Price Transparencybeta Hospital negotiated rates

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

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Hospital

Henry Ford Hospital

Detroit, MI · CCN 239801 · Rates published

22,211 distinct procedures filed
52 distinct payers
1,174,141 rate rows
2025-06-28 last MRF observed · ⚠ 14 mo old
Data quality

375,690 of 1,174,141 rate rows are consumer-grade (32.0%)

798,451 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
professional (physician) fee — not the facility price 534,061
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 259,782
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 3,808
template filing: same amount across many unrelated codes — excluded 330
placeholder amount (≤ $0.02) — excluded from medians 233
exceeds 10× this hospital's gross charge — excluded from medians 152
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 39
percent-of-charges filed in the dollar field — excluded from medians 31
per-diem day rate — not a per-procedure price 11
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 4

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 14 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.henryford.com/-/media/files/henry-ford/patients-visitors/price-transparency-2026/381357020-1134144801_henry-ford-health_standardcharges.csv
Found on page https://www.henryford.com/visitors/billing/cost-of-care/hospital-standard-charges
Discovered viaCMS hospital list
Last fetch not_modified · 2026-08-17
Content fingerprint a3ca9270b448f977… · 944,147,424 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
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 23 $1,988,560.00 $4,958,415.00 $3,672,900.00 nat. median
$3,710,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 23 $1,988,560.00 $4,866,750.00 $3,605,000.00 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 23 $1,780,474.89 $4,489,363.93 $3,325,454.76 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 23 $1,711,448.00 $4,436,100.00 $3,286,000.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 23 $1,590,848.00 $4,952,108.00 $2,968,000.00 nat. median
$2,997,086
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 23 $1,288,253.89 $4,106,790.87 $2,388,614.23 nat. median
$2,460,273
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 23 $1,249,952.00 $3,890,942.00 $2,332,000.00 nat. median
$2,405,851
1.0× median
C9081
HCPCS 		Idecabtagene Car Pos T 1 $839,922.90 $1,126,206.48 $983,064.69 nat. median
$27,427
outlier · 35.8×
C9098
HCPCS 		Ciltacabtagene Car Pos T 1 $822,403.65 $1,102,715.88 $962,559.76 nat. median
$30,221
outlier · 31.9×
C9076
HCPCS 		Lisocabtagene Car Pos T 1 $821,502.66 $1,101,507.79 $961,505.23 nat. median
$27,935
outlier · 34.4×
Q2057
HCPCS 		Afamitresgene Autoleucel 2 $717,286.16 $755,038.06 $736,162.11 nat. median
$809,151
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 25 $303,174.38 $1,496,217.90 $533,953.91 nat. median
$691,418
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 25 $295,506.63 $1,490,366.89 $527,123.43 nat. median
$631,793
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 25 $283,175.46 $1,488,851.88 $526,587.59 nat. median
$610,161
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 25 $276,836.48 $1,474,497.36 $516,726.08 nat. median
$624,417
0.8× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 25 $262,381.19 $1,383,867.44 $489,455.96 nat. median
$588,565
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 25 $261,595.61 $1,302,084.53 $460,530.40 nat. median
$577,541
0.8× median
C9073
HCPCS 		Brexucabtagene Autoleucel Ca 1 $413,145.63 $413,145.63 $413,145.63 nat. median
$27,071
outlier · 15.3×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 23 $164,440.13 $756,292.49 $288,468.31 nat. median
$370,165
0.8× median
C9301
HCPCS 		Obecabtagene Car Pos T 2 $258,992.60 $272,623.79 $265,808.20 nat. median
$459,112
0.6× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 25 $183,171.00 $759,422.92 $222,174.78 nat. median
$261,939
0.8× median
71336100301
NDC 		Vutrisiran 25 Mg/0.5 Ml Subcutaneous Syringe 16 $107,417.40 $308,646.00 $217,556.04 nat. median
$250,637
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 23 $172,721.78 $518,485.02 $181,812.40 nat. median
$205,166
0.9× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 23 $156,127.67 $582,844.00 $164,344.92 nat. median
$199,832
0.8× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 1 $98,726.40 $132,376.80 $115,551.60 nat. median
$97,404
1.2× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 23 $103,245.56 $283,363.02 $108,679.54 nat. median
$132,706
0.8× median
C9150
HCPCS 		Xe129 Xenon, Diagnostic 1 $91,967.72 $123,314.46 $107,641.09 nat. median
$925
outlier · 116.3×
L8702
HCPCS 		Ewhf S/d Uprt Micro Sensor 1 $91,222.80 $122,315.64 $106,769.22 nat. median
$70,178
1.5× median
7
MS_DRG 		Lung Transplant 24 $95,559.78 $297,307.98 $102,601.02 nat. median
$122,690
0.8× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 24 $95,798.78 $433,376.48 $101,849.23 nat. median
$114,305
0.9× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 25 $80,719.09 $314,275.00 $101,536.12 nat. median
$108,240
0.9× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 15 $53,599.97 $383,489.81 $99,999.95 nat. median
$111,503
0.9× median
90288
HCPCS 		Botulism Ig IV 2 $48,705.00 $129,068.25 $88,886.62 nat. median
$52,716
1.7× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 23 $79,807.98 $294,401.49 $84,008.40 nat. median
$100,978
0.8× median
75987015003
NDC 		Inebilizumab-cdon 10 Mg/ml Intravenous Solution 16 $41,143.59 $118,219.24 $83,329.48 nat. median
$86,701
1.0× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 23 $78,037.18 $463,710.00 $82,965.85 nat. median
$99,646
0.8× median
215
MS_DRG 		Other Heart Assist System Implant 23 $77,641.73 $232,530.85 $81,728.14 nat. median
$98,002
0.8× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 22 $16,610.31 $210,073.67 $80,817.87 nat. median
$96,835
0.8× median
G0448
HCPCS 		Place Perm Pacing Cardiovert 2 $66,579.75 $90,460.47 $78,520.11 nat. median
$8,162
outlier · 9.6×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 23 $70,806.95 $254,290.63 $74,533.63 nat. median
$92,900
0.8× median
00310453530
NDC 		Tremelimumab-actl 20 Mg/ml Intravenous Solution 16 $35,817.00 $102,914.18 $72,541.36 nat. median
$41,769
1.7× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 25 $58,322.27 $266,985.00 $71,603.49 nat. median
$69,153
1.0× median
850
MS_DRG 		Acute Leukemia With Other Procedures 22 $67,626.04 $200,730.97 $71,185.30 nat. median
$81,364
0.9× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 6 $52,266.92 $154,331.76 $71,013.94 nat. median
$75,807
0.9× median
K0743
HCPCS 		Portable Home Suction Pump 2 $56,177.10 $80,532.90 $68,355.00 nat. median
$795
outlier · 86.0×
61755000501
NDC 		Aflibercept 2 Mg/0.05 Ml Intravitreal Syringe 16 $33,322.50 $95,746.65 $67,489.17 nat. median
$3,885
outlier · 17.4×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 23 $48,458.40 $192,640.00 $65,558.99 nat. median
$79,040
0.8× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 23 $58,017.89 $169,841.34 $65,523.15 nat. median
$80,459
0.8× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 22 $61,315.60 $176,303.13 $64,542.74 nat. median
$81,124
0.8× median
10
MS_DRG 		Pancreas Transplant 25 $48,158.30 $240,875.05 $63,592.47 nat. median
$67,750
0.9× median

Other procedures at this hospital

Browse this hospital's 22,211 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
             
00003232822 NDC Ipilimumab 200 Mg/40 Ml (5 Mg/ml) Intravenous Solution 19 16 $104,487.44 — $31,346.23 $90,068.17 $63,486.57 2025-06-28
00003712511 NDC Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solutio 19 16 $44,519.36 — $13,355.81 $38,375.69 $27,049.96 2025-06-28
00008010001 NDC Inotuzumab Ozogamicin 0.9 Mg(0.25 Mg/ml Initial Concentration) I 19 16 $67,757.06 — $20,327.12 $58,406.59 $41,169.19 2025-06-28
00310453530 NDC Tremelimumab-actl 20 Mg/ml Intravenous Solution 19 16 $119,390.00 — $35,817.00 $102,914.18 $72,541.36 2025-06-28
00597003510 NDC Spesolimab-sbzo 60 Mg/ml Intravenous Solution 19 16 $78,234.99 — $23,470.50 $67,438.56 $47,535.58 2025-06-28
00703069601 NDC Treprostinil Sodium 10 Mg/ml Injection Solution 19 16 $36,294.62 — $10,888.39 $31,285.96 $22,052.61 2025-06-28
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 34 25 — — $183,171.00 $759,422.92 $222,174.78 2025-06-28
10 MS_DRG Pancreas Transplant 34 25 — — $48,158.30 $240,875.05 $63,592.47 2025-06-28
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 29 23 — — $39,988.50 $128,219.05 $42,093.16 2025-06-28
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 29 23 — — $30,629.69 $128,095.10 $32,241.78 2025-06-28
14 MS_DRG Allogeneic Bone Marrow Transplant 32 24 — — $95,798.78 $433,376.48 $101,849.23 2025-06-28
140 MS_DRG Major Head And Neck Procedures With Mcc 29 23 — — $4,264.02 $103,846.99 $33,198.56 2025-06-28
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 29 23 — — $20,687.84 $96,093.79 $26,129.08 2025-06-28
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 33 24 — — $41,085.31 $275,731.22 $47,911.80 2025-06-28
163 MS_DRG Major Chest Procedures With Mcc 29 23 — — $32,648.87 $92,432.90 $36,095.58 2025-06-28
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 29 23 — — $28,412.65 $84,274.96 $30,309.93 2025-06-28
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 34 25 — — $44,623.73 $219,870.00 $51,826.46 2025-06-28
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 29 23 — — $23,132.95 $66,869.01 $24,350.47 2025-06-28
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 29 23 — — $164,440.13 $756,292.49 $288,468.31 2025-06-28
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 34 25 — — $58,322.27 $266,985.00 $71,603.49 2025-06-28
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 34 25 — — $80,719.09 $314,275.00 $101,536.12 2025-06-28
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 29 23 — — $59,291.31 $227,572.77 $62,411.91 2025-06-28
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 29 23 — — $47,747.44 $170,942.20 $50,260.46 2025-06-28
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 29 23 — — $18,474.44 $54,923.13 $21,416.86 2025-06-28
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 29 23 — — $40,940.17 $166,340.49 $43,094.92 2025-06-28
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 29 23 — — $79,807.98 $294,401.49 $84,008.40 2025-06-28
215 MS_DRG Other Heart Assist System Implant 29 23 — — $77,641.73 $232,530.85 $81,728.14 2025-06-28
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 29 23 — — $70,806.95 $254,290.63 $74,533.63 2025-06-28
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 29 23 — — $42,960.07 $170,387.52 $50,189.56 2025-06-28
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 29 23 — — $43,996.52 $137,038.23 $46,312.13 2025-06-28
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 29 23 — — $56,947.64 $184,617.21 $59,944.88 2025-06-28
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 29 23 — — $26,477.55 $107,484.98 $27,871.10 2025-06-28
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 29 23 — — $39,270.05 $137,822.23 $41,336.89 2025-06-28
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 29 23 — — $34,170.57 $122,507.96 $35,969.02 2025-06-28
228 MS_DRG Other Cardiothoracic Procedures With Mcc 29 23 — — $37,000.23 $158,045.00 $38,947.61 2025-06-28
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 29 23 — — $23,405.99 $96,942.86 $24,637.88 2025-06-28
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 29 23 — — $42,227.90 $139,604.04 $44,450.42 2025-06-28
231 MS_DRG Coronary Bypass With Ptca With Mcc 29 23 — — $48,458.40 $192,640.00 $65,558.99 2025-06-28
232 MS_DRG Coronary Bypass With Ptca Without Mcc 29 23 — — $45,150.98 $169,904.11 $47,527.35 2025-06-28
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 29 23 — — $57,519.07 $156,750.09 $60,546.39 2025-06-28
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 29 23 — — $39,440.25 $122,616.42 $41,516.05 2025-06-28
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 29 23 — — $43,525.04 $128,984.45 $45,815.83 2025-06-28
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 29 23 — — $30,690.53 $102,012.50 $32,305.82 2025-06-28
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 29 23 — — $32,369.94 $101,009.99 $39,356.24 2025-06-28
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 29 23 — — $28,442.45 $107,255.67 $29,939.42 2025-06-28
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 29 23 — — $17,046.28 $58,886.50 $23,158.12 2025-06-28
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 29 23 — — $25,475.18 $91,365.02 $26,815.98 2025-06-28
245 MS_DRG Aicd Generator Procedures 29 23 — — $36,301.32 $113,456.36 $38,211.92 2025-06-28
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 29 23 — — $33,299.30 $119,895.67 $35,051.89 2025-06-28
252 MS_DRG Other Vascular Procedures With Mcc 29 23 — — $25,753.29 $114,633.91 $27,108.73 2025-06-28
25682002801 NDC Ravulizumab-cwvz 100 Mg/ml Intravenous Solution 19 16 $71,857.88 — $21,557.36 $61,941.49 $43,660.85 2025-06-28
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 29 23 — — $21,227.43 $67,315.23 $22,344.66 2025-06-28
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 29 23 — — $23,060.52 $89,322.91 $24,274.23 2025-06-28
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 29 23 — — $25,578.03 $102,598.17 $26,924.24 2025-06-28
263 MS_DRG Vein Ligation And Stripping 29 23 — — $20,333.71 $62,605.06 $21,403.90 2025-06-28
264 MS_DRG Other Circulatory System O.r. Procedures 29 23 — — $18,798.35 $70,090.74 $27,601.99 2025-06-28
265 MS_DRG Aicd Lead Procedures 29 23 — — $26,744.08 $93,881.24 $28,151.66 2025-06-28
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 29 23 — — $34,358.40 $152,882.40 $46,628.52 2025-06-28
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 29 23 — — $3,310.28 $128,302.72 $36,823.64 2025-06-28
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 29 23 — — $12,342.20 $142,334.08 $51,788.25 2025-06-28
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 29 23 — — $5,610.39 $92,040.56 $32,676.34 2025-06-28
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 29 23 — — $2,987.19 $129,347.01 $40,088.88 2025-06-28
271 MS_DRG Other Major Cardiovascular Procedures With Cc 29 23 — — $3,746.26 $82,570.62 $27,215.46 2025-06-28
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 29 23 — — $29,228.99 $86,081.57 $30,767.36 2025-06-28
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 29 23 — — $23,512.45 $75,341.12 $24,749.95 2025-06-28
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 29 23 — — $52,091.51 $177,056.14 $54,833.17 2025-06-28
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 29 23 — — $30,816.64 $174,524.42 $48,180.71 2025-06-28
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 29 23 — — $34,600.05 $139,569.95 $36,421.11 2025-06-28
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 29 23 — — $26,692.48 $122,002.85 $39,100.09 2025-06-28
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 29 23 — — $24,116.48 $69,084.65 $25,385.77 2025-06-28
28 MS_DRG Spinal Procedures With Mcc 29 23 — — $36,361.59 $121,918.29 $47,304.74 2025-06-28
288 MS_DRG Acute And Subacute Endocarditis With Mcc 29 23 — — $20,691.48 $83,785.35 $21,780.51 2025-06-28
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 29 23 — — $22,665.67 $79,378.86 $26,546.86 2025-06-28
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 29 23 — — $156,127.67 $582,844.00 $164,344.92 2025-06-28
31 MS_DRG Ventricular Shunt Procedures With Mcc 29 23 — — $20,229.78 $122,774.46 $32,904.29 2025-06-28
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 24 22 — — $45,713.73 $124,062.07 $48,119.72 2025-06-28
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 29 23 — — $32,723.51 $93,320.36 $34,445.80 2025-06-28
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 29 23 — — $21,526.54 $76,881.23 $22,659.52 2025-06-28
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 29 23 — — $31,757.36 $126,867.97 $33,428.80 2025-06-28
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 29 23 — — $24,049.13 $85,111.64 $25,314.87 2025-06-28
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 29 23 — — $21,637.36 $57,396.55 $22,776.17 2025-06-28
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 30 24 — — $30,000.00 $112,164.16 $39,677.20 2025-06-28
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 29 23 — — $31,926.61 $92,085.96 $35,963.69 2025-06-28
332 MS_DRG Rectal Resection With Mcc 29 23 — — $26,030.68 $76,258.37 $27,400.72 2025-06-28
335 MS_DRG Peritoneal Adhesiolysis With Mcc 29 23 — — $25,653.68 $72,815.60 $28,580.11 2025-06-28
34 MS_DRG Carotid Artery Stent Procedures With Mcc 29 23 — — $29,072.55 $82,734.86 $30,602.68 2025-06-28
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 29 23 — — $13,812.89 $66,630.40 $21,498.43 2025-06-28
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 29 23 — — $22,150.86 $77,972.01 $23,316.69 2025-06-28
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 29 23 — — $26,610.69 $88,678.36 $33,476.83 2025-06-28
37 MS_DRG Extracranial Procedures With Mcc 29 23 — — $24,960.23 $66,597.33 $26,273.93 2025-06-28
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 29 23 — — $103,245.56 $283,363.02 $108,679.54 2025-06-28
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 29 23 — — $28,228.07 $80,531.61 $29,713.76 2025-06-28
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 24 22 — — $10,089.53 $78,455.26 $30,781.84 2025-06-28
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 29 23 — — $39,266.98 $116,768.98 $42,343.22 2025-06-28
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 29 23 — — $21,248.43 $83,813.24 $22,366.77 2025-06-28
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 29 23 — — $26,266.79 $119,378.17 $27,649.25 2025-06-28
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 29 23 — — $20,726.98 $62,301.37 $21,817.87 2025-06-28
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 29 23 — — $26,284.89 $83,670.70 $27,668.31 2025-06-28
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 29 23 — — $26,471.03 $103,716.84 $27,864.24 2025-06-28
42023020901 NDC Treprostinil Sodium 10 Mg/ml Injection Solution 19 16 $36,294.68 — $10,888.40 $31,286.01 $22,052.65 2025-06-28
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 29 23 — — $30,366.79 $101,042.57 $31,965.04 2025-06-28
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 24 22 — — $16,610.31 $210,073.67 $80,817.87 2025-06-28
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 24 22 — — $12,451.80 $142,437.55 $55,105.33 2025-06-28
42747030401 NDC Burosumab-twza 30 Mg/ml Subcutaneous Solution 19 16 $40,068.08 — $12,020.42 $34,538.68 $24,345.37 2025-06-28
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 24 22 — — $9,461.34 $110,379.22 $42,918.05 2025-06-28
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 24 22 — — $61,315.60 $176,303.13 $64,542.74 2025-06-28
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 24 22 — — $40,528.80 $123,924.11 $42,661.89 2025-06-28
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 24 22 — — $49,467.54 $134,456.05 $52,071.09 2025-06-28
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 24 22 — — $30,483.40 $81,890.51 $32,087.79 2025-06-28
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 24 22 — — $38,208.29 $105,938.68 $40,219.25 2025-06-28
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 24 22 — — $23,258.96 $69,413.12 $24,483.12 2025-06-28
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 29 23 — — $58,017.89 $169,841.34 $65,523.15 2025-06-28
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 29 23 — — $42,476.31 $136,316.21 $44,711.91 2025-06-28
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 29 23 — — $32,181.77 $128,916.28 $33,875.55 2025-06-28
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 29 23 — — $45,353.78 $137,422.48 $47,740.82 2025-06-28
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 29 23 — — $19,437.18 $74,027.23 $22,789.13 2025-06-28
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 29 23 — — $40,025.44 $134,742.02 $42,132.04 2025-06-28
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 29 23 — — $22,263.84 $73,850.60 $23,435.62 2025-06-28
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 29 23 — — $37,806.32 $102,167.11 $39,796.13 2025-06-28
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 29 23 — — $25,715.64 $68,688.96 $27,069.09 2025-06-28
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 29 23 — — $24,582.17 $87,649.56 $25,875.97 2025-06-28
471 MS_DRG Cervical Spinal Fusion With Mcc 29 23 — — $36,032.77 $97,408.29 $37,987.02 2025-06-28
472 MS_DRG Cervical Spinal Fusion With Cc 29 23 — — $21,891.57 $60,469.98 $23,043.76 2025-06-28
47335017795 NDC Tildrakizumab-asmn 100 Mg/ml Subcutaneous Syringe 19 16 $51,713.91 — $15,514.17 $44,577.39 $31,421.37 2025-06-28
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 29 23 — — $33,389.10 $99,245.27 $35,146.42 2025-06-28
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 29 23 — — $25,815.58 $68,965.71 $27,174.29 2025-06-28
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 29 23 — — $22,208.80 $85,344.05 $23,377.68 2025-06-28
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 29 23 — — $24,224.39 $64,559.84 $25,499.36 2025-06-28
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 29 23 — — $26,628.20 $75,471.27 $28,029.68 2025-06-28
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 29 23 — — $18,296.13 $112,721.95 $27,796.39 2025-06-28
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 30 23 — — $78,037.18 $463,710.00 $82,965.85 2025-06-28
500 MS_DRG Soft Tissue Procedures With Mcc 29 23 — — $23,857.92 $90,704.97 $25,113.60 2025-06-28
50242010501 NDC Polatuzumab Vedotin-piiq 140 Mg Intravenous Solution 19 16 $54,257.99 — $16,277.40 $46,770.39 $32,967.15 2025-06-28
50242015001 NDC Ocrelizumab 30 Mg/ml Intravenous Solution 19 16 $59,193.14 — $17,757.94 $51,024.49 $35,965.75 2025-06-28
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 29 23 — — $21,608.39 $57,316.34 $22,745.67 2025-06-28
51144005001 NDC Brentuximab Ingredient For Desensitization 19 16 $35,276.00 — $10,582.80 $30,407.91 $21,433.70 2025-06-28
51144005001_2 NDC Brentuximab Vedotin 50 Mg Intravenous Solution 19 16 $35,276.00 — $10,582.80 $30,407.91 $21,433.70 2025-06-28
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 29 23 — — $23,305.31 $116,270.07 $24,531.91 2025-06-28
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 29 23 — — $26,865.74 $73,602.70 $28,279.73 2025-06-28
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 29 23 — — $22,018.32 $100,556.06 $23,177.18 2025-06-28
55513006901 NDC Tarlatamab-dlle 10 Mg Intravenous Solution 19 16 $45,050.00 — $13,515.00 $38,833.10 $27,372.38 2025-06-28
55513007701 NDC Tarlatamab-dlle 10 Mg Intravenous Solution 19 16 $45,050.00 — $13,515.00 $38,833.10 $27,372.38 2025-06-28
55566105000 NDC Nadofaragene Firadenovec-vncg 3x10exp11 Vp/ml Intravesical Suspe 19 16 $45,010.00 — $13,503.00 $38,798.62 $27,348.08 2025-06-28
570 MS_DRG Skin Debridement With Mcc 29 23 — — $22,709.98 $60,366.55 $23,905.24 2025-06-28
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 29 23 — — $45,509.49 $160,248.24 $47,904.73 2025-06-28
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 29 23 — — $18,537.42 $69,485.10 $27,371.75 2025-06-28
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 29 23 — — $39,984.16 $141,178.23 $42,088.59 2025-06-28
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 29 23 — — $20,193.92 $90,540.74 $21,256.76 2025-06-28
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 29 23 — — $24,514.82 $65,364.01 $25,805.07 2025-06-28
58468020001 NDC Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution 19 16 $87,524.49 — $26,257.35 $75,446.11 $53,179.88 2025-06-28
59572077501 NDC Luspatercept-aamt 75 Mg Subcutaneous Solution 19 16 $35,630.66 — $10,689.20 $30,713.63 $21,649.19 2025-06-28
6 MS_DRG Liver Transplant Without Mcc 31 24 — — $36,029.01 $250,403.00 $38,683.78 2025-06-28
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 29 23 — — $20,487.97 $73,407.47 $21,566.28 2025-06-28
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 29 23 — — $20,083.37 $77,508.71 $30,422.00 2025-06-28
61755000501 NDC Aflibercept 2 Mg/0.05 Ml Intravitreal Syringe 19 16 $111,075.00 — $33,322.50 $95,746.65 $67,489.17 2025-06-28
619 MS_DRG O.r. Procedures For Obesity With Mcc 30 24 — — $20,655.27 $53,956.31 $21,959.82 2025-06-28
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 29 23 — — $28,010.07 $75,042.07 $29,484.28 2025-06-28
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 29 23 — — $21,673.58 $57,496.82 $22,814.29 2025-06-28
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 29 23 — — $29,485.38 $79,127.07 $31,037.24 2025-06-28
63685 HCPCS Pr Implant Spinal Neurostim/receiver 33 25 — — $190.59 $82,528.40 $29,857.41 2025-06-28
64406010901 NDC Tofersen 100 Mg/15 Ml (6.7 Mg/ml) Intrathecal Solution 19 16 $43,975.72 — $13,192.72 $37,907.07 $26,719.65 2025-06-28
64568 HCPCS Pr Open Implant Cranial Neuroelec Array+pulse Gen 33 25 — — $340.46 $84,213.28 $29,857.41 2025-06-28
64582 HCPCS Pr Open Implt Hypogloss Nstim Pulse Generator 33 25 — — $460.90 $87,660.95 $29,857.41 2025-06-28
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 33 25 — — $21,644.04 $237,956.85 $36,802.71 2025-06-28
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 33 25 — — $26,058.21 $151,921.77 $28,526.88 2025-06-28
652 MS_DRG Kidney Transplant 32 24 — — $23,153.22 $189,355.27 $25,102.97 2025-06-28
653 MS_DRG Major Bladder Procedures With Mcc 29 23 — — $29,881.71 $111,793.03 $43,455.52 2025-06-28
654 MS_DRG Major Bladder Procedures With Cc 29 23 — — $21,250.60 $81,898.19 $22,471.22 2025-06-28
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 29 23 — — $24,504.68 $88,960.35 $25,794.40 2025-06-28
662 MS_DRG Minor Bladder Procedures With Mcc 29 23 — — $23,502.32 $68,313.05 $24,739.28 2025-06-28
66302001401 NDC Dinutuximab 3.5 Mg/ml Intravenous Solution 20 17 $52,044.38 — $15,613.31 $44,862.26 $31,622.17 2025-06-28
66302011001 NDC Treprostinil Sodium 10 Mg/ml Injection Solution 19 16 $38,204.60 — $11,461.38 $32,932.37 $23,213.11 2025-06-28
665 MS_DRG Prostatectomy With Mcc 29 23 — — $25,776.47 $68,857.41 $27,133.13 2025-06-28
668 MS_DRG Transurethral Procedures With Mcc 29 23 — — $22,029.90 $58,483.48 $23,189.37 2025-06-28
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 29 23 — — $24,292.59 $85,319.26 $32,896.66 2025-06-28
69930 HCPCS Pr Implant Cochlear Device 34 25 — — $659.76 $107,952.31 $31,164.67 2025-06-28
7 MS_DRG Lung Transplant 31 24 — — $95,559.78 $297,307.98 $102,601.02 2025-06-28
71336100301 NDC Vutrisiran 25 Mg/0.5 Ml Subcutaneous Syringe 19 16 $358,058.00 — $107,417.40 $308,646.00 $217,556.04 2025-06-28
72187040101 NDC Tagraxofusp-erzs 1 000 Mcg/ml Intravenous Solution 19 16 $96,497.57 — $28,949.27 $83,180.91 $58,631.92 2025-06-28
72694095401 NDC Pegaspargase 750 Unit/ml Injection Solution 19 16 $80,495.45 — $24,148.64 $69,387.08 $48,909.04 2025-06-28
72694095401_2 NDC Pegaspargase 750 Unit/ml Intramuscular Injection 19 16 $80,495.45 — $24,148.64 $69,387.08 $48,909.04 2025-06-28
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 29 23 — — $29,426.71 $93,131.34 $30,975.48 2025-06-28
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 29 23 — — $29,740.31 $79,832.97 $31,305.59 2025-06-28
75987008010 NDC Pegloticase 8 Mg/ml Intravenous Solution 19 16 $87,961.40 — $26,388.42 $75,822.73 $53,445.35 2025-06-28
75987013015 NDC Teprotumumab-trbw 500 Mg Intravenous Solution 19 16 $51,102.86 — $15,330.86 $44,050.67 $31,050.10 2025-06-28
75987015003 NDC Inebilizumab-cdon 10 Mg/ml Intravenous Solution 19 16 $137,145.29 — $41,143.59 $118,219.24 $83,329.48 2025-06-28
76128015575 NDC Porfimer 75 Mg Intravenous Solution 19 16 $70,242.91 — $21,072.87 $60,549.39 $42,679.59 2025-06-28
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 29 23 — — $6,007.92 $188,558.88 $46,277.82 2025-06-28
791 MS_DRG Prematurity With Major Problems 29 23 — — $2,372.08 $81,417.23 $31,907.87 2025-06-28
793 MS_DRG Full Term Neonate With Major Problems 29 23 — — $5,208.49 $83,635.21 $32,751.05 2025-06-28
799 MS_DRG Splenic Procedures With Mcc 29 23 — — $35,345.31 $95,352.76 $37,205.59 2025-06-28
79952011001 NDC Loncastuximab Tesirine-lpyl 10 Mg Intravenous Solution 19 16 $83,349.20 — $25,004.76 $71,847.01 $50,642.97 2025-06-28
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 32 24 — — $40,315.86 $266,985.00 $43,710.89 2025-06-28
800 MS_DRG Splenic Procedures With Cc 29 23 — — $22,011.79 $59,574.43 $23,170.31 2025-06-28
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 29 23 — — $26,871.54 $75,406.20 $28,285.83 2025-06-28
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 29 23 — — $40,362.23 $139,384.02 $45,343.92 2025-06-28
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 29 23 — — $34,799.94 $118,203.73 $36,631.52 2025-06-28
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 29 23 — — $35,495.23 $95,767.88 $37,363.40 2025-06-28
82705001001 NDC Epcoritamab-bysp 48 Mg/0.8 Ml Subcutaneous Solution 19 16 $48,481.48 — $14,544.44 $41,791.04 $29,457.35 2025-06-28
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 29 23 — — $23,243.03 $100,608.74 $24,466.35 2025-06-28
834 MS_DRG Acute Leukemia With Mcc 29 23 — — $40,940.17 $228,663.55 $43,094.92 2025-06-28
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 29 23 — — $37,173.33 $125,430.13 $39,129.82 2025-06-28
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 29 23 — — $24,004.94 $94,786.09 $25,268.36 2025-06-28
849 MS_DRG Radiotherapy 29 23 — — $20,254.04 $78,328.37 $21,320.04 2025-06-28
850 MS_DRG Acute Leukemia With Other Procedures 24 22 — — $67,626.04 $200,730.97 $71,185.30 2025-06-28
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 29 23 — — $37,130.60 $100,296.07 $39,084.84 2025-06-28
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 29 23 — — $30,120.55 $100,735.79 $35,351.50 2025-06-28
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 29 23 — — $51,291.21 $166,290.90 $53,990.75 2025-06-28
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 29 23 — — $27,602.87 $78,804.20 $30,914.49 2025-06-28
901 MS_DRG Wound Debridements For Injuries With Mcc 29 23 — — $32,996.56 $88,849.25 $34,733.22 2025-06-28
90288 HCPCS Botulism Ig IV 2 2 — — $48,705.00 $129,068.25 $88,886.62 2025-06-28
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 29 23 — — $28,872.66 $78,247.80 $30,392.27 2025-06-28
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 29 23 — — $25,201.34 $85,452.51 $31,326.94 2025-06-28
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 29 23 — — $172,721.78 $518,485.02 $181,812.40 2025-06-28
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 29 23 — — $28,141.09 $136,111.69 $51,874.40 2025-06-28
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 29 23 — — $14,251.31 $63,779.74 $25,202.80 2025-06-28
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 29 23 — — $32,246.23 $86,771.65 $33,943.40 2025-06-28
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 29 23 — — $23,896.31 $75,638.61 $25,154.01 2025-06-28
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 29 23 — — $26,991.04 $90,602.71 $28,772.99 2025-06-28
955 MS_DRG Craniotomy For Multiple Significant Trauma 29 23 — — $50,362.71 $234,049.27 $53,013.38 2025-06-28
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 29 23 — — $28,592.37 $144,478.45 $30,097.23 2025-06-28
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 29 23 — — $54,553.83 $197,604.28 $57,861.31 2025-06-28
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 29 23 — — $30,673.88 $93,915.33 $32,288.29 2025-06-28
963 MS_DRG Other Multiple Significant Trauma With Mcc 29 23 — — $20,584.30 $72,756.73 $21,667.68 2025-06-28
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 29 23 — — $46,712.48 $174,484.13 $49,171.03 2025-06-28
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 29 23 — — $21,550.79 $71,885.57 $28,284.31 2025-06-28
974 MS_DRG HIV With Major Related Condition With Mcc 29 23 — — $22,536.16 $67,216.07 $23,722.27 2025-06-28
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 29 23 — — $35,338.79 $136,471.15 $37,198.73 2025-06-28
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 29 23 — — $26,276.93 $102,678.74 $27,659.93 2025-06-28
C7534 HCPCS Fem/pop Revasc W/arthr & US 2 2 — — $24,961.96 $33,915.28 $29,438.62 2025-06-28
C7535 HCPCS Fem/pop Revasc W/stent & US 2 2 — — $24,744.99 $33,620.48 $29,182.74 2025-06-28
C7537 HCPCS Insrt Atril Pm W/l Vent Lead 2 2 — — $24,988.35 $33,951.13 $29,469.74 2025-06-28
C7538 HCPCS Insrt Vent Pm W/l Vent Lead 2 2 — — $24,919.48 $33,857.56 $29,388.52 2025-06-28
C7539 HCPCS Insrt A & V Pm W/l Vent Lead 2 2 — — $25,395.92 $34,504.89 $29,950.40 2025-06-28
C7540 HCPCS Rmv&rplc Pm Dul W/l Vnt Lead 2 2 — — $24,963.90 $33,917.92 $29,440.91 2025-06-28
C7564 HCPCS Vein Mech Throm W/intrvas US 2 2 — — $26,978.77 $36,655.48 $31,817.12 2025-06-28
C9073 HCPCS Brexucabtagene Autoleucel Ca 1 1 — — $413,145.63 $413,145.63 $413,145.63 2025-06-28
C9076 HCPCS Lisocabtagene Car Pos T 2 1 — — $821,502.66 $1,101,507.79 $961,505.23 2025-06-28
C9081 HCPCS Idecabtagene Car Pos T 2 1 — — $839,922.90 $1,126,206.48 $983,064.69 2025-06-28
C9098 HCPCS Ciltacabtagene Car Pos T 2 1 — — $822,403.65 $1,102,715.88 $962,559.76 2025-06-28
C9150 HCPCS Xe129 Xenon, Diagnostic 2 1 — — $91,967.72 $123,314.46 $107,641.09 2025-06-28
C9301 HCPCS Obecabtagene Car Pos T 2 2 — — $258,992.60 $272,623.79 $265,808.20 2025-06-28
C9754 HCPCS Perc Av Fistula, Direct 1 1 — — $31,162.99 $31,162.99 $31,162.99 2025-06-28
C9755 HCPCS Rf Magnetic-guide Av Fistula 1 1 — — $31,162.99 $31,162.99 $31,162.99 2025-06-28
C9760 HCPCS Non-blind Interatrial Shunt 29 24 — — $14,740.27 $81,234.53 $26,944.44 2025-06-28
E0469 HCPCS Lung Expans High Oscil Neb 4 3 — — $1,625.25 $60,342.50 $22,136.08 2025-06-28
E0764 HCPCS Functional Neuromuscularstim 4 3 — — $1,391.68 $60,801.53 $22,139.59 2025-06-28
G0448 HCPCS Place Perm Pacing Cardiovert 2 2 — — $66,579.75 $90,460.47 $78,520.11 2025-06-28
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 26 23 — — $1,988,560.00 $4,958,415.00 $3,672,900.00 2025-06-28
J1413 HCPCS Inj Delandistrogene Mox Rokl 27 23 — — $1,780,474.89 $4,489,363.93 $3,325,454.76 2025-06-28
J1414 HCPCS Inj, Beqvez, Per Tx Dose 26 23 — — $1,988,560.00 $4,866,750.00 $3,605,000.00 2025-06-28
J3392 HCPCS Inj, Exagamglogene Autotem 28 23 — — $1,249,952.00 $3,890,942.00 $2,332,000.00 2025-06-28
J3393 HCPCS Inj, Betibeglogene Autotemce 28 23 — — $1,590,848.00 $4,952,108.00 $2,968,000.00 2025-06-28
J3394 HCPCS Inj, Lovotibeglogene Autotem 27 23 — — $1,711,448.00 $4,436,100.00 $3,286,000.00 2025-06-28
J3399 HCPCS Inj Onase Abepar-xioi Treat 28 23 — — $1,288,253.89 $4,106,790.87 $2,388,614.23 2025-06-28
J7330 HCPCS Cultured Chondrocytes Implnt 7 6 — — $52,266.92 $154,331.76 $71,013.94 2025-06-28
J7667 HCPCS Metaproterenol Comp Con 3 2 — — $1.37 $32,536.05 $24,265.33 2025-06-28
J9029 HCPCS Instill Adstiladrin, Tx Dose 33 25 — — $33,983.49 $179,126.64 $63,354.77 2025-06-28
J9226 HCPCS Supprelin La Implant 35 26 — — $24,260.32 $128,221.32 $45,350.22 2025-06-28
J9266 HCPCS Pegaspargase Injection 35 26 — — $6,829.46 $76,538.08 $27,070.53 2025-06-28
J9600 HCPCS Porfimer Sodium Injection 35 26 — — $6,549.16 $64,112.93 $23,870.14 2025-06-28
K0606 HCPCS Aed Garment W Elec Analysis 4 3 — — $3,144.59 $155,430.87 $56,319.93 2025-06-28
K0743 HCPCS Portable Home Suction Pump 2 2 — — $56,177.10 $80,532.90 $68,355.00 2025-06-28
K0868 HCPCS Pwc Gp 4 Std Seat/back 2 2 — — $25,956.44 $37,209.96 $31,583.20 2025-06-28
K0869 HCPCS Pwc Gp 4 Std Cap Chair 2 2 — — $24,955.47 $35,775.02 $30,365.24 2025-06-28
K0870 HCPCS Pwc Gp 4 Hd Seat/back 2 2 — — $30,108.36 $43,161.95 $36,635.15 2025-06-28
K0871 HCPCS Pwc Gp 4 Vhd Seat/back 2 2 — — $34,788.28 $49,870.88 $42,329.58 2025-06-28
K0878 HCPCS Pwc Gp4 Std Sing Pow Opt Cap 2 2 — — $28,419.75 $40,741.25 $34,580.50 2025-06-28
K0879 HCPCS Pwc Gp4 Hd Sing Pow Opt S/b 2 2 — — $34,567.86 $49,554.88 $42,061.37 2025-06-28
K0880 HCPCS Pwc Gp4 Vhd Sing Pow Opt S/b 2 2 — — $49,384.33 $70,795.09 $60,089.71 2025-06-28
K0884 HCPCS Pwc Gp4 Std Mult Pow Opt S/b 2 2 — — $29,972.89 $42,967.75 $36,470.32 2025-06-28
K0885 HCPCS Pwc Gp4 Std Mult Pow Opt Cap 2 2 — — $29,972.89 $42,967.75 $36,470.32 2025-06-28
K0886 HCPCS Pwc Gp4 Hd Mult Pow S/b 2 2 — — $34,567.86 $49,554.88 $42,061.37 2025-06-28
K0898 HCPCS Power Wheelchair Noc 2 2 — — $19,796.65 $28,379.56 $24,088.11 2025-06-28
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 2 1 — — $98,726.40 $132,376.80 $115,551.60 2025-06-28
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 17 14 — — $20,776.77 $63,025.93 $38,762.63 2025-06-28
L5856 HCPCS Elec Knee-shin Swing/stance 21 16 — — $15,533.38 $108,531.35 $28,980.18 2025-06-28
L5858 HCPCS Stance Phase Only 20 15 — — $12,025.87 $84,024.46 $22,436.32 2025-06-28
L5859 HCPCS Knee-shin Pro Flex/ext Cont 3 2 — — $19,989.23 $51,216.05 $26,802.46 2025-06-28
L5969 HCPCS Ak/ft Power Asst Incl Motors 2 2 — — $36,673.32 $52,573.18 $44,623.25 2025-06-28
L5973 HCPCS Ank-foot Sys Dors-plant Flex 20 15 — — $11,423.90 $79,818.53 $21,313.25 2025-06-28
L6880 HCPCS Elec Hand Ind Art Digits 20 15 — — $845.66 $108,018.86 $27,689.60 2025-06-28
L6975 HCPCS Interscap-thor Myoelectronic 21 16 — — $11,473.66 $80,166.21 $21,406.09 2025-06-28
L7180 HCPCS Electronic Elbow Sequential 21 16 — — $25,181.48 $175,942.45 $46,980.38 2025-06-28
L7181 HCPCS Electronic Elbo Simultaneous 20 15 — — $25,926.73 $181,149.44 $48,370.76 2025-06-28
L8685 HCPCS Implt Nrostm Pls Gen Sng Rec 3 2 — — $19,546.63 $26,209.00 $24,999.76 2025-06-28
L8687 HCPCS Implt Nrostm Pls Gen Dua Rec 3 2 — — $25,437.95 $34,108.35 $32,535.45 2025-06-28
L8701 HCPCS Ewh S/d Uprt Micro Sensor 2 1 — — $46,366.20 $62,169.89 $54,268.04 2025-06-28
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 2 1 — — $91,222.80 $122,315.64 $106,769.22 2025-06-28
Q0480 HCPCS Driver Pneumatic Vad, Rep 20 15 — — $53,599.97 $383,489.81 $99,999.95 2025-06-28
Q0483 HCPCS Monitor Elec Vad, Rep 21 16 — — $317.02 $84,767.13 $22,634.63 2025-06-28
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 33 25 — — $262,381.19 $1,383,867.44 $489,455.96 2025-06-28
Q2042 HCPCS Tisagenlecleucel Car-pos T 32 25 — — $303,174.38 $1,496,217.90 $533,953.91 2025-06-28
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 34 25 — — $29,767.56 $179,958.75 $55,015.23 2025-06-28
Q2053 HCPCS Brexucabtagene Car Pos T 32 25 — — $261,595.61 $1,302,084.53 $460,530.40 2025-06-28
Q2054 HCPCS Lisocabtagene Mara Car Pos T 32 25 — — $276,836.48 $1,474,497.36 $516,726.08 2025-06-28
Q2055 HCPCS Idecabtagene Vicleucel Car 32 25 — — $283,175.46 $1,488,851.88 $526,587.59 2025-06-28
Q2056 HCPCS Ciltacabtagene Car-pos T 32 25 — — $295,506.63 $1,490,366.89 $527,123.43 2025-06-28
Q2057 HCPCS Afamitresgene Autoleucel 2 2 — — $717,286.16 $755,038.06 $736,162.11 2025-06-28
S2067 HCPCS Breast "stacked"" Diep/gap" 2 2 — — $18,522.04 $25,165.50 $21,843.77 2025-06-28
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