — $55,119.81 $55,119.81 $55,119.81 2026-03-01
01901 OTHER New Technology - Level 49 1 1 — — $104,669.69 $104,669.69 $104,669.69 2026-03-01
01902 OTHER New Technology - Level 49 1 1 — — $104,669.69 $104,669.69 $104,669.69 2026-03-01
01903 OTHER New Technology - Level 50 1 1 — — $119,274.69 $119,274.69 $119,274.69 2026-03-01
01904 OTHER New Technology - Level 50 1 1 — — $119,274.69 $119,274.69 $119,274.69 2026-03-01
01905 OTHER New Technology - Level 51 1 1 — — $133,879.59 $133,879.59 $133,879.59 2026-03-01
01906 OTHER New Technology - Level 51 1 1 — — $133,879.59 $133,879.59 $133,879.59 2026-03-01
01907 OTHER New Technology - Level 52 1 1 — — $148,484.69 $148,484.69 $148,484.69 2026-03-01
01908 OTHER New Technology - Level 52 1 1 — — $148,484.69 $148,484.69 $148,484.69 2026-03-01
0207 RC — 14 10 — — $12,350.00 $55,706.00 $55,706.00 2026-03-01
0294T CPT HInsertion Of Left Atrial Hemodynamic Monitor; Pressure Sensor Lead At Time Of I… 3 1 — — $21,437.00 $38,807.00 $35,328.00 2026-03-01
0515T CPT Insertion Of Wireless Cardiac Stimulator For Left Ventricular Pacing, Including … 1 1 — — $64,410.00 $64,410.00 $64,410.00 2026-03-01
0520T CPT Removal And Replacement Of Pulse Generator For Wireless Cardiac Stimulator For L… 1 1 — — $64,410.00 $64,410.00 $64,410.00 2026-03-01
05244 OTHER Level 4 Blood Product Exc 1 1 — — $62,571.25 $62,571.25 $62,571.25 2026-03-01
0571T CPT Insertion Or Replacement Of Implantable Cardioverter-defibrillator System With S… 1 1 — — $64,410.00 $64,410.00 $64,410.00 2026-03-01
0614T CPT Removal And Replacement Of Substernal Implantable Defibrillator Pulse Generator 1 1 — — $64,410.00 $64,410.00 $64,410.00 2026-03-01
0674T CPT Laparoscopic Insertion Of New Or Replacement Of Permanent Implantable Synchroniz… 1 1 — — $48,303.00 $48,303.00 $48,303.00 2026-03-01
0888T CPT Histotripsy (ie, Non-thermal Ablation Via Acoustic Energy Delivery) Of Malignant… 1 1 — — $39,376.13 $39,376.13 $39,376.13 2026-03-01
09035 OTHER Axicabtagene Ciloleucel C 1 1 — — $516,226.43 $516,226.43 $516,226.43 2026-03-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 1 1 — — $3,574,708.99 $3,574,708.99 $3,574,708.99 2026-03-01
09141 OTHER Inj Onase Abepar-xioi Tre 1 1 — — $2,511,311.57 $2,511,311.57 $2,511,311.57 2026-03-01
0915T CPT Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 1 1 — — $64,410.00 $64,410.00 $64,410.00 2026-03-01
0916T CPT Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 1 1 — — $64,410.00 $64,410.00 $64,410.00 2026-03-01
09194 OTHER Tisagenlecleucel Car-pos 1 1 — — $549,535.36 $549,535.36 $549,535.36 2026-03-01
0923T CPT Removal And Replacement Of Permanent Cardiac Contractility Modulation-defibrilla… 1 1 — — $64,410.00 $64,410.00 $64,410.00 2026-03-01
09273 OTHER Sipuleucel-t Auto Cd54+ 1 1 — — $52,771.99 $52,771.99 $52,771.99 2026-03-01
09391 OTHER Brexucabtagene Car Pos T 1 1 — — $474,766.69 $474,766.69 $474,766.69 2026-03-01
09413 OTHER Lisocabtagene Car Pos T 1 1 — — $545,335.16 $545,335.16 $545,335.16 2026-03-01
09422 OTHER Idecabtagene Vicleucel Ca 1 1 — — $541,339.35 $541,339.35 $541,339.35 2026-03-01
09498 OTHER Ciltacabtagene Car-pos T 1 1 — — $570,020.11 $570,020.11 $570,020.11 2026-03-01
0956T CPT Partial Craniectomy, Channel Creation, And Tunneling Of Electrode For Sub-scalp … 1 1 — — $48,303.00 $48,303.00 $48,303.00 2026-03-01
0960T CPT Replacement Of Sub-scalp Implanted Electrode Array, Receiver, And Telemetry Unit… 1 1 — — $48,303.00 $48,303.00 $48,303.00 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 44 23 — — $2,968.00 $1,252,332.04 $220,735.78 2026-03-01
10 MS_DRG Pancreas Transplant 44 24 — — $2,968.00 $320,667.68 $56,894.19 2026-03-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 47 25 — — $2,968.00 $243,732.82 $43,244.55 2026-03-01
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 11 — — $34,745.58 $52,118.37 $41,694.70 2026-03-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 11 — — $70,549.10 $105,823.65 $84,658.92 2026-03-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 11 — — $88,742.47 $133,113.71 $106,490.96 2026-03-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 11 — — $119,243.36 $178,865.04 $143,092.03 2026-03-01
1142 OTHER Supprelin La Implant 21 18 — — $38,866.81 $51,822.41 $45,344.61 2026-03-01
13 APR_DRG Liver Transplant And/or Intestinal Transplant 13 11 — — $34,436.53 $51,654.79 $41,323.84 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 45 24 — — $1,636.00 $537,055.92 $94,257.35 2026-03-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 13 11 — — $66,329.56 $99,494.34 $79,595.47 2026-03-01
1579 OTHER New Technology - Level 42 21 18 — — $32,197.87 $42,930.49 $37,564.18 2026-03-01
1580 OTHER New Technology - Level 43 21 18 — — $41,397.13 $55,196.17 $48,296.65 2026-03-01
1581 OTHER New Technology - Level 44 21 18 — — $50,596.39 $67,461.85 $59,029.12 2026-03-01
1582 OTHER New Technology - Level 45 21 18 — — $59,795.65 $79,727.53 $69,761.59 2026-03-01
1583 OTHER New Technology - Level 46 21 18 — — $68,994.91 $91,993.21 $80,494.06 2026-03-01
1584 OTHER New Technology - Level 47 21 18 — — $78,194.17 $104,258.89 $91,226.53 2026-03-01
1585 OTHER New Technology - Level 48 21 18 — — $87,393.43 $116,524.57 $101,959.00 2026-03-01
1593 OTHER New Technology - Level 42 21 18 — — $32,197.87 $42,930.49 $37,564.18 2026-03-01
1594 OTHER New Technology - Level 43 21 18 — — $41,397.13 $55,196.17 $48,296.65 2026-03-01
1595 OTHER New Technology - Level 44 21 18 — — $50,596.39 $67,461.85 $59,029.12 2026-03-01
1596 OTHER New Technology - Level 45 21 18 — — $59,795.65 $79,727.53 $69,761.59 2026-03-01
1597 OTHER New Technology - Level 46 21 18 — — $68,994.91 $91,993.21 $80,494.06 2026-03-01
1598 OTHER New Technology - Level 47 21 18 — — $78,194.17 $104,258.89 $91,226.53 2026-03-01
1599 OTHER New Technology - Level 48 21 18 — — $87,393.43 $116,524.57 $101,959.00 2026-03-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 45 24 — — $1,636.00 $310,551.08 $46,940.85 2026-03-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 13 11 — — $51,048.39 $76,572.58 $61,258.07 2026-03-01
1611 APR_DRG Implantable Heart Assist Systems 13 11 — — $51,234.90 $76,852.35 $61,481.88 2026-03-01
1612 APR_DRG Implantable Heart Assist Systems 13 11 — — $51,234.90 $76,852.35 $61,481.88 2026-03-01
1613 APR_DRG Implantable Heart Assist Systems 13 11 — — $69,631.31 $104,446.96 $83,557.57 2026-03-01
1614 APR_DRG Implantable Heart Assist Systems 13 11 — — $88,926.10 $133,389.15 $106,711.32 2026-03-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 13 11 — — $34,306.45 $51,459.67 $41,167.74 2026-03-01
163 MS_DRG Major Chest Procedures With Mcc 47 25 — — $2,968.00 $200,282.68 $35,688.00 2026-03-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 13 11 — — $30,019.36 $45,029.04 $36,023.23 2026-03-01
1643 OTHER Y90 Ibritumomab, Rx 21 18 — — $51,142.10 $68,189.46 $59,665.78 2026-03-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 45 24 — — $1,636.00 $310,551.08 $43,075.13 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 44 23 — — $1,636.00 $1,929,752.97 $322,045.92 2026-03-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 44 24 — — $2,968.00 $318,831.00 $56,573.25 2026-03-01
1901 OTHER New Technology - Level 49 21 18 — — $98,892.54 $131,856.72 $115,374.63 2026-03-01
1902 OTHER New Technology - Level 49 21 18 — — $98,892.54 $131,856.72 $115,374.63 2026-03-01
1903 OTHER New Technology - Level 50 21 18 — — $112,691.43 $150,255.24 $131,473.33 2026-03-01
1904 OTHER New Technology - Level 50 21 18 — — $112,691.43 $150,255.24 $131,473.33 2026-03-01
1905 OTHER New Technology - Level 51 21 18 — — $126,490.32 $168,653.76 $147,572.04 2026-03-01
1906 OTHER New Technology - Level 51 21 18 — — $126,490.32 $168,653.76 $147,572.04 2026-03-01
1907 OTHER New Technology - Level 52 21 18 — — $140,289.21 $187,052.28 $163,670.74 2026-03-01
1908 OTHER New Technology - Level 52 21 18 — — $140,289.21 $187,052.28 $163,670.74 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 44 23 — — $2,968.00 $506,395.48 $89,771.98 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 45 25 — — $11,680.00 $351,640.93 $64,507.00 2026-03-01
2067 OTHER Afamitresgene Autoleucel 21 18 — — $693,558.00 $924,744.00 $809,151.00 2026-03-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 48 25 — — $1,636.00 $287,553.87 $50,650.40 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 47 25 — — $2,968.00 $311,561.29 $88,824.06 2026-03-01
21 APR_DRG Heart And/or Lung Transplant 13 11 — — $43,443.38 $65,165.07 $52,132.06 2026-03-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 45 25 — — $11,680.00 $236,569.33 $44,798.64 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 47 25 — — $2,968.00 $485,941.78 $87,400.49 2026-03-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 47 25 — — $2,968.00 $177,434.00 $45,209.28 2026-03-01
215 MS_DRG Other Heart Assist System Implant 45 25 — — $11,680.00 $444,958.42 $85,691.82 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 45 25 — — $11,680.00 $201,355.44 $82,012.28 2026-03-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 45 25 — — $11,680.00 $201,355.44 $56,906.76 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 45 25 — — $11,680.00 $201,355.44 $56,906.76 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 43 25 — — $11,680.00 $177,434.00 $66,295.51 2026-03-01
22 APR_DRG Heart And/or Lung Transplant 13 11 — — $49,153.16 $73,729.74 $58,983.79 2026-03-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 43 25 — — $11,680.00 $177,434.00 $46,330.58 2026-03-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 43 25 — — $11,680.00 $177,434.00 $43,839.97 2026-03-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 43 25 — — $11,680.00 $177,434.00 $41,927.01 2026-03-01
23 APR_DRG Heart And/or Lung Transplant 13 11 — — $64,911.19 $97,366.79 $77,893.43 2026-03-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 45 25 — — $11,680.00 $256,075.65 $48,417.22 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 45 25 — — $11,680.00 $376,715.37 $70,796.79 2026-03-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 45 25 — — $11,680.00 $270,925.47 $52,542.65 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 43 25 — — $11,680.00 $177,434.00 $63,983.00 2026-03-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 43 25 — — $11,680.00 $177,434.00 $46,198.82 2026-03-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 43 25 — — $11,680.00 $177,434.00 $49,563.72 2026-03-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 43 25 — — $11,680.00 $177,434.00 $35,638.24 2026-03-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 47 25 — — $2,968.00 $219,940.93 $39,106.83 2026-03-01
24 APR_DRG Heart And/or Lung Transplant 13 11 — — $119,164.66 $178,746.99 $142,997.59 2026-03-01
245 MS_DRG Aicd Generator Procedures 45 25 — — $11,680.00 $203,884.53 $37,697.81 2026-03-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 45 25 — — $11,680.00 $104,904.34 $37,664.86 2026-03-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 45 25 — — $11,680.00 $247,513.79 $53,102.73 2026-03-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 45 25 — — $11,680.00 $185,847.29 $41,461.71 2026-03-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 43 25 — — $11,680.00 $177,434.00 $56,896.30 2026-03-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 45 25 — — $11,680.00 $177,434.00 $36,885.65 2026-03-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 43 25 — — $11,680.00 $177,434.00 $44,653.57 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 45 25 — — $11,680.00 $318,643.32 $61,631.78 2026-03-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 44 25 — — $9,905.00 $268,422.94 $49,780.46 2026-03-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 44 25 — — $9,905.00 $206,391.53 $38,380.04 2026-03-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 43 25 — — $11,680.00 $248,742.35 $45,166.16 2026-03-01
28 MS_DRG Spinal Procedures With Mcc 45 25 — — $11,680.00 $268,498.91 $49,363.20 2026-03-01
2994 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 13 11 — — $29,413.84 $44,120.76 $35,296.61 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 45 23 — — $2,968.00 $948,511.74 $165,814.95 2026-03-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 13 11 — — $34,140.79 $51,211.18 $40,968.95 2026-03-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 45 25 — — $11,680.00 $92,271.00 $37,037.06 2026-03-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 47 25 — — $2,968.00 $298,806.31 $52,822.57 2026-03-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 45 25 — — $11,680.00 $118,877.00 $36,387.33 2026-03-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 45 25 — — $9,905.00 $193,382.85 $35,309.17 2026-03-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 47 25 — — $2,968.00 $222,876.93 $39,617.44 2026-03-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 47 25 — — $2,968.00 $205,408.39 $36,927.80 2026-03-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 47 25 — — $2,968.00 $196,305.45 $34,996.31 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 45 23 — — $2,968.00 $618,991.36 $108,507.00 2026-03-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 47 25 — — $2,968.00 $244,465.70 $43,372.01 2026-03-01
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 13 11 — — $29,522.73 $44,284.10 $35,427.28 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 45 25 — — $9,905.00 $492,515.39 $87,335.07 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 44 25 — — $9,905.00 $322,584.80 $58,314.11 2026-03-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 44 25 — — $9,905.00 $251,235.94 $46,409.61 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 45 25 — — $9,905.00 $402,621.00 $71,552.35 2026-03-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 13 11 — — $46,198.91 $69,298.37 $55,438.69 2026-03-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 44 25 — — $9,905.00 $257,720.16 $47,595.94 2026-03-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 13 11 — — $66,996.16 $100,494.24 $80,395.39 2026-03-01
4404 APR_DRG Kidney Transplant 13 11 — — $33,592.77 $50,389.15 $40,311.32 2026-03-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 46 25 — — $2,968.00 $154,444.00 $52,784.49 2026-03-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 44 25 — — $9,905.00 $138,351.00 $43,585.54 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 45 25 — — $2,968.00 $375,531.14 $66,796.19 2026-03-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 45 25 — — $2,968.00 $266,479.01 $48,324.25 2026-03-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 2 1 — — $83,213.00 $83,213.00 $83,213.00 2026-03-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 2 1 — — $83,213.00 $83,213.00 $83,213.00 2026-03-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 45 25 — — $11,680.00 $246,811.82 $45,864.80 2026-03-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 47 25 — — $2,968.00 $254,699.26 $45,151.76 2026-03-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 45 25 — — $11,680.00 $99,597.00 $43,121.53 2026-03-01
471 MS_DRG Cervical Spinal Fusion With Mcc 44 25 — — $11,680.00 $93,619.00 $39,572.13 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 44 24 — — $2,968.00 $460,755.62 $81,373.37 2026-03-01
5166 OTHER Cochlear Implant Procedur 21 18 — — $30,988.88 $41,318.51 $36,153.69 2026-03-01
5244 OTHER Level 4 Blood Product Exc 21 18 — — $59,117.68 $78,823.57 $68,970.63 2026-03-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 13 11 — — $33,871.27 $50,806.90 $40,645.52 2026-03-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 13 11 — — $46,671.82 $70,007.73 $56,006.18 2026-03-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 47 25 — — $2,968.00 $292,768.96 $50,293.37 2026-03-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 47 25 — — $2,968.00 $219,024.83 $37,463.80 2026-03-01
5831 APR_DRG Neonate With Ecmo 13 11 — — $81,748.00 $122,622.00 $98,097.60 2026-03-01
5832 APR_DRG Neonate With Ecmo 13 11 — — $91,071.80 $136,607.70 $109,286.16 2026-03-01
5833 APR_DRG Neonate With Ecmo 13 11 — — $118,611.62 $177,917.43 $142,333.94 2026-03-01
5834 APR_DRG Neonate With Ecmo 13 11 — — $208,261.10 $312,391.65 $249,913.32 2026-03-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 13 11 — — $62,395.71 $93,593.57 $74,874.85 2026-03-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 13 11 — — $72,794.70 $109,192.05 $87,353.64 2026-03-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 13 11 — — $84,952.00 $127,428.00 $101,942.40 2026-03-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 13 11 — — $127,555.94 $191,333.91 $153,067.13 2026-03-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 13 11 — — $59,458.71 $89,188.07 $71,350.45 2026-03-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 13 11 — — $59,458.71 $89,188.07 $71,350.45 2026-03-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 13 11 — — $59,458.71 $89,188.07 $71,350.45 2026-03-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 13 11 — — $54,106.85 $81,160.27 $64,928.22 2026-03-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 13 11 — — $63,082.80 $94,624.20 $75,699.36 2026-03-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 13 11 — — $83,645.03 $125,467.54 $100,374.04 2026-03-01
5931 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 13 11 — — $32,930.12 $49,395.18 $39,516.14 2026-03-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 13 11 — — $43,270.17 $64,905.25 $51,924.20 2026-03-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 13 11 — — $53,796.73 $80,695.10 $64,556.08 2026-03-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 13 11 — — $73,540.00 $110,310.00 $88,248.00 2026-03-01
6 MS_DRG Liver Transplant Without Mcc 44 24 — — $2,968.00 $315,646.15 $37,069.88 2026-03-01
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 13 11 — — $30,735.91 $46,103.86 $36,883.09 2026-03-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 13 11 — — $38,465.25 $57,697.88 $46,158.30 2026-03-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 13 11 — — $55,400.17 $83,100.26 $66,480.20 2026-03-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 13 11 — — $40,520.04 $60,780.06 $48,624.05 2026-03-01
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 13 11 — — $29,361.38 $44,042.07 $35,233.66 2026-03-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 13 11 — — $42,824.58 $64,236.87 $51,389.50 2026-03-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 13 11 — — $30,828.62 $46,242.93 $36,994.34 2026-03-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 13 11 — — $88,871.48 $133,307.22 $106,645.78 2026-03-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 13 11 — — $35,617.73 $53,426.60 $42,741.28 2026-03-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 13 11 — — $35,290.36 $52,935.54 $42,348.43 2026-03-01
62 APR_DRG Pancreas Transplant 13 11 — — $28,786.05 $43,179.07 $34,543.26 2026-03-01
63 APR_DRG Pancreas Transplant 13 11 — — $33,389.74 $50,084.61 $40,067.69 2026-03-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 13 11 — — $42,730.78 $64,096.17 $51,276.94 2026-03-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 13 11 — — $77,520.20 $116,280.30 $93,024.24 2026-03-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 13 11 — — $85,478.46 $128,217.69 $102,574.15 2026-03-01
64 APR_DRG Pancreas Transplant 13 11 — — $43,326.23 $64,989.35 $51,991.48 2026-03-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 44 24 — — $2,968.00 $210,096.16 $37,572.77 2026-03-01
653 MS_DRG Major Bladder Procedures With Mcc 47 25 — — $2,968.00 $232,216.72 $41,241.75 2026-03-01
7 MS_DRG Lung Transplant 44 24 — — $2,968.00 $578,718.54 $101,986.70 2026-03-01
714 OTHER Inj Delandistrogene Mox R 20 17 — — $3,327,860.00 $3,993,432.00 $3,494,253.00 2026-03-01
717 OTHER Instill Adstiladrin, Tx D 20 17 — — $64,274.79 $77,129.75 $67,488.53 2026-03-01
72 APR_DRG Allogeneic Bone Marrow Transplant 13 11 — — $31,423.35 $47,135.02 $37,708.02 2026-03-01
73 APR_DRG Allogeneic Bone Marrow Transplant 13 11 — — $44,622.06 $66,933.09 $53,546.47 2026-03-01
74 APR_DRG Allogeneic Bone Marrow Transplant 13 11 — — $70,159.56 $105,239.34 $84,191.47 2026-03-01
746 OTHER Inj, Betibeglogene Autote 20 17 — — $2,939,969.00 $3,527,962.80 $3,086,967.45 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 20 17 — — $3,252,508.00 $3,903,009.60 $3,415,133.40 2026-03-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 28 18 — — $40,326.94 $75,436.00 $47,048.10 2026-03-01
799 MS_DRG Splenic Procedures With Mcc 47 25 — — $2,968.00 $202,387.48 $36,054.06 2026-03-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 44 24 — — $2,968.00 $250,458.36 $44,625.72 2026-03-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 47 25 — — $2,968.00 $262,086.18 $46,436.45 2026-03-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 47 25 — — $2,968.00 $204,885.54 $36,488.50 2026-03-01
824 OTHER Inj, Exagamglogene Autote 20 17 — — $2,332,000.00 $2,798,400.00 $2,448,600.00 2026-03-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. 47 25 — — $2,968.00 $209,041.53 $37,211.29 2026-03-01
831 OTHER Obecbtge Autol Up To 400 20 17 — — $278,250.00 $333,900.00 $292,162.50 2026-03-01
834 MS_DRG Acute Leukemia With Mcc 48 25 — — $1,636.00 $245,332.65 $43,276.32 2026-03-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 48 25 — — $1,636.00 $214,694.56 $37,925.26 2026-03-01
84 APR_DRG Autologous Bone Marrow Transplant 13 11 — — $31,204.86 $46,807.29 $37,445.83 2026-03-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 13 11 — — $79,102.08 $118,653.12 $94,922.50 2026-03-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 13 11 — — $44,285.71 $66,428.57 $53,142.85 2026-03-01
845 OTHER Inj, Atidarsagene Autotem 18 15 — — $4,505,000.00 $4,955,500.00 $4,673,937.50 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 47 25 — — $2,968.00 $386,975.74 $68,156.40 2026-03-01
8513 APR_DRG Gender Related Procedures 13 11 — — $40,865.02 $61,297.53 $49,038.02 2026-03-01
8514 APR_DRG Gender Related Procedures 13 11 — — $40,865.02 $61,297.53 $49,038.02 2026-03-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 47 25 — — $2,968.00 $220,696.16 $39,238.17 2026-03-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 47 25 — — $2,968.00 $203,272.31 $36,207.94 2026-03-01
8634 APR_DRG Neonatal Aftercare 13 11 — — $34,835.42 $52,253.13 $41,802.50 2026-03-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 44 25 — — $11,680.00 $112,019.54 $51,455.07 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 20 17 — — $201,669.00 $242,002.80 $211,752.45 2026-03-01
897 OTHER Revakinagene, Per Implant 20 17 — — $265,000.00 $318,000.00 $278,250.00 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 20 17 — — $532,192.20 $638,630.64 $558,801.81 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 20 17 — — $3,180,000.00 $3,816,000.00 $3,339,000.00 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 20 17 — — $3,335,820.00 $4,002,984.00 $3,502,611.00 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 20 17 — — $3,685,267.00 $4,422,320.40 $3,869,530.35 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 20 17 — — $2,588,981.00 $3,106,777.20 $2,718,430.05 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 20 17 — — $566,531.30 $679,837.56 $594,857.87 2026-03-01
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 13 11 — — $29,405.22 $44,107.83 $35,286.26 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 45 23 — — $2,968.00 $954,111.14 $166,788.83 2026-03-01
9273 OTHER Sipuleucel-t Auto Cd54+ 20 17 — — $54,404.11 $65,284.93 $57,124.32 2026-03-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 45 23 — — $2,968.00 $320,533.62 $56,601.24 2026-03-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 13 11 — — $58,588.00 $87,882.00 $70,305.60 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 20 17 — — $489,450.20 $587,340.24 $513,922.71 2026-03-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 13 11 — — $87,176.41 $130,764.62 $104,611.69 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 20 17 — — $562,201.20 $674,641.44 $590,311.26 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 20 17 — — $558,081.80 $669,698.16 $585,985.89 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 20 17 — — $587,649.60 $705,179.52 $617,032.08 2026-03-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 47 25 — — $2,968.00 $300,799.40 $53,169.20 2026-03-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 47 25 — — $2,968.00 $340,518.09 $60,076.80 2026-03-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 47 25 — — $2,968.00 $273,548.65 $48,429.93 2026-03-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 47 25 — — $2,968.00 $209,667.16 $37,320.09 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 1 1 — — $93,760.51 $93,760.51 $93,760.51 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 1 1 — — $77,046.96 $77,046.96 $77,046.96 2026-03-01
C000032901 CDM Ins Icd Gen Only Dual Ld 25 13 $101,088.00 $101,088.00 $5,660.93 $90,979.20 $42,052.61 2026-03-01
C000033001 CDM Ins Icd Gen Only Mult Ld 25 13 $116,936.25 $116,936.25 $6,548.43 $105,242.63 $48,645.48 2026-03-01
C000033401 CDM Ins Icd Gen Only Sgl Ld 25 13 $101,088.00 $101,088.00 $5,660.93 $90,979.20 $42,052.61 2026-03-01
C000033701 CDM Ins Icd Lead/generator 25 13 $120,856.75 $120,856.75 $6,767.98 $108,771.07 $50,276.41 2026-03-01
C000033801 CDM Rem/replace Icd Gen Sgl 25 13 $116,936.25 $116,936.25 $6,548.43 $105,242.63 $48,645.48 2026-03-01
C000033901 CDM Rem/replace Icd Gen Dual 25 13 $116,936.25 $116,936.25 $6,548.43 $105,242.63 $48,645.48 2026-03-01
C000034001 CDM Rem/replace Icd Gen Mult 25 13 $116,936.25 $116,936.25 $6,548.43 $105,242.63 $48,645.48 2026-03-01
C000034301 CDM Ins/repl Ldls Ppm Vent 25 13 $87,991.50 $87,991.50 $4,927.52 $79,192.35 $36,604.46 2026-03-01
C9782 HCPCS Blinded Procedure For New York Heart Association (nyha) Class Ii Or Iii Heart Fa… 1 1 — — $48,303.00 $48,303.00 $48,303.00 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 1 1 — — $4,850,948.67 $4,850,948.67 $4,850,948.67 2026-03-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 1 — — $4,271,819.03 $4,271,819.03 $4,271,819.03 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 1 1 — — $138,148.31 $138,148.31 $138,148.31 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 5 3 — — $61,338.53 $106,053.40 $61,338.53 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 5 3 — — $43,855.64 $71,255.81 $43,855.64 2026-03-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 1 1 — — $39,976.89 $39,976.89 $39,976.89 2026-03-01
N000000501 CDM Lvl 5 Bedside Proc 26 14 $82,881.00 $82,881.00 $4,641.34 $74,592.90 $34,478.50 2026-03-01
O000002801 CDM Eswl-unilateral 30 13 $149,763.25 $149,763.25 $8,386.74 $134,786.92 $40,361.19 2026-03-01
O000002901 CDM Eswl-bilateral 30 13 $149,763.25 $149,763.25 $8,386.74 $134,786.92 $40,361.19 2026-03-01
O000004001 CDM Cysto Add On To Eswl 26 14 $146,631.50 $146,631.50 $8,211.36 $131,968.35 $60,998.70 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 5 3 — — $487,755.77 $878,117.20 $487,755.77 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 5 3 — — $561,407.87 $934,776.65 $561,407.87 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 2 2 — — $55,306.59 $89,766.78 $72,536.68 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 5 3 — — $474,717.03 $807,592.83 $474,717.03 2026-03-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 5 3 — — $500,948.74 $927,632.05 $500,948.74 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 2 2 — — $511,793.34 $920,834.85 $716,314.09 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 5 3 — — $536,573.93 $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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