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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

UT OF TEXAS SOUTHWESTERN UNIVERSITY HOSPITAL - WILLIAM P. CLEMENTS JR.

Dallas, TX · CCN 450044 · Rates published

15,368 distinct procedures filed
26 distinct payers
1,300,753 rate rows
2026-03-10 last MRF observed
Data quality

781,538 of 1,300,753 rate rows are consumer-grade (60.1%)

519,215 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
professional (physician) fee — not the facility price 515,270
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 2,930
placeholder amount (≤ $0.02) — excluded from medians 378
per-diem day rate — not a per-procedure price 274
exceeds 10× this hospital's gross charge — excluded from medians 205
percent-of-charges filed in the dollar field — excluded from medians 147
template filing: same amount across many unrelated codes — excluded 11
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/10906/753175630_the-university-of-texas-southwestern-medical-center-at-dallas_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/universityoftexassouthwesternmedicalcenter/10906
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-18
Content fingerprint 1e42992b25d55650… · 1,483,795,643 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 7 $4,377,500.00 $4,946,575.00 $4,596,375.00 nat. median
$4,505,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 7 $3,710,000.00 $4,192,300.00 $3,895,500.00 nat. median
$3,710,000
1.1× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 7 $3,685,266.67 $4,164,351.34 $3,869,530.00 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 7 $3,324,571.90 $3,756,766.25 $3,490,800.50 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 7 $3,261,355.00 $3,685,331.15 $3,424,422.75 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 7 $2,950,686.67 $3,334,275.94 $3,098,221.00 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 8 $2,452,115.60 $4,763,876.00 $2,574,721.38 nat. median
$2,469,189
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 8 $2,332,000.00 $4,584,712.00 $2,448,600.00 nat. median
$2,448,600
1.0× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel 0.5 X 10exp6 To 1 X 10exp8 Cell Susp 1 Each Bag 26 $296,814.31 $1,808,089.36 $1,274,651.64 nat. median
$675,122
1.9× median
Q2054
HCPCS 		Lisocabtagene Maraleucel 1.5 X To 70 X 10exp6 cell/mL Susp 1 Each Vial 26 $284,007.78 $1,730,076.48 $1,219,654.77 nat. median
$674,188
1.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel 300x10exp6 To 510x10exp6 Cell Susp 1 Each Bag 26 $282,384.05 $1,720,185.28 $1,212,681.75 nat. median
$625,184
1.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Susp 1 Each Bag 26 $269,164.52 $1,639,656.48 $1,155,911.24 nat. median
$634,511
1.8× median
Q2053
HCPCS 		Brexucabtagene Autoleucel 2x10exp6 To 2x10exp8 Cell Susp 1 Each Bag 26 $246,939.92 $1,504,272.00 $1,060,469.02 nat. median
$620,080
1.7× median
Q2057
HCPCS 		Afamitresgene Autoleucel 7 $763,350.00 $870,800.60 $805,297.90 nat. median
$824,563
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 7 $578,324.58 $653,506.78 $609,115.51 nat. median
$754,974
0.8× median
J9999
HCPCS 		Eloxatin (oxaliplatinum) 100 Mg Inj 1 $590,100.00 $590,100.00 $590,100.00 nat. median
$1,829
outlier · 322.7×
C9301
HCPCS 		Cellular Immunotherapy 1 $551,250.00 $551,250.00 $551,250.00 nat. median
$459,112
1.2× median
0100T
CPT 		Prosth Retina Receive&gen 3 $36,039.00 $673,747.21 $514,460.43 nat. median
$11,210
outlier · 45.9×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 11 $23,784.00 $1,263,668.80 $449,634.69 nat. median
$370,174
1.2× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 14 $5,569.00 $617,230.08 $316,973.36 nat. median
$202,986
1.6× median
5834
APR_DRG 		Neonate With Ecmo 5 $292,662.37 $330,182.98 $316,075.06 nat. median
$309,665
1.0× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 5 $284,702.23 $321,202.30 $307,478.11 nat. median
$187,294
1.6× median
J2326
HCPCS 		Nusinersen (pf) 12 Mg/5 Ml Soln 5 Ml Vial 25 $1,246.94 $478,733.10 $305,192.35 nat. median
$2,677
outlier · 114.0×
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 7 $270,375.00 $305,523.75 $283,893.75 nat. median
$324,450
0.9× median
5833
APR_DRG 		Neonate With Ecmo 5 $247,815.74 $279,586.81 $267,640.74 nat. median
$244,017
1.1× median
24
APR_DRG 		Heart And/or Lung Transplant 5 $238,391.73 $268,954.59 $257,462.82 nat. median
$234,738
1.1× median
J0225
HCPCS 		Vutrisiran 25 Mg/0.5 Ml Syrg 0.5 Ml Syringe 26 $4,983.86 $402,269.41 $256,446.75 nat. median
$8,223
outlier · 31.2×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 10 $23,784.00 $943,856.06 $225,900.68 nat. median
$265,286
0.9× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And… 14 $3,606.36 $406,944.00 $218,008.46 nat. median
$133,176
1.6× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 12 $23,784.00 $794,951.03 $201,501.00 nat. median
$206,368
1.0× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 5 $185,250.48 $209,000.41 $200,070.33 nat. median
$246,434
0.8× median
1614
APR_DRG 		Implantable Heart Assist Systems 5 $179,890.93 $202,953.73 $194,282.01 nat. median
$207,730
0.9× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 5 $168,529.47 $190,135.69 $182,011.65 nat. median
$164,834
1.1× median
Q2043
HCPCS 		Sipuleucel-t In Lr 50 Million Cell/250 Ml Susp 250 Ml Bag 26 $45,218.22 $275,453.64 $175,601.70 nat. median
$66,682
outlier · 2.6×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 12 $23,784.00 $371,285.90 $169,074.16 nat. median
$102,358
1.7× median
215
MS_DRG 		Other Heart Assist System Implant 12 $23,784.00 $361,091.97 $164,551.34 nat. median
$99,019
1.7× median
Q0485
HCPCS 		Set Impl Driveline Cbl Havd Pmp Heartware Oflw Graft Surg 26 $45,005.07 $274,155.20 $163,064.71 nat. median
$448
outlier · 364.0×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 $23,784.00 $351,238.42 $162,745.82 nat. median
$98,905
1.6× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 $23,784.00 $328,928.79 $150,281.26 nat. median
$93,672
1.6× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 5 $137,838.71 $155,510.23 $148,865.66 nat. median
$150,721
1.0× median
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 $136,617.21 $154,132.14 $147,546.45 nat. median
$162,982
0.9× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 11 $23,784.00 $439,011.16 $136,361.14 nat. median
$117,303
1.2× median
850
MS_DRG 		Acute Leukemia With Other Procedures 12 $23,784.00 $308,670.66 $136,244.00 nat. median
$83,442
1.6× median
7
MS_DRG 		Lung Transplant 11 $23,784.00 $437,905.33 $136,220.16 nat. median
$122,708
1.1× median
5832
APR_DRG 		Neonate With Ecmo 5 $123,480.93 $139,311.72 $133,359.27 nat. median
$156,126
0.9× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 12 $23,784.00 $288,807.46 $132,480.40 nat. median
$79,312
1.7× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 12 $23,784.00 $279,473.40 $130,464.72 nat. median
$82,712
1.6× median
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 $117,253.22 $132,285.60 $126,633.36 nat. median
$117,173
1.1× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 11 $23,784.00 $356,834.59 $125,884.99 nat. median
$100,136
1.3× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 $23,784.00 $283,782.79 $125,259.47 nat. median
$81,118
1.5× median

Other procedures at this hospital

Browse this hospital's 15,368 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
             
33270 CPT Hchg Insert/replace Defib System W/subq Electrode 61 25 $76,070.00 $38,035.00 50% off $21,943.90 $142,624.70 $47,191.93 2026-03-10
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 5 5 — — $43,729.95 $49,336.32 $47,228.30 2026-03-10
0266T CPT Apc 14 8 — — $28,030.00 $128,646.59 $47,250.53 2026-03-10
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 19 12 — — $23,695.43 $97,024.64 $47,390.86 2026-03-10
264 APR_DRG Other Nervous System And Related Procedures 5 5 — — $43,919.53 $49,550.20 $47,433.04 2026-03-10
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 5 — — $43,946.12 $49,580.20 $47,461.76 2026-03-10
13 APR_DRG Liver Transplant And/or Intestinal Transplant 5 5 — — $43,998.14 $49,638.89 $47,517.94 2026-03-10
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 19 12 — — $23,784.00 $97,546.09 $47,622.20 2026-03-10
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 19 12 — — $23,784.00 $95,959.24 $47,647.92 2026-03-10
J9281 HCPCS mitoMYcin 4 mg/mL Kit 1 Each Kit 50 22 $94,013.20 $47,006.60 50% off $317.42 $82,731.62 $47,786.91 2026-03-10
71 APR_DRG Allogeneic Bone Marrow Transplant 5 5 — — $44,321.81 $50,004.06 $47,867.51 2026-03-10
27137 CPT Revj Tot Hip Arthrp Actblr W/wo Agrft/algrft 6 3 — — $31,034.00 $62,104.23 $48,034.79 2026-03-10
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 19 12 — — $23,784.00 $109,165.53 $48,185.82 2026-03-10
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 19 12 — — $23,784.00 $109,212.44 $48,206.53 2026-03-10
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 19 12 — — $23,784.00 $99,253.60 $48,379.80 2026-03-10
61 APR_DRG Pancreas Transplant 5 5 — — $45,102.49 $50,884.83 $48,710.64 2026-03-10
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 19 12 — — $23,784.00 $110,639.97 $48,835.10 2026-03-10
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 17 11 — — $23,784.00 $187,960.00 $48,940.44 2026-03-10
37 MS_DRG Extracranial Procedures With Mcc 19 12 — — $23,784.00 $111,276.66 $49,116.11 2026-03-10
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 5 5 — — $45,513.25 $51,348.25 $49,154.27 2026-03-10
62 APR_DRG Pancreas Transplant 5 5 — — $45,692.43 $51,550.40 $49,347.78 2026-03-10
J9229 HCPCS Inotuzumab Ozogamicin 0.9 Mg (0.25 mg/mL Initial) Solr 1 Each Vial 64 26 $87,976.72 $43,988.36 50% off $2,698.05 $77,419.51 $49,354.94 2026-03-10
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 5 — — $45,724.03 $51,586.05 $49,381.90 2026-03-10
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 19 12 — — $23,784.00 $112,476.32 $49,645.59 2026-03-10
93656 CPT Hchg Tx Atrial Fib Pulm Vein Isol 64 23 $80,213.00 $40,106.50 50% off $2,648.00 $126,882.59 $49,762.14 2026-03-10
963 MS_DRG Other Multiple Significant Trauma With Mcc 21 14 — — $22,711.78 $78,240.96 $49,773.55 2026-03-10
27138 CPT Revj Tot Hip Arthrp Fem Only W/wo Algrft 6 3 — — $31,034.00 $64,531.09 $49,911.87 2026-03-10
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $46,301.25 $52,237.28 $50,005.30 2026-03-10
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 5 — — $46,303.18 $52,239.45 $50,007.39 2026-03-10
C2624 HCPCS Cardiomems Pa Sensor And Delivery System Cm2000-gsm 52 26 $81,215.00 $40,607.50 50% off $11,732.32 $71,469.20 $50,383.75 2026-03-10
9104 APR_DRG Craniotomy For Multiple Significant Trauma 5 5 — — $46,905.84 $52,919.37 $50,658.25 2026-03-10
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 19 12 — — $23,784.00 $104,584.03 $50,744.74 2026-03-10
665 MS_DRG Prostatectomy With Mcc 19 12 — — $23,784.00 $115,053.23 $50,782.94 2026-03-10
234 APR_DRG Spinal Procedures 5 5 — — $47,076.15 $53,111.52 $50,842.19 2026-03-10
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 19 12 — — $23,784.00 $115,234.19 $50,862.81 2026-03-10
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 12 10 — — $47,118.44 $199,216.95 $50,887.92 2026-03-10
22 APR_DRG Heart And/or Lung Transplant 5 5 — — $47,168.25 $53,215.42 $50,941.66 2026-03-10
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 19 12 — — $23,784.00 $103,405.16 $51,007.88 2026-03-10
J9226 HCPCS Supprelin La Implant 14 8 — — $45,560.39 $158,204.53 $51,027.63 2026-03-10
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 19 12 — — $23,784.00 $116,102.10 $51,245.87 2026-03-10
332 MS_DRG Rectal Resection With Mcc 19 12 — — $23,784.00 $116,229.44 $51,302.07 2026-03-10
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 19 12 — — $23,784.00 $105,868.92 $51,314.86 2026-03-10
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 19 12 — — $23,784.00 $106,369.92 $51,537.16 2026-03-10
4474 APR_DRG Other Kidney, Urinary Tract And Related Procedures 5 5 — — $47,784.00 $53,910.12 $51,606.67 2026-03-10
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 5 5 — — $47,896.13 $54,036.63 $51,727.77 2026-03-10
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 19 12 — — $23,784.00 $117,321.86 $51,784.23 2026-03-10
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 19 12 — — $23,784.00 $117,385.53 $51,804.93 2026-03-10
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 19 12 — — $23,784.00 $117,405.64 $51,821.20 2026-03-10
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 5 5 — — $48,158.54 $54,332.68 $52,011.18 2026-03-10
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 19 12 — — $23,784.00 $117,965.25 $52,069.67 2026-03-10
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 19 12 — — $23,784.00 $118,263.49 $52,201.31 2026-03-10
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 19 12 — — $23,784.00 $118,994.01 $52,522.25 2026-03-10
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 19 12 — — $23,784.00 $108,895.40 $52,657.62 2026-03-10
C1824 HCPCS Gentr Cardiac Pacemaker Optimizer Smart Ipg 52 26 $85,100.00 $42,550.00 50% off $12,293.55 $74,888.00 $52,793.92 2026-03-10
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 19 12 — — $23,784.00 $109,212.36 $52,798.24 2026-03-10
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 19 12 — — $23,784.00 $120,093.14 $53,007.36 2026-03-10
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 19 12 — — $23,784.00 $120,126.65 $53,016.23 2026-03-10
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 19 12 — — $23,784.00 $120,119.95 $53,019.19 2026-03-10
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 19 12 — — $23,784.00 $108,022.84 $53,023.58 2026-03-10
93653 CPT Hchg Ep Eval Mapping Ablatn Rt Atrial Arrythmia 64 23 $85,813.00 $42,906.50 50% off $2,648.00 $126,882.59 $53,236.24 2026-03-10
335 MS_DRG Peritoneal Adhesiolysis With Mcc 19 12 — — $23,784.00 $121,436.89 $53,590.09 2026-03-10
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 19 12 — — $23,784.00 $109,527.44 $53,770.56 2026-03-10
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 19 12 — — $23,784.00 $122,257.88 $53,964.27 2026-03-10
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 17 11 — — $23,784.00 $202,249.61 $54,022.15 2026-03-10
63 APR_DRG Pancreas Transplant 5 5 — — $50,517.53 $56,994.10 $54,558.88 2026-03-10
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $50,538.34 $57,017.58 $54,581.36 2026-03-10
27132 CPT Conv Prev Hip Tot Hip Arthrp W/wo Agrft/algrft 6 3 — — $31,034.00 $70,656.71 $54,649.76 2026-03-10
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 5 5 — — $51,037.73 $57,580.99 $55,120.69 2026-03-10
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 19 12 — — $23,784.00 $125,461.44 $55,344.18 2026-03-10
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 5 5 — — $51,386.07 $57,973.99 $55,496.90 2026-03-10
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 19 12 — — $23,784.00 $115,606.14 $55,635.00 2026-03-10
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 19 12 — — $23,784.00 $126,393.02 $55,789.36 2026-03-10
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 5 5 — — $51,701.27 $58,329.60 $55,837.32 2026-03-10
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 19 12 — — $23,784.00 $116,090.11 $55,849.78 2026-03-10
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 19 12 — — $23,784.00 $114,768.40 $56,137.08 2026-03-10
252 MS_DRG Other Vascular Procedures With Mcc 19 12 — — $23,784.00 $116,914.89 $56,215.70 2026-03-10
271 MS_DRG Other Major Cardiovascular Procedures With Cc 19 12 — — $23,784.00 $117,392.04 $56,427.40 2026-03-10
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 19 12 — — $23,784.00 $128,081.92 $56,533.30 2026-03-10
0916T CPT Hchg Ins Perm Card Cntrct Mod Defib Sys Pulse Gen 64 26 $91,518.00 $45,759.00 50% off $13,220.69 $99,167.27 $56,775.48 2026-03-10
0614T CPT Hchg Rmv/repl Cardiovert-defib Syst W Substern Electrode 64 26 $91,518.00 $45,759.00 50% off $13,220.69 $100,345.55 $56,775.48 2026-03-10
33230 CPT Hchg Ins Impl Defib Pulse Gen W/exist Dual Leads 64 22 $91,518.00 $45,759.00 50% off $2,648.00 $100,345.55 $56,775.48 2026-03-10
0923T CPT Hchg Rem/repl Perm Card Cntrct Mod Defib Pulse Gen 64 26 $91,518.00 $45,759.00 50% off $13,220.69 $99,167.27 $56,775.48 2026-03-10
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 19 12 — — $23,784.00 $129,047.01 $56,945.94 2026-03-10
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $52,811.40 $59,582.06 $57,036.26 2026-03-10
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 19 12 — — $23,784.00 $129,378.76 $57,105.67 2026-03-10
23474 CPT Revis Shoulder Arthrplsty Humeral&glenoid Compnt 6 3 — — $26,812.00 $73,873.02 $57,137.42 2026-03-10
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 19 12 — — $23,784.00 $129,512.80 $57,163.35 2026-03-10
264 MS_DRG Other Circulatory System O.r. Procedures 19 12 — — $23,784.00 $119,120.00 $57,194.08 2026-03-10
27487 CPT Revj Tot Knee Arthrp Fem&entire Tibial Compone 6 3 — — $31,034.00 $74,165.40 $57,363.57 2026-03-10
22857 CPT Tot Disc Arthrp 1ntrspc Lmbr 6 3 — — $31,034.00 $74,340.83 $57,499.25 2026-03-10
34 MS_DRG Carotid Artery Stent Procedures With Mcc 19 12 — — $23,784.00 $130,303.64 $57,513.87 2026-03-10
0811 RC Hchg Organ Acquisition Living Donor Liver Procurement 140 26 $113,548.00 $56,774.00 50% off $9,517.60 $141,350.88 $57,632.46 2026-03-10
J9266 HCPCS Pegaspargase 3750 Unit/5ml Injection 64 26 $102,980.18 $51,490.09 50% off $14,876.52 $90,622.56 $57,771.88 2026-03-10
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 19 12 — — $23,784.00 $131,938.92 $58,237.10 2026-03-10
265 MS_DRG Aicd Lead Procedures 19 12 — — $23,784.00 $121,577.31 $58,284.30 2026-03-10
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 19 12 — — $23,784.00 $132,240.51 $58,356.90 2026-03-10
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 15 12 — — $23,784.00 $223,796.54 $58,462.32 2026-03-10
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $54,455.99 $61,437.49 $58,812.41 2026-03-10
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 19 12 — — $23,784.00 $133,393.26 $58,877.51 2026-03-10
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 5 5 — — $54,517.26 $61,506.61 $58,878.58 2026-03-10
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 19 12 — — $23,784.00 $133,487.09 $58,918.92 2026-03-10
6904 APR_DRG Acute Leukemia 5 5 — — $54,853.27 $61,885.70 $59,241.47 2026-03-10
61715 CPT Hchg Mr Guid Focus US Stereo Ablat Intracran Les 55 25 $95,500.00 $47,750.00 50% off $12,470.31 $84,040.00 $59,245.82 2026-03-10
0398T CPT Hchg Mrgfus Stereotactic Lesion Ablation 55 25 $95,500.00 $47,750.00 50% off $1,253.00 $84,040.00 $59,245.82 2026-03-10
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 5 5 — — $55,350.34 $62,446.50 $59,778.31 2026-03-10
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 5 5 — — $55,596.18 $62,723.86 $60,043.82 2026-03-10
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 5 5 — — $55,660.15 $62,796.02 $60,112.90 2026-03-10
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 19 12 — — $23,784.00 $136,288.52 $60,156.85 2026-03-10
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 19 12 — — $23,784.00 $137,504.93 $60,693.72 2026-03-10
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 19 12 — — $23,784.00 $137,709.35 $60,783.94 2026-03-10
1784 APR_DRG External Heart Assist Systems 5 5 — — $56,519.43 $63,765.47 $61,040.93 2026-03-10
A9543 HCPCS Y90 Ibritumomab, Rx 12 7 — — $56,824.55 $234,774.51 $61,370.51 2026-03-10
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 19 12 — — $23,784.00 $140,406.90 $61,964.18 2026-03-10
83 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 5 5 — — $57,490.08 $64,860.56 $62,089.23 2026-03-10
27134 CPT Revj Tot Hip Arthrp Bth W/wo Agrft/algrft 6 3 — — $31,034.00 $80,817.33 $62,508.53 2026-03-10
140 MS_DRG Major Head And Neck Procedures With Mcc 19 12 — — $23,784.00 $141,713.79 $62,549.87 2026-03-10
J9118 HCPCS Calaspargase Pegol-mknl 750 unit/mL Soln 5 Ml Vial 48 23 $111,508.74 $55,754.37 50% off $130.34 $98,127.69 $62,556.40 2026-03-10
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 19 12 — — $23,784.00 $142,933.55 $63,089.70 2026-03-10
J0202 HCPCS Alemtuzumab 12 Mg/1.2 Ml Soln 1.2 Ml Vial 61 24 $112,802.50 $56,401.25 50% off $2,440.70 $99,266.20 $63,282.21 2026-03-10
23 APR_DRG Heart And/or Lung Transplant 5 5 — — $58,715.81 $66,243.44 $63,413.02 2026-03-10
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 19 12 — — $23,784.00 $133,270.84 $63,472.46 2026-03-10
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 19 12 — — $23,784.00 $131,667.49 $63,501.20 2026-03-10
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 21 14 — — $23,784.00 $187,960.00 $63,617.65 2026-03-10
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 19 12 — — $23,784.00 $144,686.13 $63,863.22 2026-03-10
J2507 HCPCS Pegloticase 1 Mg IV 60 23 $114,995.98 $57,497.99 50% off $3,638.86 $101,196.46 $64,512.75 2026-03-10
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 19 12 — — $23,784.00 $147,192.68 $64,969.51 2026-03-10
4414 APR_DRG Major Bladder Procedures 5 5 — — $60,344.60 $68,081.05 $65,172.11 2026-03-10
901 MS_DRG Wound Debridements For Injuries With Mcc 19 12 — — $23,784.00 $148,456.00 $65,527.10 2026-03-10
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 19 12 — — $23,784.00 $136,828.03 $66,091.48 2026-03-10
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 21 14 — — $1,581.39 $128,802.24 $66,145.32 2026-03-10
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 19 12 — — $23,784.00 $150,272.24 $66,328.71 2026-03-10
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 19 12 — — $23,784.00 $140,148.59 $66,523.92 2026-03-10
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 5 5 — — $61,639.31 $69,541.74 $66,570.39 2026-03-10
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 19 12 — — $23,784.00 $151,173.66 $66,726.56 2026-03-10
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 5 5 — — $61,814.64 $69,739.55 $66,759.75 2026-03-10
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 5 5 — — $61,814.64 $69,739.55 $66,759.75 2026-03-10
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 19 12 — — $23,784.00 $141,804.98 $67,258.82 2026-03-10
31 MS_DRG Ventricular Shunt Procedures With Mcc 21 14 — — $1,924.07 $120,689.28 $67,710.98 2026-03-10
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 19 12 — — $23,784.00 $153,867.87 $67,914.20 2026-03-10
163 MS_DRG Major Chest Procedures With Mcc 19 12 — — $23,784.00 $154,444.24 $68,170.07 2026-03-10
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $63,451.91 $71,586.72 $68,527.99 2026-03-10
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 5 — — $63,473.48 $71,611.06 $68,551.30 2026-03-10
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 19 12 — — $23,784.00 $145,168.87 $68,751.34 2026-03-10
4404 APR_DRG Kidney Transplant 5 5 — — $63,764.79 $71,939.72 $68,865.91 2026-03-10
1611 APR_DRG Implantable Heart Assist Systems 5 5 — — $63,922.78 $72,117.96 $69,036.53 2026-03-10
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 19 12 — — $23,784.00 $156,799.99 $69,209.81 2026-03-10
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 21 14 — — $30,915.13 $109,488.96 $69,649.25 2026-03-10
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 5 5 — — $64,965.87 $73,294.78 $70,163.07 2026-03-10
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 17 11 — — $23,784.00 $265,623.72 $70,181.50 2026-03-10
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 19 12 — — $23,784.00 $159,316.59 $70,310.18 2026-03-10
799 MS_DRG Splenic Procedures With Mcc 19 12 — — $23,784.00 $159,323.30 $70,323.49 2026-03-10
10 MS_DRG Pancreas Transplant 17 11 — — $23,784.00 $267,161.83 $70,571.95 2026-03-10
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 19 12 — — $23,784.00 $160,016.95 $70,629.65 2026-03-10
8634 APR_DRG Neonatal Aftercare 5 5 — — $65,595.88 $74,005.56 $70,843.48 2026-03-10
J9029 HCPCS Instill Adstiladrin Per Thr Dose 14 8 — — $63,431.05 $688,800.00 $71,042.78 2026-03-10
471 MS_DRG Cervical Spinal Fusion With Mcc 19 12 — — $23,784.00 $162,758.07 $71,839.47 2026-03-10
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 5 — — $66,629.34 $75,171.51 $71,959.61 2026-03-10
652 MS_DRG Kidney Transplant 21 14 — — $23,784.00 $187,960.00 $72,485.04 2026-03-10
J9269 HCPCS Tagraxofusp-erzs 1,000 mcg/mL Soln 1 Ml Vial 64 26 $129,635.54 $64,817.77 50% off $348.62 $114,079.28 $72,725.54 2026-03-10
1612 APR_DRG Implantable Heart Assist Systems 5 5 — — $67,400.00 $76,040.97 $72,791.93 2026-03-10
72 APR_DRG Allogeneic Bone Marrow Transplant 5 5 — — $67,498.26 $76,151.83 $72,898.05 2026-03-10
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 5 5 — — $68,031.17 $76,753.06 $73,473.59 2026-03-10
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 19 12 — — $23,784.00 $156,524.99 $73,789.74 2026-03-10
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 19 12 — — $23,784.00 $167,600.27 $73,969.23 2026-03-10
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 19 12 — — $23,784.00 $167,777.87 $74,056.49 2026-03-10
0274 RC Kit Heartmate Ii Pocket Patient Support 52 26 $119,820.06 $59,910.03 50% off $17,309.21 $105,441.65 $74,333.37 2026-03-10
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 19 12 — — $23,784.00 $158,546.06 $74,686.50 2026-03-10
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 19 12 — — $23,784.00 $170,187.24 $75,118.41 2026-03-10
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 19 12 — — $23,784.00 $160,345.59 $75,484.90 2026-03-10
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 5 5 — — $71,059.48 $80,169.61 $76,744.16 2026-03-10
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $71,640.94 $80,825.62 $77,372.14 2026-03-10
245 MS_DRG Aicd Generator Procedures 19 12 — — $23,784.00 $166,551.92 $78,238.48 2026-03-10
J9210 HCPCS Emapalumab-lzsg 5 mg/mL Soln 20 Ml Vial 59 22 $139,823.60 $69,911.80 50% off $381.64 $123,044.77 $78,441.04 2026-03-10
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 5 5 — — $72,836.23 $82,174.16 $78,663.06 2026-03-10
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 19 12 — — $23,784.00 $185,219.82 $78,991.91 2026-03-10
228 MS_DRG Other Cardiothoracic Procedures With Mcc 19 12 — — $23,784.00 $169,840.83 $79,697.68 2026-03-10
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 19 12 — — $23,784.00 $180,783.10 $79,796.49 2026-03-10
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 19 12 — — $23,784.00 $180,806.56 $79,805.36 2026-03-10
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 19 12 — — $23,784.00 $180,977.46 $79,880.79 2026-03-10
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 19 12 — — $23,784.00 $170,522.47 $80,000.12 2026-03-10
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 19 12 — — $23,784.00 $181,905.68 $80,290.47 2026-03-10
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 19 12 — — $23,784.00 $171,667.63 $80,508.20 2026-03-10
0915T CPT Hchg Ins Perm Card Cntrct Mod Defib Sys Pulse Gen & Leads 64 26 $130,077.00 $65,038.50 50% off $18,790.92 $141,648.06 $80,696.52 2026-03-10
0571T CPT Hchg Ins/repl Cardiovert-defib Syst W Substern Electrode 57 26 $130,077.00 $65,038.50 50% off $18,790.92 $142,624.70 $80,696.52 2026-03-10
0812 RC Hchg Organ Perfusion Set Liver Transplant 336 26 $160,626.00 $80,313.00 50% off $5,028.42 $283,219.20 $81,380.00 2026-03-10
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 19 12 — — $23,784.00 $170,709.99 $81,380.68 2026-03-10
834 MS_DRG Acute Leukemia With Mcc 19 12 — — $23,784.00 $185,206.42 $81,748.77 2026-03-10
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 5 5 — — $75,758.19 $85,470.72 $81,818.77 2026-03-10
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 19 12 — — $23,784.00 $174,942.91 $81,961.36 2026-03-10
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 19 12 — — $23,784.00 $172,566.45 $82,219.96 2026-03-10
653 MS_DRG Major Bladder Procedures With Mcc 19 12 — — $23,784.00 $186,791.44 $82,448.33 2026-03-10
6 MS_DRG Liver Transplant Without Mcc 20 13 — — $23,784.00 $187,960.00 $83,255.74 2026-03-10
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 5 5 — — $77,931.45 $87,922.61 $84,165.89 2026-03-10
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 21 14 — — $23,784.00 $187,960.00 $84,409.45 2026-03-10
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 5 5 — — $78,165.35 $88,186.49 $84,418.49 2026-03-10
64 APR_DRG Pancreas Transplant 5 5 — — $78,171.51 $88,193.44 $84,425.15 2026-03-10
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 19 12 — — $23,784.00 $180,522.13 $84,436.74 2026-03-10
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 19 12 — — $23,784.00 $181,323.06 $84,792.08 2026-03-10
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 19 12 — — $23,784.00 $192,313.89 $84,885.73 2026-03-10
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 19 12 — — $23,784.00 $195,091.87 $86,111.82 2026-03-10
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 5 5 — — $80,550.15 $90,877.04 $86,994.08 2026-03-10
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 19 12 — — $23,784.00 $183,303.05 $87,064.84 2026-03-10
2464 APR_DRG Gastrointestinal Vascular Insufficiency 5 5 — — $80,967.85 $91,348.29 $87,445.20 2026-03-10
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 19 12 — — $23,784.00 $184,479.25 $87,572.92 2026-03-10
C2642 HCPCS Seed Gma Tile Ther Bioresbl Clgn Tile Implanted W Cesium-131 360 26 $164,724.00 $82,362.00 50% off $69.01 $344,549.92 $88,388.54 2026-03-10
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 19 12 — — $23,784.00 $205,640.82 $88,603.93 2026-03-10
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $82,798.17 $93,413.26 $89,421.94 2026-03-10
28 MS_DRG Spinal Procedures With Mcc 19 12 — — $23,784.00 $203,710.64 $89,915.81 2026-03-10
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 5 5 — — $83,496.00 $94,200.56 $90,175.60 2026-03-10
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 5 5 — — $83,542.63 $94,253.16 $90,225.95 2026-03-10
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 21 14 — — $24,037.68 $164,306.88 $90,612.30 2026-03-10
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 19 12 — — $23,784.00 $206,347.88 $91,079.78 2026-03-10
84 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 5 5 — — $85,053.89 $95,958.17 $91,858.11 2026-03-10
14 APR_DRG Liver Transplant And/or Intestinal Transplant 5 5 — — $85,396.06 $96,344.21 $92,227.66 2026-03-10
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 19 12 — — $23,784.00 $200,545.30 $93,320.54 2026-03-10
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 19 12 — — $23,784.00 $211,913.89 $93,536.40 2026-03-10
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 19 12 — — $23,784.00 $202,764.04 $94,304.94 2026-03-10
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 19 12 — — $23,784.00 $204,178.45 $94,932.50 2026-03-10
207 MS_DRG Respiratory System Diagnosis With Ventilator Support &gt;96 Hours 19 12 — — $23,784.00 $216,732.63 $95,649.89 2026-03-10
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 17 11 — — $23,784.00 $369,270.15 $96,601.68 2026-03-10
232 MS_DRG Coronary Bypass With Ptca Without Mcc 19 12 — — $23,784.00 $208,196.71 $96,715.26 2026-03-10
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 19 12 — — $23,784.00 $210,844.88 $97,890.20 2026-03-10
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 19 12 — — $23,784.00 $211,117.54 $98,011.20 2026-03-10
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $93,266.04 $105,223.16 $100,727.23 2026-03-10
J1823 HCPCS Inebilizumab-cdon 10 mg/mL Soln 10 Ml Vial 60 23 $179,992.58 $89,996.29 50% off $494.43 $158,393.47 $100,975.84 2026-03-10
955 MS_DRG Craniotomy For Multiple Significant Trauma 19 12 — — $23,784.00 $228,802.93 $100,990.56 2026-03-10
1613 APR_DRG Implantable Heart Assist Systems 5 5 — — $93,761.58 $105,782.22 $101,262.41 2026-03-10
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 5 5 — — $93,872.17 $105,906.99 $101,381.84 2026-03-10
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 19 12 — — $23,784.00 $220,098.15 $101,995.68 2026-03-10
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 5 5 — — $94,720.66 $106,864.27 $102,298.22 2026-03-10
870 MS_DRG Septicemia Or Severe Sepsis With Mv &gt;96 Hours 19 12 — — $23,784.00 $233,112.32 $102,886.64 2026-03-10
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 20 13 — — $23,784.00 $202,249.61 $103,039.21 2026-03-10
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 5 5 — — $97,283.49 $109,755.67 $105,066.07 2026-03-10
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 19 12 — — $23,784.00 $227,245.14 $105,166.62 2026-03-10
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 19 12 — — $23,784.00 $224,657.74 $105,727.68 2026-03-10
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 5 5 — — $98,264.93 $110,862.93 $106,126.02 2026-03-10
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $98,689.18 $111,341.56 $106,584.21 2026-03-10
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $98,945.04 $111,630.23 $106,860.54 2026-03-10
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $99,399.34 $112,142.77 $107,351.19 2026-03-10
73 APR_DRG Allogeneic Bone Marrow Transplant 5 5 — — $100,460.54 $113,340.02 $108,497.28 2026-03-10
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 19 12 — — $23,784.00 $250,108.59 $110,395.52 2026-03-10
J7330 HCPCS Cultured Chondrocytes Implnt 4 1 — — $75,670.78 $164,360.60 $110,986.36 2026-03-10
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 19 12 — — $23,784.00 $240,857.49 $111,206.10 2026-03-10
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 19 12 — — $23,784.00 $237,877.44 $111,745.98 2026-03-10
33276 CPT Hchg Insert Phrenic Nerve Stim Sys 64 26 $181,321.00 $90,660.50 50% off $32,454.62 $198,812.21 $112,487.01 2026-03-10
5831 APR_DRG Neonate With Ecmo 5 5 — — $108,727.41 $122,666.74 $117,425.49 2026-03-10
2004 APR_DRG Cardiac Structural And Valvular Disorders 5 5 — — $108,960.53 $122,929.75 $117,677.26 2026-03-10
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 19 12 — — $23,784.00 $270,107.36 $119,223.67 2026-03-10
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 19 12 — — $23,784.00 $263,709.48 $121,345.00 2026-03-10
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 19 12 — — $23,784.00 $266,398.54 $122,538.12 2026-03-10
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 19 12 — — $23,784.00 $283,782.79 $125,259.47 2026-03-10
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 18 11 — — $23,784.00 $356,834.59 $125,884.99 2026-03-10
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 5 — — $117,253.22 $132,285.60 $126,633.36 2026-03-10
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 19 12 — — $23,784.00 $279,473.40 $130,464.72 2026-03-10
231 MS_DRG Coronary Bypass With Ptca With Mcc 19 12 — — $23,784.00 $288,807.46 $132,480.40 2026-03-10
5832 APR_DRG Neonate With Ecmo 5 5 — — $123,480.93 $139,311.72 $133,359.27 2026-03-10
7 MS_DRG Lung Transplant 18 11 — — $23,784.00 $437,905.33 $136,220.16 2026-03-10
850 MS_DRG Acute Leukemia With Other Procedures 19 12 — — $23,784.00 $308,670.66 $136,244.00 2026-03-10
14 MS_DRG Allogeneic Bone Marrow Transplant 18 11 — — $23,784.00 $439,011.16 $136,361.14 2026-03-10
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 5 — — $136,617.21 $154,132.14 $147,546.45 2026-03-10
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 5 5 — — $137,838.71 $155,510.23 $148,865.66 2026-03-10
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 19 12 — — $23,784.00 $328,928.79 $150,281.26 2026-03-10
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 19 12 — — $23,784.00 $351,238.42 $162,745.82 2026-03-10
Q0485 HCPCS Set Impl Driveline Cbl Havd Pmp Heartware Oflw Graft Surg 52 26 $311,540.00 $155,770.00 50% off $45,005.07 $274,155.20 $163,064.71 2026-03-10
215 MS_DRG Other Heart Assist System Implant 19 12 — — $23,784.00 $361,091.97 $164,551.34 2026-03-10
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 19 12 — — $23,784.00 $371,285.90 $169,074.16 2026-03-10
Q2043 HCPCS Sipuleucel-t In Lr 50 Million Cell/250 Ml Susp 250 Ml Bag 64 26 $313,015.50 $156,507.75 50% off $45,218.22 $275,453.64 $175,601.70 2026-03-10
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $168,529.47 $190,135.69 $182,011.65 2026-03-10
1614 APR_DRG Implantable Heart Assist Systems 5 5 — — $179,890.93 $202,953.73 $194,282.01 2026-03-10
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $185,250.48 $209,000.41 $200,070.33 2026-03-10
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 15 12 — — $23,784.00 $794,951.03 $201,501.00 2026-03-10
4 MS_DRG Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And … 21 14 — — $3,606.36 $406,944.00 $218,008.46 2026-03-10
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 16 10 — — $23,784.00 $943,856.06 $225,900.68 2026-03-10
J0225 HCPCS Vutrisiran 25 Mg/0.5 Ml Syrg 0.5 Ml Syringe 64 26 $457,124.33 $228,562.17 50% off $4,983.86 $402,269.41 $256,446.75 2026-03-10
24 APR_DRG Heart And/or Lung Transplant 5 5 — — $238,391.73 $268,954.59 $257,462.82 2026-03-10
5833 APR_DRG Neonate With Ecmo 5 5 — — $247,815.74 $279,586.81 $267,640.74 2026-03-10
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 8 7 — — $270,375.00 $305,523.75 $283,893.75 2026-03-10
J2326 HCPCS Nusinersen (pf) 12 Mg/5 Ml Soln 5 Ml Vial 62 25 $544,014.89 $272,007.45 50% off $1,246.94 $478,733.10 $305,192.35 2026-03-10
74 APR_DRG Allogeneic Bone Marrow Transplant 5 5 — — $284,702.23 $321,202.30 $307,478.11 2026-03-10
5834 APR_DRG Neonate With Ecmo 5 5 — — $292,662.37 $330,182.98 $316,075.06 2026-03-10
3 MS_DRG Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 21 14 — — $5,569.00 $617,230.08 $316,973.36 2026-03-10
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 18 11 — — $23,784.00 $1,263,668.80 $449,634.69 2026-03-10
0100T CPT Prosth Retina Receive&gen 6 3 — — $36,039.00 $673,747.21 $514,460.43 2026-03-10
C9301 HCPCS Cellular Immunotherapy 4 1 — — $551,250.00 $551,250.00 $551,250.00 2026-03-10
J9999 HCPCS Eloxatin (oxaliplatinum) 100 Mg Inj 4 1 — — $590,100.00 $590,100.00 $590,100.00 2026-03-10
Q2042 HCPCS Tisagenlecleucel Car-pos T 12 7 — — $578,324.58 $653,506.78 $609,115.51 2026-03-10
Q2057 HCPCS Afamitresgene Autoleucel 12 7 — — $763,350.00 $870,800.60 $805,297.90 2026-03-10
Q2053 HCPCS Brexucabtagene Autoleucel 2x10exp6 To 2x10exp8 Cell Susp 1 Each Bag 64 26 $1,709,400.00 $854,700.00 50% off $246,939.92 $1,504,272.00 $1,060,469.02 2026-03-10
Q2041 HCPCS Axicabtagene Ciloleucel Susp 1 Each Bag 64 26 $1,863,246.00 $931,623.00 50% off $269,164.52 $1,639,656.48 $1,155,911.24 2026-03-10
Q2055 HCPCS Idecabtagene Vicleucel 300x10exp6 To 510x10exp6 Cell Susp 1 Each Bag 64 26 $1,954,756.00 $977,378.00 50% off $282,384.05 $1,720,185.28 $1,212,681.75 2026-03-10
Q2054 HCPCS Lisocabtagene Maraleucel 1.5 X To 70 X 10exp6 cell/mL Susp 1 Each Vial 64 26 $1,965,996.00 $982,998.00 50% off $284,007.78 $1,730,076.48 $1,219,654.77 2026-03-10
Q2056 HCPCS Ciltacabtagene Autoleucel 0.5 X 10exp6 To 1 X 10exp8 Cell Susp 1 Each Bag 64 26 $2,054,647.00 $1,027,323.50 50% off $296,814.31 $1,808,089.36 $1,274,651.64 2026-03-10
J3392 HCPCS Inj, Exagamglogene Autotem 10 8 — — $2,332,000.00 $4,584,712.00 $2,448,600.00 2026-03-10
J3399 HCPCS Inj Onase Abepar-xioi Treat 10 8 — — $2,452,115.60 $4,763,876.00 $2,574,721.38 2026-03-10
J3393 HCPCS Inj, Betibeglogene Autotemce 8 7 — — $2,950,686.67 $3,334,275.94 $3,098,221.00 2026-03-10
J3394 HCPCS Inj, Lovotibeglogene Autotem 8 7 — — $3,261,355.00 $3,685,331.15 $3,424,422.75 2026-03-10
J1413 HCPCS Inj Delandistrogene Mox Rokl 8 7 — — $3,324,571.90 $3,756,766.25 $3,490,800.50 2026-03-10
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 8 7 — — $3,685,266.67 $4,164,351.34 $3,869,530.00 2026-03-10
J1414 HCPCS Inj, Beqvez, Per Tx Dose 8 7 — — $3,710,000.00 $4,192,300.00 $3,895,500.00 2026-03-10
J3391 HCPCS Inj, Atidarsagene Autotemcel 8 7 — — $4,377,500.00 $4,946,575.00 $4,596,375.00 2026-03-10
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