Price Transparency Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

PARKVIEW DEKALB HOSPITAL

Auburn, IN · CCN 150045 · Rates published

14,476 distinct procedures filed
26 distinct payers
187,260 rate rows
2026-04-01 last MRF observed
Data quality

120,954 of 187,260 rate rows are consumer-grade (64.6%)

66,306 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 65,919
placeholder amount (≤ $0.02) — excluded from medians 319
template filing: same amount across many unrelated codes — excluded 68
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://parkview.com/-/media/parkview-media/file/price-transparency/334188855_parkview-logansport-hospital_standardcharges.ashx
Found on page https://www.parkview.com/patients-and-visitors/billing-and-insurance/request-an-estimate
Discovered viaCMS hospital list
Last fetch success · 2026-06-22
Content fingerprint 6cc24d9ab7b6e854… · 17,395,311 bytes · first seen 2026-06-22

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 2 $4,505,000.00 $4,730,250.00 $4,617,625.00 nat. median
$4,505,000
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 5 $3,248,445.72 $4,984,800.00 $4,385,401.72 nat. median
$3,286,000
1.3× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 6 $2,945,740.00 $4,897,200.00 $4,197,679.50 nat. median
$3,006,423
1.4× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 4 $3,316,462.59 $4,974,693.88 $3,979,755.11 nat. median
$3,325,455
1.2× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 3 $3,685,266.67 $4,975,110.00 $3,869,530.00 nat. median
$3,710,000
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 6 $2,455,110.60 $3,965,706.94 $3,498,532.62 nat. median
$2,469,189
1.4× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 6 $2,332,000.00 $3,847,800.00 $3,323,100.00 nat. median
$2,448,600
1.4× median
Q2057
HCPCS 		Afamitresgene Autoleucel 6 $770,620.00 $1,541,240.00 $1,098,133.50 nat. median
$824,563
1.3× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 7 $591,726.20 $1,156,649.16 $887,589.30 nat. median
$754,974
1.2× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 7 $565,868.94 $1,106,757.66 $848,803.42 nat. median
$675,122
1.3× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 7 $562,538.19 $1,083,271.32 $843,807.28 nat. median
$674,188
1.3× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 7 $557,317.93 $1,082,520.90 $835,976.90 nat. median
$625,184
1.3× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 7 $533,230.17 $1,066,152.96 $799,845.26 nat. median
$634,511
1.3× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 7 $489,304.61 $979,440.00 $733,956.91 nat. median
$620,080
1.2× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 5 $278,250.00 $422,100.00 $375,637.50 nat. median
$324,450
1.2× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 11 $336,677.62 $1,152,030.74 $336,677.62 nat. median
$370,174
0.9× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 11 $219,078.96 $747,621.60 $219,078.96 nat. median
$265,286
0.8× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 11 $167,308.52 $569,588.64 $167,308.52 nat. median
$206,368
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 11 $166,336.48 $566,245.89 $166,336.48 nat. median
$202,986
0.8× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 4 $110,901.76 $166,352.64 $141,345.39 nat. median
$111,989
1.3× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 1 $121,181.71 $121,181.71 $121,181.71 nat. median
$96,983
1.2× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 11 $109,132.53 $369,527.65 $109,132.53 nat. median
$133,176
0.8× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 3 $102,820.55 $120,116.70 $105,841.78 nat. median
$76,377
1.4× median
7
MS_DRG 		Lung Transplant 11 $102,141.26 $345,485.44 $102,141.26 nat. median
$122,708
0.8× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 7 $63,342.28 $126,862.11 $97,049.53 nat. median
$69,774
1.4× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 11 $94,908.73 $320,613.54 $94,908.73 nat. median
$117,303
0.8× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 11 $89,586.15 $302,309.76 $89,586.15 nat. median
$108,660
0.8× median
209
MS_DRG 		Complex Aortic Arch Procedures 11 $89,485.30 $301,962.95 $89,485.30 nat. median
$98,017
0.9× median
L8702
HCPCS 		Pow Ue Rom Dev Ewhf Uprt Cus 4 $68,801.71 $103,202.56 $87,688.46 nat. median
$70,825
1.2× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 11 $87,176.60 $294,023.57 $87,176.60 nat. median
$98,905
0.9× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 11 $86,035.43 $290,099.24 $86,035.43 nat. median
$102,358
0.8× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 6 $56,824.55 $107,421.88 $85,236.82 nat. median
$62,507
1.4× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 7 $55,272.32 $111,891.94 $85,150.85 nat. median
$66,682
1.3× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 11 $81,663.18 $275,063.52 $81,663.18 nat. median
$100,136
0.8× median
215
MS_DRG 		Other Heart Assist System Implant 11 $78,920.82 $265,632.85 $78,920.82 nat. median
$99,019
0.8× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 11 $77,569.42 $260,985.54 $77,569.42 nat. median
$93,672
0.8× median
90288
HCPCS 		Botulism Ig IV 1 $76,782.00 $76,782.00 $76,782.00 nat. median
$55,037
1.4× median
A9699
HCPCS 		Radiopharm Rx Agent Noc 1 $74,614.73 $74,614.73 $74,614.73 nat. median
$21,806
outlier · 3.4×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 11 $71,571.15 $240,358.11 $71,571.15 nat. median
$82,712
0.9× median
38240
HCPCS 		Transplt Allo Hct/donor 4 $40,050.00 $99,825.02 $69,877.52 nat. median
$15,912
outlier · 4.4×
J9226
HCPCS 		Supprelin La Implant 7 $45,020.65 $91,120.78 $69,350.43 nat. median
$60,368
1.1× median
850
MS_DRG 		Acute Leukemia With Other Procedures 11 $68,855.17 $231,018.14 $68,855.17 nat. median
$83,442
0.8× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 11 $67,073.99 $224,892.87 $67,073.99 nat. median
$79,312
0.8× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 11 $66,868.41 $224,185.91 $66,868.41 nat. median
$81,118
0.8× median
L7181
HCPCS 		Electronic Elbo Simultaneous 4 $49,338.18 $74,007.27 $62,881.99 nat. median
$50,598
1.2× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 11 $62,721.13 $209,923.85 $62,721.13 nat. median
$77,576
0.8× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 11 $61,243.28 $204,841.69 $61,243.28 nat. median
$74,915
0.8× median
L7180
HCPCS 		Electronic Elbow Sequential 4 $47,919.99 $71,879.98 $61,074.49 nat. median
$49,027
1.2× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 11 $60,986.50 $203,958.65 $60,986.50 nat. median
$73,807
0.8× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 11 $60,790.23 $203,283.69 $60,790.23 nat. median
$72,138
0.8× median

Other procedures at this hospital

Browse this hospital's 14,476 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
0646T HCPCS Ttvi/rplcmt W/prstc Vlv Perq 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
33875 HCPCS Thoracic Aortic Graft 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
33877 HCPCS Thoracoabdominal Graft 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
33864 HCPCS Ascending Aortic Graft 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
33427 HCPCS Repair Of Mitral Valve 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
33871 HCPCS Transvrs A-arch Grf Hypthrm 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
37225 HCPCS Fem/popl Revas W/ather 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
33858 HCPCS As-aort Grf F/aortic Dsj 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
33859 HCPCS As-aort Grf F/ds Oth/thn Dsj 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
0570T HCPCS Ttvr Perq Ea Addl Prosth 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
33430 HCPCS Replacement Of Mitral Valve 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
33863 HCPCS Ascending Aortic Graft 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
33880 HCPCS Endovasc Taa Repr Incl Subcl 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
37226 HCPCS Fem/popl Revasc W/stent 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
33851 HCPCS Remove Aorta Constriction 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
33883 HCPCS Insert Endovasc Prosth Taa 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
33425 HCPCS Repair Of Mitral Valve 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
33852 HCPCS Repair Septal Defect 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
33853 HCPCS Repair Septal Defect 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
37221 HCPCS Iliac Revasc W/stent 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
33426 HCPCS Repair Of Mitral Valve 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
33440 HCPCS Rplcmt A-valve Tlcj Autol Pv 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
33420 HCPCS Revision Of Mitral Valve 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
33845 HCPCS Remove Aorta Constriction 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
33881 HCPCS Endovasc Taa Repr Without Subcl 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
33415 HCPCS Revision Subvalvular Tissue 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
33416 HCPCS Revise Ventricle Muscle 1 1 — — $29,226.00 $29,226.00 $29,226.00 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 18 11 — — $29,265.92 $94,874.97 $29,265.92 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 18 11 — — $29,288.41 $94,952.34 $29,288.41 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 18 11 — — $29,314.79 $95,043.04 $29,314.79 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 18 11 — — $29,338.06 $95,123.08 $29,338.06 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 19 11 — — $29,379.18 $95,264.47 $29,379.18 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 18 11 — — $29,407.11 $95,360.51 $29,407.11 2026-04-01
Q0483 HCPCS Monitor Elec Vad, Rep 5 4 — — $23,087.32 $34,630.98 $29,425.02 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 20 11 — — $28,731.41 $93,036.86 $29,449.69 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 18 11 — — $29,471.50 $95,581.94 $29,471.50 2026-04-01
54410 HCPCS Remove/replace Penis Prosth 5 4 — — $21,928.45 $40,050.00 $29,603.40 2026-04-01
54411 HCPCS Remov/replc Penis Pros Comp 5 4 — — $21,928.45 $40,050.00 $29,603.40 2026-04-01
54416 HCPCS Remv/repl Penis Contain Pros 5 4 — — $21,928.45 $40,050.00 $29,603.40 2026-04-01
54401 HCPCS Insert Self-contd Prosthesis 5 4 — — $21,928.45 $40,050.00 $29,603.40 2026-04-01
54405 HCPCS Insert Multi-comp Penis Pros 5 4 — — $21,928.45 $40,050.00 $29,603.40 2026-04-01
54417 HCPCS Remv/replc Penis Pros Compl 5 4 — — $21,928.45 $40,050.00 $29,603.40 2026-04-01
53445 HCPCS Insert Uro/ves Nck Sphincter 5 4 — — $21,928.45 $40,050.00 $29,603.40 2026-04-01
53444 HCPCS Insert Tandem Cuff 5 4 — — $21,928.45 $40,050.00 $29,603.40 2026-04-01
53447 HCPCS Remove/replace Ur Sphincter 5 4 — — $21,928.45 $40,050.00 $29,603.40 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 18 11 — — $29,654.58 $96,211.54 $29,654.58 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 18 11 — — $29,696.47 $96,355.60 $29,696.47 2026-04-01
265 MS_DRG Aicd Lead Procedures 18 11 — — $29,746.12 $96,526.34 $29,746.12 2026-04-01
332 MS_DRG Rectal Resection With Mcc 18 11 — — $29,765.51 $96,593.03 $29,765.51 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 18 11 — — $29,804.30 $96,726.42 $29,804.30 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 18 11 — — $29,826.02 $96,801.12 $29,826.02 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 5 4 — — $28,478.97 $42,718.45 $29,902.92 2026-04-01
0960T HCPCS Rpl S-sclp Eltr Ra Rcvr&tlmt 5 4 — — $28,708.07 $43,062.10 $30,143.47 2026-04-01
22633 HCPCS Lumbar Spine Fusion Combined 5 4 — — $28,708.07 $43,062.10 $30,143.47 2026-04-01
22630 HCPCS Lumbar Spine Fusion 5 4 — — $28,708.07 $43,062.10 $30,143.47 2026-04-01
27702 HCPCS Reconstruct Ankle Joint 5 4 — — $10,284.00 $43,062.10 $30,143.47 2026-04-01
0956T HCPCS Prt Crn Ch Cr&tun Elt S-sclp 5 4 — — $28,708.07 $43,062.10 $30,143.47 2026-04-01
22558 HCPCS Lumbar Spine Fusion 5 4 — — $10,284.00 $43,062.10 $30,143.47 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 18 11 — — $30,160.38 $97,950.94 $30,160.38 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 18 11 — — $30,172.02 $97,990.96 $30,172.02 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 18 11 — — $30,425.70 $98,863.33 $30,425.70 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 18 11 — — $30,588.61 $99,423.57 $30,588.61 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 18 11 — — $30,670.07 $99,703.69 $30,670.07 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 18 11 — — $30,673.17 $99,714.36 $30,673.17 2026-04-01
L8614 HCPCS Cochlear Device 1 1 — — $30,728.19 $30,728.19 $30,728.19 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 18 11 — — $30,742.21 $99,951.79 $30,742.21 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 18 11 — — $30,869.44 $100,389.31 $30,869.44 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 18 11 — — $31,461.35 $102,424.85 $31,461.35 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 18 11 — — $31,631.25 $103,009.09 $31,631.25 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 18 11 — — $31,659.95 $103,107.80 $31,659.95 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 18 11 — — $31,704.95 $103,262.53 $31,704.95 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 5 4 — — $23,533.93 $40,050.00 $31,770.80 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 5 4 — — $23,533.93 $40,050.00 $31,770.80 2026-04-01
0515T HCPCS Insj Wcs Lv Compl Sys 5 4 — — $23,533.93 $40,050.00 $31,770.80 2026-04-01
0916T HCPCS Insj Perm Ccm-d Sys Pg Only 5 4 — — $23,533.93 $40,050.00 $31,770.80 2026-04-01
0409T HCPCS Insj/rplc Car Modulj Pls Gn 5 4 — — $23,533.93 $40,050.00 $31,770.80 2026-04-01
0923T HCPCS Rmvl&rplcmt Perm Ccm-d Pg 5 4 — — $23,533.93 $40,050.00 $31,770.80 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 5 4 — — $23,533.93 $40,050.00 $31,770.80 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 5 4 — — $23,533.93 $40,050.00 $31,770.80 2026-04-01
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 5 4 — — $23,533.93 $40,050.00 $31,770.80 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 18 11 — — $31,887.25 $103,889.47 $31,887.25 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 18 11 — — $32,024.57 $104,361.67 $32,024.57 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 18 11 — — $32,584.67 $106,287.82 $32,584.67 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 18 11 — — $32,867.05 $107,258.90 $32,867.05 2026-04-01
791 MS_DRG Prematurity With Major Problems 18 11 — — $33,165.73 $108,286.00 $33,165.73 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 18 11 — — $33,681.62 $110,060.09 $33,681.62 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 18 11 — — $33,894.95 $110,793.73 $33,894.95 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 18 11 — — $34,023.73 $111,236.59 $34,023.73 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 18 11 — — $34,047.01 $111,316.62 $34,047.01 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 18 11 — — $34,172.68 $111,748.81 $34,172.68 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 18 11 — — $34,233.19 $111,956.89 $34,233.19 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 18 11 — — $34,271.98 $112,090.28 $34,271.98 2026-04-01
0909T HCPCS Rplcmt Int Nstim Sys Vgs Nrv 5 4 — — $29,226.00 $48,971.64 $34,280.15 2026-04-01
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 5 4 — — $10,284.00 $48,971.64 $34,280.15 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 18 11 — — $34,367.40 $112,418.42 $34,367.40 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 18 11 — — $34,383.69 $112,474.45 $34,383.69 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 18 11 — — $34,439.55 $112,666.53 $34,439.55 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 18 11 — — $34,576.08 $113,136.06 $34,576.08 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 18 11 — — $34,766.15 $113,789.67 $34,766.15 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 18 11 — — $34,980.26 $114,525.99 $34,980.26 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 18 11 — — $35,247.90 $115,446.38 $35,247.90 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 18 11 — — $35,755.26 $117,191.12 $35,755.26 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 18 11 — — $36,299.07 $119,061.25 $36,299.07 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 7 6 — — $24,228.42 $39,976.89 $36,342.63 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 18 11 — — $36,435.61 $119,530.78 $36,435.61 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 18 11 — — $36,445.70 $119,565.46 $36,445.70 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 18 11 — — $36,811.08 $120,821.99 $36,811.08 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 18 11 — — $36,949.17 $121,296.86 $36,949.17 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 19 11 — — $34,997.12 $121,350.22 $36,964.69 2026-04-01
245 MS_DRG Aicd Generator Procedures 18 11 — — $37,070.97 $121,715.71 $37,070.97 2026-04-01
0686T HCPCS Histotripsy Mal Hepatcel Tis 6 5 — — $12,990.00 $54,368.73 $37,151.96 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 18 11 — — $37,244.74 $122,313.29 $37,244.74 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 5 4 — — $27,654.12 $41,481.18 $37,333.06 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 5 4 — — $27,654.12 $41,481.18 $37,333.06 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 5 4 — — $27,654.12 $41,481.18 $37,333.06 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 18 11 — — $37,335.51 $122,625.43 $37,335.51 2026-04-01
L6880 HCPCS Elec Hand Ind Art Digits 5 4 — — $29,420.21 $44,130.32 $37,496.34 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 18 11 — — $37,506.18 $123,212.34 $37,506.18 2026-04-01
L6700 HCPCS Ue Add Ext Power Myoel 5 4 — — $29,510.19 $44,265.28 $37,611.03 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 18 11 — — $37,649.70 $123,705.89 $37,649.70 2026-04-01
L5856 HCPCS Elec Knee-shin Swing/stance 5 4 — — $29,559.78 $44,339.67 $37,674.23 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 18 11 — — $37,966.21 $124,794.35 $37,966.21 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 18 11 — — $38,074.82 $125,167.84 $38,074.82 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 18 11 — — $38,149.29 $125,423.95 $38,149.29 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 18 11 — — $38,610.10 $127,008.62 $38,610.10 2026-04-01
21243 HCPCS Reconstruction Of Jaw Joint 5 4 — — $28,708.07 $43,062.10 $38,755.89 2026-04-01
20696 HCPCS Comp Multiplane Ext Fixation 5 4 — — $28,708.07 $43,062.10 $38,755.89 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 18 11 — — $38,947.56 $128,169.12 $38,947.56 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 18 11 — — $39,136.85 $128,820.06 $39,136.85 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 4 4 — — $32,647.76 $48,971.64 $39,177.31 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 18 11 — — $39,699.29 $130,754.21 $39,699.29 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 18 11 — — $39,858.32 $131,301.11 $39,858.32 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 21 11 — — $8,221.14 $131,751.97 $39,989.43 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 5 4 — — $30,347.28 $45,520.92 $40,050.00 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 5 4 — — $33,209.74 $49,814.60 $40,050.00 2026-04-01
33422 HCPCS Revision Of Mitral Valve 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 5 4 — — $32,647.76 $48,971.64 $40,050.00 2026-04-01
22860 HCPCS Tot Disc Arthrp 2ntrspc Lmbr 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
0871T HCPCS Rplcmt Subq Prtl Ascites Pmp 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 5 4 — — $33,209.74 $49,814.60 $40,050.00 2026-04-01
0814T HCPCS Prq Njx Biod Osteo Matrl Fem 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
32854 HCPCS Lung Transplant With Bypass 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
37227 HCPCS Fem/popl Revasc Stnt & Ather 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 5 4 — — $33,209.74 $49,814.60 $40,050.00 2026-04-01
0908T HCPCS Opn Imp Int Nstm Sys Vgs Nrv 5 4 — — $32,647.76 $48,971.64 $40,050.00 2026-04-01
33269 HCPCS Excl Laa Thrscp Any Method 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
37231 HCPCS Tib/per Revasc Stent & Ather 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
37229 HCPCS Tib/per Revasc W/ather 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
32851 HCPCS Lung Transplant Single 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
0100T HCPCS Prosth Retina Receive&Gen 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
0872T HCPCS Rplcmt Ndwllg Bldr&prtl Cath 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
0584T HCPCS Perq Islet Cell Transplant 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
0873T HCPCS Revj Subq Prtl Asct Pmp Sys 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
47135 HCPCS Transplantation Of Liver 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
0585T HCPCS Laps Islet Cell Transplant 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
32852 HCPCS Lung Transplant With Bypass 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
33736 HCPCS Revision Of Heart Chamber 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
33929 HCPCS Rmvl Rplcmt Hrt Sys F/trnspl 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 5 4 — — $33,209.74 $49,814.60 $40,050.00 2026-04-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 5 4 — — $33,209.74 $49,814.60 $40,050.00 2026-04-01
48554 HCPCS Transpl Allograft Pancreas 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
33268 HCPCS Excl Laa Opn Oth Px Any Meth 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
69930 HCPCS Implant Cochlear Device 5 4 — — $34,884.84 $52,327.26 $40,050.00 2026-04-01
C7539 HCPCS Insrt A & V Pm W/l Vent Lead 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 5 4 — — $32,647.76 $48,971.64 $40,050.00 2026-04-01
0968T HCPCS Insj/rplcmt Epcrnl Nstim Sys 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
0266T HCPCS Implt/rpl Crtd Sns Dev Total 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
0870T HCPCS Imp Subq Prtl Ascts Pmp Sys 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
61886 HCPCS Implant Neurostim Arrays 5 4 — — $32,647.76 $48,971.64 $40,050.00 2026-04-01
33935 HCPCS Transplantation Heart/lung 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
33945 HCPCS Transplantation Of Heart 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
0586T HCPCS Open Islet Cell Transplant 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
32853 HCPCS Lung Transplant Double 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 5 4 — — $33,209.74 $49,814.60 $40,050.00 2026-04-01
33391 HCPCS Valvuloplasty Aortic Valve 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 5 4 — — $33,209.74 $49,814.60 $40,050.00 2026-04-01
61889 HCPCS Ins Sk-mnt Crnl Nstm Pg/rcvr 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
50365 HCPCS Transplantation Of Kidney 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
50380 HCPCS Reimplantation Of Kidney 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 5 4 — — $32,647.76 $48,971.64 $40,050.00 2026-04-01
54438 HCPCS Replantation Of Penis 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
33927 HCPCS Impltj Tot Rplcmt Hrt Sys 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
33737 HCPCS Revision Of Heart Chamber 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
0268T HCPCS Implt/rpl Crtd Sns Dev Gen 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 5 4 — — $32,647.76 $48,971.64 $40,050.00 2026-04-01
0942T HCPCS Cysto Flx Rmv&rplc Urtl Scaf 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
37230 HCPCS Tib/per Revasc W/stent 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
G0343 HCPCS Laparotomy Islet Cell Transp 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
G0342 HCPCS Laparoscopy Islet Cell Trans 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
C9606 HCPCS Perc D-e Cor Revasc W Ami S 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
C7534 HCPCS Fem/pop Revasc W/arthr & US 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
C7535 HCPCS Fem/pop Revasc W/stent & US 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
93583 HCPCS Perq Transcath Septal Reduxn 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
33267 HCPCS Excl Laa Open Any Method 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
50360 HCPCS Transplantation Of Kidney 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 5 4 — — $32,647.76 $48,971.64 $40,050.00 2026-04-01
33928 HCPCS Rmvl & Rplcmt Tot Hrt Sys 1 1 — — $40,050.00 $40,050.00 $40,050.00 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 18 11 — — $40,057.69 $131,986.74 $40,057.69 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 18 11 — — $40,368.00 $133,053.86 $40,368.00 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 18 11 — — $40,777.61 $134,462.46 $40,777.61 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 18 11 — — $41,989.37 $138,629.56 $41,989.37 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 18 11 — — $42,059.19 $138,869.66 $42,059.19 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 18 11 — — $42,609.21 $140,761.13 $42,609.21 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 18 11 — — $42,744.97 $141,228.00 $42,744.97 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 18 11 — — $43,022.70 $142,183.07 $43,022.70 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 18 11 — — $43,047.52 $142,268.44 $43,047.52 2026-04-01
J9266 HCPCS Pegaspargase Injection 10 7 — — $28,424.06 $56,848.12 $43,518.65 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 18 11 — — $43,819.42 $144,922.90 $43,819.42 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 18 11 — — $43,988.54 $145,504.48 $43,988.54 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 18 11 — — $44,055.25 $145,733.91 $44,055.25 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 18 11 — — $44,115.76 $145,942.00 $44,115.76 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 18 11 — — $44,266.26 $146,459.55 $44,266.26 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 18 11 — — $44,523.04 $147,342.59 $44,523.04 2026-04-01
L8701 HCPCS Pow Ue Rom Dev Ewh Uprt Cust 5 4 — — $34,970.13 $52,455.19 $44,569.77 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 18 11 — — $44,858.18 $148,495.08 $44,858.18 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 18 11 — — $45,156.08 $149,519.52 $45,156.08 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 11 — — $45,291.06 $149,983.72 $45,291.06 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 18 11 — — $45,892.28 $152,051.26 $45,892.28 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 18 11 — — $45,949.69 $152,248.68 $45,949.69 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 18 11 — — $46,131.22 $152,872.94 $46,131.22 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 18 11 — — $46,416.71 $153,854.69 $46,416.71 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 18 11 — — $47,174.64 $156,461.13 $47,174.64 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 18 11 — — $47,204.12 $156,562.51 $47,204.12 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 18 11 — — $47,678.11 $158,192.54 $47,678.11 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 18 11 — — $47,785.17 $158,560.69 $47,785.17 2026-04-01
5465 OTHER Level 5 Neurostimulator And Related Procedures 1 1 — — $47,885.28 $47,885.28 $47,885.28 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 18 11 — — $47,937.22 $159,083.58 $47,937.22 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 18 11 — — $48,274.68 $160,244.07 $48,274.68 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 18 11 — — $48,287.87 $160,289.43 $48,287.87 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 18 11 — — $48,709.12 $161,738.04 $48,709.12 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 5 4 — — $40,050.00 $69,902.43 $48,931.70 2026-04-01
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 5 4 — — $40,050.00 $69,902.43 $48,931.70 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 5 4 — — $40,050.00 $69,902.43 $48,931.70 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 18 11 — — $49,164.49 $163,304.04 $49,164.49 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 18 11 — — $49,219.57 $163,493.46 $49,219.57 2026-04-01
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 5 4 — — $39,537.89 $59,306.84 $50,391.42 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 18 11 — — $51,595.77 $171,664.93 $51,595.77 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 18 11 — — $52,501.09 $174,778.25 $52,501.09 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 18 11 — — $52,686.50 $175,415.85 $52,686.50 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 18 11 — — $52,686.50 $175,415.85 $52,686.50 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 18 11 — — $53,511.15 $178,251.72 $53,511.15 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 18 11 — — $53,549.16 $178,382.45 $53,549.16 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 18 11 — — $53,895.16 $179,572.29 $53,895.16 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 18 11 — — $55,033.99 $183,488.62 $55,033.99 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 18 11 — — $55,296.98 $184,393.00 $55,296.98 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 18 11 — — $56,992.82 $190,224.81 $56,992.82 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 18 11 — — $57,025.40 $190,336.86 $57,025.40 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 18 11 — — $57,320.97 $191,353.29 $57,320.97 2026-04-01
10 MS_DRG Pancreas Transplant 18 11 — — $57,344.25 $191,433.32 $57,344.25 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 11 — — $57,677.05 $192,577.81 $57,677.05 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 18 11 — — $60,790.23 $203,283.69 $60,790.23 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 18 11 — — $60,986.50 $203,958.65 $60,986.50 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 5 4 — — $47,919.99 $71,879.98 $61,074.49 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 18 11 — — $61,243.28 $204,841.69 $61,243.28 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 18 11 — — $62,721.13 $209,923.85 $62,721.13 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 5 4 — — $49,338.18 $74,007.27 $62,881.99 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 18 11 — — $66,868.41 $224,185.91 $66,868.41 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 18 11 — — $67,073.99 $224,892.87 $67,073.99 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 18 11 — — $68,855.17 $231,018.14 $68,855.17 2026-04-01
J9226 HCPCS Supprelin La Implant 10 7 — — $45,020.65 $91,120.78 $69,350.43 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 5 4 — — $40,050.00 $99,825.02 $69,877.52 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 18 11 — — $71,571.15 $240,358.11 $71,571.15 2026-04-01
A9699 HCPCS Radiopharm Rx Agent Noc 1 1 — — $74,614.73 $74,614.73 $74,614.73 2026-04-01
90288 HCPCS Botulism Ig IV 1 1 — — $76,782.00 $76,782.00 $76,782.00 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 18 11 — — $77,569.42 $260,985.54 $77,569.42 2026-04-01
215 MS_DRG Other Heart Assist System Implant 18 11 — — $78,920.82 $265,632.85 $78,920.82 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 18 11 — — $81,663.18 $275,063.52 $81,663.18 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 10 7 — — $55,272.32 $111,891.94 $85,150.85 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 7 6 — — $56,824.55 $107,421.88 $85,236.82 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 18 11 — — $86,035.43 $290,099.24 $86,035.43 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 11 — — $87,176.60 $294,023.57 $87,176.60 2026-04-01
L8702 HCPCS Pow Ue Rom Dev Ewhf Uprt Cus 5 4 — — $68,801.71 $103,202.56 $87,688.46 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 18 11 — — $89,485.30 $301,962.95 $89,485.30 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 18 11 — — $89,586.15 $302,309.76 $89,586.15 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 18 11 — — $94,908.73 $320,613.54 $94,908.73 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 10 7 — — $63,342.28 $126,862.11 $97,049.53 2026-04-01
7 MS_DRG Lung Transplant 18 11 — — $102,141.26 $345,485.44 $102,141.26 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 3 3 — — $102,820.55 $120,116.70 $105,841.78 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 18 11 — — $109,132.53 $369,527.65 $109,132.53 2026-04-01
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 1 1 — — $121,181.71 $121,181.71 $121,181.71 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 5 4 — — $110,901.76 $166,352.64 $141,345.39 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 18 11 — — $166,336.48 $566,245.89 $166,336.48 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 18 11 — — $167,308.52 $569,588.64 $167,308.52 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 18 11 — — $219,078.96 $747,621.60 $219,078.96 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 18 11 — — $336,677.62 $1,152,030.74 $336,677.62 2026-04-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 5 5 — — $278,250.00 $422,100.00 $375,637.50 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 9 7 — — $489,304.61 $979,440.00 $733,956.91 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 9 7 — — $533,230.17 $1,066,152.96 $799,845.26 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 9 7 — — $557,317.93 $1,082,520.90 $835,976.90 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 9 7 — — $562,538.19 $1,083,271.32 $843,807.28 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 9 7 — — $565,868.94 $1,106,757.66 $848,803.42 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 9 7 — — $591,726.20 $1,156,649.16 $887,589.30 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 8 6 — — $770,620.00 $1,541,240.00 $1,098,133.50 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 6 6 — — $2,332,000.00 $3,847,800.00 $3,323,100.00 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 6 6 — — $2,455,110.60 $3,965,706.94 $3,498,532.62 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 3 3 — — $3,685,266.67 $4,975,110.00 $3,869,530.00 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 4 4 — — $3,316,462.59 $4,974,693.88 $3,979,755.11 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 6 6 — — $2,945,740.00 $4,897,200.00 $4,197,679.50 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 5 5 — — $3,248,445.72 $4,984,800.00 $4,385,401.72 2026-04-01
J3391 HCPCS Inj, Atidarsagene Autotemcel 2 2 — — $4,505,000.00 $4,730,250.00 $4,617,625.00 2026-04-01
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