|
J3391
|
HCPCS
|
Inj, Atidarsagene Autotemcel
|
10
|
4
|
—
|
—
|
$81,910.54
|
$4,815,250.00
|
$4,596,375.00
|
2025-12-30
|
|
J1414
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
12
|
5
|
—
|
—
|
$44,972.48
|
$4,777,337.32
|
$3,951,150.00
|
2025-12-30
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
12
|
5
|
—
|
—
|
$44,972.48
|
$4,745,488.41
|
$3,924,809.00
|
2025-12-30
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
12
|
5
|
—
|
—
|
$44,972.48
|
$4,281,024.64
|
$3,540,669.08
|
2025-12-30
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
12
|
5
|
—
|
—
|
$81,910.54
|
$4,199,620.74
|
$3,473,343.08
|
2025-12-30
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
12
|
5
|
—
|
—
|
$81,910.54
|
$3,799,575.62
|
$3,142,481.30
|
2025-12-30
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
10
|
5
|
—
|
—
|
$2,452,115.60
|
$3,157,569.64
|
$2,648,284.85
|
2025-12-30
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
12
|
5
|
—
|
—
|
$81,910.54
|
$3,002,897.74
|
$2,483,580.00
|
2025-12-30
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
12
|
5
|
—
|
—
|
$81,910.54
|
$992,321.21
|
$820,710.30
|
2025-12-30
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel Car-pos T
|
12
|
5
|
—
|
—
|
$81,910.54
|
$744,703.94
|
$615,915.68
|
2025-12-30
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
12
|
5
|
—
|
—
|
$81,910.54
|
$712,581.49
|
$589,348.46
|
2025-12-30
|
|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
12
|
5
|
—
|
—
|
$81,910.54
|
$697,459.91
|
$576,841.97
|
2025-12-30
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel Car
|
12
|
5
|
—
|
—
|
$81,910.54
|
$696,976.75
|
$576,442.38
|
2025-12-30
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Car+
|
12
|
5
|
—
|
—
|
$81,910.54
|
$686,438.32
|
$567,726.45
|
2025-12-30
|
|
Q2053
|
HCPCS
|
Brexucabtagene Car Pos T
|
12
|
5
|
—
|
—
|
$81,910.54
|
$630,608.53
|
$521,551.80
|
2025-12-30
|
|
Q2058
|
HCPCS
|
Obecbtge Autol Up To 400 Mil
|
12
|
5
|
—
|
—
|
$81,910.54
|
$348,159.72
|
$287,949.38
|
2025-12-30
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
12
|
6
|
—
|
—
|
$239,967.62
|
$897,922.16
|
$264,206.78
|
2025-12-30
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
12
|
6
|
—
|
—
|
$179,451.42
|
$670,672.58
|
$197,577.83
|
2025-12-30
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
12
|
6
|
—
|
—
|
$151,265.04
|
$564,827.53
|
$166,544.34
|
2025-12-30
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
12
|
6
|
—
|
—
|
$136,737.86
|
$510,275.25
|
$150,549.77
|
2025-12-30
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
12
|
6
|
—
|
—
|
$90,442.59
|
$336,427.95
|
$99,578.21
|
2025-12-30
|
|
J7330
|
HCPCS
|
Cultured Chondrocytes Implnt
|
2
|
1
|
—
|
—
|
$99,000.00
|
$99,000.00
|
$99,000.00
|
2025-12-30
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
12
|
6
|
—
|
—
|
$83,923.36
|
$311,947.05
|
$92,400.47
|
2025-12-30
|
|
7
|
MS_DRG
|
Lung Transplant
|
12
|
6
|
—
|
—
|
$83,714.13
|
$311,161.33
|
$92,170.10
|
2025-12-30
|
|
C9073
|
HCPCS
|
Brexucabtagene Autoleucel Ca
|
2
|
1
|
—
|
—
|
$81,910.54
|
$81,910.54
|
$81,910.54
|
2025-12-30
|
|
C9081
|
HCPCS
|
Idecabtagene Car Pos T
|
2
|
1
|
—
|
—
|
$81,910.54
|
$81,910.54
|
$81,910.54
|
2025-12-30
|
|
C9301
|
HCPCS
|
Obecabtagene Car Pos T
|
2
|
1
|
—
|
—
|
$81,910.54
|
$81,910.54
|
$81,910.54
|
2025-12-30
|
|
C9076
|
HCPCS
|
Lisocabtagene Car Pos T
|
2
|
1
|
—
|
—
|
$81,910.54
|
$81,910.54
|
$81,910.54
|
2025-12-30
|
|
C9098
|
HCPCS
|
Ciltacabtagene Car Pos T
|
2
|
1
|
—
|
—
|
$81,910.54
|
$81,910.54
|
$81,910.54
|
2025-12-30
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
12
|
6
|
—
|
—
|
$70,721.96
|
$262,373.33
|
$77,865.59
|
2025-12-30
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve?procedures
|
12
|
6
|
—
|
—
|
$69,924.33
|
$259,378.09
|
$76,987.39
|
2025-12-30
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
12
|
6
|
—
|
—
|
$68,374.10
|
$253,556.68
|
$75,280.58
|
2025-12-30
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
12
|
6
|
—
|
—
|
$68,027.91
|
$252,256.68
|
$74,899.42
|
2025-12-30
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
12
|
6
|
—
|
—
|
$67,270.87
|
$249,413.83
|
$74,065.90
|
2025-12-30
|
|
J2507
|
HCPCS
|
Pegloticase 8mg/mL Inj 1mL
|
24
|
10
|
$128,224.20
|
$76,934.52
40% off
|
$3,638.86
|
$122,838.78
|
$73,728.92
|
2025-12-30
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
12
|
6
|
—
|
—
|
$62,044.45
|
$229,787.67
|
$68,311.57
|
2025-12-30
|
|
J9029
|
HCPCS
|
Instill Adstiladrin, Tx Dose
|
12
|
5
|
—
|
—
|
$44,972.48
|
$81,679.66
|
$67,554.07
|
2025-12-30
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
12
|
6
|
—
|
—
|
$59,259.74
|
$219,330.55
|
$65,245.57
|
2025-12-30
|
|
J7310
|
HCPCS
|
Ganciclovir Long Act Implant
|
2
|
1
|
—
|
—
|
$62,091.57
|
$62,091.57
|
$62,091.57
|
2025-12-30
|
|
A9543
|
HCPCS
|
Y90 Ibritumomab, Rx
|
12
|
5
|
—
|
—
|
$56,824.55
|
$73,172.52
|
$61,938.76
|
2025-12-30
|
|
Q2043
|
HCPCS
|
Sipuleucel-t Auto Cd54+
|
14
|
6
|
—
|
—
|
$44,972.48
|
$99,000.00
|
$60,421.65
|
2025-12-30
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
12
|
6
|
—
|
—
|
$54,580.50
|
$201,759.15
|
$60,093.68
|
2025-12-30
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
12
|
6
|
—
|
—
|
$54,550.70
|
$201,647.25
|
$60,060.88
|
2025-12-30
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
12
|
6
|
—
|
—
|
$53,735.32
|
$198,585.35
|
$59,163.13
|
2025-12-30
|
|
38240
|
HCPCS
|
Transplt Allo Hct/donor
|
12
|
5
|
—
|
—
|
$7,581.40
|
$76,157.11
|
$57,933.80
|
2025-12-30
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
12
|
6
|
—
|
—
|
$51,963.17
|
$191,930.60
|
$57,211.97
|
2025-12-30
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
12
|
6
|
—
|
—
|
$51,404.58
|
$189,832.98
|
$56,596.96
|
2025-12-30
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
12
|
6
|
—
|
—
|
$51,114.82
|
$188,744.89
|
$56,277.93
|
2025-12-30
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
12
|
6
|
—
|
—
|
$50,411.67
|
$186,104.42
|
$55,503.76
|
2025-12-30
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
12
|
6
|
—
|
—
|
$49,911.40
|
$184,225.85
|
$54,952.96
|
2025-12-30
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
12
|
6
|
—
|
—
|
$48,178.57
|
$177,718.72
|
$53,045.09
|
2025-12-30
|
|
0952T
|
HCPCS
|
Tot Impl Amei Rev/rplc Mstdc
|
2
|
1
|
—
|
—
|
$50,830.97
|
$50,830.97
|
$50,830.97
|
2025-12-30
|
|
0951T
|
HCPCS
|
Tot Impl Amei 1st Plmt
|
2
|
1
|
—
|
—
|
$50,830.97
|
$50,830.97
|
$50,830.97
|
2025-12-30
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
12
|
6
|
—
|
—
|
$45,886.50
|
$169,111.59
|
$50,521.50
|
2025-12-30
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
12
|
6
|
—
|
—
|
$45,660.15
|
$168,261.60
|
$50,272.29
|
2025-12-30
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
12
|
6
|
—
|
—
|
$44,959.53
|
$165,630.65
|
$49,500.90
|
2025-12-30
|
|
J9226
|
HCPCS
|
Supprelin La Implant
|
14
|
6
|
—
|
—
|
$44,972.48
|
$99,000.00
|
$49,205.22
|
2025-12-30
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
12
|
6
|
—
|
—
|
$44,146.69
|
$162,578.27
|
$48,605.96
|
2025-12-30
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
12
|
6
|
—
|
—
|
$43,363.01
|
$159,635.42
|
$47,743.11
|
2025-12-30
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
12
|
6
|
—
|
—
|
$43,199.43
|
$159,021.14
|
$47,563.01
|
2025-12-30
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
12
|
6
|
—
|
—
|
$43,127.79
|
$158,752.09
|
$47,484.12
|
2025-12-30
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
12
|
6
|
—
|
—
|
$41,857.16
|
$153,980.67
|
$46,085.16
|
2025-12-30
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
12
|
6
|
—
|
—
|
$41,798.20
|
$153,759.24
|
$46,020.24
|
2025-12-30
|
|
G0448
|
HCPCS
|
Place Perm Pacing Cardiovert
|
2
|
1
|
—
|
—
|
$45,094.96
|
$45,094.96
|
$45,094.96
|
2025-12-30
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
12
|
6
|
—
|
—
|
$40,951.11
|
$150,578.29
|
$45,087.59
|
2025-12-30
|
|
C9172
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
2
|
1
|
—
|
—
|
$44,972.48
|
$44,972.48
|
$44,972.48
|
2025-12-30
|
|
C9149
|
HCPCS
|
Inj, Teplizumab-mzwv, 5 Mcg
|
2
|
1
|
—
|
—
|
$44,972.48
|
$44,972.48
|
$44,972.48
|
2025-12-30
|
|
Q5139
|
HCPCS
|
Inj, Eculizumab-aeeb, 10 Mg
|
2
|
1
|
—
|
—
|
$44,972.48
|
$44,972.48
|
$44,972.48
|
2025-12-30
|
|
J9376
|
HCPCS
|
Inj Pozelimab-bbfg, 1 Mg
|
2
|
1
|
—
|
—
|
$44,972.48
|
$44,972.48
|
$44,972.48
|
2025-12-30
|
|
C9146
|
HCPCS
|
Inj, Elahere, 1 Mg
|
2
|
1
|
—
|
—
|
$44,972.48
|
$44,972.48
|
$44,972.48
|
2025-12-30
|
|
J1300
|
HCPCS
|
Eculizumab Injection
|
2
|
1
|
—
|
—
|
$44,972.48
|
$44,972.48
|
$44,972.48
|
2025-12-30
|
|
C9304
|
HCPCS
|
Inj Marstacimab, 0.5 Mg
|
2
|
1
|
—
|
—
|
$44,972.48
|
$44,972.48
|
$44,972.48
|
2025-12-30
|
|
C9085
|
HCPCS
|
Inj Avalglucosid Alfa-ngpt
|
2
|
1
|
—
|
—
|
$44,972.48
|
$44,972.48
|
$44,972.48
|
2025-12-30
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc
|
12
|
6
|
—
|
—
|
$40,127.49
|
$147,485.44
|
$44,180.77
|
2025-12-30
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
12
|
6
|
—
|
—
|
$40,076.77
|
$147,294.97
|
$44,124.93
|
2025-12-30
|
|
0266T
|
HCPCS
|
Implt/rpl Crtd Sns Dev Total
|
12
|
5
|
—
|
—
|
$37,432.34
|
$57,946.78
|
$44,080.94
|
2025-12-30
|
|
33276
|
HCPCS
|
Insj Phrnc Nrv Stim Sys
|
12
|
5
|
—
|
—
|
$37,432.34
|
$57,946.78
|
$44,080.94
|
2025-12-30
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
12
|
6
|
—
|
—
|
$39,897.97
|
$146,623.54
|
$43,928.07
|
2025-12-30
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
12
|
6
|
—
|
—
|
$39,761.65
|
$146,111.64
|
$43,777.97
|
2025-12-30
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
12
|
6
|
—
|
—
|
$39,584.12
|
$145,444.97
|
$43,582.52
|
2025-12-30
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
12
|
6
|
—
|
—
|
$39,398.98
|
$144,749.73
|
$43,378.68
|
2025-12-30
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
12
|
6
|
—
|
—
|
$39,122.53
|
$143,711.64
|
$43,074.31
|
2025-12-30
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
12
|
6
|
—
|
—
|
$39,122.53
|
$143,711.64
|
$43,074.31
|
2025-12-30
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
12
|
6
|
—
|
—
|
$38,836.58
|
$142,637.83
|
$42,759.47
|
2025-12-30
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
12
|
6
|
—
|
—
|
$38,573.46
|
$141,649.74
|
$42,469.77
|
2025-12-30
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
12
|
6
|
—
|
—
|
$38,544.93
|
$141,542.60
|
$42,438.35
|
2025-12-30
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
12
|
6
|
—
|
—
|
$38,160.69
|
$140,099.74
|
$42,015.30
|
2025-12-30
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
12
|
6
|
—
|
—
|
$37,768.22
|
$138,625.94
|
$41,583.19
|
2025-12-30
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
12
|
6
|
—
|
—
|
$37,242.60
|
$136,652.13
|
$41,004.48
|
2025-12-30
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
12
|
6
|
—
|
—
|
$37,025.12
|
$135,835.46
|
$40,765.03
|
2025-12-30
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
12
|
6
|
—
|
—
|
$36,197.70
|
$132,728.33
|
$39,854.03
|
2025-12-30
|
|
834
|
MS_DRG
|
Acute Leukemia Without Major O.r. Procedures With Mcc
|
12
|
6
|
—
|
—
|
$35,897.80
|
$131,602.14
|
$39,523.84
|
2025-12-30
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
12
|
6
|
—
|
—
|
$35,897.80
|
$131,602.14
|
$39,523.84
|
2025-12-30
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
12
|
6
|
—
|
—
|
$35,750.69
|
$131,049.76
|
$39,361.87
|
2025-12-30
|
|
33508
|
HCPCS
|
Endoscopic Vein Harvest
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33507
|
HCPCS
|
Repair Art Intramural
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33534
|
HCPCS
|
Cabg Arterial Two
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33513
|
HCPCS
|
Cabg Vein Four
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33533
|
HCPCS
|
Cabg Arterial Single
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
35600
|
HCPCS
|
Open Hrv Uxtr Art 1 Sgm Cab
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33519
|
HCPCS
|
Cabg Artery-vein Three
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33512
|
HCPCS
|
Cabg Vein Three
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33518
|
HCPCS
|
Cabg Artery-vein Two
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33521
|
HCPCS
|
Cabg Artery-vein Four
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33516
|
HCPCS
|
Cabg Vein Six Or More
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33523
|
HCPCS
|
Cabg Art-vein Six Or More
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33502
|
HCPCS
|
Coronary Artery Correction
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33514
|
HCPCS
|
Cabg Vein Five
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33530
|
HCPCS
|
Coronary Artery Bypass/reop
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33503
|
HCPCS
|
Coronary Artery Graft
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33505
|
HCPCS
|
Repair Artery W/tunnel
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33511
|
HCPCS
|
Cabg Vein Two
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33504
|
HCPCS
|
Coronary Artery Graft
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33517
|
HCPCS
|
Cabg Artery-vein Single
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33522
|
HCPCS
|
Cabg Artery-vein Five
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33510
|
HCPCS
|
Cabg Vein Single
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33506
|
HCPCS
|
Repair Artery Translocation
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33509
|
HCPCS
|
Ndsc Hrv Uxtr Art 1 Sgm Cab
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33535
|
HCPCS
|
Cabg Arterial Three
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33536
|
HCPCS
|
Cabg Arterial Four Or More
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
33572
|
HCPCS
|
Open Coronary Endarterectomy
|
2
|
1
|
—
|
—
|
$39,130.99
|
$39,130.99
|
$39,130.99
|
2025-12-30
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
12
|
6
|
—
|
—
|
$35,537.65
|
$130,249.76
|
$39,127.32
|
2025-12-30
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
12
|
6
|
—
|
—
|
$35,351.25
|
$129,549.76
|
$38,922.08
|
2025-12-30
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
12
|
6
|
—
|
—
|
$35,272.63
|
$129,254.52
|
$38,835.52
|
2025-12-30
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
12
|
6
|
—
|
—
|
$35,096.99
|
$128,595.00
|
$38,642.15
|
2025-12-30
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
12
|
6
|
—
|
—
|
$35,064.66
|
$128,473.57
|
$38,606.55
|
2025-12-30
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
12
|
6
|
—
|
—
|
$35,060.86
|
$128,459.29
|
$38,602.36
|
2025-12-30
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
12
|
6
|
—
|
—
|
$34,584.69
|
$126,671.20
|
$38,078.09
|
2025-12-30
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
12
|
6
|
—
|
—
|
$34,435.69
|
$126,111.67
|
$37,914.04
|
2025-12-30
|
|
61889
|
HCPCS
|
Ins Sk-mnt Crnl Nstm Pg/rcvr
|
2
|
1
|
—
|
—
|
$37,432.34
|
$37,432.34
|
$37,432.34
|
2025-12-30
|
|
61868
|
HCPCS
|
Implant Neuroelectrde Addl
|
2
|
1
|
—
|
—
|
$37,432.34
|
$37,432.34
|
$37,432.34
|
2025-12-30
|
|
61867
|
HCPCS
|
Implant Neuroelectrode
|
2
|
1
|
—
|
—
|
$37,432.34
|
$37,432.34
|
$37,432.34
|
2025-12-30
|
|
61864
|
HCPCS
|
Implant Neuroelectrde Addl
|
2
|
1
|
—
|
—
|
$37,432.34
|
$37,432.34
|
$37,432.34
|
2025-12-30
|
|
61870
|
HCPCS
|
Implant Neuroelectrodes
|
2
|
1
|
—
|
—
|
$37,432.34
|
$37,432.34
|
$37,432.34
|
2025-12-30
|
|
61850
|
HCPCS
|
Implant Neuroelectrodes
|
2
|
1
|
—
|
—
|
$37,432.34
|
$37,432.34
|
$37,432.34
|
2025-12-30
|
|
61860
|
HCPCS
|
Implant Neuroelectrodes
|
2
|
1
|
—
|
—
|
$37,432.34
|
$37,432.34
|
$37,432.34
|
2025-12-30
|
|
61863
|
HCPCS
|
Implant Neuroelectrode
|
2
|
1
|
—
|
—
|
$37,432.34
|
$37,432.34
|
$37,432.34
|
2025-12-30
|
|
0431T
|
HCPCS
|
Rmvl/rplc Nstim Apnea Pls Gn
|
2
|
1
|
—
|
—
|
$37,432.34
|
$37,432.34
|
$37,432.34
|
2025-12-30
|
|
0312T
|
HCPCS
|
Laps Impltj Nstim Vagus
|
2
|
1
|
—
|
—
|
$37,432.34
|
$37,432.34
|
$37,432.34
|
2025-12-30
|
|
0316T
|
HCPCS
|
Replc Vagus Nerve Pls Gen
|
2
|
1
|
—
|
—
|
$37,432.34
|
$37,432.34
|
$37,432.34
|
2025-12-30
|
|
0427T
|
HCPCS
|
Insj/rplc Nstim Apnea Pls Gn
|
2
|
1
|
—
|
—
|
$37,432.34
|
$37,432.34
|
$37,432.34
|
2025-12-30
|
|
0466T
|
HCPCS
|
Insj Ch Wal Respir Eltrd/ra
|
2
|
1
|
—
|
—
|
$37,432.34
|
$37,432.34
|
$37,432.34
|
2025-12-30
|
|
0424T
|
HCPCS
|
Insj/rplc Nstim Apnea Compl
|
2
|
1
|
—
|
—
|
$37,432.34
|
$37,432.34
|
$37,432.34
|
2025-12-30
|
|
0968T
|
HCPCS
|
Insj/rplcmt Epcrnl Nstim Sys
|
2
|
1
|
—
|
—
|
$37,432.34
|
$37,432.34
|
$37,432.34
|
2025-12-30
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
12
|
6
|
—
|
—
|
$33,506.18
|
$122,621.20
|
$36,890.64
|
2025-12-30
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
12
|
6
|
—
|
—
|
$33,397.76
|
$122,214.06
|
$36,771.27
|
2025-12-30
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
12
|
6
|
—
|
—
|
$33,154.29
|
$121,299.78
|
$36,503.21
|
2025-12-30
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
12
|
6
|
—
|
—
|
$33,055.38
|
$120,928.35
|
$36,394.31
|
2025-12-30
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
12
|
6
|
—
|
—
|
$32,788.45
|
$119,925.97
|
$36,100.42
|
2025-12-30
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
12
|
6
|
—
|
—
|
$32,600.14
|
$119,218.83
|
$35,893.07
|
2025-12-30
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
12
|
6
|
—
|
—
|
$32,575.41
|
$119,125.97
|
$35,865.85
|
2025-12-30
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
12
|
6
|
—
|
—
|
$32,562.73
|
$119,078.35
|
$35,851.90
|
2025-12-30
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
12
|
6
|
—
|
—
|
$32,448.61
|
$118,649.78
|
$35,726.25
|
2025-12-30
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
12
|
6
|
—
|
—
|
$31,836.75
|
$116,352.17
|
$35,052.58
|
2025-12-30
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
12
|
6
|
—
|
—
|
$31,649.71
|
$115,649.79
|
$34,846.64
|
2025-12-30
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
12
|
6
|
—
|
—
|
$31,598.35
|
$115,456.93
|
$34,790.10
|
2025-12-30
|
|
0620T
|
HCPCS
|
Evasc Ven Artlz Tibl/prnl Vn
|
12
|
5
|
—
|
—
|
$19,880.26
|
$45,069.86
|
$34,285.29
|
2025-12-30
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
12
|
6
|
—
|
—
|
$31,131.06
|
$113,702.17
|
$34,275.62
|
2025-12-30
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
12
|
6
|
—
|
—
|
$30,999.81
|
$113,209.32
|
$34,131.11
|
2025-12-30
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
12
|
6
|
—
|
—
|
$30,994.11
|
$113,187.89
|
$34,124.82
|
2025-12-30
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
12
|
6
|
—
|
—
|
$30,682.16
|
$112,016.46
|
$33,781.37
|
2025-12-30
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
12
|
6
|
—
|
—
|
$30,522.38
|
$111,416.46
|
$33,605.46
|
2025-12-30
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
12
|
6
|
—
|
—
|
$30,347.38
|
$110,759.32
|
$33,412.77
|
2025-12-30
|
|
J2505
|
HCPCS
|
Pegfilgrastim 6mg/0.6ml Inj
|
14
|
7
|
$44,284.20
|
$26,570.52
40% off
|
$19,927.89
|
$42,424.26
|
$33,213.15
|
2025-12-30
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
12
|
6
|
—
|
—
|
$30,076.65
|
$109,742.66
|
$33,114.69
|
2025-12-30
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
12
|
6
|
—
|
—
|
$30,064.60
|
$109,697.42
|
$33,101.43
|
2025-12-30
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
12
|
6
|
—
|
—
|
$29,971.40
|
$109,347.42
|
$32,998.81
|
2025-12-30
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
12
|
6
|
—
|
—
|
$29,966.95
|
$109,330.75
|
$32,993.92
|
2025-12-30
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
12
|
6
|
—
|
—
|
$29,457.83
|
$107,418.85
|
$32,433.36
|
2025-12-30
|
|
34051
|
HCPCS
|
Removal Of Artery Clot
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34703
|
HCPCS
|
Evasc Rpr A-unilac Ndgft
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34717
|
HCPCS
|
Evasc Rpr A-iliac Ndgft
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34709
|
HCPCS
|
Plmt Xtn Prosth Evasc Rpr
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
33894
|
HCPCS
|
Evasc St Rpr Thrc/aa Acrs Br
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
33895
|
HCPCS
|
Evasc St Rpr Thrc/aa X Crsg
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
33886
|
HCPCS
|
Endovasc Prosth Delayed
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
33884
|
HCPCS
|
Endovasc Prosth Taa Add-on
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34701
|
HCPCS
|
Evasc Rpr A-ao Ndgft
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
33880
|
HCPCS
|
Endovasc Taa Repr Incl Subcl
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
33881
|
HCPCS
|
Endovasc Taa Repr Without Subcl
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
35840
|
HCPCS
|
Explore Abdominal Vessels
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
33883
|
HCPCS
|
Insert Endovasc Prosth Taa
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
0254T
|
HCPCS
|
Evasc Rpr Iliac Art Bifur
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34844
|
HCPCS
|
Endovasc Visc Aorta 4 Graft
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34845
|
HCPCS
|
Visc & Infraren Abd 1 Prosth
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34702
|
HCPCS
|
Evasc Rpr A-ao Ndgft Rpt
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34847
|
HCPCS
|
Visc & Infraren Abd 3 Prosth
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34842
|
HCPCS
|
Endovasc Visc Aorta 2 Graft
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34846
|
HCPCS
|
Visc & Infraren Abd 2 Prosth
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34843
|
HCPCS
|
Endovasc Visc Aorta 3 Graft
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34841
|
HCPCS
|
Endovasc Visc Aorta 1 Graft
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34848
|
HCPCS
|
Visc & Infraren Abd 4+ Prost
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34820
|
HCPCS
|
Opn Iliac Art Expos
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34833
|
HCPCS
|
Opn Ilac Art Expos Cndt Crtj
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34813
|
HCPCS
|
Femoral Endovas Graft Add-on
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34713
|
HCPCS
|
Perq Access & Clsr Fem Art
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34711
|
HCPCS
|
Dlyd Plmt Xtn Prosth Ea Addl
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34712
|
HCPCS
|
Tcat Dlvr Enhncd Fixj Dev
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34718
|
HCPCS
|
Evasc Rpr N/a A-iliac Ndgft
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34708
|
HCPCS
|
Evasc Rpr Ilio-iliac Rpt
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34705
|
HCPCS
|
Evac Rpr A-biiliac Ndgft
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34707
|
HCPCS
|
Evasc Rpr Ilio-iliac Ndgft
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34706
|
HCPCS
|
Evasc Rpr A-biiliac Rpt
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34704
|
HCPCS
|
Evasc Rpr A-unilac Ndgft Rpt
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34808
|
HCPCS
|
Endovas Iliac A Device Addon
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
34710
|
HCPCS
|
Dlyd Plmt Xtn Prosth 1st Vsl
|
2
|
1
|
—
|
—
|
$32,404.28
|
$32,404.28
|
$32,404.28
|
2025-12-30
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
12
|
6
|
—
|
—
|
$29,287.27
|
$106,778.37
|
$32,245.58
|
2025-12-30
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
12
|
6
|
—
|
—
|
$29,208.64
|
$106,483.14
|
$32,159.01
|
2025-12-30
|
|
33231
|
HCPCS
|
Insrt Pulse Gen W/mult Leads
|
12
|
5
|
—
|
—
|
$29,489.60
|
$45,094.96
|
$32,143.67
|
2025-12-30
|
|
0915T
|
HCPCS
|
Insj Perm Ccm-d Sys Pg&eltrd
|
12
|
5
|
—
|
—
|
$29,489.60
|
$45,094.96
|
$32,143.67
|
2025-12-30
|
|
33270
|
HCPCS
|
Ins/rep Subq Defibrillator
|
12
|
5
|
—
|
—
|
$29,489.60
|
$45,094.96
|
$32,143.67
|
2025-12-30
|
|
0571T
|
HCPCS
|
Insj/rplcmt Icds Ss Eltrd
|
12
|
5
|
—
|
—
|
$29,489.60
|
$45,094.96
|
$32,143.67
|
2025-12-30
|
|
33264
|
HCPCS
|
Rmvl & Rplcmt Dfb Gen Mlt Ld
|
12
|
5
|
—
|
—
|
$29,489.60
|
$45,094.96
|
$32,143.67
|
2025-12-30
|
|
33249
|
HCPCS
|
Insj/rplcmt Defib W/lead(s)
|
12
|
5
|
—
|
—
|
$29,489.60
|
$45,094.96
|
$32,143.67
|
2025-12-30
|
|
69930
|
HCPCS
|
Implant Cochlear Device
|
12
|
5
|
—
|
—
|
$29,256.20
|
$50,830.97
|
$31,889.25
|
2025-12-30
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
12
|
6
|
—
|
—
|
$28,943.61
|
$105,487.90
|
$31,867.21
|
2025-12-30
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
12
|
6
|
—
|
—
|
$28,704.57
|
$104,590.28
|
$31,604.03
|
2025-12-30
|
|
0408T
|
HCPCS
|
Insj/rplc Cardiac Modulj Sys
|
12
|
5
|
—
|
—
|
$15,040.21
|
$41,285.44
|
$31,406.43
|
2025-12-30
|
|
933
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
12
|
6
|
—
|
—
|
$28,286.75
|
$103,021.24
|
$31,144.00
|
2025-12-30
|
|
458
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
12
|
6
|
—
|
—
|
$28,230.32
|
$102,809.33
|
$31,081.86
|
2025-12-30
|
|
J9266
|
HCPCS
|
Pegaspargase Injection
|
12
|
6
|
—
|
—
|
$28,424.06
|
$50,943.98
|
$30,982.22
|
2025-12-30
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
12
|
6
|
—
|
—
|
$27,898.71
|
$101,564.10
|
$30,716.76
|
2025-12-30
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
12
|
6
|
—
|
—
|
$27,858.77
|
$101,414.10
|
$30,672.78
|
2025-12-30
|
|
61886
|
HCPCS
|
Implant Neurostim Arrays
|
12
|
5
|
—
|
—
|
$28,029.00
|
$39,240.60
|
$30,551.61
|
2025-12-30
|
|
33287
|
HCPCS
|
Rmv&rplcmt Phrnc Nrv Stim Pg
|
12
|
5
|
—
|
—
|
$28,029.00
|
$39,240.60
|
$30,551.61
|
2025-12-30
|
|
0268T
|
HCPCS
|
Implt/rpl Crtd Sns Dev Gen
|
12
|
5
|
—
|
—
|
$28,029.00
|
$39,240.60
|
$30,551.61
|
2025-12-30
|
|
64582
|
HCPCS
|
Opn Mpltj Hpglsl Nstm Ary Pg
|
12
|
5
|
—
|
—
|
$28,029.00
|
$39,240.60
|
$30,551.61
|
2025-12-30
|
|
63685
|
HCPCS
|
Ins/rplc Spi Npg/rcvr Pocket
|
12
|
5
|
—
|
—
|
$28,029.00
|
$39,240.60
|
$30,551.61
|
2025-12-30
|
|
64568
|
HCPCS
|
Opn Impltj Crnl Nrv Nea&pg
|
12
|
5
|
—
|
—
|
$28,029.00
|
$39,240.60
|
$30,551.61
|
2025-12-30
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
12
|
6
|
—
|
—
|
$27,667.28
|
$100,695.05
|
$30,461.96
|
2025-12-30
|
|
31
|
MS_DRG
|
Ventricular Shunt Procedures With Mcc
|
12
|
6
|
—
|
—
|
$27,422.54
|
$99,776.01
|
$30,192.50
|
2025-12-30
|
|
673
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Mcc
|
12
|
6
|
—
|
—
|
$27,416.21
|
$99,752.20
|
$30,185.52
|
2025-12-30
|
|
793
|
MS_DRG
|
Full Term Neonate With Major Problems
|
12
|
6
|
—
|
—
|
$27,295.10
|
$99,297.44
|
$30,052.18
|
2025-12-30
|
|
269
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
12
|
6
|
—
|
—
|
$27,232.97
|
$99,064.10
|
$29,983.78
|
2025-12-30
|
|
0674T
|
HCPCS
|
Laps Insj Nw/rpcmt Prm Isdss
|
12
|
5
|
—
|
—
|
$10,750.85
|
$39,240.60
|
$29,850.89
|
2025-12-30
|
|
236
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
12
|
6
|
—
|
—
|
$26,924.82
|
$97,906.96
|
$29,644.50
|
2025-12-30
|
|
958
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
12
|
6
|
—
|
—
|
$26,910.24
|
$97,852.20
|
$29,628.44
|
2025-12-30
|
|
0746T
|
HCPCS
|
Car Ablt Rad Arr Cnv Loc Map
|
2
|
1
|
—
|
—
|
$29,617.45
|
$29,617.45
|
$29,617.45
|
2025-12-30
|
|
0745T
|
HCPCS
|
Car Ablt Rad Arr N-invas Loc
|
2
|
1
|
—
|
—
|
$29,617.45
|
$29,617.45
|
$29,617.45
|
2025-12-30
|
|
0747T
|
HCPCS
|
Car Ablt Rad Arrhyt Dlvr Rad
|
2
|
1
|
—
|
—
|
$29,617.45
|
$29,617.45
|
$29,617.45
|
2025-12-30
|
|
93609
|
HCPCS
|
Intra-vntr Mapg Tchycar Site
|
2
|
1
|
—
|
—
|
$29,617.45
|
$29,617.45
|
$29,617.45
|
2025-12-30
|
|
93655
|
HCPCS
|
Icar Cath Abltj Dscrt Arrhyt
|
2
|
1
|
—
|
—
|
$29,617.45
|
$29,617.45
|
$29,617.45
|
2025-12-30
|
|
93657
|
HCPCS
|
Tx L/r Atrial Fib Addl
|
2
|
1
|
—
|
—
|
$29,617.45
|
$29,617.45
|
$29,617.45
|
2025-12-30
|
|
93662
|
HCPCS
|
Intracardiac ECG (ice)
|
2
|
1
|
—
|
—
|
$29,617.45
|
$29,617.45
|
$29,617.45
|
2025-12-30
|
|
93613
|
HCPCS
|
Intracardiac Ephys 3d Mapg
|
2
|
1
|
—
|
—
|
$29,617.45
|
$29,617.45
|
$29,617.45
|
2025-12-30
|
|
93621
|
HCPCS
|
Comp Ep Evl L Pac&rec C Sins
|
2
|
1
|
—
|
—
|
$29,617.45
|
$29,617.45
|
$29,617.45
|
2025-12-30
|
|
93622
|
HCPCS
|
Comp Ep Eval L Ventr Pac&rec
|
2
|
1
|
—
|
—
|
$29,617.45
|
$29,617.45
|
$29,617.45
|
2025-12-30
|
|
93623
|
HCPCS
|
Prgrmd Stimj&pacg IV Rx Nfs
|
2
|
1
|
—
|
—
|
$29,617.45
|
$29,617.45
|
$29,617.45
|
2025-12-30
|
|
12
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
12
|
6
|
—
|
—
|
$26,871.56
|
$97,706.96
|
$29,585.86
|
2025-12-30
|
|
448
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical Without Mcc
|
12
|
6
|
—
|
—
|
$26,743.48
|
$97,226.01
|
$29,444.85
|
2025-12-30
|
|
423
|
MS_DRG
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
12
|
6
|
—
|
—
|
$26,641.40
|
$96,842.68
|
$29,332.46
|
2025-12-30
|
|
791
|
MS_DRG
|
Prematurity With Major Problems
|
12
|
6
|
—
|
—
|
$26,593.86
|
$96,664.11
|
$29,280.10
|
2025-12-30
|
|
907
|
MS_DRG
|
Other O.r. Procedures For Injuries With Mcc
|
12
|
6
|
—
|
—
|
$26,110.71
|
$94,849.83
|
$28,748.15
|
2025-12-30
|
|
739
|
MS_DRG
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…
|
12
|
6
|
—
|
—
|
$26,092.95
|
$94,783.16
|
$28,728.60
|
2025-12-30
|
|
33289
|
HCPCS
|
Tcat Impl Wrls P-art Prs Snr
|
12
|
5
|
—
|
—
|
$26,147.81
|
$45,094.96
|
$28,501.11
|
2025-12-30
|
|
628
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
12
|
6
|
—
|
—
|
$25,869.77
|
$93,945.07
|
$28,482.88
|
2025-12-30
|
|
736
|
MS_DRG
|
Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc
|
12
|
6
|
—
|
—
|
$25,818.42
|
$93,752.21
|
$28,426.34
|
2025-12-30
|
|
876
|
MS_DRG
|
O.r. Procedures With Principal Diagnosis Of Mental Illness
|
12
|
6
|
—
|
—
|
$25,767.69
|
$93,561.73
|
$28,370.49
|
2025-12-30
|
|
402
|
MS_DRG
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
12
|
6
|
—
|
—
|
$25,657.37
|
$93,147.45
|
$28,249.03
|
2025-12-30
|
|
273
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures With Mcc
|
12
|
6
|
—
|
—
|
$25,645.33
|
$93,102.21
|
$28,235.76
|
2025-12-30
|
|
34
|
MS_DRG
|
Carotid Artery Stent Procedures With Mcc
|
12
|
6
|
—
|
—
|
$25,508.37
|
$92,587.92
|
$28,084.97
|
2025-12-30
|
|
616
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
12
|
6
|
—
|
—
|
$25,358.10
|
$92,023.64
|
$27,919.52
|
2025-12-30
|
|
904
|
MS_DRG
|
Skin Grafts For Injuries With Cc/mcc
|
12
|
6
|
—
|
—
|
$25,333.38
|
$91,930.78
|
$27,892.31
|
2025-12-30
|
|
166
|
MS_DRG
|
Other Respiratory System O.r. Procedures With Mcc
|
12
|
6
|
—
|
—
|
$25,264.90
|
$91,673.64
|
$27,816.91
|
2025-12-30
|
|
956
|
MS_DRG
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
12
|
6
|
—
|
—
|
$25,088.00
|
$91,009.36
|
$27,622.14
|
2025-12-30
|
|
24
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
12
|
6
|
—
|
—
|
$24,956.75
|
$90,516.50
|
$27,477.64
|
2025-12-30
|
|
24338005008
|
NDC
|
Carmustine 7.7mg Wafer
|
14
|
7
|
$36,431.94
|
$21,859.16
40% off
|
$16,394.37
|
$34,901.80
|
$27,323.96
|
2025-12-30
|
|
40
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
12
|
6
|
—
|
—
|
$24,769.08
|
$89,811.74
|
$27,271.01
|
2025-12-30
|
|
622
|
MS_DRG
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
12
|
6
|
—
|
—
|
$24,578.23
|
$89,095.07
|
$27,060.88
|
2025-12-30
|
|
C9760
|
HCPCS
|
Non-blind Interatrial Shunt
|
12
|
5
|
—
|
—
|
$18,316.12
|
$35,412.17
|
$26,938.54
|
2025-12-30
|
|
27284
|
HCPCS
|
Arthrodesis Hip Joint
|
2
|
1
|
—
|
—
|
$26,441.82
|
$26,441.82
|
$26,441.82
|
2025-12-30
|
|
27077
|
HCPCS
|
Resect Hip Tum W/innom Bone
|
2
|
1
|
—
|
—
|
$26,441.82
|
$26,441.82
|
$26,441.82
|
2025-12-30
|
|
27282
|
HCPCS
|
Arthrodesis Symphysis Pubis
|
2
|
1
|
—
|
—
|
$26,441.82
|
$26,441.82
|
$26,441.82
|
2025-12-30
|
|
27280
|
HCPCS
|
Arthr Si Jt Opn B1grf Instrm
|
2
|
1
|
—
|
—
|
$26,441.82
|
$26,441.82
|
$26,441.82
|
2025-12-30
|
|
27295
|
HCPCS
|
Amputation Of Leg At Hip
|
2
|
1
|
—
|
—
|
$26,441.82
|
$26,441.82
|
$26,441.82
|
2025-12-30
|
|
27286
|
HCPCS
|
Arthrd Hip Jt Sbtrchc Osteot
|
2
|
1
|
—
|
—
|
$26,441.82
|
$26,441.82
|
$26,441.82
|
2025-12-30
|
|
0809T
|
HCPCS
|
Arthrd Si Jt Prq Tfx&implt
|
2
|
1
|
—
|
—
|
$26,441.82
|
$26,441.82
|
$26,441.82
|
2025-12-30
|
|
27290
|
HCPCS
|
Amputation Of Leg At Hip
|
2
|
1
|
—
|
—
|
$26,441.82
|
$26,441.82
|
$26,441.82
|
2025-12-30
|
|
94
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System With Mcc
|
12
|
6
|
—
|
—
|
$23,986.67
|
$86,873.65
|
$26,409.57
|
2025-12-30
|
|
Q0187
|
HCPCS
|
NovoSeven 4.8mg/8ml Inj
|
14
|
7
|
$35,190.00
|
$21,114.00
40% off
|
$15,835.50
|
$33,712.02
|
$26,392.50
|
2025-12-30
|
|
335
|
MS_DRG
|
Peritoneal Adhesiolysis With Mcc
|
12
|
6
|
—
|
—
|
$23,826.25
|
$86,271.27
|
$26,232.94
|
2025-12-30
|
|
J9600
|
HCPCS
|
Porfimer Sodium Injection
|
14
|
6
|
—
|
—
|
$11,000.55
|
$44,972.48
|
$26,166.69
|
2025-12-30
|
|
802
|
MS_DRG
|
Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc
|
12
|
6
|
—
|
—
|
$23,581.51
|
$85,352.22
|
$25,963.49
|
2025-12-30
|
|
97
|
MS_DRG
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc
|
12
|
6
|
—
|
—
|
$23,580.25
|
$85,347.46
|
$25,962.08
|
2025-12-30
|
|
518
|
MS_DRG
|
Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…
|
12
|
6
|
—
|
—
|
$23,576.44
|
$85,333.18
|
$25,957.90
|
2025-12-30
|
|
265
|
MS_DRG
|
Aicd Lead Procedures
|
12
|
6
|
—
|
—
|
$23,469.92
|
$84,933.18
|
$25,840.62
|
2025-12-30
|
|
492
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc
|
12
|
6
|
—
|
—
|
$23,368.47
|
$84,552.23
|
$25,728.93
|
2025-12-30
|
|
22
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…
|
12
|
6
|
—
|
—
|
$23,236.60
|
$84,056.99
|
$25,583.72
|
2025-12-30
|
|
420
|
MS_DRG
|
Hepatobiliary Diagnostic Procedures With Mcc
|
12
|
6
|
—
|
—
|
$23,230.88
|
$84,035.56
|
$25,577.43
|
2025-12-30
|
|
495
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…
|
12
|
6
|
—
|
—
|
$23,174.45
|
$83,823.66
|
$25,515.31
|
2025-12-30
|
|
414
|
MS_DRG
|
Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc
|
12
|
6
|
—
|
—
|
$23,067.94
|
$83,423.66
|
$25,398.04
|
2025-12-30
|
|
987
|
MS_DRG
|
Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
12
|
6
|
—
|
—
|
$23,060.96
|
$83,397.47
|
$25,390.35
|
2025-12-30
|
|
408
|
MS_DRG
|
Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…
|
12
|
6
|
—
|
—
|
$23,052.09
|
$83,364.13
|
$25,380.58
|
2025-12-30
|
|
264
|
MS_DRG
|
Other Circulatory System O.r. Procedures
|
12
|
6
|
—
|
—
|
$23,012.78
|
$83,216.51
|
$25,337.30
|
2025-12-30
|
|
651
|
MS_DRG
|
Kidney Transplant With Hemodialysis Without Mcc
|
12
|
6
|
—
|
—
|
$22,869.49
|
$82,678.42
|
$25,179.53
|
2025-12-30
|
|
332
|
MS_DRG
|
Rectal Resection With Mcc
|
12
|
6
|
—
|
—
|
$22,845.39
|
$82,587.94
|
$25,153.01
|
2025-12-30
|
|
574
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Cc
|
12
|
6
|
—
|
—
|
$22,821.29
|
$82,497.47
|
$25,126.47
|
2025-12-30
|
|
271
|
MS_DRG
|
Other Major Cardiovascular Procedures With Cc
|
12
|
6
|
—
|
—
|
$22,691.31
|
$82,009.37
|
$24,983.36
|
2025-12-30
|
|
477
|
MS_DRG
|
Biopsies Of Musculoskeletal System And Connective Tissue With Mcc
|
12
|
6
|
—
|
—
|
$22,657.08
|
$81,880.80
|
$24,945.67
|
2025-12-30
|
|
665
|
MS_DRG
|
Prostatectomy With Mcc
|
12
|
6
|
—
|
—
|
$22,622.84
|
$81,752.23
|
$24,907.97
|
2025-12-30
|