|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
3
|
3
|
$140,938.00
|
$140,938.00
|
$87,900.96
|
$116,908.28
|
$89,658.98
|
2025-10-04
|
|
956
|
MS_DRG
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
2
|
2
|
$123,315.74
|
$123,315.74
|
$68,336.66
|
$69,703.39
|
$69,020.02
|
2025-10-04
|
|
958
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
2
|
2
|
$56,833.50
|
$56,833.50
|
$68,336.66
|
$69,703.39
|
$69,020.02
|
2025-10-04
|
|
654
|
MS_DRG
|
Major Bladder Procedures With Cc
|
3
|
3
|
$79,502.50
|
$79,502.50
|
$67,254.72
|
$89,448.78
|
$68,599.82
|
2025-10-04
|
|
77371
|
HCPCS
|
Complete Single Session Course Of Cranial Lesion Surgery Using Radiation
|
22
|
22
|
$76,101.00
|
$76,101.00
|
$1,078.50
|
$73,817.97
|
$68,490.90
|
2025-10-04
|
|
J2350
|
HCPCS
|
Injection, Ocrelizumab, 1 Mg
|
22
|
22
|
$72,995.50
|
$72,995.50
|
$62.81
|
$70,805.64
|
$65,695.95
|
2025-10-04
|
|
559
|
MS_DRG
|
Aftercare, Musculoskeletal System And Connective Tissue With Mcc
|
3
|
3
|
$27,350.10
|
$27,350.10
|
$56,443.79
|
$75,070.24
|
$57,572.66
|
2025-10-04
|
|
940
|
MS_DRG
|
O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc
|
2
|
2
|
$66,833.00
|
$66,833.00
|
$56,443.79
|
$57,572.66
|
$57,008.23
|
2025-10-04
|
|
941
|
MS_DRG
|
O.r. Procedures With Diagnoses Of Other Contact With Health Services Without Cc/…
|
2
|
2
|
$138,595.50
|
$138,595.50
|
$56,443.79
|
$57,572.66
|
$57,008.23
|
2025-10-04
|
|
939
|
MS_DRG
|
O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc
|
2
|
2
|
$60,918.00
|
$60,918.00
|
$56,443.79
|
$57,572.66
|
$57,008.23
|
2025-10-04
|
|
J3241
|
HCPCS
|
Injection, Teprotumumab-trbw, 10 Mg
|
21
|
21
|
$62,275.50
|
$62,275.50
|
$352.56
|
$60,407.24
|
$56,047.95
|
2025-10-04
|
|
327
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Cc
|
3
|
3
|
$79,377.13
|
$79,377.13
|
$54,931.39
|
$73,058.75
|
$56,030.02
|
2025-10-04
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
3
|
3
|
$159,622.50
|
$159,622.50
|
$54,931.39
|
$73,058.75
|
$56,030.02
|
2025-10-04
|
|
328
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures Without Cc/mcc
|
3
|
3
|
$44,199.50
|
$44,199.50
|
$54,931.39
|
$73,058.75
|
$56,030.02
|
2025-10-04
|
|
982
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc
|
2
|
2
|
$24,070.00
|
$24,070.00
|
$54,810.36
|
$55,906.57
|
$55,358.46
|
2025-10-04
|
|
801
|
MS_DRG
|
Splenic Procedures Without Cc/mcc
|
3
|
3
|
$64,063.80
|
$64,063.80
|
$50,965.70
|
$67,784.38
|
$51,985.01
|
2025-10-04
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
3
|
3
|
$35,839.50
|
$35,839.50
|
$49,195.45
|
$65,429.95
|
$50,179.36
|
2025-10-04
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
3
|
3
|
$39,133.98
|
$39,133.98
|
$48,499.77
|
$64,504.69
|
$49,469.76
|
2025-10-04
|
|
498
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…
|
2
|
2
|
$37,772.50
|
$37,772.50
|
$48,948.12
|
$49,927.08
|
$49,437.60
|
2025-10-04
|
|
496
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…
|
2
|
2
|
$78,061.25
|
$78,061.25
|
$48,948.12
|
$49,927.08
|
$49,437.60
|
2025-10-04
|
|
497
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…
|
2
|
2
|
$118,277.02
|
$118,277.02
|
$48,948.12
|
$49,927.08
|
$49,437.60
|
2025-10-04
|
|
481
|
MS_DRG
|
Hip And Femur Procedures Except Major Joint With Cc
|
2
|
2
|
$84,310.12
|
$84,310.12
|
$48,948.12
|
$49,927.08
|
$49,437.60
|
2025-10-04
|
|
482
|
MS_DRG
|
Hip And Femur Procedures Except Major Joint Without Cc/mcc
|
2
|
2
|
$76,498.05
|
$76,498.05
|
$48,948.12
|
$49,927.08
|
$49,437.60
|
2025-10-04
|
|
495
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…
|
2
|
2
|
$124,521.53
|
$124,521.53
|
$48,948.12
|
$49,927.08
|
$49,437.60
|
2025-10-04
|
|
480
|
MS_DRG
|
Hip And Femur Procedures Except Major Joint With Mcc
|
2
|
2
|
$122,608.42
|
$122,608.42
|
$48,948.12
|
$49,927.08
|
$49,437.60
|
2025-10-04
|
|
242
|
MS_DRG
|
Permanent Cardiac Pacemaker Implant With Mcc
|
2
|
2
|
$79,928.00
|
$79,928.00
|
$48,802.88
|
$49,778.94
|
$49,290.91
|
2025-10-04
|
|
243
|
MS_DRG
|
Permanent Cardiac Pacemaker Implant With Cc
|
2
|
2
|
$82,484.96
|
$82,484.96
|
$48,802.88
|
$49,778.94
|
$49,290.91
|
2025-10-04
|
|
854
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Cc
|
2
|
2
|
$60,121.38
|
$60,121.38
|
$48,499.77
|
$49,469.76
|
$48,984.76
|
2025-10-04
|
|
263
|
MS_DRG
|
Vein Ligation And Stripping
|
3
|
3
|
$95,603.50
|
$95,603.50
|
$47,091.57
|
$62,631.79
|
$48,033.40
|
2025-10-04
|
|
492
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc
|
2
|
2
|
$96,916.33
|
$96,916.33
|
$47,508.35
|
$48,458.51
|
$47,983.43
|
2025-10-04
|
|
487
|
MS_DRG
|
Knee Procedures With Principal Diagnosis Of Infection Without Cc/mcc
|
2
|
2
|
$48,384.17
|
$48,384.17
|
$47,508.35
|
$48,458.51
|
$47,983.43
|
2025-10-04
|
|
494
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/mcc
|
2
|
2
|
$69,009.75
|
$69,009.75
|
$47,508.35
|
$48,458.51
|
$47,983.43
|
2025-10-04
|
|
462
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc
|
2
|
2
|
$104,965.28
|
$104,965.28
|
$47,508.35
|
$48,458.51
|
$47,983.43
|
2025-10-04
|
|
489
|
MS_DRG
|
Knee Procedures Without Principal Diagnosis Of Infection Without Cc/mcc
|
2
|
2
|
$54,514.00
|
$54,514.00
|
$47,508.35
|
$48,458.51
|
$47,983.43
|
2025-10-04
|
|
488
|
MS_DRG
|
Knee Procedures Without Principal Diagnosis Of Infection With Cc/mcc
|
2
|
2
|
$68,974.50
|
$68,974.50
|
$47,508.35
|
$48,458.51
|
$47,983.43
|
2025-10-04
|
|
493
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc
|
2
|
2
|
$78,629.04
|
$78,629.04
|
$47,508.35
|
$48,458.51
|
$47,983.43
|
2025-10-04
|
|
485
|
MS_DRG
|
Knee Procedures With Principal Diagnosis Of Infection With Mcc
|
2
|
2
|
$134,063.00
|
$134,063.00
|
$47,508.35
|
$48,458.51
|
$47,983.43
|
2025-10-04
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
2
|
2
|
$182,030.99
|
$182,030.99
|
$47,508.35
|
$48,458.51
|
$47,983.43
|
2025-10-04
|
|
336
|
MS_DRG
|
Peritoneal Adhesiolysis With Cc
|
3
|
3
|
$89,172.00
|
$89,172.00
|
$44,737.20
|
$59,500.48
|
$45,631.94
|
2025-10-04
|
|
337
|
MS_DRG
|
Peritoneal Adhesiolysis Without Cc/mcc
|
3
|
3
|
$24,846.50
|
$24,846.50
|
$44,737.20
|
$59,500.48
|
$45,631.94
|
2025-10-04
|
|
742
|
MS_DRG
|
Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc
|
2
|
2
|
$53,078.13
|
$53,078.13
|
$44,076.25
|
$44,957.78
|
$44,517.01
|
2025-10-04
|
|
261
|
MS_DRG
|
Cardiac Pacemaker Revision Except Device Replacement With Cc
|
3
|
3
|
$46,017.50
|
$46,017.50
|
$42,581.75
|
$56,633.73
|
$43,433.38
|
2025-10-04
|
|
512
|
MS_DRG
|
Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures Without Cc/…
|
3
|
3
|
$31,892.00
|
$31,892.00
|
$42,371.26
|
$56,353.77
|
$43,218.68
|
2025-10-04
|
|
509
|
MS_DRG
|
Arthroscopy
|
3
|
3
|
$250,232.50
|
$250,232.50
|
$42,371.26
|
$56,353.77
|
$43,218.68
|
2025-10-04
|
|
511
|
MS_DRG
|
Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc
|
2
|
2
|
$90,890.50
|
$90,890.50
|
$42,371.26
|
$43,218.68
|
$42,794.97
|
2025-10-04
|
|
508
|
MS_DRG
|
Major Shoulder Or Elbow Joint Procedures Without Cc/mcc
|
2
|
2
|
$57,607.00
|
$57,607.00
|
$42,371.26
|
$43,218.68
|
$42,794.97
|
2025-10-04
|
|
858
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures Without Cc/mcc
|
3
|
3
|
$43,589.00
|
$43,589.00
|
$40,897.80
|
$54,394.08
|
$41,715.76
|
2025-10-04
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
2
|
2
|
$69,427.00
|
$69,427.00
|
$40,897.80
|
$41,715.76
|
$41,306.78
|
2025-10-04
|
|
857
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc
|
2
|
2
|
$84,355.00
|
$84,355.00
|
$40,897.80
|
$41,715.76
|
$41,306.78
|
2025-10-04
|
|
264
|
MS_DRG
|
Other Circulatory System O.r. Procedures
|
3
|
3
|
$126,747.50
|
$126,747.50
|
$40,350.52
|
$53,666.19
|
$41,157.53
|
2025-10-04
|
|
617
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
3
|
3
|
$42,195.27
|
$42,195.27
|
$40,275.79
|
$53,566.81
|
$41,081.31
|
2025-10-04
|
|
629
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc
|
3
|
3
|
$20,083.50
|
$20,083.50
|
$40,275.79
|
$53,566.81
|
$41,081.31
|
2025-10-04
|
|
622
|
MS_DRG
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
3
|
3
|
$71,903.50
|
$71,903.50
|
$40,275.79
|
$53,566.81
|
$41,081.31
|
2025-10-04
|
|
475
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc
|
3
|
3
|
$34,719.69
|
$34,719.69
|
$40,197.91
|
$53,463.22
|
$41,001.87
|
2025-10-04
|
|
241
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc…
|
3
|
3
|
$25,920.00
|
$25,920.00
|
$40,197.91
|
$53,463.22
|
$41,001.87
|
2025-10-04
|
|
255
|
MS_DRG
|
Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc
|
3
|
3
|
$166,532.49
|
$166,532.49
|
$40,197.91
|
$53,463.22
|
$41,001.87
|
2025-10-04
|
|
476
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders Without Cc…
|
3
|
3
|
$27,632.88
|
$27,632.88
|
$40,197.91
|
$53,463.22
|
$41,001.87
|
2025-10-04
|
|
240
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc
|
3
|
3
|
$28,054.21
|
$28,054.21
|
$40,197.91
|
$53,463.22
|
$41,001.87
|
2025-10-04
|
|
907
|
MS_DRG
|
Other O.r. Procedures For Injuries With Mcc
|
3
|
3
|
$154,161.31
|
$154,161.31
|
$40,004.26
|
$53,205.66
|
$40,804.34
|
2025-10-04
|
|
909
|
MS_DRG
|
Other O.r. Procedures For Injuries Without Cc/mcc
|
3
|
3
|
$22,479.50
|
$22,479.50
|
$40,004.26
|
$53,205.66
|
$40,804.34
|
2025-10-04
|
|
542
|
MS_DRG
|
Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With…
|
3
|
3
|
$36,216.83
|
$36,216.83
|
$40,004.26
|
$53,205.66
|
$40,804.34
|
2025-10-04
|
|
908
|
MS_DRG
|
Other O.r. Procedures For Injuries With Cc
|
3
|
3
|
$93,338.00
|
$93,338.00
|
$40,004.26
|
$53,205.66
|
$40,804.34
|
2025-10-04
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
2
|
2
|
$48,948.00
|
$48,948.00
|
$40,197.91
|
$41,001.87
|
$40,599.89
|
2025-10-04
|
|
516
|
MS_DRG
|
Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc
|
2
|
2
|
$83,116.00
|
$83,116.00
|
$40,004.26
|
$40,804.34
|
$40,404.30
|
2025-10-04
|
|
479
|
MS_DRG
|
Biopsies Of Musculoskeletal System And Connective Tissue Without Cc/mcc
|
2
|
2
|
$51,523.00
|
$51,523.00
|
$40,004.26
|
$40,804.34
|
$40,404.30
|
2025-10-04
|
|
518
|
MS_DRG
|
Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…
|
2
|
2
|
$70,558.50
|
$70,558.50
|
$40,004.26
|
$40,804.34
|
$40,404.30
|
2025-10-04
|
|
515
|
MS_DRG
|
Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc
|
2
|
2
|
$93,069.00
|
$93,069.00
|
$40,004.26
|
$40,804.34
|
$40,404.30
|
2025-10-04
|
|
483
|
MS_DRG
|
Major Joint Or Limb Reattachment Procedures Of Upper Extremities
|
2
|
2
|
$94,337.55
|
$94,337.55
|
$40,004.26
|
$40,804.34
|
$40,404.30
|
2025-10-04
|
|
344
|
MS_DRG
|
Minor Small And Large Bowel Procedures With Mcc
|
2
|
2
|
$157,187.00
|
$157,187.00
|
$39,837.97
|
$40,634.73
|
$40,236.35
|
2025-10-04
|
|
661
|
MS_DRG
|
Kidney And Ureter Procedures For Non-neoplasm Without Cc/mcc
|
2
|
2
|
$17,296.50
|
$17,296.50
|
$39,512.76
|
$40,303.01
|
$39,907.89
|
2025-10-04
|
|
660
|
MS_DRG
|
Kidney And Ureter Procedures For Non-neoplasm With Cc
|
2
|
2
|
$47,080.74
|
$47,080.74
|
$39,512.76
|
$40,303.01
|
$39,907.89
|
2025-10-04
|
|
715
|
MS_DRG
|
Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc
|
3
|
3
|
$36,050.00
|
$36,050.00
|
$38,239.27
|
$50,858.23
|
$39,004.06
|
2025-10-04
|
|
354
|
MS_DRG
|
Hernia Procedures Except Inguinal And Femoral With Cc
|
2
|
2
|
$30,531.50
|
$30,531.50
|
$38,075.09
|
$38,836.59
|
$38,455.84
|
2025-10-04
|
|
418
|
MS_DRG
|
Laparoscopic Cholecystectomy Without C.d.e. With Cc
|
3
|
3
|
$59,790.45
|
$59,790.45
|
$37,296.26
|
$49,604.03
|
$38,042.19
|
2025-10-04
|
|
419
|
MS_DRG
|
Laparoscopic Cholecystectomy Without C.d.e. Without Cc/mcc
|
2
|
2
|
$106,682.50
|
$106,682.50
|
$37,296.26
|
$38,042.19
|
$37,669.23
|
2025-10-04
|
|
417
|
MS_DRG
|
Laparoscopic Cholecystectomy Without C.d.e. With Mcc
|
2
|
2
|
$80,932.74
|
$80,932.74
|
$37,296.26
|
$38,042.19
|
$37,669.23
|
2025-10-04
|
|
138
|
MS_DRG
|
Mouth Procedures Without Cc/mcc
|
3
|
3
|
$17,382.50
|
$17,382.50
|
$36,106.97
|
$48,022.28
|
$36,829.11
|
2025-10-04
|
|
139
|
MS_DRG
|
Salivary Gland Procedures
|
3
|
3
|
$41,591.25
|
$41,591.25
|
$36,106.97
|
$48,022.28
|
$36,829.11
|
2025-10-04
|
|
988
|
MS_DRG
|
Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc
|
3
|
3
|
$34,985.90
|
$34,985.90
|
$35,507.07
|
$47,224.40
|
$36,217.21
|
2025-10-04
|
|
987
|
MS_DRG
|
Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
3
|
3
|
$44,731.35
|
$44,731.35
|
$35,507.07
|
$47,224.40
|
$36,217.21
|
2025-10-04
|
|
663
|
MS_DRG
|
Minor Bladder Procedures With Cc
|
2
|
2
|
$42,341.25
|
$42,341.25
|
$35,598.63
|
$36,310.61
|
$35,954.62
|
2025-10-04
|
|
59
|
MS_DRG
|
Multiple Sclerosis And Cerebellar Ataxia With Cc
|
3
|
3
|
$25,723.50
|
$25,723.50
|
$35,061.87
|
$46,632.29
|
$35,763.11
|
2025-10-04
|
|
501
|
MS_DRG
|
Soft Tissue Procedures With Cc
|
3
|
3
|
$51,245.70
|
$51,245.70
|
$34,882.96
|
$46,394.33
|
$35,580.61
|
2025-10-04
|
|
557
|
MS_DRG
|
Tendonitis, Myositis And Bursitis With Mcc
|
3
|
3
|
$30,105.00
|
$30,105.00
|
$34,882.96
|
$46,394.33
|
$35,580.61
|
2025-10-04
|
|
558
|
MS_DRG
|
Tendonitis, Myositis And Bursitis Without Mcc
|
3
|
3
|
$15,702.58
|
$15,702.58
|
$34,882.96
|
$46,394.33
|
$35,580.61
|
2025-10-04
|
|
500
|
MS_DRG
|
Soft Tissue Procedures With Mcc
|
2
|
2
|
$112,250.50
|
$112,250.50
|
$34,882.96
|
$35,580.61
|
$35,231.79
|
2025-10-04
|
|
502
|
MS_DRG
|
Soft Tissue Procedures Without Cc/mcc
|
2
|
2
|
$42,629.50
|
$42,629.50
|
$34,882.96
|
$35,580.61
|
$35,231.79
|
2025-10-04
|
|
711
|
MS_DRG
|
Testes Procedures With Cc/mcc
|
3
|
3
|
$119,113.75
|
$119,113.75
|
$34,194.64
|
$45,478.87
|
$34,878.53
|
2025-10-04
|
|
288
|
MS_DRG
|
Acute And Subacute Endocarditis With Mcc
|
2
|
2
|
$14,913.00
|
$14,913.00
|
$34,421.97
|
$35,110.41
|
$34,766.19
|
2025-10-04
|
|
320
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures Without Mcc
|
2
|
2
|
$85,857.50
|
$85,857.50
|
$34,421.97
|
$35,110.41
|
$34,766.19
|
2025-10-04
|
|
504
|
MS_DRG
|
Foot Procedures With Cc
|
3
|
3
|
$28,886.00
|
$28,886.00
|
$33,772.60
|
$44,917.56
|
$34,448.05
|
2025-10-04
|
|
505
|
MS_DRG
|
Foot Procedures Without Cc/mcc
|
2
|
2
|
$143,929.54
|
$143,929.54
|
$33,772.60
|
$34,448.05
|
$34,110.32
|
2025-10-04
|
|
503
|
MS_DRG
|
Foot Procedures With Mcc
|
2
|
2
|
$156,725.00
|
$156,725.00
|
$33,772.60
|
$34,448.05
|
$34,110.32
|
2025-10-04
|
|
J9316
|
HCPCS
|
Injection, Pertuzumab, Trastuzumab, And Hyaluronidase-zzxf, Per 10 Mg
|
39
|
21
|
$52,119.50
|
$52,119.50
|
$107.65
|
$50,555.92
|
$33,007.75
|
2025-10-04
|
|
841
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Cc
|
3
|
3
|
$60,753.95
|
$60,753.95
|
$31,983.41
|
$42,537.93
|
$32,623.08
|
2025-10-04
|
|
824
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Cc
|
3
|
3
|
$43,827.71
|
$43,827.71
|
$31,983.41
|
$42,537.93
|
$32,623.08
|
2025-10-04
|
|
J1930
|
HCPCS
|
Injection, Lanreotide, 1 Mg
|
22
|
22
|
$35,914.00
|
$35,914.00
|
$68.69
|
$34,836.58
|
$32,322.60
|
2025-10-04
|
|
842
|
MS_DRG
|
Lymphoma And Non-acute Leukemia Without Cc/mcc
|
2
|
2
|
$11,749.50
|
$11,749.50
|
$31,983.41
|
$32,623.08
|
$32,303.25
|
2025-10-04
|
|
906
|
MS_DRG
|
Hand Procedures For Injuries
|
3
|
3
|
$54,661.00
|
$54,661.00
|
$31,178.27
|
$41,467.10
|
$31,801.84
|
2025-10-04
|
|
514
|
MS_DRG
|
Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures Without Cc/mcc
|
3
|
3
|
$30,792.52
|
$30,792.52
|
$31,178.27
|
$41,467.10
|
$31,801.84
|
2025-10-04
|
|
506
|
MS_DRG
|
Major Thumb Or Joint Procedures
|
3
|
3
|
$29,465.50
|
$29,465.50
|
$31,178.27
|
$41,467.10
|
$31,801.84
|
2025-10-04
|
|
289
|
MS_DRG
|
Acute And Subacute Endocarditis With Cc
|
3
|
3
|
$25,383.00
|
$25,383.00
|
$30,936.21
|
$41,145.15
|
$31,554.93
|
2025-10-04
|
|
513
|
MS_DRG
|
Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures With Cc/mcc
|
2
|
2
|
$110,232.00
|
$110,232.00
|
$31,178.27
|
$31,801.84
|
$31,490.06
|
2025-10-04
|
|
350
|
MS_DRG
|
Inguinal And Femoral Hernia Procedures With Mcc
|
2
|
2
|
$77,323.66
|
$77,323.66
|
$31,016.19
|
$31,636.52
|
$31,326.35
|
2025-10-04
|
|
351
|
MS_DRG
|
Inguinal And Femoral Hernia Procedures With Cc
|
2
|
2
|
$37,136.50
|
$37,136.50
|
$31,016.19
|
$31,636.52
|
$31,326.35
|
2025-10-04
|
|
670
|
MS_DRG
|
Transurethral Procedures Without Cc/mcc
|
3
|
3
|
$21,842.00
|
$21,842.00
|
$30,707.82
|
$40,841.40
|
$31,321.98
|
2025-10-04
|
|
669
|
MS_DRG
|
Transurethral Procedures With Cc
|
2
|
2
|
$30,583.95
|
$30,583.95
|
$30,707.82
|
$31,321.98
|
$31,014.90
|
2025-10-04
|
|
J9144
|
HCPCS
|
Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj
|
21
|
21
|
$34,315.00
|
$34,315.00
|
$69.30
|
$33,285.55
|
$30,883.50
|
2025-10-04
|
|
460000004
|
CDM
|
Hchg Optime Sup Pacemaker Rev Cd 275
|
18
|
18
|
$34,046.65
|
$34,046.65
|
$29,246.07
|
$33,025.25
|
$30,641.99
|
2025-10-04
|
|
J9228
|
HCPCS
|
Injection, Ipilimumab, 1 Mg
|
22
|
22
|
$32,332.00
|
$32,332.00
|
$159.88
|
$31,362.04
|
$29,098.80
|
2025-10-04
|
|
J2323
|
HCPCS
|
Injection, Natalizumab, 1 Mg
|
22
|
22
|
$32,222.00
|
$32,222.00
|
$25.12
|
$31,255.34
|
$28,999.80
|
2025-10-04
|
|
580
|
MS_DRG
|
Other Skin, Subcutaneous Tissue And Breast Procedures With Cc
|
3
|
3
|
$50,532.00
|
$50,532.00
|
$28,354.50
|
$37,711.49
|
$28,921.59
|
2025-10-04
|
|
571
|
MS_DRG
|
Skin Debridement With Cc
|
3
|
3
|
$22,983.50
|
$22,983.50
|
$28,354.50
|
$37,711.49
|
$28,921.59
|
2025-10-04
|
|
616
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
3
|
3
|
$54,206.06
|
$54,206.06
|
$28,354.50
|
$37,711.49
|
$28,921.59
|
2025-10-04
|
|
623
|
MS_DRG
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
3
|
3
|
$35,190.50
|
$35,190.50
|
$28,354.50
|
$37,711.49
|
$28,921.59
|
2025-10-04
|
|
572
|
MS_DRG
|
Skin Debridement Without Cc/mcc
|
3
|
3
|
$38,368.99
|
$38,368.99
|
$28,354.50
|
$37,711.49
|
$28,921.59
|
2025-10-04
|
|
601
|
MS_DRG
|
Non-malignant Breast Disorders Without Cc/mcc
|
3
|
3
|
$21,866.00
|
$21,866.00
|
$28,354.50
|
$37,711.49
|
$28,921.59
|
2025-10-04
|
|
J3380
|
HCPCS
|
Injection, Vedolizumab, Intravenous, 1 Mg
|
22
|
22
|
$31,637.00
|
$31,637.00
|
$24.96
|
$30,687.89
|
$28,473.30
|
2025-10-04
|
|
964
|
MS_DRG
|
Other Multiple Significant Trauma With Cc
|
3
|
3
|
$20,204.93
|
$20,204.93
|
$27,555.68
|
$36,649.06
|
$28,106.80
|
2025-10-04
|
|
965
|
MS_DRG
|
Other Multiple Significant Trauma Without Cc/mcc
|
3
|
3
|
$39,689.50
|
$39,689.50
|
$27,555.68
|
$36,649.06
|
$28,106.80
|
2025-10-04
|
|
J9022
|
HCPCS
|
Injection, Atezolizumab, 10 Mg
|
40
|
22
|
$40,395.50
|
$40,395.50
|
$82.86
|
$39,183.64
|
$26,863.15
|
2025-10-04
|
|
91
|
MS_DRG
|
Other Disorders Of Nervous System With Mcc
|
3
|
3
|
$14,156.50
|
$14,156.50
|
$26,233.78
|
$34,890.93
|
$26,758.46
|
2025-10-04
|
|
93
|
MS_DRG
|
Other Disorders Of Nervous System Without Cc/mcc
|
3
|
3
|
$16,948.00
|
$16,948.00
|
$26,233.78
|
$34,890.93
|
$26,758.46
|
2025-10-04
|
|
J9301
|
HCPCS
|
Injection, Obinutuzumab, 10 Mg
|
22
|
22
|
$29,215.00
|
$29,215.00
|
$68.82
|
$28,338.55
|
$26,293.50
|
2025-10-04
|
|
74
|
MS_DRG
|
Cranial And Peripheral Nerve Disorders Without Mcc
|
3
|
3
|
$33,822.38
|
$33,822.38
|
$25,232.89
|
$33,559.74
|
$25,737.55
|
2025-10-04
|
|
73
|
MS_DRG
|
Cranial And Peripheral Nerve Disorders With Mcc
|
3
|
3
|
$38,777.39
|
$38,777.39
|
$25,232.89
|
$33,559.74
|
$25,737.55
|
2025-10-04
|
|
811
|
MS_DRG
|
Red Blood Cell Disorders With Mcc
|
3
|
3
|
$28,113.17
|
$28,113.17
|
$24,822.43
|
$33,013.83
|
$25,318.87
|
2025-10-04
|
|
812
|
MS_DRG
|
Red Blood Cell Disorders Without Mcc
|
3
|
3
|
$22,789.00
|
$22,789.00
|
$24,822.43
|
$33,013.83
|
$25,318.87
|
2025-10-04
|
|
545
|
MS_DRG
|
Connective Tissue Disorders With Mcc
|
3
|
3
|
$50,781.82
|
$50,781.82
|
$24,409.86
|
$32,465.11
|
$24,898.06
|
2025-10-04
|
|
65
|
MS_DRG
|
Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours
|
3
|
3
|
$14,920.33
|
$14,920.33
|
$24,395.12
|
$32,445.52
|
$24,883.03
|
2025-10-04
|
|
64
|
MS_DRG
|
Intracranial Hemorrhage Or Cerebral Infarction With Mcc
|
3
|
3
|
$38,306.30
|
$38,306.30
|
$24,395.12
|
$32,445.52
|
$24,883.03
|
2025-10-04
|
|
813
|
MS_DRG
|
Coagulation Disorders
|
1
|
1
|
$8,311.00
|
$8,311.00
|
$24,822.43
|
$24,822.43
|
$24,822.43
|
2025-10-04
|
|
66
|
MS_DRG
|
Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc
|
2
|
2
|
$10,774.50
|
$10,774.50
|
$24,395.12
|
$24,883.03
|
$24,639.07
|
2025-10-04
|
|
J9311
|
HCPCS
|
Injection, Rituximab 10 Mg And Hyaluronidase
|
22
|
22
|
$26,975.00
|
$26,975.00
|
$49.51
|
$26,165.75
|
$24,277.50
|
2025-10-04
|
|
549
|
MS_DRG
|
Septic Arthritis With Cc
|
3
|
3
|
$13,160.50
|
$13,160.50
|
$23,786.80
|
$31,636.44
|
$24,262.54
|
2025-10-04
|
|
548
|
MS_DRG
|
Septic Arthritis With Mcc
|
3
|
3
|
$18,779.00
|
$18,779.00
|
$23,786.80
|
$31,636.44
|
$24,262.54
|
2025-10-04
|
|
539
|
MS_DRG
|
Osteomyelitis With Mcc
|
3
|
3
|
$52,538.67
|
$52,538.67
|
$23,786.80
|
$31,636.44
|
$24,262.54
|
2025-10-04
|
|
540
|
MS_DRG
|
Osteomyelitis With Cc
|
2
|
2
|
$43,497.42
|
$43,497.42
|
$23,786.80
|
$24,262.54
|
$24,024.67
|
2025-10-04
|
|
146
|
MS_DRG
|
Ear, Nose, Mouth And Throat Malignancy With Mcc
|
3
|
3
|
$55,988.00
|
$55,988.00
|
$23,461.59
|
$31,203.91
|
$23,930.82
|
2025-10-04
|
|
J9308
|
HCPCS
|
Injection, Ramucirumab, 5 Mg
|
22
|
22
|
$26,537.00
|
$26,537.00
|
$63.79
|
$25,740.89
|
$23,883.30
|
2025-10-04
|
|
83
|
MS_DRG
|
Traumatic Stupor And Coma >1 Hour With Cc
|
3
|
3
|
$18,024.50
|
$18,024.50
|
$23,377.39
|
$31,091.93
|
$23,844.94
|
2025-10-04
|
|
283
|
MS_DRG
|
Acute Myocardial Infarction, Expired With Mcc
|
3
|
3
|
$16,142.00
|
$16,142.00
|
$23,280.56
|
$30,963.15
|
$23,746.17
|
2025-10-04
|
|
280
|
MS_DRG
|
Acute Myocardial Infarction, Discharged Alive With Mcc
|
3
|
3
|
$37,637.67
|
$37,637.67
|
$23,280.56
|
$30,963.15
|
$23,746.17
|
2025-10-04
|
|
282
|
MS_DRG
|
Acute Myocardial Infarction, Discharged Alive Without Cc/mcc
|
3
|
3
|
$11,716.00
|
$11,716.00
|
$23,280.56
|
$30,963.15
|
$23,746.17
|
2025-10-04
|
|
281
|
MS_DRG
|
Acute Myocardial Infarction, Discharged Alive With Cc
|
3
|
3
|
$10,934.00
|
$10,934.00
|
$23,280.56
|
$30,963.15
|
$23,746.17
|
2025-10-04
|
|
149
|
MS_DRG
|
Dysequilibrium
|
2
|
2
|
$8,569.00
|
$8,569.00
|
$23,461.59
|
$23,930.82
|
$23,696.21
|
2025-10-04
|
|
56
|
MS_DRG
|
Degenerative Nervous System Disorders With Mcc
|
3
|
3
|
$20,378.74
|
$20,378.74
|
$23,167.95
|
$30,813.37
|
$23,631.31
|
2025-10-04
|
|
57
|
MS_DRG
|
Degenerative Nervous System Disorders Without Mcc
|
3
|
3
|
$14,023.68
|
$14,023.68
|
$23,167.95
|
$30,813.37
|
$23,631.31
|
2025-10-04
|
|
55
|
MS_DRG
|
Nervous System Neoplasms Without Mcc
|
3
|
3
|
$58,561.61
|
$58,561.61
|
$23,152.16
|
$30,792.38
|
$23,615.21
|
2025-10-04
|
|
54
|
MS_DRG
|
Nervous System Neoplasms With Mcc
|
3
|
3
|
$14,178.50
|
$14,178.50
|
$23,152.16
|
$30,792.38
|
$23,615.21
|
2025-10-04
|
|
85
|
MS_DRG
|
Traumatic Stupor And Coma <1 Hour With Mcc
|
2
|
2
|
$8,138.00
|
$8,138.00
|
$23,377.39
|
$23,844.94
|
$23,611.17
|
2025-10-04
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
3
|
3
|
$193,402.80
|
$193,402.80
|
$22,890.10
|
$30,443.83
|
$23,347.90
|
2025-10-04
|
|
871
|
MS_DRG
|
Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc
|
3
|
3
|
$34,110.87
|
$34,110.87
|
$22,890.10
|
$30,443.83
|
$23,347.90
|
2025-10-04
|
|
375
|
MS_DRG
|
Digestive Malignancy With Cc
|
3
|
3
|
$23,359.00
|
$23,359.00
|
$22,799.59
|
$30,323.45
|
$23,255.58
|
2025-10-04
|
|
374
|
MS_DRG
|
Digestive Malignancy With Mcc
|
3
|
3
|
$81,159.50
|
$81,159.50
|
$22,799.59
|
$30,323.45
|
$23,255.58
|
2025-10-04
|
|
435
|
MS_DRG
|
Malignancy Of Hepatobiliary System Or Pancreas With Mcc
|
3
|
3
|
$33,065.00
|
$33,065.00
|
$22,792.22
|
$30,313.65
|
$23,248.06
|
2025-10-04
|
|
436
|
MS_DRG
|
Malignancy Of Hepatobiliary System Or Pancreas With Cc
|
3
|
3
|
$57,601.85
|
$57,601.85
|
$22,792.22
|
$30,313.65
|
$23,248.06
|
2025-10-04
|
|
872
|
MS_DRG
|
Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc
|
2
|
2
|
$25,439.90
|
$25,439.90
|
$22,890.10
|
$23,347.90
|
$23,119.00
|
2025-10-04
|
|
444
|
MS_DRG
|
Disorders Of The Biliary Tract With Mcc
|
3
|
3
|
$56,231.09
|
$56,231.09
|
$22,481.74
|
$29,900.71
|
$22,931.38
|
2025-10-04
|
|
863
|
MS_DRG
|
Postoperative And Post-traumatic Infections Without Mcc
|
3
|
3
|
$18,207.90
|
$18,207.90
|
$22,382.81
|
$29,769.14
|
$22,830.46
|
2025-10-04
|
|
862
|
MS_DRG
|
Postoperative And Post-traumatic Infections With Mcc
|
3
|
3
|
$16,478.00
|
$16,478.00
|
$22,382.81
|
$29,769.14
|
$22,830.46
|
2025-10-04
|
|
446
|
MS_DRG
|
Disorders Of The Biliary Tract Without Cc/mcc
|
2
|
2
|
$40,347.50
|
$40,347.50
|
$22,481.74
|
$22,931.38
|
$22,706.56
|
2025-10-04
|
|
445
|
MS_DRG
|
Disorders Of The Biliary Tract With Cc
|
2
|
2
|
$22,915.75
|
$22,915.75
|
$22,481.74
|
$22,931.38
|
$22,706.56
|
2025-10-04
|
|
382
|
MS_DRG
|
Complicated Peptic Ulcer Without Cc/mcc
|
3
|
3
|
$13,335.50
|
$13,335.50
|
$22,032.34
|
$29,303.01
|
$22,472.98
|
2025-10-04
|
|
380
|
MS_DRG
|
Complicated Peptic Ulcer With Mcc
|
3
|
3
|
$33,574.00
|
$33,574.00
|
$22,032.34
|
$29,303.01
|
$22,472.98
|
2025-10-04
|
|
381
|
MS_DRG
|
Complicated Peptic Ulcer With Cc
|
3
|
3
|
$27,599.90
|
$27,599.90
|
$22,032.34
|
$29,303.01
|
$22,472.98
|
2025-10-04
|
|
383
|
MS_DRG
|
Uncomplicated Peptic Ulcer With Mcc
|
3
|
3
|
$12,774.50
|
$12,774.50
|
$22,032.34
|
$29,303.01
|
$22,472.98
|
2025-10-04
|
|
846
|
MS_DRG
|
Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc
|
3
|
3
|
$30,442.50
|
$30,442.50
|
$21,944.98
|
$29,186.83
|
$22,383.88
|
2025-10-04
|
|
847
|
MS_DRG
|
Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Cc
|
3
|
3
|
$54,823.02
|
$54,823.02
|
$21,944.98
|
$29,186.83
|
$22,383.88
|
2025-10-04
|
|
180
|
MS_DRG
|
Respiratory Neoplasms With Mcc
|
3
|
3
|
$18,826.84
|
$18,826.84
|
$21,593.46
|
$28,719.30
|
$22,025.33
|
2025-10-04
|
|
843
|
MS_DRG
|
Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses…
|
3
|
3
|
$17,936.00
|
$17,936.00
|
$21,593.46
|
$28,719.30
|
$22,025.33
|
2025-10-04
|
|
828
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
3
|
3
|
$16,248.00
|
$16,248.00
|
$21,593.46
|
$28,719.30
|
$22,025.33
|
2025-10-04
|
|
71
|
MS_DRG
|
Other Cerebrovascular Disorders With Cc
|
3
|
3
|
$13,163.00
|
$13,163.00
|
$21,493.47
|
$28,586.32
|
$21,923.34
|
2025-10-04
|
|
70
|
MS_DRG
|
Other Cerebrovascular Disorders With Mcc
|
3
|
3
|
$30,309.00
|
$30,309.00
|
$21,493.47
|
$28,586.32
|
$21,923.34
|
2025-10-04
|
|
189
|
MS_DRG
|
Pulmonary Edema And Respiratory Failure
|
3
|
3
|
$27,883.71
|
$27,883.71
|
$21,405.07
|
$28,468.74
|
$21,833.17
|
2025-10-04
|
|
196
|
MS_DRG
|
Interstitial Lung Disease With Mcc
|
3
|
3
|
$12,128.50
|
$12,128.50
|
$21,405.07
|
$28,468.74
|
$21,833.17
|
2025-10-04
|
|
369
|
MS_DRG
|
Major Esophageal Disorders With Cc
|
3
|
3
|
$21,932.50
|
$21,932.50
|
$21,329.29
|
$28,367.96
|
$21,755.88
|
2025-10-04
|
|
808
|
MS_DRG
|
Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…
|
3
|
3
|
$25,690.00
|
$25,690.00
|
$21,088.27
|
$28,047.41
|
$21,510.04
|
2025-10-04
|
|
809
|
MS_DRG
|
Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…
|
3
|
3
|
$14,328.83
|
$14,328.83
|
$21,088.27
|
$28,047.41
|
$21,510.04
|
2025-10-04
|
|
184
|
MS_DRG
|
Major Chest Trauma With Cc
|
3
|
3
|
$11,463.50
|
$11,463.50
|
$21,083.01
|
$28,040.41
|
$21,504.67
|
2025-10-04
|
|
914
|
MS_DRG
|
Traumatic Injury Without Mcc
|
3
|
3
|
$20,778.00
|
$20,778.00
|
$21,052.49
|
$27,999.81
|
$21,473.54
|
2025-10-04
|
|
552
|
MS_DRG
|
Medical Back Problems Without Mcc
|
3
|
3
|
$13,070.75
|
$13,070.75
|
$21,052.49
|
$27,999.81
|
$21,473.54
|
2025-10-04
|
|
551
|
MS_DRG
|
Medical Back Problems With Mcc
|
3
|
3
|
$32,832.00
|
$32,832.00
|
$21,052.49
|
$27,999.81
|
$21,473.54
|
2025-10-04
|
|
47135
|
HCPCS
|
Transplantation Of Donor Liver
|
44
|
22
|
$23,723.00
|
$23,723.00
|
$85.00
|
$23,011.31
|
$21,350.70
|
2025-10-04
|
|
J9306
|
HCPCS
|
Injection, Pertuzumab, 1 Mg
|
22
|
22
|
$23,703.50
|
$23,703.50
|
$16.96
|
$22,992.40
|
$21,333.15
|
2025-10-04
|
|
434
|
MS_DRG
|
Cirrhosis And Alcoholic Hepatitis Without Cc/mcc
|
3
|
3
|
$15,842.85
|
$15,842.85
|
$20,899.88
|
$27,796.84
|
$21,317.88
|
2025-10-04
|
|
433
|
MS_DRG
|
Cirrhosis And Alcoholic Hepatitis With Cc
|
3
|
3
|
$46,666.25
|
$46,666.25
|
$20,899.88
|
$27,796.84
|
$21,317.88
|
2025-10-04
|
|
432
|
MS_DRG
|
Cirrhosis And Alcoholic Hepatitis With Mcc
|
3
|
3
|
$39,211.67
|
$39,211.67
|
$20,899.88
|
$27,796.84
|
$21,317.88
|
2025-10-04
|
|
88
|
MS_DRG
|
Concussion With Mcc
|
2
|
2
|
$8,025.00
|
$8,025.00
|
$21,018.81
|
$21,439.19
|
$21,229.00
|
2025-10-04
|
|
755
|
MS_DRG
|
Malignancy, Female Reproductive System With Cc
|
3
|
3
|
$18,418.38
|
$18,418.38
|
$20,698.86
|
$27,529.49
|
$21,112.84
|
2025-10-04
|
|
642
|
MS_DRG
|
Inborn And Other Disorders Of Metabolism
|
3
|
3
|
$48,350.53
|
$48,350.53
|
$20,547.31
|
$27,327.92
|
$20,958.25
|
2025-10-04
|
|
377
|
MS_DRG
|
Gastrointestinal Hemorrhage With Mcc
|
3
|
3
|
$42,785.50
|
$42,785.50
|
$20,395.75
|
$27,126.35
|
$20,803.67
|
2025-10-04
|
|
378
|
MS_DRG
|
Gastrointestinal Hemorrhage With Cc
|
3
|
3
|
$23,982.59
|
$23,982.59
|
$20,395.75
|
$27,126.35
|
$20,803.67
|
2025-10-04
|
|
175
|
MS_DRG
|
Pulmonary Embolism With Mcc Or Acute Cor Pulmonale
|
3
|
3
|
$27,068.48
|
$27,068.48
|
$20,250.51
|
$26,933.18
|
$20,655.52
|
2025-10-04
|
|
42
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/mcc
|
3
|
3
|
$14,591.50
|
$14,591.50
|
$20,013.71
|
$26,618.23
|
$20,413.98
|
2025-10-04
|
|
69
|
MS_DRG
|
Transient Ischemia Without Thrombolytic
|
3
|
3
|
$0.07
|
$0.07
|
$19,856.89
|
$26,409.66
|
$20,254.03
|
2025-10-04
|
|
867
|
MS_DRG
|
Other Infectious And Parasitic Diseases Diagnoses With Mcc
|
3
|
3
|
$16,309.84
|
$16,309.84
|
$19,849.52
|
$26,399.86
|
$20,246.51
|
2025-10-04
|
|
385
|
MS_DRG
|
Inflammatory Bowel Disease With Mcc
|
3
|
3
|
$136,002.50
|
$136,002.50
|
$19,822.16
|
$26,363.47
|
$20,218.60
|
2025-10-04
|
|
438
|
MS_DRG
|
Disorders Of Pancreas Except Malignancy With Mcc
|
3
|
3
|
$31,888.98
|
$31,888.98
|
$19,731.65
|
$26,243.09
|
$20,126.28
|
2025-10-04
|
|
439
|
MS_DRG
|
Disorders Of Pancreas Except Malignancy With Cc
|
3
|
3
|
$10,037.00
|
$10,037.00
|
$19,731.65
|
$26,243.09
|
$20,126.28
|
2025-10-04
|
|
440
|
MS_DRG
|
Disorders Of Pancreas Except Malignancy Without Cc/mcc
|
3
|
3
|
$14,957.30
|
$14,957.30
|
$19,731.65
|
$26,243.09
|
$20,126.28
|
2025-10-04
|
|
604
|
MS_DRG
|
Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc
|
3
|
3
|
$56,464.50
|
$56,464.50
|
$19,662.18
|
$26,150.70
|
$20,055.43
|
2025-10-04
|
|
605
|
MS_DRG
|
Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc
|
3
|
3
|
$16,171.50
|
$16,171.50
|
$19,662.18
|
$26,150.70
|
$20,055.43
|
2025-10-04
|
|
292
|
MS_DRG
|
Heart Failure And Shock With Cc
|
3
|
3
|
$23,953.13
|
$23,953.13
|
$19,511.68
|
$25,950.53
|
$19,901.91
|
2025-10-04
|
|
291
|
MS_DRG
|
Heart Failure And Shock With Mcc
|
3
|
3
|
$27,756.47
|
$27,756.47
|
$19,511.68
|
$25,950.53
|
$19,901.91
|
2025-10-04
|
|
293
|
MS_DRG
|
Heart Failure And Shock Without Cc/mcc
|
3
|
3
|
$8,926.50
|
$8,926.50
|
$19,511.68
|
$25,950.53
|
$19,901.91
|
2025-10-04
|
|
722
|
MS_DRG
|
Malignancy, Male Reproductive System With Mcc
|
3
|
3
|
$31,773.92
|
$31,773.92
|
$19,508.52
|
$25,946.33
|
$19,898.69
|
2025-10-04
|
|
443
|
MS_DRG
|
Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis Without C…
|
3
|
3
|
$20,105.25
|
$20,105.25
|
$19,488.53
|
$25,919.74
|
$19,878.30
|
2025-10-04
|
|
441
|
MS_DRG
|
Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc
|
3
|
3
|
$53,284.94
|
$53,284.94
|
$19,488.53
|
$25,919.74
|
$19,878.30
|
2025-10-04
|
|
442
|
MS_DRG
|
Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc
|
3
|
3
|
$20,108.91
|
$20,108.91
|
$19,488.53
|
$25,919.74
|
$19,878.30
|
2025-10-04
|
|
785
|
MS_DRG
|
Cesarean Section With Sterilization Without Cc/mcc
|
3
|
3
|
$45,308.25
|
$45,308.25
|
$19,449.58
|
$25,867.95
|
$19,838.58
|
2025-10-04
|
|
783
|
MS_DRG
|
Cesarean Section With Sterilization With Mcc
|
3
|
3
|
$51,646.50
|
$51,646.50
|
$19,449.58
|
$25,867.95
|
$19,838.58
|
2025-10-04
|
|
371
|
MS_DRG
|
Major Gastrointestinal Disorders And Peritoneal Infections With Mcc
|
3
|
3
|
$23,842.00
|
$23,842.00
|
$19,430.64
|
$25,842.75
|
$19,819.25
|
2025-10-04
|
|
372
|
MS_DRG
|
Major Gastrointestinal Disorders And Peritoneal Infections With Cc
|
3
|
3
|
$17,991.11
|
$17,991.11
|
$19,430.64
|
$25,842.75
|
$19,819.25
|
2025-10-04
|
|
694
|
MS_DRG
|
Urinary Stones Without Mcc
|
3
|
3
|
$31,521.50
|
$31,521.50
|
$19,406.43
|
$25,810.56
|
$19,794.56
|
2025-10-04
|
|
205
|
MS_DRG
|
Other Respiratory System Diagnoses With Mcc
|
3
|
3
|
$45,130.86
|
$45,130.86
|
$19,401.17
|
$25,803.56
|
$19,789.19
|
2025-10-04
|
|
206
|
MS_DRG
|
Other Respiratory System Diagnoses Without Mcc
|
3
|
3
|
$11,516.50
|
$11,516.50
|
$19,401.17
|
$25,803.56
|
$19,789.19
|
2025-10-04
|
|
788
|
MS_DRG
|
Cesarean Section Without Sterilization Without Cc/mcc
|
2
|
2
|
$47,486.86
|
$47,486.86
|
$19,449.58
|
$19,838.58
|
$19,644.08
|
2025-10-04
|
|
786
|
MS_DRG
|
Cesarean Section Without Sterilization With Mcc
|
2
|
2
|
$63,460.11
|
$63,460.11
|
$19,449.58
|
$19,838.58
|
$19,644.08
|
2025-10-04
|
|
787
|
MS_DRG
|
Cesarean Section Without Sterilization With Cc
|
2
|
2
|
$43,172.85
|
$43,172.85
|
$19,449.58
|
$19,838.58
|
$19,644.08
|
2025-10-04
|
|
784
|
MS_DRG
|
Cesarean Section With Sterilization With Cc
|
2
|
2
|
$44,134.69
|
$44,134.69
|
$19,449.58
|
$19,838.58
|
$19,644.08
|
2025-10-04
|
|
644
|
MS_DRG
|
Endocrine Disorders With Cc
|
3
|
3
|
$12,320.38
|
$12,320.38
|
$19,065.43
|
$25,357.03
|
$19,446.74
|
2025-10-04
|
|
643
|
MS_DRG
|
Endocrine Disorders With Mcc
|
3
|
3
|
$28,562.00
|
$28,562.00
|
$19,065.43
|
$25,357.03
|
$19,446.74
|
2025-10-04
|
|
394
|
MS_DRG
|
Other Digestive System Diagnoses With Cc
|
3
|
3
|
$23,655.64
|
$23,655.64
|
$18,861.26
|
$25,085.47
|
$19,238.48
|
2025-10-04
|
|
393
|
MS_DRG
|
Other Digestive System Diagnoses With Mcc
|
3
|
3
|
$28,690.56
|
$28,690.56
|
$18,861.26
|
$25,085.47
|
$19,238.48
|
2025-10-04
|
|
392
|
MS_DRG
|
Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc
|
3
|
3
|
$23,403.46
|
$23,403.46
|
$18,861.26
|
$25,085.47
|
$19,238.48
|
2025-10-04
|
|
391
|
MS_DRG
|
Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc
|
3
|
3
|
$27,088.32
|
$27,088.32
|
$18,861.26
|
$25,085.47
|
$19,238.48
|
2025-10-04
|
|
395
|
MS_DRG
|
Other Digestive System Diagnoses Without Cc/mcc
|
3
|
3
|
$19,070.10
|
$19,070.10
|
$18,861.26
|
$25,085.47
|
$19,238.48
|
2025-10-04
|
|
919
|
MS_DRG
|
Complications Of Treatment With Mcc
|
3
|
3
|
$64,497.13
|
$64,497.13
|
$18,849.68
|
$25,070.07
|
$19,226.67
|
2025-10-04
|
|
920
|
MS_DRG
|
Complications Of Treatment With Cc
|
3
|
3
|
$11,983.06
|
$11,983.06
|
$18,849.68
|
$25,070.07
|
$19,226.67
|
2025-10-04
|
|
593
|
MS_DRG
|
Skin Ulcers With Cc
|
3
|
3
|
$23,244.49
|
$23,244.49
|
$18,708.65
|
$24,882.50
|
$19,082.82
|
2025-10-04
|
|
592
|
MS_DRG
|
Skin Ulcers With Mcc
|
3
|
3
|
$62,753.00
|
$62,753.00
|
$18,708.65
|
$24,882.50
|
$19,082.82
|
2025-10-04
|
|
J9271
|
HCPCS
|
Injection, Pembrolizumab, 1 Mg
|
22
|
22
|
$21,059.50
|
$21,059.50
|
$54.85
|
$20,427.72
|
$18,953.55
|
2025-10-04
|
|
177
|
MS_DRG
|
Respiratory Infections And Inflammations With Mcc
|
3
|
3
|
$25,892.31
|
$25,892.31
|
$18,565.51
|
$24,692.13
|
$18,936.82
|
2025-10-04
|
|
178
|
MS_DRG
|
Respiratory Infections And Inflammations With Cc
|
3
|
3
|
$53,801.75
|
$53,801.75
|
$18,565.51
|
$24,692.13
|
$18,936.82
|
2025-10-04
|
|
179
|
MS_DRG
|
Respiratory Infections And Inflammations Without Cc/mcc
|
3
|
3
|
$13,324.50
|
$13,324.50
|
$18,565.51
|
$24,692.13
|
$18,936.82
|
2025-10-04
|
|
102
|
MS_DRG
|
Headaches With Mcc
|
3
|
3
|
$40,983.70
|
$40,983.70
|
$18,510.78
|
$24,619.34
|
$18,881.00
|
2025-10-04
|
|
J0717
|
HCPCS
|
Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm…
|
22
|
22
|
$20,917.00
|
$20,917.00
|
$12.78
|
$20,289.49
|
$18,825.30
|
2025-10-04
|
|
299
|
MS_DRG
|
Peripheral Vascular Disorders With Mcc
|
3
|
3
|
$13,151.00
|
$13,151.00
|
$18,229.78
|
$24,245.60
|
$18,594.37
|
2025-10-04
|
|
300
|
MS_DRG
|
Peripheral Vascular Disorders With Cc
|
3
|
3
|
$32,676.00
|
$32,676.00
|
$18,229.78
|
$24,245.60
|
$18,594.37
|
2025-10-04
|
|
306
|
MS_DRG
|
Cardiac Congenital And Valvular Disorders With Mcc
|
3
|
3
|
$60,529.00
|
$60,529.00
|
$18,020.33
|
$23,967.04
|
$18,380.74
|
2025-10-04
|
|
101
|
MS_DRG
|
Seizures Without Mcc
|
3
|
3
|
$26,974.85
|
$26,974.85
|
$18,015.07
|
$23,960.05
|
$18,375.37
|
2025-10-04
|
|
125
|
MS_DRG
|
Other Disorders Of The Eye Without Mcc
|
2
|
2
|
$7,334.00
|
$7,334.00
|
$18,181.36
|
$18,544.99
|
$18,363.18
|
2025-10-04
|
|
595
|
MS_DRG
|
Major Skin Disorders With Mcc
|
3
|
3
|
$22,460.50
|
$22,460.50
|
$17,944.56
|
$23,866.26
|
$18,303.45
|
2025-10-04
|
|
797
|
MS_DRG
|
Vaginal Delivery With Sterilization And/or D&c With Cc
|
3
|
3
|
$27,277.13
|
$27,277.13
|
$17,932.98
|
$23,850.86
|
$18,291.64
|
2025-10-04
|
|
768
|
MS_DRG
|
Vaginal Delivery With O.r. Procedures Except Sterilization And/or D&c
|
3
|
3
|
$39,167.93
|
$39,167.93
|
$17,932.98
|
$23,850.86
|
$18,291.64
|
2025-10-04
|
|
806
|
MS_DRG
|
Vaginal Delivery Without Sterilization Or D&c With Cc
|
3
|
3
|
$25,701.60
|
$25,701.60
|
$17,932.98
|
$23,850.86
|
$18,291.64
|
2025-10-04
|
|
805
|
MS_DRG
|
Vaginal Delivery Without Sterilization Or D&c With Mcc
|
3
|
3
|
$29,052.75
|
$29,052.75
|
$17,932.98
|
$23,850.86
|
$18,291.64
|
2025-10-04
|
|
796
|
MS_DRG
|
Vaginal Delivery With Sterilization And/or D&c With Mcc
|
3
|
3
|
$50,405.00
|
$50,405.00
|
$17,932.98
|
$23,850.86
|
$18,291.64
|
2025-10-04
|
|
798
|
MS_DRG
|
Vaginal Delivery With Sterilization And/or D&c Without Cc/mcc
|
3
|
3
|
$35,191.67
|
$35,191.67
|
$17,932.98
|
$23,850.86
|
$18,291.64
|
2025-10-04
|
|
807
|
MS_DRG
|
Vaginal Delivery Without Sterilization Or D&c Without Cc/mcc
|
3
|
3
|
$25,976.64
|
$25,976.64
|
$17,932.98
|
$23,850.86
|
$18,291.64
|
2025-10-04
|
|
758
|
MS_DRG
|
Infections, Female Reproductive System With Cc
|
3
|
3
|
$15,752.00
|
$15,752.00
|
$17,919.30
|
$23,832.67
|
$18,277.68
|
2025-10-04
|
|
535
|
MS_DRG
|
Fractures Of Hip And Pelvis With Mcc
|
3
|
3
|
$12,357.99
|
$12,357.99
|
$17,815.10
|
$23,694.09
|
$18,171.41
|
2025-10-04
|
|
536
|
MS_DRG
|
Fractures Of Hip And Pelvis Without Mcc
|
3
|
3
|
$19,033.50
|
$19,033.50
|
$17,815.10
|
$23,694.09
|
$18,171.41
|
2025-10-04
|
|
314
|
MS_DRG
|
Other Circulatory System Diagnoses With Mcc
|
3
|
3
|
$15,707.20
|
$15,707.20
|
$17,751.96
|
$23,610.10
|
$18,106.99
|
2025-10-04
|
|
555
|
MS_DRG
|
Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc
|
3
|
3
|
$22,502.50
|
$22,502.50
|
$17,625.66
|
$23,442.13
|
$17,978.17
|
2025-10-04
|
|
465
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
3
|
3
|
$54,570.50
|
$54,570.50
|
$17,625.66
|
$23,442.13
|
$17,978.17
|
2025-10-04
|
|
565
|
MS_DRG
|
Other Musculoskeletal System And Connective Tissue Diagnoses With Cc
|
3
|
3
|
$12,666.00
|
$12,666.00
|
$17,625.66
|
$23,442.13
|
$17,978.17
|
2025-10-04
|
|
556
|
MS_DRG
|
Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc
|
3
|
3
|
$24,505.50
|
$24,505.50
|
$17,625.66
|
$23,442.13
|
$17,978.17
|
2025-10-04
|
|
315
|
MS_DRG
|
Other Circulatory System Diagnoses With Cc
|
2
|
2
|
$56,767.09
|
$56,767.09
|
$17,751.96
|
$18,106.99
|
$17,929.47
|
2025-10-04
|
|
193
|
MS_DRG
|
Simple Pneumonia And Pleurisy With Mcc
|
3
|
3
|
$28,712.39
|
$28,712.39
|
$17,537.25
|
$23,324.55
|
$17,888.00
|
2025-10-04
|
|
194
|
MS_DRG
|
Simple Pneumonia And Pleurisy With Cc
|
3
|
3
|
$15,790.50
|
$15,790.50
|
$17,537.25
|
$23,324.55
|
$17,888.00
|
2025-10-04
|
|
195
|
MS_DRG
|
Simple Pneumonia And Pleurisy Without Cc/mcc
|
3
|
3
|
$11,112.17
|
$11,112.17
|
$17,537.25
|
$23,324.55
|
$17,888.00
|
2025-10-04
|
|
464
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
2
|
2
|
$105,728.51
|
$105,728.51
|
$17,625.66
|
$17,978.17
|
$17,801.92
|
2025-10-04
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
2
|
2
|
$73,233.83
|
$73,233.83
|
$17,625.66
|
$17,978.17
|
$17,801.92
|
2025-10-04
|
|
190
|
MS_DRG
|
Chronic Obstructive Pulmonary Disease With Mcc
|
3
|
3
|
$15,946.48
|
$15,946.48
|
$17,413.06
|
$23,159.37
|
$17,761.32
|
2025-10-04
|
|
191
|
MS_DRG
|
Chronic Obstructive Pulmonary Disease With Cc
|
3
|
3
|
$12,049.00
|
$12,049.00
|
$17,413.06
|
$23,159.37
|
$17,761.32
|
2025-10-04
|
|
312
|
MS_DRG
|
Syncope And Collapse
|
3
|
3
|
$25,253.76
|
$25,253.76
|
$17,344.65
|
$23,068.39
|
$17,691.54
|
2025-10-04
|
|
884
|
MS_DRG
|
Organic Disturbances And Intellectual Disability
|
3
|
3
|
$9,664.00
|
$9,664.00
|
$17,279.40
|
$22,981.60
|
$17,624.99
|
2025-10-04
|
|
77
|
MS_DRG
|
Hypertensive Encephalopathy With Mcc
|
3
|
3
|
$25,244.00
|
$25,244.00
|
$17,169.94
|
$22,836.02
|
$17,513.34
|
2025-10-04
|
|
304
|
MS_DRG
|
Hypertension With Mcc
|
3
|
3
|
$10,498.50
|
$10,498.50
|
$17,169.94
|
$22,836.02
|
$17,513.34
|
2025-10-04
|
|
78
|
MS_DRG
|
Hypertensive Encephalopathy With Cc
|
3
|
3
|
$12,706.50
|
$12,706.50
|
$17,169.94
|
$22,836.02
|
$17,513.34
|
2025-10-04
|
|
305
|
MS_DRG
|
Hypertension Without Mcc
|
3
|
3
|
$53,300.50
|
$53,300.50
|
$17,169.94
|
$22,836.02
|
$17,513.34
|
2025-10-04
|
|
683
|
MS_DRG
|
Renal Failure With Cc
|
3
|
3
|
$8,933.75
|
$8,933.75
|
$17,139.42
|
$22,795.43
|
$17,482.21
|
2025-10-04
|
|
682
|
MS_DRG
|
Renal Failure With Mcc
|
3
|
3
|
$9,686.00
|
$9,686.00
|
$17,139.42
|
$22,795.43
|
$17,482.21
|
2025-10-04
|
|
699
|
MS_DRG
|
Other Kidney And Urinary Tract Diagnoses With Cc
|
3
|
3
|
$13,705.13
|
$13,705.13
|
$17,139.42
|
$22,795.43
|
$17,482.21
|
2025-10-04
|
|
698
|
MS_DRG
|
Other Kidney And Urinary Tract Diagnoses With Mcc
|
3
|
3
|
$21,277.20
|
$21,277.20
|
$17,139.42
|
$22,795.43
|
$17,482.21
|
2025-10-04
|
|
637
|
MS_DRG
|
Diabetes With Mcc
|
3
|
3
|
$42,689.50
|
$42,689.50
|
$17,114.16
|
$22,761.83
|
$17,456.44
|
2025-10-04
|
|
638
|
MS_DRG
|
Diabetes With Cc
|
3
|
3
|
$26,901.30
|
$26,901.30
|
$17,114.16
|
$22,761.83
|
$17,456.44
|
2025-10-04
|
|
639
|
MS_DRG
|
Diabetes Without Cc/mcc
|
3
|
3
|
$13,754.11
|
$13,754.11
|
$17,114.16
|
$22,761.83
|
$17,456.44
|
2025-10-04
|
|
J9356
|
HCPCS
|
Injection, Trastuzumab, 10 Mg And Hyaluronidase-oysk
|
22
|
22
|
$19,176.00
|
$19,176.00
|
$85.99
|
$18,600.72
|
$17,258.40
|
2025-10-04
|
|
389
|
MS_DRG
|
Gastrointestinal Obstruction With Cc
|
3
|
3
|
$11,671.00
|
$11,671.00
|
$16,818.42
|
$22,368.50
|
$17,154.79
|
2025-10-04
|
|
388
|
MS_DRG
|
Gastrointestinal Obstruction With Mcc
|
3
|
3
|
$21,427.75
|
$21,427.75
|
$16,818.42
|
$22,368.50
|
$17,154.79
|
2025-10-04
|
|
725
|
MS_DRG
|
Benign Prostatic Hypertrophy With Mcc
|
3
|
3
|
$12,507.00
|
$12,507.00
|
$16,740.53
|
$22,264.91
|
$17,075.35
|
2025-10-04
|
|
640
|
MS_DRG
|
Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M…
|
3
|
3
|
$16,722.78
|
$16,722.78
|
$16,690.02
|
$22,197.72
|
$17,023.82
|
2025-10-04
|
|
641
|
MS_DRG
|
Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou…
|
3
|
3
|
$15,452.92
|
$15,452.92
|
$16,690.02
|
$22,197.72
|
$17,023.82
|
2025-10-04
|
|
390
|
MS_DRG
|
Gastrointestinal Obstruction Without Cc/mcc
|
2
|
2
|
$7,148.38
|
$7,148.38
|
$16,818.42
|
$17,154.79
|
$16,986.60
|
2025-10-04
|
|
562
|
MS_DRG
|
Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit…
|
3
|
3
|
$19,177.00
|
$19,177.00
|
$16,617.40
|
$22,101.14
|
$16,949.74
|
2025-10-04
|
|
602
|
MS_DRG
|
Cellulitis With Mcc
|
3
|
3
|
$36,018.00
|
$36,018.00
|
$16,473.21
|
$21,909.37
|
$16,802.67
|
2025-10-04
|
|
603
|
MS_DRG
|
Cellulitis Without Mcc
|
3
|
3
|
$23,152.04
|
$23,152.04
|
$16,473.21
|
$21,909.37
|
$16,802.67
|
2025-10-04
|
|
563
|
MS_DRG
|
Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit…
|
2
|
2
|
$38,178.17
|
$38,178.17
|
$16,617.40
|
$16,949.74
|
$16,783.57
|
2025-10-04
|
|
607
|
MS_DRG
|
Minor Skin Disorders Without Mcc
|
3
|
3
|
$15,493.50
|
$15,493.50
|
$16,433.21
|
$21,856.18
|
$16,761.88
|
2025-10-04
|
|
947
|
MS_DRG
|
Signs And Symptoms With Mcc
|
3
|
3
|
$88,119.25
|
$88,119.25
|
$16,432.16
|
$21,854.78
|
$16,760.81
|
2025-10-04
|
|
948
|
MS_DRG
|
Signs And Symptoms Without Mcc
|
3
|
3
|
$20,621.31
|
$20,621.31
|
$16,432.16
|
$21,854.78
|
$16,760.81
|
2025-10-04
|
|
690
|
MS_DRG
|
Kidney And Urinary Tract Infections Without Mcc
|
3
|
3
|
$20,143.73
|
$20,143.73
|
$16,401.64
|
$21,814.18
|
$16,729.67
|
2025-10-04
|
|
310
|
MS_DRG
|
Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc
|
3
|
3
|
$16,476.42
|
$16,476.42
|
$16,339.55
|
$21,731.59
|
$16,666.34
|
2025-10-04
|
|
308
|
MS_DRG
|
Cardiac Arrhythmia And Conduction Disorders With Mcc
|
3
|
3
|
$19,010.28
|
$19,010.28
|
$16,339.55
|
$21,731.59
|
$16,666.34
|
2025-10-04
|
|
922
|
MS_DRG
|
Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc
|
3
|
3
|
$30,966.50
|
$30,966.50
|
$16,304.81
|
$21,685.40
|
$16,630.91
|
2025-10-04
|
|
923
|
MS_DRG
|
Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc
|
3
|
3
|
$23,786.73
|
$23,786.73
|
$16,304.81
|
$21,685.40
|
$16,630.91
|
2025-10-04
|
|
J2353
|
HCPCS
|
Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg
|
40
|
22
|
$17,492.50
|
$17,492.50
|
$212.29
|
$25,407.70
|
$16,617.88
|
2025-10-04
|