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

HCA HOUSTON HEALTHCARE WEST

Houston, TX · CCN 450644 · Rates published

30,804 distinct procedures filed
63 distinct payers
1,673,473 rate rows
2026-03-01 last MRF observed
Data quality

1,618,487 of 1,673,473 rate rows are consumer-grade (96.7%)

54,986 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 26,639
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 21,199
template filing: same amount across many unrelated codes — excluded 5,545
exceeds 10× this hospital's gross charge — excluded from medians 1,408
placeholder amount (≤ $0.02) — excluded from medians 195
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1801363_HCA-HOUSTON-HEALTHCARE-WEST_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page https://hcahoustonhealthcare.com/about/legal/pricing-transparency-cms-required-file-of-standard-charges.dot
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 754718022dba6480… · 793,282,682 bytes · first seen 2026-05-08

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $4,850,948.67 $4,850,948.67 $4,850,948.67 nat. median
$3,006,423
1.6× median
845
OTHER 		Inj, Atidarsagene Autotem 24 $5,795.87 $4,910,450.00 $4,572,575.00 nat. median
$9,966
outlier · 458.8×
00845
OTHER 		Inj, Atidarsagene Autotem 2 $4,505,000.00 $4,505,000.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 $4,271,819.03 $4,271,819.03 $4,271,819.03 nat. median
$2,469,189
1.7× median
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 1 $3,847,800.00 $3,847,800.00 $3,847,800.00 nat. median
$2,448,600
1.6× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 24 $3,611,561.66 $4,790,847.10 $3,795,825.01 nat. median
$3,746,358
1.0× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 2 $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 28 $10,494.25 $4,836,939.00 $3,435,894.60 nat. median
$22,747
outlier · 151.0×
714
OTHER 		Inj Delandistrogene Mox R 28 $6,816.73 $4,825,397.00 $3,427,695.80 nat. median
$13,041
outlier · 262.8×
748
OTHER 		Inj, Lovotibeglogene Auto 28 $12,975.57 $4,716,136.60 $3,350,083.24 nat. median
$17,963
outlier · 186.5×
00908
OTHER 		Topi Adm Prad Zami Per Tr 2 $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 2 $3,327,860.00 $3,327,860.00 $3,327,860.00 nat. median
$3,228,024
1.0× median
906
OTHER 		Inj Elivaldogene Autoteme 28 $9,272.91 $4,929,000.00 $3,275,400.00 nat. median
$20,756
outlier · 157.8×
00748
OTHER 		Inj, Lovotibeglogene Auto 2 $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 2 $3,180,000.00 $3,180,000.00 $3,180,000.00 nat. median
$21
outlier · 153697.4×
746
OTHER 		Inj, Betibeglogene Autote 28 $12,002.54 $4,556,951.95 $3,028,168.07 nat. median
$21,896
outlier · 138.3×
00746
OTHER 		Inj, Betibeglogene Autote 2 $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 26 $2,537,201.38 $4,012,920.55 $2,666,650.43 nat. median
$2,588,981
1.0× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 2 $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 30 $14,054.67 $4,897,200.00 $2,401,960.00 nat. median
$25,250
outlier · 95.1×
00824
OTHER 		Inj, Exagamglogene Autote 2 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,332,000
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 2 $1,271,523.00 $1,978,603.20 $1,509,600.96 nat. median
$824,563
1.8× median
Q2058
HCPCS 		Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,… 2 $459,112.50 $1,428,840.00 $1,090,152.00 nat. median
$324,450
outlier · 3.4×
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 5 $553,169.00 $1,250,478.00 $969,621.79 nat. median
$675,122
1.4× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 5 $527,622.00 $1,128,119.40 $902,495.52 nat. median
$625,184
1.4× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 5 $516,442.00 $1,103,378.76 $882,703.01 nat. median
$674,188
1.3× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 5 $32.24 $1,037,313.00 $882,313.53 nat. median
$754,974
1.2× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 5 $8.47 $956,745.00 $821,756.60 nat. median
$634,511
1.3× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 5 $489,399.00 $1,003,071.60 $802,457.28 nat. median
$620,080
1.3× median
2067
OTHER 		Afamitresgene Autoleucel 29 $755,207.60 $1,656,833.00 $793,738.60 nat. median
$786,032
1.0× median
C9301
HCPCS 		Obecabtagene Autoleucel, Up To 400 Million Cd19 Car-positive Viable T Cells, Inc… 1 $545,370.00 $751,275.00 $751,275.00 nat. median
$459,112
1.6× median
9498
OTHER 		Ciltacabtagene Car-pos T 29 $575,896.61 $1,263,446.64 $605,279.09 nat. median
$587,650
1.0× median
09498
OTHER 		Ciltacabtagene Car-pos T 2 $587,649.60 $587,649.60 $587,649.60 nat. median
$554,552
1.1× median
9194
OTHER 		Tisagenlecleucel Car-pos 29 $555,200.67 $1,218,042.30 $583,527.24 nat. median
$566,531
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 29 $550,957.18 $1,208,732.58 $579,067.24 nat. median
$562,201
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 29 $546,920.16 $1,199,875.87 $574,824.25 nat. median
$558,082
1.0× median
09194
OTHER 		Tisagenlecleucel Car-pos 2 $566,531.30 $566,531.30 $566,531.30 nat. median
$538,205
1.1× median
09413
OTHER 		Lisocabtagene Car Pos T 2 $562,201.20 $562,201.20 $562,201.20 nat. median
$534,091
1.1× median
09422
OTHER 		Idecabtagene Vicleucel Ca 2 $558,081.80 $558,081.80 $558,081.80 nat. median
$530,178
1.1× median
9035
OTHER 		Axicabtagene Ciloleucel C 29 $521,548.36 $1,144,213.23 $548,157.97 nat. median
$532,192
1.0× median
09035
OTHER 		Axicabtagene Ciloleucel C 2 $532,192.20 $532,192.20 $532,192.20 nat. median
$505,583
1.1× median
9391
OTHER 		Brexucabtagene Car Pos T 29 $479,661.20 $1,052,317.93 $504,133.71 nat. median
$489,450
1.0× median
09391
OTHER 		Brexucabtagene Car Pos T 2 $489,450.20 $489,450.20 $489,450.20 nat. median
$464,978
1.1× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 32 $2,585.00 $633,491.68 $361,113.56 nat. median
$370,174
1.0× 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
5834
APR_DRG 		Neonate With Ecmo 8 $297,403.78 $379,341.56 $318,646.91 nat. median
$309,665
1.0× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 7 $289,314.68 $516,633.00 $309,980.01 nat. median
$187,294
1.7× median
831
OTHER 		Obecbtge Autol Up To 400 31 $3,968.76 $598,237.50 $286,597.50 nat. median
$12,362
outlier · 23.2×
00831
OTHER 		Obecbtge Autol Up To 400 2 $278,250.00 $278,250.00 $278,250.00 nat. median
$278,250
1.0× median
897
OTHER 		Revakinagene, Per Implant 29 $259,700.00 $569,750.00 $272,950.00 nat. median
$9,577
outlier · 28.5×

Other procedures at this hospital

Browse this hospital's 30,804 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
             
6904 APR_DRG Acute Leukemia 15 8 — — $55,741.94 $71,099.41 $59,723.51 2026-03-01
834 MS_DRG Acute Leukemia With Mcc 77 38 — — $2,585.00 $144,005.57 $50,250.60 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 72 38 — — $2,585.00 $227,147.34 $76,391.09 2026-03-01
850 OTHER Acute Leukemia With Other Procedures 2 2 — — $53,750.24 $53,750.24 $53,750.24 2026-03-01
L5969 HCPCS Addition, Endoskeletal Ankle-foot Or Ankle System, Power Assist, Includes Any Ty… 2 1 — — $134,238.24 $134,238.24 $134,238.24 2026-03-01
2067 OTHER Afamitresgene Autoleucel 51 29 — — $755,207.60 $1,656,833.00 $793,738.60 2026-03-01
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 8 2 — — $1,271,523.00 $1,978,603.20 $1,509,600.96 2026-03-01
74 APR_DRG Allogeneic Bone Marrow Transplant 14 7 — — $289,314.68 $516,633.00 $309,980.01 2026-03-01
73 APR_DRG Allogeneic Bone Marrow Transplant 14 7 — — $102,088.10 $182,300.00 $109,380.11 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 55 31 — — $2,585.00 $187,419.15 $104,088.65 2026-03-01
014 OTHER Allogeneic Bone Marrow Transplant 2 2 — — $74,275.22 $74,275.22 $74,275.22 2026-03-01
72 APR_DRG Allogeneic Bone Marrow Transplant 14 7 — — $68,591.80 $122,485.00 $73,491.21 2026-03-01
71 APR_DRG Allogeneic Bone Marrow Transplant 14 7 — — $45,039.87 $80,428.30 $48,257.00 2026-03-01
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 2 2 — — $66,523.48 $66,523.48 $66,523.48 2026-03-01
B1004 OTHER Amputation, Lower Extremity; M=39-45 28 13 — — $46,919.09 $50,841.12 $48,420.11 2026-03-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 92 39 — — $16,045.00 $139,875.85 $61,395.34 2026-03-01
84 APR_DRG Autologous Bone Marrow Transplant 14 7 — — $86,431.84 $154,343.00 $92,605.55 2026-03-01
83 APR_DRG Autologous Bone Marrow Transplant 14 7 — — $58,421.47 $104,324.00 $62,594.44 2026-03-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 53 29 — — $2,585.00 $92,473.67 $53,877.74 2026-03-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 54 30 — — $2,585.00 $85,399.23 $49,591.16 2026-03-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 13 4 — — $74,830.84 $325,380.58 $138,148.31 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 51 29 — — $521,548.36 $1,144,213.23 $548,157.97 2026-03-01
09035 OTHER Axicabtagene Ciloleucel C 2 2 — — $532,192.20 $532,192.20 $532,192.20 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 12 5 — — $8.47 $956,745.00 $821,756.60 2026-03-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 58 31 — — $93,179.38 $204,424.15 $97,933.43 2026-03-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 90 38 — — $2,585.00 $135,655.93 $50,028.25 2026-03-01
90288 CPT Botulism Immune Globulin, Human, For Intravenous Use 3 1 — — $117,866.10 $151,959.60 $127,607.10 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 13 5 — — $489,399.00 $1,003,071.60 $802,457.28 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 51 29 — — $479,661.20 $1,052,317.93 $504,133.71 2026-03-01
09391 OTHER Brexucabtagene Car Pos T 2 2 — — $489,450.20 $489,450.20 $489,450.20 2026-03-01
B2102 OTHER Burns; M=12-45 28 13 — — $50,526.26 $54,749.82 $52,142.69 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 86 39 — — $2,585.00 $145,010.94 $65,656.10 2026-03-01
275 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 2 — — $57,186.19 $57,186.19 $57,186.19 2026-03-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 86 39 — — $2,585.00 $122,156.22 $56,115.24 2026-03-01
2004 APR_DRG Cardiac Structural And Valvular Disorders 15 8 — — $110,725.80 $141,231.89 $118,634.79 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 92 39 — — $28,050.00 $198,952.80 $85,655.23 2026-03-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 — — $63,920.76 $63,920.76 $63,920.76 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 92 39 — — $28,050.00 $133,721.88 $60,943.41 2026-03-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 92 39 — — $28,050.00 $133,721.88 $60,943.41 2026-03-01
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 — — $48,514.15 $48,514.15 $48,514.15 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 92 39 — — $28,050.00 $156,153.59 $70,307.68 2026-03-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 92 39 — — $28,050.00 $108,453.15 $50,394.80 2026-03-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 92 39 — — $28,050.00 $102,502.55 $47,910.68 2026-03-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 20 9 — — $74,016.25 $94,408.49 $79,303.13 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 58 32 — — $2,585.00 $633,491.68 $361,113.56 2026-03-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $234,006.60 $234,006.60 $234,006.60 2026-03-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 15 8 — — $119,152.84 $151,980.66 $127,663.76 2026-03-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 15 8 — — $67,708.80 $86,363.26 $72,545.14 2026-03-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 15 8 — — $47,053.34 $60,017.01 $50,414.29 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 13 5 — — $553,169.00 $1,250,478.00 $969,621.79 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 51 29 — — $575,896.61 $1,263,446.64 $605,279.09 2026-03-01
09498 OTHER Ciltacabtagene Car-pos T 2 2 — — $587,649.60 $587,649.60 $587,649.60 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 85 38 — — $2,585.00 $209,536.27 $78,501.22 2026-03-01
429 OTHER Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 2 2 — — $61,316.82 $61,316.82 $61,316.82 2026-03-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 85 38 — — $2,585.00 $134,125.44 $52,021.67 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 78 37 — — $2,585.00 $176,516.69 $97,359.07 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 86 39 — — $2,585.00 $169,581.59 $93,727.47 2026-03-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 72 38 — — $2,585.00 $135,983.35 $60,119.26 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 92 39 — — $28,050.00 $155,480.43 $69,779.88 2026-03-01
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 2 — — $51,286.09 $51,286.09 $51,286.09 2026-03-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 92 39 — — $28,050.00 $111,094.93 $51,497.63 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 92 39 — — $28,050.00 $171,438.88 $76,679.29 2026-03-01
231 OTHER Coronary Bypass With Ptca With Mcc 2 2 — — $57,371.36 $57,371.36 $57,371.36 2026-03-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 92 39 — — $28,050.00 $156,000.00 $56,590.67 2026-03-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 92 39 — — $28,050.00 $119,349.72 $54,943.65 2026-03-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 77 38 — — $2,585.00 $104,971.50 $60,487.09 2026-03-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 15 8 — — $47,665.76 $60,798.16 $51,070.46 2026-03-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 77 38 — — $2,585.00 $104,000.00 $53,303.25 2026-03-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 15 8 — — $52,218.57 $66,605.32 $55,948.47 2026-03-01
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 15 8 — — $44,174.88 $56,345.51 $47,330.23 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 55 31 — — $109,262.16 $857,608.46 $114,836.76 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 76 38 — — $2,585.00 $331,006.99 $185,318.49 2026-03-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 2 — — $144,978.40 $144,978.40 $144,978.40 2026-03-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 55 31 — — $49,007.06 $384,659.87 $51,507.42 2026-03-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 55 31 — — $48,608.78 $381,534.40 $51,088.82 2026-03-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 78 37 — — $2,585.00 $88,999.11 $51,530.05 2026-03-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 78 38 — — $28,050.00 $124,633.27 $57,077.85 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 70 36 — — $2,585.00 $332,961.05 $181,057.04 2026-03-01
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 15 8 — — $46,250.61 $58,993.13 $49,554.22 2026-03-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 15 8 — — $99,856.91 $127,368.51 $106,989.55 2026-03-01
1784 APR_DRG External Heart Assist Devices 15 8 — — $57,435.10 $73,259.06 $61,537.61 2026-03-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 15 8 — — $171,259.81 $218,443.64 $183,492.66 2026-03-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 15 8 — — $84,139.58 $107,320.89 $90,149.55 2026-03-01
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 15 8 — — $55,338.23 $70,584.48 $59,290.96 2026-03-01
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 15 8 — — $53,667.00 $68,452.80 $57,500.35 2026-03-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 53 29 — — $6,270.00 $79,478.73 $53,462.22 2026-03-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 70 36 — — $2,585.00 $111,858.26 $64,129.07 2026-03-01
2464 APR_DRG Gastrointestinal Vascular Insufficiency 15 8 — — $82,279.61 $104,948.49 $88,156.73 2026-03-01
B1903 OTHER Guillian Barre; M < 18.05 28 13 — — $54,786.58 $59,366.27 $56,539.30 2026-03-01
24 APR_DRG Heart And/or Lung Transplant 14 7 — — $242,253.90 $432,596.00 $259,557.75 2026-03-01
23 APR_DRG Heart And/or Lung Transplant 14 7 — — $59,667.06 $106,548.00 $63,929.00 2026-03-01
22 APR_DRG Heart And/or Lung Transplant 14 7 — — $47,932.42 $85,593.60 $51,356.16 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 57 32 — — $2,585.00 $437,032.72 $233,779.55 2026-03-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 2 2 — — $205,695.50 $205,695.50 $205,695.50 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 57 32 — — $2,585.00 $184,000.00 $98,430.23 2026-03-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 2 — — $77,120.73 $77,120.73 $77,120.73 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 15 6 — — $45,212.00 $310,073.39 $99,222.35 2026-03-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 77 38 — — $2,585.00 $95,461.67 $55,457.91 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 51 29 — — $546,920.16 $1,199,875.87 $574,824.25 2026-03-01
09422 OTHER Idecabtagene Vicleucel Ca 2 2 — — $558,081.80 $558,081.80 $558,081.80 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 13 5 — — $527,622.00 $1,128,119.40 $902,495.52 2026-03-01
1614 APR_DRG Implantable Heart Assist Systems 20 9 — — $182,805.33 $233,170.06 $195,862.85 2026-03-01
1613 APR_DRG Implantable Heart Assist Systems 20 9 — — $95,280.61 $121,531.39 $102,086.37 2026-03-01
1612 APR_DRG Implantable Heart Assist Systems 20 9 — — $68,491.95 $87,362.18 $73,384.23 2026-03-01
1611 APR_DRG Implantable Heart Assist Systems 20 9 — — $64,958.39 $82,855.09 $69,598.27 2026-03-01
714 OTHER Inj Delandistrogene Mox R 48 28 — — $6,816.73 $4,825,397.00 $3,427,695.80 2026-03-01
00714 OTHER Inj Delandistrogene Mox R 2 2 — — $3,327,860.00 $3,327,860.00 $3,327,860.00 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 50 28 — — $9,272.91 $4,929,000.00 $3,275,400.00 2026-03-01
00906 OTHER Inj Elivaldogene Autoteme 2 2 — — $3,180,000.00 $3,180,000.00 $3,180,000.00 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 48 26 — — $2,537,201.38 $4,012,920.55 $2,666,650.43 2026-03-01
09141 OTHER Inj Onase Abepar-xioi Tre 2 2 — — $2,588,981.00 $2,588,981.00 $2,588,981.00 2026-03-01
845 OTHER Inj, Atidarsagene Autotem 44 24 — — $5,795.87 $4,910,450.00 $4,572,575.00 2026-03-01
00845 OTHER Inj, Atidarsagene Autotem 2 2 — — $4,505,000.00 $4,505,000.00 $4,505,000.00 2026-03-01
746 OTHER Inj, Betibeglogene Autote 50 28 — — $12,002.54 $4,556,951.95 $3,028,168.07 2026-03-01
00746 OTHER Inj, Betibeglogene Autote 2 2 — — $2,939,969.00 $2,939,969.00 $2,939,969.00 2026-03-01
824 OTHER Inj, Exagamglogene Autote 52 30 — — $14,054.67 $4,897,200.00 $2,401,960.00 2026-03-01
00824 OTHER Inj, Exagamglogene Autote 2 2 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 44 24 — — $3,611,561.66 $4,790,847.10 $3,795,825.01 2026-03-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 2 2 — — $3,685,267.00 $3,685,267.00 $3,685,267.00 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 48 28 — — $12,975.57 $4,716,136.60 $3,350,083.24 2026-03-01
00748 OTHER Inj, Lovotibeglogene Auto 2 2 — — $3,252,508.00 $3,252,508.00 $3,252,508.00 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 53 31 — — $8,684.31 $433,588.35 $207,719.07 2026-03-01
00886 OTHER Inj. Remestemcel-l-rknd/ 2 2 — — $201,669.00 $201,669.00 $201,669.00 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
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 3 1 — — $3,847,800.00 $3,847,800.00 $3,847,800.00 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
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 15 6 — — $27,070.50 $146,379.64 $47,307.21 2026-03-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 13 4 — — $39,976.89 $204,927.75 $58,512.24 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
717 OTHER Instill Adstiladrin, Tx D 53 31 — — $12,866.43 $138,190.80 $66,203.03 2026-03-01
00717 OTHER Instill Adstiladrin, Tx D 2 2 — — $64,274.79 $64,274.79 $64,274.79 2026-03-01
E0767 HCPCS Intrabuccal, Systemic Delivery Of Amplitude-modulated, Radiofrequency Electromag… 5 1 — — $94,790.81 $146,008.42 $130,719.58 2026-03-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 77 38 — — $2,585.00 $234,000.00 $50,063.70 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 77 38 — — $2,585.00 $234,000.00 $71,924.99 2026-03-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 2 — — $60,610.50 $60,610.50 $60,610.50 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 13 5 — — $63,235.60 $432,000.00 $157,200.00 2026-03-01
4404 APR_DRG Kidney Transplant 14 7 — — $64,797.85 $115,710.00 $69,426.26 2026-03-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 2 2 — — $101,465.50 $101,465.50 $101,465.50 2026-03-01
5244 OTHER Level 4 Blood Product Exc 51 29 — — $61,923.99 $135,853.66 $65,083.38 2026-03-01
05244 OTHER Level 4 Blood Product Exc 2 2 — — $64,367.62 $64,367.62 $64,367.62 2026-03-01
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 2 2 — — $47,439.34 $47,439.34 $47,439.34 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 51 29 — — $550,957.18 $1,208,732.58 $579,067.24 2026-03-01
09413 OTHER Lisocabtagene Car Pos T 2 2 — — $562,201.20 $562,201.20 $562,201.20 2026-03-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 13 5 — — $516,442.00 $1,103,378.76 $882,703.01 2026-03-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 14 7 — — $86,779.56 $154,964.00 $92,978.10 2026-03-01
13 APR_DRG Liver Transplant And/or Intestinal Transplant 14 7 — — $44,710.95 $79,841.00 $47,904.59 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 54 30 — — $2,585.00 $160,792.25 $90,007.31 2026-03-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 2 2 — — $73,492.87 $73,492.87 $73,492.87 2026-03-01
7 MS_DRG Lung Transplant 54 30 — — $2,585.00 $201,958.37 $111,777.62 2026-03-01
007 OTHER Lung Transplant 2 2 — — $87,014.73 $87,014.73 $87,014.73 2026-03-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 77 38 — — $2,585.00 $153,839.57 $53,342.49 2026-03-01
4414 APR_DRG Major Bladder Procedures 15 8 — — $61,322.25 $78,217.15 $65,702.41 2026-03-01
653 MS_DRG Major Bladder Procedures With Mcc 77 38 — — $2,585.00 $81,221.98 $47,830.02 2026-03-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 20 9 — — $84,848.71 $108,225.40 $90,909.34 2026-03-01
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 15 8 — — $62,816.10 $80,122.57 $67,302.96 2026-03-01
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 15 8 — — $48,938.76 $62,421.89 $52,434.39 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 85 38 — — $2,585.00 $256,320.05 $94,928.75 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 85 38 — — $2,585.00 $167,882.98 $63,875.20 2026-03-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 85 38 — — $2,585.00 $130,750.85 $50,836.72 2026-03-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 85 38 — — $2,585.00 $155,393.97 $59,489.84 2026-03-01
447 OTHER Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 2 2 — — $49,872.83 $49,872.83 $49,872.83 2026-03-01
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 15 8 — — $55,400.49 $70,663.89 $59,357.67 2026-03-01
8634 APR_DRG Neonatal Aftercare 15 8 — — $66,658.60 $85,023.72 $71,419.93 2026-03-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 15 8 — — $81,855.15 $104,407.08 $87,701.94 2026-03-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 15 8 — — $72,801.59 $92,859.17 $78,001.71 2026-03-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 15 8 — — $47,051.38 $60,014.51 $50,412.19 2026-03-01
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 15 8 — — $62,637.93 $79,895.32 $67,112.07 2026-03-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 15 8 — — $51,357.12 $65,506.53 $55,025.48 2026-03-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 15 8 — — $48,672.10 $62,081.76 $52,148.68 2026-03-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 15 8 — — $56,496.89 $72,062.36 $60,532.38 2026-03-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 15 8 — — $138,830.54 $177,079.78 $148,747.01 2026-03-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 15 8 — — $44,658.09 $56,961.85 $47,847.95 2026-03-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 15 8 — — $69,133.34 $88,180.27 $74,071.43 2026-03-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 15 8 — — $95,392.98 $121,674.73 $102,206.77 2026-03-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 15 8 — — $62,816.10 $80,122.57 $67,302.96 2026-03-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 15 8 — — $51,864.59 $66,153.81 $55,569.20 2026-03-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 15 8 — — $79,194.02 $101,012.77 $84,850.73 2026-03-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 15 8 — — $56,561.90 $72,145.27 $60,602.03 2026-03-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 15 8 — — $44,438.41 $56,681.65 $47,612.59 2026-03-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 15 8 — — $188,251.72 $240,116.99 $201,698.27 2026-03-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 15 8 — — $101,009.71 $128,838.91 $108,224.69 2026-03-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 15 8 — — $100,548.04 $128,250.05 $107,730.04 2026-03-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 15 8 — — $94,777.04 $120,889.09 $101,546.83 2026-03-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 15 8 — — $79,431.70 $101,315.95 $85,105.40 2026-03-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 15 8 — — $76,985.55 $98,195.85 $82,484.51 2026-03-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 15 8 — — $72,210.71 $92,105.50 $77,368.62 2026-03-01
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 15 8 — — $52,538.88 $67,013.88 $56,291.65 2026-03-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 15 8 — — $140,071.83 $178,663.05 $150,076.96 2026-03-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 15 8 — — $66,018.38 $84,207.11 $70,733.97 2026-03-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 15 8 — — $98,859.58 $126,096.40 $105,920.98 2026-03-01
5834 APR_DRG Neonate With Ecmo 15 8 — — $297,403.78 $379,341.56 $318,646.91 2026-03-01
5833 APR_DRG Neonate With Ecmo 15 8 — — $251,830.60 $321,212.50 $269,818.50 2026-03-01
5832 APR_DRG Neonate With Ecmo 15 8 — — $125,481.43 $160,052.85 $134,444.39 2026-03-01
5831 APR_DRG Neonate With Ecmo 15 8 — — $110,488.90 $140,929.73 $118,380.97 2026-03-01
B0604 OTHER Neurological; M < 25.85 28 13 — — $48,634.33 $52,699.74 $50,190.23 2026-03-01
1595 OTHER New Technology - Level 44 51 29 — — $52,998.19 $116,271.55 $55,702.18 2026-03-01
1581 OTHER New Technology - Level 44 51 29 — — $52,998.19 $116,271.55 $55,702.18 2026-03-01
01595 OTHER New Technology - Level 44 2 2 — — $55,089.60 $55,089.60 $55,089.60 2026-03-01
01581 OTHER New Technology - Level 44 2 2 — — $55,089.60 $55,089.60 $55,089.60 2026-03-01
1596 OTHER New Technology - Level 45 51 29 — — $62,634.14 $137,411.64 $65,829.76 2026-03-01
1582 OTHER New Technology - Level 45 51 29 — — $62,634.14 $137,411.64 $65,829.76 2026-03-01
01596 OTHER New Technology - Level 45 2 2 — — $65,105.80 $65,105.80 $65,105.80 2026-03-01
01582 OTHER New Technology - Level 45 2 2 — — $65,105.80 $65,105.80 $65,105.80 2026-03-01
1583 OTHER New Technology - Level 46 51 29 — — $72,270.09 $158,551.73 $75,957.34 2026-03-01
1597 OTHER New Technology - Level 46 51 29 — — $72,270.09 $158,551.73 $75,957.34 2026-03-01
01597 OTHER New Technology - Level 46 2 2 — — $75,122.00 $75,122.00 $75,122.00 2026-03-01
01583 OTHER New Technology - Level 46 2 2 — — $75,122.00 $75,122.00 $75,122.00 2026-03-01
1584 OTHER New Technology - Level 47 51 29 — — $81,906.04 $179,691.82 $86,084.92 2026-03-01
1598 OTHER New Technology - Level 47 51 29 — — $81,906.04 $179,691.82 $86,084.92 2026-03-01
01598 OTHER New Technology - Level 47 2 2 — — $85,138.20 $85,138.20 $85,138.20 2026-03-01
01584 OTHER New Technology - Level 47 2 2 — — $85,138.20 $85,138.20 $85,138.20 2026-03-01
1585 OTHER New Technology - Level 48 51 29 — — $91,542.00 $200,831.93 $96,212.51 2026-03-01
1599 OTHER New Technology - Level 48 51 29 — — $91,542.00 $200,831.93 $96,212.51 2026-03-01
01585 OTHER New Technology - Level 48 2 2 — — $95,154.40 $95,154.40 $95,154.40 2026-03-01
01599 OTHER New Technology - Level 48 2 2 — — $95,154.40 $95,154.40 $95,154.40 2026-03-01
1902 OTHER New Technology - Level 49 51 29 — — $103,586.88 $227,256.93 $108,871.93 2026-03-01
1901 OTHER New Technology - Level 49 51 29 — — $103,586.88 $227,256.93 $108,871.93 2026-03-01
01902 OTHER New Technology - Level 49 2 2 — — $107,674.60 $107,674.60 $107,674.60 2026-03-01
01901 OTHER New Technology - Level 49 2 2 — — $107,674.60 $107,674.60 $107,674.60 2026-03-01
1903 OTHER New Technology - Level 50 51 29 — — $118,040.80 $258,967.07 $124,063.29 2026-03-01
1904 OTHER New Technology - Level 50 51 29 — — $118,040.80 $258,967.07 $124,063.29 2026-03-01
01903 OTHER New Technology - Level 50 2 2 — — $122,699.00 $122,699.00 $122,699.00 2026-03-01
01904 OTHER New Technology - Level 50 2 2 — — $122,699.00 $122,699.00 $122,699.00 2026-03-01
1905 OTHER New Technology - Level 51 51 29 — — $132,494.73 $290,677.21 $139,254.66 2026-03-01
1906 OTHER New Technology - Level 51 51 29 — — $132,494.73 $290,677.21 $139,254.66 2026-03-01
01905 OTHER New Technology - Level 51 2 2 — — $137,723.20 $137,723.20 $137,723.20 2026-03-01
01906 OTHER New Technology - Level 51 2 2 — — $137,723.20 $137,723.20 $137,723.20 2026-03-01
1907 OTHER New Technology - Level 52 51 29 — — $146,948.65 $322,387.34 $154,446.03 2026-03-01
1908 OTHER New Technology - Level 52 51 29 — — $146,948.65 $322,387.34 $154,446.03 2026-03-01
01907 OTHER New Technology - Level 52 2 2 — — $152,747.50 $152,747.50 $152,747.50 2026-03-01
01908 OTHER New Technology - Level 52 2 2 — — $152,747.50 $152,747.50 $152,747.50 2026-03-01
B0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 28 13 — — $62,022.77 $67,207.34 $64,006.99 2026-03-01
C0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 28 13 — — $47,663.55 $51,647.81 $49,188.39 2026-03-01
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 8 2 — — $459,112.50 $1,428,840.00 $1,090,152.00 2026-03-01
C9301 HCPCS Obecabtagene Autoleucel, Up To 400 Million Cd19 Car-positive Viable T Cells, Inc… 5 1 — — $545,370.00 $751,275.00 $751,275.00 2026-03-01
831 OTHER Obecbtge Autol Up To 400 53 31 — — $3,968.76 $598,237.50 $286,597.50 2026-03-01
00831 OTHER Obecbtge Autol Up To 400 2 2 — — $278,250.00 $278,250.00 $278,250.00 2026-03-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 20 9 — — $56,247.07 $71,743.71 $60,264.72 2026-03-01
215 MS_DRG Other Heart Assist System Implant 91 39 — — $2,585.00 $202,495.51 $87,091.90 2026-03-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 2 — — $68,875.42 $68,875.42 $68,875.42 2026-03-01
4474 APR_DRG Other Kidney, Urinary Tract And Related Non-percutaneous Procedures 15 8 — — $48,558.15 $61,936.41 $52,026.59 2026-03-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 92 39 — — $16,045.00 $107,304.11 $48,013.59 2026-03-01
264 APR_DRG Other Nervous System And Related Procedures 15 8 — — $44,631.07 $56,927.39 $47,819.01 2026-03-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 15 8 — — $84,896.10 $108,285.84 $90,960.10 2026-03-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 77 38 — — $2,585.00 $118,832.34 $67,817.25 2026-03-01
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 2 — — $51,967.27 $51,967.27 $51,967.27 2026-03-01
1824 APR_DRG Other Upper Vascular Procedures 15 8 — — $44,139.25 $56,300.06 $47,292.05 2026-03-01
64 APR_DRG Pancreas Transplant 14 7 — — $79,437.97 $141,854.00 $85,112.11 2026-03-01
10 MS_DRG Pancreas Transplant 54 30 — — $2,585.00 $111,905.04 $64,153.82 2026-03-01
63 APR_DRG Pancreas Transplant 14 7 — — $51,335.97 $91,671.40 $55,002.82 2026-03-01
62 APR_DRG Pancreas Transplant 14 7 — — $46,432.69 $82,915.50 $49,749.32 2026-03-01
61 APR_DRG Pancreas Transplant 14 7 — — $45,833.20 $81,845.00 $49,107.00 2026-03-01
010 OTHER Pancreas Transplant 2 2 — — $48,835.43 $48,835.43 $48,835.43 2026-03-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 77 38 — — $2,585.00 $85,364.01 $50,090.60 2026-03-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 53 31 — — $67,425.67 $147,923.65 $70,865.75 2026-03-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 15 8 — — $96,255.23 $122,774.52 $103,130.60 2026-03-01
B1504 OTHER Pulmonary; M < 29.15 28 13 — — $46,504.17 $50,391.52 $47,991.92 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 3 1 — — $77,046.96 $77,046.96 $77,046.96 2026-03-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 77 38 — — $2,585.00 $138,243.09 $58,042.60 2026-03-01
897 OTHER Revakinagene, Per Implant 51 29 — — $259,700.00 $569,750.00 $272,950.00 2026-03-01
00897 OTHER Revakinagene, Per Implant 2 2 — — $265,000.00 $265,000.00 $265,000.00 2026-03-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 90 38 — — $2,585.00 $127,855.03 $47,434.60 2026-03-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 77 38 — — $2,585.00 $148,493.11 $61,977.36 2026-03-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 54 30 — — $2,585.00 $87,837.22 $51,085.19 2026-03-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 60 34 — — $2,585.00 $111,264.09 $63,814.85 2026-03-01
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 2 — — $48,555.84 $48,555.84 $48,555.84 2026-03-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 85 38 — — $2,585.00 $123,950.51 $48,448.87 2026-03-01
9273 OTHER Sipuleucel-t Auto Cd54+ 51 29 — — $53,316.03 $116,968.84 $56,036.23 2026-03-01
09273 OTHER Sipuleucel-t Auto Cd54+ 2 2 — — $54,404.11 $54,404.11 $54,404.11 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 15 6 — — $57,017.10 $422,905.25 $135,389.25 2026-03-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 77 38 — — $2,585.00 $102,169.08 $59,005.05 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 90 38 — — $2,585.00 $195,437.87 $73,550.75 2026-03-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 90 38 — — $2,585.00 $138,683.82 $54,153.20 2026-03-01
234 APR_DRG Spinal Procedures 15 8 — — $47,838.83 $61,018.91 $51,255.89 2026-03-01
28 MS_DRG Spinal Procedures With Mcc 77 38 — — $2,585.00 $93,699.44 $54,525.98 2026-03-01
B0106 OTHER Stroke; M > 30.05 & M < 34.25 28 13 — — $56,231.83 $60,932.33 $58,030.79 2026-03-01
C0106 OTHER Stroke; M > 30.05 & M < 34.25 28 13 — — $49,934.66 $54,108.77 $51,532.16 2026-03-01
B0105 OTHER Stroke; M > 34.25 & M < 38.85 28 13 — — $49,920.77 $54,093.71 $51,517.82 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 51 29 — — $555,200.67 $1,218,042.30 $583,527.24 2026-03-01
09194 OTHER Tisagenlecleucel Car-pos 2 2 — — $566,531.30 $566,531.30 $566,531.30 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 12 5 — — $32.24 $1,037,313.00 $882,313.53 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 48 28 — — $10,494.25 $4,836,939.00 $3,435,894.60 2026-03-01
00908 OTHER Topi Adm Prad Zami Per Tr 2 2 — — $3,335,820.00 $3,335,820.00 $3,335,820.00 2026-03-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 77 38 — — $2,585.00 $85,056.69 $49,955.34 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 76 38 — — $2,585.00 $216,012.58 $122,716.23 2026-03-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 2 — — $113,216.60 $113,216.60 $113,216.60 2026-03-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 15 8 — — $100,288.04 $127,918.41 $107,451.47 2026-03-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 15 8 — — $64,479.88 $82,244.75 $69,085.59 2026-03-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 15 8 — — $64,501.82 $82,272.72 $69,109.09 2026-03-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 15 8 — — $46,464.80 $59,266.32 $49,783.71 2026-03-01
B0205 OTHER Traumatic Brain Injury; M > 28.75 & M < 40.65 28 13 — — $54,093.73 $58,615.50 $55,824.29 2026-03-01
B0405 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 28 13 — — $49,950.54 $54,125.98 $51,548.55 2026-03-01
B0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 28 13 — — $63,061.05 $68,332.41 $65,078.48 2026-03-01
C0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 28 13 — — $51,544.69 $55,853.38 $53,193.69 2026-03-01
D0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 28 13 — — $50,188.77 $54,384.12 $51,794.40 2026-03-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 72 38 — — $2,585.00 $86,804.89 $50,879.85 2026-03-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 77 38 — — $2,585.00 $88,883.70 $53,016.75 2026-03-01
1643 OTHER Y90 Ibritumomab, Rx 51 29 — — $55,688.06 $122,172.78 $58,529.29 2026-03-01
01643 OTHER Y90 Ibritumomab, Rx 2 2 — — $56,824.55 $56,824.55 $56,824.55 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 13 4 — — $93,760.51 $551,754.93 $147,245.34 2026-03-01
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