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

MEDICAL CITY DECATUR

Decatur, TX · CCN 450271 · Rates published

28,143 distinct procedures filed
21 distinct payers
881,201 rate rows
2026-03-01 last MRF observed
Data quality

863,950 of 881,201 rate rows are consumer-grade (98.0%)

17,251 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 9,595
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 3,995
template filing: same amount across many unrelated codes — excluded 3,392
placeholder amount (≤ $0.02) — excluded from medians 222
exceeds 10× this hospital's gross charge — excluded from medians 47
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/93-2081386_MEDICAL-CITY-DECATUR_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page https://www.medicalcityhealthcare.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 58111d5db7463edb… · 460,007,413 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 7 $6,122.65 $4,640,150.00 $4,505,000.00 nat. median
$9,966
outlier · 452.1×
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
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
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 7 $3,666,840.67 $4,790,847.10 $3,685,267.00 nat. median
$3,746,358
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 9 $7,201.06 $4,326,218.00 $3,356,146.81 nat. median
$13,041
outlier · 257.4×
908
OTHER 		Topi Adm Prad Zami Per Tr 7 $11,085.94 $4,336,566.00 $3,335,820.00 nat. median
$22,747
outlier · 146.6×
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
748
OTHER 		Inj, Lovotibeglogene Auto 9 $13,707.16 $4,228,260.40 $3,280,154.32 nat. median
$17,963
outlier · 182.6×
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×
906
OTHER 		Inj Elivaldogene Autoteme 7 $9,795.73 $4,134,000.00 $3,180,000.00 nat. median
$20,756
outlier · 153.2×
746
OTHER 		Inj, Betibeglogene Autote 9 $12,679.26 $3,821,959.70 $2,964,958.74 nat. median
$21,896
outlier · 135.4×
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 8 $2,455,110.00 $4,634,275.99 $2,599,984.17 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
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 2 $1,271,523.00 $4,067,128.80 $2,528,215.20 nat. median
$824,563
outlier · 3.1×
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
824
OTHER 		Inj, Exagamglogene Autote 9 $14,847.10 $4,174,280.00 $2,332,000.00 nat. median
$25,250
outlier · 92.4×
Q2058
HCPCS 		Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,… 2 $459,112.50 $2,937,060.00 $1,825,740.00 nat. median
$324,450
outlier · 5.6×
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 3 $553,169.00 $2,695,474.80 $1,597,833.00 nat. median
$675,122
outlier · 2.4×
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 3 $527,622.00 $2,431,724.04 $1,441,485.90 nat. median
$625,184
outlier · 2.3×
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 3 $516,442.00 $2,378,394.22 $1,409,872.86 nat. median
$674,188
outlier · 2.1×
C9301
HCPCS 		Obecabtagene Autoleucel, Up To 400 Million Cd19 Car-positive Viable T Cells, Inc… 1 $959,962.50 $1,544,287.50 $1,405,162.50 nat. median
$459,112
outlier · 3.1×
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 4 $23.68 $2,235,985.80 $1,325,455.50 nat. median
$754,974
1.8× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 3 $489,399.00 $2,162,176.56 $1,281,702.60 nat. median
$620,080
outlier · 2.1×
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 4 $6.22 $2,062,317.00 $1,222,507.50 nat. median
$634,511
1.9× median
2067
OTHER 		Afamitresgene Autoleucel 10 $766,766.90 $2,019,024.40 $839,975.80 nat. median
$786,032
1.1× median
9498
OTHER 		Ciltacabtagene Car-pos T 9 $565,868.90 $1,539,641.95 $605,279.09 nat. median
$587,650
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos 9 $563,698.64 $1,484,312.01 $591,726.20 nat. median
$566,531
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
9413
OTHER 		Lisocabtagene Car Pos T 9 $559,390.19 $1,472,967.14 $579,067.24 nat. median
$562,201
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 9 $555,291.39 $1,462,174.32 $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 9 $529,531.24 $1,394,343.56 $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
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 13 $221,843.87 $842,426.46 $524,008.23 nat. median
$265,286
2.0× median
9391
OTHER 		Brexucabtagene Car Pos T 9 $487,002.95 $1,282,359.52 $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
J9029
HCPCS 		Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 4 $63,235.60 $931,200.00 $405,600.00 nat. median
$69,774
outlier · 5.8×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 $340,548.24 $1,273,072.13 $378,773.04 nat. median
$370,174
1.0× median
5834
APR_DRG 		Neonate With Ecmo 4 $312,919.29 $362,986.38 $336,388.23 nat. median
$309,665
1.1× median
J3402
HCPCS 		Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 $332,753.88 $332,753.88 $332,753.88 nat. median
$209,753
1.6× median
90288
CPT 		Botulism Immune Globulin, Human, For Intravenous Use 1 $294,713.96 $416,525.16 $329,245.80 nat. median
$55,037
outlier · 6.0×
74
APR_DRG 		Allogeneic Bone Marrow Transplant 5 $304,408.17 $532,714.00 $328,761.00 nat. median
$187,294
1.8× median

Other procedures at this hospital

Browse this hospital's 28,143 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
             
232 MS_DRG Coronary Bypass With Ptca Without Mcc 52 16 — — $49,872.22 $217,198.71 $113,993.64 2026-03-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 47 16 — — $43,714.97 $222,011.00 $104,383.95 2026-03-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 52 16 — — $46,093.00 $210,248.46 $97,770.01 2026-03-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 52 16 — — $41,139.46 $177,245.55 $94,033.05 2026-03-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 47 16 — — $35,468.49 $183,055.00 $87,309.22 2026-03-01
215 MS_DRG Other Heart Assist System Implant 46 15 — — $55,453.00 $567,817.00 $164,927.52 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 46 15 — — $55,453.00 $350,478.59 $159,209.40 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 46 15 — — $55,453.00 $276,270.00 $131,908.04 2026-03-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 41 15 — — $56,256.57 $294,489.00 $128,586.44 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 46 15 — — $55,453.00 $302,009.60 $124,871.32 2026-03-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 46 15 — — $53,887.01 $308,347.00 $114,932.33 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 46 15 — — $53,887.01 $304,994.00 $111,276.29 2026-03-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 46 15 — — $44,157.40 $276,270.00 $96,210.42 2026-03-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 46 15 — — $41,866.14 $261,868.00 $92,470.64 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 33 14 — — $60,607.00 $507,900.98 $202,745.98 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 33 14 — — $60,607.00 $415,198.41 $166,741.03 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 40 14 — — $60,607.00 $387,262.29 $152,496.19 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 40 14 — — $64,015.97 $236,544.00 $144,738.61 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 33 14 — — $58,924.47 $332,661.96 $134,684.50 2026-03-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 34 14 — — $62,066.92 $229,061.81 $133,593.45 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 38 14 — — $9,825.00 $326,886.32 $131,337.38 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 33 14 — — $9,825.00 $262,963.04 $128,236.48 2026-03-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 33 14 — — $36,089.00 $307,914.85 $125,072.91 2026-03-01
862710 CDM Set Vntrc 17.4x13.8in 41 14 $466,479.00 $466,479.00 $32,653.53 $349,859.25 $117,086.23 2026-03-01
422506 CDM Kit Pmp Rt Hrt 22f 170cm 41 14 $466,479.00 $466,479.00 $32,653.53 $349,859.25 $117,086.23 2026-03-01
265596 CDM Kit Lo Prfl Comp Shth 7f 41 14 $466,479.00 $466,479.00 $32,653.53 $349,859.25 $117,086.23 2026-03-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 40 14 — — $49,093.07 $274,803.50 $112,212.73 2026-03-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 34 14 — — $55,107.03 $202,343.60 $111,880.96 2026-03-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 45 14 — — $50,387.47 $422,445.00 $108,736.20 2026-03-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 33 14 — — $47,558.26 $265,771.04 $108,704.60 2026-03-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 33 14 — — $46,422.02 $259,084.25 $106,107.48 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 45 14 — — $55,453.00 $273,896.94 $104,341.69 2026-03-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 40 14 — — $5,441.00 $207,775.62 $103,893.55 2026-03-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 40 14 — — $43,159.77 $239,193.34 $102,335.05 2026-03-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 40 14 — — $9,825.00 $184,012.40 $102,313.21 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 38 14 — — $55,453.00 $329,192.00 $101,840.76 2026-03-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 33 14 — — $53,366.00 $239,550.55 $101,813.00 2026-03-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 40 14 — — $45,646.79 $253,787.37 $101,165.06 2026-03-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 40 14 — — $47,270.09 $223,223.00 $101,057.75 2026-03-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 33 14 — — $36,089.00 $245,609.29 $100,873.92 2026-03-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 40 14 — — $43,852.00 $224,331.00 $100,315.07 2026-03-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 40 14 — — $9,825.00 $196,941.64 $98,031.48 2026-03-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 40 14 — — $5,441.00 $193,433.52 $96,873.27 2026-03-01
28 MS_DRG Spinal Procedures With Mcc 40 14 — — $35,407.00 $180,615.51 $94,232.43 2026-03-01
751731 CDM Set Pump Asst 2.5in 41 14 $373,200.00 $373,200.00 $26,124.00 $279,900.00 $93,673.20 2026-03-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 38 14 — — $49,433.70 $215,192.45 $92,902.58 2026-03-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 40 14 — — $9,825.00 $178,096.38 $88,531.30 2026-03-01
834 MS_DRG Acute Leukemia With Mcc 40 14 — — $5,441.00 $166,711.79 $87,988.64 2026-03-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 40 14 — — $9,825.00 $164,448.70 $87,584.27 2026-03-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 40 14 — — $25,557.00 $171,332.67 $86,714.61 2026-03-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 45 14 — — $45,174.60 $195,706.69 $86,606.02 2026-03-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 45 14 — — $39,678.26 $317,198.00 $86,176.86 2026-03-01
653 MS_DRG Major Bladder Procedures With Mcc 40 14 — — $9,825.00 $156,208.98 $85,451.82 2026-03-01
471 MS_DRG Cervical Spinal Fusion With Mcc 40 14 — — $28,952.00 $222,525.81 $85,365.20 2026-03-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 40 14 — — $35,072.26 $219,931.00 $85,010.52 2026-03-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 40 14 — — $9,825.00 $163,955.70 $84,321.74 2026-03-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 33 14 — — $25,958.00 $167,325.54 $83,993.15 2026-03-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 40 14 — — $37,797.00 $209,530.12 $83,766.57 2026-03-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 38 14 — — $38,563.95 $165,462.38 $81,566.52 2026-03-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 33 14 — — $35,606.31 $195,433.03 $81,385.85 2026-03-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 40 14 — — $9,825.00 $147,334.97 $80,899.97 2026-03-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 40 14 — — $9,825.00 $149,926.23 $80,596.72 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 41 13 — — $221,843.87 $842,426.46 $524,008.23 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 39 13 — — $168,605.47 $712,935.00 $275,912.62 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 29 13 — — $91,133.58 $554,970.00 $212,603.19 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 39 13 — — $110,863.68 $416,386.94 $189,043.91 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 25 13 — — $75,983.00 $333,689.54 $101,249.63 2026-03-01
7 MS_DRG Lung Transplant 25 12 — — $103,806.70 $381,784.85 $242,795.77 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 25 12 — — $96,506.20 $354,299.71 $225,402.95 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 25 12 — — $83,136.11 $303,963.85 $193,549.98 2026-03-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 25 12 — — $48,831.53 $174,813.49 $111,822.51 2026-03-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 25 12 — — $58,266.69 $210,335.14 $110,841.57 2026-03-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 25 12 — — $46,285.77 $165,229.21 $105,757.49 2026-03-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 25 12 — — $44,936.55 $160,149.64 $102,543.10 2026-03-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 25 12 — — $39,213.11 $190,885.00 $101,116.50 2026-03-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 25 12 — — $31,416.90 $190,885.00 $101,116.50 2026-03-01
6 MS_DRG Liver Transplant Without Mcc 25 12 — — $38,708.82 $136,703.40 $87,706.11 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 16 11 — — $109,306.00 $629,884.36 $121,526.28 2026-03-01
10 MS_DRG Pancreas Transplant 24 11 — — $58,588.54 $211,546.81 $111,447.40 2026-03-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 22 11 — — $80,850.00 $249,112.22 $103,638.29 2026-03-01
2067 OTHER Afamitresgene Autoleucel 14 10 — — $766,766.90 $2,019,024.40 $839,975.80 2026-03-01
831 OTHER Obecbtge Autol Up To 400 12 10 — — $4,192.52 $729,015.00 $283,606.32 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 29 10 — — $9,825.00 $641,817.38 $244,676.73 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 12 10 — — $9,173.94 $528,372.78 $206,679.54 2026-03-01
1907 OTHER New Technology - Level 52 14 10 — — $145,445.80 $392,862.71 $163,442.88 2026-03-01
1908 OTHER New Technology - Level 52 14 10 — — $145,445.80 $392,862.71 $163,442.88 2026-03-01
1905 OTHER New Technology - Level 51 14 10 — — $131,139.70 $354,220.59 $147,366.58 2026-03-01
1906 OTHER New Technology - Level 51 14 10 — — $131,139.70 $354,220.59 $147,366.58 2026-03-01
1903 OTHER New Technology - Level 50 14 10 — — $116,833.60 $315,578.48 $131,290.28 2026-03-01
1904 OTHER New Technology - Level 50 14 10 — — $116,833.60 $315,578.48 $131,290.28 2026-03-01
1902 OTHER New Technology - Level 49 14 10 — — $102,527.50 $276,936.36 $115,213.98 2026-03-01
1901 OTHER New Technology - Level 49 14 10 — — $102,527.50 $276,936.36 $115,213.98 2026-03-01
1585 OTHER New Technology - Level 48 14 10 — — $90,605.77 $244,734.72 $101,817.12 2026-03-01
1599 OTHER New Technology - Level 48 14 10 — — $90,605.77 $244,734.72 $101,817.12 2026-03-01
1584 OTHER New Technology - Level 47 14 10 — — $81,068.38 $218,973.29 $91,099.57 2026-03-01
1598 OTHER New Technology - Level 47 14 10 — — $81,068.38 $218,973.29 $91,099.57 2026-03-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 29 10 — — $9,825.00 $215,618.53 $82,199.14 2026-03-01
1597 OTHER New Technology - Level 46 14 10 — — $71,530.98 $193,211.87 $80,382.04 2026-03-01
1583 OTHER New Technology - Level 46 14 10 — — $71,530.98 $193,211.87 $80,382.04 2026-03-01
714 OTHER Inj Delandistrogene Mox R 11 9 — — $7,201.06 $4,326,218.00 $3,356,146.81 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 11 9 — — $13,707.16 $4,228,260.40 $3,280,154.32 2026-03-01
746 OTHER Inj, Betibeglogene Autote 11 9 — — $12,679.26 $3,821,959.70 $2,964,958.74 2026-03-01
824 OTHER Inj, Exagamglogene Autote 9 9 — — $14,847.10 $4,174,280.00 $2,332,000.00 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 11 9 — — $565,868.90 $1,539,641.95 $605,279.09 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 11 9 — — $563,698.64 $1,484,312.01 $591,726.20 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 11 9 — — $559,390.19 $1,472,967.14 $579,067.24 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 11 9 — — $555,291.39 $1,462,174.32 $574,824.25 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 11 9 — — $529,531.24 $1,394,343.56 $548,157.97 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 11 9 — — $487,002.95 $1,282,359.52 $504,133.71 2026-03-01
476281 CDM Cage Spnl 25x35x12mm 8d 25 9 $546,750.00 $546,750.00 $73,811.25 $410,062.50 $161,291.25 2026-03-01
468568 CDM Cage Spnl 35x25x14mm 15d 25 9 $546,750.00 $546,750.00 $73,811.25 $410,062.50 $161,291.25 2026-03-01
468091 CDM Cage 25mmx705mm M3 Alif 25 9 $504,848.00 $504,848.00 $68,154.48 $378,636.00 $148,930.16 2026-03-01
474625 CDM Cage Spn St/a8d 40x27x14 25 9 $504,848.00 $504,848.00 $68,154.48 $378,636.00 $148,930.16 2026-03-01
475555 CDM Cage Stndaln25x35x13 8d 25 9 $504,848.00 $504,848.00 $68,154.48 $378,636.00 $148,930.16 2026-03-01
258384 CDM Cage Spn 12d 34x28x13mm 25 9 $481,140.00 $481,140.00 $64,953.90 $360,855.00 $141,936.30 2026-03-01
257472 CDM Cage Spnl 40x27x12mm 25 9 $426,465.00 $426,465.00 $57,572.78 $319,848.75 $125,807.18 2026-03-01
475554 CDM Cage Spn 15d 13x27x40mm 25 9 $426,465.00 $426,465.00 $57,572.78 $319,848.75 $125,807.18 2026-03-01
257469 CDM Cage Spnl 40x27x12mm 25 9 $426,465.00 $426,465.00 $57,572.78 $319,848.75 $125,807.18 2026-03-01
240666 CDM Cage Spn 20d 30x40x16mm 25 9 $426,465.00 $426,465.00 $57,572.78 $319,848.75 $125,807.18 2026-03-01
256791 CDM Cage 36mmx15mmx8 25 9 $426,465.00 $426,465.00 $57,572.78 $319,848.75 $125,807.18 2026-03-01
481710 CDM Cage Spn Ant Secured Med 25 9 $404,595.00 $404,595.00 $54,620.32 $303,446.25 $119,355.52 2026-03-01
216719 CDM Graft Endo Aaa 26x12mm 25 9 $374,663.00 $374,663.00 $50,579.50 $280,997.25 $110,525.59 2026-03-01
257280 CDM Impl Pstr Si Fsn Kt 1020 25 9 $371,790.00 $371,790.00 $50,191.65 $278,842.50 $109,678.05 2026-03-01
257390 CDM Cage Spn Lrd 9x9.5x30mm 25 9 $371,681.00 $371,681.00 $50,176.93 $278,760.75 $109,645.90 2026-03-01
230669 CDM Cage Lrdtc 9.5x30x11mm 25 9 $371,681.00 $371,681.00 $50,176.93 $278,760.75 $109,645.90 2026-03-01
879051 CDM Graft Evas 28.5x12m 16cm 25 9 $350,566.00 $350,566.00 $47,326.41 $262,924.50 $103,416.97 2026-03-01
474533 CDM Cage Spn 12d 55x12mm 25 9 $349,920.00 $349,920.00 $47,239.20 $262,440.00 $103,226.40 2026-03-01
447298 CDM Cage 12 Degree 37mmx27mm 25 9 $344,453.00 $344,453.00 $46,501.15 $258,339.75 $101,613.63 2026-03-01
880408 CDM Clamp Zip 8x35mm Intspno 25 9 $343,906.00 $343,906.00 $46,427.31 $257,929.50 $101,452.27 2026-03-01
216652 CDM Graft Endo Aaa 32x14mm 25 9 $336,747.00 $336,747.00 $45,460.85 $252,560.25 $99,340.37 2026-03-01
216750 CDM Graft Endo Aaa 36x14mm 25 9 $328,533.00 $328,533.00 $44,351.96 $246,399.75 $96,917.24 2026-03-01
211753 CDM Graft Endo Aaa 28.5x12mm 25 9 $328,533.00 $328,533.00 $44,351.96 $246,399.75 $96,917.24 2026-03-01
257562 CDM Spacer Spn 09x22x07.0mm 25 9 $328,050.00 $328,050.00 $44,286.75 $246,037.50 $96,774.75 2026-03-01
257567 CDM Spacer 9x26x7-10.5mm 25 9 $328,050.00 $328,050.00 $44,286.75 $246,037.50 $96,774.75 2026-03-01
466896 CDM Cntr Piece Turq 13mm 25 9 $325,535.00 $325,535.00 $43,947.22 $244,151.25 $96,032.82 2026-03-01
434546 CDM Cage Spnl 39-65mm 14mm 25 9 $324,826.00 $324,826.00 $43,851.51 $243,619.50 $95,823.67 2026-03-01
205164 CDM Cage Spn 6d16-25mm 14mm 25 9 $324,826.00 $324,826.00 $43,851.51 $243,619.50 $95,823.67 2026-03-01
442513 CDM Occluder Cv 25x18mm 25 9 $324,551.00 $324,551.00 $43,814.39 $243,413.25 $95,742.54 2026-03-01
256505 CDM Cage Spnl 39-65mm 16mm 25 9 $322,670.00 $322,670.00 $43,560.45 $242,002.50 $95,187.65 2026-03-01
258013 CDM Cage Spn 12d 32x24x13mm 25 9 $314,928.00 $314,928.00 $42,515.28 $236,196.00 $92,903.76 2026-03-01
743475 CDM Cage Spnl 24-40mm 14mm 25 9 $308,585.00 $308,585.00 $41,658.97 $231,438.75 $91,032.57 2026-03-01
467647 CDM Cage Spn 36x26x15mm 12d 25 9 $306,180.00 $306,180.00 $41,334.30 $229,635.00 $90,323.10 2026-03-01
174158 CDM Cage Spn 8d 12x25x35mm 25 9 $297,624.00 $297,624.00 $40,179.24 $223,218.00 $87,799.08 2026-03-01
254102 CDM Cage Spn 15d 14x25x35mm 25 9 $297,624.00 $297,624.00 $40,179.24 $223,218.00 $87,799.08 2026-03-01
258440 CDM Cage Spn 7dg 14x16x7mm 25 9 $290,106.00 $290,106.00 $39,164.31 $217,579.50 $85,581.27 2026-03-01
258441 CDM Cage Spn 7dg 14x16x8mm 25 9 $290,106.00 $290,106.00 $39,164.31 $217,579.50 $85,581.27 2026-03-01
876247 CDM Graft Evas 23x12mm 12cm 25 9 $285,687.00 $285,687.00 $38,567.75 $214,265.25 $84,277.66 2026-03-01
871623 CDM Graft Evas 23x14.5m 12cm 25 9 $285,687.00 $285,687.00 $38,567.75 $214,265.25 $84,277.66 2026-03-01
870599 CDM Graft Evas 14.5mm 12cm 25 9 $285,687.00 $285,687.00 $38,567.75 $214,265.25 $84,277.66 2026-03-01
257683 CDM Cage Lrdtc Tlif26x9x10mm 25 9 $285,336.00 $285,336.00 $38,520.36 $214,002.00 $84,174.12 2026-03-01
240701 CDM Cage Spn 16mm 14mm 6mm 25 9 $285,336.00 $285,336.00 $38,520.36 $214,002.00 $84,174.12 2026-03-01
233458 CDM Cage Spn Cerv 12x15x5mm 25 9 $285,336.00 $285,336.00 $38,520.36 $214,002.00 $84,174.12 2026-03-01
257682 CDM Cage Spn 6d 26x9x11mm 25 9 $285,336.00 $285,336.00 $38,520.36 $214,002.00 $84,174.12 2026-03-01
235992 CDM Cage Spn 15x12x7mm 25 9 $285,336.00 $285,336.00 $38,520.36 $214,002.00 $84,174.12 2026-03-01
235237 CDM Cage Spn 12mm 15mm 6mm 25 9 $285,336.00 $285,336.00 $38,520.36 $214,002.00 $84,174.12 2026-03-01
257680 CDM Cage Lrdtc Tlif26x9x13mm 25 9 $285,336.00 $285,336.00 $38,520.36 $214,002.00 $84,174.12 2026-03-01
257905 CDM Cage Spn 12x12x8mm 25 9 $285,336.00 $285,336.00 $38,520.36 $214,002.00 $84,174.12 2026-03-01
279623 CDM Allograft Troch Fem Rt 25 9 $273,375.00 $273,375.00 $36,905.63 $205,031.25 $80,645.63 2026-03-01
423117 CDM Graft Evas 10cm 14.5mm 25 9 $272,376.00 $272,376.00 $36,770.76 $204,282.00 $80,350.92 2026-03-01
422734 CDM Graft Evas 10cm 12mm 25 9 $272,376.00 $272,376.00 $36,770.76 $204,282.00 $80,350.92 2026-03-01
231788 CDM Graft Endo Aaa 23x12mm 25 9 $272,376.00 $272,376.00 $36,770.76 $204,282.00 $80,350.92 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 8 8 — — $2,455,110.00 $4,634,275.99 $2,599,984.17 2026-03-01
897 OTHER Revakinagene, Per Implant 10 8 — — $263,675.00 $694,300.00 $308,725.00 2026-03-01
845 OTHER Inj, Atidarsagene Autotem 7 7 — — $6,122.65 $4,640,150.00 $4,505,000.00 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 7 7 — — $3,666,840.67 $4,790,847.10 $3,685,267.00 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 7 7 — — $11,085.94 $4,336,566.00 $3,335,820.00 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 7 7 — — $9,795.73 $4,134,000.00 $3,180,000.00 2026-03-01
C1822 HCPCS Pulse Gen Imp 40 7 $420,997.50 $420,997.50 $39,858.07 $410,062.50 $133,068.02 2026-03-01
C1820 HCPCS Kit Generator Ipg 120 7 $386,334.00 $386,334.00 $36,718.92 $410,062.50 $117,415.29 2026-03-01
C1882 HCPCS Crt-d Volume 36mm 120 7 $341,644.00 $341,644.00 $37,470.60 $357,690.00 $104,930.91 2026-03-01
C1767 HCPCS Device Ipg Sleep 51mm 100 7 $284,310.00 $284,310.00 $36,701.37 $311,647.50 $98,397.30 2026-03-01
C1721 HCPCS Defib Icd 69x51x12mm 40 7 $319,310.50 $319,310.50 $37,470.60 $270,795.75 $95,320.10 2026-03-01
C1722 HCPCS Icd 12mm 36j Ang 51x68mm 40 7 $300,910.50 $300,910.50 $37,470.60 $243,195.75 $93,398.94 2026-03-01
C1772 HCPCS Pump Infs Pain 20ml 40 7 $271,026.00 $271,026.00 $36,406.26 $204,282.00 $83,188.78 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 9 6 — — $340,548.24 $1,273,072.13 $378,773.04 2026-03-01
74 APR_DRG Allogeneic Bone Marrow Transplant 23 5 — — $304,408.17 $532,714.00 $328,761.00 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 18 5 — — $57,017.10 $478,449.94 $316,658.49 2026-03-01
24 APR_DRG Heart And/or Lung Transplant 23 5 — — $254,892.25 $446,061.00 $275,284.00 2026-03-01
1614 APR_DRG Implantable Heart Assist Systems 19 5 — — $192,342.25 $223,117.01 $207,730.00 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 18 5 — — $45,212.00 $389,632.46 $199,363.43 2026-03-01
73 APR_DRG Allogeneic Bone Marrow Transplant 23 5 — — $107,414.02 $187,975.00 $116,007.00 2026-03-01
1613 APR_DRG Implantable Heart Assist Systems 19 5 — — $100,251.38 $116,291.60 $108,271.00 2026-03-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 23 5 — — $91,306.84 $159,787.00 $98,611.40 2026-03-01
84 APR_DRG Autologous Bone Marrow Transplant 23 5 — — $90,940.98 $159,147.00 $98,216.30 2026-03-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 19 5 — — $89,275.26 $103,559.30 $96,417.30 2026-03-01
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 18 5 — — $27,070.50 $243,082.56 $95,052.46 2026-03-01
64 APR_DRG Pancreas Transplant 23 5 — — $83,582.23 $146,269.00 $90,268.80 2026-03-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 19 5 — — $77,877.67 $90,338.10 $84,107.90 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 12 4 — — $23.68 $2,235,985.80 $1,325,455.50 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 12 4 — — $6.22 $2,062,317.00 $1,222,507.50 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 17 4 — — $63,235.60 $931,200.00 $405,600.00 2026-03-01
5834 APR_DRG Neonate With Ecmo 14 4 — — $312,919.29 $362,986.38 $336,388.23 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 17 4 — — $93,760.51 $582,739.61 $302,670.97 2026-03-01
5833 APR_DRG Neonate With Ecmo 14 4 — — $264,968.56 $307,363.53 $284,841.20 2026-03-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 14 4 — — $198,072.78 $229,764.42 $212,928.24 2026-03-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 17 4 — — $131,717.55 $574,167.94 $211,893.45 2026-03-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 14 4 — — $180,194.41 $209,025.52 $193,708.99 2026-03-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 14 4 — — $147,379.35 $170,960.05 $158,432.80 2026-03-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 14 4 — — $146,073.31 $169,445.04 $157,028.81 2026-03-01
5832 APR_DRG Neonate With Ecmo 14 4 — — $132,027.78 $153,152.22 $141,929.86 2026-03-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 14 4 — — $125,369.02 $145,428.06 $134,771.70 2026-03-01
2004 APR_DRG Cardiac Structural And Valvular Disorders 14 4 — — $116,502.35 $135,142.73 $125,240.03 2026-03-01
5831 APR_DRG Neonate With Ecmo 14 4 — — $116,253.09 $134,853.58 $124,972.07 2026-03-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 17 4 — — $39,976.89 $203,447.46 $120,275.16 2026-03-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 14 4 — — $106,279.37 $123,284.07 $114,250.32 2026-03-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 14 4 — — $105,793.62 $122,720.60 $113,728.14 2026-03-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 14 4 — — $105,520.05 $122,403.26 $113,434.05 2026-03-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 14 4 — — $105,066.44 $121,877.07 $112,946.42 2026-03-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 14 4 — — $104,017.07 $120,659.80 $111,818.35 2026-03-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 14 4 — — $101,276.85 $117,481.15 $108,872.61 2026-03-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 14 4 — — $100,369.62 $116,428.76 $107,897.34 2026-03-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 14 4 — — $99,721.55 $115,677.00 $107,200.67 2026-03-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 14 4 — — $89,325.11 $103,617.13 $96,024.49 2026-03-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 14 4 — — $88,529.13 $102,693.79 $95,168.82 2026-03-01
2464 APR_DRG Gastrointestinal Vascular Insufficiency 14 4 — — $86,572.12 $100,423.66 $93,065.03 2026-03-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 14 4 — — $86,125.51 $99,905.59 $92,584.92 2026-03-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 14 4 — — $83,575.64 $96,947.74 $89,843.81 2026-03-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 14 4 — — $83,325.55 $96,657.64 $89,574.97 2026-03-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 14 4 — — $81,001.87 $93,962.17 $87,077.01 2026-03-01
A9604 HCPCS Samarium Sm-153 Lexidronam, Therapeutic, Per Treatment Dose, Up To 150 Millicuri… 17 4 — — $5,213.67 $142,036.23 $84,120.07 2026-03-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 14 4 — — $76,599.64 $88,855.58 $82,344.61 2026-03-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 14 4 — — $75,977.93 $88,134.40 $81,676.27 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 11 3 — — $553,169.00 $2,695,474.80 $1,597,833.00 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 11 3 — — $527,622.00 $2,431,724.04 $1,441,485.90 2026-03-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 11 3 — — $516,442.00 $2,378,394.22 $1,409,872.86 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 11 3 — — $489,399.00 $2,162,176.56 $1,281,702.60 2026-03-01
J7310 HCPCS Ganciclovir, 4.5 Mg, Long-acting Implant 14 3 — — $54,979.20 $145,041.92 $97,686.24 2026-03-01
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 9 2 — — $1,271,523.00 $4,067,128.80 $2,528,215.20 2026-03-01
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 9 2 — — $459,112.50 $2,937,060.00 $1,825,740.00 2026-03-01
0894T CPT Cannulation Of The Liver Allograft In Preparation For Connection To The Normothe… 10 2 — — $4,729.65 $123,407.40 $112,310.93 2026-03-01
0901T CPT Placement Of Bone Marrow Sampling Port, Including Imaging Guidance When Performe… 9 2 — — $7,977.00 $123,407.40 $112,310.93 2026-03-01
0954T CPT Totally Implantable Active Middle Ear Hearing Implant; Replacement Of Sound Proc… 9 2 — — $7,977.00 $123,407.40 $112,310.93 2026-03-01
0874T CPT Removal Of A Peritoneal Ascites Pump System, Including Implanted Peritoneal Asci… 10 2 — — $4,729.65 $123,407.40 $112,310.93 2026-03-01
0909T CPT Replacement Of Integrated Neurostimulation System, Vagus Nerve, Including Analys… 9 2 — — $7,977.00 $123,407.40 $112,310.93 2026-03-01
0908T CPT Open Implantation Of Integrated Neurostimulation System, Vagus Nerve, Including … 9 2 — — $7,977.00 $123,407.40 $112,310.93 2026-03-01
0941T CPT Cystourethroscopy, Flexible; With Insertion And Expansion Of Prostatic Urethral … 9 2 — — $7,977.00 $123,407.40 $112,310.93 2026-03-01
0953T CPT Totally Implantable Active Middle Ear Hearing Implant; Revision Or Replacement, … 9 2 — — $7,977.00 $123,407.40 $112,310.93 2026-03-01
0942T CPT Cystourethroscopy, Flexible; With Removal And Replacement Of Prostatic Urethral … 9 2 — — $7,977.00 $123,407.40 $112,310.93 2026-03-01
0951T CPT Totally Implantable Active Middle Ear Hearing Implant; Initial Placement, Includ… 9 2 — — $7,977.00 $123,407.40 $112,310.93 2026-03-01
0871T CPT Replacement Of A Subcutaneous Peritoneal Ascites Pump, Including Reconnection Be… 10 2 — — $4,729.65 $123,407.40 $112,310.93 2026-03-01
0968T CPT Insertion Or Replacement Of Epicranial Neurostimulator System, Including Electro… 9 2 — — $7,977.00 $123,407.40 $112,310.93 2026-03-01
0952T CPT Totally Implantable Active Middle Ear Hearing Implant; Revision Or Replacement, … 9 2 — — $7,977.00 $123,407.40 $112,310.93 2026-03-01
0969T CPT Removal Of Epicranial Neurostimulator System 9 2 — — $7,977.00 $123,407.40 $112,310.93 2026-03-01
0935T CPT Cystourethroscopy With Renal Pelvic Sympathetic Denervation, Radiofrequency Abla… 9 2 — — $7,977.00 $123,407.40 $112,310.93 2026-03-01
0873T CPT Revision Of A Subcutaneously Implanted Peritoneal Ascites Pump System, Any Compo… 10 2 — — $4,729.65 $123,407.40 $112,310.93 2026-03-01
0943T CPT Cystourethroscopy, Flexible; With Removal Of Prostatic Urethral Scaffold 9 2 — — $7,977.00 $123,407.40 $112,310.93 2026-03-01
0910T CPT Removal Of Integrated Neurostimulation System, Vagus Nerve 9 2 — — $7,977.00 $123,407.40 $112,310.93 2026-03-01
0870T CPT Implantation Of Subcutaneous Peritoneal Ascites Pump System, Percutaneous, Inclu… 10 2 — — $4,729.65 $123,407.40 $112,310.93 2026-03-01
0872T CPT Replacement Of Indwelling Bladder And Peritoneal Catheters, Including Tunneling … 10 2 — — $4,729.65 $123,407.40 $112,310.93 2026-03-01
0955T CPT Totally Implantable Active Middle Ear Hearing Implant; Removal, Including Remova… 9 2 — — $7,977.00 $123,407.40 $112,310.93 2026-03-01
C7565 HCPCS Repair Of Anterior Abdominal Hernia(s) (ie, Epigastric, Incisional, Ventral, Umb… 9 2 — — $7,977.00 $91,728.50 $83,480.51 2026-03-01
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 3 1 — — $4,850,948.67 $4,850,948.67 $4,850,948.67 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… 3 1 — — $4,271,819.03 $4,271,819.03 $4,271,819.03 2026-03-01
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 3 1 — — $3,847,800.00 $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
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
00746 OTHER Inj, Betibeglogene Autote 1 1 — — $2,939,969.00 $2,939,969.00 $2,939,969.00 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
00824 OTHER Inj, Exagamglogene Autote 1 1 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2026-03-01
C9301 HCPCS Obecabtagene Autoleucel, Up To 400 Million Cd19 Car-positive Viable T Cells, Inc… 6 1 — — $959,962.50 $1,544,287.50 $1,405,162.50 2026-03-01
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
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
09391 OTHER Brexucabtagene Car Pos T 1 1 — — $489,450.20 $489,450.20 $489,450.20 2026-03-01
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 3 1 — — $332,753.88 $332,753.88 $332,753.88 2026-03-01
90288 CPT Botulism Immune Globulin, Human, For Intravenous Use 6 1 — — $294,713.96 $416,525.16 $329,245.80 2026-03-01
00831 OTHER Obecbtge Autol Up To 400 1 1 — — $278,250.00 $278,250.00 $278,250.00 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 — — $247,200.30 $247,200.30 $247,200.30 2026-03-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $217,293.00 $217,293.00 $217,293.00 2026-03-01
00886 OTHER Inj. Remestemcel-l-rknd/ 1 1 — — $201,669.00 $201,669.00 $201,669.00 2026-03-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $153,152.50 $153,152.50 $153,152.50 2026-03-01
01907 OTHER New Technology - Level 52 1 1 — — $145,445.80 $145,445.80 $145,445.80 2026-03-01
01908 OTHER New Technology - Level 52 1 1 — — $145,445.80 $145,445.80 $145,445.80 2026-03-01
01906 OTHER New Technology - Level 51 1 1 — — $131,139.70 $131,139.70 $131,139.70 2026-03-01
01905 OTHER New Technology - Level 51 1 1 — — $131,139.70 $131,139.70 $131,139.70 2026-03-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $119,600.00 $119,600.00 $119,600.00 2026-03-01
0936T CPT Photobiomodulation Therapy Of Retina, Single Session 6 1 — — $112,310.93 $123,407.40 $119,478.16 2026-03-01
0895T CPT Connection Of Liver Allograft To Normothermic Machine Perfusion Device, Hemostas… 7 1 — — $4,729.65 $123,407.40 $117,877.36 2026-03-01
0896T CPT Connection Of Liver Allograft To Normothermic Machine Perfusion Device, Hemostas… 7 1 — — $4,729.65 $123,407.40 $117,877.36 2026-03-01
01904 OTHER New Technology - Level 50 1 1 — — $116,833.60 $116,833.60 $116,833.60 2026-03-01
01903 OTHER New Technology - Level 50 1 1 — — $116,833.60 $116,833.60 $116,833.60 2026-03-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $107,186.30 $107,186.30 $107,186.30 2026-03-01
E0767 HCPCS Intrabuccal, Systemic Delivery Of Amplitude-modulated, Radiofrequency Electromag… 6 1 — — $80,266.41 $113,137.42 $103,199.67 2026-03-01
01902 OTHER New Technology - Level 49 1 1 — — $102,527.50 $102,527.50 $102,527.50 2026-03-01
01901 OTHER New Technology - Level 49 1 1 — — $102,527.50 $102,527.50 $102,527.50 2026-03-01
L5969 HCPCS Addition, Endoskeletal Ankle-foot Or Ankle System, Power Assist, Includes Any Ty… 1 1 — — $98,593.44 $98,593.44 $98,593.44 2026-03-01
007 OTHER Lung Transplant 1 1 — — $91,920.78 $91,920.78 $91,920.78 2026-03-01
01599 OTHER New Technology - Level 48 1 1 — — $90,605.77 $90,605.77 $90,605.77 2026-03-01
01585 OTHER New Technology - Level 48 1 1 — — $90,605.77 $90,605.77 $90,605.77 2026-03-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $81,468.94 $81,468.94 $81,468.94 2026-03-01
01598 OTHER New Technology - Level 47 1 1 — — $81,068.38 $81,068.38 $81,068.38 2026-03-01
01584 OTHER New Technology - Level 47 1 1 — — $81,068.38 $81,068.38 $81,068.38 2026-03-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $80,955.90 $80,955.90 $80,955.90 2026-03-01
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