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

LOYOLA UNIVERSITY MEDICAL CENTER

Maywood, IL · CCN 140276 · Rates published

35,487 distinct procedures filed
11 distinct payers
1,427,150 rate rows
2026-03-31 last MRF observed
Data quality

891,654 of 1,427,150 rate rows are consumer-grade (62.5%)

535,496 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 523,926
placeholder amount (≤ $0.02) — excluded from medians 9,208
template filing: same amount across many unrelated codes — excluded 936
percent-of-charges filed in the dollar field — excluded from medians 912
per-diem day rate — not a per-procedure price 274
exceeds 10× this hospital's gross charge — excluded from medians 240
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://trinityhealth.pt.panaceainc.com/MRFDownload/trinityhealth/loyolauniversitycenter
Found on page https://www.loyolamedicine.org/for-patients/billing-and-insurance/insurance-information/price-estimates-list
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint a11032ff53c86449… · 12,195,363 bytes · first seen 2026-05-08

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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 6 $4,243,770.00 $4,791,353.23 $4,684,118.18 nat. median
$4,505,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 8 $3,596,661.73 $4,408,811.15 $4,022,073.33 nat. median
$3,710,000
1.1× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 8 $34,189.02 $4,379,419.08 $3,929,952.38 nat. median
$3,710,000
1.1× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 9 $3,161,722.56 $4,997,561.47 $3,569,686.76 nat. median
$3,286,000
1.1× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 8 $34,189.02 $3,950,784.27 $3,545,309.05 nat. median
$3,325,455
1.1× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 10 $2,860,544.96 $4,864,551.99 $3,229,647.54 nat. median
$3,004,655
1.1× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 10 $2,377,204.94 $3,998,166.53 $2,683,941.06 nat. median
$2,468,984
1.1× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 10 $2,260,758.80 $3,847,800.00 $2,552,469.61 nat. median
$2,448,600
1.0× median
5789411102
NDC 		Ciltacabtagene 100000000 Cells Susp 1 Each Flex Cont 5 $3,929.00 $2,239,380.00 $1,628,640.00 nat. median
$1,628,640
1.0× median
5789411101
NDC 		Ciltacabtagene 100000000 Cells Susp 1 Each Flex Cont 5 $3,929.00 $2,239,380.00 $1,628,640.00 nat. median
$1,628,640
1.0× median
5957251503
NDC 		Idecabtagene Vicleucel 460000000 Cells Susp 1 Each Flex Cont 5 $3,929.00 $2,138,166.03 $1,555,029.84 nat. median
$1,555,030
1.0× median
5957251501
NDC 		Idecabtagene Vicleucel 460000000 Cells Susp 1 Each Flex Cont 5 $3,929.00 $2,138,166.03 $1,555,029.84 nat. median
$606,766
outlier · 2.6×
5957251502
NDC 		Idecabtagene Vicleucel 460000000 Cells Susp 1 Each Flex Cont 5 $3,929.00 $2,138,166.03 $1,555,029.84 nat. median
$1,555,030
1.0× median
7315390001
NDC 		Lisocabtagene Maraleucel 70000000 Cells/ml Susp 1 Each Box 5 $3,929.00 $2,091,276.33 $1,520,928.24 nat. median
$593,909
outlier · 2.6×
7128721901
NDC 		Brexucabtagene Autoleucel 200 Million Cells Susp 1 Each Flex Cont 5 $3,929.00 $1,981,980.00 $1,441,440.00 nat. median
$562,809
outlier · 2.6×
7128711901
NDC 		Axicabtagene Ciloleucel 200000000 Cells Susp 1 Each Package 5 $3,929.00 $1,981,980.00 $1,441,440.00 nat. median
$578,267
outlier · 2.5×
Q2057
HCPCS 		Afamitresgene Autoleucel 10 $747,078.02 $1,271,523.00 $843,475.19 nat. median
$824,563
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 10 $54,633.56 $954,972.35 $626,971.39 nat. median
$753,246
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 10 $54,633.56 $912,729.35 $599,927.28 nat. median
$674,867
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 10 $54,633.56 $852,129.78 $587,196.32 nat. median
$673,137
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 10 $54,633.56 $870,577.06 $586,789.54 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 10 $54,633.56 $829,687.20 $577,917.17 nat. median
$634,303
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 10 $54,633.56 $807,508.61 $530,913.68 nat. median
$619,808
0.9× median
7344180004
NDC 		Omidubicel-onlv IV Suspension Susp 1 Each Flex Cont 5 $3,929.00 $664,592.50 $464,750.00 nat. median
$464,750
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 10 $387,331.92 $715,751.23 $461,718.52 nat. median
$370,174
1.2× median
C9301
HCPCS 		Obecabtagene Car Pos T 1 $459,112.50 $459,112.50 $459,112.50 nat. median
$459,112
1.0× median
8120006
CDM 		Hc Heart Transplant Acquistion With Preservation Device (Transme 5 $3,929.00 $458,816.22 $320,850.50 nat. median
$320,850
1.0× median
999LL
MS_DRG 		Solid Organ Transplant ? Liver/Lung 1 $224,796.60 $327,842.65 $320,215.64 —
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 10 $126,537.30 $534,606.17 $313,341.07 nat. median
$265,286
1.2× median
8120013
CDM 		Hc Lung Transmedics-double 5 $3,929.00 $444,995.27 $311,185.50 nat. median
$311,186
1.0× median
999LK
MS_DRG 		Solid Organ Transplant ? Liver/Kidney 1 $222,048.90 $322,668.13 $310,411.17 —
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 9 $262,115.21 $414,311.13 $295,936.52 nat. median
$324,450
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 10 $243,885.57 $439,056.00 $290,574.15 nat. median
$206,474
1.4× median
7901004
CDM 		Hc Liver Transmedics 5 $3,929.00 $377,490.69 $263,979.50 nat. median
$263,980
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 10 $220,392.77 $406,750.34 $262,545.12 nat. median
$202,976
1.3× median
999HK
MS_DRG 		Solid Organ Transplant ? Heart/Kidney 1 $219,552.30 $271,184.01 $260,881.05 —
017C
MS_DRG 		Bone Marrow/Stem Cell Transplant Category C 1 $177,154.20 $257,425.95 $251,252.29 —
014C
MS_DRG 		Bone Marrow/Stem Cell Transplant Category C 1 $177,154.20 $257,425.95 $251,252.29 —
016C
MS_DRG 		Bone Marrow/Stem Cell Transplant Category C 1 $177,154.20 $257,425.95 $251,252.29 —
8120012
CDM 		Hc Lung Transmedics-single 5 $3,929.00 $357,027.39 $249,669.50 nat. median
$249,670
1.0× median
999HL
MS_DRG 		Solid Organ Transplant ? Heart/Lung 1 $168,717.60 $245,169.10 $239,290.54 —
8120005
CDM 		Hc Heart Transplant Acquistion With Preservation Device (Sherpap 5 $3,929.00 $335,561.66 $234,658.50 nat. median
$63
outlier · 3743.2×
8120001
CDM 		Heart / Lung Acquisition Cadaver 5 $3,929.00 $333,351.59 $233,113.00 nat. median
$233,113
1.0× median
007B
MS_DRG 		Solid Organ Transplant ? Bilateral Lung 1 $151,845.30 $220,653.26 $215,359.70 —
8120015
CDM 		Hc Lungguard-double 5 $3,929.00 $297,061.05 $207,735.00 nat. median
$207,735
1.0× median
8120003
CDM 		Lung Double Acquisition Cadaver 5 $3,929.00 $288,182.90 $201,526.50 nat. median
$201,526
1.0× median
014B
MS_DRG 		Bone Marrow/Stem Cell Transplant Category B 1 $139,192.20 $202,262.10 $197,413.93 —
017B
MS_DRG 		Bone Marrow/Stem Cell Transplant Category B 1 $139,192.20 $202,262.10 $197,413.93 —
016B
MS_DRG 		Bone Marrow/Stem Cell Transplant Category B 1 $139,192.20 $202,262.10 $197,413.93 —
8140001
CDM 		Heart Acquisition 5 $3,929.00 $274,244.69 $191,779.50 nat. median
$2,416
outlier · 79.4×

Other procedures at this hospital

Browse this hospital's 35,487 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
             
0003232822 NDC Ipilimumab 1 Mg Inj 22 5 $80,539.71 $18,524.13 77% off $3,929.00 $57,585.89 $41,880.65 2026-03-31
0012 APR_DRG — 6 3 — — $43,414.50 $43,414.50 $43,414.50 2026-03-31
0013 APR_DRG — 6 3 — — $51,799.87 $51,799.87 $51,799.87 2026-03-31
0014 APR_DRG — 6 3 — — $89,599.08 $89,599.08 $89,599.08 2026-03-31
0021 APR_DRG — 6 3 — — $55,139.97 $55,139.97 $55,139.97 2026-03-31
0022 APR_DRG — 6 3 — — $64,320.79 $64,320.79 $64,320.79 2026-03-31
0023 APR_DRG — 6 3 — — $86,673.03 $86,673.03 $86,673.03 2026-03-31
0024 APR_DRG — 6 3 — — $140,160.21 $140,160.21 $140,160.21 2026-03-31
0042 APR_DRG — 6 3 — — $42,820.19 $42,820.19 $42,820.19 2026-03-31
0043 APR_DRG — 6 3 — — $62,283.56 $62,283.56 $62,283.56 2026-03-31
0044 APR_DRG — 6 3 — — $91,014.29 $91,014.29 $91,014.29 2026-03-31
0053 APR_DRG — 6 3 — — $44,168.60 $44,168.60 $44,168.60 2026-03-31
0054 APR_DRG — 6 3 — — $59,980.29 $59,980.29 $59,980.29 2026-03-31
0062 APR_DRG — 6 3 — — $48,298.85 $48,298.85 $48,298.85 2026-03-31
0063 APR_DRG — 6 3 — — $55,637.51 $55,637.51 $55,637.51 2026-03-31
0064 APR_DRG — 6 3 — — $79,126.39 $79,126.39 $79,126.39 2026-03-31
0072 APR_DRG — 6 3 — — $42,357.56 $42,357.56 $42,357.56 2026-03-31
0073 APR_DRG — 6 3 — — $54,151.33 $54,151.33 $54,151.33 2026-03-31
0074 APR_DRG — 6 3 — — $91,886.79 $91,886.79 $91,886.79 2026-03-31
007B MS_DRG Solid Organ Transplant ? Bilateral Lung 8 1 — — $151,845.30 $220,653.26 $215,359.70 2026-03-31
007S MS_DRG Solid Organ Transplant ? Single Lung 8 1 — — $126,537.30 $183,875.22 $179,466.07 2026-03-31
0084 APR_DRG — 6 3 — — $46,481.74 $46,481.74 $46,481.74 2026-03-31
0094 APR_DRG — 6 3 — — $89,105.33 $89,105.33 $89,105.33 2026-03-31
0113 APR_DRG — 6 3 — — $47,030.51 $47,030.51 $47,030.51 2026-03-31
0114 APR_DRG — 6 3 — — $95,546.44 $95,546.44 $95,546.44 2026-03-31
014A MS_DRG Bone Marrow/Stem Cell Transplant Category A 8 1 — — $94,904.10 $137,908.02 $134,602.43 2026-03-31
014B MS_DRG Bone Marrow/Stem Cell Transplant Category B 8 1 — — $139,192.20 $202,262.10 $197,413.93 2026-03-31
014C MS_DRG Bone Marrow/Stem Cell Transplant Category C 8 1 — — $177,154.20 $257,425.95 $251,252.29 2026-03-31
016A MS_DRG Bone Marrow/Stem Cell Transplant Category A 8 1 — — $94,904.10 $137,908.02 $134,602.43 2026-03-31
016B MS_DRG Bone Marrow/Stem Cell Transplant Category B 8 1 — — $139,192.20 $202,262.10 $197,413.93 2026-03-31
016C MS_DRG Bone Marrow/Stem Cell Transplant Category C 8 1 — — $177,154.20 $257,425.95 $251,252.29 2026-03-31
017A MS_DRG Bone Marrow/Stem Cell Transplant Category A 8 1 — — $94,904.10 $137,908.02 $134,602.43 2026-03-31
017B MS_DRG Bone Marrow/Stem Cell Transplant Category B 8 1 — — $139,192.20 $202,262.10 $197,413.93 2026-03-31
017C MS_DRG Bone Marrow/Stem Cell Transplant Category C 8 1 — — $177,154.20 $257,425.95 $251,252.29 2026-03-31
0266T HCPCS Implt/rpl Crtd Sns Dev Total 24 9 — — $27,607.65 $68,956.85 $48,152.52 2026-03-31
0451T HCPCS Insj/rplcmt Aortic Ventr Sys 6 3 — — $44,945.15 $44,945.15 $44,945.15 2026-03-31
0452T HCPCS Insj/rplcmt Dev Vasc Seal 6 3 — — $44,945.15 $44,945.15 $44,945.15 2026-03-31
0453T HCPCS Insj/rplcmt Mech-elec Ntrfce 6 3 — — $44,945.15 $44,945.15 $44,945.15 2026-03-31
0454T HCPCS Insj/rplcmt Subq Electrode 6 3 — — $44,945.15 $44,945.15 $44,945.15 2026-03-31
0459T HCPCS Relocaj Rplcmt Aortic Ventr 6 3 — — $44,945.15 $44,945.15 $44,945.15 2026-03-31
0494T HCPCS Single Lung Evlp 38 7 $305,886.00 $70,353.78 77% off $4,252.00 $303,387.37 $106,142.44 2026-03-31
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 44 10 — — $126,537.30 $534,606.17 $313,341.07 2026-03-31
10 MS_DRG Pancreas Transplant 44 10 — — $82,395.12 $151,319.57 $102,588.60 2026-03-31
11 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Mcc 36 10 — — $55,970.84 $102,408.79 $66,375.02 2026-03-31
12 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Cc 36 10 — — $42,721.28 $77,884.12 $50,567.11 2026-03-31
14 MS_DRG Allogeneic Bone Marrow Transplant 36 10 — — $134,983.23 $248,659.06 $160,643.89 2026-03-31
140 MS_DRG Major Head And Neck Procedures With Mcc 36 10 — — $44,008.09 $80,265.99 $52,102.39 2026-03-31
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 36 10 — — $62,533.08 $114,555.35 $74,204.36 2026-03-31
1604 APR_DRG — 6 3 — — $61,456.98 $61,456.98 $61,456.98 2026-03-31
1611 APR_DRG — 6 3 — — $84,871.47 $84,871.47 $84,871.47 2026-03-31
1612 APR_DRG — 6 3 — — $89,338.73 $89,338.73 $89,338.73 2026-03-31
1613 APR_DRG — 6 3 — — $111,268.19 $111,268.19 $111,268.19 2026-03-31
1614 APR_DRG — 6 3 — — $145,239.25 $145,239.25 $145,239.25 2026-03-31
1624 APR_DRG — 6 3 — — $57,922.19 $57,922.19 $57,922.19 2026-03-31
163 MS_DRG Major Chest Procedures With Mcc 36 10 — — $47,904.43 $87,478.01 $56,751.07 2026-03-31
1634 APR_DRG — 6 3 — — $49,288.24 $49,288.24 $49,288.24 2026-03-31
1654 APR_DRG — 6 3 — — $45,072.98 $45,072.98 $45,072.98 2026-03-31
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 36 10 — — $40,123.05 $73,074.84 $47,467.18 2026-03-31
1674 APR_DRG — 6 3 — — $44,335.20 $44,335.20 $44,335.20 2026-03-31
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 36 10 — — $62,533.08 $114,555.35 $74,204.36 2026-03-31
1784 APR_DRG — 6 3 — — $48,959.20 $48,959.20 $48,959.20 2026-03-31
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 36 10 — — $387,331.92 $715,751.23 $461,718.52 2026-03-31
1834 APR_DRG — 6 3 — — $41,779.18 $41,779.18 $41,779.18 2026-03-31
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 44 10 — — $81,926.54 $176,522.18 $105,207.04 2026-03-31
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 44 10 — — $113,634.43 $209,142.89 $141,790.48 2026-03-31
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 36 10 — — $83,298.45 $152,991.62 $98,979.31 2026-03-31
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 36 10 — — $66,955.41 $122,740.99 $79,480.60 2026-03-31
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 36 10 — — $57,318.15 $104,902.63 $67,982.49 2026-03-31
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 36 10 — — $112,344.55 $206,755.33 $133,633.90 2026-03-31
215 MS_DRG Other Heart Assist System Implant 36 10 — — $109,277.73 $201,078.71 $129,974.92 2026-03-31
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 36 10 — — $99,601.51 $183,168.23 $118,430.32 2026-03-31
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 36 10 — — $66,860.05 $122,564.48 $79,366.83 2026-03-31
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 36 10 — — $61,645.13 $112,911.76 $73,144.96 2026-03-31
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 36 10 — — $79,980.43 $146,850.01 $95,020.61 2026-03-31
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 36 10 — — $36,842.96 $67,003.46 $43,553.74 2026-03-31
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 36 10 — — $54,953.70 $100,526.07 $65,161.48 2026-03-31
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 36 10 — — $47,734.21 $87,162.96 $56,547.99 2026-03-31
228 MS_DRG Other Cardiothoracic Procedures With Mcc 36 10 — — $51,740.26 $94,578.05 $61,327.55 2026-03-31
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 36 10 — — $59,141.23 $108,277.09 $70,157.57 2026-03-31
231 MS_DRG Coronary Bypass With Ptca With Mcc 36 10 — — $87,531.09 $160,826.15 $104,029.23 2026-03-31
232 MS_DRG Coronary Bypass With Ptca Without Mcc 36 10 — — $63,279.54 $115,937.02 $75,094.95 2026-03-31
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 36 10 — — $80,789.43 $148,347.46 $95,985.82 2026-03-31
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 36 10 — — $55,194.66 $100,972.08 $65,448.96 2026-03-31
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 36 10 — — $60,977.62 $111,676.23 $72,348.56 2026-03-31
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 36 10 — — $42,807.41 $78,043.55 $50,669.87 2026-03-31
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 36 10 — — $52,289.85 $95,595.33 $61,983.26 2026-03-31
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 36 10 — — $39,624.73 $72,152.46 $46,872.65 2026-03-31
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 36 10 — — $35,423.88 $64,376.77 $41,860.65 2026-03-31
245 MS_DRG Aicd Generator Procedures 36 10 — — $50,750.80 $92,746.58 $60,147.04 2026-03-31
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 36 10 — — $46,500.72 $84,879.78 $55,076.32 2026-03-31
252 MS_DRG Other Vascular Procedures With Mcc 36 10 — — $35,817.61 $65,105.56 $42,330.41 2026-03-31
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 36 10 — — $35,569.47 $64,646.27 $42,034.36 2026-03-31
264 MS_DRG Other Circulatory System O.r. Procedures 36 10 — — $36,481.01 $66,333.50 $43,121.90 2026-03-31
265 MS_DRG Aicd Lead Procedures 36 10 — — $37,220.29 $67,701.89 $44,003.93 2026-03-31
266 MS_DRG Endovascular Cardiac Valve Replacement W Mcc 36 10 — — $62,070.65 $113,699.39 $73,652.64 2026-03-31
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 36 10 — — $48,883.64 $89,290.50 $57,919.35 2026-03-31
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 36 10 — — $69,010.21 $126,544.38 $81,932.17 2026-03-31
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 36 10 — — $43,305.74 $78,965.93 $51,264.42 2026-03-31
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 36 10 — — $53,275.20 $97,419.21 $63,158.88 2026-03-31
271 MS_DRG Other Major Cardiovascular Procedures With Cc 36 10 — — $35,961.16 $65,371.27 $42,501.68 2026-03-31
273 MS_DRG Percutaneous Intracardiac Procedures W Mcc 36 10 — — $40,738.26 $74,213.58 $48,201.18 2026-03-31
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 36 10 — — $73,105.46 $134,124.59 $86,818.15 2026-03-31
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 36 10 — — $64,158.26 $117,563.52 $76,143.35 2026-03-31
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 36 10 — — $48,342.25 $88,288.41 $57,273.43 2026-03-31
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 36 10 — — $51,945.32 $94,957.63 $61,572.22 2026-03-31
28 MS_DRG Spinal Procedures With Mcc 36 10 — — $62,980.13 $115,382.83 $74,737.74 2026-03-31
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 36 10 — — $220,392.77 $406,750.34 $262,545.12 2026-03-31
3023789006 NDC Sipuleucel-t Min 50 Mu Autol Cd54 Cells Per Infusion 22 5 $174,074.58 $40,037.15 77% off $3,929.00 $124,463.32 $90,518.78 2026-03-31
3033 APR_DRG — 6 3 — — $41,928.33 $41,928.33 $41,928.33 2026-03-31
3034 APR_DRG — 6 3 — — $55,375.27 $55,375.27 $55,375.27 2026-03-31
3044 APR_DRG — 6 3 — — $42,503.29 $42,503.29 $42,503.29 2026-03-31
31 MS_DRG Ventricular Shunt Procedures With Mcc 36 10 — — $43,612.32 $79,533.40 $51,630.19 2026-03-31
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 6 2 — — $79,773.63 $111,528.42 $108,552.76 2026-03-31
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 36 10 — — $45,685.57 $83,370.95 $54,103.77 2026-03-31
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 36 10 — — $44,317.76 $80,839.15 $52,471.85 2026-03-31
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 36 10 — — $52,721.52 $96,394.34 $62,498.29 2026-03-31
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 36 10 — — $47,727.04 $87,149.67 $56,539.42 2026-03-31
332 MS_DRG Rectal Resection With Mcc 36 10 — — $36,210.31 $65,832.46 $42,798.94 2026-03-31
33276 HCPCS Insj Phrnc Nrv Stim Sys 24 9 — — $27,607.65 $68,956.85 $48,152.52 2026-03-31
335 MS_DRG Peritoneal Adhesiolysis With Mcc 36 10 — — $37,796.54 $68,768.51 $44,691.44 2026-03-31
33975 HCPCS Implant Ventricular Device 6 3 — — $44,945.15 $44,945.15 $44,945.15 2026-03-31
33976 HCPCS Implant Ventricular Device 6 3 — — $44,945.15 $44,945.15 $44,945.15 2026-03-31
33979 HCPCS Insert Intracorporeal Device 6 3 — — $44,945.15 $44,945.15 $44,945.15 2026-03-31
33981 HCPCS Replace Vad Pump Ext 6 3 — — $44,945.15 $44,945.15 $44,945.15 2026-03-31
33982 HCPCS Replace Vad Intra Without Bp 6 3 — — $44,945.15 $44,945.15 $44,945.15 2026-03-31
33983 HCPCS Replace Vad Intra W/bp 6 3 — — $44,945.15 $44,945.15 $44,945.15 2026-03-31
34 MS_DRG Carotid Artery Stent Procedures With Mcc 36 10 — — $40,516.78 $73,803.64 $47,936.94 2026-03-31
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 36 10 — — $44,382.35 $80,958.72 $52,548.91 2026-03-31
3621004 CDM Hvad Heartware Pump 22 5 $149,300.00 $34,339.00 77% off $3,929.00 $106,749.50 $77,636.00 2026-03-31
3621387 CDM Heartmate Ii Lvad Sys 22 5 $175,000.00 $40,250.00 77% off $3,929.00 $125,125.00 $91,000.00 2026-03-31
3621431 CDM Hw Hvad - Sterile Implant Kit #5400 22 5 $168,400.00 $38,732.00 77% off $3,929.00 $120,406.00 $87,568.00 2026-03-31
3657004 CDM Ab Pump Set Abiomed 20 5 $90,000.00 $20,700.00 77% off $3,929.00 $64,350.00 $45,000.00 2026-03-31
38240 HCPCS Trnsplj Allogeneic Hematopoietic Cells Per Donor 44 10 $91,360.00 $21,012.80 77% off $902.83 $90,627.19 $56,806.67 2026-03-31
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 36 10 — — $145,525.87 $268,173.27 $173,222.21 2026-03-31
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 36 10 — — $39,321.23 $71,590.69 $46,510.54 2026-03-31
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 6 2 — — $50,447.82 $70,529.14 $68,647.37 2026-03-31
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 36 10 — — $56,307.16 $103,031.30 $66,776.28 2026-03-31
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 36 10 — — $36,544.59 $66,451.17 $43,197.75 2026-03-31
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 36 10 — — $36,570.21 $66,498.62 $43,228.33 2026-03-31
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 36 10 — — $36,833.73 $66,986.38 $43,542.73 2026-03-31
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 36 10 — — $42,349.08 $77,195.18 $50,123.04 2026-03-31
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 2 — — $135,080.28 $188,850.51 $183,811.84 2026-03-31
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 2 — — $91,589.32 $128,047.48 $124,631.08 2026-03-31
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 2 — — $70,975.37 $99,227.91 $96,580.44 2026-03-31
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 6 2 — — $107,552.04 $150,364.34 $146,352.51 2026-03-31
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 6 2 — — $70,542.10 $98,622.17 $95,990.86 2026-03-31
4404 APR_DRG — 6 3 — — $52,643.90 $52,643.90 $52,643.90 2026-03-31
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 6 2 — — $86,457.11 $120,872.33 $117,647.37 2026-03-31
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 6 2 — — $52,656.73 $73,617.34 $71,653.17 2026-03-31
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 6 2 — — $66,410.54 $92,846.00 $90,368.80 2026-03-31
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 6 2 — — $39,793.97 $55,634.41 $54,150.04 2026-03-31
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 36 10 — — $87,482.90 $160,736.95 $103,971.74 2026-03-31
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 36 10 — — $59,492.92 $108,928.07 $70,577.18 2026-03-31
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 36 10 — — $44,918.60 $81,951.32 $53,188.71 2026-03-31
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 36 10 — — $63,566.63 $116,468.43 $75,437.48 2026-03-31
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 36 10 — — $56,023.14 $102,505.58 $66,437.42 2026-03-31
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 36 10 — — $52,881.47 $96,690.41 $62,689.12 2026-03-31
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 36 10 — — $35,764.29 $65,006.87 $42,266.79 2026-03-31
471 MS_DRG Cervical Spinal Fusion With Mcc 36 10 — — $50,448.31 $92,186.70 $59,786.15 2026-03-31
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 36 10 — — $46,627.86 $85,115.12 $55,228.01 2026-03-31
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 36 10 — — $35,905.79 $65,268.78 $42,435.62 2026-03-31
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 36 10 — — $37,056.23 $67,398.22 $43,808.19 2026-03-31
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 36 10 — — $36,742.47 $66,817.47 $43,433.85 2026-03-31
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 44 10 — — $109,837.57 $235,360.41 $141,333.35 2026-03-31
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 36 10 — — $37,392.55 $68,020.74 $44,209.45 2026-03-31
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 36 10 — — $63,787.08 $116,876.48 $75,700.50 2026-03-31
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 36 10 — — $36,171.36 $65,760.34 $42,752.46 2026-03-31
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 36 10 — — $55,964.69 $102,397.40 $66,367.69 2026-03-31
5789411101 NDC Ciltacabtagene 100000000 Cells Susp 1 Each Flex Cont 22 5 $3,132,000.00 $720,360.00 77% off $3,929.00 $2,239,380.00 $1,628,640.00 2026-03-31
5789411102 NDC Ciltacabtagene 100000000 Cells Susp 1 Each Flex Cont 22 5 $3,132,000.00 $720,360.00 77% off $3,929.00 $2,239,380.00 $1,628,640.00 2026-03-31
5801059 CDM Periph Bld Stm Cell Procur Primary Internatl 20 5 $86,528.00 $19,901.44 77% off $3,929.00 $61,867.52 $43,264.00 2026-03-31
5801060 CDM Periph Bld Stm Cell Procur Secondary Internatl 20 5 $86,528.00 $19,901.44 77% off $3,929.00 $61,867.52 $43,264.00 2026-03-31
5831 APR_DRG — 6 3 — — $93,467.47 $93,467.47 $93,467.47 2026-03-31
5832 APR_DRG — 6 3 — — $108,157.32 $108,157.32 $108,157.32 2026-03-31
5833 APR_DRG — 6 3 — — $146,673.05 $146,673.05 $146,673.05 2026-03-31
5834 APR_DRG — 6 3 — — $185,188.79 $185,188.79 $185,188.79 2026-03-31
5881 APR_DRG — 6 3 — — $63,076.74 $63,076.74 $63,076.74 2026-03-31
5882 APR_DRG — 6 3 — — $95,826.91 $95,826.91 $95,826.91 2026-03-31
5883 APR_DRG — 6 3 — — $97,863.00 $97,863.00 $97,863.00 2026-03-31
5884 APR_DRG — 6 3 — — $151,905.03 $151,905.03 $151,905.03 2026-03-31
5913 APR_DRG — 6 3 — — $56,047.77 $56,047.77 $56,047.77 2026-03-31
5914 APR_DRG — 6 3 — — $95,669.41 $95,669.41 $95,669.41 2026-03-31
5932 APR_DRG — 6 3 — — $50,495.48 $50,495.48 $50,495.48 2026-03-31
5933 APR_DRG — 6 3 — — $63,709.02 $63,709.02 $63,709.02 2026-03-31
5934 APR_DRG — 6 3 — — $99,070.99 $99,070.99 $99,070.99 2026-03-31
5957251501 NDC Idecabtagene Vicleucel 460000000 Cells Susp 1 Each Flex Cont 22 5 $2,990,442.00 $687,801.66 77% off $3,929.00 $2,138,166.03 $1,555,029.84 2026-03-31
5957251502 NDC Idecabtagene Vicleucel 460000000 Cells Susp 1 Each Flex Cont 22 5 $2,990,442.00 $687,801.66 77% off $3,929.00 $2,138,166.03 $1,555,029.84 2026-03-31
5957251503 NDC Idecabtagene Vicleucel 460000000 Cells Susp 1 Each Flex Cont 22 5 $2,990,442.00 $687,801.66 77% off $3,929.00 $2,138,166.03 $1,555,029.84 2026-03-31
6 MS_DRG Liver Transplant Without Mcc 44 10 — — $50,365.26 $235,360.41 $64,356.09 2026-03-31
6022 APR_DRG — 6 3 — — $42,727.20 $42,727.20 $42,727.20 2026-03-31
6023 APR_DRG — 6 3 — — $55,996.53 $55,996.53 $55,996.53 2026-03-31
6024 APR_DRG — 6 3 — — $71,014.28 $71,014.28 $71,014.28 2026-03-31
6034 APR_DRG — 6 3 — — $79,636.46 $79,636.46 $79,636.46 2026-03-31
6073 APR_DRG — 6 3 — — $42,433.08 $42,433.08 $42,433.08 2026-03-31
6074 APR_DRG — 6 3 — — $54,545.27 $54,545.27 $54,545.27 2026-03-31
6093 APR_DRG — 6 3 — — $47,358.79 $47,358.79 $47,358.79 2026-03-31
6094 APR_DRG — 6 3 — — $95,059.15 $95,059.15 $95,059.15 2026-03-31
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 36 10 — — $40,273.78 $73,353.84 $47,647.02 2026-03-31
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 36 10 — — $39,012.59 $71,019.42 $46,142.32 2026-03-31
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 36 10 — — $41,101.24 $74,885.44 $48,634.24 2026-03-31
6303 APR_DRG — 6 3 — — $53,274.28 $53,274.28 $53,274.28 2026-03-31
6304 APR_DRG — 6 3 — — $110,258.30 $110,258.30 $110,258.30 2026-03-31
6314 APR_DRG — 6 3 — — $91,260.97 $91,260.97 $91,260.97 2026-03-31
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 44 10 — — $47,884.94 $88,260.02 $60,074.26 2026-03-31
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 44 10 — — $36,249.28 $88,260.02 $46,085.24 2026-03-31
653 MS_DRG Major Bladder Procedures With Mcc 36 10 — — $57,803.14 $105,800.33 $68,561.12 2026-03-31
665 MS_DRG Prostatectomy With Mcc 36 10 — — $35,850.42 $65,166.29 $42,369.56 2026-03-31
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 36 10 — — $43,602.06 $79,514.42 $51,617.96 2026-03-31
6797900201 NDC Histrelin Implant 50 Mg Sq Kit 22 5 $115,081.24 $26,468.69 77% off $3,929.00 $82,283.09 $59,842.24 2026-03-31
6948801061 NDC Lutetium Lu 177 Vipivotide Tet 1000 Mbq/ml Soln 1 Each Vial 22 5 $99,456.83 $22,875.07 77% off $3,929.00 $71,111.63 $51,717.55 2026-03-31
7 MS_DRG Lung Transplant 36 10 — — $134,644.87 $248,032.76 $160,240.18 2026-03-31
7128711901 NDC Axicabtagene Ciloleucel 200000000 Cells Susp 1 Each Package 22 5 $2,772,000.00 $637,560.00 77% off $3,929.00 $1,981,980.00 $1,441,440.00 2026-03-31
7128721901 NDC Brexucabtagene Autoleucel 200 Million Cells Susp 1 Each Flex Cont 22 5 $2,772,000.00 $637,560.00 77% off $3,929.00 $1,981,980.00 $1,441,440.00 2026-03-31
7315390001 NDC Lisocabtagene Maraleucel 70000000 Cells/ml Susp 1 Each Box 22 5 $2,924,862.00 $672,718.26 77% off $3,929.00 $2,091,276.33 $1,520,928.24 2026-03-31
7344180004 NDC Omidubicel-onlv IV Suspension Susp 1 Each Flex Cont 20 5 $929,500.00 $213,785.00 77% off $3,929.00 $664,592.50 $464,750.00 2026-03-31
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 36 10 — — $41,018.18 $74,731.71 $48,535.15 2026-03-31
739 MS_DRG Uterine,adnexa Proc For Non-ovarian/adnexal Malig W Mcc 36 10 — — $41,462.16 $75,553.50 $49,064.86 2026-03-31
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 32 9 — — $61,598.99 $107,172.85 $68,266.92 2026-03-31
7901001 CDM Liver Acquisition Cadaveric 20 5 $287,390.00 $66,099.70 77% off $3,929.00 $205,483.85 $143,695.00 2026-03-31
7901002 CDM Liver Acquisition Living Donor 20 5 $163,264.00 $37,550.72 77% off $3,929.00 $116,733.76 $81,632.00 2026-03-31
7901003 CDM Hc Liver Transplant Acquistion With Preservation Device (Organox 20 5 $368,471.00 $84,748.33 77% off $3,929.00 $263,456.77 $184,235.50 2026-03-31
7901004 CDM Hc Liver Transmedics 20 5 $527,959.00 $121,430.57 77% off $3,929.00 $377,490.69 $263,979.50 2026-03-31
791 MS_DRG Prematurity With Major Problems 32 9 — — $42,272.18 $73,191.88 $46,848.04 2026-03-31
793 MS_DRG Full Term Neonate With Major Problems 32 9 — — $43,406.22 $75,185.77 $48,104.83 2026-03-31
799 MS_DRG Splenic Procedures With Mcc 36 10 — — $49,397.34 $90,241.35 $58,532.24 2026-03-31
8 MS_DRG Simultaneous Pancreas/kidney Transplant 44 10 — — $56,434.31 $176,522.18 $72,211.48 2026-03-31
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 36 10 — — $37,400.75 $68,035.92 $44,219.24 2026-03-31
8110001 CDM Kidney Acquisition Cadaver 20 5 $216,000.00 $49,680.00 77% off $3,929.00 $154,440.00 $108,000.00 2026-03-31
8110002 CDM Kidney Acquisition Donor 20 5 $165,027.00 $37,956.21 77% off $3,929.00 $117,994.31 $82,513.50 2026-03-31
8110003 CDM Pancreas Acquisition Cadaver 20 5 $155,994.00 $35,878.62 77% off $3,929.00 $111,535.71 $77,997.00 2026-03-31
8120001 CDM Heart / Lung Acquisition Cadaver 20 5 $466,226.00 $107,231.98 77% off $3,929.00 $333,351.59 $233,113.00 2026-03-31
8120002 CDM Lung Acquisition Cadaver 20 5 $268,702.00 $61,801.46 77% off $3,929.00 $192,121.93 $134,351.00 2026-03-31
8120003 CDM Lung Double Acquisition Cadaver 20 5 $403,053.00 $92,702.19 77% off $3,929.00 $288,182.90 $201,526.50 2026-03-31
8120005 CDM Hc Heart Transplant Acquistion With Preservation Device (Sherpap 20 5 $469,317.00 $107,942.91 77% off $3,929.00 $335,561.66 $234,658.50 2026-03-31
8120006 CDM Hc Heart Transplant Acquistion With Preservation Device (Transme 20 5 $641,701.00 $147,591.23 77% off $3,929.00 $458,816.22 $320,850.50 2026-03-31
8120012 CDM Hc Lung Transmedics-single 20 5 $499,339.00 $114,847.97 77% off $3,929.00 $357,027.39 $249,669.50 2026-03-31
8120013 CDM Hc Lung Transmedics-double 20 5 $622,371.00 $143,145.33 77% off $3,929.00 $444,995.27 $311,185.50 2026-03-31
8120014 CDM Hc Lungguard-single 20 5 $286,287.00 $65,846.01 77% off $3,929.00 $204,695.21 $143,143.50 2026-03-31
8120015 CDM Hc Lungguard-double 20 5 $415,470.00 $95,558.10 77% off $3,929.00 $297,061.05 $207,735.00 2026-03-31
8140001 CDM Heart Acquisition 20 5 $383,559.00 $88,218.57 77% off $3,929.00 $274,244.69 $191,779.50 2026-03-31
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 36 10 — — $60,342.93 $110,501.43 $71,591.32 2026-03-31
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 36 10 — — $48,625.25 $88,812.23 $57,611.07 2026-03-31
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 36 10 — — $49,609.58 $90,634.21 $58,785.46 2026-03-31
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 36 10 — — $57,318.15 $104,902.63 $67,982.49 2026-03-31
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 36 10 — — $51,985.32 $95,031.65 $61,619.93 2026-03-31
8414 APR_DRG — 6 3 — — $102,423.24 $102,423.24 $102,423.24 2026-03-31
8424 APR_DRG — 6 3 — — $51,761.91 $51,761.91 $51,761.91 2026-03-31
850 MS_DRG Acute Leukemia With Other Procedures 6 2 — — $118,787.45 $166,072.13 $161,641.21 2026-03-31
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 36 10 — — $51,924.82 $94,919.67 $61,547.75 2026-03-31
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 36 10 — — $46,903.68 $85,625.66 $55,557.08 2026-03-31
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 36 10 — — $71,972.45 $132,027.41 $85,466.37 2026-03-31
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 36 10 — — $40,936.15 $74,579.88 $48,437.29 2026-03-31
901 MS_DRG Wound Debridements For Injuries With Mcc 36 10 — — $46,072.13 $84,086.46 $54,564.96 2026-03-31
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 36 10 — — $40,233.79 $73,279.82 $47,599.30 2026-03-31
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 36 10 — — $41,490.87 $75,606.64 $49,099.11 2026-03-31
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 36 10 — — $243,885.57 $439,056.00 $290,574.15 2026-03-31
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 36 10 — — $69,126.08 $927,476.00 $81,615.20 2026-03-31
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 36 10 — — $45,009.86 $78,005.35 $53,297.59 2026-03-31
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 36 10 — — $38,055.94 $69,248.68 $45,000.94 2026-03-31
955 MS_DRG Craniotomy For Multiple Significant Trauma 36 10 — — $70,657.95 $129,594.31 $83,898.06 2026-03-31
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 36 10 — — $39,836.98 $72,545.33 $47,125.88 2026-03-31
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 36 10 — — $77,178.15 $141,663.05 $91,677.24 2026-03-31
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 36 10 — — $42,783.83 $77,999.89 $50,641.73 2026-03-31
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 36 10 — — $65,490.19 $120,028.89 $77,732.46 2026-03-31
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 36 10 — — $37,398.70 $68,032.12 $44,216.79 2026-03-31
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 36 10 — — $49,388.10 $90,224.27 $58,521.22 2026-03-31
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 36 10 — — $36,558.93 $66,477.74 $43,214.88 2026-03-31
999HK MS_DRG Solid Organ Transplant ? Heart/Kidney 8 1 — — $219,552.30 $271,184.01 $260,881.05 2026-03-31
999HL MS_DRG Solid Organ Transplant ? Heart/Lung 8 1 — — $168,717.60 $245,169.10 $239,290.54 2026-03-31
999LK MS_DRG Solid Organ Transplant ? Liver/Kidney 8 1 — — $222,048.90 $322,668.13 $310,411.17 2026-03-31
999LL MS_DRG Solid Organ Transplant ? Liver/Lung 8 1 — — $224,796.60 $327,842.65 $320,215.64 2026-03-31
A9543 HCPCS Y90 Ibritumomab, Rx 28 10 — — $51,473.36 $93,760.51 $61,604.45 2026-03-31
A9699 HCPCS Radiopharm Rx Agent Noc 4 1 — — $74,614.73 $74,614.73 $74,614.73 2026-03-31
C9031 HCPCS Lutetium Lu 177 Dotatate, Tx 6 3 — — $51,473.36 $51,473.36 $51,473.36 2026-03-31
C9073 HCPCS Brexucabtagene Autoleucel Ca 6 3 — — $54,633.56 $54,633.56 $54,633.56 2026-03-31
C9076 HCPCS Lisocabtagene Car Pos T 6 3 — — $54,633.56 $54,633.56 $54,633.56 2026-03-31
C9081 HCPCS Idecabtagene Car Pos T 6 3 — — $54,633.56 $54,633.56 $54,633.56 2026-03-31
C9098 HCPCS Ciltacabtagene Car Pos T 6 3 — — $54,633.56 $54,633.56 $54,633.56 2026-03-31
C9301 HCPCS Obecabtagene Car Pos T 4 1 — — $459,112.50 $459,112.50 $459,112.50 2026-03-31
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 22 8 — — $34,189.02 $4,379,419.08 $3,929,952.38 2026-03-31
J1413 HCPCS Inj Delandistrogene Mox Rokl 22 8 — — $34,189.02 $3,950,784.27 $3,545,309.05 2026-03-31
J1414 HCPCS Inj, Beqvez, Per Tx Dose 16 8 — — $3,596,661.73 $4,408,811.15 $4,022,073.33 2026-03-31
J3391 HCPCS Inj, Atidarsagene Autotemcel 12 6 — — $4,243,770.00 $4,791,353.23 $4,684,118.18 2026-03-31
J3392 HCPCS Inj, Exagamglogene Autotem 22 10 — — $2,260,758.80 $3,847,800.00 $2,552,469.61 2026-03-31
J3393 HCPCS Inj, Betibeglogene Autotemce 22 10 — — $2,860,544.96 $4,864,551.99 $3,229,647.54 2026-03-31
J3394 HCPCS Inj, Lovotibeglogene Autotem 18 9 — — $3,161,722.56 $4,997,561.47 $3,569,686.76 2026-03-31
J3399 HCPCS Inj Onase Abepar-xioi Treat 22 10 — — $2,377,204.94 $3,998,166.53 $2,683,941.06 2026-03-31
J7330 HCPCS Cultured Chondrocytes Implnt 4 1 — — $130,327.56 $130,327.56 $130,327.56 2026-03-31
J9029 HCPCS Instill Adstiladrin, Tx Dose 28 10 — — $34,189.02 $104,338.76 $68,766.67 2026-03-31
J9226 HCPCS Supprelin La Implant 28 10 — — $34,189.02 $74,599.87 $49,392.78 2026-03-31
Q2040 HCPCS Tisagenlecleucel Car-pos T 6 3 — — $54,633.56 $54,633.56 $54,633.56 2026-03-31
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 28 10 — — $54,633.56 $829,687.20 $577,917.17 2026-03-31
Q2042 HCPCS Tisagenlecleucel Car-pos T 28 10 — — $54,633.56 $954,972.35 $626,971.39 2026-03-31
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 28 10 — — $34,189.02 $94,078.22 $60,651.96 2026-03-31
Q2053 HCPCS Brexucabtagene Car Pos T 28 10 — — $54,633.56 $807,508.61 $530,913.68 2026-03-31
Q2054 HCPCS Lisocabtagene Mara Car Pos T 28 10 — — $54,633.56 $852,129.78 $587,196.32 2026-03-31
Q2055 HCPCS Idecabtagene Vicleucel Car 28 10 — — $54,633.56 $870,577.06 $586,789.54 2026-03-31
Q2056 HCPCS Ciltacabtagene Car-pos T 28 10 — — $54,633.56 $912,729.35 $599,927.28 2026-03-31
Q2057 HCPCS Afamitresgene Autoleucel 22 10 — — $747,078.02 $1,271,523.00 $843,475.19 2026-03-31
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 18 9 — — $262,115.21 $414,311.13 $295,936.52 2026-03-31
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