Hospital

MEDICAL CITY DALLAS HOSPITAL

Dallas, TX · CCN 450647 · Rates published

36,063 distinct procedures filed

66 distinct payers

2,372,132 rate rows

2026-03-01 last MRF observed

Data quality

2,331,760 of 2,372,132 rate rows are consumer-grade (98.3%)

40,372 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 — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	22,403
per-diem day rate — not a per-procedure price	13,877
template filing: same amount across many unrelated codes — excluded	3,511
placeholder amount (≤ $0.02) — excluded from medians	545
exceeds 10× this hospital's gross charge — excluded from medians	36

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1682198_MEDICAL-CITY-DALLAS_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 via	Discovered by HANK
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-05-18
Content fingerprint	6ac103cde294ec7e… · 1,050,715,330 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	20	$5,311.90	$4,955,500.00	$4,535,408.75	nat. median $9,966 outlier · 455.1×
00845 OTHER	Inj, Atidarsagene Autotem	2	$4,369,850.00	$4,505,000.00	$4,437,425.00	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	21	$3,666,840.67	$4,790,847.10	$3,740,546.00	nat. median $3,746,358 1.0× median
09138 OTHER	Inj, Hemgenix, Per Tx Dos	2	$3,574,708.99	$3,685,267.00	$3,629,988.00	nat. median $3,574,709 1.0× median
714 OTHER	Inj Delandistrogene Mox R	24	$6,247.51	$4,991,790.00	$3,460,974.40	nat. median $13,041 outlier · 265.4×
908 OTHER	Topi Adm Prad Zami Per Tr	21	$9,617.95	$4,336,566.00	$3,385,857.30	nat. median $22,747 outlier · 148.8×
748 OTHER	Inj, Lovotibeglogene Auto	24	$11,892.06	$4,878,762.00	$3,382,608.32	nat. median $17,963 outlier · 188.3×
00908 OTHER	Topi Adm Prad Zami Per Tr	2	$3,235,745.40	$3,335,820.00	$3,285,782.70	nat. median $12,675 outlier · 259.2×
00714 OTHER	Inj Delandistrogene Mox R	2	$3,228,024.20	$3,327,860.00	$3,277,942.10	nat. median $3,228,024 1.0× median
906 OTHER	Inj Elivaldogene Autoteme	22	$8,498.59	$4,770,000.00	$3,275,400.00	nat. median $20,756 outlier · 157.8×
00748 OTHER	Inj, Lovotibeglogene Auto	2	$3,154,932.76	$3,252,508.00	$3,203,720.38	nat. median $3,187,420 1.0× median
00906 OTHER	Inj Elivaldogene Autoteme	2	$3,084,600.00	$3,180,000.00	$3,132,300.00	nat. median $21 outlier · 151392.0×
746 OTHER	Inj, Betibeglogene Autote	24	$11,000.28	$4,409,953.50	$3,057,567.76	nat. median $21,896 outlier · 139.6×
00746 OTHER	Inj, Betibeglogene Autote	2	$2,851,769.93	$2,939,969.00	$2,895,869.46	nat. median $2,878,960 1.0× median
9141 OTHER	Inj Onase Abepar-xioi Tre	24	$2,455,110.00	$4,919,063.90	$2,718,430.05	nat. median $2,588,981 1.0× median
09141 OTHER	Inj Onase Abepar-xioi Tre	2	$2,511,311.57	$2,588,981.00	$2,550,146.29	nat. median $2,457,321 1.0× 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×
824 OTHER	Inj, Exagamglogene Autote	26	$12,881.06	$4,617,360.00	$2,425,280.00	nat. median $25,250 outlier · 96.1×
Q2056 HCPCS	Ciltacabtagene 100 Mil	19	$536,573.93	$4,937,864.25	$2,360,299.11	nat. median $675,122 outlier · 3.5×
00824 OTHER	Inj, Exagamglogene Autote	2	$2,262,040.00	$2,332,000.00	$2,297,020.00	nat. median $2,332,000 1.0× median
Q2054 HCPCS	Lisocabtagene	19	$500,948.74	$4,981,060.92	$2,249,511.38	nat. median $674,188 outlier · 3.3×
Q2041 HCPCS	Axicabtagene Adult	23	$6.22	$4,965,250.67	$2,148,599.38	nat. median $634,511 outlier · 3.4×
Q2053 HCPCS	Brexucabtagene	26	$474,717.03	$4,880,294.09	$2,121,146.50	nat. median $620,080 outlier · 3.4×
Q2042 HCPCS	Tisagenlecleucel Adult	26	$23.68	$4,817,860.09	$2,094,010.50	nat. median $754,974 outlier · 2.8×
Q2058 HCPCS	Obecabtagene Inj	34	$371,000.00	$4,717,000.00	$1,976,900.00	nat. median $324,450 outlier · 6.1×
Q2055 HCPCS	Idecabtagene	33	$416,855.60	$4,764,064.00	$1,845,479.29	nat. median $625,184 outlier · 3.0×
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×
2067 OTHER	Afamitresgene Autoleucel	27	$766,766.90	$2,019,024.40	$809,151.00	nat. median $786,032 1.0× median
9498 OTHER	Ciltacabtagene Car-pos T	26	$565,868.90	$1,539,641.95	$617,032.08	nat. median $587,650 1.1× median
9194 OTHER	Tisagenlecleucel Car-pos	26	$563,698.64	$1,484,312.01	$594,857.87	nat. median $566,531 1.1× median
9413 OTHER	Lisocabtagene Car Pos T	26	$559,390.19	$1,472,967.14	$590,311.26	nat. median $562,201 1.1× median
9422 OTHER	Idecabtagene Vicleucel Ca	26	$555,291.39	$1,462,174.32	$585,985.89	nat. median $558,082 1.1× median
09498 OTHER	Ciltacabtagene Car-pos T	2	$570,020.11	$587,649.60	$578,834.85	nat. median $554,552 1.0× median
9035 OTHER	Axicabtagene Ciloleucel C	26	$529,531.24	$1,394,343.56	$558,801.81	nat. median $532,192 1.1× median
09194 OTHER	Tisagenlecleucel Car-pos	2	$549,535.36	$566,531.30	$558,033.33	nat. median $538,205 1.0× median
09413 OTHER	Lisocabtagene Car Pos T	2	$545,335.16	$562,201.20	$553,768.18	nat. median $534,091 1.0× median
09422 OTHER	Idecabtagene Vicleucel Ca	2	$541,339.35	$558,081.80	$549,710.57	nat. median $530,178 1.0× median
09035 OTHER	Axicabtagene Ciloleucel C	2	$516,226.43	$532,192.20	$524,209.31	nat. median $505,583 1.0× median
443630 CDM	Kit Hrt Implant Lvas	30	$126,621.00	$1,151,100.00	$517,995.00	nat. median $260 outlier · 1995.7×
9391 OTHER	Brexucabtagene Car Pos T	26	$487,002.95	$1,282,359.52	$513,922.71	nat. median $489,450 1.1× median
09391 OTHER	Brexucabtagene Car Pos T	2	$474,766.69	$489,450.20	$482,108.45	nat. median $464,978 1.0× median
219919 CDM	Device Vntrc Asst Strl	30	$117,625.20	$1,069,320.00	$481,194.00	nat. median $9,297 outlier · 51.8×
867736 CDM	Implant Hvas Ordr Set	30	$117,625.20	$1,069,320.00	$481,194.00	nat. median $427,728 1.1× median
860906 CDM	Kit Impl Lvas W/grafts	30	$115,500.00	$1,050,000.00	$472,500.00	nat. median $420,000 1.1× median
J9029 HCPCS	Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose	5	$61,338.53	$888,000.00	$405,600.00	nat. median $69,774 outlier · 5.8×
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	22	$315,864.19	$1,273,072.13	$338,425.92	nat. median $370,174 0.9× 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

Other procedures at this hospital

Browse this hospital's 36,063 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

737806	CDM	Grft Xcldr Aaa 31/14/15	51	30	$217,292.00	$217,292.00	$23,902.12	$217,292.00	$97,781.40	2026-03-01
872483	CDM	Graft Evas 14cm 26mm 12m	51	30	$217,292.00	$217,292.00	$23,902.12	$217,292.00	$97,781.40	2026-03-01
859350	CDM	Valve Aor 17-21mm	51	30	$217,406.00	$217,406.00	$23,914.66	$217,406.00	$97,832.70	2026-03-01
745537	CDM	Valve Aortic =16mm	51	30	$217,406.00	$217,406.00	$23,914.66	$217,406.00	$97,832.70	2026-03-01
741888	CDM	Valve Pulm Large 22+mm	51	30	$217,406.00	$217,406.00	$23,914.66	$217,406.00	$97,832.70	2026-03-01
851240	CDM	Graft Vlv Aor 23mm	51	30	$217,406.00	$217,406.00	$23,914.66	$217,406.00	$97,832.70	2026-03-01
1599	OTHER	New Technology - Level 48	46	27	—	—	$91,363.88	$244,734.72	$98,080.71	2026-03-01
1585	OTHER	New Technology - Level 48	46	27	—	—	$91,363.88	$244,734.72	$98,080.71	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
5881	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	26	11	—	—	$92,557.97	$117,459.35	$98,665.85	2026-03-01
446783	CDM	Kit Tandemlife 24frx60cm	71	39	$295,185.00	$295,185.00	$20,662.95	$295,185.00	$98,886.98	2026-03-01
1613	APR_DRG	Implantable Heart Assist Systems	31	12	—	—	$93,049.74	$118,083.43	$99,190.08	2026-03-01
5914	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	26	11	—	—	$93,159.49	$118,222.70	$99,307.07	2026-03-01
719337	CDM	Stent Thorac Distl Main	51	30	$221,836.00	$221,836.00	$24,401.96	$221,836.00	$99,826.20	2026-03-01
720463	CDM	Stnt Graft Evas 116x28x2	51	30	$221,836.00	$221,836.00	$24,401.96	$221,836.00	$99,826.20	2026-03-01
719338	CDM	Stent Thorac Distl Main	51	30	$221,836.00	$221,836.00	$24,401.96	$221,836.00	$99,826.20	2026-03-01
K1007	HCPCS	Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin…	55	28	—	—	$80,850.00	$249,112.22	$99,835.05	2026-03-01
8504	APR_DRG	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	26	11	—	—	$94,001.54	$119,291.30	$100,204.69	2026-03-01
223	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…	6	1	—	—	$82,204.96	$110,251.62	$100,303.41	2026-03-01
868833	CDM	Cage Spnl Brgde 8x24x34	51	30	$223,024.00	$223,024.00	$24,532.64	$223,024.00	$100,360.80	2026-03-01
864259	CDM	Cage Brgd 30d 8x24x34	51	30	$223,024.00	$223,024.00	$24,532.64	$223,024.00	$100,360.80	2026-03-01
864258	CDM	Cage Brgd 20d 8x24x34	51	30	$223,024.00	$223,024.00	$24,532.64	$223,024.00	$100,360.80	2026-03-01
868832	CDM	Cage Spnl Brgde 10x24x34	51	30	$223,024.00	$223,024.00	$24,532.64	$223,024.00	$100,360.80	2026-03-01
868899	CDM	Cage Spnl Brgd 6x24x34	51	30	$223,024.00	$223,024.00	$24,532.64	$223,024.00	$100,360.80	2026-03-01
864569	CDM	Cage Brgd 20d 10x34x24	51	30	$223,024.00	$223,024.00	$24,532.64	$223,024.00	$100,360.80	2026-03-01
862710	CDM	Set Vntrc 17.4x13.8in	71	39	$300,000.00	$300,000.00	$21,000.00	$300,000.00	$100,500.00	2026-03-01
422506	CDM	Kit Pmp Rt Hrt 22f 170cm	71	39	$300,000.00	$300,000.00	$21,000.00	$300,000.00	$100,500.00	2026-03-01
864568	CDM	Valve Pricrd Bln 23mm	51	30	$223,625.00	$223,625.00	$24,598.75	$223,625.00	$100,631.25	2026-03-01
01902	OTHER	New Technology - Level 49	2	2	—	—	$100,283.84	$103,385.40	$101,834.62	2026-03-01
01901	OTHER	New Technology - Level 49	2	2	—	—	$100,283.84	$103,385.40	$101,834.62	2026-03-01
C1820	HCPCS	Device Neurostimulator	736	28	$202,394.00	$202,394.00	$19,219.64	$318,320.00	$101,842.95	2026-03-01
483228	CDM	Imp Coch Ultra Mid-sc	51	30	$226,515.00	$226,515.00	$24,916.65	$226,515.00	$101,931.75	2026-03-01
231601	CDM	Custom Tmj Implant	51	30	$226,973.00	$226,973.00	$24,967.03	$226,973.00	$102,137.85	2026-03-01
6314	APR_DRG	Neonate Birth Weight > 2499 Grams With Other Major Procedure	26	11	—	—	$96,544.92	$122,518.94	$102,915.91	2026-03-01
738282	CDM	Stnt Talent 38x38x199m	51	30	$228,894.00	$228,894.00	$25,178.34	$228,894.00	$103,002.30	2026-03-01
7	MS_DRG	Lung Transplant	46	28	—	—	$96,316.11	$381,784.85	$103,195.83	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
8414	APR_DRG	Extensive Third Degree Burns With Skin Graft	26	11	—	—	$97,518.90	$123,754.95	$103,954.16	2026-03-01
270502	CDM	Prothesis Cstm Cranial	51	30	$231,226.00	$231,226.00	$25,434.86	$231,226.00	$104,051.70	2026-03-01
44	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	26	11	—	—	$97,939.93	$124,289.25	$104,402.97	2026-03-01
5882	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	26	11	—	—	$98,193.85	$124,611.49	$104,673.65	2026-03-01
719336	CDM	Gft Prox Main 46x46	51	30	$232,928.00	$232,928.00	$25,622.08	$232,928.00	$104,817.60	2026-03-01
5883	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	26	11	—	—	$98,644.71	$125,183.64	$105,154.26	2026-03-01
004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	2	2	—	—	$103,762.65	$106,971.80	$105,367.23	2026-03-01
866357	CDM	Set Pump 21fr 5.0	71	39	$316,960.00	$316,960.00	$22,187.20	$316,960.00	$106,181.60	2026-03-01
73	APR_DRG	Allogeneic Bone Marrow Transplant	35	12	—	—	$99,697.85	$177,128.00	$106,276.89	2026-03-01
454	MS_DRG	Combined Anterior And Posterior Spinal Fusion With Cc Pediatric	8	1	—	—	$50,633.65	$128,626.89	$106,505.48	2026-03-01
875223	CDM	Impl Crnl Lg	51	30	$237,136.00	$237,136.00	$26,084.96	$237,136.00	$106,711.20	2026-03-01
C9293	HCPCS	Glucarpidase 1000 U Inj	61	30	$318,838.15	$318,838.15	$740.34	$318,838.15	$106,810.78	2026-03-01
C1721	HCPCS	Defib Card Thk15mm	1,104	28	$209,622.00	$209,622.00	$19,827.39	$358,800.00	$108,186.26	2026-03-01
877388	CDM	Prosthesis Tmj Pt Cstm	51	30	$244,860.00	$244,860.00	$26,934.60	$244,860.00	$110,187.00	2026-03-01
C1722	HCPCS	Defib Card 30j 50x75mm	782	28	$210,220.00	$210,220.00	$18,820.23	$393,343.00	$110,466.95	2026-03-01
1901	OTHER	New Technology - Level 49	46	27	—	—	$103,385.40	$276,936.36	$110,985.94	2026-03-01
1902	OTHER	New Technology - Level 49	46	27	—	—	$103,385.40	$276,936.36	$110,985.94	2026-03-01
33289	CPT	Cath Rt W/sensor	104	36	$236,832.04	$236,832.04	$948.00	$247,030.55	$111,107.09	2026-03-01
108820	CDM	Implt Eye Orbtl .59mg	51	30	$252,082.00	$252,082.00	$27,729.02	$252,082.00	$113,436.90	2026-03-01
477565	CDM	Valve Pulm Med 17-21mm	51	30	$253,012.00	$253,012.00	$27,831.32	$253,012.00	$113,855.40	2026-03-01
J9600	HCPCS	Injection, Porfimer Sodium, 75 Mg	17	4	—	—	$39,976.89	$203,447.46	$114,857.36	2026-03-01
5831	APR_DRG	Neonate With Ecmo	26	11	—	—	$107,901.95	$136,931.41	$115,022.39	2026-03-01
2004	APR_DRG	Cardiac Structural And Valvular Disorders	26	11	—	—	$108,133.31	$137,225.01	$115,269.01	2026-03-01
459	MS_DRG	Spinal Fusion Except Cervical With Mcc Pediatric	8	1	—	—	$55,140.13	$140,095.59	$115,984.64	2026-03-01
01904	OTHER	New Technology - Level 50	2	2	—	—	$114,276.86	$117,811.20	$116,044.03	2026-03-01
01903	OTHER	New Technology - Level 50	2	2	—	—	$114,276.86	$117,811.20	$116,044.03	2026-03-01
286017	CDM	Implant Crnl Bn Cstm	51	30	$258,375.00	$258,375.00	$28,421.25	$258,375.00	$116,268.75	2026-03-01
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	81	33	—	—	$102,650.68	$416,386.94	$116,505.38	2026-03-01
02HA3QZ	OTHER	Insertion Of Implantable Heart Assist System Into Heart, Percutaneous Approach	1	1	—	—	$116,595.00	$116,595.00	$116,595.00	2026-03-01
02HA3RS	OTHER	Insertion Of Biventricular External Heart Assist System Into Heart, Percutaneous…	1	1	—	—	$116,595.00	$116,595.00	$116,595.00	2026-03-01
02HA4RS	OTHER	Insertion Of Biventricular External Heart Assist System Into Heart, Percutaneous…	1	1	—	—	$116,595.00	$116,595.00	$116,595.00	2026-03-01
02HA0RS	OTHER	Insertion Of Biventricular External Heart Assist System Into Heart, Open Approac…	1	1	—	—	$116,595.00	$116,595.00	$116,595.00	2026-03-01
02HA4QZ	OTHER	Insertion Of Implantable Heart Assist System Into Heart, Percutaneous Endoscopic…	1	1	—	—	$116,595.00	$116,595.00	$116,595.00	2026-03-01
02WA0QZ	OTHER	Revision Of Implantable Heart Assist System In Heart, Open Approach	1	1	—	—	$116,595.00	$116,595.00	$116,595.00	2026-03-01
02HA0RZ	OTHER	Insertion Of External Heart Assist System Into Heart, Open Approach	1	1	—	—	$116,595.00	$116,595.00	$116,595.00	2026-03-01
02HA0QZ	OTHER	Insertion Of Implantable Heart Assist System Into Heart, Open Approach	1	1	—	—	$116,595.00	$116,595.00	$116,595.00	2026-03-01
02WA4RZ	OTHER	Revision Of External Heart Assist System In Heart, Percutaneous Endoscopic Appro…	1	1	—	—	$116,595.00	$116,595.00	$116,595.00	2026-03-01
02WA3QZ	OTHER	Revision Of Implantable Heart Assist System In Heart, Percutaneous Approach	1	1	—	—	$116,595.00	$116,595.00	$116,595.00	2026-03-01
02WA3RZ	OTHER	Revision Of External Heart Assist System In Heart, Percutaneous Approach	1	1	—	—	$116,595.00	$116,595.00	$116,595.00	2026-03-01
02WA4QZ	OTHER	Revision Of Implantable Heart Assist System In Heart, Percutaneous Endoscopic Ap…	1	1	—	—	$116,595.00	$116,595.00	$116,595.00	2026-03-01
02HA4RZ	OTHER	Insertion Of External Heart Assist System Into Heart, Percutaneous Endoscopic Ap…	1	1	—	—	$116,595.00	$116,595.00	$116,595.00	2026-03-01
02WA0RZ	OTHER	Revision Of External Heart Assist System In Heart, Open Approach	1	1	—	—	$116,595.00	$116,595.00	$116,595.00	2026-03-01
Q0480	HCPCS	Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only	49	28	—	—	$108,147.24	$629,884.36	$117,066.60	2026-03-01
203790	CDM	Valve Aortic L5.6cm Od16	51	30	$268,261.00	$268,261.00	$29,508.71	$268,261.00	$120,717.45	2026-03-01
226	MS_DRG	Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc Pediatric	6	1	—	—	$100,826.98	$135,174.40	$123,025.30	2026-03-01
114	APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	26	11	—	—	$116,363.03	$147,668.83	$124,041.81	2026-03-01
1903	OTHER	New Technology - Level 50	46	27	—	—	$117,811.20	$315,578.48	$126,472.29	2026-03-01
1904	OTHER	New Technology - Level 50	46	27	—	—	$117,811.20	$315,578.48	$126,472.29	2026-03-01
446781	CDM	Kit Bld Pmp 31fr Cann	71	39	$384,635.00	$384,635.00	$26,924.45	$384,635.00	$128,852.73	2026-03-01
743854	CDM	Gft Evas 28x116mm	51	30	$288,477.00	$288,477.00	$31,732.47	$288,477.00	$129,814.65	2026-03-01
01906	OTHER	New Technology - Level 51	2	2	—	—	$128,269.89	$132,237.00	$130,253.45	2026-03-01
01905	OTHER	New Technology - Level 51	2	2	—	—	$128,269.89	$132,237.00	$130,253.45	2026-03-01
5832	APR_DRG	Neonate With Ecmo	26	11	—	—	$122,543.46	$155,512.00	$130,630.08	2026-03-01
003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	2	2	—	—	$132,872.15	$136,981.60	$134,926.88	2026-03-01
C1822	HCPCS	Pulse Gen Imp	184	28	$293,673.00	$293,673.00	$27,060.00	$349,410.00	$135,300.00	2026-03-01
224	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh…	6	1	—	—	$111,669.08	$149,747.89	$136,254.42	2026-03-01
C1882	HCPCS	Crt Defib Card 71x51x12	1,334	28	$276,939.00	$276,939.00	$22,347.93	$460,000.00	$138,151.44	2026-03-01
241762	CDM	Liver Acquisition	71	39	$412,561.51	$412,561.51	$28,879.31	$412,561.51	$138,208.11	2026-03-01
712139	CDM	Graft Art St Tis 6-32mm	51	30	$312,438.00	$312,438.00	$34,368.18	$312,438.00	$140,597.10	2026-03-01
1906	OTHER	New Technology - Level 51	46	27	—	—	$132,237.00	$354,220.59	$141,958.64	2026-03-01
1905	OTHER	New Technology - Level 51	46	27	—	—	$132,237.00	$354,220.59	$141,958.64	2026-03-01
01908	OTHER	New Technology - Level 52	2	2	—	—	$142,262.92	$146,662.80	$144,462.86	2026-03-01
01907	OTHER	New Technology - Level 52	2	2	—	—	$142,262.92	$146,662.80	$144,462.86	2026-03-01
6094	APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	26	11	—	—	$135,580.01	$172,055.85	$144,526.91	2026-03-01
876436	CDM	Pins Implt Ear Fx Flx28	51	30	$323,459.00	$323,459.00	$35,580.49	$323,459.00	$145,556.55	2026-03-01
6304	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	26	11	—	—	$136,792.24	$173,594.21	$145,819.14	2026-03-01
222	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…	6	1	—	—	$120,606.76	$161,786.86	$147,159.85	2026-03-01
1908	OTHER	New Technology - Level 52	46	27	—	—	$146,662.80	$392,862.71	$157,444.98	2026-03-01
1907	OTHER	New Technology - Level 52	46	27	—	—	$146,662.80	$392,862.71	$157,444.98	2026-03-01
453	MS_DRG	Combined Anterior And Posterior Spinal Fusion With Mcc Pediatric	8	1	—	—	$76,103.85	$193,257.15	$160,080.84	2026-03-01
468694	CDM	Stent Thor 40x40mm 20cm	51	30	$360,395.00	$360,395.00	$39,643.45	$360,395.00	$162,177.75	2026-03-01
459729	CDM	Graft Stnt 15cm 37mm	51	30	$360,395.00	$360,395.00	$39,643.45	$360,395.00	$162,177.75	2026-03-01
236543	CDM	Allo Dbl Cord Donor Acq	71	39	$500,776.79	$500,776.79	$35,054.38	$500,776.79	$167,760.22	2026-03-01
234428	CDM	Allo Dbl Cord Donor Acq	71	39	$500,776.79	$500,776.79	$35,054.38	$500,776.79	$167,760.22	2026-03-01
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	63	29	—	—	$12,500.00	$641,817.38	$168,555.87	2026-03-01
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	81	33	—	—	$156,089.68	$638,050.74	$177,157.00	2026-03-01
94	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	26	11	—	—	$167,250.00	$212,246.19	$178,286.80	2026-03-01
J9226	HCPCS	Histrelin Implant (supprelin La), 50 Mg	19	5	—	—	$43,855.64	$389,632.46	$185,582.55	2026-03-01
220761	CDM	Impl Custom Cp7a1034	51	30	$417,955.00	$417,955.00	$45,975.05	$417,955.00	$188,079.75	2026-03-01
1614	APR_DRG	Implantable Heart Assist Systems	31	12	—	—	$178,525.19	$226,554.81	$190,306.04	2026-03-01
001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	2	2	—	—	$188,519.31	$194,349.80	$191,434.55	2026-03-01
5884	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	26	11	—	—	$183,844.06	$233,304.65	$195,975.91	2026-03-01
00886	OTHER	Inj. Remestemcel-l-rknd/	2	2	—	—	$195,618.93	$201,669.00	$198,643.96	2026-03-01
870432	CDM	Valve Hrt Trncath 20mm	51	30	$447,250.00	$447,250.00	$49,197.50	$447,250.00	$201,262.50	2026-03-01
863855	CDM	Valve Aor Sapien 29mm	51	30	$447,250.00	$447,250.00	$49,197.50	$447,250.00	$201,262.50	2026-03-01
863528	CDM	Valve Aor Sapien 3 26mm	51	30	$447,250.00	$447,250.00	$49,197.50	$447,250.00	$201,262.50	2026-03-01
863553	CDM	Valve Aor 23x18mm	51	30	$447,250.00	$447,250.00	$49,197.50	$447,250.00	$201,262.50	2026-03-01
872854	CDM	Valve Pulm 18mm	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
249246	CDM	Valve Tavr 26mm	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
422836	CDM	Valve Sapien 26mm Stns	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
422838	CDM	Vlv Aor 18-20mm 18f Evol	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
422845	CDM	Vlv Aor 26-29mm 0-43mm	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
868802	CDM	Valve Hrt Sapien Xt 29mm	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
422846	CDM	Valve Aor 26mm 20-23mm	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
868801	CDM	Valve Hrt Sapien Xt 26mm	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
868803	CDM	Valve Xt Sapien 23mm Ta	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
422843	CDM	Valve Aor 18-20mm 0-34mm	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
422841	CDM	Valve Aor 29mm 23-27mm	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
422844	CDM	Valve Aor 23-26mm 0-43mm	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
868804	CDM	Valve Xt Sapien 26mm Ta	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
216520	CDM	Valve Plm Trnscth 25mm	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
270499	CDM	Valve Tavr 29mm	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
249245	CDM	Valve Tavr 23mm	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
422839	CDM	Valve Aor 20-23mm 0-40m	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
877268	CDM	Valve Transcth Aor 26mm	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
876617	CDM	Kit Aor Vlv 14fr 29mm	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
433810	CDM	Valve Heart W/cert 29a	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
433567	CDM	Valve Hrt W Cert Sys 26a	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
868799	CDM	Valve Hrt Sapien Xt 23mm	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
225801	CDM	Valve Aor 23mm Evolutpro	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
437822	CDM	Valve Aor Tavr 23mm	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
872853	CDM	Valve Pulm 16mm	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
877267	CDM	Val Evlt Rtm Trnsct Aort	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
877269	CDM	Valve Aor 23-26mm Coreva	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
467879	CDM	Valve Aor 23mm Sapien 3	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
276829	CDM	Stent Vasc 8x16mm 63cm	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
422842	CDM	Vlv Aor 31mm 26-29mm Cor	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
433568	CDM	Valve Hrt W/cert Sys 23a	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
237550	CDM	Valve Aor/pulm 26mm	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
237603	CDM	Valve Aor 29mm Evolutpro	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
868805	CDM	Valve 29mm Ascendra Aor	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
216519	CDM	Valve Plm Trnscth 22mm	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
225803	CDM	Valve Aor 26mm Evolutpro	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
433811	CDM	Valve Hrt W/cert Sys 20a	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
427323	CDM	Valve Aortic 34mm	51	30	$447,320.00	$447,320.00	$49,205.20	$447,320.00	$201,294.00	2026-03-01
J7330	HCPCS	Autologous Cultured Chondrocytes, Implant	17	4	—	—	$106,519.41	$574,167.94	$202,348.70	2026-03-01
30233Y0	OTHER	Transfusion Of Autologous Hematopoietic Stem Cells Into Peripheral Vein, Percuta…	18	3	—	—	$6,444.00	$363,283.00	$207,095.00	2026-03-01
30240G0	OTHER	Transfusion Of Autologous Bone Marrow Into Central Vein, Open Approach	18	3	—	—	$6,444.00	$363,283.00	$207,095.00	2026-03-01
30253G0	OTHER	Transfusion Of Autologous Bone Marrow Into Peripheral Artery, Percutaneous Appro…	18	3	—	—	$6,444.00	$363,283.00	$207,095.00	2026-03-01
30263G0	OTHER	Transfusion Of Autologous Bone Marrow Into Central Artery, Percutaneous Approach…	18	3	—	—	$6,444.00	$363,283.00	$207,095.00	2026-03-01
30240Y0	OTHER	Transfusion Of Autologous Hematopoietic Stem Cells Into Central Vein, Open Appro…	18	3	—	—	$6,444.00	$363,283.00	$207,095.00	2026-03-01
30240C0	OTHER	Transfusion Of Autologous Hematopoietic Stem/Progenitor Cells, Genetically Modif…	18	3	—	—	$6,444.00	$363,283.00	$207,095.00	2026-03-01
30243G0	OTHER	Transfusion Of Autologous Bone Marrow Into Central Vein, Percutaneous Approach	18	3	—	—	$6,444.00	$363,283.00	$207,095.00	2026-03-01
30233C0	OTHER	Transfusion Of Autologous Hematopoietic Stem/Progenitor Cells, Genetically Modif…	18	3	—	—	$6,444.00	$363,283.00	$207,095.00	2026-03-01
30230Y0	OTHER	Transfusion Of Autologous Hematopoietic Stem Cells Into Peripheral Vein, Open Ap…	18	3	—	—	$6,444.00	$363,283.00	$207,095.00	2026-03-01
30243C0	OTHER	Transfusion Of Autologous Hematopoietic Stem/Progenitor Cells, Genetically Modif…	18	3	—	—	$6,444.00	$363,283.00	$207,095.00	2026-03-01
30260G0	OTHER	Transfusion Of Autologous Bone Marrow Into Central Artery, Open Approach	18	3	—	—	$6,444.00	$363,283.00	$207,095.00	2026-03-01
30243Y0	OTHER	Transfusion Of Autologous Hematopoietic Stem Cells Into Central Vein, Percutaneo…	18	3	—	—	$6,444.00	$363,283.00	$207,095.00	2026-03-01
30250G0	OTHER	Transfusion Of Autologous Bone Marrow Into Peripheral Artery, Open Approach	18	3	—	—	$6,444.00	$363,283.00	$207,095.00	2026-03-01
30253Y0	OTHER	Transfusion Of Autologous Hematopoietic Stem Cells Into Peripheral Artery, Percu…	18	3	—	—	$6,444.00	$363,283.00	$207,095.00	2026-03-01
30260Y0	OTHER	Transfusion Of Autologous Hematopoietic Stem Cells Into Central Artery, Open App…	18	3	—	—	$6,444.00	$363,283.00	$207,095.00	2026-03-01
30230C0	OTHER	Transfusion Of Autologous Hematopoietic Stem/Progenitor Cells, Genetically Modif…	18	3	—	—	$6,444.00	$363,283.00	$207,095.00	2026-03-01
30250Y0	OTHER	Transfusion Of Autologous Hematopoietic Stem Cells Into Peripheral Artery, Open …	18	3	—	—	$6,444.00	$363,283.00	$207,095.00	2026-03-01
30230G0	OTHER	Transfusion Of Autologous Bone Marrow Into Peripheral Vein, Open Approach Pediat…	18	3	—	—	$6,444.00	$363,283.00	$207,095.00	2026-03-01
30263Y0	OTHER	Transfusion Of Autologous Hematopoietic Stem Cells Into Central Artery, Percutan…	18	3	—	—	$6,444.00	$363,283.00	$207,095.00	2026-03-01
30233G0	OTHER	Transfusion Of Autologous Bone Marrow Into Peripheral Vein, Percutaneous Approac…	18	3	—	—	$6,444.00	$363,283.00	$207,095.00	2026-03-01
886	OTHER	Inj. Remestemcel-l-rknd/	45	27	—	—	$7,959.14	$528,372.78	$211,752.45	2026-03-01
018	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	2	2	—	—	$214,466.22	$221,099.20	$217,782.71	2026-03-01
235269	CDM	Tavr Heart Valve 29mm	51	30	$488,870.00	$488,870.00	$53,775.70	$488,870.00	$219,991.50	2026-03-01
30260X0	OTHER	Transfusion Of Autologous Cord Blood Stem Cells Into Central Artery, Open Approa…	20	3	—	—	$6,444.00	$363,283.00	$224,492.00	2026-03-01
30250X0	OTHER	Transfusion Of Autologous Cord Blood Stem Cells Into Peripheral Artery, Open App…	20	3	—	—	$6,444.00	$363,283.00	$224,492.00	2026-03-01
30240X0	OTHER	Transfusion Of Autologous Cord Blood Stem Cells Into Central Vein, Open Approach…	20	3	—	—	$6,444.00	$363,283.00	$224,492.00	2026-03-01
30253X0	OTHER	Transfusion Of Autologous Cord Blood Stem Cells Into Peripheral Artery, Percutan…	20	3	—	—	$6,444.00	$363,283.00	$224,492.00	2026-03-01
30243X0	OTHER	Transfusion Of Autologous Cord Blood Stem Cells Into Central Vein, Percutaneous …	20	3	—	—	$6,444.00	$363,283.00	$224,492.00	2026-03-01
30263X0	OTHER	Transfusion Of Autologous Cord Blood Stem Cells Into Central Artery, Percutaneou…	20	3	—	—	$6,444.00	$363,283.00	$224,492.00	2026-03-01
30230X0	OTHER	Transfusion Of Autologous Cord Blood Stem Cells Into Peripheral Vein, Open Appro…	20	3	—	—	$6,444.00	$363,283.00	$224,492.00	2026-03-01
30233X0	OTHER	Transfusion Of Autologous Cord Blood Stem Cells Into Peripheral Vein, Percutaneo…	20	3	—	—	$6,444.00	$363,283.00	$224,492.00	2026-03-01
30233G2	OTHER	Transfusion Of Allogeneic Related Bone Marrow Into Peripheral Vein, Percutaneous…	13	3	—	—	$12,082.00	$352,753.00	$232,617.00	2026-03-01
30240Y2	OTHER	Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Central Vein, Op…	13	3	—	—	$12,082.00	$352,753.00	$232,617.00	2026-03-01
30233U2	OTHER	Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into …	13	3	—	—	$12,082.00	$352,753.00	$232,617.00	2026-03-01
30240U2	OTHER	Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into …	13	3	—	—	$12,082.00	$352,753.00	$232,617.00	2026-03-01
30230Y2	OTHER	Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Peripheral Vein,…	13	3	—	—	$12,082.00	$352,753.00	$232,617.00	2026-03-01
30233Y2	OTHER	Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Peripheral Vein,…	13	3	—	—	$12,082.00	$352,753.00	$232,617.00	2026-03-01
30243G2	OTHER	Transfusion Of Allogeneic Related Bone Marrow Into Central Vein, Percutaneous Ap…	13	3	—	—	$12,082.00	$352,753.00	$232,617.00	2026-03-01
30230G2	OTHER	Transfusion Of Allogeneic Related Bone Marrow Into Peripheral Vein, Open Approac…	13	3	—	—	$12,082.00	$352,753.00	$232,617.00	2026-03-01
30243Y2	OTHER	Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Central Vein, Pe…	13	3	—	—	$12,082.00	$352,753.00	$232,617.00	2026-03-01
30230U2	OTHER	Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into …	13	3	—	—	$12,082.00	$352,753.00	$232,617.00	2026-03-01
30240G2	OTHER	Transfusion Of Allogeneic Related Bone Marrow Into Central Vein, Open Approach P…	13	3	—	—	$12,082.00	$352,753.00	$232,617.00	2026-03-01
30243U2	OTHER	Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into …	13	3	—	—	$12,082.00	$352,753.00	$232,617.00	2026-03-01
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	62	30	—	—	$70,000.00	$842,426.46	$233,078.24	2026-03-01
30240X2	OTHER	Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Central Vein, Open …	15	3	—	—	$12,082.00	$352,753.00	$236,778.00	2026-03-01
30233X2	OTHER	Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Peripheral Vein, Pe…	15	3	—	—	$12,082.00	$352,753.00	$236,778.00	2026-03-01
30243X2	OTHER	Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Central Vein, Percu…	15	3	—	—	$12,082.00	$352,753.00	$236,778.00	2026-03-01
30230X2	OTHER	Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Peripheral Vein, Op…	15	3	—	—	$12,082.00	$352,753.00	$236,778.00	2026-03-01
02YA0Z1	OTHER	Transplantation Of Heart, Syngeneic, Open Approach	7	4	—	—	$17,488.00	$304,500.00	$244,189.00	2026-03-01
02YA0Z0	OTHER	Transplantation Of Heart, Allogeneic, Open Approach	7	4	—	—	$17,488.00	$304,500.00	$244,189.00	2026-03-01
30233X4	OTHER	Transfusion Of Allogeneic Unspecified Cord Blood Stem Cells Into Peripheral Vein…	1	1	—	—	$244,860.00	$244,860.00	$244,860.00	2026-03-01
30240X4	OTHER	Transfusion Of Allogeneic Unspecified Cord Blood Stem Cells Into Central Vein, O…	1	1	—	—	$244,860.00	$244,860.00	$244,860.00	2026-03-01
30243X4	OTHER	Transfusion Of Allogeneic Unspecified Cord Blood Stem Cells Into Central Vein, P…	1	1	—	—	$244,860.00	$244,860.00	$244,860.00	2026-03-01
30230X4	OTHER	Transfusion Of Allogeneic Unspecified Cord Blood Stem Cells Into Peripheral Vein…	1	1	—	—	$244,860.00	$244,860.00	$244,860.00	2026-03-01
02YA0Z2	OTHER	Transplantation Of Heart, Zooplastic, Open Approach	8	4	—	—	$17,488.00	$304,500.00	$247,307.00	2026-03-01
24	APR_DRG	Heart And/or Lung Transplant	35	12	—	—	$236,581.86	$420,323.00	$252,193.86	2026-03-01
00897	OTHER	Revakinagene, Per Implant	2	2	—	—	$257,050.00	$265,000.00	$261,025.00	2026-03-01
30260X1	OTHER	Transfusion Of Nonautologous Cord Blood Stem Cells Into Central Artery, Open App…	2	1	—	—	$244,860.00	$278,250.00	$261,555.00	2026-03-01
30253X1	OTHER	Transfusion Of Nonautologous Cord Blood Stem Cells Into Peripheral Artery, Percu…	2	1	—	—	$244,860.00	$278,250.00	$261,555.00	2026-03-01
30263X1	OTHER	Transfusion Of Nonautologous Cord Blood Stem Cells Into Central Artery, Percutan…	2	1	—	—	$244,860.00	$278,250.00	$261,555.00	2026-03-01
30250X1	OTHER	Transfusion Of Nonautologous Cord Blood Stem Cells Into Peripheral Artery, Open …	2	1	—	—	$244,860.00	$278,250.00	$261,555.00	2026-03-01
5833	APR_DRG	Neonate With Ecmo	26	11	—	—	$245,934.33	$312,099.40	$262,163.50	2026-03-01
867737	CDM	Device Vntrc Asst Kit Pm	51	30	$606,158.00	$606,158.00	$66,677.38	$606,158.00	$272,771.10	2026-03-01
00831	OTHER	Obecbtge Autol Up To 400	2	2	—	—	$269,902.50	$278,250.00	$274,076.25	2026-03-01
897	OTHER	Revakinagene, Per Implant	41	25	—	—	$263,675.00	$694,300.00	$278,250.00	2026-03-01
30230X3	OTHER	Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Peripheral Vein, …	11	3	—	—	$9,664.00	$363,283.00	$280,356.00	2026-03-01
30233X3	OTHER	Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Peripheral Vein, …	11	3	—	—	$9,664.00	$363,283.00	$280,356.00	2026-03-01
30243X3	OTHER	Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Central Vein, Per…	10	3	—	—	$12,082.00	$363,283.00	$285,981.00	2026-03-01
30240X3	OTHER	Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Central Vein, Ope…	10	3	—	—	$12,082.00	$363,283.00	$285,981.00	2026-03-01
30240U3	OTHER	Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int…	10	3	—	—	$9,664.00	$363,283.00	$285,981.00	2026-03-01
30243Y3	OTHER	Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Central Vein, …	10	3	—	—	$9,664.00	$363,283.00	$285,981.00	2026-03-01
30230Y3	OTHER	Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Peripheral Vei…	10	3	—	—	$9,664.00	$363,283.00	$285,981.00	2026-03-01
30233G3	OTHER	Transfusion Of Allogeneic Unrelated Bone Marrow Into Peripheral Vein, Percutaneo…	10	3	—	—	$9,664.00	$363,283.00	$285,981.00	2026-03-01
30243U3	OTHER	Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int…	10	3	—	—	$9,664.00	$363,283.00	$285,981.00	2026-03-01
30243G3	OTHER	Transfusion Of Allogeneic Unrelated Bone Marrow Into Central Vein, Percutaneous …	10	3	—	—	$9,664.00	$363,283.00	$285,981.00	2026-03-01
30233U3	OTHER	Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int…	10	3	—	—	$9,664.00	$363,283.00	$285,981.00	2026-03-01
30240Y3	OTHER	Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Central Vein, …	10	3	—	—	$9,664.00	$363,283.00	$285,981.00	2026-03-01
30240G3	OTHER	Transfusion Of Allogeneic Unrelated Bone Marrow Into Central Vein, Open Approach…	10	3	—	—	$9,664.00	$363,283.00	$285,981.00	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	$289,037.14	2026-03-01
30233Y3	OTHER	Transfusion Of Allogeneic Unrelated Hamatopoietic Stem Cells Into Peripheral Vei…	9	3	—	—	$12,082.00	$363,283.00	$291,606.00	2026-03-01
30230G3	OTHER	Transfusion Of Allogeneic Unrelated Bone Marrow Into Peripheral Vein, Open Appro…	9	3	—	—	$12,082.00	$363,283.00	$291,606.00	2026-03-01
30230U3	OTHER	Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int…	9	3	—	—	$12,082.00	$363,283.00	$291,606.00	2026-03-01
831	OTHER	Obecbtge Autol Up To 400	45	27	—	—	$3,637.35	$729,015.00	$292,162.50	2026-03-01
74	APR_DRG	Allogeneic Bone Marrow Transplant	35	12	—	—	$282,540.77	$501,976.00	$301,185.59	2026-03-01
Q2043	HCPCS	Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm…	19	5	—	—	$55,306.59	$478,449.94	$307,485.36	2026-03-01
5834	APR_DRG	Neonate With Ecmo	26	11	—	—	$290,440.49	$368,579.30	$309,606.61	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
J3402	HCPCS	Injection, Remestemcel-l-rknd, Per Therapeutic Dose	3	1	—	—	$332,753.88	$332,753.88	$332,753.88	2026-03-01
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	39	22	—	—	$315,864.19	$1,273,072.13	$338,425.92	2026-03-01
J9029	HCPCS	Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose	18	5	—	—	$61,338.53	$888,000.00	$405,600.00	2026-03-01
860906	CDM	Kit Impl Lvas W/grafts	51	30	$1,050,000.00	$1,050,000.00	$115,500.00	$1,050,000.00	$472,500.00	2026-03-01
219919	CDM	Device Vntrc Asst Strl	51	30	$1,069,320.00	$1,069,320.00	$117,625.20	$1,069,320.00	$481,194.00	2026-03-01
867736	CDM	Implant Hvas Ordr Set	51	30	$1,069,320.00	$1,069,320.00	$117,625.20	$1,069,320.00	$481,194.00	2026-03-01
09391	OTHER	Brexucabtagene Car Pos T	2	2	—	—	$474,766.69	$489,450.20	$482,108.45	2026-03-01
9391	OTHER	Brexucabtagene Car Pos T	43	26	—	—	$487,002.95	$1,282,359.52	$513,922.71	2026-03-01
443630	CDM	Kit Hrt Implant Lvas	51	30	$1,151,100.00	$1,151,100.00	$126,621.00	$1,151,100.00	$517,995.00	2026-03-01
09035	OTHER	Axicabtagene Ciloleucel C	2	2	—	—	$516,226.43	$532,192.20	$524,209.31	2026-03-01
09422	OTHER	Idecabtagene Vicleucel Ca	2	2	—	—	$541,339.35	$558,081.80	$549,710.57	2026-03-01
09413	OTHER	Lisocabtagene Car Pos T	2	2	—	—	$545,335.16	$562,201.20	$553,768.18	2026-03-01
09194	OTHER	Tisagenlecleucel Car-pos	2	2	—	—	$549,535.36	$566,531.30	$558,033.33	2026-03-01
9035	OTHER	Axicabtagene Ciloleucel C	43	26	—	—	$529,531.24	$1,394,343.56	$558,801.81	2026-03-01
09498	OTHER	Ciltacabtagene Car-pos T	2	2	—	—	$570,020.11	$587,649.60	$578,834.85	2026-03-01
9422	OTHER	Idecabtagene Vicleucel Ca	43	26	—	—	$555,291.39	$1,462,174.32	$585,985.89	2026-03-01
9413	OTHER	Lisocabtagene Car Pos T	43	26	—	—	$559,390.19	$1,472,967.14	$590,311.26	2026-03-01
9194	OTHER	Tisagenlecleucel Car-pos	43	26	—	—	$563,698.64	$1,484,312.01	$594,857.87	2026-03-01
9498	OTHER	Ciltacabtagene Car-pos T	43	26	—	—	$565,868.90	$1,539,641.95	$617,032.08	2026-03-01
2067	OTHER	Afamitresgene Autoleucel	46	27	—	—	$766,766.90	$2,019,024.40	$809,151.00	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
Q2055	HCPCS	Idecabtagene	65	33	—	—	$416,855.60	$4,764,064.00	$1,845,479.29	2026-03-01
Q2058	HCPCS	Obecabtagene Inj	65	34	—	—	$371,000.00	$4,717,000.00	$1,976,900.00	2026-03-01
Q2042	HCPCS	Tisagenlecleucel Adult	56	26	—	—	$23.68	$4,817,860.09	$2,094,010.50	2026-03-01
Q2053	HCPCS	Brexucabtagene	56	26	—	—	$474,717.03	$4,880,294.09	$2,121,146.50	2026-03-01
Q2041	HCPCS	Axicabtagene Adult	51	23	—	—	$6.22	$4,965,250.67	$2,148,599.38	2026-03-01
Q2054	HCPCS	Lisocabtagene	47	19	—	—	$500,948.74	$4,981,060.92	$2,249,511.38	2026-03-01
00824	OTHER	Inj, Exagamglogene Autote	2	2	—	—	$2,262,040.00	$2,332,000.00	$2,297,020.00	2026-03-01
Q2056	HCPCS	Ciltacabtagene 100 Mil	46	19	—	—	$536,573.93	$4,937,864.25	$2,360,299.11	2026-03-01
824	OTHER	Inj, Exagamglogene Autote	42	26	—	—	$12,881.06	$4,617,360.00	$2,425,280.00	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
09141	OTHER	Inj Onase Abepar-xioi Tre	2	2	—	—	$2,511,311.57	$2,588,981.00	$2,550,146.29	2026-03-01
9141	OTHER	Inj Onase Abepar-xioi Tre	39	24	—	—	$2,455,110.00	$4,919,063.90	$2,718,430.05	2026-03-01
00746	OTHER	Inj, Betibeglogene Autote	2	2	—	—	$2,851,769.93	$2,939,969.00	$2,895,869.46	2026-03-01
746	OTHER	Inj, Betibeglogene Autote	42	24	—	—	$11,000.28	$4,409,953.50	$3,057,567.76	2026-03-01
00906	OTHER	Inj Elivaldogene Autoteme	2	2	—	—	$3,084,600.00	$3,180,000.00	$3,132,300.00	2026-03-01
00748	OTHER	Inj, Lovotibeglogene Auto	2	2	—	—	$3,154,932.76	$3,252,508.00	$3,203,720.38	2026-03-01
906	OTHER	Inj Elivaldogene Autoteme	37	22	—	—	$8,498.59	$4,770,000.00	$3,275,400.00	2026-03-01
00714	OTHER	Inj Delandistrogene Mox R	2	2	—	—	$3,228,024.20	$3,327,860.00	$3,277,942.10	2026-03-01
00908	OTHER	Topi Adm Prad Zami Per Tr	2	2	—	—	$3,235,745.40	$3,335,820.00	$3,285,782.70	2026-03-01
748	OTHER	Inj, Lovotibeglogene Auto	42	24	—	—	$11,892.06	$4,878,762.00	$3,382,608.32	2026-03-01
908	OTHER	Topi Adm Prad Zami Per Tr	32	21	—	—	$9,617.95	$4,336,566.00	$3,385,857.30	2026-03-01
714	OTHER	Inj Delandistrogene Mox R	42	24	—	—	$6,247.51	$4,991,790.00	$3,460,974.40	2026-03-01
09138	OTHER	Inj, Hemgenix, Per Tx Dos	2	2	—	—	$3,574,708.99	$3,685,267.00	$3,629,988.00	2026-03-01
9138	OTHER	Inj, Hemgenix, Per Tx Dos	32	21	—	—	$3,666,840.67	$4,790,847.10	$3,740,546.00	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
00845	OTHER	Inj, Atidarsagene Autotem	2	2	—	—	$4,369,850.00	$4,505,000.00	$4,437,425.00	2026-03-01
845	OTHER	Inj, Atidarsagene Autotem	32	20	—	—	$5,311.90	$4,955,500.00	$4,535,408.75	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

See an error in this hospital's data? Submit a correction