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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

SAINT FRANCIS HOSPITAL, INC

Tulsa, OK · CCN 370091 · Rates published

15,400 distinct procedures filed
20 distinct payers
122,587 rate rows
2026-04-01 last MRF observed
Data quality

83,547 of 122,587 rate rows are consumer-grade (68.2%)

39,040 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 39,008
placeholder amount (≤ $0.02) — excluded from medians 32
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.saintfrancis.com/finance/sfh-cms-hpt
Found on page https://www.saintfrancis.com/patients-and-guests/billing-and-insurance/standard-hospital-charges
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-16
Content fingerprint 5d9bd000bedffa21… · 34,889,316 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 3 $4,505,000.00 $4,990,350.00 $4,640,150.00 nat. median
$4,505,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 1 $4,229,400.00 $4,229,400.00 $4,229,400.00 nat. median
$3,710,000
1.1× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 3 $3,685,266.67 $4,201,204.00 $3,795,824.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 3 $3,316,462.59 $3,790,011.97 $3,415,956.47 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 3 $3,248,445.72 $3,717,944.70 $3,345,899.09 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 3 $2,945,740.00 $3,363,782.80 $3,034,112.20 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 3 $2,455,110.60 $2,795,411.78 $2,528,763.92 nat. median
$2,469,189
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 3 $2,332,000.00 $2,658,480.00 $2,401,960.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 4 $770,620.00 $1,849,488.00 $1,267,669.90 nat. median
$824,563
1.5× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 4 $591,726.20 $1,420,142.88 $951,823.96 nat. median
$754,974
1.3× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 4 $565,868.94 $1,358,085.47 $910,082.94 nat. median
$675,122
1.3× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 4 $557,317.93 $1,337,563.04 $875,712.60 nat. median
$625,184
1.4× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 4 $562,538.19 $1,350,091.64 $863,907.78 nat. median
$674,188
1.3× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $533,230.17 $1,279,752.41 $844,407.38 nat. median
$634,511
1.3× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 4 $489,304.61 $1,174,331.06 $805,244.49 nat. median
$620,080
1.3× median
C9301
HCPCS 		Obecabtagene Car Pos T 1 $598,237.50 $598,237.50 $598,237.50 nat. median
$459,112
1.3× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 8 $317,303.10 $844,482.84 $433,118.73 nat. median
$370,174
1.2× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 9 $33,000.00 $898,819.08 $308,262.90 nat. median
$265,286
1.2× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 3 $278,250.00 $667,800.00 $308,227.50 nat. median
$324,450
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 8 $157,417.02 $417,530.38 $234,855.50 nat. median
$206,368
1.1× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 14 $4,555.79 $737,889.25 $234,749.12 nat. median
$202,986
1.2× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 3 $111,492.17 $267,581.21 $163,959.00 nat. median
$111,989
1.5× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 1 $146,886.05 $200,432.87 $149,730.45 nat. median
$87,411
1.7× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 11 $2,568.53 $359,111.64 $143,066.85 nat. median
$133,176
1.1× median
7
MS_DRG 		Lung Transplant 8 $95,898.49 $253,254.11 $142,452.20 nat. median
$122,708
1.2× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 1 $139,825.05 $139,825.05 $139,825.05 nat. median
$96,983
1.4× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 8 $89,070.91 $239,407.93 $132,196.90 nat. median
$117,303
1.1× median
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 $127,948.33 $174,591.48 $130,426.01 nat. median
$63,570
outlier · 2.1×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 8 $84,046.35 $395,913.32 $123,209.00 nat. median
$108,660
1.1× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 2 $69,113.10 $169,820.76 $119,466.93 nat. median
$76,377
1.6× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 9 $78,181.44 $221,617.92 $117,504.08 nat. median
$102,358
1.1× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 8 $76,566.99 $214,792.86 $113,415.50 nat. median
$100,136
1.1× median
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 $110,696.45 $151,050.47 $112,840.05 nat. median
$54,196
outlier · 2.1×
215
MS_DRG 		Other Heart Assist System Implant 9 $73,978.17 $294,808.80 $110,247.13 nat. median
$99,019
1.1× median
209
MS_DRG 		Complex Aortic Arch Procedures 7 $83,951.14 $221,350.45 $109,136.48 nat. median
$98,017
1.1× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 9 $2,004.81 $195,463.77 $108,332.23 nat. median
$93,672
1.2× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 $2,382.98 $215,530.59 $106,303.22 nat. median
$98,905
1.1× median
226
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 1 $102,496.49 $139,861.24 $104,481.30 nat. median
$49,935
outlier · 2.1×
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 4 $63,342.28 $152,021.48 $104,133.98 nat. median
$69,774
1.5× median
L8702
HCPCS 		Pow Ue Rom Dev Ewhf Uprt Cus 3 $68,801.71 $165,124.10 $101,178.99 nat. median
$70,825
1.4× median
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 1 $97,965.25 $133,678.16 $99,862.31 nat. median
$62,270
1.6× median
223
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 $97,138.92 $132,550.59 $99,019.98 nat. median
$44,728
outlier · 2.2×
A9699
HCPCS 		Radiopharm Rx Agent Noc 1 $97,225.26 $97,225.26 $97,225.26 nat. median
$21,806
outlier · 4.5×
A9543
HCPCS 		Y90 Ibritumomab, Rx 4 $56,824.55 $136,378.92 $93,476.38 nat. median
$62,507
1.5× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 4 $55,272.32 $132,653.58 $93,182.59 nat. median
$66,682
1.4× median
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 1 $91,048.51 $124,239.95 $92,811.64 nat. median
$65,381
1.4× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 8 $62,794.65 $166,918.68 $92,728.90 nat. median
$79,312
1.2× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 11 $1,540.45 $189,389.73 $92,437.40 nat. median
$81,118
1.1× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 8 $67,040.01 $176,191.74 $91,509.61 nat. median
$82,712
1.1× median
225
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 $85,365.23 $116,484.85 $87,018.31 nat. median
$48,649
1.8× median

Other procedures at this hospital

Browse this hospital's 15,400 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
             
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 39 16 — — $909.13 $133,161.31 $53,960.46 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 40 16 — — $1,896.72 $148,788.45 $50,554.56 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 33 14 — — $4,555.79 $737,889.25 $234,749.12 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 34 14 — — $1,157.63 $283,624.31 $76,772.68 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 36 14 — — $1,029.21 $265,154.01 $50,483.64 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 36 14 — — $1,832.22 $154,253.18 $49,772.03 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 33 14 — — $289.82 $97,533.59 $48,859.12 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 33 14 — — $23,488.15 $112,220.30 $46,352.90 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 33 14 — — $1,106.16 $278,751.76 $42,925.80 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 34 13 — — $2,583.20 $151,101.91 $84,834.60 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 32 13 — — $1,956.83 $150,272.70 $82,566.29 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 30 13 — — $580.54 $176,743.40 $66,344.07 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 33 13 — — $466.54 $182,187.00 $64,536.70 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 35 13 — — $0.70 $169,643.07 $63,757.72 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 32 13 — — $864.15 $99,378.61 $51,768.26 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 31 13 — — $469.59 $104,685.02 $48,320.80 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 34 13 — — $883.51 $214,239.50 $46,034.96 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 33 13 — — $600.00 $135,491.51 $43,763.97 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 33 13 — — $1,151.51 $124,898.40 $41,921.77 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 32 13 — — $636.72 $67,045.79 $36,065.87 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 36 12 — — $400.00 $177,709.29 $65,305.27 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 28 12 — — $1,100.31 $125,836.99 $62,637.98 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 30 12 — — $2,155.86 $137,476.61 $59,313.81 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 34 12 — — $750.00 $298,771.74 $58,794.40 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 33 12 — — $654.00 $134,649.55 $58,660.80 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 28 12 — — $1,565.45 $101,207.17 $52,599.38 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 32 12 — — $733.03 $91,589.95 $46,916.66 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 28 12 — — $1,819.26 $87,620.66 $44,033.24 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 31 12 — — $100.00 $69,620.95 $39,119.30 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 29 12 — — $870.09 $84,234.03 $35,373.49 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 33 12 — — $934.92 $70,606.18 $34,201.20 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 30 12 — — $13,812.56 $64,419.34 $34,153.11 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 31 12 — — $701.70 $60,911.07 $34,133.33 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 28 11 — — $2,568.53 $359,111.64 $143,066.85 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 27 11 — — $1,540.45 $189,389.73 $92,437.40 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 28 11 — — $144.04 $205,741.48 $80,105.72 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 27 11 — — $865.48 $113,042.49 $59,007.43 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 28 11 — — $19,840.71 $122,791.63 $53,597.85 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 28 11 — — $86.79 $129,850.84 $49,036.89 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 22 11 — — $17,774.89 $100,347.09 $46,718.72 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 28 11 — — $1,628.31 $80,678.28 $44,561.97 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 26 11 — — $1,068.58 $80,605.60 $43,922.38 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 28 11 — — $307.29 $85,505.63 $43,662.83 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 31 11 — — $1,575.40 $82,933.08 $41,751.20 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 31 11 — — $2,225.17 $196,377.34 $41,114.70 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 30 11 — — $1,062.45 $130,333.22 $39,139.75 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 28 11 — — $952.57 $83,188.77 $39,129.86 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 33 11 — — $783.33 $94,539.11 $37,748.55 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 32 11 — — $1,070.13 $71,559.21 $36,699.33 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 30 11 — — $21,400.56 $62,323.02 $34,972.67 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 28 10 — — $2,291.55 $156,531.92 $85,935.60 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 21 10 — — $34,700.99 $169,345.18 $83,818.93 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 27 10 — — $2,426.57 $355,975.83 $79,916.90 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 26 10 — — $1,521.26 $141,166.94 $73,606.05 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 21 10 — — $1,315.73 $130,761.19 $71,538.72 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 23 10 — — $22,657.08 $127,781.08 $66,787.85 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 27 10 — — $2,045.70 $315,725.13 $64,198.37 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 20 10 — — $20,713.47 $222,880.77 $61,116.42 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 26 10 — — $1,916.33 $136,382.67 $60,843.40 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 24 10 — — $2,233.37 $114,692.03 $60,072.93 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 19 10 — — $28,423.15 $112,781.41 $56,282.16 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 23 10 — — $29,592.25 $113,785.28 $55,933.78 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 22 10 — — $6,539.58 $104,991.51 $52,117.00 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 28 10 — — $200.00 $89,660.35 $49,980.82 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 26 10 — — $784.04 $173,698.21 $49,471.74 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 30 10 — — $1,580.91 $84,071.70 $45,729.28 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 21 10 — — $31,616.86 $110,404.64 $45,212.11 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 24 10 — — $17,497.52 $83,951.95 $44,359.58 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 27 10 — — $590.65 $78,349.29 $42,583.07 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 26 10 — — $1,881.88 $113,980.69 $42,314.09 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 27 10 — — $1,736.19 $73,086.64 $40,055.28 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 21 10 — — $17,007.07 $71,831.14 $39,981.13 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 27 10 — — $571.32 $70,227.95 $38,371.52 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 26 10 — — $663.48 $67,558.16 $37,846.75 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 26 10 — — $21,369.86 $70,632.36 $37,551.02 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 27 10 — — $20,078.04 $190,607.38 $37,046.23 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 25 10 — — $500.29 $103,826.41 $36,202.95 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 26 10 — — $682.49 $63,332.11 $36,047.50 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 28 10 — — $953.21 $71,182.26 $35,439.69 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 25 10 — — $736.16 $75,110.32 $34,812.80 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 24 10 — — $1,086.60 $76,244.37 $34,326.79 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 26 10 — — $574.51 $65,863.78 $34,137.05 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 25 9 — — $33,000.00 $898,819.08 $308,262.90 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 22 9 — — $78,181.44 $221,617.92 $117,504.08 2026-04-01
215 MS_DRG Other Heart Assist System Implant 22 9 — — $73,978.17 $294,808.80 $110,247.13 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 24 9 — — $2,004.81 $195,463.77 $108,332.23 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 26 9 — — $2,409.02 $134,504.21 $70,200.29 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 20 9 — — $45,887.91 $119,708.14 $68,083.08 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 23 9 — — $1,430.27 $131,375.50 $64,988.56 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 26 9 — — $1,101.40 $117,498.31 $61,507.40 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 24 9 — — $26,559.30 $108,852.61 $60,517.34 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 24 9 — — $32,312.90 $108,793.54 $59,489.88 2026-04-01
5232 OTHER Level 2 Icd And Similar Procedures 16 9 — — $211.50 $112,667.66 $58,043.85 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 20 9 — — $36,952.67 $95,847.87 $54,671.10 2026-04-01
245 MS_DRG Aicd Generator Procedures 23 9 — — $25,941.37 $112,188.58 $50,186.40 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 22 9 — — $25,109.69 $83,412.21 $47,680.95 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 23 9 — — $30,367.20 $99,976.87 $47,209.98 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 22 9 — — $1,980.37 $85,474.76 $43,396.93 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 27 9 — — $1,866.07 $166,221.21 $43,379.61 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 21 9 — — $16,430.41 $77,913.06 $43,238.05 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 23 9 — — $1,858.10 $144,674.48 $40,543.50 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 24 9 — — $17,010.39 $70,526.76 $37,497.04 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 20 9 — — $24,692.61 $85,338.99 $36,268.51 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 25 9 — — $1,302.14 $66,966.65 $35,021.80 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 16 8 — — $317,303.10 $844,482.84 $433,118.73 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 19 8 — — $157,417.02 $417,530.38 $234,855.50 2026-04-01
7 MS_DRG Lung Transplant 19 8 — — $95,898.49 $253,254.11 $142,452.20 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 19 8 — — $89,070.91 $239,407.93 $132,196.90 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 19 8 — — $84,046.35 $395,913.32 $123,209.00 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 19 8 — — $76,566.99 $214,792.86 $113,415.50 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 19 8 — — $2,382.98 $215,530.59 $106,303.22 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 21 8 — — $62,794.65 $166,918.68 $92,728.90 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 16 8 — — $67,040.01 $176,191.74 $91,509.61 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 19 8 — — $53,587.71 $140,269.32 $78,899.70 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 23 8 — — $50,353.71 $172,536.56 $75,530.56 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 16 8 — — $53,308.69 $139,524.24 $72,766.36 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 19 8 — — $49,212.72 $128,586.57 $72,328.30 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 22 8 — — $1,317.84 $129,276.95 $71,351.24 2026-04-01
10 MS_DRG Pancreas Transplant 19 8 — — $53,609.68 $140,327.99 $69,692.58 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 21 8 — — $45,458.03 $120,172.07 $68,187.04 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 24 8 — — $1,324.00 $159,515.44 $68,161.13 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 19 8 — — $44,484.75 $132,593.80 $65,226.70 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 19 8 — — $49,037.70 $128,119.18 $63,749.01 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 19 8 — — $42,103.93 $109,603.56 $61,650.60 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 20 8 — — $41,506.34 $108,007.79 $60,053.54 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 19 8 — — $40,842.11 $106,234.06 $59,755.30 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 22 8 — — $2,204.74 $155,066.91 $58,986.76 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 23 8 — — $782.64 $103,764.77 $57,259.40 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 22 8 — — $37,970.61 $98,566.15 $56,415.02 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 22 8 — — $982.80 $135,727.53 $53,873.77 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 20 8 — — $35,316.62 $287,535.73 $52,215.37 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 19 8 — — $35,489.46 $92,861.55 $51,715.40 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 24 8 — — $1,060.19 $98,402.66 $51,563.51 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 19 8 — — $35,017.83 $92,629.04 $51,007.00 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 19 8 — — $33,742.83 $87,276.47 $49,091.90 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 22 8 — — $883.27 $85,184.64 $47,217.32 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 21 8 — — $1,842.57 $82,448.10 $45,666.61 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 21 8 — — $29,363.45 $75,581.98 $44,045.18 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 19 8 — — $29,578.03 $76,154.98 $42,836.20 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 23 8 — — $1,378.55 $70,904.19 $41,417.55 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 21 8 — — $27,236.75 $80,816.36 $40,855.12 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 19 8 — — $28,198.31 $75,999.51 $40,763.80 2026-04-01
265 MS_DRG Aicd Lead Procedures 19 8 — — $27,556.78 $70,757.52 $39,800.20 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 20 8 — — $746.99 $71,647.69 $39,713.78 2026-04-01
332 MS_DRG Rectal Resection With Mcc 20 8 — — $26,465.80 $78,628.30 $39,630.04 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 19 8 — — $27,297.53 $72,865.79 $39,410.80 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 21 8 — — $27,149.60 $72,978.96 $39,188.60 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 23 8 — — $680.22 $142,333.92 $39,151.20 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 20 8 — — $16,543.16 $81,211.41 $39,038.47 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 19 8 — — $26,481.71 $67,886.70 $38,185.40 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 19 8 — — $26,010.81 $83,503.58 $37,478.10 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 25 8 — — $635.33 $66,207.40 $36,499.05 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 19 8 — — $25,250.65 $67,867.88 $36,108.43 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 22 8 — — $23,870.55 $65,203.29 $36,102.12 2026-04-01
652 MS_DRG Kidney Transplant 19 8 — — $24,710.18 $68,306.15 $35,524.50 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 19 8 — — $24,646.47 $62,985.96 $35,428.80 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 19 8 — — $24,570.31 $62,782.58 $35,314.40 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 21 8 — — $24,328.64 $117,635.05 $34,951.40 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 22 8 — — $776.16 $94,324.50 $34,571.13 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 20 8 — — $19,277.05 $63,402.89 $34,491.68 2026-04-01
665 MS_DRG Prostatectomy With Mcc 20 8 — — $23,917.06 $64,265.02 $34,267.30 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 17 8 — — $16,799.58 $67,245.26 $34,113.95 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 15 7 — — $83,951.14 $221,350.45 $109,136.48 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 15 7 — — $42,853.11 $111,604.14 $55,709.04 2026-04-01
5166 OTHER Cochlear Implant Procedure 13 7 — — $211.50 $105,375.90 $52,471.71 2026-04-01
2616 OTHER Brachytx, Non-str,yttrium-90 8 5 — — $1,417.90 $67,015.01 $43,938.84 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 6 4 — — $770,620.00 $1,849,488.00 $1,267,669.90 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 6 4 — — $591,726.20 $1,420,142.88 $951,823.96 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 6 4 — — $565,868.94 $1,358,085.47 $910,082.94 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 6 4 — — $557,317.93 $1,337,563.04 $875,712.60 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 6 4 — — $562,538.19 $1,350,091.64 $863,907.78 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 6 4 — — $533,230.17 $1,279,752.41 $844,407.38 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 6 4 — — $489,304.61 $1,174,331.06 $805,244.49 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 6 4 — — $63,342.28 $152,021.48 $104,133.98 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 6 4 — — $56,824.55 $136,378.92 $93,476.38 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 6 4 — — $55,272.32 $132,653.58 $93,182.59 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 6 4 — — $11,050.00 $145,191.34 $84,383.74 2026-04-01
J9226 HCPCS Supprelin La Implant 6 4 — — $45,020.65 $108,049.56 $74,572.37 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 6 4 — — $42,362.57 $101,670.17 $66,258.45 2026-04-01
69930 HCPCS Implant Cochlear Device 6 4 — — $31,711.59 $132,697.00 $65,095.37 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 6 4 — — $30,188.86 $110,345.00 $63,572.61 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 6 4 — — $30,188.86 $110,345.00 $63,572.61 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 6 4 — — $30,188.86 $110,345.00 $63,572.61 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 6 4 — — $30,188.86 $110,345.00 $63,572.61 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 6 4 — — $29,678.00 $71,227.21 $59,267.23 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 6 4 — — $30,188.86 $72,453.27 $54,613.42 2026-04-01
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 6 4 — — $24,065.00 $101,670.17 $53,317.18 2026-04-01
61886 HCPCS Implant Neurostim Arrays 6 4 — — $29,678.00 $71,227.21 $53,184.23 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 6 4 — — $42,362.57 $101,670.17 $53,184.23 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 6 4 — — $27,586.78 $66,208.28 $51,343.49 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 6 4 — — $29,678.00 $71,227.21 $49,193.73 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 6 4 — — $29,678.00 $71,227.21 $49,193.73 2026-04-01
J9266 HCPCS Pegaspargase Injection 6 4 — — $28,424.06 $68,217.74 $45,302.54 2026-04-01
0916T HCPCS Insj Perm Ccm-d Sys Pg Only 6 4 — — $21,393.20 $51,516.00 $44,803.75 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 6 4 — — $21,393.20 $110,345.00 $44,803.75 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 6 4 — — $21,393.20 $110,345.00 $44,803.75 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 6 4 — — $21,393.20 $110,345.00 $44,803.75 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 6 4 — — $21,393.20 $110,345.00 $44,803.75 2026-04-01
0960T HCPCS Rpl S-sclp Eltr Ra Rcvr&tlmt 6 4 — — $26,096.68 $62,632.04 $42,017.95 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 6 4 — — $29,678.00 $71,227.21 $41,067.45 2026-04-01
64590 HCPCS Insrt/redo Pn/gastr Stimul 6 4 — — $18,658.44 $44,780.26 $40,757.16 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 6 4 — — $24,228.42 $58,148.21 $39,855.75 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 6 4 — — $25,138.60 $60,332.65 $38,913.57 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 6 4 — — $25,138.60 $60,332.65 $38,913.57 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 6 4 — — $25,138.60 $60,332.65 $38,913.57 2026-04-01
33274 HCPCS Tcat Insj/rpl Perm Ldls Pm 6 4 — — $18,525.31 $44,460.75 $38,468.15 2026-04-01
33229 HCPCS Remv&replc Pm Gen Mult Leads 6 4 — — $18,525.31 $44,460.75 $37,098.54 2026-04-01
33221 HCPCS Insert Pulse Gen Mult Leads 6 4 — — $18,525.31 $44,460.75 $37,098.54 2026-04-01
C9607 HCPCS Perc D-e Cor Revasc Chro Sin 6 4 — — $17,630.81 $55,148.00 $36,436.49 2026-04-01
C9602 HCPCS Perc D-e Cor Stent Ather S 6 4 — — $17,630.81 $55,148.00 $36,436.49 2026-04-01
37242 HCPCS Vasc Embolize/occlude Artery 6 4 — — $17,630.81 $74,303.00 $36,436.49 2026-04-01
36906 HCPCS Thrmbc/nfs Dialysis Circuit 6 4 — — $17,630.81 $43,535.00 $36,436.49 2026-04-01
93590 HCPCS Perq Transcath Cls Mitral 6 4 — — $17,630.81 $43,535.00 $36,436.49 2026-04-01
93591 HCPCS Perq Transcath Cls Aortic 6 4 — — $17,630.81 $43,535.00 $36,436.49 2026-04-01
92933 HCPCS Prq Card Stent/ath/angio 6 4 — — $17,630.81 $44,779.00 $36,436.49 2026-04-01
62362 HCPCS Implant Spine Infusion Pump 6 4 — — $17,334.80 $43,535.00 $35,841.72 2026-04-01
62361 HCPCS Implant Spine Infusion Pump 6 4 — — $17,334.80 $43,535.00 $35,841.72 2026-04-01
54410 HCPCS Remove/replace Penis Prosth 6 4 — — $19,933.76 $47,841.02 $34,898.71 2026-04-01
53445 HCPCS Insert Uro/ves Nck Sphincter 6 4 — — $19,933.76 $47,841.02 $34,898.71 2026-04-01
53447 HCPCS Remove/replace Ur Sphincter 6 4 — — $19,933.76 $47,841.02 $34,898.71 2026-04-01
54401 HCPCS Insert Self-contd Prosthesis 6 4 — — $19,933.76 $47,841.02 $34,898.71 2026-04-01
54405 HCPCS Insert Multi-comp Penis Pros 6 4 — — $19,933.76 $47,841.02 $34,898.71 2026-04-01
54416 HCPCS Remv/repl Penis Contain Pros 6 4 — — $19,933.76 $47,841.02 $34,898.71 2026-04-01
C9758 HCPCS Interatrial Shunt Ide 6 4 — — $16,474.62 $43,535.00 $34,696.26 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 6 4 — — $24,065.00 $71,227.21 $34,584.12 2026-04-01
J3391 HCPCS Inj, Atidarsagene Autotemcel 3 3 — — $4,505,000.00 $4,990,350.00 $4,640,150.00 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 3 3 — — $3,685,266.67 $4,201,204.00 $3,795,824.67 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 3 3 — — $3,316,462.59 $3,790,011.97 $3,415,956.47 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 3 3 — — $3,248,445.72 $3,717,944.70 $3,345,899.09 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 3 3 — — $2,945,740.00 $3,363,782.80 $3,034,112.20 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 3 3 — — $2,455,110.60 $2,795,411.78 $2,528,763.92 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 3 3 — — $2,332,000.00 $2,658,480.00 $2,401,960.00 2026-04-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 5 3 — — $278,250.00 $667,800.00 $308,227.50 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 5 3 — — $111,492.17 $267,581.21 $163,959.00 2026-04-01
L8702 HCPCS Pow Ue Rom Dev Ewhf Uprt Cus 5 3 — — $68,801.71 $165,124.10 $101,178.99 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 5 3 — — $50,007.15 $120,017.16 $73,539.93 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 5 3 — — $49,600.83 $119,041.99 $72,942.39 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 5 3 — — $30,188.86 $72,453.27 $51,516.00 2026-04-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 5 3 — — $30,188.86 $72,453.27 $51,516.00 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 5 3 — — $25,888.42 $62,132.21 $51,516.00 2026-04-01
L8701 HCPCS Pow Ue Rom Dev Ewh Uprt Cust 5 3 — — $34,970.13 $83,928.31 $51,426.66 2026-04-01
0515T HCPCS Insj Wcs Lv Compl Sys 5 3 — — $21,393.20 $51,516.00 $49,204.36 2026-04-01
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 5 3 — — $21,393.20 $51,516.00 $49,204.36 2026-04-01
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 5 3 — — $21,393.20 $51,516.00 $49,204.36 2026-04-01
0409T HCPCS Insj/rplc Car Modulj Pls Gn 5 3 — — $21,393.20 $51,516.00 $49,204.36 2026-04-01
0923T HCPCS Rmvl&rplcmt Perm Ccm-d Pg 5 3 — — $21,393.20 $51,516.00 $49,204.36 2026-04-01
L5856 HCPCS Elec Knee-shin Swing/stance 5 3 — — $29,717.20 $71,321.28 $43,701.77 2026-04-01
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 5 3 — — $29,678.00 $71,227.21 $43,535.00 2026-04-01
0956T HCPCS Prt Crn Ch Cr&tun Elt S-sclp 5 3 — — $26,096.68 $62,632.04 $43,535.00 2026-04-01
L6880 HCPCS Elec Hand Ind Art Digits 5 3 — — $29,576.84 $70,984.42 $43,495.35 2026-04-01
C9782 HCPCS Blind Myocar Trpl Bon Marrow 5 3 — — $16,474.62 $43,535.00 $37,891.63 2026-04-01
L6975 HCPCS Interscap-thor Myoelectronic 5 3 — — $23,640.73 $56,737.75 $34,765.79 2026-04-01
L6970 HCPCS Interscapular-thor Switch CT 5 3 — — $23,514.53 $56,434.87 $34,580.19 2026-04-01
Q0483 HCPCS Monitor Elec Vad, Rep 5 3 — — $23,210.23 $55,704.55 $34,132.70 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 2 2 — — $69,113.10 $169,820.76 $119,466.93 2026-04-01
1580 OTHER New Technology - Level 43 ($40,001-$50,000) 2 2 — — $43,065.71 $104,986.52 $74,026.12 2026-04-01
64654 HCPCS 1st Opn Implt Bat Modulj Sys 4 2 — — $42,362.57 $101,670.17 $70,533.68 2026-04-01
0266T HCPCS Implt/rpl Crtd Sns Dev Total 2 2 — — $43,535.00 $81,000.90 $62,267.95 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 4 2 — — $29,678.00 $71,227.21 $49,413.88 2026-04-01
0268T HCPCS Implt/rpl Crtd Sns Dev Gen 2 2 — — $43,535.00 $54,852.46 $49,193.73 2026-04-01
L6700 HCPCS Ue Add Ext Power Myoel 4 2 — — $29,510.19 $70,824.46 $49,134.47 2026-04-01
37231 HCPCS Tib/per Revasc Stent & Ather 2 2 — — $32,322.10 $43,535.00 $37,928.55 2026-04-01
37227 HCPCS Fem/popl Revasc Stnt & Ather 2 2 — — $32,322.10 $43,535.00 $37,928.55 2026-04-01
9449 OTHER Injection, Blinatumomab 2 2 — — $10,559.06 $63,047.38 $36,803.22 2026-04-01
J1414 HCPCS Inj, Beqvez, Per Tx Dose 1 1 — — $4,229,400.00 $4,229,400.00 $4,229,400.00 2026-04-01
C9301 HCPCS Obecabtagene Car Pos T 1 1 — — $598,237.50 $598,237.50 $598,237.50 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 3 1 — — $146,886.05 $200,432.87 $149,730.45 2026-04-01
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 1 1 — — $139,825.05 $139,825.05 $139,825.05 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 3 1 — — $127,948.33 $174,591.48 $130,426.01 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 3 1 — — $110,696.45 $151,050.47 $112,840.05 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 3 1 — — $102,496.49 $139,861.24 $104,481.30 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 3 1 — — $97,965.25 $133,678.16 $99,862.31 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 3 1 — — $97,138.92 $132,550.59 $99,019.98 2026-04-01
A9699 HCPCS Radiopharm Rx Agent Noc 1 1 — — $97,225.26 $97,225.26 $97,225.26 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 3 1 — — $91,048.51 $124,239.95 $92,811.64 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 3 1 — — $85,365.23 $116,484.85 $87,018.31 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 3 1 — — $81,500.49 $111,211.22 $83,078.72 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 3 1 — — $76,574.18 $104,489.04 $78,057.01 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 3 1 — — $60,540.68 $82,610.58 $61,713.03 2026-04-01
C9608 HCPCS Hc Perc D-e Cor Revasc Chro Add - Lc 1 1 — — $55,148.00 $55,148.00 $55,148.00 2026-04-01
C9606 HCPCS Hc Perc D-e Cor Revasc W Ami S - Lc 1 1 — — $55,148.00 $55,148.00 $55,148.00 2026-04-01
C9605 HCPCS Hc Add'l Pci, Des Through Bypapss Graft - Lc 1 1 — — $55,148.00 $55,148.00 $55,148.00 2026-04-01
C9603 HCPCS Hc Atherect W Balloon And/Or Stent Ea Addtl Ld (Des) 1 1 — — $55,148.00 $55,148.00 $55,148.00 2026-04-01
C9601 HCPCS Hc Perc Drug-el Cor Stent Bran - Lc 1 1 — — $55,148.00 $55,148.00 $55,148.00 2026-04-01
2046 OTHER Pmkr, Dual, Leadless 1 1 — — $53,576.44 $53,576.44 $53,576.44 2026-04-01
0100T HCPCS Prosth Retina Receive&Gen 1 1 — — $51,516.00 $51,516.00 $51,516.00 2026-04-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 3 1 — — $48,408.11 $66,055.13 $49,345.52 2026-04-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 3 1 — — $45,954.76 $62,707.42 $46,844.66 2026-04-01
92929 HCPCS Hc Prq Trluml Coronary Stent W/Angio Addl Art/Brnch 1 1 — — $44,779.00 $44,779.00 $44,779.00 2026-04-01
92934 HCPCS Prq Card Stent/ath/angio 1 1 — — $44,779.00 $44,779.00 $44,779.00 2026-04-01
92938 HCPCS Hc Prq Trluml Coronary Byp Grft Revasc Addl Vessel - Lc 1 1 — — $44,779.00 $44,779.00 $44,779.00 2026-04-01
92941 HCPCS Hc Prq Card Revasc Mi 1 Vsl - Lc 1 1 — — $44,779.00 $44,779.00 $44,779.00 2026-04-01
92944 HCPCS Hc Prq Card Revasc Chronic Addl - Rc 1 1 — — $44,779.00 $44,779.00 $44,779.00 2026-04-01
33967 HCPCS Hc Insertion Intra-aortic Balloon Assist Dev Prq 1 1 — — $43,535.00 $43,535.00 $43,535.00 2026-04-01
33968 HCPCS Hc Removal Intra-aortic Balloon Assist Device Prq 1 1 — — $43,535.00 $43,535.00 $43,535.00 2026-04-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 3 1 — — $41,676.85 $56,870.01 $42,483.91 2026-04-01
33225 HCPCS Hc Insj Eltrd Car Ven Sys Tm Insj Cvdfb/Pm Pls Gen 1 1 — — $39,869.00 $39,869.00 $39,869.00 2026-04-01
131 MS_DRG Cranial/Facial Procedures W Cc/Mcc 3 1 — — $38,771.12 $52,905.01 $39,521.92 2026-04-01
341 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Mcc 3 1 — — $37,516.55 $51,193.09 $38,243.05 2026-04-01
129 MS_DRG Major Head & Neck Procedures W Cc/Mcc Or Major Device 3 1 — — $34,567.10 $47,168.42 $35,236.48 2026-04-01
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