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

CACHE VALLEY HOSPITAL

North Logan, UT · CCN 460054 · Rates published

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You selected 93306 (CPT)

ECHO2D COMP W CF DOP

This hospital’s price: $976 across 16 payers · range $466-$2,076

Source: https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/47-1210615_CACHE-VALLEY-HOSPITAL_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D · observed 2026-03-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

24,794 distinct procedures filed
28 distinct payers
543,731 rate rows
2026-07-30 last MRF observed
Data quality

504,222 of 543,731 rate rows are consumer-grade (92.7%)

39,509 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 28,751
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 7,108
per-diem day rate — not a per-procedure price 1,801
template filing: same amount across many unrelated codes — excluded 1,712
placeholder amount (≤ $0.02) — excluded from medians 94
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 30
exceeds 10× this hospital's gross charge — excluded from medians 12
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/47-1210615_CACHE-VALLEY-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.mountainstar.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered viaDiscovered by HANK (automated)
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-10-03
Content fingerprint 09ed0df7e6ca6092… · 297,630,228 bytes · first seen 2026-05-15

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 9 $3,828,799.50 $4,595,100.00 $4,505,000.00 nat. median
$17,156
outlier · 262.6×
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 9 $3,132,108.42 $3,758,972.34 $3,685,267.00 nat. median
$3,758,972
1.0× median
908
OTHER 		Topi Adm Prad Zami Per Tr 9 $2,835,113.42 $3,402,536.40 $3,335,820.00 nat. median
$30,519
outlier · 109.3×
714
OTHER 		Inj Delandistrogene Mox R 9 $2,828,348.21 $3,394,417.20 $3,327,860.00 nat. median
$3,325,455
1.0× median
748
OTHER 		Inj, Lovotibeglogene Auto 9 $2,764,306.55 $3,317,558.16 $3,252,508.00 nat. median
$3,252,508
1.0× median
906
OTHER 		Inj Elivaldogene Autoteme 9 $2,702,682.00 $3,243,600.00 $3,180,000.00 nat. median
$25,059
outlier · 126.9×
746
OTHER 		Inj, Betibeglogene Autote 9 $2,498,679.65 $2,998,768.38 $2,939,969.00 nat. median
$2,939,969
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 1 $2,928,356.00 $2,928,356.00 $2,928,356.00 nat. median
$813,967
outlier · 3.6×
9141
OTHER 		Inj Onase Abepar-xioi Tre 9 $2,200,374.95 $2,640,760.62 $2,588,981.00 nat. median
$2,588,981
1.0× median
824
OTHER 		Inj, Exagamglogene Autote 9 $1,981,966.80 $2,378,640.00 $2,332,000.00 nat. median
$2,285,360
1.0× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 1 $2,233,068.37 $2,233,068.37 $2,233,068.37 nat. median
$646,415
outlier · 3.5×
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 1 $2,152,818.94 $2,152,818.94 $2,152,818.94 nat. median
$739,258
outlier · 2.9×
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 1 $2,136,364.71 $2,136,364.71 $2,136,364.71 nat. median
$640,950
outlier · 3.3×
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 1 $2,120,710.57 $2,120,710.57 $2,120,710.57 nat. median
$622,450
outlier · 3.4×
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 1 $2,022,330.51 $2,022,330.51 $2,022,330.51 nat. median
$608,239
outlier · 3.3×
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 1 $1,859,910.76 $1,859,910.76 $1,859,910.76 nat. median
$591,721
outlier · 3.1×
Q2058
HCPCS 		Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,… 1 $1,057,350.00 $1,057,350.00 $1,057,350.00 nat. median
$319,951
outlier · 3.3×
2067
OTHER 		Afamitresgene Autoleucel 9 $654,949.94 $786,032.40 $770,620.00 nat. median
$793,739
1.0× median
J3402
HCPCS 		Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 $766,342.28 $766,342.28 $766,342.28 nat. median
$209,753
outlier · 3.7×
9498
OTHER 		Ciltacabtagene Car-pos T 9 $499,443.40 $599,402.59 $587,649.60 nat. median
$587,650
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos 9 $481,494.95 $577,861.93 $566,531.30 nat. median
$577,163
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 9 $477,814.80 $573,445.22 $562,201.20 nat. median
$562,201
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 9 $474,313.72 $569,243.44 $558,081.80 nat. median
$563,449
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 9 $452,310.15 $542,836.04 $532,192.20 nat. median
$533,230
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 20 $235,461.70 $1,229,759.78 $490,383.88 nat. median
$359,454
1.4× median
9391
OTHER 		Brexucabtagene Car Pos T 9 $415,983.72 $499,239.20 $489,450.20 nat. median
$492,768
1.0× median
J7330
HCPCS 		Autologous Cultured Chondrocytes, Implant 1 $318,159.75 $318,159.75 $318,159.75 nat. median
$75,000
outlier · 4.2×
831
OTHER 		Obecbtge Autol Up To 400 9 $236,484.67 $283,815.00 $278,250.00 nat. median
$23,596
outlier · 11.8×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 21 $173,187.15 $582,368.49 $271,663.69 nat. median
$249,036
1.1× median
897
OTHER 		Revakinagene, Per Implant 9 $225,223.50 $270,300.00 $265,000.00 nat. median
$26,484
outlier · 10.0×
J9029
HCPCS 		Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 1 $244,244.20 $244,244.20 $244,244.20 nat. median
$68,423
outlier · 3.6×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 22 $136,258.04 $604,451.25 $241,033.37 nat. median
$190,559
1.3× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 20 $19,842.00 $608,019.54 $223,683.17 nat. median
$198,418
1.1× median
886
OTHER 		Inj. Remestemcel-l-rknd/ 9 $171,398.48 $205,702.38 $201,669.00 nat. median
$201,669
1.0× median
A9699
HCPCS 		Radiopharmaceutical, Therapeutic, Not Otherwise Classified 1 $177,441.49 $177,441.49 $177,441.49 nat. median
$1,683
outlier · 105.4×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 21 $78,252.04 $267,069.00 $158,369.67 nat. median
$104,013
1.5× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 22 $93,947.70 $394,460.17 $157,296.50 nat. median
$126,695
1.2× median
1908
OTHER 		New Technology - Level 52 9 $128,451.42 $154,159.84 $151,137.10 nat. median
$155,563
1.0× median
1907
OTHER 		New Technology - Level 52 9 $128,451.42 $154,159.84 $151,137.10 nat. median
$155,833
1.0× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 20 $66,146.85 $225,151.94 $149,580.88 nat. median
$95,038
1.6× median
7
MS_DRG 		Lung Transplant 20 $78,394.56 $270,191.90 $147,062.47 nat. median
$117,974
1.2× median
1905
OTHER 		New Technology - Level 51 9 $115,816.89 $138,996.62 $136,271.20 nat. median
$140,341
1.0× median
1906
OTHER 		New Technology - Level 51 9 $115,816.89 $138,996.62 $136,271.20 nat. median
$140,341
1.0× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 20 $73,246.61 $270,874.21 $131,896.86 nat. median
$110,307
1.2× median
209
MS_DRG 		Complex Aortic Arch Procedures 16 $74,013.00 $322,336.79 $128,536.29 nat. median
$92,678
1.4× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 22 $19,842.00 $309,672.62 $123,486.28 nat. median
$97,323
1.3× median
1903
OTHER 		New Technology - Level 50 9 $103,182.36 $123,833.41 $121,405.30 nat. median
$120,722
1.0× median
1904
OTHER 		New Technology - Level 50 9 $103,182.36 $123,833.41 $121,405.30 nat. median
$120,722
1.0× median
215
MS_DRG 		Other Heart Assist System Implant 22 $65,282.79 $306,034.00 $121,108.61 nat. median
$93,901
1.3× median
850
MS_DRG 		Acute Leukemia With Other Procedures 19 $19,842.00 $246,605.24 $118,721.74 nat. median
$78,268
1.5× median

Other procedures at this hospital

Browse this hospital's 24,794 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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 12 9 $19,690.24 — $3,828,799.50 $4,595,100.00 $4,505,000.00 2026-07-30
9138 OTHER Inj, Hemgenix, Per Tx Dos 12 9 — — $3,132,108.42 $3,758,972.34 $3,685,267.00 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 12 9 $47,559.03 — $2,835,113.42 $3,402,536.40 $3,335,820.00 2026-07-30
714 OTHER Inj Delandistrogene Mox R 12 9 $21,543.51 — $2,828,348.21 $3,394,417.20 $3,327,860.00 2026-07-30
748 OTHER Inj, Lovotibeglogene Auto 12 9 $31,257.58 — $2,764,306.55 $3,317,558.16 $3,252,508.00 2026-07-30
906 OTHER Inj Elivaldogene Autoteme 12 9 $41,839.14 — $2,702,682.00 $3,243,600.00 $3,180,000.00 2026-07-30
746 OTHER Inj, Betibeglogene Autote 12 9 $37,378.74 — $2,498,679.65 $2,998,768.38 $2,939,969.00 2026-07-30
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 1 1 — — $2,928,356.00 $2,928,356.00 $2,928,356.00 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 12 9 — — $2,200,374.95 $2,640,760.62 $2,588,981.00 2026-03-01
824 OTHER Inj, Exagamglogene Autote 12 9 $54,842.26 — $1,981,966.80 $2,378,640.00 $2,332,000.00 2026-07-30
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 1 1 — — $2,233,068.37 $2,233,068.37 $2,233,068.37 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 1 1 — — $2,152,818.94 $2,152,818.94 $2,152,818.94 2026-03-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 1 1 — — $2,136,364.71 $2,136,364.71 $2,136,364.71 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 1 1 — — $2,120,710.57 $2,120,710.57 $2,120,710.57 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 1 1 — — $2,022,330.51 $2,022,330.51 $2,022,330.51 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 1 1 — — $1,859,910.76 $1,859,910.76 $1,859,910.76 2026-03-01
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 1 1 — — $1,057,350.00 $1,057,350.00 $1,057,350.00 2026-03-01
2067 OTHER Afamitresgene Autoleucel 12 9 — — $654,949.94 $786,032.40 $770,620.00 2026-03-01
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 1 — — $766,342.28 $766,342.28 $766,342.28 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 12 9 $481,344.75 — $499,443.40 $599,402.59 $587,649.60 2026-07-30
9194 OTHER Tisagenlecleucel Car-pos 12 9 $456,125.88 — $481,494.95 $577,861.93 $566,531.30 2026-07-30
9413 OTHER Lisocabtagene Car Pos T 12 9 $437,092.59 — $477,814.80 $573,445.22 $562,201.20 2026-07-30
9422 OTHER Idecabtagene Vicleucel Ca 12 9 $446,893.35 — $474,313.72 $569,243.44 $558,081.80 2026-07-30
9035 OTHER Axicabtagene Ciloleucel C 12 9 $424,999.19 — $452,310.15 $542,836.04 $532,192.20 2026-07-30
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 46 20 — — $235,461.70 $1,229,759.78 $490,383.88 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 12 9 $425,054.70 — $415,983.72 $499,239.20 $489,450.20 2026-07-30
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 1 1 — — $318,159.75 $318,159.75 $318,159.75 2026-03-01
831 OTHER Obecbtge Autol Up To 400 12 9 $26,020.15 — $236,484.67 $283,815.00 $278,250.00 2026-07-30
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 41 21 — — $173,187.15 $582,368.49 $271,663.69 2026-03-01
897 OTHER Revakinagene, Per Implant 12 9 $15,414.45 — $225,223.50 $270,300.00 $265,000.00 2026-07-30
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 1 1 — — $244,244.20 $244,244.20 $244,244.20 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 49 22 — — $136,258.04 $604,451.25 $241,033.37 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 40 20 — — $19,842.00 $608,019.54 $223,683.17 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 12 9 $22,808.54 — $171,398.48 $205,702.38 $201,669.00 2026-07-30
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 1 1 — — $177,441.49 $177,441.49 $177,441.49 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 41 21 — — $78,252.04 $267,069.00 $158,369.67 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 49 22 — — $93,947.70 $394,460.17 $157,296.50 2026-03-01
1907 OTHER New Technology - Level 52 12 9 $147,598.40 — $128,451.42 $154,159.84 $151,137.10 2026-07-30
1908 OTHER New Technology - Level 52 12 9 $147,598.40 — $128,451.42 $154,159.84 $151,137.10 2026-07-30
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 44 20 — — $66,146.85 $225,151.94 $149,580.88 2026-03-01
7 MS_DRG Lung Transplant 44 20 — — $78,394.56 $270,191.90 $147,062.47 2026-03-01
1906 OTHER New Technology - Level 51 12 9 $133,080.57 — $115,816.89 $138,996.62 $136,271.20 2026-07-30
1905 OTHER New Technology - Level 51 12 9 $133,080.57 — $115,816.89 $138,996.62 $136,271.20 2026-07-30
14 MS_DRG Allogeneic Bone Marrow Transplant 40 20 — — $73,246.61 $270,874.21 $131,896.86 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 35 16 — — $74,013.00 $322,336.79 $128,536.29 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 49 22 — — $19,842.00 $309,672.62 $123,486.28 2026-03-01
1903 OTHER New Technology - Level 50 12 9 $118,562.75 — $103,182.36 $123,833.41 $121,405.30 2026-07-30
1904 OTHER New Technology - Level 50 12 9 $118,562.75 — $103,182.36 $123,833.41 $121,405.30 2026-07-30
215 MS_DRG Other Heart Assist System Implant 45 22 — — $65,282.79 $306,034.00 $121,108.61 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 41 19 — — $19,842.00 $246,605.24 $118,721.74 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 49 22 — — $62,026.57 $278,594.58 $114,510.60 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 49 22 — — $54,019.29 $224,087.69 $109,355.21 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 20 10 $96,923.94 — $95,479.47 $114,588.84 $108,971.74 2026-07-30
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 16 7 — — $56,633.21 $167,832.00 $107,609.67 2026-03-01
1901 OTHER New Technology - Level 49 12 9 $104,044.92 — $90,547.84 $108,670.19 $106,539.40 2026-07-30
1902 OTHER New Technology - Level 49 12 9 $104,044.92 — $90,547.84 $108,670.19 $106,539.40 2026-07-30
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 37 21 — — $19,842.00 $216,999.51 $99,520.29 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 49 22 — — $51,864.24 $240,066.69 $99,151.25 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 49 22 — — $49,282.28 $246,010.00 $97,528.70 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 41 19 — — $62,268.00 $241,231.00 $96,900.00 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 9 2 — — $72,735.42 $215,933.29 $96,033.49 2026-03-01
1599 OTHER New Technology - Level 48 12 9 $91,946.73 — $80,019.10 $96,034.22 $94,151.20 2026-07-30
1585 OTHER New Technology - Level 48 12 9 $91,946.73 — $80,019.10 $96,034.22 $94,151.20 2026-07-30
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 20 10 — — $80,809.34 $96,982.62 $93,216.70 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 41 19 — — $62,268.00 $192,070.00 $92,078.11 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 49 22 — — $53,872.30 $175,096.77 $88,578.00 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 49 22 — — $49,847.24 $217,720.01 $88,496.16 2026-03-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 41 19 — — $50,044.16 $190,418.15 $86,894.74 2026-03-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 49 22 — — $19,842.00 $174,322.38 $85,191.52 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 49 22 — — $44,965.80 $203,059.53 $85,090.26 2026-03-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 47 21 — — $51,086.46 $203,179.14 $84,283.12 2026-03-01
1598 OTHER New Technology - Level 47 12 9 $82,268.18 — $71,596.08 $85,925.40 $84,240.59 2026-07-30
1584 OTHER New Technology - Level 47 12 9 $82,268.18 — $71,596.08 $85,925.40 $84,240.59 2026-07-30
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 49 22 — — $15,035.00 $196,834.24 $83,080.39 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 12 3 — — $64,967.22 $206,735.62 $81,897.94 2026-03-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 49 22 — — $43,808.39 $195,868.84 $81,756.69 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 41 19 — — $53,772.52 $167,832.00 $81,610.00 2026-03-01
10 MS_DRG Pancreas Transplant 44 20 — — $30,763.72 $164,841.48 $81,487.25 2026-03-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 41 19 — — $50,009.82 $190,278.60 $80,382.00 2026-03-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 49 22 — — $39,249.69 $162,545.00 $79,804.02 2026-03-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 37 21 — — $19,842.00 $191,688.27 $79,178.45 2026-03-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 8 5 — — $42,387.03 $78,357.79 $77,967.95 2026-03-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 49 22 — — $15,035.00 $183,247.39 $77,941.25 2026-03-01
834 MS_DRG Acute Leukemia With Mcc 49 22 — — $15,035.00 $156,341.37 $77,636.36 2026-03-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 49 22 — — $39,918.83 $174,524.58 $77,587.27 2026-03-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 41 19 — — $42,585.31 $167,832.00 $77,077.62 2026-03-01
38240 CPT Hematopoietic Progenitor Cell (hpc); Allogeneic Transplantation Per Donor 15 5 — — $2,720.00 $123,607.47 $76,885.03 2026-03-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 41 19 — — $43,602.02 $167,832.00 $76,838.49 2026-03-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 49 22 — — $41,891.63 $157,283.99 $75,407.66 2026-03-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 49 22 — — $40,680.63 $187,251.39 $74,999.71 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 49 22 — — $36,407.61 $187,251.39 $74,669.11 2026-03-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 49 22 — — $19,842.00 $186,570.77 $74,397.70 2026-03-01
1583 OTHER New Technology - Level 46 12 9 $72,589.62 — $63,173.06 $75,816.59 $74,329.99 2026-07-30
1597 OTHER New Technology - Level 46 12 9 $72,589.62 — $63,173.06 $75,816.59 $74,329.99 2026-07-30
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 49 22 — — $37,582.91 $167,125.99 $73,000.31 2026-03-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 40 20 — — $19,842.00 $204,264.15 $72,957.36 2026-03-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 35 16 — — $43,180.20 $162,521.10 $72,506.16 2026-03-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 39 19 — — $39,477.21 $124,790.00 $71,518.49 2026-03-01
0266T CPT Implantation Or Replacement Of Carotid Sinus Baroreflex Activation Device; Total… 8 1 — — $58,500.65 $94,051.04 $70,875.79 2026-03-01
28 MS_DRG Spinal Procedures With Mcc 49 22 — — $38,512.81 $171,104.37 $69,432.48 2026-03-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 49 22 — — $38,017.50 $172,650.72 $69,199.19 2026-03-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 49 22 — — $39,689.39 $171,055.95 $68,210.95 2026-03-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 49 22 — — $38,827.24 $132,513.00 $67,716.96 2026-03-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 41 19 — — $40,536.50 $151,776.35 $67,712.57 2026-03-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 49 22 — — $33,219.78 $155,566.77 $67,677.03 2026-03-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 20 10 — — $58,474.56 $70,177.73 $67,452.66 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 12 3 — — $52,947.76 $164,104.29 $66,721.22 2026-03-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 49 22 — — $19,842.00 $167,017.77 $66,600.67 2026-03-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 44 20 — — $33,627.52 $113,240.94 $65,720.14 2026-03-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 49 22 — — $33,518.24 $151,867.48 $65,711.19 2026-03-01
653 MS_DRG Major Bladder Procedures With Mcc 49 22 — — $19,842.00 $147,983.08 $65,316.25 2026-03-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 49 22 — — $19,842.00 $155,788.90 $65,142.16 2026-03-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 49 22 — — $36,229.30 $163,187.48 $65,073.29 2026-03-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 49 22 — — $36,196.71 $222,308.00 $64,723.52 2026-03-01
1582 OTHER New Technology - Level 45 12 9 $62,911.07 — $54,750.04 $65,707.78 $64,419.39 2026-07-30
1596 OTHER New Technology - Level 45 12 9 $62,911.07 — $54,750.04 $65,707.78 $64,419.39 2026-07-30
717 OTHER Instill Adstiladrin, Tx D 12 9 $41,764.92 — $54,627.14 $65,560.29 $64,274.79 2026-07-30
5244 OTHER Level 4 Blood Product Exc 12 9 $40,695.94 — $54,129.28 $64,962.78 $63,689.00 2026-07-30
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 49 22 — — $15,035.00 $136,816.86 $63,265.47 2026-03-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 49 22 — — $28,506.42 $158,514.24 $63,209.77 2026-03-01
93621 CPT Comprehensive Electrophysiologic Evaluation Including Insertion And Repositionin… 6 3 — — $12,580.00 $92,855.00 $62,530.00 2026-03-01
93609 CPT Intraventricular And/or Intra-atrial Mapping Of Tachycardia Site(s) With Cathete… 6 3 — — $12,580.00 $92,855.00 $62,530.00 2026-03-01
93622 CPT Comprehensive Electrophysiologic Evaluation Including Insertion And Repositionin… 6 3 — — $12,580.00 $92,855.00 $62,530.00 2026-03-01
93613 CPT Intracardiac Electrophysiologic 3-dimensional Mapping (List Separately In Additi… 6 3 — — $12,580.00 $92,855.00 $62,530.00 2026-03-01
93623 CPT Programmed Stimulation And Pacing After Intravenous Drug Infusion (List Separate… 6 3 — — $12,580.00 $92,855.00 $62,530.00 2026-03-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 49 22 — — $33,147.56 $148,239.38 $61,961.66 2026-03-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 49 22 — — $19,842.00 $155,321.86 $61,936.76 2026-03-01
33276 CPT Insertion Of Phrenic Nerve Stimulator System (pulse Generator And Stimulating Le… 14 4 — — $4,927.00 $94,051.04 $61,650.68 2026-03-01
799 MS_DRG Splenic Procedures With Mcc 49 22 — — $19,842.00 $128,974.01 $61,213.53 2026-03-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. 49 22 — — $19,842.00 $133,214.39 $60,440.57 2026-03-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 49 22 — — $32,318.65 $150,258.47 $60,396.35 2026-03-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 49 22 — — $19,842.00 $142,031.18 $60,168.99 2026-03-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 49 22 — — $31,189.36 $148,663.00 $58,367.49 2026-03-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 49 22 — — $32,202.33 $166,418.00 $58,218.68 2026-03-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 41 19 — — $32,907.39 $167,832.00 $58,141.37 2026-03-01
245 MS_DRG Aicd Generator Procedures 49 22 — — $28,960.18 $129,928.03 $57,374.00 2026-03-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 49 22 — — $29,709.20 $143,534.82 $57,236.51 2026-03-01
163 MS_DRG Major Chest Procedures With Mcc 49 22 — — $19,842.00 $127,632.70 $56,935.55 2026-03-01
1643 OTHER Y90 Ibritumomab, Rx 12 9 $60,092.80 — $48,295.19 $57,961.04 $56,824.55 2026-07-30
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 49 22 — — $28,222.66 $129,480.92 $56,532.83 2026-03-01
6 MS_DRG Liver Transplant Without Mcc 44 20 — — $30,912.63 $100,255.86 $56,530.50 2026-03-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 49 22 — — $19,842.00 $140,641.45 $56,082.74 2026-03-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 49 22 — — $19,842.00 $140,160.17 $55,890.83 2026-03-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 49 22 — — $19,842.00 $139,576.37 $55,658.03 2026-03-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 39 19 — — $39,477.21 $124,790.00 $55,518.11 2026-03-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 41 19 — — $31,363.77 $167,832.00 $55,193.47 2026-03-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 47 21 — — $28,743.52 $133,886.47 $54,859.43 2026-03-01
1595 OTHER New Technology - Level 44 12 9 $53,232.52 — $46,327.03 $55,598.98 $54,508.80 2026-07-30
1581 OTHER New Technology - Level 44 12 9 $53,232.52 — $46,327.03 $55,598.98 $54,508.80 2026-07-30
9273 OTHER Sipuleucel-t Auto Cd54+ 12 9 $53,773.06 — $46,238.05 $55,492.19 $54,404.11 2026-07-30
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 49 22 — — $28,957.62 $132,513.00 $53,569.70 2026-03-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 49 22 — — $19,842.00 $133,613.08 $53,280.08 2026-03-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 49 22 — — $30,564.32 $131,525.64 $52,447.69 2026-03-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 49 22 — — $19,842.00 $130,899.13 $52,197.85 2026-03-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 49 22 — — $19,842.00 $130,565.93 $52,064.99 2026-03-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 49 22 — — $19,842.00 $129,537.88 $51,869.54 2026-03-01
901 MS_DRG Wound Debridements For Injuries With Mcc 49 22 — — $19,842.00 $119,510.77 $51,703.57 2026-03-01
471 MS_DRG Cervical Spinal Fusion With Mcc 49 22 — — $31,437.33 $137,511.72 $51,251.74 2026-03-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 49 22 — — $25,827.31 $126,976.00 $51,015.10 2026-03-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 49 22 — — $26,309.19 $127,595.68 $50,880.56 2026-03-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 49 22 — — $27,876.90 $127,094.47 $50,875.00 2026-03-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 49 22 — — $26,577.61 $120,268.29 $50,516.92 2026-03-01
0620T CPT Endovascular Venous Arterialization, Tibial Or Peroneal Vein, With Transcatheter… 13 3 — — $5,056.00 $73,151.04 $50,400.72 2026-03-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 49 22 — — $19,842.00 $101,794.61 $50,135.60 2026-03-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 49 22 — — $19,842.00 $125,098.16 $49,884.64 2026-03-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 49 22 — — $25,069.98 $162,545.00 $49,591.53 2026-03-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 49 22 — — $19,842.00 $123,235.70 $49,141.95 2026-03-01
111324 CDM Frame Exfx 180mm 40 16 $124,822.00 $124,822.00 $25,700.85 $106,098.70 $49,117.46 2026-03-01
111166 CDM Frame Ex Fx 160mm 40 16 $124,822.00 $124,822.00 $25,700.85 $106,098.70 $49,117.46 2026-03-01
334983 CDM Kit Instrmnt Prb Disp 40 16 $124,822.00 $124,822.00 $25,700.85 $106,098.70 $49,117.46 2026-03-01
110995 CDM Frame Ex Fix Foot 160mm 40 16 $124,822.00 $124,822.00 $25,700.85 $106,098.70 $49,117.46 2026-03-01
90485 CDM Filter Bloodtrnsf 40um 40 16 $124,822.00 $124,822.00 $25,700.85 $106,098.70 $49,117.46 2026-03-01
140 MS_DRG Major Head And Neck Procedures With Mcc 49 22 — — $19,842.00 $121,467.21 $48,855.46 2026-03-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 49 22 — — $19,842.00 $122,253.21 $48,750.17 2026-03-01
L8614 HCPCS Processor Snd Dual Kt 84 24 $124,822.00 $124,822.00 $20,200.76 $107,075.35 $48,704.00 2026-07-30
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 49 22 — — $24,905.73 $126,976.00 $48,511.37 2026-03-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 20 10 $42,819.53 — $42,392.25 $50,876.68 $48,382.73 2026-07-30
554284 CDM Kit Lt Audio Process Sys 40 16 $122,100.00 $122,100.00 $25,140.39 $103,785.00 $48,046.35 2026-03-01
33249 CPT Insertion Or Replacement Of Permanent Implantable Defibrillator System, With Tra… 26 9 — — $1,568.00 $73,764.00 $48,021.34 2026-03-01
33264 CPT Removal Of Implantable Defibrillator Pulse Generator With Replacement Of Implant… 26 9 — — $1,348.00 $73,764.00 $48,021.34 2026-03-01
33231 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Multi… 26 9 — — $1,568.00 $73,764.00 $48,021.34 2026-03-01
0268T CPT Implantation Or Replacement Of Carotid Sinus Baroreflex Activation Device; Pulse… 8 1 — — $39,615.67 $63,689.80 $47,995.90 2026-03-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 49 22 — — $19,842.00 $120,063.25 $47,876.90 2026-03-01
332 MS_DRG Rectal Resection With Mcc 49 22 — — $19,842.00 $103,110.29 $47,726.19 2026-03-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 49 22 — — $19,842.00 $119,653.16 $47,713.37 2026-03-01
J1412 HCPCS Injection, Valoctocogene Roxaparvovec-rvox, Per Ml, Containing Nominal 2 X 10°13… 1 1 — — $47,704.10 $47,704.10 $47,704.10 2026-03-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 49 22 — — $19,842.00 $118,269.13 $47,161.47 2026-03-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 49 22 — — $24,933.85 $110,229.79 $47,011.26 2026-03-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 25 13 — — $2,911.00 $84,628.63 $46,706.28 2026-03-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 49 22 — — $24,214.22 $111,403.09 $46,647.96 2026-03-01
0408T CPT Insertion Or Replacement Of Permanent Cardiac Contractility Modulation System, I… 13 3 — — $9,819.00 $67,008.70 $46,168.68 2026-03-01
0915T CPT Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 13 3 — — $5,949.00 $67,008.70 $46,168.68 2026-03-01
0571T CPT Insertion Or Replacement Of Implantable Cardioverter-defibrillator System With S… 13 3 — — $5,949.00 $67,008.70 $46,168.68 2026-03-01
33270 CPT Insertion Or Replacement Of Permanent Subcutaneous Implantable Defibrillator Sys… 24 8 — — $1,348.00 $73,764.00 $46,168.68 2026-03-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 49 22 — — $23,111.77 $102,030.98 $45,869.23 2026-03-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 49 22 — — $15,035.00 $102,856.84 $45,703.27 2026-03-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 49 22 — — $19,842.00 $109,335.59 $45,439.81 2026-03-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 49 22 — — $19,842.00 $113,459.20 $45,243.44 2026-03-01
110966 CDM Kit Rt Audio Process Sys 40 16 $114,774.00 $114,774.00 $23,631.97 $97,557.90 $45,163.57 2026-03-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 49 22 — — $24,608.55 $109,959.25 $44,753.72 2026-03-01
1594 OTHER New Technology - Level 43 12 9 $43,553.97 — $37,904.01 $45,490.16 $44,598.20 2026-07-30
1580 OTHER New Technology - Level 43 12 9 $43,553.97 — $37,904.01 $45,490.16 $44,598.20 2026-07-30
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 41 19 — — $25,827.62 $167,832.00 $44,288.78 2026-03-01
652 MS_DRG Kidney Transplant 44 20 — — $19,201.12 $65,252.05 $44,276.44 2026-03-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 49 22 — — $19,842.00 $99,314.18 $44,250.20 2026-03-01
64568 CPT Open Implantation Of Cranial Nerve (eg, Vagus Nerve) Neurostimulator Electrode A… 15 5 — — $1,184.00 $74,986.00 $43,881.97 2026-03-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 49 22 — — $23,338.65 $106,430.83 $43,817.29 2026-03-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 20 10 $37,524.39 — $37,149.98 $44,585.22 $43,711.00 2026-07-30
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 35 16 — — $27,286.45 $97,924.45 $43,687.41 2026-03-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 49 22 — — $22,887.45 $103,252.68 $43,660.61 2026-03-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 49 22 — — $19,842.00 $89,990.48 $43,323.60 2026-03-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 49 22 — — $19,842.00 $101,692.09 $43,300.83 2026-03-01
1142 OTHER Supprelin La Implant 12 9 $38,460.27 — $36,703.22 $44,049.05 $43,185.34 2026-07-30
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 49 22 — — $19,842.00 $101,541.16 $43,132.54 2026-03-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 49 22 — — $19,842.00 $106,442.22 $43,089.60 2026-03-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 49 22 — — $19,842.00 $106,131.81 $42,842.39 2026-03-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 49 22 — — $19,842.00 $101,358.90 $42,563.84 2026-03-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 49 22 — — $19,842.00 $106,695.67 $42,546.39 2026-03-01
C1820 HCPCS Kit Generator Ipg 140 12 $88,905.00 $88,905.00 $26,606.74 $99,144.00 $42,371.52 2026-03-01
570 MS_DRG Skin Debridement With Mcc 49 22 — — $18,675.78 $83,756.65 $42,287.09 2026-03-01
580820 CDM Graft Bn Patella Right 28 13 $102,518.00 $102,518.00 $32,600.72 $87,140.30 $42,134.90 2026-03-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 47 21 — — $22,102.63 $105,533.77 $42,083.06 2026-03-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 49 22 — — $15,035.00 $100,225.47 $42,004.44 2026-03-01
109238 CDM Algrft Bn 25x20mm 28 13 $102,135.00 $102,135.00 $32,478.93 $86,814.75 $41,977.49 2026-03-01
93243 CDM Graft Bn Cndyl Plg Latrl 28 13 $102,089.00 $102,089.00 $32,464.30 $86,775.65 $41,958.58 2026-03-01
105861 CDM Graft Bn Fem Cndyl Algrf 28 13 $102,089.00 $102,089.00 $32,464.30 $86,775.65 $41,958.58 2026-03-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 49 22 — — $18,372.21 $82,381.00 $41,753.40 2026-03-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 49 22 — — $19,842.00 $104,602.54 $41,750.26 2026-03-01
33287 CPT Removal And Replacement Of Phrenic Nerve Stimulator, Including Vessel Catheteriz… 14 4 — — $4,927.00 $63,689.80 $41,748.82 2026-03-01
64582 CPT Open Implantation Of Hypoglossal Nerve Neurostimulator Array, Pulse Generator, A… 14 4 — — $3,733.00 $63,689.80 $41,748.82 2026-03-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 49 22 — — $13,535.00 $104,559.82 $41,694.69 2026-03-01
111129 CDM Graft Bn Rt Mdl Fem 28 13 $101,323.00 $101,323.00 $32,220.71 $86,124.55 $41,643.75 2026-03-01
107550 CDM Graft Bn Lt Mdl Fem Hemi 28 13 $101,323.00 $101,323.00 $32,220.71 $86,124.55 $41,643.75 2026-03-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 49 22 — — $19,842.00 $101,455.72 $41,548.32 2026-03-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 49 22 — — $19,842.00 $103,332.42 $41,205.25 2026-03-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 49 22 — — $22,088.57 $101,276.31 $41,155.36 2026-03-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 49 22 — — $21,187.44 $92,633.24 $41,124.70 2026-03-01
265 MS_DRG Aicd Lead Procedures 49 22 — — $22,586.43 $103,039.10 $41,088.28 2026-03-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 49 22 — — $20,455.03 $102,703.06 $40,954.28 2026-03-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 9 2 — — $31,012.38 $92,068.00 $40,946.03 2026-03-01
33289 CPT Transcatheter Implantation Of Wireless Pulmonary Artery Pressure Sensor For Long… 14 4 — — $9,819.00 $59,415.21 $40,936.80 2026-03-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 49 22 — — $22,081.54 $90,924.56 $40,828.75 2026-03-01
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 12 3 — — $31,667.42 $108,011.43 $40,739.37 2026-03-01
107457 CDM Graft Bn Fem Rt Lateral 28 13 $99,050.00 $99,050.00 $31,497.90 $84,192.50 $40,709.55 2026-03-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 49 22 — — $22,280.94 $100,430.51 $40,048.07 2026-03-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 49 22 — — $19,842.00 $98,380.10 $39,997.76 2026-03-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 49 22 — — $19,431.20 $94,071.38 $39,708.77 2026-03-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 49 22 — — $20,711.95 $126,976.00 $39,686.87 2026-03-01
37 MS_DRG Extracranial Procedures With Mcc 49 22 — — $21,573.46 $93,752.42 $39,647.26 2026-03-01
252 MS_DRG Other Vascular Procedures With Mcc 49 22 — — $21,434.14 $99,339.81 $39,613.13 2026-03-01
C9760 HCPCS Non-randomized, Non-blinded Procedure For Nyha Class Ii, Iii, IV Heart Failure; … 13 3 — — $9,819.00 $57,476.04 $39,600.72 2026-03-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 49 22 — — $19,842.00 $98,858.53 $39,421.22 2026-03-01
93656 CPT Comprehensive Electrophysiologic Evaluation With Transseptal Catheterizations, I… 23 8 — — $3,280.00 $68,511.00 $39,105.00 2026-03-01
93653 CPT Comprehensive Electrophysiologic Evaluation With Insertion And Repositioning Of … 23 8 — — $3,280.00 $68,511.00 $39,105.00 2026-03-01
93654 CPT Comprehensive Electrophysiologic Evaluation With Insertion And Repositioning Of … 23 8 — — $3,280.00 $68,511.00 $39,105.00 2026-03-01
93657 CPT Additional Linear Or Focal Intracardiac Catheter Ablation Of The Left Or Right A… 15 7 — — $960.00 $68,511.00 $39,105.00 2026-03-01
93655 CPT Intracardiac Catheter Ablation Of A Discrete Mechanism Of Arrhythmia Which Is Di… 15 7 — — $960.00 $68,511.00 $39,105.00 2026-03-01
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 20 10 $34,572.17 — $34,227.26 $41,077.54 $39,063.94 2026-07-30
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 49 22 — — $19,842.00 $97,633.98 $39,006.61 2026-03-01
264 MS_DRG Other Circulatory System O.r. Procedures 49 22 — — $20,873.01 $95,133.61 $38,903.31 2026-03-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 49 22 — — $19,842.00 $90,668.26 $38,852.25 2026-03-01
C1822 HCPCS Pulse Gen Imp 56 13 $86,042.00 $86,042.00 $23,353.92 $83,847.40 $38,816.41 2026-03-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 49 22 — — $20,320.82 $89,691.46 $38,800.02 2026-03-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 49 22 — — $21,909.63 $97,155.54 $38,742.13 2026-03-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 49 22 — — $19,842.00 $97,027.39 $38,691.03 2026-03-01
J9216 HCPCS Injection, Interferon, Gamma 1-b, 3 Million Units 1 1 — — $38,576.00 $38,576.00 $38,576.00 2026-03-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 49 22 — — $21,051.95 $91,901.35 $38,404.99 2026-03-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 49 22 — — $21,280.75 $86,379.47 $38,172.87 2026-03-01
69930 CPT Cochlear Device Implantation, With Or Without Mastoidectomy 18 6 $98,836.00 — $3,280.00 $104,681.00 $37,868.42 2026-07-30
500 MS_DRG Soft Tissue Procedures With Mcc 49 22 — — $19,842.00 $90,127.17 $37,667.27 2026-03-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 29 15 — — $19,842.00 $78,090.30 $37,570.94 2026-03-01
105811 CDM Fixator Exfix Crtck 70mm 40 16 $95,283.00 $95,283.00 $19,618.77 $80,990.55 $37,493.86 2026-03-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 49 22 — — $20,205.15 $90,756.54 $36,831.51 2026-03-01
C1767 HCPCS Device Ipg Sleep 51mm 100 12 $83,669.00 $83,669.00 $19,773.88 $79,610.15 $36,808.74 2026-03-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 40 20 — — $15,035.00 $110,899.03 $36,789.97 2026-03-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 49 22 — — $19,842.00 $92,226.00 $36,776.41 2026-03-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 49 22 — — $15,035.00 $92,123.48 $36,735.52 2026-03-01
238453 CDM Probe Abltn Radio Disp 40 16 $93,240.00 $93,240.00 $19,198.12 $79,254.00 $36,689.94 2026-03-01
329275 CDM Probe Esurg Rf Disp 40 16 $93,240.00 $93,240.00 $19,198.12 $79,254.00 $36,689.94 2026-03-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 49 22 — — $16,899.72 $91,425.77 $36,457.30 2026-03-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 49 22 — — $17,764.42 $75,107.88 $36,302.41 2026-03-01
92945 CPT Percutaneous Transluminal Revascularization Of Chronic Total Occlusion, Single C… 4 1 — — $24,311.00 $41,709.00 $36,244.00 2026-03-01
665 MS_DRG Prostatectomy With Mcc 49 22 — — $19,742.44 $88,885.53 $35,971.64 2026-03-01
C1821 HCPCS Implnt Spn 12mm 20 12 $78,154.00 $78,154.00 $24,852.97 $66,430.90 $35,950.84 2026-03-01
63685 CPT Insertion Or Replacement Of Spinal Neurostimulator Pulse Generator Or Receiver, … 18 6 — — $1,184.00 $74,986.00 $35,898.61 2026-03-01
61886 CPT Insertion Or Replacement Of Cranial Neurostimulator Pulse Generator Or Receiver,… 18 6 — — $1,348.00 $74,986.00 $35,898.61 2026-03-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 49 22 — — $18,972.32 $89,734.18 $35,782.76 2026-03-01
662 MS_DRG Minor Bladder Procedures With Mcc 49 22 — — $19,151.91 $87,185.40 $35,718.63 2026-03-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 49 22 — — $17,310.66 $89,480.72 $35,681.69 2026-03-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 49 22 — — $19,135.93 $81,737.56 $35,666.27 2026-03-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 37 21 — — $19,842.00 $120,003.44 $35,392.50 2026-03-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 49 22 — — $19,181.95 $88,700.43 $35,370.53 2026-03-01
33240 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Singl… 26 9 — — $1,568.00 $73,764.00 $35,352.75 2026-03-01
33262 CPT Removal Of Implantable Defibrillator Pulse Generator With Replacement Of Implant… 26 9 — — $1,348.00 $73,764.00 $35,352.75 2026-03-01
33263 CPT Removal Of Implantable Defibrillator Pulse Generator With Replacement Of Implant… 26 9 — — $1,348.00 $73,764.00 $35,352.75 2026-03-01
33230 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Dual … 26 9 — — $1,568.00 $73,764.00 $35,352.75 2026-03-01
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 48 22 — — $18,002.17 $64,975.40 $35,311.99 2026-03-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 49 22 — — $18,873.26 $88,543.80 $35,308.08 2026-03-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 49 22 — — $18,190.70 $75,751.48 $35,094.22 2026-03-01
263 MS_DRG Vein Ligation And Stripping 49 22 — — $18,055.85 $87,068.64 $34,719.83 2026-03-01
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