Price Transparency 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

HENRICO DOCTORS' HOSPITAL

Richmond, VA · CCN 490118 · Rates published

29,247 distinct procedures filed
39 distinct payers
594,983 rate rows
2026-03-01 last MRF observed
Data quality

574,956 of 594,983 rate rows are consumer-grade (96.6%)

20,027 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 13,122
per-diem day rate — not a per-procedure price 6,147
template filing: same amount across many unrelated codes — excluded 623
placeholder amount (≤ $0.02) — excluded from medians 119
exceeds 10× this hospital's gross charge — excluded from medians 16
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1113733_RETREAT-DOCTORS-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.hcavirginia.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-06-08

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 19 $5,093.15 $4,820,350.00 $4,530,678.50 nat. median
$9,966
outlier · 454.6×
00845
OTHER 		Inj, Atidarsagene Autotem 4 $3,829,250.00 $4,505,000.00 $4,212,175.00 nat. median
$4,505,000
0.9× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 15 $3,685,267.00 $3,943,235.69 $3,758,972.34 nat. median
$3,746,358
1.0× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 4 $3,132,476.95 $3,685,267.00 $3,445,724.65 nat. median
$3,574,709
1.0× median
908
OTHER 		Topi Adm Prad Zami Per Tr 19 $9,221.88 $3,569,327.40 $3,354,834.17 nat. median
$22,747
outlier · 147.5×
714
OTHER 		Inj Delandistrogene Mox R 19 $5,990.23 $3,560,810.20 $3,346,828.80 nat. median
$13,041
outlier · 256.6×
748
OTHER 		Inj, Lovotibeglogene Auto 19 $11,402.35 $3,480,183.56 $3,271,047.29 nat. median
$17,963
outlier · 182.1×
906
OTHER 		Inj Elivaldogene Autoteme 19 $8,148.61 $3,402,600.00 $3,198,126.00 nat. median
$20,756
outlier · 154.1×
00908
OTHER 		Topi Adm Prad Zami Per Tr 4 $2,835,447.00 $3,335,820.00 $3,118,991.70 nat. median
$12,675
outlier · 246.1×
00714
OTHER 		Inj Delandistrogene Mox R 4 $2,828,681.00 $3,327,860.00 $3,111,549.10 nat. median
$3,228,024
1.0× median
00748
OTHER 		Inj, Lovotibeglogene Auto 4 $2,764,631.80 $3,252,508.00 $3,041,094.98 nat. median
$3,187,420
1.0× median
00906
OTHER 		Inj Elivaldogene Autoteme 4 $2,703,000.00 $3,180,000.00 $2,973,300.00 nat. median
$21
outlier · 143707.1×
746
OTHER 		Inj, Betibeglogene Autote 19 $10,547.29 $3,145,766.83 $2,956,726.83 nat. median
$21,896
outlier · 135.0×
00746
OTHER 		Inj, Betibeglogene Autote 4 $2,498,973.65 $2,939,969.00 $2,748,871.02 nat. median
$2,878,960
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 15 $2,588,981.00 $2,770,209.67 $2,640,760.62 nat. median
$2,588,981
1.0× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 4 $2,200,633.85 $2,588,981.00 $2,420,697.23 nat. median
$2,457,321
1.0× median
824
OTHER 		Inj, Exagamglogene Autote 19 $12,350.61 $2,495,240.00 $2,345,292.40 nat. median
$25,250
outlier · 92.9×
00824
OTHER 		Inj, Exagamglogene Autote 4 $1,982,200.00 $2,332,000.00 $2,180,420.00 nat. median
$2,332,000
0.9× median
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 1 $2,042,143.00 $2,042,143.00 $2,042,143.00 nat. median
$824,563
outlier · 2.5×
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 5 $470,193.65 $1,557,271.36 $1,055,220.18 nat. median
$675,122
1.6× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 5 $491,955.35 $1,501,307.95 $1,040,039.47 nat. median
$754,974
1.4× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 5 $448,478.70 $1,478,916.58 $1,003,269.29 nat. median
$625,184
1.6× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 5 $438,975.70 $1,489,833.29 $1,003,137.65 nat. median
$674,188
1.5× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 5 $427,414.85 $1,410,309.44 $956,575.22 nat. median
$634,511
1.5× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 5 $415,989.15 $1,297,043.03 $893,221.02 nat. median
$620,080
1.4× median
2067
OTHER 		Afamitresgene Autoleucel 15 $770,620.00 $824,563.40 $786,032.40 nat. median
$786,032
1.0× median
Q2058
HCPCS 		Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,… 1 $737,362.50 $737,362.50 $737,362.50 nat. median
$324,450
outlier · 2.3×
9498
OTHER 		Ciltacabtagene Car-pos T 14 $587,649.60 $628,785.07 $599,402.59 nat. median
$587,650
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos 15 $566,531.30 $606,188.49 $577,861.93 nat. median
$566,531
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 15 $562,201.20 $601,555.28 $573,445.22 nat. median
$562,201
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 14 $558,081.80 $597,147.53 $569,243.44 nat. median
$558,082
1.0× median
09498
OTHER 		Ciltacabtagene Car-pos T 4 $499,502.16 $587,649.60 $549,452.38 nat. median
$554,552
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 15 $532,192.20 $569,445.65 $542,836.04 nat. median
$532,192
1.0× median
J3402
HCPCS 		Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 $534,422.90 $534,422.90 $534,422.90 nat. median
$209,753
outlier · 2.5×
09194
OTHER 		Tisagenlecleucel Car-pos 4 $481,551.61 $566,531.30 $529,706.77 nat. median
$538,205
1.0× median
09413
OTHER 		Lisocabtagene Car Pos T 4 $477,871.02 $562,201.20 $525,658.12 nat. median
$534,091
1.0× median
09422
OTHER 		Idecabtagene Vicleucel Ca 4 $474,369.53 $558,081.80 $521,806.48 nat. median
$530,178
1.0× median
9391
OTHER 		Brexucabtagene Car Pos T 15 $489,450.20 $523,711.71 $499,239.20 nat. median
$489,450
1.0× median
09035
OTHER 		Axicabtagene Ciloleucel C 4 $452,363.37 $532,192.20 $497,599.70 nat. median
$505,583
1.0× median
5834
APR_DRG 		Neonate With Ecmo 6 $488,670.66 $513,104.19 $490,063.37 nat. median
$309,665
1.6× median
09391
OTHER 		Brexucabtagene Car Pos T 4 $416,032.67 $489,450.20 $457,635.93 nat. median
$464,978
1.0× median
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 6 $447,536.35 $469,913.17 $448,811.83 nat. median
$93,260
outlier · 4.8×
5892
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 6 $431,702.40 $453,287.52 $432,932.75 nat. median
$89,790
outlier · 4.8×
5833
APR_DRG 		Neonate With Ecmo 6 $429,225.92 $450,687.22 $430,449.21 nat. median
$244,017
1.8× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 6 $345,233.49 $362,495.16 $346,217.41 nat. median
$246,434
1.4× median
1614
APR_DRG 		Implantable Heart Assist Systems 6 $334,363.03 $351,081.18 $335,315.97 nat. median
$207,730
1.6× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 21 $5,284.00 $917,850.41 $323,314.18 nat. median
$370,174
0.9× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 6 $302,613.55 $317,744.23 $303,476.00 nat. median
$150,721
outlier · 2.0×
5832
APR_DRG 		Neonate With Ecmo 6 $295,335.43 $310,102.20 $296,177.14 nat. median
$156,126
1.9× median
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 6 $288,877.11 $303,320.97 $289,700.41 nat. median
$162,982
1.8× median

Other procedures at this hospital

Browse this hospital's 29,247 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
             
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 40 22 — — $27,878.00 $238,258.00 $63,674.24 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 39 21 — — $53,165.00 $178,614.27 $67,959.34 2026-03-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 39 21 — — $43,383.14 $141,828.00 $67,460.00 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 39 21 — — $55,468.74 $162,498.73 $67,164.00 2026-03-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 39 21 — — $39,787.86 $116,109.69 $61,953.00 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 38 20 — — $8,777.00 $294,411.51 $106,046.50 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 37 20 — — $79,724.73 $234,255.61 $101,189.00 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 37 20 — — $65,271.72 $191,499.05 $101,189.00 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 37 20 — — $52,403.70 $153,431.34 $89,308.00 2026-03-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 37 20 — — $40,932.40 $136,108.00 $79,744.00 2026-03-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 37 20 — — $41,974.92 $136,108.00 $79,744.00 2026-03-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 37 20 — — $29,425.90 $136,108.00 $62,124.77 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 35 21 — — $8,777.00 $329,881.00 $158,315.93 2026-03-01
215 MS_DRG Other Heart Assist System Implant 35 21 — — $56,789.00 $211,636.04 $76,757.15 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 35 21 — — $63,456.00 $207,933.41 $75,424.32 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 35 21 — — $61,106.68 $179,177.52 $67,032.00 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 35 21 — — $55,706.56 $163,202.27 $63,611.00 2026-03-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 35 21 — — $47,781.70 $139,758.00 $63,456.00 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 35 21 — — $46,345.61 $139,758.00 $62,944.28 2026-03-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 35 21 — — $44,098.04 $136,211.00 $62,086.82 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 34 21 — — $5,284.00 $917,850.41 $323,314.18 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 34 21 — — $28,998.00 $595,647.99 $225,227.97 2026-03-01
7 MS_DRG Lung Transplant 34 21 — — $7,312.00 $275,256.50 $96,877.73 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 34 21 — — $28,998.00 $375,797.00 $91,432.01 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 34 21 — — $5,284.00 $255,440.46 $90,384.18 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 34 21 — — $7,312.00 $219,149.68 $77,622.88 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 33 20 — — $27,878.00 $240,581.09 $84,802.02 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 33 20 — — $7,312.00 $231,129.00 $82,976.21 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 33 20 — — $51,770.00 $186,850.00 $82,413.16 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 33 20 — — $7,312.00 $184,057.67 $64,920.33 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 28 18 — — $7,312.00 $453,804.88 $157,685.95 2026-03-01
33151 CDM Kidney Acq-cadav Donor 21 14 $299,736.00 $299,736.00 $42,862.25 $299,736.00 $98,912.88 2026-03-01
33157 CDM Kidney Acq-living Donor 21 14 $299,736.00 $299,736.00 $42,862.25 $299,736.00 $98,912.88 2026-03-01
845 OTHER Inj, Atidarsagene Autotem 20 19 — — $5,093.15 $4,820,350.00 $4,530,678.50 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 20 19 — — $9,221.88 $3,569,327.40 $3,354,834.17 2026-03-01
714 OTHER Inj Delandistrogene Mox R 20 19 — — $5,990.23 $3,560,810.20 $3,346,828.80 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 20 19 — — $11,402.35 $3,480,183.56 $3,271,047.29 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 20 19 — — $8,148.61 $3,402,600.00 $3,198,126.00 2026-03-01
746 OTHER Inj, Betibeglogene Autote 20 19 — — $10,547.29 $3,145,766.83 $2,956,726.83 2026-03-01
824 OTHER Inj, Exagamglogene Autote 20 19 — — $12,350.61 $2,495,240.00 $2,345,292.40 2026-03-01
831 OTHER Obecbtge Autol Up To 400 20 19 — — $3,487.57 $297,727.50 $279,836.03 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 20 19 — — $7,631.38 $215,785.83 $202,818.52 2026-03-01
J9999 HCPCS Carmustine 7.7mg Implant 20 13 $392,397.00 $392,397.00 $56,112.77 $392,397.00 $133,414.98 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 20 19 — — $92,006.55 $115,820.01 $108,859.99 2026-03-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 20 19 — — $80,818.85 $101,736.67 $95,622.96 2026-03-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 20 19 — — $58,481.44 $73,617.82 $69,193.87 2026-03-01
717 OTHER Instill Adstiladrin, Tx D 20 19 — — $11,306.44 $68,774.03 $64,641.15 2026-03-01
77145 CDM Tavr/tavi Perc Fem Aprch 17 12 $375,803.00 $375,803.00 $53,739.83 $375,803.00 $169,111.35 2026-03-01
118585 CDM Ttvr - Initial Device 17 12 $375,803.00 $375,803.00 $53,739.83 $375,803.00 $169,111.35 2026-03-01
83096 CDM Tmvr Perc Initial Device 17 12 $375,803.00 $375,803.00 $53,739.83 $375,803.00 $169,111.35 2026-03-01
88556 CDM Ins/repl Ccm System 17 12 $192,476.00 $192,476.00 $27,524.07 $192,476.00 $86,614.20 2026-03-01
74727 CDM Revsc Fem/pop W Stnt/ath 17 12 $178,089.00 $178,089.00 $25,466.73 $178,089.00 $80,140.05 2026-03-01
74731 CDM Revsc Tib/per St/ath Ini 17 12 $177,487.00 $177,487.00 $25,380.64 $177,487.00 $79,869.15 2026-03-01
126092 CDM Revsc Low Ext Ivl St/ath 17 12 $177,435.00 $177,435.00 $25,373.21 $177,435.00 $79,845.75 2026-03-01
116048 CDM Revsc Tib/per Ivl/ath 17 12 $177,435.00 $177,435.00 $25,373.21 $177,435.00 $79,845.75 2026-03-01
116049 CDM Revsc Tib/per Ivl St/ath 17 12 $177,435.00 $177,435.00 $25,373.21 $177,435.00 $79,845.75 2026-03-01
116047 CDM Revsc Tib/per Ivl/stnt 17 12 $177,435.00 $177,435.00 $25,373.21 $177,435.00 $79,845.75 2026-03-01
116046 CDM Revsc Tib/per Ivl Angio 17 12 $163,382.00 $163,382.00 $23,363.63 $163,382.00 $73,521.90 2026-03-01
113647 CDM Revsc Low Extr Ivl/ather 17 12 $163,382.00 $163,382.00 $23,363.63 $163,382.00 $73,521.90 2026-03-01
126094 CDM Revsc Low Extr Ivl/stnt 17 12 $163,382.00 $163,382.00 $23,363.63 $163,382.00 $73,521.90 2026-03-01
74713 CDM Revsc Iliac W Stnt Init 17 12 $163,382.00 $163,382.00 $23,363.63 $163,382.00 $73,521.90 2026-03-01
74672 CDM Revsc Iliac W Stnt Init 17 12 $163,382.00 $163,382.00 $23,363.63 $163,382.00 $73,521.90 2026-03-01
74725 CDM Revsc Fem/pop W Stnt 17 12 $163,192.00 $163,192.00 $23,336.46 $163,192.00 $73,436.40 2026-03-01
74730 CDM Revsc Tib/per Stnt Init 17 12 $162,553.00 $162,553.00 $23,245.08 $162,553.00 $73,148.85 2026-03-01
74681 CDM Revsc Tib/per Stnt Init 17 12 $162,553.00 $162,553.00 $23,245.08 $162,553.00 $73,148.85 2026-03-01
123099 CDM Imp Wrls P-art Pres Snsr 17 12 $154,741.00 $154,741.00 $22,127.96 $154,741.00 $69,633.45 2026-03-01
33240 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Singl… 17 8 — — $4,250.00 $162,048.00 $67,036.00 2026-03-01
33249 CPT Insertion Or Replacement Of Permanent Implantable Defibrillator System, With Tra… 17 8 — — $4,250.00 $162,048.00 $67,036.00 2026-03-01
33230 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Dual … 17 8 — — $1,995.00 $162,048.00 $67,036.00 2026-03-01
33231 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Multi… 17 8 — — $1,995.00 $162,048.00 $67,036.00 2026-03-01
74722 CDM Revsc Iliac W Stnt Addl 17 12 $136,398.00 $136,398.00 $19,504.91 $136,398.00 $61,379.10 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 16 15 — — $3,685,267.00 $3,943,235.69 $3,758,972.34 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 16 15 — — $2,588,981.00 $2,770,209.67 $2,640,760.62 2026-03-01
2067 OTHER Afamitresgene Autoleucel 16 15 — — $770,620.00 $824,563.40 $786,032.40 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 16 15 — — $566,531.30 $606,188.49 $577,861.93 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 16 15 — — $562,201.20 $601,555.28 $573,445.22 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 16 15 — — $532,192.20 $569,445.65 $542,836.04 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 16 15 — — $489,450.20 $523,711.71 $499,239.20 2026-03-01
897 OTHER Revakinagene, Per Implant 16 15 — — $265,000.00 $283,550.00 $270,300.00 2026-03-01
1907 OTHER New Technology - Level 52 16 15 — — $149,755.50 $160,238.39 $152,750.61 2026-03-01
1908 OTHER New Technology - Level 52 16 15 — — $149,755.50 $160,238.39 $152,750.61 2026-03-01
1905 OTHER New Technology - Level 51 16 15 — — $135,025.50 $144,477.29 $137,726.01 2026-03-01
1906 OTHER New Technology - Level 51 16 15 — — $135,025.50 $144,477.29 $137,726.01 2026-03-01
1903 OTHER New Technology - Level 50 16 15 — — $120,295.50 $128,716.19 $122,701.41 2026-03-01
1904 OTHER New Technology - Level 50 16 15 — — $120,295.50 $128,716.19 $122,701.41 2026-03-01
1902 OTHER New Technology - Level 49 16 15 — — $105,565.50 $112,955.09 $107,676.81 2026-03-01
1901 OTHER New Technology - Level 49 16 15 — — $105,565.50 $112,955.09 $107,676.81 2026-03-01
1599 OTHER New Technology - Level 48 16 15 — — $93,290.49 $99,820.82 $95,156.30 2026-03-01
1585 OTHER New Technology - Level 48 16 15 — — $93,290.49 $99,820.82 $95,156.30 2026-03-01
1584 OTHER New Technology - Level 47 16 15 — — $83,470.49 $89,313.42 $85,139.90 2026-03-01
1598 OTHER New Technology - Level 47 16 15 — — $83,470.49 $89,313.42 $85,139.90 2026-03-01
1583 OTHER New Technology - Level 46 16 15 — — $73,650.49 $78,806.02 $75,123.50 2026-03-01
1597 OTHER New Technology - Level 46 16 15 — — $73,650.49 $78,806.02 $75,123.50 2026-03-01
1582 OTHER New Technology - Level 45 16 15 — — $63,830.49 $68,298.62 $65,107.10 2026-03-01
1596 OTHER New Technology - Level 45 16 15 — — $63,830.49 $68,298.62 $65,107.10 2026-03-01
5244 OTHER Level 4 Blood Product Exc 16 15 — — $63,106.78 $67,524.25 $64,368.92 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 15 14 — — $587,649.60 $628,785.07 $599,402.59 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 15 14 — — $558,081.80 $597,147.53 $569,243.44 2026-03-01
33263 CPT Removal Of Implantable Defibrillator Pulse Generator With Replacement Of Implant… 15 7 — — $1,995.00 $162,048.00 $117,809.00 2026-03-01
33264 CPT Removal Of Implantable Defibrillator Pulse Generator With Replacement Of Implant… 15 7 — — $1,995.00 $162,048.00 $117,809.00 2026-03-01
33262 CPT Removal Of Implantable Defibrillator Pulse Generator With Replacement Of Implant… 15 7 — — $1,995.00 $162,048.00 $117,809.00 2026-03-01
33271 CPT Insertion Of Subcutaneous Implantable Defibrillator Electrode 15 7 — — $1,995.00 $162,048.00 $117,809.00 2026-03-01
33272 CPT Removal Of Subcutaneous Implantable Defibrillator Electrode 15 7 — — $1,995.00 $162,048.00 $117,809.00 2026-03-01
33270 CPT Insertion Or Replacement Of Permanent Subcutaneous Implantable Defibrillator Sys… 15 7 — — $1,995.00 $162,048.00 $117,809.00 2026-03-01
66661 CDM Ins Icd Lead/generator 14 11 $240,066.00 $240,066.00 $36,009.90 $240,066.00 $150,041.25 2026-03-01
76842 CDM Rem/replace Icd Gen Sgl 14 11 $203,987.00 $203,987.00 $30,598.05 $203,987.00 $127,491.88 2026-03-01
76844 CDM Rem/replace Icd Gen Mult 14 11 $203,987.00 $203,987.00 $30,598.05 $203,987.00 $127,491.88 2026-03-01
76843 CDM Rem/replace Icd Gen Dual 14 11 $203,987.00 $203,987.00 $30,598.05 $203,987.00 $127,491.88 2026-03-01
66659 CDM Ins Icd Gen Only Sgl Ld 14 11 $176,155.00 $176,155.00 $26,423.25 $176,155.00 $110,096.88 2026-03-01
84398 CDM Ins/repl Sq Icd With Elec 14 11 $163,106.00 $163,106.00 $24,465.90 $163,106.00 $101,941.25 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 11 6 — — $53,750.26 $170,328.19 $92,400.00 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 11 6 — — $48,464.53 $144,170.89 $87,806.33 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 11 6 — — $38,430.20 $114,441.15 $69,626.54 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 8 5 — — $470,193.65 $1,557,271.36 $1,055,220.18 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 8 5 — — $491,955.35 $1,501,307.95 $1,040,039.47 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 8 5 — — $448,478.70 $1,478,916.58 $1,003,269.29 2026-03-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 8 5 — — $438,975.70 $1,489,833.29 $1,003,137.65 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 8 5 — — $427,414.85 $1,410,309.44 $956,575.22 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 8 5 — — $415,989.15 $1,297,043.03 $893,221.02 2026-03-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 7 2 — — $70,495.36 $221,874.56 $221,874.56 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 7 2 — — $71,547.78 $150,585.06 $150,585.06 2026-03-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 7 2 — — $24,978.93 $64,205.31 $64,205.31 2026-03-01
5834 APR_DRG Neonate With Ecmo 6 6 — — $488,670.66 $513,104.19 $490,063.37 2026-03-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 6 6 — — $447,536.35 $469,913.17 $448,811.83 2026-03-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 6 6 — — $431,702.40 $453,287.52 $432,932.75 2026-03-01
5833 APR_DRG Neonate With Ecmo 6 6 — — $429,225.92 $450,687.22 $430,449.21 2026-03-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 6 — — $345,233.49 $362,495.16 $346,217.41 2026-03-01
1614 APR_DRG Implantable Heart Assist Systems 6 6 — — $334,363.03 $351,081.18 $335,315.97 2026-03-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 6 6 — — $302,613.55 $317,744.23 $303,476.00 2026-03-01
5832 APR_DRG Neonate With Ecmo 6 6 — — $295,335.43 $310,102.20 $296,177.14 2026-03-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 6 6 — — $288,877.11 $303,320.97 $289,700.41 2026-03-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 6 6 — — $283,349.11 $297,516.57 $284,156.66 2026-03-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 6 — — $269,182.38 $282,641.50 $269,949.55 2026-03-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 6 6 — — $268,565.23 $281,993.49 $269,330.64 2026-03-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 6 6 — — $255,280.14 $268,044.15 $256,007.69 2026-03-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 6 6 — — $241,373.95 $253,442.65 $242,061.86 2026-03-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 6 6 — — $222,849.03 $233,991.48 $223,484.15 2026-03-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 6 6 — — $202,243.72 $212,355.91 $202,820.11 2026-03-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 6 6 — — $200,634.40 $210,666.12 $201,206.21 2026-03-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 6 6 — — $199,359.31 $209,327.28 $199,927.48 2026-03-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 6 6 — — $194,089.23 $203,793.69 $194,642.39 2026-03-01
5831 APR_DRG Neonate With Ecmo 6 6 — — $184,859.66 $194,102.64 $185,386.51 2026-03-01
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 6 6 — — $166,193.95 $174,503.65 $166,667.61 2026-03-01
1613 APR_DRG Implantable Heart Assist Systems 6 6 — — $162,145.00 $170,252.25 $162,607.11 2026-03-01
1612 APR_DRG Implantable Heart Assist Systems 6 6 — — $158,301.32 $166,216.39 $158,752.48 2026-03-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 6 6 — — $153,652.33 $161,334.95 $154,090.24 2026-03-01
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 6 6 — — $152,989.12 $160,638.58 $153,425.14 2026-03-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 6 — — $152,962.81 $160,610.95 $153,398.76 2026-03-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 6 6 — — $151,020.57 $158,571.60 $151,450.98 2026-03-01
1611 APR_DRG Implantable Heart Assist Systems 6 6 — — $150,350.79 $157,868.33 $150,779.29 2026-03-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $150,346.84 $157,864.18 $150,775.33 2026-03-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 6 6 — — $149,898.13 $157,393.04 $150,325.34 2026-03-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 6 6 — — $141,468.62 $148,542.05 $141,871.80 2026-03-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 6 6 — — $139,647.45 $146,629.82 $140,045.45 2026-03-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 6 6 — — $139,559.28 $146,537.24 $139,957.02 2026-03-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $135,995.89 $142,795.68 $136,383.48 2026-03-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 6 — — $127,293.99 $133,658.69 $127,656.78 2026-03-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 6 6 — — $124,825.41 $131,066.68 $125,181.16 2026-03-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 6 6 — — $123,775.34 $129,964.11 $124,128.10 2026-03-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 6 — — $121,976.53 $128,075.36 $122,324.17 2026-03-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 6 — — $121,976.53 $128,075.36 $122,324.17 2026-03-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $117,923.63 $123,819.81 $118,259.71 2026-03-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 6 6 — — $111,728.48 $117,314.90 $112,046.90 2026-03-01
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $110,296.81 $115,811.65 $110,611.15 2026-03-01
4404 APR_DRG Kidney Transplant 6 6 — — $106,970.27 $112,318.78 $107,275.14 2026-03-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 6 — — $106,300.49 $111,615.51 $106,603.45 2026-03-01
4403 APR_DRG Kidney Transplant 6 6 — — $104,500.37 $109,725.39 $104,798.20 2026-03-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 6 6 — — $104,127.98 $109,334.38 $104,424.74 2026-03-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 6 6 — — $103,670.05 $108,853.55 $103,965.51 2026-03-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 6 6 — — $103,641.10 $108,823.16 $103,936.48 2026-03-01
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 6 6 — — $103,427.93 $108,599.33 $103,722.70 2026-03-01
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $102,638.41 $107,770.33 $102,930.93 2026-03-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 6 6 — — $102,184.43 $107,293.65 $102,475.65 2026-03-01
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 6 6 — — $99,568.46 $104,546.88 $99,852.23 2026-03-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 6 6 — — $97,939.41 $102,836.38 $98,218.54 2026-03-01
6904 APR_DRG Acute Leukemia 6 6 — — $96,761.70 $101,599.79 $97,037.47 2026-03-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 6 6 — — $96,640.64 $101,472.67 $96,916.07 2026-03-01
8634 APR_DRG Neonatal Aftercare 6 6 — — $95,620.83 $100,401.87 $95,893.35 2026-03-01
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 6 6 — — $94,678.67 $99,412.60 $94,948.51 2026-03-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 6 6 — — $94,656.30 $99,389.12 $94,926.07 2026-03-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 6 6 — — $94,345.75 $99,063.04 $94,614.64 2026-03-01
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 6 6 — — $93,104.88 $97,760.12 $93,370.23 2026-03-01
3124 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 6 6 — — $91,746.89 $96,334.23 $92,008.37 2026-03-01
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 6 6 — — $89,777.02 $94,265.87 $90,032.89 2026-03-01
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 6 6 — — $89,358.58 $93,826.51 $89,613.25 2026-03-01
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 6 6 — — $89,334.89 $93,801.63 $89,589.49 2026-03-01
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 6 6 — — $89,241.46 $93,703.53 $89,495.80 2026-03-01
204 APR_DRG Open Craniotomy For Trauma 6 6 — — $89,086.19 $93,540.50 $89,340.08 2026-03-01
8904 APR_DRG HIV With Multiple Major HIV Related Conditions 6 6 — — $89,000.66 $93,450.69 $89,254.31 2026-03-01
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $87,820.32 $92,211.34 $88,070.61 2026-03-01
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 6 6 — — $85,828.08 $90,119.48 $86,072.69 2026-03-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 6 6 — — $85,058.29 $89,311.20 $85,300.70 2026-03-01
4402 APR_DRG Kidney Transplant 6 6 — — $84,593.78 $88,823.47 $84,834.87 2026-03-01
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 6 6 — — $84,527.99 $88,754.39 $84,768.90 2026-03-01
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 6 6 — — $82,337.06 $86,453.91 $82,571.72 2026-03-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 6 6 — — $81,389.62 $85,459.10 $81,621.58 2026-03-01
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 6 6 — — $81,204.09 $85,264.29 $81,435.52 2026-03-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 6 6 — — $81,127.76 $85,184.15 $81,358.98 2026-03-01
1774 APR_DRG Cardiac Pacemaker And Defibrillator Revision Except Device Replacement 6 6 — — $79,927.68 $83,924.06 $80,155.48 2026-03-01
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 6 6 — — $79,396.07 $83,365.87 $79,622.35 2026-03-01
4414 APR_DRG Major Bladder Procedures 6 6 — — $77,943.34 $81,840.51 $78,165.48 2026-03-01
1834 APR_DRG Percutaneous Structural Cardiac Procedures 6 6 — — $76,948.54 $80,795.97 $77,167.85 2026-03-01
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 6 6 — — $76,657.73 $80,490.62 $76,876.20 2026-03-01
1694 APR_DRG Major Abdominal Vascular Procedures 6 6 — — $75,674.77 $79,458.51 $75,890.45 2026-03-01
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 6 6 — — $74,902.35 $78,647.47 $75,115.82 2026-03-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 6 6 — — $74,300.99 $78,016.04 $74,512.75 2026-03-01
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition… 6 6 — — $73,993.08 $77,692.73 $74,203.96 2026-03-01
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 6 6 — — $73,302.24 $76,967.35 $73,511.15 2026-03-01
234 APR_DRG Spinal Procedures 6 6 — — $72,502.19 $76,127.30 $72,708.82 2026-03-01
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $72,191.64 $75,801.22 $72,397.39 2026-03-01
1204 APR_DRG Major Respiratory And Chest Procedures 6 6 — — $72,129.80 $75,736.29 $72,335.37 2026-03-01
1784 APR_DRG External Heart Assist Devices 6 6 — — $71,882.41 $75,476.53 $72,087.27 2026-03-01
4014 APR_DRG Adrenal Procedures 6 6 — — $71,835.04 $75,426.79 $72,039.77 2026-03-01
2304 APR_DRG Major Small Bowel Procedures 6 6 — — $71,696.87 $75,281.71 $71,901.20 2026-03-01
914 APR_DRG Other Major Head And Neck Procedures 6 6 — — $71,586.34 $75,165.66 $71,790.36 2026-03-01
274 APR_DRG Other Open Craniotomy 6 6 — — $70,949.46 $74,496.93 $71,151.67 2026-03-01
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 6 6 — — $70,542.85 $74,069.99 $70,743.90 2026-03-01
214 APR_DRG Open Craniotomy Except Trauma 6 6 — — $70,170.46 $73,678.98 $70,370.45 2026-03-01
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 6 6 — — $69,141.44 $72,598.51 $69,338.49 2026-03-01
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 6 6 — — $68,544.03 $71,971.23 $68,739.38 2026-03-01
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 6 6 — — $68,371.65 $71,790.23 $68,566.51 2026-03-01
1783 APR_DRG External Heart Assist Devices 6 6 — — $68,184.80 $71,594.04 $68,379.12 2026-03-01
894 APR_DRG Major Cranial Or Facial Bone Procedures 6 6 — — $66,983.40 $70,332.57 $67,174.30 2026-03-01
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 6 6 — — $66,837.34 $70,179.21 $67,027.82 2026-03-01
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 6 6 — — $66,397.84 $69,717.73 $66,587.07 2026-03-01
1782 APR_DRG External Heart Assist Devices 6 6 — — $66,317.57 $69,633.45 $66,506.58 2026-03-01
224 APR_DRG Ventricular Shunt Procedures 6 6 — — $65,854.38 $69,147.10 $66,042.07 2026-03-01
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 6 6 — — $65,789.90 $69,079.40 $65,977.40 2026-03-01
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 6 6 — — $65,621.47 $68,902.54 $65,808.49 2026-03-01
1214 APR_DRG Other Respiratory And Chest Procedures 6 6 — — $65,076.70 $68,330.54 $65,262.17 2026-03-01
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 6 6 — — $65,056.96 $68,309.81 $65,242.37 2026-03-01
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $64,583.24 $67,812.40 $64,767.30 2026-03-01
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 6 6 — — $64,560.87 $67,788.91 $64,744.87 2026-03-01
1794 APR_DRG Defibrillator Implants 6 6 — — $64,367.44 $67,585.81 $64,550.89 2026-03-01
264 APR_DRG Other Nervous System And Related Procedures 6 6 — — $63,673.97 $66,857.67 $63,855.44 2026-03-01
2614 APR_DRG Major Biliary Tract Procedures 6 6 — — $63,302.89 $66,468.03 $63,483.31 2026-03-01
90288 CPT Botulism Immune Globulin, Human, For Intravenous Use 6 2 — — $51,140.25 $75,005.70 $63,072.97 2026-03-01
2324 APR_DRG Gastric Fundoplication 6 6 — — $62,812.07 $65,952.67 $62,991.08 2026-03-01
4474 APR_DRG Other Kidney, Urinary Tract And Related Non-percutaneous Procedures 6 6 — — $62,630.48 $65,762.00 $62,808.98 2026-03-01
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 6 6 — — $62,300.20 $65,415.21 $62,477.75 2026-03-01
2294 APR_DRG Other Digestive System And Abdominal Procedures 6 6 — — $61,938.33 $65,035.25 $62,114.85 2026-03-01
8412 APR_DRG Extensive Third Degree Burns With Skin Graft 6 6 — — $61,525.15 $64,601.41 $61,700.49 2026-03-01
8411 APR_DRG Extensive Third Degree Burns With Skin Graft 6 6 — — $61,525.15 $64,601.41 $61,700.49 2026-03-01
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 6 6 — — $60,685.62 $63,719.90 $60,858.57 2026-03-01
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 6 6 — — $60,685.62 $63,719.90 $60,858.57 2026-03-01
1814 APR_DRG Lower Vascular Procedures 6 6 — — $60,552.71 $63,580.35 $60,725.29 2026-03-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 4 — — $205,634.46 $241,922.90 $234,665.21 2026-03-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 5 4 — — $180,755.98 $212,654.10 $206,274.48 2026-03-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 5 4 — — $127,400.46 $149,882.90 $145,386.41 2026-03-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 5 4 — — $99,489.69 $117,046.70 $113,535.30 2026-03-01
007 OTHER Lung Transplant 5 4 — — $76,464.65 $89,958.41 $87,259.66 2026-03-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 5 4 — — $67,770.24 $79,729.70 $77,337.81 2026-03-01
014 OTHER Allogeneic Bone Marrow Transplant 5 4 — — $65,269.72 $76,787.91 $74,484.27 2026-03-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 5 4 — — $64,582.24 $75,979.10 $73,699.73 2026-03-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 5 4 — — $53,261.78 $62,660.92 $60,781.09 2026-03-01
00845 OTHER Inj, Atidarsagene Autotem 4 4 — — $3,829,250.00 $4,505,000.00 $4,212,175.00 2026-03-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 4 4 — — $3,132,476.95 $3,685,267.00 $3,445,724.65 2026-03-01
00908 OTHER Topi Adm Prad Zami Per Tr 4 4 — — $2,835,447.00 $3,335,820.00 $3,118,991.70 2026-03-01
00714 OTHER Inj Delandistrogene Mox R 4 4 — — $2,828,681.00 $3,327,860.00 $3,111,549.10 2026-03-01
00748 OTHER Inj, Lovotibeglogene Auto 4 4 — — $2,764,631.80 $3,252,508.00 $3,041,094.98 2026-03-01
00906 OTHER Inj Elivaldogene Autoteme 4 4 — — $2,703,000.00 $3,180,000.00 $2,973,300.00 2026-03-01
00746 OTHER Inj, Betibeglogene Autote 4 4 — — $2,498,973.65 $2,939,969.00 $2,748,871.02 2026-03-01
09141 OTHER Inj Onase Abepar-xioi Tre 4 4 — — $2,200,633.85 $2,588,981.00 $2,420,697.23 2026-03-01
00824 OTHER Inj, Exagamglogene Autote 4 4 — — $1,982,200.00 $2,332,000.00 $2,180,420.00 2026-03-01
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 4 1 — — $2,042,143.00 $2,042,143.00 $2,042,143.00 2026-03-01
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 4 1 — — $737,362.50 $737,362.50 $737,362.50 2026-03-01
09498 OTHER Ciltacabtagene Car-pos T 4 4 — — $499,502.16 $587,649.60 $549,452.38 2026-03-01
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 4 1 — — $534,422.90 $534,422.90 $534,422.90 2026-03-01
09194 OTHER Tisagenlecleucel Car-pos 4 4 — — $481,551.61 $566,531.30 $529,706.77 2026-03-01
09413 OTHER Lisocabtagene Car Pos T 4 4 — — $477,871.02 $562,201.20 $525,658.12 2026-03-01
09422 OTHER Idecabtagene Vicleucel Ca 4 4 — — $474,369.53 $558,081.80 $521,806.48 2026-03-01
09035 OTHER Axicabtagene Ciloleucel C 4 4 — — $452,363.37 $532,192.20 $497,599.70 2026-03-01
09391 OTHER Brexucabtagene Car Pos T 4 4 — — $416,032.67 $489,450.20 $457,635.93 2026-03-01
00831 OTHER Obecbtge Autol Up To 400 4 4 — — $236,512.50 $278,250.00 $260,163.75 2026-03-01
00897 OTHER Revakinagene, Per Implant 4 4 — — $225,250.00 $265,000.00 $247,775.00 2026-03-01
00886 OTHER Inj. Remestemcel-l-rknd/ 4 4 — — $171,418.65 $201,669.00 $188,560.52 2026-03-01
01907 OTHER New Technology - Level 52 4 4 — — $123,768.93 $145,610.50 $136,145.82 2026-03-01
01908 OTHER New Technology - Level 52 4 4 — — $123,768.93 $145,610.50 $136,145.82 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 4 1 — — $123,742.09 $123,742.09 $123,742.09 2026-03-01
01905 OTHER New Technology - Level 51 4 4 — — $111,594.97 $131,288.20 $122,754.46 2026-03-01
01906 OTHER New Technology - Level 51 4 4 — — $111,594.97 $131,288.20 $122,754.46 2026-03-01
01903 OTHER New Technology - Level 50 4 4 — — $99,421.01 $116,965.90 $109,363.11 2026-03-01
01904 OTHER New Technology - Level 50 4 4 — — $99,421.01 $116,965.90 $109,363.11 2026-03-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 4 4 — — $89,163.30 $104,898.00 $98,079.63 2026-03-01
01902 OTHER New Technology - Level 49 4 4 — — $87,247.06 $102,643.60 $95,971.76 2026-03-01
01901 OTHER New Technology - Level 49 4 4 — — $87,247.06 $102,643.60 $95,971.76 2026-03-01
01599 OTHER New Technology - Level 48 4 4 — — $77,102.12 $90,708.38 $84,812.33 2026-03-01
01585 OTHER New Technology - Level 48 4 4 — — $77,102.12 $90,708.38 $84,812.33 2026-03-01
230 MS_DRG Other Cardiothoracic Procedures Without Cc/mcc 4 2 — — $47,517.00 $80,065.00 $80,065.00 2026-03-01
01598 OTHER New Technology - Level 47 4 4 — — $68,986.15 $81,160.18 $75,884.76 2026-03-01
01584 OTHER New Technology - Level 47 4 4 — — $68,986.15 $81,160.18 $75,884.76 2026-03-01
01597 OTHER New Technology - Level 46 4 4 — — $60,870.18 $71,611.98 $66,957.20 2026-03-01
01583 OTHER New Technology - Level 46 4 4 — — $60,870.18 $71,611.98 $66,957.20 2026-03-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 4 4 — — $60,524.63 $71,205.45 $66,577.10 2026-03-01
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 4 4 — — $58,457.85 $68,773.94 $64,303.64 2026-03-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 4 — — $56,170.69 $66,083.17 $61,787.76 2026-03-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 2 1 — — $71,444.06 $97,031.73 $84,237.89 2026-03-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 1 — — $59,752.11 $81,152.30 $70,452.21 2026-03-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 1 — — $55,324.12 $75,138.43 $65,231.27 2026-03-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 2 1 — — $51,740.52 $70,271.37 $61,005.94 2026-03-01
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