|
773
|
OTHER
|
Inj, Beqvez, Per Tx Dose
|
12
|
12
|
—
|
—
|
$3,605,000.00
|
$4,145,750.00
|
$3,749,200.00
|
2024-10-01
|
|
00773
|
OTHER
|
Inj, Beqvez, Per Tx Dose
|
2
|
2
|
—
|
—
|
$3,496,850.00
|
$3,605,000.00
|
$3,550,925.00
|
2024-10-01
|
|
C9150
|
HCPCS
|
Xenon Xe-129 Hyperpolarized Gas, Diagnostic, Per Study Dose
|
3
|
1
|
—
|
—
|
$45,614.40
|
$77,438.40
|
$77,438.40
|
2024-10-01
|
|
J3393
|
HCPCS
|
Injection, Betibeglogene Autotemcel, Per Treatment
|
1
|
1
|
—
|
—
|
$4,897,200.00
|
$4,897,200.00
|
$4,897,200.00
|
2026-03-01
|
|
845
|
OTHER
|
Inj, Atidarsagene Autotem
|
17
|
14
|
—
|
—
|
$5,446.86
|
$4,820,350.00
|
$4,527,525.00
|
2026-03-01
|
|
00845
|
OTHER
|
Inj, Atidarsagene Autotem
|
2
|
2
|
—
|
—
|
$4,369,850.00
|
$4,505,000.00
|
$4,437,425.00
|
2026-03-01
|
|
J3399
|
HCPCS
|
Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge…
|
1
|
1
|
—
|
—
|
$3,884,946.48
|
$3,884,946.48
|
$3,884,946.48
|
2026-03-01
|
|
9138
|
OTHER
|
Inj, Hemgenix, Per Tx Dos
|
25
|
13
|
—
|
—
|
$3,672,900.00
|
$4,223,835.00
|
$3,795,825.01
|
2026-03-01
|
|
09138
|
OTHER
|
Inj, Hemgenix, Per Tx Dos
|
4
|
2
|
—
|
—
|
$3,562,713.00
|
$3,685,267.00
|
$3,623,804.50
|
2026-03-01
|
|
714
|
OTHER
|
Inj Delandistrogene Mox R
|
29
|
15
|
—
|
—
|
$6,036.37
|
$3,824,273.25
|
$3,394,417.20
|
2026-03-01
|
|
908
|
OTHER
|
Topi Adm Prad Zami Per Tr
|
17
|
14
|
—
|
—
|
$10,790.27
|
$3,569,327.40
|
$3,352,499.10
|
2026-03-01
|
|
748
|
OTHER
|
Inj, Lovotibeglogene Auto
|
29
|
15
|
—
|
—
|
$9,956.97
|
$3,778,900.00
|
$3,350,083.24
|
2026-03-01
|
|
00908
|
OTHER
|
Topi Adm Prad Zami Per Tr
|
2
|
2
|
—
|
—
|
$3,235,745.40
|
$3,335,820.00
|
$3,285,782.70
|
2026-03-01
|
|
00714
|
OTHER
|
Inj Delandistrogene Mox R
|
4
|
2
|
—
|
—
|
$3,225,691.35
|
$3,327,860.00
|
$3,276,739.60
|
2026-03-01
|
|
00748
|
OTHER
|
Inj, Lovotibeglogene Auto
|
4
|
2
|
—
|
—
|
$3,154,932.76
|
$3,286,000.00
|
$3,219,964.00
|
2026-03-01
|
|
906
|
OTHER
|
Inj Elivaldogene Autoteme
|
17
|
14
|
—
|
—
|
$7,264.18
|
$3,402,600.00
|
$3,195,900.00
|
2026-03-01
|
|
00906
|
OTHER
|
Inj Elivaldogene Autoteme
|
2
|
2
|
—
|
—
|
$3,084,600.00
|
$3,180,000.00
|
$3,132,300.00
|
2026-03-01
|
|
746
|
OTHER
|
Inj, Betibeglogene Autote
|
29
|
15
|
—
|
—
|
$8,843.77
|
$3,413,200.00
|
$3,027,360.00
|
2026-03-01
|
|
00746
|
OTHER
|
Inj, Betibeglogene Autote
|
4
|
2
|
—
|
—
|
$2,851,769.93
|
$2,968,000.00
|
$2,909,464.50
|
2026-03-01
|
|
9141
|
OTHER
|
Inj Onase Abepar-xioi Tre
|
25
|
13
|
—
|
—
|
$2,388,614.00
|
$2,770,209.67
|
$2,588,981.00
|
2026-03-01
|
|
09141
|
OTHER
|
Inj Onase Abepar-xioi Tre
|
4
|
2
|
—
|
—
|
$2,316,955.58
|
$2,588,981.00
|
$2,449,962.79
|
2026-03-01
|
|
824
|
OTHER
|
Inj, Exagamglogene Autote
|
17
|
14
|
—
|
—
|
$14,451.12
|
$2,495,240.00
|
$2,343,660.00
|
2026-03-01
|
|
00824
|
OTHER
|
Inj, Exagamglogene Autote
|
2
|
2
|
—
|
—
|
$2,262,040.00
|
$2,332,000.00
|
$2,297,020.00
|
2026-03-01
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure…
|
3
|
2
|
—
|
—
|
$1,199,550.00
|
$2,042,143.00
|
$1,199,550.00
|
2026-03-01
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka…
|
9
|
4
|
—
|
—
|
$502,693.77
|
$1,501,307.95
|
$863,696.72
|
2026-03-01
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (…
|
9
|
4
|
—
|
—
|
$470,149.30
|
$1,478,916.58
|
$830,699.97
|
2026-03-01
|
|
2067
|
OTHER
|
Afamitresgene Autoleucel
|
13
|
12
|
—
|
—
|
$770,620.00
|
$824,563.40
|
$786,032.40
|
2026-03-01
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige…
|
11
|
4
|
—
|
—
|
$492,271.12
|
$1,557,271.36
|
$767,250.00
|
2026-03-01
|
|
Q2058
|
HCPCS
|
Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, …
|
1
|
1
|
—
|
—
|
$737,362.50
|
$737,362.50
|
$737,362.50
|
2026-03-01
|
|
Q2054
|
HCPCS
|
Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi…
|
11
|
4
|
—
|
—
|
$459,839.17
|
$1,489,833.29
|
$707,459.77
|
2026-03-01
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via…
|
11
|
4
|
—
|
—
|
$445,599.57
|
$1,410,309.44
|
$699,600.00
|
2026-03-01
|
|
Q2053
|
HCPCS
|
Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V…
|
11
|
4
|
—
|
—
|
$435,956.80
|
$1,297,043.03
|
$699,600.00
|
2026-03-01
|
|
9498
|
OTHER
|
Ciltacabtagene Car-pos T
|
25
|
13
|
—
|
—
|
$527,123.40
|
$628,785.07
|
$587,649.60
|
2026-03-01
|
|
5834
|
APR_DRG
|
Neonate With Ecmo
|
15
|
9
|
—
|
—
|
$513,393.17
|
$619,814.16
|
$573,902.00
|
2026-03-01
|
|
9194
|
OTHER
|
Tisagenlecleucel Car-pos
|
25
|
13
|
—
|
—
|
$529,192.90
|
$608,571.83
|
$566,531.30
|
2026-03-01
|
|
9413
|
OTHER
|
Lisocabtagene Car Pos T
|
25
|
13
|
—
|
—
|
$516,726.10
|
$601,555.28
|
$562,201.20
|
2026-03-01
|
|
9422
|
OTHER
|
Idecabtagene Vicleucel Ca
|
25
|
13
|
—
|
—
|
$526,587.60
|
$605,575.74
|
$558,081.80
|
2026-03-01
|
|
09498
|
OTHER
|
Ciltacabtagene Car-pos T
|
4
|
2
|
—
|
—
|
$511,309.70
|
$587,649.60
|
$548,571.76
|
2026-03-01
|
|
09194
|
OTHER
|
Tisagenlecleucel Car-pos
|
4
|
2
|
—
|
—
|
$513,317.11
|
$566,531.30
|
$539,364.13
|
2026-03-01
|
|
J3402
|
HCPCS
|
Injection, Remestemcel-l-rknd, Per Therapeutic Dose
|
1
|
1
|
—
|
—
|
$534,422.90
|
$534,422.90
|
$534,422.90
|
2026-03-01
|
|
09422
|
OTHER
|
Idecabtagene Vicleucel Ca
|
4
|
2
|
—
|
—
|
$510,789.97
|
$558,081.80
|
$533,963.47
|
2026-03-01
|
|
9035
|
OTHER
|
Axicabtagene Ciloleucel C
|
25
|
13
|
—
|
—
|
$489,456.00
|
$569,445.65
|
$532,192.20
|
2026-03-01
|
|
09413
|
OTHER
|
Lisocabtagene Car Pos T
|
4
|
2
|
—
|
—
|
$501,224.32
|
$562,201.20
|
$531,030.63
|
2026-03-01
|
|
5891
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational
|
15
|
9
|
—
|
—
|
$470,177.82
|
$567,640.44
|
$525,593.00
|
2026-03-01
|
|
5892
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational
|
15
|
9
|
—
|
—
|
$453,542.81
|
$547,557.84
|
$506,998.00
|
2026-03-01
|
|
5833
|
APR_DRG
|
Neonate With Ecmo
|
15
|
9
|
—
|
—
|
$450,941.04
|
$544,416.12
|
$504,089.00
|
2026-03-01
|
|
09035
|
OTHER
|
Axicabtagene Ciloleucel C
|
4
|
2
|
—
|
—
|
$474,772.32
|
$532,192.20
|
$502,841.21
|
2026-03-01
|
|
9391
|
OTHER
|
Brexucabtagene Car Pos T
|
25
|
13
|
—
|
—
|
$460,530.40
|
$529,609.96
|
$489,450.20
|
2026-03-01
|
|
09391
|
OTHER
|
Brexucabtagene Car Pos T
|
4
|
2
|
—
|
—
|
$446,714.49
|
$489,450.20
|
$467,648.55
|
2026-03-01
|
|
5884
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
15
|
9
|
—
|
—
|
$362,699.32
|
$437,882.76
|
$405,447.00
|
2026-03-01
|
|
1614
|
APR_DRG
|
Implantable Heart Assist Systems
|
15
|
9
|
—
|
—
|
$351,278.91
|
$424,095.48
|
$392,681.00
|
2026-03-01
|
|
6304
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
15
|
9
|
—
|
—
|
$317,923.18
|
$383,825.52
|
$355,394.00
|
2026-03-01
|
|
5832
|
APR_DRG
|
Neonate With Ecmo
|
15
|
9
|
—
|
—
|
$310,276.85
|
$374,593.68
|
$346,846.00
|
2026-03-01
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
56
|
19
|
—
|
—
|
$19,893.00
|
$753,238.00
|
$341,471.10
|
2026-03-01
|
|
6094
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
15
|
9
|
—
|
—
|
$303,491.79
|
$366,401.88
|
$339,261.00
|
2026-03-01
|
|
8414
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
15
|
9
|
—
|
—
|
$297,684.13
|
$359,390.52
|
$332,769.00
|
2026-03-01
|
|
114
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
15
|
9
|
—
|
—
|
$282,800.68
|
$341,422.56
|
$316,132.00
|
2026-03-01
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
15
|
9
|
—
|
—
|
$282,152.31
|
$340,639.56
|
$315,407.00
|
2026-03-01
|
|
5914
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
15
|
9
|
—
|
—
|
$268,195.11
|
$323,789.40
|
$299,805.00
|
2026-03-01
|
|
6314
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
15
|
9
|
—
|
—
|
$253,585.38
|
$306,150.84
|
$283,473.00
|
2026-03-01
|
|
831
|
OTHER
|
Obecbtge Autol Up To 400
|
17
|
14
|
—
|
—
|
$3,350.39
|
$297,727.50
|
$279,641.25
|
2026-03-01
|
|
00831
|
OTHER
|
Obecbtge Autol Up To 400
|
2
|
2
|
—
|
—
|
$269,902.50
|
$278,250.00
|
$274,076.25
|
2026-03-01
|
|
897
|
OTHER
|
Revakinagene, Per Implant
|
13
|
12
|
—
|
—
|
$265,000.00
|
$283,550.00
|
$270,300.00
|
2026-03-01
|
|
5934
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
15
|
9
|
—
|
—
|
$234,123.27
|
$282,654.36
|
$261,717.00
|
2026-03-01
|
|
00897
|
OTHER
|
Revakinagene, Per Implant
|
2
|
2
|
—
|
—
|
$257,050.00
|
$265,000.00
|
$261,025.00
|
2026-03-01
|
|
94
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
15
|
9
|
—
|
—
|
$212,475.50
|
$256,519.44
|
$237,518.00
|
2026-03-01
|
|
5893
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational
|
15
|
9
|
—
|
—
|
$210,784.76
|
$254,478.24
|
$235,628.00
|
2026-03-01
|
|
6034
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
15
|
9
|
—
|
—
|
$209,445.17
|
$252,860.40
|
$234,130.00
|
2026-03-01
|
|
44
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
15
|
9
|
—
|
—
|
$203,908.46
|
$246,176.28
|
$227,941.00
|
2026-03-01
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
57
|
22
|
—
|
—
|
$20,990.00
|
$410,835.11
|
$224,535.57
|
2026-03-01
|
|
5831
|
APR_DRG
|
Neonate With Ecmo
|
15
|
9
|
—
|
—
|
$194,211.97
|
$234,470.16
|
$217,102.00
|
2026-03-01
|
|
001
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
4
|
2
|
—
|
—
|
$204,607.92
|
$218,038.80
|
$211,216.82
|
2026-03-01
|
|
018
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
4
|
2
|
—
|
—
|
$168,831.70
|
$248,048.80
|
$207,330.32
|
2026-03-01
|
|
886
|
OTHER
|
Inj. Remestemcel-l-rknd/
|
17
|
14
|
—
|
—
|
$6,317.79
|
$215,785.83
|
$202,677.34
|
2026-03-01
|
|
00886
|
OTHER
|
Inj. Remestemcel-l-rknd/
|
2
|
2
|
—
|
—
|
$195,618.93
|
$201,669.00
|
$198,643.96
|
2026-03-01
|
|
7924
|
APR_DRG
|
Extensive O.r. Procedures For Other Complications Of Treatment
|
15
|
9
|
—
|
—
|
$174,601.93
|
$210,794.40
|
$195,180.00
|
2026-03-01
|
|
1613
|
APR_DRG
|
Implantable Heart Assist Systems
|
15
|
9
|
—
|
—
|
$170,348.13
|
$205,659.00
|
$190,425.00
|
2026-03-01
|
|
J7330
|
HCPCS
|
Algrf Maci Fnl 1 Membran
|
24
|
11
|
$561,710.00
|
$561,710.00
|
$49,273.20
|
$505,539.00
|
$189,139.50
|
2026-03-01
|
|
371977
|
CDM
|
Set Vntrc 17.4x13.8in
|
19
|
12
|
$379,000.00
|
$379,000.00
|
$63,750.00
|
$382,500.00
|
$187,000.00
|
2026-03-01
|
|
1612
|
APR_DRG
|
Implantable Heart Assist Systems
|
15
|
9
|
—
|
—
|
$166,310.00
|
$200,783.88
|
$185,911.00
|
2026-03-01
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
52
|
17
|
—
|
—
|
$8,596.00
|
$346,020.76
|
$181,290.64
|
2026-03-01
|
|
5933
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
15
|
9
|
—
|
—
|
$161,425.80
|
$194,887.08
|
$180,451.00
|
2026-03-01
|
|
6804
|
APR_DRG
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
15
|
9
|
—
|
—
|
$160,729.05
|
$194,045.76
|
$179,672.00
|
2026-03-01
|
|
113
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
15
|
9
|
—
|
—
|
$160,701.40
|
$194,012.28
|
$179,641.00
|
2026-03-01
|
|
6814
|
APR_DRG
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
15
|
9
|
—
|
—
|
$158,660.91
|
$191,548.80
|
$177,360.00
|
2026-03-01
|
|
1611
|
APR_DRG
|
Implantable Heart Assist Systems
|
15
|
9
|
—
|
—
|
$157,957.24
|
$190,699.92
|
$176,574.00
|
2026-03-01
|
|
6024
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
15
|
9
|
—
|
—
|
$157,953.09
|
$190,694.52
|
$176,569.00
|
2026-03-01
|
|
5913
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
15
|
9
|
—
|
—
|
$157,481.68
|
$190,125.36
|
$176,042.00
|
2026-03-01
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
61
|
22
|
—
|
—
|
$20,990.00
|
$319,209.00
|
$170,978.22
|
2026-03-01
|
|
54
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
15
|
9
|
—
|
—
|
$148,625.71
|
$179,434.44
|
$166,143.00
|
2026-03-01
|
|
8424
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
15
|
9
|
—
|
—
|
$146,712.40
|
$177,124.32
|
$164,004.00
|
2026-03-01
|
|
6093
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
15
|
9
|
—
|
—
|
$146,619.78
|
$177,012.00
|
$163,900.00
|
2026-03-01
|
|
1908
|
OTHER
|
New Technology - Level 52
|
25
|
13
|
—
|
—
|
$154,092.60
|
$177,206.49
|
$160,256.30
|
2026-03-01
|
|
1907
|
OTHER
|
New Technology - Level 52
|
25
|
13
|
—
|
—
|
$154,092.60
|
$177,206.49
|
$160,256.30
|
2026-03-01
|
|
6023
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
15
|
9
|
—
|
—
|
$142,876.10
|
$172,492.20
|
$159,715.00
|
2026-03-01
|
|
01907
|
OTHER
|
New Technology - Level 52
|
4
|
2
|
—
|
—
|
$149,469.82
|
$157,917.30
|
$153,636.19
|
2026-03-01
|
|
01908
|
OTHER
|
New Technology - Level 52
|
4
|
2
|
—
|
—
|
$149,469.82
|
$157,917.30
|
$153,636.19
|
2026-03-01
|
|
5883
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
15
|
9
|
—
|
—
|
$133,733.97
|
$161,455.68
|
$149,496.00
|
2026-03-01
|
|
6303
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
15
|
9
|
—
|
—
|
$131,140.49
|
$158,323.68
|
$146,596.00
|
2026-03-01
|
|
5912
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
15
|
9
|
—
|
—
|
$130,037.30
|
$156,992.04
|
$145,363.00
|
2026-03-01
|
|
003
|
OTHER
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
4
|
2
|
—
|
—
|
$137,046.45
|
$153,678.20
|
$145,176.42
|
2026-03-01
|
|
1906
|
OTHER
|
New Technology - Level 51
|
25
|
13
|
—
|
—
|
$138,936.00
|
$159,776.40
|
$144,493.44
|
2026-03-01
|
|
1905
|
OTHER
|
New Technology - Level 51
|
25
|
13
|
—
|
—
|
$138,936.00
|
$159,776.40
|
$144,493.44
|
2026-03-01
|
|
5882
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
15
|
9
|
—
|
—
|
$128,147.49
|
$154,711.08
|
$143,251.00
|
2026-03-01
|
|
5881
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
15
|
9
|
—
|
—
|
$128,147.49
|
$154,711.08
|
$143,251.00
|
2026-03-01
|
|
01905
|
OTHER
|
New Technology - Level 51
|
4
|
2
|
—
|
—
|
$134,767.92
|
$142,384.50
|
$138,524.48
|
2026-03-01
|
|
01906
|
OTHER
|
New Technology - Level 51
|
4
|
2
|
—
|
—
|
$134,767.92
|
$142,384.50
|
$138,524.48
|
2026-03-01
|
|
6074
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
15
|
9
|
—
|
—
|
$123,889.55
|
$149,570.28
|
$138,491.00
|
2026-03-01
|
|
585010
|
CDM
|
Cage Spn Custm L5/s1
|
12
|
7
|
$228,800.00
|
$228,800.00
|
$39,000.00
|
$234,000.00
|
$136,500.00
|
2026-03-01
|
|
6134
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
15
|
9
|
—
|
—
|
$117,380.98
|
$141,712.20
|
$131,215.00
|
2026-03-01
|
|
6124
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
15
|
9
|
—
|
—
|
$115,876.88
|
$139,896.72
|
$129,534.00
|
2026-03-01
|
|
1904
|
OTHER
|
New Technology - Level 50
|
25
|
13
|
—
|
—
|
$123,779.40
|
$142,346.31
|
$128,730.58
|
2026-03-01
|
|
1903
|
OTHER
|
New Technology - Level 50
|
25
|
13
|
—
|
—
|
$123,779.40
|
$142,346.31
|
$128,730.58
|
2026-03-01
|
|
4404
|
APR_DRG
|
Kidney Transplant
|
15
|
9
|
—
|
—
|
$112,382.04
|
$135,677.16
|
$125,627.00
|
2026-03-01
|
|
112
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
15
|
9
|
—
|
—
|
$111,678.38
|
$134,827.20
|
$124,840.00
|
2026-03-01
|
|
01903
|
OTHER
|
New Technology - Level 50
|
4
|
2
|
—
|
—
|
$120,066.02
|
$126,851.70
|
$123,412.77
|
2026-03-01
|
|
01904
|
OTHER
|
New Technology - Level 50
|
4
|
2
|
—
|
—
|
$120,066.02
|
$126,851.70
|
$123,412.77
|
2026-03-01
|
|
A9699
|
HCPCS
|
Radiopharmaceutical, Therapeutic, Not Otherwise Classified
|
3
|
1
|
—
|
—
|
$76,785.37
|
$123,742.09
|
$123,321.96
|
2026-03-01
|
|
4403
|
APR_DRG
|
Kidney Transplant
|
15
|
9
|
—
|
—
|
$109,787.19
|
$132,544.08
|
$122,726.00
|
2026-03-01
|
|
5932
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
15
|
9
|
—
|
—
|
$109,395.95
|
$132,072.12
|
$122,289.00
|
2026-03-01
|
|
43
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
15
|
9
|
—
|
—
|
$108,914.86
|
$131,491.08
|
$121,751.00
|
2026-03-01
|
|
8504
|
APR_DRG
|
Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…
|
15
|
9
|
—
|
—
|
$108,884.45
|
$131,454.36
|
$121,717.00
|
2026-03-01
|
|
6313
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
15
|
9
|
—
|
—
|
$108,660.49
|
$131,184.36
|
$121,467.00
|
2026-03-01
|
|
6022
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
15
|
9
|
—
|
—
|
$107,831.02
|
$130,183.20
|
$120,540.00
|
2026-03-01
|
|
3034
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
15
|
9
|
—
|
—
|
$107,354.08
|
$129,607.56
|
$120,007.00
|
2026-03-01
|
|
6033
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
15
|
9
|
—
|
—
|
$104,605.77
|
$126,288.72
|
$116,934.00
|
2026-03-01
|
|
93
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
15
|
9
|
—
|
—
|
$102,894.30
|
$124,222.68
|
$115,021.00
|
2026-03-01
|
|
6904
|
APR_DRG
|
Acute Leukemia
|
15
|
9
|
—
|
—
|
$101,657.00
|
$122,729.04
|
$113,638.00
|
2026-03-01
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
15
|
9
|
—
|
—
|
$101,529.82
|
$122,575.68
|
$113,496.00
|
2026-03-01
|
|
1902
|
OTHER
|
New Technology - Level 49
|
25
|
13
|
—
|
—
|
$108,622.80
|
$124,916.22
|
$112,967.71
|
2026-03-01
|
|
1901
|
OTHER
|
New Technology - Level 49
|
25
|
13
|
—
|
—
|
$108,622.80
|
$124,916.22
|
$112,967.71
|
2026-03-01
|
|
453
|
MS_DRG
|
Combined Anterior And Posterior Spinal Fusion With Mcc
|
10
|
4
|
—
|
—
|
$96,500.00
|
$144,857.31
|
$112,869.51
|
2026-03-01
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
15
|
9
|
—
|
—
|
$100,458.42
|
$121,281.84
|
$112,298.00
|
2026-03-01
|
|
8413
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
15
|
9
|
—
|
—
|
$99,468.59
|
$120,087.36
|
$111,192.00
|
2026-03-01
|
|
6114
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
15
|
9
|
—
|
—
|
$99,445.09
|
$120,058.20
|
$111,165.00
|
2026-03-01
|
|
9104
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
15
|
9
|
—
|
—
|
$99,118.83
|
$119,665.08
|
$110,801.00
|
2026-03-01
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
69
|
22
|
—
|
—
|
$8,596.00
|
$206,087.05
|
$110,152.17
|
2026-03-01
|
|
6302
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
15
|
9
|
—
|
—
|
$97,815.18
|
$118,090.44
|
$109,343.00
|
2026-03-01
|
|
01901
|
OTHER
|
New Technology - Level 49
|
4
|
2
|
—
|
—
|
$105,364.12
|
$111,318.90
|
$108,301.07
|
2026-03-01
|
|
01902
|
OTHER
|
New Technology - Level 49
|
4
|
2
|
—
|
—
|
$105,364.12
|
$111,318.90
|
$108,301.07
|
2026-03-01
|
|
Q0480
|
HCPCS
|
Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only
|
29
|
15
|
—
|
—
|
$96,999.90
|
$115,820.01
|
$108,243.00
|
2026-03-01
|
|
004
|
OTHER
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
4
|
2
|
—
|
—
|
$96,360.63
|
$120,010.50
|
$107,875.52
|
2026-03-01
|
|
3124
|
APR_DRG
|
Skin Graft For Musculoskeletal And Connective Tissue Diagnoses
|
15
|
9
|
—
|
—
|
$96,388.49
|
$116,368.92
|
$107,749.00
|
2026-03-01
|
|
7
|
MS_DRG
|
Lung Transplant
|
55
|
22
|
—
|
—
|
$20,990.00
|
$190,608.39
|
$105,922.85
|
2026-03-01
|
|
3044
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
15
|
9
|
—
|
—
|
$94,318.97
|
$113,869.80
|
$105,435.00
|
2026-03-01
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
64
|
24
|
—
|
—
|
$19,893.00
|
$209,628.00
|
$105,123.07
|
2026-03-01
|
|
42
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
15
|
9
|
—
|
—
|
$93,879.35
|
$113,339.52
|
$104,944.00
|
2026-03-01
|
|
6254
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
15
|
9
|
—
|
—
|
$93,854.46
|
$113,309.28
|
$104,916.00
|
2026-03-01
|
|
5911
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
15
|
9
|
—
|
—
|
$93,756.31
|
$113,190.48
|
$104,806.00
|
2026-03-01
|
|
C1822
|
HCPCS
|
Pulse Gen Imp
|
48
|
7
|
$198,000.00
|
$198,000.00
|
$27,000.00
|
$202,500.00
|
$104,625.00
|
2026-03-01
|
|
204
|
APR_DRG
|
Open Craniotomy For Trauma
|
15
|
9
|
—
|
—
|
$93,593.18
|
$112,993.92
|
$104,624.00
|
2026-03-01
|
|
8904
|
APR_DRG
|
HIV With Multiple Major HIV Related Conditions
|
15
|
9
|
—
|
—
|
$93,503.32
|
$112,884.84
|
$104,523.00
|
2026-03-01
|
|
6073
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
15
|
9
|
—
|
—
|
$92,263.26
|
$111,387.96
|
$103,137.00
|
2026-03-01
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
72
|
23
|
—
|
—
|
$20,990.00
|
$210,166.00
|
$101,583.00
|
2026-03-01
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
72
|
23
|
—
|
—
|
$20,990.00
|
$167,336.00
|
$101,583.00
|
2026-03-01
|
|
6334
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
15
|
9
|
—
|
—
|
$90,170.24
|
$108,860.76
|
$100,797.00
|
2026-03-01
|
|
64654
|
CPT
|
Initial Open Implantation Of Baroreflex Activation Therapy (bat) Modulation Syst…
|
5
|
4
|
—
|
—
|
$1,995.00
|
$100,433.00
|
$100,433.00
|
2026-03-01
|
|
1634
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
15
|
9
|
—
|
—
|
$89,361.50
|
$107,884.44
|
$99,893.00
|
2026-03-01
|
|
1585
|
OTHER
|
New Technology - Level 48
|
25
|
13
|
—
|
—
|
$95,992.30
|
$110,391.14
|
$99,831.99
|
2026-03-01
|
|
1599
|
OTHER
|
New Technology - Level 48
|
25
|
13
|
—
|
—
|
$95,992.30
|
$110,391.14
|
$99,831.99
|
2026-03-01
|
|
593732
|
CDM
|
Graft Condyl Whole Rt
|
12
|
7
|
$167,176.00
|
$167,176.00
|
$28,495.80
|
$170,974.80
|
$99,735.30
|
2026-03-01
|
|
A9543
|
HCPCS
|
Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil…
|
9
|
2
|
—
|
—
|
$54,184.96
|
$173,512.94
|
$99,485.48
|
2026-03-01
|
|
4402
|
APR_DRG
|
Kidney Transplant
|
15
|
9
|
—
|
—
|
$88,873.50
|
$107,295.84
|
$99,348.00
|
2026-03-01
|
|
6084
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
15
|
9
|
—
|
—
|
$88,804.38
|
$107,212.68
|
$99,271.00
|
2026-03-01
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
80
|
24
|
—
|
—
|
$62,449.96
|
$146,581.00
|
$98,698.00
|
2026-03-01
|
|
651
|
OTHER
|
Kidney Transplant With Hemodialysis Without Mcc
|
4
|
2
|
—
|
—
|
$87,194.60
|
$107,554.20
|
$97,109.46
|
2026-03-01
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
72
|
24
|
—
|
—
|
$43,687.00
|
$173,680.00
|
$97,099.14
|
2026-03-01
|
|
3614
|
APR_DRG
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
15
|
9
|
—
|
—
|
$86,502.60
|
$104,432.76
|
$96,697.00
|
2026-03-01
|
|
01585
|
OTHER
|
New Technology - Level 48
|
4
|
2
|
—
|
—
|
$93,112.53
|
$98,374.91
|
$95,707.98
|
2026-03-01
|
|
01599
|
OTHER
|
New Technology - Level 48
|
4
|
2
|
—
|
—
|
$93,112.53
|
$98,374.91
|
$95,707.98
|
2026-03-01
|
|
6214
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
15
|
9
|
—
|
—
|
$85,507.24
|
$103,231.80
|
$95,585.00
|
2026-03-01
|
|
9504
|
APR_DRG
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
15
|
9
|
—
|
—
|
$85,312.31
|
$102,996.36
|
$95,367.00
|
2026-03-01
|
|
53
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
15
|
9
|
—
|
—
|
$85,232.13
|
$102,899.16
|
$95,277.00
|
2026-03-01
|
|
K1007
|
HCPCS
|
Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin…
|
29
|
15
|
—
|
—
|
$88,300.94
|
$104,686.68
|
$95,081.00
|
2026-03-01
|
|
84398
|
CDM
|
Ins/repl Sq Icd With Elec
|
14
|
10
|
$166,771.48
|
$166,771.48
|
$27,016.98
|
$162,101.88
|
$94,559.43
|
2026-03-01
|
|
209
|
MS_DRG
|
Complex Aortic Arch Procedures
|
33
|
21
|
—
|
—
|
$27,878.00
|
$197,434.00
|
$94,448.76
|
2026-03-01
|
|
1774
|
APR_DRG
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
15
|
9
|
—
|
—
|
$83,971.33
|
$101,377.44
|
$93,868.00
|
2026-03-01
|
|
6514
|
APR_DRG
|
Other Procedures Of Blood And Blood-forming Organs
|
15
|
9
|
—
|
—
|
$83,412.83
|
$100,703.52
|
$93,244.00
|
2026-03-01
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
76
|
24
|
—
|
—
|
$56,882.86
|
$133,355.00
|
$93,171.00
|
2026-03-01
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
57
|
22
|
—
|
—
|
$20,990.00
|
$350,637.00
|
$92,788.86
|
2026-03-01
|
|
772933
|
CDM
|
Stent Graft 10cm 21x21mm
|
12
|
7
|
$176,000.00
|
$176,000.00
|
$26,400.00
|
$158,400.00
|
$92,400.00
|
2026-03-01
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
72
|
24
|
—
|
—
|
$57,125.89
|
$133,933.00
|
$91,714.22
|
2026-03-01
|
|
4414
|
APR_DRG
|
Major Bladder Procedures
|
15
|
9
|
—
|
—
|
$81,886.60
|
$98,859.96
|
$91,537.00
|
2026-03-01
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
61
|
22
|
—
|
—
|
$8,596.00
|
$189,677.00
|
$91,353.72
|
2026-03-01
|
|
1834
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
15
|
9
|
—
|
—
|
$80,841.47
|
$97,598.52
|
$90,369.00
|
2026-03-01
|
|
1623
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
15
|
9
|
—
|
—
|
$80,535.95
|
$97,230.24
|
$90,028.00
|
2026-03-01
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
68
|
23
|
—
|
—
|
$53,102.92
|
$179,233.00
|
$89,641.00
|
2026-03-01
|
|
1598
|
OTHER
|
New Technology - Level 47
|
25
|
13
|
—
|
—
|
$85,887.91
|
$98,771.10
|
$89,323.43
|
2026-03-01
|
|
1584
|
OTHER
|
New Technology - Level 47
|
25
|
13
|
—
|
—
|
$85,887.91
|
$98,771.10
|
$89,323.43
|
2026-03-01
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
72
|
23
|
—
|
—
|
$20,990.00
|
$142,500.00
|
$89,133.50
|
2026-03-01
|
|
222
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…
|
4
|
1
|
—
|
—
|
$85,554.85
|
$92,690.80
|
$89,122.83
|
2026-03-01
|
|
1694
|
APR_DRG
|
Major Abdominal Vascular Procedures
|
15
|
9
|
—
|
—
|
$79,503.26
|
$95,982.84
|
$88,873.00
|
2026-03-01
|
|
9114
|
APR_DRG
|
Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma
|
15
|
9
|
—
|
—
|
$78,691.76
|
$95,003.28
|
$87,966.00
|
2026-03-01
|
|
J9029
|
HCPCS
|
Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose
|
15
|
5
|
—
|
—
|
$54,600.00
|
$170,328.19
|
$87,600.00
|
2026-03-01
|
|
1674
|
APR_DRG
|
Other Cardiothoracic And Thoracic Circulatory Procedures
|
15
|
9
|
—
|
—
|
$78,059.98
|
$94,240.80
|
$87,260.00
|
2026-03-01
|
|
6144
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition…
|
15
|
9
|
—
|
—
|
$77,736.49
|
$93,849.84
|
$86,898.00
|
2026-03-01
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
72
|
24
|
—
|
—
|
$50,439.00
|
$147,043.00
|
$86,287.04
|
2026-03-01
|
|
1304
|
APR_DRG
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
15
|
9
|
—
|
—
|
$77,010.70
|
$92,973.96
|
$86,087.00
|
2026-03-01
|
|
01598
|
OTHER
|
New Technology - Level 47
|
4
|
2
|
—
|
—
|
$83,311.27
|
$88,019.72
|
$85,633.52
|
2026-03-01
|
|
01584
|
OTHER
|
New Technology - Level 47
|
4
|
2
|
—
|
—
|
$83,311.27
|
$88,019.72
|
$85,633.52
|
2026-03-01
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
72
|
24
|
—
|
—
|
$56,680.00
|
$170,641.00
|
$85,517.00
|
2026-03-01
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
72
|
23
|
—
|
—
|
$20,990.00
|
$134,515.00
|
$85,510.31
|
2026-03-01
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
55
|
22
|
—
|
—
|
$20,990.00
|
$155,320.48
|
$85,257.35
|
2026-03-01
|
|
234
|
APR_DRG
|
Spinal Procedures
|
15
|
9
|
—
|
—
|
$76,170.18
|
$91,958.76
|
$85,147.00
|
2026-03-01
|
|
6123
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
15
|
9
|
—
|
—
|
$75,843.92
|
$91,565.64
|
$84,783.00
|
2026-03-01
|
|
1204
|
APR_DRG
|
Major Respiratory And Chest Procedures
|
15
|
9
|
—
|
—
|
$75,778.94
|
$91,486.80
|
$84,710.00
|
2026-03-01
|
|
007
|
OTHER
|
Lung Transplant
|
4
|
2
|
—
|
—
|
$77,252.93
|
$92,236.27
|
$84,555.69
|
2026-03-01
|
|
1784
|
APR_DRG
|
External Heart Assist Devices
|
15
|
9
|
—
|
—
|
$75,519.04
|
$91,172.52
|
$84,419.00
|
2026-03-01
|
|
4014
|
APR_DRG
|
Adrenal Procedures
|
15
|
9
|
—
|
—
|
$75,469.27
|
$91,113.12
|
$84,364.00
|
2026-03-01
|
|
2304
|
APR_DRG
|
Major Small Bowel Procedures
|
15
|
9
|
—
|
—
|
$75,324.12
|
$90,937.08
|
$84,201.00
|
2026-03-01
|
|
014
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
4
|
2
|
—
|
—
|
$76,370.32
|
$92,304.75
|
$84,133.95
|
2026-03-01
|
|
914
|
APR_DRG
|
Other Major Head And Neck Procedures
|
15
|
9
|
—
|
—
|
$75,207.99
|
$90,797.76
|
$84,072.00
|
2026-03-01
|
|
585009
|
CDM
|
Cage Spn Custm L4/l5
|
12
|
7
|
$140,800.00
|
$140,800.00
|
$24,000.00
|
$144,000.00
|
$84,000.00
|
2026-03-01
|
|
274
|
APR_DRG
|
Other Open Craniotomy
|
15
|
9
|
—
|
—
|
$74,538.89
|
$89,989.92
|
$83,324.00
|
2026-03-01
|
|
9124
|
APR_DRG
|
Musculoskeletal And Other Procedures For Multiple Significant Trauma
|
15
|
9
|
—
|
—
|
$74,111.71
|
$89,473.68
|
$82,846.00
|
2026-03-01
|
|
Q2043
|
HCPCS
|
Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm…
|
17
|
5
|
—
|
—
|
$47,690.07
|
$147,108.87
|
$82,597.20
|
2026-03-01
|
|
224
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh…
|
4
|
1
|
—
|
—
|
$79,214.72
|
$85,821.86
|
$82,518.29
|
2026-03-01
|
|
214
|
APR_DRG
|
Open Craniotomy Except Trauma
|
15
|
9
|
—
|
—
|
$73,720.48
|
$89,001.72
|
$82,409.00
|
2026-03-01
|
|
41
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
15
|
9
|
—
|
—
|
$72,639.40
|
$87,696.00
|
$81,200.00
|
2026-03-01
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
80
|
24
|
—
|
—
|
$26,741.00
|
$138,171.38
|
$81,016.10
|
2026-03-01
|
|
924
|
APR_DRG
|
Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures
|
15
|
9
|
—
|
—
|
$72,011.77
|
$86,938.92
|
$80,499.00
|
2026-03-01
|
|
52
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
15
|
9
|
—
|
—
|
$71,830.67
|
$86,719.68
|
$80,296.00
|
2026-03-01
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
80
|
24
|
—
|
—
|
$44,021.68
|
$123,073.00
|
$80,218.84
|
2026-03-01
|
|
1783
|
APR_DRG
|
External Heart Assist Devices
|
15
|
9
|
—
|
—
|
$71,634.36
|
$86,483.16
|
$80,077.00
|
2026-03-01
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
72
|
24
|
—
|
—
|
$26,741.00
|
$139,640.00
|
$79,908.07
|
2026-03-01
|
|
002
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
4
|
2
|
—
|
—
|
$77,112.80
|
$81,748.55
|
$79,396.91
|
2026-03-01
|
|
454
|
MS_DRG
|
Combined Anterior And Posterior Spinal Fusion With Cc
|
10
|
4
|
—
|
—
|
$60,830.00
|
$118,330.00
|
$79,028.72
|
2026-03-01
|
|
1583
|
OTHER
|
New Technology - Level 46
|
25
|
13
|
—
|
—
|
$75,783.51
|
$87,151.04
|
$78,814.85
|
2026-03-01
|
|
1597
|
OTHER
|
New Technology - Level 46
|
25
|
13
|
—
|
—
|
$75,783.51
|
$87,151.04
|
$78,814.85
|
2026-03-01
|
|
894
|
APR_DRG
|
Major Cranial Or Facial Bone Procedures
|
15
|
9
|
—
|
—
|
$70,372.18
|
$84,959.28
|
$78,666.00
|
2026-03-01
|
|
1603
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
15
|
9
|
—
|
—
|
$70,218.73
|
$84,773.52
|
$78,494.00
|
2026-03-01
|
|
484138
|
CDM
|
Stent Eprsth 40mm 15cm
|
12
|
7
|
$149,000.00
|
$149,000.00
|
$22,350.00
|
$134,100.00
|
$78,225.00
|
2026-03-01
|
|
460202
|
CDM
|
Stent Eprsth 34mm 10cm
|
12
|
7
|
$149,000.00
|
$149,000.00
|
$22,350.00
|
$134,100.00
|
$78,225.00
|
2026-03-01
|
|
441242
|
CDM
|
Stent Eprsth 31mm 10cm
|
12
|
7
|
$149,000.00
|
$149,000.00
|
$22,350.00
|
$134,100.00
|
$78,225.00
|
2026-03-01
|
|
482347
|
CDM
|
Stent Eprsth 28mm 10cm
|
12
|
7
|
$149,000.00
|
$149,000.00
|
$22,350.00
|
$134,100.00
|
$78,225.00
|
2026-03-01
|
|
1654
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
15
|
9
|
—
|
—
|
$69,756.99
|
$84,216.24
|
$77,978.00
|
2026-03-01
|
|
1782
|
APR_DRG
|
External Heart Assist Devices
|
15
|
9
|
—
|
—
|
$69,672.66
|
$84,114.72
|
$77,884.00
|
2026-03-01
|
|
224
|
APR_DRG
|
Ventricular Shunt Procedures
|
15
|
9
|
—
|
—
|
$69,186.04
|
$83,527.20
|
$77,340.00
|
2026-03-01
|
|
4044
|
APR_DRG
|
Thyroid, Parathyroid And Thyroglossal Procedures
|
15
|
9
|
—
|
—
|
$69,118.30
|
$83,445.12
|
$77,264.00
|
2026-03-01
|
|
459
|
MS_DRG
|
Spinal Fusion Except Cervical With Mcc
|
10
|
4
|
—
|
—
|
$55,398.00
|
$108,418.21
|
$77,189.96
|
2026-03-01
|
|
4054
|
APR_DRG
|
Other Procedures For Endocrine, Nutritional And Metabolic Disorders
|
15
|
9
|
—
|
—
|
$68,941.35
|
$83,231.28
|
$77,066.00
|
2026-03-01
|
|
1214
|
APR_DRG
|
Other Respiratory And Chest Procedures
|
15
|
9
|
—
|
—
|
$68,369.02
|
$82,541.16
|
$76,427.00
|
2026-03-01
|
|
6113
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
15
|
9
|
—
|
—
|
$68,348.28
|
$82,515.24
|
$76,403.00
|
2026-03-01
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
72
|
23
|
—
|
—
|
$20,990.00
|
$136,107.00
|
$76,150.41
|
2026-03-01
|
|
C1820
|
HCPCS
|
Device Neurostimulator
|
144
|
7
|
$164,120.00
|
$164,120.00
|
$14,251.50
|
$170,100.00
|
$76,101.00
|
2026-03-01
|
|
6072
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
15
|
9
|
—
|
—
|
$67,850.60
|
$81,914.76
|
$75,847.00
|
2026-03-01
|
|
6083
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
15
|
9
|
—
|
—
|
$67,827.10
|
$81,886.68
|
$75,821.00
|
2026-03-01
|
|
1794
|
APR_DRG
|
Defibrillator Implants
|
15
|
9
|
—
|
—
|
$67,623.88
|
$81,641.52
|
$75,594.00
|
2026-03-01
|
|
01583
|
OTHER
|
New Technology - Level 46
|
4
|
2
|
—
|
—
|
$73,510.00
|
$77,664.52
|
$75,559.04
|
2026-03-01
|
|
01597
|
OTHER
|
New Technology - Level 46
|
4
|
2
|
—
|
—
|
$73,510.00
|
$77,664.52
|
$75,559.04
|
2026-03-01
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
72
|
23
|
—
|
—
|
$20,990.00
|
$136,107.00
|
$75,409.10
|
2026-03-01
|
|
264
|
APR_DRG
|
Other Nervous System And Related Procedures
|
15
|
9
|
—
|
—
|
$66,895.32
|
$80,761.32
|
$74,779.00
|
2026-03-01
|
|
226
|
MS_DRG
|
Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc
|
4
|
1
|
—
|
—
|
$71,523.66
|
$77,489.30
|
$74,506.48
|
2026-03-01
|
|
2614
|
APR_DRG
|
Major Biliary Tract Procedures
|
15
|
9
|
—
|
—
|
$66,505.47
|
$80,290.44
|
$74,343.00
|
2026-03-01
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
72
|
24
|
—
|
—
|
$45,262.57
|
$136,211.00
|
$73,778.76
|
2026-03-01
|
|
2324
|
APR_DRG
|
Gastric Fundoplication
|
15
|
9
|
—
|
—
|
$65,989.82
|
$79,668.36
|
$73,767.00
|
2026-03-01
|
|
4474
|
APR_DRG
|
Other Kidney, Urinary Tract And Related Non-percutaneous Procedures
|
15
|
9
|
—
|
—
|
$65,799.04
|
$79,438.32
|
$73,554.00
|
2026-03-01
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
72
|
24
|
—
|
—
|
$49,027.08
|
$114,693.00
|
$73,484.74
|
2026-03-01
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
72
|
24
|
—
|
—
|
$45,612.57
|
$114,693.00
|
$73,286.34
|
2026-03-01
|
|
6234
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
15
|
9
|
—
|
—
|
$65,452.05
|
$79,019.28
|
$73,166.00
|
2026-03-01
|
|
2294
|
APR_DRG
|
Other Digestive System And Abdominal Procedures
|
15
|
9
|
—
|
—
|
$65,071.87
|
$78,560.28
|
$72,741.00
|
2026-03-01
|
|
8412
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
15
|
9
|
—
|
—
|
$64,637.79
|
$78,036.48
|
$72,256.00
|
2026-03-01
|
|
8411
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
15
|
9
|
—
|
—
|
$64,637.79
|
$78,036.48
|
$72,256.00
|
2026-03-01
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
72
|
24
|
—
|
—
|
$39,903.99
|
$108,155.00
|
$71,669.54
|
2026-03-01
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
68
|
23
|
—
|
—
|
$8,596.00
|
$151,048.00
|
$71,598.22
|
2026-03-01
|
|
92
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
15
|
9
|
—
|
—
|
$63,755.78
|
$76,971.60
|
$71,270.00
|
2026-03-01
|
|
91
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
15
|
9
|
—
|
—
|
$63,755.78
|
$76,971.60
|
$71,270.00
|
2026-03-01
|
|
1814
|
APR_DRG
|
Lower Extremity Vascular Procedures
|
15
|
9
|
—
|
—
|
$63,616.16
|
$76,803.12
|
$71,114.00
|
2026-03-01
|
|
111
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
15
|
9
|
—
|
—
|
$63,509.71
|
$76,674.60
|
$70,995.00
|
2026-03-01
|
|
C1767
|
HCPCS
|
Neurostim Rechargeable
|
120
|
7
|
$168,000.00
|
$168,000.00
|
$12,825.00
|
$194,400.00
|
$70,860.13
|
2026-03-01
|
|
6133
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
15
|
9
|
—
|
—
|
$63,086.68
|
$76,163.76
|
$70,522.00
|
2026-03-01
|
|
005
|
OTHER
|
Liver Transplant With Mcc Or Intestinal Transplant
|
4
|
2
|
—
|
—
|
$63,386.71
|
$77,903.00
|
$70,456.51
|
2026-03-01
|
|
9514
|
APR_DRG
|
Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
15
|
9
|
—
|
—
|
$62,818.48
|
$75,839.76
|
$70,222.00
|
2026-03-01
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically
|
72
|
23
|
—
|
—
|
$20,990.00
|
$103,989.00
|
$69,654.73
|
2026-03-01
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
76
|
24
|
—
|
—
|
$43,838.12
|
$102,366.00
|
$69,350.00
|
2026-03-01
|
|
1764
|
APR_DRG
|
Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices
|
15
|
9
|
—
|
—
|
$61,877.03
|
$74,702.52
|
$69,169.00
|
2026-03-01
|
|
7104
|
APR_DRG
|
Infectious And Parasitic Diseases Including HIV With O.r. Procedure
|
15
|
9
|
—
|
—
|
$61,810.68
|
$74,622.60
|
$69,095.00
|
2026-03-01
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
76
|
24
|
—
|
—
|
$40,848.23
|
$120,000.00
|
$69,090.00
|
2026-03-01
|
|
L8702
|
HCPCS
|
Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge…
|
29
|
15
|
—
|
—
|
$63,895.55
|
$75,752.45
|
$68,801.70
|
2026-03-01
|
|
6954
|
APR_DRG
|
Chemotherapy For Acute Leukemia
|
15
|
9
|
—
|
—
|
$61,346.17
|
$74,062.08
|
$68,576.00
|
2026-03-01
|
|
2634
|
APR_DRG
|
Cholecystectomy
|
15
|
9
|
—
|
—
|
$61,296.41
|
$74,001.60
|
$68,520.00
|
2026-03-01
|
|
2604
|
APR_DRG
|
Major Pancreas, Liver And Shunt Procedures
|
15
|
9
|
—
|
—
|
$61,140.19
|
$73,813.68
|
$68,346.00
|
2026-03-01
|
|
1582
|
OTHER
|
New Technology - Level 45
|
25
|
13
|
—
|
—
|
$65,679.10
|
$75,530.96
|
$68,306.26
|
2026-03-01
|
|
1596
|
OTHER
|
New Technology - Level 45
|
25
|
13
|
—
|
—
|
$65,679.10
|
$75,530.96
|
$68,306.26
|
2026-03-01
|
|
612286
|
CDM
|
Graft Endovasc 10x45mm
|
12
|
7
|
$130,000.00
|
$130,000.00
|
$19,500.00
|
$117,000.00
|
$68,250.00
|
2026-03-01
|
|
6032
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
15
|
9
|
—
|
—
|
$60,845.73
|
$73,458.36
|
$68,017.00
|
2026-03-01
|
|
2204
|
APR_DRG
|
Major Stomach, Esophageal And Duodenal Procedures
|
15
|
9
|
—
|
—
|
$60,508.41
|
$73,051.20
|
$67,640.00
|
2026-03-01
|
|
1633
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
15
|
9
|
—
|
—
|
$60,421.32
|
$72,945.36
|
$67,542.00
|
2026-03-01
|
|
1673
|
APR_DRG
|
Other Cardiothoracic And Thoracic Circulatory Procedures
|
15
|
9
|
—
|
—
|
$60,050.82
|
$72,498.24
|
$67,128.00
|
2026-03-01
|
|
1773
|
APR_DRG
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
15
|
9
|
—
|
—
|
$60,050.82
|
$72,498.24
|
$67,128.00
|
2026-03-01
|
|
5114
|
APR_DRG
|
Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy
|
15
|
9
|
—
|
—
|
$60,041.14
|
$72,486.36
|
$67,117.00
|
2026-03-01
|
|
5104
|
APR_DRG
|
Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…
|
15
|
9
|
—
|
—
|
$60,027.32
|
$72,470.16
|
$67,102.00
|
2026-03-01
|
|
5244
|
OTHER
|
Level 4 Blood Product Exc
|
25
|
13
|
—
|
—
|
$52,609.74
|
$71,237.40
|
$66,577.01
|
2026-03-01
|
|
8633
|
APR_DRG
|
Neonatal Aftercare
|
15
|
9
|
—
|
—
|
$59,380.33
|
$71,689.32
|
$66,379.00
|
2026-03-01
|
|
294
|
APR_DRG
|
Other Percutaneous Intracranial Procedures
|
15
|
9
|
—
|
—
|
$59,374.80
|
$71,681.76
|
$66,372.00
|
2026-03-01
|
|
J9226
|
HCPCS
|
Histrelin Implant (supprelin La), 50 Mg
|
17
|
5
|
—
|
—
|
$38,337.72
|
$117,019.36
|
$66,009.58
|
2026-03-01
|
|
6092
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
15
|
9
|
—
|
—
|
$58,845.32
|
$71,042.40
|
$65,780.00
|
2026-03-01
|
|
6091
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
15
|
9
|
—
|
—
|
$58,845.32
|
$71,042.40
|
$65,780.00
|
2026-03-01
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
72
|
24
|
—
|
—
|
$20,990.00
|
$132,914.00
|
$65,649.25
|
2026-03-01
|
|
5894
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational
|
15
|
9
|
—
|
—
|
$58,727.82
|
$70,900.92
|
$65,649.00
|
2026-03-01
|