Price Transparencybeta Hospital negotiated rates

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

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Hospital

SOUTHWEST GENERAL HEALTH CENTER

Middleburg Heights, OH · CCN 360155 · Rates published

23,993 distinct procedures filed
40 distinct payers
779,461 rate rows
2026-07-01 last MRF observed
Data quality

407,282 of 779,461 rate rows are consumer-grade (52.3%)

372,179 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 307,866
professional (physician) fee — not the facility price 36,986
per-diem day rate — not a per-procedure price 26,628
placeholder amount (≤ $0.02) — excluded from medians 317
exceeds 10× this hospital's gross charge — excluded from medians 265
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 112
percent-of-charges filed in the dollar field — excluded from medians 5
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://southwestgeneral.pt.panaceainc.com/MRFDownload/southwestgeneral/southwestgeneral
Found on page https://www.swgeneral.com/financial-tools/price-transparency/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-08-17
Content fingerprint ca4619b9f888bcff… · 451,826,550 bytes · first seen 2026-07-31

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 12 $1,579,347.00 $4,958,415.00 $3,672,900.00 nat. median
$3,710,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 12 $1,550,150.00 $4,866,750.00 $3,605,000.00 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 12 $1,429,945.55 $4,489,363.93 $3,325,454.76 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 12 $1,412,980.00 $4,436,100.00 $3,286,000.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 12 $1,276,240.00 $4,006,800.00 $2,968,000.00 nat. median
$2,997,086
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 14 $1,027,104.12 $4,967,207.52 $2,388,614.23 nat. median
$2,460,273
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 14 $1,002,760.00 $4,477,440.00 $2,332,000.00 nat. median
$2,405,851
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 1 $1,479,590.40 $1,479,590.40 $1,479,590.40 nat. median
$809,151
1.8× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 1 $534,240.00 $534,240.00 $534,240.00 nat. median
$302,242
1.8× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 14 $227,552.93 $1,179,227.14 $529,192.86 nat. median
$691,418
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 14 $226,663.07 $1,129,910.02 $527,123.43 nat. median
$631,793
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 14 $226,432.66 $1,074,779.67 $526,587.59 nat. median
$610,161
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 14 $222,192.21 $1,079,540.79 $516,726.08 nat. median
$624,417
0.8× median
J3403
HCPCS 		Revakinagene, Per Implant 1 $503,488.84 $503,488.84 $503,488.84 nat. median
$265,000
1.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 14 $210,466.06 $1,021,150.29 $489,455.96 nat. median
$588,565
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 14 $198,028.07 $939,437.95 $460,530.40 nat. median
$577,541
0.8× median
90288
HCPCS 		Botulism Ig IV 1 $420,747.88 $420,747.88 $420,747.88 nat. median
$52,716
outlier · 8.0×
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 1 $389,210.07 $389,210.07 $389,210.07 nat. median
$209,736
1.9× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 1 $333,814.30 $333,814.30 $333,814.30 nat. median
$111,503
outlier · 3.0×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 27 $108,221.06 $615,484.45 $292,489.36 nat. median
$370,165
0.8× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 1 $286,193.90 $286,193.90 $286,193.90 nat. median
$97,404
outlier · 2.9×
J3404
HCPCS 		Inj Zopapogene Per Ther Dose 1 $234,048.00 $234,048.00 $234,048.00 nat. median
$121,900
1.9× median
L8702
HCPCS 		Ewhf S/d Uprt Micro Sensor 1 $207,093.15 $207,093.15 $207,093.15 nat. median
$70,178
outlier · 3.0×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 27 $70,232.48 $399,424.65 $189,817.50 nat. median
$261,939
0.7× median
L7181
HCPCS 		Electronic Elbo Simultaneous 1 $148,507.92 $148,507.92 $148,507.92 nat. median
$50,449
outlier · 2.9×
J7310
HCPCS 		Ganciclovir Long Act Implant 1 $146,512.35 $146,512.35 $146,512.35 nat. median
$18,387
outlier · 8.0×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 27 $53,508.77 $304,308.68 $144,618.29 nat. median
$205,166
0.7× median
L7180
HCPCS 		Electronic Elbow Sequential 1 $144,239.17 $144,239.17 $144,239.17 nat. median
$46,980
outlier · 3.1×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 27 $53,194.76 $302,522.78 $143,769.63 nat. median
$199,832
0.7× median
J9183
HCPCS 		Gemcitabine Intravesical Sys 1 $140,329.46 $140,329.46 $140,329.46 nat. median
$75,281
1.9× median
L2006
HCPCS 		Kaf Sng/dbl Swg/stn Mcpr Cus 1 $119,009.05 $119,009.05 $119,009.05 nat. median
$39,921
outlier · 3.0×
L8701
HCPCS 		Ewh S/d Uprt Micro Sensor 1 $105,260.09 $105,260.09 $105,260.09 nat. median
$35,670
outlier · 3.0×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 27 $34,715.83 $197,424.00 $93,826.58 nat. median
$132,706
0.7× median
L5856
HCPCS 		Elec Knee-shin Swing/stance 1 $88,974.94 $88,974.94 $88,974.94 nat. median
$30,017
outlier · 3.0×
L6700
HCPCS 		Ue Add Ext Power Myoel 1 $88,825.67 $88,825.67 $88,825.67 nat. median
$30,378
outlier · 2.9×
L6880
HCPCS 		Elec Hand Ind Art Digits 1 $88,554.83 $88,554.83 $88,554.83 nat. median
$30,016
outlier · 3.0×
7
MS_DRG 		Lung Transplant 27 $32,457.40 $184,579.20 $87,722.71 nat. median
$122,690
0.7× median
E2510NU
OTHER 		Sgd W Multi Methods Msg/accs 1 $81,692.39 $81,692.39 $81,692.39 nat. median
$9,457
outlier · 8.6×
S2095
HCPCS 		Transcath Emboliz Microspher 1 $81,512.03 $81,512.03 $81,512.03 nat. median
$3,399
outlier · 24.0×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 27 $30,121.04 $171,291.13 $81,408.21 nat. median
$114,305
0.7× median
64654
HCPCS 		1st Opn Implt Bat Modulj Sys 1 $80,009.02 $80,009.02 $80,009.02 nat. median
$44,598
1.8× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 27 $28,401.65 $161,512.15 $76,761.22 nat. median
$108,240
0.7× median
209
MS_DRG 		Complex Aortic Arch Procedures 17 $28,369.07 $122,677.07 $76,673.17 nat. median
$96,134
0.8× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 17 $27,623.28 $119,452.03 $74,657.52 nat. median
$96,835
0.8× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 27 $27,254.64 $154,988.55 $73,661.20 nat. median
$100,978
0.7× median
L8614
HCPCS 		Cochlear Device 1 $72,570.53 $72,570.53 $72,570.53 nat. median
$22,570
outlier · 3.2×
J9216
HCPCS 		Interferon Gamma 1-b Inj 1 $71,743.89 $71,743.89 $71,743.89 nat. median
$9,498
outlier · 7.6×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 27 $25,842.25 $146,955.56 $69,843.92 nat. median
$99,646
0.7× median
Q0483
HCPCS 		Monitor Elec Vad, Rep 1 $69,492.83 $69,492.83 $69,492.83 nat. median
$23,335
outlier · 3.0×
L5858
HCPCS 		Stance Phase Only 1 $68,884.00 $68,884.00 $68,884.00 nat. median
$23,235
outlier · 3.0×

Other procedures at this hospital

Browse this hospital's 23,993 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
             
0266T OTHER Implt/rpl Crtd Sns Dev Total 17 13 — — $17,938.42 $70,919.35 $41,717.26 2026-07-01
0268T OTHER Implt/rpl Crtd Sns Dev Gen 17 13 — — $12,147.60 $48,025.40 $28,250.24 2026-07-01
0408T OTHER Insj/rplc Cardiac Modulj Sys 18 14 — — $12,780.62 $57,016.87 $29,722.37 2026-07-01
0571T OTHER Insj/rplcmt Icds Ss Eltrd 18 14 — — $12,780.62 $57,016.87 $29,722.37 2026-07-01
0620T OTHER Evasc Ven Artlz Tibl/prnl Vn 18 14 — — $13,952.15 $80,009.02 $32,446.86 2026-07-01
0656T OTHER Ant Lmbr Vrt Bdy Teth <7 Seg 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
0657T OTHER Ant Lmbr Vrt Bdy Teth 8+ Seg 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
0674T OTHER Laps Insj Nw/rpcmt Prm Isdss 18 14 — — $12,147.60 $56,052.02 $28,250.24 2026-07-01
0790T OTHER Revj Rplcmt/rmvl Vrt Tethrg 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
0870T OTHER Imp Subq Prtl Ascts Pmp Sys 1 1 — — $62,229.43 $62,229.43 $62,229.43 2026-07-01
0871T OTHER Rplcmt Subq Prtl Ascites Pmp 1 1 — — $48,894.74 $48,894.74 $48,894.74 2026-07-01
0908T OTHER Opn Imp Int Nstm Sys Vgs Nrv 1 1 — — $56,052.02 $56,052.02 $56,052.02 2026-07-01
0909T OTHER Rplcmt Int Nstim Sys Vgs Nrv 1 1 — — $56,052.02 $56,052.02 $56,052.02 2026-07-01
0915T OTHER Insj Perm Ccm-d Sys Pg&eltrd 18 14 — — $12,780.62 $57,016.87 $29,722.37 2026-07-01
0956T OTHER Prt Crn Ch Cr&tun Elt S-sclp 1 1 — — $49,288.08 $49,288.08 $49,288.08 2026-07-01
0960T OTHER Rpl S-sclp Eltr Ra Rcvr&tlmt 1 1 — — $49,288.08 $49,288.08 $49,288.08 2026-07-01
0981T OTHER Tcat Impl Wrls Ivc Snr 1 1 — — $33,298.83 $33,298.83 $33,298.83 2026-07-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 33 27 — — $70,232.48 $399,424.65 $189,817.50 2026-07-01
10 MS_DRG Pancreas Transplant 33 27 — — $17,986.36 $102,275.25 $48,611.79 2026-07-01
1013T OTHER Lap Srg Imp/rpl Eso Nea&pg/r 1 1 — — $50,735.13 $50,735.13 $50,735.13 2026-07-01
1014T OTHER Lap Rv/rmv Eso Sph Nstm Eltr 1 1 — — $29,140.35 $29,140.35 $29,140.35 2026-07-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 33 27 — — $13,671.99 $77,737.29 $36,951.32 2026-07-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 33 27 — — $10,569.28 $60,090.65 $28,565.62 2026-07-01
14 MS_DRG Allogeneic Bone Marrow Transplant 33 27 — — $30,121.04 $171,291.13 $81,408.21 2026-07-01
140 MS_DRG Major Head And Neck Procedures With Mcc 33 27 — — $10,692.83 $60,793.32 $28,899.53 2026-07-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 33 27 — — $9,392.95 $53,400.29 $25,386.35 2026-07-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 33 27 — — $14,863.85 $84,516.01 $40,172.58 2026-07-01
163 MS_DRG Major Chest Procedures With Mcc 33 27 — — $11,235.38 $63,879.10 $30,365.89 2026-07-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 33 27 — — $9,370.65 $53,273.44 $25,326.07 2026-07-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 33 27 — — $13,617.36 $77,426.57 $36,803.67 2026-07-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 33 27 — — $108,221.06 $615,484.45 $292,489.36 2026-07-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 33 27 — — $17,883.36 $101,689.45 $48,333.41 2026-07-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 33 27 — — $28,401.65 $161,512.15 $76,761.22 2026-07-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 33 27 — — $19,723.29 $112,154.01 $53,306.18 2026-07-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 33 27 — — $16,129.40 $91,713.78 $43,592.96 2026-07-01
20802 HCPCS Replantation Arm Complete 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
20805 HCPCS Replant Forearm Complete 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
20808 HCPCS Replantation Hand Complete 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
20838 HCPCS Replantation Foot Complete 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
209 MS_DRG Complex Aortic Arch Procedures 18 17 — — $28,369.07 $122,677.07 $76,673.17 2026-07-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 33 27 — — $13,270.27 $75,452.53 $35,865.60 2026-07-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 33 27 — — $27,254.64 $154,988.55 $73,661.20 2026-07-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 18 17 — — $14,305.51 $61,861.66 $38,663.54 2026-07-01
215 MS_DRG Other Heart Assist System Implant 33 27 — — $24,956.37 $141,917.12 $67,449.65 2026-07-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 33 27 — — $24,519.82 $139,434.25 $66,269.78 2026-07-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 33 27 — — $16,481.74 $93,717.75 $44,545.25 2026-07-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 33 27 — — $16,481.74 $93,717.75 $44,545.25 2026-07-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 33 27 — — $19,245.89 $109,438.81 $52,015.92 2026-07-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 33 27 — — $13,368.01 $76,008.40 $36,129.75 2026-07-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 33 27 — — $12,634.75 $71,837.97 $34,147.96 2026-07-01
22556 HCPCS Arthrd Ant Ntrbd Min Dsc Thc 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
22586 HCPCS Arthrd Pre-sac Ntrbdy L5-s1 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 33 27 — — $12,402.19 $70,515.29 $33,519.42 2026-07-01
22800 HCPCS Arthrd Pst Dfrm<6 Vrt Sgm 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
22802 HCPCS Arthrd Pst Dfrm 7-12 Vrt Sgm 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
22804 HCPCS Arthrd Pst Dfrm 13+ Vrt Sgm 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
22808 HCPCS Arthrd Ant Dfrm 2-3 Vrt Sgm 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
22810 HCPCS Arthrd Ant Dfrm 4-7 Vrt Sgm 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
22812 HCPCS Arthrd Ant Dfrm 8+ Vrt Sgm 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
22818 HCPCS Kyphectomy 1-2 Segments 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
22819 HCPCS Kyphectomy 3 Or More 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
22836 HCPCS Ant Thrc Vrt Body Tethrg <7 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
22837 HCPCS Ant Thrc Vrt Body Tethrg 8+ 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
22838 HCPCS Rev Rplc/rmv Thrc Vrt Tethrg 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
22861 HCPCS Rev Rplcm Arthrp 1ntrspc Crv 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 33 27 — — $14,364.15 $81,673.97 $38,822.03 2026-07-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 33 27 — — $21,129.42 $120,151.36 $57,106.53 2026-07-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 33 27 — — $15,196.90 $86,410.24 $41,072.71 2026-07-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 33 27 — — $19,162.94 $108,967.04 $51,791.73 2026-07-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 33 27 — — $13,693.54 $77,859.86 $37,009.57 2026-07-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 33 27 — — $14,710.73 $83,645.16 $39,758.74 2026-07-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 33 27 — — $10,501.11 $59,702.97 $28,381.39 2026-07-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 33 27 — — $12,337.78 $70,148.99 $33,345.35 2026-07-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 33 27 — — $9,807.19 $55,756.31 $26,505.93 2026-07-01
245 MS_DRG Aicd Generator Procedures 33 27 — — $11,437.37 $65,027.89 $30,911.80 2026-07-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 33 27 — — $11,398.02 $64,804.12 $30,805.46 2026-07-01
265 MS_DRG Aicd Lead Procedures 33 27 — — $9,071.18 $51,570.20 $24,516.69 2026-07-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 33 27 — — $15,361.80 $87,348.09 $41,518.38 2026-07-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 33 27 — — $11,934.56 $67,855.68 $32,255.57 2026-07-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 33 27 — — $17,240.07 $98,030.71 $46,594.78 2026-07-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 33 27 — — $10,587.32 $60,193.27 $28,614.38 2026-07-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 33 27 — — $13,226.42 $75,203.10 $35,747.07 2026-07-01
27280 HCPCS Arthr Si Jt Opn B1grf Instrm 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
27290 HCPCS Amputation Of Leg At Hip 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
27295 HCPCS Amputation Of Leg At Hip 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 33 27 — — $10,342.48 $58,800.75 $27,952.66 2026-07-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 33 27 — — $17,872.84 $101,629.59 $48,304.97 2026-07-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 33 27 — — $15,056.57 $85,612.07 $40,693.42 2026-07-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 33 27 — — $11,577.95 $65,827.48 $31,291.77 2026-07-01
27703 HCPCS Reconstruction Ankle Joint 1 1 — — $31,849.62 $31,849.62 $31,849.62 2026-07-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 33 27 — — $13,952.91 $79,335.05 $37,710.58 2026-07-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 33 27 — — $9,041.60 $51,402.02 $24,436.77 2026-07-01
28 MS_DRG Spinal Procedures With Mcc 33 27 — — $15,060.83 $85,636.30 $40,704.94 2026-07-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 33 27 — — $53,194.76 $302,522.78 $143,769.63 2026-07-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 33 27 — — $11,232.12 $63,860.57 $30,357.09 2026-07-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 18 17 — — $16,760.41 $72,477.46 $45,298.41 2026-07-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 33 27 — — $11,188.02 $63,609.71 $30,237.88 2026-07-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 33 27 — — $10,848.45 $61,678.43 $29,320.13 2026-07-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 33 27 — — $12,502.43 $71,085.41 $33,790.34 2026-07-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 33 27 — — $11,522.82 $65,513.91 $31,142.76 2026-07-01
332 MS_DRG Rectal Resection With Mcc 33 27 — — $9,077.44 $51,605.84 $24,533.63 2026-07-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 18 14 — — $12,780.62 $57,016.87 $29,722.37 2026-07-01
33249 HCPCS Insertion/repositioning Elect Lead Singl 55 28 $53,950.00 $40,462.50 25% off $6,593.00 $82,088.09 $29,134.00 2026-07-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 54 28 $58,938.00 $44,203.50 25% off $3,785.00 $82,088.09 $29,722.37 2026-07-01
33270 HCPCS Insrt/repl Sub Defib Sys 34 28 $85,439.00 $64,079.25 25% off $3,785.00 $85,439.00 $32,466.82 2026-07-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 18 14 — — $17,938.42 $80,009.02 $41,717.26 2026-07-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 18 14 — — $12,147.60 $56,052.02 $28,250.24 2026-07-01
33361 HCPCS Transcatheter Aortic Valve Replacement 18 18 $2,220.00 $1,665.00 25% off $2,175.74 $62,507.00 $33,753.78 2026-07-01
33362 HCPCS Tavr Open Fem Approach 18 18 $65,631.00 $49,223.25 25% off $2,374.79 $65,631.00 $35,440.74 2026-07-01
33363 HCPCS Tavr Open Axillary Appr 18 18 $68,914.00 $51,685.50 25% off $2,459.59 $68,914.00 $37,213.56 2026-07-01
33882 HCPCS Evsc Rp Ta Dplmt Mlt Sys 18 18 $63,391.00 $47,543.25 25% off $20,285.12 $63,391.00 $34,231.14 2026-07-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 33 27 — — $9,703.95 $55,169.09 $26,226.89 2026-07-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 33 27 — — $11,012.34 $62,610.58 $29,763.09 2026-07-01
35602 HCPCS Bpg Crtd-clat Crtd 18 18 $63,391.00 $47,543.25 25% off $20,285.12 $63,391.00 $34,231.14 2026-07-01
37182 HCPCS Insert Hepatic Shunt (tips) 1 1 — — $33,298.83 $33,298.83 $33,298.83 2026-07-01
37275 HCPCS Rvscevsc Fpvt Stath Sf 1 18 18 $55,123.00 $41,342.25 25% off $17,639.36 $55,123.00 $29,766.42 2026-07-01
37277 HCPCS Rvscevsc Fpvt Stath Cpx1 18 18 $63,391.00 $47,543.25 25% off $20,285.12 $63,391.00 $34,231.14 2026-07-01
38240 HCPCS Transplt Allo Hct/donor 18 14 — — $23,575.74 $114,257.87 $54,827.31 2026-07-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 33 27 — — $34,715.83 $197,424.00 $93,826.58 2026-07-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 33 27 — — $9,680.14 $55,033.68 $26,162.54 2026-07-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 18 17 — — $10,079.35 $43,586.38 $27,241.49 2026-07-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 33 27 — — $13,713.09 $77,971.04 $37,062.40 2026-07-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 33 27 — — $10,411.40 $59,192.71 $28,138.92 2026-07-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 17 — — $27,623.28 $119,452.03 $74,657.52 2026-07-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 17 — — $18,093.87 $78,243.76 $48,902.35 2026-07-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 17 — — $14,092.75 $60,941.62 $38,088.51 2026-07-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 18 17 — — $22,582.16 $97,652.59 $61,032.87 2026-07-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 18 17 — — $14,456.37 $62,514.05 $39,071.28 2026-07-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 18 17 — — $16,748.14 $72,424.37 $45,265.23 2026-07-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 18 17 — — $10,631.43 $45,973.74 $28,733.59 2026-07-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 18 17 — — $13,359.99 $57,772.93 $36,108.08 2026-07-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 33 27 — — $21,063.01 $119,773.66 $56,927.05 2026-07-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 33 27 — — $14,947.56 $84,992.06 $40,398.80 2026-07-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 33 27 — — $10,460.52 $59,472.07 $28,271.67 2026-07-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 33 27 — — $13,844.65 $78,719.32 $37,417.98 2026-07-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 33 27 — — $14,286.97 $81,234.97 $38,613.42 2026-07-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 33 27 — — $13,048.74 $74,192.57 $35,266.86 2026-07-01
471 MS_DRG Cervical Spinal Fusion With Mcc 33 27 — — $12,104.72 $68,823.46 $32,715.46 2026-07-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 33 27 — — $10,761.99 $61,186.70 $29,086.46 2026-07-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 33 27 — — $9,205.00 $52,331.31 $24,878.37 2026-07-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 33 27 — — $9,089.97 $51,677.10 $24,567.49 2026-07-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 33 27 — — $25,842.25 $146,955.56 $69,843.92 2026-07-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 33 27 — — $9,369.64 $53,267.74 $25,323.36 2026-07-01
5604568 CDM Tavr Medtronic Valve/kit 23 18 $65,000.00 $48,750.00 25% off $20,800.00 $65,000.00 $33,150.00 2026-07-01
5604569 CDM Tavr Edwards Valve/kit 23 18 $65,000.00 $48,750.00 25% off $20,800.00 $65,000.00 $33,150.00 2026-07-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 33 27 — — $16,421.85 $93,377.10 $44,383.38 2026-07-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 33 27 — — $12,286.41 $69,856.80 $33,206.50 2026-07-01
6 MS_DRG Liver Transplant Without Mcc 33 27 — — $11,624.32 $66,091.16 $31,417.07 2026-07-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 33 27 — — $9,343.33 $53,118.08 $25,252.24 2026-07-01
63685 HCPCS Incision/placement, Spinal Neurostimulat 35 28 $46,579.00 $34,934.25 25% off $1,244.00 $80,699.00 $28,250.24 2026-07-01
64654 HCPCS 1st Opn Implt Bat Modulj Sys 1 1 — — $80,009.02 $80,009.02 $80,009.02 2026-07-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 1 1 — — $56,052.02 $56,052.02 $56,052.02 2026-07-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 33 27 — — $11,785.70 $67,009.05 $31,853.25 2026-07-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 33 27 — — $9,290.70 $52,818.77 $25,110.01 2026-07-01
653 MS_DRG Major Bladder Procedures With Mcc 33 27 — — $13,026.19 $74,064.29 $35,205.91 2026-07-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 33 27 — — $10,533.19 $59,885.40 $28,468.08 2026-07-01
69930 HCPCS Implant Cochlear Device 18 14 — — $12,679.46 $59,892.80 $29,487.12 2026-07-01
7 MS_DRG Lung Transplant 33 27 — — $32,457.40 $184,579.20 $87,722.71 2026-07-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 33 27 — — $8,961.66 $50,947.35 $24,220.71 2026-07-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 33 27 — — $8,982.46 $51,065.65 $24,276.93 2026-07-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 26 23 — — $14,898.44 $84,118.36 $40,266.05 2026-07-01
791 MS_DRG Prematurity With Major Problems 21 18 — — $10,175.83 $57,447.03 $27,502.25 2026-07-01
793 MS_DRG Full Term Neonate With Major Problems 21 18 — — $10,453.00 $59,012.35 $28,251.35 2026-07-01
799 MS_DRG Splenic Procedures With Mcc 33 27 — — $11,353.41 $64,550.41 $30,684.90 2026-07-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 33 27 — — $14,049.14 $79,882.36 $37,970.66 2026-07-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 33 27 — — $9,988.13 $56,785.38 $26,994.95 2026-07-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 33 27 — — $14,701.21 $83,590.99 $39,733.01 2026-07-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 33 27 — — $11,493.50 $65,347.15 $31,063.51 2026-07-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 33 27 — — $11,726.56 $66,672.68 $31,693.41 2026-07-01
834 MS_DRG Acute Leukemia With Mcc 33 27 — — $13,761.70 $78,247.54 $37,193.79 2026-07-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 33 27 — — $12,043.57 $68,475.69 $32,550.20 2026-07-01
850 MS_DRG Acute Leukemia With Other Procedures 18 17 — — $21,704.80 $93,858.61 $58,661.63 2026-07-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 33 27 — — $12,380.13 $70,389.87 $33,459.82 2026-07-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 33 27 — — $11,403.03 $64,832.62 $30,819.01 2026-07-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 33 27 — — $17,325.02 $98,513.89 $46,824.38 2026-07-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 29 26 — — $9,689.41 $54,699.93 $26,187.60 2026-07-01
901 MS_DRG Wound Debridements For Injuries With Mcc 33 27 — — $10,520.66 $59,814.14 $28,434.22 2026-07-01
90288 HCPCS Botulism Ig IV 1 1 — — $420,747.88 $420,747.88 $420,747.88 2026-07-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 33 27 — — $9,208.76 $52,352.69 $24,888.53 2026-07-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 33 27 — — $9,625.26 $54,721.54 $26,014.21 2026-07-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 33 27 — — $53,508.77 $304,308.68 $144,618.29 2026-07-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 33 27 — — $17,978.84 $102,232.49 $48,591.47 2026-07-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 33 27 — — $9,762.84 $55,504.03 $26,386.05 2026-07-01
93654 HCPCS Eps W/3d Map Vt Ablation 34 28 $80,050.00 $60,037.50 25% off $6,593.00 $80,050.00 $30,160.39 2026-07-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 33 27 — — $9,096.99 $51,717.01 $24,586.45 2026-07-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 33 27 — — $16,872.18 $95,938.37 $45,600.49 2026-07-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 33 27 — — $9,434.05 $53,634.04 $25,497.43 2026-07-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 33 27 — — $19,099.54 $108,606.43 $51,620.37 2026-07-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 33 27 — — $10,564.01 $60,060.72 $28,551.39 2026-07-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 33 27 — — $15,344.01 $87,246.89 $41,470.29 2026-07-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 33 27 — — $9,055.14 $51,478.99 $24,473.35 2026-07-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 33 27 — — $11,761.65 $66,872.23 $31,788.23 2026-07-01
A0430 HCPCS Fixed Wing Air Transport 1 1 — — $31,249.88 $31,249.88 $31,249.88 2026-07-01
A0431 HCPCS Rotary Wing Air Transport 1 1 — — $36,332.72 $36,332.72 $36,332.72 2026-07-01
B9004NU OTHER Parenteral Infus Pump Portab 1 1 — — $31,624.63 $31,624.63 $31,624.63 2026-07-01
B9006NU OTHER Parenteral Infus Pump Statio 1 1 — — $31,624.63 $31,624.63 $31,624.63 2026-07-01
C2624 HCPCS Implantable Pap Sensor 23 18 $49,900.00 $37,425.00 25% off $15,968.00 $49,900.00 $25,449.00 2026-07-01
C8005 HCPCS Pef Bronch Ablt 3d Nav Ebus 1 1 — — $31,115.16 $31,115.16 $31,115.16 2026-07-01
C8007 HCPCS Opn Mplnt Hpgls Ns Ary Ps Gn 1 1 — — $56,052.02 $56,052.02 $56,052.02 2026-07-01
C8011 HCPCS Opn Mplnt Hpgls Ns Ary Rec 1 1 — — $56,052.02 $56,052.02 $56,052.02 2026-07-01
C9760 HCPCS Non-blind Interatrial Shunt 18 14 — — $10,962.45 $48,894.74 $25,494.06 2026-07-01
E0194RR OTHER Air Fluidized Bed 1 1 — — $35,929.56 $35,929.56 $35,929.56 2026-07-01
E0652NU OTHER Pneum Compres W/cal Pressure 1 1 — — $63,241.94 $63,241.94 $63,241.94 2026-07-01
E0652UE OTHER Pneum Compres W/cal Pressure 1 1 — — $47,431.55 $47,431.55 $47,431.55 2026-07-01
E0694NU OTHER Uvl Md Cabinet Sys 6 Ft 1 1 — — $53,437.79 $53,437.79 $53,437.79 2026-07-01
E0694UE OTHER Uvl Md Cabinet Sys 6 Ft 1 1 — — $40,078.63 $40,078.63 $40,078.63 2026-07-01
E0766 HCPCS Elec Stim Cancer Treatment 1 1 — — $49,318.04 $49,318.04 $49,318.04 2026-07-01
E1230NU OTHER Power Operated Vehicle 1 1 — — $26,736.36 $26,736.36 $26,736.36 2026-07-01
E2506NU OTHER Sgd Prerec Msg > 40 Min 1 1 — — $27,917.18 $27,917.18 $27,917.18 2026-07-01
E2508NU OTHER Sgd Spelling Phys Contact 1 1 — — $43,169.39 $43,169.39 $43,169.39 2026-07-01
E2508UE OTHER Sgd Spelling Phys Contact 1 1 — — $32,377.16 $32,377.16 $32,377.16 2026-07-01
E2510NU OTHER Sgd W Multi Methods Msg/accs 1 1 — — $81,692.39 $81,692.39 $81,692.39 2026-07-01
E2510UE OTHER Sgd W Multi Methods Msg/accs 1 1 — — $61,269.12 $61,269.12 $61,269.12 2026-07-01
E2513NU OTHER Sgd Accessory, EMG Sensor 1 1 — — $38,035.68 $38,035.68 $38,035.68 2026-07-01
E2513UE OTHER Sgd Accessory, EMG Sensor 1 1 — — $28,526.88 $28,526.88 $28,526.88 2026-07-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 16 12 — — $1,579,347.00 $4,958,415.00 $3,672,900.00 2026-07-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 16 12 — — $1,429,945.55 $4,489,363.93 $3,325,454.76 2026-07-01
J1414 HCPCS Inj, Beqvez, Per Tx Dose 16 12 — — $1,550,150.00 $4,866,750.00 $3,605,000.00 2026-07-01
J3392 HCPCS Inj, Exagamglogene Autotem 18 14 — — $1,002,760.00 $4,477,440.00 $2,332,000.00 2026-07-01
J3393 HCPCS Inj, Betibeglogene Autotemce 16 12 — — $1,276,240.00 $4,006,800.00 $2,968,000.00 2026-07-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 16 12 — — $1,412,980.00 $4,436,100.00 $3,286,000.00 2026-07-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 18 14 — — $1,027,104.12 $4,967,207.52 $2,388,614.23 2026-07-01
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 1 1 — — $389,210.07 $389,210.07 $389,210.07 2026-07-01
J3403 HCPCS Revakinagene, Per Implant 1 1 — — $503,488.84 $503,488.84 $503,488.84 2026-07-01
J3404 HCPCS Inj Zopapogene Per Ther Dose 1 1 — — $234,048.00 $234,048.00 $234,048.00 2026-07-01
J7310 HCPCS Ganciclovir Long Act Implant 1 1 — — $146,512.35 $146,512.35 $146,512.35 2026-07-01
J9029 HCPCS Instill Adstiladrin, Tx Dose 18 14 — — $27,242.55 $123,422.00 $63,354.77 2026-07-01
J9183 HCPCS Gemcitabine Intravesical Sys 1 1 — — $140,329.46 $140,329.46 $140,329.46 2026-07-01
J9216 HCPCS Interferon Gamma 1-b Inj 1 1 — — $71,743.89 $71,743.89 $71,743.89 2026-07-01
J9219 HCPCS Leuprolide Acetate Implant 1 1 — — $41,636.97 $41,636.97 $41,636.97 2026-07-01
J9226 HCPCS Supprelin La Implant 18 14 — — $19,500.59 $79,052.97 $45,350.22 2026-07-01
J9266 HCPCS Pegaspargase Injection 18 14 — — $11,640.33 $54,574.18 $27,070.53 2026-07-01
K0808NU OTHER Pov Group 2 Vhd 451-600 Lbs 1 1 — — $35,241.32 $35,241.32 $35,241.32 2026-07-01
K0808UE OTHER Pov Group 2 Vhd 451-600 Lbs 1 1 — — $26,430.96 $26,430.96 $26,430.96 2026-07-01
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 1 1 — — $286,193.90 $286,193.90 $286,193.90 2026-07-01
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 1 1 — — $119,009.05 $119,009.05 $119,009.05 2026-07-01
L5856 HCPCS Elec Knee-shin Swing/stance 1 1 — — $88,974.94 $88,974.94 $88,974.94 2026-07-01
L5857 HCPCS Elec Knee-shin Swing Only 1 1 — — $31,571.65 $31,571.65 $31,571.65 2026-07-01
L5858 HCPCS Stance Phase Only 1 1 — — $68,884.00 $68,884.00 $68,884.00 2026-07-01
L5859 HCPCS Knee-shin Pro Flex/ext Cont 1 1 — — $53,777.08 $53,777.08 $53,777.08 2026-07-01
L5973 HCPCS Ank-foot Sys Dors-plant Flex 1 1 — — $65,435.96 $65,435.96 $65,435.96 2026-07-01
L5987 HCPCS Shank Ft W Vert Load Pylon 1 1 — — $26,662.88 $26,662.88 $26,662.88 2026-07-01
L5991 HCPCS Low Pros Ext Osseo Connector 1 1 — — $35,382.67 $35,382.67 $35,382.67 2026-07-01
L6700 HCPCS Ue Add Ext Power Myoel 1 1 — — $88,825.67 $88,825.67 $88,825.67 2026-07-01
L6880 HCPCS Elec Hand Ind Art Digits 1 1 — — $88,554.83 $88,554.83 $88,554.83 2026-07-01
L6920 HCPCS Wrist Disarticul Switch Ctrl 1 1 — — $31,048.18 $31,048.18 $31,048.18 2026-07-01
L6925 HCPCS Wrist Disart Myoelectronic C 1 1 — — $33,169.81 $33,169.81 $33,169.81 2026-07-01
L6930 HCPCS Below Elbow Switch Control 1 1 — — $29,903.75 $29,903.75 $29,903.75 2026-07-01
L6935 HCPCS Below Elbow Myoelectronic CT 1 1 — — $33,013.92 $33,013.92 $33,013.92 2026-07-01
L6940 HCPCS Elbow Disarticulation Switch 1 1 — — $38,615.53 $38,615.53 $38,615.53 2026-07-01
L6945 HCPCS Elbow Disart Myoelectronic C 1 1 — — $43,080.63 $43,080.63 $43,080.63 2026-07-01
L6950 HCPCS Above Elbow Switch Control 1 1 — — $38,543.89 $38,543.89 $38,543.89 2026-07-01
L6955 HCPCS Above Elbow Myoelectronic CT 1 1 — — $44,698.80 $44,698.80 $44,698.80 2026-07-01
L6960 HCPCS Shldr Disartic Switch Contro 1 1 — — $47,021.44 $47,021.44 $47,021.44 2026-07-01
L6965 HCPCS Shldr Disartic Myoelectronic 1 1 — — $55,704.17 $55,704.17 $55,704.17 2026-07-01
L6970 HCPCS Interscapular-thor Switch CT 1 1 — — $59,625.15 $59,625.15 $59,625.15 2026-07-01
L6975 HCPCS Interscap-thor Myoelectronic 1 1 — — $65,720.97 $65,720.97 $65,720.97 2026-07-01
L7180 HCPCS Electronic Elbow Sequential 1 1 — — $144,239.17 $144,239.17 $144,239.17 2026-07-01
L7181 HCPCS Electronic Elbo Simultaneous 1 1 — — $148,507.92 $148,507.92 $148,507.92 2026-07-01
L7186 HCPCS Electron Elbow Child Switch 1 1 — — $39,404.24 $39,404.24 $39,404.24 2026-07-01
L7190 HCPCS Elbow Adolescent Myoelectron 1 1 — — $31,101.28 $31,101.28 $31,101.28 2026-07-01
L7191 HCPCS Elbow Child Myoelectronic CT 1 1 — — $41,447.01 $41,447.01 $41,447.01 2026-07-01
L8040KM OTHER Nasal Prosthesis 1 1 — — $24,561.90 $24,561.90 $24,561.90 2026-07-01
L8041KM OTHER Midfacial Prosthesis 1 1 — — $29,601.88 $29,601.88 $29,601.88 2026-07-01
L8042KM OTHER Orbital Prosthesis 1 1 — — $33,261.07 $33,261.07 $33,261.07 2026-07-01
L8043KM OTHER Upper Facial Prosthesis 1 1 — — $37,252.57 $37,252.57 $37,252.57 2026-07-01
L8044KM OTHER Hemi-facial Prosthesis 1 1 — — $41,243.41 $41,243.41 $41,243.41 2026-07-01
L8045KM OTHER Auricular Prosthesis 1 1 — — $32,296.46 $32,296.46 $32,296.46 2026-07-01
L8046KM OTHER Partial Facial Prosthesis 1 1 — — $26,608.91 $26,608.91 $26,608.91 2026-07-01
L8614 HCPCS Cochlear Device 1 1 — — $72,570.53 $72,570.53 $72,570.53 2026-07-01
L8619 HCPCS Coch Imp Ext Proc/contr Rplc 1 1 — — $31,153.68 $31,153.68 $31,153.68 2026-07-01
L8627 HCPCS Cid Ext Speech Process Repl 1 1 — — $26,442.58 $26,442.58 $26,442.58 2026-07-01
L8679 HCPCS Imp Neurosti Pls Gn Any Type 1 1 — — $31,758.63 $31,758.63 $31,758.63 2026-07-01
L8686 HCPCS Implt Nrostm Pls Gen Sng Non 1 1 — — $27,187.07 $27,187.07 $27,187.07 2026-07-01
L8687 HCPCS Implt Nrostm Pls Gen Dua Rec 1 1 — — $55,449.80 $55,449.80 $55,449.80 2026-07-01
L8701 HCPCS Ewh S/d Uprt Micro Sensor 1 1 — — $105,260.09 $105,260.09 $105,260.09 2026-07-01
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 1 1 — — $207,093.15 $207,093.15 $207,093.15 2026-07-01
Q0224 HCPCS Inj, Pemivibart, 4500 Mg 1 1 — — $50,887.63 $50,887.63 $50,887.63 2026-07-01
Q0479 HCPCS Power Module Combo Vad, Rep 1 1 — — $44,490.48 $44,490.48 $44,490.48 2026-07-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 1 1 — — $333,814.30 $333,814.30 $333,814.30 2026-07-01
Q0481 HCPCS Microprcsr Cu Elec Vad, Rep 1 1 — — $53,857.18 $53,857.18 $53,857.18 2026-07-01
Q0483 HCPCS Monitor Elec Vad, Rep 1 1 — — $69,492.83 $69,492.83 $69,492.83 2026-07-01
Q0489 HCPCS Pwr Pck Base Combo Vad, Rep 1 1 — — $60,246.53 $60,246.53 $60,246.53 2026-07-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 18 14 — — $210,466.06 $1,021,150.29 $489,455.96 2026-07-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 18 14 — — $227,552.93 $1,179,227.14 $529,192.86 2026-07-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 18 14 — — $23,656.55 $108,036.84 $55,015.23 2026-07-01
Q2053 HCPCS Brexucabtagene Car Pos T 18 14 — — $198,028.07 $939,437.95 $460,530.40 2026-07-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 18 14 — — $222,192.21 $1,079,540.79 $516,726.08 2026-07-01
Q2055 HCPCS Idecabtagene Vicleucel Car 18 14 — — $226,432.66 $1,074,779.67 $526,587.59 2026-07-01
Q2056 HCPCS Ciltacabtagene Car-pos T 18 14 — — $226,663.07 $1,129,910.02 $527,123.43 2026-07-01
Q2057 HCPCS Afamitresgene Autoleucel 1 1 — — $1,479,590.40 $1,479,590.40 $1,479,590.40 2026-07-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 1 1 — — $534,240.00 $534,240.00 $534,240.00 2026-07-01
S0317 HCPCS Disease Mgmt Per Diem 1 1 — — $38,348.69 $38,348.69 $38,348.69 2026-07-01
S2095 HCPCS Transcath Emboliz Microspher 1 1 — — $81,512.03 $81,512.03 $81,512.03 2026-07-01
S4015 HCPCS Complete Ivf Nos Case Rate 1 1 — — $42,573.56 $42,573.56 $42,573.56 2026-07-01
S4021 HCPCS Ivf Canc Aftr Aspr Case Rate 1 1 — — $46,741.42 $46,741.42 $46,741.42 2026-07-01
S4025 HCPCS Donor Serv Ivf Case Rate 1 1 — — $37,319.18 $37,319.18 $37,319.18 2026-07-01
T1023 HCPCS Program Intake Assessment 1 1 — — $27,999.68 $27,999.68 $27,999.68 2026-07-01
V5248 HCPCS Hearing Aid, Binaural, Cic 1 1 — — $27,931.05 $27,931.05 $27,931.05 2026-07-01
V5249 HCPCS Hearing Aid, Binaural, Itc 1 1 — — $25,240.63 $25,240.63 $25,240.63 2026-07-01
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