Price Transparencybeta Hospital negotiated rates

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

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Hospital

TRISTAR SKYLINE MEDICAL CENTER

Nashville, TN · CCN 440006 · Rates published

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You selected 93306 (CPT)

Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echoc

This hospital’s price: $1,338 across 24 payers · range $216-$4,982

Source: https://www.hcadam.com/api/public/content/6fa010cf8e894211b7291c04e0765160?download=true · observed 2026-03-12

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

34,822 distinct procedures filed
43 distinct payers
1,583,159 rate rows
2026-07-31 last MRF observed
Data quality

1,507,700 of 1,583,159 rate rows are consumer-grade (95.2%)

75,459 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
per-diem day rate — not a per-procedure price 44,314
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 20,172
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 5,209
exceeds 10× this hospital's gross charge — excluded from medians 4,027
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 867
placeholder amount (≤ $0.02) — excluded from medians 535
template filing: same amount across many unrelated codes — excluded 173
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 162
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1560757_TRISTAR-SKYLINE-MEDICAL-CENTER_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page https://www.tristarhealth.com/cms-hpt.txt
Discovered viaDiscovered by HANK (automated)
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-10-03
Content fingerprint cce61ed78e047aad… · 370,488,267 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
845
OTHER 		Inj, Atidarsagene Autotem 17 $4,746.91 $4,955,500.00 $4,550,050.00 nat. median
$17,156
outlier · 265.2×
J1411
HCPCS 		Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 1 $4,200,000.00 $4,200,000.00 $4,200,000.00 nat. median
$3,705,478
1.1× median
J1414
HCPCS 		Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose 1 $4,200,000.00 $4,200,000.00 $4,200,000.00 nat. median
$3,710,000
1.1× median
J1413
HCPCS 		Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 1 $3,840,000.00 $3,840,000.00 $3,840,000.00 nat. median
$3,324,572
1.2× median
J3394
HCPCS 		Injection, Lovotibeglogene Autotemcel, Per Treatment 1 $3,720,000.00 $3,720,000.00 $3,720,000.00 nat. median
$3,286,000
1.1× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 19 $2,571,030.00 $4,238,057.05 $3,715,874.33 nat. median
$3,758,972
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 18 $2,523,500.00 $4,145,750.00 $3,641,050.00 nat. median
$3,672,053
1.0× median
908
OTHER 		Topi Adm Prad Zami Per Tr 21 $9,586.22 $4,903,655.40 $3,369,178.20 nat. median
$30,519
outlier · 110.4×
714
OTHER 		Inj Delandistrogene Mox R 22 $5,260.67 $4,891,954.20 $3,361,138.60 nat. median
$3,325,455
1.0× median
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $3,360,000.00 $3,360,000.00 $3,360,000.00 nat. median
$2,994,107
1.1× median
748
OTHER 		Inj, Lovotibeglogene Auto 22 $8,677.45 $4,830,420.00 $3,318,860.00 nat. median
$3,252,508
1.0× median
906
OTHER 		Inj Elivaldogene Autoteme 21 $6,330.70 $4,674,600.00 $3,211,800.00 nat. median
$25,059
outlier · 128.2×
746
OTHER 		Inj, Betibeglogene Autote 22 $7,707.30 $4,362,960.00 $2,997,680.00 nat. median
$2,939,969
1.0× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 $2,870,046.83 $2,870,046.83 $2,870,046.83 nat. median
$2,467,386
1.2× median
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 1 $2,640,000.00 $2,640,000.00 $2,640,000.00 nat. median
$2,401,965
1.1× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 22 $1,672,029.80 $3,805,802.07 $2,588,981.00 nat. median
$2,588,981
1.0× median
824
OTHER 		Inj, Exagamglogene Autote 21 $12,838.57 $3,428,040.00 $2,355,320.00 nat. median
$2,285,360
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 3 $872,400.00 $2,042,143.00 $1,749,707.25 nat. median
$813,967
outlier · 2.1×
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 1 $1,387,149.28 $1,501,307.95 $1,387,149.28 nat. median
$739,258
1.9× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 2 $620,118.79 $1,557,271.36 $1,345,370.55 nat. median
$646,415
outlier · 2.1×
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 3 $591,090.52 $1,478,916.58 $1,334,154.50 nat. median
$622,450
outlier · 2.1×
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 2 $579,352.98 $1,489,833.29 $1,315,434.06 nat. median
$640,950
outlier · 2.1×
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 2 $549,504.00 $1,410,309.44 $1,296,212.81 nat. median
$608,239
outlier · 2.1×
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 2 $549,504.00 $1,297,043.03 $1,191,016.00 nat. median
$591,721
outlier · 2.0×
2067
OTHER 		Afamitresgene Autoleucel 21 $554,846.40 $1,132,811.40 $786,032.40 nat. median
$793,739
1.0× median
Q2058
HCPCS 		Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,… 3 $630,000.00 $737,362.50 $710,521.88 nat. median
$319,951
outlier · 2.2×
9498
OTHER 		Ciltacabtagene Car-pos T 22 $368,986.38 $863,844.91 $587,649.60 nat. median
$587,650
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos 22 $370,435.03 $832,801.01 $566,531.30 nat. median
$577,163
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 22 $361,708.27 $826,435.76 $562,201.20 nat. median
$562,201
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 22 $368,611.32 $820,380.25 $558,081.80 nat. median
$563,449
1.0× median
J3402
HCPCS 		Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 $534,422.90 $534,422.90 $534,422.90 nat. median
$209,753
outlier · 2.5×
9035
OTHER 		Axicabtagene Ciloleucel C 22 $342,619.20 $782,322.53 $532,192.20 nat. median
$533,230
1.0× median
9391
OTHER 		Brexucabtagene Car Pos T 22 $322,371.28 $719,491.79 $489,450.20 nat. median
$492,768
1.0× median
0207
RC 		1 $397,211.21 $397,211.21 $397,211.21 nat. median
$7,332
outlier · 54.2×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 27 $1,854.72 $1,072,056.19 $306,976.23 nat. median
$359,454
0.9× median
831
OTHER 		Obecbtge Autol Up To 400 21 $2,919.84 $409,027.50 $281,032.50 nat. median
$23,596
outlier · 11.9×
897
OTHER 		Revakinagene, Per Implant 21 $190,800.00 $389,550.00 $270,300.00 nat. median
$26,484
outlier · 10.2×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 28 $2,253.12 $695,721.34 $210,261.21 nat. median
$249,036
0.8× median
886
OTHER 		Inj. Remestemcel-l-rknd/ 21 $5,505.92 $296,453.43 $203,685.69 nat. median
$201,669
1.0× median
J7330
HCPCS 		Autologous Cultured Chondrocytes, Implant 2 $76,729.09 $221,874.56 $192,914.70 nat. median
$75,000
outlier · 2.6×
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $178,314.80 $187,897.40 $183,106.10 nat. median
$214,523
0.9× median
018
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $147,136.00 $213,758.80 $180,447.40 nat. median
$297,123
0.6× median
J9029
HCPCS 		Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 3 $72,000.00 $170,328.19 $168,273.22 nat. median
$68,423
outlier · 2.5×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 28 $2,253.12 $573,024.23 $162,837.79 nat. median
$198,418
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 29 $2,253.12 $526,936.82 $160,340.31 nat. median
$190,559
0.8× median
A9543
HCPCS 		Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 3 $74,124.43 $173,512.94 $150,585.06 nat. median
$63,528
outlier · 2.4×
1907
OTHER 		New Technology - Level 52 22 $98,097.16 $210,510.03 $144,636.14 nat. median
$155,833
0.9× median
1908
OTHER 		New Technology - Level 52 22 $98,097.16 $210,510.03 $144,636.14 nat. median
$155,563
0.9× median
Q2043
HCPCS 		Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 3 $65,321.65 $147,108.87 $144,170.89 nat. median
$65,720
outlier · 2.2×
1906
OTHER 		New Technology - Level 51 22 $88,448.29 $189,804.20 $130,409.68 nat. median
$140,341
0.9× median

Other procedures at this hospital

Browse this hospital's 34,822 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
             
845 OTHER Inj, Atidarsagene Autotem 29 17 — — $4,746.91 $4,955,500.00 $4,550,050.00 2026-03-12
J1414 HCPCS Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose 1 1 — — $4,200,000.00 $4,200,000.00 $4,200,000.00 2026-03-12
J1411 HCPCS Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 2 1 — — $4,200,000.00 $4,200,000.00 $4,200,000.00 2026-03-12
J1413 HCPCS Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 2 1 — — $3,840,000.00 $3,840,000.00 $3,840,000.00 2026-03-12
J3394 HCPCS Injection, Lovotibeglogene Autotemcel, Per Treatment 1 1 — — $3,720,000.00 $3,720,000.00 $3,720,000.00 2026-03-12
9138 OTHER Inj, Hemgenix, Per Tx Dos 56 19 — — $2,571,030.00 $4,238,057.05 $3,715,874.33 2026-03-12
773 OTHER Inj, Beqvez, Per Tx Dose 28 18 — — $2,523,500.00 $4,145,750.00 $3,641,050.00 2024-10-01
908 OTHER Topi Adm Prad Zami Per Tr 33 21 — — $9,586.22 $4,903,655.40 $3,369,178.20 2026-03-12
714 OTHER Inj Delandistrogene Mox R 64 22 — — $5,260.67 $4,891,954.20 $3,361,138.60 2026-03-12
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 1 1 — — $3,360,000.00 $3,360,000.00 $3,360,000.00 2026-03-12
748 OTHER Inj, Lovotibeglogene Auto 64 22 — — $8,677.45 $4,830,420.00 $3,318,860.00 2026-03-12
906 OTHER Inj Elivaldogene Autoteme 33 21 — — $6,330.70 $4,674,600.00 $3,211,800.00 2026-03-12
746 OTHER Inj, Betibeglogene Autote 64 22 — — $7,707.30 $4,362,960.00 $2,997,680.00 2026-03-12
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 1 — — $2,870,046.83 $2,870,046.83 $2,870,046.83 2026-03-12
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 1 1 — — $2,640,000.00 $2,640,000.00 $2,640,000.00 2026-03-12
9141 OTHER Inj Onase Abepar-xioi Tre 62 22 — — $1,672,029.80 $3,805,802.07 $2,588,981.00 2026-03-12
824 OTHER Inj, Exagamglogene Autote 33 21 — — $12,838.57 $3,428,040.00 $2,355,320.00 2026-03-12
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 6 3 — — $872,400.00 $2,042,143.00 $1,749,707.25 2026-03-12
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 7 1 — — $1,387,149.28 $1,501,307.95 $1,387,149.28 2026-03-12
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 9 2 — — $620,118.79 $1,557,271.36 $1,345,370.55 2026-03-12
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 11 3 — — $591,090.52 $1,478,916.58 $1,334,154.50 2026-03-12
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 9 2 — — $579,352.98 $1,489,833.29 $1,315,434.06 2026-03-12
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 9 2 — — $549,504.00 $1,410,309.44 $1,296,212.81 2026-03-12
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 9 2 — — $549,504.00 $1,297,043.03 $1,191,016.00 2026-03-12
2067 OTHER Afamitresgene Autoleucel 31 21 — — $554,846.40 $1,132,811.40 $786,032.40 2026-03-12
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 6 3 — — $630,000.00 $737,362.50 $710,521.88 2026-03-12
9498 OTHER Ciltacabtagene Car-pos T 62 22 — — $368,986.38 $863,844.91 $587,649.60 2026-03-12
9194 OTHER Tisagenlecleucel Car-pos 62 22 — — $370,435.03 $832,801.01 $566,531.30 2026-03-12
9413 OTHER Lisocabtagene Car Pos T 62 22 — — $361,708.27 $826,435.76 $562,201.20 2026-03-12
9422 OTHER Idecabtagene Vicleucel Ca 62 22 — — $368,611.32 $820,380.25 $558,081.80 2026-03-12
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 3 1 — — $534,422.90 $534,422.90 $534,422.90 2026-03-12
9035 OTHER Axicabtagene Ciloleucel C 62 22 — — $342,619.20 $782,322.53 $532,192.20 2026-03-12
9391 OTHER Brexucabtagene Car Pos T 62 22 — — $322,371.28 $719,491.79 $489,450.20 2026-03-12
0207 RC — 1 1 — — $397,211.21 $397,211.21 $397,211.21 2026-03-12
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 91 27 — — $1,854.72 $1,072,056.19 $306,976.23 2026-03-12
831 OTHER Obecbtge Autol Up To 400 33 21 — — $2,919.84 $409,027.50 $281,032.50 2026-03-12
897 OTHER Revakinagene, Per Implant 31 21 — — $190,800.00 $389,550.00 $270,300.00 2026-03-12
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 102 28 — — $2,253.12 $695,721.34 $210,261.21 2026-03-12
886 OTHER Inj. Remestemcel-l-rknd/ 33 21 — — $5,505.92 $296,453.43 $203,685.69 2026-03-12
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 10 2 — — $76,729.09 $221,874.56 $192,914.70 2026-03-12
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 2 1 — — $178,314.80 $187,897.40 $183,106.10 2026-03-12
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 1 — — $147,136.00 $213,758.80 $180,447.40 2026-03-12
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 12 3 — — $72,000.00 $170,328.19 $168,273.22 2026-03-12
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 88 28 — — $2,253.12 $573,024.23 $162,837.79 2026-03-12
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 108 29 — — $2,253.12 $526,936.82 $160,340.31 2026-03-12
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 12 3 — — $74,124.43 $173,512.94 $150,585.06 2026-03-12
1908 OTHER New Technology - Level 52 62 22 — — $98,097.16 $210,510.03 $144,636.14 2026-03-12
1907 OTHER New Technology - Level 52 62 22 — — $98,097.16 $210,510.03 $144,636.14 2026-03-12
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 12 3 — — $65,321.65 $147,108.87 $144,170.89 2026-03-12
1906 OTHER New Technology - Level 51 62 22 — — $88,448.29 $189,804.20 $130,409.68 2026-03-12
1905 OTHER New Technology - Level 51 62 22 — — $88,448.29 $189,804.20 $130,409.68 2026-03-12
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 1 — — $119,435.30 $132,433.90 $125,934.60 2026-03-12
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 7 1 — — $123,321.96 $123,742.09 $123,321.96 2026-03-12
1903 OTHER New Technology - Level 50 62 22 — — $78,799.42 $169,098.36 $116,183.23 2026-03-12
1904 OTHER New Technology - Level 50 62 22 — — $78,799.42 $169,098.36 $116,183.23 2026-03-12
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 12 3 — — $54,500.39 $117,019.36 $114,441.15 2026-03-12
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 62 22 — — $69,999.93 $163,909.41 $111,503.00 2026-03-12
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 108 29 — — $2,253.12 $343,874.86 $105,504.65 2026-03-12
1901 OTHER New Technology - Level 49 62 22 — — $69,150.56 $148,392.53 $101,956.77 2026-03-12
1902 OTHER New Technology - Level 49 62 22 — — $69,150.56 $148,392.53 $101,956.77 2026-03-12
7 MS_DRG Lung Transplant 94 28 — — $2,253.12 $321,501.67 $97,843.57 2026-03-12
14 MS_DRG Allogeneic Bone Marrow Transplant 97 28 — — $1,854.72 $316,452.24 $95,811.88 2026-03-12
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 62 22 — — $63,722.33 $139,769.07 $95,583.49 2026-03-12
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 1 — — $83,977.82 $103,420.40 $93,699.11 2026-03-12
C2642 HCPCS Brachytx Strnd Cesium131 222 19 $147,752.00 $147,752.00 $19,761.48 $197,549.38 $91,006.50 2026-03-12
326053 CDM Revsc Tib/per St/ath Ini 26 21 $226,216.20 $226,216.20 $15,000.00 $221,691.88 $90,712.70 2024-10-01
1599 OTHER New Technology - Level 48 62 22 — — $61,109.83 $131,137.63 $90,101.36 2026-03-12
1585 OTHER New Technology - Level 48 62 22 — — $61,109.83 $131,137.63 $90,101.36 2026-03-12
C1825 HCPCS System Generator Ipg 41 20 $176,400.00 $176,400.00 $26,460.00 $172,872.00 $88,200.00 2026-03-12
326033 CDM Revsc Fem/pop W Stnt/ath 26 21 $217,167.14 $217,167.14 $15,000.00 $212,823.80 $87,084.02 2024-10-01
209 MS_DRG Complex Aortic Arch Procedures 51 25 — — $18,507.00 $281,000.53 $86,670.84 2026-03-12
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 102 28 — — $2,253.12 $548,737.00 $85,925.11 2026-03-12
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 2 1 — — $75,989.66 $92,686.01 $84,337.83 2026-03-12
30230X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Peripheral Vein, … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30230X2 OTHER Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Peripheral Vein, Op… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30233U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30243X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Central Vein, Per… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30233X2 OTHER Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Peripheral Vein, Pe… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30243U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30230Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Peripheral Vein,… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30240X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Central Vein, Ope… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30240U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30243G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Central Vein, Percutaneous Ap… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30230G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Peripheral Vein, Open Appro… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30230U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30243G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Central Vein, Percutaneous … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30233U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30233Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Peripheral Vein,… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30243Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Central Vein, Pe… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30240X2 OTHER Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Central Vein, Open … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30233G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Peripheral Vein, Percutaneo… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30240Y3 OTHER Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Central Vein, … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30240G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Central Vein, Open Approach 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30233X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Peripheral Vein, … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30240Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Central Vein, Op… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30230U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30243Y3 OTHER Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Central Vein, … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30243U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30230Y3 OTHER Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Peripheral Vei… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30240G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Central Vein, Open Approach… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30233G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Peripheral Vein, Percutaneous… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30230G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Peripheral Vein, Open Approac… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30240U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30243X2 OTHER Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Central Vein, Percu… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30233Y3 OTHER Transfusion Of Allogeneic Unrelated Hamatopoietic Stem Cells Into Peripheral Vei… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 101 26 — — $21,031.00 $253,183.05 $82,817.77 2026-03-12
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 115 29 — — $2,253.12 $269,960.41 $82,554.44 2026-03-12
679533 CDM Rvsc Tpvt Stnt Cl In 27 18 $249,968.90 $249,968.90 $37,495.33 $244,969.52 $81,489.86 2026-03-12
326025 CDM Revsc Fem/pop W Atherct 26 21 $201,857.46 $201,857.46 $15,000.00 $197,820.31 $80,944.85 2024-10-01
365278 CDM Stent Eprsth 8x40mm 15cm 22 17 $161,280.00 $161,280.00 $24,192.00 $158,054.40 $80,640.00 2026-03-12
407179 CDM Stent Eprsth 28x8mm 20cm 22 17 $161,280.00 $161,280.00 $24,192.00 $158,054.40 $80,640.00 2026-03-12
431236 CDM Stent Eprsth 22fr 31mm 22 17 $161,280.00 $161,280.00 $24,192.00 $158,054.40 $80,640.00 2026-03-12
1584 OTHER New Technology - Level 47 62 22 — — $54,677.25 $117,333.74 $80,617.06 2026-03-12
1598 OTHER New Technology - Level 47 62 22 — — $54,677.25 $117,333.74 $80,617.06 2026-03-12
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 94 28 — — $2,253.12 $257,216.93 $79,742.74 2026-03-12
215 MS_DRG Other Heart Assist System Implant 114 29 — — $2,253.12 $453,406.00 $79,343.77 2026-03-12
679522 CDM Rv Fpvt Stn/ath Sfl In 27 18 $239,969.69 $239,969.69 $35,995.45 $235,170.30 $78,230.12 2026-03-12
679524 CDM Rv Fpvt Stn/ath Cl In 27 18 $239,969.69 $239,969.69 $35,995.45 $235,170.30 $78,230.12 2026-03-12
326029 CDM Revsc Fem/pop W Stnt 26 21 $193,348.09 $193,348.09 $15,000.00 $189,481.13 $77,532.58 2024-10-01
C9150 HCPCS Xenon Xe-129 Hyperpolarized Gas, Diagnostic, Per Study Dose 3 1 — — $65,769.60 $74,786.40 $74,786.40 2026-03-12
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 108 26 — — $18,507.00 $242,867.79 $74,517.73 2026-03-12
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 14 4 — — $2,253.12 $92,326.93 $74,471.21 2026-03-12
007 OTHER Lung Transplant 2 1 — — $67,325.55 $79,485.63 $73,405.59 2026-03-12
014 OTHER Allogeneic Bone Marrow Transplant 2 1 — — $67,848.43 $78,029.84 $72,939.13 2026-03-12
679520 CDM Rvsc Fpvt Ath Cl In 27 18 $223,052.49 $223,052.49 $33,457.87 $218,591.44 $72,715.11 2026-03-12
679518 CDM Rvsc Fpvt Ath Sfl In 27 18 $223,052.49 $223,052.49 $33,457.87 $218,591.44 $72,715.11 2026-03-12
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 12 3 — — $31,521.48 $75,323.76 $71,589.38 2026-03-12
1597 OTHER New Technology - Level 46 62 22 — — $48,244.67 $103,529.85 $71,132.75 2026-03-12
1583 OTHER New Technology - Level 46 62 22 — — $48,244.67 $103,529.85 $71,132.75 2026-03-12
679514 CDM Rvsc Fpvt Stnt Sfl In 27 18 $213,649.64 $213,649.64 $32,047.45 $209,376.65 $69,649.78 2026-03-12
679516 CDM Rvsc Fpvt Stn Cl In 27 18 $213,649.64 $213,649.64 $32,047.45 $209,376.65 $69,649.78 2026-03-12
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 62 22 — — $46,110.19 $101,138.50 $69,165.29 2026-03-12
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 1 — — $67,203.42 $70,447.73 $68,825.57 2026-03-12
90288 CPT Botulism Immune Globulin, Human, For Intravenous Use 3 1 — — $60,394.20 $68,674.05 $68,674.05 2026-03-12
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 101 26 — — $21,031.00 $201,452.70 $68,148.87 2026-03-12
850 MS_DRG Acute Leukemia With Other Procedures 101 26 — — $8,481.00 $222,498.95 $67,844.57 2026-03-12
326048 CDM Revsc Tib/per Stnt Init 26 21 $168,550.36 $168,550.36 $15,000.00 $165,179.35 $67,588.70 2024-10-01
J9050 HCPCS Carmustine 100 Mg Inj 46 18 $147,299.29 $147,299.29 $178.02 $155,901.57 $65,913.48 2026-03-12
335058 CDM Dialysis Circ Thrmb/stnt 53 21 $201,495.49 $201,495.49 $15,000.00 $197,465.58 $65,687.53 2026-03-12
1643 OTHER Y90 Ibritumomab, Rx 62 22 — — $40,913.68 $96,250.57 $65,476.58 2026-03-12
231 MS_DRG Coronary Bypass With Ptca With Mcc 109 26 — — $18,507.00 $220,888.00 $65,040.41 2026-03-12
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 109 26 — — $33,043.26 $307,671.84 $65,004.52 2026-03-12
717 OTHER Instill Adstiladrin, Tx D 64 22 — — $11,753.14 $94,483.94 $64,917.54 2026-03-12
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 12 3 — — $26,766.00 $64,205.31 $62,320.47 2026-03-12
1596 OTHER New Technology - Level 45 62 22 — — $41,812.09 $89,725.96 $61,648.45 2026-03-12
1582 OTHER New Technology - Level 45 62 22 — — $41,812.09 $89,725.96 $61,648.45 2026-03-12
326041 CDM Revsc Tib/per W Ath Init 26 21 $153,294.67 $153,294.67 $15,000.00 $150,228.78 $61,471.16 2024-10-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 2 1 — — $55,241.20 $67,133.77 $61,187.49 2026-03-12
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 115 29 — — $2,253.12 $195,350.83 $61,014.75 2026-03-12
679531 CDM Rvsc Tpvt Stnt Sfl In 27 18 $186,248.15 $186,248.15 $27,937.22 $182,523.19 $60,716.90 2026-03-12
5244 OTHER Level 4 Blood Product Exc 62 22 — — $33,491.98 $88,708.65 $60,346.02 2026-03-12
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 108 26 — — $18,507.00 $253,492.35 $59,533.70 2026-03-12
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 109 26 — — $18,507.00 $189,799.74 $59,351.93 2026-03-12
335055 CDM Dialysis Circ Intrv Stnt 53 21 $181,381.71 $181,381.71 $15,000.00 $177,754.08 $59,130.44 2026-03-12
335114 CDM Dial Seg Ctrl Intrv Stnt 53 21 $181,381.71 $181,381.71 $15,000.00 $177,754.08 $59,130.44 2026-03-12
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 97 28 — — $2,253.12 $191,469.44 $58,607.93 2026-03-12
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 115 29 — — $2,253.12 $189,171.64 $58,589.38 2026-03-12
B0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 6 1 — — $57,095.47 $59,578.14 $58,336.81 2026-03-12
B0505 HCPCS Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 6 1 — — $56,509.08 $58,597.21 $57,553.15 2026-03-12
10 MS_DRG Pancreas Transplant 94 28 — — $2,253.12 $192,578.15 $56,559.77 2026-03-12
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 1 — — $55,366.07 $57,321.93 $56,344.00 2026-03-12
429 OTHER Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 1 1 — — $56,011.27 $56,011.27 $56,011.27 2026-03-12
459 MS_DRG Spinal Fusion Except Cervical With Mcc 14 4 — — $2,253.12 $69,101.93 $55,737.85 2026-03-12
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 101 26 — — $21,031.00 $171,469.10 $55,634.06 2026-03-12
9273 OTHER Sipuleucel-t Auto Cd54+ 62 22 — — $38,510.66 $80,872.39 $55,565.38 2026-03-12
679537 CDM Rvsc Tpvt Ath Cl In 27 18 $169,390.00 $169,390.00 $25,408.50 $166,002.20 $55,221.14 2026-03-12
679535 CDM Rvsc Tpvt Ath Sfl In 27 18 $169,390.00 $169,390.00 $25,408.50 $166,002.20 $55,221.14 2026-03-12
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $55,115.11 $55,115.11 $55,115.11 2024-10-01
325838 CDM Impl/repl Spnl Inf Pump 53 21 $168,909.53 $168,909.53 $15,000.00 $165,531.34 $55,064.51 2026-03-12
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 109 26 — — $18,507.00 $259,435.00 $54,984.53 2026-03-12
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $49,618.58 $58,389.91 $54,004.25 2026-03-12
B0106 HCPCS Stroke; M > 30.05 & M < 34.25 6 1 — — $53,126.11 $54,450.15 $53,788.13 2026-03-12
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 115 29 — — $1,854.72 $174,747.67 $53,180.88 2026-03-12
326644 CDM Rem/replace Icd Gen Sgl 53 21 $162,969.62 $162,969.62 $15,000.00 $159,710.23 $53,128.10 2026-03-12
326647 CDM Rem/replace Icd Gen Mult 53 21 $162,969.62 $162,969.62 $15,000.00 $159,710.23 $53,128.10 2026-03-12
326646 CDM Rem/replace Icd Gen Dual 53 21 $162,969.62 $162,969.62 $15,000.00 $159,710.23 $53,128.10 2026-03-12
326009 CDM Revsc Iliac W Stnt Init 26 21 $131,825.12 $131,825.12 $15,000.00 $129,188.62 $52,861.87 2024-10-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 109 26 — — $18,507.00 $170,750.75 $52,604.20 2026-03-12
332281 CDM Transcth Stnt Plc Ia 53 21 $161,172.52 $161,172.52 $15,000.00 $157,949.07 $52,542.24 2026-03-12
332283 CDM Transcth Stnt Plc In Vn 53 21 $161,172.52 $161,172.52 $15,000.00 $157,949.07 $52,542.24 2026-03-12
955 MS_DRG Craniotomy For Multiple Significant Trauma 115 29 — — $2,253.12 $167,106.29 $52,228.47 2026-03-12
1581 OTHER New Technology - Level 44 62 22 — — $35,379.51 $75,922.07 $52,164.15 2026-03-12
1595 OTHER New Technology - Level 44 62 22 — — $35,379.51 $75,922.07 $52,164.15 2026-03-12
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 1 — — $40,936.68 $62,915.86 $51,926.27 2026-03-12
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 101 26 — — $21,031.00 $161,939.95 $51,810.52 2026-03-12
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 88 28 — — $2,253.12 $178,069.45 $51,618.34 2026-03-12
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 14 4 — — $2,253.12 $63,725.73 $51,401.39 2026-03-12
332422 CDM Vasc Embol Tum/org/inf 53 21 $156,600.30 $156,600.30 $15,000.00 $153,468.29 $51,051.70 2026-03-12
332423 CDM Vasc Embol Art Ven Hem 53 21 $156,600.30 $156,600.30 $15,000.00 $153,468.29 $51,051.70 2026-03-12
332420 CDM Vasc Emboliz Venous 53 21 $156,600.30 $156,600.30 $15,000.00 $153,468.29 $51,051.70 2026-03-12
332421 CDM Vasc Emboliz Arterial 53 21 $156,600.30 $156,600.30 $15,000.00 $153,468.29 $51,051.70 2026-03-12
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 108 26 — — $18,507.00 $163,238.40 $50,896.58 2026-03-12
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 101 26 — — $18,507.00 $165,999.05 $50,701.47 2026-03-12
B0205 HCPCS Traumatic Brain Injury; M > 28.75 & M < 40.65 6 1 — — $49,431.16 $51,106.10 $50,268.63 2026-03-12
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 108 26 — — $18,507.00 $163,238.40 $50,148.10 2026-03-12
955 OTHER Craniotomy For Multiple Significant Trauma 2 1 — — $37,749.52 $62,195.92 $49,972.72 2026-03-12
C2624 HCPCS System Mntr 2x15mm 4.5cm 19 17 $71,245.00 $71,245.00 $13,116.20 $69,820.10 $49,871.50 2024-10-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 62 22 — — $33,245.10 $72,919.94 $49,867.65 2026-03-12
C0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 6 1 — — $48,697.84 $50,774.43 $49,736.13 2026-03-12
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 108 26 — — $12,000.00 $162,645.06 $49,726.05 2026-03-12
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 115 29 — — $1,854.72 $159,747.86 $49,560.83 2026-03-12
B1903 HCPCS Guillian Barre; M < 18.05 6 1 — — $47,050.00 $51,760.68 $49,405.34 2026-03-12
326017 CDM Revsc Iliac W Stnt Addl 26 21 $122,664.51 $122,664.51 $15,000.00 $120,211.22 $49,188.47 2024-10-01
C2616 HCPCS Brachytx Ns Yttrium 90 44 19 $83,983.00 $83,983.00 $10,771.00 $100,414.72 $48,670.40 2026-03-12
231 OTHER Coronary Bypass With Ptca With Mcc 2 1 — — $44,541.36 $52,407.20 $48,474.28 2026-03-12
D0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 6 1 — — $47,416.81 $49,288.78 $48,352.79 2026-03-12
334913 CDM Sp Com Carotidangio Bi 53 21 $147,455.86 $147,455.86 $15,000.00 $144,506.74 $48,070.61 2026-03-12
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 115 29 — — $2,253.12 $152,753.80 $48,025.02 2026-03-12
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 109 26 — — $18,507.00 $168,713.00 $47,624.32 2026-03-12
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 108 26 — — $18,507.00 $209,513.60 $47,605.46 2026-03-12
B0105 HCPCS Stroke; M > 34.25 & M < 38.85 6 1 — — $47,163.61 $47,872.44 $47,518.03 2026-03-12
679504 CDM Rvsc Ivt Stn Sfl In 27 18 $145,666.76 $145,666.76 $21,850.01 $142,753.42 $47,487.36 2026-03-12
679506 CDM Rvsc Ivt Stnt Cl In 27 18 $145,666.76 $145,666.76 $21,850.01 $142,753.42 $47,487.36 2026-03-12
603196 CDM Implt/rpl Crtd Sns Dev 26 21 $118,167.88 $118,167.88 $15,000.00 $115,804.52 $47,385.32 2024-10-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 109 26 — — $18,507.00 $220,888.00 $47,354.44 2026-03-12
C0106 HCPCS Stroke; M > 30.05 & M < 34.25 6 1 — — $47,176.74 $47,222.35 $47,199.54 2026-03-12
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $44,316.38 $49,342.67 $46,829.52 2026-03-12
28 MS_DRG Spinal Procedures With Mcc 115 29 — — $2,253.12 $149,162.06 $46,721.00 2026-03-12
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 109 26 — — $22,566.49 $192,851.77 $46,388.12 2026-03-12
B0604 HCPCS Neurological; M < 25.85 6 1 — — $45,948.22 $46,656.57 $46,302.40 2026-03-12
B0405 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 6 1 — — $45,405.10 $47,191.74 $46,298.42 2026-03-12
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 95 28 — — $1,854.72 $147,210.73 $46,142.16 2026-03-12
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 91 26 — — $1,854.72 $132,936.15 $45,790.41 2026-03-12
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 115 29 — — $2,253.12 $148,231.99 $45,737.33 2026-03-12
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 109 26 — — $18,507.00 $145,693.86 $45,675.67 2026-03-12
B2102 HCPCS Burns; M=12-45 6 1 — — $43,419.24 $47,735.66 $45,577.45 2026-03-12
447 OTHER Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 1 1 — — $45,557.50 $45,557.50 $45,557.50 2026-03-12
C1822 HCPCS Pulse Gen Imp 41 20 $90,720.00 $90,720.00 $13,608.00 $88,905.60 $45,360.00 2026-03-12
1142 OTHER Supprelin La Implant 62 22 — — $31,093.44 $66,664.81 $45,350.21 2026-03-12
367810 CDM Set Vntrc 17.4x13.8in 68 26 $139,525.00 $139,525.00 $15,000.00 $147,661.50 $45,275.86 2026-03-12
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 111 29 — — $2,253.12 $314,996.79 $45,212.78 2026-03-12
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 1 — — $42,665.84 $47,470.71 $45,068.27 2026-03-12
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 95 28 — — $1,854.72 $145,787.50 $45,009.67 2026-03-12
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 51 25 — — $18,507.00 $141,679.50 $44,937.66 2026-03-12
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 115 29 — — $2,253.12 $168,016.30 $44,673.71 2026-03-12
215 OTHER Other Heart Assist System Implant 2 1 — — $37,986.99 $51,259.23 $44,623.11 2026-03-12
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 101 26 — — $21,031.00 $132,130.27 $44,504.08 2026-03-12
C0505 HCPCS Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 6 1 — — $43,962.54 $45,031.06 $44,496.80 2026-03-12
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 1 — — $43,873.34 $44,354.46 $44,113.90 2026-03-12
326066 CDM Revsc Tib/per Ath Addl 26 21 $109,963.41 $109,963.41 $15,000.00 $107,764.14 $44,095.32 2024-10-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 101 26 — — $21,031.00 $132,978.11 $43,876.15 2026-03-12
A0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 6 1 — — $42,907.89 $44,786.86 $43,847.38 2026-03-12
B1004 HCPCS Amputation, Lower Extremity; M=39-45 6 1 — — $43,110.12 $44,327.71 $43,718.92 2026-03-12
J1303 HCPCS Ravuliz-cwvz 1100mg Inj 46 18 $105,446.06 $105,446.06 $269.38 $103,337.14 $43,689.82 2026-03-12
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 115 29 — — $2,253.12 $141,495.79 $43,575.38 2026-03-12
450497 CDM Impl Crnl Ostmtch150-200 46 21 $83,526.00 $83,526.00 $12,528.90 $88,397.96 $43,432.00 2026-03-12
B0704 HCPCS Fracture Of Lower Extremity; M < 28.15 6 1 — — $43,026.05 $43,600.96 $43,313.51 2026-03-12
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 94 28 — — $2,253.12 $139,139.80 $43,295.71 2026-03-12
B1504 HCPCS Pulmonary; M < 29.15 6 1 — — $42,609.90 $43,935.71 $43,272.81 2026-03-12
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 2 1 — — $43,176.13 $43,334.57 $43,255.35 2026-03-12
360 OTHER Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 1 1 — — $43,076.93 $43,076.93 $43,076.93 2026-03-12
D0106 HCPCS Stroke; M > 30.05 & M < 34.25 6 1 — — $42,742.84 $43,153.21 $42,948.02 2026-03-12
A5104 HCPCS Expired, Not Orthopedic, Length Of Stay Is 16 Days 6 1 — — $41,039.80 $44,651.97 $42,845.89 2026-03-12
456185 CDM Stnt Thorac 28x28mm 10cm 46 21 $82,140.00 $82,140.00 $12,321.00 $86,929.92 $42,711.00 2026-03-12
461465 CDM Stent Graft 15cm 31x31mm 46 21 $82,140.00 $82,140.00 $12,321.00 $86,929.92 $42,711.00 2026-03-12
461317 CDM Stent 34mmx34mmx15cm 46 21 $82,140.00 $82,140.00 $12,321.00 $86,929.92 $42,711.00 2026-03-12
460799 CDM Stnt Thorac 26x26mm 10cm 46 21 $82,140.00 $82,140.00 $12,321.00 $86,929.92 $42,711.00 2026-03-12
460972 CDM Stent Graft 10cm 21x21mm 46 21 $82,140.00 $82,140.00 $12,321.00 $86,929.92 $42,711.00 2026-03-12
1594 OTHER New Technology - Level 43 62 22 — — $28,946.93 $62,118.19 $42,679.84 2026-03-12
1580 OTHER New Technology - Level 43 62 22 — — $28,946.93 $62,118.19 $42,679.84 2026-03-12
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 115 29 — — $2,253.12 $138,186.48 $42,612.96 2026-03-12
834 MS_DRG Acute Leukemia With Mcc 115 29 — — $1,854.72 $136,292.26 $42,593.28 2026-03-12
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 108 26 — — $12,000.00 $135,810.63 $42,341.23 2026-03-12
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 109 26 — — $18,507.00 $135,616.99 $42,284.35 2026-03-12
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 115 29 — — $2,253.12 $156,158.93 $42,272.09 2026-03-12
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 2 1 — — $23,616.38 $60,767.42 $42,191.90 2026-03-12
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 1 — — $37,238.04 $46,848.47 $42,043.26 2026-03-12
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 115 29 — — $2,253.12 $135,403.49 $42,024.95 2026-03-12
437224 CDM Gft Evas 42x198 25fr 24 20 $83,890.00 $83,890.00 $12,583.50 $82,212.20 $41,945.00 2024-10-01
437226 CDM Gft Evas 46x197 25fr 24 20 $83,890.00 $83,890.00 $12,583.50 $82,212.20 $41,945.00 2024-10-01
653 MS_DRG Major Bladder Procedures With Mcc 108 26 — — $12,000.00 $134,644.80 $41,901.26 2026-03-12
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 108 26 — — $18,507.00 $132,392.09 $41,746.38 2026-03-12
D0505 HCPCS Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 6 1 — — $41,532.67 $41,893.20 $41,712.93 2026-03-12
C0105 HCPCS Stroke; M > 34.25 & M < 38.85 6 1 — — $41,517.68 $41,881.94 $41,699.81 2026-03-12
B2005 HCPCS Miscellaneous; M=12-32 And A Tm81 6 1 — — $41,484.32 $41,613.22 $41,548.77 2026-03-12
B1304 HCPCS Rheumatoid, Other Arthritis; M=12-35 6 1 — — $40,121.95 $42,973.54 $41,547.74 2026-03-12
B1704 HCPCS Major Multiple Trauma,no Brain Or Spinal Cord Inju 6 1 — — $41,174.85 $41,858.65 $41,516.75 2026-03-12
332284 CDM Transcth Stnt Plc Ea Vn 53 21 $126,880.93 $126,880.93 $15,000.00 $124,343.31 $41,363.18 2026-03-12
332282 CDM Transcth Stnt Plc Ea Ad 53 21 $126,880.93 $126,880.93 $15,000.00 $124,343.31 $41,363.18 2026-03-12
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 101 26 — — $20,249.29 $124,391.00 $41,345.36 2026-03-12
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 109 26 — — $18,507.00 $130,989.42 $41,330.29 2026-03-12
B0904 HCPCS Other Orthopedic; M < 24.15 6 1 — — $40,121.95 $42,167.03 $41,144.49 2026-03-12
B0504 HCPCS Nontraumatic Spinal Cord Injury; M > 29.25 & M < 3 6 1 — — $40,667.13 $41,242.37 $40,954.75 2026-03-12
A0106 HCPCS Stroke; M > 30.05 & M < 34.25 6 1 — — $40,542.77 $41,124.25 $40,833.51 2026-03-12
679534 CDM Rvsc Tpvt Stnt Cl Ea 27 18 $124,984.45 $124,984.45 $18,747.67 $122,484.76 $40,744.93 2026-03-12
679529 CDM Rvsc Tpvt Ang Cl In 27 18 $124,984.45 $124,984.45 $18,747.67 $122,484.76 $40,744.93 2026-03-12
C0205 HCPCS Traumatic Brain Injury; M > 28.75 & M < 40.65 6 1 — — $40,634.67 $40,712.09 $40,673.38 2026-03-12
B1204 HCPCS Osteoarthritis; M=39-47 6 1 — — $40,259.56 $40,910.68 $40,585.12 2026-03-12
B0304 HCPCS Nontraumatic Brain Injury; M < 26.15 6 1 — — $40,506.01 $40,578.41 $40,542.21 2026-03-12
334920 CDM Sp Vert Angio Bi 53 21 $124,268.78 $124,268.78 $15,000.00 $121,783.40 $40,511.62 2026-03-12
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 115 29 — — $2,253.12 $130,313.81 $40,403.58 2026-03-12
436739 CDM Gft Evas 38x199 24fr 24 20 $80,656.00 $80,656.00 $12,098.40 $79,042.88 $40,328.00 2024-10-01
834 OTHER Acute Leukemia With Mcc 2 1 — — $38,755.97 $41,893.48 $40,324.73 2026-03-12
437221 CDM Gft Evas 36x199 24fr 24 20 $80,623.00 $80,623.00 $12,093.45 $79,010.54 $40,311.50 2024-10-01
436991 CDM Gft Evas 32x200 22fr 24 20 $80,623.00 $80,623.00 $12,093.45 $79,010.54 $40,311.50 2024-10-01
B1404 HCPCS Cardiac; M < 31.15 6 1 — — $40,200.64 $40,265.18 $40,232.91 2026-03-12
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 62 22 — — $26,802.65 $58,789.12 $40,203.97 2026-03-12
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 115 29 — — $2,253.12 $129,229.26 $40,008.00 2026-03-12
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 62 22 — — $26,391.05 $57,886.25 $39,586.58 2026-03-12
B2004 HCPCS Miscellaneous; M < 27.85 6 1 — — $39,479.36 $39,633.11 $39,556.24 2026-03-12
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