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

WOMANS HOSPITAL OF TEXAS,THE

Houston, TX · CCN 450674 · Rates published

26,539 distinct procedures filed
57 distinct payers
1,079,492 rate rows
2026-03-01 last MRF observed
Data quality

1,037,971 of 1,079,492 rate rows are consumer-grade (96.2%)

41,521 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 18,622
per-diem day rate — not a per-procedure price 16,551
template filing: same amount across many unrelated codes — excluded 4,656
exceeds 10× this hospital's gross charge — excluded from medians 1,322
placeholder amount (≤ $0.02) — excluded from medians 370
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://core.secure.ehc.com/src/util/json-detail-price-list/62-1810381_the-womans-hospital-of-texas_standardcharges.json
Found on page https://womanshospital.com/about/legal/pricing-transparency-cms-required-file-of-standard-charges.dot
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 2c611b32d87b0411… · 523,458,756 bytes · first seen 2026-05-06

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $4,850,948.67 $4,850,948.67 $4,850,948.67 nat. median
$3,006,423
1.6× median
845
OTHER 		Inj, Atidarsagene Autotem 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 21 $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 25 $9,877.87 $4,836,939.00 $3,435,894.60 nat. median
$22,747
outlier · 151.0×
714
OTHER 		Inj Delandistrogene Mox R 25 $6,416.35 $4,825,397.00 $3,427,695.80 nat. median
$13,041
outlier · 262.8×
748
OTHER 		Inj, Lovotibeglogene Auto 25 $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 25 $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 25 $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 23 $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 27 $13,229.17 $4,897,200.00 $2,401,960.00 nat. median
$25,250
outlier · 95.1×
00824
OTHER 		Inj, Exagamglogene Autote 2 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,332,000
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 2 $1,271,523.00 $1,978,603.20 $1,509,600.96 nat. median
$824,563
1.8× median
Q2058
HCPCS 		Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,… 2 $459,112.50 $1,428,840.00 $1,090,152.00 nat. median
$324,450
outlier · 3.4×
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 5 $553,169.00 $1,250,478.00 $969,621.79 nat. median
$675,122
1.4× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 5 $527,622.00 $1,128,119.40 $902,495.52 nat. median
$625,184
1.4× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 5 $516,442.00 $1,103,378.76 $882,703.01 nat. median
$674,188
1.3× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 5 $32.24 $1,037,313.00 $882,313.53 nat. median
$754,974
1.2× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 5 $8.47 $956,745.00 $821,756.60 nat. median
$634,511
1.3× median
2067
OTHER 		Afamitresgene Autoleucel 26 $755,207.60 $1,687,657.80 $809,151.00 nat. median
$786,032
1.0× 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
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 26 $575,896.61 $1,286,952.62 $617,032.08 nat. median
$587,650
1.1× median
9194
OTHER 		Tisagenlecleucel Car-pos 26 $555,200.67 $1,240,703.55 $594,857.87 nat. median
$566,531
1.1× median
9413
OTHER 		Lisocabtagene Car Pos T 26 $550,957.18 $1,231,220.63 $590,311.26 nat. median
$562,201
1.1× median
09498
OTHER 		Ciltacabtagene Car-pos T 2 $587,649.60 $587,649.60 $587,649.60 nat. median
$554,552
1.1× median
9422
OTHER 		Idecabtagene Vicleucel Ca 26 $546,920.16 $1,222,199.14 $585,985.89 nat. median
$558,082
1.1× 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
9035
OTHER 		Axicabtagene Ciloleucel C 26 $521,548.36 $1,165,500.92 $558,801.81 nat. median
$532,192
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
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 26 $479,661.20 $1,071,895.94 $513,922.71 nat. median
$489,450
1.1× median
09391
OTHER 		Brexucabtagene Car Pos T 2 $489,450.20 $489,450.20 $489,450.20 nat. median
$464,978
1.1× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 32 $2,585.00 $633,491.68 $373,348.04 nat. median
$370,174
1.0× median
J3402
HCPCS 		Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 $332,753.88 $332,753.88 $332,753.88 nat. median
$209,753
1.6× median
5834
APR_DRG 		Neonate With Ecmo 8 $301,618.87 $384,717.95 $323,163.08 nat. median
$309,665
1.0× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 7 $293,415.12 $523,956.00 $314,373.34 nat. median
$187,294
1.7× median
831
OTHER 		Obecbtge Autol Up To 400 28 $3,735.66 $609,367.50 $286,597.50 nat. median
$12,362
outlier · 23.2×
00831
OTHER 		Obecbtge Autol Up To 400 2 $278,250.00 $278,250.00 $278,250.00 nat. median
$278,250
1.0× median
897
OTHER 		Revakinagene, Per Implant 26 $259,700.00 $580,350.00 $278,250.00 nat. median
$9,577
outlier · 29.1×

Other procedures at this hospital

Browse this hospital's 26,539 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
             
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 72 38 — — $2,585.00 $225,800.69 $108,549.73 2026-03-01
215 MS_DRG Other Heart Assist System Implant 82 38 — — $2,585.00 $206,757.11 $104,214.67 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 83 38 — — $28,050.00 $203,139.84 $102,784.80 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 83 38 — — $28,050.00 $175,046.87 $91,679.96 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 83 38 — — $28,050.00 $159,439.90 $85,510.71 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 83 38 — — $28,050.00 $158,752.58 $83,615.41 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 72 38 — — $2,585.00 $148,062.76 $78,698.77 2026-03-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 83 38 — — $28,050.00 $142,819.59 $77,437.24 2026-03-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 83 38 — — $28,050.00 $136,536.10 $76,457.08 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 83 38 — — $28,050.00 $136,536.10 $75,000.76 2026-03-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 83 38 — — $28,050.00 $156,000.00 $72,248.76 2026-03-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 72 38 — — $2,585.00 $124,727.05 $69,737.97 2026-03-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 83 38 — — $28,050.00 $121,861.48 $68,637.61 2026-03-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 83 38 — — $28,050.00 $113,432.97 $65,401.10 2026-03-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 83 38 — — $28,050.00 $110,735.59 $64,884.18 2026-03-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 83 38 — — $28,050.00 $109,562.37 $63,914.81 2026-03-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 83 38 — — $28,050.00 $102,732.76 $63,094.99 2026-03-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 83 38 — — $28,050.00 $104,659.75 $62,032.24 2026-03-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 72 38 — — $2,585.00 $95,903.15 $58,669.75 2026-03-01
245 MS_DRG Aicd Generator Procedures 83 38 — — $28,050.00 $97,265.76 $58,222.42 2026-03-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 83 38 — — $28,050.00 $87,694.75 $55,517.76 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 80 37 — — $2,585.00 $440,741.28 $196,706.06 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 80 37 — — $2,585.00 $287,624.32 $136,180.59 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 71 37 — — $2,585.00 $269,424.26 $109,722.62 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 71 37 — — $2,585.00 $220,248.68 $93,682.87 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 71 37 — — $2,585.00 $227,147.34 $90,891.29 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 80 37 — — $2,585.00 $205,429.52 $90,591.37 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 81 37 — — $2,585.00 $234,000.00 $87,074.36 2026-03-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 81 37 — — $2,585.00 $158,227.22 $83,216.93 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 71 37 — — $2,585.00 $176,465.90 $79,402.05 2026-03-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 81 37 — — $2,585.00 $143,523.53 $77,710.20 2026-03-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 81 37 — — $2,585.00 $139,771.29 $75,514.88 2026-03-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 71 37 — — $2,585.00 $138,845.17 $75,159.26 2026-03-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 71 37 — — $2,585.00 $163,338.39 $75,120.20 2026-03-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 81 37 — — $2,585.00 $136,039.82 $74,082.03 2026-03-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 81 37 — — $2,585.00 $133,616.55 $73,151.50 2026-03-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 82 37 — — $28,050.00 $127,256.23 $72,788.85 2026-03-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 80 37 — — $2,585.00 $145,773.94 $70,751.74 2026-03-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 81 37 — — $2,585.00 $127,108.79 $70,652.55 2026-03-01
28 MS_DRG Spinal Procedures With Mcc 81 37 — — $2,585.00 $124,762.35 $69,751.53 2026-03-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 81 37 — — $2,585.00 $153,839.57 $68,607.31 2026-03-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 81 37 — — $2,585.00 $118,989.68 $68,196.96 2026-03-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 71 37 — — $2,585.00 $140,982.53 $67,828.29 2026-03-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 81 37 — — $2,585.00 $118,350.12 $67,289.27 2026-03-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 71 37 — — $2,585.00 $137,435.41 $66,671.31 2026-03-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 81 37 — — $2,585.00 $160,614.36 $66,527.81 2026-03-01
834 MS_DRG Acute Leukemia With Mcc 81 37 — — $2,585.00 $144,005.57 $66,261.30 2026-03-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 71 37 — — $2,585.00 $115,582.14 $66,226.38 2026-03-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 81 37 — — $2,585.00 $234,000.00 $65,938.31 2026-03-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 81 37 — — $2,585.00 $113,594.93 $65,463.30 2026-03-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 81 37 — — $2,585.00 $113,254.39 $65,332.53 2026-03-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 71 37 — — $2,585.00 $130,287.40 $64,339.82 2026-03-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 81 37 — — $2,585.00 $151,378.24 $63,970.56 2026-03-01
653 MS_DRG Major Bladder Procedures With Mcc 81 37 — — $2,585.00 $107,903.25 $63,277.72 2026-03-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 81 37 — — $2,585.00 $103,563.36 $61,611.22 2026-03-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 81 37 — — $2,585.00 $102,550.03 $61,222.11 2026-03-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 81 37 — — $2,585.00 $102,199.10 $61,087.36 2026-03-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 81 37 — — $2,585.00 $101,773.42 $60,923.90 2026-03-01
471 MS_DRG Cervical Spinal Fusion With Mcc 80 37 — — $2,585.00 $118,042.40 $60,641.62 2026-03-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 82 37 — — $28,050.00 $100,500.89 $60,282.35 2026-03-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 81 37 — — $2,585.00 $126,021.59 $60,151.25 2026-03-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 81 37 — — $2,585.00 $97,425.23 $59,254.22 2026-03-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. 81 37 — — $2,585.00 $122,703.37 $59,142.58 2026-03-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 81 37 — — $2,585.00 $95,446.32 $58,494.33 2026-03-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 81 37 — — $2,585.00 $120,263.89 $58,401.03 2026-03-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 80 37 — — $2,585.00 $111,148.63 $58,382.02 2026-03-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 81 37 — — $2,585.00 $94,453.76 $58,113.18 2026-03-01
799 MS_DRG Splenic Procedures With Mcc 81 37 — — $2,585.00 $94,042.61 $57,955.31 2026-03-01
163 MS_DRG Major Chest Procedures With Mcc 81 37 — — $2,585.00 $93,064.58 $57,579.74 2026-03-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 81 37 — — $2,585.00 $93,037.58 $57,569.38 2026-03-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 81 37 — — $2,585.00 $92,672.12 $57,429.04 2026-03-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 81 37 — — $2,585.00 $91,216.49 $56,870.09 2026-03-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 80 37 — — $2,585.00 $102,003.38 $56,194.96 2026-03-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 81 37 — — $2,585.00 $89,142.07 $56,073.52 2026-03-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 71 37 — — $2,585.00 $89,858.46 $55,796.18 2026-03-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 71 37 — — $2,585.00 $103,670.60 $55,658.10 2026-03-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 81 37 — — $2,585.00 $87,501.63 $55,443.60 2026-03-01
140 MS_DRG Major Head And Neck Procedures With Mcc 81 37 — — $2,585.00 $88,568.95 $55,384.92 2026-03-01
901 MS_DRG Wound Debridements For Injuries With Mcc 81 37 — — $2,585.00 $87,142.40 $55,305.65 2026-03-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 82 37 — — $28,050.00 $86,980.43 $55,243.47 2026-03-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 81 37 — — $2,585.00 $86,237.04 $54,958.01 2026-03-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 81 37 — — $2,585.00 $87,545.24 $54,372.89 2026-03-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 81 37 — — $2,585.00 $87,246.22 $54,260.32 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 65 36 — — $2,585.00 $189,567.26 $112,095.65 2026-03-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 65 36 — — $2,585.00 $102,342.97 $66,713.66 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 69 35 — — $2,585.00 $443,343.13 $192,154.50 2026-03-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 69 35 — — $2,585.00 $148,941.12 $79,036.06 2026-03-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 60 34 — — $2,585.00 $119,642.16 $78,732.26 2026-03-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 65 34 — — $2,585.00 $245,466.00 $59,330.76 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 58 32 — — $2,585.00 $633,491.68 $373,348.04 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 56 31 — — $2,585.00 $469,344.28 $245,296.33 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 55 31 — — $2,585.00 $201,884.90 $117,670.06 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 56 31 — — $2,585.00 $192,498.77 $112,199.29 2026-03-01
7 MS_DRG Lung Transplant 54 30 — — $2,585.00 $216,889.95 $125,103.82 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 54 30 — — $2,585.00 $178,527.13 $104,055.81 2026-03-01
10 MS_DRG Pancreas Transplant 54 30 — — $2,585.00 $135,642.11 $79,059.98 2026-03-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 54 30 — — $2,585.00 $114,149.02 $66,206.43 2026-03-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 54 30 — — $2,585.00 $111,791.91 $64,200.49 2026-03-01
6 MS_DRG Liver Transplant Without Mcc 54 30 — — $2,585.00 $100,911.97 $57,952.30 2026-03-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 53 29 — — $2,585.00 $118,596.47 $68,447.10 2026-03-01
831 OTHER Obecbtge Autol Up To 400 49 28 — — $3,735.66 $609,367.50 $286,597.50 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 49 28 — — $8,174.23 $441,655.11 $207,719.07 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 51 28 — — $109,262.16 $857,608.46 $117,066.60 2026-03-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 54 28 — — $93,179.38 $208,227.39 $99,835.05 2026-03-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 49 28 — — $67,425.67 $150,675.72 $70,865.75 2026-03-01
717 OTHER Instill Adstiladrin, Tx D 49 28 — — $12,110.72 $140,761.79 $66,203.03 2026-03-01
824 OTHER Inj, Exagamglogene Autote 48 27 — — $13,229.17 $4,897,200.00 $2,401,960.00 2026-03-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 51 27 — — $6,270.00 $101,917.77 $68,556.07 2026-03-01
2067 OTHER Afamitresgene Autoleucel 47 26 — — $755,207.60 $1,687,657.80 $809,151.00 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 47 26 — — $575,896.61 $1,286,952.62 $617,032.08 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 47 26 — — $555,200.67 $1,240,703.55 $594,857.87 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 47 26 — — $550,957.18 $1,231,220.63 $590,311.26 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 47 26 — — $546,920.16 $1,222,199.14 $585,985.89 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 47 26 — — $521,548.36 $1,165,500.92 $558,801.81 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 47 26 — — $479,661.20 $1,071,895.94 $513,922.71 2026-03-01
897 OTHER Revakinagene, Per Implant 47 26 — — $259,700.00 $580,350.00 $278,250.00 2026-03-01
1908 OTHER New Technology - Level 52 47 26 — — $146,948.65 $328,385.24 $157,444.98 2026-03-01
1907 OTHER New Technology - Level 52 47 26 — — $146,948.65 $328,385.24 $157,444.98 2026-03-01
1906 OTHER New Technology - Level 51 47 26 — — $132,494.73 $296,085.15 $141,958.64 2026-03-01
1905 OTHER New Technology - Level 51 47 26 — — $132,494.73 $296,085.15 $141,958.64 2026-03-01
1904 OTHER New Technology - Level 50 47 26 — — $118,040.80 $263,785.06 $126,472.29 2026-03-01
1903 OTHER New Technology - Level 50 47 26 — — $118,040.80 $263,785.06 $126,472.29 2026-03-01
1902 OTHER New Technology - Level 49 47 26 — — $103,586.88 $231,484.97 $110,985.94 2026-03-01
1901 OTHER New Technology - Level 49 47 26 — — $103,586.88 $231,484.97 $110,985.94 2026-03-01
1599 OTHER New Technology - Level 48 47 26 — — $91,542.00 $204,568.34 $98,080.71 2026-03-01
1585 OTHER New Technology - Level 48 47 26 — — $91,542.00 $204,568.34 $98,080.71 2026-03-01
1584 OTHER New Technology - Level 47 47 26 — — $81,906.04 $183,034.92 $87,756.47 2026-03-01
1598 OTHER New Technology - Level 47 47 26 — — $81,906.04 $183,034.92 $87,756.47 2026-03-01
1597 OTHER New Technology - Level 46 47 26 — — $72,270.09 $161,501.53 $77,432.24 2026-03-01
1583 OTHER New Technology - Level 46 47 26 — — $72,270.09 $161,501.53 $77,432.24 2026-03-01
1596 OTHER New Technology - Level 45 47 26 — — $62,634.14 $139,968.13 $67,108.01 2026-03-01
1582 OTHER New Technology - Level 45 47 26 — — $62,634.14 $139,968.13 $67,108.01 2026-03-01
5244 OTHER Level 4 Blood Product Exc 47 26 — — $61,923.99 $138,381.17 $66,347.14 2026-03-01
1643 OTHER Y90 Ibritumomab, Rx 47 26 — — $55,688.06 $124,445.76 $59,665.78 2026-03-01
9273 OTHER Sipuleucel-t Auto Cd54+ 47 26 — — $53,316.03 $119,145.00 $57,124.32 2026-03-01
1581 OTHER New Technology - Level 44 47 26 — — $52,998.19 $118,434.74 $56,783.78 2026-03-01
1595 OTHER New Technology - Level 44 47 26 — — $52,998.19 $118,434.74 $56,783.78 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 44 25 — — $9,877.87 $4,836,939.00 $3,435,894.60 2026-03-01
714 OTHER Inj Delandistrogene Mox R 44 25 — — $6,416.35 $4,825,397.00 $3,427,695.80 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 44 25 — — $12,213.45 $4,716,136.60 $3,350,083.24 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 46 25 — — $8,728.26 $4,929,000.00 $3,275,400.00 2026-03-01
746 OTHER Inj, Betibeglogene Autote 46 25 — — $11,297.57 $4,556,951.95 $3,028,168.07 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 44 23 — — $2,537,201.38 $4,012,920.55 $2,666,650.43 2026-03-01
845 OTHER Inj, Atidarsagene Autotem 40 21 — — $5,455.45 $4,910,450.00 $4,640,150.00 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 40 21 — — $3,611,561.66 $4,790,847.10 $3,795,825.01 2026-03-01
1614 APR_DRG Implantable Heart Assist Systems 20 9 — — $185,396.22 $236,474.78 $198,638.81 2026-03-01
1613 APR_DRG Implantable Heart Assist Systems 20 9 — — $96,631.02 $123,253.85 $103,533.23 2026-03-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 20 9 — — $86,051.27 $109,759.27 $92,197.79 2026-03-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 20 9 — — $75,065.28 $95,746.52 $80,427.08 2026-03-01
1612 APR_DRG Implantable Heart Assist Systems 20 9 — — $69,462.67 $88,600.35 $74,424.29 2026-03-01
1611 APR_DRG Implantable Heart Assist Systems 20 9 — — $65,879.04 $84,029.39 $70,584.69 2026-03-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 20 9 — — $57,044.26 $72,760.54 $61,118.85 2026-03-01
5834 APR_DRG Neonate With Ecmo 15 8 — — $301,618.87 $384,717.95 $323,163.08 2026-03-01
5833 APR_DRG Neonate With Ecmo 15 8 — — $255,399.78 $325,765.02 $273,642.62 2026-03-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 15 8 — — $190,919.80 $243,520.15 $204,556.93 2026-03-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 15 8 — — $173,687.07 $221,539.63 $186,093.29 2026-03-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 15 8 — — $142,057.06 $181,195.22 $152,203.99 2026-03-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 15 8 — — $140,798.18 $179,589.51 $150,855.19 2026-03-01
5832 APR_DRG Neonate With Ecmo 15 8 — — $127,259.88 $162,321.27 $136,349.87 2026-03-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 15 8 — — $120,841.59 $154,134.68 $129,473.13 2026-03-01
2004 APR_DRG Cardiac Structural And Valvular Disorders 15 8 — — $112,295.11 $143,233.56 $120,316.19 2026-03-01
5831 APR_DRG Neonate With Ecmo 15 8 — — $112,054.86 $142,927.11 $120,058.77 2026-03-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 15 8 — — $102,441.31 $130,664.94 $109,758.55 2026-03-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 15 8 — — $101,973.11 $130,067.74 $109,256.90 2026-03-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 15 8 — — $101,709.42 $129,731.40 $108,974.38 2026-03-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 15 8 — — $101,272.18 $129,173.70 $108,505.91 2026-03-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 15 8 — — $100,260.71 $127,883.56 $107,422.19 2026-03-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 15 8 — — $97,619.46 $124,514.61 $104,592.27 2026-03-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 15 8 — — $96,744.99 $123,399.23 $103,655.35 2026-03-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 15 8 — — $96,120.31 $122,602.44 $102,986.05 2026-03-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 15 8 — — $86,099.33 $109,820.58 $92,249.28 2026-03-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 15 8 — — $85,332.09 $108,841.95 $91,427.24 2026-03-01
2464 APR_DRG Gastrointestinal Vascular Insufficiency 15 8 — — $83,445.76 $106,435.91 $89,406.17 2026-03-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 15 8 — — $83,015.27 $105,886.83 $88,944.93 2026-03-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 15 8 — — $80,557.48 $102,751.89 $86,311.59 2026-03-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 15 8 — — $80,316.43 $102,444.42 $86,053.32 2026-03-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 15 8 — — $78,076.66 $99,587.57 $83,653.56 2026-03-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 15 8 — — $73,833.41 $94,175.26 $79,107.22 2026-03-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 15 8 — — $73,234.15 $93,410.90 $78,465.16 2026-03-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 15 8 — — $70,113.16 $89,430.05 $75,121.24 2026-03-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 15 8 — — $68,668.43 $87,587.29 $73,573.32 2026-03-01
8634 APR_DRG Neonatal Aftercare 15 8 — — $67,603.35 $86,228.76 $72,432.16 2026-03-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 15 8 — — $66,954.05 $85,400.58 $71,736.48 2026-03-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 15 8 — — $65,416.00 $83,438.78 $70,088.57 2026-03-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 15 8 — — $65,393.75 $83,410.40 $70,064.74 2026-03-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 15 8 — — $63,706.39 $81,258.15 $68,256.85 2026-03-01
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 15 8 — — $63,706.39 $81,258.15 $68,256.85 2026-03-01
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 15 8 — — $63,525.70 $81,027.68 $68,063.25 2026-03-01
4414 APR_DRG Major Bladder Procedures 15 8 — — $62,191.36 $79,325.71 $66,633.60 2026-03-01
1784 APR_DRG External Heart Assist Devices 15 8 — — $58,249.13 $74,297.36 $62,409.78 2026-03-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 15 8 — — $57,363.55 $73,167.79 $61,460.94 2026-03-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 15 8 — — $57,297.62 $73,083.70 $61,390.31 2026-03-01
6904 APR_DRG Acute Leukemia 15 8 — — $56,531.97 $72,107.10 $60,569.96 2026-03-01
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 15 8 — — $56,185.68 $71,665.41 $60,198.95 2026-03-01
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 15 8 — — $56,122.54 $71,584.88 $60,131.30 2026-03-01
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 15 8 — — $54,427.62 $69,422.99 $58,315.31 2026-03-01
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 15 8 — — $53,283.51 $67,963.66 $57,089.48 2026-03-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 15 8 — — $52,958.66 $67,549.31 $56,741.42 2026-03-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 15 8 — — $52,599.67 $67,091.41 $56,356.79 2026-03-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 15 8 — — $52,084.99 $66,434.94 $55,805.35 2026-03-01
74 APR_DRG Allogeneic Bone Marrow Transplant 14 7 — — $293,415.12 $523,956.00 $314,373.34 2026-03-01
24 APR_DRG Heart And/or Lung Transplant 14 7 — — $245,687.35 $438,727.00 $263,236.45 2026-03-01
73 APR_DRG Allogeneic Bone Marrow Transplant 14 7 — — $103,534.99 $184,884.00 $110,930.35 2026-03-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 14 7 — — $88,009.49 $157,160.00 $94,295.88 2026-03-01
84 APR_DRG Autologous Bone Marrow Transplant 14 7 — — $87,656.84 $156,530.00 $93,918.05 2026-03-01
64 APR_DRG Pancreas Transplant 14 7 — — $80,563.84 $143,864.00 $86,318.40 2026-03-01
72 APR_DRG Allogeneic Bone Marrow Transplant 14 7 — — $69,563.94 $124,221.00 $74,532.79 2026-03-01
4404 APR_DRG Kidney Transplant 14 7 — — $65,716.22 $117,350.00 $70,410.24 2026-03-01
23 APR_DRG Heart And/or Lung Transplant 14 7 — — $60,512.73 $108,058.00 $64,835.06 2026-03-01
83 APR_DRG Autologous Bone Marrow Transplant 14 7 — — $59,249.48 $105,803.00 $63,481.58 2026-03-01
63 APR_DRG Pancreas Transplant 14 7 — — $52,063.55 $92,970.60 $55,782.37 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
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
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
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
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
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
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 17 5 — — $74,830.84 $325,380.58 $162,475.02 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
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
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 13 4 — — $39,976.89 $204,927.75 $58,512.24 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
09138 OTHER Inj, Hemgenix, Per Tx Dos 2 2 — — $3,685,267.00 $3,685,267.00 $3,685,267.00 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
00714 OTHER Inj Delandistrogene Mox R 2 2 — — $3,327,860.00 $3,327,860.00 $3,327,860.00 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
00906 OTHER Inj Elivaldogene Autoteme 2 2 — — $3,180,000.00 $3,180,000.00 $3,180,000.00 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
09141 OTHER Inj Onase Abepar-xioi Tre 2 2 — — $2,588,981.00 $2,588,981.00 $2,588,981.00 2026-03-01
00824 OTHER Inj, Exagamglogene Autote 2 2 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2026-03-01
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
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
09498 OTHER Ciltacabtagene Car-pos T 2 2 — — $587,649.60 $587,649.60 $587,649.60 2026-03-01
09194 OTHER Tisagenlecleucel Car-pos 2 2 — — $566,531.30 $566,531.30 $566,531.30 2026-03-01
09413 OTHER Lisocabtagene Car Pos T 2 2 — — $562,201.20 $562,201.20 $562,201.20 2026-03-01
09422 OTHER Idecabtagene Vicleucel Ca 2 2 — — $558,081.80 $558,081.80 $558,081.80 2026-03-01
09035 OTHER Axicabtagene Ciloleucel C 2 2 — — $532,192.20 $532,192.20 $532,192.20 2026-03-01
09391 OTHER Brexucabtagene Car Pos T 2 2 — — $489,450.20 $489,450.20 $489,450.20 2026-03-01
00831 OTHER Obecbtge Autol Up To 400 2 2 — — $278,250.00 $278,250.00 $278,250.00 2026-03-01
00897 OTHER Revakinagene, Per Implant 2 2 — — $265,000.00 $265,000.00 $265,000.00 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
00886 OTHER Inj. Remestemcel-l-rknd/ 2 2 — — $201,669.00 $201,669.00 $201,669.00 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
01908 OTHER New Technology - Level 52 2 2 — — $152,747.50 $152,747.50 $152,747.50 2026-03-01
01907 OTHER New Technology - Level 52 2 2 — — $152,747.50 $152,747.50 $152,747.50 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
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
01904 OTHER New Technology - Level 50 2 2 — — $122,699.00 $122,699.00 $122,699.00 2026-03-01
01903 OTHER New Technology - Level 50 2 2 — — $122,699.00 $122,699.00 $122,699.00 2026-03-01
01901 OTHER New Technology - Level 49 2 2 — — $107,674.60 $107,674.60 $107,674.60 2026-03-01
01902 OTHER New Technology - Level 49 2 2 — — $107,674.60 $107,674.60 $107,674.60 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
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 2 2 — — $95,505.91 $95,505.91 $95,505.91 2026-03-01
01585 OTHER New Technology - Level 48 2 2 — — $95,154.40 $95,154.40 $95,154.40 2026-03-01
01599 OTHER New Technology - Level 48 2 2 — — $95,154.40 $95,154.40 $95,154.40 2026-03-01
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
007 OTHER Lung Transplant 2 2 — — $81,903.93 $81,903.93 $81,903.93 2026-03-01
01583 OTHER New Technology - Level 46 2 2 — — $75,122.00 $75,122.00 $75,122.00 2026-03-01
01597 OTHER New Technology - Level 46 2 2 — — $75,122.00 $75,122.00 $75,122.00 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
014 OTHER Allogeneic Bone Marrow Transplant 2 2 — — $69,912.66 $69,912.66 $69,912.66 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
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
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
05244 OTHER Level 4 Blood Product Exc 2 2 — — $64,367.62 $64,367.62 $64,367.62 2026-03-01
00717 OTHER Instill Adstiladrin, Tx D 2 2 — — $64,274.79 $64,274.79 $64,274.79 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
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
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
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
01643 OTHER Y90 Ibritumomab, Rx 2 2 — — $56,824.55 $56,824.55 $56,824.55 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
09273 OTHER Sipuleucel-t Auto Cd54+ 2 2 — — $54,404.11 $54,404.11 $54,404.11 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
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
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 3 1 — — $332,753.88 $332,753.88 $332,753.88 2026-03-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc Pediatric 5 1 — — $111,569.88 $164,952.16 $164,952.16 2026-03-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 5 1 — — $96,548.99 $142,744.30 $142,744.30 2026-03-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 5 1 — — $91,304.43 $134,990.40 $134,990.40 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
E0767 HCPCS Intrabuccal, Systemic Delivery Of Amplitude-modulated, Radiofrequency Electromag… 5 1 — — $94,790.81 $146,008.42 $130,719.58 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
459 MS_DRG Spinal Fusion Except Cervical With Mcc Pediatric 5 1 — — $81,764.89 $120,886.53 $120,886.53 2026-03-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc Pediatric 5 1 — — $79,718.79 $117,861.45 $117,861.45 2026-03-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc Pediatric 5 1 — — $73,988.51 $109,389.42 $109,389.42 2026-03-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 5 1 — — $70,412.40 $104,102.27 $104,102.27 2026-03-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 5 1 — — $68,216.95 $100,856.36 $100,856.36 2026-03-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc Pediat… 5 1 — — $63,290.53 $93,572.83 $93,572.83 2026-03-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc Pediatric 5 1 — — $58,059.33 $85,838.68 $85,838.68 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 3 1 — — $77,046.96 $77,046.96 $77,046.96 2026-03-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc Pediatric 5 1 — — $47,730.49 $70,567.86 $70,567.86 2026-03-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 5 1 — — $38,398.59 $56,770.98 $56,770.98 2026-03-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 5 1 — — $37,938.37 $56,090.56 $56,090.56 2026-03-01
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