Price Transparency Hospital negotiated rates

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

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Hospital

MEDICAL CITY LEWISVILLE

Lewisville, TX · CCN 450669 · Rates published

36,353 distinct procedures filed
59 distinct payers
2,158,507 rate rows
2026-03-01 last MRF observed
Data quality

2,118,525 of 2,158,507 rate rows are consumer-grade (98.1%)

39,982 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 19,888
per-diem day rate — not a per-procedure price 15,049
template filing: same amount across many unrelated codes — excluded 4,807
placeholder amount (≤ $0.02) — excluded from medians 224
exceeds 10× this hospital's gross charge — excluded from medians 14
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1682210_MEDICAL-CITY-LEWISVILLE_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page https://medicalcityhealthcare.com/about/legal/pricing-transparency-cms-required-file-of-standard-charges.dot
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-16
Content fingerprint 115a2dffa7b6a17d… · 953,007,043 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 19 $5,291.79 $4,955,500.00 $4,543,292.50 nat. median
$9,966
outlier · 455.9×
00845
OTHER 		Inj, Atidarsagene Autotem 1 $4,369,850.00 $4,369,850.00 $4,369,850.00 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 1 $3,574,708.99 $3,574,708.99 $3,574,708.99 nat. median
$3,574,709
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 23 $6,223.86 $4,991,790.00 $3,494,253.00 nat. median
$13,041
outlier · 267.9×
748
OTHER 		Inj, Lovotibeglogene Auto 23 $11,847.05 $4,878,762.00 $3,415,133.40 nat. median
$17,963
outlier · 190.1×
908
OTHER 		Topi Adm Prad Zami Per Tr 20 $9,581.54 $4,336,566.00 $3,402,536.40 nat. median
$22,747
outlier · 149.6×
906
OTHER 		Inj Elivaldogene Autoteme 21 $8,466.42 $4,770,000.00 $3,307,200.00 nat. median
$20,756
outlier · 159.3×
00908
OTHER 		Topi Adm Prad Zami Per Tr 1 $3,235,745.40 $3,235,745.40 $3,235,745.40 nat. median
$12,675
outlier · 255.3×
00714
OTHER 		Inj Delandistrogene Mox R 1 $3,228,024.20 $3,228,024.20 $3,228,024.20 nat. median
$3,228,024
1.0× median
00748
OTHER 		Inj, Lovotibeglogene Auto 1 $3,154,932.76 $3,154,932.76 $3,154,932.76 nat. median
$3,187,420
1.0× median
746
OTHER 		Inj, Betibeglogene Autote 23 $10,958.64 $4,409,953.50 $3,086,967.45 nat. median
$21,896
outlier · 141.0×
00906
OTHER 		Inj Elivaldogene Autoteme 1 $3,084,600.00 $3,084,600.00 $3,084,600.00 nat. median
$21
outlier · 149086.5×
00746
OTHER 		Inj, Betibeglogene Autote 1 $2,851,769.93 $2,851,769.93 $2,851,769.93 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
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×
09141
OTHER 		Inj Onase Abepar-xioi Tre 1 $2,511,311.57 $2,511,311.57 $2,511,311.57 nat. median
$2,457,321
1.0× median
824
OTHER 		Inj, Exagamglogene Autote 25 $12,832.29 $4,617,360.00 $2,448,600.00 nat. median
$25,250
outlier · 97.0×
00824
OTHER 		Inj, Exagamglogene Autote 1 $2,262,040.00 $2,262,040.00 $2,262,040.00 nat. median
$2,332,000
1.0× median
Q2058
HCPCS 		Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,… 2 $459,112.50 $2,937,060.00 $1,825,740.00 nat. median
$324,450
outlier · 5.6×
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 3 $536,573.93 $2,570,427.00 $1,597,833.00 nat. median
$675,122
outlier · 2.4×
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 3 $511,793.34 $2,318,912.10 $1,441,485.90 nat. median
$625,184
outlier · 2.3×
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 3 $500,948.74 $2,268,056.34 $1,409,872.86 nat. median
$674,188
outlier · 2.1×
C9301
HCPCS 		Obecabtagene Autoleucel, Up To 400 Million Cd19 Car-positive Viable T Cells, Inc… 1 $959,962.50 $1,544,287.50 $1,405,162.50 nat. median
$459,112
outlier · 3.1×
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 3 $23.68 $2,132,254.50 $1,325,455.50 nat. median
$754,974
1.8× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 3 $474,717.03 $2,061,869.40 $1,281,702.60 nat. median
$620,080
outlier · 2.1×
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 3 $6.22 $1,966,642.50 $1,222,507.50 nat. median
$634,511
1.9× median
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 1 $570,020.11 $570,020.11 $570,020.11 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 1 $549,535.36 $549,535.36 $549,535.36 nat. median
$538,205
1.0× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $545,335.16 $545,335.16 $545,335.16 nat. median
$534,091
1.0× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $541,339.35 $541,339.35 $541,339.35 nat. median
$530,178
1.0× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $516,226.43 $516,226.43 $516,226.43 nat. median
$505,583
1.0× median
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 1 $474,766.69 $474,766.69 $474,766.69 nat. median
$464,978
1.0× median
877269
CDM 		Transcth Aortic Vlv 29mm 24 $134,999.86 $999,999.00 $408,499.59 nat. median
$177,294
outlier · 2.3×
427323
CDM 		Valve Aor Evolutr-34mm 24 $134,999.86 $999,999.00 $408,499.59 nat. median
$207,592
2.0× median
877268
CDM 		Valve Transcth Aor 26mm 24 $134,999.86 $999,999.00 $408,499.59 nat. median
$177,294
outlier · 2.3×
437822
CDM 		Valve Aor Tavr 23mm 24 $134,999.86 $999,999.00 $408,499.59 nat. median
$217,000
1.9× median
877267
CDM 		Val Evlt Rtm Trnsct Aort 24 $134,999.86 $999,999.00 $408,499.59 nat. median
$177,294
outlier · 2.3×
J9029
HCPCS 		Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 4 $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 21 $314,934.86 $1,273,072.13 $337,430.21 nat. median
$370,174
0.9× median

Other procedures at this hospital

Browse this hospital's 36,353 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
00845 OTHER Inj, Atidarsagene Autotem 1 1 — — $4,369,850.00 $4,369,850.00 $4,369,850.00 2026-03-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 1 1 — — $3,574,708.99 $3,574,708.99 $3,574,708.99 2026-03-01
00908 OTHER Topi Adm Prad Zami Per Tr 1 1 — — $3,235,745.40 $3,235,745.40 $3,235,745.40 2026-03-01
00714 OTHER Inj Delandistrogene Mox R 1 1 — — $3,228,024.20 $3,228,024.20 $3,228,024.20 2026-03-01
00748 OTHER Inj, Lovotibeglogene Auto 1 1 — — $3,154,932.76 $3,154,932.76 $3,154,932.76 2026-03-01
00906 OTHER Inj Elivaldogene Autoteme 1 1 — — $3,084,600.00 $3,084,600.00 $3,084,600.00 2026-03-01
00746 OTHER Inj, Betibeglogene Autote 1 1 — — $2,851,769.93 $2,851,769.93 $2,851,769.93 2026-03-01
09141 OTHER Inj Onase Abepar-xioi Tre 1 1 — — $2,511,311.57 $2,511,311.57 $2,511,311.57 2026-03-01
00824 OTHER Inj, Exagamglogene Autote 1 1 — — $2,262,040.00 $2,262,040.00 $2,262,040.00 2026-03-01
09498 OTHER Ciltacabtagene Car-pos T 1 1 — — $570,020.11 $570,020.11 $570,020.11 2026-03-01
09194 OTHER Tisagenlecleucel Car-pos 1 1 — — $549,535.36 $549,535.36 $549,535.36 2026-03-01
09413 OTHER Lisocabtagene Car Pos T 1 1 — — $545,335.16 $545,335.16 $545,335.16 2026-03-01
09422 OTHER Idecabtagene Vicleucel Ca 1 1 — — $541,339.35 $541,339.35 $541,339.35 2026-03-01
09035 OTHER Axicabtagene Ciloleucel C 1 1 — — $516,226.43 $516,226.43 $516,226.43 2026-03-01
09391 OTHER Brexucabtagene Car Pos T 1 1 — — $474,766.69 $474,766.69 $474,766.69 2026-03-01
00831 OTHER Obecbtge Autol Up To 400 1 1 — — $269,902.50 $269,902.50 $269,902.50 2026-03-01
00897 OTHER Revakinagene, Per Implant 1 1 — — $257,050.00 $257,050.00 $257,050.00 2026-03-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $213,654.33 $213,654.33 $213,654.33 2026-03-01
00886 OTHER Inj. Remestemcel-l-rknd/ 1 1 — — $195,618.93 $195,618.93 $195,618.93 2026-03-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $187,805.58 $187,805.58 $187,805.58 2026-03-01
01908 OTHER New Technology - Level 52 1 1 — — $142,262.92 $142,262.92 $142,262.92 2026-03-01
01907 OTHER New Technology - Level 52 1 1 — — $142,262.92 $142,262.92 $142,262.92 2026-03-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $132,369.21 $132,369.21 $132,369.21 2026-03-01
01905 OTHER New Technology - Level 51 1 1 — — $128,269.89 $128,269.89 $128,269.89 2026-03-01
01906 OTHER New Technology - Level 51 1 1 — — $128,269.89 $128,269.89 $128,269.89 2026-03-01
01903 OTHER New Technology - Level 50 1 1 — — $114,276.86 $114,276.86 $114,276.86 2026-03-01
01904 OTHER New Technology - Level 50 1 1 — — $114,276.86 $114,276.86 $114,276.86 2026-03-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $103,369.89 $103,369.89 $103,369.89 2026-03-01
01902 OTHER New Technology - Level 49 1 1 — — $100,283.84 $100,283.84 $100,283.84 2026-03-01
01901 OTHER New Technology - Level 49 1 1 — — $100,283.84 $100,283.84 $100,283.84 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
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $92,640.73 $92,640.73 $92,640.73 2026-03-01
01599 OTHER New Technology - Level 48 1 1 — — $88,622.96 $88,622.96 $88,622.96 2026-03-01
01585 OTHER New Technology - Level 48 1 1 — — $88,622.96 $88,622.96 $88,622.96 2026-03-01
0200 RC — 1 1 — — $80,643.59 $80,643.59 $80,643.59 2026-03-01
007 OTHER Lung Transplant 1 1 — — $79,446.81 $79,446.81 $79,446.81 2026-03-01
01598 OTHER New Technology - Level 47 1 1 — — $79,294.28 $79,294.28 $79,294.28 2026-03-01
01584 OTHER New Technology - Level 47 1 1 — — $79,294.28 $79,294.28 $79,294.28 2026-03-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $73,494.73 $73,494.73 $73,494.73 2026-03-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $70,413.32 $70,413.32 $70,413.32 2026-03-01
01597 OTHER New Technology - Level 46 1 1 — — $69,965.60 $69,965.60 $69,965.60 2026-03-01
01583 OTHER New Technology - Level 46 1 1 — — $69,965.60 $69,965.60 $69,965.60 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
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 3 1 — — $4,271,819.03 $4,271,819.03 $4,271,819.03 2026-03-01
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 3 1 — — $3,847,800.00 $3,847,800.00 $3,847,800.00 2026-03-01
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 3 1 — — $332,753.88 $332,753.88 $332,753.88 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 3 1 — — $77,046.96 $77,046.96 $77,046.96 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
90288 CPT Botulism Immune Globulin, Human, For Intravenous Use 6 1 — — $294,713.96 $416,525.16 $329,245.80 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
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 9 2 — — $1,271,523.00 $4,067,128.80 $2,528,215.20 2026-03-01
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 9 2 — — $459,112.50 $2,937,060.00 $1,825,740.00 2026-03-01
0915T CPT Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 9 2 — — $22,365.00 $82,718.88 $70,535.48 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 11 3 — — $536,573.93 $2,570,427.00 $1,597,833.00 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 11 3 — — $511,793.34 $2,318,912.10 $1,441,485.90 2026-03-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 11 3 — — $500,948.74 $2,268,056.34 $1,409,872.86 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 11 3 — — $474,717.03 $2,061,869.40 $1,281,702.60 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 12 3 — — $23.68 $2,132,254.50 $1,325,455.50 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 12 3 — — $6.22 $1,966,642.50 $1,222,507.50 2026-03-01
J7310 HCPCS Ganciclovir, 4.5 Mg, Long-acting Implant 14 3 — — $54,979.20 $145,041.92 $95,534.88 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 17 4 — — $61,338.53 $888,000.00 $405,600.00 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
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 17 4 — — $131,717.55 $574,167.94 $202,348.70 2026-03-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 17 4 — — $39,976.89 $203,447.46 $114,857.36 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 18 4 — — $55,306.59 $478,449.94 $309,047.47 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 18 4 — — $43,855.64 $389,632.46 $190,176.18 2026-03-01
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 18 4 — — $26,258.38 $243,082.56 $90,672.16 2026-03-01
5834 APR_DRG Neonate With Ecmo 25 10 — — $268,525.11 $340,767.90 $286,245.04 2026-03-01
5833 APR_DRG Neonate With Ecmo 25 10 — — $227,377.19 $288,549.74 $242,381.78 2026-03-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 25 10 — — $169,971.98 $215,700.49 $181,188.41 2026-03-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 25 10 — — $154,630.04 $196,231.01 $164,834.05 2026-03-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 25 10 — — $126,470.48 $160,495.54 $134,816.25 2026-03-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 25 10 — — $125,349.73 $159,073.26 $133,621.54 2026-03-01
5832 APR_DRG Neonate With Ecmo 25 10 — — $113,296.86 $143,777.74 $120,773.30 2026-03-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 25 10 — — $107,582.78 $136,526.38 $114,682.16 2026-03-01
2004 APR_DRG Cardiac Structural And Valvular Disorders 25 10 — — $99,974.04 $126,870.61 $106,571.31 2026-03-01
5831 APR_DRG Neonate With Ecmo 25 10 — — $99,760.14 $126,599.16 $106,343.30 2026-03-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 25 10 — — $91,201.41 $115,737.82 $97,219.77 2026-03-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 25 10 — — $90,784.56 $115,208.84 $96,775.42 2026-03-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 25 10 — — $90,549.81 $114,910.93 $96,525.18 2026-03-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 25 10 — — $90,160.55 $114,416.94 $96,110.23 2026-03-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 25 10 — — $89,260.06 $113,274.19 $95,150.32 2026-03-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 25 10 — — $86,908.60 $110,290.10 $92,643.68 2026-03-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 25 10 — — $86,130.08 $109,302.14 $91,813.80 2026-03-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 25 10 — — $85,573.94 $108,596.38 $91,220.96 2026-03-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 25 10 — — $76,652.46 $97,274.70 $81,710.75 2026-03-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 25 10 — — $75,969.41 $96,407.88 $80,982.62 2026-03-01
2464 APR_DRG Gastrointestinal Vascular Insufficiency 25 10 — — $74,290.05 $94,276.71 $79,192.44 2026-03-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 25 10 — — $73,906.80 $93,790.35 $78,783.89 2026-03-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 25 10 — — $71,718.68 $91,013.55 $76,451.38 2026-03-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 25 10 — — $71,504.08 $90,741.21 $76,222.62 2026-03-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 25 10 — — $69,510.05 $88,210.73 $74,097.01 2026-03-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 25 10 — — $65,732.37 $83,416.71 $70,070.04 2026-03-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 25 10 — — $65,198.86 $82,739.68 $69,501.33 2026-03-01
1614 APR_DRG Implantable Heart Assist Systems 30 11 — — $165,054.46 $209,459.98 $175,946.38 2026-03-01
1613 APR_DRG Implantable Heart Assist Systems 30 11 — — $86,028.61 $109,173.36 $91,705.62 2026-03-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 30 11 — — $76,609.69 $97,220.41 $81,665.15 2026-03-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 30 11 — — $66,829.08 $84,808.48 $71,239.12 2026-03-01
845 OTHER Inj, Atidarsagene Autotem 31 19 — — $5,291.79 $4,955,500.00 $4,543,292.50 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 31 20 — — $9,581.54 $4,336,566.00 $3,402,536.40 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
74 APR_DRG Allogeneic Bone Marrow Transplant 34 11 — — $261,221.47 $464,099.00 $282,437.21 2026-03-01
24 APR_DRG Heart And/or Lung Transplant 34 11 — — $218,730.42 $388,607.00 $236,495.21 2026-03-01
73 APR_DRG Allogeneic Bone Marrow Transplant 34 11 — — $92,175.08 $163,763.00 $99,661.35 2026-03-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 34 11 — — $78,353.05 $139,206.00 $84,716.73 2026-03-01
84 APR_DRG Autologous Bone Marrow Transplant 34 11 — — $78,039.09 $138,648.00 $84,377.29 2026-03-01
64 APR_DRG Pancreas Transplant 35 11 — — $3,595.31 $127,429.00 $76,457.41 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 36 21 — — $8,466.42 $4,770,000.00 $3,307,200.00 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 38 21 — — $314,934.86 $1,273,072.13 $337,430.21 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
714 OTHER Inj Delandistrogene Mox R 41 23 — — $6,223.86 $4,991,790.00 $3,494,253.00 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 41 23 — — $11,847.05 $4,878,762.00 $3,415,133.40 2026-03-01
746 OTHER Inj, Betibeglogene Autote 41 23 — — $10,958.64 $4,409,953.50 $3,086,967.45 2026-03-01
824 OTHER Inj, Exagamglogene Autote 41 25 — — $12,832.29 $4,617,360.00 $2,448,600.00 2026-03-01
897 OTHER Revakinagene, Per Implant 41 25 — — $263,675.00 $694,300.00 $278,250.00 2026-03-01
427323 CDM Valve Aor Evolutr-34mm 42 24 $999,999.00 $999,999.00 $134,999.86 $999,999.00 $408,499.59 2026-03-01
437822 CDM Valve Aor Tavr 23mm 42 24 $999,999.00 $999,999.00 $134,999.86 $999,999.00 $408,499.59 2026-03-01
877267 CDM Val Evlt Rtm Trnsct Aort 42 24 $999,999.00 $999,999.00 $134,999.86 $999,999.00 $408,499.59 2026-03-01
877269 CDM Transcth Aortic Vlv 29mm 42 24 $999,999.00 $999,999.00 $134,999.86 $999,999.00 $408,499.59 2026-03-01
877268 CDM Valve Transcth Aor 26mm 42 24 $999,999.00 $999,999.00 $134,999.86 $999,999.00 $408,499.59 2026-03-01
248168 CDM Graft Bn Fem Whole Left 42 24 $572,394.00 $572,394.00 $77,273.19 $572,394.00 $233,822.95 2026-03-01
216719 CDM Graft Endo Aaa 26x12mm 42 24 $453,789.00 $453,789.00 $61,261.51 $453,789.00 $185,372.81 2026-03-01
211753 CDM Graft Endo Aaa 28.5x12mm 42 24 $453,789.00 $453,789.00 $61,261.51 $453,789.00 $185,372.81 2026-03-01
216652 CDM Graft Endo Aaa 32x14mm 42 24 $453,789.00 $453,789.00 $61,261.51 $453,789.00 $185,372.81 2026-03-01
869125 CDM Graft Evas 12cm 26mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
737806 CDM Graft Evas 15cm 31mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
865804 CDM Graft Evas 16cm 23mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
742019 CDM Graft Evas 18cm 28.5mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
864007 CDM Graft Evas 14cm 26mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
753429 CDM Graft Evas 18cm 28.5mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
859347 CDM Graft Evas 16cm 26mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
869127 CDM Graft Evas 16cm 28.5mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
858902 CDM Graft Evas 31x14.5m 13cm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
747478 CDM Graft Evas 18cm 26mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
747006 CDM Graft Evas 13cm 31mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
857849 CDM Graft Evas 35x14.5m 18cm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
754009 CDM Graft Evas 12cm 26mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
869126 CDM Graft Evas 16cm 26mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
742791 CDM Stent Aaa Exldr C3 23x12 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
849424 CDM Graft Evas 18cm 26mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
866807 CDM Graft Evas 18cm 23mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
747574 CDM Graft Evas 14cm 23mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
856438 CDM Graft Evas 14cm 26mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
741966 CDM Graft Evas 18cm 23mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
742786 CDM Graft Evas 12cm 23x14.5m 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
741446 CDM Graft Evas 17cm 31mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
857329 CDM Graft Evas 12cm 28.5mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
856437 CDM Graft Evas 16cm 25.5mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
738989 CDM Graft Evas 14cm 28.5mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
860921 CDM Graft Evas 12cm 23mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
858921 CDM Graft Evas 12cm 28.5mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
749679 CDM Graft Evas 14cm 23x14.5m 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
751779 CDM Graft Evas 14cm 28.5mm 42 24 $402,465.00 $402,465.00 $54,332.78 $402,465.00 $164,406.95 2026-03-01
871572 CDM Graft Evas 14.5mm 16cm 42 24 $394,608.00 $394,608.00 $53,272.08 $394,608.00 $161,197.36 2026-03-01
857566 CDM Graft Evas 31x14.5m 15cm 42 24 $385,608.00 $385,608.00 $52,057.08 $385,608.00 $157,520.86 2026-03-01
857807 CDM Graft Evas 35x14.5m 14cm 42 24 $385,608.00 $385,608.00 $52,057.08 $385,608.00 $157,520.86 2026-03-01
590994 CDM Graft Evas 18cm 23mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
869123 CDM Graft Evas 15cm 31mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
588582 CDM Graft Evas 18cm 26mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
723177 CDM Graft Evas 12cm 28.5mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
869124 CDM Graft Evas 17cm 31mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
588572 CDM Graft Evas 16cm 26mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
709536 CDM Graft Evas 12cm 26mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
588662 CDM Graft Evas 18cm 28.5mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
725381 CDM Graft Evas 12cm 26mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
158329 CDM Graft Evas 14cm 26mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
588622 CDM Graft Evas 16cm 28.5mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
588612 CDM Graft Evas 14cm 28.5mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
588652 CDM Graft Evas 16cm 28.5mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
637051 CDM Graft Evas 12cm 23mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
588602 CDM Graft Evas 18cm 26mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
588642 CDM Graft Evas 14cm 28.5mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
588632 CDM Graft Evas 18cm 28.5mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
588542 CDM Graft Evas 14cm 23mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
588592 CDM Graft Evas 16cm 26mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
708518 CDM Graft Evas 12cm 28.5mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
588512 CDM Graft Evas 14cm 23mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
588532 CDM Graft Evas 18cm 23mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
717974 CDM Graft Evas 13cm 31mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
588552 CDM Graft Evas 16cm 23mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
588562 CDM Graft Evas 14cm 26mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
709809 CDM Graft Evas 12cm 23mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
588522 CDM Graft Evas 16cm 23mm 42 24 $359,759.00 $359,759.00 $48,567.46 $359,759.00 $146,961.55 2026-03-01
730191 CDM Device Ast Vent 00551042 42 24 $331,470.00 $331,470.00 $44,748.45 $331,470.00 $135,405.49 2026-03-01
481326 CDM Graft Hemi Cndyl Mdl Lt 42 24 $329,763.00 $329,763.00 $44,518.00 $329,763.00 $134,708.18 2026-03-01
747118 CDM Graft Bn Fem Hemi Cndyl 42 24 $321,720.00 $321,720.00 $43,432.20 $321,720.00 $131,422.62 2026-03-01
477786 CDM Valve Aortic Xl 25-27mm 42 24 $308,448.00 $308,448.00 $41,640.48 $308,448.00 $126,001.01 2026-03-01
231788 CDM Graft Endo Aaa 23x12mm 42 24 $302,250.00 $302,250.00 $40,803.75 $302,250.00 $123,469.12 2026-03-01
435427 CDM Graft Bn Cartiform 25x20 42 24 $294,910.00 $294,910.00 $39,812.85 $294,910.00 $120,470.73 2026-03-01
850516 CDM Device Vntrc Asst 2 Lvas 42 24 $280,800.00 $280,800.00 $37,908.00 $280,800.00 $114,706.80 2026-03-01
225598 CDM Valve Aortic 23mm 42 24 $277,776.00 $277,776.00 $37,499.76 $277,776.00 $113,471.49 2026-03-01
861960 CDM Graft Evas 35x14.5m 16cm 42 24 $268,065.00 $268,065.00 $36,188.78 $268,065.00 $109,504.55 2026-03-01
859730 CDM Graft Evas 31x14.5m 17cm 42 24 $268,065.00 $268,065.00 $36,188.78 $268,065.00 $109,504.55 2026-03-01
870016 CDM Graft Evas 23x14.5m 16cm 42 24 $263,520.00 $263,520.00 $35,575.20 $263,520.00 $107,647.92 2026-03-01
604803 CDM Vlv Aor Tis Tfx 19 42 24 $260,107.00 $260,107.00 $35,114.44 $260,107.00 $106,253.71 2026-03-01
604917 CDM Vlv Aor Tis Tfx 29 42 24 $250,578.00 $250,578.00 $33,828.03 $250,578.00 $102,361.11 2026-03-01
879387 CDM Graft Nrv 1-2mm 70mm 42 24 $235,920.00 $235,920.00 $31,849.20 $235,920.00 $96,373.32 2026-03-01
466963 CDM Cage Spn 13x16-21.5mm 42 24 $224,332.00 $224,332.00 $30,284.82 $224,332.00 $91,639.62 2026-03-01
862773 CDM Valve Aortic 27mm 42 24 $221,450.00 $221,450.00 $29,895.75 $221,450.00 $90,462.33 2026-03-01
233839 CDM Graft Drms Ptch 16x20cm 42 24 $215,401.00 $215,401.00 $29,079.13 $215,401.00 $87,991.30 2026-03-01
563181 CDM Cnla Vntrc Art 42f 42 24 $212,141.00 $212,141.00 $28,639.03 $212,141.00 $86,659.60 2026-03-01
589332 CDM Spacer Spn Tlif 17mm 42 24 $211,883.00 $211,883.00 $28,604.21 $211,883.00 $86,554.21 2026-03-01
589322 CDM Spacer Spn Tlif 15mm 42 24 $211,883.00 $211,883.00 $28,604.21 $211,883.00 $86,554.21 2026-03-01
589312 CDM Spacer Spn Tlif 13mm 42 24 $211,883.00 $211,883.00 $28,604.21 $211,883.00 $86,554.21 2026-03-01
481290 CDM Impl Spn Mag 13x24-32mm 42 24 $201,899.00 $201,899.00 $27,256.37 $201,899.00 $82,475.74 2026-03-01
466896 CDM Cntr Piece Turq Spn 13mm 42 24 $201,899.00 $201,899.00 $27,256.37 $201,899.00 $82,475.74 2026-03-01
223668 CDM Allograft Dermis 16x20cm 42 24 $199,445.00 $199,445.00 $26,925.08 $199,445.00 $81,473.28 2026-03-01
469722 CDM Valve Aortic 21mm 42 24 $196,758.00 $196,758.00 $26,562.33 $196,758.00 $80,375.64 2026-03-01
245684 CDM Cement W Gentamacin 10ml 42 24 $195,965.00 $195,965.00 $26,455.28 $195,965.00 $80,051.70 2026-03-01
225726 CDM Valve Aortic 23mm 42 24 $192,043.00 $192,043.00 $25,925.81 $192,043.00 $78,449.57 2026-03-01
448908 CDM Valve Aortic 25mm 42 24 $192,043.00 $192,043.00 $25,925.81 $192,043.00 $78,449.57 2026-03-01
855412 CDM Valve Aortic 25mm 42 24 $190,490.00 $190,490.00 $25,716.15 $190,490.00 $77,815.17 2026-03-01
748910 CDM Valve Aortic 23mm 42 24 $190,490.00 $190,490.00 $25,716.15 $190,490.00 $77,815.17 2026-03-01
423052 CDM Valve Aortic 19mm 42 24 $190,218.00 $190,218.00 $25,679.43 $190,218.00 $77,704.05 2026-03-01
423054 CDM Valve Aortic 23mm 42 24 $190,218.00 $190,218.00 $25,679.43 $190,218.00 $77,704.05 2026-03-01
422655 CDM Valve Aortic 25mm 42 24 $190,218.00 $190,218.00 $25,679.43 $190,218.00 $77,704.05 2026-03-01
423053 CDM Valve Aortic 21mm 42 24 $190,218.00 $190,218.00 $25,679.43 $190,218.00 $77,704.05 2026-03-01
423056 CDM Valve Aortic 33mm 42 24 $190,218.00 $190,218.00 $25,679.43 $190,218.00 $77,704.05 2026-03-01
423057 CDM Valve Aortic 29mm 42 24 $190,218.00 $190,218.00 $25,679.43 $190,218.00 $77,704.05 2026-03-01
879277 CDM Spacer Spn 20x31x20mm 42 24 $188,336.00 $188,336.00 $25,425.36 $188,336.00 $76,935.26 2026-03-01
437139 CDM Cement Bn Ca Phs Ha 15cc 42 24 $187,560.00 $187,560.00 $25,320.60 $187,560.00 $76,618.26 2026-03-01
750080 CDM Cage Spn 27-38mm 20mm 42 24 $187,425.00 $187,425.00 $25,302.38 $187,425.00 $76,563.11 2026-03-01
737492 CDM Valve Aortic 27mm 42 24 $182,027.00 $182,027.00 $24,573.65 $182,027.00 $74,358.03 2026-03-01
737494 CDM Valve Aortic 31mm 42 24 $182,027.00 $182,027.00 $24,573.65 $182,027.00 $74,358.03 2026-03-01
737493 CDM Valve Aortic 29mm 42 24 $182,027.00 $182,027.00 $24,573.65 $182,027.00 $74,358.03 2026-03-01
865144 CDM Cage Spn 0d 24-29mm 42 24 $172,104.00 $172,104.00 $23,234.04 $172,104.00 $70,304.49 2026-03-01
233512 CDM Valve Mitral 31mm 42 24 $170,808.00 $170,808.00 $23,059.08 $170,808.00 $69,775.07 2026-03-01
588492 CDM Stnt/gft Eprsth 12cm 14. 42 24 $170,808.00 $170,808.00 $23,059.08 $170,808.00 $69,775.07 2026-03-01
233510 CDM Valve Mitral 33mm 42 24 $170,808.00 $170,808.00 $23,059.08 $170,808.00 $69,775.07 2026-03-01
233516 CDM Valve Mitral 27mm 42 24 $170,808.00 $170,808.00 $23,059.08 $170,808.00 $69,775.07 2026-03-01
233519 CDM Valve Mitral 25mm 42 24 $170,808.00 $170,808.00 $23,059.08 $170,808.00 $69,775.07 2026-03-01
233514 CDM Valve Mitral 29mm 42 24 $170,808.00 $170,808.00 $23,059.08 $170,808.00 $69,775.07 2026-03-01
233468 CDM Cap Impl Shldr 36mm 42 24 $169,405.00 $169,405.00 $22,869.67 $169,405.00 $69,201.94 2026-03-01
718680 CDM Cage Spn 32-47mm 20mm 42 24 $168,683.00 $168,683.00 $22,772.21 $168,683.00 $68,907.01 2026-03-01
427978 CDM Cage Spn 17-23mm 20mm 42 24 $168,683.00 $168,683.00 $22,772.21 $168,683.00 $68,907.01 2026-03-01
446557 CDM Spacer Spn 12x12x21mm 42 24 $168,588.00 $168,588.00 $22,759.38 $168,588.00 $68,868.20 2026-03-01
280377 CDM Cage Spn 12x14 12-16 0d 42 24 $168,588.00 $168,588.00 $22,759.38 $168,588.00 $68,868.20 2026-03-01
276558 CDM Cage Spn 12x14 17-25 5d 42 24 $168,588.00 $168,588.00 $22,759.38 $168,588.00 $68,868.20 2026-03-01
717751 CDM Disc Intvrtb Spn Xl 5mm 42 24 $168,179.00 $168,179.00 $22,704.17 $168,179.00 $68,701.12 2026-03-01
243953 CDM Graft Bn Lg 8cc 1x2in 42 24 $167,798.00 $167,798.00 $22,652.73 $167,798.00 $68,545.48 2026-03-01
749924 CDM Graft Evas 12cm 23mm 42 24 $166,926.00 $166,926.00 $22,535.01 $166,926.00 $68,189.27 2026-03-01
869095 CDM Graft Evas 23mm 12cm 42 24 $166,926.00 $166,926.00 $22,535.01 $166,926.00 $68,189.27 2026-03-01
233207 CDM Graft Evas 9.5cm 18mm 42 24 $166,926.00 $166,926.00 $22,535.01 $166,926.00 $68,189.27 2026-03-01
749698 CDM Graft Evas 10cm 27mm 42 24 $166,926.00 $166,926.00 $22,535.01 $166,926.00 $68,189.27 2026-03-01
858903 CDM Graft Evas 18mm 13.5cm 42 24 $166,926.00 $166,926.00 $22,535.01 $166,926.00 $68,189.27 2026-03-01
753117 CDM Graft Evas 14cm 27mm 42 24 $166,926.00 $166,926.00 $22,535.01 $166,926.00 $68,189.27 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 43 26 — — $565,868.90 $1,539,641.95 $617,032.08 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 43 26 — — $563,698.64 $1,484,312.01 $594,857.87 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 43 26 — — $559,390.19 $1,472,967.14 $590,311.26 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 43 26 — — $555,291.39 $1,462,174.32 $585,985.89 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 43 26 — — $529,531.24 $1,394,343.56 $558,801.81 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 43 26 — — $487,002.95 $1,282,359.52 $513,922.71 2026-03-01
831 OTHER Obecbtge Autol Up To 400 44 26 — — $3,623.59 $729,015.00 $292,162.50 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 44 26 — — $7,929.01 $528,372.78 $211,752.45 2026-03-01
7 MS_DRG Lung Transplant 44 26 — — $96,551.40 $381,784.85 $103,447.93 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 44 26 — — $89,816.99 $354,299.71 $96,232.49 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 44 26 — — $77,483.68 $303,963.85 $83,018.23 2026-03-01
2067 OTHER Afamitresgene Autoleucel 46 27 — — $766,766.90 $2,019,024.40 $809,151.00 2026-03-01
1907 OTHER New Technology - Level 52 46 27 — — $146,662.80 $392,862.71 $157,444.98 2026-03-01
1908 OTHER New Technology - Level 52 46 27 — — $146,662.80 $392,862.71 $157,444.98 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
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
1902 OTHER New Technology - Level 49 46 27 — — $103,385.40 $276,936.36 $110,985.94 2026-03-01
1901 OTHER New Technology - Level 49 46 27 — — $103,385.40 $276,936.36 $110,985.94 2026-03-01
1585 OTHER New Technology - Level 48 46 27 — — $91,363.88 $244,734.72 $98,080.71 2026-03-01
1599 OTHER New Technology - Level 48 46 27 — — $91,363.88 $244,734.72 $98,080.71 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 46 26 — — $84,860.98 $554,970.00 $90,922.48 2026-03-01
1584 OTHER New Technology - Level 47 46 27 — — $81,746.68 $218,973.29 $87,756.47 2026-03-01
1598 OTHER New Technology - Level 47 46 27 — — $81,746.68 $218,973.29 $87,756.47 2026-03-01
1583 OTHER New Technology - Level 46 46 27 — — $72,129.48 $193,211.87 $77,432.24 2026-03-01
1597 OTHER New Technology - Level 46 46 27 — — $72,129.48 $193,211.87 $77,432.24 2026-03-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 47 27 — — $66,737.65 $180,260.45 $72,241.79 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 48 27 — — $108,147.24 $629,884.36 $117,066.60 2026-03-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 54 27 — — $80,850.00 $249,112.22 $99,835.05 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 58 27 — — $205,435.44 $842,426.46 $231,638.94 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 59 32 — — $75,983.00 $333,689.54 $90,821.87 2026-03-01
248063 CDM Kit Cath Rt Heart 62 33 $565,390.00 $565,390.00 $39,577.30 $565,390.00 $177,786.89 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 62 28 — — $9,825.00 $641,817.38 $168,461.26 2026-03-01
862710 CDM Set Vntrc 17.4x13.8in 62 33 $344,750.00 $344,750.00 $24,132.50 $344,750.00 $108,406.64 2026-03-01
265596 CDM Kit Lo Prfl Comp Shth 7f 62 33 $344,750.00 $344,750.00 $24,132.50 $344,750.00 $108,406.64 2026-03-01
870461 CDM Graft Evas 26x14.5m 16cm 62 33 $263,369.00 $263,369.00 $18,435.83 $263,369.00 $82,816.38 2026-03-01
248124 CDM Cath Vasc Acc 6fr 62 33 $234,362.00 $234,362.00 $16,405.34 $234,362.00 $73,695.13 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 67 33 — — $60,607.00 $471,244.47 $91,890.76 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 67 33 — — $60,607.00 $385,232.48 $75,729.09 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 67 33 — — $9,825.00 $262,963.04 $72,247.35 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 72 33 — — $9,825.00 $326,886.32 $87,796.26 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 73 32 — — $156,006.35 $638,050.74 $177,062.43 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 73 32 — — $102,850.88 $416,386.94 $116,732.60 2026-03-01
C1822 HCPCS Pulse Gen Imp 74 22 $494,907.50 $494,907.50 $62,970.75 $523,365.00 $232,799.53 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 74 33 — — $60,607.00 $359,312.58 $71,833.85 2026-03-01
215 MS_DRG Other Heart Assist System Implant 79 33 — — $55,453.00 $567,817.00 $84,869.91 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 79 33 — — $55,453.00 $335,921.79 $83,444.67 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 79 33 — — $55,453.00 $289,465.91 $72,375.71 2026-03-01
C1767 HCPCS Generator Interstim 3058 703 22 $229,245.00 $229,245.00 $253.13 $439,116.00 $68,404.60 2026-03-01
C1820 HCPCS Nrstm Impl 1.9inx.6in 797 31 $389,333.00 $389,333.00 $786.59 $457,600.00 $120,806.40 2026-03-01
C1722 HCPCS Defib Card Impl 1 Chmbr 1,295 22 $145,854.00 $145,854.00 $13,747.18 $544,699.00 $78,721.08 2026-03-01
C1882 HCPCS Aicd Crt-d Inogn G141 1,480 22 $230,935.50 $230,935.50 $14.98 $567,226.00 $113,277.24 2026-03-01
C1721 HCPCS Icd Crd 5.23x7.03x0.99cm 1,665 22 $150,109.00 $150,109.00 $601.70 $597,637.00 $76,621.51 2026-03-01
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