Hospital

LUTHERAN MEDICAL CENTER

Wheat Ridge, CO · CCN 060009 · Rates published

24,055 distinct procedures filed

21 distinct payers

1,500,046 rate rows

2026-07-15 last MRF observed

Data quality

1,483,939 of 1,500,046 rate rows are consumer-grade (98.9%)

16,107 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
template filing: same amount across many unrelated codes — excluded	5,658
placeholder amount (≤ $0.02) — excluded from medians	5,233
per-diem day rate — not a per-procedure price	2,940
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	2,045
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	231

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://intermountainhealthcare.org/sc10media/files/intermountain-health/locations/hospital-prices/841103606_lutheran-medical-center_standardcharges.ashx
Discovered via	Discovered by HANK (automated)
Last fetch	not_modified · 2026-10-15
Content fingerprint	3b73f6c2dc1c6b19… · 6,090,258 bytes · first seen 2026-05-15

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code	Description	Payers	Min $	Max $	Avg median	vs national
J3399 HCPCS	Inj Onase Abepar-xioi Treat	6	$2,430,559.50	$3,884,946.48	$3,884,946.48	nat. median $2,455,111 1.6× median
J3393 HCPCS	Inj Betibeglogene Autotemce	6	$50.00	$4,897,200.00	$2,916,282.60	nat. median $2,968,000 1.0× median
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell Immunotherapy	17	$302,027.59	$991,606.64	$908,566.11	nat. median $168,055 outlier · 5.4×
Q2042 HCPCS	Tisagenlecleucel Car-pos T	9	$50.00	$1,538,488.12	$863,696.72	nat. median $621,313 1.4× median
Q2056 HCPCS	Ciltacabtagene Car-pos T	9	$50.00	$1,471,259.27	$837,683.55	nat. median $599,737 1.4× median
Q2055 HCPCS	Idecabtagene Vicleucel Car	9	$50.00	$1,449,026.62	$830,699.97	nat. median $574,037 1.4× median
Q2054 HCPCS	Lisocabtagene Mara Car Pos T	9	$50.00	$1,462,599.29	$819,043.85	nat. median $579,571 1.4× median
Q2041 HCPCS	Axicabtagene Ciloleucel Car+	9	$50.00	$1,386,398.44	$807,075.90	nat. median $562,501 1.4× median
Q2053 HCPCS	Brexucabtagene Car Pos T	9	$50.00	$1,272,191.99	$741,576.00	nat. median $513,770 1.4× median
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	17	$196,003.76	$643,512.82	$544,067.58	nat. median $186,516 outlier · 2.9×
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	17	$149,328.90	$490,271.53	$449,214.52	nat. median $131,925 outlier · 3.4×
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…	17	$148,452.53	$487,394.27	$446,578.21	nat. median $145,435 outlier · 3.1×
4 MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec…	17	$96,878.97	$318,069.70	$291,433.46	nat. median $97,418 outlier · 3.0×
7 MS_DRG	Lung Transplant	16	$90,575.83	$297,375.44	$267,343.93	nat. median $70,649 outlier · 3.8×
J3403 HCPCS	Revakinagene Per Implant	5	$254,925.00	$669,500.00	$256,212.50	nat. median $264,195 1.0× median
14 MS_DRG	Allogeneic Bone Marrow Transplant	16	$84,055.17	$275,967.04	$248,097.53	nat. median $72,715 outlier · 3.4×
209 MS_DRG	Complex Aortic Arch Procedures	17	$79,165.55	$259,913.60	$238,147.55	nat. median $2,110 outlier · 112.8×
426 MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	17	$77,084.08	$253,079.82	$231,886.05	nat. median $2,736 outlier · 84.8×
212 MS_DRG	Concomitant Aortic And Mitral Valve?procedures	17	$76,055.24	$249,701.96	$228,791.06	nat. median $74,509 outlier · 3.1×
2 MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	17	$79,256.47	$260,212.12	$220,000.25	nat. median $65,418 outlier · 3.4×
5 MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	17	$72,113.33	$236,760.01	$216,932.92	nat. median $69,922 outlier · 3.1×
215 MS_DRG	Other Heart Assist System Implant	17	$69,640.89	$228,642.59	$209,495.28	nat. median $73,023 outlier · 2.9×
216 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	17	$68,422.51	$224,642.44	$205,830.11	nat. median $69,822 outlier · 2.9×
J3402 HCPCS	Inj. Remestemcel-l-rknd/ Td	5	$203,583.60	$534,664.00	$204,611.80	nat. median $207,733 1.0× median
453 MS_DRG	Combined Anterior/posterior Spinal Fusion W Mcc	4	$134,303.38	$203,484.33	$203,484.33	nat. median $2,106 outlier · 96.6×
429 MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	17	$63,014.62	$206,887.44	$189,561.98	nat. median $2,596 outlier · 73.0×
850 MS_DRG	Acute Leukemia With Other Procedures	17	$60,565.97	$198,848.10	$182,195.88	nat. median $2,633 outlier · 69.2×
231 MS_DRG	Coronary Bypass With Ptca With Mcc	17	$58,960.10	$193,575.79	$177,365.10	nat. median $60,505 outlier · 2.9×
456 MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	17	$58,774.76	$192,967.27	$176,807.54	nat. median $59,651 outlier · 3.0×
20 MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	17	$55,035.68	$180,691.25	$165,559.55	nat. median $56,428 outlier · 2.9×
219 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	17	$53,703.29	$176,316.80	$161,551.43	nat. median $55,923 outlier · 2.9×
233 MS_DRG	Coronary Bypass With Cardiac Catheterization With Mcc	17	$53,471.78	$175,556.73	$160,855.01	nat. median $55,935 outlier · 2.9×
957 MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	17	$53,294.83	$174,975.76	$160,322.70	nat. median $52,327 outlier · 3.1×
J1823 HCPCS	Inebilizumab-cdon 10 Mg/ml Intravenous Solution	21	$50.00	$384,643.69	$153,049.72	nat. median $562 outlier · 272.2×
459 MS_DRG	Spinal Fusion Except Cervical With Mcc	4	$100,519.14	$152,297.50	$152,297.50	nat. median $2,106 outlier · 72.3×
427 MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	17	$50,488.07	$165,760.71	$151,879.34	nat. median $9,905 outlier · 15.3×
928 MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	17	$50,167.04	$164,706.71	$150,913.61	nat. median $37,013 outlier · 4.1×
19 MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	17	$49,900.56	$163,831.82	$150,111.98	nat. median $45,605 outlier · 3.3×
275 MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	17	$49,871.19	$163,735.38	$150,023.62	nat. median $51,518 outlier · 2.9×
10 MS_DRG	Pancreas Transplant	16	$50,188.02	$164,775.60	$148,135.15	nat. median $23,080 outlier · 6.4×
870 MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	17	$48,342.26	$158,715.66	$145,424.27	nat. median $48,611 outlier · 3.0×
268 MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	17	$48,105.16	$157,937.22	$144,711.02	nat. median $49,569 outlier · 2.9×
K1007 HCPCS	Bil Hkaf Pc S/d Micro Sensor	1	$142,064.43	$142,064.43	$142,064.43	nat. median $95,583 1.5× median
955 MS_DRG	Craniotomy For Multiple Significant Trauma	17	$47,078.42	$154,566.25	$141,622.34	nat. median $47,340 outlier · 3.0×
317 MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	17	$46,766.48	$153,542.10	$140,683.96	nat. median $2,633 outlier · 53.4×
447 MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	17	$46,732.21	$153,429.58	$140,580.86	nat. median $2,958 outlier · 47.5×
454 MS_DRG	Combined Anterior/posterior Spinal Fusion W Cc	4	$92,698.64	$140,448.60	$140,448.60	nat. median $2,106 outlier · 66.7×
Q2043 HCPCS	Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension	21	$50.00	$551,465.43	$139,107.15	nat. median $63,499 outlier · 2.2×
217 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	17	$45,988.73	$150,988.61	$138,344.31	nat. median $47,458 outlier · 2.9×
218 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	17	$45,988.73	$150,988.61	$138,344.31	nat. median $45,446 outlier · 3.0×

Other procedures at this hospital

Browse this hospital's 24,055 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

J3399	HCPCS	Inj Onase Abepar-xioi Treat	20	6	—	—	$2,430,559.50	$3,884,946.48	$3,884,946.48	2026-07-15
J3393	HCPCS	Inj Betibeglogene Autotemce	33	6	—	—	$50.00	$4,897,200.00	$2,916,282.60	2026-07-15
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell Immunotherapy	57	17	—	—	$302,027.59	$991,606.64	$908,566.11	2026-07-15
Q2042	HCPCS	Tisagenlecleucel Car-pos T	45	9	—	—	$50.00	$1,538,488.12	$863,696.72	2026-07-15
Q2056	HCPCS	Ciltacabtagene Car-pos T	45	9	—	—	$50.00	$1,471,259.27	$837,683.55	2026-07-15
Q2055	HCPCS	Idecabtagene Vicleucel Car	45	9	—	—	$50.00	$1,449,026.62	$830,699.97	2026-07-15
Q2054	HCPCS	Lisocabtagene Mara Car Pos T	45	9	—	—	$50.00	$1,462,599.29	$819,043.85	2026-07-15
Q2041	HCPCS	Axicabtagene Ciloleucel Car+	45	9	—	—	$50.00	$1,386,398.44	$807,075.90	2026-07-15
Q2053	HCPCS	Brexucabtagene Car Pos T	45	9	—	—	$50.00	$1,272,191.99	$741,576.00	2026-07-15
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	46	17	—	—	$196,003.76	$643,512.82	$544,067.58	2026-07-15
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	58	17	—	—	$149,328.90	$490,271.53	$449,214.52	2026-07-15
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…	58	17	—	—	$148,452.53	$487,394.27	$446,578.21	2026-07-15
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec…	58	17	—	—	$96,878.97	$318,069.70	$291,433.46	2026-07-15
7	MS_DRG	Lung Transplant	45	16	—	—	$90,575.83	$297,375.44	$267,343.93	2026-07-15
J3403	HCPCS	Revakinagene Per Implant	10	5	—	—	$254,925.00	$669,500.00	$256,212.50	2026-07-15
14	MS_DRG	Allogeneic Bone Marrow Transplant	45	16	—	—	$84,055.17	$275,967.04	$248,097.53	2026-07-15
209	MS_DRG	Complex Aortic Arch Procedures	58	17	—	—	$79,165.55	$259,913.60	$238,147.55	2026-07-15
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	58	17	—	—	$77,084.08	$253,079.82	$231,886.05	2026-07-15
212	MS_DRG	Concomitant Aortic And Mitral Valve?procedures	58	17	—	—	$76,055.24	$249,701.96	$228,791.06	2026-07-15
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	46	17	—	—	$79,256.47	$260,212.12	$220,000.25	2026-07-15
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	57	17	—	—	$72,113.33	$236,760.01	$216,932.92	2026-07-15
215	MS_DRG	Other Heart Assist System Implant	58	17	—	—	$69,640.89	$228,642.59	$209,495.28	2026-07-15
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	58	17	—	—	$68,422.51	$224,642.44	$205,830.11	2026-07-15
J3402	HCPCS	Inj. Remestemcel-l-rknd/ Td	10	5	—	—	$203,583.60	$534,664.00	$204,611.80	2026-07-15
453	MS_DRG	Combined Anterior/posterior Spinal Fusion W Mcc	11	4	—	—	$134,303.38	$203,484.33	$203,484.33	2026-07-15
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	58	17	—	—	$63,014.62	$206,887.44	$189,561.98	2026-07-15
850	MS_DRG	Acute Leukemia With Other Procedures	58	17	—	—	$60,565.97	$198,848.10	$182,195.88	2026-07-15
231	MS_DRG	Coronary Bypass With Ptca With Mcc	58	17	—	—	$58,960.10	$193,575.79	$177,365.10	2026-07-15
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	58	17	—	—	$58,774.76	$192,967.27	$176,807.54	2026-07-15
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	58	17	—	—	$55,035.68	$180,691.25	$165,559.55	2026-07-15
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	58	17	—	—	$53,703.29	$176,316.80	$161,551.43	2026-07-15
233	MS_DRG	Coronary Bypass With Cardiac Catheterization With Mcc	58	17	—	—	$53,471.78	$175,556.73	$160,855.01	2026-07-15
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	58	17	—	—	$53,294.83	$174,975.76	$160,322.70	2026-07-15
J1823	HCPCS	Inebilizumab-cdon 10 Mg/ml Intravenous Solution	203	21	$376,093.03	—	$50.00	$384,643.69	$153,049.72	2026-07-15
459	MS_DRG	Spinal Fusion Except Cervical With Mcc	11	4	—	—	$100,519.14	$152,297.50	$152,297.50	2026-07-15
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	58	17	—	—	$50,488.07	$165,760.71	$151,879.34	2026-07-15
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	58	17	—	—	$50,167.04	$164,706.71	$150,913.61	2026-07-15
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	57	17	—	—	$49,900.56	$163,831.82	$150,111.98	2026-07-15
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	58	17	—	—	$49,871.19	$163,735.38	$150,023.62	2026-07-15
10	MS_DRG	Pancreas Transplant	45	16	—	—	$50,188.02	$164,775.60	$148,135.15	2026-07-15
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	58	17	—	—	$48,342.26	$158,715.66	$145,424.27	2026-07-15
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	58	17	—	—	$48,105.16	$157,937.22	$144,711.02	2026-07-15
K1007	HCPCS	Bil Hkaf Pc S/d Micro Sensor	4	1	—	—	$142,064.43	$142,064.43	$142,064.43	2026-07-15
955	MS_DRG	Craniotomy For Multiple Significant Trauma	58	17	—	—	$47,078.42	$154,566.25	$141,622.34	2026-07-15
317	MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	58	17	—	—	$46,766.48	$153,542.10	$140,683.96	2026-07-15
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	58	17	—	—	$46,732.21	$153,429.58	$140,580.86	2026-07-15
454	MS_DRG	Combined Anterior/posterior Spinal Fusion W Cc	11	4	—	—	$92,698.64	$140,448.60	$140,448.60	2026-07-15
Q2043	HCPCS	Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension	132	21	$551,465.43	—	$50.00	$551,465.43	$139,107.15	2026-07-15
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	58	17	—	—	$45,988.73	$150,988.61	$138,344.31	2026-07-15
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	58	17	—	—	$45,988.73	$150,988.61	$138,344.31	2026-07-15
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	58	17	—	—	$45,821.57	$150,439.80	$137,841.46	2026-07-15
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	58	17	—	—	$45,005.35	$147,760.02	$135,386.09	2026-07-15
Q0480	HCPCS	Driver Pneumatic Vad Rep	14	6	—	—	$109,037.80	$286,361.89	$133,099.54	2026-07-15
266	MS_DRG	Endovascular Cardiac Valve Replacement W Mcc	58	17	—	—	$42,863.04	$140,726.45	$128,941.54	2026-07-15
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	58	17	—	—	$42,813.38	$140,563.41	$128,792.15	2026-07-15
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	58	17	—	—	$42,402.82	$139,215.48	$127,557.10	2026-07-15
28	MS_DRG	Spinal Procedures With Mcc	58	17	—	—	$42,023.04	$137,968.59	$126,414.63	2026-07-15
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	58	17	—	—	$42,011.15	$137,929.56	$126,378.86	2026-07-15
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	58	17	—	—	$41,706.90	$136,930.67	$125,463.62	2026-07-15
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome- Neonate	48	15	—	—	$41,569.82	$136,106.15	$125,051.24	2026-07-15
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	58	17	—	—	$41,045.95	$134,760.66	$123,475.34	2026-07-15
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	58	17	—	—	$41,019.37	$134,673.40	$123,395.39	2026-07-15
16	MS_DRG	Autolous Bone Marrow Transplant With Cc/mcc	45	16	—	—	$41,473.30	$136,163.70	$122,412.73	2026-07-15
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	58	17	—	—	$40,336.04	$132,429.92	$121,339.78	2026-07-15
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	58	17	—	—	$40,078.66	$131,584.88	$120,565.51	2026-07-15
213	MS_DRG	Endovascular Abdominal Aorta With Iliac Branch Procedures	58	17	—	—	$39,915.00	$131,047.54	$120,073.18	2026-07-15
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	58	17	—	—	$39,863.24	$130,877.62	$119,917.48	2026-07-15
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	58	17	—	—	$39,321.19	$129,097.99	$118,286.88	2026-07-15
Q9982	HCPCS	Flutemetamol F-18 5 Mci (185 Mbq) Intravenous Solution	183	21	$405,240.00	—	$50.00	$607,860.00	$117,519.60	2026-07-15
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	58	17	—	—	$38,930.92	$127,816.65	$117,112.85	2026-07-15
461	MS_DRG	Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc	58	17	—	—	$38,628.77	$126,824.65	$116,203.92	2026-07-15
8	MS_DRG	Simultaneous Pancreas/kidney Transplant	45	16	—	—	$39,199.49	$128,698.43	$115,701.36	2026-07-15
834	MS_DRG	Acute Leukemia Without Major O.r. Procedures With Mcc	58	17	—	—	$38,397.26	$126,064.57	$115,507.50	2026-07-15
405	MS_DRG	Pancreas- Liver And Shunt Procedures With Mcc	58	17	—	—	$38,261.58	$125,619.09	$115,099.32	2026-07-15
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Without Mcc	58	17	—	—	$38,207.02	$125,439.98	$114,935.21	2026-07-15
11	MS_DRG	Tracheostomy For Facemouth & Neck Diagnoses W Mcc	58	17	—	—	$38,146.87	$125,242.50	$114,754.26	2026-07-15
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	58	17	—	—	$37,298.48	$122,457.09	$112,202.11	2026-07-15
17	MS_DRG	Autolous Bone Marrow Transplant Without Cc/mcc	45	16	—	—	$37,994.40	$124,741.90	$112,144.40	2026-07-15
450	MS_DRG	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	58	17	—	—	$37,276.10	$122,383.60	$112,134.78	2026-07-15
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	58	17	—	—	$37,025.71	$121,561.53	$111,381.55	2026-07-15
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	58	17	—	—	$36,903.31	$121,159.68	$111,013.35	2026-07-15
466	MS_DRG	Revision Of Hip Or Knee Replacement With Mcc	58	17	—	—	$36,407.42	$119,531.60	$109,521.62	2026-07-15
653	MS_DRG	Major Bladder Procedures With Mcc	58	17	—	—	$36,344.47	$119,324.93	$109,332.26	2026-07-15
A9513	HCPCS	Lutetium Lu 177 Dotatate 10 Mci/ml (370 Mbq/ml) Intravenous Solution	126	21	$429,001.80	—	$50.00	$429,001.80	$108,215.71	2026-07-15
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	58	17	—	—	$35,251.99	$115,738.11	$106,045.81	2026-07-15
455	MS_DRG	Combined Anterior/posterior Spinal Fusion Without Cc/mcc	11	4	—	—	$69,802.47	$105,758.39	$105,758.39	2026-07-15
326	MS_DRG	Stomach- Esophageal And Duodenal Procedures With Mcc	58	17	—	—	$34,882.69	$114,525.67	$104,934.90	2026-07-15
228	MS_DRG	Other Cardiothoracic Procedures With Mcc	58	17	—	—	$34,602.93	$113,607.15	$104,093.30	2026-07-15
853	MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	58	17	—	—	$34,541.38	$113,405.07	$103,908.14	2026-07-15
239	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	58	17	—	—	$34,423.18	$113,017.00	$103,552.57	2026-07-15
576	MS_DRG	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	58	17	—	—	$34,279.80	$112,546.26	$103,121.25	2026-07-15
471	MS_DRG	Cervical Spinal Fusion With Mcc	58	17	—	—	$33,772.72	$110,881.44	$101,595.85	2026-07-15
837	MS_DRG	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	58	17	—	—	$33,602.06	$110,321.14	$101,082.47	2026-07-15
267	MS_DRG	Endovascular Cardiac Valve Replacement Without Mcc	58	17	—	—	$33,297.82	$109,322.25	$100,167.23	2026-07-15
650	MS_DRG	Kidney Transplant With Hemodialysis With Mcc	57	17	—	—	$32,882.36	$107,958.25	$98,917.46	2026-07-15
981	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	58	17	—	—	$32,815.22	$107,737.80	$98,715.47	2026-07-15
826	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	58	17	—	—	$32,717.30	$107,416.32	$98,420.91	2026-07-15
6	MS_DRG	Liver Transplant Without Mcc	57	17	—	—	$32,431.94	$106,479.43	$97,562.48	2026-07-15
277	MS_DRG	Cardiac Defibrillator Implant Without Mcc	58	17	—	—	$32,302.55	$106,054.62	$97,173.24	2026-07-15
329	MS_DRG	Major Small And Large Bowel Procedures With Mcc	58	17	—	—	$32,148.68	$105,549.43	$96,710.36	2026-07-15
823	MS_DRG	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	58	17	—	—	$32,066.84	$105,280.76	$96,464.19	2026-07-15
245	MS_DRG	Aicd Generator Procedures	58	17	—	—	$31,910.17	$104,766.39	$95,992.90	2026-07-15
C1826	HCPCS	Hc Gen Neuro Rchg W Bat & Lds & Cmpnts Implant Lvl 56	81	21	$167,425.75	—	$25.85	$167,425.75	$95,851.24	2026-07-15
856	MS_DRG	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	58	17	—	—	$31,814.35	$104,451.80	$95,704.65	2026-07-15
25	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Mcc	58	17	—	—	$31,800.37	$104,405.87	$95,662.57	2026-07-15
799	MS_DRG	Splenic Procedures With Mcc	58	17	—	—	$31,675.87	$103,997.13	$95,288.06	2026-07-15
163	MS_DRG	Major Chest Procedures With Mcc	58	17	—	—	$31,346.45	$102,915.57	$94,297.07	2026-07-15
31	MS_DRG	Ventricular Shunt Procedures With Mcc	58	17	—	—	$31,337.35	$102,885.72	$94,269.72	2026-07-15
319	MS_DRG	Other Endovascular Cardiac Valve Procedures With Mcc	58	17	—	—	$31,214.26	$102,481.57	$93,899.42	2026-07-15
356	MS_DRG	Other Digestive System O.r. Procedures With Mcc	58	17	—	—	$30,723.96	$100,871.87	$92,424.51	2026-07-15
323	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	58	17	—	—	$30,266.55	$99,370.09	$91,048.50	2026-07-15
474	MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	58	17	—	—	$30,025.25	$98,577.86	$90,322.62	2026-07-15
140	MS_DRG	Major Head And Neck Procedures With Mcc	58	17	—	—	$29,832.21	$97,944.08	$89,741.91	2026-07-15
448	MS_DRG	Multiple Level Spinal Fusion Except Cervical Without Mcc	58	17	—	—	$29,660.85	$97,381.49	$89,226.43	2026-07-15
A9607	HCPCS	Lutetium Lu-177 Vipivotide Tetraxetan 27 Mci/ml (1,000 Mbq/ml) IV Soln	123	21	$349,346.82	—	$50.00	$349,346.82	$88,908.77	2026-07-15
269	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	58	17	—	—	$29,537.75	$96,977.34	$88,856.13	2026-07-15
12	MS_DRG	Tracheostomy For Facemouth & Neck Diagnoses W Cc	58	17	—	—	$29,487.40	$96,812.01	$88,704.64	2026-07-15
958	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Cc	58	17	—	—	$29,472.71	$96,763.79	$88,660.46	2026-07-15
673	MS_DRG	Other Kidney And Urinary Tract Procedures With Mcc	58	17	—	—	$29,386.68	$96,481.34	$88,401.66	2026-07-15
901	MS_DRG	Wound Debridements For Injuries With Mcc	58	17	—	—	$29,351.71	$96,366.53	$88,296.46	2026-07-15
236	MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	58	17	—	—	$29,297.16	$96,187.41	$88,132.35	2026-07-15
458	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	58	17	—	—	$29,183.85	$95,815.41	$87,791.50	2026-07-15
423	MS_DRG	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	58	17	—	—	$29,046.76	$95,365.34	$87,379.12	2026-07-15
273	MS_DRG	Percutaneous Intracardiac Procedures W Mcc	58	17	—	—	$28,854.42	$94,733.86	$86,800.52	2026-07-15
791	MS_DRG	Prematurity With Major Problems	48	15	—	—	$28,389.31	$96,758.00	$85,401.36	2026-07-15
J7330	HCPCS	Cultured Chondrocytes Implnt	28	4	—	—	$50.00	$203,694.25	$85,400.52	2026-07-15
C1823	HCPCS	Hc Neurostim Generator/lead Lvl 46	284	16	$203,749.65	—	$13,686.98	$272,719.90	$85,259.44	2026-07-15
L8702	HCPCS	Ewhf S/d Uprt Micro Sensor	14	6	—	—	$66,778.13	$175,376.92	$85,126.05	2026-07-15
402	MS_DRG	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	58	17	—	—	$28,120.04	$92,322.74	$84,591.32	2026-07-15
460	MS_DRG	Spinal Fusion Except Cervical Without Mcc	11	4	—	—	$55,439.13	$83,996.36	$83,996.36	2026-07-15
802	MS_DRG	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	58	17	—	—	$27,865.45	$91,486.89	$83,825.46	2026-07-15
A9543	HCPCS	Y90 Ibritumomab Rx	52	9	—	—	$50.00	$147,743.83	$82,995.41	2026-07-15
24	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	58	17	—	—	$27,360.47	$89,828.96	$82,306.38	2026-07-15
933	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	58	17	—	—	$27,236.67	$89,422.51	$81,933.97	2026-07-15
793	MS_DRG	Full Term Neonate With Major Problems	48	15	—	—	$25,181.10	$95,483.84	$81,775.92	2026-07-15
34	MS_DRG	Carotid Artery Stent Procedures With Mcc	58	17	—	—	$27,072.31	$88,882.88	$81,439.53	2026-07-15
876	MS_DRG	O.r. Procedures With Principal Diagnosis Of Mental Illness	58	17	—	—	$27,031.75	$88,749.70	$81,317.50	2026-07-15
40	MS_DRG	Peripheral- Cranial Nerve And Other Nervous System Procedures With Mcc	58	17	—	—	$27,005.87	$88,664.74	$81,239.65	2026-07-15
907	MS_DRG	Other O.r. Procedures For Injuries With Mcc	58	17	—	—	$26,852.69	$88,161.85	$80,778.87	2026-07-15
956	MS_DRG	Limb Reattachment- Hip And Femur Procedures For Multiple Significant Trauma	58	17	—	—	$26,319.04	$86,409.77	$79,173.52	2026-07-15
143	MS_DRG	Other Ear- Nose- Mouth And Throat O.r. Procedures With Mcc	58	17	—	—	$26,204.34	$86,033.18	$78,828.46	2026-07-15
166	MS_DRG	Other Respiratory System O.r. Procedures With Mcc	58	17	—	—	$26,142.09	$85,828.81	$78,641.21	2026-07-15
518	MS_DRG	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	58	17	—	—	$26,139.29	$85,819.62	$78,632.79	2026-07-15
628	MS_DRG	Other Endocrine- Nutritional And Metabolic O.r. Procedures With Mcc	58	17	—	—	$26,065.85	$85,578.51	$78,411.87	2026-07-15
651	MS_DRG	Kidney Transplant With Hemodialysis Without Mcc	57	17	—	—	$25,918.97	$85,096.29	$77,970.03	2026-07-15
904	MS_DRG	Skin Grafts For Injuries With Cc/mcc	58	17	—	—	$25,690.26	$84,345.40	$77,282.02	2026-07-15
492	MS_DRG	Lower Extremity And Humerus Procedures Except Hip- Foot And Femur With Mcc	58	17	—	—	$25,679.77	$84,310.95	$77,250.46	2026-07-15
939	MS_DRG	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	58	17	—	—	$25,378.32	$83,321.25	$76,343.64	2026-07-15
495	MS_DRG	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	58	17	—	—	$25,358.74	$83,256.95	$76,284.73	2026-07-15
332	MS_DRG	Rectal Resection With Mcc	58	17	—	—	$25,323.77	$83,142.13	$76,179.53	2026-07-15
265	MS_DRG	Aicd Lead Procedures	58	17	—	—	$25,306.28	$83,084.73	$76,126.93	2026-07-15
97	MS_DRG	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	58	17	—	—	$25,261.52	$82,937.76	$75,992.27	2026-07-15
279	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	58	17	—	—	$25,223.75	$82,813.76	$75,878.66	2026-07-15
739	MS_DRG	Uterineadnexa Proc For Non-ovarian/adnexal Malig W Mcc	58	17	—	—	$25,058.69	$82,271.84	$75,382.11	2026-07-15
736	MS_DRG	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	58	17	—	—	$25,000.64	$82,081.24	$75,207.48	2026-07-15
335	MS_DRG	Peritoneal Adhesiolysis With Mcc	58	17	—	—	$24,975.46	$81,998.58	$75,131.74	2026-07-15
408	MS_DRG	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	58	17	—	—	$24,938.39	$81,876.87	$75,020.22	2026-07-15
414	MS_DRG	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	58	17	—	—	$24,917.41	$81,807.98	$74,957.10	2026-07-15
622	MS_DRG	Skin Grafts And Wound Debridement For Endocrine- Nutritional And Metabolic Disor…	58	17	—	—	$24,893.63	$81,729.91	$74,885.57	2026-07-15
271	MS_DRG	Other Major Cardiovascular Procedures With Cc	58	17	—	—	$24,873.35	$81,663.32	$74,824.55	2026-07-15
467	MS_DRG	Revision Of Hip Or Knee Replacement With Cc	58	17	—	—	$24,665.62	$80,981.32	$74,199.66	2026-07-15
94	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System With Mcc	58	17	—	—	$24,615.26	$80,815.98	$74,048.18	2026-07-15
252	MS_DRG	Other Vascular Procedures With Mcc	58	17	—	—	$24,397.74	$80,101.83	$73,393.83	2026-07-15
616	MS_DRG	Amputation Of Lower Limb For Endocrine- Nutritional And Metabolic Disorders With…	58	17	—	—	$24,391.45	$80,081.17	$73,374.90	2026-07-15
J9029	HCPCS	Instill Adstiladrin Tx Dose	55	11	—	—	$50.00	$164,689.93	$73,080.00	2026-07-15
574	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Cc	58	17	—	—	$24,279.54	$79,713.76	$73,038.26	2026-07-15
J9226	HCPCS	Supprelin La Implant	64	13	—	—	$50.00	$117,053.69	$72,861.11	2026-07-15
477	MS_DRG	Biopsies Of Musculoskeletal System And Connective Tissue With Mcc	58	17	—	—	$24,162.04	$79,327.98	$72,684.78	2026-07-15
359	MS_DRG	Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc	58	17	—	—	$24,050.13	$78,960.57	$72,348.14	2026-07-15
987	MS_DRG	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	58	17	—	—	$23,978.79	$78,726.35	$72,133.54	2026-07-15
29	MS_DRG	Spinal Procedures With Cc Or Spinal Neurostimulators	58	17	—	—	$23,861.29	$78,340.57	$71,780.06	2026-07-15
420	MS_DRG	Hepatobiliary Diagnostic Procedures With Mcc	58	17	—	—	$23,829.82	$78,237.24	$71,685.38	2026-07-15
264	MS_DRG	Other Circulatory System O.r. Procedures	58	17	—	—	$23,364.71	$76,710.20	$70,286.22	2026-07-15
411	MS_DRG	Cholecystectomy With C.d.e. With Mcc	58	17	—	—	$23,103.82	$75,853.68	$69,501.43	2026-07-15
37	MS_DRG	Extracranial Procedures With Mcc	58	17	—	—	$23,025.49	$75,596.49	$69,265.78	2026-07-15
274	MS_DRG	Percutaneous Intracardiac Procedures Without Mcc	58	17	—	—	$23,022.69	$75,587.31	$69,257.37	2026-07-15
260	MS_DRG	Cardiac Pacemaker Revision Except Device Replacement With Mcc	58	17	—	—	$22,750.62	$74,694.05	$68,438.91	2026-07-15
579	MS_DRG	Other Skin- Subcutaneous Tissue And Breast Procedures With Mcc	58	17	—	—	$22,650.60	$74,365.68	$68,138.04	2026-07-15
840	MS_DRG	Lymphoma And Non-acute Leukemia With Mcc	58	17	—	—	$22,625.42	$74,283.01	$68,062.30	2026-07-15
451	MS_DRG	Single Level Spinal Fusion Except Cervical Without Mcc	58	17	—	—	$22,593.95	$74,179.68	$67,967.62	2026-07-15
485	MS_DRG	Knee Procedures With Principal Diagnosis Of Infection With Mcc	58	17	—	—	$22,570.87	$74,103.90	$67,898.18	2026-07-15
929	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc	58	17	—	—	$22,526.80	$73,959.23	$67,765.63	2026-07-15
0427T	CPT	Insj/rplc Nstim Apnea Pls Gn	16	4	—	—	$4,129.00	$67,659.00	$67,659.00	2026-07-15
0424T	CPT	Insj/rplc Nstim Apnea Compl	16	4	—	—	$4,129.00	$67,659.00	$67,659.00	2026-07-15
0431T	CPT	Rmvl/rplc Nstim Apnea Pls Gn	16	4	—	—	$4,129.00	$67,659.00	$67,659.00	2026-07-15
325	MS_DRG	Coronary Intravascular Lithotripsy Without Intraluminal Device	58	17	—	—	$22,454.06	$73,720.42	$67,546.82	2026-07-15
242	MS_DRG	Permanent Cardiac Pacemaker Implant With Mcc	58	17	—	—	$22,330.97	$73,316.27	$67,176.51	2026-07-15
515	MS_DRG	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc	58	17	—	—	$22,289.70	$73,180.78	$67,052.38	2026-07-15
656	MS_DRG	Kidney And Ureter Procedures For Neoplasm With Mcc	58	17	—	—	$22,268.02	$73,109.60	$66,987.15	2026-07-15
22	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	58	17	—	—	$22,223.26	$72,962.64	$66,852.50	2026-07-15
652	MS_DRG	Kidney Transplant	45	16	—	—	$22,587.65	$74,159.01	$66,669.80	2026-07-15
500	MS_DRG	Soft Tissue Procedures With Mcc	58	17	—	—	$22,135.13	$72,673.30	$66,587.39	2026-07-15
829	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…	58	17	—	—	$22,101.56	$72,563.08	$66,486.40	2026-07-15
324	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc	58	17	—	—	$22,038.61	$72,356.41	$66,297.04	2026-07-15
229	MS_DRG	Other Cardiothoracic Procedures Without Mcc	58	17	—	—	$22,028.12	$72,321.97	$66,265.48	2026-07-15
258	MS_DRG	Cardiac Pacemaker Device Replacement With Mcc	58	17	—	—	$21,976.36	$72,152.04	$66,109.78	2026-07-15
665	MS_DRG	Prostatectomy With Mcc	58	17	—	—	$21,830.19	$71,672.12	$65,670.05	2026-07-15
464	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	58	17	—	—	$21,784.72	$71,522.86	$65,533.29	2026-07-15
26	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Cc	58	17	—	—	$21,746.26	$71,396.56	$65,417.57	2026-07-15
662	MS_DRG	Minor Bladder Procedures With Mcc	58	17	—	—	$21,412.63	$70,301.22	$64,413.96	2026-07-15
263	MS_DRG	Vein Ligation And Stripping	58	17	—	—	$21,383.96	$70,207.08	$64,327.70	2026-07-15
469	MS_DRG	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…	58	17	—	—	$21,214.70	$69,651.37	$63,818.53	2026-07-15
C1882	HCPCS	Hc Icd Biv/crt-d Lvl 46	923	16	$131,067.25	—	$13,686.98	$286,355.95	$63,621.75	2026-07-15
510	MS_DRG	Shoulderelbow Or Forearm Procexc Major Joint Proc W Mcc	58	17	—	—	$21,125.87	$69,359.74	$63,551.32	2026-07-15
625	MS_DRG	Thyroid- Parathyroid And Thyroglossal Procedures With Mcc	58	17	—	—	$21,123.08	$69,350.56	$63,542.90	2026-07-15
498	MS_DRG	Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…	58	17	—	—	$21,099.99	$69,274.78	$63,473.47	2026-07-15
173	MS_DRG	Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…	58	17	—	—	$20,817.43	$68,347.07	$62,623.46	2026-07-15
472	MS_DRG	Cervical Spinal Fusion With Cc	58	17	—	—	$20,605.51	$67,651.29	$61,985.94	2026-07-15
959	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc	58	17	—	—	$20,591.52	$67,605.37	$61,943.86	2026-07-15
570	MS_DRG	Skin Debridement With Mcc	58	17	—	—	$20,570.54	$67,536.48	$61,880.74	2026-07-15
L7181	HCPCS	Electronic Elbo Simultaneous	14	6	—	—	$48,412.11	$127,142.91	$61,713.79	2026-07-15
668	MS_DRG	Transurethral Procedures With Mcc	58	17	—	—	$20,422.96	$67,051.96	$61,436.80	2026-07-15
480	MS_DRG	Hip And Femur Procedures Except Major Joint With Mcc	58	17	—	—	$20,369.10	$66,875.14	$61,274.79	2026-07-15
353	MS_DRG	Hernia Procedures Except Inguinal And Femoral With Mcc	58	17	—	—	$20,297.06	$66,638.63	$61,058.08	2026-07-15
406	MS_DRG	Pancreas- Liver And Shunt Procedures With Cc	58	17	—	—	$20,284.48	$66,597.29	$61,020.21	2026-07-15
619	MS_DRG	O.r. Procedures For Obesity With Mcc	58	17	—	—	$20,194.95	$66,303.37	$60,750.90	2026-07-15
C1717	HCPCS	Hc Brachytherapy Source Hdr Ir192	81	21	$144,174.05	—	$338.97	$144,174.05	$60,740.53	2026-07-15
C2616	HCPCS	Hc Brachytx Non-str Yttrium-90	81	21	$144,174.05	—	$17,310.25	$144,174.05	$60,740.53	2026-07-15
974	MS_DRG	HIV With Major Related Condition With Mcc	58	17	—	—	$20,185.16	$66,271.22	$60,721.44	2026-07-15
13	MS_DRG	Tracheostomy For Facemouth & Neck Diagnoses Without Cc/mcc	58	17	—	—	$20,155.78	$66,174.77	$60,633.07	2026-07-15
521	MS_DRG	Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc	58	17	—	—	$20,074.65	$65,908.40	$60,389.01	2026-07-15
240	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc	58	17	—	—	$19,936.87	$65,456.03	$59,974.52	2026-07-15
800	MS_DRG	Splenic Procedures With Cc	58	17	—	—	$19,649.40	$64,512.25	$59,109.78	2026-07-15
654	MS_DRG	Major Bladder Procedures With Cc	58	17	—	—	$19,578.76	$64,280.33	$58,897.27	2026-07-15
A9606	HCPCS	Radium Ra 223 Dichlor 1,100 Kbq/ml (30 Microcurie/ml) Intravenous Soln	123	21	$230,906.68	—	$50.00	$230,906.68	$58,765.75	2026-07-15
503	MS_DRG	Foot Procedures With Mcc	58	17	—	—	$19,521.41	$64,092.03	$58,724.74	2026-07-15
90288	CPT	Botulism Ig IV	11	1	—	—	$58,446.00	$58,446.00	$58,446.00	2026-07-15
483	MS_DRG	Major Joint/limb Reattachment Procedure Of Upper Extremities	58	17	—	—	$19,387.12	$63,651.14	$58,320.78	2026-07-15
C9601	HCPCS	Perc Drug-el Cor Stent Bran	39	5	—	—	$4,669.00	$58,947.00	$58,282.00	2026-07-15
C9608	HCPCS	Perc D-e Cor Revasc Chro Add	38	5	—	—	$7,617.00	$58,947.00	$58,282.00	2026-07-15
61	MS_DRG	Ischemic Stroke- Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…	58	17	—	—	$19,283.61	$63,311.29	$58,009.38	2026-07-15
208	MS_DRG	Respiratory System Diagnosis With Ventilator Support <=96 Hours	58	17	—	—	$19,224.86	$63,118.40	$57,832.65	2026-07-15
468	MS_DRG	Revision Of Hip Or Knee Replacement Without Cc/mcc	58	17	—	—	$19,219.96	$63,102.32	$57,817.92	2026-07-15
963	MS_DRG	Other Multiple Significant Trauma With Mcc	58	17	—	—	$19,120.65	$62,776.25	$57,519.15	2026-07-15
321	MS_DRG	Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A…	58	17	—	—	$19,029.72	$62,477.73	$57,245.63	2026-07-15
849	MS_DRG	Radiotherapy	58	17	—	—	$18,950.69	$62,218.25	$57,007.88	2026-07-15
288	MS_DRG	Acute And Subacute Endocarditis With Mcc	58	17	—	—	$18,927.61	$62,142.47	$56,938.45	2026-07-15
255	MS_DRG	Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc	58	17	—	—	$18,866.06	$61,940.40	$56,753.30	2026-07-15
462	MS_DRG	Bilateral Or Multiple Major Joint Procs Of Lower Extremity Without Mcc	58	17	—	—	$18,604.48	$61,081.58	$55,966.40	2026-07-15
577	MS_DRG	Skin Graft Except For Skin Ulcer Or Cellulitis With Cc	58	17	—	—	$18,539.43	$60,868.02	$55,770.73	2026-07-15
970	MS_DRG	HIV With Extensive O.r. Procedures Without Mcc	58	17	—	—	$18,446.41	$60,562.62	$55,490.90	2026-07-15
253	MS_DRG	Other Vascular Procedures With Cc	58	17	—	—	$18,154.05	$59,602.76	$54,611.42	2026-07-15
846	MS_DRG	Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc	58	17	—	—	$18,132.37	$59,531.58	$54,546.20	2026-07-15
344	MS_DRG	Minor Small And Large Bowel Procedures With Mcc	58	17	—	—	$18,064.53	$59,308.84	$54,342.11	2026-07-15
95	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System With Cc	58	17	—	—	$18,039.35	$59,226.17	$54,266.37	2026-07-15
96	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc	58	17	—	—	$18,039.35	$59,226.17	$54,266.37	2026-07-15
L7180	HCPCS	Electronic Elbow Sequential	14	6	—	—	$42,425.37	$111,420.17	$54,082.14	2026-07-15
749	MS_DRG	Other Female Reproductive System O.r. Procedures With Cc/mcc	58	17	—	—	$17,958.22	$58,959.80	$54,022.30	2026-07-15
272	MS_DRG	Other Major Cardiovascular Procedures Without Cc/mcc	58	17	—	—	$17,856.10	$58,624.54	$53,715.12	2026-07-15
659	MS_DRG	Kidney And Ureter Procedures For Non-neoplasm With Mcc	58	17	—	—	$17,771.47	$58,346.69	$53,460.54	2026-07-15
493	MS_DRG	Lower Extremity And Humerus Procedures Except Hip- Foot And Femur With Cc	58	17	—	—	$17,737.90	$58,236.46	$53,359.54	2026-07-15
164	MS_DRG	Major Chest Procedures With Cc	58	17	—	—	$17,653.27	$57,958.61	$53,104.96	2026-07-15
27	MS_DRG	Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc	58	17	—	—	$17,645.58	$57,933.35	$53,081.82	2026-07-15
350	MS_DRG	Inguinal And Femoral Hernia Procedures With Mcc	58	17	—	—	$17,428.76	$57,221.50	$52,429.58	2026-07-15
C1820	HCPCS	Hc Generator Neuro Rechg Battery System Implant Lvl 16	213	16	$131,067.25	—	$500.14	$144,174.05	$52,295.83	2026-07-15
545	MS_DRG	Connective Tissue Disorders With Mcc	58	17	—	—	$17,357.42	$56,987.28	$52,214.97	2026-07-15
478	MS_DRG	Biopsies Of Musculoskeletal System And Connective Tissue With Cc	58	17	—	—	$17,200.05	$56,470.61	$51,741.57	2026-07-15
982	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc	58	17	—	—	$17,195.15	$56,454.54	$51,726.84	2026-07-15
327	MS_DRG	Stomach- Esophageal And Duodenal Procedures With Cc	58	17	—	—	$17,095.14	$56,126.16	$51,425.97	2026-07-15
473	MS_DRG	Cervical Spinal Fusion Without Cc/mcc	58	17	—	—	$17,074.85	$56,059.57	$51,364.95	2026-07-15
318	MS_DRG	Percutaneous Coronary Atherectomy Without Intraluminal Device	58	17	—	—	$16,941.26	$55,620.98	$50,963.09	2026-07-15
360	MS_DRG	Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc	58	17	—	—	$16,886.01	$55,439.57	$50,796.87	2026-07-15
320	MS_DRG	Other Endovascular Cardiac Valve Procedures Without Mcc	58	17	—	—	$16,823.06	$55,232.90	$50,607.51	2026-07-15
330	MS_DRG	Major Small And Large Bowel Procedures With Cc	58	17	—	—	$16,766.41	$55,046.90	$50,437.09	2026-07-15
397	MS_DRG	Appendix Procedures With Mcc	58	17	—	—	$16,750.32	$54,994.09	$50,388.70	2026-07-15
35	MS_DRG	Carotid Artery Stent Procedures With Cc	58	17	—	—	$16,719.55	$54,893.05	$50,296.12	2026-07-15
417	MS_DRG	Laparoscopic Cholecystectomy Without C.d.e. With Mcc	58	17	—	—	$16,690.87	$54,798.90	$50,209.86	2026-07-15
L2006	HCPCS	Kaf Sng/dbl Swg/stn Mcpr Cus	14	6	—	—	$39,087.58	$102,654.24	$49,827.24	2026-07-15
113	MS_DRG	Orbital Procedures With Cc/mcc	58	17	—	—	$16,443.98	$53,988.31	$49,467.14	2026-07-15
C1721	HCPCS	Hc Icd Dual Chamber Lvl 44	639	16	$98,472.55	—	$11,311.53	$193,816.50	$49,326.30	2026-07-15
333	MS_DRG	Rectal Resection With Cc	58	17	—	—	$16,381.73	$53,783.94	$49,279.89	2026-07-15
674	MS_DRG	Other Kidney And Urinary Tract Procedures With Cc	58	17	—	—	$16,356.55	$53,701.27	$49,204.14	2026-07-15
940	MS_DRG	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc	58	17	—	—	$16,344.66	$53,662.23	$49,168.38	2026-07-15
709	MS_DRG	Penis Procedures With Cc/mcc	58	17	—	—	$16,276.12	$53,437.20	$48,962.18	2026-07-15
357	MS_DRG	Other Digestive System O.r. Procedures With Cc	58	17	—	—	$16,264.93	$53,400.46	$48,928.52	2026-07-15
56	MS_DRG	Degenerative Nervous System Disorders With Mcc	58	17	—	—	$16,248.14	$53,345.35	$48,878.02	2026-07-15
827	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	58	17	—	—	$16,164.91	$53,072.09	$48,627.65	2026-07-15
347	MS_DRG	Anal And Stomal Procedures With Mcc	58	17	—	—	$16,055.80	$52,713.86	$48,299.42	2026-07-15
98	MS_DRG	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc	58	17	—	—	$16,050.91	$52,697.79	$48,284.70	2026-07-15
82	MS_DRG	Traumatic Stupor And Coma >1 Hour With Mcc	58	17	—	—	$15,985.86	$52,484.23	$48,089.02	2026-07-15
792	MS_DRG	Prematurity Without Major Problems	48	15	—	—	$17,130.11	$56,086.68	$48,034.72	2026-07-15
817	MS_DRG	Other Antepartum Diagnoses With O.r. Procedures With Mcc	58	17	—	—	$15,957.89	$52,392.38	$48,004.86	2026-07-15
475	MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc	58	17	—	—	$15,916.62	$52,256.90	$47,880.73	2026-07-15
85	MS_DRG	Traumatic Stupor And Coma <1 Hour With Mcc	58	17	—	—	$15,890.04	$52,169.64	$47,800.78	2026-07-15
824	MS_DRG	Lymphoma And Non-acute Leukemia With Other Procedures With Cc	58	17	—	—	$15,845.98	$52,024.97	$47,668.22	2026-07-15
821	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Cc	58	17	—	—	$15,657.14	$51,404.97	$47,100.14	2026-07-15
715	MS_DRG	Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc	58	17	—	—	$15,648.04	$51,375.12	$47,072.79	2026-07-15
C9602	HCPCS	Perc D-e Cor Stent Ather S	53	10	—	—	$11,476.00	$58,947.00	$46,919.97	2026-07-15
26497	CPT	Hc Valve Implant Lvl 59	130	21	$193,816.50	—	$3,228.16	$193,816.50	$46,845.44	2026-07-15
407	MS_DRG	Pancreas- Liver And Shunt Procedures Without Cc/mcc	58	17	—	—	$15,524.25	$50,968.67	$46,700.38	2026-07-15
286	MS_DRG	Circulatory Disorders Except Ami- With Cardiac Catheterization With Mcc	58	17	—	—	$15,476.69	$50,812.53	$46,557.31	2026-07-15
934	MS_DRG	Full Thickness Burn Without Skin Graft Or Inhalation Injury	58	17	—	—	$15,461.30	$50,762.01	$46,511.02	2026-07-15
808	MS_DRG	Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…	58	17	—	—	$15,442.42	$50,700.01	$46,454.22	2026-07-15
41	MS_DRG	Peripheral- Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe…	58	17	—	—	$15,378.07	$50,488.75	$46,260.65	2026-07-15
30	MS_DRG	Spinal Procedures Without Cc/mcc	58	17	—	—	$15,353.59	$50,408.38	$46,187.01	2026-07-15
614	MS_DRG	Adrenal And Pituitary Procedures With Cc/mcc	58	17	—	—	$15,329.81	$50,330.30	$46,115.47	2026-07-15
424	MS_DRG	Other Hepatobiliary Or Pancreas O.r. Procedures With Cc	58	17	—	—	$15,302.53	$50,240.75	$46,033.42	2026-07-15
250	MS_DRG	Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc	58	17	—	—	$15,264.76	$50,116.75	$45,919.80	2026-07-15
141	MS_DRG	Major Head And Neck Procedures With Cc	58	17	—	—	$15,254.97	$50,084.60	$45,890.34	2026-07-15
629	MS_DRG	Other Endocrine- Nutritional And Metabolic O.r. Procedures With Cc	58	17	—	—	$15,238.89	$50,031.78	$45,841.95	2026-07-15

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