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 ASHLAND CITY MEDICAL CENTER

Ashland City, TN · CCN 440779 · Rates published

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You selected 93306 (CPT)

ECHO2D COMP W CF DOP

This hospital’s price: $784 across 19 payers · range $149-$2,922

Source: https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1113737_TRISTAR-ASHLAND-CITY-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.

18,919 distinct procedures filed
32 distinct payers
392,532 rate rows
2026-03-01 last MRF observed
Data quality

360,687 of 392,532 rate rows are consumer-grade (91.9%)

31,845 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 19,497
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 9,271
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 1,494
exceeds 10× this hospital's gross charge — excluded from medians 730
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 431
placeholder amount (≤ $0.02) — excluded from medians 222
template filing: same amount across many unrelated codes — excluded 172
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 28
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1113737_TRISTAR-ASHLAND-CITY-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 viaDiscovered by HANK (automated)
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-10-22
Content fingerprint 66e00a36e1ca0840… · 235,837,911 bytes · first seen 2026-05-13

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 12 $4,909.22 $4,955,500.00 $4,730,250.00 nat. median
$17,156
outlier · 275.7×
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
$3,705,478
1.1× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 14 $3,685,267.00 $4,449,959.90 $3,869,530.35 nat. median
$3,758,972
1.0× median
J1413
HCPCS 		Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 1 $3,840,000.00 $3,840,000.00 $3,840,000.00 nat. median
$3,324,572
1.2× median
J3394
HCPCS 		Injection, Lovotibeglogene Autotemcel, Per Treatment 1 $3,720,000.00 $3,720,000.00 $3,720,000.00 nat. median
$3,286,000
1.1× median
908
OTHER 		Topi Adm Prad Zami Per Tr 17 $8,888.84 $4,903,655.40 $3,502,611.00 nat. median
$30,519
outlier · 114.8×
714
OTHER 		Inj Delandistrogene Mox R 17 $5,773.90 $4,891,954.20 $3,494,253.00 nat. median
$3,325,455
1.1× median
748
OTHER 		Inj, Lovotibeglogene Auto 17 $10,990.57 $4,781,186.76 $3,415,133.40 nat. median
$3,252,508
1.1× median
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $3,360,000.00 $3,360,000.00 $3,360,000.00 nat. median
$2,994,107
1.1× median
906
OTHER 		Inj Elivaldogene Autoteme 17 $7,854.34 $4,674,600.00 $3,339,000.00 nat. median
$25,059
outlier · 133.2×
746
OTHER 		Inj, Betibeglogene Autote 17 $10,166.39 $4,321,754.43 $3,086,967.45 nat. median
$2,939,969
1.1× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 $2,870,046.83 $2,870,046.83 $2,870,046.83 nat. median
$2,467,386
1.2× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 17 $2,588,981.00 $3,805,802.07 $2,718,430.05 nat. median
$2,588,981
1.0× median
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 1 $2,640,000.00 $2,640,000.00 $2,640,000.00 nat. median
$2,401,965
1.1× median
824
OTHER 		Inj, Exagamglogene Autote 17 $11,904.59 $3,428,040.00 $2,448,600.00 nat. median
$2,285,360
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
$813,967
outlier · 2.1×
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 2 $676,327.75 $1,557,271.36 $1,557,271.36 nat. median
$646,415
outlier · 2.4×
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 1 $1,501,307.95 $1,501,307.95 $1,501,307.95 nat. median
$739,258
outlier · 2.0×
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 2 $631,423.78 $1,489,833.29 $1,489,833.29 nat. median
$640,950
outlier · 2.3×
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 2 $614,793.95 $1,410,309.44 $1,410,309.44 nat. median
$608,239
outlier · 2.3×
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 2 $598,359.73 $1,297,043.03 $1,297,043.03 nat. median
$591,721
outlier · 2.2×
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 3 $645,093.12 $1,478,916.58 $1,270,460.72 nat. median
$622,450
outlier · 2.0×
2067
OTHER 		Afamitresgene Autoleucel 17 $770,620.00 $1,132,811.40 $809,151.00 nat. median
$793,739
1.0× median
Q2058
HCPCS 		Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,… 3 $630,000.00 $737,362.50 $710,521.88 nat. median
$319,951
outlier · 2.2×
9498
OTHER 		Ciltacabtagene Car-pos T 17 $587,649.60 $863,844.91 $617,032.08 nat. median
$587,650
1.1× median
9194
OTHER 		Tisagenlecleucel Car-pos 17 $566,531.30 $832,801.01 $594,857.87 nat. median
$577,163
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 17 $562,201.20 $826,435.76 $590,311.26 nat. median
$562,201
1.1× median
9422
OTHER 		Idecabtagene Vicleucel Ca 17 $558,081.80 $820,380.25 $585,985.89 nat. median
$563,449
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 17 $532,192.20 $782,322.53 $558,801.81 nat. median
$533,230
1.0× median
J3402
HCPCS 		Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 $534,422.90 $534,422.90 $534,422.90 nat. median
$209,753
outlier · 2.5×
9391
OTHER 		Brexucabtagene Car Pos T 17 $489,450.20 $719,491.79 $513,922.71 nat. median
$492,768
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 11 $1,854.72 $1,072,056.19 $320,310.43 nat. median
$359,454
0.9× median
831
OTHER 		Obecbtge Autol Up To 400 17 $3,361.62 $409,027.50 $292,162.50 nat. median
$23,596
outlier · 12.4×
897
OTHER 		Revakinagene, Per Implant 17 $265,000.00 $389,550.00 $278,250.00 nat. median
$26,484
outlier · 10.5×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 12 $2,253.12 $695,721.34 $272,937.10 nat. median
$249,036
1.1× median
J7330
HCPCS 		Autologous Cultured Chondrocytes, Implant 2 $76,729.09 $221,874.56 $221,874.56 nat. median
$75,000
outlier · 3.0×
886
OTHER 		Inj. Remestemcel-l-rknd/ 17 $7,355.78 $296,453.43 $211,752.45 nat. median
$201,669
1.1× median
018
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $198,208.30 $198,208.30 $198,208.30 nat. median
$297,123
0.7× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 12 $2,253.12 $526,936.82 $191,268.85 nat. median
$190,559
1.0× median
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $174,228.20 $174,228.20 $174,228.20 nat. median
$214,523
0.8× median
1908
OTHER 		New Technology - Level 52 17 $135,426.50 $199,076.95 $142,197.83 nat. median
$155,563
0.9× median
1907
OTHER 		New Technology - Level 52 17 $135,426.50 $199,076.95 $142,197.83 nat. median
$155,833
0.9× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 12 $2,253.12 $343,874.86 $137,930.10 nat. median
$126,695
1.1× median
J9029
HCPCS 		Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 3 $77,314.48 $170,328.19 $132,540.10 nat. median
$68,423
1.9× median
1905
OTHER 		New Technology - Level 51 17 $122,105.90 $179,495.67 $128,211.19 nat. median
$140,341
0.9× median
1906
OTHER 		New Technology - Level 51 17 $122,105.90 $179,495.67 $128,211.19 nat. median
$140,341
0.9× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 $31,692.56 $224,204.99 $126,721.76 nat. median
$93,276
1.4× median
A9699
HCPCS 		Radiopharmaceutical, Therapeutic, Not Otherwise Classified 1 $123,742.09 $123,742.09 $123,742.09 nat. median
$1,683
outlier · 73.5×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 12 $2,253.12 $547,133.00 $123,322.58 nat. median
$104,013
1.2× median

Other procedures at this hospital

Browse this hospital's 18,919 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 21 12 — — $4,909.22 $4,955,500.00 $4,730,250.00 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
J1411 HCPCS Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 1 1 — — $4,200,000.00 $4,200,000.00 $4,200,000.00 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 22 14 — — $3,685,267.00 $4,449,959.90 $3,869,530.35 2026-03-01
J1413 HCPCS Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 1 1 — — $3,840,000.00 $3,840,000.00 $3,840,000.00 2026-03-01
J3394 HCPCS Injection, Lovotibeglogene Autotemcel, Per Treatment 1 1 — — $3,720,000.00 $3,720,000.00 $3,720,000.00 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 26 17 — — $8,888.84 $4,903,655.40 $3,502,611.00 2026-03-01
714 OTHER Inj Delandistrogene Mox R 26 17 — — $5,773.90 $4,891,954.20 $3,494,253.00 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 26 17 — — $10,990.57 $4,781,186.76 $3,415,133.40 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
906 OTHER Inj Elivaldogene Autoteme 26 17 — — $7,854.34 $4,674,600.00 $3,339,000.00 2026-03-01
746 OTHER Inj, Betibeglogene Autote 26 17 — — $10,166.39 $4,321,754.43 $3,086,967.45 2026-03-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 1 — — $2,870,046.83 $2,870,046.83 $2,870,046.83 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 25 17 — — $2,588,981.00 $3,805,802.07 $2,718,430.05 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
824 OTHER Inj, Exagamglogene Autote 26 17 — — $11,904.59 $3,428,040.00 $2,448,600.00 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
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 4 2 — — $676,327.75 $1,557,271.36 $1,557,271.36 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 3 1 — — $1,501,307.95 $1,501,307.95 $1,501,307.95 2026-03-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 4 2 — — $631,423.78 $1,489,833.29 $1,489,833.29 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 4 2 — — $614,793.95 $1,410,309.44 $1,410,309.44 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 4 2 — — $598,359.73 $1,297,043.03 $1,297,043.03 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 6 3 — — $645,093.12 $1,478,916.58 $1,270,460.72 2026-03-01
2067 OTHER Afamitresgene Autoleucel 25 17 — — $770,620.00 $1,132,811.40 $809,151.00 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 25 17 — — $587,649.60 $863,844.91 $617,032.08 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 25 17 — — $566,531.30 $832,801.01 $594,857.87 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 25 17 — — $562,201.20 $826,435.76 $590,311.26 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 25 17 — — $558,081.80 $820,380.25 $585,985.89 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 25 17 — — $532,192.20 $782,322.53 $558,801.81 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
9391 OTHER Brexucabtagene Car Pos T 25 17 — — $489,450.20 $719,491.79 $513,922.71 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 23 11 — — $1,854.72 $1,072,056.19 $320,310.43 2026-03-01
831 OTHER Obecbtge Autol Up To 400 26 17 — — $3,361.62 $409,027.50 $292,162.50 2026-03-01
897 OTHER Revakinagene, Per Implant 25 17 — — $265,000.00 $389,550.00 $278,250.00 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 25 12 — — $2,253.12 $695,721.34 $272,937.10 2026-03-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 5 2 — — $76,729.09 $221,874.56 $221,874.56 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 26 17 — — $7,355.78 $296,453.43 $211,752.45 2026-03-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $198,208.30 $198,208.30 $198,208.30 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 26 12 — — $2,253.12 $526,936.82 $191,268.85 2026-03-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $174,228.20 $174,228.20 $174,228.20 2026-03-01
1907 OTHER New Technology - Level 52 25 17 — — $135,426.50 $199,076.95 $142,197.83 2026-03-01
1908 OTHER New Technology - Level 52 25 17 — — $135,426.50 $199,076.95 $142,197.83 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 28 12 — — $2,253.12 $343,874.86 $137,930.10 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 6 3 — — $77,314.48 $170,328.19 $132,540.10 2026-03-01
1905 OTHER New Technology - Level 51 25 17 — — $122,105.90 $179,495.67 $128,211.19 2026-03-01
1906 OTHER New Technology - Level 51 25 17 — — $122,105.90 $179,495.67 $128,211.19 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 19 8 — — $31,692.56 $224,204.99 $126,721.76 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 3 1 — — $123,742.09 $123,742.09 $123,742.09 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 25 12 — — $2,253.12 $547,133.00 $123,322.58 2026-03-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $122,799.60 $122,799.60 $122,799.60 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 19 8 — — $18,507.00 $281,000.53 $121,560.00 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 6 3 — — $78,127.16 $150,585.06 $119,711.60 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 25 17 — — $111,503.00 $163,909.41 $117,078.15 2026-03-01
1903 OTHER New Technology - Level 50 25 17 — — $108,785.30 $159,914.39 $114,224.57 2026-03-01
1904 OTHER New Technology - Level 50 25 17 — — $108,785.30 $159,914.39 $114,224.57 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 26 12 — — $1,854.72 $298,356.39 $111,282.20 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 6 3 — — $68,835.85 $144,170.89 $111,221.96 2026-03-01
7 MS_DRG Lung Transplant 22 11 — — $2,253.12 $321,501.67 $106,547.36 2026-03-01
215 MS_DRG Other Heart Assist System Implant 26 12 — — $2,253.12 $461,974.00 $104,655.74 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 19 8 — — $25,908.01 $178,513.86 $103,592.38 2026-03-01
30230G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Peripheral Vein, Open Approac… 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30243U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30230U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30230X2 OTHER Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Peripheral Vein, Op… 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30230G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Peripheral Vein, Open Appro… 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30240X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Central Vein, Ope… 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30230Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Peripheral Vein,… 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30233U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30230U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30243G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Central Vein, Percutaneous Ap… 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30233Y3 OTHER Transfusion Of Allogeneic Unrelated Hamatopoietic Stem Cells Into Peripheral Vei… 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30240U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30240X2 OTHER Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Central Vein, Open … 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30240G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Central Vein, Open Approach 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30233Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Peripheral Vein,… 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30233X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Peripheral Vein, … 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30240Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Central Vein, Op… 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30243G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Central Vein, Percutaneous … 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30240G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Central Vein, Open Approach… 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30230Y3 OTHER Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Peripheral Vei… 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30243X2 OTHER Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Central Vein, Percu… 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30233U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30240Y3 OTHER Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Central Vein, … 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30243Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Central Vein, Pe… 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30233G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Peripheral Vein, Percutaneous… 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30233X2 OTHER Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Peripheral Vein, Pe… 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30233G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Peripheral Vein, Percutaneo… 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30240U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30243U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30243Y3 OTHER Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Central Vein, … 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30243X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Central Vein, Per… 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
30230X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Peripheral Vein, … 1 1 — — $101,551.00 $101,551.00 $101,551.00 2026-03-01
1901 OTHER New Technology - Level 49 25 17 — — $95,464.74 $140,333.17 $100,237.98 2026-03-01
1902 OTHER New Technology - Level 49 25 17 — — $95,464.74 $140,333.17 $100,237.98 2026-03-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 25 17 — — $95,081.00 $139,769.07 $99,835.05 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 23 9 — — $18,507.00 $242,867.79 $97,751.78 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 23 9 — — $18,507.00 $225,064.00 $96,926.99 2026-03-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $95,896.76 $95,896.76 $95,896.76 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 26 12 — — $2,253.12 $269,960.41 $89,951.03 2026-03-01
1585 OTHER New Technology - Level 48 25 17 — — $84,364.24 $124,015.43 $88,582.45 2026-03-01
1599 OTHER New Technology - Level 48 25 17 — — $84,364.24 $124,015.43 $88,582.45 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 22 11 — — $2,253.12 $255,968.47 $88,482.15 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 6 3 — — $54,756.23 $114,441.15 $88,352.14 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 23 9 — — $18,507.00 $232,853.94 $88,285.09 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 23 9 — — $24,164.82 $282,622.33 $87,699.00 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 19 8 — — $20,757.81 $152,019.09 $87,699.00 2026-03-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $85,943.29 $85,943.29 $85,943.29 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 23 9 — — $18,507.00 $264,336.00 $81,985.34 2026-03-01
1584 OTHER New Technology - Level 47 25 17 — — $75,483.84 $110,961.24 $79,258.03 2026-03-01
1598 OTHER New Technology - Level 47 25 17 — — $75,483.84 $110,961.24 $79,258.03 2026-03-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 19 8 — — $19,213.61 $143,500.69 $76,825.04 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 23 9 — — $18,507.00 $163,238.40 $75,602.80 2026-03-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 23 9 — — $18,507.00 $163,238.40 $75,602.80 2026-03-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 23 9 — — $17,147.49 $177,150.49 $74,944.24 2026-03-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 7 4 — — $2,253.12 $92,326.93 $74,471.21 2026-03-01
007 OTHER Lung Transplant 1 1 — — $73,703.22 $73,703.22 $73,703.22 2026-03-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 19 8 — — $16,583.87 $117,085.11 $72,480.91 2026-03-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 25 17 — — $68,801.70 $101,138.50 $72,241.79 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 19 8 — — $12,480.00 $214,980.75 $71,181.09 2026-03-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 19 8 — — $16,166.62 $117,804.25 $70,657.30 2026-03-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 23 9 — — $17,622.83 $192,455.78 $70,464.34 2026-03-01
C9150 HCPCS Xenon Xe-129 Hyperpolarized Gas, Diagnostic, Per Study Dose 2 1 — — $65,769.60 $74,786.40 $70,278.00 2026-03-01
1597 OTHER New Technology - Level 46 25 17 — — $66,603.45 $97,907.07 $69,933.62 2026-03-01
1583 OTHER New Technology - Level 46 25 17 — — $66,603.45 $97,907.07 $69,933.62 2026-03-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 23 9 — — $17,433.61 $225,064.00 $69,707.77 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 26 12 — — $2,253.12 $195,350.83 $69,097.99 2026-03-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 23 9 — — $17,272.58 $171,901.00 $69,063.89 2026-03-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 22 11 — — $2,253.12 $177,123.58 $68,336.43 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 23 9 — — $18,507.00 $189,799.74 $67,809.72 2026-03-01
717 OTHER Instill Adstiladrin, Tx D 26 17 — — $10,898.13 $94,483.94 $67,488.53 2026-03-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 19 8 — — $15,325.80 $110,227.59 $66,035.00 2026-03-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 19 8 — — $16,410.76 $141,679.50 $65,617.94 2026-03-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $65,322.80 $65,322.80 $65,322.80 2026-03-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 23 9 — — $18,507.00 $170,750.75 $64,867.00 2026-03-01
90288 CPT Botulism Immune Globulin, Human, For Intravenous Use 2 1 — — $60,394.20 $68,674.05 $64,534.12 2026-03-01
014 OTHER Allogeneic Bone Marrow Transplant 1 1 — — $62,912.59 $62,912.59 $62,912.59 2026-03-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $62,249.93 $62,249.93 $62,249.93 2026-03-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 26 12 — — $2,253.12 $189,171.64 $61,708.76 2026-03-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 23 9 — — $15,335.00 $132,392.09 $61,316.53 2026-03-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 19 8 — — $18,507.00 $165,999.05 $60,763.00 2026-03-01
1582 OTHER New Technology - Level 45 25 17 — — $57,723.04 $84,852.87 $60,609.19 2026-03-01
1596 OTHER New Technology - Level 45 25 17 — — $57,723.04 $84,852.87 $60,609.19 2026-03-01
5244 OTHER Level 4 Blood Product Exc 25 17 — — $57,068.58 $83,890.81 $59,922.01 2026-03-01
1643 OTHER Y90 Ibritumomab, Rx 25 17 — — $56,824.55 $83,532.09 $59,665.78 2026-03-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $58,338.86 $58,338.86 $58,338.86 2026-03-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 26 12 — — $2,253.12 $154,337.03 $58,079.69 2026-03-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 23 9 — — $14,493.60 $125,128.01 $57,952.22 2026-03-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 14 7 — — $1,854.72 $100,831.48 $57,339.96 2026-03-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 25 12 — — $1,854.72 $144,928.00 $57,205.20 2026-03-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 25 12 — — $1,854.72 $147,210.73 $57,205.20 2026-03-01
9273 OTHER Sipuleucel-t Auto Cd54+ 25 17 — — $54,404.11 $79,974.04 $57,124.32 2026-03-01
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 6 3 — — $33,097.56 $75,323.76 $56,707.35 2026-03-01
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 1 1 — — $56,346.71 $56,346.71 $56,346.71 2026-03-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 7 4 — — $2,253.12 $69,101.93 $55,737.85 2026-03-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 23 9 — — $13,690.16 $144,506.64 $54,739.68 2026-03-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $54,142.16 $54,142.16 $54,142.16 2026-03-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 23 9 — — $12,480.00 $162,645.06 $54,060.16 2026-03-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 26 12 — — $2,253.12 $151,967.39 $54,037.21 2026-03-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 26 12 — — $2,253.12 $143,445.05 $53,561.67 2026-03-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 19 8 — — $12,194.84 $87,399.15 $53,298.37 2026-03-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 23 9 — — $13,280.96 $171,901.00 $53,103.51 2026-03-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 26 12 — — $2,253.12 $167,106.29 $53,075.40 2026-03-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 26 12 — — $2,253.12 $137,114.00 $53,044.83 2026-03-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 23 9 — — $15,172.53 $130,989.42 $52,687.84 2026-03-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 23 9 — — $11,998.73 $148,534.68 $52,441.24 2026-03-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 26 12 — — $1,854.72 $171,592.35 $52,330.52 2026-03-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 25 17 — — $49,605.40 $72,919.94 $52,085.67 2026-03-01
429 OTHER Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 1 1 — — $51,936.57 $51,936.57 $51,936.57 2026-03-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 26 12 — — $2,253.12 $156,729.89 $51,624.01 2026-03-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 7 4 — — $2,253.12 $63,725.73 $51,401.39 2026-03-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $51,338.30 $51,338.30 $51,338.30 2026-03-01
1595 OTHER New Technology - Level 44 25 17 — — $48,842.64 $71,798.68 $51,284.77 2026-03-01
1581 OTHER New Technology - Level 44 25 17 — — $48,842.64 $71,798.68 $51,284.77 2026-03-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 23 9 — — $16,875.75 $145,693.86 $51,125.94 2026-03-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 19 8 — — $11,561.35 $87,699.00 $50,529.64 2026-03-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 26 12 — — $1,854.72 $159,747.86 $50,356.12 2026-03-01
28 MS_DRG Spinal Procedures With Mcc 26 12 — — $2,253.12 $149,162.06 $50,015.79 2026-03-01
471 MS_DRG Cervical Spinal Fusion With Mcc 23 9 — — $13,885.41 $138,914.03 $49,544.17 2026-03-01
10 MS_DRG Pancreas Transplant 22 11 — — $2,253.12 $178,143.93 $49,317.74 2026-03-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 6 3 — — $27,987.60 $64,205.31 $48,626.85 2026-03-01
231 OTHER Coronary Bypass With Ptca With Mcc 1 1 — — $48,594.68 $48,594.68 $48,594.68 2026-03-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 23 9 — — $12,144.23 $104,845.16 $48,558.35 2026-03-01
275 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 1 1 — — $48,437.85 $48,437.85 $48,437.85 2026-03-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 26 12 — — $2,253.12 $141,495.79 $48,418.97 2026-03-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 23 9 — — $12,480.00 $135,810.63 $47,862.21 2026-03-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 24 12 — — $2,253.12 $314,996.79 $47,282.02 2026-03-01
653 MS_DRG Major Bladder Procedures With Mcc 23 9 — — $12,480.00 $129,005.83 $47,065.84 2026-03-01
245 MS_DRG Aicd Generator Procedures 26 12 — — $2,253.12 $124,606.13 $46,426.46 2026-03-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 26 12 — — $2,253.12 $138,186.48 $46,113.54 2026-03-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 22 11 — — $2,253.12 $139,139.80 $45,907.51 2026-03-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 23 9 — — $15,708.54 $135,616.99 $45,638.00 2026-03-01
850 OTHER Acute Leukemia With Other Procedures 1 1 — — $45,527.52 $45,527.52 $45,527.52 2026-03-01
1142 OTHER Supprelin La Implant 25 17 — — $43,185.34 $63,482.45 $45,344.61 2026-03-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 26 12 — — $2,253.12 $112,876.37 $45,244.12 2026-03-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 26 12 — — $2,253.12 $110,795.96 $44,689.85 2026-03-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 23 9 — — $12,480.00 $123,817.19 $44,156.83 2026-03-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 26 12 — — $2,253.12 $135,403.49 $44,081.21 2026-03-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 26 12 — — $2,253.12 $121,677.19 $44,024.32 2026-03-01
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $44,017.32 $44,017.32 $44,017.32 2026-03-01
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 1 — — $43,440.34 $43,440.34 $43,440.34 2026-03-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 26 12 — — $2,253.12 $129,229.26 $43,188.29 2026-03-01
799 MS_DRG Splenic Procedures With Mcc 23 9 — — $12,480.00 $112,434.47 $43,075.29 2026-03-01
447 OTHER Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 1 1 — — $42,243.29 $42,243.29 $42,243.29 2026-03-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 26 12 — — $2,253.12 $156,064.26 $42,176.63 2026-03-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 25 17 — — $39,992.60 $58,789.12 $41,992.23 2026-03-01
1594 OTHER New Technology - Level 43 25 17 — — $39,962.24 $58,744.49 $41,960.35 2026-03-01
1580 OTHER New Technology - Level 43 25 17 — — $39,962.24 $58,744.49 $41,960.35 2026-03-01
834 MS_DRG Acute Leukemia With Mcc 26 12 — — $1,854.72 $136,292.26 $41,823.64 2026-03-01
010 OTHER Pancreas Transplant 1 1 — — $41,364.58 $41,364.58 $41,364.58 2026-03-01
6 MS_DRG Liver Transplant Without Mcc 22 11 — — $2,253.12 $115,118.16 $41,350.66 2026-03-01
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 25 17 — — $39,378.40 $57,886.25 $41,347.32 2026-03-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 26 12 — — $2,253.12 $122,605.68 $41,304.71 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 16 9 — — $2,253.12 $530,047.51 $41,213.25 2026-03-01
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 1 — — $41,127.77 $41,127.77 $41,127.77 2026-03-01
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $41,092.45 $41,092.45 $41,092.45 2026-03-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 23 9 — — $10,226.50 $88,288.70 $40,890.34 2026-03-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 23 9 — — $12,045.31 $103,991.15 $40,702.97 2026-03-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 19 8 — — $9,289.34 $66,049.66 $40,599.67 2026-03-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 26 12 — — $2,253.12 $149,684.02 $40,426.36 2026-03-01
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 1 — — $40,182.07 $40,182.07 $40,182.07 2026-03-01
252 MS_DRG Other Vascular Procedures With Mcc 23 9 — — $10,030.96 $108,683.00 $40,108.47 2026-03-01
360 OTHER Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 1 1 — — $39,943.18 $39,943.18 $39,943.18 2026-03-01
011 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 1 1 — — $39,498.11 $39,498.11 $39,498.11 2026-03-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 23 9 — — $12,480.00 $114,112.71 $39,269.06 2026-03-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 23 9 — — $11,863.29 $102,419.66 $39,250.58 2026-03-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 26 12 — — $2,253.12 $116,478.63 $39,202.46 2026-03-01
791 MS_DRG Prematurity With Major Problems 14 7 — — $1,854.72 $68,860.93 $39,159.67 2026-03-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 23 11 — — $2,253.12 $116,716.96 $39,101.26 2026-03-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 26 12 — — $2,253.12 $96,094.00 $38,959.95 2026-03-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 26 12 — — $2,253.12 $100,480.00 $38,818.15 2026-03-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 7 4 — — $2,253.12 $47,985.75 $38,705.46 2026-03-01
163 MS_DRG Major Chest Procedures With Mcc 26 12 — — $2,253.12 $111,265.17 $38,226.74 2026-03-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 26 12 — — $2,253.12 $120,038.73 $38,021.59 2026-03-01
218 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $37,903.77 $37,903.77 $37,903.77 2026-03-01
573 OTHER Skin Graft For Skin Ulcer Or Cellulitis With Mcc 1 1 — — $37,766.15 $37,766.15 $37,766.15 2026-03-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. 24 12 — — $2,253.12 $241,075.40 $37,712.43 2026-03-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 20 8 — — $10,746.98 $92,782.21 $37,414.51 2026-03-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 26 12 — — $2,253.12 $112,926.03 $37,303.29 2026-03-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 24 12 — — $2,253.12 $234,521.98 $36,962.66 2026-03-01
L8701 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand With S… 25 17 — — $34,970.10 $51,406.05 $36,718.61 2026-03-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 23 9 — — $9,181.22 $107,425.94 $36,710.81 2026-03-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 23 9 — — $9,164.25 $107,336.04 $36,642.98 2026-03-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 21 9 — — $9,155.34 $163,450.13 $36,607.33 2026-03-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 26 12 — — $1,854.72 $143,787.49 $36,385.03 2026-03-01
265 MS_DRG Aicd Lead Procedures 26 12 — — $2,253.12 $89,825.43 $36,208.62 2026-03-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 26 12 — — $2,253.12 $109,055.65 $36,033.51 2026-03-01
834 OTHER Acute Leukemia With Mcc 1 1 — — $35,936.55 $35,936.55 $35,936.55 2026-03-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 26 12 — — $2,253.12 $113,335.31 $35,724.18 2026-03-01
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $35,589.64 $35,589.64 $35,589.64 2026-03-01
023 OTHER Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 1 1 — — $35,515.38 $35,515.38 $35,515.38 2026-03-01
901 MS_DRG Wound Debridements For Injuries With Mcc 26 12 — — $2,253.12 $104,184.79 $35,433.44 2026-03-01
969 OTHER HIV With Extensive O.r. Procedures With Mcc 1 1 — — $35,286.35 $35,286.35 $35,286.35 2026-03-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 23 9 — — $10,748.13 $92,792.14 $35,278.51 2026-03-01
215 OTHER Other Heart Assist System Implant 1 1 — — $35,223.51 $35,223.51 $35,223.51 2026-03-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 26 12 — — $2,253.12 $107,432.03 $35,181.90 2026-03-01
955 OTHER Craniotomy For Multiple Significant Trauma 1 1 — — $35,003.32 $35,003.32 $35,003.32 2026-03-01
456 OTHER Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $35,002.28 $35,002.28 $35,002.28 2026-03-01
232 OTHER Coronary Bypass With Ptca Without Mcc 1 1 — — $34,948.27 $34,948.27 $34,948.27 2026-03-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 26 12 — — $2,253.12 $104,614.28 $34,315.38 2026-03-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 26 12 — — $2,253.12 $104,666.42 $34,156.35 2026-03-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 23 9 — — $11,942.37 $103,102.38 $34,137.66 2026-03-01
207 OTHER Respiratory System Diagnosis With Ventilator Support >96 Hours 1 1 — — $34,053.46 $34,053.46 $34,053.46 2026-03-01
472 MS_DRG Cervical Spinal Fusion With Cc 23 9 — — $8,471.81 $84,175.86 $33,874.26 2026-03-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 23 9 — — $8,722.27 $75,302.22 $33,537.75 2026-03-01
140 MS_DRG Major Head And Neck Procedures With Mcc 26 12 — — $2,253.12 $105,890.34 $33,279.87 2026-03-01
J1412 HCPCS Injection, Valoctocogene Roxaparvovec-rvox, Per Ml, Containing Nominal 2 X 10°13… 4 2 — — $14,001.76 $33,267.33 $33,267.33 2026-03-01
234 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 1 1 — — $33,037.66 $33,037.66 $33,037.66 2026-03-01
213 OTHER Endovascular Abdominal Aorta With Iliac Branch Procedures 1 1 — — $32,897.95 $32,897.95 $32,897.95 2026-03-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 26 12 — — $2,253.12 $108,683.00 $32,791.75 2026-03-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 26 12 — — $2,253.12 $104,308.92 $32,679.93 2026-03-01
235 OTHER Coronary Bypass Without Cardiac Catheterization With Mcc 1 1 — — $32,668.93 $32,668.93 $32,668.93 2026-03-01
1579 OTHER New Technology - Level 42 25 17 — — $31,081.84 $45,690.30 $32,635.93 2026-03-01
1593 OTHER New Technology - Level 42 25 17 — — $31,081.84 $45,690.30 $32,635.93 2026-03-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 26 12 — — $2,253.12 $87,551.37 $32,611.00 2026-03-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 26 12 — — $2,253.12 $103,162.46 $32,576.59 2026-03-01
008 OTHER Simultaneous Pancreas And Kidney Transplant 1 1 — — $32,308.00 $32,308.00 $32,308.00 2026-03-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 26 12 — — $2,253.12 $123,683.66 $32,186.08 2026-03-01
430 OTHER Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 1 1 — — $32,124.67 $32,124.67 $32,124.67 2026-03-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 26 12 — — $2,253.12 $99,348.45 $32,049.33 2026-03-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 19 8 — — $9,888.04 $85,366.68 $32,041.00 2026-03-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 18 6 — — $11,113.91 $52,719.87 $31,900.60 2026-03-01
461 OTHER Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 1 1 — — $31,837.48 $31,837.48 $31,837.48 2026-03-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 26 12 — — $2,253.12 $182,274.37 $31,762.12 2026-03-01
016 OTHER Autologous Bone Marrow Transplant With Cc/mcc 1 1 — — $31,663.51 $31,663.51 $31,663.51 2026-03-01
5166 OTHER Cochlear Implant Procedur 25 17 — — $29,914.76 $43,974.70 $31,410.50 2026-03-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 26 12 — — $2,253.12 $95,314.46 $31,408.86 2026-03-01
017 OTHER Autologous Bone Marrow Transplant Without Cc/mcc 1 1 — — $31,315.04 $31,315.04 $31,315.04 2026-03-01
L5856 HCPCS Addition To Lower Extremity Prosthesis, Endoskeletal Knee-shin System, Microproc… 25 17 — — $29,720.00 $43,688.40 $31,206.00 2026-03-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 23 9 — — $10,306.00 $94,736.10 $31,134.95 2026-03-01
L6880 HCPCS Electric Hand, Switch Or Myoelectric Controlled, Independently Articulating Digi… 25 17 — — $29,579.70 $43,482.16 $31,058.69 2026-03-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 26 12 — — $2,253.12 $88,740.54 $31,025.21 2026-03-01
L6700 HCPCS Upper Extremity Addition, External Powered Feature, Myoelectronic Control Module… 25 17 — — $29,510.20 $43,379.99 $30,985.71 2026-03-01
793 MS_DRG Full Term Neonate With Major Problems 14 7 — — $1,854.72 $70,737.26 $30,971.33 2026-03-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 26 12 — — $2,253.12 $86,578.19 $30,963.47 2026-03-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 26 12 — — $2,253.12 $82,962.00 $30,915.75 2026-03-01
021 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 1 — — $30,909.96 $30,909.96 $30,909.96 2026-03-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 23 9 — — $10,773.72 $93,013.09 $30,797.05 2026-03-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 26 12 — — $2,253.12 $77,325.54 $30,750.85 2026-03-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 7 4 — — $2,253.12 $38,111.66 $30,740.99 2026-03-01
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