|
J9999
|
HCPCS
|
Chemotherapy Drug
|
1
|
1
|
—
|
—
|
$224,999.49
|
$224,999.49
|
$224,999.49
|
2026-04-30
|
|
J8499
|
HCPCS
|
Oral Prescrip Drug Non Chemo
|
1
|
1
|
—
|
—
|
$179,999.79
|
$179,999.79
|
$179,999.79
|
2026-04-30
|
|
J8597
|
HCPCS
|
Antiemetic Drug Oral Nos
|
1
|
1
|
—
|
—
|
$179,999.79
|
$179,999.79
|
$179,999.79
|
2026-04-30
|
|
Q0181
|
HCPCS
|
Unspecified Oral Anti-emetic
|
1
|
1
|
—
|
—
|
$179,999.79
|
$179,999.79
|
$179,999.79
|
2026-04-30
|
|
J8999
|
HCPCS
|
Oral Prescription Drug Chemo
|
1
|
1
|
—
|
—
|
$179,999.79
|
$179,999.79
|
$179,999.79
|
2026-04-30
|
|
J8498
|
HCPCS
|
Antiemetic Rectal/supp Nos
|
1
|
1
|
—
|
—
|
$179,999.79
|
$179,999.79
|
$179,999.79
|
2026-04-30
|
|
S5000
|
HCPCS
|
Prescription Drug, Generic
|
1
|
1
|
—
|
—
|
$179,999.58
|
$179,999.58
|
$179,999.58
|
2026-04-30
|
|
J7599
|
HCPCS
|
Immunosuppressive Drug Noc
|
1
|
1
|
—
|
—
|
$179,999.58
|
$179,999.58
|
$179,999.58
|
2026-04-30
|
|
S5001
|
HCPCS
|
Prescription Drug,brand Name
|
1
|
1
|
—
|
—
|
$179,999.58
|
$179,999.58
|
$179,999.58
|
2026-04-30
|
|
J3490
|
HCPCS
|
Drugs Unclassified Injection
|
1
|
1
|
—
|
—
|
$179,999.58
|
$179,999.58
|
$179,999.58
|
2026-04-30
|
|
J7999
|
HCPCS
|
Compounded Drug, Noc
|
1
|
1
|
—
|
—
|
$179,999.58
|
$179,999.58
|
$179,999.58
|
2026-04-30
|
|
J3590
|
HCPCS
|
Unclassified Biologics
|
1
|
1
|
—
|
—
|
$179,999.58
|
$179,999.58
|
$179,999.58
|
2026-04-30
|
|
J7199
|
HCPCS
|
Hemophilia Clot Factor Noc
|
1
|
1
|
—
|
—
|
$179,999.58
|
$179,999.58
|
$179,999.58
|
2026-04-30
|
|
C9172
|
HCPCS
|
Oncology Drugs
|
1
|
1
|
—
|
—
|
$179,999.58
|
$179,999.58
|
$179,999.58
|
2026-04-30
|
|
C9399
|
HCPCS
|
Unclassified Drugs Or Biolog
|
1
|
1
|
—
|
—
|
$179,999.58
|
$179,999.58
|
$179,999.58
|
2026-04-30
|
|
J3570
|
HCPCS
|
Laetrile Amygdalin Vit B17
|
1
|
1
|
—
|
—
|
$159,999.99
|
$159,999.99
|
$159,999.99
|
2026-04-30
|
|
G0419
|
HCPCS
|
Mammogram
|
1
|
1
|
—
|
—
|
$124,331.74
|
$124,331.74
|
$124,331.74
|
2026-04-30
|
|
93524
|
CPT
|
Mammogram
|
1
|
1
|
—
|
—
|
$117,731.57
|
$117,731.57
|
$117,731.57
|
2026-04-30
|
|
93527
|
CPT
|
Mammogram
|
1
|
1
|
—
|
—
|
$117,731.57
|
$117,731.57
|
$117,731.57
|
2026-04-30
|
|
93528
|
CPT
|
Mammogram
|
1
|
1
|
—
|
—
|
$117,731.57
|
$117,731.57
|
$117,731.57
|
2026-04-30
|
|
93529
|
CPT
|
Mammogram
|
1
|
1
|
—
|
—
|
$117,731.57
|
$117,731.57
|
$117,731.57
|
2026-04-30
|
|
G0418
|
HCPCS
|
Mammogram
|
1
|
1
|
—
|
—
|
$103,613.07
|
$103,613.07
|
$103,613.07
|
2026-04-30
|
|
93511
|
CPT
|
Mammogram
|
1
|
1
|
—
|
—
|
$90,053.43
|
$90,053.43
|
$90,053.43
|
2026-04-30
|
|
95956
|
CPT
|
Mammogram
|
1
|
1
|
—
|
—
|
$85,198.75
|
$85,198.75
|
$85,198.75
|
2026-04-30
|
|
E0766
|
HCPCS
|
Elec Stim Cancer Treatment
|
1
|
1
|
—
|
—
|
$77,368.39
|
$77,368.39
|
$77,368.39
|
2026-04-30
|
|
93526
|
CPT
|
Mammogram
|
1
|
1
|
—
|
—
|
$77,214.08
|
$77,214.08
|
$77,214.08
|
2026-04-30
|
|
93652
|
CPT
|
Mammogram
|
1
|
1
|
—
|
—
|
$65,198.91
|
$65,198.91
|
$65,198.91
|
2026-04-30
|
|
0503T
|
CPT
|
Mammogram
|
1
|
1
|
—
|
—
|
$63,366.92
|
$63,366.92
|
$63,366.92
|
2026-04-30
|
|
93510
|
CPT
|
Mammogram
|
1
|
1
|
—
|
—
|
$61,620.81
|
$61,620.81
|
$61,620.81
|
2026-04-30
|
|
G0417
|
HCPCS
|
Mammogram
|
1
|
1
|
—
|
—
|
$60,672.66
|
$60,672.66
|
$60,672.66
|
2026-04-30
|
|
93651
|
CPT
|
Mammogram
|
1
|
1
|
—
|
—
|
$59,895.27
|
$59,895.27
|
$59,895.27
|
2026-04-30
|
|
76094
|
CPT
|
Mammogram
|
1
|
1
|
—
|
—
|
$59,418.26
|
$59,418.26
|
$59,418.26
|
2026-04-30
|
|
99295
|
CPT
|
Mammogram
|
1
|
1
|
—
|
—
|
$56,075.85
|
$56,075.85
|
$56,075.85
|
2026-04-30
|
|
92980
|
CPT
|
Mammogram
|
1
|
1
|
—
|
—
|
$55,299.93
|
$55,299.93
|
$55,299.93
|
2026-04-30
|
|
0775T
|
CPT
|
Ambulatory Surgery Groups
|
1
|
1
|
—
|
—
|
$52,872.00
|
$52,872.00
|
$52,872.00
|
2026-04-30
|
|
0809T
|
CPT
|
Ambulatory Surgery Groups
|
1
|
1
|
—
|
—
|
$52,872.00
|
$52,872.00
|
$52,872.00
|
2026-04-30
|
|
0424T
|
CPT
|
Ambulatory Surgery Groups
|
1
|
1
|
—
|
—
|
$52,872.00
|
$52,872.00
|
$52,872.00
|
2026-04-30
|
|
0427T
|
CPT
|
Ambulatory Surgery Groups
|
1
|
1
|
—
|
—
|
$52,872.00
|
$52,872.00
|
$52,872.00
|
2026-04-30
|
|
0431T
|
CPT
|
Ambulatory Surgery Groups
|
1
|
1
|
—
|
—
|
$52,872.00
|
$52,872.00
|
$52,872.00
|
2026-04-30
|
|
0426T
|
CPT
|
Ambulatory Surgery Groups
|
1
|
1
|
—
|
—
|
$52,872.00
|
$52,872.00
|
$52,872.00
|
2026-04-30
|
|
93508
|
CPT
|
Mammogram
|
1
|
1
|
—
|
—
|
$51,893.33
|
$51,893.33
|
$51,893.33
|
2026-04-30
|
|
75564
|
CPT
|
Mammogram
|
1
|
1
|
—
|
—
|
$51,522.77
|
$51,522.77
|
$51,522.77
|
2026-04-30
|
|
C9150
|
HCPCS
|
Drugs - Other
|
2
|
2
|
—
|
—
|
$86,361.60
|
$272,693.20
|
$179,527.40
|
2026-04-30
|
|
47136
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$272,885.41
|
$138,614.70
|
2026-04-30
|
|
33860
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$208,310.27
|
$106,327.13
|
2026-04-30
|
|
90399
|
CPT
|
Unlisted Immune Globulin
|
2
|
2
|
—
|
—
|
$706.02
|
$179,999.58
|
$90,352.80
|
2026-04-30
|
|
J7304
|
HCPCS
|
Contraceptive Hormone Patch
|
2
|
2
|
—
|
—
|
$93.43
|
$179,999.58
|
$90,046.50
|
2026-04-30
|
|
90288
|
CPT
|
Botulism Ig IV
|
2
|
2
|
—
|
—
|
$84,259.65
|
$87,669.00
|
$85,964.32
|
2026-04-30
|
|
33870
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$164,106.02
|
$84,225.01
|
2026-04-30
|
|
33861
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$156,183.70
|
$80,263.85
|
2026-04-30
|
|
33400
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$148,378.74
|
$76,361.37
|
2026-04-30
|
|
48005
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$145,677.61
|
$75,010.80
|
2026-04-30
|
|
63199
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$143,875.15
|
$74,109.57
|
2026-04-30
|
|
63198
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$137,412.91
|
$70,878.46
|
2026-04-30
|
|
61542
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$132,460.48
|
$68,402.24
|
2026-04-30
|
|
61332
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$129,249.38
|
$66,796.69
|
2026-04-30
|
|
61440
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$127,921.36
|
$66,132.68
|
2026-04-30
|
|
61480
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$126,374.19
|
$65,359.10
|
2026-04-30
|
|
31582
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$125,691.37
|
$65,017.68
|
2026-04-30
|
|
61470
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$122,435.44
|
$63,389.72
|
2026-04-30
|
|
61610
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$122,119.88
|
$63,231.94
|
2026-04-30
|
|
61490
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$120,852.01
|
$62,598.00
|
2026-04-30
|
|
57112
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$119,958.13
|
$62,151.07
|
2026-04-30
|
|
63196
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$117,278.56
|
$60,811.28
|
2026-04-30
|
|
61612
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$114,740.97
|
$59,542.49
|
2026-04-30
|
|
19272
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$114,282.58
|
$59,313.29
|
2026-04-30
|
|
43855
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$112,294.53
|
$58,319.26
|
2026-04-30
|
|
33253
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$111,991.71
|
$58,167.86
|
2026-04-30
|
|
44153
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$110,457.15
|
$57,400.57
|
2026-04-30
|
|
43850
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$108,253.25
|
$56,298.62
|
2026-04-30
|
|
35551
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$107,966.48
|
$56,155.24
|
2026-04-30
|
|
62116
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$107,309.14
|
$55,826.57
|
2026-04-30
|
|
33722
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$106,613.59
|
$55,478.79
|
2026-04-30
|
|
63194
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$105,429.63
|
$54,886.82
|
2026-04-30
|
|
63182
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$105,038.97
|
$54,691.49
|
2026-04-30
|
|
19271
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$104,829.25
|
$54,586.62
|
2026-04-30
|
|
A9699
|
HCPCS
|
Radiopharm Rx Agent Noc
|
2
|
2
|
—
|
—
|
$31,840.96
|
$75,532.13
|
$53,686.54
|
2026-04-30
|
|
43401
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$102,421.64
|
$53,382.82
|
2026-04-30
|
|
69605
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$102,384.15
|
$53,364.07
|
2026-04-30
|
|
63195
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$100,942.82
|
$52,643.41
|
2026-04-30
|
|
23222
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$99,607.94
|
$51,975.97
|
2026-04-30
|
|
32500
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$98,793.80
|
$51,568.90
|
2026-04-30
|
|
35549
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$98,007.84
|
$51,175.92
|
2026-04-30
|
|
44152
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$97,475.09
|
$50,909.54
|
2026-04-30
|
|
33403
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$96,757.48
|
$50,550.74
|
2026-04-30
|
|
63180
|
CPT
|
Ambulatory Surgery Groups - Cpt/hcpcs
|
2
|
2
|
—
|
—
|
$4,344.00
|
$95,746.98
|
$50,045.49
|
2026-04-30
|
|
J3391
|
HCPCS
|
Inj, Atidarsagene Autotemcel
|
3
|
3
|
—
|
—
|
$4,505,000.00
|
$4,505,000.00
|
$4,505,000.00
|
2026-04-30
|
|
J3389
|
HCPCS
|
Topi Adm Prad Zami Per Treat
|
3
|
3
|
—
|
—
|
$3,335,820.00
|
$3,335,820.00
|
$3,335,820.00
|
2026-04-30
|
|
J3387
|
HCPCS
|
Inj Elivaldogene Autotemecel
|
3
|
3
|
—
|
—
|
$3,180,000.00
|
$3,180,000.00
|
$3,180,000.00
|
2026-04-30
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
4
|
4
|
—
|
—
|
$179,999.58
|
$3,691,450.00
|
$3,691,450.00
|
2026-04-30
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
4
|
4
|
—
|
—
|
$179,999.58
|
$3,321,376.38
|
$3,321,376.38
|
2026-04-30
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
4
|
4
|
—
|
—
|
$179,999.58
|
$3,245,381.39
|
$3,245,381.39
|
2026-04-30
|
|
C9309
|
HCPCS
|
Inj Onase Abepar-brve Treat
|
4
|
4
|
—
|
—
|
$2,664,228.59
|
$4,337,896.99
|
$2,664,228.59
|
2026-04-30
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
4
|
4
|
—
|
—
|
$2,332,000.00
|
$3,796,962.40
|
$2,332,000.00
|
2026-04-30
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
4
|
4
|
—
|
—
|
$770,620.00
|
$1,254,723.48
|
$770,620.00
|
2026-04-30
|
|
Q2058
|
HCPCS
|
Obecbtge Autol Up To 400 Mil
|
4
|
4
|
—
|
—
|
$278,250.00
|
$453,046.65
|
$278,250.00
|
2026-04-30
|
|
J3403
|
HCPCS
|
Revakinagene, Per Implant
|
4
|
4
|
—
|
—
|
$262,233.77
|
$426,969.03
|
$262,233.77
|
2026-04-30
|
|
J3402
|
HCPCS
|
Inj. Remestemcel-l-rknd/ Td
|
4
|
4
|
—
|
—
|
$202,713.58
|
$330,058.26
|
$202,713.58
|
2026-04-30
|
|
J7330
|
HCPCS
|
Cultured Chondrocytes Implnt
|
4
|
4
|
—
|
—
|
$111,218.58
|
$294,566.34
|
$125,285.36
|
2026-04-30
|
|
J3404
|
HCPCS
|
Inj Zopapogene Per Ther Dose
|
4
|
4
|
—
|
—
|
$121,900.00
|
$198,477.58
|
$121,900.00
|
2026-04-30
|
|
K1007
|
HCPCS
|
Bil Hkaf Pc S/d Micro Sensor
|
4
|
4
|
—
|
—
|
$95,081.03
|
$154,810.93
|
$95,081.03
|
2026-04-30
|
|
J9183
|
HCPCS
|
Gemcitabine Intravesical Sys
|
4
|
4
|
—
|
—
|
$73,088.26
|
$119,002.30
|
$73,088.26
|
2026-04-30
|
|
L8702
|
HCPCS
|
Ewhf S/d Uprt Micro Sensor
|
4
|
4
|
—
|
—
|
$68,801.71
|
$112,022.94
|
$68,801.71
|
2026-04-30
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
5
|
5
|
—
|
—
|
$179,999.58
|
$4,784,172.62
|
$2,938,320.00
|
2026-04-30
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
5
|
5
|
—
|
—
|
$179,999.58
|
$4,212,295.47
|
$2,587,087.26
|
2026-04-30
|
|
209
|
MS_DRG
|
Complex Aortic Arch Procedures
|
5
|
4
|
—
|
—
|
$127,938.16
|
$339,484.77
|
$127,938.16
|
2026-04-30
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
5
|
4
|
—
|
—
|
$124,903.54
|
$330,558.85
|
$124,903.54
|
2026-04-30
|
|
Q0480
|
HCPCS
|
Driver Pneumatic Vad, Rep
|
5
|
4
|
—
|
—
|
$67,103.07
|
$182,915.20
|
$112,341.97
|
2026-04-30
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
5
|
4
|
—
|
—
|
$104,391.41
|
$270,224.93
|
$104,391.41
|
2026-04-30
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
5
|
4
|
—
|
—
|
$100,821.47
|
$259,724.38
|
$100,821.47
|
2026-04-30
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
5
|
4
|
—
|
—
|
$86,128.72
|
$216,507.47
|
$86,128.72
|
2026-04-30
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
5
|
4
|
—
|
—
|
$80,702.93
|
$200,548.19
|
$80,702.93
|
2026-04-30
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
5
|
4
|
—
|
—
|
$80,652.96
|
$200,401.23
|
$80,652.96
|
2026-04-30
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
5
|
4
|
—
|
—
|
$73,126.61
|
$178,263.40
|
$73,126.61
|
2026-04-30
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
5
|
4
|
—
|
—
|
$71,327.86
|
$172,972.63
|
$71,327.86
|
2026-04-30
|
|
213
|
MS_DRG
|
Endovascular Abdominal Aorta With Iliac Branch Procedures
|
5
|
4
|
—
|
—
|
$70,714.02
|
$171,167.05
|
$70,714.02
|
2026-04-30
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
5
|
4
|
—
|
—
|
$69,848.31
|
$168,620.65
|
$69,848.31
|
2026-04-30
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
5
|
4
|
—
|
—
|
$66,866.72
|
$159,850.69
|
$66,866.72
|
2026-04-30
|
|
448
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical Without Mcc
|
5
|
4
|
—
|
—
|
$55,764.31
|
$127,194.31
|
$55,764.31
|
2026-04-30
|
|
793
|
MS_DRG
|
Full Term Neonate With Major Problems
|
5
|
4
|
—
|
—
|
$55,038.29
|
$125,058.81
|
$55,038.29
|
2026-04-30
|
|
791
|
MS_DRG
|
Prematurity With Major Problems
|
5
|
4
|
—
|
—
|
$53,910.49
|
$121,741.59
|
$53,910.49
|
2026-04-30
|
|
402
|
MS_DRG
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
5
|
4
|
—
|
—
|
$53,517.92
|
$120,586.86
|
$53,517.92
|
2026-04-30
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel Car-pos T
|
6
|
6
|
—
|
—
|
$179,999.58
|
$1,000,009.19
|
$614,180.81
|
2026-04-30
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
6
|
6
|
—
|
—
|
$179,999.58
|
$958,187.25
|
$588,494.81
|
2026-04-30
|
|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
6
|
6
|
—
|
—
|
$179,999.58
|
$915,473.09
|
$562,260.84
|
2026-04-30
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel Car
|
6
|
6
|
—
|
—
|
$179,999.58
|
$911,435.56
|
$559,781.08
|
2026-04-30
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
6
|
5
|
—
|
—
|
$452,853.00
|
$1,295,181.72
|
$545,053.87
|
2026-04-30
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Car+
|
6
|
6
|
—
|
—
|
$179,999.58
|
$865,956.73
|
$531,849.12
|
2026-04-30
|
|
Q2053
|
HCPCS
|
Brexucabtagene Car Pos T
|
6
|
6
|
—
|
—
|
$179,999.58
|
$796,662.96
|
$489,290.60
|
2026-04-30
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
6
|
5
|
—
|
—
|
$298,278.83
|
$840,520.83
|
$359,008.40
|
2026-04-30
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
6
|
5
|
—
|
—
|
$230,230.65
|
$640,365.55
|
$277,105.61
|
2026-04-30
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…
|
6
|
5
|
—
|
—
|
$228,952.97
|
$636,607.42
|
$275,567.79
|
2026-04-30
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …
|
6
|
5
|
—
|
—
|
$153,762.88
|
$415,445.04
|
$185,069.00
|
2026-04-30
|
|
7
|
MS_DRG
|
Lung Transplant
|
6
|
5
|
—
|
—
|
$144,573.43
|
$388,415.35
|
$174,008.58
|
2026-04-30
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
6
|
5
|
—
|
—
|
$135,066.83
|
$360,452.87
|
$162,566.43
|
2026-04-30
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
6
|
5
|
—
|
—
|
$128,070.71
|
$339,874.68
|
$154,145.90
|
2026-04-30
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
6
|
5
|
—
|
—
|
$123,403.58
|
$326,146.88
|
$148,528.55
|
2026-04-30
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
6
|
5
|
—
|
—
|
$117,656.59
|
$309,242.83
|
$141,611.47
|
2026-04-30
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
6
|
5
|
—
|
—
|
$114,051.96
|
$298,640.30
|
$137,272.94
|
2026-04-30
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
6
|
5
|
—
|
—
|
$112,275.66
|
$293,415.52
|
$135,134.98
|
2026-04-30
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
6
|
5
|
—
|
—
|
$98,480.24
|
$252,837.99
|
$118,530.82
|
2026-04-30
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
6
|
5
|
—
|
—
|
$98,210.02
|
$252,043.18
|
$118,205.58
|
2026-04-30
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
6
|
5
|
—
|
—
|
$92,758.75
|
$236,008.92
|
$111,644.43
|
2026-04-30
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
6
|
5
|
—
|
—
|
$90,816.24
|
$230,295.25
|
$109,306.43
|
2026-04-30
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
6
|
5
|
—
|
—
|
$90,478.72
|
$229,302.48
|
$108,900.18
|
2026-04-30
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
6
|
5
|
—
|
—
|
$90,220.74
|
$228,543.66
|
$108,589.68
|
2026-04-30
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
6
|
5
|
—
|
—
|
$85,691.24
|
$215,220.77
|
$103,137.98
|
2026-04-30
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
6
|
5
|
—
|
—
|
$85,660.66
|
$215,130.79
|
$103,101.17
|
2026-04-30
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
6
|
5
|
—
|
—
|
$85,272.17
|
$213,988.06
|
$102,633.58
|
2026-04-30
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
6
|
5
|
—
|
—
|
$85,229.34
|
$213,862.09
|
$102,582.04
|
2026-04-30
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
6
|
5
|
—
|
—
|
$83,000.29
|
$207,305.62
|
$99,899.15
|
2026-04-30
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
6
|
5
|
—
|
—
|
$82,654.62
|
$206,288.85
|
$99,483.10
|
2026-04-30
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
6
|
5
|
—
|
—
|
$81,157.71
|
$201,885.88
|
$97,681.42
|
2026-04-30
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
6
|
5
|
—
|
—
|
$79,569.03
|
$197,212.97
|
$95,769.29
|
2026-04-30
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
6
|
5
|
—
|
—
|
$79,569.03
|
$197,212.97
|
$95,769.29
|
2026-04-30
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
6
|
5
|
—
|
—
|
$79,325.33
|
$196,496.14
|
$95,475.96
|
2026-04-30
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
6
|
5
|
—
|
—
|
$78,135.33
|
$192,995.96
|
$94,043.68
|
2026-04-30
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
6
|
5
|
—
|
—
|
$75,012.03
|
$183,809.10
|
$90,284.48
|
2026-04-30
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
6
|
5
|
—
|
—
|
$74,939.63
|
$183,596.15
|
$90,197.34
|
2026-04-30
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
6
|
5
|
—
|
—
|
$74,341.07
|
$181,835.56
|
$89,476.91
|
2026-04-30
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
6
|
5
|
—
|
—
|
$73,787.36
|
$180,206.94
|
$88,810.46
|
2026-04-30
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
6
|
5
|
—
|
—
|
$73,770.05
|
$180,155.95
|
$88,789.63
|
2026-04-30
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
6
|
5
|
—
|
—
|
$73,326.48
|
$178,851.26
|
$88,255.75
|
2026-04-30
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
6
|
5
|
—
|
—
|
$72,985.90
|
$177,849.49
|
$87,845.83
|
2026-04-30
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
6
|
5
|
—
|
—
|
$72,362.85
|
$176,016.92
|
$87,095.93
|
2026-04-30
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
6
|
5
|
—
|
—
|
$72,324.11
|
$175,902.95
|
$87,049.30
|
2026-04-30
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
6
|
5
|
—
|
—
|
$70,952.62
|
$171,868.89
|
$85,398.57
|
2026-04-30
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
6
|
5
|
—
|
—
|
$70,638.56
|
$170,945.10
|
$85,020.57
|
2026-04-30
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
6
|
5
|
—
|
—
|
$69,670.87
|
$168,098.77
|
$83,855.86
|
2026-04-30
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
6
|
5
|
—
|
—
|
$69,279.33
|
$166,947.04
|
$83,384.60
|
2026-04-30
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
6
|
5
|
—
|
—
|
$68,838.80
|
$165,651.34
|
$82,854.38
|
2026-04-30
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
6
|
5
|
—
|
—
|
$68,501.27
|
$164,658.57
|
$82,448.13
|
2026-04-30
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
6
|
5
|
—
|
—
|
$68,303.46
|
$164,076.71
|
$82,210.05
|
2026-04-30
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
6
|
5
|
—
|
—
|
$68,223.93
|
$163,842.76
|
$82,114.32
|
2026-04-30
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
6
|
5
|
—
|
—
|
$68,136.24
|
$163,584.82
|
$82,008.78
|
2026-04-30
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
6
|
5
|
—
|
—
|
$67,913.95
|
$162,930.97
|
$81,741.23
|
2026-04-30
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
6
|
5
|
—
|
—
|
$66,899.36
|
$159,946.67
|
$80,520.07
|
2026-04-30
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
6
|
5
|
—
|
—
|
$66,501.67
|
$158,776.94
|
$80,041.41
|
2026-04-30
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
6
|
5
|
—
|
—
|
$66,323.22
|
$158,252.07
|
$79,826.63
|
2026-04-30
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
6
|
5
|
—
|
—
|
$65,600.24
|
$156,125.56
|
$78,956.45
|
2026-04-30
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
6
|
5
|
—
|
—
|
$65,508.48
|
$155,855.63
|
$78,846.01
|
2026-04-30
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
6
|
5
|
—
|
—
|
$63,915.75
|
$151,170.72
|
$76,928.99
|
2026-04-30
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
6
|
5
|
—
|
—
|
$63,377.32
|
$149,587.09
|
$76,280.94
|
2026-04-30
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
6
|
5
|
—
|
—
|
$62,969.47
|
$148,387.37
|
$75,790.05
|
2026-04-30
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
6
|
5
|
—
|
—
|
$62,879.72
|
$148,123.43
|
$75,682.03
|
2026-04-30
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
6
|
5
|
—
|
—
|
$62,707.40
|
$147,616.55
|
$75,474.62
|
2026-04-30
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
6
|
5
|
—
|
—
|
$62,498.37
|
$147,001.69
|
$75,223.04
|
2026-04-30
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
6
|
5
|
—
|
—
|
$61,759.08
|
$144,827.20
|
$74,333.23
|
2026-04-30
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
6
|
5
|
—
|
—
|
$61,510.27
|
$144,095.37
|
$74,033.76
|
2026-04-30
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
6
|
5
|
—
|
—
|
$61,066.71
|
$142,790.67
|
$73,499.89
|
2026-04-30
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
6
|
5
|
—
|
—
|
$60,461.00
|
$141,009.09
|
$72,770.86
|
2026-04-30
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
6
|
5
|
—
|
—
|
$60,363.11
|
$140,721.16
|
$72,653.04
|
2026-04-30
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
6
|
5
|
—
|
—
|
$60,220.36
|
$140,301.26
|
$72,481.23
|
2026-04-30
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
6
|
5
|
—
|
—
|
$59,804.32
|
$139,077.54
|
$71,980.48
|
2026-04-30
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
6
|
5
|
—
|
—
|
$59,615.69
|
$138,522.67
|
$71,753.45
|
2026-04-30
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
6
|
5
|
—
|
—
|
$59,391.36
|
$137,862.82
|
$71,483.44
|
2026-04-30
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
6
|
5
|
—
|
—
|
$59,272.05
|
$137,511.91
|
$71,339.84
|
2026-04-30
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
6
|
5
|
—
|
—
|
$59,043.63
|
$136,840.06
|
$71,064.91
|
2026-04-30
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
6
|
5
|
—
|
—
|
$58,903.94
|
$136,429.16
|
$70,896.78
|
2026-04-30
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
6
|
5
|
—
|
—
|
$58,883.55
|
$136,369.17
|
$70,872.24
|
2026-04-30
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
6
|
5
|
—
|
—
|
$58,702.05
|
$135,835.30
|
$70,653.79
|
2026-04-30
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
6
|
5
|
—
|
—
|
$58,221.77
|
$134,422.63
|
$70,075.72
|
2026-04-30
|
|
31
|
MS_DRG
|
Ventricular Shunt Procedures With Mcc
|
6
|
5
|
—
|
—
|
$58,208.50
|
$134,383.64
|
$70,059.75
|
2026-04-30
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
6
|
5
|
—
|
—
|
$58,029.06
|
$133,855.76
|
$69,843.77
|
2026-04-30
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
6
|
5
|
—
|
—
|
$57,314.23
|
$131,753.25
|
$68,983.40
|
2026-04-30
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
6
|
5
|
—
|
—
|
$56,647.37
|
$129,791.71
|
$68,180.77
|
2026-04-30
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
6
|
5
|
—
|
—
|
$56,295.56
|
$128,756.95
|
$67,757.33
|
2026-04-30
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
6
|
5
|
—
|
—
|
$56,014.13
|
$127,929.14
|
$67,418.60
|
2026-04-30
|
|
269
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
6
|
5
|
—
|
—
|
$55,584.83
|
$126,666.44
|
$66,901.90
|
2026-04-30
|
|
12
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
6
|
5
|
—
|
—
|
$55,511.41
|
$126,450.49
|
$66,813.54
|
2026-04-30
|
|
958
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
6
|
5
|
—
|
—
|
$55,490.00
|
$126,387.50
|
$66,787.76
|
2026-04-30
|
|
673
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Mcc
|
6
|
5
|
—
|
—
|
$55,364.59
|
$126,018.59
|
$66,636.82
|
2026-04-30
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
6
|
5
|
—
|
—
|
$55,313.61
|
$125,868.62
|
$66,575.46
|
2026-04-30
|
|
236
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
6
|
5
|
—
|
—
|
$55,234.07
|
$125,634.68
|
$66,479.73
|
2026-04-30
|
|
458
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
6
|
5
|
—
|
—
|
$55,068.88
|
$125,148.79
|
$66,280.90
|
2026-04-30
|
|
423
|
MS_DRG
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
6
|
5
|
—
|
—
|
$54,869.02
|
$124,560.93
|
$66,040.35
|
2026-04-30
|
|
273
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures With Mcc
|
6
|
5
|
—
|
—
|
$54,588.59
|
$123,736.12
|
$65,702.82
|
2026-04-30
|
|
802
|
MS_DRG
|
Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc
|
6
|
5
|
—
|
—
|
$53,146.76
|
$119,495.11
|
$63,967.44
|
2026-04-30
|
|
24
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
6
|
5
|
—
|
—
|
$52,410.53
|
$117,329.62
|
$63,081.32
|
2026-04-30
|
|
933
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
6
|
5
|
—
|
—
|
$52,230.04
|
$116,798.74
|
$62,864.07
|
2026-04-30
|
|
34
|
MS_DRG
|
Carotid Artery Stent Procedures With Mcc
|
6
|
5
|
—
|
—
|
$51,990.41
|
$116,093.91
|
$62,575.65
|
2026-04-30
|
|
40
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
6
|
5
|
—
|
—
|
$51,893.56
|
$115,808.97
|
$62,459.09
|
2026-04-30
|
|
907
|
MS_DRG
|
Other O.r. Procedures For Injuries With Mcc
|
6
|
5
|
—
|
—
|
$51,670.25
|
$115,152.12
|
$62,190.32
|
2026-04-30
|
|
956
|
MS_DRG
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
6
|
5
|
—
|
—
|
$50,892.21
|
$112,863.66
|
$61,253.87
|
2026-04-30
|
|
143
|
MS_DRG
|
Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc
|
6
|
5
|
—
|
—
|
$50,725.00
|
$112,371.77
|
$61,052.61
|
2026-04-30
|
|
166
|
MS_DRG
|
Other Respiratory System O.r. Procedures With Mcc
|
6
|
5
|
—
|
—
|
$50,634.23
|
$112,104.84
|
$60,943.36
|
2026-04-30
|
|
518
|
MS_DRG
|
Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…
|
6
|
5
|
—
|
—
|
$50,630.16
|
$112,092.84
|
$60,938.46
|
2026-04-30
|
|
628
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
6
|
5
|
—
|
—
|
$50,523.08
|
$111,777.91
|
$60,809.58
|
2026-04-30
|
|
651
|
MS_DRG
|
Kidney Transplant With Hemodialysis Without Mcc
|
6
|
5
|
—
|
—
|
$50,308.95
|
$111,148.06
|
$60,551.85
|
2026-04-30
|
|
904
|
MS_DRG
|
Skin Grafts For Injuries With Cc/mcc
|
6
|
5
|
—
|
—
|
$49,975.49
|
$110,167.29
|
$60,150.50
|
2026-04-30
|
|
492
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc
|
6
|
5
|
—
|
—
|
$49,960.21
|
$110,122.30
|
$60,132.11
|
2026-04-30
|
|
939
|
MS_DRG
|
O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc
|
6
|
5
|
—
|
—
|
$49,520.72
|
$108,829.60
|
$59,603.14
|
2026-04-30
|
|
495
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…
|
6
|
5
|
—
|
—
|
$49,492.17
|
$108,745.62
|
$59,568.78
|
2026-04-30
|
|
332
|
MS_DRG
|
Rectal Resection With Mcc
|
6
|
5
|
—
|
—
|
$49,441.18
|
$108,595.66
|
$59,507.40
|
2026-04-30
|
|
265
|
MS_DRG
|
Aicd Lead Procedures
|
6
|
5
|
—
|
—
|
$49,415.68
|
$108,520.67
|
$59,476.71
|
2026-04-30
|
|
97
|
MS_DRG
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc
|
6
|
5
|
—
|
—
|
$49,350.43
|
$108,328.72
|
$59,398.18
|
2026-04-30
|
|
279
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
6
|
5
|
—
|
—
|
$49,295.36
|
$108,166.76
|
$59,331.89
|
2026-04-30
|
|
739
|
MS_DRG
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…
|
6
|
5
|
—
|
—
|
$49,054.73
|
$107,458.92
|
$59,042.28
|
2026-04-30
|
|
736
|
MS_DRG
|
Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc
|
6
|
5
|
—
|
—
|
$48,970.09
|
$107,209.98
|
$58,940.40
|
2026-04-30
|
|
335
|
MS_DRG
|
Peritoneal Adhesiolysis With Mcc
|
6
|
5
|
—
|
—
|
$48,933.37
|
$107,102.00
|
$58,896.21
|
2026-04-30
|
|
408
|
MS_DRG
|
Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…
|
6
|
5
|
—
|
—
|
$48,879.35
|
$106,943.04
|
$58,831.18
|
2026-04-30
|
|
414
|
MS_DRG
|
Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc
|
6
|
5
|
—
|
—
|
$48,848.75
|
$106,853.06
|
$58,794.36
|
2026-04-30
|
|
622
|
MS_DRG
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
6
|
5
|
—
|
—
|
$48,814.08
|
$106,751.09
|
$58,752.62
|
2026-04-30
|
|
271
|
MS_DRG
|
Other Major Cardiovascular Procedures With Cc
|
6
|
5
|
—
|
—
|
$48,784.53
|
$106,664.11
|
$58,717.06
|
2026-04-30
|
|
467
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Cc
|
6
|
5
|
—
|
—
|
$48,481.67
|
$105,773.31
|
$58,352.54
|
2026-04-30
|
|
94
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System With Mcc
|
6
|
5
|
—
|
—
|
$48,408.24
|
$105,557.36
|
$58,264.16
|
2026-04-30
|
|
252
|
MS_DRG
|
Other Vascular Procedures With Mcc
|
6
|
5
|
—
|
—
|
$48,091.10
|
$104,624.58
|
$57,882.45
|
2026-04-30
|
|
616
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
6
|
5
|
—
|
—
|
$48,081.94
|
$104,597.59
|
$57,871.43
|
2026-04-30
|
|
574
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Cc
|
6
|
5
|
—
|
—
|
$47,918.79
|
$104,117.70
|
$57,675.06
|
2026-04-30
|
|
477
|
MS_DRG
|
Biopsies Of Musculoskeletal System And Connective Tissue With Mcc
|
6
|
5
|
—
|
—
|
$47,747.49
|
$103,613.82
|
$57,468.88
|
2026-04-30
|
|
987
|
MS_DRG
|
Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
6
|
5
|
—
|
—
|
$47,480.32
|
$102,828.00
|
$57,147.32
|
2026-04-30
|
|
29
|
MS_DRG
|
Spinal Procedures With Cc Or Spinal Neurostimulators
|
6
|
5
|
—
|
—
|
$47,309.02
|
$102,324.12
|
$56,941.13
|
2026-04-30
|
|
420
|
MS_DRG
|
Hepatobiliary Diagnostic Procedures With Mcc
|
6
|
5
|
—
|
—
|
$47,263.12
|
$102,189.15
|
$56,885.89
|
2026-04-30
|
|
264
|
MS_DRG
|
Other Circulatory System O.r. Procedures
|
6
|
5
|
—
|
—
|
$46,585.05
|
$100,194.62
|
$56,069.76
|
2026-04-30
|
|
37
|
MS_DRG
|
Extracranial Procedures With Mcc
|
6
|
5
|
—
|
—
|
$46,090.49
|
$98,739.96
|
$55,474.51
|
2026-04-30
|
|
274
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures Without Mcc
|
6
|
5
|
—
|
—
|
$46,086.39
|
$98,727.96
|
$55,469.58
|
2026-04-30
|
|
260
|
MS_DRG
|
Cardiac Pacemaker Revision Except Device Replacement With Mcc
|
6
|
5
|
—
|
—
|
$45,689.73
|
$97,561.23
|
$54,992.16
|
2026-04-30
|
|
579
|
MS_DRG
|
Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc
|
6
|
5
|
—
|
—
|
$45,543.93
|
$97,132.33
|
$54,816.68
|
2026-04-30
|
|
840
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Mcc
|
6
|
5
|
—
|
—
|
$45,507.21
|
$97,024.36
|
$54,772.48
|
2026-04-30
|
|
652
|
MS_DRG
|
Kidney Transplant
|
6
|
5
|
—
|
—
|
$45,452.15
|
$96,862.39
|
$54,706.21
|
2026-04-30
|
|
485
|
MS_DRG
|
Knee Procedures With Principal Diagnosis Of Infection With Mcc
|
6
|
5
|
—
|
—
|
$45,427.69
|
$96,790.41
|
$54,676.77
|
2026-04-30
|
|
929
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc
|
6
|
5
|
—
|
—
|
$45,363.43
|
$96,601.45
|
$54,599.43
|
2026-04-30
|
|
325
|
MS_DRG
|
Coronary Intravascular Lithotripsy Without Intraluminal Device
|
6
|
5
|
—
|
—
|
$45,257.39
|
$96,289.53
|
$54,471.79
|
2026-04-30
|
|
242
|
MS_DRG
|
Permanent Cardiac Pacemaker Implant With Mcc
|
6
|
5
|
—
|
—
|
$45,077.93
|
$95,761.65
|
$54,255.79
|
2026-04-30
|
|
515
|
MS_DRG
|
Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc
|
6
|
5
|
—
|
—
|
$45,017.75
|
$95,584.69
|
$54,183.37
|
2026-04-30
|
|
656
|
MS_DRG
|
Kidney And Ureter Procedures For Neoplasm With Mcc
|
6
|
5
|
—
|
—
|
$44,986.15
|
$95,491.71
|
$54,145.33
|
2026-04-30
|
|
22
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…
|
6
|
5
|
—
|
—
|
$44,920.90
|
$95,299.76
|
$54,066.79
|
2026-04-30
|
|
411
|
MS_DRG
|
Cholecystectomy With C.d.e. With Mcc
|
6
|
5
|
—
|
—
|
$46,204.68
|
$99,075.88
|
$53,921.04
|
2026-04-30
|
|
500
|
MS_DRG
|
Soft Tissue Procedures With Mcc
|
6
|
5
|
—
|
—
|
$44,792.42
|
$94,921.85
|
$53,912.15
|
2026-04-30
|
|
829
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…
|
6
|
5
|
—
|
—
|
$44,743.46
|
$94,777.88
|
$53,853.23
|
2026-04-30
|
|
324
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc
|
6
|
5
|
—
|
—
|
$44,651.70
|
$94,507.94
|
$53,742.79
|
2026-04-30
|
|
229
|
MS_DRG
|
Other Cardiothoracic Procedures Without Mcc
|
6
|
5
|
—
|
—
|
$44,636.39
|
$94,462.95
|
$53,724.36
|
2026-04-30
|
|
258
|
MS_DRG
|
Cardiac Pacemaker Device Replacement With Mcc
|
6
|
5
|
—
|
—
|
$44,560.93
|
$94,241.01
|
$53,633.54
|
2026-04-30
|
|
665
|
MS_DRG
|
Prostatectomy With Mcc
|
6
|
5
|
—
|
—
|
$44,347.84
|
$93,614.15
|
$53,377.06
|
2026-04-30
|
|
464
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
6
|
5
|
—
|
—
|
$44,281.54
|
$93,419.20
|
$53,297.26
|
2026-04-30
|
|
26
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Cc
|
6
|
5
|
—
|
—
|
$44,225.47
|
$93,254.24
|
$53,229.78
|
2026-04-30
|
|
662
|
MS_DRG
|
Minor Bladder Procedures With Mcc
|
6
|
5
|
—
|
—
|
$43,739.05
|
$91,823.57
|
$52,644.32
|
2026-04-30
|
|
469
|
MS_DRG
|
Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…
|
6
|
5
|
—
|
—
|
$43,450.49
|
$90,974.77
|
$52,297.01
|
2026-04-30
|
|
510
|
MS_DRG
|
Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc
|
6
|
5
|
—
|
—
|
$43,320.99
|
$90,593.86
|
$52,141.15
|
2026-04-30
|
|
625
|
MS_DRG
|
Thyroid, Parathyroid And Thyroglossal Procedures With Mcc
|
6
|
5
|
—
|
—
|
$43,316.91
|
$90,581.86
|
$52,136.24
|
2026-04-30
|
|
263
|
MS_DRG
|
Vein Ligation And Stripping
|
6
|
5
|
—
|
—
|
$43,697.26
|
$91,700.60
|
$52,055.78
|
2026-04-30
|
|
173
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…
|
6
|
5
|
—
|
—
|
$42,871.31
|
$89,271.17
|
$51,599.91
|
2026-04-30
|
|
472
|
MS_DRG
|
Cervical Spinal Fusion With Cc
|
6
|
5
|
—
|
—
|
$42,562.34
|
$88,362.38
|
$51,228.03
|
2026-04-30
|
|
570
|
MS_DRG
|
Skin Debridement With Mcc
|
6
|
5
|
—
|
—
|
$42,511.37
|
$88,212.41
|
$51,166.68
|
2026-04-30
|
|
959
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc
|
6
|
5
|
—
|
—
|
$42,541.94
|
$88,302.39
|
$51,047.90
|
2026-04-30
|
|
668
|
MS_DRG
|
Transurethral Procedures With Mcc
|
6
|
5
|
—
|
—
|
$42,296.19
|
$87,579.56
|
$50,907.69
|
2026-04-30
|
|
480
|
MS_DRG
|
Hip And Femur Procedures Except Major Joint With Mcc
|
6
|
5
|
—
|
—
|
$42,217.68
|
$87,348.61
|
$50,813.20
|
2026-04-30
|
|
353
|
MS_DRG
|
Hernia Procedures Except Inguinal And Femoral With Mcc
|
6
|
5
|
—
|
—
|
$42,112.65
|
$87,039.69
|
$50,686.79
|
2026-04-30
|
|
406
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Cc
|
6
|
5
|
—
|
—
|
$42,094.31
|
$86,985.70
|
$50,664.71
|
2026-04-30
|
|
974
|
MS_DRG
|
HIV With Major Related Condition With Mcc
|
6
|
5
|
—
|
—
|
$41,949.51
|
$86,559.80
|
$50,490.43
|
2026-04-30
|
|
13
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc
|
6
|
5
|
—
|
—
|
$41,906.69
|
$86,433.83
|
$50,438.89
|
2026-04-30
|
|
521
|
MS_DRG
|
Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc
|
6
|
5
|
—
|
—
|
$41,788.40
|
$86,085.91
|
$50,296.52
|
2026-04-30
|
|
498
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…
|
6
|
5
|
—
|
—
|
$43,283.26
|
$90,482.88
|
$50,078.32
|
2026-04-30
|
|
240
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc
|
6
|
5
|
—
|
—
|
$41,587.54
|
$85,495.05
|
$50,054.76
|
2026-04-30
|
|
J9029
|
HCPCS
|
Instill Adstiladrin, Tx Dose
|
7
|
6
|
—
|
—
|
$64,282.30
|
$135,000.00
|
$101,970.00
|
2026-04-30
|
|
38240
|
CPT
|
Transplt Allo Hct/donor
|
7
|
6
|
—
|
—
|
$9,611.00
|
$108,036.56
|
$66,353.37
|
2026-04-30
|
|
A9543
|
HCPCS
|
Y90 Ibritumomab, Rx
|
8
|
7
|
—
|
—
|
$56,824.55
|
$323,929.93
|
$97,554.96
|
2026-04-30
|
|
Q2043
|
HCPCS
|
Sipuleucel-t Auto Cd54+
|
8
|
7
|
—
|
—
|
$56,269.19
|
$278,264.75
|
$89,885.74
|
2026-04-30
|
|
876
|
MS_DRG
|
O.r. Procedures With Principal Diagnosis Of Mental Illness
|
8
|
7
|
—
|
—
|
$31,763.00
|
$115,919.95
|
$51,931.28
|
2026-04-30
|
|
C2624
|
HCPCS
|
Hc Cardiomems Implant-supply
|
18
|
8
|
$108,675.00
|
$38,036.25
65% off
|
$12,888.00
|
$80,962.88
|
$53,223.58
|
2026-04-30
|