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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

ARNOT OGDEN MEDICAL CENTER

Elmira, NY · CCN 330090 · Rates published

57,832 distinct procedures filed
13 distinct payers
588,989 rate rows
2026-03-27 last MRF observed
Data quality

361,036 of 588,989 rate rows are consumer-grade (61.3%)

227,953 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 225,881
template filing: same amount across many unrelated codes — excluded 1,765
placeholder amount (≤ $0.02) — excluded from medians 168
per-diem day rate — not a per-procedure price 103
exceeds 10× this hospital's gross charge — excluded from medians 36
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://CayugaHealth.pt.panaceainc.com/MRFDownload/CayugaHealth/aomc
Found on page https://centralushealth.org/billing
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint f073e681420c18e1… · 322,281,756 bytes · first seen 2026-05-13

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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 5 $4,505,000.00 $4,955,500.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
J339100
HCPCS 		Inj, Atidarsagene Autotemcel 1 $4,505,000.00 $4,505,000.00 $4,505,000.00 —
J141100
HCPCS 		Inj, Hemgenix, Per Tx Dose 1 $3,710,000.00 $3,710,000.00 $3,710,000.00 —
J141400
HCPCS 		Inj, Beqvez, Per Tx Dose 1 $3,710,000.00 $3,710,000.00 $3,710,000.00 —
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 5 $3,685,266.66 $4,053,793.33 $3,685,266.67 nat. median
$3,710,000
1.0× median
J141300
HCPCS 		Inj Delandistrogene Mox Rokl 1 $3,392,000.00 $3,392,000.00 $3,392,000.00 —
J3389
HCPCS 		Topi Adm Prad Zami Per Treat 5 $3,335,820.00 $3,669,402.00 $3,335,820.00 nat. median
$3,335,820
1.0× median
J338900
HCPCS 		Topi Adm Prad Zami Per Treat 1 $3,335,820.00 $3,335,820.00 $3,335,820.00 —
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 5 $3,327,859.72 $3,660,645.69 $3,327,859.73 nat. median
$3,325,455
1.0× median
J339400
HCPCS 		Inj, Lovotibeglogene Autotem 1 $3,286,000.00 $3,286,000.00 $3,286,000.00 —
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 5 $3,252,508.07 $3,577,758.88 $3,252,508.08 nat. median
$3,286,000
1.0× median
J3387
HCPCS 		Inj Elivaldogene Autotemecel 5 $3,180,000.00 $3,498,000.00 $3,180,000.00 nat. median
$3,180,000
1.0× median
J338700
HCPCS 		Inj Elivaldogene Autotemecel 1 $3,180,000.00 $3,180,000.00 $3,180,000.00 —
J339300
HCPCS 		Inj, Betibeglogene Autotemce 1 $2,968,000.00 $2,968,000.00 $2,968,000.00 —
J3393
HCPCS 		Inj, Betibeglogene Autotemce 5 $2,939,968.88 $3,233,965.77 $2,939,968.89 nat. median
$3,004,655
1.0× median
J339900
HCPCS 		Inj Onase Abepar-xioi Treat 1 $2,661,968.43 $2,661,968.43 $2,661,968.43 —
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 5 $2,588,981.22 $2,847,879.34 $2,588,981.23 nat. median
$2,468,984
1.0× median
J339200
HCPCS 		Inj, Exagamglogene Autotem 1 $2,332,000.00 $2,332,000.00 $2,332,000.00 —
J3392
HCPCS 		Inj, Exagamglogene Autotem 5 $2,332,000.00 $2,565,200.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
Q205700
HCPCS 		Afamitresgene Autoleucel 1 $1,032,630.80 $1,032,630.80 $1,032,630.80 —
Q205600
HCPCS 		Ciltacabtagene Car-pos T 1 $787,450.42 $787,450.42 $787,450.42 —
Q2057
HCPCS 		Afamitresgene Autoleucel 4 $770,620.00 $1,024,924.60 $778,326.20 nat. median
$824,563
0.9× median
Q204200
HCPCS 		Tisagenlecleucel Car-pos T 1 $759,151.94 $759,151.94 $759,151.94 —
Q205400
HCPCS 		Lisocabtagene Mara Car Pos T 1 $753,349.66 $753,349.66 $753,349.66 —
Q205500
HCPCS 		Idecabtagene Vicleucel Car 1 $747,829.52 $747,829.52 $747,829.52 —
Q204100
HCPCS 		Axicabtagene Ciloleucel Car+ 1 $713,137.60 $713,137.60 $713,137.60 —
Q205300
HCPCS 		Brexucabtagene Car Pos T 1 $655,863.27 $655,863.27 $655,863.27 —
Q2056
HCPCS 		Ciltacabtagene Car-pos T 4 $587,649.57 $781,573.93 $593,526.06 nat. median
$674,867
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 4 $566,531.30 $753,486.63 $572,196.61 nat. median
$753,246
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 4 $562,201.24 $747,727.65 $567,823.25 nat. median
$673,137
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 4 $558,081.72 $742,248.70 $563,662.54 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $532,192.24 $707,815.68 $537,514.16 nat. median
$634,303
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 7 $6,929.00 $1,137,653.58 $505,691.24 nat. median
$370,174
1.4× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 4 $489,450.20 $650,968.77 $494,344.70 nat. median
$619,808
0.8× median
Q205800
HCPCS 		Obecbtge Autol Up To 400 Mil 1 $351,750.00 $351,750.00 $351,750.00 —
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 7 $6,929.00 $738,827.85 $328,411.72 nat. median
$265,286
1.2× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 4 $278,250.00 $306,075.00 $281,032.50 nat. median
$324,450
0.9× median
J340300
HCPCS 		Revakinagene, Per Implant 1 $280,900.00 $280,900.00 $280,900.00 —
J3403
HCPCS 		Revakinagene, Per Implant 5 $265,000.00 $352,450.00 $265,000.00 nat. median
$265,000
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 7 $6,929.00 $563,252.87 $250,367.99 nat. median
$206,474
1.2× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 7 $6,929.00 $559,956.25 $248,902.63 nat. median
$202,976
1.2× median
J340200
HCPCS 		Inj. Remestemcel-l-rknd/ Td 1 $213,769.16 $213,769.16 $213,769.16 —
0024
APR_DRG 		7 $206,011.26 $474,471.72 $206,011.26 nat. median
$372,987
0.6× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 5 $201,669.02 $268,219.80 $201,669.02 nat. median
$209,753
1.0× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 7 $6,929.00 $365,953.97 $162,667.90 nat. median
$133,161
1.2× median
7
MS_DRG 		Lung Transplant 7 $6,929.00 $342,243.69 $152,128.59 nat. median
$122,708
1.2× median
5834
APR_DRG 		7 $151,759.86 $349,267.72 $151,759.86 nat. median
$309,665
outlier · 0.5×
5883
APR_DRG 		7 $149,099.64 $343,128.34 $149,099.64 nat. median
$182,665
0.8× median
5884
APR_DRG 		7 $149,099.64 $343,128.34 $149,099.64 nat. median
$246,434
0.6× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 7 $6,929.00 $317,715.19 $141,225.58 nat. median
$117,357
1.2× median

Other procedures at this hospital

Browse this hospital's 57,832 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
             
0013 APR_DRG — 9 7 — — $49,715.83 $113,765.57 $49,715.83 2026-03-27
0014 APR_DRG — 9 7 — — $103,561.86 $238,034.05 $103,561.86 2026-03-27
0021 APR_DRG — 9 7 — — $71,714.05 $164,534.13 $71,714.05 2026-03-27
0022 APR_DRG — 9 7 — — $76,107.68 $174,673.97 $76,107.68 2026-03-27
0023 APR_DRG — 9 7 — — $89,205.51 $204,901.77 $89,205.51 2026-03-27
0024 APR_DRG — 9 7 — — $206,011.26 $474,471.72 $206,011.26 2026-03-27
0032 APR_DRG — 9 7 — — $46,145.89 $105,526.69 $46,145.89 2026-03-27
0033 APR_DRG — 9 7 — — $70,081.98 $160,767.55 $70,081.98 2026-03-27
0034 APR_DRG — 9 7 — — $132,461.34 $304,729.65 $132,461.34 2026-03-27
0041 APR_DRG — 9 7 — — $42,775.69 $97,748.78 $42,775.69 2026-03-27
0042 APR_DRG — 9 7 — — $42,775.69 $97,748.78 $42,775.69 2026-03-27
0043 APR_DRG — 9 7 — — $59,756.32 $136,937.50 $59,756.32 2026-03-27
0044 APR_DRG — 9 7 — — $106,900.84 $245,739.89 $106,900.84 2026-03-27
0053 APR_DRG — 9 7 — — $54,819.44 $125,543.94 $54,819.44 2026-03-27
0054 APR_DRG — 9 7 — — $81,667.93 $187,506.17 $81,667.93 2026-03-27
0063 APR_DRG — 9 7 — — $43,515.72 $99,456.66 $43,515.72 2026-03-27
0064 APR_DRG — 9 7 — — $45,428.84 $103,871.85 $45,428.84 2026-03-27
0214 APR_DRG — 9 7 — — $43,086.78 $98,466.74 $43,086.78 2026-03-27
0234 APR_DRG — 9 7 — — $48,040.15 $109,898.37 $48,040.15 2026-03-27
0244 APR_DRG — 9 7 — — $40,448.36 $92,377.67 $40,448.36 2026-03-27
0894 APR_DRG — 9 7 — — $40,595.66 $92,717.61 $40,595.66 2026-03-27
0904 APR_DRG — 9 7 — — $66,589.81 $152,708.17 $66,589.81 2026-03-27
0924 APR_DRG — 9 7 — — $43,746.68 $99,989.69 $43,746.68 2026-03-27
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 9 7 — — $6,929.00 $738,827.85 $328,411.72 2026-03-27
10 MS_DRG Pancreas Transplant 9 7 — — $6,929.00 $190,318.48 $84,597.27 2026-03-27
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 9 7 — — $6,929.00 $145,023.74 $64,463.59 2026-03-27
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 9 7 — — $6,929.00 $112,449.72 $49,984.32 2026-03-27
14 MS_DRG Allogeneic Bone Marrow Transplant 9 7 — — $6,929.00 $317,715.19 $141,225.58 2026-03-27
140 MS_DRG Major Head And Neck Procedures With Mcc 9 7 — — $6,929.00 $113,746.79 $50,560.87 2026-03-27
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 9 7 — — $6,929.00 $100,099.97 $44,494.81 2026-03-27
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 9 7 — — $6,929.00 $157,536.61 $70,025.61 2026-03-27
1604 APR_DRG — 9 7 — — $59,009.81 $135,214.66 $59,009.81 2026-03-27
1613 APR_DRG — 9 7 — — $58,395.27 $133,796.42 $58,395.27 2026-03-27
1614 APR_DRG — 9 7 — — $136,411.90 $313,846.94 $136,411.90 2026-03-27
1624 APR_DRG — 9 7 — — $55,715.02 $127,610.80 $55,715.02 2026-03-27
163 MS_DRG Major Chest Procedures With Mcc 9 7 — — $6,929.00 $119,442.85 $53,092.79 2026-03-27
1634 APR_DRG — 9 7 — — $41,941.39 $95,823.34 $41,941.39 2026-03-27
1654 APR_DRG — 9 7 — — $42,115.79 $96,225.83 $42,115.79 2026-03-27
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 9 7 — — $6,929.00 $99,865.80 $44,390.72 2026-03-27
1694 APR_DRG — 9 7 — — $42,742.10 $97,671.27 $42,742.10 2026-03-27
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 9 7 — — $6,929.00 $144,450.18 $64,208.64 2026-03-27
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 9 7 — — $6,929.00 $1,137,653.58 $505,691.24 2026-03-27
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 9 7 — — $6,929.00 $189,237.14 $84,116.61 2026-03-27
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 9 7 — — $6,929.00 $299,664.11 $133,201.81 2026-03-27
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 9 7 — — $6,929.00 $208,553.71 $92,702.90 2026-03-27
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 9 7 — — $6,929.00 $170,823.01 $75,931.46 2026-03-27
209 MS_DRG Complex Aortic Arch Procedures 9 7 — — $6,929.00 $299,322.09 $133,049.78 2026-03-27
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 9 7 — — $6,929.00 $140,806.29 $62,588.92 2026-03-27
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 9 7 — — $6,929.00 $287,622.19 $127,849.13 2026-03-27
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 9 7 — — $6,929.00 $151,674.82 $67,420.02 2026-03-27
215 MS_DRG Other Heart Assist System Implant 9 7 — — $6,929.00 $263,493.57 $117,123.87 2026-03-27
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 9 7 — — $6,929.00 $258,910.44 $115,086.65 2026-03-27
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 9 7 — — $6,929.00 $174,522.14 $77,575.74 2026-03-27
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 9 7 — — $6,929.00 $174,522.14 $77,575.74 2026-03-27
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 9 7 — — $6,929.00 $203,541.72 $90,475.05 2026-03-27
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 9 7 — — $6,929.00 $141,832.38 $63,045.02 2026-03-27
2204 APR_DRG — 9 7 — — $42,181.19 $96,376.77 $42,181.19 2026-03-27
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 9 7 — — $6,929.00 $134,134.16 $59,623.13 2026-03-27
228 MS_DRG Other Cardiothoracic Procedures With Mcc 9 7 — — $6,929.00 $131,692.62 $58,537.86 2026-03-27
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 9 7 — — $6,929.00 $152,290.47 $67,693.68 2026-03-27
231 MS_DRG Coronary Bypass With Ptca With Mcc 9 7 — — $6,929.00 $223,316.07 $99,264.82 2026-03-27
232 MS_DRG Coronary Bypass With Ptca Without Mcc 9 7 — — $6,929.00 $161,033.17 $71,579.84 2026-03-27
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 9 7 — — $6,929.00 $202,670.86 $90,087.95 2026-03-27
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 9 7 — — $6,929.00 $145,249.99 $64,564.16 2026-03-27
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 9 7 — — $6,929.00 $155,929.09 $69,311.06 2026-03-27
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 9 7 — — $6,929.00 $111,734.12 $49,666.23 2026-03-27
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 9 7 — — $6,929.00 $131,016.48 $58,237.31 2026-03-27
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 9 7 — — $6,929.00 $104,448.96 $46,427.95 2026-03-27
245 MS_DRG Aicd Generator Procedures 9 7 — — $6,929.00 $121,563.39 $54,035.38 2026-03-27
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 9 7 — — $6,929.00 $121,150.35 $53,851.78 2026-03-27
252 MS_DRG Other Vascular Procedures With Mcc 9 7 — — $6,929.00 $93,304.17 $41,474.05 2026-03-27
2604 APR_DRG — 9 7 — — $44,177.39 $100,983.69 $44,177.39 2026-03-27
265 MS_DRG Aicd Lead Procedures 9 7 — — $6,929.00 $96,721.80 $42,993.20 2026-03-27
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 9 7 — — $6,929.00 $162,764.36 $72,349.36 2026-03-27
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 9 7 — — $6,929.00 $126,783.24 $56,355.62 2026-03-27
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 9 7 — — $6,929.00 $182,483.45 $81,114.57 2026-03-27
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 9 7 — — $6,929.00 $112,639.15 $50,068.52 2026-03-27
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 9 7 — — $6,929.00 $140,345.87 $62,384.26 2026-03-27
27000000S1-178 CDM Icd Maximo Ii D284trk Sc Pm C1882 Defib 9 7 $77,175.00 $15,435.00 80% off $15,435.00 $77,175.00 $55,566.00 2026-03-27
271 MS_DRG Other Major Cardiovascular Procedures With Cc 9 7 — — $6,929.00 $95,093.24 $42,269.30 2026-03-27
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 9 7 — — $6,929.00 $110,068.71 $48,925.95 2026-03-27
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 9 7 — — $6,929.00 $189,126.65 $84,067.50 2026-03-27
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 9 7 — — $6,929.00 $159,559.84 $70,924.94 2026-03-27
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 9 7 — — $6,929.00 $123,039.38 $54,691.46 2026-03-27
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 9 7 — — $6,929.00 $147,973.05 $65,774.57 2026-03-27
27800000S1-11787 CDM Eterna Implantable Pulse Generator 32400 9 7 $61,726.98 $12,345.40 80% off $12,345.40 $55,554.28 $40,091.67 2026-03-27
27800000S1-11789 CDM Generator Neurostimulation Lead L60cm Proclaim Plus 5 9 7 $64,329.00 $12,865.80 80% off $12,865.80 $57,896.10 $41,781.69 2026-03-27
27800000S1-13370 CDM Stimulator 2 Lead Lumbar Scs 9 7 $61,726.98 $12,345.40 80% off $12,345.40 $55,554.28 $40,091.67 2026-03-27
27800000S1-14046 CDM Icd Generator Cd3357-40q C1882 9 7 $67,800.00 $13,560.00 80% off $13,560.00 $61,020.00 $44,036.10 2026-03-27
27800000S1-14175 CDM Icd Generator Cd3357-40c C1882 9 7 $67,800.00 $13,560.00 80% off $13,560.00 $61,020.00 $44,036.10 2026-03-27
27800000S1-15059 CDM Icd Hv Generator Cd3369-40q C1722 9 7 $74,040.00 $14,808.00 80% off $14,808.00 $66,636.00 $48,088.98 2026-03-27
27800000S1-6378 CDM Generator Crt-d G150 C1882 9 7 $67,704.75 $13,540.95 80% off $13,540.95 $60,934.28 $43,974.24 2026-03-27
27800000S1-6385 CDM Icd Generator Cd2357-40q Fortify Assura C1721 9 7 $64,230.00 $12,846.00 80% off $12,846.00 $57,807.00 $41,717.39 2026-03-27
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 9 7 — — $6,929.00 $96,411.34 $42,855.20 2026-03-27
28 MS_DRG Spinal Procedures With Mcc 9 7 — — $6,929.00 $159,604.56 $70,944.82 2026-03-27
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 9 7 — — $6,929.00 $91,286.23 $40,577.07 2026-03-27
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 9 7 — — $6,929.00 $559,956.25 $248,902.63 2026-03-27
3033 APR_DRG — 9 7 — — $41,593.76 $95,021.07 $41,593.76 2026-03-27
3034 APR_DRG — 9 7 — — $64,610.70 $148,140.68 $64,610.70 2026-03-27
3044 APR_DRG — 9 7 — — $54,521.90 $124,857.26 $54,521.90 2026-03-27
31 MS_DRG Ventricular Shunt Procedures With Mcc 9 7 — — $6,929.00 $119,408.63 $53,077.58 2026-03-27
3104 APR_DRG — 9 7 — — $40,734.71 $93,038.52 $40,734.71 2026-03-27
3124 APR_DRG — 9 7 — — $53,461.94 $122,411.02 $53,461.94 2026-03-27
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 9 7 — — $6,929.00 $177,447.79 $78,876.20 2026-03-27
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 9 7 — — $6,929.00 $118,945.60 $52,871.76 2026-03-27
3214 APR_DRG — 9 7 — — $42,042.73 $96,057.22 $42,042.73 2026-03-27
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 9 7 — — $6,929.00 $115,380.63 $51,287.12 2026-03-27
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 9 7 — — $6,929.00 $132,745.01 $59,005.65 2026-03-27
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 9 7 — — $6,929.00 $122,460.55 $54,434.17 2026-03-27
332 MS_DRG Rectal Resection With Mcc 9 7 — — $6,929.00 $96,787.58 $43,022.44 2026-03-27
335 MS_DRG Peritoneal Adhesiolysis With Mcc 9 7 — — $6,929.00 $95,477.36 $42,440.04 2026-03-27
34 MS_DRG Carotid Artery Stent Procedures With Mcc 9 7 — — $6,929.00 $103,365.01 $45,946.13 2026-03-27
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 9 7 — — $6,929.00 $117,101.27 $52,051.95 2026-03-27
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 9 7 — — $6,929.00 $91,996.58 $40,892.82 2026-03-27
3614 APR_DRG — 9 7 — — $56,986.51 $130,545.19 $56,986.51 2026-03-27
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 9 7 — — $6,929.00 $365,953.97 $162,667.90 2026-03-27
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 9 7 — — $6,929.00 $103,115.07 $45,835.03 2026-03-27
4014 APR_DRG — 9 7 — — $41,591.99 $95,016.99 $41,591.99 2026-03-27
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 9 7 — — $6,929.00 $107,306.19 $47,698.00 2026-03-27
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 9 7 — — $6,929.00 $145,455.21 $64,655.38 2026-03-27
4054 APR_DRG — 9 7 — — $49,843.09 $114,059.28 $49,843.09 2026-03-27
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 9 7 — — $6,929.00 $95,337.92 $42,378.06 2026-03-27
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 9 7 — — $6,929.00 $95,258.98 $42,342.97 2026-03-27
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 9 7 — — $6,929.00 $91,167.83 $40,524.44 2026-03-27
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 9 7 — — $6,929.00 $110,792.21 $49,247.55 2026-03-27
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 9 7 — — $6,929.00 $291,492.32 $129,569.42 2026-03-27
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 9 7 — — $6,929.00 $191,447.15 $85,098.97 2026-03-27
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 9 7 — — $6,929.00 $149,441.14 $66,427.14 2026-03-27
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 9 7 — — $6,929.00 $238,567.79 $106,044.27 2026-03-27
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 9 7 — — $6,929.00 $153,258.68 $68,124.05 2026-03-27
4404 APR_DRG — 9 7 — — $61,603.45 $141,200.39 $61,603.45 2026-03-27
4414 APR_DRG — 9 7 — — $40,269.84 $91,965.66 $40,269.84 2026-03-27
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 9 7 — — $6,929.00 $177,318.86 $78,818.89 2026-03-27
4474 APR_DRG — 9 7 — — $45,379.93 $103,758.99 $45,379.93 2026-03-27
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 9 7 — — $6,929.00 $113,102.21 $50,274.35 2026-03-27
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 9 7 — — $6,929.00 $141,748.18 $63,007.59 2026-03-27
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 9 7 — — $6,929.00 $222,618.86 $98,954.91 2026-03-27
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 9 7 — — $6,929.00 $158,415.37 $70,416.22 2026-03-27
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 9 7 — — $6,929.00 $111,307.89 $49,476.77 2026-03-27
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 9 7 — — $6,929.00 $146,836.48 $65,269.36 2026-03-27
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 9 7 — — $6,929.00 $151,480.13 $67,333.48 2026-03-27
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 9 7 — — $6,929.00 $138,480.53 $61,555.11 2026-03-27
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 9 7 — — $6,929.00 $94,311.83 $41,921.96 2026-03-27
471 MS_DRG Cervical Spinal Fusion With Mcc 9 7 — — $6,929.00 $128,569.66 $57,149.69 2026-03-27
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 9 7 — — $6,929.00 $114,472.95 $50,883.65 2026-03-27
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 9 7 — — $6,929.00 $92,417.54 $41,079.94 2026-03-27
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 9 7 — — $6,929.00 $98,126.74 $43,617.70 2026-03-27
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 9 7 — — $6,929.00 $96,919.12 $43,080.91 2026-03-27
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 9 7 — — $6,929.00 $272,794.06 $121,257.97 2026-03-27
5124 APR_DRG — 9 7 — — $44,630.48 $102,029.35 $44,630.48 2026-03-27
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 9 7 — — $6,929.00 $99,855.30 $44,386.05 2026-03-27
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 9 7 — — $6,929.00 $173,893.35 $77,296.24 2026-03-27
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 9 7 — — $6,929.00 $92,859.54 $41,276.41 2026-03-27
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 9 7 — — $6,929.00 $130,477.11 $57,997.56 2026-03-27
5831 APR_DRG — 9 7 — — $84,790.67 $194,712.98 $84,790.67 2026-03-27
5832 APR_DRG — 9 7 — — $84,790.67 $194,712.98 $84,790.67 2026-03-27
5833 APR_DRG — 9 7 — — $86,398.58 $198,423.80 $86,398.58 2026-03-27
5834 APR_DRG — 9 7 — — $151,759.86 $349,267.72 $151,759.86 2026-03-27
5881 APR_DRG — 9 7 — — $114,162.09 $262,497.76 $114,162.09 2026-03-27
5882 APR_DRG — 9 7 — — $114,162.09 $262,497.76 $114,162.09 2026-03-27
5883 APR_DRG — 9 7 — — $149,099.64 $343,128.34 $149,099.64 2026-03-27
5884 APR_DRG — 9 7 — — $149,099.64 $343,128.34 $149,099.64 2026-03-27
5891 APR_DRG — 9 7 — — $71,942.66 $165,061.72 $71,942.66 2026-03-27
5892 APR_DRG — 9 7 — — $71,942.66 $165,061.72 $71,942.66 2026-03-27
5911 APR_DRG — 9 7 — — $52,796.73 $120,875.83 $52,796.73 2026-03-27
5912 APR_DRG — 9 7 — — $65,361.34 $149,873.04 $65,361.34 2026-03-27
5913 APR_DRG — 9 7 — — $70,033.07 $160,654.69 $70,033.07 2026-03-27
5914 APR_DRG — 9 7 — — $114,574.52 $263,449.60 $114,574.52 2026-03-27
5931 APR_DRG — 9 7 — — $64,070.41 $146,893.77 $64,070.41 2026-03-27
5932 APR_DRG — 9 7 — — $66,069.55 $151,507.49 $66,069.55 2026-03-27
5933 APR_DRG — 9 7 — — $80,657.46 $185,174.15 $80,657.46 2026-03-27
5934 APR_DRG — 9 7 — — $103,152.37 $237,089.00 $103,152.37 2026-03-27
6 MS_DRG Liver Transplant Without Mcc 9 7 — — $6,929.00 $123,526.10 $54,907.81 2026-03-27
6022 APR_DRG — 9 7 — — $56,300.09 $128,961.06 $56,300.09 2026-03-27
6023 APR_DRG — 9 7 — — $66,187.39 $151,779.44 $66,187.39 2026-03-27
6024 APR_DRG — 9 7 — — $89,516.61 $205,619.73 $89,516.61 2026-03-27
6032 APR_DRG — 9 7 — — $41,066.43 $93,804.07 $41,066.43 2026-03-27
6033 APR_DRG — 9 7 — — $53,321.71 $122,087.39 $53,321.71 2026-03-27
6034 APR_DRG — 9 7 — — $82,494.57 $189,413.93 $82,494.57 2026-03-27
6072 APR_DRG — 9 7 — — $44,483.18 $101,689.41 $44,483.18 2026-03-27
6073 APR_DRG — 9 7 — — $54,326.88 $124,407.17 $54,326.88 2026-03-27
6074 APR_DRG — 9 7 — — $73,160.53 $167,872.38 $73,160.53 2026-03-27
6083 APR_DRG — 9 7 — — $40,625.12 $92,785.60 $40,625.12 2026-03-27
6084 APR_DRG — 9 7 — — $42,739.16 $97,664.47 $42,739.16 2026-03-27
6093 APR_DRG — 9 7 — — $43,332.48 $99,033.77 $43,332.48 2026-03-27
6094 APR_DRG — 9 7 — — $94,481.17 $217,077.20 $94,481.17 2026-03-27
6114 APR_DRG — 9 7 — — $48,815.54 $111,687.83 $48,815.54 2026-03-27
6124 APR_DRG — 9 7 — — $50,346.86 $115,221.89 $50,346.86 2026-03-27
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 9 7 — — $6,929.00 $93,280.50 $41,463.53 2026-03-27
6214 APR_DRG — 9 7 — — $40,439.53 $92,357.27 $40,439.53 2026-03-27
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 9 7 — — $6,929.00 $95,169.53 $42,303.21 2026-03-27
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 9 7 — — $6,929.00 $99,579.03 $44,263.25 2026-03-27
6304 APR_DRG — 9 7 — — $72,476.47 $166,293.68 $72,476.47 2026-03-27
6314 APR_DRG — 9 7 — — $62,365.28 $142,958.58 $62,365.28 2026-03-27
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 9 7 — — $6,929.00 $125,220.44 $55,660.95 2026-03-27
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 9 7 — — $6,929.00 $99,026.53 $44,017.66 2026-03-27
653 MS_DRG Major Bladder Procedures With Mcc 9 7 — — $6,929.00 $138,243.73 $61,449.85 2026-03-27
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 9 7 — — $6,929.00 $112,070.88 $49,815.92 2026-03-27
6804 APR_DRG — 9 7 — — $53,131.99 $121,649.55 $53,131.99 2026-03-27
6814 APR_DRG — 9 7 — — $53,278.70 $121,988.13 $53,278.70 2026-03-27
6904 APR_DRG — 9 7 — — $51,993.66 $119,022.46 $51,993.66 2026-03-27
6954 APR_DRG — 9 7 — — $43,943.48 $100,443.85 $43,943.48 2026-03-27
7 MS_DRG Lung Transplant 9 7 — — $6,929.00 $342,243.69 $152,128.59 2026-03-27
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 9 7 — — $6,929.00 $95,572.07 $42,482.14 2026-03-27
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 9 7 — — $6,929.00 $95,790.45 $42,579.21 2026-03-27
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 8 6 — — $44,100.77 $157,899.69 $70,187.00 2026-03-27
791 MS_DRG Prematurity With Major Problems 8 6 — — $30,117.78 $108,319.12 $48,148.25 2026-03-27
793 MS_DRG Full Term Neonate With Major Problems 8 6 — — $30,938.43 $111,228.97 $49,441.69 2026-03-27
799 MS_DRG Splenic Procedures With Mcc 9 7 — — $6,929.00 $120,682.03 $53,643.61 2026-03-27
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 9 7 — — $6,929.00 $148,983.35 $66,223.65 2026-03-27
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 9 7 — — $6,929.00 $106,348.52 $47,272.31 2026-03-27
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 9 7 — — $6,929.00 $155,829.12 $69,266.62 2026-03-27
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 9 7 — — $6,929.00 $122,152.75 $54,297.35 2026-03-27
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 9 7 — — $6,929.00 $124,599.54 $55,384.96 2026-03-27
834 MS_DRG Acute Leukemia With Mcc 9 7 — — $6,929.00 $145,965.62 $64,882.26 2026-03-27
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 9 7 — — $6,929.00 $127,927.71 $56,864.34 2026-03-27
8412 APR_DRG — 9 7 — — $42,147.02 $96,297.90 $42,147.02 2026-03-27
8413 APR_DRG — 9 7 — — $86,696.13 $199,110.49 $86,696.13 2026-03-27
8414 APR_DRG — 9 7 — — $110,826.65 $254,800.07 $110,826.65 2026-03-27
8424 APR_DRG — 9 7 — — $51,313.73 $117,453.28 $51,313.73 2026-03-27
850 MS_DRG Acute Leukemia With Other Procedures 9 7 — — $6,929.00 $229,356.78 $101,949.94 2026-03-27
8504 APR_DRG — 8 7 — — $45,356.96 $79,374.68 $45,356.96 2026-03-27
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 9 7 — — $6,929.00 $131,461.11 $58,434.95 2026-03-27
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 9 7 — — $6,929.00 $121,202.95 $53,875.16 2026-03-27
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 9 7 — — $6,929.00 $183,375.34 $81,511.02 2026-03-27
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 9 7 — — $6,929.00 $103,212.41 $45,878.30 2026-03-27
901 MS_DRG Wound Debridements For Injuries With Mcc 9 7 — — $6,929.00 $111,939.31 $49,757.44 2026-03-27
9028800 HCPCS Botulism Ig IV 2 1 — — $81,774.00 $81,774.00 $81,774.00 2026-03-27
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 9 7 — — $6,929.00 $98,166.20 $43,635.24 2026-03-27
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 9 7 — — $6,929.00 $102,538.87 $45,578.91 2026-03-27
9104 APR_DRG — 9 7 — — $42,739.75 $97,665.83 $42,739.75 2026-03-27
9124 APR_DRG — 9 7 — — $45,061.77 $103,024.71 $45,061.77 2026-03-27
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 9 7 — — $6,929.00 $563,252.87 $250,367.99 2026-03-27
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 9 7 — — $6,929.00 $190,239.54 $84,562.18 2026-03-27
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 9 7 — — $6,929.00 $103,983.27 $46,220.95 2026-03-27
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 9 7 — — $6,929.00 $96,992.80 $43,113.66 2026-03-27
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 9 7 — — $6,929.00 $94,122.41 $41,837.76 2026-03-27
9504 APR_DRG — 9 7 — — $48,229.88 $110,336.22 $48,229.88 2026-03-27
955 MS_DRG Craniotomy For Multiple Significant Trauma 9 7 — — $6,929.00 $178,621.19 $79,397.78 2026-03-27
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 9 7 — — $6,929.00 $100,531.44 $44,686.60 2026-03-27
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 9 7 — — $6,929.00 $202,005.24 $89,792.08 2026-03-27
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 9 7 — — $6,929.00 $112,394.47 $49,959.76 2026-03-27
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 9 7 — — $6,929.00 $162,577.56 $72,266.33 2026-03-27
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 9 7 — — $6,929.00 $96,553.43 $42,918.36 2026-03-27
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 9 7 — — $6,929.00 $124,967.87 $55,548.68 2026-03-27
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 9 7 — — $6,929.00 $91,728.23 $40,773.54 2026-03-27
A9543 HCPCS Y90 Ibritumomab, Rx 4 4 — — $56,824.54 $62,506.99 $57,392.79 2026-03-27
A954300 HCPCS Y90 Ibritumomab, Rx 2 1 — — $71,875.11 $71,875.11 $71,875.11 2026-03-27
E076600 HCPCS Elec Stim Cancer Treatment 2 1 — — $83,988.32 $83,988.32 $83,988.32 2026-03-27
E0766NU HCPCS Elec Stim Cancer Treatment 2 1 — — $83,988.32 $83,988.32 $83,988.32 2026-03-27
E0766UE HCPCS Elec Stim Cancer Treatment 2 1 — — $62,991.19 $62,991.19 $62,991.19 2026-03-27
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 5 5 — — $3,685,266.66 $4,053,793.33 $3,685,266.67 2026-03-27
J141100 HCPCS Inj, Hemgenix, Per Tx Dose 2 1 — — $3,710,000.00 $3,710,000.00 $3,710,000.00 2026-03-27
J1413 HCPCS Inj Delandistrogene Mox Rokl 5 5 — — $3,327,859.72 $3,660,645.69 $3,327,859.73 2026-03-27
J141300 HCPCS Inj Delandistrogene Mox Rokl 2 1 — — $3,392,000.00 $3,392,000.00 $3,392,000.00 2026-03-27
J141400 HCPCS Inj, Beqvez, Per Tx Dose 2 1 — — $3,710,000.00 $3,710,000.00 $3,710,000.00 2026-03-27
J3387 HCPCS Inj Elivaldogene Autotemecel 5 5 — — $3,180,000.00 $3,498,000.00 $3,180,000.00 2026-03-27
J338700 HCPCS Inj Elivaldogene Autotemecel 2 1 — — $3,180,000.00 $3,180,000.00 $3,180,000.00 2026-03-27
J3389 HCPCS Topi Adm Prad Zami Per Treat 5 5 — — $3,335,820.00 $3,669,402.00 $3,335,820.00 2026-03-27
J338900 HCPCS Topi Adm Prad Zami Per Treat 2 1 — — $3,335,820.00 $3,335,820.00 $3,335,820.00 2026-03-27
J3391 HCPCS Inj, Atidarsagene Autotemcel 5 5 — — $4,505,000.00 $4,955,500.00 $4,505,000.00 2026-03-27
J339100 HCPCS Inj, Atidarsagene Autotemcel 2 1 — — $4,505,000.00 $4,505,000.00 $4,505,000.00 2026-03-27
J3392 HCPCS Inj, Exagamglogene Autotem 5 5 — — $2,332,000.00 $2,565,200.00 $2,332,000.00 2026-03-27
J339200 HCPCS Inj, Exagamglogene Autotem 2 1 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2026-03-27
J3393 HCPCS Inj, Betibeglogene Autotemce 5 5 — — $2,939,968.88 $3,233,965.77 $2,939,968.89 2026-03-27
J339300 HCPCS Inj, Betibeglogene Autotemce 2 1 — — $2,968,000.00 $2,968,000.00 $2,968,000.00 2026-03-27
J3394 HCPCS Inj, Lovotibeglogene Autotem 5 5 — — $3,252,508.07 $3,577,758.88 $3,252,508.08 2026-03-27
J339400 HCPCS Inj, Lovotibeglogene Autotem 2 1 — — $3,286,000.00 $3,286,000.00 $3,286,000.00 2026-03-27
J3399 HCPCS Inj Onase Abepar-xioi Treat 5 5 — — $2,588,981.22 $2,847,879.34 $2,588,981.23 2026-03-27
J339900 HCPCS Inj Onase Abepar-xioi Treat 2 1 — — $2,661,968.43 $2,661,968.43 $2,661,968.43 2026-03-27
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 7 5 — — $201,669.02 $268,219.80 $201,669.02 2026-03-27
J340200 HCPCS Inj. Remestemcel-l-rknd/ Td 2 1 — — $213,769.16 $213,769.16 $213,769.16 2026-03-27
J3403 HCPCS Revakinagene, Per Implant 7 5 — — $265,000.00 $352,450.00 $265,000.00 2026-03-27
J340300 HCPCS Revakinagene, Per Implant 2 1 — — $280,900.00 $280,900.00 $280,900.00 2026-03-27
J733000 HCPCS Cultured Chondrocytes Implnt 2 1 — — $73,958.32 $73,958.32 $73,958.32 2026-03-27
J9029 HCPCS Instill Adstiladrin, Tx Dose 7 5 — — $64,274.79 $85,485.47 $64,274.79 2026-03-27
J902900 HCPCS Instill Adstiladrin, Tx Dose 2 1 — — $86,128.22 $86,128.22 $86,128.22 2026-03-27
J9226 HCPCS Supprelin La Implant 7 5 — — $43,185.33 $57,436.50 $43,185.34 2026-03-27
J922600 HCPCS Supprelin La Implant 2 1 — — $57,868.36 $57,868.36 $57,868.36 2026-03-27
K100700 HCPCS Bil Hkaf Pc S/d Micro Sensor 2 1 — — $61,802.67 $61,802.67 $61,802.67 2026-03-27
L870200 HCPCS Ewhf S/d Uprt Micro Sensor 2 1 — — $44,721.11 $44,721.11 $44,721.11 2026-03-27
Q048000 HCPCS Driver Pneumatic Vad, Rep 2 1 — — $70,358.18 $70,358.18 $70,358.18 2026-03-27
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 6 4 — — $532,192.24 $707,815.68 $537,514.16 2026-03-27
Q204100 HCPCS Axicabtagene Ciloleucel Car+ 2 1 — — $713,137.60 $713,137.60 $713,137.60 2026-03-27
Q2042 HCPCS Tisagenlecleucel Car-pos T 6 4 — — $566,531.30 $753,486.63 $572,196.61 2026-03-27
Q204200 HCPCS Tisagenlecleucel Car-pos T 2 1 — — $759,151.94 $759,151.94 $759,151.94 2026-03-27
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 6 4 — — $54,404.10 $72,357.46 $54,948.15 2026-03-27
Q204300 HCPCS Sipuleucel-t Auto Cd54+ 2 1 — — $72,901.51 $72,901.51 $72,901.51 2026-03-27
Q2053 HCPCS Brexucabtagene Car Pos T 6 4 — — $489,450.20 $650,968.77 $494,344.70 2026-03-27
Q205300 HCPCS Brexucabtagene Car Pos T 2 1 — — $655,863.27 $655,863.27 $655,863.27 2026-03-27
Q2054 HCPCS Lisocabtagene Mara Car Pos T 6 4 — — $562,201.24 $747,727.65 $567,823.25 2026-03-27
Q205400 HCPCS Lisocabtagene Mara Car Pos T 2 1 — — $753,349.66 $753,349.66 $753,349.66 2026-03-27
Q2055 HCPCS Idecabtagene Vicleucel Car 6 4 — — $558,081.72 $742,248.70 $563,662.54 2026-03-27
Q205500 HCPCS Idecabtagene Vicleucel Car 2 1 — — $747,829.52 $747,829.52 $747,829.52 2026-03-27
Q2056 HCPCS Ciltacabtagene Car-pos T 6 4 — — $587,649.57 $781,573.93 $593,526.06 2026-03-27
Q205600 HCPCS Ciltacabtagene Car-pos T 2 1 — — $787,450.42 $787,450.42 $787,450.42 2026-03-27
Q2057 HCPCS Afamitresgene Autoleucel 6 4 — — $770,620.00 $1,024,924.60 $778,326.20 2026-03-27
Q205700 HCPCS Afamitresgene Autoleucel 2 1 — — $1,032,630.80 $1,032,630.80 $1,032,630.80 2026-03-27
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 4 4 — — $278,250.00 $306,075.00 $281,032.50 2026-03-27
Q205800 HCPCS Obecbtge Autol Up To 400 Mil 2 1 — — $351,750.00 $351,750.00 $351,750.00 2026-03-27
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