|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel 460000000 Cells IV Susp
|
61
|
36
|
$1,674,653.22
|
$669,861.29
60% off
|
$24,610.00
|
$1,590,921.00
|
$704,024.00
|
2024-12-15
|
|
Q2054
|
HCPCS
|
Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp
|
61
|
36
|
$1,637,938.50
|
$655,175.40
60% off
|
$24,610.00
|
$1,556,042.00
|
$688,589.00
|
2024-12-15
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel IV Infusion (wrapped)
|
61
|
36
|
$1,434,896.05
|
$573,958.42
60% off
|
$24,610.00
|
$1,363,151.00
|
$603,230.00
|
2024-12-15
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies
|
73
|
34
|
$0.01
|
—
|
$279,819.00
|
$1,894,602.17
|
$568,256.00
|
2026-04-01
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
73
|
34
|
$0.01
|
—
|
$204,499.84
|
$1,229,520.59
|
$409,064.87
|
2026-04-01
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
73
|
34
|
$0.01
|
—
|
$156,045.42
|
$1,015,288.00
|
$335,074.75
|
2026-04-01
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
73
|
34
|
$0.01
|
—
|
$155,135.65
|
$931,234.42
|
$309,824.24
|
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
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
73
|
34
|
$0.01
|
—
|
$101,595.75
|
$607,716.32
|
$202,188.89
|
2026-04-01
|
|
7
|
MS_DRG
|
Lung Transplant
|
73
|
34
|
$0.01
|
—
|
$95,052.28
|
$568,177.07
|
$189,034.07
|
2026-04-01
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
73
|
34
|
$0.01
|
—
|
$88,283.02
|
$560,731.00
|
$185,404.00
|
2026-04-01
|
|
209
|
MS_DRG
|
Complex Aortic Arch Procedures
|
39
|
16
|
—
|
—
|
$83,206.97
|
$496,601.03
|
$177,637.25
|
2026-04-01
|
|
453
|
MS_DRG
|
Combined Anterior And Posterior Spinal Fusion With Mcc
|
17
|
6
|
—
|
—
|
$127,940.89
|
$388,785.06
|
$175,384.83
|
2026-04-01
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
73
|
34
|
$0.01
|
—
|
$82,320.00
|
$497,171.39
|
$165,410.28
|
2026-04-01
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
73
|
34
|
$0.01
|
—
|
$79,978.08
|
$477,090.26
|
$158,729.24
|
2026-04-01
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
73
|
34
|
$0.01
|
—
|
$78,293.00
|
$483,544.13
|
$158,093.00
|
2026-04-01
|
|
222
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…
|
17
|
6
|
—
|
—
|
$110,545.99
|
$335,925.67
|
$151,539.43
|
2026-04-01
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
73
|
34
|
$0.01
|
—
|
$75,885.88
|
$455,773.00
|
$150,700.00
|
2026-04-01
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
73
|
34
|
$0.01
|
—
|
$73,319.17
|
$453,436.00
|
$149,927.00
|
2026-04-01
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
73
|
34
|
$0.01
|
—
|
$72,054.34
|
$429,210.57
|
$142,799.53
|
2026-04-01
|
|
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
|
|
5833
|
APR_DRG
|
Neonate With Ecmo
|
9
|
6
|
$0.01
|
—
|
$133,012.00
|
$159,615.00
|
$140,993.00
|
2024-12-15
|
|
224
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh…
|
17
|
6
|
—
|
—
|
$102,353.87
|
$311,031.56
|
$140,309.45
|
2026-04-01
|
|
459
|
MS_DRG
|
Spinal Fusion Except Cervical With Mcc
|
17
|
6
|
—
|
—
|
$95,757.15
|
$290,985.53
|
$131,266.48
|
2026-04-01
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
73
|
34
|
$0.01
|
—
|
$63,898.24
|
$394,251.00
|
$130,358.00
|
2026-04-01
|
|
226
|
MS_DRG
|
Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc
|
17
|
6
|
—
|
—
|
$92,416.19
|
$280,833.09
|
$126,686.61
|
2026-04-01
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
73
|
34
|
$0.01
|
—
|
$62,498.00
|
$395,287.19
|
$126,036.00
|
2026-04-01
|
|
A9520
|
HCPCS
|
Technetium-99 (tc-99) Tilmanocept (lymphoseek) Radio-isotope Injection
|
52
|
32
|
$242,855.70
|
$97,142.28
60% off
|
$10.00
|
$218,570.00
|
$125,799.00
|
2024-12-15
|
|
24
|
APR_DRG
|
Heart And/or Lung Transplant
|
9
|
6
|
$0.01
|
—
|
$118,623.00
|
$142,347.00
|
$125,740.00
|
2024-12-15
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
73
|
34
|
$0.01
|
—
|
$62,231.16
|
$369,853.43
|
$123,051.25
|
2026-04-01
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
73
|
34
|
$0.01
|
—
|
$62,038.74
|
$368,690.77
|
$122,664.43
|
2026-04-01
|
|
454
|
MS_DRG
|
Combined Anterior And Posterior Spinal Fusion With Cc
|
17
|
6
|
—
|
—
|
$88,307.14
|
$268,346.55
|
$121,053.81
|
2026-04-01
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
73
|
34
|
$0.01
|
—
|
$58,157.11
|
$345,235.73
|
$114,860.87
|
2026-04-01
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
73
|
34
|
$0.01
|
—
|
$53,124.63
|
$341,228.00
|
$112,615.44
|
2026-04-01
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
73
|
34
|
$0.01
|
—
|
$56,773.92
|
$336,877.73
|
$112,080.15
|
2026-04-01
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
73
|
34
|
$0.01
|
—
|
$52,826.20
|
$339,273.00
|
$111,970.41
|
2026-04-01
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
73
|
34
|
$0.01
|
—
|
$56,533.59
|
$335,425.50
|
$111,596.98
|
2026-04-01
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
73
|
34
|
$0.01
|
—
|
$56,014.00
|
$334,315.49
|
$111,227.68
|
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
|
|
5832
|
APR_DRG
|
Neonate With Ecmo
|
9
|
6
|
$0.01
|
—
|
$102,129.00
|
$122,555.00
|
$108,257.00
|
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
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
73
|
34
|
$0.01
|
—
|
$53,339.00
|
$316,708.86
|
$105,369.90
|
2026-04-01
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
73
|
34
|
$0.01
|
—
|
$52,795.71
|
$312,839.17
|
$104,082.45
|
2026-04-01
|
|
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
|
|
223
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…
|
17
|
6
|
—
|
—
|
$75,347.59
|
$228,965.24
|
$103,288.51
|
2026-04-01
|
|
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
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc
|
73
|
34
|
$0.01
|
—
|
$50,203.00
|
$314,695.04
|
$101,082.00
|
2026-04-01
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
74
|
34
|
$0.01
|
—
|
$51,208.50
|
$303,248.31
|
$100,342.05
|
2026-04-01
|
|
225
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh…
|
17
|
6
|
—
|
—
|
$73,023.07
|
$221,901.53
|
$100,102.00
|
2026-04-01
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
74
|
34
|
$0.01
|
—
|
$15,733.18
|
$301,760.98
|
$99,849.92
|
2026-04-01
|
|
227
|
MS_DRG
|
Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc
|
17
|
6
|
—
|
—
|
$72,488.87
|
$220,278.19
|
$99,369.69
|
2026-04-01
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
73
|
34
|
$0.01
|
—
|
$49,896.46
|
$295,320.28
|
$98,253.87
|
2026-04-01
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
73
|
34
|
$0.01
|
—
|
$49,537.05
|
$293,148.52
|
$97,531.32
|
2026-04-01
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
73
|
34
|
$0.01
|
—
|
$48,568.00
|
$288,484.71
|
$95,979.65
|
2026-04-01
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
73
|
34
|
$0.01
|
—
|
$47,744.35
|
$282,316.03
|
$93,927.32
|
2026-04-01
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
73
|
34
|
$0.01
|
—
|
$46,559.00
|
$293,363.50
|
$93,687.00
|
2026-04-01
|
|
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
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
73
|
34
|
$0.01
|
—
|
$46,351.00
|
$287,436.12
|
$93,263.00
|
2026-04-01
|
|
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
|
|
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
|
|
455
|
MS_DRG
|
Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc
|
19
|
7
|
—
|
—
|
$35,059.50
|
$202,066.09
|
$91,154.04
|
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
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
73
|
34
|
$0.01
|
—
|
$44,805.00
|
$288,484.71
|
$90,126.00
|
2026-04-01
|
|
213
|
MS_DRG
|
Endovascular Abdominal Aorta With Iliac Branch Procedures
|
39
|
16
|
—
|
—
|
$42,459.92
|
$250,384.53
|
$89,564.09
|
2026-04-01
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$45,468.80
|
$270,667.00
|
$89,495.00
|
2026-04-01
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$45,112.00
|
$268,877.42
|
$89,456.25
|
2026-04-01
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
73
|
34
|
$0.01
|
—
|
$45,042.60
|
$265,990.51
|
$88,495.77
|
2026-04-01
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$44,648.34
|
$263,608.15
|
$87,703.16
|
2026-04-01
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
73
|
34
|
$0.01
|
—
|
$44,635.99
|
$265,108.00
|
$87,678.34
|
2026-04-01
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
73
|
34
|
$0.01
|
—
|
$41,124.65
|
$262,638.00
|
$86,677.96
|
2026-04-01
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/Mcc
|
73
|
34
|
$0.01
|
—
|
$44,077.63
|
$260,159.66
|
$86,555.83
|
2026-04-01
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
73
|
34
|
$0.01
|
—
|
$43,252.00
|
$261,625.05
|
$86,481.00
|
2026-04-01
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
73
|
34
|
$0.01
|
—
|
$43,633.99
|
$257,478.96
|
$85,663.95
|
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
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$43,606.41
|
$257,312.24
|
$85,608.49
|
2026-04-01
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/Mcc
|
73
|
34
|
$0.01
|
—
|
$40,466.10
|
$258,324.00
|
$85,254.52
|
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
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
73
|
34
|
$0.01
|
—
|
$42,629.82
|
$251,411.18
|
$83,645.19
|
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
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
73
|
34
|
$0.01
|
—
|
$41,263.00
|
$253,025.75
|
$82,936.00
|
2026-04-01
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
73
|
34
|
$0.01
|
—
|
$41,511.00
|
$246,659.63
|
$82,064.33
|
2026-04-01
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
73
|
34
|
$0.01
|
—
|
$40,748.00
|
$250,059.86
|
$81,893.00
|
2026-04-01
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
73
|
34
|
$0.01
|
—
|
$41,045.00
|
$245,896.22
|
$81,810.35
|
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
|
|
A9595
|
HCPCS
|
Piflufolastat F 18 9 Mci IV Sosy
|
52
|
32
|
$149,769.93
|
$59,907.97
60% off
|
$615.00
|
$142,281.00
|
$80,202.00
|
2024-12-15
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
73
|
34
|
$0.01
|
—
|
$40,884.32
|
$240,863.87
|
$80,136.07
|
2026-04-01
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$40,743.46
|
$240,012.72
|
$79,852.89
|
2026-04-01
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
73
|
34
|
$0.01
|
—
|
$40,151.00
|
$239,670.50
|
$79,739.03
|
2026-04-01
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
73
|
34
|
$0.01
|
—
|
$40,624.38
|
$239,293.18
|
$79,613.50
|
2026-04-01
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$38,753.26
|
$238,582.00
|
$78,886.00
|
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
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
73
|
34
|
$0.01
|
—
|
$39,460.47
|
$236,557.00
|
$78,217.00
|
2026-04-01
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
73
|
34
|
$0.01
|
—
|
$39,743.64
|
$233,971.27
|
$77,842.88
|
2026-04-01
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
73
|
34
|
$0.01
|
—
|
$38,892.00
|
$233,830.87
|
$77,602.00
|
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
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
74
|
34
|
$0.01
|
—
|
$38,765.00
|
$231,492.39
|
$76,598.68
|
2026-04-01
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
73
|
34
|
$0.01
|
—
|
$36,609.86
|
$230,908.00
|
$76,349.00
|
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
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
73
|
34
|
$0.01
|
—
|
$38,481.00
|
$228,381.72
|
$75,983.22
|
2026-04-01
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
73
|
34
|
$0.01
|
—
|
$37,806.00
|
$244,211.46
|
$75,920.00
|
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
|
|
A9588
|
HCPCS
|
Fluciclovine F 18 9-221 Mci/ml IV Soln
|
52
|
32
|
$145,045.20
|
$58,018.08
60% off
|
$84.00
|
$130,541.00
|
$75,133.50
|
2024-12-15
|
|
1613
|
APR_DRG
|
Implantable Heart Assist Systems
|
9
|
6
|
$0.01
|
—
|
$68,785.00
|
$82,542.00
|
$72,912.00
|
2024-12-15
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
75
|
34
|
$0.01
|
—
|
$12,976.64
|
$218,817.19
|
$72,801.08
|
2026-04-01
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
68
|
34
|
$0.01
|
—
|
$44,177.83
|
$260,765.12
|
$72,521.95
|
2026-04-01
|
|
460
|
MS_DRG
|
Spinal Fusion Except Cervical Without Mcc
|
17
|
6
|
—
|
—
|
$52,812.76
|
$160,486.70
|
$72,397.16
|
2026-04-01
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$36,945.32
|
$217,062.23
|
$72,217.20
|
2026-04-01
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
74
|
34
|
$0.01
|
—
|
$36,758.72
|
$215,934.67
|
$71,559.52
|
2026-04-01
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
73
|
34
|
$0.01
|
—
|
$35,906.30
|
$214,298.00
|
$70,857.00
|
2026-04-01
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
77
|
34
|
$0.01
|
—
|
$17,607.30
|
$216,676.14
|
$70,773.00
|
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
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
73
|
34
|
$0.01
|
—
|
$36,083.46
|
$211,854.38
|
$70,484.53
|
2026-04-01
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
73
|
34
|
$0.01
|
—
|
$34,767.00
|
$221,133.73
|
$69,753.00
|
2026-04-01
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
73
|
34
|
$0.01
|
—
|
$35,590.45
|
$208,875.34
|
$69,493.40
|
2026-04-01
|
|
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
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
73
|
34
|
$0.01
|
—
|
$34,149.90
|
$209,145.00
|
$69,153.00
|
2026-04-01
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
73
|
34
|
$0.01
|
—
|
$34,876.00
|
$206,269.22
|
$68,626.34
|
2026-04-01
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
73
|
34
|
$0.01
|
—
|
$34,691.56
|
$207,536.00
|
$68,621.00
|
2026-04-01
|
|
C1831
|
HCPCS
|
Kit Imp Aprevo Spine Lvl 1
|
296
|
37
|
$165,680.00
|
$66,272.00
60% off
|
$25,733.00
|
$196,200.00
|
$68,330.00
|
2024-12-15
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
73
|
34
|
$0.01
|
—
|
$34,987.80
|
$205,233.80
|
$68,281.85
|
2026-04-01
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
74
|
34
|
$0.01
|
—
|
$35,089.45
|
$205,848.03
|
$68,113.21
|
2026-04-01
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$33,906.66
|
$203,496.00
|
$67,285.00
|
2026-04-01
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
74
|
34
|
$0.01
|
—
|
$13,260.98
|
$202,632.07
|
$67,049.07
|
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
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$34,312.55
|
$201,153.52
|
$66,924.33
|
2026-04-01
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
74
|
34
|
$0.01
|
—
|
$34,397.50
|
$201,666.84
|
$66,729.69
|
2026-04-01
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$34,050.42
|
$199,569.66
|
$66,397.37
|
2026-04-01
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$33,877.00
|
$199,481.92
|
$66,368.18
|
2026-04-01
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$33,564.68
|
$197,265.00
|
$65,420.83
|
2026-04-01
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$33,289.00
|
$195,805.27
|
$65,144.95
|
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
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$32,348.00
|
$192,729.71
|
$64,121.70
|
2026-04-01
|
|
31
|
MS_DRG
|
Ventricular Shunt Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$31,793.00
|
$196,577.46
|
$63,716.00
|
2026-04-01
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
73
|
34
|
$0.01
|
—
|
$32,193.11
|
$191,936.00
|
$63,463.00
|
2026-04-01
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
73
|
34
|
$0.01
|
—
|
$32,302.00
|
$189,860.35
|
$63,167.06
|
2026-04-01
|
|
A9572
|
HCPCS
|
Indium In-111 Pentetreotide IV Kit
|
52
|
32
|
$121,897.31
|
$48,758.92
60% off
|
$60.00
|
$109,708.00
|
$63,142.50
|
2024-12-15
|
|
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
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
73
|
34
|
$0.01
|
—
|
$31,493.89
|
$189,617.00
|
$62,696.00
|
2026-04-01
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$31,992.70
|
$187,135.77
|
$62,260.58
|
2026-04-01
|
|
C1824
|
HCPCS
|
Generator Pul Implantable Optimizer Smt F/hrt Fail
|
134
|
37
|
$113,360.00
|
$45,344.00
60% off
|
$22,487.00
|
$102,024.00
|
$62,111.00
|
2024-12-15
|
|
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
|
|
12
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
73
|
34
|
$0.01
|
—
|
$31,150.00
|
$184,972.78
|
$61,540.95
|
2026-04-01
|
|
448
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical Without Mcc
|
73
|
34
|
$0.01
|
—
|
$31,000.00
|
$186,060.86
|
$61,530.00
|
2026-04-01
|
|
958
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
73
|
34
|
$0.01
|
—
|
$31,195.00
|
$184,880.65
|
$61,510.30
|
2026-04-01
|
|
269
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
74
|
34
|
$0.01
|
—
|
$31,572.00
|
$185,288.68
|
$61,310.31
|
2026-04-01
|
|
236
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
73
|
34
|
$0.01
|
—
|
$31,212.00
|
$183,779.41
|
$61,143.91
|
2026-04-01
|
|
933
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
73
|
34
|
$0.01
|
—
|
$29,298.22
|
$185,183.00
|
$61,115.57
|
2026-04-01
|
|
458
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
73
|
34
|
$0.01
|
—
|
$31,319.63
|
$184,802.00
|
$61,104.00
|
2026-04-01
|
|
423
|
MS_DRG
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$30,881.00
|
$182,208.72
|
$60,621.34
|
2026-04-01
|
|
C1825
|
HCPCS
|
System Neo Barostim Includes 2102 Ipg 1036 Csl Kit
|
134
|
37
|
$106,680.00
|
$42,672.00
60% off
|
$24,216.00
|
$109,872.00
|
$60,114.00
|
2024-12-15
|
|
673
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Mcc
|
76
|
34
|
$0.01
|
—
|
$31,530.20
|
$184,341.00
|
$59,974.85
|
2026-04-01
|
|
248
|
MS_DRG
|
Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4…
|
17
|
6
|
—
|
—
|
$43,455.49
|
$132,051.97
|
$59,569.96
|
2026-04-01
|
|
273
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$29,719.00
|
$181,002.19
|
$59,507.00
|
2026-04-01
|
|
246
|
MS_DRG
|
Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar…
|
17
|
6
|
—
|
—
|
$43,247.59
|
$131,420.18
|
$59,284.96
|
2026-04-01
|
|
402
|
MS_DRG
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
73
|
34
|
$0.01
|
—
|
$29,733.00
|
$176,395.42
|
$58,687.24
|
2026-04-01
|
|
1612
|
APR_DRG
|
Implantable Heart Assist Systems
|
9
|
6
|
$0.01
|
—
|
$55,215.00
|
$66,258.00
|
$58,528.00
|
2024-12-15
|
|
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
|
|
24
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
73
|
34
|
$0.01
|
—
|
$28,915.00
|
$171,630.70
|
$57,102.00
|
2026-04-01
|
|
34
|
MS_DRG
|
Carotid Artery Stent Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$29,127.59
|
$169,823.09
|
$56,500.61
|
2026-04-01
|
|
876
|
MS_DRG
|
O.r. Procedures With Principal Diagnosis Of Mental Illness
|
73
|
34
|
$0.01
|
—
|
$29,085.48
|
$169,568.62
|
$56,415.95
|
2026-04-01
|
|
907
|
MS_DRG
|
Other O.r. Procedures For Injuries With Mcc
|
73
|
34
|
$0.01
|
—
|
$28,899.60
|
$170,494.00
|
$56,373.00
|
2026-04-01
|
|
40
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$28,696.00
|
$169,406.29
|
$56,361.94
|
2026-04-01
|
|
739
|
MS_DRG
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…
|
73
|
34
|
$0.01
|
—
|
$27,037.19
|
$170,375.00
|
$56,228.46
|
2026-04-01
|
|
628
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$28,082.75
|
$168,868.00
|
$55,836.00
|
2026-04-01
|
|
1611
|
APR_DRG
|
Implantable Heart Assist Systems
|
9
|
6
|
$0.01
|
—
|
$52,607.00
|
$63,128.00
|
$55,763.00
|
2024-12-15
|
|
736
|
MS_DRG
|
Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc
|
73
|
34
|
$0.01
|
—
|
$26,976.93
|
$168,521.00
|
$55,721.00
|
2026-04-01
|
|
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
|
|
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
|
|
956
|
MS_DRG
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
73
|
34
|
$0.01
|
—
|
$28,345.60
|
$165,097.86
|
$54,928.51
|
2026-04-01
|
|
64
|
APR_DRG
|
Pancreas Transplant
|
9
|
6
|
$0.01
|
—
|
$51,673.00
|
$62,007.00
|
$54,773.00
|
2024-12-15
|
|
616
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
73
|
34
|
$0.01
|
—
|
$26,344.51
|
$165,414.00
|
$54,694.00
|
2026-04-01
|
|
904
|
MS_DRG
|
Skin Grafts For Injuries With Cc/Mcc
|
73
|
34
|
$0.01
|
—
|
$27,692.84
|
$165,247.00
|
$54,638.00
|
2026-04-01
|
|
166
|
MS_DRG
|
Other Respiratory System O.r. Procedures With Mcc
|
74
|
34
|
$0.01
|
—
|
$21,912.59
|
$164,785.00
|
$54,522.60
|
2026-04-01
|
|
802
|
MS_DRG
|
Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc
|
74
|
34
|
$0.01
|
—
|
$27,311.00
|
$174,798.40
|
$54,317.50
|
2026-04-01
|
|
518
|
MS_DRG
|
Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…
|
73
|
34
|
$0.01
|
—
|
$27,305.00
|
$163,970.30
|
$54,004.00
|
2026-04-01
|
|
359
|
MS_DRG
|
Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc
|
39
|
16
|
—
|
—
|
$25,990.18
|
$150,865.14
|
$53,965.39
|
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
|
|
492
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc
|
73
|
34
|
$0.01
|
—
|
$27,062.00
|
$161,087.78
|
$53,509.00
|
2026-04-01
|
|
52427-273-75
|
NDC
|
Naproxen Sodium ER 500 Mg Po Tb24
|
35
|
20
|
$85,454.33
|
$34,181.73
60% off
|
$19,398.00
|
$76,909.00
|
$53,409.00
|
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
|
|
622
|
MS_DRG
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
73
|
34
|
$0.01
|
—
|
$26,865.84
|
$160,150.00
|
$52,953.00
|
2026-04-01
|
|
651
|
MS_DRG
|
Kidney Transplant With Hemodialysis Without Mcc
|
73
|
34
|
$0.01
|
—
|
$26,480.00
|
$162,588.27
|
$52,933.00
|
2026-04-01
|
|
495
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…
|
73
|
34
|
$0.01
|
—
|
$26,836.00
|
$159,073.96
|
$52,924.34
|
2026-04-01
|
|
265
|
MS_DRG
|
Aicd Lead Procedures
|
73
|
34
|
$0.01
|
—
|
$27,180.00
|
$158,744.91
|
$52,814.87
|
2026-04-01
|
|
97
|
MS_DRG
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc
|
73
|
34
|
$0.01
|
—
|
$27,247.76
|
$158,464.11
|
$52,721.44
|
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
|
|
338
|
MS_DRG
|
Appendectomy With Complicated Principal Diagnosis With Mcc
|
17
|
6
|
—
|
—
|
$38,354.55
|
$116,551.28
|
$52,577.45
|
2026-04-01
|
|
33249
|
CPT
|
Hc Insj/rplcmt Perm Dfb W/trnsvns Lds 1/dual Chmbr
|
70
|
37
|
$118,735.79
|
$47,494.32
60% off
|
$14,380.00
|
$106,862.00
|
$52,347.00
|
2024-12-15
|
|
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
|
|
332
|
MS_DRG
|
Rectal Resection With Mcc
|
73
|
34
|
$0.01
|
—
|
$26,452.00
|
$158,854.59
|
$52,275.67
|
2026-04-01
|
|
335
|
MS_DRG
|
Peritoneal Adhesiolysis With Mcc
|
73
|
34
|
$0.01
|
—
|
$26,950.79
|
$156,669.67
|
$52,124.43
|
2026-04-01
|
|
408
|
MS_DRG
|
Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…
|
73
|
34
|
$0.01
|
—
|
$26,693.00
|
$156,437.13
|
$52,047.06
|
2026-04-01
|
|
414
|
MS_DRG
|
Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc
|
73
|
34
|
$0.01
|
—
|
$26,711.00
|
$156,305.51
|
$52,003.27
|
2026-04-01
|
|
A9569
|
HCPCS
|
Technetium-99 (tc-99) Exametazime White Blood Cells Radio-isotope Injection
|
52
|
32
|
$100,047.74
|
$40,019.09
60% off
|
$57.00
|
$90,043.00
|
$51,824.50
|
2024-12-15
|
|
271
|
MS_DRG
|
Other Major Cardiovascular Procedures With Cc
|
76
|
34
|
$0.01
|
—
|
$9,528.89
|
$156,029.11
|
$51,622.93
|
2026-04-01
|
|
94
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System With Mcc
|
74
|
34
|
$0.01
|
—
|
$26,576.86
|
$156,157.00
|
$51,502.84
|
2026-04-01
|
|
574
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Cc
|
74
|
34
|
$0.01
|
—
|
$26,228.33
|
$152,304.20
|
$51,440.51
|
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
|
|
467
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Cc
|
74
|
34
|
$0.01
|
—
|
$26,130.00
|
$154,726.05
|
$51,197.42
|
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
|
|
252
|
MS_DRG
|
Other Vascular Procedures With Mcc
|
74
|
34
|
$0.01
|
—
|
$26,168.00
|
$153,045.67
|
$50,641.40
|
2026-04-01
|
|
477
|
MS_DRG
|
Biopsies Of Musculoskeletal System And Connective Tissue With Mcc
|
73
|
34
|
$0.01
|
—
|
$26,106.35
|
$151,567.12
|
$50,426.80
|
2026-04-01
|
|
143
|
MS_DRG
|
Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$25,217.00
|
$164,378.33
|
$50,371.00
|
2026-04-01
|
|
C1822
|
HCPCS
|
Construct Neuromod Nevro Pain Mgmt Omnia With Ipg Rm
|
188
|
37
|
$96,901.00
|
$38,760.40
60% off
|
$20,289.00
|
$102,024.00
|
$50,365.50
|
2024-12-15
|
|
987
|
MS_DRG
|
Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
73
|
34
|
$0.01
|
—
|
$25,916.12
|
$150,417.62
|
$50,044.35
|
2026-04-01
|
|
420
|
MS_DRG
|
Hepatobiliary Diagnostic Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$25,761.46
|
$151,056.00
|
$49,946.00
|
2026-04-01
|
|
22
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…
|
73
|
34
|
$0.01
|
—
|
$24,093.65
|
$151,094.00
|
$49,866.12
|
2026-04-01
|
|
29
|
MS_DRG
|
Spinal Procedures With Cc Or Spinal Neurostimulators
|
73
|
34
|
$0.01
|
—
|
$25,623.00
|
$149,680.54
|
$49,799.13
|
2026-04-01
|
|
791
|
MS_DRG
|
Prematurity With Major Problems
|
68
|
34
|
$0.01
|
—
|
$30,494.80
|
$178,084.57
|
$49,751.36
|
2026-04-01
|
|
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
|
|
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
|
|
264
|
MS_DRG
|
Other Circulatory System O.r. Procedures
|
74
|
34
|
$0.01
|
—
|
$25,278.62
|
$149,583.00
|
$49,110.87
|
2026-04-01
|
|
279
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
73
|
34
|
$0.01
|
—
|
$24,496.00
|
$158,227.19
|
$48,907.00
|
2026-04-01
|
|
665
|
MS_DRG
|
Prostatectomy With Mcc
|
73
|
34
|
$0.01
|
—
|
$23,685.59
|
$146,951.00
|
$48,589.00
|
2026-04-01
|
|
939
|
MS_DRG
|
O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc
|
73
|
34
|
$0.01
|
—
|
$24,271.00
|
$159,196.81
|
$48,450.00
|
2026-04-01
|
|
260
|
MS_DRG
|
Cardiac Pacemaker Revision Except Device Replacement With Mcc
|
73
|
34
|
$0.01
|
—
|
$24,641.12
|
$145,779.00
|
$48,201.00
|
2026-04-01
|
|
37
|
MS_DRG
|
Extracranial Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$24,926.47
|
$144,437.60
|
$48,054.78
|
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
|
|
274
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures Without Mcc
|
73
|
34
|
$0.01
|
—
|
$23,879.00
|
$144,420.05
|
$47,525.56
|
2026-04-01
|
|
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
|
|
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
|
|
579
|
MS_DRG
|
Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$24,537.28
|
$142,085.95
|
$47,272.38
|
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
|
|
840
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Mcc
|
73
|
34
|
$0.01
|
—
|
$24,382.00
|
$141,928.00
|
$47,219.84
|
2026-04-01
|
|
485
|
MS_DRG
|
Knee Procedures With Principal Diagnosis Of Infection With Mcc
|
73
|
34
|
$0.01
|
—
|
$24,454.51
|
$141,585.79
|
$47,105.98
|
2026-04-01
|
|
929
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc
|
73
|
34
|
$0.01
|
—
|
$24,318.00
|
$141,309.38
|
$47,014.02
|
2026-04-01
|
|
451
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical Without Mcc
|
73
|
34
|
$0.01
|
—
|
$23,620.00
|
$141,730.57
|
$46,640.52
|
2026-04-01
|
|
652
|
MS_DRG
|
Kidney Transplant
|
73
|
34
|
$0.01
|
—
|
$23,512.00
|
$141,691.08
|
$46,627.52
|
2026-04-01
|
|
242
|
MS_DRG
|
Permanent Cardiac Pacemaker Implant With Mcc
|
75
|
34
|
$0.01
|
—
|
$7,262.69
|
$145,171.00
|
$46,605.30
|
2026-04-01
|
|
515
|
MS_DRG
|
Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$23,667.00
|
$139,822.05
|
$46,519.18
|
2026-04-01
|
|
656
|
MS_DRG
|
Kidney And Ureter Procedures For Neoplasm With Mcc
|
73
|
34
|
$0.01
|
—
|
$24,140.12
|
$139,686.04
|
$46,473.93
|
2026-04-01
|
|
58468-0132-2
|
NDC
|
Sevelamer Carbonate 0.8 G Po Pack
|
35
|
20
|
$74,112.26
|
$29,644.90
60% off
|
$16,823.00
|
$66,701.00
|
$46,320.00
|
2024-12-15
|
|
58468-0132-1
|
NDC
|
Sevelamer Carbonate 0.8 G Po Pack
|
35
|
20
|
$74,112.26
|
$29,644.90
60% off
|
$16,823.00
|
$66,701.00
|
$46,320.00
|
2024-12-15
|
|
500
|
MS_DRG
|
Soft Tissue Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$24,002.17
|
$138,852.44
|
$46,196.59
|
2026-04-01
|
|
829
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…
|
73
|
34
|
$0.01
|
—
|
$23,604.00
|
$138,641.84
|
$46,126.52
|
2026-04-01
|
|
229
|
MS_DRG
|
Other Cardiothoracic Procedures Without Mcc
|
73
|
34
|
$0.01
|
—
|
$23,770.00
|
$138,181.16
|
$45,973.25
|
2026-04-01
|
|
33264
|
CPT
|
Hc Rmvl Impltbl Dfb Pls Gen W/rplcmt Pls Gen Mlt Ld
|
108
|
37
|
$88,061.88
|
$35,224.75
60% off
|
$14,380.00
|
$79,256.00
|
$45,780.00
|
2024-12-15
|
|
324
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc
|
75
|
34
|
$0.01
|
—
|
$9,117.98
|
$138,246.97
|
$45,494.14
|
2026-04-01
|
|
26
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Cc
|
73
|
34
|
$0.01
|
—
|
$23,417.00
|
$136,413.04
|
$45,384.99
|
2026-04-01
|
|
469
|
MS_DRG
|
Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…
|
74
|
34
|
$0.01
|
—
|
$19,978.72
|
$139,894.00
|
$45,265.31
|
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
|
|
464
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
73
|
34
|
$0.01
|
—
|
$22,603.00
|
$136,654.35
|
$44,970.04
|
2026-04-01
|
|
341
|
MS_DRG
|
Appendectomy Without Complicated Principal Diagnosis With Mcc
|
17
|
6
|
—
|
—
|
$32,615.44
|
$99,111.37
|
$44,710.13
|
2026-04-01
|
|
662
|
MS_DRG
|
Minor Bladder Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$23,252.12
|
$134,320.25
|
$44,688.72
|
2026-04-01
|
|
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
|
|
325
|
MS_DRG
|
Coronary Intravascular Lithotripsy Without Intraluminal Device
|
73
|
34
|
$0.01
|
—
|
$21,963.00
|
$140,853.09
|
$43,767.00
|
2026-04-01
|
|
510
|
MS_DRG
|
Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$21,934.00
|
$132,521.42
|
$43,609.98
|
2026-04-01
|
|
625
|
MS_DRG
|
Thyroid, Parathyroid And Thyroglossal Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$22,000.00
|
$132,503.87
|
$43,604.20
|
2026-04-01
|
|
173
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…
|
73
|
34
|
$0.01
|
—
|
$22,634.22
|
$131,330.00
|
$43,446.51
|
2026-04-01
|
|
68382-395-04
|
NDC
|
Ribavirin 6 G In Solr
|
35
|
20
|
$69,198.81
|
$27,679.52
60% off
|
$15,708.00
|
$62,279.00
|
$43,249.00
|
2024-12-15
|
|
68382-395-01
|
NDC
|
Ribavirin 6 G In Solr
|
35
|
20
|
$69,198.81
|
$27,679.52
60% off
|
$15,708.00
|
$62,279.00
|
$43,249.00
|
2024-12-15
|
|
793
|
MS_DRG
|
Full Term Neonate With Major Problems
|
69
|
34
|
$0.01
|
—
|
$1,428.35
|
$182,937.03
|
$43,158.08
|
2026-04-01
|
|
472
|
MS_DRG
|
Cervical Spinal Fusion With Cc
|
73
|
34
|
$0.01
|
—
|
$22,223.00
|
$129,257.19
|
$43,004.22
|
2026-04-01
|
|
570
|
MS_DRG
|
Skin Debridement With Mcc
|
73
|
34
|
$0.01
|
—
|
$22,377.92
|
$129,037.82
|
$42,931.24
|
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
|
|
258
|
MS_DRG
|
Cardiac Pacemaker Device Replacement With Mcc
|
73
|
34
|
$0.01
|
—
|
$21,545.00
|
$137,856.50
|
$42,917.00
|
2026-04-01
|
|
C2624
|
HCPCS
|
System Cardiomems Hrt Failure Ptnt
|
80
|
37
|
$76,009.50
|
$30,403.80
60% off
|
$17,254.00
|
$68,409.00
|
$42,831.50
|
2024-12-15
|
|
668
|
MS_DRG
|
Transurethral Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$22,224.72
|
$128,112.08
|
$42,623.24
|
2026-04-01
|
|
480
|
MS_DRG
|
Hip And Femur Procedures Except Major Joint With Mcc
|
73
|
34
|
$0.01
|
—
|
$22,168.80
|
$127,774.25
|
$42,510.84
|
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
|
|
353
|
MS_DRG
|
Hernia Procedures Except Inguinal And Femoral With Mcc
|
73
|
34
|
$0.01
|
—
|
$22,094.02
|
$127,322.35
|
$42,360.49
|
2026-04-01
|
|
406
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Cc
|
73
|
34
|
$0.01
|
—
|
$21,566.00
|
$127,243.37
|
$42,317.00
|
2026-04-01
|
|
974
|
MS_DRG
|
HIV With Major Related Condition With Mcc
|
74
|
34
|
$0.01
|
—
|
$21,977.84
|
$127,803.00
|
$42,192.47
|
2026-04-01
|
|
521
|
MS_DRG
|
Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc
|
73
|
34
|
$0.01
|
—
|
$21,863.13
|
$125,927.15
|
$41,896.31
|
2026-04-01
|
|
411
|
MS_DRG
|
Cholecystectomy With C.d.e. With Mcc
|
73
|
34
|
$0.01
|
—
|
$21,033.00
|
$144,928.98
|
$41,879.00
|
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
|
|
619
|
MS_DRG
|
O.r. Procedures For Obesity With Mcc
|
73
|
34
|
$0.01
|
—
|
$20,960.00
|
$126,681.79
|
$41,688.28
|
2026-04-01
|
|
240
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc
|
73
|
34
|
$0.01
|
—
|
$21,720.09
|
$125,062.84
|
$41,608.75
|
2026-04-01
|
|
59385-027-60
|
NDC
|
Buprenorphine Hcl 900 Mcg Bu Film
|
35
|
20
|
$66,560.68
|
$26,624.27
60% off
|
$15,109.00
|
$59,905.00
|
$41,600.00
|
2024-12-15
|
|
59385-027-01
|
NDC
|
Buprenorphine Hcl 900 Mcg Bu Film
|
35
|
20
|
$66,560.68
|
$26,624.27
60% off
|
$15,109.00
|
$59,905.00
|
$41,600.00
|
2024-12-15
|
|
33262
|
CPT
|
Hc Rmvl Impltbl Dfb Plse Gen W/repl Plse Gen 1 Lead
|
70
|
37
|
$94,120.36
|
$37,648.14
60% off
|
$14,380.00
|
$84,708.00
|
$41,495.00
|
2024-12-15
|
|
33263
|
CPT
|
Hc Rmvl Impltbl Dfb Plse Gen W/rplcmt Plse Gen 2 Ld
|
70
|
37
|
$94,120.36
|
$37,648.14
60% off
|
$14,380.00
|
$84,708.00
|
$41,495.00
|
2024-12-15
|
|
800
|
MS_DRG
|
Splenic Procedures With Cc
|
73
|
34
|
$0.01
|
—
|
$21,421.66
|
$124,705.00
|
$41,233.00
|
2026-04-01
|
|
37235
|
CPT
|
Hc Ccl Tib/per Revasc Stnt And Arthrectomy Addl
|
105
|
37
|
$65,779.15
|
$26,311.66
60% off
|
$7,047.00
|
$118,402.00
|
$41,112.00
|
2024-12-15
|
|
37229
|
CPT
|
Hc Revascularize Tibial/peron Artery,angioplasty/atherectomy Initial
|
105
|
37
|
$65,779.15
|
$26,311.66
60% off
|
$7,047.00
|
$118,402.00
|
$41,112.00
|
2024-12-15
|
|
37230
|
CPT
|
Hc Revascularize Tibial/peron Artery,angioplasty/stent Initial
|
105
|
37
|
$65,779.15
|
$26,311.66
60% off
|
$7,047.00
|
$118,402.00
|
$41,112.00
|
2024-12-15
|
|
37227
|
CPT
|
Hc Revascularize Fem/pop Artery,angioplasty/stent/atherectomy
|
105
|
37
|
$65,779.15
|
$26,311.66
60% off
|
$7,047.00
|
$118,402.00
|
$41,112.00
|
2024-12-15
|
|
37233
|
CPT
|
Hc Revascularize Tibial/peron Artery,angioplasty/atherectomy Ea Add
|
105
|
37
|
$65,779.15
|
$26,311.66
60% off
|
$7,047.00
|
$118,402.00
|
$41,112.00
|
2024-12-15
|
|
263
|
MS_DRG
|
Vein Ligation And Stripping
|
73
|
34
|
$0.01
|
—
|
$20,632.00
|
$134,140.37
|
$41,063.00
|
2026-04-01
|
|
654
|
MS_DRG
|
Major Bladder Procedures With Cc
|
73
|
34
|
$0.01
|
—
|
$21,348.33
|
$122,816.49
|
$40,861.38
|
2026-04-01
|
|
13
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc
|
73
|
34
|
$0.01
|
—
|
$20,394.00
|
$126,436.09
|
$40,581.00
|
2026-04-01
|
|
462
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc
|
73
|
34
|
$0.01
|
—
|
$20,336.90
|
$122,565.00
|
$40,526.00
|
2026-04-01
|
|
959
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc
|
73
|
34
|
$0.01
|
—
|
$20,349.00
|
$129,169.44
|
$40,490.00
|
2026-04-01
|
|
503
|
MS_DRG
|
Foot Procedures With Mcc
|
73
|
34
|
$0.01
|
—
|
$20,369.00
|
$122,456.72
|
$40,297.90
|
2026-04-01
|
|
33240
|
CPT
|
Hc Insj Implntbl Defib Pulse Gen W/1 Existing Ld
|
108
|
37
|
$88,061.88
|
$35,224.75
60% off
|
$14,380.00
|
$79,256.00
|
$40,283.00
|
2024-12-15
|
|
208
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support <=96 Hours
|
75
|
34
|
$0.01
|
—
|
$20,644.00
|
$120,596.46
|
$40,122.77
|
2026-04-01
|
|
4404
|
APR_DRG
|
Kidney Transplant
|
9
|
6
|
$0.01
|
—
|
$37,839.00
|
$45,407.00
|
$40,110.00
|
2024-12-15
|
|
61
|
MS_DRG
|
Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…
|
74
|
34
|
$0.01
|
—
|
$20,789.00
|
$120,965.01
|
$40,026.20
|
2026-04-01
|
|
963
|
MS_DRG
|
Other Multiple Significant Trauma With Mcc
|
73
|
34
|
$0.01
|
—
|
$20,872.74
|
$119,942.74
|
$39,905.28
|
2026-04-01
|
|
C1827
|
HCPCS
|
Generator Imp Vivistim Vns Ipg 1001
|
134
|
37
|
$128,620.00
|
$51,448.00
60% off
|
$6,433.00
|
$115,758.00
|
$39,885.00
|
2024-12-15
|
|
A9591
|
HCPCS
|
Fluoroestradiol F 18 4-100 Mci/ml IV Soln
|
52
|
32
|
$76,839.34
|
$30,735.74
60% off
|
$69.00
|
$69,155.00
|
$39,803.00
|
2024-12-15
|
|
321
|
MS_DRG
|
Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A…
|
77
|
34
|
$0.01
|
—
|
$9,204.82
|
$121,837.00
|
$39,715.52
|
2026-04-01
|
|
35355
|
CPT
|
Hc Thromboendarterectomy With Without Patch Graft Iliofemoral
|
88
|
27
|
$58,423.68
|
$23,369.47
60% off
|
$2,603.00
|
$105,163.00
|
$39,699.00
|
2024-12-15
|
|
35371
|
CPT
|
Hc Thromboendartectmy Femoral Common
|
88
|
27
|
$58,423.66
|
$23,369.46
60% off
|
$2,603.00
|
$105,163.00
|
$39,699.00
|
2024-12-15
|
|
468
|
MS_DRG
|
Revision Of Hip Or Knee Replacement Without Cc/Mcc
|
73
|
34
|
$0.01
|
—
|
$20,197.00
|
$120,565.75
|
$39,675.62
|
2026-04-01
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
9
|
6
|
$0.01
|
—
|
$37,397.00
|
$44,877.00
|
$39,641.00
|
2024-12-15
|
|
849
|
MS_DRG
|
Radiotherapy
|
73
|
34
|
$0.01
|
—
|
$20,550.00
|
$118,876.60
|
$39,550.57
|
2026-04-01
|
|
288
|
MS_DRG
|
Acute And Subacute Endocarditis With Mcc
|
73
|
34
|
$0.01
|
—
|
$20,672.35
|
$118,731.82
|
$39,502.40
|
2026-04-01
|
|
255
|
MS_DRG
|
Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc
|
73
|
34
|
$0.01
|
—
|
$20,146.00
|
$118,345.73
|
$39,373.95
|
2026-04-01
|
|
34708
|
CPT
|
Hc Evasc Rpr Dplmnt Ilio-iliac Ndgft Rpt
|
105
|
37
|
$62,489.49
|
$24,995.80
60% off
|
$9,941.00
|
$112,481.00
|
$39,056.00
|
2024-12-15
|