Hospital

TRISTAR CENTENNIAL MEDICAL CENTER

Nashville, TN · CCN 440161 · Rates published

29,716 distinct procedures filed

50 distinct payers

1,135,463 rate rows

2026-03-01 last MRF observed

Data quality

1,093,670 of 1,135,463 rate rows are consumer-grade (96.3%)

41,793 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 — reason	Rows
per-diem day rate — not a per-procedure price	24,292
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	17,083
placeholder amount (≤ $0.02) — excluded from medians	236
template filing: same amount across many unrelated codes — excluded	170
exceeds 10× this hospital's gross charge — excluded from medians	12

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://hcah-p-001-delivery.stylelabs.cloud/api/public/content/fe023408e5d149039a9e3f473be277e9
Found on page	https://www.tristarhealth.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered via	Discovered by HANK
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-04-30

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	18	$4,726.94	$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	19	$3,501,003.65	$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	22	$8,558.79	$4,903,655.40	$3,369,178.20	nat. median $22,747 outlier · 148.1×
714 OTHER	Inj Delandistrogene Mox R	22	$5,559.52	$4,891,954.20	$3,361,138.60	nat. median $13,041 outlier · 257.7×
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	22	$10,582.48	$4,781,186.76	$3,285,033.08	nat. median $17,963 outlier · 182.9×
906 OTHER	Inj Elivaldogene Autoteme	22	$7,562.70	$4,674,600.00	$3,211,800.00	nat. median $20,756 outlier · 154.7×
746 OTHER	Inj, Betibeglogene Autote	22	$9,788.91	$4,321,754.43	$2,969,368.69	nat. median $21,896 outlier · 135.6×
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	22	$2,459,531.95	$3,805,802.07	$2,627,815.71	nat. median $2,588,981 1.0× median
J3392 HCPCS	Exagamglogene Inj	16	$1,699,999.83	$4,999,999.50	$2,469,999.75	nat. median $2,448,600 1.0× median
Q2042 HCPCS	Tisagenlecleucel Adult	27	$951,600.00	$4,975,202.25	$2,444,000.00	nat. median $754,974 outlier · 3.2×
824 OTHER	Inj, Exagamglogene Autote	22	$11,462.56	$3,428,040.00	$2,355,320.00	nat. median $25,250 outlier · 93.3×
Q2053 HCPCS	Brexucabtagene	24	$598,359.73	$4,879,690.20	$1,791,133.34	nat. median $620,080 outlier · 2.9×
Q2055 HCPCS	Idecabtagene	25	$645,093.12	$4,962,756.00	$1,774,185.27	nat. median $625,184 outlier · 2.8×
Q2054 HCPCS	Lisocabtagene	22	$631,423.78	$4,770,198.00	$1,771,333.52	nat. median $674,188 outlier · 2.6×
Q2056 HCPCS	Ciltacabtagene 100 Mil	22	$676,327.75	$4,747,900.50	$1,763,053.71	nat. median $675,122 outlier · 2.6×
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×
Q2041 HCPCS	Axicabtagene Adult	22	$614,793.95	$4,693,095.00	$1,742,702.61	nat. median $634,511 outlier · 2.7×
Q2058 HCPCS	Obecabtagene Inj	28	$548,288.31	$2,996,111.00	$1,234,397.73	nat. median $324,450 outlier · 3.8×
2067 OTHER	Afamitresgene Autoleucel	22	$732,089.00	$1,132,811.40	$782,179.30	nat. median $786,032 1.0× median
9498 OTHER	Ciltacabtagene Car-pos T	22	$558,267.12	$863,844.91	$596,464.34	nat. median $587,650 1.0× median
9194 OTHER	Tisagenlecleucel Car-pos	22	$538,204.73	$832,801.01	$575,029.27	nat. median $566,531 1.0× median
9413 OTHER	Lisocabtagene Car Pos T	22	$534,091.14	$826,435.76	$570,634.21	nat. median $562,201 1.0× median
9422 OTHER	Idecabtagene Vicleucel Ca	22	$530,177.71	$820,380.25	$566,453.03	nat. median $558,082 1.0× median
9035 OTHER	Axicabtagene Ciloleucel C	22	$505,582.59	$782,322.53	$540,175.08	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	22	$464,977.69	$719,491.79	$496,791.95	nat. median $489,450 1.0× median
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	28	$1,854.72	$1,072,056.19	$325,101.74	nat. median $370,174 0.9× median
831 OTHER	Obecbtge Autol Up To 400	22	$3,236.80	$409,027.50	$281,032.50	nat. median $12,362 outlier · 22.7×
897 OTHER	Revakinagene, Per Implant	22	$251,750.00	$389,550.00	$268,975.00	nat. median $9,577 outlier · 28.1×
30233X4 OTHER	Transfusion Of Allogeneic Unspecified Cord Blood Stem Cells Into Peripheral Vein…	1	$202,345.00	$296,860.00	$249,602.50	nat. median $301,078 0.8× median
30260X1 OTHER	Transfusion Of Nonautologous Cord Blood Stem Cells Into Central Artery, Open App…	1	$202,345.00	$296,860.00	$249,602.50	nat. median $275,325 0.9× median
30263X1 OTHER	Transfusion Of Nonautologous Cord Blood Stem Cells Into Central Artery, Percutan…	1	$202,345.00	$296,860.00	$249,602.50	nat. median $275,325 0.9× median
30230X4 OTHER	Transfusion Of Allogeneic Unspecified Cord Blood Stem Cells Into Peripheral Vein…	1	$202,345.00	$296,860.00	$249,602.50	nat. median $301,078 0.8× median
30243X4 OTHER	Transfusion Of Allogeneic Unspecified Cord Blood Stem Cells Into Central Vein, P…	1	$202,345.00	$296,860.00	$249,602.50	nat. median $301,078 0.8× median
30250X1 OTHER	Transfusion Of Nonautologous Cord Blood Stem Cells Into Peripheral Artery, Open…	1	$202,345.00	$296,860.00	$249,602.50	nat. median $275,325 0.9× median
30240X4 OTHER	Transfusion Of Allogeneic Unspecified Cord Blood Stem Cells Into Central Vein, O…	1	$202,345.00	$296,860.00	$249,602.50	nat. median $301,078 0.8× median
30253X1 OTHER	Transfusion Of Nonautologous Cord Blood Stem Cells Into Peripheral Artery, Percu…	1	$202,345.00	$296,860.00	$249,602.50	nat. median $275,325 0.9× median
30240Y3 OTHER	Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Central Vein,…	7	$21,700.00	$372,381.00	$236,900.00	nat. median $255,150 0.9× median
30230Y3 OTHER	Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Peripheral Vei…	7	$21,700.00	$372,381.00	$236,900.00	nat. median $255,150 0.9× median
30233U3 OTHER	Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int…	7	$21,700.00	$372,381.00	$236,900.00	nat. median $247,431 1.0× median
30240U3 OTHER	Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int…	7	$21,700.00	$372,381.00	$236,900.00	nat. median $247,431 1.0× median
30230U3 OTHER	Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int…	7	$21,700.00	$372,381.00	$236,900.00	nat. median $250,002 0.9× median
30243X3 OTHER	Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Central Vein, Per…	7	$21,700.00	$372,381.00	$236,900.00	nat. median $270,000 0.9× median
30243Y3 OTHER	Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Central Vein,…	7	$21,700.00	$372,381.00	$236,900.00	nat. median $252,547 0.9× median

Other procedures at this hospital

Browse this hospital's 29,716 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

J1414	HCPCS	Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose	1	1	—	—	$4,200,000.00	$4,200,000.00	$4,200,000.00	2026-03-01
J1411	HCPCS	Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose	1	1	—	—	$4,200,000.00	$4,200,000.00	$4,200,000.00	2026-03-01
J1413	HCPCS	Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose	1	1	—	—	$3,840,000.00	$3,840,000.00	$3,840,000.00	2026-03-01
J3394	HCPCS	Injection, Lovotibeglogene Autotemcel, Per Treatment	1	1	—	—	$3,720,000.00	$3,720,000.00	$3,720,000.00	2026-03-01
9138	OTHER	Inj, Hemgenix, Per Tx Dos	29	19	—	—	$3,501,003.65	$4,238,057.05	$3,722,119.67	2026-03-01
J3393	HCPCS	Injection, Betibeglogene Autotemcel, Per Treatment	1	1	—	—	$3,360,000.00	$3,360,000.00	$3,360,000.00	2026-03-01
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	2026-03-01
9141	OTHER	Inj Onase Abepar-xioi Tre	32	22	—	—	$2,459,531.95	$3,805,802.07	$2,627,815.71	2026-03-01
J3392	HCPCS	Exagamglogene Inj	22	16	—	—	$1,699,999.83	$4,999,999.50	$2,469,999.75	2026-03-01
Q2042	HCPCS	Tisagenlecleucel Adult	62	27	—	—	$951,600.00	$4,975,202.25	$2,444,000.00	2026-03-01
Q2057	HCPCS	Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure…	6	3	—	—	$872,400.00	$2,042,143.00	$1,749,707.25	2026-03-01
2067	OTHER	Afamitresgene Autoleucel	32	22	—	—	$732,089.00	$1,132,811.40	$782,179.30	2026-03-01
Q2056	HCPCS	Ciltacabtagene 100 Mil	30	22	—	—	$676,327.75	$4,747,900.50	$1,763,053.71	2026-03-01
Q2055	HCPCS	Idecabtagene	37	25	—	—	$645,093.12	$4,962,756.00	$1,774,185.27	2026-03-01
Q2054	HCPCS	Lisocabtagene	30	22	—	—	$631,423.78	$4,770,198.00	$1,771,333.52	2026-03-01
Q2041	HCPCS	Axicabtagene Adult	30	22	—	—	$614,793.95	$4,693,095.00	$1,742,702.61	2026-03-01
Q2053	HCPCS	Brexucabtagene	33	24	—	—	$598,359.73	$4,879,690.20	$1,791,133.34	2026-03-01
9498	OTHER	Ciltacabtagene Car-pos T	32	22	—	—	$558,267.12	$863,844.91	$596,464.34	2026-03-01
Q2058	HCPCS	Obecabtagene Inj	43	28	$2,996,111.00	$2,996,111.00	$548,288.31	$2,996,111.00	$1,234,397.73	2026-03-01
9194	OTHER	Tisagenlecleucel Car-pos	32	22	—	—	$538,204.73	$832,801.01	$575,029.27	2026-03-01
J3402	HCPCS	Injection, Remestemcel-l-rknd, Per Therapeutic Dose	3	1	—	—	$534,422.90	$534,422.90	$534,422.90	2026-03-01
9413	OTHER	Lisocabtagene Car Pos T	32	22	—	—	$534,091.14	$826,435.76	$570,634.21	2026-03-01
9422	OTHER	Idecabtagene Vicleucel Ca	32	22	—	—	$530,177.71	$820,380.25	$566,453.03	2026-03-01
9035	OTHER	Axicabtagene Ciloleucel C	32	22	—	—	$505,582.59	$782,322.53	$540,175.08	2026-03-01
9391	OTHER	Brexucabtagene Car Pos T	32	22	—	—	$464,977.69	$719,491.79	$496,791.95	2026-03-01
897	OTHER	Revakinagene, Per Implant	32	22	—	—	$251,750.00	$389,550.00	$268,975.00	2026-03-01
30230X4	OTHER	Transfusion Of Allogeneic Unspecified Cord Blood Stem Cells Into Peripheral Vein…	2	1	—	—	$202,345.00	$296,860.00	$249,602.50	2026-03-01
30250X1	OTHER	Transfusion Of Nonautologous Cord Blood Stem Cells Into Peripheral Artery, Open …	2	1	—	—	$202,345.00	$296,860.00	$249,602.50	2026-03-01
30253X1	OTHER	Transfusion Of Nonautologous Cord Blood Stem Cells Into Peripheral Artery, Percu…	2	1	—	—	$202,345.00	$296,860.00	$249,602.50	2026-03-01
30243X4	OTHER	Transfusion Of Allogeneic Unspecified Cord Blood Stem Cells Into Central Vein, P…	2	1	—	—	$202,345.00	$296,860.00	$249,602.50	2026-03-01
30260X1	OTHER	Transfusion Of Nonautologous Cord Blood Stem Cells Into Central Artery, Open App…	2	1	—	—	$202,345.00	$296,860.00	$249,602.50	2026-03-01
30233X4	OTHER	Transfusion Of Allogeneic Unspecified Cord Blood Stem Cells Into Peripheral Vein…	2	1	—	—	$202,345.00	$296,860.00	$249,602.50	2026-03-01
30240X4	OTHER	Transfusion Of Allogeneic Unspecified Cord Blood Stem Cells Into Central Vein, O…	2	1	—	—	$202,345.00	$296,860.00	$249,602.50	2026-03-01
30263X1	OTHER	Transfusion Of Nonautologous Cord Blood Stem Cells Into Central Artery, Percutan…	2	1	—	—	$202,345.00	$296,860.00	$249,602.50	2026-03-01
018	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	1	1	—	—	$190,848.68	$190,848.68	$190,848.68	2026-03-01
001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	1	1	—	—	$167,759.05	$167,759.05	$167,759.05	2026-03-01
1907	OTHER	New Technology - Level 52	32	22	—	—	$136,043.89	$210,510.03	$145,352.16	2026-03-01
1908	OTHER	New Technology - Level 52	32	22	—	—	$136,043.89	$210,510.03	$145,352.16	2026-03-01
A9699	HCPCS	Radiopharmaceutical, Therapeutic, Not Otherwise Classified	3	1	—	—	$123,742.09	$123,742.09	$123,742.09	2026-03-01
1906	OTHER	New Technology - Level 51	32	22	—	—	$122,662.57	$189,804.20	$131,055.27	2026-03-01
1905	OTHER	New Technology - Level 51	32	22	—	—	$122,662.57	$189,804.20	$131,055.27	2026-03-01
003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	1	1	—	—	$118,239.96	$118,239.96	$118,239.96	2026-03-01
1904	OTHER	New Technology - Level 50	32	22	—	—	$109,281.25	$169,098.36	$116,758.39	2026-03-01
1903	OTHER	New Technology - Level 50	32	22	—	—	$109,281.25	$169,098.36	$116,758.39	2026-03-01
Q0480	HCPCS	Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only	32	22	—	—	$105,927.85	$163,909.41	$113,175.54	2026-03-01
0815	RC	—	1	1	—	—	$104,905.00	$104,905.00	$104,905.00	2026-03-01
1902	OTHER	New Technology - Level 49	32	22	—	—	$95,899.93	$148,392.53	$102,461.51	2026-03-01
1901	OTHER	New Technology - Level 49	32	22	—	—	$95,899.93	$148,392.53	$102,461.51	2026-03-01
004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	1	1	—	—	$92,336.06	$92,336.06	$92,336.06	2026-03-01
K1007	HCPCS	Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin…	32	22	—	—	$90,326.95	$139,769.07	$96,507.21	2026-03-01
1585	OTHER	New Technology - Level 48	32	22	—	—	$84,748.81	$131,137.63	$90,547.41	2026-03-01
1599	OTHER	New Technology - Level 48	32	22	—	—	$84,748.81	$131,137.63	$90,547.41	2026-03-01
30230X2	OTHER	Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Peripheral Vein, Op…	28	7	—	—	$83,298.00	$372,160.00	$208,972.50	2026-03-01
30240X2	OTHER	Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Central Vein, Open …	28	7	—	—	$83,298.00	$372,160.00	$208,972.50	2026-03-01
30243X2	OTHER	Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Central Vein, Percu…	28	7	—	—	$83,298.00	$372,160.00	$208,972.50	2026-03-01
30233X2	OTHER	Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Peripheral Vein, Pe…	28	7	—	—	$83,298.00	$372,160.00	$208,972.50	2026-03-01
30233Y2	OTHER	Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Peripheral Vein,…	26	7	—	—	$83,298.00	$372,160.00	$206,976.00	2026-03-01
30240G2	OTHER	Transfusion Of Allogeneic Related Bone Marrow Into Central Vein, Open Approach	26	7	—	—	$83,298.00	$372,160.00	$206,976.00	2026-03-01
30243U2	OTHER	Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into …	26	7	—	—	$83,298.00	$372,160.00	$206,976.00	2026-03-01
30233U2	OTHER	Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into …	26	7	—	—	$83,298.00	$372,160.00	$206,976.00	2026-03-01
30243G2	OTHER	Transfusion Of Allogeneic Related Bone Marrow Into Central Vein, Percutaneous Ap…	26	7	—	—	$83,298.00	$372,160.00	$206,976.00	2026-03-01
30240Y2	OTHER	Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Central Vein, Op…	26	7	—	—	$83,298.00	$372,160.00	$206,976.00	2026-03-01
30243Y2	OTHER	Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Central Vein, Pe…	26	7	—	—	$83,298.00	$372,160.00	$206,976.00	2026-03-01
30230Y2	OTHER	Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Peripheral Vein,…	26	7	—	—	$83,298.00	$372,160.00	$206,976.00	2026-03-01
30233G2	OTHER	Transfusion Of Allogeneic Related Bone Marrow Into Peripheral Vein, Percutaneous…	26	7	—	—	$83,298.00	$372,160.00	$206,976.00	2026-03-01
30240U2	OTHER	Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into …	26	7	—	—	$83,298.00	$372,160.00	$206,976.00	2026-03-01
30230G2	OTHER	Transfusion Of Allogeneic Related Bone Marrow Into Peripheral Vein, Open Approac…	26	7	—	—	$83,298.00	$372,160.00	$206,976.00	2026-03-01
30230U2	OTHER	Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into …	26	7	—	—	$83,298.00	$372,160.00	$206,976.00	2026-03-01
651	OTHER	Kidney Transplant With Hemodialysis Without Mcc	1	1	—	—	$82,752.18	$82,752.18	$82,752.18	2026-03-01
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	2026-03-01
J9029	HCPCS	Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose	6	3	—	—	$77,314.48	$170,328.19	$132,540.10	2026-03-01
J7330	HCPCS	Autologous Cultured Chondrocytes, Implant	5	2	—	—	$76,729.09	$221,874.56	$221,874.56	2026-03-01
1598	OTHER	New Technology - Level 47	32	22	—	—	$75,827.93	$117,333.74	$81,016.15	2026-03-01
1584	OTHER	New Technology - Level 47	32	22	—	—	$75,827.93	$117,333.74	$81,016.15	2026-03-01
007	OTHER	Lung Transplant	1	1	—	—	$70,966.58	$70,966.58	$70,966.58	2026-03-01
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	2026-03-01
1583	OTHER	New Technology - Level 46	32	22	—	—	$66,907.05	$103,529.85	$71,484.89	2026-03-01
1597	OTHER	New Technology - Level 46	32	22	—	—	$66,907.05	$103,529.85	$71,484.89	2026-03-01
C9150	HCPCS	Xenon Xe-129 Hyperpolarized Gas, Diagnostic, Per Study Dose	2	1	—	—	$65,769.60	$74,786.40	$70,278.00	2026-03-01
L8702	HCPCS	Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge…	32	22	—	—	$65,361.61	$101,138.50	$69,833.73	2026-03-01
002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	1	1	—	—	$62,897.34	$62,897.34	$62,897.34	2026-03-01
014	OTHER	Allogeneic Bone Marrow Transplant	1	1	—	—	$60,576.62	$60,576.62	$60,576.62	2026-03-01
005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	1	1	—	—	$59,938.56	$59,938.56	$59,938.56	2026-03-01
1582	OTHER	New Technology - Level 45	32	22	—	—	$57,986.17	$89,725.96	$61,953.64	2026-03-01
1596	OTHER	New Technology - Level 45	32	22	—	—	$57,986.17	$89,725.96	$61,953.64	2026-03-01
475415	CDM	Kit Hrt Implant Lvas	32	24	$384,517.00	$384,517.00	$57,677.55	$384,517.00	$201,871.42	2026-03-01
5244	OTHER	Level 4 Blood Product Exc	32	22	—	—	$57,328.72	$88,708.65	$61,251.21	2026-03-01
423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	1	1	—	—	$56,172.71	$56,172.71	$56,172.71	2026-03-01
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	54	27	—	—	$54,978.71	$244,076.82	$84,964.18	2026-03-01
J9226	HCPCS	Histrelin Implant (supprelin La), 50 Mg	6	3	—	—	$54,756.23	$114,441.15	$88,352.14	2026-03-01
1643	OTHER	Y90 Ibritumomab, Rx	32	22	—	—	$53,983.32	$83,532.09	$57,676.92	2026-03-01
90288	CPT	Botulism Ig Human IV	33	23	$353,368.14	$353,368.14	$53,005.22	$353,368.14	$176,684.07	2026-03-01
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	54	27	—	—	$44,943.94	$194,335.98	$69,745.04	2026-03-01
J9999	HCPCS	Carmustine 7.7mg Implant	37	28	$249,749.05	$249,749.05	$37,462.36	$249,749.05	$124,874.52	2026-03-01
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	54	27	—	—	$36,009.63	$165,492.91	$56,194.88	2026-03-01
108763	CDM	Rv Fpvt Stn/ath Cl In	38	26	$239,197.92	$239,197.92	$35,879.69	$239,197.92	$118,402.97	2026-03-01
108727	CDM	Rv Fpvt Stn/ath Cl In	38	26	$239,197.92	$239,197.92	$35,879.69	$239,197.92	$118,402.97	2026-03-01
108725	CDM	Rv Fpvt Stn/ath Sfl In	38	26	$239,197.92	$239,197.92	$35,879.69	$239,197.92	$118,402.97	2026-03-01
108761	CDM	Rv Fpvt Stn/ath Sfl In	38	26	$239,197.92	$239,197.92	$35,879.69	$239,197.92	$118,402.97	2026-03-01
105921	CDM	Revsc Tib/per Ivl St/ath	38	26	$239,197.51	$239,197.51	$35,879.63	$239,197.51	$118,402.77	2026-03-01
108739	CDM	Rvs Tpvt St/ath Cl In	38	26	$223,904.57	$223,904.57	$33,585.69	$223,904.57	$110,832.76	2026-03-01
108775	CDM	Rvs Tpvt St/ath Cl In	38	26	$223,904.57	$223,904.57	$33,585.69	$223,904.57	$110,832.76	2026-03-01
432390	CDM	System Valve Mitral 29mm	32	24	$215,320.00	$215,320.00	$32,298.00	$215,320.00	$113,043.00	2026-03-01
106020	CDM	Donr Stem Cell Acq	44	30	$178,880.42	$178,880.42	$26,832.06	$178,880.42	$77,097.46	2026-03-01
432389	CDM	Valve Mitral 29mm	32	24	$177,144.00	$177,144.00	$26,571.60	$177,144.00	$93,000.60	2026-03-01
502299	CDM	Kit Cath Rt Heart	44	30	$168,649.50	$168,649.50	$25,297.42	$168,649.50	$72,687.93	2026-03-01
490915	CDM	Pump Heart 21fr 85mm	44	30	$168,649.50	$168,649.50	$25,297.42	$168,649.50	$72,687.93	2026-03-01
J9266	HCPCS	Pegasparga Single Vl Inj	31	21	$135,957.01	$135,957.01	$25,029.69	$135,957.01	$75,323.76	2026-03-01
377515	CDM	Valve Tricuspid 52mm	32	24	$165,335.00	$165,335.00	$24,800.25	$165,335.00	$86,800.88	2026-03-01
373584	CDM	Valve Aor Tavr 48mm	32	24	$165,335.00	$165,335.00	$24,800.25	$165,335.00	$86,800.88	2026-03-01
377516	CDM	Valve Aor 56mm	32	24	$165,335.00	$165,335.00	$24,800.25	$165,335.00	$86,800.88	2026-03-01
373583	CDM	Valve Aor Tavr 52mm	32	24	$165,335.00	$165,335.00	$24,800.25	$165,335.00	$86,800.88	2026-03-01
377514	CDM	Valve Tricuspid 48mm	32	24	$165,335.00	$165,335.00	$24,800.25	$165,335.00	$86,800.88	2026-03-01
377513	CDM	Valve Tricuspid 44mm	32	24	$165,335.00	$165,335.00	$24,800.25	$165,335.00	$86,800.88	2026-03-01
373582	CDM	Valve Aor Tavr 44mm	32	24	$165,335.00	$165,335.00	$24,800.25	$165,335.00	$86,800.88	2026-03-01
105307	CDM	Imp Wrls P-art Pres Snsr	38	26	$163,305.80	$163,305.80	$24,495.87	$163,305.80	$80,836.37	2026-03-01
108769	CDM	Rvsc Tpvt Stnt Sfl In	38	26	$160,434.10	$160,434.10	$24,065.12	$160,434.10	$79,414.88	2026-03-01
105920	CDM	Revsc Tib/per Ivl/ath	38	26	$160,434.10	$160,434.10	$24,065.12	$160,434.10	$79,414.88	2026-03-01
108733	CDM	Rvsc Tpvt Stnt Sfl In	38	26	$160,434.10	$160,434.10	$24,065.12	$160,434.10	$79,414.88	2026-03-01
108755	CDM	Rvsc Fpvt Stn Cl In	38	26	$160,434.10	$160,434.10	$24,065.12	$160,434.10	$79,414.88	2026-03-01
105919	CDM	Revsc Tib/per Ivl/stnt	38	26	$160,434.10	$160,434.10	$24,065.12	$160,434.10	$79,414.88	2026-03-01
108753	CDM	Rvsc Fpvt Stnt Sfl In	38	26	$160,434.10	$160,434.10	$24,065.12	$160,434.10	$79,414.88	2026-03-01
108717	CDM	Rvsc Fpvt Stnt Sfl In	38	26	$160,434.10	$160,434.10	$24,065.12	$160,434.10	$79,414.88	2026-03-01
108719	CDM	Rvsc Fpvt Stn Cl In	38	26	$160,434.10	$160,434.10	$24,065.12	$160,434.10	$79,414.88	2026-03-01
336224	CDM	Evas Rpr Ilioiliac Norup	38	26	$159,900.81	$159,900.81	$23,985.12	$159,900.81	$79,150.90	2026-03-01
108721	CDM	Rvsc Fpvt Ath Sfl In	38	26	$153,973.81	$153,973.81	$23,096.07	$153,973.81	$76,217.04	2026-03-01
108737	CDM	Rvsc Tpvt Ath Cl In	38	26	$153,973.81	$153,973.81	$23,096.07	$153,973.81	$76,217.04	2026-03-01
108773	CDM	Rvsc Tpvt Ath Cl In	38	26	$153,973.81	$153,973.81	$23,096.07	$153,973.81	$76,217.04	2026-03-01
108757	CDM	Rvsc Fpvt Ath Sfl In	38	26	$153,973.81	$153,973.81	$23,096.07	$153,973.81	$76,217.04	2026-03-01
108735	CDM	Rvsc Tpvt Ath Sfl In	38	26	$153,973.81	$153,973.81	$23,096.07	$153,973.81	$76,217.04	2026-03-01
108771	CDM	Rvsc Tpvt Ath Sfl In	38	26	$153,973.81	$153,973.81	$23,096.07	$153,973.81	$76,217.04	2026-03-01
108759	CDM	Rvsc Fpvt Ath Cl In	38	26	$153,973.81	$153,973.81	$23,096.07	$153,973.81	$76,217.04	2026-03-01
108723	CDM	Rvsc Fpvt Ath Cl In	38	26	$153,973.81	$153,973.81	$23,096.07	$153,973.81	$76,217.04	2026-03-01
502573	CDM	Valve Tavr 20mm	32	24	$150,586.00	$150,586.00	$22,587.90	$150,586.00	$79,057.65	2026-03-01
500090	CDM	System Dlv 1 Cath 1 Clip	44	30	$148,364.00	$148,364.00	$22,254.60	$148,364.00	$63,944.89	2026-03-01
406136	CDM	System Dlv Cath 1 Clip	44	30	$148,364.00	$148,364.00	$22,254.60	$148,364.00	$63,944.89	2026-03-01
30230Y3	OTHER	Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Peripheral Vei…	27	7	—	—	$21,700.00	$372,381.00	$236,900.00	2026-03-01
30243X3	OTHER	Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Central Vein, Per…	29	7	—	—	$21,700.00	$372,381.00	$236,900.00	2026-03-01
30240U3	OTHER	Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int…	27	7	—	—	$21,700.00	$372,381.00	$236,900.00	2026-03-01
30233Y3	OTHER	Transfusion Of Allogeneic Unrelated Hamatopoietic Stem Cells Into Peripheral Vei…	27	7	—	—	$21,700.00	$372,381.00	$236,900.00	2026-03-01
30240G3	OTHER	Transfusion Of Allogeneic Unrelated Bone Marrow Into Central Vein, Open Approach…	27	7	—	—	$21,700.00	$372,381.00	$236,900.00	2026-03-01
30240Y3	OTHER	Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Central Vein, …	27	7	—	—	$21,700.00	$372,381.00	$236,900.00	2026-03-01
30240X3	OTHER	Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Central Vein, Ope…	29	7	—	—	$21,700.00	$372,381.00	$236,900.00	2026-03-01
30233X3	OTHER	Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Peripheral Vein, …	29	7	—	—	$21,700.00	$372,381.00	$236,900.00	2026-03-01
30243Y3	OTHER	Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Central Vein, …	27	7	—	—	$21,700.00	$372,381.00	$236,900.00	2026-03-01
30243U3	OTHER	Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int…	27	7	—	—	$21,700.00	$372,381.00	$236,900.00	2026-03-01
30233G3	OTHER	Transfusion Of Allogeneic Unrelated Bone Marrow Into Peripheral Vein, Percutaneo…	27	7	—	—	$21,700.00	$372,381.00	$236,900.00	2026-03-01
30233U3	OTHER	Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int…	27	7	—	—	$21,700.00	$372,381.00	$236,900.00	2026-03-01
30230X3	OTHER	Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Peripheral Vein, …	29	7	—	—	$21,700.00	$372,381.00	$236,900.00	2026-03-01
30230G3	OTHER	Transfusion Of Allogeneic Unrelated Bone Marrow Into Peripheral Vein, Open Appro…	27	7	—	—	$21,700.00	$372,381.00	$236,900.00	2026-03-01
30243G3	OTHER	Transfusion Of Allogeneic Unrelated Bone Marrow Into Central Vein, Percutaneous …	27	7	—	—	$21,700.00	$372,381.00	$236,900.00	2026-03-01
30230U3	OTHER	Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int…	27	7	—	—	$21,700.00	$372,381.00	$236,900.00	2026-03-01
30253X0	OTHER	Transfusion Of Autologous Cord Blood Stem Cells Into Peripheral Artery, Percutan…	42	6	—	—	$21,700.00	$372,381.00	$168,119.50	2026-03-01
30243X0	OTHER	Transfusion Of Autologous Cord Blood Stem Cells Into Central Vein, Percutaneous …	42	6	—	—	$21,700.00	$372,381.00	$168,119.50	2026-03-01
30263X0	OTHER	Transfusion Of Autologous Cord Blood Stem Cells Into Central Artery, Percutaneou…	42	6	—	—	$21,700.00	$372,381.00	$168,119.50	2026-03-01
30233X0	OTHER	Transfusion Of Autologous Cord Blood Stem Cells Into Peripheral Vein, Percutaneo…	42	6	—	—	$21,700.00	$372,381.00	$168,119.50	2026-03-01
30230X0	OTHER	Transfusion Of Autologous Cord Blood Stem Cells Into Peripheral Vein, Open Appro…	42	6	—	—	$21,700.00	$372,381.00	$168,119.50	2026-03-01
30250X0	OTHER	Transfusion Of Autologous Cord Blood Stem Cells Into Peripheral Artery, Open App…	42	6	—	—	$21,700.00	$372,381.00	$168,119.50	2026-03-01
30240X0	OTHER	Transfusion Of Autologous Cord Blood Stem Cells Into Central Vein, Open Approach…	42	6	—	—	$21,700.00	$372,381.00	$168,119.50	2026-03-01
30260X0	OTHER	Transfusion Of Autologous Cord Blood Stem Cells Into Central Artery, Open Approa…	42	6	—	—	$21,700.00	$372,381.00	$168,119.50	2026-03-01
30253Y0	OTHER	Transfusion Of Autologous Hematopoietic Stem Cells Into Peripheral Artery, Percu…	40	6	—	—	$21,700.00	$372,381.00	$162,869.50	2026-03-01
30230Y0	OTHER	Transfusion Of Autologous Hematopoietic Stem Cells Into Peripheral Vein, Open Ap…	40	6	—	—	$21,700.00	$372,381.00	$162,869.50	2026-03-01
30250Y0	OTHER	Transfusion Of Autologous Hematopoietic Stem Cells Into Peripheral Artery, Open …	40	6	—	—	$21,700.00	$372,381.00	$162,869.50	2026-03-01
30250G0	OTHER	Transfusion Of Autologous Bone Marrow Into Peripheral Artery, Open Approach	40	6	—	—	$21,700.00	$372,381.00	$162,869.50	2026-03-01
30240Y0	OTHER	Transfusion Of Autologous Hematopoietic Stem Cells Into Central Vein, Open Appro…	40	6	—	—	$21,700.00	$372,381.00	$162,869.50	2026-03-01
30233C0	OTHER	Transfusion Of Autologous Hematopoietic Stem/Progenitor Cells, Genetically Modif…	40	6	—	—	$21,700.00	$372,381.00	$162,869.50	2026-03-01
30263Y0	OTHER	Transfusion Of Autologous Hematopoietic Stem Cells Into Central Artery, Percutan…	40	6	—	—	$21,700.00	$372,381.00	$162,869.50	2026-03-01
30253G0	OTHER	Transfusion Of Autologous Bone Marrow Into Peripheral Artery, Percutaneous Appro…	40	6	—	—	$21,700.00	$372,381.00	$162,869.50	2026-03-01
30233G0	OTHER	Transfusion Of Autologous Bone Marrow Into Peripheral Vein, Percutaneous Approac…	40	6	—	—	$21,700.00	$372,381.00	$162,869.50	2026-03-01
30260G0	OTHER	Transfusion Of Autologous Bone Marrow Into Central Artery, Open Approach	40	6	—	—	$21,700.00	$372,381.00	$162,869.50	2026-03-01
30243C0	OTHER	Transfusion Of Autologous Hematopoietic Stem/Progenitor Cells, Genetically Modif…	40	6	—	—	$21,700.00	$372,381.00	$162,869.50	2026-03-01
30240G0	OTHER	Transfusion Of Autologous Bone Marrow Into Central Vein, Open Approach	40	6	—	—	$21,700.00	$372,381.00	$162,869.50	2026-03-01
30263G0	OTHER	Transfusion Of Autologous Bone Marrow Into Central Artery, Percutaneous Approach…	40	6	—	—	$21,700.00	$372,381.00	$162,869.50	2026-03-01
30230G0	OTHER	Transfusion Of Autologous Bone Marrow Into Peripheral Vein, Open Approach	40	6	—	—	$21,700.00	$372,381.00	$162,869.50	2026-03-01
30243Y0	OTHER	Transfusion Of Autologous Hematopoietic Stem Cells Into Central Vein, Percutaneo…	40	6	—	—	$21,700.00	$372,381.00	$162,869.50	2026-03-01
30240C0	OTHER	Transfusion Of Autologous Hematopoietic Stem/Progenitor Cells, Genetically Modif…	40	6	—	—	$21,700.00	$372,381.00	$162,869.50	2026-03-01
30233Y0	OTHER	Transfusion Of Autologous Hematopoietic Stem Cells Into Peripheral Vein, Percuta…	40	6	—	—	$21,700.00	$372,381.00	$162,869.50	2026-03-01
30230C0	OTHER	Transfusion Of Autologous Hematopoietic Stem/Progenitor Cells, Genetically Modif…	40	6	—	—	$21,700.00	$372,381.00	$162,869.50	2026-03-01
30243G0	OTHER	Transfusion Of Autologous Bone Marrow Into Central Vein, Percutaneous Approach	40	6	—	—	$21,700.00	$372,381.00	$162,869.50	2026-03-01
30260Y0	OTHER	Transfusion Of Autologous Hematopoietic Stem Cells Into Central Artery, Open App…	40	6	—	—	$21,700.00	$372,381.00	$162,869.50	2026-03-01
480791	CDM	Valve Heart Trnscth 26mm	32	24	$143,943.00	$143,943.00	$21,591.45	$143,943.00	$75,570.07	2026-03-01
481744	CDM	Valve Aor With Intro 23mm	32	24	$143,943.00	$143,943.00	$21,591.45	$143,943.00	$75,570.07	2026-03-01
480309	CDM	Kit Vlv Aor 18fr 26mm	32	24	$143,943.00	$143,943.00	$21,591.45	$143,943.00	$75,570.07	2026-03-01
494885	CDM	Valve Heart Trnscth 20mm	32	24	$143,943.00	$143,943.00	$21,591.45	$143,943.00	$75,570.07	2026-03-01
480789	CDM	Valve Heart Trnscth 23mm	32	24	$143,943.00	$143,943.00	$21,591.45	$143,943.00	$75,570.07	2026-03-01
481733	CDM	Valve Aor With Intro 27mm	32	24	$143,943.00	$143,943.00	$21,591.45	$143,943.00	$75,570.07	2026-03-01
457289	CDM	Set Pump 21fr 5.0	44	30	$143,248.00	$143,248.00	$21,487.20	$143,248.00	$61,739.89	2026-03-01
367513	CDM	Stent Eprsth 8x40mm 15cm	32	24	$141,728.00	$141,728.00	$21,259.20	$141,728.00	$74,407.20	2026-03-01
407179	CDM	Stent Eprsth 28x8mm 20cm	32	24	$141,728.00	$141,728.00	$21,259.20	$141,728.00	$74,407.20	2026-03-01
365278	CDM	Stent Eprsth 8x40mm 15cm	32	24	$141,728.00	$141,728.00	$21,259.20	$141,728.00	$74,407.20	2026-03-01
335039	CDM	Dialysis Circ Thrmb/stnt	38	26	$135,783.37	$135,783.37	$20,367.51	$135,783.37	$67,212.76	2026-03-01
335038	CDM	Dialysis Circ Thrmb/bln	38	26	$135,783.37	$135,783.37	$20,367.51	$135,783.37	$67,212.76	2026-03-01
105862	CDM	Tmvi Trnsthor Aprch	38	26	$134,510.58	$134,510.58	$20,176.59	$134,510.58	$66,582.73	2026-03-01
481779	CDM	Valve Mitral 36.5x49.5mm	32	24	$132,870.00	$132,870.00	$19,930.50	$132,870.00	$69,756.75	2026-03-01
481754	CDM	Valve Triclip 1sgc 2cds	32	24	$132,870.00	$132,870.00	$19,930.50	$132,870.00	$69,756.75	2026-03-01
481756	CDM	Valve Bndl 4cds	32	24	$132,870.00	$132,870.00	$19,930.50	$132,870.00	$69,756.75	2026-03-01
481753	CDM	Valve Bndl 1cds	32	24	$132,870.00	$132,870.00	$19,930.50	$132,870.00	$69,756.75	2026-03-01
481755	CDM	Valve Bndl 3cds	32	24	$132,870.00	$132,870.00	$19,930.50	$132,870.00	$69,756.75	2026-03-01
502371	CDM	Valve Tavr 29mm	32	24	$130,730.00	$130,730.00	$19,609.50	$130,730.00	$68,633.25	2026-03-01
502574	CDM	Valve Tavr 23mm	32	24	$130,730.00	$130,730.00	$19,609.50	$130,730.00	$68,633.25	2026-03-01
502576	CDM	Valve Tavr 29mm	32	24	$130,730.00	$130,730.00	$19,609.50	$130,730.00	$68,633.25	2026-03-01
502575	CDM	Valve Tavr 26mm	32	24	$130,730.00	$130,730.00	$19,609.50	$130,730.00	$68,633.25	2026-03-01
457507	CDM	Kit Vlv Aor 18fr 29mm	32	24	$124,963.00	$124,963.00	$18,744.45	$124,963.00	$65,605.57	2026-03-01
488746	CDM	Kit Aor Vlv 14fr 29mm	32	24	$124,963.00	$124,963.00	$18,744.45	$124,963.00	$65,605.57	2026-03-01
488096	CDM	Kit Aor Vlv 14fr 20mm	32	24	$124,963.00	$124,963.00	$18,744.45	$124,963.00	$65,605.57	2026-03-01
488744	CDM	Kit Aor Vlv 14fr 23mm	32	24	$124,963.00	$124,963.00	$18,744.45	$124,963.00	$65,605.57	2026-03-01
481732	CDM	Valve Aor With Intro 25mm	32	24	$124,963.00	$124,963.00	$18,744.45	$124,963.00	$65,605.57	2026-03-01
488745	CDM	Kit Aor Vlv 14fr 26mm	32	24	$124,963.00	$124,963.00	$18,744.45	$124,963.00	$65,605.57	2026-03-01
501285	CDM	Sys Valve Aor 26mm	32	24	$124,963.00	$124,963.00	$18,744.45	$124,963.00	$65,605.57	2026-03-01
199416	CDM	Valve Tavr 23mm	32	24	$124,963.00	$124,963.00	$18,744.45	$124,963.00	$65,605.57	2026-03-01
332183	CDM	Transcth Stnt Plc In Vn	38	26	$124,503.06	$124,503.06	$18,675.46	$124,503.06	$61,629.01	2026-03-01
332179	CDM	Transcth Stnt Plc Ia	38	26	$124,503.06	$124,503.06	$18,675.46	$124,503.06	$61,629.01	2026-03-01
332283	CDM	Transcth Stnt Plc In Vn	38	26	$124,503.06	$124,503.06	$18,675.46	$124,503.06	$61,629.01	2026-03-01
473988	CDM	Valve Aor Tavr 27mm	32	24	$124,012.00	$124,012.00	$18,601.80	$124,012.00	$65,106.30	2026-03-01
473909	CDM	Valve Aor Tavr 23mm	32	24	$124,012.00	$124,012.00	$18,601.80	$124,012.00	$65,106.30	2026-03-01
473908	CDM	Valve Aor Tavr 25mm	32	24	$124,012.00	$124,012.00	$18,601.80	$124,012.00	$65,106.30	2026-03-01
209	MS_DRG	Complex Aortic Arch Procedures	54	27	—	—	$18,507.00	$281,000.53	$87,215.74	2026-03-01
432099	CDM	Stent Eprsth 15cm 8mm	32	24	$123,040.00	$123,040.00	$18,456.00	$123,040.00	$64,596.00	2026-03-01
430406	CDM	Stent Eprsth 24f 34mm	32	24	$123,040.00	$123,040.00	$18,456.00	$123,040.00	$64,596.00	2026-03-01
373521	CDM	Stent Eprsth 15cm 40mm	32	24	$123,040.00	$123,040.00	$18,456.00	$123,040.00	$64,596.00	2026-03-01
366333	CDM	System Trcsd 1clip 1cath	32	24	$123,040.00	$123,040.00	$18,456.00	$123,040.00	$64,596.00	2026-03-01
406086	CDM	Stent Eprsth 12x37mm	32	24	$123,040.00	$123,040.00	$18,456.00	$123,040.00	$64,596.00	2026-03-01
430930	CDM	Cage Spn 18d 8x36x22mm	32	24	$121,798.00	$121,798.00	$18,269.70	$121,798.00	$63,943.95	2026-03-01
374017	CDM	Valve Tavr 34mm	32	24	$121,118.00	$121,118.00	$18,167.70	$121,118.00	$63,586.95	2026-03-01
374016	CDM	Valve Tavr 29mm	32	24	$121,118.00	$121,118.00	$18,167.70	$121,118.00	$63,586.95	2026-03-01
332421	CDM	Vasc Emboliz Arterial	38	26	$120,721.70	$120,721.70	$18,108.26	$120,721.70	$59,757.24	2026-03-01
332420	CDM	Vasc Emboliz Venous	38	26	$120,721.70	$120,721.70	$18,108.26	$120,721.70	$59,757.24	2026-03-01
332188	CDM	Vasc Embol Art Ven Hem	38	26	$120,721.70	$120,721.70	$18,108.26	$120,721.70	$59,757.24	2026-03-01
332185	CDM	Vasc Emboliz Venous	38	26	$120,721.70	$120,721.70	$18,108.26	$120,721.70	$59,757.24	2026-03-01
332186	CDM	Vasc Emboliz Arterial	38	26	$120,721.70	$120,721.70	$18,108.26	$120,721.70	$59,757.24	2026-03-01
332423	CDM	Vasc Embol Art Ven Hem	38	26	$120,721.70	$120,721.70	$18,108.26	$120,721.70	$59,757.24	2026-03-01
332422	CDM	Vasc Embol Tum/org/inf	38	26	$120,721.70	$120,721.70	$18,108.26	$120,721.70	$59,757.24	2026-03-01
108728	CDM	Rv Fpvt Stn/ath Cl Ea	38	26	$119,598.96	$119,598.96	$17,939.84	$119,598.96	$59,201.49	2026-03-01
108726	CDM	Rv Fpvt Stn/ath Sfl Ea	38	26	$119,598.96	$119,598.96	$17,939.84	$119,598.96	$59,201.49	2026-03-01
108764	CDM	Rv Fpvt Stn/ath Cl Ea	38	26	$119,598.96	$119,598.96	$17,939.84	$119,598.96	$59,201.49	2026-03-01
108762	CDM	Rv Fpvt Stn/ath Sfl Ea	38	26	$119,598.96	$119,598.96	$17,939.84	$119,598.96	$59,201.49	2026-03-01
374015	CDM	Valve Tavr 26mm	32	24	$116,802.00	$116,802.00	$17,520.30	$116,802.00	$61,321.05	2026-03-01
374014	CDM	Valve Tavr 23mm	32	24	$116,802.00	$116,802.00	$17,520.30	$116,802.00	$61,321.05	2026-03-01
326651	CDM	Rem/replace Icd Gen Mult	38	26	$115,456.88	$115,456.88	$17,318.53	$115,456.88	$57,151.15	2026-03-01
502238	CDM	Valve Tavr Sz 23mm	32	24	$115,350.00	$115,350.00	$17,302.50	$115,350.00	$60,558.75	2026-03-01
272539	CDM	Valve Aor 31x26-29mm	32	24	$115,350.00	$115,350.00	$17,302.50	$115,350.00	$60,558.75	2026-03-01
502241	CDM	Valve Tavr Size 34mm	32	24	$115,350.00	$115,350.00	$17,302.50	$115,350.00	$60,558.75	2026-03-01
488548	CDM	Valve Tavr 26mm	32	24	$115,350.00	$115,350.00	$17,302.50	$115,350.00	$60,558.75	2026-03-01
362844	CDM	Valve Mitral 29x42.5mm	32	24	$115,350.00	$115,350.00	$17,302.50	$115,350.00	$60,558.75	2026-03-01
205832	CDM	Valve Aor 23x18-20mm	32	24	$115,350.00	$115,350.00	$17,302.50	$115,350.00	$60,558.75	2026-03-01
488547	CDM	Valve Tavr 23mm	32	24	$115,350.00	$115,350.00	$17,302.50	$115,350.00	$60,558.75	2026-03-01
273466	CDM	Valve Aor 26x20-23mm	32	24	$115,350.00	$115,350.00	$17,302.50	$115,350.00	$60,558.75	2026-03-01
205856	CDM	Valve Aor 26x20-23mm	32	24	$115,350.00	$115,350.00	$17,302.50	$115,350.00	$60,558.75	2026-03-01
452129	CDM	Valve Tavr 34mm	32	24	$115,350.00	$115,350.00	$17,302.50	$115,350.00	$60,558.75	2026-03-01
502239	CDM	Valve Tavr Sz 29mm	32	24	$115,350.00	$115,350.00	$17,302.50	$115,350.00	$60,558.75	2026-03-01
455710	CDM	Valve Tavr 23mm	32	24	$115,350.00	$115,350.00	$17,302.50	$115,350.00	$60,558.75	2026-03-01
494818	CDM	System Tavr 5	32	24	$115,350.00	$115,350.00	$17,302.50	$115,350.00	$60,558.75	2026-03-01
205833	CDM	Valve Aor 29x23-26mm	32	24	$115,350.00	$115,350.00	$17,302.50	$115,350.00	$60,558.75	2026-03-01
488549	CDM	Valve Tavr 29mm	32	24	$115,350.00	$115,350.00	$17,302.50	$115,350.00	$60,558.75	2026-03-01
502240	CDM	Valve Tavr Sz 26mm	32	24	$115,350.00	$115,350.00	$17,302.50	$115,350.00	$60,558.75	2026-03-01
205834	CDM	Valve Aor 31x26-29mm	32	24	$115,350.00	$115,350.00	$17,302.50	$115,350.00	$60,558.75	2026-03-01
332281	CDM	Transcth Stnt Plc Ia	38	26	$113,184.60	$113,184.60	$16,977.69	$113,184.60	$56,026.38	2026-03-01
108740	CDM	Rv Tpvt St/ath Cl Ea	38	26	$111,952.29	$111,952.29	$16,792.84	$111,952.29	$55,416.38	2026-03-01
108776	CDM	Rv Tpvt St/ath Cl Ea	38	26	$111,952.29	$111,952.29	$16,792.84	$111,952.29	$55,416.38	2026-03-01
199895	CDM	Graft Art St Tis 6-32mm	32	24	$110,703.00	$110,703.00	$16,605.45	$110,703.00	$58,119.07	2026-03-01
850	MS_DRG	Acute Leukemia With Other Procedures	54	27	—	—	$12,480.00	$214,980.75	$66,770.58	2026-03-01
824	OTHER	Inj, Exagamglogene Autote	33	22	—	—	$11,462.56	$3,428,040.00	$2,355,320.00	2026-03-01
748	OTHER	Inj, Lovotibeglogene Auto	33	22	—	—	$10,582.48	$4,781,186.76	$3,285,033.08	2026-03-01
717	OTHER	Instill Adstiladrin, Tx D	33	22	—	—	$10,493.47	$94,483.94	$64,917.54	2026-03-01
746	OTHER	Inj, Betibeglogene Autote	33	22	—	—	$9,788.91	$4,321,754.43	$2,969,368.69	2026-03-01
908	OTHER	Topi Adm Prad Zami Per Tr	33	22	—	—	$8,558.79	$4,903,655.40	$3,369,178.20	2026-03-01
906	OTHER	Inj Elivaldogene Autoteme	33	22	—	—	$7,562.70	$4,674,600.00	$3,211,800.00	2026-03-01
886	OTHER	Inj. Remestemcel-l-rknd/	33	22	—	—	$7,082.66	$296,453.43	$203,685.69	2026-03-01
714	OTHER	Inj Delandistrogene Mox R	33	22	—	—	$5,559.52	$4,891,954.20	$3,361,138.60	2026-03-01
845	OTHER	Inj, Atidarsagene Autotem	29	18	—	—	$4,726.94	$4,955,500.00	$4,550,050.00	2026-03-01
93656	CPT	Com Ep Repo Cth Tx Afib	44	26	$233,407.32	$233,407.32	$3,723.00	$233,407.32	$60,802.60	2026-03-01
93654	CPT	Ep Repos Ele Vt 3d Map	44	26	$218,395.69	$218,395.69	$3,723.00	$218,395.69	$56,892.07	2026-03-01
831	OTHER	Obecbtge Autol Up To 400	33	22	—	—	$3,236.80	$409,027.50	$281,032.50	2026-03-01
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	56	29	—	—	$2,253.12	$695,721.34	$213,601.40	2026-03-01
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	61	30	—	—	$2,253.12	$526,936.82	$162,164.54	2026-03-01
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	54	29	—	—	$2,253.12	$530,047.51	$161,528.93	2026-03-01
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	63	30	—	—	$2,253.12	$343,874.86	$106,376.65	2026-03-01
7	MS_DRG	Lung Transplant	50	29	—	—	$2,253.12	$321,501.67	$99,075.12	2026-03-01
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	56	29	—	—	$2,253.12	$547,133.00	$87,314.09	2026-03-01
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	61	30	—	—	$2,253.12	$269,960.41	$83,851.28	2026-03-01
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	50	29	—	—	$2,253.12	$255,968.47	$79,200.90	2026-03-01
215	MS_DRG	Other Heart Assist System Implant	60	30	—	—	$2,253.12	$461,974.00	$76,912.78	2026-03-01
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	60	30	—	—	$2,253.12	$242,867.79	$75,594.83	2026-03-01
453	MS_DRG	Combined Anterior And Posterior Spinal Fusion With Mcc	7	4	—	—	$2,253.12	$92,326.93	$74,471.21	2026-03-01
231	MS_DRG	Coronary Bypass With Ptca With Mcc	61	30	—	—	$2,253.12	$225,064.00	$65,359.21	2026-03-01
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	61	30	—	—	$2,253.12	$307,671.84	$65,158.72	2026-03-01
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	61	30	—	—	$2,253.12	$195,350.83	$61,114.09	2026-03-01
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	60	30	—	—	$2,253.12	$253,492.35	$59,672.83	2026-03-01
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	61	30	—	—	$2,253.12	$189,799.74	$59,422.41	2026-03-01
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	61	30	—	—	$2,253.12	$189,171.64	$59,230.99	2026-03-01
459	MS_DRG	Spinal Fusion Except Cervical With Mcc	7	4	—	—	$2,253.12	$69,101.93	$55,737.85	2026-03-01
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	61	30	—	—	$2,253.12	$264,336.00	$55,527.59	2026-03-01
10	MS_DRG	Pancreas Transplant	50	29	—	—	$2,253.12	$178,143.93	$55,327.88	2026-03-01
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	54	29	—	—	$2,253.12	$178,069.45	$55,305.40	2026-03-01
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	48	28	—	—	$1,854.72	$1,072,056.19	$325,101.74	2026-03-01
14	MS_DRG	Allogeneic Bone Marrow Transplant	59	32	—	—	$1,854.72	$298,356.39	$92,504.91	2026-03-01
J1823	HCPCS	Inebiliz-cdon 100 Mg Inj	31	21	$201,643.73	$201,643.73	$592.25	$201,643.73	$100,821.87	2026-03-01
C9293	HCPCS	Glucarpidase 1000 U Inj	35	23	$284,862.25	$284,862.25	$486.70	$284,862.25	$139,582.50	2026-03-01
J9359	HCPCS	Loncast-lpyl 10 Mg Inj	31	21	$142,460.60	$142,460.60	$255.95	$142,460.60	$71,230.30	2026-03-01
J9118	HCPCS	Calaspar 3750 U Inj	31	21	$116,389.22	$116,389.22	$94.72	$116,389.22	$58,194.61	2026-03-01

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