Price Transparency 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

MAYO CLINIC HEALTH SYSTEM CHIPPEWA VALLEY

Bloomer, WI · CCN 521314 · Rates published

5,868 distinct procedures filed
285 distinct payers
6,877,461 rate rows
2026-03-31 last MRF observed
Data quality

3,202,697 of 6,877,461 rate rows are consumer-grade (46.6%)

3,674,764 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 3,673,808
per-diem day rate — not a per-procedure price 875
placeholder amount (≤ $0.02) — excluded from medians 43
exceeds 10× this hospital's gross charge — excluded from medians 38
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://mcorgstatic.blob.core.windows.net/cms-price/390813418_mayo-clinic-health-system-chippewa-valley_standardcharges.csv
Found on page https://www.mayoclinichealthsystem.org/for-patients-and-visitors/price-transparency
Discovered viaDiscovered by HANK
Last fetch — · 2026-05-15
Content fingerprint d939f6e4182979be… · 3,563,041,962 bytes · first seen 2026-05-04

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
J0225
HCPCS 		Vutrisiran 25 Mg/0.5 Ml Subcutaneous Syringe 262 $43,692.06 $207,957.42 $201,655.68 nat. median
$8,223
outlier · 24.5×
A9607
HCPCS 		Lutetium Lu-177 Vipivotide Tetraxetan 27 Mci/ml (1,000 Mbq/ml) IV Soln 262 $33,592.00 $159,885.00 $155,040.00 nat. median
$415
outlier · 373.2×
33276
CPT 		Hc Insn Phrnc Nrv Stim Sys 263 $519.01 $93,731.22 $90,890.88 nat. median
$43,787
outlier · 2.1×
J9359
HCPCS 		Loncastuximab Tesirine-lpyl 10 Mg/2 Ml Intravenous Solution (wetted) 262 $17,000.55 $80,916.07 $77,646.73 nat. median
$701
outlier · 110.8×
J2507
HCPCS 		Pegloticase 8 Mg/ml Intravenous Solution 263 $16,527.39 $78,664.01 $76,280.26 nat. median
$8,558
outlier · 8.9×
RX-707820
CDM 		Belantamab Mafodotin-blmf 70 Mg/1.4 Ml Intravenous Solution (wetted) 262 $13,994.32 $66,607.60 $64,589.18 nat. median
$63,916
1.0× median
RX-219415
CDM 		Belantamab Mafodotin-blmf 70 Mg Intravenous Solution 262 $13,994.32 $66,607.60 $64,589.18 nat. median
$63,916
1.0× median
0823T
CPT 		Hc Tcat Ins 1chmbr Ldls Pm Ra 262 $12,002.22 $57,125.97 $55,394.88 nat. median
$21,361
outlier · 2.6×
J0638
HCPCS 		Canakinumab (pf) 150 Mg/ml Subcutaneous Solution 263 $11,683.46 $55,608.80 $53,923.68 nat. median
$257
outlier · 209.5×
J2350
HCPCS 		Ocrelizumab 30 Mg/ml Intravenous Solution 263 $11,205.44 $53,333.58 $51,717.41 nat. median
$712
outlier · 72.6×
33231
CPT 		Hc Ins Pulse Gen W Exst Mult Lead 263 $364.93 $52,521.48 $50,929.92 nat. median
$30,121
1.7× median
641
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 1 $50,116.02 $50,116.02 $50,116.02 nat. median
$8,665
outlier · 5.8×
93580
CPT 		Hc Tx Cath Clsr Asd W Imp 263 $856.77 $45,350.91 $43,976.64 nat. median
$18,266
outlier · 2.4×
J9298
HCPCS 		Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution 262 $9,204.62 $43,810.47 $42,482.88 nat. median
$562
outlier · 75.6×
33249
CPT 		Hc Ins/rplc Dfib W Transven Lead 263 $816.94 $43,270.92 $41,959.68 nat. median
$31,833
1.3× median
33264
CPT 		Hc Rmvl&rplc Icd Gen Multi Lead 263 $365.07 $43,257.06 $41,946.24 nat. median
$31,873
1.3× median
33270
CPT 		Hc Ins/rplc Subq Icd W Subq Elec 263 $505.52 $42,389.82 $41,105.28 nat. median
$32,221
1.3× median
C2616
HCPCS 		Yttrium-90 Microspheres 3 Gbq/5 Ml For Intravenous Solution 262 $8,629.40 $42,441.30 $40,242.88 nat. median
$28,125
1.4× median
J9043
HCPCS 		Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution 263 $8,619.29 $41,024.51 $39,781.34 nat. median
$739
outlier · 53.9×
0796T
CPT 		Hc Tcat Ins 2chmbr Ldls Pm Ra 262 $8,345.79 $39,722.76 $38,519.04 nat. median
$20,860
1.8× median
551
MS_DRG 		Medical Back Problems With Mcc 1 $36,176.06 $36,176.06 $36,176.06 nat. median
$16,881
outlier · 2.1×
92930
CPT 		Hc Perq Tcat Plmt Ntrac St 2+les 2+st 2+c Segments 263 $482.29 $37,579.41 $36,061.05 nat. median
$29,757
1.2× median
J9042
HCPCS 		Brentuximab Vedotin 50 Mg/10 Ml Intravenous Solution (wetted) 263 $7,721.73 $36,752.46 $35,638.75 nat. median
$1,050
outlier · 33.9×
93656
CPT 		Hc Ep Eval Tx Art Fib Pulm Vein 263 $817.79 $36,642.87 $35,532.48 nat. median
$26,811
1.3× median
33263
CPT 		Hc Rmvl&rplc Icd Gen Dual Lead 263 $351.79 $36,588.42 $35,479.68 nat. median
$23,504
1.5× median
33262
CPT 		Hc Rmvl&rplc Icd Gen Sngl Lead 263 $338.76 $36,588.42 $35,479.68 nat. median
$23,398
1.5× median
1134
APR_DRG 		4 $12,693.84 $57,976.60 $35,335.22 nat. median
$13,626
outlier · 2.6×
J1628
HCPCS 		Guselkumab 200 Mg/20 Ml (10 Mg/ml) Intravenous Solution 262 $7,617.52 $36,256.47 $35,157.79 nat. median
$208
outlier · 169.3×
0795T
CPT 		Hc Tcat Ins 2chmbr Ldls Pm Cmpl 262 $7,388.78 $35,167.77 $34,102.08 nat. median
$21,836
1.6× median
J9281
HCPCS 		Mitomycin 40 Mg X 2 Intra-pyelocalyceal Kit 263 $7,222.18 $34,374.78 $33,333.12 nat. median
$545
outlier · 61.2×
J9272
HCPCS 		Dostarlimab-gxly 50 Mg/ml Intravenous Solution 262 $7,200.86 $34,273.31 $33,234.72 nat. median
$742
outlier · 44.8×
J9382
HCPCS 		Zenocutuzumab-zbco 375 Mg/18.75 Ml (20 Mg/ml) Intravenous Solution 262 $7,164.89 $34,102.13 $32,724.27 nat. median
$169
outlier · 193.4×
J9022
HCPCS 		Atezolizumab 60 Mg/ml Intravenous Solution (wrapper) 263 $7,007.52 $33,353.10 $32,342.40 nat. median
$6,951
outlier · 4.7×
J9024
HCPCS 		Atezolizumab 1,875 Mg-hyaluronidase-tqjs 30,000 Unit/15 Ml Subcut Soln 262 $7,007.50 $33,353.00 $32,342.30 nat. median
$77
outlier · 418.9×
93654
CPT 		Hc Ep Eval W Vent Tachy Ablate 263 $869.46 $32,998.68 $31,998.72 nat. median
$26,704
1.2× median
1392
APR_DRG 		4 $21,291.50 $42,139.40 $31,715.45 nat. median
$5,416
outlier · 5.9×
37294
CPT 		Hc Rvsc Evsc Tpvt St Athr Cpx 1 263 $834.67 $32,246.28 $31,269.12 nat. median
$26,849
1.2× median
33229
CPT 		Hc Rplc Perm Gen Mult Lead 263 $339.10 $32,231.43 $31,254.72 nat. median
$18,727
1.7× median
C9607
HCPCS 		Hc Perc Translum Revasc Cor Sngl 262 $6,689.28 $31,838.40 $30,873.60 nat. median
$19,992
1.5× median
J9119
HCPCS 		Cemiplimab-rwlc 50 Mg/ml Intravenous Solution 263 $6,658.60 $31,692.38 $30,732.00 nat. median
$91
outlier · 336.7×
C9606
HCPCS 		Hc Perc Translum Revasc Ami Sngl 262 $519.20 $31,838.40 $30,552.00 nat. median
$18,126
1.7× median
J9144
HCPCS 		Daratumumab 1,800 Mg-hyaluronidase-fihj 30,000 Unit/15 Ml Subcut Soln 263 $6,570.01 $31,270.73 $30,323.14 nat. median
$233
outlier · 130.1×
93653
CPT 		Hc Ep Eval W Supravent Ablate 263 $721.26 $31,027.59 $30,087.36 nat. median
$26,156
1.2× median
C9602
HCPCS 		Hc Perc Translum Ather Wangio Sng 262 $6,342.96 $30,190.05 $29,275.20 nat. median
$20,440
1.4× median
33274
CPT 		Hc Rplc/insrt Transcath Leadls Pm 263 $430.26 $29,462.40 $28,569.60 nat. median
$19,643
1.5× median
J3245
HCPCS 		Tildrakizumab-asmn 100 Mg/ml Subcutaneous Syringe 263 $6,127.49 $29,164.51 $28,280.74 nat. median
$256
outlier · 110.4×
C9766
HCPCS 		Hc Revasc Intra Lithotrip-ather 262 $5,966.90 $28,400.13 $27,539.52 nat. median
$19,548
1.4× median
J3263
HCPCS 		Toripalimab-tpzi 240 Mg/6 Ml (40 Mg/ml) Intravenous Solution 262 $5,744.98 $27,343.90 $26,239.10 nat. median
$73
outlier · 358.8×
J9228
HCPCS 		Ipilimumab 5 Mg/ml Intravenous Solution (wrapper) 263 $5,442.96 $102,289.08 $25,383.06 nat. median
$9,906
outlier · 2.6×
100
MS_DRG 		Seizures With Mcc 1 $25,370.31 $25,370.31 $25,370.31 nat. median
$19,360
1.3× median

Other procedures at this hospital

Browse this hospital's 5,868 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
             
J0225 HCPCS Vutrisiran 25 Mg/0.5 Ml Subcutaneous Syringe 417 262 $210,058.00 $189,052.20 $43,692.06 $207,957.42 $201,655.68 2026-03-31
A9607 HCPCS Lutetium Lu-177 Vipivotide Tetraxetan 27 Mci/ml (1,000 Mbq/ml) IV Soln 421 262 $161,500.00 $145,350.00 $33,592.00 $159,885.00 $155,040.00 2026-03-31
33276 CPT Hc Insn Phrnc Nrv Stim Sys 423 263 $94,678.00 $85,210.20 $519.01 $93,731.22 $90,890.88 2026-03-31
J9359 HCPCS Loncastuximab Tesirine-lpyl 10 Mg/2 Ml Intravenous Solution (wetted) 409 262 $81,733.40 $73,560.06 $17,000.55 $80,916.07 $77,646.73 2026-03-31
J2507 HCPCS Pegloticase 8 Mg/ml Intravenous Solution 419 263 $79,458.60 $71,512.74 $16,527.39 $78,664.01 $76,280.26 2026-03-31
RX-707820 CDM Belantamab Mafodotin-blmf 70 Mg/1.4 Ml Intravenous Solution (wetted) 421 262 $67,280.40 $60,552.36 $13,994.32 $66,607.60 $64,589.18 2026-03-31
RX-219415 CDM Belantamab Mafodotin-blmf 70 Mg Intravenous Solution 421 262 $67,280.40 $60,552.36 $13,994.32 $66,607.60 $64,589.18 2026-03-31
0823T CPT Hc Tcat Ins 1chmbr Ldls Pm Ra 421 262 $57,703.00 $51,932.70 $12,002.22 $57,125.97 $55,394.88 2026-03-31
J0638 HCPCS Canakinumab (pf) 150 Mg/ml Subcutaneous Solution 419 263 $56,170.50 $50,553.45 $11,683.46 $55,608.80 $53,923.68 2026-03-31
J2350 HCPCS Ocrelizumab 30 Mg/ml Intravenous Solution 419 263 $53,872.30 $48,485.07 $11,205.44 $53,333.58 $51,717.41 2026-03-31
33231 CPT Hc Ins Pulse Gen W Exst Mult Lead 423 263 $53,052.00 $47,746.80 $364.93 $52,521.48 $50,929.92 2026-03-31
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 1 1 — — $50,116.02 $50,116.02 $50,116.02 2026-03-31
93580 CPT Hc Tx Cath Clsr Asd W Imp 423 263 $45,809.00 $41,228.10 $856.77 $45,350.91 $43,976.64 2026-03-31
J9298 HCPCS Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution 417 262 $44,253.00 $39,827.70 $9,204.62 $43,810.47 $42,482.88 2026-03-31
33249 CPT Hc Ins/rplc Dfib W Transven Lead 423 263 $43,708.00 $39,337.20 $816.94 $43,270.92 $41,959.68 2026-03-31
33264 CPT Hc Rmvl&rplc Icd Gen Multi Lead 423 263 $43,694.00 $39,324.60 $365.07 $43,257.06 $41,946.24 2026-03-31
33270 CPT Hc Ins/rplc Subq Icd W Subq Elec 423 263 $42,818.00 $38,536.20 $505.52 $42,389.82 $41,105.28 2026-03-31
C2616 HCPCS Yttrium-90 Microspheres 3 Gbq/5 Ml For Intravenous Solution 842 262 $42,178.75 $37,960.88 $8,629.40 $42,441.30 $40,242.88 2026-03-31
J9043 HCPCS Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution 419 263 $41,438.90 $37,295.01 $8,619.29 $41,024.51 $39,781.34 2026-03-31
0796T CPT Hc Tcat Ins 2chmbr Ldls Pm Ra 421 262 $40,124.00 $36,111.60 $8,345.79 $39,722.76 $38,519.04 2026-03-31
551 MS_DRG Medical Back Problems With Mcc 1 1 — — $36,176.06 $36,176.06 $36,176.06 2026-03-31
92930 CPT Hc Perq Tcat Plmt Ntrac St 2+les 2+st 2+c Segments 414 263 $37,959.00 $34,163.10 $482.29 $37,579.41 $36,061.05 2026-03-31
J9042 HCPCS Brentuximab Vedotin 50 Mg/10 Ml Intravenous Solution (wetted) 419 263 $37,123.70 $33,411.33 $7,721.73 $36,752.46 $35,638.75 2026-03-31
93656 CPT Hc Ep Eval Tx Art Fib Pulm Vein 423 263 $37,013.00 $33,311.70 $817.79 $36,642.87 $35,532.48 2026-03-31
33263 CPT Hc Rmvl&rplc Icd Gen Dual Lead 423 263 $36,958.00 $33,262.20 $351.79 $36,588.42 $35,479.68 2026-03-31
33262 CPT Hc Rmvl&rplc Icd Gen Sngl Lead 423 263 $36,958.00 $33,262.20 $338.76 $36,588.42 $35,479.68 2026-03-31
1134 APR_DRG — 4 4 — — $12,693.84 $57,976.60 $35,335.22 2026-03-31
J1628 HCPCS Guselkumab 200 Mg/20 Ml (10 Mg/ml) Intravenous Solution 417 262 $36,622.70 $32,960.43 $7,617.52 $36,256.47 $35,157.79 2026-03-31
0795T CPT Hc Tcat Ins 2chmbr Ldls Pm Cmpl 421 262 $35,523.00 $31,970.70 $7,388.78 $35,167.77 $34,102.08 2026-03-31
J9281 HCPCS Mitomycin 40 Mg X 2 Intra-pyelocalyceal Kit 419 263 $34,722.00 $31,249.80 $7,222.18 $34,374.78 $33,333.12 2026-03-31
J9272 HCPCS Dostarlimab-gxly 50 Mg/ml Intravenous Solution 417 262 $34,619.50 $31,157.55 $7,200.86 $34,273.31 $33,234.72 2026-03-31
J9382 HCPCS Zenocutuzumab-zbco 375 Mg/18.75 Ml (20 Mg/ml) Intravenous Solution 409 262 $34,446.60 $31,001.94 $7,164.89 $34,102.13 $32,724.27 2026-03-31
J9022 HCPCS Atezolizumab 60 Mg/ml Intravenous Solution (wrapper) 419 263 $33,690.00 $30,321.00 $7,007.52 $33,353.10 $32,342.40 2026-03-31
J9024 HCPCS Atezolizumab 1,875 Mg-hyaluronidase-tqjs 30,000 Unit/15 Ml Subcut Soln 417 262 $33,689.90 $30,320.91 $7,007.50 $33,353.00 $32,342.30 2026-03-31
93654 CPT Hc Ep Eval W Vent Tachy Ablate 423 263 $33,332.00 $29,998.80 $869.46 $32,998.68 $31,998.72 2026-03-31
1392 APR_DRG — 4 4 — — $21,291.50 $42,139.40 $31,715.45 2026-03-31
37294 CPT Hc Rvsc Evsc Tpvt St Athr Cpx 1 423 263 $32,572.00 $29,314.80 $834.67 $32,246.28 $31,269.12 2026-03-31
33229 CPT Hc Rplc Perm Gen Mult Lead 423 263 $32,557.00 $29,301.30 $339.10 $32,231.43 $31,254.72 2026-03-31
C9607 HCPCS Hc Perc Translum Revasc Cor Sngl 421 262 $32,160.00 $28,944.00 $6,689.28 $31,838.40 $30,873.60 2026-03-31
J9119 HCPCS Cemiplimab-rwlc 50 Mg/ml Intravenous Solution 419 263 $32,012.50 $28,811.25 $6,658.60 $31,692.38 $30,732.00 2026-03-31
C9606 HCPCS Hc Perc Translum Revasc Ami Sngl 412 262 $32,160.00 $28,944.00 $519.20 $31,838.40 $30,552.00 2026-03-31
J9144 HCPCS Daratumumab 1,800 Mg-hyaluronidase-fihj 30,000 Unit/15 Ml Subcut Soln 419 263 $31,586.60 $28,427.94 $6,570.01 $31,270.73 $30,323.14 2026-03-31
93653 CPT Hc Ep Eval W Supravent Ablate 423 263 $31,341.00 $28,206.90 $721.26 $31,027.59 $30,087.36 2026-03-31
C9602 HCPCS Hc Perc Translum Ather Wangio Sng 421 262 $30,495.00 $27,445.50 $6,342.96 $30,190.05 $29,275.20 2026-03-31
33274 CPT Hc Rplc/insrt Transcath Leadls Pm 423 263 $29,760.00 $26,784.00 $430.26 $29,462.40 $28,569.60 2026-03-31
J3245 HCPCS Tildrakizumab-asmn 100 Mg/ml Subcutaneous Syringe 419 263 $29,459.10 $26,513.19 $6,127.49 $29,164.51 $28,280.74 2026-03-31
C9766 HCPCS Hc Revasc Intra Lithotrip-ather 421 262 $28,687.00 $25,818.30 $5,966.90 $28,400.13 $27,539.52 2026-03-31
J3263 HCPCS Toripalimab-tpzi 240 Mg/6 Ml (40 Mg/ml) Intravenous Solution 409 262 $27,620.10 $24,858.09 $5,744.98 $27,343.90 $26,239.10 2026-03-31
J9228 HCPCS Ipilimumab 5 Mg/ml Intravenous Solution (wrapper) 838 263 $64,745.20 $58,270.68 $5,442.96 $102,289.08 $25,383.06 2026-03-31
100 MS_DRG Seizures With Mcc 1 1 — — $25,370.31 $25,370.31 $25,370.31 2026-03-31
3853 APR_DRG — 4 4 — — $16,879.97 $33,408.20 $25,144.08 2026-03-31
J9316 HCPCS Pertuzumab 600 Mg-trastuzumab 600 Mg-hyaluronid-zzxf/10 Ml Subcut Soln 419 263 $26,096.40 $23,486.76 $5,428.05 $25,835.44 $25,052.54 2026-03-31
J2327 HCPCS Risankizumab-rzaa 360 Mg/2.4 Ml (150 Mg/ml) Subcut Wearable Injector 834 262 $40,667.00 $36,600.30 $5,340.46 $58,441.64 $24,905.04 2026-03-31
J3380 HCPCS Vedolizumab 300 Mg Intravenous Solution 419 263 $25,557.80 $23,002.02 $5,316.02 $25,302.22 $24,535.49 2026-03-31
J2427 HCPCS Paliperidone Palmitate (3 Month) 546 Mg/1.75 Ml Intramuscular Syringe 2,085 262 $25,321.60 $22,789.44 $1,814.51 $49,715.82 $24,308.74 2026-03-31
0483T CPT Hc Tmvi Percutaneous Approach 423 263 $25,308.00 $22,777.20 $1,468.86 $25,054.92 $24,295.68 2026-03-31
J1930 HCPCS Lanreotide 120 Mg/0.5 Ml Subcutaneous Syringe 419 263 $25,148.30 $22,633.47 $4,883.54 $24,896.82 $24,142.37 2026-03-31
92941 CPT Hc Perc Revasc Trans Mi Sngl Vesl 423 263 $24,983.00 $22,484.70 $597.08 $24,733.17 $23,983.68 2026-03-31
950 MS_DRG Aftercare Without Cc/mcc 1 1 — — $23,673.81 $23,673.81 $23,673.81 2026-03-31
37288 CPT Hc Revsc Evsc Tpvt Athrc Sf 1st 423 263 $24,658.00 $22,192.20 $622.43 $24,411.42 $23,671.68 2026-03-31
J9301 HCPCS Obinutuzumab 1,000 Mg/40 Ml Intravenous Solution 419 263 $24,133.80 $21,720.42 $5,019.83 $23,892.46 $23,168.45 2026-03-31
722 MS_DRG Malignancy, Male Reproductive System With Mcc 1 1 — — $22,943.33 $22,943.33 $22,943.33 2026-03-31
J9223 HCPCS Lurbinectedin 4 Mg/8 Ml Intravenous Solution (wetted) 419 263 $23,868.50 $21,481.65 $4,964.65 $23,629.82 $22,913.76 2026-03-31
92945 CPT Hc Perq Trluml Revsc Chrnc Tot Occls 1 Antgrd&rtrgr 414 263 $23,904.00 $21,513.60 $603.00 $23,664.96 $22,708.80 2026-03-31
37282 CPT Hc Rvsc Evsc Tpvt Angio Cplx 1 423 263 $23,121.00 $20,808.90 $566.03 $22,889.79 $22,196.16 2026-03-31
J9299 HCPCS Nivolumab 10 Mg/ml Intravenous Solution (wrapper) 419 263 $23,010.70 $20,709.63 $4,786.23 $22,780.59 $22,090.27 2026-03-31
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 3 3 — — $12,570.41 $61,814.61 $21,905.95 2026-03-31
J9289 HCPCS Nivolumab 600 Mg-hyaluronidase-nvhy 10,000 Unit/5 Ml Subcut Solution 409 262 $23,010.70 $20,709.63 $4,786.23 $22,780.59 $21,860.17 2026-03-31
33214 CPT Hc Upgrade Impl Pcmkr Sys 423 263 $22,677.00 $20,409.30 $438.05 $22,450.23 $21,769.92 2026-03-31
J2323 HCPCS Natalizumab 300 Mg/15 Ml Intravenous Solution 419 263 $22,623.10 $20,360.79 $4,705.60 $22,396.87 $21,718.18 2026-03-31
37243 CPT Hc Vasc Embl/occlude Tmr Infarct 423 263 $22,553.00 $20,297.70 $517.37 $22,327.47 $21,650.88 2026-03-31
C9608 HCPCS Hc Perc Trnslum Revasc Cor Ea Add 421 262 $22,443.00 $20,198.70 $4,668.14 $22,218.57 $21,545.28 2026-03-31
7201 APR_DRG — 4 4 — — $14,405.76 $28,511.40 $21,458.58 2026-03-31
33340 CPT Hc Perc Txcath Clsr Lt Atr Apndg 423 263 $22,199.00 $19,979.10 $638.94 $21,977.01 $21,311.04 2026-03-31
92924 CPT Hc Ptca W Cor Angio Sngl Mjr 423 263 $22,076.00 $19,868.40 $475.27 $21,855.24 $21,192.96 2026-03-31
36906 CPT Hc Av Fistula Stent Thrombectomy 423 263 $21,954.00 $19,758.60 $469.45 $21,734.46 $21,075.84 2026-03-31
27412 CPT Hc Impl Knee Auto Chondrocyte 413 262 $22,156.00 $19,940.40 $1,354.37 $21,934.44 $21,048.20 2026-03-31
J1323 HCPCS Elranatamab-bcmm 40 Mg/ml Subcutaneous Solution 834 262 $29,051.30 $26,146.17 $4,431.27 $36,430.42 $20,665.07 2026-03-31
C9604 HCPCS Hc Perc Translum Revasc Sngl Vssl 421 262 $21,177.00 $19,059.30 $4,404.82 $20,965.23 $20,329.92 2026-03-31
C9600 HCPCS Hc Perc Transcath Plct Drug Stnt Sng 421 262 $21,177.00 $19,059.30 $4,404.82 $20,965.23 $20,329.92 2026-03-31
J9273 HCPCS Tisotumab Vedotin-tftv 40 Mg/4 Ml Intravenous Solution (wetted) 417 262 $21,058.30 $18,952.47 $4,380.13 $20,847.72 $20,215.97 2026-03-31
36903 CPT Hc Av Fistula Stent 423 263 $20,966.00 $18,869.40 $290.12 $20,756.34 $20,127.36 2026-03-31
37258 CPT Hc Revsc Evasc Ivt Stent Sf 1st 423 263 $20,526.00 $18,473.40 $403.88 $20,320.74 $19,704.96 2026-03-31
0238T CPT Hc Tlpa Iliac Arty Ea Vssl 412 262 $20,706.00 $18,635.40 $4,306.85 $20,498.94 $19,670.70 2026-03-31
J3101 HCPCS Tenecteplase 50 Mg Intravenous Solution 439 263 $20,226.50 $18,203.85 $4,207.11 $20,024.24 $19,417.44 2026-03-31
37298 CPT Hc Revsc Evsc Imvt Angio Cplx 1 423 263 $20,038.00 $18,034.20 $627.45 $19,837.62 $19,236.48 2026-03-31
33362 CPT Hc Rplc Aortic Vlv Open Fem Arty 423 263 $19,902.00 $17,911.80 $1,189.20 $19,702.98 $19,105.92 2026-03-31
J9331 HCPCS Sirolimus-protein Bound 100 Mg Intravenous Suspension 409 262 $20,018.00 $18,016.20 $4,163.74 $19,817.82 $19,017.10 2026-03-31
291 MS_DRG Heart Failure And Shock With Mcc 2 2 — — $824.40 $37,147.56 $18,985.98 2026-03-31
J9306 HCPCS Pertuzumab 420 Mg/14 Ml (30 Mg/ml) Intravenous Solution 419 263 $19,632.30 $17,669.07 $4,083.52 $19,435.98 $18,847.01 2026-03-31
J9063 HCPCS Mirvetuximab Soravtansine-gynx 5 Mg/ml Intravenous Solution 417 262 $19,572.30 $17,615.07 $4,071.04 $19,376.58 $18,789.41 2026-03-31
92943 CPT Hc Perc Revasc Trans Chr Sngl Vesl 423 263 $19,555.00 $17,599.50 $642.06 $19,359.45 $18,772.80 2026-03-31
37241 CPT Hc Vasc Embl/occlude Venous 423 263 $19,358.00 $17,422.20 $390.87 $19,164.42 $18,583.68 2026-03-31
33206 CPT Hc Ins/rplc Pcmkr Atrial 423 263 $19,321.00 $17,388.90 $413.57 $19,127.79 $18,548.16 2026-03-31
J9354 HCPCS Ado-trastuzumab Emtansine 160 Mg/8 Ml Mg Intravenous Solution (wetted) 419 263 $18,936.30 $17,042.67 $3,938.75 $18,746.94 $18,178.85 2026-03-31
33213 CPT Hc Ins Pcmkr Pls Gen Exist 2 Lead 423 263 $18,904.00 $17,013.60 $312.34 $18,714.96 $18,147.84 2026-03-31
J0775 HCPCS Collagenase Clostridium Histolyticum 0.9 Mg Solution For Injection 419 263 $18,888.10 $16,999.29 $3,928.72 $18,699.22 $18,132.58 2026-03-31
37244 CPT Hc Vasc Embl/occlude Hemorrhage 423 263 $18,794.00 $16,914.60 $607.15 $18,606.06 $18,042.24 2026-03-31
33208 CPT Hc Ins/rplc Pcmkr Atrial & Vent 423 263 $18,772.00 $16,894.80 $467.02 $18,584.28 $18,021.12 2026-03-31
33228 CPT Hc Rplc Perm Gen Dual Lead 423 263 $18,772.00 $16,894.80 $324.09 $18,584.28 $18,021.12 2026-03-31
27487 CPT Hc Rev Tot Knee Arthro Fem&tib 413 262 $18,631.00 $16,767.90 $1,423.89 $18,444.69 $17,699.45 2026-03-31
37280 CPT Hc Revsc Evsc Tpvt Angio Sf 1st 423 263 $18,431.00 $16,587.90 $451.23 $18,246.69 $17,693.76 2026-03-31
37242 CPT Hc Vasc Embl/occlude Arterial 423 263 $18,429.00 $16,586.10 $434.03 $18,244.71 $17,691.84 2026-03-31
36224 CPT Hc Sel Cath Intrnl Cartd Artery 423 263 $18,425.00 $16,582.50 $326.66 $18,240.75 $17,688.00 2026-03-31
33361 CPT Hc Rplc Aortic Vlv Perc Fem Arty 423 263 $18,268.00 $16,441.20 $1,092.96 $18,085.32 $17,537.28 2026-03-31
C9765 HCPCS Hc Revasc Intra Lithotrip-stent 421 262 $18,252.00 $16,426.80 $3,796.42 $18,069.48 $17,521.92 2026-03-31
27130 CPT Hc Arthro Acetab&fem Prosth (tha) 422 262 $18,176.00 $16,358.40 $1,209.90 $17,994.24 $17,448.96 2026-03-31
J9347 HCPCS Tremelimumab-actl 20 Mg/ml Intravenous Solution 834 262 $64,435.90 $57,992.31 $2,141.15 $117,392.02 $17,427.62 2026-03-31
22513 CPT Hc Perc Vertebplsty Cavty Img Guid 1 423 263 $18,014.00 $16,212.60 $474.11 $17,833.86 $17,293.44 2026-03-31
22514 CPT Hc Perc Vert Agmntj Cav Crtj Lmbr 423 263 $18,014.00 $16,212.60 $443.95 $17,833.86 $17,293.44 2026-03-31
33212 CPT Hc Ins Pcmkr Pls Gen Exist 1 Lead 423 263 $17,791.00 $16,011.90 $300.89 $17,613.09 $17,079.36 2026-03-31
SUP-ZARTHABS110120 CDM Graft Tissue Disc Frozen Regenerative Sterile 20mm 421 262 $17,510.00 $15,759.00 $3,642.08 $17,334.90 $16,809.60 2026-03-31
948 MS_DRG Signs And Symptoms Without Mcc 2 2 — — $10,820.09 $22,600.99 $16,710.54 2026-03-31
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 1 1 — — $16,604.04 $16,604.04 $16,604.04 2026-03-31
33207 CPT Hc Ins/rplc Pcmkr Vent 423 263 $17,271.00 $15,543.90 $432.96 $17,098.29 $16,580.16 2026-03-31
C9764 HCPCS Hc Revasc Intravasc Lithotripsy 421 262 $17,263.00 $15,536.70 $3,590.70 $17,090.37 $16,572.48 2026-03-31
J9271 HCPCS Pembrolizumab 25 Mg/ml Intravenous Solution 419 263 $17,201.30 $15,481.17 $3,577.87 $17,029.29 $16,513.25 2026-03-31
J9039 HCPCS Blinatumomab 35 Mcg Intravenous (wrapper) 419 263 $16,850.20 $15,165.18 $3,504.84 $16,681.70 $16,176.19 2026-03-31
J9302 HCPCS Ofatumumab 20 Mg/ml Intravenous Solution (wrapper) 414 263 $16,922.00 $15,229.80 $3,519.78 $16,922.00 $16,075.90 2026-03-31
33418 CPT Hc Txcath Mitral Valve Repair Ini 423 263 $16,727.00 $15,054.30 $1,606.85 $16,559.73 $16,057.92 2026-03-31
J9311 HCPCS Rituximab 1,400 Mg/11.7 Ml (120 Mg/ml)-hyaluronidase Subcutaneous Soln 419 263 $16,565.60 $14,909.04 $3,445.64 $16,399.94 $15,902.98 2026-03-31
92928 CPT Hc Plc Intracor Stnt Sngl 423 263 $16,290.00 $14,661.00 $469.43 $16,127.10 $15,638.40 2026-03-31
93459 CPT Hc Cath Plc Arty/grft Ang W L Hrt 423 263 $16,266.00 $14,639.40 $1,175.91 $16,103.34 $15,615.36 2026-03-31
J9332 HCPCS Efgartigimod Alfa-fcab 20 Mg/ml Intravenous Solution (restricted) 417 262 $16,210.50 $14,589.45 $3,371.78 $16,048.40 $15,562.08 2026-03-31
50592 CPT Hc Ablation Renal Tumors Unilat Rf 423 263 $16,054.00 $14,448.60 $320.95 $15,893.46 $15,411.84 2026-03-31
2802 APR_DRG — 4 4 — — $10,332.14 $20,449.00 $15,390.57 2026-03-31
93457 CPT Hc Cath Plc Arty/grft Ang W R Hrt 423 263 $15,907.00 $14,316.30 $1,292.01 $15,747.93 $15,270.72 2026-03-31
36905 CPT Hc Av Fistula Pta Thrombectomy 423 263 $15,842.00 $14,257.80 $406.97 $15,683.58 $15,208.32 2026-03-31
93461 CPT Hc Cath Plc Art/grft Ang W R&l Hrt 423 263 $15,470.00 $13,923.00 $1,437.58 $15,315.30 $14,851.20 2026-03-31
93655 CPT Hc Ablt Arrhythmia Add On 423 263 $15,469.00 $13,922.10 $264.33 $15,314.31 $14,850.24 2026-03-31
37263 CPT Hc Revsc Evasc Fpvt Angio Sf 1 423 263 $15,430.00 $13,887.00 $359.08 $15,275.70 $14,812.80 2026-03-31
23472 CPT Hc Arthro Glh Jt Total Shoulder 422 262 $15,414.00 $13,872.60 $1,358.50 $15,259.86 $14,797.44 2026-03-31
93596 CPT Hc R&l Hrt Cath Chd Nml Nt Cnj 421 262 $15,395.00 $13,855.50 $3,202.16 $15,241.05 $14,779.20 2026-03-31
93657 CPT Hc Ablt Atrium Add Linear Cath 423 263 $15,263.00 $13,736.70 $264.33 $15,110.37 $14,652.48 2026-03-31
27447 CPT Hc Arthro Knee Condyle&plat (tka) 422 262 $15,192.00 $13,672.80 $1,207.71 $15,040.08 $14,584.32 2026-03-31
C9605 HCPCS Hc Perc Translum Revasc Addl Vssl 421 262 $14,833.00 $13,349.70 $3,085.26 $14,684.67 $14,239.68 2026-03-31
61624 CPT Hc Txcath Occl/embl Cns 423 263 $14,731.00 $13,257.90 $1,023.45 $14,583.69 $14,141.76 2026-03-31
33285 CPT Hc Impl Pt Actv Card Event Record 423 263 $14,581.00 $13,122.90 $76.95 $14,435.19 $13,997.76 2026-03-31
36227 CPT Hc Sel Cath Ext Cartd W Angio 423 263 $14,543.00 $13,088.70 $106.28 $14,397.57 $13,961.28 2026-03-31
37236 CPT Hc Plc Opn/perc Stent Init 423 263 $14,498.00 $13,048.20 $394.37 $14,353.02 $13,918.08 2026-03-31
33990 CPT Hc Ins Perc Vent Assist Dev Left Heart Arterial Only W Img 423 263 $14,430.00 $12,987.00 $317.22 $14,285.70 $13,852.80 2026-03-31
J9011 HCPCS Datopotamab Deruxtecan-dlnk 100 Mg/5 Ml Intravenous Solution (wetted) 417 262 $14,341.70 $12,907.53 $2,983.07 $14,198.28 $13,768.03 2026-03-31
33227 CPT Hc Rplc Perm Gen Sngl Lead 423 263 $14,291.00 $12,861.90 $310.71 $14,148.09 $13,719.36 2026-03-31
33216 CPT Hc Ins Sngl Eltrd/ppcmkr/icd 423 263 $14,185.00 $12,766.50 $341.67 $14,043.15 $13,617.60 2026-03-31
27486 CPT Hc Rev Tot Knee Arthro 1 Compnt 413 262 $14,298.00 $12,868.20 $1,155.81 $14,155.02 $13,583.10 2026-03-31
93458 CPT Hc Cath Plc Arty/vent Ang W L Hrt 423 263 $14,048.00 $12,643.20 $1,093.36 $13,907.52 $13,486.08 2026-03-31
552 MS_DRG Medical Back Problems Without Mcc 1 1 — — $13,448.38 $13,448.38 $13,448.38 2026-03-31
RX-166064 CDM Uridine Triacetate 10 Gram Oral Granules In Packet 421 262 $13,921.40 $12,529.26 $2,895.65 $14,617.47 $13,364.54 2026-03-31
J0517 HCPCS Benralizumab 30 Mg/ml Subcutaneous Syringe 419 263 $13,676.50 $12,308.85 $2,844.71 $13,539.74 $13,129.44 2026-03-31
93456 CPT Hc Cath Plc Cor Arty/ang W Rt Hrt 423 263 $13,612.00 $12,250.80 $1,185.08 $13,475.88 $13,067.52 2026-03-31
C9601 HCPCS Hc Perc Transcath Plct Drug Stnt Add 421 262 $13,611.00 $12,249.90 $2,831.09 $13,474.89 $13,066.56 2026-03-31
A9586 HCPCS Florbetapir F-18 10 Mci (370 Mbq) Intravenous Solution 421 262 $13,597.50 $12,237.75 $2,828.28 $13,461.53 $13,053.60 2026-03-31
33992 CPT Hc Rmvl Perc Vent Assist Dev Left Heart,art &/or Art&ven 423 263 $13,582.00 $12,223.80 $166.89 $13,446.18 $13,038.72 2026-03-31
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 1 1 — — $12,979.60 $12,979.60 $12,979.60 2026-03-31
47534 CPT Hc Plc Biliary Drn Cath Intrnl-extrnl 423 263 $13,512.00 $12,160.80 $340.69 $13,376.88 $12,971.52 2026-03-31
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 3 3 — — $997.16 $57,902.88 $12,678.19 2026-03-31
36223 CPT Hc Sel Cath Cartd Angio Intrcr 423 263 $13,117.00 $11,805.30 $293.86 $12,985.83 $12,592.32 2026-03-31
33210 CPT Hc Ins/rplc Temp Elec/pcmkr Sngl 423 263 $13,073.00 $11,765.70 $143.49 $12,942.27 $12,550.08 2026-03-31
33244 CPT Hc Rmvl Icd Elec Transven Extract 423 263 $13,004.00 $11,703.60 $786.73 $12,873.96 $12,483.84 2026-03-31
93460 CPT Hc Cath Plc Art/ven Ang W R&l Hrt 423 263 $12,980.00 $11,682.00 $1,304.61 $12,850.20 $12,460.80 2026-03-31
37191 CPT Hc Insert Evasc Vena Cava Filter 423 263 $12,886.00 $11,597.40 $201.53 $12,757.14 $12,370.56 2026-03-31
J7504 HCPCS Lymphocyte,anti-thymo Immune Globulin 50 Mg/ml Intravenous Solution 419 263 $12,738.30 $11,464.47 $2,649.57 $12,610.92 $12,228.77 2026-03-31
47382 CPT Hc Ablt >=1 Lvr Tmr Perc Radiofreq 423 263 $12,681.00 $11,412.90 $688.39 $12,554.19 $12,173.76 2026-03-31
33233 CPT Hc Rmvl Pcmkr Pulse Gen Only 423 263 $12,665.00 $11,398.50 $221.00 $12,538.35 $12,158.40 2026-03-31
50695 CPT Hc Plc Ureter Stnt New W Nephrost Cath 423 263 $12,492.00 $11,242.80 $316.05 $12,367.08 $11,992.32 2026-03-31
36222 CPT Hc Sel Cath Cartd Angio Extracran 423 263 $12,482.00 $11,233.80 $253.79 $12,357.18 $11,982.72 2026-03-31
J9038 HCPCS Axatilimab-csfr 50 Mg/ml Intravenous Solution 834 262 $20,965.20 $18,868.68 $2,569.13 $29,283.01 $11,981.05 2026-03-31
J7189 HCPCS Coagulation Factor Viia Recomb 1 Mg (1,000 Mcg) Intravenous Solution 1,257 263 $12,475.00 $11,227.50 $1,341.60 $30,244.50 $11,976.00 2026-03-31
92937 CPT Hc Perc Revasc Trans Cor Sngl Vesl 423 263 $12,411.00 $11,169.90 $530.10 $12,286.89 $11,914.56 2026-03-31
A9588 HCPCS Fluciclovine F18 10 Mci (370 Mbq) Intravenous Solution 421 262 $12,387.60 $11,148.84 $2,576.62 $12,263.72 $11,892.10 2026-03-31
J0741 HCPCS Cabotegravir ER 400 Mg/2 Ml-rilpivirine ER 600 Mg/2ml IM Suspension,er (restrict… 834 262 $15,203.65 $13,683.28 $2,547.56 $17,977.81 $11,880.46 2026-03-31
J9309 HCPCS Polatuzumab Vedotin-piiq 140 Mg/7 Ml Intravenous Solution (wetted) 838 263 $33,803.35 $30,423.01 $2,542.13 $54,831.05 $11,855.15 2026-03-31
A9608 HCPCS Flotufolastat F 18 296-5,846 Mbq/ml (8-158 Mci/ml) IV Solution 421 262 $12,295.60 $11,066.04 $2,557.48 $12,172.64 $11,803.78 2026-03-31
37248 CPT Hc Pta Venous Initial 423 263 $12,195.00 $10,975.50 $272.87 $12,073.05 $11,707.20 2026-03-31
19318 CPT Hc Breast Reduc 413 262 $12,274.00 $11,046.60 $896.81 $12,151.26 $11,660.30 2026-03-31
J9200 HCPCS Floxuridine 0.5 Gram/5 Ml Solution For Injection (wetted) 419 263 $12,145.60 $10,931.04 $2,526.28 $12,024.14 $11,659.78 2026-03-31
A9582 HCPCS Iobenguane Sulfate I-123 10 Mci/5 Ml (370 Mbq/5 Ml) Intravenous Soln 421 262 $12,059.00 $10,853.10 $2,508.27 $11,938.41 $11,576.64 2026-03-31
77373 CPT Hc Stereotactic Body Radtn Del 423 263 $12,049.00 $10,844.10 $1,071.94 $11,928.51 $11,567.04 2026-03-31
8612 APR_DRG — 4 4 — — $4,148.62 $18,948.00 $11,548.31 2026-03-31
0913T CPT Hc Prq Tcat Ther Rx Ntrac Balo1 421 262 $11,995.00 $10,795.50 $2,494.96 $11,875.05 $11,515.20 2026-03-31
J9312 HCPCS Rituximab 10 Mg/ml Concentrate,intravenous 419 263 $11,961.30 $10,765.17 $2,487.95 $11,841.69 $11,482.85 2026-03-31
29888 CPT Hc Arthsc Aid Acl Rpr 413 262 $11,969.00 $10,772.10 $812.18 $11,849.31 $11,370.55 2026-03-31
J2356 HCPCS Tezepelumab-ekko 210 Mg/1.91 Ml (110 Mg/ml) Subcutaneous Syringe 417 262 $11,836.50 $10,652.85 $2,461.99 $11,718.14 $11,363.04 2026-03-31
J1162 HCPCS Digoxin Immune Fab 40 Mg Intravenous Solution 411 263 $11,949.80 $10,754.82 $2,485.56 $11,830.30 $11,352.31 2026-03-31
33234 CPT Hc Rmvl Pcmkr Elec 1 Lead Sys 423 263 $11,804.00 $10,623.60 $440.96 $11,685.96 $11,331.84 2026-03-31
33235 CPT Hc Rmvl Pcmkr Elec Dual Lead Sys 423 263 $11,804.00 $10,623.60 $584.20 $11,685.96 $11,331.84 2026-03-31
A9572 HCPCS Indium 111-pentetreotide 3 Mci/ml-10 Mcg Intravenous Kit 412 262 $11,901.00 $10,710.90 $2,475.41 $11,781.99 $11,305.95 2026-03-31
A9548 HCPCS Pentetate Indium Disodium In-111 1.5 Mci/1.5 Ml Intrathecal Solution 423 263 $11,758.00 $10,582.20 $2,445.66 $11,640.42 $11,287.68 2026-03-31
J2506 HCPCS Pegfilgrastim 6 Mg/0.6 Ml Subcutaneous Syringe 417 262 $11,722.90 $10,550.61 $1,842.56 $11,605.67 $11,253.98 2026-03-31
37212 CPT Hc Transcath Ven Thpy W S&i Init 423 263 $11,720.00 $10,548.00 $305.06 $11,602.80 $11,251.20 2026-03-31
37211 CPT Hc Transcath Artl Thpy W S&i Init 423 263 $11,720.00 $10,548.00 $347.51 $11,602.80 $11,251.20 2026-03-31
47533 CPT Hc Plc Biliary Drn Cath Extrnl 423 263 $11,706.00 $10,535.40 $244.10 $11,588.94 $11,237.76 2026-03-31
50593 CPT Hc Ablation Renal Tumor Perc Cryo 423 263 $11,540.00 $10,386.00 $429.62 $11,424.60 $11,078.40 2026-03-31
2803 APR_DRG — 4 4 — — $7,431.17 $14,707.60 $11,069.39 2026-03-31
A9595 HCPCS Piflufolastat F 18 37 Mbq/ml To 2,960 Mbq/ml (1-80 Mci/ml) IV Solution 421 262 $11,500.00 $10,350.00 $2,392.00 $11,385.00 $11,040.00 2026-03-31
20982 CPT Hc Ablation Bn Tmr Radiofrequency 423 263 $11,497.00 $10,347.30 $338.43 $11,382.03 $11,037.12 2026-03-31
J9352 HCPCS Trabectedin 1 Mg/20 Ml Intravenous Solution (wetted) 419 263 $11,442.50 $10,298.25 $2,380.04 $11,328.08 $10,984.80 2026-03-31
37246 CPT Hc Pta Arterial Initial 423 263 $11,395.00 $10,255.50 $317.20 $11,281.05 $10,939.20 2026-03-31
37283 CPT Hc Rvsc Evsc Tpvt Angio Cplx Ea 423 263 $11,289.00 $10,160.10 $194.37 $11,176.11 $10,837.44 2026-03-31
1403 APR_DRG — 4 4 — — $7,272.77 $14,394.00 $10,833.39 2026-03-31
27446 CPT Hc Arthro Knee Med/lat Cmprt (unilat) 413 262 $11,391.00 $10,251.90 $950.25 $11,277.09 $10,821.45 2026-03-31
33215 CPT Hc Reposition Pcmkr/lead Ra/rv 423 263 $11,187.00 $10,068.30 $282.50 $11,075.13 $10,739.52 2026-03-31
J9061 HCPCS Amivantamab-vmjw 50 Mg/ml Intravenous Solution 417 262 $11,050.10 $9,945.09 $2,298.42 $10,939.60 $10,608.10 2026-03-31
25405 CPT Hc Rpr Non/malunion Rad/uln W Autgrft 422 262 $11,041.00 $9,936.90 $986.70 $10,930.59 $10,599.36 2026-03-31
93650 CPT Hc Ablt Av Node 423 263 $10,956.00 $9,860.40 $504.98 $10,846.44 $10,517.76 2026-03-31
J0739 HCPCS Cabotegravir ER 600 Mg/3 Ml (200 Mg/ml) IM Suspension,extended Release 417 262 $10,939.40 $9,845.46 $2,275.40 $10,830.01 $10,501.82 2026-03-31
37183 CPT Hc Revise Hepatic Shunt (tips) 423 263 $10,811.00 $9,729.90 $345.69 $10,702.89 $10,378.56 2026-03-31
Q5117 HCPCS Trastuzumab-anns 420 Mg Intravenous Solution 423 263 $10,713.10 $9,641.79 $2,228.32 $10,605.97 $10,284.58 2026-03-31
37249 CPT Hc Pta Venous Ea Add 423 263 $10,655.00 $9,589.50 $132.50 $10,548.45 $10,228.80 2026-03-31
93455 CPT Hc Cath Plc Cor Arty/grft Angio 423 263 $10,631.00 $9,567.90 $1,060.27 $10,524.69 $10,205.76 2026-03-31
93602 CPT Hc Recording Intra-atrial Elec 423 263 $10,593.00 $9,533.70 $168.65 $10,487.07 $10,169.28 2026-03-31
92986 CPT Hc Perc Balloon Valvulo Aortic 423 263 $10,570.00 $9,513.00 $1,193.30 $10,464.30 $10,147.20 2026-03-31
1393 APR_DRG — 4 4 — — $6,812.02 $13,482.20 $10,147.11 2026-03-31
RX-707829 CDM Denileukin Diftitox-cxdl 150 Mcg/ml Intravenous Solution (wetted) 421 262 $10,558.20 $9,502.38 $2,196.11 $10,452.62 $10,135.87 2026-03-31
J9276 HCPCS Zanidatamab-hrii 300 Mg/6 Ml Intravenous Solution (wetted) 409 262 $10,641.70 $9,577.53 $2,213.47 $10,535.28 $10,109.62 2026-03-31
A9606 HCPCS Radium Ra 223 Dichlor 1,100 Kbq/ml (30 Microcurie/ml) Intravenous Soln 423 263 $10,470.00 $9,423.00 $2,177.76 $10,365.30 $10,051.20 2026-03-31
36251 CPT Hc Sel Cath Renal Arty&angio Unilat 423 263 $10,438.00 $9,394.20 $231.58 $10,333.62 $10,020.48 2026-03-31
32994 CPT Hc Ablate Pulm Tumor Perq Crybl 423 263 $10,405.00 $9,364.50 $408.72 $10,300.95 $9,988.80 2026-03-31
27870 CPT Hc Arthrodesis Ankle Opn 422 262 $10,392.00 $9,352.80 $979.32 $10,288.08 $9,976.32 2026-03-31
66180 CPT Hc Shnt Aqus Extraocl Rsrvr W Grft 422 262 $10,368.00 $9,331.20 $1,063.74 $10,264.32 $9,953.28 2026-03-31
93600 CPT Hc Recording His Bundle 423 263 $10,347.00 $9,312.30 $209.54 $10,243.53 $9,933.12 2026-03-31
26123 CPT Hc Fasctmy Palm Prtl W Sngl Dig 422 262 $10,343.00 $9,308.70 $827.38 $10,239.57 $9,929.28 2026-03-31
27822 CPT Hc Opn Tx Trimalor Ank Fx Wo Fix 422 262 $10,320.00 $9,288.00 $874.58 $10,216.80 $9,907.20 2026-03-31
J2353 HCPCS Octreotide,microspheres ER 10 Mg Intramuscular Susp, Extended Release 1,257 263 $10,265.30 $9,238.77 $1,650.63 $15,008.50 $9,854.69 2026-03-31
27726 CPT Hc Rpr Non/malunion Fib W Fix 413 262 $10,362.00 $9,325.80 $798.04 $10,258.38 $9,843.90 2026-03-31
93620 CPT Hc Ep Eval W Arrhythmia 423 263 $10,216.00 $9,194.40 $1,023.22 $10,113.84 $9,807.36 2026-03-31
66183 CPT Hc Ins Antr Drn Wo Extrclr Rsrvr 422 262 $10,208.00 $9,187.20 $965.89 $10,105.92 $9,799.68 2026-03-31
1943 APR_DRG — 4 4 — — $6,566.69 $12,996.60 $9,781.65 2026-03-31
37254 CPT Hc Revsc Evasc Ivt Angio Sf 1st 423 263 $10,153.00 $9,137.70 $338.91 $10,051.47 $9,746.88 2026-03-31
24342 CPT Hc Reins Tndn Bicep/tricep Distal 413 262 $10,255.00 $9,229.50 $655.09 $10,152.45 $9,742.25 2026-03-31
37184 CPT Hc Thrmbct Mech Prim Perc Init Vsl 423 263 $10,144.00 $9,129.60 $390.24 $10,042.56 $9,738.24 2026-03-31
27245 CPT Hc Tx Fem Fx W Intramedullry Impl 413 262 $10,242.00 $9,217.80 $1,015.62 $10,139.58 $9,729.90 2026-03-31
37193 CPT Hc Rtrev/rmvl Evasc Venacava Fltr 423 263 $10,135.00 $9,121.50 $317.10 $10,033.65 $9,729.60 2026-03-31
36902 CPT Hc Av Fistula Pta 423 263 $10,081.00 $9,072.90 $221.08 $9,980.19 $9,677.76 2026-03-31
66989 CPT Hc Xcpsl Ctrc Rmvl Cplx Insj 1+ 422 262 $10,058.00 $9,052.20 $788.00 $9,957.42 $9,655.68 2026-03-31
93453 CPT Hc Rt&lt Hrt Cath W Ventriclgrphy 423 263 $10,027.00 $9,024.30 $1,208.52 $9,926.73 $9,625.92 2026-03-31
A9800 HCPCS Kit For Preparation Of Ga-68-gozetotide 25 Mcg Intravenous Solution 421 262 $10,000.00 $9,000.00 $2,080.00 $9,900.00 $9,600.00 2026-03-31
92920 CPT Hc Ptca Sngl Mjr Arty/brnch 423 263 $9,982.00 $8,983.80 $391.93 $9,882.18 $9,582.72 2026-03-31
58563 CPT Hc Hysteroscopy Endometrial Ablt 422 262 $9,947.00 $8,952.30 $226.75 $9,847.53 $9,549.12 2026-03-31
93462 CPT Hc Lt Hrt Cath Txsptl Punc 423 263 $9,916.00 $8,924.40 $179.42 $9,816.84 $9,519.36 2026-03-31
J0597 HCPCS C1 Esterase Inhibitor 500 Unit/10 Ml Intravenous Solution (wrapper) 419 263 $9,875.00 $8,887.50 $2,054.00 $9,776.25 $9,480.00 2026-03-31
J0565 HCPCS Bezlotoxumab 25 Mg/ml Intravenous Solution 419 263 $9,872.60 $8,885.34 $2,053.50 $9,773.87 $9,477.70 2026-03-31
95716 CPT Hc Veeg By Tech Ea Incr 12-26 Hr Cont R-t Mntr 423 263 $9,841.00 $8,856.90 $1,178.52 $9,742.59 $9,447.36 2026-03-31
93619 CPT Hc Ep Eval Wo Arrhythmia 423 263 $9,837.00 $8,853.30 $751.42 $9,738.63 $9,443.52 2026-03-31
29807 CPT Hc Arthsc Shldr Rpr Slap Lesn 413 262 $9,844.00 $8,859.60 $868.39 $9,745.56 $9,351.80 2026-03-31
36252 CPT Hc Sel Cath Renal Arty&angio Bil 423 263 $9,739.00 $8,765.10 $314.77 $9,641.61 $9,349.44 2026-03-31
3832 APR_DRG — 4 4 — — $6,236.06 $12,342.20 $9,289.13 2026-03-31
37238 CPT Hc Plc Opn/perc Stent Same Init 423 263 $9,650.00 $8,685.00 $276.98 $9,553.50 $9,264.00 2026-03-31
RX-190640 CDM Aminolevulinic Acid Hcl 30 Mg/ml Oral Solution 421 262 $9,648.00 $8,683.20 $2,006.78 $10,130.40 $9,262.08 2026-03-31
28415 CPT Hc Opn Tx Calcaneal Fx 422 262 $9,598.00 $8,638.20 $1,113.26 $9,502.02 $9,214.08 2026-03-31
949 MS_DRG Aftercare With Cc/mcc 2 2 — — $4,598.70 $13,799.92 $9,199.31 2026-03-31
93610 CPT Hc Pacing Intra Atrial 423 263 $9,558.00 $8,602.20 $227.00 $9,462.42 $9,175.68 2026-03-31
26356 CPT Hc Rpr Flex Tndn Zn 2 Prim Wo Grft 422 262 $9,552.00 $8,596.80 $800.50 $9,456.48 $9,169.92 2026-03-31
67400 CPT Hc Orbitotomy Exploration 413 262 $9,615.00 $8,653.50 $868.90 $9,518.85 $9,134.25 2026-03-31
J9358 HCPCS Fam-trastuzumab Deruxtecan-nxki 100 Mg/5 Ml Intravenous Solution (wetted) 419 263 $9,474.40 $8,526.96 $1,970.68 $9,379.66 $9,095.42 2026-03-31
29806 CPT Hc Arthsc Shldr Capsulorrhaphy 413 262 $9,501.00 $8,550.90 $887.24 $9,405.99 $9,025.95 2026-03-31
65755 CPT Hc Keratoplasty Penetrate Pseudo 422 262 $9,334.00 $8,400.60 $1,166.81 $9,240.66 $8,960.64 2026-03-31
50694 CPT Hc Plc Ureter Stnt New Wo Nephrost Cath 423 263 $9,292.00 $8,362.80 $246.96 $9,199.08 $8,920.32 2026-03-31
67904 CPT Hc Rpr Blepharopt Levat Rsect Ext 422 262 $9,232.00 $8,308.80 $556.00 $9,139.68 $8,862.72 2026-03-31
93612 CPT Hc Pacing Intra Ventricular 423 263 $9,194.00 $8,274.60 $239.41 $9,102.06 $8,826.24 2026-03-31
36225 CPT Hc Sel Cath Subcl Arty Angio Vert 423 263 $9,155.00 $8,239.50 $291.04 $9,063.45 $8,788.80 2026-03-31
J1306 HCPCS Inclisiran 284 Mg/1.5 Ml Subcutaneous Syringe 417 262 $9,098.80 $8,188.92 $1,892.55 $9,007.81 $8,734.85 2026-03-31
43276 CPT Hc Ercp Stent Exchange W Dil 423 263 $9,096.00 $8,186.40 $451.25 $9,005.04 $8,732.16 2026-03-31
28725 CPT Hc Arthrodesis Subtalar 413 262 $9,187.00 $8,268.30 $673.70 $9,095.13 $8,727.65 2026-03-31
58571 CPT Hc Lap Tot Hyst Utrs<=250g W Tb/ov 413 262 $9,177.00 $8,259.30 $749.92 $9,085.23 $8,718.15 2026-03-31
49616 CPT Hc Rpr Aa Hrn Rcr 3-10 Ncr/strn 422 262 $9,026.00 $8,123.40 $788.74 $8,935.74 $8,664.96 2026-03-31
SUP-00810063820046 CDM Tapestry Biointegrative Implant 30mmx30mm 421 262 $9,000.00 $8,100.00 $1,872.00 $8,910.00 $8,640.00 2026-03-31
37187 CPT Hc Thrmbct Mech Trluml Vein 423 263 $8,982.00 $8,083.80 $360.40 $8,892.18 $8,622.72 2026-03-31
J9205 HCPCS Irinotecan Liposomal 4.3 Mg/ml Intravenous 419 263 $8,951.40 $8,056.26 $1,861.89 $8,861.89 $8,593.34 2026-03-31
36253 CPT Hc Cath 2nd+ord Renal Artery Unilat 423 263 $8,947.00 $8,052.30 $325.48 $8,857.53 $8,589.12 2026-03-31
58150 CPT Hc Hysterectomy Total Abd 413 262 $9,028.00 $8,125.20 $843.67 $9,183.82 $8,576.60 2026-03-31
47383 CPT Hc Ablt Perc Liver Tmr Cryoablat 423 263 $8,930.00 $8,037.00 $430.16 $8,840.70 $8,572.80 2026-03-31
43274 CPT Hc Ercp Duct Stent Plc W Dil 423 263 $8,866.00 $7,979.40 $433.41 $8,777.34 $8,511.36 2026-03-31
25609 CPT Hc Opn Tx Dist Rdl Inart Fx 3 Fix 422 262 $8,780.00 $7,902.00 $1,020.73 $8,692.20 $8,428.80 2026-03-31
27610 CPT Hc Arthrt Ankle Explr/drn/rmvl Fb 413 262 $8,793.00 $7,913.70 $560.84 $8,705.07 $8,353.35 2026-03-31
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 1 1 — — $8,344.17 $8,344.17 $8,344.17 2026-03-31
36478 CPT Hc Endovenous Ablt Laser 1st Vein 843 263 $10,003.00 $9,002.70 $253.06 $9,902.97 $8,315.81 2026-03-31
J2182 HCPCS Mepolizumab 100 Mg Subcutaneous Solution 419 263 $8,648.00 $7,783.20 $1,798.78 $8,561.52 $8,302.08 2026-03-31
27422 CPT Hc Rcnst Disloc Patel Extn Realign 413 262 $8,686.00 $7,817.40 $638.20 $8,599.14 $8,251.70 2026-03-31
27814 CPT Hc Opn Tx Bimalor Ank Fx 413 262 $8,675.00 $7,807.50 $654.67 $8,588.25 $8,241.25 2026-03-31
J1950 HCPCS Leuprolide 3.75 Mg Intramuscular Syringe Kit 1,237 263 $8,575.30 $7,717.77 $653.49 $28,843.95 $8,232.29 2026-03-31
37200 CPT Hc Transcatheter Biopsy 423 263 $8,560.00 $7,704.00 $199.04 $8,474.40 $8,217.60 2026-03-31
43266 CPT Hc Egd W Stent Plc 423 263 $8,550.00 $7,695.00 $206.14 $8,464.50 $8,208.00 2026-03-31
29882 CPT Hc Arthsc Kne W Mnsc Rpr Med/lat 422 262 $8,535.00 $7,681.50 $675.91 $8,449.65 $8,193.60 2026-03-31
J9326 HCPCS Telisotuzumab Vedotin-tllv 20 Mg/ml Intravenous Solution (wrapper) 818 262 $23,807.30 $21,426.57 $1,713.05 $38,985.01 $8,172.11 2026-03-31
2822 APR_DRG — 4 4 — — $5,484.43 $10,854.60 $8,169.52 2026-03-31
A9592 HCPCS Copper Cu-64 Dotatate 148 Mbq/4 Ml (4 Mci/4 Ml) Intravenous Solution 421 262 $8,500.00 $7,650.00 $1,768.00 $8,415.00 $8,160.00 2026-03-31
35206 CPT Hc Rpr Blood Vssl Dir Upr Extrm 422 262 $8,492.00 $7,642.80 $741.39 $8,407.08 $8,152.32 2026-03-31
22515 CPT Hc Perc Vert Agmnt Mech Ea Add 423 263 $8,484.00 $7,635.60 $194.84 $8,399.16 $8,144.64 2026-03-31
58262 CPT Hc Hyst Vag <=250g Rmvl Tubes/ov 413 262 $8,550.00 $7,695.00 $747.89 $8,464.50 $8,122.50 2026-03-31
29898 CPT Hc Arthsc Ankle Drbd Exten 413 262 $8,540.00 $7,686.00 $485.99 $8,454.60 $8,113.00 2026-03-31
29891 CPT Hc Arthsc Ankle Excisn Defect 413 262 $8,540.00 $7,686.00 $586.47 $8,454.60 $8,113.00 2026-03-31
29827 CPT Hc Arthsc Shldr W Rotator Cuff Rpr 422 262 $8,443.00 $7,598.70 $1,023.97 $8,358.57 $8,105.28 2026-03-31
PX-360000008 CDM Hc Or Level 12 529 262 $8,413.00 $7,571.70 $1,749.90 $8,328.87 $8,076.48 2026-03-31
43265 CPT Hc Ercp W Destruct Calculi 423 263 $8,403.00 $7,562.70 $405.82 $8,318.97 $8,066.88 2026-03-31
43240 CPT Hc Egd W Transmural Drn 423 263 $8,403.00 $7,562.70 $368.33 $8,318.97 $8,066.88 2026-03-31
J9177 HCPCS Enfortumab Vedotin-ejfv 20 Mg/2 Ml Intravenous Solution (wetted) 838 263 $10,227.50 $9,204.75 $1,720.58 $12,061.17 $8,023.84 2026-03-31
Q5111 HCPCS Pegfilgrastim-cbqv 6 Mg/0.6 Ml Subcutaneous Syringe 844 263 $8,261.00 $7,434.90 $1,718.29 $10,697.15 $8,013.17 2026-03-31
29879 CPT Hc Arthsc Knee Abrasion Arthro 413 262 $8,433.00 $7,589.70 $569.87 $8,348.67 $8,011.35 2026-03-31
66991 CPT Hc Xcapsl Ctrc Rmvl Insj 1+ 422 262 $8,314.00 $7,482.60 $638.68 $8,230.86 $7,981.44 2026-03-31
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