|
J3391
|
HCPCS
|
Inj, Atidarsagene Autotemcel
|
10
|
10
|
—
|
—
|
$4,505,000.00
|
$4,505,000.00
|
$4,505,000.00
|
2025-11-01
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
10
|
10
|
—
|
—
|
$3,685,266.67
|
$3,685,266.67
|
$3,685,266.67
|
2025-11-01
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
10
|
10
|
—
|
—
|
$3,316,462.59
|
$3,316,462.59
|
$3,316,462.59
|
2025-11-01
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
10
|
10
|
—
|
—
|
$3,248,445.72
|
$3,248,445.72
|
$3,248,445.72
|
2025-11-01
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
10
|
10
|
—
|
—
|
$2,945,740.00
|
$2,945,740.00
|
$2,945,740.00
|
2025-11-01
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
11
|
10
|
—
|
—
|
$186.59
|
$2,455,110.61
|
$2,455,110.61
|
2025-11-01
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
10
|
10
|
—
|
—
|
$2,332,000.00
|
$2,332,000.00
|
$2,332,000.00
|
2025-11-01
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
10
|
10
|
—
|
—
|
$770,620.00
|
$770,620.00
|
$770,620.00
|
2025-11-01
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel Car-pos T
|
11
|
10
|
—
|
—
|
$468,441.50
|
$591,726.20
|
$591,726.20
|
2025-11-01
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
13
|
10
|
—
|
—
|
$492,900.00
|
$3,450,300.00
|
$565,868.95
|
2025-11-01
|
|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
13
|
10
|
—
|
—
|
$434,918.00
|
$3,181,425.17
|
$562,538.19
|
2025-11-01
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel Car
|
11
|
10
|
—
|
—
|
$444,670.00
|
$557,317.93
|
$557,317.93
|
2025-11-01
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Car+
|
13
|
10
|
—
|
—
|
$449,245.86
|
$3,146,080.00
|
$533,230.17
|
2025-11-01
|
|
Q2053
|
HCPCS
|
Brexucabtagene Car Pos T
|
13
|
10
|
—
|
—
|
$448,752.40
|
$3,146,080.00
|
$489,304.61
|
2025-11-01
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
23
|
14
|
—
|
—
|
$312,945.75
|
$1,205,231.95
|
$342,310.06
|
2025-11-01
|
|
E0194NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$259,670.40
|
$302,948.80
|
$281,309.60
|
2025-11-01
|
|
Q2058
|
HCPCS
|
Obecbtge Autol Up To 400 Mil
|
10
|
10
|
—
|
—
|
$278,250.00
|
$278,250.00
|
$278,250.00
|
2025-11-01
|
|
J3403
|
HCPCS
|
Revakinagene, Per Implant
|
10
|
10
|
—
|
—
|
$257,500.00
|
$257,500.00
|
$257,500.00
|
2025-11-01
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
25
|
15
|
—
|
—
|
$162,000.00
|
$782,147.05
|
$220,950.20
|
2025-11-01
|
|
K0606NUKF
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$200,939.40
|
$234,429.30
|
$217,684.35
|
2025-11-01
|
|
J3402
|
HCPCS
|
Inj. Remestemcel-l-rknd/ Td
|
10
|
10
|
—
|
—
|
$205,640.00
|
$205,640.00
|
$205,640.00
|
2025-11-01
|
|
5834
|
APR_DRG
|
Neonate W Ecmo
|
1
|
1
|
—
|
—
|
$191,132.26
|
$191,132.26
|
$191,132.26
|
2025-11-01
|
|
5884
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
1
|
1
|
—
|
—
|
$171,904.07
|
$171,904.07
|
$171,904.07
|
2025-11-01
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
23
|
14
|
—
|
—
|
$154,727.07
|
$595,892.46
|
$169,245.41
|
2025-11-01
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…
|
23
|
14
|
—
|
—
|
$153,819.02
|
$592,395.33
|
$168,252.16
|
2025-11-01
|
|
24
|
APR_DRG
|
Heart &/or Lung Transplant
|
1
|
1
|
—
|
—
|
$149,739.33
|
$149,739.33
|
$149,739.33
|
2025-11-01
|
|
1614
|
APR_DRG
|
Cardiac Defibrillator & Heart Assist Implant
|
1
|
1
|
—
|
—
|
$149,355.70
|
$149,355.70
|
$149,355.70
|
2025-11-01
|
|
34
|
APR_DRG
|
Bone Marrow Transplant
|
1
|
1
|
—
|
—
|
$141,163.34
|
$141,163.34
|
$141,163.34
|
2025-11-01
|
|
5833
|
APR_DRG
|
Neonate W Ecmo
|
1
|
1
|
—
|
—
|
$137,458.28
|
$137,458.28
|
$137,458.28
|
2025-11-01
|
|
7
|
MS_DRG
|
Lung Transplant
|
26
|
15
|
—
|
—
|
$93,850.10
|
$361,440.08
|
$128,206.98
|
2025-11-01
|
|
44
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
1
|
1
|
—
|
—
|
$127,196.58
|
$127,196.58
|
$127,196.58
|
2025-11-01
|
|
8414
|
APR_DRG
|
Extensive 3rd Degree Burns W Skin Graft
|
1
|
1
|
—
|
—
|
$126,013.84
|
$126,013.84
|
$126,013.84
|
2025-11-01
|
|
5832
|
APR_DRG
|
Neonate W Ecmo
|
1
|
1
|
—
|
—
|
$124,961.67
|
$124,961.67
|
$124,961.67
|
2025-11-01
|
|
14
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
1
|
1
|
—
|
—
|
$121,705.22
|
$121,705.22
|
$121,705.22
|
2025-11-01
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
25
|
15
|
—
|
—
|
$87,093.72
|
$335,419.59
|
$118,977.21
|
2025-11-01
|
|
5883
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
1
|
1
|
—
|
—
|
$113,384.15
|
$113,384.15
|
$113,384.15
|
2025-11-01
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
25
|
15
|
—
|
—
|
$82,121.55
|
$316,270.54
|
$112,184.82
|
2025-11-01
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …
|
23
|
14
|
—
|
—
|
$100,381.10
|
$386,592.57
|
$110,764.45
|
2025-11-01
|
|
Q0480
|
HCPCS
|
Driver Pneumatic Vad, Rep
|
12
|
10
|
—
|
—
|
$110,139.19
|
$699,999.51
|
$110,139.19
|
2025-11-01
|
|
C9150
|
HCPCS
|
Other Radiology
|
1
|
1
|
—
|
—
|
$105,830.40
|
$105,830.40
|
$105,830.40
|
2025-11-01
|
|
5914
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
1
|
1
|
—
|
—
|
$104,959.98
|
$104,959.98
|
$104,959.98
|
2025-11-01
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
25
|
15
|
—
|
—
|
$74,720.19
|
$287,766.06
|
$102,073.95
|
2025-11-01
|
|
E0766
|
HCPCS
|
Elec Stim Cancer Treatment
|
2
|
1
|
—
|
—
|
$91,736.64
|
$107,026.08
|
$99,381.36
|
2025-11-01
|
|
E0766RRKF
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$91,736.64
|
$107,026.08
|
$99,381.36
|
2025-11-01
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
25
|
15
|
—
|
—
|
$72,158.38
|
$277,899.87
|
$98,574.30
|
2025-11-01
|
|
5934
|
APR_DRG
|
Neonate Birthwt 750-999g Without Major Procedure
|
1
|
1
|
—
|
—
|
$97,158.74
|
$97,158.74
|
$97,158.74
|
2025-11-01
|
|
E0764NUKF
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$88,303.20
|
$103,020.40
|
$95,661.80
|
2025-11-01
|
|
6094
|
APR_DRG
|
Neonate Bwt 1500-2499g W Major Procedure
|
1
|
1
|
—
|
—
|
$94,524.59
|
$94,524.59
|
$94,524.59
|
2025-11-01
|
|
64
|
APR_DRG
|
Pancreas Transplant
|
1
|
1
|
—
|
—
|
$93,578.65
|
$93,578.65
|
$93,578.65
|
2025-11-01
|
|
K1007
|
HCPCS
|
Bil Hkaf Pc S/d Micro Sensor
|
10
|
10
|
—
|
—
|
$93,216.70
|
$93,216.70
|
$93,216.70
|
2025-11-01
|
|
J7330
|
HCPCS
|
Hb Autologous Cultured Chondrocyctes, Implant
|
49
|
19
|
$182,777.50
|
$63,972.13
65% off
|
$60,316.58
|
$155,324.32
|
$93,216.53
|
2025-11-01
|
|
9104
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
1
|
1
|
—
|
—
|
$93,146.91
|
$93,146.91
|
$93,146.91
|
2025-11-01
|
|
E0483NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$84,830.40
|
$98,968.80
|
$91,899.60
|
2025-11-01
|
|
23
|
APR_DRG
|
Heart &/or Lung Transplant
|
1
|
1
|
—
|
—
|
$91,762.35
|
$91,762.35
|
$91,762.35
|
2025-11-01
|
|
5891
|
APR_DRG
|
Neonate Bwt <500g Or Ga <24 Weeks
|
1
|
1
|
—
|
—
|
$91,615.53
|
$91,615.53
|
$91,615.53
|
2025-11-01
|
|
209
|
MS_DRG
|
Complex Aortic Arch Procedures
|
23
|
14
|
—
|
—
|
$82,027.34
|
$315,907.71
|
$91,074.46
|
2025-11-01
|
|
54
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
1
|
1
|
—
|
—
|
$89,576.81
|
$89,576.81
|
$89,576.81
|
2025-11-01
|
|
K0864NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$82,282.80
|
$95,996.60
|
$89,139.70
|
2025-11-01
|
|
6304
|
APR_DRG
|
Neonate Birthwt >2499g W Major Cardiovascular Procedure
|
1
|
1
|
—
|
—
|
$88,920.77
|
$88,920.77
|
$88,920.77
|
2025-11-01
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
23
|
14
|
—
|
—
|
$79,870.64
|
$307,601.69
|
$88,760.73
|
2025-11-01
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
23
|
14
|
—
|
—
|
$78,804.60
|
$303,496.13
|
$87,617.09
|
2025-11-01
|
|
5892
|
APR_DRG
|
Neonate Bwt <500g Or Ga <24 Weeks
|
1
|
1
|
—
|
—
|
$83,287.58
|
$83,287.58
|
$83,287.58
|
2025-11-01
|
|
6024
|
APR_DRG
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
1
|
1
|
—
|
—
|
$83,097.64
|
$83,097.64
|
$83,097.64
|
2025-11-01
|
|
E0636NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$73,154.40
|
$85,346.80
|
$79,250.60
|
2025-11-01
|
|
5831
|
APR_DRG
|
Neonate W Ecmo
|
1
|
1
|
—
|
—
|
$79,137.04
|
$79,137.04
|
$79,137.04
|
2025-11-01
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
23
|
14
|
—
|
—
|
$70,895.95
|
$273,037.95
|
$79,132.65
|
2025-11-01
|
|
9114
|
APR_DRG
|
Extensive Abdominal/thoracic Procedures For Mult Significant Trauma
|
1
|
1
|
—
|
—
|
$77,886.82
|
$77,886.82
|
$77,886.82
|
2025-11-01
|
|
6314
|
APR_DRG
|
Neonate Birthwt >2499g W Other Major Procedure
|
1
|
1
|
—
|
—
|
$76,426.66
|
$76,426.66
|
$76,426.66
|
2025-11-01
|
|
4404
|
APR_DRG
|
Kidney Transplant
|
1
|
1
|
—
|
—
|
$76,097.39
|
$76,097.39
|
$76,097.39
|
2025-11-01
|
|
5893
|
APR_DRG
|
Neonate Bwt <500g Or Ga <24 Weeks
|
1
|
1
|
—
|
—
|
$75,716.27
|
$75,716.27
|
$75,716.27
|
2025-11-01
|
|
9124
|
APR_DRG
|
Musculoskeletal & Other Procedures For Multiple Significant Trauma
|
1
|
1
|
—
|
—
|
$75,380.75
|
$75,380.75
|
$75,380.75
|
2025-11-01
|
|
K0860NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$69,145.20
|
$80,669.40
|
$74,907.30
|
2025-11-01
|
|
K0863NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$69,145.20
|
$80,669.40
|
$74,907.30
|
2025-11-01
|
|
3034
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
1
|
1
|
—
|
—
|
$74,421.68
|
$74,421.68
|
$74,421.68
|
2025-11-01
|
|
33
|
APR_DRG
|
Bone Marrow Transplant
|
1
|
1
|
—
|
—
|
$74,370.45
|
$74,370.45
|
$74,370.45
|
2025-11-01
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
1
|
1
|
—
|
—
|
$73,248.31
|
$73,248.31
|
$73,248.31
|
2025-11-01
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
23
|
14
|
—
|
—
|
$65,292.57
|
$251,457.94
|
$73,121.31
|
2025-11-01
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures W Cardiac Catheterization
|
1
|
1
|
—
|
—
|
$72,313.61
|
$72,313.61
|
$72,313.61
|
2025-11-01
|
|
K0854NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$66,286.80
|
$77,334.60
|
$71,810.70
|
2025-11-01
|
|
22
|
APR_DRG
|
Heart &/or Lung Transplant
|
1
|
1
|
—
|
—
|
$71,136.49
|
$71,136.49
|
$71,136.49
|
2025-11-01
|
|
43
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
1
|
1
|
—
|
—
|
$70,677.26
|
$70,677.26
|
$70,677.26
|
2025-11-01
|
|
E0783NUKF
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$65,150.58
|
$76,009.01
|
$70,579.79
|
2025-11-01
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
23
|
14
|
—
|
—
|
$62,755.40
|
$241,686.65
|
$70,399.43
|
2025-11-01
|
|
5913
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
1
|
1
|
—
|
—
|
$70,045.59
|
$70,045.59
|
$70,045.59
|
2025-11-01
|
|
8424
|
APR_DRG
|
Full Thickness Burns W Skin Graft
|
1
|
1
|
—
|
—
|
$69,552.00
|
$69,552.00
|
$69,552.00
|
2025-11-01
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
23
|
14
|
—
|
—
|
$61,091.49
|
$235,278.51
|
$68,614.37
|
2025-11-01
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
23
|
14
|
—
|
—
|
$60,899.44
|
$234,538.89
|
$68,408.34
|
2025-11-01
|
|
K0855NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$62,617.62
|
$73,053.89
|
$67,835.76
|
2025-11-01
|
|
L8702
|
HCPCS
|
Ewhf S/d Uprt Micro Sensor
|
10
|
10
|
—
|
—
|
$67,452.66
|
$67,452.66
|
$67,452.66
|
2025-11-01
|
|
1634
|
APR_DRG
|
Cardiac Valve Procedures Without Cardiac Catheterization
|
1
|
1
|
—
|
—
|
$67,295.23
|
$67,295.23
|
$67,295.23
|
2025-11-01
|
|
C2616
|
HCPCS
|
Hb Brachy Tx Ns Spheres Yt-90
|
83
|
19
|
$169,668.05
|
$59,383.82
65% off
|
$17,485.10
|
$152,701.25
|
$66,679.54
|
2025-11-01
|
|
E0786NUKF
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$61,420.98
|
$71,657.81
|
$66,539.40
|
2025-11-01
|
|
5933
|
APR_DRG
|
Neonate Birthwt 750-999g Without Major Procedure
|
1
|
1
|
—
|
—
|
$65,696.37
|
$65,696.37
|
$65,696.37
|
2025-11-01
|
|
E2402NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$60,607.20
|
$70,708.40
|
$65,657.80
|
2025-11-01
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
1
|
1
|
—
|
—
|
$65,551.41
|
$65,551.41
|
$65,551.41
|
2025-11-01
|
|
E1036NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$60,405.60
|
$70,473.20
|
$65,439.40
|
2025-11-01
|
|
E1008NUKU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$60,121.20
|
$70,141.40
|
$65,131.30
|
2025-11-01
|
|
E1007NUKU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$60,117.00
|
$70,136.50
|
$65,126.75
|
2025-11-01
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
24
|
15
|
—
|
—
|
$52,002.30
|
$200,273.79
|
$64,951.43
|
2025-11-01
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
24
|
15
|
—
|
—
|
$51,704.45
|
$199,126.69
|
$64,588.22
|
2025-11-01
|
|
3124
|
APR_DRG
|
Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses
|
1
|
1
|
—
|
—
|
$64,476.13
|
$64,476.13
|
$64,476.13
|
2025-11-01
|
|
E1008NUKE
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$59,497.80
|
$69,414.10
|
$64,455.95
|
2025-11-01
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
23
|
14
|
—
|
—
|
$57,025.19
|
$219,618.21
|
$64,252.04
|
2025-11-01
|
|
13
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
1
|
1
|
—
|
—
|
$64,153.74
|
$64,153.74
|
$64,153.74
|
2025-11-01
|
|
21
|
APR_DRG
|
Heart &/or Lung Transplant
|
1
|
1
|
—
|
—
|
$63,878.82
|
$63,878.82
|
$63,878.82
|
2025-11-01
|
|
J9029
|
HCPCS
|
Instill Adstiladrin, Tx Dose
|
16
|
14
|
—
|
—
|
$63,342.28
|
$149,184.00
|
$63,342.28
|
2025-11-01
|
|
E1007NUKE
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$58,435.80
|
$68,175.10
|
$63,305.45
|
2025-11-01
|
|
90288
|
CPT
|
Botulism Ig IV
|
2
|
2
|
—
|
—
|
$186.59
|
$126,145.95
|
$63,166.27
|
2025-11-01
|
|
6074
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
1
|
1
|
—
|
—
|
$63,084.08
|
$63,084.08
|
$63,084.08
|
2025-11-01
|
|
J3357
|
HCPCS
|
Ustekinumab 90 Mg/ml Subcutaneous Syringe
|
60
|
19
|
$124,898.32
|
$43,714.42
65% off
|
$149.40
|
$86,179.84
|
$63,073.65
|
2025-11-01
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
23
|
14
|
—
|
—
|
$55,644.64
|
$214,301.35
|
$62,770.97
|
2025-11-01
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
23
|
14
|
—
|
—
|
$55,404.76
|
$213,377.53
|
$62,513.63
|
2025-11-01
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
23
|
14
|
—
|
—
|
$55,221.42
|
$212,671.41
|
$62,316.93
|
2025-11-01
|
|
3044
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc Except For Curvature Of Back
|
1
|
1
|
—
|
—
|
$62,247.47
|
$62,247.47
|
$62,247.47
|
2025-11-01
|
|
E1008NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$57,318.60
|
$66,871.70
|
$62,095.15
|
2025-11-01
|
|
0909T
|
CPT
|
Hb Replacement Int Neurostimulation Sys Vagus Nerve
|
47
|
19
|
$121,083.00
|
$42,379.05
65% off
|
$2,766.00
|
$83,547.27
|
$61,752.33
|
2025-11-01
|
|
0908T
|
CPT
|
Hb Open Impltj Int Neurostimulation Sys Vagus Nerve
|
47
|
19
|
$121,080.00
|
$42,378.00
65% off
|
$2,766.00
|
$83,545.20
|
$61,750.80
|
2025-11-01
|
|
6023
|
APR_DRG
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
1
|
1
|
—
|
—
|
$61,563.94
|
$61,563.94
|
$61,563.94
|
2025-11-01
|
|
E1007NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$56,256.60
|
$65,632.70
|
$60,944.65
|
2025-11-01
|
|
63
|
APR_DRG
|
Pancreas Transplant
|
1
|
1
|
—
|
—
|
$60,359.96
|
$60,359.96
|
$60,359.96
|
2025-11-01
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
23
|
14
|
—
|
—
|
$52,313.19
|
$201,471.13
|
$59,196.98
|
2025-11-01
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
23
|
14
|
—
|
—
|
$51,980.56
|
$200,190.06
|
$58,840.13
|
2025-11-01
|
|
62
|
APR_DRG
|
Pancreas Transplant
|
1
|
1
|
—
|
—
|
$58,561.79
|
$58,561.79
|
$58,561.79
|
2025-11-01
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
23
|
14
|
—
|
—
|
$51,674.01
|
$199,009.46
|
$58,511.26
|
2025-11-01
|
|
E2510NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$54,005.40
|
$63,006.30
|
$58,505.85
|
2025-11-01
|
|
E0193NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$52,812.60
|
$61,614.70
|
$57,213.65
|
2025-11-01
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
23
|
14
|
—
|
—
|
$50,089.81
|
$192,908.34
|
$56,811.73
|
2025-11-01
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
23
|
14
|
—
|
—
|
$49,844.14
|
$191,962.19
|
$56,548.16
|
2025-11-01
|
|
6034
|
APR_DRG
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
1
|
1
|
—
|
—
|
$56,134.44
|
$56,134.44
|
$56,134.44
|
2025-11-01
|
|
214
|
APR_DRG
|
Craniotomy Except For Trauma
|
1
|
1
|
—
|
—
|
$55,887.65
|
$55,887.65
|
$55,887.65
|
2025-11-01
|
|
1674
|
APR_DRG
|
Other Cardiothoracic Procedures
|
1
|
1
|
—
|
—
|
$55,618.36
|
$55,618.36
|
$55,618.36
|
2025-11-01
|
|
5882
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
1
|
1
|
—
|
—
|
$55,567.12
|
$55,567.12
|
$55,567.12
|
2025-11-01
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
23
|
14
|
—
|
—
|
$48,780.28
|
$187,865.00
|
$55,406.85
|
2025-11-01
|
|
Q2043
|
HCPCS
|
Sipuleucel-t Auto Cd54+
|
21
|
14
|
—
|
—
|
$53,630.37
|
$371,437.08
|
$55,272.32
|
2025-11-01
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
23
|
14
|
—
|
—
|
$48,457.07
|
$186,620.22
|
$55,060.10
|
2025-11-01
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
23
|
14
|
—
|
—
|
$48,421.56
|
$186,483.46
|
$55,022.01
|
2025-11-01
|
|
6804
|
APR_DRG
|
Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms
|
1
|
1
|
—
|
—
|
$54,462.48
|
$54,462.48
|
$54,462.48
|
2025-11-01
|
|
K0853NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$50,036.40
|
$58,375.80
|
$54,206.10
|
2025-11-01
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
23
|
14
|
—
|
—
|
$47,651.20
|
$183,516.62
|
$54,195.57
|
2025-11-01
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
23
|
14
|
—
|
—
|
$47,651.20
|
$183,516.62
|
$54,195.57
|
2025-11-01
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
23
|
14
|
—
|
—
|
$47,478.00
|
$182,849.57
|
$54,009.75
|
2025-11-01
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
24
|
15
|
—
|
—
|
$42,972.54
|
$165,497.93
|
$53,940.15
|
2025-11-01
|
|
4014
|
APR_DRG
|
Pituitary & Adrenal Procedures
|
1
|
1
|
—
|
—
|
$53,788.95
|
$53,788.95
|
$53,788.95
|
2025-11-01
|
|
2604
|
APR_DRG
|
Major Pancreas, Liver & Shunt Procedures
|
1
|
1
|
—
|
—
|
$53,583.39
|
$53,583.39
|
$53,583.39
|
2025-11-01
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
23
|
14
|
—
|
—
|
$46,632.27
|
$179,592.48
|
$53,102.46
|
2025-11-01
|
|
E0783UEKF
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$48,863.10
|
$57,006.95
|
$52,935.02
|
2025-11-01
|
|
K0852NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$48,708.42
|
$56,826.49
|
$52,767.46
|
2025-11-01
|
|
K0840NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$48,694.38
|
$56,810.11
|
$52,752.24
|
2025-11-01
|
|
K0858NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$48,399.60
|
$56,466.20
|
$52,432.90
|
2025-11-01
|
|
K0862NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$48,399.60
|
$56,466.20
|
$52,432.90
|
2025-11-01
|
|
6093
|
APR_DRG
|
Neonate Bwt 1500-2499g W Major Procedure
|
1
|
1
|
—
|
—
|
$52,077.00
|
$52,077.00
|
$52,077.00
|
2025-11-01
|
|
6033
|
APR_DRG
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
1
|
1
|
—
|
—
|
$52,038.88
|
$52,038.88
|
$52,038.88
|
2025-11-01
|
|
42
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
1
|
1
|
—
|
—
|
$51,625.89
|
$51,625.89
|
$51,625.89
|
2025-11-01
|
|
12
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
1
|
1
|
—
|
—
|
$51,480.94
|
$51,480.94
|
$51,480.94
|
2025-11-01
|
|
6904
|
APR_DRG
|
Acute Leukemia
|
1
|
1
|
—
|
—
|
$51,412.21
|
$51,412.21
|
$51,412.21
|
2025-11-01
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
24
|
15
|
—
|
—
|
$40,616.54
|
$156,424.39
|
$51,067.15
|
2025-11-01
|
|
904
|
APR_DRG
|
Major Larynx & Trachea Procedures
|
1
|
1
|
—
|
—
|
$50,957.98
|
$50,957.98
|
$50,957.98
|
2025-11-01
|
|
3214
|
APR_DRG
|
Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp
|
1
|
1
|
—
|
—
|
$50,864.89
|
$50,864.89
|
$50,864.89
|
2025-11-01
|
|
224
|
APR_DRG
|
Ventricular Shunt Procedures
|
1
|
1
|
—
|
—
|
$50,799.28
|
$50,799.28
|
$50,799.28
|
2025-11-01
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
23
|
14
|
—
|
—
|
$44,412.51
|
$171,043.64
|
$50,721.10
|
2025-11-01
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
23
|
14
|
—
|
—
|
$44,361.06
|
$170,845.48
|
$50,665.88
|
2025-11-01
|
|
1694
|
APR_DRG
|
Major Thoracic & Abdominal Vascular Procedures
|
1
|
1
|
—
|
—
|
$50,574.98
|
$50,574.98
|
$50,574.98
|
2025-11-01
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
23
|
14
|
—
|
—
|
$43,935.66
|
$169,207.17
|
$50,209.52
|
2025-11-01
|
|
K0859NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$46,158.42
|
$53,851.49
|
$50,004.96
|
2025-11-01
|
|
E0786UEKF
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$46,065.84
|
$53,743.48
|
$49,904.66
|
2025-11-01
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
23
|
14
|
—
|
—
|
$43,542.15
|
$167,691.65
|
$49,787.36
|
2025-11-01
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
23
|
14
|
—
|
—
|
$43,529.83
|
$167,644.21
|
$49,774.14
|
2025-11-01
|
|
E1006NUKE
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$45,921.60
|
$53,575.20
|
$49,748.40
|
2025-11-01
|
|
234
|
APR_DRG
|
Spinal Procedures
|
1
|
1
|
—
|
—
|
$49,732.75
|
$49,732.75
|
$49,732.75
|
2025-11-01
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
24
|
15
|
—
|
—
|
$39,367.88
|
$151,615.49
|
$49,544.47
|
2025-11-01
|
|
1613
|
APR_DRG
|
Cardiac Defibrillator & Heart Assist Implant
|
1
|
1
|
—
|
—
|
$49,540.31
|
$49,540.31
|
$49,540.31
|
2025-11-01
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
23
|
14
|
—
|
—
|
$43,214.59
|
$166,430.12
|
$49,435.95
|
2025-11-01
|
|
6124
|
APR_DRG
|
Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond
|
1
|
1
|
—
|
—
|
$49,427.85
|
$49,427.85
|
$49,427.85
|
2025-11-01
|
|
53
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
1
|
1
|
—
|
—
|
$49,355.37
|
$49,355.37
|
$49,355.37
|
2025-11-01
|
|
6814
|
APR_DRG
|
Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms
|
1
|
1
|
—
|
—
|
$49,334.75
|
$49,334.75
|
$49,334.75
|
2025-11-01
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
23
|
14
|
—
|
—
|
$5,377.00
|
$165,883.09
|
$49,283.57
|
2025-11-01
|
|
6073
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
1
|
1
|
—
|
—
|
$49,099.83
|
$49,099.83
|
$49,099.83
|
2025-11-01
|
|
L7181
|
HCPCS
|
Electronic Elbo Simultaneous
|
12
|
10
|
—
|
—
|
$48,901.12
|
$325,813.81
|
$48,901.12
|
2025-11-01
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
23
|
14
|
—
|
—
|
$42,529.74
|
$163,792.63
|
$48,701.24
|
2025-11-01
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
23
|
14
|
—
|
—
|
$42,502.21
|
$163,686.57
|
$48,671.69
|
2025-11-01
|
|
204
|
APR_DRG
|
Craniotomy For Trauma
|
1
|
1
|
—
|
—
|
$48,638.73
|
$48,638.73
|
$48,638.73
|
2025-11-01
|
|
K1014
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$44,446.14
|
$51,853.83
|
$48,149.99
|
2025-11-01
|
|
9504
|
APR_DRG
|
Extensive Procedure Unrelated To Principal Diagnosis
|
1
|
1
|
—
|
—
|
$48,132.64
|
$48,132.64
|
$48,132.64
|
2025-11-01
|
|
E1006NUKU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$44,396.40
|
$51,795.80
|
$48,096.10
|
2025-11-01
|
|
E1006NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$44,312.40
|
$51,697.80
|
$48,005.10
|
2025-11-01
|
|
6084
|
APR_DRG
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
1
|
1
|
—
|
—
|
$47,942.08
|
$47,942.08
|
$47,942.08
|
2025-11-01
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
23
|
14
|
—
|
—
|
$41,794.17
|
$160,959.76
|
$47,912.12
|
2025-11-01
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
23
|
14
|
—
|
—
|
$41,527.48
|
$159,932.67
|
$47,626.01
|
2025-11-01
|
|
33264
|
CPT
|
Hb Radiant Ccl-remv&replc Cvd Gen Mult Lead
|
66
|
19
|
$97,107.00
|
$33,987.45
65% off
|
$1,361.68
|
$68,705.00
|
$47,582.43
|
2025-11-01
|
|
894
|
APR_DRG
|
Major Cranial/facial Bone Procedures
|
1
|
1
|
—
|
—
|
$47,512.84
|
$47,512.84
|
$47,512.84
|
2025-11-01
|
|
1664
|
APR_DRG
|
Coronary Bypass Without Cardiac Cath Or Percutaneous Cardiac Procedure
|
1
|
1
|
—
|
—
|
$47,487.22
|
$47,487.22
|
$47,487.22
|
2025-11-01
|
|
213
|
MS_DRG
|
Endovascular Abdominal Aorta With Iliac Branch Procedures
|
23
|
14
|
—
|
—
|
$41,357.90
|
$159,279.58
|
$47,444.09
|
2025-11-01
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
23
|
14
|
—
|
—
|
$41,304.28
|
$159,073.05
|
$47,386.55
|
2025-11-01
|
|
E1035NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$43,692.00
|
$50,974.00
|
$47,333.00
|
2025-11-01
|
|
11
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
1
|
1
|
—
|
—
|
$47,031.12
|
$47,031.12
|
$47,031.12
|
2025-11-01
|
|
4034
|
APR_DRG
|
Procedures For Obesity
|
1
|
1
|
—
|
—
|
$46,841.18
|
$46,841.18
|
$46,841.18
|
2025-11-01
|
|
2204
|
APR_DRG
|
Major Stomach, Esophageal & Duodenal Procedures
|
1
|
1
|
—
|
—
|
$46,823.69
|
$46,823.69
|
$46,823.69
|
2025-11-01
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
23
|
14
|
—
|
—
|
$40,742.63
|
$156,910.02
|
$46,784.03
|
2025-11-01
|
|
6022
|
APR_DRG
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
1
|
1
|
—
|
—
|
$46,579.39
|
$46,579.39
|
$46,579.39
|
2025-11-01
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
25
|
15
|
—
|
—
|
$34,071.05
|
$131,216.07
|
$46,543.86
|
2025-11-01
|
|
K0828NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$42,907.62
|
$50,058.89
|
$46,483.26
|
2025-11-01
|
|
41
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
1
|
1
|
—
|
—
|
$46,463.18
|
$46,463.18
|
$46,463.18
|
2025-11-01
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
23
|
14
|
—
|
—
|
$40,338.25
|
$155,352.64
|
$46,350.20
|
2025-11-01
|
|
33276
|
CPT
|
Hb Insertion Phrenic Nerve Stimulator System
|
57
|
19
|
$90,449.00
|
$31,657.15
65% off
|
$3,478.00
|
$68,705.00
|
$46,128.99
|
2025-11-01
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
23
|
14
|
—
|
—
|
$40,025.18
|
$154,146.93
|
$46,014.33
|
2025-11-01
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
25
|
15
|
—
|
—
|
$33,604.34
|
$194,000.00
|
$45,906.30
|
2025-11-01
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
23
|
14
|
—
|
—
|
$39,785.31
|
$153,223.11
|
$45,756.99
|
2025-11-01
|
|
33263
|
CPT
|
Hb Radiant Ccl-remv&replc Cvd Gen Dual Lead
|
66
|
19
|
$93,203.00
|
$32,621.05
65% off
|
$1,307.33
|
$68,705.00
|
$45,669.47
|
2025-11-01
|
|
K0850NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$42,155.58
|
$49,181.51
|
$45,668.54
|
2025-11-01
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
23
|
14
|
—
|
—
|
$39,644.71
|
$152,681.66
|
$45,606.17
|
2025-11-01
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
23
|
14
|
—
|
—
|
$39,588.19
|
$152,463.96
|
$45,545.53
|
2025-11-01
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
23
|
14
|
—
|
—
|
$39,525.86
|
$152,223.93
|
$45,478.67
|
2025-11-01
|
|
9103
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
1
|
1
|
—
|
—
|
$45,442.88
|
$45,442.88
|
$45,442.88
|
2025-11-01
|
|
32
|
APR_DRG
|
Bone Marrow Transplant
|
1
|
1
|
—
|
—
|
$45,232.32
|
$45,232.32
|
$45,232.32
|
2025-11-01
|
|
0266T
|
CPT
|
Outpatient Rates
|
22
|
14
|
—
|
—
|
$1,581.72
|
$61,071.00
|
$45,224.60
|
2025-11-01
|
|
J9226
|
HCPCS
|
Supprelin La Implant
|
21
|
14
|
—
|
—
|
$186.59
|
$302,890.14
|
$45,020.65
|
2025-11-01
|
|
C1815
|
HCPCS
|
Hb Or-impl Urinary Incont Male (40)
|
72
|
19
|
$88,646.96
|
$31,026.44
65% off
|
$14,679.94
|
$79,782.26
|
$44,761.40
|
2025-11-01
|
|
61
|
APR_DRG
|
Pancreas Transplant
|
1
|
1
|
—
|
—
|
$44,707.49
|
$44,707.49
|
$44,707.49
|
2025-11-01
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
23
|
14
|
—
|
—
|
$38,646.80
|
$148,838.45
|
$44,535.61
|
2025-11-01
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
23
|
14
|
—
|
—
|
$38,623.61
|
$148,749.14
|
$44,510.73
|
2025-11-01
|
|
5104
|
APR_DRG
|
Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs
|
1
|
1
|
—
|
—
|
$44,508.18
|
$44,508.18
|
$44,508.18
|
2025-11-01
|
|
K0829NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$40,984.80
|
$47,815.60
|
$44,400.20
|
2025-11-01
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
23
|
14
|
—
|
—
|
$38,364.17
|
$147,749.96
|
$44,232.39
|
2025-11-01
|
|
914
|
APR_DRG
|
Other Major Head & Neck Procedures
|
1
|
1
|
—
|
—
|
$44,205.15
|
$44,205.15
|
$44,205.15
|
2025-11-01
|
|
5912
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
1
|
1
|
—
|
—
|
$44,172.04
|
$44,172.04
|
$44,172.04
|
2025-11-01
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
23
|
14
|
—
|
—
|
$38,237.35
|
$147,261.53
|
$44,096.34
|
2025-11-01
|
|
4414
|
APR_DRG
|
Major Bladder Procedures
|
1
|
1
|
—
|
—
|
$43,928.37
|
$43,928.37
|
$43,928.37
|
2025-11-01
|
|
K0851NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$40,533.18
|
$47,288.71
|
$43,910.94
|
2025-11-01
|
|
E2510UE
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$40,503.90
|
$47,254.55
|
$43,879.23
|
2025-11-01
|
|
4403
|
APR_DRG
|
Kidney Transplant
|
1
|
1
|
—
|
—
|
$43,860.89
|
$43,860.89
|
$43,860.89
|
2025-11-01
|
|
2644
|
APR_DRG
|
Other Hepatobiliary, Pancreas & Abdominal Procedures
|
1
|
1
|
—
|
—
|
$43,788.41
|
$43,788.41
|
$43,788.41
|
2025-11-01
|
|
9304
|
APR_DRG
|
Multiple Significant Trauma Without O.r. Procedure
|
1
|
1
|
—
|
—
|
$43,730.31
|
$43,730.31
|
$43,730.31
|
2025-11-01
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
23
|
14
|
—
|
—
|
$37,723.53
|
$145,282.71
|
$43,545.12
|
2025-11-01
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
23
|
14
|
—
|
—
|
$37,658.31
|
$145,031.52
|
$43,475.15
|
2025-11-01
|
|
K0857NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$39,791.58
|
$46,423.51
|
$43,107.54
|
2025-11-01
|
|
244
|
APR_DRG
|
Extracranial Vascular Procedures
|
1
|
1
|
—
|
—
|
$43,058.02
|
$43,058.02
|
$43,058.02
|
2025-11-01
|
|
L7180
|
HCPCS
|
Electronic Elbow Sequential
|
12
|
10
|
—
|
—
|
$42,853.91
|
$285,523.07
|
$42,853.91
|
2025-11-01
|
|
8504
|
APR_DRG
|
Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service
|
1
|
1
|
—
|
—
|
$42,819.97
|
$42,819.97
|
$42,819.97
|
2025-11-01
|
|
7114
|
APR_DRG
|
Post-op, Post-trauma, Other Device Infections W O.r. Procedure
|
1
|
1
|
—
|
—
|
$42,757.49
|
$42,757.49
|
$42,757.49
|
2025-11-01
|
|
C1882
|
HCPCS
|
Hb Ep Defib(2)
|
504
|
19
|
$99,099.16
|
$34,684.71
65% off
|
$10,571.66
|
$128,350.47
|
$42,701.33
|
2025-11-01
|
|
6514
|
APR_DRG
|
Other Procedures Of Blood & Blood-forming Organs
|
1
|
1
|
—
|
—
|
$42,612.54
|
$42,612.54
|
$42,612.54
|
2025-11-01
|
|
8413
|
APR_DRG
|
Extensive 3rd Degree Burns W Skin Graft
|
1
|
1
|
—
|
—
|
$42,487.58
|
$42,487.58
|
$42,487.58
|
2025-11-01
|
|
K0861NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$39,072.00
|
$45,584.00
|
$42,328.00
|
2025-11-01
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
23
|
14
|
—
|
—
|
$36,526.33
|
$140,671.98
|
$42,260.75
|
2025-11-01
|
|
K0856NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$39,009.18
|
$45,510.71
|
$42,259.94
|
2025-11-01
|
|
1204
|
APR_DRG
|
Major Respiratory & Chest Procedures
|
1
|
1
|
—
|
—
|
$42,084.59
|
$42,084.59
|
$42,084.59
|
2025-11-01
|
|
E0986NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$38,814.00
|
$45,283.00
|
$42,048.50
|
2025-11-01
|
|
1304
|
APR_DRG
|
Respiratory System Diagnosis W Ventilator Support 96+ Hours
|
1
|
1
|
—
|
—
|
$42,027.73
|
$42,027.73
|
$42,027.73
|
2025-11-01
|
|
8444
|
APR_DRG
|
Partial Thickness Burns W Or Without Skin Graft
|
1
|
1
|
—
|
—
|
$41,949.00
|
$41,949.00
|
$41,949.00
|
2025-11-01
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
23
|
14
|
—
|
—
|
$36,143.69
|
$139,198.33
|
$41,850.26
|
2025-11-01
|
|
6083
|
APR_DRG
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
1
|
1
|
—
|
—
|
$41,800.93
|
$41,800.93
|
$41,800.93
|
2025-11-01
|
|
6934
|
APR_DRG
|
Chemotherapy
|
1
|
1
|
—
|
—
|
$41,722.20
|
$41,722.20
|
$41,722.20
|
2025-11-01
|
|
6114
|
APR_DRG
|
Neonate Birthwt 1500-1999g W Major Anomaly
|
1
|
1
|
—
|
—
|
$41,608.49
|
$41,608.49
|
$41,608.49
|
2025-11-01
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
23
|
14
|
—
|
—
|
$35,853.81
|
$138,081.93
|
$41,539.27
|
2025-11-01
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
23
|
14
|
—
|
—
|
$35,790.03
|
$137,836.33
|
$41,470.84
|
2025-11-01
|
|
6303
|
APR_DRG
|
Neonate Birthwt >2499g W Major Cardiovascular Procedure
|
1
|
1
|
—
|
—
|
$41,456.04
|
$41,456.04
|
$41,456.04
|
2025-11-01
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
23
|
14
|
—
|
—
|
$35,667.56
|
$137,364.65
|
$41,339.46
|
2025-11-01
|
|
264
|
APR_DRG
|
Other Nervous System & Related Procedures
|
1
|
1
|
—
|
—
|
$41,334.20
|
$41,334.20
|
$41,334.20
|
2025-11-01
|
|
5932
|
APR_DRG
|
Neonate Birthwt 750-999g Without Major Procedure
|
1
|
1
|
—
|
—
|
$41,189.25
|
$41,189.25
|
$41,189.25
|
2025-11-01
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
23
|
14
|
—
|
—
|
$35,519.00
|
$136,792.49
|
$41,180.09
|
2025-11-01
|
|
E0304NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$37,820.40
|
$44,123.80
|
$40,972.10
|
2025-11-01
|
|
33287
|
CPT
|
Hb Radiant-rmvl&rplcmt Phrenic Nrv Stimulator Pls Generator
|
57
|
19
|
$79,691.00
|
$27,891.85
65% off
|
$3,478.00
|
$61,071.00
|
$40,642.41
|
2025-11-01
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
23
|
14
|
—
|
—
|
$34,993.59
|
$134,769.02
|
$40,616.42
|
2025-11-01
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
23
|
14
|
—
|
—
|
$34,816.76
|
$134,088.01
|
$40,426.72
|
2025-11-01
|
|
E1005NUKE
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$37,312.80
|
$43,531.60
|
$40,422.20
|
2025-11-01
|
|
6144
|
APR_DRG
|
Neonate Bwt 1500-1999g W Or Without Other Significant Condition
|
1
|
1
|
—
|
—
|
$40,307.66
|
$40,307.66
|
$40,307.66
|
2025-11-01
|
|
1654
|
APR_DRG
|
Coronary Bypass W Cardiac Cath Or Percutaneous Cardiac Procedure
|
1
|
1
|
—
|
—
|
$40,125.22
|
$40,125.22
|
$40,125.22
|
2025-11-01
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
23
|
14
|
—
|
—
|
$34,501.52
|
$132,873.93
|
$40,088.53
|
2025-11-01
|
|
3614
|
APR_DRG
|
Skin Graft For Skin & Subcutaneous Tissue Diagnoses
|
1
|
1
|
—
|
—
|
$40,020.25
|
$40,020.25
|
$40,020.25
|
2025-11-01
|
|
4054
|
APR_DRG
|
Other Procedures For Endocrine, Nutritional & Metabolic Disorders
|
1
|
1
|
—
|
—
|
$39,953.40
|
$39,953.40
|
$39,953.40
|
2025-11-01
|
|
0520T
|
CPT
|
Hb Radiant Ccl-rmvl&rplcmt Pg Wcs Lv Pacg Battery Compnt Only
|
66
|
19
|
$78,240.00
|
$27,384.00
65% off
|
$3,606.00
|
$68,705.00
|
$39,902.40
|
2025-11-01
|
|
0515T
|
CPT
|
Hb Radiant Ccl-insertion Wrls Car Stimulator Lv Pacg Compl Sys
|
66
|
19
|
$78,240.00
|
$27,384.00
65% off
|
$3,606.00
|
$68,705.00
|
$39,902.40
|
2025-11-01
|
|
7914
|
APR_DRG
|
O.r. Procedure For Other Complications Of Treatment
|
1
|
1
|
—
|
—
|
$39,901.54
|
$39,901.54
|
$39,901.54
|
2025-11-01
|
|
1623
|
APR_DRG
|
Cardiac Valve Procedures W Cardiac Catheterization
|
1
|
1
|
—
|
—
|
$39,889.67
|
$39,889.67
|
$39,889.67
|
2025-11-01
|
|
E0302NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$36,616.80
|
$42,719.60
|
$39,668.20
|
2025-11-01
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
23
|
14
|
—
|
—
|
$34,001.47
|
$130,948.14
|
$39,552.07
|
2025-11-01
|
|
L2006
|
HCPCS
|
Kaf Sng/dbl Swg/stn Mcpr Cus
|
12
|
10
|
—
|
—
|
$39,482.40
|
$263,059.58
|
$39,482.40
|
2025-11-01
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
23
|
14
|
—
|
—
|
$33,900.02
|
$130,557.40
|
$39,443.23
|
2025-11-01
|
|
K0848NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$36,343.20
|
$42,400.40
|
$39,371.80
|
2025-11-01
|
|
C1767
|
HCPCS
|
Hb Or-impl Pain Gen/stimulator (41)
|
576
|
19
|
$85,692.07
|
$29,992.22
65% off
|
$8,271.65
|
$186,190.78
|
$39,332.65
|
2025-11-01
|
|
4424
|
APR_DRG
|
Kidney & Urinary Tract Procedures For Malignancy
|
1
|
1
|
—
|
—
|
$39,292.36
|
$39,292.36
|
$39,292.36
|
2025-11-01
|
|
E1005NUKU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$36,246.00
|
$42,287.00
|
$39,266.50
|
2025-11-01
|
|
E1841NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$36,145.20
|
$42,169.40
|
$39,157.30
|
2025-11-01
|
|
1214
|
APR_DRG
|
Other Respiratory & Chest Procedures
|
1
|
1
|
—
|
—
|
$39,053.06
|
$39,053.06
|
$39,053.06
|
2025-11-01
|
|
K0826NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$36,000.78
|
$42,000.91
|
$39,000.85
|
2025-11-01
|
|
E1005NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$35,998.80
|
$41,998.60
|
$38,998.70
|
2025-11-01
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
23
|
14
|
—
|
—
|
$33,470.27
|
$128,902.34
|
$38,982.20
|
2025-11-01
|
|
33230
|
CPT
|
Hb Insert Dfib Pulse Gen Only W Exist Dual Lead
|
64
|
19
|
$76,432.00
|
$26,751.20
65% off
|
$2,210.04
|
$68,705.00
|
$38,980.32
|
2025-11-01
|
|
E0652NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$35,956.26
|
$41,948.97
|
$38,952.62
|
2025-11-01
|
|
K1024NU
|
HCPCS
|
Other Outpatient
|
2
|
1
|
—
|
—
|
$35,956.20
|
$41,948.90
|
$38,952.55
|
2025-11-01
|
|
6504
|
APR_DRG
|
Splenectomy
|
1
|
1
|
—
|
—
|
$38,825.63
|
$38,825.63
|
$38,825.63
|
2025-11-01
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
23
|
14
|
—
|
—
|
$33,310.84
|
$128,288.32
|
$38,811.16
|
2025-11-01
|
|
6134
|
APR_DRG
|
Neonate Birthwt 1500-1999g W Congenital/perinatal Infection
|
1
|
1
|
—
|
—
|
$38,740.66
|
$38,740.66
|
$38,740.66
|
2025-11-01
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
23
|
14
|
—
|
—
|
$33,226.05
|
$127,961.77
|
$38,720.20
|
2025-11-01
|
|
924
|
APR_DRG
|
Facial Bone Procedures Except Major Cranial/facial Bone Procedures
|
1
|
1
|
—
|
—
|
$38,576.34
|
$38,576.34
|
$38,576.34
|
2025-11-01
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
23
|
14
|
—
|
—
|
$33,063.71
|
$127,336.58
|
$38,546.04
|
2025-11-01
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
23
|
14
|
—
|
—
|
$32,964.43
|
$126,954.22
|
$38,439.53
|
2025-11-01
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
23
|
14
|
—
|
—
|
$32,949.93
|
$126,898.40
|
$38,423.98
|
2025-11-01
|
|
5881
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
1
|
1
|
—
|
—
|
$38,409.52
|
$38,409.52
|
$38,409.52
|
2025-11-01
|
|
33270
|
CPT
|
Hb Insert/replace S-icd W Subq Lead
|
66
|
19
|
$75,244.00
|
$26,335.40
65% off
|
$1,886.09
|
$68,705.00
|
$38,374.44
|
2025-11-01
|