Price Transparency 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

37,050 distinct procedures filed
62 distinct payers
1,882,373 rate rows
2026-03-01 last MRF observed
Data quality

1,799,788 of 1,882,373 rate rows are consumer-grade (95.6%)

82,585 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
template filing: same amount across many unrelated codes — excluded 49,137
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 17,690
per-diem day rate — not a per-procedure price 15,369
placeholder amount (≤ $0.02) — excluded from medians 355
exceeds 10× this hospital's gross charge — excluded from medians 34
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 not_modified · 2026-05-15
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
$3,006,423
1.6× median
845
OTHER 		Inj, Atidarsagene Autotem 24 $5,892.44 $4,955,500.00 $4,640,150.00 nat. median
$9,966
outlier · 465.6×
00845
OTHER 		Inj, Atidarsagene Autotem 1 $4,505,000.00 $4,505,000.00 $4,505,000.00 nat. median
$4,505,000
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
$2,469,189
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
$2,448,600
1.6× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 25 $3,611,561.66 $4,975,110.45 $3,795,825.01 nat. median
$3,746,358
1.0× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 1 $3,685,267.00 $3,685,267.00 $3,685,267.00 nat. median
$3,574,709
1.0× median
908
OTHER 		Topi Adm Prad Zami Per Tr 26 $10,669.09 $4,503,357.00 $3,435,894.60 nat. median
$22,747
outlier · 151.0×
714
OTHER 		Inj Delandistrogene Mox R 27 $6,930.30 $4,492,611.00 $3,427,695.80 nat. median
$13,041
outlier · 262.8×
748
OTHER 		Inj, Lovotibeglogene Auto 27 $13,191.75 $4,390,885.80 $3,350,083.24 nat. median
$17,963
outlier · 186.5×
00908
OTHER 		Topi Adm Prad Zami Per Tr 1 $3,335,820.00 $3,335,820.00 $3,335,820.00 nat. median
$12,675
outlier · 263.2×
00714
OTHER 		Inj Delandistrogene Mox R 1 $3,327,860.00 $3,327,860.00 $3,327,860.00 nat. median
$3,228,024
1.0× median
906
OTHER 		Inj Elivaldogene Autoteme 26 $9,427.40 $4,929,000.00 $3,275,400.00 nat. median
$20,756
outlier · 157.8×
00748
OTHER 		Inj, Lovotibeglogene Auto 1 $3,252,508.00 $3,252,508.00 $3,252,508.00 nat. median
$3,187,420
1.0× median
00906
OTHER 		Inj Elivaldogene Autoteme 1 $3,180,000.00 $3,180,000.00 $3,180,000.00 nat. median
$21
outlier · 153697.4×
746
OTHER 		Inj, Betibeglogene Autote 27 $12,202.51 $4,556,951.95 $3,028,168.07 nat. median
$21,896
outlier · 138.3×
00746
OTHER 		Inj, Betibeglogene Autote 1 $2,939,969.00 $2,939,969.00 $2,939,969.00 nat. median
$2,878,960
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 25 $2,537,201.38 $4,012,920.55 $2,666,650.43 nat. median
$2,588,981
1.0× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 1 $2,588,981.00 $2,588,981.00 $2,588,981.00 nat. median
$2,457,321
1.1× median
824
OTHER 		Inj, Exagamglogene Autote 28 $14,288.83 $4,780,600.00 $2,401,960.00 nat. median
$25,250
outlier · 95.1×
00824
OTHER 		Inj, Exagamglogene Autote 1 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,332,000
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 2 $1,113,880.32 $1,905,321.60 $1,722,117.60 nat. median
$824,563
outlier · 2.1×
Q2058
HCPCS 		Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,… 2 $459,112.50 $1,375,920.00 $1,243,620.00 nat. median
$324,450
outlier · 3.8×
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 4 $553,169.00 $1,204,164.00 $969,621.79 nat. median
$675,122
1.4× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 4 $516,442.00 $1,062,512.88 $927,632.05 nat. median
$674,188
1.4× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 4 $527,622.00 $1,086,337.20 $920,834.85 nat. median
$625,184
1.5× median
2067
OTHER 		Afamitresgene Autoleucel 28 $755,207.60 $1,926,550.00 $809,151.00 nat. median
$786,032
1.0× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 4 $489,399.00 $965,920.80 $807,592.83 nat. median
$620,080
1.3× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 4 $578,771.00 $998,894.00 $788,832.50 nat. median
$754,974
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 5 $502,841.00 $921,310.00 $712,075.50 nat. median
$634,511
1.1× median
C9301
HCPCS 		Obecabtagene Autoleucel, Up To 400 Million Cd19 Car-positive Viable T Cells, Inc… 1 $422,940.00 $723,450.00 $653,887.50 nat. median
$459,112
1.4× median
9498
OTHER 		Ciltacabtagene Car-pos T 27 $575,896.61 $1,469,124.00 $605,279.09 nat. median
$587,650
1.0× median
09498
OTHER 		Ciltacabtagene Car-pos T 1 $587,649.60 $587,649.60 $587,649.60 nat. median
$554,552
1.1× median
9194
OTHER 		Tisagenlecleucel Car-pos 27 $555,200.67 $1,416,328.25 $583,527.24 nat. median
$566,531
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 27 $550,957.18 $1,405,503.00 $579,067.24 nat. median
$562,201
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 27 $546,920.16 $1,395,204.50 $574,824.25 nat. median
$558,082
1.0× median
09194
OTHER 		Tisagenlecleucel Car-pos 1 $566,531.30 $566,531.30 $566,531.30 nat. median
$538,205
1.1× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $562,201.20 $562,201.20 $562,201.20 nat. median
$534,091
1.1× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $558,081.80 $558,081.80 $558,081.80 nat. median
$530,178
1.1× median
9035
OTHER 		Axicabtagene Ciloleucel C 27 $521,548.36 $1,330,480.50 $548,157.97 nat. median
$532,192
1.0× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $532,192.20 $532,192.20 $532,192.20 nat. median
$505,583
1.1× median
9391
OTHER 		Brexucabtagene Car Pos T 27 $479,661.20 $1,223,625.50 $504,133.71 nat. median
$489,450
1.0× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $489,450.20 $489,450.20 $489,450.20 nat. median
$464,978
1.1× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 23 $318,299.85 $644,546.47 $371,349.83 nat. median
$370,174
1.0× median
5834
APR_DRG 		Neonate With Ecmo 10 $345,402.06 $431,752.58 $345,402.06 nat. median
$309,665
1.1× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 10 $336,007.44 $588,013.00 $336,007.44 nat. median
$187,294
1.8× 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
24
APR_DRG 		Heart And/or Lung Transplant 11 $281,351.48 $492,365.00 $292,605.53 nat. median
$234,738
1.2× median
5833
APR_DRG 		Neonate With Ecmo 10 $292,473.77 $365,592.21 $292,473.77 nat. median
$244,017
1.2× median
831
OTHER 		Obecbtge Autol Up To 400 28 $4,034.88 $695,625.00 $286,597.50 nat. median
$12,362
outlier · 23.2×

Other procedures at this hospital

Browse this hospital's 37,050 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
             
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 2 1 — — $4,850,948.67 $4,850,948.67 $4,850,948.67 2026-03-01
845 OTHER Inj, Atidarsagene Autotem 38 24 — — $5,892.44 $4,955,500.00 $4,640,150.00 2026-03-01
00845 OTHER Inj, Atidarsagene Autotem 1 1 — — $4,505,000.00 $4,505,000.00 $4,505,000.00 2026-03-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 2 1 — — $4,271,819.03 $4,271,819.03 $4,271,819.03 2026-03-01
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 2 1 — — $3,847,800.00 $3,847,800.00 $3,847,800.00 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 39 25 — — $3,611,561.66 $4,975,110.45 $3,795,825.01 2026-03-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 1 1 — — $3,685,267.00 $3,685,267.00 $3,685,267.00 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 40 26 — — $10,669.09 $4,503,357.00 $3,435,894.60 2026-03-01
714 OTHER Inj Delandistrogene Mox R 43 27 — — $6,930.30 $4,492,611.00 $3,427,695.80 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 43 27 — — $13,191.75 $4,390,885.80 $3,350,083.24 2026-03-01
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
00714 OTHER Inj Delandistrogene Mox R 1 1 — — $3,327,860.00 $3,327,860.00 $3,327,860.00 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 41 26 — — $9,427.40 $4,929,000.00 $3,275,400.00 2026-03-01
00748 OTHER Inj, Lovotibeglogene Auto 1 1 — — $3,252,508.00 $3,252,508.00 $3,252,508.00 2026-03-01
00906 OTHER Inj Elivaldogene Autoteme 1 1 — — $3,180,000.00 $3,180,000.00 $3,180,000.00 2026-03-01
746 OTHER Inj, Betibeglogene Autote 44 27 — — $12,202.51 $4,556,951.95 $3,028,168.07 2026-03-01
00746 OTHER Inj, Betibeglogene Autote 1 1 — — $2,939,969.00 $2,939,969.00 $2,939,969.00 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 40 25 — — $2,537,201.38 $4,012,920.55 $2,666,650.43 2026-03-01
09141 OTHER Inj Onase Abepar-xioi Tre 1 1 — — $2,588,981.00 $2,588,981.00 $2,588,981.00 2026-03-01
824 OTHER Inj, Exagamglogene Autote 43 28 — — $14,288.83 $4,780,600.00 $2,401,960.00 2026-03-01
00824 OTHER Inj, Exagamglogene Autote 1 1 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2026-03-01
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 7 2 — — $1,113,880.32 $1,905,321.60 $1,722,117.60 2026-03-01
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 7 2 — — $459,112.50 $1,375,920.00 $1,243,620.00 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 11 4 — — $553,169.00 $1,204,164.00 $969,621.79 2026-03-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 11 4 — — $516,442.00 $1,062,512.88 $927,632.05 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 11 4 — — $527,622.00 $1,086,337.20 $920,834.85 2026-03-01
2067 OTHER Afamitresgene Autoleucel 46 28 — — $755,207.60 $1,926,550.00 $809,151.00 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 11 4 — — $489,399.00 $965,920.80 $807,592.83 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 13 4 — — $578,771.00 $998,894.00 $788,832.50 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 16 5 — — $502,841.00 $921,310.00 $712,075.50 2026-03-01
C9301 HCPCS Obecabtagene Autoleucel, Up To 400 Million Cd19 Car-positive Viable T Cells, Inc… 5 1 — — $422,940.00 $723,450.00 $653,887.50 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 43 27 — — $575,896.61 $1,469,124.00 $605,279.09 2026-03-01
09498 OTHER Ciltacabtagene Car-pos T 1 1 — — $587,649.60 $587,649.60 $587,649.60 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 43 27 — — $555,200.67 $1,416,328.25 $583,527.24 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 43 27 — — $550,957.18 $1,405,503.00 $579,067.24 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 43 27 — — $546,920.16 $1,395,204.50 $574,824.25 2026-03-01
09194 OTHER Tisagenlecleucel Car-pos 1 1 — — $566,531.30 $566,531.30 $566,531.30 2026-03-01
09413 OTHER Lisocabtagene Car Pos T 1 1 — — $562,201.20 $562,201.20 $562,201.20 2026-03-01
09422 OTHER Idecabtagene Vicleucel Ca 1 1 — — $558,081.80 $558,081.80 $558,081.80 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 43 27 — — $521,548.36 $1,330,480.50 $548,157.97 2026-03-01
09035 OTHER Axicabtagene Ciloleucel C 1 1 — — $532,192.20 $532,192.20 $532,192.20 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 43 27 — — $479,661.20 $1,223,625.50 $504,133.71 2026-03-01
09391 OTHER Brexucabtagene Car Pos T 1 1 — — $489,450.20 $489,450.20 $489,450.20 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 36 23 — — $318,299.85 $644,546.47 $371,349.83 2026-03-01
5834 APR_DRG Neonate With Ecmo 11 10 — — $345,402.06 $431,752.58 $345,402.06 2026-03-01
74 APR_DRG Allogeneic Bone Marrow Transplant 11 10 — — $336,007.44 $588,013.00 $336,007.44 2026-03-01
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 2 1 — — $332,753.88 $332,753.88 $332,753.88 2026-03-01
24 APR_DRG Heart And/or Lung Transplant 12 11 — — $281,351.48 $492,365.00 $292,605.53 2026-03-01
5833 APR_DRG Neonate With Ecmo 11 10 — — $292,473.77 $365,592.21 $292,473.77 2026-03-01
831 OTHER Obecbtge Autol Up To 400 44 28 — — $4,034.88 $695,625.00 $286,597.50 2026-03-01
00831 OTHER Obecbtge Autol Up To 400 1 1 — — $278,250.00 $278,250.00 $278,250.00 2026-03-01
897 OTHER Revakinagene, Per Implant 43 27 — — $259,700.00 $662,500.00 $272,950.00 2026-03-01
248063 CDM Kit Cath Rt Heart 52 34 $563,832.00 $563,832.00 $31,574.59 $535,640.40 $265,846.79 2026-03-01
00897 OTHER Revakinagene, Per Implant 1 1 — — $265,000.00 $265,000.00 $265,000.00 2026-03-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $237,905.20 $237,905.20 $237,905.20 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 48 26 — — $129,000.00 $461,351.40 $235,289.21 2026-03-01
1614 APR_DRG Implantable Heart Assist Systems 12 11 — — $212,308.45 $265,385.56 $220,800.93 2026-03-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 11 10 — — $218,633.83 $273,292.29 $218,633.83 2026-03-01
249245 CDM Valve Tavr 23mm 37 25 $428,298.00 $428,298.00 $46,256.18 $406,883.10 $214,149.00 2026-03-01
249248 CDM Valve Tavr 29mm 37 25 $428,298.00 $428,298.00 $46,256.18 $406,883.10 $214,149.00 2026-03-01
249246 CDM Valve Tavr 26mm 37 25 $428,298.00 $428,298.00 $46,256.18 $406,883.10 $214,149.00 2026-03-01
249249 CDM Valve Tavr 20mm 37 25 $428,298.00 $428,298.00 $46,256.18 $406,883.10 $214,149.00 2026-03-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $209,122.50 $209,122.50 $209,122.50 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 44 28 — — $8,828.99 $504,172.50 $207,719.07 2026-03-01
482359 CDM Valve Heart Trnscth 20mm 37 25 $409,403.00 $409,403.00 $44,215.52 $388,932.85 $204,701.50 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
482360 CDM Valve Heart Trnscth 23mm 37 25 $409,403.00 $409,403.00 $44,215.52 $388,932.85 $204,701.50 2026-03-01
482361 CDM Valve Heart Trnscth 26mm 37 25 $409,403.00 $409,403.00 $44,215.52 $388,932.85 $204,701.50 2026-03-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 12 11 — — $198,899.59 $248,624.49 $201,883.29 2026-03-01
00886 OTHER Inj. Remestemcel-l-rknd/ 1 1 — — $201,669.00 $201,669.00 $201,669.00 2026-03-01
471443 CDM Valve Aor Tavr 26mm 37 25 $377,910.00 $377,910.00 $40,814.28 $359,014.50 $188,955.00 2026-03-01
471441 CDM Valve Aor Tavr 34mm 37 25 $377,910.00 $377,910.00 $40,814.28 $359,014.50 $188,955.00 2026-03-01
471442 CDM Valve Aor Tavr 29mm 37 25 $377,910.00 $377,910.00 $40,814.28 $359,014.50 $188,955.00 2026-03-01
437822 CDM Valve Aor Tavr 23mm 37 25 $377,910.00 $377,910.00 $40,814.28 $359,014.50 $188,955.00 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 67 31 — — $80,627.00 $513,182.89 $184,290.64 2026-03-01
271390 CDM Valve Tavr 23mm 37 25 $367,416.00 $367,416.00 $39,680.93 $349,045.20 $183,708.00 2026-03-01
270575 CDM Valve Tavr 34mm 37 25 $367,416.00 $367,416.00 $39,680.93 $349,045.20 $183,708.00 2026-03-01
270574 CDM Valve Tavr 29mm 37 25 $367,416.00 $367,416.00 $39,680.93 $349,045.20 $183,708.00 2026-03-01
270573 CDM Valve Tavr 26mm 37 25 $367,416.00 $367,416.00 $39,680.93 $349,045.20 $183,708.00 2026-03-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc Pediatric 5 1 — — $110,283.56 $212,637.88 $181,995.90 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 58 30 — — $10,949.00 $516,212.39 $180,062.13 2026-03-01
E0767 HCPCS Intrabuccal, Systemic Delivery Of Amplitude-modulated, Radiofrequency Electromag… 5 1 — — $110,844.09 $188,817.17 $170,470.57 2026-03-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 11 10 — — $162,678.15 $203,347.69 $162,678.15 2026-03-01
277621 CDM Set Vntrc 17.4x13.8in 52 34 $343,800.00 $343,800.00 $19,252.80 $326,610.00 $162,101.70 2026-03-01
254667 CDM Cath Vasc Assist Strl 52 34 $343,800.00 $343,800.00 $19,252.80 $326,610.00 $162,101.70 2026-03-01
265596 CDM Kit Lo Prfl Comp Shth 7f 52 34 $343,800.00 $343,800.00 $19,252.80 $326,610.00 $162,101.70 2026-03-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 11 10 — — $161,236.53 $201,545.66 $161,236.53 2026-03-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 5 1 — — $95,435.85 $184,009.99 $157,493.41 2026-03-01
1907 OTHER New Technology - Level 52 46 28 — — $146,948.65 $374,869.00 $157,444.98 2026-03-01
1908 OTHER New Technology - Level 52 46 28 — — $146,948.65 $374,869.00 $157,444.98 2026-03-01
749575 CDM Kit Generator Nrstm Chg 37 25 $306,297.00 $306,297.00 $33,080.08 $290,982.15 $153,148.50 2026-03-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 5 1 — — $90,251.76 $174,014.53 $148,938.33 2026-03-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $147,393.80 $147,393.80 $147,393.80 2026-03-01
5832 APR_DRG Neonate With Ecmo 11 10 — — $145,733.00 $182,166.25 $145,733.00 2026-03-01
01908 OTHER New Technology - Level 52 1 1 — — $143,194.90 $143,194.90 $143,194.90 2026-03-01
01907 OTHER New Technology - Level 52 1 1 — — $143,194.90 $143,194.90 $143,194.90 2026-03-01
1905 OTHER New Technology - Level 51 46 28 — — $132,494.73 $337,996.75 $141,958.64 2026-03-01
1906 OTHER New Technology - Level 51 46 28 — — $132,494.73 $337,996.75 $141,958.64 2026-03-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 11 10 — — $138,383.02 $172,978.77 $138,383.02 2026-03-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc Pediatric 5 1 — — $80,822.20 $155,833.39 $133,377.17 2026-03-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc Pediatric 5 1 — — $78,799.70 $151,933.80 $130,039.52 2026-03-01
473202 CDM Set Pump Asst 2.5in 52 34 $275,040.00 $275,040.00 $15,402.24 $261,288.00 $129,681.36 2026-03-01
01905 OTHER New Technology - Level 51 1 1 — — $129,110.20 $129,110.20 $129,110.20 2026-03-01
01906 OTHER New Technology - Level 51 1 1 — — $129,110.20 $129,110.20 $129,110.20 2026-03-01
2004 APR_DRG Cardiac Structural And Valvular Disorders 11 10 — — $128,595.94 $160,744.92 $128,595.94 2026-03-01
5831 APR_DRG Neonate With Ecmo 11 10 — — $128,320.80 $160,401.00 $128,320.80 2026-03-01
1904 OTHER New Technology - Level 50 46 28 — — $118,040.80 $301,124.50 $126,472.29 2026-03-01
1903 OTHER New Technology - Level 50 46 28 — — $118,040.80 $301,124.50 $126,472.29 2026-03-01
462517 CDM Kit Implant Crnmxf Xlg 37 25 $248,231.00 $248,231.00 $26,808.95 $235,819.45 $124,115.50 2026-03-01
424881 CDM Stent Fgt Vlnt 200x38x38 37 25 $245,579.00 $245,579.00 $26,522.53 $233,300.05 $122,789.50 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 67 31 — — $104,119.29 $334,899.15 $121,472.51 2026-03-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc Pediatric 5 1 — — $73,135.48 $141,012.61 $120,692.12 2026-03-01
73 APR_DRG Allogeneic Bone Marrow Transplant 11 10 — — $118,564.19 $207,487.00 $118,564.19 2026-03-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 11 10 — — $117,311.76 $146,639.70 $117,311.76 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 47 29 — — $109,262.16 $278,730.00 $117,066.60 2026-03-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 11 10 — — $116,775.58 $145,969.48 $116,775.58 2026-03-01
C2624 HCPCS System Mntr 2x15mm 4.5cm 37 25 $233,045.00 $233,045.00 $25,168.86 $221,392.75 $116,522.50 2026-03-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 11 10 — — $116,473.62 $145,592.02 $116,473.62 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
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $115,102.90 $115,102.90 $115,102.90 2026-03-01
1613 APR_DRG Implantable Heart Assist Systems 12 11 — — $110,658.03 $138,322.54 $115,084.46 2026-03-01
01904 OTHER New Technology - Level 50 1 1 — — $115,025.50 $115,025.50 $115,025.50 2026-03-01
01903 OTHER New Technology - Level 50 1 1 — — $115,025.50 $115,025.50 $115,025.50 2026-03-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 5 1 — — $69,600.60 $134,197.00 $114,858.67 2026-03-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 11 10 — — $114,814.62 $143,518.27 $114,814.62 2026-03-01
229031 CDM Occluder Cardiac Lt 18mm 37 25 $226,746.00 $226,746.00 $24,488.57 $215,408.70 $113,373.00 2026-03-01
229036 CDM Occluder Cardiac Lt 16mm 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 37 25 $226,746.00 $226,746.00 $24,488.57 $215,408.70 $113,373.00 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
229026 CDM Occluder Cardiac Lt 28mm 37 25 $226,746.00 $226,746.00 $24,488.57 $215,408.70 $113,373.00 2026-03-01
229023 CDM Occluder Cardiac Lt 34mm 37 25 $226,746.00 $226,746.00 $24,488.57 $215,408.70 $113,373.00 2026-03-01
229025 CDM Occluder Cardiac Lt 31mm 37 25 $226,746.00 $226,746.00 $24,488.57 $215,408.70 $113,373.00 2026-03-01
7 MS_DRG Lung Transplant 46 26 — — $97,538.58 $216,752.40 $112,169.36 2026-03-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 11 10 — — $111,789.95 $139,737.44 $111,789.95 2026-03-01
422236 CDM Generator Nrstm 7 Ipg 37 25 $222,904.00 $222,904.00 $24,073.63 $211,758.80 $111,452.00 2026-03-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 5 1 — — $67,430.45 $130,012.75 $111,277.38 2026-03-01
1901 OTHER New Technology - Level 49 46 28 — — $103,586.88 $264,252.25 $110,985.94 2026-03-01
1902 OTHER New Technology - Level 49 46 28 — — $103,586.88 $264,252.25 $110,985.94 2026-03-01
339477 CDM Graft Evas 40x40x10cm 37 25 $221,708.00 $221,708.00 $23,944.46 $210,622.60 $110,854.00 2026-03-01
483550 CDM Stnt Thorac 26x26mm 10cm 37 25 $221,708.00 $221,708.00 $23,944.46 $210,622.60 $110,854.00 2026-03-01
473088 CDM Stent 31mmx31mmx10cm 37 25 $221,708.00 $221,708.00 $23,944.46 $210,622.60 $110,854.00 2026-03-01
473093 CDM Stent Gft Thor Act 37x37 37 25 $221,708.00 $221,708.00 $23,944.46 $210,622.60 $110,854.00 2026-03-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 11 10 — — $110,788.55 $138,485.69 $110,788.55 2026-03-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 11 10 — — $110,073.20 $137,591.50 $110,073.20 2026-03-01
485102 CDM Generator Pulse Imp Kit 37 25 $217,929.00 $217,929.00 $23,536.33 $207,032.55 $108,964.50 2026-03-01
263480 CDM Device Clsr 20mm 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 37 25 $214,149.00 $214,149.00 $23,128.09 $203,441.55 $107,074.50 2026-03-01
263482 CDM Device Clsr 27mm 37 25 $214,149.00 $214,149.00 $23,128.09 $203,441.55 $107,074.50 2026-03-01
263493 CDM Device Clsr 31mm 37 25 $214,149.00 $214,149.00 $23,128.09 $203,441.55 $107,074.50 2026-03-01
263481 CDM Device Clsr 24mm 37 25 $214,149.00 $214,149.00 $23,128.09 $203,441.55 $107,074.50 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
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
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 11 4 — — $63,235.60 $416,000.00 $106,053.40 2026-03-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 12 11 — — $100,785.00 $176,374.00 $104,816.62 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 46 26 — — $90,730.89 $201,624.20 $104,340.52 2026-03-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc Pediat… 5 1 — — $62,560.84 $120,623.63 $103,241.28 2026-03-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $103,155.90 $103,155.90 $103,155.90 2026-03-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 12 11 — — $98,542.53 $123,178.16 $102,484.33 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 52 34 $216,501.00 $216,501.00 $12,124.06 $205,675.95 $102,080.22 2026-03-01
01901 OTHER New Technology - Level 49 1 1 — — $100,940.80 $100,940.80 $100,940.80 2026-03-01
01902 OTHER New Technology - Level 49 1 1 — — $100,940.80 $100,940.80 $100,940.80 2026-03-01
84 APR_DRG Autologous Bone Marrow Transplant 11 10 — — $100,381.16 $175,667.00 $100,381.16 2026-03-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 52 29 — — $93,179.38 $237,702.50 $99,835.05 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
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 12 11 — — $97,718.94 $122,148.68 $99,184.97 2026-03-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 11 10 — — $98,597.56 $123,246.95 $98,597.56 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 48 26 — — $85,720.90 $200,000.00 $98,579.04 2026-03-01
1585 OTHER New Technology - Level 48 46 28 — — $91,542.00 $233,525.50 $98,080.71 2026-03-01
1599 OTHER New Technology - Level 48 46 28 — — $91,542.00 $233,525.50 $98,080.71 2026-03-01
877388 CDM Kit Pt Specific Tmj Comp 37 25 $195,254.00 $195,254.00 $21,087.43 $185,491.30 $97,627.00 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 60 32 — — $83,452.87 $312,715.53 $97,361.68 2026-03-01
C1767 HCPCS Gen Nrstm 52x52x6.9mm 666 25 $210,880.50 $210,880.50 $1,086.91 $443,718.40 $97,307.21 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 57 30 — — $14,158.00 $168,944.41 $97,042.78 2026-03-01
64 APR_DRG Pancreas Transplant 12 11 — — $92,258.53 $161,452.00 $95,948.88 2026-03-01
2464 APR_DRG Gastrointestinal Vascular Insufficiency 11 10 — — $95,558.79 $119,448.49 $95,558.79 2026-03-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 11 10 — — $95,065.82 $118,832.28 $95,065.82 2026-03-01
480381 CDM Implant Crnl Custm 37 25 $189,797.00 $189,797.00 $20,498.08 $180,307.15 $94,898.50 2026-03-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc Pediatric 5 1 — — $57,389.94 $110,653.63 $94,707.99 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
C2616 HCPCS Brachytx Ns Yttrium 90 36 22 $196,295.00 $196,295.00 $17,929.00 $186,480.25 $94,221.60 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 10 3 — — $76,999.04 $141,791.81 $93,760.51 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 61 33 — — $10,949.00 $262,913.99 $93,362.57 2026-03-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 11 10 — — $92,251.26 $115,314.07 $92,251.26 2026-03-01
880563 CDM Implant Cust Cranial Xl 37 25 $184,490.00 $184,490.00 $19,924.92 $175,265.50 $92,245.00 2026-03-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 11 10 — — $91,975.21 $114,969.01 $91,975.21 2026-03-01
880409 CDM Set Implant Peek Crnl 37 25 $182,814.00 $182,814.00 $19,743.91 $173,673.30 $91,407.00 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 48 26 — — $78,263.28 $173,918.40 $91,307.16 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
233599 CDM Device Embl 3.25mm 16mm 37 25 $181,208.00 $181,208.00 $19,570.46 $172,147.60 $90,604.00 2026-03-01
232511 CDM Device Embl 3.75mm 12mm 37 25 $181,208.00 $181,208.00 $19,570.46 $172,147.60 $90,604.00 2026-03-01
235622 CDM Device Embl 4mm 16mm 37 25 $181,208.00 $181,208.00 $19,570.46 $172,147.60 $90,604.00 2026-03-01
748438 CDM Unit Esurg Bnld Max 1 52 34 $191,743.00 $191,743.00 $10,737.61 $182,155.85 $90,406.82 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
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
267842 CDM Device W/cannula 30cm 52 34 $191,743.00 $191,743.00 $10,737.61 $182,155.85 $90,406.82 2026-03-01
C1823 HCPCS Lead Stim Right 148 25 $185,530.00 $185,530.00 $12,943.15 $329,097.10 $89,883.00 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 11 4 — — $57,017.10 $158,309.29 $89,766.78 2026-03-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 10 3 — — $58,032.08 $138,148.31 $89,720.65 2026-03-01
572470 CDM Plate Cranial Lf Ft 37 25 $178,965.00 $178,965.00 $19,328.22 $170,016.75 $89,482.50 2026-03-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 11 10 — — $89,410.31 $111,762.89 $89,410.31 2026-03-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 12 11 — — $85,961.80 $107,452.25 $89,400.24 2026-03-01
01585 OTHER New Technology - Level 48 1 1 — — $89,203.57 $89,203.57 $89,203.57 2026-03-01
01599 OTHER New Technology - Level 48 1 1 — — $89,203.57 $89,203.57 $89,203.57 2026-03-01
007 OTHER Lung Transplant 1 1 — — $88,464.44 $88,464.44 $88,464.44 2026-03-01
215 MS_DRG Other Heart Assist System Implant 68 33 — — $52,547.00 $244,353.05 $88,295.64 2026-03-01
285110 CDM Valve Aortic 29mm 37 25 $176,358.00 $176,358.00 $19,046.66 $167,540.10 $88,179.00 2026-03-01
484234 CDM Valve Aortic 25mm 37 25 $176,358.00 $176,358.00 $19,046.66 $167,540.10 $88,179.00 2026-03-01
204057 CDM Valve Aortic 27mm 37 25 $176,358.00 $176,358.00 $19,046.66 $167,540.10 $88,179.00 2026-03-01
101061 CDM Valve Aortic 23mm 37 25 $176,358.00 $176,358.00 $19,046.66 $167,540.10 $88,179.00 2026-03-01
285109 CDM Valve Aortic 21mm 37 25 $176,358.00 $176,358.00 $19,046.66 $167,540.10 $88,179.00 2026-03-01
1598 OTHER New Technology - Level 47 46 28 — — $81,906.04 $208,943.97 $87,756.47 2026-03-01
1584 OTHER New Technology - Level 47 46 28 — — $81,906.04 $208,943.97 $87,756.47 2026-03-01
285526 CDM System Shunt Lumbar 37 25 $174,807.00 $174,807.00 $18,879.16 $166,066.65 $87,403.50 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 69 34 — — $35,280.00 $236,528.54 $86,811.62 2026-03-01
427515 CDM Kit Implant Crnmxf Xlg 37 25 $171,678.00 $171,678.00 $18,541.22 $163,094.10 $85,839.00 2026-03-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 11 10 — — $84,551.11 $105,688.89 $84,551.11 2026-03-01
875410 CDM Device Intrivia Montrng 52 34 $178,530.00 $178,530.00 $9,997.68 $169,603.50 $84,176.90 2026-03-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 11 10 — — $83,864.86 $104,831.07 $83,864.86 2026-03-01
422126 CDM Graft Bn Hemi Condrl Rt 37 25 $167,724.00 $167,724.00 $18,114.19 $159,337.80 $83,862.00 2026-03-01
443285 CDM Kit Impl Sz Sm Crnln Cus 37 25 $167,724.00 $167,724.00 $18,114.19 $159,337.80 $83,862.00 2026-03-01
462971 CDM Impl Ips Crnl Peek 18.0 37 25 $167,724.00 $167,724.00 $18,114.19 $159,337.80 $83,862.00 2026-03-01
451742 CDM Implant Mndb Half Model 37 25 $167,724.00 $167,724.00 $18,114.19 $159,337.80 $83,862.00 2026-03-01
872152 CDM Kit Implant Crnmxf Lg 37 25 $167,724.00 $167,724.00 $18,114.19 $159,337.80 $83,862.00 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
481638 CDM Graft Evas 34x34x10cm 37 25 $167,724.00 $167,724.00 $18,114.19 $159,337.80 $83,862.00 2026-03-01
436688 CDM Graft Bn Cartiform 25x20 37 25 $167,724.00 $167,724.00 $18,114.19 $159,337.80 $83,862.00 2026-03-01
455211 CDM Implant Crnl Ips Ti Ns 37 25 $166,043.00 $166,043.00 $17,932.64 $157,740.85 $83,021.50 2026-03-01
1612 APR_DRG Implantable Heart Assist Systems 12 11 — — $79,545.92 $99,432.40 $82,727.76 2026-03-01
93654 CPT Ep Repos Ele Vt 3d Map 76 28 $171,941.00 $171,941.00 $5,591.00 $173,430.10 $82,151.10 2026-03-01
422684 CDM Defit 7 Vr-t Dx W Hm Ipr 37 25 $161,514.00 $161,514.00 $17,443.51 $153,438.30 $80,757.00 2026-03-01
447927 CDM Icd .99cm 5.37x8.08CM 37 25 $161,514.00 $161,514.00 $17,443.51 $153,438.30 $80,757.00 2026-03-01
744885 CDM Cage Spnl 28mm 12mm 37 25 $160,616.00 $160,616.00 $17,346.53 $152,585.20 $80,308.00 2026-03-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 11 10 — — $80,290.83 $100,363.54 $80,290.83 2026-03-01
424813 CDM Defib Card .99cm Mini Sm 37 25 $160,541.00 $160,541.00 $17,338.43 $152,513.95 $80,270.50 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 60 32 — — $68,763.99 $255,638.39 $80,224.65 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
424321 CDM Liner R3 Constrain 46mm 37 25 $159,828.00 $159,828.00 $17,261.42 $151,836.60 $79,914.00 2026-03-01
01584 OTHER New Technology - Level 47 1 1 — — $79,813.77 $79,813.77 $79,813.77 2026-03-01
01598 OTHER New Technology - Level 47 1 1 — — $79,813.77 $79,813.77 $79,813.77 2026-03-01
741017 CDM Forcep Grasp 2.4fr 90cm 52 34 $169,270.00 $169,270.00 $9,479.12 $160,806.50 $79,810.80 2026-03-01
72 APR_DRG Allogeneic Bone Marrow Transplant 11 10 — — $79,661.89 $139,408.00 $79,661.89 2026-03-01
4404 APR_DRG Kidney Transplant 11 10 — — $75,255.63 $131,697.00 $79,018.41 2026-03-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 11 10 — — $78,636.38 $98,295.48 $78,636.38 2026-03-01
1611 APR_DRG Implantable Heart Assist Systems 12 11 — — $75,442.08 $94,302.60 $78,459.79 2026-03-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $78,405.59 $78,405.59 $78,405.59 2026-03-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc Pediatric 5 1 — — $47,180.19 $90,968.19 $77,859.31 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
1583 OTHER New Technology - Level 46 46 28 — — $72,270.09 $184,362.48 $77,432.24 2026-03-01
1597 OTHER New Technology - Level 46 46 28 — — $72,270.09 $184,362.48 $77,432.24 2026-03-01
8634 APR_DRG Neonatal Aftercare 11 10 — — $77,416.69 $96,770.86 $77,416.69 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
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 2 1 — — $77,046.96 $77,046.96 $77,046.96 2026-03-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 11 10 — — $76,673.14 $95,841.43 $76,673.14 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 60 32 — — $10,949.00 $257,091.90 $76,138.65 2026-03-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 12 11 — — $74,911.82 $93,639.78 $76,035.51 2026-03-01
J9266 HCPCS Pegaspargase Singl Vial 46 28 $168,804.00 $168,804.00 $9,453.02 $160,363.80 $75,961.80 2026-03-01
C1882 HCPCS Crt-d Hf 5.37x8.18x0.99 407 25 $167,724.00 $167,724.00 $6,086.34 $208,529.75 $75,824.10 2026-03-01
716492 CDM Implant Axailif Spinal S 37 25 $151,074.00 $151,074.00 $16,315.99 $143,520.30 $75,537.00 2026-03-01
014 OTHER Allogeneic Bone Marrow Transplant 1 1 — — $75,512.67 $75,512.67 $75,512.67 2026-03-01
C1820 HCPCS Ipg Nrstm 5.55cm 4.95cm 740 25 $190,530.00 $190,530.00 $1,606.93 $223,606.25 $75,475.80 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 69 34 — — $27,563.00 $203,818.12 $75,286.12 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 70 32 — — $64,337.45 $238,438.07 $75,060.36 2026-03-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 11 10 — — $74,886.36 $93,607.95 $74,886.36 2026-03-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $74,717.29 $74,717.29 $74,717.29 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
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 11 10 — — $72,954.04 $91,192.55 $72,954.04 2026-03-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 11 10 — — $72,954.04 $91,192.55 $72,954.04 2026-03-01
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 11 10 — — $72,747.12 $90,933.90 $72,747.12 2026-03-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 47 29 — — $67,425.67 $172,004.25 $72,241.79 2026-03-01
471473 CDM Frame Exfx 180mm 52 34 $152,971.00 $152,971.00 $8,566.38 $145,322.45 $72,125.83 2026-03-01
23 APR_DRG Heart And/or Lung Transplant 12 11 — — $69,296.79 $121,269.00 $72,068.67 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
424366 CDM Cage Spnl 50x22x14mm 37 25 $142,812.00 $142,812.00 $15,423.70 $135,671.40 $71,406.00 2026-03-01
422094 CDM Mesh Viaable Crtlg 20mm 37 25 $142,562.00 $142,562.00 $15,396.70 $135,433.90 $71,281.00 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 11 4 — — $45,212.00 $95,547.45 $71,255.81 2026-03-01
4414 APR_DRG Major Bladder Procedures 11 10 — — $71,219.10 $89,023.88 $71,219.10 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
221425 CDM Ex Frm Salv 180mm Assm 52 34 $149,960.00 $149,960.00 $8,397.76 $142,462.00 $70,706.14 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 70 32 — — $60,433.76 $239,229.19 $70,506.05 2026-03-01
37231 CPT Stent/ath/tib/peron Ini 86 34 $156,597.00 $156,597.00 $8,541.66 $148,767.15 $70,468.65 2026-03-01
37227 CPT Fempop Revas Stnt&ath 59 86 34 $156,597.00 $156,597.00 $8,541.66 $148,767.15 $70,468.65 2026-03-01
441604 CDM Mandible Plate Sz Med 37 25 $140,885.00 $140,885.00 $15,215.58 $133,840.75 $70,442.50 2026-03-01
468805 CDM Implant Midface Ips 37 25 $140,885.00 $140,885.00 $15,215.58 $133,840.75 $70,442.50 2026-03-01
01583 OTHER New Technology - Level 46 1 1 — — $70,423.97 $70,423.97 $70,423.97 2026-03-01
01597 OTHER New Technology - Level 46 1 1 — — $70,423.97 $70,423.97 $70,423.97 2026-03-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $70,022.91 $70,022.91 $70,022.91 2026-03-01
748488 CDM Gft Sft Tis Frzn Strut 37 25 $139,661.00 $139,661.00 $15,083.39 $132,677.95 $69,830.50 2026-03-01
C8004 HCPCS Simulation Angiogram With Use Of A Pressure-generating Catheter (e.g., One-way V… 5 1 — — $37,537.29 $85,394.49 $69,404.29 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 69 34 — — $30,870.00 $186,477.04 $68,883.16 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 67 32 — — $58,801.01 $184,845.65 $68,601.18 2026-03-01
435086 CDM Cap Fh Reverse Shoulder 37 25 $136,995.00 $136,995.00 $14,795.46 $130,145.25 $68,497.50 2026-03-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 70 32 — — $58,616.27 $184,233.94 $68,385.65 2026-03-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 12 11 — — $65,324.84 $81,656.05 $67,937.84 2026-03-01
83 APR_DRG Autologous Bone Marrow Transplant 11 10 — — $67,850.17 $118,738.00 $67,850.17 2026-03-01
33270 CPT Ins/rpl Sq Defib With Elec 54 35 $206,720.00 $206,720.00 $948.00 $196,384.00 $67,793.54 2026-03-01
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 1 1 — — $67,631.78 $67,631.78 $67,631.78 2026-03-01
750672 CDM Dvc Revasc 6mm 42mm 52 34 $143,326.00 $143,326.00 $8,026.26 $136,159.70 $67,578.21 2026-03-01
717 OTHER Instill Adstiladrin, Tx D 47 29 — — $13,080.79 $160,686.98 $67,488.53 2026-03-01
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