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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

KETTERING HEALTH DAYTON

Dayton, OH · CCN 360133 · Rates published

13,848 distinct procedures filed
37 distinct payers
322,356 rate rows
2026-04-01 last MRF observed
Data quality

190,656 of 322,356 rate rows are consumer-grade (59.1%)

131,700 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 127,993
template filing: same amount across many unrelated codes — excluded 3,454
placeholder amount (≤ $0.02) — excluded from medians 253
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://ketteringhealth.org/wp-content/uploads/2026/03/310564121_1053339507_dayton-osteopathic-hospital_standardcharges.json
Found on page https://ketteringhealth.org/billing-insurance/patient-pricing/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint 7d35830cca09a4c8… · 62,090,290 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
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 1 $4,526,200.00 $4,526,200.00 $4,526,200.00 nat. median
$3,710,000
1.2× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 3 $3,685,266.67 $4,526,200.00 $4,197,865.00 nat. median
$3,710,000
1.1× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 4 $3,316,462.59 $4,958,780.45 $4,052,573.44 nat. median
$3,325,455
1.2× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 4 $3,248,445.72 $4,857,081.50 $3,895,460.00 nat. median
$3,286,000
1.2× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 5 $2,455,110.60 $3,809,595.13 $3,670,885.51 nat. median
$2,469,189
1.5× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 5 $2,945,740.00 $4,570,904.76 $3,620,960.00 nat. median
$3,006,423
1.2× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 6 $2,332,000.00 $4,897,200.00 $3,486,810.33 nat. median
$2,448,600
1.4× median
Q2057
HCPCS 		Afamitresgene Autoleucel 6 $770,620.00 $2,070,347.69 $1,193,382.13 nat. median
$824,563
1.4× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 6 $591,726.20 $1,589,731.61 $901,051.07 nat. median
$754,974
1.2× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 6 $565,868.94 $1,520,263.51 $861,676.94 nat. median
$675,122
1.3× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 6 $562,538.19 $1,511,315.09 $856,605.02 nat. median
$674,188
1.3× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 6 $557,317.93 $1,497,290.36 $848,655.89 nat. median
$625,184
1.4× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 6 $533,230.17 $1,432,576.18 $811,976.24 nat. median
$634,511
1.3× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 6 $489,304.61 $1,314,565.76 $745,088.59 nat. median
$620,080
1.2× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 15 $372,858.08 $953,398.11 $437,435.16 nat. median
$370,174
1.2× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 18 $120,808.78 $620,027.39 $242,482.36 nat. median
$265,286
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 15 $185,087.08 $499,151.43 $240,196.76 nat. median
$206,368
1.2× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 16 $85,649.81 $470,512.11 $184,009.43 nat. median
$202,986
0.9× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 6 $110,901.76 $297,948.67 $172,086.26 nat. median
$111,989
1.5× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 7 $39,039.81 $186,452.72 $154,406.17 nat. median
$87,411
1.8× median
7
MS_DRG 		Lung Transplant 15 $112,839.41 $288,530.37 $142,992.86 nat. median
$122,708
1.2× median
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 5 $98,142.30 $161,102.52 $141,823.20 nat. median
$63,570
outlier · 2.2×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 15 $104,821.07 $275,656.04 $136,031.54 nat. median
$117,303
1.2× median
90288
HCPCS 		Botulism Ig IV 1 $135,886.95 $135,886.95 $135,886.95 nat. median
$55,037
outlier · 2.5×
J7330
HCPCS 		Cultured Chondrocytes Implnt 3 $88,813.56 $187,316.25 $134,648.12 nat. median
$76,377
1.8× median
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 5 $90,869.37 $149,163.86 $131,313.25 nat. median
$54,196
outlier · 2.4×
215
MS_DRG 		Other Heart Assist System Implant 18 $81,056.69 $222,912.56 $126,682.29 nat. median
$99,019
1.3× median
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 5 $85,012.82 $139,550.22 $122,850.09 nat. median
$65,381
1.9× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 18 $33,507.54 $308,349.35 $120,590.28 nat. median
$133,176
0.9× median
226
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 5 $82,046.74 $134,681.34 $118,563.87 nat. median
$49,935
outlier · 2.4×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 15 $90,136.39 $230,478.75 $115,568.48 nat. median
$100,136
1.2× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 15 $69,297.07 $238,598.21 $108,612.04 nat. median
$79,312
1.4× median
L8702
HCPCS 		Pow Ue Rom Dev Ewhf Uprt Cus 6 $68,801.71 $184,842.67 $106,759.61 nat. median
$70,825
1.5× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 18 $42,097.22 $197,563.31 $104,317.97 nat. median
$74,915
1.4× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 18 $37,048.18 $257,748.80 $103,878.00 nat. median
$73,807
1.4× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 15 $97,335.40 $252,938.93 $103,866.20 nat. median
$108,660
1.0× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 15 $91,041.21 $246,108.31 $101,061.29 nat. median
$98,905
1.0× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 17 $63,700.63 $218,873.70 $100,904.65 nat. median
$93,672
1.1× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 15 $37,531.12 $242,873.32 $99,732.88 nat. median
$102,358
1.0× median
209
MS_DRG 		Complex Aortic Arch Procedures 15 $98,808.39 $252,653.05 $98,808.39 nat. median
$98,017
1.0× median
850
MS_DRG 		Acute Leukemia With Other Procedures 15 $75,936.79 $194,170.37 $98,546.97 nat. median
$83,442
1.2× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 9 $63,342.28 $170,175.37 $98,288.22 nat. median
$69,774
1.4× median
223
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 5 $66,893.30 $109,806.67 $96,665.98 nat. median
$44,728
outlier · 2.2×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 15 $78,947.87 $201,869.70 $94,898.69 nat. median
$82,712
1.1× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 16 $62,785.61 $230,495.89 $93,809.99 nat. median
$68,887
1.4× median
225
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 5 $64,829.60 $106,419.07 $93,683.78 nat. median
$48,649
1.9× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 15 $73,734.18 $188,538.30 $92,985.70 nat. median
$81,118
1.1× median
38240
HCPCS 		Transplt Allo Hct/donor 7 $13,471.00 $213,537.11 $92,668.15 nat. median
$15,912
outlier · 5.8×
A9543
HCPCS 		Y90 Ibritumomab, Rx 8 $56,824.55 $195,784.65 $87,998.49 nat. median
$62,507
1.4× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 15 $69,136.30 $176,781.52 $87,956.30 nat. median
$77,576
1.1× median

Other procedures at this hospital

Browse this hospital's 13,848 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
             
793 MS_DRG Full Term Neonate With Major Problems 58 22 — — $2,131.58 $95,429.64 $31,528.94 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 63 21 — — $16,867.08 $157,684.87 $87,557.91 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 63 21 — — $17,261.96 $140,366.95 $61,837.02 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 86 21 — — $6,275.59 $140,919.94 $54,923.25 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 67 21 — — $3,639.00 $134,440.80 $40,353.00 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 66 21 — — $11,321.27 $76,123.07 $35,843.18 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 58 20 — — $25,785.53 $243,177.34 $71,272.63 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 46 20 — — $20,623.56 $111,969.62 $51,292.15 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 52 20 — — $4,442.96 $96,133.36 $46,615.04 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 60 20 — — $9,890.56 $106,913.72 $42,857.47 2026-04-01
791 MS_DRG Prematurity With Major Problems 51 20 — — $93.85 $92,997.35 $36,369.71 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 48 20 — — $3,479.55 $77,198.46 $30,191.03 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 63 20 — — $3,197.65 $72,230.55 $29,660.57 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 46 19 — — $27,239.66 $121,010.43 $66,853.22 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 46 19 — — $28,519.63 $144,348.22 $59,381.44 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 58 19 — — $16,579.88 $102,295.44 $53,700.76 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 67 19 — — $14,196.57 $104,817.90 $51,126.14 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 41 19 — — $9,420.19 $184,306.35 $50,479.00 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 43 19 — — $14,034.71 $80,074.99 $41,744.07 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 48 19 — — $19,038.16 $88,165.77 $40,217.11 2026-04-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 56 19 — — $9,069.25 $67,118.94 $38,094.10 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 57 19 — — $9,667.13 $132,431.07 $37,742.92 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 58 19 — — $3,714.26 $81,288.95 $35,444.14 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 42 19 — — $13,888.80 $82,263.16 $33,780.34 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 53 19 — — $2,388.58 $79,129.36 $30,946.17 2026-04-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 69 19 — — $8,772.62 $56,451.45 $29,983.44 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 40 19 — — $15,086.47 $76,131.86 $29,773.90 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 40 19 — — $19,054.57 $74,702.40 $29,214.86 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 38 18 — — $120,808.78 $620,027.39 $242,482.36 2026-04-01
215 MS_DRG Other Heart Assist System Implant 40 18 — — $81,056.69 $222,912.56 $126,682.29 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 49 18 — — $33,507.54 $308,349.35 $120,590.28 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 41 18 — — $42,097.22 $197,563.31 $104,317.97 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 51 18 — — $37,048.18 $257,748.80 $103,878.00 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 34 18 — — $37,074.56 $138,507.06 $80,250.64 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 34 18 — — $41,033.62 $154,989.90 $60,613.96 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 52 18 — — $5,977.89 $180,633.60 $58,921.31 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 35 18 — — $26,252.50 $114,575.64 $57,910.86 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 44 18 — — $5,585.45 $118,208.68 $56,919.82 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 39 18 — — $34,630.74 $100,338.19 $54,677.74 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 49 18 — — $18,059.67 $143,137.48 $49,181.19 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 44 18 — — $10,838.90 $113,414.48 $46,572.24 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 52 18 — — $15,031.45 $96,608.40 $43,625.35 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 49 18 — — $10,736.13 $160,446.49 $42,610.49 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 47 18 — — $2,855.63 $135,730.91 $41,743.93 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 53 18 — — $16,235.13 $81,321.36 $40,329.29 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 42 18 — — $18,086.06 $98,141.21 $38,381.39 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 36 18 — — $4,610.78 $96,023.40 $37,553.15 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 43 18 — — $13,902.63 $86,487.79 $35,515.13 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 49 18 — — $15,544.49 $80,446.65 $33,034.41 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 40 18 — — $5,204.20 $74,873.95 $30,746.05 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 45 18 — — $20,363.49 $73,948.08 $30,365.85 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 40 18 — — $4,900.82 $73,332.33 $30,113.00 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 43 18 — — $3,543.92 $74,953.11 $29,312.91 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 39 18 — — $16,366.41 $70,438.22 $28,924.57 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 36 17 — — $63,700.63 $218,873.70 $100,904.65 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 32 17 — — $49,537.73 $148,335.18 $86,213.79 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 38 17 — — $30,959.47 $105,301.73 $68,971.19 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 35 17 — — $15,784.82 $114,942.33 $45,949.97 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 33 17 — — $15,744.14 $88,647.38 $43,306.87 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 36 17 — — $4,735.53 $98,899.93 $38,678.11 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 40 17 — — $4,000.00 $84,477.73 $33,037.83 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 38 17 — — $15,848.53 $83,043.87 $32,477.07 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 35 17 — — $4,480.08 $82,005.88 $32,071.13 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 35 17 — — $21,700.77 $78,185.69 $31,844.73 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 33 17 — — $19,971.52 $78,759.90 $30,801.68 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 32 17 — — $13,701.47 $57,421.30 $30,513.64 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 32 17 — — $13,652.96 $74,335.14 $29,798.01 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 35 17 — — $11,201.81 $151,322.53 $28,869.12 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 33 16 — — $85,649.81 $470,512.11 $184,009.43 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 34 16 — — $62,785.61 $230,495.89 $93,809.99 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 30 16 — — $48,961.00 $129,122.30 $77,164.73 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 30 16 — — $46,152.04 $118,010.77 $71,389.04 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 30 16 — — $27,255.55 $171,307.77 $70,345.39 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 30 16 — — $41,691.76 $106,605.83 $62,821.57 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 29 16 — — $22,506.25 $150,672.91 $61,871.94 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 30 16 — — $39,994.86 $102,266.86 $57,761.66 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 30 16 — — $27,906.23 $137,060.01 $56,281.97 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 30 16 — — $40,943.44 $135,865.86 $55,791.61 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 31 16 — — $46,585.22 $134,871.83 $55,383.43 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 34 16 — — $37,203.94 $112,534.82 $44,010.49 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 32 16 — — $40,877.15 $108,431.14 $43,465.75 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 33 16 — — $38,222.63 $109,924.38 $42,989.59 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 30 16 — — $9,330.50 $103,331.26 $42,431.69 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 30 16 — — $19,217.07 $97,534.23 $40,051.21 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 33 16 — — $23,517.81 $72,995.86 $39,813.99 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 31 16 — — $4,499.08 $96,450.04 $39,606.00 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 30 16 — — $36,629.27 $95,495.61 $39,214.08 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 33 16 — — $23,642.53 $85,911.54 $39,000.72 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 34 16 — — $31,261.00 $94,459.80 $37,865.19 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 31 16 — — $4,759.06 $86,127.12 $35,367.02 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 32 16 — — $11,079.14 $82,080.65 $33,705.39 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 33 16 — — $17,570.06 $85,691.69 $33,512.59 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 34 16 — — $8,555.05 $81,130.59 $31,728.82 2026-04-01
397 MS_DRG Appendix Procedures With Mcc 33 16 — — $18,633.78 $56,400.87 $30,960.63 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 30 16 — — $28,110.65 $75,267.60 $30,907.70 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 30 16 — — $26,763.12 $73,750.17 $30,284.58 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 30 16 — — $23,158.32 $59,215.82 $29,342.07 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 28 15 — — $372,858.08 $953,398.11 $437,435.16 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 28 15 — — $185,087.08 $499,151.43 $240,196.76 2026-04-01
7 MS_DRG Lung Transplant 28 15 — — $112,839.41 $288,530.37 $142,992.86 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 28 15 — — $104,821.07 $275,656.04 $136,031.54 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 28 15 — — $90,136.39 $230,478.75 $115,568.48 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 31 15 — — $69,297.07 $238,598.21 $108,612.04 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 30 15 — — $97,335.40 $252,938.93 $103,866.20 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 30 15 — — $91,041.21 $246,108.31 $101,061.29 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 30 15 — — $37,531.12 $242,873.32 $99,732.88 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 19 15 — — $98,808.39 $252,653.05 $98,808.39 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 28 15 — — $75,936.79 $194,170.37 $98,546.97 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 28 15 — — $78,947.87 $201,869.70 $94,898.69 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 28 15 — — $73,734.18 $188,538.30 $92,985.70 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 28 15 — — $69,136.30 $176,781.52 $87,956.30 2026-04-01
10 MS_DRG Pancreas Transplant 28 15 — — $63,175.22 $167,751.48 $81,985.64 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 28 15 — — $62,821.73 $166,785.69 $81,526.90 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 31 15 — — $50,154.07 $135,828.48 $79,394.69 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 28 15 — — $63,149.41 $161,473.04 $75,955.95 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 28 15 — — $59,351.39 $151,761.50 $74,919.49 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 28 15 — — $57,805.86 $147,809.58 $69,813.41 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 28 15 — — $54,106.74 $138,350.93 $68,935.92 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 30 15 — — $19,075.71 $162,482.47 $66,721.39 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 28 15 — — $52,458.86 $134,137.31 $66,222.42 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 28 15 — — $51,900.68 $132,710.04 $64,560.41 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 28 15 — — $50,743.90 $129,752.15 $63,201.97 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 28 15 — — $48,180.92 $126,992.96 $62,526.79 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 29 15 — — $54,969.39 $150,780.66 $61,916.19 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 28 15 — — $51,060.40 $130,561.44 $61,864.58 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 28 15 — — $48,676.31 $124,465.32 $60,976.96 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 28 15 — — $49,662.80 $126,987.78 $60,943.06 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 30 15 — — $47,073.23 $148,335.18 $60,911.98 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 28 15 — — $48,509.46 $124,038.69 $60,258.08 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 28 15 — — $46,989.74 $120,152.77 $60,094.08 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 28 15 — — $47,297.64 $120,940.07 $57,835.68 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 28 15 — — $43,613.14 $113,514.09 $56,598.96 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 28 15 — — $42,779.74 $109,387.80 $54,547.95 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 28 15 — — $41,340.86 $105,708.58 $52,780.55 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 29 15 — — $37,701.94 $96,403.86 $52,675.57 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 29 15 — — $40,837.43 $127,370.43 $52,303.07 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 30 15 — — $41,746.52 $126,143.30 $51,799.17 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 28 15 — — $41,894.74 $107,124.85 $51,521.01 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 28 15 — — $40,891.91 $104,560.61 $51,457.25 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 19 15 — — $50,542.65 $129,237.56 $50,542.65 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 34 15 — — $5,915.78 $123,678.02 $49,577.62 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 28 15 — — $39,843.49 $101,879.80 $49,069.37 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 28 15 — — $37,933.30 $96,995.45 $46,084.21 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 28 15 — — $37,178.17 $95,064.58 $45,584.58 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 28 15 — — $34,952.33 $91,038.09 $45,359.39 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 29 15 — — $32,126.17 $82,146.62 $44,877.10 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 28 15 — — $34,700.33 $88,728.74 $43,401.20 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 28 15 — — $35,104.56 $89,762.36 $42,793.07 2026-04-01
245 MS_DRG Aicd Generator Procedures 29 15 — — $37,770.33 $104,067.98 $42,734.21 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 29 15 — — $13,014.23 $103,722.71 $42,592.43 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 28 15 — — $32,274.10 $83,757.91 $41,883.71 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 28 15 — — $32,202.71 $82,844.73 $41,791.07 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 28 15 — — $35,725.52 $91,350.15 $41,729.60 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 28 15 — — $33,602.89 $85,922.59 $40,610.09 2026-04-01
265 MS_DRG Aicd Lead Procedures 28 15 — — $32,578.56 $83,303.38 $39,964.00 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 28 15 — — $33,331.97 $85,229.85 $39,752.62 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 28 15 — — $32,643.07 $83,468.33 $39,699.21 2026-04-01
332 MS_DRG Rectal Resection With Mcc 28 15 — — $32,600.06 $83,358.35 $39,344.65 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 28 15 — — $30,762.97 $78,660.91 $38,769.21 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 31 15 — — $31,070.41 $92,150.67 $37,840.52 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 28 15 — — $32,667.15 $83,529.90 $37,491.14 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 28 15 — — $28,787.41 $74,283.15 $37,358.86 2026-04-01
665 MS_DRG Prostatectomy With Mcc 28 15 — — $28,304.06 $72,373.48 $36,731.59 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 30 15 — — $31,218.61 $88,856.29 $36,487.72 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 28 15 — — $29,160.68 $74,563.86 $35,691.26 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 29 15 — — $29,870.23 $76,378.18 $35,075.18 2026-04-01
652 MS_DRG Kidney Transplant 28 15 — — $29,235.51 $74,755.20 $35,031.96 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 28 15 — — $28,637.76 $73,226.75 $34,797.62 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 29 15 — — $32,592.18 $84,510.72 $34,703.27 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 28 15 — — $28,200.85 $72,109.57 $34,406.73 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 30 15 — — $10,324.01 $79,705.53 $32,730.08 2026-04-01
800 MS_DRG Splenic Procedures With Cc 28 15 — — $25,622.39 $65,516.45 $32,125.01 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 28 15 — — $25,535.53 $65,294.35 $31,491.71 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 28 15 — — $26,293.24 $67,231.81 $31,277.45 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 28 15 — — $24,337.46 $62,230.89 $31,129.98 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 20 15 — — $13,674.22 $79,353.66 $31,033.89 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 30 15 — — $26,257.09 $74,774.99 $30,705.41 2026-04-01
849 MS_DRG Radiotherapy 28 15 — — $24,763.19 $63,319.48 $30,118.47 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 29 15 — — $20,312.29 $72,833.10 $29,908.00 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 29 15 — — $15,424.80 $71,060.56 $29,180.13 2026-04-01
263 MS_DRG Vein Ligation And Stripping 29 15 — — $19,080.17 $70,970.40 $29,143.11 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 28 15 — — $23,756.92 $60,746.44 $28,838.40 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 29 15 — — $24,445.13 $70,150.12 $28,806.27 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 33 15 — — $20,399.91 $70,077.55 $28,776.47 2026-04-01
5213 OTHER Level 3 Electrophysiologic Procedures 44 13 — — $14,186.99 $69,652.40 $41,919.69 2025-01-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 17 9 — — $63,342.28 $170,175.37 $98,288.22 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 19 9 — — $27,818.04 $128,693.07 $78,398.73 2026-04-01
J9226 HCPCS Supprelin La Implant 17 9 — — $45,020.65 $126,141.59 $69,858.54 2026-04-01
69930 HCPCS Implant Cochlear Device 16 9 — — $15,624.00 $111,933.97 $49,392.74 2026-04-01
61886 HCPCS Implant Neurostim Arrays 16 9 — — $6,350.00 $104,755.92 $46,225.29 2026-04-01
J9266 HCPCS Pegaspargase Injection 17 9 — — $28,424.06 $76,364.08 $43,929.38 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 14 8 — — $56,824.55 $195,784.65 $87,998.49 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 15 8 — — $55,272.32 $159,077.71 $85,525.65 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 15 8 — — $3,958.00 $149,529.27 $50,273.00 2026-04-01
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 15 8 — — $14,014.53 $149,529.27 $45,569.35 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 16 8 — — $24,228.42 $83,477.18 $38,301.50 2026-04-01
20696 HCPCS Comp Multiplane Ext Fixation 14 8 — — $10,499.00 $92,114.75 $34,023.48 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 15 8 — — $4,830.00 $104,755.92 $31,924.58 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 15 8 — — $4,830.00 $104,755.92 $31,924.58 2026-04-01
64590 HCPCS Insrt/redo Pn/gastr Stimul 15 8 — — $4,830.00 $65,859.63 $29,542.39 2026-04-01
63655 HCPCS Implant Neuroelectrodes 14 8 — — $19,115.10 $65,859.63 $29,061.66 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 13 7 — — $39,039.81 $186,452.72 $154,406.17 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 13 7 — — $13,471.00 $213,537.11 $92,668.15 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 13 7 — — $10,817.74 $149,529.27 $64,890.83 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 15 7 — — $27,906.24 $84,251.00 $63,737.37 2026-04-01
5232 OTHER Level 2 Icd And Similar Procedures 24 7 — — $16,150.00 $96,690.33 $56,420.17 2025-01-01
5166 OTHER Cochlear Implant Procedure 22 7 — — $9,738.04 $98,557.84 $54,147.94 2025-01-01
0686T HCPCS Histotripsy Mal Hepatcel Tis 11 7 — — $14,014.53 $116,300.91 $52,168.63 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 13 7 — — $10,817.74 $106,559.12 $47,990.55 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 13 7 — — $18,353.44 $106,559.12 $47,990.55 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 13 7 — — $18,353.44 $106,559.12 $47,990.55 2026-04-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 13 7 — — $23,576.00 $106,559.12 $47,990.55 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 13 7 — — $18,353.44 $106,559.12 $47,990.55 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 13 7 — — $10,817.74 $106,559.12 $47,990.55 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 13 7 — — $10,817.74 $106,559.12 $47,990.55 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 13 7 — — $8,386.90 $104,755.92 $45,460.65 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 13 7 — — $10,817.74 $104,755.92 $45,460.65 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 13 7 — — $10,817.74 $104,755.92 $45,460.65 2026-04-01
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 13 7 — — $10,817.74 $104,755.92 $45,460.65 2026-04-01
0909T HCPCS Rplcmt Int Nstim Sys Vgs Nrv 13 7 — — $3,086.00 $104,755.92 $45,460.65 2026-04-01
0908T HCPCS Opn Imp Int Nstm Sys Vgs Nrv 13 7 — — $3,086.00 $104,755.92 $45,460.65 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 13 7 — — $23,576.00 $97,374.44 $43,854.09 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 13 7 — — $23,576.00 $91,379.64 $41,154.24 2026-04-01
22558 HCPCS Lumbar Spine Fusion 13 7 — — $11,376.86 $92,114.75 $39,974.80 2026-04-01
22633 HCPCS Lumbar Spine Fusion Combined 13 7 — — $11,376.86 $92,114.75 $39,974.80 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 13 7 — — $18,353.44 $88,732.97 $38,507.22 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 13 7 — — $18,353.44 $88,732.97 $38,507.22 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 13 7 — — $18,353.44 $88,732.97 $38,507.22 2026-04-01
C2616 HCPCS Brachytx, Non-str,yttrium-90 11 7 — — $17,771.01 $61,228.66 $36,309.70 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 13 7 — — $10,817.74 $75,512.64 $34,008.29 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 13 7 — — $18,353.44 $75,512.64 $34,008.29 2026-04-01
0916T HCPCS Insj Perm Ccm-d Sys Pg Only 13 7 — — $10,817.74 $75,512.64 $34,008.29 2026-04-01
0515T HCPCS Insj Wcs Lv Compl Sys 13 7 — — $14,014.53 $75,512.64 $34,008.29 2026-04-01
0409T HCPCS Insj/rplc Car Modulj Pls Gn 13 7 — — $18,353.44 $75,512.64 $34,008.29 2026-04-01
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 13 7 — — $18,353.44 $75,512.64 $34,008.29 2026-04-01
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 13 7 — — $11,376.86 $75,512.64 $34,008.29 2026-04-01
0923T HCPCS Rmvl&rplcmt Perm Ccm-d Pg 13 7 — — $10,817.74 $75,512.64 $34,008.29 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 13 7 — — $10,817.74 $75,512.64 $34,008.29 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 13 7 — — $10,817.74 $75,512.64 $34,008.29 2026-04-01
54411 HCPCS Remov/replc Penis Pros Comp 11 7 — — $17,331.79 $70,361.18 $31,561.63 2026-04-01
54417 HCPCS Remv/replc Penis Pros Compl 13 7 — — $5,437.00 $70,361.18 $30,534.46 2026-04-01
33274 HCPCS Tcat Insj/rpl Perm Ldls Pm 13 7 — — $14,014.53 $65,389.72 $29,449.27 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 9 6 — — $2,332,000.00 $4,897,200.00 $3,486,810.33 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 10 6 — — $770,620.00 $2,070,347.69 $1,193,382.13 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 12 6 — — $591,726.20 $1,589,731.61 $901,051.07 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 12 6 — — $565,868.94 $1,520,263.51 $861,676.94 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 12 6 — — $562,538.19 $1,511,315.09 $856,605.02 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 12 6 — — $557,317.93 $1,497,290.36 $848,655.89 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 12 6 — — $533,230.17 $1,432,576.18 $811,976.24 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 12 6 — — $489,304.61 $1,314,565.76 $745,088.59 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 7 6 — — $110,901.76 $297,948.67 $172,086.26 2026-04-01
L8702 HCPCS Pow Ue Rom Dev Ewhf Uprt Cus 7 6 — — $68,801.71 $184,842.67 $106,759.61 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 11 6 — — $39,335.58 $105,640.55 $87,483.59 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 13 6 — — $36,200.67 $96,906.43 $80,250.65 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 7 6 — — $49,338.18 $132,551.95 $76,558.05 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 7 6 — — $47,919.99 $128,741.85 $74,357.45 2026-04-01
L8701 HCPCS Pow Ue Rom Dev Ewh Uprt Cust 7 6 — — $34,970.13 $93,950.75 $54,263.15 2026-04-01
L5856 HCPCS Elec Knee-shin Swing/stance 7 6 — — $29,559.78 $79,415.30 $45,867.91 2026-04-01
L6700 HCPCS Ue Add Ext Power Myoel 7 6 — — $29,510.19 $79,282.08 $45,790.96 2026-04-01
L6880 HCPCS Elec Hand Ind Art Digits 7 6 — — $29,420.21 $79,040.34 $45,651.34 2026-04-01
Q0483 HCPCS Monitor Elec Vad, Rep 7 6 — — $23,087.32 $62,026.39 $35,824.59 2026-04-01
L5858 HCPCS Stance Phase Only 7 6 — — $22,885.05 $61,482.98 $35,510.73 2026-04-01
L6975 HCPCS Interscap-thor Myoelectronic 7 6 — — $21,834.21 $58,659.79 $33,880.14 2026-04-01
L5973 HCPCS Ank-foot Sys Dors-plant Flex 7 6 — — $21,739.52 $58,405.39 $33,733.21 2026-04-01
Q0489 HCPCS Pwr Pck Base Combo Vad, Rep 7 6 — — $20,015.46 $53,773.53 $31,057.99 2026-04-01
5464 OTHER Level 4 Neurostimulator And Related Procedures 20 6 — — $12,889.72 $49,193.63 $31,041.67 2025-01-01
L6970 HCPCS Interscapular-thor Switch CT 7 6 — — $19,809.02 $53,218.91 $30,737.66 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 5 5 — — $2,455,110.60 $3,809,595.13 $3,670,885.51 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 7 5 — — $2,945,740.00 $4,570,904.76 $3,620,960.00 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 9 5 — — $98,142.30 $161,102.52 $141,823.20 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 9 5 — — $90,869.37 $149,163.86 $131,313.25 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 9 5 — — $85,012.82 $139,550.22 $122,850.09 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 9 5 — — $82,046.74 $134,681.34 $118,563.87 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 9 5 — — $66,893.30 $109,806.67 $96,665.98 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 9 5 — — $64,829.60 $106,419.07 $93,683.78 2026-04-01
9312 OTHER Inj., Ravulizumab-cwvz 10 Mg 12 5 — — $68,650.73 $97,891.72 $83,271.23 2025-01-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 9 5 — — $38,579.62 $63,329.20 $55,750.53 2026-04-01
9236 OTHER Eculizumab Injection 14 5 — — $37,198.60 $67,012.80 $52,105.70 2025-01-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 9 5 — — $34,051.02 $55,895.42 $49,206.35 2026-04-01
341 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Mcc 9 5 — — $28,955.86 $47,531.62 $41,843.46 2026-04-01
249 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc 9 5 — — $23,286.46 $38,225.18 $33,650.73 2026-04-01
9378 OTHER Daratumumab, Hyaluronidase 14 5 — — $10,028.03 $56,237.83 $33,132.93 2025-01-01
509 MS_DRG Arthroscopy 9 5 — — $22,514.82 $36,958.52 $32,535.65 2026-04-01
339 MS_DRG Appendectomy With Complicated Principal Diagnosis With Cc 9 5 — — $20,872.83 $34,263.16 $30,162.85 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 5 4 — — $3,316,462.59 $4,958,780.45 $4,052,573.44 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 5 4 — — $3,248,445.72 $4,857,081.50 $3,895,460.00 2026-04-01
5224 OTHER Level 4 Pacemaker And Similar Procedures 8 4 — — $14,519.56 $53,861.89 $34,190.72 2025-01-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 4 3 — — $3,685,266.67 $4,526,200.00 $4,197,865.00 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 5 3 — — $88,813.56 $187,316.25 $134,648.12 2026-04-01
J7310 HCPCS Ganciclovir Long Act Implant 5 3 — — $5,007.82 $47,318.40 $32,730.24 2026-04-01
9284 OTHER Ipilimumab Injection 6 2 — — $74,578.79 $83,009.74 $78,794.26 2025-01-01
9067 OTHER Lutetium Lu 177 Dotatat Ther 4 2 — — $60,137.54 $62,835.54 $61,486.54 2025-01-01
5231 OTHER Level 1 Icd And Similar Procedures 4 2 — — $41,614.01 $69,276.34 $55,445.18 2025-01-01
J1414 HCPCS Inj, Beqvez, Per Tx Dose 2 1 — — $4,526,200.00 $4,526,200.00 $4,526,200.00 2026-04-01
90288 HCPCS Botulism Ig IV 1 1 — — $135,886.95 $135,886.95 $135,886.95 2026-04-01
9374 OTHER Mitomycin Instillation 2 1 — — $70,362.44 $70,362.44 $70,362.44 2025-01-01
A9699 HCPCS Radiopharm Rx Agent Noc 2 1 — — $55,169.68 $55,169.68 $55,169.68 2026-04-01
9250 OTHER Inj Epcoritamab-bysp 0.16 Mg 2 1 — — $48,366.54 $48,366.54 $48,366.54 2025-01-01
5463 OTHER Level 3 Neurostimulator And Related Procedures 2 1 — — $38,810.76 $38,810.76 $38,810.76 2025-01-01
5094 OTHER Level 4 Breast/Lymphatic Surgery And Related Procedures 4 1 — — $25,067.68 $51,790.76 $38,429.22 2025-01-01
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