Price Transparencybeta 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

ANGEL MEDICAL CENTER

Franklin, NC · CCN 341326 · Rates published

28,762 distinct procedures filed
36 distinct payers
1,516,673 rate rows
2026-03-01 last MRF observed
Data quality

885,263 of 1,516,673 rate rows are consumer-grade (58.4%)

631,410 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 590,035
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 33,741
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 3,835
per-diem day rate — not a per-procedure price 3,580
placeholder amount (≤ $0.02) — excluded from medians 123
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 82
exceeds 10× this hospital's gross charge — excluded from medians 14
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.hcadam.com/api/public/content/4e8c79acd9774072b8f4cec67eb8b2bb?download=true
Found on page https://www.missionhealth.org/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-08-04
Content fingerprint 71e664703840cb80… · 548,074,736 bytes · first seen 2026-05-05

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
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 1 $4,407,480.00 $4,422,320.40 $4,414,900.20 nat. median
$3,758,972
1.2× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 1 $4,326,000.00 $4,326,000.00 $4,326,000.00 nat. median
$3,646,097
1.2× median
908
OTHER 		Topi Adm Prad Zami Per Tr 1 $4,002,984.00 $4,002,984.00 $4,002,984.00 nat. median
$29,683
outlier · 134.9×
714
OTHER 		Inj Delandistrogene Mox R 1 $3,990,546.00 $3,993,432.00 $3,991,989.00 nat. median
$3,325,455
1.2× median
748
OTHER 		Inj, Lovotibeglogene Auto 1 $3,903,009.60 $3,943,200.00 $3,923,104.80 nat. median
$3,252,508
1.2× median
906
OTHER 		Inj Elivaldogene Autoteme 1 $3,816,000.00 $3,816,000.00 $3,816,000.00 nat. median
$24,604
outlier · 155.1×
746
OTHER 		Inj, Betibeglogene Autote 1 $3,527,962.80 $3,561,600.00 $3,544,781.40 nat. median
$2,939,969
1.2× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 2 $2,866,336.80 $4,299,505.20 $3,106,777.20 nat. median
$2,588,981
1.2× median
824
OTHER 		Inj, Exagamglogene Autote 1 $2,798,400.00 $2,798,400.00 $2,798,400.00 nat. median
$58,186
outlier · 48.1×
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 $2,125,000.00 $2,125,000.00 $2,125,000.00 nat. median
$2,460,273
0.9× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 1 $1,369,371.65 $1,369,371.65 $1,369,371.65 nat. median
$691,418
2.0× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 1 $1,328,128.35 $1,328,128.35 $1,328,128.35 nat. median
$631,793
outlier · 2.1×
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 1 $1,279,600.63 $1,279,600.63 $1,279,600.63 nat. median
$588,565
outlier · 2.2×
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 2 $373,000.00 $1,175,752.00 $1,175,752.00 nat. median
$577,541
outlier · 2.0×
2067
OTHER 		Afamitresgene Autoleucel 1 $924,744.00 $924,744.00 $924,744.00 nat. median
$786,032
1.2× median
9498
OTHER 		Ciltacabtagene Car-pos T 2 $632,548.08 $948,822.12 $705,179.52 nat. median
$587,650
1.2× median
9194
OTHER 		Tisagenlecleucel Car-pos 2 $635,031.48 $952,547.22 $679,837.56 nat. median
$576,820
1.2× median
9413
OTHER 		Lisocabtagene Car Pos T 2 $620,071.32 $930,106.98 $674,641.44 nat. median
$562,201
1.2× median
9422
OTHER 		Idecabtagene Vicleucel Ca 2 $631,905.12 $947,857.68 $669,698.16 nat. median
$560,872
1.2× median
9035
OTHER 		Axicabtagene Ciloleucel C 2 $587,347.20 $881,020.80 $638,630.64 nat. median
$533,230
1.2× median
9391
OTHER 		Brexucabtagene Car Pos T 2 $552,636.48 $828,954.72 $587,340.24 nat. median
$492,768
1.2× median
831
OTHER 		Obecbtge Autol Up To 400 1 $333,900.00 $333,900.00 $333,900.00 nat. median
$20,175
outlier · 16.6×
897
OTHER 		Revakinagene, Per Implant 1 $318,000.00 $318,000.00 $318,000.00 nat. median
$19,528
outlier · 16.3×
886
OTHER 		Inj. Remestemcel-l-rknd/ 1 $242,002.80 $242,002.80 $242,002.80 nat. median
$200,661
1.2× median
1907
OTHER 		New Technology - Level 52 2 $183,000.60 $274,500.90 $191,257.56 nat. median
$155,877
1.2× median
1908
OTHER 		New Technology - Level 52 2 $183,000.60 $274,500.90 $191,257.56 nat. median
$155,877
1.2× median
1906
OTHER 		New Technology - Level 51 2 $165,000.60 $247,500.90 $172,445.40 nat. median
$140,545
1.2× median
1905
OTHER 		New Technology - Level 51 2 $165,000.60 $247,500.90 $172,445.40 nat. median
$140,545
1.2× median
J9029
HCPCS 		Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 1 $166,116.65 $166,116.65 $166,116.65 nat. median
$69,291
outlier · 2.4×
516430
CDM 		Kit Implnt Hrtmt 3 Kit 17 $68,849.21 $364,495.82 $158,069.68 nat. median
$162,274
1.0× median
1904
OTHER 		New Technology - Level 50 2 $147,000.60 $220,500.90 $153,633.24 nat. median
$122,500
1.3× median
1903
OTHER 		New Technology - Level 50 2 $147,000.60 $220,500.90 $153,633.24 nat. median
$122,500
1.3× median
Q2043
HCPCS 		Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 2 $51,363.25 $145,223.54 $145,223.54 nat. median
$65,655
outlier · 2.2×
456896
CDM 		Device Vntrc Asst Hrtmt 17 $59,931.29 $317,283.30 $137,595.19 nat. median
$66,206
outlier · 2.1×
1901
OTHER 		New Technology - Level 49 2 $129,000.60 $193,500.90 $134,821.08 nat. median
$107,500
1.3× median
1902
OTHER 		New Technology - Level 49 2 $129,000.60 $193,500.90 $134,821.08 nat. median
$107,500
1.3× median
494847
CDM 		Syst Imp Hrtmt2 Lft Vent 17 $56,489.73 $299,063.26 $129,693.76 nat. median
$132,044
1.0× median
C9293
HCPCS 		Glucarpidase 1000 U Inj 16 $52,309.71 $276,933.76 $120,004.63 nat. median
$24,377
outlier · 4.9×
1599
OTHER 		New Technology - Level 48 2 $114,000.60 $171,000.90 $119,144.30 nat. median
$97,104
1.2× median
1585
OTHER 		New Technology - Level 48 2 $114,000.60 $171,000.90 $119,144.30 nat. median
$97,104
1.2× median
J9999
HCPCS 		Carmustine Wafers 8/box 16 $51,915.48 $274,846.66 $119,100.22 nat. median
$2,547
outlier · 46.8×
J9226
HCPCS 		Histrelin Implant (supprelin La), 50 Mg 2 $41,773.13 $110,645.59 $110,645.59 nat. median
$55,200
outlier · 2.0×
1584
OTHER 		New Technology - Level 47 2 $102,000.60 $153,000.90 $106,602.86 nat. median
$86,882
1.2× median
1598
OTHER 		New Technology - Level 47 2 $102,000.60 $153,000.90 $106,602.86 nat. median
$86,882
1.2× median
1597
OTHER 		New Technology - Level 46 2 $90,000.60 $135,000.90 $94,061.42 nat. median
$76,661
1.2× median
1583
OTHER 		New Technology - Level 46 2 $90,000.60 $135,000.90 $94,061.42 nat. median
$76,661
1.2× median
1596
OTHER 		New Technology - Level 45 2 $78,000.60 $117,000.90 $81,519.98 nat. median
$66,440
1.2× median
1582
OTHER 		New Technology - Level 45 2 $78,000.60 $117,000.90 $81,519.98 nat. median
$66,440
1.2× median
5244
OTHER 		Level 4 Blood Product Exc 2 $62,479.40 $93,719.11 $80,595.71 nat. median
$64,263
1.3× median
1643
OTHER 		Y90 Ibritumomab, Rx 2 $68,189.46 $117,857.84 $78,571.90 nat. median
$60,802
1.3× median

Other procedures at this hospital

Browse this hospital's 28,762 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
             
1142 OTHER Supprelin La Implant 5 2 — — $51,822.41 $81,630.38 $54,420.25 2026-03-01
1577 OTHER New Technology - Level 40 5 2 — — $27,000.60 $40,500.90 $28,218.86 2026-03-01
1578 OTHER New Technology - Level 41 5 2 — — $33,000.60 $49,500.90 $34,489.58 2026-03-01
1579 OTHER New Technology - Level 42 5 2 — — $42,000.60 $63,000.90 $43,895.66 2026-03-01
1580 OTHER New Technology - Level 43 5 2 — — $54,000.60 $81,000.90 $56,437.10 2026-03-01
1581 OTHER New Technology - Level 44 5 2 — — $66,000.60 $99,000.90 $68,978.54 2026-03-01
1582 OTHER New Technology - Level 45 5 2 — — $78,000.60 $117,000.90 $81,519.98 2026-03-01
1583 OTHER New Technology - Level 46 5 2 — — $90,000.60 $135,000.90 $94,061.42 2026-03-01
1584 OTHER New Technology - Level 47 5 2 — — $102,000.60 $153,000.90 $106,602.86 2026-03-01
1585 OTHER New Technology - Level 48 5 2 — — $114,000.60 $171,000.90 $119,144.30 2026-03-01
1591 OTHER New Technology - Level 40 5 2 — — $27,000.60 $40,500.90 $28,218.86 2026-03-01
1592 OTHER New Technology - Level 41 5 2 — — $33,000.60 $49,500.90 $34,489.58 2026-03-01
1593 OTHER New Technology - Level 42 5 2 — — $42,000.60 $63,000.90 $43,895.66 2026-03-01
1594 OTHER New Technology - Level 43 5 2 — — $54,000.60 $81,000.90 $56,437.10 2026-03-01
1595 OTHER New Technology - Level 44 5 2 — — $66,000.60 $99,000.90 $68,978.54 2026-03-01
1596 OTHER New Technology - Level 45 5 2 — — $78,000.60 $117,000.90 $81,519.98 2026-03-01
1597 OTHER New Technology - Level 46 5 2 — — $90,000.60 $135,000.90 $94,061.42 2026-03-01
1598 OTHER New Technology - Level 47 5 2 — — $102,000.60 $153,000.90 $106,602.86 2026-03-01
1599 OTHER New Technology - Level 48 5 2 — — $114,000.60 $171,000.90 $119,144.30 2026-03-01
163 MS_DRG Major Chest Procedures With Mcc 63 32 — — $2,208.21 $45,541.16 $23,305.31 2026-03-01
1643 OTHER Y90 Ibritumomab, Rx 5 2 — — $68,189.46 $117,857.84 $78,571.90 2026-03-01
1901 OTHER New Technology - Level 49 5 2 — — $129,000.60 $193,500.90 $134,821.08 2026-03-01
1902 OTHER New Technology - Level 49 5 2 — — $129,000.60 $193,500.90 $134,821.08 2026-03-01
1903 OTHER New Technology - Level 50 5 2 — — $147,000.60 $220,500.90 $153,633.24 2026-03-01
1904 OTHER New Technology - Level 50 5 2 — — $147,000.60 $220,500.90 $153,633.24 2026-03-01
1905 OTHER New Technology - Level 51 5 2 — — $165,000.60 $247,500.90 $172,445.40 2026-03-01
1906 OTHER New Technology - Level 51 5 2 — — $165,000.60 $247,500.90 $172,445.40 2026-03-01
1907 OTHER New Technology - Level 52 5 2 — — $183,000.60 $274,500.90 $191,257.56 2026-03-01
1908 OTHER New Technology - Level 52 5 2 — — $183,000.60 $274,500.90 $191,257.56 2026-03-01
2067 OTHER Afamitresgene Autoleucel 2 1 — — $924,744.00 $924,744.00 $924,744.00 2026-03-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 62 31 — — $2,208.21 $46,944.57 $23,987.29 2026-03-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 63 32 — — $2,208.21 $44,828.11 $22,958.81 2026-03-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 63 32 — — $2,208.21 $46,183.20 $23,617.17 2026-03-01
264 MS_DRG Other Circulatory System O.r. Procedures 63 32 — — $2,208.21 $46,092.46 $23,573.06 2026-03-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 62 31 — — $2,208.21 $44,349.80 $22,726.24 2026-03-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 63 32 — — $2,208.21 $46,750.27 $23,892.79 2026-03-01
28 MS_DRG Spinal Procedures With Mcc 85 32 — — $2,208.21 $43,781.72 $22,450.09 2026-03-01
318042 CDM Device Embl Pipln 4x18mm 38 17 $55,585.98 $55,585.98 $10,206.26 $54,033.16 $23,432.38 2026-03-01
322980 CDM Device Embl Pln 30x4.25 38 17 $60,511.32 $60,511.32 $11,110.62 $58,820.90 $25,508.67 2026-03-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 63 32 — — $2,208.21 $45,625.98 $23,346.26 2026-03-01
336174 CDM Device Embl Pln 4.5x12mm 38 17 $57,403.67 $57,403.67 $10,540.01 $55,800.06 $24,198.63 2026-03-01
336175 CDM Device Embl 4.75x12mm 38 17 $55,585.98 $55,585.98 $10,206.26 $54,033.16 $23,432.38 2026-03-01
336176 CDM Device Embl 5x35mm 38 17 $60,511.32 $60,511.32 $11,110.62 $58,820.90 $25,508.67 2026-03-01
336177 CDM Device Embl 4.25x10mm 38 17 $57,403.67 $57,403.67 $10,540.01 $55,800.06 $24,198.63 2026-03-01
336178 CDM Device Embl 4x30mm 38 17 $60,511.32 $60,511.32 $11,110.62 $58,820.90 $25,508.67 2026-03-01
337140 CDM Stnt Prox Str24x24x152 38 17 $68,682.11 $68,682.11 $12,610.87 $66,763.44 $28,953.08 2026-03-01
337141 CDM Stnt Clsweb Tpr42x38x150 38 17 $65,896.94 $65,896.94 $12,099.48 $64,056.08 $27,778.99 2026-03-01
337142 CDM Stent Evas Cls 150x40x40 38 17 $65,896.94 $65,896.94 $12,099.48 $64,056.08 $27,778.99 2026-03-01
337143 CDM Stent Gft Vlnt 100x46x46 38 17 $60,326.62 $60,326.62 $11,076.70 $58,641.36 $25,430.81 2026-03-01
337144 CDM Stnt Distal Str40x40x107 38 17 $60,326.62 $60,326.62 $11,076.70 $58,641.36 $25,430.81 2026-03-01
337145 CDM Stnt Clsweb Tpr44x40x150 38 17 $65,896.94 $65,896.94 $12,099.48 $64,056.08 $27,778.99 2026-03-01
359872 CDM Graft Cv Excluder L18cm 38 17 $52,844.88 $52,844.88 $9,702.20 $51,364.58 $22,275.11 2026-03-01
359924 CDM Graft Evas 16cm 26mm 12m 38 17 $52,844.88 $52,844.88 $9,702.20 $51,364.58 $22,275.11 2026-03-01
359925 CDM Graft Evas 18cm 28.5mm 1 38 17 $52,844.88 $52,844.88 $9,702.20 $51,364.58 $22,275.11 2026-03-01
359926 CDM Stnt/gft Eprsth 14cm 28. 38 17 $52,844.88 $52,844.88 $9,702.20 $51,364.58 $22,275.11 2026-03-01
359943 CDM Graft Evas 16cm 28.5mm 1 38 17 $52,844.88 $52,844.88 $9,702.20 $51,364.58 $22,275.11 2026-03-01
359967 CDM Graft Evas 18cm 26mm 12m 38 17 $52,844.88 $52,844.88 $9,702.20 $51,364.58 $22,275.11 2026-03-01
359973 CDM Graft Evas 14cm 28.5mm 1 38 17 $52,844.88 $52,844.88 $9,702.20 $51,364.58 $22,275.11 2026-03-01
368334 CDM Graft Evas 145mm 28x20mm 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
371977 CDM Set Vntrc 17.4x13.8in 39 18 $97,725.00 $97,725.00 $18,836.00 $99,720.00 $43,212.00 2026-03-01
374005 CDM Graft Evas 12cm 26mm 12m 38 17 $52,844.88 $52,844.88 $9,702.20 $51,364.58 $22,275.11 2026-03-01
388684 CDM Graft Cv Ilc L14cm Od26m 38 17 $52,844.88 $52,844.88 $9,702.20 $51,364.58 $22,275.11 2026-03-01
397692 CDM Graft Evas 15cm 31mm 14. 38 17 $52,844.88 $52,844.88 $9,702.20 $51,364.58 $22,275.11 2026-03-01
398129 CDM Graft Cv 135mm 28x16mm 2 38 17 $53,301.26 $53,301.26 $9,785.99 $51,808.18 $22,467.48 2026-03-01
398227 CDM Graft Cv 120mm 25x16mm 2 38 17 $56,534.50 $56,534.50 $10,379.60 $54,950.85 $23,830.35 2026-03-01
398371 CDM Graft Evas 13cm 31mm 38 17 $52,844.88 $52,844.88 $9,702.20 $51,364.58 $22,275.11 2026-03-01
399606 CDM Stent Grft Main C3 28mmx 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
414085 CDM Graft Cv 18cm 23x14.5mm 38 17 $52,844.88 $52,844.88 $9,702.20 $51,364.58 $22,275.11 2026-03-01
417828 CDM Graft Evas 17cm 31mm 14. 38 17 $52,844.88 $52,844.88 $9,702.20 $51,364.58 $22,275.11 2026-03-01
418030 CDM Stent Graft Evas 161mm 2 38 17 $63,032.63 $63,032.63 $11,573.56 $61,271.78 $26,571.53 2026-03-01
418419 CDM Stent Graft Evas 111mmx4 38 17 $56,387.33 $56,387.33 $10,353.40 $54,812.11 $23,770.19 2026-03-01
420304 CDM Stent Aaa Exldr C3 23x12 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
421342 CDM Graft Evas 145mm 28mm 16 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421470 CDM Graft Evas 145mm 25mm 16 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421581 CDM Stent Graft Endurant Mai 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421582 CDM Graft Evas 166mm 23x16mm 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421584 CDM Stent Graft Endurant Mai 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421585 CDM Graft Evas 145mm 23x13mm 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421586 CDM Stent Graft Endurant Mai 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421589 CDM Graft Evas 166mm 20x36mm 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421590 CDM Stent Graft Endurant Mai 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421591 CDM Graft Evas 145mm 32mm 16 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421593 CDM Stent Graft Endurant Mai 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421596 CDM Stnet Graft Endurant Mai 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421602 CDM Graft Evas 166mm 28x13mm 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421615 CDM Graft Evas 145mm 28x13mm 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421617 CDM Graft Evas 124mm 28x13mm 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421619 CDM Graft Evas Endurant Stnt 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421620 CDM Graft Evas 145mm 36mm 16 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421622 CDM Stent Graft Endurant Mai 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421624 CDM Graft Endur Main 32mmx20 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421625 CDM Stent Graft End Main 25x 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421627 CDM Stent Graft End Main 25m 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421681 CDM Graft Evas 28mm 16mm End 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421682 CDM Stent Graft Endurant Mai 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421686 CDM Graft Evas 166mm 25x13mm 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421687 CDM Graft Vasc Aaa 32x16x166 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
421752 CDM Stent Aaa 40x40x159mm Ta 38 17 $63,032.63 $63,032.63 $11,573.56 $61,271.78 $26,571.53 2026-03-01
421811 CDM Graft Evas 16cm 26mm 14. 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
421992 CDM Stent Graft Endurant Mai 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
423167 CDM Graft Excluder Stent Trk 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 60 30 — — $2,208.21 $48,039.28 $24,519.12 2026-03-01
428598 CDM Graft Evas 13cm 31mm 14. 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
429502 CDM Stnt/gft Eprsth 17cm 31m 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
429513 CDM Graft Evas 18cm 28.5mm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
429542 CDM Graft Evas 14cm 23x14.5m 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
429860 CDM Graft Evas 18cm 23mm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 60 30 — — $2,208.21 $46,067.81 $23,560.99 2026-03-01
430213 CDM Stent Grf Mn Prx Thr 38m 38 17 $63,032.63 $63,032.63 $11,573.56 $61,271.78 $26,571.53 2026-03-01
430572 CDM Graft Evas 15cm 31mm 14. 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
432582 CDM Graft Evas 12cm 23mm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
432583 CDM Graft Evas 14cm 23mm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
432584 CDM Graft Evas 12cm 23x14.5m 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
432585 CDM Graft Evas 16cm 23mm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
432586 CDM Graft Evas 18cm 23mm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
432587 CDM Graft Evas 12cm 26mm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
432588 CDM Graft Evas 14cm 26mm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
432589 CDM Graft Evas 16cm 26mm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
432590 CDM Graft Evas 18cm 26mm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
432591 CDM Graft Evas 12cm 26mm 14. 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
432592 CDM Stent Excluder Gore C3 D 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
432593 CDM Graft Evas 18cm 26mm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
432594 CDM Graft Evas 12cm 28.5mm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
432595 CDM Graft Evas 14cm 28.5mm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
432597 CDM Graft Evas 16cm 28.5mm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
432598 CDM Graft Evas 16cm 28.5mm 1 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
432599 CDM Graft Evas 12cm 28.5mm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
438918 CDM Stent Graft Evas 199mm 3 38 17 $67,527.98 $67,527.98 $12,398.96 $65,641.54 $28,466.55 2026-03-01
441861 CDM Valve Pulm 23mm Sapien R 38 17 $127,042.50 $127,042.50 $23,326.55 $123,493.50 $53,555.01 2026-03-01
441862 CDM Valve Pulm 26mm Sapien R 38 17 $127,042.50 $127,042.50 $23,326.55 $123,493.50 $53,555.01 2026-03-01
442536 CDM Pros Knee Amk 1488-01 38 17 $56,616.43 $56,616.43 $10,395.47 $55,034.82 $23,866.76 2026-03-01
443409 CDM Graft Evas 112mm 36mm 32 38 17 $56,387.33 $56,387.33 $10,353.40 $54,812.11 $23,770.19 2026-03-01
443520 CDM Pump Cath Lv Impella 9fr 39 18 $78,180.00 $78,180.00 $15,068.80 $79,776.00 $34,569.60 2026-03-01
449767 CDM Graft Evas 124mm 32-20mm 38 17 $59,361.23 $59,361.23 $10,898.59 $57,698.40 $25,021.87 2026-03-01
451502 CDM Valve Heart Sapien Trans 38 17 $127,042.50 $127,042.50 $23,326.55 $123,493.50 $53,555.01 2026-03-01
451503 CDM Valve Heart Sapien Trans 38 17 $127,042.50 $127,042.50 $23,326.55 $123,493.50 $53,555.01 2026-03-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 3 2 — — $21,909.15 $33,122.23 $33,122.23 2026-03-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 3 2 — — $14,380.91 $22,861.57 $22,861.57 2026-03-01
456456 CDM Graft Evas 18cm 35mm 14. 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
456896 CDM Device Vntrc Asst Hrtmt 38 17 $326,401.50 $326,401.50 $59,931.29 $317,283.30 $137,595.19 2026-03-01
457578 CDM Valve Hrt Sapien 23mm As 38 17 $127,042.50 $127,042.50 $23,326.55 $123,493.50 $53,555.01 2026-03-01
457579 CDM Valve Hrt Sapien 26mm As 38 17 $127,042.50 $127,042.50 $23,326.55 $123,493.50 $53,555.01 2026-03-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 85 32 — — $2,208.21 $43,549.96 $22,337.74 2026-03-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 3 2 — — $22,369.73 $24,790.28 $24,790.28 2026-03-01
459060 CDM Graft Evas 17cm 31x14.5 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
459377 CDM Graft Evas 15cm 31x14.5 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
463209 CDM Valve 23mm Sapien Xt Trn 38 17 $127,042.50 $127,042.50 $23,326.55 $123,493.50 $53,555.01 2026-03-01
463210 CDM Valve 26mm Sapien Xt Trn 38 17 $127,042.50 $127,042.50 $23,326.55 $123,493.50 $53,555.01 2026-03-01
463211 CDM Valve 29mm Sapien Xt Trn 38 17 $127,042.50 $127,042.50 $23,326.55 $123,493.50 $53,555.01 2026-03-01
463212 CDM Valve 29mm Sapien Xt Trn 38 17 $127,042.50 $127,042.50 $23,326.55 $123,493.50 $53,555.01 2026-03-01
463213 CDM Valve Xt Sapien 23mm Ta 38 17 $127,042.50 $127,042.50 $23,326.55 $123,493.50 $53,555.01 2026-03-01
463214 CDM Valve Xt Sapien 26mm Ta 38 17 $127,042.50 $127,042.50 $23,326.55 $123,493.50 $53,555.01 2026-03-01
467555 CDM Graft Evas 12cm 26x14.5 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
468315 CDM Graft Evas 13cm 31mm 14. 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
468669 CDM Graft Evas 14cm 23mm 14. 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
469504 CDM Valve 23mm Thv 38 17 $127,042.50 $127,042.50 $23,326.55 $123,493.50 $53,555.01 2026-03-01
469507 CDM Valve 29mm Thv 38 17 $127,042.50 $127,042.50 $23,326.55 $123,493.50 $53,555.01 2026-03-01
469508 CDM Valve Aor 20mm Edwrd Sap 38 17 $127,042.50 $127,042.50 $23,326.55 $123,493.50 $53,555.01 2026-03-01
472352 CDM Stent Gft Ilic 14cm 23mm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
473744 CDM Graft Excluder 16cm 28.5 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
473999 CDM Graft Evas 18x23x14.5mm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
474099 CDM Graft Evas 14 Cm 28.5 14 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
474489 CDM Graft Evas 18cm 28.5mm 1 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
476296 CDM Graft Evas 16cm 23mm 12m 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
476745 CDM Graft Evas 12cm 23mm 12m 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
476831 CDM Graft Evas 10cm 12mm Aaa 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
477230 CDM Graft Evs 16cm 26x14.5mm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
477365 CDM Graft Evas 14cm 35mm 14. 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
478737 CDM Graft Evas 10cm 14.5mm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
479246 CDM Graft Evas 26x12mm 12cm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
479247 CDM Graft Evas 28.5x12m 12cm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
480996 CDM Graft Evas 12cm 28.5mm 1 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
482281 CDM Graft Evas 18cm 23mm 12m 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
482282 CDM Graft Excldr 12x23x15.5 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
482284 CDM Graft Evas 16cm 23mm 14. 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
482285 CDM Graft Evas 14cm 26mm 12m 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
482288 CDM Graft Evas 14cm 26mm 14. 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
482289 CDM Graft Evs 18cm 26x14.5mm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
482290 CDM Graft Excluder 14cm 28.5 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
482291 CDM Graft Evas 28.5x12m 16cm 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
482292 CDM Graft Evas 18cm 28.5mm 1 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
482331 CDM Graft Evas 10cm 10mm Gor 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
482334 CDM Graft Evas 16cm 35mm 14. 38 17 $59,480.25 $59,480.25 $10,920.44 $57,814.08 $25,072.04 2026-03-01
485646 CDM Valve Hrt W Cert Sys 26a 38 17 $127,042.50 $127,042.50 $23,326.55 $123,493.50 $53,555.01 2026-03-01
485939 CDM Valve Hrt W/cert Sys 20a 38 17 $127,042.50 $127,042.50 $23,326.55 $123,493.50 $53,555.01 2026-03-01
485942 CDM Valve Hrt W/cert Sys 23a 38 17 $127,042.50 $127,042.50 $23,326.55 $123,493.50 $53,555.01 2026-03-01
485943 CDM Valve Heart W/cert 29a 38 17 $127,042.50 $127,042.50 $23,326.55 $123,493.50 $53,555.01 2026-03-01
487214 CDM Valve Aor Evolut Pro 23m 38 17 $117,270.00 $117,270.00 $21,532.20 $113,994.00 $49,435.40 2026-03-01
487218 CDM Valve Tavr 34mm 38 17 $117,270.00 $117,270.00 $21,532.20 $113,994.00 $49,435.40 2026-03-01
488819 CDM Set Pump 21fr 5.0 39 18 $109,452.00 $109,452.00 $21,096.32 $111,686.40 $48,397.44 2026-03-01
494621 CDM Device Embl 10mm 3.25mm 38 17 $55,585.98 $55,585.98 $10,206.26 $54,033.16 $23,432.38 2026-03-01
494847 CDM Syst Imp Hrtmt2 Lft Vent 38 17 $307,657.85 $307,657.85 $56,489.73 $299,063.26 $129,693.76 2026-03-01
495512 CDM Kit Nucleus 7 Processor 39 18 $59,185.13 $59,185.13 $11,408.98 $60,400.47 $26,173.54 2026-03-01
495522 CDM Kit Nucleus 6 Processor 39 18 $59,185.13 $59,185.13 $11,408.98 $60,400.47 $26,173.54 2026-03-01
496433 CDM Valve Ao 9000tfx 23mm 38 17 $127,042.50 $127,042.50 $23,326.55 $123,493.50 $53,555.01 2026-03-01
496750 CDM Device Embl 10mm 2.5mm P 38 17 $55,585.98 $55,585.98 $10,206.26 $54,033.16 $23,432.38 2026-03-01
5116 OTHER Level 6 Musculoskeletal P 5 2 — — $21,307.54 $31,961.30 $22,466.22 2026-03-01
5117 OTHER Level 7 Musculoskeletal P 2 1 — — $34,767.05 $34,767.05 $34,767.05 2026-03-01
514609 CDM Device Embl 18mm 4.25mm 38 17 $55,585.98 $55,585.98 $10,206.26 $54,033.16 $23,432.38 2026-03-01
514663 CDM Cap Endrnt Grft 162698 38 17 $73,489.20 $73,489.20 $13,493.51 $71,436.24 $30,979.51 2026-03-01
514675 CDM Cap Endrnt Grft 162700 38 17 $55,312.35 $55,312.35 $10,156.02 $53,767.17 $23,317.03 2026-03-01
515340 CDM Device Embl 12mm 3.5mm 38 17 $55,585.98 $55,585.98 $10,206.26 $54,033.16 $23,432.38 2026-03-01
516430 CDM Kit Implnt Hrtmt 3 Kit 38 17 $374,970.83 $374,970.83 $68,849.21 $364,495.82 $158,069.68 2026-03-01
5166 OTHER Cochlear Implant Procedur 5 2 — — $38,341.68 $57,512.52 $42,247.44 2026-03-01
517271 CDM Device Embl 12mm 4mm Pip 38 17 $55,585.98 $55,585.98 $10,206.26 $54,033.16 $23,432.38 2026-03-01
517339 CDM Device Embl 14mm 3.5mm P 38 17 $55,585.98 $55,585.98 $10,206.26 $54,033.16 $23,432.38 2026-03-01
517537 CDM Device Embl 16mm 3.75mm 38 17 $55,585.98 $55,585.98 $10,206.26 $54,033.16 $23,432.38 2026-03-01
519194 CDM Device Embl 12mm 2.5mm P 38 17 $55,585.98 $55,585.98 $10,206.26 $54,033.16 $23,432.38 2026-03-01
5194 OTHER Level 4 Endovascular Proc 5 2 — — $20,048.77 $30,073.16 $23,488.48 2026-03-01
5200 OTHER Implantation Wireless Pa 5 2 — — $33,230.96 $49,846.45 $36,752.21 2026-03-01
5213 OTHER Level 3 Electrophysiologi 5 2 — — $27,155.03 $40,732.54 $33,490.66 2026-03-01
5224 OTHER Level 4 Pacemaker And Sim 5 2 — — $22,278.42 $33,417.63 $24,680.16 2026-03-01
5231 OTHER Level 1 Icd And Similar P 5 2 — — $26,950.38 $40,425.57 $28,500.88 2026-03-01
5232 OTHER Level 2 Icd And Similar P 5 2 — — $37,615.18 $56,422.76 $40,218.80 2026-03-01
5244 OTHER Level 4 Blood Product Exc 5 2 — — $62,479.40 $93,719.11 $80,595.71 2026-03-01
534130 CDM Device Embl 25mm 3.5mm P 38 17 $60,511.32 $60,511.32 $11,110.62 $58,820.90 $25,508.67 2026-03-01
534224 CDM Device Embl 25mm 5mm Pip 38 17 $60,511.32 $60,511.32 $11,110.62 $58,820.90 $25,508.67 2026-03-01
534231 CDM Device Embl 20mm 5mm Pip 38 17 $55,585.98 $55,585.98 $10,206.26 $54,033.16 $23,432.38 2026-03-01
534450 CDM Device Embl 12mm 5mm Pip 38 17 $55,585.98 $55,585.98 $10,206.26 $54,033.16 $23,432.38 2026-03-01
534459 CDM Device Embl 10mm 2.75mm 38 17 $55,585.98 $55,585.98 $10,206.26 $54,033.16 $23,432.38 2026-03-01
534460 CDM Device Embl 12mm 3.25mm 38 17 $55,585.98 $55,585.98 $10,206.26 $54,033.16 $23,432.38 2026-03-01
5378 OTHER Level 8 Urology And Relat 5 2 — — $23,063.40 $34,595.10 $26,556.55 2026-03-01
544807 CDM Valve Heart 29 Mm 38 17 $89,907.00 $89,907.00 $16,508.02 $87,395.40 $37,900.47 2026-03-01
544808 CDM Valve Tavr 27mm 38 17 $89,907.00 $89,907.00 $16,508.02 $87,395.40 $37,900.47 2026-03-01
544809 CDM Valve Tavr 25mm 38 17 $123,133.50 $123,133.50 $22,608.81 $119,693.70 $51,907.17 2026-03-01
545183 CDM Device Embl 3mm 4mm Web 38 17 $58,439.55 $58,439.55 $10,730.21 $56,807.01 $24,635.31 2026-03-01
545195 CDM Coil Emb Endo Sn Ly 8mm 38 17 $58,439.55 $58,439.55 $10,730.21 $56,807.01 $24,635.31 2026-03-01
545198 CDM Coil Emb Endo Sn Ly 8mmx 38 17 $58,439.55 $58,439.55 $10,730.21 $56,807.01 $24,635.31 2026-03-01
545213 CDM Coil Emb Endo Sn Ly Sphr 38 17 $58,439.55 $58,439.55 $10,730.21 $56,807.01 $24,635.31 2026-03-01
545488 CDM Valve Aor Tavr 26mm 38 17 $117,270.00 $117,270.00 $21,532.20 $113,994.00 $49,435.40 2026-03-01
5464 OTHER Level 4 Neurostimulator A 5 2 — — $24,857.52 $37,517.11 $25,011.41 2026-03-01
5465 OTHER Level 5 Neurostimulator A 5 2 — — $35,503.55 $53,255.32 $39,538.22 2026-03-01
5471 OTHER Implantation Of Drug Infu 5 2 — — $20,390.86 $30,586.28 $23,094.11 2026-03-01
547215 CDM Valve Mitral 29m 38 17 $117,270.00 $117,270.00 $21,532.20 $113,994.00 $49,435.40 2026-03-01
547223 CDM Valve Mitral 36.5x52.5mm 38 17 $117,270.00 $117,270.00 $21,532.20 $113,994.00 $49,435.40 2026-03-01
547229 CDM Valve Mitral 46.5x39.5mm 38 17 $117,270.00 $117,270.00 $21,532.20 $113,994.00 $49,435.40 2026-03-01
547294 CDM Graft Bn Hum Hd 38 17 $53,529.25 $53,529.25 $9,827.85 $52,029.78 $22,563.58 2026-03-01
551728 CDM Device Embl 5x18mm 38 17 $53,553.30 $53,553.30 $9,833.04 $52,057.26 $22,575.50 2026-03-01
551863 CDM Device Embl 16mm 2.5mm P 38 17 $55,585.98 $55,585.98 $10,206.26 $54,033.16 $23,432.38 2026-03-01
551864 CDM Device Embl Ped25x4.75mm 38 17 $60,511.32 $60,511.32 $11,110.62 $58,820.90 $25,508.67 2026-03-01
551981 CDM Pump Heart 21fr 85mm 39 18 $136,815.00 $136,815.00 $26,370.40 $139,608.00 $60,496.80 2026-03-01
566176 CDM Device Emblz 5mm 20mm 38 17 $56,230.97 $56,230.97 $10,324.69 $54,660.12 $23,704.27 2026-03-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 63 32 — — $2,208.21 $44,840.93 $22,965.12 2026-03-01
714 OTHER Inj Delandistrogene Mox R 4 1 — — $3,990,546.00 $3,993,432.00 $3,991,989.00 2026-03-01
717 OTHER Instill Adstiladrin, Tx D 5 2 — — $76,025.72 $114,038.59 $77,129.75 2026-03-01
746 OTHER Inj, Betibeglogene Autote 4 1 — — $3,527,962.80 $3,561,600.00 $3,544,781.40 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 4 1 — — $3,903,009.60 $3,943,200.00 $3,923,104.80 2026-03-01
772801 CDM Kit Impl Neurostim 38 17 $77,320.02 $77,320.02 $14,196.90 $75,160.04 $32,594.40 2026-03-01
773 OTHER Inj, Beqvez, Per Tx Dose 2 1 — — $4,326,000.00 $4,326,000.00 $4,326,000.00 2024-10-01
773094 CDM Device Clsr 12fr 20mm 38 17 $66,453.00 $66,453.00 $12,201.58 $64,596.60 $28,013.39 2026-03-01
773095 CDM Device Clsr 12fr 24mm 38 17 $66,453.00 $66,453.00 $12,201.58 $64,596.60 $28,013.39 2026-03-01
773096 CDM Device Clsr 12fr 27mm 38 17 $66,453.00 $66,453.00 $12,201.58 $64,596.60 $28,013.39 2026-03-01
773097 CDM Device Clsr 12fr 31mm 38 17 $66,453.00 $66,453.00 $12,201.58 $64,596.60 $28,013.39 2026-03-01
773098 CDM Device Clsr 12f 35mm 38 17 $66,453.00 $66,453.00 $12,201.58 $64,596.60 $28,013.39 2026-03-01
777080 CDM Valve Tavor Aor 29mm 38 17 $117,270.00 $117,270.00 $21,532.20 $113,994.00 $49,435.40 2026-03-01
779338 CDM Cannula Introd 29fx46cm 39 18 $50,817.00 $50,817.00 $9,794.72 $51,854.40 $22,470.24 2026-03-01
779339 CDM Cannula Dual 31fr 51cm 39 18 $50,817.00 $50,817.00 $9,794.72 $51,854.40 $22,470.24 2026-03-01
824 OTHER Inj, Exagamglogene Autote 2 1 — — $2,798,400.00 $2,798,400.00 $2,798,400.00 2026-03-01
831 OTHER Obecbtge Autol Up To 400 2 1 — — $333,900.00 $333,900.00 $333,900.00 2026-03-01
843 OTHER Pegaspargase Injection 5 2 — — $32,484.64 $48,726.95 $34,108.87 2026-03-01
856 OTHER Porfimer Sodium Injection 5 2 — — $28,644.17 $42,966.25 $29,074.10 2026-03-01
867960 CDM Dev Embl 16x5mm 38 17 $55,585.98 $55,585.98 $10,206.26 $54,033.16 $23,432.38 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 2 1 — — $242,002.80 $242,002.80 $242,002.80 2026-03-01
897 OTHER Revakinagene, Per Implant 2 1 — — $318,000.00 $318,000.00 $318,000.00 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 5 2 — — $587,347.20 $881,020.80 $638,630.64 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 2 1 — — $3,816,000.00 $3,816,000.00 $3,816,000.00 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 2 1 — — $4,002,984.00 $4,002,984.00 $4,002,984.00 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 4 1 — — $4,407,480.00 $4,422,320.40 $4,414,900.20 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 5 2 — — $2,866,336.80 $4,299,505.20 $3,106,777.20 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 5 2 — — $635,031.48 $952,547.22 $679,837.56 2026-03-01
9273 OTHER Sipuleucel-t Auto Cd54+ 5 2 — — $65,284.93 $99,027.41 $66,018.28 2026-03-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 63 32 — — $2,208.21 $48,352.90 $24,671.37 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 5 2 — — $552,636.48 $828,954.72 $587,340.24 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 5 2 — — $620,071.32 $930,106.98 $674,641.44 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 5 2 — — $631,905.12 $947,857.68 $669,698.16 2026-03-01
949 MS_DRG Aftercare With Cc/mcc 63 32 — — $2,208.21 $44,391.22 $22,746.19 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 5 2 — — $632,548.08 $948,822.12 $705,179.52 2026-03-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 85 32 — — $2,208.21 $44,053.93 $22,582.39 2026-03-01
A9543 HCPCS Y90 Ibritum Tiu Tx 40mci 30 17 $133,686.05 $133,686.05 $24,544.76 $129,942.84 $56,019.80 2026-03-01
C1767 HCPCS System Nrv Vns Thrpy Dl 762 18 $64,143.07 $64,143.07 $980.73 $140,888.99 $24,921.92 2026-03-01
C1772 HCPCS Pump Infus 40ml Imp Fltr 76 17 $58,914.90 $58,914.90 $8,728.70 $57,264.57 $22,591.93 2026-03-01
C1822 HCPCS Pulse Gen Imp 190 17 $84,043.50 $84,043.50 $10,254.06 $81,695.70 $31,591.12 2026-03-01
C9293 HCPCS Glucarpidase 1000 U Inj 29 16 $284,911.28 $284,911.28 $52,309.71 $276,933.76 $120,004.63 2026-03-01
J1412 HCPCS Injection, Valoctocogene Roxaparvovec-rvox, Per Ml, Containing Nominal 2 X 10°13… 8 1 — — $28,750.78 $28,750.78 $28,750.78 2026-03-01
J2327 HCPCS Risankizum-rzaa 1mg Inj 37 16 $72,508.18 $72,508.18 $39.21 $70,477.95 $27,173.16 2026-03-01
J2350 HCPCS Ocrelizumab 300 Mg Inj 39 17 $139,200.48 $139,200.48 $57.24 $135,302.87 $51,114.42 2026-03-01
J3357 HCPCS Ustekinumab 90 Mg Sq 100 18 $197,731.82 $197,731.82 $171.18 $192,195.33 $28,500.53 2026-03-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 2 1 — — $2,125,000.00 $2,125,000.00 $2,125,000.00 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 8 1 — — $166,116.65 $166,116.65 $166,116.65 2026-03-01
J9119 HCPCS Cemiplimab-rwlc 350mginj 39 17 $77,952.26 $77,952.26 $27.39 $75,769.60 $28,624.07 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 10 2 — — $41,773.13 $110,645.59 $110,645.59 2026-03-01
J9228 HCPCS Ipilimumab 50 Mg Inj 97 17 $64,258.47 $64,258.47 $156.72 $249,836.18 $23,595.71 2026-03-01
J9266 HCPCS Pegaspargase Singl Vial 39 17 $115,974.63 $115,974.63 $19,717.46 $112,727.34 $56,363.67 2026-03-01
J9999 HCPCS Carmustine Wafers 8/box 29 16 $282,764.06 $282,764.06 $51,915.48 $274,846.66 $119,100.22 2026-03-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 2 1 — — $27,113.90 $27,113.90 $27,113.90 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 8 1 — — $1,279,600.63 $1,279,600.63 $1,279,600.63 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 8 1 — — $1,369,371.65 $1,369,371.65 $1,369,371.65 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 10 2 — — $51,363.25 $145,223.54 $145,223.54 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 10 2 — — $373,000.00 $1,175,752.00 $1,175,752.00 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 8 1 — — $1,328,128.35 $1,328,128.35 $1,328,128.35 2026-03-01
See an error in this hospital's data? Submit a correction