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

St. David's Georgetown Hospital

Georgetown, TX · CCN 450191 · Rates published

36,016 distinct procedures filed
67 distinct payers
2,014,666 rate rows
2026-03-01 last MRF observed
Data quality

1,978,995 of 2,014,666 rate rows are consumer-grade (98.2%)

35,671 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
per-diem day rate — not a per-procedure price 18,873
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 11,356
template filing: same amount across many unrelated codes — excluded 5,119
placeholder amount (≤ $0.02) — excluded from medians 193
exceeds 10× this hospital's gross charge — excluded from medians 130
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/74-2781812_ST.-DAVID'S-GEORGETOWN-HOSPITAL_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-05-18
Content fingerprint 0475aa38517f649c… · 880,515,518 bytes · first seen 2026-05-13

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $3,586,762.05 $4,850,948.67 $4,850,948.67 nat. median
$3,006,423
1.6× median
845
OTHER 		Inj, Atidarsagene Autotem 20 $5,455.45 $4,955,500.00 $4,524,146.25 nat. median
$9,966
outlier · 454.0×
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
J1411
HCPCS 		Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 1 $4,496,025.34 $4,496,025.34 $4,496,025.34 nat. median
$3,710,000
1.2× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 $3,158,557.10 $4,271,819.03 $4,271,819.03 nat. median
$2,469,189
1.7× median
J3389
HCPCS 		Topical Administration, Prademagene Zamikeracel, Per Treatment 1 $4,069,700.40 $4,069,700.40 $4,069,700.40 nat. median
$3,335,820
1.2× median
J1413
HCPCS 		Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 1 $4,059,988.87 $4,059,988.87 $4,059,988.87 nat. median
$3,325,455
1.2× median
J3394
HCPCS 		Injection, Lovotibeglogene Autotemcel, Per Treatment 1 $3,968,059.86 $3,968,059.86 $3,968,059.86 nat. median
$3,286,000
1.2× median
J3387
HCPCS 		Injection, Elivaldogene Autotemcel, Per Treatment 1 $3,879,600.00 $3,879,600.00 $3,879,600.00 nat. median
$3,180,000
1.2× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 22 $3,574,708.99 $4,975,110.45 $3,869,530.35 nat. median
$3,746,358
1.0× median
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 1 $2,845,040.00 $3,847,800.00 $3,847,800.00 nat. median
$2,448,600
1.6× 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 23 $9,877.87 $4,503,357.00 $3,502,611.00 nat. median
$22,747
outlier · 154.0×
714
OTHER 		Inj Delandistrogene Mox R 23 $6,416.35 $4,492,611.00 $3,494,253.00 nat. median
$13,041
outlier · 267.9×
748
OTHER 		Inj, Lovotibeglogene Auto 23 $12,213.45 $4,390,885.80 $3,415,133.40 nat. median
$17,963
outlier · 190.1×
906
OTHER 		Inj Elivaldogene Autoteme 24 $8,728.26 $4,929,000.00 $3,339,000.00 nat. median
$20,756
outlier · 160.9×
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
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 24 $11,297.57 $4,556,951.95 $3,086,967.45 nat. median
$21,896
outlier · 141.0×
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 23 $2,511,311.57 $4,427,157.51 $2,718,430.05 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 25 $13,229.17 $4,617,360.00 $2,448,600.00 nat. median
$25,250
outlier · 97.0×
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 $940,156.40 $1,905,321.60 $1,271,523.00 nat. median
$824,563
1.5× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 3 $553,169.00 $1,204,164.00 $969,621.79 nat. median
$675,122
1.4× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 3 $527,622.00 $1,086,337.20 $920,834.85 nat. median
$625,184
1.5× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 3 $516,442.00 $1,062,512.88 $907,222.54 nat. median
$674,188
1.3× median
2067
OTHER 		Afamitresgene Autoleucel 24 $747,501.40 $1,525,827.60 $813,004.10 nat. median
$786,032
1.0× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 3 $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 $549,391.70 $998,894.00 $774,142.85 nat. median
$754,974
1.0× median
Q2058
HCPCS 		Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,… 2 $339,465.00 $1,375,920.00 $756,756.00 nat. median
$324,450
outlier · 2.3×
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 4 $502,841.00 $921,310.00 $712,075.50 nat. median
$634,511
1.1× median
9498
OTHER 		Ciltacabtagene Car-pos T 24 $570,020.11 $1,163,546.21 $619,970.33 nat. median
$587,650
1.1× median
C9301
HCPCS 		Obecabtagene Autoleucel, Up To 400 Million Cd19 Car-positive Viable T Cells, Inc… 1 $397,897.50 $723,450.00 $617,715.00 nat. median
$459,112
1.3× median
9194
OTHER 		Tisagenlecleucel Car-pos 24 $549,535.36 $1,121,731.97 $597,690.53 nat. median
$566,531
1.1× median
9413
OTHER 		Lisocabtagene Car Pos T 24 $545,335.16 $1,113,158.38 $593,122.27 nat. median
$562,201
1.1× median
9422
OTHER 		Idecabtagene Vicleucel Ca 24 $541,339.35 $1,105,001.96 $588,776.30 nat. median
$558,082
1.1× median
09498
OTHER 		Ciltacabtagene Car-pos T 1 $587,649.60 $587,649.60 $587,649.60 nat. median
$554,552
1.1× 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
9035
OTHER 		Axicabtagene Ciloleucel C 24 $516,226.43 $1,053,740.56 $561,462.77 nat. median
$532,192
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
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 24 $474,766.69 $969,111.40 $516,369.96 nat. median
$489,450
1.1× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $489,450.20 $489,450.20 $489,450.20 nat. median
$464,978
1.1× median
102901
CDM 		Tube Inj Cemnt 4.2mm 36 $49,999.95 $899,999.10 $352,999.65 nat. median
$313
outlier · 1126.7×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 43 $290,065.41 $713,984.42 $335,098.53 nat. median
$370,174
0.9× median

Other procedures at this hospital

Browse this hospital's 36,016 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 — — $3,586,762.05 $4,850,948.67 $4,850,948.67 2026-03-01
845 OTHER Inj, Atidarsagene Autotem 34 20 — — $5,455.45 $4,955,500.00 $4,524,146.25 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
J1411 HCPCS Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 1 1 — — $4,496,025.34 $4,496,025.34 $4,496,025.34 2026-03-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 3 1 — — $3,158,557.10 $4,271,819.03 $4,271,819.03 2026-03-01
J3389 HCPCS Topical Administration, Prademagene Zamikeracel, Per Treatment 1 1 — — $4,069,700.40 $4,069,700.40 $4,069,700.40 2026-03-01
J1413 HCPCS Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 1 1 — — $4,059,988.87 $4,059,988.87 $4,059,988.87 2026-03-01
J3394 HCPCS Injection, Lovotibeglogene Autotemcel, Per Treatment 1 1 — — $3,968,059.86 $3,968,059.86 $3,968,059.86 2026-03-01
J3387 HCPCS Injection, Elivaldogene Autotemcel, Per Treatment 1 1 — — $3,879,600.00 $3,879,600.00 $3,879,600.00 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 38 22 — — $3,574,708.99 $4,975,110.45 $3,869,530.35 2026-03-01
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 3 1 — — $2,845,040.00 $3,847,800.00 $3,847,800.00 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 39 23 — — $9,877.87 $4,503,357.00 $3,502,611.00 2026-03-01
714 OTHER Inj Delandistrogene Mox R 39 23 — — $6,416.35 $4,492,611.00 $3,494,253.00 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 39 23 — — $12,213.45 $4,390,885.80 $3,415,133.40 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 40 24 — — $8,728.26 $4,929,000.00 $3,339,000.00 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
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 40 24 — — $11,297.57 $4,556,951.95 $3,086,967.45 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 41 23 — — $2,511,311.57 $4,427,157.51 $2,718,430.05 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 25 — — $13,229.17 $4,617,360.00 $2,448,600.00 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… 9 2 — — $940,156.40 $1,905,321.60 $1,271,523.00 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 10 3 — — $553,169.00 $1,204,164.00 $969,621.79 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 10 3 — — $527,622.00 $1,086,337.20 $920,834.85 2026-03-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 10 3 — — $516,442.00 $1,062,512.88 $907,222.54 2026-03-01
2067 OTHER Afamitresgene Autoleucel 42 24 — — $747,501.40 $1,525,827.60 $813,004.10 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 10 3 — — $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… 16 4 — — $549,391.70 $998,894.00 $774,142.85 2026-03-01
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 9 2 — — $339,465.00 $1,375,920.00 $756,756.00 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 16 4 — — $502,841.00 $921,310.00 $712,075.50 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 42 24 — — $570,020.11 $1,163,546.21 $619,970.33 2026-03-01
C9301 HCPCS Obecabtagene Autoleucel, Up To 400 Million Cd19 Car-positive Viable T Cells, Inc… 6 1 — — $397,897.50 $723,450.00 $617,715.00 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 42 24 — — $549,535.36 $1,121,731.97 $597,690.53 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 42 24 — — $545,335.16 $1,113,158.38 $593,122.27 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 42 24 — — $541,339.35 $1,105,001.96 $588,776.30 2026-03-01
09498 OTHER Ciltacabtagene Car-pos T 1 1 — — $587,649.60 $587,649.60 $587,649.60 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
9035 OTHER Axicabtagene Ciloleucel C 42 24 — — $516,226.43 $1,053,740.56 $561,462.77 2026-03-01
09422 OTHER Idecabtagene Vicleucel Ca 1 1 — — $558,081.80 $558,081.80 $558,081.80 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 42 24 — — $474,766.69 $969,111.40 $516,369.96 2026-03-01
09391 OTHER Brexucabtagene Car Pos T 1 1 — — $489,450.20 $489,450.20 $489,450.20 2026-03-01
102901 CDM Tube Inj Cemnt 4.2mm 71 36 $999,999.00 $999,999.00 $49,999.95 $899,999.10 $352,999.65 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 65 43 — — $290,065.41 $713,984.42 $335,098.53 2026-03-01
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 3 1 — — $246,036.20 $332,753.88 $332,753.88 2026-03-01
74 APR_DRG Allogeneic Bone Marrow Transplant 14 7 — — $293,914.21 $501,033.00 $321,288.50 2026-03-01
5834 APR_DRG Neonate With Ecmo 10 6 — — $302,131.93 $370,259.71 $311,018.16 2026-03-01
831 OTHER Obecbtge Autol Up To 400 43 25 — — $3,735.66 $550,935.00 $292,162.50 2026-03-01
897 OTHER Revakinagene, Per Implant 42 24 — — $257,050.00 $524,700.00 $279,575.00 2026-03-01
00831 OTHER Obecbtge Autol Up To 400 1 1 — — $278,250.00 $278,250.00 $278,250.00 2026-03-01
24 APR_DRG Heart And/or Lung Transplant 14 7 — — $246,105.26 $419,534.00 $269,026.50 2026-03-01
00897 OTHER Revakinagene, Per Implant 1 1 — — $265,000.00 $265,000.00 $265,000.00 2026-03-01
5833 APR_DRG Neonate With Ecmo 10 6 — — $255,834.21 $313,522.31 $263,358.74 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 10 3 — — $63,235.60 $416,000.00 $228,800.00 2026-03-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $220,262.20 $220,262.20 $220,262.20 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 79 41 — — $129,000.00 $463,347.16 $213,769.05 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 43 25 — — $8,174.23 $399,304.62 $211,752.45 2026-03-01
00886 OTHER Inj. Remestemcel-l-rknd/ 1 1 — — $201,669.00 $201,669.00 $201,669.00 2026-03-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 10 6 — — $191,244.55 $234,368.33 $196,869.39 2026-03-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $193,614.00 $193,614.00 $193,614.00 2026-03-01
1614 APR_DRG Implantable Heart Assist Systems 14 7 — — $185,711.58 $227,587.72 $192,083.85 2026-03-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 10 6 — — $173,982.51 $213,213.86 $179,099.64 2026-03-01
322996 CDM Set Vntrc 17.4x13.8in 71 36 $490,250.00 $490,250.00 $24,512.50 $441,225.00 $173,058.25 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 81 45 — — $143,121.78 $350,937.46 $166,975.41 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 71 41 — — $11,384.00 $353,009.17 $163,155.02 2026-03-01
1907 OTHER New Technology - Level 52 42 24 — — $145,449.17 $296,896.25 $158,194.72 2026-03-01
1908 OTHER New Technology - Level 52 42 24 — — $145,449.17 $296,896.25 $158,194.72 2026-03-01
E0767 HCPCS Intrabuccal, Systemic Delivery Of Amplitude-modulated, Radiofrequency Electromag… 6 1 — — $103,964.11 $188,817.17 $149,830.63 2026-03-01
01907 OTHER New Technology - Level 52 1 1 — — $147,788.20 $147,788.20 $147,788.20 2026-03-01
01908 OTHER New Technology - Level 52 1 1 — — $147,788.20 $147,788.20 $147,788.20 2026-03-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 10 6 — — $142,298.69 $174,385.65 $146,483.95 2026-03-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 10 6 — — $141,037.67 $172,840.29 $145,185.84 2026-03-01
1906 OTHER New Technology - Level 51 42 24 — — $131,142.74 $267,693.43 $142,634.63 2026-03-01
1905 OTHER New Technology - Level 51 42 24 — — $131,142.74 $267,693.43 $142,634.63 2026-03-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $136,463.10 $136,463.10 $136,463.10 2026-03-01
01905 OTHER New Technology - Level 51 1 1 — — $133,251.70 $133,251.70 $133,251.70 2026-03-01
01906 OTHER New Technology - Level 51 1 1 — — $133,251.70 $133,251.70 $133,251.70 2026-03-01
5832 APR_DRG Neonate With Ecmo 10 6 — — $127,476.35 $156,221.01 $131,225.65 2026-03-01
1903 OTHER New Technology - Level 50 42 24 — — $116,836.31 $238,490.60 $127,074.54 2026-03-01
1904 OTHER New Technology - Level 50 42 24 — — $116,836.31 $238,490.60 $127,074.54 2026-03-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 10 6 — — $121,047.13 $148,342.08 $124,607.34 2026-03-01
33990 CPT Insertion Impella Lvad 70 32 $883,335.00 $883,335.00 $929.00 $795,001.50 $123,666.90 2026-03-01
01903 OTHER New Technology - Level 50 1 1 — — $118,715.20 $118,715.20 $118,715.20 2026-03-01
01904 OTHER New Technology - Level 50 1 1 — — $118,715.20 $118,715.20 $118,715.20 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 45 26 — — $57,259.65 $220,754.16 $117,066.60 2026-03-01
2004 APR_DRG Cardiac Structural And Valvular Disorders 10 6 — — $112,486.12 $137,850.64 $115,794.54 2026-03-01
5831 APR_DRG Neonate With Ecmo 10 6 — — $112,245.46 $137,555.71 $115,546.80 2026-03-01
73 APR_DRG Allogeneic Bone Marrow Transplant 14 7 — — $103,711.10 $176,796.00 $113,370.50 2026-03-01
1902 OTHER New Technology - Level 49 42 24 — — $102,529.87 $209,287.78 $111,514.45 2026-03-01
1901 OTHER New Technology - Level 49 42 24 — — $102,529.87 $209,287.78 $111,514.45 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 81 45 — — $93,775.14 $229,019.05 $109,404.33 2026-03-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $106,566.90 $106,566.90 $106,566.90 2026-03-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 10 6 — — $102,615.56 $125,754.36 $105,633.66 2026-03-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 10 6 — — $102,146.56 $125,179.61 $105,150.87 2026-03-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 10 6 — — $101,882.42 $124,855.91 $104,878.97 2026-03-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 10 6 — — $101,444.45 $124,319.17 $104,428.11 2026-03-01
01902 OTHER New Technology - Level 49 1 1 — — $104,178.70 $104,178.70 $104,178.70 2026-03-01
01901 OTHER New Technology - Level 49 1 1 — — $104,178.70 $104,178.70 $104,178.70 2026-03-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 10 6 — — $100,431.26 $123,077.53 $103,385.12 2026-03-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 49 25 — — $92,228.57 $190,190.00 $100,785.86 2026-03-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 10 6 — — $97,785.50 $119,835.18 $100,661.55 2026-03-01
1613 APR_DRG Implantable Heart Assist Systems 14 7 — — $96,795.38 $118,621.79 $100,116.65 2026-03-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 10 6 — — $96,909.55 $118,761.70 $99,759.83 2026-03-01
7 MS_DRG Lung Transplant 67 39 — — $87,744.20 $214,118.61 $99,443.42 2026-03-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 10 6 — — $96,283.82 $117,994.88 $99,115.69 2026-03-01
1599 OTHER New Technology - Level 48 42 24 — — $90,607.89 $184,952.20 $98,547.76 2026-03-01
1585 OTHER New Technology - Level 48 42 24 — — $90,607.89 $184,952.20 $98,547.76 2026-03-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 14 7 — — $88,159.19 $150,284.00 $96,370.20 2026-03-01
349401 CDM Device Clsr 20mm 35 23 $259,760.00 $259,760.00 $36,366.40 $233,784.00 $96,111.20 2026-03-01
349402 CDM Device Clsr 24mm 35 23 $259,760.00 $259,760.00 $36,366.40 $233,784.00 $96,111.20 2026-03-01
349405 CDM Device Clsr 35mm 35 23 $259,760.00 $259,760.00 $36,366.40 $233,784.00 $96,111.20 2026-03-01
349404 CDM Device Clsr 31mm 35 23 $259,760.00 $259,760.00 $36,366.40 $233,784.00 $96,111.20 2026-03-01
349403 CDM Device Clsr 27mm 35 23 $259,760.00 $259,760.00 $36,366.40 $233,784.00 $96,111.20 2026-03-01
84 APR_DRG Autologous Bone Marrow Transplant 14 7 — — $87,805.95 $149,682.00 $95,984.15 2026-03-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $95,505.91 $95,505.91 $95,505.91 2026-03-01
117107 CDM Genrator Imp Pulse 7 35 23 $256,414.00 $256,414.00 $35,897.96 $230,772.60 $94,873.18 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 9 2 — — $69,325.95 $141,791.81 $93,760.51 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 70 38 — — $81,505.11 $165,919.13 $92,372.45 2026-03-01
01585 OTHER New Technology - Level 48 1 1 — — $92,064.98 $92,064.98 $92,064.98 2026-03-01
01599 OTHER New Technology - Level 48 1 1 — — $92,064.98 $92,064.98 $92,064.98 2026-03-01
102743 CDM Kit Prfsn Canula Dil 20d 71 36 $254,930.00 $254,930.00 $12,746.50 $229,437.00 $89,990.29 2026-03-01
339930 CDM Kit Prfsn Bypass Tube 71 36 $254,930.00 $254,930.00 $12,746.50 $229,437.00 $89,990.29 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 10 3 — — $57,017.10 $158,309.29 $89,766.78 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 79 41 — — $76,913.62 $298,508.00 $89,732.56 2026-03-01
254137 CDM Set Ventricle Ab5000 71 36 $253,107.00 $253,107.00 $12,655.35 $227,796.30 $89,346.77 2026-03-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 14 7 — — $86,197.65 $105,634.38 $89,155.39 2026-03-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 10 6 — — $86,245.78 $105,693.36 $88,782.42 2026-03-01
64 APR_DRG Pancreas Transplant 14 7 — — $80,700.87 $137,570.00 $88,217.10 2026-03-01
1584 OTHER New Technology - Level 47 42 24 — — $81,070.26 $165,483.63 $88,174.36 2026-03-01
1598 OTHER New Technology - Level 47 42 24 — — $81,070.26 $165,483.63 $88,174.36 2026-03-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 10 6 — — $85,477.23 $104,751.51 $87,991.27 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 90 47 — — $57,342.00 $187,145.04 $87,833.89 2026-03-01
2464 APR_DRG Gastrointestinal Vascular Insufficiency 10 6 — — $83,587.69 $102,435.90 $86,046.16 2026-03-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 10 6 — — $83,156.48 $101,907.45 $85,602.26 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 80 46 — — $48,305.00 $203,567.00 $84,813.05 2026-03-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 11 3 — — $14,506.67 $138,148.31 $84,757.38 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 120 64 — — $13,723.00 $230,793.47 $83,711.42 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 87 47 — — $11,384.00 $179,792.37 $83,697.38 2026-03-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 10 6 — — $80,694.51 $98,890.32 $83,067.87 2026-03-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 10 6 — — $80,453.05 $98,594.42 $82,819.32 2026-03-01
01598 OTHER New Technology - Level 47 1 1 — — $82,373.98 $82,373.98 $82,373.98 2026-03-01
01584 OTHER New Technology - Level 47 1 1 — — $82,373.98 $82,373.98 $82,373.98 2026-03-01
007 OTHER Lung Transplant 1 1 — — $81,903.93 $81,903.93 $81,903.93 2026-03-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 10 6 — — $78,209.47 $95,844.94 $80,509.75 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 71 39 — — $70,078.93 $170,473.81 $79,422.79 2026-03-01
215 MS_DRG Other Heart Assist System Implant 98 48 — — $58,771.00 $320,760.00 $79,374.99 2026-03-01
1583 OTHER New Technology - Level 46 42 24 — — $71,532.64 $146,015.08 $77,800.96 2026-03-01
1597 OTHER New Technology - Level 46 42 24 — — $71,532.64 $146,015.08 $77,800.96 2026-03-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 14 7 — — $75,192.96 $92,148.24 $77,773.11 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 3 1 — — $56,968.06 $77,046.96 $77,046.96 2026-03-01
72 APR_DRG Allogeneic Bone Marrow Transplant 14 7 — — $69,682.27 $118,787.00 $76,172.30 2026-03-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 10 6 — — $73,959.00 $90,636.03 $76,134.26 2026-03-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 10 6 — — $73,358.72 $89,900.39 $75,516.33 2026-03-01
329734 CDM Graft Bn Cartiform 25x20 35 23 $197,640.00 $197,640.00 $27,669.60 $177,876.00 $73,126.80 2026-03-01
01597 OTHER New Technology - Level 46 1 1 — — $72,682.98 $72,682.98 $72,682.98 2026-03-01
01583 OTHER New Technology - Level 46 1 1 — — $72,682.98 $72,682.98 $72,682.98 2026-03-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $72,591.05 $72,591.05 $72,591.05 2026-03-01
263252 CDM Kit Implant Unilat Tmj M 35 23 $195,840.00 $195,840.00 $27,417.60 $176,256.00 $72,460.80 2026-03-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 10 6 — — $70,232.43 $86,069.15 $72,298.09 2026-03-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 43 25 — — $66,737.65 $136,227.37 $72,241.79 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 120 64 — — $13,723.00 $200,369.83 $72,134.65 2026-03-01
1612 APR_DRG Implantable Heart Assist Systems 14 7 — — $69,580.83 $85,270.63 $71,968.41 2026-03-01
4404 APR_DRG Kidney Transplant 14 7 — — $65,828.01 $112,217.00 $71,959.05 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 10 3 — — $45,212.00 $95,547.45 $71,255.81 2026-03-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 10 6 — — $68,785.23 $84,295.63 $70,808.32 2026-03-01
014 OTHER Allogeneic Bone Marrow Transplant 1 1 — — $69,912.66 $69,912.66 $69,912.66 2026-03-01
8634 APR_DRG Neonatal Aftercare 10 6 — — $67,718.34 $82,988.16 $69,710.06 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 80 46 — — $48,305.00 $162,082.00 $69,556.19 2026-03-01
349587 CDM Matrix Bn Cellular 10cc 35 23 $187,720.00 $187,720.00 $26,280.80 $168,948.00 $69,456.40 2026-03-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $69,176.27 $69,176.27 $69,176.27 2026-03-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 10 6 — — $67,067.94 $82,191.10 $69,040.52 2026-03-01
261942 CDM Sys Mitraclip 3 Clip 35 23 $185,185.00 $185,185.00 $25,925.90 $166,666.50 $68,518.45 2026-03-01
261943 CDM Sys Mitraclip 4 Clip 35 23 $185,185.00 $185,185.00 $25,925.90 $166,666.50 $68,518.45 2026-03-01
261941 CDM Sys Mitraclip 2 Clip 35 23 $185,185.00 $185,185.00 $25,925.90 $166,666.50 $68,518.45 2026-03-01
261940 CDM Sys Mitraclip 1 Clip 35 23 $185,185.00 $185,185.00 $25,925.90 $166,666.50 $68,518.45 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 120 64 — — $13,723.00 $185,236.17 $68,265.61 2026-03-01
1611 APR_DRG Implantable Heart Assist Systems 14 7 — — $65,991.10 $80,871.45 $68,255.51 2026-03-01
717 OTHER Instill Adstiladrin, Tx D 43 25 — — $12,110.72 $127,264.08 $67,488.53 2026-03-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 10 6 — — $65,527.27 $80,303.02 $67,454.54 2026-03-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 10 6 — — $65,504.99 $80,275.73 $67,431.61 2026-03-01
1582 OTHER New Technology - Level 45 42 24 — — $61,995.02 $126,546.53 $67,427.57 2026-03-01
1596 OTHER New Technology - Level 45 42 24 — — $61,995.02 $126,546.53 $67,427.57 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 80 46 — — $11,384.00 $143,176.17 $66,900.87 2026-03-01
5244 OTHER Level 4 Blood Product Exc 42 24 — — $61,292.12 $125,111.74 $66,663.07 2026-03-01
23 APR_DRG Heart And/or Lung Transplant 14 7 — — $60,615.66 $103,331.00 $66,261.20 2026-03-01
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 10 6 — — $63,814.75 $78,204.35 $65,691.65 2026-03-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 10 6 — — $63,814.75 $78,204.35 $65,691.65 2026-03-01
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 10 6 — — $63,633.75 $77,982.54 $65,505.33 2026-03-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 120 64 — — $13,723.00 $188,609.00 $65,119.01 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 86 46 — — $48,305.00 $234,066.20 $64,958.50 2026-03-01
83 APR_DRG Autologous Bone Marrow Transplant 14 7 — — $59,350.26 $101,174.00 $64,877.95 2026-03-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $64,830.03 $64,830.03 $64,830.03 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 120 64 — — $13,723.00 $188,608.00 $64,667.06 2026-03-01
107223 CDM Tiss Aclr Drml 16cm 20cm 35 23 $174,080.00 $174,080.00 $24,371.20 $156,672.00 $64,409.60 2026-03-01
00717 OTHER Instill Adstiladrin, Tx D 1 1 — — $64,274.79 $64,274.79 $64,274.79 2026-03-01
4414 APR_DRG Major Bladder Procedures 10 6 — — $62,297.15 $76,344.55 $64,129.42 2026-03-01
01596 OTHER New Technology - Level 45 1 1 — — $62,991.98 $62,991.98 $62,991.98 2026-03-01
01582 OTHER New Technology - Level 45 1 1 — — $62,991.98 $62,991.98 $62,991.98 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 86 46 — — $53,738.69 $196,371.99 $62,695.14 2026-03-01
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 1 1 — — $62,616.22 $62,616.22 $62,616.22 2026-03-01
110915 CDM Graft Nrv 1-2mm 70mm 35 23 $169,027.00 $169,027.00 $23,663.78 $152,124.30 $62,539.99 2026-03-01
05244 OTHER Level 4 Blood Product Exc 1 1 — — $62,277.78 $62,277.78 $62,277.78 2026-03-01
339426 CDM Mesh Viable Crtlg 20mm 35 23 $167,960.00 $167,960.00 $23,514.40 $151,164.00 $62,145.20 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 97 47 — — $52,242.34 $150,499.93 $62,110.33 2026-03-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 91 47 — — $11,384.00 $198,136.00 $60,751.86 2026-03-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 120 64 — — $13,723.00 $136,871.91 $60,624.00 2026-03-01
B0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 13 7 — — $59,704.87 $62,547.96 $60,491.26 2026-03-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $60,166.38 $60,166.38 $60,166.38 2026-03-01
1784 APR_DRG External Heart Assist Devices 10 6 — — $58,348.21 $71,505.16 $60,064.34 2026-03-01
1643 OTHER Y90 Ibritumomab, Rx 42 24 — — $55,119.81 $112,512.61 $59,949.90 2026-03-01
B0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 13 7 — — $58,721.85 $61,518.13 $59,495.29 2026-03-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 10 6 — — $57,461.12 $70,418.04 $59,151.15 2026-03-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 14 7 — — $57,141.29 $70,026.09 $59,102.01 2026-03-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 10 6 — — $57,395.08 $70,337.11 $59,083.17 2026-03-01
337198 CDM Kit Revasc Hi-flow 71 36 $165,725.00 $165,725.00 $8,286.25 $149,152.50 $58,500.92 2026-03-01
6904 APR_DRG Acute Leukemia 10 6 — — $56,628.14 $69,397.23 $58,293.67 2026-03-01
346190 CDM Allograft Dermis 16x20cm 35 23 $157,358.00 $157,358.00 $22,030.12 $141,622.20 $58,222.46 2026-03-01
C2616 HCPCS Brachytx Ns Yttrium 90 59 19 $178,297.00 $178,297.00 $9,816.00 $247,467.60 $57,940.42 2026-03-01
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 10 6 — — $56,281.25 $68,972.13 $57,936.58 2026-03-01
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 10 6 — — $56,218.00 $68,894.61 $57,871.47 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 92 48 — — $48,797.21 $145,475.00 $57,743.36 2026-03-01
429 OTHER Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 1 1 — — $57,715.38 $57,715.38 $57,715.38 2026-03-01
9273 OTHER Sipuleucel-t Auto Cd54+ 42 24 — — $52,771.99 $107,720.14 $57,396.34 2026-03-01
1595 OTHER New Technology - Level 44 42 24 — — $52,457.40 $107,077.98 $57,054.18 2026-03-01
1581 OTHER New Technology - Level 44 42 24 — — $52,457.40 $107,077.98 $57,054.18 2026-03-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $57,050.54 $57,050.54 $57,050.54 2026-03-01
63 APR_DRG Pancreas Transplant 14 7 — — $52,152.11 $88,903.30 $57,009.40 2026-03-01
01643 OTHER Y90 Ibritumomab, Rx 1 1 — — $56,824.55 $56,824.55 $56,824.55 2026-03-01
0915T CPT Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 9 2 — — $18,564.00 $102,917.67 $56,749.00 2026-03-01
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 10 6 — — $54,520.20 $66,813.98 $56,123.74 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 80 46 — — $48,305.00 $138,026.00 $55,972.46 2026-03-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 120 64 — — $13,723.00 $160,079.30 $55,743.82 2026-03-01
10 MS_DRG Pancreas Transplant 71 39 — — $49,100.36 $118,643.02 $55,647.08 2026-03-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 71 41 — — $11,384.00 $118,593.42 $55,624.33 2026-03-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 75 44 — — $48,825.32 $117,963.48 $55,335.37 2026-03-01
33270 CPT Insertion Or Replacement Of Permanent Subcutaneous Implantable Defibrillator Sys… 109 33 $173,782.00 $173,782.00 $929.00 $165,537.90 $55,179.30 2026-03-01
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 10 6 — — $53,374.14 $65,409.49 $54,943.97 2026-03-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 10 6 — — $53,048.74 $65,010.71 $54,609.00 2026-03-01
09273 OTHER Sipuleucel-t Auto Cd54+ 1 1 — — $54,404.11 $54,404.11 $54,404.11 2026-03-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 10 6 — — $52,689.14 $64,570.02 $54,238.82 2026-03-01
C1982 HCPCS Cath Micro 120cm .021in 70 35 $151,978.00 $151,978.00 $7,598.90 $136,780.20 $54,180.15 2026-03-01
231 OTHER Coronary Bypass With Ptca With Mcc 1 1 — — $54,001.65 $54,001.65 $54,001.65 2026-03-01
B0106 OTHER Stroke; M > 30.05 & M < 34.25 13 7 — — $53,239.11 $55,774.31 $53,940.34 2026-03-01
275 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 1 1 — — $53,827.36 $53,827.36 $53,827.36 2026-03-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 10 6 — — $52,173.59 $63,938.23 $53,708.11 2026-03-01
261558 CDM Valve Xt Sapien Nf 26mm 35 23 $145,112.00 $145,112.00 $20,315.68 $130,600.80 $53,691.44 2026-03-01
261559 CDM Valve Xt Sapien Nf 29mm 35 23 $145,112.00 $145,112.00 $20,315.68 $130,600.80 $53,691.44 2026-03-01
261562 CDM Valve Xt Sapien As 29mm 35 23 $145,112.00 $145,112.00 $20,315.68 $130,600.80 $53,691.44 2026-03-01
261557 CDM Valve Xt Sapien Nf 23mm 35 23 $145,112.00 $145,112.00 $20,315.68 $130,600.80 $53,691.44 2026-03-01
261560 CDM Valve Xt Sapien As 23mm 35 23 $145,112.00 $145,112.00 $20,315.68 $130,600.80 $53,691.44 2026-03-01
261561 CDM Valve Xt Sapien As 26mm 35 23 $145,112.00 $145,112.00 $20,315.68 $130,600.80 $53,691.44 2026-03-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 86 46 — — $6,024.00 $114,279.70 $53,645.55 2026-03-01
01581 OTHER New Technology - Level 44 1 1 — — $53,300.98 $53,300.98 $53,300.98 2026-03-01
01595 OTHER New Technology - Level 44 1 1 — — $53,300.98 $53,300.98 $53,300.98 2026-03-01
22 APR_DRG Heart And/or Lung Transplant 14 7 — — $48,694.45 $83,009.10 $53,229.70 2026-03-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 120 64 — — $13,723.00 $124,262.44 $52,802.42 2026-03-01
B1903 OTHER Guillian Barre; M < 18.05 13 7 — — $51,870.78 $54,340.82 $52,553.98 2026-03-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 45 26 — — $24,077.31 $99,014.26 $52,507.56 2026-03-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 91 47 — — $11,384.00 $119,477.83 $52,275.04 2026-03-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 45 26 — — $23,881.67 $98,209.58 $52,080.84 2026-03-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 80 46 — — $45,826.57 $110,554.59 $51,936.78 2026-03-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 80 46 — — $28,473.00 $130,292.00 $51,899.61 2026-03-01
B0205 OTHER Traumatic Brain Injury; M > 28.75 & M < 40.65 13 7 — — $51,214.81 $53,653.61 $51,889.37 2026-03-01
C2624 HCPCS Cardiomems Hf System 34 22 $135,825.00 $135,825.00 $19,015.50 $122,242.50 $51,613.50 2026-03-01
62 APR_DRG Pancreas Transplant 14 7 — — $47,170.88 $80,411.90 $51,564.25 2026-03-01
0981T CPT Transcatheter Implantation Of Wireless Inferior Vena Cava Sensor For Long-term H… 6 1 — — $26,935.08 $57,641.07 $51,356.22 2026-03-01
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 10 6 — — $49,716.79 $60,927.44 $51,179.05 2026-03-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 120 64 — — $13,723.00 $119,787.00 $51,115.50 2026-03-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 86 46 — — $11,384.00 $108,320.85 $50,912.12 2026-03-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 10 6 — — $49,445.89 $60,595.45 $50,900.18 2026-03-01
61 APR_DRG Pancreas Transplant 14 7 — — $46,561.86 $79,373.60 $50,898.50 2026-03-01
4474 APR_DRG Other Kidney, Urinary Tract And Related Non-percutaneous Procedures 10 6 — — $49,330.13 $60,453.59 $50,781.01 2026-03-01
850 OTHER Acute Leukemia With Other Procedures 1 1 — — $50,593.22 $50,593.22 $50,593.22 2026-03-01
118056 CDM Wedge Augmt 24d 30x12mm 35 23 $135,620.00 $135,620.00 $18,986.80 $122,058.00 $50,179.40 2026-03-01
234 APR_DRG Spinal Procedures 10 6 — — $48,599.38 $59,558.06 $50,028.77 2026-03-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 86 46 — — $6,024.00 $106,391.33 $50,027.01 2026-03-01
71 APR_DRG Allogeneic Bone Marrow Transplant 14 7 — — $45,755.91 $77,999.80 $50,017.50 2026-03-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 10 6 — — $48,423.55 $59,342.59 $49,847.77 2026-03-01
13 APR_DRG Liver Transplant And/or Intestinal Transplant 14 7 — — $45,421.76 $77,430.10 $49,652.20 2026-03-01
692643 CDM Impella 2.5l Catheter 71 36 $140,614.00 $140,614.00 $7,030.70 $126,552.60 $49,636.74 2026-03-01
C0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 13 7 — — $48,801.43 $51,125.30 $49,444.20 2026-03-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 10 6 — — $47,801.39 $58,580.14 $49,207.32 2026-03-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 10 6 — — $47,799.40 $58,577.70 $49,205.27 2026-03-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 86 46 — — $42,091.68 $188,225.00 $49,106.96 2026-03-01
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $48,914.98 $48,914.98 $48,914.98 2026-03-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 92 48 — — $41,276.57 $130,348.00 $48,843.94 2026-03-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 10 6 — — $47,203.50 $57,847.43 $48,591.84 2026-03-01
B2102 OTHER Burns; M=12-45 13 7 — — $47,837.20 $50,115.16 $48,467.28 2026-03-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 98 48 — — $40,353.06 $119,787.00 $48,423.67 2026-03-01
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 10 6 — — $46,985.90 $57,580.76 $48,367.84 2026-03-01
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 1 — — $48,273.80 $48,273.80 $48,273.80 2026-03-01
D0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 13 7 — — $47,517.67 $49,780.42 $48,143.54 2026-03-01
0823T CPT Transcatheter Insertion Of Permanent Single-chamber Leadless Pacemaker, Right At… 9 2 — — $18,068.00 $100,809.85 $48,084.26 2026-03-01
0825T CPT Transcatheter Removal And Replacement Of Permanent Single-chamber Leadless Pacem… 9 2 — — $18,068.00 $100,809.85 $48,084.26 2026-03-01
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