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

VALLEY REGIONAL MEDICAL CENTER

Brownsville, TX · CCN 450662 · Rates published

27,488 distinct procedures filed
44 distinct payers
1,073,137 rate rows
2026-03-01 last MRF observed
Data quality

1,040,262 of 1,073,137 rate rows are consumer-grade (96.9%)

32,875 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 17,134
per-diem day rate — not a per-procedure price 9,777
template filing: same amount across many unrelated codes — excluded 4,779
exceeds 10× this hospital's gross charge — excluded from medians 1,018
placeholder amount (≤ $0.02) — excluded from medians 167
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://valleyregionalmedicalcenter.com/dA/5753c2b90b/fileAsset/62-1669572_VALLEY-REGIONAL-MEDICAL-CENTER_standardcharges.json
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-05-17
Content fingerprint c75c4b239292e2e0… · 538,814,112 bytes · first seen 2026-05-13

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $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 15 $4,491,485.00 $4,910,450.00 $4,505,000.00 nat. median
$9,966
outlier · 452.1×
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 15 $3,674,211.20 $4,016,941.03 $3,685,267.00 nat. median
$3,746,358
1.0× median
908
OTHER 		Topi Adm Prad Zami Per Tr 15 $3,325,812.54 $3,636,043.80 $3,335,820.00 nat. median
$22,747
outlier · 146.6×
714
OTHER 		Inj Delandistrogene Mox R 15 $3,317,876.42 $3,627,367.40 $3,327,860.00 nat. median
$13,041
outlier · 255.2×
748
OTHER 		Inj, Lovotibeglogene Auto 15 $3,242,750.48 $3,545,233.72 $3,252,508.00 nat. median
$17,963
outlier · 181.1×
906
OTHER 		Inj Elivaldogene Autoteme 16 $3,170,460.00 $4,929,000.00 $3,193,515.00 nat. median
$20,756
outlier · 153.9×
746
OTHER 		Inj, Betibeglogene Autote 16 $2,931,149.09 $4,556,951.95 $2,952,463.87 nat. median
$21,896
outlier · 134.8×
9141
OTHER 		Inj Onase Abepar-xioi Tre 16 $2,581,214.06 $4,012,920.55 $2,599,984.17 nat. median
$2,588,981
1.0× median
824
OTHER 		Inj, Exagamglogene Autote 19 $2,325,004.00 $4,897,200.00 $2,378,640.00 nat. median
$25,250
outlier · 94.2×
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 2 $1,033,270.56 $1,700,133.12 $1,516,929.12 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 $1,227,744.00 $1,095,444.00 nat. median
$324,450
outlier · 3.4×
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 2 $653,027.40 $1,074,484.80 $969,621.79 nat. median
$675,122
1.4× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 2 $589,129.02 $969,347.04 $919,208.40 nat. median
$625,184
1.5× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 2 $576,208.91 $948,088.42 $899,049.36 nat. median
$674,188
1.3× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 2 $523,826.28 $861,898.56 $807,592.83 nat. median
$620,080
1.3× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 3 $48.69 $934,776.65 $795,273.30 nat. median
$754,974
1.1× median
2067
OTHER 		Afamitresgene Autoleucel 19 $768,308.14 $1,618,302.00 $786,032.40 nat. median
$786,032
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 3 $12.80 $878,117.20 $733,504.50 nat. median
$634,511
1.2× median
9498
OTHER 		Ciltacabtagene Car-pos T 19 $585,886.65 $1,234,064.16 $599,402.59 nat. median
$587,650
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos 19 $564,831.71 $1,189,715.73 $577,861.93 nat. median
$566,531
1.0× median
C9301
HCPCS 		Obecabtagene Autoleucel, Up To 400 Million Cd19 Car-positive Viable T Cells, Inc… 1 $392,332.50 $645,540.00 $575,977.50 nat. median
$459,112
1.3× median
9413
OTHER 		Lisocabtagene Car Pos T 19 $560,514.60 $1,180,622.52 $573,445.22 nat. median
$562,201
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 19 $556,407.55 $1,171,971.78 $569,243.44 nat. median
$558,082
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 19 $530,595.62 $1,117,603.62 $542,836.04 nat. median
$532,192
1.0× median
9391
OTHER 		Brexucabtagene Car Pos T 19 $487,981.85 $1,027,845.42 $499,239.20 nat. median
$489,450
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 19 $322,871.08 $1,045,326.04 $344,846.60 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
5834
APR_DRG 		Neonate With Ecmo 7 $288,154.47 $334,375.72 $293,975.77 nat. median
$309,665
0.9× median
831
OTHER 		Obecbtge Autol Up To 400 19 $277,415.25 $584,325.00 $283,815.00 nat. median
$12,362
outlier · 23.0×
74
APR_DRG 		Allogeneic Bone Marrow Transplant 6 $280,316.94 $495,510.00 $283,148.42 nat. median
$187,294
1.5× median
897
OTHER 		Revakinagene, Per Implant 19 $264,205.00 $556,500.00 $270,300.00 nat. median
$9,577
outlier · 28.2×
5833
APR_DRG 		Neonate With Ecmo 7 $243,998.62 $283,137.07 $248,927.89 nat. median
$244,017
1.0× median
24
APR_DRG 		Heart And/or Lung Transplant 6 $234,719.75 $414,909.00 $237,090.66 nat. median
$234,738
1.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 20 $158,818.00 $678,374.55 $224,719.26 nat. median
$265,286
0.8× median
886
OTHER 		Inj. Remestemcel-l-rknd/ 19 $201,063.99 $423,504.90 $205,702.38 nat. median
$17,985
outlier · 11.4×
L5969
HCPCS 		Addition, Endoskeletal Ankle-foot Or Ankle System, Power Assist, Includes Any Ty… 1 $202,735.57 $202,735.57 $202,735.57 nat. median
$15,234
outlier · 13.3×
J9029
HCPCS 		Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 3 $106,053.40 $371,200.00 $191,400.00 nat. median
$69,774
outlier · 2.7×
1614
APR_DRG 		Implantable Heart Assist Systems 7 $177,120.05 $205,530.89 $187,854.60 nat. median
$207,730
0.9× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc Pediatric 1 $121,639.93 $249,049.93 $187,848.66 nat. median
$87,411
outlier · 2.1×
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 7 $182,397.06 $211,654.34 $186,081.85 nat. median
$246,434
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 21 $123,311.00 $517,873.68 $175,867.55 nat. median
$202,986
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 20 $19,840.00 $516,831.55 $171,835.63 nat. median
$206,368
0.8× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 7 $165,933.59 $192,550.08 $169,285.79 nat. median
$164,834
1.0× median
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 $105,263.29 $215,519.81 $162,558.19 nat. median
$63,570
outlier · 2.6×
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 $99,545.36 $203,812.72 $153,728.00 nat. median
$54,196
outlier · 2.8×
1908
OTHER 		New Technology - Level 52 19 $149,497.76 $314,889.96 $152,946.55 nat. median
$152,962
1.0× median
1907
OTHER 		New Technology - Level 52 19 $149,497.76 $314,889.96 $152,946.55 nat. median
$153,199
1.0× median

Other procedures at this hospital

Browse this hospital's 27,488 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
             
37233 CPT Revsc Tb/pr Ath Add Bi 86 26 $201,004.44 $201,004.44 $300.00 $180,904.00 $49,681.60 2026-03-01
37229 CPT Revsc Tb/pr W Ath Ini Bi 86 29 $201,004.44 $201,004.44 $300.00 $180,904.00 $46,231.02 2026-03-01
37230 CPT Revsc Tib/per Stnt Init 86 29 $134,002.95 $134,002.95 $300.00 $180,904.00 $46,231.02 2026-03-01
37225 CPT Revsc Fem/pop W Ath Bi 86 29 $201,004.44 $201,004.44 $300.00 $180,904.00 $46,231.02 2026-03-01
37226 CPT Revsc Fem/pop W Stnt 86 29 $134,002.95 $134,002.95 $300.00 $180,904.00 $46,231.02 2026-03-01
92924 CPT Ptca Cor Sgl Arty Ld 75 24 $136,804.76 $136,804.76 $300.00 $124,264.32 $53,307.62 2026-03-01
215 MS_DRG Other Heart Assist System Implant 67 25 — — $42,318.00 $286,195.99 $83,945.87 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 67 25 — — $42,318.00 $272,125.27 $82,524.82 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 67 25 — — $42,318.00 $236,253.19 $71,488.39 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 67 25 — — $42,318.00 $218,409.31 $65,357.12 2026-03-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 67 25 — — $15,728.00 $188,747.21 $58,827.77 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 67 25 — — $42,318.00 $165,598.69 $56,359.28 2026-03-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 67 25 — — $42,318.00 $175,741.75 $56,359.28 2026-03-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 67 25 — — $42,318.00 $161,383.70 $54,164.55 2026-03-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 67 25 — — $42,041.32 $185,369.00 $52,939.00 2026-03-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 67 25 — — $34,096.00 $165,457.73 $52,521.69 2026-03-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 67 25 — — $39,870.36 $185,369.00 $49,614.06 2026-03-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 67 25 — — $15,728.00 $140,598.82 $45,762.53 2026-03-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 67 25 — — $33,553.36 $111,053.28 $42,318.00 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 65 24 — — $27,527.00 $233,111.60 $69,914.65 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 65 24 — — $39,895.00 $214,741.86 $66,326.86 2026-03-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 65 24 — — $27,527.00 $176,077.87 $51,365.18 2026-03-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 65 24 — — $34,733.00 $144,637.62 $48,183.75 2026-03-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 65 24 — — $16,222.00 $164,850.56 $46,865.02 2026-03-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 65 24 — — $39,181.83 $144,483.11 $44,720.62 2026-03-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 65 24 — — $16,222.00 $144,900.54 $43,893.18 2026-03-01
471 MS_DRG Cervical Spinal Fusion With Mcc 65 24 — — $6,488.00 $136,063.99 $41,309.07 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 59 24 — — $60,857.28 $282,532.00 $66,911.15 2026-03-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 59 24 — — $43,279.00 $201,150.92 $64,880.72 2026-03-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 59 24 — — $7,093.00 $174,535.53 $59,104.31 2026-03-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 59 24 — — $49,464.00 $170,477.77 $57,630.23 2026-03-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 59 24 — — $7,093.00 $155,764.78 $55,212.32 2026-03-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 59 24 — — $19,840.00 $158,589.74 $54,559.62 2026-03-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 59 24 — — $47,944.30 $191,040.38 $52,713.63 2026-03-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 59 24 — — $19,840.00 $158,621.60 $52,655.72 2026-03-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 59 24 — — $19,840.00 $154,279.22 $50,563.29 2026-03-01
28 MS_DRG Spinal Procedures With Mcc 59 24 — — $19,814.00 $157,840.95 $50,255.80 2026-03-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 59 24 — — $29,175.00 $153,742.52 $48,523.88 2026-03-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 59 24 — — $31,443.00 $145,567.35 $48,277.41 2026-03-01
834 MS_DRG Acute Leukemia With Mcc 59 24 — — $7,093.00 $164,050.93 $47,505.00 2026-03-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 59 24 — — $19,840.00 $155,523.39 $47,346.74 2026-03-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 59 24 — — $19,840.00 $136,110.07 $47,212.96 2026-03-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 59 24 — — $41,751.95 $282,532.00 $45,905.29 2026-03-01
653 MS_DRG Major Bladder Procedures With Mcc 59 24 — — $19,840.00 $147,977.08 $45,110.74 2026-03-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 59 24 — — $19,840.00 $144,103.63 $43,405.80 2026-03-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 59 24 — — $19,840.00 $134,657.19 $43,007.71 2026-03-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 59 24 — — $19,840.00 $130,542.50 $42,869.84 2026-03-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 59 24 — — $19,840.00 $137,256.65 $42,702.61 2026-03-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 59 24 — — $7,093.00 $154,485.23 $41,912.14 2026-03-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 59 24 — — $37,797.33 $151,739.39 $41,557.28 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 57 22 — — $105,245.49 $335,300.84 $115,714.93 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 57 25 — — $42,318.00 $172,605.59 $60,887.57 2026-03-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 57 25 — — $42,318.00 $145,401.77 $51,720.04 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 55 24 — — $23,594.00 $266,790.19 $88,216.39 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 55 24 — — $23,594.00 $218,095.39 $72,587.95 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 55 24 — — $23,594.00 $174,740.65 $58,673.40 2026-03-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 55 24 — — $16,222.00 $161,741.49 $55,591.39 2026-03-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 55 24 — — $23,594.00 $139,604.19 $48,344.39 2026-03-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 55 24 — — $23,594.00 $136,091.75 $47,194.54 2026-03-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 55 24 — — $16,222.00 $129,013.63 $44,877.41 2026-03-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 54 24 — — $25,286.00 $138,146.93 $47,867.34 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 53 24 — — $46,758.00 $273,994.19 $92,339.06 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 51 21 — — $123,311.00 $517,873.68 $175,867.55 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 51 24 — — $19,840.00 $263,229.34 $87,073.55 2026-03-01
137227 CDM Fem/pop Revas Stnt/ather 46 24 $173,394.56 $173,394.56 $300.00 $156,055.10 $56,873.41 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 43 23 — — $19,840.00 $209,620.52 $71,265.34 2026-03-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 43 23 — — $45,575.00 $161,860.11 $55,630.22 2026-03-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 43 23 — — $13,314.00 $134,741.00 $46,752.35 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 41 20 — — $19,840.00 $516,831.55 $171,835.63 2026-03-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 41 20 — — $19,840.00 $173,629.55 $59,483.13 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 40 20 — — $158,818.00 $678,374.55 $224,719.26 2026-03-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 40 19 — — $89,320.00 $199,670.10 $98,884.24 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 40 20 — — $86,551.16 $274,308.88 $92,442.08 2026-03-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 40 19 — — $6,270.00 $75,000.00 $49,742.29 2026-03-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 38 20 — — $55,409.85 $172,707.26 $59,181.21 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 37 19 — — $322,871.08 $1,045,326.04 $344,846.60 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 37 19 — — $111,157.52 $1,295,217.71 $114,836.76 2026-03-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 37 19 — — $49,857.18 $580,939.09 $51,507.42 2026-03-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 37 19 — — $49,452.00 $576,218.80 $51,088.82 2026-03-01
824 OTHER Inj, Exagamglogene Autote 35 19 — — $2,325,004.00 $4,897,200.00 $2,378,640.00 2026-03-01
2067 OTHER Afamitresgene Autoleucel 35 19 — — $768,308.14 $1,618,302.00 $786,032.40 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 35 19 — — $585,886.65 $1,234,064.16 $599,402.59 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 35 19 — — $564,831.71 $1,189,715.73 $577,861.93 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 35 19 — — $560,514.60 $1,180,622.52 $573,445.22 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 35 19 — — $556,407.55 $1,171,971.78 $569,243.44 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 35 19 — — $530,595.62 $1,117,603.62 $542,836.04 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 35 19 — — $487,981.85 $1,027,845.42 $499,239.20 2026-03-01
831 OTHER Obecbtge Autol Up To 400 35 19 — — $277,415.25 $584,325.00 $283,815.00 2026-03-01
897 OTHER Revakinagene, Per Implant 35 19 — — $264,205.00 $556,500.00 $270,300.00 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 35 19 — — $201,063.99 $423,504.90 $205,702.38 2026-03-01
1907 OTHER New Technology - Level 52 35 19 — — $149,497.76 $314,889.96 $152,946.55 2026-03-01
1908 OTHER New Technology - Level 52 35 19 — — $149,497.76 $314,889.96 $152,946.55 2026-03-01
1906 OTHER New Technology - Level 51 35 19 — — $134,793.10 $283,917.27 $137,902.67 2026-03-01
1905 OTHER New Technology - Level 51 35 19 — — $134,793.10 $283,917.27 $137,902.67 2026-03-01
1904 OTHER New Technology - Level 50 35 19 — — $120,088.45 $252,944.58 $122,858.80 2026-03-01
1903 OTHER New Technology - Level 50 35 19 — — $120,088.45 $252,944.58 $122,858.80 2026-03-01
1901 OTHER New Technology - Level 49 35 19 — — $105,383.80 $221,971.89 $107,814.92 2026-03-01
1902 OTHER New Technology - Level 49 35 19 — — $105,383.80 $221,971.89 $107,814.92 2026-03-01
7 MS_DRG Lung Transplant 35 19 — — $98,558.96 $180,605.43 $105,267.16 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 35 19 — — $91,641.71 $167,929.84 $97,879.11 2026-03-01
1599 OTHER New Technology - Level 48 35 19 — — $93,129.97 $196,161.42 $95,278.40 2026-03-01
1585 OTHER New Technology - Level 48 35 19 — — $93,129.97 $196,161.42 $95,278.40 2026-03-01
1598 OTHER New Technology - Level 47 35 19 — — $83,326.86 $175,512.94 $85,249.14 2026-03-01
1584 OTHER New Technology - Level 47 35 19 — — $83,326.86 $175,512.94 $85,249.14 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 35 19 — — $78,973.58 $144,715.99 $84,348.75 2026-03-01
1583 OTHER New Technology - Level 46 35 19 — — $73,523.76 $154,864.48 $75,219.89 2026-03-01
1597 OTHER New Technology - Level 46 35 19 — — $73,523.76 $154,864.48 $75,219.89 2026-03-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 35 19 — — $68,595.29 $144,483.57 $70,177.73 2026-03-01
717 OTHER Instill Adstiladrin, Tx D 35 19 — — $64,081.97 $134,977.06 $65,560.29 2026-03-01
1596 OTHER New Technology - Level 45 35 19 — — $63,720.65 $134,216.02 $65,190.64 2026-03-01
1582 OTHER New Technology - Level 45 35 19 — — $63,720.65 $134,216.02 $65,190.64 2026-03-01
5244 OTHER Level 4 Blood Product Exc 35 19 — — $62,998.19 $132,694.27 $64,451.51 2026-03-01
10 MS_DRG Pancreas Transplant 35 19 — — $55,714.80 $102,095.18 $59,506.90 2026-03-01
1643 OTHER Y90 Ibritumomab, Rx 35 19 — — $56,654.08 $119,331.56 $57,961.04 2026-03-01
9273 OTHER Sipuleucel-t Auto Cd54+ 35 19 — — $54,240.90 $114,248.63 $55,492.19 2026-03-01
1581 OTHER New Technology - Level 44 35 19 — — $53,917.55 $113,567.56 $55,161.39 2026-03-01
1595 OTHER New Technology - Level 44 35 19 — — $53,917.55 $113,567.56 $55,161.39 2026-03-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 35 19 — — $46,470.04 $85,154.53 $49,632.92 2026-03-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 35 19 — — $44,057.95 $80,734.47 $47,056.66 2026-03-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 35 19 — — $42,779.56 $78,391.86 $45,691.26 2026-03-01
1580 OTHER New Technology - Level 43 35 19 — — $44,114.45 $92,919.10 $45,132.13 2026-03-01
1594 OTHER New Technology - Level 43 35 19 — — $44,114.45 $92,919.10 $45,132.13 2026-03-01
1142 OTHER Supprelin La Implant 35 19 — — $43,055.78 $90,689.21 $44,049.05 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 32 16 — — $3,170,460.00 $4,929,000.00 $3,193,515.00 2026-03-01
746 OTHER Inj, Betibeglogene Autote 32 16 — — $2,931,149.09 $4,556,951.95 $2,952,463.87 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 32 16 — — $2,581,214.06 $4,012,920.55 $2,599,984.17 2026-03-01
845 OTHER Inj, Atidarsagene Autotem 31 15 — — $4,491,485.00 $4,910,450.00 $4,505,000.00 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 31 15 — — $3,674,211.20 $4,016,941.03 $3,685,267.00 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 31 15 — — $3,325,812.54 $3,636,043.80 $3,335,820.00 2026-03-01
714 OTHER Inj Delandistrogene Mox R 31 15 — — $3,317,876.42 $3,627,367.40 $3,327,860.00 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 31 15 — — $3,242,750.48 $3,545,233.72 $3,252,508.00 2026-03-01
275506 CDM Cage Spn 0d 16-25mm 14mm 26 16 $99,041.50 $99,041.50 $15,252.39 $89,137.35 $44,568.68 2026-03-01
101281 CDM Graft Evas 10cm 10mm 26 16 $97,710.00 $97,710.00 $15,047.34 $87,939.00 $43,969.50 2026-03-01
101961 CDM Graft Evas 26x14.5m 14cm 26 16 $97,710.00 $97,710.00 $15,047.34 $87,939.00 $43,969.50 2026-03-01
101554 CDM Graft Evas 31x14.5m 17cm 26 16 $97,710.00 $97,710.00 $15,047.34 $87,939.00 $43,969.50 2026-03-01
190662 CDM Graft Evas 23x12mm 14cm 26 16 $97,710.00 $97,710.00 $15,047.34 $87,939.00 $43,969.50 2026-03-01
190680 CDM Graft Evas 23x14.5m 16cm 26 16 $97,710.00 $97,710.00 $15,047.34 $87,939.00 $43,969.50 2026-03-01
101409 CDM Graft Evas 35x14.5m 18cm 26 16 $97,710.00 $97,710.00 $15,047.34 $87,939.00 $43,969.50 2026-03-01
168691 CDM Occluder Cv 18x18mm 26 16 $94,863.00 $94,863.00 $14,608.90 $85,376.70 $42,688.35 2026-03-01
C1817 HCPCS Occluder Cv 9f 30mm 26 16 $94,863.00 $94,863.00 $14,608.90 $85,376.70 $42,688.35 2026-03-01
177256 CDM Occluder Cv 25x18mm 26 16 $94,863.00 $94,863.00 $14,608.90 $85,376.70 $42,688.35 2026-03-01
168694 CDM Occluder Cv 35x18mm 26 16 $94,863.00 $94,863.00 $14,608.90 $85,376.70 $42,688.35 2026-03-01
734294 CDM Valve Aortic Med 26 16 $92,367.00 $92,367.00 $14,224.52 $83,130.30 $41,565.15 2026-03-01
734296 CDM Valve Aortic Lg 26 16 $92,367.00 $92,367.00 $14,224.52 $83,130.30 $41,565.15 2026-03-01
101364 CDM Valve Aortic 29mm 26 16 $92,367.00 $92,367.00 $14,224.52 $83,130.30 $41,565.15 2026-03-01
739927 CDM Valve Aortic Sm 26 16 $92,367.00 $92,367.00 $14,224.52 $83,130.30 $41,565.15 2026-03-01
739928 CDM Valve Aortic Xl 26 16 $92,367.00 $92,367.00 $14,224.52 $83,130.30 $41,565.15 2026-03-01
101359 CDM Valve Aortic 27mm 26 16 $92,367.00 $92,367.00 $14,224.52 $83,130.30 $41,565.15 2026-03-01
771101 CDM Spcr Spn 19x50mm 26 16 $92,285.00 $92,285.00 $14,211.89 $83,056.50 $41,528.25 2026-03-01
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 18 5 — — $24,704.88 $221,072.32 $68,786.23 2026-03-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 18 5 — — $30,556.39 $309,495.61 $57,570.49 2026-03-01
5834 APR_DRG Neonate With Ecmo 14 7 — — $288,154.47 $334,375.72 $293,975.77 2026-03-01
5833 APR_DRG Neonate With Ecmo 14 7 — — $243,998.62 $283,137.07 $248,927.89 2026-03-01
1614 APR_DRG Implantable Heart Assist Systems 14 7 — — $177,120.05 $205,530.89 $187,854.60 2026-03-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 14 7 — — $182,397.06 $211,654.34 $186,081.85 2026-03-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 14 7 — — $165,933.59 $192,550.08 $169,285.79 2026-03-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 14 7 — — $135,715.57 $157,484.94 $138,457.29 2026-03-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 14 7 — — $134,512.88 $156,089.34 $137,230.32 2026-03-01
5832 APR_DRG Neonate With Ecmo 14 7 — — $121,578.94 $141,080.74 $124,035.08 2026-03-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 14 7 — — $115,447.16 $133,965.39 $117,779.42 2026-03-01
2004 APR_DRG Cardiac Structural And Valvular Disorders 14 7 — — $107,282.21 $124,490.75 $109,449.53 2026-03-01
5831 APR_DRG Neonate With Ecmo 14 7 — — $107,052.67 $124,224.39 $109,215.35 2026-03-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 14 7 — — $97,868.28 $113,566.79 $99,845.42 2026-03-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 14 7 — — $97,420.98 $113,047.73 $99,389.08 2026-03-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 14 7 — — $97,169.06 $112,755.41 $99,132.08 2026-03-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 14 7 — — $96,751.34 $112,270.69 $98,705.92 2026-03-01
1613 APR_DRG Implantable Heart Assist Systems 14 7 — — $92,317.36 $107,125.47 $97,912.35 2026-03-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 14 7 — — $95,785.02 $111,149.37 $97,720.08 2026-03-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 14 7 — — $93,261.67 $108,221.26 $95,145.74 2026-03-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 14 7 — — $92,426.25 $107,251.83 $94,293.45 2026-03-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 14 7 — — $91,829.46 $106,559.31 $93,684.60 2026-03-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 14 7 — — $82,209.91 $95,396.74 $87,192.33 2026-03-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 14 7 — — $82,255.81 $95,450.01 $83,917.54 2026-03-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 14 7 — — $81,522.82 $94,599.44 $83,169.74 2026-03-01
2464 APR_DRG Gastrointestinal Vascular Insufficiency 14 7 — — $79,720.70 $92,508.25 $81,331.22 2026-03-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 14 7 — — $79,309.43 $92,031.02 $80,911.64 2026-03-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 14 7 — — $76,961.36 $89,306.30 $78,516.14 2026-03-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 14 7 — — $76,731.07 $89,039.07 $78,281.19 2026-03-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 14 7 — — $74,591.28 $86,556.05 $76,098.17 2026-03-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 14 7 — — $71,714.33 $83,217.63 $76,060.66 2026-03-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 14 7 — — $70,537.45 $81,851.97 $71,962.45 2026-03-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 14 7 — — $69,964.94 $81,187.63 $71,378.38 2026-03-01
1612 APR_DRG Implantable Heart Assist Systems 14 7 — — $66,361.83 $77,006.56 $70,383.76 2026-03-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 14 7 — — $66,983.28 $77,727.69 $68,336.48 2026-03-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 14 7 — — $65,603.04 $76,126.06 $66,928.35 2026-03-01
1611 APR_DRG Implantable Heart Assist Systems 14 7 — — $62,938.17 $73,033.73 $66,752.61 2026-03-01
8634 APR_DRG Neonatal Aftercare 14 7 — — $64,585.50 $74,945.30 $65,890.26 2026-03-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 14 7 — — $63,965.20 $74,225.49 $65,257.42 2026-03-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 14 7 — — $62,495.80 $72,520.40 $63,758.34 2026-03-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 14 7 — — $62,474.55 $72,495.74 $63,736.67 2026-03-01
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 14 7 — — $60,862.51 $70,625.12 $62,092.06 2026-03-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 14 7 — — $60,862.51 $70,625.12 $62,092.06 2026-03-01
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 14 7 — — $60,689.88 $70,424.80 $61,915.94 2026-03-01
4414 APR_DRG Major Bladder Procedures 14 7 — — $59,415.11 $68,945.56 $60,615.42 2026-03-01
1784 APR_DRG External Heart Assist Devices 14 7 — — $55,648.86 $64,575.18 $59,021.52 2026-03-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 14 7 — — $54,497.78 $63,239.46 $57,800.67 2026-03-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 14 7 — — $54,802.81 $63,593.42 $55,909.93 2026-03-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 14 7 — — $54,739.83 $63,520.34 $55,845.69 2026-03-01
6904 APR_DRG Acute Leukemia 14 7 — — $54,008.36 $62,671.54 $55,099.44 2026-03-01
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 14 7 — — $53,677.52 $62,287.64 $54,761.92 2026-03-01
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 14 7 — — $53,617.20 $62,217.64 $54,700.38 2026-03-01
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 14 7 — — $51,997.95 $60,338.64 $53,048.41 2026-03-01
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 14 7 — — $50,904.91 $59,070.28 $51,933.29 2026-03-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 14 7 — — $50,594.56 $58,710.16 $51,616.68 2026-03-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 14 7 — — $50,251.59 $58,312.17 $51,266.77 2026-03-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 14 7 — — $49,759.89 $57,741.60 $50,765.14 2026-03-01
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 14 7 — — $47,416.75 $55,022.61 $48,374.67 2026-03-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 14 7 — — $47,158.38 $54,722.80 $48,111.07 2026-03-01
4474 APR_DRG Other Kidney, Urinary Tract And Related Non-percutaneous Procedures 14 7 — — $47,047.98 $54,594.69 $47,998.44 2026-03-01
234 APR_DRG Spinal Procedures 14 7 — — $46,351.04 $53,785.94 $47,287.42 2026-03-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 14 7 — — $46,183.34 $53,591.35 $47,116.34 2026-03-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 14 7 — — $45,589.97 $52,902.80 $46,510.98 2026-03-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 14 7 — — $45,588.07 $52,900.60 $46,509.04 2026-03-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 14 7 — — $45,019.74 $52,241.10 $45,929.23 2026-03-01
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 14 7 — — $44,812.21 $52,000.28 $45,717.51 2026-03-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 14 7 — — $42,741.09 $49,596.95 $45,331.46 2026-03-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 14 7 — — $43,269.21 $50,209.78 $44,143.33 2026-03-01
264 APR_DRG Other Nervous System And Related Procedures 14 7 — — $43,243.03 $50,179.41 $44,116.63 2026-03-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 14 7 — — $43,056.37 $49,962.80 $43,926.19 2026-03-01
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 14 7 — — $42,801.04 $49,666.51 $43,665.71 2026-03-01
1824 APR_DRG Other Upper Vascular Procedures 14 7 — — $42,766.51 $49,626.45 $43,630.49 2026-03-01
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 14 7 — — $42,041.49 $48,785.13 $42,890.81 2026-03-01
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 14 7 — — $42,031.24 $48,773.24 $42,880.36 2026-03-01
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 14 7 — — $40,349.77 $46,822.05 $42,795.21 2026-03-01
2054 APR_DRG Cardiomyopathy 14 7 — — $41,912.49 $48,635.44 $42,759.21 2026-03-01
6954 APR_DRG Chemotherapy For Acute Leukemia 14 7 — — $41,858.62 $48,572.93 $42,704.24 2026-03-01
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 14 7 — — $41,815.75 $48,523.18 $42,660.51 2026-03-01
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 14 7 — — $41,113.11 $47,707.83 $41,943.68 2026-03-01
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 14 7 — — $40,975.39 $47,548.02 $41,803.18 2026-03-01
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 14 7 — — $40,847.53 $47,399.66 $41,672.73 2026-03-01
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition… 14 7 — — $40,418.44 $46,901.73 $41,234.97 2026-03-01
74 APR_DRG Allogeneic Bone Marrow Transplant 13 6 — — $280,316.94 $495,510.00 $283,148.42 2026-03-01
24 APR_DRG Heart And/or Lung Transplant 13 6 — — $234,719.75 $414,909.00 $237,090.66 2026-03-01
73 APR_DRG Allogeneic Bone Marrow Transplant 13 6 — — $98,913.14 $174,846.00 $99,912.26 2026-03-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 13 6 — — $84,080.70 $148,628.00 $84,930.00 2026-03-01
84 APR_DRG Autologous Bone Marrow Transplant 13 6 — — $83,743.80 $148,032.00 $84,589.70 2026-03-01
64 APR_DRG Pancreas Transplant 13 6 — — $76,967.43 $136,054.00 $77,744.88 2026-03-01
72 APR_DRG Allogeneic Bone Marrow Transplant 13 6 — — $66,458.57 $117,477.00 $67,129.87 2026-03-01
4404 APR_DRG Kidney Transplant 13 6 — — $62,782.62 $110,979.00 $63,416.79 2026-03-01
23 APR_DRG Heart And/or Lung Transplant 13 6 — — $57,811.41 $102,192.00 $58,395.36 2026-03-01
83 APR_DRG Autologous Bone Marrow Transplant 13 6 — — $56,604.56 $100,059.00 $57,176.32 2026-03-01
63 APR_DRG Pancreas Transplant 13 6 — — $49,739.41 $87,923.20 $50,241.83 2026-03-01
22 APR_DRG Heart And/or Lung Transplant 13 6 — — $46,441.71 $82,093.90 $46,910.82 2026-03-01
62 APR_DRG Pancreas Transplant 13 6 — — $44,988.63 $79,525.40 $45,443.06 2026-03-01
61 APR_DRG Pancreas Transplant 13 6 — — $44,407.78 $78,498.60 $44,856.34 2026-03-01
71 APR_DRG Allogeneic Bone Marrow Transplant 13 6 — — $43,639.12 $77,139.90 $44,079.92 2026-03-01
13 APR_DRG Liver Transplant And/or Intestinal Transplant 13 6 — — $43,320.43 $76,576.50 $43,758.01 2026-03-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 12 4 — — $53,832.39 $491,411.53 $134,534.14 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 12 4 — — $85,852.35 $638,699.82 $126,038.55 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 12 4 — — $76,894.79 $833,297.23 $123,249.80 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 12 4 — — $51,816.12 $468,293.59 $83,052.79 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 10 3 — — $106,053.40 $371,200.00 $191,400.00 2026-03-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 10 1 — — $35,791.45 $75,823.61 $53,485.78 2026-03-01
341 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Mcc 10 1 — — $29,715.11 $62,950.97 $44,405.44 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 9 3 — — $48.69 $934,776.65 $795,273.30 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 9 3 — — $12.80 $878,117.20 $733,504.50 2026-03-01
J9371 HCPCS Injection, Vincristine Sulfate Liposome, 1 Mg 8 2 — — $42,903.48 $42,903.48 $42,903.48 2026-03-01
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 7 2 — — $1,033,270.56 $1,700,133.12 $1,516,929.12 2026-03-01
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 7 2 — — $459,112.50 $1,227,744.00 $1,095,444.00 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 7 2 — — $653,027.40 $1,074,484.80 $969,621.79 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 7 2 — — $589,129.02 $969,347.04 $919,208.40 2026-03-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 7 2 — — $576,208.91 $948,088.42 $899,049.36 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 7 2 — — $523,826.28 $861,898.56 $807,592.83 2026-03-01
C2616 HCPCS Brachytherapy Source, Non-stranded, Yttrium-90, Per Source 7 2 — — $16,257.00 $62,384.23 $55,718.52 2026-03-01
0894T CPT Cannulation Of The Liver Allograft In Preparation For Connection To The Normothe… 7 2 — — $1,017.00 $47,078.18 $42,093.86 2026-03-01
S3865 HCPCS Comprehensive Gene Sequence Analysis For Hypertrophic Cardiomyopathy 6 1 — — $26,647.64 $57,324.93 $44,066.10 2026-03-01
C9301 HCPCS Obecabtagene Autoleucel, Up To 400 Million Cd19 Car-positive Viable T Cells, Inc… 5 1 — — $392,332.50 $645,540.00 $575,977.50 2026-03-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc Pediatric 5 1 — — $121,639.93 $249,049.93 $187,848.66 2026-03-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 5 1 — — $105,263.29 $215,519.81 $162,558.19 2026-03-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 5 1 — — $99,545.36 $203,812.72 $153,728.00 2026-03-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc Pediatric 5 1 — — $89,144.81 $182,518.25 $137,666.41 2026-03-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc Pediatric 5 1 — — $86,914.04 $177,950.89 $134,221.43 2026-03-01
E0767 HCPCS Intrabuccal, Systemic Delivery Of Amplitude-modulated, Radiofrequency Electromag… 5 1 — — $88,675.27 $146,008.42 $130,719.58 2026-03-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc Pediatric 5 1 — — $80,666.55 $165,159.57 $124,573.43 2026-03-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 5 1 — — $76,767.67 $157,176.85 $118,552.38 2026-03-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 5 1 — — $74,374.05 $152,276.09 $114,855.92 2026-03-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc Pediat… 5 1 — — $69,002.99 $141,279.18 $106,561.38 2026-03-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc Pediatric 5 1 — — $63,299.63 $129,601.92 $97,753.68 2026-03-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc Pediatric 5 1 — — $52,038.54 $106,545.55 $80,363.16 2026-03-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 5 1 — — $41,864.37 $85,714.59 $64,651.18 2026-03-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 5 1 — — $41,362.61 $84,687.28 $63,876.31 2026-03-01
C8004 HCPCS Simulation Angiogram With Use Of A Pressure-generating Catheter (e.g., One-way V… 5 1 — — $48,651.05 $91,064.78 $61,012.27 2026-03-01
0896T CPT Connection Of Liver Allograft To Normothermic Machine Perfusion Device, Hemostas… 5 1 — — $28,596.17 $47,078.18 $42,093.86 2026-03-01
0895T CPT Connection Of Liver Allograft To Normothermic Machine Perfusion Device, Hemostas… 5 1 — — $28,596.17 $47,078.18 $42,093.86 2026-03-01
0936T CPT Photobiomodulation Therapy Of Retina, Single Session 5 1 — — $28,596.17 $47,078.18 $42,093.86 2026-03-01
L8687 HCPCS Implantable Neurostimulator Pulse Generator, Dual Array, Rechargeable, Includes … 4 3 — — $14,324.19 $127,518.34 $71,342.57 2026-03-01
L8685 HCPCS Implantable Neurostimulator Pulse Generator, Single Array, Rechargeable, Include… 4 3 — — $12,132.45 $97,983.31 $55,414.72 2026-03-01
L8688 HCPCS Implantable Neurostimulator Pulse Generator, Dual Array, Non-rechargeable, Inclu… 4 3 — — $10,028.31 $81,367.92 $45,993.06 2026-03-01
90288 CPT Botulism Immune Globulin, Human, For Intravenous Use 3 1 — — $94,974.75 $127,607.10 $108,125.10 2026-03-01
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 2 1 — — $4,850,948.67 $4,850,948.67 $4,850,948.67 2026-03-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 2 1 — — $4,271,819.03 $4,271,819.03 $4,271,819.03 2026-03-01
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 2 1 — — $3,847,800.00 $3,847,800.00 $3,847,800.00 2026-03-01
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 2 1 — — $332,753.88 $332,753.88 $332,753.88 2026-03-01
L5969 HCPCS Addition, Endoskeletal Ankle-foot Or Ankle System, Power Assist, Includes Any Ty… 2 1 — — $202,735.57 $202,735.57 $202,735.57 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 2 1 — — $77,046.96 $77,046.96 $77,046.96 2026-03-01
J2505 HCPCS Injection, Pegfilgrastim, 6 Mg 2 1 — — $68,956.21 $68,956.21 $68,956.21 2026-03-01
J0800 HCPCS Injection, Corticotropin, Up To 40 Units 2 1 — — $58,615.82 $58,615.82 $58,615.82 2026-03-01
A0431 HCPCS Ambulance Service, Conventional Air Services, Transport, One Way (rotary Wing) 2 1 — — $50,540.62 $50,540.62 $50,540.62 2026-03-01
A0430 HCPCS Ambulance Service, Conventional Air Services, Transport, One Way (fixed Wing) 2 1 — — $43,470.26 $43,470.26 $43,470.26 2026-03-01
J0350 HCPCS Injection, Anistreplase, Per 30 Units 2 1 — — $41,711.38 $41,711.38 $41,711.38 2026-03-01
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