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 →

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Hospital

Carepartners Rehabilitation Hosp

Asheville, NC · CCN 343025 · Rates published

15,765 distinct procedures filed
28 distinct payers
504,830 rate rows
2026-09-01 last MRF observed
Data quality

430,572 of 504,830 rate rows are consumer-grade (85.3%)

74,258 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 55,232
per-diem day rate — not a per-procedure price 9,673
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 9,196
placeholder amount (≤ $0.02) — excluded from medians 147
exceeds 10× this hospital's gross charge — excluded from medians 8
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.hcadam.com/api/public/content/569fc7d62b6f4d82af86e4a4132f31f1?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 · 2026-09-21
Content fingerprint a2d8455bd74fc706… · 50,241,247 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
845
OTHER 		Inj, Atidarsagene Autotem 10 $4,505,000.00 $4,955,500.00 $4,640,150.00 nat. median
$17,146
outlier · 270.6×
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 12 $3,672,900.00 $4,429,740.00 $3,802,193.50 nat. median
$3,758,972
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 9 $3,605,000.00 $4,326,000.00 $3,713,150.00 nat. median
$3,646,097
1.0× median
908
OTHER 		Topi Adm Prad Zami Per Tr 12 $3,285,783.00 $4,002,984.00 $3,435,894.60 nat. median
$30,329
outlier · 113.3×
714
OTHER 		Inj Delandistrogene Mox R 12 $3,316,897.00 $3,993,432.00 $3,427,695.80 nat. median
$3,325,455
1.0× median
748
OTHER 		Inj, Lovotibeglogene Auto 12 $3,235,304.00 $3,943,200.00 $3,364,716.16 nat. median
$3,252,508
1.0× median
906
OTHER 		Inj Elivaldogene Autoteme 12 $3,180,000.00 $3,816,000.00 $3,291,300.00 nat. median
$24,952
outlier · 131.9×
746
OTHER 		Inj, Betibeglogene Autote 12 $2,930,260.00 $3,561,600.00 $3,047,470.40 nat. median
$2,939,969
1.0× median
922
OTHER 		Inj Onase Abepar-brve Trea 12 $2,664,228.00 $3,197,073.60 $2,757,475.98 nat. median
$707
outlier · 3902.8×
9141
OTHER 		Inj Onase Abepar-xioi Tre 12 $2,388,614.00 $3,216,045.60 $2,680,038.00 nat. median
$2,588,981
1.0× median
824
OTHER 		Inj, Exagamglogene Autote 12 $2,300,907.00 $2,798,400.00 $2,401,960.00 nat. median
$2,262,040
1.1× 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
$738,272
1.9× 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
$646,415
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
$608,101
outlier · 2.1×
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 1 $1,175,752.00 $1,175,752.00 $1,175,752.00 nat. median
$591,650
2.0× median
2067
OTHER 		Afamitresgene Autoleucel 12 $770,620.00 $976,760.88 $831,258.18 nat. median
$789,886
1.1× median
9194
OTHER 		Tisagenlecleucel Car-pos 12 $529,192.90 $734,031.84 $611,693.20 nat. median
$577,003
1.1× median
9498
OTHER 		Ciltacabtagene Car-pos T 12 $527,123.40 $705,573.36 $599,737.36 nat. median
$587,650
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 12 $516,726.10 $695,484.72 $579,570.60 nat. median
$562,201
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 12 $526,587.60 $681,573.36 $574,824.25 nat. median
$562,826
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 12 $489,456.00 $675,001.08 $562,500.90 nat. median
$533,230
1.1× median
9391
OTHER 		Brexucabtagene Car Pos T 12 $460,530.40 $612,124.68 $510,103.90 nat. median
$492,768
1.0× median
831
OTHER 		Obecbtge Autol Up To 400 12 $278,250.00 $333,900.00 $287,988.75 nat. median
$23,568
outlier · 12.2×
897
OTHER 		Revakinagene, Per Implant 12 $261,579.70 $318,000.00 $272,950.00 nat. median
$25,189
outlier · 10.8×
886
OTHER 		Inj. Remestemcel-l-rknd/ 12 $201,669.00 $244,391.76 $209,769.59 nat. median
$201,669
1.0× median
J9999
HCPCS 		Carmustine 8 Wafers/box 10 $76,346.29 $250,415.85 $187,964.58 nat. median
$2,702
outlier · 69.6×
C9293
HCPCS 		Glucarpidase 1000 U Inj 10 $76,926.04 $252,317.43 $186,791.83 nat. median
$30,181
outlier · 6.2×
J9029
HCPCS 		Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 1 $166,116.65 $166,116.65 $166,116.65 nat. median
$68,423
outlier · 2.4×
1907
OTHER 		New Technology - Level 52 12 $141,474.70 $171,208.08 $146,953.60 nat. median
$155,877
0.9× median
1908
OTHER 		New Technology - Level 52 12 $141,474.70 $171,208.08 $146,953.60 nat. median
$155,833
0.9× median
Q2043
HCPCS 		Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 1 $145,223.54 $145,223.54 $145,223.54 nat. median
$65,720
outlier · 2.2×
1905
OTHER 		New Technology - Level 51 12 $127,559.20 $154,368.00 $132,499.20 nat. median
$140,530
0.9× median
1906
OTHER 		New Technology - Level 51 12 $127,559.20 $154,368.00 $132,499.20 nat. median
$140,545
0.9× median
924
OTHER 		Inj Zopapogene Per Ther Do 12 $121,900.00 $146,280.00 $126,166.50 nat. median
$203
outlier · 620.4×
1903
OTHER 		New Technology - Level 50 12 $113,643.70 $137,527.92 $118,044.80 nat. median
$120,722
1.0× median
1904
OTHER 		New Technology - Level 50 12 $113,643.70 $137,527.92 $118,044.80 nat. median
$120,722
1.0× median
Q0480
HCPCS 		Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 12 $99,999.90 $133,803.60 $113,733.06 nat. median
$111,503
1.0× median
J9226
HCPCS 		Histrelin Implant (supprelin La), 50 Mg 1 $110,645.59 $110,645.59 $110,645.59 nat. median
$55,159
outlier · 2.0×
1901
OTHER 		New Technology - Level 49 12 $99,728.21 $120,687.84 $103,590.40 nat. median
$105,940
1.0× median
1902
OTHER 		New Technology - Level 49 12 $99,728.21 $120,687.84 $103,590.40 nat. median
$105,940
1.0× median
K1007
HCPCS 		Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 12 $91,031.90 $114,097.20 $97,933.43 nat. median
$97,020
1.0× median
1599
OTHER 		New Technology - Level 48 12 $88,131.96 $106,654.39 $91,545.02 nat. median
$97,104
0.9× median
1585
OTHER 		New Technology - Level 48 12 $88,131.96 $106,654.39 $91,545.02 nat. median
$96,908
0.9× median
J2350
HCPCS 		Ocrelizumab 300 Mg Inj 10 $157.62 $123,275.95 $88,172.37 nat. median
$414
outlier · 212.8×
1584
OTHER 		New Technology - Level 47 12 $78,854.96 $95,427.68 $81,908.76 nat. median
$86,858
0.9× median
1598
OTHER 		New Technology - Level 47 12 $78,854.96 $95,427.68 $81,908.76 nat. median
$86,882
0.9× median
J9266
HCPCS 		Pegasparga Single Vl Inj 10 $67,636.40 $102,707.13 $77,781.86 nat. median
$33,238
outlier · 2.3×
926
OTHER 		Gemcitabine Intravesical S 12 $72,984.24 $87,581.09 $75,538.69 nat. median
$64
outlier · 1184.9×
1583
OTHER 		New Technology - Level 46 12 $69,577.96 $84,200.96 $72,272.49 nat. median
$76,639
0.9× median
1597
OTHER 		New Technology - Level 46 12 $69,577.96 $84,200.96 $72,272.49 nat. median
$76,661
0.9× median

Other procedures at this hospital

Browse this hospital's 15,765 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
             
0024 RC Maj Mult Trauma No Brain Or Spinal Cord Injury; M 3,452 3 — — $3,031.02 $66,040.12 $25,139.75 2026-09-01
0118 RC Room & Board - Private (One Bed) Rehabilitation 9,311 11 — — $1,552.00 $66,040.12 $25,407.71 2026-09-01
0128 RC Room & Board - Semi-private (Two Beds) Rehabilitation 9,311 11 — — $1,583.00 $66,040.12 $25,407.71 2026-09-01
0138 RC Room & Board - Three And Four Beds Rehabilitation 9,311 11 — — $1,583.00 $66,040.12 $25,407.71 2026-09-01
0148 RC Room & Board - Deluxe Private Rehabilitation 9,311 11 — — $1,583.00 $66,040.12 $25,407.71 2026-09-01
0158 RC Room & Board - Ward Rehabilitation 8,617 10 — — $1,583.00 $66,040.12 $25,368.40 2026-09-01
1142 OTHER Supprelin La Implant 39 12 — — $37,491.97 $54,420.25 $44,480.90 2026-09-01
1578 OTHER New Technology - Level 41 39 12 — — $25,512.21 $30,874.04 $26,500.22 2026-09-01
1579 OTHER New Technology - Level 42 39 12 — — $32,469.96 $39,294.08 $33,727.42 2026-09-01
1580 OTHER New Technology - Level 43 39 12 — — $41,746.96 $50,520.80 $43,363.69 2026-09-01
1581 OTHER New Technology - Level 44 39 12 — — $51,023.96 $61,747.52 $52,999.96 2026-09-01
1582 OTHER New Technology - Level 45 39 12 — — $60,300.96 $72,974.24 $62,636.23 2026-09-01
1583 OTHER New Technology - Level 46 39 12 — — $69,577.96 $84,200.96 $72,272.49 2026-09-01
1584 OTHER New Technology - Level 47 39 12 — — $78,854.96 $95,427.68 $81,908.76 2026-09-01
1585 OTHER New Technology - Level 48 39 12 — — $88,131.96 $106,654.39 $91,545.02 2026-09-01
1592 OTHER New Technology - Level 41 39 12 — — $25,512.21 $30,874.04 $26,500.22 2026-09-01
1593 OTHER New Technology - Level 42 39 12 — — $32,469.96 $39,294.08 $33,727.42 2026-09-01
1594 OTHER New Technology - Level 43 39 12 — — $41,746.96 $50,520.80 $43,363.69 2026-09-01
1595 OTHER New Technology - Level 44 39 12 — — $51,023.96 $61,747.52 $52,999.96 2026-09-01
1596 OTHER New Technology - Level 45 39 12 — — $60,300.96 $72,974.24 $62,636.23 2026-09-01
1597 OTHER New Technology - Level 46 39 12 — — $69,577.96 $84,200.96 $72,272.49 2026-09-01
1598 OTHER New Technology - Level 47 39 12 — — $78,854.96 $95,427.68 $81,908.76 2026-09-01
1599 OTHER New Technology - Level 48 39 12 — — $88,131.96 $106,654.39 $91,545.02 2026-09-01
1643 OTHER Y90 Ibritumomab, Rx 39 12 — — $56,824.55 $78,571.90 $61,370.51 2026-09-01
1901 OTHER New Technology - Level 49 39 12 — — $99,728.21 $120,687.84 $103,590.40 2026-09-01
1902 OTHER New Technology - Level 49 39 12 — — $99,728.21 $120,687.84 $103,590.40 2026-09-01
1903 OTHER New Technology - Level 50 39 12 — — $113,643.70 $137,527.92 $118,044.80 2026-09-01
1904 OTHER New Technology - Level 50 39 12 — — $113,643.70 $137,527.92 $118,044.80 2026-09-01
1905 OTHER New Technology - Level 51 39 12 — — $127,559.20 $154,368.00 $132,499.20 2026-09-01
1906 OTHER New Technology - Level 51 39 12 — — $127,559.20 $154,368.00 $132,499.20 2026-09-01
1907 OTHER New Technology - Level 52 39 12 — — $141,474.70 $171,208.08 $146,953.60 2026-09-01
1908 OTHER New Technology - Level 52 39 12 — — $141,474.70 $171,208.08 $146,953.60 2026-09-01
2067 OTHER Afamitresgene Autoleucel 28 12 — — $770,620.00 $976,760.88 $831,258.18 2026-09-01
487218 CDM Valve Tavr 34mm 22 10 $108,570.00 $108,570.00 $29,317.50 $96,161.40 $71,188.76 2026-03-01
5117 OTHER Level 7 Musculoskeletal P 28 12 — — $25,935.34 $31,122.41 $26,843.08 2026-09-01
5166 OTHER Cochlear Implant Procedur 39 12 — — $29,641.31 $37,818.65 $32,145.85 2026-09-01
5200 OTHER Implantation Wireless Pa 39 12 — — $25,690.30 $32,899.48 $27,964.55 2026-09-01
5213 OTHER Level 3 Electrophysiologi 39 12 — — $20,993.10 $29,979.83 $25,482.85 2026-09-01
5232 OTHER Level 2 Icd And Similar P 39 12 — — $29,079.67 $36,002.66 $30,902.29 2026-09-01
5244 OTHER Level 4 Blood Product Exc 39 12 — — $48,301.79 $72,146.86 $61,324.83 2026-09-01
5465 OTHER Level 5 Neurostimulator A 39 12 — — $27,447.20 $35,393.42 $30,084.41 2026-09-01
566176 CDM Device Emblz 5mm 20mm 22 10 $52,060.00 $52,060.00 $14,057.75 $46,109.42 $34,135.03 2026-03-01
714 OTHER Inj Delandistrogene Mox R 39 12 — — $3,316,897.00 $3,993,432.00 $3,427,695.80 2026-09-01
717 OTHER Instill Adstiladrin, Tx D 39 12 — — $63,354.77 $77,197.93 $66,203.03 2026-09-01
746 OTHER Inj, Betibeglogene Autote 39 12 — — $2,930,260.00 $3,561,600.00 $3,047,470.40 2026-09-01
748 OTHER Inj, Lovotibeglogene Auto 39 12 — — $3,235,304.00 $3,943,200.00 $3,364,716.16 2026-09-01
773 OTHER Inj, Beqvez, Per Tx Dose 11 9 — — $3,605,000.00 $4,326,000.00 $3,713,150.00 2024-10-01
779338 CDM Cannula Introd 29fx46cm 23 11 $47,047.00 $47,047.00 $10,670.40 $43,748.64 $32,229.94 2026-03-01
779339 CDM Cannula Dual 31fr 51cm 23 11 $47,047.00 $47,047.00 $10,670.40 $43,748.64 $32,229.94 2026-03-01
824 OTHER Inj, Exagamglogene Autote 28 12 — — $2,300,907.00 $2,798,400.00 $2,401,960.00 2026-09-01
831 OTHER Obecbtge Autol Up To 400 28 12 — — $278,250.00 $333,900.00 $287,988.75 2026-09-01
843 OTHER Pegaspargase Injection 39 12 — — $27,070.53 $35,596.75 $29,663.96 2026-09-01
845 OTHER Inj, Atidarsagene Autotem 24 10 — — $4,505,000.00 $4,955,500.00 $4,640,150.00 2026-09-01
856 OTHER Porfimer Sodium Injection 25 12 — — $23,870.14 $29,074.10 $24,824.95 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 28 12 — — $201,669.00 $244,391.76 $209,769.59 2026-09-01
897 OTHER Revakinagene, Per Implant 28 12 — — $261,579.70 $318,000.00 $272,950.00 2026-09-01
9035 OTHER Axicabtagene Ciloleucel C 39 12 — — $489,456.00 $675,001.08 $562,500.90 2026-09-01
906 OTHER Inj Elivaldogene Autoteme 28 12 — — $3,180,000.00 $3,816,000.00 $3,291,300.00 2026-09-01
908 OTHER Topi Adm Prad Zami Per Tr 28 12 — — $3,285,783.00 $4,002,984.00 $3,435,894.60 2026-09-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 39 12 — — $3,672,900.00 $4,429,740.00 $3,802,193.50 2026-09-01
9141 OTHER Inj Onase Abepar-xioi Tre 39 12 — — $2,388,614.00 $3,216,045.60 $2,680,038.00 2026-09-01
9194 OTHER Tisagenlecleucel Car-pos 39 12 — — $529,192.90 $734,031.84 $611,693.20 2026-09-01
922 OTHER Inj Onase Abepar-brve Trea 14 12 — — $2,664,228.00 $3,197,073.60 $2,757,475.98 2026-09-01
924 OTHER Inj Zopapogene Per Ther Do 14 12 — — $121,900.00 $146,280.00 $126,166.50 2026-09-01
926 OTHER Gemcitabine Intravesical S 14 12 — — $72,984.24 $87,581.09 $75,538.69 2026-09-01
9273 OTHER Sipuleucel-t Auto Cd54+ 39 12 — — $54,404.11 $67,118.92 $57,051.08 2026-09-01
9391 OTHER Brexucabtagene Car Pos T 39 12 — — $460,530.40 $612,124.68 $510,103.90 2026-09-01
941 OTHER Riboflavin Epioxa/hd<=2ml 14 12 — — $40,427.50 $48,513.00 $41,842.46 2026-09-01
9413 OTHER Lisocabtagene Car Pos T 39 12 — — $516,726.10 $695,484.72 $579,570.60 2026-09-01
9422 OTHER Idecabtagene Vicleucel Ca 39 12 — — $526,587.60 $681,573.36 $574,824.25 2026-09-01
9498 OTHER Ciltacabtagene Car-pos T 39 12 — — $527,123.40 $705,573.36 $599,737.36 2026-09-01
A0104 HCPCS Stroke; M > 38.85 & M < 44.45 3 1 — — $28,451.46 $29,204.63 $29,125.23 2026-09-01
A0105 HCPCS Stroke; M > 34.25 & M < 38.85 3 1 — — $35,578.15 $36,396.74 $36,297.77 2026-09-01
A0106 HCPCS Stroke; M > 30.05 & M < 34.25 3 1 — — $40,465.08 $40,998.01 $40,886.54 2026-09-01
A0204 HCPCS Traumatic Brain Injury; M > 40.65 & M < 44.25 3 1 — — $26,744.45 $27,491.96 $27,417.21 2026-09-01
A0205 HCPCS Traumatic Brain Injury; M > 28.75 & M < 40.65 3 1 — — $34,256.42 $35,270.13 $35,174.23 2026-09-01
A0304 HCPCS Nontraumatic Brain Injury; M < 26.15 3 1 — — $27,609.02 $28,383.38 $28,306.21 2026-09-01
A0403 HCPCS Traumatic Spinal Cord Injury; M > 16.05 & M < 30.3 3 1 — — $26,704.12 $28,224.72 $26,776.92 2026-09-01
A0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 3 1 — — $43,271.71 $44,068.98 $43,389.69 2026-09-01
A0405 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 3 1 — — $34,275.77 $35,045.40 $34,369.22 2026-09-01
A0504 HCPCS Nontraumatic Spinal Cord Injury; M > 29.25 & M < 3 3 1 — — $27,102.07 $27,476.79 $27,402.08 2026-09-01
A0505 HCPCS Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 3 1 — — $37,659.38 $39,040.67 $38,934.52 2026-09-01
A0604 HCPCS Neurological; M < 25.85 3 1 — — $28,938.13 $29,769.84 $29,688.89 2026-09-01
A0704 HCPCS Fracture Of Lower Extremity; M < 28.15 3 1 — — $29,045.05 $30,190.89 $30,108.81 2026-09-01
A0805 HCPCS Replacement Of Lower Extremity Joint; M > 22.05 & 3 1 — — $25,927.81 $27,973.71 $27,897.65 2026-09-01
A0904 HCPCS Other Orthopedic; M < 24.15 3 1 — — $26,965.66 $27,833.36 $27,757.68 2026-09-01
A1004 HCPCS Amputation, Lower Extremity; M=39-45 3 1 — — $28,711.39 $31,389.58 $31,304.23 2026-09-01
A1103 HCPCS Amputation, Non-lower Extremity; M=12-37 3 1 — — $26,081.81 $29,118.78 $26,152.92 2026-09-01
A1203 HCPCS Osteoarthritis; M < 30.75 3 1 — — $25,015.31 $25,976.53 $25,905.91 2026-09-01
A1204 HCPCS Osteoarthritis; M=39-47 3 1 — — $26,233.82 $26,742.78 $26,670.07 2026-09-01
A1304 HCPCS Rheumatoid, Other Arthritis; M=12-35 3 1 — — $28,837.72 $28,986.06 $28,916.34 2026-09-01
A1404 HCPCS Cardiac; M < 31.15 3 1 — — $26,659.65 $27,890.26 $27,814.42 2026-09-01
A1503 HCPCS Pulmonary; M > 29.15 & M < 39.05 3 1 — — $24,174.71 $25,502.37 $25,433.03 2026-09-01
A1504 HCPCS Pulmonary; M < 29.15 3 1 — — $29,937.26 $31,981.33 $31,894.38 2026-09-01
A1703 HCPCS Maj Mult Trauma No Brain Or Spinal Cord Injury; M 3 1 — — $23,767.31 $24,502.84 $24,436.21 2026-09-01
A1704 HCPCS Major Multiple Trauma,no Brain Or Spinal Cord Inju 3 1 — — $26,899.30 $28,195.62 $28,118.95 2026-09-01
A1804 HCPCS Major Multiple Trauma With Brain Or Spinal Code In 3 1 — — $25,870.66 $27,685.42 $27,610.14 2026-09-01
A1903 HCPCS Guillian Barre; M < 18.05 3 1 — — $32,079.74 $32,636.04 $32,167.20 2026-09-01
A2004 HCPCS Miscellaneous; M < 27.85 3 1 — — $26,383.14 $27,362.99 $27,288.59 2026-09-01
A2005 HCPCS Miscellaneous; M=12-32 And A Tm81 3 1 — — $27,809.95 $28,641.33 $28,563.45 2026-09-01
A2102 HCPCS Burns; M=12-45 3 1 — — $27,725.15 $29,348.78 $29,268.98 2026-09-01
A5104 HCPCS Expired, Not Orthopedic, Length Of Stay Is 16 Days 3 1 — — $41,387.79 $43,936.25 $41,500.62 2026-09-01
B0103 HCPCS Stroke; M > 44.45 & M < 51.05 & C < 18.5 3 1 — — $29,516.96 $29,963.30 $29,881.83 2026-09-01
B0104 HCPCS Stroke; M > 38.85 & M < 44.45 3 1 — — $37,670.44 $38,268.73 $38,164.68 2026-09-01
B0105 HCPCS Stroke; M > 34.25 & M < 38.85 3 1 — — $47,105.11 $47,693.19 $47,563.51 2026-09-01
B0106 HCPCS Stroke; M > 30.05 & M < 34.25 3 1 — — $53,576.57 $53,722.64 $53,577.38 2026-09-01
B0202 HCPCS Traumatic Brain Injury; M > 44.25 & M < 53.35 & C 3 1 — — $24,583.95 $26,289.48 $26,218.00 2026-09-01
B0203 HCPCS Traumatic Brain Injury; M > 44.25 & C < 23.5 3 1 — — $30,615.65 $32,684.99 $32,596.12 2026-09-01
B0204 HCPCS Traumatic Brain Injury; M > 40.65 & M < 44.25 3 1 — — $37,970.92 $40,282.97 $40,173.45 2026-09-01
B0205 HCPCS Traumatic Brain Injury; M > 28.75 & M < 40.65 3 1 — — $48,638.84 $51,679.95 $51,539.43 2026-09-01
B0302 HCPCS Nontraumatic Brain Injury; M > 35.05 & M < 41.05 3 1 — — $28,569.44 $29,293.78 $29,214.13 2026-09-01
B0303 HCPCS Nontraumatic Brain Injury; M > 26.15 & M < 35.05 3 1 — — $34,376.24 $34,636.64 $34,542.47 2026-09-01
B0304 HCPCS Nontraumatic Brain Injury; M < 26.15 3 1 — — $39,856.75 $41,034.05 $40,922.48 2026-09-01
B0401 HCPCS Traumatic Spinal Cord Injury; M > 48.45 3 1 — — $22,231.74 $25,695.83 $25,625.96 2026-09-01
B0402 HCPCS Traumatic Spinal Cord Injury; M > 30.35 & M < 48.4 3 1 — — $28,672.67 $32,214.62 $32,127.03 2026-09-01
B0403 HCPCS Traumatic Spinal Cord Injury; M > 16.05 & M < 30.3 3 1 — — $35,981.86 $37,181.95 $37,080.85 2026-09-01
B0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 3 1 — — $56,180.30 $60,247.12 $60,083.31 2026-09-01
B0405 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 3 1 — — $44,677.31 $47,721.64 $47,591.89 2026-09-01
B0501 HCPCS Nontraumatic Spinal Cord Injury; M > 51.35 3 1 — — $23,409.69 $24,827.16 $24,759.66 2026-09-01
B0502 HCPCS Nontraumatic Spinal Cord Injury; M > 40.15 & M < 5 3 1 — — $29,367.65 $30,822.48 $30,738.67 2026-09-01
B0503 HCPCS Nontraumatic Spinal Cord Injury; M > 31.25 & M < 4 3 1 — — $33,662.83 $34,902.18 $34,807.28 2026-09-01
B0504 HCPCS Nontraumatic Spinal Cord Injury; M > 29.25 & M < 3 3 1 — — $40,015.28 $41,705.46 $41,592.07 2026-09-01
B0505 HCPCS Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 3 1 — — $55,603.31 $59,255.18 $59,094.06 2026-09-01
B0601 HCPCS Neurological; M > 47.75 3 1 — — $24,493.62 $24,836.65 $24,769.12 2026-09-01
B0602 HCPCS Neurological; M > 37.35 & M < 47.75 3 1 — — $30,810.55 $31,067.29 $30,894.55 2026-09-01
B0603 HCPCS Neurological; M > 25.85 & M < 37.35 3 1 — — $36,606.79 $36,738.13 $36,638.24 2026-09-01
B0604 HCPCS Neurological; M < 25.85 3 1 — — $45,908.72 $46,464.16 $46,337.83 2026-09-01
B0702 HCPCS Fracture Of Lower Extremity; M > 34.15 & M < 42.15 3 1 — — $28,558.38 $28,762.72 $28,684.51 2026-09-01
B0703 HCPCS Fracture Of Lower Extremity; M > 28.15 & M < 34.15 3 1 — — $35,119.14 $35,235.99 $35,140.18 2026-09-01
B0704 HCPCS Fracture Of Lower Extremity; M < 28.15 3 1 — — $42,902.09 $43,509.18 $43,390.88 2026-09-01
B0802 HCPCS Replacement Of Lower Extremity Joint; M > 37.05 & 3 1 — — $25,398.98 $25,468.23 $25,407.96 2026-09-01
B0803 HCPCS Replacement Of Lower Ext Joint; M > 28.65 & M < 37 3 1 — — $27,952.50 $28,280.02 $28,028.71 2026-09-01
B0804 HCPCS Replacement Of Lower Ext Joint; M > 28.65 & M < 37 3 1 — — $31,682.99 $31,840.98 $31,754.41 2026-09-01
B0805 HCPCS Replacement Of Lower Extremity Joint; M > 22.05 & 3 1 — — $37,998.57 $39,658.98 $39,551.14 2026-09-01
B0902 HCPCS Other Orthopedic; M > 34.35 & M < 44.75 3 1 — — $27,590.58 $29,840.01 $29,758.88 2026-09-01
B0903 HCPCS Other Orthopedic; M > 24.15 & M < 34.35 3 1 — — $32,947.58 $35,410.48 $35,314.20 2026-09-01
B0904 HCPCS Other Orthopedic; M < 24.15 3 1 — — $39,478.85 $42,640.51 $42,524.57 2026-09-01
B1002 HCPCS Amputation, Lower Extremity; M > 36.25 & M < 47.65 3 1 — — $28,238.12 $28,315.11 $28,280.02 2026-09-01
B1003 HCPCS Amputation, Lower Extremity; M < 36.25 3 1 — — $33,133.77 $33,699.70 $33,608.07 2026-09-01
B1004 HCPCS Amputation, Lower Extremity; M=39-45 3 1 — — $42,419.11 $44,825.45 $44,703.57 2026-09-01
B1101 HCPCS Amputation, Non-lower Extremity; M > 36.35 3 1 — — $23,319.36 $25,650.31 $25,580.57 2026-09-01
B1102 HCPCS Amputation, Non-lower Extremity; M < 36.35 3 1 — — $29,212.24 $29,647.85 $29,291.88 2026-09-01
B1103 HCPCS Amputation, Non-lower Extremity; M=12-37 3 1 — — $36,589.06 $36,971.78 $36,688.82 2026-09-01
B1201 HCPCS Osteoarthritis; M > 37.65 3 1 — — $24,475.19 $25,124.94 $25,056.62 2026-09-01
B1202 HCPCS Osteoarthritis; M > 30.75 & M < 37.65 3 1 — — $29,461.91 $29,631.26 $29,542.24 2026-09-01
B1203 HCPCS Osteoarthritis; M < 30.75 3 1 — — $38,387.54 $39,545.18 $39,437.65 2026-09-01
B1204 HCPCS Osteoarthritis; M=39-47 3 1 — — $40,254.93 $40,711.62 $40,600.92 2026-09-01
B1302 HCPCS Rheumatoid, Other Arthritis; M > 26.15 & M < 36.35 3 1 — — $27,478.13 $29,132.56 $29,053.35 2026-09-01
B1303 HCPCS Rheumatoid, Other Arthritis; M < 26.15 3 1 — — $31,260.85 $33,669.35 $33,577.81 2026-09-01
B1304 HCPCS Rheumatoid, Other Arthritis; M=12-35 3 1 — — $39,478.85 $43,456.07 $43,337.92 2026-09-01
B1402 HCPCS Cardiac; M > 38.55 & M < 48.85 3 1 — — $26,383.14 $27,000.73 $26,927.31 2026-09-01
B1403 HCPCS Cardiac; M > 31.15 & M < 38.55 3 1 — — $32,282.10 $32,635.68 $32,546.94 2026-09-01
B1404 HCPCS Cardiac; M < 31.15 3 1 — — $39,556.27 $40,717.31 $40,606.60 2026-09-01
B1501 HCPCS Pulmonary; M > 49.25 3 1 — — $23,483.42 $24,851.82 $24,784.25 2026-09-01
B1502 HCPCS Pulmonary; M > 39.05 & M < 49.25 3 1 — — $29,789.79 $30,388.15 $30,305.52 2026-09-01
B1503 HCPCS Pulmonary; M > 29.15 & M < 39.05 3 1 — — $33,856.39 $35,429.44 $35,333.11 2026-09-01
B1504 HCPCS Pulmonary; M < 29.15 3 1 — — $41,926.92 $44,429.05 $44,308.25 2026-09-01
B1603 HCPCS Pain Syndrome: M < 26.75 3 1 — — $28,972.02 $34,927.42 $29,051.01 2026-09-01
B1701 HCPCS Major Multiple Trauma No Brain Or Spinal Cord Inju 3 1 — — $24,648.47 $25,018.73 $24,950.70 2026-09-01
B1702 HCPCS Maj Mult Trauma No Brain Or Spinal Cord Injury; M 3 1 — — $30,623.02 $30,839.55 $30,755.70 2026-09-01
B1703 HCPCS Maj Mult Trauma No Brain Or Spinal Cord Injury; M 3 1 — — $36,085.93 $36,389.26 $36,184.31 2026-09-01
B1704 HCPCS Major Multiple Trauma,no Brain Or Spinal Cord Inju 3 1 — — $41,187.70 $41,637.18 $41,523.97 2026-09-01
B1802 HCPCS Maj Mult Trauma W Brain Or Spinal Cord Injury; M > 3 1 — — $26,222.76 $26,976.07 $26,902.72 2026-09-01
B1803 HCPCS Major Multiple Trauma With Brain Or Spinal Cord In 3 1 — — $33,468.10 $33,690.48 $33,559.35 2026-09-01
B1804 HCPCS Major Multiple Trauma With Brain Or Spinal Code In 3 1 — — $36,842.74 $39,194.30 $39,087.73 2026-09-01
B1901 HCPCS Guillian Barre; M > 35.95 3 1 — — $19,175.33 $25,428.40 $25,359.26 2026-09-01
B1902 HCPCS Guillian Barre; M > 18.05 & M < 35.95 3 1 — — $30,683.85 $36,994.18 $36,893.60 2026-09-01
B1903 HCPCS Guillian Barre; M < 18.05 3 1 — — $46,295.84 $52,341.88 $52,199.57 2026-09-01
B2002 HCPCS Miscellaneous; M > 38.75 & M < 49.15 3 1 — — $27,131.57 $27,985.09 $27,909.00 2026-09-01
B2003 HCPCS Miscellaneous; M > 27.85 & M < 38.75 3 1 — — $32,490.41 $32,861.38 $32,772.03 2026-09-01
B2004 HCPCS Miscellaneous; M < 27.85 3 1 — — $38,846.55 $40,078.14 $39,969.16 2026-09-01
B2005 HCPCS Miscellaneous; M=12-32 And A Tm81 3 1 — — $40,946.21 $41,950.13 $41,836.07 2026-09-01
B2101 HCPCS Burns; M > 0 3 1 — — $27,741.74 $30,462.11 $30,379.29 2026-09-01
B2102 HCPCS Burns; M=12-45 3 1 — — $42,723.28 $48,271.67 $48,140.42 2026-09-01
C0103 HCPCS Stroke; M > 44.45 & M < 51.05 & C < 18.5 3 1 — — $25,599.68 $26,608.12 $26,535.77 2026-09-01
C0104 HCPCS Stroke; M > 38.85 & M < 44.45 3 1 — — $32,669.22 $33,984.20 $33,891.79 2026-09-01
C0105 HCPCS Stroke; M > 34.25 & M < 38.85 3 1 — — $40,852.20 $42,352.22 $42,237.07 2026-09-01
C0106 HCPCS Stroke; M > 30.05 & M < 34.25 3 1 — — $46,465.44 $47,706.47 $47,576.75 2026-09-01
C0203 HCPCS Traumatic Brain Injury; M > 44.25 & C < 23.5 3 1 — — $25,216.25 $25,987.91 $25,917.25 2026-09-01
C0204 HCPCS Traumatic Brain Injury; M > 40.65 & M < 44.25 3 1 — — $31,275.59 $32,028.75 $31,941.66 2026-09-01
C0205 HCPCS Traumatic Brain Injury; M > 28.75 & M < 40.65 3 1 — — $40,059.53 $41,090.95 $40,979.22 2026-09-01
C0303 HCPCS Nontraumatic Brain Injury; M > 26.15 & M < 35.05 3 1 — — $27,377.49 $27,502.10 $27,452.13 2026-09-01
C0304 HCPCS Nontraumatic Brain Injury; M < 26.15 3 1 — — $31,887.61 $32,521.88 $32,433.45 2026-09-01
C0402 HCPCS Traumatic Spinal Cord Injury; M > 30.35 & M < 48.4 3 1 — — $25,498.29 $26,331.21 $26,259.61 2026-09-01
C0403 HCPCS Traumatic Spinal Cord Injury; M > 16.05 & M < 30.3 3 1 — — $30,309.30 $31,998.22 $30,391.94 2026-09-01
C0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 3 1 — — $49,110.76 $49,960.58 $49,244.65 2026-09-01
C0405 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 3 1 — — $38,900.47 $39,731.40 $39,006.53 2026-09-01
C0503 HCPCS Nontraumatic Spinal Cord Injury; M > 31.25 & M < 4 3 1 — — $26,187.73 $26,822.44 $26,749.51 2026-09-01
C0504 HCPCS Nontraumatic Spinal Cord Injury; M > 29.25 & M < 3 3 1 — — $31,129.96 $32,049.61 $31,962.47 2026-09-01
C0505 HCPCS Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 3 1 — — $43,257.87 $45,536.70 $45,412.89 2026-09-01
C0603 HCPCS Neurological; M > 25.85 & M < 37.35 3 1 — — $27,406.24 $27,823.87 $27,748.22 2026-09-01
C0604 HCPCS Neurological; M < 25.85 3 1 — — $34,370.71 $35,188.57 $35,092.89 2026-09-01
C0703 HCPCS Fracture Of Lower Extremity; M > 28.15 & M < 34.15 3 1 — — $27,166.59 $28,172.86 $28,096.26 2026-09-01
C0704 HCPCS Fracture Of Lower Extremity; M < 28.15 3 1 — — $33,187.23 $34,788.38 $34,693.79 2026-09-01
C0804 HCPCS Replacement Of Lower Ext Joint; M > 28.65 & M < 37 3 1 — — $25,422.71 $26,818.65 $26,745.73 2026-09-01
C0805 HCPCS Replacement Of Lower Extremity Joint; M > 22.05 & 3 1 — — $30,490.29 $33,401.92 $33,311.10 2026-09-01
C0903 HCPCS Other Orthopedic; M > 24.15 & M < 34.35 3 1 — — $26,388.67 $26,820.54 $26,747.62 2026-09-01
C0904 HCPCS Other Orthopedic; M < 24.15 3 1 — — $31,620.31 $32,298.07 $32,210.26 2026-09-01
C1003 HCPCS Amputation, Lower Extremity; M < 36.25 3 1 — — $27,402.55 $28,002.16 $27,926.02 2026-09-01
C1004 HCPCS Amputation, Lower Extremity; M=39-45 3 1 — — $35,082.27 $37,246.44 $37,145.16 2026-09-01
C1102 HCPCS Amputation, Non-lower Extremity; M < 36.35 3 1 — — $23,831.83 $27,730.94 $27,655.54 2026-09-01
C1103 HCPCS Amputation, Non-lower Extremity; M=12-37 3 1 — — $29,719.74 $34,733.37 $34,638.93 2026-09-01
C1203 HCPCS Osteoarthritis; M < 30.75 3 1 — — $29,183.30 $31,385.78 $31,300.45 2026-09-01
C1204 HCPCS Osteoarthritis; M=39-47 3 1 — — $30,604.59 $32,313.25 $32,225.39 2026-09-01
C1303 HCPCS Rheumatoid, Other Arthritis; M < 26.15 3 1 — — $25,848.54 $26,917.27 $26,844.09 2026-09-01
C1304 HCPCS Rheumatoid, Other Arthritis; M=12-35 3 1 — — $32,641.57 $34,742.86 $34,648.39 2026-09-01
C1403 HCPCS Cardiac; M > 31.15 & M < 38.55 3 1 — — $25,431.93 $26,289.48 $26,218.00 2026-09-01
C1404 HCPCS Cardiac; M < 31.15 3 1 — — $31,161.30 $32,800.69 $32,711.50 2026-09-01
C1503 HCPCS Pulmonary; M > 29.15 & M < 39.05 3 1 — — $27,478.13 $28,487.70 $28,410.24 2026-09-01
C1504 HCPCS Pulmonary; M < 29.15 3 1 — — $34,029.67 $35,723.42 $35,626.29 2026-09-01
C1603 HCPCS Pain Syndrome: M < 26.75 3 1 — — $25,942.56 $26,035.33 $25,964.54 2026-09-01
C1703 HCPCS Maj Mult Trauma No Brain Or Spinal Cord Injury; M 3 1 — — $28,285.55 $28,665.99 $28,588.04 2026-09-01
C1704 HCPCS Major Multiple Trauma,no Brain Or Spinal Cord Inju 3 1 — — $32,014.81 $32,986.56 $32,896.87 2026-09-01
C1721 HCPCS Icd Defb Dlchmbr MRI Is1 44 10 $54,781.00 $54,781.00 $13,695.25 $48,515.30 $35,359.96 2026-03-01
C1722 HCPCS Icd Xt MRI Df4 44 10 $51,998.00 $51,998.00 $12,568.75 $42,638.36 $31,076.60 2026-03-01
C1803 HCPCS Major Multiple Trauma With Brain Or Spinal Cord In 3 1 — — $26,877.17 $27,454.03 $27,379.38 2026-09-01
C1804 HCPCS Major Multiple Trauma With Brain Or Spinal Code In 3 1 — — $29,391.61 $32,064.78 $31,977.60 2026-09-01
C1882 HCPCS Defib Cardiac Crtd 132 10 $50,436.00 $50,436.00 $8,692.00 $50,395.56 $30,351.30 2026-03-01
C1902 HCPCS Guillian Barre; M > 18.05 & M < 35.95 3 1 — — $23,590.34 $26,145.34 $26,074.25 2026-09-01
C1903 HCPCS Guillian Barre; M < 18.05 3 1 — — $35,591.06 $36,992.28 $36,891.70 2026-09-01
C2003 HCPCS Miscellaneous; M > 27.85 & M < 38.75 3 1 — — $25,951.77 $26,353.97 $26,282.31 2026-09-01
C2004 HCPCS Miscellaneous; M < 27.85 3 1 — — $31,028.57 $32,140.65 $32,053.26 2026-09-01
C2005 HCPCS Miscellaneous; M=12-32 And A Tm81 3 1 — — $32,706.09 $33,642.80 $33,551.32 2026-09-01
C2101 HCPCS Burns; M > 0 3 1 — — $21,079.59 $25,610.48 $25,540.85 2026-09-01
C2102 HCPCS Burns; M=12-45 3 1 — — $32,464.60 $40,582.65 $40,472.30 2026-09-01
C9293 HCPCS Glucarpidase 1000 U Inj 22 10 $307,704.18 $307,704.18 $76,926.04 $252,317.43 $186,791.83 2026-09-01
D0104 HCPCS Stroke; M > 38.85 & M < 44.45 3 1 — — $29,854.31 $30,790.24 $30,706.52 2026-09-01
D0105 HCPCS Stroke; M > 34.25 & M < 38.85 3 1 — — $37,331.25 $38,371.15 $38,266.82 2026-09-01
D0106 HCPCS Stroke; M > 30.05 & M < 34.25 3 1 — — $42,461.51 $43,222.78 $43,105.26 2026-09-01
D0204 HCPCS Traumatic Brain Injury; M > 40.65 & M < 44.25 3 1 — — $28,405.38 $29,261.53 $29,181.97 2026-09-01
D0205 HCPCS Traumatic Brain Injury; M > 28.75 & M < 40.65 3 1 — — $36,385.57 $37,540.42 $37,438.35 2026-09-01
D0303 HCPCS Nontraumatic Brain Injury; M > 26.15 & M < 35.05 3 1 — — $25,264.18 $25,593.41 $25,523.82 2026-09-01
D0304 HCPCS Nontraumatic Brain Injury; M < 26.15 3 1 — — $29,292.06 $30,317.97 $30,235.54 2026-09-01
D0402 HCPCS Traumatic Spinal Cord Injury; M > 30.35 & M < 48.4 3 1 — — $24,751.70 $25,638.93 $25,569.22 2026-09-01
D0403 HCPCS Traumatic Spinal Cord Injury; M > 16.05 & M < 30.3 3 1 — — $29,511.09 $31,061.76 $29,591.55 2026-09-01
D0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 3 1 — — $47,818.87 $48,498.74 $47,949.24 2026-09-01
D0405 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 3 1 — — $37,877.17 $38,568.19 $37,980.44 2026-09-01
D0503 HCPCS Nontraumatic Spinal Cord Injury; M > 31.25 & M < 4 3 1 — — $24,740.64 $24,952.34 $24,884.50 2026-09-01
D0504 HCPCS Nontraumatic Spinal Cord Injury; M > 29.25 & M < 3 3 1 — — $29,410.04 $29,815.36 $29,734.29 2026-09-01
D0505 HCPCS Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 3 1 — — $40,866.95 $42,363.60 $42,248.42 2026-09-01
D0603 HCPCS Neurological; M > 25.85 & M < 37.35 3 1 — — $25,584.93 $26,206.03 $26,134.78 2026-09-01
D0604 HCPCS Neurological; M < 25.85 3 1 — — $32,086.70 $33,143.98 $33,053.86 2026-09-01
D0703 HCPCS Fracture Of Lower Extremity; M > 28.15 & M < 34.15 3 1 — — $25,734.25 $26,757.95 $26,685.20 2026-09-01
D0704 HCPCS Fracture Of Lower Extremity; M < 28.15 3 1 — — $31,437.81 $33,039.66 $32,949.83 2026-09-01
D0805 HCPCS Replacement Of Lower Extremity Joint; M > 22.05 & 3 1 — — $27,798.89 $29,857.08 $29,775.90 2026-09-01
D0903 HCPCS Other Orthopedic; M > 24.15 & M < 34.35 3 1 — — $24,596.85 $25,335.47 $25,266.58 2026-09-01
D0904 HCPCS Other Orthopedic; M < 24.15 3 1 — — $29,472.72 $30,509.53 $30,426.58 2026-09-01
D1003 HCPCS Amputation, Lower Extremity; M < 36.25 3 1 — — $25,031.90 $25,415.13 $25,346.02 2026-09-01
D1004 HCPCS Amputation, Lower Extremity; M=39-45 3 1 — — $32,046.15 $33,805.91 $33,713.99 2026-09-01
D1103 HCPCS Amputation, Non-lower Extremity; M=12-37 3 1 — — $29,719.74 $29,891.22 $29,809.95 2026-09-01
D1203 HCPCS Osteoarthritis; M < 30.75 3 1 — — $27,363.84 $28,047.68 $27,971.42 2026-09-01
D1204 HCPCS Osteoarthritis; M=39-47 3 1 — — $28,694.79 $28,876.51 $28,798.00 2026-09-01
D1303 HCPCS Rheumatoid, Other Arthritis; M < 26.15 3 1 — — $24,596.99 $24,672.44 $24,664.05 2026-09-01
D1304 HCPCS Rheumatoid, Other Arthritis; M=12-35 3 1 — — $31,157.61 $31,833.39 $31,746.84 2026-09-01
D1404 HCPCS Cardiac; M < 31.15 3 1 — — $28,973.15 $30,329.35 $30,246.88 2026-09-01
D1503 HCPCS Pulmonary; M > 29.15 & M < 39.05 3 1 — — $25,843.01 $26,678.30 $26,605.76 2026-09-01
D1504 HCPCS Pulmonary; M < 29.15 3 1 — — $32,003.75 $33,455.03 $33,364.07 2026-09-01
D1703 HCPCS Maj Mult Trauma No Brain Or Spinal Cord Injury; M 3 1 — — $26,196.95 $26,615.71 $26,543.34 2026-09-01
D1704 HCPCS Major Multiple Trauma,no Brain Or Spinal Cord Inju 3 1 — — $29,649.69 $30,627.12 $30,543.85 2026-09-01
D1803 HCPCS Major Multiple Trauma With Brain Or Spinal Cord In 3 1 — — $25,187.14 $25,516.73 $25,255.81 2026-09-01
D1804 HCPCS Major Multiple Trauma With Brain Or Spinal Code In 3 1 — — $27,902.12 $29,496.72 $29,416.52 2026-09-01
D1903 HCPCS Guillian Barre; M < 18.05 3 1 — — $32,072.18 $33,211.19 $32,159.62 2026-09-01
D2003 HCPCS Miscellaneous; M > 27.85 & M < 38.75 3 1 — — $24,242.92 $24,508.53 $24,441.89 2026-09-01
D2004 HCPCS Miscellaneous; M < 27.85 3 1 — — $28,986.06 $29,891.22 $29,809.95 2026-09-01
D2005 HCPCS Miscellaneous; M=12-32 And A Tm81 3 1 — — $30,552.97 $31,287.16 $31,202.09 2026-09-01
D2102 HCPCS Burns; M=12-45 3 1 — — $30,521.15 $32,464.60 $30,604.36 2026-09-01
J1299 HCPCS Eculizumab 300 Mg Inj 21 10 $48,029.48 $48,029.48 $19,538.39 $39,384.17 $29,297.98 2026-09-01
J1303 HCPCS Ravuliz-cwvz 1100mg Inj 63 10 $59,246.46 $59,246.46 $578.70 $164,846.66 $34,748.05 2026-09-01
J1412 HCPCS Injection, Valoctocogene Roxaparvovec-rvox, Per Ml, Containing Nominal 2 X 10°13… 12 1 — — $28,750.78 $28,750.78 $28,750.78 2026-09-01
J1930 HCPCS Lanreotide 120 Mg Inj 63 10 $62,502.98 $62,502.98 $124.20 $60,439.35 $36,658.00 2026-09-01
J1932 HCPCS 505cp Lanreot 120 Mg Inj 29 10 $58,861.81 $58,861.81 $110.78 $48,266.68 $34,522.45 2026-09-01
J2323 HCPCS Natalizumab 300 Mg Inj 29 10 $48,744.97 $48,744.97 $59.77 $39,970.88 $28,588.92 2026-09-01
J2327 HCPCS Risankizum-rzaa 1mg Inj 29 10 $78,308.83 $78,308.83 $39.21 $64,213.24 $45,928.13 2026-09-01
J2350 HCPCS Ocrelizumab 300 Mg Inj 29 10 $150,336.52 $150,336.52 $157.62 $123,275.95 $88,172.37 2026-09-01
J3101 HCPCS Tenecteplase 1 Mg Inj 63 10 $57,533.64 $57,533.64 $468.10 $51,437.75 $33,743.48 2026-09-01
J3357 HCPCS Ustekinumab 1 Mg Inj 66 10 $101,787.63 $101,787.63 $378.69 $175,111.30 $55,677.83 2026-09-01
J3380 HCPCS Vedolizumab 300 Mg IV 29 10 $59,846.88 $59,846.88 $56.80 $49,074.44 $35,100.20 2026-09-01
J9022 HCPCS Atezolizumab 10 Mg Inj 63 10 $61,362.10 $61,362.10 $224.39 $68,380.19 $35,988.87 2026-09-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 12 1 — — $166,116.65 $166,116.65 $166,116.65 2026-09-01
J9119 HCPCS Cemiplimab-rwlc 350mginj 29 10 $84,188.44 $84,188.44 $72.46 $69,034.52 $49,376.52 2026-09-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 12 1 — — $110,645.59 $110,645.59 $110,645.59 2026-09-01
J9228 HCPCS Ipilimumab 1 Mg Inj 63 10 $69,399.15 $69,399.15 $427.29 $227,628.52 $40,702.60 2026-09-01
J9266 HCPCS Pegasparga Single Vl Inj 29 10 $125,252.60 $125,252.60 $67,636.40 $102,707.13 $77,781.86 2026-09-01
J9307 HCPCS Pralatrexate 20 Mg Inj 63 10 $54,403.52 $54,403.52 $723.00 $89,221.75 $31,907.66 2026-09-01
J9999 HCPCS Carmustine 8 Wafers/box 18 10 $305,385.18 $305,385.18 $76,346.29 $250,415.85 $187,964.58 2026-09-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 39 12 — — $91,031.90 $114,097.20 $97,933.43 2026-09-01
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 39 12 — — $37,701.50 $47,254.08 $40,559.75 2026-09-01
L5856 HCPCS Addition To Lower Extremity Prosthesis, Endoskeletal Knee-shin System, Microproc… 39 12 — — $28,454.30 $35,664.00 $30,611.60 2026-09-01
L6700 HCPCS Upper Extremity Addition, External Powered Feature, Myoelectronic Control Module… 28 12 — — $29,510.20 $35,412.24 $30,543.06 2026-09-01
L6880 HCPCS Electric Hand, Switch Or Myoelectric Controlled, Independently Articulating Digi… 39 12 — — $28,320.00 $35,495.64 $30,467.09 2026-09-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 39 12 — — $38,289.50 $47,991.12 $41,192.38 2026-09-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 39 12 — — $47,493.00 $59,526.48 $51,093.56 2026-09-01
L8701 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand With S… 39 12 — — $33,480.90 $41,964.12 $36,019.20 2026-09-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 39 12 — — $65,871.70 $82,562.04 $70,865.75 2026-09-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 39 12 — — $99,999.90 $133,803.60 $113,733.06 2026-09-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 12 1 — — $1,279,600.63 $1,279,600.63 $1,279,600.63 2026-09-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 12 1 — — $1,369,371.65 $1,369,371.65 $1,369,371.65 2026-09-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 12 1 — — $145,223.54 $145,223.54 $145,223.54 2026-09-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 12 1 — — $1,175,752.00 $1,175,752.00 $1,175,752.00 2026-09-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 12 1 — — $1,328,128.35 $1,328,128.35 $1,328,128.35 2026-09-01
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