|
J3391
|
HCPCS
|
Inj, Atidarsagene Autotemcel
|
16
|
13
|
—
|
—
|
$4,505,000.00
|
$4,505,000.00
|
$4,505,000.00
|
2026-04-01
|
|
0845
|
OTHER
|
Inj, Atidarsagene Autotemcel
|
16
|
13
|
—
|
—
|
$4,505,000.00
|
$4,505,000.00
|
$4,505,000.00
|
2026-04-01
|
|
9138
|
OTHER
|
Inj, Hemgenix, Per Tx Dose
|
16
|
13
|
—
|
—
|
$3,685,266.67
|
$3,685,266.67
|
$3,685,266.67
|
2026-04-01
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
16
|
13
|
—
|
—
|
$3,685,266.67
|
$3,685,266.67
|
$3,685,266.67
|
2026-04-01
|
|
J3389
|
HCPCS
|
Topi Adm Prad Zami Per Treat
|
16
|
13
|
—
|
—
|
$3,335,820.00
|
$3,335,820.00
|
$3,335,820.00
|
2026-04-01
|
|
0908
|
OTHER
|
Topi Adm Prad Zami Per Treat
|
16
|
13
|
—
|
—
|
$3,335,820.00
|
$3,335,820.00
|
$3,335,820.00
|
2026-04-01
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
16
|
13
|
—
|
—
|
$3,316,462.59
|
$3,316,462.59
|
$3,316,462.59
|
2026-04-01
|
|
0714
|
OTHER
|
Inj Delandistrogene Mox Rokl
|
16
|
13
|
—
|
—
|
$3,316,462.59
|
$3,316,462.59
|
$3,316,462.59
|
2026-04-01
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
16
|
13
|
—
|
—
|
$3,248,445.72
|
$3,248,445.72
|
$3,248,445.72
|
2026-04-01
|
|
0748
|
OTHER
|
Inj, Lovotibeglogene Autotem
|
16
|
13
|
—
|
—
|
$3,248,445.72
|
$3,248,445.72
|
$3,248,445.72
|
2026-04-01
|
|
J3387
|
HCPCS
|
Inj Elivaldogene Autotemecel
|
16
|
13
|
—
|
—
|
$3,090,000.00
|
$3,090,000.00
|
$3,090,000.00
|
2026-04-01
|
|
0906
|
OTHER
|
Inj Elivaldogene Autotemecel
|
16
|
13
|
—
|
—
|
$3,090,000.00
|
$3,090,000.00
|
$3,090,000.00
|
2026-04-01
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
16
|
13
|
—
|
—
|
$2,945,740.00
|
$2,945,740.00
|
$2,945,740.00
|
2026-04-01
|
|
0746
|
OTHER
|
Inj, Betibeglogene Autotemce
|
16
|
13
|
—
|
—
|
$2,945,740.00
|
$2,945,740.00
|
$2,945,740.00
|
2026-04-01
|
|
9141
|
OTHER
|
Inj Onase Abepar-xioi Treat
|
16
|
13
|
—
|
—
|
$2,455,110.61
|
$2,455,110.61
|
$2,455,110.61
|
2026-04-01
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
16
|
13
|
—
|
—
|
$2,455,110.60
|
$2,455,110.60
|
$2,455,110.60
|
2026-04-01
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
16
|
13
|
—
|
—
|
$2,332,000.00
|
$2,332,000.00
|
$2,332,000.00
|
2026-04-01
|
|
0824
|
OTHER
|
Inj, Exagamglogene Autotem
|
16
|
13
|
—
|
—
|
$2,332,000.00
|
$2,332,000.00
|
$2,332,000.00
|
2026-04-01
|
|
2067
|
OTHER
|
Afamitresgene Autoleucel
|
16
|
13
|
—
|
—
|
$770,620.00
|
$770,620.00
|
$770,620.00
|
2026-04-01
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
16
|
13
|
—
|
—
|
$770,620.00
|
$770,620.00
|
$770,620.00
|
2026-04-01
|
|
9194
|
OTHER
|
Tisagenlecleucel Car-pos T
|
16
|
13
|
—
|
—
|
$591,726.20
|
$591,726.20
|
$591,726.20
|
2026-04-01
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel Car-pos T
|
16
|
13
|
—
|
—
|
$591,726.20
|
$591,726.20
|
$591,726.20
|
2026-04-01
|
|
9498
|
OTHER
|
Ciltacabtagene Car-pos T
|
16
|
13
|
—
|
—
|
$565,868.95
|
$565,868.95
|
$565,868.95
|
2026-04-01
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
16
|
13
|
—
|
—
|
$565,868.94
|
$565,868.94
|
$565,868.94
|
2026-04-01
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
13
|
13
|
—
|
—
|
$457,348.00
|
$763,255.99
|
$563,570.99
|
2026-04-01
|
|
9413
|
OTHER
|
Lisocabtagene Car Pos T
|
16
|
13
|
—
|
—
|
$562,538.19
|
$562,538.19
|
$562,538.19
|
2026-04-01
|
|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
16
|
13
|
—
|
—
|
$562,538.18
|
$562,538.18
|
$562,538.18
|
2026-04-01
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel Car
|
16
|
13
|
—
|
—
|
$557,317.93
|
$557,317.93
|
$557,317.93
|
2026-04-01
|
|
9422
|
OTHER
|
Idecabtagene Vicleucel Car
|
16
|
13
|
—
|
—
|
$557,317.93
|
$557,317.93
|
$557,317.93
|
2026-04-01
|
|
9035
|
OTHER
|
Axicabtagene Ciloleucel Car+
|
16
|
13
|
—
|
—
|
$533,230.17
|
$533,230.17
|
$533,230.17
|
2026-04-01
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Car+
|
16
|
13
|
—
|
—
|
$533,230.17
|
$533,230.17
|
$533,230.17
|
2026-04-01
|
|
9391
|
OTHER
|
Brexucabtagene Car Pos T
|
16
|
13
|
—
|
—
|
$489,304.61
|
$489,304.61
|
$489,304.61
|
2026-04-01
|
|
Q2053
|
HCPCS
|
Brexucabtagene Car Pos T
|
16
|
13
|
—
|
—
|
$489,304.61
|
$489,304.61
|
$489,304.61
|
2026-04-01
|
|
24
|
APR_DRG
|
—
|
22
|
16
|
—
|
—
|
$298,555.30
|
$1,591,376.34
|
$447,240.85
|
2026-04-01
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
13
|
13
|
—
|
—
|
$336,935.24
|
$495,322.43
|
$366,233.95
|
2026-04-01
|
|
5834
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$220,388.97
|
$1,477,561.28
|
$359,238.41
|
2026-04-01
|
|
5884
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$216,556.08
|
$1,247,116.29
|
$352,923.76
|
2026-04-01
|
|
5883
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$216,556.08
|
$981,372.10
|
$335,677.06
|
2026-04-01
|
|
1614
|
APR_DRG
|
—
|
23
|
16
|
—
|
—
|
$198,275.36
|
$1,462,879.00
|
$315,191.40
|
2026-04-01
|
|
SUP-218562
|
CDM
|
Kit Total Artifical Heart 50cc
|
23
|
19
|
—
|
—
|
$292,275.00
|
$292,275.00
|
$292,275.00
|
2026-04-01
|
|
34
|
APR_DRG
|
—
|
22
|
16
|
—
|
—
|
$192,583.33
|
$1,425,150.60
|
$287,825.86
|
2026-04-01
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
13
|
13
|
—
|
—
|
$257,011.48
|
$377,370.09
|
$279,360.30
|
2026-04-01
|
|
Q2058
|
HCPCS
|
Obecbtge Autol Up To 400 Mil
|
16
|
13
|
—
|
—
|
$278,250.00
|
$278,250.00
|
$278,250.00
|
2026-04-01
|
|
0831
|
OTHER
|
Obecbtge Autol Up To 400 Mil
|
16
|
13
|
—
|
—
|
$278,250.00
|
$278,250.00
|
$278,250.00
|
2026-04-01
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
13
|
13
|
—
|
—
|
$255,510.82
|
$768,529.00
|
$277,729.16
|
2026-04-01
|
|
5914
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$166,811.71
|
$936,042.41
|
$270,970.40
|
2026-04-01
|
|
5882
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$166,217.46
|
$967,178.66
|
$269,991.39
|
2026-04-01
|
|
5881
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$166,217.46
|
$967,178.66
|
$269,991.39
|
2026-04-01
|
|
0897
|
OTHER
|
Revakinagene, Per Implant
|
16
|
13
|
—
|
—
|
$257,500.00
|
$257,500.00
|
$257,500.00
|
2026-04-01
|
|
J3403
|
HCPCS
|
Revakinagene, Per Implant
|
16
|
13
|
—
|
—
|
$257,500.00
|
$257,500.00
|
$257,500.00
|
2026-04-01
|
|
44
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$155,755.33
|
$1,064,356.46
|
$252,755.12
|
2026-04-01
|
|
14
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$150,944.48
|
$1,050,563.31
|
$244,829.30
|
2026-04-01
|
|
1907
|
OTHER
|
New Technology - Level 52 ($145,001-$160,000)
|
16
|
13
|
—
|
—
|
$171,421.91
|
$744,567.33
|
$244,089.89
|
2026-04-01
|
|
1908
|
OTHER
|
New Technology - Level 52 ($145,001-$160,000)
|
16
|
13
|
—
|
—
|
$171,421.91
|
$744,567.33
|
$244,089.89
|
2026-04-01
|
|
5934
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$150,354.47
|
$861,651.64
|
$243,857.27
|
2026-04-01
|
|
8414
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$161,411.70
|
$1,089,838.09
|
$225,976.39
|
2026-04-01
|
|
SUP-227416
|
CDM
|
Kit Hm Iii Implant Commercial
|
23
|
19
|
—
|
—
|
$223,503.75
|
$223,503.75
|
$223,503.75
|
2026-04-01
|
|
6094
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$137,860.87
|
$721,516.39
|
$223,274.18
|
2026-04-01
|
|
1906
|
OTHER
|
New Technology - Level 51 ($130,001-$145,000)
|
16
|
13
|
—
|
—
|
$154,560.79
|
$671,331.44
|
$220,081.12
|
2026-04-01
|
|
1905
|
OTHER
|
New Technology - Level 51 ($130,001-$145,000)
|
16
|
13
|
—
|
—
|
$154,560.79
|
$671,331.44
|
$220,081.12
|
2026-04-01
|
|
6024
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$130,707.84
|
$683,368.74
|
$211,489.64
|
2026-04-01
|
|
J3402
|
HCPCS
|
Inj. Remestemcel-l-rknd/ Td
|
16
|
13
|
—
|
—
|
$205,640.00
|
$205,640.00
|
$205,640.00
|
2026-04-01
|
|
0886
|
OTHER
|
Inj. Remestemcel-l-rknd/ Td
|
16
|
13
|
—
|
—
|
$205,640.00
|
$205,640.00
|
$205,640.00
|
2026-04-01
|
|
5833
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$126,215.33
|
$1,074,058.23
|
$204,088.29
|
2026-04-01
|
|
5832
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$123,898.62
|
$1,074,058.23
|
$200,271.52
|
2026-04-01
|
|
5831
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$123,898.62
|
$1,074,058.23
|
$200,271.52
|
2026-04-01
|
|
1903
|
OTHER
|
New Technology - Level 50 ($115,001-$130,000)
|
16
|
13
|
—
|
—
|
$137,699.68
|
$598,095.55
|
$196,072.36
|
2026-04-01
|
|
1904
|
OTHER
|
New Technology - Level 50 ($115,001-$130,000)
|
16
|
13
|
—
|
—
|
$137,699.68
|
$598,095.55
|
$196,072.36
|
2026-04-01
|
|
54
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$119,399.33
|
$769,894.61
|
$192,858.98
|
2026-04-01
|
|
5933
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$117,943.42
|
$649,485.23
|
$190,460.40
|
2026-04-01
|
|
1734
|
APR_DRG
|
—
|
6
|
3
|
—
|
—
|
$131,671.33
|
$387,293.09
|
$183,402.96
|
2026-04-01
|
|
23
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$130,259.61
|
$968,390.06
|
$182,363.45
|
2026-04-01
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
13
|
13
|
—
|
—
|
$90,782.00
|
$244,823.50
|
$181,737.77
|
2026-04-01
|
|
SUP-195084
|
CDM
|
Kit Hm Ii Implant W Pocket Controller
|
23
|
19
|
—
|
—
|
$180,000.00
|
$180,000.00
|
$180,000.00
|
2026-04-01
|
|
8413
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$126,644.04
|
$1,089,838.09
|
$177,301.66
|
2026-04-01
|
|
6934
|
APR_DRG
|
—
|
6
|
3
|
—
|
—
|
$125,007.59
|
$367,394.46
|
$174,035.89
|
2026-04-01
|
|
6074
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$107,141.72
|
$535,684.86
|
$172,664.70
|
2026-04-01
|
|
1901
|
OTHER
|
New Technology - Level 49 ($100,001-$115,000)
|
16
|
13
|
—
|
—
|
$120,838.56
|
$524,859.66
|
$172,063.60
|
2026-04-01
|
|
1902
|
OTHER
|
New Technology - Level 49 ($100,001-$115,000)
|
16
|
13
|
—
|
—
|
$120,838.56
|
$524,859.66
|
$172,063.60
|
2026-04-01
|
|
6304
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$106,156.12
|
$524,373.50
|
$171,040.93
|
2026-04-01
|
|
7
|
MS_DRG
|
Lung Transplant
|
13
|
13
|
—
|
—
|
$156,405.55
|
$228,894.78
|
$170,006.04
|
2026-04-01
|
|
6034
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$120,590.37
|
$300,732.48
|
$168,826.52
|
2026-04-01
|
|
5891
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$105,387.00
|
$496,654.46
|
$167,029.89
|
2026-04-01
|
|
5892
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$105,387.00
|
$496,654.46
|
$167,029.89
|
2026-04-01
|
|
33
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$102,706.10
|
$732,979.43
|
$165,357.04
|
2026-04-01
|
|
5913
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$102,635.63
|
$511,239.77
|
$165,240.96
|
2026-04-01
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
13
|
13
|
—
|
—
|
$145,239.89
|
$212,416.38
|
$157,869.45
|
2026-04-01
|
|
6023
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$97,094.71
|
$561,941.78
|
$156,112.35
|
2026-04-01
|
|
22
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$111,388.04
|
$711,759.84
|
$155,943.25
|
2026-04-01
|
|
5932
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$96,924.93
|
$511,121.79
|
$155,832.63
|
2026-04-01
|
|
3034
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$94,822.99
|
$662,231.31
|
$152,369.72
|
2026-04-01
|
|
1599
|
OTHER
|
New Technology - Level 48 ($90,001-$100,000)
|
16
|
13
|
—
|
—
|
$106,787.63
|
$463,829.75
|
$152,056.29
|
2026-04-01
|
|
1585
|
OTHER
|
New Technology - Level 48 ($90,001-$100,000)
|
16
|
13
|
—
|
—
|
$106,787.63
|
$463,829.75
|
$152,056.29
|
2026-04-01
|
|
5931
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$94,044.53
|
$486,508.16
|
$151,087.21
|
2026-04-01
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
13
|
13
|
—
|
—
|
$137,022.84
|
$200,289.56
|
$148,937.87
|
2026-04-01
|
|
209
|
MS_DRG
|
Complex Aortic Arch Procedures
|
12
|
12
|
—
|
—
|
$136,867.14
|
$200,059.79
|
$148,768.63
|
2026-04-01
|
|
21
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$105,057.61
|
$653,477.60
|
$147,080.66
|
2026-04-01
|
|
6314
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$91,587.74
|
$589,915.74
|
$147,039.67
|
2026-04-01
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
12
|
12
|
—
|
—
|
$133,302.95
|
$194,799.71
|
$144,894.51
|
2026-04-01
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
13
|
13
|
—
|
—
|
$131,541.21
|
$192,199.72
|
$142,979.57
|
2026-04-01
|
|
1613
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$85,867.70
|
$590,202.26
|
$137,615.96
|
2026-04-01
|
|
1584
|
OTHER
|
New Technology - Level 47 ($80,001-$90,000)
|
16
|
13
|
—
|
—
|
$95,546.89
|
$415,005.82
|
$136,050.46
|
2026-04-01
|
|
1598
|
OTHER
|
New Technology - Level 47 ($80,001-$90,000)
|
16
|
13
|
—
|
—
|
$95,546.89
|
$415,005.82
|
$136,050.46
|
2026-04-01
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
13
|
13
|
—
|
—
|
$124,791.27
|
$182,238.09
|
$135,642.69
|
2026-04-01
|
|
3614
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$83,837.92
|
$549,496.97
|
$134,271.92
|
2026-04-01
|
|
4404
|
APR_DRG
|
—
|
22
|
16
|
—
|
—
|
$90,490.09
|
$506,716.49
|
$134,245.70
|
2026-04-01
|
|
6022
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$82,848.93
|
$428,550.36
|
$132,642.56
|
2026-04-01
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
13
|
13
|
—
|
—
|
$120,557.59
|
$175,989.98
|
$131,040.86
|
2026-04-01
|
|
43
|
APR_DRG
|
—
|
22
|
16
|
—
|
—
|
$87,828.71
|
$618,163.58
|
$130,242.15
|
2026-04-01
|
|
53
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$80,715.58
|
$511,102.83
|
$129,127.90
|
2026-04-01
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
13
|
13
|
—
|
—
|
$118,471.29
|
$172,910.99
|
$128,773.14
|
2026-04-01
|
|
1604
|
APR_DRG
|
—
|
22
|
16
|
—
|
—
|
$86,753.12
|
$507,974.24
|
$128,624.14
|
2026-04-01
|
|
3044
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$80,286.87
|
$548,900.75
|
$128,421.60
|
2026-04-01
|
|
1624
|
APR_DRG
|
—
|
23
|
16
|
—
|
—
|
$82,005.94
|
$192,554.15
|
$128,157.46
|
2026-04-01
|
|
6073
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$80,005.88
|
$427,334.74
|
$127,958.67
|
2026-04-01
|
|
3124
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$78,759.66
|
$701,339.66
|
$125,905.54
|
2026-04-01
|
|
6814
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$78,495.65
|
$493,793.44
|
$125,470.58
|
2026-04-01
|
|
6904
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$76,644.14
|
$545,932.28
|
$122,420.24
|
2026-04-01
|
|
6804
|
APR_DRG
|
—
|
23
|
16
|
—
|
—
|
$78,284.26
|
$231,141.15
|
$122,170.67
|
2026-04-01
|
|
1597
|
OTHER
|
New Technology - Level 46 ($70,001-$80,000)
|
16
|
13
|
—
|
—
|
$84,306.14
|
$366,181.90
|
$120,044.61
|
2026-04-01
|
|
1583
|
OTHER
|
New Technology - Level 46 ($70,001-$80,000)
|
16
|
13
|
—
|
—
|
$84,306.14
|
$366,181.90
|
$120,044.61
|
2026-04-01
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
12
|
12
|
—
|
—
|
$109,211.08
|
$159,244.68
|
$118,707.70
|
2026-04-01
|
|
6124
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$74,271.40
|
$395,979.39
|
$118,511.17
|
2026-04-01
|
|
453
|
MS_DRG
|
Combined Anterior And Posterior Spinal Fusion With Mcc
|
1
|
1
|
—
|
—
|
$116,778.45
|
$116,778.45
|
$116,778.45
|
2026-04-01
|
|
904
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$97,674.53
|
$296,532.57
|
$116,587.10
|
2026-04-01
|
|
6033
|
APR_DRG
|
—
|
22
|
16
|
—
|
—
|
$78,557.62
|
$179,779.89
|
$116,295.53
|
2026-04-01
|
|
6114
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$72,065.05
|
$364,029.91
|
$114,876.23
|
2026-04-01
|
|
5912
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$94,264.09
|
$275,580.54
|
$114,351.30
|
2026-04-01
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
12
|
12
|
—
|
—
|
$105,018.12
|
$153,056.66
|
$114,150.13
|
2026-04-01
|
|
234
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$70,947.87
|
$459,566.53
|
$113,035.68
|
2026-04-01
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
13
|
13
|
—
|
—
|
$89,894.00
|
$148,998.48
|
$111,161.22
|
2026-04-01
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
13
|
13
|
—
|
—
|
$101,950.95
|
$148,530.10
|
$110,816.25
|
2026-04-01
|
|
4054
|
APR_DRG
|
—
|
22
|
16
|
—
|
—
|
$73,545.57
|
$171,114.00
|
$108,755.85
|
2026-04-01
|
|
13
|
APR_DRG
|
—
|
22
|
16
|
—
|
—
|
$73,362.21
|
$507,049.36
|
$108,480.01
|
2026-04-01
|
|
4474
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$67,114.98
|
$400,917.70
|
$106,721.04
|
2026-04-01
|
|
8424
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$75,664.49
|
$842,943.35
|
$105,930.28
|
2026-04-01
|
|
9504
|
APR_DRG
|
—
|
22
|
16
|
—
|
—
|
$71,221.22
|
$174,132.53
|
$105,259.30
|
2026-04-01
|
|
6072
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$65,822.92
|
$343,383.37
|
$104,592.38
|
2026-04-01
|
|
1596
|
OTHER
|
New Technology - Level 45 ($60,001-$70,000)
|
16
|
13
|
—
|
—
|
$73,065.40
|
$317,357.97
|
$104,038.77
|
2026-04-01
|
|
1582
|
OTHER
|
New Technology - Level 45 ($60,001-$70,000)
|
16
|
13
|
—
|
—
|
$73,065.40
|
$317,357.97
|
$104,038.77
|
2026-04-01
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
13
|
13
|
—
|
—
|
$95,548.33
|
$139,081.04
|
$103,856.88
|
2026-04-01
|
|
9124
|
APR_DRG
|
—
|
23
|
16
|
—
|
—
|
$66,656.56
|
$445,826.04
|
$103,466.05
|
2026-04-01
|
|
6954
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$65,045.30
|
$367,394.46
|
$103,311.26
|
2026-04-01
|
|
5244
|
OTHER
|
Level 4 Blood Product Exchange And Related Services
|
16
|
13
|
—
|
—
|
$72,236.98
|
$313,759.74
|
$102,859.17
|
2026-04-01
|
|
6093
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$64,164.97
|
$372,315.92
|
$101,860.92
|
2026-04-01
|
|
2604
|
APR_DRG
|
—
|
23
|
16
|
—
|
—
|
$65,382.32
|
$160,422.54
|
$101,416.28
|
2026-04-01
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
13
|
13
|
—
|
—
|
$93,266.81
|
$135,713.95
|
$101,376.97
|
2026-04-01
|
|
214
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$63,810.97
|
$504,811.95
|
$101,277.71
|
2026-04-01
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
13
|
13
|
—
|
—
|
$92,870.39
|
$135,128.91
|
$100,946.08
|
2026-04-01
|
|
32
|
APR_DRG
|
—
|
22
|
16
|
—
|
—
|
$68,218.58
|
$458,437.29
|
$100,742.38
|
2026-04-01
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
13
|
13
|
—
|
—
|
$92,567.39
|
$134,681.73
|
$100,616.72
|
2026-04-01
|
|
1694
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$63,314.35
|
$430,623.44
|
$100,459.54
|
2026-04-01
|
|
6084
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$63,310.10
|
$546,437.91
|
$100,452.54
|
2026-04-01
|
|
64
|
APR_DRG
|
—
|
22
|
16
|
—
|
—
|
$67,185.44
|
$587,695.18
|
$99,188.21
|
2026-04-01
|
|
2204
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$62,506.17
|
$419,404.79
|
$99,128.08
|
2026-04-01
|
|
8504
|
APR_DRG
|
—
|
22
|
16
|
—
|
—
|
$67,081.87
|
$215,192.03
|
$99,032.42
|
2026-04-01
|
|
SUP-307902
|
CDM
|
Set Impella 5.5 W/smart Assist
|
23
|
19
|
—
|
—
|
$99,000.00
|
$99,000.00
|
$99,000.00
|
2026-04-01
|
|
3214
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$62,306.67
|
$448,312.05
|
$98,799.41
|
2026-04-01
|
|
3033
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$61,659.79
|
$406,222.60
|
$97,733.68
|
2026-04-01
|
|
4014
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$61,657.25
|
$428,902.20
|
$97,729.48
|
2026-04-01
|
|
6083
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$60,264.16
|
$416,189.82
|
$95,434.39
|
2026-04-01
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
12
|
12
|
—
|
—
|
$87,761.23
|
$127,588.76
|
$95,392.64
|
2026-04-01
|
|
894
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$60,221.72
|
$574,032.65
|
$95,364.46
|
2026-04-01
|
|
244
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$60,009.49
|
$394,045.35
|
$95,014.82
|
2026-04-01
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
13
|
13
|
—
|
—
|
$64,084.59
|
$126,830.50
|
$94,834.17
|
2026-04-01
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
13
|
13
|
—
|
—
|
$87,211.51
|
$126,777.47
|
$94,795.12
|
2026-04-01
|
|
4414
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$59,752.26
|
$459,063.00
|
$94,591.04
|
2026-04-01
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
13
|
13
|
—
|
—
|
$86,755.21
|
$126,104.06
|
$94,299.14
|
2026-04-01
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
13
|
13
|
—
|
—
|
$86,704.91
|
$126,029.82
|
$94,244.46
|
2026-04-01
|
|
204
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$59,130.00
|
$141,338.21
|
$93,565.87
|
2026-04-01
|
|
5911
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$77,801.23
|
$235,058.54
|
$92,877.65
|
2026-04-01
|
|
1674
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$58,630.84
|
$362,538.31
|
$92,743.50
|
2026-04-01
|
|
1814
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$58,506.04
|
$387,293.09
|
$92,537.90
|
2026-04-01
|
|
7914
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$58,456.81
|
$377,576.57
|
$92,456.79
|
2026-04-01
|
|
5124
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$66,035.15
|
$148,575.11
|
$92,449.20
|
2026-04-01
|
|
2214
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$58,436.43
|
$365,260.28
|
$92,423.22
|
2026-04-01
|
|
1654
|
APR_DRG
|
—
|
22
|
16
|
—
|
—
|
$62,411.94
|
$152,597.70
|
$92,007.39
|
2026-04-01
|
|
1634
|
APR_DRG
|
—
|
22
|
16
|
—
|
—
|
$62,160.66
|
$174,528.83
|
$91,629.38
|
2026-04-01
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
13
|
13
|
—
|
—
|
$82,218.00
|
$122,166.06
|
$91,398.75
|
2026-04-01
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
13
|
13
|
—
|
—
|
$83,680.85
|
$121,566.88
|
$90,957.44
|
2026-04-01
|
|
6021
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$57,455.08
|
$297,012.92
|
$90,806.45
|
2026-04-01
|
|
3134
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$57,273.41
|
$382,344.24
|
$90,507.15
|
2026-04-01
|
|
63
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$64,428.98
|
$436,728.92
|
$90,200.58
|
2026-04-01
|
|
4604
|
APR_DRG
|
—
|
6
|
3
|
—
|
—
|
$65,349.41
|
$189,227.43
|
$90,178.01
|
2026-04-01
|
|
4424
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$56,463.53
|
$344,006.98
|
$89,172.89
|
2026-04-01
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
13
|
13
|
—
|
—
|
$80,703.24
|
$118,972.19
|
$89,046.42
|
2026-04-01
|
|
6123
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$56,184.24
|
$310,222.49
|
$88,712.76
|
2026-04-01
|
|
42
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$63,362.74
|
$468,549.88
|
$88,707.83
|
2026-04-01
|
|
41
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$63,362.74
|
$461,536.38
|
$88,707.83
|
2026-04-01
|
|
9104
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$63,310.95
|
$443,200.98
|
$88,635.33
|
2026-04-01
|
|
9114
|
APR_DRG
|
—
|
23
|
16
|
—
|
—
|
$57,434.70
|
$387,786.08
|
$88,631.54
|
2026-04-01
|
|
6914
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$56,097.65
|
$300,316.36
|
$88,570.10
|
2026-04-01
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
12
|
12
|
—
|
—
|
$81,388.55
|
$118,183.89
|
$88,465.82
|
2026-04-01
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
12
|
12
|
—
|
—
|
$81,329.87
|
$118,097.28
|
$88,402.03
|
2026-04-01
|
|
7104
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$55,992.38
|
$385,569.74
|
$88,396.67
|
2026-04-01
|
|
6214
|
APR_DRG
|
—
|
22
|
16
|
—
|
—
|
$59,996.75
|
$137,368.54
|
$88,374.18
|
2026-04-01
|
|
3174
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$55,972.01
|
$350,597.02
|
$88,363.11
|
2026-04-01
|
|
1595
|
OTHER
|
New Technology - Level 44 ($50,001-$60,000)
|
16
|
13
|
—
|
—
|
$61,824.65
|
$268,534.04
|
$88,032.93
|
2026-04-01
|
|
1581
|
OTHER
|
New Technology - Level 44 ($50,001-$60,000)
|
16
|
13
|
—
|
—
|
$61,824.65
|
$268,534.04
|
$88,032.93
|
2026-04-01
|
|
264
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$55,614.61
|
$506,505.81
|
$87,774.30
|
2026-04-01
|
|
9514
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$55,607.82
|
$344,769.64
|
$87,763.11
|
2026-04-01
|
|
459
|
MS_DRG
|
Spinal Fusion Except Cervical With Mcc
|
1
|
1
|
—
|
—
|
$87,760.25
|
$87,760.25
|
$87,760.25
|
2026-04-01
|
|
1824
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$55,581.50
|
$387,293.09
|
$87,719.75
|
2026-04-01
|
|
L7181
|
CPT
|
Hb Electronic Elbo Simultaneous
|
30
|
26
|
—
|
—
|
$37,769.02
|
$137,632.00
|
$87,700.51
|
2026-04-01
|
|
6113
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$55,528.87
|
$287,652.45
|
$87,633.04
|
2026-04-01
|
|
1733
|
APR_DRG
|
—
|
6
|
3
|
—
|
—
|
$63,403.07
|
$183,421.11
|
$87,455.08
|
2026-04-01
|
|
8412
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$62,456.93
|
$1,087,847.17
|
$87,439.71
|
2026-04-01
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
13
|
13
|
—
|
—
|
$80,056.77
|
$116,218.43
|
$87,018.23
|
2026-04-01
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
13
|
13
|
—
|
—
|
$75,580.70
|
$116,218.43
|
$87,018.23
|
2026-04-01
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
13
|
13
|
—
|
—
|
$79,770.53
|
$115,796.00
|
$86,707.10
|
2026-04-01
|
|
2614
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$54,466.02
|
$417,186.34
|
$85,882.00
|
2026-04-01
|
|
1612
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$54,355.66
|
$379,087.14
|
$85,700.18
|
2026-04-01
|
|
6032
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$60,900.01
|
$137,047.09
|
$85,260.01
|
2026-04-01
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
13
|
13
|
—
|
—
|
$78,372.88
|
$113,733.32
|
$85,187.91
|
2026-04-01
|
|
1204
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$54,043.25
|
$387,164.58
|
$85,185.50
|
2026-04-01
|
|
1304
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$53,890.45
|
$331,873.97
|
$84,933.76
|
2026-04-01
|
|
6903
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$53,806.40
|
$329,141.47
|
$84,795.30
|
2026-04-01
|
|
1214
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$53,757.17
|
$354,770.57
|
$84,714.18
|
2026-04-01
|
|
3104
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$60,422.06
|
$135,946.03
|
$84,590.89
|
2026-04-01
|
|
7114
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$53,577.19
|
$382,708.71
|
$84,417.68
|
2026-04-01
|
|
6071
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$53,622.19
|
$251,232.37
|
$84,305.18
|
2026-04-01
|
|
494
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$52,996.53
|
$282,029.43
|
$83,461.04
|
2026-04-01
|
|
1714
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$52,965.12
|
$304,513.09
|
$83,409.29
|
2026-04-01
|
|
9524
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$52,691.77
|
$361,141.50
|
$82,958.95
|
2026-04-01
|
|
PX-81200005
|
CDM
|
Hb Heart, Incoming
|
22
|
19
|
—
|
—
|
$82,900.00
|
$82,900.00
|
$82,900.00
|
2026-04-01
|
|
6303
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$52,639.98
|
$293,840.09
|
$82,873.63
|
2026-04-01
|
|
434
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$52,573.77
|
$267,452.54
|
$82,764.54
|
2026-04-01
|
|
31
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$58,583.30
|
$360,115.50
|
$82,016.61
|
2026-04-01
|
|
52
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$51,944.71
|
$362,761.63
|
$81,728.18
|
2026-04-01
|
|
4034
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$58,168.17
|
$147,159.50
|
$81,435.44
|
2026-04-01
|
|
1664
|
APR_DRG
|
—
|
22
|
16
|
—
|
—
|
$55,235.14
|
$136,362.36
|
$81,211.24
|
2026-04-01
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
13
|
13
|
—
|
—
|
$74,704.48
|
$108,319.47
|
$81,200.53
|
2026-04-01
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
13
|
13
|
—
|
—
|
$74,619.45
|
$108,193.98
|
$81,108.10
|
2026-04-01
|
|
454
|
MS_DRG
|
Combined Anterior And Posterior Spinal Fusion With Cc
|
1
|
1
|
—
|
—
|
$81,043.01
|
$81,043.01
|
$81,043.01
|
2026-04-01
|
|
2294
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$51,462.53
|
$322,749.47
|
$80,933.78
|
2026-04-01
|
|
3084
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$51,309.72
|
$281,968.33
|
$80,682.03
|
2026-04-01
|
|
3094
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$51,108.52
|
$370,314.47
|
$80,350.57
|
2026-04-01
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
13
|
13
|
—
|
—
|
$73,916.43
|
$107,156.46
|
$80,343.95
|
2026-04-01
|
|
2644
|
APR_DRG
|
—
|
22
|
16
|
—
|
—
|
$54,584.87
|
$143,011.50
|
$80,233.01
|
2026-04-01
|
|
6504
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$50,751.13
|
$367,952.76
|
$79,761.76
|
2026-04-01
|
|
51
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$50,692.55
|
$350,765.56
|
$79,665.26
|
2026-04-01
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
13
|
13
|
—
|
—
|
$73,266.11
|
$106,196.70
|
$79,637.08
|
2026-04-01
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
13
|
13
|
—
|
—
|
$73,245.75
|
$106,166.66
|
$79,614.95
|
2026-04-01
|
|
6082
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$50,606.81
|
$291,453.10
|
$79,524.00
|
2026-04-01
|
|
5104
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$56,747.07
|
$150,920.01
|
$79,445.90
|
2026-04-01
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
13
|
13
|
—
|
—
|
$72,724.77
|
$105,397.79
|
$79,048.67
|
2026-04-01
|
|
3014
|
APR_DRG
|
—
|
22
|
16
|
—
|
—
|
$53,728.30
|
$120,885.48
|
$78,944.48
|
2026-04-01
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
13
|
13
|
—
|
—
|
$72,490.04
|
$256,889.00
|
$78,793.52
|
2026-04-01
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
13
|
13
|
—
|
—
|
$72,324.76
|
$104,807.45
|
$78,613.87
|
2026-04-01
|
|
1774
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$56,112.93
|
$126,250.74
|
$78,558.10
|
2026-04-01
|
|
3814
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$52,447.28
|
$221,387.58
|
$78,363.42
|
2026-04-01
|
|
1623
|
APR_DRG
|
—
|
23
|
16
|
—
|
—
|
$51,037.22
|
$120,175.47
|
$78,340.38
|
2026-04-01
|
|
3054
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$55,834.48
|
$125,624.25
|
$78,168.27
|
2026-04-01
|
|
2234
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$49,694.22
|
$333,982.87
|
$78,020.51
|
2026-04-01
|
|
2244
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$49,610.17
|
$255,060.41
|
$77,882.05
|
2026-04-01
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
13
|
13
|
—
|
—
|
$71,593.00
|
$103,727.50
|
$77,818.48
|
2026-04-01
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
13
|
13
|
—
|
—
|
$71,547.49
|
$103,660.34
|
$77,769.01
|
2026-04-01
|
|
4403
|
APR_DRG
|
—
|
23
|
16
|
—
|
—
|
$50,491.36
|
$333,820.65
|
$77,462.29
|
2026-04-01
|
|
2224
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$49,316.45
|
$359,135.84
|
$77,398.14
|
2026-04-01
|
|
5114
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$55,194.39
|
$124,184.09
|
$77,272.15
|
2026-04-01
|
|
924
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$50,380.74
|
$145,710.07
|
$77,154.70
|
2026-04-01
|
|
4444
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$54,850.58
|
$142,621.80
|
$76,790.81
|
2026-04-01
|
|
12
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$54,658.72
|
$431,112.22
|
$76,522.21
|
2026-04-01
|
|
11
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$54,658.72
|
$431,112.22
|
$76,522.21
|
2026-04-01
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
12
|
12
|
—
|
—
|
$70,377.39
|
$101,933.49
|
$76,497.16
|
2026-04-01
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
13
|
13
|
—
|
—
|
$69,936.65
|
$101,283.05
|
$76,018.10
|
2026-04-01
|
|
213
|
MS_DRG
|
Endovascular Abdominal Aorta With Iliac Branch Procedures
|
12
|
12
|
—
|
—
|
$69,656.40
|
$100,869.46
|
$75,713.48
|
2026-04-01
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
13
|
13
|
—
|
—
|
$69,567.78
|
$100,738.66
|
$75,617.15
|
2026-04-01
|
|
PX-81200007
|
CDM
|
Hb Liver, Incoming
|
22
|
19
|
—
|
—
|
$75,300.00
|
$75,300.00
|
$75,300.00
|
2026-04-01
|
|
2624
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$53,727.45
|
$120,883.57
|
$75,218.43
|
2026-04-01
|
|
5194
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$53,686.71
|
$120,791.89
|
$75,161.38
|
2026-04-01
|
|
504
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$47,724.72
|
$283,422.01
|
$74,775.77
|
2026-04-01
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
12
|
12
|
—
|
—
|
$68,639.60
|
$99,368.85
|
$74,608.26
|
2026-04-01
|
|
3043
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$47,564.27
|
$313,568.07
|
$74,511.45
|
2026-04-01
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
13
|
13
|
—
|
—
|
$68,431.21
|
$99,061.30
|
$74,381.75
|
2026-04-01
|
|
5184
|
APR_DRG
|
—
|
21
|
16
|
—
|
—
|
$53,084.82
|
$119,437.68
|
$74,318.74
|
2026-04-01
|
|
3644
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$47,408.92
|
$278,574.29
|
$74,255.50
|
2026-04-01
|
|
3032
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$47,231.49
|
$304,051.70
|
$73,963.19
|
2026-04-01
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
13
|
13
|
—
|
—
|
$59,486.67
|
$98,382.58
|
$73,881.86
|
2026-04-01
|
|
2274
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$47,106.70
|
$303,263.76
|
$73,757.60
|
2026-04-01
|
|
4234
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$48,504.03
|
$212,722.35
|
$73,740.30
|
2026-04-01
|
|
A9543
|
CPT
|
Hb Y90 Ibritumomab, Rx
|
37
|
29
|
—
|
—
|
$56,824.55
|
$160,311.02
|
$73,468.00
|
2026-04-01
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
13
|
13
|
—
|
—
|
$67,453.93
|
$97,619.02
|
$73,319.49
|
2026-04-01
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
13
|
13
|
—
|
—
|
$67,057.51
|
$97,033.98
|
$72,888.60
|
2026-04-01
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
13
|
13
|
—
|
—
|
$66,825.17
|
$96,691.09
|
$72,636.05
|
2026-04-01
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
13
|
13
|
—
|
—
|
$66,731.75
|
$96,553.22
|
$72,534.51
|
2026-04-01
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
13
|
13
|
—
|
—
|
$66,628.75
|
$96,401.22
|
$72,422.56
|
2026-04-01
|
|
6224
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$46,217.88
|
$258,515.54
|
$72,293.27
|
2026-04-01
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
13
|
13
|
—
|
—
|
$66,367.67
|
$96,015.90
|
$72,138.77
|
2026-04-01
|
|
1580
|
OTHER
|
New Technology - Level 43 ($40,001-$50,000)
|
16
|
13
|
—
|
—
|
$50,583.91
|
$219,710.11
|
$72,027.08
|
2026-04-01
|
|
1594
|
OTHER
|
New Technology - Level 43 ($40,001-$50,000)
|
16
|
13
|
—
|
—
|
$50,583.91
|
$219,710.11
|
$72,027.08
|
2026-04-01
|
|
3154
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$45,915.66
|
$298,989.09
|
$71,795.38
|
2026-04-01
|
|
4434
|
APR_DRG
|
—
|
24
|
16
|
—
|
—
|
$45,358.77
|
$309,666.30
|
$70,877.90
|
2026-04-01
|
|
C1825
|
HCPCS
|
Generator Neo System Barostim 2102
|
55
|
19
|
—
|
—
|
$58,500.00
|
$78,750.00
|
$70,875.00
|
2026-04-01
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
13
|
13
|
—
|
—
|
$65,176.01
|
$98,058.00
|
$70,843.49
|
2026-04-01
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
12
|
12
|
—
|
—
|
$65,137.68
|
$94,200.68
|
$70,801.83
|
2026-04-01
|
|
224
|
APR_DRG
|
—
|
22
|
16
|
—
|
—
|
$48,072.77
|
$461,327.80
|
$70,436.79
|
2026-04-01
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
13
|
13
|
—
|
—
|
$64,708.92
|
$93,567.92
|
$70,335.79
|
2026-04-01
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
13
|
13
|
—
|
—
|
$64,499.34
|
$259,564.00
|
$70,107.97
|
2026-04-01
|
|
6334
|
APR_DRG
|
—
|
22
|
16
|
—
|
—
|
$47,787.54
|
$107,519.12
|
$70,007.71
|
2026-04-01
|