|
J3391
|
HCPCS
|
Inj, Atidarsagene Autotemcel
|
12
|
6
|
—
|
—
|
$4,505,000.00
|
$4,505,000.00
|
$4,505,000.00
|
2026-04-10
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
12
|
6
|
—
|
—
|
$3,685,266.66
|
$3,685,266.66
|
$3,685,266.66
|
2026-04-10
|
|
J3389
|
HCPCS
|
Topi Adm Prad Zami Per Treat
|
12
|
6
|
—
|
—
|
$3,335,820.00
|
$3,335,820.00
|
$3,335,820.00
|
2026-04-10
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
12
|
6
|
—
|
—
|
$3,327,859.72
|
$3,327,859.72
|
$3,327,859.72
|
2026-04-10
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
12
|
6
|
—
|
—
|
$3,252,508.07
|
$3,252,508.07
|
$3,252,508.07
|
2026-04-10
|
|
J3387
|
HCPCS
|
Inj Elivaldogene Autotemecel
|
12
|
6
|
—
|
—
|
$3,180,000.00
|
$3,180,000.00
|
$3,180,000.00
|
2026-04-10
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
12
|
6
|
—
|
—
|
$2,939,968.88
|
$2,939,968.88
|
$2,939,968.88
|
2026-04-10
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
12
|
6
|
—
|
—
|
$2,588,981.22
|
$2,588,981.22
|
$2,588,981.22
|
2026-04-10
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
12
|
6
|
—
|
—
|
$2,332,000.00
|
$2,332,000.00
|
$2,332,000.00
|
2026-04-10
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
12
|
6
|
—
|
—
|
$770,620.00
|
$770,620.00
|
$770,620.00
|
2026-04-10
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
12
|
6
|
—
|
—
|
$587,649.57
|
$587,649.57
|
$587,649.57
|
2026-04-10
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel Car-pos T
|
12
|
6
|
—
|
—
|
$566,531.30
|
$566,531.30
|
$566,531.30
|
2026-04-10
|
|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
12
|
6
|
—
|
—
|
$562,201.24
|
$562,201.24
|
$562,201.24
|
2026-04-10
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel Car
|
12
|
6
|
—
|
—
|
$558,081.72
|
$558,081.72
|
$558,081.72
|
2026-04-10
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Car+
|
12
|
6
|
—
|
—
|
$532,192.24
|
$532,192.24
|
$532,192.24
|
2026-04-10
|
|
Q2053
|
HCPCS
|
Brexucabtagene Car Pos T
|
12
|
6
|
—
|
—
|
$489,450.20
|
$489,450.20
|
$489,450.20
|
2026-04-10
|
|
Q2058
|
HCPCS
|
Obecbtge Autol Up To 400 Mil
|
12
|
6
|
—
|
—
|
$278,250.00
|
$278,250.00
|
$278,250.00
|
2026-04-10
|
|
J3403
|
HCPCS
|
Revakinagene, Per Implant
|
12
|
6
|
—
|
—
|
$265,000.00
|
$265,000.00
|
$265,000.00
|
2026-04-10
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
12
|
6
|
—
|
—
|
$234,466.26
|
$234,466.26
|
$234,466.26
|
2026-04-10
|
|
J3402
|
HCPCS
|
Inj. Remestemcel-l-rknd/ Td
|
12
|
6
|
—
|
—
|
$201,669.02
|
$201,669.02
|
$201,669.02
|
2026-04-10
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
12
|
6
|
—
|
—
|
$175,543.44
|
$175,543.44
|
$175,543.44
|
2026-04-10
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
12
|
6
|
—
|
—
|
$148,099.22
|
$148,099.22
|
$148,099.22
|
2026-04-10
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
12
|
6
|
—
|
—
|
$133,954.53
|
$133,954.53
|
$133,954.53
|
2026-04-10
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
12
|
6
|
—
|
—
|
$88,878.22
|
$88,878.22
|
$88,878.22
|
2026-04-10
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
12
|
6
|
—
|
—
|
$82,530.64
|
$82,530.64
|
$82,530.64
|
2026-04-10
|
|
7
|
MS_DRG
|
Lung Transplant
|
12
|
6
|
—
|
—
|
$82,326.92
|
$82,326.92
|
$82,326.92
|
2026-04-10
|
|
C9098
|
EAPG
|
Ciltacabtagene Car Pos T
|
2
|
1
|
—
|
—
|
$72,542.47
|
$72,542.47
|
$72,542.47
|
2026-04-10
|
|
Q2040
|
EAPG
|
Tisagenlecleucel Car-pos T
|
2
|
1
|
—
|
—
|
$72,542.47
|
$72,542.47
|
$72,542.47
|
2026-04-10
|
|
Q2055
|
EAPG
|
Idecabtagene Vicleucel Car
|
2
|
1
|
—
|
—
|
$72,542.47
|
$72,542.47
|
$72,542.47
|
2026-04-10
|
|
Q2042
|
EAPG
|
Tisagenlecleucel Car-pos T
|
2
|
1
|
—
|
—
|
$72,542.47
|
$72,542.47
|
$72,542.47
|
2026-04-10
|
|
C9073
|
EAPG
|
Brexucabtagene Autoleucel Ca
|
2
|
1
|
—
|
—
|
$72,542.47
|
$72,542.47
|
$72,542.47
|
2026-04-10
|
|
C9076
|
EAPG
|
Lisocabtagene Car Pos T
|
2
|
1
|
—
|
—
|
$72,542.47
|
$72,542.47
|
$72,542.47
|
2026-04-10
|
|
Q2053
|
EAPG
|
Brexucabtagene Car Pos T
|
2
|
1
|
—
|
—
|
$72,542.47
|
$72,542.47
|
$72,542.47
|
2026-04-10
|
|
Q2041
|
EAPG
|
Axicabtagene Ciloleucel Car+
|
2
|
1
|
—
|
—
|
$72,542.47
|
$72,542.47
|
$72,542.47
|
2026-04-10
|
|
Q2056
|
EAPG
|
Ciltacabtagene Car-pos T
|
2
|
1
|
—
|
—
|
$72,542.47
|
$72,542.47
|
$72,542.47
|
2026-04-10
|
|
C9081
|
EAPG
|
Idecabtagene Car Pos T
|
2
|
1
|
—
|
—
|
$72,542.47
|
$72,542.47
|
$72,542.47
|
2026-04-10
|
|
Q2054
|
EAPG
|
Lisocabtagene Mara Car Pos T
|
2
|
1
|
—
|
—
|
$72,542.47
|
$72,542.47
|
$72,542.47
|
2026-04-10
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
12
|
6
|
—
|
—
|
$69,676.83
|
$69,676.83
|
$69,676.83
|
2026-04-10
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve?procedures
|
12
|
6
|
—
|
—
|
$68,900.21
|
$68,900.21
|
$68,900.21
|
2026-04-10
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
12
|
6
|
—
|
—
|
$67,390.79
|
$67,390.79
|
$67,390.79
|
2026-04-10
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
12
|
6
|
—
|
—
|
$67,053.72
|
$67,053.72
|
$67,053.72
|
2026-04-10
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
12
|
6
|
—
|
—
|
$66,316.61
|
$66,316.61
|
$66,316.61
|
2026-04-10
|
|
J9029
|
HCPCS
|
Instill Adstiladrin, Tx Dose
|
12
|
6
|
—
|
—
|
$64,274.79
|
$64,274.79
|
$64,274.79
|
2026-04-10
|
|
A9513
|
EAPG
|
Lutetium Lu 177 Dotatat Ther
|
2
|
1
|
—
|
—
|
$63,909.23
|
$63,909.23
|
$63,909.23
|
2026-04-10
|
|
A9607
|
EAPG
|
Lutetium Lu 177 Vipivotide
|
2
|
1
|
—
|
—
|
$63,909.23
|
$63,909.23
|
$63,909.23
|
2026-04-10
|
|
C9031
|
EAPG
|
Lutetium Lu 177 Dotatate, Tx
|
2
|
1
|
—
|
—
|
$63,909.23
|
$63,909.23
|
$63,909.23
|
2026-04-10
|
|
A9543
|
EAPG
|
Y90 Ibritumomab, Rx
|
2
|
1
|
—
|
—
|
$63,909.23
|
$63,909.23
|
$63,909.23
|
2026-04-10
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
12
|
6
|
—
|
—
|
$61,227.80
|
$61,227.80
|
$61,227.80
|
2026-04-10
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
12
|
6
|
—
|
—
|
$58,516.41
|
$58,516.41
|
$58,516.41
|
2026-04-10
|
|
A9543
|
HCPCS
|
Y90 Ibritumomab, Rx
|
12
|
6
|
—
|
—
|
$56,824.54
|
$56,824.54
|
$56,824.54
|
2026-04-10
|
|
Q2043
|
HCPCS
|
Sipuleucel-t Auto Cd54+
|
12
|
6
|
—
|
—
|
$54,404.10
|
$54,404.10
|
$54,404.10
|
2026-04-10
|
|
38240
|
HCPCS
|
Transplt Allo Hct/donor
|
12
|
6
|
—
|
—
|
$54,211.42
|
$54,211.42
|
$54,211.42
|
2026-04-10
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
12
|
6
|
—
|
—
|
$53,960.38
|
$53,960.38
|
$53,960.38
|
2026-04-10
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
12
|
6
|
—
|
—
|
$53,931.36
|
$53,931.36
|
$53,931.36
|
2026-04-10
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
12
|
6
|
—
|
—
|
$53,137.45
|
$53,137.45
|
$53,137.45
|
2026-04-10
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
12
|
6
|
—
|
—
|
$51,411.96
|
$51,411.96
|
$51,411.96
|
2026-04-10
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
12
|
6
|
—
|
—
|
$50,868.08
|
$50,868.08
|
$50,868.08
|
2026-04-10
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
12
|
6
|
—
|
—
|
$50,585.95
|
$50,585.95
|
$50,585.95
|
2026-04-10
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
12
|
6
|
—
|
—
|
$49,901.31
|
$49,901.31
|
$49,901.31
|
2026-04-10
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
12
|
6
|
—
|
—
|
$49,414.22
|
$49,414.22
|
$49,414.22
|
2026-04-10
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
12
|
6
|
—
|
—
|
$47,727.01
|
$47,727.01
|
$47,727.01
|
2026-04-10
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
12
|
6
|
—
|
—
|
$45,495.30
|
$45,495.30
|
$45,495.30
|
2026-04-10
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
12
|
6
|
—
|
—
|
$45,274.90
|
$45,274.90
|
$45,274.90
|
2026-04-10
|
|
S2235
|
EAPG
|
Implant Auditory Brain Imp
|
2
|
1
|
—
|
—
|
$45,017.45
|
$45,017.45
|
$45,017.45
|
2026-04-10
|
|
69930
|
EAPG
|
Implant Cochlear Device
|
2
|
1
|
—
|
—
|
$45,017.45
|
$45,017.45
|
$45,017.45
|
2026-04-10
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
12
|
6
|
—
|
—
|
$44,592.73
|
$44,592.73
|
$44,592.73
|
2026-04-10
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
12
|
6
|
—
|
—
|
$43,801.29
|
$43,801.29
|
$43,801.29
|
2026-04-10
|
|
J9226
|
HCPCS
|
Supprelin La Implant
|
12
|
6
|
—
|
—
|
$43,185.33
|
$43,185.33
|
$43,185.33
|
2026-04-10
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
12
|
6
|
—
|
—
|
$43,038.25
|
$43,038.25
|
$43,038.25
|
2026-04-10
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
12
|
6
|
—
|
—
|
$42,878.97
|
$42,878.97
|
$42,878.97
|
2026-04-10
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
12
|
6
|
—
|
—
|
$42,809.21
|
$42,809.21
|
$42,809.21
|
2026-04-10
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
12
|
6
|
—
|
—
|
$41,572.05
|
$41,572.05
|
$41,572.05
|
2026-04-10
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
12
|
6
|
—
|
—
|
$41,514.63
|
$41,514.63
|
$41,514.63
|
2026-04-10
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
12
|
6
|
—
|
—
|
$40,689.86
|
$40,689.86
|
$40,689.86
|
2026-04-10
|
|
33230
|
EAPG
|
Insrt Pulse Gen W/dual Leads
|
2
|
1
|
—
|
—
|
$39,937.47
|
$39,937.47
|
$39,937.47
|
2026-04-10
|
|
33240
|
EAPG
|
Insrt Pulse Gen W/singl Lead
|
2
|
1
|
—
|
—
|
$39,937.47
|
$39,937.47
|
$39,937.47
|
2026-04-10
|
|
0614T
|
EAPG
|
Rmvl&rplcmt Ss Impl Dfb Pg
|
2
|
1
|
—
|
—
|
$39,937.47
|
$39,937.47
|
$39,937.47
|
2026-04-10
|
|
0414T
|
EAPG
|
Rmvl & Rpl Car Modulj Pls Gn
|
2
|
1
|
—
|
—
|
$39,937.47
|
$39,937.47
|
$39,937.47
|
2026-04-10
|
|
33262
|
EAPG
|
Rmvl& Replc Pulse Gen 1 Lead
|
2
|
1
|
—
|
—
|
$39,937.47
|
$39,937.47
|
$39,937.47
|
2026-04-10
|
|
C9741
|
EAPG
|
Impl Pressure Sensor W/angio
|
2
|
1
|
—
|
—
|
$39,937.47
|
$39,937.47
|
$39,937.47
|
2026-04-10
|
|
0409T
|
EAPG
|
Insj/rplc Car Modulj Pls Gn
|
2
|
1
|
—
|
—
|
$39,937.47
|
$39,937.47
|
$39,937.47
|
2026-04-10
|
|
33264
|
EAPG
|
Rmvl & Rplcmt Dfb Gen Mlt Ld
|
2
|
1
|
—
|
—
|
$39,937.47
|
$39,937.47
|
$39,937.47
|
2026-04-10
|
|
G0448
|
EAPG
|
Place Perm Pacing Cardiovert
|
2
|
1
|
—
|
—
|
$39,937.47
|
$39,937.47
|
$39,937.47
|
2026-04-10
|
|
0520T
|
EAPG
|
Rmv&rplcmt Pg Wcs Lv Battery
|
2
|
1
|
—
|
—
|
$39,937.47
|
$39,937.47
|
$39,937.47
|
2026-04-10
|
|
33263
|
EAPG
|
Rmvl & Rplcmt Dfb Gen 2 Lead
|
2
|
1
|
—
|
—
|
$39,937.47
|
$39,937.47
|
$39,937.47
|
2026-04-10
|
|
33270
|
EAPG
|
Ins/rep Subq Defibrillator
|
2
|
1
|
—
|
—
|
$39,937.47
|
$39,937.47
|
$39,937.47
|
2026-04-10
|
|
0571T
|
EAPG
|
Insj/rplcmt Icds Ss Eltrd
|
2
|
1
|
—
|
—
|
$39,937.47
|
$39,937.47
|
$39,937.47
|
2026-04-10
|
|
33249
|
EAPG
|
Insj/rplcmt Defib W/lead(s)
|
2
|
1
|
—
|
—
|
$39,937.47
|
$39,937.47
|
$39,937.47
|
2026-04-10
|
|
33289
|
EAPG
|
Tcat Impl Wrls P-art Prs Snr
|
2
|
1
|
—
|
—
|
$39,937.47
|
$39,937.47
|
$39,937.47
|
2026-04-10
|
|
33231
|
EAPG
|
Insrt Pulse Gen W/mult Leads
|
2
|
1
|
—
|
—
|
$39,937.47
|
$39,937.47
|
$39,937.47
|
2026-04-10
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc
|
12
|
6
|
—
|
—
|
$39,887.92
|
$39,887.92
|
$39,887.92
|
2026-04-10
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
12
|
6
|
—
|
—
|
$39,838.53
|
$39,838.53
|
$39,838.53
|
2026-04-10
|
|
J9226
|
EAPG
|
Supprelin La Implant
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J9269
|
EAPG
|
Inj. Tagraxofusp-erzs 10 Mcg
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J0223
|
EAPG
|
Inj Givosiran 0.5 Mg
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J9381
|
EAPG
|
Inj Teplizumab Mzwv 5 Mcg
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J1300
|
EAPG
|
Eculizumab Injection
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J1412
|
EAPG
|
Inj Roctavian Ml 2x10^13vc G
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J7180
|
EAPG
|
Factor Xiii Anti-hem Factor
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J0221
|
EAPG
|
Lumizyme Injection
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J7170
|
EAPG
|
Inj., Emicizumab-kxwh 0.5 Mg
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J2350
|
EAPG
|
Injection, Ocrelizumab, 1 Mg
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J1413
|
EAPG
|
Inj Delandistrogene Mox Rokl
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J7175
|
EAPG
|
Inj, Factor X, (human), 1iu
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J0219
|
EAPG
|
Inj Aval Alfa-nqpt 4mg
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
C9149
|
EAPG
|
Inj, Teplizumab-mzwv, 5 Mcg
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J9029
|
EAPG
|
Inj, Adstiladrin, Per Tx Dos
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J1411
|
EAPG
|
Inj, Hemgenix, Per Tx Dose
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
C9146
|
EAPG
|
Inj, Elahere, 1 Mg
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J2840
|
EAPG
|
Inj Sebelipase Alfa 1 Mg
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
Q2043
|
EAPG
|
Sipuleucel-t Auto Cd54+
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
C9052
|
EAPG
|
Injection, Ravulizumab-cwv
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J9210
|
EAPG
|
Inj., Emapalumab-lzsg, 1 Mg
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J9350
|
EAPG
|
Inj Mosunetuzumab-axgb, 1 Mg
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J1747
|
EAPG
|
Inj, Spesolimab-sbzo, 1 Mg
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J2326
|
EAPG
|
Inj, Nusinersen, 0.1mg
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
C9085
|
EAPG
|
Inj Avalglucosid Alfa-ngpt
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J0217
|
EAPG
|
Inj Velmanase Alfa-tycv 1 Mg
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J9600
|
EAPG
|
Porfimer Sodium Injection
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J9298
|
EAPG
|
Inj Nivol Relatlimab 3mg/1mg
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
Q9995
|
EAPG
|
Inj. Emicizumab-kxwh, 0.5 Mg
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
J1303
|
EAPG
|
Inj., Ravulizumab-cwvz 10 Mg
|
2
|
1
|
—
|
—
|
$39,828.99
|
$39,828.99
|
$39,828.99
|
2026-04-10
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
12
|
6
|
—
|
—
|
$39,664.44
|
$39,664.44
|
$39,664.44
|
2026-04-10
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
12
|
6
|
—
|
—
|
$39,531.71
|
$39,531.71
|
$39,531.71
|
2026-04-10
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
12
|
6
|
—
|
—
|
$39,358.85
|
$39,358.85
|
$39,358.85
|
2026-04-10
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
12
|
6
|
—
|
—
|
$39,178.59
|
$39,178.59
|
$39,178.59
|
2026-04-10
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
12
|
6
|
—
|
—
|
$38,909.42
|
$38,909.42
|
$38,909.42
|
2026-04-10
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
12
|
6
|
—
|
—
|
$38,909.42
|
$38,909.42
|
$38,909.42
|
2026-04-10
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
12
|
6
|
—
|
—
|
$38,631.00
|
$38,631.00
|
$38,631.00
|
2026-04-10
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
12
|
6
|
—
|
—
|
$38,374.80
|
$38,374.80
|
$38,374.80
|
2026-04-10
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
12
|
6
|
—
|
—
|
$38,347.02
|
$38,347.02
|
$38,347.02
|
2026-04-10
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
12
|
6
|
—
|
—
|
$37,972.91
|
$37,972.91
|
$37,972.91
|
2026-04-10
|
|
33276
|
HCPCS
|
Insj Phrnc Nrv Stim Sys
|
12
|
6
|
—
|
—
|
$37,961.52
|
$37,961.52
|
$37,961.52
|
2026-04-10
|
|
64654
|
HCPCS
|
1st Opn Implt Bat Modulj Sys
|
12
|
6
|
—
|
—
|
$37,961.52
|
$37,961.52
|
$37,961.52
|
2026-04-10
|
|
64568
|
HCPCS
|
Opn Impltj Crnl Nrv Nea&pg
|
12
|
6
|
—
|
—
|
$37,961.52
|
$37,961.52
|
$37,961.52
|
2026-04-10
|
|
0620T
|
HCPCS
|
Evasc Ven Artlz Tibl/prnl Vn
|
12
|
6
|
—
|
—
|
$37,961.52
|
$37,961.52
|
$37,961.52
|
2026-04-10
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
12
|
6
|
—
|
—
|
$37,590.77
|
$37,590.77
|
$37,590.77
|
2026-04-10
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
12
|
6
|
—
|
—
|
$37,078.98
|
$37,078.98
|
$37,078.98
|
2026-04-10
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
12
|
6
|
—
|
—
|
$36,867.23
|
$36,867.23
|
$36,867.23
|
2026-04-10
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
12
|
6
|
—
|
—
|
$36,061.59
|
$36,061.59
|
$36,061.59
|
2026-04-10
|
|
834
|
MS_DRG
|
Acute Leukemia Without Major O.r. Procedures With Mcc
|
12
|
6
|
—
|
—
|
$35,769.59
|
$35,769.59
|
$35,769.59
|
2026-04-10
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
12
|
6
|
—
|
—
|
$35,769.59
|
$35,769.59
|
$35,769.59
|
2026-04-10
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
12
|
6
|
—
|
—
|
$35,626.36
|
$35,626.36
|
$35,626.36
|
2026-04-10
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
12
|
6
|
—
|
—
|
$35,418.94
|
$35,418.94
|
$35,418.94
|
2026-04-10
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
12
|
6
|
—
|
—
|
$35,237.43
|
$35,237.43
|
$35,237.43
|
2026-04-10
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
12
|
6
|
—
|
—
|
$35,160.88
|
$35,160.88
|
$35,160.88
|
2026-04-10
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
12
|
6
|
—
|
—
|
$34,989.88
|
$34,989.88
|
$34,989.88
|
2026-04-10
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
12
|
6
|
—
|
—
|
$34,958.39
|
$34,958.39
|
$34,958.39
|
2026-04-10
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
12
|
6
|
—
|
—
|
$34,954.69
|
$34,954.69
|
$34,954.69
|
2026-04-10
|
|
33510
|
EAPG
|
Cabg Vein Single
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33572
|
EAPG
|
Open Coronary Endarterectomy
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33533
|
EAPG
|
Cabg Arterial Single
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33513
|
EAPG
|
Cabg Vein Four
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33534
|
EAPG
|
Cabg Arterial Two
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33535
|
EAPG
|
Cabg Arterial Three
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33507
|
EAPG
|
Repair Art Intramural
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33521
|
EAPG
|
Cabg Artery-vein Four
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33518
|
EAPG
|
Cabg Artery-vein Two
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33517
|
EAPG
|
Cabg Artery-vein Single
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33522
|
EAPG
|
Cabg Artery-vein Five
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33519
|
EAPG
|
Cabg Artery-vein Three
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33514
|
EAPG
|
Cabg Vein Five
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33516
|
EAPG
|
Cabg Vein Six Or More
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33523
|
EAPG
|
Cabg Art-vein Six Or More
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33511
|
EAPG
|
Cabg Vein Two
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33512
|
EAPG
|
Cabg Vein Three
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33508
|
EAPG
|
Endoscopic Vein Harvest
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33509
|
EAPG
|
Ndsc Hrv Uxtr Art 1 Sgm Cab
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33504
|
EAPG
|
Coronary Artery Graft
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33505
|
EAPG
|
Repair Artery W/tunnel
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33530
|
EAPG
|
Coronary Artery Bypass/reop
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
35600
|
EAPG
|
Open Hrv Uxtr Art 1 Sgm Cab
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33502
|
EAPG
|
Coronary Artery Correction
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33506
|
EAPG
|
Repair Artery Translocation
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33503
|
EAPG
|
Coronary Artery Graft
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
33536
|
EAPG
|
Cabg Arterial Four Or More
|
2
|
1
|
—
|
—
|
$34,655.60
|
$34,655.60
|
$34,655.60
|
2026-04-10
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
12
|
6
|
—
|
—
|
$34,491.06
|
$34,491.06
|
$34,491.06
|
2026-04-10
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
12
|
6
|
—
|
—
|
$34,345.98
|
$34,345.98
|
$34,345.98
|
2026-04-10
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
12
|
6
|
—
|
—
|
$33,440.95
|
$33,440.95
|
$33,440.95
|
2026-04-10
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
12
|
6
|
—
|
—
|
$33,335.38
|
$33,335.38
|
$33,335.38
|
2026-04-10
|
|
61868
|
EAPG
|
Implant Neuroelectrde Addl
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
61860
|
EAPG
|
Implant Neuroelectrodes
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
0268T
|
EAPG
|
Implt/rpl Crtd Sns Dev Gen
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
61867
|
EAPG
|
Implant Neuroelectrode
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
0816T
|
EAPG
|
Opn Insj/rplcmt Ins Ptn Subq
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
0424T
|
EAPG
|
Insj/rplc Nstim Apnea Compl
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
0427T
|
EAPG
|
Insj/rplc Nstim Apnea Pls Gn
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
63655
|
EAPG
|
Implant Neuroelectrodes
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
0312T
|
EAPG
|
Laps Impltj Nstim Vagus
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
0316T
|
EAPG
|
Replc Vagus Nerve Pls Gen
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
64575
|
EAPG
|
Opn Impltj Nea Perph Nerve
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
61870
|
EAPG
|
Implant Neuroelectrodes
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
0466T
|
EAPG
|
Insj Ch Wal Respir Eltrd/ra
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
0266T
|
EAPG
|
Implt/rpl Crtd Sns Dev Total
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
61850
|
EAPG
|
Implant Neuroelectrodes
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
0431T
|
EAPG
|
Rmvl/rplc Nstim Apnea Pls Gn
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
64580
|
EAPG
|
Opn Impltj Nea Neuromuscular
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
64582
|
EAPG
|
Opn Mpltj Hpglsl Nstm Ary Pg
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
61863
|
EAPG
|
Implant Neuroelectrode
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
64553
|
EAPG
|
Implant Neuroelectrodes
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
64568
|
EAPG
|
Opn Impltj Crnl Nrv Nea&pg
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
61864
|
EAPG
|
Implant Neuroelectrde Addl
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
61885
|
EAPG
|
Insrt/redo Neurostim 1 Array
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
63664
|
EAPG
|
Revise Spine Eltrd Plate
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
33276
|
EAPG
|
Insj Phrnc Nrv Stim Sys
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
0817T
|
EAPG
|
Opn Insj/rplcmt Ins Ptn Subf
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
64590
|
EAPG
|
Ins/rpl Prph Sac/gstr Npg/r
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
61889
|
EAPG
|
Ins Sk-mnt Crnl Nstm Pg/rcvr
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
63685
|
EAPG
|
Ins/rplc Spi Npg/rcvr Pocket
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
33287
|
EAPG
|
Rmv&rplcmt Phrnc Nrv Stim Pg
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
61886
|
EAPG
|
Implant Neurostim Arrays
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
64569
|
EAPG
|
Revise/repl Vagus N Eltrd
|
2
|
1
|
—
|
—
|
$33,151.22
|
$33,151.22
|
$33,151.22
|
2026-04-10
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
12
|
6
|
—
|
—
|
$33,098.32
|
$33,098.32
|
$33,098.32
|
2026-04-10
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
12
|
6
|
—
|
—
|
$33,002.02
|
$33,002.02
|
$33,002.02
|
2026-04-10
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
12
|
6
|
—
|
—
|
$32,742.11
|
$32,742.11
|
$32,742.11
|
2026-04-10
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
12
|
6
|
—
|
—
|
$32,558.76
|
$32,558.76
|
$32,558.76
|
2026-04-10
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
12
|
6
|
—
|
—
|
$32,534.68
|
$32,534.68
|
$32,534.68
|
2026-04-10
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
12
|
6
|
—
|
—
|
$32,522.34
|
$32,522.34
|
$32,522.34
|
2026-04-10
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
12
|
6
|
—
|
—
|
$32,411.21
|
$32,411.21
|
$32,411.21
|
2026-04-10
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
12
|
6
|
—
|
—
|
$31,815.47
|
$31,815.47
|
$31,815.47
|
2026-04-10
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
12
|
6
|
—
|
—
|
$31,633.35
|
$31,633.35
|
$31,633.35
|
2026-04-10
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
12
|
6
|
—
|
—
|
$31,583.35
|
$31,583.35
|
$31,583.35
|
2026-04-10
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
12
|
6
|
—
|
—
|
$31,128.36
|
$31,128.36
|
$31,128.36
|
2026-04-10
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
12
|
6
|
—
|
—
|
$31,000.57
|
$31,000.57
|
$31,000.57
|
2026-04-10
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
12
|
6
|
—
|
—
|
$30,995.02
|
$30,995.02
|
$30,995.02
|
2026-04-10
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
12
|
6
|
—
|
—
|
$30,691.28
|
$30,691.28
|
$30,691.28
|
2026-04-10
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
12
|
6
|
—
|
—
|
$30,535.71
|
$30,535.71
|
$30,535.71
|
2026-04-10
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
12
|
6
|
—
|
—
|
$30,365.32
|
$30,365.32
|
$30,365.32
|
2026-04-10
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
12
|
6
|
—
|
—
|
$30,101.71
|
$30,101.71
|
$30,101.71
|
2026-04-10
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
12
|
6
|
—
|
—
|
$30,089.98
|
$30,089.98
|
$30,089.98
|
2026-04-10
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
12
|
6
|
—
|
—
|
$29,999.23
|
$29,999.23
|
$29,999.23
|
2026-04-10
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
12
|
6
|
—
|
—
|
$29,994.91
|
$29,994.91
|
$29,994.91
|
2026-04-10
|
|
0870T
|
HCPCS
|
Imp Subq Prtl Ascts Pmp Sys
|
12
|
6
|
—
|
—
|
$29,525.72
|
$29,525.72
|
$29,525.72
|
2026-04-10
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
12
|
6
|
—
|
—
|
$29,499.18
|
$29,499.18
|
$29,499.18
|
2026-04-10
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
12
|
6
|
—
|
—
|
$29,333.11
|
$29,333.11
|
$29,333.11
|
2026-04-10
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
12
|
6
|
—
|
—
|
$29,256.56
|
$29,256.56
|
$29,256.56
|
2026-04-10
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
12
|
6
|
—
|
—
|
$28,998.51
|
$28,998.51
|
$28,998.51
|
2026-04-10
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
12
|
6
|
—
|
—
|
$28,765.77
|
$28,765.77
|
$28,765.77
|
2026-04-10
|
|
34703
|
EAPG
|
Evasc Rpr A-unilac Ndgft
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34702
|
EAPG
|
Evasc Rpr A-ao Ndgft Rpt
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34051
|
EAPG
|
Removal Of Artery Clot
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34701
|
EAPG
|
Evasc Rpr A-ao Ndgft
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34704
|
EAPG
|
Evasc Rpr A-unilac Ndgft Rpt
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34845
|
EAPG
|
Visc & Infraren Abd 1 Prosth
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34705
|
EAPG
|
Evac Rpr A-biiliac Ndgft
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34711
|
EAPG
|
Dlyd Plmt Xtn Prosth Ea Addl
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
33894
|
EAPG
|
Evasc St Rpr Thrc/aa Acrs Br
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
0234T
|
EAPG
|
Trluml Perip Athrc Renal Art
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
33884
|
EAPG
|
Endovasc Prosth Taa Add-on
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
0338T
|
EAPG
|
Trnscth Renal Symp Denrv Unl
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
33886
|
EAPG
|
Endovasc Prosth Delayed
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34706
|
EAPG
|
Evasc Rpr A-biiliac Rpt
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34713
|
EAPG
|
Perq Access & Clsr Fem Art
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
33895
|
EAPG
|
Evasc St Rpr Thrc/aa X Crsg
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
33880
|
EAPG
|
Endovasc Taa Repr Incl Subcl
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34820
|
EAPG
|
Opn Iliac Art Expos
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34843
|
EAPG
|
Endovasc Visc Aorta 3 Graft
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
33881
|
EAPG
|
Endovasc Taa Repr Without Subcl
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34842
|
EAPG
|
Endovasc Visc Aorta 2 Graft
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
33883
|
EAPG
|
Insert Endovasc Prosth Taa
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34844
|
EAPG
|
Endovasc Visc Aorta 4 Graft
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34710
|
EAPG
|
Dlyd Plmt Xtn Prosth 1st Vsl
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34848
|
EAPG
|
Visc & Infraren Abd 4+ Prost
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34846
|
EAPG
|
Visc & Infraren Abd 2 Prosth
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34707
|
EAPG
|
Evasc Rpr Ilio-iliac Ndgft
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34709
|
EAPG
|
Plmt Xtn Prosth Evasc Rpr
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
0254T
|
EAPG
|
Evasc Rpr Iliac Art Bifur
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
0339T
|
EAPG
|
Trnscth Renal Symp Denrv Bil
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34847
|
EAPG
|
Visc & Infraren Abd 3 Prosth
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34708
|
EAPG
|
Evasc Rpr Ilio-iliac Rpt
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34712
|
EAPG
|
Tcat Dlvr Enhncd Fixj Dev
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34717
|
EAPG
|
Evasc Rpr A-iliac Ndgft
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34813
|
EAPG
|
Femoral Endovas Graft Add-on
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34718
|
EAPG
|
Evasc Rpr N/a A-iliac Ndgft
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34841
|
EAPG
|
Endovasc Visc Aorta 1 Graft
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
34808
|
EAPG
|
Endovas Iliac A Device Addon
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
35840
|
EAPG
|
Explore Abdominal Vessels
|
2
|
1
|
—
|
—
|
$28,698.21
|
$28,698.21
|
$28,698.21
|
2026-04-10
|
|
J9266
|
HCPCS
|
Pegaspargase Injection
|
12
|
6
|
—
|
—
|
$28,424.05
|
$28,424.05
|
$28,424.05
|
2026-04-10
|
|
69930
|
HCPCS
|
Implant Cochlear Device
|
12
|
6
|
—
|
—
|
$28,417.07
|
$28,417.07
|
$28,417.07
|
2026-04-10
|
|
933
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
12
|
6
|
—
|
—
|
$28,358.94
|
$28,358.94
|
$28,358.94
|
2026-04-10
|
|
458
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
12
|
6
|
—
|
—
|
$28,303.99
|
$28,303.99
|
$28,303.99
|
2026-04-10
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
12
|
6
|
—
|
—
|
$27,981.12
|
$27,981.12
|
$27,981.12
|
2026-04-10
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
12
|
6
|
—
|
—
|
$27,942.23
|
$27,942.23
|
$27,942.23
|
2026-04-10
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
12
|
6
|
—
|
—
|
$27,755.79
|
$27,755.79
|
$27,755.79
|
2026-04-10
|
|
31
|
MS_DRG
|
Ventricular Shunt Procedures With Mcc
|
12
|
6
|
—
|
—
|
$27,517.49
|
$27,517.49
|
$27,517.49
|
2026-04-10
|
|
673
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Mcc
|
12
|
6
|
—
|
—
|
$27,511.32
|
$27,511.32
|
$27,511.32
|
2026-04-10
|
|
793
|
MS_DRG
|
Full Term Neonate With Major Problems
|
12
|
6
|
—
|
—
|
$27,393.41
|
$27,393.41
|
$27,393.41
|
2026-04-10
|
|
269
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
12
|
6
|
—
|
—
|
$27,332.91
|
$27,332.91
|
$27,332.91
|
2026-04-10
|
|
33270
|
HCPCS
|
Ins/rep Subq Defibrillator
|
12
|
6
|
—
|
—
|
$27,052.54
|
$27,052.54
|
$27,052.54
|
2026-04-10
|
|
33264
|
HCPCS
|
Rmvl & Rplcmt Dfb Gen Mlt Ld
|
12
|
6
|
—
|
—
|
$27,052.54
|
$27,052.54
|
$27,052.54
|
2026-04-10
|
|
33231
|
HCPCS
|
Insrt Pulse Gen W/mult Leads
|
12
|
6
|
—
|
—
|
$27,052.54
|
$27,052.54
|
$27,052.54
|
2026-04-10
|
|
33249
|
HCPCS
|
Insj/rplcmt Defib W/lead(s)
|
12
|
6
|
—
|
—
|
$27,052.54
|
$27,052.54
|
$27,052.54
|
2026-04-10
|
|
0571T
|
HCPCS
|
Insj/rplcmt Icds Ss Eltrd
|
12
|
6
|
—
|
—
|
$27,052.54
|
$27,052.54
|
$27,052.54
|
2026-04-10
|
|
0408T
|
HCPCS
|
Insj/rplc Cardiac Modulj Sys
|
12
|
6
|
—
|
—
|
$27,052.54
|
$27,052.54
|
$27,052.54
|
2026-04-10
|
|
0915T
|
HCPCS
|
Insj Perm Ccm-d Sys Pg&eltrd
|
12
|
6
|
—
|
—
|
$27,052.54
|
$27,052.54
|
$27,052.54
|
2026-04-10
|
|
236
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
12
|
6
|
—
|
—
|
$27,032.87
|
$27,032.87
|
$27,032.87
|
2026-04-10
|
|
958
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
12
|
6
|
—
|
—
|
$27,018.68
|
$27,018.68
|
$27,018.68
|
2026-04-10
|
|
12
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
12
|
6
|
—
|
—
|
$26,981.02
|
$26,981.02
|
$26,981.02
|
2026-04-10
|
|
448
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical Without Mcc
|
12
|
6
|
—
|
—
|
$26,856.31
|
$26,856.31
|
$26,856.31
|
2026-04-10
|
|
423
|
MS_DRG
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
12
|
6
|
—
|
—
|
$26,756.92
|
$26,756.92
|
$26,756.92
|
2026-04-10
|