|
Q2042
|
HCPCS
|
Kymriah 0.2 X 10exp6 To 2.5 X 10exp8 Cell Intravenous Suspension
|
25
|
14
|
$2,848,960.04
|
$1,851,824.03
35% off
|
$529,192.86
|
$2,564,064.04
|
$890,857.55
|
2025-06-28
|
|
Q2056
|
HCPCS
|
Carvykti 0.5x 10exp6 To 1x 10exp8 Cell Intravenous Suspension
|
21
|
14
|
$2,505,866.40
|
$1,628,813.16
35% off
|
$527,123.43
|
$2,255,279.76
|
$579,835.77
|
2025-06-28
|
|
Q2041
|
HCPCS
|
Yescarta Intravenous Suspension
|
21
|
14
|
$2,417,184.00
|
$1,571,169.60
35% off
|
$489,455.96
|
$2,175,465.60
|
$538,401.56
|
2025-06-28
|
|
Q2054
|
HCPCS
|
Breyanzi 1.5x To 70x10exp6 Cell/ml Intravenous Suspension
|
21
|
14
|
$2,339,891.68
|
$1,520,929.59
35% off
|
$516,726.08
|
$2,105,902.51
|
$568,398.69
|
2025-06-28
|
|
Q2053
|
HCPCS
|
Tecartus 2x10exp6 To 2x10exp8 Cell Intravenous Suspension
|
24
|
14
|
$2,217,600.00
|
$1,441,440.00
35% off
|
$460,530.40
|
$1,995,840.00
|
$615,878.02
|
2025-06-28
|
|
J9226
|
HCPCS
|
Supprelin La 50 Mg (65 Mcg/day) Implant Kit
|
27
|
14
|
$175,562.52
|
$114,115.64
35% off
|
$45,350.22
|
$175,562.52
|
$71,287.34
|
2025-06-28
|
|
27879075
|
CDM
|
Tavr Device Kit
|
21
|
7
|
$152,727.00
|
$99,272.55
35% off
|
$31,767.22
|
$137,454.30
|
$64,298.07
|
2025-06-28
|
|
81200100
|
CDM
|
Acquisition Fee Liver
|
14
|
6
|
$149,100.00
|
$96,915.00
35% off
|
$31,012.80
|
$134,190.00
|
$57,403.50
|
2025-06-28
|
|
A9543
|
HCPCS
|
Zevalin (y-90) 3.2 Mg/2 Ml Intravenous Kit
|
24
|
14
|
$148,248.86
|
$96,361.76
35% off
|
$14,774.74
|
$219,601.49
|
$34,720.64
|
2025-06-28
|
|
C9293
|
HCPCS
|
Voraxaze 1000 Unit Intravenous Solution
|
14
|
6
|
$148,226.40
|
$96,347.16
35% off
|
$618.80
|
$148,226.40
|
$54,102.63
|
2025-06-28
|
|
81200110
|
CDM
|
Acquisition Kidney Cadaver
|
14
|
6
|
$116,200.00
|
$75,530.00
35% off
|
$24,169.60
|
$104,580.00
|
$44,737.00
|
2025-06-28
|
|
J9600
|
HCPCS
|
Photofrin 75 Mg Intravenous Solution
|
24
|
14
|
$111,950.40
|
$72,767.76
35% off
|
$23,870.14
|
$111,950.40
|
$33,526.02
|
2025-06-28
|
|
81200120
|
CDM
|
Acquisition Fee Heart
|
14
|
6
|
$109,100.00
|
$70,915.00
35% off
|
$22,692.80
|
$98,190.00
|
$42,003.50
|
2025-06-28
|
|
J9029
|
HCPCS
|
Adstiladrin 3x10exp11 Vp/ml Intravesical Suspension
|
27
|
14
|
$72,000.00
|
$46,800.00
35% off
|
$25,200.00
|
$244,495.79
|
$65,888.96
|
2025-06-28
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
12
|
11
|
—
|
—
|
$3,672,900.00
|
$4,424,158.31
|
$3,672,900.00
|
2025-06-28
|
|
J1414
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
12
|
11
|
—
|
—
|
$3,605,000.00
|
$4,424,158.31
|
$3,605,000.00
|
2025-06-28
|
|
J3394
|
HCPCS
|
Lyfgenia 1.7 X To 20 X 10exp6 Cell/ml Intravenous Suspension
|
14
|
11
|
—
|
—
|
$3,286,000.00
|
$4,865,760.00
|
$3,351,720.00
|
2025-06-28
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
12
|
11
|
—
|
—
|
$3,325,454.76
|
$3,961,209.50
|
$3,325,454.76
|
2025-06-28
|
|
J3393
|
HCPCS
|
Zynteglo 2 X 10exp6 To 20 X 10exp6 Cell/ml Intravenous Suspension
|
15
|
11
|
—
|
—
|
$2,968,000.00
|
$4,674,600.00
|
$3,086,720.00
|
2025-06-28
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
1
|
1
|
—
|
—
|
$2,978,101.83
|
$2,978,101.83
|
$2,978,101.83
|
2025-06-28
|
|
J3399
|
HCPCS
|
Zolgensma 2 X 10exp13 Vg/ml Intravenous Suspension Kit
|
19
|
13
|
—
|
$4,972,500.00
|
$2,388,614.23
|
$4,972,500.00
|
$2,508,044.94
|
2025-06-28
|
|
J3392
|
HCPCS
|
Casgevy 4x10exp6 To 13x10exp6 Cell/ml Intravenous Suspension
|
16
|
11
|
—
|
—
|
$2,332,000.00
|
$4,897,200.00
|
$2,436,940.00
|
2025-06-28
|
|
C9301
|
HCPCS
|
Obecabtagene Car Pos T
|
1
|
1
|
—
|
—
|
$1,075,311.87
|
$1,075,311.87
|
$1,075,311.87
|
2025-06-28
|
|
INTESTONLYP
|
CPT
|
Intestine Only-pediatric
|
1
|
1
|
—
|
—
|
$540,500.00
|
$540,500.00
|
$540,500.00
|
2025-06-28
|
|
INTESTONLYA
|
CPT
|
Intestine Only-adult
|
1
|
1
|
—
|
—
|
$485,000.00
|
$485,000.00
|
$485,000.00
|
2025-06-28
|
|
005-LA
|
MS_DRG
|
Liver (Live Donor) - Adult
|
1
|
1
|
—
|
—
|
$458,602.00
|
$458,602.00
|
$458,602.00
|
2025-06-28
|
|
006-LA
|
MS_DRG
|
Liver (Live Donor) - Adult
|
1
|
1
|
—
|
—
|
$458,602.00
|
$458,602.00
|
$458,602.00
|
2025-06-28
|
|
006-LP
|
MS_DRG
|
Liver (Live Donor) - Pediatric
|
1
|
1
|
—
|
—
|
$457,752.00
|
$457,752.00
|
$457,752.00
|
2025-06-28
|
|
005-LP
|
MS_DRG
|
Liver (Live Donor) - Pediatric
|
1
|
1
|
—
|
—
|
$457,752.00
|
$457,752.00
|
$457,752.00
|
2025-06-28
|
|
014-UP
|
MS_DRG
|
Allogeneic Unrelated Bmt ? Pediatric
|
1
|
1
|
—
|
—
|
$444,062.00
|
$444,062.00
|
$444,062.00
|
2025-06-28
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell Immunotherapy
|
34
|
14
|
—
|
—
|
$270,317.46
|
$734,192.79
|
$407,618.80
|
2025-06-28
|
|
006-DA
|
MS_DRG
|
Liver (Deceased Donor) - Adult
|
1
|
1
|
—
|
—
|
$397,360.00
|
$397,360.00
|
$397,360.00
|
2025-06-28
|
|
005-DA
|
MS_DRG
|
Liver (Deceased Donor) - Adult
|
1
|
1
|
—
|
—
|
$397,360.00
|
$397,360.00
|
$397,360.00
|
2025-06-28
|
|
014-RP
|
MS_DRG
|
Allogeneic Related Bmt ? Pediatric
|
1
|
1
|
—
|
—
|
$394,880.00
|
$394,880.00
|
$394,880.00
|
2025-06-28
|
|
014-UA
|
MS_DRG
|
Allogeneic Unrelated Bmt ? Adult
|
1
|
1
|
—
|
—
|
$392,967.00
|
$392,967.00
|
$392,967.00
|
2025-06-28
|
|
005-DP
|
MS_DRG
|
Liver (Deceased Donor) - Pediatric
|
1
|
1
|
—
|
—
|
$385,169.00
|
$385,169.00
|
$385,169.00
|
2025-06-28
|
|
006-DP
|
MS_DRG
|
Liver (Deceased Donor) - Pediatric
|
1
|
1
|
—
|
—
|
$385,169.00
|
$385,169.00
|
$385,169.00
|
2025-06-28
|
|
002-P
|
MS_DRG
|
Heart - Pediatric
|
1
|
1
|
—
|
—
|
$363,339.00
|
$363,339.00
|
$363,339.00
|
2025-06-28
|
|
001-P
|
MS_DRG
|
Heart - Pediatric
|
1
|
1
|
—
|
—
|
$363,339.00
|
$363,339.00
|
$363,339.00
|
2025-06-28
|
|
007-D
|
MS_DRG
|
Lung (Double) - Adult
|
1
|
1
|
—
|
—
|
$354,264.00
|
$354,264.00
|
$354,264.00
|
2025-06-28
|
|
007-S
|
MS_DRG
|
Lung (Single) - Adult
|
1
|
1
|
—
|
—
|
$349,729.00
|
$349,729.00
|
$349,729.00
|
2025-06-28
|
|
014-RA
|
MS_DRG
|
Allogeneic Related Bmt ? Adult
|
1
|
1
|
—
|
—
|
$349,444.00
|
$349,444.00
|
$349,444.00
|
2025-06-28
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
34
|
14
|
—
|
—
|
$201,904.48
|
$548,380.46
|
$304,457.07
|
2025-06-28
|
|
001-A
|
MS_DRG
|
Heart - Adult & Pediatric
|
1
|
1
|
—
|
—
|
$295,292.00
|
$295,292.00
|
$295,292.00
|
2025-06-28
|
|
002-A
|
MS_DRG
|
Heart - Adult & Pediatric
|
1
|
1
|
—
|
—
|
$295,292.00
|
$295,292.00
|
$295,292.00
|
2025-06-28
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
34
|
14
|
—
|
—
|
$170,040.07
|
$461,835.47
|
$256,407.89
|
2025-06-28
|
|
KIDPANC
|
CPT
|
Kidney/Pancreas - Adult & Pediatric
|
1
|
1
|
—
|
—
|
$238,302.00
|
$238,302.00
|
$238,302.00
|
2025-06-28
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
34
|
14
|
—
|
—
|
$153,617.22
|
$417,230.39
|
$231,643.45
|
2025-06-28
|
|
017-P
|
MS_DRG
|
Autologous Bmt - Pediatric
|
1
|
1
|
—
|
—
|
$222,030.00
|
$222,030.00
|
$222,030.00
|
2025-06-28
|
|
016-P
|
MS_DRG
|
Autologous Bmt - Pediatric
|
1
|
1
|
—
|
—
|
$222,030.00
|
$222,030.00
|
$222,030.00
|
2025-06-28
|
|
Q0480
|
HCPCS
|
Driver Pneumatic Vad, Rep
|
3
|
1
|
—
|
—
|
$161,066.00
|
$283,566.43
|
$213,166.75
|
2025-06-28
|
|
5834
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$192,207.36
|
$230,648.83
|
$199,895.65
|
2025-06-28
|
|
017-A
|
MS_DRG
|
Autologous Bmt - Adult
|
1
|
1
|
—
|
—
|
$196,483.00
|
$196,483.00
|
$196,483.00
|
2025-06-28
|
|
016-A
|
MS_DRG
|
Autologous Bmt - Adult
|
1
|
1
|
—
|
—
|
$196,483.00
|
$196,483.00
|
$196,483.00
|
2025-06-28
|
|
K1007
|
HCPCS
|
Bil Hkaf Pc S/d Micro Sensor
|
3
|
1
|
—
|
—
|
$137,344.97
|
$241,804.12
|
$181,772.57
|
2025-06-28
|
|
650-DP
|
MS_DRG
|
Kidney (Deceased) - Pediatric
|
1
|
1
|
—
|
—
|
$166,486.00
|
$166,486.00
|
$166,486.00
|
2025-06-28
|
|
651-DP
|
MS_DRG
|
Kidney (Deceased) - Pediatric
|
1
|
1
|
—
|
—
|
$166,486.00
|
$166,486.00
|
$166,486.00
|
2025-06-28
|
|
652-DP
|
MS_DRG
|
Kidney (Deceased) - Pediatric
|
1
|
1
|
—
|
—
|
$166,486.00
|
$166,486.00
|
$166,486.00
|
2025-06-28
|
|
651-LP
|
MS_DRG
|
Kidney (Live Donor) - Pediatric
|
1
|
1
|
—
|
—
|
$153,120.00
|
$153,120.00
|
$153,120.00
|
2025-06-28
|
|
650-LP
|
MS_DRG
|
Kidney ( Live Donor) - Pediatric
|
1
|
1
|
—
|
—
|
$153,120.00
|
$153,120.00
|
$153,120.00
|
2025-06-28
|
|
652-LP
|
MS_DRG
|
Kidney (Live Donor) - Pediatric
|
1
|
1
|
—
|
—
|
$153,120.00
|
$153,120.00
|
$153,120.00
|
2025-06-28
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
34
|
14
|
—
|
—
|
$101,280.88
|
$275,082.84
|
$152,724.11
|
2025-06-28
|
|
651-DA
|
MS_DRG
|
Kidney (Deceased ) - Adult
|
1
|
1
|
—
|
—
|
$143,039.00
|
$143,039.00
|
$143,039.00
|
2025-06-28
|
|
650-DA
|
MS_DRG
|
Kidney (Deceased ) - Adult
|
1
|
1
|
—
|
—
|
$143,039.00
|
$143,039.00
|
$143,039.00
|
2025-06-28
|
|
652-DA
|
MS_DRG
|
Kidney (Deceased ) - Adult
|
1
|
1
|
—
|
—
|
$143,039.00
|
$143,039.00
|
$143,039.00
|
2025-06-28
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
34
|
14
|
—
|
—
|
$93,910.96
|
$255,065.84
|
$141,610.80
|
2025-06-28
|
|
7
|
MS_DRG
|
Lung Transplant
|
34
|
14
|
—
|
—
|
$93,674.42
|
$254,423.40
|
$141,254.12
|
2025-06-28
|
|
650-LA
|
MS_DRG
|
Kidney ( Live Donor) - Adult
|
1
|
1
|
—
|
—
|
$131,556.00
|
$131,556.00
|
$131,556.00
|
2025-06-28
|
|
652-LA
|
MS_DRG
|
Kidney ( Live Donor) - Adult
|
1
|
1
|
—
|
—
|
$131,556.00
|
$131,556.00
|
$131,556.00
|
2025-06-28
|
|
651-LA
|
MS_DRG
|
Kidney ( Live Donor) - Adult
|
1
|
1
|
—
|
—
|
$131,556.00
|
$131,556.00
|
$131,556.00
|
2025-06-28
|
|
L8702
|
HCPCS
|
Ewhf S/d Uprt Micro Sensor
|
3
|
1
|
—
|
—
|
$99,384.37
|
$174,972.20
|
$131,532.69
|
2025-06-28
|
|
5884
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$125,393.59
|
$150,472.31
|
$130,409.33
|
2025-06-28
|
|
5833
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$124,517.93
|
$149,421.52
|
$129,498.65
|
2025-06-28
|
|
453
|
MS_DRG
|
Combined Anterior/posterior Spinal Fusion W Mcc
|
1
|
1
|
—
|
—
|
$123,643.11
|
$123,643.11
|
$123,643.11
|
2025-06-28
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
34
|
14
|
—
|
—
|
$78,986.90
|
$214,531.52
|
$119,106.43
|
2025-06-28
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
34
|
14
|
—
|
—
|
$78,085.19
|
$212,082.45
|
$117,746.71
|
2025-06-28
|
|
0024
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$111,047.26
|
$133,256.71
|
$115,489.15
|
2025-06-28
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
34
|
14
|
—
|
—
|
$76,332.67
|
$207,322.52
|
$115,104.04
|
2025-06-28
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
34
|
14
|
—
|
—
|
$75,941.31
|
$206,259.57
|
$114,513.89
|
2025-06-28
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
32
|
14
|
—
|
—
|
$75,085.47
|
$203,935.09
|
$109,164.14
|
2025-06-28
|
|
0114
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$97,644.17
|
$117,173.00
|
$101,549.94
|
2025-06-28
|
|
5832
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$95,607.07
|
$114,728.48
|
$99,431.35
|
2025-06-28
|
|
1614
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$95,167.09
|
$114,200.51
|
$98,973.77
|
2025-06-28
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
32
|
14
|
—
|
—
|
$66,028.97
|
$179,337.27
|
$95,997.21
|
2025-06-28
|
|
6304
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$91,470.33
|
$109,764.40
|
$95,129.15
|
2025-06-28
|
|
L7181
|
HCPCS
|
Electronic Elbo Simultaneous
|
3
|
1
|
—
|
—
|
$71,655.28
|
$126,153.46
|
$94,833.94
|
2025-06-28
|
|
8414
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$90,217.23
|
$108,260.68
|
$93,825.92
|
2025-06-28
|
|
459
|
MS_DRG
|
Spinal Fusion Except Cervical With Mcc
|
1
|
1
|
—
|
—
|
$92,540.48
|
$92,540.48
|
$92,540.48
|
2025-06-28
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
34
|
14
|
—
|
—
|
$69,177.06
|
$187,887.61
|
$91,724.32
|
2025-06-28
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
34
|
14
|
—
|
—
|
$60,705.45
|
$164,878.39
|
$91,539.35
|
2025-06-28
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
34
|
14
|
—
|
—
|
$57,780.27
|
$156,933.49
|
$87,128.40
|
2025-06-28
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
32
|
14
|
—
|
—
|
$59,783.67
|
$162,374.80
|
$86,917.39
|
2025-06-28
|
|
6094
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$82,446.63
|
$98,935.96
|
$85,744.49
|
2025-06-28
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
34
|
14
|
—
|
—
|
$56,821.22
|
$154,328.68
|
$85,682.23
|
2025-06-28
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
34
|
14
|
—
|
—
|
$60,739.14
|
$164,969.89
|
$85,598.18
|
2025-06-28
|
|
454
|
MS_DRG
|
Combined Anterior/posterior Spinal Fusion W Cc
|
1
|
1
|
—
|
—
|
$85,340.73
|
$85,340.73
|
$85,340.73
|
2025-06-28
|
|
5883
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$81,552.63
|
$97,863.16
|
$84,814.74
|
2025-06-28
|
|
6314
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$80,942.26
|
$97,130.71
|
$84,179.95
|
2025-06-28
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
35
|
15
|
—
|
—
|
$57,148.79
|
$186,135.00
|
$83,190.28
|
2025-06-28
|
|
5914
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$79,657.88
|
$95,589.46
|
$82,844.20
|
2025-06-28
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization With Mcc
|
35
|
14
|
—
|
—
|
$56,026.32
|
$227,659.00
|
$81,556.32
|
2025-06-28
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
34
|
14
|
—
|
—
|
$53,501.82
|
$145,313.05
|
$80,676.80
|
2025-06-28
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
34
|
14
|
—
|
—
|
$55,460.78
|
$150,633.65
|
$80,632.49
|
2025-06-28
|
|
0074
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$75,611.36
|
$90,733.63
|
$78,635.82
|
2025-06-28
|
|
0094
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$75,232.48
|
$90,278.98
|
$78,241.77
|
2025-06-28
|
|
5934
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$73,863.27
|
$88,635.92
|
$76,817.80
|
2025-06-28
|
|
L7180
|
HCPCS
|
Electronic Elbow Sequential
|
3
|
1
|
—
|
—
|
$57,769.47
|
$101,706.64
|
$76,456.42
|
2025-06-28
|
|
L2006
|
HCPCS
|
Kaf Sng/dbl Swg/stn Mcpr Cus
|
3
|
1
|
—
|
—
|
$56,882.34
|
$100,144.79
|
$75,282.32
|
2025-06-28
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
34
|
14
|
—
|
—
|
$49,862.73
|
$135,429.14
|
$75,189.33
|
2025-06-28
|
|
5882
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$71,560.89
|
$85,873.07
|
$74,423.32
|
2025-06-28
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
32
|
14
|
—
|
—
|
$50,910.66
|
$138,275.36
|
$74,017.24
|
2025-06-28
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
34
|
14
|
—
|
—
|
$48,943.82
|
$132,933.34
|
$73,803.68
|
2025-06-28
|
|
5831
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$69,493.59
|
$83,392.31
|
$72,273.33
|
2025-06-28
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
34
|
14
|
—
|
—
|
$47,872.95
|
$130,024.83
|
$72,188.89
|
2025-06-28
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
34
|
14
|
—
|
—
|
$47,791.96
|
$129,804.84
|
$72,066.76
|
2025-06-28
|
|
6034
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$68,321.01
|
$81,985.21
|
$71,053.85
|
2025-06-28
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
34
|
14
|
—
|
—
|
$46,288.87
|
$125,722.40
|
$69,960.36
|
2025-06-28
|
|
0014
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$67,242.61
|
$80,691.13
|
$69,932.32
|
2025-06-28
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
34
|
14
|
—
|
—
|
$46,355.53
|
$125,903.45
|
$69,900.73
|
2025-06-28
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
32
|
14
|
—
|
—
|
$48,057.88
|
$130,527.10
|
$69,869.68
|
2025-06-28
|
|
0044
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$66,782.13
|
$80,138.56
|
$69,453.42
|
2025-06-28
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
34
|
14
|
—
|
—
|
$50,654.77
|
$137,580.36
|
$68,564.67
|
2025-06-28
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
34
|
14
|
—
|
—
|
$45,331.26
|
$123,121.47
|
$68,356.20
|
2025-06-28
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
34
|
14
|
—
|
—
|
$43,785.88
|
$125,209.00
|
$68,138.59
|
2025-06-28
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
34
|
14
|
—
|
—
|
$42,643.33
|
$125,209.00
|
$67,307.00
|
2025-06-28
|
|
1613
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$64,392.40
|
$77,270.88
|
$66,968.10
|
2025-06-28
|
|
L8701
|
HCPCS
|
Ewh S/d Uprt Micro Sensor
|
3
|
1
|
—
|
—
|
$50,514.50
|
$88,933.84
|
$66,854.66
|
2025-06-28
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
34
|
14
|
—
|
—
|
$44,140.69
|
$119,887.84
|
$66,560.90
|
2025-06-28
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc
|
34
|
14
|
—
|
—
|
$43,986.58
|
$119,469.28
|
$66,328.52
|
2025-06-28
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
34
|
14
|
—
|
—
|
$43,576.58
|
$118,355.71
|
$65,710.27
|
2025-06-28
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
34
|
14
|
—
|
—
|
$43,264.06
|
$117,506.90
|
$65,239.03
|
2025-06-28
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
34
|
14
|
—
|
—
|
$43,264.06
|
$117,506.90
|
$65,239.03
|
2025-06-28
|
|
0023
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$62,352.42
|
$74,822.90
|
$64,846.51
|
2025-06-28
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement W Mcc
|
34
|
14
|
—
|
—
|
$42,940.80
|
$116,628.89
|
$64,751.57
|
2025-06-28
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
32
|
14
|
—
|
—
|
$44,342.82
|
$120,436.84
|
$64,468.48
|
2025-06-28
|
|
455
|
MS_DRG
|
Combined Anterior/posterior Spinal Fusion Without Cc/mcc
|
1
|
1
|
—
|
—
|
$64,261.94
|
$64,261.94
|
$64,261.94
|
2025-06-28
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
34
|
14
|
—
|
—
|
$42,611.08
|
$115,733.37
|
$64,254.37
|
2025-06-28
|
|
5881
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$61,338.01
|
$73,605.61
|
$63,791.53
|
2025-06-28
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
34
|
14
|
—
|
—
|
$42,176.71
|
$114,553.61
|
$63,599.38
|
2025-06-28
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
34
|
14
|
—
|
—
|
$41,733.02
|
$113,348.54
|
$62,930.33
|
2025-06-28
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
34
|
14
|
—
|
—
|
$41,138.81
|
$111,734.64
|
$62,034.31
|
2025-06-28
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
34
|
14
|
—
|
—
|
$40,892.96
|
$111,066.89
|
$61,663.57
|
2025-06-28
|
|
5913
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$59,125.13
|
$70,950.16
|
$61,490.13
|
2025-06-28
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Without Mcc
|
34
|
14
|
—
|
—
|
$38,134.08
|
$125,209.00
|
$60,652.94
|
2025-06-28
|
|
38240
|
HCPCS
|
Transplt Allo Hct/donor
|
14
|
10
|
—
|
—
|
$59,365.89
|
$228,558.67
|
$60,553.21
|
2025-06-28
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
34
|
14
|
—
|
—
|
$44,400.16
|
$120,592.58
|
$60,518.66
|
2025-06-28
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
34
|
14
|
—
|
—
|
$37,965.63
|
$125,209.00
|
$60,385.03
|
2025-06-28
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
34
|
14
|
—
|
—
|
$39,957.56
|
$108,526.31
|
$60,253.07
|
2025-06-28
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
34
|
14
|
—
|
—
|
$39,618.53
|
$107,605.48
|
$59,741.82
|
2025-06-28
|
|
834
|
MS_DRG
|
Acute Leukemia Without Major O.r. Procedures With Mcc
|
34
|
14
|
—
|
—
|
$39,618.53
|
$107,605.48
|
$59,741.82
|
2025-06-28
|
|
0113
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$56,946.04
|
$68,335.25
|
$59,223.88
|
2025-06-28
|
|
8
|
MS_DRG
|
Simultaneous Pancreas/kidney Transplant
|
34
|
14
|
—
|
—
|
$39,000.66
|
$105,927.33
|
$58,810.13
|
2025-06-28
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
34
|
14
|
—
|
—
|
$38,911.78
|
$105,685.93
|
$58,676.10
|
2025-06-28
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
34
|
14
|
—
|
—
|
$38,713.23
|
$105,146.67
|
$58,376.71
|
2025-06-28
|
|
11
|
MS_DRG
|
Tracheostomy For Face,mouth & Neck Diagnoses W Mcc
|
34
|
14
|
—
|
—
|
$38,676.68
|
$105,047.38
|
$58,321.58
|
2025-06-28
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
34
|
14
|
—
|
—
|
$38,672.38
|
$105,035.70
|
$58,315.10
|
2025-06-28
|
|
1604
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$55,523.63
|
$66,628.36
|
$57,744.57
|
2025-06-28
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
32
|
14
|
—
|
—
|
$39,452.23
|
$107,153.82
|
$57,358.22
|
2025-06-28
|
|
6024
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$54,849.27
|
$65,819.12
|
$57,043.24
|
2025-06-28
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
32
|
14
|
—
|
—
|
$39,211.40
|
$106,499.69
|
$57,008.08
|
2025-06-28
|
|
L5856
|
HCPCS
|
Elec Knee-shin Swing/stance
|
3
|
1
|
—
|
—
|
$42,930.62
|
$75,581.95
|
$56,817.58
|
2025-06-28
|
|
L6880
|
HCPCS
|
Elec Hand Ind Art Digits
|
3
|
1
|
—
|
—
|
$42,727.97
|
$75,225.17
|
$56,549.38
|
2025-06-28
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
34
|
14
|
—
|
—
|
$36,792.27
|
$99,929.24
|
$55,480.03
|
2025-06-28
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
34
|
14
|
—
|
—
|
$36,405.21
|
$98,877.97
|
$54,896.38
|
2025-06-28
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
34
|
14
|
—
|
—
|
$36,103.44
|
$98,058.37
|
$54,441.33
|
2025-06-28
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
34
|
14
|
—
|
—
|
$35,890.56
|
$97,480.17
|
$54,120.32
|
2025-06-28
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
34
|
14
|
—
|
—
|
$35,862.60
|
$97,404.24
|
$54,078.17
|
2025-06-28
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
34
|
14
|
—
|
—
|
$35,848.27
|
$97,365.31
|
$54,056.55
|
2025-06-28
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
34
|
14
|
—
|
—
|
$35,719.25
|
$97,014.88
|
$53,861.99
|
2025-06-28
|
|
1612
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$51,688.83
|
$62,026.60
|
$53,756.38
|
2025-06-28
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
32
|
14
|
—
|
—
|
$36,914.84
|
$100,262.15
|
$53,669.19
|
2025-06-28
|
|
5933
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$51,226.92
|
$61,472.30
|
$53,276.00
|
2025-06-28
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
34
|
14
|
—
|
—
|
$34,758.05
|
$94,404.23
|
$52,412.57
|
2025-06-28
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
34
|
14
|
—
|
—
|
$32,918.79
|
$125,209.00
|
$52,357.93
|
2025-06-28
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
34
|
14
|
—
|
—
|
$34,229.78
|
$92,969.43
|
$51,615.99
|
2025-06-28
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
34
|
14
|
—
|
—
|
$34,081.41
|
$92,566.45
|
$51,392.26
|
2025-06-28
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
34
|
14
|
—
|
—
|
$34,074.96
|
$92,548.93
|
$51,382.53
|
2025-06-28
|
|
1611
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$49,247.33
|
$59,096.80
|
$51,217.22
|
2025-06-28
|
|
460
|
MS_DRG
|
Spinal Fusion Except Cervical Without Mcc
|
1
|
1
|
—
|
—
|
$51,038.68
|
$51,038.68
|
$51,038.68
|
2025-06-28
|
|
5891
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$48,983.84
|
$58,780.61
|
$50,943.19
|
2025-06-28
|
|
0112
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$48,895.77
|
$58,674.92
|
$50,851.60
|
2025-06-28
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement Without Mcc
|
34
|
14
|
—
|
—
|
$33,722.30
|
$91,591.10
|
$50,850.75
|
2025-06-28
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
34
|
14
|
—
|
—
|
$33,541.67
|
$91,100.51
|
$50,578.38
|
2025-06-28
|
|
0064
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$48,372.75
|
$58,047.30
|
$50,307.66
|
2025-06-28
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
34
|
14
|
—
|
—
|
$33,343.84
|
$90,563.19
|
$50,280.06
|
2025-06-28
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
34
|
14
|
—
|
—
|
$33,037.78
|
$89,731.91
|
$49,818.54
|
2025-06-28
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
34
|
14
|
—
|
—
|
$33,024.16
|
$89,694.92
|
$49,798.01
|
2025-06-28
|
|
C9734
|
HCPCS
|
U/s Trtmt, Not Leiomyomata
|
1
|
1
|
—
|
—
|
$49,724.51
|
$49,724.51
|
$49,724.51
|
2025-06-28
|
|
5892
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$47,538.79
|
$57,046.55
|
$49,440.34
|
2025-06-28
|
|
8514
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$46,902.89
|
$56,283.47
|
$48,779.01
|
2025-06-28
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
34
|
14
|
—
|
—
|
$32,338.20
|
$87,831.83
|
$48,763.62
|
2025-06-28
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
34
|
14
|
—
|
—
|
$32,145.39
|
$87,308.14
|
$48,472.88
|
2025-06-28
|
|
5893
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$46,525.81
|
$55,830.97
|
$48,386.84
|
2025-06-28
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
34
|
14
|
—
|
—
|
$32,056.51
|
$87,066.74
|
$48,338.86
|
2025-06-28
|
|
8424
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$46,203.37
|
$55,444.04
|
$48,051.51
|
2025-06-28
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
34
|
14
|
—
|
—
|
$31,756.89
|
$86,252.97
|
$47,887.06
|
2025-06-28
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
34
|
14
|
—
|
—
|
$31,486.67
|
$85,519.03
|
$47,479.58
|
2025-06-28
|
|
0022
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$45,376.95
|
$54,452.34
|
$47,192.03
|
2025-06-28
|
|
458
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
34
|
14
|
—
|
—
|
$30,950.52
|
$84,062.82
|
$46,671.10
|
2025-06-28
|
|
5912
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$44,835.59
|
$53,802.71
|
$46,629.01
|
2025-06-28
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
34
|
14
|
—
|
—
|
$30,575.64
|
$83,044.65
|
$46,105.82
|
2025-06-28
|
|
33276
|
HCPCS
|
Insj Phrnc Nrv Stim Sys
|
14
|
10
|
—
|
—
|
$45,170.60
|
$173,906.82
|
$46,074.01
|
2025-06-28
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
34
|
14
|
—
|
—
|
$30,314.02
|
$82,334.07
|
$45,711.31
|
2025-06-28
|
|
6303
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$43,677.03
|
$52,412.44
|
$45,424.11
|
2025-06-28
|
|
0054
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$43,560.21
|
$52,272.25
|
$45,302.62
|
2025-06-28
|
|
31
|
MS_DRG
|
Ventricular Shunt Procedures With Mcc
|
34
|
14
|
—
|
—
|
$30,037.34
|
$81,582.60
|
$45,294.10
|
2025-06-28
|
|
673
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Mcc
|
34
|
14
|
—
|
—
|
$30,030.17
|
$81,563.13
|
$45,283.29
|
2025-06-28
|
|
0266T
|
HCPCS
|
Implt/rpl Crtd Sns Dev Total
|
24
|
15
|
—
|
—
|
$12,436.05
|
$173,906.82
|
$45,170.60
|
2025-06-28
|
|
933
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
34
|
14
|
—
|
—
|
$31,014.31
|
$84,236.09
|
$45,090.62
|
2025-06-28
|
|
793
|
MS_DRG
|
Full Term Neonate With Major Problems
|
34
|
14
|
—
|
—
|
$29,893.27
|
$81,191.29
|
$45,076.85
|
2025-06-28
|
|
269
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
34
|
14
|
—
|
—
|
$29,823.02
|
$81,000.51
|
$44,970.93
|
2025-06-28
|
|
236
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
34
|
14
|
—
|
—
|
$29,474.67
|
$80,054.36
|
$44,445.63
|
2025-06-28
|
|
958
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
34
|
14
|
—
|
—
|
$29,458.18
|
$80,009.59
|
$44,420.77
|
2025-06-28
|
|
12
|
MS_DRG
|
Tracheostomy For Face,mouth & Neck Diagnoses W Cc
|
34
|
14
|
—
|
—
|
$29,414.46
|
$79,890.83
|
$44,354.85
|
2025-06-28
|
|
L5858
|
HCPCS
|
Stance Phase Only
|
3
|
1
|
—
|
—
|
$33,236.67
|
$58,515.17
|
$43,987.89
|
2025-06-28
|
|
423
|
MS_DRG
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
34
|
14
|
—
|
—
|
$29,154.27
|
$79,184.14
|
$43,962.49
|
2025-06-28
|
|
791
|
MS_DRG
|
Prematurity With Major Problems
|
34
|
14
|
—
|
—
|
$29,100.51
|
$79,038.13
|
$43,881.43
|
2025-06-28
|
|
C8004
|
HCPCS
|
Sim Ang W/prs Cath Rad Emb
|
1
|
1
|
—
|
—
|
$43,826.23
|
$43,826.23
|
$43,826.23
|
2025-06-28
|
|
6074
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$42,035.35
|
$50,442.42
|
$43,716.76
|
2025-06-28
|
|
5932
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$41,957.34
|
$50,348.81
|
$43,635.63
|
2025-06-28
|
|
0043
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$41,876.46
|
$50,251.75
|
$43,551.51
|
2025-06-28
|
|
0021
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$41,730.88
|
$50,077.06
|
$43,400.11
|
2025-06-28
|
|
907
|
MS_DRG
|
Other O.r. Procedures For Injuries With Mcc
|
34
|
14
|
—
|
—
|
$28,554.32
|
$77,554.67
|
$43,057.82
|
2025-06-28
|
|
628
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
34
|
14
|
—
|
—
|
$28,281.95
|
$76,814.89
|
$42,647.10
|
2025-06-28
|
|
448
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical Without Mcc
|
32
|
14
|
—
|
—
|
$29,269.67
|
$79,497.58
|
$42,554.15
|
2025-06-28
|
|
876
|
MS_DRG
|
O.r. Procedures With Principal Diagnosis Of Mental Illness
|
34
|
14
|
—
|
—
|
$28,166.55
|
$76,501.45
|
$42,473.08
|
2025-06-28
|
|
616
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
34
|
14
|
—
|
—
|
$27,703.51
|
$75,243.82
|
$41,774.86
|
2025-06-28
|
|
904
|
MS_DRG
|
Skin Grafts For Injuries With Cc/mcc
|
34
|
14
|
—
|
—
|
$27,675.55
|
$75,167.89
|
$41,732.70
|
2025-06-28
|
|
166
|
MS_DRG
|
Other Respiratory System O.r. Procedures With Mcc
|
34
|
14
|
—
|
—
|
$27,598.14
|
$74,957.64
|
$41,615.96
|
2025-06-28
|
|
3034
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$39,878.55
|
$47,854.26
|
$41,473.70
|
2025-06-28
|
|
956
|
MS_DRG
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
34
|
14
|
—
|
—
|
$27,398.16
|
$74,414.48
|
$41,314.41
|
2025-06-28
|
|
24
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
34
|
14
|
—
|
—
|
$27,249.79
|
$74,011.50
|
$41,090.68
|
2025-06-28
|
|
40
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
34
|
14
|
—
|
—
|
$27,037.62
|
$73,435.24
|
$40,770.74
|
2025-06-28
|
|
402
|
MS_DRG
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
32
|
14
|
—
|
—
|
$28,041.83
|
$76,162.71
|
$40,769.04
|
2025-06-28
|
|
L5973
|
HCPCS
|
Ank-foot Sys Dors-plant Flex
|
3
|
1
|
—
|
—
|
$30,767.85
|
$54,168.66
|
$40,720.47
|
2025-06-28
|
|
6023
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$38,906.55
|
$46,687.86
|
$40,462.82
|
2025-06-28
|
|
622
|
MS_DRG
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
34
|
14
|
—
|
—
|
$26,821.87
|
$72,849.26
|
$40,445.41
|
2025-06-28
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
34
|
14
|
—
|
—
|
$30,466.00
|
$82,922.00
|
$40,399.92
|
2025-06-28
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
34
|
14
|
—
|
—
|
$25,671.00
|
$89,395.11
|
$40,257.57
|
2025-06-28
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
34
|
14
|
—
|
—
|
$20,946.00
|
$99,181.67
|
$39,803.55
|
2025-06-28
|
|
94
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System With Mcc
|
34
|
14
|
—
|
—
|
$26,153.11
|
$71,032.89
|
$39,436.98
|
2025-06-28
|
|
1624
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$37,904.71
|
$45,485.65
|
$39,420.90
|
2025-06-28
|
|
335
|
MS_DRG
|
Peritoneal Adhesiolysis With Mcc
|
34
|
14
|
—
|
—
|
$25,971.77
|
$70,540.35
|
$39,163.52
|
2025-06-28
|
|
0084
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$37,476.23
|
$44,971.48
|
$38,975.28
|
2025-06-28
|
|
802
|
MS_DRG
|
Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc
|
34
|
14
|
—
|
—
|
$25,695.09
|
$69,788.89
|
$38,746.31
|
2025-06-28
|
|
97
|
MS_DRG
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc
|
34
|
14
|
—
|
—
|
$25,693.66
|
$69,784.99
|
$38,744.15
|
2025-06-28
|
|
265
|
MS_DRG
|
Aicd Lead Procedures
|
34
|
14
|
—
|
—
|
$25,568.94
|
$69,446.25
|
$38,556.08
|
2025-06-28
|
|
L6975
|
HCPCS
|
Interscap-thor Myoelectronic
|
3
|
1
|
—
|
—
|
$29,079.97
|
$51,197.05
|
$38,486.60
|
2025-06-28
|
|
Q0489
|
HCPCS
|
Pwr Pck Base Combo Vad, Rep
|
3
|
1
|
—
|
—
|
$29,069.04
|
$51,177.80
|
$38,472.14
|
2025-06-28
|
|
0073
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$36,953.92
|
$44,344.70
|
$38,432.08
|
2025-06-28
|
|
492
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc
|
34
|
14
|
—
|
—
|
$25,454.25
|
$69,134.76
|
$38,383.15
|
2025-06-28
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
34
|
14
|
—
|
—
|
$16,044.00
|
$95,136.22
|
$38,180.04
|
2025-06-28
|
|
22
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…
|
34
|
14
|
—
|
—
|
$25,305.16
|
$68,729.83
|
$38,158.32
|
2025-06-28
|
|
420
|
MS_DRG
|
Hepatobiliary Diagnostic Procedures With Mcc
|
34
|
14
|
—
|
—
|
$25,298.71
|
$68,712.31
|
$38,148.60
|
2025-06-28
|
|
495
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…
|
34
|
14
|
—
|
—
|
$25,234.92
|
$68,539.04
|
$38,052.40
|
2025-06-28
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
34
|
14
|
—
|
—
|
$11,206.00
|
$94,561.92
|
$37,949.56
|
2025-06-28
|
|
414
|
MS_DRG
|
Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc
|
34
|
14
|
—
|
—
|
$25,114.50
|
$68,211.98
|
$37,870.82
|
2025-06-28
|
|
987
|
MS_DRG
|
Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
34
|
14
|
—
|
—
|
$25,106.62
|
$68,190.56
|
$37,858.93
|
2025-06-28
|
|
408
|
MS_DRG
|
Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…
|
34
|
14
|
—
|
—
|
$25,096.58
|
$68,163.31
|
$37,843.80
|
2025-06-28
|
|
264
|
MS_DRG
|
Other Circulatory System O.r. Procedures
|
34
|
14
|
—
|
—
|
$25,052.14
|
$68,042.61
|
$37,776.79
|
2025-06-28
|
|
651
|
MS_DRG
|
Kidney Transplant With Hemodialysis Without Mcc
|
34
|
14
|
—
|
—
|
$24,890.15
|
$67,602.63
|
$37,532.52
|
2025-06-28
|
|
332
|
MS_DRG
|
Rectal Resection With Mcc
|
34
|
14
|
—
|
—
|
$24,862.91
|
$67,528.65
|
$37,491.44
|
2025-06-28
|
|
574
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Cc
|
34
|
14
|
—
|
—
|
$24,835.67
|
$67,454.67
|
$37,450.38
|
2025-06-28
|
|
271
|
MS_DRG
|
Other Major Cardiovascular Procedures With Cc
|
34
|
14
|
—
|
—
|
$24,688.73
|
$67,055.58
|
$37,228.80
|
2025-06-28
|
|
477
|
MS_DRG
|
Biopsies Of Musculoskeletal System And Connective Tissue With Mcc
|
34
|
14
|
—
|
—
|
$24,650.03
|
$66,950.45
|
$37,170.43
|
2025-06-28
|
|
665
|
MS_DRG
|
Prostatectomy With Mcc
|
34
|
14
|
—
|
—
|
$24,611.32
|
$66,845.32
|
$37,112.07
|
2025-06-28
|
|
252
|
MS_DRG
|
Other Vascular Procedures With Mcc
|
34
|
14
|
—
|
—
|
$24,588.39
|
$66,783.03
|
$37,077.48
|
2025-06-28
|
|
4404
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$35,422.95
|
$42,507.54
|
$36,839.87
|
2025-06-28
|
|
8634
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$35,009.21
|
$42,011.05
|
$36,409.58
|
2025-06-28
|
|
29
|
MS_DRG
|
Spinal Procedures With Cc Or Spinal Neurostimulators
|
34
|
14
|
—
|
—
|
$24,060.12
|
$65,348.24
|
$36,280.90
|
2025-06-28
|
|
37
|
MS_DRG
|
Extracranial Procedures With Mcc
|
34
|
14
|
—
|
—
|
$23,803.51
|
$64,651.28
|
$35,893.94
|
2025-06-28
|
|
0620T
|
HCPCS
|
Evasc Ven Artlz Tibl/prnl Vn
|
14
|
10
|
—
|
—
|
$35,132.80
|
$135,261.29
|
$35,835.46
|
2025-06-28
|
|
0063
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$34,364.32
|
$41,237.18
|
$35,738.90
|
2025-06-28
|
|
143
|
MS_DRG
|
Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc
|
34
|
14
|
—
|
—
|
$23,667.32
|
$64,281.39
|
$35,688.58
|
2025-06-28
|
|
6134
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$34,228.80
|
$41,074.56
|
$35,597.95
|
2025-06-28
|
|
6114
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$34,068.84
|
$40,882.61
|
$35,431.60
|
2025-06-28
|
|
579
|
MS_DRG
|
Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc
|
34
|
14
|
—
|
—
|
$23,362.69
|
$63,454.00
|
$35,229.23
|
2025-06-28
|
|
656
|
MS_DRG
|
Kidney And Ureter Procedures For Neoplasm With Mcc
|
34
|
14
|
—
|
—
|
$23,352.66
|
$63,426.74
|
$35,214.09
|
2025-06-28
|
|
L6970
|
HCPCS
|
Interscapular-thor Switch CT
|
3
|
1
|
—
|
—
|
$26,589.17
|
$46,811.84
|
$35,190.09
|
2025-06-28
|
|
279
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
34
|
14
|
—
|
—
|
$22,968.46
|
$62,383.26
|
$34,634.76
|
2025-06-28
|
|
324
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc
|
34
|
14
|
—
|
—
|
$22,901.80
|
$62,202.21
|
$34,534.24
|
2025-06-28
|
|
840
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Mcc
|
34
|
14
|
—
|
—
|
$22,858.08
|
$62,083.45
|
$34,468.31
|
2025-06-28
|
|
929
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc
|
34
|
14
|
—
|
—
|
$22,796.44
|
$61,916.03
|
$34,375.35
|
2025-06-28
|
|
L5859
|
HCPCS
|
Knee-shin Pro Flex/ext Cont
|
3
|
1
|
—
|
—
|
$25,947.61
|
$45,682.34
|
$34,341.00
|
2025-06-28
|
|
939
|
MS_DRG
|
O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc
|
34
|
14
|
—
|
—
|
$22,750.56
|
$61,791.43
|
$34,306.18
|
2025-06-28
|
|
500
|
MS_DRG
|
Soft Tissue Procedures With Mcc
|
34
|
14
|
—
|
—
|
$22,712.57
|
$61,688.25
|
$34,248.90
|
2025-06-28
|
|
L6965
|
HCPCS
|
Shldr Disartic Myoelectronic
|
3
|
1
|
—
|
—
|
$25,517.04
|
$44,924.29
|
$33,771.15
|
2025-06-28
|
|
0093
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$32,422.48
|
$38,906.98
|
$33,719.38
|
2025-06-28
|
|
662
|
MS_DRG
|
Minor Bladder Procedures With Mcc
|
34
|
14
|
—
|
—
|
$22,360.64
|
$60,732.37
|
$33,718.20
|
2025-06-28
|
|
229
|
MS_DRG
|
Other Cardiothoracic Procedures Without Mcc
|
34
|
14
|
—
|
—
|
$22,265.30
|
$60,473.45
|
$33,574.44
|
2025-06-28
|
|
829
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…
|
34
|
14
|
—
|
—
|
$22,104.03
|
$60,035.42
|
$33,331.25
|
2025-06-28
|
|
652
|
MS_DRG
|
Kidney Transplant
|
34
|
14
|
—
|
—
|
$22,015.15
|
$59,794.02
|
$33,197.23
|
2025-06-28
|
|
173
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…
|
34
|
14
|
—
|
—
|
$21,995.08
|
$59,739.50
|
$33,166.96
|
2025-06-28
|
|
J7310
|
HCPCS
|
Ganciclovir Long Act Implant
|
3
|
1
|
—
|
—
|
$24,988.77
|
$43,994.24
|
$33,072.00
|
2025-06-28
|
|
1674
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$31,789.10
|
$38,146.92
|
$33,060.67
|
2025-06-28
|
|
26
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Cc
|
34
|
14
|
—
|
—
|
$21,923.40
|
$59,544.82
|
$33,058.88
|
2025-06-28
|
|
1634
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$31,574.50
|
$37,889.40
|
$32,837.49
|
2025-06-28
|
|
0571T
|
HCPCS
|
Insj/rplcmt Icds Ss Eltrd
|
14
|
10
|
—
|
—
|
$32,182.77
|
$123,903.68
|
$32,826.43
|
2025-06-28
|
|
0915T
|
HCPCS
|
Insj Perm Ccm-d Sys Pg&dual Transvns Eltrds/lds
|
14
|
10
|
—
|
—
|
$32,182.77
|
$123,903.68
|
$32,826.43
|
2025-06-28
|
|
0013
|
APR_DRG
|
—
|
10
|
8
|
—
|
—
|
$31,456.59
|
$37,747.91
|
$32,714.85
|
2025-06-28
|