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

SEATTLE CHILDREN'S HOSPITAL

Seattle, WA · CCN 503300 · Rates published

Your selected procedure

You selected 93306 (CPT)

Echo Transthoracic Real Time 2d

This hospital’s price: $2,826 across 100 payers · range $457-$11,942

Source: https://www.seattlechildrens.org/globalassets/documents/for-patients-and-families/910564748_seattle-childrens-hospital_standardcharges.csv · observed 2026-03-31

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.

6,751 distinct procedures filed
107 distinct payers
1,704,557 rate rows
2026-03-31 last MRF observed
Data quality

1,067,460 of 1,704,557 rate rows are consumer-grade (62.6%)

637,097 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
professional (physician) fee — not the facility price 361,271
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 248,696
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 26,341
percent-of-charges filed in the dollar field — excluded from medians 670
per-diem day rate — not a per-procedure price 119
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.seattlechildrens.org/globalassets/documents/for-patients-and-families/910564748_seattle-childrens-hospital_standardcharges.csv
Found on page https://www.seattlechildrens.org/clinics/paying-for-care/price-transparency/
Discovered viaDiscovered by HANK
Last fetch success · 2026-10-29
Content fingerprint 90cf65c1ab09d0ea… · 954,276,953 bytes · first seen 2026-10-29

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
J3392
HCPCS 		Exagamglogene Autotemcel 4 X 10exp6 To 13 X 10exp6 Cell/ml IV Susp 63 $2,327,160.00 $4,994,880.00 $4,824,600.00 nat. median
$2,401,965
outlier · 2.0×
J3394
HCPCS 		Lovotibeglogene Autotemcel 1.7 X 10exp6 To 20 X 10exp6 Cell/ml IV Susp 85 $1,589,242.00 $3,721,152.00 $3,294,770.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Betibeglogene Autotemcel 2 X 10exp6 To 20 X 10exp6 Cell/ml IV Susp 24 $2,348,377.92 $4,912,320.00 $2,825,000.00 nat. median
$2,994,107
0.9× median
J1413
HCPCS 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 91 $355,022.83 $4,217,634.86 $2,818,471.32 nat. median
$3,324,572
0.8× median
J3399
HCPCS 		Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 91 $233,805.58 $3,234,487.15 $932,338.70 nat. median
$2,467,386
outlier · 0.4×
Q2042
HCPCS 		Tisagenlecleucel 0.2 X10exp6 To 2.5x10exp8 Cell Intravenous Suspension 91 $246,396.03 $757,955.05 $644,261.79 nat. median
$739,258
0.9× median
J3402
HCPCS 		Remestemcel-l-rknd (wt. 75 - <87.5 Kg) 6.68 X 10exp6 Cell/ml Intravenous Suspens… 85 $238,620.00 $558,720.00 $494,700.00 nat. median
$209,753
outlier · 2.4×
588
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure,extreme 14 $424,255.10 $445,467.86 $441,225.30 nat. median
$259,357
1.7× median
J2326
HCPCS 		Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution 91 $143,066.70 $440,096.90 $374,082.37 nat. median
$2,480
outlier · 150.8×
583
APR_DRG 		Neonate With Ecmo,minor 14 $230,670.59 $562,373.90 $368,404.77 nat. median
$12,353
outlier · 29.8×
J0224
HCPCS 		Lumasiran 94.5 Mg/0.5 Ml Subcutaneous Solution 85 $164,982.57 $386,300.64 $342,037.03 nat. median
$362
outlier · 945.0×
161
APR_DRG 		Implantable Heart Assist Systems,extreme 14 $328,475.01 $344,898.76 $341,614.01 nat. median
$137,490
outlier · 2.5×
PX-699280
CDM 		Berlin Heart Pump 85 $140,445.34 $328,847.62 $291,167.16 nat. median
$291,167
1.0× median
9
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo),extreme 14 $255,402.22 $268,172.33 $265,618.31 nat. median
$120,304
outlier · 2.2×
RX-119589
CDM 		Teduglutide 5 Mg Subcutaneous Kit 85 $124,985.43 $292,648.80 $259,116.13 nat. median
$259,116
1.0× median
PX-501416
CDM 		Cad Liver W/Normo Perf Sac 85 $123,000.00 $288,000.00 $255,000.00 nat. median
$255,000
1.0× median
PX-500944
CDM 		Cad Heart Stnd Acq Charge 85 $122,139.00 $285,984.00 $253,215.00 nat. median
$253,215
1.0× median
J0801
HCPCS 		Corticotropin 80 Unit/ml Injection Gel 85 $120,755.66 $282,744.96 $250,347.10 nat. median
$5,212
outlier · 48.0×
38205
CPT 		Cord Blood Procurement 85 $22,051.03 $482,657.47 $239,782.76 nat. median
$2,403
outlier · 99.8×
C9293
HCPCS 		Glucarpidase 1,000 Unit Intravenous Solution 85 $115,236.45 $269,821.92 $238,904.83 nat. median
$30,297
outlier · 7.9×
591
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure,major 14 $172,147.15 $304,141.99 $235,206.77 nat. median
$6,406
outlier · 36.7×
PX-502259
CDM 		Heartmate Vad Package 85 $100,643.27 $235,652.54 $208,650.69 nat. median
$208,651
1.0× median
J0567
HCPCS 		Cerliponase Alfa 150 Mg/5 Ml Intraventricular Solution 91 $74,330.03 $228,651.50 $194,353.78 nat. median
$171
outlier · 1134.0×
602
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 16 $126,874.07 $476,907.87 $187,954.70 nat. median
$86,947
outlier · 2.2×
J9330
HCPCS 		Temsirolimus 25 Mg/2.5 Ml IV (wet Soln Vial) 100 $52,852.50 $201,342.86 $178,272.33 nat. median
$670
outlier · 266.1×
593
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure,moderate 16 $144,262.78 $591,890.74 $174,863.50 nat. median
$12,919
outlier · 13.5×
PX-501324
CDM 		Cad Intestine Stnd Acq Charge 85 $79,827.00 $186,912.00 $165,495.00 nat. median
$165,495
1.0× median
J9118
HCPCS 		Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution 100 $48,781.71 $185,835.07 $164,541.47 nat. median
$200
outlier · 823.3×
PX-500941
CDM 		Cad Liver Stnd Acq Charge 85 $79,130.00 $185,280.00 $164,050.00 nat. median
$164,050
1.0× median
4
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure,moderate 14 $107,404.16 $235,454.67 $159,467.70 nat. median
$117,543
1.4× median
SUP-40021
CDM 		Heart Artificial Syncardia70cc Ea/1 85 $76,690.50 $179,568.00 $158,992.50 nat. median
$11,301
outlier · 14.1×
607
APR_DRG 		Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 16 $99,521.68 $367,842.82 $155,140.05 nat. median
$71,946
outlier · 2.2×
PX-500942
CDM 		Liv Rel Liver Stnd Acq Charge 85 $74,825.00 $175,200.00 $155,125.00 nat. median
$155,125
1.0× median
5
APR_DRG 		Tracheostomy With Mv >96 Hours Without Extensive Procedure,major 16 $103,450.29 $261,400.45 $147,172.91 nat. median
$87,627
1.7× median
PX-699284
CDM 		Berlin Heart Limited 85 $70,222.67 $164,423.81 $145,583.58 nat. median
$145,584
1.0× median
PX-500938
CDM 		Cad Kidney Stnd Acq Charge 85 $69,741.00 $163,296.00 $144,585.00 nat. median
$144,585
1.0× median
630
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure,moderate 14 $67,711.24 $255,830.40 $126,516.26 nat. median
$82,555
1.5× median
L8699
HCPCS 		Auditory Brainstem Implant 100 $37,168.01 $141,592.42 $125,368.29 nat. median
$2,008
outlier · 62.4×
PX-500939
CDM 		Liv Rel Kidney Stnd Acq Charge 85 $58,835.00 $137,760.00 $121,975.00 nat. median
$121,975
1.0× median
38230
CPT 		Marrow Procurement 85 $6,542.74 $278,131.20 $118,785.20 nat. median
$2,130
outlier · 55.8×
609
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure,moderate 14 $76,924.31 $297,937.86 $118,013.60 nat. median
$93,344
1.3× median
27495
CPT 		Proph Tx N/P/Pltwr W/wo Methylmethacrylate Femur 1 $113,295.00 $113,295.00 $113,295.00 nat. median
$5,874
outlier · 19.3×
93654
CPT 		Intracrd Abl For Tx Of Vt 100 $33,206.82 $126,502.18 $112,007.14 nat. median
$27,016
outlier · 4.1×
93653
CPT 		Ephys Eval W/Ablation Supravent Arrhythmia|PHYSICIAN Assistant/nurse Practitione… 100 $32,220.62 $122,745.22 $108,680.66 nat. median
$26,652
outlier · 4.1×
303
APR_DRG 		Dorsal And Lumbar Fusion Procedure For Curvature Of Back,minor 16 $56,678.55 $167,245.78 $104,664.63 nat. median
$27,749
outlier · 3.8×
27705
CPT 		Osteotomy Tibia 1 $103,729.44 $103,729.44 $103,729.44 nat. median
$6,816
outlier · 15.2×
612
APR_DRG 		Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 16 $67,842.66 $254,387.98 $103,662.88 nat. median
$53,141
2.0× median
162
APR_DRG 		Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis,moderate 14 $65,468.31 $142,218.81 $102,094.11 nat. median
$68,742
1.5× median
J9348
HCPCS 		Naxitamab-gqgk 4 Mg/ml Intravenous Solution 100 $29,590.23 $112,724.69 $99,808.32 nat. median
$832
outlier · 120.0×
33270
CPT 		Ins/Rep Subq 85 $47,890.46 $112,133.76 $99,285.10 nat. median
$32,114
outlier · 3.1×

Other procedures at this hospital

Browse this hospital's 6,751 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
             
J3392 HCPCS Exagamglogene Autotemcel 4 X 10exp6 To 13 X 10exp6 Cell/ml IV Susp 78 63 — — $2,327,160.00 $4,994,880.00 $4,824,600.00 2026-03-31
J3394 HCPCS Lovotibeglogene Autotemcel 1.7 X 10exp6 To 20 X 10exp6 Cell/ml IV Susp 101 85 $3,876,200.00 $3,876,200.00 $1,589,242.00 $3,721,152.00 $3,294,770.00 2026-03-31
J3393 HCPCS Betibeglogene Autotemcel 2 X 10exp6 To 20 X 10exp6 Cell/ml IV Susp 28 24 — — $2,348,377.92 $4,912,320.00 $2,825,000.00 2026-03-31
J1413 HCPCS Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 741 91 $3,429,771.45 $3,429,771.45 $355,022.83 $4,217,634.86 $2,818,471.32 2026-03-31
J3399 HCPCS Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 1,819 91 $1,141,141.00 $1,141,141.00 $233,805.58 $3,234,487.15 $932,338.70 2026-03-31
Q2042 HCPCS Tisagenlecleucel 0.2 X10exp6 To 2.5x10exp8 Cell Intravenous Suspension 107 91 $757,955.05 $757,955.05 $246,396.03 $757,955.05 $644,261.79 2026-03-31
J3402 HCPCS Remestemcel-l-rknd (wt. 75 - <87.5 Kg) 6.68 X 10exp6 Cell/ml Intravenous Suspens… 101 85 $582,000.00 $582,000.00 $238,620.00 $558,720.00 $494,700.00 2026-03-31
588 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure,extreme 14 14 — $2,564,636.94 $424,255.10 $445,467.86 $441,225.30 2026-03-31
J2326 HCPCS Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution 107 91 $440,096.90 $440,096.90 $143,066.70 $440,096.90 $374,082.37 2026-03-31
583 APR_DRG Neonate With Ecmo,minor 56 14 — $1,684,967.25 $230,670.59 $562,373.90 $368,404.77 2026-03-31
J0224 HCPCS Lumasiran 94.5 Mg/0.5 Ml Subcutaneous Solution 101 85 $402,396.50 $402,396.50 $164,982.57 $386,300.64 $342,037.03 2026-03-31
161 APR_DRG Implantable Heart Assist Systems,extreme 14 14 — — $328,475.01 $344,898.76 $341,614.01 2026-03-31
PX-699280 CDM Berlin Heart Pump 101 85 $342,549.60 $342,549.60 $140,445.34 $328,847.62 $291,167.16 2026-03-31
9 APR_DRG Extracorporeal Membrane Oxygenation (ecmo),extreme 14 14 — $1,440,939.90 $255,402.22 $268,172.33 $265,618.31 2026-03-31
RX-119589 CDM Teduglutide 5 Mg Subcutaneous Kit 101 85 $304,842.50 $304,842.50 $124,985.43 $292,648.80 $259,116.13 2026-03-31
PX-501416 CDM Cad Liver W/Normo Perf Sac 101 85 $300,000.00 $300,000.00 $123,000.00 $288,000.00 $255,000.00 2026-03-31
PX-500944 CDM Cad Heart Stnd Acq Charge 101 85 $297,900.00 $297,900.00 $122,139.00 $285,984.00 $253,215.00 2026-03-31
J0801 HCPCS Corticotropin 80 Unit/ml Injection Gel 101 85 $294,526.00 $294,526.00 $120,755.66 $282,744.96 $250,347.10 2026-03-31
38205 CPT Cord Blood Procurement 404 85 $291,239.30 $291,239.30 $22,051.03 $482,657.47 $239,782.76 2026-03-31
C9293 HCPCS Glucarpidase 1,000 Unit Intravenous Solution 101 85 $281,064.50 $281,064.50 $115,236.45 $269,821.92 $238,904.83 2026-03-31
591 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure,major 28 14 — $2,726,659.08 $172,147.15 $304,141.99 $235,206.77 2026-03-31
PX-502259 CDM Heartmate Vad Package 101 85 $245,471.40 $245,471.40 $100,643.27 $235,652.54 $208,650.69 2026-03-31
J0567 HCPCS Cerliponase Alfa 150 Mg/5 Ml Intraventricular Solution 214 91 $228,651.50 $228,651.50 $74,330.03 $228,651.50 $194,353.78 2026-03-31
602 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 36 16 — $199,425.83 $126,874.07 $476,907.87 $187,954.70 2026-03-31
J9330 HCPCS Temsirolimus 25 Mg/2.5 Ml IV (wet Soln Vial) 118 100 $209,732.15 $209,732.15 $52,852.50 $201,342.86 $178,272.33 2026-03-31
593 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure,moderate 46 16 — $558,244.40 $144,262.78 $591,890.74 $174,863.50 2026-03-31
PX-501324 CDM Cad Intestine Stnd Acq Charge 101 85 $194,700.00 $194,700.00 $79,827.00 $186,912.00 $165,495.00 2026-03-31
J9118 HCPCS Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution 117 100 $193,578.20 $193,578.20 $48,781.71 $185,835.07 $164,541.47 2026-03-31
PX-500941 CDM Cad Liver Stnd Acq Charge 101 85 $193,000.00 $193,000.00 $79,130.00 $185,280.00 $164,050.00 2026-03-31
4 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure,moderate 42 14 — $980,117.28 $107,404.16 $235,454.67 $159,467.70 2026-03-31
SUP-40021 CDM Heart Artificial Syncardia70cc Ea/1 101 85 $187,050.00 $187,050.00 $76,690.50 $179,568.00 $158,992.50 2026-03-31
607 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 32 16 — $269,693.30 $99,521.68 $367,842.82 $155,140.05 2026-03-31
PX-500942 CDM Liv Rel Liver Stnd Acq Charge 101 85 $182,500.00 $182,500.00 $74,825.00 $175,200.00 $155,125.00 2026-03-31
5 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure,major 32 16 — $261,269.10 $103,450.29 $261,400.45 $147,172.91 2026-03-31
PX-699284 CDM Berlin Heart Limited 101 85 $171,274.80 $171,274.80 $70,222.67 $164,423.81 $145,583.58 2026-03-31
PX-500938 CDM Cad Kidney Stnd Acq Charge 101 85 $170,100.00 $170,100.00 $69,741.00 $163,296.00 $144,585.00 2026-03-31
630 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure,moderate 42 14 — $370,047.20 $67,711.24 $255,830.40 $126,516.26 2026-03-31
L8699 HCPCS Auditory Brainstem Implant 117 100 $147,492.10 $147,492.10 $37,168.01 $141,592.42 $125,368.29 2026-03-31
PX-500939 CDM Liv Rel Kidney Stnd Acq Charge 101 85 $143,500.00 $143,500.00 $58,835.00 $137,760.00 $121,975.00 2026-03-31
38230 CPT Marrow Procurement 201 85 $289,720.00 $289,720.00 $6,542.74 $278,131.20 $118,785.20 2026-03-31
609 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure,moderate 42 14 — $1,772,699.00 $76,924.31 $297,937.86 $118,013.60 2026-03-31
27495 CPT Proph Tx N/P/Pltwr W/wo Methylmethacrylate Femur 1 1 — $171,337.69 $113,295.00 $113,295.00 $113,295.00 2026-03-31
93654 CPT Intracrd Abl For Tx Of Vt 117 100 $131,773.10 $131,773.10 $33,206.82 $126,502.18 $112,007.14 2026-03-31
93653 CPT Ephys Eval W/Ablation Supravent Arrhythmia|PHYSICIAN Assistant/nurse Practitione… 117 100 $127,859.60 $127,859.60 $32,220.62 $122,745.22 $108,680.66 2026-03-31
303 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back,minor 60 16 — $294,345.59 $56,678.55 $167,245.78 $104,664.63 2026-03-31
27705 CPT Osteotomy Tibia 1 1 — $127,331.40 $103,729.44 $103,729.44 $103,729.44 2026-03-31
612 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 36 16 — $128,354.65 $67,842.66 $254,387.98 $103,662.88 2026-03-31
162 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis,moderate 28 14 — $728,512.41 $65,468.31 $142,218.81 $102,094.11 2026-03-31
J9348 HCPCS Naxitamab-gqgk 4 Mg/ml Intravenous Solution 117 100 $117,421.55 $117,421.55 $29,590.23 $112,724.69 $99,808.32 2026-03-31
33270 CPT Ins/Rep Subq 101 85 $116,806.00 $116,806.00 $47,890.46 $112,133.76 $99,285.10 2026-03-31
J1290 HCPCS Ecallantide 10 Mg/ml (1 Ml) Subcutaneous Solution 101 85 $111,328.30 $111,328.30 $45,644.60 $106,875.17 $94,629.06 2026-03-31
J9229 HCPCS Inotuzumab Ozogamicin 0.9 Mg(0.25 Mg/ml Initial Concentration) IV Soln 117 100 $109,899.25 $109,899.25 $27,694.61 $105,503.28 $93,414.36 2026-03-31
24515 CPT Optx Humeral Shft Fx W/Plate/Screws W/Wocerclage|LEFT Side 1 1 — $96,713.84 $92,199.21 $92,199.21 $92,199.21 2026-03-31
631 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure,moderate 42 14 — $516,844.35 $45,203.59 $265,628.84 $87,679.96 2026-03-31
33249 CPT Insj/Rplcmt 119 100 $101,078.40 $142,562.12 $24,502.72 $97,035.26 $85,916.64 2026-03-31
J9226 HCPCS Histrelin 50 Mg (65 Mcg/day) Implant Kit 117 100 $100,363.25 $100,363.25 $25,291.54 $96,348.72 $85,308.76 2026-03-31
33263 CPT Removal & Replacement Of Implantable Defibrillator Pulse Generator; Dual Lead Sy… 100 84 $97,968.40 $97,968.40 $40,167.04 $94,049.66 $83,273.14 2026-03-31
J1246 HCPCS Dinutuximab 3.5 Mg/ml Intravenous Solution 101 85 $94,323.25 $94,323.25 $38,672.53 $90,550.32 $80,174.76 2026-03-31
J2350 HCPCS Ocrelizumab 30 Mg/ml Intravenous Solution 117 100 $93,009.35 $93,009.35 $23,438.36 $89,288.98 $79,057.95 2026-03-31
160 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly,moderate 42 14 — $442,269.30 $54,294.09 $163,003.20 $76,587.08 2026-03-31
J7189 HCPCS Coagulation Factor Viia Recomb 1 Mg (1,000 Mcg) Intravenous Solution 351 100 $91,375.00 $91,375.00 $4,615.38 $140,323.20 $75,841.25 2026-03-31
J3285 HCPCS Treprostinil Sodium 10 Mg/ml Injection Solution 404 85 $91,092.40 $91,092.40 $8,079.85 $1,986,427.20 $74,743.67 2026-03-31
PX-502405 CDM Ecmo/Ecls Initial Day Vv With Remote Start 101 85 $86,433.70 $86,433.70 $35,437.82 $82,976.35 $73,468.65 2026-03-31
L8614 HCPCS Abutment 10mm (abutment Baha Ba400 10mm Dermalock Ea/1) 351 100 $86,734.80 $86,734.80 $1,718.96 $135,477.12 $71,989.88 2026-03-31
J9210 HCPCS Emapalumab-lzsg 5 Mg/ml Intravenous Solution 107 91 $83,622.50 $83,622.50 $27,184.00 $83,622.50 $71,079.13 2026-03-31
J9256 HCPCS Nipocalimab-aahu 185 Mg/ml Intravenous Solution 101 85 $82,493.00 $82,493.00 $33,822.13 $79,193.28 $70,119.05 2026-03-31
PX-648235 CDM Impella Aic 5.5 101 85 $80,175.00 $80,175.00 $32,871.75 $76,968.00 $68,148.75 2026-03-31
30117 CPT Excision/Destruction Intranasal Lesion Int Appr 1 1 — $69,086.45 $67,918.05 $67,918.05 $67,918.05 2026-03-31
167 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures,minor 50 16 — $322,580.15 $40,188.27 $118,532.07 $65,686.09 2026-03-31
163 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis,minor 56 14 — $517,536.30 $48,687.39 $118,305.82 $64,137.56 2026-03-31
J0638 HCPCS Canakinumab (pf) 150 Mg/ml Subcutaneous Solution 117 100 $74,885.25 $74,885.25 $18,871.08 $71,889.84 $63,652.46 2026-03-31
SUP-38445 CDM Distal Femoral Right Custom Ea/1 101 85 $74,718.51 $74,718.51 $30,634.59 $71,729.77 $63,510.73 2026-03-31
403 APR_DRG Procedures For Obesity,extreme 14 14 — $851,888.55 $60,786.58 $63,825.91 $63,218.04 2026-03-31
J1640 HCPCS Hemin 350 Mg Intravenous Powder For Solution 101 85 $74,326.55 $74,326.55 $30,473.89 $71,353.49 $63,177.57 2026-03-31
53430 CPT Urethroplasty Rcnstj Female Urethra 1 1 — $73,801.95 $62,604.40 $62,604.40 $62,604.40 2026-03-31
54352 CPT Rpr Hypospadias Cripple W/Dsj & Exc & Grfs/Flap 1 1 — $160,366.50 $61,131.84 $61,131.84 $61,131.84 2026-03-31
PX-502350 CDM Ecmo/Ecls Initial Day Va With Remote Start 101 85 $71,649.30 $71,649.30 $29,376.21 $68,783.33 $60,901.91 2026-03-31
J9153 HCPCS Daunorubicin 44 Mg And Cytarabine 100 Mg In Liposome IV Solution 101 85 $71,495.00 $71,495.00 $29,312.95 $68,635.20 $60,770.75 2026-03-31
PX-502011 CDM Ecmo/Ecls Initial Day Vv 101 85 $71,024.30 $71,024.30 $29,119.96 $68,183.33 $60,370.66 2026-03-31
93613 CPT Intracardiac Ep Mapping 3d 117 100 $68,508.50 $68,508.50 $17,264.14 $65,768.16 $58,232.23 2026-03-31
93580 CPT Pfo Fon/Asd Closure W/Implant 126 100 $68,115.60 $104,286.45 $3,794.43 $153,839.16 $57,898.26 2026-03-31
130 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours,moderate 50 16 — $214,574.20 $46,465.94 $137,391.40 $57,372.34 2026-03-31
21 APR_DRG Open Craniotomy Except Trauma,minor 64 16 — $287,183.43 $27,708.73 $98,122.30 $56,782.05 2026-03-31
J9381 HCPCS Teplizumab-mzwv 100 Mcg/ml 107 91 $66,275.00 $66,275.00 $21,544.68 $66,275.00 $56,333.75 2026-03-31
179 APR_DRG Defibrillator Implants,minor 36 16 — $258,806.82 $47,792.75 $160,102.54 $54,692.82 2026-03-31
312 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses,min… 32 16 — $69,343.20 $17,829.72 $101,467.35 $54,171.45 2026-03-31
33274 CPT Tcat Insj/Rpl Perm Ldls Pm 101 85 $63,287.60 $63,287.60 $25,947.92 $60,756.10 $53,794.46 2026-03-31
169 APR_DRG Major Abdominal Vascular Procedures,major 14 14 — $908,793.36 $51,521.70 $54,097.79 $53,582.57 2026-03-31
89 APR_DRG Major Cranial Or Facial Bone Procedures,minor 68 16 — $213,869.39 $22,548.09 $129,553.27 $52,553.11 2026-03-31
91 APR_DRG Other Major Head And Neck Procedures,minor 68 16 — $103,065.10 $19,850.25 $143,843.47 $52,216.69 2026-03-31
J9332 HCPCS Efgartigimod Alfa-fcab 20 Mg/ml Intravenous Solution 101 85 $60,109.90 $60,109.90 $24,645.06 $57,705.50 $51,093.42 2026-03-31
34716 CPT Opn Axillary/Subclavian Art Expos W/Cndt Crtj 101 85 $60,029.70 $60,029.70 $24,612.18 $57,628.51 $51,025.25 2026-03-31
SUP-62163 CDM Implant My3d Pelvic Patient Specific Ea/1 101 85 $59,712.00 $59,712.00 $24,481.92 $57,323.52 $50,755.20 2026-03-31
J9042 HCPCS Brentuximab Vedotin 50 Mg Intravenous Solution 117 100 $59,390.75 $59,390.75 $14,966.47 $57,015.12 $50,482.14 2026-03-31
33240 CPT Insert Icd G 101 85 $58,069.30 $58,069.30 $23,808.41 $55,746.53 $49,358.91 2026-03-31
444 APR_DRG Renal Dialysis Access Device Procedures And Vessel Repair,moderate 32 16 — $75,963.65 $21,404.51 $64,233.25 $49,291.37 2026-03-31
177 APR_DRG Cardiac Pacemaker And Defibrillator Revision Except Device Replacement,extreme 14 14 — $1,096,761.95 $47,280.98 $49,645.03 $49,172.22 2026-03-31
27360 CPT Prtl Exc Bone Femur Prox Tibia&/Fibula|LEFT Side 1 1 — $34,791.00 $48,204.70 $48,204.70 $48,204.70 2026-03-31
PX-502010 CDM Ecmo/Ecls Initial Day Va 101 85 $56,239.80 $56,239.80 $23,058.32 $53,990.21 $47,803.83 2026-03-31
93582 CPT Rt & Lt Hrt Cath W/Pda Closure 247 100 $63,072.05 $69,969.00 $9,757.09 $126,871.47 $47,748.84 2026-03-31
SUP-57526 CDM Neurostimulator Rns-320-k Ea/1 101 85 $55,560.00 $55,560.00 $22,779.60 $53,337.60 $47,226.00 2026-03-31
J9272 HCPCS Dostarlimab-gxly 50 Mg/ml Intravenous Solution 117 100 $55,344.00 $55,344.00 $13,946.69 $53,130.24 $47,042.40 2026-03-31
120 APR_DRG Major Respiratory And Chest Procedures,minor 72 16 — $164,300.45 $23,556.46 $222,893.50 $46,749.95 2026-03-31
890 APR_DRG HIV With Multiple Major HIV Related Conditions,extreme 14 14 — $694,844.40 $44,881.36 $47,125.43 $46,676.62 2026-03-31
304 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back,minor 50 16 — $229,029.04 $35,186.85 $124,330.34 $46,495.20 2026-03-31
49329 CPT Unlisted Laparoscopic Px Abd Pertoneum & Omentum 2 2 — $96,881.60 $40,547.51 $51,864.71 $46,206.11 2026-03-31
621 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly,minor 64 16 — $101,634.20 $10,437.53 $101,841.51 $46,195.54 2026-03-31
260 APR_DRG Major Pancreas, Liver And Shunt Procedures,minor 64 16 — $262,891.80 $24,808.71 $283,794.03 $46,117.63 2026-03-31
36906 CPT Per Mechthro 101 85 $53,768.60 $53,768.60 $22,045.13 $51,617.86 $45,703.31 2026-03-31
77372 CPT Sbrt Single Treatment Rad Px 100 84 $53,178.70 $53,178.70 $21,803.27 $51,051.55 $45,201.90 2026-03-31
176 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices,majo… 18 16 — $189,334.10 $43,909.64 $46,105.12 $45,007.38 2026-03-31
J1809 HCPCS Fosdenopterin 9.5 Mg Intravenous Solution 101 85 $52,765.00 $52,765.00 $21,633.65 $50,654.40 $44,850.25 2026-03-31
SUP-50405 CDM Dstr Halo Cust. Ext (distractor Halo Custom Ext Ea/1) 101 85 $52,500.00 $52,500.00 $21,525.00 $50,400.00 $44,625.00 2026-03-31
43280 CPT Laps Surg Esopg/Gstr Fundoplasty 3 3 — $120,035.25 $5,310.09 $47,015.85 $44,485.22 2026-03-31
611 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly,minor 50 16 — $205,525.50 $25,976.30 $131,289.92 $44,238.31 2026-03-31
220 APR_DRG Major Stomach, Esophageal And Duodenal Procedures,minor 68 16 — $139,268.15 $18,246.72 $124,266.83 $44,157.55 2026-03-31
622 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 50 16 — $282,943.40 $20,977.41 $203,212.25 $43,950.39 2026-03-31
C1820 HCPCS Deep Brain Stimulator System 117 100 $51,584.40 $51,584.40 $12,999.27 $49,521.02 $43,846.74 2026-03-31
62141 CPT Cranioplasty Skull Defect >5 Cm Diameter 1 1 — $96,721.14 $43,788.53 $43,788.53 $43,788.53 2026-03-31
21600 CPT Excision Rib Partial|LEFT Side 1 1 — $94,809.80 $43,575.00 $43,575.00 $43,575.00 2026-03-31
J3357 HCPCS Ustekinumab 45 Mg/0.5 Ml Subcutaneous Syringe 117 100 $51,055.10 $51,055.10 $12,865.89 $49,012.90 $43,396.84 2026-03-31
J1628 HCPCS Guselkumab 200 Mg/20 Ml (10 Mg/ml) Intravenous Solution 234 100 $58,348.28 $58,348.28 $12,857.68 $63,047.04 $43,369.17 2026-03-31
93581 CPT Vsd Closure W/Implant 101 85 $50,902.90 $50,902.90 $20,870.19 $48,866.78 $43,267.47 2026-03-31
950 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis,minor 68 16 — $150,687.20 $19,617.75 $126,979.17 $43,260.48 2026-03-31
60650 CPT Laparoscopy Adrenalectomy Prtl/Compl Tabdl 1 1 — $117,748.95 $43,199.10 $43,199.10 $43,199.10 2026-03-31
42420 CPT Exc Prtd Tum/Prtd Glnd Tot Dsj&Prsrv Facial Nr 2 1 — $130,463.05 $10,220.02 $75,717.66 $42,968.84 2026-03-31
33477 CPT Implant Tcat 117 100 $50,465.80 $50,465.80 $12,717.38 $48,447.17 $42,895.93 2026-03-31
34715 CPT Open Artery For Delivery Of Endovasc Prosthesis 101 85 $50,425.10 $50,425.10 $20,674.29 $48,408.10 $42,861.34 2026-03-31
61635 CPT Intracranial 101 85 $50,401.90 $50,401.90 $20,664.78 $48,385.82 $42,841.62 2026-03-31
J2327 HCPCS Risankizumab-rzaa 180 Mg/1.2 Ml (150 Mg/ml) Subcut Wearable Injector 234 100 $63,175.68 $63,175.68 $12,088.21 $75,246.96 $42,718.33 2026-03-31
325 APR_DRG Non-elective Or Complex Knee Joint Replacement,moderate 46 16 — $391,452.36 $31,821.82 $174,975.56 $42,688.60 2026-03-31
42440 CPT Excision Submandibular Submaxillary Gland 2 2 — $57,483.78 $22,357.39 $62,120.63 $42,239.01 2026-03-31
SUP-56816 CDM Valve Harmony Tpv 25mm Ea/1 101 85 $49,500.00 $49,500.00 $20,295.00 $47,520.00 $42,075.00 2026-03-31
SUP-56814 CDM Valve Harmony Tpv 22mm Ea/1 101 85 $49,500.00 $49,500.00 $20,295.00 $47,520.00 $42,075.00 2026-03-31
261 APR_DRG Major Biliary Tract Procedures,moderate 46 16 — $345,385.55 $26,427.41 $79,738.28 $41,493.14 2026-03-31
SUP-48078 CDM Valve Heart Sapien 3 23mm Transcath Ea/1 101 85 $48,750.00 $48,750.00 $19,987.50 $46,800.00 $41,437.50 2026-03-31
SUP-54755 CDM Valve Heart Sapien 3 29mm Transcath Ea/1 101 85 $48,750.00 $48,750.00 $19,987.50 $46,800.00 $41,437.50 2026-03-31
650 APR_DRG Splenectomy,minor 50 16 — $164,522.90 $18,635.91 $95,111.09 $41,421.50 2026-03-31
93596 CPT R&l Hrt Cath Chd Nml Nt Cnj 128 100 $48,651.40 $73,802.62 $1,717.08 $55,812.96 $41,353.69 2026-03-31
93597 CPT R&l Hrt Cath Chd Abnl Nt Cnj 133 100 $48,651.40 $87,456.45 $2,272.61 $137,563.88 $41,353.69 2026-03-31
69642 CPT Tmpp Mastoidectomy W/Ossicular Chain Recnstj 3 3 — $84,507.70 $4,499.40 $48,820.46 $41,236.95 2026-03-31
32505 CPT Thoracotomy W/Therapeutic Wedge Resexn Initial|LEFT Side 1 1 — $225,645.20 $41,004.86 $41,004.86 $41,004.86 2026-03-31
50780 CPT Ureteroneocystostomy Anast 1 Ureter Bladder|BILATERAL Procedure 1 1 — $95,203.10 $40,977.43 $40,977.43 $40,977.43 2026-03-31
681 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms,minor 68 16 — $115,792.00 $16,085.92 $97,730.02 $40,888.31 2026-03-31
441 APR_DRG Major Bladder Procedures,moderate 46 16 — $545,257.50 $30,254.93 $84,680.62 $40,742.17 2026-03-31
20 APR_DRG Open Craniotomy For Trauma,minor 50 16 — $243,817.30 $30,666.87 $93,258.03 $40,391.89 2026-03-31
63200 CPT Laminectomy Release Tethered Spinal Cord Lumbar 2 2 — $106,476.83 $19,873.23 $60,910.38 $40,391.80 2026-03-31
J9203 HCPCS Gemtuzumab Ozogamicin 4.5 Mg (1 Mg/ml Initial Concentration) IV Soln 117 100 $47,382.00 $47,382.00 $11,940.26 $45,486.72 $40,274.70 2026-03-31
175 APR_DRG Percutaneous Cardiac Intervention Without Ami,minor 72 16 — $164,348.12 $27,162.84 $165,329.21 $39,644.91 2026-03-31
28465 CPT Open Tx Tarsal Fracture Xcp Talus & Calcaneus Ea|RIGHT Side 1 1 — $107,062.24 $39,515.97 $39,515.97 $39,515.97 2026-03-31
J0741 HCPCS Cabotegravir ER 600 Mg/3 Ml-rilpivirine ER 900 Mg/3ml IM Suspension,er 116 99 $46,404.30 $46,404.30 $11,693.88 $44,548.13 $39,443.66 2026-03-31
93593 CPT R Hrt Cath Chd Nrml Nt Cnj 120 100 $46,153.50 $67,664.45 $1,193.12 $44,307.36 $39,230.48 2026-03-31
93594 CPT R Hrt Cath Chd Abnl Nt Cnj 122 100 $46,153.50 $77,048.60 $2,318.06 $44,307.36 $39,230.48 2026-03-31
33881 CPT Endovascular Repair Of Descending Thoracic Aorta Initial Endoprosthesis Plus Des… 101 85 $46,035.80 $46,035.80 $18,874.68 $44,194.37 $39,130.43 2026-03-31
309 APR_DRG Other Significant Hip And Femur Surgery,minor 72 16 — $213,452.47 $18,911.38 $176,152.40 $38,217.32 2026-03-31
792 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment,moderate 50 16 — $197,389.30 $24,705.09 $107,410.00 $38,145.62 2026-03-31
22 APR_DRG Ventricular Shunt Procedures,minor 68 16 — $116,439.24 $17,747.59 $134,574.46 $38,000.51 2026-03-31
121 APR_DRG Other Respiratory And Chest Procedures,minor 68 16 — $172,879.50 $17,425.36 $94,606.73 $37,625.43 2026-03-31
50405 CPT Pyeloplasty Complicated 1 1 — $78,058.05 $37,562.65 $37,562.65 $37,562.65 2026-03-31
54332 CPT 1 Stage Prox Penile/Penoscrotal Hypospadias Rpr 2 2 — $68,680.35 $35,855.25 $39,270.04 $37,562.65 2026-03-31
60240 CPT Thyroidectomy Total/Complete 1 1 — $130,901.15 $37,439.22 $37,439.22 $37,439.22 2026-03-31
21143 CPT Rcnstj Midface Lefort I 3/> Piece Without Bone Graft 2 2 — $136,511.05 $32,746.99 $41,843.39 $37,295.19 2026-03-31
29 APR_DRG Other Percutaneous Intracranial Procedures,minor 36 16 — $228,200.39 $27,142.62 $108,754.96 $37,151.91 2026-03-31
230 APR_DRG Major Small Bowel Procedures,minor 64 16 — $215,100.25 $17,910.59 $74,348.80 $37,074.05 2026-03-31
28261 CPT Capsulotomy Midfoot W/Tendon Lengthening 2 1 — $108,357.43 $34,576.47 $39,395.41 $36,985.94 2026-03-31
SUP-56647 CDM Valve Harmony Tpv Htpv254252 Ea/1 101 85 $43,500.00 $43,500.00 $17,835.00 $41,760.00 $36,975.00 2026-03-31
182 APR_DRG Other Peripheral Vascular Procedures,minor 68 16 — $149,637.50 $26,309.89 $106,546.98 $36,938.19 2026-03-31
690 APR_DRG Acute Leukemia,minor 60 16 — $403,536.95 $18,110.24 $104,461.95 $36,917.50 2026-03-31
231 APR_DRG Major Large Bowel Procedures,minor 64 16 — $137,695.40 $18,538.61 $70,050.00 $36,862.19 2026-03-31
28615 CPT Open Treatment Tarsometatarsal Joint Dislocation|RIGHT Side 1 1 — $97,569.17 $36,842.37 $36,842.37 $36,842.37 2026-03-31
64792 CPT Exc Neurofibroma/Neurolemmoma Extnsv 1 1 — $129,869.15 $36,424.38 $36,424.38 $36,424.38 2026-03-31
27176 CPT Tx Slp Fem Epiphysis Single/Multipl Pinning Situ|RIGHT Side 4 2 — $49,183.69 $16,766.63 $54,636.57 $36,322.80 2026-03-31
49 APR_DRG Bacterial And Tuberculous Infections Of Nervous System,moderate 54 16 — $222,269.45 $26,059.70 $165,844.78 $36,177.97 2026-03-31
711 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure,moderat… 46 16 — $307,824.75 $19,635.44 $71,331.65 $36,062.53 2026-03-31
36903 CPT Peripheral S 101 85 $42,246.80 $42,246.80 $17,321.19 $40,556.93 $35,909.78 2026-03-31
614 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition… 18 16 — $29,627.70 $33,978.82 $98,290.42 $35,677.76 2026-03-31
710 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure,minor 64 16 — $120,245.65 $15,134.41 $72,069.34 $35,622.80 2026-03-31
193 APR_DRG Acute And Subacute Endocarditis,extreme 18 16 — $198,647.80 $33,861.31 $115,875.78 $35,554.38 2026-03-31
J2506 HCPCS Pegfilgrastim 6 Mg/0.6 Ml Subcutaneous Syringe 117 100 $41,756.95 $41,756.95 $10,522.75 $40,086.67 $35,493.41 2026-03-31
401 APR_DRG Adrenal Procedures,minor 54 16 — $212,120.00 $17,302.79 $116,495.95 $35,440.26 2026-03-31
36478 CPT Endoven Abltj Incmptnt Vein Xtr Laser 1st Vein 2 1 — $45,490.80 $18,219.83 $52,290.00 $35,254.92 2026-03-31
26 APR_DRG Other Nervous System And Related Procedures,minor 36 16 — $114,170.27 $18,426.15 $93,833.38 $35,251.56 2026-03-31
14041 CPT Adjt/Reargmt F/C/C/M/N/Ax/G/H/F 10.1-30.0 Sq Cm 2 2 — $68,028.25 $1,947.28 $68,506.46 $35,226.87 2026-03-31
36905 CPT Perc Mechthr 101 85 $41,202.80 $41,202.80 $16,893.15 $39,554.69 $35,022.38 2026-03-31
J1930 HCPCS Lanreotide 60 Mg/0.2 Ml Subcutaneous Syringe 234 100 $48,023.03 $48,023.03 $10,381.90 $52,654.13 $35,018.30 2026-03-31
695 APR_DRG Chemotherapy For Acute Leukemia,moderate 50 16 — $95,340.65 $12,665.29 $98,492.17 $34,978.53 2026-03-31
69644 CPT Tmpp Mastoidect Ntc/Rcnsted Canal Wall Ocr 6 5 — $80,757.00 $4,499.40 $53,484.60 $34,865.82 2026-03-31
J9228 HCPCS Ipilimumab 50 Mg/10 Ml (5 Mg/ml) Intravenous Solution 117 100 $40,871.35 $40,871.35 $10,299.58 $39,236.50 $34,740.65 2026-03-31
36224 CPT Slctv Cath Intrnl Carotid Art Angio Intrcrnl Art 206 87 $45,609.65 $83,960.55 $4,504.36 $107,568.00 $34,663.22 2026-03-31
33995 CPT Insertion Of Vad, Percutaneous; Rt Heart 101 85 $40,758.80 $40,758.80 $16,711.11 $39,128.45 $34,644.98 2026-03-31
27730 CPT Arrest Epiphyseal Open Distal Tibia 3 2 — $51,986.18 $3,010.37 $78,957.90 $34,576.47 2026-03-31
54690 CPT Laparoscopy Surgical Orchiectomy 3 3 — $69,516.05 $1,952.29 $67,295.34 $34,576.47 2026-03-31
J9301 HCPCS Obinutuzumab 1,000 Mg/40 Ml Intravenous Solution 117 100 $40,626.30 $40,626.30 $10,237.83 $39,001.25 $34,532.36 2026-03-31
37243 CPT Vasc Emboliz 101 85 $40,332.40 $40,332.40 $16,536.28 $38,719.10 $34,282.54 2026-03-31
93460 CPT R&l Heart Cath W Art/Ventricle Imaging 134 100 $40,304.30 $60,403.03 $2,272.61 $47,467.43 $34,258.66 2026-03-31
C9047 HCPCS Caplacizumab-yhdp 11 Mg Solution For Injection 101 85 $40,240.50 $40,240.50 $16,498.61 $38,630.88 $34,204.43 2026-03-31
J7504 HCPCS Lymphocyte,anti-thymo Immune Globulin 50 Mg/ml Intravenous Solution 101 85 $39,922.85 $39,922.85 $16,368.37 $38,325.94 $33,934.42 2026-03-31
SUP-62029 CDM Nail Femur 12.5x190mm 10deg Retrograde Bend Ea/1 101 85 $39,664.50 $39,664.50 $16,262.45 $38,077.92 $33,714.83 2026-03-31
SUP-59039 CDM Nail Femur 8.5x165mm 10deg Ea/1 101 85 $39,664.50 $39,664.50 $16,262.45 $38,077.92 $33,714.83 2026-03-31
SUP-60714 CDM Nail Femur 10.7 X 190mm Ster Precice Ea/1 101 85 $39,664.50 $39,664.50 $16,262.45 $38,077.92 $33,714.83 2026-03-31
SUP-49483 CDM Femur Troch 10.7x275mm 10deg Ea/1 101 85 $39,664.50 $39,664.50 $16,262.45 $38,077.92 $33,714.83 2026-03-31
37242 CPT Artery Occlu 132 100 $39,498.00 $217,926.38 $9,953.50 $230,325.00 $33,573.30 2026-03-31
27709 CPT Osteotomy Tibia & Fibula 1 1 — $96,077.69 $33,536.07 $33,536.07 $33,536.07 2026-03-31
23156 CPT Exc/Curtg Bone Cyst/Benign Tum Prox Hum W/Algrft 2 2 — $52,025.54 $19,233.88 $47,807.00 $33,520.44 2026-03-31
19380 CPT Revision Reconstructed Breast 5 4 — $54,033.22 $3,473.54 $44,392.22 $33,291.30 2026-03-31
242 APR_DRG Major Esophageal Disorders,major 36 16 — $101,658.02 $14,248.61 $98,122.30 $33,259.82 2026-03-31
J3380 HCPCS Vedolizumab 300 Mg Intravenous Solution 117 100 $39,124.65 $39,124.65 $9,859.41 $37,559.66 $33,255.95 2026-03-31
59 APR_DRG Anoxic And Other Severe Brain Damage,major 22 16 — $166,807.55 $31,545.08 $93,265.50 $33,122.33 2026-03-31
951 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis,minor 68 16 — $98,637.35 $14,214.50 $94,468.50 $32,884.88 2026-03-31
RX-119867 CDM Glycerol Phenylbutyrate 1.1 Gram/ml Oral Liquid 101 85 $38,458.50 $38,458.50 $15,767.99 $36,920.16 $32,689.73 2026-03-31
92928 CPT Stent Placement Initial 117 100 $38,446.20 $38,446.20 $9,688.44 $36,908.35 $32,679.27 2026-03-31
442 APR_DRG Kidney And Urinary Tract Procedures For Malignancy,moderate 36 16 — $200,277.98 $20,942.02 $86,817.17 $32,667.12 2026-03-31
SUP-40730 CDM Valve Melody Pulmonic <20mm Melody Valve <20mm Ea/1 101 85 $38,250.00 $38,250.00 $15,682.50 $36,720.00 $32,512.50 2026-03-31
25609 CPT Optx Dstl Radl I-artic Fx/Epiphysl Sep 3 Frag|LEFT Side 1 1 — $61,780.15 $32,440.47 $32,440.47 $32,440.47 2026-03-31
69646 CPT Tympanoplasty Mastoidectomy Rad/Compl W/Ocr 1 1 — $108,642.98 $32,440.47 $32,440.47 $32,440.47 2026-03-31
323 APR_DRG Non-elective Or Complex Hip Joint Replacement,major 14 14 — $364,586.26 $31,179.90 $32,738.90 $32,427.10 2026-03-31
32666 CPT Thoracoscopy W/Thera Wedge Resexn Initial Unilat 1 1 — $72,626.88 $32,106.72 $32,106.72 $32,106.72 2026-03-31
33903 CPT Percutaneous Pulmonary Artery Revascularization By Stent Placement, Initial; Bil… 101 85 $37,500.80 $37,500.80 $15,375.33 $36,000.77 $31,875.68 2026-03-31
180 APR_DRG Other Circulatory System Procedures,major 14 14 — $539,530.95 $30,553.14 $32,080.80 $31,775.26 2026-03-31
J1162 HCPCS Digoxin Immune Fab 40 Mg Intravenous Solution 101 85 $37,370.00 $37,370.00 $15,321.70 $35,875.20 $31,764.50 2026-03-31
315 APR_DRG Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement,minor 68 16 — $107,968.30 $13,901.12 $176,768.84 $31,747.26 2026-03-31
680 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms,minor 46 16 — $290,925.05 $21,289.52 $52,292.79 $31,673.47 2026-03-31
518 APR_DRG Other Female Reproductive System And Related Procedures,moderate 36 16 — $86,027.98 $16,058.12 $72,792.22 $31,620.90 2026-03-31
30580 CPT Repair Fistula Oromaxillary 1 1 — $113,738.30 $31,579.18 $31,579.18 $31,579.18 2026-03-31
36836 CPT Perq Av Fistula Creation Uxtr Single Access 101 85 $37,106.70 $37,106.70 $15,213.75 $35,622.43 $31,540.70 2026-03-31
L5999 HCPCS Le, Adjustable Pros Socket, Boa 202 85 $73,815.35 $73,815.35 $1,866.61 $137,354.88 $31,516.28 2026-03-31
911 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma,moder… 18 16 — $131,894.85 $30,002.20 $76,602.94 $31,502.31 2026-03-31
61650 CPT Evasc Prlng Admn Rx Agnt 1st 104 85 $36,886.90 $120,743.30 $15,123.63 $170,426.68 $31,353.87 2026-03-31
224 APR_DRG Peritoneal Adhesiolysis,moderate 50 16 — $149,083.40 $20,660.24 $89,025.14 $31,234.30 2026-03-31
171 APR_DRG Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock,moderate 36 16 — $148,702.90 $23,485.70 $86,690.14 $31,208.36 2026-03-31
23 APR_DRG Spinal Procedures,minor 50 16 — $183,034.81 $21,648.39 $74,761.10 $31,185.20 2026-03-31
447 APR_DRG Other Kidney, Urinary Tract And Related Procedures,major 18 16 — $143,041.90 $29,658.50 $79,737.45 $31,141.43 2026-03-31
J9022 HCPCS Atezolizumab 840 Mg/14 Ml (60 Mg/ml) Intravenous Solution 117 100 $36,631.55 $36,631.55 $9,231.15 $35,166.29 $31,136.82 2026-03-31
52353 CPT Cysto W/Ureteroscopy W/Lithotripsy 3 2 — $41,147.60 $25,847.40 $44,309.82 $31,060.32 2026-03-31
589 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 14 14 — $1,593,858.25 $29,725.47 $31,211.74 $30,914.49 2026-03-31
98 APR_DRG Other Ear, Nose, Mouth And Throat Procedures,minor 68 16 — $79,310.00 $12,727.21 $64,240.52 $30,896.85 2026-03-31
37236 CPT Intravascula 118 100 $36,282.90 $92,064.50 $9,143.29 $34,831.58 $30,840.47 2026-03-31
58541 CPT Laparoscopy Supracervical Hysterectomy 250 Gm/< 3 3 — $90,249.20 $5,764.77 $32,880.38 $30,818.23 2026-03-31
37799 CPT Placement Of Flow Regulator Plug In Btt Shunt 101 85 $36,238.90 $36,238.90 $14,857.95 $34,789.34 $30,803.07 2026-03-31
42699 CPT Unlisted Px Salivary Glands/Ducts 1 1 — $59,259.35 $30,733.07 $30,733.07 $30,733.07 2026-03-31
J1602 HCPCS Golimumab 12.5 Mg/ml Intravenous Solution 117 100 $36,110.50 $36,110.50 $9,099.85 $34,666.08 $30,693.93 2026-03-31
52356 CPT Cysto/Uretero W/Lithotripsy &Indwell Stent Insrt|BILATERAL Procedure 17 11 — $71,370.10 $3,015.43 $58,301.10 $30,577.50 2026-03-31
J9299 HCPCS Nivolumab 100 Mg/10 Ml Intravenous Solution 234 100 $35,868.88 $35,868.88 $9,038.91 $34,434.29 $30,488.40 2026-03-31
443 APR_DRG Kidney And Urinary Tract Procedures For Non-malignancy,minor 68 16 — $200,213.20 $16,180.69 $73,277.90 $30,213.44 2026-03-31
227 APR_DRG Hernia Procedures Except Inguinal, Femoral And Umbilical,minor 32 16 — $115,117.30 $15,423.78 $35,562.98 $30,146.25 2026-03-31
131 APR_DRG Cystic Fibrosis - Pulmonary Disease,moderate 54 16 — $156,538.26 $21,064.60 $106,304.14 $30,050.79 2026-03-31
27 APR_DRG Other Open Craniotomy,minor 50 16 — $133,605.25 $23,104.08 $84,493.38 $30,007.01 2026-03-31
952 APR_DRG Non-extensive O.r. Procedure Unrelated To Principal Diagnosis,moderate 46 16 — $519,374.30 $17,396.30 $59,248.44 $29,912.80 2026-03-31
J0391 HCPCS Artesunate 110 Mg Intravenous Solution 101 85 $35,010.25 $35,010.25 $14,354.20 $33,609.84 $29,758.71 2026-03-31
33225 CPT Biventric Le 101 85 $34,994.60 $34,994.60 $14,347.79 $33,594.82 $29,745.41 2026-03-31
321 APR_DRG Cervical Spinal Fusion And Other Back Or Neck Procedures Except Disc Excision Or… 50 16 — $236,850.62 $22,275.15 $79,629.10 $29,516.09 2026-03-31
623 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection,mode… 18 16 — $111,286.65 $28,109.29 $69,717.50 $29,514.75 2026-03-31
J9021 HCPCS Asparaginase Erwinia Chrysanthemi-rywn 10 Mg/0.5 Ml IM Solution 117 100 $34,640.00 $34,640.00 $8,729.28 $33,254.40 $29,444.00 2026-03-31
61630 CPT Intracranial 101 85 $34,578.30 $34,578.30 $14,177.10 $33,195.17 $29,391.56 2026-03-31
37244 CPT Vascular Hem 101 85 $34,547.70 $34,547.70 $14,164.56 $33,165.79 $29,365.55 2026-03-31
793 APR_DRG Moderately Extensive O.r. Procedures For Other Complications Of Treatment,minor 64 16 — $89,612.45 $12,803.03 $60,989.21 $29,315.67 2026-03-31
317 APR_DRG Tendon, Muscle And Other Soft Tissue Procedures,minor 64 16 — $162,966.50 $13,074.71 $60,004.72 $29,294.57 2026-03-31
633 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly,minor 68 16 — $109,997.80 $3,912.18 $100,194.94 $29,230.39 2026-03-31
22840 CPT Posterior Non-segmental Instrumentation 1 1 — $178,026.45 $29,150.55 $29,150.55 $29,150.55 2026-03-31
50 APR_DRG Non-bacterial Infections Of Nervous System Except Viral Meningitis,minor 72 16 — $179,263.42 $9,072.81 $172,046.54 $29,048.93 2026-03-31
232 APR_DRG Gastric Fundoplication,major 18 16 — $224,737.80 $27,603.84 $81,612.92 $28,984.03 2026-03-31
33228 CPT Rmv & Replac 122 100 $33,972.00 $46,726.05 $8,252.34 $32,613.12 $28,876.20 2026-03-31
27415 CPT Osteochondral Allograft Knee Open 1 1 — $123,525.90 $28,850.63 $28,850.63 $28,850.63 2026-03-31
RX-80820 CDM Fidaxomicin 40 Mg/ml Oral Suspension 101 85 $33,849.95 $33,849.95 $13,878.48 $32,495.95 $28,772.46 2026-03-31
PX-501212 CDM Ecmo/Ecls Subsq Day 101 85 $33,725.20 $33,725.20 $13,827.33 $32,376.19 $28,666.42 2026-03-31
69930 CPT Cochlear Device Implantation W/wo Mastoidectomy 22 12 — $214,712.77 $19,611.02 $82,858.32 $28,431.77 2026-03-31
SUP-37905 CDM Generator Icd Protecta Xtcrt-d Ea/1 101 85 $33,390.00 $33,390.00 $13,689.90 $32,054.40 $28,381.50 2026-03-31
625 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition,minor 36 16 — $151,704.83 $18,162.05 $77,921.75 $28,324.03 2026-03-31
33895 CPT Evasc St Rpr Thrc/Aa X Crsg 119 100 $33,150.20 $83,085.92 $8,353.85 $31,824.19 $28,177.67 2026-03-31
64905 CPT Nerve Pedicle Transfer First Stage 6 5 — $188,805.40 $4,639.71 $53,498.31 $28,130.84 2026-03-31
33902 CPT Perq P-art Revsc 1 Abnor Uni 119 100 $33,091.70 $135,688.13 $4,358.72 $31,768.03 $28,127.95 2026-03-31
C1882 HCPCS Battery Vigilant X4 Crt-d Ea/1 606 85 $33,631.80 $33,631.80 $11,662.86 $50,685.12 $28,125.00 2026-03-31
691 APR_DRG Lymphoma, Myeloma And Non-acute Leukemia,minor 64 16 — $174,028.90 $14,038.85 $60,577.90 $28,115.61 2026-03-31
27745 CPT Proph Tx N/P/Pltwr W/wo Methylmethacrylate Tibia 1 1 — $105,822.82 $28,079.42 $28,079.42 $28,079.42 2026-03-31
77373 CPT Sbrt Up To 5 Treatments Rad Px 100 84 $32,945.90 $32,945.90 $13,507.82 $31,628.06 $28,004.02 2026-03-31
93595 CPT L Hrt Cath Chd Nm/abn Nt Cnj 234 100 $39,538.95 $39,538.95 $8,296.95 $44,307.36 $27,985.74 2026-03-31
27356 CPT Excision/Curettage Cyst/Tumor Femur W/Allograft 5 4 — $77,834.02 $3,469.56 $31,185.00 $27,976.56 2026-03-31
27524 CPT Optx Patllr Fx W/Int Fixj/Patllc&Soft Tiss Rpr 1 1 — $57,139.04 $27,976.56 $27,976.56 $27,976.56 2026-03-31
93456 CPT Cmplx Rt Hrt Coronary Artery Angio 234 100 $39,033.90 $39,033.90 $8,285.36 $43,381.82 $27,946.64 2026-03-31
SUP-38726 CDM Pulmonary Valve W/conduit 9-23 9mm -23mm 101 85 $32,250.00 $32,250.00 $13,222.50 $30,960.00 $27,412.50 2026-03-31
51999 CPT Unlisted Laparoscopy Procedure Bladder 3 2 — $110,020.65 $1,519.88 $62,381.71 $27,289.16 2026-03-31
25810 CPT Arthrodesis Wrist W/Iliac/Other Autograft 1 1 — $99,080.01 $27,167.26 $27,167.26 $27,167.26 2026-03-31
25365 CPT Osteotomy Radius & Ulna 1 1 — $61,921.57 $27,167.23 $27,167.23 $27,167.23 2026-03-31
52317 CPT Litholapaxy Smpl/Sm <2.5 Cm 1 1 — $46,554.00 $27,071.28 $27,071.28 $27,071.28 2026-03-31
361 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses,moderate 18 16 — $112,933.95 $25,709.67 $60,706.26 $26,995.15 2026-03-31
33208 CPT Perm Pacemaker-atrial&vent 117 100 $31,704.00 $31,704.00 $7,989.41 $30,435.84 $26,948.40 2026-03-31
RX-138987 CDM Dronabinol 5 Mg/ml Oral Solution 101 85 $31,620.60 $31,620.60 $12,964.45 $30,355.78 $26,877.51 2026-03-31
19318 CPT Reduction Mammaplasty 12 12 — $72,930.55 $9,862.28 $44,392.22 $26,783.44 2026-03-31
24635 CPT Open Tx Monteggia Fracture Dislocation Elbow 2 2 — $30,159.24 $24,479.49 $29,025.68 $26,752.58 2026-03-31
33214 CPT Pm Upgrade To Dual Comp 117 100 $31,372.50 $31,372.50 $7,905.87 $30,117.60 $26,666.63 2026-03-31
33206 CPT Perm Pacemak 117 100 $31,006.80 $55,902.25 $7,813.71 $29,766.53 $26,355.78 2026-03-31
25450 CPT Epiphysl Arrst Epiphysiod/Stapling Dstl Rds/U 1 1 — $45,816.20 $26,315.98 $26,315.98 $26,315.98 2026-03-31
21552 CPT Exc Tumor Soft Tis Neck/Ant Thorax Subq 3 Cm/> 3 3 — $47,435.40 $6,690.48 $54,794.88 $26,312.32 2026-03-31
55150 CPT Resection Scrotum 1 1 — $50,640.55 $26,228.02 $26,228.02 $26,228.02 2026-03-31
43 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies,mi… 72 16 — $132,000.60 $11,752.96 $128,099.97 $25,988.99 2026-03-31
J1303 HCPCS Ravulizumab-cwvz 100 Mg/ml Intravenous Solution 106 90 $30,254.25 $30,254.25 $9,835.05 $30,254.25 $25,716.11 2026-03-31
33904 CPT Percutaneous Pulmonary Artery Revascularization By Stent Placement 117 100 $30,242.88 $30,242.88 $7,621.21 $29,033.16 $25,706.45 2026-03-31
316 APR_DRG Hand And Wrist Procedures,moderate 36 16 — $67,942.60 $15,878.69 $68,529.45 $25,623.46 2026-03-31
60281 CPT Excision Thyroglossal Duct Cyst/Sinus Recurrent 1 1 — $58,769.80 $25,610.90 $25,610.90 $25,610.90 2026-03-31
37238 CPT Intravascula 122 100 $30,036.00 $175,322.85 $7,569.07 $56,504.26 $25,530.60 2026-03-31
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