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 →

Export CSV
Hospital

MEDICAL CITY LAS COLINAS

Irving, TX · CCN 450822 · Rates published

40,031 distinct procedures filed
57 distinct payers
2,143,619 rate rows
2026-07-17 last MRF observed
Data quality

2,086,119 of 2,143,619 rate rows are consumer-grade (97.3%)

57,500 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 23,483
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 16,778
per-diem day rate — not a per-procedure price 11,192
template filing: same amount across many unrelated codes — excluded 4,775
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 916
placeholder amount (≤ $0.02) — excluded from medians 241
exceeds 10× this hospital's gross charge — excluded from medians 108
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 7
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1650582_MEDICAL-CITY-LAS-COLINAS_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page https://www.medicalcityhealthcare.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-10-03
Content fingerprint 5d801214c19e1ca3… · 928,926,099 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
$2,968,000
1.6× median
845
OTHER 		Inj, Atidarsagene Autotem 20 $5,291.79 $4,955,500.00 $4,535,408.75 nat. median
$4,505,000
1.0× median
00845
OTHER 		Inj, Atidarsagene Autotem 2 $4,369,850.00 $4,505,000.00 $4,437,425.00 —
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
$2,455,111
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
$2,332,000
1.6× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 21 $3,666,840.67 $4,790,847.10 $3,740,546.00 nat. median
$3,765,001
1.0× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 2 $3,574,708.99 $3,685,267.00 $3,629,988.00 nat. median
$3,562,713
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 24 $6,223.86 $4,991,790.00 $3,460,974.40 nat. median
$3,391,964
1.0× median
908
OTHER 		Topi Adm Prad Zami Per Tr 21 $9,581.54 $4,336,566.00 $3,385,857.30 nat. median
$8,800
outlier · 384.8×
748
OTHER 		Inj, Lovotibeglogene Auto 24 $11,847.05 $4,878,762.00 $3,382,608.32 nat. median
$3,351,720
1.0× median
00908
OTHER 		Topi Adm Prad Zami Per Tr 2 $3,235,745.40 $3,335,820.00 $3,285,782.70 —
00714
OTHER 		Inj Delandistrogene Mox R 2 $3,228,024.20 $3,327,860.00 $3,277,942.10 nat. median
$3,225,691
1.0× median
906
OTHER 		Inj Elivaldogene Autoteme 22 $8,466.42 $4,770,000.00 $3,275,400.00 nat. median
$2,726
outlier · 1201.4×
00748
OTHER 		Inj, Lovotibeglogene Auto 2 $3,154,932.76 $3,252,508.00 $3,203,720.38 nat. median
$3,187,420
1.0× median
00906
OTHER 		Inj Elivaldogene Autoteme 2 $3,084,600.00 $3,180,000.00 $3,132,300.00 —
746
OTHER 		Inj, Betibeglogene Autote 24 $10,958.64 $4,409,953.50 $3,057,567.76 nat. median
$3,001,835
1.0× median
00746
OTHER 		Inj, Betibeglogene Autote 2 $2,851,769.93 $2,939,969.00 $2,895,869.46 nat. median
$2,878,960
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 24 $2,455,110.00 $4,919,063.90 $2,718,430.05 nat. median
$2,508,045
1.1× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 2 $2,511,311.57 $2,588,981.00 $2,550,146.29 nat. median
$2,316,956
1.1× median
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 2 $1,271,523.00 $4,067,128.80 $2,528,215.20 nat. median
$813,967
outlier · 3.1×
824
OTHER 		Inj, Exagamglogene Autote 26 $12,832.29 $4,617,360.00 $2,425,280.00 nat. median
$28,063
outlier · 86.4×
00824
OTHER 		Inj, Exagamglogene Autote 2 $2,262,040.00 $2,332,000.00 $2,297,020.00 —
Q2058
HCPCS 		Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,… 2 $459,112.50 $2,937,060.00 $1,825,740.00 nat. median
$286,598
outlier · 6.4×
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 4 $536,573.93 $2,570,427.00 $1,597,833.00 nat. median
$599,737
outlier · 2.7×
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 4 $511,793.34 $2,318,912.10 $1,441,485.90 nat. median
$574,037
outlier · 2.5×
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 4 $500,948.74 $2,268,056.34 $1,409,872.86 nat. median
$579,571
outlier · 2.4×
C9301
HCPCS 		Obecabtagene Autoleucel, Up To 400 Million Cd19 Car-positive Viable T Cells, Inc… 1 $959,962.50 $1,544,287.50 $1,405,162.50 nat. median
$377,029
outlier · 3.7×
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 4 $23.68 $2,132,254.50 $1,325,455.50 nat. median
$621,313
outlier · 2.1×
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 4 $474,717.03 $2,061,869.40 $1,281,702.60 nat. median
$513,770
outlier · 2.5×
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 4 $6.22 $1,966,642.50 $1,222,507.50 nat. median
$562,501
outlier · 2.2×
2067
OTHER 		Afamitresgene Autoleucel 27 $766,766.90 $2,019,024.40 $809,151.00 nat. median
$838,386
1.0× median
9498
OTHER 		Ciltacabtagene Car-pos T 26 $565,868.90 $1,539,641.95 $617,032.08 nat. median
$553,480
1.1× median
9194
OTHER 		Tisagenlecleucel Car-pos 26 $563,698.64 $1,484,312.01 $594,857.87 nat. median
$555,653
1.1× median
9413
OTHER 		Lisocabtagene Car Pos T 26 $559,390.19 $1,472,967.14 $590,311.26 nat. median
$542,562
1.1× median
9422
OTHER 		Idecabtagene Vicleucel Ca 26 $555,291.39 $1,462,174.32 $585,985.89 nat. median
$552,917
1.1× median
09498
OTHER 		Ciltacabtagene Car-pos T 2 $570,020.11 $587,649.60 $578,834.85 nat. median
$511,310
1.1× median
9035
OTHER 		Axicabtagene Ciloleucel C 26 $529,531.24 $1,394,343.56 $558,801.81 nat. median
$513,929
1.1× median
09194
OTHER 		Tisagenlecleucel Car-pos 2 $549,535.36 $566,531.30 $558,033.33 nat. median
$513,317
1.1× median
09413
OTHER 		Lisocabtagene Car Pos T 2 $545,335.16 $562,201.20 $553,768.18 nat. median
$501,224
1.1× median
09422
OTHER 		Idecabtagene Vicleucel Ca 2 $541,339.35 $558,081.80 $549,710.57 nat. median
$510,790
1.1× median
09035
OTHER 		Axicabtagene Ciloleucel C 2 $516,226.43 $532,192.20 $524,209.31 nat. median
$474,772
1.1× median
9391
OTHER 		Brexucabtagene Car Pos T 26 $487,002.95 $1,282,359.52 $513,922.71 nat. median
$483,557
1.1× median
09391
OTHER 		Brexucabtagene Car Pos T 2 $474,766.69 $489,450.20 $482,108.45 nat. median
$446,714
1.1× median
J9029
HCPCS 		Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 5 $61,338.53 $888,000.00 $405,600.00 nat. median
$66,211
outlier · 6.1×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 20 $313,633.03 $1,273,072.13 $336,035.39 nat. median
$168,055
2.0× median
J3402
HCPCS 		Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 $332,753.88 $332,753.88 $332,753.88 nat. median
$207,733
1.6× median
90288
CPT 		Botulism Immune Globulin, Human, For Intravenous Use 1 $294,713.96 $416,525.16 $329,245.80 nat. median
$43,548
outlier · 7.6×
Q2043
HCPCS 		Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 5 $55,306.59 $478,449.94 $310,609.58 nat. median
$63,499
outlier · 4.9×
831
OTHER 		Obecbtge Autol Up To 400 27 $3,623.59 $729,015.00 $292,162.50 nat. median
$278,250
1.1× median
A9543
HCPCS 		Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 4 $93,760.51 $582,739.61 $289,037.14 nat. median
$65,477
outlier · 4.4×

Other procedures at this hospital

Browse this hospital's 40,031 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 2 2 $484,340.00 — $187,805.58 $193,614.00 $190,709.79 2026-07-17
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 2 $484,340.00 — $70,413.32 $72,591.05 $71,502.18 2026-07-17
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 2 $568,197.06 — $132,369.21 $136,463.10 $134,416.15 2026-07-17
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 2 $385,544.94 — $103,369.89 $106,566.90 $104,968.39 2026-07-17
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 2 2 $174,360.29 — $67,100.98 $69,176.27 $68,138.62 2026-07-17
007 OTHER Lung Transplant 2 2 $186,118.44 — $79,446.81 $81,903.93 $80,675.37 2026-07-17
00714 OTHER Inj Delandistrogene Mox R 2 2 — — $3,228,024.20 $3,327,860.00 $3,277,942.10 2026-03-01
00717 OTHER Instill Adstiladrin, Tx D 2 2 — — $62,346.55 $64,274.79 $63,310.67 2026-03-01
00746 OTHER Inj, Betibeglogene Autote 2 2 — — $2,851,769.93 $2,939,969.00 $2,895,869.46 2026-03-01
00748 OTHER Inj, Lovotibeglogene Auto 2 2 — — $3,154,932.76 $3,252,508.00 $3,203,720.38 2026-03-01
00824 OTHER Inj, Exagamglogene Autote 2 2 — — $2,262,040.00 $2,332,000.00 $2,297,020.00 2026-03-01
00831 OTHER Obecbtge Autol Up To 400 2 2 — — $269,902.50 $278,250.00 $274,076.25 2026-03-01
00845 OTHER Inj, Atidarsagene Autotem 2 2 — — $4,369,850.00 $4,505,000.00 $4,437,425.00 2026-03-01
00886 OTHER Inj. Remestemcel-l-rknd/ 2 2 — — $195,618.93 $201,669.00 $198,643.96 2026-03-01
00897 OTHER Revakinagene, Per Implant 2 2 — — $257,050.00 $265,000.00 $261,025.00 2026-03-01
00906 OTHER Inj Elivaldogene Autoteme 2 2 — — $3,084,600.00 $3,180,000.00 $3,132,300.00 2026-03-01
00908 OTHER Topi Adm Prad Zami Per Tr 2 2 — — $3,235,745.40 $3,335,820.00 $3,285,782.70 2026-03-01
014 OTHER Allogeneic Bone Marrow Transplant 2 2 $171,216.17 — $67,815.28 $69,912.66 $68,863.97 2026-07-17
01582 OTHER New Technology - Level 45 2 2 — — $60,636.91 $62,512.28 $61,574.60 2026-03-01
01583 OTHER New Technology - Level 46 2 2 — — $69,965.60 $72,129.48 $71,047.54 2026-03-01
01584 OTHER New Technology - Level 47 2 2 — — $79,294.28 $81,746.68 $80,520.48 2026-03-01
01585 OTHER New Technology - Level 48 2 2 — — $88,622.96 $91,363.88 $89,993.42 2026-03-01
01596 OTHER New Technology - Level 45 2 2 — — $60,636.91 $62,512.28 $61,574.60 2026-03-01
01597 OTHER New Technology - Level 46 2 2 — — $69,965.60 $72,129.48 $71,047.54 2026-03-01
01598 OTHER New Technology - Level 47 2 2 — — $79,294.28 $81,746.68 $80,520.48 2026-03-01
01599 OTHER New Technology - Level 48 2 2 — — $88,622.96 $91,363.88 $89,993.42 2026-03-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 $1,014,848.78 — $213,654.33 $220,262.20 $216,958.27 2026-07-17
01901 OTHER New Technology - Level 49 2 2 — — $100,283.84 $103,385.40 $101,834.62 2026-03-01
01902 OTHER New Technology - Level 49 2 2 — — $100,283.84 $103,385.40 $101,834.62 2026-03-01
01903 OTHER New Technology - Level 50 2 2 — — $114,276.86 $117,811.20 $116,044.03 2026-03-01
01904 OTHER New Technology - Level 50 2 2 — — $114,276.86 $117,811.20 $116,044.03 2026-03-01
01905 OTHER New Technology - Level 51 2 2 — — $128,269.89 $132,237.00 $130,253.45 2026-03-01
01906 OTHER New Technology - Level 51 2 2 — — $128,269.89 $132,237.00 $130,253.45 2026-03-01
01907 OTHER New Technology - Level 52 2 2 — — $142,262.92 $146,662.80 $144,462.86 2026-03-01
01908 OTHER New Technology - Level 52 2 2 — — $142,262.92 $146,662.80 $144,462.86 2026-03-01
05244 OTHER Level 4 Blood Product Exc 2 2 — — $59,949.40 $61,803.51 $60,876.46 2026-03-01
0870T CPT Implantation Of Subcutaneous Peritoneal Ascites Pump System, Percutaneous, Inclu… 10 2 — — $4,511.36 $64,941.69 $59,084.21 2026-03-01
0871T CPT Replacement Of A Subcutaneous Peritoneal Ascites Pump, Including Reconnection Be… 10 2 — — $4,511.36 $64,941.69 $59,084.21 2026-03-01
0872T CPT Replacement Of Indwelling Bladder And Peritoneal Catheters, Including Tunneling … 10 2 — — $4,511.36 $64,941.69 $59,084.21 2026-03-01
0873T CPT Revision Of A Subcutaneously Implanted Peritoneal Ascites Pump System, Any Compo… 10 2 — — $4,511.36 $64,941.69 $59,084.21 2026-03-01
0894T CPT Cannulation Of The Liver Allograft In Preparation For Connection To The Normothe… 10 2 — — $4,511.36 $64,941.69 $59,084.21 2026-03-01
0895T CPT Connection Of Liver Allograft To Normothermic Machine Perfusion Device, Hemostas… 7 1 — — $4,511.36 $64,941.69 $62,031.14 2026-03-01
0896T CPT Connection Of Liver Allograft To Normothermic Machine Perfusion Device, Hemostas… 7 1 — — $4,511.36 $64,941.69 $62,031.14 2026-03-01
0901T CPT Placement Of Bone Marrow Sampling Port, Including Imaging Guidance When Performe… 9 2 — — $7,977.00 $64,941.69 $59,084.21 2026-03-01
09035 OTHER Axicabtagene Ciloleucel C 2 2 — — $516,226.43 $532,192.20 $524,209.31 2026-03-01
0908T CPT Open Implantation Of Integrated Neurostimulation System, Vagus Nerve, Including … 9 2 — — $7,977.00 $64,941.69 $59,084.21 2026-03-01
0909T CPT Replacement Of Integrated Neurostimulation System, Vagus Nerve, Including Analys… 9 2 — — $7,977.00 $64,941.69 $59,084.21 2026-03-01
0910T CPT Removal Of Integrated Neurostimulation System, Vagus Nerve 9 2 — — $7,977.00 $64,941.69 $59,084.21 2026-03-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 2 2 — — $3,574,708.99 $3,685,267.00 $3,629,988.00 2026-03-01
09141 OTHER Inj Onase Abepar-xioi Tre 2 2 — — $2,511,311.57 $2,588,981.00 $2,550,146.29 2026-03-01
0915T CPT Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 9 2 — — $22,045.00 $84,963.19 $65,085.01 2026-03-01
09194 OTHER Tisagenlecleucel Car-pos 2 2 — — $549,535.36 $566,531.30 $558,033.33 2026-03-01
0935T CPT Cystourethroscopy With Renal Pelvic Sympathetic Denervation, Radiofrequency Abla… 9 2 — — $7,977.00 $64,941.69 $59,084.21 2026-03-01
0936T CPT Photobiomodulation Therapy Of Retina, Single Session 6 1 — — $59,084.21 $64,941.69 $62,867.93 2026-03-01
09391 OTHER Brexucabtagene Car Pos T 2 2 — — $474,766.69 $489,450.20 $482,108.45 2026-03-01
09413 OTHER Lisocabtagene Car Pos T 2 2 — — $545,335.16 $562,201.20 $553,768.18 2026-03-01
0941T CPT Cystourethroscopy, Flexible; With Insertion And Expansion Of Prostatic Urethral … 9 2 — — $7,977.00 $64,941.69 $59,084.21 2026-03-01
09422 OTHER Idecabtagene Vicleucel Ca 2 2 — — $541,339.35 $558,081.80 $549,710.57 2026-03-01
0942T CPT Cystourethroscopy, Flexible; With Removal And Replacement Of Prostatic Urethral … 9 2 — — $7,977.00 $64,941.69 $59,084.21 2026-03-01
0943T CPT Cystourethroscopy, Flexible; With Removal Of Prostatic Urethral Scaffold 9 2 — — $7,977.00 $64,941.69 $59,084.21 2026-03-01
09498 OTHER Ciltacabtagene Car-pos T 2 2 — — $570,020.11 $587,649.60 $578,834.85 2026-03-01
0951T CPT Totally Implantable Active Middle Ear Hearing Implant; Initial Placement, Includ… 9 2 — — $7,977.00 $64,941.69 $59,084.21 2026-03-01
0952T CPT Totally Implantable Active Middle Ear Hearing Implant; Revision Or Replacement, … 9 2 — — $7,977.00 $64,941.69 $59,084.21 2026-03-01
0953T CPT Totally Implantable Active Middle Ear Hearing Implant; Revision Or Replacement, … 9 2 — — $7,977.00 $64,941.69 $59,084.21 2026-03-01
0954T CPT Totally Implantable Active Middle Ear Hearing Implant; Replacement Of Sound Proc… 9 2 — — $7,977.00 $64,941.69 $59,084.21 2026-03-01
0955T CPT Totally Implantable Active Middle Ear Hearing Implant; Removal, Including Remova… 9 2 — — $7,977.00 $64,941.69 $59,084.21 2026-03-01
0968T CPT Insertion Or Replacement Of Epicranial Neurostimulator System, Including Electro… 9 2 — — $7,977.00 $64,941.69 $59,084.21 2026-03-01
0969T CPT Removal Of Epicranial Neurostimulator System 9 2 — — $7,977.00 $64,941.69 $59,084.21 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 57 26 — — $205,283.34 $842,426.46 $230,420.08 2026-03-01
10 MS_DRG Pancreas Transplant 43 25 — — $56,268.77 $211,546.81 $60,287.97 2026-03-01
101680 CDM Graft Bn Tib Dist Rt 41 23 $183,560.00 $183,560.00 $24,780.60 $183,560.00 $68,467.88 2026-03-01
108814 CDM Dvc Revasc 3x20mm 200c 60 31 $194,176.00 $194,176.00 $13,592.32 $194,176.00 $61,058.64 2026-03-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 24 9 — — $62,065.07 $77,581.34 $65,168.32 2026-03-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 24 9 — — $109,221.10 $136,526.38 $114,682.16 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 43 25 — — $90,878.86 $354,299.71 $97,370.21 2026-03-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 33 10 — — $79,546.24 $139,206.00 $85,909.90 2026-03-01
1582 OTHER New Technology - Level 45 46 27 $144,850.03 — $62,512.28 $167,450.46 $67,108.01 2026-07-17
1583 OTHER New Technology - Level 46 46 27 $167,134.47 — $72,129.48 $193,211.87 $77,432.24 2026-07-17
1584 OTHER New Technology - Level 47 46 27 $189,418.92 — $81,746.68 $218,973.29 $87,756.47 2026-07-17
1585 OTHER New Technology - Level 48 46 27 $211,703.37 — $91,363.88 $244,734.72 $98,080.71 2026-07-17
1596 OTHER New Technology - Level 45 46 27 $144,850.03 — $62,512.28 $167,450.46 $67,108.01 2026-07-17
1597 OTHER New Technology - Level 46 46 27 $167,134.47 — $72,129.48 $193,211.87 $77,432.24 2026-07-17
1598 OTHER New Technology - Level 47 46 27 $189,418.92 — $81,746.68 $218,973.29 $87,756.47 2026-07-17
1599 OTHER New Technology - Level 48 46 27 $211,703.37 — $91,363.88 $244,734.72 $98,080.71 2026-07-17
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 29 10 — — $77,776.33 $97,220.41 $81,665.15 2026-03-01
1611 APR_DRG Implantable Heart Assist Systems 29 10 — — $59,543.92 $74,429.90 $62,521.12 2026-03-01
1612 APR_DRG Implantable Heart Assist Systems 29 10 — — $62,782.94 $78,478.68 $65,922.09 2026-03-01
1613 APR_DRG Implantable Heart Assist Systems 29 10 — — $87,338.69 $109,173.36 $91,705.62 2026-03-01
1614 APR_DRG Implantable Heart Assist Systems 29 10 — — $167,567.98 $209,459.98 $175,946.38 2026-03-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 29 10 — — $67,846.78 $84,808.48 $71,239.12 2026-03-01
162563 CDM Dvc Revasc 4x40mm 200cm 60 31 $194,176.00 $194,176.00 $13,592.32 $194,176.00 $61,058.64 2026-03-01
1643 OTHER Y90 Ibritumomab, Rx 46 27 $136,927.86 — $56,540.43 $148,880.32 $59,665.78 2026-07-17
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 37 20 — — $313,633.03 $1,273,072.13 $336,035.39 2026-03-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 45 27 — — $55,975.00 $210,335.14 $59,973.22 2026-03-01
1901 OTHER New Technology - Level 49 46 27 $239,558.93 — $103,385.40 $276,936.36 $110,985.94 2026-07-17
1902 OTHER New Technology - Level 49 46 27 $239,558.93 — $103,385.40 $276,936.36 $110,985.94 2026-07-17
1903 OTHER New Technology - Level 50 46 27 $272,985.60 — $117,811.20 $315,578.48 $126,472.29 2026-07-17
1904 OTHER New Technology - Level 50 46 27 $272,985.60 — $117,811.20 $315,578.48 $126,472.29 2026-07-17
1905 OTHER New Technology - Level 51 46 27 $306,412.27 — $132,237.00 $354,220.59 $141,958.64 2026-07-17
1906 OTHER New Technology - Level 51 46 27 $306,412.27 — $132,237.00 $354,220.59 $141,958.64 2026-07-17
1907 OTHER New Technology - Level 52 46 27 $339,838.95 — $146,662.80 $392,862.71 $157,444.98 2026-07-17
1908 OTHER New Technology - Level 52 46 27 $339,838.95 — $146,662.80 $392,862.71 $157,444.98 2026-07-17
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 45 25 — — $85,974.89 $554,970.00 $92,115.95 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 73 32 — — $61,097.82 $236,544.00 $69,344.15 2026-03-01
2004 APR_DRG Cardiac Structural And Valvular Disorders 24 9 — — $101,496.49 $126,870.61 $106,571.31 2026-03-01
204698 CDM Disc Intvrtb 19x7x15mm 41 23 $170,618.00 $170,618.00 $23,033.43 $170,618.00 $63,640.51 2026-03-01
2067 OTHER Afamitresgene Autoleucel 46 27 — — $766,766.90 $2,019,024.40 $809,151.00 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 58 31 — — $75,983.00 $333,689.54 $92,016.40 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 71 32 — — $9,825.00 $326,886.32 $88,610.83 2026-03-01
215 MS_DRG Other Heart Assist System Implant 79 33 — — $55,453.00 $567,817.00 $84,695.65 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 79 33 — — $55,453.00 $335,921.79 $84,839.42 2026-03-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 $273,523.33 — $58,361.39 $60,166.38 $59,263.88 2026-07-17
218345 CDM Device Solitare 6x40x10 60 31 $194,176.00 $194,176.00 $13,592.32 $194,176.00 $61,058.64 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 79 33 — — $55,453.00 $276,270.00 $67,801.92 2026-03-01
221496 CDM Kit Imp Bone Cducting 41 23 $173,246.00 $173,246.00 $23,388.21 $173,246.00 $64,620.76 2026-03-01
228741 CDM Valve Aor 16mm 25mm 41 23 $280,736.00 $280,736.00 $37,899.36 $280,736.00 $104,714.53 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 79 33 — — $55,453.00 $289,465.91 $73,886.68 2026-03-01
231691 CDM Kit Bld Pump Cann 29fr 60 31 $362,895.00 $362,895.00 $25,402.65 $362,895.00 $114,112.33 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 78 32 — — $55,453.00 $262,520.88 $67,533.94 2026-03-01
234701 CDM Graft Pstr 6x9x20mm 41 23 $313,380.00 $313,380.00 $42,306.30 $313,380.00 $116,890.74 2026-03-01
237711 CDM Graft Hemi Cndyl L/l Fem 41 23 $282,420.00 $282,420.00 $38,126.70 $282,420.00 $105,342.66 2026-03-01
24 APR_DRG Heart And/or Lung Transplant 33 10 — — $222,061.34 $388,607.00 $239,826.00 2026-03-01
240094 CDM Spacer Tissue Shldr Med 41 23 $194,752.00 $194,752.00 $26,291.52 $194,752.00 $72,642.50 2026-03-01
240852 CDM Kit Bngf Infs 18x26 8ml 41 23 $161,957.00 $161,957.00 $21,864.19 $161,957.00 $60,409.96 2026-03-01
244768 CDM Cage Spnl 22x14x12mm San 41 23 $167,518.00 $167,518.00 $22,614.93 $167,518.00 $62,484.21 2026-03-01
2464 APR_DRG Gastrointestinal Vascular Insufficiency 24 9 — — $75,421.37 $94,276.71 $79,192.44 2026-03-01
251949 CDM Graft Bn Lrg 12.5cc 10cm 41 23 $250,255.00 $250,255.00 $33,784.43 $250,255.00 $93,345.12 2026-03-01
259911 CDM Cage Spn 12x14mm 32-46mm 41 23 $263,161.00 $263,161.00 $35,526.74 $263,161.00 $98,159.05 2026-03-01
265596 CDM Kit Lo Prfl Comp Shth 7f 60 31 $465,210.00 $465,210.00 $32,564.70 $465,210.00 $146,285.28 2026-03-01
265719 CDM Putty Bngf Subst 6cc 41 23 $169,343.00 $169,343.00 $22,861.31 $169,343.00 $63,164.94 2026-03-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 74 33 — — $54,029.73 $294,489.00 $61,322.08 2026-03-01
271184 CDM Graft Bn Sub 12.5cc 41 23 $303,372.00 $303,372.00 $40,955.22 $303,372.00 $113,157.76 2026-03-01
274505 CDM Kit Spn Scrl Jnt Fusion 41 23 $317,304.00 $317,304.00 $42,836.04 $317,304.00 $118,354.39 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 71 32 — — $55,453.00 $329,192.00 $62,795.39 2026-03-01
280349 CDM Kit Transvrs Bn Trnsprt 60 31 $303,372.00 $303,372.00 $21,236.04 $303,372.00 $95,395.32 2026-03-01
280934 CDM Spacer Tissue Shldr Lg 41 23 $203,072.00 $203,072.00 $27,414.72 $203,072.00 $75,745.86 2026-03-01
281183 CDM Graft Ostchd Tlus Ankl R 41 23 $176,133.00 $176,133.00 $23,777.96 $176,133.00 $65,697.61 2026-03-01
281184 CDM Graft Bn Tib Dist Rt Frs 41 23 $176,133.00 $176,133.00 $23,777.96 $176,133.00 $65,697.61 2026-03-01
298108 CDM Cage Spnl Cg/infs Ti 26 41 23 $184,131.00 $184,131.00 $24,857.69 $184,131.00 $68,680.86 2026-03-01
299900 CDM Icd Card Thk1400 41 23 $214,704.00 $214,704.00 $28,985.04 $214,704.00 $80,084.59 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 72 31 — — $155,845.91 $638,050.74 $176,674.80 2026-03-01
321377 CDM Vlv Aor 21 Hi Prfl 41 23 $177,724.00 $177,724.00 $23,992.74 $177,724.00 $66,291.05 2026-03-01
335611 CDM Spacer Boomerang Peek 11 41 23 $219,722.00 $219,722.00 $29,662.47 $219,722.00 $81,956.31 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 72 31 — — $103,771.77 $416,386.94 $117,247.24 2026-03-01
422094 CDM Graft Algrf 20mm Disc 41 23 $205,785.00 $205,785.00 $27,780.97 $205,785.00 $76,757.80 2026-03-01
422126 CDM Graft Bn Hemi Condrl Rt 41 23 $282,420.00 $282,420.00 $38,126.70 $282,420.00 $105,342.66 2026-03-01
422236 CDM Gnrtr Nrstm 7 Ipg 1.35cm 41 23 $317,304.00 $317,304.00 $42,836.04 $317,304.00 $118,354.39 2026-03-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 2 $110,395.96 — $62,885.13 $64,830.03 $63,857.58 2026-07-17
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 66 32 — — $60,607.00 $471,244.47 $93,155.91 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 66 32 — — $56,459.94 $308,652.90 $62,925.70 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 66 32 — — $60,607.00 $385,232.48 $77,163.93 2026-03-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 24 9 — — $59,105.30 $73,881.63 $62,060.57 2026-03-01
435299 CDM Cage Spnl 15d 8x38x28mm 41 23 $182,805.00 $182,805.00 $24,678.67 $182,805.00 $68,186.26 2026-03-01
435427 CDM Algrft Bn 25x20mm 41 23 $282,420.00 $282,420.00 $38,126.70 $282,420.00 $105,342.66 2026-03-01
435784 CDM Disc Intvrtb 17x7x13mm 41 23 $170,618.00 $170,618.00 $23,033.43 $170,618.00 $63,640.51 2026-03-01
437822 CDM Valve Aor Tavr 23mm 41 23 $497,070.00 $497,070.00 $67,104.45 $497,070.00 $185,407.11 2026-03-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 24 9 — — $91,928.74 $114,910.93 $96,525.18 2026-03-01
4404 APR_DRG Kidney Transplant 33 10 — — $59,396.76 $103,944.00 $64,148.50 2026-03-01
445128 CDM Cage Spn 38x28x6mm 15d 41 23 $182,805.00 $182,805.00 $24,678.67 $182,805.00 $68,186.26 2026-03-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $70,501.11 $70,501.11 $70,501.11 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 73 32 — — $60,607.00 $359,312.58 $73,008.43 2026-03-01
461551 CDM Disc Spnl Std 5x17x17mm 41 23 $170,618.00 $170,618.00 $23,033.43 $170,618.00 $63,640.51 2026-03-01
467828 CDM Disc Intvrtb 15x7x15mm 41 23 $170,618.00 $170,618.00 $23,033.43 $170,618.00 $63,640.51 2026-03-01
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 2 2 $115,028.66 — $60,737.73 $62,616.22 $61,676.98 2026-07-17
481326 CDM Graft Hemi Cndyl Mdl Lt 41 23 $282,420.00 $282,420.00 $38,126.70 $282,420.00 $105,342.66 2026-03-01
483446 CDM Cage Spn Xpd 16x18-25mm 41 23 $180,107.00 $180,107.00 $24,314.44 $180,107.00 $67,179.91 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 43 25 — — $78,675.06 $303,963.85 $84,294.70 2026-03-01
5244 OTHER Level 4 Blood Product Exc 46 27 $91,426.36 — $56,878.36 $165,551.90 $66,347.14 2026-07-17
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 24 9 — — $59,125.40 $73,906.75 $62,081.67 2026-03-01
546957 CDM Spacer 12mm Add On Lordo 41 23 $168,912.00 $168,912.00 $22,803.12 $168,912.00 $63,004.18 2026-03-01
546977 CDM Spacer Peek Sm 16 Vrtbrl 41 23 $168,912.00 $168,912.00 $22,803.12 $168,912.00 $63,004.18 2026-03-01
563181 CDM Cnla Vntrc Art 42f 41 23 $171,994.00 $171,994.00 $23,219.19 $171,994.00 $64,153.76 2026-03-01
5831 APR_DRG Neonate With Ecmo 24 9 — — $101,279.33 $126,599.16 $106,343.30 2026-03-01
5832 APR_DRG Neonate With Ecmo 24 9 — — $115,022.19 $143,777.74 $120,773.30 2026-03-01
5833 APR_DRG Neonate With Ecmo 24 9 — — $230,839.79 $288,549.74 $242,381.78 2026-03-01
5834 APR_DRG Neonate With Ecmo 24 9 — — $272,614.32 $340,767.90 $286,245.04 2026-03-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 24 9 — — $86,877.10 $108,596.38 $91,220.96 2026-03-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 24 9 — — $92,167.07 $115,208.84 $96,775.42 2026-03-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 24 9 — — $92,590.26 $115,737.82 $97,219.77 2026-03-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 24 9 — — $172,560.39 $215,700.49 $181,188.41 2026-03-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 24 9 — — $72,810.84 $91,013.55 $76,451.38 2026-03-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 24 9 — — $70,568.58 $88,210.73 $74,097.01 2026-03-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 24 9 — — $66,191.74 $82,739.68 $69,501.33 2026-03-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 24 9 — — $57,580.19 $71,975.24 $60,459.20 2026-03-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 24 9 — — $87,441.71 $109,302.14 $91,813.80 2026-03-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 24 9 — — $72,592.97 $90,741.21 $76,222.62 2026-03-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 24 9 — — $66,733.37 $83,416.71 $70,070.04 2026-03-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 24 9 — — $75,032.28 $93,790.35 $78,783.89 2026-03-01
604803 CDM Valve Aortic 19mm 41 23 $305,278.00 $305,278.00 $41,212.53 $305,278.00 $113,868.69 2026-03-01
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 24 9 — — $57,416.88 $71,771.10 $60,287.72 2026-03-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 24 9 — — $127,258.61 $159,073.26 $133,621.54 2026-03-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 24 9 — — $63,370.87 $79,213.59 $66,539.41 2026-03-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 24 9 — — $60,515.55 $75,644.44 $63,541.33 2026-03-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 24 9 — — $128,396.43 $160,495.54 $134,816.25 2026-03-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 24 9 — — $90,619.35 $113,274.19 $95,150.32 2026-03-01
64 APR_DRG Pancreas Transplant 33 10 — — $72,816.58 $127,429.00 $78,641.90 2026-03-01
640502 CDM Spacer 4d Peek 25x7mm 41 23 $172,751.00 $172,751.00 $23,321.38 $172,751.00 $64,436.12 2026-03-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 2 2 $99,566.66 — $92,640.73 $95,505.91 $94,073.32 2026-07-17
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 24 9 — — $57,580.19 $71,975.24 $60,459.20 2026-03-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 24 9 — — $77,819.76 $97,274.70 $81,710.75 2026-03-01
7 MS_DRG Lung Transplant 43 25 — — $97,542.57 $381,784.85 $104,509.89 2026-03-01
706935 CDM Spacer 26/32 13.5x8 Deg 41 23 $290,747.00 $290,747.00 $39,250.85 $290,747.00 $108,448.63 2026-03-01
706936 CDM Spacer Cage Peek 12d 32x 41 23 $191,510.00 $191,510.00 $25,853.85 $191,510.00 $71,433.23 2026-03-01
713649 CDM Valve Aortic 19mm 41 23 $271,454.00 $271,454.00 $36,646.29 $271,454.00 $101,252.34 2026-03-01
714 OTHER Inj Delandistrogene Mox R 42 24 $26,903.38 — $6,223.86 $4,991,790.00 $3,460,974.40 2026-07-17
717 OTHER Instill Adstiladrin, Tx D 48 28 $49,704.71 — $11,747.40 $168,399.95 $67,488.53 2026-07-17
717729 CDM Valve Aortic Tiss 21mm 41 23 $271,454.00 $271,454.00 $36,646.29 $271,454.00 $101,252.34 2026-03-01
717736 CDM Valve Aor Primnt 23mm 41 23 $271,454.00 $271,454.00 $36,646.29 $271,454.00 $101,252.34 2026-03-01
717793 CDM Valve Aor Primnt 25mm 41 23 $271,454.00 $271,454.00 $36,646.29 $271,454.00 $101,252.34 2026-03-01
718034 CDM Valve Aor Primnt 27mm 41 23 $271,454.00 $271,454.00 $36,646.29 $271,454.00 $101,252.34 2026-03-01
718835 CDM Valve Aor Primnt 19mm 41 23 $271,454.00 $271,454.00 $36,646.29 $271,454.00 $101,252.34 2026-03-01
719282 CDM Cage Peek 30x25x16 6deg 41 23 $226,330.00 $226,330.00 $30,554.55 $226,330.00 $84,421.09 2026-03-01
72 APR_DRG Allogeneic Bone Marrow Transplant 33 10 — — $62,874.47 $110,030.00 $67,904.40 2026-03-01
720078 CDM Cage Spnl 35x16x6mm Crnt 41 23 $174,100.00 $174,100.00 $23,503.50 $174,100.00 $64,939.30 2026-03-01
725763 CDM Ring Orth Frm Ex Fx160d 60 31 $228,734.00 $228,734.00 $16,011.38 $228,734.00 $71,925.41 2026-03-01
73 APR_DRG Allogeneic Bone Marrow Transplant 33 10 — — $93,578.76 $163,763.00 $101,065.00 2026-03-01
730191 CDM Device Ast Vent 00551042 41 23 $268,740.00 $268,740.00 $36,279.90 $268,740.00 $100,240.02 2026-03-01
74 APR_DRG Allogeneic Bone Marrow Transplant 33 10 — — $265,199.46 $464,099.00 $286,415.00 2026-03-01
746 OTHER Inj, Betibeglogene Autote 42 24 $43,895.58 — $10,958.64 $4,409,953.50 $3,057,567.76 2026-07-17
747118 CDM Graft Bn Fem Hemi Cndyl 41 23 $317,304.00 $317,304.00 $42,836.04 $317,304.00 $118,354.39 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 42 24 $39,790.72 — $11,847.05 $4,878,762.00 $3,382,608.32 2026-07-17
824 OTHER Inj, Exagamglogene Autote 42 26 $64,304.75 — $12,832.29 $4,617,360.00 $2,425,280.00 2026-07-17
831 OTHER Obecbtge Autol Up To 400 45 27 $33,546.40 — $3,623.59 $729,015.00 $292,162.50 2026-07-17
84 APR_DRG Autologous Bone Marrow Transplant 33 10 — — $79,227.50 $138,648.00 $85,565.70 2026-03-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 24 9 — — $91,533.55 $114,416.94 $96,110.23 2026-03-01
845 OTHER Inj, Atidarsagene Autotem 32 20 $23,739.10 — $5,291.79 $4,955,500.00 $4,535,408.75 2026-07-17
849446 CDM Spacer Mid 8 Dg 36x13 41 23 $282,042.00 $282,042.00 $38,075.67 $282,042.00 $105,201.67 2026-03-01
849576 CDM Spacer Mid 8 Dg 36x15 41 23 $282,042.00 $282,042.00 $38,075.67 $282,042.00 $105,201.67 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 66 32 — — $9,825.00 $262,963.04 $73,015.90 2026-03-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 24 9 — — $88,232.08 $110,290.10 $92,643.68 2026-03-01
850516 CDM Device Vntrc Asst 2 Lvas 41 23 $417,300.00 $417,300.00 $56,335.50 $417,300.00 $155,652.90 2026-03-01
851381 CDM Cage Spacer 13deg 16mm 41 23 $260,454.00 $260,454.00 $35,161.29 $260,454.00 $97,149.34 2026-03-01
853112 CDM Spacer 30/38 15x12 Deg 41 23 $191,510.00 $191,510.00 $25,853.85 $191,510.00 $71,433.23 2026-03-01
853113 CDM Spacer 30/38 13.5x12 41 23 $191,510.00 $191,510.00 $25,853.85 $191,510.00 $71,433.23 2026-03-01
856703 CDM Gft Bif 36-20x166mm 20fr 41 23 $451,668.00 $451,668.00 $60,975.18 $451,668.00 $168,472.16 2026-03-01
858166 CDM Cage 39 X 13 Mm 12 Deg 41 23 $198,474.00 $198,474.00 $26,793.99 $198,474.00 $74,030.80 2026-03-01
862710 CDM Set Vntrc 17.4x13.8in 60 31 $465,210.00 $465,210.00 $32,564.70 $465,210.00 $146,285.28 2026-03-01
8634 APR_DRG Neonatal Aftercare 24 9 — — $61,102.41 $76,378.01 $64,157.53 2026-03-01
864406 CDM Disc Intvrtb 15x5x13mm 41 23 $170,618.00 $170,618.00 $23,033.43 $170,618.00 $63,640.51 2026-03-01
865173 CDM Disc Intvrtb 17mm 5mm 41 23 $170,618.00 $170,618.00 $23,033.43 $170,618.00 $63,640.51 2026-03-01
865420 CDM Disc Spnl 13x17x5mm 41 23 $170,618.00 $170,618.00 $23,033.43 $170,618.00 $63,640.51 2026-03-01
867299 CDM Disc Intvrtb 19x5x15mm 41 23 $170,618.00 $170,618.00 $23,033.43 $170,618.00 $63,640.51 2026-03-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 73 32 — — $5,441.00 $207,775.62 $60,486.68 2026-03-01
872070 CDM Disc Intvrtb 15x15mm 41 23 $170,618.00 $170,618.00 $23,033.43 $170,618.00 $63,640.51 2026-03-01
879387 CDM Graft Nrv 1-2mm 70mm 41 23 $215,161.00 $215,161.00 $29,046.74 $215,161.00 $80,255.05 2026-03-01
880453 CDM Disc Intvrtb 15x6x13mm 41 23 $170,618.00 $170,618.00 $23,033.43 $170,618.00 $63,640.51 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 45 27 $38,325.11 — $7,929.01 $528,372.78 $211,752.45 2026-07-17
897 OTHER Revakinagene, Per Implant 41 25 $23,901.95 — $263,675.00 $694,300.00 $278,250.00 2026-07-17
90288 CPT Botulism Immune Globulin, Human, For Intravenous Use 6 1 — — $294,713.96 $416,525.16 $329,245.80 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 43 26 $968,406.12 — $529,531.24 $1,394,343.56 $558,801.81 2026-07-17
906 OTHER Inj Elivaldogene Autoteme 37 22 $50,196.06 — $8,466.42 $4,770,000.00 $3,275,400.00 2026-07-17
908 OTHER Topi Adm Prad Zami Per Tr 32 21 $57,740.35 — $9,581.54 $4,336,566.00 $3,385,857.30 2026-07-17
9138 OTHER Inj, Hemgenix, Per Tx Dos 32 21 — — $3,666,840.67 $4,790,847.10 $3,740,546.00 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 39 24 — — $2,455,110.00 $4,919,063.90 $2,718,430.05 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 43 26 $1,039,331.61 — $563,698.64 $1,484,312.01 $594,857.87 2026-07-17
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 61 27 — — $9,825.00 $641,817.38 $168,840.52 2026-03-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 61 27 — — $9,825.00 $215,618.53 $60,264.99 2026-03-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 24 9 — — $77,126.30 $96,407.88 $80,982.62 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 43 26 $968,532.60 — $487,002.95 $1,282,359.52 $513,922.71 2026-07-17
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 24 9 — — $156,984.81 $196,231.01 $164,834.05 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 43 26 $995,962.22 — $559,390.19 $1,472,967.14 $590,311.26 2026-07-17
9422 OTHER Idecabtagene Vicleucel Ca 43 26 $1,018,294.30 — $555,291.39 $1,462,174.32 $585,985.89 2026-07-17
9498 OTHER Ciltacabtagene Car-pos T 43 26 $1,096,795.50 — $565,868.90 $1,539,641.95 $617,032.08 2026-07-17
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 67 32 — — $57,068.26 $229,061.81 $66,115.99 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 17 4 $385,945.21 — $93,760.51 $582,739.61 $289,037.14 2026-07-17
A9604 HCPCS Samarium Sm-153 Lexidronam, Therapeutic, Per Treatment Dose, Up To 150 Millicuri… 17 4 $102,822.55 — $5,213.67 $142,036.23 $80,330.88 2026-07-17
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 3 1 $78,168.72 — $77,046.96 $77,046.96 $77,046.96 2026-07-17
C1767 HCPCS Generator Ipg Medtr 360 21 $277,637.50 $277,637.50 $348.57 $379,080.00 $82,371.08 2026-03-01
C1772 HCPCS Pump Inf Isomd Cnst Flow 144 21 $199,644.00 $199,644.00 $6,594.35 $317,304.00 $65,999.77 2026-03-01
C1820 HCPCS Generator Ipg Nrstm 180 21 $109,489.00 $109,489.00 $2,478.33 $348,192.00 $60,218.95 2026-03-01
C1822 HCPCS Pulse Gen Imp 72 21 $332,748.00 $332,748.00 $42,836.04 $348,192.00 $148,692.02 2026-03-01
C1882 HCPCS Crtd Atls2 Hf V365 972 21 $145,900.00 $145,900.00 $135.00 $331,028.00 $68,612.12 2026-03-01
C2616 HCPCS Brachytherapy Source, Non-stranded, Yttrium-90, Per Source 10 2 $83,065.03 — $17,424.00 $88,363.42 $59,820.49 2026-07-17
C2624 HCPCS Crd Mems Pa Snsr Delsys 36 21 $452,844.00 $452,844.00 $61,133.94 $452,844.00 $202,421.27 2026-03-01
C9301 HCPCS Obecabtagene Autoleucel, Up To 400 Million Cd19 Car-positive Viable T Cells, Inc… 6 1 — — $959,962.50 $1,544,287.50 $1,405,162.50 2026-03-01
E0767 HCPCS Intrabuccal, Systemic Delivery Of Amplitude-modulated, Radiofrequency Electromag… 6 1 — — $80,266.41 $113,137.42 $103,199.67 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
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 $4,463,735.93 — $4,271,819.03 $4,271,819.03 $4,271,819.03 2026-07-17
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 3 1 — — $332,753.88 $332,753.88 $332,753.88 2026-03-01
J7310 HCPCS Ganciclovir, 4.5 Mg, Long-acting Implant 14 3 $115,548.48 — $54,979.20 $145,041.92 $95,534.88 2026-07-17
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 17 4 $227,599.37 — $131,717.55 $574,167.94 $202,348.70 2026-07-17
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 18 5 — — $61,338.53 $888,000.00 $405,600.00 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 19 5 $216,892.20 — $43,855.64 $389,632.46 $192,564.86 2026-07-17
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 19 5 $102,390.60 — $26,258.38 $243,082.56 $91,811.04 2026-07-17
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 17 4 $143,344.23 — $39,976.89 $203,447.46 $114,857.36 2026-07-17
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 55 28 $107,800.00 — $80,850.00 $249,112.22 $99,835.05 2026-07-17
L5969 HCPCS $93,897.86 1 1 $93,897.86 — $98,593.44 $98,593.44 $98,593.44 2026-07-17
L8687 HCPCS $14,043.32 1 1 $59,060.67 — $62,014.14 $62,014.14 $62,014.14 2026-07-17
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 48 28 — — $66,737.65 $180,260.45 $72,241.79 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 49 28 $599,885.67 — $108,147.24 $629,884.36 $117,066.60 2026-07-17
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 13 4 $1,973,729.50 — $6.22 $1,966,642.50 $1,222,507.50 2026-07-17
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 13 4 $2,139,938.30 — $23.68 $2,132,254.50 $1,325,455.50 2026-07-17
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 19 5 $339,147.22 — $55,306.59 $478,449.94 $310,609.58 2026-07-17
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 12 4 $2,069,299.56 — $474,717.03 $2,061,869.40 $1,281,702.60 2026-07-17
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 12 4 $2,276,229.52 — $500,948.74 $2,268,056.34 $1,409,872.86 2026-07-17
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 12 4 $2,327,268.54 — $511,793.34 $2,318,912.10 $1,441,485.90 2026-07-17
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 12 4 $2,579,689.80 — $536,573.93 $2,570,427.00 $1,597,833.00 2026-07-17
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 9 2 — — $1,271,523.00 $4,067,128.80 $2,528,215.20 2026-03-01
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 9 2 — — $459,112.50 $2,937,060.00 $1,825,740.00 2026-03-01
See an error in this hospital's data? Submit a correction