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Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

RIVERSIDE METHODIST HOSPITAL

Columbus, OH · CCN 360006 · Rates published

13,396 distinct procedures filed
23 distinct payers
317,958 rate rows
2026-04-01 last MRF observed
Data quality

178,750 of 317,958 rate rows are consumer-grade (56.2%)

139,208 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 137,226
template filing: same amount across many unrelated codes — excluded 1,152
placeholder amount (≤ $0.02) — excluded from medians 830
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.ohiohealth.com/siteassets/patients-and-visitors/preparing-for-your-visit/out-of-pocket-estimates/314394942_riverside-methodist-hospital_standardcharges.json
Found on page https://www.ohiohealth.com/billing-insurance/pre-visit-financial-checklist/healthcare-estimates-and-pricing
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint b62d197b75d8d518… · 28,787,507 bytes · first seen 2026-05-09

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
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 3 $3,685,266.67 $3,832,677.33 $3,685,266.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 3 $3,316,462.59 $3,449,121.09 $3,316,462.59 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 3 $3,248,445.72 $3,378,383.54 $3,248,445.72 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 3 $2,945,740.00 $3,063,569.60 $2,945,740.00 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 3 $2,455,110.60 $2,553,315.03 $2,455,110.60 nat. median
$2,469,189
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 3 $2,332,000.00 $2,425,280.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 1 $1,310,054.00 $1,310,054.00 $1,310,054.00 nat. median
$824,563
1.6× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 4 $591,726.20 $1,532,840.61 $961,560.52 nat. median
$754,974
1.3× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 4 $565,868.94 $1,494,072.70 $937,241.17 nat. median
$675,122
1.4× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 4 $557,317.93 $1,431,726.69 $898,131.13 nat. median
$625,184
1.4× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 4 $562,538.19 $1,399,676.98 $878,026.14 nat. median
$674,188
1.3× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $533,230.17 $1,326,591.48 $832,179.16 nat. median
$634,511
1.3× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 4 $489,304.61 $1,322,619.59 $829,687.57 nat. median
$620,080
1.3× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 15 $269,986.18 $882,569.52 $336,560.13 nat. median
$370,174
0.9× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 16 $193,145.43 $1,449,668.48 $253,922.96 nat. median
$265,286
1.0× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 2 $141,956.10 $394,322.50 $197,282.58 nat. median
$76,377
outlier · 2.6×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 15 $147,151.23 $555,208.41 $167,014.58 nat. median
$206,368
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 17 $73,346.68 $673,554.60 $166,041.53 nat. median
$202,986
0.8× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 5 $56,824.55 $421,582.72 $151,769.78 nat. median
$62,507
outlier · 2.4×
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 5 $63,342.28 $412,113.26 $148,360.77 nat. median
$69,774
outlier · 2.1×
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 5 $55,272.32 $360,987.25 $129,955.41 nat. median
$66,682
1.9× median
A9699
HCPCS 		Radiopharm Rx Agent Noc 1 $122,549.05 $122,549.05 $122,549.05 nat. median
$21,806
outlier · 5.6×
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 5 $106,753.90 $143,145.89 $117,393.20 nat. median
$62,270
1.9× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 1 $110,901.76 $110,901.76 $110,901.76 nat. median
$111,989
1.0× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 16 $46,654.56 $697,789.00 $108,777.98 nat. median
$133,176
0.8× median
J9226
HCPCS 		Supprelin La Implant 5 $45,020.65 $294,201.70 $105,912.61 nat. median
$60,368
1.8× median
7
MS_DRG 		Lung Transplant 15 $89,254.95 $305,841.13 $101,779.43 nat. median
$122,708
0.8× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 15 $9,286.94 $306,613.46 $94,539.36 nat. median
$117,303
0.8× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 15 $78,100.67 $257,905.06 $89,211.24 nat. median
$108,660
0.8× median
209
MS_DRG 		Complex Aortic Arch Procedures 14 $78,011.07 $104,380.34 $89,110.28 nat. median
$98,017
0.9× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 17 $7,716.41 $343,275.73 $86,799.17 nat. median
$98,905
0.9× median
455
MS_DRG 		Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 3 $85,143.73 $91,107.98 $85,687.19 nat. median
$48,483
1.8× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 15 $7,721.92 $408,002.30 $85,656.82 nat. median
$102,358
0.8× median
215
MS_DRG 		Other Heart Assist System Implant 15 $13,815.00 $934,772.22 $83,191.77 nat. median
$99,019
0.8× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 15 $71,061.70 $249,219.83 $81,280.01 nat. median
$100,136
0.8× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 $32,429.55 $347,710.92 $77,181.99 nat. median
$93,672
0.8× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 15 $6,445.39 $195,189.36 $71,177.47 nat. median
$82,712
0.9× median
460
MS_DRG 		Spinal Fusion Except Cervical Without Mcc 5 $63,844.99 $85,609.49 $70,207.90 nat. median
$39,075
1.8× median
L8702
HCPCS 		Pow Ue Rom Dev Ewhf Uprt Cus 1 $68,801.71 $68,801.71 $68,801.71 nat. median
$70,825
1.0× median
850
MS_DRG 		Acute Leukemia With Other Procedures 16 $24,836.26 $215,581.27 $68,458.65 nat. median
$83,442
0.8× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 16 $23,960.91 $236,096.15 $66,675.62 nat. median
$79,312
0.8× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 16 $500.00 $209,603.40 $66,469.83 nat. median
$81,118
0.8× median
5094
OTHER 		Level 4 Breast/Lymphatic Surgery And Related Procedures 5 $17,919.92 $118,098.63 $65,015.25 nat. median
$16,303
outlier · 4.0×
J9266
HCPCS 		Pegaspargase Injection 5 $28,424.06 $175,958.45 $63,345.04 nat. median
$34,109
1.9× median
37230
HCPCS 		Hc Revasc Endo Tibiopero W Stent 1 $63,079.00 $63,079.00 $63,079.00 nat. median
$16,861
outlier · 3.7×
33737
HCPCS 		Revision Of Heart Chamber 1 $63,079.00 $63,079.00 $63,079.00 nat. median
$3,875
outlier · 16.3×
37231
HCPCS 		Hc Revasc/Endo Tibioper W Stnt&Ather 1 $63,079.00 $63,079.00 $63,079.00 nat. median
$18,086
outlier · 3.5×
0814T
HCPCS 		Prq Njx Biod Osteo Matrl Fem 1 $63,079.00 $63,079.00 $63,079.00 nat. median
$5,395
outlier · 11.7×
33736
HCPCS 		Revision Of Heart Chamber 1 $63,079.00 $63,079.00 $63,079.00 nat. median
$3,595
outlier · 17.5×
33927
HCPCS 		Impltj Tot Rplcmt Hrt Sys 1 $63,079.00 $63,079.00 $63,079.00 nat. median
$4,334
outlier · 14.6×

Other procedures at this hospital

Browse this hospital's 13,396 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
             
33460 HCPCS Revision Of Tricuspid Valve 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33440 HCPCS Rplcmt A-valve Tlcj Autol Pv 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33619 HCPCS Repair Single Ventricle 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33203 HCPCS Insert Epicard Eltrd Endo 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33202 HCPCS Insert Epicard Eltrd Open 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33430 HCPCS Replacement Of Mitral Valve 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33883 HCPCS Hc Plcmnt Prox Ext Prosthesis Rpr Desc Aorta 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33427 HCPCS Repair Of Mitral Valve 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
0235T HCPCS Trluml Perip Athrc Visceral 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33426 HCPCS Repair Of Mitral Valve 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33894 HCPCS Evasc St Rpr Thrc/aa Acrs Br 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
22632 HCPCS Spine Fusion Extra Segment 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33463 HCPCS Valvuloplasty Tricuspid 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33880 HCPCS Hc Endovasc Rep Descend Thorac Aorta Subclav 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33425 HCPCS Repair Of Mitral Valve 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33120 HCPCS Removal Of Heart Lesion 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33420 HCPCS Revision Of Mitral Valve 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33884 HCPCS Hc Plcmnt Prox Ext Prosthesis Rpr Desc Aorta Addl 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33416 HCPCS Revise Ventricle Muscle 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33612 HCPCS Repair Double Ventricle 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
32905 HCPCS Revise & Repair Chest Wall 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33415 HCPCS Revision Subvalvular Tissue 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33615 HCPCS Repair Modified Fontan 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
32906 HCPCS Revise & Repair Chest Wall 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33414 HCPCS Repair Of Aortic Valve 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
0545T HCPCS Hc Transcath Tricuspid Valve Annulus Reconstruct W Device Perct 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
0553T HCPCS Perq Tcat Iliac Anast Implt 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33617 HCPCS Repair Single Ventricle 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
43279 HCPCS Lap Myotomy Heller 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
43283 HCPCS Lap Esoph Lengthening 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
32940 HCPCS Revision Of Lung 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33412 HCPCS Replacement Of Aortic Valve 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33611 HCPCS Repair Double Ventricle 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33417 HCPCS Repair Of Aortic Valve 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
0569T HCPCS Hc Transcath Tricuspid Valve Repair Perct App Initial Prosthesis 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33464 HCPCS Valvuloplasty Tricuspid 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33413 HCPCS Replacement Of Aortic Valve 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33610 HCPCS Repair By Enlargement 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33622 HCPCS Redo Compl Cardiac Anomaly 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33895 HCPCS Evasc St Rpr Thrc/aa X Crsg 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
51721 HCPCS Ins Trurl Ablt Trnsdc Thr US 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33600 HCPCS Closure Of Valve 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
15778 HCPCS Impl Absrb Msh/prsth Dly Cls 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33602 HCPCS Closure Of Valve 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33641 HCPCS Repair Heart Septum Defect 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33406 HCPCS Replacement Aortic Valve Opn 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33871 HCPCS Transvrs A-arch Grf Hypthrm 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33608 HCPCS Repair Anomaly W/conduit 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
37226 HCPCS Hc Revasc Endo Fempop W Stent 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
37228 HCPCS Hc Revasc Endo Tibiopero W Pta 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
37221 HCPCS Hc Revasc/Endo Iliac W Stnt W/Wo Pta 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33665 HCPCS Repair Of Heart Defects 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33606 HCPCS Anastomosis/artery-aorta 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33877 HCPCS Thoracoabdominal Graft 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33875 HCPCS Thoracic Aortic Graft 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
37225 HCPCS Hc Revasc Endo Fempop W Atherectomy 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33410 HCPCS Replacement Aortic Valve Opn 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
34830 HCPCS Open Aortic Tube Prosth Repr 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
34718 HCPCS Hc Endovasc Repair Of Iliac Artery Not Assoc W Aortoiliac Endograft Plcmt Unilat 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
32666 HCPCS Thoracoscopy W/wedge Resect 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
34831 HCPCS Open Aortoiliac Prosth Repr 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
34832 HCPCS Open Aortofemor Prosth Repr 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
34705 HCPCS Hc Endvsc Rep Infrnl Aort/Ilc Art By Aorto-bi-ilc Endgrft Not Rupt W Img 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
34706 HCPCS Hc Endvsc Rep Infrnl Aort/Ilc Art By Aorto-bi-ilc Endgrft Rupt W Img 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
34704 HCPCS Hc Endvsc Rep Infrnl Aort/Ilc Art By Aorto-uni-ilc Endgrft Rupt W Img 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
34717 HCPCS Hc Endovasc Repair Of Iliac Artery At Time Of Aortoiliac Endograft Plcmt Unilat 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33675 HCPCS Close Mult Vsd 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33864 HCPCS Ascending Aortic Graft 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33881 HCPCS Hc Endovasc Rep Descend Thorac Aorta No Subcl 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
33572 HCPCS Open Coronary Endarterectomy 3 1 — — $38,216.00 $38,216.00 $38,216.00 2026-04-01
67027 HCPCS Implant Eye Drug System 6 2 — — $13,453.74 $63,079.00 $38,413.49 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 71 15 — — $23,011.28 $261,877.15 $38,519.89 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 85 15 — — $3,442.99 $128,852.99 $38,709.38 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 67 15 — — $33,779.89 $126,262.24 $39,272.40 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 85 16 — — $12,307.73 $117,874.25 $39,431.60 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 138 17 — — $9,298.46 $282,479.97 $39,562.84 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 81 16 — — $16,396.16 $116,619.79 $39,631.18 2026-04-01
0308T HCPCS Insj Ocular Telescope Prosth 6 2 — — $15,871.89 $63,079.00 $39,649.00 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 100 17 — — $14,715.56 $212,496.84 $39,941.81 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 67 15 — — $32,878.57 $107,478.19 $40,351.85 2026-04-01
62360 HCPCS Insert Spine Infusion Device 6 2 — — $17,378.99 $63,079.00 $40,419.03 2026-04-01
62361 HCPCS Implant Spine Infusion Pump 6 2 — — $17,378.99 $63,079.00 $40,419.03 2026-04-01
62362 HCPCS Implant Spine Infusion Pump 6 2 — — $17,378.99 $63,079.00 $40,419.03 2026-04-01
0793T HCPCS Prq Tcat Thrm Ablt Nrv P-art 6 2 — — $17,675.76 $63,079.00 $40,570.66 2026-04-01
0238T HCPCS Trluml Perip Athrc Iliac Art 6 2 — — $17,675.76 $63,079.00 $40,570.66 2026-04-01
93581 HCPCS Transcath Closure Of Vsd 6 2 — — $17,675.76 $63,079.00 $40,570.66 2026-04-01
C9774 HCPCS Revasc Lithotr-ather Tib/per 6 2 — — $17,675.76 $63,079.00 $40,570.66 2026-04-01
C9775 HCPCS Revasc Lith-sten-ath Tib/per 6 2 — — $17,675.76 $63,079.00 $40,570.66 2026-04-01
36906 HCPCS Thrmbc/nfs Dialysis Circuit 6 2 — — $17,675.76 $63,079.00 $40,570.66 2026-04-01
36837 HCPCS Prq Av Fstl Crt Uxtr Sep Acs 6 2 — — $17,675.76 $63,079.00 $40,570.66 2026-04-01
36836 HCPCS Prq Av Fstl Crtj Uxtr 1 Acs 6 2 — — $17,675.76 $63,079.00 $40,570.66 2026-04-01
C9797 HCPCS Vasc Emb/occ W/prs Cath 6 2 — — $17,675.76 $63,079.00 $40,570.66 2026-04-01
C9767 HCPCS Revasc Lithotrip-stent-ather 6 2 — — $17,675.76 $63,079.00 $40,570.66 2026-04-01
C9773 HCPCS Revasc Lithotr-stent Tib/per 6 2 — — $17,675.76 $63,079.00 $40,570.66 2026-04-01
C9602 HCPCS Perc D-e Cor Stent Ather S 6 2 — — $17,675.76 $63,079.00 $40,570.66 2026-04-01
C9607 HCPCS Perc D-e Cor Revasc Chro Sin 6 2 — — $17,675.76 $63,079.00 $40,570.66 2026-04-01
93591 HCPCS Perq Transcath Cls Aortic 6 2 — — $17,675.76 $63,079.00 $40,570.66 2026-04-01
93590 HCPCS Perq Transcath Cls Mitral 6 2 — — $17,675.76 $63,079.00 $40,570.66 2026-04-01
93582 HCPCS Perq Transcath Closure Pda 6 2 — — $17,675.76 $63,079.00 $40,570.66 2026-04-01
92933 HCPCS Prq Card Stent/ath/angio 6 2 — — $17,675.76 $63,079.00 $40,570.66 2026-04-01
93580 HCPCS Transcath Closure Of Asd 6 2 — — $17,675.76 $63,079.00 $40,570.66 2026-04-01
33902 HCPCS Perq P-art Revsc 1 Abnor Uni 6 2 — — $17,675.76 $63,079.00 $40,570.66 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 95 17 — — $4,789.80 $238,004.71 $40,777.89 2026-04-01
33221 HCPCS Insert Pulse Gen Mult Leads 6 2 — — $18,572.54 $63,079.00 $41,028.86 2026-04-01
0802T HCPCS Tcat Rmv&rpl2chmb Ldls Pm Ra 6 2 — — $18,572.54 $63,079.00 $41,028.86 2026-04-01
33229 HCPCS Remv&replc Pm Gen Mult Leads 6 2 — — $18,572.54 $63,079.00 $41,028.86 2026-04-01
0803T HCPCS Tcat Rmv&rpl2chmb Ldls Pm Rv 6 2 — — $18,572.54 $63,079.00 $41,028.86 2026-04-01
0796T HCPCS Tcat Ins 2chmbr Ldls Pm Ra 6 2 — — $18,572.54 $63,079.00 $41,028.86 2026-04-01
0823T HCPCS Tcat Ins 1chmbr Ldls Pm Ra 6 2 — — $18,572.54 $63,079.00 $41,028.86 2026-04-01
0801T HCPCS Tcat Rmv&rpl 2chmbr Ldls Pm 6 2 — — $18,572.54 $63,079.00 $41,028.86 2026-04-01
33274 HCPCS Tcat Insj/rpl Perm Ldls Pm 6 2 — — $18,572.54 $63,079.00 $41,028.86 2026-04-01
0825T HCPCS Tcat Rmv&rpl1chmb Ldls Pm Ra 6 2 — — $18,572.54 $63,079.00 $41,028.86 2026-04-01
0797T HCPCS Tcat Ins 2chmbr Ldls Pm Rv 6 2 — — $18,572.54 $63,079.00 $41,028.86 2026-04-01
0795T HCPCS Tcat Ins 2chmbr Ldls Pm Cmpl 6 2 — — $18,572.54 $63,079.00 $41,028.86 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 64 15 — — $35,814.46 $130,458.58 $41,564.87 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 78 15 — — $35,190.03 $236,205.77 $41,634.76 2026-04-01
54417 HCPCS Remv/replc Penis Pros Compl 6 2 — — $19,984.58 $63,079.00 $41,750.32 2026-04-01
54416 HCPCS Remv/repl Penis Contain Pros 6 2 — — $19,984.58 $63,079.00 $41,750.32 2026-04-01
54411 HCPCS Remov/replc Penis Pros Comp 6 2 — — $19,984.58 $63,079.00 $41,750.32 2026-04-01
53447 HCPCS Remove/replace Ur Sphincter 6 2 — — $19,984.58 $63,079.00 $41,750.32 2026-04-01
53445 HCPCS Insert Uro/ves Nck Sphincter 6 2 — — $19,984.58 $63,079.00 $41,750.32 2026-04-01
54401 HCPCS Insert Self-contd Prosthesis 6 2 — — $19,984.58 $63,079.00 $41,750.32 2026-04-01
54405 HCPCS Insert Multi-comp Penis Pros 6 2 — — $19,984.58 $63,079.00 $41,750.32 2026-04-01
53444 HCPCS Insert Tandem Cuff 6 2 — — $19,984.58 $63,079.00 $41,750.32 2026-04-01
54410 HCPCS Remove/replace Penis Prosth 6 2 — — $19,984.58 $63,079.00 $41,750.32 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 114 17 — — $4,776.00 $231,062.13 $42,185.36 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 77 15 — — $3,787.14 $297,819.85 $42,321.26 2026-04-01
1580 OTHER New Technology - Level 43 ($40,001-$50,000) 10 4 — — $42,111.78 $55,813.91 $42,413.17 2026-04-01
64654 HCPCS 1st Opn Implt Bat Modulj Sys 2 1 — — $42,470.57 $42,470.57 $42,470.57 2026-04-01
0515T HCPCS Insj Wcs Lv Compl Sys 6 2 — — $21,447.74 $63,079.00 $42,497.90 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 6 2 — — $21,447.74 $63,079.00 $42,497.90 2026-04-01
0916T HCPCS Insj Perm Ccm-d Sys Pg Only 6 2 — — $21,447.74 $63,079.00 $42,497.90 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 6 2 — — $21,447.74 $63,079.00 $42,497.90 2026-04-01
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 6 2 — — $21,447.74 $63,079.00 $42,497.90 2026-04-01
0409T HCPCS Insj/rplc Car Modulj Pls Gn 6 2 — — $21,447.74 $63,079.00 $42,497.90 2026-04-01
0923T HCPCS Rmvl&rplcmt Perm Ccm-d Pg 6 2 — — $21,447.74 $63,079.00 $42,497.90 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 6 2 — — $21,447.74 $63,079.00 $42,497.90 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 6 2 — — $21,447.74 $63,079.00 $42,497.90 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 79 16 — — $18,120.53 $153,452.11 $42,599.27 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 111 18 — — $26,857.85 $261,283.08 $42,624.13 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 63 15 — — $37,440.32 $141,254.84 $43,396.82 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 67 15 — — $10,260.94 $126,278.62 $43,566.12 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 97 16 — — $26,507.62 $249,550.15 $43,632.90 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 107 17 — — $17,413.63 $299,697.52 $43,693.48 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 63 15 — — $38,065.44 $143,623.33 $44,101.18 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 6 2 — — $25,202.69 $63,079.00 $44,416.43 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 6 2 — — $25,202.69 $63,079.00 $44,416.43 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 6 2 — — $25,202.69 $63,079.00 $44,416.43 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 67 15 — — $35,818.26 $117,087.87 $44,436.67 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 63 15 — — $38,627.85 $127,336.48 $44,734.87 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 91 15 — — $25,878.60 $250,603.93 $44,870.00 2026-04-01
21243 HCPCS Reconstruction Of Jaw Joint 6 2 — — $26,163.21 $63,079.00 $44,907.19 2026-04-01
20696 HCPCS Comp Multiplane Ext Fixation 6 2 — — $26,163.21 $63,079.00 $44,907.19 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 87 15 — — $22,238.44 $449,330.38 $45,071.46 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 83 15 — — $8,757.02 $371,291.98 $45,471.85 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 47 14 — — $4,082.67 $54,143.10 $45,529.32 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 6 2 — — $27,657.11 $63,079.00 $45,670.48 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 111 17 — — $10,606.28 $313,328.81 $45,711.04 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 75 15 — — $24,860.88 $128,022.22 $45,996.82 2026-04-01
0908T HCPCS Opn Imp Int Nstm Sys Vgs Nrv 6 2 — — $29,753.66 $63,079.00 $46,741.68 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 6 2 — — $29,753.66 $63,079.00 $46,741.68 2026-04-01
61886 HCPCS Implant Neurostim Arrays 6 2 — — $29,753.66 $63,079.00 $46,741.68 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 6 2 — — $29,753.66 $63,079.00 $46,741.68 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 6 2 — — $29,753.66 $63,079.00 $46,741.68 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 6 2 — — $29,753.66 $63,079.00 $46,741.68 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 6 2 — — $29,753.66 $63,079.00 $46,741.68 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 79 16 — — $25,083.20 $231,524.40 $46,755.54 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 107 17 — — $4,198.35 $243,320.05 $46,785.05 2026-04-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 6 2 — — $30,265.83 $63,079.00 $47,003.36 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 6 2 — — $30,265.83 $63,079.00 $47,003.36 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 6 2 — — $30,265.83 $63,079.00 $47,003.36 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 6 2 — — $30,265.83 $63,079.00 $47,003.36 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 6 2 — — $30,265.83 $63,079.00 $47,003.36 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 6 2 — — $30,265.83 $63,079.00 $47,003.36 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 6 2 — — $30,265.83 $63,079.00 $47,003.36 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 83 16 — — $4,278.43 $141,254.84 $47,259.54 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 69 15 — — $2,894.00 $139,136.78 $47,366.71 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 85 16 — — $27,465.35 $134,315.56 $47,518.92 2026-04-01
69930 HCPCS Implant Cochlear Device 6 2 — — $31,792.44 $63,079.00 $47,783.36 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 83 16 — — $30,117.89 $273,338.32 $47,856.73 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 87 16 — — $24,496.24 $355,642.95 $47,869.93 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 2 1 — — $47,919.99 $47,919.99 $47,919.99 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 67 15 — — $41,784.46 $262,245.85 $48,291.62 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 67 15 — — $42,189.03 $263,819.20 $48,747.47 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 93 16 — — $38,737.47 $252,324.01 $48,802.61 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 2 1 — — $49,338.18 $49,338.18 $49,338.18 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 99 16 — — $23,819.12 $157,141.29 $51,181.27 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 66 15 — — $27,593.11 $144,117.15 $52,087.54 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 65 16 — — $36,294.26 $139,232.74 $52,273.15 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 77 15 — — $4,703.91 $210,649.15 $52,273.15 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 91 16 — — $4,779.96 $343,052.99 $53,098.65 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 101 17 — — $12,784.29 $383,552.19 $53,136.71 2026-04-01
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 6 2 — — $42,470.57 $63,079.00 $53,239.19 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 6 2 — — $42,470.57 $63,079.00 $53,239.19 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 6 2 — — $42,470.57 $63,079.00 $53,239.19 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 67 16 — — $46,391.87 $159,800.17 $53,483.06 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 21 5 — — $24,228.42 $151,599.50 $54,575.82 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 93 15 — — $17,574.95 $208,346.35 $54,623.08 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 118 17 — — $13,387.04 $475,578.32 $54,886.34 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 83 16 — — $34,310.39 $308,661.20 $56,583.95 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 63 15 — — $49,172.86 $185,516.49 $56,616.57 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 63 15 — — $47,814.72 $156,303.61 $56,912.44 2026-04-01
10 MS_DRG Pancreas Transplant 63 15 — — $49,456.13 $186,590.73 $56,935.74 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 111 17 — — $26,654.74 $178,222.61 $57,268.89 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 90 17 — — $11,606.15 $274,858.72 $60,385.32 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 95 15 — — $30,151.33 $308,747.01 $60,581.79 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 107 16 — — $5,492.99 $353,443.78 $60,838.84 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 91 16 — — $32,307.16 $311,209.05 $62,318.23 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 6 2 — — $60,650.62 $63,079.00 $62,528.01 2026-04-01
33935 HCPCS Transplantation Heart/lung 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
0871T HCPCS Rplcmt Subq Prtl Ascites Pmp 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
33268 HCPCS Excl Laa Opn Oth Px Any Meth 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
0872T HCPCS Rplcmt Ndwllg Bldr&prtl Cath 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
93583 HCPCS Hc Perq Transcath Septal Reduction 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
50360 HCPCS Transplantation Of Kidney 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
33928 HCPCS Rmvl & Rplcmt Tot Hrt Sys 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
G0342 HCPCS Laparoscopy Islet Cell Trans 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
37227 HCPCS Hc Revasc Endo Fempop W Stnt&Atherec 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
0100T HCPCS Prosth Retina Receive&Gen 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
0586T HCPCS Open Islet Cell Transplant 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
54438 HCPCS Replantation Of Penis 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
33391 HCPCS Valvuloplasty Aortic Valve 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
22860 HCPCS Tot Disc Arthrp 2ntrspc Lmbr 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
50380 HCPCS Reimplantation Of Kidney 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
C7534 HCPCS Fem/pop Revasc W/arthr & US 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
33929 HCPCS Rmvl Rplcmt Hrt Sys F/trnspl 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
32851 HCPCS Lung Transplant Single 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
C9606 HCPCS Hc Revasc Occ During Mi De Stent Sgl 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
61889 HCPCS Ins Sk-mnt Crnl Nstm Pg/rcvr 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
33422 HCPCS Revision Of Mitral Valve 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
G0343 HCPCS Laparotomy Islet Cell Transp 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
C7539 HCPCS Insrt A & V Pm W/l Vent Lead 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
0268T HCPCS Implt/rpl Crtd Sns Dev Gen 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
33927 HCPCS Impltj Tot Rplcmt Hrt Sys 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
32854 HCPCS Lung Transplant With Bypass 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
32852 HCPCS Lung Transplant With Bypass 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
32853 HCPCS Lung Transplant Double 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
33267 HCPCS Excl Laa Open Any Method 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
0942T HCPCS Cysto Flx Rmv&rplc Urtl Scaf 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
0584T HCPCS Perq Islet Cell Transplant 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
48554 HCPCS Transpl Allograft Pancreas 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
C7535 HCPCS Fem/pop Revasc W/stent & US 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
0585T HCPCS Laps Islet Cell Transplant 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
0814T HCPCS Prq Njx Biod Osteo Matrl Fem 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
47135 HCPCS Transplantation Of Liver 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
33945 HCPCS Transplantation Of Heart 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
37229 HCPCS Hc Revasc Endo Tibiopero W Atherectm 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
33736 HCPCS Revision Of Heart Chamber 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
0873T HCPCS Revj Subq Prtl Asct Pmp Sys 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
33737 HCPCS Revision Of Heart Chamber 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
0266T HCPCS Implt/rpl Crtd Sns Dev Total 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
33269 HCPCS Hc Exclusion L Atr Appendage Thoracoscopic Any Method 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
50365 HCPCS Transplantation Of Kidney 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
37231 HCPCS Hc Revasc/Endo Tibioper W Stnt&Ather 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
37230 HCPCS Hc Revasc Endo Tibiopero W Stent 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
0870T HCPCS Imp Subq Prtl Ascts Pmp Sys 3 1 — — $63,079.00 $63,079.00 $63,079.00 2026-04-01
J9266 HCPCS Pegaspargase Injection 26 5 — — $28,424.06 $175,958.45 $63,345.04 2026-04-01
5094 OTHER Level 4 Breast/Lymphatic Surgery And Related Procedures 18 5 — — $17,919.92 $118,098.63 $65,015.25 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 83 16 — — $500.00 $209,603.40 $66,469.83 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 67 16 — — $23,960.91 $236,096.15 $66,675.62 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 71 16 — — $24,836.26 $215,581.27 $68,458.65 2026-04-01
L8702 HCPCS Pow Ue Rom Dev Ewhf Uprt Cus 2 1 — — $68,801.71 $68,801.71 $68,801.71 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 12 5 — — $63,844.99 $85,609.49 $70,207.90 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 75 15 — — $6,445.39 $195,189.36 $71,177.47 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 95 16 — — $32,429.55 $347,710.92 $77,181.99 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 63 15 — — $71,061.70 $249,219.83 $81,280.01 2026-04-01
215 MS_DRG Other Heart Assist System Implant 90 15 — — $13,815.00 $934,772.22 $83,191.77 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 73 15 — — $7,721.92 $408,002.30 $85,656.82 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 6 3 — — $85,143.73 $91,107.98 $85,687.19 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 101 17 — — $7,716.41 $343,275.73 $86,799.17 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 45 14 — — $78,011.07 $104,380.34 $89,110.28 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 63 15 — — $78,100.67 $257,905.06 $89,211.24 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 71 15 — — $9,286.94 $306,613.46 $94,539.36 2026-04-01
7 MS_DRG Lung Transplant 63 15 — — $89,254.95 $305,841.13 $101,779.43 2026-04-01
J9226 HCPCS Supprelin La Implant 26 5 — — $45,020.65 $294,201.70 $105,912.61 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 95 16 — — $46,654.56 $697,789.00 $108,777.98 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 2 1 — — $110,901.76 $110,901.76 $110,901.76 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 12 5 — — $106,753.90 $143,145.89 $117,393.20 2026-04-01
A9699 HCPCS Radiopharm Rx Agent Noc 6 1 — — $122,549.05 $122,549.05 $122,549.05 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 26 5 — — $55,272.32 $360,987.25 $129,955.41 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 26 5 — — $63,342.28 $412,113.26 $148,360.77 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 21 5 — — $56,824.55 $421,582.72 $151,769.78 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 109 17 — — $73,346.68 $673,554.60 $166,041.53 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 63 15 — — $147,151.23 $555,208.41 $167,014.58 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 15 2 — — $141,956.10 $394,322.50 $197,282.58 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 85 16 — — $193,145.43 $1,449,668.48 $253,922.96 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 63 15 — — $269,986.18 $882,569.52 $336,560.13 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 17 4 — — $489,304.61 $1,322,619.59 $829,687.57 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 17 4 — — $533,230.17 $1,326,591.48 $832,179.16 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 17 4 — — $562,538.19 $1,399,676.98 $878,026.14 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 17 4 — — $557,317.93 $1,431,726.69 $898,131.13 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 17 4 — — $565,868.94 $1,494,072.70 $937,241.17 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 17 4 — — $591,726.20 $1,532,840.61 $961,560.52 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 1 1 — — $1,310,054.00 $1,310,054.00 $1,310,054.00 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 6 3 — — $2,332,000.00 $2,425,280.00 $2,332,000.00 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 6 3 — — $2,455,110.60 $2,553,315.03 $2,455,110.60 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 6 3 — — $2,945,740.00 $3,063,569.60 $2,945,740.00 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 6 3 — — $3,248,445.72 $3,378,383.54 $3,248,445.72 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 6 3 — — $3,316,462.59 $3,449,121.09 $3,316,462.59 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 6 3 — — $3,685,266.67 $3,832,677.33 $3,685,266.67 2026-04-01
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