Price Transparency Hospital negotiated rates

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

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Hospital

SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER

Las Vegas, NV · CCN 290047 · Rates published

33,668 distinct procedures filed
36 distinct payers
659,427 rate rows
2026-03-01 last MRF observed
Data quality

636,103 of 659,427 rate rows are consumer-grade (96.5%)

23,324 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
per-diem day rate — not a per-procedure price 11,466
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 9,902
template filing: same amount across many unrelated codes — excluded 1,675
placeholder amount (≤ $0.02) — excluded from medians 234
exceeds 10× this hospital's gross charge — excluded from medians 47
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/74-3048428_SOUTHERN-HILLS-HOSPITAL-AND-MEDICAL-CENTER_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page https://sunrisehealthinfo.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 58641f1bc29bf0eb… · 444,622,906 bytes · first seen 2026-05-08

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
845
OTHER 		Inj, Atidarsagene Autotem 12 $7,020.58 $4,955,500.00 $4,505,000.00 nat. median
$9,966
outlier · 452.1×
00845
OTHER 		Inj, Atidarsagene Autotem 1 $4,505,000.00 $4,505,000.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 12 $552,790.05 $4,422,320.40 $3,685,267.00 nat. median
$3,746,358
1.0× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 1 $3,685,267.00 $3,685,267.00 $3,685,267.00 nat. median
$3,574,709
1.0× median
J1414
HCPCS 		Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose 1 $3,500,490.28 $3,500,490.28 $3,500,490.28 nat. median
$3,710,000
0.9× median
908
OTHER 		Topi Adm Prad Zami Per Tr 13 $12,711.76 $4,002,984.00 $3,335,820.00 nat. median
$22,747
outlier · 146.6×
00908
OTHER 		Topi Adm Prad Zami Per Tr 1 $3,335,820.00 $3,335,820.00 $3,335,820.00 nat. median
$12,675
outlier · 263.2×
00714
OTHER 		Inj Delandistrogene Mox R 1 $3,327,860.00 $3,327,860.00 $3,327,860.00 nat. median
$3,228,024
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 13 $8,257.15 $3,993,432.00 $3,327,860.00 nat. median
$13,041
outlier · 255.2×
748
OTHER 		Inj, Lovotibeglogene Auto 13 $15,717.39 $3,903,009.60 $3,252,508.00 nat. median
$17,963
outlier · 181.1×
00748
OTHER 		Inj, Lovotibeglogene Auto 1 $3,252,508.00 $3,252,508.00 $3,252,508.00 nat. median
$3,187,420
1.0× median
J1411
HCPCS 		Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 3 $2,968,000.00 $3,444,000.00 $3,206,000.00 nat. median
$3,710,000
0.9× median
C9172
HCPCS 		Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose 2 $2,884,000.00 $3,500,490.28 $3,192,245.14 nat. median
$3,570,000
0.9× median
00906
OTHER 		Inj Elivaldogene Autoteme 1 $3,180,000.00 $3,180,000.00 $3,180,000.00 nat. median
$21
outlier · 153697.4×
906
OTHER 		Inj Elivaldogene Autoteme 13 $11,232.33 $3,816,000.00 $3,180,000.00 nat. median
$20,756
outlier · 153.2×
746
OTHER 		Inj, Betibeglogene Autote 13 $14,538.76 $3,527,962.80 $2,939,969.00 nat. median
$21,896
outlier · 134.3×
00746
OTHER 		Inj, Betibeglogene Autote 1 $2,939,969.00 $2,939,969.00 $2,939,969.00 nat. median
$2,878,960
1.0× median
J1413
HCPCS 		Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 2 $2,636,800.00 $3,200,490.28 $2,918,645.14 nat. median
$3,325,455
0.9× median
J3394
HCPCS 		Injection, Lovotibeglogene Autotemcel, Per Treatment 2 $2,628,800.00 $3,100,490.28 $2,864,645.14 nat. median
$3,286,000
0.9× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 12 $388,347.15 $3,106,777.20 $2,588,981.00 nat. median
$2,588,981
1.0× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 1 $2,588,981.00 $2,588,981.00 $2,588,981.00 nat. median
$2,457,321
1.1× median
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 2 $2,374,400.00 $2,800,490.28 $2,587,445.14 nat. median
$3,006,423
0.9× median
824
OTHER 		Inj, Exagamglogene Autote 13 $17,024.52 $2,798,400.00 $2,332,000.00 nat. median
$25,250
outlier · 92.4×
00824
OTHER 		Inj, Exagamglogene Autote 1 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,332,000
1.0× median
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 1 $2,200,490.28 $2,200,490.28 $2,200,490.28 nat. median
$2,448,600
0.9× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 3 $1,842,227.74 $2,322,534.64 $2,082,381.19 nat. median
$2,469,189
0.8× median
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 4 $732,102.01 $1,656,833.00 $1,656,833.00 nat. median
$824,563
outlier · 2.0×
2067
OTHER 		Afamitresgene Autoleucel 12 $115,593.00 $924,744.00 $770,620.00 nat. median
$786,032
1.0× median
Q2058
HCPCS 		Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,… 2 $598,237.50 $598,237.50 $598,237.50 nat. median
$324,450
1.8× median
9498
OTHER 		Ciltacabtagene Car-pos T 12 $88,147.44 $705,179.52 $587,649.60 nat. median
$587,650
1.0× median
09498
OTHER 		Ciltacabtagene Car-pos T 1 $587,649.60 $587,649.60 $587,649.60 nat. median
$554,552
1.1× median
9194
OTHER 		Tisagenlecleucel Car-pos 12 $84,979.70 $679,837.56 $566,531.30 nat. median
$566,531
1.0× median
09194
OTHER 		Tisagenlecleucel Car-pos 1 $566,531.30 $566,531.30 $566,531.30 nat. median
$538,205
1.1× median
9413
OTHER 		Lisocabtagene Car Pos T 12 $84,330.18 $674,641.44 $562,201.20 nat. median
$562,201
1.0× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $562,201.20 $562,201.20 $562,201.20 nat. median
$534,091
1.1× median
9422
OTHER 		Idecabtagene Vicleucel Ca 12 $83,712.27 $669,698.16 $558,081.80 nat. median
$558,082
1.0× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $558,081.80 $558,081.80 $558,081.80 nat. median
$530,178
1.1× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 8 $405,756.74 $1,263,446.58 $553,169.00 nat. median
$675,122
0.8× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 8 $408,858.00 $1,218,042.30 $538,217.75 nat. median
$754,974
0.7× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $532,192.20 $532,192.20 $532,192.20 nat. median
$505,583
1.1× median
9035
OTHER 		Axicabtagene Ciloleucel C 12 $79,828.83 $638,630.64 $532,192.20 nat. median
$532,192
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 7 $387,752.24 $1,199,875.72 $530,190.66 nat. median
$625,184
0.8× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 8 $379,082.81 $1,208,732.67 $516,726.08 nat. median
$674,188
0.8× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 8 $359,552.00 $1,144,213.32 $502,841.00 nat. median
$634,511
0.8× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 1 $501,787.64 $501,787.64 $501,787.64 nat. median
$160,267
outlier · 3.1×
9391
OTHER 		Brexucabtagene Car Pos T 12 $73,417.53 $587,340.24 $489,450.20 nat. median
$489,450
1.0× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $489,450.20 $489,450.20 $489,450.20 nat. median
$464,978
1.1× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 14 $395,508.48 $837,547.38 $465,304.10 nat. median
$370,174
1.3× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 8 $359,552.00 $1,052,317.93 $464,990.71 nat. median
$620,080
0.7× median
J3402
HCPCS 		Injection, Remestemcel-l-rknd, Per Therapeutic Dose 4 $191,598.58 $433,588.39 $433,588.39 nat. median
$209,753
outlier · 2.1×

Other procedures at this hospital

Browse this hospital's 33,668 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
845 OTHER Inj, Atidarsagene Autotem 13 12 — — $7,020.58 $4,955,500.00 $4,505,000.00 2026-03-01
00845 OTHER Inj, Atidarsagene Autotem 1 1 — — $4,505,000.00 $4,505,000.00 $4,505,000.00 2026-03-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 1 1 — — $3,685,267.00 $3,685,267.00 $3,685,267.00 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 13 12 — — $552,790.05 $4,422,320.40 $3,685,267.00 2026-03-01
J1414 HCPCS Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose 1 1 — — $3,500,490.28 $3,500,490.28 $3,500,490.28 2026-03-01
00908 OTHER Topi Adm Prad Zami Per Tr 1 1 — — $3,335,820.00 $3,335,820.00 $3,335,820.00 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 14 13 — — $12,711.76 $4,002,984.00 $3,335,820.00 2026-03-01
714 OTHER Inj Delandistrogene Mox R 14 13 — — $8,257.15 $3,993,432.00 $3,327,860.00 2026-03-01
00714 OTHER Inj Delandistrogene Mox R 1 1 — — $3,327,860.00 $3,327,860.00 $3,327,860.00 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 14 13 — — $15,717.39 $3,903,009.60 $3,252,508.00 2026-03-01
00748 OTHER Inj, Lovotibeglogene Auto 1 1 — — $3,252,508.00 $3,252,508.00 $3,252,508.00 2026-03-01
J1411 HCPCS Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 4 3 — — $2,968,000.00 $3,444,000.00 $3,206,000.00 2026-03-01
C9172 HCPCS Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose 2 2 — — $2,884,000.00 $3,500,490.28 $3,192,245.14 2026-03-01
00906 OTHER Inj Elivaldogene Autoteme 1 1 — — $3,180,000.00 $3,180,000.00 $3,180,000.00 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 14 13 — — $11,232.33 $3,816,000.00 $3,180,000.00 2026-03-01
746 OTHER Inj, Betibeglogene Autote 14 13 — — $14,538.76 $3,527,962.80 $2,939,969.00 2026-03-01
00746 OTHER Inj, Betibeglogene Autote 1 1 — — $2,939,969.00 $2,939,969.00 $2,939,969.00 2026-03-01
J1413 HCPCS Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 2 2 — — $2,636,800.00 $3,200,490.28 $2,918,645.14 2026-03-01
J3394 HCPCS Injection, Lovotibeglogene Autotemcel, Per Treatment 2 2 — — $2,628,800.00 $3,100,490.28 $2,864,645.14 2026-03-01
09141 OTHER Inj Onase Abepar-xioi Tre 1 1 — — $2,588,981.00 $2,588,981.00 $2,588,981.00 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 13 12 — — $388,347.15 $3,106,777.20 $2,588,981.00 2026-03-01
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 2 2 — — $2,374,400.00 $2,800,490.28 $2,587,445.14 2026-03-01
00824 OTHER Inj, Exagamglogene Autote 1 1 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2026-03-01
824 OTHER Inj, Exagamglogene Autote 14 13 — — $17,024.52 $2,798,400.00 $2,332,000.00 2026-03-01
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 1 1 — — $2,200,490.28 $2,200,490.28 $2,200,490.28 2026-03-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 4 3 — — $1,842,227.74 $2,322,534.64 $2,082,381.19 2026-03-01
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 5 4 — — $732,102.01 $1,656,833.00 $1,656,833.00 2026-03-01
2067 OTHER Afamitresgene Autoleucel 13 12 — — $115,593.00 $924,744.00 $770,620.00 2026-03-01
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 3 2 — — $598,237.50 $598,237.50 $598,237.50 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 13 12 — — $88,147.44 $705,179.52 $587,649.60 2026-03-01
09498 OTHER Ciltacabtagene Car-pos T 1 1 — — $587,649.60 $587,649.60 $587,649.60 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 13 12 — — $84,979.70 $679,837.56 $566,531.30 2026-03-01
09194 OTHER Tisagenlecleucel Car-pos 1 1 — — $566,531.30 $566,531.30 $566,531.30 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 13 12 — — $84,330.18 $674,641.44 $562,201.20 2026-03-01
09413 OTHER Lisocabtagene Car Pos T 1 1 — — $562,201.20 $562,201.20 $562,201.20 2026-03-01
09422 OTHER Idecabtagene Vicleucel Ca 1 1 — — $558,081.80 $558,081.80 $558,081.80 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 13 12 — — $83,712.27 $669,698.16 $558,081.80 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 11 8 — — $405,756.74 $1,263,446.58 $553,169.00 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 11 8 — — $408,858.00 $1,218,042.30 $538,217.75 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 13 12 — — $79,828.83 $638,630.64 $532,192.20 2026-03-01
09035 OTHER Axicabtagene Ciloleucel C 1 1 — — $532,192.20 $532,192.20 $532,192.20 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 9 7 — — $387,752.24 $1,199,875.72 $530,190.66 2026-03-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 11 8 — — $379,082.81 $1,208,732.67 $516,726.08 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 11 8 — — $359,552.00 $1,144,213.32 $502,841.00 2026-03-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 1 1 — — $501,787.64 $501,787.64 $501,787.64 2026-03-01
09391 OTHER Brexucabtagene Car Pos T 1 1 — — $489,450.20 $489,450.20 $489,450.20 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 13 12 — — $73,417.53 $587,340.24 $489,450.20 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 21 14 — — $395,508.48 $837,547.38 $465,304.10 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 11 8 — — $359,552.00 $1,052,317.93 $464,990.71 2026-03-01
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 5 4 — — $191,598.58 $433,588.39 $433,588.39 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 24 17 — — $232,760.00 $544,026.06 $302,236.70 2026-03-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $283,453.80 $283,453.80 $283,453.80 2026-03-01
831 OTHER Obecbtge Autol Up To 400 14 13 — — $4,807.39 $333,900.00 $278,250.00 2026-03-01
00831 OTHER Obecbtge Autol Up To 400 1 1 — — $278,250.00 $278,250.00 $278,250.00 2026-03-01
00897 OTHER Revakinagene, Per Implant 1 1 — — $265,000.00 $265,000.00 $265,000.00 2026-03-01
897 OTHER Revakinagene, Per Implant 13 12 — — $39,750.00 $318,000.00 $265,000.00 2026-03-01
J3403 HCPCS Revakinagene Taroretcel-lwey, Per Implant 2 2 — — $251,763.01 $265,013.70 $258,388.36 2026-03-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 1 1 — — $249,535.74 $249,535.74 $249,535.74 2026-03-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $249,160.40 $249,160.40 $249,160.40 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 21 15 — — $5,995.00 $414,809.28 $230,449.60 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 26 17 — — $5,995.00 $490,660.00 $229,101.70 2026-03-01
5834 APR_DRG Neonate With Ecmo 1 1 — — $227,217.11 $227,217.11 $227,217.11 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 14 13 — — $10,519.36 $242,002.80 $201,669.00 2026-03-01
00886 OTHER Inj. Remestemcel-l-rknd/ 1 1 — — $201,669.00 $201,669.00 $201,669.00 2026-03-01
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 1 1 — — $199,330.81 $199,330.81 $199,330.81 2026-03-01
01908 OTHER New Technology - Level 52 1 1 — — $192,376.30 $192,376.30 $192,376.30 2026-03-01
01907 OTHER New Technology - Level 52 1 1 — — $192,376.30 $192,376.30 $192,376.30 2026-03-01
1908 OTHER New Technology - Level 52 13 12 — — $28,363.72 $226,909.80 $189,091.50 2026-03-01
1907 OTHER New Technology - Level 52 13 12 — — $28,363.72 $226,909.80 $189,091.50 2026-03-01
5833 APR_DRG Neonate With Ecmo 1 1 — — $182,534.43 $182,534.43 $182,534.43 2026-03-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $179,983.28 $179,983.28 $179,983.28 2026-03-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $175,613.30 $175,613.30 $175,613.30 2026-03-01
01905 OTHER New Technology - Level 51 1 1 — — $173,454.10 $173,454.10 $173,454.10 2026-03-01
01906 OTHER New Technology - Level 51 1 1 — — $173,454.10 $173,454.10 $173,454.10 2026-03-01
1906 OTHER New Technology - Level 51 13 12 — — $25,573.86 $204,590.88 $170,492.40 2026-03-01
1905 OTHER New Technology - Level 51 13 12 — — $25,573.86 $204,590.88 $170,492.40 2026-03-01
C2624 HCPCS System Mntr 2x15mm 4.5cm 23 17 $331,047.00 $331,047.00 $45,022.39 $331,047.00 $165,523.50 2026-03-01
463928 CDM Set Vntrc 17.4x13.8in 23 17 $331,047.00 $331,047.00 $45,022.39 $331,047.00 $165,523.50 2026-03-01
24 APR_DRG Heart And/or Lung Transplant 1 1 — — $162,058.85 $162,058.85 $162,058.85 2026-03-01
01903 OTHER New Technology - Level 50 1 1 — — $154,531.90 $154,531.90 $154,531.90 2026-03-01
01904 OTHER New Technology - Level 50 1 1 — — $154,531.90 $154,531.90 $154,531.90 2026-03-01
1903 OTHER New Technology - Level 50 13 12 — — $22,783.99 $182,271.96 $151,893.30 2026-03-01
1904 OTHER New Technology - Level 50 13 12 — — $22,783.99 $182,271.96 $151,893.30 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 26 17 — — $5,995.00 $289,726.00 $149,780.20 2026-03-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 7 5 — — $59,694.36 $180,011.44 $143,236.05 2026-03-01
1614 APR_DRG Implantable Heart Assist Systems 1 1 — — $142,833.96 $142,833.96 $142,833.96 2026-03-01
7 MS_DRG Lung Transplant 21 14 — — $119,072.93 $252,154.44 $140,085.80 2026-03-01
482755 CDM Stent Eprsth 22fr 31mm 13 11 $233,280.00 $233,280.00 $47,822.40 $233,280.00 $139,968.00 2026-03-01
412374 CDM Stent Eprsth 37x37x20cm 13 11 $233,280.00 $233,280.00 $47,822.40 $233,280.00 $139,968.00 2026-03-01
410559 CDM Stent Graft 10cm 21x21mm 13 11 $233,280.00 $233,280.00 $47,822.40 $233,280.00 $139,968.00 2026-03-01
410522 CDM Stent Thor 20f 26x21x10 13 11 $233,280.00 $233,280.00 $47,822.40 $233,280.00 $139,968.00 2026-03-01
431640 CDM Stent Eprsth 28x8mm 15cm 13 11 $233,280.00 $233,280.00 $47,822.40 $233,280.00 $139,968.00 2026-03-01
410563 CDM Stent 20fr 31x31mm 10cm 13 11 $233,280.00 $233,280.00 $47,822.40 $233,280.00 $139,968.00 2026-03-01
915770 CDM Stent Graft 15cm 31x31mm 13 11 $233,280.00 $233,280.00 $47,822.40 $233,280.00 $139,968.00 2026-03-01
455921 CDM Kit Atsbwl Carticel 1000 13 11 $233,280.00 $233,280.00 $47,822.40 $233,280.00 $139,968.00 2026-03-01
914155 CDM Stent Eprsth 34x34x20cm 13 11 $233,280.00 $233,280.00 $47,822.40 $233,280.00 $139,968.00 2026-03-01
431499 CDM Stent Eprsth 24f 34mm 13 11 $233,280.00 $233,280.00 $47,822.40 $233,280.00 $139,968.00 2026-03-01
481469 CDM Stent Thor 31x26mm 10cm 13 11 $233,280.00 $233,280.00 $47,822.40 $233,280.00 $139,968.00 2026-03-01
919971 CDM Stnt Thorac 26x26mm 10cm 13 11 $233,280.00 $233,280.00 $47,822.40 $233,280.00 $139,968.00 2026-03-01
437690 CDM Graft Evas 34x34x10cm 13 11 $233,280.00 $233,280.00 $47,822.40 $233,280.00 $139,968.00 2026-03-01
411366 CDM Stent Eprsth 37x37x15cm 13 11 $233,280.00 $233,280.00 $47,822.40 $233,280.00 $139,968.00 2026-03-01
485291 CDM Stent Thorac 22fr 34x28 13 11 $233,280.00 $233,280.00 $47,822.40 $233,280.00 $139,968.00 2026-03-01
438278 CDM Stent Eprsth 15cm 8mm 13 11 $233,280.00 $233,280.00 $47,822.40 $233,280.00 $139,968.00 2026-03-01
439727 CDM Graft Evas 40x40x10cm 13 11 $233,280.00 $233,280.00 $47,822.40 $233,280.00 $139,968.00 2026-03-01
440158 CDM Stent Eprsth 8x40mm 15cm 13 11 $233,280.00 $233,280.00 $47,822.40 $233,280.00 $139,968.00 2026-03-01
919754 CDM Graft Evas 45x45mm 15cm 13 11 $232,584.00 $232,584.00 $47,679.72 $232,584.00 $139,550.40 2026-03-01
409871 CDM Stent Eprsth 40x40x15cm 13 11 $232,584.00 $232,584.00 $47,679.72 $232,584.00 $139,550.40 2026-03-01
918199 CDM Stent Graft 15cn 28x28mm 13 11 $232,584.00 $232,584.00 $47,679.72 $232,584.00 $139,550.40 2026-03-01
410975 CDM Stent Eprsth 40x40x20cm 13 11 $232,584.00 $232,584.00 $47,679.72 $232,584.00 $139,550.40 2026-03-01
919923 CDM Stent 34mmx34mmx15cm 13 11 $232,584.00 $232,584.00 $47,679.72 $232,584.00 $139,550.40 2026-03-01
485219 CDM Stent Graft 24f 45x37x15 13 11 $229,804.00 $229,804.00 $47,109.82 $229,804.00 $137,882.40 2026-03-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $137,140.10 $137,140.10 $137,140.10 2026-03-01
01901 OTHER New Technology - Level 49 1 1 — — $135,609.70 $135,609.70 $135,609.70 2026-03-01
01902 OTHER New Technology - Level 49 1 1 — — $135,609.70 $135,609.70 $135,609.70 2026-03-01
1902 OTHER New Technology - Level 49 13 12 — — $19,994.13 $159,953.04 $133,294.20 2026-03-01
1901 OTHER New Technology - Level 49 13 12 — — $19,994.13 $159,953.04 $133,294.20 2026-03-01
C9150 HCPCS Xenon Xe-129 Hyperpolarized Gas, Diagnostic, Per Study Dose 1 1 — — $132,600.00 $132,600.00 $132,600.00 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 21 14 — — $110,548.36 $234,102.42 $130,056.90 2026-03-01
C1822 HCPCS Pulse Gen Imp 39 11 $217,512.00 $217,512.00 $42,243.12 $233,280.00 $129,820.32 2026-03-01
470127 CDM Kit Impl Crnl Cstm Lg 13 11 $216,000.00 $216,000.00 $44,280.00 $216,000.00 $129,600.00 2026-03-01
8411 APR_DRG Extensive Third Degree Burns With Skin Graft 1 1 — — $129,533.11 $129,533.11 $129,533.11 2026-03-01
8412 APR_DRG Extensive Third Degree Burns With Skin Graft 1 1 — — $129,533.11 $129,533.11 $129,533.11 2026-03-01
C1604 HCPCS System Graft Stent Case 12 10 $233,280.00 $233,280.00 $47,822.40 $186,624.00 $128,304.00 2026-03-01
8434 APR_DRG Extensive Third Degree Burns Without Skin Graft 1 1 — — $124,196.61 $124,196.61 $124,196.61 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 24 17 — — $104,274.94 $412,954.00 $123,903.16 2026-03-01
5832 APR_DRG Neonate With Ecmo 1 1 — — $123,852.29 $123,852.29 $123,852.29 2026-03-01
74 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $122,909.77 $122,909.77 $122,909.77 2026-03-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $122,905.80 $122,905.80 $122,905.80 2026-03-01
482650 CDM Stent Vasc 300mm 14mm 13 11 $204,833.00 $204,833.00 $41,990.76 $204,833.00 $122,899.80 2026-03-01
482763 CDM Stent Vasc 325mm 14mm 13 11 $204,833.00 $204,833.00 $41,990.76 $204,833.00 $122,899.80 2026-03-01
482651 CDM Stent Vasc 350mm 12mm 13 11 $204,833.00 $204,833.00 $41,990.76 $204,833.00 $122,899.80 2026-03-01
482767 CDM Stent Vasc 350mm 16mm 13 11 $204,833.00 $204,833.00 $41,990.76 $204,833.00 $122,899.80 2026-03-01
482621 CDM Stent Vasc 20mm 275mm 13 11 $204,833.00 $204,833.00 $41,990.76 $204,833.00 $122,899.80 2026-03-01
482614 CDM Device Embl 2.5x14mm 13 11 $204,833.00 $204,833.00 $41,990.76 $204,833.00 $122,899.80 2026-03-01
482764 CDM Stent Vasc 325mm 16mm 13 11 $204,833.00 $204,833.00 $41,990.76 $204,833.00 $122,899.80 2026-03-01
482766 CDM Stent Vasc 350mm 14mm 13 11 $204,833.00 $204,833.00 $41,990.76 $204,833.00 $122,899.80 2026-03-01
482615 CDM Stent Vasc 20mm 250mm 13 11 $204,833.00 $204,833.00 $41,990.76 $204,833.00 $122,899.80 2026-03-01
482768 CDM Stent Vasc 350mm 20mm 13 11 $204,833.00 $204,833.00 $41,990.76 $204,833.00 $122,899.80 2026-03-01
482616 CDM Stent Vasc 275mm 12mm 13 11 $204,833.00 $204,833.00 $41,990.76 $204,833.00 $122,899.80 2026-03-01
482617 CDM Stent Vasc 275mm 14mm 13 11 $204,833.00 $204,833.00 $41,990.76 $204,833.00 $122,899.80 2026-03-01
482769 CDM Stent Vasc 350mm 25mm 13 11 $204,833.00 $204,833.00 $41,990.76 $204,833.00 $122,899.80 2026-03-01
482618 CDM Stent Vasc 16mm 13 11 $204,833.00 $204,833.00 $41,990.76 $204,833.00 $122,899.80 2026-03-01
482760 CDM Stent Vasc 300mm 16mm 13 11 $204,833.00 $204,833.00 $41,990.76 $204,833.00 $122,899.80 2026-03-01
482622 CDM Stent Vasc 300mm 12mm 13 11 $204,833.00 $204,833.00 $41,990.76 $204,833.00 $122,899.80 2026-03-01
482765 CDM Stent Vasc 325mm 20mm 13 11 $204,833.00 $204,833.00 $41,990.76 $204,833.00 $122,899.80 2026-03-01
437762 CDM Stent Vasc 250mm 16mm 13 11 $204,833.00 $204,833.00 $41,990.76 $204,833.00 $122,899.80 2026-03-01
482762 CDM Stent Vasc 325mm 12mm 13 11 $204,833.00 $204,833.00 $41,990.76 $204,833.00 $122,899.80 2026-03-01
482761 CDM Stent Vasc 20mm 300mm 13 11 $204,833.00 $204,833.00 $41,990.76 $204,833.00 $122,899.80 2026-03-01
437463 CDM Stent Vasc 250mm 12mm 13 11 $204,833.00 $204,833.00 $41,990.76 $204,833.00 $122,899.80 2026-03-01
482613 CDM Stent Vasc 250mm 10mm 13 11 $204,833.00 $204,833.00 $41,990.76 $204,833.00 $122,899.80 2026-03-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $122,883.00 $122,883.00 $122,883.00 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 23 16 — — $5,995.00 $220,565.70 $122,536.50 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 6 4 — — $52,381.27 $157,514.42 $122,172.78 2026-03-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 1 1 — — $120,376.27 $120,376.27 $120,376.27 2026-03-01
C1824 HCPCS Gen Pls Card Smart Mini 13 11 $200,000.00 $200,000.00 $41,000.00 $200,000.00 $120,000.00 2026-03-01
01599 OTHER New Technology - Level 48 1 1 — — $119,841.20 $119,841.20 $119,841.20 2026-03-01
01585 OTHER New Technology - Level 48 1 1 — — $119,841.20 $119,841.20 $119,841.20 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 29 18 — — $20,650.00 $214,803.36 $119,335.20 2026-03-01
1599 OTHER New Technology - Level 48 13 12 — — $17,669.23 $141,353.88 $117,794.90 2026-03-01
1585 OTHER New Technology - Level 48 13 12 — — $17,669.23 $141,353.88 $117,794.90 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 26 17 — — $5,995.00 $211,955.04 $117,752.80 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 21 14 — — $94,936.50 $201,042.00 $111,690.00 2026-03-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 1 1 — — $111,058.85 $111,058.85 $111,058.85 2026-03-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $109,710.92 $109,710.92 $109,710.92 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 15 13 — — $16,236.45 $129,891.60 $108,243.00 2026-03-01
215 MS_DRG Other Heart Assist System Implant 33 21 — — $51,900.00 $319,959.00 $107,887.40 2026-03-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 1 1 — — $107,322.40 $107,322.40 $107,322.40 2026-03-01
01598 OTHER New Technology - Level 47 1 1 — — $107,226.40 $107,226.40 $107,226.40 2026-03-01
01584 OTHER New Technology - Level 47 1 1 — — $107,226.40 $107,226.40 $107,226.40 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 33 21 — — $52,200.00 $272,598.00 $106,013.50 2026-03-01
007 OTHER Lung Transplant 1 1 — — $105,401.50 $105,401.50 $105,401.50 2026-03-01
1584 OTHER New Technology - Level 47 13 12 — — $15,809.32 $126,474.60 $105,395.50 2026-03-01
1598 OTHER New Technology - Level 47 13 12 — — $15,809.32 $126,474.60 $105,395.50 2026-03-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 1 1 — — $105,024.66 $105,024.66 $105,024.66 2026-03-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 1 1 — — $103,363.67 $103,363.67 $103,363.67 2026-03-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 1 1 — — $102,018.76 $102,018.76 $102,018.76 2026-03-01
8423 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 1 1 — — $101,600.71 $101,600.71 $101,600.71 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 3 2 — — $100,394.53 $100,394.53 $100,394.53 2026-03-01
C1882 HCPCS Crt-d Crd 5.37x8.08x0.99 65 11 $195,019.00 $195,019.00 $29,873.83 $200,000.00 $99,791.37 2026-03-01
C1830 HCPCS Generator Nrstm 53x48mm 13 11 $166,152.00 $166,152.00 $34,061.16 $166,152.00 $99,691.20 2026-03-01
1613 APR_DRG Implantable Heart Assist Systems 1 1 — — $99,580.87 $99,580.87 $99,580.87 2026-03-01
470355 CDM Device Embl 5.0x20mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
914699 CDM Device Embl 4.75mm 14mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
431511 CDM Device Embl 3.75mm 20mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
914698 CDM Device Embl 4.5mm 20mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
914690 CDM Device Embl 3.5mm 14mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
914694 CDM Device Emb 4.25mm 16mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
914693 CDM Device Embl 4.25mm 12mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
914702 CDM Device Embl 5.0x16mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
470033 CDM Device Embl 5mm 12mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
913620 CDM Device Embl 4.00x2mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
914692 CDM Device Embl 4mm 16mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
438140 CDM Device Embl 4.5mm 18mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
470354 CDM Device Embl 5mm 18mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
916573 CDM Device Embl 4.25mm 14mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
914688 CDM Device Embl 10mm 2.5mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
913621 CDM Device Embl 4mm 12mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
914691 CDM Device Embl 3.75mm 14mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
915600 CDM Device Embl 4.5mm 14mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
914700 CDM Device Embl 4.75mm 20mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
914697 CDM Device Embl 4.50x16mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
914689 CDM Device Embl 3mm 12mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
914695 CDM Device Embl 4.25mm 20mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
409057 CDM Device Embl 4mm 25mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
914696 CDM Device Embl 4.5mm 12mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
407954 CDM Device Embl 3.5mm 20mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
913449 CDM Device Embl 5mm 35mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
914704 CDM Device Embl 5mm 25mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
916572 CDM Device Embl 5.0x.0mm 13 11 $164,680.00 $164,680.00 $33,759.40 $164,680.00 $98,808.00 2026-03-01
423227 CDM Cage Spnl 6d 12x14x23mm 13 11 $163,530.00 $163,530.00 $33,523.65 $163,530.00 $98,118.00 2026-03-01
430403 CDM Cage Spn 6d 12x14x27mm 13 11 $163,530.00 $163,530.00 $33,523.65 $163,530.00 $98,118.00 2026-03-01
440195 CDM Cage Spnl 6d 12x14x19mm 13 11 $163,530.00 $163,530.00 $33,523.65 $163,530.00 $98,118.00 2026-03-01
486863 CDM Cage Spn 6d 12x14x25mm 13 11 $163,530.00 $163,530.00 $33,523.65 $163,530.00 $98,118.00 2026-03-01
5831 APR_DRG Neonate With Ecmo 1 1 — — $97,858.39 $97,858.39 $97,858.39 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 29 18 — — $20,650.00 $175,852.76 $97,695.98 2026-03-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 1 1 — — $97,509.36 $97,509.36 $97,509.36 2026-03-01
914107 CDM Graft Endo Aaa 32x14mm 13 11 $160,364.00 $160,364.00 $32,874.62 $160,364.00 $96,218.40 2026-03-01
913391 CDM Graft Endo Aaa 23x12mm 13 11 $160,364.00 $160,364.00 $32,874.62 $160,364.00 $96,218.40 2026-03-01
918878 CDM Graft Endo Aaa 26x12mm 13 11 $160,364.00 $160,364.00 $32,874.62 $160,364.00 $96,218.40 2026-03-01
411781 CDM Graft Endo Aaa 28.5x12mm 13 11 $160,364.00 $160,364.00 $32,874.62 $160,364.00 $96,218.40 2026-03-01
411669 CDM Graft Endo Aaa 36x14mm 13 11 $160,364.00 $160,364.00 $32,874.62 $160,364.00 $96,218.40 2026-03-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 1 1 — — $95,570.84 $95,570.84 $95,570.84 2026-03-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 15 13 — — $14,262.15 $114,097.20 $95,081.00 2026-03-01
01583 OTHER New Technology - Level 46 1 1 — — $94,611.63 $94,611.63 $94,611.63 2026-03-01
01597 OTHER New Technology - Level 46 1 1 — — $94,611.63 $94,611.63 $94,611.63 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 25 16 — — $5,995.00 $169,073.78 $93,929.88 2026-03-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $93,416.86 $93,416.86 $93,416.86 2026-03-01
1583 OTHER New Technology - Level 46 13 12 — — $13,949.42 $111,595.34 $92,996.12 2026-03-01
1597 OTHER New Technology - Level 46 13 12 — — $13,949.42 $111,595.34 $92,996.12 2026-03-01
466911 CDM Model Ips Cranl W/mrkng 23 17 $185,327.00 $185,327.00 $25,204.47 $185,327.00 $92,663.50 2026-03-01
466910 CDM Implant Crnl 22.0mm 13 11 $153,404.00 $153,404.00 $31,447.82 $153,404.00 $92,042.40 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 32 20 — — $66,673.00 $176,508.00 $91,460.03 2026-03-01
468950 CDM Retrvr Revac .021in 32mm 23 17 $180,063.00 $180,063.00 $24,488.57 $180,063.00 $90,031.50 2026-03-01
468951 CDM Mcath Rtr 23mm 23 17 $180,063.00 $180,063.00 $24,488.57 $180,063.00 $90,031.50 2026-03-01
014 OTHER Allogeneic Bone Marrow Transplant 1 1 — — $89,970.07 $89,970.07 $89,970.07 2026-03-01
C1823 HCPCS Implantable Pulse Gentr 26 11 $177,140.00 $177,140.00 $24,805.00 $233,280.00 $89,540.00 2026-03-01
430871 CDM Solution Embolic 6ml 23 17 $178,678.00 $178,678.00 $24,300.21 $178,678.00 $89,339.00 2026-03-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $89,022.41 $89,022.41 $89,022.41 2026-03-01
469205 CDM Dvc Revasc 4x40mm 200cm 23 17 $177,293.00 $177,293.00 $24,111.85 $177,293.00 $88,646.50 2026-03-01
469206 CDM Dvc Revasc 6x40mm 200cm 23 17 $177,293.00 $177,293.00 $24,111.85 $177,293.00 $88,646.50 2026-03-01
914344 CDM Dvc Revasc 3x40mm 23 17 $177,293.00 $177,293.00 $24,111.85 $177,293.00 $88,646.50 2026-03-01
486896 CDM Dvc Revasc 4x20mm 200cm 23 17 $177,293.00 $177,293.00 $24,111.85 $177,293.00 $88,646.50 2026-03-01
469204 CDM Dvc Revasc 3x20mm 200c 23 17 $177,293.00 $177,293.00 $24,111.85 $177,293.00 $88,646.50 2026-03-01
408736 CDM Device Wire Thrmb 6x30mm 23 17 $177,155.00 $177,155.00 $24,093.08 $177,155.00 $88,577.50 2026-03-01
408735 CDM Device Wire Thrmb 5x40mm 23 17 $177,155.00 $177,155.00 $24,093.08 $177,155.00 $88,577.50 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 31 20 — — $24,000.00 $164,114.93 $88,439.71 2026-03-01
C1820 HCPCS Nrstm Impl 1.9inx.6in 169 11 $174,582.00 $174,582.00 $2,319.16 $233,280.00 $88,357.50 2026-03-01
C1722 HCPCS Icd Defib Card 7.36cm 156 11 $146,528.00 $146,528.00 $24,626.44 $200,000.00 $87,564.89 2026-03-01
64 APR_DRG Pancreas Transplant 1 1 — — $86,801.47 $86,801.47 $86,801.47 2026-03-01
C1767 HCPCS Gen Nrstm 52x52x6.9mm 130 11 $164,152.50 $164,152.50 $21,223.65 $233,280.00 $86,741.00 2026-03-01
453374 CDM Graft Hemi Cndyl Mdl Rt 13 11 $143,372.00 $143,372.00 $29,391.26 $143,372.00 $86,023.20 2026-03-01
457870 CDM Graft Skn Flx Hd Ult Thk 13 11 $142,476.00 $142,476.00 $29,207.58 $142,476.00 $85,485.60 2026-03-01
23 APR_DRG Heart And/or Lung Transplant 1 1 — — $85,185.86 $85,185.86 $85,185.86 2026-03-01
914449 CDM Implant Cranial Peek 13 11 $141,772.00 $141,772.00 $29,063.26 $141,772.00 $85,063.20 2026-03-01
746235 CDM Ins Icd Lead/generator 18 15 $261,150.00 $261,150.00 $35,516.40 $261,150.00 $84,939.04 2026-03-01
465179 CDM Graft Bn Fm Troch 13 11 $141,339.00 $141,339.00 $28,974.49 $141,339.00 $84,803.40 2026-03-01
455934 CDM Graft Ostchnd Tochlr Lt 13 11 $140,171.00 $140,171.00 $28,735.06 $140,171.00 $84,102.60 2026-03-01
425131 CDM Graft Evas 10cm 12mm 13 11 $139,445.00 $139,445.00 $28,586.22 $139,445.00 $83,667.00 2026-03-01
425245 CDM Graft Evas 10cm 14.5mm 13 11 $139,445.00 $139,445.00 $28,586.22 $139,445.00 $83,667.00 2026-03-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $83,429.27 $83,429.27 $83,429.27 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 33 21 — — $68,312.00 $254,425.00 $83,374.91 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 33 21 — — $31,450.00 $255,000.00 $83,018.85 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 12 9 — — $49,440.00 $153,000.00 $82,754.24 2026-03-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 25 16 — — $5,995.00 $148,944.06 $82,746.70 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 32 20 — — $5,670.00 $153,763.49 $82,391.61 2026-03-01
01582 OTHER New Technology - Level 45 1 1 — — $81,996.83 $81,996.83 $81,996.83 2026-03-01
01596 OTHER New Technology - Level 45 1 1 — — $81,996.83 $81,996.83 $81,996.83 2026-03-01
428693 CDM Graft Hemi Cndyl L/l Fem 13 11 $136,558.00 $136,558.00 $27,994.39 $136,558.00 $81,934.80 2026-03-01
C1721 HCPCS Cardioverter 359654 169 11 $147,330.00 $147,330.00 $21,228.57 $200,000.00 $81,324.18 2026-03-01
916377 CDM Gft Evs 15f 20x14.5x12mm 13 11 $135,533.00 $135,533.00 $27,784.26 $135,533.00 $81,319.80 2026-03-01
05244 OTHER Level 4 Blood Product Exc 1 1 — — $81,067.15 $81,067.15 $81,067.15 2026-03-01
1596 OTHER New Technology - Level 45 13 12 — — $12,089.51 $96,716.06 $80,596.72 2026-03-01
1582 OTHER New Technology - Level 45 13 12 — — $12,089.51 $96,716.06 $80,596.72 2026-03-01
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 1 1 — — $80,580.34 $80,580.34 $80,580.34 2026-03-01
5244 OTHER Level 4 Blood Product Exc 13 12 — — $11,952.44 $95,619.49 $79,682.91 2026-03-01
746705 CDM Rem/replace Icd Gen Mult 18 15 $244,048.00 $244,048.00 $33,190.53 $244,048.00 $79,376.61 2026-03-01
746710 CDM Rem/replace Icd Gen Dual 18 15 $244,048.00 $244,048.00 $33,190.53 $244,048.00 $79,376.61 2026-03-01
746715 CDM Rem/replace Icd Gen Sgl 18 15 $244,048.00 $244,048.00 $33,190.53 $244,048.00 $79,376.61 2026-03-01
746725 CDM Ins Icd Gen Only Dual Ld 18 15 $244,044.00 $244,044.00 $33,189.98 $244,044.00 $79,375.31 2026-03-01
746720 CDM Ins Icd Gen Only Mult Ld 18 15 $244,044.00 $244,044.00 $33,189.98 $244,044.00 $79,375.31 2026-03-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $78,947.04 $78,947.04 $78,947.04 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 30 18 — — $20,650.00 $198,837.48 $78,429.83 2026-03-01
10 MS_DRG Pancreas Transplant 21 14 — — $66,273.09 $140,343.01 $77,968.34 2026-03-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 21 15 — — $5,995.00 $140,284.93 $77,936.07 2026-03-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 21 14 — — $65,897.29 $139,547.20 $77,526.22 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 28 17 — — $63,747.00 $181,732.00 $77,481.04 2026-03-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $77,427.65 $77,427.65 $77,427.65 2026-03-01
454615 CDM Graft Bn Hemi Condrl Rt 13 11 $128,010.00 $128,010.00 $26,242.05 $128,010.00 $76,806.00 2026-03-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 2 1 — — $70,667.00 $82,033.00 $76,350.00 2026-03-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 1 1 — — $75,895.51 $75,895.51 $75,895.51 2026-03-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 24 16 — — $8,063.00 $135,233.14 $75,129.52 2026-03-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 31 19 — — $18,000.00 $134,576.71 $74,764.84 2026-03-01
429 OTHER Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 1 1 — — $74,273.47 $74,273.47 $74,273.47 2026-03-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $73,417.90 $73,417.90 $73,417.90 2026-03-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 1 1 — — $73,210.51 $73,210.51 $73,210.51 2026-03-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 25 16 — — $5,995.00 $131,734.24 $73,185.69 2026-03-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $73,030.33 $73,030.33 $73,030.33 2026-03-01
425160 CDM Cage Spnl Exp 18mm 13 11 $121,581.00 $121,581.00 $24,924.10 $121,581.00 $72,948.60 2026-03-01
408184 CDM Cage Spn Crpctmy 18mm 13 11 $121,581.00 $121,581.00 $24,924.10 $121,581.00 $72,948.60 2026-03-01
916564 CDM Cage Spn 18mm 24mm 13 11 $121,581.00 $121,581.00 $24,924.10 $121,581.00 $72,948.60 2026-03-01
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