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

LAS PALMAS MEDICAL CENTER A CAMPUS OF LPDS HEALTHC

El Paso, TX · CCN 450107 · Rates published

39,214 distinct procedures filed
63 distinct payers
811,327 rate rows
2026-08-01 last MRF observed
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/74-2499952_LAS-PALMAS-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.laspalmasdelsolhealthcare.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-10-11
Content fingerprint 63ce1f580b854cd2… · 954,832,567 bytes · first seen 2026-05-06

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
$2,968,000
1.6× median
00908
OTHER 		Topi Adm Prad Zami Per Tr 1 $3,335,820.00 $3,335,820.00 $3,335,820.00 —
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 1 $934,776.65 $934,776.65 $934,776.65 nat. median
$621,313
1.5× median
9422
OTHER 		Idecabtagene Vicleucel Ca 27 $546,920.16 $1,395,204.50 $574,824.25 nat. median
$552,917
1.0× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $489,450.20 $489,450.20 $489,450.20 nat. median
$446,714
1.1× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $374,886.49 $374,886.49 $374,886.49 nat. median
$168,055
outlier · 2.2×
249249
CDM 		Valve Tavr 20mm 1 $364,053.30 $364,053.30 $364,053.30 nat. median
$1,575
outlier · 231.1×
482361
CDM 		Valve Heart Trnscth 26mm 1 $347,992.55 $347,992.55 $347,992.55 nat. median
$4,548
outlier · 76.5×
482360
CDM 		Valve Heart Trnscth 23mm 1 $347,992.55 $347,992.55 $347,992.55 nat. median
$4,860
outlier · 71.6×
249248
CDM 		Valve Tavr 29mm 2 $295,525.62 $364,053.30 $329,789.46 —
471443
CDM 		Valve Aor Tavr 26mm 1 $321,223.50 $321,223.50 $321,223.50 nat. median
$7,927
outlier · 40.5×
471441
CDM 		Valve Aor Tavr 34mm 1 $321,223.50 $321,223.50 $321,223.50 —
271390
CDM 		Valve Tavr 23mm 1 $312,303.60 $312,303.60 $312,303.60 —
270574
CDM 		Valve Tavr 29mm 2 $253,517.04 $312,303.60 $282,910.32 —
215
MS_DRG 		Other Heart Assist System Implant 1 $226,900.12 $240,740.35 $226,900.12 nat. median
$73,023
outlier · 3.1×
L8614
HCPCS 		Impl Coclr Hifcs 90k 22 $18,342.96 $412,927.00 $217,330.00 nat. median
$22,495
outlier · 9.7×
249246
CDM 		Valve Tavr 26mm 25 $46,256.18 $406,883.10 $205,583.04 nat. median
$3,076
outlier · 66.8×
876617
CDM 		Kit Aor Vlv 14fr 29mm 25 $44,215.52 $388,932.85 $204,701.50 —
229026
CDM 		Occluder Cardiac Lt 28mm 1 $192,734.10 $192,734.10 $192,734.10 —
229036
CDM 		Occluder Cardiac Lt 16mm 1 $192,734.10 $192,734.10 $192,734.10 —
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 $75,775.22 $203,177.41 $191,496.68 nat. median
$59,651
outlier · 3.2×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 2 $187,123.39 $194,184.65 $190,654.02 nat. median
$131,925
1.4× median
424881
CDM 		Stent Fgt Vlnt 200x38x38 2 $169,449.51 $208,742.15 $189,095.83 nat. median
$76
outlier · 2479.0×
482359
CDM 		Valve Heart Trnscth 20mm 24 $44,215.52 $388,932.85 $188,325.38 nat. median
$4,860
outlier · 38.8×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 $186,045.79 $186,045.79 $186,045.79 nat. median
$145,435
1.3× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 3 $129,000.00 $244,516.24 $184,929.00 nat. median
$186,516
1.0× median
263481
CDM 		Device Clsr 24mm 1 $182,026.65 $182,026.65 $182,026.65 —
471442
CDM 		Valve Aor Tavr 29mm 24 $40,814.28 $359,014.50 $181,396.80 nat. median
$16,730
outlier · 10.8×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc Pediatric 2 $69,254.53 $184,845.65 $174,218.82 nat. median
$55,935
outlier · 3.1×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 2 $97,023.85 $183,424.32 $172,887.32 nat. median
$74,509
outlier · 2.3×
473093
CDM 		Stent Gft Thor Act 37x37 2 $152,978.52 $188,451.80 $170,715.16 —
270575
CDM 		Valve Tavr 34mm 24 $39,680.93 $349,045.20 $169,011.36 —
263493
CDM 		Device Clsr 31mm 2 $147,762.81 $182,026.65 $164,894.73 —
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 2 $65,190.91 $173,421.54 $163,451.49 nat. median
$37,013
outlier · 4.4×
1905
OTHER 		New Technology - Level 51 1 $162,238.44 $162,238.44 $162,238.44 nat. median
$135,199
1.2× median
480381
CDM 		Implant Crnl Custm 1 $161,327.45 $161,327.45 $161,327.45 nat. median
$893
outlier · 180.6×
277621
CDM 		Set Vntrc 17.4x13.8in 33 $19,252.80 $326,610.00 $158,148.00 —
254667
CDM 		Cath Vasc Assist Strl 34 $19,252.80 $326,610.00 $158,148.00 —
265596
CDM 		Kit Lo Prfl Comp Shth 7f 33 $19,252.80 $326,610.00 $156,429.00 —
1907
OTHER 		New Technology - Level 52 27 $146,948.65 $374,869.00 $154,446.03 nat. median
$149,948
1.0× median
233599
CDM 		Device Embl 3.25mm 16mm 1 $154,026.80 $154,026.80 $154,026.80 —
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 2 $60,967.33 $161,547.72 $152,260.30 nat. median
$2,958
outlier · 51.5×
C2616
HCPCS 		Brachytx Ns Yttrium 90 2 $135,443.55 $166,850.75 $151,147.15 nat. median
$22,121
outlier · 6.8×
285110
CDM 		Valve Aortic 29mm 1 $149,904.30 $149,904.30 $149,904.30 nat. median
$1,396
outlier · 107.4×
749575
CDM 		Kit Generator Nrstm Chg 25 $33,080.08 $290,982.15 $147,022.56 —
741017
CDM 		Forcep Grasp 2.4fr 90cm 1 $143,879.50 $143,879.50 $143,879.50 —
436688
CDM 		Graft Bn Cartiform 25x20 1 $142,565.40 $142,565.40 $142,565.40 —
235622
CDM 		Device Embl 4mm 16mm 2 $125,033.52 $154,026.80 $139,530.16 nat. median
$1,130
outlier · 123.5×
572470
CDM 		Plate Cranial Lf Ft 2 $123,485.85 $152,120.25 $137,803.05 —
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator Pediatri… 2 $55,162.17 $145,227.57 $136,878.40 nat. median
$43,533
outlier · 3.1×

Other procedures at this hospital

Browse this hospital's 39,214 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
             
00908 OTHER Topi Adm Prad Zami Per Tr 1 1 — — $3,335,820.00 $3,335,820.00 $3,335,820.00 2026-03-01
09391 OTHER Brexucabtagene Car Pos T 1 1 — — $489,450.20 $489,450.20 $489,450.20 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 4 3 — — $129,000.00 $244,516.24 $184,929.00 2026-03-01
10 MS_DRG Pancreas Transplant 1 1 — — $65,216.71 $65,216.71 $65,216.71 2026-03-01
101061 CDM Valve Aortic 23mm 2 2 $176,358.00 $176,358.00 $121,687.02 $149,904.30 $135,795.66 2026-03-01
102211 CDM Kidney Acq Living Donor 52 34 $216,543.00 $216,543.00 $12,126.41 $205,715.85 $102,100.02 2026-03-01
102212 CDM Kidney Acquisition 50 33 $216,501.00 $216,501.00 $12,124.06 $205,675.95 $98,507.96 2026-03-01
108814 CDM Dvc Revasc 3x20mm 200c 2 2 $122,714.00 $122,714.00 $84,672.66 $104,306.90 $94,489.78 2026-03-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 4 2 — — $39,762.57 $71,115.49 $67,030.18 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 1 1 — — $106,860.83 $106,860.83 $106,860.83 2026-03-01
140 MS_DRG Major Head And Neck Procedures With Mcc 4 2 — — $40,186.57 $71,947.08 $67,814.00 2026-03-01
1581 OTHER New Technology - Level 44 3 1 $99,975.46 — $64,895.75 $64,895.75 $64,895.75 2026-08-01
1585 OTHER New Technology - Level 48 3 1 $172,684.23 — $112,092.24 $112,092.24 $112,092.24 2026-08-01
162563 CDM Dvc Revasc 4x40mm 200cm 2 2 $122,714.00 $122,714.00 $84,672.66 $104,306.90 $94,489.78 2026-03-01
1643 OTHER Y90 Ibritumomab, Rx 3 1 $118,391.78 — $68,189.46 $68,189.46 $68,189.46 2026-08-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 7 2 — — $35,649.08 $90,370.11 $63,047.52 2026-03-01
174277 CDM Ptca Rvs Gft Stnt Sgl Ld 1 1 $73,234.00 $73,234.00 $62,248.90 $62,248.90 $62,248.90 2026-03-01
174280 CDM Ptca Rvs Gft Stnt Sgl Lm 1 1 $73,234.00 $73,234.00 $62,248.90 $62,248.90 $62,248.90 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $374,886.49 $374,886.49 $374,886.49 2026-03-01
184995 CDM Cranial Optical Navi Sys 1 1 $76,696.00 $76,696.00 $65,191.60 $65,191.60 $65,191.60 2026-03-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 46 27 — — $55,072.57 $122,383.48 $63,333.45 2026-03-01
1902 OTHER New Technology - Level 49 3 1 $195,405.72 — $126,841.08 $126,841.08 $126,841.08 2026-08-01
1903 OTHER New Technology - Level 50 43 27 $222,671.51 — $118,040.80 $301,124.50 $124,063.29 2026-08-01
1905 OTHER New Technology - Level 51 3 1 $249,937.30 — $162,238.44 $162,238.44 $162,238.44 2026-08-01
1907 OTHER New Technology - Level 52 43 27 $277,203.09 — $146,948.65 $374,869.00 $154,446.03 2026-08-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 2 — — $100,960.18 $200,000.00 $122,254.00 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 1 — — $125,106.05 $132,730.92 $125,106.05 2026-03-01
202998 CDM Spacer Spnl 38x8mm 1 1 $94,480.00 $94,480.00 $65,191.20 $65,191.20 $65,191.20 2026-03-01
204057 CDM Valve Aortic 27mm 36 25 $176,358.00 $176,358.00 $19,046.66 $167,540.10 $84,651.84 2026-03-01
205010 CDM Cage 0/6d Lrg 33/46mm 1 1 $76,529.00 $76,529.00 $65,049.65 $65,049.65 $65,049.65 2026-03-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 4 2 — — $58,843.93 $106,372.03 $100,259.06 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 1 1 — — $100,848.38 $100,848.38 $100,848.38 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 4 2 — — $97,023.85 $183,424.32 $172,887.32 2026-03-01
215 MS_DRG Other Heart Assist System Implant 3 1 — — $226,900.12 $240,740.35 $226,900.12 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $87,638.39 $87,638.39 $87,638.39 2026-03-01
216982 CDM Device Clsr Clp Int 50mm 1 1 $72,862.00 $72,862.00 $61,932.70 $61,932.70 $61,932.70 2026-03-01
217386 CDM Device Clsr Clp Int 50mm 1 1 $92,246.00 $92,246.00 $63,649.74 $63,649.74 $63,649.74 2026-03-01
217477 CDM Cage Spnl 30x16x25mm 18d 2 2 $101,094.00 $101,094.00 $69,754.86 $85,929.90 $77,842.38 2026-03-01
217481 CDM Cage Spn 12x14x22m 2 2 $102,039.00 $102,039.00 $70,406.91 $86,733.15 $78,570.03 2026-03-01
218044 CDM Nail 10x700mm Lt Arthro 2 2 $107,813.00 $107,813.00 $74,390.97 $91,641.05 $83,016.01 2026-03-01
219631 CDM Cage Spn 12x39-65mm 6d 1 1 $113,376.00 $113,376.00 $78,229.44 $78,229.44 $78,229.44 2026-03-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 6 1 — — $50,517.48 $76,823.18 $63,001.49 2026-03-01
222330 CDM Peek Crnl Cust Sz Lrg 37 25 $167,724.00 $167,724.00 $18,114.19 $159,337.80 $83,862.00 2026-03-01
222417 CDM Endplate Intvrtb 31x26mm 2 2 $85,032.00 $85,032.00 $58,672.08 $72,277.20 $65,474.64 2026-03-01
222471 CDM Plate Sup Sz S 6 /spikes 2 2 $85,032.00 $85,032.00 $58,672.08 $72,277.20 $65,474.64 2026-03-01
225596 CDM Valve Aortic 19mm 1 1 $90,699.00 $90,699.00 $62,582.31 $62,582.31 $62,582.31 2026-03-01
227284 CDM Kit Device Guided 3cm 52 34 $191,743.00 $191,743.00 $10,737.61 $182,155.85 $90,406.82 2026-03-01
227517 CDM Cath Trvo Provu Xp 3mm 2 2 $132,780.00 $132,780.00 $91,618.20 $112,863.00 $102,240.60 2026-03-01
227518 CDM Retriever 20mm 4mm Endo- 52 34 $132,790.00 $132,790.00 $7,436.24 $126,150.50 $62,610.49 2026-03-01
229023 CDM Occluder Cardiac Lt 34mm 36 24 $226,746.00 $226,746.00 $24,488.57 $215,408.70 $108,838.08 2026-03-01
229025 CDM Occluder Cardiac Lt 31mm 36 25 $226,746.00 $226,746.00 $24,488.57 $215,408.70 $108,838.08 2026-03-01
229026 CDM Occluder Cardiac Lt 28mm 1 1 $226,746.00 $226,746.00 $192,734.10 $192,734.10 $192,734.10 2026-03-01
229028 CDM Occluder Cardiac Lt 25mm 37 25 $226,746.00 $226,746.00 $24,488.57 $215,408.70 $113,373.00 2026-03-01
229029 CDM Occluder Cardiac Lt 22mm 37 25 $226,746.00 $226,746.00 $24,488.57 $215,408.70 $113,373.00 2026-03-01
229030 CDM Occluder Cardiac Lt 20mm 36 25 $226,746.00 $226,746.00 $24,488.57 $215,408.70 $108,838.08 2026-03-01
229031 CDM Occluder Cardiac Lt 18mm 36 25 $226,746.00 $226,746.00 $24,488.57 $215,408.70 $108,838.08 2026-03-01
229036 CDM Occluder Cardiac Lt 16mm 1 1 $226,746.00 $226,746.00 $192,734.10 $192,734.10 $192,734.10 2026-03-01
229066 CDM Cage Spn 7d 22x50x8-13mm 1 1 $75,584.00 $75,584.00 $64,246.40 $64,246.40 $64,246.40 2026-03-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 9 3 — — $52,785.92 $131,264.78 $96,658.70 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 1 1 — — $76,003.13 $76,003.13 $76,003.13 2026-03-01
232511 CDM Device Embl 3.75mm 12mm 36 24 $181,208.00 $181,208.00 $19,570.46 $172,147.60 $86,979.84 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc Pediatric 4 2 — — $69,254.53 $184,845.65 $174,218.82 2026-03-01
233011 CDM Cage Lateral Expandable 1 1 $75,584.00 $75,584.00 $64,246.40 $64,246.40 $64,246.40 2026-03-01
233599 CDM Device Embl 3.25mm 16mm 1 1 $181,208.00 $181,208.00 $154,026.80 $154,026.80 $154,026.80 2026-03-01
23474 CPT Revision Of Total Shoulder Arthroplasty, Including Allograft When Performed; Hum… 8 3 $49,205.01 — $948.00 $71,097.19 $63,575.57 2026-08-01
235622 CDM Device Embl 4mm 16mm 2 2 $181,208.00 $181,208.00 $125,033.52 $154,026.80 $139,530.16 2026-03-01
235708 CDM Cage Intrbd Spn 4d 44mm 1 1 $102,039.00 $102,039.00 $70,406.91 $70,406.91 $70,406.91 2026-03-01
236794 CDM Cage Spn Alf 15d 8x34x24 2 2 $80,497.00 $80,497.00 $55,542.93 $68,422.45 $61,982.69 2026-03-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 7 2 — — $45,831.77 $118,996.86 $83,019.24 2026-03-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 7 2 — — $37,147.24 $94,581.92 $65,985.93 2026-03-01
240852 CDM Graft Bn Lg Sp 26x18mm 1 1 $96,188.00 $96,188.00 $66,369.72 $66,369.72 $66,369.72 2026-03-01
245 MS_DRG Aicd Generator Procedures 7 2 — — $42,741.70 $110,309.71 $76,958.56 2026-03-01
249246 CDM Valve Tavr 26mm 36 25 $428,298.00 $428,298.00 $46,256.18 $406,883.10 $205,583.04 2026-03-01
249248 CDM Valve Tavr 29mm 2 2 $428,298.00 $428,298.00 $295,525.62 $364,053.30 $329,789.46 2026-03-01
249249 CDM Valve Tavr 20mm 1 1 $428,298.00 $428,298.00 $364,053.30 $364,053.30 $364,053.30 2026-03-01
252222 CDM Device Embl 2.75mm 16mm 37 25 $181,208.00 $181,208.00 $19,570.46 $172,147.60 $90,604.00 2026-03-01
254667 CDM Cath Vasc Assist Strl 51 34 $343,800.00 $343,800.00 $19,252.80 $326,610.00 $158,148.00 2026-03-01
254706 CDM Valve Mitral Size 33 2 2 $120,759.00 $120,759.00 $83,323.71 $102,645.15 $92,984.43 2026-03-01
262907 CDM Cage Spn 6d 12x26mm 1 1 $94,008.00 $94,008.00 $79,906.80 $79,906.80 $79,906.80 2026-03-01
263480 CDM Device Clsr 20mm 36 25 $214,149.00 $214,149.00 $23,128.09 $203,441.55 $102,791.52 2026-03-01
263481 CDM Device Clsr 24mm 1 1 $214,149.00 $214,149.00 $182,026.65 $182,026.65 $182,026.65 2026-03-01
263482 CDM Device Clsr 27mm 36 24 $214,149.00 $214,149.00 $23,128.09 $203,441.55 $102,791.52 2026-03-01
263484 CDM Device Clsr 35mm 37 25 $214,149.00 $214,149.00 $23,128.09 $203,441.55 $107,074.50 2026-03-01
263485 CDM Device Clsr 40mm 36 25 $214,149.00 $214,149.00 $23,128.09 $203,441.55 $102,791.52 2026-03-01
263493 CDM Device Clsr 31mm 2 2 $214,149.00 $214,149.00 $147,762.81 $182,026.65 $164,894.73 2026-03-01
265596 CDM Kit Lo Prfl Comp Shth 7f 50 33 $343,800.00 $343,800.00 $19,252.80 $326,610.00 $156,429.00 2026-03-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc Ped… 3 1 — — $108,489.11 $115,106.62 $108,489.11 2026-03-01
267842 CDM Device W/cannula 30cm 50 33 $191,743.00 $191,743.00 $10,737.61 $182,155.85 $87,243.07 2026-03-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 1 1 — — $62,655.56 $62,655.56 $62,655.56 2026-03-01
270574 CDM Valve Tavr 29mm 2 2 $367,416.00 $367,416.00 $253,517.04 $312,303.60 $282,910.32 2026-03-01
270575 CDM Valve Tavr 34mm 35 24 $367,416.00 $367,416.00 $39,680.93 $349,045.20 $169,011.36 2026-03-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc Pediatric 4 2 — — $34,089.00 $85,984.22 $81,040.96 2026-03-01
27134 CPT Revision Of Total Hip Arthroplasty; Both Components, With Or Without Autograft O… 7 2 $24,294.00 — $23,000.00 $77,780.58 $77,584.65 2026-08-01
271390 CDM Valve Tavr 23mm 1 1 $367,416.00 $367,416.00 $312,303.60 $312,303.60 $312,303.60 2026-03-01
271677 CDM Valve Mitral 25mm 2 2 $90,699.00 $90,699.00 $62,582.31 $77,094.15 $69,838.23 2026-03-01
271680 CDM Valve Mitral 31mm 2 2 $90,699.00 $90,699.00 $62,582.31 $77,094.15 $69,838.23 2026-03-01
272226 CDM Cage Spnl 24-40mm 12mm 1 1 $102,124.00 $102,124.00 $86,805.40 $86,805.40 $86,805.40 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 1 1 — — $64,827.12 $64,827.12 $64,827.12 2026-03-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator Pediatri… 4 2 — — $55,162.17 $145,227.57 $136,878.40 2026-03-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc Pediatric 4 2 — — $43,224.17 $111,666.09 $105,246.38 2026-03-01
277621 CDM Set Vntrc 17.4x13.8in 51 33 $343,800.00 $343,800.00 $19,252.80 $326,610.00 $158,148.00 2026-03-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 4 2 — — $53,313.28 $134,579.58 $126,842.57 2026-03-01
279952 CDM Valve Aortic 27mm 2 2 $90,905.00 $90,905.00 $62,724.45 $77,269.25 $69,996.85 2026-03-01
28 MS_DRG Spinal Procedures With Mcc 7 2 — — $55,176.78 $145,268.68 $101,348.00 2026-03-01
285109 CDM Valve Aortic 21mm 36 24 $176,358.00 $176,358.00 $19,046.66 $167,540.10 $84,651.84 2026-03-01
285110 CDM Valve Aortic 29mm 1 1 $176,358.00 $176,358.00 $149,904.30 $149,904.30 $149,904.30 2026-03-01
285526 CDM System Shunt Lumbar 35 24 $174,807.00 $174,807.00 $18,879.16 $166,066.65 $80,411.22 2026-03-01
285899 CDM Cage Spn 6d 11x9x26mm 1 1 $94,008.00 $94,008.00 $79,906.80 $79,906.80 $79,906.80 2026-03-01
286098 CDM Vlv Aor Tis Mgna 27 1 1 $75,519.00 $75,519.00 $64,191.15 $64,191.15 $64,191.15 2026-03-01
286757 CDM Cage Spn 6d 13x26mm 1 1 $94,008.00 $94,008.00 $64,865.52 $64,865.52 $64,865.52 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $186,045.79 $186,045.79 $186,045.79 2026-03-01
308880 CDM Cage Spnl Ovl 50x22x17 1 1 $80,389.00 $80,389.00 $68,330.65 $68,330.65 $68,330.65 2026-03-01
308911 CDM Cage Lmbr 14x15x130mm 1 1 $116,560.00 $116,560.00 $99,076.00 $99,076.00 $99,076.00 2026-03-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 4 2 — — $42,037.34 $75,577.07 $71,235.47 2026-03-01
317524 CDM Guide Cutting Mandible 1 1 $81,298.00 $81,298.00 $69,103.30 $69,103.30 $69,103.30 2026-03-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 9 3 — — $41,885.97 $99,929.16 $75,280.20 2026-03-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 4 2 — — $26,903.49 $65,783.50 $62,001.59 2026-03-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 7 2 — — $40,720.64 $104,627.88 $72,994.58 2026-03-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 4 2 — — $46,396.80 $84,127.46 $79,294.67 2026-03-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 4 2 — — $43,034.97 $77,533.76 $73,079.75 2026-03-01
33249 CPT Ins/repo Sgl Icd+lead 29 24 $122,729.00 $122,729.00 $13,254.73 $116,592.55 $73,637.40 2026-08-01
33270 CPT Ins/rpl Sq Defib With Elec 29 24 $206,720.00 $206,720.00 $22,325.76 $196,384.00 $124,032.00 2026-08-01
33276 CPT Insertion Of Phrenic Nerve Stimulator System (pulse Generator And Stimulating Le… 2 2 $118,167.00 $118,167.00 $33,428.26 $100,441.95 $66,935.11 2026-03-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 4 2 — — $41,283.10 $74,097.75 $69,841.13 2026-03-01
37227 CPT Rvs O Or P Fem/pop Stnt 35 26 $156,597.00 $156,597.00 $8,769.43 $148,767.15 $86,128.35 2026-08-01
37231 CPT Stent/ath/tib/peron Ini 77 28 $156,597.00 $156,597.00 $8,541.66 $148,767.15 $72,034.62 2026-08-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $122,629.39 $122,629.39 $122,629.39 2026-03-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 4 2 — — $50,551.58 $92,276.39 $86,975.48 2026-03-01
422236 CDM Generator Nrstm 7 Ipg 35 24 $222,904.00 $222,904.00 $24,073.63 $211,758.80 $102,535.84 2026-03-01
422684 CDM Defit 7 Vr-t Dx W Hm Ipr 35 24 $161,514.00 $161,514.00 $17,443.51 $153,438.30 $74,296.44 2026-03-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 4 2 — — $39,220.76 $70,052.80 $66,028.55 2026-03-01
423239 CDM Plate Hemi 2mm Mndb Cstm 37 25 $143,904.00 $143,904.00 $15,541.63 $136,708.80 $71,952.00 2026-03-01
423241 CDM Guide Cut 65 Md Mdl 2 2 $123,307.00 $123,307.00 $85,081.83 $104,810.95 $94,946.39 2026-03-01
424321 CDM Liner R3 Constrain 46mm 2 2 $159,828.00 $159,828.00 $110,281.32 $135,853.80 $123,067.56 2026-03-01
424327 CDM Cage Spnl 16mm 18mm 2 2 $97,740.00 $97,740.00 $67,440.60 $83,079.00 $75,259.80 2026-03-01
424366 CDM Cage Spnl 50x22x14mm 35 24 $142,812.00 $142,812.00 $15,423.70 $135,671.40 $65,693.52 2026-03-01
424401 CDM Stm 10mmx194mm W 4mm H 37 25 $146,128.00 $146,128.00 $15,781.82 $138,821.60 $73,064.00 2026-03-01
424421 CDM Stem Hum Shldr 13x130mm 37 25 $154,750.00 $154,750.00 $16,713.00 $147,012.50 $77,375.00 2026-03-01
424881 CDM Stent Fgt Vlnt 200x38x38 2 2 $245,579.00 $245,579.00 $169,449.51 $208,742.15 $189,095.83 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 1 — — $98,288.93 $98,288.93 $98,288.93 2026-03-01
426614 CDM Sys Nrstm 4.8x6.5cm 1.1c 37 25 $198,403.00 $198,403.00 $21,427.52 $188,482.85 $99,201.50 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 1 — — $65,585.67 $65,585.67 $65,585.67 2026-03-01
427515 CDM Kit Implant Crnmxf Xlg 2 2 $171,678.00 $171,678.00 $118,457.82 $145,926.30 $132,192.06 2026-03-01
427702 CDM Spacer Spn 6d 14x12x38mm 1 1 $96,049.00 $96,049.00 $66,273.81 $66,273.81 $66,273.81 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 1 1 — — $80,988.70 $80,988.70 $80,988.70 2026-03-01
429233 CDM Spacer Spn 6d 14x12x32mm 1 1 $105,818.00 $105,818.00 $73,014.42 $73,014.42 $73,014.42 2026-03-01
431692 CDM Screw Ex Fx Hffman 3 52 34 $139,933.00 $139,933.00 $7,836.25 $132,936.35 $65,978.41 2026-03-01
435085 CDM Cap Fh Total Shoulder 2 2 $89,504.00 $89,504.00 $61,757.76 $76,078.40 $68,918.08 2026-03-01
435086 CDM Cap Fh Reverse Shoulder 2 2 $136,995.00 $136,995.00 $94,526.55 $116,445.75 $105,486.15 2026-03-01
436688 CDM Graft Bn Cartiform 25x20 1 1 $167,724.00 $167,724.00 $142,565.40 $142,565.40 $142,565.40 2026-03-01
437104 CDM Sys Cath Trevo Xp 4x30mm 2 2 $137,967.00 $137,967.00 $95,197.23 $117,271.95 $106,234.59 2026-03-01
441604 CDM Mandible Plate Sz Med 2 2 $140,885.00 $140,885.00 $97,210.65 $119,752.25 $108,481.45 2026-03-01
442814 CDM Cage Spn 24mmx6d 1 1 $102,039.00 $102,039.00 $70,406.91 $70,406.91 $70,406.91 2026-03-01
443285 CDM Kit Impl Sz Sm Crnln Cus 36 24 $167,724.00 $167,724.00 $18,114.19 $159,337.80 $80,507.52 2026-03-01
443461 CDM Plate Nmdb 2.0thick Lt 37 25 $124,113.00 $124,113.00 $13,404.20 $117,907.35 $62,056.50 2026-03-01
444440 CDM Stem Bn Fem Ofst 11.25mm 2 2 $89,047.00 $89,047.00 $61,442.43 $75,689.95 $68,566.19 2026-03-01
446809 CDM Alve Aor 27mm 400 Ser - 1 1 $85,538.00 $85,538.00 $72,707.30 $72,707.30 $72,707.30 2026-03-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 4 2 — — $60,967.33 $161,547.72 $152,260.30 2026-03-01
447927 CDM Icd .99cm 5.37x8.08CM 36 25 $161,514.00 $161,514.00 $17,443.51 $153,438.30 $77,526.72 2026-03-01
451742 CDM Implant Mndb Half Model 36 24 $167,724.00 $167,724.00 $18,114.19 $159,337.80 $80,507.52 2026-03-01
455211 CDM Implant Crnl Ips Ti Ns 1 1 $166,043.00 $166,043.00 $114,569.67 $114,569.67 $114,569.67 2026-03-01
455353 CDM Amnion Liquid 2.0ml Strl 1 1 $73,378.00 $73,378.00 $62,371.30 $62,371.30 $62,371.30 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 2 — — $75,775.22 $203,177.41 $191,496.68 2026-03-01
462517 CDM Kit Implant Crnmxf Xlg 36 24 $248,231.00 $248,231.00 $26,808.95 $235,819.45 $119,150.88 2026-03-01
462685 CDM Plate Facil Id Orthognat 2 2 $111,199.00 $111,199.00 $76,727.31 $94,519.15 $85,623.23 2026-03-01
462971 CDM Impl Ips Crnl Peek 18.0 2 2 $167,724.00 $167,724.00 $115,729.56 $142,565.40 $129,147.48 2026-03-01
463565 CDM Graft Amnion Thin 7x7cm 2 2 $82,603.00 $82,603.00 $56,996.07 $70,212.55 $63,604.31 2026-03-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 4 2 — — $48,271.66 $125,856.16 $118,620.66 2026-03-01
466317 CDM Spacer Spn 6d 12x14x36mm 1 1 $96,049.00 $96,049.00 $81,641.65 $81,641.65 $81,641.65 2026-03-01
467887 CDM Spacer Spn 6d 14x12x30mm 1 1 $96,049.00 $96,049.00 $66,273.81 $66,273.81 $66,273.81 2026-03-01
468805 CDM Implant Midface Ips 2 2 $140,885.00 $140,885.00 $97,210.65 $119,752.25 $108,481.45 2026-03-01
471 MS_DRG Cervical Spinal Fusion With Mcc 4 2 — — $45,031.94 $116,748.31 $110,036.42 2026-03-01
471441 CDM Valve Aor Tavr 34mm 1 1 $377,910.00 $377,910.00 $321,223.50 $321,223.50 $321,223.50 2026-03-01
471442 CDM Valve Aor Tavr 29mm 36 24 $377,910.00 $377,910.00 $40,814.28 $359,014.50 $181,396.80 2026-03-01
471443 CDM Valve Aor Tavr 26mm 1 1 $377,910.00 $377,910.00 $321,223.50 $321,223.50 $321,223.50 2026-03-01
471473 CDM Frame Exfx 180mm 50 33 $152,971.00 $152,971.00 $8,566.38 $145,322.45 $69,601.80 2026-03-01
471900 CDM Spacer Spn 6d 14x12x28mm 1 1 $96,049.00 $96,049.00 $66,273.81 $66,273.81 $66,273.81 2026-03-01
473093 CDM Stent Gft Thor Act 37x37 2 2 $221,708.00 $221,708.00 $152,978.52 $188,451.80 $170,715.16 2026-03-01
473202 CDM Set Pump Asst 2.5in 51 33 $275,040.00 $275,040.00 $15,402.24 $261,288.00 $126,518.40 2026-03-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 4 2 — — $40,423.94 $72,412.64 $68,252.82 2026-03-01
475883 CDM Spacer Spn 45x18x10mm 8d 1 1 $75,584.00 $75,584.00 $64,246.40 $64,246.40 $64,246.40 2026-03-01
475884 CDM Spacer Spnl 50x18x12mm 1 1 $75,584.00 $75,584.00 $64,246.40 $64,246.40 $64,246.40 2026-03-01
480381 CDM Implant Crnl Custm 1 1 $189,797.00 $189,797.00 $161,327.45 $161,327.45 $161,327.45 2026-03-01
482359 CDM Valve Heart Trnscth 20mm 35 24 $409,403.00 $409,403.00 $44,215.52 $388,932.85 $188,325.38 2026-03-01
482360 CDM Valve Heart Trnscth 23mm 1 1 $409,403.00 $409,403.00 $347,992.55 $347,992.55 $347,992.55 2026-03-01
482361 CDM Valve Heart Trnscth 26mm 1 1 $409,403.00 $409,403.00 $347,992.55 $347,992.55 $347,992.55 2026-03-01
484234 CDM Valve Aortic 25mm 36 25 $176,358.00 $176,358.00 $19,046.66 $167,540.10 $84,651.84 2026-03-01
485102 CDM Generator Pulse Imp Kit 36 24 $217,929.00 $217,929.00 $23,536.33 $207,032.55 $104,605.92 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $92,176.75 $92,176.75 $92,176.75 2026-03-01
572470 CDM Plate Cranial Lf Ft 2 2 $178,965.00 $178,965.00 $123,485.85 $152,120.25 $137,803.05 2026-03-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 7 2 — — $59,847.58 $158,399.75 $110,509.02 2026-03-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 4 2 — — $45,655.46 $82,673.44 $77,924.18 2026-03-01
589302 CDM Spacer Spnl 27x9.5x9mm 1 1 $90,701.00 $90,701.00 $62,583.69 $62,583.69 $62,583.69 2026-03-01
589312 CDM Spacer Spnl 27x9.5x13mm 1 1 $90,701.00 $90,701.00 $62,583.69 $62,583.69 $62,583.69 2026-03-01
589322 CDM Spacer Spnl 27x9.5x15mm 1 1 $90,701.00 $90,701.00 $62,583.69 $62,583.69 $62,583.69 2026-03-01
598824 CDM Cage Spnl 28x9x7mm Crv 1 1 $90,701.00 $90,701.00 $77,095.85 $77,095.85 $77,095.85 2026-03-01
6 MS_DRG Liver Transplant Without Mcc 2 2 — — $43,383.28 $125,000.00 $84,191.64 2026-03-01
602658 CDM Spacer Spnl 25x9mm 1 1 $84,374.00 $84,374.00 $71,717.90 $71,717.90 $71,717.90 2026-03-01
609236 CDM Spacer Spnl 25x10mm 2 2 $84,374.00 $84,374.00 $58,218.06 $71,717.90 $64,967.98 2026-03-01
612466 CDM Cage Spnl 28x9x10mm Crv 1 1 $90,701.00 $90,701.00 $62,583.69 $62,583.69 $62,583.69 2026-03-01
612669 CDM Cage Spnl 31x23x10mm0d 1 1 $90,701.00 $90,701.00 $77,095.85 $77,095.85 $77,095.85 2026-03-01
612683 CDM Cage Spnl 31x23x12mm0d 2 2 $90,701.00 $90,701.00 $62,583.69 $77,095.85 $69,839.77 2026-03-01
614144 CDM Spacer Spnl 38mmx14mm 1 1 $94,480.00 $94,480.00 $80,308.00 $80,308.00 $80,308.00 2026-03-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 3 1 — — $81,107.05 $86,054.34 $81,107.05 2026-03-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc Pediatric 6 2 — — $35,555.34 $85,152.35 $72,881.56 2026-03-01
640449 CDM Spacer Spnl 30x12mm 1 1 $84,374.00 $84,374.00 $71,717.90 $71,717.90 $71,717.90 2026-03-01
640527 CDM Spacer Spnl 25x9mm 2 2 $84,374.00 $84,374.00 $58,218.06 $71,717.90 $64,967.98 2026-03-01
641343 CDM Cage Spnl 28x9x8mm Crv 1 1 $90,701.00 $90,701.00 $77,095.85 $77,095.85 $77,095.85 2026-03-01
644288 CDM Spcr Sm 39-65x14 Cs2250 1 1 $113,376.00 $113,376.00 $78,229.44 $78,229.44 $78,229.44 2026-03-01
647374 CDM Stnt Bfr Anrx 165 26x15 36 24 $130,822.00 $130,822.00 $14,128.78 $124,280.90 $62,794.56 2026-03-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 4 2 — — $39,638.73 $70,872.59 $66,801.24 2026-03-01
7 MS_DRG Lung Transplant 1 1 — — $114,878.77 $114,878.77 $114,878.77 2026-03-01
712753 CDM Spacer Peek Crnt55x18x10 1 1 $85,032.00 $85,032.00 $72,277.20 $72,277.20 $72,277.20 2026-03-01
714108 CDM Spacer Spnl Od10mm X Stp 1 1 $87,394.00 $87,394.00 $74,284.90 $74,284.90 $74,284.90 2026-03-01
716492 CDM Implant Axailif Spinal S 1 1 $151,074.00 $151,074.00 $104,241.06 $104,241.06 $104,241.06 2026-03-01
716714 CDM Spcr Spnl 28x10x9 Tlif 2 2 $103,928.00 $103,928.00 $71,710.32 $88,338.80 $80,024.56 2026-03-01
716997 CDM Cage Spnl Std Xl 50x10 36 25 $134,805.00 $134,805.00 $14,558.94 $128,064.75 $64,706.40 2026-03-01
717462 CDM Cage Spn Tlif 7mm 1 1 $103,928.00 $103,928.00 $88,338.80 $88,338.80 $88,338.80 2026-03-01
717793 CDM Valve Aortic 25mm 1 1 $75,519.00 $75,519.00 $64,191.15 $64,191.15 $64,191.15 2026-03-01
718680 CDM Cage Spn 32-47mm 20mm 1 1 $107,141.00 $107,141.00 $73,927.29 $73,927.29 $73,927.29 2026-03-01
722257 CDM Cage Spnl 50x18x10mm 1 1 $85,032.00 $85,032.00 $72,277.20 $72,277.20 $72,277.20 2026-03-01
732807 CDM Cage Spn Crntc55x22x10 1 1 $78,570.00 $78,570.00 $66,784.50 $66,784.50 $66,784.50 2026-03-01
738739 CDM Cage Plt 8x18x50 Lord Xl 2 2 $85,032.00 $85,032.00 $58,672.08 $72,277.20 $65,474.64 2026-03-01
741017 CDM Forcep Grasp 2.4fr 90cm 1 1 $169,270.00 $169,270.00 $143,879.50 $143,879.50 $143,879.50 2026-03-01
741535 CDM Valve Trfcta 15x24x19mm 2 2 $80,558.00 $80,558.00 $55,585.02 $68,474.30 $62,029.66 2026-03-01
744324 CDM Cage Spnl 55x22x12mm Crn 1 1 $85,032.00 $85,032.00 $72,277.20 $72,277.20 $72,277.20 2026-03-01
744885 CDM Cage Spnl 28mm 12mm 35 24 $160,616.00 $160,616.00 $17,346.53 $152,585.20 $73,883.36 2026-03-01
745947 CDM Spacer Spn 10x9x22x4d 2 2 $85,032.00 $85,032.00 $58,672.08 $72,277.20 $65,474.64 2026-03-01
747460 CDM Spacer Spn 45x18x12mm 1 1 $75,584.00 $75,584.00 $64,246.40 $64,246.40 $64,246.40 2026-03-01
748438 CDM Unit Esurg Bnld Max 1 51 34 $191,743.00 $191,743.00 $10,737.61 $182,155.85 $88,201.78 2026-03-01
748488 CDM Gft Sft Tis Frzn Strut 2 2 $139,661.00 $139,661.00 $96,366.09 $118,711.85 $107,538.97 2026-03-01
749139 CDM Cage Spn 53-87mm 20mm 37 25 $141,720.00 $141,720.00 $15,305.76 $134,634.00 $70,860.00 2026-03-01
749569 CDM Dvc Revasc 4mm 31mm 1 1 $122,714.00 $122,714.00 $104,306.90 $104,306.90 $104,306.90 2026-03-01
749575 CDM Kit Generator Nrstm Chg 36 25 $306,297.00 $306,297.00 $33,080.08 $290,982.15 $147,022.56 2026-03-01
750000 CDM Cage Spn 18x25mm 2 2 $112,531.00 $112,531.00 $77,646.39 $95,651.35 $86,648.87 2026-03-01
750074 CDM Cage Spn 45x18x12mm 1 1 $85,032.00 $85,032.00 $72,277.20 $72,277.20 $72,277.20 2026-03-01
750672 CDM Dvc Revasc 6mm 42mm 2 2 $143,326.00 $143,326.00 $98,894.94 $121,827.10 $110,361.02 2026-03-01
752895 CDM Cage Spnl 9mmx10mmx25mm 1 1 $114,888.00 $114,888.00 $97,654.80 $97,654.80 $97,654.80 2026-03-01
754265 CDM Cage Spnl 9x9x21mm 1 1 $114,888.00 $114,888.00 $79,272.72 $79,272.72 $79,272.72 2026-03-01
799 MS_DRG Splenic Procedures With Mcc 4 2 — — $42,453.59 $76,393.49 $72,004.98 2026-03-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 4 2 — — $53,942.66 $141,799.13 $133,647.06 2026-03-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 11 10 — — $115,972.92 $144,966.15 $115,972.92 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 1 1 — — $77,977.74 $77,977.74 $77,977.74 2026-03-01
850420 CDM Spacer Pk Crnt45x18x8 Xl 1 1 $75,584.00 $75,584.00 $64,246.40 $64,246.40 $64,246.40 2026-03-01
852514 CDM Spacer Spn 6d 14x12x12mm 1 1 $86,444.00 $86,444.00 $73,477.40 $73,477.40 $73,477.40 2026-03-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 4 2 — — $45,977.11 $83,304.30 $78,518.80 2026-03-01
853590 CDM Sleeve Atch Msc Ex Fix L 2 2 $111,938.00 $111,938.00 $77,237.22 $95,147.30 $86,192.26 2026-03-01
854250 CDM Cage Spnl 60x22x12mm Crn 1 1 $85,032.00 $85,032.00 $72,277.20 $72,277.20 $72,277.20 2026-03-01
855363 CDM Spacer Spnl 60x22x10mm 2 2 $85,032.00 $85,032.00 $58,672.08 $72,277.20 $65,474.64 2026-03-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 3 1 — — $72,319.78 $76,727.47 $72,319.78 2026-03-01
863353 CDM Occluder Cv 4x6mm 2 2 $81,127.00 $81,127.00 $55,977.63 $68,957.95 $62,467.79 2026-03-01
863637 CDM Mandible & Maxilla Clear 1 1 $135,676.00 $135,676.00 $115,324.60 $115,324.60 $115,324.60 2026-03-01
864406 CDM Disc Intvrtb 15x5x13mm 2 2 $92,591.00 $92,591.00 $63,887.79 $78,702.35 $71,295.07 2026-03-01
865612 CDM Disc Spn Mobi-c 15x15x5 2 2 $92,591.00 $92,591.00 $63,887.79 $78,702.35 $71,295.07 2026-03-01
866956 CDM Spacer Spn 6d 14x12x24mm 2 2 $86,444.00 $86,444.00 $59,646.36 $73,477.40 $66,561.88 2026-03-01
868398 CDM Spacer Spn 6d 14x12x44mm 1 1 $105,818.00 $105,818.00 $89,945.30 $89,945.30 $89,945.30 2026-03-01
868775 CDM Capsule Cam Sb3 Ex 12hr 1 1 $99,705.00 $99,705.00 $68,796.45 $68,796.45 $68,796.45 2026-03-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 4 2 — — $62,947.10 $114,258.97 $107,692.76 2026-03-01
871257 CDM Kit Implant Crnmxf Sm 37 25 $160,341.00 $160,341.00 $17,316.83 $152,323.95 $80,170.50 2026-03-01
872152 CDM Kit Implant Crnmxf Lg 35 24 $167,724.00 $167,724.00 $18,114.19 $159,337.80 $77,153.04 2026-03-01
872929 CDM Kit Implant Crnmxf Med 37 25 $188,957.00 $188,957.00 $20,407.36 $179,509.15 $94,478.50 2026-03-01
875410 CDM Device Intrivia Montrng 50 33 $178,530.00 $178,530.00 $9,997.68 $169,603.50 $81,231.15 2026-03-01
875506 CDM Can Prfsn 22fr Vsn 20d 52 34 $191,743.00 $191,743.00 $10,737.61 $182,155.85 $90,406.82 2026-03-01
876617 CDM Kit Aor Vlv 14fr 29mm 37 25 $409,403.00 $409,403.00 $44,215.52 $388,932.85 $204,701.50 2026-03-01
876961 CDM Kit Bone Tamp 2 2 $95,961.00 $95,961.00 $66,213.09 $81,566.85 $73,889.97 2026-03-01
877388 CDM Kit Pt Specific Tmj Comp 36 25 $195,254.00 $195,254.00 $21,087.43 $185,491.30 $93,721.92 2026-03-01
877605 CDM Compnt Shldr Sz2 Mtphs 37 25 $155,298.00 $155,298.00 $16,772.18 $147,533.10 $77,649.00 2026-03-01
879722 CDM Retreive Rpr Trv Xp 4x30 50 33 $137,967.00 $137,967.00 $7,726.15 $131,068.65 $62,774.99 2026-03-01
880409 CDM Set Implant Peek Crnl 36 24 $182,814.00 $182,814.00 $19,743.91 $173,673.30 $87,750.72 2026-03-01
880563 CDM Implant Cust Cranial Xl 36 24 $184,490.00 $184,490.00 $19,924.92 $175,265.50 $88,555.20 2026-03-01
901 MS_DRG Wound Debridements For Injuries With Mcc 4 2 — — $39,595.73 $70,788.25 $66,721.74 2026-03-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc Pediatric 6 2 — — $35,093.50 $86,253.96 $73,824.42 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 2 2 — — $187,123.39 $194,184.65 $190,654.02 2026-03-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 4 2 — — $65,190.91 $173,421.54 $163,451.49 2026-03-01
93653 CPT Ep Repos Ele Svt Sgl 2 2 $96,838.00 $96,838.00 $66,818.22 $82,312.30 $74,565.26 2026-08-01
93654 CPT Ep Repos Ele Vt 3d Map 60 24 $161,324.00 $171,941.00 $9,034.14 $173,430.10 $94,036.70 2026-08-01
93656 CPT $875.86 1 1 $117,442.85 $132,505.00 $91,428.45 $91,428.45 $91,428.45 2026-08-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc Pe… 3 1 — — $82,686.26 $87,729.87 $82,686.26 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 43 27 $880,446.60 — $546,920.16 $1,395,204.50 $574,824.25 2026-08-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 4 2 — — $61,393.04 $113,540.19 $107,017.76 2026-03-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 7 2 — — $69,036.94 $184,233.94 $128,532.47 2026-03-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 7 2 — — $39,744.51 $101,883.67 $71,080.07 2026-03-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 4 2 — — $43,854.56 $79,141.28 $74,594.93 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 2 1 $1,598,049.95 — $93,760.51 $93,760.51 $93,760.51 2026-08-01
C1721 HCPCS Icd Iperia 7 Dr-t Df-1 378 25 $150,382.00 $150,382.00 $12,830.62 $179,478.75 $72,681.30 2026-03-01
C1735 HCPCS Catheter Renal 6fr 48 30 $220,032.00 $220,032.00 $12,321.79 $209,030.40 $106,275.46 2026-03-01
C1761 HCPCS Cath Ivl 2.5x12mm 2 2 $90,118.00 $90,118.00 $62,181.42 $76,600.30 $69,390.86 2026-03-01
C1767 HCPCS Gen Nrstm 52x52x6.9mm 407 25 $216,669.00 $216,669.00 $1,086.91 $394,389.65 $92,120.60 2026-03-01
C1817 HCPCS Occluder Cv 12fr 44mm 150 25 $136,659.00 $136,659.00 $13,597.96 $144,994.70 $68,681.70 2026-03-01
C1823 HCPCS Lead Stim Right 73 25 $145,359.00 $145,359.00 $12,943.15 $155,733.69 $65,411.55 2026-03-01
C1882 HCPCS Icd Unify Cd3231-40 225 25 $166,293.00 $166,293.00 $6,086.34 $187,298.20 $72,681.30 2026-03-01
C2616 HCPCS Brachytx Ns Yttrium 90 2 2 $196,295.00 $196,295.00 $135,443.55 $166,850.75 $151,147.15 2026-08-01
C2624 HCPCS System Mntr 2x15mm 4.5cm 35 24 $233,045.00 $233,045.00 $25,168.86 $221,392.75 $107,200.70 2026-03-01
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 2 1 — — $4,850,948.67 $4,850,948.67 $4,850,948.67 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 2 1 — — $106,053.40 $106,053.40 $106,053.40 2026-03-01
J9266 HCPCS Pegaspargase Singl Vial 30 25 $168,804.00 $168,804.00 $9,453.02 $160,363.80 $101,282.40 2026-08-01
J9272 HCPCS $369.55 1 1 $45,782.99 $89,382.00 $75,974.70 $75,974.70 $75,974.70 2026-08-01
L8614 HCPCS Impl Coclr Hifcs 90k 37 22 $434,660.00 $434,660.00 $18,342.96 $412,927.00 $217,330.00 2026-08-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 44 28 $2,483,894.73 — $109,262.16 $278,730.00 $114,836.76 2026-08-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 2 1 $3,503,812.80 — $934,776.65 $934,776.65 $934,776.65 2026-08-01
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