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

CATHOLIC MEDICAL CENTER

Manchester, NH · CCN 300034 · Rates published

24,040 distinct procedures filed
14 distinct payers
335,983 rate rows
2026-03-01 last MRF observed
Data quality

329,035 of 335,983 rate rows are consumer-grade (97.9%)

6,948 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
template filing: same amount across many unrelated codes — excluded 3,970
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 1,565
placeholder amount (≤ $0.02) — excluded from medians 1,062
per-diem day rate — not a per-procedure price 351
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://core.secure.ehc.com/src/util/json-detail-price-list/99-3123201_CATHOLIC-MEDICAL-CENTER_standardcharges.json
Found on page https://catholicmc.com/about/legal/pricing-transparency-cms-required-file-of-standard-charges.dot
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-16

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 6 $6,037.93 $4,685,200.00 $4,505,000.00 nat. median
$9,966
outlier · 452.1×
00845
OTHER 		Inj, Atidarsagene Autotem 2 $4,369,850.00 $4,505,000.00 $4,437,425.00 nat. median
$4,505,000
1.0× median
J3391
HCPCS 		Injection, Atidarsagene Autotemcel, Per Treatment 1 $4,335,000.00 $4,335,000.00 $4,335,000.00 nat. median
$4,505,000
1.0× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 5 $3,685,267.00 $3,832,677.68 $3,758,972.34 nat. median
$3,746,358
1.0× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 2 $3,574,708.99 $3,685,267.00 $3,629,988.00 nat. median
$3,574,709
1.0× median
J1411
HCPCS 		Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 1 $3,570,000.00 $3,570,000.00 $3,570,000.00 nat. median
$3,710,000
1.0× median
J1414
HCPCS 		Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose 1 $3,570,000.00 $3,570,000.00 $3,570,000.00 nat. median
$3,710,000
1.0× median
908
OTHER 		Topi Adm Prad Zami Per Tr 6 $10,932.52 $3,469,252.80 $3,335,820.00 nat. median
$22,747
outlier · 146.6×
714
OTHER 		Inj Delandistrogene Mox R 6 $7,101.41 $3,460,974.40 $3,327,860.00 nat. median
$13,041
outlier · 255.2×
00908
OTHER 		Topi Adm Prad Zami Per Tr 2 $3,235,745.40 $3,335,820.00 $3,285,782.70 nat. median
$12,675
outlier · 259.2×
00714
OTHER 		Inj Delandistrogene Mox R 2 $3,228,024.20 $3,327,860.00 $3,277,942.10 nat. median
$3,228,024
1.0× median
J1413
HCPCS 		Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 1 $3,264,000.00 $3,264,000.00 $3,264,000.00 nat. median
$3,325,455
1.0× median
748
OTHER 		Inj, Lovotibeglogene Auto 6 $13,517.46 $3,382,608.32 $3,252,508.00 nat. median
$17,963
outlier · 181.1×
00748
OTHER 		Inj, Lovotibeglogene Auto 2 $3,154,932.76 $3,252,508.00 $3,203,720.38 nat. median
$3,187,420
1.0× median
906
OTHER 		Inj Elivaldogene Autoteme 6 $9,660.17 $3,307,200.00 $3,180,000.00 nat. median
$20,756
outlier · 153.2×
J3394
HCPCS 		Injection, Lovotibeglogene Autotemcel, Per Treatment 1 $3,162,000.00 $3,162,000.00 $3,162,000.00 nat. median
$3,286,000
1.0× median
00906
OTHER 		Inj Elivaldogene Autoteme 2 $3,084,600.00 $3,180,000.00 $3,132,300.00 nat. median
$21
outlier · 151392.0×
746
OTHER 		Inj, Betibeglogene Autote 6 $12,503.79 $3,057,567.76 $2,939,969.00 nat. median
$21,896
outlier · 134.3×
00746
OTHER 		Inj, Betibeglogene Autote 2 $2,851,769.93 $2,939,969.00 $2,895,869.46 nat. median
$2,878,960
1.0× median
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $2,856,000.00 $2,856,000.00 $2,856,000.00 nat. median
$3,006,423
0.9× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 6 $2,588,981.00 $4,615,635.33 $2,640,760.62 nat. median
$2,588,981
1.0× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 2 $2,511,311.57 $2,588,981.00 $2,550,146.29 nat. median
$2,457,321
1.0× median
824
OTHER 		Inj, Exagamglogene Autote 7 $14,641.64 $4,157,489.60 $2,355,320.00 nat. median
$25,250
outlier · 93.3×
00824
OTHER 		Inj, Exagamglogene Autote 2 $2,262,040.00 $2,332,000.00 $2,297,020.00 nat. median
$2,332,000
1.0× median
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 1 $2,244,000.00 $2,244,000.00 $2,244,000.00 nat. median
$2,448,600
0.9× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 $2,146,250.00 $2,146,250.00 $2,146,250.00 nat. median
$2,469,189
0.9× median
2067
OTHER 		Afamitresgene Autoleucel 6 $770,620.00 $1,373,861.34 $786,032.40 nat. median
$786,032
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 1 $770,620.00 $770,620.00 $770,620.00 nat. median
$824,563
0.9× median
9498
OTHER 		Ciltacabtagene Car-pos T 6 $587,649.60 $1,047,661.71 $599,402.59 nat. median
$587,650
1.0× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 3 $536,573.93 $587,649.57 $587,649.57 nat. median
$675,122
0.9× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 11 $271,952.69 $1,592,279.38 $581,542.77 nat. median
$370,174
1.6× median
09498
OTHER 		Ciltacabtagene Car-pos T 2 $570,020.11 $587,649.60 $578,834.85 nat. median
$554,552
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos 6 $566,531.30 $1,010,012.00 $577,861.93 nat. median
$566,531
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 6 $562,201.20 $1,002,292.30 $573,445.22 nat. median
$562,201
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 6 $558,081.80 $994,948.23 $569,243.44 nat. median
$558,082
1.0× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 3 $561,407.87 $578,771.00 $566,531.30 nat. median
$754,974
0.8× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 3 $500,948.74 $562,201.24 $562,201.24 nat. median
$674,188
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 3 $511,793.34 $558,081.73 $558,081.73 nat. median
$625,184
0.9× median
09194
OTHER 		Tisagenlecleucel Car-pos 2 $549,535.36 $566,531.30 $558,033.33 nat. median
$538,205
1.0× median
09413
OTHER 		Lisocabtagene Car Pos T 2 $545,335.16 $562,201.20 $553,768.18 nat. median
$534,091
1.0× median
09422
OTHER 		Idecabtagene Vicleucel Ca 2 $541,339.35 $558,081.80 $549,710.57 nat. median
$530,178
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 6 $532,192.20 $948,792.25 $542,836.04 nat. median
$532,192
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 3 $487,755.77 $532,192.24 $532,192.24 nat. median
$634,511
0.8× median
09035
OTHER 		Axicabtagene Ciloleucel C 2 $516,226.43 $532,192.20 $524,209.31 nat. median
$505,583
1.0× median
9391
OTHER 		Brexucabtagene Car Pos T 6 $489,450.20 $872,591.82 $499,239.20 nat. median
$489,450
1.0× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 3 $474,717.03 $489,450.20 $489,450.20 nat. median
$620,080
0.8× median
09391
OTHER 		Brexucabtagene Car Pos T 2 $474,766.69 $489,450.20 $482,108.45 nat. median
$464,978
1.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 11 $203,126.17 $1,033,325.26 $452,894.25 nat. median
$265,286
1.7× median
J3403
HCPCS 		Revakinagene Taroretcel-lwey, Per Implant 2 $265,000.00 $1,140,825.00 $443,504.00 nat. median
$265,000
1.7× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 12 $166,223.32 $486,940.85 $326,582.09 nat. median
$206,368
1.6× median

Other procedures at this hospital

Browse this hospital's 24,040 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
             
93653 CPT Comprehensive Electrophysiologic Evaluation With Insertion And Repositioning Of … 24 7 $163,297.00 $163,297.00 $18,501.55 $117,900.43 $65,441.27 2026-03-01
93656 CPT Comprehensive Electrophysiologic Evaluation With Transseptal Catheterizations, I… 24 7 $157,983.00 $157,983.00 $17,899.47 $114,063.73 $63,311.69 2026-03-01
C1824 HCPCS Gen Pls Card Smart Mini 16 7 $135,000.00 $135,000.00 $15,295.50 $117,531.00 $87,102.00 2026-03-01
C2624 HCPCS System Mntr 2x15mm 4.5cm 17 8 $135,000.00 $135,000.00 $15,295.50 $117,531.00 $85,698.00 2026-03-01
573195 CDM Kit Cath Rt Heart 12 7 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $68,343.75 2026-03-01
574836 CDM System Hrt Vlv Transcath 12 7 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $68,343.75 2026-03-01
371977 CDM Set Vntrc 17.4x13.8in 12 7 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $68,343.75 2026-03-01
581224 CDM Cath Vasc Assist Strl 12 7 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $68,343.75 2026-03-01
488819 CDM Set Pump 21fr 5.0 12 7 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $68,343.75 2026-03-01
578762 CDM Kit Cath Rt Heart 12 7 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $68,343.75 2026-03-01
488823 CDM Kit Pmp Rt Hrt 22f 170cm 12 7 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $68,343.75 2026-03-01
399586 CDM Kit Device Guided 3cm 12 7 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $68,343.75 2026-03-01
595991 CDM Valve Tavr 29mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
487214 CDM Valve Tavr 23mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
777080 CDM Valve Aor Tavr 29mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
608765 CDM Stent Eprsth 28x8mm 20cm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
574830 CDM Valve Tavr 23mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
575013 CDM Valve Tavr Sz 23mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
575012 CDM Valve Tavr Sz 26mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
607138 CDM Graft Vasc 28mm 150mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
585066 CDM Valve Tavr 29mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
585068 CDM Valve Tavr 20mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
777081 CDM Valve Aor Tavr 34mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
575010 CDM Valve Tavr Size 34mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
595689 CDM System Pascal Implant 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
545488 CDM Valve Aor Tavr 26mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
585067 CDM Valve Tavr 26mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
477173 CDM Valve Tavr 23mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
463211 CDM Valve 29mm Ascendra Aor 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
551582 CDM Valve Heart Trnscth 20mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
477175 CDM Valve Tavr 29mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
551580 CDM Valve Heart Trnscth 26mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
551581 CDM Valve Heart Trnscth 23mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
596518 CDM Valve Tavr 26mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
469507 CDM Kit Aor Vlv 14fr 29mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
783607 CDM Valve Tavr 23mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
597336 CDM Valve Tavr 26mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
777083 CDM Valve Aor Tavr 23mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
584925 CDM Valve Tavr 23mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
575011 CDM Valve Tavr Sz 29mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
477174 CDM Valve Tavr 26mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
578977 CDM Valve Aor 26mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
599593 CDM Valve Tavr 20mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
606667 CDM Valve Tavr 23mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
586409 CDM Valve Pulm 27mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
560361 CDM Sys Valve Aor 26mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
560363 CDM Valve Aortic 23mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
599201 CDM Valve Tavr 20mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
599202 CDM Valve Tavr 29mm 11 6 $135,000.00 $135,000.00 $15,295.50 $97,470.00 $67,635.00 2026-03-01
127342 CDM Ins/repl Ccm System 12 7 $134,659.00 $134,659.00 $15,256.86 $97,223.80 $68,171.12 2026-03-01
122540 CDM Ins Icd Lead/generator 11 6 $130,882.00 $130,882.00 $14,828.93 $94,496.80 $65,571.88 2026-03-01
122550 CDM Ins/repl Sq Icd With Elec 11 6 $130,882.00 $130,882.00 $14,828.93 $94,496.80 $65,571.88 2026-03-01
127340 CDM Ins Icd Gen Only Mult Ld 11 6 $130,882.00 $130,882.00 $14,828.93 $94,496.80 $65,571.88 2026-03-01
122561 CDM Rem/replace Icd Gen Mult 11 6 $130,882.00 $130,882.00 $14,828.93 $94,496.80 $65,571.88 2026-03-01
85360 CDM Imp Wrls P-art Pres Snsr 12 7 $125,266.00 $125,266.00 $14,192.64 $90,442.05 $63,415.91 2026-03-01
544413 CDM Valve Tavi 23mm 11 6 $123,176.00 $123,176.00 $13,955.84 $88,933.07 $61,711.18 2026-03-01
544415 CDM Valve Tavi 27mm 11 6 $123,176.00 $123,176.00 $13,955.84 $88,933.07 $61,711.18 2026-03-01
544414 CDM Valve Tavi 25mm 11 6 $123,176.00 $123,176.00 $13,955.84 $88,933.07 $61,711.18 2026-03-01
544416 CDM Valve Tavi 29mm 11 6 $123,176.00 $123,176.00 $13,955.84 $88,933.07 $61,711.18 2026-03-01
586410 CDM Valve Pulm 22-26mm 11 6 $122,228.00 $122,228.00 $13,848.43 $88,248.62 $61,236.23 2026-03-01
C1604 HCPCS System Graft Stent Case 16 7 $119,575.00 $119,575.00 $13,547.85 $104,101.99 $77,149.79 2026-03-01
C1882 HCPCS Crt-d Crd 5.37x8.08x0.99 160 7 $118,355.50 $118,355.50 $9,069.21 $117,531.00 $61,630.03 2026-03-01
C1820 HCPCS Kit Generator Nrstm Ipg 112 7 $111,568.00 $111,568.00 $8,833.21 $101,060.99 $66,893.32 2026-03-01
845 OTHER Inj, Atidarsagene Autotem 7 6 — — $6,037.93 $4,685,200.00 $4,505,000.00 2026-03-01
00845 OTHER Inj, Atidarsagene Autotem 2 2 — — $4,369,850.00 $4,505,000.00 $4,437,425.00 2026-03-01
J3391 HCPCS Injection, Atidarsagene Autotemcel, Per Treatment 5 1 — — $4,335,000.00 $4,335,000.00 $4,335,000.00 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 5 5 — — $3,685,267.00 $3,832,677.68 $3,758,972.34 2026-03-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 2 2 — — $3,574,708.99 $3,685,267.00 $3,629,988.00 2026-03-01
J1411 HCPCS Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 5 1 — — $3,570,000.00 $3,570,000.00 $3,570,000.00 2026-03-01
J1414 HCPCS Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose 5 1 — — $3,570,000.00 $3,570,000.00 $3,570,000.00 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 7 6 — — $10,932.52 $3,469,252.80 $3,335,820.00 2026-03-01
714 OTHER Inj Delandistrogene Mox R 7 6 — — $7,101.41 $3,460,974.40 $3,327,860.00 2026-03-01
00908 OTHER Topi Adm Prad Zami Per Tr 2 2 — — $3,235,745.40 $3,335,820.00 $3,285,782.70 2026-03-01
00714 OTHER Inj Delandistrogene Mox R 2 2 — — $3,228,024.20 $3,327,860.00 $3,277,942.10 2026-03-01
J1413 HCPCS Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 5 1 — — $3,264,000.00 $3,264,000.00 $3,264,000.00 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 7 6 — — $13,517.46 $3,382,608.32 $3,252,508.00 2026-03-01
00748 OTHER Inj, Lovotibeglogene Auto 2 2 — — $3,154,932.76 $3,252,508.00 $3,203,720.38 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 7 6 — — $9,660.17 $3,307,200.00 $3,180,000.00 2026-03-01
J3394 HCPCS Injection, Lovotibeglogene Autotemcel, Per Treatment 5 1 — — $3,162,000.00 $3,162,000.00 $3,162,000.00 2026-03-01
00906 OTHER Inj Elivaldogene Autoteme 2 2 — — $3,084,600.00 $3,180,000.00 $3,132,300.00 2026-03-01
746 OTHER Inj, Betibeglogene Autote 7 6 — — $12,503.79 $3,057,567.76 $2,939,969.00 2026-03-01
00746 OTHER Inj, Betibeglogene Autote 2 2 — — $2,851,769.93 $2,939,969.00 $2,895,869.46 2026-03-01
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 5 1 — — $2,856,000.00 $2,856,000.00 $2,856,000.00 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 6 6 — — $2,588,981.00 $4,615,635.33 $2,640,760.62 2026-03-01
09141 OTHER Inj Onase Abepar-xioi Tre 2 2 — — $2,511,311.57 $2,588,981.00 $2,550,146.29 2026-03-01
824 OTHER Inj, Exagamglogene Autote 8 7 — — $14,641.64 $4,157,489.60 $2,355,320.00 2026-03-01
00824 OTHER Inj, Exagamglogene Autote 2 2 — — $2,262,040.00 $2,332,000.00 $2,297,020.00 2026-03-01
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 5 1 — — $2,244,000.00 $2,244,000.00 $2,244,000.00 2026-03-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 5 1 — — $2,146,250.00 $2,146,250.00 $2,146,250.00 2026-03-01
2067 OTHER Afamitresgene Autoleucel 6 6 — — $770,620.00 $1,373,861.34 $786,032.40 2026-03-01
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 5 1 — — $770,620.00 $770,620.00 $770,620.00 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 6 6 — — $587,649.60 $1,047,661.71 $599,402.59 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 7 3 — — $536,573.93 $587,649.57 $587,649.57 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 28 11 — — $271,952.69 $1,592,279.38 $581,542.77 2026-03-01
09498 OTHER Ciltacabtagene Car-pos T 2 2 — — $570,020.11 $587,649.60 $578,834.85 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 6 6 — — $566,531.30 $1,010,012.00 $577,861.93 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 6 6 — — $562,201.20 $1,002,292.30 $573,445.22 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 6 6 — — $558,081.80 $994,948.23 $569,243.44 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 7 3 — — $561,407.87 $578,771.00 $566,531.30 2026-03-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 7 3 — — $500,948.74 $562,201.24 $562,201.24 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 7 3 — — $511,793.34 $558,081.73 $558,081.73 2026-03-01
09194 OTHER Tisagenlecleucel Car-pos 2 2 — — $549,535.36 $566,531.30 $558,033.33 2026-03-01
09413 OTHER Lisocabtagene Car Pos T 2 2 — — $545,335.16 $562,201.20 $553,768.18 2026-03-01
09422 OTHER Idecabtagene Vicleucel Ca 2 2 — — $541,339.35 $558,081.80 $549,710.57 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 6 6 — — $532,192.20 $948,792.25 $542,836.04 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 7 3 — — $487,755.77 $532,192.24 $532,192.24 2026-03-01
09035 OTHER Axicabtagene Ciloleucel C 2 2 — — $516,226.43 $532,192.20 $524,209.31 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 6 6 — — $489,450.20 $872,591.82 $499,239.20 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 7 3 — — $474,717.03 $489,450.20 $489,450.20 2026-03-01
09391 OTHER Brexucabtagene Car Pos T 2 2 — — $474,766.69 $489,450.20 $482,108.45 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 29 11 — — $203,126.17 $1,033,325.26 $452,894.25 2026-03-01
J3403 HCPCS Revakinagene Taroretcel-lwey, Per Implant 14 2 — — $265,000.00 $1,140,825.00 $443,504.00 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 31 12 — — $166,223.32 $486,940.85 $326,582.09 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 31 12 — — $154,547.06 $484,083.14 $319,315.10 2026-03-01
831 OTHER Obecbtge Autol Up To 400 8 7 — — $4,134.51 $496,064.10 $281,032.50 2026-03-01
00831 OTHER Obecbtge Autol Up To 400 2 2 — — $269,902.50 $278,250.00 $274,076.25 2026-03-01
897 OTHER Revakinagene, Per Implant 6 6 — — $265,000.00 $472,442.00 $270,300.00 2026-03-01
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 5 1 — — $267,750.00 $267,750.00 $267,750.00 2026-03-01
00897 OTHER Revakinagene, Per Implant 2 2 — — $257,050.00 $265,000.00 $261,025.00 2026-03-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $243,779.43 $251,319.00 $247,549.21 2026-03-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 2 2 — — $214,286.00 $220,913.40 $217,599.70 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 31 12 — — $101,894.10 $315,908.88 $208,901.49 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 8 7 — — $9,046.99 $359,535.49 $203,685.69 2026-03-01
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 5 1 — — $201,669.02 $201,669.02 $201,669.02 2026-03-01
00886 OTHER Inj. Remestemcel-l-rknd/ 2 2 — — $195,618.93 $201,669.00 $198,643.96 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 29 11 — — $79,470.20 $417,837.46 $183,133.22 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 29 10 — — $88,352.38 $417,358.11 $182,923.13 2026-03-01
7 MS_DRG Lung Transplant 27 10 — — $94,241.10 $477,512.72 $180,383.34 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 31 12 — — $78,557.20 $400,960.69 $173,126.55 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 27 10 — — $94,479.08 $443,136.03 $167,397.33 2026-03-01
1908 OTHER New Technology - Level 52 6 6 — — $163,068.80 $290,719.06 $166,330.18 2026-03-01
1907 OTHER New Technology - Level 52 6 6 — — $163,068.80 $290,719.06 $166,330.18 2026-03-01
01908 OTHER New Technology - Level 52 2 2 — — $158,141.23 $163,032.20 $160,586.72 2026-03-01
01907 OTHER New Technology - Level 52 2 2 — — $158,141.23 $163,032.20 $160,586.72 2026-03-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 2 — — $151,033.07 $155,704.20 $153,368.64 2026-03-01
1905 OTHER New Technology - Level 51 6 6 — — $147,029.30 $262,123.84 $149,969.89 2026-03-01
1906 OTHER New Technology - Level 51 6 6 — — $147,029.30 $262,123.84 $149,969.89 2026-03-01
215 MS_DRG Other Heart Assist System Implant 31 12 — — $76,401.64 $227,089.30 $147,560.00 2026-03-01
01905 OTHER New Technology - Level 51 2 2 — — $142,586.41 $146,996.30 $144,791.35 2026-03-01
01906 OTHER New Technology - Level 51 2 2 — — $142,586.41 $146,996.30 $144,791.35 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 27 10 — — $76,793.96 $380,179.07 $143,614.95 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 31 12 — — $61,746.30 $223,116.32 $142,431.31 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 31 12 — — $66,428.66 $319,301.74 $137,867.90 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 31 12 — — $61,107.18 $310,835.70 $134,212.44 2026-03-01
1903 OTHER New Technology - Level 50 6 6 — — $130,989.80 $233,528.62 $133,609.60 2026-03-01
1904 OTHER New Technology - Level 50 6 6 — — $130,989.80 $233,528.62 $133,609.60 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 31 12 — — $72,800.00 $251,360.51 $132,782.32 2026-03-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 15 3 — — $31,905.54 $300,368.46 $131,366.72 2026-03-01
01904 OTHER New Technology - Level 50 2 2 — — $127,031.59 $130,960.40 $128,995.99 2026-03-01
01903 OTHER New Technology - Level 50 2 2 — — $127,031.59 $130,960.40 $128,995.99 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 15 3 — — $69,162.84 $291,907.89 $127,666.47 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 31 12 — — $51,939.30 $213,164.96 $126,354.10 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 31 12 — — $58,129.49 $290,146.26 $125,279.16 2026-03-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 31 12 — — $53,825.58 $280,968.57 $121,316.43 2026-03-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 2 — — $117,944.92 $121,592.70 $119,768.81 2026-03-01
1902 OTHER New Technology - Level 49 6 6 — — $114,950.30 $204,933.39 $117,249.31 2026-03-01
1901 OTHER New Technology - Level 49 6 6 — — $114,950.30 $204,933.39 $117,249.31 2026-03-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 31 12 — — $43,200.65 $264,166.00 $115,133.00 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 31 12 — — $51,193.33 $266,171.44 $114,927.33 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 31 12 — — $50,961.11 $262,919.24 $113,523.10 2026-03-01
01902 OTHER New Technology - Level 49 2 2 — — $111,476.76 $114,924.50 $113,200.63 2026-03-01
01901 OTHER New Technology - Level 49 2 2 — — $111,476.76 $114,924.50 $113,200.63 2026-03-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 31 12 — — $48,081.50 $253,608.81 $113,182.72 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 31 12 — — $48,602.40 $174,364.08 $111,483.24 2026-03-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 31 12 — — $50,167.83 $254,858.80 $110,042.77 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 8 7 — — $104,995.71 $192,975.62 $109,325.43 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 31 12 — — $61,072.56 $191,656.34 $108,789.00 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 31 12 — — $60,145.14 $205,481.95 $108,789.00 2026-03-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 2 2 — — $105,702.94 $108,972.10 $107,337.52 2026-03-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 31 12 — — $49,240.41 $248,195.85 $107,165.84 2026-03-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 31 12 — — $44,611.26 $246,551.31 $106,455.77 2026-03-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 31 12 — — $48,163.00 $163,587.77 $105,875.38 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 31 12 — — $42,902.82 $186,246.00 $104,685.35 2026-03-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 31 12 — — $46,568.49 $186,246.00 $104,685.35 2026-03-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 31 12 — — $44,407.88 $241,569.77 $104,304.84 2026-03-01
1585 OTHER New Technology - Level 48 6 6 — — $101,584.00 $181,103.96 $103,615.68 2026-03-01
1599 OTHER New Technology - Level 48 6 6 — — $101,584.00 $181,103.96 $103,615.68 2026-03-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 31 12 — — $46,642.78 $237,266.69 $102,446.86 2026-03-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 31 12 — — $48,348.33 $152,387.25 $100,367.79 2026-03-01
01599 OTHER New Technology - Level 48 2 2 — — $98,514.36 $101,561.20 $100,037.78 2026-03-01
01585 OTHER New Technology - Level 48 2 2 — — $98,514.36 $101,561.20 $100,037.78 2026-03-01
10 MS_DRG Pancreas Transplant 27 10 — — $57,455.64 $264,589.59 $99,950.33 2026-03-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 31 12 — — $38,195.05 $177,367.01 $99,120.00 2026-03-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 31 12 — — $45,605.74 $225,710.69 $97,457.22 2026-03-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 31 12 — — $44,050.91 $223,546.25 $96,522.65 2026-03-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 28 11 — — $55,872.58 $263,074.11 $96,081.65 2026-03-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 8 7 — — $92,228.57 $169,510.41 $96,031.81 2026-03-01
28 MS_DRG Spinal Procedures With Mcc 31 12 — — $43,840.33 $221,544.05 $95,658.14 2026-03-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 31 12 — — $44,668.95 $221,481.36 $95,631.08 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 17 5 — — $61,338.53 $276,702.97 $94,124.00 2026-03-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 31 12 — — $41,985.50 $216,252.77 $93,373.48 2026-03-01
1584 OTHER New Technology - Level 47 6 6 — — $90,891.03 $162,040.53 $92,708.85 2026-03-01
1598 OTHER New Technology - Level 47 6 6 — — $90,891.03 $162,040.53 $92,708.85 2026-03-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 29 10 — — $44,790.07 $210,430.52 $92,229.21 2026-03-01
007 OTHER Lung Transplant 2 2 — — $90,648.71 $93,452.28 $92,050.49 2026-03-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 31 12 — — $41,140.29 $211,293.35 $91,232.11 2026-03-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 31 12 — — $38,947.95 $210,157.66 $90,741.74 2026-03-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 31 12 — — $37,031.40 $157,925.12 $89,894.19 2026-03-01
01598 OTHER New Technology - Level 47 2 2 — — $88,144.51 $90,870.63 $89,507.57 2026-03-01
01584 OTHER New Technology - Level 47 2 2 — — $88,144.51 $90,870.63 $89,507.57 2026-03-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 31 12 — — $41,387.65 $136,000.42 $88,694.04 2026-03-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 31 12 — — $36,079.15 $205,242.49 $88,619.47 2026-03-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 31 12 — — $43,362.55 $203,649.58 $87,931.68 2026-03-01
834 MS_DRG Acute Leukemia With Mcc 31 12 — — $39,858.05 $202,429.08 $87,404.70 2026-03-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 31 12 — — $39,147.71 $201,713.75 $87,095.83 2026-03-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 31 12 — — $38,911.16 $201,109.03 $86,834.73 2026-03-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 31 12 — — $37,015.94 $146,480.64 $86,826.79 2026-03-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 31 12 — — $33,926.48 $198,351.00 $86,448.00 2026-03-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 31 12 — — $39,448.43 $131,530.25 $85,489.34 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 1 1 — — $85,368.45 $85,368.45 $85,368.45 2026-03-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 31 12 — — $39,860.94 $195,198.29 $84,282.59 2026-03-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 31 12 — — $39,701.57 $128,220.95 $83,961.26 2026-03-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 31 12 — — $33,118.05 $174,552.00 $82,941.53 2026-03-01
653 MS_DRG Major Bladder Procedures With Mcc 31 12 — — $40,199.17 $191,606.86 $82,731.88 2026-03-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 27 10 — — $43,525.90 $218,645.83 $82,594.79 2026-03-01
1583 OTHER New Technology - Level 46 6 6 — — $80,198.03 $142,977.05 $81,801.99 2026-03-01
1597 OTHER New Technology - Level 46 6 6 — — $80,198.03 $142,977.05 $81,801.99 2026-03-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 2 — — $80,341.51 $82,826.30 $81,583.90 2026-03-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 31 12 — — $35,934.92 $182,425.48 $81,414.41 2026-03-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 31 12 — — $28,331.10 $133,845.16 $81,088.13 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 17 5 — — $54,404.11 $234,209.69 $79,669.38 2026-03-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 31 12 — — $36,625.80 $183,900.40 $79,404.40 2026-03-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 31 12 — — $37,137.82 $121,552.19 $79,345.01 2026-03-01
01597 OTHER New Technology - Level 46 2 2 — — $77,774.63 $80,180.03 $78,977.33 2026-03-01
01583 OTHER New Technology - Level 46 2 2 — — $77,774.63 $80,180.03 $78,977.33 2026-03-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 31 12 — — $36,069.06 $182,101.00 $78,627.45 2026-03-01
014 OTHER Allogeneic Bone Marrow Transplant 2 2 — — $77,377.16 $79,770.27 $78,573.71 2026-03-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 31 12 — — $36,321.47 $181,477.84 $78,358.39 2026-03-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 27 10 — — $39,237.14 $206,658.42 $78,066.47 2026-03-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 31 12 — — $38,535.84 $180,721.95 $78,032.01 2026-03-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 2 2 — — $76,562.14 $78,930.04 $77,746.09 2026-03-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 31 12 — — $36,107.28 $177,148.95 $76,489.26 2026-03-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 27 10 — — $43,525.90 $200,305.20 $75,666.51 2026-03-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 31 12 — — $34,286.34 $173,000.74 $74,698.15 2026-03-01
22586 CPT Arthrodesis, Pre-sacral Interbody Technique, Including Disc Space Preparation, D… 8 1 — — $52,500.00 $87,031.00 $74,530.35 2026-03-01
22556 CPT Arthrodesis, Anterior Interbody Technique, Including Minimal Discectomy To Prepa… 8 1 — — $52,500.00 $87,031.00 $74,530.35 2026-03-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. 31 12 — — $34,437.06 $172,484.52 $74,475.25 2026-03-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 31 12 — — $33,550.03 $170,297.95 $73,531.14 2026-03-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 31 12 — — $33,113.73 $169,486.74 $73,180.88 2026-03-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 31 12 — — $33,744.75 $169,055.33 $72,994.60 2026-03-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 2 — — $71,751.85 $73,970.98 $72,861.42 2026-03-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 31 12 — — $32,533.91 $167,724.22 $72,419.85 2026-03-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 31 12 — — $32,250.49 $167,650.47 $72,388.01 2026-03-01
799 MS_DRG Splenic Procedures With Mcc 31 12 — — $34,287.78 $166,994.13 $72,104.62 2026-03-01
163 MS_DRG Major Chest Procedures With Mcc 31 12 — — $33,237.76 $165,257.41 $71,354.74 2026-03-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 31 12 — — $30,218.96 $165,209.48 $71,334.04 2026-03-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 31 12 — — $31,677.17 $164,560.51 $71,053.83 2026-03-01
1582 OTHER New Technology - Level 45 6 6 — — $69,505.03 $123,913.57 $70,895.13 2026-03-01
1596 OTHER New Technology - Level 45 6 6 — — $69,505.03 $123,913.57 $70,895.13 2026-03-01
22812 CPT Arthrodesis, Anterior, For Spinal Deformity, With Or Without Cast; 8 Or More Ver… 9 2 — — $52,500.00 $87,031.00 $70,608.00 2026-03-01
22808 CPT Arthrodesis, Anterior, For Spinal Deformity, With Or Without Cast; 2 To 3 Verteb… 9 2 — — $52,500.00 $87,031.00 $70,608.00 2026-03-01
22810 CPT Arthrodesis, Anterior, For Spinal Deformity, With Or Without Cast; 4 To 7 Verteb… 9 2 — — $52,500.00 $87,031.00 $70,608.00 2026-03-01
22800 CPT Arthrodesis, Posterior, For Spinal Deformity, With Or Without Cast; Up To 6 Vert… 9 2 — — $52,500.00 $87,031.00 $70,608.00 2026-03-01
22802 CPT Arthrodesis, Posterior, For Spinal Deformity, With Or Without Cast; 7 To 12 Vert… 9 2 — — $52,500.00 $87,031.00 $70,608.00 2026-03-01
22804 CPT Arthrodesis, Posterior, For Spinal Deformity, With Or Without Cast; 13 Or More V… 9 2 — — $52,500.00 $87,031.00 $70,608.00 2026-03-01
22830 CPT Exploration Of Spinal Fusion 9 2 — — $52,500.00 $87,031.00 $70,607.70 2026-03-01
22633 CPT Arthrodesis, Combined Posterior Or Posterolateral Technique With Posterior Inter… 9 2 — — $52,500.00 $87,031.00 $70,607.70 2026-03-01
22558 CPT Arthrodesis, Anterior Interbody Technique, Including Minimal Discectomy To Prepa… 9 2 — — $52,500.00 $87,031.00 $70,607.70 2026-03-01
22610 CPT Arthrodesis, Posterior Or Posterolateral Technique, Single Interspace; Thoracic … 9 2 — — $52,500.00 $87,031.00 $70,607.70 2026-03-01
22612 CPT Arthrodesis, Posterior Or Posterolateral Technique, Single Interspace; Lumbar (w… 9 2 — — $52,500.00 $87,031.00 $70,607.70 2026-03-01
22532 CPT Arthrodesis, Lateral Extracavitary Technique, Including Minimal Discectomy To Pr… 9 2 — — $52,500.00 $87,031.00 $70,607.70 2026-03-01
22533 CPT Arthrodesis, Lateral Extracavitary Technique, Including Minimal Discectomy To Pr… 9 2 — — $52,500.00 $87,031.00 $70,607.70 2026-03-01
22630 CPT Arthrodesis, Posterior Interbody Technique, Including Laminectomy And/or Discect… 9 2 — — $52,500.00 $87,031.00 $70,607.70 2026-03-01
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 2 2 — — $69,301.68 $71,445.03 $70,373.35 2026-03-01
5244 OTHER Level 4 Blood Product Exc 6 6 — — $68,716.98 $122,508.63 $70,091.32 2026-03-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 31 12 — — $31,137.73 $108,789.00 $69,963.37 2026-03-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 31 12 — — $30,760.56 $161,975.71 $69,937.77 2026-03-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 31 12 — — $30,003.34 $155,722.05 $69,496.98 2026-03-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 8 7 — — $66,737.65 $122,659.67 $69,489.71 2026-03-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 31 12 — — $29,446.60 $108,789.00 $69,117.80 2026-03-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 31 12 — — $29,652.86 $117,943.00 $68,930.89 2026-03-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 31 12 — — $30,715.85 $159,564.22 $68,896.54 2026-03-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 31 12 — — $28,336.01 $108,789.00 $68,562.51 2026-03-01
01596 OTHER New Technology - Level 45 2 2 — — $67,404.76 $69,489.44 $68,447.10 2026-03-01
01582 OTHER New Technology - Level 45 2 2 — — $67,404.76 $69,489.44 $68,447.10 2026-03-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 31 12 — — $32,339.92 $158,292.10 $68,347.26 2026-03-01
140 MS_DRG Major Head And Neck Procedures With Mcc 31 12 — — $30,498.06 $157,274.41 $67,907.84 2026-03-01
05244 OTHER Level 4 Blood Product Exc 2 2 — — $66,640.51 $68,701.56 $67,671.04 2026-03-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 — — $66,590.28 $68,649.77 $67,620.02 2026-03-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 31 12 — — $29,592.28 $155,456.57 $67,122.94 2026-03-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 31 12 — — $29,636.27 $155,379.13 $67,089.50 2026-03-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 31 12 — — $30,216.80 $154,925.60 $66,893.67 2026-03-01
901 MS_DRG Wound Debridements For Injuries With Mcc 31 12 — — $31,949.04 $154,741.23 $66,814.07 2026-03-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 31 12 — — $29,330.50 $153,133.57 $66,119.91 2026-03-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 31 12 — — $22,253.71 $108,789.00 $65,521.36 2026-03-01
717 OTHER Instill Adstiladrin, Tx D 8 7 — — $13,403.77 $114,589.10 $64,917.54 2026-03-01
429 OTHER Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 2 2 — — $63,877.57 $65,853.17 $64,865.37 2026-03-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 31 12 — — $26,678.40 $114,532.13 $64,553.00 2026-03-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 2 — — $63,141.76 $65,094.60 $64,118.18 2026-03-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 31 12 — — $25,850.88 $146,905.72 $63,430.86 2026-03-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 28 11 — — $33,224.06 $173,354.72 $63,313.76 2026-03-01
00717 OTHER Instill Adstiladrin, Tx D 2 2 — — $62,346.55 $64,274.79 $63,310.67 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 17 5 — — $43,185.34 $185,912.89 $63,240.61 2026-03-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 31 12 — — $22,913.10 $118,719.56 $62,714.14 2026-03-01
6 MS_DRG Liver Transplant Without Mcc 28 11 — — $34,968.56 $170,980.10 $62,446.47 2026-03-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 31 12 — — $27,414.36 $144,243.49 $62,281.36 2026-03-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 31 12 — — $28,042.49 $142,724.32 $61,625.41 2026-03-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 31 12 — — $27,200.89 $142,374.03 $61,474.17 2026-03-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 31 12 — — $28,727.60 $141,566.51 $61,125.50 2026-03-01
252 MS_DRG Other Vascular Procedures With Mcc 31 12 — — $24,737.40 $96,842.18 $60,789.79 2026-03-01
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