Price Transparency Hospital negotiated rates

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

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Hospital

COLLETON MEDICAL CENTER

Walterboro, SC · CCN 420030 · Rates published

34,291 distinct procedures filed
54 distinct payers
567,380 rate rows
2026-06-05 last MRF observed
Data quality

512,893 of 567,380 rate rows are consumer-grade (90.4%)

54,487 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 47,266
per-diem day rate — not a per-procedure price 7,116
placeholder amount (≤ $0.02) — excluded from medians 102
exceeds 10× this hospital's gross charge — excluded from medians 3
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/57-0712623_HCA-Healthcare-Colleton-Hospital_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page https://colletonmedical.com/about/legal/pricing-transparency-cms-required-file-of-standard-charges.dot
Discovered viaDiscovered by HANK
Last fetch success · 2026-06-16
Content fingerprint 57ce1e59705c9a96… · 215,570,301 bytes · first seen 2026-06-16

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
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $4,850,948.67 $4,850,948.67 $4,850,948.67 nat. median
$3,006,423
1.6× median
845
OTHER 		Inj, Atidarsagene Autotem 17 $4,896.40 $4,865,400.00 $4,595,100.00 nat. median
$9,966
outlier · 461.1×
00845
OTHER 		Inj, Atidarsagene Autotem 1 $4,369,850.00 $4,369,850.00 $4,369,850.00 nat. median
$4,505,000
1.0× median
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 1 $3,847,800.00 $3,847,800.00 $3,847,800.00 nat. median
$2,448,600
1.6× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 18 $3,685,267.00 $4,422,320.40 $3,758,972.34 nat. median
$3,746,358
1.0× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 1 $3,574,708.99 $3,574,708.99 $3,574,708.99 nat. median
$3,574,709
1.0× median
908
OTHER 		Topi Adm Prad Zami Per Tr 23 $8,865.63 $4,903,655.40 $3,402,536.40 nat. median
$22,747
outlier · 149.6×
714
OTHER 		Inj Delandistrogene Mox R 23 $5,758.83 $4,891,954.20 $3,394,417.20 nat. median
$13,041
outlier · 260.3×
748
OTHER 		Inj, Lovotibeglogene Auto 23 $10,961.87 $4,781,186.76 $3,317,558.16 nat. median
$17,963
outlier · 184.7×
906
OTHER 		Inj Elivaldogene Autoteme 23 $7,833.83 $4,674,600.00 $3,243,600.00 nat. median
$20,756
outlier · 156.3×
00908
OTHER 		Topi Adm Prad Zami Per Tr 1 $3,235,745.40 $3,235,745.40 $3,235,745.40 nat. median
$12,675
outlier · 255.3×
00714
OTHER 		Inj Delandistrogene Mox R 1 $3,228,024.20 $3,228,024.20 $3,228,024.20 nat. median
$3,228,024
1.0× median
00748
OTHER 		Inj, Lovotibeglogene Auto 1 $3,154,932.76 $3,154,932.76 $3,154,932.76 nat. median
$3,187,420
1.0× median
00906
OTHER 		Inj Elivaldogene Autoteme 1 $3,084,600.00 $3,084,600.00 $3,084,600.00 nat. median
$21
outlier · 149086.5×
746
OTHER 		Inj, Betibeglogene Autote 23 $10,139.85 $4,321,754.43 $2,998,768.38 nat. median
$21,896
outlier · 137.0×
00746
OTHER 		Inj, Betibeglogene Autote 1 $2,851,769.93 $2,851,769.93 $2,851,769.93 nat. median
$2,878,960
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 23 $2,588,981.00 $4,530,716.75 $2,640,760.62 nat. median
$2,588,981
1.0× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 1 $2,511,311.57 $2,511,311.57 $2,511,311.57 nat. median
$2,457,321
1.0× median
824
OTHER 		Inj, Exagamglogene Autote 25 $11,873.51 $4,897,200.00 $2,378,640.00 nat. median
$25,250
outlier · 94.2×
00824
OTHER 		Inj, Exagamglogene Autote 1 $2,262,040.00 $2,262,040.00 $2,262,040.00 nat. median
$2,332,000
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 1 $1,271,523.00 $1,271,523.00 $1,271,523.00 nat. median
$824,563
1.5× median
2067
OTHER 		Afamitresgene Autoleucel 24 $770,620.00 $1,618,302.00 $786,032.40 nat. median
$786,032
1.0× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 2 $536,573.93 $969,621.79 $753,097.86 nat. median
$675,122
1.1× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 2 $511,793.34 $920,834.85 $716,314.09 nat. median
$625,184
1.1× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 2 $500,948.74 $927,632.05 $714,290.40 nat. median
$674,188
1.1× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 2 $487,755.77 $878,117.20 $682,936.48 nat. median
$634,511
1.1× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 2 $474,717.03 $807,592.83 $641,154.93 nat. median
$620,080
1.0× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 3 $561,407.87 $934,776.65 $630,230.00 nat. median
$754,974
0.8× median
9498
OTHER 		Ciltacabtagene Car-pos T 24 $587,649.60 $1,234,064.16 $599,402.59 nat. median
$587,650
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos 24 $566,531.30 $1,189,715.73 $577,861.93 nat. median
$566,531
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 24 $562,201.20 $1,180,622.52 $573,445.22 nat. median
$562,201
1.0× median
09498
OTHER 		Ciltacabtagene Car-pos T 1 $570,020.11 $570,020.11 $570,020.11 nat. median
$554,552
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 24 $558,081.80 $1,171,971.78 $569,243.44 nat. median
$558,082
1.0× median
09194
OTHER 		Tisagenlecleucel Car-pos 1 $549,535.36 $549,535.36 $549,535.36 nat. median
$538,205
1.0× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $545,335.16 $545,335.16 $545,335.16 nat. median
$534,091
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 24 $532,192.20 $1,117,603.62 $542,836.04 nat. median
$532,192
1.0× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $541,339.35 $541,339.35 $541,339.35 nat. median
$530,178
1.0× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $516,226.43 $516,226.43 $516,226.43 nat. median
$505,583
1.0× median
9391
OTHER 		Brexucabtagene Car Pos T 24 $489,450.20 $1,027,845.42 $499,239.20 nat. median
$489,450
1.0× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $474,766.69 $474,766.69 $474,766.69 nat. median
$464,978
1.0× median
Q2058
HCPCS 		Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,… 1 $459,112.50 $459,112.50 $459,112.50 nat. median
$324,450
1.4× median
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $409,345.68 $409,345.68 $409,345.68 nat. median
$117,173
outlier · 3.5×
J3402
HCPCS 		Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 $332,753.88 $332,753.88 $332,753.88 nat. median
$209,753
1.6× median
113
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $319,494.08 $319,494.08 $319,494.08 nat. median
$60,845
outlier · 5.3×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 28 $14,714.00 $772,885.75 $301,914.08 nat. median
$370,174
0.8× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 1 $297,478.60 $297,478.60 $297,478.60 nat. median
$164,834
1.8× median
831
OTHER 		Obecbtge Autol Up To 400 25 $3,352.84 $584,325.00 $283,815.00 nat. median
$12,362
outlier · 23.0×
897
OTHER 		Revakinagene, Per Implant 24 $265,000.00 $556,500.00 $270,300.00 nat. median
$9,577
outlier · 28.2×
112
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $269,984.37 $269,984.37 $269,984.37 nat. median
$58,674
outlier · 4.6×
00831
OTHER 		Obecbtge Autol Up To 400 1 $269,902.50 $269,902.50 $269,902.50 nat. median
$278,250
1.0× median

Other procedures at this hospital

Browse this hospital's 34,291 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
             
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 3 3 — — $47,377.17 $71,728.74 $47,377.17 2026-03-01
B1903 HCPCS Guillian Barre; M < 18.05 1 1 — — $47,650.20 $47,650.20 $47,650.20 2026-03-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 45 31 — — $14,166.00 $120,408.00 $47,887.47 2026-03-01
1824 APR_DRG Other Upper Vascular Procedures 1 1 — — $48,041.22 $48,041.22 $48,041.22 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 45 31 — — $16,639.00 $166,366.00 $48,053.20 2026-03-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 45 31 — — $16,639.00 $166,366.00 $48,053.20 2026-03-01
275 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 1 1 — — $48,311.38 $48,311.38 $48,311.38 2026-03-01
231 OTHER Coronary Bypass With Ptca With Mcc 1 1 — — $48,467.81 $48,467.81 $48,467.81 2026-03-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 45 31 — — $16,639.00 $119,587.28 $48,790.36 2026-03-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 45 31 — — $16,639.00 $119,674.98 $48,824.34 2026-03-01
1831 APR_DRG Percutaneous Structural Cardiac Procedures 1 1 — — $48,847.50 $48,847.50 $48,847.50 2026-03-01
B0106 HCPCS Stroke; M > 30.05 & M < 34.25 1 1 — — $48,907.20 $48,907.20 $48,907.20 2026-03-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 45 31 — — $14,166.00 $184,147.00 $49,133.62 2026-03-01
2214 APR_DRG Major Small & Large Bowel Procedures 2 2 — — $49,242.79 $49,242.79 $49,242.79 2026-03-01
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 3 3 — — $49,306.85 $56,470.18 $49,306.85 2026-03-01
01595 OTHER New Technology - Level 44 1 1 — — $49,416.42 $49,416.42 $49,416.42 2026-03-01
01581 OTHER New Technology - Level 44 1 1 — — $49,416.42 $49,416.42 $49,416.42 2026-03-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 3 3 — — $49,529.26 $193,924.17 $49,529.26 2026-03-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 45 31 — — $16,639.00 $128,248.00 $50,151.64 2026-03-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 45 31 — — $10,323.00 $123,707.40 $50,386.72 2026-03-01
69930 CPT Cochlear Device Implantation, With Or Without Mastoidectomy 16 10 $117,790.17 — $2,500.00 $161,670.54 $50,859.03 2026-06-05
1792 APR_DRG Defibrillator Implants 1 1 — — $51,005.96 $51,005.96 $51,005.96 2026-03-01
1204 APR_DRG Major Respiratory And Chest Procedures 3 3 — — $51,070.16 $68,764.00 $51,070.16 2026-03-01
1581 OTHER New Technology - Level 44 29 24 — — $50,070.25 $105,147.53 $51,071.65 2026-03-01
1595 OTHER New Technology - Level 44 29 24 — — $50,070.25 $105,147.53 $51,071.65 2026-03-01
3254 APR_DRG Non-elective Or Complex Knee Joint Replacement 1 1 — — $51,132.85 $51,132.85 $51,132.85 2026-03-01
2991 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 1 1 — — $51,180.44 $51,180.44 $51,180.44 2026-03-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $51,204.26 $51,204.26 $51,204.26 2026-03-01
894 APR_DRG Major Cranial Or Facial Bone Procedures 3 3 — — $51,258.77 $70,055.38 $51,258.77 2026-03-01
204 APR_DRG Open Craniotomy For Trauma 3 3 — — $51,519.44 $67,222.82 $51,519.44 2026-03-01
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 3 3 — — $51,634.20 $83,630.00 $51,634.20 2026-03-01
4484 APR_DRG Other Kidney, Urinary Tract And Related Percutaneous Procedures 1 1 — — $51,681.39 $51,681.39 $51,681.39 2026-03-01
1832 APR_DRG Percutaneous Structural Cardiac Procedures 1 1 — — $51,765.98 $51,765.98 $51,765.98 2026-03-01
429 OTHER Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 1 1 — — $51,800.97 $51,800.97 $51,800.97 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 45 31 — — $16,639.00 $177,734.00 $51,902.64 2026-03-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 38 29 — — $16,639.00 $127,695.07 $51,931.77 2026-03-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 39 28 — — $14,166.00 $128,376.98 $52,195.98 2026-03-01
2314 APR_DRG Major Large Bowel Procedures 1 1 — — $52,214.06 $52,214.06 $52,214.06 2026-03-01
10 MS_DRG Pancreas Transplant 37 28 — — $16,639.00 $128,430.68 $52,216.78 2026-03-01
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $52,228.50 $103,267.61 $52,228.50 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 45 31 — — $16,639.00 $129,198.50 $52,514.28 2026-03-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 3 3 — — $52,640.41 $65,468.82 $52,640.41 2026-03-01
09273 OTHER Sipuleucel-t Auto Cd54+ 1 1 — — $52,771.99 $52,771.99 $52,771.99 2026-03-01
82 APR_DRG Autologous Bone Marrow Transplant 1 1 — — $52,823.40 $52,823.40 $52,823.40 2026-03-01
C1772 HCPCS Pump Infs Pain 40ml 26 20 $81,774.00 $81,774.00 $12,266.10 $81,774.00 $52,826.00 2026-03-01
3003 APR_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 1 1 — — $52,890.81 $52,890.81 $52,890.81 2026-03-01
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 3 3 — — $52,970.48 $58,878.45 $52,970.48 2026-03-01
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 3 3 — — $53,030.08 $69,765.91 $53,030.08 2026-03-01
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 3 3 — — $53,461.57 $68,385.98 $53,461.57 2026-03-01
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 3 3 — — $53,756.94 $73,867.38 $53,756.94 2026-03-01
4403 APR_DRG Kidney Transplant 3 3 — — $53,878.82 $78,234.52 $53,878.82 2026-03-01
B0505 HCPCS Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 1 1 — — $53,943.82 $53,943.82 $53,943.82 2026-03-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $54,000.80 $54,000.80 $54,000.80 2026-03-01
4034 APR_DRG Procedures For Obesity 3 3 — — $54,403.72 $55,706.19 $54,403.72 2026-03-01
8634 APR_DRG Neonatal Aftercare 3 3 — — $54,665.28 $121,279.43 $54,665.28 2026-03-01
294 APR_DRG Other Percutaneous Intracranial Procedures 1 1 — — $54,749.23 $54,749.23 $54,749.23 2026-03-01
B0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 1 1 — — $54,846.85 $54,846.85 $54,846.85 2026-03-01
4414 APR_DRG Major Bladder Procedures 3 3 — — $55,017.59 $66,413.89 $55,017.59 2026-03-01
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $55,054.95 $105,933.63 $55,054.95 2026-03-01
01643 OTHER Y90 Ibritumomab, Rx 1 1 — — $55,119.81 $55,119.81 $55,119.81 2026-03-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 45 31 — — $14,166.00 $136,380.97 $55,297.16 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 9 6 — — $25,159.47 $89,766.78 $55,306.59 2026-03-01
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $55,422.38 $93,154.71 $55,422.38 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 45 31 — — $16,639.00 $136,833.79 $55,472.61 2026-03-01
9273 OTHER Sipuleucel-t Auto Cd54+ 29 24 — — $54,404.11 $114,248.63 $55,492.19 2026-03-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 1 1 — — $55,695.00 $55,695.00 $55,695.00 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 45 31 — — $16,639.00 $141,811.00 $55,702.15 2026-03-01
4284 APR_DRG Genetic Disorders 1 1 — — $55,716.77 $55,716.77 $55,716.77 2026-03-01
32 APR_DRG Bone Marrow Transplant 2 2 — — $55,749.78 $55,749.78 $55,749.78 2026-03-01
214 APR_DRG Open Craniotomy Except Trauma 3 3 — — $56,030.91 $75,869.86 $56,030.91 2026-03-01
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 1 1 — — $56,199.60 $56,199.60 $56,199.60 2026-03-01
914 APR_DRG Other Major Head And Neck Procedures 3 3 — — $56,261.34 $82,296.33 $56,261.34 2026-03-01
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 3 3 — — $56,349.41 $88,421.44 $56,349.41 2026-03-01
1694 APR_DRG Major Abdominal Vascular Procedures 3 3 — — $56,576.28 $75,962.39 $56,576.28 2026-03-01
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 3 3 — — $56,780.90 $71,773.69 $56,780.90 2026-03-01
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 3 3 — — $56,997.98 $79,964.72 $56,997.98 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 45 31 — — $16,639.00 $140,835.78 $57,023.20 2026-03-01
234 APR_DRG Spinal Procedures 3 3 — — $57,167.01 $73,203.85 $57,167.01 2026-03-01
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 1 1 — — $57,263.24 $57,263.24 $57,263.24 2026-03-01
05244 OTHER Level 4 Blood Product Exc 1 1 — — $57,738.99 $57,738.99 $57,738.99 2026-03-01
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 3 3 — — $57,753.30 $66,560.61 $57,753.30 2026-03-01
C1767 HCPCS Ipg Nrstm 44mm 51mm 78 20 $86,363.00 $86,363.00 $12,018.30 $100,000.00 $57,900.00 2026-03-01
424255 CDM Device Lnthnr Hgmn2 Exfx 31 24 $100,000.00 $100,000.00 $14,600.00 $100,000.00 $57,900.00 2026-03-01
458600 CDM Set Ex Fix Wrist Disp 31 24 $100,000.00 $100,000.00 $14,600.00 $100,000.00 $57,900.00 2026-03-01
473155 CDM Ankl Spn Kit W/clamp 31 24 $100,000.00 $100,000.00 $14,600.00 $100,000.00 $57,900.00 2026-03-01
1643 OTHER Y90 Ibritumomab, Rx 29 24 — — $56,824.55 $119,331.56 $57,961.04 2026-03-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $58,186.54 $58,186.54 $58,186.54 2026-03-01
3214 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 3 3 — — $58,211.47 $61,243.11 $58,211.47 2026-03-01
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 3 3 — — $58,350.26 $59,986.10 $58,350.26 2026-03-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 3 — — $58,392.97 $98,649.33 $58,392.97 2026-03-01
01596 OTHER New Technology - Level 45 1 1 — — $58,401.14 $58,401.14 $58,401.14 2026-03-01
01582 OTHER New Technology - Level 45 1 1 — — $58,401.14 $58,401.14 $58,401.14 2026-03-01
33270 CPT Insertion Or Replacement Of Permanent Subcutaneous Implantable Defibrillator Sys… 11 9 $83,609.80 — $3,850.00 $114,756.96 $58,491.92 2026-06-05
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 3 3 — — $58,973.91 $80,991.74 $58,973.91 2026-03-01
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 1 1 — — $59,220.79 $59,220.79 $59,220.79 2026-03-01
1814 APR_DRG Lower Vascular Procedures 1 1 — — $59,549.91 $59,549.91 $59,549.91 2026-03-01
274 APR_DRG Other Open Craniotomy 1 1 — — $59,601.46 $59,601.46 $59,601.46 2026-03-01
6954 APR_DRG Chemotherapy For Acute Leukemia 1 1 — — $59,645.08 $59,645.08 $59,645.08 2026-03-01
2304 APR_DRG Major Small Bowel Procedures 1 1 — — $59,668.87 $59,668.87 $59,668.87 2026-03-01
5244 OTHER Level 4 Blood Product Exc 29 24 — — $58,502.94 $122,856.17 $59,673.00 2026-03-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 3 3 — — $59,727.46 $114,051.97 $59,727.46 2026-03-01
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 3 3 — — $60,053.96 $93,946.46 $60,053.96 2026-03-01
2992 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 1 1 — — $60,142.07 $60,142.07 $60,142.07 2026-03-01
1582 OTHER New Technology - Level 45 29 24 — — $59,173.86 $124,265.11 $60,357.34 2026-03-01
1596 OTHER New Technology - Level 45 29 24 — — $59,173.86 $124,265.11 $60,357.34 2026-03-01
1781 APR_DRG External Heart Assist Devices 1 1 — — $60,707.79 $60,707.79 $60,707.79 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 45 31 — — $51,234.00 $150,404.05 $60,730.47 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 45 31 — — $16,639.00 $154,558.00 $60,914.25 2026-03-01
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 3 3 — — $61,283.48 $79,839.15 $61,283.48 2026-03-01
1793 APR_DRG Defibrillator Implants 1 1 — — $62,048.07 $62,048.07 $62,048.07 2026-03-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $62,087.40 $62,087.40 $62,087.40 2026-03-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 — — $62,306.59 $285,200.64 $62,306.59 2026-03-01
00717 OTHER Instill Adstiladrin, Tx D 1 1 — — $62,346.55 $62,346.55 $62,346.55 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 45 31 — — $14,166.00 $154,987.73 $62,506.45 2026-03-01
014 OTHER Allogeneic Bone Marrow Transplant 1 1 — — $62,748.33 $62,748.33 $62,748.33 2026-03-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 3 3 — — $62,942.70 $146,567.63 $62,942.70 2026-03-01
1833 APR_DRG Percutaneous Structural Cardiac Procedures 1 1 — — $63,287.89 $63,287.89 $63,287.89 2026-03-01
3124 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 3 3 — — $63,296.78 $66,445.61 $63,296.78 2026-03-01
4854 APR_DRG Prostatectomy Procedures 1 1 — — $63,383.06 $63,383.06 $63,383.06 2026-03-01
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 3 3 — — $63,411.55 $84,130.96 $63,411.55 2026-03-01
904 APR_DRG Major Larynx & Trachea Procedures 2 2 — — $63,560.12 $63,560.12 $63,560.12 2026-03-01
4014 APR_DRG Adrenal Procedures 3 3 — — $63,978.26 $69,226.63 $63,978.26 2026-03-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 3 3 — — $64,157.09 $87,099.66 $64,157.09 2026-03-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 3 3 — — $64,592.13 $82,576.55 $64,592.13 2026-03-01
C1820 HCPCS Nrstm Impl 1.9inx.6in 26 20 $100,000.00 $100,000.00 $15,000.00 $100,000.00 $64,600.00 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 45 31 — — $16,639.00 $161,253.82 $64,934.27 2026-03-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $65,152.25 $65,152.25 $65,152.25 2026-03-01
83 APR_DRG Autologous Bone Marrow Transplant 1 1 — — $65,269.23 $65,269.23 $65,269.23 2026-03-01
717 OTHER Instill Adstiladrin, Tx D 30 25 — — $10,869.67 $134,977.06 $65,560.29 2026-03-01
5204 APR_DRG Other GYN Procedures For Malignancy 1 1 — — $65,688.23 $65,688.23 $65,688.23 2026-03-01
1782 APR_DRG External Heart Assist Devices 1 1 — — $66,168.04 $66,168.04 $66,168.04 2026-03-01
11 APR_DRG Liver Transplant And/or Intestinal Transplant 3 3 — — $66,581.41 $77,167.85 $66,581.41 2026-03-01
12 APR_DRG Liver Transplant And/or Intestinal Transplant 3 3 — — $66,953.29 $93,912.09 $66,953.29 2026-03-01
61 APR_DRG Pancreas Transplant 3 3 — — $67,027.14 $82,540.86 $67,027.14 2026-03-01
01583 OTHER New Technology - Level 46 1 1 — — $67,385.86 $67,385.86 $67,385.86 2026-03-01
01597 OTHER New Technology - Level 46 1 1 — — $67,385.86 $67,385.86 $67,385.86 2026-03-01
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 3 3 — — $68,992.40 $75,551.32 $68,992.40 2026-03-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $69,030.65 $141,259.38 $69,030.65 2026-03-01
1597 OTHER New Technology - Level 46 29 24 — — $68,277.45 $143,382.64 $69,643.00 2026-03-01
1583 OTHER New Technology - Level 46 29 24 — — $68,277.45 $143,382.64 $69,643.00 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 45 31 — — $16,639.00 $175,092.55 $70,296.16 2026-03-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $70,735.25 $150,843.57 $70,735.25 2026-03-01
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 3 3 — — $71,481.67 $97,294.51 $71,481.67 2026-03-01
215 MS_DRG Other Heart Assist System Implant 41 30 — — $16,639.00 $178,210.39 $71,504.17 2026-03-01
21 APR_DRG Heart And/or Lung Transplant 3 3 — — $72,598.20 $118,945.18 $72,598.20 2026-03-01
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 3 3 — — $72,651.58 $83,183.24 $72,651.58 2026-03-01
007 OTHER Lung Transplant 1 1 — — $73,510.78 $73,510.78 $73,510.78 2026-03-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 3 3 — — $73,664.01 $198,208.04 $73,664.01 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 37 28 — — $16,639.00 $184,537.33 $73,955.59 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 7 5 — — $61,338.53 $106,053.40 $74,713.35 2026-03-01
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 1 1 — — $74,718.60 $74,718.60 $74,718.60 2026-03-01
1613 APR_DRG Implantable Heart Assist Systems 3 3 — — $74,793.88 $248,724.94 $74,793.88 2026-03-01
62 APR_DRG Pancreas Transplant 3 3 — — $75,474.48 $102,286.85 $75,474.48 2026-03-01
01598 OTHER New Technology - Level 47 1 1 — — $76,370.58 $76,370.58 $76,370.58 2026-03-01
01584 OTHER New Technology - Level 47 1 1 — — $76,370.58 $76,370.58 $76,370.58 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 1 1 — — $77,046.96 $77,046.96 $77,046.96 2026-03-01
3004 APR_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 1 1 — — $77,420.31 $77,420.31 $77,420.31 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 45 31 — — $14,166.00 $194,624.64 $77,863.96 2026-03-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 3 3 — — $78,493.10 $108,522.99 $78,493.10 2026-03-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 3 3 — — $78,541.14 $238,826.17 $78,541.14 2026-03-01
13 APR_DRG Liver Transplant And/or Intestinal Transplant 3 3 — — $78,642.56 $116,392.83 $78,642.56 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 45 31 — — $16,639.00 $197,257.44 $78,884.05 2026-03-01
1584 OTHER New Technology - Level 47 29 24 — — $77,381.05 $162,500.21 $78,928.67 2026-03-01
1598 OTHER New Technology - Level 47 29 24 — — $77,381.05 $162,500.21 $78,928.67 2026-03-01
2993 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 1 1 — — $80,272.70 $80,272.70 $80,272.70 2026-03-01
63 APR_DRG Pancreas Transplant 3 3 — — $80,944.12 $120,962.21 $80,944.12 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 45 31 — — $16,639.00 $208,027.00 $80,947.81 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 39 28 — — $16,639.00 $256,367.00 $81,037.96 2026-03-01
1783 APR_DRG External Heart Assist Devices 1 1 — — $82,080.88 $82,080.88 $82,080.88 2026-03-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 3 3 — — $82,275.05 $150,645.30 $82,275.05 2026-03-01
1794 APR_DRG Defibrillator Implants 1 1 — — $84,049.01 $84,049.01 $84,049.01 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 6 4 — — $84,429.31 $93,760.51 $84,429.31 2026-03-01
71 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $84,532.78 $84,532.78 $84,532.78 2026-03-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 3 3 — — $84,565.04 $141,411.38 $84,565.04 2026-03-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 3 3 — — $84,899.55 $242,623.63 $84,899.55 2026-03-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 3 3 — — $85,333.71 $161,659.65 $85,333.71 2026-03-01
01599 OTHER New Technology - Level 48 1 1 — — $85,355.31 $85,355.31 $85,355.31 2026-03-01
01585 OTHER New Technology - Level 48 1 1 — — $85,355.31 $85,355.31 $85,355.31 2026-03-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 3 3 — — $85,695.80 $274,175.72 $85,695.80 2026-03-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $85,718.90 $85,718.90 $85,718.90 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 37 28 — — $14,714.00 $215,096.37 $85,795.84 2026-03-01
22 APR_DRG Heart And/or Lung Transplant 3 3 — — $86,004.52 $155,165.77 $86,004.52 2026-03-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 3 3 — — $86,283.87 $123,447.14 $86,283.87 2026-03-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 3 3 — — $86,589.02 $163,421.57 $86,589.02 2026-03-01
1599 OTHER New Technology - Level 48 29 24 — — $86,484.66 $181,617.79 $88,214.35 2026-03-01
1585 OTHER New Technology - Level 48 29 24 — — $86,484.66 $181,617.79 $88,214.35 2026-03-01
4404 APR_DRG Kidney Transplant 3 3 — — $88,228.67 $117,525.59 $88,228.67 2026-03-01
5831 APR_DRG Neonate With Ecmo 3 3 — — $88,734.89 $231,058.10 $88,734.89 2026-03-01
1834 APR_DRG Percutaneous Structural Cardiac Procedures 1 1 — — $89,819.87 $89,819.87 $89,819.87 2026-03-01
33 APR_DRG Bone Marrow Transplant 2 2 — — $90,178.81 $90,178.81 $90,178.81 2026-03-01
7 MS_DRG Lung Transplant 37 28 — — $16,639.00 $231,782.68 $92,261.03 2026-03-01
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 1 1 — — $92,349.75 $92,349.75 $92,349.75 2026-03-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $93,176.08 $202,649.20 $93,176.08 2026-03-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 3 3 — — $93,388.71 $242,623.63 $93,388.71 2026-03-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 3 3 — — $94,075.53 $113,169.02 $94,075.53 2026-03-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $95,646.38 $95,646.38 $95,646.38 2026-03-01
01902 OTHER New Technology - Level 49 1 1 — — $96,586.21 $96,586.21 $96,586.21 2026-03-01
01901 OTHER New Technology - Level 49 1 1 — — $96,586.21 $96,586.21 $96,586.21 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 44 30 — — $16,639.00 $1,009,700.00 $98,510.56 2026-03-01
84 APR_DRG Autologous Bone Marrow Transplant 1 1 — — $99,508.48 $99,508.48 $99,508.48 2026-03-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 3 — — $99,705.31 $232,976.00 $99,705.31 2026-03-01
1901 OTHER New Technology - Level 49 29 24 — — $97,864.16 $205,514.74 $99,821.44 2026-03-01
1902 OTHER New Technology - Level 49 29 24 — — $97,864.16 $205,514.74 $99,821.44 2026-03-01
1784 APR_DRG External Heart Assist Devices 1 1 — — $101,221.50 $101,221.50 $101,221.50 2026-03-01
72 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $101,553.27 $101,553.27 $101,553.27 2026-03-01
2994 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 1 1 — — $102,388.63 $102,388.63 $102,388.63 2026-03-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 3 3 — — $102,726.60 $242,623.63 $102,726.60 2026-03-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 3 — — $105,988.99 $321,238.82 $105,988.99 2026-03-01
8514 APR_DRG Gender Related Procedures 1 1 — — $106,381.71 $106,381.71 $106,381.71 2026-03-01
23 APR_DRG Heart And/or Lung Transplant 3 3 — — $107,248.75 $201,027.38 $107,248.75 2026-03-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 3 3 — — $108,942.67 $277,453.72 $108,942.67 2026-03-01
01904 OTHER New Technology - Level 50 1 1 — — $110,063.28 $110,063.28 $110,063.28 2026-03-01
01903 OTHER New Technology - Level 50 1 1 — — $110,063.28 $110,063.28 $110,063.28 2026-03-01
1903 OTHER New Technology - Level 50 29 24 — — $111,519.60 $234,191.16 $113,749.99 2026-03-01
1904 OTHER New Technology - Level 50 29 24 — — $111,519.60 $234,191.16 $113,749.99 2026-03-01
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $114,055.93 $114,055.93 $114,055.93 2026-03-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 3 3 — — $117,689.83 $314,320.66 $117,689.83 2026-03-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $122,478.99 $122,478.99 $122,478.99 2026-03-01
01906 OTHER New Technology - Level 51 1 1 — — $123,540.36 $123,540.36 $123,540.36 2026-03-01
01905 OTHER New Technology - Level 51 1 1 — — $123,540.36 $123,540.36 $123,540.36 2026-03-01
64 APR_DRG Pancreas Transplant 3 3 — — $124,323.15 $142,129.11 $124,323.15 2026-03-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 3 3 — — $125,976.14 $227,258.00 $125,976.14 2026-03-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 — — $127,135.37 $295,716.68 $127,135.37 2026-03-01
1906 OTHER New Technology - Level 51 29 24 — — $125,175.00 $262,867.50 $127,678.50 2026-03-01
1905 OTHER New Technology - Level 51 29 24 — — $125,175.00 $262,867.50 $127,678.50 2026-03-01
73 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $136,441.51 $136,441.51 $136,441.51 2026-03-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 3 3 — — $136,765.96 $210,762.26 $136,765.96 2026-03-01
01908 OTHER New Technology - Level 52 1 1 — — $137,017.45 $137,017.45 $137,017.45 2026-03-01
01907 OTHER New Technology - Level 52 1 1 — — $137,017.45 $137,017.45 $137,017.45 2026-03-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 1 1 — — $138,148.31 $138,148.31 $138,148.31 2026-03-01
5832 APR_DRG Neonate With Ecmo 3 3 — — $140,117.32 $273,846.59 $140,117.32 2026-03-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 3 3 — — $141,592.38 $264,434.24 $141,592.38 2026-03-01
1907 OTHER New Technology - Level 52 29 24 — — $138,830.40 $291,543.84 $141,607.01 2026-03-01
1908 OTHER New Technology - Level 52 29 24 — — $138,830.40 $291,543.84 $141,607.01 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 44 30 — — $16,639.00 $1,009,700.00 $149,645.42 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 39 28 — — $14,166.00 $382,131.25 $150,514.36 2026-03-01
5833 APR_DRG Neonate With Ecmo 3 3 — — $154,129.49 $436,393.15 $154,129.49 2026-03-01
24 APR_DRG Heart And/or Lung Transplant 3 3 — — $160,851.78 $371,746.48 $160,851.78 2026-03-01
34 APR_DRG Bone Marrow Transplant 2 2 — — $162,062.61 $162,062.61 $162,062.61 2026-03-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 1 1 — — $168,289.67 $168,289.67 $168,289.67 2026-03-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $173,773.37 $173,773.37 $173,773.37 2026-03-01
1614 APR_DRG Implantable Heart Assist Systems 3 3 — — $177,791.83 $309,099.65 $177,791.83 2026-03-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 — — $192,753.28 $456,821.18 $192,753.28 2026-03-01
00886 OTHER Inj. Remestemcel-l-rknd/ 1 1 — — $195,618.93 $195,618.93 $195,618.93 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 39 28 — — $16,639.00 $501,571.76 $196,792.17 2026-03-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $197,690.75 $197,690.75 $197,690.75 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 30 25 — — $7,336.58 $423,504.90 $205,702.38 2026-03-01
5834 APR_DRG Neonate With Ecmo 3 3 — — $214,313.35 $722,775.46 $214,313.35 2026-03-01
74 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $229,004.07 $229,004.07 $229,004.07 2026-03-01
00897 OTHER Revakinagene, Per Implant 1 1 — — $257,050.00 $257,050.00 $257,050.00 2026-03-01
00831 OTHER Obecbtge Autol Up To 400 1 1 — — $269,902.50 $269,902.50 $269,902.50 2026-03-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $269,984.37 $269,984.37 $269,984.37 2026-03-01
897 OTHER Revakinagene, Per Implant 29 24 — — $265,000.00 $556,500.00 $270,300.00 2026-03-01
831 OTHER Obecbtge Autol Up To 400 30 25 — — $3,352.84 $584,325.00 $283,815.00 2026-03-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 1 1 — — $297,478.60 $297,478.60 $297,478.60 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 37 28 — — $14,714.00 $772,885.75 $301,914.08 2026-03-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $319,494.08 $319,494.08 $319,494.08 2026-03-01
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 1 — — $332,753.88 $332,753.88 $332,753.88 2026-03-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $409,345.68 $409,345.68 $409,345.68 2026-03-01
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 1 1 — — $459,112.50 $459,112.50 $459,112.50 2026-03-01
09391 OTHER Brexucabtagene Car Pos T 1 1 — — $474,766.69 $474,766.69 $474,766.69 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 29 24 — — $489,450.20 $1,027,845.42 $499,239.20 2026-03-01
09035 OTHER Axicabtagene Ciloleucel C 1 1 — — $516,226.43 $516,226.43 $516,226.43 2026-03-01
09422 OTHER Idecabtagene Vicleucel Ca 1 1 — — $541,339.35 $541,339.35 $541,339.35 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 29 24 — — $532,192.20 $1,117,603.62 $542,836.04 2026-03-01
09413 OTHER Lisocabtagene Car Pos T 1 1 — — $545,335.16 $545,335.16 $545,335.16 2026-03-01
09194 OTHER Tisagenlecleucel Car-pos 1 1 — — $549,535.36 $549,535.36 $549,535.36 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 29 24 — — $558,081.80 $1,171,971.78 $569,243.44 2026-03-01
09498 OTHER Ciltacabtagene Car-pos T 1 1 — — $570,020.11 $570,020.11 $570,020.11 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 29 24 — — $562,201.20 $1,180,622.52 $573,445.22 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 29 24 — — $566,531.30 $1,189,715.73 $577,861.93 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 29 24 — — $587,649.60 $1,234,064.16 $599,402.59 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 4 3 — — $561,407.87 $934,776.65 $630,230.00 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 2 2 — — $474,717.03 $807,592.83 $641,154.93 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 2 2 — — $487,755.77 $878,117.20 $682,936.48 2026-03-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 2 2 — — $500,948.74 $927,632.05 $714,290.40 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 2 2 — — $511,793.34 $920,834.85 $716,314.09 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 2 2 — — $536,573.93 $969,621.79 $753,097.86 2026-03-01
2067 OTHER Afamitresgene Autoleucel 29 24 — — $770,620.00 $1,618,302.00 $786,032.40 2026-03-01
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 1 1 — — $1,271,523.00 $1,271,523.00 $1,271,523.00 2026-03-01
00824 OTHER Inj, Exagamglogene Autote 1 1 — — $2,262,040.00 $2,262,040.00 $2,262,040.00 2026-03-01
824 OTHER Inj, Exagamglogene Autote 30 25 — — $11,873.51 $4,897,200.00 $2,378,640.00 2026-03-01
09141 OTHER Inj Onase Abepar-xioi Tre 1 1 — — $2,511,311.57 $2,511,311.57 $2,511,311.57 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 28 23 — — $2,588,981.00 $4,530,716.75 $2,640,760.62 2026-03-01
00746 OTHER Inj, Betibeglogene Autote 1 1 — — $2,851,769.93 $2,851,769.93 $2,851,769.93 2026-03-01
746 OTHER Inj, Betibeglogene Autote 28 23 — — $10,139.85 $4,321,754.43 $2,998,768.38 2026-03-01
00906 OTHER Inj Elivaldogene Autoteme 1 1 — — $3,084,600.00 $3,084,600.00 $3,084,600.00 2026-03-01
00748 OTHER Inj, Lovotibeglogene Auto 1 1 — — $3,154,932.76 $3,154,932.76 $3,154,932.76 2026-03-01
00714 OTHER Inj Delandistrogene Mox R 1 1 — — $3,228,024.20 $3,228,024.20 $3,228,024.20 2026-03-01
00908 OTHER Topi Adm Prad Zami Per Tr 1 1 — — $3,235,745.40 $3,235,745.40 $3,235,745.40 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 28 23 — — $7,833.83 $4,674,600.00 $3,243,600.00 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 28 23 — — $10,961.87 $4,781,186.76 $3,317,558.16 2026-03-01
714 OTHER Inj Delandistrogene Mox R 28 23 — — $5,758.83 $4,891,954.20 $3,394,417.20 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 28 23 — — $8,865.63 $4,903,655.40 $3,402,536.40 2026-03-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 1 1 — — $3,574,708.99 $3,574,708.99 $3,574,708.99 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 23 18 — — $3,685,267.00 $4,422,320.40 $3,758,972.34 2026-03-01
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 1 1 — — $3,847,800.00 $3,847,800.00 $3,847,800.00 2026-03-01
00845 OTHER Inj, Atidarsagene Autotem 1 1 — — $4,369,850.00 $4,369,850.00 $4,369,850.00 2026-03-01
845 OTHER Inj, Atidarsagene Autotem 22 17 — — $4,896.40 $4,865,400.00 $4,595,100.00 2026-03-01
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 1 1 — — $4,850,948.67 $4,850,948.67 $4,850,948.67 2026-03-01
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