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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

RIVERSIDE WALTER REED HOSPITAL

Gloucester, VA · CCN 490130 · Rates published

21,461 distinct procedures filed
10 distinct payers
287,782 rate rows
2026-01-02 last MRF observed
Data quality

277,646 of 287,782 rate rows are consumer-grade (96.5%)

10,136 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 5,196
template filing: same amount across many unrelated codes — excluded 2,026
placeholder amount (≤ $0.02) — excluded from medians 1,934
exceeds 10× this hospital's gross charge — excluded from medians 923
per-diem day rate — not a per-procedure price 57
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://riverside.pt.panaceainc.com/MRFDownload/riverside/RWRH
Found on page https://www.riversideonline.com/patients-and-visitors/paying-for-healthcare-services
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-16
Content fingerprint e0c244f3dec49e16… · 111,299,076 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 7 $51,775.08 $4,596,375.00 $4,421,275.00 nat. median
$4,505,000
1.0× median
C9172
HCPCS 		Inj, Beqvez, Per Tx Dose 6 $32,400.21 $3,895,500.00 $3,710,000.00 nat. median
$3,570,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 7 $32,400.21 $3,869,530.00 $3,685,266.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 7 $32,400.21 $3,490,800.50 $3,320,517.25 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 7 $51,775.08 $4,864,830.00 $3,261,355.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 7 $51,775.08 $4,394,040.00 $2,950,686.67 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 7 $2,452,115.60 $4,806,917.50 $2,525,679.07 nat. median
$2,469,189
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 7 $51,775.08 $4,664,000.00 $2,355,320.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 6 $51,775.08 $1,140,881.10 $778,326.20 nat. median
$824,563
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 7 $51,775.08 $1,131,247.68 $589,891.07 nat. median
$754,974
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 7 $51,775.08 $1,102,636.68 $565,157.68 nat. median
$675,122
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 7 $51,775.08 $1,032,971.94 $552,468.37 nat. median
$674,188
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 7 $51,775.08 $1,056,624.86 $552,085.66 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 7 $51,775.08 $979,034.30 $533,230.17 nat. median
$634,511
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 7 $51,775.08 $976,103.02 $489,720.00 nat. median
$620,080
0.8× median
5831
APR_DRG 		5 $182,178.94 $505,663.48 $364,303.43 nat. median
$145,122
outlier · 2.5×
5891
APR_DRG 		5 $55,089.14 $463,098.78 $316,526.65 nat. median
$93,260
outlier · 3.4×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 10 $208,896.19 $505,295.64 $295,050.75 nat. median
$206,368
1.4× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 7 $51,775.08 $283,893.75 $273,078.75 nat. median
$324,450
0.8× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 5 $173,790.39 $232,040.07 $207,490.67 nat. median
$102,358
outlier · 2.0×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 $198,299.32 $198,299.32 $198,299.32 nat. median
$98,905
outlier · 2.0×
850
MS_DRG 		Acute Leukemia With Other Procedures 1 $174,381.27 $174,381.27 $174,381.27 nat. median
$83,442
outlier · 2.1×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 9 $169,076.85 $405,700.19 $174,149.16 nat. median
$202,986
0.9× median
1611
APR_DRG 		5 $148,170.49 $345,990.02 $159,793.67 nat. median
$76,806
outlier · 2.1×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 1 $157,887.56 $157,887.56 $157,887.56 nat. median
$82,712
1.9× median
0111
APR_DRG 		6 $59,574.76 $306,340.70 $152,644.02 nat. median
$85,731
1.8× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization With Mcc 6 $111,140.98 $166,489.32 $148,238.03 nat. median
$73,807
outlier · 2.0×
5911
APR_DRG 		5 $87,947.34 $264,157.14 $137,901.92 nat. median
$40,550
outlier · 3.4×
6091
APR_DRG 		5 $55,199.37 $298,922.39 $137,535.48 nat. median
$32,820
outlier · 4.2×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 $134,454.11 $134,454.11 $134,454.11 nat. median
$68,090
2.0× median
5931
APR_DRG 		5 $33,331.52 $230,598.29 $129,586.51 nat. median
$29,713
outlier · 4.4×
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 1 $126,919.97 $126,919.97 $126,919.97 nat. median
$63,738
2.0× median
5881
APR_DRG 		5 $120,207.70 $357,238.49 $126,218.09 nat. median
$124,573
1.0× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 9 $116,755.48 $267,480.90 $120,258.14 nat. median
$133,176
0.9× median
6021
APR_DRG 		5 $29,875.56 $155,574.94 $120,115.64 nat. median
$29,949
outlier · 4.0×
215
MS_DRG 		Other Heart Assist System Implant 10 $76,800.17 $225,669.24 $118,304.15 nat. median
$99,019
1.2× median
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 6 $80,805.87 $131,940.72 $117,476.80 nat. median
$59,099
2.0× median
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 1 $117,108.55 $117,108.55 $117,108.55 nat. median
$60,691
1.9× median
461
MS_DRG 		Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 6 $92,589.17 $130,711.71 $116,382.51 nat. median
$55,736
outlier · 2.1×
266
MS_DRG 		Endovascular Cardiac Valve Replacement W Mcc 6 $82,974.84 $127,604.04 $113,615.52 nat. median
$60,726
1.9× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 $74,342.03 $205,568.43 $110,550.41 nat. median
$93,672
1.2× median
6301
APR_DRG 		5 $38,881.80 $313,136.50 $109,678.87 nat. median
$25,184
outlier · 4.4×
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 1 $106,120.90 $106,120.90 $106,120.90 nat. median
$111,989
0.9× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 10 $67,379.63 $171,701.43 $105,930.67 nat. median
$77,576
1.4× median
428
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 $104,192.61 $104,192.61 $104,192.61 nat. median
$54,211
1.9× median
430
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 1 $103,556.57 $103,556.57 $103,556.57 nat. median
$54,596
1.9× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 3 $45,737.00 $115,121.61 $103,294.46 nat. median
$76,377
1.4× median
11
MS_DRG 		Tracheostomy For Face,mouth & Neck Diagnoses W Mcc 1 $102,144.39 $102,144.39 $102,144.39 nat. median
$52,857
1.9× median
234
MS_DRG 		Coronary Bypass With Cardiac Catheterization Without Mcc 6 $77,489.51 $113,320.26 $100,897.60 nat. median
$53,268
1.9× median
450
MS_DRG 		Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically… 1 $97,491.39 $97,491.39 $97,491.39 nat. median
$51,319
1.9× median

Other procedures at this hospital

Browse this hospital's 21,461 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
             
0041 APR_DRG — 20 5 — — $68,138.79 $200,838.40 $97,316.29 2026-01-02
0051 APR_DRG — 20 5 — — $45,809.28 $146,387.99 $75,350.24 2026-01-02
0091 APR_DRG — 15 5 — — $59,805.59 $209,276.45 $96,519.15 2026-01-02
0111 APR_DRG — 26 6 — — $59,574.76 $306,340.70 $152,644.02 2026-01-02
0201 APR_DRG — 20 5 — — $24,999.61 $92,184.03 $34,659.86 2026-01-02
0211 APR_DRG — 20 5 — — $22,450.11 $72,610.53 $36,736.03 2026-01-02
0266T HCPCS Implt/rpl Crtd Sns Dev Total 13 8 — — $26,163.19 $45,115.75 $41,325.75 2026-01-02
0451T HCPCS Insj/rplcmt Aortic Ventr Sys 5 5 — — $42,593.57 $44,723.25 $42,593.57 2026-01-02
0452T HCPCS Insj/rplcmt Dev Vasc Seal 5 5 — — $42,593.57 $44,723.25 $42,593.57 2026-01-02
0453T HCPCS Insj/rplcmt Mech-elec Ntrfce 5 5 — — $42,593.57 $44,723.25 $42,593.57 2026-01-02
0454T HCPCS Insj/rplcmt Subq Electrode 5 5 — — $42,593.57 $44,723.25 $42,593.57 2026-01-02
0459T HCPCS Relocaj Rplcmt Aortic Ventr 5 5 — — $42,593.57 $44,723.25 $42,593.57 2026-01-02
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 11 6 — — $14,826.20 $35,090.14 $33,419.18 2026-01-02
0891 APR_DRG — 20 5 — — $19,400.05 $69,312.65 $33,658.73 2026-01-02
0911 APR_DRG — 20 5 — — $17,355.00 $74,075.65 $34,239.08 2026-01-02
0951T HCPCS Tot Impl Amei 1st Plmt 5 5 — — $32,865.93 $34,509.23 $32,865.93 2026-01-02
0952T HCPCS Tot Impl Amei Rev/rplc Mstdc 5 5 — — $32,865.93 $34,509.23 $32,865.93 2026-01-02
11 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Mcc 1 1 — — $102,144.39 $102,144.39 $102,144.39 2026-01-02
12 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Cc 1 1 — — $77,683.04 $77,683.04 $77,683.04 2026-01-02
13 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses Without Cc/mcc 1 1 — — $50,164.50 $50,164.50 $50,164.50 2026-01-02
1301 APR_DRG — 20 5 — — $36,102.77 $75,851.22 $45,077.69 2026-01-02
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 14 8 — — $21,538.86 $51,356.43 $36,447.64 2026-01-02
140 MS_DRG Major Head And Neck Procedures With Mcc 12 7 — — $30,437.83 $90,081.96 $49,714.07 2026-01-02
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 14 8 — — $26,861.64 $70,330.47 $40,249.68 2026-01-02
1601 APR_DRG — 20 5 — — $26,040.94 $277,904.20 $49,086.44 2026-01-02
1611 APR_DRG — 20 5 — — $148,170.49 $345,990.02 $159,793.67 2026-01-02
1621 APR_DRG — 20 5 — — $46,119.21 $100,001.17 $63,364.96 2026-01-02
163 MS_DRG Major Chest Procedures With Mcc 16 10 — — $27,700.37 $98,175.96 $51,330.49 2026-01-02
1631 APR_DRG — 20 5 — — $33,391.17 $88,016.07 $47,529.06 2026-01-02
1651 APR_DRG — 20 5 — — $31,698.85 $68,706.72 $41,160.99 2026-01-02
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 16 10 — — $32,648.35 $82,011.39 $50,173.49 2026-01-02
1661 APR_DRG — 20 5 — — $24,867.34 $50,752.21 $36,415.52 2026-01-02
1671 APR_DRG — 20 5 — — $24,161.88 $76,884.70 $41,592.85 2026-01-02
1691 APR_DRG — 20 5 — — $27,599.68 $78,306.25 $33,539.36 2026-01-02
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 16 10 — — $19,233.93 $65,361.18 $34,211.36 2026-01-02
1771 APR_DRG — 20 5 — — $14,555.22 $82,707.05 $48,668.58 2026-01-02
1781 APR_DRG — 20 5 — — $52,452.76 $74,382.02 $67,196.02 2026-01-02
1791 APR_DRG — 20 5 — — $35,276.71 $66,605.72 $48,256.49 2026-01-02
1831 APR_DRG — 20 5 — — $38,490.17 $79,624.31 $45,549.34 2026-01-02
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 16 10 — — $67,379.63 $171,701.43 $105,930.67 2026-01-02
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 16 10 — — $48,966.45 $137,751.36 $75,645.79 2026-01-02
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 16 10 — — $49,115.40 $117,731.49 $77,932.14 2026-01-02
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 6 5 — — $173,790.39 $232,040.07 $207,490.67 2026-01-02
215 MS_DRG Other Heart Assist System Implant 16 10 — — $76,800.17 $225,669.24 $118,304.15 2026-01-02
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 10 — — $74,342.03 $205,568.43 $110,550.41 2026-01-02
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 10 — — $50,884.92 $137,553.27 $86,844.38 2026-01-02
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 10 — — $45,600.85 $126,720.09 $68,258.89 2026-01-02
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 16 10 — — $56,643.87 $164,808.75 $87,662.10 2026-01-02
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 16 10 — — $28,055.81 $75,197.52 $43,381.01 2026-01-02
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 16 10 — — $39,242.06 $112,819.71 $60,080.05 2026-01-02
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 16 10 — — $30,065.89 $97,822.38 $51,563.78 2026-01-02
228 MS_DRG Other Cardiothoracic Procedures With Mcc 16 10 — — $40,400.57 $106,144.29 $62,205.89 2026-01-02
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 16 10 — — $25,707.78 $66,164.19 $39,959.89 2026-01-02
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 16 10 — — $45,380.36 $121,518.63 $66,469.77 2026-01-02
231 MS_DRG Coronary Bypass With Ptca With Mcc 16 10 — — $64,714.68 $180,494.07 $97,170.61 2026-01-02
232 MS_DRG Coronary Bypass With Ptca Without Mcc 16 10 — — $47,591.66 $130,115.31 $74,874.22 2026-01-02
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 8 6 — — $111,140.98 $166,489.32 $148,238.03 2026-01-02
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 8 6 — — $77,489.51 $113,320.26 $100,897.60 2026-01-02
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 16 10 — — $45,787.46 $125,333.46 $67,483.71 2026-01-02
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 16 10 — — $32,517.15 $87,587.73 $48,903.14 2026-01-02
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 16 10 — — $32,009.88 $107,285.97 $55,072.07 2026-01-02
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 16 10 — — $30,522.39 $80,976.21 $46,030.85 2026-01-02
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 16 10 — — $22,780.45 $62,029.86 $35,717.74 2026-01-02
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 16 10 — — $26,863.94 $72,249.60 $39,418.07 2026-01-02
245 MS_DRG Aicd Generator Procedures 16 10 — — $36,391.29 $104,088.84 $55,148.51 2026-01-02
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 14 8 — — $35,479.26 $95,259.99 $64,615.82 2026-01-02
252 MS_DRG Other Vascular Procedures With Mcc 16 10 — — $27,084.51 $73,067.52 $44,008.10 2026-01-02
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 16 10 — — $21,985.39 $59,757.15 $32,407.17 2026-01-02
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 14 8 — — $23,917.71 $65,148.18 $43,353.82 2026-01-02
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 16 10 — — $23,676.07 $72,552.06 $38,116.24 2026-01-02
263 MS_DRG Vein Ligation And Stripping 16 10 — — $22,906.90 $57,128.73 $32,496.10 2026-01-02
264 MS_DRG Other Circulatory System O.r. Procedures 16 10 — — $26,390.61 $74,445.63 $41,193.14 2026-01-02
265 MS_DRG Aicd Lead Procedures 16 10 — — $28,509.46 $75,981.36 $41,743.24 2026-01-02
266 MS_DRG Endovascular Cardiac Valve Replacement W Mcc 8 6 — — $82,974.84 $127,604.04 $113,615.52 2026-01-02
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 6 5 — — $75,054.08 $100,210.11 $89,608.07 2026-01-02
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 16 10 — — $38,620.48 $142,019.88 $69,460.93 2026-01-02
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 14 9 — — $29,671.02 $88,622.91 $34,782.79 2026-01-02
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 14 8 — — $19,806.48 $52,564.14 $36,185.31 2026-01-02
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 14 9 — — $34,872.52 $109,332.90 $42,166.18 2026-01-02
273 MS_DRG Percutaneous Intracardiac Procedures W Mcc 8 6 — — $57,333.46 $83,289.39 $74,158.84 2026-01-02
274 MS_DRG Percutaneous Intracardiac Procedures Without Mcc 8 6 — — $46,334.38 $66,477.30 $59,189.76 2026-01-02
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 14 8 — — $56,183.99 $150,527.10 $94,573.79 2026-01-02
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 8 6 — — $80,805.87 $131,940.72 $117,476.80 2026-01-02
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 14 8 — — $38,374.98 $99,085.47 $66,978.99 2026-01-02
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 14 8 — — $35,830.16 $106,570.29 $67,158.29 2026-01-02
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 14 8 — — $25,873.75 $68,253.72 $43,860.88 2026-01-02
28 MS_DRG Spinal Procedures With Mcc 16 10 — — $31,578.71 $129,493.35 $65,575.20 2026-01-02
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 16 10 — — $19,887.37 $71,497.71 $37,374.34 2026-01-02
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 9 9 — — $169,076.85 $405,700.19 $174,149.16 2026-01-02
3031 APR_DRG — 20 5 — — $48,609.06 $105,737.74 $53,824.77 2026-01-02
3041 APR_DRG — 20 5 — — $27,470.00 $92,898.89 $41,658.36 2026-01-02
31 MS_DRG Ventricular Shunt Procedures With Mcc 14 8 — — $33,113.05 $89,259.78 $53,595.28 2026-01-02
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 1 1 — — $117,108.55 $117,108.55 $117,108.55 2026-01-02
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 16 10 — — $35,051.70 $93,566.64 $51,433.68 2026-01-02
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mmc Or 4+ A… 8 6 — — $41,967.47 $60,636.84 $53,989.56 2026-01-02
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 16 10 — — $33,297.99 $90,725.22 $56,555.96 2026-01-02
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 16 10 — — $24,040.21 $68,055.63 $36,455.25 2026-01-02
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 16 10 — — $21,477.21 $60,962.73 $32,297.61 2026-01-02
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 14 8 — — $40,719.07 $108,182.70 $69,814.77 2026-01-02
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 14 8 — — $20,316.24 $51,718.53 $35,952.60 2026-01-02
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 16 10 — — $33,694.57 $97,807.47 $51,920.36 2026-01-02
332 MS_DRG Rectal Resection With Mcc 16 10 — — $29,248.40 $73,883.31 $41,934.65 2026-01-02
33276 HCPCS Insj Phrnc Nrv Stim Sys 15 8 — — $535.94 $45,115.75 $38,019.69 2026-01-02
335 MS_DRG Peritoneal Adhesiolysis With Mcc 16 10 — — $20,937.89 $77,178.42 $39,666.24 2026-01-02
33975 HCPCS Implant Ventricular Device 9 5 — — $1,190.19 $44,723.25 $42,593.57 2026-01-02
33979 HCPCS Insert Intracorporeal Device 7 5 — — $1,768.15 $44,723.25 $42,593.57 2026-01-02
33981 HCPCS Replace Vad Pump Ext 7 5 — — $752.38 $44,723.25 $42,593.57 2026-01-02
33982 HCPCS Replace Vad Intra Without Bp 7 5 — — $1,768.89 $44,723.25 $42,593.57 2026-01-02
33983 HCPCS Replace Vad Intra W/bp 7 5 — — $2,080.76 $44,723.25 $42,593.57 2026-01-02
33991 HCPCS Insj Perq Vad L Hrt Artl&ven 7 5 — — $412.87 $44,723.25 $42,593.57 2026-01-02
34 MS_DRG Carotid Artery Stent Procedures With Mcc 16 10 — — $24,922.92 $82,829.31 $43,429.51 2026-01-02
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 14 8 — — $19,546.47 $51,518.31 $35,532.39 2026-01-02
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 14 8 — — $23,690.10 $62,472.90 $43,081.50 2026-01-02
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 16 10 — — $28,159.69 $90,859.41 $47,811.71 2026-01-02
37 MS_DRG Extracranial Procedures With Mcc 16 10 — — $27,256.80 $70,735.17 $39,417.72 2026-01-02
38240 HCPCS Transplt Allo Hct/donor 15 8 — — $5,642.64 $224,109.29 $56,470.28 2026-01-02
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 9 9 — — $116,755.48 $267,480.90 $120,258.14 2026-01-02
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 16 10 — — $25,583.02 $80,345.73 $42,762.45 2026-01-02
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 1 1 — — $74,057.95 $74,057.95 $74,057.95 2026-01-02
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 16 10 — — $44,087.40 $115,631.31 $67,188.47 2026-01-02
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 16 10 — — $21,479.44 $59,818.92 $32,608.78 2026-01-02
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 16 10 — — $29,996.04 $74,577.69 $49,636.95 2026-01-02
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 16 10 — — $23,343.94 $58,285.32 $33,845.38 2026-01-02
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 16 10 — — $28,439.12 $74,630.94 $41,348.63 2026-01-02
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 16 10 — — $23,773.85 $75,178.35 $38,322.60 2026-01-02
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 16 10 — — $31,487.37 $86,635.62 $60,197.84 2026-01-02
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 1 — — $198,299.32 $198,299.32 $198,299.32 2026-01-02
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 1 — — $134,454.11 $134,454.11 $134,454.11 2026-01-02
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 1 — — $104,192.61 $104,192.61 $104,192.61 2026-01-02
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 1 1 — — $157,887.56 $157,887.56 $157,887.56 2026-01-02
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 1 1 — — $103,556.57 $103,556.57 $103,556.57 2026-01-02
4401 APR_DRG — 35 9 — — $24,323.15 $110,690.01 $65,420.82 2026-01-02
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 1 1 — — $126,919.97 $126,919.97 $126,919.97 2026-01-02
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 1 1 — — $77,300.66 $77,300.66 $77,300.66 2026-01-02
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 1 1 — — $97,491.39 $97,491.39 $97,491.39 2026-01-02
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 1 1 — — $58,417.98 $58,417.98 $58,417.98 2026-01-02
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 16 10 — — $45,343.70 $180,393.96 $91,713.29 2026-01-02
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 16 10 — — $47,924.07 $122,249.22 $68,301.34 2026-01-02
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 16 10 — — $36,257.92 $91,973.40 $51,545.57 2026-01-02
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 8 6 — — $92,589.17 $130,711.71 $116,382.51 2026-01-02
462 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity Without Mcc 8 6 — — $41,409.59 $60,998.94 $54,311.96 2026-01-02
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 16 10 — — $40,703.76 $115,041.30 $62,739.79 2026-01-02
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 16 10 — — $24,299.44 $62,805.18 $36,535.81 2026-01-02
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 16 10 — — $41,569.45 $108,514.98 $67,847.94 2026-01-02
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 16 10 — — $27,784.82 $72,956.76 $40,119.06 2026-01-02
469 MS_DRG Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc 8 6 — — $47,046.42 $69,623.31 $61,990.90 2026-01-02
470 MS_DRG Major Joint Replacement Or Reattachment Of Lower Extremity Without Mcc 8 6 — — $27,754.29 $40,161.15 $35,758.51 2026-01-02
471 MS_DRG Cervical Spinal Fusion With Mcc 16 10 — — $30,913.43 $103,460.49 $54,307.12 2026-01-02
472 MS_DRG Cervical Spinal Fusion With Cc 16 10 — — $21,658.74 $61,710.36 $33,408.62 2026-01-02
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 16 10 — — $34,584.62 $95,524.11 $51,545.06 2026-01-02
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 16 10 — — $23,710.89 $73,250.70 $38,522.83 2026-01-02
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 14 8 — — $23,884.52 $62,643.30 $43,263.91 2026-01-02
483 MS_DRG Major Joint/limb Reattachment Procedure Of Upper Extremities 8 6 — — $35,810.35 $54,276.66 $48,326.62 2026-01-02
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 16 10 — — $26,611.90 $68,571.09 $38,354.71 2026-01-02
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 14 8 — — $27,940.43 $75,640.56 $51,573.41 2026-01-02
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 14 8 — — $19,559.90 $51,141.30 $35,350.60 2026-01-02
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 16 10 — — $28,881.69 $74,988.78 $41,796.01 2026-01-02
500 MS_DRG Soft Tissue Procedures With Mcc 16 10 — — $20,457.07 $67,493.31 $35,746.40 2026-01-02
510 MS_DRG Shoulder,elbow Or Forearm Proc,exc Major Joint Proc W Mcc 8 6 — — $41,478.88 $60,877.53 $54,203.87 2026-01-02
511 MS_DRG Shoulder,elbow Or Forearm Proc,exc Major Joint Proc W Cc 8 6 — — $29,054.88 $41,773.56 $37,194.16 2026-01-02
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 16 10 — — $24,631.76 $65,868.12 $36,046.46 2026-01-02
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 16 10 — — $26,615.02 $76,339.20 $41,194.38 2026-01-02
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 16 10 — — $24,242.53 $62,083.11 $35,066.86 2026-01-02
570 MS_DRG Skin Debridement With Mcc 16 10 — — $23,673.50 $64,117.26 $34,863.33 2026-01-02
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 16 10 — — $49,721.57 $131,169.66 $72,706.17 2026-01-02
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 16 10 — — $13,782.76 $73,802.37 $36,331.41 2026-01-02
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 16 10 — — $45,493.37 $114,919.89 $65,221.84 2026-01-02
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 16 10 — — $21,515.15 $56,717.64 $32,520.03 2026-01-02
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 16 10 — — $20,291.87 $69,425.22 $36,600.51 2026-01-02
5831 APR_DRG — 20 5 — — $182,178.94 $505,663.48 $364,303.43 2026-01-02
5881 APR_DRG — 15 5 — — $120,207.70 $357,238.49 $126,218.09 2026-01-02
5891 APR_DRG — 20 5 — — $55,089.14 $463,098.78 $316,526.65 2026-01-02
5911 APR_DRG — 20 5 — — $87,947.34 $264,157.14 $137,901.92 2026-01-02
5931 APR_DRG — 20 5 — — $33,331.52 $230,598.29 $129,586.51 2026-01-02
6021 APR_DRG — 20 5 — — $29,875.56 $155,574.94 $120,115.64 2026-01-02
6031 APR_DRG — 20 5 — — $28,476.32 $206,291.74 $79,027.10 2026-01-02
6071 APR_DRG — 20 5 — — $45,109.01 $122,024.25 $76,687.92 2026-01-02
6081 APR_DRG — 20 5 — — $23,805.26 $87,467.33 $55,336.60 2026-01-02
6091 APR_DRG — 15 5 — — $55,199.37 $298,922.39 $137,535.48 2026-01-02
6111 APR_DRG — 20 5 — — $18,344.46 $97,947.83 $51,743.96 2026-01-02
6121 APR_DRG — 20 5 — — $32,807.61 $114,132.22 $58,266.07 2026-01-02
6131 APR_DRG — 20 5 — — $20,691.66 $115,613.68 $47,975.80 2026-01-02
6141 APR_DRG — 20 5 — — $16,482.26 $76,566.08 $35,881.92 2026-01-02
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 16 10 — — $31,857.24 $82,324.50 $49,519.21 2026-01-02
619 MS_DRG O.r. Procedures For Obesity With Mcc 16 10 — — $21,036.22 $58,074.45 $33,975.47 2026-01-02
6211 APR_DRG — 20 5 — — $11,878.64 $84,219.83 $32,659.45 2026-01-02
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 16 10 — — $30,813.23 $79,704.60 $44,538.13 2026-01-02
6221 APR_DRG — 20 5 — — $15,552.46 $43,634.94 $32,388.46 2026-01-02
6231 APR_DRG — 20 5 — — $12,503.69 $64,466.59 $36,687.30 2026-01-02
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 16 10 — — $17,693.70 $61,069.23 $32,115.17 2026-01-02
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 16 10 — — $32,306.14 $84,043.41 $46,831.06 2026-01-02
6301 APR_DRG — 20 5 — — $38,881.80 $313,136.50 $109,678.87 2026-01-02
6311 APR_DRG — 20 5 — — $12,062.78 $249,767.38 $77,306.90 2026-01-02
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 13 7 — — $36,123.37 $98,135.49 $56,984.09 2026-01-02
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 13 7 — — $27,911.19 $75,148.80 $55,396.79 2026-01-02
653 MS_DRG Major Bladder Procedures With Mcc 16 10 — — $43,363.47 $118,738.98 $64,453.16 2026-01-02
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 16 10 — — $15,908.26 $69,395.40 $34,648.24 2026-01-02
662 MS_DRG Minor Bladder Procedures With Mcc 16 10 — — $24,262.29 $66,447.48 $35,922.38 2026-01-02
665 MS_DRG Prostatectomy With Mcc 16 10 — — $24,992.54 $73,135.68 $38,185.54 2026-01-02
668 MS_DRG Transurethral Procedures With Mcc 16 10 — — $22,849.99 $62,117.19 $33,697.13 2026-01-02
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 16 10 — — $27,635.91 $89,238.48 $44,866.11 2026-01-02
6901 APR_DRG — 20 5 — — $14,716.02 $100,126.44 $41,998.06 2026-01-02
70 MS_DRG Other Cerebrovascular Disorders With Mcc 8 6 — — $27,739.08 $37,036.44 $32,976.34 2026-01-02
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 16 10 — — $31,300.07 $83,870.88 $45,973.77 2026-01-02
739 MS_DRG Uterine,adnexa Proc For Non-ovarian/adnexal Malig W Mcc 8 6 — — $56,976.14 $84,793.17 $75,497.77 2026-01-02
740 MS_DRG Uterine,adnexa Proc For Non-ovarian/adnexal Malig W Cc 8 6 — — $26,715.81 $38,729.79 $34,484.06 2026-01-02
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 12 7 — — $47,998.68 $126,624.24 $72,618.00 2026-01-02
791 MS_DRG Prematurity With Major Problems 12 7 — — $32,963.68 $86,475.87 $49,689.72 2026-01-02
793 MS_DRG Full Term Neonate With Major Problems 14 8 — — $33,845.68 $88,831.65 $61,338.67 2026-01-02
799 MS_DRG Splenic Procedures With Mcc 14 8 — — $39,735.91 $101,277.24 $69,235.79 2026-01-02
800 MS_DRG Splenic Procedures With Cc 14 8 — — $22,847.62 $62,063.94 $40,893.42 2026-01-02
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 16 10 — — $27,372.98 $76,356.24 $48,090.69 2026-01-02
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 16 10 — — $46,455.71 $124,014.99 $68,010.34 2026-01-02
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 16 10 — — $34,899.94 $99,673.35 $52,626.35 2026-01-02
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 16 10 — — $35,264.30 $101,718.15 $55,727.08 2026-01-02
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 16 10 — — $20,042.94 $65,684.94 $34,821.51 2026-01-02
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 14 8 — — $44,828.71 $117,731.49 $81,280.10 2026-01-02
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 16 10 — — $34,266.51 $106,653.36 $55,269.78 2026-01-02
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 16 10 — — $25,277.85 $67,925.70 $39,930.83 2026-01-02
8411 APR_DRG — 15 5 — — $60,632.94 $293,202.17 $93,305.69 2026-01-02
8421 APR_DRG — 20 5 — — $16,982.82 $144,503.48 $36,243.02 2026-01-02
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 14 8 — — $18,541.18 $48,265.80 $32,181.85 2026-01-02
850 MS_DRG Acute Leukemia With Other Procedures 1 1 — — $174,381.27 $174,381.27 $174,381.27 2026-01-02
8501 APR_DRG — 20 5 — — $18,649.20 $107,245.07 $39,189.46 2026-01-02
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 16 10 — — $37,210.65 $106,527.69 $56,981.40 2026-01-02
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 16 10 — — $23,503.45 $96,097.08 $48,578.19 2026-01-02
8631 APR_DRG — 20 5 — — $13,659.14 $98,945.91 $41,040.09 2026-01-02
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 16 10 — — $55,597.05 $148,173.45 $80,824.68 2026-01-02
8901 APR_DRG — 20 5 — — $10,745.24 $92,095.52 $36,433.25 2026-01-02
896 MS_DRG Alcohol/drug Abuse Or Dependence Without Rehabilitation Therapy W Mcc 5 4 — — $19,944.02 $37,931.04 $33,710.54 2026-01-02
901 MS_DRG Wound Debridements For Injuries With Mcc 16 10 — — $34,782.20 $94,369.65 $51,416.54 2026-01-02
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 16 10 — — $25,955.66 $82,241.43 $40,999.80 2026-01-02
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 16 10 — — $27,798.89 $84,852.81 $43,899.64 2026-01-02
9101 APR_DRG — 31 10 — — $33,480.65 $145,442.79 $51,550.13 2026-01-02
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 16 10 — — $208,896.19 $505,295.64 $295,050.75 2026-01-02
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 16 10 — — $35,111.08 $142,260.57 $73,357.79 2026-01-02
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 16 10 — — $16,178.67 $67,742.52 $34,625.84 2026-01-02
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 16 10 — — $24,541.27 $92,162.97 $42,577.09 2026-01-02
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 16 10 — — $25,989.92 $67,606.20 $37,610.38 2026-01-02
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 16 10 — — $23,828.68 $77,717.31 $40,721.58 2026-01-02
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 16 10 — — $31,228.94 $81,417.12 $58,650.89 2026-01-02
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 16 10 — — $57,738.55 $158,987.46 $88,539.59 2026-01-02
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 16 10 — — $32,545.61 $87,538.74 $48,362.44 2026-01-02
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 16 10 — — $20,592.85 $56,315.07 $33,363.46 2026-01-02
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 16 10 — — $54,894.19 $134,707.59 $77,776.65 2026-01-02
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 16 10 — — $28,047.08 $76,351.98 $41,493.76 2026-01-02
974 MS_DRG HIV With Major Related Condition With Mcc 16 10 — — $22,408.48 $63,606.06 $33,908.57 2026-01-02
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 16 10 — — $38,043.05 $101,258.07 $55,567.71 2026-01-02
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 16 10 — — $27,265.50 $74,607.51 $41,298.63 2026-01-02
A9543 HCPCS Y90 Ibritumomab, Rx 16 7 — — $48,780.22 $113,649.10 $58,245.17 2026-01-02
A9545 HCPCS I131 Tositumomab, Rx 1 1 — — $45,605.41 $45,605.41 $45,605.41 2026-01-02
C9073 HCPCS Brexucabtagene Autoleucel Ca 5 5 — — $51,775.08 $54,363.83 $51,775.08 2026-01-02
C9076 HCPCS Lisocabtagene Car Pos T 5 5 — — $51,775.08 $54,363.83 $51,775.08 2026-01-02
C9081 HCPCS Idecabtagene Car Pos T 5 5 — — $51,775.08 $54,363.83 $51,775.08 2026-01-02
C9085 HCPCS Inj Avalglucosid Alfa-ngpt 5 5 — — $32,400.21 $34,020.22 $32,400.21 2026-01-02
C9098 HCPCS Ciltacabtagene Car Pos T 5 5 — — $51,775.08 $54,363.83 $51,775.08 2026-01-02
C9146 HCPCS Inj, Elahere, 1 Mg 5 5 — — $32,400.21 $34,020.22 $32,400.21 2026-01-02
C9149 HCPCS Inj, Teplizumab-mzwv, 5 Mcg 5 5 — — $32,400.21 $34,020.22 $32,400.21 2026-01-02
C9172 HCPCS Inj, Beqvez, Per Tx Dose 11 6 — — $32,400.21 $3,895,500.00 $3,710,000.00 2026-01-02
C9301 HCPCS Obecabtagene Car Pos T 5 5 — — $51,775.08 $54,363.83 $51,775.08 2026-01-02
C9304 HCPCS Inj Marstacimab, 0.5 Mg 5 5 — — $32,400.21 $34,020.22 $32,400.21 2026-01-02
C9309 HCPCS Inj Onase Abepar-brve Treat 5 5 — — $32,400.21 $34,020.22 $32,400.21 2026-01-02
J1300 HCPCS Eculizumab Injection 8 6 — — $404.57 $34,020.22 $32,400.21 2026-01-02
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 12 7 — — $32,400.21 $3,869,530.00 $3,685,266.67 2026-01-02
J1413 HCPCS Inj Delandistrogene Mox Rokl 12 7 — — $32,400.21 $3,490,800.50 $3,320,517.25 2026-01-02
J3387 HCPCS Inj Elivaldogene Autotemecel 5 5 — — $51,775.08 $54,363.83 $51,775.08 2026-01-02
J3389 HCPCS Topi Adm Prad Zami Per Treat 5 5 — — $51,775.08 $54,363.83 $51,775.08 2026-01-02
J3391 HCPCS Inj, Atidarsagene Autotemcel 12 7 — — $51,775.08 $4,596,375.00 $4,421,275.00 2026-01-02
J3392 HCPCS Inj, Exagamglogene Autotem 14 7 — — $51,775.08 $4,664,000.00 $2,355,320.00 2026-01-02
J3393 HCPCS Inj, Betibeglogene Autotemce 13 7 — — $51,775.08 $4,394,040.00 $2,950,686.67 2026-01-02
J3394 HCPCS Inj, Lovotibeglogene Autotem 13 7 — — $51,775.08 $4,864,830.00 $3,261,355.00 2026-01-02
J3399 HCPCS Inj Onase Abepar-xioi Treat 8 7 — — $2,452,115.60 $4,806,917.50 $2,525,679.07 2026-01-02
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 6 6 — — $51,775.08 $205,640.00 $52,427.44 2026-01-02
J3403 HCPCS Revakinagene, Per Implant 6 6 — — $51,775.08 $257,500.00 $52,427.44 2026-01-02
J3404 HCPCS Inj Zopap Imad-drba 5 5 — — $32,400.21 $34,020.22 $32,400.21 2026-01-02
J7174 HCPCS Injection Fitusiran 0.04 Mg 6 6 — — $133.25 $34,020.22 $32,400.21 2026-01-02
J7330 HCPCS Cultured Chondrocytes Implnt 3 3 — — $45,737.00 $115,121.61 $103,294.46 2026-01-02
J9029 HCPCS Instill Adstiladrin, Tx Dose 17 8 — — $32,400.21 $126,804.08 $65,333.98 2026-01-02
J9183 HCPCS Gemcit Intraves Sys, 225 Mg 5 5 — — $32,400.21 $34,020.22 $32,400.21 2026-01-02
J9226 HCPCS Supprelin La Implant 18 8 — — $32,400.21 $98,260.19 $46,927.20 2026-01-02
J9376 HCPCS Inj Pozelimab-bbfg, 1 Mg 7 6 — — $91.73 $34,020.22 $32,400.21 2026-01-02
J9600 HCPCS Porfimer Sodium Injection 17 7 — — $24,228.42 $48,456.84 $32,400.21 2026-01-02
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 2 1 — — $93,216.70 $93,216.70 $93,216.70 2026-01-02
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 2 1 — — $37,828.21 $37,828.21 $37,828.21 2026-01-02
L7180 HCPCS Electronic Elbow Sequential 2 1 — — $41,907.21 $41,907.21 $41,907.21 2026-01-02
L7181 HCPCS Electronic Elbo Simultaneous 2 1 — — $47,211.27 $47,211.27 $47,211.27 2026-01-02
L8701 HCPCS Ewh S/d Uprt Micro Sensor 2 1 — — $34,284.44 $34,284.44 $34,284.44 2026-01-02
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 2 1 — — $67,452.66 $67,452.66 $67,452.66 2026-01-02
Q0480 HCPCS Driver Pneumatic Vad, Rep 2 1 — — $106,120.90 $106,120.90 $106,120.90 2026-01-02
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 13 7 — — $51,775.08 $979,034.30 $533,230.17 2026-01-02
Q2042 HCPCS Tisagenlecleucel Car-pos T 13 7 — — $51,775.08 $1,131,247.68 $589,891.07 2026-01-02
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 17 8 — — $32,400.21 $111,073.00 $57,624.35 2026-01-02
Q2053 HCPCS Brexucabtagene Car Pos T 13 7 — — $51,775.08 $976,103.02 $489,720.00 2026-01-02
Q2054 HCPCS Lisocabtagene Mara Car Pos T 13 7 — — $51,775.08 $1,032,971.94 $552,468.37 2026-01-02
Q2055 HCPCS Idecabtagene Vicleucel Car 13 7 — — $51,775.08 $1,056,624.86 $552,085.66 2026-01-02
Q2056 HCPCS Ciltacabtagene Car-pos T 14 7 — — $51,775.08 $1,102,636.68 $565,157.68 2026-01-02
Q2057 HCPCS Afamitresgene Autoleucel 12 6 — — $51,775.08 $1,140,881.10 $778,326.20 2026-01-02
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 12 7 — — $51,775.08 $283,893.75 $273,078.75 2026-01-02
Q5139 HCPCS Inj, Eculizumab-aeeb, 10 Mg 5 5 — — $32,400.21 $34,020.22 $32,400.21 2026-01-02
S2235 HCPCS Implant Auditory Brain Imp 5 5 — — $32,865.93 $34,509.23 $32,865.93 2026-01-02
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