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 — reason	Rows
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 via	Discovered 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.

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

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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
C1721	HCPCS	Cardioverter 359654	169	11	$147,330.00	$147,330.00	$21,228.57	$200,000.00	$81,324.18	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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
1613	APR_DRG	Implantable Heart Assist Systems	1	1	—	—	$99,580.87	$99,580.87	$99,580.87	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
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
231	MS_DRG	Coronary Bypass With Ptca With Mcc	32	20	—	—	$66,673.00	$176,508.00	$91,460.03	2026-03-01
014	OTHER	Allogeneic Bone Marrow Transplant	1	1	—	—	$89,970.07	$89,970.07	$89,970.07	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
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
64	APR_DRG	Pancreas Transplant	1	1	—	—	$86,801.47	$86,801.47	$86,801.47	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
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
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
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
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

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