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Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

ADVENTHEALTH WATERMAN

Tavares, FL · CCN 100057 · Rates published

22,233 distinct procedures filed
54 distinct payers
1,355,390 rate rows
2026-04-01 last MRF observed
Data quality

1,327,916 of 1,355,390 rate rows are consumer-grade (98.0%)

27,474 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 18,826
exceeds 10× this hospital's gross charge — excluded from medians 6,062
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 1,778
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 424
template filing: same amount across many unrelated codes — excluded 226
per-diem day rate — not a per-procedure price 158
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://hospitalpricedisclosure.com/download.aspx?pi=x3YESeJnUDOE*__*ruwq*_*TCpg*-*
Found on page https://urldefense.com/v3/__https://HospitalPriceDisclosure.com/Default.aspx?ci=RsbcVwMa5jfnDZuYpIqAxQ*-*__;Kio!!OwHQNGuS!NNxzc3gzcCDbWC_3aBKJU3Bm28st5mdzWI_DoAkJmDmhsUhsHjB8niD15jvlGIrs7b_d4aR0fJBjowy6rVbgBT5sJPyOLA$
Discovered viaCMS hospital list
Last fetch not_modified · 2026-08-12
Content fingerprint 7137809ed5377807… · 23,556,363 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
Q2055
HCPCS 		Idecabtagene Vicleucel 460000000 Cells IV Susp 37 $24,610.00 $3,462,925.00 $1,546,773.00 nat. median
$610,161
outlier · 2.5×
Q2054
HCPCS 		Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp 37 $24,610.00 $3,387,004.00 $1,512,862.00 nat. median
$624,417
outlier · 2.4×
Q2042
HCPCS 		Tisagenlecleucel IV Infusion (wrapped) 37 $24,610.00 $2,967,142.00 $1,371,808.00 nat. median
$691,418
2.0× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 32 $259,966.00 $1,213,998.06 $556,980.00 nat. median
$370,165
1.5× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 32 $194,312.00 $787,835.90 $407,747.75 nat. median
$261,939
1.6× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 32 $161,144.06 $632,141.00 $312,912.93 nat. median
$205,166
1.5× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 32 $122,997.74 $596,704.05 $305,636.00 nat. median
$199,832
1.5× median
5834
APR_DRG 		Neonate With Ecmo 6 $205,319.00 $246,383.00 $217,638.00 nat. median
$311,018
0.7× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 32 $97,745.00 $389,404.41 $201,537.87 nat. median
$132,706
1.5× median
7
MS_DRG 		Lung Transplant 32 $90,445.00 $364,068.97 $188,425.41 nat. median
$122,690
1.5× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 32 $90,672.00 $349,124.00 $175,557.48 nat. median
$114,305
1.5× median
209
MS_DRG 		Complex Aortic Arch Procedures 14 $85,756.59 $318,205.42 $165,616.68 nat. median
$96,134
1.7× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 32 $76,350.00 $318,570.89 $162,750.00 nat. median
$108,240
1.5× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 32 $75,485.00 $305,703.57 $158,218.16 nat. median
$100,978
1.6× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 32 $72,606.00 $309,839.00 $154,711.00 nat. median
$96,835
1.6× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 6 $128,933.37 $249,120.54 $152,311.16 nat. median
$83,623
1.8× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 32 $73,803.00 $289,859.09 $150,615.78 nat. median
$99,646
1.5× median
215
MS_DRG 		Other Heart Assist System Implant 32 $600.00 $282,320.00 $145,163.10 nat. median
$98,002
1.5× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 32 $66,936.00 $275,023.86 $142,339.74 nat. median
$92,900
1.5× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 6 $133,948.00 $160,737.00 $141,985.00 nat. median
$254,667
0.6× median
5833
APR_DRG 		Neonate With Ecmo 6 $133,012.00 $159,615.00 $140,993.00 nat. median
$250,089
0.6× median
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 6 $111,403.53 $215,250.00 $131,602.86 nat. median
$58,534
outlier · 2.2×
850
MS_DRG 		Acute Leukemia With Other Procedures 32 $63,914.00 $245,469.00 $126,497.98 nat. median
$81,364
1.6× median
24
APR_DRG 		Heart And/or Lung Transplant 6 $118,623.00 $142,347.00 $125,740.00 nat. median
$243,231
0.5× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 32 $57,921.00 $253,286.88 $123,182.00 nat. median
$81,124
1.5× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 32 $58,838.00 $236,989.78 $122,655.05 nat. median
$79,040
1.6× median
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 6 $103,147.86 $199,298.68 $121,850.30 nat. median
$51,048
outlier · 2.4×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 32 $19,856.52 $236,244.78 $120,779.00 nat. median
$80,459
1.5× median
J1950
HCPCS 		Leuprolide Acetate (3 Month) 11.25 Mg IM Kit 37 $614.00 $266,827.00 $119,183.00 nat. median
$3,885
outlier · 30.7×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 32 $55,998.00 $221,215.57 $114,947.43 nat. median
$77,385
1.5× median
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 6 $96,499.97 $186,453.85 $113,997.03 nat. median
$62,767
1.8× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 32 $2,301.18 $214,929.51 $111,470.00 nat. median
$73,475
1.5× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 32 $53,772.00 $215,860.05 $111,031.64 nat. median
$74,472
1.5× median
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 $104,305.00 $125,166.00 $110,564.00 nat. median
$119,243
0.9× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 32 $51,892.00 $214,218.25 $110,239.00 nat. median
$71,485
1.5× median
226
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 6 $93,133.10 $179,948.50 $110,019.69 nat. median
$46,826
outlier · 2.3×
5832
APR_DRG 		Neonate With Ecmo 6 $102,129.00 $122,555.00 $108,257.00 nat. median
$169,230
0.6× median
1614
APR_DRG 		Implantable Heart Assist Systems 6 $101,659.00 $121,991.00 $107,759.00 nat. median
$209,486
0.5× median
A9520
HCPCS 		Technetium-99 (tc-99) Tilmanocept (lymphoseek) Radio-isotope Injection 33 $10.00 $218,570.00 $105,545.50 nat. median
$1,032
outlier · 102.2×
10
MS_DRG 		Pancreas Transplant 32 $54,621.50 $212,457.00 $105,167.06 nat. median
$67,750
1.6× median
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 6 $88,992.17 $171,947.54 $105,127.95 nat. median
$57,648
1.8× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 32 $49,406.00 $202,936.50 $104,900.00 nat. median
$66,640
1.6× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 32 $54,312.64 $211,239.00 $104,564.70 nat. median
$69,153
1.5× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 32 $49,160.00 $200,456.94 $103,747.32 nat. median
$68,581
1.5× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 6 $97,710.00 $117,252.00 $103,573.00 nat. median
$160,171
0.6× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 6 $96,372.00 $115,646.00 $102,154.00 nat. median
$165,646
0.6× median
24338-050-08
NDC 		Carmustine In Polifeprosan 7.7 Mg Il Wafr 22 $52,406.00 $156,696.00 $101,853.00 nat. median
$49,264
outlier · 2.1×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 32 $48,400.00 $194,311.43 $99,886.85 nat. median
$65,958
1.5× median
52427-273-75
NDC 		Naproxen Sodium ER 500 Mg Po Tb24 22 $50,988.00 $152,457.00 $99,097.00 nat. median
$111,860
0.9× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 32 $46,490.00 $201,646.12 $98,641.00 nat. median
$62,911
1.6× median

Other procedures at this hospital

Browse this hospital's 22,233 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 9 6 $0.01 — $36,564.00 $43,877.00 $38,758.00 2024-12-15
341 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Mcc 16 6 — — $32,868.45 $63,507.27 $38,828.05 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 67 32 $0.01 — $20,247.00 $76,312.00 $38,857.28 2026-04-01
63 APR_DRG Pancreas Transplant 9 6 $0.01 — $36,709.00 $44,050.00 $38,911.00 2024-12-15
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 67 32 $0.01 — $18,734.00 $82,767.48 $39,048.00 2026-04-01
503 MS_DRG Foot Procedures With Mcc 67 32 $0.01 — $18,753.00 $78,466.19 $39,088.00 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 67 32 $0.01 — $18,776.00 $81,016.04 $39,138.00 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 67 32 $0.01 — $19,337.00 $76,079.40 $39,375.21 2026-04-01
849 MS_DRG Radiotherapy 67 32 $0.01 — $18,922.00 $76,172.17 $39,423.23 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 73 32 $0.01 — $12,228.88 $76,489.85 $39,587.64 2026-04-01
33224 CPT Hc Insj Eltrd Car Ven Sys Attch Prev Pm/dfb Pls Gen 65 37 $98,513.97 $39,405.59 60% off $5,079.00 $88,663.00 $39,603.00 2024-12-15
263 MS_DRG Vein Ligation And Stripping 67 32 $0.01 — $18,997.00 $85,952.69 $39,612.00 2026-04-01
8634 APR_DRG Neonatal Aftercare 9 6 $0.01 — $37,397.00 $44,877.00 $39,641.00 2024-12-15
963 MS_DRG Other Multiple Significant Trauma With Mcc 67 32 $0.01 — $19,235.00 $76,855.32 $39,776.79 2026-04-01
4404 APR_DRG Kidney Transplant 9 6 $0.01 — $37,839.00 $45,407.00 $40,110.00 2024-12-15
619 MS_DRG O.r. Procedures For Obesity With Mcc 67 32 $0.01 — $19,303.00 $81,173.48 $40,268.00 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 67 32 $0.01 — $19,371.00 $92,865.67 $40,414.00 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 67 32 $0.01 — $19,960.00 $78,696.72 $40,729.82 2026-04-01
800 MS_DRG Splenic Procedures With Cc 67 32 $0.01 — $20,591.00 $78,980.66 $41,039.72 2026-04-01
51167-331-01 NDC Elexacaf-tezacaf-ivacaf&ivacaf 100-50-75 (trikafta Kit Morning Dose) 39 22 $70,306.78 $28,122.71 60% off $21,162.00 $63,276.00 $41,129.00 2024-12-15
0187-3013-30 NDC Pyridostigmine Bromide ER 180 Mg Po Tbcr 39 22 $70,644.05 $28,257.62 60% off $21,264.00 $63,580.00 $41,327.00 2024-12-15
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 67 32 $0.01 — $19,846.00 $88,333.86 $41,434.00 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 67 32 $0.01 — $19,866.00 $81,533.32 $41,477.00 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 67 32 $0.01 — $20,580.00 $80,136.11 $41,531.00 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 69 33 $0.01 — $20,597.00 $80,689.93 $41,567.00 2026-04-01
73 APR_DRG Allogeneic Bone Marrow Transplant 9 6 $0.01 — $39,475.00 $47,370.00 $41,843.00 2024-12-15
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 68 32 $0.01 — $20,723.00 $81,583.93 $42,026.05 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 67 32 $0.01 — $21,089.00 $81,134.12 $42,158.69 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 67 32 $0.01 — $20,208.00 $84,915.32 $42,211.00 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 67 32 $0.01 — $20,235.00 $90,253.98 $42,270.00 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 67 32 $0.01 — $20,270.00 $84,904.07 $42,344.00 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 67 32 $0.01 — $20,778.00 $81,873.49 $42,373.97 2026-04-01
84 APR_DRG Autologous Bone Marrow Transplant 9 6 $0.01 — $40,033.00 $48,039.00 $42,435.00 2024-12-15
668 MS_DRG Transurethral Procedures With Mcc 67 32 $0.01 — $20,608.00 $82,089.96 $42,486.00 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 68 32 $0.01 — $20,477.00 $82,823.71 $42,789.00 2026-04-01
570 MS_DRG Skin Debridement With Mcc 68 32 $0.01 — $700.00 $82,683.14 $42,860.51 2026-04-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 9 6 $0.01 — $40,490.00 $48,589.00 $42,920.00 2024-12-15
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 68 32 $0.01 — $6,519.55 $87,563.56 $43,235.84 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 68 32 $0.01 — $21,656.00 $83,675.53 $43,392.93 2026-04-01
A9569 HCPCS Technetium-99 (tc-99) Exametazime White Blood Cells Radio-isotope Injection 56 33 $100,047.74 $40,019.09 60% off $57.00 $90,043.00 $43,481.00 2024-12-15
33270 CPT Hc Ins/rplcmnt Perm Subq Impltbl Dfb W/subq Eltrd 65 37 $102,274.76 $40,909.90 60% off $14,380.00 $92,047.00 $43,671.00 2024-12-15
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 9 6 $0.01 — $41,561.00 $49,873.00 $44,054.00 2024-12-15
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 69 32 $0.01 — $21,617.47 $89,593.32 $44,101.00 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 67 32 $0.01 — $23,032.00 $87,101.00 $44,308.99 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 67 32 $0.01 — $22,007.00 $86,067.95 $44,544.83 2026-04-01
C9089 HCPCS Bupivacaine Hcl (300 Mg Dose) 3 X 100 Mg Il Impl 104 37 $74,181.59 $29,672.64 60% off $22,329.00 $68,632.00 $44,546.00 2024-12-15
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 68 32 $0.01 — $21,915.00 $88,541.89 $45,062.12 2026-04-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 9 6 $0.01 — $42,599.00 $51,119.00 $45,155.00 2024-12-15
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 67 32 $0.01 — $21,587.00 $87,408.94 $45,172.00 2026-04-01
652 MS_DRG Kidney Transplant 67 32 $0.01 — $21,675.00 $90,790.93 $45,362.00 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 67 32 $0.01 — $21,760.00 $88,837.08 $45,545.00 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 69 32 $0.01 — $22,526.00 $88,584.06 $45,565.00 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 67 32 $0.01 — $21,776.00 $90,816.24 $45,577.00 2026-04-01
665 MS_DRG Prostatectomy With Mcc 67 32 $0.01 — $24,152.23 $91,495.00 $45,643.00 2026-04-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 16 6 — — $38,652.08 $74,682.18 $45,660.35 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 67 32 $0.01 — $22,344.00 $88,972.02 $46,047.84 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 67 32 $0.01 — $22,016.00 $92,539.56 $46,094.00 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 67 32 $0.01 — $22,959.00 $89,506.17 $46,462.00 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 67 32 $0.01 — $24,574.57 $94,075.00 $46,567.97 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 67 32 $0.01 — $23,880.00 $90,387.00 $46,640.42 2026-04-01
J3357 HCPCS Ustekinumab 45 Mg/0.5ml Sc Sosy 65 37 $116,381.30 $46,552.52 60% off $158.00 $104,743.00 $46,785.00 2024-12-15
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 68 32 $0.01 — $15,778.60 $91,043.95 $46,801.09 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 67 32 $0.01 — $22,425.00 $90,546.35 $46,862.64 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 67 32 $0.01 — $22,381.00 $102,008.02 $46,877.00 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 67 32 $0.01 — $22,693.00 $90,723.46 $46,954.31 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 67 32 $0.01 — $22,484.00 $90,942.74 $47,067.80 2026-04-01
21 APR_DRG Heart And/or Lung Transplant 9 6 $0.01 — $44,578.00 $53,493.00 $47,252.00 2024-12-15
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 67 32 $0.01 — $22,590.00 $101,386.72 $47,326.00 2026-04-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 9 6 $0.01 — $44,733.00 $53,680.00 $47,417.00 2024-12-15
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 9 6 $0.01 — $44,820.00 $53,783.00 $47,509.00 2024-12-15
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 67 32 $0.01 — $23,978.00 $91,445.97 $47,516.90 2026-04-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 9 6 $0.01 — $44,903.00 $53,883.00 $47,597.00 2024-12-15
37 MS_DRG Extracranial Procedures With Mcc 67 32 $0.01 — $23,391.00 $92,550.81 $47,900.06 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 70 32 $0.01 — $4,564.09 $98,066.58 $48,496.63 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 67 32 $0.01 — $23,261.00 $105,328.17 $48,766.00 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 67 32 $0.01 — $24,590.00 $93,914.29 $48,799.48 2026-04-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 9 6 $0.01 — $46,532.00 $55,838.00 $49,324.00 2024-12-15
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 9 6 $0.01 — $46,657.00 $55,988.00 $49,456.00 2024-12-15
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 67 32 $0.01 — $23,638.00 $95,910.31 $49,575.00 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 67 32 $0.01 — $24,826.00 $95,783.80 $49,770.92 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 69 32 $0.01 — $21,433.08 $96,382.61 $49,883.22 2026-04-01
J7311 HCPCS Fluocinolone Acetonide 0.59 Mg Iz Impl 65 37 $124,325.13 $49,730.05 60% off $316.00 $111,893.00 $49,979.00 2024-12-15
271 MS_DRG Other Major Cardiovascular Procedures With Cc 70 32 $0.01 — $24,241.00 $99,978.26 $49,995.50 2026-04-01
47781-153-01 NDC Naproxen Sodium ER 375 Mg Po Tb24 39 22 $85,549.37 $34,219.75 60% off $25,750.00 $76,994.00 $50,046.00 2024-12-15
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 67 32 $0.01 — $24,204.00 $97,119.17 $50,264.43 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 34 14 — — $26,537.47 $96,669.36 $50,313.60 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 67 32 $0.01 — $24,382.00 $97,591.47 $50,508.87 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 69 32 $0.01 — $24,109.00 $99,143.31 $50,587.00 2026-04-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 9 6 $0.01 — $47,894.00 $57,473.00 $50,768.00 2024-12-15
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 67 32 $0.01 — $26,904.20 $102,991.00 $51,111.33 2026-04-01
332 MS_DRG Rectal Resection With Mcc 67 32 $0.01 — $24,408.00 $101,788.74 $51,229.00 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 67 32 $0.01 — $24,434.00 $104,181.16 $51,285.00 2026-04-01
22 APR_DRG Heart And/or Lung Transplant 9 6 $0.01 — $48,472.00 $58,167.00 $51,381.00 2024-12-15
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 67 32 $0.01 — $25,646.00 $98,940.89 $51,411.40 2026-04-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 16 6 — — $43,583.07 $84,209.68 $51,485.42 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 68 32 $0.01 — $24,976.00 $103,219.69 $51,546.00 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 67 32 $0.01 — $24,632.00 $100,239.71 $51,711.00 2026-04-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 16 6 — — $43,792.59 $84,614.51 $51,732.93 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 67 32 $0.01 — $24,650.00 $100,155.37 $51,748.00 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 67 32 $0.01 — $25,472.00 $100,388.71 $51,956.60 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 67 32 $0.01 — $26,288.00 $100,059.79 $51,992.79 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 67 32 $0.01 — $24,765.00 $101,929.30 $51,996.00 2026-04-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 9 6 $0.01 — $49,355.00 $59,226.00 $52,317.00 2024-12-15
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 67 32 $0.01 — $27,558.75 $104,925.00 $52,343.00 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 67 32 $0.01 — $27,621.12 $106,079.00 $52,509.52 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 67 32 $0.01 — $25,205.00 $101,538.53 $52,551.69 2026-04-01
265 MS_DRG Aicd Lead Procedures 67 32 $0.01 — $25,086.00 $101,718.46 $52,644.81 2026-04-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 9 6 $0.01 — $49,700.00 $59,640.00 $52,682.00 2024-12-15
C1822 HCPCS Construct Neuromod Nevro Pain Mgmt Omnia With Ipg Rm 167 37 $101,790.50 $40,716.20 60% off $12,957.00 $107,172.00 $52,869.50 2024-12-15
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 67 32 $0.01 — $25,201.00 $105,066.71 $52,932.00 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 67 32 $0.01 — $25,207.00 $112,005.00 $52,944.00 2026-04-01
A9572 HCPCS Indium In-111 Pentetreotide IV Kit 56 33 $121,897.31 $48,758.92 60% off $60.00 $109,708.00 $52,976.50 2024-12-15
8514 APR_DRG Gender Related Procedures 9 6 $0.01 — $50,103.00 $60,123.00 $53,109.00 2024-12-15
791 MS_DRG Prematurity With Major Problems 62 32 $0.01 — $7,729.78 $114,110.67 $53,375.50 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 67 32 $0.01 — $27,107.00 $103,261.86 $53,656.64 2026-04-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 9 6 $0.01 — $50,782.00 $60,938.00 $53,829.00 2024-12-15
J2326 HCPCS Nusinersen 12 Mg/5ml It Soln 65 37 $134,375.07 $53,750.03 60% off $1,211.00 $120,938.00 $54,019.00 2024-12-15
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 67 32 $0.01 — $27,689.00 $105,141.00 $54,441.09 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 68 32 $0.01 — $1,064.76 $105,077.96 $54,491.93 2026-04-01
C2624 HCPCS System Cardiomems Hrt Failure Ptnt 73 37 $96,957.00 $38,782.80 60% off $13,380.00 $87,261.00 $54,596.50 2024-12-15
63323-877-15 NDC Pentamidine Isethionate 300 Mg In Solr 39 22 $93,477.38 $37,390.95 60% off $28,137.00 $84,130.00 $54,684.00 2024-12-15
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 67 32 $0.01 — $26,841.00 $105,789.22 $54,751.65 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 68 32 $0.01 — $26,495.00 $108,549.92 $54,752.00 2026-04-01
64 APR_DRG Pancreas Transplant 9 6 $0.01 — $51,673.00 $62,007.00 $54,773.00 2024-12-15
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 9 6 $0.01 — $52,231.00 $62,678.00 $55,365.00 2024-12-15
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 9 6 $0.01 — $52,325.00 $62,790.00 $55,465.00 2024-12-15
1611 APR_DRG Implantable Heart Assist Systems 9 6 $0.01 — $52,607.00 $63,128.00 $55,763.00 2024-12-15
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 67 32 $0.01 — $27,951.00 $107,934.24 $56,084.49 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 67 32 $0.01 — $26,699.00 $109,975.24 $56,147.00 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 67 32 $0.01 — $27,579.00 $108,653.93 $56,234.30 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 67 32 $0.01 — $27,297.00 $108,816.99 $56,318.69 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 67 32 $0.01 — $29,961.27 $115,299.00 $57,073.40 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 67 32 $0.01 — $27,446.00 $115,980.18 $57,751.00 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 67 32 $0.01 — $27,459.00 $113,028.32 $57,779.00 2026-04-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 9 6 $0.01 — $54,722.00 $65,666.00 $58,005.00 2024-12-15
1612 APR_DRG Implantable Heart Assist Systems 9 6 $0.01 — $55,215.00 $66,258.00 $58,528.00 2024-12-15
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 68 32 $0.01 — $28,834.00 $117,759.73 $59,687.50 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 67 32 $0.01 — $28,526.00 $116,753.29 $60,071.00 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 67 32 $0.01 — $28,637.00 $119,221.61 $60,309.00 2026-04-01
0781-5893-31 NDC Nevirapine ER 400 Mg Po Tb24 39 22 $103,145.70 $41,258.28 60% off $31,047.00 $92,831.00 $60,340.00 2024-12-15
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 70 32 $0.01 — $9,943.94 $118,119.58 $60,440.64 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 67 32 $0.01 — $28,776.00 $118,524.41 $60,608.00 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 67 32 $0.01 — $28,818.00 $118,465.37 $60,698.00 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 67 32 $0.01 — $30,250.00 $117,304.30 $60,953.34 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 67 32 $0.01 — $31,024.00 $118,060.00 $61,303.93 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 67 32 $0.01 — $29,168.00 $118,726.82 $61,447.56 2026-04-01
0187-0007-14 NDC Ribavirin 6 G In Solr 39 22 $105,205.58 $42,082.23 60% off $31,667.00 $94,685.00 $61,545.00 2024-12-15
31 MS_DRG Ventricular Shunt Procedures With Mcc 67 32 $0.01 — $29,374.00 $125,960.30 $61,891.00 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 67 32 $0.01 — $29,639.00 $119,910.38 $62,060.12 2026-04-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 9 6 $0.01 — $58,591.00 $70,309.00 $62,106.00 2024-12-15
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 67 32 $0.01 — $31,397.00 $120,686.30 $62,710.68 2026-04-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 9 6 $0.01 — $59,311.00 $71,174.00 $62,870.00 2024-12-15
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 67 32 $0.01 — $29,847.00 $121,656.20 $62,907.00 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 67 32 $0.01 — $29,891.00 $123,494.79 $63,000.00 2026-04-01
A9588 HCPCS Fluciclovine F 18 9-221 Mci/ml IV Soln 56 33 $145,045.20 $58,018.08 60% off $84.00 $130,541.00 $63,036.50 2024-12-15
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 19 6 — — $33,976.67 $102,834.54 $64,032.71 2026-04-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 9 6 $0.01 — $60,831.00 $72,997.00 $64,481.00 2024-12-15
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 67 32 $0.01 — $30,765.00 $125,465.51 $64,877.00 2026-04-01
A9595 HCPCS Piflufolastat F 18 9 Mci IV Sosy 56 33 $149,769.93 $59,907.97 60% off $615.00 $134,793.00 $65,090.00 2024-12-15
163 MS_DRG Major Chest Procedures With Mcc 69 32 $0.01 — $32,253.00 $125,996.84 $65,470.13 2026-04-01
58914-501-56 NDC Mesalamine 1000 Mg Re Supp 39 22 $111,999.69 $44,799.88 60% off $33,712.00 $100,800.00 $65,520.00 2024-12-15
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 67 32 $0.01 — $31,312.00 $127,821.38 $66,051.00 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 67 32 $0.01 — $33,255.00 $127,320.97 $66,158.17 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 67 32 $0.01 — $31,582.00 $127,877.60 $66,183.59 2026-04-01
245 MS_DRG Aicd Generator Procedures 67 32 $0.01 — $34,163.00 $130,219.00 $66,647.54 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 67 32 $0.01 — $32,737.00 $128,892.48 $66,734.00 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 69 32 $0.01 — $32,134.00 $129,221.40 $66,879.08 2026-04-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 9 6 $0.01 — $63,159.00 $75,790.00 $66,948.00 2024-12-15
C1824 HCPCS Generator Pul Implantable Optimizer Smt F/hrt Fail 120 37 $119,080.00 $47,632.00 60% off $16,433.00 $113,724.00 $67,054.00 2024-12-15
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 69 32 $0.01 — $32,910.00 $133,840.37 $67,094.00 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 68 32 $0.01 — $32,547.00 $129,839.89 $67,333.11 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 67 32 $0.01 — $33,904.00 $130,359.98 $67,737.30 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 67 32 $0.01 — $32,139.00 $141,695.14 $67,828.00 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 68 32 $0.01 — $10,118.17 $131,900.57 $68,030.35 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 67 32 $0.01 — $32,240.00 $132,170.46 $68,045.00 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 67 32 $0.01 — $33,397.00 $131,506.99 $68,103.00 2026-04-01
J9302 HCPCS Ofatumumab 100 Mg/5ml IV Conc 65 37 $169,770.02 $67,908.01 60% off $64.00 $152,793.00 $68,248.00 2024-12-15
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 9 6 $0.01 — $65,522.00 $78,627.00 $69,454.00 2024-12-15
13925-522-01 NDC Pentamidine Isethionate 300 Mg In Solr 39 22 $119,182.91 $47,673.16 60% off $35,874.00 $107,265.00 $69,722.00 2024-12-15
J2353 HCPCS Octreotide Acetate 10 Mg IM Kit 143 37 $174,010.83 $69,604.33 60% off $215.00 $441,603.00 $69,952.00 2024-12-15
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 67 32 $0.01 — $34,991.00 $135,063.29 $70,181.21 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 67 32 $0.01 — $33,960.00 $135,749.24 $70,257.59 2026-04-01
23 APR_DRG Heart And/or Lung Transplant 9 6 $0.01 — $66,606.00 $79,927.00 $70,602.00 2024-12-15
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 71 32 $0.01 — $34,951.00 $138,838.86 $71,324.00 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 67 32 $0.01 — $37,528.80 $143,769.00 $71,720.00 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 68 32 $0.01 — $35,195.00 $138,363.75 $71,720.87 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 67 32 $0.01 — $34,827.00 $139,086.26 $71,984.67 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 67 32 $0.01 — $35,485.00 $140,210.78 $72,566.67 2026-04-01
1613 APR_DRG Implantable Heart Assist Systems 9 6 $0.01 — $68,785.00 $82,542.00 $72,912.00 2024-12-15
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 69 32 $0.01 — $35,856.00 $148,332.62 $73,202.00 2026-04-01
C1831 HCPCS Kit Imp Aprevo Spine Lvl 1 261 37 $174,040.00 $69,616.00 60% off $16,433.00 $206,100.00 $73,738.00 2024-12-15
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 67 32 $0.01 — $34,964.00 $156,482.58 $73,894.00 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 67 32 $0.01 — $35,592.00 $146,339.41 $75,242.00 2026-04-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 9 6 $0.01 — $71,338.00 $85,605.00 $75,618.00 2024-12-15
653 MS_DRG Major Bladder Procedures With Mcc 67 32 $0.01 — $38,894.00 $148,546.00 $75,909.01 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 67 32 $0.01 — $35,974.00 $149,831.04 $76,062.00 2026-04-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 9 6 $0.01 — $71,830.00 $86,196.00 $76,140.00 2024-12-15
C1825 HCPCS System Neo Barostim Includes 2102 Ipg 1036 Csl Kit 120 37 $136,080.00 $54,432.00 60% off $17,697.00 $122,472.00 $76,626.50 2024-12-15
59385-027-60 NDC Buprenorphine Hcl 900 Mcg Bu Film 39 22 $131,942.95 $52,777.18 60% off $39,715.00 $118,749.00 $77,187.00 2024-12-15
59385-027-01 NDC Buprenorphine Hcl 900 Mcg Bu Film 39 22 $131,942.95 $52,777.18 60% off $39,715.00 $118,749.00 $77,187.00 2024-12-15
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 70 32 $0.01 — $3,315.14 $190,961.50 $77,222.50 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 67 32 $0.01 — $38,569.00 $148,824.60 $77,331.83 2026-04-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 9 6 $0.01 — $72,982.00 $87,578.00 $77,361.00 2024-12-15
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 67 32 $0.01 — $36,983.00 $149,921.01 $77,592.24 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 62 32 $0.01 — $7,083.08 $167,089.62 $78,156.00 2026-04-01
5831 APR_DRG Neonate With Ecmo 9 6 $0.01 — $74,234.00 $89,081.00 $78,688.00 2024-12-15
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 16 6 — — $67,011.48 $129,477.23 $79,161.79 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 67 32 $0.01 — $37,665.00 $153,331.11 $79,357.16 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 67 32 $0.01 — $37,891.00 $153,792.17 $79,595.78 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 67 32 $0.01 — $41,519.98 $160,839.00 $79,615.79 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 67 32 $0.01 — $37,700.00 $160,230.04 $79,767.00 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 67 32 $0.01 — $38,569.00 $154,337.56 $79,878.05 2026-04-01
68382-395-04 NDC Ribavirin 6 G In Solr 39 22 $137,172.59 $54,869.04 60% off $41,289.00 $123,455.00 $80,246.00 2024-12-15
68382-395-01 NDC Ribavirin 6 G In Solr 39 22 $137,172.59 $54,869.04 60% off $41,289.00 $123,455.00 $80,246.00 2024-12-15
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 67 32 $0.01 — $37,976.00 $157,562.12 $80,360.00 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 67 32 $0.01 — $38,178.00 $162,130.48 $80,794.00 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 67 32 $0.01 — $42,201.58 $163,525.00 $80,945.09 2026-04-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 9 6 $0.01 — $76,443.00 $91,731.00 $81,029.00 2024-12-15
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 67 32 $0.01 — $38,409.00 $158,051.29 $81,290.00 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 69 32 $0.01 — $40,028.00 $167,640.63 $82,177.48 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 67 32 $0.01 — $39,792.00 $161,095.92 $83,375.87 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 34 14 — — $43,583.58 $160,438.08 $83,503.36 2026-04-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 9 6 $0.01 — $78,902.00 $94,682.00 $83,636.00 2024-12-15
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 68 32 $0.01 — $29,524.53 $164,983.95 $84,651.57 2026-04-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 9 6 $0.01 — $80,365.00 $96,438.00 $85,187.00 2024-12-15
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 67 32 $0.01 — $40,598.00 $164,877.12 $85,332.84 2026-04-01
74 APR_DRG Allogeneic Bone Marrow Transplant 9 6 $0.01 — $80,769.00 $96,923.00 $85,616.00 2024-12-15
58468-0132-1 NDC Sevelamer Carbonate 0.8 G Po Pack 39 22 $146,912.67 $58,765.07 60% off $44,221.00 $132,221.00 $85,944.00 2024-12-15
58468-0132-2 NDC Sevelamer Carbonate 0.8 G Po Pack 39 22 $146,912.67 $58,765.07 60% off $44,221.00 $132,221.00 $85,944.00 2024-12-15
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 67 32 $0.01 — $42,067.00 $166,701.66 $86,277.14 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 16 6 — — $73,051.19 $141,146.94 $86,296.60 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 16 6 — — $73,589.54 $142,187.12 $86,932.56 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 67 32 $0.01 — $42,367.00 $168,911.34 $87,420.77 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 68 32 $0.01 — $43,158.00 $168,863.55 $87,570.22 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 67 32 $0.01 — $41,472.00 $184,851.41 $87,865.00 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 67 32 $0.01 — $42,568.00 $170,437.87 $88,210.83 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 67 32 $0.01 — $41,757.00 $172,287.71 $88,478.00 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 67 32 $0.01 — $44,051.00 $172,088.11 $89,419.95 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 16 6 — — $75,932.09 $146,713.31 $89,699.85 2026-04-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 9 6 $0.01 — $85,092.00 $102,110.00 $90,197.00 2024-12-15
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 67 32 $0.01 — $42,909.00 $184,179.51 $90,950.00 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 67 32 $0.01 — $43,103.00 $187,977.57 $91,367.00 2026-04-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 9 6 $0.01 — $86,464.00 $103,757.00 $91,652.00 2024-12-15
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 9 6 $0.01 — $87,116.00 $104,539.00 $92,343.00 2024-12-15
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 9 6 $0.01 — $88,071.00 $105,685.00 $93,355.00 2024-12-15
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 67 32 $0.01 — $45,034.00 $180,898.72 $93,624.89 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 67 32 $0.01 — $44,970.00 $184,851.41 $95,377.00 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 67 32 $0.01 — $46,668.00 $187,839.82 $97,217.28 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 67 32 $0.01 — $47,518.00 $189,231.41 $97,937.51 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 67 32 $0.01 — $46,413.00 $193,358.40 $98,474.00 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 67 32 $0.01 — $46,490.00 $201,646.12 $98,641.00 2026-04-01
52427-273-75 NDC Naproxen Sodium ER 500 Mg Po Tb24 39 22 $169,396.43 $67,758.57 60% off $50,988.00 $152,457.00 $99,097.00 2024-12-15
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 68 32 $0.01 — $48,400.00 $194,311.43 $99,886.85 2026-04-01
24338-050-08 NDC Carmustine In Polifeprosan 7.7 Mg Il Wafr 39 22 $174,106.94 $69,642.78 60% off $52,406.00 $156,696.00 $101,853.00 2024-12-15
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 9 6 $0.01 — $96,372.00 $115,646.00 $102,154.00 2024-12-15
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 9 6 $0.01 — $97,710.00 $117,252.00 $103,573.00 2024-12-15
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 67 32 $0.01 — $49,160.00 $200,456.94 $103,747.32 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 67 32 $0.01 — $54,312.64 $211,239.00 $104,564.70 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 67 32 $0.01 — $49,406.00 $202,936.50 $104,900.00 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 16 6 — — $88,992.17 $171,947.54 $105,127.95 2026-04-01
10 MS_DRG Pancreas Transplant 67 32 $0.01 — $54,621.50 $212,457.00 $105,167.06 2026-04-01
A9520 HCPCS Technetium-99 (tc-99) Tilmanocept (lymphoseek) Radio-isotope Injection 56 33 $242,855.70 $97,142.28 60% off $10.00 $218,570.00 $105,545.50 2024-12-15
1614 APR_DRG Implantable Heart Assist Systems 9 6 $0.01 — $101,659.00 $121,991.00 $107,759.00 2024-12-15
5832 APR_DRG Neonate With Ecmo 9 6 $0.01 — $102,129.00 $122,555.00 $108,257.00 2024-12-15
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 16 6 — — $93,133.10 $179,948.50 $110,019.69 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 67 32 $0.01 — $51,892.00 $214,218.25 $110,239.00 2026-04-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 9 6 $0.01 — $104,305.00 $125,166.00 $110,564.00 2024-12-15
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 68 32 $0.01 — $53,772.00 $215,860.05 $111,031.64 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 71 32 $0.01 — $2,301.18 $214,929.51 $111,470.00 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 16 6 — — $96,499.97 $186,453.85 $113,997.03 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 67 32 $0.01 — $55,998.00 $221,215.57 $114,947.43 2026-04-01
J1950 HCPCS Leuprolide Acetate (3 Month) 11.25 Mg IM Kit 65 37 $296,474.29 $118,589.72 60% off $614.00 $266,827.00 $119,183.00 2024-12-15
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 69 32 $0.01 — $19,856.52 $236,244.78 $120,779.00 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 16 6 — — $103,147.86 $199,298.68 $121,850.30 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 67 32 $0.01 — $58,838.00 $236,989.78 $122,655.05 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 67 32 $0.01 — $57,921.00 $253,286.88 $123,182.00 2026-04-01
24 APR_DRG Heart And/or Lung Transplant 9 6 $0.01 — $118,623.00 $142,347.00 $125,740.00 2024-12-15
850 MS_DRG Acute Leukemia With Other Procedures 67 32 $0.01 — $63,914.00 $245,469.00 $126,497.98 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 16 6 — — $111,403.53 $215,250.00 $131,602.86 2026-04-01
5833 APR_DRG Neonate With Ecmo 9 6 $0.01 — $133,012.00 $159,615.00 $140,993.00 2024-12-15
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 9 6 $0.01 — $133,948.00 $160,737.00 $141,985.00 2024-12-15
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 67 32 $0.01 — $66,936.00 $275,023.86 $142,339.74 2026-04-01
215 MS_DRG Other Heart Assist System Implant 68 32 $0.01 — $600.00 $282,320.00 $145,163.10 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 67 32 $0.01 — $73,803.00 $289,859.09 $150,615.78 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 16 6 — — $128,933.37 $249,120.54 $152,311.16 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 67 32 $0.01 — $72,606.00 $309,839.00 $154,711.00 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 67 32 $0.01 — $75,485.00 $305,703.57 $158,218.16 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 67 32 $0.01 — $76,350.00 $318,570.89 $162,750.00 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 34 14 — — $85,756.59 $318,205.42 $165,616.68 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 67 32 $0.01 — $90,672.00 $349,124.00 $175,557.48 2026-04-01
7 MS_DRG Lung Transplant 67 32 $0.01 — $90,445.00 $364,068.97 $188,425.41 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 67 32 $0.01 — $97,745.00 $389,404.41 $201,537.87 2026-04-01
5834 APR_DRG Neonate With Ecmo 9 6 $0.01 — $205,319.00 $246,383.00 $217,638.00 2024-12-15
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 69 32 $0.01 — $122,997.74 $596,704.05 $305,636.00 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 67 32 $0.01 — $161,144.06 $632,141.00 $312,912.93 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 67 32 $0.01 — $194,312.00 $787,835.90 $407,747.75 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 67 32 $0.01 — $259,966.00 $1,213,998.06 $556,980.00 2026-04-01
Q2042 HCPCS Tisagenlecleucel IV Infusion (wrapped) 65 37 $3,296,824.02 $1,318,729.61 60% off $24,610.00 $2,967,142.00 $1,371,808.00 2024-12-15
Q2054 HCPCS Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp 65 37 $3,763,338.22 $1,505,335.29 60% off $24,610.00 $3,387,004.00 $1,512,862.00 2024-12-15
Q2055 HCPCS Idecabtagene Vicleucel 460000000 Cells IV Susp 65 37 $3,847,694.66 $1,539,077.86 60% off $24,610.00 $3,462,925.00 $1,546,773.00 2024-12-15
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