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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

THIBODAUX REGIONAL MEDICAL CENTER

Thibodaux, LA · CCN 190004 · Rates published

12,920 distinct procedures filed
18 distinct payers
146,540 rate rows
2026-04-01 last MRF observed
Data quality

82,856 of 146,540 rate rows are consumer-grade (56.5%)

63,684 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 42,032
placeholder amount (≤ $0.02) — excluded from medians 21,652
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.thibodaux.com/documents/84-2046902%20_thibodaux-regional-medical-center_standardcharges.json
Found on page https://www.thibodaux.com/patients-visitors/hospital-charges-estimates/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-16
Content fingerprint 6a11eaf23d1963f3… · 22,431,798 bytes · first seen 2026-05-09

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 1 $4,505,000.00 $4,505,000.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 2 $3,685,266.67 $4,496,025.34 $4,090,646.00 nat. median
$3,710,000
1.1× median
J3389
HCPCS 		Topi Adm Prad Zami Per Treat 2 $3,335,820.00 $4,069,700.40 $3,702,760.20 nat. median
$3,335,820
1.1× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 2 $3,316,462.59 $4,059,988.87 $3,688,225.73 nat. median
$3,325,455
1.1× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 2 $3,248,445.72 $3,968,059.86 $3,608,252.79 nat. median
$3,286,000
1.1× median
J3387
HCPCS 		Inj Elivaldogene Autotemecel 2 $3,090,000.00 $3,879,600.00 $3,484,800.00 nat. median
$3,180,000
1.1× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 2 $2,945,740.00 $3,586,762.05 $3,266,251.02 nat. median
$3,006,423
1.1× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 2 $2,332,000.00 $2,845,040.00 $2,588,520.00 nat. median
$2,448,600
1.1× median
Q2057
HCPCS 		Afamitresgene Autoleucel 2 $770,620.00 $940,156.40 $855,388.20 nat. median
$824,563
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 2 $591,726.20 $691,168.19 $641,447.19 nat. median
$754,974
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 2 $565,868.94 $716,932.48 $641,400.71 nat. median
$675,122
1.0× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 2 $562,538.19 $685,885.51 $624,211.85 nat. median
$674,188
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 2 $557,317.93 $680,859.71 $619,088.82 nat. median
$625,184
1.0× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 2 $489,304.61 $597,129.24 $543,216.93 nat. median
$620,080
0.9× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 3 $285,231.40 $622,552.72 $467,281.08 nat. median
$370,174
1.3× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 2 $278,250.00 $339,465.00 $308,857.50 nat. median
$324,450
1.0× median
0100T
HCPCS 		Prosth Retina Receive&Gen 2 $296,369.47 $311,680.53 $304,025.00 nat. median
$11,210
outlier · 27.1×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 3 $185,206.16 $464,994.69 $303,246.62 nat. median
$265,286
1.1× median
J3403
HCPCS 		Revakinagene, Per Implant 3 $257,500.00 $270,000.00 $270,000.00 nat. median
$265,000
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $0.95 $649,274.53 $266,615.56 nat. median
$634,511
outlier · 0.4×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 5 $141,172.07 $391,609.58 $231,033.76 nat. median
$206,368
1.1× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 5 $140,345.28 $353,787.07 $229,677.89 nat. median
$202,986
1.1× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 2 $205,640.00 $246,036.20 $225,838.10 nat. median
$209,753
1.1× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 3 $111,492.17 $185,752.77 $176,627.81 nat. median
$111,989
1.6× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 6 $34,037.88 $233,254.22 $147,960.65 nat. median
$133,176
1.1× median
7
MS_DRG 		Lung Transplant 3 $85,743.11 $215,736.22 $140,134.11 nat. median
$122,708
1.1× median
5231
OTHER 		Level 1 Icd And Similar Procedures 1 $136,516.37 $136,516.37 $136,516.37 nat. median
$23,015
outlier · 5.9×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 3 $79,591.38 $216,280.98 $130,045.70 nat. median
$117,303
1.1× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 $75,064.18 $181,910.23 $122,621.41 nat. median
$108,660
1.1× median
209
MS_DRG 		Complex Aortic Arch Procedures 4 $74,978.40 $130,211.48 $120,907.42 nat. median
$98,017
1.2× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 $73,014.70 $172,925.07 $117,728.46 nat. median
$98,905
1.2× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 5 $72,044.07 $179,833.56 $117,668.64 nat. median
$102,358
1.1× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 3 $68,325.19 $175,797.42 $111,569.92 nat. median
$100,136
1.1× median
215
MS_DRG 		Other Heart Assist System Implant 5 $65,992.63 $174,896.10 $107,744.70 nat. median
$99,019
1.1× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 5 $64,843.18 $159,317.75 $105,859.68 nat. median
$93,672
1.1× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 5 $59,741.26 $137,684.37 $97,492.88 nat. median
$82,712
1.2× median
850
MS_DRG 		Acute Leukemia With Other Procedures 5 $57,431.14 $152,067.56 $93,704.45 nat. median
$83,442
1.1× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 5 $55,916.14 $139,884.85 $91,219.95 nat. median
$79,312
1.2× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 5 $55,741.28 $139,807.27 $90,933.19 nat. median
$81,118
1.1× median
33276
HCPCS 		Insj Phrnc Nrv Stim Sys 3 $39,883.94 $91,972.02 $87,453.97 nat. median
$43,787
2.0× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 5 $52,213.75 $133,070.46 $85,148.28 nat. median
$77,576
1.1× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 5 $50,956.75 $127,728.56 $83,086.88 nat. median
$74,915
1.1× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 5 $50,571.40 $123,217.00 $82,454.94 nat. median
$72,138
1.1× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 6 $10,563.48 $129,031.02 $80,603.34 nat. median
$73,807
1.1× median
L7180
HCPCS 		Electronic Elbow Sequential 3 $50,007.15 $83,314.98 $79,222.20 nat. median
$49,027
1.6× median
L7181
HCPCS 		Electronic Elbo Simultaneous 3 $49,600.83 $82,638.03 $78,578.50 nat. median
$50,598
1.6× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 $47,165.84 $117,249.45 $78,112.47 nat. median
$68,090
1.1× median
10
MS_DRG 		Pancreas Transplant 3 $47,640.37 $131,616.13 $77,648.25 nat. median
$68,882
1.1× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 5 $47,620.57 $110,253.48 $77,615.79 nat. median
$64,027
1.2× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 3 $47,369.17 $130,861.73 $77,203.51 nat. median
$71,240
1.1× median

Other procedures at this hospital

Browse this hospital's 12,920 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
             
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 22 7 — — $3,521.16 $112,548.66 $43,505.83 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 20 7 — — $19,126.14 $90,860.20 $58,684.22 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 20 7 — — $5,868.60 $67,881.44 $43,682.12 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 18 5 — — $35,423.90 $87,824.43 $56,491.20 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 18 5 — — $29,399.11 $75,801.85 $48,460.90 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 18 7 — — $22,010.10 $56,542.28 $38,161.34 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 18 6 — — $1,173.72 $118,644.99 $37,494.07 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 18 5 — — $19,742.95 $50,942.85 $34,551.70 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 16 5 — — $38,028.02 $97,134.78 $55,336.66 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 16 5 — — $28,274.58 $67,409.32 $45,899.58 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 16 6 — — $19,225.84 $47,826.20 $32,158.73 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 14 6 — — $10,563.48 $129,031.02 $80,603.34 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 5 — — $47,165.84 $117,249.45 $78,112.47 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 14 6 — — $2,417.86 $90,305.54 $60,802.54 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 14 6 — — $4,835.72 $84,734.18 $57,094.84 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 14 6 — — $10,880.37 $57,197.63 $36,598.97 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 14 5 — — $20,751.87 $235,276.13 $34,080.74 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 14 5 — — $19,046.87 $48,674.69 $32,838.28 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 14 5 — — $20,306.29 $53,958.82 $32,822.26 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 12 6 — — $34,037.88 $233,254.22 $147,960.65 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 5 — — $73,014.70 $172,925.07 $117,728.46 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 12 6 — — $45,899.03 $319,922.99 $77,152.97 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 12 6 — — $37,899.73 $238,020.41 $63,620.67 2026-04-01
5213 OTHER Level 3 Electrophysiologic Procedures 12 6 — — $22,109.84 $108,438.59 $56,490.45 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 12 5 — — $23,859.21 $84,100.28 $55,604.08 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 12 5 — — $32,030.03 $82,560.11 $52,754.12 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 12 5 — — $31,250.48 $146,804.10 $52,372.22 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 12 5 — — $17,202.43 $89,064.16 $52,354.62 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 12 5 — — $31,333.90 $80,183.00 $51,580.17 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 12 5 — — $31,992.80 $82,657.51 $51,319.53 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 12 5 — — $30,544.44 $77,247.92 $48,974.84 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 12 5 — — $28,729.63 $73,827.52 $48,567.85 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 12 5 — — $29,127.71 $76,087.43 $47,874.59 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 12 5 — — $28,158.44 $68,683.71 $45,890.56 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 12 5 — — $28,618.35 $74,032.22 $45,856.76 2026-04-01
791 MS_DRG Prematurity With Major Problems 12 6 — — $3,521.16 $67,019.73 $43,358.24 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 12 5 — — $25,769.80 $62,268.81 $41,245.34 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 12 5 — — $25,611.34 $65,761.84 $41,011.40 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 12 5 — — $24,088.52 $201,262.44 $40,256.44 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 12 5 — — $23,781.85 $63,559.71 $39,926.11 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 12 5 — — $24,882.97 $65,134.55 $39,809.68 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 12 5 — — $24,528.64 $63,738.00 $39,236.06 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 12 5 — — $125.00 $58,622.25 $39,220.03 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 12 5 — — $22,973.19 $59,173.61 $38,581.25 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 12 5 — — $23,189.92 $61,771.93 $38,019.38 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 12 5 — — $20,490.15 $57,821.63 $36,622.17 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 12 5 — — $21,556.35 $55,411.50 $36,442.71 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 12 5 — — $200.00 $57,696.17 $35,684.29 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 12 5 — — $20,290.66 $54,820.52 $35,166.21 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 12 5 — — $21,300.01 $53,782.18 $34,727.18 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 12 5 — — $20,535.70 $52,743.85 $33,658.98 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 12 5 — — $19,508.53 $166,491.86 $32,508.55 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 12 5 — — $16,321.79 $41,680.37 $32,225.46 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 12 5 — — $19,440.57 $48,417.17 $32,120.55 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 10 5 — — $141,172.07 $391,609.58 $231,033.76 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 10 5 — — $140,345.28 $353,787.07 $229,677.89 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 10 5 — — $72,044.07 $179,833.56 $117,668.64 2026-04-01
215 MS_DRG Other Heart Assist System Implant 10 5 — — $65,992.63 $174,896.10 $107,744.70 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 5 — — $64,843.18 $159,317.75 $105,859.68 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 10 5 — — $59,741.26 $137,684.37 $97,492.88 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 10 5 — — $57,431.14 $152,067.56 $93,704.45 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 10 5 — — $55,916.14 $139,884.85 $91,219.95 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 5 — — $55,741.28 $139,807.27 $90,933.19 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 10 5 — — $52,213.75 $133,070.46 $85,148.28 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 10 5 — — $50,956.75 $127,728.56 $83,086.88 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 10 5 — — $50,571.40 $123,217.00 $82,454.94 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 10 5 — — $47,620.57 $110,253.48 $77,615.79 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 10 5 — — $47,341.46 $116,660.13 $77,158.06 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 10 5 — — $45,675.35 $110,066.94 $74,425.76 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 10 5 — — $44,706.69 $112,719.73 $72,837.23 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 10 5 — — $44,412.40 $102,123.42 $72,354.62 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 10 5 — — $44,380.07 $110,679.38 $72,301.59 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 5 — — $43,678.66 $98,209.44 $71,151.32 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 5 — — $43,678.66 $106,605.27 $71,151.32 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 10 5 — — $43,520.95 $101,657.90 $70,892.70 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 10 5 — — $42,750.91 $106,758.79 $69,629.89 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 10 5 — — $40,729.81 $98,894.51 $66,315.42 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 10 5 — — $40,682.96 $104,399.84 $66,238.59 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 10 5 — — $40,295.63 $100,840.77 $65,603.39 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 10 5 — — $39,937.33 $100,358.74 $65,015.81 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 10 5 — — $39,926.12 $102,255.48 $64,997.42 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 5 — — $39,639.09 $94,744.47 $64,526.71 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 10 5 — — $39,509.76 $98,135.15 $64,314.61 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 10 5 — — $38,990.46 $96,112.96 $63,463.00 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 10 5 — — $38,102.97 $94,178.25 $62,007.58 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 10 5 — — $37,020.16 $82,593.13 $60,231.85 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 10 5 — — $36,735.11 $101,302.99 $59,764.38 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 10 5 — — $36,516.70 $91,243.18 $59,406.21 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 10 5 — — $36,388.69 $89,615.51 $59,196.28 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 10 5 — — $36,280.47 $89,074.06 $59,018.82 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 10 5 — — $35,480.08 $87,436.49 $57,706.23 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 10 5 — — $35,458.97 $85,016.46 $57,671.60 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 10 5 — — $35,222.74 $91,243.18 $57,284.21 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 10 5 — — $34,580.05 $92,023.99 $56,230.24 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 10 5 — — $33,549.38 $75,813.40 $54,540.00 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 10 5 — — $33,200.98 $83,842.76 $53,968.66 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 10 5 — — $32,937.04 $82,262.97 $53,535.82 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 10 5 — — $32,767.46 $83,147.79 $53,257.72 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 10 5 — — $31,705.77 $77,663.92 $51,516.62 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 10 5 — — $31,158.10 $78,832.66 $50,618.47 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 10 5 — — $30,766.81 $76,792.31 $49,976.79 2026-04-01
245 MS_DRG Aicd Generator Procedures 10 5 — — $30,396.64 $80,669.97 $49,369.73 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 10 5 — — $30,306.24 $74,476.27 $49,221.48 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 10 5 — — $30,175.59 $78,490.95 $49,007.23 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 10 5 — — $29,856.22 $69,177.29 $48,483.49 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 10 5 — — $29,740.09 $72,515.16 $48,293.04 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 10 5 — — $29,277.54 $70,417.02 $47,534.49 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 10 5 — — $28,846.00 $70,313.03 $46,826.80 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 10 5 — — $28,436.24 $69,814.49 $46,154.81 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 10 5 — — $28,110.93 $67,742.77 $45,621.34 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 10 5 — — $28,097.08 $67,843.47 $45,598.61 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 10 5 — — $28,015.92 $69,160.79 $45,465.51 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 10 5 — — $27,982.92 $73,137.50 $45,411.41 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 5 — — $27,824.56 $71,280.38 $45,151.70 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 10 5 — — $27,695.23 $67,143.54 $44,939.61 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 10 5 — — $27,513.77 $64,550.18 $44,642.04 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 10 5 — — $26,580.75 $59,176.91 $43,111.95 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 10 5 — — $26,104.35 $62,757.44 $42,330.67 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 10 5 — — $25,987.55 $71,427.30 $42,139.14 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 10 5 — — $25,832.49 $64,193.61 $41,884.84 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 10 5 — — $25,794.22 $64,868.78 $41,822.08 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 10 5 — — $25,121.84 $63,099.15 $40,719.42 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 10 5 — — $25,013.62 $54,506.87 $40,541.96 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 10 5 — — $24,952.26 $59,163.70 $40,441.32 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 10 5 — — $24,234.34 $52,395.54 $39,264.00 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 10 5 — — $24,215.87 $58,117.11 $39,233.70 2026-04-01
332 MS_DRG Rectal Resection With Mcc 10 5 — — $24,182.88 $57,260.36 $39,179.59 2026-04-01
265 MS_DRG Aicd Lead Procedures 10 5 — — $24,166.38 $58,886.37 $39,152.54 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 10 5 — — $23,932.80 $65,715.62 $38,769.48 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 10 5 — — $23,878.03 $65,000.84 $38,679.66 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 10 5 — — $23,854.27 $59,814.11 $38,640.71 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 10 5 — — $23,819.30 $57,798.52 $38,583.36 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 10 5 — — $23,799.51 $57,839.78 $38,550.89 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 10 5 — — $23,514.45 $60,231.75 $38,083.43 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 10 5 — — $23,309.24 $56,628.12 $37,746.89 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 10 5 — — $23,303.30 $63,802.38 $37,737.16 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 10 5 — — $23,086.87 $56,770.08 $37,382.23 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 10 5 — — $22,773.45 $58,264.03 $36,868.23 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 10 5 — — $22,088.53 $45,171.75 $35,745.01 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 10 5 — — $22,011.99 $51,520.63 $35,619.49 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 10 5 — — $21,755.31 $56,228.63 $35,198.55 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 10 5 — — $21,660.95 $53,805.30 $35,043.81 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 10 5 — — $21,637.19 $52,643.15 $35,004.85 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 10 5 — — $21,585.73 $53,143.34 $34,920.45 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 10 5 — — $21,544.16 $52,501.18 $34,852.28 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 10 5 — — $21,475.53 $47,246.77 $34,739.74 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 10 5 — — $21,359.40 $55,994.22 $34,549.29 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 10 5 — — $21,320.47 $51,048.50 $34,485.44 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 10 5 — — $21,257.78 $58,278.89 $34,382.65 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 10 5 — — $21,174.64 $52,308.04 $34,246.30 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 10 5 — — $21,142.97 $50,906.54 $34,194.36 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 10 5 — — $21,024.86 $46,312.44 $34,000.66 2026-04-01
665 MS_DRG Prostatectomy With Mcc 10 5 — — $20,886.95 $56,680.94 $33,774.51 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 10 5 — — $20,807.77 $50,490.54 $33,644.65 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 10 5 — — $20,493.02 $51,497.51 $33,128.49 2026-04-01
263 MS_DRG Vein Ligation And Stripping 10 5 — — $20,465.97 $44,275.38 $33,084.13 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 10 5 — — $20,222.49 $47,180.74 $32,684.83 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 10 5 — — $20,219.85 $47,329.31 $32,680.50 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 10 5 — — $19,931.50 $50,655.62 $32,207.62 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 10 5 — — $19,718.37 $43,644.79 $31,858.11 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 8 4 — — $0.95 $649,274.53 $266,615.56 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 8 4 — — $74,978.40 $130,211.48 $120,907.42 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 8 4 — — $56,824.55 $72,149.02 $70,737.49 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 8 4 — — $63,342.28 $78,415.24 $69,559.17 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 8 4 — — $55,272.32 $66,373.01 $62,718.81 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 8 4 — — $37,948.56 $65,652.18 $60,961.10 2026-04-01
J9226 HCPCS Supprelin La Implant 8 4 — — $45,020.65 $52,686.11 $47,109.28 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 8 4 — — $22,981.30 $39,557.65 $36,731.12 2026-04-01
0888T HCPCS Histotripsy Mal Renal Tissue 8 4 — — $15,510.69 $39,376.13 $34,888.99 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 6 3 — — $285,231.40 $622,552.72 $467,281.08 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 6 3 — — $185,206.16 $464,994.69 $303,246.62 2026-04-01
J3403 HCPCS Revakinagene, Per Implant 6 3 — — $257,500.00 $270,000.00 $270,000.00 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 6 3 — — $111,492.17 $185,752.77 $176,627.81 2026-04-01
7 MS_DRG Lung Transplant 6 3 — — $85,743.11 $215,736.22 $140,134.11 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 6 3 — — $79,591.38 $216,280.98 $130,045.70 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 6 3 — — $75,064.18 $181,910.23 $122,621.41 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 6 3 — — $68,325.19 $175,797.42 $111,569.92 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 6 3 — — $39,883.94 $91,972.02 $87,453.97 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 6 3 — — $50,007.15 $83,314.98 $79,222.20 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 6 3 — — $49,600.83 $82,638.03 $78,578.50 2026-04-01
10 MS_DRG Pancreas Transplant 6 3 — — $47,640.37 $131,616.13 $77,648.25 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 6 3 — — $47,369.17 $130,861.73 $77,203.51 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 6 3 — — $56,956.76 $76,511.45 $72,752.89 2026-04-01
69930 HCPCS Implant Cochlear Device 6 3 — — $29,856.15 $67,666.78 $64,342.71 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 6 3 — — $39,418.70 $99,639.01 $64,165.28 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 6 3 — — $28,422.52 $65,979.26 $62,738.08 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 6 3 — — $28,422.52 $65,979.26 $62,738.08 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 6 3 — — $28,422.52 $65,979.26 $62,738.08 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 6 3 — — $28,422.52 $65,979.26 $62,738.08 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 6 3 — — $28,422.52 $65,979.26 $62,738.08 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 6 3 — — $28,422.52 $65,527.46 $62,308.47 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 6 3 — — $37,273.54 $89,820.21 $60,647.38 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 6 3 — — $36,136.63 $99,639.01 $58,782.92 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 6 3 — — $27,941.55 $61,443.74 $58,425.37 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 6 3 — — $27,941.55 $60,468.46 $57,498.00 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 6 3 — — $27,941.55 $59,512.88 $56,589.36 2026-04-01
61886 HCPCS Implant Neurostim Arrays 6 3 — — $27,941.55 $59,512.88 $56,589.36 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 6 3 — — $39,883.94 $59,512.88 $56,589.36 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 6 3 — — $25,972.68 $58,292.30 $55,428.74 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 6 3 — — $31,313.82 $76,056.06 $50,873.85 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 6 3 — — $30,888.88 $80,049.28 $50,176.98 2026-04-01
L5856 HCPCS Elec Knee-shin Swing/stance 6 3 — — $29,717.20 $49,510.67 $47,078.50 2026-04-01
L6880 HCPCS Elec Hand Ind Art Digits 6 3 — — $29,576.84 $49,276.84 $46,856.15 2026-04-01
0515T HCPCS Insj Wcs Lv Compl Sys 6 3 — — $20,141.49 $46,420.60 $44,140.23 2026-04-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 6 3 — — $28,422.52 $46,420.60 $44,140.23 2026-04-01
0520T HCPCS Rmvl&rplcmt Pg Wcs New Eltrd 6 3 — — $9,464.25 $46,420.60 $44,140.23 2026-04-01
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 6 3 — — $20,141.49 $46,420.60 $44,140.23 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 6 3 — — $20,141.49 $46,420.60 $44,140.23 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 6 3 — — $20,141.49 $46,420.60 $44,140.23 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 6 3 — — $20,141.49 $46,420.60 $44,140.23 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 6 3 — — $20,141.49 $46,420.60 $44,140.23 2026-04-01
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 6 3 — — $20,141.49 $46,420.60 $44,140.23 2026-04-01
0409T HCPCS Insj/rplc Car Modulj Pls Gn 6 3 — — $20,141.49 $46,420.60 $44,140.23 2026-04-01
0923T HCPCS Rmvl&rplcmt Perm Ccm-d Pg 6 3 — — $20,141.49 $45,875.52 $43,621.93 2026-04-01
0916T HCPCS Insj Perm Ccm-d Sys Pg Only 6 3 — — $20,141.49 $45,875.52 $43,621.93 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 6 3 — — $27,941.55 $42,598.60 $40,505.98 2026-04-01
0816T HCPCS Opn Insj/rplcmt Ins Ptn Subq 6 3 — — $17,566.74 $42,598.60 $40,505.98 2026-04-01
0817T HCPCS Opn Insj/rplcmt Ins Ptn Subf 6 3 — — $17,566.74 $42,598.60 $40,505.98 2026-04-01
0308T HCPCS Insj Ocular Telescope Prosth 6 3 — — $14,905.23 $42,256.83 $40,181.00 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 6 3 — — $24,744.40 $57,323.09 $40,100.46 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 6 3 — — $23,667.75 $41,765.60 $39,713.90 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 6 3 — — $23,667.75 $41,765.60 $39,713.90 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 6 3 — — $23,667.75 $41,765.60 $39,713.90 2026-04-01
63655 HCPCS Implant Neuroelectrodes 6 3 — — $17,566.74 $39,403.28 $37,467.62 2026-04-01
64590 HCPCS Insrt/redo Pn/gastr Stimul 6 3 — — $17,566.74 $39,403.28 $37,467.62 2026-04-01
64580 HCPCS Implant Neuroelectrodes 6 3 — — $17,566.74 $39,403.28 $37,467.62 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 6 3 — — $27,941.55 $39,403.28 $37,467.62 2026-04-01
63664 HCPCS Revise Spine Eltrd Plate 6 3 — — $10,089.67 $39,403.28 $37,467.62 2026-04-01
64575 HCPCS Implant Neuroelectrodes 6 3 — — $10,089.67 $39,403.28 $37,467.62 2026-04-01
L6975 HCPCS Interscap-thor Myoelectronic 6 3 — — $23,640.73 $39,386.91 $37,452.06 2026-04-01
L6970 HCPCS Interscapular-thor Switch CT 6 3 — — $23,514.53 $39,176.62 $37,252.10 2026-04-01
Q0483 HCPCS Monitor Elec Vad, Rep 6 3 — — $23,210.23 $38,669.68 $36,770.06 2026-04-01
L6965 HCPCS Shldr Disartic Myoelectronic 6 3 — — $23,134.38 $38,543.29 $36,649.88 2026-04-01
L5858 HCPCS Stance Phase Only 6 3 — — $23,006.91 $38,330.92 $36,447.94 2026-04-01
0796T HCPCS Tcat Ins 2chmbr Ldls Pm Ra 6 3 — — $17,441.40 $37,943.86 $36,079.90 2026-04-01
0803T HCPCS Tcat Rmv&rpl2chmb Ldls Pm Rv 6 3 — — $17,441.40 $37,943.86 $36,079.90 2026-04-01
0802T HCPCS Tcat Rmv&rpl2chmb Ldls Pm Ra 6 3 — — $17,441.40 $37,943.86 $36,079.90 2026-04-01
0823T HCPCS Tcat Ins 1chmbr Ldls Pm Ra 6 3 — — $17,441.40 $37,943.86 $36,079.90 2026-04-01
0797T HCPCS Tcat Ins 2chmbr Ldls Pm Rv 6 3 — — $17,441.40 $37,943.86 $36,079.90 2026-04-01
0801T HCPCS Tcat Rmv&rpl 2chmbr Ldls Pm 6 3 — — $17,441.40 $37,943.86 $36,079.90 2026-04-01
0825T HCPCS Tcat Rmv&rpl1chmb Ldls Pm Ra 6 3 — — $17,441.40 $37,943.86 $36,079.90 2026-04-01
0795T HCPCS Tcat Ins 2chmbr Ldls Pm Cmpl 6 3 — — $17,441.40 $37,943.86 $36,079.90 2026-04-01
C8003 HCPCS Imp Extar Knee Shck Absrb 6 3 — — $15,876.81 $37,585.58 $35,739.22 2026-04-01
33229 HCPCS Remv&replc Pm Gen Mult Leads 6 3 — — $17,441.40 $37,428.56 $35,589.91 2026-04-01
33221 HCPCS Insert Pulse Gen Mult Leads 6 3 — — $17,441.40 $37,428.56 $35,589.91 2026-04-01
652 MS_DRG Kidney Transplant 6 3 — — $21,601.56 $50,701.84 $34,946.42 2026-04-01
C9797 HCPCS Vasc Emb/occ W/prs Cath 6 3 — — $16,599.24 $36,699.94 $34,897.09 2026-04-01
27278 HCPCS Arthrd Si Jt Prq Wo Tfxj Dev 6 3 — — $15,876.81 $36,290.29 $34,507.55 2026-04-01
53444 HCPCS Insert Tandem Cuff 6 3 — — $18,767.44 $35,917.66 $34,153.23 2026-04-01
54417 HCPCS Remv/replc Penis Pros Compl 6 3 — — $18,767.44 $35,917.66 $34,153.23 2026-04-01
54401 HCPCS Insert Self-contd Prosthesis 6 3 — — $18,767.44 $35,917.66 $34,153.23 2026-04-01
54400 HCPCS Insert Semi-rigid Prosthesis 6 3 — — $11,946.63 $35,917.66 $34,153.23 2026-04-01
54405 HCPCS Insert Multi-comp Penis Pros 6 3 — — $18,767.44 $35,917.66 $34,153.23 2026-04-01
53445 HCPCS Insert Uro/ves Nck Sphincter 6 3 — — $18,767.44 $35,917.66 $34,153.23 2026-04-01
54410 HCPCS Remove/replace Penis Prosth 6 3 — — $18,767.44 $35,917.66 $34,153.23 2026-04-01
54411 HCPCS Remov/replc Penis Pros Comp 6 3 — — $18,767.44 $35,917.66 $34,153.23 2026-04-01
53447 HCPCS Remove/replace Ur Sphincter 6 3 — — $18,767.44 $35,917.66 $34,153.23 2026-04-01
54416 HCPCS Remv/repl Penis Contain Pros 6 3 — — $18,767.44 $35,917.66 $34,153.23 2026-04-01
C9782 HCPCS Blind Myocar Trpl Bon Marrow 6 3 — — $15,510.69 $35,767.52 $34,010.47 2026-04-01
L5973 HCPCS Ank-foot Sys Dors-plant Flex 6 3 — — $21,297.95 $35,483.70 $33,740.59 2026-04-01
36836 HCPCS Prq Av Fstl Crtj Uxtr 1 Acs 6 3 — — $16,599.24 $35,107.58 $33,382.95 2026-04-01
33902 HCPCS Perq P-art Revsc 1 Abnor Uni 6 3 — — $16,599.24 $35,107.58 $33,382.95 2026-04-01
36837 HCPCS Prq Av Fstl Crt Uxtr Sep Acs 6 3 — — $16,599.24 $35,107.58 $33,382.95 2026-04-01
C2616 HCPCS Brachytx, Non-str,yttrium-90 6 3 — — $17,771.01 $34,931.75 $33,215.76 2026-04-01
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 6 3 — — $30,977.74 $39,883.94 $32,578.11 2026-04-01
0793T HCPCS Prq Tcat Thrm Ablt Nrv P-art 6 3 — — $16,599.24 $34,146.40 $32,468.99 2026-04-01
62361 HCPCS Implant Spine Infusion Pump 6 3 — — $16,320.54 $33,756.30 $32,098.05 2026-04-01
62362 HCPCS Implant Spine Infusion Pump 6 3 — — $16,320.54 $33,756.30 $32,098.05 2026-04-01
62360 HCPCS Insert Spine Infusion Device 6 3 — — $16,320.54 $33,756.30 $32,098.05 2026-04-01
66683 HCPCS Implantation Iris Prosthesis 6 3 — — $14,905.23 $33,551.92 $31,903.71 2026-04-01
Q0489 HCPCS Pwr Pck Base Combo Vad, Rep 6 3 — — $20,122.03 $33,524.53 $31,877.67 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 4 2 — — $3,685,266.67 $4,496,025.34 $4,090,646.00 2026-04-01
J3389 HCPCS Topi Adm Prad Zami Per Treat 4 2 — — $3,335,820.00 $4,069,700.40 $3,702,760.20 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 4 2 — — $3,316,462.59 $4,059,988.87 $3,688,225.73 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 4 2 — — $3,248,445.72 $3,968,059.86 $3,608,252.79 2026-04-01
J3387 HCPCS Inj Elivaldogene Autotemecel 4 2 — — $3,090,000.00 $3,879,600.00 $3,484,800.00 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 4 2 — — $2,945,740.00 $3,586,762.05 $3,266,251.02 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 4 2 — — $2,332,000.00 $2,845,040.00 $2,588,520.00 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 4 2 — — $770,620.00 $940,156.40 $855,388.20 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 4 2 — — $591,726.20 $691,168.19 $641,447.19 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 4 2 — — $565,868.94 $716,932.48 $641,400.71 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 4 2 — — $562,538.19 $685,885.51 $624,211.85 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 4 2 — — $557,317.93 $680,859.71 $619,088.82 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 4 2 — — $489,304.61 $597,129.24 $543,216.93 2026-04-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 4 2 — — $278,250.00 $339,465.00 $308,857.50 2026-04-01
0100T HCPCS Prosth Retina Receive&Gen 4 2 — — $296,369.47 $311,680.53 $304,025.00 2026-04-01
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 4 2 — — $205,640.00 $246,036.20 $225,838.10 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 4 2 — — $71,087.76 $71,087.76 $71,087.76 2026-04-01
5054 OTHER Level 4 Skin Procedures 4 2 — — $481.27 $127,157.00 $63,819.13 2026-04-01
0268T HCPCS Implt/rpl Crtd Sns Dev Gen 4 2 — — $56,589.36 $59,512.88 $58,051.12 2026-04-01
0266T HCPCS Implt/rpl Crtd Sns Dev Total 4 2 — — $56,589.36 $59,512.88 $58,051.12 2026-04-01
5627 OTHER Level 7 Radiation Therapy 4 2 — — $8,184.15 $75,901.33 $42,042.74 2026-04-01
L8614 HCPCS Cochlear Device 4 2 — — $37,538.73 $39,478.06 $38,508.40 2026-04-01
61867 HCPCS Implant Neuroelectrode 4 2 — — $37,467.62 $39,403.28 $38,435.45 2026-04-01
J3391 HCPCS Inj, Atidarsagene Autotemcel 2 1 — — $4,505,000.00 $4,505,000.00 $4,505,000.00 2026-04-01
5231 OTHER Level 1 Icd And Similar Procedures 2 1 — — $136,516.37 $136,516.37 $136,516.37 2026-04-01
L8702 HCPCS Pow Ue Rom Dev Ewhf Uprt Cus 2 1 — — $68,801.71 $68,801.71 $68,801.71 2026-04-01
5212 OTHER Level 2 Electrophysiologic Procedures 2 1 — — $55,160.90 $55,160.90 $55,160.90 2026-04-01
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 2 1 — — $39,525.62 $39,525.62 $39,525.62 2026-04-01
L8701 HCPCS Pow Ue Rom Dev Ewh Uprt Cust 2 1 — — $34,970.13 $34,970.13 $34,970.13 2026-04-01
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