Hospital

DOMINION HOSPITAL

Falls Church, VA · CCN 494023 · Rates published

14,004 distinct procedures filed

31 distinct payers

108,815 rate rows

2026-03-01 last MRF observed

Data quality

102,026 of 108,815 rate rows are consumer-grade (93.8%)

6,789 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 — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	6,242
per-diem day rate — not a per-procedure price	493
placeholder amount (≤ $0.02) — excluded from medians	54

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1410313_DOMINION-HOSPITAL_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page	https://www.hcavirginia.com/locations/dominion-hospital
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-17
Content fingerprint	ab2e07012af82784… · 49,603,933 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
845 OTHER	Inj, Atidarsagene Autotem	11	$5,812.19	$4,820,350.00	$4,595,100.00	nat. median $9,966 outlier · 461.1×
00845 OTHER	Inj, Atidarsagene Autotem	3	$4,369,850.00	$4,505,000.00	$4,505,000.00	nat. median $4,505,000 1.0× median
9138 OTHER	Inj, Hemgenix, Per Tx Dos	9	$3,685,267.00	$3,943,235.69	$3,832,677.68	nat. median $3,746,358 1.0× median
09138 OTHER	Inj, Hemgenix, Per Tx Dos	3	$3,574,708.99	$3,685,267.00	$3,685,267.00	nat. median $3,574,709 1.0× median
908 OTHER	Topi Adm Prad Zami Per Tr	11	$10,523.79	$3,569,327.40	$3,402,536.40	nat. median $22,747 outlier · 149.6×
714 OTHER	Inj Delandistrogene Mox R	11	$6,835.91	$3,560,810.20	$3,394,417.20	nat. median $13,041 outlier · 260.3×
00908 OTHER	Topi Adm Prad Zami Per Tr	3	$3,235,745.40	$3,335,820.00	$3,335,820.00	nat. median $12,675 outlier · 263.2×
00714 OTHER	Inj Delandistrogene Mox R	3	$3,228,024.20	$3,327,860.00	$3,327,860.00	nat. median $3,228,024 1.0× median
748 OTHER	Inj, Lovotibeglogene Auto	11	$13,012.09	$3,480,183.56	$3,317,558.16	nat. median $17,963 outlier · 184.7×
00748 OTHER	Inj, Lovotibeglogene Auto	3	$3,154,932.76	$3,252,508.00	$3,252,508.00	nat. median $3,187,420 1.0× median
906 OTHER	Inj Elivaldogene Autoteme	11	$9,299.01	$3,402,600.00	$3,243,600.00	nat. median $20,756 outlier · 156.3×
00906 OTHER	Inj Elivaldogene Autoteme	3	$3,084,600.00	$3,180,000.00	$3,180,000.00	nat. median $21 outlier · 153697.4×
746 OTHER	Inj, Betibeglogene Autote	11	$12,036.32	$3,145,766.83	$2,998,768.38	nat. median $21,896 outlier · 137.0×
00746 OTHER	Inj, Betibeglogene Autote	3	$2,851,769.93	$2,939,969.00	$2,939,969.00	nat. median $2,878,960 1.0× median
9141 OTHER	Inj Onase Abepar-xioi Tre	9	$2,588,981.00	$2,770,209.67	$2,692,540.24	nat. median $2,588,981 1.0× median
09141 OTHER	Inj Onase Abepar-xioi Tre	3	$2,511,311.57	$2,588,981.00	$2,588,981.00	nat. median $2,457,321 1.1× median
824 OTHER	Inj, Exagamglogene Autote	11	$14,094.23	$2,495,240.00	$2,378,640.00	nat. median $25,250 outlier · 94.2×
00824 OTHER	Inj, Exagamglogene Autote	3	$2,262,040.00	$2,332,000.00	$2,332,000.00	nat. median $2,332,000 1.0× median
2067 OTHER	Afamitresgene Autoleucel	9	$770,620.00	$824,563.40	$801,444.80	nat. median $786,032 1.0× median
9498 OTHER	Ciltacabtagene Car-pos T	9	$587,649.60	$628,785.07	$611,155.58	nat. median $587,650 1.0× median
9194 OTHER	Tisagenlecleucel Car-pos	9	$566,531.30	$606,188.49	$589,192.55	nat. median $566,531 1.0× median
09498 OTHER	Ciltacabtagene Car-pos T	3	$570,020.11	$587,649.60	$587,649.60	nat. median $554,552 1.1× median
9413 OTHER	Lisocabtagene Car Pos T	9	$562,201.20	$601,555.28	$584,689.25	nat. median $562,201 1.0× median
9422 OTHER	Idecabtagene Vicleucel Ca	9	$558,081.80	$597,147.53	$580,405.07	nat. median $558,082 1.0× median
Q2042 HCPCS	Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka…	3	$561,407.87	$578,771.00	$578,771.00	nat. median $753,246 0.8× median
09194 OTHER	Tisagenlecleucel Car-pos	3	$549,535.36	$566,531.30	$566,531.30	nat. median $538,205 1.1× median
09413 OTHER	Lisocabtagene Car Pos T	3	$545,335.16	$562,201.20	$562,201.20	nat. median $534,091 1.1× median
09422 OTHER	Idecabtagene Vicleucel Ca	3	$541,339.35	$558,081.80	$558,081.80	nat. median $530,178 1.1× median
9035 OTHER	Axicabtagene Ciloleucel C	9	$532,192.20	$569,445.65	$553,479.89	nat. median $532,192 1.0× median
Q2056 HCPCS	Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige…	3	$536,573.93	$553,169.00	$553,169.00	nat. median $674,867 0.8× median
09035 OTHER	Axicabtagene Ciloleucel C	3	$516,226.43	$532,192.20	$532,192.20	nat. median $505,583 1.1× median
Q2055 HCPCS	Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (…	3	$511,793.34	$527,622.00	$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	$500,948.74	$516,442.00	$516,442.00	nat. median $673,137 0.8× median
9391 OTHER	Brexucabtagene Car Pos T	9	$489,450.20	$523,711.71	$509,028.21	nat. median $489,450 1.0× median
Q2041 HCPCS	Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via…	3	$487,755.77	$502,841.00	$502,841.00	nat. median $634,303 0.8× median
09391 OTHER	Brexucabtagene Car Pos T	3	$474,766.69	$489,450.20	$489,450.20	nat. median $464,978 1.1× median
Q2053 HCPCS	Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V…	3	$474,717.03	$489,399.00	$489,399.00	nat. median $619,808 0.8× median
831 OTHER	Obecbtge Autol Up To 400	11	$3,979.93	$297,727.50	$283,815.00	nat. median $12,362 outlier · 23.0×
00831 OTHER	Obecbtge Autol Up To 400	3	$269,902.50	$278,250.00	$278,250.00	nat. median $278,250 1.0× median
897 OTHER	Revakinagene, Per Implant	9	$265,000.00	$283,550.00	$275,600.00	nat. median $9,577 outlier · 28.8×
00897 OTHER	Revakinagene, Per Implant	3	$257,050.00	$265,000.00	$265,000.00	nat. median $265,000 1.0× median
018 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	3	$234,665.21	$241,922.90	$237,084.44	nat. median $424,868 0.6× median
001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	3	$206,274.48	$212,654.10	$208,401.02	nat. median $263,894 0.8× median
886 OTHER	Inj. Remestemcel-l-rknd/	11	$8,708.75	$215,785.83	$205,702.38	nat. median $17,985 outlier · 11.4×
00886 OTHER	Inj. Remestemcel-l-rknd/	3	$195,618.93	$201,669.00	$201,669.00	nat. median $201,669 1.0× median
275 MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	8	$179,233.00	$179,233.00	$179,233.00	nat. median $68,886 outlier · 2.6×
652 MS_DRG	Kidney Transplant	8	$166,555.00	$166,555.00	$166,555.00	nat. median $31,494 outlier · 5.3×
1908 OTHER	New Technology - Level 52	9	$160,012.70	$171,213.59	$166,413.21	nat. median $152,962 1.1× median
1907 OTHER	New Technology - Level 52	9	$160,012.70	$171,213.59	$166,413.21	nat. median $153,199 1.1× median
01908 OTHER	New Technology - Level 52	3	$148,946.22	$153,552.80	$153,552.80	nat. median $82,736 1.9× median

Other procedures at this hospital

Browse this hospital's 14,004 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

845	OTHER	Inj, Atidarsagene Autotem	11	11	—	—	$5,812.19	$4,820,350.00	$4,595,100.00	2026-03-01
00845	OTHER	Inj, Atidarsagene Autotem	3	3	—	—	$4,369,850.00	$4,505,000.00	$4,505,000.00	2026-03-01
9138	OTHER	Inj, Hemgenix, Per Tx Dos	9	9	—	—	$3,685,267.00	$3,943,235.69	$3,832,677.68	2026-03-01
09138	OTHER	Inj, Hemgenix, Per Tx Dos	3	3	—	—	$3,574,708.99	$3,685,267.00	$3,685,267.00	2026-03-01
908	OTHER	Topi Adm Prad Zami Per Tr	11	11	—	—	$10,523.79	$3,569,327.40	$3,402,536.40	2026-03-01
714	OTHER	Inj Delandistrogene Mox R	11	11	—	—	$6,835.91	$3,560,810.20	$3,394,417.20	2026-03-01
00908	OTHER	Topi Adm Prad Zami Per Tr	3	3	—	—	$3,235,745.40	$3,335,820.00	$3,335,820.00	2026-03-01
00714	OTHER	Inj Delandistrogene Mox R	3	3	—	—	$3,228,024.20	$3,327,860.00	$3,327,860.00	2026-03-01
748	OTHER	Inj, Lovotibeglogene Auto	11	11	—	—	$13,012.09	$3,480,183.56	$3,317,558.16	2026-03-01
00748	OTHER	Inj, Lovotibeglogene Auto	3	3	—	—	$3,154,932.76	$3,252,508.00	$3,252,508.00	2026-03-01
906	OTHER	Inj Elivaldogene Autoteme	11	11	—	—	$9,299.01	$3,402,600.00	$3,243,600.00	2026-03-01
00906	OTHER	Inj Elivaldogene Autoteme	3	3	—	—	$3,084,600.00	$3,180,000.00	$3,180,000.00	2026-03-01
746	OTHER	Inj, Betibeglogene Autote	11	11	—	—	$12,036.32	$3,145,766.83	$2,998,768.38	2026-03-01
00746	OTHER	Inj, Betibeglogene Autote	3	3	—	—	$2,851,769.93	$2,939,969.00	$2,939,969.00	2026-03-01
9141	OTHER	Inj Onase Abepar-xioi Tre	9	9	—	—	$2,588,981.00	$2,770,209.67	$2,692,540.24	2026-03-01
09141	OTHER	Inj Onase Abepar-xioi Tre	3	3	—	—	$2,511,311.57	$2,588,981.00	$2,588,981.00	2026-03-01
824	OTHER	Inj, Exagamglogene Autote	11	11	—	—	$14,094.23	$2,495,240.00	$2,378,640.00	2026-03-01
00824	OTHER	Inj, Exagamglogene Autote	3	3	—	—	$2,262,040.00	$2,332,000.00	$2,332,000.00	2026-03-01
2067	OTHER	Afamitresgene Autoleucel	9	9	—	—	$770,620.00	$824,563.40	$801,444.80	2026-03-01
9498	OTHER	Ciltacabtagene Car-pos T	9	9	—	—	$587,649.60	$628,785.07	$611,155.58	2026-03-01
9194	OTHER	Tisagenlecleucel Car-pos	9	9	—	—	$566,531.30	$606,188.49	$589,192.55	2026-03-01
09498	OTHER	Ciltacabtagene Car-pos T	3	3	—	—	$570,020.11	$587,649.60	$587,649.60	2026-03-01
9413	OTHER	Lisocabtagene Car Pos T	9	9	—	—	$562,201.20	$601,555.28	$584,689.25	2026-03-01
9422	OTHER	Idecabtagene Vicleucel Ca	9	9	—	—	$558,081.80	$597,147.53	$580,405.07	2026-03-01
Q2042	HCPCS	Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka…	3	3	—	—	$561,407.87	$578,771.00	$578,771.00	2026-03-01
09194	OTHER	Tisagenlecleucel Car-pos	3	3	—	—	$549,535.36	$566,531.30	$566,531.30	2026-03-01
09413	OTHER	Lisocabtagene Car Pos T	3	3	—	—	$545,335.16	$562,201.20	$562,201.20	2026-03-01
09422	OTHER	Idecabtagene Vicleucel Ca	3	3	—	—	$541,339.35	$558,081.80	$558,081.80	2026-03-01
9035	OTHER	Axicabtagene Ciloleucel C	9	9	—	—	$532,192.20	$569,445.65	$553,479.89	2026-03-01
Q2056	HCPCS	Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige…	3	3	—	—	$536,573.93	$553,169.00	$553,169.00	2026-03-01
09035	OTHER	Axicabtagene Ciloleucel C	3	3	—	—	$516,226.43	$532,192.20	$532,192.20	2026-03-01
Q2055	HCPCS	Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (…	3	3	—	—	$511,793.34	$527,622.00	$527,622.00	2026-03-01
Q2054	HCPCS	Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi…	3	3	—	—	$500,948.74	$516,442.00	$516,442.00	2026-03-01
9391	OTHER	Brexucabtagene Car Pos T	9	9	—	—	$489,450.20	$523,711.71	$509,028.21	2026-03-01
Q2041	HCPCS	Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via…	3	3	—	—	$487,755.77	$502,841.00	$502,841.00	2026-03-01
09391	OTHER	Brexucabtagene Car Pos T	3	3	—	—	$474,766.69	$489,450.20	$489,450.20	2026-03-01
Q2053	HCPCS	Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V…	3	3	—	—	$474,717.03	$489,399.00	$489,399.00	2026-03-01
831	OTHER	Obecbtge Autol Up To 400	11	11	—	—	$3,979.93	$297,727.50	$283,815.00	2026-03-01
00831	OTHER	Obecbtge Autol Up To 400	3	3	—	—	$269,902.50	$278,250.00	$278,250.00	2026-03-01
897	OTHER	Revakinagene, Per Implant	9	9	—	—	$265,000.00	$283,550.00	$275,600.00	2026-03-01
00897	OTHER	Revakinagene, Per Implant	3	3	—	—	$257,050.00	$265,000.00	$265,000.00	2026-03-01
018	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	3	3	—	—	$234,665.21	$241,922.90	$237,084.44	2026-03-01
001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	3	3	—	—	$206,274.48	$212,654.10	$208,401.02	2026-03-01
886	OTHER	Inj. Remestemcel-l-rknd/	11	11	—	—	$8,708.75	$215,785.83	$205,702.38	2026-03-01
00886	OTHER	Inj. Remestemcel-l-rknd/	3	3	—	—	$195,618.93	$201,669.00	$201,669.00	2026-03-01
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	9	8	—	—	$179,233.00	$179,233.00	$179,233.00	2026-03-01
652	MS_DRG	Kidney Transplant	9	8	—	—	$166,555.00	$166,555.00	$166,555.00	2026-03-01
1907	OTHER	New Technology - Level 52	9	9	—	—	$160,012.70	$171,213.59	$166,413.21	2026-03-01
1908	OTHER	New Technology - Level 52	9	9	—	—	$160,012.70	$171,213.59	$166,413.21	2026-03-01
01908	OTHER	New Technology - Level 52	3	3	—	—	$148,946.22	$153,552.80	$153,552.80	2026-03-01
01907	OTHER	New Technology - Level 52	3	3	—	—	$148,946.22	$153,552.80	$153,552.80	2026-03-01
1905	OTHER	New Technology - Level 51	9	9	—	—	$144,273.80	$154,372.97	$150,044.75	2026-03-01
1906	OTHER	New Technology - Level 51	9	9	—	—	$144,273.80	$154,372.97	$150,044.75	2026-03-01
277	MS_DRG	Cardiac Defibrillator Implant Without Mcc	9	8	—	—	$148,749.00	$148,749.00	$148,749.00	2026-03-01
003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	3	3	—	—	$145,386.41	$149,882.90	$146,885.24	2026-03-01
215	MS_DRG	Other Heart Assist System Implant	9	8	—	—	$138,542.00	$138,542.00	$138,542.00	2026-03-01
01906	OTHER	New Technology - Level 51	3	3	—	—	$134,295.72	$138,449.20	$138,449.20	2026-03-01
01905	OTHER	New Technology - Level 51	3	3	—	—	$134,295.72	$138,449.20	$138,449.20	2026-03-01
1904	OTHER	New Technology - Level 50	9	9	—	—	$128,534.90	$137,532.34	$133,676.30	2026-03-01
1903	OTHER	New Technology - Level 50	9	9	—	—	$128,534.90	$137,532.34	$133,676.30	2026-03-01
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	9	8	—	—	$130,658.00	$130,658.00	$130,658.00	2026-03-01
231	MS_DRG	Coronary Bypass With Ptca With Mcc	9	8	—	—	$130,658.00	$130,658.00	$130,658.00	2026-03-01
402	MS_DRG	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	9	8	—	—	$130,559.00	$130,559.00	$130,559.00	2026-03-01
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	9	8	—	—	$130,559.00	$130,559.00	$130,559.00	2026-03-01
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	9	8	—	—	$130,559.00	$130,559.00	$130,559.00	2026-03-01
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	9	8	—	—	$130,559.00	$130,559.00	$130,559.00	2026-03-01
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	9	8	—	—	$130,559.00	$130,559.00	$130,559.00	2026-03-01
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	9	8	—	—	$130,559.00	$130,559.00	$130,559.00	2026-03-01
01903	OTHER	New Technology - Level 50	3	3	—	—	$119,645.43	$123,345.80	$123,345.80	2026-03-01
01904	OTHER	New Technology - Level 50	3	3	—	—	$119,645.43	$123,345.80	$123,345.80	2026-03-01
1902	OTHER	New Technology - Level 49	9	9	—	—	$112,796.00	$120,691.72	$117,307.84	2026-03-01
1901	OTHER	New Technology - Level 49	9	9	—	—	$112,796.00	$120,691.72	$117,307.84	2026-03-01
004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	3	3	—	—	$113,535.30	$117,046.70	$114,705.77	2026-03-01
Q0480	HCPCS	Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only	12	12	—	—	$104,995.71	$115,820.01	$109,325.43	2026-03-01
01901	OTHER	New Technology - Level 49	3	3	—	—	$104,994.93	$108,242.20	$108,242.20	2026-03-01
01902	OTHER	New Technology - Level 49	3	3	—	—	$104,994.93	$108,242.20	$108,242.20	2026-03-01
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	9	8	—	—	$107,566.00	$107,566.00	$107,566.00	2026-03-01
458	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	9	8	—	—	$104,644.00	$104,644.00	$104,644.00	2026-03-01
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	9	8	—	—	$104,644.00	$104,644.00	$104,644.00	2026-03-01
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	9	8	—	—	$104,644.00	$104,644.00	$104,644.00	2026-03-01
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	9	8	—	—	$103,745.00	$103,745.00	$103,745.00	2026-03-01
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	9	8	—	—	$103,745.00	$103,745.00	$103,745.00	2026-03-01
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	9	8	—	—	$103,745.00	$103,745.00	$103,745.00	2026-03-01
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	9	8	—	—	$103,745.00	$103,745.00	$103,745.00	2026-03-01
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	9	8	—	—	$103,745.00	$103,745.00	$103,745.00	2026-03-01
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	9	8	—	—	$103,745.00	$103,745.00	$103,745.00	2026-03-01
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	9	8	—	—	$103,745.00	$103,745.00	$103,745.00	2026-03-01
1599	OTHER	New Technology - Level 48	9	9	—	—	$99,680.23	$106,657.85	$103,667.44	2026-03-01
1585	OTHER	New Technology - Level 48	9	9	—	—	$99,680.23	$106,657.85	$103,667.44	2026-03-01
651	OTHER	Kidney Transplant With Hemodialysis Without Mcc	2	2	—	—	$101,751.06	$104,898.00	$103,324.53	2026-03-01
450	MS_DRG	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically	9	8	—	—	$99,750.00	$99,750.00	$99,750.00	2026-03-01
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	9	8	—	—	$99,750.00	$99,750.00	$99,750.00	2026-03-01
K1007	HCPCS	Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin…	12	12	—	—	$92,228.57	$101,736.67	$96,031.81	2026-03-01
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	9	8	—	—	$96,003.00	$96,003.00	$96,003.00	2026-03-01
01585	OTHER	New Technology - Level 48	3	3	—	—	$92,786.32	$95,656.00	$95,656.00	2026-03-01
01599	OTHER	New Technology - Level 48	3	3	—	—	$92,786.32	$95,656.00	$95,656.00	2026-03-01
1598	OTHER	New Technology - Level 47	9	9	—	—	$89,187.62	$95,430.75	$92,755.12	2026-03-01
1584	OTHER	New Technology - Level 47	9	9	—	—	$89,187.62	$95,430.75	$92,755.12	2026-03-01
481	MS_DRG	Hip And Femur Procedures Except Major Joint With Cc	9	8	—	—	$88,469.00	$88,469.00	$88,469.00	2026-03-01
480	MS_DRG	Hip And Femur Procedures Except Major Joint With Mcc	9	8	—	—	$88,469.00	$88,469.00	$88,469.00	2026-03-01
007	OTHER	Lung Transplant	3	3	—	—	$87,259.66	$89,958.41	$88,159.24	2026-03-01
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	9	8	—	—	$87,784.00	$87,784.00	$87,784.00	2026-03-01
488	MS_DRG	Knee Procedures Without Principal Diagnosis Of Infection With Cc/mcc	9	8	—	—	$87,527.00	$87,527.00	$87,527.00	2026-03-01
489	MS_DRG	Knee Procedures Without Principal Diagnosis Of Infection Without Cc/mcc	9	8	—	—	$87,527.00	$87,527.00	$87,527.00	2026-03-01
01598	OTHER	New Technology - Level 47	3	3	—	—	$83,019.39	$85,587.00	$85,587.00	2026-03-01
01584	OTHER	New Technology - Level 47	3	3	—	—	$83,019.39	$85,587.00	$85,587.00	2026-03-01
1597	OTHER	New Technology - Level 46	9	9	—	—	$78,695.02	$84,203.67	$81,842.82	2026-03-01
1583	OTHER	New Technology - Level 46	9	9	—	—	$78,695.02	$84,203.67	$81,842.82	2026-03-01
405	MS_DRG	Pancreas, Liver And Shunt Procedures With Mcc	9	8	—	—	$80,939.00	$80,939.00	$80,939.00	2026-03-01
406	MS_DRG	Pancreas, Liver And Shunt Procedures With Cc	9	8	—	—	$80,939.00	$80,939.00	$80,939.00	2026-03-01
002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	3	3	—	—	$77,337.81	$79,729.70	$78,135.11	2026-03-01
228	MS_DRG	Other Cardiothoracic Procedures With Mcc	9	8	—	—	$76,801.00	$76,801.00	$76,801.00	2026-03-01
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	9	8	—	—	$76,801.00	$76,801.00	$76,801.00	2026-03-01
229	MS_DRG	Other Cardiothoracic Procedures Without Mcc	9	8	—	—	$76,801.00	$76,801.00	$76,801.00	2026-03-01
230	MS_DRG	Other Cardiothoracic Procedures Without Cc/mcc	2	1	—	—	$76,801.00	$76,801.00	$76,801.00	2026-03-01
236	MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	9	8	—	—	$76,801.00	$76,801.00	$76,801.00	2026-03-01
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	9	8	—	—	$75,619.00	$75,619.00	$75,619.00	2026-03-01
208	MS_DRG	Respiratory System Diagnosis With Ventilator Support <=96 Hours	9	8	—	—	$75,619.00	$75,619.00	$75,619.00	2026-03-01
01583	OTHER	New Technology - Level 46	3	3	—	—	$73,252.46	$75,518.00	$75,518.00	2026-03-01
01597	OTHER	New Technology - Level 46	3	3	—	—	$73,252.46	$75,518.00	$75,518.00	2026-03-01
014	OTHER	Allogeneic Bone Marrow Transplant	3	3	—	—	$74,484.27	$76,787.91	$75,252.15	2026-03-01
005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	3	3	—	—	$73,699.73	$75,979.10	$74,459.52	2026-03-01
13	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc	9	8	—	—	$72,555.00	$72,555.00	$72,555.00	2026-03-01
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	9	8	—	—	$72,555.00	$72,555.00	$72,555.00	2026-03-01
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	9	8	—	—	$72,555.00	$72,555.00	$72,555.00	2026-03-01
12	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	9	8	—	—	$72,555.00	$72,555.00	$72,555.00	2026-03-01
11	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	9	8	—	—	$72,555.00	$72,555.00	$72,555.00	2026-03-01
1596	OTHER	New Technology - Level 45	9	9	—	—	$68,202.42	$72,976.59	$70,930.52	2026-03-01
1582	OTHER	New Technology - Level 45	9	9	—	—	$68,202.42	$72,976.59	$70,930.52	2026-03-01
423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	2	2	—	—	$69,069.29	$71,205.45	$70,137.37	2026-03-01
5244	OTHER	Level 4 Blood Product Exc	9	9	—	—	$67,429.14	$72,149.18	$70,126.31	2026-03-01
L8702	HCPCS	Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge…	12	12	—	—	$66,737.65	$73,617.82	$69,489.71	2026-03-01
474	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	2	2	—	—	$66,710.72	$68,773.94	$67,742.33	2026-03-01
717	OTHER	Instill Adstiladrin, Tx D	11	11	—	—	$12,902.65	$68,774.03	$65,560.29	2026-03-01
01596	OTHER	New Technology - Level 45	3	3	—	—	$63,485.53	$65,449.00	$65,449.00	2026-03-01
01582	OTHER	New Technology - Level 45	3	3	—	—	$63,485.53	$65,449.00	$65,449.00	2026-03-01
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	2	2	—	—	$64,100.67	$66,083.17	$65,091.92	2026-03-01
05244	OTHER	Level 4 Blood Product Exc	3	3	—	—	$62,765.73	$64,706.94	$64,706.94	2026-03-01
00717	OTHER	Instill Adstiladrin, Tx D	3	3	—	—	$62,346.55	$64,274.79	$64,274.79	2026-03-01
26	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Cc	9	8	—	—	$63,409.00	$63,409.00	$63,409.00	2026-03-01
25	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Mcc	9	8	—	—	$63,409.00	$63,409.00	$63,409.00	2026-03-01
27	MS_DRG	Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc	9	8	—	—	$63,409.00	$63,409.00	$63,409.00	2026-03-01
J9029	HCPCS	Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose	3	3	—	—	$61,338.53	$63,235.60	$63,235.60	2026-03-01
429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	2	2	—	—	$61,489.41	$63,391.14	$62,440.28	2026-03-01
020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	3	3	—	—	$60,781.09	$62,660.92	$61,407.70	2026-03-01
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	9	8	—	—	$60,224.00	$60,224.00	$60,224.00	2026-03-01
269	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	9	8	—	—	$60,224.00	$60,224.00	$60,224.00	2026-03-01
271	MS_DRG	Other Major Cardiovascular Procedures With Cc	9	8	—	—	$60,224.00	$60,224.00	$60,224.00	2026-03-01
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	9	8	—	—	$60,224.00	$60,224.00	$60,224.00	2026-03-01
272	MS_DRG	Other Major Cardiovascular Procedures Without Cc/mcc	9	8	—	—	$60,224.00	$60,224.00	$60,224.00	2026-03-01
1595	OTHER	New Technology - Level 44	9	9	—	—	$57,709.82	$61,749.51	$60,018.21	2026-03-01
1581	OTHER	New Technology - Level 44	9	9	—	—	$57,709.82	$61,749.51	$60,018.21	2026-03-01
1643	OTHER	Y90 Ibritumomab, Rx	9	9	—	—	$56,824.55	$60,802.27	$59,097.53	2026-03-01
231	OTHER	Coronary Bypass With Ptca With Mcc	2	2	—	—	$57,532.83	$59,312.20	$58,422.51	2026-03-01
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	2	2	—	—	$57,347.15	$59,120.77	$58,233.96	2026-03-01
Q2043	HCPCS	Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm…	3	3	—	—	$55,306.59	$57,017.10	$57,017.10	2026-03-01
01643	OTHER	Y90 Ibritumomab, Rx	3	3	—	—	$55,119.81	$56,824.55	$56,824.55	2026-03-01
9273	OTHER	Sipuleucel-t Auto Cd54+	9	9	—	—	$54,404.11	$58,212.40	$56,580.27	2026-03-01
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	9	8	—	—	$56,299.00	$56,299.00	$56,299.00	2026-03-01
462	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc	9	8	—	—	$56,299.00	$56,299.00	$56,299.00	2026-03-01
01595	OTHER	New Technology - Level 44	3	3	—	—	$53,718.60	$55,380.00	$55,380.00	2026-03-01
01581	OTHER	New Technology - Level 44	3	3	—	—	$53,718.60	$55,380.00	$55,380.00	2026-03-01
850	OTHER	Acute Leukemia With Other Procedures	2	2	—	—	$53,901.52	$55,568.58	$54,735.05	2026-03-01
164	MS_DRG	Major Chest Procedures With Cc	9	8	—	—	$54,585.00	$54,585.00	$54,585.00	2026-03-01
165	MS_DRG	Major Chest Procedures Without Cc/mcc	9	8	—	—	$54,585.00	$54,585.00	$54,585.00	2026-03-01
163	MS_DRG	Major Chest Procedures With Mcc	9	8	—	—	$54,585.00	$54,585.00	$54,585.00	2026-03-01
09273	OTHER	Sipuleucel-t Auto Cd54+	3	3	—	—	$52,771.99	$54,404.11	$54,404.11	2026-03-01
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	2	2	—	—	$52,113.54	$53,725.30	$52,919.42	2026-03-01
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	2	2	—	—	$51,430.44	$53,021.07	$52,225.76	2026-03-01
451	MS_DRG	Single Level Spinal Fusion Except Cervical Without Mcc	9	8	—	—	$51,590.00	$51,590.00	$51,590.00	2026-03-01
448	MS_DRG	Multiple Level Spinal Fusion Except Cervical Without Mcc	9	8	—	—	$51,590.00	$51,590.00	$51,590.00	2026-03-01
447	OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	2	2	—	—	$50,013.21	$51,560.01	$50,786.61	2026-03-01
010	OTHER	Pancreas Transplant	3	3	—	—	$48,972.88	$50,487.51	$49,477.76	2026-03-01
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	2	2	—	—	$48,650.70	$50,155.36	$49,403.03	2026-03-01
019	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	3	3	—	—	$48,692.51	$50,198.46	$49,194.49	2026-03-01
1594	OTHER	New Technology - Level 43	9	9	—	—	$47,217.23	$50,522.44	$49,105.92	2026-03-01
1580	OTHER	New Technology - Level 43	9	9	—	—	$47,217.23	$50,522.44	$49,105.92	2026-03-01
L7181	HCPCS	Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi…	12	12	—	—	$46,710.83	$51,526.39	$48,637.06	2026-03-01
956	OTHER	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	2	2	—	—	$47,572.86	$49,044.19	$48,308.53	2026-03-01
360	OTHER	Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc	2	2	—	—	$47,290.03	$48,752.61	$48,021.32	2026-03-01
011	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	3	3	—	—	$46,763.11	$48,209.39	$47,245.20	2026-03-01
252	MS_DRG	Other Vascular Procedures With Mcc	9	8	—	—	$46,375.00	$46,375.00	$46,375.00	2026-03-01
254	MS_DRG	Other Vascular Procedures Without Cc/mcc	9	8	—	—	$46,375.00	$46,375.00	$46,375.00	2026-03-01
253	MS_DRG	Other Vascular Procedures With Cc	9	8	—	—	$46,375.00	$46,375.00	$46,375.00	2026-03-01
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures	9	8	—	—	$46,375.00	$46,375.00	$46,375.00	2026-03-01
279	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures	9	8	—	—	$46,375.00	$46,375.00	$46,375.00	2026-03-01
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	2	2	—	—	$44,875.52	$46,263.42	$45,569.47	2026-03-01
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	2	2	—	—	$44,712.58	$46,095.44	$45,404.01	2026-03-01
01594	OTHER	New Technology - Level 43	3	3	—	—	$43,951.67	$45,311.00	$45,311.00	2026-03-01
01580	OTHER	New Technology - Level 43	3	3	—	—	$43,951.67	$45,311.00	$45,311.00	2026-03-01
J9226	HCPCS	Histrelin Implant (supprelin La), 50 Mg	3	3	—	—	$43,855.64	$45,212.00	$45,212.00	2026-03-01
1142	OTHER	Supprelin La Implant	9	9	—	—	$43,185.34	$46,208.31	$44,912.75	2026-03-01
322	MS_DRG	Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc	9	8	—	—	$44,106.00	$44,106.00	$44,106.00	2026-03-01
834	OTHER	Acute Leukemia With Mcc	2	2	—	—	$42,546.46	$43,862.33	$43,204.40	2026-03-01
01142	OTHER	Supprelin La Implant	3	3	—	—	$41,889.78	$43,185.34	$43,185.34	2026-03-01
L7180	HCPCS	Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device…	12	12	—	—	$41,462.94	$45,737.47	$43,172.76	2026-03-01
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	2	2	—	—	$42,135.74	$43,438.91	$42,787.32	2026-03-01
242	MS_DRG	Permanent Cardiac Pacemaker Implant With Mcc	9	8	—	—	$42,673.00	$42,673.00	$42,673.00	2026-03-01
243	MS_DRG	Permanent Cardiac Pacemaker Implant With Cc	9	8	—	—	$42,673.00	$42,673.00	$42,673.00	2026-03-01
244	MS_DRG	Permanent Cardiac Pacemaker Implant Without Cc/mcc	9	8	—	—	$42,673.00	$42,673.00	$42,673.00	2026-03-01
023	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	3	3	—	—	$42,047.81	$43,348.26	$42,481.29	2026-03-01
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	2	2	—	—	$41,776.67	$43,068.73	$42,422.70	2026-03-01
215	OTHER	Other Heart Assist System Implant	2	2	—	—	$41,702.27	$42,992.03	$42,347.15	2026-03-01
955	OTHER	Craniotomy For Multiple Significant Trauma	2	2	—	—	$41,441.57	$42,723.27	$42,082.42	2026-03-01
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	2	2	—	—	$41,440.34	$42,722.00	$42,081.17	2026-03-01
232	OTHER	Coronary Bypass With Ptca Without Mcc	2	2	—	—	$41,376.40	$42,656.08	$42,016.24	2026-03-01
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	2	2	—	—	$40,317.01	$41,563.93	$40,940.47	2026-03-01
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	2	2	—	—	$39,114.36	$40,324.08	$39,719.22	2026-03-01
213	OTHER	Endovascular Abdominal Aorta With Iliac Branch Procedures	2	2	—	—	$38,948.96	$40,153.57	$39,551.26	2026-03-01
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	2	2	—	—	$38,677.82	$39,874.04	$39,275.93	2026-03-01
L2006	HCPCS	Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance…	12	12	—	—	$37,427.26	$41,285.74	$38,970.65	2026-03-01
008	OTHER	Simultaneous Pancreas And Kidney Transplant	3	3	—	—	$38,250.49	$39,433.50	$38,644.83	2026-03-01
430	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	2	2	—	—	$38,033.46	$39,209.75	$38,621.60	2026-03-01
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	2	2	—	—	$37,693.43	$38,859.21	$38,276.32	2026-03-01
1593	OTHER	New Technology - Level 42	9	9	—	—	$36,724.62	$39,295.34	$38,193.60	2026-03-01
1579	OTHER	New Technology - Level 42	9	9	—	—	$36,724.62	$39,295.34	$38,193.60	2026-03-01
016	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	3	3	—	—	$37,487.46	$38,646.87	$37,873.93	2026-03-01
017	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	3	3	—	—	$37,074.90	$38,221.55	$37,457.12	2026-03-01
021	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	3	3	—	—	$36,595.32	$37,727.13	$36,972.59	2026-03-01
317	OTHER	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	2	2	—	—	$36,384.42	$37,509.71	$36,947.07	2026-03-01
467	MS_DRG	Revision Of Hip Or Knee Replacement With Cc	9	8	—	—	$36,767.00	$36,767.00	$36,767.00	2026-03-01
466	MS_DRG	Revision Of Hip Or Knee Replacement With Mcc	9	8	—	—	$36,767.00	$36,767.00	$36,767.00	2026-03-01
468	MS_DRG	Revision Of Hip Or Knee Replacement Without Cc/mcc	9	8	—	—	$36,767.00	$36,767.00	$36,767.00	2026-03-01
5166	OTHER	Cochlear Implant Procedur	9	9	—	—	$35,345.67	$37,819.87	$36,759.50	2026-03-01
321	MS_DRG	Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A…	9	8	—	—	$36,363.00	$36,363.00	$36,363.00	2026-03-01
277	OTHER	Cardiac Defibrillator Implant Without Mcc	2	2	—	—	$35,429.56	$36,525.32	$35,977.44	2026-03-01
251	MS_DRG	Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc	9	8	—	—	$35,710.00	$35,710.00	$35,710.00	2026-03-01
250	MS_DRG	Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc	9	8	—	—	$35,710.00	$35,710.00	$35,710.00	2026-03-01
273	MS_DRG	Percutaneous And Other Intracardiac Procedures With Mcc	9	8	—	—	$35,710.00	$35,710.00	$35,710.00	2026-03-01
274	MS_DRG	Percutaneous And Other Intracardiac Procedures Without Mcc	9	8	—	—	$35,710.00	$35,710.00	$35,710.00	2026-03-01
228	OTHER	Other Cardiothoracic Procedures With Mcc	2	2	—	—	$35,145.50	$36,232.47	$35,688.99	2026-03-01
L8701	HCPCS	Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand With S…	12	12	—	—	$33,921.00	$37,418.01	$35,319.80	2026-03-01
01593	OTHER	New Technology - Level 42	3	3	—	—	$34,184.74	$35,242.00	$35,242.00	2026-03-01
01579	OTHER	New Technology - Level 42	3	3	—	—	$34,184.74	$35,242.00	$35,242.00	2026-03-01
5232	OTHER	Level 2 Icd And Similar P	9	9	—	—	$33,648.44	$36,003.83	$34,994.38	2026-03-01
5465	OTHER	Level 5 Neurostimulator A	9	9	—	—	$33,079.04	$35,394.57	$34,402.20	2026-03-01
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	2	2	—	—	$33,449.74	$34,484.27	$33,967.00	2026-03-01
05166	OTHER	Cochlear Implant Procedur	3	3	—	—	$32,901.15	$33,918.71	$33,918.71	2026-03-01
006	OTHER	Liver Transplant Without Mcc	3	3	—	—	$33,569.01	$34,607.23	$33,915.09	2026-03-01
457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	2	2	—	—	$33,310.17	$34,340.38	$33,825.27	2026-03-01
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	2	2	—	—	$32,573.57	$33,581.00	$33,077.29	2026-03-01
323	OTHER	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	2	2	—	—	$32,318.41	$33,317.95	$32,818.18	2026-03-01
482	MS_DRG	Hip And Femur Procedures Except Major Joint Without Cc/mcc	9	8	—	—	$32,722.00	$32,722.00	$32,722.00	2026-03-01
823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	2	2	—	—	$32,218.19	$33,214.63	$32,716.41	2026-03-01
05232	OTHER	Level 2 Icd And Similar P	3	3	—	—	$31,321.30	$32,290.00	$32,290.00	2026-03-01
220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	2	2	—	—	$31,674.66	$32,654.29	$32,164.47	2026-03-01
318	OTHER	Percutaneous Coronary Atherectomy Without Intraluminal Device	2	2	—	—	$31,540.01	$32,515.47	$32,027.74	2026-03-01
5200	OTHER	Implantation Wireless Pa	9	9	—	—	$30,748.17	$32,900.54	$31,978.10	2026-03-01
05465	OTHER	Level 5 Neurostimulator A	3	3	—	—	$30,791.28	$31,743.59	$31,743.59	2026-03-01
245	MS_DRG	Aicd Generator Procedures	9	8	—	—	$31,740.00	$31,740.00	$31,740.00	2026-03-01
245	OTHER	Aicd Generator Procedures	2	2	—	—	$31,137.90	$32,100.93	$31,619.42	2026-03-01
221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	2	2	—	—	$31,136.67	$32,099.66	$31,618.17	2026-03-01
622	OTHER	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	2	2	—	—	$31,083.80	$32,045.15	$31,564.47	2026-03-01
92937	CPT	Percutaneous Transluminal Revascularization Of Or Through Coronary Artery Bypass…	2	1	—	—	$31,504.00	$31,504.00	$31,504.00	2026-03-01
92933	CPT	Percutaneous Transluminal Coronary Atherectomy, With Intracoronary Stent, With C…	2	1	—	—	$31,504.00	$31,504.00	$31,504.00	2026-03-01
92941	CPT	Percutaneous Transluminal Revascularization Of Acute Total/subtotal Occlusion Du…	2	1	—	—	$31,504.00	$31,504.00	$31,504.00	2026-03-01
92943	CPT	Percutaneous Transluminal Revascularization Of Chronic Total Occlusion, Single C…	2	1	—	—	$31,504.00	$31,504.00	$31,504.00	2026-03-01
92930	CPT	Percutaneous Transcatheter Placement Of Intracoronary Stent(s), With Coronary An…	2	1	—	—	$31,504.00	$31,504.00	$31,504.00	2026-03-01
92928	CPT	Percutaneous Transcatheter Placement Of Intracoronary Stent(s), With Coronary An…	2	1	—	—	$31,504.00	$31,504.00	$31,504.00	2026-03-01
92920	CPT	Percutaneous Transluminal Coronary Angioplasty, Single Major Coronary Artery And…	2	1	—	—	$31,504.00	$31,504.00	$31,504.00	2026-03-01
92924	CPT	Percutaneous Transluminal Coronary Atherectomy, With Coronary Angioplasty When P…	2	1	—	—	$31,504.00	$31,504.00	$31,504.00	2026-03-01
C9608	HCPCS	Percutaneous Transluminal Revascularization Of Chronic Total Occlusion, Coronary…	2	1	—	—	$31,504.00	$31,504.00	$31,504.00	2026-03-01
C9606	HCPCS	Percutaneous Transluminal Revascularization Of Acute Total/subtotal Occlusion Du…	2	1	—	—	$31,504.00	$31,504.00	$31,504.00	2026-03-01
C9607	HCPCS	Percutaneous Transluminal Revascularization Of Chronic Total Occlusion, Coronary…	2	1	—	—	$31,504.00	$31,504.00	$31,504.00	2026-03-01
C9605	HCPCS	Percutaneous Transluminal Revascularization Of Or Through Coronary Artery Bypass…	2	1	—	—	$31,504.00	$31,504.00	$31,504.00	2026-03-01
C9602	HCPCS	Percutaneous Transluminal Coronary Atherectomy, With Drug Eluting Intracoronary …	2	1	—	—	$31,504.00	$31,504.00	$31,504.00	2026-03-01
C9601	HCPCS	Percutaneous Transcatheter Placement Of Drug-eluting Intracoronary Stent(s), Wit…	2	1	—	—	$31,504.00	$31,504.00	$31,504.00	2026-03-01
C9600	HCPCS	Percutaneous Transcatheter Placement Of Drug Eluting Intracoronary Stent(s), Wit…	2	1	—	—	$31,504.00	$31,504.00	$31,504.00	2026-03-01
C9603	HCPCS	Percutaneous Transluminal Coronary Atherectomy, With Drug-eluting Intracoronary …	2	1	—	—	$31,504.00	$31,504.00	$31,504.00	2026-03-01
C9604	HCPCS	Percutaneous Transluminal Revascularization Of Or Through Coronary Artery Bypass…	2	1	—	—	$31,504.00	$31,504.00	$31,504.00	2026-03-01
469	MS_DRG	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…	9	8	—	—	$31,395.00	$31,395.00	$31,395.00	2026-03-01
470	MS_DRG	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without	9	8	—	—	$31,395.00	$31,395.00	$31,395.00	2026-03-01
522	MS_DRG	Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc	9	8	—	—	$31,395.00	$31,395.00	$31,395.00	2026-03-01
521	MS_DRG	Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc	9	8	—	—	$31,395.00	$31,395.00	$31,395.00	2026-03-01
799	OTHER	Splenic Procedures With Mcc	2	2	—	—	$30,909.18	$31,865.13	$31,387.15	2026-03-01
239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	2	2	—	—	$30,561.78	$31,506.99	$31,034.39	2026-03-01
319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	2	2	—	—	$30,458.49	$31,400.50	$30,929.50	2026-03-01
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective	2	2	—	—	$30,348.43	$31,287.04	$30,817.74	2026-03-01
826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r.	2	2	—	—	$30,304.78	$31,242.04	$30,773.41	2026-03-01
240	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc	2	2	—	—	$30,104.34	$31,035.40	$30,569.87	2026-03-01
981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	2	2	—	—	$30,087.73	$31,018.28	$30,553.00	2026-03-01
5117	OTHER	Level 7 Musculoskeletal P	9	9	—	—	$29,087.30	$31,123.41	$30,250.79	2026-03-01
1592	OTHER	New Technology - Level 41	9	9	—	—	$28,855.17	$30,875.03	$30,009.38	2026-03-01
1578	OTHER	New Technology - Level 41	9	9	—	—	$28,855.17	$30,875.03	$30,009.38	2026-03-01
L6700	HCPCS	Upper Extremity Addition, External Powered Feature, Myoelectronic Control Module…	12	12	—	—	$28,624.89	$31,575.91	$29,805.30	2026-03-01
466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	2	2	—	—	$29,329.62	$30,236.72	$29,783.17	2026-03-01
450	OTHER	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically	2	2	—	—	$29,254.61	$30,159.39	$29,707.00	2026-03-01
05200	OTHER	Implantation Wireless Pa	3	3	—	—	$28,621.62	$29,506.82	$29,506.82	2026-03-01
236	OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	2	2	—	—	$28,824.22	$29,715.69	$29,269.96	2026-03-01
5213	OTHER	Level 3 Electrophysiologi	9	9	—	—	$28,019.43	$29,980.79	$29,140.21	2026-03-01
L5856	HCPCS	Addition To Lower Extremity Prosthesis, Endoskeletal Knee-shin System, Microproc…	12	12	—	—	$27,985.66	$30,870.78	$29,139.71	2026-03-01
448	OTHER	Multiple Level Spinal Fusion Except Cervical Without Mcc	2	2	—	—	$28,687.72	$29,574.97	$29,131.35	2026-03-01
L6880	HCPCS	Electric Hand, Switch Or Myoelectric Controlled, Independently Articulating Digi…	12	12	—	—	$27,853.55	$30,725.05	$29,002.15	2026-03-01
843	OTHER	Pegaspargase Injection	11	11	—	—	$7,665.96	$30,413.74	$28,992.54	2026-03-01
037	OTHER	Extracranial Procedures With Mcc	3	3	—	—	$28,676.03	$29,562.92	$28,971.66	2026-03-01
793	OTHER	Full Term Neonate With Major Problems	2	2	—	—	$28,457.15	$29,337.27	$28,897.21	2026-03-01
00843	OTHER	Pegaspargase Injection	3	3	—	—	$27,571.34	$28,424.06	$28,424.06	2026-03-01
028	OTHER	Spinal Procedures With Mcc	3	3	—	—	$27,951.74	$28,816.23	$28,239.91	2026-03-01
27485	CPT	Arrest, Hemiepiphyseal, Distal Femur Or Proximal Tibia Or Fibula (eg, Genu Varus…	2	1	—	—	$28,112.00	$28,112.00	$28,112.00	2026-03-01
27479	CPT	Arrest, Epiphyseal, Any Method (eg, Epiphysiodesis); Combined Distal Femur, Prox…	2	1	—	—	$28,112.00	$28,112.00	$28,112.00	2026-03-01

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