|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
4
|
1
|
—
|
—
|
$2,351,133.00
|
$2,612,370.00
|
$2,481,751.50
|
2025-11-01
|
|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
4
|
1
|
—
|
—
|
$2,167,914.01
|
$2,408,793.34
|
$2,288,353.67
|
2025-11-01
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Car+
|
4
|
1
|
—
|
—
|
$2,143,828.80
|
$2,382,032.00
|
$2,262,930.40
|
2025-11-01
|
|
Q2053
|
HCPCS
|
Brexucabtagene Car Pos T
|
4
|
1
|
—
|
—
|
$2,143,828.80
|
$2,382,032.00
|
$2,262,930.40
|
2025-11-01
|
|
Q0480
|
HCPCS
|
Driver Pneumatic Vad, Rep
|
4
|
1
|
—
|
—
|
$476,999.67
|
$529,999.63
|
$503,499.65
|
2025-11-01
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
16
|
6
|
—
|
—
|
$448,496.56
|
$798,881.80
|
$494,615.79
|
2025-11-01
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
16
|
6
|
—
|
—
|
$291,056.23
|
$518,442.15
|
$320,985.75
|
2025-11-01
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
16
|
6
|
—
|
—
|
$221,746.29
|
$394,984.25
|
$244,548.63
|
2025-11-01
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…
|
16
|
6
|
—
|
—
|
$220,444.93
|
$392,666.20
|
$243,113.44
|
2025-11-01
|
|
L7181
|
HCPCS
|
Electronic Elbo Simultaneous
|
4
|
1
|
—
|
—
|
$222,018.84
|
$246,687.60
|
$234,353.22
|
2025-11-01
|
|
E0194NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$206,437.97
|
$229,375.52
|
$217,906.74
|
2025-11-01
|
|
L7180
|
HCPCS
|
Electronic Elbow Sequential
|
4
|
1
|
—
|
—
|
$194,563.58
|
$216,181.75
|
$205,372.66
|
2025-11-01
|
|
L2006
|
HCPCS
|
Kaf Sng/dbl Swg/stn Mcpr Cus
|
4
|
1
|
—
|
—
|
$179,256.31
|
$199,173.68
|
$189,214.99
|
2025-11-01
|
|
K0606NUKF
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$159,746.82
|
$177,496.47
|
$168,621.65
|
2025-11-01
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …
|
16
|
6
|
—
|
—
|
$143,860.64
|
$256,250.90
|
$158,653.94
|
2025-11-01
|
|
7
|
MS_DRG
|
Lung Transplant
|
16
|
6
|
—
|
—
|
$134,500.78
|
$239,578.70
|
$148,331.60
|
2025-11-01
|
|
L5856
|
HCPCS
|
Elec Knee-shin Swing/stance
|
4
|
1
|
—
|
—
|
$132,923.68
|
$147,692.98
|
$140,308.33
|
2025-11-01
|
|
L6880
|
HCPCS
|
Elec Hand Ind Art Digits
|
4
|
1
|
—
|
—
|
$132,654.03
|
$147,393.37
|
$140,023.70
|
2025-11-01
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
16
|
6
|
—
|
—
|
$124,817.91
|
$222,331.15
|
$137,653.02
|
2025-11-01
|
|
A9543
|
HCPCS
|
Y90 Ibritumomab, Rx
|
12
|
5
|
—
|
—
|
$105,551.35
|
$373,216.51
|
$134,945.40
|
2025-11-01
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
16
|
6
|
—
|
—
|
$117,692.07
|
$209,638.30
|
$129,794.44
|
2025-11-01
|
|
209
|
MS_DRG
|
Complex Aortic Arch Procedures
|
16
|
6
|
—
|
—
|
$117,557.06
|
$209,397.80
|
$129,645.54
|
2025-11-01
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
16
|
6
|
—
|
—
|
$114,466.18
|
$203,892.20
|
$126,236.82
|
2025-11-01
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
16
|
6
|
—
|
—
|
$112,938.40
|
$201,170.85
|
$124,551.95
|
2025-11-01
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
16
|
6
|
—
|
—
|
$107,084.85
|
$190,744.25
|
$118,096.47
|
2025-11-01
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
16
|
6
|
—
|
—
|
$103,413.40
|
$184,204.50
|
$114,047.48
|
2025-11-01
|
|
Q2043
|
HCPCS
|
Sipuleucel-t Auto Cd54+
|
12
|
5
|
—
|
—
|
$88,394.63
|
$281,230.93
|
$113,010.86
|
2025-11-01
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
16
|
6
|
—
|
—
|
$101,604.16
|
$180,981.80
|
$112,052.19
|
2025-11-01
|
|
L8614
|
HCPCS
|
Cochlear Device
|
4
|
1
|
—
|
—
|
$105,796.26
|
$117,551.40
|
$111,673.83
|
2025-11-01
|
|
J7330
|
HCPCS
|
Cultured Chondrocytes Implnt
|
8
|
4
|
—
|
—
|
$103,998.76
|
$151,390.60
|
$110,580.96
|
2025-11-01
|
|
Q0483
|
HCPCS
|
Monitor Elec Vad, Rep
|
4
|
1
|
—
|
—
|
$104,099.48
|
$115,666.09
|
$109,882.79
|
2025-11-01
|
|
L5858
|
HCPCS
|
Stance Phase Only
|
4
|
1
|
—
|
—
|
$102,981.20
|
$114,423.56
|
$108,702.38
|
2025-11-01
|
|
L6975
|
HCPCS
|
Interscap-thor Myoelectronic
|
4
|
1
|
—
|
—
|
$102,850.60
|
$114,278.44
|
$108,564.52
|
2025-11-01
|
|
J9029
|
HCPCS
|
Instill Adstiladrin, Tx Dose
|
8
|
4
|
—
|
—
|
$100,221.06
|
$145,891.42
|
$106,564.17
|
2025-11-01
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
16
|
6
|
—
|
—
|
$93,573.71
|
$166,677.60
|
$103,195.96
|
2025-11-01
|
|
L5973
|
HCPCS
|
Ank-foot Sys Dors-plant Flex
|
4
|
1
|
—
|
—
|
$96,641.20
|
$107,379.11
|
$102,010.15
|
2025-11-01
|
|
L6970
|
HCPCS
|
Interscapular-thor Switch CT
|
4
|
1
|
—
|
—
|
$95,996.39
|
$106,662.66
|
$101,329.52
|
2025-11-01
|
|
L6965
|
HCPCS
|
Shldr Disartic Myoelectronic
|
4
|
1
|
—
|
—
|
$94,825.69
|
$105,361.88
|
$100,093.79
|
2025-11-01
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
16
|
6
|
—
|
—
|
$89,937.57
|
$160,200.75
|
$99,185.91
|
2025-11-01
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
16
|
6
|
—
|
—
|
$87,552.94
|
$155,953.15
|
$96,556.07
|
2025-11-01
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
16
|
6
|
—
|
—
|
$87,277.71
|
$155,462.90
|
$96,252.54
|
2025-11-01
|
|
Q0489
|
HCPCS
|
Pwr Pck Base Combo Vad, Rep
|
4
|
1
|
—
|
—
|
$90,248.64
|
$100,276.27
|
$95,262.46
|
2025-11-01
|
|
L6960
|
HCPCS
|
Shldr Disartic Switch Contro
|
4
|
1
|
—
|
—
|
$87,522.44
|
$97,247.16
|
$92,384.80
|
2025-11-01
|
|
J9226
|
HCPCS
|
Supprelin La Implant
|
12
|
5
|
—
|
—
|
$71,985.42
|
$229,331.11
|
$92,031.99
|
2025-11-01
|
|
L6955
|
HCPCS
|
Above Elbow Myoelectronic CT
|
4
|
1
|
—
|
—
|
$86,778.27
|
$96,420.30
|
$91,599.29
|
2025-11-01
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
16
|
6
|
—
|
—
|
$81,725.36
|
$145,572.80
|
$90,129.24
|
2025-11-01
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
16
|
6
|
—
|
—
|
$79,746.82
|
$142,048.55
|
$87,947.24
|
2025-11-01
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
16
|
6
|
—
|
—
|
$79,403.05
|
$141,436.20
|
$87,568.12
|
2025-11-01
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
16
|
6
|
—
|
—
|
$79,140.28
|
$140,968.15
|
$87,278.33
|
2025-11-01
|
|
Q0481
|
HCPCS
|
Microprcsr Cu Elec Vad, Rep
|
4
|
1
|
—
|
—
|
$80,677.25
|
$89,641.39
|
$85,159.32
|
2025-11-01
|
|
L5859
|
HCPCS
|
Knee-shin Pro Flex/ext Cont
|
4
|
1
|
—
|
—
|
$80,396.49
|
$89,329.43
|
$84,862.96
|
2025-11-01
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
16
|
6
|
—
|
—
|
$74,972.38
|
$133,544.10
|
$82,681.85
|
2025-11-01
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
16
|
6
|
—
|
—
|
$74,526.82
|
$132,750.45
|
$82,190.47
|
2025-11-01
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
16
|
6
|
—
|
—
|
$74,495.66
|
$132,694.95
|
$82,156.10
|
2025-11-01
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
16
|
6
|
—
|
—
|
$74,099.96
|
$131,990.10
|
$81,719.71
|
2025-11-01
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
16
|
6
|
—
|
—
|
$74,056.33
|
$131,912.40
|
$81,671.60
|
2025-11-01
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
16
|
6
|
—
|
—
|
$71,785.95
|
$127,868.30
|
$79,167.76
|
2025-11-01
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
16
|
6
|
—
|
—
|
$71,433.87
|
$127,241.15
|
$78,779.46
|
2025-11-01
|
|
L6945
|
HCPCS
|
Elbow Disart Myoelectronic C
|
4
|
1
|
—
|
—
|
$74,162.77
|
$82,403.08
|
$78,282.93
|
2025-11-01
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
16
|
6
|
—
|
—
|
$69,909.20
|
$124,525.35
|
$77,098.02
|
2025-11-01
|
|
E0766
|
HCPCS
|
Elec Stim Cancer Treatment
|
4
|
1
|
—
|
—
|
$72,930.63
|
$81,034.03
|
$76,982.33
|
2025-11-01
|
|
E0766RRKF
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$72,930.63
|
$81,034.03
|
$76,982.33
|
2025-11-01
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
16
|
6
|
—
|
—
|
$69,445.99
|
$123,700.25
|
$76,587.17
|
2025-11-01
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
16
|
6
|
—
|
—
|
$69,395.10
|
$123,609.60
|
$76,531.04
|
2025-11-01
|
|
L6950
|
HCPCS
|
Above Elbow Switch Control
|
4
|
1
|
—
|
—
|
$72,457.97
|
$80,508.86
|
$76,483.42
|
2025-11-01
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
16
|
6
|
—
|
—
|
$68,291.07
|
$121,643.05
|
$75,313.49
|
2025-11-01
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
16
|
6
|
—
|
—
|
$68,291.07
|
$121,643.05
|
$75,313.49
|
2025-11-01
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
16
|
6
|
—
|
—
|
$68,042.84
|
$121,200.90
|
$75,039.74
|
2025-11-01
|
|
E0764NUKF
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$70,201.04
|
$78,001.16
|
$74,101.10
|
2025-11-01
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
16
|
6
|
—
|
—
|
$66,830.79
|
$119,041.95
|
$73,703.05
|
2025-11-01
|
|
E0483NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$67,440.17
|
$74,933.52
|
$71,186.85
|
2025-11-01
|
|
Q0479
|
HCPCS
|
Power Module Combo Vad, Rep
|
4
|
1
|
—
|
—
|
$66,514.45
|
$73,904.95
|
$70,209.70
|
2025-11-01
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
16
|
6
|
—
|
—
|
$63,649.56
|
$113,375.40
|
$70,194.70
|
2025-11-01
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
16
|
6
|
—
|
—
|
$63,575.82
|
$113,244.05
|
$70,113.37
|
2025-11-01
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
16
|
6
|
—
|
—
|
$62,966.16
|
$112,158.10
|
$69,441.02
|
2025-11-01
|
|
K0864NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$65,414.83
|
$72,683.14
|
$69,048.99
|
2025-11-01
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
16
|
6
|
—
|
—
|
$62,402.20
|
$111,153.55
|
$68,819.07
|
2025-11-01
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
16
|
6
|
—
|
—
|
$62,384.55
|
$111,122.10
|
$68,799.60
|
2025-11-01
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
16
|
6
|
—
|
—
|
$61,932.76
|
$110,317.35
|
$68,301.35
|
2025-11-01
|
|
L7191
|
HCPCS
|
Elbow Child Myoelectronic CT
|
4
|
1
|
—
|
—
|
$64,587.85
|
$71,764.28
|
$68,176.07
|
2025-11-01
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
16
|
6
|
—
|
—
|
$61,729.19
|
$109,954.75
|
$68,076.85
|
2025-11-01
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
16
|
6
|
—
|
—
|
$61,585.86
|
$109,699.45
|
$67,918.79
|
2025-11-01
|
|
L6940
|
HCPCS
|
Elbow Disarticulation Switch
|
4
|
1
|
—
|
—
|
$63,747.47
|
$70,830.53
|
$67,289.00
|
2025-11-01
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
16
|
6
|
—
|
—
|
$60,951.28
|
$108,569.10
|
$67,218.95
|
2025-11-01
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
16
|
6
|
—
|
—
|
$60,911.81
|
$108,498.80
|
$67,175.42
|
2025-11-01
|
|
L7186
|
HCPCS
|
Electron Elbow Child Switch
|
4
|
1
|
—
|
—
|
$63,038.79
|
$70,043.10
|
$66,540.95
|
2025-11-01
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
16
|
6
|
—
|
—
|
$59,897.10
|
$106,691.35
|
$66,056.36
|
2025-11-01
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
16
|
6
|
—
|
—
|
$59,514.90
|
$106,010.55
|
$65,634.85
|
2025-11-01
|
|
213
|
MS_DRG
|
Endovascular Abdominal Aorta With Iliac Branch Procedures
|
16
|
6
|
—
|
—
|
$59,271.86
|
$105,577.65
|
$65,366.83
|
2025-11-01
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
16
|
6
|
—
|
—
|
$59,195.01
|
$105,440.75
|
$65,282.07
|
2025-11-01
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
16
|
6
|
—
|
—
|
$58,390.09
|
$104,007.00
|
$64,394.39
|
2025-11-01
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
16
|
6
|
—
|
—
|
$58,209.38
|
$103,685.10
|
$64,195.09
|
2025-11-01
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
16
|
6
|
—
|
—
|
$57,810.55
|
$102,974.70
|
$63,755.25
|
2025-11-01
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
16
|
6
|
—
|
—
|
$57,361.88
|
$102,175.50
|
$63,260.45
|
2025-11-01
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
16
|
6
|
—
|
—
|
$57,018.10
|
$101,563.15
|
$62,881.32
|
2025-11-01
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
16
|
6
|
—
|
—
|
$56,816.61
|
$101,204.25
|
$62,659.11
|
2025-11-01
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
16
|
6
|
—
|
—
|
$56,735.60
|
$101,059.95
|
$62,569.76
|
2025-11-01
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
16
|
6
|
—
|
—
|
$56,646.28
|
$100,900.85
|
$62,471.26
|
2025-11-01
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
16
|
6
|
—
|
—
|
$56,419.87
|
$100,497.55
|
$62,221.57
|
2025-11-01
|
|
E0636NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$58,157.75
|
$64,619.72
|
$61,388.74
|
2025-11-01
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
16
|
6
|
—
|
—
|
$55,386.46
|
$98,656.80
|
$61,081.89
|
2025-11-01
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
16
|
6
|
—
|
—
|
$55,353.23
|
$98,597.60
|
$61,045.24
|
2025-11-01
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
16
|
6
|
—
|
—
|
$54,981.41
|
$97,935.30
|
$60,635.19
|
2025-11-01
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
16
|
6
|
—
|
—
|
$54,799.65
|
$97,611.55
|
$60,434.74
|
2025-11-01
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
16
|
6
|
—
|
—
|
$54,063.28
|
$96,299.90
|
$59,622.65
|
2025-11-01
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
16
|
6
|
—
|
—
|
$53,969.81
|
$96,133.40
|
$59,519.57
|
2025-11-01
|
|
J9309
|
HCPCS
|
Polatuzumab Vedotin-piiq 140 Mg Intravenous Solution
|
92
|
20
|
$88,332.53
|
$70,666.03
|
$215.24
|
$76,504.80
|
$58,343.64
|
2025-11-01
|
|
K0863NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$54,970.43
|
$61,078.26
|
$58,024.35
|
2025-11-01
|
|
K0860NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$54,970.43
|
$61,078.26
|
$58,024.35
|
2025-11-01
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
16
|
6
|
—
|
—
|
$52,347.52
|
$93,243.70
|
$57,730.46
|
2025-11-01
|
|
J9266
|
HCPCS
|
Pegaspargase Injection
|
12
|
5
|
—
|
—
|
$44,910.01
|
$136,541.04
|
$57,416.60
|
2025-11-01
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
16
|
6
|
—
|
—
|
$51,799.14
|
$92,266.90
|
$57,125.68
|
2025-11-01
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
16
|
6
|
—
|
—
|
$51,383.70
|
$91,526.90
|
$56,667.52
|
2025-11-01
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
16
|
6
|
—
|
—
|
$51,292.30
|
$91,364.10
|
$56,566.72
|
2025-11-01
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
16
|
6
|
—
|
—
|
$51,116.78
|
$91,051.45
|
$56,373.15
|
2025-11-01
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
16
|
6
|
—
|
—
|
$50,903.86
|
$90,672.20
|
$56,138.35
|
2025-11-01
|
|
K0854NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$52,698.01
|
$58,553.34
|
$55,625.68
|
2025-11-01
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
16
|
6
|
—
|
—
|
$50,150.88
|
$89,330.95
|
$55,307.93
|
2025-11-01
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
16
|
6
|
—
|
—
|
$49,897.46
|
$88,879.55
|
$55,028.45
|
2025-11-01
|
|
E0783NUKF
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$51,794.71
|
$57,549.68
|
$54,672.19
|
2025-11-01
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
16
|
6
|
—
|
—
|
$49,445.67
|
$88,074.80
|
$54,530.21
|
2025-11-01
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
16
|
6
|
—
|
—
|
$48,828.74
|
$86,975.90
|
$53,849.84
|
2025-11-01
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
16
|
6
|
—
|
—
|
$48,729.03
|
$86,798.30
|
$53,739.88
|
2025-11-01
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
16
|
6
|
—
|
—
|
$48,583.63
|
$86,539.30
|
$53,579.53
|
2025-11-01
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
16
|
6
|
—
|
—
|
$48,159.88
|
$85,784.50
|
$53,112.20
|
2025-11-01
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
16
|
6
|
—
|
—
|
$47,967.74
|
$85,442.25
|
$52,900.30
|
2025-11-01
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
16
|
6
|
—
|
—
|
$47,739.25
|
$85,035.25
|
$52,648.31
|
2025-11-01
|
|
L6935
|
HCPCS
|
Below Elbow Myoelectronic CT
|
4
|
1
|
—
|
—
|
$49,867.73
|
$55,408.59
|
$52,638.16
|
2025-11-01
|
|
K0855NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$49,781.01
|
$55,312.23
|
$52,546.62
|
2025-11-01
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
16
|
6
|
—
|
—
|
$47,617.73
|
$84,818.80
|
$52,514.30
|
2025-11-01
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
16
|
6
|
—
|
—
|
$47,385.09
|
$84,404.40
|
$52,257.73
|
2025-11-01
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
16
|
6
|
—
|
—
|
$47,242.80
|
$84,150.95
|
$52,100.81
|
2025-11-01
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
16
|
6
|
—
|
—
|
$47,222.03
|
$84,113.95
|
$52,077.90
|
2025-11-01
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
16
|
6
|
—
|
—
|
$47,037.16
|
$83,784.65
|
$51,874.02
|
2025-11-01
|
|
E0786NUKF
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$48,829.68
|
$54,255.20
|
$51,542.44
|
2025-11-01
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
16
|
6
|
—
|
—
|
$46,547.97
|
$82,913.30
|
$51,334.54
|
2025-11-01
|
|
31
|
MS_DRG
|
Ventricular Shunt Procedures With Mcc
|
16
|
6
|
—
|
—
|
$46,534.47
|
$82,889.25
|
$51,319.65
|
2025-11-01
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
16
|
6
|
—
|
—
|
$46,351.68
|
$82,563.65
|
$51,118.06
|
2025-11-01
|
|
E2402NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$48,182.72
|
$53,536.36
|
$50,859.54
|
2025-11-01
|
|
E1036NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$48,022.45
|
$53,358.28
|
$50,690.36
|
2025-11-01
|
|
81416
|
CPT
|
Exome Sequence Analysis
|
16
|
6
|
—
|
—
|
$9,720.00
|
$69,240.00
|
$50,520.00
|
2025-11-01
|
|
E1008NUKU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$47,796.35
|
$53,107.06
|
$50,451.71
|
2025-11-01
|
|
E1007NUKU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$47,793.02
|
$53,103.35
|
$50,448.18
|
2025-11-01
|
|
L6925
|
HCPCS
|
Wrist Disart Myoelectronic C
|
4
|
1
|
—
|
—
|
$47,678.82
|
$52,976.47
|
$50,327.65
|
2025-11-01
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
16
|
6
|
—
|
—
|
$45,623.62
|
$81,266.80
|
$50,315.13
|
2025-11-01
|
|
E1008NUKE
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$47,300.75
|
$52,556.39
|
$49,928.57
|
2025-11-01
|
|
L5857
|
HCPCS
|
Elec Knee-shin Swing Only
|
4
|
1
|
—
|
—
|
$47,105.90
|
$52,339.89
|
$49,722.90
|
2025-11-01
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
16
|
6
|
—
|
—
|
$44,944.38
|
$80,056.90
|
$49,566.04
|
2025-11-01
|
|
L8679
|
HCPCS
|
Imp Neurosti Pls Gn Any Type
|
4
|
1
|
—
|
—
|
$46,829.90
|
$52,033.23
|
$49,431.57
|
2025-11-01
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
16
|
6
|
—
|
—
|
$44,586.06
|
$79,418.65
|
$49,170.88
|
2025-11-01
|
|
E1007NUKE
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$46,456.46
|
$51,618.29
|
$49,037.38
|
2025-11-01
|
|
L6930
|
HCPCS
|
Below Elbow Switch Control
|
4
|
1
|
—
|
—
|
$46,448.07
|
$51,608.96
|
$49,028.51
|
2025-11-01
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
16
|
6
|
—
|
—
|
$44,299.41
|
$78,908.05
|
$48,854.74
|
2025-11-01
|
|
448
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical Without Mcc
|
16
|
6
|
—
|
—
|
$44,044.95
|
$78,454.80
|
$48,574.12
|
2025-11-01
|
|
269
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
16
|
6
|
—
|
—
|
$43,862.16
|
$78,129.20
|
$48,372.54
|
2025-11-01
|
|
12
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
16
|
6
|
—
|
—
|
$43,787.38
|
$77,996.00
|
$48,290.07
|
2025-11-01
|
|
958
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
16
|
6
|
—
|
—
|
$43,765.57
|
$77,957.15
|
$48,266.01
|
2025-11-01
|
|
673
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Mcc
|
16
|
6
|
—
|
—
|
$43,637.82
|
$77,729.60
|
$48,125.12
|
2025-11-01
|
|
E1008NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$45,568.29
|
$50,631.43
|
$48,099.86
|
2025-11-01
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
16
|
6
|
—
|
—
|
$43,585.89
|
$77,637.10
|
$48,067.86
|
2025-11-01
|
|
236
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
16
|
6
|
—
|
—
|
$43,504.88
|
$77,492.80
|
$47,978.51
|
2025-11-01
|
|
L8619
|
HCPCS
|
Coch Imp Ext Proc/contr Rplc
|
4
|
1
|
—
|
—
|
$45,417.60
|
$50,464.00
|
$47,940.80
|
2025-11-01
|
|
458
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
16
|
6
|
—
|
—
|
$43,336.62
|
$77,193.10
|
$47,792.96
|
2025-11-01
|
|
793
|
MS_DRG
|
Full Term Neonate With Major Problems
|
16
|
6
|
—
|
—
|
$43,305.47
|
$77,137.60
|
$47,758.60
|
2025-11-01
|
|
423
|
MS_DRG
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
16
|
6
|
—
|
—
|
$43,133.06
|
$76,830.50
|
$47,568.46
|
2025-11-01
|
|
273
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures With Mcc
|
16
|
6
|
—
|
—
|
$42,847.44
|
$76,321.75
|
$47,253.48
|
2025-11-01
|
|
E1007NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$44,724.00
|
$49,693.33
|
$47,208.67
|
2025-11-01
|
|
L6920
|
HCPCS
|
Wrist Disarticul Switch Ctrl
|
4
|
1
|
—
|
—
|
$44,206.83
|
$49,118.70
|
$46,662.76
|
2025-11-01
|
|
791
|
MS_DRG
|
Prematurity With Major Problems
|
16
|
6
|
—
|
—
|
$42,156.77
|
$75,091.50
|
$46,491.79
|
2025-11-01
|
|
L7190
|
HCPCS
|
Elbow Adolescent Myoelectron
|
4
|
1
|
—
|
—
|
$44,005.87
|
$48,895.42
|
$46,450.65
|
2025-11-01
|
|
402
|
MS_DRG
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
16
|
6
|
—
|
—
|
$41,756.91
|
$74,379.25
|
$46,050.81
|
2025-11-01
|
|
802
|
MS_DRG
|
Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc
|
16
|
6
|
—
|
—
|
$41,378.86
|
$73,705.85
|
$45,633.89
|
2025-11-01
|
|
E2510NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$42,934.29
|
$47,704.77
|
$45,319.53
|
2025-11-01
|
|
24
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
16
|
6
|
—
|
—
|
$40,628.99
|
$72,370.15
|
$44,806.90
|
2025-11-01
|
|
933
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
16
|
6
|
—
|
—
|
$40,445.16
|
$72,042.70
|
$44,604.17
|
2025-11-01
|
|
34
|
MS_DRG
|
Carotid Artery Stent Procedures With Mcc
|
16
|
6
|
—
|
—
|
$40,201.09
|
$71,607.95
|
$44,334.99
|
2025-11-01
|
|
E0193NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$41,986.02
|
$46,651.13
|
$44,318.57
|
2025-11-01
|
|
40
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
16
|
6
|
—
|
—
|
$40,102.42
|
$71,432.20
|
$44,226.18
|
2025-11-01
|
|
907
|
MS_DRG
|
Other O.r. Procedures For Injuries With Mcc
|
16
|
6
|
—
|
—
|
$39,874.97
|
$71,027.05
|
$43,975.35
|
2025-11-01
|
|
876
|
MS_DRG
|
O.r. Procedures With Principal Diagnosis Of Mental Illness
|
4
|
1
|
—
|
—
|
$40,140.85
|
$46,390.39
|
$43,265.62
|
2025-11-01
|
|
956
|
MS_DRG
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
16
|
6
|
—
|
—
|
$39,082.52
|
$69,615.50
|
$43,101.40
|
2025-11-01
|
|
143
|
MS_DRG
|
Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc
|
16
|
6
|
—
|
—
|
$38,912.19
|
$69,312.10
|
$42,913.56
|
2025-11-01
|
|
166
|
MS_DRG
|
Other Respiratory System O.r. Procedures With Mcc
|
16
|
6
|
—
|
—
|
$38,819.75
|
$69,147.45
|
$42,811.61
|
2025-11-01
|
|
518
|
MS_DRG
|
Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…
|
16
|
6
|
—
|
—
|
$38,815.60
|
$69,140.05
|
$42,807.04
|
2025-11-01
|
|
628
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
16
|
6
|
—
|
—
|
$38,706.54
|
$68,945.80
|
$42,686.76
|
2025-11-01
|
|
651
|
MS_DRG
|
Kidney Transplant With Hemodialysis Without Mcc
|
16
|
6
|
—
|
—
|
$38,488.44
|
$68,557.30
|
$42,446.24
|
2025-11-01
|
|
L5987
|
HCPCS
|
Shank Ft W Vert Load Pylon
|
4
|
1
|
—
|
—
|
$39,860.79
|
$44,289.77
|
$42,075.28
|
2025-11-01
|
|
904
|
MS_DRG
|
Skin Grafts For Injuries With Cc/mcc
|
16
|
6
|
—
|
—
|
$38,148.82
|
$67,952.35
|
$42,071.68
|
2025-11-01
|
|
492
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc
|
16
|
6
|
—
|
—
|
$38,133.24
|
$67,924.60
|
$42,054.51
|
2025-11-01
|
|
K0853NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$39,778.94
|
$44,198.82
|
$41,988.88
|
2025-11-01
|
|
939
|
MS_DRG
|
O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc
|
16
|
6
|
—
|
—
|
$37,685.60
|
$67,127.25
|
$41,560.84
|
2025-11-01
|
|
495
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…
|
16
|
6
|
—
|
—
|
$37,656.52
|
$67,075.45
|
$41,528.77
|
2025-11-01
|
|
332
|
MS_DRG
|
Rectal Resection With Mcc
|
16
|
6
|
—
|
—
|
$37,604.59
|
$66,982.95
|
$41,471.49
|
2025-11-01
|
|
265
|
MS_DRG
|
Aicd Lead Procedures
|
16
|
6
|
—
|
—
|
$37,578.63
|
$66,936.70
|
$41,442.87
|
2025-11-01
|
|
97
|
MS_DRG
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc
|
16
|
6
|
—
|
—
|
$37,512.15
|
$66,818.30
|
$41,369.56
|
2025-11-01
|
|
279
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
16
|
6
|
—
|
—
|
$37,456.07
|
$66,718.40
|
$41,307.71
|
2025-11-01
|
|
739
|
MS_DRG
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…
|
16
|
6
|
—
|
—
|
$37,210.96
|
$66,281.80
|
$41,037.39
|
2025-11-01
|
|
E0783UEKF
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$38,846.16
|
$43,162.41
|
$41,004.29
|
2025-11-01
|
|
736
|
MS_DRG
|
Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc
|
16
|
6
|
—
|
—
|
$37,124.76
|
$66,128.25
|
$40,942.32
|
2025-11-01
|
|
335
|
MS_DRG
|
Peritoneal Adhesiolysis With Mcc
|
16
|
6
|
—
|
—
|
$37,087.37
|
$66,061.65
|
$40,901.09
|
2025-11-01
|
|
K0852NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$38,723.19
|
$43,025.77
|
$40,874.48
|
2025-11-01
|
|
K0840NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$38,712.03
|
$43,013.37
|
$40,862.70
|
2025-11-01
|
|
408
|
MS_DRG
|
Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…
|
16
|
6
|
—
|
—
|
$37,032.32
|
$65,963.60
|
$40,840.38
|
2025-11-01
|
|
414
|
MS_DRG
|
Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc
|
16
|
6
|
—
|
—
|
$37,001.16
|
$65,908.10
|
$40,806.03
|
2025-11-01
|
|
622
|
MS_DRG
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
16
|
6
|
—
|
—
|
$36,965.85
|
$65,845.20
|
$40,767.07
|
2025-11-01
|
|
271
|
MS_DRG
|
Other Major Cardiovascular Procedures With Cc
|
16
|
6
|
—
|
—
|
$36,935.73
|
$65,791.55
|
$40,733.86
|
2025-11-01
|
|
K0858NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$38,477.68
|
$42,752.98
|
$40,615.33
|
2025-11-01
|
|
K0862NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$38,477.68
|
$42,752.98
|
$40,615.33
|
2025-11-01
|
|
L8627
|
HCPCS
|
Cid Ext Speech Process Repl
|
4
|
1
|
—
|
—
|
$38,474.58
|
$42,749.54
|
$40,612.06
|
2025-11-01
|
|
467
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Cc
|
16
|
6
|
—
|
—
|
$36,627.27
|
$65,242.10
|
$40,393.68
|
2025-11-01
|
|
94
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System With Mcc
|
16
|
6
|
—
|
—
|
$36,552.49
|
$65,108.90
|
$40,311.21
|
2025-11-01
|
|
252
|
MS_DRG
|
Other Vascular Procedures With Mcc
|
16
|
6
|
—
|
—
|
$36,229.48
|
$64,533.55
|
$39,954.99
|
2025-11-01
|
|
616
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
16
|
6
|
—
|
—
|
$36,220.14
|
$64,516.90
|
$39,944.68
|
2025-11-01
|
|
574
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Cc
|
16
|
6
|
—
|
—
|
$36,053.96
|
$64,220.90
|
$39,761.42
|
2025-11-01
|
|
477
|
MS_DRG
|
Biopsies Of Musculoskeletal System And Connective Tissue With Mcc
|
16
|
6
|
—
|
—
|
$35,879.48
|
$63,910.10
|
$39,568.99
|
2025-11-01
|
|
359
|
MS_DRG
|
Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc
|
16
|
6
|
—
|
—
|
$35,713.30
|
$63,614.10
|
$39,385.72
|
2025-11-01
|
|
987
|
MS_DRG
|
Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
16
|
6
|
—
|
—
|
$35,607.36
|
$63,425.40
|
$39,268.90
|
2025-11-01
|
|
J9600
|
HCPCS
|
Porfimer Sodium Injection
|
8
|
4
|
—
|
—
|
$36,850.34
|
$53,642.90
|
$39,182.64
|
2025-11-01
|
|
29
|
MS_DRG
|
Spinal Procedures With Cc Or Spinal Neurostimulators
|
16
|
6
|
—
|
—
|
$35,432.88
|
$63,114.60
|
$39,076.46
|
2025-11-01
|
|
420
|
MS_DRG
|
Hepatobiliary Diagnostic Procedures With Mcc
|
16
|
6
|
—
|
—
|
$35,386.14
|
$63,031.35
|
$39,024.92
|
2025-11-01
|
|
L5280
|
HCPCS
|
Hemipelvect Canad Sing Axis
|
4
|
1
|
—
|
—
|
$36,799.55
|
$40,888.39
|
$38,843.97
|
2025-11-01
|
|
K0859NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$36,695.94
|
$40,773.27
|
$38,734.60
|
2025-11-01
|
|
E0786UEKF
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$36,622.34
|
$40,691.49
|
$38,656.91
|
2025-11-01
|
|
E1006NUKE
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$36,507.67
|
$40,564.08
|
$38,535.88
|
2025-11-01
|
|
264
|
MS_DRG
|
Other Circulatory System O.r. Procedures
|
16
|
6
|
—
|
—
|
$34,695.47
|
$61,801.10
|
$38,263.24
|
2025-11-01
|
|
L8609
|
HCPCS
|
Artificial Cornea
|
4
|
1
|
—
|
—
|
$36,174.39
|
$40,193.77
|
$38,184.08
|
2025-11-01
|
|
411
|
MS_DRG
|
Cholecystectomy With C.d.e. With Mcc
|
16
|
6
|
—
|
—
|
$34,308.07
|
$61,111.05
|
$37,836.00
|
2025-11-01
|
|
37
|
MS_DRG
|
Extracranial Procedures With Mcc
|
16
|
6
|
—
|
—
|
$34,191.75
|
$60,903.85
|
$37,707.71
|
2025-11-01
|
|
274
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures Without Mcc
|
16
|
6
|
—
|
—
|
$34,187.60
|
$60,896.45
|
$37,703.14
|
2025-11-01
|
|
L5250
|
HCPCS
|
Hip Canad Sing Axi Cons Fric
|
4
|
1
|
—
|
—
|
$35,515.18
|
$39,461.31
|
$37,488.24
|
2025-11-01
|
|
K1014
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$35,334.68
|
$39,260.76
|
$37,297.72
|
2025-11-01
|
|
260
|
MS_DRG
|
Cardiac Pacemaker Revision Except Device Replacement With Mcc
|
16
|
6
|
—
|
—
|
$33,783.58
|
$60,176.80
|
$37,257.57
|
2025-11-01
|
|
E1006NUKU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$35,295.14
|
$39,216.82
|
$37,255.98
|
2025-11-01
|
|
E1006NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$35,228.36
|
$39,142.62
|
$37,185.49
|
2025-11-01
|
|
579
|
MS_DRG
|
Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc
|
16
|
6
|
—
|
—
|
$33,635.06
|
$59,912.25
|
$37,093.78
|
2025-11-01
|
|
840
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Mcc
|
16
|
6
|
—
|
—
|
$33,597.67
|
$59,845.65
|
$37,052.54
|
2025-11-01
|
|
451
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical Without Mcc
|
16
|
6
|
—
|
—
|
$33,550.93
|
$59,762.40
|
$37,001.00
|
2025-11-01
|
|
652
|
MS_DRG
|
Kidney Transplant
|
16
|
6
|
—
|
—
|
$33,541.59
|
$59,745.75
|
$36,990.69
|
2025-11-01
|
|
485
|
MS_DRG
|
Knee Procedures With Principal Diagnosis Of Infection With Mcc
|
16
|
6
|
—
|
—
|
$33,516.66
|
$59,701.35
|
$36,963.20
|
2025-11-01
|
|
929
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc
|
16
|
6
|
—
|
—
|
$33,451.23
|
$59,584.80
|
$36,891.04
|
2025-11-01
|
|
325
|
MS_DRG
|
Coronary Intravascular Lithotripsy Without Intraluminal Device
|
16
|
6
|
—
|
—
|
$33,343.21
|
$59,392.40
|
$36,771.92
|
2025-11-01
|
|
L7185
|
HCPCS
|
Electron Elbow Adolescent Sw
|
4
|
1
|
—
|
—
|
$34,781.84
|
$38,646.49
|
$36,714.16
|
2025-11-01
|
|
E1035NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$34,735.14
|
$38,594.60
|
$36,664.87
|
2025-11-01
|
|
242
|
MS_DRG
|
Permanent Cardiac Pacemaker Implant With Mcc
|
16
|
6
|
—
|
—
|
$33,160.42
|
$59,066.80
|
$36,570.33
|
2025-11-01
|
|
515
|
MS_DRG
|
Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc
|
16
|
6
|
—
|
—
|
$33,099.14
|
$58,957.65
|
$36,502.75
|
2025-11-01
|
|
656
|
MS_DRG
|
Kidney And Ureter Procedures For Neoplasm With Mcc
|
16
|
6
|
—
|
—
|
$33,066.95
|
$58,900.30
|
$36,467.25
|
2025-11-01
|
|
22
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…
|
16
|
6
|
—
|
—
|
$33,000.48
|
$58,781.90
|
$36,393.94
|
2025-11-01
|
|
500
|
MS_DRG
|
Soft Tissue Procedures With Mcc
|
16
|
6
|
—
|
—
|
$32,869.61
|
$58,548.80
|
$36,249.62
|
2025-11-01
|
|
829
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…
|
16
|
6
|
—
|
—
|
$32,819.76
|
$58,460.00
|
$36,194.64
|
2025-11-01
|
|
324
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc
|
16
|
6
|
—
|
—
|
$32,726.29
|
$58,293.50
|
$36,091.56
|
2025-11-01
|
|
229
|
MS_DRG
|
Other Cardiothoracic Procedures Without Mcc
|
16
|
6
|
—
|
—
|
$32,710.71
|
$58,265.75
|
$36,074.37
|
2025-11-01
|
|
K0828NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$34,111.56
|
$37,901.73
|
$36,006.65
|
2025-11-01
|
|
258
|
MS_DRG
|
Cardiac Pacemaker Device Replacement With Mcc
|
16
|
6
|
—
|
—
|
$32,633.85
|
$58,128.85
|
$35,989.62
|
2025-11-01
|
|
665
|
MS_DRG
|
Prostatectomy With Mcc
|
16
|
6
|
—
|
—
|
$32,416.78
|
$57,742.20
|
$35,750.23
|
2025-11-01
|
|
464
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
16
|
6
|
—
|
—
|
$32,349.27
|
$57,621.95
|
$35,675.78
|
2025-11-01
|
|
26
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Cc
|
16
|
6
|
—
|
—
|
$32,292.15
|
$57,520.20
|
$35,612.78
|
2025-11-01
|
|
0211U
|
CPT
|
Onc Pan-tum Dna&rna Gnrj Seq
|
16
|
6
|
—
|
—
|
$2,976.75
|
$48,785.35
|
$35,595.55
|
2025-11-01
|
|
L7170
|
HCPCS
|
Electronic Elbow Hosmer Swit
|
4
|
1
|
—
|
—
|
$33,525.23
|
$37,250.26
|
$35,387.75
|
2025-11-01
|
|
K0850NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$33,513.69
|
$37,237.43
|
$35,375.56
|
2025-11-01
|
|
L8682
|
HCPCS
|
Implt Neurostim Radiofq Rec
|
4
|
1
|
—
|
—
|
$33,459.26
|
$37,176.96
|
$35,318.11
|
2025-11-01
|
|
J9229
|
HCPCS
|
Inotuzumab Ozogamicin 0.9 Mg(0.25 Mg/ml Initial Concentration) IV Soln
|
92
|
20
|
$53,336.70
|
$42,669.36
|
$4,262.92
|
$46,194.92
|
$35,228.89
|
2025-11-01
|
|
662
|
MS_DRG
|
Minor Bladder Procedures With Mcc
|
16
|
6
|
—
|
—
|
$31,796.74
|
$56,637.75
|
$35,066.42
|
2025-11-01
|
|
263
|
MS_DRG
|
Vein Ligation And Stripping
|
16
|
6
|
—
|
—
|
$31,754.16
|
$56,561.90
|
$35,019.46
|
2025-11-01
|
|
L5341
|
HCPCS
|
Hemipelvectomy Canadian Sach
|
4
|
1
|
—
|
—
|
$33,056.20
|
$36,729.11
|
$34,892.65
|
2025-11-01
|
|
469
|
MS_DRG
|
Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…
|
16
|
6
|
—
|
—
|
$31,502.82
|
$56,114.20
|
$34,742.28
|
2025-11-01
|
|
510
|
MS_DRG
|
Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc
|
16
|
6
|
—
|
—
|
$31,370.91
|
$55,879.25
|
$34,596.81
|
2025-11-01
|
|
625
|
MS_DRG
|
Thyroid, Parathyroid And Thyroglossal Procedures With Mcc
|
16
|
6
|
—
|
—
|
$31,366.76
|
$55,871.85
|
$34,592.22
|
2025-11-01
|
|
498
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…
|
16
|
6
|
—
|
—
|
$31,332.48
|
$55,810.80
|
$34,554.43
|
2025-11-01
|
|
K0829NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$32,582.92
|
$36,203.24
|
$34,393.08
|
2025-11-01
|
|
L5270
|
HCPCS
|
Tilt Table Locking Hip Sing
|
4
|
1
|
—
|
—
|
$32,396.31
|
$35,995.90
|
$34,196.11
|
2025-11-01
|
|
173
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…
|
16
|
6
|
—
|
—
|
$30,912.89
|
$55,063.40
|
$34,091.68
|
2025-11-01
|
|
K0851NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$32,223.88
|
$35,804.31
|
$34,014.10
|
2025-11-01
|
|
0315U
|
CPT
|
Onc Cutan Sq Cll Ca Mrna 40
|
12
|
5
|
—
|
—
|
$6,885.00
|
$49,045.00
|
$34,000.00
|
2025-11-01
|
|
E2510UE
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$32,200.60
|
$35,778.45
|
$33,989.52
|
2025-11-01
|
|
472
|
MS_DRG
|
Cervical Spinal Fusion With Cc
|
16
|
6
|
—
|
—
|
$30,598.19
|
$54,502.85
|
$33,744.63
|
2025-11-01
|
|
959
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc
|
16
|
6
|
—
|
—
|
$30,577.42
|
$54,465.85
|
$33,721.72
|
2025-11-01
|
|
570
|
MS_DRG
|
Skin Debridement With Mcc
|
16
|
6
|
—
|
—
|
$30,546.26
|
$54,410.35
|
$33,687.36
|
2025-11-01
|
|
668
|
MS_DRG
|
Transurethral Procedures With Mcc
|
16
|
6
|
—
|
—
|
$30,327.12
|
$54,020.00
|
$33,445.68
|
2025-11-01
|
|
K0857NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$31,634.31
|
$35,149.23
|
$33,391.77
|
2025-11-01
|
|
480
|
MS_DRG
|
Hip And Femur Procedures Except Major Joint With Mcc
|
16
|
6
|
—
|
—
|
$30,247.15
|
$53,877.55
|
$33,357.49
|
2025-11-01
|
|
L7008
|
HCPCS
|
Pediatric Electric Hand
|
4
|
1
|
—
|
—
|
$31,555.27
|
$35,061.41
|
$33,308.34
|
2025-11-01
|
|
353
|
MS_DRG
|
Hernia Procedures Except Inguinal And Femoral With Mcc
|
16
|
6
|
—
|
—
|
$30,140.17
|
$53,687.00
|
$33,239.51
|
2025-11-01
|
|
406
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Cc
|
16
|
6
|
—
|
—
|
$30,121.48
|
$53,653.70
|
$33,218.90
|
2025-11-01
|
|
619
|
MS_DRG
|
O.r. Procedures For Obesity With Mcc
|
16
|
6
|
—
|
—
|
$29,988.54
|
$53,416.90
|
$33,072.28
|
2025-11-01
|
|
974
|
MS_DRG
|
HIV With Major Related Condition With Mcc
|
16
|
6
|
—
|
—
|
$29,974.00
|
$53,391.00
|
$33,056.25
|
2025-11-01
|
|
13
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc
|
16
|
6
|
—
|
—
|
$29,930.37
|
$53,313.30
|
$33,008.14
|
2025-11-01
|
|
A9604
|
HCPCS
|
Sm 153 Lexidronam
|
12
|
5
|
—
|
—
|
$25,726.95
|
$98,381.20
|
$32,891.42
|
2025-11-01
|
|
521
|
MS_DRG
|
Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc
|
16
|
6
|
—
|
—
|
$29,809.90
|
$53,098.70
|
$32,875.28
|
2025-11-01
|
|
K0861NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$31,062.24
|
$34,513.60
|
$32,787.92
|
2025-11-01
|
|
81552
|
CPT
|
Onc Uveal Mlnma Mrna 15 Gene
|
16
|
6
|
—
|
—
|
$6,298.56
|
$44,867.52
|
$32,736.96
|
2025-11-01
|
|
K0856NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$31,012.30
|
$34,458.11
|
$32,735.21
|
2025-11-01
|
|
240
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc
|
16
|
6
|
—
|
—
|
$29,605.29
|
$52,734.25
|
$32,649.63
|
2025-11-01
|
|
E0986NU
|
HCPCS
|
Other Outpatient
|
4
|
1
|
—
|
—
|
$30,857.13
|
$34,285.70
|
$32,571.42
|
2025-11-01
|
|
L5331
|
HCPCS
|
Hip Disart Canadian Sach Ft
|
4
|
1
|
—
|
—
|
$30,528.52
|
$33,920.58
|
$32,224.55
|
2025-11-01
|
|
800
|
MS_DRG
|
Splenic Procedures With Cc
|
16
|
6
|
—
|
—
|
$29,178.43
|
$51,973.90
|
$32,178.87
|
2025-11-01
|
|
654
|
MS_DRG
|
Major Bladder Procedures With Cc
|
16
|
6
|
—
|
—
|
$29,073.53
|
$51,787.05
|
$32,063.19
|
2025-11-01
|
|
503
|
MS_DRG
|
Foot Procedures With Mcc
|
16
|
6
|
—
|
—
|
$28,988.36
|
$51,635.35
|
$31,969.26
|
2025-11-01
|
|
0094U
|
CPT
|
Genome Rapid Sequence Alys
|
16
|
6
|
—
|
—
|
$6,141.58
|
$43,749.29
|
$31,921.07
|
2025-11-01
|
|
483
|
MS_DRG
|
Major Joint Or Limb Reattachment Procedures Of Upper Extremities
|
16
|
6
|
—
|
—
|
$28,788.95
|
$51,280.15
|
$31,749.34
|
2025-11-01
|
|
J2350
|
HCPCS
|
Ocrelizumab 30 Mg/ml Intravenous Solution
|
92
|
20
|
$48,058.36
|
$38,446.69
|
$94.33
|
$41,623.35
|
$31,742.55
|
2025-11-01
|