|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel 460000000 Cells IV Susp
|
75
|
42
|
$3,374,196.08
|
$1,349,678.43
60% off
|
$224,740.00
|
$3,079,291.00
|
$1,258,575.00
|
2024-12-15
|
|
Q2054
|
HCPCS
|
Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp
|
71
|
42
|
$3,300,220.29
|
$1,320,088.12
60% off
|
$224,740.00
|
$3,011,781.00
|
$1,191,380.00
|
2024-12-15
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel IV Infusion (wrapped)
|
71
|
42
|
$2,891,113.93
|
$1,156,445.57
60% off
|
$224,740.00
|
$2,638,431.00
|
$1,069,712.00
|
2024-12-15
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
34
|
21
|
$0.01
|
—
|
$308,583.00
|
$1,527,632.00
|
$630,200.00
|
2024-12-15
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
34
|
21
|
$0.01
|
—
|
$194,523.00
|
$960,939.00
|
$396,419.50
|
2024-12-15
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
34
|
21
|
$0.01
|
—
|
$175,843.00
|
$868,130.00
|
$358,132.50
|
2024-12-15
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
42
|
27
|
$0.01
|
—
|
$145,000.00
|
$1,141,013.00
|
$246,843.00
|
2024-12-15
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
34
|
21
|
$0.01
|
—
|
$116,314.00
|
$572,364.00
|
$236,119.50
|
2024-12-15
|
|
5834
|
APR_DRG
|
Neonate With Ecmo
|
10
|
8
|
$0.01
|
—
|
$205,319.00
|
$246,383.00
|
$218,665.00
|
2024-12-15
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
42
|
27
|
$0.01
|
—
|
$90,955.00
|
$446,375.00
|
$190,099.00
|
2024-12-15
|
|
7
|
MS_DRG
|
Lung Transplant
|
42
|
27
|
$0.01
|
—
|
$75,324.00
|
$529,378.00
|
$188,500.00
|
2024-12-15
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
34
|
21
|
$0.01
|
—
|
$89,930.00
|
$441,279.00
|
$182,042.50
|
2024-12-15
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
43
|
28
|
$0.01
|
—
|
$87,936.00
|
$431,375.00
|
$181,434.00
|
2024-12-15
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
34
|
21
|
$0.01
|
—
|
$87,491.00
|
$429,164.00
|
$180,723.00
|
2024-12-15
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
34
|
21
|
$0.01
|
—
|
$86,518.00
|
$424,327.00
|
$175,049.00
|
2024-12-15
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
34
|
21
|
$0.01
|
—
|
$79,797.00
|
$390,937.00
|
$156,496.00
|
2024-12-15
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
34
|
21
|
$0.01
|
—
|
$76,216.00
|
$373,146.00
|
$153,935.50
|
2024-12-15
|
|
A9520
|
HCPCS
|
Technetium-99 (tc-99) Tilmanocept (lymphoseek) Radio-isotope Injection
|
71
|
42
|
$429,949.20
|
$171,979.68
60% off
|
$10.00
|
$392,372.00
|
$152,202.00
|
2024-12-15
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
43
|
28
|
$0.01
|
—
|
$74,216.00
|
$530,715.00
|
$143,000.00
|
2024-12-15
|
|
5884
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
10
|
8
|
$0.01
|
—
|
$133,948.00
|
$160,737.00
|
$142,654.50
|
2024-12-15
|
|
5833
|
APR_DRG
|
Neonate With Ecmo
|
10
|
8
|
$0.01
|
—
|
$133,012.00
|
$159,615.00
|
$141,658.00
|
2024-12-15
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
34
|
21
|
$0.01
|
—
|
$69,113.00
|
$337,853.00
|
$139,375.50
|
2024-12-15
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
34
|
21
|
$0.01
|
—
|
$70,200.00
|
$343,252.00
|
$138,508.50
|
2024-12-15
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
34
|
21
|
$0.01
|
—
|
$66,834.00
|
$326,531.00
|
$134,705.00
|
2024-12-15
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
34
|
21
|
$0.01
|
—
|
$64,839.00
|
$316,619.00
|
$127,517.00
|
2024-12-15
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
34
|
21
|
$0.01
|
—
|
$70,161.00
|
$343,062.00
|
$127,468.00
|
2024-12-15
|
|
24
|
APR_DRG
|
Heart And/or Lung Transplant
|
10
|
8
|
$0.01
|
—
|
$118,623.00
|
$142,347.00
|
$126,333.00
|
2024-12-15
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
34
|
21
|
$0.01
|
—
|
$64,196.00
|
$313,423.00
|
$125,645.00
|
2024-12-15
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
34
|
21
|
$0.01
|
—
|
$61,967.00
|
$302,352.00
|
$124,730.50
|
2024-12-15
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
34
|
21
|
$0.01
|
—
|
$59,020.00
|
$287,709.00
|
$118,690.00
|
2024-12-15
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
34
|
21
|
$0.01
|
—
|
$58,729.00
|
$286,263.00
|
$118,093.00
|
2024-12-15
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
34
|
21
|
$0.01
|
—
|
$57,828.00
|
$281,787.00
|
$116,246.50
|
2024-12-15
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
34
|
21
|
$0.01
|
—
|
$56,783.00
|
$276,594.00
|
$114,104.50
|
2024-12-15
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
34
|
21
|
$0.01
|
—
|
$55,775.00
|
$271,587.00
|
$112,039.00
|
2024-12-15
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
34
|
21
|
$0.01
|
—
|
$55,565.00
|
$270,542.00
|
$111,607.50
|
2024-12-15
|
|
114
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
10
|
8
|
$0.01
|
—
|
$104,305.00
|
$125,166.00
|
$111,085.50
|
2024-12-15
|
|
5832
|
APR_DRG
|
Neonate With Ecmo
|
10
|
8
|
$0.01
|
—
|
$102,129.00
|
$122,555.00
|
$108,767.50
|
2024-12-15
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
34
|
21
|
$0.01
|
—
|
$55,473.00
|
$270,084.00
|
$108,298.00
|
2024-12-15
|
|
1614
|
APR_DRG
|
Implantable Heart Assist Systems
|
10
|
8
|
$0.01
|
—
|
$101,659.00
|
$121,991.00
|
$108,267.00
|
2024-12-15
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
34
|
21
|
$0.01
|
—
|
$53,839.00
|
$261,967.00
|
$108,070.50
|
2024-12-15
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$52,674.00
|
$256,178.00
|
$105,682.00
|
2024-12-15
|
|
A9595
|
HCPCS
|
Piflufolastat F 18 9 Mci IV Sosy
|
62
|
37
|
$265,150.82
|
$106,060.33
60% off
|
$615.00
|
$241,977.00
|
$104,946.50
|
2024-12-15
|
|
6304
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
10
|
8
|
$0.01
|
—
|
$97,710.00
|
$117,252.00
|
$104,061.50
|
2024-12-15
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
34
|
21
|
$0.01
|
—
|
$51,550.00
|
$250,593.00
|
$103,378.00
|
2024-12-15
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
34
|
21
|
$0.01
|
—
|
$53,763.00
|
$261,590.00
|
$103,242.50
|
2024-12-15
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
34
|
21
|
$0.01
|
—
|
$51,320.00
|
$249,450.00
|
$102,906.50
|
2024-12-15
|
|
8414
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
10
|
8
|
$0.01
|
—
|
$96,372.00
|
$115,646.00
|
$102,636.00
|
2024-12-15
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$50,678.00
|
$246,262.00
|
$101,591.50
|
2024-12-15
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
34
|
21
|
$0.01
|
—
|
$50,916.00
|
$247,445.00
|
$99,774.00
|
2024-12-15
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
34
|
21
|
$0.01
|
—
|
$49,617.00
|
$240,988.00
|
$99,415.50
|
2024-12-15
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$49,955.00
|
$242,669.00
|
$99,305.00
|
2024-12-15
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
43
|
28
|
$0.01
|
—
|
$50,323.00
|
$244,496.00
|
$98,892.00
|
2024-12-15
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
43
|
28
|
$0.01
|
—
|
$50,323.00
|
$244,496.00
|
$98,892.00
|
2024-12-15
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
43
|
28
|
$0.01
|
—
|
$65,743.00
|
$321,111.00
|
$98,803.00
|
2024-12-15
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
34
|
21
|
$0.01
|
—
|
$51,615.00
|
$250,917.00
|
$98,495.00
|
2024-12-15
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
34
|
21
|
$0.01
|
—
|
$49,086.00
|
$238,351.00
|
$98,026.50
|
2024-12-15
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
43
|
28
|
$0.01
|
—
|
$45,473.00
|
$220,403.00
|
$98,000.00
|
2024-12-15
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$48,581.00
|
$235,844.00
|
$97,294.00
|
2024-12-15
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
34
|
21
|
$0.01
|
—
|
$47,626.00
|
$231,096.00
|
$95,335.00
|
2024-12-15
|
|
6094
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
10
|
8
|
$0.01
|
—
|
$88,071.00
|
$105,685.00
|
$93,795.50
|
2024-12-15
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$46,562.00
|
$225,810.00
|
$93,154.00
|
2024-12-15
|
|
C2616
|
HCPCS
|
Sphere Embol Sir Msphre 90
|
210
|
42
|
$166,093.85
|
$66,437.54
60% off
|
$17,177.00
|
$152,392.00
|
$93,128.00
|
2024-12-15
|
|
5883
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
10
|
8
|
$0.01
|
—
|
$87,116.00
|
$104,539.00
|
$92,778.50
|
2024-12-15
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
43
|
28
|
$0.01
|
—
|
$40,647.00
|
$216,002.00
|
$92,600.00
|
2024-12-15
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
34
|
21
|
$0.01
|
—
|
$46,176.00
|
$223,894.00
|
$92,364.00
|
2024-12-15
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
34
|
21
|
$0.01
|
—
|
$46,176.00
|
$223,894.00
|
$92,364.00
|
2024-12-15
|
|
6314
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
10
|
8
|
$0.01
|
—
|
$86,464.00
|
$103,757.00
|
$92,084.00
|
2024-12-15
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
34
|
21
|
$0.01
|
—
|
$45,987.00
|
$222,955.00
|
$91,976.00
|
2024-12-15
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
34
|
21
|
$0.01
|
—
|
$45,713.00
|
$221,594.00
|
$91,415.00
|
2024-12-15
|
|
A9588
|
HCPCS
|
Fluciclovine F 18 9-221 Mci/ml IV Soln
|
71
|
42
|
$256,786.20
|
$102,714.48
60% off
|
$84.00
|
$234,343.00
|
$90,902.00
|
2024-12-15
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$45,372.00
|
$219,900.00
|
$90,716.50
|
2024-12-15
|
|
5914
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
10
|
8
|
$0.01
|
—
|
$85,092.00
|
$102,110.00
|
$90,622.50
|
2024-12-15
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
34
|
21
|
$0.01
|
—
|
$45,146.00
|
$218,778.00
|
$90,253.50
|
2024-12-15
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
34
|
21
|
$0.01
|
—
|
$45,105.00
|
$218,572.00
|
$90,168.00
|
2024-12-15
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
34
|
21
|
$0.01
|
—
|
$45,100.00
|
$218,547.00
|
$90,158.50
|
2024-12-15
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
34
|
21
|
$0.01
|
—
|
$47,905.00
|
$232,486.00
|
$89,806.50
|
2024-12-15
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
34
|
21
|
$0.01
|
—
|
$44,488.00
|
$215,505.00
|
$87,335.00
|
2024-12-15
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
34
|
21
|
$0.01
|
—
|
$51,144.00
|
$248,579.00
|
$86,953.50
|
2024-12-15
|
|
C1831
|
HCPCS
|
Kit Imp Aprevo Spine Lvl 3
|
313
|
42
|
$284,240.00
|
$113,696.00
60% off
|
$1,097.00
|
$336,600.00
|
$86,559.00
|
2024-12-15
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
34
|
21
|
$0.01
|
—
|
$43,101.00
|
$208,615.00
|
$86,060.50
|
2024-12-15
|
|
74
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
10
|
8
|
$0.01
|
—
|
$80,769.00
|
$96,923.00
|
$86,019.50
|
2024-12-15
|
|
94
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
10
|
8
|
$0.01
|
—
|
$80,365.00
|
$96,438.00
|
$85,588.50
|
2024-12-15
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$41,741.00
|
$203,523.00
|
$85,003.50
|
2024-12-15
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$42,521.00
|
$205,735.00
|
$84,872.50
|
2024-12-15
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
34
|
21
|
$0.01
|
—
|
$44,296.00
|
$214,553.00
|
$84,549.50
|
2024-12-15
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
34
|
21
|
$0.01
|
—
|
$42,178.00
|
$204,030.00
|
$84,169.50
|
2024-12-15
|
|
5934
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
10
|
8
|
$0.01
|
—
|
$78,902.00
|
$94,682.00
|
$84,030.50
|
2024-12-15
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$42,961.00
|
$207,922.00
|
$83,690.00
|
2024-12-15
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
34
|
21
|
$0.01
|
—
|
$41,936.00
|
$202,827.00
|
$83,673.00
|
2024-12-15
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$41,888.00
|
$202,588.00
|
$83,574.00
|
2024-12-15
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
34
|
21
|
$0.01
|
—
|
$40,954.00
|
$197,950.00
|
$81,660.50
|
2024-12-15
|
|
5882
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
10
|
8
|
$0.01
|
—
|
$76,443.00
|
$91,731.00
|
$81,411.50
|
2024-12-15
|
|
13925-522-01
|
NDC
|
Pentamidine Isethionate 300 Mg In Solr
|
43
|
24
|
$146,625.40
|
$58,650.16
60% off
|
$24,926.00
|
$133,810.00
|
$80,351.00
|
2024-12-15
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
34
|
21
|
$0.01
|
—
|
$40,047.00
|
$193,441.00
|
$79,801.00
|
2024-12-15
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$39,878.00
|
$192,603.00
|
$79,455.50
|
2024-12-15
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
34
|
21
|
$0.01
|
—
|
$39,871.00
|
$192,566.00
|
$79,440.00
|
2024-12-15
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
34
|
21
|
$0.01
|
—
|
$42,648.00
|
$206,367.00
|
$79,353.50
|
2024-12-15
|
|
5831
|
APR_DRG
|
Neonate With Ecmo
|
10
|
8
|
$0.01
|
—
|
$74,234.00
|
$89,081.00
|
$79,059.50
|
2024-12-15
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$39,264.00
|
$189,553.00
|
$78,197.00
|
2024-12-15
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
43
|
28
|
$0.01
|
—
|
$65,000.00
|
$322,962.00
|
$78,000.00
|
2024-12-15
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
34
|
21
|
$0.01
|
—
|
$39,469.00
|
$190,573.00
|
$77,739.50
|
2024-12-15
|
|
6034
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
10
|
8
|
$0.01
|
—
|
$72,982.00
|
$87,578.00
|
$77,725.50
|
2024-12-15
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
34
|
21
|
$0.01
|
—
|
$40,714.00
|
$196,755.00
|
$77,380.50
|
2024-12-15
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$38,691.00
|
$186,705.00
|
$77,022.00
|
2024-12-15
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
34
|
21
|
$0.01
|
—
|
$38,555.00
|
$186,032.00
|
$76,744.50
|
2024-12-15
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$38,550.00
|
$186,004.00
|
$76,733.00
|
2024-12-15
|
|
14
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
10
|
8
|
$0.01
|
—
|
$71,830.00
|
$86,196.00
|
$76,499.00
|
2024-12-15
|
|
A9572
|
HCPCS
|
Indium In-111 Pentetreotide IV Kit
|
71
|
42
|
$215,805.34
|
$86,322.14
60% off
|
$60.00
|
$196,944.00
|
$76,395.00
|
2024-12-15
|
|
44
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
10
|
8
|
$0.01
|
—
|
$71,338.00
|
$85,605.00
|
$75,975.00
|
2024-12-15
|
|
58914-501-56
|
NDC
|
Mesalamine 1000 Mg Re Supp
|
43
|
24
|
$137,788.00
|
$55,115.20
60% off
|
$23,424.00
|
$125,745.00
|
$75,508.00
|
2024-12-15
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$37,895.00
|
$182,751.00
|
$75,391.00
|
2024-12-15
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
34
|
21
|
$0.01
|
—
|
$37,676.00
|
$181,662.00
|
$74,941.50
|
2024-12-15
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$37,575.00
|
$181,159.00
|
$74,734.50
|
2024-12-15
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
43
|
28
|
$0.01
|
—
|
$38,675.00
|
$186,628.00
|
$74,216.00
|
2024-12-15
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
34
|
21
|
$0.01
|
—
|
$37,234.00
|
$179,466.00
|
$74,035.50
|
2024-12-15
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
34
|
21
|
$0.01
|
—
|
$39,039.00
|
$188,435.00
|
$73,269.50
|
2024-12-15
|
|
1613
|
APR_DRG
|
Implantable Heart Assist Systems
|
10
|
8
|
$0.01
|
—
|
$68,785.00
|
$82,542.00
|
$73,256.00
|
2024-12-15
|
|
933
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
34
|
21
|
$0.01
|
—
|
$36,389.00
|
$175,270.00
|
$72,304.50
|
2024-12-15
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$35,890.00
|
$172,791.00
|
$71,282.00
|
2024-12-15
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
34
|
21
|
$0.01
|
—
|
$35,839.00
|
$172,536.00
|
$71,176.50
|
2024-12-15
|
|
23
|
APR_DRG
|
Heart And/or Lung Transplant
|
10
|
8
|
$0.01
|
—
|
$66,606.00
|
$79,927.00
|
$70,935.00
|
2024-12-15
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$35,593.00
|
$171,312.00
|
$70,672.00
|
2024-12-15
|
|
31
|
MS_DRG
|
Ventricular Shunt Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$35,278.00
|
$169,749.00
|
$70,027.00
|
2024-12-15
|
|
673
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$35,270.00
|
$169,708.00
|
$70,010.00
|
2024-12-15
|
|
5881
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
10
|
8
|
$0.01
|
—
|
$65,522.00
|
$78,627.00
|
$69,781.50
|
2024-12-15
|
|
958
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
34
|
21
|
$0.01
|
—
|
$34,619.00
|
$166,476.00
|
$68,677.00
|
2024-12-15
|
|
12
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
34
|
21
|
$0.01
|
—
|
$34,569.00
|
$166,229.00
|
$68,575.00
|
2024-12-15
|
|
448
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical Without Mcc
|
34
|
21
|
$0.01
|
—
|
$34,405.00
|
$165,410.00
|
$68,237.50
|
2024-12-15
|
|
J1950
|
HCPCS
|
Leuprolide Acetate (3 Month) 11.25 Mg IM Kit
|
71
|
42
|
$192,611.55
|
$77,044.62
60% off
|
$1,674.00
|
$175,777.00
|
$68,184.00
|
2024-12-15
|
|
423
|
MS_DRG
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$34,273.00
|
$164,758.00
|
$67,968.00
|
2024-12-15
|
|
236
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
34
|
21
|
$0.01
|
—
|
$34,638.00
|
$166,569.00
|
$67,276.00
|
2024-12-15
|
|
5913
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
10
|
8
|
$0.01
|
—
|
$63,159.00
|
$75,790.00
|
$67,264.00
|
2024-12-15
|
|
907
|
MS_DRG
|
Other O.r. Procedures For Injuries With Mcc
|
34
|
21
|
$0.01
|
—
|
$33,591.00
|
$161,368.00
|
$66,569.50
|
2024-12-15
|
|
739
|
MS_DRG
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…
|
34
|
21
|
$0.01
|
—
|
$33,568.00
|
$161,254.00
|
$66,523.00
|
2024-12-15
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$36,926.00
|
$177,939.00
|
$66,366.50
|
2024-12-15
|
|
628
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$33,281.00
|
$159,828.00
|
$65,934.50
|
2024-12-15
|
|
C1825
|
HCPCS
|
System Neo Barostim Includes 2102 Ipg 1036 Csl Kit
|
144
|
42
|
$258,440.00
|
$103,376.00
60% off
|
$1,097.00
|
$232,596.00
|
$65,907.00
|
2024-12-15
|
|
736
|
MS_DRG
|
Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc
|
34
|
21
|
$0.01
|
—
|
$33,215.00
|
$159,500.00
|
$65,799.50
|
2024-12-15
|
|
876
|
MS_DRG
|
O.r. Procedures With Principal Diagnosis Of Mental Illness
|
34
|
21
|
$0.01
|
—
|
$33,150.00
|
$159,176.00
|
$65,666.00
|
2024-12-15
|
|
402
|
MS_DRG
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
34
|
21
|
$0.01
|
—
|
$33,008.00
|
$158,471.00
|
$65,374.50
|
2024-12-15
|
|
651
|
MS_DRG
|
Kidney Transplant With Hemodialysis Without Mcc
|
43
|
28
|
$0.01
|
—
|
$29,423.00
|
$158,000.00
|
$65,099.00
|
2024-12-15
|
|
34
|
MS_DRG
|
Carotid Artery Stent Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$32,817.00
|
$157,520.00
|
$64,982.00
|
2024-12-15
|
|
113
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
10
|
8
|
$0.01
|
—
|
$60,831.00
|
$72,997.00
|
$64,785.00
|
2024-12-15
|
|
616
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
34
|
21
|
$0.01
|
—
|
$32,623.00
|
$156,560.00
|
$64,586.00
|
2024-12-15
|
|
904
|
MS_DRG
|
Skin Grafts For Injuries With Cc/mcc
|
34
|
21
|
$0.01
|
—
|
$32,592.00
|
$156,402.00
|
$64,521.00
|
2024-12-15
|
|
166
|
MS_DRG
|
Other Respiratory System O.r. Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$32,503.00
|
$155,964.00
|
$64,340.50
|
2024-12-15
|
|
956
|
MS_DRG
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
34
|
21
|
$0.01
|
—
|
$32,276.00
|
$154,834.00
|
$63,874.00
|
2024-12-15
|
|
269
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
34
|
21
|
$0.01
|
—
|
$35,034.00
|
$168,537.00
|
$63,728.50
|
2024-12-15
|
|
24
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
34
|
21
|
$0.01
|
—
|
$32,107.00
|
$153,995.00
|
$63,528.50
|
2024-12-15
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
10
|
8
|
$0.01
|
—
|
$59,311.00
|
$71,174.00
|
$63,166.50
|
2024-12-15
|
|
40
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$31,866.00
|
$152,796.00
|
$63,033.50
|
2024-12-15
|
|
63323-877-15
|
NDC
|
Pentamidine Isethionate 300 Mg In Solr
|
43
|
24
|
$115,000.30
|
$46,000.12
60% off
|
$19,550.00
|
$104,949.00
|
$63,020.00
|
2024-12-15
|
|
A9569
|
HCPCS
|
Technetium-99 (tc-99) Exametazime White Blood Cells Radio-isotope Injection
|
71
|
42
|
$177,123.02
|
$70,849.21
60% off
|
$57.00
|
$161,642.00
|
$62,702.00
|
2024-12-15
|
|
622
|
MS_DRG
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
34
|
21
|
$0.01
|
—
|
$31,621.00
|
$151,577.00
|
$62,530.50
|
2024-12-15
|
|
6024
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
8
|
$0.01
|
—
|
$58,591.00
|
$70,309.00
|
$62,399.00
|
2024-12-15
|
|
0187-0007-14
|
NDC
|
Ribavirin 6 G In Solr
|
43
|
24
|
$113,455.32
|
$45,382.13
60% off
|
$19,287.00
|
$103,539.00
|
$62,174.00
|
2024-12-15
|
|
24338-050-08
|
NDC
|
Carmustine In Polifeprosan 7.7 Mg Il Wafr
|
43
|
24
|
$113,104.92
|
$45,241.97
60% off
|
$19,228.00
|
$103,220.00
|
$61,981.00
|
2024-12-15
|
|
273
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$32,993.00
|
$158,395.00
|
$61,974.50
|
2024-12-15
|
|
652
|
MS_DRG
|
Kidney Transplant
|
43
|
28
|
$0.01
|
—
|
$26,153.00
|
$158,000.00
|
$61,087.00
|
2024-12-15
|
|
94
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System With Mcc
|
34
|
21
|
$0.01
|
—
|
$30,860.00
|
$147,798.00
|
$60,971.50
|
2024-12-15
|
|
0781-5893-31
|
NDC
|
Nevirapine ER 400 Mg Po Tb24
|
43
|
24
|
$111,233.88
|
$44,493.55
60% off
|
$18,910.00
|
$101,512.00
|
$60,956.00
|
2024-12-15
|
|
335
|
MS_DRG
|
Peritoneal Adhesiolysis With Mcc
|
34
|
21
|
$0.01
|
—
|
$30,654.00
|
$146,773.00
|
$60,549.00
|
2024-12-15
|
|
34708
|
CPT
|
Hc Evasc Rpr Dplmnt Ilio-iliac Ndgft Rpt
|
110
|
42
|
$94,976.00
|
$37,990.40
60% off
|
$11,302.00
|
$173,350.00
|
$60,120.00
|
2024-12-15
|
|
458
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
34
|
21
|
$0.01
|
—
|
$36,317.00
|
$174,909.00
|
$59,975.50
|
2024-12-15
|
|
802
|
MS_DRG
|
Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc
|
34
|
21
|
$0.01
|
—
|
$30,339.00
|
$145,209.00
|
$59,903.50
|
2024-12-15
|
|
97
|
MS_DRG
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc
|
34
|
21
|
$0.01
|
—
|
$30,337.00
|
$145,201.00
|
$59,900.50
|
2024-12-15
|
|
265
|
MS_DRG
|
Aicd Lead Procedures
|
34
|
21
|
$0.01
|
—
|
$30,195.00
|
$144,497.00
|
$59,609.50
|
2024-12-15
|
|
8120000001
|
CDM
|
Hc Cadaver Donor - Heart
|
52
|
30
|
$140,000.00
|
$56,000.00
60% off
|
$128.00
|
$127,764.00
|
$59,528.00
|
2024-12-15
|
|
33881
|
CPT
|
Hc Endovasc Taa Rew/o Subcl
|
71
|
42
|
$84,568.00
|
$33,827.20
60% off
|
$10,064.00
|
$108,938.00
|
$59,198.00
|
2024-12-15
|
|
34710
|
CPT
|
Hc Dlyd Placement Xtn Prosth For Evasc Rpr 1st Vsl
|
71
|
42
|
$84,568.00
|
$33,827.20
60% off
|
$10,064.00
|
$108,938.00
|
$59,198.00
|
2024-12-15
|
|
34707
|
CPT
|
Hc Evasc Rpr Dplmnt Ilio-iliac Ndgft
|
110
|
42
|
$76,958.00
|
$30,783.20
60% off
|
$9,158.00
|
$140,464.00
|
$59,048.00
|
2024-12-15
|
|
22
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…
|
34
|
21
|
$0.01
|
—
|
$29,895.00
|
$143,006.00
|
$58,994.50
|
2024-12-15
|
|
420
|
MS_DRG
|
Hepatobiliary Diagnostic Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$29,888.00
|
$142,969.00
|
$58,979.50
|
2024-12-15
|
|
495
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…
|
34
|
21
|
$0.01
|
—
|
$29,815.00
|
$142,609.00
|
$58,831.00
|
2024-12-15
|
|
1612
|
APR_DRG
|
Implantable Heart Assist Systems
|
10
|
8
|
$0.01
|
—
|
$55,215.00
|
$66,258.00
|
$58,804.00
|
2024-12-15
|
|
414
|
MS_DRG
|
Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc
|
34
|
21
|
$0.01
|
—
|
$29,678.00
|
$141,928.00
|
$58,550.00
|
2024-12-15
|
|
987
|
MS_DRG
|
Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
34
|
21
|
$0.01
|
—
|
$29,670.00
|
$141,884.00
|
$58,531.50
|
2024-12-15
|
|
408
|
MS_DRG
|
Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…
|
34
|
21
|
$0.01
|
—
|
$29,658.00
|
$141,827.00
|
$58,508.50
|
2024-12-15
|
|
264
|
MS_DRG
|
Other Circulatory System O.r. Procedures
|
34
|
21
|
$0.01
|
—
|
$29,608.00
|
$141,576.00
|
$58,405.00
|
2024-12-15
|
|
5933
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
10
|
8
|
$0.01
|
—
|
$54,722.00
|
$65,666.00
|
$58,278.50
|
2024-12-15
|
|
260
|
MS_DRG
|
Cardiac Pacemaker Revision Except Device Replacement With Mcc
|
34
|
21
|
$0.01
|
—
|
$28,883.00
|
$137,975.00
|
$58,101.50
|
2024-12-15
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
34
|
21
|
$0.01
|
—
|
$41,904.00
|
$202,669.00
|
$57,999.50
|
2024-12-15
|
|
332
|
MS_DRG
|
Rectal Resection With Mcc
|
34
|
21
|
$0.01
|
—
|
$29,392.00
|
$140,507.00
|
$57,963.50
|
2024-12-15
|
|
574
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Cc
|
34
|
21
|
$0.01
|
—
|
$29,361.00
|
$140,353.00
|
$57,900.50
|
2024-12-15
|
|
477
|
MS_DRG
|
Biopsies Of Musculoskeletal System And Connective Tissue With Mcc
|
34
|
21
|
$0.01
|
—
|
$29,150.00
|
$139,304.00
|
$57,467.50
|
2024-12-15
|
|
665
|
MS_DRG
|
Prostatectomy With Mcc
|
34
|
21
|
$0.01
|
—
|
$29,106.00
|
$139,085.00
|
$57,377.00
|
2024-12-15
|
|
33363
|
CPT
|
Hc Replace Aortic Valve Open Axillry Artry Approach
|
71
|
42
|
$101,375.00
|
$40,550.00
60% off
|
$12,064.00
|
$102,585.00
|
$57,324.50
|
2024-12-15
|
|
C1824
|
HCPCS
|
Generator Pul Implantable Optimizer Smt F/hrt Fail
|
142
|
42
|
$194,480.00
|
$77,792.00
60% off
|
$1,097.00
|
$215,982.00
|
$57,177.00
|
2024-12-15
|
|
271
|
MS_DRG
|
Other Major Cardiovascular Procedures With Cc
|
34
|
21
|
$0.01
|
—
|
$29,194.00
|
$139,522.00
|
$56,172.00
|
2024-12-15
|
|
29
|
MS_DRG
|
Spinal Procedures With Cc Or Spinal Neurostimulators
|
34
|
21
|
$0.01
|
—
|
$28,479.00
|
$135,970.00
|
$56,092.00
|
2024-12-15
|
|
1611
|
APR_DRG
|
Implantable Heart Assist Systems
|
10
|
8
|
$0.01
|
—
|
$52,607.00
|
$63,128.00
|
$56,026.00
|
2024-12-15
|
|
492
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc
|
34
|
21
|
$0.01
|
—
|
$30,065.00
|
$143,848.00
|
$55,763.00
|
2024-12-15
|
|
242
|
MS_DRG
|
Permanent Cardiac Pacemaker Implant With Mcc
|
34
|
21
|
$0.01
|
—
|
$28,767.00
|
$137,400.00
|
$55,757.00
|
2024-12-15
|
|
5891
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
10
|
8
|
$0.01
|
—
|
$52,325.00
|
$62,790.00
|
$55,726.50
|
2024-12-15
|
|
112
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
10
|
8
|
$0.01
|
—
|
$52,231.00
|
$62,678.00
|
$55,626.50
|
2024-12-15
|
|
37
|
MS_DRG
|
Extracranial Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$28,187.00
|
$134,520.00
|
$55,494.00
|
2024-12-15
|
|
252
|
MS_DRG
|
Other Vascular Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$29,080.00
|
$138,955.00
|
$55,420.00
|
2024-12-15
|
|
8120000004
|
CDM
|
Hc Cadaver Donor - Lung
|
52
|
30
|
$130,000.00
|
$52,000.00
60% off
|
$128.00
|
$118,638.00
|
$55,276.00
|
2024-12-15
|
|
143
|
MS_DRG
|
Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$28,032.00
|
$133,750.00
|
$55,176.00
|
2024-12-15
|
|
64
|
APR_DRG
|
Pancreas Transplant
|
10
|
8
|
$0.01
|
—
|
$51,673.00
|
$62,007.00
|
$55,031.50
|
2024-12-15
|
|
579
|
MS_DRG
|
Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$27,686.00
|
$132,029.00
|
$54,466.00
|
2024-12-15
|
|
656
|
MS_DRG
|
Kidney And Ureter Procedures For Neoplasm With Mcc
|
34
|
21
|
$0.01
|
—
|
$27,674.00
|
$131,972.00
|
$54,443.00
|
2024-12-15
|
|
5892
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
10
|
8
|
$0.01
|
—
|
$50,782.00
|
$60,938.00
|
$54,083.00
|
2024-12-15
|
|
34701
|
CPT
|
Hc Ccl Evasc Rpr A-ao Non-ruptre
|
71
|
42
|
$76,958.00
|
$30,783.20
60% off
|
$9,158.00
|
$108,938.00
|
$53,871.00
|
2024-12-15
|
|
485
|
MS_DRG
|
Knee Procedures With Principal Diagnosis Of Infection With Mcc
|
34
|
21
|
$0.01
|
—
|
$27,359.00
|
$130,404.00
|
$53,796.00
|
2024-12-15
|
|
324
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc
|
34
|
21
|
$0.01
|
—
|
$27,162.00
|
$129,424.00
|
$53,392.00
|
2024-12-15
|
|
8514
|
APR_DRG
|
Gender Related Procedures
|
10
|
8
|
$0.01
|
—
|
$50,103.00
|
$60,123.00
|
$53,359.50
|
2024-12-15
|
|
840
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Mcc
|
34
|
21
|
$0.01
|
—
|
$27,112.00
|
$129,177.00
|
$53,290.00
|
2024-12-15
|
|
929
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc
|
34
|
21
|
$0.01
|
—
|
$27,042.00
|
$128,828.00
|
$53,146.00
|
2024-12-15
|
|
939
|
MS_DRG
|
O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc
|
34
|
21
|
$0.01
|
—
|
$26,990.00
|
$128,569.00
|
$53,039.00
|
2024-12-15
|
|
229
|
MS_DRG
|
Other Cardiothoracic Procedures Without Mcc
|
34
|
21
|
$0.01
|
—
|
$26,438.00
|
$128,470.00
|
$52,986.50
|
2024-12-15
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
28
|
21
|
$0.01
|
—
|
$49,580.00
|
$240,806.00
|
$52,973.00
|
2024-12-15
|
|
500
|
MS_DRG
|
Soft Tissue Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$26,946.00
|
$128,355.00
|
$52,950.50
|
2024-12-15
|
|
5893
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
10
|
8
|
$0.01
|
—
|
$49,700.00
|
$59,640.00
|
$52,930.50
|
2024-12-15
|
|
8424
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
10
|
8
|
$0.01
|
—
|
$49,355.00
|
$59,226.00
|
$52,563.50
|
2024-12-15
|
|
662
|
MS_DRG
|
Minor Bladder Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$26,546.00
|
$126,366.00
|
$52,130.50
|
2024-12-15
|
|
0068-0597-01
|
NDC
|
Rifampin 600 Mg IV Solr
|
43
|
24
|
$94,596.46
|
$37,838.58
60% off
|
$16,081.00
|
$86,329.00
|
$51,839.00
|
2024-12-15
|
|
0398T
|
CPT
|
Hc MRI Guided Focused US Stereo Lesion Ablate
|
71
|
42
|
$159,456.00
|
$63,782.40
60% off
|
$12,979.00
|
$145,520.00
|
$51,743.00
|
2024-12-15
|
|
515
|
MS_DRG
|
Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$26,324.00
|
$125,264.00
|
$51,675.50
|
2024-12-15
|
|
22
|
APR_DRG
|
Heart And/or Lung Transplant
|
10
|
8
|
$0.01
|
—
|
$48,472.00
|
$58,167.00
|
$51,623.50
|
2024-12-15
|
|
451
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical Without Mcc
|
34
|
21
|
$0.01
|
—
|
$26,272.00
|
$125,005.00
|
$51,568.50
|
2024-12-15
|
|
829
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…
|
34
|
21
|
$0.01
|
—
|
$26,254.00
|
$124,915.00
|
$51,532.00
|
2024-12-15
|
|
467
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Cc
|
34
|
21
|
$0.01
|
—
|
$29,038.00
|
$138,745.00
|
$51,524.00
|
2024-12-15
|
|
173
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…
|
34
|
21
|
$0.01
|
—
|
$26,130.00
|
$124,300.00
|
$51,278.00
|
2024-12-15
|
|
33880
|
CPT
|
Hc Endovasc Taa Repr Incl Subcl
|
71
|
42
|
$73,219.00
|
$29,287.60
60% off
|
$8,713.00
|
$108,938.00
|
$51,253.00
|
2024-12-15
|
|
469
|
MS_DRG
|
Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…
|
34
|
21
|
$0.01
|
—
|
$27,762.00
|
$132,405.00
|
$51,223.50
|
2024-12-15
|
|
C1822
|
HCPCS
|
Construct Neuromod Nevro Pain Mgmt Omnia With Ipg Rm
|
199
|
42
|
$166,243.00
|
$66,497.20
60% off
|
$1,097.00
|
$175,032.00
|
$51,148.00
|
2024-12-15
|
|
26
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Cc
|
34
|
21
|
$0.01
|
—
|
$26,049.00
|
$123,895.00
|
$51,110.50
|
2024-12-15
|
|
5912
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
10
|
8
|
$0.01
|
—
|
$47,894.00
|
$57,473.00
|
$51,007.50
|
2024-12-15
|
|
47781-153-01
|
NDC
|
Naproxen Sodium ER 375 Mg Po Tb24
|
43
|
24
|
$92,257.45
|
$36,902.98
60% off
|
$15,684.00
|
$84,194.00
|
$50,557.00
|
2024-12-15
|
|
570
|
MS_DRG
|
Skin Debridement With Mcc
|
34
|
21
|
$0.01
|
—
|
$25,654.00
|
$121,934.00
|
$50,302.00
|
2024-12-15
|
|
33365
|
CPT
|
Hc Cath Replace Aortic Valve Open Transaortic Approach
|
71
|
42
|
$71,777.00
|
$28,710.80
60% off
|
$8,541.00
|
$102,585.00
|
$50,244.00
|
2024-12-15
|
|
974
|
MS_DRG
|
HIV With Major Related Condition With Mcc
|
34
|
21
|
$0.01
|
—
|
$25,458.00
|
$120,962.00
|
$49,901.00
|
2024-12-15
|
|
6303
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
10
|
8
|
$0.01
|
—
|
$46,657.00
|
$55,988.00
|
$49,689.50
|
2024-12-15
|
|
54
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
10
|
8
|
$0.01
|
—
|
$46,532.00
|
$55,838.00
|
$49,556.50
|
2024-12-15
|
|
464
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
34
|
21
|
$0.01
|
—
|
$25,152.00
|
$119,439.00
|
$49,272.50
|
2024-12-15
|
|
480
|
MS_DRG
|
Hip And Femur Procedures Except Major Joint With Mcc
|
34
|
21
|
$0.01
|
—
|
$25,090.00
|
$119,131.00
|
$49,145.50
|
2024-12-15
|
|
353
|
MS_DRG
|
Hernia Procedures Except Inguinal And Femoral With Mcc
|
34
|
21
|
$0.01
|
—
|
$25,025.00
|
$118,807.00
|
$49,012.00
|
2024-12-15
|
|
35371
|
CPT
|
Hc Thromboendartectmy Femoral Common
|
110
|
42
|
$88,797.00
|
$35,518.80
60% off
|
$10,567.00
|
$162,072.00
|
$48,749.50
|
2024-12-15
|
|
35355
|
CPT
|
Hc Thromboendarterectomy With Without Patch Graft Iliofemoral
|
110
|
42
|
$88,797.00
|
$35,518.80
60% off
|
$10,567.00
|
$162,072.00
|
$48,749.50
|
2024-12-15
|
|
668
|
MS_DRG
|
Transurethral Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$24,889.00
|
$118,131.00
|
$48,733.00
|
2024-12-15
|
|
800
|
MS_DRG
|
Splenic Procedures With Cc
|
34
|
21
|
$0.01
|
—
|
$24,868.00
|
$118,029.00
|
$48,691.00
|
2024-12-15
|
|
240
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc
|
34
|
21
|
$0.01
|
—
|
$24,855.00
|
$117,964.00
|
$48,664.00
|
2024-12-15
|
|
274
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures Without Mcc
|
34
|
21
|
$0.01
|
—
|
$26,558.00
|
$126,422.00
|
$48,421.50
|
2024-12-15
|
|
37227
|
CPT
|
Hc Revascularize Fem/pop Artery,angioplasty/stent/atherectomy
|
110
|
42
|
$79,496.00
|
$31,798.40
60% off
|
$9,460.00
|
$145,096.00
|
$48,238.50
|
2024-12-15
|
|
37231
|
CPT
|
Hc Revascularize Tibial/peron Artery,angioplasty/stent/atherectomy Init
|
110
|
42
|
$79,467.00
|
$31,786.80
60% off
|
$9,457.00
|
$145,043.00
|
$48,220.50
|
2024-12-15
|
|
521
|
MS_DRG
|
Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc
|
34
|
21
|
$0.01
|
—
|
$24,876.00
|
$118,066.00
|
$48,208.00
|
2024-12-15
|
|
C1767
|
HCPCS
|
Stimulator Proclaim Elite 7 Rechrg-free Scs
|
1,516
|
42
|
$123,420.00
|
$49,368.00
60% off
|
$10,148.00
|
$263,524.00
|
$48,198.00
|
2024-12-15
|
|
A9591
|
HCPCS
|
Fluoroestradiol F 18 4-100 Mci/ml IV Soln
|
71
|
42
|
$136,035.04
|
$54,414.02
60% off
|
$69.00
|
$124,146.00
|
$48,156.00
|
2024-12-15
|
|
625
|
MS_DRG
|
Thyroid, Parathyroid And Thyroglossal Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$24,487.00
|
$116,138.00
|
$47,911.00
|
2024-12-15
|
|
325
|
MS_DRG
|
Coronary Intravascular Lithotripsy Without Intraluminal Device
|
34
|
21
|
$0.01
|
—
|
$24,447.00
|
$115,935.00
|
$47,827.50
|
2024-12-15
|
|
6074
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
8
|
$0.01
|
—
|
$44,903.00
|
$53,883.00
|
$47,821.50
|
2024-12-15
|
|
510
|
MS_DRG
|
Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$24,414.00
|
$115,773.00
|
$47,760.00
|
2024-12-15
|
|
5932
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
10
|
8
|
$0.01
|
—
|
$44,820.00
|
$53,783.00
|
$47,733.00
|
2024-12-15
|
|
43
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
10
|
8
|
$0.01
|
—
|
$44,733.00
|
$53,680.00
|
$47,641.00
|
2024-12-15
|
|
321
|
MS_DRG
|
Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A…
|
34
|
21
|
$0.01
|
—
|
$24,322.00
|
$115,315.00
|
$47,571.50
|
2024-12-15
|
|
21
|
APR_DRG
|
Heart And/or Lung Transplant
|
10
|
8
|
$0.01
|
—
|
$44,578.00
|
$53,493.00
|
$47,475.00
|
2024-12-15
|
|
33276
|
CPT
|
Hc Insert Phrenic Nerve Stimulator System
|
71
|
42
|
$75,869.00
|
$30,347.60
60% off
|
$9,028.00
|
$136,280.00
|
$47,251.00
|
2024-12-15
|
|
654
|
MS_DRG
|
Major Bladder Procedures With Cc
|
34
|
21
|
$0.01
|
—
|
$24,121.00
|
$114,315.00
|
$47,158.50
|
2024-12-15
|
|
406
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Cc
|
34
|
21
|
$0.01
|
—
|
$24,009.00
|
$113,760.00
|
$46,930.00
|
2024-12-15
|
|
258
|
MS_DRG
|
Cardiac Pacemaker Device Replacement With Mcc
|
34
|
21
|
$0.01
|
—
|
$23,985.00
|
$113,642.00
|
$46,582.50
|
2024-12-15
|
|
77371
|
CPT
|
Hc Tr Srs 1 Session Multi Cobalt 60
|
71
|
42
|
$129,616.00
|
$51,846.40
60% off
|
$7,420.00
|
$118,288.00
|
$45,884.00
|
2024-12-15
|
|
411
|
MS_DRG
|
Cholecystectomy With C.d.e. With Mcc
|
34
|
21
|
$0.01
|
—
|
$23,422.00
|
$110,843.00
|
$45,726.50
|
2024-12-15
|
|
288
|
MS_DRG
|
Acute And Subacute Endocarditis With Mcc
|
34
|
21
|
$0.01
|
—
|
$23,382.00
|
$110,645.00
|
$45,645.00
|
2024-12-15
|
|
619
|
MS_DRG
|
O.r. Procedures For Obesity With Mcc
|
34
|
21
|
$0.01
|
—
|
$23,341.00
|
$110,442.00
|
$45,561.00
|
2024-12-15
|
|
963
|
MS_DRG
|
Other Multiple Significant Trauma With Mcc
|
34
|
21
|
$0.01
|
—
|
$23,261.00
|
$110,045.00
|
$45,397.00
|
2024-12-15
|
|
3034
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
10
|
8
|
$0.01
|
—
|
$42,599.00
|
$51,119.00
|
$45,368.00
|
2024-12-15
|
|
462
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc
|
34
|
21
|
$0.01
|
—
|
$24,461.00
|
$116,004.00
|
$45,281.00
|
2024-12-15
|
|
61
|
MS_DRG
|
Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…
|
34
|
21
|
$0.01
|
—
|
$23,153.00
|
$109,507.00
|
$45,175.50
|
2024-12-15
|
|
344
|
MS_DRG
|
Minor Small And Large Bowel Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$23,080.00
|
$109,146.00
|
$45,026.50
|
2024-12-15
|
|
518
|
MS_DRG
|
Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…
|
34
|
21
|
$0.01
|
—
|
$30,332.00
|
$145,177.00
|
$44,926.50
|
2024-12-15
|
|
208
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support <=96 Hours
|
34
|
21
|
$0.01
|
—
|
$22,993.00
|
$108,713.00
|
$44,847.50
|
2024-12-15
|
|
263
|
MS_DRG
|
Vein Ligation And Stripping
|
34
|
21
|
$0.01
|
—
|
$22,979.00
|
$108,644.00
|
$44,819.50
|
2024-12-15
|
|
849
|
MS_DRG
|
Radiotherapy
|
34
|
21
|
$0.01
|
—
|
$22,889.00
|
$108,198.00
|
$44,635.50
|
2024-12-15
|
|
279
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
34
|
21
|
$0.01
|
—
|
$27,237.00
|
$129,801.00
|
$44,543.50
|
2024-12-15
|
|
577
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Cc
|
34
|
21
|
$0.01
|
—
|
$22,822.00
|
$107,862.00
|
$44,496.50
|
2024-12-15
|
|
970
|
MS_DRG
|
HIV With Extensive O.r. Procedures Without Mcc
|
34
|
21
|
$0.01
|
—
|
$22,744.00
|
$107,477.00
|
$44,338.00
|
2024-12-15
|
|
13
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc
|
34
|
21
|
$0.01
|
—
|
$22,717.00
|
$107,344.00
|
$44,283.00
|
2024-12-15
|
|
6023
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
8
|
$0.01
|
—
|
$41,561.00
|
$49,873.00
|
$44,262.00
|
2024-12-15
|
|
503
|
MS_DRG
|
Foot Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$22,690.00
|
$107,206.00
|
$44,226.00
|
2024-12-15
|
|
959
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc
|
34
|
21
|
$0.01
|
—
|
$22,668.00
|
$107,096.00
|
$44,181.00
|
2024-12-15
|
|
37235
|
CPT
|
Hc Ccl Tib/per Revasc Stnt And Arthrectomy Addl
|
110
|
42
|
$72,121.00
|
$28,848.40
60% off
|
$8,582.00
|
$131,635.00
|
$43,763.00
|
2024-12-15
|
|
255
|
MS_DRG
|
Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc
|
34
|
21
|
$0.01
|
—
|
$22,444.00
|
$105,987.00
|
$43,723.00
|
2024-12-15
|
|
472
|
MS_DRG
|
Cervical Spinal Fusion With Cc
|
34
|
21
|
$0.01
|
—
|
$24,733.00
|
$117,357.00
|
$43,656.00
|
2024-12-15
|
|
J9302
|
HCPCS
|
Ofatumumab 100 Mg/5ml IV Conc
|
62
|
37
|
$110,287.06
|
$44,114.82
60% off
|
$64.00
|
$100,648.00
|
$43,651.50
|
2024-12-15
|
|
C1882
|
HCPCS
|
Defibrillator Consulta 2chb Is1 Df1 Av 35jl 38ml 6
|
3,510
|
42
|
$116,025.40
|
$46,410.16
60% off
|
$5.00
|
$211,776.00
|
$43,328.50
|
2024-12-15
|
|
749
|
MS_DRG
|
Other Female Reproductive System O.r. Procedures With Cc/mcc
|
34
|
21
|
$0.01
|
—
|
$22,217.00
|
$104,856.00
|
$43,257.00
|
2024-12-15
|
|
659
|
MS_DRG
|
Kidney And Ureter Procedures For Non-neoplasm With Mcc
|
34
|
21
|
$0.01
|
—
|
$22,182.00
|
$104,682.00
|
$43,185.00
|
2024-12-15
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
10
|
8
|
$0.01
|
—
|
$40,490.00
|
$48,589.00
|
$43,122.50
|
2024-12-15
|
|
846
|
MS_DRG
|
Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc
|
34
|
21
|
$0.01
|
—
|
$21,933.00
|
$103,447.00
|
$42,675.00
|
2024-12-15
|
|
84
|
APR_DRG
|
Autologous Bone Marrow Transplant
|
10
|
8
|
$0.01
|
—
|
$40,033.00
|
$48,039.00
|
$42,635.00
|
2024-12-15
|
|
483
|
MS_DRG
|
Major Joint Or Limb Reattachment Procedures Of Upper Extremities
|
34
|
21
|
$0.01
|
—
|
$21,887.00
|
$103,220.00
|
$42,582.00
|
2024-12-15
|
|
817
|
MS_DRG
|
Other Antepartum Diagnoses With O.r. Procedures With Mcc
|
34
|
21
|
$0.01
|
—
|
$21,781.00
|
$102,689.00
|
$42,362.50
|
2024-12-15
|
|
545
|
MS_DRG
|
Connective Tissue Disorders With Mcc
|
34
|
21
|
$0.01
|
—
|
$21,714.00
|
$102,357.00
|
$42,226.00
|
2024-12-15
|
|
498
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…
|
34
|
21
|
$0.01
|
—
|
$21,698.00
|
$102,276.00
|
$42,192.50
|
2024-12-15
|
|
164
|
MS_DRG
|
Major Chest Procedures With Cc
|
34
|
21
|
$0.01
|
—
|
$21,633.00
|
$101,956.00
|
$42,060.50
|
2024-12-15
|
|
73
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
10
|
8
|
$0.01
|
—
|
$39,475.00
|
$47,370.00
|
$42,040.50
|
2024-12-15
|
|
253
|
MS_DRG
|
Other Vascular Procedures With Cc
|
34
|
21
|
$0.01
|
—
|
$21,927.00
|
$103,414.00
|
$41,867.50
|
2024-12-15
|
|
56
|
MS_DRG
|
Degenerative Nervous System Disorders With Mcc
|
34
|
21
|
$0.01
|
—
|
$21,528.00
|
$101,434.00
|
$41,844.50
|
2024-12-15
|
|
0187-3013-30
|
NDC
|
Pyridostigmine Bromide ER 180 Mg Po Tbcr
|
43
|
24
|
$76,183.08
|
$30,473.23
60% off
|
$12,951.00
|
$69,525.00
|
$41,748.00
|
2024-12-15
|