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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

LIMA MEMORIAL HEALTH SYSTEM

Lima, OH · CCN 360009 · Rates published

10,842 distinct procedures filed
36 distinct payers
146,668 rate rows
2026-04-01 last MRF observed
Data quality

85,519 of 146,668 rate rows are consumer-grade (58.3%)

61,149 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 60,712
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 238
placeholder amount (≤ $0.02) — excluded from medians 199
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.limamemorial.org/media/bahnfbgb/344434676_lima-memorial-health-system_standardcharges.json
Found on page https://www.limamemorial.org/patient-resources/patient-price-information/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-11
Content fingerprint dac2e26e1809422b… · 36,150,118 bytes · first seen 2026-05-13

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 2 $4,505,000.00 $4,550,050.00 $4,527,525.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 2 $3,685,266.67 $4,422,320.00 $3,722,119.33 nat. median
$3,685,267
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 2 $3,316,462.59 $3,979,755.11 $3,349,627.21 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 2 $3,248,445.72 $3,898,134.86 $3,280,930.17 nat. median
$3,248,446
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 2 $2,945,740.00 $3,534,888.00 $2,975,197.40 nat. median
$2,968,000
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 4 $2,455,110.60 $4,296,443.56 $2,946,132.73 nat. median
$2,455,111
1.2× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 4 $2,332,000.00 $4,081,000.00 $2,798,400.00 nat. median
$2,332,000
1.2× median
Q2057
HCPCS 		Afamitresgene Autoleucel 5 $770,620.00 $3,543,146.55 $1,310,054.00 nat. median
$813,967
1.6× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 5 $591,726.20 $2,720,630.98 $1,005,934.54 nat. median
$621,313
1.6× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 5 $565,868.94 $2,601,744.83 $961,977.21 nat. median
$599,737
1.6× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 5 $562,538.19 $2,586,430.70 $956,314.91 nat. median
$579,571
1.7× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 5 $557,317.93 $2,562,429.10 $947,440.49 nat. median
$574,037
1.7× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 5 $533,230.17 $2,451,678.70 $906,491.29 nat. median
$562,501
1.6× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 5 $489,304.61 $2,249,718.32 $831,817.83 nat. median
$513,770
1.6× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 9 $297,187.14 $875,747.18 $505,218.14 nat. median
$168,055
outlier · 3.0×
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 5 $278,250.00 $1,279,334.21 $473,025.00 nat. median
$286,598
1.7× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 9 $193,112.89 $568,324.69 $328,291.91 nat. median
$186,516
1.8× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 9 $147,296.30 $432,988.14 $250,403.71 nat. median
$131,925
1.9× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 11 $65,801.22 $574,701.30 $248,941.27 nat. median
$145,435
1.7× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 5 $110,901.76 $509,902.66 $188,532.99 nat. median
$108,243
1.7× median
9195
OTHER 		Injection, Udenyca 0.5 Mg 1 $157,623.91 $157,623.91 $157,623.91 nat. median
$149
outlier · 1057.0×
7
MS_DRG 		Lung Transplant 9 $89,623.58 $262,630.06 $152,360.09 nat. median
$70,649
outlier · 2.2×
9012
OTHER 		Arsenic Trioxide Injection 1 $148,278.37 $148,278.37 $148,278.37 nat. median
$7
outlier · 20201.4×
9173
OTHER 		Injection, Fulphila 1 $145,757.50 $145,757.50 $145,757.50 nat. median
$138
outlier · 1054.4×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 9 $83,222.82 $243,723.01 $141,478.79 nat. median
$72,715
1.9× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 9 $78,512.37 $229,808.90 $133,471.03 nat. median
$65,418
outlier · 2.0×
209
MS_DRG 		Complex Aortic Arch Procedures 9 $78,423.12 $229,545.26 $133,319.30 nat. median
$2,110
outlier · 63.2×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 9 $75,370.00 $220,526.75 $128,129.00 nat. median
$74,509
1.7× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 9 $71,500.58 $209,096.94 $121,550.99 nat. median
$69,922
1.7× median
L8702
HCPCS 		Pow Ue Rom Dev Ewhf Uprt Cus 5 $68,801.71 $316,335.60 $116,962.91 nat. median
$68,802
1.7× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 9 $67,877.62 $198,395.18 $115,391.95 nat. median
$69,822
1.7× median
9492
OTHER 		Inj., Durvalumab, 10 Mg 1 $115,226.94 $115,226.94 $115,226.94 nat. median
$86
outlier · 1341.3×
0822
RC 		Inj, Romiplostim 1 Microgram 1 $113,607.01 $113,607.01 $113,607.01 nat. median
$1,136
outlier · 100.0×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 9 $62,569.18 $182,714.69 $106,367.61 nat. median
$2,596
outlier · 41.0×
850
MS_DRG 		Acute Leukemia With Other Procedures 9 $60,165.55 $175,614.66 $102,281.44 nat. median
$2,633
outlier · 38.8×
1297
OTHER 		Ferumoxytol, Non-esrd 1 $101,686.77 $101,686.77 $101,686.77 nat. median
$0
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 10 $53,201.82 $292,268.65 $101,658.19 nat. median
$55,935
1.8× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 9 $58,589.22 $170,958.37 $99,601.67 nat. median
$60,505
1.6× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 9 $58,407.28 $170,420.95 $99,292.38 nat. median
$59,651
1.7× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 10 $47,789.88 $280,906.39 $96,768.93 nat. median
$97,418
1.0× median
215
MS_DRG 		Other Heart Assist System Implant 9 $65,644.72 $201,927.96 $93,594.73 nat. median
$73,023
1.3× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 9 $54,736.95 $159,579.26 $93,052.81 nat. median
$56,428
1.6× median
9494
OTHER 		Injection, Ocrelizumab 1 $90,927.53 $90,927.53 $90,927.53 nat. median
$62
outlier · 1462.1×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 9 $53,429.07 $155,715.92 $90,829.42 nat. median
$55,923
1.6× median
9483
OTHER 		Inj, Atezolizumab,10 Mg 2 $78,324.48 $95,281.55 $86,803.01 nat. median
$91
outlier · 958.6×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 9 $28,576.68 $146,393.21 $85,464.05 nat. median
$9,905
outlier · 8.6×
10
MS_DRG 		Pancreas Transplant 9 $49,978.44 $145,523.20 $84,963.35 nat. median
$23,080
outlier · 3.7×
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 9 $49,957.84 $145,462.36 $84,928.33 nat. median
$37,013
outlier · 2.3×
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 9 $49,696.26 $144,689.69 $84,483.64 nat. median
$45,605
1.9× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 9 $49,667.43 $144,604.51 $84,434.63 nat. median
$51,518
1.6× median

Other procedures at this hospital

Browse this hospital's 10,842 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
0238T CPT Trluml Perip Athrc Iliac Art 7 5 — — $17,503.83 $80,478.90 $29,756.52 2026-04-01
0408T CPT Insj/rplc Cardiac Modulj Sys 7 5 — — $29,971.44 $137,802.27 $50,951.44 2026-04-01
0409T CPT Insj/rplc Car Modulj Pls Gn 7 5 — — $21,239.12 $97,652.95 $36,106.51 2026-04-01
0414T CPT Rmvl & Rpl Car Modulj Pls Gn 7 5 — — $21,239.12 $97,652.95 $36,106.51 2026-04-01
0515T CPT Insj Wcs Lv Compl Sys 7 5 — — $21,239.12 $97,652.95 $36,106.51 2026-04-01
0571T CPT Insj/rplcmt Icds Ss Eltrd 7 5 — — $29,971.44 $137,802.27 $50,951.44 2026-04-01
0614T CPT Rmvl&rplcmt Ss Impl Dfb Pg 7 5 — — $21,239.12 $97,652.95 $36,106.51 2026-04-01
0674T CPT Laps Insj Nw/rpcmt Prm Isdss 7 5 — — $29,464.26 $135,470.37 $50,089.23 2026-04-01
0822 RC Inj, Romiplostim 1 Microgram 1 1 — — $113,607.01 $113,607.01 $113,607.01 2026-04-01
0908T CPT Opn Imp Int Nstm Sys Vgs Nrv 7 5 — — $29,464.26 $135,470.37 $50,089.23 2026-04-01
0909T CPT Rplcmt Int Nstim Sys Vgs Nrv 7 5 — — $29,464.26 $135,470.37 $50,089.23 2026-04-01
0915T CPT Insj Perm Ccm-d Sys Pg&eltrd 7 5 — — $29,971.44 $137,802.27 $50,951.44 2026-04-01
0916T CPT Insj Perm Ccm-d Sys Pg Only 7 5 — — $21,239.12 $97,652.95 $36,106.51 2026-04-01
0923T CPT Rmvl&rplcmt Perm Ccm-d Pg 7 5 — — $21,239.12 $97,652.95 $36,106.51 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 13 9 — — $193,112.89 $568,324.69 $328,291.91 2026-04-01
10 MS_DRG Pancreas Transplant 13 9 — — $49,978.44 $145,523.20 $84,963.35 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 13 9 — — $38,158.70 $110,609.15 $64,869.79 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 13 9 — — $29,658.46 $85,500.48 $50,419.38 2026-04-01
1297 OTHER Ferumoxytol, Non-esrd 1 1 — — $101,686.77 $101,686.77 $101,686.77 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 13 9 — — $83,222.82 $243,723.01 $141,478.79 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 13 9 — — $29,996.93 $86,500.28 $50,994.78 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 14 9 — — $6,282.82 $75,981.05 $35,820.47 2026-04-01
1490 OTHER Inj Pembrolizumab 2 2 — — $1,652.58 $132,356.34 $67,004.46 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 13 9 — — $41,423.96 $120,254.32 $70,420.73 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 17 10 — — $19,694.37 $96,684.63 $53,521.64 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 16 10 — — $12,652.92 $85,111.18 $30,671.30 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 18 11 — — $8,593.85 $75,800.56 $35,533.01 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 13 9 — — $38,009.03 $110,167.04 $64,615.35 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 13 9 — — $21,147.92 $60,361.39 $35,951.46 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 13 9 — — $297,187.14 $875,747.18 $505,218.14 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 13 9 — — $49,696.26 $144,689.69 $84,483.64 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 13 9 — — $78,512.37 $229,808.90 $133,471.03 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 13 9 — — $54,736.95 $159,579.26 $93,052.81 2026-04-01
2043 OTHER Orth/matrx/bn Fill Drug-elut 2 2 — — $16,391.60 $50,320.60 $33,356.10 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 16 12 — — $20,249.49 $130,495.72 $45,115.51 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 13 9 — — $78,423.12 $229,545.26 $133,319.30 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 13 9 — — $37,058.15 $107,358.26 $62,998.86 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 13 9 — — $75,370.00 $220,526.75 $128,129.00 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 13 9 — — $39,894.31 $115,735.93 $67,820.33 2026-04-01
215 MS_DRG Other Heart Assist System Implant 14 9 — — $65,644.72 $201,927.96 $93,594.73 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 13 9 — — $67,877.62 $198,395.18 $115,391.95 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 15 10 — — $11,822.27 $133,347.08 $46,314.92 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 14 10 — — $11,822.27 $133,347.08 $62,135.36 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 13 9 — — $53,429.07 $155,715.92 $90,829.42 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 13 9 — — $22,527.89 $64,437.67 $38,297.41 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 17 12 — — $23,750.56 $187,551.71 $63,454.05 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 13 9 — — $35,317.05 $102,215.26 $60,038.98 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 13 9 — — $34,679.92 $100,333.27 $58,955.86 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 13 9 — — $22,336.34 $63,871.86 $37,971.78 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 13 9 — — $40,054.97 $116,210.48 $68,093.45 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 13 9 — — $58,589.22 $170,958.37 $99,601.67 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 15 10 — — $42,336.39 $175,264.17 $71,971.86 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 20 10 — — $53,201.82 $292,268.65 $101,658.19 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 26 13 — — $25,328.63 $225,896.73 $83,890.71 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 16 10 — — $41,004.47 $173,759.97 $70,732.71 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 28 16 — — $21,336.94 $180,064.97 $76,453.98 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 14 10 — — $14,252.48 $99,812.08 $46,752.21 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 14 10 — — $27,570.64 $79,333.33 $46,870.09 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 16 10 — — $10,332.35 $57,808.14 $34,482.02 2026-04-01
245 MS_DRG Aicd Generator Procedures 13 9 — — $32,036.68 $92,525.47 $54,462.36 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 19 12 — — $18,037.36 $131,751.23 $44,535.14 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 21 12 — — $10,359.94 $54,778.32 $31,506.97 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 13 9 — — $22,285.54 $63,721.79 $37,885.42 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 13 9 — — $22,059.66 $63,054.58 $37,501.42 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 13 9 — — $23,045.55 $65,966.78 $39,177.44 2026-04-01
263 MS_DRG Vein Ligation And Stripping 14 9 — — $21,704.03 $62,004.07 $36,896.85 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 16 10 — — $5,116.13 $67,747.37 $36,098.82 2026-04-01
265 MS_DRG Aicd Lead Procedures 13 9 — — $25,554.23 $73,377.10 $43,442.19 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 13 9 — — $42,788.14 $124,283.95 $72,739.84 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 13 9 — — $33,398.81 $96,549.02 $56,777.98 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 14 9 — — $47,933.88 $139,483.81 $81,487.60 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 15 11 — — $29,707.89 $85,646.50 $50,503.41 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 20 12 — — $7,441.62 $107,003.36 $40,169.61 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 17 10 — — $15,330.03 $72,121.76 $42,719.72 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 18 11 — — $16,206.57 $138,362.22 $31,465.79 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 14 10 — — $16,012.79 $83,665.14 $39,345.29 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 13 9 — — $49,667.43 $144,604.51 $84,434.63 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 13 9 — — $41,951.92 $121,813.85 $71,318.26 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 13 9 — — $32,421.84 $93,663.18 $55,117.13 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 13 9 — — $38,928.33 $112,882.54 $66,178.16 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 15 9 — — $14,503.48 $73,137.79 $43,304.46 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 15 10 — — $35,943.46 $121,848.32 $71,338.10 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 16 10 — — $24,135.80 $69,596.67 $41,030.86 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 17 11 — — $65,801.22 $574,701.30 $248,941.27 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 14 10 — — $16,935.81 $90,864.54 $42,647.81 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 13 9 — — $46,619.81 $135,602.22 $79,253.68 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 13 9 — — $31,353.56 $90,507.61 $53,301.05 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 26 14 — — $7,686.77 $73,284.98 $36,580.47 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 13 9 — — $30,423.28 $87,759.67 $51,719.58 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 14 9 — — $22,346.64 $63,902.28 $37,989.29 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 13 9 — — $22,754.46 $65,106.91 $38,682.58 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 13 9 — — $34,954.55 $101,144.47 $59,422.74 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 23 13 — — $9,309.74 $170,462.77 $71,532.07 2026-04-01
332 MS_DRG Rectal Resection With Mcc 13 9 — — $25,571.39 $73,427.80 $43,471.36 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 7 5 — — $21,239.12 $97,652.95 $36,106.51 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 7 5 — — $29,971.44 $137,802.27 $50,951.44 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 7 5 — — $21,239.12 $97,652.95 $36,106.51 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 7 5 — — $29,971.44 $137,802.27 $50,951.44 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 7 5 — — $21,239.12 $97,652.95 $36,106.51 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 7 5 — — $21,239.12 $97,652.95 $36,106.51 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 7 5 — — $29,971.44 $137,802.27 $50,951.44 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 7 5 — — $29,971.44 $137,802.27 $50,951.44 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 7 5 — — $29,464.26 $135,470.37 $50,089.23 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 16 10 — — $25,229.49 $72,417.85 $42,967.58 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 13 9 — — $27,287.78 $78,497.80 $46,389.23 2026-04-01
343 MS_DRG Appendectomy Without Complicated Principal Diagnosis Without Cc/Mcc 1 1 — — $39,965.93 $39,965.93 $39,965.93 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 13 9 — — $18,445.63 $52,379.18 $31,357.57 2026-04-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 13 9 — — $17,821.55 $50,535.73 $30,296.64 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 13 9 — — $20,637.12 $58,852.56 $35,083.10 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 15 10 — — $7,918.32 $89,085.98 $52,482.89 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 14 9 — — $24,321.17 $69,734.81 $41,280.94 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 14 10 — — $23,315.37 $66,763.79 $38,316.76 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 15 10 — — $47,789.88 $280,906.39 $96,768.93 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 13 9 — — $27,222.56 $78,305.14 $46,278.35 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 15 9 — — $20,040.13 $81,535.74 $45,083.37 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 13 9 — — $38,271.29 $110,941.74 $65,061.19 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 13 9 — — $20,624.76 $58,816.06 $35,062.09 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 13 9 — — $25,193.10 $72,310.37 $42,828.27 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 13 9 — — $23,392.27 $66,990.92 $39,766.86 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 13 9 — — $25,172.50 $72,249.53 $42,793.25 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 14 9 — — $24,104.91 $69,095.99 $40,978.35 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 15 11 — — $29,225.93 $84,222.84 $30,439.44 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 15 10 — — $35,171.36 $223,509.94 $77,143.73 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 17 9 — — $28,576.68 $146,393.21 $85,464.05 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 17 9 — — $23,936.69 $179,919.29 $66,829.43 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 13 9 — — $62,569.18 $182,714.69 $106,367.61 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 13 9 — — $40,307.62 $116,956.79 $68,522.95 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 13 9 — — $46,586.17 $135,502.85 $79,196.49 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 24 11 — — $20,212.58 $140,529.92 $40,417.92 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 13 9 — — $37,303.94 $108,084.29 $63,416.70 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 20 9 — — $20,408.81 $103,612.49 $31,018.35 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 1 1 — — $80,840.80 $80,840.80 $80,840.80 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 13 9 — — $58,407.28 $170,420.95 $99,292.38 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 14 9 — — $41,653.27 $120,931.67 $70,810.56 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 16 9 — — $29,360.49 $101,101.85 $49,912.83 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 9 7 — — $55,897.34 $55,897.34 $55,897.34 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 13 9 — — $38,631.74 $112,006.44 $65,673.96 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 13 9 — — $18,975.65 $53,944.80 $32,258.61 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 13 9 — — $39,843.51 $115,585.86 $67,733.97 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 13 9 — — $22,097.42 $63,166.12 $37,565.61 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 13 9 — — $36,451.24 $105,565.51 $61,967.11 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 17 11 — — $16,576.82 $71,519.45 $30,582.17 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 13 9 — — $19,579.82 $55,729.44 $33,285.69 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 14 10 — — $17,969.96 $97,926.04 $45,887.05 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 16 9 — — $16,023.08 $107,111.75 $35,597.81 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 13 9 — — $30,186.42 $87,060.01 $51,316.91 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 13 9 — — $24,431.02 $70,059.29 $41,532.73 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 16 11 — — $20,707.83 $59,061.44 $35,203.31 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 15 10 — — $10,101.82 $56,214.13 $33,203.02 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 14 9 — — $22,869.11 $65,445.59 $37,607.21 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 14 10 — — $9,573.86 $74,460.05 $35,122.75 2026-04-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 16 12 — — $18,125.01 $93,755.83 $31,265.65 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 13 9 — — $25,605.72 $73,529.20 $43,529.72 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 13 9 — — $71,500.58 $209,096.94 $121,550.99 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 13 9 — — $22,441.39 $64,182.14 $38,150.36 2026-04-01
503 MS_DRG Foot Procedures With Mcc 13 9 — — $19,875.73 $56,603.51 $33,788.74 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 13 9 — — $21,450.69 $61,255.74 $36,466.17 2026-04-01
5115 OTHER Level 5 Musculoskeletal Procedures 31 17 — — $86.32 $102,221.61 $35,808.75 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 13 9 — — $22,593.11 $64,630.33 $38,408.29 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 14 9 — — $26,371.92 $75,792.44 $44,832.26 2026-04-01
5194 OTHER Level 4 Endovascular Procedures 13 9 — — $16,200.57 $73,799.97 $51,344.62 2026-04-01
5200 OTHER Implantation Wireless Pa Pressure Monitor 1 1 — — $47,390.96 $47,390.96 $47,390.96 2025-01-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 14 10 — — $20,418.79 $58,207.66 $34,711.94 2026-04-01
5213 OTHER Level 3 Electrophysiologic Procedures 7 6 — — $14,014.04 $70,293.49 $48,038.05 2026-04-01
5232 OTHER Level 2 Icd And Similar Procedures 11 9 — — $23,579.82 $134,259.59 $74,017.46 2026-04-01
5376 OTHER Level 6 Urology And Related Services 6 5 — — $6,642.67 $41,354.94 $41,354.94 2026-04-01
5465 OTHER Level 5 Neurostimulator And Related Procedures 10 9 — — $21,450.32 $127,609.79 $65,266.99 2026-04-01
5471 OTHER Implantation Of Drug Infusion Device 2 2 — — $69,424.23 $77,970.99 $73,697.61 2026-04-01
5611 OTHER Level 1 Therapeutic Radiation Treatment Preparation 24 16 — — $3,265.37 $83,592.60 $40,086.85 2026-04-01
5612 OTHER Level 2 Therapeutic Radiation Treatment Preparation 27 16 — — $3,265.37 $80,237.19 $40,824.93 2026-04-01
5613 OTHER Level 3 Therapeutic Radiation Treatment Preparation 25 16 — — $3,887.69 $88,989.33 $44,807.13 2026-04-01
5622 OTHER Level 2 Radiation Therapy 24 14 — — $2,793.82 $153,619.48 $43,849.75 2026-04-01
5623 OTHER Level 3 Radiation Therapy 16 13 — — $14,747.86 $132,578.33 $46,169.64 2026-04-01
5694 OTHER Level 4 Drug Administration 17 11 — — $1,132.43 $148,278.37 $44,753.69 2026-04-01
570 MS_DRG Skin Debridement With Mcc 13 9 — — $20,905.56 $59,645.51 $35,539.45 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 14 10 — — $26,771.22 $132,862.39 $61,913.03 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 14 10 — — $24,546.36 $70,399.99 $41,728.81 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 13 9 — — $34,362.73 $99,396.34 $58,416.64 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 13 9 — — $18,911.80 $53,756.20 $32,150.06 2026-04-01
5801 OTHER Ventilation Initiation And Management 1 1 — — $32,305.24 $32,305.24 $32,305.24 2025-01-01
6 MS_DRG Liver Transplant Without Mcc 13 9 — — $32,548.85 $94,038.36 $55,333.04 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 13 9 — — $19,642.30 $55,913.99 $33,391.91 2026-04-01
61624 HCPCS Transcath Occlusion Cns 7 5 — — $17,503.83 $80,478.90 $29,756.52 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 7 5 — — $29,464.26 $135,470.37 $50,089.23 2026-04-01
61886 HCPCS Implant Neurostim Arrays 7 5 — — $29,464.26 $135,470.37 $50,089.23 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 7 5 — — $29,464.26 $135,470.37 $50,089.23 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 13 9 — — $20,536.88 $58,556.47 $34,912.70 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 13 9 — — $25,149.16 $72,180.58 $42,753.57 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 13 9 — — $21,447.94 $61,247.63 $36,461.50 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 13 9 — — $26,299.83 $75,579.50 $44,709.71 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 7 5 — — $29,464.26 $135,470.37 $50,089.23 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 7 5 — — $29,464.26 $135,470.37 $50,089.23 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 7 5 — — $29,464.26 $135,470.37 $50,089.23 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 13 9 — — $32,991.00 $95,344.39 $56,084.70 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 13 9 — — $26,155.65 $75,153.62 $44,464.60 2026-04-01
652 MS_DRG Kidney Transplant 13 9 — — $22,885.59 $65,494.26 $38,905.50 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 13 9 — — $36,389.45 $105,382.99 $61,862.06 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 13 9 — — $19,932.03 $56,769.80 $33,884.45 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 14 10 — — $22,571.83 $110,171.22 $38,372.11 2026-04-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 17 11 — — $18,157.97 $51,529.45 $30,868.55 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 13 9 — — $21,732.17 $62,087.22 $36,944.69 2026-04-01
665 MS_DRG Prostatectomy With Mcc 13 9 — — $22,142.05 $63,297.94 $37,641.48 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 13 9 — — $20,760.70 $59,217.60 $35,293.19 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 20 11 — — $7,775.61 $104,964.66 $50,990.29 2026-04-01
7 MS_DRG Lung Transplant 13 9 — — $89,623.58 $262,630.06 $152,360.09 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 13 9 — — $25,254.20 $72,490.86 $42,932.14 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 13 9 — — $25,311.19 $72,659.18 $43,029.02 2026-04-01
783 MS_DRG Cesarean Section With Sterilization With Mcc 15 9 — — $5,220.02 $116,649.50 $29,867.13 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 18 9 — — $1,405.08 $120,534.18 $41,518.70 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 13 9 — — $31,806.69 $91,846.09 $54,071.37 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 13 9 — — $39,191.97 $113,661.29 $66,626.35 2026-04-01
800 MS_DRG Splenic Procedures With Cc 13 9 — — $20,001.37 $56,974.63 $34,002.33 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 13 9 — — $28,066.33 $80,797.55 $47,712.76 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 14 9 — — $21,037.22 $118,938.14 $55,525.71 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 15 9 — — $22,078.78 $92,979.74 $54,723.80 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 15 9 — — $32,828.97 $94,865.78 $55,809.25 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 14 10 — — $22,408.43 $64,084.80 $38,094.33 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 13 9 — — $38,404.49 $111,335.17 $65,287.63 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 13 9 — — $33,697.46 $97,431.20 $57,285.68 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 16 9 — — $16,138.34 $65,603.77 $36,337.54 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 13 9 — — $18,512.23 $52,575.90 $31,470.79 2026-04-01
849 MS_DRG Radiotherapy 13 9 — — $19,315.50 $54,948.66 $32,836.35 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 13 9 — — $60,165.55 $175,614.66 $102,281.44 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 26 16 — — $7,912.82 $265,038.42 $66,928.23 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 15 10 — — $17,096.04 $92,247.64 $54,302.47 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 20 10 — — $15,258.78 $140,171.30 $65,265.77 2026-04-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 33 15 — — $7,912.82 $50,342.73 $31,114.97 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 13 9 — — $27,247.96 $78,380.17 $46,321.53 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 13 9 — — $29,525.26 $85,107.05 $50,192.94 2026-04-01
9012 OTHER Arsenic Trioxide Injection 1 1 — — $148,278.37 $148,278.37 $148,278.37 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 13 9 — — $25,931.15 $74,490.47 $44,082.96 2026-04-01
9131 OTHER Inj, Ado-trastuzumab Emt 1mg 1 1 — — $67,227.41 $67,227.41 $67,227.41 2026-04-01
9173 OTHER Injection, Fulphila 1 1 — — $145,757.50 $145,757.50 $145,757.50 2025-01-01
9195 OTHER Injection, Udenyca 0.5 Mg 1 1 — — $157,623.91 $157,623.91 $157,623.91 2025-01-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 13 9 — — $147,296.30 $432,988.14 $250,403.71 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 13 9 — — $49,957.84 $145,462.36 $84,928.33 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 13 9 — — $22,825.86 $65,317.82 $38,803.96 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 13 9 — — $27,449.12 $78,974.38 $46,663.50 2026-04-01
9336 OTHER Inj Truxima 10 Mg 1 1 — — $49,882.80 $49,882.80 $49,882.80 2025-01-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 7 5 — — $24,957.55 $114,749.49 $42,427.83 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 7 5 — — $24,957.55 $114,749.49 $42,427.83 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 7 5 — — $24,957.55 $114,749.49 $42,427.83 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 13 9 — — $25,624.94 $73,585.98 $43,562.40 2026-04-01
9390 OTHER Pertuzu, Trastuzu, 10 Mg 4 3 — — $25,661.49 $74,021.79 $74,021.79 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 13 9 — — $24,875.91 $71,373.43 $42,289.05 2026-04-01
9453 OTHER Injection, Nivolumab 1 1 — — $35,526.41 $35,526.41 $35,526.41 2025-01-01
9483 OTHER Inj, Atezolizumab,10 Mg 2 2 — — $78,324.48 $95,281.55 $86,803.01 2026-04-01
9492 OTHER Inj., Durvalumab, 10 Mg 1 1 — — $115,226.94 $115,226.94 $115,226.94 2025-01-01
9494 OTHER Injection, Ocrelizumab 1 1 — — $90,927.53 $90,927.53 $90,927.53 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 13 9 — — $18,420.92 $52,306.18 $31,315.56 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 14 10 — — $46,926.01 $136,506.71 $79,774.22 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 13 9 — — $26,548.36 $76,313.64 $45,132.21 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 19 11 — — $14,777.66 $212,563.01 $82,192.09 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 16 10 — — $29,644.04 $283,652.86 $43,471.97 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 13 9 — — $42,739.40 $124,139.96 $72,656.98 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 14 9 — — $17,352.00 $73,247.30 $34,566.44 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 13 9 — — $18,820.49 $53,486.47 $31,994.83 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 19 12 — — $15,570.86 $95,149.70 $39,073.22 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 10 5 — — $56,824.55 $261,267.17 $69,859.77 2026-04-01
C9773 HCPCS Revasc Lithotr-stent Tib/per 7 5 — — $17,503.83 $80,478.90 $29,756.52 2026-04-01
C9774 HCPCS Revasc Lithotr-ather Tib/per 7 5 — — $17,503.83 $80,478.90 $29,756.52 2026-04-01
C9775 HCPCS Revasc Lith-sten-ath Tib/per 7 5 — — $17,503.83 $80,478.90 $29,756.52 2026-04-01
C9797 HCPCS Vasc Emb/occ W/prs Cath 7 5 — — $17,503.83 $80,478.90 $29,756.52 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 3 2 — — $3,685,266.67 $4,422,320.00 $3,722,119.33 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 3 2 — — $3,316,462.59 $3,979,755.11 $3,349,627.21 2026-04-01
J3391 HCPCS Inj, Atidarsagene Autotemcel 2 2 — — $4,505,000.00 $4,550,050.00 $4,527,525.00 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 5 4 — — $2,332,000.00 $4,081,000.00 $2,798,400.00 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 3 2 — — $2,945,740.00 $3,534,888.00 $2,975,197.40 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 3 2 — — $3,248,445.72 $3,898,134.86 $3,280,930.17 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 5 4 — — $2,455,110.60 $4,296,443.56 $2,946,132.73 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 1 1 — — $56,285.75 $56,285.75 $56,285.75 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 9 5 — — $63,342.28 $291,234.31 $76,010.74 2026-04-01
J9226 HCPCS Supprelin La Implant 10 5 — — $44,315.41 $206,995.36 $49,792.58 2026-04-01
J9266 HCPCS Pegaspargase Injection 10 5 — — $27,302.18 $130,687.77 $31,408.58 2026-04-01
L5856 HCPCS Elec Knee-shin Swing/stance 7 5 — — $29,559.78 $135,909.57 $50,251.63 2026-04-01
L5858 HCPCS Stance Phase Only 7 5 — — $22,885.05 $105,220.58 $38,904.58 2026-04-01
L5859 HCPCS Knee-shin Pro Flex/ext Cont 7 5 — — $17,866.14 $82,144.70 $30,372.44 2026-04-01
L5973 HCPCS Ank-foot Sys Dors-plant Flex 7 5 — — $21,739.52 $99,953.68 $36,957.18 2026-04-01
L6700 HCPCS Ue Add Ext Power Myoel 7 5 — — $29,510.19 $135,681.57 $50,167.32 2026-04-01
L6880 HCPCS Elec Hand Ind Art Digits 7 5 — — $29,420.21 $135,267.86 $50,014.36 2026-04-01
L6965 HCPCS Shldr Disartic Myoelectronic 7 5 — — $18,506.37 $85,088.35 $31,460.83 2026-04-01
L6970 HCPCS Interscapular-thor Switch CT 7 5 — — $19,809.02 $91,077.65 $33,675.33 2026-04-01
L6975 HCPCS Interscap-thor Myoelectronic 7 5 — — $21,834.21 $100,389.04 $37,118.16 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 7 5 — — $47,919.99 $220,325.90 $81,463.98 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 7 5 — — $49,338.18 $226,846.44 $83,874.91 2026-04-01
L8701 HCPCS Pow Ue Rom Dev Ewh Uprt Cust 7 5 — — $34,970.13 $160,785.21 $59,449.22 2026-04-01
L8702 HCPCS Pow Ue Rom Dev Ewhf Uprt Cus 7 5 — — $68,801.71 $316,335.60 $116,962.91 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 7 5 — — $110,901.76 $509,902.66 $188,532.99 2026-04-01
Q0481 HCPCS Microprcsr Cu Elec Vad, Rep 7 5 — — $17,892.75 $82,267.05 $30,417.68 2026-04-01
Q0483 HCPCS Monitor Elec Vad, Rep 7 5 — — $23,087.32 $106,150.58 $39,248.44 2026-04-01
Q0489 HCPCS Pwr Pck Base Combo Vad, Rep 7 5 — — $20,015.46 $92,026.82 $34,026.28 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 7 5 — — $533,230.17 $2,451,678.70 $906,491.29 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 7 5 — — $591,726.20 $2,720,630.98 $1,005,934.54 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 10 5 — — $55,272.32 $254,130.37 $64,143.10 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 7 5 — — $489,304.61 $2,249,718.32 $831,817.83 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 7 5 — — $562,538.19 $2,586,430.70 $956,314.91 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 7 5 — — $557,317.93 $2,562,429.10 $947,440.49 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 7 5 — — $565,868.94 $2,601,744.83 $961,977.21 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 7 5 — — $770,620.00 $3,543,146.55 $1,310,054.00 2026-04-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 7 5 — — $278,250.00 $1,279,334.21 $473,025.00 2026-04-01
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