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

STONESPRINGS HOSPITAL CENTER

Dulles, VA · CCN 490145 · Rates published

Your selected procedure

You selected 27447 (CPT)

Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)

This hospital’s price: $25,831 across 11 payers · range $2,550-$45,094

Source: https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/04-3665595_STONESPRINGS-HOSPITAL-CENTER_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D · observed 2026-03-01

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

55,765 distinct procedures filed
27 distinct payers
801,061 rate rows
2026-07-17 last MRF observed
Data quality

750,746 of 801,061 rate rows are consumer-grade (93.7%)

50,315 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 29,658
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 13,100
per-diem day rate — not a per-procedure price 6,775
template filing: same amount across many unrelated codes — excluded 324
placeholder amount (≤ $0.02) — excluded from medians 219
percent-of-charges filed in the dollar field — excluded from medians 135
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 75
exceeds 10× this hospital's gross charge — excluded from medians 17
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 12
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/04-3665595_STONESPRINGS-HOSPITAL-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 · 2026-08-11
Content fingerprint 04877d48f340c46d… · 240,821,303 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
$2,997,086
1.6× median
845
OTHER 		Inj, Atidarsagene Autotem 12 $4,829.51 $4,820,350.00 $4,505,000.00 nat. median
$16,015
outlier · 281.3×
00845
OTHER 		Inj, Atidarsagene Autotem 2 $3,378,750.00 $4,505,000.00 $3,941,875.00 nat. median
$4,414,900
0.9× 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
$2,460,273
1.6× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 11 $3,672,900.00 $4,223,835.00 $3,758,972.34 nat. median
$3,758,972
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 10 $3,605,000.00 $4,145,750.00 $3,731,175.00 nat. median
$3,646,097
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 13 $5,352.21 $3,824,273.25 $3,365,797.60 nat. median
$3,325,455
1.0× median
908
OTHER 		Topi Adm Prad Zami Per Tr 12 $9,438.86 $3,569,327.40 $3,335,820.00 nat. median
$29,683
outlier · 112.4×
748
OTHER 		Inj, Lovotibeglogene Auto 13 $8,828.45 $3,778,900.00 $3,317,558.16 nat. median
$3,252,508
1.0× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 2 $2,754,675.00 $3,685,267.00 $3,218,425.12 nat. median
$3,574,709
0.9× median
906
OTHER 		Inj Elivaldogene Autoteme 12 $6,440.86 $3,402,600.00 $3,180,000.00 nat. median
$24,604
outlier · 129.2×
00773
OTHER 		Inj, Beqvez, Per Tx Dose 2 $2,703,750.00 $3,605,000.00 $3,154,375.00 nat. median
$3,496,850
0.9× median
746
OTHER 		Inj, Betibeglogene Autote 13 $7,841.42 $3,413,200.00 $2,998,768.38 nat. median
$2,939,969
1.0× median
00908
OTHER 		Topi Adm Prad Zami Per Tr 2 $2,501,865.00 $3,335,820.00 $2,918,842.50 nat. median
$14,170
outlier · 206.0×
00714
OTHER 		Inj Delandistrogene Mox R 2 $2,494,091.25 $3,327,860.00 $2,910,675.00 nat. median
$3,228,024
0.9× median
00748
OTHER 		Inj, Lovotibeglogene Auto 2 $2,439,381.00 $3,286,000.00 $2,858,504.00 nat. median
$3,187,420
0.9× median
00906
OTHER 		Inj Elivaldogene Autoteme 2 $2,385,000.00 $3,180,000.00 $2,782,500.00 nat. median
$3,084,600
0.9× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 11 $2,388,614.00 $2,770,209.67 $2,588,981.00 nat. median
$2,588,981
1.0× median
00746
OTHER 		Inj, Betibeglogene Autote 2 $2,204,976.75 $2,968,000.00 $2,582,984.50 nat. median
$2,878,960
0.9× median
824
OTHER 		Inj, Exagamglogene Autote 12 $12,641.21 $2,495,240.00 $2,332,000.00 nat. median
$58,186
outlier · 40.1×
09141
OTHER 		Inj Onase Abepar-xioi Tre 2 $1,791,460.50 $2,588,981.00 $2,165,174.88 nat. median
$2,511,312
0.9× median
00824
OTHER 		Inj, Exagamglogene Autote 2 $1,749,000.00 $2,332,000.00 $2,040,500.00 nat. median
$2,285,360
0.9× median
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 2 $1,199,550.00 $2,042,143.00 $1,199,550.00 nat. median
$809,151
1.5× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 4 $388,680.75 $1,501,307.95 $863,696.72 nat. median
$691,418
1.2× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 4 $363,517.50 $1,478,916.58 $830,699.97 nat. median
$610,161
1.4× median
2067
OTHER 		Afamitresgene Autoleucel 10 $770,620.00 $824,563.40 $779,405.07 nat. median
$786,032
1.0× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 4 $380,622.00 $1,557,271.36 $767,250.00 nat. median
$631,793
1.2× 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
$302,242
outlier · 2.4×
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 4 $355,545.75 $1,489,833.29 $707,459.77 nat. median
$624,417
1.1× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 4 $344,535.75 $1,410,309.44 $699,600.00 nat. median
$588,565
1.2× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 4 $337,080.00 $1,297,043.03 $699,600.00 nat. median
$577,541
1.2× median
5834
APR_DRG 		Neonate With Ecmo 8 $513,393.17 $652,435.56 $604,107.00 nat. median
$311,018
1.9× median
9498
OTHER 		Ciltacabtagene Car-pos T 11 $527,123.40 $628,785.07 $587,649.60 nat. median
$587,650
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos 11 $529,192.90 $608,571.83 $566,531.30 nat. median
$576,820
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 11 $516,726.10 $601,555.28 $562,201.20 nat. median
$562,201
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 11 $526,587.60 $605,575.74 $558,081.80 nat. median
$560,872
1.0× median
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 8 $470,177.82 $597,516.48 $553,256.00 nat. median
$96,420
outlier · 5.7×
J3402
HCPCS 		Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 $534,422.90 $534,422.90 $534,422.90 nat. median
$209,736
outlier · 2.5×
5892
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 8 $453,542.81 $576,376.56 $533,682.00 nat. median
$89,188
outlier · 6.0×
9035
OTHER 		Axicabtagene Ciloleucel C 11 $489,456.00 $569,445.65 $532,192.20 nat. median
$533,230
1.0× median
5833
APR_DRG 		Neonate With Ecmo 8 $450,941.04 $573,069.60 $530,620.00 nat. median
$250,089
outlier · 2.1×
9391
OTHER 		Brexucabtagene Car Pos T 11 $460,530.40 $529,609.96 $489,450.20 nat. median
$492,768
1.0× median
09498
OTHER 		Ciltacabtagene Car-pos T 2 $395,342.55 $587,649.60 $483,930.30 nat. median
$570,020
0.8× median
09194
OTHER 		Tisagenlecleucel Car-pos 2 $396,894.68 $566,531.30 $477,045.69 nat. median
$549,535
0.9× median
09422
OTHER 		Idecabtagene Vicleucel Ca 2 $394,940.70 $558,081.80 $472,574.47 nat. median
$541,339
0.9× median
09413
OTHER 		Lisocabtagene Car Pos T 2 $387,544.57 $562,201.20 $469,188.50 nat. median
$545,335
0.9× median
09035
OTHER 		Axicabtagene Ciloleucel C 2 $367,092.00 $532,192.20 $444,300.08 nat. median
$516,226
0.9× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 8 $362,699.32 $460,929.96 $426,787.00 nat. median
$254,667
1.7× median
09391
OTHER 		Brexucabtagene Car Pos T 2 $345,397.80 $489,450.20 $413,809.03 nat. median
$474,767
0.9× median
1614
APR_DRG 		Implantable Heart Assist Systems 8 $351,278.91 $446,415.84 $413,348.00 nat. median
$209,486
2.0× median

Other procedures at this hospital

Browse this hospital's 55,765 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
             
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 1 1 — — $4,897,200.00 $4,897,200.00 $4,897,200.00 2026-03-01
845 OTHER Inj, Atidarsagene Autotem 15 12 — — $4,829.51 $4,820,350.00 $4,505,000.00 2026-03-01
00845 OTHER Inj, Atidarsagene Autotem 2 2 — — $3,378,750.00 $4,505,000.00 $3,941,875.00 2026-03-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 1 — — $3,884,946.48 $3,884,946.48 $3,884,946.48 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 21 11 — — $3,672,900.00 $4,223,835.00 $3,758,972.34 2026-03-01
773 OTHER Inj, Beqvez, Per Tx Dose 10 10 — — $3,605,000.00 $4,145,750.00 $3,731,175.00 2024-10-01
714 OTHER Inj Delandistrogene Mox R 25 13 — — $5,352.21 $3,824,273.25 $3,365,797.60 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 15 12 — — $9,438.86 $3,569,327.40 $3,335,820.00 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 25 13 — — $8,828.45 $3,778,900.00 $3,317,558.16 2026-03-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 4 2 — — $2,754,675.00 $3,685,267.00 $3,218,425.12 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 15 12 — — $6,440.86 $3,402,600.00 $3,180,000.00 2026-03-01
00773 OTHER Inj, Beqvez, Per Tx Dose 2 2 — — $2,703,750.00 $3,605,000.00 $3,154,375.00 2024-10-01
746 OTHER Inj, Betibeglogene Autote 25 13 — — $7,841.42 $3,413,200.00 $2,998,768.38 2026-03-01
00908 OTHER Topi Adm Prad Zami Per Tr 2 2 — — $2,501,865.00 $3,335,820.00 $2,918,842.50 2026-03-01
00714 OTHER Inj Delandistrogene Mox R 4 2 — — $2,494,091.25 $3,327,860.00 $2,910,675.00 2026-03-01
00748 OTHER Inj, Lovotibeglogene Auto 4 2 — — $2,439,381.00 $3,286,000.00 $2,858,504.00 2026-03-01
00906 OTHER Inj Elivaldogene Autoteme 2 2 — — $2,385,000.00 $3,180,000.00 $2,782,500.00 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 21 11 — — $2,388,614.00 $2,770,209.67 $2,588,981.00 2026-03-01
00746 OTHER Inj, Betibeglogene Autote 4 2 — — $2,204,976.75 $2,968,000.00 $2,582,984.50 2026-03-01
824 OTHER Inj, Exagamglogene Autote 15 12 — — $12,641.21 $2,495,240.00 $2,332,000.00 2026-03-01
09141 OTHER Inj Onase Abepar-xioi Tre 4 2 — — $1,791,460.50 $2,588,981.00 $2,165,174.88 2026-03-01
00824 OTHER Inj, Exagamglogene Autote 2 2 — — $1,749,000.00 $2,332,000.00 $2,040,500.00 2026-03-01
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 3 2 — — $1,199,550.00 $2,042,143.00 $1,199,550.00 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 9 4 — — $388,680.75 $1,501,307.95 $863,696.72 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 9 4 — — $363,517.50 $1,478,916.58 $830,699.97 2026-03-01
2067 OTHER Afamitresgene Autoleucel 11 10 — — $770,620.00 $824,563.40 $779,405.07 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 11 4 — — $380,622.00 $1,557,271.36 $767,250.00 2026-03-01
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 1 1 — — $737,362.50 $737,362.50 $737,362.50 2026-03-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 11 4 — — $355,545.75 $1,489,833.29 $707,459.77 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 11 4 — — $344,535.75 $1,410,309.44 $699,600.00 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 11 4 — — $337,080.00 $1,297,043.03 $699,600.00 2026-03-01
5834 APR_DRG Neonate With Ecmo 13 8 — — $513,393.17 $652,435.56 $604,107.00 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 21 11 — — $527,123.40 $628,785.07 $587,649.60 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 21 11 — — $529,192.90 $608,571.83 $566,531.30 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 21 11 — — $516,726.10 $601,555.28 $562,201.20 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 21 11 — — $526,587.60 $605,575.74 $558,081.80 2026-03-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 13 8 — — $470,177.82 $597,516.48 $553,256.00 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
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 13 8 — — $453,542.81 $576,376.56 $533,682.00 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 21 11 — — $489,456.00 $569,445.65 $532,192.20 2026-03-01
5833 APR_DRG Neonate With Ecmo 13 8 — — $450,941.04 $573,069.60 $530,620.00 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 21 11 — — $460,530.40 $529,609.96 $489,450.20 2026-03-01
09498 OTHER Ciltacabtagene Car-pos T 4 2 — — $395,342.55 $587,649.60 $483,930.30 2026-03-01
09194 OTHER Tisagenlecleucel Car-pos 4 2 — — $396,894.68 $566,531.30 $477,045.69 2026-03-01
09422 OTHER Idecabtagene Vicleucel Ca 4 2 — — $394,940.70 $558,081.80 $472,574.47 2026-03-01
09413 OTHER Lisocabtagene Car Pos T 4 2 — — $387,544.57 $562,201.20 $469,188.50 2026-03-01
09035 OTHER Axicabtagene Ciloleucel C 4 2 — — $367,092.00 $532,192.20 $444,300.08 2026-03-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 13 8 — — $362,699.32 $460,929.96 $426,787.00 2026-03-01
09391 OTHER Brexucabtagene Car Pos T 4 2 — — $345,397.80 $489,450.20 $413,809.03 2026-03-01
1614 APR_DRG Implantable Heart Assist Systems 13 8 — — $351,278.91 $446,415.84 $413,348.00 2026-03-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 13 8 — — $317,923.18 $404,026.92 $374,099.00 2026-03-01
5832 APR_DRG Neonate With Ecmo 13 8 — — $310,276.85 $394,309.08 $365,101.00 2026-03-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 13 8 — — $303,491.79 $385,686.36 $357,117.00 2026-03-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 13 8 — — $297,684.13 $378,305.64 $350,283.00 2026-03-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 8 — — $282,800.68 $359,391.60 $332,770.00 2026-03-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 13 8 — — $282,152.31 $358,567.56 $332,007.00 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 50 16 — — $19,893.00 $753,238.00 $331,921.12 2026-03-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 13 8 — — $268,195.11 $340,830.72 $315,584.00 2026-03-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 13 8 — — $253,585.38 $322,264.44 $298,393.00 2026-03-01
831 OTHER Obecbtge Autol Up To 400 15 12 — — $2,970.65 $297,727.50 $278,250.00 2026-03-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 13 8 — — $234,123.27 $297,531.36 $275,492.00 2026-03-01
897 OTHER Revakinagene, Per Implant 11 10 — — $265,000.00 $283,550.00 $268,021.00 2026-03-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 13 8 — — $212,475.50 $270,020.52 $250,019.00 2026-03-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 13 8 — — $210,784.76 $267,871.32 $248,029.00 2026-03-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 13 8 — — $209,445.17 $266,169.24 $246,453.00 2026-03-01
00831 OTHER Obecbtge Autol Up To 400 2 2 — — $208,687.50 $278,250.00 $243,468.75 2026-03-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 13 8 — — $203,908.46 $259,133.04 $239,938.00 2026-03-01
00897 OTHER Revakinagene, Per Implant 2 2 — — $198,750.00 $265,000.00 $231,875.00 2026-03-01
5831 APR_DRG Neonate With Ecmo 13 8 — — $194,211.97 $246,810.24 $228,528.00 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 51 18 — — $20,990.00 $438,013.56 $218,141.43 2026-03-01
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 13 8 — — $174,601.93 $221,889.24 $205,453.00 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 15 12 — — $5,601.73 $215,785.83 $201,669.00 2026-03-01
1613 APR_DRG Implantable Heart Assist Systems 13 8 — — $170,348.13 $216,483.84 $200,448.00 2026-03-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 4 2 — — $181,417.62 $212,654.10 $196,767.54 2026-03-01
1612 APR_DRG Implantable Heart Assist Systems 13 8 — — $166,310.00 $211,351.68 $195,696.00 2026-03-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 2 — — $149,696.29 $241,922.90 $191,268.81 2026-03-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 13 8 — — $161,425.80 $205,144.92 $189,949.00 2026-03-01
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 13 8 — — $160,729.05 $204,259.32 $189,129.00 2026-03-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 8 — — $160,701.40 $204,223.68 $189,096.00 2026-03-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 13 8 — — $158,660.91 $201,630.60 $186,695.00 2026-03-01
1611 APR_DRG Implantable Heart Assist Systems 13 8 — — $157,957.24 $200,736.36 $185,867.00 2026-03-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 13 8 — — $157,953.09 $200,730.96 $185,862.00 2026-03-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 13 8 — — $157,481.68 $200,132.64 $185,308.00 2026-03-01
00886 OTHER Inj. Remestemcel-l-rknd/ 2 2 — — $151,251.75 $201,669.00 $176,460.38 2026-03-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 13 8 — — $148,625.71 $188,877.96 $174,887.00 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 46 14 — — $8,596.00 $351,287.22 $173,192.29 2026-03-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 13 8 — — $146,712.40 $186,445.80 $172,635.00 2026-03-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 13 8 — — $146,619.78 $186,328.08 $172,526.00 2026-03-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 13 8 — — $142,876.10 $181,570.68 $168,121.00 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 55 18 — — $8,596.00 $325,358.00 $163,673.79 2026-03-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 13 8 — — $133,733.97 $169,953.12 $157,364.00 2026-03-01
1908 OTHER New Technology - Level 52 21 11 — — $152,528.00 $175,407.20 $157,103.84 2026-03-01
1907 OTHER New Technology - Level 52 21 11 — — $152,528.00 $175,407.20 $157,103.84 2026-03-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 13 8 — — $131,140.49 $166,656.96 $154,312.00 2026-03-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 13 8 — — $130,037.30 $165,255.12 $153,014.00 2026-03-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 13 8 — — $128,147.49 $162,853.20 $150,790.00 2026-03-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 13 8 — — $128,147.49 $162,853.20 $150,790.00 2026-03-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 13 8 — — $123,889.55 $157,442.40 $145,780.00 2026-03-01
1906 OTHER New Technology - Level 51 21 11 — — $137,525.20 $158,153.98 $141,650.96 2026-03-01
1905 OTHER New Technology - Level 51 21 11 — — $137,525.20 $158,153.98 $141,650.96 2026-03-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 13 8 — — $117,380.98 $149,170.68 $138,121.00 2026-03-01
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 13 8 — — $115,876.88 $147,259.08 $136,351.00 2026-03-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 4 2 — — $121,513.60 $149,882.90 $135,034.46 2026-03-01
01907 OTHER New Technology - Level 52 4 2 — — $114,396.00 $153,552.80 $133,846.30 2026-03-01
01908 OTHER New Technology - Level 52 4 2 — — $114,396.00 $153,552.80 $133,846.30 2026-03-01
4404 APR_DRG Kidney Transplant 13 8 — — $112,382.04 $142,818.12 $132,239.00 2026-03-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 8 — — $111,678.38 $141,923.88 $131,411.00 2026-03-01
4403 APR_DRG Kidney Transplant 13 8 — — $109,787.19 $139,520.88 $129,186.00 2026-03-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 13 8 — — $109,395.95 $139,023.00 $128,725.00 2026-03-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 13 8 — — $108,914.86 $138,411.72 $128,159.00 2026-03-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 13 8 — — $108,884.45 $138,372.84 $128,123.00 2026-03-01
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 13 8 — — $108,660.49 $138,088.80 $127,860.00 2026-03-01
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 13 8 — — $107,831.02 $137,034.72 $126,884.00 2026-03-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 13 8 — — $107,354.08 $136,428.84 $126,323.00 2026-03-01
1903 OTHER New Technology - Level 50 21 11 — — $122,522.50 $140,900.88 $126,198.18 2026-03-01
1904 OTHER New Technology - Level 50 21 11 — — $122,522.50 $140,900.88 $126,198.18 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 3 1 — — $76,785.37 $123,742.09 $123,321.96 2026-03-01
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 13 8 — — $104,605.77 $132,936.12 $123,089.00 2026-03-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 13 8 — — $102,894.30 $130,761.00 $121,075.00 2026-03-01
01906 OTHER New Technology - Level 51 4 2 — — $103,143.90 $138,449.20 $120,681.05 2026-03-01
01905 OTHER New Technology - Level 51 4 2 — — $103,143.90 $138,449.20 $120,681.05 2026-03-01
6904 APR_DRG Acute Leukemia 13 8 — — $101,657.00 $129,188.52 $119,619.00 2026-03-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 13 8 — — $101,529.82 $129,026.52 $119,469.00 2026-03-01
8634 APR_DRG Neonatal Aftercare 13 8 — — $100,458.42 $127,665.72 $118,209.00 2026-03-01
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 13 8 — — $99,468.59 $126,407.52 $117,044.00 2026-03-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 13 8 — — $99,445.09 $126,377.28 $117,016.00 2026-03-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 13 8 — — $99,118.83 $125,962.56 $116,632.00 2026-03-01
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 13 8 — — $97,815.18 $124,305.84 $115,098.00 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 65 18 — — $20,990.00 $210,166.00 $114,911.00 2026-03-01
3124 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 13 8 — — $96,388.49 $122,493.60 $113,420.00 2026-03-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 10 4 — — $96,500.00 $144,857.31 $112,869.51 2026-03-01
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 13 8 — — $94,318.97 $119,862.72 $110,984.00 2026-03-01
1901 OTHER New Technology - Level 49 21 11 — — $107,519.90 $123,647.88 $110,745.50 2026-03-01
1902 OTHER New Technology - Level 49 21 11 — — $107,519.90 $123,647.88 $110,745.50 2026-03-01
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 13 8 — — $93,879.35 $119,304.36 $110,467.00 2026-03-01
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 13 8 — — $93,854.46 $119,273.04 $110,438.00 2026-03-01
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 13 8 — — $93,756.31 $119,147.76 $110,322.00 2026-03-01
204 APR_DRG Open Craniotomy For Trauma 13 8 — — $93,593.18 $118,940.40 $110,130.00 2026-03-01
8904 APR_DRG HIV With Multiple Major HIV Related Conditions 13 8 — — $93,503.32 $118,827.00 $110,025.00 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 65 18 — — $20,990.00 $167,336.00 $109,926.37 2026-03-01
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 13 8 — — $92,263.26 $117,250.20 $108,565.00 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 63 18 — — $8,596.00 $216,497.38 $108,300.90 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 25 13 — — $74,999.92 $115,820.01 $108,243.00 2026-03-01
01903 OTHER New Technology - Level 50 4 2 — — $91,891.88 $123,345.80 $107,515.93 2026-03-01
01904 OTHER New Technology - Level 50 4 2 — — $91,891.88 $123,345.80 $107,515.93 2026-03-01
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 13 8 — — $90,170.24 $114,591.24 $106,103.00 2026-03-01
215 MS_DRG Other Heart Assist System Implant 65 19 — — $43,687.00 $173,680.00 $105,334.17 2026-03-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 13 8 — — $89,361.50 $113,563.08 $105,151.00 2026-03-01
4402 APR_DRG Kidney Transplant 13 8 — — $88,873.50 $112,943.16 $104,577.00 2026-03-01
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 13 8 — — $88,804.38 $112,854.60 $104,495.00 2026-03-01
J9999 HCPCS Carmustine Wafers 8/box 11 6 $142,605.98 $142,605.98 $48,913.85 $121,215.08 $102,676.31 2024-10-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 65 19 — — $56,680.00 $170,641.00 $102,444.00 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 57 19 — — $19,893.00 $209,628.00 $101,972.69 2026-03-01
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 13 8 — — $86,502.60 $109,929.96 $101,787.00 2026-03-01
7 MS_DRG Lung Transplant 49 18 — — $20,990.00 $202,411.63 $101,337.33 2026-03-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 13 8 — — $85,507.24 $108,665.28 $100,616.00 2026-03-01
64654 CPT Initial Open Implantation Of Baroreflex Activation Therapy (bat) Modulation Syst… 4 3 — — $2,550.00 $100,433.00 $100,433.00 2026-03-01
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 13 8 — — $85,312.31 $108,416.88 $100,386.00 2026-03-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 13 8 — — $85,232.13 $108,315.36 $100,292.00 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 73 19 — — $61,062.04 $146,581.00 $100,149.32 2026-03-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 4 2 — — $85,439.12 $117,046.70 $100,018.26 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 9 2 — — $54,184.96 $173,512.94 $99,485.48 2026-03-01
1774 APR_DRG Cardiac Pacemaker And Defibrillator Revision Except Device Replacement 13 8 — — $83,971.33 $106,712.64 $98,808.00 2026-03-01
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 13 8 — — $83,412.83 $106,003.08 $98,151.00 2026-03-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 9 2 — — $49,273.20 $221,874.56 $98,022.12 2026-03-01
1599 OTHER New Technology - Level 48 21 11 — — $95,017.60 $109,270.24 $97,868.13 2026-03-01
1585 OTHER New Technology - Level 48 21 11 — — $95,017.60 $109,270.24 $97,868.13 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 61 18 — — $51,989.54 $179,233.00 $97,574.23 2026-03-01
4414 APR_DRG Major Bladder Procedures 13 8 — — $81,886.60 $104,063.40 $96,355.00 2026-03-01
1834 APR_DRG Percutaneous Structural Cardiac Procedures 13 8 — — $80,841.47 $102,735.00 $95,125.00 2026-03-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 25 13 — — $68,273.92 $104,686.68 $95,081.00 2026-03-01
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 13 8 — — $80,535.95 $102,347.28 $94,766.00 2026-03-01
01901 OTHER New Technology - Level 49 4 2 — — $80,639.92 $108,242.20 $94,350.77 2026-03-01
01902 OTHER New Technology - Level 49 4 2 — — $80,639.92 $108,242.20 $94,350.77 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 65 18 — — $20,990.00 $142,500.00 $93,665.48 2026-03-01
1694 APR_DRG Major Abdominal Vascular Procedures 13 8 — — $79,503.26 $101,035.08 $93,551.00 2026-03-01
84398 CDM Ins/repl Sq Icd With Elec 27 9 $154,418.04 $154,418.04 $23,162.71 $141,755.76 $92,650.82 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 65 19 — — $55,658.45 $133,355.00 $92,627.26 2026-03-01
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 13 8 — — $78,691.76 $100,003.68 $92,596.00 2026-03-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 13 8 — — $78,059.98 $99,200.16 $91,852.00 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 65 19 — — $55,894.35 $133,933.00 $91,618.12 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 65 19 — — $50,439.00 $147,043.00 $91,549.09 2026-03-01
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition… 13 8 — — $77,736.49 $98,789.76 $91,472.00 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 30 17 — — $27,878.00 $197,434.00 $90,885.13 2026-03-01
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 13 8 — — $77,010.70 $97,867.44 $90,618.00 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 51 18 — — $20,990.00 $350,637.00 $90,556.82 2026-03-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 4 2 — — $77,311.94 $104,898.00 $90,062.78 2026-03-01
234 APR_DRG Spinal Procedures 13 8 — — $76,170.18 $96,799.32 $89,629.00 2026-03-01
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 13 8 — — $75,843.92 $96,384.60 $89,245.00 2026-03-01
1204 APR_DRG Major Respiratory And Chest Procedures 13 8 — — $75,778.94 $96,301.44 $89,168.00 2026-03-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 4 1 — — $85,554.85 $92,690.80 $89,122.83 2026-03-01
1784 APR_DRG External Heart Assist Devices 13 8 — — $75,519.04 $95,972.04 $88,863.00 2026-03-01
4014 APR_DRG Adrenal Procedures 13 8 — — $75,469.27 $95,908.32 $88,804.00 2026-03-01
2304 APR_DRG Major Small Bowel Procedures 13 8 — — $75,324.12 $95,723.64 $88,633.00 2026-03-01
914 APR_DRG Other Major Head And Neck Procedures 13 8 — — $75,207.99 $95,575.68 $88,496.00 2026-03-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 65 18 — — $20,990.00 $134,515.00 $88,453.60 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 55 18 — — $8,596.00 $189,677.00 $87,779.59 2026-03-01
274 APR_DRG Other Open Craniotomy 13 8 — — $74,538.89 $94,725.72 $87,709.00 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 15 5 — — $47,426.70 $170,328.19 $87,600.00 2026-03-01
1584 OTHER New Technology - Level 47 21 11 — — $85,015.80 $97,768.17 $87,566.27 2026-03-01
1598 OTHER New Technology - Level 47 21 11 — — $85,015.80 $97,768.17 $87,566.27 2026-03-01
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 13 8 — — $74,111.71 $94,182.48 $87,206.00 2026-03-01
214 APR_DRG Open Craniotomy Except Trauma 13 8 — — $73,720.48 $93,685.68 $86,746.00 2026-03-01
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 13 8 — — $72,639.40 $92,311.92 $85,474.00 2026-03-01
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 13 8 — — $72,011.77 $91,514.88 $84,736.00 2026-03-01
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 13 8 — — $71,830.67 $91,283.76 $84,522.00 2026-03-01
1783 APR_DRG External Heart Assist Devices 13 8 — — $71,634.36 $91,034.28 $84,291.00 2026-03-01
01599 OTHER New Technology - Level 48 4 2 — — $71,263.20 $95,656.00 $83,379.80 2026-03-01
01585 OTHER New Technology - Level 48 4 2 — — $71,263.20 $95,656.00 $83,379.80 2026-03-01
894 APR_DRG Major Cranial Or Facial Bone Procedures 13 8 — — $70,372.18 $89,430.48 $82,806.00 2026-03-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 65 19 — — $26,741.00 $139,640.00 $82,715.44 2026-03-01
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 13 8 — — $70,218.73 $89,236.08 $82,626.00 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 17 5 — — $41,590.20 $147,108.87 $82,597.20 2026-03-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 4 1 — — $79,214.72 $85,821.86 $82,518.29 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 73 19 — — $26,741.00 $138,171.38 $82,456.19 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 49 18 — — $20,990.00 $161,153.11 $82,279.60 2026-03-01
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 13 8 — — $69,756.99 $88,648.56 $82,082.00 2026-03-01
1782 APR_DRG External Heart Assist Devices 13 8 — — $69,672.66 $88,541.64 $81,983.00 2026-03-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 65 18 — — $20,990.00 $136,107.00 $81,736.00 2026-03-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 65 18 — — $20,990.00 $136,107.00 $81,521.00 2026-03-01
224 APR_DRG Ventricular Shunt Procedures 13 8 — — $69,186.04 $87,922.80 $81,410.00 2026-03-01
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 13 8 — — $69,118.30 $87,837.48 $81,331.00 2026-03-01
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 13 8 — — $68,941.35 $87,612.84 $81,123.00 2026-03-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 65 19 — — $44,379.47 $136,211.00 $80,694.00 2026-03-01
1214 APR_DRG Other Respiratory And Chest Procedures 13 8 — — $68,369.02 $86,884.92 $80,449.00 2026-03-01
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 13 8 — — $68,348.28 $86,859.00 $80,425.00 2026-03-01
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 13 8 — — $67,850.60 $86,226.12 $79,839.00 2026-03-01
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 13 8 — — $67,827.10 $86,195.88 $79,811.00 2026-03-01
1794 APR_DRG Defibrillator Implants 13 8 — — $67,623.88 $85,937.76 $79,572.00 2026-03-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 73 19 — — $42,646.90 $123,073.00 $79,531.45 2026-03-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 10 4 — — $60,830.00 $118,330.00 $79,028.72 2026-03-01
264 APR_DRG Other Nervous System And Related Procedures 13 8 — — $66,895.32 $85,012.20 $78,715.00 2026-03-01
007 OTHER Lung Transplant 4 2 — — $68,497.07 $89,958.41 $78,498.05 2026-03-01
2614 APR_DRG Major Biliary Tract Procedures 13 8 — — $66,505.47 $84,516.48 $78,256.00 2026-03-01
014 OTHER Allogeneic Bone Marrow Transplant 4 2 — — $66,805.48 $91,250.15 $78,087.77 2026-03-01
2324 APR_DRG Gastric Fundoplication 13 8 — — $65,989.82 $83,862.00 $77,650.00 2026-03-01
C9150 HCPCS Xenon Xe-129 Hyperpolarized Gas, Diagnostic, Per Study Dose 3 1 — — $45,614.40 $77,438.40 $77,438.40 2024-10-01
4474 APR_DRG Other Kidney, Urinary Tract And Related Non-percutaneous Procedures 13 8 — — $65,799.04 $83,619.00 $77,425.00 2026-03-01
1583 OTHER New Technology - Level 46 21 11 — — $75,014.00 $86,266.10 $77,264.42 2026-03-01
1597 OTHER New Technology - Level 46 21 11 — — $75,014.00 $86,266.10 $77,264.42 2026-03-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 10 4 — — $55,398.00 $108,418.21 $77,189.96 2026-03-01
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 13 8 — — $65,452.05 $83,178.36 $77,017.00 2026-03-01
2294 APR_DRG Other Digestive System And Abdominal Procedures 13 8 — — $65,071.87 $82,694.52 $76,569.00 2026-03-01
8412 APR_DRG Extensive Third Degree Burns With Skin Graft 13 8 — — $64,637.79 $82,143.72 $76,059.00 2026-03-01
8411 APR_DRG Extensive Third Degree Burns With Skin Graft 13 8 — — $64,637.79 $82,143.72 $76,059.00 2026-03-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 65 19 — — $47,872.86 $114,693.00 $75,963.21 2026-03-01
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 13 8 — — $63,755.78 $81,022.68 $75,021.00 2026-03-01
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 13 8 — — $63,755.78 $81,022.68 $75,021.00 2026-03-01
1814 APR_DRG Lower Extremity Vascular Procedures 13 8 — — $63,616.16 $80,844.48 $74,856.00 2026-03-01
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 8 — — $63,509.71 $80,709.48 $74,731.00 2026-03-01
01584 OTHER New Technology - Level 47 4 2 — — $63,761.85 $85,587.00 $74,603.02 2026-03-01
01598 OTHER New Technology - Level 47 4 2 — — $63,761.85 $85,587.00 $74,603.02 2026-03-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 4 1 — — $71,523.66 $77,489.30 $74,506.48 2026-03-01
6133 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 13 8 — — $63,086.68 $80,171.64 $74,233.00 2026-03-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 4 2 — — $68,372.82 $79,729.70 $73,977.14 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 65 19 — — $44,175.26 $114,693.00 $73,960.13 2026-03-01
9514 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 13 8 — — $62,818.48 $79,831.44 $73,918.00 2026-03-01
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 13 8 — — $61,877.03 $78,634.80 $72,810.00 2026-03-01
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 13 8 — — $61,810.68 $78,550.56 $72,732.00 2026-03-01
6954 APR_DRG Chemotherapy For Acute Leukemia 13 8 — — $61,346.17 $77,959.80 $72,185.00 2026-03-01
2634 APR_DRG Cholecystectomy 13 8 — — $61,296.41 $77,897.16 $72,127.00 2026-03-01
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 13 8 — — $61,140.19 $77,698.44 $71,943.00 2026-03-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 65 19 — — $39,178.29 $108,155.00 $71,610.25 2026-03-01
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 13 8 — — $60,845.73 $77,323.68 $71,596.00 2026-03-01
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 13 8 — — $60,508.41 $76,896.00 $71,200.00 2026-03-01
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 13 8 — — $60,421.32 $76,784.76 $71,097.00 2026-03-01
1773 APR_DRG Cardiac Pacemaker And Defibrillator Revision Except Device Replacement 13 8 — — $60,050.82 $76,313.88 $70,661.00 2026-03-01
1673 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 13 8 — — $60,050.82 $76,313.88 $70,661.00 2026-03-01
5114 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 13 8 — — $60,041.14 $76,302.00 $70,650.00 2026-03-01
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 13 8 — — $60,027.32 $76,283.64 $70,633.00 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 61 18 — — $8,596.00 $151,048.00 $70,168.92 2026-03-01
C1767 HCPCS Generator Nrstm 5 Ipg 162 6 $149,160.00 $149,160.00 $14,970.45 $144,075.00 $70,142.33 2026-03-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 65 19 — — $42,996.86 $102,366.00 $69,915.21 2026-03-01
8633 APR_DRG Neonatal Aftercare 13 8 — — $59,380.33 $75,461.76 $69,872.00 2026-03-01
294 APR_DRG Other Percutaneous Intracranial Procedures 13 8 — — $59,374.80 $75,455.28 $69,866.00 2026-03-01
6091 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 13 8 — — $58,845.32 $74,782.44 $69,243.00 2026-03-01
6092 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 13 8 — — $58,845.32 $74,782.44 $69,243.00 2026-03-01
5894 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 13 8 — — $58,727.82 $74,632.32 $69,104.00 2026-03-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 65 19 — — $39,598.18 $107,566.00 $69,090.00 2026-03-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 65 18 — — $20,990.00 $103,989.00 $69,055.04 2026-03-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 25 13 — — $49,403.77 $75,752.45 $68,801.70 2026-03-01
4424 APR_DRG Kidney And Urinary Tract Procedures For Malignancy 13 8 — — $58,225.99 $73,995.12 $68,514.00 2026-03-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 65 19 — — $34,305.29 $108,155.00 $68,002.78 2026-03-01
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 13 8 — — $57,379.93 $72,919.44 $67,518.00 2026-03-01
2314 APR_DRG Major Large Bowel Procedures 13 8 — — $57,377.16 $72,916.20 $67,515.00 2026-03-01
1582 OTHER New Technology - Level 45 21 11 — — $65,012.20 $74,764.03 $66,962.57 2026-03-01
1596 OTHER New Technology - Level 45 21 11 — — $65,012.20 $74,764.03 $66,962.57 2026-03-01
494 APR_DRG Bacterial And Tuberculous Infections Of Nervous System 13 8 — — $56,742.62 $72,109.44 $66,768.00 2026-03-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 61 18 — — $34,087.56 $148,749.00 $66,626.48 2026-03-01
3254 APR_DRG Non-elective Or Complex Knee Joint Replacement 13 8 — — $56,544.93 $71,858.88 $66,536.00 2026-03-01
2244 APR_DRG Peritoneal Adhesiolysis 13 8 — — $56,410.83 $71,688.24 $66,378.00 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 17 5 — — $33,434.10 $117,019.36 $66,009.58 2026-03-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 73 19 — — $30,909.69 $123,073.00 $65,980.42 2026-03-01
9524 APR_DRG Non-extensive O.r. Procedure Unrelated To Principal Diagnosis 13 8 — — $56,026.51 $71,200.08 $65,926.00 2026-03-01
01597 OTHER New Technology - Level 46 4 2 — — $56,260.50 $75,518.00 $65,826.25 2026-03-01
01583 OTHER New Technology - Level 46 4 2 — — $56,260.50 $75,518.00 $65,826.25 2026-03-01
1781 APR_DRG External Heart Assist Devices 13 8 — — $55,917.30 $71,060.76 $65,797.00 2026-03-01
6604 APR_DRG Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula… 13 8 — — $55,762.46 $70,864.20 $65,615.00 2026-03-01
5184 APR_DRG Other Female Reproductive System And Related Procedures 13 8 — — $55,662.93 $70,737.84 $65,498.00 2026-03-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 4 2 — — $56,202.45 $75,979.10 $65,351.17 2026-03-01
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