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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

INTEGRIS HEALTH PONCA CITY

Ponca City, OK · CCN 370006 · Rates published

15,550 distinct procedures filed
30 distinct payers
106,345 rate rows
2026-04-01 last MRF observed
Data quality

79,180 of 106,345 rate rows are consumer-grade (74.5%)

27,165 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 26,509
template filing: same amount across many unrelated codes — excluded 625
placeholder amount (≤ $0.02) — excluded from medians 31
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://hospitalpricedisclosure.com/Download.aspx?pxi=xO*_*y3fOOMLGcE*__*jd2jdm*_*A*-*&f=1Uqk9sV2mcxtBmvoqWiwog*-*
Found on page https://hospitalpricedisclosure.com/default.aspx?ci=fFJE38ye7xsB8Of*_*qxAfVQ*-*
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-16
Content fingerprint fa59003933082526… · 32,914,656 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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 4 $79.40 $4,640,150.00 $4,550,050.00 nat. median
$4,505,000
1.0× median
H2000
HCPCS 		Comp Multidisipln Evaluation 1 $4,165,959.00 $4,165,959.00 $4,165,959.00 nat. median
$173
outlier · 24108.6×
H2010
HCPCS 		Comprehensive Medication Services, Per 15 Minutes 1 $3,807,119.13 $3,807,119.13 $3,807,119.13 nat. median
$32
outlier · 118601.8×
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 4 $13.04 $3,795,824.67 $3,722,119.33 nat. median
$3,710,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 1 $3,408,903.61 $3,408,903.61 $3,408,903.61 nat. median
$3,710,000
0.9× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 4 $3,334.25 $3,415,956.47 $3,349,627.21 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 4 $89.91 $3,345,899.09 $3,280,930.17 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 4 $42.45 $4,864,551.99 $3,019,383.50 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 4 $38.88 $3,998,166.53 $2,516,488.37 nat. median
$2,469,189
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 4 $141.40 $3,847,800.00 $2,390,300.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 3 $770,620.00 $1,271,523.00 $793,738.60 nat. median
$824,563
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 4 $1,284.99 $954,972.35 $606,519.36 nat. median
$754,974
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 3 $565,868.94 $912,729.35 $582,845.01 nat. median
$675,122
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 3 $562,538.19 $852,129.78 $579,414.33 nat. median
$674,188
0.9× median
M1107
HCPCS 		Docu Dx Degen Neuro 1 $578,544.93 $578,544.93 $578,544.93 nat. median
$260
outlier · 2222.4×
Q2055
HCPCS 		Idecabtagene Vicleucel Car 3 $557,317.93 $870,577.06 $574,037.47 nat. median
$625,184
0.9× median
M1106
HCPCS 		Start Eoc Doc Med Rec 1 $552,546.94 $552,546.94 $552,546.94 nat. median
$260
outlier · 2122.5×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 3 $533,230.17 $829,687.20 $549,227.08 nat. median
$634,511
0.9× median
M1070
HCPCS 		Pt Not Scrn Fut Fall No Rsn 1 $540,429.11 $540,429.11 $540,429.11 nat. median
$260
outlier · 2075.9×
M1058
HCPCS 		Pt Prm Nurs Hm Res In Pp 1 $523,694.85 $523,694.85 $523,694.85 nat. median
$260
outlier · 2011.7×
M1069
HCPCS 		Pt Scr Ft Fall Rsk 1 $512,361.60 $512,361.60 $512,361.60 nat. median
$260
outlier · 1968.1×
Q2053
HCPCS 		Brexucabtagene Car Pos T 3 $489,304.61 $807,508.61 $503,983.75 nat. median
$620,080
0.8× median
C9301
HCPCS 		Obecabtagene Car Pos T 1 $459,112.50 $459,112.50 $459,112.50 nat. median
$459,112
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 8 $307,328.01 $1,018,662.39 $435,917.58 nat. median
$370,174
1.2× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 8 $199,769.58 $661,070.91 $290,697.53 nat. median
$265,286
1.1× median
J3403
HCPCS 		Revakinagene, Per Implant 4 $61.30 $265,225.00 $260,075.00 nat. median
$265,000
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 8 $151,530.09 $500,692.70 $209,646.91 nat. median
$202,986
1.0× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 4 $422.01 $211,809.20 $207,696.40 nat. median
$209,753
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 8 $152,419.14 $503,648.47 $205,839.98 nat. median
$206,368
1.0× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 8 $99,210.04 $326,748.15 $134,036.87 nat. median
$133,176
1.0× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 2 $490.71 $130,327.56 $130,327.56 nat. median
$76,377
1.7× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 8 $86,200.63 $283,496.73 $129,269.38 nat. median
$117,303
1.1× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 8 $81,332.48 $310,854.77 $125,159.64 nat. median
$108,660
1.2× median
209
MS_DRG 		Complex Aortic Arch Procedures 8 $81,240.24 $267,005.29 $124,048.39 nat. median
$98,017
1.3× median
7
MS_DRG 		Lung Transplant 8 $92,815.67 $305,489.26 $121,780.61 nat. median
$122,708
1.0× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 8 $78,084.91 $256,515.02 $118,515.06 nat. median
$102,358
1.2× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 $79,128.65 $259,985.04 $117,344.46 nat. median
$98,905
1.2× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 8 $74,085.95 $243,219.95 $113,817.69 nat. median
$100,136
1.1× median
215
MS_DRG 		Other Heart Assist System Implant 8 $71,577.72 $262,734.29 $109,975.06 nat. median
$99,019
1.1× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 $70,341.70 $230,771.75 $105,407.92 nat. median
$93,672
1.1× median
850
MS_DRG 		Acute Leukemia With Other Procedures 8 $62,371.44 $204,273.62 $95,644.01 nat. median
$83,442
1.1× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 8 $64,855.54 $212,532.32 $94,469.00 nat. median
$82,712
1.1× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 8 $60,554.31 $198,232.34 $92,815.57 nat. median
$81,118
1.1× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 8 $60,742.34 $198,857.46 $90,361.36 nat. median
$79,312
1.1× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 8 $56,761.11 $203,871.65 $86,911.11 nat. median
$77,576
1.1× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 $55,409.44 $181,127.56 $83,698.66 nat. median
$74,915
1.1× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 8 $55,174.58 $180,346.75 $81,863.51 nat. median
$73,807
1.1× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 8 $54,995.07 $179,749.94 $81,490.54 nat. median
$72,138
1.1× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 $52,147.68 $170,283.45 $78,347.35 nat. median
$68,090
1.2× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 8 $51,521.87 $168,202.86 $77,542.12 nat. median
$68,887
1.1× median

Other procedures at this hospital

Browse this hospital's 15,550 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
             
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 16 8 — — $17,522.14 $55,166.50 $25,488.90 2026-04-01
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 16 8 — — $17,327.72 $54,520.14 $25,527.29 2026-04-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 16 8 — — $18,377.84 $58,011.40 $25,544.28 2026-04-01
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 18 8 — — $17,255.34 $55,126.40 $25,649.53 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 16 8 — — $18,250.84 $57,589.14 $25,800.42 2026-04-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 16 8 — — $17,995.40 $56,739.92 $25,993.42 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 18 8 — — $17,858.41 $68,699.82 $26,177.93 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 17 8 — — $21,294.05 $67,706.70 $26,291.03 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 7 5 — — $80.30 $41,207.16 $26,406.19 2026-04-01
545 MS_DRG Connective Tissue Disorders With Mcc 16 8 — — $18,537.49 $58,542.16 $26,443.49 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 15 7 — — $21,416.09 $68,112.44 $26,448.58 2026-04-01
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 16 8 — — $18,059.26 $56,952.23 $26,459.52 2026-04-01
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 16 8 — — $18,115.31 $57,138.58 $26,546.10 2026-04-01
0956T HCPCS Prt Crn Ch Cr&tun Elt S-sclp 7 5 — — $2,756.39 $32,706.80 $26,618.62 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 16 8 — — $18,829.82 $59,514.05 $26,651.96 2026-04-01
0960T HCPCS Rpl S-sclp Eltr Ra Rcvr&tlmt 6 4 — — $9,523.00 $32,706.80 $26,749.10 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 16 8 — — $19,229.29 $60,842.14 $26,813.49 2026-04-01
570 MS_DRG Skin Debridement With Mcc 17 8 — — $21,797.12 $69,379.20 $26,940.48 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 16 8 — — $19,323.66 $61,155.88 $27,059.41 2026-04-01
4210F HCPCS Ace/arb Thxpy For Mos/> 1 1 — — $27,069.16 $27,069.16 $27,069.16 2026-04-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 16 8 — — $18,372.88 $57,994.88 $27,105.97 2026-04-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 16 8 — — $18,609.86 $58,782.77 $27,110.93 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 16 8 — — $19,043.39 $60,224.10 $27,346.75 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 16 8 — — $19,736.61 $62,528.79 $27,722.14 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 16 8 — — $18,837.63 $59,540.00 $27,877.42 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 16 8 — — $19,345.66 $61,229.01 $28,059.89 2026-04-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 16 8 — — $18,957.54 $69,585.62 $28,064.32 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 7 5 — — $6,741.00 $41,207.16 $28,138.52 2026-04-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/Mcc 16 8 — — $19,146.99 $60,568.50 $28,200.22 2026-04-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 17 8 — — $19,229.29 $60,842.14 $28,302.01 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 16 8 — — $20,067.97 $63,630.43 $28,400.44 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 16 8 — — $19,642.24 $62,215.05 $28,470.78 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 16 8 — — $19,254.84 $60,927.06 $28,527.22 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 17 8 — — $23,028.88 $73,474.34 $28,530.65 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 16 8 — — $21,376.36 $67,980.34 $28,565.58 2026-04-01
503 MS_DRG Foot Procedures With Mcc 16 8 — — $20,732.81 $65,840.77 $28,652.24 2026-04-01
M1005 HCPCS TB Scr No Perf 1 1 — — $28,897.68 $28,897.68 $28,897.68 2026-04-01
263 MS_DRG Vein Ligation And Stripping 16 8 — — $22,622.31 $72,122.66 $28,911.14 2026-04-01
J9266 HCPCS Pegaspargase Injection 6 4 — — $144.18 $44,666.37 $29,134.66 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 16 8 — — $22,334.24 $71,164.92 $29,312.75 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 16 8 — — $19,802.60 $66,549.70 $29,379.80 2026-04-01
J3265 HCPCS Injection Torsemide 10 Mg/ml 1 1 — — $29,390.86 $29,390.86 $29,390.86 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 16 8 — — $20,326.24 $64,489.08 $29,608.30 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 17 8 — — $23,907.29 $76,394.73 $29,664.66 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 16 8 — — $20,130.41 $63,838.01 $29,670.72 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 16 8 — — $22,360.49 $71,252.21 $29,705.45 2026-04-01
800 MS_DRG Splenic Procedures With Cc 16 8 — — $20,862.65 $66,272.45 $30,008.13 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 16 8 — — $20,234.00 $64,182.42 $30,051.26 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 16 8 — — $21,154.27 $67,241.98 $30,068.78 2026-04-01
B4164 HCPCS Parenteral 50% Dextrose Solu 1 1 — — $30,073.16 $30,073.16 $30,073.16 2026-04-01
B4178 HCPCS Parenteral Sol Amino Acid > 1 1 — — $30,073.16 $30,073.16 $30,073.16 2026-04-01
C1725 HCPCS Cath, Translumin Non-laser 1 1 — — $30,073.16 $30,073.16 $30,073.16 2026-04-01
C1724 HCPCS Cath, Trans Atherec,rotation 1 1 — — $30,073.16 $30,073.16 $30,073.16 2026-04-01
C1722 HCPCS Aicd, Single Chamber 1 1 — — $30,073.16 $30,073.16 $30,073.16 2026-04-01
C1715 HCPCS Brachytherapy Needle 1 1 — — $30,073.16 $30,073.16 $30,073.16 2026-04-01
C1714 HCPCS Cath, Trans Atherectomy, Dir 1 1 — — $30,073.16 $30,073.16 $30,073.16 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 16 8 — — $21,647.40 $68,881.46 $30,183.58 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 7 5 — — $3,060.70 $32,706.80 $30,271.56 2026-04-01
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 7 5 — — $2,756.39 $32,706.80 $30,271.56 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 7 5 — — $4,504.00 $32,706.80 $30,271.56 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 7 5 — — $37.50 $32,706.80 $30,271.56 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 6 4 — — $3,695.00 $32,706.80 $30,419.95 2026-04-01
61886 HCPCS Implant Neurostim Arrays 6 4 — — $4,504.00 $41,207.16 $30,419.95 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 16 8 — — $20,491.56 $65,038.72 $30,452.02 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 16 8 — — $20,790.99 $66,034.20 $30,508.60 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 16 8 — — $21,818.40 $69,449.96 $30,674.18 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 7 5 — — $4,504.00 $41,207.16 $30,792.64 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 7 5 — — $4,504.00 $41,207.16 $30,792.64 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 7 5 — — $4,504.00 $41,207.16 $30,792.64 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 7 5 — — $341.75 $41,207.16 $30,792.64 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 16 8 — — $21,406.16 $68,079.41 $30,910.14 2026-04-01
A7523 HCPCS Tracheostomy Shower Protect 1 1 — — $30,918.62 $30,918.62 $30,918.62 2026-04-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 6 4 — — $6,741.00 $41,207.16 $30,943.58 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 6 4 — — $6,741.00 $41,207.16 $30,943.58 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 6 4 — — $6,741.00 $41,207.16 $30,943.58 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 16 8 — — $22,357.65 $71,242.77 $30,982.07 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 16 8 — — $21,506.91 $68,414.38 $31,118.72 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 17 8 — — $25,254.70 $80,874.38 $31,404.14 2026-04-01
B5200 HCPCS Parenteral Sol Hepatic Fream 1 1 — — $31,500.90 $31,500.90 $31,500.90 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 16 8 — — $23,781.70 $75,977.19 $31,559.97 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 16 8 — — $23,707.91 $75,731.86 $31,572.94 2026-04-01
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 6 4 — — $5,128.00 $43,633.45 $31,587.53 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 16 8 — — $21,832.59 $69,497.14 $31,696.40 2026-04-01
0662T HCPCS Scalp Cool 1st Meas&calbrj 1 1 — — $31,961.30 $31,961.30 $31,961.30 2026-04-01
0742T HCPCS Aqmbf Spect Xers/strs & Rest 1 1 — — $31,961.30 $31,961.30 $31,961.30 2026-04-01
0896T HCPCS Connj Lvr Algrft Prfu Dev Ea 1 1 — — $31,961.30 $31,961.30 $31,961.30 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 16 8 — — $21,519.69 $68,456.85 $32,052.66 2026-04-01
33968 HCPCS Remove Aortic Assist Device 3 2 — — $2,990.00 $32,706.80 $32,093.31 2026-04-01
33967 HCPCS Insert I-aort Percut Device 3 2 — — $4,504.00 $32,706.80 $32,093.31 2026-04-01
37231 HCPCS Tib/per Revasc Stent & Ather 3 2 — — $5,128.00 $32,706.80 $32,093.31 2026-04-01
37227 HCPCS Fem/popl Revasc Stnt & Ather 3 2 — — $5,128.00 $32,706.80 $32,093.31 2026-04-01
69930 HCPCS Implant Cochlear Device 7 5 — — $6.53 $41,207.16 $32,345.82 2026-04-01
0268T HCPCS Implt/rpl Crtd Sns Dev Gen 4 3 — — $9,523.00 $60,947.18 $32,400.06 2026-04-01
0266T HCPCS Implt/rpl Crtd Sns Dev Total 4 3 — — $9,523.00 $90,001.00 $32,400.06 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 16 8 — — $24,284.76 $77,649.69 $32,736.99 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 16 8 — — $22,047.58 $70,211.91 $32,874.41 2026-04-01
0686T HCPCS Histotripsy Mal Hepatcel Tis 5 5 — — $4,873.23 $33,937.23 $32,948.77 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 18 8 — — $22,450.60 $71,551.79 $33,158.99 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 16 8 — — $23,541.17 $75,177.51 $33,220.95 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 16 8 — — $22,989.85 $73,344.60 $33,360.14 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 16 8 — — $23,286.44 $74,330.64 $33,369.76 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 16 8 — — $23,384.36 $74,656.18 $33,373.00 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 16 8 — — $22,651.40 $72,219.38 $33,451.07 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 17 8 — — $26,980.30 $86,611.36 $33,631.86 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 17 8 — — $25,673.33 $82,432.73 $33,693.32 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 16 8 — — $23,223.29 $74,120.69 $34,048.61 2026-04-01
665 MS_DRG Prostatectomy With Mcc 16 8 — — $23,075.00 $73,627.67 $34,220.18 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 16 8 — — $23,473.76 $116,565.95 $34,432.99 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 16 8 — — $23,350.30 $74,542.95 $34,445.74 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 16 8 — — $23,881.74 $76,309.80 $34,460.24 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 16 8 — — $23,849.82 $76,203.65 $34,481.09 2026-04-01
3141F HCPCS Upper Gi Endo Not Barrtts 1 1 — — $34,595.10 $34,595.10 $34,595.10 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 16 8 — — $25,559.81 $81,888.73 $34,778.50 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 16 8 — — $23,275.80 $93,467.25 $34,786.21 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 16 8 — — $23,519.17 $75,104.38 $35,165.31 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 16 8 — — $23,583.03 $75,551.44 $35,264.53 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 16 8 — — $24,287.60 $77,659.12 $35,293.82 2026-04-01
L8701 HCPCS Pow Ue Rom Dev Ewh Uprt Cust 4 4 — — $0.62 $36,019.23 $35,319.83 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 16 8 — — $23,826.40 $76,125.80 $35,535.18 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 16 8 — — $27,446.47 $88,161.19 $35,572.73 2026-04-01
652 MS_DRG Kidney Transplant 16 8 — — $23,843.43 $76,182.42 $35,669.61 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 16 8 — — $26,654.63 $85,528.60 $35,821.40 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 16 8 — — $24,631.73 $78,803.22 $35,827.26 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 16 8 — — $24,008.75 $76,732.06 $35,927.32 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 16 8 — — $27,512.46 $88,380.57 $36,066.99 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 16 8 — — $24,367.07 $77,923.33 $36,171.26 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 16 8 — — $25,440.60 $81,492.42 $36,448.27 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 16 8 — — $25,135.50 $80,478.07 $36,509.70 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 16 8 — — $25,679.72 $82,287.39 $36,603.89 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 16 8 — — $26,517.68 $85,073.32 $36,935.54 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 16 8 — — $26,990.95 $86,646.74 $37,561.92 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 16 8 — — $25,103.57 $82,744.68 $37,631.52 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 16 8 — — $25,327.08 $81,114.99 $37,685.34 2026-04-01
265 MS_DRG Aicd Lead Procedures 16 8 — — $26,601.41 $85,351.67 $37,864.85 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 16 8 — — $26,162.21 $83,891.48 $37,873.53 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 16 8 — — $25,900.39 $83,021.03 $37,892.72 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 17 9 — — $16,881.93 $98,358.95 $38,193.54 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 16 8 — — $26,556.00 $85,200.70 $38,258.50 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 16 8 — — $28,559.74 $91,862.39 $38,605.18 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 16 8 — — $26,674.49 $85,594.65 $38,832.58 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 16 8 — — $26,206.91 $84,040.10 $38,943.52 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 16 8 — — $26,350.23 $84,516.60 $39,000.95 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 16 8 — — $29,197.62 $93,983.09 $39,005.43 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 16 8 — — $26,182.78 $83,959.89 $39,311.14 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 16 8 — — $26,228.19 $84,110.86 $39,381.95 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 16 8 — — $26,265.80 $84,235.89 $39,440.72 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 16 8 — — $26,291.34 $84,320.81 $39,480.21 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 16 8 — — $27,449.31 $88,170.62 $39,746.75 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 16 8 — — $27,371.97 $87,913.50 $39,883.75 2026-04-01
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 4 4 — — $843.93 $40,711.39 $39,920.88 2026-04-01
332 MS_DRG Rectal Resection With Mcc 16 8 — — $26,619.15 $85,410.65 $39,990.81 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 16 8 — — $28,351.85 $91,171.21 $40,089.46 2026-04-01
0100T HCPCS Prosth Retina Receive&Gen 3 2 — — $6,741.00 $41,207.16 $40,432.88 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 16 8 — — $27,222.97 $87,418.12 $40,535.88 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 7 5 — — $4,504.00 $43,633.45 $41,207.16 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 7 5 — — $32.25 $43,633.45 $41,207.16 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 16 8 — — $27,628.82 $88,767.44 $41,562.54 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 16 8 — — $30,740.87 $99,113.81 $41,725.96 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 16 8 — — $30,200.91 $97,318.65 $41,727.66 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 16 8 — — $30,843.04 $99,453.50 $41,788.08 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 16 8 — — $28,325.59 $91,083.93 $41,976.15 2026-04-01
791 MS_DRG Prematurity With Major Problems 16 8 — — $29,729.06 $95,749.94 $42,170.76 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 16 8 — — $28,685.33 $92,279.92 $42,358.92 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 16 8 — — $28,170.20 $90,567.32 $42,404.99 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 16 8 — — $28,393.00 $91,308.03 $42,751.81 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 18 8 — — $17,209.34 $107,301.74 $43,153.80 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 16 8 — — $30,396.03 $97,967.36 $43,179.90 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 16 8 — — $29,455.89 $94,841.75 $43,480.22 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 16 8 — — $30,650.04 $98,811.87 $43,961.40 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 16 8 — — $31,388.68 $101,267.54 $44,305.49 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 17 8 — — $25,951.47 $83,190.87 $44,373.25 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 16 8 — — $32,097.51 $103,624.13 $44,400.04 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 16 8 — — $31,192.84 $100,616.46 $44,929.32 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 17 8 — — $35,970.17 $116,499.30 $45,237.58 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 16 8 — — $31,019.01 $100,038.52 $45,471.64 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 16 8 — — $30,705.39 $98,995.86 $45,721.51 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 16 8 — — $30,894.13 $99,623.35 $45,852.90 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 16 8 — — $30,535.10 $109,401.26 $46,086.51 2026-04-01
J9226 HCPCS Supprelin La Implant 6 4 — — $1,296.38 $74,599.87 $46,146.16 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 16 8 — — $31,633.47 $102,081.38 $46,230.62 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 16 8 — — $30,828.14 $99,403.96 $46,449.54 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 16 8 — — $32,719.77 $105,692.93 $46,512.05 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 16 8 — — $32,594.89 $105,277.76 $46,600.50 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 16 8 — — $33,189.49 $107,254.56 $48,296.57 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 16 8 — — $33,459.82 $108,153.32 $48,510.61 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 16 8 — — $34,219.03 $110,677.40 $48,982.82 2026-04-01
90695 HCPCS H5n8 Vacc Drv Cll Cul Adj IM 1 1 — — $49,500.90 $49,500.90 $49,500.90 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 16 8 — — $32,729.00 $105,723.60 $49,501.65 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 16 8 — — $33,830.20 $109,384.70 $49,956.69 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 16 8 — — $33,063.19 $106,834.67 $50,021.86 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 16 8 — — $34,287.15 $110,903.86 $50,323.73 2026-04-01
245 MS_DRG Aicd Generator Procedures 16 8 — — $33,300.89 $111,168.98 $50,391.79 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 16 8 — — $33,698.94 $108,948.29 $51,011.23 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 16 8 — — $35,704.81 $115,617.05 $51,365.13 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 16 8 — — $34,119.69 $110,347.15 $51,666.32 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 16 8 — — $36,316.43 $117,650.47 $51,854.98 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 16 8 — — $35,850.26 $116,100.64 $52,177.99 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 16 8 — — $36,691.07 $118,896.00 $52,326.46 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 16 8 — — $34,708.61 $124,507.47 $52,582.96 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 16 8 — — $35,017.26 $116,292.74 $53,063.69 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 16 8 — — $35,190.39 $113,906.81 $53,332.94 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 16 8 — — $47,413.63 $154,544.51 $53,479.72 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 16 8 — — $39,473.17 $128,145.46 $53,766.31 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 16 8 — — $40,423.25 $131,304.10 $53,948.32 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 17 8 — — $16,881.93 $140,204.43 $54,442.46 2026-04-01
10 MS_DRG Pancreas Transplant 16 8 — — $39,694.00 $169,271.46 $54,591.74 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 16 8 — — $36,032.61 $134,494.00 $54,644.09 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 16 8 — — $38,366.29 $124,465.49 $55,687.20 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 16 8 — — $37,863.23 $122,792.99 $56,012.55 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 16 8 — — $39,627.85 $128,659.71 $56,361.18 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 16 8 — — $40,116.73 $130,285.03 $56,507.04 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 6 4 — — $1,732.50 $94,078.22 $56,654.13 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 16 8 — — $38,767.18 $125,798.30 $57,216.77 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 16 8 — — $38,744.48 $125,722.81 $57,262.08 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 16 8 — — $39,688.87 $128,862.58 $57,277.75 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 16 8 — — $37,799.37 $122,580.69 $57,394.01 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 19 8 — — $33,542.84 $108,429.32 $57,863.57 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 16 8 — — $40,695.71 $132,209.94 $57,962.10 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 16 8 — — $41,369.06 $134,448.58 $58,110.30 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 16 8 — — $38,490.46 $153,657.62 $58,470.10 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 5 3 — — $56,824.55 $93,760.51 $58,529.29 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 16 8 — — $39,744.22 $129,046.58 $58,785.86 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 17 8 — — $45,626.81 $151,791.61 $58,941.85 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 16 8 — — $39,881.87 $129,504.22 $60,192.07 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 16 8 — — $40,819.17 $132,620.39 $60,869.18 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 16 8 — — $41,587.60 $135,175.14 $61,299.49 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 16 8 — — $41,848.71 $136,043.24 $61,309.82 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 16 8 — — $42,541.93 $138,347.93 $61,422.37 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 16 8 — — $41,421.57 $134,623.15 $62,544.77 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 16 8 — — $44,361.90 $144,398.65 $62,765.56 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 16 8 — — $43,560.12 $141,733.03 $62,979.10 2026-04-01
M1060 HCPCS Pt Died In Pp 1 1 — — $63,217.07 $63,217.07 $63,217.07 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 16 8 — — $42,568.90 $138,437.57 $63,742.77 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 6 4 — — $938.10 $104,338.76 $64,925.84 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 16 8 — — $43,945.40 $143,013.95 $65,025.54 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 16 8 — — $43,002.42 $139,878.90 $65,493.53 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 16 8 — — $43,239.41 $140,666.79 $65,862.50 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 16 8 — — $43,548.06 $141,692.93 $66,342.73 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 8 — — $47,583.21 $155,108.30 $66,375.96 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 16 8 — — $44,412.28 $158,065.72 $67,688.07 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 16 8 — — $51,822.00 $169,200.69 $69,235.80 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 16 8 — — $48,688.68 $158,783.55 $69,298.10 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 16 8 — — $48,372.22 $157,731.46 $70,087.76 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 8 — — $47,583.21 $155,108.30 $70,196.64 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 16 8 — — $49,970.81 $163,046.18 $70,504.65 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 16 8 — — $49,730.28 $162,246.50 $73,138.50 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 16 8 — — $48,337.45 $157,615.87 $73,371.18 2026-04-01
A9699 HCPCS Radiopharm Rx Agent Noc 3 2 — — $1,373.18 $74,614.73 $74,614.73 2026-04-01
A5083 HCPCS Stoma Absorptive Cover 1 1 — — $74,643.30 $74,643.30 $74,643.30 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 16 8 — — $51,551.67 $168,301.93 $75,176.06 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 16 8 — — $51,521.87 $168,202.86 $77,542.12 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 16 8 — — $52,147.68 $170,283.45 $78,347.35 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 16 8 — — $54,995.07 $179,749.94 $81,490.54 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 16 8 — — $55,174.58 $180,346.75 $81,863.51 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 16 8 — — $55,409.44 $181,127.56 $83,698.66 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 16 8 — — $56,761.11 $203,871.65 $86,911.11 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 16 8 — — $60,742.34 $198,857.46 $90,361.36 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 16 8 — — $60,554.31 $198,232.34 $92,815.57 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 16 8 — — $64,855.54 $212,532.32 $94,469.00 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 16 8 — — $62,371.44 $204,273.62 $95,644.01 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 8 — — $70,341.70 $230,771.75 $105,407.92 2026-04-01
215 MS_DRG Other Heart Assist System Implant 16 8 — — $71,577.72 $262,734.29 $109,975.06 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 16 8 — — $74,085.95 $243,219.95 $113,817.69 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 16 8 — — $79,128.65 $259,985.04 $117,344.46 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 16 8 — — $78,084.91 $256,515.02 $118,515.06 2026-04-01
7 MS_DRG Lung Transplant 16 8 — — $92,815.67 $305,489.26 $121,780.61 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 16 8 — — $81,240.24 $267,005.29 $124,048.39 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 16 8 — — $81,332.48 $310,854.77 $125,159.64 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 16 8 — — $86,200.63 $283,496.73 $129,269.38 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 3 2 — — $490.71 $130,327.56 $130,327.56 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 16 8 — — $99,210.04 $326,748.15 $134,036.87 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 16 8 — — $152,419.14 $503,648.47 $205,839.98 2026-04-01
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 4 4 — — $422.01 $211,809.20 $207,696.40 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 16 8 — — $151,530.09 $500,692.70 $209,646.91 2026-04-01
J3403 HCPCS Revakinagene, Per Implant 4 4 — — $61.30 $265,225.00 $260,075.00 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 16 8 — — $199,769.58 $661,070.91 $290,697.53 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 16 8 — — $307,328.01 $1,018,662.39 $435,917.58 2026-04-01
C9301 HCPCS Obecabtagene Car Pos T 2 1 — — $459,112.50 $459,112.50 $459,112.50 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 5 3 — — $489,304.61 $807,508.61 $503,983.75 2026-04-01
M1069 HCPCS Pt Scr Ft Fall Rsk 1 1 — — $512,361.60 $512,361.60 $512,361.60 2026-04-01
M1058 HCPCS Pt Prm Nurs Hm Res In Pp 1 1 — — $523,694.85 $523,694.85 $523,694.85 2026-04-01
M1070 HCPCS Pt Not Scrn Fut Fall No Rsn 1 1 — — $540,429.11 $540,429.11 $540,429.11 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 5 3 — — $533,230.17 $829,687.20 $549,227.08 2026-04-01
M1106 HCPCS Start Eoc Doc Med Rec 1 1 — — $552,546.94 $552,546.94 $552,546.94 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 5 3 — — $557,317.93 $870,577.06 $574,037.47 2026-04-01
M1107 HCPCS Docu Dx Degen Neuro 1 1 — — $578,544.93 $578,544.93 $578,544.93 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 5 3 — — $562,538.19 $852,129.78 $579,414.33 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 5 3 — — $565,868.94 $912,729.35 $582,845.01 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 6 4 — — $1,284.99 $954,972.35 $606,519.36 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 5 3 — — $770,620.00 $1,271,523.00 $793,738.60 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 6 4 — — $141.40 $3,847,800.00 $2,390,300.00 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 6 4 — — $38.88 $3,998,166.53 $2,516,488.37 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 6 4 — — $42.45 $4,864,551.99 $3,019,383.50 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 4 4 — — $89.91 $3,345,899.09 $3,280,930.17 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 4 4 — — $3,334.25 $3,415,956.47 $3,349,627.21 2026-04-01
J1414 HCPCS Inj, Beqvez, Per Tx Dose 1 1 — — $3,408,903.61 $3,408,903.61 $3,408,903.61 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 4 4 — — $13.04 $3,795,824.67 $3,722,119.33 2026-04-01
H2010 HCPCS Comprehensive Medication Services, Per 15 Minutes 1 1 — — $3,807,119.13 $3,807,119.13 $3,807,119.13 2026-04-01
H2000 HCPCS Comp Multidisipln Evaluation 1 1 — — $4,165,959.00 $4,165,959.00 $4,165,959.00 2026-04-01
J3391 HCPCS Inj, Atidarsagene Autotemcel 4 4 — — $79.40 $4,640,150.00 $4,550,050.00 2026-04-01
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