|
10180
|
HCPCS
|
Complex Drainage Of Wound Infection After Surgery
|
50
|
50
|
$7,749.75
|
$4,856.74
37% off
|
$168.76
|
$6,587.29
|
$3,735.95
|
2026-02-25
|
|
111
|
OTHER
|
Outpatient Obs Bed Rate
|
10
|
8
|
—
|
—
|
$1,942.50
|
$3,950.00
|
$2,762.75
|
2026-05-08
|
|
1110000001
|
CDM
|
Room & Board - Private (one Bed) - Medical/surgical/gyn
|
18
|
18
|
$5,145.00
|
—
|
$1,286.25
|
$4,733.40
|
$3,134.85
|
2026-02-25
|
|
1110000001{2}
|
CDM
|
Room & Board - Private (one Bed) - Medical/surgical/gyn
|
18
|
18
|
$5,145.00
|
—
|
$1,286.25
|
$4,733.40
|
$3,134.85
|
2026-02-25
|
|
175
|
MS_DRG
|
Pulmonary Embolism With Mcc Or Acute Cor Pulmonale
|
20
|
20
|
$66,691.27
|
—
|
$13,051.47
|
$61,355.97
|
$13,051.47
|
2026-02-25
|
|
177
|
MS_DRG
|
Respiratory Infections And Inflammations With Mcc
|
20
|
20
|
$65,818.05
|
—
|
$14,848.23
|
$60,552.61
|
$14,848.23
|
2026-02-25
|
|
186
|
MS_DRG
|
Pleural Effusion With Mcc
|
20
|
20
|
$49,419.67
|
—
|
$14,808.32
|
$45,466.10
|
$14,808.32
|
2026-02-25
|
|
189
|
MS_DRG
|
Pulmonary Edema And Respiratory Failure
|
21
|
21
|
$52,106.50
|
—
|
$2,200.00
|
$47,937.98
|
$11,738.34
|
2026-02-25
|
|
190
|
MS_DRG
|
Chronic Obstructive Pulmonary Disease With Mcc
|
20
|
20
|
$36,505.36
|
$4,509,197.05
|
$5,914.29
|
$33,584.93
|
$10,524.98
|
2026-02-25
|
|
193
|
MS_DRG
|
Simple Pneumonia And Pleurisy With Mcc
|
21
|
21
|
$29,113.83
|
$3,596,183.71
|
$2,200.00
|
$26,784.72
|
$12,488.97
|
2026-02-25
|
|
194
|
MS_DRG
|
Simple Pneumonia And Pleurisy With Cc
|
37
|
37
|
$11,253.20
|
$1,390,012.39
|
$2,200.00
|
$10,490.61
|
$7,657.38
|
2026-02-25
|
|
200
|
OTHER
|
ICU General
|
9
|
7
|
—
|
—
|
$3,075.00
|
$5,843.60
|
$4,982.00
|
2026-05-08
|
|
2000000000
|
CDM
|
Intensive Care Unit - General Classification
|
18
|
18
|
$7,950.00
|
—
|
$1,987.50
|
$7,314.00
|
$4,843.94
|
2026-02-25
|
|
2000000001
|
CDM
|
Intensive Care Unit - General Classification
|
18
|
18
|
$8,348.00
|
—
|
$2,087.00
|
$7,680.16
|
$5,086.44
|
2026-02-25
|
|
20240
|
HCPCS
|
Biopsy Of Surface Bone
|
50
|
50
|
$7,749.75
|
$4,856.74
37% off
|
$126.58
|
$6,587.29
|
$3,735.95
|
2026-02-25
|
|
206
|
OTHER
|
Telemetry ICU
|
7
|
7
|
—
|
—
|
$2,350.00
|
$4,329.00
|
$3,290.00
|
2026-05-08
|
|
2060000000
|
CDM
|
Intensive Care Unit - Intermediate ICU
|
18
|
18
|
$4,700.00
|
—
|
$1,175.00
|
$4,324.00
|
$2,863.71
|
2026-02-25
|
|
2502131100
|
CDM
|
Activase 50 Mg Vial
|
28
|
28
|
$13,200.54
|
—
|
$1,500.00
|
$11,220.46
|
$6,600.27
|
2026-02-25
|
|
2502745703
|
CDM
|
Octagam 10% Vial
|
28
|
28
|
$10,776.00
|
—
|
$1,500.00
|
$9,159.60
|
$5,388.00
|
2026-02-25
|
|
2505879600
|
CDM
|
Praxbind 5g Dose(2x 2.5g/50ml)
|
28
|
28
|
$6,675.66
|
—
|
$1,500.00
|
$5,674.31
|
$3,337.83
|
2026-02-25
|
|
264
|
MS_DRG
|
Other Circulatory System O.r. Procedures
|
40
|
40
|
$83,635.84
|
—
|
$28,567.11
|
$76,944.97
|
$33,493.96
|
2026-02-25
|
|
2780000100
|
CDM
|
Certas Plus Programmable Valve
|
29
|
29
|
$11,924.25
|
—
|
$1,500.00
|
$12,520.46
|
$5,962.13
|
2026-02-25
|
|
2781713000
|
CDM
|
Phan Cs Acf Dist Lt 120mm Rack
|
29
|
29
|
$6,001.20
|
—
|
$1,500.00
|
$6,301.26
|
$3,000.60
|
2026-02-25
|
|
2781713008
|
CDM
|
Phan Cs Acf Dist Rt 120mm Rack
|
29
|
29
|
$6,001.20
|
—
|
$1,500.00
|
$6,301.26
|
$3,000.60
|
2026-02-25
|
|
2781713039
|
CDM
|
Phan Cs Ls Ret Sl/sl 120mm Rak
|
29
|
29
|
$7,362.00
|
—
|
$1,500.00
|
$7,730.10
|
$3,681.00
|
2026-02-25
|
|
2781776004
|
CDM
|
Comp Primary Stem 12mm Mini
|
29
|
29
|
$13,257.00
|
—
|
$1,500.00
|
$13,919.85
|
$6,628.50
|
2026-02-25
|
|
2781776011
|
CDM
|
Srom Sleeve Prx Ztt 16b-sml
|
29
|
29
|
$5,878.80
|
—
|
$1,469.70
|
$6,172.74
|
$2,939.40
|
2026-02-25
|
|
2781776012
|
CDM
|
Srom Stm St 36+ 6lnk 11x16x150
|
29
|
29
|
$12,103.20
|
—
|
$1,500.00
|
$12,708.36
|
$6,051.60
|
2026-02-25
|
|
2781776014
|
CDM
|
G7 Freedom Const E1 Lnr 36mm D
|
29
|
29
|
$11,952.00
|
—
|
$1,500.00
|
$12,549.60
|
$5,976.00
|
2026-02-25
|
|
2781776043
|
CDM
|
Biolox Da Opt Fem Hd 28mm +0mm
|
29
|
29
|
$6,606.00
|
—
|
$1,500.00
|
$6,936.30
|
$3,303.00
|
2026-02-25
|
|
2781776047
|
CDM
|
St Ao Fit. Modular Shaft 450mm
|
29
|
29
|
$5,400.00
|
—
|
$1,350.00
|
$5,670.00
|
$2,700.00
|
2026-02-25
|
|
2781776048
|
CDM
|
Wag Sl Rev 135 Nk Ang 21x225mm
|
29
|
29
|
$22,932.00
|
—
|
$1,500.00
|
$24,078.60
|
$11,466.00
|
2026-02-25
|
|
2781776049
|
CDM
|
Radial Hd 19 Hd 5.5 Stm 9 +3 S
|
29
|
29
|
$21,468.00
|
—
|
$1,500.00
|
$22,541.40
|
$10,734.00
|
2026-02-25
|
|
2781776050
|
CDM
|
Tria Cr Fem Comp - Cem 801
|
29
|
29
|
$18,130.20
|
—
|
$1,500.00
|
$19,036.71
|
$9,065.10
|
2026-02-25
|
|
2781776051
|
CDM
|
Tria Cr Fem Comp - Cem 802
|
29
|
29
|
$18,130.20
|
—
|
$1,500.00
|
$19,036.71
|
$9,065.10
|
2026-02-25
|
|
2781776066
|
CDM
|
Psn Fem Cem Cr Stand Lt Sz 12
|
29
|
29
|
$11,115.00
|
—
|
$1,500.00
|
$11,670.75
|
$5,557.50
|
2026-02-25
|
|
2781776068
|
CDM
|
Psn Rev Fem Cmt Ccr Pls Sz 3 R
|
29
|
29
|
$28,278.00
|
—
|
$1,500.00
|
$29,691.90
|
$14,139.00
|
2026-02-25
|
|
2781776069
|
CDM
|
Psn Rev Fem Cem Ccr Pls Sz 9 L
|
29
|
29
|
$26,424.00
|
—
|
$1,500.00
|
$27,745.20
|
$13,212.00
|
2026-02-25
|
|
2781776088
|
CDM
|
Psn Rev Cck Ve 10mm L Ef 7-9+
|
29
|
29
|
$9,270.00
|
—
|
$1,500.00
|
$9,733.50
|
$4,635.00
|
2026-02-25
|
|
2781776089
|
CDM
|
Psn Rev Cck Ve 12mm L Ef 7-9+
|
29
|
29
|
$9,270.00
|
—
|
$1,500.00
|
$9,733.50
|
$4,635.00
|
2026-02-25
|
|
2781776113
|
CDM
|
Psn Asf Cps 16mm Ve R Cd 3-5
|
29
|
29
|
$7,908.75
|
—
|
$1,500.00
|
$8,304.19
|
$3,954.38
|
2026-02-25
|
|
2781776114
|
CDM
|
Psn Rev Cck Asf Ve 12mm R3-5ef
|
29
|
29
|
$9,270.00
|
—
|
$1,500.00
|
$9,733.50
|
$4,635.00
|
2026-02-25
|
|
2781776129
|
CDM
|
Psn Rev Tib Fx Keel Cmt Sz E R
|
29
|
29
|
$9,468.00
|
—
|
$1,500.00
|
$9,941.40
|
$4,734.00
|
2026-02-25
|
|
2781776130
|
CDM
|
Psn Rev Tib Fixed Keel Cem F L
|
29
|
29
|
$9,468.00
|
—
|
$1,500.00
|
$9,941.40
|
$4,734.00
|
2026-02-25
|
|
2781776131
|
CDM
|
Psn Rev Tm Tib Cntrl Cone Fix
|
29
|
29
|
$19,008.00
|
—
|
$1,500.00
|
$19,958.40
|
$9,504.00
|
2026-02-25
|
|
2781776132
|
CDM
|
Psn Rev Tm Tib Cntrl Cone Sm
|
29
|
29
|
$19,008.00
|
—
|
$1,500.00
|
$19,958.40
|
$9,504.00
|
2026-02-25
|
|
2781776133
|
CDM
|
Psn Rev Tm Tib Cntrl Cone M
|
29
|
29
|
$19,008.00
|
—
|
$1,500.00
|
$19,958.40
|
$9,504.00
|
2026-02-25
|
|
2781776142
|
CDM
|
Psn Rev Tapered Stem Ext 14x75
|
29
|
29
|
$5,976.00
|
—
|
$1,494.00
|
$6,274.80
|
$2,988.00
|
2026-02-25
|
|
2781776146
|
CDM
|
Tria Cr Fem Comp - Cem 101
|
29
|
29
|
$5,400.00
|
—
|
$1,350.00
|
$5,670.00
|
$2,700.00
|
2026-02-25
|
|
2781776147
|
CDM
|
Tria Cr Fem Comp - Cem 201
|
29
|
29
|
$5,400.00
|
—
|
$1,350.00
|
$5,670.00
|
$2,700.00
|
2026-02-25
|
|
2781776173
|
CDM
|
X3 Tria Insert Cs #7 10mm
|
29
|
29
|
$6,629.16
|
—
|
$1,500.00
|
$6,960.62
|
$3,314.58
|
2026-02-25
|
|
2781776184
|
CDM
|
X3 Tria Insert Ps #4 12mm
|
29
|
29
|
$11,568.00
|
—
|
$1,500.00
|
$12,146.40
|
$5,784.00
|
2026-02-25
|
|
2781776188
|
CDM
|
Tria Trit Baseplate Sz 4
|
29
|
29
|
$6,675.00
|
—
|
$1,500.00
|
$7,008.75
|
$3,337.50
|
2026-02-25
|
|
2781776188{2}
|
CDM
|
Tria Trit Baseplate Sz 4
|
29
|
29
|
$6,675.00
|
—
|
$1,500.00
|
$7,008.75
|
$3,337.50
|
2026-02-25
|
|
2781776189
|
CDM
|
Tria Trit Baseplate Sz 5
|
29
|
29
|
$6,675.00
|
—
|
$1,500.00
|
$7,008.75
|
$3,337.50
|
2026-02-25
|
|
2781776190
|
CDM
|
Tria Trit Baseplate Sz 8
|
29
|
29
|
$6,675.00
|
—
|
$1,500.00
|
$7,008.75
|
$3,337.50
|
2026-02-25
|
|
2781776197
|
CDM
|
Tri Lm/rl Tib Aug Sz2 5mm
|
29
|
29
|
$6,600.00
|
—
|
$1,500.00
|
$6,930.00
|
$3,300.00
|
2026-02-25
|
|
2781776198
|
CDM
|
Tri Rm/ll Tib Aug Sz2 5mm
|
29
|
29
|
$6,600.00
|
—
|
$1,500.00
|
$6,930.00
|
$3,300.00
|
2026-02-25
|
|
2781776199
|
CDM
|
Tri Lm/rl Tib Aug Sz3 5mm
|
29
|
29
|
$6,600.00
|
—
|
$1,500.00
|
$6,930.00
|
$3,300.00
|
2026-02-25
|
|
2781776203
|
CDM
|
Trident 0-¦ X3 Insert 40mm G
|
29
|
29
|
$6,600.00
|
—
|
$1,500.00
|
$6,930.00
|
$3,300.00
|
2026-02-25
|
|
2781776218
|
CDM
|
Delta V-40 Ceramic Head 28/-4
|
29
|
29
|
$6,600.00
|
—
|
$1,500.00
|
$6,930.00
|
$3,300.00
|
2026-02-25
|
|
2781776225
|
CDM
|
Sz 6 Accolade Ii 127 Deg
|
29
|
29
|
$6,600.00
|
—
|
$1,500.00
|
$6,930.00
|
$3,300.00
|
2026-02-25
|
|
2781776226
|
CDM
|
Sz 8 Accolade Ii 127 Deg
|
29
|
29
|
$6,600.00
|
—
|
$1,500.00
|
$6,930.00
|
$3,300.00
|
2026-02-25
|
|
2781776228
|
CDM
|
Insignia Collared High 4
|
29
|
29
|
$6,600.00
|
—
|
$1,500.00
|
$6,930.00
|
$3,300.00
|
2026-02-25
|
|
2781776229
|
CDM
|
Insignia Collared High 6
|
29
|
29
|
$6,600.00
|
—
|
$1,500.00
|
$6,930.00
|
$3,300.00
|
2026-02-25
|
|
2781776231
|
CDM
|
Trident Ii Trit Clustrhole 52e
|
29
|
29
|
$6,675.00
|
—
|
$1,500.00
|
$7,008.75
|
$3,337.50
|
2026-02-25
|
|
2781776235
|
CDM
|
Trident 0 Deg Insert 36mm
|
29
|
29
|
$6,600.00
|
—
|
$1,500.00
|
$6,930.00
|
$3,300.00
|
2026-02-25
|
|
2781776236
|
CDM
|
Fem/cem Tib/flx Prlng Surf/std
|
29
|
29
|
$13,200.00
|
—
|
$1,500.00
|
$13,860.00
|
$6,600.00
|
2026-02-25
|
|
2781776238
|
CDM
|
Psn Cem Fm/cm Tb/std Sf/std Pt
|
29
|
29
|
$13,200.00
|
—
|
$1,500.00
|
$13,860.00
|
$6,600.00
|
2026-02-25
|
|
2781776239
|
CDM
|
Psn Cm Fm/cm Tb/ve/xlpe Pt
|
29
|
29
|
$13,950.00
|
—
|
$1,500.00
|
$14,647.50
|
$6,975.00
|
2026-02-25
|
|
2781776240
|
CDM
|
Psn Cm Fm/cm Tb/ve/ve Psn Pt
|
29
|
29
|
$14,400.00
|
—
|
$1,500.00
|
$15,120.00
|
$7,200.00
|
2026-02-25
|
|
2781776241
|
CDM
|
Psn Tm Fm/tm Tb/ve/tm Pt
|
29
|
29
|
$18,300.00
|
—
|
$1,500.00
|
$19,215.00
|
$9,150.00
|
2026-02-25
|
|
2781776242
|
CDM
|
Pr Prm St/cer
|
29
|
29
|
$8,985.00
|
—
|
$1,500.00
|
$9,434.25
|
$4,492.50
|
2026-02-25
|
|
2781776243
|
CDM
|
Pr Std St/cer
|
29
|
29
|
$8,985.00
|
—
|
$1,500.00
|
$9,434.25
|
$4,492.50
|
2026-02-25
|
|
2781776251
|
CDM
|
G7 Osseoti Multihole 54mm F
|
29
|
29
|
$12,402.00
|
—
|
$1,500.00
|
$13,022.10
|
$6,201.00
|
2026-02-25
|
|
2781776253
|
CDM
|
Tria Cr Fem Comp - Cem 302
|
29
|
29
|
$5,400.00
|
—
|
$1,350.00
|
$5,670.00
|
$2,700.00
|
2026-02-25
|
|
2781776257
|
CDM
|
G7 Osseoti Multihole 58mm G
|
29
|
29
|
$12,402.00
|
—
|
$1,500.00
|
$13,022.10
|
$6,201.00
|
2026-02-25
|
|
2781776258
|
CDM
|
G7 Osseoti Multihole 62mm H
|
29
|
29
|
$12,402.00
|
—
|
$1,500.00
|
$13,022.10
|
$6,201.00
|
2026-02-25
|
|
2781776264
|
CDM
|
Avenir Lateral Stem Cem 5
|
29
|
29
|
$6,000.00
|
—
|
$1,500.00
|
$6,300.00
|
$3,000.00
|
2026-02-25
|
|
2781776270
|
CDM
|
Tria Cr Fem Comp - Cem 501
|
29
|
29
|
$5,400.00
|
—
|
$1,350.00
|
$5,670.00
|
$2,700.00
|
2026-02-25
|
|
2781776273
|
CDM
|
Osc357816 Attune Fb With Dom
|
29
|
29
|
$15,300.00
|
—
|
$1,500.00
|
$16,065.00
|
$7,650.00
|
2026-02-25
|
|
2781776276
|
CDM
|
Stry Tria Pat Symmetric 33x9
|
29
|
29
|
$6,000.00
|
—
|
$1,500.00
|
$6,300.00
|
$3,000.00
|
2026-02-25
|
|
2781776277
|
CDM
|
Stry Tria Pat Asymetric A32x10
|
29
|
29
|
$6,675.00
|
—
|
$1,500.00
|
$7,008.75
|
$3,337.50
|
2026-02-25
|
|
2781776278
|
CDM
|
Stry Tria Pat Asymetric A29x9
|
29
|
29
|
$6,000.00
|
—
|
$1,500.00
|
$6,300.00
|
$3,000.00
|
2026-02-25
|
|
2781776281
|
CDM
|
Tria Cr Fem Comp - Cem 401
|
29
|
29
|
$5,400.00
|
—
|
$1,350.00
|
$5,670.00
|
$2,700.00
|
2026-02-25
|
|
2781776282
|
CDM
|
Tria Cr Fem Comp - Cem 301
|
29
|
29
|
$5,400.00
|
—
|
$1,350.00
|
$5,670.00
|
$2,700.00
|
2026-02-25
|
|
2781776283
|
CDM
|
X3 Tria Insert Cs #6 14mm
|
29
|
29
|
$6,629.70
|
—
|
$1,500.00
|
$6,961.19
|
$3,314.85
|
2026-02-25
|
|
2781776285
|
CDM
|
Stry Tria Pat Symmetric 39x11
|
29
|
29
|
$6,000.00
|
—
|
$1,500.00
|
$6,300.00
|
$3,000.00
|
2026-02-25
|
|
2781776287
|
CDM
|
G7 Osseoti Multihole 52mm E
|
29
|
29
|
$12,402.00
|
—
|
$1,500.00
|
$13,022.10
|
$6,201.00
|
2026-02-25
|
|
2781776291
|
CDM
|
Tria Trit Baseplate Sz 7
|
29
|
29
|
$6,675.00
|
—
|
$1,500.00
|
$7,008.75
|
$3,337.50
|
2026-02-25
|
|
2781776292
|
CDM
|
Tria Cr Fem Comp - Cem 601
|
29
|
29
|
$5,400.00
|
—
|
$1,350.00
|
$5,670.00
|
$2,700.00
|
2026-02-25
|
|
2781776293
|
CDM
|
Tria Cr Fem Comp - Cem 602
|
29
|
29
|
$5,400.00
|
—
|
$1,350.00
|
$5,670.00
|
$2,700.00
|
2026-02-25
|
|
278C1713UZ
|
CDM
|
10 Ti Cann Tib Nail-ex Prox Bn
|
29
|
29
|
$9,951.00
|
—
|
$1,500.00
|
$10,448.55
|
$4,975.50
|
2026-02-25
|
|
278C1713VA
|
CDM
|
10/130 Def Ti Cann Tfna 170 St
|
29
|
29
|
$10,098.00
|
—
|
$1,500.00
|
$10,602.90
|
$5,049.00
|
2026-02-25
|
|
278C1713VB
|
CDM
|
10/130 Deg Ti Cann Tfna 235/lt
|
29
|
29
|
$11,109.00
|
—
|
$1,500.00
|
$11,664.45
|
$5,554.50
|
2026-02-25
|
|
278C1713VC
|
CDM
|
11/130 Deg Ti Cann Tfna 235/lt
|
29
|
29
|
$10,098.00
|
—
|
$1,500.00
|
$10,602.90
|
$5,049.00
|
2026-02-25
|
|
278C173434
|
CDM
|
Xlif Ams Plate 10mm Single Sid
|
29
|
29
|
$9,000.00
|
—
|
$1,500.00
|
$9,450.00
|
$4,500.00
|
2026-02-25
|
|
278C173436
|
CDM
|
Acu-loc2 Vdr Prox Plt Std R
|
29
|
29
|
$7,938.00
|
—
|
$1,500.00
|
$8,334.90
|
$3,969.00
|
2026-02-25
|
|
278C173441
|
CDM
|
Grafton Dbf Inject 9cc
|
29
|
29
|
$5,880.00
|
—
|
$1,470.00
|
$6,174.00
|
$2,940.00
|
2026-02-25
|
|
278C173446
|
CDM
|
Duragen Plus 4 X 5 (sub)
|
29
|
29
|
$6,913.89
|
—
|
$1,500.00
|
$7,259.58
|
$3,456.95
|
2026-02-25
|
|
278C173450
|
CDM
|
3.5va Prox Tib Plsmall 4/87/lt
|
29
|
29
|
$13,182.00
|
—
|
$1,500.00
|
$13,841.10
|
$6,591.00
|
2026-02-25
|
|
278C173452
|
CDM
|
Syndesmosis Tighrope Tray .
|
29
|
29
|
$6,300.00
|
—
|
$1,500.00
|
$6,615.00
|
$3,150.00
|
2026-02-25
|
|
278C173456
|
CDM
|
10.0mmx40mm Ifuse-torq
|
29
|
29
|
$9,678.00
|
—
|
$1,500.00
|
$10,161.90
|
$4,839.00
|
2026-02-25
|
|
278C173462
|
CDM
|
Anterior Tt Plate Right
|
29
|
29
|
$9,747.81
|
—
|
$1,500.00
|
$10,235.20
|
$4,873.91
|
2026-02-25
|
|
278C173464
|
CDM
|
Xlif Ams Plate 12mm Dual-sided
|
29
|
29
|
$10,500.00
|
—
|
$1,500.00
|
$11,025.00
|
$5,250.00
|
2026-02-25
|
|
278C173466
|
CDM
|
8- Hole Plate Synthes
|
29
|
29
|
$17,697.00
|
—
|
$1,500.00
|
$18,581.85
|
$8,848.50
|
2026-02-25
|
|
278C173467
|
CDM
|
Cellular Bone Matrix
|
29
|
29
|
$11,182.20
|
—
|
$1,500.00
|
$11,741.31
|
$5,591.10
|
2026-02-25
|
|
278C173472
|
CDM
|
2.7/3.5 Va-lcp Olecranon Pl2h
|
29
|
29
|
$9,069.00
|
—
|
$1,500.00
|
$9,522.45
|
$4,534.50
|
2026-02-25
|
|
278C173475
|
CDM
|
Tibial Nail-advanced10 285 St
|
29
|
29
|
$12,840.00
|
—
|
$1,500.00
|
$13,482.00
|
$6,420.00
|
2026-02-25
|
|
278C173477
|
CDM
|
3.5mm Lcp Metaphyseal Plate 6
|
29
|
29
|
$7,464.00
|
—
|
$1,500.00
|
$7,837.20
|
$3,732.00
|
2026-02-25
|
|
278C173484
|
CDM
|
Echelon Reloads 45mm Gold
|
29
|
29
|
$8,141.16
|
—
|
$1,500.00
|
$8,548.22
|
$4,070.58
|
2026-02-25
|
|
278C173491
|
CDM
|
Strand Plus Large
|
29
|
29
|
$6,900.00
|
—
|
$1,500.00
|
$7,245.00
|
$3,450.00
|
2026-02-25
|
|
278C173495
|
CDM
|
Staple Nitinol 18x16fuseforce
|
29
|
29
|
$5,797.14
|
—
|
$1,449.29
|
$6,087.00
|
$2,898.57
|
2026-02-25
|
|
278C173500
|
CDM
|
Helistat 3 X 4 Inch X 5.0mm
|
29
|
29
|
$5,977.95
|
—
|
$1,494.49
|
$6,276.85
|
$2,988.98
|
2026-02-25
|
|
278C173509
|
CDM
|
6 Hole Clavical Plate
|
29
|
29
|
$5,745.00
|
—
|
$1,436.25
|
$6,032.25
|
$2,872.50
|
2026-02-25
|
|
278C173517
|
CDM
|
Shift Fix Mdco Plate
|
29
|
29
|
$5,793.96
|
—
|
$1,448.49
|
$6,083.66
|
$2,896.98
|
2026-02-25
|
|
278C173518
|
CDM
|
12mmev Wedge Allopure Bicortic
|
29
|
29
|
$5,928.00
|
—
|
$1,482.00
|
$6,224.40
|
$2,964.00
|
2026-02-25
|
|
278C173531
|
CDM
|
Sm Occip Plate Virage
|
29
|
29
|
$10,431.00
|
—
|
$1,500.00
|
$10,952.55
|
$5,215.50
|
2026-02-25
|
|
278C173541
|
CDM
|
10cc Attrax Putty 12.5x50x8mm
|
29
|
29
|
$5,400.00
|
—
|
$1,350.00
|
$5,670.00
|
$2,700.00
|
2026-02-25
|
|
278C173557
|
CDM
|
Omega3 Surgiclose Micro
|
29
|
29
|
$12,900.00
|
—
|
$1,500.00
|
$13,545.00
|
$6,450.00
|
2026-02-25
|
|
278C173563
|
CDM
|
Surgiclose Micro 93sq Cm
|
29
|
29
|
$12,900.00
|
—
|
$1,500.00
|
$13,545.00
|
$6,450.00
|
2026-02-25
|
|
278C1776CN
|
CDM
|
Mck Fem-lm-rl-sz 5
|
29
|
29
|
$9,283.95
|
—
|
$1,500.00
|
$9,748.15
|
$4,641.98
|
2026-02-25
|
|
278C1776CZ
|
CDM
|
Zim NexGen Pat All Poly 38mm
|
29
|
29
|
$15,876.00
|
—
|
$1,500.00
|
$16,669.80
|
$7,938.00
|
2026-02-25
|
|
278C1776DG
|
CDM
|
Zim Pers Rev Stem Ext 14/+75
|
29
|
29
|
$5,976.00
|
—
|
$1,494.00
|
$6,274.80
|
$2,988.00
|
2026-02-25
|
|
278C1776FU
|
CDM
|
ZimAM Stem UnCem Ha 5 12/14
|
29
|
29
|
$6,750.00
|
—
|
$1,500.00
|
$7,087.50
|
$3,375.00
|
2026-02-25
|
|
278C1776GP
|
CDM
|
ZimBio Delta Fem Cer 36/-3.5 S
|
29
|
29
|
$38,832.00
|
—
|
$1,500.00
|
$40,773.60
|
$19,416.00
|
2026-02-25
|
|
278C1776IY
|
CDM
|
DepSyn Tfna Can Ti 10/130 235l
|
29
|
29
|
$8,808.00
|
—
|
$1,500.00
|
$9,248.40
|
$4,404.00
|
2026-02-25
|
|
278C1776LS
|
CDM
|
Pers Fem Cem Cr 12 Rt
|
29
|
29
|
$11,115.00
|
—
|
$1,500.00
|
$11,670.75
|
$5,557.50
|
2026-02-25
|
|
278C177807
|
CDM
|
Cyber Perennial Flex Vns Lead
|
29
|
29
|
$21,099.00
|
—
|
$1,500.00
|
$22,153.95
|
$10,549.50
|
2026-02-25
|
|
278C177811
|
CDM
|
Ins 37603 Activa Sc Dbs Eman
|
29
|
29
|
$27,480.00
|
—
|
$1,500.00
|
$28,854.00
|
$13,740.00
|
2026-02-25
|
|
278C177818
|
CDM
|
Proclaim 5 Penta Sys
|
29
|
29
|
$75,000.00
|
—
|
$1,500.00
|
$78,750.00
|
$37,500.00
|
2026-02-25
|
|
278C177819
|
CDM
|
Lead Istm Ssmri 4.32mm Eman US
|
29
|
29
|
$13,662.00
|
—
|
$1,500.00
|
$14,345.10
|
$6,831.00
|
2026-02-25
|
|
278C177822
|
CDM
|
Ins 37603 Activa Sc No Paryln
|
29
|
29
|
$27,480.00
|
—
|
$1,500.00
|
$28,854.00
|
$13,740.00
|
2026-02-25
|
|
278C178121
|
CDM
|
Ventrio St Large Oval 5.4x7"
|
29
|
29
|
$5,460.30
|
—
|
$1,365.08
|
$5,733.32
|
$2,730.15
|
2026-02-25
|
|
278C183163
|
CDM
|
Coroent Xlf 10x18x50 10
|
29
|
29
|
$49,392.00
|
—
|
$1,500.00
|
$51,861.60
|
$24,696.00
|
2026-02-25
|
|
278C183164
|
CDM
|
Coroent Xlf 12x18x55 10
|
29
|
29
|
$19,392.00
|
—
|
$1,500.00
|
$20,361.60
|
$9,696.00
|
2026-02-25
|
|
278C183165
|
CDM
|
Jts Intbdy Cage 10x22x10
|
29
|
29
|
$8,700.00
|
—
|
$1,500.00
|
$9,135.00
|
$4,350.00
|
2026-02-25
|
|
278C183166
|
CDM
|
Jts Silversto Intbdy 22x10x11
|
29
|
29
|
$8,700.00
|
—
|
$1,500.00
|
$9,135.00
|
$4,350.00
|
2026-02-25
|
|
278C183167
|
CDM
|
Jts Silversto Intbdy 22x10x8
|
29
|
29
|
$8,700.00
|
—
|
$1,500.00
|
$9,135.00
|
$4,350.00
|
2026-02-25
|
|
278C183168
|
CDM
|
Jts Silversto P Intbdy 22x11
|
29
|
29
|
$8,700.00
|
—
|
$1,500.00
|
$9,135.00
|
$4,350.00
|
2026-02-25
|
|
278C183175
|
CDM
|
10x27x12mm Cage 5 Deg
|
29
|
29
|
$8,700.00
|
—
|
$1,500.00
|
$9,135.00
|
$4,350.00
|
2026-02-25
|
|
278C183176
|
CDM
|
10x32x10mm Cage 5 Deg
|
29
|
29
|
$8,700.00
|
—
|
$1,500.00
|
$9,135.00
|
$4,350.00
|
2026-02-25
|
|
278C183177
|
CDM
|
10x32x12mm Cage 5 Deg
|
29
|
29
|
$8,700.00
|
—
|
$1,500.00
|
$9,135.00
|
$4,350.00
|
2026-02-25
|
|
278C183183
|
CDM
|
Silstone 26x10x15mm 7a-¦ Plif
|
29
|
29
|
$8,700.00
|
—
|
$1,500.00
|
$9,135.00
|
$4,350.00
|
2026-02-25
|
|
278C183184
|
CDM
|
Silstone 30x10x8mm 7a-¦ Tplif
|
29
|
29
|
$8,700.00
|
—
|
$1,500.00
|
$9,135.00
|
$4,350.00
|
2026-02-25
|
|
278C183185
|
CDM
|
Silstone 30x10x9mm 7a-¦ Tplif
|
29
|
29
|
$8,700.00
|
—
|
$1,500.00
|
$9,135.00
|
$4,350.00
|
2026-02-25
|
|
278C183186
|
CDM
|
Silstone 30x10x10mm 7a-¦ Tplif
|
29
|
29
|
$8,700.00
|
—
|
$1,500.00
|
$9,135.00
|
$4,350.00
|
2026-02-25
|
|
278C183187
|
CDM
|
Silstone 30x10x11mm 7a-¦ Tplif
|
29
|
29
|
$8,700.00
|
—
|
$1,500.00
|
$9,135.00
|
$4,350.00
|
2026-02-25
|
|
278C183188
|
CDM
|
Silstone 30x10x13mm 7a-¦ Tplif
|
29
|
29
|
$8,700.00
|
—
|
$1,500.00
|
$9,135.00
|
$4,350.00
|
2026-02-25
|
|
278C183189
|
CDM
|
Silstone 26x10x11mm 7a-¦ Plif
|
29
|
29
|
$8,700.00
|
—
|
$1,500.00
|
$9,135.00
|
$4,350.00
|
2026-02-25
|
|
278C183190
|
CDM
|
Silstone 26x10x9mm 7a-¦ Plif
|
29
|
29
|
$8,700.00
|
—
|
$1,500.00
|
$9,135.00
|
$4,350.00
|
2026-02-25
|
|
278C183191
|
CDM
|
Silstone 22x10x12mm 7a-¦ Plif
|
29
|
29
|
$8,700.00
|
—
|
$1,500.00
|
$9,135.00
|
$4,350.00
|
2026-02-25
|
|
278C183192
|
CDM
|
Silstone 22x10x11mm 7a-¦ Plif
|
29
|
29
|
$8,700.00
|
—
|
$1,500.00
|
$9,135.00
|
$4,350.00
|
2026-02-25
|
|
278C183193
|
CDM
|
Silstone 22x10x8mm 7a-¦ Plif
|
29
|
29
|
$8,700.00
|
—
|
$1,500.00
|
$9,135.00
|
$4,350.00
|
2026-02-25
|
|
278C183194
|
CDM
|
Silstone 22x10x7mm 7a-¦ Plif
|
29
|
29
|
$8,700.00
|
—
|
$1,500.00
|
$9,135.00
|
$4,350.00
|
2026-02-25
|
|
278C183198
|
CDM
|
Jts Xp 10x27x8mm 5-10a-¦expca
|
29
|
29
|
$19,200.00
|
—
|
$1,500.00
|
$20,160.00
|
$9,600.00
|
2026-02-25
|
|
278C183199
|
CDM
|
Spin El 12x27x12mm Cage 5d Pc
|
29
|
29
|
$9,600.00
|
—
|
$1,500.00
|
$10,080.00
|
$4,800.00
|
2026-02-25
|
|
278C1831AA
|
CDM
|
Spin El 12x27x10mm Cage 5d Pc
|
29
|
29
|
$9,600.00
|
—
|
$1,500.00
|
$10,080.00
|
$4,800.00
|
2026-02-25
|
|
278C1831AB
|
CDM
|
Spin El 12x27x9mm Cage 5d Pc
|
29
|
29
|
$9,600.00
|
—
|
$1,500.00
|
$10,080.00
|
$4,800.00
|
2026-02-25
|
|
278C1831AC
|
CDM
|
Spin El 12x27x8mm Cage 5d Pc
|
29
|
29
|
$9,600.00
|
—
|
$1,500.00
|
$10,080.00
|
$4,800.00
|
2026-02-25
|
|
278C1831AD
|
CDM
|
Stalif Mid Cage 42x13x12
|
29
|
29
|
$18,450.00
|
—
|
$1,500.00
|
$19,372.50
|
$9,225.00
|
2026-02-25
|
|
278C1831AE
|
CDM
|
Zim Peek Optima D14 W17 - H7
|
29
|
29
|
$12,600.00
|
—
|
$1,500.00
|
$13,230.00
|
$6,300.00
|
2026-02-25
|
|
278C1831AF
|
CDM
|
Zim Peek Optima D14 W15.5 -h7
|
29
|
29
|
$12,600.00
|
—
|
$1,500.00
|
$13,230.00
|
$6,300.00
|
2026-02-25
|
|
278C1831AG
|
CDM
|
Roi-c Lord Coat IM 12x15.5 H8
|
29
|
29
|
$12,600.00
|
—
|
$1,500.00
|
$13,230.00
|
$6,300.00
|
2026-02-25
|
|
278C1831AH
|
CDM
|
Roi-c Lord Coat IM 12x15.5 H7
|
29
|
29
|
$12,600.00
|
—
|
$1,500.00
|
$13,230.00
|
$6,300.00
|
2026-02-25
|
|
278C1831AI
|
CDM
|
Roi-c Lord Coat IM 12x14 H7
|
29
|
29
|
$12,600.00
|
—
|
$1,500.00
|
$13,230.00
|
$6,300.00
|
2026-02-25
|
|
278C1831AJ
|
CDM
|
Roic Lord Coated Cage H6 12x14
|
29
|
29
|
$25,200.00
|
—
|
$1,500.00
|
$26,460.00
|
$12,600.00
|
2026-02-25
|
|
278C1831AK
|
CDM
|
Roi-c Lord Coat IM 12x14 H5
|
29
|
29
|
$12,600.00
|
—
|
$1,500.00
|
$13,230.00
|
$6,300.00
|
2026-02-25
|
|
278C1831AL
|
CDM
|
Roi-c Lord Coat IM 14x17 H8
|
29
|
29
|
$12,600.00
|
—
|
$1,500.00
|
$13,230.00
|
$6,300.00
|
2026-02-25
|
|
278C1831AM
|
CDM
|
Roi-c Lord Coat IM 14x17 H5
|
29
|
29
|
$12,600.00
|
—
|
$1,500.00
|
$13,230.00
|
$6,300.00
|
2026-02-25
|
|
278C1831AN
|
CDM
|
Roic Lord Coat Cage H6 14x15.5
|
29
|
29
|
$12,600.00
|
—
|
$1,500.00
|
$13,230.00
|
$6,300.00
|
2026-02-25
|
|
278C1831AO
|
CDM
|
Roic Ana Coat Cage H6 14x15.5
|
29
|
29
|
$12,600.00
|
—
|
$1,500.00
|
$13,230.00
|
$6,300.00
|
2026-02-25
|
|
278C1831AP
|
CDM
|
Cohere Xl, 8x18x55mm 10a-¦
|
29
|
29
|
$16,464.00
|
—
|
$1,500.00
|
$17,287.20
|
$8,232.00
|
2026-02-25
|
|
278C1831AQ
|
CDM
|
Spin El 12x27x11mm Cage 5d Pc
|
29
|
29
|
$9,600.00
|
—
|
$1,500.00
|
$10,080.00
|
$4,800.00
|
2026-02-25
|
|
280
|
MS_DRG
|
Acute Myocardial Infarction, Discharged Alive With Mcc
|
39
|
39
|
$23,445.91
|
$2,896,073.97
|
$13,717.45
|
$21,570.24
|
$15,241.60
|
2026-02-25
|
|
28124
|
HCPCS
|
Partial Removal Of Toe Bone
|
50
|
50
|
$8,929.98
|
$5,470.84
39% off
|
$299.59
|
$7,590.48
|
$4,208.34
|
2026-02-25
|
|
291
|
MS_DRG
|
Heart Failure And Shock With Mcc
|
21
|
21
|
$44,442.79
|
—
|
$2,200.00
|
$40,887.36
|
$12,198.22
|
2026-02-25
|
|
308
|
MS_DRG
|
Cardiac Arrhythmia And Conduction Disorders With Mcc
|
20
|
20
|
$54,196.21
|
—
|
$11,439.99
|
$49,860.51
|
$11,439.99
|
2026-02-25
|
|
314
|
MS_DRG
|
Other Circulatory System Diagnoses With Mcc
|
37
|
37
|
$51,501.31
|
—
|
$2,200.00
|
$47,381.20
|
$19,812.84
|
2026-02-25
|
|
31614
|
HCPCS
|
Revision Of Permanent Opening Of Windpipe For Breathing With Flap Rotation
|
50
|
50
|
$17,746.98
|
$9,898.06
44% off
|
$316.46
|
$15,084.93
|
$7,613.89
|
2026-02-25
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
39
|
39
|
$115,132.41
|
—
|
$39,306.92
|
$105,921.82
|
$43,674.33
|
2026-02-25
|
|
330
|
MS_DRG
|
Major Small And Large Bowel Procedures With Cc
|
40
|
40
|
$66,232.83
|
—
|
$20,499.63
|
$60,934.20
|
$22,777.36
|
2026-02-25
|
|
331
|
MS_DRG
|
Major Small And Large Bowel Procedures Without Cc/mcc
|
40
|
40
|
$63,724.44
|
—
|
$14,391.30
|
$58,626.48
|
$15,990.33
|
2026-02-25
|
|
33285
|
HCPCS
|
Insertion Of Heart Rhythm Monitor Under Skin
|
50
|
50
|
$24,460.00
|
$13,836.55
43% off
|
$1,208.95
|
$20,791.00
|
$10,643.50
|
2026-02-25
|
|
3607950200
|
CDM
|
Operating Room Services - General Classification
|
28
|
28
|
$6,050.00
|
—
|
$1,500.00
|
$5,142.50
|
$3,025.00
|
2026-02-25
|
|
3607950200{2}
|
CDM
|
Operating Room Services - General Classification
|
28
|
28
|
$6,050.00
|
—
|
$1,500.00
|
$5,142.50
|
$3,025.00
|
2026-02-25
|
|
3607950400
|
CDM
|
Operating Room Services - General Classification
|
28
|
28
|
$8,250.00
|
—
|
$1,500.00
|
$7,012.50
|
$4,125.00
|
2026-02-25
|
|
3607950400{2}
|
CDM
|
Operating Room Services - General Classification
|
28
|
28
|
$8,250.00
|
—
|
$1,500.00
|
$7,012.50
|
$4,125.00
|
2026-02-25
|
|
3607950600
|
CDM
|
Operating Room Services - General Classification
|
28
|
28
|
$10,450.00
|
—
|
$1,500.00
|
$8,882.50
|
$5,225.00
|
2026-02-25
|
|
3607950600{2}
|
CDM
|
Operating Room Services - General Classification
|
28
|
28
|
$10,450.00
|
—
|
$1,500.00
|
$8,882.50
|
$5,225.00
|
2026-02-25
|
|
3607950800
|
CDM
|
Operating Room Services - General Classification
|
28
|
28
|
$12,675.00
|
—
|
$1,500.00
|
$10,773.75
|
$6,337.50
|
2026-02-25
|
|
3607950800{2}
|
CDM
|
Operating Room Services - General Classification
|
28
|
28
|
$12,675.00
|
—
|
$1,500.00
|
$10,773.75
|
$6,337.50
|
2026-02-25
|
|
36556
|
HCPCS
|
Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older)
|
57
|
50
|
$8,936.91
|
$5,279.37
41% off
|
$74.21
|
$9,383.76
|
$4,061.05
|
2026-02-25
|
|
36558
|
HCPCS
|
Insertion Of Tunneled Central Venous Tube For Infusion (5 Years Or Older)
|
50
|
50
|
$8,936.91
|
$5,279.37
41% off
|
$135.63
|
$7,596.37
|
$4,061.05
|
2026-02-25
|
|
3700000000
|
CDM
|
Anes 1st Hr Gnrl
|
28
|
28
|
$8,500.00
|
—
|
$1,500.00
|
$7,225.00
|
$4,250.00
|
2026-02-25
|
|
3700000000{2}
|
CDM
|
Anes 1st Hr Gnrl
|
28
|
28
|
$8,500.00
|
—
|
$1,500.00
|
$7,225.00
|
$4,250.00
|
2026-02-25
|
|
3700000001
|
CDM
|
Anes 1st Hr Gnrl W Rgnl
|
28
|
28
|
$7,500.00
|
—
|
$1,500.00
|
$6,375.00
|
$3,750.00
|
2026-02-25
|
|
3700000001{2}
|
CDM
|
Anes 1st Hr Gnrl W Rgnl
|
28
|
28
|
$7,500.00
|
—
|
$1,500.00
|
$6,375.00
|
$3,750.00
|
2026-02-25
|
|
3700000002
|
CDM
|
Anes 1st Hr Gnrl W Spinal
|
28
|
28
|
$8,500.00
|
—
|
$1,500.00
|
$7,225.00
|
$4,250.00
|
2026-02-25
|
|
3700000002{2}
|
CDM
|
Anes 1st Hr Gnrl W Spinal
|
28
|
28
|
$8,500.00
|
—
|
$1,500.00
|
$7,225.00
|
$4,250.00
|
2026-02-25
|
|
3700000003
|
CDM
|
Anes 1st Hr Rgnl
|
28
|
28
|
$5,500.00
|
—
|
$1,375.00
|
$4,675.00
|
$2,750.00
|
2026-02-25
|
|
3700000003{2}
|
CDM
|
Anes 1st Hr Rgnl
|
28
|
28
|
$5,500.00
|
—
|
$1,375.00
|
$4,675.00
|
$2,750.00
|
2026-02-25
|
|
3700000015
|
CDM
|
Anes 1st Hr Gnrl W Fem Block
|
28
|
28
|
$7,000.00
|
—
|
$1,500.00
|
$5,950.00
|
$3,500.00
|
2026-02-25
|
|
3700000025
|
CDM
|
Anes 1st Hr Spinal&Epidural
|
28
|
28
|
$5,500.00
|
—
|
$1,375.00
|
$4,675.00
|
$2,750.00
|
2026-02-25
|
|
3700000027
|
CDM
|
Anes 1st Hr Gnrl W Epidural
|
28
|
28
|
$7,500.00
|
—
|
$1,500.00
|
$6,375.00
|
$3,750.00
|
2026-02-25
|
|
3700000028
|
CDM
|
Anes 1st Hr Gnrl & Fem
|
28
|
28
|
$7,500.00
|
—
|
$1,500.00
|
$6,375.00
|
$3,750.00
|
2026-02-25
|
|
3700000041
|
CDM
|
Anes 1stáhr Mac W Spinal
|
28
|
28
|
$6,400.00
|
—
|
$1,500.00
|
$5,440.00
|
$3,200.00
|
2026-02-25
|
|
3700000044
|
CDM
|
Anes 1stáhr Mac W Spinal&Rgnl
|
28
|
28
|
$8,600.00
|
—
|
$1,500.00
|
$7,310.00
|
$4,300.00
|
2026-02-25
|
|
3700000045
|
CDM
|
Anes 1st Sub.5hr MAC&Spnl&Rgnl
|
28
|
28
|
$5,765.00
|
—
|
$1,441.25
|
$4,900.25
|
$2,882.50
|
2026-02-25
|
|
3700000047
|
CDM
|
Anes 1stáhr Spinal&Regional
|
28
|
28
|
$6,200.00
|
—
|
$1,500.00
|
$5,270.00
|
$3,100.00
|
2026-02-25
|
|
37191
|
HCPCS
|
Insertion Of Vena Cava Filter With Review By Radiologist
|
50
|
50
|
$15,419.28
|
$9,303.92
40% off
|
$196.27
|
$13,106.39
|
$7,156.86
|
2026-02-25
|
|
37193
|
HCPCS
|
Removal Of Vena Cava Filter With Review By Radiologist
|
50
|
50
|
$8,936.91
|
$5,279.37
41% off
|
$303.15
|
$7,596.37
|
$4,061.05
|
2026-02-25
|
|
377
|
MS_DRG
|
Gastrointestinal Hemorrhage With Mcc
|
20
|
20
|
$83,390.99
|
—
|
$13,320.00
|
$76,719.71
|
$17,369.02
|
2026-02-25
|
|
378
|
MS_DRG
|
Gastrointestinal Hemorrhage With Cc
|
20
|
20
|
$26,319.08
|
$3,250,972.24
|
$1,080.00
|
$24,213.55
|
$9,318.27
|
2026-02-25
|
|
379
|
MS_DRG
|
Gastrointestinal Hemorrhage Without Cc/mcc
|
20
|
20
|
$40,311.44
|
$4,979,328.92
|
$5,989.84
|
$37,086.52
|
$5,989.84
|
2026-02-25
|
|
390
|
MS_DRG
|
Gastrointestinal Obstruction Without Cc/mcc
|
40
|
40
|
$18,599.61
|
$2,297,451.73
|
$4,652.01
|
$17,111.64
|
$5,168.90
|
2026-02-25
|
|
392
|
MS_DRG
|
Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc
|
21
|
21
|
$33,646.81
|
$4,156,103.82
|
$2,200.00
|
$30,955.06
|
$7,407.49
|
2026-02-25
|
|
393
|
MS_DRG
|
Other Digestive System Diagnoses With Mcc
|
37
|
37
|
$47,511.33
|
—
|
$2,200.00
|
$43,710.43
|
$15,195.99
|
2026-02-25
|
|
42
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/mcc
|
40
|
40
|
$20,407.70
|
$2,520,789.72
|
$10,203.85
|
$22,489.92
|
$16,416.00
|
2026-02-25
|
|
439
|
MS_DRG
|
Disorders Of Pancreas Except Malignancy With Cc
|
20
|
20
|
$40,268.14
|
$4,973,981.45
|
$7,992.79
|
$37,046.69
|
$7,992.79
|
2026-02-25
|
|
441
|
MS_DRG
|
Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc
|
9
|
9
|
$4,841.94
|
$598,083.69
|
$2,420.97
|
$4,454.58
|
$3,245.07
|
2026-02-25
|
|
470
|
MS_DRG
|
Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without …
|
41
|
41
|
$79,069.16
|
—
|
$16,494.97
|
$72,743.62
|
$18,327.73
|
2026-02-25
|
|
472
|
MS_DRG
|
Cervical Spinal Fusion With Cc
|
41
|
41
|
$106,153.79
|
—
|
$25,193.54
|
$97,661.49
|
$33,591.37
|
2026-02-25
|
|
47490
|
HCPCS
|
Insertion Of Tube Into Gallbladder Using Imaging Guidance With Review By Radiolo…
|
50
|
50
|
$1,134.00
|
$5,986.49
|
$444.53
|
$5,756.24
|
$4,441.87
|
2026-02-25
|
|
481
|
MS_DRG
|
Hip And Femur Procedures Except Major Joint With Cc
|
41
|
41
|
$75,997.29
|
—
|
$17,911.10
|
$69,917.50
|
$23,881.45
|
2026-02-25
|
|
483
|
MS_DRG
|
Major Joint Or Limb Reattachment Procedures Of Upper Extremities
|
41
|
41
|
$74,367.28
|
—
|
$23,703.88
|
$68,417.90
|
$31,605.15
|
2026-02-25
|
|
49560
|
HCPCS
|
Repair Initial Incisional Or Ventral Hernia; Reducible
|
23
|
23
|
$5,975.00
|
—
|
$1,500.00
|
$14,937.50
|
$2,987.50
|
2026-02-25
|
|
49585
|
HCPCS
|
Repair Umbilical Hernia, Age 5 Years Or Older; Reducible
|
23
|
23
|
$7,840.00
|
—
|
$1,500.00
|
$19,600.00
|
$3,920.00
|
2026-02-25
|
|
49652
|
HCPCS
|
Laparoscopy, Surgical, Repair, Ventral, Umbilical, Spigelian Or Epigastric Herni…
|
23
|
23
|
$10,785.00
|
—
|
$1,500.00
|
$26,962.50
|
$5,392.50
|
2026-02-25
|
|
49653
|
HCPCS
|
Laparoscopy, Surgical, Repair, Ventral, Umbilical, Spigelian Or Epigastric Herni…
|
23
|
23
|
$10,785.00
|
—
|
$1,500.00
|
$26,962.50
|
$5,392.50
|
2026-02-25
|
|
49654
|
HCPCS
|
Laparoscopy, Surgical, Repair, Incisional Hernia (includes Mesh Insertion, When …
|
23
|
23
|
$10,785.00
|
—
|
$1,500.00
|
$26,962.50
|
$5,392.50
|
2026-02-25
|
|
516
|
MS_DRG
|
Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc
|
41
|
41
|
$85,929.95
|
—
|
$17,770.85
|
$79,055.55
|
$22,680.56
|
2026-02-25
|
|
517
|
MS_DRG
|
Other Musculoskeletal System And Connective Tissue O.r. Procedures Without Cc/mc…
|
40
|
40
|
$39,964.25
|
$4,936,443.49
|
$13,141.07
|
$36,767.11
|
$14,601.19
|
2026-02-25
|
|
519
|
MS_DRG
|
Back And Neck Procedures Except Spinal Fusion With Cc
|
39
|
39
|
$54,825.12
|
—
|
$12,929.40
|
$50,439.11
|
$19,005.20
|
2026-02-25
|
|
520
|
MS_DRG
|
Back And Neck Procedures Except Spinal Fusion Without Cc/mcc
|
39
|
39
|
$40,738.41
|
—
|
$12,775.07
|
$37,479.34
|
$14,194.51
|
2026-02-25
|
|
522
|
MS_DRG
|
Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc
|
41
|
41
|
$70,172.54
|
—
|
$18,109.49
|
$64,558.74
|
$24,145.97
|
2026-02-25
|
|
536
|
MS_DRG
|
Fractures Of Hip And Pelvis Without Mcc
|
39
|
39
|
$32,091.67
|
$3,964,011.22
|
$6,906.18
|
$29,524.34
|
$7,673.53
|
2026-02-25
|
|
540
|
MS_DRG
|
Osteomyelitis With Cc
|
40
|
40
|
$34,920.06
|
$4,313,378.19
|
$11,085.30
|
$32,126.46
|
$12,316.99
|
2026-02-25
|
|
552
|
MS_DRG
|
Medical Back Problems Without Mcc
|
21
|
21
|
$60,226.03
|
—
|
$2,200.00
|
$55,407.95
|
$9,133.94
|
2026-02-25
|
|
554
|
MS_DRG
|
Bone Diseases And Arthropathies Without Mcc
|
20
|
20
|
$38,842.62
|
$4,797,898.07
|
$7,887.32
|
$35,735.21
|
$7,887.32
|
2026-02-25
|
|
57
|
MS_DRG
|
Degenerative Nervous System Disorders Without Mcc
|
20
|
20
|
$74,196.56
|
—
|
$12,310.34
|
$68,260.84
|
$12,310.34
|
2026-02-25
|
|
57288
|
HCPCS
|
Creation Of Sling Around Urethra In Female To Control Leakage
|
50
|
50
|
$13,905.33
|
$8,364.19
40% off
|
$775.25
|
$11,819.53
|
$6,433.99
|
2026-02-25
|
|
59
|
MS_DRG
|
Multiple Sclerosis And Cerebellar Ataxia With Cc
|
20
|
20
|
$62,964.00
|
—
|
$11,790.60
|
$57,926.88
|
$11,790.60
|
2026-02-25
|
|
593
|
MS_DRG
|
Skin Ulcers With Cc
|
38
|
38
|
$18,223.67
|
$2,251,015.05
|
$2,200.00
|
$16,765.78
|
$11,271.81
|
2026-02-25
|
|
602
|
MS_DRG
|
Cellulitis With Mcc
|
37
|
37
|
$15,794.31
|
$1,950,936.86
|
$2,200.00
|
$18,501.43
|
$13,504.70
|
2026-02-25
|
|
603
|
MS_DRG
|
Cellulitis Without Mcc
|
21
|
21
|
$23,034.26
|
$2,845,226.52
|
$2,200.00
|
$21,191.52
|
$8,274.99
|
2026-02-25
|
|
617
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
40
|
40
|
$21,334.24
|
$2,635,237.33
|
$10,667.12
|
$24,346.18
|
$17,770.94
|
2026-02-25
|
|
623
|
MS_DRG
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
37
|
37
|
$47,051.81
|
—
|
$2,200.00
|
$43,287.67
|
$17,045.01
|
2026-02-25
|
|
629
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc
|
41
|
41
|
$62,244.90
|
—
|
$18,631.99
|
$57,265.30
|
$24,842.63
|
2026-02-25
|
|
636Q414803
|
CDM
|
Neox-« Cord 1k 6.0x3.0cm
|
29
|
29
|
$6,300.00
|
—
|
$1,500.00
|
$6,615.00
|
$3,150.00
|
2026-02-25
|
|
638
|
MS_DRG
|
Diabetes With Cc
|
21
|
21
|
$33,333.36
|
$4,117,386.61
|
$2,200.00
|
$30,666.69
|
$8,515.38
|
2026-02-25
|
|
64
|
MS_DRG
|
Intracranial Hemorrhage Or Cerebral Infarction With Mcc
|
40
|
40
|
$27,794.04
|
$3,433,161.51
|
$13,897.02
|
$26,177.71
|
$19,107.82
|
2026-02-25
|
|
640
|
MS_DRG
|
Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M…
|
37
|
37
|
$21,898.44
|
$2,704,928.47
|
$2,200.00
|
$20,146.57
|
$12,690.40
|
2026-02-25
|
|
641
|
MS_DRG
|
Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou…
|
21
|
21
|
$13,997.18
|
$1,728,952.66
|
$300.00
|
$12,877.41
|
$7,394.18
|
2026-02-25
|
|
674
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Cc
|
20
|
20
|
$72,815.69
|
—
|
$22,220.56
|
$66,990.43
|
$22,220.56
|
2026-02-25
|
|
682
|
MS_DRG
|
Renal Failure With Mcc
|
20
|
20
|
$36,638.54
|
$4,525,646.97
|
$6,000.00
|
$33,707.45
|
$14,071.94
|
2026-02-25
|
|
683
|
MS_DRG
|
Renal Failure With Cc
|
21
|
21
|
$27,095.70
|
$3,346,901.48
|
$2,200.00
|
$24,928.04
|
$8,321.55
|
2026-02-25
|
|
689
|
MS_DRG
|
Kidney And Urinary Tract Infections With Mcc
|
21
|
21
|
$33,175.01
|
$4,097,827.42
|
$2,200.00
|
$30,521.01
|
$11,024.76
|
2026-02-25
|
|
690
|
MS_DRG
|
Kidney And Urinary Tract Infections Without Mcc
|
21
|
21
|
$22,591.44
|
$2,790,528.06
|
$2,200.00
|
$20,784.12
|
$7,691.59
|
2026-02-25
|
|
75825
|
HCPCS
|
Review By Radiologist Of Major Lower Body Vein Image
|
49
|
49
|
$523.60
|
$5,279.37
|
$173.32
|
$5,076.31
|
$3,858.00
|
2026-02-25
|
|
811
|
MS_DRG
|
Red Blood Cell Disorders With Mcc
|
39
|
39
|
$95,598.37
|
—
|
$12,008.86
|
$87,950.50
|
$13,343.17
|
2026-02-25
|
|
812
|
MS_DRG
|
Red Blood Cell Disorders Without Mcc
|
38
|
38
|
$11,931.91
|
$1,473,847.42
|
$2,200.00
|
$11,952.45
|
$8,724.42
|
2026-02-25
|
|
813
|
MS_DRG
|
Coagulation Disorders
|
40
|
40
|
$19,642.58
|
$2,426,280.95
|
$9,821.29
|
$19,855.23
|
$14,492.87
|
2026-02-25
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
37
|
37
|
$131,013.71
|
—
|
$2,200.00
|
$120,532.62
|
$46,924.85
|
2026-02-25
|
|
854
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Cc
|
37
|
37
|
$80,248.68
|
—
|
$2,200.00
|
$73,828.79
|
$18,985.25
|
2026-02-25
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
39
|
39
|
$287,481.93
|
—
|
$59,106.19
|
$264,483.38
|
$65,673.50
|
2026-02-25
|
|
871
|
MS_DRG
|
Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc
|
21
|
21
|
$62,061.40
|
—
|
$1,408.70
|
$57,096.49
|
$18,456.96
|
2026-02-25
|
|
872
|
MS_DRG
|
Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc
|
37
|
37
|
$22,904.62
|
$2,829,213.23
|
$2,200.00
|
$21,072.25
|
$9,723.04
|
2026-02-25
|
|
897
|
MS_DRG
|
Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc
|
40
|
40
|
$13,003.66
|
$1,606,231.59
|
$6,501.83
|
$11,963.37
|
$8,388.06
|
2026-02-25
|
|
909
|
MS_DRG
|
Other O.r. Procedures For Injuries Without Cc/mcc
|
41
|
41
|
$105,938.48
|
—
|
$11,225.54
|
$97,463.40
|
$14,967.38
|
2026-02-25
|
|
93
|
MS_DRG
|
Other Disorders Of Nervous System Without Cc/mcc
|
20
|
20
|
$78,007.47
|
—
|
$7,566.16
|
$71,766.87
|
$7,566.16
|
2026-02-25
|
|
948
|
MS_DRG
|
Signs And Symptoms Without Mcc
|
20
|
20
|
$49,305.14
|
—
|
$7,606.07
|
$45,360.73
|
$7,606.07
|
2026-02-25
|
|
988
|
MS_DRG
|
Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc
|
40
|
40
|
$26,547.43
|
$3,279,178.37
|
$13,273.72
|
$24,423.64
|
$15,616.91
|
2026-02-25
|
|
C1052
|
HCPCS
|
Hemostatic Agent, Gastrointestinal, Topical
|
25
|
25
|
$4,875.00
|
—
|
$1,500.00
|
$12,187.50
|
$3,500.00
|
2026-02-25
|
|
C1602
|
HCPCS
|
Orthopedic/device/drug Matrix/absorbable Bone Void Filler, Antimicrobial-eluting…
|
25
|
25
|
$12,366.00
|
—
|
$1,500.00
|
$30,915.00
|
$6,183.00
|
2026-02-25
|
|
C1729
|
HCPCS
|
Catheter, Drainage
|
126
|
25
|
$4,696.56
|
—
|
$330.40
|
$44,533.20
|
$3,500.00
|
2026-02-25
|
|
C1755
|
HCPCS
|
Catheter, Intraspinal
|
25
|
25
|
$3,483.00
|
—
|
$1,299.16
|
$8,707.50
|
$2,786.40
|
2026-02-25
|
|
C1767
|
HCPCS
|
Generator, Neurostimulator (implantable), Non-rechargeable
|
76
|
25
|
$57,300.00
|
—
|
$1,500.00
|
$145,125.00
|
$28,650.00
|
2026-02-25
|
|
C1771
|
HCPCS
|
Repair Device, Urinary, Incontinence, With Sling Graft
|
50
|
25
|
$4,242.00
|
—
|
$1,106.69
|
$13,792.50
|
$2,758.50
|
2026-02-25
|
|
C1776
|
HCPCS
|
Joint Device (implantable)
|
7,225
|
25
|
$4,077.00
|
—
|
$1.20
|
$158,355.00
|
$3,000.00
|
2026-02-25
|
|
C1778
|
HCPCS
|
Lead, Neurostimulator (implantable)
|
511
|
25
|
$9,000.00
|
—
|
$48.00
|
$195,000.00
|
$5,812.50
|
2026-02-25
|
|
C1787
|
HCPCS
|
Patient Programmer, Neurostimulator
|
25
|
25
|
$8,427.00
|
—
|
$1,500.00
|
$21,067.50
|
$4,213.50
|
2026-02-25
|
|
C1820
|
HCPCS
|
Generator, Neurostimulator (implantable), With Rechargeable Battery And Charging…
|
67
|
25
|
$58,500.00
|
—
|
$1,119.00
|
$147,000.00
|
$21,820.50
|
2026-02-25
|
|
C1823
|
HCPCS
|
Generator, Neurostimulator (implantable), Non-rechargeable, With Transvenous Sen…
|
25
|
25
|
$81,300.00
|
—
|
$1,500.00
|
$203,250.00
|
$40,650.00
|
2026-02-25
|
|
C1827
|
HCPCS
|
Generator, Neurostimulator (implantable), Non-rechargeable, With Implantable Sti…
|
25
|
25
|
$27,500.00
|
—
|
$1,500.00
|
$68,750.00
|
$13,750.00
|
2026-02-25
|
|
C1831
|
HCPCS
|
Interbody Cage, Anterior, Lateral Or Posterior, Personalized (implantable)
|
851
|
25
|
$12,600.00
|
—
|
$496.80
|
$132,168.75
|
$8,100.00
|
2026-02-25
|
|
C1876
|
HCPCS
|
Stent, Non-coated/non-covered, With Delivery System
|
25
|
25
|
$9,523.35
|
—
|
$1,500.00
|
$23,808.38
|
$4,761.68
|
2026-02-25
|
|
C1889
|
HCPCS
|
Implantable/insertable Device, Not Otherwise Classified
|
25
|
25
|
$39,906.00
|
—
|
$1,500.00
|
$99,765.00
|
$19,953.00
|
2026-02-25
|
|
C9761
|
HCPCS
|
Cystourethroscopy, With Ureteroscopy And/or Pyeloscopy, With Lithotripsy, And Ur…
|
56
|
47
|
$13,635.00
|
$15,828.15
|
$1,500.00
|
$15,219.38
|
$9,908.33
|
2026-02-25
|
|
E0783
|
HCPCS
|
Infusion Pump System, Implantable, Programmable (includes All Components, E.g., …
|
65
|
50
|
$37,347.00
|
$15,167.69
59% off
|
$9,333.96
|
$128,400.00
|
$14,584.31
|
2026-02-25
|
|
J0139
|
HCPCS
|
Injection, Adalimumab, 1 Mg
|
27
|
27
|
$9,313.36
|
—
|
$1,500.00
|
$10,244.70
|
$4,656.68
|
2026-02-25
|
|
J0630
|
HCPCS
|
Injection, Calcitonin Salmon, Up To 400 Units
|
23
|
23
|
$11,275.56
|
—
|
$1,500.00
|
$12,403.12
|
$5,637.78
|
2026-02-25
|
|
J1162
|
HCPCS
|
Injection, Digoxin Immune Fab (ovine), Per Vial
|
50
|
50
|
$13,266.00
|
$6,718.70
49% off
|
$1,500.00
|
$14,592.60
|
$5,168.23
|
2026-02-25
|
|
L8679
|
HCPCS
|
Implantable Neurostimulator, Pulse Generator, Any Type
|
65
|
50
|
$27,480.00
|
$13,688.92
50% off
|
$8,423.95
|
$63,030.00
|
$13,162.43
|
2026-02-25
|
|
L8687
|
HCPCS
|
Implantable Neurostimulator Pulse Generator, Dual Array, Rechargeable, Includes …
|
25
|
25
|
$63,342.00
|
—
|
$1,500.00
|
$69,676.20
|
$31,671.00
|
2026-02-25
|
|
L8692
|
HCPCS
|
Auditory Osseointegrated Device, External Sound Processor, Used Without Osseoint…
|
38
|
23
|
$12,474.00
|
—
|
$1,500.00
|
$14,784.00
|
$6,720.00
|
2026-02-25
|
|
V2790
|
HCPCS
|
Amniotic Membrane For Surgical Reconstruction, Per Procedure
|
25
|
25
|
$6,200.00
|
—
|
$1,500.00
|
$15,500.00
|
$3,500.00
|
2026-02-25
|
|
V5130
|
HCPCS
|
Binaural, In The Ear
|
23
|
23
|
$8,000.00
|
—
|
$1,500.00
|
$20,000.00
|
$4,000.00
|
2026-02-25
|
|
V5140
|
HCPCS
|
Binaural, Behind The Ear
|
23
|
23
|
$8,000.00
|
—
|
$1,500.00
|
$20,000.00
|
$4,000.00
|
2026-02-25
|
|
V5221
|
HCPCS
|
Hearing Aid, Contralateral Routing System, Binaural, Bte/bte
|
23
|
23
|
$8,000.00
|
—
|
$1,500.00
|
$20,000.00
|
$4,000.00
|
2026-02-25
|