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 HENDERSONVILLE MEDICAL CENTER

Hendersonville, TN · CCN 440194 · Rates published

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You selected 93306 (CPT)

ECHO2D COMP W CF DOP

This hospital’s price: $1,840 across 19 payers · range $253-$7,175

Source: https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1321255_TRISTAR-HENDERSONVILLE-MEDICAL-CENTER_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D · observed 2026-03-01

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.

29,131 distinct procedures filed
35 distinct payers
1,209,141 rate rows
2026-03-01 last MRF observed
Data quality

1,132,849 of 1,209,141 rate rows are consumer-grade (93.7%)

76,292 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 45,713
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 22,411
exceeds 10× this hospital's gross charge — excluded from medians 3,835
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 2,918
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 864
placeholder amount (≤ $0.02) — excluded from medians 475
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 59
percent-of-charges filed in the dollar field — excluded from medians 17
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1321255_TRISTAR-HENDERSONVILLE-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/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-10-10
Content fingerprint a63c943183ae60c4… · 292,134,275 bytes · first seen 2026-06-08

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 15 $4,057.59 $4,955,500.00 $4,550,050.00 nat. median
$17,146
outlier · 265.4×
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
J1411
HCPCS 		Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 1 $4,200,000.00 $4,200,000.00 $4,200,000.00 nat. median
$3,703,693
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
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 17 $3,489,255.00 $4,238,057.05 $3,722,119.67 nat. median
$3,758,972
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
773
OTHER 		Inj, Beqvez, Per Tx Dose 16 $3,424,750.00 $4,145,750.00 $3,641,050.00 nat. median
$3,646,097
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 20 $4,496.74 $4,891,954.20 $3,409,817.92 nat. median
$3,325,455
1.0× median
908
OTHER 		Topi Adm Prad Zami Per Tr 19 $8,194.15 $4,903,655.40 $3,402,536.40 nat. median
$30,329
outlier · 112.2×
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 20 $7,417.36 $4,830,420.00 $3,334,471.62 nat. median
$3,252,508
1.0× median
906
OTHER 		Inj Elivaldogene Autoteme 19 $5,411.39 $4,674,600.00 $3,243,600.00 nat. median
$24,952
outlier · 130.0×
746
OTHER 		Inj, Betibeglogene Autote 20 $6,588.09 $4,362,960.00 $3,013,468.22 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
$2,466,282
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
$2,401,960
1.1× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 20 $2,269,183.30 $3,805,802.07 $2,588,981.00 nat. median
$2,588,981
1.0× median
824
OTHER 		Inj, Exagamglogene Autote 19 $10,974.21 $3,428,040.00 $2,378,640.00 nat. median
$2,262,040
1.1× 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
$809,217
outlier · 2.2×
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
$738,272
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
$622,245
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
$608,101
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
$591,650
outlier · 2.0×
2067
OTHER 		Afamitresgene Autoleucel 19 $747,501.40 $1,132,811.40 $793,738.60 nat. median
$789,886
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 20 $500,767.23 $863,844.91 $587,649.60 nat. median
$587,650
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos 20 $502,733.26 $832,801.01 $566,531.30 nat. median
$577,003
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 20 $490,889.79 $826,435.76 $562,201.20 nat. median
$562,201
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 20 $500,258.22 $820,380.25 $558,081.80 nat. median
$562,826
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 20 $464,983.20 $782,322.53 $532,192.20 nat. median
$533,230
1.0× median
9391
OTHER 		Brexucabtagene Car Pos T 20 $437,503.88 $719,491.79 $489,450.20 nat. median
$492,768
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 25 $1,854.72 $1,072,056.19 $295,565.07 nat. median
$359,358
0.8× median
831
OTHER 		Obecbtge Autol Up To 400 19 $2,495.84 $409,027.50 $283,815.00 nat. median
$23,568
outlier · 12.0×
897
OTHER 		Revakinagene, Per Implant 19 $257,050.00 $389,550.00 $272,950.00 nat. median
$25,189
outlier · 10.8×
886
OTHER 		Inj. Remestemcel-l-rknd/ 19 $4,706.38 $296,453.43 $205,702.38 nat. median
$201,669
1.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 26 $2,253.12 $695,721.34 $202,728.93 nat. median
$249,124
0.8× median
J7330
HCPCS 		Autologous Cultured Chondrocytes, Implant 2 $76,729.09 $221,874.56 $192,914.70 nat. median
$75,037
outlier · 2.6×
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×
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $152,420.78 $160,611.83 $156,516.30 nat. median
$214,523
0.7× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 26 $2,253.12 $573,024.23 $156,303.99 nat. median
$198,433
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 27 $2,253.12 $526,936.82 $154,793.24 nat. median
$190,557
0.8× median
018
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $125,769.64 $182,717.75 $154,243.70 nat. median
$297,577
0.5× 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
$63,643
outlier · 2.4×
1907
OTHER 		New Technology - Level 52 20 $133,131.86 $210,510.03 $145,352.16 nat. median
$155,877
0.9× median
1908
OTHER 		New Technology - Level 52 20 $133,131.86 $210,510.03 $145,352.16 nat. median
$155,833
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×
1905
OTHER 		New Technology - Level 51 20 $120,036.96 $189,804.20 $131,055.27 nat. median
$140,530
0.9× median
1906
OTHER 		New Technology - Level 51 20 $120,036.96 $189,804.20 $131,055.27 nat. median
$140,545
0.9× median

Other procedures at this hospital

Browse this hospital's 29,131 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 27 15 — — $4,057.59 $4,955,500.00 $4,550,050.00 2026-03-01
J1411 HCPCS Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 2 1 — — $4,200,000.00 $4,200,000.00 $4,200,000.00 2026-03-01
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
J1413 HCPCS Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 2 1 — — $3,840,000.00 $3,840,000.00 $3,840,000.00 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 52 17 — — $3,489,255.00 $4,238,057.05 $3,722,119.67 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
773 OTHER Inj, Beqvez, Per Tx Dose 26 16 — — $3,424,750.00 $4,145,750.00 $3,641,050.00 2024-10-01
714 OTHER Inj Delandistrogene Mox R 60 20 — — $4,496.74 $4,891,954.20 $3,409,817.92 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 31 19 — — $8,194.15 $4,903,655.40 $3,402,536.40 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
748 OTHER Inj, Lovotibeglogene Auto 60 20 — — $7,417.36 $4,830,420.00 $3,334,471.62 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 31 19 — — $5,411.39 $4,674,600.00 $3,243,600.00 2026-03-01
746 OTHER Inj, Betibeglogene Autote 60 20 — — $6,588.09 $4,362,960.00 $3,013,468.22 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
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 1 1 — — $2,640,000.00 $2,640,000.00 $2,640,000.00 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 58 20 — — $2,269,183.30 $3,805,802.07 $2,588,981.00 2026-03-01
824 OTHER Inj, Exagamglogene Autote 31 19 — — $10,974.21 $3,428,040.00 $2,378,640.00 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
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 2026-03-01
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 2026-03-01
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 2026-03-01
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 2026-03-01
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 2026-03-01
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 2026-03-01
2067 OTHER Afamitresgene Autoleucel 29 19 — — $747,501.40 $1,132,811.40 $793,738.60 2026-03-01
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 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 58 20 — — $500,767.23 $863,844.91 $587,649.60 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 58 20 — — $502,733.26 $832,801.01 $566,531.30 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 58 20 — — $490,889.79 $826,435.76 $562,201.20 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 58 20 — — $500,258.22 $820,380.25 $558,081.80 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
9035 OTHER Axicabtagene Ciloleucel C 58 20 — — $464,983.20 $782,322.53 $532,192.20 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 58 20 — — $437,503.88 $719,491.79 $489,450.20 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 89 25 — — $1,854.72 $1,072,056.19 $295,565.07 2026-03-01
831 OTHER Obecbtge Autol Up To 400 31 19 — — $2,495.84 $409,027.50 $283,815.00 2026-03-01
897 OTHER Revakinagene, Per Implant 29 19 — — $257,050.00 $389,550.00 $272,950.00 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 31 19 — — $4,706.38 $296,453.43 $205,702.38 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 99 26 — — $2,253.12 $695,721.34 $202,728.93 2026-03-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 10 2 — — $76,729.09 $221,874.56 $192,914.70 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 12 3 — — $72,000.00 $170,328.19 $168,273.22 2026-03-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 2 1 — — $152,420.78 $160,611.83 $156,516.30 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 93 26 — — $2,253.12 $573,024.23 $156,303.99 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 113 27 — — $2,253.12 $526,936.82 $154,793.24 2026-03-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 1 — — $125,769.64 $182,717.75 $154,243.70 2026-03-01
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 2026-03-01
1907 OTHER New Technology - Level 52 58 20 — — $133,131.86 $210,510.03 $145,352.16 2026-03-01
1908 OTHER New Technology - Level 52 58 20 — — $133,131.86 $210,510.03 $145,352.16 2026-03-01
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 2026-03-01
1905 OTHER New Technology - Level 51 58 20 — — $120,036.96 $189,804.20 $131,055.27 2026-03-01
1906 OTHER New Technology - Level 51 58 20 — — $120,036.96 $189,804.20 $131,055.27 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 7 1 — — $123,321.96 $123,742.09 $123,321.96 2026-03-01
1903 OTHER New Technology - Level 50 58 20 — — $106,942.07 $169,098.36 $116,758.39 2026-03-01
1904 OTHER New Technology - Level 50 58 20 — — $106,942.07 $169,098.36 $116,758.39 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 12 3 — — $54,500.39 $117,019.36 $114,441.15 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 58 20 — — $94,999.90 $163,909.41 $111,503.00 2026-03-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 1 — — $102,091.46 $113,202.49 $107,646.98 2026-03-01
1902 OTHER New Technology - Level 49 58 20 — — $93,847.18 $148,392.53 $102,461.51 2026-03-01
1901 OTHER New Technology - Level 49 58 20 — — $93,847.18 $148,392.53 $102,461.51 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 115 27 — — $2,253.12 $343,874.86 $101,410.46 2026-03-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 58 20 — — $86,480.30 $139,769.07 $95,583.49 2026-03-01
7 MS_DRG Lung Transplant 92 26 — — $2,253.12 $321,501.67 $94,170.34 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 92 26 — — $1,854.72 $316,452.24 $91,797.83 2026-03-01
1599 OTHER New Technology - Level 48 58 20 — — $82,934.77 $131,137.63 $90,547.41 2026-03-01
1585 OTHER New Technology - Level 48 58 20 — — $82,934.77 $131,137.63 $90,547.41 2026-03-01
30243Y3 OTHER Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Central Vein, … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
30243U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
30230G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Peripheral Vein, Open Appro… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
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 2026-03-01
30233G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Peripheral Vein, Percutaneous… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
30243G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Central Vein, Percutaneous … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
30240G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Central Vein, Open Approach 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
30233G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Peripheral Vein, Percutaneo… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
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 2026-03-01
30233U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
30243G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Central Vein, Percutaneous Ap… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
30240Y3 OTHER Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Central Vein, … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
30233U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
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 2026-03-01
30233Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Peripheral Vein,… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
30230Y3 OTHER Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Peripheral Vei… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
30230U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
30233X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Peripheral Vein, … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
30240Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Central Vein, Op… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
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 2026-03-01
30230G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Peripheral Vein, Open Approac… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
30230U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
30233Y3 OTHER Transfusion Of Allogeneic Unrelated Hamatopoietic Stem Cells Into Peripheral Vei… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
30240U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
30243U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
30240U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
30240G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Central Vein, Open Approach… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
30230Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Peripheral Vein,… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
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 2026-03-01
30243Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Central Vein, Pe… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
30230X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Peripheral Vein, … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-01
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 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 50 23 — — $18,507.00 $281,000.53 $82,754.29 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 99 26 — — $2,253.12 $665,462.00 $82,043.30 2026-03-01
1584 OTHER New Technology - Level 47 58 20 — — $74,204.84 $117,333.74 $81,016.15 2026-03-01
1598 OTHER New Technology - Level 47 58 20 — — $74,204.84 $117,333.74 $81,016.15 2026-03-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 1 — — $71,782.97 $88,402.18 $80,092.57 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 113 27 — — $2,253.12 $269,960.41 $79,184.98 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 99 24 — — $21,031.00 $253,183.05 $79,051.57 2026-03-01
679573 CDM Rv Fpvt Stn/ath Sfl Ea 24 15 $291,062.80 $291,062.80 $43,659.42 $267,777.78 $77,422.71 2026-03-01
679575 CDM Rv Fpvt Stn/ath Cl Ea 24 15 $291,062.80 $291,062.80 $43,659.42 $267,777.78 $77,422.71 2026-03-01
679574 CDM Rv Fpvt Stn/ath Cl In 24 15 $291,062.80 $291,062.80 $43,659.42 $267,777.78 $77,422.71 2026-03-01
679572 CDM Rv Fpvt Stn/ath Sfl In 24 15 $291,062.80 $291,062.80 $43,659.42 $267,777.78 $77,422.71 2026-03-01
679591 CDM Rvs Tpvt St/ath Cl In 24 15 $291,062.80 $291,062.80 $43,659.42 $267,777.78 $77,422.71 2026-03-01
679589 CDM Rvs Tpvt St/ath Sfl In 24 15 $291,062.80 $291,062.80 $43,659.42 $267,777.78 $77,422.71 2026-03-01
215 MS_DRG Other Heart Assist System Implant 112 27 — — $2,253.12 $482,325.00 $76,292.29 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 92 26 — — $2,253.12 $257,216.93 $76,245.89 2026-03-01
C9150 HCPCS Xenon Xe-129 Hyperpolarized Gas, Diagnostic, Per Study Dose 3 1 — — $65,769.60 $74,786.40 $74,786.40 2026-03-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 14 4 — — $2,253.12 $92,326.93 $74,471.21 2026-03-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 2 1 — — $64,954.81 $79,226.59 $72,090.70 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 106 24 — — $18,507.00 $242,867.79 $71,632.50 2026-03-01
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 12 3 — — $31,521.48 $75,323.76 $71,589.38 2026-03-01
1583 OTHER New Technology - Level 46 58 20 — — $65,474.91 $103,529.85 $71,484.89 2026-03-01
1597 OTHER New Technology - Level 46 58 20 — — $65,474.91 $103,529.85 $71,484.89 2026-03-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 58 20 — — $62,578.11 $101,138.50 $69,165.29 2026-03-01
90288 CPT Botulism Immune Globulin, Human, For Intravenous Use 3 1 — — $60,394.20 $68,674.05 $68,674.05 2026-03-01
326033 CDM Revsc Fem/pop W Stnt/ath 22 17 $264,602.55 $264,602.55 $15,000.00 $243,434.35 $68,664.36 2024-10-01
326053 CDM Revsc Tib/per St/ath Ini 22 17 $264,602.55 $264,602.55 $15,000.00 $243,434.35 $68,664.36 2024-10-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 99 24 — — $21,031.00 $201,452.70 $65,527.38 2026-03-01
1643 OTHER Y90 Ibritumomab, Rx 58 20 — — $55,119.81 $96,250.57 $65,476.58 2026-03-01
717 OTHER Instill Adstiladrin, Tx D 60 20 — — $10,046.41 $94,483.94 $65,255.41 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 99 24 — — $9,386.00 $222,498.95 $64,891.45 2026-03-01
007 OTHER Lung Transplant 2 1 — — $57,548.86 $67,943.11 $62,745.99 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 107 24 — — $18,507.00 $234,979.00 $62,422.81 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 107 24 — — $26,581.30 $282,622.33 $62,416.29 2026-03-01
014 OTHER Allogeneic Bone Marrow Transplant 2 1 — — $57,995.80 $66,698.72 $62,347.26 2026-03-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 12 3 — — $26,766.00 $64,205.31 $62,320.47 2026-03-01
1596 OTHER New Technology - Level 45 58 20 — — $56,744.98 $89,725.96 $61,953.64 2026-03-01
1582 OTHER New Technology - Level 45 58 20 — — $56,744.98 $89,725.96 $61,953.64 2026-03-01
5244 OTHER Level 4 Blood Product Exc 58 20 — — $45,453.41 $88,708.65 $60,346.02 2026-03-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 1 — — $57,444.46 $60,217.65 $58,831.06 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 113 27 — — $2,253.12 $195,350.83 $58,288.40 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 106 24 — — $18,507.00 $232,853.94 $57,087.52 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 107 24 — — $18,507.00 $189,799.74 $56,549.62 2026-03-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 95 26 — — $2,253.12 $191,469.44 $56,213.38 2026-03-01
9273 OTHER Sipuleucel-t Auto Cd54+ 58 20 — — $52,264.47 $80,872.39 $56,036.23 2026-03-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 14 4 — — $2,253.12 $69,101.93 $55,737.85 2026-03-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 113 27 — — $2,253.12 $189,171.64 $55,643.58 2026-03-01
10 MS_DRG Pancreas Transplant 92 26 — — $2,253.12 $192,578.15 $53,513.45 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 99 24 — — $21,031.00 $171,469.10 $52,967.43 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 107 24 — — $18,507.00 $275,982.00 $52,673.56 2026-03-01
1581 OTHER New Technology - Level 44 58 20 — — $48,015.05 $75,922.07 $52,422.39 2026-03-01
1595 OTHER New Technology - Level 44 58 20 — — $48,015.05 $75,922.07 $52,422.39 2026-03-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 2 1 — — $47,219.35 $57,384.93 $52,302.14 2026-03-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 14 4 — — $2,253.12 $63,725.73 $51,401.39 2026-03-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 113 27 — — $1,854.72 $171,592.35 $50,607.43 2026-03-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 107 24 — — $18,507.00 $170,750.75 $50,366.34 2026-03-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 113 27 — — $2,253.12 $167,106.29 $50,015.42 2026-03-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 58 20 — — $45,118.35 $72,919.94 $49,867.65 2026-03-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 99 24 — — $21,031.00 $161,939.95 $49,450.31 2026-03-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 93 26 — — $2,253.12 $178,069.45 $49,418.60 2026-03-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 106 24 — — $18,507.00 $163,238.40 $48,276.47 2026-03-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 1 — — $47,326.08 $48,997.92 $48,162.00 2026-03-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 99 24 — — $18,507.00 $165,999.05 $48,044.18 2026-03-01
429 OTHER Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 1 1 — — $47,877.59 $47,877.59 $47,877.59 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 106 24 — — $18,507.00 $163,238.40 $47,875.07 2026-03-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 106 24 — — $13,500.00 $162,645.06 $47,337.67 2026-03-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 113 27 — — $1,854.72 $159,747.86 $47,214.21 2026-03-01
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $47,111.56 $47,111.56 $47,111.56 2024-10-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $42,413.21 $49,910.80 $46,162.01 2026-03-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 113 27 — — $2,253.12 $152,753.80 $45,867.32 2026-03-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 107 24 — — $18,507.00 $179,472.00 $45,466.91 2026-03-01
1142 OTHER Supprelin La Implant 58 20 — — $41,889.78 $66,664.81 $45,350.21 2026-03-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 107 24 — — $18,507.00 $234,979.00 $45,287.43 2026-03-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 106 24 — — $18,507.00 $192,455.78 $45,035.75 2026-03-01
679568 CDM Rvsc Fpvt Ath Sfl In 24 15 $168,065.77 $168,065.77 $25,209.87 $154,620.51 $44,705.49 2026-03-01
679569 CDM Rvsc Fpvt Ath Sfl Ea 24 15 $168,065.77 $168,065.77 $25,209.87 $154,620.51 $44,705.49 2026-03-01
679581 CDM Rvsc Tpvt Stnt Sfl In 24 15 $168,065.77 $168,065.77 $25,209.87 $154,620.51 $44,705.49 2026-03-01
679567 CDM Rvsc Fpvt Stnt Cl Ea 24 15 $168,065.77 $168,065.77 $25,209.87 $154,620.51 $44,705.49 2026-03-01
679570 CDM Rvsc Fpvt Ath Cl In 24 15 $168,065.77 $168,065.77 $25,209.87 $154,620.51 $44,705.49 2026-03-01
679588 CDM Rvsc Tpvt Ath Cl Ea 24 15 $168,065.77 $168,065.77 $25,209.87 $154,620.51 $44,705.49 2026-03-01
679586 CDM Rvsc Tpvt Ath Sfl Ea 24 15 $168,065.77 $168,065.77 $25,209.87 $154,620.51 $44,705.49 2026-03-01
679587 CDM Rvsc Tpvt Ath Cl In 24 15 $168,065.77 $168,065.77 $25,209.87 $154,620.51 $44,705.49 2026-03-01
679571 CDM Rvsc Fpvt Ath Cl Ea 24 15 $168,065.77 $168,065.77 $25,209.87 $154,620.51 $44,705.49 2026-03-01
679566 CDM Rvsc Fpvt Stn Cl In 24 15 $168,065.77 $168,065.77 $25,209.87 $154,620.51 $44,705.49 2026-03-01
679585 CDM Rvsc Tpvt Ath Sfl In 24 15 $168,065.77 $168,065.77 $25,209.87 $154,620.51 $44,705.49 2026-03-01
679583 CDM Rvsc Tpvt Stnt Cl In 24 15 $168,065.77 $168,065.77 $25,209.87 $154,620.51 $44,705.49 2026-03-01
679565 CDM Rvsc Fpvt Stnt Sfl Ea 24 15 $168,065.77 $168,065.77 $25,209.87 $154,620.51 $44,705.49 2026-03-01
679564 CDM Rvsc Fpvt Stnt Sfl In 24 15 $168,065.77 $168,065.77 $25,209.87 $154,620.51 $44,705.49 2026-03-01
28 MS_DRG Spinal Procedures With Mcc 113 27 — — $2,253.12 $149,162.06 $44,614.73 2026-03-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 1 — — $34,992.05 $53,779.52 $44,385.79 2026-03-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 107 24 — — $18,153.38 $177,150.49 $44,290.10 2026-03-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 92 26 — — $1,854.72 $147,210.73 $43,899.22 2026-03-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 113 27 — — $2,253.12 $148,231.99 $43,743.46 2026-03-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 87 24 — — $1,854.72 $122,110.30 $43,720.71 2026-03-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 107 24 — — $18,507.00 $145,693.86 $43,611.42 2026-03-01
1580 OTHER New Technology - Level 43 58 20 — — $39,285.12 $62,118.19 $42,891.13 2026-03-01
1594 OTHER New Technology - Level 43 58 20 — — $39,285.12 $62,118.19 $42,891.13 2026-03-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 92 26 — — $1,854.72 $145,787.50 $42,862.16 2026-03-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 109 27 — — $2,253.12 $314,996.79 $42,796.93 2026-03-01
955 OTHER Craniotomy For Multiple Significant Trauma 2 1 — — $32,267.71 $53,164.13 $42,715.92 2026-03-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 99 24 — — $17,302.80 $132,130.27 $42,466.12 2026-03-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 50 23 — — $18,051.84 $141,679.50 $42,450.10 2026-03-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 113 27 — — $2,253.12 $154,337.03 $42,363.31 2026-03-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 113 27 — — $2,253.12 $141,495.79 $41,573.71 2026-03-01
231 OTHER Coronary Bypass With Ptca With Mcc 2 1 — — $38,073.28 $44,796.87 $41,435.07 2026-03-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 99 24 — — $17,413.83 $132,978.11 $41,434.13 2026-03-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 92 26 — — $2,253.12 $139,139.80 $41,310.39 2026-03-01
834 MS_DRG Acute Leukemia With Mcc 113 27 — — $1,854.72 $136,292.26 $40,494.62 2026-03-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 107 24 — — $9,386.00 $135,810.63 $40,356.65 2026-03-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 113 27 — — $2,253.12 $143,445.05 $40,288.07 2026-03-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 113 27 — — $2,253.12 $138,186.48 $40,232.62 2026-03-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 58 20 — — $36,375.03 $58,789.12 $40,203.97 2026-03-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 113 27 — — $2,253.12 $135,403.49 $40,123.86 2026-03-01
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $37,880.97 $42,177.37 $40,029.17 2026-03-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 107 24 — — $16,827.69 $135,616.99 $39,955.93 2026-03-01
653 MS_DRG Major Bladder Procedures With Mcc 107 24 — — $9,386.00 $134,644.80 $39,824.84 2026-03-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 106 24 — — $16,753.04 $132,392.09 $39,763.35 2026-03-01
326066 CDM Revsc Tib/per Ath Addl 22 17 $152,787.06 $152,787.06 $15,000.00 $140,564.10 $39,648.24 2024-10-01
326029 CDM Revsc Fem/pop W Stnt 22 17 $152,787.06 $152,787.06 $15,000.00 $140,564.10 $39,648.24 2024-10-01
326041 CDM Revsc Tib/per W Ath Init 22 17 $152,787.06 $152,787.06 $15,000.00 $140,564.10 $39,648.24 2024-10-01
326025 CDM Revsc Fem/pop W Atherct 22 17 $152,787.06 $152,787.06 $15,000.00 $140,564.10 $39,648.24 2024-10-01
326048 CDM Revsc Tib/per Stnt Init 22 17 $152,787.06 $152,787.06 $15,000.00 $140,564.10 $39,648.24 2024-10-01
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 58 20 — — $35,816.42 $57,886.25 $39,586.58 2026-03-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 99 24 — — $16,289.33 $124,391.00 $39,354.54 2026-03-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 107 24 — — $16,235.87 $130,989.42 $38,975.45 2026-03-01
447 OTHER Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 1 1 — — $38,941.86 $38,941.86 $38,941.86 2026-03-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 14 4 — — $2,253.12 $47,985.75 $38,705.46 2026-03-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 113 27 — — $2,253.12 $130,313.81 $38,575.75 2026-03-01
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 1 — — $36,470.11 $40,577.24 $38,523.68 2026-03-01
C2624 HCPCS System Mntr 2x15mm 4.5cm 13 11 $76,939.00 $76,939.00 $14,164.47 $70,783.88 $38,469.50 2024-10-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 113 27 — — $2,253.12 $129,229.26 $38,305.72 2026-03-01
215 OTHER Other Heart Assist System Implant 2 1 — — $32,470.70 $43,815.62 $38,143.16 2026-03-01
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 1 — — $37,502.26 $37,913.52 $37,707.89 2026-03-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 106 24 — — $14,526.18 $125,128.01 $37,296.27 2026-03-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 107 24 — — $9,386.00 $123,817.19 $37,282.71 2026-03-01
C1820 HCPCS Ipg Nrstm 5.3x4.8cm 168 14 $75,996.00 $75,996.00 $8,688.05 $85,374.16 $37,252.50 2026-03-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 113 27 — — $2,253.12 $156,729.89 $36,995.44 2026-03-01
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 2 1 — — $36,906.30 $37,041.73 $36,974.01 2026-03-01
678553 CDM Imp Wrls P-art Pres Snsr 46 17 $146,570.72 $146,570.72 $15,000.00 $134,845.06 $36,935.82 2026-03-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 113 27 — — $2,253.12 $122,605.68 $36,910.21 2026-03-01
360 OTHER Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 1 1 — — $36,821.51 $36,821.51 $36,821.51 2026-03-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 113 27 — — $2,253.12 $149,684.02 $36,810.86 2026-03-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 113 27 — — $1,854.72 $143,787.49 $36,230.80 2026-03-01
471 MS_DRG Cervical Spinal Fusion With Mcc 107 24 — — $15,273.95 $138,914.03 $36,221.64 2026-03-01
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 2 1 — — $20,186.92 $51,943.06 $36,064.99 2026-03-01
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 1 — — $31,830.52 $40,045.36 $35,937.94 2026-03-01
245 MS_DRG Aicd Generator Procedures 113 27 — — $2,253.12 $124,606.13 $35,734.70 2026-03-01
603302 CDM Stent Eprsth 28mm 10cm 17 12 $78,821.00 $78,821.00 $11,823.15 $72,515.32 $35,469.45 2026-03-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 106 24 — — $14,880.77 $144,506.64 $35,453.70 2026-03-01
L8701 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand With S… 58 20 — — $31,806.85 $51,406.05 $35,154.94 2026-03-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 113 27 — — $2,253.12 $116,478.63 $35,136.44 2026-03-01
6 MS_DRG Liver Transplant Without Mcc 93 26 — — $2,253.12 $117,125.18 $35,119.80 2026-03-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. 109 27 — — $2,253.12 $241,075.40 $34,943.82 2026-03-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 107 24 — — $14,609.05 $179,472.00 $34,737.85 2026-03-01
799 MS_DRG Splenic Procedures With Mcc 107 24 — — $9,386.00 $114,844.95 $34,649.80 2026-03-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 96 26 — — $2,253.12 $116,716.96 $34,648.51 2026-03-01
834 OTHER Acute Leukemia With Mcc 2 1 — — $33,128.02 $35,809.91 $34,468.96 2026-03-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 109 27 — — $2,253.12 $234,521.98 $34,261.67 2026-03-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 107 24 — — $9,386.00 $114,112.71 $34,140.58 2026-03-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 113 27 — — $2,253.12 $112,876.37 $33,786.40 2026-03-01
163 MS_DRG Major Chest Procedures With Mcc 113 27 — — $2,253.12 $111,327.98 $33,762.13 2026-03-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 113 27 — — $2,253.12 $112,926.03 $33,717.02 2026-03-01
C1767 HCPCS Generator Nrstm 5 Ipg 185 14 $62,088.00 $62,088.00 $7,647.75 $85,384.28 $33,689.67 2026-03-01
021 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 2 1 — — $28,494.27 $38,446.92 $33,470.60 2026-03-01
1593 OTHER New Technology - Level 42 58 20 — — $30,555.19 $48,314.30 $33,359.88 2026-03-01
1579 OTHER New Technology - Level 42 58 20 — — $30,555.19 $48,314.30 $33,359.88 2026-03-01
275 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 1 — — $22,033.55 $44,652.30 $33,342.93 2026-03-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 112 27 — — $2,253.12 $110,795.96 $33,181.31 2026-03-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 113 27 — — $2,253.12 $156,064.26 $33,122.50 2026-03-01
335058 CDM Dialysis Circ Thrmb/stnt 22 17 $126,768.63 $126,768.63 $15,000.00 $116,627.14 $32,896.46 2024-10-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 113 27 — — $2,253.12 $113,335.31 $32,608.41 2026-03-01
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $32,316.16 $32,808.21 $32,562.18 2026-03-01
969 OTHER HIV With Extensive O.r. Procedures With Mcc 2 1 — — $32,243.46 $32,528.63 $32,386.04 2026-03-01
232 OTHER Coronary Bypass With Ptca Without Mcc 2 1 — — $32,216.97 $32,319.12 $32,268.04 2026-03-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 113 27 — — $2,253.12 $109,055.65 $32,242.52 2026-03-01
901 MS_DRG Wound Debridements For Injuries With Mcc 113 27 — — $2,253.12 $107,011.48 $32,173.78 2026-03-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 107 24 — — $13,198.60 $148,534.68 $32,041.19 2026-03-01
573 OTHER Skin Graft For Skin Ulcer Or Cellulitis With Mcc 2 1 — — $29,172.80 $34,814.62 $31,993.71 2026-03-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 113 27 — — $2,253.12 $107,432.03 $31,910.75 2026-03-01
J1412 HCPCS Injection, Valoctocogene Roxaparvovec-rvox, Per Ml, Containing Nominal 2 X 10°13… 9 2 — — $13,593.76 $33,267.33 $31,820.70 2026-03-01
140 MS_DRG Major Head And Neck Procedures With Mcc 113 27 — — $2,253.12 $105,890.34 $31,671.72 2026-03-01
5166 OTHER Cochlear Implant Procedur 58 20 — — $27,893.35 $46,500.16 $31,632.76 2026-03-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 99 24 — — $12,915.81 $98,629.70 $31,610.78 2026-03-01
678551 CDM Ather Ilac Ea Vessel 22 17 $121,586.87 $121,586.87 $15,000.00 $111,859.92 $31,551.79 2024-10-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 107 24 — — $13,160.01 $104,845.16 $31,485.60 2026-03-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 113 27 — — $2,253.12 $104,614.28 $31,419.47 2026-03-01
612076 CDM Set Vntrc 17.4x13.8in 59 21 $111,999.00 $111,999.00 $15,000.00 $115,403.88 $31,359.75 2026-03-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 107 24 — — $13,006.28 $103,991.15 $31,240.95 2026-03-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 113 27 — — $2,253.12 $104,308.92 $31,087.35 2026-03-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 113 27 — — $2,253.12 $104,666.42 $31,057.53 2026-03-01
793 MS_DRG Full Term Neonate With Major Problems 87 24 — — $1,854.72 $85,664.12 $30,948.14 2026-03-01
218 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $26,726.41 $34,941.49 $30,833.95 2026-03-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 107 24 — — $9,386.00 $103,102.38 $30,792.00 2026-03-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 106 24 — — $12,367.96 $102,419.66 $30,790.75 2026-03-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 14 4 — — $2,253.12 $38,111.66 $30,740.99 2026-03-01
461 OTHER Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 2 1 — — $29,349.30 $31,989.43 $30,669.36 2026-03-01
011 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 2 1 — — $24,676.90 $36,411.22 $30,544.06 2026-03-01
L6700 HCPCS Upper Extremity Addition, External Powered Feature, Myoelectronic Control Module… 29 19 — — $28,624.89 $43,379.99 $30,395.51 2026-03-01
010 OTHER Pancreas Transplant 2 1 — — $22,583.43 $38,131.83 $30,357.63 2026-03-01
213 OTHER Endovascular Abdominal Aorta With Iliac Branch Procedures 1 1 — — $30,326.90 $30,326.90 $30,326.90 2026-03-01
791 MS_DRG Prematurity With Major Problems 87 24 — — $1,854.72 $83,394.45 $30,317.79 2026-03-01
5232 OTHER Level 2 Icd And Similar P 58 20 — — $27,364.82 $44,267.32 $30,245.32 2026-03-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 99 24 — — $12,428.69 $94,909.83 $30,043.97 2026-03-01
L5856 HCPCS Addition To Lower Extremity Prosthesis, Endoskeletal Knee-shin System, Microproc… 58 20 — — $27,031.58 $43,688.40 $29,877.01 2026-03-01
L6880 HCPCS Electric Hand, Switch Or Myoelectric Controlled, Independently Articulating Digi… 58 20 — — $26,904.00 $43,482.16 $29,736.00 2026-03-01
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