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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

TEXAS ORTHOPEDIC HOSPITAL

Houston, TX · CCN 450804 · Rates published

32,873 distinct procedures filed
116 distinct payers
2,006,382 rate rows
2026-07-31 last MRF observed
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://core.secure.ehc.com/src/util/json-detail-price-list/76-0418502_texas-orthopedic-hospital_standardcharges.json
Found on page https://texasorthopedic.com/about/legal/pricing-transparency-cms-required-file-of-standard-charges.dot
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-11
Content fingerprint 318518bc07f7622e… · 722,833,905 bytes · first seen 2026-05-09

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
$2,994,107
1.6× median
845
OTHER 		Inj, Atidarsagene Autotem 22 $5,455.45 $4,910,450.00 $4,640,150.00 nat. median
$17,156
outlier · 270.5×
00845
OTHER 		Inj, Atidarsagene Autotem 1 $4,505,000.00 $4,505,000.00 $4,505,000.00 nat. median
$4,414,900
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
$2,467,386
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
$2,401,965
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
$3,758,972
1.0× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 1 $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 26 $8,651.17 $4,836,939.00 $3,435,894.60 nat. median
$30,519
outlier · 112.6×
714
OTHER 		Inj Delandistrogene Mox R 26 $6,416.35 $4,825,397.00 $3,427,695.80 nat. median
$3,325,455
1.0× median
748
OTHER 		Inj, Lovotibeglogene Auto 26 $12,213.45 $4,716,136.60 $3,350,083.24 nat. median
$3,252,508
1.0× median
00908
OTHER 		Topi Adm Prad Zami Per Tr 1 $3,335,820.00 $3,335,820.00 $3,335,820.00 nat. median
$14,890
outlier · 224.0×
00714
OTHER 		Inj Delandistrogene Mox R 1 $3,327,860.00 $3,327,860.00 $3,327,860.00 nat. median
$3,228,024
1.0× median
00748
OTHER 		Inj, Lovotibeglogene Auto 1 $3,252,508.00 $3,252,508.00 $3,252,508.00 nat. median
$3,187,420
1.0× median
906
OTHER 		Inj Elivaldogene Autoteme 41 $15.06 $4,929,000.00 $3,180,000.00 nat. median
$25,059
outlier · 126.9×
00906
OTHER 		Inj Elivaldogene Autoteme 1 $3,180,000.00 $3,180,000.00 $3,180,000.00 nat. median
$3,084,600
1.0× median
746
OTHER 		Inj, Betibeglogene Autote 26 $9,894.57 $4,556,951.95 $3,028,168.07 nat. median
$2,939,969
1.0× median
00746
OTHER 		Inj, Betibeglogene Autote 1 $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 1 $2,588,981.00 $2,588,981.00 $2,588,981.00 nat. median
$2,511,312
1.0× median
824
OTHER 		Inj, Exagamglogene Autote 28 $5,358.66 $4,897,200.00 $2,401,960.00 nat. median
$2,285,360
1.1× median
00824
OTHER 		Inj, Exagamglogene Autote 1 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,285,360
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
$813,967
1.9× 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
$319,951
outlier · 3.4×
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 4 $553,169.00 $1,250,478.00 $969,621.79 nat. median
$646,415
1.5× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 4 $32.24 $1,037,313.00 $934,776.65 nat. median
$739,258
1.3× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 4 $527,622.00 $1,128,119.40 $911,665.19 nat. median
$622,450
1.5× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 4 $516,442.00 $1,103,378.76 $905,167.53 nat. median
$640,950
1.4× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 4 $8.47 $956,745.00 $878,117.20 nat. median
$608,239
1.4× median
2067
OTHER 		Afamitresgene Autoleucel 26 $755,207.60 $1,687,657.80 $809,151.00 nat. median
$793,739
1.0× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 4 $489,399.00 $1,003,071.60 $805,025.05 nat. median
$591,721
1.4× 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
$577,163
1.0× 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 1 $587,649.60 $587,649.60 $587,649.60 nat. median
$570,020
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 26 $546,920.16 $1,222,199.14 $585,985.89 nat. median
$563,449
1.0× median
09194
OTHER 		Tisagenlecleucel Car-pos 1 $566,531.30 $566,531.30 $566,531.30 nat. median
$549,535
1.0× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $562,201.20 $562,201.20 $562,201.20 nat. median
$545,335
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 26 $521,548.36 $1,165,500.92 $558,801.81 nat. median
$533,230
1.0× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $558,081.80 $558,081.80 $558,081.80 nat. median
$541,339
1.0× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $532,192.20 $532,192.20 $532,192.20 nat. median
$516,226
1.0× median
9391
OTHER 		Brexucabtagene Car Pos T 26 $479,661.20 $1,071,895.94 $513,922.71 nat. median
$492,768
1.0× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $489,450.20 $489,450.20 $489,450.20 nat. median
$474,767
1.0× median
24
APR_DRG 		Heart And/or Lung Transplant 16 $216,146.20 $537,458.68 $385,975.00 nat. median
$241,437
1.6× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 14 $224,142.59 $460,956.00 $333,375.47 nat. median
$170,082
2.0× 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
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 68 $2,585.00 $979,659.81 $328,821.09 nat. median
$359,454
0.9× median
5834
APR_DRG 		Neonate With Ecmo 17 $265,352.59 $588,944.20 $314,090.82 nat. median
$307,206
1.0× median
681
OTHER 		Neonate, Birth Weight >2499 Grams, With Significant O.r. Procedures, With Multip… 2 $282,239.43 $332,745.43 $307,492.43 nat. median
$1
18
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $267,555.45 $315,433.80 $291,494.62 nat. median
$380,401
0.8× median

Other procedures at this hospital

Browse this hospital's 32,873 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
             
018 OTHER $1,157.00 1 1 $504,984.59 — $220,262.20 $220,262.20 $220,262.20 2026-07-31
001 OTHER $1,157.00 1 1 $393,229.16 — $193,614.00 $193,614.00 $193,614.00 2026-07-31
003 OTHER $1,157.00 1 1 $282,732.52 — $136,463.10 $136,463.10 $136,463.10 2026-07-31
004 OTHER $1,157.00 1 1 $191,845.58 — $106,566.90 $106,566.90 $106,566.90 2026-07-31
007 OTHER $1,157.00 1 1 $170,548.19 — $81,903.93 $81,903.93 $81,903.93 2026-07-31
002 OTHER $1,157.00 1 1 $188,232.68 — $72,591.05 $72,591.05 $72,591.05 2026-07-31
014 OTHER $1,157.00 1 1 $156,377.40 — $69,912.66 $69,912.66 $69,912.66 2026-07-31
005 OTHER $1,157.00 1 1 $159,367.20 — $69,176.27 $69,176.27 $69,176.27 2026-07-31
020 OTHER $1,157.00 1 1 $244,122.00 — $57,050.54 $57,050.54 $57,050.54 2026-07-31
010 OTHER $1,157.00 1 1 $57,934.94 — $45,967.08 $45,967.08 $45,967.08 2026-07-31
019 OTHER $1,157.00 1 1 $99,677.50 — $45,703.92 $45,703.92 $45,703.92 2026-07-31
429 OTHER $20.00 1 1 $319.00 — $57,715.38 $57,715.38 $57,715.38 2026-07-31
850 OTHER $322.99 1 1 $699.25 — $50,593.22 $50,593.22 $50,593.22 2026-07-31
6904 APR_DRG Acute Leukemia 27 17 — — $49,734.64 $95,802.54 $58,869.57 2026-07-17
850 MS_DRG Acute Leukemia With Other Procedures 70 36 — — $2,585.00 $227,147.34 $65,010.19 2026-03-01
266 OTHER Acute Leukemia Without Major O.r. Procedures Age 0-17 3 3 $24,701.64 — $23,520.26 $107,102.25 $90,845.66 2026-07-31
L5969 HCPCS Addition, Endoskeletal Ankle-foot Or Ankle System, Power Assist, Includes Any Ty… 2 1 $127,898.44 — $134,238.24 $134,238.24 $134,238.24 2026-07-31
2067 OTHER Afamitresgene Autoleucel 47 26 — — $755,207.60 $1,687,657.80 $809,151.00 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
74 APR_DRG Allogeneic Bone Marrow Transplant 24 14 — — $224,142.59 $460,956.00 $333,375.47 2026-07-17
73 APR_DRG Allogeneic Bone Marrow Transplant 24 14 — — $91,086.07 $220,943.88 $162,654.00 2026-07-17
72 APR_DRG Allogeneic Bone Marrow Transplant 24 14 — — $61,199.66 $198,437.33 $109,285.00 2026-07-17
14 MS_DRG Allogeneic Bone Marrow Transplant 99 65 — — $2,585.00 $272,642.19 $90,222.99 2026-07-17
71 APR_DRG Allogeneic Bone Marrow Transplant 24 14 — — $40,185.92 $122,893.92 $71,760.60 2026-07-17
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 127 75 — — $28,050.00 $156,034.38 $53,602.09 2026-07-17
84 APR_DRG Autologous Bone Marrow Transplant 24 14 — — $77,117.09 $166,222.61 $137,709.00 2026-07-17
83 APR_DRG Autologous Bone Marrow Transplant 24 14 — — $52,125.40 $166,061.36 $93,081.10 2026-07-17
82 APR_DRG Autologous Bone Marrow Transplant 24 14 — — $27,134.05 $80,603.23 $48,453.70 2026-07-17
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 97 63 — — $2,585.00 $134,523.21 $44,940.50 2026-07-17
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 13 4 $310,013.53 — $74,830.84 $325,380.58 $138,148.31 2026-07-31
9035 OTHER Axicabtagene Ciloleucel C 47 26 $888,058.02 — $521,548.36 $1,165,500.92 $558,801.81 2026-07-31
09035 OTHER Axicabtagene Ciloleucel C 1 1 — — $532,192.20 $532,192.20 $532,192.20 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 11 4 $1,268,573.00 — $8.47 $956,745.00 $878,117.20 2026-07-31
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 53 27 $86,240.00 — $93,179.38 $208,227.39 $99,835.05 2026-07-31
20939 CPT Bone Marrow Aspir Bone Grfg 55 25 $304,484.42 $82,210.79 73% off $63.05 $304,484.42 $95,425.42 2026-07-31
0055T CPT Bone Srgry Cmptr Ct/mri Imag 47 21 $156,450.00 $42,241.50 73% off $343.13 $156,450.00 $61,015.50 2026-07-31
0054T CPT Bone Srgry Cmptr Fluor Image 47 21 $144,556.83 $39,030.34 73% off $442.88 $144,556.83 $56,377.16 2026-07-31
90288 CPT Botulism Immune Globulin, Human, For Intravenous Use 3 1 $7,874.00 — $117,866.10 $151,959.60 $127,607.10 2026-07-31
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 12 4 $1,329,998.64 — $489,399.00 $1,003,071.60 $805,025.05 2026-07-31
9391 OTHER Brexucabtagene Car Pos T 47 26 $888,174.00 — $479,661.20 $1,071,895.94 $513,922.71 2026-07-31
09391 OTHER Brexucabtagene Car Pos T 1 1 — — $489,450.20 $489,450.20 $489,450.20 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 119 75 — — $41,178.06 $161,762.70 $56,077.74 2026-07-17
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 119 75 — — $34,688.11 $136,267.77 $47,239.49 2026-07-17
2004 APR_DRG Cardiac Structural And Valvular Disorders 27 17 — — $72,644.36 $126,011.34 $105,849.52 2026-07-17
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 128 75 — — $28,050.00 $221,935.98 $76,589.44 2026-07-17
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 128 75 — — $28,050.00 $149,169.51 $52,431.76 2026-07-17
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 128 75 — — $28,050.00 $149,169.51 $52,342.61 2026-07-17
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 128 75 — — $28,050.00 $174,192.54 $60,941.43 2026-07-17
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 32 18 — — $66,039.52 $181,159.91 $72,778.30 2026-07-17
6954 APR_DRG Chemotherapy For Acute Leukemia 27 17 — — $38,546.32 $111,363.86 $45,626.25 2026-07-17
18 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $267,555.45 $315,433.80 $291,494.62 2026-07-17
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 106 68 — — $2,585.00 $979,659.81 $328,821.09 2026-07-17
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 27 17 — — $106,311.74 $647,979.12 $125,838.39 2026-07-17
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 27 17 — — $60,411.83 $378,177.99 $71,507.87 2026-07-17
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 27 17 — — $41,982.40 $304,837.81 $49,693.45 2026-07-17
414 OTHER Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 3 3 $49,383.29 — $22,821.95 $76,888.25 $65,217.72 2026-07-31
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 12 4 $1,658,041.20 — $553,169.00 $1,250,478.00 $969,621.79 2026-07-31
9498 OTHER Ciltacabtagene Car-pos T 47 26 $1,005,795.00 — $575,896.61 $1,286,952.62 $617,032.08 2026-07-31
09498 OTHER Ciltacabtagene Car-pos T 1 1 — — $587,649.60 $587,649.60 $587,649.60 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 75 37 — — $2,585.00 $220,248.68 $67,638.52 2026-03-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 48 39 — — $35,838.64 $138,756.48 $69,378.24 2026-07-17
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 48 39 — — $59,134.88 $273,655.62 $113,365.68 2026-07-17
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 48 39 — — $30,749.61 $146,158.35 $59,706.23 2026-07-17
209 MS_DRG Complex Aortic Arch Procedures 68 36 — — $2,585.00 $168,469.02 $84,974.58 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 121 75 — — $2,585.00 $246,693.57 $83,191.02 2026-07-17
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 70 36 — — $2,585.00 $135,983.35 $50,437.16 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 128 75 — — $28,050.00 $173,441.61 $59,737.26 2026-07-17
231 MS_DRG Coronary Bypass With Ptca With Mcc 128 75 — — $28,050.00 $191,243.61 $66,297.78 2026-07-17
232 MS_DRG Coronary Bypass With Ptca Without Mcc 128 75 — — $28,050.00 $156,000.00 $47,680.76 2026-07-17
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 128 75 — — $28,050.00 $133,137.06 $46,154.18 2026-07-17
955 OTHER Craniotomy For Multiple Significant Trauma 3 3 $94,108.66 — $38,898.02 $84,560.51 $71,725.43 2026-07-31
955 MS_DRG Craniotomy For Multiple Significant Trauma 125 74 — — $2,585.00 $152,704.05 $52,458.02 2026-07-17
9104 APR_DRG Craniotomy For Multiple Significant Trauma 27 17 — — $42,528.82 $127,441.76 $50,340.23 2026-07-17
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 125 74 — — $2,585.00 $129,999.54 $45,068.11 2026-07-17
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 27 17 — — $38,705.28 $111,053.89 $45,814.41 2026-07-17
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 27 17 — — $46,590.97 $180,120.92 $55,148.50 2026-07-17
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 27 17 — — $39,414.16 $142,378.87 $46,653.49 2026-07-17
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 50 27 $817,105.39 — $109,262.16 $857,608.46 $117,066.60 2026-07-31
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 124 74 — — $2,585.00 $481,522.17 $166,927.69 2026-07-17
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 50 27 $366,493.18 — $49,007.06 $384,659.87 $52,507.56 2026-07-31
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 50 27 $363,515.32 — $48,608.78 $381,534.40 $52,080.84 2026-07-31
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 126 74 — — $28,050.00 $139,030.98 $48,868.15 2026-07-17
318 OTHER Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 3 3 $20,478.46 — $29,604.18 $56,549.77 $47,966.33 2026-07-31
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 117 72 — — $2,585.00 $484,364.76 $161,812.92 2026-07-17
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 27 17 — — $41,266.18 $141,031.91 $48,845.69 2026-07-17
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 27 17 — — $38,714.71 $83,239.52 $45,825.58 2026-07-17
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 27 17 — — $919.50 $113,642.01 $90,913.61 2026-07-17
1784 APR_DRG External Heart Assist Devices 27 17 — — $51,245.33 $118,390.37 $60,657.73 2026-07-17
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 27 17 — — $152,611.53 $227,390.60 $163,717.66 2026-07-17
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 27 17 — — $75,071.86 $119,929.30 $80,442.35 2026-07-17
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 27 17 — — $49,374.43 $88,620.13 $58,443.21 2026-07-17
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 27 17 — — $47,883.31 $88,491.13 $56,678.20 2026-07-17
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 101 62 — — $5,125.05 $134,836.29 $44,620.14 2026-07-17
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 117 72 — — $2,585.00 $162,722.34 $54,361.05 2026-07-17
2464 APR_DRG Gastrointestinal Vascular Insufficiency 27 17 — — $13,818.80 $93,638.19 $74,910.55 2026-07-17
24 APR_DRG Heart And/or Lung Transplant 26 16 — — $216,146.20 $537,458.68 $385,975.00 2026-07-17
23 APR_DRG Heart And/or Lung Transplant 24 14 — — $53,236.75 $295,712.02 $95,065.60 2026-07-17
22 APR_DRG Heart And/or Lung Transplant 24 14 — — $42,766.74 $243,586.70 $76,369.20 2026-07-17
21 APR_DRG Heart And/or Lung Transplant 24 14 — — $33,125.79 $217,018.03 $59,153.20 2026-07-17
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 101 67 — — $2,585.00 $635,759.79 $212,389.87 2026-07-17
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 100 66 — — $2,585.00 $257,077.08 $85,882.39 2026-07-17
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 14 5 $295,429.26 — $45,212.00 $310,073.39 $99,222.35 2026-07-31
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 125 74 — — $2,585.00 $138,869.91 $47,705.62 2026-07-17
974 OTHER HIV With Major Related Condition With Mcc 3 3 $40,138.68 — $11,013.05 $71,353.51 $60,523.06 2026-07-31
9422 OTHER Idecabtagene Vicleucel Ca 47 26 $933,807.00 — $546,920.16 $1,222,199.14 $585,985.89 2026-07-31
09422 OTHER Idecabtagene Vicleucel Ca 1 1 — — $558,081.80 $558,081.80 $558,081.80 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 12 4 $1,495,802.76 — $527,622.00 $1,128,119.40 $911,665.19 2026-07-31
1614 APR_DRG Implantable Heart Assist Systems 32 18 — — $163,104.41 $469,930.95 $179,748.00 2026-07-17
1613 APR_DRG Implantable Heart Assist Systems 32 18 — — $85,012.22 $303,870.59 $93,686.90 2026-07-17
1612 APR_DRG Implantable Heart Assist Systems 32 18 — — $61,110.57 $303,851.24 $67,346.30 2026-07-17
1611 APR_DRG Implantable Heart Assist Systems 32 18 — — $57,957.83 $302,838.59 $63,871.90 2026-07-17
714 OTHER Inj Delandistrogene Mox R 45 26 $22,904.00 — $6,416.35 $4,825,397.00 $3,427,695.80 2026-07-31
00714 OTHER Inj Delandistrogene Mox R 1 1 — — $3,327,860.00 $3,327,860.00 $3,327,860.00 2026-03-01
00906 OTHER Inj Elivaldogene Autoteme 1 1 — — $3,180,000.00 $3,180,000.00 $3,180,000.00 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 79 41 $63.00 $17.01 73% off $15.06 $4,929,000.00 $3,180,000.00 2026-07-31
9141 OTHER Inj Onase Abepar-xioi Tre 44 23 — — $2,537,201.38 $4,012,920.55 $2,666,650.43 2026-03-01
09141 OTHER Inj Onase Abepar-xioi Tre 1 1 — — $2,588,981.00 $2,588,981.00 $2,588,981.00 2026-03-01
845 OTHER Inj, Atidarsagene Autotem 41 22 $11,812.48 — $5,455.45 $4,910,450.00 $4,640,150.00 2026-07-31
00845 OTHER Inj, Atidarsagene Autotem 1 1 — — $4,505,000.00 $4,505,000.00 $4,505,000.00 2026-03-01
746 OTHER Inj, Betibeglogene Autote 47 26 $22,904.00 — $9,894.57 $4,556,951.95 $3,028,168.07 2026-07-31
00746 OTHER Inj, Betibeglogene Autote 1 1 — — $2,939,969.00 $2,939,969.00 $2,939,969.00 2026-03-01
824 OTHER Inj, Exagamglogene Autote 49 28 $31,997.78 — $5,358.66 $4,897,200.00 $2,401,960.00 2026-07-31
00824 OTHER Inj, Exagamglogene Autote 1 1 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 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
09138 OTHER Inj, Hemgenix, Per Tx Dos 1 1 — — $3,685,267.00 $3,685,267.00 $3,685,267.00 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 45 26 $22,904.00 — $12,213.45 $4,716,136.60 $3,350,083.24 2026-07-31
00748 OTHER Inj, Lovotibeglogene Auto 1 1 — — $3,252,508.00 $3,252,508.00 $3,252,508.00 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 50 29 $19,070.42 — $1,905.66 $441,655.11 $207,719.07 2026-07-31
00886 OTHER Inj. Remestemcel-l-rknd/ 1 1 — — $201,669.00 $201,669.00 $201,669.00 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
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 3 1 — — $3,847,800.00 $3,847,800.00 $3,847,800.00 2026-03-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 3 1 $4,463,735.93 — $4,271,819.03 $4,271,819.03 $4,271,819.03 2026-07-31
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 14 5 $139,466.43 — $27,070.50 $146,379.64 $47,307.21 2026-07-31
J2505 HCPCS Injection, Pegfilgrastim, 6 Mg 2 1 $43,501.95 — $45,658.30 $45,658.30 $45,658.30 2026-07-31
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 13 4 $195,249.44 — $39,976.89 $204,927.75 $58,512.24 2026-07-31
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 3 1 — — $332,753.88 $332,753.88 $332,753.88 2026-03-01
22848 CPT Insert Pelv Fixation Device 77 37 $349,120.74 $94,262.60 73% off $326.18 $349,120.74 $109,414.44 2026-07-31
22846 CPT Insert Spine Fixation Device 77 37 $154,484.54 $41,710.83 73% off $679.96 $154,484.54 $48,415.45 2026-07-31
22859 CPT Insj Biomechanical Device 56 26 $350,682.30 $94,684.22 73% off $300.50 $350,682.30 $106,151.53 2026-07-31
22853 CPT Insj Biomechanical Device 56 26 $182,397.07 $49,247.21 73% off $232.46 $182,397.07 $55,211.59 2026-07-31
717 OTHER Instill Adstiladrin, Tx D 50 29 $24,732.86 — $7,547.10 $140,761.79 $66,203.03 2026-07-31
00717 OTHER Instill Adstiladrin, Tx D 1 1 — — $64,274.79 $64,274.79 $64,274.79 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
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 125 74 — — $2,585.00 $256,000.00 $61,887.16 2026-07-17
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 12 4 — — $63,235.60 $432,000.00 $172,200.00 2026-03-01
4404 APR_DRG Kidney Transplant 26 16 — — $57,814.58 $140,057.84 $103,240.00 2026-07-17
4403 APR_DRG Kidney Transplant 26 16 — — $35,385.19 $138,967.79 $63,187.80 2026-07-17
63052 CPT Lam Facetc/frmt Arthrd Lum 1 54 24 $361,916.85 $97,717.55 73% off $232.62 $361,916.85 $114,456.21 2026-07-31
63053 CPT Lam Factc/frmt Arthrd Lum Ea 54 24 $417,109.60 $112,619.59 73% off $174.27 $417,109.60 $131,910.91 2026-07-31
5244 OTHER Level 4 Blood Product Exc 47 26 $85,500.14 — $61,923.99 $138,381.17 $66,347.14 2026-07-31
05244 OTHER Level 4 Blood Product Exc 1 1 — — $64,367.62 $64,367.62 $64,367.62 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 47 26 $913,327.80 — $550,957.18 $1,231,220.63 $590,311.26 2026-07-31
09413 OTHER Lisocabtagene Car Pos T 1 1 — — $562,201.20 $562,201.20 $562,201.20 2026-03-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 12 4 $1,462,998.50 — $516,442.00 $1,103,378.76 $905,167.53 2026-07-31
14 APR_DRG Liver Transplant And/or Intestinal Transplant 24 14 — — $77,427.33 $328,688.97 $138,263.00 2026-07-17
13 APR_DRG Liver Transplant And/or Intestinal Transplant 24 14 — — $39,892.45 $180,772.13 $71,236.50 2026-07-17
12 APR_DRG Liver Transplant And/or Intestinal Transplant 24 14 — — $30,641.05 $120,077.11 $54,716.20 2026-07-17
11 APR_DRG Liver Transplant And/or Intestinal Transplant 24 14 — — $29,490.57 $52,666.95 $52,661.70 2026-07-17
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 98 65 — — $2,585.00 $233,907.54 $78,142.08 2026-07-17
7 MS_DRG Lung Transplant 98 65 — — $2,585.00 $373,268.85 $121,969.21 2026-07-17
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 125 74 — — $2,585.00 $153,839.57 $45,706.61 2026-07-17
4414 APR_DRG Major Bladder Procedures 27 17 — — $53,345.02 $79,252.26 $58,621.66 2026-07-17
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 32 18 — — $75,704.58 $242,358.25 $83,429.50 2026-07-17
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 27 17 — — $56,046.41 $111,276.39 $66,340.65 2026-07-17
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 27 17 — — $43,664.63 $97,069.40 $51,684.66 2026-07-17
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 75 37 — — $2,585.00 $269,424.26 $82,740.39 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 75 37 — — $2,585.00 $176,465.90 $54,192.80 2026-03-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 73 37 — — $13,366.00 $163,338.39 $50,161.33 2026-03-01
447 OTHER Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 1 1 — — $46,943.55 $46,943.55 $46,943.55 2026-03-01
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 27 17 — — $47,656.83 $70,758.66 $52,960.70 2026-07-17
8634 APR_DRG Neonatal Aftercare 27 17 — — $59,474.81 $150,117.29 $70,398.75 2026-07-17
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 27 17 — — $73,033.62 $115,963.34 $78,867.96 2026-07-17
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 27 17 — — $64,955.76 $245,243.37 $76,886.42 2026-07-17
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 27 17 — — $41,980.65 $172,990.93 $49,691.38 2026-07-17
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 27 17 — — $55,887.44 $97,374.00 $66,152.48 2026-07-17
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 27 17 — — $45,822.36 $219,132.78 $54,238.71 2026-07-17
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 27 17 — — $34,358.10 $55,391.21 $46,528.62 2026-07-17
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 27 17 — — $50,408.23 $152,229.56 $59,666.88 2026-07-17
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 27 17 — — $123,868.78 $250,369.68 $146,620.19 2026-07-17
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 27 17 — — $39,845.28 $157,422.04 $47,163.81 2026-07-17
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 27 17 — — $61,682.84 $149,016.91 $73,012.34 2026-07-17
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 27 17 — — $85,112.49 $332,614.53 $100,745.39 2026-07-17
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 27 17 — — $56,046.41 $147,993.49 $66,340.65 2026-07-17
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 27 17 — — $46,275.15 $112,195.05 $54,774.66 2026-07-17
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 27 17 — — $70,659.28 $317,330.38 $83,637.51 2026-07-17
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 27 17 — — $50,466.23 $191,842.30 $59,735.53 2026-07-17
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 27 17 — — $39,649.29 $167,555.65 $46,931.81 2026-07-17
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 27 17 — — $167,963.84 $503,124.62 $198,814.34 2026-07-17
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 27 17 — — $90,123.90 $396,403.43 $106,677.26 2026-07-17
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 27 17 — — $89,711.98 $294,207.35 $106,189.69 2026-07-17
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 27 17 — — $84,562.93 $294,207.35 $100,094.89 2026-07-17
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 27 17 — — $70,871.35 $127,924.41 $83,888.54 2026-07-17
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 27 17 — — $68,688.82 $127,924.41 $81,305.13 2026-07-17
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 27 17 — — $64,428.56 $134,367.74 $76,262.38 2026-07-17
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 27 17 — — $46,876.76 $169,641.18 $55,486.78 2026-07-17
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 27 17 — — $124,976.29 $235,523.02 $147,931.12 2026-07-17
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 27 17 — — $58,903.58 $96,758.04 $64,972.41 2026-07-17
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 27 17 — — $88,205.49 $469,136.53 $104,406.50 2026-07-17
5834 APR_DRG Neonate With Ecmo 27 17 — — $265,352.59 $588,944.20 $314,090.82 2026-07-17
5833 APR_DRG Neonate With Ecmo 27 17 — — $224,690.82 $588,944.20 $265,960.56 2026-07-17
5832 APR_DRG Neonate With Ecmo 27 17 — — $111,958.31 $558,502.30 $132,522.08 2026-07-17
5831 APR_DRG Neonate With Ecmo 27 17 — — $98,581.51 $558,502.30 $116,688.32 2026-07-17
681 OTHER Neonate, Birth Weight >2499 Grams, With Significant O.r. Procedures, With Multip… 2 2 $59,448.43 — $282,239.43 $332,745.43 $307,492.43 2026-07-31
1594 OTHER New Technology - Level 43 47 26 $93,780.95 — $43,362.25 $96,901.35 $46,459.55 2026-07-31
1580 OTHER New Technology - Level 43 47 26 $93,780.95 — $43,362.25 $96,901.35 $46,459.55 2026-07-31
01580 OTHER New Technology - Level 43 1 1 — — $45,073.40 $45,073.40 $45,073.40 2026-03-01
01594 OTHER New Technology - Level 43 1 1 — — $45,073.40 $45,073.40 $45,073.40 2026-03-01
1595 OTHER New Technology - Level 44 47 26 $114,620.93 — $52,998.19 $118,434.74 $56,783.78 2026-07-31
1581 OTHER New Technology - Level 44 47 26 $114,620.93 — $52,998.19 $118,434.74 $56,783.78 2026-07-31
01595 OTHER New Technology - Level 44 1 1 — — $55,089.60 $55,089.60 $55,089.60 2026-03-01
01581 OTHER New Technology - Level 44 1 1 — — $55,089.60 $55,089.60 $55,089.60 2026-03-01
1596 OTHER New Technology - Level 45 47 26 $135,460.91 — $62,634.14 $139,968.13 $67,108.01 2026-07-31
1582 OTHER New Technology - Level 45 47 26 $135,460.91 — $62,634.14 $139,968.13 $67,108.01 2026-07-31
01582 OTHER New Technology - Level 45 1 1 — — $65,105.80 $65,105.80 $65,105.80 2026-03-01
01596 OTHER New Technology - Level 45 1 1 — — $65,105.80 $65,105.80 $65,105.80 2026-03-01
1597 OTHER New Technology - Level 46 47 26 $156,300.89 — $72,270.09 $161,501.53 $77,432.24 2026-07-31
1583 OTHER New Technology - Level 46 47 26 $156,300.89 — $72,270.09 $161,501.53 $77,432.24 2026-07-31
01583 OTHER New Technology - Level 46 1 1 — — $75,122.00 $75,122.00 $75,122.00 2026-03-01
01597 OTHER New Technology - Level 46 1 1 — — $75,122.00 $75,122.00 $75,122.00 2026-03-01
1584 OTHER New Technology - Level 47 47 26 $177,140.87 — $81,906.04 $183,034.92 $87,756.47 2026-07-31
1598 OTHER New Technology - Level 47 47 26 $177,140.87 — $81,906.04 $183,034.92 $87,756.47 2026-07-31
01584 OTHER New Technology - Level 47 1 1 — — $85,138.20 $85,138.20 $85,138.20 2026-03-01
01598 OTHER New Technology - Level 47 1 1 — — $85,138.20 $85,138.20 $85,138.20 2026-03-01
1599 OTHER New Technology - Level 48 47 26 $197,980.85 — $91,542.00 $204,568.34 $98,080.71 2026-07-31
1585 OTHER New Technology - Level 48 47 26 $197,980.85 — $91,542.00 $204,568.34 $98,080.71 2026-07-31
01585 OTHER New Technology - Level 48 1 1 — — $95,154.40 $95,154.40 $95,154.40 2026-03-01
01599 OTHER New Technology - Level 48 1 1 — — $95,154.40 $95,154.40 $95,154.40 2026-03-01
1901 OTHER New Technology - Level 49 47 26 $224,030.83 — $103,586.88 $231,484.97 $110,985.94 2026-07-31
1902 OTHER New Technology - Level 49 47 26 $224,030.83 — $103,586.88 $231,484.97 $110,985.94 2026-07-31
01901 OTHER New Technology - Level 49 1 1 — — $107,674.60 $107,674.60 $107,674.60 2026-03-01
01902 OTHER New Technology - Level 49 1 1 — — $107,674.60 $107,674.60 $107,674.60 2026-03-01
1904 OTHER New Technology - Level 50 47 26 $255,290.80 — $118,040.80 $263,785.06 $126,472.29 2026-07-31
1903 OTHER New Technology - Level 50 47 26 $255,290.80 — $118,040.80 $263,785.06 $126,472.29 2026-07-31
01904 OTHER New Technology - Level 50 1 1 — — $122,699.00 $122,699.00 $122,699.00 2026-03-01
01903 OTHER New Technology - Level 50 1 1 — — $122,699.00 $122,699.00 $122,699.00 2026-03-01
1905 OTHER New Technology - Level 51 47 26 $286,550.77 — $132,494.73 $296,085.15 $141,958.64 2026-07-31
1906 OTHER New Technology - Level 51 47 26 $286,550.77 — $132,494.73 $296,085.15 $141,958.64 2026-07-31
01906 OTHER New Technology - Level 51 1 1 — — $137,723.20 $137,723.20 $137,723.20 2026-03-01
01905 OTHER New Technology - Level 51 1 1 — — $137,723.20 $137,723.20 $137,723.20 2026-03-01
1907 OTHER New Technology - Level 52 47 26 $317,810.74 — $146,948.65 $328,385.24 $157,444.98 2026-07-31
1908 OTHER New Technology - Level 52 47 26 $317,810.74 — $146,948.65 $328,385.24 $157,444.98 2026-07-31
01908 OTHER New Technology - Level 52 1 1 — — $152,747.50 $152,747.50 $152,747.50 2026-03-01
01907 OTHER New Technology - Level 52 1 1 — — $152,747.50 $152,747.50 $152,747.50 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
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
831 OTHER Obecbtge Autol Up To 400 50 29 $16,285.12 — $3,458.69 $609,367.50 $286,597.50 2026-07-31
00831 OTHER Obecbtge Autol Up To 400 1 1 — — $278,250.00 $278,250.00 $278,250.00 2026-03-01
G0269 HCPCS Occlusive Device In Vein Art 41 20 $167,236.62 $45,153.89 73% off $1,120.00 $167,236.62 $66,894.65 2026-07-31
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 32 18 — — $50,185.33 $131,273.94 $55,306.30 2026-07-17
215 OTHER Other Heart Assist System Implant 3 3 $143,946.01 — $39,142.71 $84,287.29 $71,493.69 2026-07-31
215 MS_DRG Other Heart Assist System Implant 127 75 — — $2,585.00 $225,887.91 $79,734.42 2026-07-17
4474 APR_DRG Other Kidney, Urinary Tract And Related Non-percutaneous Procedures 27 17 — — $43,325.04 $77,900.70 $51,282.70 2026-07-17
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 27 17 — — $75,746.85 $116,133.18 $81,157.34 2026-07-17
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 125 74 — — $2,585.00 $172,867.68 $59,384.78 2026-07-17
166 OTHER Other Respiratory System O.r. Procedures With Mcc 3 3 $51,214.89 — $23,328.08 $306,790.96 $260,224.48 2026-07-31
1824 APR_DRG Other Upper Vascular Procedures 27 17 — — $39,382.37 $70,195.10 $46,615.86 2026-07-17
64 APR_DRG Pancreas Transplant 24 14 — — $70,876.94 $171,455.28 $126,566.00 2026-07-17
63 APR_DRG Pancreas Transplant 24 14 — — $45,803.49 $171,455.28 $81,791.90 2026-07-17
62 APR_DRG Pancreas Transplant 24 14 — — $41,428.65 $171,455.28 $73,979.70 2026-07-17
10 MS_DRG Pancreas Transplant 98 65 — — $2,585.00 $162,790.38 $54,383.79 2026-07-17
61 APR_DRG Pancreas Transplant 24 14 — — $34,971.13 $73,024.60 $51,945.63 2026-07-17
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 48 27 — — $67,425.67 $150,675.72 $71,553.77 2026-03-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 27 17 — — $85,881.81 $186,758.52 $101,656.02 2026-07-17
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 3 1 $78,168.72 — $77,046.96 $77,046.96 $77,046.96 2026-07-31
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 124 73 — — $2,585.00 $145,979.79 $49,918.02 2026-07-17
897 OTHER Revakinagene, Per Implant 47 26 $11,893.51 — $259,700.00 $580,350.00 $278,250.00 2026-07-31
00897 OTHER Revakinagene, Per Implant 1 1 — — $265,000.00 $265,000.00 $265,000.00 2026-03-01
61783 CPT Scan Proc Spinal 56 26 $391,943.14 $105,824.65 73% off $207.06 $391,943.14 $118,641.19 2026-07-31
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 124 73 — — $2,585.00 $156,803.46 $53,619.19 2026-07-17
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 109 71 — — $2,585.00 $161,857.98 $54,072.30 2026-07-17
9273 OTHER Sipuleucel-t Auto Cd54+ 47 26 $112,361.62 — $53,316.03 $119,145.00 $57,124.32 2026-07-31
09273 OTHER Sipuleucel-t Auto Cd54+ 1 1 — — $54,404.11 $54,404.11 $54,404.11 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 14 5 $402,932.31 — $57,017.10 $422,905.25 $140,983.85 2026-07-31
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 123 74 — — $17,770.00 $148,627.32 $51,524.14 2026-07-17
622 OTHER Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 3 3 $50,590.39 — $29,175.97 $66,154.95 $56,113.58 2026-07-31
20930 CPT Spinal Bone Allograft 54 24 $214,022.29 $57,786.02 73% off $397.89 $214,022.29 $67,684.55 2026-07-31
20937 CPT Spinal Bone Autograft 56 26 $384,159.46 $103,723.05 73% off $151.60 $384,159.46 $116,285.07 2026-07-31
20938 CPT Spinal Bone Autograft 56 26 $349,120.74 $94,262.60 73% off $165.57 $349,120.74 $105,678.85 2026-07-31
459 MS_DRG Spinal Fusion Except Cervical With Mcc 49 39 — — $44,267.26 $176,973.88 $79,638.25 2026-07-17
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 123 74 — — $40,600.00 $205,429.52 $66,089.37 2026-07-17
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 123 74 — — $34,436.90 $145,773.94 $46,897.40 2026-07-17
234 APR_DRG Spinal Procedures 27 17 — — $42,683.24 $90,204.57 $50,523.02 2026-07-17
28 MS_DRG Spinal Procedures With Mcc 125 74 — — $2,585.00 $136,306.35 $46,824.96 2026-07-17
22632 CPT Spine Fusion, Extra Segment 79 39 $453,040.79 $122,321.01 73% off $287.11 $453,040.79 $135,912.24 2026-07-31
1142 OTHER Supprelin La Implant 47 26 $80,364.74 — $42,321.63 $94,575.89 $45,344.61 2026-07-31
9194 OTHER Tisagenlecleucel Car-pos 47 26 $953,098.86 — $555,200.67 $1,240,703.55 $594,857.87 2026-07-31
09194 OTHER Tisagenlecleucel Car-pos 1 1 — — $566,531.30 $566,531.30 $566,531.30 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 11 4 $1,375,400.20 — $32.24 $1,037,313.00 $934,776.65 2026-07-31
908 OTHER Topi Adm Prad Zami Per Tr 45 26 $28,731.36 — $8,651.17 $4,836,939.00 $3,435,894.60 2026-07-31
00908 OTHER Topi Adm Prad Zami Per Tr 1 1 — — $3,335,820.00 $3,335,820.00 $3,335,820.00 2026-03-01
22858 CPT Tot Disc Arthrp 2nd Lvl Crv 57 27 $187,440.83 $50,609.02 73% off $457.94 $187,440.83 $54,732.72 2026-07-31
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 124 74 — — $2,585.00 $314,237.61 $108,937.64 2026-07-17
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 27 17 — — $89,480.00 $393,435.20 $105,915.10 2026-07-17
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 27 17 — — $57,530.89 $199,957.70 $68,097.79 2026-07-17
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 27 17 — — $37,615.24 $114,623.02 $44,524.16 2026-07-17
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 25 15 — — $57,550.46 $228,748.68 $61,661.21 2026-07-17
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 130 75 — — $2,585.00 $129,300.81 $44,621.32 2026-07-17
A9543 HCPCS Y90 Ibritum Rx/40mci 117 46 $116,139.00 $31,357.53 73% off $17,214.00 $551,754.93 $58,069.50 2026-07-31
1643 OTHER Y90 Ibritumomab, Rx 47 26 $125,567.03 — $55,688.06 $124,445.76 $59,665.78 2026-07-31
01643 OTHER Y90 Ibritumomab, Rx 1 1 — — $56,824.55 $56,824.55 $56,824.55 2026-03-01
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