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

MEDICAL CITY NORTH HILLS

North Richland Hills, TX · CCN 450087 · Rates published

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You selected 93306 (CPT)

ECHO2D COMP W CF DOP

This hospital’s price: $2,555 across 31 payers · range $320-$8,661

Source: https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1682205_MEDICAL-CITY-NORTH-HILLS_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.

38,520 distinct procedures filed
62 distinct payers
2,055,031 rate rows
2026-07-17 last MRF observed
Data quality

1,994,837 of 2,055,031 rate rows are consumer-grade (97.1%)

60,194 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 23,654
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 19,043
per-diem day rate — not a per-procedure price 12,908
template filing: same amount across many unrelated codes — excluded 3,267
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 949
placeholder amount (≤ $0.02) — excluded from medians 257
exceeds 10× this hospital's gross charge — excluded from medians 109
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 7
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1682205_MEDICAL-CITY-NORTH-HILLS_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page https://medicalcityhealthcare.com/about/legal/pricing-transparency-cms-required-file-of-standard-charges.dot
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-10-22
Content fingerprint e338b13c4c5c3dc2… · 878,994,658 bytes · first seen 2026-05-08

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $4,850,948.67 $4,850,948.67 $4,850,948.67 nat. median
$2,994,107
1.6× median
845
OTHER 		Inj, Atidarsagene Autotem 21 $6,154.88 $4,955,500.00 $4,543,292.50 nat. median
$17,146
outlier · 265.0×
00845
OTHER 		Inj, Atidarsagene Autotem 2 $4,369,850.00 $4,505,000.00 $4,437,425.00 nat. median
$4,414,900
1.0× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 $4,271,819.03 $4,271,819.03 $4,271,819.03 nat. median
$2,466,282
1.7× median
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 1 $3,847,800.00 $3,847,800.00 $3,847,800.00 nat. median
$2,401,960
1.6× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 21 $3,666,840.67 $4,790,847.10 $3,740,546.00 nat. median
$3,758,972
1.0× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 2 $3,574,708.99 $3,685,267.00 $3,629,988.00 nat. median
$3,574,709
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 25 $7,238.97 $4,991,790.00 $3,494,253.00 nat. median
$3,325,455
1.1× median
748
OTHER 		Inj, Lovotibeglogene Auto 25 $13,779.30 $4,878,762.00 $3,415,133.40 nat. median
$3,252,508
1.1× median
908
OTHER 		Topi Adm Prad Zami Per Tr 22 $11,144.28 $4,336,566.00 $3,402,536.40 nat. median
$30,329
outlier · 112.2×
906
OTHER 		Inj Elivaldogene Autoteme 23 $9,847.28 $4,770,000.00 $3,307,200.00 nat. median
$24,952
outlier · 132.5×
00908
OTHER 		Topi Adm Prad Zami Per Tr 2 $3,235,745.40 $3,335,820.00 $3,285,782.70 nat. median
$14,694
outlier · 223.6×
00714
OTHER 		Inj Delandistrogene Mox R 2 $3,228,024.20 $3,327,860.00 $3,277,942.10 nat. median
$3,228,024
1.0× median
00748
OTHER 		Inj, Lovotibeglogene Auto 2 $3,154,932.76 $3,252,508.00 $3,203,720.38 nat. median
$3,187,420
1.0× median
00906
OTHER 		Inj Elivaldogene Autoteme 2 $3,084,600.00 $3,180,000.00 $3,132,300.00 nat. median
$3,084,600
1.0× median
746
OTHER 		Inj, Betibeglogene Autote 25 $12,746.00 $4,409,953.50 $3,086,967.45 nat. median
$2,939,969
1.1× median
00746
OTHER 		Inj, Betibeglogene Autote 2 $2,851,769.93 $2,939,969.00 $2,895,869.46 nat. median
$2,878,960
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 24 $2,455,110.00 $4,919,063.90 $2,718,430.05 nat. median
$2,588,981
1.0× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 2 $2,511,311.57 $2,588,981.00 $2,550,146.29 nat. median
$2,511,312
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 2 $1,271,523.00 $4,067,128.80 $2,528,215.20 nat. median
$809,217
outlier · 3.1×
824
OTHER 		Inj, Exagamglogene Autote 27 $14,925.24 $4,617,360.00 $2,448,600.00 nat. median
$2,262,040
1.1× median
00824
OTHER 		Inj, Exagamglogene Autote 2 $2,262,040.00 $2,332,000.00 $2,297,020.00 nat. median
$2,285,360
1.0× median
Q2058
HCPCS 		Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,… 2 $459,112.50 $2,937,060.00 $1,825,740.00 nat. median
$319,951
outlier · 5.7×
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 4 $536,573.93 $2,570,427.00 $1,597,833.00 nat. median
$646,415
outlier · 2.5×
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 4 $511,793.34 $2,318,912.10 $1,441,485.90 nat. median
$622,245
outlier · 2.3×
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 4 $500,948.74 $2,268,056.34 $1,409,872.86 nat. median
$640,950
outlier · 2.2×
C9301
HCPCS 		Obecabtagene Autoleucel, Up To 400 Million Cd19 Car-positive Viable T Cells, Inc… 1 $959,962.50 $1,544,287.50 $1,405,162.50 nat. median
$459,112
outlier · 3.1×
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 4 $23.68 $2,132,254.50 $1,325,455.50 nat. median
$738,272
1.8× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 4 $474,717.03 $2,061,869.40 $1,281,702.60 nat. median
$591,650
outlier · 2.2×
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 4 $6.22 $1,966,642.50 $1,222,507.50 nat. median
$608,101
outlier · 2.0×
2067
OTHER 		Afamitresgene Autoleucel 28 $766,766.90 $2,019,024.40 $809,151.00 nat. median
$789,886
1.0× median
9498
OTHER 		Ciltacabtagene Car-pos T 26 $565,868.90 $1,539,641.95 $617,032.08 nat. median
$587,650
1.1× median
9194
OTHER 		Tisagenlecleucel Car-pos 26 $563,698.64 $1,484,312.01 $594,857.87 nat. median
$577,003
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 26 $559,390.19 $1,472,967.14 $590,311.26 nat. median
$562,201
1.1× median
9422
OTHER 		Idecabtagene Vicleucel Ca 26 $555,291.39 $1,462,174.32 $585,985.89 nat. median
$562,826
1.0× median
09498
OTHER 		Ciltacabtagene Car-pos T 2 $570,020.11 $587,649.60 $578,834.85 nat. median
$570,020
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 27 $529,531.24 $1,394,343.56 $558,801.81 nat. median
$533,230
1.0× median
09194
OTHER 		Tisagenlecleucel Car-pos 2 $549,535.36 $566,531.30 $558,033.33 nat. median
$549,535
1.0× median
09413
OTHER 		Lisocabtagene Car Pos T 2 $545,335.16 $562,201.20 $553,768.18 nat. median
$545,335
1.0× median
09422
OTHER 		Idecabtagene Vicleucel Ca 2 $541,339.35 $558,081.80 $549,710.57 nat. median
$541,339
1.0× median
09035
OTHER 		Axicabtagene Ciloleucel C 2 $516,226.43 $532,192.20 $524,209.31 nat. median
$516,226
1.0× median
9391
OTHER 		Brexucabtagene Car Pos T 26 $487,002.95 $1,282,359.52 $513,922.71 nat. median
$492,768
1.0× median
09391
OTHER 		Brexucabtagene Car Pos T 2 $474,766.69 $489,450.20 $482,108.45 nat. median
$474,767
1.0× median
J9029
HCPCS 		Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 5 $61,338.53 $888,000.00 $405,600.00 nat. median
$68,423
outlier · 5.9×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 21 $346,816.12 $1,273,072.13 $371,588.70 nat. median
$359,358
1.0× median
J3402
HCPCS 		Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 $332,753.88 $332,753.88 $332,753.88 nat. median
$209,753
1.6× median
90288
CPT 		Botulism Immune Globulin, Human, For Intravenous Use 1 $294,713.96 $416,525.16 $329,245.80 nat. median
$51,570
outlier · 6.4×
Q2043
HCPCS 		Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 5 $55,306.59 $478,449.94 $307,485.36 nat. median
$65,720
outlier · 4.7×
437822
CDM 		Valve Aor Tavr 23mm 25 $91,813.50 $680,100.00 $304,004.70 nat. median
$200,000
1.5× median
248063
CDM 		Kit Cath Rt Heart 34 $65,436.00 $934,800.00 $298,201.20 nat. median
$5,511
outlier · 54.1×

Other procedures at this hospital

Browse this hospital's 38,520 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 3 1 — — $4,850,948.67 $4,850,948.67 $4,850,948.67 2026-03-01
845 OTHER Inj, Atidarsagene Autotem 33 21 $23,739.10 — $6,154.88 $4,955,500.00 $4,543,292.50 2026-07-17
00845 OTHER Inj, Atidarsagene Autotem 2 2 — — $4,369,850.00 $4,505,000.00 $4,437,425.00 2026-03-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 3 1 $4,463,735.93 — $4,271,819.03 $4,271,819.03 $4,271,819.03 2026-07-17
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 3 1 — — $3,847,800.00 $3,847,800.00 $3,847,800.00 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 32 21 — — $3,666,840.67 $4,790,847.10 $3,740,546.00 2026-03-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 2 2 — — $3,574,708.99 $3,685,267.00 $3,629,988.00 2026-03-01
714 OTHER Inj Delandistrogene Mox R 43 25 $26,903.38 — $7,238.97 $4,991,790.00 $3,494,253.00 2026-07-17
748 OTHER Inj, Lovotibeglogene Auto 43 25 $39,790.72 — $13,779.30 $4,878,762.00 $3,415,133.40 2026-07-17
908 OTHER Topi Adm Prad Zami Per Tr 33 22 $57,740.35 — $11,144.28 $4,336,566.00 $3,402,536.40 2026-07-17
906 OTHER Inj Elivaldogene Autoteme 38 23 $50,196.06 — $9,847.28 $4,770,000.00 $3,307,200.00 2026-07-17
00908 OTHER Topi Adm Prad Zami Per Tr 2 2 — — $3,235,745.40 $3,335,820.00 $3,285,782.70 2026-03-01
00714 OTHER Inj Delandistrogene Mox R 2 2 — — $3,228,024.20 $3,327,860.00 $3,277,942.10 2026-03-01
00748 OTHER Inj, Lovotibeglogene Auto 2 2 — — $3,154,932.76 $3,252,508.00 $3,203,720.38 2026-03-01
00906 OTHER Inj Elivaldogene Autoteme 2 2 — — $3,084,600.00 $3,180,000.00 $3,132,300.00 2026-03-01
746 OTHER Inj, Betibeglogene Autote 43 25 $43,895.58 — $12,746.00 $4,409,953.50 $3,086,967.45 2026-07-17
00746 OTHER Inj, Betibeglogene Autote 2 2 — — $2,851,769.93 $2,939,969.00 $2,895,869.46 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 39 24 — — $2,455,110.00 $4,919,063.90 $2,718,430.05 2026-03-01
09141 OTHER Inj Onase Abepar-xioi Tre 2 2 — — $2,511,311.57 $2,588,981.00 $2,550,146.29 2026-03-01
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 9 2 — — $1,271,523.00 $4,067,128.80 $2,528,215.20 2026-03-01
824 OTHER Inj, Exagamglogene Autote 43 27 $64,304.75 — $14,925.24 $4,617,360.00 $2,448,600.00 2026-07-17
00824 OTHER Inj, Exagamglogene Autote 2 2 — — $2,262,040.00 $2,332,000.00 $2,297,020.00 2026-03-01
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 9 2 — — $459,112.50 $2,937,060.00 $1,825,740.00 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 12 4 $1,556,150.40 — $536,573.93 $2,570,427.00 $1,597,833.00 2026-07-17
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 12 4 $1,403,881.92 — $511,793.34 $2,318,912.10 $1,441,485.90 2026-07-17
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 12 4 $1,373,093.57 — $500,948.74 $2,268,056.34 $1,409,872.86 2026-07-17
C9301 HCPCS Obecabtagene Autoleucel, Up To 400 Million Cd19 Car-positive Viable T Cells, Inc… 6 1 — — $959,962.50 $1,544,287.50 $1,405,162.50 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 13 4 $1,290,878.40 — $23.68 $2,132,254.50 $1,325,455.50 2026-07-17
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 12 4 $1,248,266.88 — $474,717.03 $2,061,869.40 $1,281,702.60 2026-07-17
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 13 4 $1,190,616.00 — $6.22 $1,966,642.50 $1,222,507.50 2026-07-17
2067 OTHER Afamitresgene Autoleucel 47 28 — — $766,766.90 $2,019,024.40 $809,151.00 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 43 26 $1,096,795.50 — $565,868.90 $1,539,641.95 $617,032.08 2026-07-17
9194 OTHER Tisagenlecleucel Car-pos 43 26 $1,039,331.61 — $563,698.64 $1,484,312.01 $594,857.87 2026-07-17
9413 OTHER Lisocabtagene Car Pos T 43 26 $995,962.22 — $559,390.19 $1,472,967.14 $590,311.26 2026-07-17
9422 OTHER Idecabtagene Vicleucel Ca 43 26 $1,018,294.30 — $555,291.39 $1,462,174.32 $585,985.89 2026-07-17
09498 OTHER Ciltacabtagene Car-pos T 2 2 — — $570,020.11 $587,649.60 $578,834.85 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 44 27 $968,406.12 — $529,531.24 $1,394,343.56 $558,801.81 2026-07-17
09194 OTHER Tisagenlecleucel Car-pos 2 2 — — $549,535.36 $566,531.30 $558,033.33 2026-03-01
09413 OTHER Lisocabtagene Car Pos T 2 2 — — $545,335.16 $562,201.20 $553,768.18 2026-03-01
09422 OTHER Idecabtagene Vicleucel Ca 2 2 — — $541,339.35 $558,081.80 $549,710.57 2026-03-01
09035 OTHER Axicabtagene Ciloleucel C 2 2 — — $516,226.43 $532,192.20 $524,209.31 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 43 26 $968,532.60 — $487,002.95 $1,282,359.52 $513,922.71 2026-07-17
09391 OTHER Brexucabtagene Car Pos T 2 2 — — $474,766.69 $489,450.20 $482,108.45 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 18 5 — — $61,338.53 $888,000.00 $405,600.00 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 38 21 — — $346,816.12 $1,273,072.13 $371,588.70 2026-03-01
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 3 1 — — $332,753.88 $332,753.88 $332,753.88 2026-03-01
90288 CPT Botulism Immune Globulin, Human, For Intravenous Use 6 1 — — $294,713.96 $416,525.16 $329,245.80 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 19 5 $295,816.58 — $55,306.59 $478,449.94 $307,485.36 2026-07-17
437822 CDM Valve Aor Tavr 23mm 44 25 $680,100.00 $680,100.00 $91,813.50 $680,100.00 $304,004.70 2026-03-01
248063 CDM Kit Cath Rt Heart 64 34 $934,800.00 $934,800.00 $65,436.00 $934,800.00 $298,201.20 2026-03-01
74 APR_DRG Allogeneic Bone Marrow Transplant 33 10 — — $273,358.62 $478,378.00 $295,227.00 2026-03-01
5834 APR_DRG Neonate With Ecmo 24 9 — — $281,001.60 $351,252.00 $295,051.68 2026-03-01
831 OTHER Obecbtge Autol Up To 400 46 28 $33,546.40 — $4,214.59 $729,015.00 $292,162.50 2026-07-17
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 17 4 $385,945.21 — $93,760.51 $582,739.61 $289,037.14 2026-07-17
897 OTHER Revakinagene, Per Implant 42 26 $23,901.95 — $263,675.00 $694,300.00 $278,250.00 2026-07-17
00831 OTHER Obecbtge Autol Up To 400 2 2 — — $269,902.50 $278,250.00 $274,076.25 2026-03-01
00897 OTHER Revakinagene, Per Implant 2 2 — — $257,050.00 $265,000.00 $261,025.00 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 58 27 — — $225,717.62 $842,426.46 $254,508.13 2026-03-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 $1,014,848.78 — $248,501.39 $256,187.00 $252,344.20 2026-07-17
5833 APR_DRG Neonate With Ecmo 24 9 — — $237,941.83 $297,427.29 $249,838.92 2026-03-01
24 APR_DRG Heart And/or Lung Transplant 33 10 — — $228,893.30 $400,563.00 $247,205.00 2026-03-01
C1822 HCPCS Pulse Gen Imp 39 23 $446,310.00 $446,310.00 $60,251.85 $446,310.00 $223,155.00 2026-03-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 2 2 $484,340.00 — $218,436.73 $225,192.50 $221,814.61 2026-07-17
886 OTHER Inj. Remestemcel-l-rknd/ 46 28 $38,325.11 — $9,222.23 $528,372.78 $211,752.45 2026-07-17
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 17 4 $227,599.37 — $131,717.55 $574,167.94 $202,348.70 2026-07-17
263483 CDM Device Clsr 31mm 39 23 $399,330.00 $399,330.00 $53,909.55 $399,330.00 $199,665.00 2026-03-01
00886 OTHER Inj. Remestemcel-l-rknd/ 2 2 — — $195,618.93 $201,669.00 $198,643.96 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 73 32 — — $152,587.73 $638,050.74 $193,157.00 2026-03-01
263480 CDM Device Clsr 20mm 39 23 $385,390.00 $385,390.00 $52,027.65 $385,390.00 $192,695.00 2026-03-01
480582 CDM Device Clsr 20mm 39 23 $385,390.00 $385,390.00 $52,027.65 $385,390.00 $192,695.00 2026-03-01
480578 CDM Device Clsr 31mm 39 23 $385,390.00 $385,390.00 $52,027.65 $385,390.00 $192,695.00 2026-03-01
480581 CDM Device Clsr 24mm 39 23 $385,390.00 $385,390.00 $52,027.65 $385,390.00 $192,695.00 2026-03-01
263484 CDM Device Clsr 35mm 39 23 $385,390.00 $385,390.00 $52,027.65 $385,390.00 $192,695.00 2026-03-01
480580 CDM Device Clsr 27mm 39 23 $385,390.00 $385,390.00 $52,027.65 $385,390.00 $192,695.00 2026-03-01
263482 CDM Device Clsr 27mm 39 23 $385,390.00 $385,390.00 $52,027.65 $385,390.00 $192,695.00 2026-03-01
480577 CDM Device Clsr 35mm 39 23 $385,390.00 $385,390.00 $52,027.65 $385,390.00 $192,695.00 2026-03-01
263481 CDM Device Clsr 24mm 39 23 $385,390.00 $385,390.00 $52,027.65 $385,390.00 $192,695.00 2026-03-01
263485 CDM Device Clsr 40mm 39 23 $385,390.00 $385,390.00 $52,027.65 $385,390.00 $192,695.00 2026-03-01
281733 CDM Endplate Spn 18x50mm 44 25 $420,525.00 $420,525.00 $56,770.88 $420,525.00 $187,974.67 2026-03-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 24 9 — — $177,869.40 $222,336.75 $186,762.87 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 19 5 $216,892.20 — $43,855.64 $389,632.46 $185,582.55 2026-07-17
473595 CDM Stent Thor 20f 26x21x10 44 25 $413,424.00 $413,424.00 $55,812.24 $413,424.00 $184,800.53 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 62 28 — — $9,825.00 $641,817.38 $184,721.25 2026-03-01
265596 CDM Kit Lo Prfl Comp Shth 7f 64 34 $570,000.00 $570,000.00 $39,900.00 $570,000.00 $181,830.00 2026-03-01
862710 CDM Set Vntrc 17.4x13.8in 64 34 $570,000.00 $570,000.00 $39,900.00 $570,000.00 $181,830.00 2026-03-01
860714 CDM Kit Generator Nrstm Ipg 44 25 $406,377.00 $406,377.00 $54,860.89 $406,377.00 $181,650.52 2026-03-01
1614 APR_DRG Implantable Heart Assist Systems 29 10 — — $172,723.39 $215,904.24 $181,359.56 2026-03-01
483550 CDM Stnt Thorac 26x26mm 10cm 44 25 $398,992.00 $398,992.00 $53,863.92 $398,992.00 $178,349.42 2026-03-01
874637 CDM Generator Nrstm Implant 44 25 $384,925.00 $384,925.00 $51,964.88 $384,925.00 $172,061.48 2026-03-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 24 9 — — $161,814.62 $202,268.27 $169,905.35 2026-03-01
850516 CDM Device Vntrc Asst 2 Lvas 44 25 $373,750.00 $373,750.00 $50,456.25 $373,750.00 $167,066.25 2026-03-01
1908 OTHER New Technology - Level 52 47 28 $339,838.95 — $145,692.90 $393,510.11 $157,704.44 2026-07-17
1907 OTHER New Technology - Level 52 47 28 $339,838.95 — $145,692.90 $393,510.11 $157,704.44 2026-07-17
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 2 $568,197.06 — $153,958.59 $158,720.20 $156,339.40 2026-07-17
C1833 HCPCS Monitor Imp Cardiac 40 23 $321,859.00 $321,859.00 $551.25 $321,859.00 $152,883.02 2026-07-17
751731 CDM Set Pump Asst 2.5in 64 34 $456,000.00 $456,000.00 $31,920.00 $456,000.00 $145,464.00 2026-03-01
216652 CDM Graft Endo Aaa 32x14mm 44 25 $324,136.00 $324,136.00 $43,758.36 $324,136.00 $144,888.79 2026-03-01
01907 OTHER New Technology - Level 52 2 2 — — $141,322.11 $145,692.90 $143,507.51 2026-03-01
01908 OTHER New Technology - Level 52 2 2 — — $141,322.11 $145,692.90 $143,507.51 2026-03-01
1905 OTHER New Technology - Level 51 47 28 $306,412.27 — $131,362.50 $354,804.33 $142,192.58 2026-07-17
1906 OTHER New Technology - Level 51 47 28 $306,412.27 — $131,362.50 $354,804.33 $142,192.58 2026-07-17
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 24 9 — — $132,346.69 $165,433.36 $138,964.02 2026-03-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 24 9 — — $131,173.87 $163,967.34 $137,732.56 2026-03-01
01906 OTHER New Technology - Level 51 2 2 — — $127,421.63 $131,362.50 $129,392.07 2026-03-01
01905 OTHER New Technology - Level 51 2 2 — — $127,421.63 $131,362.50 $129,392.07 2026-03-01
C1820 HCPCS Programmer Pt Prodigy 683 32 $352,350.00 $352,350.00 $2,816.64 $430,424.00 $127,534.00 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 73 32 — — $103,537.02 $416,386.94 $127,422.45 2026-03-01
1903 OTHER New Technology - Level 50 47 28 $272,985.60 — $117,032.10 $316,098.55 $126,680.72 2026-07-17
1904 OTHER New Technology - Level 50 47 28 $272,985.60 — $117,032.10 $316,098.55 $126,680.72 2026-07-17
5832 APR_DRG Neonate With Ecmo 24 9 — — $118,560.98 $148,201.23 $124,489.03 2026-03-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 2 $385,544.94 — $120,229.46 $123,947.90 $122,088.68 2026-07-17
442680 CDM Valve Aortic 23mm 44 25 $272,040.00 $272,040.00 $36,725.40 $272,040.00 $121,601.88 2026-03-01
433688 CDM Valve Aortic 25mm 44 25 $272,040.00 $272,040.00 $36,725.40 $272,040.00 $121,601.88 2026-03-01
445334 CDM Valve Aortic 21mm 44 25 $272,040.00 $272,040.00 $36,725.40 $272,040.00 $121,601.88 2026-03-01
428227 CDM Valve Aortic 27mm 44 25 $272,040.00 $272,040.00 $36,725.40 $272,040.00 $121,601.88 2026-03-01
211753 CDM Graft Endo Aaa 28.5x12mm 44 25 $268,391.00 $268,391.00 $36,232.79 $268,391.00 $119,970.77 2026-03-01
222589 CDM Gft Evs 15f 20x14.5x12mm 44 25 $268,391.00 $268,391.00 $36,232.79 $268,391.00 $119,970.77 2026-03-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 24 9 — — $112,581.41 $140,726.76 $118,210.48 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 50 29 $599,885.67 — $108,147.24 $629,884.36 $117,066.60 2026-07-17
01903 OTHER New Technology - Level 50 2 2 — — $113,521.14 $117,032.10 $115,276.62 2026-03-01
01904 OTHER New Technology - Level 50 2 2 — — $113,521.14 $117,032.10 $115,276.62 2026-03-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 17 4 $143,344.23 — $39,976.89 $203,447.46 $114,857.36 2026-07-17
7 MS_DRG Lung Transplant 44 26 — — $105,299.82 $381,784.85 $112,821.24 2026-03-01
1901 OTHER New Technology - Level 49 47 28 $239,558.93 — $102,701.70 $277,392.76 $111,168.86 2026-07-17
1902 OTHER New Technology - Level 49 47 28 $239,558.93 — $102,701.70 $277,392.76 $111,168.86 2026-07-17
2004 APR_DRG Cardiac Structural And Valvular Disorders 24 9 — — $104,619.14 $130,773.93 $109,850.10 2026-03-01
5831 APR_DRG Neonate With Ecmo 24 9 — — $104,395.30 $130,494.13 $109,615.07 2026-03-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 2 2 $99,566.66 — $107,750.41 $111,082.90 $109,416.65 2026-07-17
873698 CDM Graft Evas 14.5mm 14cm 44 25 $234,783.00 $234,783.00 $31,695.71 $234,783.00 $104,948.00 2026-03-01
875911 CDM Graft Evas 23x14.5m14cm 44 25 $234,783.00 $234,783.00 $31,695.71 $234,783.00 $104,948.00 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 44 26 — — $97,852.00 $354,299.71 $104,841.43 2026-03-01
73 APR_DRG Allogeneic Bone Marrow Transplant 33 10 — — $96,457.81 $168,801.00 $104,174.00 2026-03-01
857566 CDM Graft Evas 31x14.5m 15cm 44 25 $232,255.00 $232,255.00 $31,354.42 $232,255.00 $103,817.99 2026-03-01
E0767 HCPCS Intrabuccal, Systemic Delivery Of Amplitude-modulated, Radiofrequency Electromag… 6 1 — — $80,266.41 $113,137.42 $103,199.67 2026-03-01
870031 CDM Graft Evas 26x14.5m 18cm 44 25 $226,587.00 $226,587.00 $30,589.24 $226,587.00 $101,284.39 2026-03-01
858902 CDM Graft Evas 31x14.5m 13cm 44 25 $226,587.00 $226,587.00 $30,589.24 $226,587.00 $101,284.39 2026-03-01
872483 CDM Graft Evas 26x12mm 14cm 44 25 $226,587.00 $226,587.00 $30,589.24 $226,587.00 $101,284.39 2026-03-01
870599 CDM Graft Evas 14.5mm 12cm 44 25 $226,587.00 $226,587.00 $30,589.24 $226,587.00 $101,284.39 2026-03-01
01902 OTHER New Technology - Level 49 2 2 — — $99,620.65 $102,701.70 $101,161.17 2026-03-01
01901 OTHER New Technology - Level 49 2 2 — — $99,620.65 $102,701.70 $101,161.17 2026-03-01
730191 CDM Device Ast Vent 00551042 44 25 $225,000.00 $225,000.00 $30,375.00 $225,000.00 $100,575.00 2026-03-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 24 9 — — $95,438.90 $119,298.63 $100,210.85 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 67 33 — — $60,607.00 $471,244.47 $99,979.42 2026-03-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 56 29 $107,800.00 — $80,850.00 $249,112.22 $99,835.05 2026-07-17
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 24 9 — — $95,002.69 $118,753.36 $99,752.82 2026-03-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 24 9 — — $94,757.03 $118,446.29 $99,494.88 2026-03-01
423402 CDM Valve Aortic Lg 44 25 $222,166.00 $222,166.00 $29,992.41 $222,166.00 $99,308.20 2026-03-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 24 9 — — $94,349.68 $117,937.10 $99,067.16 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 46 26 — — $92,371.02 $554,970.00 $98,968.95 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 59 32 — — $75,983.00 $333,689.54 $98,857.68 2026-03-01
L5969 HCPCS $93,897.86 1 1 $93,897.86 — $98,593.44 $98,593.44 $98,593.44 2026-07-17
1599 OTHER New Technology - Level 48 47 28 $211,703.37 — $90,759.68 $245,137.92 $98,242.29 2026-07-17
1585 OTHER New Technology - Level 48 47 28 $211,703.37 — $90,759.68 $245,137.92 $98,242.29 2026-07-17
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 24 9 — — $93,407.35 $116,759.19 $98,077.72 2026-03-01
J7310 HCPCS Ganciclovir, 4.5 Mg, Long-acting Implant 14 3 $115,548.48 — $54,979.20 $145,041.92 $95,534.88 2026-07-17
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 24 9 — — $90,946.64 $113,683.30 $95,493.97 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 72 33 — — $9,825.00 $326,886.32 $95,282.20 2026-03-01
715204 CDM Evas L155mm Od26x 18mm T 44 25 $211,998.00 $211,998.00 $28,619.73 $211,998.00 $94,763.11 2026-03-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 24 9 — — $90,131.95 $112,664.94 $94,638.55 2026-03-01
1613 APR_DRG Implantable Heart Assist Systems 29 10 — — $90,025.76 $112,532.20 $94,527.05 2026-03-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 24 9 — — $89,549.97 $111,937.46 $94,027.47 2026-03-01
007 OTHER Lung Transplant 2 2 $186,223.37 — $92,404.59 $95,262.46 $93,833.52 2026-07-17
230908 CDM Tiss Mtrx Aclr 16mm 20cm 44 25 $209,077.00 $209,077.00 $28,225.40 $209,077.00 $93,457.42 2026-03-01
265452 CDM Cage Spnl Exp 18mm 44 25 $208,640.00 $208,640.00 $28,166.40 $208,640.00 $93,262.08 2026-03-01
723487 CDM Cage Expanding 22x54 Mm 44 25 $208,640.00 $208,640.00 $28,166.40 $208,640.00 $93,262.08 2026-03-01
720803 CDM Cage Expanding 19x34 Mm 44 25 $208,640.00 $208,640.00 $28,166.40 $208,640.00 $93,262.08 2026-03-01
854234 CDM Cage Sp 32x18mm Vlft Ti 44 25 $208,640.00 $208,640.00 $28,166.40 $208,640.00 $93,262.08 2026-03-01
717390 CDM Cage Expanding 22x31 Mm 44 25 $208,640.00 $208,640.00 $28,166.40 $208,640.00 $93,262.08 2026-03-01
423182 CDM Cage Expanding 25x54 Mm 44 25 $208,640.00 $208,640.00 $28,166.40 $208,640.00 $93,262.08 2026-03-01
425794 CDM Endplate Spnl 43-65x20mm 44 25 $208,640.00 $208,640.00 $28,166.40 $208,640.00 $93,262.08 2026-03-01
732849 CDM Spacer Spnl 32x23x12mm8d 44 25 $208,640.00 $208,640.00 $28,166.40 $208,640.00 $93,262.08 2026-03-01
424366 CDM Cage Cpri Crpct24x30x8mm 44 25 $208,640.00 $208,640.00 $28,166.40 $208,640.00 $93,262.08 2026-03-01
720808 CDM Cage Expanding 22x37 Mm 44 25 $208,640.00 $208,640.00 $28,166.40 $208,640.00 $93,262.08 2026-03-01
C1882 HCPCS Crt-d Volume 36mm 1,365 23 $198,291.00 $198,291.00 $135.00 $411,516.00 $91,852.63 2026-03-01
335601 CDM Spacer Boomerang Peek 9x 44 25 $204,477.00 $204,477.00 $27,604.40 $204,477.00 $91,401.22 2026-03-01
215 MS_DRG Other Heart Assist System Implant 80 34 — — $55,453.00 $567,817.00 $91,354.20 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 80 34 — — $55,453.00 $335,921.79 $90,608.47 2026-03-01
C1767 HCPCS Generator Nrstm 5 Ipg 546 23 $228,855.00 $228,855.00 $375.03 $404,028.00 $90,586.83 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 44 26 — — $84,212.26 $303,963.85 $90,227.42 2026-03-01
278510 CDM Implant Spn Cerv Sys 4mm 44 25 $201,695.00 $201,695.00 $27,228.83 $201,695.00 $90,157.67 2026-03-01
01599 OTHER New Technology - Level 48 2 2 — — $88,036.89 $90,759.68 $89,398.29 2026-03-01
01585 OTHER New Technology - Level 48 2 2 — — $88,036.89 $90,759.68 $89,398.29 2026-03-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 33 10 — — $81,993.56 $143,489.00 $88,553.10 2026-03-01
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 19 5 $102,390.60 — $26,258.38 $243,082.56 $88,482.01 2026-07-17
84 APR_DRG Autologous Bone Marrow Transplant 33 10 — — $81,665.02 $142,914.00 $88,198.20 2026-03-01
1598 OTHER New Technology - Level 47 47 28 $189,418.92 — $81,206.08 $219,334.06 $87,901.05 2026-07-17
1584 OTHER New Technology - Level 47 47 28 $189,418.92 — $81,206.08 $219,334.06 $87,901.05 2026-07-17
879277 CDM Spacer Spn 20x31x20mm 44 25 $195,686.00 $195,686.00 $26,417.61 $195,686.00 $87,471.64 2026-03-01
879276 CDM Spacer Spnl 20mmx23mm-28 44 25 $195,686.00 $195,686.00 $26,417.61 $195,686.00 $87,471.64 2026-03-01
445469 CDM Valve Aortic 29mm 44 25 $192,695.00 $192,695.00 $26,013.83 $192,695.00 $86,134.67 2026-03-01
462289 CDM Valve Aortic 27mm 44 25 $192,456.00 $192,456.00 $25,981.56 $192,456.00 $86,027.83 2026-03-01
224748 CDM Valve Aortic 25mm 44 25 $192,456.00 $192,456.00 $25,981.56 $192,456.00 $86,027.83 2026-03-01
854776 CDM Stent Aaa Cvf2616c126xh 44 25 $192,129.00 $192,129.00 $25,937.42 $192,129.00 $85,881.67 2026-03-01
714329 CDM Cage Expanding 25x43 Mm 44 25 $190,567.00 $190,567.00 $25,726.54 $190,567.00 $85,183.45 2026-03-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 24 9 — — $80,213.97 $100,267.46 $84,224.67 2026-03-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 29 10 — — $80,169.21 $100,211.51 $84,177.67 2026-03-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 24 9 — — $79,499.18 $99,373.97 $83,474.14 2026-03-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 2 $484,340.00 — $81,897.73 $84,430.65 $83,164.19 2026-07-17
711283 CDM Cage Spn Roi 10x30 5d 44 25 $184,169.00 $184,169.00 $24,862.81 $184,169.00 $82,323.54 2026-03-01
713518 CDM Cage Spn Roi 12x30 5d 44 25 $184,169.00 $184,169.00 $24,862.81 $184,169.00 $82,323.54 2026-03-01
711282 CDM Cage Spn Roi 8x30 5d 44 25 $184,169.00 $184,169.00 $24,862.81 $184,169.00 $82,323.54 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 67 33 — — $60,607.00 $385,232.48 $82,105.79 2026-03-01
710304 CDM Gft Bfr 28x16x13.5 44 25 $182,635.00 $182,635.00 $24,655.72 $182,635.00 $81,637.85 2026-03-01
850996 CDM Gft Bfr 24x14x13.5 44 25 $182,635.00 $182,635.00 $24,655.72 $182,635.00 $81,637.85 2026-03-01
2464 APR_DRG Gastrointestinal Vascular Insufficiency 24 9 — — $77,741.79 $97,177.24 $81,628.88 2026-03-01
738691 CDM Spacer Spnl Mag+ Pk 44 25 $182,221.00 $182,221.00 $24,599.83 $182,221.00 $81,452.79 2026-03-01
740909 CDM Spacer Spnl Mag+ Pk Alif 44 25 $182,221.00 $182,221.00 $24,599.83 $182,221.00 $81,452.79 2026-03-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 24 9 — — $77,340.73 $96,675.91 $81,207.77 2026-03-01
64 APR_DRG Pancreas Transplant 33 10 — — $75,056.86 $131,350.00 $81,061.40 2026-03-01
463506 CDM Valve Aortic 21mm 44 25 $181,247.00 $181,247.00 $24,468.35 $181,247.00 $81,017.41 2026-03-01
A9604 HCPCS Samarium Sm-153 Lexidronam, Therapeutic, Per Treatment Dose, Up To 150 Millicuri… 17 4 $102,822.55 — $5,213.67 $142,036.23 $80,330.88 2026-07-17
716633 CDM Cage Spn Roi Pk 30x30x16 44 25 $179,579.00 $179,579.00 $24,243.17 $179,579.00 $80,271.82 2026-03-01
718750 CDM Cage Spn Roi-a 33x30x10 44 25 $179,579.00 $179,579.00 $24,243.17 $179,579.00 $80,271.82 2026-03-01
715164 CDM Cage Spn Roi33x30x16 10d 44 25 $179,579.00 $179,579.00 $24,243.17 $179,579.00 $80,271.82 2026-03-01
718753 CDM Cage Spnl 30x9.5-10mm Ro 44 25 $179,579.00 $179,579.00 $24,243.17 $179,579.00 $80,271.82 2026-03-01
014 OTHER Allogeneic Bone Marrow Transplant 2 2 $170,750.14 — $78,875.96 $81,315.42 $80,095.69 2026-07-17
738542 CDM Valve Aortic 20.2mm 44 25 $179,093.00 $179,093.00 $24,177.56 $179,093.00 $80,054.57 2026-03-01
714218 CDM Valve Aortic 22mm 44 25 $179,093.00 $179,093.00 $24,177.56 $179,093.00 $80,054.57 2026-03-01
01584 OTHER New Technology - Level 47 2 2 — — $78,769.90 $81,206.08 $79,987.99 2026-03-01
01598 OTHER New Technology - Level 47 2 2 — — $78,769.90 $81,206.08 $79,987.99 2026-03-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 2 2 $174,014.73 — $78,045.15 $80,458.92 $79,252.04 2026-07-17
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 24 9 — — $75,050.94 $93,813.68 $78,803.49 2026-03-01
452947 CDM Spacer Spn 20mm 41mm 44 25 $176,118.00 $176,118.00 $23,775.93 $176,118.00 $78,724.74 2026-03-01
229481 CDM Spacer Spnl 20x62mm 44 25 $176,118.00 $176,118.00 $23,775.93 $176,118.00 $78,724.74 2026-03-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 24 9 — — $74,826.37 $93,532.96 $78,567.69 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 80 34 — — $55,453.00 $289,465.91 $78,367.00 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 67 33 — — $9,825.00 $262,963.04 $78,270.32 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 74 33 — — $60,607.00 $359,312.58 $77,775.29 2026-03-01
1597 OTHER New Technology - Level 46 47 28 $167,134.47 — $71,652.48 $193,530.20 $77,559.81 2026-07-17
1583 OTHER New Technology - Level 46 47 28 $167,134.47 — $71,652.48 $193,530.20 $77,559.81 2026-07-17
865071 CDM Cage Peek Fonft 14x35-45 44 25 $172,484.00 $172,484.00 $23,285.34 $172,484.00 $77,100.35 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 3 1 $78,168.72 — $77,046.96 $77,046.96 $77,046.96 2026-07-17
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 24 9 — — $72,739.70 $90,924.63 $76,376.68 2026-03-01
714703 CDM Cage Spn Roi36x33x16 10d 44 25 $166,225.00 $166,225.00 $22,440.38 $166,225.00 $74,302.57 2026-03-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 2 $110,395.96 — $73,141.69 $75,403.80 $74,272.74 2026-07-17
C1722 HCPCS Crt-d Hf-t Df1 360d 858 23 $171,883.00 $171,883.00 $7,779.24 $521,950.00 $74,004.29 2026-03-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 29 10 — — $69,934.16 $87,417.70 $73,430.87 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 74 33 — — $64,574.43 $236,544.00 $73,289.99 2026-03-01
101680 CDM Graft Bn Tib Dist Rt 44 25 $163,735.00 $163,735.00 $22,104.22 $163,735.00 $73,189.54 2026-03-01
254705 CDM Valve Mitral 29mm 44 25 $163,224.00 $163,224.00 $22,035.24 $163,224.00 $72,961.13 2026-03-01
254387 CDM Valve Mitral 31mm 44 25 $163,224.00 $163,224.00 $22,035.24 $163,224.00 $72,961.13 2026-03-01
254706 CDM Valve Mitral Size 33 44 25 $163,224.00 $163,224.00 $22,035.24 $163,224.00 $72,961.13 2026-03-01
225894 CDM Valve Aortic 19mm 44 25 $163,224.00 $163,224.00 $22,035.24 $163,224.00 $72,961.13 2026-03-01
254704 CDM Valve Mitral 25mm 44 25 $163,224.00 $163,224.00 $22,035.24 $163,224.00 $72,961.13 2026-03-01
455164 CDM Valve Aortic 23mm 44 25 $163,224.00 $163,224.00 $22,035.24 $163,224.00 $72,961.13 2026-03-01
254561 CDM Valve Mitral 27mm 44 25 $163,224.00 $163,224.00 $22,035.24 $163,224.00 $72,961.13 2026-03-01
712625 CDM Cylinder Thoracic Shrt 44 25 $162,277.00 $162,277.00 $21,907.40 $162,277.00 $72,537.82 2026-03-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 49 29 — — $66,737.65 $180,260.45 $72,241.79 2026-03-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 24 9 — — $68,786.49 $85,983.11 $72,225.81 2026-03-01
856166 CDM Spacer Spn 8d 37x27x12 44 25 $161,356.00 $161,356.00 $21,783.06 $161,356.00 $72,126.13 2026-03-01
744192 CDM Spacer Spn 32x23x16mm12d 44 25 $161,356.00 $161,356.00 $21,783.06 $161,356.00 $72,126.13 2026-03-01
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 2 2 $115,028.66 — $70,644.06 $72,828.93 $71,736.49 2026-07-17
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 24 9 — — $68,228.20 $85,285.25 $71,639.61 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 80 34 — — $55,453.00 $276,270.00 $71,566.28 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 79 33 — — $55,453.00 $262,520.88 $71,266.78 2026-03-01
861938 CDM Spacer 8 Deg 15 Mm Lg 44 25 $158,574.00 $158,574.00 $21,407.49 $158,574.00 $70,882.58 2026-03-01
853963 CDM Spacer Spn 37x27x14 8d 44 25 $158,574.00 $158,574.00 $21,407.49 $158,574.00 $70,882.58 2026-03-01
01583 OTHER New Technology - Level 46 2 2 — — $69,502.91 $71,652.48 $70,577.70 2026-03-01
01597 OTHER New Technology - Level 46 2 2 — — $69,502.91 $71,652.48 $70,577.70 2026-03-01
750080 CDM Cage Spn 27-38mm 20mm 44 25 $157,740.00 $157,740.00 $21,294.90 $157,740.00 $70,509.78 2026-03-01
708337 CDM Cage Spn Crsnt 9x30mm 44 25 $157,666.00 $157,666.00 $21,284.91 $157,666.00 $70,476.70 2026-03-01
37235 CPT Revsc Tb/pr St/ath Ad Bi 161 32 $172,118.75 $172,118.75 $2,369.00 $234,707.39 $70,412.22 2026-07-17
240852 CDM Graft Bn Lgii 8cc 3x4in 44 25 $157,139.00 $157,139.00 $21,213.76 $157,139.00 $70,241.14 2026-03-01
72 APR_DRG Allogeneic Bone Marrow Transplant 33 10 — — $64,808.87 $113,416.00 $69,993.60 2026-03-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 68 33 — — $55,875.17 $229,061.81 $69,757.90 2026-03-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $69,027.19 $69,027.19 $69,027.19 2026-03-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 $273,523.33 — $67,880.13 $69,979.52 $68,929.83 2026-07-17
423052 CDM Valve Aortic 19mm 44 25 $154,043.00 $154,043.00 $20,795.81 $154,043.00 $68,857.22 2026-03-01
741800 CDM Cage Spnl 37x25mm Cntrpc 44 25 $153,706.00 $153,706.00 $20,750.31 $153,706.00 $68,706.58 2026-03-01
742088 CDM Cage Spn 25mm 25mm 44 25 $153,706.00 $153,706.00 $20,750.31 $153,706.00 $68,706.58 2026-03-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 24 9 — — $65,320.55 $81,650.69 $68,586.58 2026-03-01
604803 CDM Valve Aortic 19mm 44 25 $152,842.00 $152,842.00 $20,633.67 $152,842.00 $68,320.38 2026-03-01
604904 CDM Valve Aortic 27mm 44 25 $152,842.00 $152,842.00 $20,633.67 $152,842.00 $68,320.38 2026-03-01
604827 CDM Valve Aortic 21mm 44 25 $152,842.00 $152,842.00 $20,633.67 $152,842.00 $68,320.38 2026-03-01
604852 CDM Valve Aortic 23mm 44 25 $152,842.00 $152,842.00 $20,633.67 $152,842.00 $68,320.38 2026-03-01
604879 CDM Valve Aortic 25mm 44 25 $152,842.00 $152,842.00 $20,633.67 $152,842.00 $68,320.38 2026-03-01
870034 CDM Spacer 8 Deg 13 Mm Lg 44 25 $152,732.00 $152,732.00 $20,618.82 $152,732.00 $68,271.20 2026-03-01
427328 CDM Alt Revi Mnblc Stm 195mm 44 25 $152,685.00 $152,685.00 $20,612.47 $152,685.00 $68,250.20 2026-03-01
424628 CDM Stem Fem Hip 195mm 18mm 44 25 $152,685.00 $152,685.00 $20,612.47 $152,685.00 $68,250.20 2026-03-01
1612 APR_DRG Implantable Heart Assist Systems 29 10 — — $64,714.53 $80,893.16 $67,950.26 2026-03-01
718836 CDM Valve Aortic 29mm 44 25 $151,889.00 $151,889.00 $20,505.01 $151,889.00 $67,894.39 2026-03-01
717 OTHER Instill Adstiladrin, Tx D 49 29 $49,704.71 — $13,663.40 $168,399.95 $67,488.53 2026-07-17
709753 CDM Spacer Vert Pk 6x10x46 44 25 $150,751.00 $150,751.00 $20,351.38 $150,751.00 $67,385.70 2026-03-01
724421 CDM Cage Spnl 12x45x45mm 44 25 $150,751.00 $150,751.00 $20,351.38 $150,751.00 $67,385.70 2026-03-01
1596 OTHER New Technology - Level 45 47 28 $144,850.03 — $62,098.88 $167,726.35 $67,218.57 2026-07-17
1582 OTHER New Technology - Level 45 47 28 $144,850.03 — $62,098.88 $167,726.35 $67,218.57 2026-07-17
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 24 9 — — $63,974.57 $79,968.21 $67,173.30 2026-03-01
718262 CDM Mag Stnd Alne Alif Pk 37 44 25 $149,340.00 $149,340.00 $20,160.90 $149,340.00 $66,754.98 2026-03-01
5244 OTHER Level 4 Blood Product Exc 47 28 $91,426.36 — $56,502.21 $165,824.67 $66,456.45 2026-07-17
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 72 33 — — $55,453.00 $329,192.00 $66,308.68 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 67 33 — — $59,390.83 $308,652.90 $66,192.23 2026-03-01
8634 APR_DRG Neonatal Aftercare 24 9 — — $62,982.29 $78,727.86 $66,131.40 2026-03-01
4404 APR_DRG Kidney Transplant 33 10 — — $61,224.16 $107,142.00 $66,122.10 2026-03-01
429 OTHER Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 2 2 $298.00 — $65,114.90 $67,128.76 $66,121.83 2026-07-17
604917 CDM Valve Aortic 29mm 44 25 $147,242.00 $147,242.00 $19,877.67 $147,242.00 $65,817.17 2026-03-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 24 9 — — $62,377.38 $77,971.72 $65,496.25 2026-03-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 2 $261,208.75 — $64,364.82 $66,355.48 $65,360.15 2026-07-17
861939 CDM Spacer 15 Deg 15 Mm Lg 44 25 $146,055.00 $146,055.00 $19,717.42 $146,055.00 $65,286.58 2026-03-01
862261 CDM Spacer 8 Deg 13 Mm Med 44 25 $146,055.00 $146,055.00 $19,717.42 $146,055.00 $65,286.58 2026-03-01
862704 CDM Spacer 15 Deg 11 Mm Sm 44 25 $146,055.00 $146,055.00 $19,717.42 $146,055.00 $65,286.58 2026-03-01
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