|
J3391
|
HCPCS
|
Inj, Atidarsagene Autotemcel
|
16
|
8
|
—
|
—
|
$4,505,000.00
|
$4,955,500.00
|
$4,505,000.00
|
2025-11-01
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
16
|
8
|
—
|
—
|
$3,685,266.67
|
$4,053,793.33
|
$3,685,266.67
|
2025-11-01
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
16
|
8
|
—
|
—
|
$3,316,462.59
|
$3,648,108.85
|
$3,316,462.59
|
2025-11-01
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
16
|
8
|
—
|
—
|
$3,248,445.72
|
$3,573,290.29
|
$3,248,445.72
|
2025-11-01
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
16
|
8
|
—
|
—
|
$2,945,740.00
|
$3,240,314.00
|
$2,945,740.00
|
2025-11-01
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
16
|
8
|
—
|
—
|
$2,455,110.61
|
$2,700,621.67
|
$2,455,110.61
|
2025-11-01
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
16
|
8
|
—
|
—
|
$2,332,000.00
|
$2,565,200.00
|
$2,332,000.00
|
2025-11-01
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
20
|
8
|
—
|
—
|
$770,620.00
|
$1,695,364.00
|
$770,620.00
|
2025-11-01
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
42
|
11
|
—
|
—
|
$17,140.00
|
$960,817.30
|
$726,421.06
|
2025-11-01
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel Car-pos T
|
24
|
8
|
—
|
—
|
$591,726.20
|
$1,301,797.64
|
$591,726.20
|
2025-11-01
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
24
|
8
|
—
|
—
|
$565,868.95
|
$1,244,911.68
|
$565,868.95
|
2025-11-01
|
|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
24
|
8
|
—
|
—
|
$562,538.19
|
$1,237,584.01
|
$562,538.19
|
2025-11-01
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel Car
|
24
|
8
|
—
|
—
|
$557,317.93
|
$1,226,099.45
|
$557,317.93
|
2025-11-01
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Car+
|
24
|
8
|
—
|
—
|
$533,230.17
|
$1,173,106.38
|
$533,230.17
|
2025-11-01
|
|
Q2053
|
HCPCS
|
Brexucabtagene Car Pos T
|
24
|
8
|
—
|
—
|
$489,304.61
|
$1,076,470.14
|
$489,304.61
|
2025-11-01
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$623,531.78
|
$471,418.05
|
2025-11-01
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
42
|
11
|
—
|
—
|
$17,140.00
|
$475,048.63
|
$359,158.11
|
2025-11-01
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$472,260.70
|
$357,050.31
|
2025-11-01
|
|
Q2058
|
HCPCS
|
Obecbtge Autol Up To 400 Mil
|
20
|
8
|
—
|
—
|
$278,250.00
|
$612,150.00
|
$278,250.00
|
2025-11-01
|
|
J3403
|
HCPCS
|
Revakinagene, Per Implant
|
20
|
8
|
—
|
—
|
$257,500.00
|
$566,500.00
|
$257,500.00
|
2025-11-01
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …
|
42
|
11
|
—
|
—
|
$17,140.00
|
$308,193.65
|
$233,008.25
|
2025-11-01
|
|
7
|
MS_DRG
|
Lung Transplant
|
42
|
11
|
—
|
—
|
$17,140.00
|
$288,141.95
|
$217,848.26
|
2025-11-01
|
|
J3402
|
HCPCS
|
Inj. Remestemcel-l-rknd/ Td
|
20
|
8
|
—
|
—
|
$205,640.00
|
$452,408.00
|
$205,640.00
|
2025-11-01
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
42
|
11
|
—
|
—
|
$17,140.00
|
$267,398.28
|
$202,165.11
|
2025-11-01
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$252,132.55
|
$190,623.54
|
2025-11-01
|
|
209
|
MS_DRG
|
Complex Aortic Arch Procedures
|
42
|
11
|
—
|
—
|
$17,140.00
|
$251,843.30
|
$190,404.85
|
2025-11-01
|
|
90288
|
CPT
|
Botulism Ig IV
|
2
|
1
|
—
|
—
|
$188,001.30
|
$188,001.30
|
$188,001.30
|
2025-11-01
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$245,221.70
|
$185,398.63
|
2025-11-01
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
42
|
11
|
—
|
—
|
$17,140.00
|
$241,948.73
|
$182,924.11
|
2025-11-01
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
42
|
11
|
—
|
—
|
$17,140.00
|
$229,408.63
|
$173,443.23
|
2025-11-01
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
42
|
11
|
—
|
—
|
$17,140.00
|
$221,543.25
|
$167,496.65
|
2025-11-01
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
44
|
12
|
—
|
—
|
$17,140.00
|
$217,667.30
|
$156,167.73
|
2025-11-01
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$200,463.60
|
$151,559.49
|
2025-11-01
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
42
|
11
|
—
|
—
|
$17,140.00
|
$192,673.88
|
$145,670.11
|
2025-11-01
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$186,975.65
|
$141,361.99
|
2025-11-01
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
44
|
12
|
—
|
—
|
$17,140.00
|
$187,565.28
|
$134,570.71
|
2025-11-01
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$175,080.80
|
$132,368.95
|
2025-11-01
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$169,542.78
|
$128,181.96
|
2025-11-01
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
44
|
12
|
—
|
—
|
$17,140.00
|
$170,842.18
|
$122,572.54
|
2025-11-01
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
44
|
12
|
—
|
—
|
$17,140.00
|
$170,105.70
|
$122,044.15
|
2025-11-01
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$160,613.85
|
$121,431.29
|
2025-11-01
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
42
|
11
|
—
|
—
|
$17,140.00
|
$159,659.33
|
$120,709.63
|
2025-11-01
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$159,592.58
|
$120,659.16
|
2025-11-01
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
42
|
11
|
—
|
—
|
$17,140.00
|
$158,744.85
|
$120,018.24
|
2025-11-01
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$158,651.40
|
$119,947.59
|
2025-11-01
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
42
|
11
|
—
|
—
|
$17,140.00
|
$153,787.55
|
$116,270.30
|
2025-11-01
|
|
J7330
|
HCPCS
|
Cultured Chondrocytes Implnt
|
16
|
6
|
—
|
—
|
$104,262.05
|
$243,910.00
|
$115,517.61
|
2025-11-01
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
42
|
11
|
—
|
—
|
$17,140.00
|
$149,766.98
|
$113,230.56
|
2025-11-01
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
42
|
11
|
—
|
—
|
$17,140.00
|
$148,774.63
|
$112,480.30
|
2025-11-01
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$148,665.60
|
$112,397.88
|
2025-11-01
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$145,768.65
|
$110,207.65
|
2025-11-01
|
|
Q0480
|
HCPCS
|
Driver Pneumatic Vad, Rep
|
20
|
8
|
—
|
—
|
$110,139.19
|
$242,306.22
|
$110,139.19
|
2025-11-01
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
44
|
12
|
—
|
—
|
$17,140.00
|
$153,033.28
|
$109,795.35
|
2025-11-01
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
42
|
11
|
—
|
—
|
$17,140.00
|
$143,172.08
|
$108,244.52
|
2025-11-01
|
|
A9543
|
HCPCS
|
Y90 Ibritumomab, Rx
|
36
|
11
|
—
|
—
|
$56,824.55
|
$462,395.04
|
$106,927.46
|
2025-11-01
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
44
|
12
|
—
|
—
|
$17,140.00
|
$146,300.43
|
$104,964.80
|
2025-11-01
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
44
|
12
|
—
|
—
|
$17,140.00
|
$146,300.43
|
$104,964.80
|
2025-11-01
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$136,198.93
|
$102,972.51
|
2025-11-01
|
|
J9029
|
HCPCS
|
Instill Adstiladrin, Tx Dose
|
36
|
11
|
—
|
—
|
$63,342.28
|
$259,534.51
|
$101,222.39
|
2025-11-01
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$133,684.68
|
$101,071.62
|
2025-11-01
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
42
|
11
|
—
|
—
|
$17,140.00
|
$133,646.85
|
$101,043.03
|
2025-11-01
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$132,678.98
|
$100,311.27
|
2025-11-01
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
42
|
11
|
—
|
—
|
$17,140.00
|
$132,242.88
|
$99,981.56
|
2025-11-01
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$131,935.83
|
$99,749.41
|
2025-11-01
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$130,491.80
|
$98,657.67
|
2025-11-01
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
44
|
12
|
—
|
—
|
$17,140.00
|
$136,356.90
|
$97,830.71
|
2025-11-01
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$128,317.98
|
$97,014.16
|
2025-11-01
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
44
|
12
|
—
|
—
|
$17,140.00
|
$134,892.85
|
$96,780.32
|
2025-11-01
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$127,499.18
|
$96,395.11
|
2025-11-01
|
|
213
|
MS_DRG
|
Endovascular Abdominal Aorta With Iliac Branch Procedures
|
42
|
11
|
—
|
—
|
$17,140.00
|
$126,978.53
|
$96,001.47
|
2025-11-01
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
42
|
11
|
—
|
—
|
$17,140.00
|
$126,813.88
|
$95,876.99
|
2025-11-01
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$125,089.50
|
$94,573.28
|
2025-11-01
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
42
|
11
|
—
|
—
|
$17,140.00
|
$124,702.35
|
$94,280.58
|
2025-11-01
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
44
|
12
|
—
|
—
|
$17,140.00
|
$130,576.35
|
$93,683.39
|
2025-11-01
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
42
|
11
|
—
|
—
|
$17,140.00
|
$123,847.95
|
$93,634.62
|
2025-11-01
|
|
K1007
|
HCPCS
|
Bil Hkaf Pc S/d Micro Sensor
|
20
|
8
|
—
|
—
|
$93,216.70
|
$205,076.74
|
$93,216.70
|
2025-11-01
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$122,886.75
|
$92,907.91
|
2025-11-01
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$122,150.28
|
$92,351.10
|
2025-11-01
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$121,718.63
|
$92,024.75
|
2025-11-01
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$121,353.73
|
$91,748.87
|
2025-11-01
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$120,868.68
|
$91,382.15
|
2025-11-01
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
42
|
11
|
—
|
—
|
$17,140.00
|
$118,583.60
|
$89,654.53
|
2025-11-01
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$117,787.05
|
$89,052.30
|
2025-11-01
|
|
Q2043
|
HCPCS
|
Sipuleucel-t Auto Cd54+
|
38
|
11
|
—
|
—
|
$55,272.32
|
$228,908.54
|
$88,153.99
|
2025-11-01
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$115,820.15
|
$87,565.24
|
2025-11-01
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$115,619.90
|
$87,413.84
|
2025-11-01
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
44
|
12
|
—
|
—
|
$17,140.00
|
$121,545.08
|
$87,203.81
|
2025-11-01
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
44
|
12
|
—
|
—
|
$17,140.00
|
$118,654.80
|
$85,130.15
|
2025-11-01
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
44
|
12
|
—
|
—
|
$17,140.00
|
$117,397.68
|
$84,228.21
|
2025-11-01
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$110,969.65
|
$83,898.04
|
2025-11-01
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$109,883.85
|
$83,077.13
|
2025-11-01
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$109,507.83
|
$82,792.84
|
2025-11-01
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$109,051.70
|
$82,447.99
|
2025-11-01
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$107,438.58
|
$81,228.39
|
2025-11-01
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$106,895.68
|
$80,817.93
|
2025-11-01
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
44
|
12
|
—
|
—
|
$17,140.00
|
$112,144.45
|
$80,459.23
|
2025-11-01
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$104,606.15
|
$79,086.95
|
2025-11-01
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
44
|
12
|
—
|
—
|
$17,140.00
|
$110,079.65
|
$78,977.82
|
2025-11-01
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$104,392.55
|
$78,925.46
|
2025-11-01
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
42
|
11
|
—
|
—
|
$17,140.00
|
$104,081.05
|
$78,689.95
|
2025-11-01
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
44
|
12
|
—
|
—
|
$17,140.00
|
$105,927.80
|
$78,437.09
|
2025-11-01
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$103,173.25
|
$78,003.61
|
2025-11-01
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$102,761.63
|
$77,692.41
|
2025-11-01
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$102,272.13
|
$77,322.32
|
2025-11-01
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$102,011.80
|
$77,125.51
|
2025-11-01
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
42
|
11
|
—
|
—
|
$17,140.00
|
$101,513.40
|
$76,748.69
|
2025-11-01
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$101,208.58
|
$76,518.23
|
2025-11-01
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$101,164.08
|
$76,484.59
|
2025-11-01
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$100,768.03
|
$76,185.16
|
2025-11-01
|
|
A9699
|
HCPCS
|
Radiopharm Rx Agent Noc
|
6
|
2
|
—
|
—
|
$75,532.13
|
$132,701.35
|
$75,532.13
|
2025-11-01
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$99,720.05
|
$75,392.84
|
2025-11-01
|
|
31
|
MS_DRG
|
Ventricular Shunt Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$99,691.13
|
$75,370.97
|
2025-11-01
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$99,299.53
|
$75,074.90
|
2025-11-01
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$97,739.80
|
$73,895.68
|
2025-11-01
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$96,284.65
|
$72,795.52
|
2025-11-01
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$95,517.03
|
$72,215.16
|
2025-11-01
|
|
J9226
|
HCPCS
|
Supprelin La Implant
|
38
|
11
|
—
|
—
|
$45,020.65
|
$186,414.88
|
$72,167.66
|
2025-11-01
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$94,902.93
|
$71,750.88
|
2025-11-01
|
|
448
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical Without Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$94,357.80
|
$71,338.74
|
2025-11-01
|
|
12
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$93,806.00
|
$70,921.55
|
2025-11-01
|
|
958
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$93,759.28
|
$70,886.23
|
2025-11-01
|
|
673
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$93,485.60
|
$70,679.32
|
2025-11-01
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$93,374.35
|
$70,595.21
|
2025-11-01
|
|
458
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$92,840.35
|
$70,191.48
|
2025-11-01
|
|
793
|
MS_DRG
|
Full Term Neonate With Major Problems
|
42
|
11
|
—
|
—
|
$17,140.00
|
$92,773.60
|
$70,141.01
|
2025-11-01
|
|
423
|
MS_DRG
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$92,404.25
|
$69,861.77
|
2025-11-01
|
|
222
|
MS_DRG
|
Cardiac Implants: 222, 223
|
2
|
1
|
—
|
—
|
$69,083.00
|
$69,083.00
|
$69,083.00
|
2025-11-01
|
|
223
|
MS_DRG
|
Cardiac Implants: 222, 223
|
2
|
1
|
—
|
—
|
$69,083.00
|
$69,083.00
|
$69,083.00
|
2025-11-01
|
|
791
|
MS_DRG
|
Prematurity With Major Problems
|
42
|
11
|
—
|
—
|
$17,140.00
|
$90,312.75
|
$68,280.50
|
2025-11-01
|
|
402
|
MS_DRG
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
42
|
11
|
—
|
—
|
$17,140.00
|
$89,456.13
|
$67,632.85
|
2025-11-01
|
|
L8702
|
HCPCS
|
Ewhf S/d Uprt Micro Sensor
|
20
|
8
|
—
|
—
|
$67,452.66
|
$148,395.85
|
$67,452.66
|
2025-11-01
|
|
269
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
44
|
12
|
—
|
—
|
$17,140.00
|
$93,966.20
|
$67,417.05
|
2025-11-01
|
|
27451
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27460
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27453
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27474
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27462
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27452
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27469
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27484
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27456
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27471
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27463
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27464
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27480
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27483
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27449
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27481
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27482
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27461
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27467
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27478
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27473
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27458
|
CPT
|
Osteot Femur Imed Lngth Dev
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27459
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
27476
|
CPT
|
Ambulatory Surgery Knee
|
2
|
1
|
—
|
—
|
$67,032.00
|
$67,032.00
|
$67,032.00
|
2025-11-01
|
|
802
|
MS_DRG
|
Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$88,646.23
|
$67,020.53
|
2025-11-01
|
|
236
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
44
|
12
|
—
|
—
|
$17,140.00
|
$93,200.80
|
$66,867.90
|
2025-11-01
|
|
273
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures With Mcc
|
44
|
12
|
—
|
—
|
$17,140.00
|
$91,792.38
|
$65,857.42
|
2025-11-01
|
|
24
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$87,039.78
|
$65,805.98
|
2025-11-01
|
|
933
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
42
|
11
|
—
|
—
|
$17,140.00
|
$86,645.95
|
$65,508.23
|
2025-11-01
|
|
34
|
MS_DRG
|
Carotid Artery Stent Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$86,123.08
|
$65,112.92
|
2025-11-01
|
|
40
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$85,911.70
|
$64,953.11
|
2025-11-01
|
|
907
|
MS_DRG
|
Other O.r. Procedures For Injuries With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$85,424.43
|
$64,584.70
|
2025-11-01
|
|
956
|
MS_DRG
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
42
|
11
|
—
|
—
|
$17,140.00
|
$83,726.75
|
$63,301.19
|
2025-11-01
|
|
143
|
MS_DRG
|
Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$83,361.85
|
$63,025.31
|
2025-11-01
|
|
166
|
MS_DRG
|
Other Respiratory System O.r. Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$83,163.83
|
$62,875.59
|
2025-11-01
|
|
518
|
MS_DRG
|
Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$83,154.93
|
$62,868.86
|
2025-11-01
|
|
628
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$82,921.30
|
$62,692.23
|
2025-11-01
|
|
651
|
MS_DRG
|
Kidney Transplant With Hemodialysis Without Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$82,454.05
|
$62,338.97
|
2025-11-01
|
|
904
|
MS_DRG
|
Skin Grafts For Injuries With Cc/mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$81,726.48
|
$61,788.89
|
2025-11-01
|
|
492
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$81,693.10
|
$61,763.66
|
2025-11-01
|
|
939
|
MS_DRG
|
O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$80,734.13
|
$61,038.63
|
2025-11-01
|
|
495
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$80,671.83
|
$60,991.53
|
2025-11-01
|
|
332
|
MS_DRG
|
Rectal Resection With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$80,560.58
|
$60,907.42
|
2025-11-01
|
|
265
|
MS_DRG
|
Aicd Lead Procedures
|
42
|
11
|
—
|
—
|
$17,140.00
|
$80,504.95
|
$60,865.36
|
2025-11-01
|
|
97
|
MS_DRG
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$80,362.55
|
$60,757.70
|
2025-11-01
|
|
279
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
42
|
11
|
—
|
—
|
$17,140.00
|
$80,242.40
|
$60,666.86
|
2025-11-01
|
|
739
|
MS_DRG
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$79,717.30
|
$60,269.86
|
2025-11-01
|
|
736
|
MS_DRG
|
Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$79,532.63
|
$60,130.24
|
2025-11-01
|
|
335
|
MS_DRG
|
Peritoneal Adhesiolysis With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$79,452.53
|
$60,069.68
|
2025-11-01
|
|
408
|
MS_DRG
|
Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$79,334.60
|
$59,980.52
|
2025-11-01
|
|
414
|
MS_DRG
|
Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$79,267.85
|
$59,930.06
|
2025-11-01
|
|
622
|
MS_DRG
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$79,192.20
|
$59,872.86
|
2025-11-01
|
|
467
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$78,466.85
|
$59,324.47
|
2025-11-01
|
|
230
|
MS_DRG
|
Major Chest Procedures: 228-230
|
2
|
1
|
—
|
—
|
$59,214.00
|
$59,214.00
|
$59,214.00
|
2025-11-01
|
|
94
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$78,306.65
|
$59,203.35
|
2025-11-01
|
|
252
|
MS_DRG
|
Other Vascular Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$77,614.68
|
$58,680.18
|
2025-11-01
|
|
616
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$77,594.65
|
$58,665.04
|
2025-11-01
|
|
574
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$77,238.65
|
$58,395.89
|
2025-11-01
|
|
477
|
MS_DRG
|
Biopsies Of Musculoskeletal System And Connective Tissue With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$76,864.85
|
$58,113.28
|
2025-11-01
|
|
359
|
MS_DRG
|
Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$76,508.85
|
$57,844.13
|
2025-11-01
|
|
987
|
MS_DRG
|
Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$76,281.90
|
$57,672.54
|
2025-11-01
|
|
29
|
MS_DRG
|
Spinal Procedures With Cc Or Spinal Neurostimulators
|
42
|
11
|
—
|
—
|
$17,140.00
|
$75,908.10
|
$57,389.94
|
2025-11-01
|
|
420
|
MS_DRG
|
Hepatobiliary Diagnostic Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$75,807.98
|
$57,314.24
|
2025-11-01
|
|
271
|
MS_DRG
|
Other Major Cardiovascular Procedures With Cc
|
44
|
12
|
—
|
—
|
$17,140.00
|
$79,127.68
|
$56,771.00
|
2025-11-01
|
|
264
|
MS_DRG
|
Other Circulatory System O.r. Procedures
|
42
|
11
|
—
|
—
|
$17,140.00
|
$74,328.35
|
$56,195.57
|
2025-11-01
|
|
411
|
MS_DRG
|
Cholecystectomy With C.d.e. With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$73,498.43
|
$55,568.11
|
2025-11-01
|
|
37
|
MS_DRG
|
Extracranial Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$73,249.23
|
$55,379.71
|
2025-11-01
|
|
260
|
MS_DRG
|
Cardiac Pacemaker Revision Except Device Replacement With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$72,374.80
|
$54,718.60
|
2025-11-01
|
|
579
|
MS_DRG
|
Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$72,056.63
|
$54,478.05
|
2025-11-01
|
|
840
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$71,976.53
|
$54,417.49
|
2025-11-01
|
|
451
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical Without Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$71,876.40
|
$54,341.79
|
2025-11-01
|
|
652
|
MS_DRG
|
Kidney Transplant
|
42
|
11
|
—
|
—
|
$17,140.00
|
$71,856.38
|
$54,326.65
|
2025-11-01
|
|
485
|
MS_DRG
|
Knee Procedures With Principal Diagnosis Of Infection With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$71,802.98
|
$54,286.28
|
2025-11-01
|
|
929
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$71,662.80
|
$54,180.30
|
2025-11-01
|
|
325
|
MS_DRG
|
Coronary Intravascular Lithotripsy Without Intraluminal Device
|
42
|
11
|
—
|
—
|
$17,140.00
|
$71,431.40
|
$54,005.35
|
2025-11-01
|
|
515
|
MS_DRG
|
Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$70,908.53
|
$53,610.03
|
2025-11-01
|
|
656
|
MS_DRG
|
Kidney And Ureter Procedures For Neoplasm With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$70,839.55
|
$53,557.88
|
2025-11-01
|
|
22
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$70,697.15
|
$53,450.22
|
2025-11-01
|
|
229
|
MS_DRG
|
Other Cardiothoracic Procedures Without Mcc
|
44
|
12
|
—
|
—
|
$17,140.00
|
$70,076.38
|
$53,418.67
|
2025-11-01
|
|
500
|
MS_DRG
|
Soft Tissue Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$70,416.80
|
$53,238.27
|
2025-11-01
|
|
829
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$70,310.00
|
$53,157.52
|
2025-11-01
|
|
324
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$70,109.75
|
$53,006.12
|
2025-11-01
|
|
227
|
MS_DRG
|
Major Chest Procedures: 219-221, 226, 227
|
2
|
1
|
—
|
—
|
$52,963.00
|
$52,963.00
|
$52,963.00
|
2025-11-01
|
|
226
|
MS_DRG
|
Major Chest Procedures: 219-221, 226, 227
|
2
|
1
|
—
|
—
|
$52,963.00
|
$52,963.00
|
$52,963.00
|
2025-11-01
|
|
225
|
MS_DRG
|
Cardiac Implants: 224, 225
|
2
|
1
|
—
|
—
|
$52,963.00
|
$52,963.00
|
$52,963.00
|
2025-11-01
|
|
224
|
MS_DRG
|
Cardiac Implants: 224, 225
|
2
|
1
|
—
|
—
|
$52,963.00
|
$52,963.00
|
$52,963.00
|
2025-11-01
|
|
258
|
MS_DRG
|
Cardiac Pacemaker Device Replacement With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$69,911.73
|
$52,856.41
|
2025-11-01
|
|
274
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures Without Mcc
|
44
|
12
|
—
|
—
|
$17,140.00
|
$73,240.33
|
$52,547.06
|
2025-11-01
|
|
665
|
MS_DRG
|
Prostatectomy With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$69,446.70
|
$52,504.83
|
2025-11-01
|
|
464
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
42
|
11
|
—
|
—
|
$17,140.00
|
$69,302.08
|
$52,395.48
|
2025-11-01
|
|
26
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$69,179.70
|
$52,302.96
|
2025-11-01
|
|
662
|
MS_DRG
|
Minor Bladder Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$68,118.38
|
$51,500.55
|
2025-11-01
|
|
263
|
MS_DRG
|
Vein Ligation And Stripping
|
42
|
11
|
—
|
—
|
$17,140.00
|
$68,027.15
|
$51,431.58
|
2025-11-01
|
|
469
|
MS_DRG
|
Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$67,488.70
|
$51,024.49
|
2025-11-01
|
|
242
|
MS_DRG
|
Permanent Cardiac Pacemaker Implant With Mcc
|
44
|
12
|
—
|
—
|
$17,140.00
|
$71,039.80
|
$50,968.26
|
2025-11-01
|
|
510
|
MS_DRG
|
Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$67,206.13
|
$50,810.85
|
2025-11-01
|
|
625
|
MS_DRG
|
Thyroid, Parathyroid And Thyroglossal Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$67,197.23
|
$50,804.12
|
2025-11-01
|
|
498
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$67,123.80
|
$50,748.61
|
2025-11-01
|
|
J9281
|
HCPCS
|
Mitomycin 40 Mg X 2 Intra-pyelocalyceal Kit
|
104
|
17
|
$106,488.00
|
$42,595.20
60% off
|
$318.53
|
$73,476.72
|
$50,294.28
|
2025-11-01
|
|
173
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$66,224.90
|
$50,069.00
|
2025-11-01
|
|
472
|
MS_DRG
|
Cervical Spinal Fusion With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$65,550.73
|
$49,559.29
|
2025-11-01
|
|
959
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$65,506.23
|
$49,525.65
|
2025-11-01
|
|
570
|
MS_DRG
|
Skin Debridement With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$65,439.48
|
$49,475.18
|
2025-11-01
|
|
668
|
MS_DRG
|
Transurethral Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$64,970.00
|
$49,120.24
|
2025-11-01
|
|
480
|
MS_DRG
|
Hip And Femur Procedures Except Major Joint With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$64,798.68
|
$48,990.71
|
2025-11-01
|
|
L7181
|
HCPCS
|
Electronic Elbo Simultaneous
|
20
|
8
|
—
|
—
|
$48,901.12
|
$107,582.46
|
$48,901.12
|
2025-11-01
|
|
353
|
MS_DRG
|
Hernia Procedures Except Inguinal And Femoral With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$64,569.50
|
$48,817.44
|
2025-11-01
|
|
406
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$64,529.45
|
$48,787.16
|
2025-11-01
|
|
619
|
MS_DRG
|
O.r. Procedures For Obesity With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$64,244.65
|
$48,571.84
|
2025-11-01
|
|
974
|
MS_DRG
|
HIV With Major Related Condition With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$64,213.50
|
$48,548.29
|
2025-11-01
|
|
13
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$64,120.05
|
$48,477.64
|
2025-11-01
|
|
521
|
MS_DRG
|
Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$63,861.95
|
$48,282.50
|
2025-11-01
|
|
240
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$63,423.63
|
$47,951.11
|
2025-11-01
|
|
800
|
MS_DRG
|
Splenic Procedures With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$62,509.15
|
$47,259.73
|
2025-11-01
|
|
654
|
MS_DRG
|
Major Bladder Procedures With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$62,284.43
|
$47,089.82
|
2025-11-01
|
|
503
|
MS_DRG
|
Foot Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$62,101.98
|
$46,951.88
|
2025-11-01
|
|
483
|
MS_DRG
|
Major Joint Or Limb Reattachment Procedures Of Upper Extremities
|
42
|
11
|
—
|
—
|
$17,140.00
|
$61,674.78
|
$46,628.90
|
2025-11-01
|
|
61
|
MS_DRG
|
Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$61,345.48
|
$46,379.94
|
2025-11-01
|
|
208
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support <=96 Hours
|
42
|
11
|
—
|
—
|
$17,140.00
|
$61,158.58
|
$46,238.63
|
2025-11-01
|
|
468
|
MS_DRG
|
Revision Of Hip Or Knee Replacement Without Cc/mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$61,143.00
|
$46,226.86
|
2025-11-01
|
|
963
|
MS_DRG
|
Other Multiple Significant Trauma With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$60,827.05
|
$45,987.98
|
2025-11-01
|
|
321
|
MS_DRG
|
Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A…
|
42
|
11
|
—
|
—
|
$17,140.00
|
$60,537.80
|
$45,769.30
|
2025-11-01
|
|
849
|
MS_DRG
|
Radiotherapy
|
42
|
11
|
—
|
—
|
$17,140.00
|
$60,286.38
|
$45,579.21
|
2025-11-01
|
|
288
|
MS_DRG
|
Acute And Subacute Endocarditis With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$60,212.95
|
$45,523.70
|
2025-11-01
|
|
255
|
MS_DRG
|
Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$60,017.15
|
$45,375.66
|
2025-11-01
|
|
0266T
|
CPT
|
Outpatient Rates
|
34
|
11
|
—
|
—
|
$15,648.00
|
$99,494.13
|
$45,224.60
|
2025-11-01
|
|
462
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$59,185.00
|
$44,746.52
|
2025-11-01
|
|
577
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$58,978.08
|
$44,590.08
|
2025-11-01
|
|
970
|
MS_DRG
|
HIV With Extensive O.r. Procedures Without Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$58,682.15
|
$44,366.34
|
2025-11-01
|
|
846
|
MS_DRG
|
Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$57,683.13
|
$43,611.03
|
2025-11-01
|
|
344
|
MS_DRG
|
Minor Small And Large Bowel Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$57,467.30
|
$43,447.86
|
2025-11-01
|
|
95
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$57,387.20
|
$43,387.30
|
2025-11-01
|
|
96
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$57,387.20
|
$43,387.30
|
2025-11-01
|
|
749
|
MS_DRG
|
Other Female Reproductive System O.r. Procedures With Cc/mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$57,129.10
|
$43,192.17
|
2025-11-01
|
|
L7180
|
HCPCS
|
Electronic Elbow Sequential
|
20
|
8
|
—
|
—
|
$42,853.91
|
$94,278.60
|
$42,853.91
|
2025-11-01
|
|
659
|
MS_DRG
|
Kidney And Ureter Procedures For Non-neoplasm With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$56,535.03
|
$42,743.02
|
2025-11-01
|
|
493
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$56,428.23
|
$42,662.27
|
2025-11-01
|
|
J9266
|
HCPCS
|
Pegaspargase Injection
|
38
|
11
|
—
|
—
|
$28,424.06
|
$116,299.87
|
$42,539.41
|
2025-11-01
|
|
164
|
MS_DRG
|
Major Chest Procedures With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$56,159.00
|
$42,458.73
|
2025-11-01
|
|
27
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$56,134.53
|
$42,440.22
|
2025-11-01
|
|
J2350
|
HCPCS
|
Ocrelizumab 30 Mg/ml Intravenous Solution
|
104
|
17
|
$89,339.26
|
$35,735.71
60% off
|
$59.41
|
$61,644.09
|
$42,194.93
|
2025-11-01
|
|
350
|
MS_DRG
|
Inguinal And Femoral Hernia Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$55,444.78
|
$41,918.74
|
2025-11-01
|
|
545
|
MS_DRG
|
Connective Tissue Disorders With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$55,217.83
|
$41,747.16
|
2025-11-01
|
|
253
|
MS_DRG
|
Other Vascular Procedures With Cc
|
44
|
12
|
—
|
—
|
$17,140.00
|
$57,752.10
|
$41,434.86
|
2025-11-01
|
|
478
|
MS_DRG
|
Biopsies Of Musculoskeletal System And Connective Tissue With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$54,717.20
|
$41,368.66
|
2025-11-01
|
|
982
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$54,701.63
|
$41,356.89
|
2025-11-01
|
|
792
|
MS_DRG
|
Prematurity Without Major Problems
|
42
|
11
|
—
|
—
|
$17,140.00
|
$54,494.70
|
$41,200.44
|
2025-11-01
|
|
327
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$54,383.45
|
$41,116.33
|
2025-11-01
|
|
473
|
MS_DRG
|
Cervical Spinal Fusion Without Cc/mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$54,318.93
|
$41,067.55
|
2025-11-01
|
|
272
|
MS_DRG
|
Other Major Cardiovascular Procedures Without Cc/mcc
|
44
|
12
|
—
|
—
|
$17,140.00
|
$56,804.25
|
$40,754.82
|
2025-11-01
|
|
318
|
MS_DRG
|
Percutaneous Coronary Atherectomy Without Intraluminal Device
|
42
|
11
|
—
|
—
|
$17,140.00
|
$53,893.95
|
$40,746.25
|
2025-11-01
|
|
360
|
MS_DRG
|
Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$53,718.18
|
$40,613.35
|
2025-11-01
|
|
320
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures Without Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$53,517.93
|
$40,461.96
|
2025-11-01
|
|
330
|
MS_DRG
|
Major Small And Large Bowel Procedures With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$53,337.70
|
$40,325.70
|
2025-11-01
|
|
397
|
MS_DRG
|
Appendix Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$53,286.53
|
$40,287.01
|
2025-11-01
|
|
35
|
MS_DRG
|
Carotid Artery Stent Procedures With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$53,188.63
|
$40,212.99
|
2025-11-01
|
|
417
|
MS_DRG
|
Laparoscopic Cholecystectomy Without C.d.e. With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$53,097.40
|
$40,144.02
|
2025-11-01
|
|
33276
|
CPT
|
Insj Phrnc Nrv Stim Sys
|
46
|
11
|
—
|
—
|
$3,907.83
|
$99,494.13
|
$40,132.00
|
2025-11-01
|
|
113
|
MS_DRG
|
Orbital Procedures With Cc/mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$52,311.98
|
$39,550.20
|
2025-11-01
|
|
L2006
|
HCPCS
|
Kaf Sng/dbl Swg/stn Mcpr Cus
|
20
|
8
|
—
|
—
|
$39,482.40
|
$86,861.28
|
$39,482.40
|
2025-11-01
|
|
333
|
MS_DRG
|
Rectal Resection With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$52,113.95
|
$39,400.49
|
2025-11-01
|
|
674
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$52,033.85
|
$39,339.93
|
2025-11-01
|
|
940
|
MS_DRG
|
O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$51,996.03
|
$39,311.33
|
2025-11-01
|
|
709
|
MS_DRG
|
Penis Procedures With Cc/mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$51,777.98
|
$39,146.48
|
2025-11-01
|
|
357
|
MS_DRG
|
Other Digestive System O.r. Procedures With Cc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$51,742.38
|
$39,119.56
|
2025-11-01
|
|
56
|
MS_DRG
|
Degenerative Nervous System Disorders With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$51,688.98
|
$39,079.19
|
2025-11-01
|
|
827
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
42
|
11
|
—
|
—
|
$17,140.00
|
$51,424.20
|
$38,879.01
|
2025-11-01
|
|
347
|
MS_DRG
|
Anal And Stomal Procedures With Mcc
|
42
|
11
|
—
|
—
|
$17,140.00
|
$51,077.10
|
$38,616.58
|
2025-11-01
|