Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

SPOTSYLVANIA REGIONAL MEDICAL CENTER

Fredericksburg, VA · CCN 490141 · Rates published

26,946 distinct procedures filed
31 distinct payers
754,231 rate rows
2026-03-01 last MRF observed
Data quality

593,046 of 754,231 rate rows are consumer-grade (78.6%)

161,185 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 154,965
per-diem day rate — not a per-procedure price 5,193
template filing: same amount across many unrelated codes — excluded 818
placeholder amount (≤ $0.02) — excluded from medians 197
exceeds 10× this hospital's gross charge — excluded from medians 12
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/06-1760818_SPOTSYLVANIA-REGIONAL-MEDICAL-CENTER_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 not_modified · 2026-06-08
Content fingerprint ab44817383d3f0bb… · 245,457,793 bytes · first seen 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
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $4,897,200.00 $4,897,200.00 $4,897,200.00 nat. median
$3,004,655
1.6× median
845
OTHER 		Inj, Atidarsagene Autotem 14 $5,384.63 $4,820,350.00 $4,505,000.00 nat. median
$9,966
outlier · 452.1×
00845
OTHER 		Inj, Atidarsagene Autotem 2 $4,369,850.00 $4,505,000.00 $4,437,425.00 nat. median
$4,505,000
1.0× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 $3,884,946.48 $3,884,946.48 $3,884,946.48 nat. median
$2,468,984
1.6× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 13 $3,672,900.00 $4,223,835.00 $3,752,665.17 nat. median
$3,746,358
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 11 $3,605,000.00 $4,145,750.00 $3,713,150.00 nat. median
$3,605,000
1.0× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 2 $3,562,713.00 $3,685,267.00 $3,623,804.50 nat. median
$3,574,709
1.0× median
00773
OTHER 		Inj, Beqvez, Per Tx Dose 2 $3,496,850.00 $3,605,000.00 $3,550,925.00 nat. median
$3,496,850
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 15 $5,967.40 $3,824,273.25 $3,364,581.40 nat. median
$13,041
outlier · 258.0×
908
OTHER 		Topi Adm Prad Zami Per Tr 14 $10,523.79 $3,569,327.40 $3,335,820.00 nat. median
$22,747
outlier · 146.6×
748
OTHER 		Inj, Lovotibeglogene Auto 15 $9,843.21 $3,778,900.00 $3,303,572.38 nat. median
$17,963
outlier · 183.9×
00908
OTHER 		Topi Adm Prad Zami Per Tr 2 $3,235,745.40 $3,335,820.00 $3,285,782.70 nat. median
$12,675
outlier · 259.2×
00714
OTHER 		Inj Delandistrogene Mox R 2 $3,225,691.35 $3,327,860.00 $3,276,739.60 nat. median
$3,228,024
1.0× median
00748
OTHER 		Inj, Lovotibeglogene Auto 2 $3,154,932.76 $3,286,000.00 $3,219,964.00 nat. median
$3,187,420
1.0× median
906
OTHER 		Inj Elivaldogene Autoteme 14 $7,181.19 $3,402,600.00 $3,180,000.00 nat. median
$20,756
outlier · 153.2×
00906
OTHER 		Inj Elivaldogene Autoteme 2 $3,084,600.00 $3,180,000.00 $3,132,300.00 nat. median
$21
outlier · 151392.0×
746
OTHER 		Inj, Betibeglogene Autote 15 $8,742.73 $3,413,200.00 $2,986,126.51 nat. median
$21,896
outlier · 136.4×
00746
OTHER 		Inj, Betibeglogene Autote 2 $2,851,769.93 $2,968,000.00 $2,909,464.50 nat. median
$2,878,960
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 13 $2,388,614.00 $2,770,209.67 $2,588,981.00 nat. median
$2,588,981
1.0× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 2 $2,316,955.58 $2,588,981.00 $2,449,962.79 nat. median
$2,457,321
1.0× median
824
OTHER 		Inj, Exagamglogene Autote 14 $14,094.23 $2,495,240.00 $2,332,000.00 nat. median
$25,250
outlier · 92.4×
00824
OTHER 		Inj, Exagamglogene Autote 2 $2,262,040.00 $2,332,000.00 $2,297,020.00 nat. median
$2,332,000
1.0× 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×
2067
OTHER 		Afamitresgene Autoleucel 12 $770,620.00 $824,563.40 $779,405.07 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 12 $527,123.40 $628,785.07 $587,649.60 nat. median
$587,650
1.0× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 3 $502,693.77 $1,501,307.95 $578,771.00 nat. median
$753,246
0.8× median
9194
OTHER 		Tisagenlecleucel Car-pos 13 $529,192.90 $608,571.83 $566,531.30 nat. median
$566,531
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 13 $516,726.10 $601,555.28 $562,201.20 nat. median
$562,201
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 12 $526,587.60 $605,575.74 $558,081.80 nat. median
$558,082
1.0× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 3 $492,271.12 $1,557,271.36 $553,169.00 nat. median
$674,867
0.8× median
09498
OTHER 		Ciltacabtagene Car-pos T 2 $511,309.70 $587,649.60 $548,571.76 nat. median
$554,552
1.0× median
09194
OTHER 		Tisagenlecleucel Car-pos 2 $513,317.11 $566,531.30 $539,364.13 nat. median
$538,205
1.0× median
5834
APR_DRG 		Neonate With Ecmo 8 $513,393.17 $582,350.04 $539,213.00 nat. median
$309,665
1.7× 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×
09422
OTHER 		Idecabtagene Vicleucel Ca 2 $510,789.97 $558,081.80 $533,963.47 nat. median
$530,178
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 13 $489,456.00 $569,445.65 $532,192.20 nat. median
$532,192
1.0× median
09413
OTHER 		Lisocabtagene Car Pos T 2 $501,224.32 $562,201.20 $531,030.63 nat. median
$534,091
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 3 $470,149.30 $1,478,916.58 $527,622.00 nat. median
$625,184
0.8× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 3 $459,839.17 $1,489,833.29 $516,442.00 nat. median
$673,137
0.8× median
09035
OTHER 		Axicabtagene Ciloleucel C 2 $474,772.32 $532,192.20 $502,841.21 nat. median
$505,583
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 3 $445,599.57 $1,410,309.44 $502,841.00 nat. median
$634,303
0.8× median
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 8 $470,177.82 $533,329.92 $493,824.00 nat. median
$93,370
outlier · 5.3×
9391
OTHER 		Brexucabtagene Car Pos T 13 $460,530.40 $529,609.96 $489,450.20 nat. median
$489,450
1.0× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 3 $435,956.80 $1,297,043.03 $489,399.00 nat. median
$619,808
0.8× median
5892
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 8 $453,542.81 $514,460.16 $476,352.00 nat. median
$89,796
outlier · 5.3×
5833
APR_DRG 		Neonate With Ecmo 8 $450,941.04 $511,509.60 $473,620.00 nat. median
$244,017
1.9× median
09391
OTHER 		Brexucabtagene Car Pos T 2 $446,714.49 $489,450.20 $467,648.55 nat. median
$464,978
1.0× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 8 $362,699.32 $411,415.20 $380,940.00 nat. median
$246,434
1.5× median
1614
APR_DRG 		Implantable Heart Assist Systems 8 $351,278.91 $398,460.60 $368,945.00 nat. median
$207,730
1.8× median

Other procedures at this hospital

Browse this hospital's 26,946 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
             
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 4 2 — — $202,270.22 $212,654.10 $207,400.24 2026-03-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 4 2 — — $76,231.77 $79,729.70 $77,963.63 2026-03-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 4 2 — — $135,480.68 $149,882.90 $142,528.60 2026-03-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 4 2 — — $95,259.70 $117,046.70 $105,870.59 2026-03-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 4 2 — — $62,662.50 $75,979.10 $69,150.12 2026-03-01
007 OTHER Lung Transplant 4 2 — — $76,370.30 $89,958.41 $82,995.96 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
00746 OTHER Inj, Betibeglogene Autote 4 2 — — $2,851,769.93 $2,968,000.00 $2,909,464.50 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
00773 OTHER Inj, Beqvez, Per Tx Dose 2 2 — — $3,496,850.00 $3,605,000.00 $3,550,925.00 2024-10-01
00824 OTHER Inj, Exagamglogene Autote 2 2 — — $2,262,040.00 $2,332,000.00 $2,297,020.00 2026-03-01
00831 OTHER Obecbtge Autol Up To 400 2 2 — — $269,902.50 $278,250.00 $274,076.25 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
00886 OTHER Inj. Remestemcel-l-rknd/ 2 2 — — $195,618.93 $201,669.00 $198,643.96 2026-03-01
00897 OTHER Revakinagene, Per Implant 2 2 — — $257,050.00 $265,000.00 $261,025.00 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
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
014 OTHER Allogeneic Bone Marrow Transplant 4 2 — — $74,484.27 $91,250.15 $82,650.28 2026-03-01
01582 OTHER New Technology - Level 45 4 2 — — $63,061.83 $65,449.00 $64,248.86 2026-03-01
01583 OTHER New Technology - Level 46 4 2 — — $72,763.58 $75,518.00 $74,133.23 2026-03-01
01584 OTHER New Technology - Level 47 4 2 — — $82,465.33 $85,587.00 $84,017.60 2026-03-01
01585 OTHER New Technology - Level 48 4 2 — — $92,167.07 $95,656.00 $93,901.96 2026-03-01
01596 OTHER New Technology - Level 45 4 2 — — $63,061.83 $65,449.00 $64,248.86 2026-03-01
01597 OTHER New Technology - Level 46 4 2 — — $72,763.58 $75,518.00 $74,133.23 2026-03-01
01598 OTHER New Technology - Level 47 4 2 — — $82,465.33 $85,587.00 $84,017.60 2026-03-01
01599 OTHER New Technology - Level 48 4 2 — — $92,167.07 $95,656.00 $93,901.96 2026-03-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 2 — — $166,902.76 $241,922.90 $203,364.96 2026-03-01
01901 OTHER New Technology - Level 49 4 2 — — $104,294.30 $108,242.20 $106,257.41 2026-03-01
01902 OTHER New Technology - Level 49 4 2 — — $104,294.30 $108,242.20 $106,257.41 2026-03-01
01903 OTHER New Technology - Level 50 4 2 — — $118,846.82 $123,345.80 $121,083.96 2026-03-01
01904 OTHER New Technology - Level 50 4 2 — — $118,846.82 $123,345.80 $121,083.96 2026-03-01
01905 OTHER New Technology - Level 51 4 2 — — $133,399.44 $138,449.20 $135,910.46 2026-03-01
01906 OTHER New Technology - Level 51 4 2 — — $133,399.44 $138,449.20 $135,910.46 2026-03-01
01907 OTHER New Technology - Level 52 4 2 — — $147,952.16 $153,552.80 $150,737.11 2026-03-01
01908 OTHER New Technology - Level 52 4 2 — — $147,952.16 $153,552.80 $150,737.11 2026-03-01
09035 OTHER Axicabtagene Ciloleucel C 4 2 — — $474,772.32 $532,192.20 $502,841.21 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
09141 OTHER Inj Onase Abepar-xioi Tre 4 2 — — $2,316,955.58 $2,588,981.00 $2,449,962.79 2026-03-01
09194 OTHER Tisagenlecleucel Car-pos 4 2 — — $513,317.11 $566,531.30 $539,364.13 2026-03-01
09391 OTHER Brexucabtagene Car Pos T 4 2 — — $446,714.49 $489,450.20 $467,648.55 2026-03-01
09413 OTHER Lisocabtagene Car Pos T 4 2 — — $501,224.32 $562,201.20 $531,030.63 2026-03-01
09422 OTHER Idecabtagene Vicleucel Ca 4 2 — — $510,789.97 $558,081.80 $533,963.47 2026-03-01
09498 OTHER Ciltacabtagene Car-pos T 4 2 — — $511,309.70 $587,649.60 $548,571.76 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 77 24 — — $20,990.00 $392,126.00 $296,456.67 2026-03-01
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 8 — — $63,509.71 $72,039.24 $66,703.00 2026-03-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 8 — — $111,678.38 $126,678.60 $117,295.00 2026-03-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 8 — — $160,701.40 $182,285.64 $168,783.00 2026-03-01
113648 CDM Revasc Litho/ath W Stnt 20 13 $106,711.22 $106,711.22 $16,695.97 $111,306.44 $69,566.52 2026-03-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 8 — — $282,800.68 $320,784.84 $297,023.00 2026-03-01
1204 APR_DRG Major Respiratory And Chest Procedures 13 8 — — $75,778.94 $85,957.20 $79,590.00 2026-03-01
1214 APR_DRG Other Respiratory And Chest Procedures 13 8 — — $68,369.02 $77,551.56 $71,807.00 2026-03-01
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 13 8 — — $77,010.70 $87,353.64 $80,883.00 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 73 24 — — $19,893.00 $169,211.22 $94,552.11 2026-03-01
1582 OTHER New Technology - Level 45 24 13 — — $65,012.20 $74,764.03 $66,768.18 2026-03-01
1583 OTHER New Technology - Level 46 24 13 — — $75,014.00 $86,266.10 $77,040.13 2026-03-01
1584 OTHER New Technology - Level 47 24 13 — — $85,015.80 $97,768.17 $87,312.08 2026-03-01
1585 OTHER New Technology - Level 48 24 13 — — $95,017.60 $109,270.24 $97,584.02 2026-03-01
1596 OTHER New Technology - Level 45 24 13 — — $65,012.20 $74,764.03 $66,768.18 2026-03-01
1597 OTHER New Technology - Level 46 24 13 — — $75,014.00 $86,266.10 $77,040.13 2026-03-01
1598 OTHER New Technology - Level 47 24 13 — — $85,015.80 $97,768.17 $87,312.08 2026-03-01
1599 OTHER New Technology - Level 48 24 13 — — $95,017.60 $109,270.24 $97,584.02 2026-03-01
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 13 8 — — $70,218.73 $79,650.00 $73,750.00 2026-03-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 13 8 — — $282,152.31 $320,049.36 $296,342.00 2026-03-01
1611 APR_DRG Implantable Heart Assist Systems 13 8 — — $157,957.24 $179,173.08 $165,901.00 2026-03-01
1612 APR_DRG Implantable Heart Assist Systems 13 8 — — $166,310.00 $188,647.92 $174,674.00 2026-03-01
1613 APR_DRG Implantable Heart Assist Systems 13 8 — — $170,348.13 $193,228.20 $178,915.00 2026-03-01
1614 APR_DRG Implantable Heart Assist Systems 13 8 — — $351,278.91 $398,460.60 $368,945.00 2026-03-01
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 13 8 — — $80,535.95 $91,352.88 $84,586.00 2026-03-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 13 8 — — $101,529.82 $115,166.88 $106,636.00 2026-03-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 13 8 — — $89,361.50 $101,363.40 $93,855.00 2026-03-01
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 13 8 — — $69,756.99 $79,126.20 $73,265.00 2026-03-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 13 8 — — $78,059.98 $88,543.80 $81,985.00 2026-03-01
1694 APR_DRG Major Abdominal Vascular Procedures 13 8 — — $79,503.26 $90,181.08 $83,501.00 2026-03-01
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 13 8 — — $61,877.03 $70,188.12 $64,989.00 2026-03-01
1774 APR_DRG Cardiac Pacemaker And Defibrillator Revision Except Device Replacement 13 8 — — $83,971.33 $95,249.52 $88,194.00 2026-03-01
1782 APR_DRG External Heart Assist Devices 13 8 — — $69,672.66 $79,030.08 $73,176.00 2026-03-01
1783 APR_DRG External Heart Assist Devices 13 8 — — $71,634.36 $81,255.96 $75,237.00 2026-03-01
1784 APR_DRG External Heart Assist Devices 13 8 — — $75,519.04 $85,662.36 $79,317.00 2026-03-01
1794 APR_DRG Defibrillator Implants 13 8 — — $67,623.88 $76,705.92 $71,024.00 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 50 16 — — $19,893.00 $587,458.81 $332,316.92 2026-03-01
1814 APR_DRG Lower Extremity Vascular Procedures 13 8 — — $63,616.16 $72,160.20 $66,815.00 2026-03-01
1834 APR_DRG Percutaneous Structural Cardiac Procedures 13 8 — — $80,841.47 $91,699.56 $84,907.00 2026-03-01
1901 OTHER New Technology - Level 49 24 13 — — $107,519.90 $123,647.88 $110,424.01 2026-03-01
1902 OTHER New Technology - Level 49 24 13 — — $107,519.90 $123,647.88 $110,424.01 2026-03-01
1903 OTHER New Technology - Level 50 24 13 — — $122,522.50 $140,900.88 $125,831.88 2026-03-01
1904 OTHER New Technology - Level 50 24 13 — — $122,522.50 $140,900.88 $125,831.88 2026-03-01
1905 OTHER New Technology - Level 51 24 13 — — $137,525.20 $158,153.98 $141,239.76 2026-03-01
1906 OTHER New Technology - Level 51 24 13 — — $137,525.20 $158,153.98 $141,239.76 2026-03-01
1907 OTHER New Technology - Level 52 24 13 — — $152,528.00 $175,407.20 $156,647.78 2026-03-01
1908 OTHER New Technology - Level 52 24 13 — — $152,528.00 $175,407.20 $156,647.78 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 77 24 — — $20,990.00 $392,126.00 $218,322.91 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 81 24 — — $26,741.00 $107,047.16 $65,425.21 2026-03-01
204 APR_DRG Open Craniotomy For Trauma 13 8 — — $93,593.18 $106,164.00 $98,300.00 2026-03-01
2067 OTHER Afamitresgene Autoleucel 13 12 — — $770,620.00 $824,563.40 $779,405.07 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 38 22 — — $27,878.00 $153,980.96 $90,929.48 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 63 23 — — $5,400.00 $147,931.26 $84,214.26 2026-03-01
214 APR_DRG Open Craniotomy Except Trauma 13 8 — — $73,720.48 $83,622.24 $77,428.00 2026-03-01
215 MS_DRG Other Heart Assist System Implant 81 24 — — $21,935.00 $144,430.00 $87,342.00 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 81 24 — — $21,935.00 $133,085.21 $88,152.29 2026-03-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 81 24 — — $21,935.00 $103,745.00 $76,244.24 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 81 24 — — $21,935.00 $103,745.00 $74,418.70 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 81 24 — — $21,935.00 $116,077.00 $80,631.12 2026-03-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 81 24 — — $21,935.00 $116,077.00 $69,164.00 2026-03-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 81 24 — — $21,935.00 $116,077.00 $68,566.88 2026-03-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 4 1 — — $59,752.11 $81,152.30 $70,452.21 2026-03-01
224 APR_DRG Ventricular Shunt Procedures 13 8 — — $69,186.04 $78,478.20 $72,665.00 2026-03-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 4 1 — — $55,324.12 $75,138.43 $65,231.27 2026-03-01
22633 CPT Arthrodesis, Combined Posterior Or Posterolateral Technique With Posterior Inter… 19 4 — — $4,950.00 $92,036.00 $69,566.00 2026-03-01
22800 CPT Arthrodesis, Posterior, For Spinal Deformity, With Or Without Cast; Up To 6 Vert… 20 4 — — $4,950.00 $117,921.00 $76,151.00 2026-03-01
22802 CPT Arthrodesis, Posterior, For Spinal Deformity, With Or Without Cast; 7 To 12 Vert… 20 4 — — $4,950.00 $117,921.00 $76,151.00 2026-03-01
22804 CPT Arthrodesis, Posterior, For Spinal Deformity, With Or Without Cast; 13 Or More V… 20 4 — — $4,950.00 $117,921.00 $76,151.00 2026-03-01
22808 CPT Arthrodesis, Anterior, For Spinal Deformity, With Or Without Cast; 2 To 3 Verteb… 20 4 — — $4,950.00 $117,921.00 $76,151.00 2026-03-01
22810 CPT Arthrodesis, Anterior, For Spinal Deformity, With Or Without Cast; 4 To 7 Verteb… 20 4 — — $4,950.00 $117,921.00 $76,151.00 2026-03-01
22812 CPT Arthrodesis, Anterior, For Spinal Deformity, With Or Without Cast; 8 Or More Ver… 19 4 — — $4,950.00 $117,921.00 $81,393.00 2026-03-01
2294 APR_DRG Other Digestive System And Abdominal Procedures 13 8 — — $65,071.87 $73,811.52 $68,344.00 2026-03-01
230 MS_DRG Other Cardiothoracic Procedures Without Cc/mcc 10 2 — — $18,626.00 $80,065.00 $76,801.00 2026-03-01
2304 APR_DRG Major Small Bowel Procedures 13 8 — — $75,324.12 $85,440.96 $79,112.00 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 81 24 — — $21,935.00 $136,211.00 $90,548.50 2026-03-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 81 24 — — $21,935.00 $136,211.00 $78,894.80 2026-03-01
2324 APR_DRG Gastric Fundoplication 13 8 — — $65,989.82 $74,852.64 $69,308.00 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 81 24 — — $21,935.00 $108,244.00 $80,284.99 2026-03-01
234 APR_DRG Spinal Procedures 13 8 — — $76,170.18 $86,400.00 $80,000.00 2026-03-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 81 24 — — $21,935.00 $112,138.00 $69,090.00 2026-03-01
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 13 8 — — $61,140.19 $69,352.20 $64,215.00 2026-03-01
2614 APR_DRG Major Biliary Tract Procedures 13 8 — — $66,505.47 $75,438.00 $69,850.00 2026-03-01
2634 APR_DRG Cholecystectomy 13 8 — — $61,296.41 $69,529.32 $64,379.00 2026-03-01
264 APR_DRG Other Nervous System And Related Procedures 13 8 — — $66,895.32 $75,879.72 $70,259.00 2026-03-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 81 24 — — $21,935.00 $156,164.00 $76,893.03 2026-03-01
274 APR_DRG Other Open Craniotomy 13 8 — — $74,538.89 $84,549.96 $78,287.00 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 77 23 — — $52,801.38 $186,850.00 $91,270.91 2026-03-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 77 23 — — $34,438.82 $155,071.00 $66,209.00 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 67 24 — — $5,400.00 $324,555.00 $164,244.58 2026-03-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 13 8 — — $107,354.08 $121,773.24 $112,753.00 2026-03-01
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 13 8 — — $94,318.97 $106,986.96 $99,062.00 2026-03-01
3124 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 13 8 — — $96,388.49 $109,334.88 $101,236.00 2026-03-01
33230 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Dual … 23 6 — — $2,550.00 $156,238.00 $67,036.00 2026-03-01
33231 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Multi… 23 6 — — $2,550.00 $156,238.00 $67,036.00 2026-03-01
33240 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Singl… 23 6 — — $4,259.00 $156,238.00 $67,036.00 2026-03-01
33249 CPT Insertion Or Replacement Of Permanent Implantable Defibrillator System, With Tra… 23 6 — — $4,259.00 $156,238.00 $67,036.00 2026-03-01
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 13 8 — — $86,502.60 $98,121.24 $90,853.00 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 62 16 — — $5,400.00 $188,434.45 $107,119.77 2026-03-01
4014 APR_DRG Adrenal Procedures 13 8 — — $75,469.27 $85,605.12 $79,264.00 2026-03-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 81 23 — — $20,990.00 $136,108.00 $72,045.00 2026-03-01
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 13 8 — — $69,118.30 $78,401.52 $72,594.00 2026-03-01
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 13 8 — — $68,941.35 $78,200.64 $72,408.00 2026-03-01
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 13 8 — — $72,639.40 $82,395.36 $76,292.00 2026-03-01
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 13 8 — — $93,879.35 $106,488.00 $98,600.00 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 81 23 — — $20,990.00 $154,988.00 $112,819.23 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 81 23 — — $20,990.00 $136,108.00 $92,130.15 2026-03-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 81 23 — — $20,990.00 $136,108.00 $76,481.69 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 81 23 — — $20,990.00 $136,108.00 $96,777.94 2026-03-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 13 8 — — $108,914.86 $123,543.36 $114,392.00 2026-03-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 81 23 — — $20,990.00 $136,108.00 $76,560.00 2026-03-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 13 8 — — $203,908.46 $231,296.04 $214,163.00 2026-03-01
4402 APR_DRG Kidney Transplant 13 8 — — $88,873.50 $100,810.44 $93,343.00 2026-03-01
4403 APR_DRG Kidney Transplant 13 8 — — $109,787.19 $124,532.64 $115,308.00 2026-03-01
4404 APR_DRG Kidney Transplant 13 8 — — $112,382.04 $127,476.72 $118,034.00 2026-03-01
4414 APR_DRG Major Bladder Procedures 13 8 — — $81,886.60 $92,884.32 $86,004.00 2026-03-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 81 23 — — $20,990.00 $103,989.00 $75,248.51 2026-03-01
4474 APR_DRG Other Kidney, Urinary Tract And Related Non-percutaneous Procedures 13 8 — — $65,799.04 $74,636.64 $69,108.00 2026-03-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 81 23 — — $20,990.00 $103,989.00 $69,428.01 2026-03-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 8 3 — — $71,444.06 $128,445.00 $97,031.73 2026-03-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 8 3 — — $47,533.38 $128,445.00 $80,578.73 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 89 24 — — $38,309.00 $134,029.00 $92,881.15 2026-03-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 89 24 — — $38,309.00 $134,029.00 $74,819.02 2026-03-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 8 3 — — $51,740.52 $97,291.00 $70,287.27 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 73 24 — — $20,990.00 $140,264.04 $82,235.91 2026-03-01
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 13 8 — — $71,830.67 $81,478.44 $75,443.00 2026-03-01
5244 OTHER Level 4 Blood Product Exc 24 13 — — $52,075.54 $69,632.50 $65,077.10 2026-03-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 13 8 — — $85,232.13 $96,679.44 $89,518.00 2026-03-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 13 8 — — $148,625.71 $168,588.00 $156,100.00 2026-03-01
57289 CDM Per Cl Con Int Com W/imp 17 12 $97,549.20 $97,549.20 $15,329.16 $102,194.40 $66,426.36 2026-03-01
5831 APR_DRG Neonate With Ecmo 13 8 — — $194,211.97 $220,297.32 $203,979.00 2026-03-01
5832 APR_DRG Neonate With Ecmo 13 8 — — $310,276.85 $351,951.48 $325,881.00 2026-03-01
5833 APR_DRG Neonate With Ecmo 13 8 — — $450,941.04 $511,509.60 $473,620.00 2026-03-01
5834 APR_DRG Neonate With Ecmo 13 8 — — $513,393.17 $582,350.04 $539,213.00 2026-03-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 13 8 — — $128,147.49 $145,359.36 $134,592.00 2026-03-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 13 8 — — $128,147.49 $145,359.36 $134,592.00 2026-03-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 13 8 — — $133,733.97 $151,695.72 $140,459.00 2026-03-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 13 8 — — $362,699.32 $411,415.20 $380,940.00 2026-03-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 13 8 — — $470,177.82 $533,329.92 $493,824.00 2026-03-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 13 8 — — $453,542.81 $514,460.16 $476,352.00 2026-03-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 13 8 — — $210,784.76 $239,095.80 $221,385.00 2026-03-01
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 13 8 — — $93,756.31 $106,348.68 $98,471.00 2026-03-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 13 8 — — $130,037.30 $147,503.16 $136,577.00 2026-03-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 13 8 — — $157,481.68 $178,633.08 $165,401.00 2026-03-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 13 8 — — $268,195.11 $304,217.64 $281,683.00 2026-03-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 13 8 — — $109,395.95 $124,088.76 $114,897.00 2026-03-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 13 8 — — $161,425.80 $183,107.52 $169,544.00 2026-03-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 13 8 — — $234,123.27 $265,569.84 $245,898.00 2026-03-01
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 13 8 — — $107,831.02 $122,314.32 $113,254.00 2026-03-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 13 8 — — $142,876.10 $162,065.88 $150,061.00 2026-03-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 13 8 — — $157,953.09 $179,168.76 $165,897.00 2026-03-01
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 13 8 — — $60,845.73 $69,017.40 $63,905.00 2026-03-01
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 13 8 — — $104,605.77 $118,655.28 $109,866.00 2026-03-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 13 8 — — $209,445.17 $237,576.24 $219,978.00 2026-03-01
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 13 8 — — $67,850.60 $76,964.04 $71,263.00 2026-03-01
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 13 8 — — $92,263.26 $104,655.24 $96,903.00 2026-03-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 13 8 — — $123,889.55 $140,529.60 $130,120.00 2026-03-01
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 13 8 — — $67,827.10 $76,937.04 $71,238.00 2026-03-01
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 13 8 — — $88,804.38 $100,731.60 $93,270.00 2026-03-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 13 8 — — $146,619.78 $166,312.44 $153,993.00 2026-03-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 13 8 — — $303,491.79 $344,255.40 $318,755.00 2026-03-01
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 13 8 — — $68,348.28 $77,527.80 $71,785.00 2026-03-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 13 8 — — $99,445.09 $112,801.68 $104,446.00 2026-03-01
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 13 8 — — $75,843.92 $86,030.64 $79,658.00 2026-03-01
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 13 8 — — $115,876.88 $131,440.32 $121,704.00 2026-03-01
6133 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 13 8 — — $63,086.68 $71,559.72 $66,259.00 2026-03-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 13 8 — — $117,380.98 $133,146.72 $123,284.00 2026-03-01
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition… 13 8 — — $77,736.49 $88,177.68 $81,646.00 2026-03-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 13 8 — — $85,507.24 $96,991.56 $89,807.00 2026-03-01
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 13 8 — — $65,452.05 $74,242.44 $68,743.00 2026-03-01
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 13 8 — — $93,854.46 $106,459.92 $98,574.00 2026-03-01
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 13 8 — — $97,815.18 $110,952.72 $102,734.00 2026-03-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 13 8 — — $131,140.49 $148,753.80 $137,735.00 2026-03-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 13 8 — — $317,923.18 $360,624.96 $333,912.00 2026-03-01
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 13 8 — — $108,660.49 $123,255.00 $114,125.00 2026-03-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 13 8 — — $253,585.38 $287,645.04 $266,338.00 2026-03-01
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 13 8 — — $90,170.24 $102,281.40 $94,705.00 2026-03-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 4 2 — — $86,198.37 $104,898.00 $95,307.68 2026-03-01
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 13 8 — — $83,412.83 $94,615.56 $87,607.00 2026-03-01
66661 CDM Icd Ins/repl Ld/gen 17 12 $196,924.00 $196,924.00 $32,492.46 $216,616.40 $140,800.66 2026-03-01
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 13 8 — — $160,729.05 $182,316.96 $168,812.00 2026-03-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 13 8 — — $158,660.91 $179,971.20 $166,640.00 2026-03-01
6904 APR_DRG Acute Leukemia 13 8 — — $101,657.00 $115,310.52 $106,769.00 2026-03-01
6954 APR_DRG Chemotherapy For Acute Leukemia 13 8 — — $61,346.17 $69,585.48 $64,431.00 2026-03-01
7 MS_DRG Lung Transplant 73 24 — — $20,990.00 $176,174.52 $100,508.03 2026-03-01
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 13 8 — — $61,810.68 $70,112.52 $64,919.00 2026-03-01
714 OTHER Inj Delandistrogene Mox R 28 15 — — $5,967.40 $3,824,273.25 $3,364,581.40 2026-03-01
717 OTHER Instill Adstiladrin, Tx D 28 15 — — $12,902.65 $72,857.99 $64,609.01 2026-03-01
746 OTHER Inj, Betibeglogene Autote 28 15 — — $8,742.73 $3,413,200.00 $2,986,126.51 2026-03-01
74727 CDM Revasc Fem/pop Stnt/ath 20 13 $112,431.55 $112,431.55 $17,590.97 $117,273.10 $73,295.68 2026-03-01
74731 CDM Revasc Tib Stnt/ath Init 20 13 $112,431.55 $112,431.55 $17,590.97 $117,273.10 $73,295.68 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 28 15 — — $9,843.21 $3,778,900.00 $3,303,572.38 2026-03-01
76842 CDM Rmv Icd W Rplc Sgl Ld 17 12 $141,462.00 $141,462.00 $23,341.23 $155,608.20 $101,145.33 2026-03-01
76843 CDM Rmv Icd W Rplc Dual Ld 17 12 $141,462.00 $141,462.00 $23,341.23 $155,608.20 $101,145.33 2026-03-01
76844 CDM Rmv Icd W Rplc Mult Ld 17 12 $196,924.00 $196,924.00 $32,492.46 $216,616.40 $140,800.66 2026-03-01
773 OTHER Inj, Beqvez, Per Tx Dose 11 11 — — $3,605,000.00 $4,145,750.00 $3,713,150.00 2024-10-01
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 13 8 — — $174,601.93 $198,053.64 $183,383.00 2026-03-01
824 OTHER Inj, Exagamglogene Autote 17 14 — — $14,094.23 $2,495,240.00 $2,332,000.00 2026-03-01
831 OTHER Obecbtge Autol Up To 400 17 14 — — $3,312.11 $297,727.50 $278,250.00 2026-03-01
8411 APR_DRG Extensive Third Degree Burns With Skin Graft 13 8 — — $64,637.79 $73,319.04 $67,888.00 2026-03-01
8412 APR_DRG Extensive Third Degree Burns With Skin Graft 13 8 — — $64,637.79 $73,319.04 $67,888.00 2026-03-01
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 13 8 — — $99,468.59 $112,828.68 $104,471.00 2026-03-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 13 8 — — $297,684.13 $337,667.40 $312,655.00 2026-03-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 13 8 — — $146,712.40 $166,417.20 $154,090.00 2026-03-01
84398 CDM Ins/repl Subq Icd W/eval 17 12 $194,865.00 $194,865.00 $32,152.72 $214,351.50 $139,328.48 2026-03-01
845 OTHER Inj, Atidarsagene Autotem 17 14 — — $5,384.63 $4,820,350.00 $4,505,000.00 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 63 23 — — $5,400.00 $118,973.15 $67,208.07 2026-03-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 13 8 — — $108,884.45 $123,508.80 $114,360.00 2026-03-01
85331 CDM Insrt Perm Pcmkr Ldless 17 12 $97,599.00 $97,599.00 $16,103.83 $107,358.90 $69,783.29 2026-03-01
8634 APR_DRG Neonatal Aftercare 13 8 — — $100,458.42 $113,950.80 $105,510.00 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 17 14 — — $6,245.61 $215,785.83 $201,669.00 2026-03-01
8904 APR_DRG HIV With Multiple Major HIV Related Conditions 13 8 — — $93,503.32 $106,061.40 $98,205.00 2026-03-01
894 APR_DRG Major Cranial Or Facial Bone Procedures 13 8 — — $70,372.18 $79,823.88 $73,911.00 2026-03-01
897 OTHER Revakinagene, Per Implant 13 12 — — $265,000.00 $283,550.00 $268,021.00 2026-03-01
90288 CPT Botulism Immune Globulin, Human, For Intravenous Use 12 2 — — $48,705.00 $82,311.45 $65,508.22 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 24 13 — — $489,456.00 $569,445.65 $532,192.20 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 17 14 — — $7,181.19 $3,402,600.00 $3,180,000.00 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 17 14 — — $10,523.79 $3,569,327.40 $3,335,820.00 2026-03-01
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 13 8 — — $63,755.78 $72,318.96 $66,962.00 2026-03-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 13 8 — — $99,118.83 $112,431.24 $104,103.00 2026-03-01
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 13 8 — — $78,691.76 $89,260.92 $82,649.00 2026-03-01
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 13 8 — — $74,111.71 $84,066.12 $77,839.00 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 24 13 — — $3,672,900.00 $4,223,835.00 $3,752,665.17 2026-03-01
914 APR_DRG Other Major Head And Neck Procedures 13 8 — — $75,207.99 $85,309.20 $78,990.00 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 24 13 — — $2,388,614.00 $2,770,209.67 $2,588,981.00 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 24 13 — — $529,192.90 $608,571.83 $566,531.30 2026-03-01
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 13 8 — — $63,755.78 $72,318.96 $66,962.00 2026-03-01
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 13 8 — — $72,011.77 $81,683.64 $75,633.00 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 50 15 — — $5,400.00 $306,403.68 $178,192.50 2026-03-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 13 8 — — $102,894.30 $116,714.52 $108,069.00 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 24 13 — — $460,530.40 $529,609.96 $489,450.20 2026-03-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 13 8 — — $212,475.50 $241,013.88 $223,161.00 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 24 13 — — $516,726.10 $601,555.28 $562,201.20 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 23 12 — — $526,587.60 $605,575.74 $558,081.80 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 23 12 — — $527,123.40 $628,785.07 $587,649.60 2026-03-01
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 13 8 — — $85,312.31 $96,770.16 $89,602.00 2026-03-01
9514 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 13 8 — — $62,818.48 $71,255.16 $65,977.00 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 9 2 — — $63,005.77 $173,512.94 $106,479.75 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 3 1 — — $76,785.37 $123,742.09 $123,321.96 2026-03-01
C9150 HCPCS Xenon Xe-129 Hyperpolarized Gas, Diagnostic, Per Study Dose 3 1 — — $53,040.00 $89,637.60 $89,637.60 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
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
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 1 — — $534,422.90 $534,422.90 $534,422.90 2026-03-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 9 2 — — $57,294.42 $221,874.56 $98,022.12 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 13 4 — — $61,338.53 $170,328.19 $87,600.00 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 13 4 — — $43,241.44 $117,019.36 $66,009.58 2026-03-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 28 15 — — $88,300.94 $104,686.68 $95,081.00 2026-03-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 28 15 — — $63,895.55 $75,752.45 $68,801.70 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 28 15 — — $96,999.90 $115,820.01 $108,243.00 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 7 3 — — $445,599.57 $1,410,309.44 $502,841.00 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 7 3 — — $502,693.77 $1,501,307.95 $578,771.00 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 13 4 — — $53,789.99 $147,108.87 $83,244.97 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 7 3 — — $435,956.80 $1,297,043.03 $489,399.00 2026-03-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 7 3 — — $459,839.17 $1,489,833.29 $516,442.00 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 7 3 — — $470,149.30 $1,478,916.58 $527,622.00 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 7 3 — — $492,271.12 $1,557,271.36 $553,169.00 2026-03-01
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 1 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, … 1 1 — — $737,362.50 $737,362.50 $737,362.50 2026-03-01
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