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 →

Export CSV
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.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
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
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
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 31 12 — — $78,557.20 $400,960.69 $173,126.55 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 31 12 — — $26,678.40 $114,532.13 $64,553.00 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
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
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
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
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
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
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 28 11 — — $55,872.58 $263,074.11 $96,081.65 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
6 MS_DRG Liver Transplant Without Mcc 28 11 — — $34,968.56 $170,980.10 $62,446.47 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
14 MS_DRG Allogeneic Bone Marrow Transplant 27 10 — — $94,479.08 $443,136.03 $167,397.33 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
10 MS_DRG Pancreas Transplant 27 10 — — $57,455.64 $264,589.59 $99,950.33 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
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 27 10 — — $43,525.90 $218,645.83 $82,594.79 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
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 27 10 — — $43,525.90 $200,305.20 $75,666.51 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
824 OTHER Inj, Exagamglogene Autote 8 7 — — $14,641.64 $4,157,489.60 $2,355,320.00 2026-03-01
831 OTHER Obecbtge Autol Up To 400 8 7 — — $4,134.51 $496,064.10 $281,032.50 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 8 7 — — $9,046.99 $359,535.49 $203,685.69 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
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
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
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
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
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
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
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
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
717 OTHER Instill Adstiladrin, Tx D 8 7 — — $13,403.77 $114,589.10 $64,917.54 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
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
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
845 OTHER Inj, Atidarsagene Autotem 7 6 — — $6,037.93 $4,685,200.00 $4,505,000.00 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
748 OTHER Inj, Lovotibeglogene Auto 7 6 — — $13,517.46 $3,382,608.32 $3,252,508.00 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 7 6 — — $9,660.17 $3,307,200.00 $3,180,000.00 2026-03-01
746 OTHER Inj, Betibeglogene Autote 7 6 — — $12,503.79 $3,057,567.76 $2,939,969.00 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 6 6 — — $2,588,981.00 $4,615,635.33 $2,640,760.62 2026-03-01
2067 OTHER Afamitresgene Autoleucel 6 6 — — $770,620.00 $1,373,861.34 $786,032.40 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 6 6 — — $587,649.60 $1,047,661.71 $599,402.59 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
9035 OTHER Axicabtagene Ciloleucel C 6 6 — — $532,192.20 $948,792.25 $542,836.04 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 6 6 — — $489,450.20 $872,591.82 $499,239.20 2026-03-01
897 OTHER Revakinagene, Per Implant 6 6 — — $265,000.00 $472,442.00 $270,300.00 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
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
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
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
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
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
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
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
5244 OTHER Level 4 Blood Product Exc 6 6 — — $68,716.98 $122,508.63 $70,091.32 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
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
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
9138 OTHER Inj, Hemgenix, Per Tx Dos 5 5 — — $3,685,267.00 $3,832,677.68 $3,758,972.34 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
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
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 17 5 — — $43,185.34 $185,912.89 $63,240.61 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
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
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
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
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 15 3 — — $31,905.54 $300,368.46 $131,366.72 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
00845 OTHER Inj, Atidarsagene Autotem 2 2 — — $4,369,850.00 $4,505,000.00 $4,437,425.00 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
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
00748 OTHER Inj, Lovotibeglogene Auto 2 2 — — $3,154,932.76 $3,252,508.00 $3,203,720.38 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
00746 OTHER Inj, Betibeglogene Autote 2 2 — — $2,851,769.93 $2,939,969.00 $2,895,869.46 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
00824 OTHER Inj, Exagamglogene Autote 2 2 — — $2,262,040.00 $2,332,000.00 $2,297,020.00 2026-03-01
09498 OTHER Ciltacabtagene Car-pos T 2 2 — — $570,020.11 $587,649.60 $578,834.85 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
09035 OTHER Axicabtagene Ciloleucel C 2 2 — — $516,226.43 $532,192.20 $524,209.31 2026-03-01
09391 OTHER Brexucabtagene Car Pos T 2 2 — — $474,766.69 $489,450.20 $482,108.45 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
00831 OTHER Obecbtge Autol Up To 400 2 2 — — $269,902.50 $278,250.00 $274,076.25 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
00886 OTHER Inj. Remestemcel-l-rknd/ 2 2 — — $195,618.93 $201,669.00 $198,643.96 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
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
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
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
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
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 2 2 — — $105,702.94 $108,972.10 $107,337.52 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
007 OTHER Lung Transplant 2 2 — — $90,648.71 $93,452.28 $92,050.49 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
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
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
014 OTHER Allogeneic Bone Marrow Transplant 2 2 — — $77,377.16 $79,770.27 $78,573.71 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
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
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
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
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
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
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
00717 OTHER Instill Adstiladrin, Tx D 2 2 — — $62,346.55 $64,274.79 $63,310.67 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
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
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
J3394 HCPCS Injection, Lovotibeglogene Autotemcel, Per Treatment 5 1 — — $3,162,000.00 $3,162,000.00 $3,162,000.00 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
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
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 5 1 — — $770,620.00 $770,620.00 $770,620.00 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
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 5 1 — — $201,669.02 $201,669.02 $201,669.02 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 1 1 — — $85,368.45 $85,368.45 $85,368.45 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
See an error in this hospital's data? Submit a correction