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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

BOSTON CHILDREN'S HOSPITAL

Boston, MA · CCN 223302 · Rates published

4,028 distinct procedures filed
26 distinct payers
3,052,940 rate rows
2026-04-01 last MRF observed
Data quality

3,024,538 of 3,052,940 rate rows are consumer-grade (99.1%)

28,402 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
placeholder amount (≤ $0.02) — excluded from medians 18,399
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 9,803
exceeds 10× this hospital's gross charge — excluded from medians 170
per-diem day rate — not a per-procedure price 30
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.childrenshospital.org/sites/default/files/cms-hpt/comp-2026/04-2774441_Boston-Childrens-Needham_StandardCharges.json
Found on page https://www.childrenshospital.org/patient-resources/financial-and-billing-matters/hospital-services-and-charges
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint e776aab9d9872c43… · 70,791,288 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
J3393
HCPCS 		Betibeglogene Autotemcel 2 X 10exp6 To 20 X 10exp6 Cell/ml IV Susp 13 $99,999.99 $4,791,933.67 $3,916,095.75 nat. median
$3,006,423
1.3× median
J1413
HCPCS 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 14 $99,999.99 $4,962,756.96 $3,848,016.25 nat. median
$3,325,455
1.2× median
J3394
HCPCS 		Lovotibeglogene Autotemcel 1.7 X 10exp6 To 20 X 10exp6 Cell/ml IV Susp 18 $99,999.99 $4,874,771.25 $3,786,263.51 nat. median
$3,286,000
1.2× median
44
APR_DRG 		Tracheostomy W Mv 96+ Hours W Extensive Procedure 1 $3,439,097.36 $3,439,097.36 $3,439,097.36 nat. median
$105,658
outlier · 32.5×
J3399
HCPCS 		Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 24 $99,999.99 $3,970,719.61 $3,009,387.50 nat. median
$2,469,189
1.2× median
J3392
HCPCS 		Exagamglogene Autotemcel 4 X 10exp6 To 13 X 10exp6 Cell/ml IV Susp 24 $99,999.99 $3,866,523.75 $2,930,418.00 nat. median
$2,448,600
1.2× median
1674
APR_DRG 		Other Cardiothoracic And Thoracic Vascular Procedures 1 $2,026,021.75 $2,026,021.75 $2,026,021.75 nat. median
$62,356
outlier · 32.5×
1824
APR_DRG 		Other Peripheral Vascular Procedures 1 $1,356,010.94 $1,356,010.94 $1,356,010.94 nat. median
$45,299
outlier · 29.9×
2204
APR_DRG 		Major Stomach Esophageal And Duodenal Procedures 1 $1,152,840.39 $1,152,840.39 $1,152,840.39 nat. median
$53,105
outlier · 21.7×
4234
APR_DRG 		Inborn Errors Of Metabolism 1 $883,279.92 $883,279.92 $883,279.92 nat. median
$28,864
outlier · 30.6×
34
APR_DRG 		Bone Marrow Transplant 1 $864,133.75 $864,133.75 $864,133.75 nat. median
$209,067
outlier · 4.1×
5884
APR_DRG 		Neonate Bwt Less Than 1500g W Major Procedure 1 $827,273.56 $827,273.56 $827,273.56 nat. median
$246,434
outlier · 3.4×
6214
APR_DRG 		Neonate Bwt 2000-2499g W Major Anomaly 1 $825,458.20 $825,458.20 $825,458.20 nat. median
$69,159
outlier · 11.9×
Q2042
HCPCS 		Tisagenlecleucel 0.2 X10exp6 To 2.5x10exp8 Cell Intravenous Suspension 24 $527,500.46 $1,022,704.97 $775,102.71 nat. median
$754,974
1.0× median
J3398
HCPCS 		Voretigene Neparvovec-rzyl 1.5x10exp11 Vg/0.3 Ml (final) Dilution 0.8 Ml Subreti… 24 $414,169.44 $802,981.56 $608,575.50 nat. median
$3,496
outlier · 174.1×
6804
APR_DRG 		Major O.r. Procedures For Lymphatic-hematopoietic-other Neoplasms 1 $551,207.90 $551,207.90 $551,207.90 nat. median
$66,068
outlier · 8.3×
3094
APR_DRG 		Other Significant Hip And Femur Surgery 1 $521,494.20 $521,494.20 $521,494.20 nat. median
$36,581
outlier · 14.3×
7532
APR_DRG 		Bipolar Disorders 1 $479,001.67 $479,001.67 $479,001.67 nat. median
$4,653
outlier · 102.9×
32
APR_DRG 		Bone Marrow Transplant 1 $474,848.93 $474,848.93 $474,848.93 nat. median
$74,778
outlier · 6.4×
14
APR_DRG 		Liver Transplant And-or Intestinal Transplant 1 $458,953.43 $458,953.43 $458,953.43 nat. median
$129,535
outlier · 3.5×
867
MS_DRG 		Other Infectious And Parasitic Diseases Diagnoses With Mcc 1 $439,200.22 $439,200.22 $439,200.22 nat. median
$21,263
outlier · 20.7×
13
APR_DRG 		Liver Transplant And-or Intestinal Transplant 1 $439,192.62 $439,192.62 $439,192.62 nat. median
$68,633
outlier · 6.4×
6814
APR_DRG 		Other O.r. Procedures For Lymphatic-hematopoietic-other Neoplasms 1 $407,166.88 $407,166.88 $407,166.88 nat. median
$73,428
outlier · 5.5×
981
MS_DRG 		Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 1 $388,880.51 $388,880.51 $388,880.51 nat. median
$46,084
outlier · 8.4×
1611
APR_DRG 		Cardiac Defibrillator And Heart Assist Implant 1 $378,901.71 $378,901.71 $378,901.71 nat. median
$76,806
outlier · 4.9×
6954
APR_DRG 		Chemotherapy For Acute Leukemia 1 $355,439.70 $355,439.70 $355,439.70 nat. median
$50,868
outlier · 7.0×
8133
APR_DRG 		Other Complications Of Treatment 1 $346,124.63 $346,124.63 $346,124.63 nat. median
$9,119
outlier · 38.0×
1303
APR_DRG 		Respiratory System Diagnosis W Ventilator Support 96+ Hours 1 $336,608.11 $336,608.11 $336,608.11 nat. median
$35,191
outlier · 9.6×
3843
APR_DRG 		Contusion Open Wound And Other Trauma To Skin And Subcutaneous Tissue 1 $323,307.95 $323,307.95 $323,307.95 nat. median
$8,929
outlier · 36.2×
224
APR_DRG 		Ventricular Shunt Procedures 1 $321,916.82 $321,916.82 $321,916.82 nat. median
$39,321
outlier · 8.2×
26
MS_DRG 		Craniotomy And Endovascular Intracranial Procedures With Cc 1 $320,152.38 $320,152.38 $320,152.38 nat. median
$31,109
outlier · 10.3×
6634
APR_DRG 		Other Anemia And Disorders Of Blood And Blood-forming Organs 1 $310,354.94 $310,354.94 $310,354.94 nat. median
$15,753
outlier · 19.7×
6304
APR_DRG 		Neonate Birthwt Greater Than 2499g W Major Cardiovascular Procedure 1 $277,524.04 $277,524.04 $277,524.04 nat. median
$150,721
1.8× median
228
MS_DRG 		Other Cardiothoracic Procedures With Mcc 1 $262,510.82 $262,510.82 $262,510.82 nat. median
$50,673
outlier · 5.2×
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support Greater Than 96 Hours 1 $260,886.63 $260,886.63 $260,886.63 nat. median
$62,134
outlier · 4.2×
904
APR_DRG 		Major Larynx And Trachea Procedures 1 $247,866.35 $247,866.35 $247,866.35 nat. median
$98,750
outlier · 2.5×
3034
APR_DRG 		Dorsal And Lumbar Fusion Proc For Curvature Of Back 1 $247,228.89 $247,228.89 $247,228.89 nat. median
$84,162
outlier · 2.9×
0812
RC 		24 $4,640.00 $798,299.25 $237,263.22 nat. median
$70,278
outlier · 3.4×
2484
APR_DRG 		Major Gastrointestinal And Peritoneal Infections 1 $234,162.84 $234,162.84 $234,162.84 nat. median
$20,306
outlier · 11.5×
793
MS_DRG 		Full Term Neonate With Major Problems 1 $232,824.76 $232,824.76 $232,824.76 nat. median
$34,190
outlier · 6.8×
40
MS_DRG 		Peripheral Cranial Nerve And Other Nervous System Procedures With Mcc 1 $231,115.50 $231,115.50 $231,115.50 nat. median
$37,698
outlier · 6.1×
4224
APR_DRG 		Hypovolemia And Related Electrolyte Disorders 1 $230,414.73 $230,414.73 $230,414.73 nat. median
$12,818
outlier · 18.0×
6314
APR_DRG 		Neonate Birthwt Greater Than 2499g W Other Major Procedure 1 $228,840.17 $228,840.17 $228,840.17 nat. median
$122,924
1.9× median
3162
APR_DRG 		Hand And Wrist Procedures 1 $225,537.11 $225,537.11 $225,537.11 nat. median
$9,598
outlier · 23.5×
6334
APR_DRG 		Neonate Birthwt Greater Than 2499g W Major Anomaly 1 $215,076.60 $215,076.60 $215,076.60 nat. median
$57,983
outlier · 3.7×
J0224
HCPCS 		Lumasiran 94.5 Mg/0.5 Ml Subcutaneous Solution 23 $9.68 $267,758.14 $211,388.00 nat. median
$376
outlier · 561.7×
1103
APR_DRG 		Ear Nose Mouth Throat Cranial-facial Malignancies 1 $210,457.57 $210,457.57 $210,457.57 nat. median
$11,752
outlier · 17.9×
J2326
HCPCS 		Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution 23 $9.68 $256,402.03 $200,978.71 nat. median
$2,677
outlier · 75.1×
6904
APR_DRG 		Acute Leukemia 1 $198,634.10 $198,634.10 $198,634.10 nat. median
$60,471
outlier · 3.3×
4231
APR_DRG 		Inborn Errors Of Metabolism 1 $194,274.85 $194,274.85 $194,274.85 nat. median
$7,100
outlier · 27.4×

Other procedures at this hospital

Browse this hospital's 4,028 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
             
0812 RC — 293 24 $337,674.00 $337,674.00 $4,640.00 $798,299.25 $237,263.22 2026-04-01
0811 RC — 88 24 $212,496.00 $212,496.00 $43,636.35 $249,128.95 $170,456.65 2026-04-01
6904 APR_DRG Acute Leukemia 1 1 — — $198,634.10 $198,634.10 $198,634.10 2026-04-01
6903 APR_DRG Acute Leukemia 1 1 — — $169,262.20 $169,262.20 $169,262.20 2026-04-01
C1882 HCPCS Aicd Other Than Sing-dual 476 24 $50,014.00 $50,014.00 $4,230.50 $47,513.30 $37,510.50 2026-04-01
C1722 HCPCS Aicd Single Chamber 476 24 $45,983.05 $45,983.05 $4,230.50 $43,683.90 $34,487.29 2026-04-01
3052 APR_DRG Amputation Of Lower Limb Except Toes 1 1 — — $43,504.75 $43,504.75 $43,504.75 2026-04-01
2253 APR_DRG Appendectomy 1 1 — — $46,039.56 $46,039.56 $46,039.56 2026-04-01
398 MS_DRG Appendix Procedures With Cc 1 1 — — $32,024.23 $32,024.23 $32,024.23 2026-04-01
1414 APR_DRG Asthma 1 1 — — $37,486.57 $37,486.57 $37,486.57 2026-04-01
J9038 HCPCS Axatilimab-csfr 50 Mg/ml Intravenous Solution 472 23 $55,811.50 $55,811.50 $9.68 $53,020.93 $41,858.63 2026-04-01
492 APR_DRG Bacterial And Tuberculous Infections Of Nervous System 1 1 — — $56,485.15 $56,485.15 $56,485.15 2026-04-01
J3393 HCPCS Betibeglogene Autotemcel 2 X 10exp6 To 20 X 10exp6 Cell/ml IV Susp 25 13 — — $99,999.99 $4,791,933.67 $3,916,095.75 2026-04-01
7532 APR_DRG Bipolar Disorders 1 1 — — $479,001.67 $479,001.67 $479,001.67 2026-04-01
34 APR_DRG Bone Marrow Transplant 1 1 — — $864,133.75 $864,133.75 $864,133.75 2026-04-01
32 APR_DRG Bone Marrow Transplant 1 1 — — $474,848.93 $474,848.93 $474,848.93 2026-04-01
90287 CPT Botulism Immune Globulin, Human 100 Mg/2 Ml Injection 472 23 $241,831.00 $241,831.00 $3.98 $229,739.45 $181,373.25 2026-04-01
1324 APR_DRG Bpd And Oth Chronic Respiratory Diseases Arising In Perinatal Period 1 1 — — $54,481.35 $54,481.35 $54,481.35 2026-04-01
J9042 HCPCS Brentuximab Vedotin 50 Mg/10ml IV (wet Vial) 472 23 $61,249.11 $61,249.11 $9.68 $58,186.66 $45,936.84 2026-04-01
1384 APR_DRG Bronchiolitis And Rsv Pneumonia 1 1 — — $68,616.82 $68,616.82 $68,616.82 2026-04-01
J9118 HCPCS Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution 472 23 $130,789.14 $130,789.14 $9.68 $124,249.68 $98,091.85 2026-04-01
J0638 HCPCS Canakinumab (pf) 150 Mg/ml Subcutaneous Solution 472 23 $103,311.41 $103,311.41 $9.68 $98,145.84 $77,483.56 2026-04-01
1921 APR_DRG Cardiac Catheterization For Other Non-coronary Conditions 1 1 — — $101,101.27 $101,101.27 $101,101.27 2026-04-01
1611 APR_DRG Cardiac Defibrillator And Heart Assist Implant 1 1 — — $378,901.71 $378,901.71 $378,901.71 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $177,889.07 $177,889.07 $177,889.07 2026-04-01
1623 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 1 1 — — $162,212.13 $162,212.13 $162,212.13 2026-04-01
1634 APR_DRG Cardiac Valve Procedures W-o Ami Or Complex Pdx 1 1 — — $159,917.57 $159,917.57 $159,917.57 2026-04-01
1631 APR_DRG Cardiac Valve Procedures W-o Ami Or Complex Pdx 1 1 — — $156,614.42 $156,614.42 $156,614.42 2026-04-01
1633 APR_DRG Cardiac Valve Procedures W-o Ami Or Complex Pdx 1 1 — — $103,153.30 $103,153.30 $103,153.30 2026-04-01
1632 APR_DRG Cardiac Valve Procedures W-o Ami Or Complex Pdx 1 1 — — $91,173.74 $91,173.74 $91,173.74 2026-04-01
602 MS_DRG Cellulitis With Mcc 1 1 — — $31,570.16 $31,570.16 $31,570.16 2026-04-01
J0567 HCPCS Cerliponase Alfa 300 Mg/10 Ml(150 Mg/5ml X2) Intraventricular Kit 930 23 $169,900.93 $169,900.93 $9.68 $161,405.88 $76,325.92 2026-04-01
6954 APR_DRG Chemotherapy For Acute Leukemia 1 1 — — $355,439.70 $355,439.70 $355,439.70 2026-04-01
6953 APR_DRG Chemotherapy For Acute Leukemia 1 1 — — $55,325.53 $55,325.53 $55,325.53 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 1 1 — — $54,876.05 $54,876.05 $54,876.05 2026-04-01
2633 APR_DRG Cholecystectomy 1 1 — — $36,220.80 $36,220.80 $36,220.80 2026-04-01
2623 APR_DRG Cholecystectomy Except Laparoscopic 1 1 — — $58,587.33 $58,587.33 $58,587.33 2026-04-01
6613 APR_DRG Coagulation And Platelet Disorders 1 1 — — $44,382.97 $44,382.97 $44,382.97 2026-04-01
813 MS_DRG Coagulation Disorders 1 1 — — $33,018.42 $33,018.42 $33,018.42 2026-04-01
3464 APR_DRG Connective Tissue Disorders 1 1 — — $139,323.49 $139,323.49 $139,323.49 2026-04-01
3463 APR_DRG Connective Tissue Disorders 1 1 — — $37,736.19 $37,736.19 $37,736.19 2026-04-01
546 MS_DRG Connective Tissue Disorders With Cc 1 1 — — $82,938.01 $82,938.01 $82,938.01 2026-04-01
545 MS_DRG Connective Tissue Disorders With Mcc 1 1 — — $54,298.02 $54,298.02 $54,298.02 2026-04-01
3843 APR_DRG Contusion Open Wound And Other Trauma To Skin And Subcutaneous Tissue 1 1 — — $323,307.95 $323,307.95 $323,307.95 2026-04-01
J0802 HCPCS Corticotropin 80 Unit/ml Injection Gel 472 23 $212,467.72 $212,467.72 $9.68 $201,844.33 $159,350.79 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 1 1 — — $320,152.38 $320,152.38 $320,152.38 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 1 1 — — $124,659.85 $124,659.85 $124,659.85 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc-mcc 1 1 — — $182,740.43 $182,740.43 $182,740.43 2026-04-01
214 APR_DRG Craniotomy Except For Trauma 1 1 — — $177,339.14 $177,339.14 $177,339.14 2026-04-01
213 APR_DRG Craniotomy Except For Trauma 1 1 — — $98,303.81 $98,303.81 $98,303.81 2026-04-01
212 APR_DRG Craniotomy Except For Trauma 1 1 — — $60,753.70 $60,753.70 $60,753.70 2026-04-01
211 APR_DRG Craniotomy Except For Trauma 1 1 — — $42,982.81 $42,982.81 $42,982.81 2026-04-01
202 APR_DRG Craniotomy For Trauma 1 1 — — $51,181.79 $51,181.79 $51,181.79 2026-04-01
J9153 HCPCS Daunorubicin 44 Mg And Cytarabine 100 Mg In Liposome IV Solution 472 23 $52,032.03 $52,032.03 $9.68 $49,430.42 $39,024.02 2026-04-01
J1413 HCPCS Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 29 14 — — $99,999.99 $4,962,756.96 $3,848,016.25 2026-04-01
4204 APR_DRG Diabetes 1 1 — — $57,640.22 $57,640.22 $57,640.22 2026-04-01
2403 APR_DRG Digestive Malignancy 1 1 — — $35,067.07 $35,067.07 $35,067.07 2026-04-01
J9999 HCPCS Dinutuximab 3.5 Mg/ml Intravenous Solution 476 24 $92,023.32 $92,023.32 $9.68 $87,422.15 $69,017.49 2026-04-01
3043 APR_DRG Dorsal And Lumbar Fusion Proc Except For Curvature Of Back 1 1 — — $115,716.63 $115,716.63 $115,716.63 2026-04-01
3041 APR_DRG Dorsal And Lumbar Fusion Proc Except For Curvature Of Back 1 1 — — $69,579.01 $69,579.01 $69,579.01 2026-04-01
3034 APR_DRG Dorsal And Lumbar Fusion Proc For Curvature Of Back 1 1 — — $247,228.89 $247,228.89 $247,228.89 2026-04-01
3033 APR_DRG Dorsal And Lumbar Fusion Proc For Curvature Of Back 1 1 — — $158,578.68 $158,578.68 $158,578.68 2026-04-01
3032 APR_DRG Dorsal And Lumbar Fusion Proc For Curvature Of Back 1 1 — — $120,009.66 $120,009.66 $120,009.66 2026-04-01
3031 APR_DRG Dorsal And Lumbar Fusion Proc For Curvature Of Back 1 1 — — $100,298.52 $100,298.52 $100,298.52 2026-04-01
1103 APR_DRG Ear Nose Mouth Throat Cranial-facial Malignancies 1 1 — — $210,457.57 $210,457.57 $210,457.57 2026-04-01
7593 APR_DRG Eating Disorders 1 1 — — $37,353.80 $37,353.80 $37,353.80 2026-04-01
J1305 HCPCS Evinacumab-dgnb 150 Mg/ml Intravenous Solution 472 23 $60,943.57 $60,943.57 $9.68 $57,896.39 $45,707.68 2026-04-01
J3392 HCPCS Exagamglogene Autotemcel 4 X 10exp6 To 13 X 10exp6 Cell/ml IV Susp 47 24 $4,070,025.00 $4,070,025.00 $99,999.99 $3,866,523.75 $2,930,418.00 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 1 1 — — $388,880.51 $388,880.51 $388,880.51 2026-04-01
9503 APR_DRG Extensive Procedure Unrelated To Principal Diagnosis 1 1 — — $90,644.92 $90,644.92 $90,644.92 2026-04-01
9502 APR_DRG Extensive Procedure Unrelated To Principal Diagnosis 1 1 — — $48,994.19 $48,994.19 $48,994.19 2026-04-01
244 APR_DRG Extracranial Vascular Procedures 1 1 — — $154,167.16 $154,167.16 $154,167.16 2026-04-01
243 APR_DRG Extracranial Vascular Procedures 1 1 — — $83,743.98 $83,743.98 $83,743.98 2026-04-01
242 APR_DRG Extracranial Vascular Procedures 1 1 — — $71,801.51 $71,801.51 $71,801.51 2026-04-01
823 APR_DRG Eye Infections And Other Eye Disorders 1 1 — — $94,233.62 $94,233.62 $94,233.62 2026-04-01
J7169 HCPCS Factor Xa,inactivated-zhzo (recombinant) 200 Mg Intravenous Solution (andexxa) 472 23 $47,359.00 $47,359.00 $9.68 $44,991.05 $35,519.25 2026-04-01
J7180 HCPCS Factor Xiii 1,000 Unit-1,600 Unit Intravenous Solution (corifact) 472 23 $64,897.55 $64,897.55 $9.68 $61,652.67 $48,673.16 2026-04-01
3143 APR_DRG Foot And Toe Procedures 1 1 — — $50,006.66 $50,006.66 $50,006.66 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 1 1 — — $232,824.76 $232,824.76 $232,824.76 2026-04-01
J9203 HCPCS Gemtuzumab Ozogamicin 4.5 Mg/4.5ml IV (wet Vial) 472 23 $49,270.14 $49,270.14 $9.68 $46,806.63 $36,952.60 2026-04-01
C1767 HCPCS Generator Neuro Non-recharg 476 24 $65,884.06 $65,884.06 $4,230.50 $62,589.86 $49,413.05 2026-04-01
C1820 HCPCS Generator Neuro Rechg Bat Sy 476 24 $98,460.94 $98,460.94 $4,230.50 $93,537.89 $73,845.70 2026-04-01
C9293 HCPCS Glucarpidase 1,000 Unit Intravenous Solution 472 23 $208,840.39 $208,840.39 $9.68 $198,398.37 $156,630.29 2026-04-01
3162 APR_DRG Hand And Wrist Procedures 1 1 — — $225,537.11 $225,537.11 $225,537.11 2026-04-01
33620 CPT Hc Application Of Right And Left Pulmonary Artery Bands 47 24 $50,402.00 $50,402.00 $5,956.05 $47,881.90 $36,289.44 2026-04-01
L8614 HCPCS Hc Bundle - Cochlear America Implant & Sound Processor 1,405 24 $90,106.00 $90,106.00 $4,230.50 $104,115.25 $62,778.89 2026-04-01
38230 CPT Hc Bwh Bone Marrow Harvest Transplantation Allogenic 47 24 $57,522.00 $57,522.00 $1,209.78 $54,645.90 $38,867.62 2026-04-01
0483T CPT Hc Cath Tmvi W/prosthetic Valve Percutaneous Approach 47 24 $47,722.00 $47,722.00 $1,209.78 $45,335.90 $32,245.76 2026-04-01
93656 CPT Hc Comprehensive Ep Eval Ablate Atr Fib Pulm Vein Isolation 48 25 $50,124.00 $50,124.00 $2,194.03 $47,617.80 $36,089.28 2026-04-01
0569T CPT Hc Transcatheter Tricuspid Valve Repair Initial Prothesis 47 24 $46,993.00 $46,993.00 $2,194.03 $44,643.35 $33,834.96 2026-04-01
0646T CPT Hc Ttvi/replace With Prstc Valve Perq With R Hrt Cath & Angrph 47 24 $46,993.00 $46,993.00 $5,956.05 $44,643.35 $33,834.96 2026-04-01
2793 APR_DRG Hepatic Coma And Other Major Acute Liver Disorders 1 1 — — $47,903.33 $47,903.33 $47,903.33 2026-04-01
3083 APR_DRG Hip And Femur Fracture Repair 1 1 — — $62,308.17 $62,308.17 $62,308.17 2026-04-01
3082 APR_DRG Hip And Femur Fracture Repair 1 1 — — $37,894.54 $37,894.54 $37,894.54 2026-04-01
J9226 HCPCS Histrelin 50 Mg (65 Mcg/day) Implant Kit 489 24 $242,402.23 $242,402.23 $9.68 $230,282.11 $181,801.67 2026-04-01
1994 APR_DRG Hypertension 1 1 — — $55,740.82 $55,740.82 $55,740.82 2026-04-01
4224 APR_DRG Hypovolemia And Related Electrolyte Disorders 1 1 — — $230,414.73 $230,414.73 $230,414.73 2026-04-01
4234 APR_DRG Inborn Errors Of Metabolism 1 1 — — $883,279.92 $883,279.92 $883,279.92 2026-04-01
4231 APR_DRG Inborn Errors Of Metabolism 1 1 — — $194,274.85 $194,274.85 $194,274.85 2026-04-01
4233 APR_DRG Inborn Errors Of Metabolism 1 1 — — $36,304.26 $36,304.26 $36,304.26 2026-04-01
7104 APR_DRG Infectious And Parasitic Diseases Including HIV W O.r. Procedure 1 1 — — $157,166.03 $157,166.03 $157,166.03 2026-04-01
7103 APR_DRG Infectious And Parasitic Diseases Including HIV W O.r. Procedure 1 1 — — $67,824.30 $67,824.30 $67,824.30 2026-04-01
7102 APR_DRG Infectious And Parasitic Diseases Including HIV W O.r. Procedure 1 1 — — $37,808.81 $37,808.81 $37,808.81 2026-04-01
2454 APR_DRG Inflammatory Bowel Disease 1 1 — — $94,904.01 $94,904.01 $94,904.01 2026-04-01
C1772 HCPCS Infusion Pump Programmable 476 24 $43,354.80 $43,354.80 $4,230.50 $41,187.06 $32,516.10 2026-04-01
2283 APR_DRG Inguinal Femoral And Umbilical Hernia Procedures 1 1 — — $50,276.92 $50,276.92 $50,276.92 2026-04-01
J9229 HCPCS Inotuzumab Ozogamicin 0.9 Mg/3.6ml IV (wet Vial) 472 23 $115,539.04 $115,539.04 $9.68 $109,762.09 $86,654.28 2026-04-01
1424 APR_DRG Interstitial And Alveolar Lung Diseases 1 1 — — $51,616.64 $51,616.64 $51,616.64 2026-04-01
2474 APR_DRG Intestinal Obstruction 1 1 — — $173,989.50 $173,989.50 $173,989.50 2026-04-01
443 APR_DRG Intracranial Hemorrhage 1 1 — — $48,007.04 $48,007.04 $48,007.04 2026-04-01
442 APR_DRG Intracranial Hemorrhage 1 1 — — $33,202.13 $33,202.13 $33,202.13 2026-04-01
J9228 HCPCS Ipilimumab 50 Mg/10 Ml (5 Mg/ml) Intravenous Solution 930 23 $43,759.39 $43,759.39 $9.68 $166,214.08 $41,571.43 2026-04-01
4634 APR_DRG Kidney And Urinary Tract Infections 1 1 — — $49,493.43 $49,493.43 $49,493.43 2026-04-01
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 1 1 — — $73,755.07 $73,755.07 $73,755.07 2026-04-01
4423 APR_DRG Kidney And Urinary Tract Procedures For Malignancy 1 1 — — $166,414.51 $166,414.51 $166,414.51 2026-04-01
3133 APR_DRG Knee And Lower Leg Procedures Except Foot 1 1 — — $98,286.48 $98,286.48 $98,286.48 2026-04-01
3132 APR_DRG Knee And Lower Leg Procedures Except Foot 1 1 — — $39,839.83 $39,839.83 $39,839.83 2026-04-01
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 1 1 — — $45,739.93 $45,739.93 $45,739.93 2026-04-01
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 1 1 — — $138,927.59 $138,927.59 $138,927.59 2026-04-01
14 APR_DRG Liver Transplant And-or Intestinal Transplant 1 1 — — $458,953.43 $458,953.43 $458,953.43 2026-04-01
13 APR_DRG Liver Transplant And-or Intestinal Transplant 1 1 — — $439,192.62 $439,192.62 $439,192.62 2026-04-01
J9359 HCPCS Loncastuximab Tesirine-lpyl 10 Mg/2 Ml IV (wet Solr Vial) 472 23 $136,818.96 $136,818.96 $9.68 $129,978.01 $102,614.22 2026-04-01
J3394 HCPCS Lovotibeglogene Autotemcel 1.7 X 10exp6 To 20 X 10exp6 Cell/ml IV Susp 35 18 — — $99,999.99 $4,874,771.25 $3,786,263.51 2026-04-01
494 MS_DRG Lower Extremity And Humerus Procedures Except Hip Foot And Femur Without Cc-mcc 1 1 — — $40,513.47 $40,513.47 $40,513.47 2026-04-01
J0224 HCPCS Lumasiran 94.5 Mg/0.5 Ml Subcutaneous Solution 472 23 $281,850.67 $281,850.67 $9.68 $267,758.14 $211,388.00 2026-04-01
6944 APR_DRG Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior 1 1 — — $76,734.11 $76,734.11 $76,734.11 2026-04-01
822 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures Without Cc-mcc 1 1 — — $73,543.29 $73,543.29 $73,543.29 2026-04-01
6913 APR_DRG Lymphoma Myeloma And Non-acute Leukemia 1 1 — — $147,211.77 $147,211.77 $147,211.77 2026-04-01
6914 APR_DRG Lymphoma Myeloma And Non-acute Leukemia 1 1 — — $143,710.23 $143,710.23 $143,710.23 2026-04-01
4413 APR_DRG Major Bladder Procedures 1 1 — — $71,430.76 $71,430.76 $71,430.76 2026-04-01
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 1 1 — — $108,474.81 $108,474.81 $108,474.81 2026-04-01
1602 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 1 1 — — $68,254.48 $68,254.48 $68,254.48 2026-04-01
892 APR_DRG Major Cranial-facial Bone Procedures 1 1 — — $98,133.60 $98,133.60 $98,133.60 2026-04-01
2484 APR_DRG Major Gastrointestinal And Peritoneal Infections 1 1 — — $234,162.84 $234,162.84 $234,162.84 2026-04-01
2483 APR_DRG Major Gastrointestinal And Peritoneal Infections 1 1 — — $36,797.43 $36,797.43 $36,797.43 2026-04-01
142 MS_DRG Major Head And Neck Procedures Without Cc-mcc 1 1 — — $33,421.56 $33,421.56 $33,421.56 2026-04-01
6604 APR_DRG Major Hematologic-immunologic Diag Exc Sickle Cell Crisis And Coagul 1 1 — — $112,965.75 $112,965.75 $112,965.75 2026-04-01
6603 APR_DRG Major Hematologic-immunologic Diag Exc Sickle Cell Crisis And Coagul 1 1 — — $34,882.45 $34,882.45 $34,882.45 2026-04-01
904 APR_DRG Major Larynx And Trachea Procedures 1 1 — — $247,866.35 $247,866.35 $247,866.35 2026-04-01
903 APR_DRG Major Larynx And Trachea Procedures 1 1 — — $133,852.51 $133,852.51 $133,852.51 2026-04-01
902 APR_DRG Major Larynx And Trachea Procedures 2 1 — — $51,560.77 $51,560.77 $51,560.77 2026-04-01
6804 APR_DRG Major O.r. Procedures For Lymphatic-hematopoietic-other Neoplasms 1 1 — — $551,207.90 $551,207.90 $551,207.90 2026-04-01
1202 APR_DRG Major Respiratory And Chest Procedures 1 1 — — $46,671.20 $46,671.20 $46,671.20 2026-04-01
1201 APR_DRG Major Respiratory And Chest Procedures 1 1 — — $39,320.16 $39,320.16 $39,320.16 2026-04-01
1374 APR_DRG Major Respiratory Infections And Inflammations 1 1 — — $74,270.12 $74,270.12 $74,270.12 2026-04-01
1373 APR_DRG Major Respiratory Infections And Inflammations 1 1 — — $38,051.62 $38,051.62 $38,051.62 2026-04-01
2214 APR_DRG Major Small And Large Bowel Procedures 1 1 — — $149,962.15 $149,962.15 $149,962.15 2026-04-01
2213 APR_DRG Major Small And Large Bowel Procedures 1 1 — — $70,380.07 $70,380.07 $70,380.07 2026-04-01
2212 APR_DRG Major Small And Large Bowel Procedures 1 1 — — $42,724.11 $42,724.11 $42,724.11 2026-04-01
2211 APR_DRG Major Small And Large Bowel Procedures 1 1 — — $33,735.41 $33,735.41 $33,735.41 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 1 1 — — $98,769.59 $98,769.59 $98,769.59 2026-04-01
2204 APR_DRG Major Stomach Esophageal And Duodenal Procedures 1 1 — — $1,152,840.39 $1,152,840.39 $1,152,840.39 2026-04-01
2203 APR_DRG Major Stomach Esophageal And Duodenal Procedures 1 1 — — $77,219.74 $77,219.74 $77,219.74 2026-04-01
2522 APR_DRG Malfunction Reaction And Complication Of Gi Device Or Procedure 1 1 — — $70,874.76 $70,874.76 $70,874.76 2026-04-01
2524 APR_DRG Malfunction Reaction And Complication Of Gi Device Or Procedure 1 1 — — $64,316.50 $64,316.50 $64,316.50 2026-04-01
4214 APR_DRG Malnutrition Failure To Thrive And Other Nutritional Disorders 1 1 — — $77,081.95 $77,081.95 $77,081.95 2026-04-01
4213 APR_DRG Malnutrition Failure To Thrive And Other Nutritional Disorders 1 1 — — $31,488.81 $31,488.81 $31,488.81 2026-04-01
7402 APR_DRG Mental Illness Diagnosis W O.r. Procedure 1 1 — — $68,669.02 $68,669.02 $68,669.02 2026-04-01
7401 APR_DRG Mental Illness Diagnosis W O.r. Procedure 1 1 — — $68,669.02 $68,669.02 $68,669.02 2026-04-01
345 MS_DRG Minor Small And Large Bowel Procedures With Cc 1 1 — — $94,846.61 $94,846.61 $94,846.61 2026-04-01
J2267 HCPCS Mirikizumab-mrkz 300 Mg/15 Ml (20 Mg/ml) Intravenous Solution 472 23 $46,360.25 $46,360.25 $9.68 $44,042.24 $34,770.19 2026-04-01
9514 APR_DRG Moderately Extensive Procedure Unrelated To Principal Diagnosis 1 1 — — $170,024.52 $170,024.52 $170,024.52 2026-04-01
9513 APR_DRG Moderately Extensive Procedure Unrelated To Principal Diagnosis 1 1 — — $61,538.88 $61,538.88 $61,538.88 2026-04-01
9512 APR_DRG Moderately Extensive Procedure Unrelated To Principal Diagnosis 1 1 — — $31,541.15 $31,541.15 $31,541.15 2026-04-01
9123 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 1 1 — — $89,308.30 $89,308.30 $89,308.30 2026-04-01
9122 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 1 1 — — $52,694.68 $52,694.68 $52,694.68 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 1 1 — — $66,264.69 $66,264.69 $66,264.69 2026-04-01
J2323 HCPCS Natalizumab 300 Mg/15 Ml Intravenous Solution 472 23 $42,911.63 $42,911.63 $9.68 $40,766.05 $32,183.72 2026-04-01
6363 APR_DRG Neonate Birthwt Greater Than 2499g W Congenital-perinatal Infection 1 1 — — $48,439.95 $48,439.95 $48,439.95 2026-04-01
6334 APR_DRG Neonate Birthwt Greater Than 2499g W Major Anomaly 1 1 — — $215,076.60 $215,076.60 $215,076.60 2026-04-01
6333 APR_DRG Neonate Birthwt Greater Than 2499g W Major Anomaly 1 1 — — $45,726.22 $45,726.22 $45,726.22 2026-04-01
6304 APR_DRG Neonate Birthwt Greater Than 2499g W Major Cardiovascular Procedure 2 1 — — $277,524.04 $277,524.04 $277,524.04 2026-04-01
6302 APR_DRG Neonate Birthwt Greater Than 2499g W Major Cardiovascular Procedure 1 1 — — $78,674.16 $78,674.16 $78,674.16 2026-04-01
6314 APR_DRG Neonate Birthwt Greater Than 2499g W Other Major Procedure 1 1 — — $228,840.17 $228,840.17 $228,840.17 2026-04-01
6394 APR_DRG Neonate Birthwt Greater Than 2499g W Other Significant Condition 1 1 — — $92,425.51 $92,425.51 $92,425.51 2026-04-01
6393 APR_DRG Neonate Birthwt Greater Than 2499g W Other Significant Condition 1 1 — — $51,173.25 $51,173.25 $51,173.25 2026-04-01
6344 APR_DRG Neonate Birthwt Greater Than 2499g W Resp Dist Synd-oth Maj Resp Cond 1 1 — — $185,328.20 $185,328.20 $185,328.20 2026-04-01
6342 APR_DRG Neonate Birthwt Greater Than 2499g W Resp Dist Synd-oth Maj Resp Cond 1 1 — — $124,431.79 $124,431.79 $124,431.79 2026-04-01
6343 APR_DRG Neonate Birthwt Greater Than 2499g W Resp Dist Synd-oth Maj Resp Cond 1 1 — — $77,595.30 $77,595.30 $77,595.30 2026-04-01
6123 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd-oth Maj Resp Cond 1 1 — — $143,941.70 $143,941.70 $143,941.70 2026-04-01
6093 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 1 1 — — $165,595.85 $165,595.85 $165,595.85 2026-04-01
6214 APR_DRG Neonate Bwt 2000-2499g W Major Anomaly 1 1 — — $825,458.20 $825,458.20 $825,458.20 2026-04-01
6213 APR_DRG Neonate Bwt 2000-2499g W Major Anomaly 1 1 — — $90,279.56 $90,279.56 $90,279.56 2026-04-01
5884 APR_DRG Neonate Bwt Less Than 1500g W Major Procedure 1 1 — — $827,273.56 $827,273.56 $827,273.56 2026-04-01
794 MS_DRG Neonate With Other Significant Problems 1 1 — — $31,720.58 $31,720.58 $31,720.58 2026-04-01
4624 APR_DRG Nephritis And Nephrosis 1 1 — — $91,182.74 $91,182.74 $91,182.74 2026-04-01
J9298 HCPCS Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution 472 23 $74,513.16 $74,513.16 $9.68 $70,787.51 $55,884.87 2026-04-01
99 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis Without Cc-mcc 1 1 — — $78,750.36 $78,750.36 $78,750.36 2026-04-01
502 APR_DRG Non-bacterial Infections Of Nervous System Exc Viral Meningitis 1 1 — — $38,330.90 $38,330.90 $38,330.90 2026-04-01
J2326 HCPCS Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution 42 23 $269,896.88 $269,896.88 $9.68 $256,402.03 $200,978.71 2026-04-01
7912 APR_DRG O.r. Procedure For Other Complications Of Treatment 1 1 — — $129,195.80 $129,195.80 $129,195.80 2026-04-01
J9301 HCPCS Obinutuzumab 1,000 Mg/40 Ml Intravenous Solution 472 23 $43,496.35 $43,496.35 $9.68 $41,321.54 $32,622.26 2026-04-01
J2350 HCPCS Ocrelizumab 30 Mg/ml Intravenous Solution 472 23 $99,720.84 $99,720.84 $9.68 $94,734.80 $74,790.63 2026-04-01
J3399 HCPCS Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 50 24 $4,179,704.85 $4,179,704.85 $99,999.99 $3,970,719.61 $3,009,387.50 2026-04-01
3443 APR_DRG Osteomyelitis Septic Arthritis And Other Musculoskeletal Infections 1 1 — — $39,559.07 $39,559.07 $39,559.07 2026-04-01
6634 APR_DRG Other Anemia And Disorders Of Blood And Blood-forming Organs 1 1 — — $310,354.94 $310,354.94 $310,354.94 2026-04-01
4452 APR_DRG Other Bladder Procedures 1 1 — — $50,049.41 $50,049.41 $50,049.41 2026-04-01
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 1 1 — — $2,026,021.75 $2,026,021.75 $2,026,021.75 2026-04-01
1673 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 1 1 — — $89,170.48 $89,170.48 $89,170.48 2026-04-01
1671 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 1 1 — — $82,904.49 $82,904.49 $82,904.49 2026-04-01
1672 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 1 1 — — $71,201.21 $71,201.21 $71,201.21 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 1 1 — — $262,510.82 $262,510.82 $262,510.82 2026-04-01
6964 APR_DRG Other Chemotherapy 1 1 — — $171,384.68 $171,384.68 $171,384.68 2026-04-01
6963 APR_DRG Other Chemotherapy 1 1 — — $34,379.90 $34,379.90 $34,379.90 2026-04-01
2074 APR_DRG Other Circulatory System Diagnoses 1 1 — — $57,345.21 $57,345.21 $57,345.21 2026-04-01
2072 APR_DRG Other Circulatory System Diagnoses 1 1 — — $34,857.46 $34,857.46 $34,857.46 2026-04-01
8133 APR_DRG Other Complications Of Treatment 1 1 — — $346,124.63 $346,124.63 $346,124.63 2026-04-01
8134 APR_DRG Other Complications Of Treatment 1 1 — — $62,397.04 $62,397.04 $62,397.04 2026-04-01
2294 APR_DRG Other Digestive System And Abdominal Procedures 1 1 — — $131,319.85 $131,319.85 $131,319.85 2026-04-01
2544 APR_DRG Other Digestive System Diagnoses 1 1 — — $59,185.61 $59,185.61 $59,185.61 2026-04-01
984 APR_DRG Other Ear Nose Mouth And Throat Procedures 1 1 — — $94,436.92 $94,436.92 $94,436.92 2026-04-01
983 APR_DRG Other Ear Nose Mouth And Throat Procedures 1 1 — — $42,283.87 $42,283.87 $42,283.87 2026-04-01
1154 APR_DRG Other Ear Nose Mouththroat And Cranial-facial Diagnoses 1 1 — — $59,496.51 $59,496.51 $59,496.51 2026-04-01
4244 APR_DRG Other Endocrine Disorders 1 1 — — $63,156.89 $63,156.89 $63,156.89 2026-04-01
4241 APR_DRG Other Endocrine Disorders 1 1 — — $35,339.47 $35,339.47 $35,339.47 2026-04-01
2434 APR_DRG Other Esophageal Disorders 1 1 — — $52,164.40 $52,164.40 $52,164.40 2026-04-01
2494 APR_DRG Other Gastroenteritis Nausea And Vomiting 1 1 — — $45,901.13 $45,901.13 $45,901.13 2026-04-01
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 1 1 — — $439,200.22 $439,200.22 $439,200.22 2026-04-01
8153 APR_DRG Other Injury Poisoning And Toxic Effect Diagnoses 1 1 — — $36,252.75 $36,252.75 $36,252.75 2026-04-01
700 MS_DRG Other Kidney And Urinary Tract Diagnoses Without Cc-mcc 1 1 — — $37,226.21 $37,226.21 $37,226.21 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 1 1 — — $73,738.26 $73,738.26 $73,738.26 2026-04-01
912 APR_DRG Other Major Head And Neck Procedures 1 1 — — $118,778.93 $118,778.93 $118,778.93 2026-04-01
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 1 1 — — $42,952.40 $42,952.40 $42,952.40 2026-04-01
517 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures Without Cc-mc… 1 1 — — $31,800.13 $31,800.13 $31,800.13 2026-04-01
3203 APR_DRG Other Musculoskeletal System And Connective Tissue Procedures 1 1 — — $57,070.63 $57,070.63 $57,070.63 2026-04-01
3202 APR_DRG Other Musculoskeletal System And Connective Tissue Procedures 1 1 — — $36,939.67 $36,939.67 $36,939.67 2026-04-01
4254 APR_DRG Other Non-hypovolemic Electrolyte Disorders 1 1 — — $56,528.26 $56,528.26 $56,528.26 2026-04-01
6814 APR_DRG Other O.r. Procedures For Lymphatic-hematopoietic-other Neoplasms 1 1 — — $407,166.88 $407,166.88 $407,166.88 2026-04-01
6812 APR_DRG Other O.r. Procedures For Lymphatic-hematopoietic-other Neoplasms 1 1 — — $35,979.75 $35,979.75 $35,979.75 2026-04-01
803 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Cc 1 1 — — $38,248.64 $38,248.64 $38,248.64 2026-04-01
1824 APR_DRG Other Peripheral Vascular Procedures 1 1 — — $1,356,010.94 $1,356,010.94 $1,356,010.94 2026-04-01
1823 APR_DRG Other Peripheral Vascular Procedures 1 1 — — $73,162.23 $73,162.23 $73,162.23 2026-04-01
1822 APR_DRG Other Peripheral Vascular Procedures 1 1 — — $48,063.77 $48,063.77 $48,063.77 2026-04-01
1821 APR_DRG Other Peripheral Vascular Procedures 1 1 — — $45,607.69 $45,607.69 $45,607.69 2026-04-01
1394 APR_DRG Other Pneumonia 1 1 — — $49,239.27 $49,239.27 $49,239.27 2026-04-01
1212 APR_DRG Other Respiratory And Chest Procedures 1 1 — — $36,614.32 $36,614.32 $36,614.32 2026-04-01
1434 APR_DRG Other Respiratory Diagnoses Except Signs Symptoms And Minor Diagnoses 1 1 — — $46,695.39 $46,695.39 $46,695.39 2026-04-01
168 MS_DRG Other Respiratory System O.r. Procedures Without Cc-mcc 1 1 — — $34,177.74 $34,177.74 $34,177.74 2026-04-01
3094 APR_DRG Other Significant Hip And Femur Surgery 1 1 — — $521,494.20 $521,494.20 $521,494.20 2026-04-01
3093 APR_DRG Other Significant Hip And Femur Surgery 1 1 — — $59,770.45 $59,770.45 $59,770.45 2026-04-01
3092 APR_DRG Other Significant Hip And Femur Surgery 1 1 — — $42,544.84 $42,544.84 $42,544.84 2026-04-01
2233 APR_DRG Other Small And Large Bowel Procedures 1 1 — — $92,569.70 $92,569.70 $92,569.70 2026-04-01
2231 APR_DRG Other Small And Large Bowel Procedures 1 1 — — $37,599.29 $37,599.29 $37,599.29 2026-04-01
2232 APR_DRG Other Small And Large Bowel Procedures 1 1 — — $35,732.40 $35,732.40 $35,732.40 2026-04-01
2223 APR_DRG Other Stomach Esophageal And Duodenal Procedures 1 1 — — $90,899.88 $90,899.88 $90,899.88 2026-04-01
2224 APR_DRG Other Stomach Esophageal And Duodenal Procedures 1 1 — — $84,364.25 $84,364.25 $84,364.25 2026-04-01
J9266 HCPCS Pegaspargase 750 Unit/ml Injection Solution 489 24 $123,374.70 $123,374.70 $9.68 $117,205.97 $92,531.03 2026-04-01
4813 APR_DRG Penis Procedures 1 1 — — $44,355.74 $44,355.74 $44,355.74 2026-04-01
4832 APR_DRG Penis Testes And Scrotal Procedures 1 1 — — $87,209.19 $87,209.19 $87,209.19 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 1 1 — — $124,109.59 $124,109.59 $124,109.59 2026-04-01
1751 APR_DRG Percutaneous Coronary Intervention W-o Ami 1 1 — — $77,250.80 $77,250.80 $77,250.80 2026-04-01
1753 APR_DRG Percutaneous Coronary Intervention W-o Ami 1 1 — — $64,199.94 $64,199.94 $64,199.94 2026-04-01
1752 APR_DRG Percutaneous Coronary Intervention W-o Ami 1 1 — — $37,990.35 $37,990.35 $37,990.35 2026-04-01
1974 APR_DRG Peripheral And Other Vascular Disorders 1 1 — — $64,990.48 $64,990.48 $64,990.48 2026-04-01
40 MS_DRG Peripheral Cranial Nerve And Other Nervous System Procedures With Mcc 1 1 — — $231,115.50 $231,115.50 $231,115.50 2026-04-01
1711 APR_DRG Perm Cardiac Pacemaker Implant W-o Ami Heart Failure Or Shock 1 1 — — $49,553.80 $49,553.80 $49,553.80 2026-04-01
1712 APR_DRG Perm Cardiac Pacemaker Implant W-o Ami Heart Failure Or Shock 1 1 — — $48,757.60 $48,757.60 $48,757.60 2026-04-01
917 MS_DRG Poisoning And Toxic Effects Of Drugs With Mcc 1 1 — — $35,233.87 $35,233.87 $35,233.87 2026-04-01
7114 APR_DRG Post-op Post-trauma Other Device Infections W O.r. Procedure 1 1 — — $136,972.68 $136,972.68 $136,972.68 2026-04-01
7112 APR_DRG Post-op Post-trauma Other Device Infections W O.r. Procedure 1 1 — — $100,771.69 $100,771.69 $100,771.69 2026-04-01
7113 APR_DRG Post-op Post-trauma Other Device Infections W O.r. Procedure 1 1 — — $65,240.11 $65,240.11 $65,240.11 2026-04-01
7214 APR_DRG Post-operative Post-traumatic Other Device Infections 1 1 — — $72,496.13 $72,496.13 $72,496.13 2026-04-01
7213 APR_DRG Post-operative Post-traumatic Other Device Infections 1 1 — — $32,487.30 $32,487.30 $32,487.30 2026-04-01
1334 APR_DRG Respiratory Failure 1 1 — — $45,774.05 $45,774.05 $45,774.05 2026-04-01
1364 APR_DRG Respiratory Malignancy 1 1 — — $52,048.66 $52,048.66 $52,048.66 2026-04-01
1363 APR_DRG Respiratory Malignancy 1 1 — — $34,263.56 $34,263.56 $34,263.56 2026-04-01
1303 APR_DRG Respiratory System Diagnosis W Ventilator Support 96+ Hours 1 1 — — $336,608.11 $336,608.11 $336,608.11 2026-04-01
1304 APR_DRG Respiratory System Diagnosis W Ventilator Support 96+ Hours 1 1 — — $164,865.27 $164,865.27 $164,865.27 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support Greater Than 96 Hours 1 1 — — $260,886.63 $260,886.63 $260,886.63 2026-04-01
J2327 HCPCS Risankizumab-rzaa 60 Mg/ml Intravenous Solution 1,138 23 $104,083.05 $104,083.05 $9.68 $98,878.91 $62,449.83 2026-04-01
J2840 HCPCS Sebelipase Alfa 2 Mg/ml Intravenous Solution 472 23 $49,339.30 $49,339.30 $9.68 $46,872.34 $37,004.48 2026-04-01
534 APR_DRG Seizure 1 1 — — $60,746.89 $60,746.89 $60,746.89 2026-04-01
100 MS_DRG Seizures With Mcc 1 1 — — $59,322.76 $59,322.76 $59,322.76 2026-04-01
101 MS_DRG Seizures Without Mcc 1 1 — — $45,811.43 $45,811.43 $45,811.43 2026-04-01
7204 APR_DRG Septicemia And Disseminated Infections 1 1 — — $72,624.41 $72,624.41 $72,624.41 2026-04-01
7203 APR_DRG Septicemia And Disseminated Infections 1 1 — — $33,767.18 $33,767.18 $33,767.18 2026-04-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv Greater Than 96 Hours With Mcc 1 1 — — $62,700.51 $62,700.51 $62,700.51 2026-04-01
3153 APR_DRG Shoulder Upper Arm And Forearm Procedures Except Joint Replacement 1 1 — — $53,834.20 $53,834.20 $53,834.20 2026-04-01
6624 APR_DRG Sickle Cell Anemia Crisis 1 1 — — $75,166.02 $75,166.02 $75,166.02 2026-04-01
6623 APR_DRG Sickle Cell Anemia Crisis 1 1 — — $34,963.11 $34,963.11 $34,963.11 2026-04-01
934 APR_DRG Sinus And Mastoid Procedures 1 1 — — $97,474.10 $97,474.10 $97,474.10 2026-04-01
932 APR_DRG Sinus And Mastoid Procedures 1 1 — — $43,889.36 $43,889.36 $43,889.36 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature Malignancy Infection Or Exte… 1 1 — — $181,486.16 $181,486.16 $181,486.16 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature Malignancy Infection Or Exte… 1 1 — — $92,785.18 $92,785.18 $92,785.18 2026-04-01
233 APR_DRG Spinal Procedures 1 1 — — $97,498.21 $97,498.21 $97,498.21 2026-04-01
232 APR_DRG Spinal Procedures 1 1 — — $50,060.76 $50,060.76 $50,060.76 2026-04-01
231 APR_DRG Spinal Procedures 1 1 — — $37,239.21 $37,239.21 $37,239.21 2026-04-01
30 MS_DRG Spinal Procedures Without Cc-mcc 1 1 — — $47,819.39 $47,819.39 $47,819.39 2026-04-01
6502 APR_DRG Splenectomy 1 1 — — $45,031.99 $45,031.99 $45,031.99 2026-04-01
3174 APR_DRG Tendon Muscle And Other Soft Tissue Procedures 1 1 — — $143,374.37 $143,374.37 $143,374.37 2026-04-01
3172 APR_DRG Tendon Muscle And Other Soft Tissue Procedures 1 1 — — $32,562.19 $32,562.19 $32,562.19 2026-04-01
J9381 HCPCS Teplizumab-mzwv 1 Mg/ml Intravenous Solution 472 23 $68,940.74 $68,940.74 $9.68 $65,493.71 $51,705.56 2026-04-01
Q2042 HCPCS Tisagenlecleucel 0.2 X10exp6 To 2.5x10exp8 Cell Intravenous Suspension 47 24 $1,076,531.55 $1,076,531.55 $527,500.46 $1,022,704.97 $775,102.71 2026-04-01
973 APR_DRG Tonsil And Adenoid Procedures 1 1 — — $33,565.22 $33,565.22 $33,565.22 2026-04-01
44 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure 1 1 — — $3,439,097.36 $3,439,097.36 $3,439,097.36 2026-04-01
J3357 HCPCS Ustekinumab 90 Mg/ml Subcutaneous Syringe 1,388 23 $70,425.82 $70,425.82 $9.68 $128,769.21 $59,861.95 2026-04-01
J3380 HCPCS Vedolizumab 300 Mg/5ml IV (wet Solr Vial) 472 23 $45,233.37 $45,233.37 $9.68 $42,971.70 $33,925.02 2026-04-01
224 APR_DRG Ventricular Shunt Procedures 1 1 — — $321,916.82 $321,916.82 $321,916.82 2026-04-01
223 APR_DRG Ventricular Shunt Procedures 1 1 — — $60,635.70 $60,635.70 $60,635.70 2026-04-01
J3398 HCPCS Voretigene Neparvovec-rzyl 1.5x10exp11 Vg/0.3 Ml (final) Dilution 0.8 Ml Subreti… 47 24 $845,243.75 $845,243.75 $414,169.44 $802,981.56 $608,575.50 2026-04-01
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