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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

CLINTON REGIONAL HOSPITAL

Clinton, OK · CCN 370245 · Rates published

20,029 distinct procedures filed
22 distinct payers
143,722 rate rows
2026-05-18 last MRF observed
Data quality

119,627 of 143,722 rate rows are consumer-grade (83.2%)

24,095 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 20,899
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 2,667
exceeds 10× this hospital's gross charge — excluded from medians 462
placeholder amount (≤ $0.02) — excluded from medians 52
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 15
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.trihealth.com/static/pricing/273633811_clinton-memorial-hospital_standardcharges.json
Found on page https://www.trihealth.com/patients-and-visitors/billing-and-insurance/pricing-estimates
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-02
Content fingerprint ff1614eb9bfc4865… · 30,398,128 bytes · first seen 2026-07-09

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 2 $4,505,000.00 $4,640,150.00 $4,572,575.00 nat. median
$4,505,000
1.0× median
J3389
HCPCS 		Topi Adm Prad Zami Per Treat 3 $3,335,820.00 $4,836,939.00 $3,886,230.30 nat. median
$3,335,820
1.2× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 3 $3,321,376.38 $4,815,995.75 $3,869,403.48 nat. median
$3,325,455
1.2× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 3 $3,691,450.00 $4,798,885.00 $3,802,193.50 nat. median
$3,685,267
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 3 $3,245,381.39 $4,705,803.01 $3,780,869.32 nat. median
$3,248,446
1.2× median
J3387
HCPCS 		Inj Elivaldogene Autotemecel 3 $3,180,000.00 $4,611,000.00 $3,704,700.00 nat. median
$3,180,000
1.2× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 3 $2,938,320.00 $4,260,564.00 $3,423,142.80 nat. median
$2,968,000
1.2× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 3 $2,587,087.26 $3,751,276.52 $3,013,956.65 nat. median
$2,455,111
1.2× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 3 $2,332,000.00 $3,381,400.00 $2,716,780.00 nat. median
$2,332,000
1.2× median
Q2057
HCPCS 		Afamitresgene Autoleucel 3 $770,620.00 $2,160,818.48 $1,117,399.00 nat. median
$813,967
1.4× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 3 $614,180.81 $1,588,553.77 $890,562.17 nat. median
$621,313
1.4× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 3 $588,494.81 $1,647,769.39 $853,317.47 nat. median
$599,737
1.4× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 3 $562,260.84 $1,576,412.28 $815,278.21 nat. median
$579,571
1.4× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 3 $559,781.08 $1,564,861.17 $811,682.57 nat. median
$574,037
1.4× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 3 $531,849.12 $1,492,267.04 $771,181.22 nat. median
$562,501
1.4× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 3 $489,290.60 $1,372,418.36 $709,471.37 nat. median
$513,770
1.4× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 3 $278,250.00 $796,950.00 $403,462.50 nat. median
$286,598
1.4× median
J3403
HCPCS 		Revakinagene, Per Implant 4 $262,233.77 $743,060.00 $380,238.97 nat. median
$264,195
1.4× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 12 $302,118.23 $755,353.54 $302,118.23 nat. median
$168,055
1.8× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 3 $202,713.58 $565,479.93 $293,934.70 nat. median
$207,733
1.4× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 12 $196,521.07 $490,194.06 $196,521.07 nat. median
$186,516
1.1× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 1 $184,197.20 $211,826.78 $187,814.16 nat. median
$92,809
outlier · 2.0×
E0766
HCPCS 		Elec Stim Cancer Treatment 1 $23,726.53 $241,924.47 $179,696.20 nat. median
$16,158
outlier · 11.1×
L5969
HCPCS 		Ak/ft Power Asst Incl Motors 1 $171,795.25 $175,168.68 $173,481.96 nat. median
$13,709
outlier · 12.7×
90288
HCPCS 		Botulism Ig IV 1 $149,029.65 $165,169.62 $161,988.75 nat. median
$43,548
outlier · 3.7×
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 3 $110,901.76 $193,521.71 $152,489.92 nat. median
$108,243
1.4× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 12 $150,034.05 $373,462.95 $150,034.05 nat. median
$131,925
1.1× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 12 $149,161.20 $371,271.20 $149,161.20 nat. median
$145,435
1.0× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 1 $137,685.79 $140,389.44 $139,037.61 nat. median
$95,583
1.5× median
C1882
HCPCS 		Aicd, Other Than Sing/dual 1 $117,562.50 $119,871.00 $118,716.75 nat. median
$24,131
outlier · 4.9×
C1721
HCPCS 		Aicd, Dual Chamber 1 $103,237.75 $105,264.96 $104,251.36 nat. median
$19,958
outlier · 5.2×
C1722
HCPCS 		Aicd, Single Chamber 1 $99,618.75 $101,574.90 $100,596.82 nat. median
$19,800
outlier · 5.1×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 12 $97,795.19 $242,288.69 $97,795.19 nat. median
$97,418
1.0× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 4 $64,282.30 $180,226.51 $93,209.33 nat. median
$66,211
1.4× median
7
MS_DRG 		Lung Transplant 12 $91,517.41 $226,524.90 $91,517.41 nat. median
$70,649
1.3× median
L8702
HCPCS 		Pow Ue Rom Dev Ewhf Uprt Cus 3 $68,801.71 $99,762.48 $90,007.93 nat. median
$68,802
1.3× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 12 $85,022.99 $210,217.11 $85,022.99 nat. median
$72,715
1.2× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 4 $56,824.55 $205,861.17 $82,395.60 nat. median
$65,477
1.3× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 4 $56,269.19 $152,549.12 $81,590.33 nat. median
$63,499
1.3× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 12 $80,243.61 $198,215.85 $80,243.61 nat. median
$65,418
1.2× median
209
MS_DRG 		Complex Aortic Arch Procedures 12 $80,153.05 $197,988.45 $80,153.05 nat. median
$2,110
outlier · 38.0×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 $78,079.96 $192,782.83 $78,079.96 nat. median
$2,736
outlier · 28.5×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 12 $77,055.26 $190,209.76 $77,055.26 nat. median
$74,509
1.0× median
A9699
HCPCS 		Radiopharm Rx Agent Noc 1 $75,780.76 $77,268.82 $76,524.79 nat. median
$7,098
outlier · 10.8×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 12 $73,129.21 $180,351.27 $73,129.21 nat. median
$69,922
1.0× median
215
MS_DRG 		Other Heart Assist System Implant 12 $70,666.73 $174,167.84 $70,666.73 nat. median
$73,023
1.0× median
C1817
HCPCS 		Septal Defect Imp Sys 1 $69,305.50 $70,666.41 $69,985.96 nat. median
$10,054
outlier · 7.0×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 $69,453.25 $171,120.74 $69,453.25 nat. median
$69,822
1.0× median
S9989
HCPCS 		Services Outside US 1 $67,375.00 $68,698.00 $68,036.50 —
C9601
HCPCS 		Perc Drug-el Cor Stent Bran 2 $965.00 $103,276.93 $65,148.50 nat. median
$9,005
outlier · 7.2×

Other procedures at this hospital

Browse this hospital's 20,029 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
             
64654 HCPCS 1st Opn Implt Bat Modulj Sys 8 4 — — $1,395.57 $61,762.42 $37,688.88 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 18 12 — — $39,548.83 $96,029.33 $39,548.83 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 18 12 — — $61,628.32 $151,471.97 $61,628.32 2026-04-01
K0606 HCPCS Aed Garment W Elec Analysis 6 1 — — $5,197.03 $52,990.92 $39,360.50 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 7 3 — — $770,620.00 $2,160,818.48 $1,117,399.00 2026-04-01
245 MS_DRG Aicd Generator Procedures 18 12 — — $33,087.85 $79,805.50 $33,087.85 2026-04-01
265 MS_DRG Aicd Lead Procedures 18 12 — — $26,510.53 $63,289.55 $26,510.53 2026-04-01
C1721 HCPCS Aicd, Dual Chamber 2 1 — — $103,237.75 $105,264.96 $104,251.36 2026-04-01
C1882 HCPCS Aicd, Other Than Sing/dual 2 1 — — $117,562.50 $119,871.00 $118,716.75 2026-04-01
C1722 HCPCS Aicd, Single Chamber 2 1 — — $99,618.75 $101,574.90 $100,596.82 2026-04-01
E0194 HCPCS Air Fluidized Bed 6 1 — — $6,143.25 $62,638.92 $46,526.83 2026-04-01
L5969 HCPCS Ak/ft Power Asst Incl Motors 2 1 — — $171,795.25 $175,168.68 $173,481.96 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 18 12 — — $85,022.99 $210,217.11 $85,022.99 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 18 12 — — $35,590.74 $86,090.38 $35,590.74 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 18 12 — — $31,210.51 $75,091.41 $31,210.51 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 18 12 — — $25,599.38 $61,001.60 $25,599.38 2026-04-01
L5973 HCPCS Ank-foot Sys Dors-plant Flex 6 3 — — $21,739.52 $31,522.30 $28,440.12 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 18 12 — — $49,217.66 $120,308.23 $49,217.66 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 18 12 — — $30,724.98 $73,872.21 $30,724.98 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 18 12 — — $42,612.48 $103,722.31 $42,612.48 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 18 12 — — $39,147.59 $95,021.79 $39,147.59 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 7 3 — — $531,849.12 $1,492,267.04 $771,181.22 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 18 12 — — $27,340.19 $65,372.85 $27,340.19 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 18 12 — — $25,822.29 $61,561.34 $25,822.29 2026-04-01
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 2 1 — — $137,685.79 $140,389.44 $139,037.61 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 18 12 — — $39,779.40 $96,608.32 $39,779.40 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 18 12 — — $26,144.12 $62,369.48 $26,144.12 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 18 12 — — $25,370.89 $60,427.86 $25,370.89 2026-04-01
90288 HCPCS Botulism Ig IV 3 1 — — $149,029.65 $165,169.62 $161,988.75 2026-04-01
C2616 HCPCS Brachytx, Non-str,yttrium-90 6 3 — — $17,771.01 $55,991.00 $24,435.14 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 7 3 — — $489,290.60 $1,372,418.36 $709,471.37 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 18 12 — — $50,976.58 $124,724.96 $50,976.58 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 18 12 — — $43,148.17 $105,067.45 $43,148.17 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 18 12 — — $33,478.64 $80,786.80 $33,478.64 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 18 12 — — $23,194.01 $54,961.61 $23,194.01 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 18 12 — — $23,965.15 $56,897.98 $23,965.15 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 18 12 — — $69,453.25 $171,120.74 $69,453.25 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 18 12 — — $47,109.74 $115,015.15 $47,109.74 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 18 12 — — $47,109.74 $115,015.15 $47,109.74 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 18 12 — — $54,793.26 $134,308.82 $54,793.26 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 18 12 — — $38,454.47 $93,281.34 $38,454.47 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 18 12 — — $36,416.21 $88,163.18 $36,416.21 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 18 12 — — $28,269.45 $67,706.28 $28,269.45 2026-04-01
C1714 HCPCS Cath, Trans Atherectomy, Dir 2 1 — — $44,825.00 $45,705.20 $45,265.10 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 18 12 — — $21,828.67 $51,533.18 $21,828.67 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 18 12 — — $34,942.90 $84,463.62 $34,942.90 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 18 12 — — $34,772.93 $84,036.82 $34,772.93 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 18 12 — — $302,118.23 $755,353.54 $302,118.23 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 18 12 — — $26,123.22 $62,317.00 $26,123.22 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 18 12 — — $24,316.94 $57,781.32 $24,316.94 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 7 3 — — $588,494.81 $1,647,769.39 $853,317.47 2026-04-01
L8614 HCPCS Cochlear Device 2 1 — — $31,739.24 $32,362.48 $32,050.86 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 18 12 — — $64,067.12 $157,595.92 $64,067.12 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 18 12 — — $41,479.81 $100,878.11 $41,479.81 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 18 12 — — $80,153.05 $197,988.45 $80,153.05 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 18 12 — — $77,055.26 $190,209.76 $77,055.26 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 18 12 — — $47,884.37 $116,960.26 $47,884.37 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 18 12 — — $54,562.69 $133,729.84 $54,562.69 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 18 12 — — $39,359.35 $95,553.55 $39,359.35 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 18 12 — — $60,028.92 $147,455.81 $60,028.92 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 18 12 — — $43,538.27 $106,047.00 $43,538.27 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 18 12 — — $42,186.86 $102,653.55 $42,186.86 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 18 12 — — $30,485.34 $73,270.49 $30,485.34 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 18 12 — — $31,450.83 $75,694.88 $31,450.83 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 18 12 — — $23,256.01 $55,117.29 $23,256.01 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 18 12 — — $23,669.79 $56,156.32 $23,669.79 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 18 12 — — $22,964.83 $54,386.13 $22,964.83 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 18 12 — — $32,978.48 $79,530.88 $32,978.48 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 18 12 — — $48,195.05 $117,740.40 $48,195.05 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 18 12 — — $41,223.46 $100,234.41 $41,223.46 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 18 12 — — $28,556.45 $68,426.95 $28,556.45 2026-04-01
K0008 HCPCS Cstm Manual Wheelchair/base 2 1 — — $35,200.00 $35,891.20 $35,545.60 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 3 1 — — $184,197.20 $211,826.78 $187,814.16 2026-04-01
S1034 HCPCS Description Not Available 2 1 — — $23,945.96 $24,416.17 $24,181.06 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 6 3 — — $110,901.76 $193,521.71 $152,489.92 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 18 12 — — $149,161.20 $371,271.20 $149,161.20 2026-04-01
L6880 HCPCS Elec Hand Ind Art Digits 6 3 — — $29,420.21 $42,659.30 $38,488.17 2026-04-01
L5856 HCPCS Elec Knee-shin Swing/stance 6 3 — — $29,559.78 $42,861.68 $38,670.76 2026-04-01
E0766 HCPCS Elec Stim Cancer Treatment 6 1 — — $23,726.53 $241,924.47 $179,696.20 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 6 3 — — $49,338.18 $71,540.36 $64,545.31 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 6 3 — — $47,919.99 $69,483.99 $62,690.00 2026-04-01
C1884 HCPCS Embolization Protect Syst 2 1 — — $23,245.75 $23,702.21 $23,473.98 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 18 12 — — $41,060.46 $99,825.09 $41,060.46 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 18 12 — — $43,996.63 $107,197.97 $43,996.63 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 18 12 — — $34,469.91 $83,275.91 $34,469.91 2026-04-01
0620T OTHER Evasc Ven Artlz Tibl/prnl Vn 8 4 — — $3,660.47 $61,762.42 $28,539.88 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 18 12 — — $150,034.05 $373,462.95 $150,034.05 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 18 12 — — $28,433.16 $68,117.35 $28,433.16 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 18 12 — — $33,989.25 $82,068.97 $33,989.25 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 18 12 — — $24,238.92 $57,585.41 $24,238.92 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 18 12 — — $42,708.62 $103,963.70 $42,708.62 2026-04-01
S2411 HCPCS Fetoscop Laser Ther Ttts 3 1 — — $10,593.00 $22,640.95 $22,204.93 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 21 13 — — $1,982.96 $72,934.64 $30,351.60 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 18 12 — — $51,271.24 $125,464.87 $51,271.24 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 18 12 — — $23,742.24 $56,338.23 $23,742.24 2026-04-01
C1820 HCPCS Generator Neuro Rechg Bat Sy 2 1 — — $32,089.37 $32,719.48 $32,404.42 2026-04-01
C1767 HCPCS Generator, Neuro Non-recharg 2 1 — — $36,290.16 $37,002.76 $36,646.46 2026-04-01
V5249 HCPCS Hearing Aid, Binaural, Itc 2 1 — — $52,250.00 $53,276.00 $52,763.00 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 18 12 — — $196,521.07 $490,194.06 $196,521.07 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 18 12 — — $80,243.61 $198,215.85 $80,243.61 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 18 12 — — $25,040.01 $59,596.99 $25,040.01 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 18 12 — — $43,947.17 $107,073.78 $43,947.17 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 7 3 — — $559,781.08 $1,564,861.17 $811,682.57 2026-04-01
0870T OTHER Imp Subq Prtl Ascts Pmp Sys 6 4 — — $5,219.00 $48,037.59 $33,626.31 2026-04-01
69930 HCPCS Implant Cochlear Device 8 4 — — $3,093.45 $86,874.00 $32,812.49 2026-04-01
61886 HCPCS Implant Neurostim Arrays 8 4 — — $2,190.35 $61,137.00 $31,759.45 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 8 4 — — $1,485.83 $61,762.42 $37,688.88 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 19 12 — — $5,961.44 $86,385.99 $35,708.46 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 4 3 — — $3,321,376.38 $4,815,995.75 $3,869,403.48 2026-04-01
J3387 HCPCS Inj Elivaldogene Autotemecel 4 3 — — $3,180,000.00 $4,611,000.00 $3,704,700.00 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 4 3 — — $2,587,087.26 $3,751,276.52 $3,013,956.65 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 9 4 — — $64,282.30 $180,226.51 $93,209.33 2026-04-01
J3391 HCPCS Inj, Atidarsagene Autotemcel 2 2 — — $4,505,000.00 $4,640,150.00 $4,572,575.00 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 4 3 — — $2,938,320.00 $4,260,564.00 $3,423,142.80 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 4 3 — — $2,332,000.00 $3,381,400.00 $2,716,780.00 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 3 3 — — $3,691,450.00 $4,798,885.00 $3,802,193.50 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 4 3 — — $3,245,381.39 $4,705,803.01 $3,780,869.32 2026-04-01
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 7 3 — — $202,713.58 $565,479.93 $293,934.70 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 8 4 — — $1,679.37 $44,013.79 $30,809.65 2026-04-01
0916T OTHER Insj Perm Ccm-d Sys Pg Only 6 4 — — $10,993.00 $32,783.00 $25,059.69 2026-04-01
0915T OTHER Insj Perm Ccm-d Sys Pg&eltrd 6 4 — — $15,006.00 $44,013.79 $32,023.99 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 8 4 — — $1,736.65 $61,762.42 $37,688.88 2026-04-01
0515T OTHER Insj Wcs Lv Compl Sys 8 4 — — $1,374.31 $32,783.00 $21,833.12 2026-04-01
0409T OTHER Insj/rplc Car Modulj Pls Gn 8 4 — — $977.13 $32,783.00 $21,833.12 2026-04-01
0408T OTHER Insj/rplc Cardiac Modulj Sys 8 4 — — $2,185.54 $44,013.79 $30,809.65 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 8 4 — — $2,734.46 $60,327.00 $32,023.99 2026-04-01
0571T OTHER Insj/rplcmt Icds Ss Eltrd 8 4 — — $1,943.65 $44,013.79 $30,809.65 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 8 4 — — $1,124.70 $32,783.00 $21,833.12 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 8 4 — — $1,202.71 $44,013.79 $30,809.65 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 8 4 — — $1,105.14 $60,327.00 $25,059.69 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 8 4 — — $1,312.80 $61,137.00 $30,288.29 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 8 4 — — $839.00 $61,137.00 $30,288.29 2026-04-01
J9216 HCPCS Interferon Gamma 1-b Inj 3 1 — — $22,333.47 $25,683.50 $22,772.01 2026-04-01
L6975 HCPCS Interscap-thor Myoelectronic 6 3 — — $21,834.21 $31,659.60 $28,564.00 2026-04-01
L6970 HCPCS Interscapular-thor Switch CT 6 3 — — $19,809.02 $28,723.08 $25,914.60 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 18 12 — — $38,182.79 $92,599.15 $38,182.79 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 18 12 — — $56,120.29 $137,641.05 $56,120.29 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 18 12 — — $23,439.91 $55,579.08 $23,439.91 2026-04-01
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 6 3 — — $39,537.89 $58,378.66 $54,326.83 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 18 12 — — $23,484.50 $55,691.03 $23,484.50 2026-04-01
652 MS_DRG Kidney Transplant 18 12 — — $23,802.84 $56,490.41 $23,802.84 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 18 12 — — $34,056.12 $82,236.89 $34,056.12 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 18 12 — — $27,120.76 $64,821.85 $27,120.76 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 18 12 — — $23,786.13 $56,448.43 $23,786.13 2026-04-01
L5859 HCPCS Knee-shin Pro Flex/ext Cont 6 3 — — $17,866.14 $25,905.90 $23,372.89 2026-04-01
0674T OTHER Laps Insj Nw/rpcmt Prm Isdss 6 4 — — $10,993.00 $43,268.98 $30,288.29 2026-04-01
S2120 HCPCS Ldl Apheresis, Heparin Induced 3 1 — — $10,593.00 $32,829.23 $32,197.00 2026-04-01
C1895 HCPCS Lead, Aicd, Endo Dual Coil 2 1 — — $28,407.50 $28,965.32 $28,686.41 2026-04-01
C1777 HCPCS Lead, Aicd, Endo Single Coil 2 1 — — $23,595.00 $24,058.32 $23,826.66 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 18 12 — — $27,519.21 $65,822.40 $27,519.21 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 7 3 — — $562,260.84 $1,576,412.28 $815,278.21 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 18 12 — — $73,129.21 $180,351.27 $73,129.21 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 18 12 — — $33,607.51 $81,110.40 $33,607.51 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 18 12 — — $26,562.78 $63,420.74 $26,562.78 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 18 12 — — $22,321.17 $52,769.87 $22,321.17 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 18 12 — — $26,882.52 $64,223.63 $26,882.52 2026-04-01
7 MS_DRG Lung Transplant 18 12 — — $91,517.41 $226,524.90 $91,517.41 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 18 12 — — $42,160.39 $102,587.08 $42,160.39 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 18 12 — — $23,840.46 $56,584.87 $23,840.46 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 18 12 — — $33,243.89 $80,197.32 $33,243.89 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 18 12 — — $37,504.30 $90,895.43 $37,504.30 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 18 12 — — $32,526.39 $78,395.65 $32,526.39 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 18 12 — — $31,018.24 $74,608.63 $31,018.24 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 19 12 — — $885.00 $53,056.73 $22,435.41 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 20 12 — — $19,678.20 $80,401.98 $33,325.39 2026-04-01
Q0481 HCPCS Microprcsr Cu Elec Vad, Rep 6 3 — — $17,892.75 $31,222.54 $24,602.54 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 18 12 — — $22,632.55 $53,551.76 $22,632.55 2026-04-01
Q0483 HCPCS Monitor Elec Vad, Rep 6 3 — — $23,087.32 $40,286.97 $31,745.07 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 12 — — $78,079.96 $192,782.83 $78,079.96 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 12 — — $51,590.98 $126,267.75 $51,590.98 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 12 — — $40,469.04 $98,340.02 $40,469.04 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 18 12 — — $47,850.23 $116,874.55 $47,850.23 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 18 12 — — $30,847.58 $74,180.07 $30,847.58 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 18 12 — — $33,891.73 $81,824.08 $33,891.73 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 18 12 — — $23,318.71 $55,274.72 $23,318.71 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 18 12 — — $26,465.95 $63,177.61 $26,465.95 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 6 4 — — $10,593.00 $37,743.97 $29,797.11 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 18 12 — — $25,188.38 $59,969.57 $25,188.38 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 18 12 — — $26,582.28 $63,469.72 $26,582.28 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 18 12 — — $28,229.05 $67,604.83 $28,229.05 2026-04-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 7 3 — — $278,250.00 $796,950.00 $403,462.50 2026-04-01
0908T OTHER Opn Imp Int Nstm Sys Vgs Nrv 6 4 — — $5,219.00 $43,268.98 $30,288.29 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 8 4 — — $2,053.92 $43,268.98 $25,843.84 2026-04-01
K1027 HCPCS Oral Dev Without Fix Mech 2 1 — — $27,754.27 $28,299.26 $28,026.76 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 18 12 — — $35,769.77 $86,539.92 $35,769.77 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 18 12 — — $23,245.56 $55,091.05 $23,245.56 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 19 12 — — $11,815.75 $58,433.78 $24,576.77 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 18 12 — — $31,906.41 $76,838.86 $31,906.41 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 18 12 — — $27,404.97 $65,535.53 $27,404.97 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 18 12 — — $27,267.04 $65,189.19 $27,267.04 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 18 12 — — $32,394.73 $78,065.05 $32,394.73 2026-04-01
215 MS_DRG Other Heart Assist System Implant 18 12 — — $70,666.73 $174,167.84 $70,666.73 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 18 12 — — $30,235.96 $72,644.28 $30,235.96 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 18 12 — — $30,574.51 $73,494.39 $30,574.51 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 18 12 — — $26,079.34 $62,206.80 $26,079.34 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 18 12 — — $38,060.89 $92,293.04 $38,060.89 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 18 12 — — $23,506.09 $55,745.25 $23,506.09 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 18 12 — — $28,050.72 $67,157.04 $28,050.72 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 18 12 — — $30,660.19 $73,709.54 $30,660.19 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 18 12 — — $54,386.45 $133,287.29 $54,386.45 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 18 12 — — $21,814.74 $51,498.20 $21,814.74 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 18 12 — — $29,059.40 $69,689.88 $29,059.40 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 18 12 — — $27,342.97 $65,379.85 $27,342.97 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 18 12 — — $23,865.54 $56,647.84 $23,865.54 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 18 12 — — $25,605.65 $61,017.34 $25,605.65 2026-04-01
10 MS_DRG Pancreas Transplant 18 12 — — $51,292.14 $125,517.34 $51,292.14 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 18 12 — — $39,413.69 $95,689.99 $39,413.69 2026-04-01
E0329 HCPCS Ped Hospital Bed Semi/elect 6 1 — — $5,922.68 $60,389.78 $44,856.21 2026-04-01
E0328 HCPCS Ped Hospital Bed, Manual 6 1 — — $3,025.72 $30,851.18 $22,915.58 2026-04-01
J9266 HCPCS Pegaspargase Injection 9 4 — — $28,424.06 $79,701.06 $41,214.89 2026-04-01
C9607 HCPCS Perc D-e Cor Revasc Chro Sin 8 4 — — $14,485.00 $46,370.51 $24,375.25 2026-04-01
C9606 HCPCS Perc D-e Cor Revasc W Ami S 4 2 — — $4,025.00 $67,109.06 $47,412.83 2026-04-01
C9602 HCPCS Perc D-e Cor Stent Ather S 8 4 — — $14,485.00 $53,858.84 $24,375.25 2026-04-01
C9601 HCPCS Perc Drug-el Cor Stent Bran 4 2 — — $965.00 $103,276.93 $65,148.50 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 18 12 — — $30,044.40 $72,163.25 $30,044.40 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 18 12 — — $24,236.13 $57,578.42 $24,236.13 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 18 12 — — $25,259.44 $60,147.99 $25,259.44 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 18 12 — — $28,203.28 $67,540.11 $28,203.28 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 18 12 — — $26,181.04 $62,462.18 $26,181.04 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 18 12 — — $23,547.19 $55,848.46 $23,547.19 2026-04-01
C2621 HCPCS Pmkr, Other Than Sing/dual 2 1 — — $24,172.50 $24,647.16 $24,409.83 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 5 2 — — $30,285.53 $70,808.63 $61,572.72 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 18 12 — — $32,992.41 $79,565.86 $32,992.41 2026-04-01
L8701 HCPCS Pow Ue Rom Dev Ewh Uprt Cust 6 3 — — $34,970.13 $50,706.69 $45,748.71 2026-04-01
L8702 HCPCS Pow Ue Rom Dev Ewhf Uprt Cus 6 3 — — $68,801.71 $99,762.48 $90,007.93 2026-04-01
791 MS_DRG Prematurity With Major Problems 19 13 — — $11,352.76 $71,000.03 $29,581.16 2026-04-01
665 MS_DRG Prostatectomy With Mcc 18 12 — — $23,048.42 $54,596.03 $23,048.42 2026-04-01
0956T OTHER Prt Crn Ch Cr&tun Elt S-sclp 6 4 — — $10,993.00 $38,047.60 $29,904.96 2026-04-01
K0864 HCPCS Pwc Gp3 Xhd Mult Pow Opt S/b 6 1 — — $3,192.20 $32,548.92 $24,176.62 2026-04-01
K0884 HCPCS Pwc Gp4 Std Mult Pow Opt S/b 6 1 — — $5,496.48 $56,044.22 $41,628.43 2026-04-01
K0880 HCPCS Pwc Gp4 Vhd Sing Pow Opt S/b 6 1 — — $2,983.39 $30,419.75 $22,595.15 2026-04-01
K0891 HCPCS Pwc Gp5 Ped Mult Pow Opt S/b 6 1 — — $4,467.93 $45,556.59 $33,838.44 2026-04-01
K0890 HCPCS Pwc Gp5 Ped Sing Pow Opt S/b 6 1 — — $2,906.48 $29,635.48 $22,012.58 2026-04-01
Q0489 HCPCS Pwr Pck Base Combo Vad, Rep 6 3 — — $20,015.46 $34,926.65 $27,521.26 2026-04-01
A9699 HCPCS Radiopharm Rx Agent Noc 2 1 — — $75,780.76 $77,268.82 $76,524.79 2026-04-01
C1816 HCPCS Receiver/transmitter, Neuro 2 1 — — $30,448.00 $31,045.89 $30,746.94 2026-04-01
332 MS_DRG Rectal Resection With Mcc 18 12 — — $26,527.95 $63,333.28 $26,527.95 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 20 13 — — $21,261.44 $112,555.77 $46,130.32 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 8 4 — — $1,478.54 $43,268.98 $22,162.84 2026-04-01
J3403 HCPCS Revakinagene, Per Implant 9 4 — — $262,233.77 $743,060.00 $380,238.97 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 18 12 — — $25,872.45 $61,687.29 $25,872.45 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 18 12 — — $37,567.00 $91,052.86 $37,567.00 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 8 4 — — $1,061.56 $43,268.98 $25,843.84 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 8 4 — — $1,161.46 $43,268.98 $25,843.84 2026-04-01
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 8 4 — — $979.80 $32,783.00 $21,833.12 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 8 4 — — $1,159.84 $61,137.00 $25,059.69 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 8 4 — — $1,209.84 $61,137.00 $32,023.99 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 8 4 — — $1,115.57 $32,783.00 $21,833.12 2026-04-01
0923T OTHER Rmvl&rplcmt Perm Ccm-d Pg 6 4 — — $10,993.00 $32,783.00 $25,059.69 2026-04-01
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 8 4 — — $978.07 $32,783.00 $21,833.12 2026-04-01
0960T OTHER Rpl S-sclp Eltr Ra Rcvr&tlmt 6 4 — — $5,219.00 $38,047.60 $29,904.96 2026-04-01
0909T OTHER Rplcmt Int Nstim Sys Vgs Nrv 6 4 — — $5,219.00 $43,268.98 $30,288.29 2026-04-01
0871T OTHER Rplcmt Subq Prtl Ascites Pmp 6 4 — — $5,219.00 $37,743.97 $29,797.11 2026-04-01
C1817 HCPCS Septal Defect Imp Sys 2 1 — — $69,305.50 $70,666.41 $69,985.96 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 19 12 — — $35,122.42 $120,901.21 $49,453.81 2026-04-01
S9989 HCPCS Services Outside US 2 1 — — $67,375.00 $68,698.00 $68,036.50 2026-04-01
L6965 HCPCS Shldr Disartic Myoelectronic 6 3 — — $18,506.37 $26,834.24 $24,210.44 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 18 12 — — $22,346.95 $52,834.59 $22,346.95 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 18 12 — — $40,347.83 $98,035.66 $40,347.83 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 18 12 — — $51,005.84 $124,798.42 $51,005.84 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 18 12 — — $29,312.96 $70,326.59 $29,312.96 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 18 12 — — $38,432.18 $93,225.36 $38,432.18 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 18 12 — — $23,809.11 $56,506.16 $23,809.11 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 9 4 — — $56,269.19 $152,549.12 $81,590.33 2026-04-01
570 MS_DRG Skin Debridement With Mcc 18 12 — — $21,793.84 $51,445.72 $21,793.84 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 18 12 — — $35,447.94 $85,731.79 $35,447.94 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 18 12 — — $25,487.92 $60,721.73 $25,487.92 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 18 12 — — $46,943.26 $114,597.09 $46,943.26 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 18 12 — — $26,099.54 $62,257.53 $26,099.54 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 18 12 — — $26,892.97 $64,249.87 $26,892.97 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 18 12 — — $23,352.14 $55,358.68 $23,352.14 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 18 12 — — $59,844.32 $146,992.27 $59,844.32 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 18 12 — — $42,845.15 $104,306.55 $42,845.15 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 18 12 — — $30,372.49 $72,987.12 $30,372.49 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 18 12 — — $25,071.36 $59,675.71 $25,071.36 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 18 12 — — $43,160.01 $105,097.18 $43,160.01 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 18 12 — — $32,854.49 $79,219.52 $32,854.49 2026-04-01
L5858 HCPCS Stance Phase Only 6 3 — — $22,885.05 $33,183.32 $29,938.74 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 18 12 — — $36,048.41 $87,239.60 $36,048.41 2026-04-01
J9226 HCPCS Supprelin La Implant 9 4 — — $41,173.43 $121,091.69 $59,701.47 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 8 4 — — $1,003.64 $40,220.09 $28,154.07 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 18 12 — — $22,344.16 $52,827.59 $22,344.16 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 7 3 — — $614,180.81 $1,588,553.77 $890,562.17 2026-04-01
J3389 HCPCS Topi Adm Prad Zami Per Treat 4 3 — — $3,335,820.00 $4,836,939.00 $3,886,230.30 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 18 12 — — $30,674.82 $73,746.27 $30,674.82 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 18 12 — — $39,299.45 $95,403.12 $39,299.45 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 18 12 — — $97,795.19 $242,288.69 $97,795.19 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 8 4 — — $638.91 $88,200.59 $36,856.49 2026-04-01
L6700 HCPCS Ue Add Ext Power Myoel 6 3 — — $29,510.19 $44,618.26 $40,576.51 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 18 12 — — $40,080.34 $97,363.97 $40,080.34 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 18 12 — — $26,428.34 $63,083.15 $26,428.34 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 18 12 — — $22,039.74 $52,063.19 $22,039.74 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 18 12 — — $26,263.94 $62,670.34 $26,263.94 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 18 12 — — $26,206.12 $62,525.15 $26,206.12 2026-04-01
263 MS_DRG Vein Ligation And Stripping 18 12 — — $22,603.99 $53,480.04 $22,603.99 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 18 12 — — $32,517.33 $78,372.91 $32,517.33 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 18 12 — — $41,008.91 $99,695.65 $41,008.91 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 18 12 — — $23,003.14 $54,482.33 $23,003.14 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 18 12 — — $30,539.68 $73,406.93 $30,539.68 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 9 4 — — $56,824.55 $205,861.17 $82,395.60 2026-04-01
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