|
845
|
OTHER
|
Inj, Atidarsagene Autotem
|
18
|
13
|
—
|
—
|
$4,505,000.00
|
$4,955,500.00
|
$4,527,525.00
|
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
|
|
9138
|
OTHER
|
Inj, Hemgenix, Per Tx Dos
|
18
|
13
|
—
|
—
|
$3,685,267.00
|
$4,790,847.10
|
$3,703,693.33
|
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
|
|
714
|
OTHER
|
Inj Delandistrogene Mox R
|
22
|
15
|
—
|
—
|
$3,327,860.00
|
$4,326,218.00
|
$3,427,695.80
|
2026-03-01
|
|
908
|
OTHER
|
Topi Adm Prad Zami Per Tr
|
19
|
14
|
—
|
—
|
$3,335,820.00
|
$4,336,566.00
|
$3,369,178.20
|
2026-03-01
|
|
748
|
OTHER
|
Inj, Lovotibeglogene Auto
|
22
|
15
|
—
|
—
|
$3,252,508.00
|
$4,228,260.40
|
$3,350,083.24
|
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
|
|
00714
|
OTHER
|
Inj Delandistrogene Mox R
|
1
|
1
|
—
|
—
|
$3,327,860.00
|
$3,327,860.00
|
$3,327,860.00
|
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
|
|
906
|
OTHER
|
Inj Elivaldogene Autoteme
|
19
|
14
|
—
|
—
|
$3,180,000.00
|
$4,134,000.00
|
$3,211,800.00
|
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
|
|
746
|
OTHER
|
Inj, Betibeglogene Autote
|
22
|
15
|
—
|
—
|
$2,939,969.00
|
$3,821,959.70
|
$3,028,168.07
|
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
|
|
9141
|
OTHER
|
Inj Onase Abepar-xioi Tre
|
19
|
14
|
—
|
—
|
$2,588,981.00
|
$4,634,275.99
|
$2,614,870.81
|
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
|
|
824
|
OTHER
|
Inj, Exagamglogene Autote
|
20
|
15
|
—
|
—
|
$2,332,000.00
|
$4,174,280.00
|
$2,378,640.00
|
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
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
21
|
17
|
—
|
—
|
$551,617.09
|
$1,273,072.13
|
$912,344.61
|
2026-03-01
|
|
2067
|
OTHER
|
Afamitresgene Autoleucel
|
26
|
17
|
—
|
—
|
$770,620.00
|
$2,019,024.40
|
$809,151.00
|
2026-03-01
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
23
|
19
|
—
|
—
|
$629,434.09
|
$629,434.09
|
$629,434.09
|
2026-03-01
|
|
9498
|
OTHER
|
Ciltacabtagene Car-pos T
|
22
|
15
|
—
|
—
|
$587,649.60
|
$1,539,641.95
|
$605,279.09
|
2026-03-01
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
22
|
18
|
—
|
—
|
$357,977.30
|
$826,172.60
|
$592,074.95
|
2026-03-01
|
|
09498
|
OTHER
|
Ciltacabtagene Car-pos T
|
1
|
1
|
—
|
—
|
$587,649.60
|
$587,649.60
|
$587,649.60
|
2026-03-01
|
|
9194
|
OTHER
|
Tisagenlecleucel Car-pos
|
22
|
15
|
—
|
—
|
$566,531.30
|
$1,484,312.01
|
$583,527.24
|
2026-03-01
|
|
9413
|
OTHER
|
Lisocabtagene Car Pos T
|
22
|
15
|
—
|
—
|
$562,201.20
|
$1,472,967.14
|
$579,067.24
|
2026-03-01
|
|
9422
|
OTHER
|
Idecabtagene Vicleucel Ca
|
22
|
15
|
—
|
—
|
$558,081.80
|
$1,462,174.32
|
$574,824.25
|
2026-03-01
|
|
09194
|
OTHER
|
Tisagenlecleucel Car-pos
|
1
|
1
|
—
|
—
|
$566,531.30
|
$566,531.30
|
$566,531.30
|
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
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige…
|
1
|
1
|
—
|
—
|
$553,169.00
|
$553,169.00
|
$553,169.00
|
2026-03-01
|
|
9035
|
OTHER
|
Axicabtagene Ciloleucel C
|
23
|
16
|
—
|
—
|
$532,192.20
|
$1,394,343.56
|
$548,157.97
|
2026-03-01
|
|
09035
|
OTHER
|
Axicabtagene Ciloleucel C
|
1
|
1
|
—
|
—
|
$532,192.20
|
$532,192.20
|
$532,192.20
|
2026-03-01
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (…
|
1
|
1
|
—
|
—
|
$527,622.00
|
$527,622.00
|
$527,622.00
|
2026-03-01
|
|
Q2054
|
HCPCS
|
Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi…
|
1
|
1
|
—
|
—
|
$516,442.00
|
$516,442.00
|
$516,442.00
|
2026-03-01
|
|
9391
|
OTHER
|
Brexucabtagene Car Pos T
|
22
|
15
|
—
|
—
|
$489,450.20
|
$1,282,359.52
|
$504,133.71
|
2026-03-01
|
|
09391
|
OTHER
|
Brexucabtagene Car Pos T
|
1
|
1
|
—
|
—
|
$489,450.20
|
$489,450.20
|
$489,450.20
|
2026-03-01
|
|
Q2053
|
HCPCS
|
Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V…
|
1
|
1
|
—
|
—
|
$489,399.00
|
$489,399.00
|
$489,399.00
|
2026-03-01
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
23
|
19
|
—
|
—
|
$271,130.70
|
$625,740.12
|
$448,435.41
|
2026-03-01
|
|
A9543
|
HCPCS
|
Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil…
|
1
|
1
|
—
|
—
|
$405,245.30
|
$405,245.30
|
$405,245.30
|
2026-03-01
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
23
|
19
|
—
|
—
|
$176,937.78
|
$408,353.12
|
$292,645.45
|
2026-03-01
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka…
|
2
|
2
|
—
|
—
|
$23.68
|
$578,771.00
|
$289,397.34
|
2026-03-01
|
|
831
|
OTHER
|
Obecbtge Autol Up To 400
|
23
|
16
|
—
|
—
|
$278,250.00
|
$729,015.00
|
$286,597.50
|
2026-03-01
|
|
00831
|
OTHER
|
Obecbtge Autol Up To 400
|
1
|
1
|
—
|
—
|
$278,250.00
|
$278,250.00
|
$278,250.00
|
2026-03-01
|
|
7
|
MS_DRG
|
Lung Transplant
|
23
|
19
|
—
|
—
|
$165,425.85
|
$381,784.85
|
$273,605.35
|
2026-03-01
|
|
897
|
OTHER
|
Revakinagene, Per Implant
|
23
|
16
|
—
|
—
|
$265,000.00
|
$694,300.00
|
$272,950.00
|
2026-03-01
|
|
00897
|
OTHER
|
Revakinagene, Per Implant
|
1
|
1
|
—
|
—
|
$265,000.00
|
$265,000.00
|
$265,000.00
|
2026-03-01
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
22
|
18
|
—
|
—
|
$153,516.65
|
$354,299.71
|
$253,908.18
|
2026-03-01
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via…
|
2
|
2
|
—
|
—
|
$6.22
|
$502,841.00
|
$251,423.61
|
2026-03-01
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
22
|
18
|
—
|
—
|
$144,752.41
|
$334,072.80
|
$239,412.61
|
2026-03-01
|
|
209
|
MS_DRG
|
Complex Aortic Arch Procedures
|
23
|
19
|
—
|
—
|
$144,586.35
|
$333,689.54
|
$239,137.95
|
2026-03-01
|
|
J7330
|
HCPCS
|
Autologous Cultured Chondrocytes, Implant
|
1
|
1
|
—
|
—
|
$238,981.01
|
$238,981.01
|
$238,981.01
|
2026-03-01
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
23
|
19
|
—
|
—
|
$140,784.81
|
$324,916.00
|
$232,850.40
|
2026-03-01
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
23
|
19
|
—
|
—
|
$138,905.75
|
$320,579.34
|
$229,742.55
|
2026-03-01
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
22
|
18
|
—
|
—
|
$131,706.33
|
$303,963.85
|
$217,835.09
|
2026-03-01
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
23
|
19
|
—
|
—
|
$211,458.37
|
$211,458.37
|
$211,458.37
|
2026-03-01
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
23
|
19
|
—
|
—
|
$127,190.72
|
$293,542.32
|
$210,366.52
|
2026-03-01
|
|
886
|
OTHER
|
Inj. Remestemcel-l-rknd/
|
23
|
16
|
—
|
—
|
$201,669.00
|
$528,372.78
|
$207,719.07
|
2026-03-01
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
23
|
19
|
—
|
—
|
$124,965.49
|
$288,406.73
|
$206,686.11
|
2026-03-01
|
|
00886
|
OTHER
|
Inj. Remestemcel-l-rknd/
|
1
|
1
|
—
|
—
|
$201,669.00
|
$201,669.00
|
$201,669.00
|
2026-03-01
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
23
|
19
|
—
|
—
|
$115,088.63
|
$265,612.02
|
$190,350.33
|
2026-03-01
|
|
Q2043
|
HCPCS
|
Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm…
|
2
|
2
|
—
|
—
|
$57,017.10
|
$310,609.58
|
$183,813.34
|
2026-03-01
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
23
|
19
|
—
|
—
|
$110,616.45
|
$255,290.72
|
$182,953.58
|
2026-03-01
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
23
|
19
|
—
|
—
|
$107,683.54
|
$248,521.88
|
$178,102.71
|
2026-03-01
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
23
|
19
|
—
|
—
|
$107,345.03
|
$247,740.64
|
$177,542.83
|
2026-03-01
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
23
|
19
|
—
|
—
|
$100,516.05
|
$231,980.09
|
$166,248.07
|
2026-03-01
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
23
|
19
|
—
|
—
|
$98,082.60
|
$226,363.96
|
$162,223.28
|
2026-03-01
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
23
|
19
|
—
|
—
|
$97,659.78
|
$225,388.14
|
$161,523.96
|
2026-03-01
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
23
|
19
|
—
|
—
|
$97,336.60
|
$224,642.27
|
$160,989.43
|
2026-03-01
|
|
1907
|
OTHER
|
New Technology - Level 52
|
26
|
17
|
—
|
—
|
$149,947.60
|
$392,862.71
|
$157,444.98
|
2026-03-01
|
|
1908
|
OTHER
|
New Technology - Level 52
|
26
|
17
|
—
|
—
|
$149,947.60
|
$392,862.71
|
$157,444.98
|
2026-03-01
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
23
|
19
|
—
|
—
|
$92,210.40
|
$212,811.55
|
$152,510.98
|
2026-03-01
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
22
|
18
|
—
|
—
|
$91,662.39
|
$211,546.81
|
$151,604.60
|
2026-03-01
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
22
|
18
|
—
|
—
|
$91,137.38
|
$210,335.14
|
$150,736.26
|
2026-03-01
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
23
|
19
|
—
|
—
|
$91,083.73
|
$210,211.32
|
$150,647.52
|
2026-03-01
|
|
J9600
|
HCPCS
|
Injection, Porfimer Sodium, 75 Mg
|
1
|
1
|
—
|
—
|
$150,512.49
|
$150,512.49
|
$150,512.49
|
2026-03-01
|
|
01907
|
OTHER
|
New Technology - Level 52
|
1
|
1
|
—
|
—
|
$146,662.80
|
$146,662.80
|
$146,662.80
|
2026-03-01
|
|
01908
|
OTHER
|
New Technology - Level 52
|
1
|
1
|
—
|
—
|
$146,662.80
|
$146,662.80
|
$146,662.80
|
2026-03-01
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
23
|
19
|
—
|
—
|
$88,291.33
|
$203,766.78
|
$146,029.05
|
2026-03-01
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
23
|
19
|
—
|
—
|
$87,858.29
|
$202,767.37
|
$145,312.83
|
2026-03-01
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
23
|
19
|
—
|
—
|
$85,983.07
|
$198,439.56
|
$142,211.32
|
2026-03-01
|
|
1905
|
OTHER
|
New Technology - Level 51
|
26
|
17
|
—
|
—
|
$135,198.70
|
$354,220.59
|
$141,958.64
|
2026-03-01
|
|
1906
|
OTHER
|
New Technology - Level 51
|
26
|
17
|
—
|
—
|
$135,198.70
|
$354,220.59
|
$141,958.64
|
2026-03-01
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
23
|
19
|
—
|
—
|
$85,413.35
|
$197,124.71
|
$141,269.03
|
2026-03-01
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
23
|
19
|
—
|
—
|
$85,350.76
|
$196,980.25
|
$141,165.51
|
2026-03-01
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
23
|
19
|
—
|
—
|
$83,992.88
|
$193,846.42
|
$138,919.65
|
2026-03-01
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
23
|
19
|
—
|
—
|
$83,992.88
|
$193,846.42
|
$138,919.65
|
2026-03-01
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
23
|
19
|
—
|
—
|
$83,687.58
|
$193,141.82
|
$138,414.70
|
2026-03-01
|
|
J9226
|
HCPCS
|
Histrelin Implant (supprelin La), 50 Mg
|
2
|
2
|
—
|
—
|
$45,212.00
|
$227,738.40
|
$136,475.20
|
2026-03-01
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
23
|
19
|
—
|
—
|
$82,196.86
|
$189,701.39
|
$135,949.12
|
2026-03-01
|
|
01906
|
OTHER
|
New Technology - Level 51
|
1
|
1
|
—
|
—
|
$132,237.00
|
$132,237.00
|
$132,237.00
|
2026-03-01
|
|
01905
|
OTHER
|
New Technology - Level 51
|
1
|
1
|
—
|
—
|
$132,237.00
|
$132,237.00
|
$132,237.00
|
2026-03-01
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
23
|
19
|
—
|
—
|
$78,284.18
|
$180,671.36
|
$129,477.77
|
2026-03-01
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
23
|
19
|
—
|
—
|
$78,193.49
|
$180,462.05
|
$129,327.77
|
2026-03-01
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
23
|
19
|
—
|
—
|
$77,443.65
|
$178,731.51
|
$128,087.58
|
2026-03-01
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
23
|
19
|
—
|
—
|
$76,750.02
|
$177,130.69
|
$126,940.35
|
2026-03-01
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
23
|
19
|
—
|
—
|
$76,728.31
|
$177,080.57
|
$126,904.44
|
2026-03-01
|
|
1904
|
OTHER
|
New Technology - Level 50
|
26
|
17
|
—
|
—
|
$120,449.80
|
$315,578.48
|
$126,472.29
|
2026-03-01
|
|
1903
|
OTHER
|
New Technology - Level 50
|
26
|
17
|
—
|
—
|
$120,449.80
|
$315,578.48
|
$126,472.29
|
2026-03-01
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
23
|
19
|
—
|
—
|
$76,172.64
|
$175,798.15
|
$125,985.40
|
2026-03-01
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
22
|
18
|
—
|
—
|
$75,745.99
|
$174,813.49
|
$125,279.74
|
2026-03-01
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
23
|
19
|
—
|
—
|
$74,965.50
|
$173,012.20
|
$123,988.85
|
2026-03-01
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
23
|
19
|
—
|
—
|
$74,916.96
|
$172,900.17
|
$123,908.57
|
2026-03-01
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
23
|
19
|
—
|
—
|
$73,668.94
|
$170,019.88
|
$121,844.41
|
2026-03-01
|
|
J7310
|
HCPCS
|
Ganciclovir, 4.5 Mg, Long-acting Implant
|
1
|
1
|
—
|
—
|
$121,326.75
|
$121,326.75
|
$121,326.75
|
2026-03-01
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
23
|
19
|
—
|
—
|
$73,198.85
|
$168,934.97
|
$121,066.91
|
2026-03-01
|
|
213
|
MS_DRG
|
Endovascular Abdominal Aorta With Iliac Branch Procedures
|
23
|
19
|
—
|
—
|
$72,899.94
|
$168,245.12
|
$120,572.53
|
2026-03-01
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective
|
23
|
19
|
—
|
—
|
$72,805.41
|
$168,026.96
|
$120,416.18
|
2026-03-01
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
23
|
19
|
—
|
—
|
$71,815.43
|
$165,742.18
|
$118,778.80
|
2026-03-01
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
22
|
18
|
—
|
—
|
$71,593.16
|
$165,229.21
|
$118,411.18
|
2026-03-01
|
|
01904
|
OTHER
|
New Technology - Level 50
|
1
|
1
|
—
|
—
|
$117,811.20
|
$117,811.20
|
$117,811.20
|
2026-03-01
|
|
01903
|
OTHER
|
New Technology - Level 50
|
1
|
1
|
—
|
—
|
$117,811.20
|
$117,811.20
|
$117,811.20
|
2026-03-01
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures
|
23
|
19
|
—
|
—
|
$71,102.64
|
$164,097.14
|
$117,599.89
|
2026-03-01
|
|
Q0480
|
HCPCS
|
Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only
|
28
|
18
|
—
|
—
|
$111,492.00
|
$629,884.36
|
$117,066.60
|
2026-03-01
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
23
|
19
|
—
|
—
|
$70,550.80
|
$162,823.56
|
$116,687.18
|
2026-03-01
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
23
|
19
|
—
|
—
|
$70,127.98
|
$161,847.74
|
$115,987.86
|
2026-03-01
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
23
|
19
|
—
|
—
|
$69,880.17
|
$161,275.81
|
$115,577.99
|
2026-03-01
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
23
|
19
|
—
|
—
|
$69,780.53
|
$161,045.86
|
$115,413.20
|
2026-03-01
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
23
|
19
|
—
|
—
|
$69,670.67
|
$160,792.32
|
$115,231.49
|
2026-03-01
|
|
933
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
23
|
19
|
—
|
—
|
$114,804.91
|
$114,804.91
|
$114,804.91
|
2026-03-01
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
22
|
18
|
—
|
—
|
$69,392.20
|
$160,149.64
|
$114,770.92
|
2026-03-01
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
23
|
19
|
—
|
—
|
$68,121.19
|
$157,216.28
|
$112,668.74
|
2026-03-01
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically
|
23
|
19
|
—
|
—
|
$68,080.31
|
$157,121.94
|
$112,601.12
|
2026-03-01
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
23
|
19
|
—
|
—
|
$67,623.00
|
$156,066.52
|
$111,844.76
|
2026-03-01
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
23
|
19
|
—
|
—
|
$67,399.46
|
$155,550.60
|
$111,475.03
|
2026-03-01
|
|
1902
|
OTHER
|
New Technology - Level 49
|
26
|
17
|
—
|
—
|
$105,700.90
|
$276,936.36
|
$110,985.94
|
2026-03-01
|
|
1901
|
OTHER
|
New Technology - Level 49
|
26
|
17
|
—
|
—
|
$105,700.90
|
$276,936.36
|
$110,985.94
|
2026-03-01
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
23
|
19
|
—
|
—
|
$66,493.78
|
$153,460.40
|
$109,977.09
|
2026-03-01
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
23
|
19
|
—
|
—
|
$66,378.81
|
$153,195.07
|
$109,786.94
|
2026-03-01
|
|
A9604
|
HCPCS
|
Samarium Sm-153 Lexidronam, Therapeutic, Per Treatment Dose, Up To 150 Millicuri…
|
1
|
1
|
—
|
—
|
$107,964.43
|
$107,964.43
|
$107,964.43
|
2026-03-01
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
23
|
19
|
—
|
—
|
$64,383.51
|
$148,590.14
|
$106,486.82
|
2026-03-01
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
23
|
19
|
—
|
—
|
$63,709.05
|
$147,033.54
|
$105,371.29
|
2026-03-01
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
23
|
19
|
—
|
—
|
$63,198.09
|
$145,854.30
|
$104,526.20
|
2026-03-01
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
23
|
19
|
—
|
—
|
$63,085.68
|
$145,594.87
|
$104,340.27
|
2026-03-01
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
23
|
19
|
—
|
—
|
$62,869.80
|
$145,096.64
|
$103,983.22
|
2026-03-01
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
23
|
19
|
—
|
—
|
$62,607.93
|
$144,492.28
|
$103,550.10
|
2026-03-01
|
|
01901
|
OTHER
|
New Technology - Level 49
|
1
|
1
|
—
|
—
|
$103,385.40
|
$103,385.40
|
$103,385.40
|
2026-03-01
|
|
01902
|
OTHER
|
New Technology - Level 49
|
1
|
1
|
—
|
—
|
$103,385.40
|
$103,385.40
|
$103,385.40
|
2026-03-01
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
23
|
19
|
—
|
—
|
$61,681.81
|
$142,354.90
|
$102,018.35
|
2026-03-01
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
23
|
19
|
—
|
—
|
$61,370.13
|
$141,635.57
|
$101,502.85
|
2026-03-01
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
23
|
19
|
—
|
—
|
$60,814.46
|
$140,353.14
|
$100,583.80
|
2026-03-01
|
|
K1007
|
HCPCS
|
Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin…
|
27
|
18
|
—
|
—
|
$95,081.00
|
$249,112.22
|
$99,835.05
|
2026-03-01
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
22
|
18
|
—
|
—
|
$60,055.68
|
$138,601.97
|
$99,328.82
|
2026-03-01
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
23
|
19
|
—
|
—
|
$59,933.05
|
$138,318.96
|
$99,126.01
|
2026-03-01
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r.
|
23
|
19
|
—
|
—
|
$59,754.22
|
$137,906.22
|
$98,830.22
|
2026-03-01
|
|
L5969
|
HCPCS
|
Addition, Endoskeletal Ankle-foot Or Ankle System, Power Assist, Includes Any Ty…
|
1
|
1
|
—
|
—
|
$98,593.44
|
$98,593.44
|
$98,593.44
|
2026-03-01
|
|
1599
|
OTHER
|
New Technology - Level 48
|
26
|
17
|
—
|
—
|
$93,410.20
|
$244,734.72
|
$98,080.71
|
2026-03-01
|
|
1585
|
OTHER
|
New Technology - Level 48
|
26
|
17
|
—
|
—
|
$93,410.20
|
$244,734.72
|
$98,080.71
|
2026-03-01
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
22
|
18
|
—
|
—
|
$59,233.04
|
$136,703.40
|
$97,968.22
|
2026-03-01
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
23
|
19
|
—
|
—
|
$58,996.72
|
$136,158.00
|
$97,577.36
|
2026-03-01
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
23
|
19
|
—
|
—
|
$58,715.69
|
$135,509.42
|
$97,112.55
|
2026-03-01
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
23
|
19
|
—
|
—
|
$58,566.24
|
$135,164.49
|
$96,865.37
|
2026-03-01
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
23
|
19
|
—
|
—
|
$58,280.10
|
$134,504.11
|
$96,392.10
|
2026-03-01
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
23
|
19
|
—
|
—
|
$58,105.09
|
$134,100.22
|
$96,102.65
|
2026-03-01
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
23
|
19
|
—
|
—
|
$58,079.55
|
$134,041.26
|
$96,060.40
|
2026-03-01
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
23
|
19
|
—
|
—
|
$57,852.17
|
$133,516.50
|
$95,684.34
|
2026-03-01
|
|
929
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc
|
23
|
19
|
—
|
—
|
$94,952.40
|
$94,952.40
|
$94,952.40
|
2026-03-01
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
23
|
19
|
—
|
—
|
$57,250.51
|
$132,127.95
|
$94,689.23
|
2026-03-01
|
|
31
|
MS_DRG
|
Ventricular Shunt Procedures With Mcc
|
23
|
19
|
—
|
—
|
$57,233.91
|
$132,089.62
|
$94,661.76
|
2026-03-01
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
23
|
19
|
—
|
—
|
$57,009.08
|
$131,570.75
|
$94,289.91
|
2026-03-01
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
23
|
19
|
—
|
—
|
$56,113.63
|
$129,504.14
|
$92,808.88
|
2026-03-01
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
23
|
19
|
—
|
—
|
$55,278.21
|
$127,576.08
|
$91,427.15
|
2026-03-01
|
|
01599
|
OTHER
|
New Technology - Level 48
|
1
|
1
|
—
|
—
|
$91,363.88
|
$91,363.88
|
$91,363.88
|
2026-03-01
|
|
01585
|
OTHER
|
New Technology - Level 48
|
1
|
1
|
—
|
—
|
$91,363.88
|
$91,363.88
|
$91,363.88
|
2026-03-01
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
23
|
19
|
—
|
—
|
$54,837.50
|
$126,558.98
|
$90,698.24
|
2026-03-01
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
23
|
19
|
—
|
—
|
$54,484.94
|
$125,745.31
|
$90,115.12
|
2026-03-01
|
|
448
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical Without Mcc
|
23
|
19
|
—
|
—
|
$54,171.98
|
$125,023.02
|
$89,597.50
|
2026-03-01
|
|
269
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
23
|
19
|
—
|
—
|
$53,947.16
|
$124,504.16
|
$89,225.66
|
2026-03-01
|
|
12
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
23
|
19
|
—
|
—
|
$53,855.18
|
$124,291.90
|
$89,073.54
|
2026-03-01
|
|
958
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
23
|
19
|
—
|
—
|
$53,828.36
|
$124,229.99
|
$89,029.18
|
2026-03-01
|
|
673
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Mcc
|
23
|
19
|
—
|
—
|
$53,671.24
|
$123,867.37
|
$88,769.30
|
2026-03-01
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
23
|
19
|
—
|
—
|
$53,607.37
|
$123,719.96
|
$88,663.66
|
2026-03-01
|
|
236
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
23
|
19
|
—
|
—
|
$53,507.73
|
$123,490.01
|
$88,498.87
|
2026-03-01
|
|
458
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
23
|
19
|
—
|
—
|
$53,300.79
|
$123,012.42
|
$88,156.60
|
2026-03-01
|
|
1598
|
OTHER
|
New Technology - Level 47
|
26
|
17
|
—
|
—
|
$83,577.59
|
$218,973.29
|
$87,756.47
|
2026-03-01
|
|
1584
|
OTHER
|
New Technology - Level 47
|
26
|
17
|
—
|
—
|
$83,577.59
|
$218,973.29
|
$87,756.47
|
2026-03-01
|
|
423
|
MS_DRG
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
23
|
19
|
—
|
—
|
$53,050.42
|
$122,434.59
|
$87,742.51
|
2026-03-01
|
|
273
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures With Mcc
|
23
|
19
|
—
|
—
|
$52,699.14
|
$121,623.87
|
$87,161.51
|
2026-03-01
|
|
402
|
MS_DRG
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
23
|
19
|
—
|
—
|
$51,357.87
|
$118,528.36
|
$84,943.12
|
2026-03-01
|
|
802
|
MS_DRG
|
Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc
|
23
|
19
|
—
|
—
|
$50,892.89
|
$117,455.25
|
$84,174.07
|
2026-03-01
|
|
24
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
23
|
19
|
—
|
—
|
$49,970.61
|
$115,326.72
|
$82,648.66
|
2026-03-01
|
|
34
|
MS_DRG
|
Carotid Artery Stent Procedures With Mcc
|
23
|
19
|
—
|
—
|
$49,444.32
|
$114,112.11
|
$81,778.21
|
2026-03-01
|
|
01584
|
OTHER
|
New Technology - Level 47
|
1
|
1
|
—
|
—
|
$81,746.68
|
$81,746.68
|
$81,746.68
|
2026-03-01
|
|
01598
|
OTHER
|
New Technology - Level 47
|
1
|
1
|
—
|
—
|
$81,746.68
|
$81,746.68
|
$81,746.68
|
2026-03-01
|
|
40
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
23
|
19
|
—
|
—
|
$49,322.97
|
$113,832.04
|
$81,577.51
|
2026-03-01
|
|
907
|
MS_DRG
|
Other O.r. Procedures For Injuries With Mcc
|
23
|
19
|
—
|
—
|
$49,043.22
|
$113,186.40
|
$81,114.81
|
2026-03-01
|
|
956
|
MS_DRG
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
23
|
19
|
—
|
—
|
$48,068.56
|
$110,937.00
|
$79,502.78
|
2026-03-01
|
|
143
|
MS_DRG
|
Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc
|
23
|
19
|
—
|
—
|
$47,859.07
|
$110,453.51
|
$79,156.29
|
2026-03-01
|
|
166
|
MS_DRG
|
Other Respiratory System O.r. Procedures With Mcc
|
23
|
19
|
—
|
—
|
$47,745.38
|
$110,191.13
|
$78,968.26
|
2026-03-01
|
|
518
|
MS_DRG
|
Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…
|
23
|
19
|
—
|
—
|
$47,740.27
|
$110,179.34
|
$78,959.80
|
2026-03-01
|
|
628
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
23
|
19
|
—
|
—
|
$47,606.14
|
$109,869.79
|
$78,737.96
|
2026-03-01
|
|
651
|
MS_DRG
|
Kidney Transplant With Hemodialysis Without Mcc
|
22
|
18
|
—
|
—
|
$47,337.89
|
$109,250.69
|
$78,294.29
|
2026-03-01
|
|
904
|
MS_DRG
|
Skin Grafts For Injuries With Cc/mcc
|
23
|
19
|
—
|
—
|
$46,920.18
|
$108,286.66
|
$77,603.42
|
2026-03-01
|
|
492
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc
|
23
|
19
|
—
|
—
|
$46,901.02
|
$108,242.44
|
$77,571.73
|
2026-03-01
|
|
1597
|
OTHER
|
New Technology - Level 46
|
26
|
17
|
—
|
—
|
$73,744.99
|
$193,211.87
|
$77,432.24
|
2026-03-01
|
|
1583
|
OTHER
|
New Technology - Level 46
|
26
|
17
|
—
|
—
|
$73,744.99
|
$193,211.87
|
$77,432.24
|
2026-03-01
|
|
939
|
MS_DRG
|
O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc
|
23
|
19
|
—
|
—
|
$46,350.46
|
$106,971.81
|
$76,661.13
|
2026-03-01
|
|
495
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…
|
23
|
19
|
—
|
—
|
$46,314.69
|
$106,889.26
|
$76,601.98
|
2026-03-01
|
|
332
|
MS_DRG
|
Rectal Resection With Mcc
|
23
|
19
|
—
|
—
|
$46,250.82
|
$106,741.86
|
$76,496.34
|
2026-03-01
|
|
265
|
MS_DRG
|
Aicd Lead Procedures
|
23
|
19
|
—
|
—
|
$46,218.89
|
$106,668.15
|
$76,443.52
|
2026-03-01
|
|
97
|
MS_DRG
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc
|
23
|
19
|
—
|
—
|
$46,137.13
|
$106,479.48
|
$76,308.30
|
2026-03-01
|
|
279
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures
|
23
|
19
|
—
|
—
|
$46,068.15
|
$106,320.28
|
$76,194.21
|
2026-03-01
|
|
739
|
MS_DRG
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…
|
23
|
19
|
—
|
—
|
$45,766.69
|
$105,624.53
|
$75,695.61
|
2026-03-01
|
|
736
|
MS_DRG
|
Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc
|
23
|
19
|
—
|
—
|
$45,660.66
|
$105,379.83
|
$75,520.24
|
2026-03-01
|
|
335
|
MS_DRG
|
Peritoneal Adhesiolysis With Mcc
|
23
|
19
|
—
|
—
|
$45,614.68
|
$105,273.70
|
$75,444.19
|
2026-03-01
|
|
408
|
MS_DRG
|
Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…
|
23
|
19
|
—
|
—
|
$45,546.97
|
$105,117.45
|
$75,332.21
|
2026-03-01
|
|
414
|
MS_DRG
|
Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc
|
23
|
19
|
—
|
—
|
$45,508.65
|
$105,029.01
|
$75,268.83
|
2026-03-01
|
|
622
|
MS_DRG
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
23
|
19
|
—
|
—
|
$45,465.22
|
$104,928.78
|
$75,197.00
|
2026-03-01
|
|
271
|
MS_DRG
|
Other Major Cardiovascular Procedures With Cc
|
23
|
19
|
—
|
—
|
$45,428.18
|
$104,843.28
|
$75,135.73
|
2026-03-01
|
|
467
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Cc
|
23
|
19
|
—
|
—
|
$45,048.79
|
$103,967.69
|
$74,508.24
|
2026-03-01
|
|
94
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System With Mcc
|
23
|
19
|
—
|
—
|
$44,956.82
|
$103,755.43
|
$74,356.12
|
2026-03-01
|
|
252
|
MS_DRG
|
Other Vascular Procedures With Mcc
|
23
|
19
|
—
|
—
|
$44,559.54
|
$102,838.57
|
$73,699.05
|
2026-03-01
|
|
616
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
23
|
19
|
—
|
—
|
$44,548.05
|
$102,812.04
|
$73,680.04
|
2026-03-01
|
|
574
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Cc
|
23
|
19
|
—
|
—
|
$44,343.66
|
$102,340.34
|
$73,342.00
|
2026-03-01
|
|
477
|
MS_DRG
|
Biopsies Of Musculoskeletal System And Connective Tissue With Mcc
|
23
|
19
|
—
|
—
|
$44,129.06
|
$101,845.06
|
$72,987.06
|
2026-03-01
|
|
359
|
MS_DRG
|
Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc
|
23
|
19
|
—
|
—
|
$43,924.68
|
$101,373.37
|
$72,649.02
|
2026-03-01
|
|
987
|
MS_DRG
|
Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
23
|
19
|
—
|
—
|
$43,794.38
|
$101,072.66
|
$72,433.52
|
2026-03-01
|
|
L8702
|
HCPCS
|
Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge…
|
27
|
18
|
—
|
—
|
$68,801.70
|
$180,260.45
|
$72,241.79
|
2026-03-01
|
|
J7311
|
HCPCS
|
Injection, Fluocinolone Acetonide, Intravitreal Implant (retisert), 0.01 Mg
|
2
|
2
|
—
|
—
|
$340.04
|
$144,007.56
|
$72,173.80
|
2026-03-01
|
|
01583
|
OTHER
|
New Technology - Level 46
|
1
|
1
|
—
|
—
|
$72,129.48
|
$72,129.48
|
$72,129.48
|
2026-03-01
|
|
01597
|
OTHER
|
New Technology - Level 46
|
1
|
1
|
—
|
—
|
$72,129.48
|
$72,129.48
|
$72,129.48
|
2026-03-01
|
|
29
|
MS_DRG
|
Spinal Procedures With Cc Or Spinal Neurostimulators
|
23
|
19
|
—
|
—
|
$43,579.78
|
$100,577.38
|
$72,078.58
|
2026-03-01
|
|
420
|
MS_DRG
|
Hepatobiliary Diagnostic Procedures With Mcc
|
23
|
19
|
—
|
—
|
$43,522.30
|
$100,444.72
|
$71,983.51
|
2026-03-01
|
|
264
|
MS_DRG
|
Other Circulatory System O.r. Procedures
|
23
|
19
|
—
|
—
|
$42,672.82
|
$98,484.23
|
$70,578.52
|
2026-03-01
|
|
411
|
MS_DRG
|
Cholecystectomy With C.d.e. With Mcc
|
23
|
19
|
—
|
—
|
$42,196.35
|
$97,384.59
|
$69,790.47
|
2026-03-01
|
|
37
|
MS_DRG
|
Extracranial Procedures With Mcc
|
23
|
19
|
—
|
—
|
$42,053.29
|
$97,054.40
|
$69,553.85
|
2026-03-01
|
|
274
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures Without Mcc
|
23
|
19
|
—
|
—
|
$42,048.18
|
$97,042.61
|
$69,545.40
|
2026-03-01
|
|
260
|
MS_DRG
|
Cardiac Pacemaker Revision Except Device Replacement With Mcc
|
23
|
19
|
—
|
—
|
$41,551.27
|
$95,895.80
|
$68,723.54
|
2026-03-01
|
|
579
|
MS_DRG
|
Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc
|
23
|
19
|
—
|
—
|
$41,368.60
|
$95,474.22
|
$68,421.41
|
2026-03-01
|
|
840
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Mcc
|
23
|
19
|
—
|
—
|
$41,322.61
|
$95,368.09
|
$68,345.35
|
2026-03-01
|
|
451
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical Without Mcc
|
23
|
19
|
—
|
—
|
$41,265.13
|
$95,235.42
|
$68,250.27
|
2026-03-01
|
|
652
|
MS_DRG
|
Kidney Transplant
|
22
|
18
|
—
|
—
|
$41,253.63
|
$95,208.89
|
$68,231.26
|
2026-03-01
|
|
485
|
MS_DRG
|
Knee Procedures With Principal Diagnosis Of Infection With Mcc
|
23
|
19
|
—
|
—
|
$41,222.98
|
$95,138.14
|
$68,180.56
|
2026-03-01
|
|
325
|
MS_DRG
|
Coronary Intravascular Lithotripsy Without Intraluminal Device
|
23
|
19
|
—
|
—
|
$41,009.65
|
$94,645.80
|
$67,827.73
|
2026-03-01
|
|
717
|
OTHER
|
Instill Adstiladrin, Tx D
|
26
|
17
|
—
|
—
|
$64,274.79
|
$168,399.95
|
$67,488.53
|
2026-03-01
|
|
242
|
MS_DRG
|
Permanent Cardiac Pacemaker Implant With Mcc
|
23
|
19
|
—
|
—
|
$40,784.83
|
$94,126.94
|
$67,455.88
|
2026-03-01
|
|
515
|
MS_DRG
|
Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc
|
23
|
19
|
—
|
—
|
$40,709.46
|
$93,953.00
|
$67,331.23
|
2026-03-01
|
|
J9266
|
HCPCS
|
Injection, Pegaspargase, Per Single Dose Vial
|
2
|
2
|
—
|
—
|
$27,070.50
|
$107,510.88
|
$67,290.69
|
2026-03-01
|
|
656
|
MS_DRG
|
Kidney And Ureter Procedures For Neoplasm With Mcc
|
23
|
19
|
—
|
—
|
$40,669.86
|
$93,861.61
|
$67,265.74
|
2026-03-01
|
|
22
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…
|
23
|
19
|
—
|
—
|
$40,588.11
|
$93,672.93
|
$67,130.52
|
2026-03-01
|
|
1582
|
OTHER
|
New Technology - Level 45
|
26
|
17
|
—
|
—
|
$63,912.39
|
$167,450.46
|
$67,108.01
|
2026-03-01
|
|
1596
|
OTHER
|
New Technology - Level 45
|
26
|
17
|
—
|
—
|
$63,912.39
|
$167,450.46
|
$67,108.01
|
2026-03-01
|
|
500
|
MS_DRG
|
Soft Tissue Procedures With Mcc
|
23
|
19
|
—
|
—
|
$40,427.16
|
$93,301.47
|
$66,864.32
|
2026-03-01
|
|
829
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…
|
23
|
19
|
—
|
—
|
$40,365.84
|
$93,159.96
|
$66,762.90
|
2026-03-01
|
|
324
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc
|
23
|
19
|
—
|
—
|
$40,250.87
|
$92,894.63
|
$66,572.75
|
2026-03-01
|
|
229
|
MS_DRG
|
Other Cardiothoracic Procedures Without Mcc
|
23
|
19
|
—
|
—
|
$40,231.71
|
$92,850.41
|
$66,541.06
|
2026-03-01
|
|
258
|
MS_DRG
|
Cardiac Pacemaker Device Replacement With Mcc
|
23
|
19
|
—
|
—
|
$40,137.19
|
$92,632.25
|
$66,384.72
|
2026-03-01
|
|
5244
|
OTHER
|
Level 4 Blood Product Exc
|
26
|
17
|
—
|
—
|
$63,187.75
|
$165,551.90
|
$66,347.14
|
2026-03-01
|
|
665
|
MS_DRG
|
Prostatectomy With Mcc
|
23
|
19
|
—
|
—
|
$39,870.21
|
$92,016.10
|
$65,943.15
|
2026-03-01
|
|
464
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective
|
23
|
19
|
—
|
—
|
$39,787.18
|
$91,824.47
|
$65,805.82
|
2026-03-01
|
|
26
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Cc
|
23
|
19
|
—
|
—
|
$39,716.92
|
$91,662.33
|
$65,689.62
|
2026-03-01
|
|
934
|
MS_DRG
|
Full Thickness Burn Without Skin Graft Or Inhalation Injury
|
23
|
19
|
—
|
—
|
$65,170.70
|
$65,170.70
|
$65,170.70
|
2026-03-01
|
|
662
|
MS_DRG
|
Minor Bladder Procedures With Mcc
|
23
|
19
|
—
|
—
|
$39,107.60
|
$90,256.08
|
$64,681.84
|
2026-03-01
|
|
263
|
MS_DRG
|
Vein Ligation And Stripping
|
23
|
19
|
—
|
—
|
$39,055.23
|
$90,135.21
|
$64,595.22
|
2026-03-01
|
|
00717
|
OTHER
|
Instill Adstiladrin, Tx D
|
1
|
1
|
—
|
—
|
$64,274.79
|
$64,274.79
|
$64,274.79
|
2026-03-01
|
|
469
|
MS_DRG
|
Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…
|
23
|
19
|
—
|
—
|
$38,746.10
|
$89,421.77
|
$64,083.93
|
2026-03-01
|
|
510
|
MS_DRG
|
Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc
|
23
|
19
|
—
|
—
|
$38,583.87
|
$89,047.36
|
$63,815.61
|
2026-03-01
|
|
625
|
MS_DRG
|
Thyroid, Parathyroid And Thyroglossal Procedures With Mcc
|
23
|
19
|
—
|
—
|
$38,578.76
|
$89,035.57
|
$63,807.17
|
2026-03-01
|
|
498
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…
|
23
|
19
|
—
|
—
|
$38,536.60
|
$88,938.28
|
$63,737.44
|
2026-03-01
|
|
J9029
|
HCPCS
|
Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose
|
1
|
1
|
—
|
—
|
$63,235.60
|
$63,235.60
|
$63,235.60
|
2026-03-01
|
|
173
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…
|
23
|
19
|
—
|
—
|
$38,020.53
|
$87,747.25
|
$62,883.89
|
2026-03-01
|
|
01596
|
OTHER
|
New Technology - Level 45
|
1
|
1
|
—
|
—
|
$62,512.28
|
$62,512.28
|
$62,512.28
|
2026-03-01
|
|
01582
|
OTHER
|
New Technology - Level 45
|
1
|
1
|
—
|
—
|
$62,512.28
|
$62,512.28
|
$62,512.28
|
2026-03-01
|
|
472
|
MS_DRG
|
Cervical Spinal Fusion With Cc
|
23
|
19
|
—
|
—
|
$37,633.48
|
$86,853.97
|
$62,243.72
|
2026-03-01
|
|
959
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc
|
23
|
19
|
—
|
—
|
$37,607.93
|
$86,795.01
|
$62,201.47
|
2026-03-01
|
|
570
|
MS_DRG
|
Skin Debridement With Mcc
|
23
|
19
|
—
|
—
|
$37,569.61
|
$86,706.57
|
$62,138.09
|
2026-03-01
|
|
L8687
|
HCPCS
|
Implantable Neurostimulator Pulse Generator, Dual Array, Rechargeable, Includes …
|
1
|
1
|
—
|
—
|
$62,014.14
|
$62,014.14
|
$62,014.14
|
2026-03-01
|
|
05244
|
OTHER
|
Level 4 Blood Product Exc
|
1
|
1
|
—
|
—
|
$61,803.51
|
$61,803.51
|
$61,803.51
|
2026-03-01
|
|
668
|
MS_DRG
|
Transurethral Procedures With Mcc
|
23
|
19
|
—
|
—
|
$37,300.08
|
$86,084.52
|
$61,692.30
|
2026-03-01
|
|
480
|
MS_DRG
|
Hip And Femur Procedures Except Major Joint With Mcc
|
23
|
19
|
—
|
—
|
$37,201.72
|
$85,857.52
|
$61,529.62
|
2026-03-01
|
|
353
|
MS_DRG
|
Hernia Procedures Except Inguinal And Femoral With Mcc
|
23
|
19
|
—
|
—
|
$37,070.15
|
$85,553.86
|
$61,312.00
|
2026-03-01
|
|
406
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Cc
|
23
|
19
|
—
|
—
|
$37,047.15
|
$85,500.80
|
$61,273.97
|
2026-03-01
|
|
974
|
MS_DRG
|
HIV With Major Related Condition With Mcc
|
23
|
19
|
—
|
—
|
$36,865.76
|
$85,082.17
|
$60,973.96
|
2026-03-01
|
|
13
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc
|
23
|
19
|
—
|
—
|
$36,812.11
|
$84,958.35
|
$60,885.23
|
2026-03-01
|
|
935
|
MS_DRG
|
Non-extensive Burns
|
23
|
19
|
—
|
—
|
$60,730.86
|
$60,730.86
|
$60,730.86
|
2026-03-01
|
|
521
|
MS_DRG
|
Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc
|
23
|
19
|
—
|
—
|
$36,663.93
|
$84,616.37
|
$60,640.15
|
2026-03-01
|
|
240
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc
|
23
|
19
|
—
|
—
|
$36,412.29
|
$84,035.59
|
$60,223.94
|
2026-03-01
|
|
1643
|
OTHER
|
Y90 Ibritumomab, Rx
|
26
|
17
|
—
|
—
|
$56,824.55
|
$148,880.32
|
$59,665.78
|
2026-03-01
|
|
800
|
MS_DRG
|
Splenic Procedures With Cc
|
23
|
19
|
—
|
—
|
$35,887.28
|
$82,823.92
|
$59,355.60
|
2026-03-01
|
|
654
|
MS_DRG
|
Major Bladder Procedures With Cc
|
23
|
19
|
—
|
—
|
$35,758.26
|
$82,526.16
|
$59,142.21
|
2026-03-01
|
|
503
|
MS_DRG
|
Foot Procedures With Mcc
|
23
|
19
|
—
|
—
|
$35,653.51
|
$82,284.42
|
$58,968.96
|
2026-03-01
|
|
483
|
MS_DRG
|
Major Joint Or Limb Reattachment Procedures Of Upper Extremities
|
23
|
19
|
—
|
—
|
$35,408.25
|
$81,718.38
|
$58,563.32
|
2026-03-01
|
|
61
|
MS_DRG
|
Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…
|
23
|
19
|
—
|
—
|
$35,219.20
|
$81,282.07
|
$58,250.64
|
2026-03-01
|
|
208
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support <=96 Hours
|
23
|
19
|
—
|
—
|
$35,111.89
|
$81,034.42
|
$58,073.15
|
2026-03-01
|
|
468
|
MS_DRG
|
Revision Of Hip Or Knee Replacement Without Cc/mcc
|
23
|
19
|
—
|
—
|
$35,102.95
|
$98,225.00
|
$58,058.37
|
2026-03-01
|
|
963
|
MS_DRG
|
Other Multiple Significant Trauma With Mcc
|
23
|
19
|
—
|
—
|
$34,921.56
|
$80,595.16
|
$57,758.36
|
2026-03-01
|
|
321
|
MS_DRG
|
Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A…
|
23
|
19
|
—
|
—
|
$34,755.50
|
$80,211.90
|
$57,483.70
|
2026-03-01
|
|
849
|
MS_DRG
|
Radiotherapy
|
23
|
19
|
—
|
—
|
$34,611.15
|
$79,878.77
|
$57,244.96
|
2026-03-01
|
|
288
|
MS_DRG
|
Acute And Subacute Endocarditis With Mcc
|
23
|
19
|
—
|
—
|
$34,569.00
|
$79,781.48
|
$57,175.24
|
2026-03-01
|
|
255
|
MS_DRG
|
Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc
|
23
|
19
|
—
|
—
|
$34,456.59
|
$79,522.05
|
$56,989.32
|
2026-03-01
|
|
01643
|
OTHER
|
Y90 Ibritumomab, Rx
|
1
|
1
|
—
|
—
|
$56,824.55
|
$56,824.55
|
$56,824.55
|
2026-03-01
|
|
1581
|
OTHER
|
New Technology - Level 44
|
26
|
17
|
—
|
—
|
$54,079.79
|
$141,689.05
|
$56,783.78
|
2026-03-01
|
|
1595
|
OTHER
|
New Technology - Level 44
|
26
|
17
|
—
|
—
|
$54,079.79
|
$141,689.05
|
$56,783.78
|
2026-03-01
|
|
462
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc
|
23
|
19
|
—
|
—
|
$33,978.84
|
$78,419.46
|
$56,199.15
|
2026-03-01
|
|
9273
|
OTHER
|
Sipuleucel-t Auto Cd54+
|
22
|
15
|
—
|
—
|
$54,404.11
|
$142,538.77
|
$56,036.23
|
2026-03-01
|
|
577
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Cc
|
23
|
19
|
—
|
—
|
$33,860.04
|
$78,145.29
|
$56,002.67
|
2026-03-01
|
|
970
|
MS_DRG
|
HIV With Extensive O.r. Procedures Without Mcc
|
23
|
19
|
—
|
—
|
$33,690.15
|
$77,753.19
|
$55,721.67
|
2026-03-01
|
|
253
|
MS_DRG
|
Other Vascular Procedures With Cc
|
23
|
19
|
—
|
—
|
$33,156.19
|
$76,520.88
|
$54,838.54
|
2026-03-01
|
|
846
|
MS_DRG
|
Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc
|
23
|
19
|
—
|
—
|
$33,116.59
|
$76,429.49
|
$54,773.04
|
2026-03-01
|
|
344
|
MS_DRG
|
Minor Small And Large Bowel Procedures With Mcc
|
23
|
19
|
—
|
—
|
$32,992.69
|
$76,143.53
|
$54,568.11
|
2026-03-01
|