|
J1414
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
6
|
6
|
—
|
$4,435,230.80
|
$4,435,230.80
|
$4,435,230.80
|
$4,435,230.80
|
2025-11-26
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
8
|
7
|
—
|
$4,405,662.60
|
$2,193.33
|
$4,405,662.60
|
$4,405,662.60
|
2025-11-26
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
8
|
7
|
—
|
$3,971,950.38
|
$2,202.48
|
$3,974,459.22
|
$3,974,459.22
|
2025-11-26
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
6
|
6
|
—
|
$3,928,347.28
|
$3,898,884.68
|
$3,898,884.68
|
$3,898,884.68
|
2025-11-26
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
6
|
6
|
—
|
$3,524,530.07
|
$3,527,486.90
|
$3,527,486.90
|
$3,527,486.90
|
2025-11-26
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
8
|
7
|
—
|
$2,896,804.92
|
$3,726.06
|
$2,931,455.16
|
$2,931,455.16
|
2025-11-26
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
6
|
6
|
—
|
$2,787,859.36
|
$2,787,859.36
|
$2,787,859.36
|
$2,787,859.36
|
2025-11-26
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
6
|
6
|
—
|
$921,260.80
|
$921,260.80
|
$921,260.80
|
$921,260.80
|
2025-11-26
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel Car-pos T
|
12
|
9
|
—
|
$691,909.30
|
$5,784.95
|
$1,306,591.06
|
$691,375.47
|
2025-11-26
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
12
|
9
|
—
|
$661,302.83
|
$5,816.98
|
$1,273,545.36
|
$661,553.32
|
2025-11-26
|
|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
12
|
9
|
—
|
$617,396.43
|
$5,807.83
|
$1,193,082.58
|
$647,514.60
|
2025-11-26
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel Car
|
12
|
9
|
—
|
$630,762.10
|
$5,812.41
|
$1,220,401.71
|
$647,066.04
|
2025-11-26
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Car+
|
12
|
9
|
—
|
$601,136.04
|
$5,780.38
|
$1,130,784.62
|
$637,282.27
|
2025-11-26
|
|
Q2053
|
HCPCS
|
Brexucabtagene Car Pos T
|
12
|
9
|
—
|
$585,066.91
|
$5,803.26
|
$1,127,398.99
|
$585,450.47
|
2025-11-26
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
15
|
10
|
—
|
—
|
$285,631.75
|
$643,842.83
|
$406,479.00
|
2025-11-26
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
11
|
10
|
—
|
—
|
$382,347.56
|
$862,001.47
|
$382,347.56
|
2025-11-26
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
15
|
10
|
—
|
—
|
$240,584.85
|
$542,232.04
|
$353,079.72
|
2025-11-26
|
|
Q2058
|
HCPCS
|
Obecbtge Autol Up To 400 Mil
|
6
|
6
|
—
|
—
|
$323,227.91
|
$323,227.91
|
$323,227.91
|
2025-11-26
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
15
|
10
|
—
|
—
|
$217,367.79
|
$489,862.08
|
$319,804.50
|
2025-11-26
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
15
|
10
|
—
|
—
|
$143,379.62
|
$322,969.41
|
$204,371.44
|
2025-11-26
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
15
|
10
|
—
|
—
|
$111,862.50
|
$255,778.00
|
$191,834.00
|
2025-11-26
|
|
7
|
MS_DRG
|
Lung Transplant
|
15
|
10
|
—
|
—
|
$132,626.32
|
$298,713.56
|
$183,996.00
|
2025-11-26
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
15
|
10
|
—
|
—
|
$107,556.92
|
$242,165.34
|
$176,398.00
|
2025-11-26
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
15
|
10
|
—
|
—
|
$132,960.72
|
$299,467.84
|
$174,600.00
|
2025-11-26
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
15
|
10
|
—
|
—
|
$108,110.19
|
$243,413.34
|
$155,250.00
|
2025-11-26
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
15
|
10
|
—
|
—
|
$97,994.27
|
$220,595.19
|
$145,579.50
|
2025-11-26
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
15
|
10
|
—
|
—
|
$81,882.57
|
$197,505.00
|
$142,907.18
|
2025-11-26
|
|
J7330
|
HCPCS
|
Cultured Chondrocytes Implnt
|
7
|
4
|
—
|
—
|
$4,215.62
|
$203,403.14
|
$140,603.27
|
2025-11-26
|
|
453
|
MS_DRG
|
Combined Anterior And Posterior Spinal Fusion With Mcc
|
1
|
1
|
—
|
—
|
$132,921.00
|
$132,921.00
|
$132,921.00
|
2025-11-26
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
15
|
10
|
—
|
—
|
$86,017.91
|
$193,580.50
|
$126,441.00
|
2025-11-26
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
15
|
10
|
—
|
—
|
$86,065.53
|
$193,687.93
|
$121,728.00
|
2025-11-26
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization With Mcc
|
15
|
10
|
—
|
—
|
$79,402.99
|
$178,659.45
|
$116,994.00
|
2025-11-26
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
15
|
10
|
—
|
—
|
$78,603.49
|
$176,856.04
|
$115,668.00
|
2025-11-26
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve?procedures
|
9
|
8
|
—
|
—
|
$110,587.75
|
$249,001.87
|
$110,587.75
|
2025-11-26
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
15
|
10
|
—
|
—
|
$75,834.10
|
$170,609.22
|
$108,487.50
|
2025-11-26
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
8
|
7
|
—
|
—
|
$106,347.03
|
$239,436.22
|
$106,347.03
|
2025-11-26
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
15
|
10
|
—
|
—
|
$70,689.50
|
$159,004.72
|
$104,473.50
|
2025-11-26
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
15
|
10
|
—
|
—
|
$67,876.54
|
$152,659.62
|
$103,795.50
|
2025-11-26
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
15
|
10
|
—
|
—
|
$67,762.03
|
$152,401.33
|
$102,820.50
|
2025-11-26
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
15
|
10
|
—
|
—
|
$64,283.33
|
$144,554.53
|
$102,731.00
|
2025-11-26
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
15
|
10
|
—
|
—
|
$65,731.35
|
$147,820.79
|
$101,543.06
|
2025-11-26
|
|
459
|
MS_DRG
|
Spinal Fusion Except Cervical With Mcc
|
1
|
1
|
—
|
—
|
$99,484.50
|
$99,484.50
|
$99,484.50
|
2025-11-26
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
15
|
10
|
—
|
—
|
$56,207.21
|
$151,012.00
|
$97,987.97
|
2025-11-26
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement W Mcc
|
15
|
10
|
—
|
—
|
$60,903.92
|
$136,931.72
|
$97,485.00
|
2025-11-26
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
15
|
10
|
—
|
—
|
$65,637.11
|
$147,608.22
|
$95,479.50
|
2025-11-26
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc
|
15
|
10
|
—
|
—
|
$62,382.35
|
$140,266.55
|
$95,226.28
|
2025-11-26
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
15
|
10
|
—
|
—
|
$61,360.93
|
$137,962.57
|
$94,252.00
|
2025-11-26
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
8
|
7
|
—
|
—
|
$93,543.80
|
$210,556.40
|
$93,543.80
|
2025-11-26
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
15
|
10
|
—
|
—
|
$62,600.21
|
$140,757.98
|
$93,271.50
|
2025-11-26
|
|
454
|
MS_DRG
|
Combined Anterior And Posterior Spinal Fusion With Cc
|
1
|
1
|
—
|
—
|
$91,744.50
|
$91,744.50
|
$91,744.50
|
2025-11-26
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
15
|
10
|
—
|
—
|
$69,390.43
|
$156,074.45
|
$91,353.00
|
2025-11-26
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
15
|
10
|
—
|
—
|
$58,356.45
|
$131,185.47
|
$91,129.50
|
2025-11-26
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
15
|
10
|
—
|
—
|
$59,196.49
|
$133,080.31
|
$90,700.50
|
2025-11-26
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
15
|
10
|
—
|
—
|
$61,802.73
|
$138,959.13
|
$90,391.50
|
2025-11-26
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
15
|
10
|
—
|
—
|
$60,437.80
|
$135,880.29
|
$90,001.50
|
2025-11-26
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
15
|
10
|
—
|
—
|
$62,098.62
|
$139,626.56
|
$89,229.00
|
2025-11-26
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
15
|
10
|
—
|
—
|
$59,823.73
|
$134,495.16
|
$88,209.00
|
2025-11-26
|
|
JO475
|
HCPCS
|
Baclofen Inj
|
11
|
7
|
$128,053.11
|
—
|
$3,200.00
|
$123,571.25
|
$86,858.42
|
2025-11-26
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
15
|
10
|
—
|
—
|
$50,694.78
|
$114,738.00
|
$86,053.00
|
2025-11-26
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
15
|
10
|
—
|
—
|
$60,483.40
|
$135,983.15
|
$85,450.50
|
2025-11-26
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
15
|
10
|
—
|
—
|
$54,869.63
|
$123,320.37
|
$85,246.50
|
2025-11-26
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
15
|
10
|
—
|
—
|
$58,008.88
|
$130,401.47
|
$85,032.00
|
2025-11-26
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
15
|
10
|
—
|
—
|
$54,927.39
|
$123,450.66
|
$84,955.50
|
2025-11-26
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
8
|
7
|
—
|
—
|
$84,714.79
|
$190,641.09
|
$84,714.79
|
2025-11-26
|
|
834
|
MS_DRG
|
Acute Leukemia Without Major O.r. Procedures With Mcc
|
15
|
10
|
—
|
—
|
$56,207.21
|
$126,337.50
|
$83,985.00
|
2025-11-26
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
15
|
10
|
—
|
—
|
$55,208.08
|
$124,083.80
|
$82,578.00
|
2025-11-26
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
15
|
10
|
—
|
—
|
$50,936.96
|
$114,449.57
|
$82,008.00
|
2025-11-26
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
15
|
10
|
—
|
—
|
$56,686.51
|
$127,418.63
|
$81,204.00
|
2025-11-26
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
15
|
10
|
—
|
—
|
$54,429.00
|
$182,238.86
|
$80,989.84
|
2025-11-26
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
11
|
10
|
—
|
—
|
$80,526.76
|
$181,194.30
|
$80,526.76
|
2025-11-26
|
|
Q2043
|
HCPCS
|
Sipuleucel-t Auto Cd54+
|
17
|
9
|
—
|
$68,162.80
|
$5,789.53
|
$176,194.24
|
$79,823.94
|
2025-11-26
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
15
|
10
|
—
|
—
|
$55,333.73
|
$124,367.22
|
$78,925.50
|
2025-11-26
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
15
|
10
|
—
|
—
|
$60,880.00
|
$137,962.57
|
$78,736.77
|
2025-11-26
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
15
|
10
|
—
|
—
|
$53,870.51
|
$121,066.67
|
$78,669.00
|
2025-11-26
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Without Mcc
|
15
|
10
|
—
|
—
|
$54,108.63
|
$121,603.81
|
$77,968.50
|
2025-11-26
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement Without Mcc
|
15
|
10
|
—
|
—
|
$47,871.68
|
$107,535.33
|
$77,693.00
|
2025-11-26
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
15
|
10
|
—
|
—
|
$54,875.71
|
$123,334.09
|
$77,344.50
|
2025-11-26
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
15
|
10
|
—
|
—
|
$51,664.52
|
$116,090.70
|
$76,185.00
|
2025-11-26
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
15
|
10
|
—
|
—
|
$52,211.71
|
$117,324.98
|
$75,853.50
|
2025-11-26
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
15
|
10
|
—
|
—
|
$50,877.17
|
$114,314.71
|
$74,989.50
|
2025-11-26
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
15
|
10
|
—
|
—
|
$48,379.35
|
$108,680.46
|
$74,319.00
|
2025-11-26
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
15
|
10
|
—
|
—
|
$49,418.00
|
$111,023.31
|
$73,785.00
|
2025-11-26
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
15
|
10
|
—
|
—
|
$49,335.92
|
$110,838.16
|
$72,553.50
|
2025-11-26
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
8
|
7
|
—
|
—
|
$72,170.97
|
$162,346.41
|
$72,170.97
|
2025-11-26
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
15
|
10
|
—
|
—
|
$51,237.91
|
$115,128.42
|
$72,102.00
|
2025-11-26
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
9
|
8
|
—
|
—
|
$71,809.21
|
$161,530.42
|
$71,809.21
|
2025-11-26
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
15
|
10
|
—
|
—
|
$49,716.93
|
$111,697.59
|
$71,290.00
|
2025-11-26
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
15
|
10
|
—
|
—
|
$48,370.23
|
$108,659.89
|
$71,106.00
|
2025-11-26
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
15
|
10
|
—
|
—
|
$46,903.97
|
$105,352.48
|
$70,704.00
|
2025-11-26
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
17
|
10
|
—
|
—
|
$51,822.60
|
$116,447.27
|
$69,802.00
|
2025-11-26
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
15
|
10
|
—
|
—
|
$46,735.76
|
$104,973.06
|
$69,729.00
|
2025-11-26
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
15
|
10
|
—
|
—
|
$48,589.11
|
$109,153.60
|
$69,415.50
|
2025-11-26
|
|
455
|
MS_DRG
|
Combined Anterior And Posterior Spinal Fusion Without Cc/mcc
|
1
|
1
|
—
|
—
|
$69,084.00
|
$69,084.00
|
$69,084.00
|
2025-11-26
|
|
90288
|
HCPCS
|
Botulism Ig IV
|
1
|
1
|
—
|
—
|
$68,187.00
|
$68,187.00
|
$68,187.00
|
2025-11-26
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
8
|
7
|
—
|
—
|
$68,137.97
|
$153,249.33
|
$68,137.97
|
2025-11-26
|
|
458
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
15
|
10
|
—
|
—
|
$43,953.20
|
$98,696.53
|
$67,965.00
|
2025-11-26
|
|
A9543
|
HCPCS
|
Y90 Ibritumomab, Rx
|
12
|
7
|
—
|
$67,932.61
|
$587.40
|
$206,439.73
|
$67,932.61
|
2025-11-26
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
15
|
10
|
—
|
—
|
$46,728.66
|
$104,957.06
|
$67,752.00
|
2025-11-26
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
15
|
10
|
—
|
—
|
$47,616.33
|
$106,959.33
|
$67,528.50
|
2025-11-26
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
15
|
10
|
—
|
—
|
$45,914.97
|
$103,121.64
|
$66,426.00
|
2025-11-26
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
15
|
10
|
—
|
—
|
$45,516.74
|
$102,223.36
|
$66,240.00
|
2025-11-26
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
15
|
10
|
—
|
—
|
$44,711.16
|
$100,406.23
|
$65,428.50
|
2025-11-26
|
|
C1820
|
HCPCS
|
Generator Neuro Rechg Bat Sys
|
49
|
8
|
$97,674.00
|
—
|
$3,200.00
|
$168,113.62
|
$65,216.63
|
2025-11-26
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
15
|
10
|
—
|
—
|
$45,093.18
|
$101,267.94
|
$64,917.00
|
2025-11-26
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
15
|
10
|
—
|
—
|
$45,642.39
|
$102,506.79
|
$64,542.00
|
2025-11-26
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
15
|
10
|
—
|
—
|
$43,423.23
|
$97,501.10
|
$64,180.50
|
2025-11-26
|
|
J9226
|
HCPCS
|
Supprelin La Implant
|
17
|
9
|
—
|
$54,050.09
|
$5,158.14
|
$139,714.25
|
$63,296.86
|
2025-11-26
|
|
793
|
MS_DRG
|
Full Term Neonate With Major Problems
|
15
|
10
|
—
|
—
|
$42,458.56
|
$95,325.12
|
$63,139.50
|
2025-11-26
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc
|
9
|
8
|
—
|
—
|
$62,967.03
|
$141,585.40
|
$62,967.03
|
2025-11-26
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
8
|
7
|
—
|
—
|
$62,885.96
|
$141,402.54
|
$62,885.96
|
2025-11-26
|
|
22
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…
|
15
|
10
|
—
|
—
|
$35,972.33
|
$90,015.00
|
$62,586.93
|
2025-11-26
|
|
269
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
15
|
10
|
—
|
—
|
$42,359.25
|
$95,101.12
|
$62,379.00
|
2025-11-26
|
|
31
|
MS_DRG
|
Ventricular Shunt Procedures With Mcc
|
15
|
10
|
—
|
—
|
$42,662.23
|
$95,784.54
|
$61,749.00
|
2025-11-26
|
|
791
|
MS_DRG
|
Prematurity With Major Problems
|
15
|
10
|
—
|
—
|
$41,337.83
|
$92,797.13
|
$61,465.50
|
2025-11-26
|
|
166
|
MS_DRG
|
Other Respiratory System O.r. Procedures With Mcc
|
15
|
10
|
—
|
—
|
$39,213.92
|
$88,006.31
|
$60,867.00
|
2025-11-26
|
|
958
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
15
|
10
|
—
|
—
|
$41,843.48
|
$93,937.70
|
$60,672.00
|
2025-11-26
|
|
236
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
15
|
10
|
—
|
—
|
$41,866.78
|
$93,990.27
|
$60,618.00
|
2025-11-26
|
|
628
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
15
|
10
|
—
|
—
|
$40,180.63
|
$90,186.86
|
$60,217.50
|
2025-11-26
|
|
12
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
15
|
10
|
—
|
—
|
$41,781.66
|
$93,798.27
|
$60,073.50
|
2025-11-26
|
|
467
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Cc
|
17
|
10
|
—
|
—
|
$34,906.32
|
$78,289.80
|
$59,419.00
|
2025-11-26
|
|
616
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
15
|
10
|
—
|
—
|
$39,362.88
|
$88,342.31
|
$59,365.50
|
2025-11-26
|
|
736
|
MS_DRG
|
Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc
|
15
|
10
|
—
|
—
|
$40,098.55
|
$90,001.72
|
$59,149.00
|
2025-11-26
|
|
423
|
MS_DRG
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
15
|
10
|
—
|
—
|
$41,413.83
|
$92,968.56
|
$58,663.50
|
2025-11-26
|
|
34
|
MS_DRG
|
Carotid Artery Stent Procedures With Mcc
|
15
|
10
|
—
|
—
|
$39,603.04
|
$88,884.02
|
$58,521.00
|
2025-11-26
|
|
956
|
MS_DRG
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
15
|
10
|
—
|
—
|
$38,931.21
|
$87,368.60
|
$58,173.00
|
2025-11-26
|
|
40
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
15
|
10
|
—
|
—
|
$38,421.51
|
$86,218.89
|
$57,757.50
|
2025-11-26
|
|
622
|
MS_DRG
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
15
|
10
|
—
|
—
|
$38,116.50
|
$85,530.89
|
$57,384.00
|
2025-11-26
|
|
24
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
15
|
10
|
—
|
—
|
$38,721.45
|
$86,895.46
|
$56,832.00
|
2025-11-26
|
|
876
|
MS_DRG
|
O.r. Procedures With Principal Diagnosis Of Mental Illness
|
15
|
10
|
—
|
—
|
$40,017.48
|
$89,818.87
|
$55,972.50
|
2025-11-26
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
8
|
7
|
—
|
—
|
$55,972.12
|
$125,807.21
|
$55,972.12
|
2025-11-26
|
|
408
|
MS_DRG
|
Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…
|
15
|
10
|
—
|
—
|
$35,677.46
|
$80,029.21
|
$55,833.00
|
2025-11-26
|
|
907
|
MS_DRG
|
Other O.r. Procedures For Injuries With Mcc
|
15
|
10
|
—
|
—
|
$40,565.69
|
$91,055.43
|
$55,792.50
|
2025-11-26
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
8
|
7
|
—
|
—
|
$55,631.65
|
$125,039.22
|
$55,631.65
|
2025-11-26
|
|
673
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Mcc
|
15
|
10
|
—
|
—
|
$42,652.10
|
$95,761.69
|
$55,470.00
|
2025-11-26
|
|
335
|
MS_DRG
|
Peritoneal Adhesiolysis With Mcc
|
15
|
10
|
—
|
—
|
$36,914.71
|
$82,820.05
|
$55,373.00
|
2025-11-26
|
|
229
|
MS_DRG
|
Other Cardiothoracic Procedures Without Mcc
|
15
|
10
|
—
|
—
|
$31,674.86
|
$74,923.00
|
$55,068.49
|
2025-11-26
|
|
460
|
MS_DRG
|
Spinal Fusion Except Cervical Without Mcc
|
1
|
1
|
—
|
—
|
$54,868.50
|
$54,868.50
|
$54,868.50
|
2025-11-26
|
|
332
|
MS_DRG
|
Rectal Resection With Mcc
|
15
|
10
|
—
|
—
|
$35,347.12
|
$79,284.08
|
$54,814.50
|
2025-11-26
|
|
518
|
MS_DRG
|
Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…
|
15
|
10
|
—
|
—
|
$36,515.47
|
$81,919.49
|
$54,777.00
|
2025-11-26
|
|
273
|
MS_DRG
|
Percutaneous Intracardiac Procedures W Mcc
|
18
|
10
|
—
|
—
|
$39,821.91
|
$89,377.73
|
$54,622.50
|
2025-11-26
|
|
97
|
MS_DRG
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc
|
15
|
10
|
—
|
—
|
$36,521.55
|
$81,933.20
|
$54,553.50
|
2025-11-26
|
|
94
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System With Mcc
|
15
|
10
|
—
|
—
|
$37,171.08
|
$83,398.34
|
$54,340.50
|
2025-11-26
|
|
739
|
MS_DRG
|
Uterine,adnexa Proc For Non-ovarian/adnexal Malig W Mcc
|
15
|
10
|
—
|
—
|
$40,537.31
|
$90,991.43
|
$54,244.50
|
2025-11-26
|
|
0266T
|
HCPCS
|
Implt/rpl Crtd Sns Dev Total
|
8
|
7
|
—
|
$53,797.20
|
$8,119.00
|
$53,797.20
|
$53,797.20
|
2025-11-26
|
|
33276
|
HCPCS
|
Insj Phrnc Nrv Stim Sys
|
10
|
9
|
—
|
$53,797.20
|
$7,569.00
|
$53,797.20
|
$53,797.20
|
2025-11-26
|
|
495
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…
|
15
|
10
|
—
|
—
|
$35,873.03
|
$80,470.35
|
$53,718.00
|
2025-11-26
|
|
265
|
MS_DRG
|
Aicd Lead Procedures
|
15
|
10
|
—
|
—
|
$36,345.23
|
$81,535.49
|
$53,011.50
|
2025-11-26
|
|
414
|
MS_DRG
|
Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc
|
15
|
10
|
—
|
—
|
$35,702.79
|
$80,086.36
|
$52,878.00
|
2025-11-26
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
8
|
7
|
—
|
—
|
$52,384.99
|
$117,715.84
|
$52,384.99
|
2025-11-26
|
|
492
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc
|
15
|
10
|
—
|
—
|
$36,183.10
|
$81,169.78
|
$51,931.50
|
2025-11-26
|
|
271
|
MS_DRG
|
Other Major Cardiovascular Procedures With Cc
|
15
|
10
|
—
|
—
|
$35,100.88
|
$78,728.65
|
$51,843.00
|
2025-11-26
|
|
242
|
MS_DRG
|
Permanent Cardiac Pacemaker Implant With Mcc
|
15
|
10
|
—
|
—
|
$34,569.90
|
$77,530.94
|
$51,826.50
|
2025-11-26
|
|
802
|
MS_DRG
|
Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc
|
15
|
10
|
—
|
—
|
$36,523.57
|
$81,937.77
|
$51,462.00
|
2025-11-26
|
|
29
|
MS_DRG
|
Spinal Procedures With Cc Or Spinal Neurostimulators
|
15
|
10
|
—
|
—
|
$34,212.20
|
$76,724.09
|
$51,423.00
|
2025-11-26
|
|
574
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Cc
|
15
|
10
|
—
|
—
|
$35,308.61
|
$79,197.22
|
$51,087.00
|
2025-11-26
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
9
|
8
|
—
|
—
|
$50,897.44
|
$114,360.43
|
$50,897.44
|
2025-11-26
|
|
987
|
MS_DRG
|
Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
15
|
10
|
—
|
—
|
$35,691.64
|
$80,061.21
|
$50,650.50
|
2025-11-26
|
|
260
|
MS_DRG
|
Cardiac Pacemaker Revision Except Device Replacement With Mcc
|
15
|
10
|
—
|
—
|
$34,713.79
|
$77,855.51
|
$50,644.00
|
2025-11-26
|
|
37
|
MS_DRG
|
Extracranial Procedures With Mcc
|
15
|
10
|
—
|
—
|
$33,849.44
|
$75,905.81
|
$50,634.00
|
2025-11-26
|
|
477
|
MS_DRG
|
Biopsies Of Musculoskeletal System And Connective Tissue With Mcc
|
15
|
10
|
—
|
—
|
$35,046.16
|
$78,605.22
|
$50,535.00
|
2025-11-26
|
|
619
|
MS_DRG
|
O.r. Procedures For Obesity With Mcc
|
18
|
10
|
—
|
—
|
$27,826.30
|
$62,442.73
|
$50,486.60
|
2025-11-26
|
|
252
|
MS_DRG
|
Other Vascular Procedures With Mcc
|
15
|
10
|
—
|
—
|
$34,959.02
|
$78,408.65
|
$50,307.00
|
2025-11-26
|
|
579
|
MS_DRG
|
Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc
|
15
|
10
|
—
|
—
|
$33,226.25
|
$74,500.11
|
$50,133.00
|
2025-11-26
|
|
939
|
MS_DRG
|
O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc
|
15
|
10
|
—
|
—
|
$32,360.88
|
$72,548.12
|
$50,025.00
|
2025-11-26
|
|
485
|
MS_DRG
|
Knee Procedures With Principal Diagnosis Of Infection With Mcc
|
15
|
10
|
—
|
—
|
$32,819.91
|
$73,583.54
|
$49,410.00
|
2025-11-26
|
|
264
|
MS_DRG
|
Other Circulatory System O.r. Procedures
|
15
|
10
|
—
|
—
|
$35,614.63
|
$79,887.50
|
$48,990.00
|
2025-11-26
|
|
904
|
MS_DRG
|
Skin Grafts For Injuries With Cc/mcc
|
15
|
10
|
—
|
—
|
$39,323.36
|
$88,253.16
|
$48,843.00
|
2025-11-26
|
|
469
|
MS_DRG
|
Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc
|
17
|
10
|
—
|
—
|
$33,320.49
|
$74,712.68
|
$48,801.00
|
2025-11-26
|
|
500
|
MS_DRG
|
Soft Tissue Procedures With Mcc
|
15
|
10
|
—
|
—
|
$32,307.17
|
$72,426.98
|
$48,642.00
|
2025-11-26
|
|
411
|
MS_DRG
|
Cholecystectomy With C.d.e. With Mcc
|
15
|
10
|
—
|
—
|
$27,926.61
|
$69,912.00
|
$48,510.90
|
2025-11-26
|
|
929
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc
|
15
|
10
|
—
|
—
|
$32,425.73
|
$72,694.40
|
$48,232.50
|
2025-11-26
|
|
420
|
MS_DRG
|
Hepatobiliary Diagnostic Procedures With Mcc
|
15
|
10
|
—
|
—
|
$35,963.21
|
$80,673.78
|
$48,012.00
|
2025-11-26
|
|
515
|
MS_DRG
|
Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc
|
15
|
10
|
—
|
—
|
$31,534.01
|
$70,682.99
|
$47,422.50
|
2025-11-26
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
9
|
8
|
—
|
—
|
$47,336.65
|
$106,328.48
|
$47,336.65
|
2025-11-26
|
|
829
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…
|
15
|
10
|
—
|
—
|
$31,446.87
|
$70,486.42
|
$47,307.00
|
2025-11-26
|
|
274
|
MS_DRG
|
Percutaneous Intracardiac Procedures Without Mcc
|
18
|
10
|
—
|
—
|
$31,823.82
|
$71,336.70
|
$47,196.00
|
2025-11-26
|
|
656
|
MS_DRG
|
Kidney And Ureter Procedures For Neoplasm With Mcc
|
15
|
10
|
—
|
—
|
$33,212.06
|
$74,468.11
|
$47,064.00
|
2025-11-26
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
11
|
10
|
—
|
—
|
$46,884.72
|
$105,309.06
|
$46,884.72
|
2025-11-26
|
|
840
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Mcc
|
15
|
10
|
—
|
—
|
$32,512.88
|
$72,890.97
|
$46,878.00
|
2025-11-26
|
|
468
|
MS_DRG
|
Revision Of Hip Or Knee Replacement Without Cc/mcc
|
17
|
10
|
—
|
—
|
$26,780.56
|
$59,960.77
|
$46,505.86
|
2025-11-26
|
|
665
|
MS_DRG
|
Prostatectomy With Mcc
|
15
|
10
|
—
|
—
|
$34,991.44
|
$78,481.80
|
$46,336.50
|
2025-11-26
|
|
652
|
MS_DRG
|
Kidney Transplant
|
15
|
10
|
—
|
—
|
$31,321.22
|
$70,202.99
|
$46,336.00
|
2025-11-26
|
|
C1767
|
HCPCS
|
Ans Pain Pump 3608
|
25
|
8
|
$76,883.00
|
—
|
$3,200.00
|
$118,914.06
|
$45,952.70
|
2025-11-26
|
|
933
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
15
|
10
|
—
|
—
|
$42,986.00
|
$98,899.95
|
$45,480.00
|
2025-11-26
|
|
464
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
15
|
10
|
—
|
—
|
$30,076.87
|
$67,396.15
|
$45,021.00
|
2025-11-26
|
|
662
|
MS_DRG
|
Minor Bladder Procedures With Mcc
|
15
|
10
|
—
|
—
|
$31,809.64
|
$71,304.70
|
$44,950.50
|
2025-11-26
|
|
472
|
MS_DRG
|
Cervical Spinal Fusion With Cc
|
15
|
10
|
—
|
—
|
$29,556.02
|
$66,221.30
|
$44,331.00
|
2025-11-26
|
|
26
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Cc
|
15
|
10
|
—
|
—
|
$31,191.51
|
$69,910.42
|
$44,296.50
|
2025-11-26
|
|
480
|
MS_DRG
|
Hip And Femur Procedures Except Major Joint With Mcc
|
15
|
10
|
—
|
—
|
$29,999.86
|
$67,222.44
|
$44,233.50
|
2025-11-26
|
|
353
|
MS_DRG
|
Hernia Procedures Except Inguinal And Femoral With Mcc
|
15
|
10
|
—
|
—
|
$29,918.79
|
$67,039.58
|
$43,864.50
|
2025-11-26
|
|
570
|
MS_DRG
|
Skin Debridement With Mcc
|
15
|
10
|
—
|
—
|
$30,701.07
|
$68,804.14
|
$43,833.00
|
2025-11-26
|
|
625
|
MS_DRG
|
Thyroid, Parathyroid And Thyroglossal Procedures With Mcc
|
15
|
10
|
—
|
—
|
$29,251.02
|
$65,533.30
|
$43,818.00
|
2025-11-26
|
|
974
|
MS_DRG
|
HIV With Major Related Condition With Mcc
|
15
|
10
|
—
|
—
|
$30,457.87
|
$68,255.57
|
$43,747.50
|
2025-11-26
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
9
|
8
|
—
|
—
|
$43,359.39
|
$97,357.11
|
$43,359.39
|
2025-11-26
|
|
406
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Cc
|
15
|
10
|
—
|
—
|
$28,656.20
|
$64,191.60
|
$43,311.00
|
2025-11-26
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
11
|
10
|
—
|
—
|
$43,053.37
|
$96,666.82
|
$43,053.37
|
2025-11-26
|
|
462
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procs Of Lower Extremity Without Mcc
|
15
|
10
|
—
|
—
|
$29,217.58
|
$65,457.88
|
$42,934.00
|
2025-11-26
|
|
668
|
MS_DRG
|
Transurethral Procedures With Mcc
|
15
|
10
|
—
|
—
|
$29,749.57
|
$66,657.87
|
$42,270.00
|
2025-11-26
|
|
800
|
MS_DRG
|
Splenic Procedures With Cc
|
15
|
10
|
—
|
—
|
$29,724.23
|
$66,600.73
|
$42,265.50
|
2025-11-26
|
|
240
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc
|
15
|
10
|
—
|
—
|
$29,708.02
|
$66,564.16
|
$42,138.00
|
2025-11-26
|
|
61
|
MS_DRG
|
Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…
|
15
|
10
|
—
|
—
|
$27,592.22
|
$61,791.61
|
$42,042.00
|
2025-11-26
|
|
258
|
MS_DRG
|
Cardiac Pacemaker Device Replacement With Mcc
|
15
|
10
|
—
|
—
|
$28,626.81
|
$64,125.31
|
$41,871.00
|
2025-11-26
|
|
0620T
|
HCPCS
|
Evasc Ven Artlz Tibl/prnl Vn
|
10
|
7
|
—
|
$41,842.40
|
$6,343.00
|
$41,842.40
|
$41,842.40
|
2025-11-26
|
|
263
|
MS_DRG
|
Vein Ligation And Stripping
|
15
|
10
|
—
|
—
|
$27,376.38
|
$61,304.76
|
$41,763.74
|
2025-11-26
|
|
970
|
MS_DRG
|
HIV With Extensive O.r. Procedures Without Mcc
|
15
|
10
|
—
|
—
|
$27,084.55
|
$60,646.48
|
$41,694.00
|
2025-11-26
|
|
448
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical Without Mcc
|
8
|
7
|
—
|
—
|
$41,576.97
|
$93,336.56
|
$41,576.97
|
2025-11-26
|
|
255
|
MS_DRG
|
Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc
|
15
|
10
|
—
|
—
|
$26,711.65
|
$59,805.34
|
$41,211.00
|
2025-11-26
|
|
344
|
MS_DRG
|
Minor Small And Large Bowel Procedures With Mcc
|
15
|
10
|
—
|
—
|
$27,502.03
|
$61,588.19
|
$41,106.00
|
2025-11-26
|
|
654
|
MS_DRG
|
Major Bladder Procedures With Cc
|
15
|
10
|
—
|
—
|
$28,795.02
|
$64,504.74
|
$41,062.50
|
2025-11-26
|
|
963
|
MS_DRG
|
Other Multiple Significant Trauma With Mcc
|
15
|
10
|
—
|
—
|
$27,726.99
|
$62,095.61
|
$41,014.50
|
2025-11-26
|
|
510
|
MS_DRG
|
Shoulder,elbow Or Forearm Proc,exc Major Joint Proc W Mcc
|
15
|
10
|
—
|
—
|
$29,159.82
|
$65,327.59
|
$40,809.00
|
2025-11-26
|
|
208
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support <=96 Hours
|
15
|
10
|
—
|
—
|
$27,393.61
|
$61,343.62
|
$40,557.00
|
2025-11-26
|
|
13
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc
|
15
|
10
|
—
|
—
|
$27,051.11
|
$60,571.05
|
$40,285.50
|
2025-11-26
|
|
503
|
MS_DRG
|
Foot Procedures With Mcc
|
15
|
10
|
—
|
—
|
$27,016.66
|
$60,493.34
|
$40,228.50
|
2025-11-26
|
|
402
|
MS_DRG
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
8
|
7
|
—
|
—
|
$39,841.17
|
$89,421.16
|
$39,841.17
|
2025-11-26
|
|
135
|
MS_DRG
|
Sinus And Mastoid Procedures With Cc/mcc
|
15
|
10
|
—
|
—
|
$24,630.30
|
$55,110.51
|
$39,781.50
|
2025-11-26
|
|
577
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Cc
|
15
|
10
|
—
|
—
|
$27,180.81
|
$60,863.62
|
$39,736.50
|
2025-11-26
|
|
C1882
|
HCPCS
|
Bi VicD Is1/df1 #25139
|
47
|
8
|
$43,919.64
|
—
|
$3,200.00
|
$64,804.58
|
$39,487.57
|
2025-11-26
|
|
498
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…
|
15
|
10
|
—
|
—
|
$25,783.45
|
$57,711.64
|
$39,165.00
|
2025-11-26
|
|
288
|
MS_DRG
|
Acute And Subacute Endocarditis With Mcc
|
15
|
10
|
—
|
—
|
$27,876.96
|
$62,433.90
|
$38,895.00
|
2025-11-26
|
|
659
|
MS_DRG
|
Kidney And Ureter Procedures For Non-neoplasm With Mcc
|
15
|
10
|
—
|
—
|
$26,385.36
|
$59,069.35
|
$38,833.50
|
2025-11-26
|
|
959
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc
|
15
|
10
|
—
|
—
|
$26,989.30
|
$60,431.62
|
$38,336.00
|
2025-11-26
|
|
0571T
|
HCPCS
|
Insj/rplcmt Icds Ss Eltrd
|
10
|
7
|
—
|
$38,328.98
|
$6,343.00
|
$38,328.98
|
$38,328.98
|
2025-11-26
|
|
0408T
|
HCPCS
|
Insj/rplc Cardiac Modulj Sys
|
10
|
7
|
—
|
$38,328.98
|
$6,343.00
|
$38,328.98
|
$38,328.98
|
2025-11-26
|
|
33270
|
HCPCS
|
Ins/rep Subq Defibrillator
|
16
|
9
|
—
|
$38,328.98
|
$6,343.00
|
$70,633.00
|
$38,328.98
|
2025-11-26
|
|
33249
|
HCPCS
|
Insj/rplcmt Defib W/lead(s)
|
16
|
9
|
—
|
$38,328.98
|
$5,823.00
|
$70,633.00
|
$38,328.98
|
2025-11-26
|
|
33264
|
HCPCS
|
Rmvl & Rplcmt Dfb Gen Mlt Ld
|
16
|
9
|
—
|
$38,328.98
|
$6,343.00
|
$70,633.00
|
$38,328.98
|
2025-11-26
|
|
0915T
|
HCPCS
|
Insj Perm Ccm-d Sys Pg&eltrd
|
8
|
7
|
—
|
$38,328.98
|
$8,119.00
|
$38,328.98
|
$38,328.98
|
2025-11-26
|
|
253
|
MS_DRG
|
Other Vascular Procedures With Cc
|
15
|
10
|
—
|
—
|
$26,068.19
|
$58,353.92
|
$38,266.50
|
2025-11-26
|
|
164
|
MS_DRG
|
Major Chest Procedures With Cc
|
15
|
10
|
—
|
—
|
$25,703.40
|
$57,531.07
|
$38,256.00
|
2025-11-26
|
|
347
|
MS_DRG
|
Anal And Stomal Procedures With Mcc
|
15
|
10
|
—
|
—
|
$24,181.40
|
$54,097.95
|
$38,236.50
|
2025-11-26
|
|
J9266
|
HCPCS
|
Pegaspargase Injection
|
17
|
9
|
—
|
$32,362.28
|
$5,235.92
|
$83,653.35
|
$37,898.74
|
2025-11-26
|
|
749
|
MS_DRG
|
Other Female Reproductive System O.r. Procedures With Cc/mcc
|
15
|
10
|
—
|
—
|
$26,428.93
|
$59,167.63
|
$37,758.00
|
2025-11-26
|
|
C1772
|
HCPCS
|
Infusion Pump, Progra 07418
|
13
|
8
|
$72,411.00
|
—
|
$3,200.00
|
$69,876.62
|
$37,640.09
|
2025-11-26
|
|
849
|
MS_DRG
|
Radiotherapy
|
15
|
10
|
—
|
—
|
$27,264.92
|
$61,053.33
|
$37,635.16
|
2025-11-26
|
|
113
|
MS_DRG
|
Orbital Procedures With Cc/mcc
|
15
|
10
|
—
|
—
|
$23,064.73
|
$51,579.11
|
$37,609.50
|
2025-11-26
|
|
327
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Cc
|
15
|
10
|
—
|
—
|
$24,802.57
|
$55,499.08
|
$37,461.00
|
2025-11-26
|
|
545
|
MS_DRG
|
Connective Tissue Disorders With Mcc
|
15
|
10
|
—
|
—
|
$25,803.72
|
$57,757.35
|
$37,398.00
|
2025-11-26
|
|
982
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc
|
15
|
10
|
—
|
—
|
$25,007.25
|
$55,960.79
|
$37,290.00
|
2025-11-26
|
|
483
|
MS_DRG
|
Major Joint/limb Reattachment Procedure Of Upper Extremities
|
15
|
10
|
—
|
—
|
$26,019.56
|
$58,244.21
|
$37,263.00
|
2025-11-26
|
|
792
|
MS_DRG
|
Prematurity Without Major Problems
|
15
|
10
|
—
|
—
|
$25,021.44
|
$55,992.79
|
$37,087.50
|
2025-11-26
|
|
473
|
MS_DRG
|
Cervical Spinal Fusion Without Cc/mcc
|
15
|
10
|
—
|
—
|
$24,187.48
|
$54,111.66
|
$36,909.00
|
2025-11-26
|
|
846
|
MS_DRG
|
Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc
|
15
|
10
|
—
|
—
|
$26,076.30
|
$58,372.21
|
$36,660.00
|
2025-11-26
|
|
272
|
MS_DRG
|
Other Major Cardiovascular Procedures Without Cc/mcc
|
15
|
10
|
—
|
—
|
$25,553.43
|
$57,192.79
|
$36,592.50
|
2025-11-26
|
|
27
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc
|
15
|
10
|
—
|
—
|
$25,204.85
|
$56,406.50
|
$36,493.50
|
2025-11-26
|
|
0674T
|
HCPCS
|
Laps Insj Nw/rpcmt Prm Isdss
|
10
|
7
|
—
|
$36,430.57
|
$6,343.00
|
$36,430.57
|
$36,430.57
|
2025-11-26
|
|
33287
|
HCPCS
|
Rmv&rplcmt Phrnc Nrv Stim Pg
|
10
|
9
|
—
|
$36,430.57
|
$7,569.00
|
$36,430.57
|
$36,430.57
|
2025-11-26
|
|
0268T
|
HCPCS
|
Implt/rpl Crtd Sns Dev Gen
|
8
|
7
|
—
|
$36,430.57
|
$8,119.00
|
$36,430.57
|
$36,430.57
|
2025-11-26
|
|
493
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc
|
15
|
10
|
—
|
—
|
$24,527.96
|
$54,879.66
|
$36,025.50
|
2025-11-26
|
|
350
|
MS_DRG
|
Inguinal And Femoral Hernia Procedures With Mcc
|
15
|
10
|
—
|
—
|
$24,707.31
|
$55,284.23
|
$36,000.00
|
2025-11-26
|
|
56
|
MS_DRG
|
Degenerative Nervous System Disorders With Mcc
|
15
|
10
|
—
|
—
|
$25,572.68
|
$57,236.21
|
$35,910.00
|
2025-11-26
|
|
95
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System With Cc
|
15
|
10
|
—
|
—
|
$24,489.45
|
$54,792.80
|
$35,763.00
|
2025-11-26
|
|
478
|
MS_DRG
|
Biopsies Of Musculoskeletal System And Connective Tissue With Cc
|
15
|
10
|
—
|
—
|
$23,895.65
|
$53,453.38
|
$35,755.50
|
2025-11-26
|
|
674
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Cc
|
15
|
10
|
—
|
—
|
$23,589.63
|
$52,763.10
|
$35,733.00
|
2025-11-26
|
|
330
|
MS_DRG
|
Major Small And Large Bowel Procedures With Cc
|
15
|
10
|
—
|
—
|
$24,149.99
|
$54,027.09
|
$35,581.50
|
2025-11-26
|
|
651
|
MS_DRG
|
Kidney Transplant With Hemodialysis Without Mcc
|
11
|
10
|
—
|
—
|
$35,385.62
|
$79,370.93
|
$35,385.62
|
2025-11-26
|
|
250
|
MS_DRG
|
Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc
|
15
|
10
|
—
|
—
|
$23,632.19
|
$52,859.10
|
$35,262.00
|
2025-11-26
|
|
64582
|
HCPCS
|
Opn Mpltj Hpglsl Nstm Ary Pg
|
16
|
9
|
—
|
$36,430.57
|
$6,343.00
|
$44,977.00
|
$35,081.79
|
2025-11-26
|
|
C1824
|
HCPCS
|
Optimizer Smart Ipg #24470
|
13
|
8
|
$88,780.00
|
—
|
$3,200.00
|
$85,672.70
|
$34,799.86
|
2025-11-26
|
|
30
|
MS_DRG
|
Spinal Procedures Without Cc/mcc
|
15
|
10
|
—
|
—
|
$22,748.58
|
$50,865.97
|
$34,785.00
|
2025-11-26
|
|
417
|
MS_DRG
|
Laparoscopic Cholecystectomy Without C.d.e. With Mcc
|
15
|
10
|
—
|
—
|
$24,279.69
|
$54,319.66
|
$34,767.00
|
2025-11-26
|
|
827
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
15
|
10
|
—
|
—
|
$24,111.48
|
$53,940.23
|
$34,758.00
|
2025-11-26
|
|
243
|
MS_DRG
|
Permanent Cardiac Pacemaker Implant With Cc
|
15
|
10
|
—
|
—
|
$23,026.22
|
$51,492.25
|
$34,625.00
|
2025-11-26
|
|
792299
|
CDM
|
TrueLok Elevate Kit #26846
|
3
|
3
|
$54,500.00
|
—
|
$28,955.85
|
$52,592.50
|
$34,607.50
|
2025-11-26
|
|
35
|
MS_DRG
|
Carotid Artery Stent Procedures With Cc
|
15
|
10
|
—
|
—
|
$23,249.15
|
$51,995.10
|
$34,492.50
|
2025-11-26
|
|
817
|
MS_DRG
|
Other Antepartum Diagnoses With O.r. Procedures With Mcc
|
13
|
8
|
—
|
—
|
$25,886.81
|
$57,944.78
|
$34,444.00
|
2025-11-26
|
|
82
|
MS_DRG
|
Traumatic Stupor And Coma >1 Hour With Mcc
|
15
|
10
|
—
|
—
|
$23,709.20
|
$53,032.81
|
$34,174.50
|
2025-11-26
|
|
85
|
MS_DRG
|
Traumatic Stupor And Coma <1 Hour With Mcc
|
15
|
10
|
—
|
—
|
$23,159.98
|
$51,793.96
|
$34,092.00
|
2025-11-26
|
|
629
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc
|
15
|
10
|
—
|
—
|
$22,988.73
|
$51,407.68
|
$33,942.00
|
2025-11-26
|
|
614
|
MS_DRG
|
Adrenal And Pituitary Procedures With Cc/mcc
|
15
|
10
|
—
|
—
|
$23,291.71
|
$52,091.10
|
$33,786.00
|
2025-11-26
|
|
93653
|
HCPCS
|
Compre Ep Eval Tx Svt
|
16
|
9
|
—
|
$29,327.87
|
$29,327.87
|
$44,977.00
|
$33,733.00
|
2025-11-26
|
|
93654
|
HCPCS
|
Compre Ep Eval Tx Vt
|
16
|
9
|
—
|
$29,327.87
|
$29,327.87
|
$44,977.00
|
$33,733.00
|
2025-11-26
|
|
143
|
MS_DRG
|
Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc
|
11
|
10
|
—
|
—
|
$33,656.91
|
$75,471.53
|
$33,656.91
|
2025-11-26
|
|
835
|
MS_DRG
|
Acute Leukemia Without Major O.r. Procedures With Cc
|
15
|
10
|
—
|
—
|
$21,841.66
|
$48,820.27
|
$33,532.50
|
2025-11-26
|
|
824
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Cc
|
15
|
10
|
—
|
—
|
$22,485.11
|
$50,271.69
|
$33,493.50
|
2025-11-26
|
|
821
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Cc
|
15
|
10
|
—
|
—
|
$22,819.51
|
$51,025.97
|
$33,481.50
|
2025-11-26
|
|
41
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe…
|
15
|
10
|
—
|
—
|
$23,080.94
|
$51,615.68
|
$33,460.50
|
2025-11-26
|
|
470
|
MS_DRG
|
Major Joint Replacement Or Reattachment Of Lower Extremity Without Mcc
|
17
|
10
|
—
|
—
|
$19,304.32
|
$43,096.87
|
$33,426.14
|
2025-11-26
|
|
320
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures Without Mcc
|
15
|
10
|
—
|
—
|
$23,654.48
|
$52,909.38
|
$33,390.00
|
2025-11-26
|
|
80
|
MS_DRG
|
Nontraumatic Stupor And Coma With Mcc
|
15
|
10
|
—
|
—
|
$20,340.94
|
$45,435.14
|
$33,130.50
|
2025-11-26
|
|
715
|
MS_DRG
|
Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc
|
15
|
10
|
—
|
—
|
$23,081.96
|
$51,617.96
|
$33,112.50
|
2025-11-26
|
|
357
|
MS_DRG
|
Other Digestive System O.r. Procedures With Cc
|
15
|
10
|
—
|
—
|
$23,018.12
|
$51,473.96
|
$32,952.00
|
2025-11-26
|
|
709
|
MS_DRG
|
Penis Procedures With Cc/mcc
|
15
|
10
|
—
|
—
|
$22,968.47
|
$51,361.96
|
$32,930.00
|
2025-11-26
|
|
C9760
|
HCPCS
|
Non-blind Interatrial Shunt
|
10
|
9
|
—
|
$32,876.30
|
$7,569.00
|
$32,876.30
|
$32,876.30
|
2025-11-26
|
|
808
|
MS_DRG
|
Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…
|
15
|
10
|
—
|
—
|
$23,406.22
|
$52,349.39
|
$32,851.50
|
2025-11-26
|
|
409
|
MS_DRG
|
Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…
|
15
|
10
|
—
|
—
|
$21,442.41
|
$47,919.70
|
$32,769.00
|
2025-11-26
|
|
96
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc
|
15
|
10
|
—
|
—
|
$24,489.45
|
$54,792.80
|
$32,695.50
|
2025-11-26
|
|
279
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
9
|
8
|
—
|
—
|
$32,668.93
|
$73,242.97
|
$32,668.93
|
2025-11-26
|
|
595
|
MS_DRG
|
Major Skin Disorders With Mcc
|
15
|
10
|
—
|
—
|
$21,630.89
|
$48,344.84
|
$32,625.00
|
2025-11-26
|
|
734
|
MS_DRG
|
Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc
|
15
|
10
|
—
|
—
|
$21,506.25
|
$48,063.70
|
$32,604.00
|
2025-11-26
|
|
324
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc
|
9
|
8
|
—
|
—
|
$32,574.69
|
$73,030.40
|
$32,574.69
|
2025-11-26
|
|
412
|
MS_DRG
|
Cholecystectomy With C.d.e. With Cc
|
15
|
10
|
—
|
—
|
$21,798.09
|
$48,721.98
|
$32,539.00
|
2025-11-26
|
|
940
|
MS_DRG
|
O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc
|
15
|
10
|
—
|
—
|
$21,593.40
|
$48,260.27
|
$32,499.00
|
2025-11-26
|
|
286
|
MS_DRG
|
Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc
|
15
|
10
|
—
|
—
|
$22,625.97
|
$50,589.40
|
$32,334.00
|
2025-11-26
|
|
98
|
MS_DRG
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc
|
15
|
10
|
—
|
—
|
$22,180.11
|
$49,583.69
|
$32,317.50
|
2025-11-26
|
|
32
|
MS_DRG
|
Ventricular Shunt Procedures With Cc
|
15
|
10
|
—
|
—
|
$21,838.62
|
$48,813.41
|
$32,307.00
|
2025-11-26
|
|
407
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures Without Cc/mcc
|
15
|
10
|
—
|
—
|
$21,840.65
|
$48,817.98
|
$32,265.00
|
2025-11-26
|
|
475
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc
|
15
|
10
|
—
|
—
|
$22,058.51
|
$49,309.41
|
$32,170.50
|
2025-11-26
|
|
857
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc
|
15
|
10
|
—
|
—
|
$22,277.39
|
$49,803.12
|
$32,035.50
|
2025-11-26
|
|
507
|
MS_DRG
|
Major Shoulder Or Elbow Joint Procedures With Cc/mcc
|
15
|
10
|
—
|
—
|
$19,838.34
|
$44,301.44
|
$31,975.50
|
2025-11-26
|