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

TRISTAR SKYLINE MEDICAL CENTER

Nashville, TN · CCN 440006 · Rates published

25,243 distinct procedures filed
39 distinct payers
754,122 rate rows
2026-03-12 last MRF observed
Data quality

725,508 of 754,122 rate rows are consumer-grade (96.2%)

28,614 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 21,808
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 6,326
placeholder amount (≤ $0.02) — excluded from medians 286
template filing: same amount across many unrelated codes — excluded 173
exceeds 10× this hospital's gross charge — excluded from medians 21
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 not_modified · 2026-05-17
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 $5,294.38 $4,955,500.00 $4,550,050.00 nat. median
$9,966
outlier · 456.6×
J1411
HCPCS 		Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 1 $4,200,000.00 $4,200,000.00 $4,200,000.00 nat. median
$3,710,000
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
$3,325,455
1.2× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 18 $2,653,392.24 $4,238,057.05 $3,722,119.67 nat. median
$3,746,358
1.0× 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
908
OTHER 		Topi Adm Prad Zami Per Tr 21 $9,586.22 $4,903,655.40 $3,385,857.30 nat. median
$22,747
outlier · 148.8×
714
OTHER 		Inj Delandistrogene Mox R 21 $6,226.90 $4,891,954.20 $3,377,777.90 nat. median
$13,041
outlier · 259.0×
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $3,360,000.00 $3,360,000.00 $3,360,000.00 nat. median
$3,006,423
1.1× median
748
OTHER 		Inj, Lovotibeglogene Auto 21 $11,852.84 $4,781,186.76 $3,301,295.62 nat. median
$17,963
outlier · 183.8×
906
OTHER 		Inj Elivaldogene Autoteme 21 $8,470.55 $4,674,600.00 $3,227,700.00 nat. median
$20,756
outlier · 155.5×
746
OTHER 		Inj, Betibeglogene Autote 21 $10,964.00 $4,321,754.43 $2,984,068.54 nat. median
$21,896
outlier · 136.3×
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
$2,469,189
1.2× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 21 $1,864,066.32 $3,805,802.07 $2,640,760.62 nat. median
$2,588,981
1.0× median
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 1 $2,640,000.00 $2,640,000.00 $2,640,000.00 nat. median
$2,448,600
1.1× median
824
OTHER 		Inj, Exagamglogene Autote 21 $12,838.57 $3,428,040.00 $2,366,980.00 nat. median
$25,250
outlier · 93.7×
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 3 $872,400.00 $2,042,143.00 $1,749,707.25 nat. median
$824,563
outlier · 2.1×
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 2 $676,327.75 $1,557,271.36 $1,557,271.36 nat. median
$675,122
outlier · 2.3×
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 1 $1,501,307.95 $1,501,307.95 $1,501,307.95 nat. median
$754,974
2.0× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 2 $631,423.78 $1,489,833.29 $1,489,833.29 nat. median
$674,188
outlier · 2.2×
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 2 $614,793.95 $1,410,309.44 $1,410,309.44 nat. median
$634,511
outlier · 2.2×
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 2 $598,359.73 $1,297,043.03 $1,297,043.03 nat. median
$620,080
outlier · 2.1×
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 3 $645,093.12 $1,478,916.58 $1,270,460.72 nat. median
$625,184
outlier · 2.0×
2067
OTHER 		Afamitresgene Autoleucel 21 $554,846.40 $1,132,811.40 $786,032.40 nat. median
$786,032
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
$324,450
outlier · 2.2×
9498
OTHER 		Ciltacabtagene Car-pos T 21 $423,107.71 $863,844.91 $599,402.59 nat. median
$587,650
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos 21 $407,902.54 $832,801.01 $577,861.93 nat. median
$566,531
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 21 $404,784.86 $826,435.76 $573,445.22 nat. median
$562,201
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 21 $401,818.90 $820,380.25 $569,243.44 nat. median
$558,082
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 21 $383,178.38 $782,322.53 $542,836.04 nat. median
$532,192
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×
9391
OTHER 		Brexucabtagene Car Pos T 21 $352,404.14 $719,491.79 $499,239.20 nat. median
$489,450
1.0× median
0207
RC 		1 $397,211.21 $397,211.21 $397,211.21 nat. median
$7,090
outlier · 56.0×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 26 $1,854.72 $1,072,056.19 $320,486.96 nat. median
$370,174
0.9× median
831
OTHER 		Obecbtge Autol Up To 400 21 $3,625.36 $409,027.50 $282,423.75 nat. median
$12,362
outlier · 22.8×
897
OTHER 		Revakinagene, Per Implant 21 $190,800.00 $389,550.00 $270,300.00 nat. median
$9,577
outlier · 28.2×
J7330
HCPCS 		Autologous Cultured Chondrocytes, Implant 2 $76,729.09 $221,874.56 $221,874.56 nat. median
$76,377
outlier · 2.9×
018
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $213,758.80 $213,758.80 $213,758.80 nat. median
$424,868
0.5× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 27 $2,253.12 $695,721.34 $210,899.09 nat. median
$265,286
0.8× median
886
OTHER 		Inj. Remestemcel-l-rknd/ 21 $7,932.88 $296,453.43 $204,694.04 nat. median
$17,985
outlier · 11.4×
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $187,897.40 $187,897.40 $187,897.40 nat. median
$263,894
0.7× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 28 $2,253.12 $1,921,402.40 $160,340.31 nat. median
$202,986
0.8× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 27 $2,253.12 $530,047.51 $159,706.30 nat. median
$206,368
0.8× median
1907
OTHER 		New Technology - Level 52 21 $103,106.95 $210,510.03 $146,068.18 nat. median
$153,199
1.0× median
1908
OTHER 		New Technology - Level 52 21 $103,106.95 $210,510.03 $146,068.18 nat. median
$152,962
1.0× median
J9029
HCPCS 		Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 3 $77,314.48 $170,328.19 $132,540.10 nat. median
$69,774
1.9× median
003
OTHER 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 $132,433.90 $132,433.90 $132,433.90 nat. median
$218,232
0.6× median
1905
OTHER 		New Technology - Level 51 21 $92,965.32 $189,804.20 $131,700.87 nat. median
$137,903
1.0× median
1906
OTHER 		New Technology - Level 51 21 $92,965.32 $189,804.20 $131,700.87 nat. median
$138,020
1.0× median
A9699
HCPCS 		Radiopharmaceutical, Therapeutic, Not Otherwise Classified 1 $123,742.09 $123,742.09 $123,742.09 nat. median
$21,806
outlier · 5.7×

Other procedures at this hospital

Browse this hospital's 25,243 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
             
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
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
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
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
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
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
335058 CDM Dialysis Circ Thrmb/stnt 27 18 $201,495.49 $201,495.49 $30,224.32 $197,465.58 $65,687.53 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
335114 CDM Dial Seg Ctrl Intrv Stnt 27 18 $181,381.71 $181,381.71 $27,207.26 $177,754.08 $59,130.44 2026-03-12
335055 CDM Dialysis Circ Intrv Stnt 27 18 $181,381.71 $181,381.71 $27,207.26 $177,754.08 $59,130.44 2026-03-12
C1825 HCPCS System Generator Ipg 22 17 $176,400.00 $176,400.00 $26,460.00 $172,872.00 $88,200.00 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
325838 CDM Impl/repl Spnl Inf Pump 27 18 $168,909.53 $168,909.53 $25,336.43 $165,531.34 $55,064.51 2026-03-12
326646 CDM Rem/replace Icd Gen Dual 27 18 $162,969.62 $162,969.62 $24,445.44 $159,710.23 $53,128.10 2026-03-12
326644 CDM Rem/replace Icd Gen Sgl 27 18 $162,969.62 $162,969.62 $24,445.44 $159,710.23 $53,128.10 2026-03-12
326647 CDM Rem/replace Icd Gen Mult 27 18 $162,969.62 $162,969.62 $24,445.44 $159,710.23 $53,128.10 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
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
332281 CDM Transcth Stnt Plc Ia 27 18 $161,172.52 $161,172.52 $24,175.88 $157,949.07 $52,542.24 2026-03-12
332283 CDM Transcth Stnt Plc In Vn 27 18 $161,172.52 $161,172.52 $24,175.88 $157,949.07 $52,542.24 2026-03-12
J9050 HCPCS Carmustine 100 Mg Inj 22 15 $159,083.23 $159,083.23 $178.02 $155,901.57 $58,701.71 2026-03-12
332423 CDM Vasc Embol Art Ven Hem 27 18 $156,600.30 $156,600.30 $23,490.04 $153,468.29 $51,051.70 2026-03-12
332422 CDM Vasc Embol Tum/org/inf 27 18 $156,600.30 $156,600.30 $23,490.04 $153,468.29 $51,051.70 2026-03-12
332420 CDM Vasc Emboliz Venous 27 18 $156,600.30 $156,600.30 $23,490.04 $153,468.29 $51,051.70 2026-03-12
332421 CDM Vasc Emboliz Arterial 27 18 $156,600.30 $156,600.30 $23,490.04 $153,468.29 $51,051.70 2026-03-12
C2642 HCPCS Brachytx Strnd Cesium131 108 16 $153,720.00 $153,720.00 $21,340.87 $197,549.38 $88,825.73 2026-03-12
367810 CDM Set Vntrc 17.4x13.8in 33 22 $150,675.00 $150,675.00 $22,601.25 $147,661.50 $43,093.05 2026-03-12
334913 CDM Sp Com Carotidangio Bi 27 18 $147,455.86 $147,455.86 $22,118.38 $144,506.74 $48,070.61 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
332282 CDM Transcth Stnt Plc Ea Ad 27 18 $126,880.93 $126,880.93 $19,032.14 $124,343.31 $41,363.18 2026-03-12
332284 CDM Transcth Stnt Plc Ea Vn 27 18 $126,880.93 $126,880.93 $19,032.14 $124,343.31 $41,363.18 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
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
334920 CDM Sp Vert Angio Bi 27 18 $124,268.78 $124,268.78 $18,640.32 $121,783.40 $40,511.62 2026-03-12
C2616 HCPCS Brachytx Ns Yttrium 90 21 16 $102,464.00 $102,464.00 $12,041.00 $100,414.72 $51,232.00 2026-03-12
C1822 HCPCS Pulse Gen Imp 22 17 $90,720.00 $90,720.00 $13,608.00 $88,905.60 $45,360.00 2026-03-12
450497 CDM Impl Crnl Lg 22 17 $90,202.00 $90,202.00 $13,530.30 $88,397.96 $45,101.00 2026-03-12
456185 CDM Stnt Thorac 28x28mm 10cm 22 17 $88,704.00 $88,704.00 $13,305.60 $86,929.92 $44,352.00 2026-03-12
461465 CDM Stent Graft 15cm 31x31mm 22 17 $88,704.00 $88,704.00 $13,305.60 $86,929.92 $44,352.00 2026-03-12
460799 CDM Stnt Thorac 26x26mm 10cm 22 17 $88,704.00 $88,704.00 $13,305.60 $86,929.92 $44,352.00 2026-03-12
461317 CDM Stent 34mmx34mmx15cm 22 17 $88,704.00 $88,704.00 $13,305.60 $86,929.92 $44,352.00 2026-03-12
460972 CDM Stent Graft 10cm 21x21mm 22 17 $88,704.00 $88,704.00 $13,305.60 $86,929.92 $44,352.00 2026-03-12
437220 CDM Gft Evas 36x159 24fr 22 17 $81,270.00 $81,270.00 $12,190.50 $79,644.60 $40,635.00 2026-03-12
459365 CDM Coil Embl 4x3mm 22 17 $78,979.00 $78,979.00 $11,846.85 $77,399.42 $39,489.50 2026-03-12
459366 CDM Coil Embl 4.5mm 3mm 22 17 $78,979.00 $78,979.00 $11,846.85 $77,399.42 $39,489.50 2026-03-12
456380 CDM Coil Emb Neuro 6x3mm 22 17 $78,979.00 $78,979.00 $11,846.85 $77,399.42 $39,489.50 2026-03-12
459364 CDM Coil Embol Neuro 4x2mm 22 17 $78,979.00 $78,979.00 $11,846.85 $77,399.42 $39,489.50 2026-03-12
460110 CDM Coil Embl 5mm 2mm 22 17 $78,979.00 $78,979.00 $11,846.85 $77,399.42 $39,489.50 2026-03-12
460111 CDM Coil Emb Neuro 6x4mm 22 17 $78,979.00 $78,979.00 $11,846.85 $77,399.42 $39,489.50 2026-03-12
405603 CDM Coil Embl 6mm 2mm 22 17 $78,979.00 $78,979.00 $11,846.85 $77,399.42 $39,489.50 2026-03-12
459368 CDM Coil Embol Neuro 7x3mm 22 17 $78,979.00 $78,979.00 $11,846.85 $77,399.42 $39,489.50 2026-03-12
459367 CDM Device Endo Sng 5x3mm 22 17 $78,979.00 $78,979.00 $11,846.85 $77,399.42 $39,489.50 2026-03-12
460112 CDM Coil Emb Neuro 7x4mm 22 17 $78,979.00 $78,979.00 $11,846.85 $77,399.42 $39,489.50 2026-03-12
460109 CDM Coil Embz .017 4.5mm 2mm 22 17 $78,979.00 $78,979.00 $11,846.85 $77,399.42 $39,489.50 2026-03-12
348624 CDM Coil Emb Neuro 7mm 2mm 22 17 $78,979.00 $78,979.00 $11,846.85 $77,399.42 $39,489.50 2026-03-12
459369 CDM Coil Emb 7x5mm 22 17 $78,979.00 $78,979.00 $11,846.85 $77,399.42 $39,489.50 2026-03-12
845 OTHER Inj, Atidarsagene Autotem 28 17 — — $5,294.38 $4,955,500.00 $4,550,050.00 2026-03-12
J1411 HCPCS Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 1 1 — — $4,200,000.00 $4,200,000.00 $4,200,000.00 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
J1413 HCPCS Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 1 1 — — $3,840,000.00 $3,840,000.00 $3,840,000.00 2026-03-12
9138 OTHER Inj, Hemgenix, Per Tx Dos 28 18 — — $2,653,392.24 $4,238,057.05 $3,722,119.67 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
908 OTHER Topi Adm Prad Zami Per Tr 32 21 — — $9,586.22 $4,903,655.40 $3,385,857.30 2026-03-12
714 OTHER Inj Delandistrogene Mox R 32 21 — — $6,226.90 $4,891,954.20 $3,377,777.90 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 32 21 — — $11,852.84 $4,781,186.76 $3,301,295.62 2026-03-12
906 OTHER Inj Elivaldogene Autoteme 32 21 — — $8,470.55 $4,674,600.00 $3,227,700.00 2026-03-12
746 OTHER Inj, Betibeglogene Autote 32 21 — — $10,964.00 $4,321,754.43 $2,984,068.54 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
9141 OTHER Inj Onase Abepar-xioi Tre 31 21 — — $1,864,066.32 $3,805,802.07 $2,640,760.62 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
824 OTHER Inj, Exagamglogene Autote 32 21 — — $12,838.57 $3,428,040.00 $2,366,980.00 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
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 4 2 — — $676,327.75 $1,557,271.36 $1,557,271.36 2026-03-12
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 3 1 — — $1,501,307.95 $1,501,307.95 $1,501,307.95 2026-03-12
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 4 2 — — $631,423.78 $1,489,833.29 $1,489,833.29 2026-03-12
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 4 2 — — $614,793.95 $1,410,309.44 $1,410,309.44 2026-03-12
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 4 2 — — $598,359.73 $1,297,043.03 $1,297,043.03 2026-03-12
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 6 3 — — $645,093.12 $1,478,916.58 $1,270,460.72 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 31 21 — — $423,107.71 $863,844.91 $599,402.59 2026-03-12
9194 OTHER Tisagenlecleucel Car-pos 31 21 — — $407,902.54 $832,801.01 $577,861.93 2026-03-12
9413 OTHER Lisocabtagene Car Pos T 31 21 — — $404,784.86 $826,435.76 $573,445.22 2026-03-12
9422 OTHER Idecabtagene Vicleucel Ca 31 21 — — $401,818.90 $820,380.25 $569,243.44 2026-03-12
9035 OTHER Axicabtagene Ciloleucel C 31 21 — — $383,178.38 $782,322.53 $542,836.04 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
9391 OTHER Brexucabtagene Car Pos T 31 21 — — $352,404.14 $719,491.79 $499,239.20 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 45 26 — — $1,854.72 $1,072,056.19 $320,486.96 2026-03-12
831 OTHER Obecbtge Autol Up To 400 32 21 — — $3,625.36 $409,027.50 $282,423.75 2026-03-12
897 OTHER Revakinagene, Per Implant 31 21 — — $190,800.00 $389,550.00 $270,300.00 2026-03-12
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 5 2 — — $76,729.09 $221,874.56 $221,874.56 2026-03-12
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $213,758.80 $213,758.80 $213,758.80 2026-03-12
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 53 27 — — $2,253.12 $695,721.34 $210,899.09 2026-03-12
886 OTHER Inj. Remestemcel-l-rknd/ 32 21 — — $7,932.88 $296,453.43 $204,694.04 2026-03-12
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $187,897.40 $187,897.40 $187,897.40 2026-03-12
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 57 28 — — $2,253.12 $1,921,402.40 $160,340.31 2026-03-12
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 49 27 — — $2,253.12 $530,047.51 $159,706.30 2026-03-12
1907 OTHER New Technology - Level 52 31 21 — — $103,106.95 $210,510.03 $146,068.18 2026-03-12
1908 OTHER New Technology - Level 52 31 21 — — $103,106.95 $210,510.03 $146,068.18 2026-03-12
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 6 3 — — $77,314.48 $170,328.19 $132,540.10 2026-03-12
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $132,433.90 $132,433.90 $132,433.90 2026-03-12
1905 OTHER New Technology - Level 51 31 21 — — $92,965.32 $189,804.20 $131,700.87 2026-03-12
1906 OTHER New Technology - Level 51 31 21 — — $92,965.32 $189,804.20 $131,700.87 2026-03-12
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 3 1 — — $123,742.09 $123,742.09 $123,742.09 2026-03-12
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 6 3 — — $78,127.16 $150,585.06 $119,711.60 2026-03-12
1903 OTHER New Technology - Level 50 31 21 — — $82,823.69 $169,098.36 $117,333.56 2026-03-12
1904 OTHER New Technology - Level 50 31 21 — — $82,823.69 $169,098.36 $117,333.56 2026-03-12
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 31 21 — — $80,282.16 $163,909.41 $113,733.06 2026-03-12
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 6 3 — — $68,835.85 $144,170.89 $111,221.96 2026-03-12
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 58 28 — — $2,253.12 $343,874.86 $105,504.65 2026-03-12
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $103,420.40 $103,420.40 $103,420.40 2026-03-12
1902 OTHER New Technology - Level 49 31 21 — — $72,682.06 $148,392.53 $102,966.25 2026-03-12
1901 OTHER New Technology - Level 49 31 21 — — $72,682.06 $148,392.53 $102,966.25 2026-03-12
7 MS_DRG Lung Transplant 47 27 — — $2,253.12 $321,501.67 $97,843.57 2026-03-12
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 31 21 — — $68,458.32 $139,769.07 $96,982.62 2026-03-12
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $92,686.01 $92,686.01 $92,686.01 2026-03-12
1599 OTHER New Technology - Level 48 31 21 — — $64,230.67 $131,137.63 $90,993.46 2026-03-12
1585 OTHER New Technology - Level 48 31 21 — — $64,230.67 $131,137.63 $90,993.46 2026-03-12
14 MS_DRG Allogeneic Bone Marrow Transplant 49 27 — — $1,854.72 $298,356.39 $90,977.79 2026-03-12
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 6 3 — — $54,756.23 $114,441.15 $88,352.14 2026-03-12
209 MS_DRG Complex Aortic Arch Procedures 63 32 — — $18,507.00 $281,000.53 $87,512.31 2026-03-12
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 53 27 — — $2,253.12 $548,737.00 $86,767.51 2026-03-12
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 63 32 — — $43,336.79 $244,076.82 $85,277.70 2026-03-12
30230X2 OTHER Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Peripheral Vein, Op… 1 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30230X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Peripheral Vein, … 1 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… 1 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… 1 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… 1 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, … 1 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… 1 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,… 1 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… 1 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… 1 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… 1 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, … 1 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 … 1 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… 1 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 … 1 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… 1 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… 1 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… 1 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 … 1 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 1 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… 1 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 … 1 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 … 1 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… 1 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… 1 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… 1 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 … 1 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… 1 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… 1 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, … 1 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,… 1 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… 1 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 58 28 — — $2,253.12 $269,960.41 $82,959.12 2026-03-12
1598 OTHER New Technology - Level 47 31 21 — — $57,469.59 $117,333.74 $81,415.25 2026-03-12
1584 OTHER New Technology - Level 47 31 21 — — $57,469.59 $117,333.74 $81,415.25 2026-03-12
007 OTHER Lung Transplant 1 1 — — $79,485.63 $79,485.63 $79,485.63 2026-03-12
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 47 27 — — $2,253.12 $255,968.47 $78,403.90 2026-03-12
215 MS_DRG Other Heart Assist System Implant 57 28 — — $2,253.12 $453,406.00 $76,543.74 2026-03-12
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 57 28 — — $2,253.12 $242,867.79 $75,248.30 2026-03-12
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 7 4 — — $2,253.12 $92,326.93 $74,471.21 2026-03-12
1597 OTHER New Technology - Level 46 31 21 — — $50,708.50 $103,529.85 $71,837.04 2026-03-12
1583 OTHER New Technology - Level 46 31 21 — — $50,708.50 $103,529.85 $71,837.04 2026-03-12
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $70,447.73 $70,447.73 $70,447.73 2026-03-12
C9150 HCPCS Xenon Xe-129 Hyperpolarized Gas, Diagnostic, Per Study Dose 2 1 — — $65,769.60 $74,786.40 $70,278.00 2026-03-12
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 31 21 — — $49,537.22 $101,138.50 $70,177.73 2026-03-12
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 63 32 — — $35,426.92 $194,335.98 $70,173.10 2026-03-12
014 OTHER Allogeneic Bone Marrow Transplant 1 1 — — $67,848.43 $67,848.43 $67,848.43 2026-03-12
850 MS_DRG Acute Leukemia With Other Procedures 63 32 — — $12,480.00 $214,980.75 $67,544.29 2026-03-12
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $67,133.77 $67,133.77 $67,133.77 2026-03-12
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 58 28 — — $2,253.12 $307,671.84 $65,621.30 2026-03-12
717 OTHER Instill Adstiladrin, Tx D 32 21 — — $11,753.14 $94,483.94 $65,238.91 2026-03-12
231 MS_DRG Coronary Bypass With Ptca With Mcc 58 28 — — $2,253.12 $220,888.00 $65,187.39 2026-03-12
90288 CPT Botulism Immune Globulin, Human, For Intravenous Use 2 1 — — $60,394.20 $68,674.05 $64,534.12 2026-03-12
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $62,915.86 $62,915.86 $62,915.86 2026-03-12
1596 OTHER New Technology - Level 45 31 21 — — $43,947.41 $89,725.96 $62,258.83 2026-03-12
1582 OTHER New Technology - Level 45 31 21 — — $43,947.41 $89,725.96 $62,258.83 2026-03-12
5244 OTHER Level 4 Blood Product Exc 31 21 — — $43,449.13 $88,708.65 $61,552.94 2026-03-12
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 58 28 — — $2,253.12 $195,350.83 $61,014.75 2026-03-12
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 1 1 — — $60,767.42 $60,767.42 $60,767.42 2026-03-12
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 57 28 — — $2,253.12 $253,492.35 $59,598.08 2026-03-12
B0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 3 1 — — $59,578.14 $59,578.14 $59,578.14 2026-03-12
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 58 28 — — $2,253.12 $189,171.64 $59,163.79 2026-03-12
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 58 28 — — $2,253.12 $189,799.74 $59,063.81 2026-03-12
B0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 3 1 — — $58,597.21 $58,597.21 $58,597.21 2026-03-12
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $58,389.91 $58,389.91 $58,389.91 2026-03-12
1643 OTHER Y90 Ibritumomab, Rx 31 21 — — $40,913.68 $83,532.09 $57,961.04 2026-03-12
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 63 32 — — $28,384.47 $165,492.91 $56,724.93 2026-03-12
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 6 3 — — $33,097.56 $75,323.76 $56,707.35 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 7 4 — — $2,253.12 $69,101.93 $55,737.85 2026-03-12
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 58 28 — — $2,253.12 $259,435.00 $55,523.59 2026-03-12
9273 OTHER Sipuleucel-t Auto Cd54+ 31 21 — — $39,170.96 $79,974.04 $55,492.19 2026-03-12
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $55,366.07 $55,366.07 $55,366.07 2026-03-12
10 MS_DRG Pancreas Transplant 47 27 — — $2,253.12 $178,143.93 $55,318.14 2026-03-12
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 50 28 — — $2,253.12 $178,069.45 $55,296.05 2026-03-12
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 49 27 — — $2,253.12 $177,123.58 $55,015.46 2026-03-12
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 58 28 — — $2,253.12 $170,750.75 $53,645.87 2026-03-12
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 58 28 — — $1,854.72 $174,747.67 $53,374.68 2026-03-12
B0106 OTHER Stroke; M > 30.05 & M < 34.25 3 1 — — $53,126.11 $53,126.11 $53,126.11 2026-03-12
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 63 32 — — $18,507.00 $165,999.05 $52,729.53 2026-03-12
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 63 32 — — $26,272.92 $156,219.51 $52,692.73 2026-03-12
1595 OTHER New Technology - Level 44 31 21 — — $37,186.32 $75,922.07 $52,680.62 2026-03-12
1581 OTHER New Technology - Level 44 31 21 — — $37,186.32 $75,922.07 $52,680.62 2026-03-12
955 MS_DRG Craniotomy For Multiple Significant Trauma 58 28 — — $2,253.12 $167,106.29 $52,554.18 2026-03-12
231 OTHER Coronary Bypass With Ptca With Mcc 1 1 — — $52,407.20 $52,407.20 $52,407.20 2026-03-12
275 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 1 1 — — $52,238.06 $52,238.06 $52,238.06 2026-03-12
B1903 OTHER Guillian Barre; M < 18.05 3 1 — — $51,760.68 $51,760.68 $51,760.68 2026-03-12
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 7 4 — — $2,253.12 $63,725.73 $51,401.39 2026-03-12
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 57 28 — — $2,253.12 $163,238.40 $51,395.57 2026-03-12
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 57 28 — — $2,253.12 $163,238.40 $51,395.57 2026-03-12
B0205 OTHER Traumatic Brain Injury; M > 28.75 & M < 40.65 3 1 — — $51,106.10 $51,106.10 $51,106.10 2026-03-12
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 58 28 — — $2,253.12 $162,645.06 $50,969.20 2026-03-12
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 31 21 — — $35,715.89 $72,919.94 $50,597.51 2026-03-12
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 58 28 — — $1,854.72 $159,747.86 $49,861.15 2026-03-12
850 OTHER Acute Leukemia With Other Procedures 1 1 — — $49,099.41 $49,099.41 $49,099.41 2026-03-12
C0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 3 1 — — $48,697.84 $48,697.84 $48,697.84 2026-03-12
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 6 3 — — $27,987.60 $64,205.31 $48,626.85 2026-03-12
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 57 28 — — $2,253.12 $209,513.60 $48,072.18 2026-03-12
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 58 28 — — $2,253.12 $151,967.39 $47,786.27 2026-03-12
B2102 OTHER Burns; M=12-45 3 1 — — $47,735.66 $47,735.66 $47,735.66 2026-03-12
232 MS_DRG Coronary Bypass With Ptca Without Mcc 58 28 — — $2,253.12 $220,888.00 $47,582.85 2026-03-12
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $47,470.71 $47,470.71 $47,470.71 2026-03-12
D0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 3 1 — — $47,416.81 $47,416.81 $47,416.81 2026-03-12
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 58 28 — — $2,253.12 $192,851.77 $47,215.01 2026-03-12
B0405 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 3 1 — — $47,191.74 $47,191.74 $47,191.74 2026-03-12
C0106 OTHER Stroke; M > 30.05 & M < 34.25 3 1 — — $47,176.74 $47,176.74 $47,176.74 2026-03-12
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 58 28 — — $2,253.12 $168,713.00 $47,166.40 2026-03-12
B0105 OTHER Stroke; M > 34.25 & M < 38.85 3 1 — — $47,163.61 $47,163.61 $47,163.61 2026-03-12
28 MS_DRG Spinal Procedures With Mcc 58 28 — — $2,253.12 $149,162.06 $46,950.03 2026-03-12
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 1 — — $46,848.47 $46,848.47 $46,848.47 2026-03-12
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 46 25 — — $1,854.72 $102,644.25 $46,243.78 2026-03-12
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 48 27 — — $1,854.72 $147,210.73 $46,142.16 2026-03-12
B0604 OTHER Neurological; M < 25.85 3 1 — — $45,948.22 $45,948.22 $45,948.22 2026-03-12
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 58 28 — — $2,253.12 $145,693.86 $45,916.18 2026-03-12
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 63 32 — — $22,676.99 $127,462.65 $45,825.99 2026-03-12
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 56 28 — — $2,253.12 $314,996.79 $45,664.22 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
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 63 32 — — $18,507.00 $141,679.50 $45,373.95 2026-03-12
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 58 28 — — $2,253.12 $168,016.30 $45,111.68 2026-03-12
C0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 3 1 — — $45,031.06 $45,031.06 $45,031.06 2026-03-12
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 58 28 — — $2,253.12 $141,495.79 $44,882.64 2026-03-12
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 63 32 — — $22,106.43 $128,245.53 $44,736.46 2026-03-12
010 OTHER Pancreas Transplant 1 1 — — $44,609.86 $44,609.86 $44,609.86 2026-03-12
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 1 — — $44,354.46 $44,354.46 $44,354.46 2026-03-12
B1004 OTHER Amputation, Lower Extremity; M=39-45 3 1 — — $44,327.71 $44,327.71 $44,327.71 2026-03-12
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $44,316.38 $44,316.38 $44,316.38 2026-03-12
1142 OTHER Supprelin La Implant 31 21 — — $31,093.44 $63,482.45 $44,049.05 2026-03-12
B1504 OTHER Pulmonary; M < 29.15 3 1 — — $43,935.71 $43,935.71 $43,935.71 2026-03-12
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 58 28 — — $2,253.12 $138,186.48 $43,891.35 2026-03-12
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 47 27 — — $2,253.12 $139,139.80 $43,748.00 2026-03-12
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 58 28 — — $2,253.12 $137,114.00 $43,570.08 2026-03-12
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 1 — — $43,334.57 $43,334.57 $43,334.57 2026-03-12
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 58 28 — — $2,253.12 $135,616.99 $43,121.66 2026-03-12
1594 OTHER New Technology - Level 43 31 21 — — $30,425.23 $62,118.19 $43,102.42 2026-03-12
1580 OTHER New Technology - Level 43 31 21 — — $30,425.23 $62,118.19 $43,102.42 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
B0704 OTHER Fracture Of Lower Extremity; M < 28.15 3 1 — — $43,026.05 $43,026.05 $43,026.05 2026-03-12
B1304 OTHER Rheumatoid, Other Arthritis; M=12-35 3 1 — — $42,973.54 $42,973.54 $42,973.54 2026-03-12
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 58 28 — — $2,253.12 $135,810.63 $42,970.06 2026-03-12
A0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 3 1 — — $42,907.89 $42,907.89 $42,907.89 2026-03-12
834 MS_DRG Acute Leukemia With Mcc 58 28 — — $1,854.72 $136,292.26 $42,903.31 2026-03-12
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 58 28 — — $2,253.12 $135,403.49 $42,848.69 2026-03-12
D0106 OTHER Stroke; M > 30.05 & M < 34.25 3 1 — — $42,742.84 $42,742.84 $42,742.84 2026-03-12
011 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 1 1 — — $42,596.95 $42,596.95 $42,596.95 2026-03-12
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 63 32 — — $20,956.68 $119,997.33 $42,540.91 2026-03-12
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 48 27 — — $1,854.72 $142,521.00 $42,479.13 2026-03-12
B0904 OTHER Other Orthopedic; M < 24.15 3 1 — — $42,167.03 $42,167.03 $42,167.03 2026-03-12
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 57 28 — — $2,253.12 $132,392.09 $42,155.65 2026-03-12
D0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 3 1 — — $41,893.20 $41,893.20 $41,893.20 2026-03-12
C0105 OTHER Stroke; M > 34.25 & M < 38.85 3 1 — — $41,881.94 $41,881.94 $41,881.94 2026-03-12
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 58 28 — — $2,253.12 $156,158.93 $41,865.63 2026-03-12
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 58 28 — — $2,253.12 $130,989.42 $41,735.49 2026-03-12
B2005 OTHER Miscellaneous; M=12-32 And A Tm81 3 1 — — $41,484.32 $41,484.32 $41,484.32 2026-03-12
B0504 OTHER Nontraumatic Spinal Cord Injury; M > 29.25 & M < 3 3 1 — — $41,242.37 $41,242.37 $41,242.37 2026-03-12
B1704 OTHER Major Multiple Trauma,no Brain Or Spinal Cord Inju 3 1 — — $41,174.85 $41,174.85 $41,174.85 2026-03-12
A5104 OTHER Expired, Not Orthopedic, Length Of Stay Is 16 Days 3 1 — — $41,039.80 $41,039.80 $41,039.80 2026-03-12
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 58 28 — — $2,253.12 $129,229.26 $40,975.82 2026-03-12
653 MS_DRG Major Bladder Procedures With Mcc 58 28 — — $2,253.12 $129,005.83 $40,907.11 2026-03-12
218 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $40,877.53 $40,877.53 $40,877.53 2026-03-12
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 31 21 — — $28,794.67 $58,789.12 $40,792.45 2026-03-12
573 OTHER Skin Graft For Skin Ulcer Or Cellulitis With Mcc 1 1 — — $40,729.11 $40,729.11 $40,729.11 2026-03-12
C0205 OTHER Traumatic Brain Injury; M > 28.75 & M < 40.65 3 1 — — $40,634.67 $40,634.67 $40,634.67 2026-03-12
B0304 OTHER Nontraumatic Brain Injury; M < 26.15 3 1 — — $40,578.41 $40,578.41 $40,578.41 2026-03-12
A0106 OTHER Stroke; M > 30.05 & M < 34.25 3 1 — — $40,542.77 $40,542.77 $40,542.77 2026-03-12
B1404 OTHER Cardiac; M < 31.15 3 1 — — $40,265.18 $40,265.18 $40,265.18 2026-03-12
B1204 OTHER Osteoarthritis; M=39-47 3 1 — — $40,259.56 $40,259.56 $40,259.56 2026-03-12
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 31 21 — — $28,352.45 $57,886.25 $40,165.97 2026-03-12
C2102 OTHER Burns; M=12-45 3 1 — — $40,132.02 $40,132.02 $40,132.02 2026-03-12
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 57 28 — — $2,253.12 $125,128.01 $39,979.73 2026-03-12
B0204 OTHER Traumatic Brain Injury; M > 40.65 & M < 44.25 3 1 — — $39,835.67 $39,835.67 $39,835.67 2026-03-12
B2004 OTHER Miscellaneous; M < 27.85 3 1 — — $39,633.11 $39,633.11 $39,633.11 2026-03-12
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