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

38,282 distinct procedures filed
52 distinct payers
1,884,615 rate rows
2025-06-28 last MRF observed · ⚠ 12 mo old
Data quality

870,916 of 1,884,615 rate rows are consumer-grade (46.2%)

1,013,699 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 477,233
percent-of-charges filed in the dollar field — excluded from medians 881
exceeds 10× this hospital's gross charge — excluded from medians 669
template filing: same amount across many unrelated codes — excluded 391
placeholder amount (≤ $0.02) — excluded from medians 389
per-diem day rate — not a per-procedure price 75

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 12 months old.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 · 2026-05-17
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
$3,325,455
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
$3,004,655
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
$2,468,984
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 23 $1,249,952.00 $3,890,942.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
C9081
HCPCS 		Idecabtagene Car Pos T 1 $839,922.90 $1,126,206.48 $983,064.69 nat. median
$30,475
outlier · 32.3×
C9098
HCPCS 		Ciltacabtagene Car Pos T 1 $822,403.65 $1,102,715.88 $962,559.76 nat. median
$57,174
outlier · 16.8×
C9076
HCPCS 		Lisocabtagene Car Pos T 1 $821,502.66 $1,101,507.79 $961,505.23 nat. median
$30,475
outlier · 31.6×
Q2057
HCPCS 		Afamitresgene Autoleucel 2 $717,286.16 $755,038.06 $736,162.11 nat. median
$824,563
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 25 $303,174.38 $1,496,217.90 $533,953.91 nat. median
$753,246
0.7× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 25 $295,506.63 $1,490,366.89 $527,123.43 nat. median
$674,867
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 25 $283,175.46 $1,488,851.88 $526,587.59 nat. median
$625,184
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 25 $276,836.48 $1,474,497.36 $516,726.08 nat. median
$673,137
0.8× median
5834
APR_DRG 		7 $494,365.71 $538,858.63 $494,365.71 nat. median
$309,665
1.6× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 25 $262,381.19 $1,383,867.44 $489,455.96 nat. median
$634,303
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 25 $261,595.61 $1,302,084.53 $460,530.40 nat. median
$619,808
0.7× median
583-4.1
APR_DRG 		Neonate With Ecmo 1 $459,958.63 $459,958.63 $459,958.63 —
MULVISC
CPT 		Multivisceral - Adult & Pediatric 1 $430,512.00 $430,512.00 $430,512.00 —
C9073
HCPCS 		Brexucabtagene Autoleucel Ca 1 $413,145.63 $413,145.63 $413,145.63 nat. median
$29,278
outlier · 14.1×
LIVKID
CPT 		Liver-kidney Transplant 1 $404,068.00 $404,068.00 $404,068.00 —
ACHL
CPT 		Adult Combination Heart-lung 1 $384,452.00 $384,452.00 $384,452.00 —
INTESTONLYA
CPT 		Intestine Only 1 $332,044.00 $332,044.00 $332,044.00 —
007-D
MS_DRG 		Lung (Double) 2 $323,577.00 $332,234.00 $327,905.50 —
583-3.1
APR_DRG 		Neonate With Ecmo 1 $297,927.92 $297,927.92 $297,927.92 —
016-B
MS_DRG 		Autologous/Allogeneic Bmt - Tandems 1 $296,050.00 $296,050.00 $296,050.00 —
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 23 $164,440.13 $756,292.49 $288,468.31 nat. median
$370,174
0.8× median
631-4.1
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 1 $286,025.60 $286,025.60 $286,025.60 —
5833
APR_DRG 		7 $281,887.48 $307,257.36 $281,887.48 nat. median
$244,017
1.2× median
007-S
MS_DRG 		Lung (Single) 3 $238,504.00 $350,193.00 $279,077.00 —
007-B
MS_DRG 		Adult Lung (Bilateral) 1 $277,343.00 $277,343.00 $277,343.00 —
ACLK
CPT 		Adult Combination Liver-kidney 1 $274,089.00 $274,089.00 $274,089.00 —
AUTOTAN
CPT 		Autologous Allogeneic Stem Cell - Tandem 1 $269,380.00 $269,380.00 $269,380.00 —
005-L
MS_DRG 		Liver (Live Donor) 3 $253,846.00 $305,295.00 $268,626.00 —
006-L
MS_DRG 		Liver (Live Donor) 3 $253,846.00 $305,295.00 $268,626.00 —
C9301
HCPCS 		Obecabtagene Car Pos T 2 $258,992.60 $272,623.79 $265,808.20 nat. median
$459,112
0.6× median
014-U
MS_DRG 		Adult Allogeneic Unrelated Bmt 2 $213,910.00 $296,050.00 $254,980.00 —
006-D
MS_DRG 		Liver (Deceased Donor) 3 $218,172.00 $323,255.00 $244,660.00 —
005-D
MS_DRG 		Liver (Deceased Donor) 3 $218,172.00 $323,255.00 $244,660.00 —
KIDPANC
CPT 		Kidney/Pancreas 1 $226,279.00 $226,279.00 $226,279.00 —
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
$265,286
0.8× median
016-A
MS_DRG 		Autologous/Autologous Bmt - Tandems 1 $222,037.00 $222,037.00 $222,037.00 —
5884
APR_DRG 		7 $220,807.48 $240,680.16 $220,807.48 nat. median
$246,434
0.9× median
014-R
MS_DRG 		Adult Allogeneic Related Bmt 2 $170,589.00 $266,445.00 $218,517.00 —
588-4.1
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 1 $218,345.84 $218,345.84 $218,345.84 —
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
630-4.1
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 1 $215,719.02 $215,719.02 $215,719.02 —
014-CB
MS_DRG 		Adult Allogeneic Cord Blood (Single Or Multiple Unit) Bmt 1 $213,910.00 $213,910.00 $213,910.00 —
014-CBSP
MS_DRG 		Adult Allogeneic Cord Blood (Single Or Multiple Unit) Bmt (Second Procedure) 1 $213,910.00 $213,910.00 $213,910.00 —

Other procedures at this hospital

Browse this hospital's 38,282 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
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
0042 APR_DRG — 7 7 — — $45,077.95 $49,134.97 $45,077.95 2025-06-28
0043 APR_DRG — 7 7 — — $70,291.88 $76,618.16 $70,291.88 2025-06-28
0044 APR_DRG — 7 7 — — $102,844.31 $112,100.30 $102,844.31 2025-06-28
005-D MS_DRG Liver (Deceased Donor) 3 3 — — $218,172.00 $323,255.00 $244,660.00 2025-06-28
005-L MS_DRG Liver (Live Donor) 3 3 — — $253,846.00 $305,295.00 $268,626.00 2025-06-28
0053 APR_DRG — 7 7 — — $59,800.93 $65,183.02 $59,800.93 2025-06-28
0054 APR_DRG — 7 7 — — $67,569.67 $73,650.95 $67,569.67 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
006-D MS_DRG Liver (Deceased Donor) 3 3 — — $218,172.00 $323,255.00 $244,660.00 2025-06-28
006-L MS_DRG Liver (Live Donor) 3 3 — — $253,846.00 $305,295.00 $268,626.00 2025-06-28
007-B MS_DRG Adult Lung (Bilateral) 1 1 — — $277,343.00 $277,343.00 $277,343.00 2025-06-28
007-D MS_DRG Lung (Double) 2 2 — — $323,577.00 $332,234.00 $327,905.50 2025-06-28
007-S MS_DRG Lung (Single) 3 3 — — $238,504.00 $350,193.00 $279,077.00 2025-06-28
0071 APR_DRG — 7 7 — — $57,571.40 $62,752.83 $57,571.40 2025-06-28
0072 APR_DRG — 7 7 — — $64,001.17 $69,761.28 $64,001.17 2025-06-28
0073 APR_DRG — 7 7 — — $64,659.59 $70,478.95 $64,659.59 2025-06-28
0074 APR_DRG — 7 7 — — $120,870.72 $131,749.09 $120,870.72 2025-06-28
0084 APR_DRG — 7 7 — — $55,526.90 $60,524.33 $55,526.90 2025-06-28
0092 APR_DRG — 7 7 — — $52,357.99 $57,070.22 $52,357.99 2025-06-28
0093 APR_DRG — 7 7 — — $86,228.39 $93,988.95 $86,228.39 2025-06-28
0094 APR_DRG — 7 7 — — $119,520.40 $130,277.24 $119,520.40 2025-06-28
0111 APR_DRG — 7 7 — — $56,980.53 $62,108.78 $56,980.53 2025-06-28
0112 APR_DRG — 7 7 — — $114,797.96 $125,129.79 $114,797.96 2025-06-28
0113 APR_DRG — 7 7 — — $144,176.94 $157,152.87 $144,176.94 2025-06-28
0114 APR_DRG — 7 7 — — $193,431.00 $210,839.79 $193,431.00 2025-06-28
014-CB MS_DRG Adult Allogeneic Cord Blood (Single Or Multiple Unit) Bmt 1 1 — — $213,910.00 $213,910.00 $213,910.00 2025-06-28
014-CBSP MS_DRG Adult Allogeneic Cord Blood (Single Or Multiple Unit) Bmt (Second Procedure) 1 1 — — $213,910.00 $213,910.00 $213,910.00 2025-06-28
014-R MS_DRG Adult Allogeneic Related Bmt 2 2 — — $170,589.00 $266,445.00 $218,517.00 2025-06-28
014-RSP MS_DRG Adult Allogeneic Related Bmt (Second Procedure) 1 1 — — $170,589.00 $170,589.00 $170,589.00 2025-06-28
014-U MS_DRG Adult Allogeneic Unrelated Bmt 2 2 — — $213,910.00 $296,050.00 $254,980.00 2025-06-28
014-USP MS_DRG Adult Allogeneic Unrelated Bmt (Second Procedure) 1 1 — — $213,910.00 $213,910.00 $213,910.00 2025-06-28
016-A MS_DRG Autologous/Autologous Bmt - Tandems 1 1 — — $222,037.00 $222,037.00 $222,037.00 2025-06-28
016-B MS_DRG Autologous/Allogeneic Bmt - Tandems 1 1 — — $296,050.00 $296,050.00 $296,050.00 2025-06-28
016-SP MS_DRG Adult Autologous Bmt (Second Procedure) 1 1 — — $121,984.00 $121,984.00 $121,984.00 2025-06-28
017-SP MS_DRG Adult Autologous Bmt (Second Procedure) 1 1 — — $121,984.00 $121,984.00 $121,984.00 2025-06-28
0266T HCPCS Implt/rpl Crtd Sns Dev Total 30 23 — — $193.06 $101,408.36 $44,090.59 2025-06-28
0913 APR_DRG — 7 7 — — $41,876.12 $45,644.98 $41,876.12 2025-06-28
0914 APR_DRG — 7 7 — — $43,551.11 $47,470.71 $43,551.11 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
14 MS_DRG Allogeneic Bone Marrow Transplant 32 24 — — $95,798.78 $433,376.48 $101,849.23 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
1602 APR_DRG — 7 7 — — $41,765.44 $45,524.33 $41,765.44 2025-06-28
1603 APR_DRG — 7 7 — — $52,490.24 $57,214.37 $52,490.24 2025-06-28
1604 APR_DRG — 7 7 — — $87,536.14 $95,414.39 $87,536.14 2025-06-28
1611 APR_DRG — 7 7 — — $74,212.29 $80,891.41 $74,212.29 2025-06-28
1612 APR_DRG — 7 7 — — $85,181.73 $92,848.09 $85,181.73 2025-06-28
1613 APR_DRG — 7 7 — — $96,686.42 $105,388.20 $96,686.42 2025-06-28
1614 APR_DRG — 7 7 — — $160,124.23 $174,535.42 $160,124.23 2025-06-28
1623 APR_DRG — 7 7 — — $40,593.35 $44,246.75 $40,593.35 2025-06-28
1624 APR_DRG — 7 7 — — $51,684.25 $56,335.84 $51,684.25 2025-06-28
1634 APR_DRG — 7 7 — — $49,346.87 $53,788.10 $49,346.87 2025-06-28
1674 APR_DRG — 7 7 — — $44,345.75 $48,336.87 $44,345.75 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
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
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
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
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
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
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
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
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 29 23 — — $2,987.19 $129,347.01 $40,088.88 2025-06-28
274000170-36-7140 CDM Hb Go Gear Heart Mate Ii Support Kit- Pocket Controller With Eq 20 17 $89,955.00 — $26,986.50 $89,955.00 $53,523.22 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
278000001-SUP-7899 CDM Device Ventricular Assist Impella 5.5 Smartassist Catheter 20 17 $105,000.00 — $31,500.00 $90,510.00 $63,798.00 2025-06-28
278000001-SUP-8360 CDM Implant: Graft Xenograft; Cryoartery Aortoiliac 8-15mm X 4-5mm X 20 17 $70,185.00 — $21,055.50 $60,499.47 $42,644.41 2025-06-28
28 MS_DRG Spinal Procedures With Mcc 29 23 — — $36,361.59 $121,918.29 $47,304.74 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
3034 APR_DRG — 7 7 — — $57,283.06 $62,438.54 $57,283.06 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
360000073-36-17909 CDM Hb Ivad Pump 20 17 $197,168.00 — $59,150.40 $169,958.82 $119,050.04 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
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 29 23 — — $39,266.98 $116,768.98 $42,343.22 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
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
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
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
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
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
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 30 23 — — $78,037.18 $463,710.00 $82,965.85 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
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
581-4.1 APR_DRG Neonate, Transferred < 5 Days Old, Born Here 1 1 — — $57,727.86 $57,727.86 $57,727.86 2025-06-28
5814 APR_DRG — 7 7 — — $62,108.22 $67,697.97 $62,108.22 2025-06-28
583-1.1 APR_DRG Neonate With Ecmo 1 1 — — $120,060.93 $120,060.93 $120,060.93 2025-06-28
583-2.1 APR_DRG Neonate With Ecmo 1 1 — — $165,174.11 $165,174.11 $165,174.11 2025-06-28
583-3.1 APR_DRG Neonate With Ecmo 1 1 — — $297,927.92 $297,927.92 $297,927.92 2025-06-28
583-4.1 APR_DRG Neonate With Ecmo 1 1 — — $459,958.63 $459,958.63 $459,958.63 2025-06-28
5831 APR_DRG — 7 7 — — $140,720.26 $153,385.08 $140,720.26 2025-06-28
5832 APR_DRG — 7 7 — — $156,668.68 $170,768.87 $156,668.68 2025-06-28
5833 APR_DRG — 7 7 — — $281,887.48 $307,257.36 $281,887.48 2025-06-28
5834 APR_DRG — 7 7 — — $494,365.71 $538,858.63 $494,365.71 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
588-1.1 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $142,931.74 $142,931.74 $142,931.74 2025-06-28
588-2.1 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $166,758.08 $166,758.08 $166,758.08 2025-06-28
588-3.1 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $145,950.71 $145,950.71 $145,950.71 2025-06-28
588-4.1 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $218,345.84 $218,345.84 $218,345.84 2025-06-28
5881 APR_DRG — 7 7 — — $144,843.30 $157,879.21 $144,843.30 2025-06-28
5882 APR_DRG — 7 7 — — $168,843.70 $184,039.64 $168,843.70 2025-06-28
5883 APR_DRG — 7 7 — — $151,416.68 $165,044.18 $151,416.68 2025-06-28
5884 APR_DRG — 7 7 — — $220,807.48 $240,680.16 $220,807.48 2025-06-28
589-1.1 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 1 1 — — $117,411.85 $117,411.85 $117,411.85 2025-06-28
589-2.1 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 1 1 — — $115,523.64 $115,523.64 $115,523.64 2025-06-28
589-3.1 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 1 1 — — $113,061.78 $113,061.78 $113,061.78 2025-06-28
5891 APR_DRG — 7 7 — — $141,995.09 $154,774.65 $141,995.09 2025-06-28
5892 APR_DRG — 7 7 — — $143,946.49 $156,901.68 $143,946.49 2025-06-28
5893 APR_DRG — 7 7 — — $143,945.93 $156,901.07 $143,945.93 2025-06-28
591-1.1 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $56,220.95 $56,220.95 $56,220.95 2025-06-28
591-2.1 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $101,045.30 $101,045.30 $101,045.30 2025-06-28
591-3.1 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $134,008.43 $134,008.43 $134,008.43 2025-06-28
591-4.1 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $174,300.06 $174,300.06 $174,300.06 2025-06-28
5912 APR_DRG — 7 7 — — $121,616.54 $132,562.04 $121,616.54 2025-06-28
5913 APR_DRG — 7 7 — — $142,449.73 $155,270.21 $142,449.73 2025-06-28
5914 APR_DRG — 7 7 — — $182,102.84 $198,492.10 $182,102.84 2025-06-28
593-2.1 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 1 1 — — $84,806.61 $84,806.61 $84,806.61 2025-06-28
593-3.1 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 1 1 — — $96,604.48 $96,604.48 $96,604.48 2025-06-28
593-4.1 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 1 1 — — $130,906.13 $130,906.13 $130,906.13 2025-06-28
5931 APR_DRG — 7 7 — — $48,435.88 $52,795.11 $48,435.88 2025-06-28
5932 APR_DRG — 7 7 — — $87,475.40 $95,348.19 $87,475.40 2025-06-28
5933 APR_DRG — 7 7 — — $101,328.25 $110,447.80 $101,328.25 2025-06-28
5934 APR_DRG — 7 7 — — $129,927.91 $141,621.43 $129,927.91 2025-06-28
602-2.1 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $68,242.56 $68,242.56 $68,242.56 2025-06-28
602-3.1 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $68,936.66 $68,936.66 $68,936.66 2025-06-28
602-4.1 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $91,255.51 $91,255.51 $91,255.51 2025-06-28
6021 APR_DRG — 7 7 — — $41,576.43 $45,318.31 $41,576.43 2025-06-28
6022 APR_DRG — 7 7 — — $67,624.73 $73,710.96 $67,624.73 2025-06-28
6023 APR_DRG — 7 7 — — $68,358.07 $74,510.30 $68,358.07 2025-06-28
6024 APR_DRG — 7 7 — — $92,140.51 $100,433.16 $92,140.51 2025-06-28
603-3.1 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 1 1 — — $81,408.64 $81,408.64 $81,408.64 2025-06-28
603-4.1 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 1 1 — — $160,471.86 $160,471.86 $160,471.86 2025-06-28
6033 APR_DRG — 7 7 — — $62,160.44 $67,754.89 $62,160.44 2025-06-28
6034 APR_DRG — 7 7 — — $95,112.46 $103,672.59 $95,112.46 2025-06-28
607-3.1 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $48,837.08 $48,837.08 $48,837.08 2025-06-28
607-4.1 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $70,054.85 $70,054.85 $70,054.85 2025-06-28
6072 APR_DRG — 7 7 — — $41,312.50 $45,030.63 $41,312.50 2025-06-28
6073 APR_DRG — 7 7 — — $49,666.43 $54,136.42 $49,666.43 2025-06-28
6074 APR_DRG — 7 7 — — $71,542.30 $77,981.12 $71,542.30 2025-06-28
608-4.1 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 1 1 — — $43,082.84 $43,082.84 $43,082.84 2025-06-28
6084 APR_DRG — 7 7 — — $40,106.35 $43,715.92 $40,106.35 2025-06-28
609-3.1 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 1 1 — — $82,606.18 $82,606.18 $82,606.18 2025-06-28
609-4.1 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 1 1 — — $159,309.14 $159,309.14 $159,309.14 2025-06-28
6092 APR_DRG — 7 7 — — $46,689.94 $50,892.04 $46,689.94 2025-06-28
6093 APR_DRG — 7 7 — — $82,787.59 $90,238.48 $82,787.59 2025-06-28
6094 APR_DRG — 7 7 — — $170,912.60 $186,294.74 $170,912.60 2025-06-28
611-4.1 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 1 1 — — $73,379.76 $73,379.76 $73,379.76 2025-06-28
6114 APR_DRG — 7 7 — — $76,835.17 $83,750.34 $76,835.17 2025-06-28
612-4.1 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $65,924.55 $65,924.55 $65,924.55 2025-06-28
6124 APR_DRG — 7 7 — — $61,870.40 $67,438.74 $61,870.40 2025-06-28
613-3.1 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 1 1 — — $51,126.56 $51,126.56 $51,126.56 2025-06-28
613-4.1 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 1 1 — — $81,824.75 $81,824.75 $81,824.75 2025-06-28
6133 APR_DRG — 7 7 — — $47,343.81 $51,604.76 $47,343.81 2025-06-28
6134 APR_DRG — 7 7 — — $84,406.96 $92,003.59 $84,406.96 2025-06-28
614-4.1 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 1 1 — — $43,182.73 $43,182.73 $43,182.73 2025-06-28
6144 APR_DRG — 7 7 — — $41,943.67 $45,718.60 $41,943.67 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
623-4.1 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 1 1 — — $46,019.61 $46,019.61 $46,019.61 2025-06-28
6234 APR_DRG — 7 7 — — $45,198.28 $49,266.14 $45,198.28 2025-06-28
624000003-36-19601 CDM Hb Tendyne Mitral Valve (summit) Ide G140240 20 17 $95,400.00 — $28,620.00 $82,234.80 $57,965.04 2025-06-28
624000012-36-19603 CDM Hb Mitraclip (pascal/clasp) Ide G170166 20 17 $90,000.00 — $27,000.00 $77,580.00 $54,684.00 2025-06-28
624000013-36-19604 CDM Hb Acurate Valve Ide G190051 (boston Scientific) 20 17 $85,500.00 — $25,650.00 $73,701.00 $51,949.80 2025-06-28
624000014-36-19605 CDM Hb Pascal Clasp Tr Efs Ide G180266 20 17 $105,000.00 — $31,500.00 $90,510.00 $63,798.00 2025-06-28
624000016-36-19606 CDM Hb Edwards Tricuspid Valve Ide G190289 20 17 $114,000.00 — $34,200.00 $98,268.00 $69,266.40 2025-06-28
624000019-36-19608 CDM Hb Impella Ecp Pump Set Ide G200126 20 17 $79,500.00 — $23,850.00 $68,529.00 $48,304.20 2025-06-28
624000023-36-19611 CDM Hb Navitor Valve (abbott/envision Trial) Ide G230146 20 17 $79,500.00 — $23,850.00 $68,529.00 $48,304.20 2025-06-28
625-4.1 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 1 1 — — $56,814.01 $56,814.01 $56,814.01 2025-06-28
6254 APR_DRG — 7 7 — — $58,084.51 $63,312.12 $58,084.51 2025-06-28
630-2.1 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 1 1 — — $59,711.96 $59,711.96 $59,711.96 2025-06-28
630-3.1 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 1 1 — — $105,069.44 $105,069.44 $105,069.44 2025-06-28
630-4.1 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 1 1 — — $215,719.02 $215,719.02 $215,719.02 2025-06-28
6302 APR_DRG — 7 7 — — $46,940.25 $51,164.88 $46,940.25 2025-06-28
6303 APR_DRG — 7 7 — — $102,657.57 $111,896.75 $102,657.57 2025-06-28
6304 APR_DRG — 7 7 — — $181,900.77 $198,271.85 $181,900.77 2025-06-28
631-3.1 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 1 1 — — $55,172.39 $55,172.39 $55,172.39 2025-06-28
631-4.1 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 1 1 — — $286,025.60 $286,025.60 $286,025.60 2025-06-28
6313 APR_DRG — 7 7 — — $57,342.65 $62,503.50 $57,342.65 2025-06-28
6314 APR_DRG — 7 7 — — $179,083.21 $195,200.70 $179,083.21 2025-06-28
633-4.1 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 1 1 — — $69,288.84 $69,288.84 $69,288.84 2025-06-28
6334 APR_DRG — 7 7 — — $68,120.81 $74,251.69 $68,120.81 2025-06-28
650-D MS_DRG Kidney (Deceased ) 2 2 — — $132,904.00 $161,626.00 $147,265.00 2025-06-28
650-L MS_DRG Kidney ( Live Donor) 2 2 — — $139,553.00 $143,668.00 $141,610.50 2025-06-28
651-D MS_DRG Kidney (Deceased ) 2 2 — — $132,904.00 $161,626.00 $147,265.00 2025-06-28
651-L MS_DRG Kidney ( Live Donor) 2 2 — — $139,553.00 $143,668.00 $141,610.50 2025-06-28
652-D MS_DRG Kidney (Deceased ) 2 2 — — $132,904.00 $161,626.00 $147,265.00 2025-06-28
652-L MS_DRG Kidney ( Live Donor) 2 2 — — $139,553.00 $143,668.00 $141,610.50 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
6804 APR_DRG — 7 7 — — $41,209.76 $44,918.64 $41,209.76 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
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
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
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
811000001-36-21024 CDM Hb Kidney Acquisition Charge Living Donor 20 17 $148,400.00 — $44,520.00 $127,920.80 $90,167.84 2025-06-28
811000002-36-21025 CDM Hb Liver Acquisition Chg, Living Donor 20 17 $169,951.00 — $50,985.30 $146,497.76 $103,262.23 2025-06-28
812000001-36-21026 CDM Hb Heart Acquisition Chrg, Cadaver Donor 20 17 $141,482.00 — $42,444.60 $121,957.48 $85,964.46 2025-06-28
812000002-36-21027 CDM Hb Intestine Acquisition Chg Cadaver Donor 20 17 $94,976.00 — $28,492.80 $81,869.31 $57,707.42 2025-06-28
812000003-36-21028 CDM Hb Kidney Acquisition Chg Cadaver Donor 20 17 $148,400.00 — $44,520.00 $127,920.80 $90,167.84 2025-06-28
812000004-36-21029 CDM Hb Liver Acquisition Charge, Cadaver Donor 20 17 $169,951.00 — $50,985.30 $146,497.76 $103,262.23 2025-06-28
812000005-36-21030 CDM Hb Lung Acquisition Chg Cadaver Donor 20 17 $266,816.00 — $80,044.80 $229,995.39 $162,117.40 2025-06-28
812000006-36-21031 CDM Hb Pancreas Acquisition Chrg Cadaver Donor 20 17 $111,035.00 — $33,310.50 $95,712.17 $67,464.87 2025-06-28
812000009-36-21032 CDM Hb Double Lung Acquisition Chrg Cadaver Donor 20 17 $266,816.00 — $80,044.80 $229,995.39 $162,117.40 2025-06-28
812000010-36-21033 CDM Hb Double Kidney Acquistion Chg Cadaver Donor 20 17 $140,000.00 — $42,000.00 $120,680.00 $85,064.00 2025-06-28
819000002-36-21036 CDM Hb Allogeneic Bone Mrr Acq Chg,complex 20 17 $87,649.00 — $26,294.70 $75,553.44 $53,255.53 2025-06-28
819000003-36-21037 CDM Hb Matched Unrelated Donor Procurement 20 17 $134,395.00 — $40,318.50 $115,848.49 $81,658.40 2025-06-28
819000004-36-21038 CDM Hb Unrelated Donor Allogeneic Procurement 20 17 $88,771.00 — $26,631.30 $76,520.60 $53,937.26 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
834 MS_DRG Acute Leukemia With Mcc 29 23 — — $40,940.17 $228,663.55 $43,094.92 2025-06-28
8413 APR_DRG — 7 7 — — $41,671.22 $45,421.63 $41,671.22 2025-06-28
8414 APR_DRG — 7 7 — — $130,711.77 $142,475.83 $130,711.77 2025-06-28
8424 APR_DRG — 7 7 — — $92,167.18 $100,462.24 $92,167.18 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
8504 APR_DRG — 7 7 — — $48,737.27 $53,123.63 $48,737.27 2025-06-28
8513 APR_DRG — 7 7 — — $54,158.42 $59,032.68 $54,158.42 2025-06-28
8514 APR_DRG — 7 7 — — $54,158.42 $59,032.68 $54,158.42 2025-06-28
8634 APR_DRG — 7 7 — — $51,546.32 $56,185.50 $51,546.32 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
90288 HCPCS Botulism Ig IV 2 2 — — $48,705.00 $129,068.25 $88,886.62 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
955 MS_DRG Craniotomy For Multiple Significant Trauma 29 23 — — $50,362.71 $234,049.27 $53,013.38 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
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
A9543 HCPCS Hb Y90 Ibritumomab Therapeutic Up To 40mci 46 33 $87,500.00 — $14,774.74 $153,808.42 $52,695.89 2025-06-28
ACHL CPT Adult Combination Heart-lung 1 1 — — $384,452.00 $384,452.00 $384,452.00 2025-06-28
ACLK CPT Adult Combination Liver-kidney 1 1 — — $274,089.00 $274,089.00 $274,089.00 2025-06-28
AUTOTAN CPT Autologous Allogeneic Stem Cell - Tandem 1 1 — — $269,380.00 $269,380.00 $269,380.00 2025-06-28
C1605 HCPCS Hb Pmkr Dual Leadless Lvl 69 20 17 $91,500.00 — $27,450.00 $78,873.00 $54,442.50 2025-06-28
C1822 HCPCS Kit Pulse Generator Vercise Genus R16 40 17 $66,000.00 — $19,800.00 $68,735.00 $40,807.32 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
G0448 HCPCS Place Perm Pacing Cardiovert 2 2 — — $66,579.75 $90,460.47 $78,520.11 2025-06-28
INTESTONLYA CPT Intestine Only 1 1 — — $332,044.00 $332,044.00 $332,044.00 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
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
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
K0871 HCPCS Pwc Gp 4 Vhd Seat/back 2 2 — — $34,788.28 $49,870.88 $42,329.58 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
K0886 HCPCS Pwc Gp4 Hd Mult Pow S/b 2 2 — — $34,567.86 $49,554.88 $42,061.37 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
KIDPANC CPT Kidney/Pancreas 1 1 — — $226,279.00 $226,279.00 $226,279.00 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
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
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
LIVKID CPT Liver-kidney Transplant 1 1 — — $404,068.00 $404,068.00 $404,068.00 2025-06-28
MULVISC CPT Multivisceral - Adult & Pediatric 1 1 — — $430,512.00 $430,512.00 $430,512.00 2025-06-28
Q0480 HCPCS Driver Pneumatic Vad, Rep 20 15 — — $53,599.97 $383,489.81 $99,999.95 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
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