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Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

POUDRE VALLEY HOSPITAL

Fort Collins, CO · CCN 060010 · Rates published

19,923 distinct procedures filed
27 distinct payers
592,128 rate rows
2025-11-01 last MRF observed
Data quality

584,108 of 592,128 rate rows are consumer-grade (98.6%)

8,020 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 — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 3,226
template filing: same amount across many unrelated codes — excluded 2,702
per-diem day rate — not a per-procedure price 1,171
placeholder amount (≤ $0.02) — excluded from medians 393
exceeds 10× this hospital's gross charge — excluded from medians 304
percent-of-charges filed in the dollar field — excluded from medians 224
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/8080/841262971_poudre-valley-health-care%2C-inc_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/PoudreValleyHospital/8080
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-17
Content fingerprint 72aa184a789f7ea2… · 306,143,961 bytes · first seen 2026-05-09

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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 9 $4,505,000.00 $4,505,000.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 9 $3,685,266.67 $3,685,266.67 $3,685,266.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 9 $3,316,462.59 $3,316,462.59 $3,316,462.59 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 9 $3,248,445.72 $3,248,445.72 $3,248,445.72 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 9 $2,945,740.00 $2,945,740.00 $2,945,740.00 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 9 $2,455,110.61 $2,455,110.61 $2,455,110.61 nat. median
$2,469,189
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 9 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 9 $770,620.00 $3,729,800.80 $770,620.00 nat. median
$824,563
0.9× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 14 $358,457.87 $1,508,159.29 $595,706.73 nat. median
$370,174
1.6× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 9 $591,726.20 $2,799,090.98 $591,726.20 nat. median
$754,974
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 9 $565,868.95 $2,678,353.55 $565,868.95 nat. median
$675,122
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 9 $562,538.19 $2,621,516.59 $562,538.19 nat. median
$674,188
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 9 $557,317.93 $2,619,700.58 $557,317.93 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 9 $533,230.17 $2,580,090.17 $533,230.17 nat. median
$634,511
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 9 $489,304.61 $2,370,244.80 $489,304.61 nat. median
$620,080
0.8× median
J0225
HCPCS 		Vutrisiran 25 Mg/0.5 Ml Subcutaneous Syringe 27 $3,996.49 $578,852.35 $404,689.41 nat. median
$8,223
outlier · 49.2×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 14 $233,019.95 $978,734.71 $386,589.70 nat. median
$265,286
1.5× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 14 $177,798.43 $745,666.21 $294,530.15 nat. median
$206,368
1.4× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 14 $176,761.58 $741,290.11 $292,801.63 nat. median
$202,986
1.4× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 9 $278,250.00 $1,308,615.00 $278,250.00 nat. median
$324,450
0.9× median
J3403
HCPCS 		Revakinagene, Per Implant 9 $257,500.00 $257,500.00 $257,500.00 nat. median
$265,000
1.0× median
Q2043
HCPCS 		Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension 27 $55,272.32 $354,447.70 $247,802.79 nat. median
$66,682
outlier · 3.7×
90288
CPT 		Botulism Ig IV 2 $207,483.30 $215,276.10 $211,379.70 nat. median
$55,037
outlier · 3.8×
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 9 $205,640.00 $205,640.00 $205,640.00 nat. median
$209,753
1.0× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 7 $113,213.84 $279,295.91 $202,073.54 nat. median
$76,377
outlier · 2.6×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And… 14 $115,744.36 $483,760.15 $191,080.06 nat. median
$133,176
1.4× median
7
MS_DRG 		Lung Transplant 14 $108,287.05 $452,285.74 $178,648.01 nat. median
$122,708
1.5× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 14 $100,572.38 $419,725.16 $165,786.93 nat. median
$117,303
1.4× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 14 $94,895.00 $395,763.12 $156,322.18 nat. median
$108,660
1.4× median
209
MS_DRG 		Complex Aortic Arch Procedures 14 $94,787.42 $395,309.09 $156,142.85 nat. median
$98,017
1.6× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 $92,324.82 $384,915.41 $152,037.45 nat. median
$98,905
1.5× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 14 $91,107.59 $379,777.94 $150,008.21 nat. median
$102,358
1.5× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 14 $86,443.87 $360,094.21 $142,233.35 nat. median
$100,136
1.4× median
J9347
HCPCS 		Tremelimumab-actl 20 Mg/ml Intravenous Solution 27 $140.90 $199,723.85 $139,631.68 nat. median
$3,461
outlier · 40.3×
C9293
HCPCS 		Glucarpidase 1,000 Unit Intravenous Solution 27 $708.19 $199,693.90 $139,610.74 nat. median
$21,340
outlier · 6.5×
J2351
HCPCS 		Ocrelizumab 920 Mg-hyaluronidase-ocsq 23,000 Unit/23 Ml Subcut Soln 27 $37.88 $199,216.25 $139,276.80 nat. median
$78
outlier · 1786.7×
215
MS_DRG 		Other Heart Assist System Implant 14 $83,518.70 $347,748.23 $137,356.82 nat. median
$99,019
1.4× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 14 $82,077.22 $341,664.29 $134,953.73 nat. median
$93,672
1.4× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 14 $75,679.10 $314,660.28 $124,287.43 nat. median
$82,712
1.5× median
850
MS_DRG 		Acute Leukemia With Other Procedures 14 $72,782.08 $302,433.04 $119,457.80 nat. median
$83,442
1.4× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 14 $70,882.15 $294,414.26 $116,290.47 nat. median
$79,312
1.5× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 14 $70,662.86 $293,488.75 $115,924.90 nat. median
$81,118
1.4× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 9 $110,139.19 $255,999.82 $110,139.19 nat. median
$111,989
1.0× median
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 15 $63,342.28 $307,006.28 $109,101.41 nat. median
$69,774
1.6× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 14 $66,239.12 $274,817.84 $108,550.10 nat. median
$77,576
1.4× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 14 $64,662.78 $268,164.63 $105,922.15 nat. median
$74,915
1.4× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 14 $64,388.86 $267,008.61 $105,465.53 nat. median
$73,807
1.4× median
E0194NU
HCPCS 		Other Outpatient 1 $99,973.10 $110,792.70 $105,382.90 —
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 14 $64,179.52 $266,125.01 $105,116.52 nat. median
$72,138
1.5× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 $60,858.80 $252,109.61 $99,580.59 nat. median
$68,090
1.5× median

Other procedures at this hospital

Browse this hospital's 19,923 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
J3391 HCPCS Inj, Atidarsagene Autotemcel 9 9 — — $4,505,000.00 $4,505,000.00 $4,505,000.00 2025-11-01
Q2057 HCPCS Afamitresgene Autoleucel 12 9 — — $770,620.00 $3,729,800.80 $770,620.00 2025-11-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 9 9 — — $3,685,266.67 $3,685,266.67 $3,685,266.67 2025-11-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 9 9 — — $3,316,462.59 $3,316,462.59 $3,316,462.59 2025-11-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 9 9 — — $3,248,445.72 $3,248,445.72 $3,248,445.72 2025-11-01
J3393 HCPCS Inj, Betibeglogene Autotemce 9 9 — — $2,945,740.00 $2,945,740.00 $2,945,740.00 2025-11-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 12 9 — — $591,726.20 $2,799,090.98 $591,726.20 2025-11-01
Q2056 HCPCS Ciltacabtagene Car-pos T 14 9 — — $565,868.95 $2,678,353.55 $565,868.95 2025-11-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 14 9 — — $562,538.19 $2,621,516.59 $562,538.19 2025-11-01
Q2055 HCPCS Idecabtagene Vicleucel Car 12 9 — — $557,317.93 $2,619,700.58 $557,317.93 2025-11-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 14 9 — — $533,230.17 $2,580,090.17 $533,230.17 2025-11-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 9 9 — — $2,455,110.61 $2,455,110.61 $2,455,110.61 2025-11-01
Q2053 HCPCS Brexucabtagene Car Pos T 14 9 — — $489,304.61 $2,370,244.80 $489,304.61 2025-11-01
J3392 HCPCS Inj, Exagamglogene Autotem 9 9 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2025-11-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 21 14 — — $358,457.87 $1,508,159.29 $595,706.73 2025-11-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 12 9 — — $278,250.00 $1,308,615.00 $278,250.00 2025-11-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 21 14 — — $233,019.95 $978,734.71 $386,589.70 2025-11-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 21 14 — — $177,798.43 $745,666.21 $294,530.15 2025-11-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 21 14 — — $176,761.58 $741,290.11 $292,801.63 2025-11-01
J0225 HCPCS Vutrisiran 25 Mg/0.5 Ml Subcutaneous Syringe 68 27 $596,755.00 $417,728.50 30% off $3,996.49 $578,852.35 $404,689.41 2025-11-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And … 21 14 — — $115,744.36 $483,760.15 $191,080.06 2025-11-01
7 MS_DRG Lung Transplant 21 14 — — $108,287.05 $452,285.74 $178,648.01 2025-11-01
14 MS_DRG Allogeneic Bone Marrow Transplant 21 14 — — $100,572.38 $419,725.16 $165,786.93 2025-11-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 21 14 — — $94,895.00 $395,763.12 $156,322.18 2025-11-01
209 MS_DRG Complex Aortic Arch Procedures 21 14 — — $94,787.42 $395,309.09 $156,142.85 2025-11-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 21 14 — — $92,324.82 $384,915.41 $152,037.45 2025-11-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 21 14 — — $91,107.59 $379,777.94 $150,008.21 2025-11-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 21 14 — — $86,443.87 $360,094.21 $142,233.35 2025-11-01
Q2043 HCPCS Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension 69 27 $365,410.00 $255,787.00 30% off $55,272.32 $354,447.70 $247,802.79 2025-11-01
215 MS_DRG Other Heart Assist System Implant 21 14 — — $83,518.70 $347,748.23 $137,356.82 2025-11-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 21 14 — — $82,077.22 $341,664.29 $134,953.73 2025-11-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 21 14 — — $75,679.10 $314,660.28 $124,287.43 2025-11-01
J9029 HCPCS Instill Adstiladrin, Tx Dose 19 15 — — $63,342.28 $307,006.28 $109,101.41 2025-11-01
850 MS_DRG Acute Leukemia With Other Procedures 21 14 — — $72,782.08 $302,433.04 $119,457.80 2025-11-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 21 14 — — $70,882.15 $294,414.26 $116,290.47 2025-11-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 21 14 — — $70,662.86 $293,488.75 $115,924.90 2025-11-01
A9543 HCPCS Hb Radiant-yttriumy90ibritumomab/dose To 40 Mc 91 27 $74,079.32 $51,855.53 30% off $16,008.54 $283,465.47 $50,236.89 2025-11-01
J7330 HCPCS Cultured Chondrocytes Implnt 7 7 — — $113,213.84 $279,295.91 $202,073.54 2025-11-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 21 14 — — $66,239.12 $274,817.84 $108,550.10 2025-11-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 21 14 — — $64,662.78 $268,164.63 $105,922.15 2025-11-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 21 14 — — $64,388.86 $267,008.61 $105,465.53 2025-11-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 21 14 — — $64,179.52 $266,125.01 $105,116.52 2025-11-01
J3403 HCPCS Revakinagene, Per Implant 9 9 — — $257,500.00 $257,500.00 $257,500.00 2025-11-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 11 9 — — $110,139.19 $255,999.82 $110,139.19 2025-11-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 21 14 — — $60,858.80 $252,109.61 $99,580.59 2025-11-01
10 MS_DRG Pancreas Transplant 21 14 — — $60,503.80 $250,611.32 $98,988.78 2025-11-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 21 14 — — $60,478.98 $250,506.55 $98,947.40 2025-11-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 21 14 — — $60,163.72 $249,175.91 $98,421.81 2025-11-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 21 14 — — $60,128.95 $249,029.22 $98,363.87 2025-11-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 21 14 — — $58,320.06 $241,394.62 $95,348.28 2025-11-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 21 14 — — $58,039.56 $240,210.66 $94,880.63 2025-11-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 21 14 — — $56,824.81 $235,083.67 $92,855.52 2025-11-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 21 14 — — $56,455.74 $233,526.01 $92,240.27 2025-11-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 21 14 — — $56,415.21 $233,354.88 $92,172.67 2025-11-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 21 14 — — $55,535.58 $229,642.35 $90,706.26 2025-11-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 21 14 — — $55,535.58 $229,642.35 $90,706.26 2025-11-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 21 14 — — $55,337.81 $228,807.65 $90,376.56 2025-11-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 21 14 — — $54,372.14 $224,731.90 $88,766.69 2025-11-01
J9226 HCPCS Supprelin La Implant 25 15 — — $36,534.28 $220,512.29 $51,577.80 2025-11-01
90288 CPT Botulism Ig IV 2 2 — — $207,483.30 $215,276.10 $211,379.70 2025-11-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 21 14 — — $51,837.55 $214,034.37 $84,541.28 2025-11-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 21 14 — — $51,778.79 $213,786.40 $84,443.33 2025-11-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 21 14 — — $51,293.05 $211,736.31 $83,633.57 2025-11-01
28 MS_DRG Spinal Procedures With Mcc 21 14 — — $50,843.73 $209,839.88 $82,884.50 2025-11-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 21 14 — — $50,829.66 $209,780.51 $82,861.05 2025-11-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 21 14 — — $50,469.71 $208,261.27 $82,260.96 2025-11-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 21 14 — — $50,307.53 $207,576.74 $81,990.58 2025-11-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 21 14 — — $50,193.34 $207,094.77 $81,800.21 2025-11-01
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 9 9 — — $205,640.00 $205,640.00 $205,640.00 2025-11-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 21 14 — — $49,687.73 $204,960.86 $80,957.34 2025-11-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 21 14 — — $49,656.28 $204,828.14 $80,904.92 2025-11-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 21 14 — — $48,847.82 $201,415.97 $79,557.14 2025-11-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 21 14 — — $48,543.31 $200,130.73 $79,049.49 2025-11-01
J9347 HCPCS Tremelimumab-actl 20 Mg/ml Intravenous Solution 68 27 $205,900.88 $144,130.62 30% off $140.90 $199,723.85 $139,631.68 2025-11-01
C9293 HCPCS Glucarpidase 1,000 Unit Intravenous Solution 59 27 $205,870.00 $144,109.00 30% off $708.19 $199,693.90 $139,610.74 2025-11-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 21 14 — — $48,349.69 $199,313.48 $78,726.69 2025-11-01
J2351 HCPCS Ocrelizumab 920 Mg-hyaluronidase-ocsq 23,000 Unit/23 Ml Subcut Soln 68 27 $205,377.58 $143,764.31 30% off $37.88 $199,216.25 $139,276.80 2025-11-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 21 14 — — $48,288.46 $199,055.04 $78,624.60 2025-11-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 21 14 — — $47,647.15 $196,348.35 $77,555.49 2025-11-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 21 14 — — $47,503.16 $195,740.66 $77,315.46 2025-11-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 21 14 — — $47,185.42 $194,399.54 $76,785.73 2025-11-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 21 14 — — $46,827.93 $192,890.78 $76,189.79 2025-11-01
834 MS_DRG Acute Leukemia With Mcc 21 14 — — $46,554.04 $191,734.76 $75,733.17 2025-11-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 21 14 — — $46,393.52 $191,057.21 $75,465.55 2025-11-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 21 14 — — $46,328.96 $190,784.80 $75,357.95 2025-11-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 21 14 — — $46,257.80 $190,484.44 $75,239.31 2025-11-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 21 14 — — $46,077.41 $189,723.08 $74,938.58 2025-11-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 21 14 — — $45,254.07 $186,248.04 $73,565.98 2025-11-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 21 14 — — $45,227.58 $186,136.28 $73,521.83 2025-11-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 21 14 — — $44,931.33 $184,885.97 $73,027.97 2025-11-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 21 14 — — $44,786.53 $184,274.78 $72,786.56 2025-11-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 21 14 — — $44,199.84 $181,798.60 $71,808.49 2025-11-01
653 MS_DRG Major Bladder Procedures With Mcc 21 14 — — $44,125.35 $181,484.27 $71,684.34 2025-11-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 21 14 — — $42,832.84 $176,028.99 $69,529.56 2025-11-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 21 14 — — $42,395.90 $174,184.95 $68,801.18 2025-11-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 21 14 — — $42,064.92 $172,787.95 $68,249.38 2025-11-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 21 14 — — $41,992.09 $172,480.61 $68,127.99 2025-11-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 21 14 — — $41,852.26 $171,890.37 $67,894.85 2025-11-01
J9228 HCPCS Ipilimumab 200 Mg/40 Ml (5 Mg/ml) Intravenous Solution 84 26 $176,656.00 $123,659.20 30% off $183.48 $171,356.32 $40,189.29 2025-11-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 21 14 — — $41,682.63 $171,174.41 $67,612.05 2025-11-01
471 MS_DRG Cervical Spinal Fusion With Mcc 21 14 — — $41,082.70 $168,642.35 $66,611.92 2025-11-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 21 14 — — $40,880.78 $167,790.18 $66,275.32 2025-11-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 21 14 — — $40,520.82 $166,270.94 $65,675.24 2025-11-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 21 14 — — $40,029.30 $164,196.40 $64,855.81 2025-11-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 21 14 — — $39,949.87 $163,861.12 $64,723.38 2025-11-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 21 14 — — $39,834.02 $163,372.17 $64,530.25 2025-11-01
6 MS_DRG Liver Transplant Without Mcc 21 14 — — $39,496.40 $161,947.23 $63,967.42 2025-11-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 21 14 — — $39,343.32 $161,301.11 $63,712.21 2025-11-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 21 14 — — $39,161.27 $160,532.76 $63,408.72 2025-11-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 21 14 — — $39,064.44 $160,124.14 $63,247.32 2025-11-01
245 MS_DRG Aicd Generator Procedures 21 14 — — $38,879.10 $159,341.82 $62,938.31 2025-11-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 21 14 — — $38,765.73 $158,863.35 $62,749.32 2025-11-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 21 14 — — $38,749.19 $158,793.50 $62,721.73 2025-11-01
799 MS_DRG Splenic Procedures With Mcc 21 14 — — $38,601.90 $158,171.83 $62,476.18 2025-11-01
163 MS_DRG Major Chest Procedures With Mcc 21 14 — — $38,212.15 $156,526.87 $61,826.43 2025-11-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 21 14 — — $38,201.38 $156,481.46 $61,808.50 2025-11-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 21 14 — — $38,055.75 $155,866.78 $61,565.71 2025-11-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 21 14 — — $37,475.67 $153,418.54 $60,598.68 2025-11-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 21 14 — — $36,934.51 $151,134.45 $59,696.48 2025-11-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 21 14 — — $36,649.02 $149,929.53 $59,220.56 2025-11-01
140 MS_DRG Major Head And Neck Procedures With Mcc 21 14 — — $36,420.64 $148,965.60 $58,839.81 2025-11-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 21 14 — — $36,217.90 $148,109.94 $58,501.84 2025-11-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 21 14 — — $36,072.27 $147,495.26 $58,259.04 2025-11-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 21 14 — — $36,012.67 $147,243.80 $58,159.72 2025-11-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 21 14 — — $35,995.31 $147,170.46 $58,130.75 2025-11-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 21 14 — — $35,893.52 $146,740.88 $57,961.07 2025-11-01
901 MS_DRG Wound Debridements For Injuries With Mcc 21 14 — — $35,852.14 $146,566.26 $57,892.10 2025-11-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 21 14 — — $35,787.60 $146,293.84 $57,784.50 2025-11-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 21 14 — — $35,653.55 $145,728.06 $57,561.02 2025-11-01
793 MS_DRG Full Term Neonate With Major Problems 21 14 — — $35,628.73 $145,623.28 $57,519.63 2025-11-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 21 14 — — $35,491.36 $145,043.53 $57,290.64 2025-11-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 21 14 — — $35,263.80 $144,083.09 $56,911.27 2025-11-01
791 MS_DRG Prematurity With Major Problems 21 14 — — $34,713.53 $141,760.58 $55,993.91 2025-11-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 21 14 — — $34,394.95 $140,415.96 $55,462.80 2025-11-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 21 14 — — $34,093.75 $139,144.69 $54,960.66 2025-11-01
J9266 HCPCS Pegaspargase 750 Unit/ml Injection Solution 69 27 $134,075.75 $93,853.03 30% off $28,424.06 $137,572.45 $90,923.47 2025-11-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 21 14 — — $33,496.29 $136,623.11 $53,964.66 2025-11-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 21 14 — — $33,349.82 $136,004.94 $53,720.49 2025-11-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 21 14 — — $33,155.37 $135,184.20 $53,396.31 2025-11-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 21 14 — — $33,076.76 $134,852.41 $53,265.25 2025-11-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 21 14 — — $32,895.53 $134,087.55 $52,963.14 2025-11-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 21 14 — — $32,264.16 $131,422.78 $51,910.59 2025-11-01
J2507 HCPCS Pegloticase 8 Mg/ml Intravenous Solution 68 27 $135,206.25 $94,644.38 30% off $2,917.96 $131,150.06 $91,690.12 2025-11-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 21 14 — — $32,128.45 $130,850.01 $51,684.35 2025-11-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 21 14 — — $32,054.83 $130,539.17 $51,561.57 2025-11-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 21 14 — — $32,051.50 $130,525.20 $51,556.05 2025-11-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 21 14 — — $31,964.61 $130,158.49 $51,411.21 2025-11-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 21 14 — — $31,790.84 $129,425.07 $51,121.51 2025-11-01
J3357 HCPCS Ustekinumab 90 Mg/ml Subcutaneous Syringe 90 27 $133,076.40 $93,153.48 30% off $149.40 $129,084.11 $60,217.12 2025-11-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 21 14 — — $31,520.25 $128,283.02 $50,670.41 2025-11-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 21 14 — — $31,507.83 $128,230.63 $50,649.72 2025-11-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 21 14 — — $31,151.18 $126,725.36 $50,055.16 2025-11-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 21 14 — — $31,128.02 $126,627.57 $50,016.53 2025-11-01
332 MS_DRG Rectal Resection With Mcc 21 14 — — $31,086.65 $126,452.95 $49,947.56 2025-11-01
265 MS_DRG Aicd Lead Procedures 21 14 — — $31,065.95 $126,365.64 $49,913.07 2025-11-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 21 14 — — $31,013.01 $126,142.12 $49,824.78 2025-11-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 21 14 — — $30,968.32 $125,953.52 $49,750.29 2025-11-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 21 14 — — $30,773.03 $125,129.29 $49,424.73 2025-11-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 21 14 — — $30,704.35 $124,839.41 $49,310.23 2025-11-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 21 14 — — $30,674.55 $124,713.68 $49,260.57 2025-11-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 21 14 — — $30,630.70 $124,528.58 $49,187.45 2025-11-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 21 14 — — $30,605.88 $124,423.81 $49,146.07 2025-11-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 21 14 — — $30,577.74 $124,305.06 $49,099.16 2025-11-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 21 14 — — $30,553.75 $124,203.78 $49,059.16 2025-11-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 21 14 — — $30,307.98 $123,166.51 $48,649.45 2025-11-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 21 14 — — $30,248.40 $122,915.05 $48,550.12 2025-11-01
252 MS_DRG Other Vascular Procedures With Mcc 21 14 — — $29,991.05 $121,828.88 $48,121.10 2025-11-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 21 14 — — $29,983.60 $121,797.45 $48,108.68 2025-11-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 21 14 — — $29,851.22 $121,238.65 $47,887.96 2025-11-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 21 14 — — $29,712.19 $120,651.91 $47,656.21 2025-11-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 21 14 — — $29,579.79 $120,093.11 $47,435.49 2025-11-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 21 14 — — $29,495.40 $119,736.87 $47,294.78 2025-11-01
L7181 HCPCS Electronic Elbo Simultaneous 11 9 — — $48,901.12 $119,154.76 $48,901.12 2025-11-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 21 14 — — $29,356.38 $119,150.13 $47,063.02 2025-11-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 21 14 — — $29,319.13 $118,992.97 $47,000.94 2025-11-01
J9600 HCPCS Porfimer Sodium Injection 19 15 — — $24,228.42 $117,265.54 $40,115.56 2025-11-01
264 MS_DRG Other Circulatory System O.r. Procedures 21 14 — — $28,768.87 $116,670.46 $46,083.58 2025-11-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 21 14 — — $28,460.20 $115,367.75 $45,569.02 2025-11-01
37 MS_DRG Extracranial Procedures With Mcc 21 14 — — $28,367.54 $114,976.59 $45,414.52 2025-11-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 21 14 — — $28,364.22 $114,962.62 $45,409.00 2025-11-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 21 14 — — $28,042.32 $113,604.04 $44,872.38 2025-11-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 21 14 — — $27,924.00 $113,104.61 $44,675.11 2025-11-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 21 14 — — $27,894.21 $112,978.88 $44,625.45 2025-11-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 21 14 — — $27,856.97 $112,821.72 $44,563.37 2025-11-01
652 MS_DRG Kidney Transplant 21 14 — — $27,849.52 $112,790.29 $44,550.95 2025-11-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 21 14 — — $27,829.68 $112,706.47 $44,517.84 2025-11-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 21 14 — — $27,777.52 $112,486.44 $44,430.94 2025-11-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 21 14 — — $27,691.47 $112,123.22 $44,287.47 2025-11-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 21 14 — — $27,545.84 $111,508.54 $44,044.68 2025-11-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 21 14 — — $27,497.01 $111,302.48 $43,963.29 2025-11-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 21 14 — — $27,471.36 $111,194.22 $43,920.52 2025-11-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 21 14 — — $27,418.41 $110,970.70 $43,832.23 2025-11-01
E0194NU HCPCS Other Outpatient 2 1 — — $99,973.10 $110,792.70 $105,382.90 2025-11-01
J9229 HCPCS Inotuzumab Ozogamicin 0.9 Mg(0.25 Mg/ml Initial Concentration) IV Soln 66 26 $113,967.30 $79,777.11 30% off $2,698.05 $110,548.28 $75,113.00 2025-11-01
500 MS_DRG Soft Tissue Procedures With Mcc 21 14 — — $27,314.14 $110,530.64 $43,658.42 2025-11-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 21 14 — — $27,274.42 $110,363.00 $43,592.20 2025-11-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 21 14 — — $27,199.94 $110,048.68 $43,468.05 2025-11-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 21 14 — — $27,187.53 $109,996.29 $43,447.35 2025-11-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 21 14 — — $27,126.30 $109,737.84 $43,345.27 2025-11-01
665 MS_DRG Prostatectomy With Mcc 21 14 — — $26,953.35 $109,007.91 $43,056.95 2025-11-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 21 14 — — $26,899.56 $108,780.90 $42,967.29 2025-11-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 21 14 — — $26,854.05 $108,588.81 $42,891.41 2025-11-01
662 MS_DRG Minor Bladder Procedures With Mcc 21 14 — — $26,459.33 $106,922.89 $42,233.39 2025-11-01
263 MS_DRG Vein Ligation And Stripping 21 14 — — $26,425.43 $106,779.70 $42,176.83 2025-11-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 21 14 — — $26,225.16 $105,934.51 $41,842.99 2025-11-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 21 14 — — $26,120.07 $105,490.96 $41,667.80 2025-11-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 21 14 — — $26,116.76 $105,476.99 $41,662.28 2025-11-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 21 14 — — $26,089.45 $105,361.74 $41,616.76 2025-11-01
L7180 HCPCS Electronic Elbow Sequential 11 9 — — $42,853.91 $104,419.87 $42,853.91 2025-11-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 21 14 — — $25,755.15 $103,950.77 $41,059.44 2025-11-01
472 MS_DRG Cervical Spinal Fusion With Cc 21 14 — — $25,504.42 $102,892.54 $40,641.45 2025-11-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 21 14 — — $25,487.88 $102,822.69 $40,613.86 2025-11-01
570 MS_DRG Skin Debridement With Mcc 21 14 — — $25,463.06 $102,717.92 $40,572.47 2025-11-01
668 MS_DRG Transurethral Procedures With Mcc 21 14 — — $25,288.45 $101,981.00 $40,281.40 2025-11-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 21 14 — — $25,224.73 $101,712.08 $40,175.18 2025-11-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 21 14 — — $25,139.49 $101,352.35 $40,033.09 2025-11-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 21 14 — — $25,124.60 $101,289.49 $40,008.26 2025-11-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 21 14 — — $15,380.00 $100,842.45 $36,285.96 2025-11-01
974 MS_DRG HIV With Major Related Condition With Mcc 21 14 — — $25,007.12 $100,793.55 $39,812.37 2025-11-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 21 14 — — $24,972.35 $100,646.87 $39,754.43 2025-11-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 21 14 — — $24,876.37 $100,241.74 $39,594.41 2025-11-01
C1823 HCPCS Hb Xper-zoll Generator & Stimulator Leads Remede 128 27 $37,567.81 $26,297.47 30% off $2,573.01 $99,706.44 $33,998.87 2025-11-01
J2350 HCPCS Ocrelizumab 30 Mg/ml Intravenous Solution 68 27 $102,688.80 $71,882.16 30% off $47.87 $99,608.14 $69,638.41 2025-11-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 21 14 — — $24,713.37 $99,553.71 $39,322.65 2025-11-01
800 MS_DRG Splenic Procedures With Cc 21 14 — — $24,373.25 $98,118.30 $38,755.67 2025-11-01
654 MS_DRG Major Bladder Procedures With Cc 21 14 — — $24,289.67 $97,765.55 $38,616.34 2025-11-01
503 MS_DRG Foot Procedures With Mcc 21 14 — — $24,221.82 $97,479.17 $38,503.22 2025-11-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 21 14 — — $24,062.93 $96,808.61 $38,238.36 2025-11-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 21 14 — — $23,940.47 $96,291.72 $38,034.19 2025-11-01
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 11 9 — — $39,482.40 $96,204.65 $39,482.40 2025-11-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 21 14 — — $23,870.95 $95,998.35 $37,918.32 2025-11-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 21 14 — — $23,865.16 $95,973.90 $37,908.66 2025-11-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 21 14 — — $23,747.68 $95,477.97 $37,712.77 2025-11-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 21 14 — — $23,640.09 $95,023.94 $37,533.44 2025-11-01
849 MS_DRG Radiotherapy 21 14 — — $23,546.59 $94,629.29 $37,377.55 2025-11-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 21 14 — — $15,380.00 $94,514.04 $34,008.82 2025-11-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 21 14 — — $23,446.47 $94,206.70 $37,210.63 2025-11-01
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 9 9 — — $93,216.70 $93,216.70 $93,216.70 2025-11-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 21 14 — — $23,136.99 $92,900.50 $36,694.70 2025-11-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 21 14 — — $23,060.03 $92,575.70 $36,566.41 2025-11-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 21 14 — — $22,949.97 $92,111.20 $36,382.93 2025-11-01
253 MS_DRG Other Vascular Procedures With Cc 21 14 — — $22,604.07 $90,651.33 $35,806.30 2025-11-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 21 14 — — $22,578.44 $90,543.06 $35,763.54 2025-11-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 21 14 — — $22,498.16 $90,204.29 $35,629.73 2025-11-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 21 14 — — $22,468.38 $90,078.56 $35,580.06 2025-11-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 21 14 — — $22,468.38 $90,078.56 $35,580.06 2025-11-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 21 14 — — $22,372.39 $89,673.43 $35,420.04 2025-11-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 21 14 — — $22,251.57 $89,163.53 $35,218.64 2025-11-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 21 14 — — $22,151.45 $88,740.93 $35,051.72 2025-11-01
93656 CPT Hb Radiant Ccl-compre Ep Eval Abltj Atr Fib Pulm Vein Isolation 68 26 $91,433.00 $64,003.10 30% off $2,110.79 $88,690.01 $62,005.29 2025-11-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 21 14 — — $22,111.74 $88,573.29 $34,985.50 2025-11-01
164 MS_DRG Major Chest Procedures With Cc 21 14 — — $22,011.59 $88,150.70 $34,818.58 2025-11-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 21 14 — — $22,002.49 $88,112.28 $34,803.41 2025-11-01
33276 CPT Hb Radiant-insertion Phrenic Nerve Stimulator System 66 27 $90,563.00 $63,394.10 30% off $2,547.86 $87,846.11 $61,415.30 2025-11-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 21 14 — — $21,745.97 $87,029.61 $34,375.76 2025-11-01
545 MS_DRG Connective Tissue Disorders With Mcc 21 14 — — $21,661.58 $86,673.37 $34,235.05 2025-11-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 21 14 — — $21,475.39 $85,887.56 $33,924.66 2025-11-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 21 14 — — $21,469.60 $85,863.11 $33,915.01 2025-11-01
K0606NUKF HCPCS Other Outpatient 2 1 — — $77,361.67 $85,734.14 $81,547.90 2025-11-01
792 MS_DRG Prematurity Without Major Problems 21 14 — — $21,392.64 $85,538.31 $33,786.71 2025-11-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 21 14 — — $21,351.27 $85,363.69 $33,717.74 2025-11-01
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 21 14 — — $21,327.27 $85,262.40 $33,677.73 2025-11-01
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 21 14 — — $21,169.22 $84,595.34 $33,414.25 2025-11-01
J3241 HCPCS Teprotumumab-trbw 500 Mg Intravenous Solution 68 27 $87,117.85 $60,982.50 30% off $287.95 $84,504.31 $59,078.97 2025-11-01
A9699 HCPCS Radiopharm Rx Agent Noc 2 2 — — $78,406.07 $81,350.90 $79,878.49 2025-11-01
33287 CPT Hb Rmvl&rplcmt Phrenic Nrv Stimulator Pls Generator 66 27 $83,651.00 $58,555.70 30% off $1,718.68 $81,141.47 $56,727.93 2025-11-01
0571T CPT Hb Insert/rplcmt Icds W/substernal Electrode 71 27 $82,751.00 $57,925.70 30% off $4,016.00 $80,268.47 $56,117.59 2025-11-01
33270 CPT Hb Insert/replace S-icd W Subq Lead 70 27 $81,589.00 $57,112.30 30% off $1,247.84 $79,141.33 $55,329.58 2025-11-01
J9298 HCPCS Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution 68 27 $75,219.90 $52,653.93 30% off $197.83 $72,963.30 $51,010.38 2025-11-01
93654 CPT Hb Radiant Ccl-ep Eval With Ablation Ventricular Tachycardia 70 27 $72,537.00 $50,775.90 30% off $2,243.59 $70,360.89 $49,190.96 2025-11-01
J9043 HCPCS Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution 66 26 $71,434.71 $50,004.30 30% off $227.28 $69,291.67 $47,080.83 2025-11-01
33249 CPT Hb Insrt/repl Dfib W Leads Sngl/dual Chmb 70 27 $69,891.00 $48,923.70 30% off $2,027.76 $67,794.27 $47,396.58 2025-11-01
0515T CPT Hb Radiant Ccl-insertion Wrls Car Stimulator Lv Pacg Compl Sys 71 27 $69,790.00 $48,853.00 30% off $4,016.00 $67,696.30 $47,328.09 2025-11-01
0520T CPT Hb Radiant Ccl-rmvl&rplcmt Pg Wcs Lv Pacg Battery Compnt Only 71 27 $69,790.00 $48,853.00 30% off $4,016.00 $67,696.30 $47,328.09 2025-11-01
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 9 9 — — $67,452.66 $67,452.66 $67,452.66 2025-11-01
J9316 HCPCS Pertuzumab 1,200 Mg-trastuzumab 600 Mg-hyaluron-zzxf/15 Ml Subcut Soln 84 26 $65,772.98 $46,041.09 30% off $62.10 $63,799.79 $37,533.72 2025-11-01
93653 CPT Hb Ep Eval With Ablation Supravent Arrhythmia 70 27 $63,476.00 $44,433.20 30% off $1,861.42 $61,571.72 $43,046.25 2025-11-01
J9042 HCPCS Brentuximab Vedotin 50 Mg Intravenous Solution 66 26 $61,000.00 $42,700.00 30% off $258.64 $59,170.00 $40,203.57 2025-11-01
33289 CPT Hb Tcat Impl Wrls P-art Prs Snr L-t Hemodyn Mntr 70 27 $60,510.00 $42,357.00 30% off $735.92 $58,694.70 $41,034.86 2025-11-01
J9272 HCPCS Dostarlimab-gxly 50 Mg/ml Intravenous Solution 67 26 $58,677.05 $41,073.94 30% off $243.71 $56,916.74 $39,791.84 2025-11-01
33230 CPT Hb Insert Dfib Pulse Gen Only W Exist Dual Lead 73 26 $56,420.00 $39,494.00 30% off $850.87 $54,727.40 $38,261.22 2025-11-01
33288 CPT Hb Rmvl&rplcmt Phrnc Nrv Stim Trnsvns Stimj/snsg Ld 64 26 $55,659.00 $38,961.30 30% off $2,201.55 $53,989.23 $37,745.15 2025-11-01
C2616 HCPCS Hb Radiant-brachy Tx Ns Spheres Yt-90 103 27 $54,391.59 $38,074.12 30% off $16,355.55 $52,765.46 $36,885.65 2025-11-01
J9119 HCPCS Cemiplimab-rwlc 50 Mg/ml Intravenous Solution 66 26 $54,351.71 $38,046.20 30% off $28.96 $52,721.16 $35,821.85 2025-11-01
J9144 HCPCS Daratumumab 1,800 Mg-hyaluronidase-fihj 30,000 Unit/15 Ml Subcut Soln 66 26 $52,332.08 $36,632.46 30% off $55.18 $50,762.12 $34,490.76 2025-11-01
J1640 HCPCS Hemin 350 Mg Intravenous Powder For Solution 66 26 $52,066.80 $36,446.76 30% off $27.40 $50,504.80 $34,315.93 2025-11-01
J2327 HCPCS Risankizumab-rzaa 60 Mg/ml Intravenous Solution 68 27 $51,604.20 $36,122.94 30% off $11.90 $50,056.07 $34,995.39 2025-11-01
0266T CPT Outpatient Rates 19 14 — — $608.96 $49,590.00 $45,224.60 2025-11-01
0620T CPT Evasc Ven Artlz Tibl/prnl Vn 17 14 — — $9,640.00 $49,590.00 $35,174.80 2025-11-01
93590 CPT Hb Radiant Ccl-perq Transcath Cls Paravalvr Leak 1 Mitral Valve 70 27 $51,085.00 $35,759.50 30% off $2,384.01 $49,552.45 $34,643.29 2025-11-01
J0206 HCPCS Allopurinol 500 Mg Intravenous Solution 68 27 $49,686.50 $34,780.55 30% off $3.64 $48,195.91 $33,694.90 2025-11-01
93591 CPT Hb Perq Transcath Cls Paravalvr Leak 1 Aortic Valve 70 27 $49,629.00 $34,740.30 30% off $1,965.67 $48,140.13 $33,655.90 2025-11-01
C9607 HCPCS Hb Radiant Ccl Prq Drug Eluding Cor Revasc Chro One Vessel 71 27 $49,234.00 $34,463.80 30% off $4,048.00 $47,756.98 $33,388.04 2025-11-01
0553T CPT Op Surgery 6 6 — — $8,255.00 $44,198.00 $33,813.00 2025-11-01
E0766 HCPCS Elec Stim Cancer Treatment 2 1 — — $35,318.61 $39,140.97 $37,229.79 2025-11-01
E0766RRKF HCPCS Other Outpatient 2 1 — — $35,318.61 $39,140.97 $37,229.79 2025-11-01
E0764NUKF HCPCS Other Outpatient 2 1 — — $33,996.73 $37,676.03 $35,836.38 2025-11-01
E0483NU HCPCS Other Outpatient 2 1 — — $32,659.70 $36,194.30 $34,427.00 2025-11-01
K0864NU HCPCS Other Outpatient 2 1 — — $31,678.88 $35,107.33 $33,393.11 2025-11-01
L8701 HCPCS Ewh S/d Uprt Micro Sensor 9 9 — — $34,284.44 $34,284.44 $34,284.44 2025-11-01
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