|
J3391
|
HCPCS
|
Inj, Atidarsagene Autotemcel
|
13
|
10
|
—
|
—
|
$4,369,850.00
|
$4,505,000.00
|
$4,505,000.00
|
2025-11-01
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
13
|
10
|
—
|
—
|
$3,574,708.67
|
$3,685,266.67
|
$3,685,266.67
|
2025-11-01
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
13
|
10
|
—
|
—
|
$3,216,968.71
|
$3,316,462.59
|
$3,316,462.59
|
2025-11-01
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
13
|
10
|
—
|
—
|
$3,150,992.34
|
$3,248,445.72
|
$3,248,445.72
|
2025-11-01
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
13
|
10
|
—
|
—
|
$2,857,367.80
|
$2,945,740.00
|
$2,945,740.00
|
2025-11-01
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
13
|
10
|
—
|
—
|
$2,381,457.29
|
$2,455,110.61
|
$2,455,110.61
|
2025-11-01
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
13
|
10
|
—
|
—
|
$2,262,040.00
|
$2,332,000.00
|
$2,332,000.00
|
2025-11-01
|
|
Q2057
|
HCPCS
|
Hb Car-t Tecelra
|
84
|
28
|
$3,475,060.00
|
$1,216,271.00
65% off
|
$747,501.40
|
$2,432,542.00
|
$1,461,610.24
|
2025-11-01
|
|
Q2056
|
HCPCS
|
Hb Car-t Carvykti Up To 100m Per Therapeutic Dose (q2056)
|
84
|
28
|
$2,438,388.24
|
$853,435.89
65% off
|
$548,892.88
|
$1,706,871.77
|
$1,025,586.09
|
2025-11-01
|
|
Q2041
|
HCPCS
|
Hb Car-t Yescarta
|
84
|
28
|
$2,416,439.43
|
$845,753.81
65% off
|
$517,233.27
|
$1,691,507.60
|
$1,016,354.43
|
2025-11-01
|
|
Q2042
|
HCPCS
|
Hb Car-t Kymriah Lymphoma Up To 600m Per Therapeutic Dose
|
84
|
28
|
$2,403,551.74
|
$841,243.11
65% off
|
$567,238.21
|
$1,682,486.22
|
$1,010,933.86
|
2025-11-01
|
|
Q2058
|
HCPCS
|
Hb Car-t Aucatzyl 10 Up To 400 Million Cd19 Car-positive Viable T Cells
|
84
|
28
|
$2,362,500.00
|
$826,875.00
65% off
|
$269,902.50
|
$1,653,750.00
|
$993,667.50
|
2025-11-01
|
|
Q2053
|
HCPCS
|
Hb Car T Tecartus (q2053)
|
84
|
28
|
$2,270,335.72
|
$794,617.51
65% off
|
$474,625.47
|
$1,589,235.00
|
$954,903.20
|
2025-11-01
|
|
Q2055
|
HCPCS
|
Hb Car T Abecma
|
84
|
28
|
$2,251,010.38
|
$787,853.64
65% off
|
$531,238.45
|
$1,575,707.27
|
$946,774.96
|
2025-11-01
|
|
Q2054
|
HCPCS
|
Hb Car T Lisocabtagene Mara Car Pos T
|
84
|
28
|
$2,148,002.19
|
$751,800.77
65% off
|
$518,098.13
|
$1,503,601.53
|
$903,449.72
|
2025-11-01
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
33
|
20
|
—
|
—
|
$416,033.47
|
$1,320,314.11
|
$623,473.27
|
2025-11-01
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
33
|
20
|
—
|
—
|
$271,031.22
|
$837,886.59
|
$417,612.16
|
2025-11-01
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
33
|
20
|
—
|
—
|
$207,196.88
|
$638,358.60
|
$308,258.52
|
2025-11-01
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…
|
33
|
20
|
—
|
—
|
$205,998.32
|
$634,612.25
|
$306,449.44
|
2025-11-01
|
|
J0225
|
HCPCS
|
Vutrisiran 25 Mg/0.5 Ml Subcutaneous Syringe
|
84
|
28
|
$571,358.30
|
$199,975.41
65% off
|
$4,853.53
|
$457,086.64
|
$297,449.13
|
2025-11-01
|
|
J2326
|
HCPCS
|
Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution
|
84
|
28
|
$519,882.29
|
$181,958.81
65% off
|
$1,241.84
|
$415,905.83
|
$270,650.72
|
2025-11-01
|
|
J3403
|
HCPCS
|
Revakinagene, Per Implant
|
13
|
10
|
—
|
—
|
$249,775.00
|
$257,500.00
|
$257,500.00
|
2025-11-01
|
|
J3402
|
HCPCS
|
Inj. Remestemcel-l-rknd/ Td
|
13
|
10
|
—
|
—
|
$199,470.80
|
$205,640.00
|
$205,640.00
|
2025-11-01
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …
|
33
|
20
|
—
|
—
|
$135,464.33
|
$414,143.01
|
$199,986.51
|
2025-11-01
|
|
7
|
MS_DRG
|
Lung Transplant
|
33
|
20
|
—
|
—
|
$126,843.91
|
$387,198.03
|
$186,974.99
|
2025-11-01
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
33
|
20
|
—
|
—
|
$111,363.13
|
$648,442.00
|
$178,645.83
|
2025-11-01
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
33
|
20
|
—
|
—
|
$117,926.01
|
$367,447.29
|
$173,514.44
|
2025-11-01
|
|
209
|
MS_DRG
|
Complex Aortic Arch Procedures
|
33
|
20
|
—
|
—
|
$111,238.78
|
$338,420.80
|
$163,420.83
|
2025-11-01
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
33
|
20
|
—
|
—
|
$108,392.08
|
$329,522.86
|
$159,124.09
|
2025-11-01
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
33
|
20
|
—
|
—
|
$106,985.01
|
$325,124.72
|
$157,000.26
|
2025-11-01
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
33
|
20
|
—
|
—
|
$98,212.49
|
$648,442.00
|
$156,972.11
|
2025-11-01
|
|
J9029
|
HCPCS
|
Nadofaragene Firadenovec-vncg 3x10exp11 Vp/ml Intravesical Suspension
|
84
|
28
|
$287,232.60
|
$100,531.41
65% off
|
$61,442.01
|
$229,786.08
|
$149,533.29
|
2025-11-01
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
33
|
20
|
—
|
—
|
$101,593.89
|
$308,273.64
|
$148,863.00
|
2025-11-01
|
|
J9118
|
HCPCS
|
Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution
|
84
|
28
|
$278,004.10
|
$97,301.44
65% off
|
$79.61
|
$222,403.28
|
$144,728.93
|
2025-11-01
|
|
Q2043
|
HCPCS
|
Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension
|
106
|
28
|
$349,858.88
|
$122,450.61
65% off
|
$50,829.17
|
$279,887.10
|
$142,136.70
|
2025-11-01
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
33
|
20
|
—
|
—
|
$96,546.20
|
$292,495.94
|
$141,244.07
|
2025-11-01
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
33
|
20
|
—
|
—
|
$89,150.15
|
$269,378.03
|
$130,080.60
|
2025-11-01
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
33
|
20
|
—
|
—
|
$85,801.28
|
$258,910.39
|
$125,025.86
|
2025-11-01
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
33
|
20
|
—
|
—
|
$83,605.02
|
$252,045.58
|
$121,710.90
|
2025-11-01
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
33
|
20
|
—
|
—
|
$83,351.55
|
$251,253.26
|
$121,328.29
|
2025-11-01
|
|
0815
|
RC
|
Hb Bmt-allogeneic Cord Blood Acq
|
142
|
28
|
$302,917.43
|
$106,021.11
65% off
|
$33,276.34
|
$235,638.82
|
$121,318.43
|
2025-11-01
|
|
J1823
|
HCPCS
|
Inebilizumab-cdon 10 Mg/ml Intravenous Solution
|
84
|
28
|
$222,680.66
|
$77,938.24
65% off
|
$480.68
|
$178,144.53
|
$115,927.55
|
2025-11-01
|
|
A9699
|
HCPCS
|
Radiopharm Rx Agent Noc
|
2
|
2
|
—
|
—
|
$109,510.82
|
$118,161.26
|
$113,836.04
|
2025-11-01
|
|
0812
|
RC
|
Hb Pancreas Acquisition
|
278
|
28
|
$281,812.53
|
$98,634.39
65% off
|
$38,340.82
|
$309,319.56
|
$113,772.02
|
2025-11-01
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
33
|
20
|
—
|
—
|
$78,237.84
|
$235,269.25
|
$113,609.73
|
2025-11-01
|
|
E0194NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$106,032.08
|
$117,717.25
|
$111,874.67
|
2025-11-01
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
33
|
20
|
—
|
—
|
$76,415.62
|
$229,573.49
|
$110,859.30
|
2025-11-01
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
33
|
20
|
—
|
—
|
$76,098.99
|
$228,583.83
|
$110,381.40
|
2025-11-01
|
|
Q0480
|
HCPCS
|
Driver Pneumatic Vad, Rep
|
12
|
10
|
—
|
—
|
$106,835.01
|
$271,999.81
|
$110,139.19
|
2025-11-01
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
33
|
20
|
—
|
—
|
$75,856.99
|
$227,827.39
|
$110,016.12
|
2025-11-01
|
|
90288
|
CPT
|
Botulism Ig IV
|
2
|
2
|
—
|
—
|
$105,202.80
|
$113,482.65
|
$109,342.73
|
2025-11-01
|
|
J7352
|
HCPCS
|
Afamelanotide 16 Mg Subcutaneous Implant
|
81
|
26
|
$207,626.09
|
$72,669.14
65% off
|
$2,855.12
|
$166,100.87
|
$108,090.14
|
2025-11-01
|
|
C1820
|
HCPCS
|
Hb Or-neurostim Recharge Dbs Activa Rc
|
112
|
28
|
$271,363.60
|
$94,977.26
65% off
|
$24,739.54
|
$189,954.52
|
$104,529.26
|
2025-11-01
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
33
|
20
|
—
|
—
|
$72,018.36
|
$215,828.92
|
$104,222.15
|
2025-11-01
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
33
|
20
|
—
|
—
|
$71,607.99
|
$214,546.25
|
$103,602.76
|
2025-11-01
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
33
|
20
|
—
|
—
|
$71,579.30
|
$214,456.56
|
$103,559.44
|
2025-11-01
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
33
|
20
|
—
|
—
|
$71,214.86
|
$213,317.41
|
$103,009.35
|
2025-11-01
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
33
|
20
|
—
|
—
|
$71,174.69
|
$213,191.83
|
$102,948.72
|
2025-11-01
|
|
J9347
|
HCPCS
|
Tremelimumab-actl 20 Mg/ml Intravenous Solution
|
81
|
26
|
$197,138.15
|
$68,998.36
65% off
|
$136.67
|
$157,710.52
|
$102,630.12
|
2025-11-01
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
33
|
20
|
—
|
—
|
$69,083.66
|
$211,328.28
|
$99,792.57
|
2025-11-01
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
33
|
20
|
—
|
—
|
$68,759.41
|
$205,642.33
|
$99,303.12
|
2025-11-01
|
|
C1882
|
HCPCS
|
Hb Aicd, Biventricular
|
74
|
28
|
$221,467.57
|
$77,513.65
65% off
|
$52,266.35
|
$155,027.30
|
$98,685.95
|
2025-11-01
|
|
0811
|
RC
|
Hb Liver-living Acquisition
|
108
|
28
|
$231,787.13
|
$81,125.50
65% off
|
$50,700.84
|
$162,250.99
|
$97,489.67
|
2025-11-01
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
33
|
20
|
—
|
—
|
$67,355.18
|
$201,253.16
|
$97,183.62
|
2025-11-01
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
33
|
20
|
—
|
—
|
$66,928.56
|
$199,919.66
|
$96,539.69
|
2025-11-01
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
33
|
20
|
—
|
—
|
$66,881.68
|
$199,773.16
|
$96,468.94
|
2025-11-01
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
33
|
20
|
—
|
—
|
$65,864.88
|
$196,594.89
|
$94,934.18
|
2025-11-01
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
33
|
20
|
—
|
—
|
$65,864.88
|
$196,594.89
|
$94,934.18
|
2025-11-01
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
33
|
20
|
—
|
—
|
$65,636.26
|
$195,880.31
|
$94,589.11
|
2025-11-01
|
|
K1007
|
HCPCS
|
Bil Hkaf Pc S/d Micro Sensor
|
10
|
10
|
—
|
—
|
$90,420.20
|
$93,216.70
|
$93,216.70
|
2025-11-01
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
33
|
20
|
—
|
—
|
$64,519.98
|
$196,740.95
|
$92,904.20
|
2025-11-01
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
33
|
20
|
—
|
—
|
$61,590.08
|
$183,233.03
|
$88,481.84
|
2025-11-01
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
33
|
20
|
—
|
—
|
$61,522.15
|
$183,020.75
|
$88,379.33
|
2025-11-01
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
33
|
20
|
—
|
—
|
$60,960.67
|
$181,265.68
|
$87,531.82
|
2025-11-01
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
33
|
20
|
—
|
—
|
$60,441.25
|
$179,642.16
|
$86,747.84
|
2025-11-01
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
33
|
20
|
—
|
—
|
$60,425.01
|
$179,591.33
|
$86,723.29
|
2025-11-01
|
|
K0606NUKF
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$82,050.26
|
$91,092.53
|
$86,571.39
|
2025-11-01
|
|
92970
|
CPT
|
Hb Cardioasst-method Circ Asst-intrl
|
84
|
28
|
$204,806.00
|
$71,682.10
65% off
|
$172.01
|
$143,364.20
|
$86,141.40
|
2025-11-01
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
33
|
20
|
—
|
—
|
$60,008.90
|
$178,290.73
|
$86,095.24
|
2025-11-01
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
33
|
20
|
—
|
—
|
$59,821.41
|
$181,722.51
|
$85,812.25
|
2025-11-01
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
33
|
20
|
—
|
—
|
$59,689.42
|
$181,300.58
|
$85,613.01
|
2025-11-01
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
33
|
20
|
—
|
—
|
$59,104.94
|
$175,465.27
|
$84,730.85
|
2025-11-01
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
33
|
20
|
—
|
—
|
$59,068.61
|
$175,351.66
|
$84,675.98
|
2025-11-01
|
|
J9269
|
HCPCS
|
Tagraxofusp-erzs 1,000 Mcg/ml Intravenous Solution
|
81
|
26
|
$161,600.17
|
$56,560.06
65% off
|
$346.22
|
$129,280.14
|
$84,129.05
|
2025-11-01
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
33
|
20
|
—
|
—
|
$58,134.04
|
$172,430.52
|
$83,265.39
|
2025-11-01
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
33
|
20
|
—
|
—
|
$57,782.03
|
$171,330.24
|
$82,734.07
|
2025-11-01
|
|
213
|
MS_DRG
|
Endovascular Abdominal Aorta With Iliac Branch Procedures
|
33
|
20
|
—
|
—
|
$57,558.23
|
$170,630.60
|
$82,396.22
|
2025-11-01
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
33
|
20
|
—
|
—
|
$57,487.45
|
$170,409.35
|
$82,289.38
|
2025-11-01
|
|
C1721
|
HCPCS
|
Hb Aicd, Dual Chamber
|
74
|
28
|
$182,653.67
|
$63,928.79
65% off
|
$43,106.27
|
$127,857.57
|
$81,390.48
|
2025-11-01
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
33
|
20
|
—
|
—
|
$56,746.12
|
$168,092.18
|
$81,170.44
|
2025-11-01
|
|
C2624
|
HCPCS
|
Hb Wireless Pulm Artery Pressure Sensor
|
74
|
28
|
$181,693.28
|
$63,592.65
65% off
|
$42,879.61
|
$127,185.30
|
$80,962.52
|
2025-11-01
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
33
|
20
|
—
|
—
|
$56,579.64
|
$167,571.94
|
$80,919.21
|
2025-11-01
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
33
|
20
|
—
|
—
|
$56,212.35
|
$166,423.81
|
$80,364.80
|
2025-11-01
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
33
|
20
|
—
|
—
|
$55,799.10
|
$165,132.18
|
$79,741.07
|
2025-11-01
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
33
|
20
|
—
|
—
|
$55,482.50
|
$167,853.69
|
$79,263.18
|
2025-11-01
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
33
|
20
|
—
|
—
|
$55,296.95
|
$163,562.48
|
$78,983.08
|
2025-11-01
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
33
|
20
|
—
|
—
|
$55,222.32
|
$163,329.27
|
$78,870.46
|
2025-11-01
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
33
|
20
|
—
|
—
|
$55,140.06
|
$163,072.14
|
$78,746.30
|
2025-11-01
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
33
|
20
|
—
|
—
|
$54,931.53
|
$166,092.57
|
$78,431.55
|
2025-11-01
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
33
|
20
|
—
|
—
|
$53,979.76
|
$159,445.39
|
$76,994.97
|
2025-11-01
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
33
|
20
|
—
|
—
|
$53,949.15
|
$159,349.71
|
$76,948.76
|
2025-11-01
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
33
|
20
|
—
|
—
|
$53,606.71
|
$158,279.33
|
$76,431.88
|
2025-11-01
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
33
|
20
|
—
|
—
|
$53,439.32
|
$157,756.09
|
$76,179.22
|
2025-11-01
|
|
33881
|
CPT
|
Hb Radiant-endo Rpr Desc Thor Aorta Proc
|
84
|
28
|
$179,846.00
|
$62,946.10
65% off
|
$1,391.74
|
$125,892.20
|
$75,643.23
|
2025-11-01
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
33
|
20
|
—
|
—
|
$52,761.10
|
$155,636.25
|
$75,155.57
|
2025-11-01
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
33
|
20
|
—
|
—
|
$52,675.03
|
$155,367.16
|
$75,025.62
|
2025-11-01
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
33
|
20
|
—
|
—
|
$51,180.91
|
$150,696.94
|
$72,770.41
|
2025-11-01
|
|
33880
|
CPT
|
Hb Radiant Endo Prp Desc Thor Aorta Cvr L Sblclv
|
90
|
28
|
$172,541.00
|
$60,389.35
65% off
|
$993.00
|
$120,778.70
|
$72,570.74
|
2025-11-01
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
33
|
20
|
—
|
—
|
$50,675.83
|
$149,118.27
|
$72,008.08
|
2025-11-01
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
33
|
20
|
—
|
—
|
$50,293.22
|
$147,922.31
|
$71,430.56
|
2025-11-01
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
33
|
20
|
—
|
—
|
$50,209.03
|
$147,659.20
|
$71,303.51
|
2025-11-01
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
33
|
20
|
—
|
—
|
$50,047.39
|
$147,153.91
|
$71,059.50
|
2025-11-01
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
33
|
20
|
—
|
—
|
$49,851.29
|
$146,540.98
|
$70,763.53
|
2025-11-01
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
33
|
20
|
—
|
—
|
$49,157.81
|
$144,373.30
|
$69,716.77
|
2025-11-01
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
33
|
20
|
—
|
—
|
$48,924.40
|
$146,891.47
|
$69,364.48
|
2025-11-01
|
|
J9359
|
HCPCS
|
Loncastuximab Tesirine-lpyl 10 Mg Intravenous Solution
|
84
|
28
|
$132,923.59
|
$46,523.26
65% off
|
$210.40
|
$106,338.87
|
$69,200.02
|
2025-11-01
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
33
|
20
|
—
|
—
|
$48,508.30
|
$142,343.16
|
$68,736.43
|
2025-11-01
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
33
|
20
|
—
|
—
|
$47,940.10
|
$140,567.16
|
$67,878.81
|
2025-11-01
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
33
|
20
|
—
|
—
|
$47,848.29
|
$140,280.13
|
$67,740.21
|
2025-11-01
|
|
J7330
|
HCPCS
|
Hb Or-carticel Auto Cltrd Chondrocytes
|
74
|
28
|
$160,861.83
|
$56,301.65
65% off
|
$37,963.39
|
$147,230.65
|
$67,658.49
|
2025-11-01
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
33
|
20
|
—
|
—
|
$47,714.37
|
$139,861.54
|
$67,538.08
|
2025-11-01
|
|
L8702
|
HCPCS
|
Ewhf S/d Uprt Micro Sensor
|
10
|
10
|
—
|
—
|
$65,429.08
|
$67,452.66
|
$67,452.66
|
2025-11-01
|
|
J2507
|
HCPCS
|
Pegloticase 8 Mg/ml Intravenous Solution
|
81
|
26
|
$129,452.14
|
$45,308.25
65% off
|
$3,551.01
|
$103,561.71
|
$67,392.79
|
2025-11-01
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
33
|
20
|
—
|
—
|
$47,324.09
|
$138,641.66
|
$66,949.01
|
2025-11-01
|
|
J9266
|
HCPCS
|
Pegaspargase 750 Unit/ml Injection Solution
|
84
|
28
|
$128,369.76
|
$44,929.42
65% off
|
$27,571.34
|
$102,695.81
|
$66,829.30
|
2025-11-01
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
33
|
20
|
—
|
—
|
$47,147.14
|
$138,088.53
|
$66,681.90
|
2025-11-01
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
33
|
20
|
—
|
—
|
$46,936.70
|
$137,430.75
|
$66,364.27
|
2025-11-01
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
33
|
20
|
—
|
—
|
$46,824.77
|
$137,080.94
|
$66,195.34
|
2025-11-01
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
33
|
20
|
—
|
—
|
$46,610.51
|
$136,411.20
|
$65,871.93
|
2025-11-01
|
|
33886
|
CPT
|
Hb Radiant-thor Stnt Grft Exten Delay Proc
|
81
|
26
|
$156,537.00
|
$54,787.95
65% off
|
$872.53
|
$109,575.90
|
$65,839.46
|
2025-11-01
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
33
|
20
|
—
|
—
|
$46,479.47
|
$136,001.58
|
$65,674.13
|
2025-11-01
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
33
|
20
|
—
|
—
|
$46,460.33
|
$135,941.78
|
$65,645.25
|
2025-11-01
|
|
C1722
|
HCPCS
|
Hb Icd Subcutaneous Generator
|
150
|
28
|
$159,821.97
|
$55,937.69
65% off
|
$21,587.35
|
$122,413.97
|
$65,578.92
|
2025-11-01
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
33
|
20
|
—
|
—
|
$46,290.08
|
$135,409.58
|
$65,388.26
|
2025-11-01
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
33
|
20
|
—
|
—
|
$45,839.53
|
$134,001.34
|
$64,708.23
|
2025-11-01
|
|
31
|
MS_DRG
|
Ventricular Shunt Procedures With Mcc
|
33
|
20
|
—
|
—
|
$45,827.10
|
$133,962.47
|
$64,689.46
|
2025-11-01
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
33
|
20
|
—
|
—
|
$45,658.75
|
$133,436.25
|
$64,435.35
|
2025-11-01
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
33
|
20
|
—
|
—
|
$44,988.20
|
$131,340.33
|
$63,423.25
|
2025-11-01
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
33
|
20
|
—
|
—
|
$44,362.63
|
$129,384.93
|
$62,479.00
|
2025-11-01
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
33
|
20
|
—
|
—
|
$44,032.61
|
$128,353.42
|
$61,980.89
|
2025-11-01
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
33
|
20
|
—
|
—
|
$43,768.59
|
$127,528.20
|
$61,582.40
|
2025-11-01
|
|
448
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical Without Mcc
|
33
|
20
|
—
|
—
|
$43,534.25
|
$126,795.68
|
$61,228.67
|
2025-11-01
|
|
J9281
|
HCPCS
|
Mitomycin 40 Mg X 2 Intra-pyelocalyceal Kit
|
103
|
26
|
$117,190.90
|
$41,016.82
65% off
|
$308.98
|
$93,752.72
|
$61,009.58
|
2025-11-01
|
|
269
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
33
|
20
|
—
|
—
|
$43,365.89
|
$126,269.46
|
$60,974.56
|
2025-11-01
|
|
12
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
33
|
20
|
—
|
—
|
$43,297.03
|
$126,054.18
|
$60,870.61
|
2025-11-01
|
|
958
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
33
|
20
|
—
|
—
|
$43,276.95
|
$125,991.40
|
$60,840.29
|
2025-11-01
|
|
673
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Mcc
|
33
|
20
|
—
|
—
|
$43,159.28
|
$125,623.64
|
$60,662.70
|
2025-11-01
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
33
|
20
|
—
|
—
|
$43,111.47
|
$125,474.14
|
$60,590.51
|
2025-11-01
|
|
236
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
33
|
20
|
—
|
—
|
$43,036.85
|
$125,240.93
|
$60,477.89
|
2025-11-01
|
|
458
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
33
|
20
|
—
|
—
|
$42,881.89
|
$124,756.57
|
$60,244.00
|
2025-11-01
|
|
793
|
MS_DRG
|
Full Term Neonate With Major Problems
|
33
|
20
|
—
|
—
|
$42,853.19
|
$127,485.52
|
$60,200.68
|
2025-11-01
|
|
423
|
MS_DRG
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
33
|
20
|
—
|
—
|
$42,694.40
|
$124,170.55
|
$59,961.01
|
2025-11-01
|
|
C1823
|
HCPCS
|
Hb Radiant-remede Generator & Stimulator Lead
|
112
|
28
|
$155,289.39
|
$54,351.29
65% off
|
$10,775.47
|
$108,702.57
|
$59,817.48
|
2025-11-01
|
|
273
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures With Mcc
|
33
|
20
|
—
|
—
|
$42,431.34
|
$123,348.32
|
$59,563.97
|
2025-11-01
|
|
34701
|
CPT
|
Hb Radiant Ir-evasc Rpr Dplmnt Aorto-aortic Ndgft
|
81
|
26
|
$140,447.00
|
$49,156.45
65% off
|
$1,123.63
|
$98,312.90
|
$59,072.01
|
2025-11-01
|
|
34702
|
CPT
|
Hb Radiant Ir-evasc Rpr Dplmnt Aorto-aortic Ndgft Rpt
|
84
|
28
|
$140,447.00
|
$49,156.45
65% off
|
$1,426.00
|
$98,312.90
|
$59,072.01
|
2025-11-01
|
|
791
|
MS_DRG
|
Prematurity With Major Problems
|
33
|
20
|
—
|
—
|
$41,795.24
|
$124,103.92
|
$58,603.84
|
2025-11-01
|
|
402
|
MS_DRG
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
33
|
20
|
—
|
—
|
$41,426.97
|
$120,208.93
|
$58,047.98
|
2025-11-01
|
|
802
|
MS_DRG
|
Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc
|
33
|
20
|
—
|
—
|
$41,078.79
|
$119,120.61
|
$57,522.44
|
2025-11-01
|
|
J9229
|
HCPCS
|
Inotuzumab Ozogamicin 0.9 Mg(0.25 Mg/ml Initial Concentration) IV Soln
|
81
|
26
|
$109,117.08
|
$38,190.98
65% off
|
$2,617.11
|
$87,293.66
|
$56,806.35
|
2025-11-01
|
|
24
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
33
|
20
|
—
|
—
|
$40,388.15
|
$116,961.90
|
$56,480.01
|
2025-11-01
|
|
933
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
33
|
20
|
—
|
—
|
$40,218.84
|
$119,065.17
|
$56,224.46
|
2025-11-01
|
|
34
|
MS_DRG
|
Carotid Artery Stent Procedures With Mcc
|
33
|
20
|
—
|
—
|
$39,994.06
|
$115,730.06
|
$55,885.17
|
2025-11-01
|
|
40
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
33
|
20
|
—
|
—
|
$39,903.20
|
$115,446.02
|
$55,748.01
|
2025-11-01
|
|
907
|
MS_DRG
|
Other O.r. Procedures For Injuries With Mcc
|
33
|
20
|
—
|
—
|
$39,693.71
|
$114,791.23
|
$55,431.81
|
2025-11-01
|
|
J0202
|
HCPCS
|
Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution
|
84
|
28
|
$104,362.71
|
$36,526.95
65% off
|
$2,356.99
|
$83,490.17
|
$54,331.23
|
2025-11-01
|
|
956
|
MS_DRG
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
33
|
20
|
—
|
—
|
$38,963.85
|
$112,509.94
|
$54,330.19
|
2025-11-01
|
|
L8614
|
HCPCS
|
Hb Or-cochlear Nucleus Hybrid
|
120
|
28
|
$121,703.79
|
$42,596.33
65% off
|
$22,603.26
|
$165,631.73
|
$54,231.21
|
2025-11-01
|
|
143
|
MS_DRG
|
Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc
|
33
|
20
|
—
|
—
|
$38,806.98
|
$112,019.59
|
$54,093.41
|
2025-11-01
|
|
166
|
MS_DRG
|
Other Respiratory System O.r. Procedures With Mcc
|
33
|
20
|
—
|
—
|
$38,721.86
|
$111,753.49
|
$53,964.91
|
2025-11-01
|
|
518
|
MS_DRG
|
Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…
|
33
|
20
|
—
|
—
|
$38,718.04
|
$111,741.53
|
$53,959.14
|
2025-11-01
|
|
628
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
33
|
20
|
—
|
—
|
$38,617.59
|
$111,427.59
|
$53,807.54
|
2025-11-01
|
|
651
|
MS_DRG
|
Kidney Transplant With Hemodialysis Without Mcc
|
33
|
20
|
—
|
—
|
$38,416.71
|
$110,799.71
|
$53,504.34
|
2025-11-01
|
|
904
|
MS_DRG
|
Skin Grafts For Injuries With Cc/mcc
|
33
|
20
|
—
|
—
|
$38,103.92
|
$109,822.02
|
$53,032.22
|
2025-11-01
|
|
492
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc
|
33
|
20
|
—
|
—
|
$38,089.56
|
$109,777.17
|
$53,010.56
|
2025-11-01
|
|
33883
|
CPT
|
Hb Radiant-endo Des Thor Aorta 1st Prox Ext
|
84
|
28
|
$124,813.00
|
$43,684.55
65% off
|
$1,008.84
|
$87,369.10
|
$52,496.35
|
2025-11-01
|
|
939
|
MS_DRG
|
O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc
|
33
|
20
|
—
|
—
|
$37,677.28
|
$108,488.52
|
$52,388.28
|
2025-11-01
|
|
495
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…
|
33
|
20
|
—
|
—
|
$37,650.51
|
$108,404.80
|
$52,347.86
|
2025-11-01
|
|
33884
|
CPT
|
Hb Radiant-endo Des Thor Aorta Ea Addl Prx Ext
|
84
|
28
|
$124,405.00
|
$43,541.75
65% off
|
$355.37
|
$87,083.50
|
$52,324.75
|
2025-11-01
|
|
332
|
MS_DRG
|
Rectal Resection With Mcc
|
33
|
20
|
—
|
—
|
$37,602.68
|
$108,255.31
|
$52,275.67
|
2025-11-01
|
|
265
|
MS_DRG
|
Aicd Lead Procedures
|
33
|
20
|
—
|
—
|
$37,578.76
|
$108,180.56
|
$52,239.57
|
2025-11-01
|
|
97
|
MS_DRG
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc
|
33
|
20
|
—
|
—
|
$37,517.56
|
$110,430.78
|
$52,147.17
|
2025-11-01
|
|
279
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
33
|
20
|
—
|
—
|
$37,465.90
|
$107,827.75
|
$52,069.20
|
2025-11-01
|
|
739
|
MS_DRG
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…
|
33
|
20
|
—
|
—
|
$37,240.16
|
$107,122.14
|
$51,728.47
|
2025-11-01
|
|
876
|
MS_DRG
|
O.r. Procedures With Principal Diagnosis Of Mental Illness
|
29
|
18
|
—
|
—
|
$39,938.58
|
$115,556.65
|
$51,631.20
|
2025-11-01
|
|
736
|
MS_DRG
|
Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc
|
33
|
20
|
—
|
—
|
$37,160.77
|
$106,873.98
|
$51,608.63
|
2025-11-01
|
|
335
|
MS_DRG
|
Peritoneal Adhesiolysis With Mcc
|
33
|
20
|
—
|
—
|
$37,126.32
|
$106,766.34
|
$51,556.65
|
2025-11-01
|
|
408
|
MS_DRG
|
Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…
|
33
|
20
|
—
|
—
|
$37,075.63
|
$106,607.87
|
$51,480.13
|
2025-11-01
|
|
414
|
MS_DRG
|
Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc
|
33
|
20
|
—
|
—
|
$37,046.93
|
$106,518.18
|
$51,436.82
|
2025-11-01
|
|
622
|
MS_DRG
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
33
|
20
|
—
|
—
|
$37,014.40
|
$106,416.52
|
$51,387.73
|
2025-11-01
|
|
271
|
MS_DRG
|
Other Major Cardiovascular Procedures With Cc
|
33
|
20
|
—
|
—
|
$36,986.69
|
$106,329.81
|
$51,345.86
|
2025-11-01
|
|
J2350
|
HCPCS
|
Ocrelizumab 30 Mg/ml Intravenous Solution
|
84
|
28
|
$98,318.57
|
$34,411.50
65% off
|
$57.63
|
$78,654.86
|
$51,184.65
|
2025-11-01
|
|
467
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Cc
|
33
|
20
|
—
|
—
|
$36,702.59
|
$105,441.81
|
$50,917.05
|
2025-11-01
|
|
94
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System With Mcc
|
33
|
20
|
—
|
—
|
$36,633.71
|
$107,605.66
|
$50,813.10
|
2025-11-01
|
|
J9274
|
HCPCS
|
Tebentafusp-tebn 100 Mcg/0.5 Ml Intravenous Solution
|
84
|
28
|
$97,551.85
|
$34,143.15
65% off
|
$210.58
|
$78,041.48
|
$50,785.50
|
2025-11-01
|
|
252
|
MS_DRG
|
Other Vascular Procedures With Mcc
|
33
|
20
|
—
|
—
|
$36,336.21
|
$104,296.68
|
$50,364.08
|
2025-11-01
|
|
616
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
33
|
20
|
—
|
—
|
$36,327.61
|
$104,269.77
|
$50,351.08
|
2025-11-01
|
|
574
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Cc
|
33
|
20
|
—
|
—
|
$36,174.56
|
$103,791.39
|
$50,120.07
|
2025-11-01
|
|
477
|
MS_DRG
|
Biopsies Of Musculoskeletal System And Connective Tissue With Mcc
|
33
|
20
|
—
|
—
|
$36,013.87
|
$103,289.09
|
$49,877.51
|
2025-11-01
|
|
359
|
MS_DRG
|
Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc
|
33
|
20
|
—
|
—
|
$35,860.80
|
$102,810.70
|
$49,646.51
|
2025-11-01
|
|
987
|
MS_DRG
|
Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
33
|
20
|
—
|
—
|
$35,763.24
|
$102,505.73
|
$49,499.24
|
2025-11-01
|
|
29
|
MS_DRG
|
Spinal Procedures With Cc Or Spinal Neurostimulators
|
33
|
20
|
—
|
—
|
$35,602.55
|
$102,003.43
|
$49,256.68
|
2025-11-01
|
|
420
|
MS_DRG
|
Hepatobiliary Diagnostic Procedures With Mcc
|
33
|
20
|
—
|
—
|
$35,559.49
|
$101,868.88
|
$49,191.71
|
2025-11-01
|
|
L7181
|
HCPCS
|
Electronic Elbo Simultaneous
|
12
|
10
|
—
|
—
|
$47,434.09
|
$126,601.94
|
$48,901.12
|
2025-11-01
|
|
C1767
|
HCPCS
|
Hb Or-neurostimulator Dbs Non-recharge
|
454
|
28
|
$127,136.53
|
$44,497.79
65% off
|
$18,360.09
|
$129,347.16
|
$48,349.08
|
2025-11-01
|
|
264
|
MS_DRG
|
Other Circulatory System O.r. Procedures
|
33
|
20
|
—
|
—
|
$34,923.40
|
$99,880.60
|
$48,231.58
|
2025-11-01
|
|
411
|
MS_DRG
|
Cholecystectomy With C.d.e. With Mcc
|
33
|
20
|
—
|
—
|
$34,566.60
|
$98,765.37
|
$47,693.05
|
2025-11-01
|
|
37
|
MS_DRG
|
Extracranial Procedures With Mcc
|
33
|
20
|
—
|
—
|
$34,459.47
|
$98,430.50
|
$47,531.34
|
2025-11-01
|
|
274
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures Without Mcc
|
33
|
20
|
—
|
—
|
$34,455.65
|
$98,418.54
|
$47,525.56
|
2025-11-01
|
|
J7311
|
HCPCS
|
Fluocinolone 0.59 Mg Intravitreal Implant
|
81
|
26
|
$91,076.67
|
$31,876.84
65% off
|
$330.10
|
$72,861.34
|
$47,414.51
|
2025-11-01
|
|
J3357
|
HCPCS
|
Ustekinumab 90 Mg/ml Subcutaneous Syringe
|
109
|
28
|
$127,412.94
|
$44,594.53
65% off
|
$144.92
|
$101,930.35
|
$47,142.79
|
2025-11-01
|
|
260
|
MS_DRG
|
Cardiac Pacemaker Revision Except Device Replacement With Mcc
|
33
|
20
|
—
|
—
|
$34,083.55
|
$97,255.47
|
$46,963.93
|
2025-11-01
|
|
579
|
MS_DRG
|
Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc
|
33
|
20
|
—
|
—
|
$33,946.75
|
$96,827.91
|
$46,757.46
|
2025-11-01
|
|
840
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Mcc
|
33
|
20
|
—
|
—
|
$33,912.31
|
$98,907.07
|
$46,705.49
|
2025-11-01
|
|
451
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical Without Mcc
|
33
|
20
|
—
|
—
|
$33,869.29
|
$96,585.73
|
$46,640.52
|
2025-11-01
|
|
652
|
MS_DRG
|
Kidney Transplant
|
33
|
20
|
—
|
—
|
$33,860.65
|
$96,558.82
|
$46,627.52
|
2025-11-01
|
|
485
|
MS_DRG
|
Knee Procedures With Principal Diagnosis Of Infection With Mcc
|
33
|
20
|
—
|
—
|
$33,837.72
|
$96,487.06
|
$46,592.87
|
2025-11-01
|
|
929
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc
|
33
|
20
|
—
|
—
|
$33,777.44
|
$96,298.70
|
$46,501.91
|
2025-11-01
|
|
J9226
|
HCPCS
|
Supprelin La Implant
|
26
|
17
|
—
|
—
|
$43,670.03
|
$117,694.45
|
$46,429.53
|
2025-11-01
|
|
325
|
MS_DRG
|
Coronary Intravascular Lithotripsy Without Intraluminal Device
|
33
|
20
|
—
|
—
|
$33,677.96
|
$95,987.75
|
$46,351.76
|
2025-11-01
|
|
93654
|
CPT
|
Hb Radiant Ccl-ep Eval With Ablation Ventricular Tachycardia
|
85
|
28
|
$110,107.00
|
$38,537.45
65% off
|
$5,222.76
|
$77,074.90
|
$46,311.00
|
2025-11-01
|
|
242
|
MS_DRG
|
Permanent Cardiac Pacemaker Implant With Mcc
|
33
|
20
|
—
|
—
|
$33,509.62
|
$95,461.53
|
$46,097.65
|
2025-11-01
|
|
515
|
MS_DRG
|
Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc
|
33
|
20
|
—
|
—
|
$33,453.19
|
$95,285.12
|
$46,012.46
|
2025-11-01
|
|
656
|
MS_DRG
|
Kidney And Ureter Procedures For Neoplasm With Mcc
|
33
|
20
|
—
|
—
|
$33,423.53
|
$95,192.44
|
$45,967.70
|
2025-11-01
|
|
C1605
|
HCPCS
|
Hb Pmkr, Dual Chamber, Rate-resp, Leadless System
|
74
|
28
|
$103,000.00
|
$36,050.00
65% off
|
$24,308.00
|
$72,100.00
|
$45,896.80
|
2025-11-01
|
|
22
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…
|
33
|
20
|
—
|
—
|
$33,362.32
|
$95,001.08
|
$45,875.30
|
2025-11-01
|
|
500
|
MS_DRG
|
Soft Tissue Procedures With Mcc
|
33
|
20
|
—
|
—
|
$33,241.77
|
$94,624.36
|
$45,693.38
|
2025-11-01
|
|
829
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…
|
33
|
20
|
—
|
—
|
$33,195.87
|
$94,480.84
|
$45,624.08
|
2025-11-01
|
|
324
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc
|
33
|
20
|
—
|
—
|
$33,109.78
|
$94,211.75
|
$45,494.14
|
2025-11-01
|
|
229
|
MS_DRG
|
Other Cardiothoracic Procedures Without Mcc
|
33
|
20
|
—
|
—
|
$33,095.42
|
$94,166.90
|
$45,472.48
|
2025-11-01
|
|
258
|
MS_DRG
|
Cardiac Pacemaker Device Replacement With Mcc
|
33
|
20
|
—
|
—
|
$33,024.64
|
$93,945.65
|
$45,365.64
|
2025-11-01
|
|
665
|
MS_DRG
|
Prostatectomy With Mcc
|
33
|
20
|
—
|
—
|
$32,824.72
|
$93,320.76
|
$45,063.89
|
2025-11-01
|
|
464
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
33
|
20
|
—
|
—
|
$32,762.55
|
$93,126.42
|
$44,970.04
|
2025-11-01
|
|
26
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Cc
|
33
|
20
|
—
|
—
|
$32,709.94
|
$92,961.97
|
$44,890.63
|
2025-11-01
|
|
662
|
MS_DRG
|
Minor Bladder Procedures With Mcc
|
33
|
20
|
—
|
—
|
$32,253.66
|
$91,535.79
|
$44,201.94
|
2025-11-01
|
|
263
|
MS_DRG
|
Vein Ligation And Stripping
|
33
|
20
|
—
|
—
|
$32,214.44
|
$91,413.20
|
$44,142.74
|
2025-11-01
|
|
469
|
MS_DRG
|
Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…
|
33
|
20
|
—
|
—
|
$31,982.97
|
$90,689.65
|
$43,793.34
|
2025-11-01
|
|
510
|
MS_DRG
|
Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc
|
33
|
20
|
—
|
—
|
$31,861.47
|
$90,309.93
|
$43,609.98
|
2025-11-01
|
|
625
|
MS_DRG
|
Thyroid, Parathyroid And Thyroglossal Procedures With Mcc
|
33
|
20
|
—
|
—
|
$31,857.67
|
$90,297.97
|
$43,604.20
|
2025-11-01
|
|
498
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…
|
33
|
20
|
—
|
—
|
$31,826.09
|
$90,199.30
|
$43,556.56
|
2025-11-01
|
|
93656
|
CPT
|
Hb Compre Ep Eval Abltj Atr Fib Pulm Vein Isolation
|
87
|
28
|
$103,533.00
|
$36,236.55
65% off
|
$4,912.55
|
$72,473.10
|
$43,545.98
|
2025-11-01
|
|
J3241
|
HCPCS
|
Teprotumumab-trbw 500 Mg Intravenous Solution
|
84
|
28
|
$83,410.29
|
$29,193.61
65% off
|
$348.42
|
$66,728.23
|
$43,423.39
|
2025-11-01
|
|
A9543
|
HCPCS
|
Hb Radiant-yttriumy90ibritumomab/dose To 40 Mc
|
102
|
26
|
$102,592.37
|
$35,907.33
65% off
|
$3,693.00
|
$411,730.39
|
$43,150.35
|
2025-11-01
|
|
173
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…
|
33
|
20
|
—
|
—
|
$31,439.64
|
$88,991.38
|
$42,973.26
|
2025-11-01
|
|
L7180
|
HCPCS
|
Electronic Elbow Sequential
|
12
|
10
|
—
|
—
|
$41,568.29
|
$110,946.11
|
$42,853.91
|
2025-11-01
|
|
472
|
MS_DRG
|
Cervical Spinal Fusion With Cc
|
33
|
20
|
—
|
—
|
$31,149.82
|
$88,085.44
|
$42,535.79
|
2025-11-01
|
|
959
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc
|
33
|
20
|
—
|
—
|
$31,130.70
|
$88,025.65
|
$42,506.92
|
2025-11-01
|
|
570
|
MS_DRG
|
Skin Debridement With Mcc
|
33
|
20
|
—
|
—
|
$31,101.99
|
$87,935.95
|
$42,463.60
|
2025-11-01
|
|
668
|
MS_DRG
|
Transurethral Procedures With Mcc
|
33
|
20
|
—
|
—
|
$30,900.15
|
$87,305.08
|
$42,158.96
|
2025-11-01
|
|
480
|
MS_DRG
|
Hip And Femur Procedures Except Major Joint With Mcc
|
33
|
20
|
—
|
—
|
$30,826.49
|
$87,074.86
|
$42,047.79
|
2025-11-01
|
|
353
|
MS_DRG
|
Hernia Procedures Except Inguinal And Femoral With Mcc
|
33
|
20
|
—
|
—
|
$30,727.96
|
$86,766.90
|
$41,899.08
|
2025-11-01
|
|
406
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Cc
|
33
|
20
|
—
|
—
|
$30,710.75
|
$86,713.08
|
$41,873.09
|
2025-11-01
|
|
974
|
MS_DRG
|
HIV With Major Related Condition With Mcc
|
33
|
20
|
—
|
—
|
$30,574.93
|
$88,239.45
|
$41,668.07
|
2025-11-01
|
|
13
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc
|
33
|
20
|
—
|
—
|
$30,534.77
|
$86,162.94
|
$41,607.43
|
2025-11-01
|
|
521
|
MS_DRG
|
Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc
|
33
|
20
|
—
|
—
|
$30,423.79
|
$85,816.11
|
$41,439.95
|
2025-11-01
|
|
240
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc
|
33
|
20
|
—
|
—
|
$30,235.37
|
$85,227.10
|
$41,155.52
|
2025-11-01
|
|
800
|
MS_DRG
|
Splenic Procedures With Cc
|
33
|
20
|
—
|
—
|
$29,842.20
|
$83,998.25
|
$40,562.12
|
2025-11-01
|
|
654
|
MS_DRG
|
Major Bladder Procedures With Cc
|
33
|
20
|
—
|
—
|
$29,745.59
|
$83,696.27
|
$40,416.29
|
2025-11-01
|
|
503
|
MS_DRG
|
Foot Procedures With Mcc
|
33
|
20
|
—
|
—
|
$29,667.17
|
$83,451.10
|
$40,297.90
|
2025-11-01
|
|
483
|
MS_DRG
|
Major Joint Or Limb Reattachment Procedures Of Upper Extremities
|
33
|
20
|
—
|
—
|
$29,483.50
|
$82,877.04
|
$40,020.69
|
2025-11-01
|
|
61
|
MS_DRG
|
Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…
|
33
|
20
|
—
|
—
|
$29,341.93
|
$84,298.33
|
$39,807.01
|
2025-11-01
|
|
0266T
|
CPT
|
Op Surgery
|
24
|
15
|
—
|
—
|
$645.87
|
$48,493.00
|
$39,797.00
|
2025-11-01
|
|
208
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support <=96 Hours
|
33
|
20
|
—
|
—
|
$29,261.59
|
$84,041.50
|
$39,685.73
|
2025-11-01
|
|
468
|
MS_DRG
|
Revision Of Hip Or Knee Replacement Without Cc/mcc
|
33
|
20
|
—
|
—
|
$29,254.89
|
$82,162.45
|
$39,675.62
|
2025-11-01
|
|
E0766RRKF
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$37,459.13
|
$41,587.28
|
$39,523.21
|
2025-11-01
|
|
E0766
|
HCPCS
|
Elec Stim Cancer Treatment
|
2
|
1
|
—
|
—
|
$37,459.13
|
$41,587.28
|
$39,523.21
|
2025-11-01
|
|
L2006
|
HCPCS
|
Kaf Sng/dbl Swg/stn Mcpr Cus
|
12
|
10
|
—
|
—
|
$38,297.93
|
$102,217.44
|
$39,482.40
|
2025-11-01
|
|
963
|
MS_DRG
|
Other Multiple Significant Trauma With Mcc
|
33
|
20
|
—
|
—
|
$29,119.07
|
$83,585.94
|
$39,470.60
|
2025-11-01
|
|
321
|
MS_DRG
|
Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A…
|
33
|
20
|
—
|
—
|
$28,994.71
|
$81,349.20
|
$39,282.91
|
2025-11-01
|
|
849
|
MS_DRG
|
Radiotherapy
|
33
|
20
|
—
|
—
|
$28,886.62
|
$82,842.96
|
$39,119.76
|
2025-11-01
|
|
C1815
|
HCPCS
|
Hb Or-urinary Sphincter Implant
|
74
|
28
|
$87,738.96
|
$30,708.64
65% off
|
$20,706.39
|
$61,417.27
|
$39,096.48
|
2025-11-01
|
|
93653
|
CPT
|
Hb Ep Eval With Ablation Supravent Arrhythmia
|
86
|
28
|
$92,898.00
|
$32,514.30
65% off
|
$4,334.11
|
$65,028.60
|
$39,072.90
|
2025-11-01
|
|
288
|
MS_DRG
|
Acute And Subacute Endocarditis With Mcc
|
33
|
20
|
—
|
—
|
$28,855.06
|
$82,742.06
|
$39,072.12
|
2025-11-01
|
|
255
|
MS_DRG
|
Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc
|
33
|
20
|
—
|
—
|
$28,770.88
|
$80,649.56
|
$38,945.06
|
2025-11-01
|
|
C7529
|
HCPCS
|
Hb Radiant Ccl Cath Placement R&l Hrt Graft Angio W/flow Resever Msrmt S&i
|
75
|
28
|
$91,331.00
|
$31,965.85
65% off
|
$1,426.00
|
$63,931.70
|
$38,413.82
|
2025-11-01
|
|
462
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc
|
33
|
20
|
—
|
—
|
$28,413.13
|
$79,531.34
|
$38,405.08
|
2025-11-01
|
|
577
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Cc
|
33
|
20
|
—
|
—
|
$28,324.16
|
$79,253.28
|
$38,270.81
|
2025-11-01
|
|
970
|
MS_DRG
|
HIV With Extensive O.r. Procedures Without Mcc
|
33
|
20
|
—
|
—
|
$28,196.95
|
$78,855.62
|
$38,078.78
|
2025-11-01
|
|
E0764NUKF
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$36,057.14
|
$40,030.78
|
$38,043.96
|
2025-11-01
|
|
33276
|
CPT
|
Hb Insertion Phrenic Nerve Stimulator System
|
84
|
28
|
$90,449.00
|
$31,657.15
65% off
|
$3,058.55
|
$74,250.00
|
$38,042.85
|
2025-11-01
|
|
J9298
|
HCPCS
|
Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution
|
84
|
28
|
$72,018.69
|
$25,206.55
65% off
|
$191.90
|
$57,614.95
|
$37,492.93
|
2025-11-01
|
|
77371
|
CPT
|
Hb Gamma Knife Srs (cobalt 60) Complete Tx Cranial Lesion(s)
|
82
|
26
|
$89,119.00
|
$31,191.65
65% off
|
$937.00
|
$62,383.30
|
$37,483.45
|
2025-11-01
|
|
253
|
MS_DRG
|
Other Vascular Procedures With Cc
|
33
|
20
|
—
|
—
|
$27,797.11
|
$77,605.84
|
$37,475.27
|
2025-11-01
|
|
846
|
MS_DRG
|
Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc
|
33
|
20
|
—
|
—
|
$27,767.46
|
$79,265.69
|
$37,430.52
|
2025-11-01
|
|
93581
|
CPT
|
Hb Perq Trnscath Clo Vent Septal Defec
|
84
|
28
|
$88,888.00
|
$31,110.80
65% off
|
$5,943.00
|
$62,221.60
|
$37,386.29
|
2025-11-01
|
|
344
|
MS_DRG
|
Minor Small And Large Bowel Procedures With Mcc
|
33
|
20
|
—
|
—
|
$27,674.68
|
$77,223.14
|
$37,290.47
|
2025-11-01
|
|
95
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System With Cc
|
33
|
20
|
—
|
—
|
$27,640.23
|
$78,859.04
|
$37,238.49
|
2025-11-01
|
|
96
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc
|
33
|
20
|
—
|
—
|
$27,640.23
|
$78,859.04
|
$37,238.49
|
2025-11-01
|
|
749
|
MS_DRG
|
Other Female Reproductive System O.r. Procedures With Cc/mcc
|
33
|
20
|
—
|
—
|
$27,529.28
|
$76,768.67
|
$37,071.01
|
2025-11-01
|
|
272
|
MS_DRG
|
Other Major Cardiovascular Procedures Without Cc/mcc
|
33
|
20
|
—
|
—
|
$27,389.63
|
$76,332.15
|
$36,860.21
|
2025-11-01
|
|
659
|
MS_DRG
|
Kidney And Ureter Procedures For Non-neoplasm With Mcc
|
33
|
20
|
—
|
—
|
$27,273.89
|
$75,970.37
|
$36,685.51
|
2025-11-01
|
|
493
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc
|
33
|
20
|
—
|
—
|
$27,227.96
|
$75,826.85
|
$36,616.21
|
2025-11-01
|
|
E0483NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$34,639.08
|
$38,456.45
|
$36,547.76
|
2025-11-01
|
|
164
|
MS_DRG
|
Major Chest Procedures With Cc
|
33
|
20
|
—
|
—
|
$27,112.22
|
$75,465.08
|
$36,441.51
|
2025-11-01
|
|
27
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc
|
33
|
20
|
—
|
—
|
$27,101.70
|
$75,432.19
|
$36,425.63
|
2025-11-01
|
|
350
|
MS_DRG
|
Inguinal And Femoral Hernia Procedures With Mcc
|
33
|
20
|
—
|
—
|
$26,805.16
|
$74,505.32
|
$35,978.05
|
2025-11-01
|
|
619
|
MS_DRG
|
O.r. Procedures For Obesity With Mcc
|
33
|
20
|
—
|
—
|
$17,830.00
|
$83,006.98
|
$35,962.57
|
2025-11-01
|
|
545
|
MS_DRG
|
Connective Tissue Disorders With Mcc
|
33
|
20
|
—
|
—
|
$26,707.61
|
$75,877.98
|
$35,830.78
|
2025-11-01
|
|
C7526
|
HCPCS
|
Hb Radiant Ccl Cath Placement Left Hrt Graft Angio W/flow Resever Msrmt S&i
|
62
|
22
|
$84,657.00
|
$29,629.95
65% off
|
$1,426.00
|
$59,259.90
|
$35,606.74
|
2025-11-01
|
|
J9043
|
HCPCS
|
Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution
|
84
|
28
|
$68,394.59
|
$23,938.11
65% off
|
$220.46
|
$54,715.67
|
$35,606.22
|
2025-11-01
|