Price Transparencybeta 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

NORTH AUSTIN MEDICAL CENTER

Austin, TX · CCN 450809 · Rates published

36,619 distinct procedures filed
74 distinct payers
2,232,799 rate rows
2026-03-01 last MRF observed
Data quality

2,195,678 of 2,232,799 rate rows are consumer-grade (98.3%)

37,121 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 17,781
template filing: same amount across many unrelated codes — excluded 10,813
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 8,128
placeholder amount (≤ $0.02) — excluded from medians 255
exceeds 10× this hospital's gross charge — excluded from medians 144
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/74-2781812_ST.-DAVID'S-NORTH-AUSTIN-MEDICAL-CENTER_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page https://stdavids.com/about/legal/pricing-transparency-cms-required-file-of-standard-charges.dot
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-18
Content fingerprint 6d3e9f070aaa06e6… · 929,746,826 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 $3,586,762.05 $4,850,948.67 $4,850,948.67 nat. median
$3,004,655
1.6× median
00845
OTHER 		Inj, Atidarsagene Autotem 1 $4,505,000.00 $4,505,000.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
845
OTHER 		Inj, Atidarsagene Autotem 21 $5,516.55 $4,955,500.00 $4,505,000.00 nat. median
$9,966
outlier · 452.1×
J1411
HCPCS 		Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 1 $4,496,025.34 $4,496,025.34 $4,496,025.34 nat. median
$3,710,000
1.2× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 $3,158,557.10 $4,271,819.03 $4,271,819.03 nat. median
$2,468,984
1.7× median
J3389
HCPCS 		Topical Administration, Prademagene Zamikeracel, Per Treatment 1 $4,069,700.40 $4,069,700.40 $4,069,700.40 nat. median
$3,335,820
1.2× median
J1413
HCPCS 		Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 1 $4,059,988.87 $4,059,988.87 $4,059,988.87 nat. median
$3,325,455
1.2× median
J3394
HCPCS 		Injection, Lovotibeglogene Autotemcel, Per Treatment 1 $3,968,059.86 $3,968,059.86 $3,968,059.86 nat. median
$3,286,000
1.2× median
J3387
HCPCS 		Injection, Elivaldogene Autotemcel, Per Treatment 1 $3,879,600.00 $3,879,600.00 $3,879,600.00 nat. median
$3,180,000
1.2× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 23 $3,574,708.99 $4,975,110.45 $3,869,530.35 nat. median
$3,746,358
1.0× median
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 1 $2,845,040.00 $3,847,800.00 $3,847,800.00 nat. median
$2,448,600
1.6× 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 24 $9,988.50 $4,503,357.00 $3,452,573.70 nat. median
$22,747
outlier · 151.8×
714
OTHER 		Inj Delandistrogene Mox R 24 $6,488.21 $4,492,611.00 $3,444,335.10 nat. median
$13,041
outlier · 264.1×
748
OTHER 		Inj, Lovotibeglogene Auto 24 $12,350.24 $4,390,885.80 $3,366,345.78 nat. median
$17,963
outlier · 187.4×
906
OTHER 		Inj Elivaldogene Autoteme 26 $8,826.02 $4,929,000.00 $3,339,000.00 nat. median
$20,756
outlier · 160.9×
00908
OTHER 		Topi Adm Prad Zami Per Tr 1 $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 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
00906
OTHER 		Inj Elivaldogene Autoteme 1 $3,180,000.00 $3,180,000.00 $3,180,000.00 nat. median
$21
outlier · 153697.4×
746
OTHER 		Inj, Betibeglogene Autote 26 $11,424.10 $4,556,951.95 $3,086,967.45 nat. median
$21,896
outlier · 141.0×
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 25 $2,511,311.57 $4,427,157.51 $2,718,430.05 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
$2,457,321
1.1× median
824
OTHER 		Inj, Exagamglogene Autote 27 $13,377.34 $4,617,360.00 $2,448,600.00 nat. median
$25,250
outlier · 97.0×
00824
OTHER 		Inj, Exagamglogene Autote 1 $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 $940,156.40 $1,905,321.60 $1,271,523.00 nat. median
$824,563
1.5× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 3 $553,169.00 $1,204,164.00 $969,621.79 nat. median
$674,867
1.4× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 3 $527,622.00 $1,086,337.20 $920,834.85 nat. median
$625,184
1.5× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 3 $516,442.00 $1,062,512.88 $907,222.54 nat. median
$673,137
1.3× median
2067
OTHER 		Afamitresgene Autoleucel 26 $747,501.40 $1,525,827.60 $813,004.10 nat. median
$786,032
1.0× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 3 $489,399.00 $965,920.80 $807,592.83 nat. median
$619,808
1.3× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 4 $549,391.70 $998,894.00 $774,142.85 nat. median
$753,246
1.0× median
Q2058
HCPCS 		Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,… 2 $339,465.00 $1,375,920.00 $756,756.00 nat. median
$324,450
outlier · 2.3×
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 4 $502,841.00 $921,310.00 $712,075.50 nat. median
$634,303
1.1× median
9498
OTHER 		Ciltacabtagene Car-pos T 26 $570,020.11 $1,163,546.21 $619,970.33 nat. median
$587,650
1.1× median
C9301
HCPCS 		Obecabtagene Autoleucel, Up To 400 Million Cd19 Car-positive Viable T Cells, Inc… 1 $397,897.50 $723,450.00 $617,715.00 nat. median
$459,112
1.3× median
9194
OTHER 		Tisagenlecleucel Car-pos 26 $549,535.36 $1,121,731.97 $597,690.53 nat. median
$566,531
1.1× median
9413
OTHER 		Lisocabtagene Car Pos T 26 $545,335.16 $1,113,158.38 $593,122.27 nat. median
$562,201
1.1× median
9422
OTHER 		Idecabtagene Vicleucel Ca 26 $541,339.35 $1,105,001.96 $588,776.30 nat. median
$558,082
1.1× median
09498
OTHER 		Ciltacabtagene Car-pos T 1 $587,649.60 $587,649.60 $587,649.60 nat. median
$554,552
1.1× median
09194
OTHER 		Tisagenlecleucel Car-pos 1 $566,531.30 $566,531.30 $566,531.30 nat. median
$538,205
1.1× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $562,201.20 $562,201.20 $562,201.20 nat. median
$534,091
1.1× median
9035
OTHER 		Axicabtagene Ciloleucel C 26 $516,226.43 $1,053,740.56 $561,462.77 nat. median
$532,192
1.1× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $558,081.80 $558,081.80 $558,081.80 nat. median
$530,178
1.1× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $532,192.20 $532,192.20 $532,192.20 nat. median
$505,583
1.1× median
9391
OTHER 		Brexucabtagene Car Pos T 26 $474,766.69 $969,111.40 $516,369.96 nat. median
$489,450
1.1× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $489,450.20 $489,450.20 $489,450.20 nat. median
$464,978
1.1× median
107796
CDM 		Kit Cath Rt Heart 42 $49,999.95 $899,999.10 $369,999.63 nat. median
$227
outlier · 1628.9×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 67 $290,731.59 $713,984.42 $369,515.22 nat. median
$370,174
1.0× median

Other procedures at this hospital

Browse this hospital's 36,619 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
             
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $195,782.50 $195,782.50 $195,782.50 2026-03-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $73,404.07 $73,404.07 $73,404.07 2026-03-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $137,991.50 $137,991.50 $137,991.50 2026-03-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $107,760.40 $107,760.40 $107,760.40 2026-03-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $69,951.05 $69,951.05 $69,951.05 2026-03-01
007 OTHER Lung Transplant 1 1 — — $82,821.25 $82,821.25 $82,821.25 2026-03-01
00714 OTHER Inj Delandistrogene Mox R 1 1 — — $3,327,860.00 $3,327,860.00 $3,327,860.00 2026-03-01
00746 OTHER Inj, Betibeglogene Autote 1 1 — — $2,939,969.00 $2,939,969.00 $2,939,969.00 2026-03-01
00748 OTHER Inj, Lovotibeglogene Auto 1 1 — — $3,252,508.00 $3,252,508.00 $3,252,508.00 2026-03-01
00824 OTHER Inj, Exagamglogene Autote 1 1 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2026-03-01
00831 OTHER Obecbtge Autol Up To 400 1 1 — — $278,250.00 $278,250.00 $278,250.00 2026-03-01
00845 OTHER Inj, Atidarsagene Autotem 1 1 — — $4,505,000.00 $4,505,000.00 $4,505,000.00 2026-03-01
00886 OTHER Inj. Remestemcel-l-rknd/ 1 1 — — $201,669.00 $201,669.00 $201,669.00 2026-03-01
00897 OTHER Revakinagene, Per Implant 1 1 — — $265,000.00 $265,000.00 $265,000.00 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
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
014 OTHER Allogeneic Bone Marrow Transplant 1 1 — — $70,695.69 $70,695.69 $70,695.69 2026-03-01
01583 OTHER New Technology - Level 46 1 1 — — $72,682.98 $72,682.98 $72,682.98 2026-03-01
01584 OTHER New Technology - Level 47 1 1 — — $82,373.98 $82,373.98 $82,373.98 2026-03-01
01585 OTHER New Technology - Level 48 1 1 — — $92,064.98 $92,064.98 $92,064.98 2026-03-01
01597 OTHER New Technology - Level 46 1 1 — — $72,682.98 $72,682.98 $72,682.98 2026-03-01
01598 OTHER New Technology - Level 47 1 1 — — $82,373.98 $82,373.98 $82,373.98 2026-03-01
01599 OTHER New Technology - Level 48 1 1 — — $92,064.98 $92,064.98 $92,064.98 2026-03-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $222,729.20 $222,729.20 $222,729.20 2026-03-01
01901 OTHER New Technology - Level 49 1 1 — — $104,178.70 $104,178.70 $104,178.70 2026-03-01
01902 OTHER New Technology - Level 49 1 1 — — $104,178.70 $104,178.70 $104,178.70 2026-03-01
01903 OTHER New Technology - Level 50 1 1 — — $118,715.20 $118,715.20 $118,715.20 2026-03-01
01904 OTHER New Technology - Level 50 1 1 — — $118,715.20 $118,715.20 $118,715.20 2026-03-01
01905 OTHER New Technology - Level 51 1 1 — — $133,251.70 $133,251.70 $133,251.70 2026-03-01
01906 OTHER New Technology - Level 51 1 1 — — $133,251.70 $133,251.70 $133,251.70 2026-03-01
01907 OTHER New Technology - Level 52 1 1 — — $147,788.20 $147,788.20 $147,788.20 2026-03-01
01908 OTHER New Technology - Level 52 1 1 — — $147,788.20 $147,788.20 $147,788.20 2026-03-01
09035 OTHER Axicabtagene Ciloleucel C 1 1 — — $532,192.20 $532,192.20 $532,192.20 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
09141 OTHER Inj Onase Abepar-xioi Tre 1 1 — — $2,588,981.00 $2,588,981.00 $2,588,981.00 2026-03-01
09194 OTHER Tisagenlecleucel Car-pos 1 1 — — $566,531.30 $566,531.30 $566,531.30 2026-03-01
09391 OTHER Brexucabtagene Car Pos T 1 1 — — $489,450.20 $489,450.20 $489,450.20 2026-03-01
09413 OTHER Lisocabtagene Car Pos T 1 1 — — $562,201.20 $562,201.20 $562,201.20 2026-03-01
09422 OTHER Idecabtagene Vicleucel Ca 1 1 — — $558,081.80 $558,081.80 $558,081.80 2026-03-01
09498 OTHER Ciltacabtagene Car-pos T 1 1 — — $587,649.60 $587,649.60 $587,649.60 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 120 68 — — $129,000.00 $463,347.16 $248,672.36 2026-03-01
10 MS_DRG Pancreas Transplant 110 66 — — $50,119.29 $118,643.02 $77,008.29 2026-03-01
100058 CDM Graft Evas 26x14.5m 12cm 43 29 $293,953.00 $293,953.00 $41,153.42 $264,557.70 $132,278.85 2026-03-01
100225 CDM Graft Stent 24x100mm 43 29 $249,280.00 $249,280.00 $34,899.20 $224,352.00 $112,176.00 2026-03-01
100945 CDM Valve Aortic 29mm 43 29 $213,787.00 $213,787.00 $29,930.18 $192,408.30 $96,204.15 2026-03-01
101411 CDM Valve Crd Clgn Od21mm 43 29 $152,050.00 $152,050.00 $21,287.00 $136,845.00 $68,422.50 2026-03-01
102035 CDM Cage Spnl 13x16x18-21mm 43 29 $176,474.00 $176,474.00 $24,706.36 $158,826.60 $79,413.30 2026-03-01
102705 CDM Impl Crnl Ostmtch 20-100 43 29 $216,864.00 $216,864.00 $30,360.96 $195,177.60 $97,588.80 2026-03-01
102890 CDM Stent Aaa 36mm 120mm 42 28 $249,280.00 $249,280.00 $34,899.20 $224,352.00 $112,176.00 2026-03-01
104315 CDM Tiss Aclr Drml 16cm 16cm 43 29 $160,384.00 $160,384.00 $22,453.76 $144,345.60 $72,172.80 2026-03-01
104573 CDM Graft Evas 10cm 12mm 43 29 $250,560.00 $250,560.00 $35,078.40 $225,504.00 $112,752.00 2026-03-01
104896 CDM Graft Evas 23x14.5m14cm 43 29 $294,140.00 $294,140.00 $41,179.60 $264,726.00 $132,363.00 2026-03-01
105022 CDM Tiss Aclr Drml 16cm 20cm 43 29 $183,932.00 $183,932.00 $25,750.48 $165,538.80 $82,769.40 2026-03-01
105228 CDM Implant Crnl Ossdsgncstm 43 29 $220,333.00 $220,333.00 $30,846.62 $198,299.70 $99,149.85 2026-03-01
107188 CDM Valve Aortic 19mm 43 29 $291,159.00 $291,159.00 $40,762.26 $262,043.10 $131,021.55 2026-03-01
107268 CDM Cage Spnl 20mm 43 29 $171,915.00 $171,915.00 $24,068.10 $154,723.50 $77,361.75 2026-03-01
107796 CDM Kit Cath Rt Heart 79 42 $999,999.00 $999,999.00 $49,999.95 $899,999.10 $369,999.63 2026-03-01
108047 CDM Valve Mitral 27mm 43 29 $176,460.00 $176,460.00 $24,704.40 $158,814.00 $79,407.00 2026-03-01
108048 CDM Valve Mtral 29mm 43 29 $176,460.00 $176,460.00 $24,704.40 $158,814.00 $79,407.00 2026-03-01
108049 CDM Valve Mitral 31mm 43 29 $176,460.00 $176,460.00 $24,704.40 $158,814.00 $79,407.00 2026-03-01
108050 CDM Valve Mitral 33mm 43 29 $176,460.00 $176,460.00 $24,704.40 $158,814.00 $79,407.00 2026-03-01
108446 CDM Valve Aor 19mm 30mm 43 29 $164,785.00 $164,785.00 $23,069.90 $148,306.50 $74,153.25 2026-03-01
108447 CDM Valve Aor 21mm 32mm 43 29 $164,785.00 $164,785.00 $23,069.90 $148,306.50 $74,153.25 2026-03-01
108448 CDM Valve Aor 23mm 32mm 43 29 $164,785.00 $164,785.00 $23,069.90 $148,306.50 $74,153.25 2026-03-01
108449 CDM Valve Aor 25mm 34mm 43 29 $164,785.00 $164,785.00 $23,069.90 $148,306.50 $74,153.25 2026-03-01
108452 CDM Valve Aor 27mm 34mm 43 29 $164,785.00 $164,785.00 $23,069.90 $148,306.50 $74,153.25 2026-03-01
108456 CDM Valve Aor 29mm 39+3mm 43 29 $164,785.00 $164,785.00 $23,069.90 $148,306.50 $74,153.25 2026-03-01
109595 CDM Valve Mitral 25mm 43 29 $211,752.00 $211,752.00 $29,645.28 $190,576.80 $95,288.40 2026-03-01
109596 CDM Valve Mitral 27mm 43 29 $220,575.00 $220,575.00 $30,880.50 $198,517.50 $99,258.75 2026-03-01
109597 CDM Valve Mitral 29mm 43 29 $211,752.00 $211,752.00 $29,645.28 $190,576.80 $95,288.40 2026-03-01
109598 CDM Valve Mitral 31mm 43 29 $220,575.00 $220,575.00 $30,880.50 $198,517.50 $99,258.75 2026-03-01
109599 CDM Valve Mitral Size 33 43 29 $220,575.00 $220,575.00 $30,880.50 $198,517.50 $99,258.75 2026-03-01
110161 CDM Model Skull Kt Resection 79 42 $299,760.00 $299,760.00 $14,988.00 $269,784.00 $110,911.20 2026-03-01
110909 CDM Pump Pain Infn 148gm 43 29 $216,864.00 $216,864.00 $30,360.96 $195,177.60 $97,588.80 2026-03-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 10 6 — — $68,803.40 $84,317.89 $70,827.03 2026-03-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 10 6 — — $121,079.10 $148,381.25 $124,640.25 2026-03-01
114409 CDM Model Antm Skl Adlt 79 42 $178,892.00 $178,892.00 $8,944.60 $161,002.80 $66,190.04 2026-03-01
116271 CDM Kit Lo Prfl Comp Shth 7f 79 42 $624,500.00 $624,500.00 $31,225.00 $562,050.00 $231,065.00 2026-03-01
116615 CDM Spacer Spn Stalif 15x12 43 29 $147,105.00 $147,105.00 $20,594.70 $132,394.50 $66,197.25 2026-03-01
117391 CDM Ipg Dbs Rchrgbl Battery 43 29 $373,898.00 $373,898.00 $52,345.72 $336,508.20 $168,254.10 2026-03-01
117666 CDM Implant Crnl Mesh Custm 43 29 $220,333.00 $220,333.00 $30,846.62 $198,299.70 $99,149.85 2026-03-01
118812 CDM Valve Aortic 21mm 43 29 $193,959.00 $193,959.00 $27,154.26 $174,563.10 $87,281.55 2026-03-01
118839 CDM Cath Vasc Assist Strl 79 42 $624,500.00 $624,500.00 $31,225.00 $562,050.00 $231,065.00 2026-03-01
118924 CDM Cage Spn 0d 13x16x0-24mm 43 29 $176,474.00 $176,474.00 $24,706.36 $158,826.60 $79,413.30 2026-03-01
119303 CDM Graft Evas 34x34x10cm 43 29 $421,693.00 $421,693.00 $59,037.02 $379,523.70 $189,761.85 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 110 66 — — $82,476.59 $165,919.13 $123,956.38 2026-03-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 14 7 — — $88,182.47 $150,815.00 $96,395.30 2026-03-01
1582 OTHER New Technology - Level 45 44 26 — — $61,995.02 $126,546.53 $67,427.57 2026-03-01
1583 OTHER New Technology - Level 46 44 26 — — $71,532.64 $146,015.08 $77,800.96 2026-03-01
1584 OTHER New Technology - Level 47 44 26 — — $81,070.26 $165,483.63 $88,174.36 2026-03-01
1585 OTHER New Technology - Level 48 44 26 — — $90,607.89 $184,952.20 $98,547.76 2026-03-01
1596 OTHER New Technology - Level 45 44 26 — — $61,995.02 $126,546.53 $67,427.57 2026-03-01
1597 OTHER New Technology - Level 46 44 26 — — $71,532.64 $146,015.08 $77,800.96 2026-03-01
1598 OTHER New Technology - Level 47 44 26 — — $81,070.26 $165,483.63 $88,174.36 2026-03-01
1599 OTHER New Technology - Level 48 44 26 — — $90,607.89 $184,952.20 $98,547.76 2026-03-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 14 7 — — $86,220.42 $105,662.28 $89,178.96 2026-03-01
1611 APR_DRG Implantable Heart Assist Systems 14 7 — — $66,008.52 $80,892.80 $68,273.52 2026-03-01
1612 APR_DRG Implantable Heart Assist Systems 14 7 — — $69,599.21 $85,293.15 $71,987.43 2026-03-01
1613 APR_DRG Implantable Heart Assist Systems 14 7 — — $96,820.95 $118,653.13 $100,143.32 2026-03-01
1614 APR_DRG Implantable Heart Assist Systems 14 7 — — $185,760.63 $227,647.83 $192,134.59 2026-03-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 14 7 — — $75,212.82 $92,172.57 $77,793.68 2026-03-01
178488 CDM Valve Aortic 23mm 43 29 $193,959.00 $193,959.00 $27,154.26 $174,563.10 $87,281.55 2026-03-01
178626 CDM Implant Crnl Ptspc Peek 43 29 $191,003.00 $191,003.00 $26,740.42 $171,902.70 $85,951.35 2026-03-01
178865 CDM Valve Aor11cm 34x26x23.4 43 29 $220,575.00 $220,575.00 $30,880.50 $198,517.50 $99,258.75 2026-03-01
178968 CDM Spacer Spnl 17mm Stalif 43 29 $147,105.00 $147,105.00 $20,594.70 $132,394.50 $66,197.25 2026-03-01
178970 CDM Spcr Spnl Stalif 15x15 43 29 $147,105.00 $147,105.00 $20,594.70 $132,394.50 $66,197.25 2026-03-01
179209 CDM Valve Aortic 25mm 43 29 $193,959.00 $193,959.00 $27,154.26 $174,563.10 $87,281.55 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 93 67 — — $290,731.59 $713,984.42 $369,515.22 2026-03-01
180939 CDM Valve Mitral 19mm 43 29 $166,314.00 $166,314.00 $23,283.96 $149,682.60 $74,841.30 2026-03-01
181219 CDM Valve Aortic 29mm 43 29 $193,959.00 $193,959.00 $27,154.26 $174,563.10 $87,281.55 2026-03-01
1901 OTHER New Technology - Level 49 44 26 — — $102,529.87 $209,287.78 $111,514.45 2026-03-01
1902 OTHER New Technology - Level 49 44 26 — — $102,529.87 $209,287.78 $111,514.45 2026-03-01
1903 OTHER New Technology - Level 50 44 26 — — $116,836.31 $238,490.60 $127,074.54 2026-03-01
1904 OTHER New Technology - Level 50 44 26 — — $116,836.31 $238,490.60 $127,074.54 2026-03-01
1905 OTHER New Technology - Level 51 44 26 — — $131,142.74 $267,693.43 $142,634.63 2026-03-01
1906 OTHER New Technology - Level 51 44 26 — — $131,142.74 $267,693.43 $142,634.63 2026-03-01
1907 OTHER New Technology - Level 52 44 26 — — $145,449.17 $296,896.25 $158,194.72 2026-03-01
1908 OTHER New Technology - Level 52 44 26 — — $145,449.17 $296,896.25 $158,194.72 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 120 68 — — $77,891.83 $298,508.00 $132,625.90 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 96 50 — — $54,750.83 $190,500.57 $66,917.69 2026-03-01
2004 APR_DRG Cardiac Structural And Valvular Disorders 10 6 — — $112,515.83 $137,887.05 $115,825.12 2026-03-01
2067 OTHER Afamitresgene Autoleucel 44 26 — — $747,501.40 $1,525,827.60 $813,004.10 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 94 51 — — $57,342.00 $187,145.04 $92,069.21 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 122 70 — — $11,384.00 $179,792.37 $92,672.04 2026-03-01
215 MS_DRG Other Heart Assist System Implant 133 71 — — $58,771.00 $320,760.00 $95,622.00 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 133 71 — — $58,771.00 $230,793.47 $93,806.76 2026-03-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 133 71 — — $46,107.21 $188,609.00 $70,828.00 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 133 71 — — $46,107.21 $188,608.00 $70,828.00 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 133 71 — — $53,477.85 $185,236.17 $80,216.77 2026-03-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 6 1 — — $78,261.69 $146,528.98 $120,831.35 2026-03-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 6 1 — — $57,075.62 $106,862.40 $88,121.32 2026-03-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 6 1 — — $74,010.50 $138,569.49 $114,267.76 2026-03-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 6 1 — — $55,296.01 $103,530.44 $85,373.71 2026-03-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc Pediartic 6 1 — — $64,619.30 $120,986.39 $99,768.31 2026-03-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc Pediar… 6 1 — — $51,302.70 $96,053.79 $79,208.28 2026-03-01
23 APR_DRG Heart And/or Lung Transplant 14 7 — — $60,631.67 $103,696.00 $66,278.75 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 133 71 — — $58,500.31 $200,369.83 $81,986.00 2026-03-01
24 APR_DRG Heart And/or Lung Transplant 14 7 — — $246,170.27 $421,015.00 $269,098.00 2026-03-01
2464 APR_DRG Gastrointestinal Vascular Insufficiency 10 6 — — $83,609.77 $102,462.95 $86,068.88 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 127 71 — — $49,816.58 $145,475.00 $71,682.00 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 91 49 — — $144,003.06 $352,095.26 $176,003.74 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 91 49 — — $94,728.69 $229,019.05 $114,726.97 2026-03-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $65,556.12 $65,556.12 $65,556.12 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 84 50 — — $48,305.00 $203,567.00 $88,873.55 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 84 50 — — $48,305.00 $162,082.00 $73,116.27 2026-03-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 10 6 — — $65,522.29 $80,296.93 $67,449.42 2026-03-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 10 6 — — $101,909.33 $124,888.89 $104,906.67 2026-03-01
4404 APR_DRG Kidney Transplant 14 7 — — $65,845.39 $112,613.00 $71,978.05 2026-03-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc Pediartic 6 1 — — $90,437.48 $169,325.65 $139,630.04 2026-03-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc Pediartic 6 1 — — $59,974.38 $112,289.74 $92,596.84 2026-03-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc Pediartic 6 1 — — $47,062.34 $88,114.58 $72,661.42 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 96 50 — — $48,305.00 $234,066.20 $69,339.83 2026-03-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc Pediartic 6 1 — — $66,277.84 $124,091.67 $102,329.00 2026-03-01
460039 CDM Ld Kidney Transplant 79 42 $438,958.00 $438,958.00 $21,947.90 $395,062.20 $162,414.46 2026-03-01
460040 CDM Dd Kidney Transplant 79 42 $438,958.00 $438,958.00 $21,947.90 $395,062.20 $162,414.46 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 110 66 — — $71,067.14 $170,473.81 $109,194.66 2026-03-01
5244 OTHER Level 4 Blood Product Exc 44 26 — — $61,292.12 $125,111.74 $66,663.07 2026-03-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 10 6 — — $65,544.58 $80,324.24 $67,472.36 2026-03-01
5831 APR_DRG Neonate With Ecmo 10 6 — — $112,275.10 $137,592.04 $115,577.31 2026-03-01
5832 APR_DRG Neonate With Ecmo 10 6 — — $127,510.02 $156,262.28 $131,260.31 2026-03-01
5833 APR_DRG Neonate With Ecmo 10 6 — — $255,901.78 $313,605.13 $263,428.30 2026-03-01
5834 APR_DRG Neonate With Ecmo 10 6 — — $302,211.72 $370,357.50 $311,100.30 2026-03-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 10 6 — — $96,309.25 $118,026.04 $99,141.87 2026-03-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 10 6 — — $102,173.53 $125,212.66 $105,178.64 2026-03-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 10 6 — — $102,642.66 $125,787.57 $105,661.56 2026-03-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 10 6 — — $191,295.06 $234,430.22 $196,921.39 2026-03-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 10 6 — — $80,715.82 $98,916.45 $83,089.82 2026-03-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 10 6 — — $78,230.12 $95,870.25 $80,531.01 2026-03-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 10 6 — — $73,378.10 $89,924.14 $75,536.28 2026-03-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 10 6 — — $63,831.60 $78,225.00 $65,709.00 2026-03-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 10 6 — — $96,935.15 $118,793.08 $99,786.18 2026-03-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 10 6 — — $80,474.30 $98,620.46 $82,841.19 2026-03-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 10 6 — — $73,978.53 $90,659.96 $76,154.37 2026-03-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 10 6 — — $83,178.44 $101,934.36 $85,624.86 2026-03-01
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 10 6 — — $63,650.56 $78,003.14 $65,522.64 2026-03-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 10 6 — — $141,074.92 $172,885.94 $145,224.19 2026-03-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 10 6 — — $70,250.97 $86,091.88 $72,317.18 2026-03-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 10 6 — — $67,085.65 $82,212.81 $69,058.76 2026-03-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 10 6 — — $142,336.28 $174,431.71 $146,522.64 2026-03-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 10 6 — — $100,457.78 $123,110.03 $103,412.42 2026-03-01
64 APR_DRG Pancreas Transplant 14 7 — — $80,722.19 $138,056.00 $88,240.45 2026-03-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $96,575.58 $96,575.58 $96,575.58 2026-03-01
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 10 6 — — $63,831.60 $78,225.00 $65,709.00 2026-03-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 10 6 — — $86,268.56 $105,721.28 $88,805.87 2026-03-01
7 MS_DRG Lung Transplant 106 66 — — $88,706.56 $214,118.61 $133,059.83 2026-03-01
714 OTHER Inj Delandistrogene Mox R 40 24 — — $6,488.21 $4,492,611.00 $3,444,335.10 2026-03-01
717 OTHER Instill Adstiladrin, Tx D 45 27 — — $12,246.36 $127,264.08 $67,488.53 2026-03-01
72 APR_DRG Allogeneic Bone Marrow Transplant 14 7 — — $69,700.67 $119,206.00 $76,192.40 2026-03-01
73 APR_DRG Allogeneic Bone Marrow Transplant 14 7 — — $103,738.49 $177,420.00 $113,400.50 2026-03-01
74 APR_DRG Allogeneic Bone Marrow Transplant 14 7 — — $293,991.84 $502,802.00 $321,373.50 2026-03-01
746 OTHER Inj, Betibeglogene Autote 42 26 — — $11,424.10 $4,556,951.95 $3,086,967.45 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 40 24 — — $12,350.24 $4,390,885.80 $3,366,345.78 2026-03-01
813159 CDM Valve Mitral 25mm 43 29 $176,460.00 $176,460.00 $24,704.40 $158,814.00 $79,407.00 2026-03-01
820176 CDM Bit Drill Prfx Fan 2k 79 42 $182,979.00 $182,979.00 $9,148.95 $164,681.10 $67,702.23 2026-03-01
821043 CDM Graft Tlnt Tf3434 43 29 $216,864.00 $216,864.00 $30,360.96 $195,177.60 $97,588.80 2026-03-01
821737 CDM Valve Mtrl 18mm 25mm Msc 43 29 $166,314.00 $166,314.00 $23,283.96 $149,682.60 $74,841.30 2026-03-01
821740 CDM Valve Mitral 23mm 43 29 $166,314.00 $166,314.00 $23,283.96 $149,682.60 $74,841.30 2026-03-01
821805 CDM Vlv Mtrl Ts Mgna Trxfx27 43 29 $176,313.00 $176,313.00 $24,683.82 $158,681.70 $79,340.85 2026-03-01
824 OTHER Inj, Exagamglogene Autote 45 27 — — $13,377.34 $4,617,360.00 $2,448,600.00 2026-03-01
825641 CDM Gft Bfr 24x14x16.5 43 29 $172,978.00 $172,978.00 $24,216.92 $155,680.20 $77,840.10 2026-03-01
826103 CDM Valve Aortic 19mm 43 29 $193,959.00 $193,959.00 $27,154.26 $174,563.10 $87,281.55 2026-03-01
826104 CDM Valve Aortic 27mm 43 29 $193,959.00 $193,959.00 $27,154.26 $174,563.10 $87,281.55 2026-03-01
826529 CDM Graft Talent Aaa Stent W 43 29 $196,295.00 $196,295.00 $27,481.30 $176,665.50 $88,332.75 2026-03-01
827207 CDM Set Pump Asst 2.5in 79 42 $499,600.00 $499,600.00 $24,980.00 $449,640.00 $184,852.00 2026-03-01
828574 CDM Graft Nrv 4-5mm 70mm 43 29 $234,988.00 $234,988.00 $32,898.32 $211,489.20 $105,744.60 2026-03-01
829721 CDM Handle Bx Asp 20 Ml Syr 79 42 $286,960.00 $286,960.00 $14,348.00 $258,264.00 $106,175.20 2026-03-01
830032 CDM Kit Neuro Proc Thrml Trp 79 42 $324,616.00 $324,616.00 $16,230.80 $292,154.40 $120,107.92 2026-03-01
830215 CDM Set Vntrc 17.4x13.8in 79 42 $573,750.00 $573,750.00 $28,687.50 $516,375.00 $212,287.50 2026-03-01
830962 CDM Impl Crnl Ns Peek 43 29 $196,447.00 $196,447.00 $27,502.58 $176,802.30 $88,401.15 2026-03-01
831 OTHER Obecbtge Autol Up To 400 45 27 — — $3,777.49 $550,935.00 $292,162.50 2026-03-01
831053 CDM Valve Aor 11cm 36x26mm 43 29 $205,723.00 $205,723.00 $28,801.22 $185,150.70 $92,575.35 2026-03-01
831316 CDM Cage Spnl Vlift 32x22mm 43 29 $146,334.00 $146,334.00 $20,486.76 $131,700.60 $65,850.30 2026-03-01
832986 CDM Cg Spn Lmbr 26/32x13x12d 43 29 $192,054.00 $192,054.00 $26,887.56 $172,848.60 $86,424.30 2026-03-01
833643 CDM Cage Spn Aero 32x15mm 43 29 $192,054.00 $192,054.00 $26,887.56 $172,848.60 $86,424.30 2026-03-01
833671 CDM Valve Aortic 25mm 43 29 $166,755.00 $166,755.00 $23,345.70 $150,079.50 $75,039.75 2026-03-01
833679 CDM Graft Bn Algrf Cndyl Lt 43 29 $386,060.00 $386,060.00 $54,048.40 $347,454.00 $173,727.00 2026-03-01
835172 CDM Cage Aero 22 28mm 11mm 43 29 $207,348.00 $207,348.00 $29,028.72 $186,613.20 $93,306.60 2026-03-01
836030 CDM Occluder Cv 25x18mm 43 29 $293,953.00 $293,953.00 $41,153.42 $264,557.70 $132,278.85 2026-03-01
836034 CDM Occluder Cv 35x18mm 43 29 $293,953.00 $293,953.00 $41,153.42 $264,557.70 $132,278.85 2026-03-01
836035 CDM Occluder Cv 18x18mm 43 29 $293,953.00 $293,953.00 $41,153.42 $264,557.70 $132,278.85 2026-03-01
836304 CDM Cage Spnl 28x36x8mm 43 29 $196,082.00 $196,082.00 $27,451.48 $176,473.80 $88,236.90 2026-03-01
837552 CDM Cage Spn 28x36x24mm 43 29 $196,082.00 $196,082.00 $27,451.48 $176,473.80 $88,236.90 2026-03-01
837939 CDM Graft Evas 26x14.5m 14cm 43 29 $216,792.00 $216,792.00 $30,350.88 $195,112.80 $97,556.40 2026-03-01
838274 CDM Kit Neuro Fbr Lsr 3mm 79 42 $324,616.00 $324,616.00 $16,230.80 $292,154.40 $120,107.92 2026-03-01
839009 CDM Gft Bn Spn Frzdr 11x22mm 43 29 $201,671.00 $201,671.00 $28,233.94 $181,503.90 $90,751.95 2026-03-01
839779 CDM Cage Spnl 10x12x21.25mm 43 29 $175,125.00 $175,125.00 $24,517.50 $157,612.50 $78,806.25 2026-03-01
839966 CDM Implant Crnl Lg Peek 43 29 $216,864.00 $216,864.00 $30,360.96 $195,177.60 $97,588.80 2026-03-01
84 APR_DRG Autologous Bone Marrow Transplant 14 7 — — $87,829.13 $150,211.00 $96,009.20 2026-03-01
840735 CDM Spacer Spnl 20x90mm 43 29 $164,244.00 $164,244.00 $22,994.16 $147,819.60 $73,909.80 2026-03-01
841155 CDM Graft Evas 23x12mm 14cm 43 29 $216,792.00 $216,792.00 $30,350.88 $195,112.80 $97,556.40 2026-03-01
841162 CDM Valve Aortic 23mm 43 29 $211,752.00 $211,752.00 $29,645.28 $190,576.80 $95,288.40 2026-03-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 10 6 — — $101,471.24 $124,352.01 $104,455.69 2026-03-01
841413 CDM Valve Aortic 27mm 43 29 $160,540.00 $160,540.00 $22,475.60 $144,486.00 $72,243.00 2026-03-01
841485 CDM Valve Aortic 25mm 43 29 $211,752.00 $211,752.00 $29,645.28 $190,576.80 $95,288.40 2026-03-01
841978 CDM Cath Pmp Impella 5.0 9f 79 42 $699,440.00 $699,440.00 $34,972.00 $629,496.00 $258,792.80 2026-03-01
842029 CDM Valve Aortic 21mm 43 29 $294,140.00 $294,140.00 $41,179.60 $264,726.00 $132,363.00 2026-03-01
842101 CDM Kit Impl Crnl Cstm Lg 43 29 $295,945.00 $295,945.00 $41,432.30 $266,350.50 $133,175.25 2026-03-01
842203 CDM Implant Cranial Med 43 29 $216,864.00 $216,864.00 $30,360.96 $195,177.60 $97,588.80 2026-03-01
844197 CDM Cage Spnl 20mm C Centerp 43 29 $180,963.00 $180,963.00 $25,334.82 $162,866.70 $81,433.35 2026-03-01
844516 CDM Graft Drms Ptch 16x20cm 43 29 $188,470.00 $188,470.00 $26,385.80 $169,623.00 $84,811.50 2026-03-01
845 OTHER Inj, Atidarsagene Autotem 35 21 — — $5,516.55 $4,955,500.00 $4,505,000.00 2026-03-01
845278 CDM Valve Aortic 27mm 43 29 $352,350.00 $352,350.00 $49,329.00 $317,115.00 $158,557.50 2026-03-01
845312 CDM Valve Aor Conduit 27mm 43 29 $352,350.00 $352,350.00 $49,329.00 $317,115.00 $158,557.50 2026-03-01
845591 CDM Cage Spn W/set Scr 14x18 43 29 $176,474.00 $176,474.00 $24,706.36 $158,826.60 $79,413.30 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 84 50 — — $11,384.00 $143,176.17 $70,373.86 2026-03-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 10 6 — — $97,811.33 $119,866.83 $100,688.13 2026-03-01
8634 APR_DRG Neonatal Aftercare 10 6 — — $67,736.22 $83,010.07 $69,728.46 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 45 27 — — $8,265.78 $399,304.62 $211,752.45 2026-03-01
897 OTHER Revakinagene, Per Implant 44 26 — — $257,050.00 $524,700.00 $279,575.00 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 44 26 — — $516,226.43 $1,053,740.56 $561,462.77 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 42 26 — — $8,826.02 $4,929,000.00 $3,339,000.00 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 40 24 — — $9,988.50 $4,503,357.00 $3,452,573.70 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 39 23 — — $3,574,708.99 $4,975,110.45 $3,869,530.35 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 43 25 — — $2,511,311.57 $4,427,157.51 $2,718,430.05 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 44 26 — — $549,535.36 $1,121,731.97 $597,690.53 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 75 45 — — $11,384.00 $353,009.17 $168,980.39 2026-03-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 10 6 — — $85,499.81 $104,779.17 $88,014.51 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 44 26 — — $474,766.69 $969,111.40 $516,369.96 2026-03-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 10 6 — — $174,028.45 $213,270.16 $179,146.94 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 44 26 — — $545,335.16 $1,113,158.38 $593,122.27 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 44 26 — — $541,339.35 $1,105,001.96 $588,776.30 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 44 26 — — $570,020.11 $1,163,546.21 $619,970.33 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 9 2 — — $69,325.95 $141,791.81 $93,760.51 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 3 1 — — $56,968.06 $77,046.96 $77,046.96 2026-03-01
C1721 HCPCS Defib Icd 5.37x7.68x.99 546 28 $228,744.00 $228,744.00 $24,305.82 $337,954.50 $113,675.50 2026-03-01
C1722 HCPCS Defib Dm3vr 1chmbr 336 28 $252,098.50 $252,098.50 $26,853.54 $278,352.00 $108,050.40 2026-03-01
C1767 HCPCS Nrstm Impl 2.4inx2.2in 1,470 28 $255,775.00 $255,775.00 $131.18 $405,781.20 $107,248.05 2026-03-01
C1772 HCPCS Pump Infs Pain 40ml 126 28 $214,731.00 $214,731.00 $23,857.26 $195,177.60 $93,724.95 2026-03-01
C1815 HCPCS Cuff Urth Sphncr 4cm 126 28 $147,731.00 $147,731.00 $19,655.72 $138,888.00 $66,478.95 2026-03-01
C1817 HCPCS Occluder Cv 10x3mm 294 28 $176,731.00 $176,731.00 $20,302.80 $195,112.80 $79,528.95 2026-03-01
C1820 HCPCS Ipg Nrstm 49.5x55.5x1.34 714 28 $257,833.00 $257,833.00 $2,181.62 $353,565.00 $115,798.50 2026-03-01
C1882 HCPCS Crt -d Defib Card 14mm 1,050 28 $290,936.00 $290,936.00 $12,400.92 $434,970.00 $123,492.60 2026-03-01
C2624 HCPCS System Mntr 2x15mm 4.5cm 42 28 $329,910.00 $329,910.00 $46,187.40 $296,919.00 $148,459.50 2026-03-01
C9301 HCPCS Obecabtagene Autoleucel, Up To 400 Million Cd19 Car-positive Viable T Cells, Inc… 6 1 — — $397,897.50 $723,450.00 $617,715.00 2026-03-01
E0767 HCPCS Intrabuccal, Systemic Delivery Of Amplitude-modulated, Radiofrequency Electromag… 6 1 — — $103,964.11 $188,817.17 $149,830.63 2026-03-01
J1411 HCPCS Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 1 1 — — $4,496,025.34 $4,496,025.34 $4,496,025.34 2026-03-01
J1413 HCPCS Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 1 1 — — $4,059,988.87 $4,059,988.87 $4,059,988.87 2026-03-01
J3387 HCPCS Injection, Elivaldogene Autotemcel, Per Treatment 1 1 — — $3,879,600.00 $3,879,600.00 $3,879,600.00 2026-03-01
J3389 HCPCS Topical Administration, Prademagene Zamikeracel, Per Treatment 1 1 — — $4,069,700.40 $4,069,700.40 $4,069,700.40 2026-03-01
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 3 1 — — $2,845,040.00 $3,847,800.00 $3,847,800.00 2026-03-01
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 3 1 — — $3,586,762.05 $4,850,948.67 $4,850,948.67 2026-03-01
J3394 HCPCS Injection, Lovotibeglogene Autotemcel, Per Treatment 1 1 — — $3,968,059.86 $3,968,059.86 $3,968,059.86 2026-03-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 3 1 — — $3,158,557.10 $4,271,819.03 $4,271,819.03 2026-03-01
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 3 1 — — $246,036.20 $332,753.88 $332,753.88 2026-03-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 11 3 — — $14,506.67 $138,148.31 $84,757.38 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 10 3 — — $63,235.60 $416,000.00 $228,800.00 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 10 3 — — $45,212.00 $95,547.45 $71,255.81 2026-03-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 51 27 — — $92,228.57 $190,190.00 $100,785.86 2026-03-01
L8614 HCPCS Processor Snd Dual Kt 226 58 $318,848.00 $318,848.00 $11,408.82 $353,565.00 $109,046.02 2026-03-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 45 27 — — $66,737.65 $136,227.37 $72,241.79 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 47 28 — — $57,259.65 $220,754.16 $117,066.60 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 16 4 — — $502,841.00 $921,310.00 $712,075.50 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 16 4 — — $549,391.70 $998,894.00 $774,142.85 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 10 3 — — $57,017.10 $158,309.29 $89,766.78 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 10 3 — — $489,399.00 $965,920.80 $807,592.83 2026-03-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 10 3 — — $516,442.00 $1,062,512.88 $907,222.54 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 10 3 — — $527,622.00 $1,086,337.20 $920,834.85 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 10 3 — — $553,169.00 $1,204,164.00 $969,621.79 2026-03-01
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 9 2 — — $940,156.40 $1,905,321.60 $1,271,523.00 2026-03-01
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 9 2 — — $339,465.00 $1,375,920.00 $756,756.00 2026-03-01
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