Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

ST DAVID'S MEDICAL CENTER

Austin, TX · CCN 450431 · Rates published

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You selected 807 (MS_DRG)

VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC

This hospital’s price: $6,399 across 52 payers · range $2,573-$12,540

Source: https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/74-2781812_ST.-DAVID'S-MEDICAL-CENTER_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D · observed 2026-03-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

65,327 distinct procedures filed
76 distinct payers
2,653,009 rate rows
2026-07-30 last MRF observed
Data quality

2,530,923 of 2,653,009 rate rows are consumer-grade (95.4%)

122,086 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 53,868
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 28,106
per-diem day rate — not a per-procedure price 19,657
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 19,005
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 1,090
placeholder amount (≤ $0.02) — excluded from medians 195
exceeds 10× this hospital's gross charge — excluded from medians 158
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 7
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/74-2781812_ST.-DAVID'S-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.stdavids.com/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-08-11
Content fingerprint 01e91d5a41f3a569… · 1,168,231,961 bytes · first seen 2026-05-15

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
$2,997,086
1.6× median
845
OTHER 		Inj, Atidarsagene Autotem 20 $5,455.45 $4,955,500.00 $4,524,146.25 nat. median
$16,015
outlier · 282.5×
00845
OTHER 		Inj, Atidarsagene Autotem 1 $4,505,000.00 $4,505,000.00 $4,505,000.00 nat. median
$4,414,900
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
$2,460,273
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
$3,324,572
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
$3,758,972
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
$2,405,851
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
$29,683
outlier · 118.0×
714
OTHER 		Inj Delandistrogene Mox R 23 $6,416.35 $4,492,611.00 $3,494,253.00 nat. median
$3,325,455
1.1× median
748
OTHER 		Inj, Lovotibeglogene Auto 23 $12,213.45 $4,390,885.80 $3,415,133.40 nat. median
$3,252,508
1.1× median
906
OTHER 		Inj Elivaldogene Autoteme 25 $8,728.26 $4,929,000.00 $3,339,000.00 nat. median
$24,604
outlier · 135.7×
00908
OTHER 		Topi Adm Prad Zami Per Tr 1 $3,335,820.00 $3,335,820.00 $3,335,820.00 nat. median
$14,170
outlier · 235.4×
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
$3,084,600
1.0× median
746
OTHER 		Inj, Betibeglogene Autote 25 $11,297.57 $4,556,951.95 $3,086,967.45 nat. median
$2,939,969
1.1× median
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 24 $2,511,311.57 $4,427,157.51 $2,731,374.96 nat. median
$2,588,981
1.1× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 1 $2,588,981.00 $2,588,981.00 $2,588,981.00 nat. median
$2,511,312
1.0× median
824
OTHER 		Inj, Exagamglogene Autote 26 $13,229.17 $4,617,360.00 $2,460,260.00 nat. median
$58,186
outlier · 42.3×
00824
OTHER 		Inj, Exagamglogene Autote 1 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,285,360
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
$809,151
1.6× 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
$631,793
1.5× 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
$610,161
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
$624,417
1.5× median
2067
OTHER 		Afamitresgene Autoleucel 25 $747,501.40 $1,525,827.60 $816,857.20 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
$577,541
1.4× 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
$691,418
1.1× 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
$302,242
outlier · 2.5×
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
$588,565
1.2× median
9498
OTHER 		Ciltacabtagene Car-pos T 25 $570,020.11 $1,163,546.21 $622,908.58 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 25 $549,535.36 $1,121,731.97 $600,523.18 nat. median
$576,820
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 25 $545,335.16 $1,113,158.38 $595,933.27 nat. median
$562,201
1.1× median
9422
OTHER 		Idecabtagene Vicleucel Ca 25 $541,339.35 $1,105,001.96 $591,566.71 nat. median
$560,872
1.1× median
09498
OTHER 		Ciltacabtagene Car-pos T 1 $587,649.60 $587,649.60 $587,649.60 nat. median
$570,020
1.0× median
09194
OTHER 		Tisagenlecleucel Car-pos 1 $566,531.30 $566,531.30 $566,531.30 nat. median
$549,535
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 25 $516,226.43 $1,053,740.56 $564,123.73 nat. median
$533,230
1.1× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $562,201.20 $562,201.20 $562,201.20 nat. median
$545,335
1.0× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $558,081.80 $558,081.80 $558,081.80 nat. median
$541,339
1.0× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $532,192.20 $532,192.20 $532,192.20 nat. median
$516,226
1.0× median
9391
OTHER 		Brexucabtagene Car Pos T 25 $474,766.69 $969,111.40 $518,817.21 nat. median
$492,768
1.1× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $489,450.20 $489,450.20 $489,450.20 nat. median
$474,767
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 46 $290,065.41 $713,984.42 $335,098.53 nat. median
$370,165
0.9× median
J3402
HCPCS 		Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 $246,036.20 $332,753.88 $332,753.88 nat. median
$209,736
1.6× median

Other procedures at this hospital

Browse this hospital's 65,327 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 41 25 — — $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 41 25 — — $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 42 24 — — $2,511,311.57 $4,427,157.51 $2,731,374.96 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 44 26 — — $13,229.17 $4,617,360.00 $2,460,260.00 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 43 25 — — $747,501.40 $1,525,827.60 $816,857.20 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 43 25 — — $570,020.11 $1,163,546.21 $622,908.58 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 43 25 — — $549,535.36 $1,121,731.97 $600,523.18 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 43 25 — — $545,335.16 $1,113,158.38 $595,933.27 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 43 25 — — $541,339.35 $1,105,001.96 $591,566.71 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
9035 OTHER Axicabtagene Ciloleucel C 43 25 — — $516,226.43 $1,053,740.56 $564,123.73 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
9391 OTHER Brexucabtagene Car Pos T 43 25 — — $474,766.69 $969,111.40 $518,817.21 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 68 46 — — $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
111928 CDM Kit Cath Rt Heart 78 42 $804,010.00 $804,010.00 $40,200.50 $723,609.00 $297,483.70 2026-03-01
831 OTHER Obecbtge Autol Up To 400 44 26 — — $3,735.66 $550,935.00 $293,553.75 2026-03-01
897 OTHER Revakinagene, Per Implant 43 25 — — $257,050.00 $524,700.00 $280,900.00 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 82 44 — — $129,000.00 $463,347.16 $215,864.83 2026-03-01
C1825 HCPCS System Generator Ipg 82 28 $459,725.00 $459,725.00 $61,691.00 $430,920.00 $215,460.00 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 44 26 — — $8,174.23 $399,304.62 $212,760.80 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
C1824 HCPCS Gen Pls Card Mod Sys 82 28 $413,970.00 $413,970.00 $55,545.00 $388,071.00 $194,035.50 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
C1827 HCPCS Pulse Gen Implant 42 29 $403,560.00 $403,560.00 $8,414.50 $363,204.00 $181,602.00 2026-03-01
115512 CDM Kit Lo Prfl Comp Shth 7f 78 42 $490,250.00 $490,250.00 $24,512.50 $441,225.00 $181,392.50 2026-03-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 10 6 — — $173,982.51 $213,213.86 $179,099.64 2026-03-01
C1822 HCPCS Pulse Gen Imp 41 28 $392,040.00 $392,040.00 $54,885.60 $352,836.00 $176,418.00 2026-03-01
116544 CDM Implant Generator Pulse 42 29 $382,050.00 $382,050.00 $53,487.00 $343,845.00 $171,922.50 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 84 48 — — $143,121.78 $350,937.46 $165,385.17 2026-03-01
115562 CDM Ipg Dbs Rchrgbl Battery 42 29 $363,664.00 $363,664.00 $50,912.96 $327,297.60 $163,648.80 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 74 44 — — $11,384.00 $353,009.17 $163,155.02 2026-03-01
1908 OTHER New Technology - Level 52 43 25 — — $145,449.17 $296,896.25 $158,944.46 2026-03-01
1907 OTHER New Technology - Level 52 43 25 — — $145,449.17 $296,896.25 $158,944.46 2026-03-01
33990 CPT Insertion Impella Lvad 77 38 $883,335.00 $883,335.00 $929.00 $795,001.50 $150,166.95 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
331925 CDM Graft Art St Tis 6-32mm 42 29 $327,089.00 $327,089.00 $45,792.46 $294,380.10 $147,190.05 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
318451 CDM Set Pump Asst 2.5in 78 42 $392,200.00 $392,200.00 $19,610.00 $352,980.00 $145,114.00 2026-03-01
1905 OTHER New Technology - Level 51 43 25 — — $131,142.74 $267,693.43 $143,310.62 2026-03-01
1906 OTHER New Technology - Level 51 43 25 — — $131,142.74 $267,693.43 $143,310.62 2026-03-01
335050 CDM Kit Impl Crnl Cstm Lg 42 29 $317,753.00 $317,753.00 $44,485.42 $285,977.70 $142,988.85 2026-03-01
108296 CDM Allograft 20x20cm 42 29 $305,600.00 $305,600.00 $42,784.00 $275,040.00 $137,520.00 2026-03-01
118399 CDM Implant Battery 42 29 $304,072.00 $304,072.00 $42,570.08 $273,664.80 $136,832.40 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
316630 CDM Pump 505 & Cnla Set 32f 78 42 $352,980.00 $352,980.00 $17,649.00 $317,682.00 $130,602.60 2026-03-01
1903 OTHER New Technology - Level 50 43 25 — — $116,836.31 $238,490.60 $127,676.79 2026-03-01
1904 OTHER New Technology - Level 50 43 25 — — $116,836.31 $238,490.60 $127,676.79 2026-03-01
C2616 HCPCS Brachytx Ns Yttrium 90 71 24 $254,756.00 $254,756.00 $9,816.00 $252,280.80 $126,060.00 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
333578 CDM Catheter Xtrt Bln Spec R 78 42 $333,578.00 $333,578.00 $16,678.90 $300,220.20 $123,423.86 2026-03-01
C1823 HCPCS Generator Impl Pulse 82 28 $307,170.00 $307,170.00 $25,641.00 $388,071.00 $123,339.87 2026-03-01
118397 CDM Catheter Electrode 2.8mm 78 42 $331,409.00 $331,409.00 $16,570.45 $298,268.10 $122,621.33 2026-03-01
113691 CDM Generator Impl Pulse 42 29 $267,400.00 $267,400.00 $37,436.00 $240,660.00 $120,330.00 2026-03-01
338439 CDM Stent Eprsth 37x37x20cm 42 29 $266,640.00 $266,640.00 $37,329.60 $239,976.00 $119,988.00 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 46 27 — — $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 43 25 — — $102,529.87 $209,287.78 $112,042.95 2026-03-01
1901 OTHER New Technology - Level 49 43 25 — — $102,529.87 $209,287.78 $112,042.95 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 84 48 — — $93,775.14 $229,019.05 $108,362.39 2026-03-01
C1820 HCPCS Eon Mini 16 Channel 697 28 $239,904.00 $239,904.00 $7,127.82 $343,845.00 $107,956.80 2026-03-01
116003 CDM Coil Emb Neuro 6x3mm 42 29 $239,442.00 $239,442.00 $33,521.88 $215,497.80 $107,748.90 2026-03-01
115983 CDM Coil Emb Neuro 7mm 2mm 42 29 $239,442.00 $239,442.00 $33,521.88 $215,497.80 $107,748.90 2026-03-01
115995 CDM Coil Emb Neuro 7x4mm 42 29 $239,442.00 $239,442.00 $33,521.88 $215,497.80 $107,748.90 2026-03-01
115984 CDM Coil Embl 6mm 2mm 42 29 $239,442.00 $239,442.00 $33,521.88 $215,497.80 $107,748.90 2026-03-01
115989 CDM Coil Embz .017 4.5mm 2mm 42 29 $239,442.00 $239,442.00 $33,521.88 $215,497.80 $107,748.90 2026-03-01
116005 CDM Coil Embol Neuro 4x2.6mm 42 29 $239,442.00 $239,442.00 $33,521.88 $215,497.80 $107,748.90 2026-03-01
115993 CDM Coil Emb Neuro 6x4mm 42 29 $239,442.00 $239,442.00 $33,521.88 $215,497.80 $107,748.90 2026-03-01
115990 CDM Coil Embl 4.5mm 3mm 42 29 $239,442.00 $239,442.00 $33,521.88 $215,497.80 $107,748.90 2026-03-01
115986 CDM Coil Embol Neuro 4x2mm 42 29 $239,442.00 $239,442.00 $33,521.88 $215,497.80 $107,748.90 2026-03-01
116000 CDM Coil Embl 5.6mm 7mm 42 29 $239,442.00 $239,442.00 $33,521.88 $215,497.80 $107,748.90 2026-03-01
115999 CDM Coil Emb Neuro 6x4.6mm 42 29 $239,442.00 $239,442.00 $33,521.88 $215,497.80 $107,748.90 2026-03-01
115987 CDM Coil Embl 4x3mm 42 29 $239,442.00 $239,442.00 $33,521.88 $215,497.80 $107,748.90 2026-03-01
115998 CDM Coil Emb 7x5mm 42 29 $239,442.00 $239,442.00 $33,521.88 $215,497.80 $107,748.90 2026-03-01
115045 CDM Coil Embol Neuro 7x3mm 42 29 $239,442.00 $239,442.00 $33,521.88 $215,497.80 $107,748.90 2026-03-01
115992 CDM Coil Embl 5mm 2mm 42 29 $239,442.00 $239,442.00 $33,521.88 $215,497.80 $107,748.90 2026-03-01
116002 CDM Device Endo Sng 5x3mm 42 29 $239,442.00 $239,442.00 $33,521.88 $215,497.80 $107,748.90 2026-03-01
116007 CDM Device 17 Sng Sphr 5 .0 42 29 $239,442.00 $239,442.00 $33,521.88 $215,497.80 $107,748.90 2026-03-01
319242 CDM Graft Peek Bcmpt Cust 42 29 $238,613.00 $238,613.00 $33,405.82 $214,751.70 $107,375.85 2026-03-01
324506 CDM Kit Pt Specific Tmj Comp 42 29 $236,840.00 $236,840.00 $33,157.60 $213,156.00 $106,578.00 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
383464 CDM Device Embl 25x4.5mm Pl 42 29 $229,124.00 $229,124.00 $32,077.36 $206,211.60 $103,105.80 2026-03-01
254794 CDM Stent Eprsth 31mm 10cm 41 28 $227,672.00 $227,672.00 $31,874.08 $204,904.80 $102,452.40 2026-03-01
345053 CDM Stent Eprsth 34mm 15cm 41 28 $227,672.00 $227,672.00 $31,874.08 $204,904.80 $102,452.40 2026-03-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 50 26 — — $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
C1767 HCPCS Kit Impl Neurostim 770 41 $258,721.00 $258,721.00 $0.14 $388,071.00 $100,640.00 2026-03-01
7 MS_DRG Lung Transplant 70 42 — — $87,744.20 $214,118.61 $100,418.36 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
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
1585 OTHER New Technology - Level 48 43 25 — — $90,607.89 $184,952.20 $99,014.81 2026-03-01
1599 OTHER New Technology - Level 48 43 25 — — $90,607.89 $184,952.20 $99,014.81 2026-03-01
108245 CDM Device Embl 4.5mm 12mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108794 CDM Device Embl 4.5mm 20mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108246 CDM Device Embl 4.5mm 14mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108787 CDM Device Embl 4.75mm 12mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108867 CDM Device Embl 3.25x12mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108795 CDM Device Embl 4.50x16mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108786 CDM Device Embl 4.75mm 14mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108785 CDM Device Embl 4.75mm 16mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
106281 CDM Device Embl 4mm 14mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108791 CDM Device Embl 3.75mm 14mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
116567 CDM Device Embl 3.75x16mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108784 CDM Device Embl 5.0x16mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108801 CDM Device Embl 3.50x12mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108802 CDM Device Embl 3.25mm 16mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108800 CDM Device Embl 3.5mm 14mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108790 CDM Device Embl 4mm 12mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108793 CDM Device Embl 4.75mm 20mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
107779 CDM Device Embl 3.5mm 20mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108519 CDM Device Embl 3mm 10mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
109866 CDM Device Embl 4mm 18mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
106328 CDM Device Embl 3.75mm 12mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108796 CDM Device Embl 4.25mm 14mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108244 CDM Device Embl 3.25mm 10mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108783 CDM Device Embl 5.0x20mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108797 CDM Device Embl 4.00x2mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108789 CDM Device Embl 4mm 16mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108799 CDM Device Embl 3.5mm 18mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108782 CDM Device Emb 4.25mm 16mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108781 CDM Device Emb 5mm 14mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108792 CDM Device Embl 5mm 12mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
117961 CDM Device Embl 2.5mm 12mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108788 CDM Device Embl 4.25mm 18mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108798 CDM Device Embl 3.75mm 18mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108803 CDM Device Embl 5mm 35mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
108520 CDM Device Embl 3mm 12mm 42 29 $219,803.00 $219,803.00 $30,772.42 $197,822.70 $98,911.35 2026-03-01
382836 CDM Device Emb Pipeln 3x18 42 29 $217,620.00 $217,620.00 $30,466.80 $195,858.00 $97,929.00 2026-03-01
117687 CDM Coil Emb Endo Sn Ly 10mm 42 29 $217,620.00 $217,620.00 $30,466.80 $195,858.00 $97,929.00 2026-03-01
345884 CDM Impl Crnl Ostmtch 20-100 42 29 $217,620.00 $217,620.00 $30,466.80 $195,858.00 $97,929.00 2026-03-01
116297 CDM Pump Pain Infn 148gm 42 29 $217,620.00 $217,620.00 $30,466.80 $195,858.00 $97,929.00 2026-03-01
383450 CDM Embl Sys Mesh 12 X 3.75 42 29 $217,620.00 $217,620.00 $30,466.80 $195,858.00 $97,929.00 2026-03-01
277327 CDM Graft Evas 23x14.5m14cm 42 29 $217,620.00 $217,620.00 $30,466.80 $195,858.00 $97,929.00 2026-03-01
114552 CDM Implant Cranial Med 42 29 $217,620.00 $217,620.00 $30,466.80 $195,858.00 $97,929.00 2026-03-01
106222 CDM Graft Endo Aaa 36x14mm 42 29 $217,620.00 $217,620.00 $30,466.80 $195,858.00 $97,929.00 2026-03-01
322353 CDM Graft Evas 14.5mm 16cm 42 29 $217,620.00 $217,620.00 $30,466.80 $195,858.00 $97,929.00 2026-03-01
277326 CDM Graft Evas 23x14.5m 12cm 42 29 $217,620.00 $217,620.00 $30,466.80 $195,858.00 $97,929.00 2026-03-01
262048 CDM Graft Evas 26x14.5m 16cm 42 29 $217,620.00 $217,620.00 $30,466.80 $195,858.00 $97,929.00 2026-03-01
C1772 HCPCS Pump Inf 20ml Snchr 123 28 $217,620.00 $217,620.00 $30,159.36 $197,892.00 $97,929.00 2026-03-01
333677 CDM Implant Cust Cranial Lge 42 29 $217,620.00 $217,620.00 $30,466.80 $195,858.00 $97,929.00 2026-03-01
266490 CDM Graft Evas 26x14.5m 14cm 42 29 $217,620.00 $217,620.00 $30,466.80 $195,858.00 $97,929.00 2026-03-01
317887 CDM Graft Evas 31x14.5m 15cm 42 29 $217,620.00 $217,620.00 $30,466.80 $195,858.00 $97,929.00 2026-03-01
108947 CDM Valve Aortic 27mm 42 29 $217,620.00 $217,620.00 $30,466.80 $195,858.00 $97,929.00 2026-03-01
114166 CDM Graft Evas 23x12mm 12cm 42 29 $217,620.00 $217,620.00 $30,466.80 $195,858.00 $97,929.00 2026-03-01
345111 CDM Algrft Bn 25x20mm 42 29 $217,620.00 $217,620.00 $30,466.80 $195,858.00 $97,929.00 2026-03-01
383448 CDM Pipeline Emb Dev 3.5x16 42 29 $217,620.00 $217,620.00 $30,466.80 $195,858.00 $97,929.00 2026-03-01
271980 CDM Embl Sys Mesh 20 X 4 42 29 $217,620.00 $217,620.00 $30,466.80 $195,858.00 $97,929.00 2026-03-01
108442 CDM Graft Endo Aaa 23x12mm 42 29 $217,620.00 $217,620.00 $30,466.80 $195,858.00 $97,929.00 2026-03-01
324123 CDM Graft Evas 10cm 14.5mm 42 29 $217,620.00 $217,620.00 $30,466.80 $195,858.00 $97,929.00 2026-03-01
321912 CDM Implant Crnl Peek-optma 42 29 $217,620.00 $217,620.00 $30,466.80 $195,858.00 $97,929.00 2026-03-01
313088 CDM Graft Evas 14.5mm 14cm 42 29 $217,492.00 $217,492.00 $30,448.88 $195,742.80 $97,871.40 2026-03-01
266485 CDM Graft Evas 23x14.5m 16cm 42 29 $217,492.00 $217,492.00 $30,448.88 $195,742.80 $97,871.40 2026-03-01
266484 CDM Graft Evas 23x12mm 18cm 42 29 $217,492.00 $217,492.00 $30,448.88 $195,742.80 $97,871.40 2026-03-01
317894 CDM Graft Evas 35x14.5m 14cm 42 29 $217,492.00 $217,492.00 $30,448.88 $195,742.80 $97,871.40 2026-03-01
262139 CDM Mesh Srg Scafold 20x30cm 42 29 $217,492.00 $217,492.00 $30,448.88 $195,742.80 $97,871.40 2026-03-01
277331 CDM Graft Evas 28.5x12m 18cm 42 29 $217,492.00 $217,492.00 $30,448.88 $195,742.80 $97,871.40 2026-03-01
258278 CDM Graft Evas 35x14.5m 18cm 42 29 $217,492.00 $217,492.00 $30,448.88 $195,742.80 $97,871.40 2026-03-01
314031 CDM Stent Aaa Exldr Trk14cm 42 29 $217,492.00 $217,492.00 $30,448.88 $195,742.80 $97,871.40 2026-03-01
327615 CDM Graft Evas 26x14.5m 18cm 42 29 $217,492.00 $217,492.00 $30,448.88 $195,742.80 $97,871.40 2026-03-01
266487 CDM Graft Evas 26x12mm 16cm 42 29 $217,492.00 $217,492.00 $30,448.88 $195,742.80 $97,871.40 2026-03-01
277328 CDM Graft Evas 26x12mm 14cm 42 29 $217,492.00 $217,492.00 $30,448.88 $195,742.80 $97,871.40 2026-03-01
319991 CDM Graft Evas 23x12mm 14cm 42 29 $217,492.00 $217,492.00 $30,448.88 $195,742.80 $97,871.40 2026-03-01
266491 CDM Graft Evas 14.5mm 12cm 42 29 $217,492.00 $217,492.00 $30,448.88 $195,742.80 $97,871.40 2026-03-01
118400 CDM Transmitter Thorax 42 29 $215,424.00 $215,424.00 $30,159.36 $193,881.60 $96,940.80 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
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
111370 CDM Cannula Introd 29fx46cm 78 42 $254,930.00 $254,930.00 $12,746.50 $229,437.00 $94,324.10 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
327461 CDM Device Delivery Suture 78 42 $252,969.00 $252,969.00 $12,648.45 $227,672.10 $93,598.53 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 73 41 — — $81,505.11 $165,919.13 $93,278.07 2026-03-01
112274 CDM Device W/cannula 30cm 78 42 $251,989.00 $251,989.00 $12,599.45 $226,790.10 $93,235.93 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
119410 CDM Device Imp Spn 30mm 42 29 $202,824.00 $202,824.00 $28,395.36 $182,541.60 $91,270.80 2026-03-01
330919 CDM Spacer Spn Elev 32x8mm 42 29 $202,824.00 $202,824.00 $28,395.36 $182,541.60 $91,270.80 2026-03-01
322760 CDM Cg Spn Alif 10x34x24 15 42 29 $202,824.00 $202,824.00 $28,395.36 $182,541.60 $91,270.80 2026-03-01
330921 CDM Spacer Spnl 32mmx9mm 42 29 $202,824.00 $202,824.00 $28,395.36 $182,541.60 $91,270.80 2026-03-01
C1882 HCPCS Crt-d Crd 5.37x8.08x0.99 1,845 28 $238,620.00 $238,620.00 $5,330.92 $388,071.00 $90,117.90 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 82 44 — — $76,913.62 $298,508.00 $89,732.56 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
266486 CDM Graft Evas 23x14.5m 18cm 42 29 $197,640.00 $197,640.00 $27,669.60 $177,876.00 $88,938.00 2026-03-01
112160 CDM Graft Endo Aaa 28.5x12mm 42 29 $197,640.00 $197,640.00 $27,669.60 $177,876.00 $88,938.00 2026-03-01
104086 CDM Graft Endo Aaa 26x12mm 42 29 $197,640.00 $197,640.00 $27,669.60 $177,876.00 $88,938.00 2026-03-01
336901 CDM Graft Crani Peek Lg Cstm 42 29 $197,640.00 $197,640.00 $27,669.60 $177,876.00 $88,938.00 2026-03-01
334075 CDM Graft Hemi Cndyl Mdl Rt 42 29 $197,640.00 $197,640.00 $27,669.60 $177,876.00 $88,938.00 2026-03-01
331531 CDM Graft Bn Hemi Condrl Rt 42 29 $197,640.00 $197,640.00 $27,669.60 $177,876.00 $88,938.00 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
C1722 HCPCS Icd Defib Card 7.36cm 1,102 41 $202,279.00 $202,279.00 $6,958.00 $597,195.00 $88,759.32 2026-03-01
1584 OTHER New Technology - Level 47 43 25 — — $81,070.26 $165,483.63 $88,592.25 2026-03-01
1598 OTHER New Technology - Level 47 43 25 — — $81,070.26 $165,483.63 $88,592.25 2026-03-01
64 APR_DRG Pancreas Transplant 14 7 — — $80,700.87 $137,570.00 $88,217.10 2026-03-01
263252 CDM Kit Implant Unilat Tmj M 42 29 $195,840.00 $195,840.00 $27,417.60 $176,256.00 $88,128.00 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 93 50 — — $57,342.00 $187,145.04 $87,923.80 2026-03-01
114896 CDM Implant Crnl Small 42 29 $192,054.00 $192,054.00 $26,887.56 $172,848.60 $86,424.30 2026-03-01
2464 APR_DRG Gastrointestinal Vascular Insufficiency 10 6 — — $83,587.69 $102,435.90 $86,046.16 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 83 49 — — $48,305.00 $203,567.00 $85,644.55 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
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 11 3 — — $14,506.67 $138,148.31 $84,757.38 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 90 50 — — $11,384.00 $179,792.37 $84,517.94 2026-03-01
261940 CDM Sys Mitraclip 1 Clip 42 29 $185,185.00 $185,185.00 $25,925.90 $166,666.50 $83,333.25 2026-03-01
261941 CDM Sys Mitraclip 2 Clip 42 29 $185,185.00 $185,185.00 $25,925.90 $166,666.50 $83,333.25 2026-03-01
261942 CDM Sys Mitraclip 3 Clip 42 29 $185,185.00 $185,185.00 $25,925.90 $166,666.50 $83,333.25 2026-03-01
261943 CDM Sys Mitraclip 4 Clip 42 29 $185,185.00 $185,185.00 $25,925.90 $166,666.50 $83,333.25 2026-03-01
349060 CDM Graft Bn Disc 20mm 42 29 $184,960.00 $184,960.00 $25,894.40 $166,464.00 $83,232.00 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
115918 CDM Spacer Spn 30d 6x22x50mm 42 29 $184,548.00 $184,548.00 $25,836.72 $166,093.20 $83,046.60 2026-03-01
107223 CDM Tiss Aclr Drml 16cm 20cm 42 29 $184,525.00 $184,525.00 $25,833.50 $166,072.50 $83,036.25 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
315671 CDM Spacer Spnl Au 30x38x13. 42 29 $183,169.00 $183,169.00 $25,643.66 $164,852.10 $82,426.05 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
249161 CDM Stent Aaa Exldr 14cm 42 29 $182,132.00 $182,132.00 $25,498.48 $163,918.80 $81,959.40 2026-03-01
007 OTHER Lung Transplant 1 1 — — $81,903.93 $81,903.93 $81,903.93 2026-03-01
328439 CDM Cage Spn 50x22x12mm 42 29 $180,695.00 $180,695.00 $25,297.30 $162,625.50 $81,312.75 2026-03-01
327746 CDM Cage Crn Xl 10x22x50 10d 42 29 $180,695.00 $180,695.00 $25,297.30 $162,625.50 $81,312.75 2026-03-01
116390 CDM Graft Nrv 2-3mm 70mm 42 29 $179,847.00 $179,847.00 $25,178.58 $161,862.30 $80,931.15 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 74 42 — — $70,078.93 $170,473.81 $80,201.44 2026-03-01
326650 CDM Corent Xlctw 14x22x60 42 29 $177,714.00 $177,714.00 $24,879.96 $159,942.60 $79,971.30 2026-03-01
312019 CDM Endplate Spn Disc Ti 8d 42 29 $176,112.00 $176,112.00 $24,655.68 $158,500.80 $79,250.40 2026-03-01
312458 CDM Spacer Cage Peek 12d 32x 42 29 $176,112.00 $176,112.00 $24,655.68 $158,500.80 $79,250.40 2026-03-01
215 MS_DRG Other Heart Assist System Implant 101 51 — — $58,771.00 $320,760.00 $78,998.80 2026-03-01
1597 OTHER New Technology - Level 46 43 25 — — $71,532.64 $146,015.08 $78,169.69 2026-03-01
1583 OTHER New Technology - Level 46 43 25 — — $71,532.64 $146,015.08 $78,169.69 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
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 104 52 — — $13,723.00 $230,793.47 $77,638.72 2026-03-01
272058 CDM Kit Device Guided 3cm 78 42 $209,827.00 $209,827.00 $10,491.35 $188,844.30 $77,635.99 2026-03-01
324290 CDM Coag Dvc Kit Cdp-4330-1 78 42 $209,827.00 $209,827.00 $10,491.35 $188,844.30 $77,635.99 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 3 1 — — $56,968.06 $77,046.96 $77,046.96 2026-03-01
321913 CDM Implant Crnl Peek-optma 42 29 $170,773.00 $170,773.00 $23,908.22 $153,695.70 $76,847.85 2026-03-01
342142 CDM Cage Spn W/set Scr 13x16 42 29 $170,302.00 $170,302.00 $23,842.28 $153,271.80 $76,635.90 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
110915 CDM Graft Nrv 1-2mm 70mm 42 29 $169,027.00 $169,027.00 $23,663.78 $152,124.30 $76,062.15 2026-03-01
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