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 STONECREST MEDICAL CENTER

Smyrna, TN · CCN 440227 · Rates published

31,730 distinct procedures filed
36 distinct payers
1,238,599 rate rows
2026-07-31 last MRF observed
Data quality

1,137,655 of 1,238,599 rate rows are consumer-grade (91.9%)

100,944 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 45,717
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 29,717
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 19,329
exceeds 10× this hospital's gross charge — excluded from medians 3,718
template filing: same amount across many unrelated codes — excluded 974
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 867
placeholder amount (≤ $0.02) — excluded from medians 499
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 123
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1113737_TRISTAR-STONECREST-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 not_modified · 2026-08-11
Content fingerprint b843a27a63756b04… · 317,992,915 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 16 $4,070.57 $4,955,500.00 $4,550,050.00 nat. median
$16,015
outlier · 284.1×
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
$3,710,000
1.1× median
J1413
HCPCS 		Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 1 $3,840,000.00 $3,840,000.00 $3,840,000.00 nat. median
$3,324,572
1.2× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 18 $3,232,152.00 $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 17 $3,172,400.00 $4,145,750.00 $3,641,050.00 nat. median
$3,646,097
1.0× median
908
OTHER 		Topi Adm Prad Zami Per Tr 20 $8,224.47 $4,903,655.40 $3,385,857.30 nat. median
$29,683
outlier · 114.1×
714
OTHER 		Inj Delandistrogene Mox R 21 $4,511.13 $4,891,954.20 $3,377,777.90 nat. median
$3,325,455
1.0× median
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $3,360,000.00 $3,360,000.00 $3,360,000.00 nat. median
$2,997,086
1.1× median
748
OTHER 		Inj, Lovotibeglogene Auto 21 $7,441.09 $4,830,420.00 $3,318,860.00 nat. median
$3,252,508
1.0× median
906
OTHER 		Inj Elivaldogene Autoteme 20 $5,428.70 $4,674,600.00 $3,227,700.00 nat. median
$24,604
outlier · 131.2×
746
OTHER 		Inj, Betibeglogene Autote 21 $6,609.17 $4,362,960.00 $2,998,224.19 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
$2,460,273
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
$2,405,851
1.1× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 21 $2,101,980.32 $3,805,802.07 $2,588,981.00 nat. median
$2,588,981
1.0× median
824
OTHER 		Inj, Exagamglogene Autote 20 $11,014.82 $3,428,040.00 $2,366,980.00 nat. median
$58,186
outlier · 40.7×
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 3 $872,400.00 $2,042,143.00 $1,749,707.25 nat. median
$809,151
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
$691,418
outlier · 2.0×
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
$631,793
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
$610,161
outlier · 2.2×
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
$624,417
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
$588,565
outlier · 2.2×
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
$577,541
outlier · 2.1×
2067
OTHER 		Afamitresgene Autoleucel 20 $693,558.00 $1,132,811.40 $789,885.50 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
$302,242
outlier · 2.4×
9498
OTHER 		Ciltacabtagene Car-pos T 21 $463,868.59 $863,844.91 $587,649.60 nat. median
$587,650
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos 21 $465,689.75 $832,801.01 $566,531.30 nat. median
$576,820
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 21 $454,718.97 $826,435.76 $562,201.20 nat. median
$562,201
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 21 $463,397.09 $820,380.25 $558,081.80 nat. median
$560,872
1.0× median
J3402
HCPCS 		Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 $534,422.90 $534,422.90 $534,422.90 nat. median
$209,736
outlier · 2.5×
9035
OTHER 		Axicabtagene Ciloleucel C 21 $430,721.28 $782,322.53 $532,192.20 nat. median
$533,230
1.0× median
9391
OTHER 		Brexucabtagene Car Pos T 21 $405,266.75 $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 26 $1,854.72 $1,072,056.19 $300,462.38 nat. median
$370,165
0.8× median
831
OTHER 		Obecbtge Autol Up To 400 20 $2,503.83 $409,027.50 $282,423.75 nat. median
$20,175
outlier · 14.0×
897
OTHER 		Revakinagene, Per Implant 20 $238,500.00 $389,550.00 $271,625.00 nat. median
$19,528
outlier · 13.9×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 27 $2,253.12 $695,721.34 $206,647.00 nat. median
$261,939
0.8× median
886
OTHER 		Inj. Remestemcel-l-rknd/ 20 $4,721.44 $296,453.43 $204,694.04 nat. median
$200,661
1.0× median
J7330
HCPCS 		Autologous Cultured Chondrocytes, Implant 2 $76,729.09 $221,874.56 $192,914.70 nat. median
$75,807
outlier · 2.5×
J9029
HCPCS 		Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 3 $72,000.00 $170,328.19 $168,273.22 nat. median
$69,291
outlier · 2.4×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 27 $2,253.12 $573,024.23 $160,096.83 nat. median
$205,166
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 28 $2,253.12 $526,936.82 $158,409.58 nat. median
$199,832
0.8× median
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $152,908.50 $161,206.13 $157,057.32 nat. median
$214,447
0.7× median
018
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $126,172.10 $183,393.83 $154,782.96 nat. median
$292,434
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 21 $123,322.14 $210,510.03 $144,636.14 nat. median
$155,877
0.9× median
1908
OTHER 		New Technology - Level 52 21 $123,322.14 $210,510.03 $144,636.14 nat. median
$155,877
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
$65,655
outlier · 2.2×
1905
OTHER 		New Technology - Level 51 21 $111,192.14 $189,804.20 $130,409.68 nat. median
$140,545
0.9× median
1906
OTHER 		New Technology - Level 51 21 $111,192.14 $189,804.20 $130,409.68 nat. median
$140,545
0.9× median

Other procedures at this hospital

Browse this hospital's 31,730 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
845 OTHER Inj, Atidarsagene Autotem 28 16 — — $4,070.57 $4,955,500.00 $4,550,050.00 2026-03-12
J1414 HCPCS Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose 1 1 — — $4,200,000.00 $4,200,000.00 $4,200,000.00 2026-03-12
J1411 HCPCS Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 2 1 — — $4,200,000.00 $4,200,000.00 $4,200,000.00 2026-03-12
J1413 HCPCS Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 2 1 — — $3,840,000.00 $3,840,000.00 $3,840,000.00 2026-03-12
9138 OTHER Inj, Hemgenix, Per Tx Dos 54 18 — — $3,232,152.00 $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
773 OTHER Inj, Beqvez, Per Tx Dose 27 17 — — $3,172,400.00 $4,145,750.00 $3,641,050.00 2024-10-01
908 OTHER Topi Adm Prad Zami Per Tr 32 20 — — $8,224.47 $4,903,655.40 $3,385,857.30 2026-03-12
714 OTHER Inj Delandistrogene Mox R 62 21 — — $4,511.13 $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 62 21 — — $7,441.09 $4,830,420.00 $3,318,860.00 2026-03-12
906 OTHER Inj Elivaldogene Autoteme 32 20 — — $5,428.70 $4,674,600.00 $3,227,700.00 2026-03-12
746 OTHER Inj, Betibeglogene Autote 62 21 — — $6,609.17 $4,362,960.00 $2,998,224.19 2026-03-12
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 1 — — $2,870,046.83 $2,870,046.83 $2,870,046.83 2026-03-12
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 1 1 — — $2,640,000.00 $2,640,000.00 $2,640,000.00 2026-03-12
9141 OTHER Inj Onase Abepar-xioi Tre 60 21 — — $2,101,980.32 $3,805,802.07 $2,588,981.00 2026-03-12
824 OTHER Inj, Exagamglogene Autote 32 20 — — $11,014.82 $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
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 7 1 — — $1,387,149.28 $1,501,307.95 $1,387,149.28 2026-03-12
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 9 2 — — $620,118.79 $1,557,271.36 $1,345,370.55 2026-03-12
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 11 3 — — $591,090.52 $1,478,916.58 $1,334,154.50 2026-03-12
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 9 2 — — $579,352.98 $1,489,833.29 $1,315,434.06 2026-03-12
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 9 2 — — $549,504.00 $1,410,309.44 $1,296,212.81 2026-03-12
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 9 2 — — $549,504.00 $1,297,043.03 $1,191,016.00 2026-03-12
2067 OTHER Afamitresgene Autoleucel 30 20 — — $693,558.00 $1,132,811.40 $789,885.50 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 60 21 — — $463,868.59 $863,844.91 $587,649.60 2026-03-12
9194 OTHER Tisagenlecleucel Car-pos 60 21 — — $465,689.75 $832,801.01 $566,531.30 2026-03-12
9413 OTHER Lisocabtagene Car Pos T 60 21 — — $454,718.97 $826,435.76 $562,201.20 2026-03-12
9422 OTHER Idecabtagene Vicleucel Ca 60 21 — — $463,397.09 $820,380.25 $558,081.80 2026-03-12
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 3 1 — — $534,422.90 $534,422.90 $534,422.90 2026-03-12
9035 OTHER Axicabtagene Ciloleucel C 60 21 — — $430,721.28 $782,322.53 $532,192.20 2026-03-12
9391 OTHER Brexucabtagene Car Pos T 60 21 — — $405,266.75 $719,491.79 $489,450.20 2026-03-12
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 91 26 — — $1,854.72 $1,072,056.19 $300,462.38 2026-03-12
831 OTHER Obecbtge Autol Up To 400 32 20 — — $2,503.83 $409,027.50 $282,423.75 2026-03-12
897 OTHER Revakinagene, Per Implant 30 20 — — $238,500.00 $389,550.00 $271,625.00 2026-03-12
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 105 27 — — $2,253.12 $695,721.34 $206,647.00 2026-03-12
886 OTHER Inj. Remestemcel-l-rknd/ 32 20 — — $4,721.44 $296,453.43 $204,694.04 2026-03-12
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 10 2 — — $76,729.09 $221,874.56 $192,914.70 2026-03-12
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 12 3 — — $72,000.00 $170,328.19 $168,273.22 2026-03-12
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 98 27 — — $2,253.12 $573,024.23 $160,096.83 2026-03-12
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 115 28 — — $2,253.12 $526,936.82 $158,409.58 2026-03-12
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 2 1 — — $152,908.50 $161,206.13 $157,057.32 2026-03-12
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 1 — — $126,172.10 $183,393.83 $154,782.96 2026-03-12
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 12 3 — — $74,124.43 $173,512.94 $150,585.06 2026-03-12
1907 OTHER New Technology - Level 52 60 21 — — $123,322.14 $210,510.03 $144,636.14 2026-03-12
1908 OTHER New Technology - Level 52 60 21 — — $123,322.14 $210,510.03 $144,636.14 2026-03-12
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 12 3 — — $65,321.65 $147,108.87 $144,170.89 2026-03-12
1906 OTHER New Technology - Level 51 60 21 — — $111,192.14 $189,804.20 $130,409.68 2026-03-12
1905 OTHER New Technology - Level 51 60 21 — — $111,192.14 $189,804.20 $130,409.68 2026-03-12
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 7 1 — — $123,321.96 $123,742.09 $123,321.96 2026-03-12
1903 OTHER New Technology - Level 50 60 21 — — $99,062.13 $169,098.36 $116,183.23 2026-03-12
1904 OTHER New Technology - Level 50 60 21 — — $99,062.13 $169,098.36 $116,183.23 2026-03-12
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 12 3 — — $54,500.39 $117,019.36 $114,441.15 2026-03-12
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 60 21 — — $87,999.91 $163,909.41 $111,503.00 2026-03-12
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 1 — — $102,418.14 $113,621.30 $108,019.72 2026-03-12
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 117 28 — — $2,253.12 $343,874.86 $104,198.95 2026-03-12
1902 OTHER New Technology - Level 49 60 21 — — $86,932.13 $148,392.53 $101,956.77 2026-03-12
1901 OTHER New Technology - Level 49 60 21 — — $86,932.13 $148,392.53 $101,956.77 2026-03-12
7 MS_DRG Lung Transplant 94 27 — — $2,253.12 $321,501.67 $96,678.21 2026-03-12
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 60 21 — — $80,108.07 $139,769.07 $95,583.49 2026-03-12
14 MS_DRG Allogeneic Bone Marrow Transplant 94 27 — — $1,854.72 $316,452.24 $92,655.93 2026-03-12
1599 OTHER New Technology - Level 48 60 21 — — $76,823.79 $131,137.63 $90,101.36 2026-03-12
1585 OTHER New Technology - Level 48 60 21 — — $76,823.79 $131,137.63 $90,101.36 2026-03-12
209 MS_DRG Complex Aortic Arch Procedures 63 31 — — $18,507.00 $281,000.53 $85,579.85 2026-03-12
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 105 27 — — $2,253.12 $527,174.00 $84,027.82 2026-03-12
30230Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Peripheral Vein,… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30233Y3 OTHER Transfusion Of Allogeneic Unrelated Hamatopoietic Stem Cells Into Peripheral Vei… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30230X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Peripheral Vein, … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30233X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Peripheral Vein, … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30240Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Central Vein, Op… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30243G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Central Vein, Percutaneous … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30243Y3 OTHER Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Central Vein, … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30240Y3 OTHER Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Central Vein, … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30233X2 OTHER Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Peripheral Vein, Pe… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30230U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30243U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30243U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30233Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Peripheral Vein,… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30230Y3 OTHER Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Peripheral Vei… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30233U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30240G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Central Vein, Open Approach 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30243X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Central Vein, Per… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30243Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Central Vein, Pe… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30243G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Central Vein, Percutaneous Ap… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30233U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30240X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Central Vein, Ope… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30240U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30233G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Peripheral Vein, Percutaneous… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30230G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Peripheral Vein, Open Appro… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30240G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Central Vein, Open Approach… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30243X2 OTHER Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Central Vein, Percu… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30233G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Peripheral Vein, Percutaneo… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30230X2 OTHER Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Peripheral Vein, Op… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30240U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30240X2 OTHER Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Central Vein, Open … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30230G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Peripheral Vein, Open Approac… 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
30230U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 2 1 — — $83,298.00 $83,298.00 $83,298.00 2026-03-12
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 126 33 — — $21,031.00 $253,183.05 $82,693.84 2026-03-12
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 115 28 — — $2,253.12 $269,960.41 $80,887.27 2026-03-12
1584 OTHER New Technology - Level 47 60 21 — — $68,737.12 $117,333.74 $80,617.06 2026-03-12
1598 OTHER New Technology - Level 47 60 21 — — $68,737.12 $117,333.74 $80,617.06 2026-03-12
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 1 — — $72,012.68 $88,729.21 $80,370.95 2026-03-12
215 MS_DRG Other Heart Assist System Implant 114 28 — — $2,253.12 $393,965.00 $78,319.78 2026-03-12
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 94 27 — — $2,253.12 $257,216.93 $78,249.32 2026-03-12
C9150 HCPCS Xenon Xe-129 Hyperpolarized Gas, Diagnostic, Per Study Dose 3 1 — — $65,769.60 $74,786.40 $74,786.40 2026-03-12
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 14 4 — — $2,253.12 $92,326.93 $74,471.21 2026-03-12
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 114 28 — — $2,253.12 $242,867.79 $73,053.61 2026-03-12
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 2 1 — — $65,162.66 $79,519.73 $72,341.20 2026-03-12
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 12 3 — — $31,521.48 $75,323.76 $71,589.38 2026-03-12
1583 OTHER New Technology - Level 46 60 21 — — $60,650.44 $103,529.85 $71,132.75 2026-03-12
1597 OTHER New Technology - Level 46 60 21 — — $60,650.44 $103,529.85 $71,132.75 2026-03-12
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 60 21 — — $57,967.10 $101,138.50 $69,165.29 2026-03-12
90288 CPT Botulism Immune Globulin, Human, For Intravenous Use 3 1 — — $60,394.20 $68,674.05 $68,674.05 2026-03-12
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 126 33 — — $21,031.00 $201,452.70 $68,273.29 2026-03-12
850 MS_DRG Acute Leukemia With Other Procedures 113 32 — — $10,109.00 $222,498.95 $67,969.82 2026-03-12
1643 OTHER Y90 Ibritumomab, Rx 60 21 — — $51,142.10 $96,250.57 $65,476.58 2026-03-12
717 OTHER Instill Adstiladrin, Tx D 62 21 — — $10,083.58 $94,483.94 $65,086.48 2026-03-12
231 MS_DRG Coronary Bypass With Ptca With Mcc 115 28 — — $2,253.12 $209,280.70 $63,890.75 2026-03-12
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 115 28 — — $2,253.12 $282,622.33 $63,855.46 2026-03-12
007 OTHER Lung Transplant 2 1 — — $57,733.02 $68,194.50 $62,963.76 2026-03-12
014 OTHER Allogeneic Bone Marrow Transplant 2 1 — — $58,210.39 $66,912.16 $62,561.28 2026-03-12
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 12 3 — — $26,766.00 $64,205.31 $62,320.47 2026-03-12
1582 OTHER New Technology - Level 45 60 21 — — $52,563.77 $89,725.96 $61,648.45 2026-03-12
1596 OTHER New Technology - Level 45 60 21 — — $52,563.77 $89,725.96 $61,648.45 2026-03-12
5244 OTHER Level 4 Blood Product Exc 60 21 — — $42,104.21 $88,708.65 $60,346.02 2026-03-12
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 115 28 — — $2,253.12 $195,350.83 $60,216.20 2026-03-12
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 1 — — $57,628.29 $60,440.46 $59,034.38 2026-03-12
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 115 28 — — $2,253.12 $189,799.74 $58,482.74 2026-03-12
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 114 28 — — $2,253.12 $232,853.94 $58,476.76 2026-03-12
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 97 27 — — $2,253.12 $191,469.44 $58,127.60 2026-03-12
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 115 28 — — $2,253.12 $189,171.64 $57,263.52 2026-03-12
9273 OTHER Sipuleucel-t Auto Cd54+ 60 21 — — $48,413.40 $80,872.39 $55,800.81 2026-03-12
459 MS_DRG Spinal Fusion Except Cervical With Mcc 14 4 — — $2,253.12 $69,101.93 $55,737.85 2026-03-12
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 126 33 — — $21,031.00 $171,469.10 $55,436.07 2026-03-12
10 MS_DRG Pancreas Transplant 94 27 — — $2,253.12 $192,578.15 $55,120.68 2026-03-12
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 115 28 — — $2,253.12 $225,494.00 $54,067.15 2026-03-12
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 2 1 — — $47,370.45 $57,597.25 $52,483.85 2026-03-12
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 115 28 — — $1,854.72 $171,592.35 $52,226.53 2026-03-12
1581 OTHER New Technology - Level 44 60 21 — — $44,477.10 $75,922.07 $52,164.15 2026-03-12
1595 OTHER New Technology - Level 44 60 21 — — $44,477.10 $75,922.07 $52,164.15 2026-03-12
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 126 33 — — $21,031.00 $161,939.95 $51,871.69 2026-03-12
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 115 28 — — $2,253.12 $170,750.75 $51,404.44 2026-03-12
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 14 4 — — $2,253.12 $63,725.73 $51,401.39 2026-03-12
955 MS_DRG Craniotomy For Multiple Significant Trauma 115 28 — — $2,253.12 $167,106.29 $51,353.49 2026-03-12
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 98 27 — — $2,253.12 $178,069.45 $51,186.89 2026-03-12
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 126 33 — — $18,507.00 $165,999.05 $50,533.33 2026-03-12
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 60 21 — — $41,793.84 $72,919.94 $49,867.65 2026-03-12
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 114 28 — — $2,253.12 $163,238.40 $49,731.54 2026-03-12
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 114 28 — — $2,253.12 $163,238.40 $48,756.41 2026-03-12
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 115 28 — — $1,854.72 $159,747.86 $48,717.75 2026-03-12
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 115 28 — — $2,253.12 $162,645.06 $48,587.46 2026-03-12
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 1 — — $47,501.18 $49,154.71 $48,327.94 2026-03-12
429 OTHER Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 1 1 — — $48,054.73 $48,054.73 $48,054.73 2026-03-12
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 115 28 — — $2,253.12 $152,753.80 $47,368.95 2026-03-12
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $47,262.32 $47,262.32 $47,262.32 2024-10-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 115 28 — — $2,253.12 $149,616.07 $46,675.09 2026-03-12
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 114 28 — — $2,253.12 $192,455.78 $46,509.21 2026-03-12
232 MS_DRG Coronary Bypass With Ptca Without Mcc 115 28 — — $2,253.12 $191,996.00 $46,502.63 2026-03-12
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $42,548.93 $50,095.47 $46,322.20 2026-03-12
28 MS_DRG Spinal Procedures With Mcc 115 28 — — $2,253.12 $149,162.06 $45,838.54 2026-03-12
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 94 27 — — $1,854.72 $147,210.73 $45,518.42 2026-03-12
1142 OTHER Supprelin La Implant 60 21 — — $38,866.81 $66,664.81 $45,350.21 2026-03-12
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 115 28 — — $2,253.12 $177,150.49 $45,317.33 2026-03-12
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 89 25 — — $1,854.72 $122,110.30 $45,176.00 2026-03-12
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 115 28 — — $2,253.12 $148,231.99 $44,897.38 2026-03-12
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 115 28 — — $2,253.12 $145,693.86 $44,635.94 2026-03-12
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 126 33 — — $17,302.80 $132,130.27 $44,549.74 2026-03-12
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 1 — — $35,104.02 $53,978.51 $44,541.26 2026-03-12
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 94 27 — — $1,854.72 $145,787.50 $44,405.40 2026-03-12
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 111 28 — — $2,253.12 $314,996.79 $44,397.02 2026-03-12
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 63 31 — — $18,051.84 $141,679.50 $44,322.37 2026-03-12
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 115 28 — — $2,253.12 $154,337.03 $43,958.04 2026-03-12
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 126 33 — — $17,413.83 $132,978.11 $43,601.31 2026-03-12
955 OTHER Craniotomy For Multiple Significant Trauma 2 1 — — $32,387.10 $53,334.25 $42,860.68 2026-03-12
1594 OTHER New Technology - Level 43 60 21 — — $36,390.43 $62,118.19 $42,679.84 2026-03-12
1580 OTHER New Technology - Level 43 60 21 — — $36,390.43 $62,118.19 $42,679.84 2026-03-12
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 115 28 — — $2,253.12 $141,495.79 $42,565.35 2026-03-12
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 94 27 — — $2,253.12 $139,139.80 $42,365.71 2026-03-12
834 MS_DRG Acute Leukemia With Mcc 115 28 — — $1,854.72 $136,292.26 $41,905.36 2026-03-12
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 115 28 — — $2,253.12 $135,810.63 $41,765.48 2026-03-12
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 115 28 — — $2,253.12 $143,445.05 $41,682.32 2026-03-12
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 115 28 — — $2,253.12 $135,403.49 $41,647.22 2026-03-12
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 115 28 — — $2,253.12 $138,186.48 $41,623.05 2026-03-12
231 OTHER Coronary Bypass With Ptca With Mcc 2 1 — — $38,195.11 $44,962.63 $41,578.87 2026-03-12
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 126 33 — — $16,289.33 $124,391.00 $41,348.79 2026-03-12
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 115 28 — — $2,253.12 $135,616.99 $41,300.32 2026-03-12
653 MS_DRG Major Bladder Procedures With Mcc 115 28 — — $2,253.12 $134,644.80 $41,072.35 2026-03-12
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 114 28 — — $2,253.12 $132,392.09 $40,926.35 2026-03-12
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 60 21 — — $33,694.76 $58,789.12 $40,203.97 2026-03-12
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $38,021.13 $42,312.33 $40,166.73 2026-03-12
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 115 28 — — $2,253.12 $130,989.42 $40,094.49 2026-03-12
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 115 28 — — $2,253.12 $130,313.81 $39,655.49 2026-03-12
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 60 21 — — $33,177.32 $57,886.25 $39,586.58 2026-03-12
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 115 28 — — $2,253.12 $129,229.26 $39,463.28 2026-03-12
447 OTHER Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 1 1 — — $39,085.95 $39,085.95 $39,085.95 2026-03-12
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 14 4 — — $2,253.12 $47,985.75 $38,705.46 2026-03-12
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 1 — — $36,586.81 $40,727.38 $38,657.10 2026-03-12
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 115 28 — — $2,253.12 $123,817.19 $38,555.05 2026-03-12
228 MS_DRG Other Cardiothoracic Procedures With Mcc 115 28 — — $2,253.12 $156,729.89 $38,366.20 2026-03-12
215 OTHER Other Heart Assist System Implant 2 1 — — $32,590.84 $43,955.83 $38,273.33 2026-03-12
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 115 28 — — $2,253.12 $149,684.02 $38,247.81 2026-03-12
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 114 28 — — $2,253.12 $125,128.01 $38,094.28 2026-03-12
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 115 28 — — $2,253.12 $122,605.68 $37,992.99 2026-03-12
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 1 — — $37,622.27 $38,053.80 $37,838.04 2026-03-12
471 MS_DRG Cervical Spinal Fusion With Mcc 115 28 — — $2,253.12 $138,914.03 $37,501.94 2026-03-12
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 115 28 — — $1,854.72 $143,787.49 $37,324.27 2026-03-12
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 2 1 — — $37,024.41 $37,178.79 $37,101.60 2026-03-12
360 OTHER Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 1 1 — — $36,957.75 $36,957.75 $36,957.75 2026-03-12
245 MS_DRG Aicd Generator Procedures 115 28 — — $2,253.12 $124,606.13 $36,791.45 2026-03-12
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 114 28 — — $2,253.12 $144,506.64 $36,648.25 2026-03-12
6 MS_DRG Liver Transplant Without Mcc 95 27 — — $2,253.12 $117,125.18 $36,456.70 2026-03-12
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. 111 28 — — $2,253.12 $241,075.40 $36,345.39 2026-03-12
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 2 1 — — $20,251.52 $52,135.25 $36,193.39 2026-03-12
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 115 28 — — $2,253.12 $116,478.63 $36,193.23 2026-03-12
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 1 — — $31,932.38 $40,193.53 $36,062.96 2026-03-12
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 115 28 — — $2,253.12 $146,673.00 $35,971.45 2026-03-12
799 MS_DRG Splenic Procedures With Mcc 116 28 — — $2,253.12 $114,844.95 $35,818.13 2026-03-12
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 98 27 — — $2,253.12 $116,716.96 $35,809.45 2026-03-12
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 111 28 — — $2,253.12 $234,521.98 $35,646.46 2026-03-12
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 115 28 — — $2,253.12 $114,112.71 $35,463.58 2026-03-12
L8701 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand With S… 60 21 — — $29,463.19 $51,406.05 $35,154.94 2026-03-12
163 MS_DRG Major Chest Procedures With Mcc 115 28 — — $2,253.12 $111,327.98 $35,134.63 2026-03-12
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 115 28 — — $2,253.12 $112,876.37 $35,104.50 2026-03-12
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 115 28 — — $2,253.12 $112,926.03 $35,099.03 2026-03-12
834 OTHER Acute Leukemia With Mcc 2 1 — — $33,250.59 $35,924.50 $34,587.54 2026-03-12
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 114 28 — — $2,253.12 $110,795.96 $34,500.28 2026-03-12
31 MS_DRG Ventricular Shunt Procedures With Mcc 115 28 — — $2,253.12 $156,064.26 $34,287.69 2026-03-12
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 115 28 — — $2,253.12 $113,335.31 $33,926.94 2026-03-12
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 115 28 — — $2,253.12 $109,055.65 $33,593.57 2026-03-12
021 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 2 1 — — $28,599.69 $38,569.94 $33,584.82 2026-03-12
275 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 1 — — $22,104.06 $44,817.51 $33,460.79 2026-03-12
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 126 33 — — $12,915.81 $98,629.70 $33,370.33 2026-03-12
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 115 28 — — $2,253.12 $148,534.68 $33,338.20 2026-03-12
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 115 28 — — $2,253.12 $107,432.03 $33,227.60 2026-03-12
901 MS_DRG Wound Debridements For Injuries With Mcc 115 28 — — $2,253.12 $107,011.48 $33,218.97 2026-03-12
1593 OTHER New Technology - Level 42 60 21 — — $28,303.76 $48,314.30 $33,195.54 2026-03-12
1579 OTHER New Technology - Level 42 60 21 — — $28,303.76 $48,314.30 $33,195.54 2026-03-12
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 115 28 — — $2,253.12 $104,845.16 $32,771.94 2026-03-12
140 MS_DRG Major Head And Neck Procedures With Mcc 115 28 — — $2,253.12 $105,890.34 $32,751.23 2026-03-12
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $32,419.57 $32,929.60 $32,674.58 2026-03-12
969 OTHER HIV With Extensive O.r. Procedures With Mcc 2 1 — — $32,346.63 $32,648.99 $32,497.81 2026-03-12
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 115 28 — — $2,253.12 $104,614.28 $32,425.14 2026-03-12
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 115 28 — — $2,253.12 $104,308.92 $32,399.35 2026-03-12
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 115 28 — — $2,253.12 $104,666.42 $32,379.43 2026-03-12
232 OTHER Coronary Bypass With Ptca Without Mcc 2 1 — — $32,336.17 $32,422.53 $32,379.35 2026-03-12
793 MS_DRG Full Term Neonate With Major Problems 89 25 — — $1,854.72 $85,664.12 $32,256.73 2026-03-12
C1882 HCPCS Crt Defib Card 71x51x12 51 12 $71,609.00 $71,609.00 $9,813.00 $66,651.24 $32,224.05 2026-03-12
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 115 28 — — $2,253.12 $103,991.15 $32,205.04 2026-03-12
573 OTHER Skin Graft For Skin Ulcer Or Cellulitis With Mcc 2 1 — — $29,266.15 $34,943.44 $32,104.80 2026-03-12
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 115 28 — — $2,253.12 $103,102.38 $31,949.44 2026-03-12
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 2026-03-12
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 126 33 — — $12,428.69 $94,909.83 $31,697.69 2026-03-12
5166 OTHER Cochlear Implant Procedur 60 21 — — $25,838.05 $46,500.16 $31,632.76 2026-03-12
791 MS_DRG Prematurity With Major Problems 90 25 — — $1,854.72 $83,394.45 $31,516.16 2026-03-12
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 114 28 — — $2,253.12 $102,419.66 $31,281.51 2026-03-12
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 98 27 — — $1,854.72 $104,511.44 $30,995.79 2026-03-12
218 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $26,811.93 $35,070.77 $30,941.35 2026-03-12
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 126 32 — — $10,109.00 $80,709.88 $30,779.39 2026-03-12
461 OTHER Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 2 1 — — $29,457.89 $32,091.80 $30,774.85 2026-03-12
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 14 4 — — $2,253.12 $38,111.66 $30,740.99 2026-03-12
011 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 2 1 — — $24,755.87 $36,545.95 $30,650.91 2026-03-12
34 MS_DRG Carotid Artery Stent Procedures With Mcc 115 28 — — $2,253.12 $96,094.00 $30,475.78 2026-03-12
010 OTHER Pancreas Transplant 2 1 — — $22,655.70 $38,272.92 $30,464.31 2026-03-12
213 OTHER Endovascular Abdominal Aorta With Iliac Branch Procedures 1 1 — — $30,439.10 $30,439.10 $30,439.10 2026-03-12
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 115 28 — — $2,253.12 $96,221.44 $30,345.83 2026-03-12
L6700 HCPCS Upper Extremity Addition, External Powered Feature, Myoelectronic Control Module… 30 20 — — $26,559.18 $43,379.99 $30,247.96 2026-03-12
5232 OTHER Level 2 Icd And Similar P 60 21 — — $25,348.46 $44,267.32 $30,245.32 2026-03-12
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 115 28 — — $2,253.12 $97,116.83 $30,228.06 2026-03-12
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 115 28 — — $2,253.12 $82,962.00 $29,961.74 2026-03-12
L5856 HCPCS Addition To Lower Extremity Prosthesis, Endoskeletal Knee-shin System, Microproc… 60 21 — — $25,039.78 $43,688.40 $29,877.01 2026-03-12
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 115 28 — — $2,253.12 $99,348.45 $29,814.68 2026-03-12
207 OTHER Respiratory System Diagnosis With Ventilator Support >96 Hours 2 1 — — $28,025.47 $31,508.24 $29,766.86 2026-03-12
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 115 28 — — $2,253.12 $123,683.66 $29,765.10 2026-03-12
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 115 28 — — $2,253.12 $182,274.37 $29,742.48 2026-03-12
L6880 HCPCS Electric Hand, Switch Or Myoelectric Controlled, Independently Articulating Digi… 60 21 — — $24,921.60 $43,482.16 $29,736.00 2026-03-12
430 OTHER Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 1 1 — — $29,723.61 $29,723.61 $29,723.61 2026-03-12
C1820 HCPCS Generator Ipg Nrstm 102 12 $75,627.00 $75,627.00 $6,569.85 $75,986.48 $29,708.07 2026-03-12
023 OTHER Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 2 1 — — $26,350.18 $32,860.89 $29,605.53 2026-03-12
5465 OTHER Level 5 Neurostimulator A 60 21 — — $23,925.47 $43,518.22 $29,604.23 2026-03-12
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 115 28 — — $2,253.12 $93,020.90 $29,558.26 2026-03-12
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 115 28 — — $2,253.12 $95,105.48 $29,355.44 2026-03-12
456 OTHER Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 1 — — $25,952.02 $32,386.14 $29,169.08 2026-03-12
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 115 28 — — $2,253.12 $93,260.04 $29,106.62 2026-03-12
017 OTHER Autologous Bone Marrow Transplant Without Cc/mcc 2 1 — — $28,974.50 $29,072.79 $29,023.65 2026-03-12
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 115 28 — — $2,253.12 $98,909.27 $28,832.44 2026-03-12
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 115 28 — — $2,253.12 $93,356.66 $28,666.43 2026-03-12
006 OTHER Liver Transplant Without Mcc 2 1 — — $26,234.61 $30,907.52 $28,571.07 2026-03-12
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 115 28 — — $2,253.12 $116,175.48 $28,532.94 2026-03-12
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 115 28 — — $2,253.12 $92,782.21 $28,485.17 2026-03-12
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 98 27 — — $2,253.12 $92,000.19 $28,471.84 2026-03-12
843 OTHER Pegaspargase Injection 62 21 — — $5,991.04 $41,783.37 $28,424.06 2026-03-12
265 MS_DRG Aicd Lead Procedures 115 28 — — $2,253.12 $89,825.43 $28,358.51 2026-03-12
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 114 28 — — $2,253.12 $91,151.14 $28,230.08 2026-03-12
234 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 2 1 — — $25,866.80 $30,568.36 $28,217.58 2026-03-12
235 OTHER Coronary Bypass Without Cardiac Catheterization With Mcc 2 1 — — $26,206.01 $30,227.19 $28,216.60 2026-03-12
678270 CDM Rvsc Fpvt Stn Cl In 24 15 $99,525.61 $99,525.61 $14,928.84 $91,563.56 $28,165.74 2026-03-12
678268 CDM Rvsc Fpvt Stnt Sfl In 24 15 $99,525.61 $99,525.61 $14,928.84 $91,563.56 $28,165.74 2026-03-12
678316 CDM Rvsc Fpvt Stnt Sfl In 24 15 $99,525.61 $99,525.61 $14,928.84 $91,563.56 $28,165.74 2026-03-12
678318 CDM Rvsc Fpvt Stn Cl In 24 15 $99,525.61 $99,525.61 $14,928.84 $91,563.56 $28,165.74 2026-03-12
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