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

MEDICAL CITY GREEN OAKS HOSPITAL

Dallas, TX · CCN 454094 · Rates published

19,913 distinct procedures filed
50 distinct payers
264,617 rate rows
2026-07-17 last MRF observed
Data quality

232,127 of 264,617 rate rows are consumer-grade (87.7%)

32,490 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
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 16,033
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 14,898
per-diem day rate — not a per-procedure price 1,293
placeholder amount (≤ $0.02) — excluded from medians 254
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 9
exceeds 10× this hospital's gross charge — excluded from medians 3
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1797829_MEDICAL-CITY-GREEN-OAKS-HOSPITAL_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 · 2026-09-21
Content fingerprint b5707a70fae07476… · 143,071,012 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
845
OTHER 		Inj, Atidarsagene Autotem 13 $4,505,000.00 $4,955,500.00 $4,527,525.00 nat. median
$4,505,000
1.0× median
00845
OTHER 		Inj, Atidarsagene Autotem 1 $4,505,000.00 $4,505,000.00 $4,505,000.00 —
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 13 $3,685,267.00 $4,790,847.10 $3,703,693.33 nat. median
$3,765,001
1.0× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 1 $3,685,267.00 $3,685,267.00 $3,685,267.00 nat. median
$3,562,713
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 15 $3,327,860.00 $4,326,218.00 $3,427,695.80 nat. median
$3,391,964
1.0× median
908
OTHER 		Topi Adm Prad Zami Per Tr 14 $3,335,820.00 $4,336,566.00 $3,369,178.20 nat. median
$8,800
outlier · 382.9×
748
OTHER 		Inj, Lovotibeglogene Auto 15 $3,252,508.00 $4,228,260.40 $3,350,083.24 nat. median
$3,351,720
1.0× median
00908
OTHER 		Topi Adm Prad Zami Per Tr 1 $3,335,820.00 $3,335,820.00 $3,335,820.00 —
00714
OTHER 		Inj Delandistrogene Mox R 1 $3,327,860.00 $3,327,860.00 $3,327,860.00 nat. median
$3,225,691
1.0× median
00748
OTHER 		Inj, Lovotibeglogene Auto 1 $3,252,508.00 $3,252,508.00 $3,252,508.00 nat. median
$3,187,420
1.0× median
906
OTHER 		Inj Elivaldogene Autoteme 14 $3,180,000.00 $4,134,000.00 $3,211,800.00 nat. median
$2,726
outlier · 1178.1×
00906
OTHER 		Inj Elivaldogene Autoteme 1 $3,180,000.00 $3,180,000.00 $3,180,000.00 —
746
OTHER 		Inj, Betibeglogene Autote 15 $2,939,969.00 $3,821,959.70 $3,028,168.07 nat. median
$3,001,835
1.0× median
00746
OTHER 		Inj, Betibeglogene Autote 1 $2,939,969.00 $2,939,969.00 $2,939,969.00 nat. median
$2,878,960
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 14 $2,588,981.00 $4,634,275.99 $2,614,870.81 nat. median
$2,508,045
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
$2,316,956
1.1× median
824
OTHER 		Inj, Exagamglogene Autote 15 $2,332,000.00 $4,174,280.00 $2,378,640.00 nat. median
$28,063
outlier · 84.8×
00824
OTHER 		Inj, Exagamglogene Autote 1 $2,332,000.00 $2,332,000.00 $2,332,000.00 —
2067
OTHER 		Afamitresgene Autoleucel 17 $770,620.00 $2,019,024.40 $809,151.00 nat. median
$838,386
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 1 $629,434.09 $629,434.09 $629,434.09 nat. median
$131,925
outlier · 4.8×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 $551,617.09 $1,273,072.13 $609,957.05 nat. median
$168,055
outlier · 3.6×
9498
OTHER 		Ciltacabtagene Car-pos T 15 $587,649.60 $1,539,641.95 $605,279.09 nat. median
$553,480
1.1× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 2 $357,977.30 $826,172.60 $592,074.95 nat. median
$186,516
outlier · 3.2×
09498
OTHER 		Ciltacabtagene Car-pos T 1 $587,649.60 $587,649.60 $587,649.60 nat. median
$511,310
1.1× median
9194
OTHER 		Tisagenlecleucel Car-pos 15 $566,531.30 $1,484,312.01 $583,527.24 nat. median
$555,653
1.1× median
9413
OTHER 		Lisocabtagene Car Pos T 15 $562,201.20 $1,472,967.14 $579,067.24 nat. median
$542,562
1.1× median
9422
OTHER 		Idecabtagene Vicleucel Ca 15 $558,081.80 $1,462,174.32 $574,824.25 nat. median
$552,917
1.0× median
09194
OTHER 		Tisagenlecleucel Car-pos 1 $566,531.30 $566,531.30 $566,531.30 nat. median
$513,317
1.1× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $562,201.20 $562,201.20 $562,201.20 nat. median
$501,224
1.1× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $558,081.80 $558,081.80 $558,081.80 nat. median
$510,790
1.1× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 1 $553,169.00 $553,169.00 $553,169.00 nat. median
$599,737
0.9× median
9035
OTHER 		Axicabtagene Ciloleucel C 16 $532,192.20 $1,394,343.56 $548,157.97 nat. median
$513,929
1.1× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $532,192.20 $532,192.20 $532,192.20 nat. median
$474,772
1.1× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 1 $527,622.00 $527,622.00 $527,622.00 nat. median
$574,037
0.9× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 1 $516,442.00 $516,442.00 $516,442.00 nat. median
$579,571
0.9× median
9391
OTHER 		Brexucabtagene Car Pos T 15 $489,450.20 $1,282,359.52 $504,133.71 nat. median
$483,557
1.0× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $489,450.20 $489,450.20 $489,450.20 nat. median
$446,714
1.1× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 1 $489,399.00 $489,399.00 $489,399.00 nat. median
$513,770
1.0× median
A9543
HCPCS 		Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 1 $405,245.30 $405,245.30 $405,245.30 nat. median
$65,477
outlier · 6.2×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 3 $271,130.70 $625,740.12 $299,805.95 nat. median
$145,435
outlier · 2.1×
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 2 $23.68 $578,771.00 $289,397.34 nat. median
$621,313
outlier · 0.5×
831
OTHER 		Obecbtge Autol Up To 400 16 $278,250.00 $729,015.00 $286,597.50 nat. median
$278,250
1.0× median
00831
OTHER 		Obecbtge Autol Up To 400 1 $278,250.00 $278,250.00 $278,250.00 —
7
MS_DRG 		Lung Transplant 2 $165,425.85 $381,784.85 $273,605.35 nat. median
$70,649
outlier · 3.9×
897
OTHER 		Revakinagene, Per Implant 16 $265,000.00 $694,300.00 $272,950.00 nat. median
$269,427
1.0× median
00897
OTHER 		Revakinagene, Per Implant 1 $265,000.00 $265,000.00 $265,000.00 —
14
MS_DRG 		Allogeneic Bone Marrow Transplant 2 $153,516.65 $354,299.71 $253,908.18 nat. median
$72,715
outlier · 3.5×
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 2 $6.22 $502,841.00 $251,423.61 nat. median
$562,501
outlier · 0.4×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 $144,752.41 $334,072.80 $239,412.60 nat. median
$65,418
outlier · 3.7×
J7330
HCPCS 		Autologous Cultured Chondrocytes, Implant 1 $238,981.01 $238,981.01 $238,981.01 nat. median
$92,809
outlier · 2.6×

Other procedures at this hospital

Browse this hospital's 19,913 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
             
845 OTHER Inj, Atidarsagene Autotem 18 13 $22,250.52 — $4,505,000.00 $4,955,500.00 $4,527,525.00 2026-07-17
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 $24,344.78 — $3,327,860.00 $4,326,218.00 $3,427,695.80 2026-07-17
908 OTHER Topi Adm Prad Zami Per Tr 19 14 $53,743.03 — $3,335,820.00 $4,336,566.00 $3,369,178.20 2026-07-17
748 OTHER Inj, Lovotibeglogene Auto 22 15 $35,321.94 — $3,252,508.00 $4,228,260.40 $3,350,083.24 2026-07-17
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 $47,279.40 — $3,180,000.00 $4,134,000.00 $3,211,800.00 2026-07-17
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 $42,239.03 — $2,939,969.00 $3,821,959.70 $3,028,168.07 2026-07-17
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 $61,973.29 — $2,332,000.00 $4,174,280.00 $2,378,640.00 2026-07-17
00824 OTHER Inj, Exagamglogene Autote 1 1 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 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 1 1 — — $629,434.09 $629,434.09 $629,434.09 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 3 — — $551,617.09 $1,273,072.13 $609,957.05 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 22 15 $886,057.50 — $587,649.60 $1,539,641.95 $605,279.09 2026-07-17
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 2 2 — — $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 $839,634.71 — $566,531.30 $1,484,312.01 $583,527.24 2026-07-17
9413 OTHER Lisocabtagene Car Pos T 22 15 $804,598.30 — $562,201.20 $1,472,967.14 $579,067.24 2026-07-17
9422 OTHER Idecabtagene Vicleucel Ca 22 15 $822,639.50 — $558,081.80 $1,462,174.32 $574,824.25 2026-07-17
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 $782,336.82 — $532,192.20 $1,394,343.56 $548,157.97 2026-07-17
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 $782,439.00 — $489,450.20 $1,282,359.52 $504,133.71 2026-07-17
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
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
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 3 3 — — $271,130.70 $625,740.12 $299,805.95 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 $29,403.50 — $278,250.00 $729,015.00 $286,597.50 2026-07-17
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 2 2 — — $165,425.85 $381,784.85 $273,605.35 2026-03-01
897 OTHER Revakinagene, Per Implant 23 16 $10,530.58 — $265,000.00 $694,300.00 $272,950.00 2026-07-17
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 2 2 — — $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 2 2 — — $144,752.41 $334,072.80 $239,412.60 2026-03-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 1 1 — — $238,981.01 $238,981.01 $238,981.01 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 2 2 — — $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 1 1 — — $211,458.37 $211,458.37 $211,458.37 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 23 16 $16,885.05 — $201,669.00 $528,372.78 $207,719.07 2026-07-17
00886 OTHER Inj. Remestemcel-l-rknd/ 1 1 — — $201,669.00 $201,669.00 $201,669.00 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 3 3 — — $176,937.78 $408,353.12 $195,651.02 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 2 2 $55,114.75 — $57,017.10 $310,609.58 $183,813.34 2026-07-17
209 MS_DRG Complex Aortic Arch Procedures 3 3 — — $144,586.35 $333,689.54 $159,878.05 2026-03-01
1907 OTHER New Technology - Level 52 26 17 $274,542.38 — $149,947.60 $392,862.71 $157,444.98 2026-07-17
1908 OTHER New Technology - Level 52 26 17 $274,542.38 — $149,947.60 $392,862.71 $157,444.98 2026-07-17
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 3 — — $140,784.81 $324,916.00 $155,674.45 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 3 3 — — $138,905.75 $320,579.34 $153,596.66 2026-03-01
10 MS_DRG Pancreas Transplant 2 2 — — $91,662.39 $211,546.81 $151,604.60 2026-03-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 1 1 — — $150,512.49 $150,512.49 $150,512.49 2026-03-01
01908 OTHER New Technology - Level 52 1 1 — — $146,662.80 $146,662.80 $146,662.80 2026-03-01
01907 OTHER New Technology - Level 52 1 1 — — $146,662.80 $146,662.80 $146,662.80 2026-03-01
1906 OTHER New Technology - Level 51 26 17 $247,538.30 — $135,198.70 $354,220.59 $141,958.64 2026-07-17
1905 OTHER New Technology - Level 51 26 17 $247,538.30 — $135,198.70 $354,220.59 $141,958.64 2026-07-17
215 MS_DRG Other Heart Assist System Implant 3 3 — — $127,190.72 $293,542.32 $140,642.63 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 3 — — $124,965.49 $288,406.73 $138,182.05 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 2 2 $42,302.58 — $45,212.00 $227,738.40 $136,475.20 2026-07-17
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
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 3 3 — — $115,088.63 $265,612.02 $127,260.60 2026-03-01
1904 OTHER New Technology - Level 50 26 17 $220,534.22 — $120,449.80 $315,578.48 $126,472.29 2026-07-17
1903 OTHER New Technology - Level 50 26 17 $220,534.22 — $120,449.80 $315,578.48 $126,472.29 2026-07-17
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 2 2 — — $75,745.99 $174,813.49 $125,279.74 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 3 3 — — $110,616.45 $255,290.72 $122,315.44 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
231 MS_DRG Coronary Bypass With Ptca With Mcc 3 3 — — $107,683.54 $248,521.88 $119,072.34 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 3 — — $107,345.03 $247,740.64 $118,698.02 2026-03-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 2 2 — — $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
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 28 18 $177,067.59 — $111,492.00 $629,884.36 $117,066.60 2026-07-17
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 1 1 — — $114,804.91 $114,804.91 $114,804.91 2026-03-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 2 2 — — $69,392.20 $160,149.64 $114,770.92 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 3 — — $100,516.05 $231,980.09 $111,146.80 2026-03-01
1901 OTHER New Technology - Level 49 26 17 $193,530.14 — $105,700.90 $276,936.36 $110,985.94 2026-07-17
1902 OTHER New Technology - Level 49 26 17 $193,530.14 — $105,700.90 $276,936.36 $110,985.94 2026-07-17
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 3 — — $98,082.60 $226,363.96 $108,455.99 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 3 3 — — $97,659.78 $225,388.14 $107,988.45 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
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 3 3 — — $97,336.60 $224,642.27 $107,631.09 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
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 3 — — $92,210.40 $212,811.55 $101,962.73 2026-03-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 3 3 — — $91,137.38 $210,335.14 $100,776.22 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 3 3 — — $91,083.73 $210,211.32 $100,716.90 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
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
1585 OTHER New Technology - Level 48 26 17 $171,026.74 — $93,410.20 $244,734.72 $98,080.71 2026-07-17
1599 OTHER New Technology - Level 48 26 17 $171,026.74 — $93,410.20 $244,734.72 $98,080.71 2026-07-17
6 MS_DRG Liver Transplant Without Mcc 2 2 — — $59,233.04 $136,703.40 $97,968.22 2026-03-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 3 3 — — $88,291.33 $203,766.78 $97,629.18 2026-03-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 3 3 — — $87,858.29 $202,767.37 $97,150.34 2026-03-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 3 3 — — $85,983.07 $198,439.56 $95,076.79 2026-03-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 1 1 — — $94,952.40 $94,952.40 $94,952.40 2026-03-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 3 3 — — $85,413.35 $197,124.71 $94,446.81 2026-03-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 3 3 — — $85,350.76 $196,980.25 $94,377.60 2026-03-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 3 — — $83,992.88 $193,846.42 $92,876.11 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 3 — — $83,992.88 $193,846.42 $92,876.11 2026-03-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 3 3 — — $83,687.58 $193,141.82 $92,538.53 2026-03-01
01585 OTHER New Technology - Level 48 1 1 — — $91,363.88 $91,363.88 $91,363.88 2026-03-01
01599 OTHER New Technology - Level 48 1 1 — — $91,363.88 $91,363.88 $91,363.88 2026-03-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 3 3 — — $82,196.86 $189,701.39 $90,890.14 2026-03-01
1584 OTHER New Technology - Level 47 26 17 $153,024.02 — $83,577.59 $218,973.29 $87,756.47 2026-07-17
1598 OTHER New Technology - Level 47 26 17 $153,024.02 — $83,577.59 $218,973.29 $87,756.47 2026-07-17
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 3 3 — — $78,284.18 $180,671.36 $86,563.65 2026-03-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 3 3 — — $78,193.49 $180,462.05 $86,463.36 2026-03-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 3 3 — — $77,443.65 $178,731.51 $85,634.22 2026-03-01
28 MS_DRG Spinal Procedures With Mcc 3 3 — — $76,750.02 $177,130.69 $84,867.24 2026-03-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 3 3 — — $76,728.31 $177,080.57 $84,843.22 2026-03-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 3 — — $76,172.64 $175,798.15 $84,228.79 2026-03-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 3 3 — — $74,965.50 $173,012.20 $82,893.97 2026-03-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 3 3 — — $74,916.96 $172,900.17 $82,840.30 2026-03-01
01598 OTHER New Technology - Level 47 1 1 — — $81,746.68 $81,746.68 $81,746.68 2026-03-01
01584 OTHER New Technology - Level 47 1 1 — — $81,746.68 $81,746.68 $81,746.68 2026-03-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 3 3 — — $73,668.94 $170,019.88 $81,460.29 2026-03-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 3 — — $73,198.85 $168,934.97 $80,940.49 2026-03-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 3 3 — — $72,899.94 $168,245.12 $80,609.96 2026-03-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 3 3 — — $72,805.41 $168,026.96 $80,505.44 2026-03-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 3 — — $71,815.43 $165,742.18 $79,410.75 2026-03-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 3 3 — — $71,102.64 $164,097.14 $78,622.57 2026-03-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 3 3 — — $70,550.80 $162,823.56 $78,012.38 2026-03-01
834 MS_DRG Acute Leukemia With Mcc 3 3 — — $70,127.98 $161,847.74 $77,544.84 2026-03-01
1597 OTHER New Technology - Level 46 26 17 $135,021.30 — $73,744.99 $193,211.87 $77,432.24 2026-07-17
1583 OTHER New Technology - Level 46 26 17 $135,021.30 — $73,744.99 $193,211.87 $77,432.24 2026-07-17
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 3 3 — — $69,880.17 $161,275.81 $77,270.81 2026-03-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 3 3 — — $69,780.53 $161,045.86 $77,160.64 2026-03-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 3 3 — — $69,670.67 $160,792.32 $77,039.16 2026-03-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 4 3 — — $45,048.79 $103,967.69 $75,856.62 2026-03-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 3 — — $68,121.19 $157,216.28 $75,325.80 2026-03-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 3 3 — — $68,080.31 $157,121.94 $75,280.60 2026-03-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 3 3 — — $67,623.00 $156,066.52 $74,774.93 2026-03-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 3 3 — — $67,399.46 $155,550.60 $74,527.74 2026-03-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 3 3 — — $66,493.78 $153,460.40 $73,526.27 2026-03-01
653 MS_DRG Major Bladder Procedures With Mcc 3 3 — — $66,378.81 $153,195.07 $73,399.15 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 $332.61 — $340.04 $144,007.56 $72,173.80 2026-07-17
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
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 3 — — $64,383.51 $148,590.14 $71,192.82 2026-03-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 3 3 — — $63,709.05 $147,033.54 $70,447.02 2026-03-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 3 3 — — $63,198.09 $145,854.30 $69,882.02 2026-03-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 3 3 — — $63,085.68 $145,594.87 $69,757.73 2026-03-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 3 3 — — $62,869.80 $145,096.64 $69,519.01 2026-03-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 3 3 — — $62,607.93 $144,492.28 $69,229.45 2026-03-01
652 MS_DRG Kidney Transplant 2 2 — — $41,253.63 $95,208.89 $68,231.26 2026-03-01
471 MS_DRG Cervical Spinal Fusion With Mcc 3 3 — — $61,681.81 $142,354.90 $68,205.39 2026-03-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 3 3 — — $61,370.13 $141,635.57 $67,860.74 2026-03-01
717 OTHER Instill Adstiladrin, Tx D 26 17 $47,195.53 — $64,274.79 $168,399.95 $67,488.53 2026-07-17
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 2 2 $23,554.48 — $27,070.50 $107,510.88 $67,290.69 2026-07-17
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 3 3 — — $60,814.46 $140,353.14 $67,246.30 2026-03-01
1582 OTHER New Technology - Level 45 26 17 $117,018.58 — $63,912.39 $167,450.46 $67,108.01 2026-07-17
1596 OTHER New Technology - Level 45 26 17 $117,018.58 — $63,912.39 $167,450.46 $67,108.01 2026-07-17
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 3 3 — — $60,055.68 $138,601.97 $66,407.27 2026-03-01
5244 OTHER Level 4 Blood Product Exc 26 17 $73,859.72 — $63,187.75 $165,551.90 $66,347.14 2026-07-17
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 3 — — $59,933.05 $138,318.96 $66,271.68 2026-03-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. 3 3 — — $59,754.22 $137,906.22 $66,073.93 2026-03-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 3 3 — — $58,996.72 $136,158.00 $65,236.31 2026-03-01
934 MS_DRG Full Thickness Burn Without Skin Graft Or Inhalation Injury 1 1 — — $65,170.70 $65,170.70 $65,170.70 2026-03-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 3 3 — — $58,715.69 $135,509.42 $64,925.56 2026-03-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 3 3 — — $58,566.24 $135,164.49 $64,760.30 2026-03-01
245 MS_DRG Aicd Generator Procedures 3 3 — — $58,280.10 $134,504.11 $64,443.90 2026-03-01
00717 OTHER Instill Adstiladrin, Tx D 1 1 — — $64,274.79 $64,274.79 $64,274.79 2026-03-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 3 3 — — $58,105.09 $134,100.22 $64,250.39 2026-03-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 3 3 — — $58,079.55 $134,041.26 $64,222.14 2026-03-01
799 MS_DRG Splenic Procedures With Mcc 3 3 — — $57,852.17 $133,516.50 $63,970.71 2026-03-01
163 MS_DRG Major Chest Procedures With Mcc 3 3 — — $57,250.51 $132,127.95 $63,305.42 2026-03-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 3 3 — — $57,233.91 $132,089.62 $63,287.06 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
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 3 3 — — $57,009.08 $131,570.75 $63,038.46 2026-03-01
01582 OTHER New Technology - Level 45 1 1 — — $62,512.28 $62,512.28 $62,512.28 2026-03-01
01596 OTHER New Technology - Level 45 1 1 — — $62,512.28 $62,512.28 $62,512.28 2026-03-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 3 3 — — $56,113.63 $129,504.14 $62,048.30 2026-03-01
L8687 HCPCS $15,447.65 1 1 $17,554.15 — $62,014.14 $62,014.14 $62,014.14 2026-07-17
05244 OTHER Level 4 Blood Product Exc 1 1 — — $61,803.51 $61,803.51 $61,803.51 2026-03-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 3 3 — — $55,278.21 $127,576.08 $61,124.53 2026-03-01
935 MS_DRG Non-extensive Burns 1 1 — — $60,730.86 $60,730.86 $60,730.86 2026-03-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 3 3 — — $54,837.50 $126,558.98 $60,637.21 2026-03-01
140 MS_DRG Major Head And Neck Procedures With Mcc 3 3 — — $54,484.94 $125,745.31 $60,247.36 2026-03-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 4 3 — — $35,102.95 $98,225.00 $59,914.64 2026-03-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 3 3 — — $54,171.98 $125,023.02 $59,901.30 2026-03-01
1643 OTHER Y90 Ibritumomab, Rx 26 17 $110,618.58 — $56,824.55 $148,880.32 $59,665.78 2026-07-17
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 3 3 — — $53,947.16 $124,504.16 $59,652.70 2026-03-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 3 3 — — $53,855.18 $124,291.90 $59,551.00 2026-03-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 3 3 — — $53,828.36 $124,229.99 $59,521.34 2026-03-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 3 3 — — $53,671.24 $123,867.37 $59,347.60 2026-03-01
901 MS_DRG Wound Debridements For Injuries With Mcc 3 3 — — $53,607.37 $123,719.96 $59,276.97 2026-03-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 3 3 — — $53,507.73 $123,490.01 $59,166.80 2026-03-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 3 — — $53,300.79 $123,012.42 $58,937.97 2026-03-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 3 3 — — $53,050.42 $122,434.59 $58,661.12 2026-03-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 3 3 — — $52,699.14 $121,623.87 $58,272.69 2026-03-01
01643 OTHER Y90 Ibritumomab, Rx 1 1 — — $56,824.55 $56,824.55 $56,824.55 2026-03-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 3 — — $51,357.87 $118,528.36 $56,789.56 2026-03-01
1581 OTHER New Technology - Level 44 26 17 $99,015.86 — $54,079.79 $141,689.05 $56,783.78 2026-07-17
1595 OTHER New Technology - Level 44 26 17 $99,015.86 — $54,079.79 $141,689.05 $56,783.78 2026-07-17
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 3 3 — — $50,892.89 $117,455.25 $56,275.41 2026-03-01
9273 OTHER Sipuleucel-t Auto Cd54+ 22 15 $98,985.24 — $54,404.11 $142,538.77 $56,036.23 2026-07-17
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 3 — — $49,970.61 $115,326.72 $55,255.59 2026-03-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 3 3 — — $49,444.32 $114,112.11 $54,673.64 2026-03-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 3 3 — — $49,322.97 $113,832.04 $54,539.45 2026-03-01
09273 OTHER Sipuleucel-t Auto Cd54+ 1 1 — — $54,404.11 $54,404.11 $54,404.11 2026-03-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 3 3 — — $49,043.22 $113,186.40 $54,230.11 2026-03-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 3 3 — — $48,068.56 $110,937.00 $53,152.38 2026-03-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 3 3 — — $47,859.07 $110,453.51 $52,920.72 2026-03-01
01595 OTHER New Technology - Level 44 1 1 — — $52,895.08 $52,895.08 $52,895.08 2026-03-01
01581 OTHER New Technology - Level 44 1 1 — — $52,895.08 $52,895.08 $52,895.08 2026-03-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 3 3 — — $47,745.38 $110,191.13 $52,795.01 2026-03-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 3 3 — — $47,740.27 $110,179.34 $52,789.36 2026-03-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 3 3 — — $47,606.14 $109,869.79 $52,641.05 2026-03-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 28 18 $79,419.45 — $50,007.20 $282,519.64 $52,507.56 2026-07-17
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 3 3 — — $47,337.89 $109,250.69 $52,344.43 2026-03-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 28 18 $78,774.15 — $49,600.80 $280,224.09 $52,080.84 2026-07-17
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 3 3 — — $46,920.18 $108,286.66 $51,882.54 2026-03-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 3 3 — — $46,901.02 $108,242.44 $51,861.35 2026-03-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 3 3 — — $46,350.46 $106,971.81 $51,252.56 2026-03-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 3 3 — — $46,314.69 $106,889.26 $51,213.01 2026-03-01
332 MS_DRG Rectal Resection With Mcc 3 3 — — $46,250.82 $106,741.86 $51,142.39 2026-03-01
265 MS_DRG Aicd Lead Procedures 3 3 — — $46,218.89 $106,668.15 $51,107.07 2026-03-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 3 3 — — $46,137.13 $106,479.48 $51,016.68 2026-03-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 3 3 — — $46,068.15 $106,320.28 $50,940.40 2026-03-01
A9582 HCPCS Iodine I-123 Iobenguane, Diagnostic, Per Study Dose, Up To 15 Millicuries 1 1 — — $50,684.04 $50,684.04 $50,684.04 2026-03-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 3 3 — — $45,766.69 $105,624.53 $50,607.05 2026-03-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 3 3 — — $45,660.66 $105,379.83 $50,489.81 2026-03-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 3 3 — — $45,614.68 $105,273.70 $50,438.96 2026-03-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 3 3 — — $45,546.97 $105,117.45 $50,364.10 2026-03-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 3 3 — — $45,508.65 $105,029.01 $50,321.73 2026-03-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 3 3 — — $45,465.22 $104,928.78 $50,273.70 2026-03-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 3 3 — — $45,428.18 $104,843.28 $50,232.74 2026-03-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 3 3 — — $44,956.82 $103,755.43 $49,711.53 2026-03-01
252 MS_DRG Other Vascular Procedures With Mcc 3 3 — — $44,559.54 $102,838.57 $49,272.24 2026-03-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 3 3 — — $44,548.05 $102,812.04 $49,259.53 2026-03-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 3 3 — — $44,343.66 $102,340.34 $49,033.53 2026-03-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 3 3 — — $44,129.06 $101,845.06 $48,796.22 2026-03-01
A9572 HCPCS Indium In-111 Pentetreotide, Diagnostic, Per Study Dose, Up To 6 Millicuries 1 1 — — $48,725.28 $48,725.28 $48,725.28 2026-03-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 3 3 — — $43,924.68 $101,373.37 $48,570.22 2026-03-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 3 — — $43,794.38 $101,072.66 $48,426.15 2026-03-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 3 3 — — $43,579.78 $100,577.38 $48,188.85 2026-03-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 3 3 — — $43,522.30 $100,444.72 $48,125.29 2026-03-01
L8685 HCPCS $13,084.02 1 1 $14,868.20 — $47,650.80 $47,650.80 $47,650.80 2026-07-17
264 MS_DRG Other Circulatory System O.r. Procedures 3 3 — — $42,672.82 $98,484.23 $47,185.97 2026-03-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 3 3 — — $42,196.35 $97,384.59 $46,659.11 2026-03-01
37 MS_DRG Extracranial Procedures With Mcc 3 3 — — $42,053.29 $97,054.40 $46,500.91 2026-03-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 3 3 — — $42,048.18 $97,042.61 $46,495.26 2026-03-01
1580 OTHER New Technology - Level 43 26 17 $81,013.14 — $44,247.19 $115,927.64 $46,459.55 2026-07-17
1594 OTHER New Technology - Level 43 26 17 $81,013.14 — $44,247.19 $115,927.64 $46,459.55 2026-07-17
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 3 3 — — $41,551.27 $95,895.80 $45,945.80 2026-03-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 3 3 — — $41,368.60 $95,474.22 $45,743.81 2026-03-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 3 3 — — $41,322.61 $95,368.09 $45,692.96 2026-03-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 3 3 — — $41,265.13 $95,235.42 $45,629.40 2026-03-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 3 3 — — $41,222.98 $95,138.14 $45,582.79 2026-03-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 3 3 — — $41,009.65 $94,645.80 $45,346.90 2026-03-01
1142 OTHER Supprelin La Implant 26 17 $70,797.51 — $43,185.34 $113,145.59 $45,344.61 2026-07-17
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 3 3 — — $40,784.83 $94,126.94 $45,098.30 2026-03-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 3 3 — — $40,709.46 $93,953.00 $45,014.96 2026-03-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 3 3 — — $40,669.86 $93,861.61 $44,971.18 2026-03-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 3 3 — — $40,588.11 $93,672.93 $44,880.78 2026-03-01
500 MS_DRG Soft Tissue Procedures With Mcc 3 3 — — $40,427.16 $93,301.47 $44,702.80 2026-03-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 3 3 — — $40,365.84 $93,159.96 $44,635.00 2026-03-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 3 3 — — $40,250.87 $92,894.63 $44,507.88 2026-03-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 3 3 — — $40,231.71 $92,850.41 $44,486.69 2026-03-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 3 3 — — $40,137.19 $92,632.25 $44,382.16 2026-03-01
665 MS_DRG Prostatectomy With Mcc 3 3 — — $39,870.21 $92,016.10 $44,086.95 2026-03-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 3 3 — — $39,787.18 $91,824.47 $43,995.14 2026-03-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 3 3 — — $39,716.92 $91,662.33 $43,917.45 2026-03-01
01594 OTHER New Technology - Level 43 1 1 — — $43,277.88 $43,277.88 $43,277.88 2026-03-01
01580 OTHER New Technology - Level 43 1 1 — — $43,277.88 $43,277.88 $43,277.88 2026-03-01
662 MS_DRG Minor Bladder Procedures With Mcc 3 3 — — $39,107.60 $90,256.08 $43,243.69 2026-03-01
263 MS_DRG Vein Ligation And Stripping 3 3 — — $39,055.23 $90,135.21 $43,185.78 2026-03-01
01142 OTHER Supprelin La Implant 1 1 — — $43,185.34 $43,185.34 $43,185.34 2026-03-01
A9515 HCPCS Choline C-11, Diagnostic, Per Study Dose Up To 20 Millicuries 1 1 — — $42,922.20 $42,922.20 $42,922.20 2026-03-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 3 3 — — $38,746.10 $89,421.77 $42,843.95 2026-03-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 3 3 — — $38,583.87 $89,047.36 $42,664.56 2026-03-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 3 3 — — $38,578.76 $89,035.57 $42,658.91 2026-03-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 3 3 — — $38,536.60 $88,938.28 $42,612.30 2026-03-01
D7949 HCPCS Reconstruct Midface W/graft 1 1 — — $42,501.35 $42,501.35 $42,501.35 2026-03-01
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without 4 3 — — $24,639.77 $60,000.00 $42,055.81 2026-03-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 3 3 — — $38,020.53 $87,747.25 $42,041.65 2026-03-01
472 MS_DRG Cervical Spinal Fusion With Cc 3 3 — — $37,633.48 $86,853.97 $41,613.66 2026-03-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 3 3 — — $37,607.93 $86,795.01 $41,585.41 2026-03-01
570 MS_DRG Skin Debridement With Mcc 3 3 — — $37,569.61 $86,706.57 $41,543.04 2026-03-01
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 27 18 $62,773.00 — $39,525.60 $103,557.07 $41,501.88 2026-07-17
A9600 HCPCS Strontium Sr-89 Chloride, Therapeutic, Per Millicurie 1 1 — — $41,417.99 $41,417.99 $41,417.99 2026-03-01
668 MS_DRG Transurethral Procedures With Mcc 3 3 — — $37,300.08 $86,084.52 $41,245.00 2026-03-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 3 3 — — $37,201.72 $85,857.52 $41,136.24 2026-03-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 3 3 — — $37,070.15 $85,553.86 $40,990.75 2026-03-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 3 3 — — $37,047.15 $85,500.80 $40,965.32 2026-03-01
J9216 HCPCS Injection, Interferon, Gamma 1-b, 3 Million Units 1 1 — — $40,938.48 $40,938.48 $40,938.48 2026-03-01
974 MS_DRG HIV With Major Related Condition With Mcc 3 3 — — $36,865.76 $85,082.17 $40,764.75 2026-03-01
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