Price Transparency Hospital negotiated rates

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

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Hospital

HCA HOUSTON HEALTHCARE TOMBALL

Tomball, TX · CCN 450670 · Rates published

28,924 distinct procedures filed
35 distinct payers
1,159,487 rate rows
2026-03-01 last MRF observed
Data quality

1,128,895 of 1,159,487 rate rows are consumer-grade (97.4%)

30,592 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
per-diem day rate — not a per-procedure price 22,498
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 4,029
template filing: same amount across many unrelated codes — excluded 3,864
placeholder amount (≤ $0.02) — excluded from medians 175
exceeds 10× this hospital's gross charge — excluded from medians 26
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/82-1349955_HCA-HOUSTON-HEALTHCARE-TOMBALL_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page https://hcahoustonhealthcare.com/about/legal/pricing-transparency-cms-required-file-of-standard-charges.dot
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-16
Content fingerprint f67cbdebdbeb6c3f… · 607,561,025 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 21 $5,455.45 $4,910,450.00 $4,640,150.00 nat. median
$9,966
outlier · 465.6×
00845
OTHER 		Inj, Atidarsagene Autotem 2 $4,505,000.00 $4,505,000.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 $4,271,819.03 $4,271,819.03 $4,271,819.03 nat. median
$2,469,189
1.7× median
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 1 $3,847,800.00 $3,847,800.00 $3,847,800.00 nat. median
$2,448,600
1.6× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 20 $3,611,561.66 $4,790,847.10 $3,795,825.01 nat. median
$3,746,358
1.0× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 2 $3,685,267.00 $3,685,267.00 $3,685,267.00 nat. median
$3,574,709
1.0× median
908
OTHER 		Topi Adm Prad Zami Per Tr 24 $9,877.87 $4,836,939.00 $3,435,894.60 nat. median
$22,747
outlier · 151.0×
714
OTHER 		Inj Delandistrogene Mox R 24 $6,416.35 $4,825,397.00 $3,427,695.80 nat. median
$13,041
outlier · 262.8×
748
OTHER 		Inj, Lovotibeglogene Auto 24 $12,213.45 $4,716,136.60 $3,350,083.24 nat. median
$17,963
outlier · 186.5×
00908
OTHER 		Topi Adm Prad Zami Per Tr 2 $3,335,820.00 $3,335,820.00 $3,335,820.00 nat. median
$12,675
outlier · 263.2×
00714
OTHER 		Inj Delandistrogene Mox R 2 $3,327,860.00 $3,327,860.00 $3,327,860.00 nat. median
$3,228,024
1.0× median
906
OTHER 		Inj Elivaldogene Autoteme 24 $8,728.26 $4,929,000.00 $3,275,400.00 nat. median
$20,756
outlier · 157.8×
00748
OTHER 		Inj, Lovotibeglogene Auto 2 $3,252,508.00 $3,252,508.00 $3,252,508.00 nat. median
$3,187,420
1.0× median
00906
OTHER 		Inj Elivaldogene Autoteme 2 $3,180,000.00 $3,180,000.00 $3,180,000.00 nat. median
$21
outlier · 153697.4×
746
OTHER 		Inj, Betibeglogene Autote 24 $11,297.57 $4,556,951.95 $3,028,168.07 nat. median
$21,896
outlier · 138.3×
00746
OTHER 		Inj, Betibeglogene Autote 2 $2,939,969.00 $2,939,969.00 $2,939,969.00 nat. median
$2,878,960
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 22 $2,537,201.38 $4,012,920.55 $2,666,650.43 nat. median
$2,588,981
1.0× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 2 $2,588,981.00 $2,588,981.00 $2,588,981.00 nat. median
$2,457,321
1.1× median
824
OTHER 		Inj, Exagamglogene Autote 24 $13,229.17 $3,614,600.00 $2,401,960.00 nat. median
$25,250
outlier · 95.1×
00824
OTHER 		Inj, Exagamglogene Autote 2 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,332,000
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 2 $1,271,523.00 $1,978,603.20 $1,509,600.96 nat. median
$824,563
1.8× median
Q2058
HCPCS 		Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,… 2 $459,112.50 $1,428,840.00 $1,090,152.00 nat. median
$324,450
outlier · 3.4×
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 5 $553,169.00 $1,250,478.00 $969,621.79 nat. median
$675,122
1.4× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 5 $527,622.00 $1,128,119.40 $902,495.52 nat. median
$625,184
1.4× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 5 $516,442.00 $1,103,378.76 $882,703.01 nat. median
$674,188
1.3× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 5 $32.24 $1,037,313.00 $882,313.53 nat. median
$754,974
1.2× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 5 $8.47 $956,745.00 $821,756.60 nat. median
$634,511
1.3× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 5 $489,399.00 $1,003,071.60 $802,457.28 nat. median
$620,080
1.3× median
2067
OTHER 		Afamitresgene Autoleucel 23 $755,207.60 $1,656,833.00 $793,738.60 nat. median
$786,032
1.0× median
C9301
HCPCS 		Obecabtagene Autoleucel, Up To 400 Million Cd19 Car-positive Viable T Cells, Inc… 1 $545,370.00 $751,275.00 $751,275.00 nat. median
$459,112
1.6× median
9498
OTHER 		Ciltacabtagene Car-pos T 23 $575,896.61 $1,263,446.64 $605,279.09 nat. median
$587,650
1.0× median
09498
OTHER 		Ciltacabtagene Car-pos T 2 $587,649.60 $587,649.60 $587,649.60 nat. median
$554,552
1.1× median
9194
OTHER 		Tisagenlecleucel Car-pos 23 $555,200.67 $1,218,042.30 $583,527.24 nat. median
$566,531
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 23 $550,957.18 $1,208,732.58 $579,067.24 nat. median
$562,201
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 23 $546,920.16 $1,199,875.87 $574,824.25 nat. median
$558,082
1.0× median
09194
OTHER 		Tisagenlecleucel Car-pos 2 $566,531.30 $566,531.30 $566,531.30 nat. median
$538,205
1.1× median
09413
OTHER 		Lisocabtagene Car Pos T 2 $562,201.20 $562,201.20 $562,201.20 nat. median
$534,091
1.1× median
09422
OTHER 		Idecabtagene Vicleucel Ca 2 $558,081.80 $558,081.80 $558,081.80 nat. median
$530,178
1.1× median
9035
OTHER 		Axicabtagene Ciloleucel C 23 $521,548.36 $1,144,213.23 $548,157.97 nat. median
$532,192
1.0× median
09035
OTHER 		Axicabtagene Ciloleucel C 2 $532,192.20 $532,192.20 $532,192.20 nat. median
$505,583
1.1× median
9391
OTHER 		Brexucabtagene Car Pos T 23 $479,661.20 $1,052,317.93 $504,133.71 nat. median
$489,450
1.0× median
09391
OTHER 		Brexucabtagene Car Pos T 2 $489,450.20 $489,450.20 $489,450.20 nat. median
$464,978
1.1× median
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
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 23 $307,728.04 $633,491.68 $323,924.26 nat. median
$370,174
0.9× median
5834
APR_DRG 		Neonate With Ecmo 6 $278,236.22 $347,795.27 $292,148.03 nat. median
$309,665
0.9× median
831
OTHER 		Obecbtge Autol Up To 400 25 $3,735.66 $598,237.50 $286,597.50 nat. median
$12,362
outlier · 23.2×
74
APR_DRG 		Allogeneic Bone Marrow Transplant 5 $270,668.45 $473,670.00 $284,201.87 nat. median
$187,294
1.5× median
00831
OTHER 		Obecbtge Autol Up To 400 2 $278,250.00 $278,250.00 $278,250.00 nat. median
$278,250
1.0× median
897
OTHER 		Revakinagene, Per Implant 23 $259,700.00 $569,750.00 $272,950.00 nat. median
$9,577
outlier · 28.5×

Other procedures at this hospital

Browse this hospital's 28,924 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
             
011 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 2 2 — — $43,892.93 $43,892.93 $43,892.93 2026-03-01
360 OTHER Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 2 2 — — $44,387.52 $44,387.52 $44,387.52 2026-03-01
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 2 2 — — $44,652.99 $44,652.99 $44,652.99 2026-03-01
01580 OTHER New Technology - Level 43 2 2 — — $45,073.40 $45,073.40 $45,073.40 2026-03-01
01594 OTHER New Technology - Level 43 2 2 — — $45,073.40 $45,073.40 $45,073.40 2026-03-01
J2505 HCPCS Injection, Pegfilgrastim, 6 Mg 2 1 — — $45,658.30 $45,658.30 $45,658.30 2026-03-01
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 — — $45,664.67 $45,664.67 $45,664.67 2026-03-01
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 2 — — $45,703.92 $45,703.92 $45,703.92 2026-03-01
010 OTHER Pancreas Transplant 2 2 — — $45,967.08 $45,967.08 $45,967.08 2026-03-01
A0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 27 12 — — $42,597.21 $46,157.96 $43,959.97 2026-03-01
B1304 OTHER Rheumatoid, Other Arthritis; M=12-35 27 12 — — $42,662.38 $46,228.58 $44,027.22 2026-03-01
B0704 OTHER Fracture Of Lower Extremity; M < 28.15 27 12 — — $42,714.51 $46,285.08 $44,081.03 2026-03-01
447 OTHER Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 2 2 — — $46,943.55 $46,943.55 $46,943.55 2026-03-01
B1504 OTHER Pulmonary; M < 29.15 27 12 — — $43,617.59 $47,263.64 $45,012.99 2026-03-01
B1004 OTHER Amputation, Lower Extremity; M=39-45 27 12 — — $44,006.75 $47,685.33 $45,414.60 2026-03-01
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 2 — — $48,273.80 $48,273.80 $48,273.80 2026-03-01
C0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 27 12 — — $44,705.00 $48,441.95 $46,135.19 2026-03-01
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 2 — — $48,914.98 $48,914.98 $48,914.98 2026-03-01
B0604 OTHER Neurological; M < 25.85 27 12 — — $45,615.53 $49,428.59 $47,074.85 2026-03-01
850 OTHER Acute Leukemia With Other Procedures 2 2 — — $50,593.22 $50,593.22 $50,593.22 2026-03-01
B0105 OTHER Stroke; M > 34.25 & M < 38.85 27 12 — — $46,822.11 $50,736.03 $48,320.03 2026-03-01
C0106 OTHER Stroke; M > 30.05 & M < 34.25 27 12 — — $46,835.14 $50,750.15 $48,333.48 2026-03-01
B0405 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 27 12 — — $46,850.04 $50,766.30 $48,348.85 2026-03-01
D0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 27 12 — — $47,073.48 $51,008.41 $48,579.44 2026-03-01
B2102 OTHER Burns; M=12-45 27 12 — — $47,390.02 $51,351.42 $48,906.11 2026-03-01
C0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 27 12 — — $48,345.23 $52,386.48 $49,891.88 2026-03-01
275 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 2 — — $53,827.36 $53,827.36 $53,827.36 2026-03-01
231 OTHER Coronary Bypass With Ptca With Mcc 2 2 — — $54,001.65 $54,001.65 $54,001.65 2026-03-01
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 13 6 — — $43,269.78 $54,087.22 $45,433.27 2026-03-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 13 6 — — $43,470.16 $54,337.70 $45,643.67 2026-03-01
09273 OTHER Sipuleucel-t Auto Cd54+ 2 2 — — $54,404.11 $54,404.11 $54,404.11 2026-03-01
B0205 OTHER Traumatic Brain Injury; M > 28.75 & M < 40.65 27 12 — — $50,736.05 $54,977.15 $52,359.19 2026-03-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 13 6 — — $44,018.93 $55,023.66 $46,219.88 2026-03-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 6 — — $44,020.77 $55,025.96 $46,221.81 2026-03-01
01595 OTHER New Technology - Level 44 2 2 — — $55,089.60 $55,089.60 $55,089.60 2026-03-01
01581 OTHER New Technology - Level 44 2 2 — — $55,089.60 $55,089.60 $55,089.60 2026-03-01
B1903 OTHER Guillian Barre; M < 18.05 27 12 — — $51,385.90 $55,681.31 $53,029.82 2026-03-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 13 6 — — $44,593.71 $55,742.14 $46,823.40 2026-03-01
234 APR_DRG Spinal Procedures 13 6 — — $44,755.64 $55,944.55 $46,993.42 2026-03-01
4474 APR_DRG Other Kidney, Urinary Tract And Related Non-percutaneous Procedures 13 6 — — $45,428.59 $56,785.74 $47,700.02 2026-03-01
01643 OTHER Y90 Ibritumomab, Rx 2 2 — — $56,824.55 $56,824.55 $56,824.55 2026-03-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 13 6 — — $45,535.20 $56,919.00 $47,811.96 2026-03-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 2 — — $57,050.54 $57,050.54 $57,050.54 2026-03-01
B0106 OTHER Stroke; M > 30.05 & M < 34.25 27 12 — — $52,741.44 $57,150.17 $54,428.73 2026-03-01
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 13 6 — — $45,784.67 $57,230.84 $48,073.90 2026-03-01
429 OTHER Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 2 2 — — $57,715.38 $57,715.38 $57,715.38 2026-03-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 13 6 — — $48,047.16 $60,058.95 $50,449.52 2026-03-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 — — $60,166.38 $60,166.38 $60,166.38 2026-03-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 13 6 — — $48,521.94 $60,652.43 $50,948.04 2026-03-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 13 6 — — $48,853.10 $61,066.38 $51,295.75 2026-03-01
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 13 6 — — $49,152.77 $61,440.96 $51,610.41 2026-03-01
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 2 2 — — $62,616.22 $62,616.22 $62,616.22 2026-03-01
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 13 6 — — $50,208.18 $62,760.22 $52,718.59 2026-03-01
B0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 27 12 — — $58,172.92 $63,035.67 $60,033.98 2026-03-01
B0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 27 12 — — $59,146.75 $64,090.91 $61,038.96 2026-03-01
00717 OTHER Instill Adstiladrin, Tx D 2 2 — — $64,274.79 $64,274.79 $64,274.79 2026-03-01
05244 OTHER Level 4 Blood Product Exc 2 2 — — $64,367.62 $64,367.62 $64,367.62 2026-03-01
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 13 6 — — $51,771.70 $64,714.63 $54,360.28 2026-03-01
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 13 6 — — $51,829.95 $64,787.44 $54,421.45 2026-03-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 2 — — $64,830.03 $64,830.03 $64,830.03 2026-03-01
01596 OTHER New Technology - Level 45 2 2 — — $65,105.80 $65,105.80 $65,105.80 2026-03-01
01582 OTHER New Technology - Level 45 2 2 — — $65,105.80 $65,105.80 $65,105.80 2026-03-01
6904 APR_DRG Acute Leukemia 13 6 — — $52,149.39 $65,186.74 $54,756.86 2026-03-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 18 7 — — $52,621.97 $65,777.46 $55,253.07 2026-03-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 13 6 — — $52,855.69 $66,069.61 $55,498.47 2026-03-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 13 6 — — $52,916.50 $66,145.63 $55,562.33 2026-03-01
1784 APR_DRG External Heart Assist Devices 13 6 — — $53,733.43 $67,166.79 $56,420.10 2026-03-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 2 2 — — $69,176.27 $69,176.27 $69,176.27 2026-03-01
014 OTHER Allogeneic Bone Marrow Transplant 2 2 — — $69,912.66 $69,912.66 $69,912.66 2026-03-01
4414 APR_DRG Major Bladder Procedures 13 6 — — $57,370.05 $71,712.56 $60,238.55 2026-03-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 2 — — $72,591.05 $72,591.05 $72,591.05 2026-03-01
13 APR_DRG Liver Transplant And/or Intestinal Transplant 12 5 — — $41,829.34 $73,201.40 $43,920.81 2026-03-01
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 13 6 — — $58,600.94 $73,251.18 $61,530.99 2026-03-01
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 13 6 — — $58,767.62 $73,459.53 $61,706.00 2026-03-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 13 6 — — $58,767.62 $73,459.53 $61,706.00 2026-03-01
71 APR_DRG Allogeneic Bone Marrow Transplant 12 5 — — $42,137.07 $73,739.90 $44,243.92 2026-03-01
61 APR_DRG Pancreas Transplant 12 5 — — $42,879.26 $75,038.70 $45,023.22 2026-03-01
01597 OTHER New Technology - Level 46 2 2 — — $75,122.00 $75,122.00 $75,122.00 2026-03-01
01583 OTHER New Technology - Level 46 2 2 — — $75,122.00 $75,122.00 $75,122.00 2026-03-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 13 6 — — $60,324.18 $75,405.23 $63,340.39 2026-03-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 13 6 — — $60,344.70 $75,430.88 $63,361.93 2026-03-01
1611 APR_DRG Implantable Heart Assist Systems 18 7 — — $60,771.85 $75,964.81 $63,810.44 2026-03-01
62 APR_DRG Pancreas Transplant 12 5 — — $43,440.12 $76,020.20 $45,612.13 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 3 1 — — $77,046.96 $77,046.96 $77,046.96 2026-03-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 13 6 — — $61,763.52 $77,204.40 $64,851.70 2026-03-01
8634 APR_DRG Neonatal Aftercare 13 6 — — $62,362.48 $77,953.10 $65,480.60 2026-03-01
22 APR_DRG Heart And/or Lung Transplant 12 5 — — $44,843.19 $78,475.60 $47,085.35 2026-03-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 6 — — $63,344.99 $79,181.24 $66,512.24 2026-03-01
1612 APR_DRG Implantable Heart Assist Systems 18 7 — — $64,077.66 $80,097.08 $67,281.54 2026-03-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 13 6 — — $64,677.72 $80,847.15 $67,911.61 2026-03-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 69 29 — — $18,953.00 $81,656.15 $45,318.41 2026-03-01
007 OTHER Lung Transplant 2 2 — — $81,903.93 $81,903.93 $81,903.93 2026-03-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 51 23 — — $42,093.86 $82,219.48 $44,309.33 2026-03-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 69 29 — — $8,960.00 $83,269.88 $44,459.76 2026-03-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 75 28 — — $21,308.00 $83,720.22 $45,070.54 2026-03-01
63 APR_DRG Pancreas Transplant 12 5 — — $48,027.38 $84,047.90 $50,428.75 2026-03-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 13 6 — — $67,556.75 $84,445.94 $70,934.59 2026-03-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 13 6 — — $68,109.56 $85,136.95 $71,515.04 2026-03-01
01584 OTHER New Technology - Level 47 2 2 — — $85,138.20 $85,138.20 $85,138.20 2026-03-01
01598 OTHER New Technology - Level 47 2 2 — — $85,138.20 $85,138.20 $85,138.20 2026-03-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 18 7 — — $69,245.93 $86,557.41 $72,708.23 2026-03-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 49 21 — — $44,391.94 $86,988.70 $46,728.36 2026-03-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 69 29 — — $42,764.70 $89,055.68 $46,339.46 2026-03-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 13 6 — — $72,023.86 $90,029.82 $75,625.05 2026-03-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 13 6 — — $74,089.99 $92,612.49 $77,794.49 2026-03-01
1142 OTHER Supprelin La Implant 44 23 — — $42,321.63 $92,848.48 $44,480.90 2026-03-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 13 6 — — $74,312.36 $92,890.45 $78,027.98 2026-03-01
1594 OTHER New Technology - Level 43 44 23 — — $43,362.25 $95,131.46 $45,574.61 2026-03-01
1580 OTHER New Technology - Level 43 44 23 — — $43,362.25 $95,131.46 $45,574.61 2026-03-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 69 29 — — $8,960.00 $95,146.62 $44,585.38 2026-03-01
01599 OTHER New Technology - Level 48 2 2 — — $95,154.40 $95,154.40 $95,154.40 2026-03-01
01585 OTHER New Technology - Level 48 2 2 — — $95,154.40 $95,154.40 $95,154.40 2026-03-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 2 2 — — $95,505.91 $95,505.91 $95,505.91 2026-03-01
83 APR_DRG Autologous Bone Marrow Transplant 12 5 — — $54,656.23 $95,648.40 $57,389.04 2026-03-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 13 6 — — $76,579.61 $95,724.51 $80,408.59 2026-03-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 69 29 — — $8,960.00 $96,109.04 $52,534.52 2026-03-01
2464 APR_DRG Gastrointestinal Vascular Insufficiency 13 6 — — $76,976.72 $96,220.90 $80,825.56 2026-03-01
28 MS_DRG Spinal Procedures With Mcc 69 29 — — $21,000.00 $96,564.47 $48,704.79 2026-03-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 69 29 — — $8,960.00 $97,042.06 $49,570.33 2026-03-01
23 APR_DRG Heart And/or Lung Transplant 12 5 — — $55,821.55 $97,687.70 $58,612.63 2026-03-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 13 6 — — $78,716.81 $98,396.01 $82,652.65 2026-03-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 18 7 — — $79,380.25 $99,225.31 $83,349.26 2026-03-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 13 6 — — $79,424.58 $99,280.73 $83,395.81 2026-03-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 47 22 — — $6,270.00 $100,022.88 $46,371.92 2026-03-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 82 29 — — $37,448.23 $102,000.00 $44,265.80 2026-03-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 82 29 — — $38,104.21 $102,502.55 $48,018.99 2026-03-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 69 29 — — $42,982.42 $104,000.00 $46,575.38 2026-03-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 69 29 — — $50,056.91 $104,295.46 $54,241.24 2026-03-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 55 25 — — $52,909.18 $104,664.58 $57,331.93 2026-03-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 70 29 — — $8,960.00 $105,223.51 $57,091.75 2026-03-01
10 MS_DRG Pancreas Transplant 51 23 — — $53,199.72 $105,267.52 $55,999.70 2026-03-01
4404 APR_DRG Kidney Transplant 12 5 — — $60,621.65 $106,088.00 $63,652.73 2026-03-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 2 — — $106,566.90 $106,566.90 $106,566.90 2026-03-01
01902 OTHER New Technology - Level 49 2 2 — — $107,674.60 $107,674.60 $107,674.60 2026-03-01
01901 OTHER New Technology - Level 49 2 2 — — $107,674.60 $107,674.60 $107,674.60 2026-03-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 82 29 — — $40,172.56 $108,453.15 $50,592.00 2026-03-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 13 6 — — $88,668.70 $110,835.88 $93,102.13 2026-03-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 82 29 — — $41,090.79 $111,094.93 $46,774.32 2026-03-01
1613 APR_DRG Implantable Heart Assist Systems 18 7 — — $89,139.81 $111,424.76 $93,596.80 2026-03-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 13 6 — — $89,244.94 $111,556.18 $93,707.19 2026-03-01
72 APR_DRG Allogeneic Bone Marrow Transplant 12 5 — — $64,171.08 $112,299.00 $67,379.63 2026-03-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 13 6 — — $90,051.62 $112,564.52 $94,554.20 2026-03-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 13 6 — — $92,488.12 $115,610.15 $97,112.53 2026-03-01
1595 OTHER New Technology - Level 44 44 23 — — $52,998.19 $116,271.55 $55,702.18 2026-03-01
1581 OTHER New Technology - Level 44 44 23 — — $52,998.19 $116,271.55 $55,702.18 2026-03-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 13 6 — — $93,421.18 $116,776.47 $98,092.24 2026-03-01
9273 OTHER Sipuleucel-t Auto Cd54+ 44 23 — — $53,316.03 $116,968.84 $56,036.23 2026-03-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 13 6 — — $93,824.51 $117,280.64 $98,515.74 2026-03-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 13 6 — — $94,067.76 $117,584.70 $98,771.15 2026-03-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 13 6 — — $94,499.67 $118,124.59 $99,224.65 2026-03-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 82 29 — — $43,960.04 $119,349.72 $49,676.21 2026-03-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 82 29 — — $44,935.54 $122,156.22 $50,897.21 2026-03-01
1643 OTHER Y90 Ibritumomab, Rx 44 23 — — $55,688.06 $122,172.78 $58,529.29 2026-03-01
01903 OTHER New Technology - Level 50 2 2 — — $122,699.00 $122,699.00 $122,699.00 2026-03-01
01904 OTHER New Technology - Level 50 2 2 — — $122,699.00 $122,699.00 $122,699.00 2026-03-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 69 29 — — $45,796.52 $124,633.27 $49,624.71 2026-03-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 69 29 — — $56,339.69 $128,000.00 $61,049.21 2026-03-01
5831 APR_DRG Neonate With Ecmo 13 6 — — $103,367.93 $129,209.91 $108,536.33 2026-03-01
2004 APR_DRG Cardiac Structural And Valvular Disorders 13 6 — — $103,589.56 $129,486.95 $108,769.04 2026-03-01
64 APR_DRG Pancreas Transplant 12 5 — — $74,318.22 $130,057.00 $78,034.13 2026-03-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 82 29 — — $24,066.00 $130,750.85 $45,622.91 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 82 29 — — $48,955.59 $133,721.88 $59,006.50 2026-03-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 82 29 — — $48,955.59 $133,721.88 $59,006.50 2026-03-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 82 29 — — $24,066.00 $134,125.44 $46,187.87 2026-03-01
L5969 HCPCS Addition, Endoskeletal Ankle-foot Or Ankle System, Power Assist, Includes Any Ty… 2 1 — — $134,238.24 $134,238.24 $134,238.24 2026-03-01
5244 OTHER Level 4 Blood Product Exc 44 23 — — $61,923.99 $135,853.66 $65,083.38 2026-03-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 69 29 — — $46,200.00 $135,983.35 $53,899.61 2026-03-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 2 — — $136,463.10 $136,463.10 $136,463.10 2026-03-01
1596 OTHER New Technology - Level 45 44 23 — — $62,634.14 $137,411.64 $65,829.76 2026-03-01
1582 OTHER New Technology - Level 45 44 23 — — $62,634.14 $137,411.64 $65,829.76 2026-03-01
01906 OTHER New Technology - Level 51 2 2 — — $137,723.20 $137,723.20 $137,723.20 2026-03-01
01905 OTHER New Technology - Level 51 2 2 — — $137,723.20 $137,723.20 $137,723.20 2026-03-01
717 OTHER Instill Adstiladrin, Tx D 46 25 — — $12,110.72 $138,190.80 $66,203.03 2026-03-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 65 28 — — $5,119.00 $138,243.09 $51,970.89 2026-03-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 82 29 — — $28,078.00 $138,683.82 $47,667.72 2026-03-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 6 — — $111,473.48 $139,341.85 $117,047.15 2026-03-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 82 29 — — $16,045.00 $139,875.85 $53,783.80 2026-03-01
84 APR_DRG Autologous Bone Marrow Transplant 12 5 — — $80,861.35 $141,507.00 $84,904.42 2026-03-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 12 5 — — $81,186.65 $142,077.00 $85,245.98 2026-03-01
834 MS_DRG Acute Leukemia With Mcc 65 28 — — $5,119.00 $144,005.57 $44,733.98 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 82 29 — — $50,784.00 $145,010.94 $60,624.96 2026-03-01
E0767 HCPCS Intrabuccal, Systemic Delivery Of Amplitude-modulated, Radiofrequency Electromag… 5 1 — — $94,790.81 $146,008.42 $130,719.58 2026-03-01
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 15 6 — — $27,070.50 $146,379.64 $47,307.21 2026-03-01
5832 APR_DRG Neonate With Ecmo 13 6 — — $117,394.20 $146,742.75 $123,263.91 2026-03-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 46 25 — — $67,425.67 $147,923.65 $70,865.75 2026-03-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 66 28 — — $5,119.00 $148,493.11 $55,625.35 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 51 23 — — $75,359.11 $151,255.04 $79,325.38 2026-03-01
90288 CPT Botulism Immune Globulin, Human, For Intravenous Use 3 1 — — $117,866.10 $151,959.60 $127,607.10 2026-03-01
01907 OTHER New Technology - Level 52 2 2 — — $152,747.50 $152,747.50 $152,747.50 2026-03-01
01908 OTHER New Technology - Level 52 2 2 — — $152,747.50 $152,747.50 $152,747.50 2026-03-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 69 29 — — $8,960.00 $153,839.57 $47,605.61 2026-03-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 82 29 — — $16,516.00 $155,393.97 $52,323.16 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 82 29 — — $44,800.00 $155,480.43 $62,992.79 2026-03-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 82 29 — — $45,331.39 $156,000.00 $51,756.63 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 82 29 — — $50,784.00 $156,153.59 $67,447.00 2026-03-01
1583 OTHER New Technology - Level 46 44 23 — — $72,270.09 $158,551.73 $75,957.34 2026-03-01
1597 OTHER New Technology - Level 46 44 23 — — $72,270.09 $158,551.73 $75,957.34 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 82 29 — — $8,960.00 $159,523.05 $84,241.52 2026-03-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 13 6 — — $129,882.96 $162,353.70 $136,377.11 2026-03-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 13 6 — — $131,044.25 $163,805.31 $137,596.46 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 75 28 — — $67,447.00 $166,046.80 $86,828.02 2026-03-01
73 APR_DRG Allogeneic Bone Marrow Transplant 12 5 — — $95,508.56 $167,140.00 $100,283.99 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 82 29 — — $24,066.00 $167,882.98 $56,318.91 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 82 29 — — $50,784.00 $171,438.88 $67,990.80 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 51 23 — — $87,428.43 $176,302.59 $92,029.93 2026-03-01
1598 OTHER New Technology - Level 47 44 23 — — $81,906.04 $179,691.82 $86,084.92 2026-03-01
1584 OTHER New Technology - Level 47 44 23 — — $81,906.04 $179,691.82 $86,084.92 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 57 25 — — $82,578.51 $184,000.00 $89,481.36 2026-03-01
7 MS_DRG Lung Transplant 51 23 — — $94,018.72 $189,979.43 $98,967.07 2026-03-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 2 2 — — $193,614.00 $193,614.00 $193,614.00 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 82 29 — — $28,078.00 $195,437.87 $65,134.86 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 82 29 — — $50,784.00 $198,952.80 $77,616.43 2026-03-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 13 6 — — $160,222.18 $200,277.72 $168,233.29 2026-03-01
1599 OTHER New Technology - Level 48 44 23 — — $91,542.00 $200,831.93 $96,212.51 2026-03-01
1585 OTHER New Technology - Level 48 44 23 — — $91,542.00 $200,831.93 $96,212.51 2026-03-01
00886 OTHER Inj. Remestemcel-l-rknd/ 2 2 — — $201,669.00 $201,669.00 $201,669.00 2026-03-01
215 MS_DRG Other Heart Assist System Implant 82 29 — — $50,784.00 $202,495.51 $78,950.76 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 69 29 — — $100,389.18 $203,200.04 $108,780.84 2026-03-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 51 25 — — $93,179.38 $204,424.15 $97,933.43 2026-03-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 13 4 — — $39,976.89 $204,927.75 $58,512.24 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 82 29 — — $24,066.00 $209,536.27 $69,645.53 2026-03-01
1614 APR_DRG Implantable Heart Assist Systems 18 7 — — $171,023.60 $213,779.50 $179,574.78 2026-03-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 13 6 — — $176,118.96 $220,148.70 $184,924.91 2026-03-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $220,262.20 $220,262.20 $220,262.20 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 60 28 — — $8,960.00 $227,147.34 $67,040.48 2026-03-01
1902 OTHER New Technology - Level 49 44 23 — — $103,586.88 $227,256.93 $108,871.93 2026-03-01
1901 OTHER New Technology - Level 49 44 23 — — $103,586.88 $227,256.93 $108,871.93 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 69 29 — — $58,099.13 $234,000.00 $62,955.71 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 82 29 — — $24,066.00 $256,320.05 $84,613.61 2026-03-01
1904 OTHER New Technology - Level 50 44 23 — — $118,040.80 $258,967.07 $124,063.29 2026-03-01
1903 OTHER New Technology - Level 50 44 23 — — $118,040.80 $258,967.07 $124,063.29 2026-03-01
00897 OTHER Revakinagene, Per Implant 2 2 — — $265,000.00 $265,000.00 $265,000.00 2026-03-01
00831 OTHER Obecbtge Autol Up To 400 2 2 — — $278,250.00 $278,250.00 $278,250.00 2026-03-01
1905 OTHER New Technology - Level 51 44 23 — — $132,494.73 $290,677.21 $139,254.66 2026-03-01
1906 OTHER New Technology - Level 51 44 23 — — $132,494.73 $290,677.21 $139,254.66 2026-03-01
5833 APR_DRG Neonate With Ecmo 13 6 — — $235,600.21 $294,500.26 $247,380.22 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 15 6 — — $45,212.00 $310,073.39 $99,222.35 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 69 29 — — $8,896.04 $311,373.68 $165,262.13 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 58 26 — — $8,960.00 $313,211.84 $161,472.73 2026-03-01
1907 OTHER New Technology - Level 52 44 23 — — $146,948.65 $322,387.34 $154,446.03 2026-03-01
1908 OTHER New Technology - Level 52 44 23 — — $146,948.65 $322,387.34 $154,446.03 2026-03-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 13 4 — — $74,830.84 $325,380.58 $138,148.31 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
5834 APR_DRG Neonate With Ecmo 13 6 — — $278,236.22 $347,795.27 $292,148.03 2026-03-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 48 25 — — $48,608.78 $381,534.40 $51,088.82 2026-03-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 48 25 — — $49,007.06 $384,659.87 $51,507.42 2026-03-01
24 APR_DRG Heart And/or Lung Transplant 12 5 — — $226,640.73 $396,621.00 $237,972.77 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 57 25 — — $128,800.00 $411,110.61 $211,128.68 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 15 6 — — $57,017.10 $422,905.25 $135,389.25 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 13 5 — — $63,235.60 $432,000.00 $157,200.00 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 46 25 — — $8,174.23 $433,588.35 $207,719.07 2026-03-01
74 APR_DRG Allogeneic Bone Marrow Transplant 12 5 — — $270,668.45 $473,670.00 $284,201.87 2026-03-01
09391 OTHER Brexucabtagene Car Pos T 2 2 — — $489,450.20 $489,450.20 $489,450.20 2026-03-01
09035 OTHER Axicabtagene Ciloleucel C 2 2 — — $532,192.20 $532,192.20 $532,192.20 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 13 4 — — $93,760.51 $551,754.93 $147,245.34 2026-03-01
09422 OTHER Idecabtagene Vicleucel Ca 2 2 — — $558,081.80 $558,081.80 $558,081.80 2026-03-01
09413 OTHER Lisocabtagene Car Pos T 2 2 — — $562,201.20 $562,201.20 $562,201.20 2026-03-01
09194 OTHER Tisagenlecleucel Car-pos 2 2 — — $566,531.30 $566,531.30 $566,531.30 2026-03-01
897 OTHER Revakinagene, Per Implant 44 23 — — $259,700.00 $569,750.00 $272,950.00 2026-03-01
09498 OTHER Ciltacabtagene Car-pos T 2 2 — — $587,649.60 $587,649.60 $587,649.60 2026-03-01
831 OTHER Obecbtge Autol Up To 400 46 25 — — $3,735.66 $598,237.50 $286,597.50 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 48 23 — — $307,728.04 $633,491.68 $323,924.26 2026-03-01
C9301 HCPCS Obecabtagene Autoleucel, Up To 400 Million Cd19 Car-positive Viable T Cells, Inc… 5 1 — — $545,370.00 $751,275.00 $751,275.00 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 48 25 — — $109,262.16 $857,608.46 $114,836.76 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 12 5 — — $8.47 $956,745.00 $821,756.60 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 13 5 — — $489,399.00 $1,003,071.60 $802,457.28 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 12 5 — — $32.24 $1,037,313.00 $882,313.53 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 44 23 — — $479,661.20 $1,052,317.93 $504,133.71 2026-03-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 13 5 — — $516,442.00 $1,103,378.76 $882,703.01 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 13 5 — — $527,622.00 $1,128,119.40 $902,495.52 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 44 23 — — $521,548.36 $1,144,213.23 $548,157.97 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 44 23 — — $546,920.16 $1,199,875.87 $574,824.25 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 44 23 — — $550,957.18 $1,208,732.58 $579,067.24 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 44 23 — — $555,200.67 $1,218,042.30 $583,527.24 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 13 5 — — $553,169.00 $1,250,478.00 $969,621.79 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 44 23 — — $575,896.61 $1,263,446.64 $605,279.09 2026-03-01
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 8 2 — — $459,112.50 $1,428,840.00 $1,090,152.00 2026-03-01
2067 OTHER Afamitresgene Autoleucel 44 23 — — $755,207.60 $1,656,833.00 $793,738.60 2026-03-01
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 8 2 — — $1,271,523.00 $1,978,603.20 $1,509,600.96 2026-03-01
00824 OTHER Inj, Exagamglogene Autote 2 2 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2026-03-01
09141 OTHER Inj Onase Abepar-xioi Tre 2 2 — — $2,588,981.00 $2,588,981.00 $2,588,981.00 2026-03-01
00746 OTHER Inj, Betibeglogene Autote 2 2 — — $2,939,969.00 $2,939,969.00 $2,939,969.00 2026-03-01
00906 OTHER Inj Elivaldogene Autoteme 2 2 — — $3,180,000.00 $3,180,000.00 $3,180,000.00 2026-03-01
00748 OTHER Inj, Lovotibeglogene Auto 2 2 — — $3,252,508.00 $3,252,508.00 $3,252,508.00 2026-03-01
00714 OTHER Inj Delandistrogene Mox R 2 2 — — $3,327,860.00 $3,327,860.00 $3,327,860.00 2026-03-01
00908 OTHER Topi Adm Prad Zami Per Tr 2 2 — — $3,335,820.00 $3,335,820.00 $3,335,820.00 2026-03-01
824 OTHER Inj, Exagamglogene Autote 45 24 — — $13,229.17 $3,614,600.00 $2,401,960.00 2026-03-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 2 2 — — $3,685,267.00 $3,685,267.00 $3,685,267.00 2026-03-01
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 3 1 — — $3,847,800.00 $3,847,800.00 $3,847,800.00 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 43 22 — — $2,537,201.38 $4,012,920.55 $2,666,650.43 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 — — $4,505,000.00 $4,505,000.00 $4,505,000.00 2026-03-01
746 OTHER Inj, Betibeglogene Autote 45 24 — — $11,297.57 $4,556,951.95 $3,028,168.07 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 43 24 — — $12,213.45 $4,716,136.60 $3,350,083.24 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 39 20 — — $3,611,561.66 $4,790,847.10 $3,795,825.01 2026-03-01
714 OTHER Inj Delandistrogene Mox R 43 24 — — $6,416.35 $4,825,397.00 $3,427,695.80 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 42 24 — — $9,877.87 $4,836,939.00 $3,435,894.60 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
845 OTHER Inj, Atidarsagene Autotem 40 21 — — $5,455.45 $4,910,450.00 $4,640,150.00 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 44 24 — — $8,728.26 $4,929,000.00 $3,275,400.00 2026-03-01
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