|
J3391
|
OTHER
|
Inj Atidarsagene Autotemcel
|
1
|
1
|
—
|
—
|
$4,246,175.00
|
$4,246,175.00
|
$4,246,175.00
|
2026-05-17
|
|
J1414
|
OTHER
|
Inj Beqvez Per Tx Dose
|
9
|
8
|
—
|
—
|
$3,598,700.00
|
$4,637,500.00
|
$3,969,700.00
|
2026-05-17
|
|
J1413
|
OTHER
|
Inj Delandistrogene Mox Rokl
|
10
|
9
|
—
|
—
|
$3,224,834.74
|
$4,650,494.11
|
$3,604,132.94
|
2026-05-17
|
|
J3394
|
OTHER
|
Inj Lovotibeglogene Autotem
|
10
|
9
|
—
|
—
|
$3,163,514.35
|
$4,470,200.00
|
$3,464,405.00
|
2026-05-17
|
|
J3393
|
OTHER
|
Inj Betibeglogene Autotemce
|
10
|
9
|
—
|
—
|
$2,862,166.07
|
$4,155,200.00
|
$3,220,280.00
|
2026-05-17
|
|
J3392
|
OTHER
|
Inj Exagamglogene Autotem
|
10
|
9
|
—
|
—
|
$2,262,040.00
|
$3,264,800.00
|
$2,530,220.00
|
2026-05-17
|
|
J3399
|
OTHER
|
Inj Onase Abepar-xioi Treat
|
22
|
15
|
—
|
—
|
$10,687.19
|
$3,364,842.25
|
$2,391,610.02
|
2026-05-17
|
|
J1411
|
OTHER
|
Inj Hemgenix Per Tx Dose
|
18
|
14
|
—
|
—
|
$15,363.65
|
$4,637,500.00
|
$1,795,720.67
|
2026-05-17
|
|
Q2042
|
OTHER
|
Tisagenlecleucel Car-pos T
|
12
|
10
|
—
|
—
|
$560,974.84
|
$1,442,340.79
|
$636,326.82
|
2026-05-17
|
|
Q2056
|
OTHER
|
Ciltacabtagene Car-pos T
|
12
|
10
|
—
|
—
|
$536,777.47
|
$1,405,861.77
|
$620,233.13
|
2026-05-17
|
|
Q2055
|
OTHER
|
Idecabtagene Vicleucel Car
|
12
|
10
|
—
|
—
|
$525,022.64
|
$1,347,196.70
|
$594,351.48
|
2026-05-17
|
|
Q2054
|
OTHER
|
Lisocabtagene Mara Car Pos T
|
12
|
10
|
—
|
—
|
$516,485.97
|
$1,317,039.22
|
$581,046.72
|
2026-05-17
|
|
Q2041
|
OTHER
|
Axicabtagene Ciloleucel Car+
|
12
|
10
|
—
|
—
|
$489,517.15
|
$1,248,268.73
|
$550,706.79
|
2026-05-17
|
|
Q2053
|
OTHER
|
Brexucabtagene Car Pos T
|
12
|
10
|
—
|
—
|
$475,028.40
|
$1,244,531.35
|
$549,057.95
|
2026-05-17
|
|
5834
|
OTHER
|
Neonate With Ecmo
|
18
|
9
|
—
|
—
|
$233,481.52
|
$587,402.50
|
$396,814.55
|
2026-05-17
|
|
MS-018
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell Immunotherapy
|
32
|
18
|
—
|
—
|
$250,888.25
|
$1,277,596.53
|
$342,376.60
|
2026-05-17
|
|
MS-633
|
OTHER
|
Neonate- Birthwt 1000-1499g- W Signif O.r. Pro- Discharged Alive
|
1
|
1
|
—
|
—
|
$312,460.08
|
$312,460.08
|
$312,460.08
|
2026-05-17
|
|
MS-001
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
33
|
19
|
—
|
—
|
$187,392.49
|
$954,257.50
|
$292,919.34
|
2026-05-17
|
|
MS-612
|
OTHER
|
Neonate- Birthwt <750g-- Discharged Alive
|
1
|
1
|
—
|
—
|
$286,326.48
|
$286,326.48
|
$286,326.48
|
2026-05-17
|
|
Q2058
|
OTHER
|
Obecbtge Autol Up To 400 Mil
|
1
|
1
|
—
|
—
|
$262,263.75
|
$262,263.75
|
$262,263.75
|
2026-05-17
|
|
5884
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
18
|
9
|
—
|
—
|
$143,002.96
|
$359,772.79
|
$243,041.32
|
2026-05-17
|
|
114
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
18
|
9
|
—
|
—
|
$133,683.73
|
$336,327.09
|
$227,202.78
|
2026-05-17
|
|
24
|
OTHER
|
Heart And/or Lung Transplant
|
18
|
9
|
—
|
—
|
$133,595.50
|
$336,105.12
|
$227,052.83
|
2026-05-17
|
|
5833
|
OTHER
|
Neonate With Ecmo
|
18
|
9
|
—
|
—
|
$132,975.48
|
$334,545.25
|
$225,999.07
|
2026-05-17
|
|
MS-927
|
OTHER
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
33
|
19
|
—
|
—
|
$157,818.35
|
$803,657.30
|
$220,945.68
|
2026-05-17
|
|
MS-631
|
OTHER
|
Neonate- Birthwt 750-999g- Discharged Alive
|
1
|
1
|
—
|
—
|
$207,618.07
|
$207,618.07
|
$207,618.07
|
2026-05-17
|
|
MS-003
|
OTHER
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…
|
33
|
19
|
—
|
—
|
$142,575.90
|
$726,038.31
|
$200,911.34
|
2026-05-17
|
|
MS-636
|
OTHER
|
Neonate- Birthwt 1500-1999g- W Signif O.r. Proc W Mult Major Prob
|
1
|
1
|
—
|
—
|
$183,596.31
|
$183,596.31
|
$183,596.31
|
2026-05-17
|
|
MS-453
|
OTHER
|
Combined Anterior/posterior Spinal Fusion W Mcc
|
8
|
3
|
—
|
—
|
$99,714.20
|
$264,016.55
|
$183,479.71
|
2026-05-17
|
|
1614
|
OTHER
|
Implantable Heart Assist Systems
|
18
|
9
|
—
|
—
|
$99,695.05
|
$250,816.95
|
$169,437.17
|
2026-05-17
|
|
6094
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
18
|
9
|
—
|
—
|
$99,633.81
|
$250,662.89
|
$169,333.10
|
2026-05-17
|
|
113
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
18
|
9
|
—
|
—
|
$99,489.18
|
$250,299.02
|
$169,087.29
|
2026-05-17
|
|
94
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
18
|
9
|
—
|
—
|
$97,733.47
|
$245,881.92
|
$166,103.35
|
2026-05-17
|
|
2424195
|
OTHER
|
Impl Maci Double Membrane
|
33
|
16
|
$313,500.00
|
$188,100.00
40% off
|
$56,430.00
|
$313,500.00
|
$165,214.50
|
2026-05-17
|
|
6314
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
18
|
9
|
—
|
—
|
$95,829.90
|
$241,092.85
|
$162,868.13
|
2026-05-17
|
|
5883
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
18
|
9
|
—
|
—
|
$95,239.69
|
$239,607.98
|
$161,865.04
|
2026-05-17
|
|
5914
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
18
|
9
|
—
|
—
|
$93,774.45
|
$235,921.65
|
$159,374.78
|
2026-05-17
|
|
2423837
|
OTHER
|
Impl-cardio Vasc 99001-100000
|
33
|
16
|
$298,500.00
|
$179,100.00
40% off
|
$53,730.00
|
$298,500.00
|
$157,309.50
|
2026-05-17
|
|
8414
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
18
|
9
|
—
|
—
|
$88,681.34
|
$223,108.21
|
$150,718.77
|
2026-05-17
|
|
6304
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
18
|
9
|
—
|
—
|
$86,907.90
|
$218,646.51
|
$147,704.71
|
2026-05-17
|
|
2423695
|
OTHER
|
Impl-heart 89001-90000
|
33
|
16
|
$268,500.00
|
$161,100.00
40% off
|
$48,330.00
|
$268,500.00
|
$141,499.50
|
2026-05-17
|
|
5934
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
18
|
9
|
—
|
—
|
$82,445.69
|
$207,420.30
|
$140,120.95
|
2026-05-17
|
|
2423618
|
OTHER
|
Impl-cardio Vasc 87001-88000
|
33
|
16
|
$262,500.00
|
$157,500.00
40% off
|
$47,250.00
|
$262,500.00
|
$138,337.50
|
2026-05-17
|
|
MS-459
|
OTHER
|
Spinal Fusion Except Cervical With Mcc
|
8
|
3
|
—
|
—
|
$44,989.74
|
$197,602.75
|
$137,227.66
|
2026-05-17
|
|
74
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
18
|
9
|
—
|
—
|
$78,655.88
|
$197,885.73
|
$133,679.95
|
2026-05-17
|
|
5832
|
OTHER
|
Neonate With Ecmo
|
18
|
9
|
—
|
—
|
$102,100.60
|
$169,021.98
|
$133,195.79
|
2026-05-17
|
|
MS-224
|
OTHER
|
Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami- Hf Or Sh…
|
9
|
5
|
—
|
—
|
$83.30
|
$241,784.27
|
$132,922.50
|
2026-05-17
|
|
1613
|
OTHER
|
Implantable Heart Assist Systems
|
18
|
9
|
—
|
—
|
$78,063.66
|
$196,395.79
|
$132,673.43
|
2026-05-17
|
|
MS-004
|
OTHER
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec…
|
33
|
19
|
—
|
—
|
$94,001.27
|
$478,682.01
|
$131,601.77
|
2026-05-17
|
|
44
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
18
|
9
|
—
|
—
|
$75,109.40
|
$188,963.35
|
$127,652.51
|
2026-05-17
|
|
MS-454
|
OTHER
|
Combined Anterior/posterior Spinal Fusion W Cc
|
8
|
3
|
—
|
—
|
$64,925.00
|
$182,229.04
|
$126,641.05
|
2026-05-17
|
|
14
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
18
|
9
|
—
|
—
|
$74,362.07
|
$187,083.19
|
$126,382.39
|
2026-05-17
|
|
2423694
|
OTHER
|
Impl-heart 79001-80000
|
33
|
16
|
$238,500.00
|
$143,100.00
40% off
|
$42,930.00
|
$238,500.00
|
$125,689.50
|
2026-05-17
|
|
MS-681
|
OTHER
|
Neonate- Birthwt >2499g- W Signif O.r. Proc- W Mult Major Prob
|
1
|
1
|
—
|
—
|
$125,052.34
|
$125,052.34
|
$125,052.34
|
2026-05-17
|
|
23
|
OTHER
|
Heart And/or Lung Transplant
|
18
|
9
|
—
|
—
|
$72,771.93
|
$183,082.66
|
$123,679.87
|
2026-05-17
|
|
Q0480
|
OTHER
|
Driver Pneumatic Vad Rep
|
12
|
10
|
—
|
—
|
$106,036.81
|
$278,756.57
|
$122,980.84
|
2026-05-17
|
|
MS-014
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
33
|
19
|
—
|
—
|
$87,161.06
|
$443,849.68
|
$122,025.48
|
2026-05-17
|
|
5913
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
18
|
9
|
—
|
—
|
$70,722.13
|
$177,925.66
|
$120,196.10
|
2026-05-17
|
|
MS-226
|
OTHER
|
Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc
|
9
|
5
|
—
|
—
|
$83.30
|
$232,381.28
|
$120,016.88
|
2026-05-17
|
|
MS-020
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
33
|
19
|
—
|
—
|
$53,627.29
|
$273,085.88
|
$114,702.60
|
2026-05-17
|
|
MS-007
|
OTHER
|
Lung Transplant
|
33
|
19
|
—
|
—
|
$86,941.52
|
$442,731.74
|
$114,334.78
|
2026-05-17
|
|
5893
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
18
|
9
|
—
|
—
|
$66,659.16
|
$167,703.89
|
$113,290.88
|
2026-05-17
|
|
MS-002
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
33
|
19
|
—
|
—
|
$73,309.68
|
$373,314.38
|
$112,312.42
|
2026-05-17
|
|
MS-634
|
OTHER
|
Neonate- Birthwt 1000-1499g- Without Signif O.r. Proc- Discharged Alive
|
1
|
1
|
—
|
—
|
$111,995.64
|
$111,995.64
|
$111,995.64
|
2026-05-17
|
|
93
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
18
|
9
|
—
|
—
|
$65,683.01
|
$165,248.03
|
$111,631.85
|
2026-05-17
|
|
MS-005
|
OTHER
|
Liver Transplant With Mcc Or Intestinal Transplant
|
33
|
19
|
—
|
—
|
$70,846.22
|
$360,769.72
|
$109,314.62
|
2026-05-17
|
|
5882
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
18
|
9
|
—
|
—
|
$81,610.14
|
$135,101.14
|
$106,464.87
|
2026-05-17
|
|
MS-212
|
OTHER
|
Testes Procedures Age 0-17
|
32
|
18
|
—
|
—
|
$72,472.78
|
$369,052.65
|
$106,245.79
|
2026-05-17
|
|
6024
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
18
|
9
|
—
|
—
|
$62,109.13
|
$156,256.73
|
$105,557.85
|
2026-05-17
|
|
MS-222
|
OTHER
|
Cardiac Defibrillator Implant With Cardiac Catheterization With Ami- Hf Or Shock…
|
9
|
5
|
—
|
—
|
$83.30
|
$259,382.64
|
$104,715.59
|
2026-05-17
|
|
112
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
18
|
9
|
—
|
—
|
$79,092.60
|
$130,933.48
|
$103,180.59
|
2026-05-17
|
|
5933
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
18
|
9
|
—
|
—
|
$60,311.51
|
$151,734.22
|
$102,502.71
|
2026-05-17
|
|
MS-632
|
OTHER
|
Neonate- Birthwt 750-999g- Died
|
1
|
1
|
—
|
—
|
$101,894.61
|
$101,894.61
|
$101,894.61
|
2026-05-17
|
|
1604
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
18
|
9
|
—
|
—
|
$57,230.35
|
$143,982.50
|
$97,266.10
|
2026-05-17
|
|
MS-455
|
OTHER
|
Combined Anterior/posterior Spinal Fusion Without Cc/mcc
|
8
|
3
|
—
|
—
|
$51,020.98
|
$137,219.25
|
$95,361.26
|
2026-05-17
|
|
5831
|
OTHER
|
Neonate With Ecmo
|
9
|
9
|
—
|
—
|
$91,647.68
|
$99,814.31
|
$95,277.30
|
2026-05-17
|
|
MS-225
|
OTHER
|
Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami- Hf Or Sh…
|
9
|
5
|
—
|
—
|
$83.30
|
$177,232.59
|
$94,831.88
|
2026-05-17
|
|
MS-227
|
OTHER
|
Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc
|
9
|
5
|
—
|
—
|
$83.30
|
$170,086.25
|
$94,138.13
|
2026-05-17
|
|
MS-215
|
OTHER
|
Other Heart Assist System Implant
|
38
|
19
|
—
|
—
|
$65.55
|
$358,920.04
|
$89,222.24
|
2026-05-17
|
|
54
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
18
|
9
|
—
|
—
|
$52,323.78
|
$131,638.33
|
$88,927.10
|
2026-05-17
|
|
43
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
18
|
9
|
—
|
—
|
$51,793.60
|
$130,304.49
|
$88,026.04
|
2026-05-17
|
|
5892
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
18
|
9
|
—
|
—
|
$66,659.16
|
$110,350.61
|
$86,960.51
|
2026-05-17
|
|
73
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
18
|
9
|
—
|
—
|
$50,025.79
|
$125,856.98
|
$85,021.56
|
2026-05-17
|
|
8424
|
OTHER
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
18
|
9
|
—
|
—
|
$49,648.71
|
$124,908.28
|
$84,380.68
|
2026-05-17
|
|
2424194
|
OTHER
|
Impl Maci Single Membrane
|
33
|
16
|
$157,500.00
|
$94,500.00
40% off
|
$28,350.00
|
$157,500.00
|
$83,002.50
|
2026-05-17
|
|
64
|
OTHER
|
Pancreas Transplant
|
18
|
9
|
—
|
—
|
$48,573.04
|
$122,202.08
|
$82,552.53
|
2026-05-17
|
|
MS-216
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
38
|
19
|
—
|
—
|
$65.55
|
$335,720.20
|
$81,861.29
|
2026-05-17
|
|
6074
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
18
|
9
|
—
|
—
|
$48,010.63
|
$120,787.14
|
$81,596.68
|
2026-05-17
|
|
6303
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
18
|
9
|
—
|
—
|
$47,905.48
|
$120,522.60
|
$81,417.98
|
2026-05-17
|
|
MS-426
|
OTHER
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
29
|
17
|
—
|
—
|
$18,645.74
|
$354,875.13
|
$80,141.97
|
2026-05-17
|
|
5912
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
18
|
9
|
—
|
—
|
$60,659.20
|
$100,417.99
|
$79,133.22
|
2026-05-17
|
|
MS-456
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…
|
33
|
19
|
—
|
—
|
$56,342.22
|
$286,911.09
|
$78,879.10
|
2026-05-17
|
|
2424631
|
OTHER
|
C1767 Neurostm Gen 49001-50000
|
33
|
16
|
$148,501.00
|
$89,100.60
40% off
|
$26,730.18
|
$148,501.00
|
$78,260.03
|
2026-05-17
|
|
2424856
|
OTHER
|
Impl-heart 49001-50000
|
33
|
16
|
$148,501.00
|
$89,100.60
40% off
|
$26,730.18
|
$148,501.00
|
$78,260.03
|
2026-05-17
|
|
2422945
|
OTHER
|
Impl-spine 49001-50000
|
33
|
16
|
$148,501.00
|
$89,100.60
40% off
|
$26,730.18
|
$148,501.00
|
$78,260.03
|
2026-05-17
|
|
MS-850
|
OTHER
|
Acute Leukemia With Other Procedures
|
30
|
18
|
—
|
—
|
$61,283.10
|
$312,071.54
|
$78,135.96
|
2026-05-17
|
|
8513
|
OTHER
|
Gender Related Procedures
|
18
|
9
|
—
|
—
|
$45,813.77
|
$115,260.19
|
$77,863.00
|
2026-05-17
|
|
8514
|
OTHER
|
Gender Related Procedures
|
18
|
9
|
—
|
—
|
$45,813.77
|
$115,260.19
|
$77,863.00
|
2026-05-17
|
|
MS-019
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
32
|
18
|
—
|
—
|
$52,737.17
|
$268,553.14
|
$77,313.29
|
2026-05-17
|
|
6034
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
18
|
9
|
—
|
—
|
$45,427.01
|
$114,287.17
|
$77,205.68
|
2026-05-17
|
|
2424630
|
OTHER
|
C1767 Neurostm Gen 48001-49000
|
33
|
16
|
$145,501.00
|
$87,300.60
40% off
|
$26,190.18
|
$145,501.00
|
$76,679.03
|
2026-05-17
|
|
2422800
|
OTHER
|
Impl-totl Knee 48001-49000
|
33
|
16
|
$145,501.00
|
$87,300.60
40% off
|
$26,190.18
|
$145,501.00
|
$76,679.03
|
2026-05-17
|
|
2424855
|
OTHER
|
Impl-heart 48001-49000
|
33
|
16
|
$145,501.00
|
$87,300.60
40% off
|
$26,190.18
|
$145,501.00
|
$76,679.03
|
2026-05-17
|
|
2422944
|
OTHER
|
Impl-spine 48001-49000
|
33
|
16
|
$145,501.00
|
$87,300.60
40% off
|
$26,190.18
|
$145,501.00
|
$76,679.03
|
2026-05-17
|
|
L8702
|
OTHER
|
Ewhf S/d Uprt Micro Sensor
|
12
|
10
|
—
|
—
|
$65,429.08
|
$172,004.28
|
$75,884.24
|
2026-05-17
|
|
MS-460
|
OTHER
|
Spinal Fusion Except Cervical Without Mcc
|
8
|
3
|
—
|
—
|
$26,489.41
|
$108,983.47
|
$75,738.65
|
2026-05-17
|
|
2424077
|
OTHER
|
L8614 Cochlear Imp 47001-48000
|
33
|
16
|
$142,501.00
|
$85,500.60
40% off
|
$25,650.18
|
$142,501.00
|
$75,098.03
|
2026-05-17
|
|
2424854
|
OTHER
|
Impl-heart 47001-48000
|
33
|
16
|
$142,501.00
|
$85,500.60
40% off
|
$25,650.18
|
$142,501.00
|
$75,098.03
|
2026-05-17
|
|
2424629
|
OTHER
|
C1767 Neurostm Gen 47001-48000
|
33
|
16
|
$142,501.00
|
$85,500.60
40% off
|
$25,650.18
|
$142,501.00
|
$75,098.03
|
2026-05-17
|
|
2422943
|
OTHER
|
Impl-spine 47001-48000
|
33
|
16
|
$142,501.00
|
$85,500.60
40% off
|
$25,650.18
|
$142,501.00
|
$75,098.03
|
2026-05-17
|
|
1612
|
OTHER
|
Implantable Heart Assist Systems
|
18
|
9
|
—
|
—
|
$57,439.45
|
$95,087.87
|
$74,932.89
|
2026-05-17
|
|
MS-010
|
OTHER
|
Pancreas Transplant
|
33
|
19
|
—
|
—
|
$42,146.66
|
$270,101.32
|
$74,257.67
|
2026-05-17
|
|
38240
|
OTHER
|
Transplt Allo Hct/donor
|
19
|
10
|
—
|
—
|
$14,280.00
|
$151,383.01
|
$74,207.36
|
2026-05-17
|
|
2424853
|
OTHER
|
Impl-heart 46001-47000
|
33
|
16
|
$139,501.00
|
$83,700.60
40% off
|
$25,110.18
|
$139,501.00
|
$73,517.03
|
2026-05-17
|
|
2424628
|
OTHER
|
C1767 Neurostm Gen 46001-47000
|
33
|
16
|
$139,501.00
|
$83,700.60
40% off
|
$25,110.18
|
$139,501.00
|
$73,517.03
|
2026-05-17
|
|
2424076
|
OTHER
|
L8614 Cochlear Imp 46001-47000
|
33
|
16
|
$139,501.00
|
$83,700.60
40% off
|
$25,110.18
|
$139,501.00
|
$73,517.03
|
2026-05-17
|
|
2422942
|
OTHER
|
Impl-spine 46001-47000
|
33
|
16
|
$139,501.00
|
$83,700.60
40% off
|
$25,110.18
|
$139,501.00
|
$73,517.03
|
2026-05-17
|
|
6023
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
18
|
9
|
—
|
—
|
$43,123.39
|
$108,491.63
|
$73,290.55
|
2026-05-17
|
|
5881
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
9
|
9
|
—
|
—
|
$69,951.83
|
$76,185.17
|
$72,722.20
|
2026-05-17
|
|
MS-233
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
38
|
19
|
—
|
—
|
$65.55
|
$264,796.18
|
$72,427.17
|
2026-05-17
|
|
2424075
|
OTHER
|
L8614 Cochlear Imp 45001-46000
|
33
|
16
|
$136,501.00
|
$81,900.60
40% off
|
$24,570.18
|
$136,501.00
|
$71,936.03
|
2026-05-17
|
|
2422941
|
OTHER
|
Impl-spine 45001-46000
|
33
|
16
|
$136,501.00
|
$81,900.60
40% off
|
$24,570.18
|
$136,501.00
|
$71,936.03
|
2026-05-17
|
|
2424627
|
OTHER
|
C1767 Neurostm Gen 45001-46000
|
33
|
16
|
$136,501.00
|
$81,900.60
40% off
|
$24,570.18
|
$136,501.00
|
$71,936.03
|
2026-05-17
|
|
22
|
OTHER
|
Heart And/or Lung Transplant
|
18
|
9
|
—
|
—
|
$55,105.61
|
$91,224.33
|
$71,888.26
|
2026-05-17
|
|
J9029
|
OTHER
|
Instill Adstiladrin Tx Dose
|
12
|
10
|
—
|
—
|
$61,528.12
|
$161,675.20
|
$71,327.30
|
2026-05-17
|
|
MS-219
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
38
|
19
|
—
|
—
|
$65.55
|
$276,498.26
|
$70,955.15
|
2026-05-17
|
|
MS-429
|
OTHER
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
30
|
18
|
—
|
—
|
$55,486.69
|
$282,554.51
|
$70,745.54
|
2026-05-17
|
|
2424120
|
OTHER
|
Cardiovasc Supply 44001-45000
|
33
|
16
|
$133,501.00
|
$80,100.60
40% off
|
$24,030.18
|
$133,501.00
|
$70,355.03
|
2026-05-17
|
|
2424074
|
OTHER
|
L8614 Cochlear Imp 44001-45000
|
33
|
16
|
$133,501.00
|
$80,100.60
40% off
|
$24,030.18
|
$133,501.00
|
$70,355.03
|
2026-05-17
|
|
2423699
|
OTHER
|
Impl-heart 44001-45000
|
33
|
16
|
$133,501.00
|
$80,100.60
40% off
|
$24,030.18
|
$133,501.00
|
$70,355.03
|
2026-05-17
|
|
2422940
|
OTHER
|
Impl-spine 44001-45000
|
33
|
16
|
$133,501.00
|
$80,100.60
40% off
|
$24,030.18
|
$133,501.00
|
$70,355.03
|
2026-05-17
|
|
2424626
|
OTHER
|
C1767 Neurostm Gen 44001-45000
|
33
|
16
|
$133,501.00
|
$80,100.60
40% off
|
$24,030.18
|
$133,501.00
|
$70,355.03
|
2026-05-17
|
|
MS-957
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
33
|
19
|
—
|
—
|
$49,656.35
|
$252,864.70
|
$69,518.89
|
2026-05-17
|
|
5891
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
9
|
9
|
—
|
—
|
$66,659.16
|
$72,599.09
|
$69,299.13
|
2026-05-17
|
|
2424073
|
OTHER
|
L8614 Cochlear Imp 43001-44000
|
33
|
16
|
$130,501.00
|
$78,300.60
40% off
|
$23,490.18
|
$130,501.00
|
$68,774.03
|
2026-05-17
|
|
2424852
|
OTHER
|
Impl-heart 43001-44000
|
33
|
16
|
$130,501.00
|
$78,300.60
40% off
|
$23,490.18
|
$130,501.00
|
$68,774.03
|
2026-05-17
|
|
2424213
|
OTHER
|
Cardiovasc Supply 43001-44000
|
33
|
16
|
$130,501.00
|
$78,300.60
40% off
|
$23,490.18
|
$130,501.00
|
$68,774.03
|
2026-05-17
|
|
2424625
|
OTHER
|
C1767 Neurostm Gen 43001-44000
|
33
|
16
|
$130,501.00
|
$78,300.60
40% off
|
$23,490.18
|
$130,501.00
|
$68,774.03
|
2026-05-17
|
|
2422939
|
OTHER
|
Impl-spine 43001-44000
|
33
|
16
|
$130,501.00
|
$78,300.60
40% off
|
$23,490.18
|
$130,501.00
|
$68,774.03
|
2026-05-17
|
|
2424376
|
OTHER
|
Impl-totl Knee 43001-44000
|
33
|
16
|
$130,501.00
|
$78,300.60
40% off
|
$23,490.18
|
$130,501.00
|
$68,774.03
|
2026-05-17
|
|
S2068
|
OTHER
|
Breast Diep Or Siea Flap
|
1
|
1
|
—
|
—
|
$68,089.13
|
$68,089.13
|
$68,089.13
|
2026-05-17
|
|
6114
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
18
|
9
|
—
|
—
|
$39,931.04
|
$100,460.17
|
$67,864.97
|
2026-05-17
|
|
6134
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
18
|
9
|
—
|
—
|
$39,564.02
|
$99,536.81
|
$67,241.21
|
2026-05-17
|
|
2424212
|
OTHER
|
Cardiovasc Supply 42001-43000
|
33
|
16
|
$127,501.00
|
$76,500.60
40% off
|
$22,950.18
|
$127,501.00
|
$67,193.03
|
2026-05-17
|
|
2424072
|
OTHER
|
L8614 Cochlear Imp 42001-43000
|
33
|
16
|
$127,501.00
|
$76,500.60
40% off
|
$22,950.18
|
$127,501.00
|
$67,193.03
|
2026-05-17
|
|
2422938
|
OTHER
|
Impl-spine 42001-43000
|
33
|
16
|
$127,501.00
|
$76,500.60
40% off
|
$22,950.18
|
$127,501.00
|
$67,193.03
|
2026-05-17
|
|
2424851
|
OTHER
|
Impl-heart 42001-43000
|
33
|
16
|
$127,501.00
|
$76,500.60
40% off
|
$22,950.18
|
$127,501.00
|
$67,193.03
|
2026-05-17
|
|
2424375
|
OTHER
|
Impl-totl Knee 42001-43000
|
33
|
16
|
$127,501.00
|
$76,500.60
40% off
|
$22,950.18
|
$127,501.00
|
$67,193.03
|
2026-05-17
|
|
2424624
|
OTHER
|
C1767 Neurostm Gen 42001-43000
|
33
|
16
|
$127,501.00
|
$76,500.60
40% off
|
$22,950.18
|
$127,501.00
|
$67,193.03
|
2026-05-17
|
|
MS-870
|
OTHER
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
33
|
19
|
—
|
—
|
$46,278.83
|
$235,665.35
|
$67,037.58
|
2026-05-17
|
|
8634
|
OTHER
|
Neonatal Aftercare
|
18
|
9
|
—
|
—
|
$39,053.98
|
$98,253.64
|
$66,374.37
|
2026-05-17
|
|
MS-338
|
OTHER
|
Appendectomy With Complicated Principal Diagnosis With Mcc
|
4
|
2
|
—
|
—
|
$30,847.06
|
$79,147.76
|
$66,096.38
|
2026-05-17
|
|
13
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
18
|
9
|
—
|
—
|
$38,606.80
|
$97,128.59
|
$65,614.36
|
2026-05-17
|
|
2424152
|
OTHER
|
Impl-heart 41001-42000
|
33
|
16
|
$124,501.00
|
$74,700.60
40% off
|
$22,410.18
|
$124,501.00
|
$65,612.03
|
2026-05-17
|
|
2424211
|
OTHER
|
Cardiovasc Supply 41001-42000
|
33
|
16
|
$124,501.00
|
$74,700.60
40% off
|
$22,410.18
|
$124,501.00
|
$65,612.03
|
2026-05-17
|
|
2424623
|
OTHER
|
C1767 Neurostm Gen 41001-42000
|
33
|
16
|
$124,501.00
|
$74,700.60
40% off
|
$22,410.18
|
$124,501.00
|
$65,612.03
|
2026-05-17
|
|
2424374
|
OTHER
|
Impl-totl Knee 41001-42000
|
33
|
16
|
$124,501.00
|
$74,700.60
40% off
|
$22,410.18
|
$124,501.00
|
$65,612.03
|
2026-05-17
|
|
2422937
|
OTHER
|
Impl-spine 41001-42000
|
33
|
16
|
$124,501.00
|
$74,700.60
40% off
|
$22,410.18
|
$124,501.00
|
$65,612.03
|
2026-05-17
|
|
2424071
|
OTHER
|
L8614 Cochlear Imp 41001-42000
|
33
|
16
|
$124,501.00
|
$74,700.60
40% off
|
$22,410.18
|
$124,501.00
|
$65,612.03
|
2026-05-17
|
|
1624
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
18
|
9
|
—
|
—
|
$38,460.96
|
$96,761.68
|
$65,366.49
|
2026-05-17
|
|
MS-223
|
OTHER
|
Cardiac Defibrillator Implant With Cardiac Catheterization With Ami- Hf Or Shock…
|
9
|
5
|
—
|
—
|
$83.30
|
$176,793.90
|
$65,054.62
|
2026-05-17
|
|
3034
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
18
|
9
|
—
|
—
|
$38,275.23
|
$96,294.43
|
$65,050.85
|
2026-05-17
|
|
3550723
|
OTHER
|
Cl Endovascular Venous Arterialization Tibl/prnl Vn
|
33
|
16
|
$122,965.00
|
$73,779.00
40% off
|
$22,133.70
|
$122,965.00
|
$64,802.56
|
2026-05-17
|
|
3570723
|
OTHER
|
Cl Endovascular Venous Arterialization Tibl/prnl Vn
|
33
|
16
|
$122,965.00
|
$73,779.00
40% off
|
$22,133.70
|
$122,965.00
|
$64,802.56
|
2026-05-17
|
|
3560723
|
OTHER
|
Cl Endovascular Venous Arterialization Tibl/prnl Vn
|
33
|
16
|
$122,965.00
|
$73,779.00
40% off
|
$22,133.70
|
$122,965.00
|
$64,802.56
|
2026-05-17
|
|
53
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
18
|
9
|
—
|
—
|
$37,973.08
|
$95,534.26
|
$64,537.32
|
2026-05-17
|
|
0100T
|
OTHER
|
Prosth Retina Receive&gen
|
1
|
1
|
—
|
—
|
$64,230.00
|
$64,230.00
|
$64,230.00
|
2026-05-17
|
|
0424T
|
OTHER
|
Insj/rplc Nstim Apnea Compl
|
1
|
1
|
—
|
—
|
$64,230.00
|
$64,230.00
|
$64,230.00
|
2026-05-17
|
|
2424210
|
OTHER
|
Cardiovasc Supply 40001-41000
|
33
|
16
|
$121,501.00
|
$72,900.60
40% off
|
$21,870.18
|
$121,501.00
|
$64,031.03
|
2026-05-17
|
|
2424373
|
OTHER
|
Impl-totl Knee 40001-41000
|
33
|
16
|
$121,501.00
|
$72,900.60
40% off
|
$21,870.18
|
$121,501.00
|
$64,031.03
|
2026-05-17
|
|
2424850
|
OTHER
|
Impl-heart 40001-41000
|
33
|
16
|
$121,501.00
|
$72,900.60
40% off
|
$21,870.18
|
$121,501.00
|
$64,031.03
|
2026-05-17
|
|
2424070
|
OTHER
|
L8614 Cochlear Imp 40001-41000
|
33
|
16
|
$121,501.00
|
$72,900.60
40% off
|
$21,870.18
|
$121,501.00
|
$64,031.03
|
2026-05-17
|
|
2422936
|
OTHER
|
Impl-spine 40001-41000
|
33
|
16
|
$121,501.00
|
$72,900.60
40% off
|
$21,870.18
|
$121,501.00
|
$64,031.03
|
2026-05-17
|
|
2424622
|
OTHER
|
C1767 Neurostm Gen 40001-41000
|
33
|
16
|
$121,501.00
|
$72,900.60
40% off
|
$21,870.18
|
$121,501.00
|
$64,031.03
|
2026-05-17
|
|
4404
|
OTHER
|
Kidney Transplant
|
18
|
9
|
—
|
—
|
$37,660.86
|
$94,748.75
|
$64,006.67
|
2026-05-17
|
|
A9543
|
OTHER
|
Y90 Ibritumomab Rx
|
12
|
10
|
—
|
—
|
$55,119.81
|
$144,902.60
|
$63,927.62
|
2026-05-17
|
|
63
|
OTHER
|
Pancreas Transplant
|
18
|
9
|
—
|
—
|
$37,433.24
|
$94,176.09
|
$63,619.82
|
2026-05-17
|
|
5932
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
18
|
9
|
—
|
—
|
$48,510.19
|
$80,305.98
|
$63,284.18
|
2026-05-17
|
|
MS-275
|
OTHER
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
34
|
18
|
—
|
—
|
$52.30
|
$239,408.76
|
$62,806.11
|
2026-05-17
|
|
MS-647
|
OTHER
|
Neonate- Birthwt 1500-1999g- Without Signif O.r. Proc- W Mult Major Prob
|
1
|
1
|
—
|
—
|
$62,463.74
|
$62,463.74
|
$62,463.74
|
2026-05-17
|
|
2423367
|
OTHER
|
L8614 Cochlear Imp 39001-40000
|
33
|
16
|
$118,501.00
|
$71,100.60
40% off
|
$21,330.18
|
$118,501.00
|
$62,450.03
|
2026-05-17
|
|
2424580
|
OTHER
|
C1822 Gen Neu Rchg Hf 39001-40000
|
33
|
16
|
$118,501.00
|
$71,100.60
40% off
|
$21,330.18
|
$118,501.00
|
$62,450.03
|
2026-05-17
|
|
2424209
|
OTHER
|
Cardiovasc Supply 39001-40000
|
33
|
16
|
$118,501.00
|
$71,100.60
40% off
|
$21,330.18
|
$118,501.00
|
$62,450.03
|
2026-05-17
|
|
2424849
|
OTHER
|
Impl-heart 39001-40000
|
33
|
16
|
$118,501.00
|
$71,100.60
40% off
|
$21,330.18
|
$118,501.00
|
$62,450.03
|
2026-05-17
|
|
2424012
|
OTHER
|
C1767 Neurostm Gen 39001-40000
|
33
|
16
|
$118,501.00
|
$71,100.60
40% off
|
$21,330.18
|
$118,501.00
|
$62,450.03
|
2026-05-17
|
|
2422935
|
OTHER
|
Impl-spine 39001-40000
|
33
|
16
|
$118,501.00
|
$71,100.60
40% off
|
$21,330.18
|
$118,501.00
|
$62,450.03
|
2026-05-17
|
|
2424372
|
OTHER
|
Impl-totl Knee 39001-40000
|
33
|
16
|
$118,501.00
|
$71,100.60
40% off
|
$21,330.18
|
$118,501.00
|
$62,450.03
|
2026-05-17
|
|
MS-635
|
OTHER
|
Neonate- Birthwt 1000-1499g- Died
|
1
|
1
|
—
|
—
|
$62,333.35
|
$62,333.35
|
$62,333.35
|
2026-05-17
|
|
MS-928
|
OTHER
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
33
|
19
|
—
|
—
|
$31,589.50
|
$226,261.10
|
$62,204.89
|
2026-05-17
|
|
MS-834
|
OTHER
|
Acute Leukemia Without Major O.r. Procedures With Mcc
|
33
|
19
|
—
|
—
|
$36,770.93
|
$187,248.34
|
$61,930.50
|
2026-05-17
|
|
MS-317
|
OTHER
|
Endovascular Cardiac Valve Replacement & Supplement Procedures W Mcc
|
32
|
18
|
—
|
—
|
$41,155.66
|
$209,576.67
|
$61,665.11
|
2026-05-17
|
|
MS-969
|
OTHER
|
HIV With Extensive O.r. Procedures With Mcc
|
33
|
19
|
—
|
—
|
$42,073.05
|
$214,248.31
|
$61,508.62
|
2026-05-17
|
|
MS-231
|
OTHER
|
Coronary Bypass With Ptca With Mcc
|
38
|
19
|
—
|
—
|
$65.55
|
$287,070.31
|
$61,165.23
|
2026-05-17
|
|
2424579
|
OTHER
|
C1822 Gen Neu Rchg Hf 38001-39000
|
33
|
16
|
$115,501.00
|
$69,300.60
40% off
|
$20,790.18
|
$115,501.00
|
$60,869.03
|
2026-05-17
|
|
2423366
|
OTHER
|
L8614 Cochlear Imp 38001-39000
|
33
|
16
|
$115,501.00
|
$69,300.60
40% off
|
$20,790.18
|
$115,501.00
|
$60,869.03
|
2026-05-17
|
|
2424208
|
OTHER
|
Cardiovasc Supply 38001-39000
|
33
|
16
|
$115,501.00
|
$69,300.60
40% off
|
$20,790.18
|
$115,501.00
|
$60,869.03
|
2026-05-17
|
|
2424011
|
OTHER
|
C1767 Neurostm Gen 38001-39000
|
33
|
16
|
$115,501.00
|
$69,300.60
40% off
|
$20,790.18
|
$115,501.00
|
$60,869.03
|
2026-05-17
|
|
2424371
|
OTHER
|
Impl-totl Knee 38001-39000
|
33
|
16
|
$115,501.00
|
$69,300.60
40% off
|
$20,790.18
|
$115,501.00
|
$60,869.03
|
2026-05-17
|
|
2424848
|
OTHER
|
Impl-heart 38001-39000
|
33
|
16
|
$115,501.00
|
$69,300.60
40% off
|
$20,790.18
|
$115,501.00
|
$60,869.03
|
2026-05-17
|
|
2424830
|
OTHER
|
C1889 Implantable Device Nos 38001-39000
|
33
|
16
|
$115,501.00
|
$69,300.60
40% off
|
$20,790.18
|
$115,501.00
|
$60,869.03
|
2026-05-17
|
|
2422934
|
OTHER
|
Impl-spine 38001-39000
|
33
|
16
|
$115,501.00
|
$69,300.60
40% off
|
$20,790.18
|
$115,501.00
|
$60,869.03
|
2026-05-17
|
|
MS-207
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
33
|
19
|
—
|
—
|
$43,023.71
|
$219,089.33
|
$60,797.36
|
2026-05-17
|
|
1611
|
OTHER
|
Implantable Heart Assist Systems
|
9
|
9
|
—
|
—
|
$57,439.45
|
$62,557.81
|
$59,714.27
|
2026-05-17
|
|
84
|
OTHER
|
Autologous Bone Marrow Transplant
|
18
|
9
|
—
|
—
|
$34,983.77
|
$88,013.63
|
$59,456.82
|
2026-05-17
|
|
2423365
|
OTHER
|
L8614 Cochlear Imp 37001-38000
|
33
|
16
|
$112,501.00
|
$67,500.60
40% off
|
$20,250.18
|
$112,501.00
|
$59,288.03
|
2026-05-17
|
|
2424578
|
OTHER
|
C1822 Gen Neu Rchg Hf 37001-38000
|
33
|
16
|
$112,501.00
|
$67,500.60
40% off
|
$20,250.18
|
$112,501.00
|
$59,288.03
|
2026-05-17
|
|
2424207
|
OTHER
|
Cardiovasc Supply 37001-38000
|
33
|
16
|
$112,501.00
|
$67,500.60
40% off
|
$20,250.18
|
$112,501.00
|
$59,288.03
|
2026-05-17
|
|
2424370
|
OTHER
|
Impl-totl Knee 37001-38000
|
33
|
16
|
$112,501.00
|
$67,500.60
40% off
|
$20,250.18
|
$112,501.00
|
$59,288.03
|
2026-05-17
|
|
2424829
|
OTHER
|
C1889 Implantable Device Nos 37001-38000
|
33
|
16
|
$112,501.00
|
$67,500.60
40% off
|
$20,250.18
|
$112,501.00
|
$59,288.03
|
2026-05-17
|
|
2423380
|
OTHER
|
Impl-heart 37001-38000
|
33
|
16
|
$112,501.00
|
$67,500.60
40% off
|
$20,250.18
|
$112,501.00
|
$59,288.03
|
2026-05-17
|
|
2424010
|
OTHER
|
C1767 Neurostm Gen 37001-38000
|
33
|
16
|
$112,501.00
|
$67,500.60
40% off
|
$20,250.18
|
$112,501.00
|
$59,288.03
|
2026-05-17
|
|
2422933
|
OTHER
|
Impl-spine 37001-38000
|
33
|
16
|
$112,501.00
|
$67,500.60
40% off
|
$20,250.18
|
$112,501.00
|
$59,288.03
|
2026-05-17
|
|
MS-023
|
OTHER
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
34
|
19
|
—
|
—
|
$37,953.76
|
$293,885.73
|
$58,829.14
|
2026-05-17
|
|
6093
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
18
|
9
|
—
|
—
|
$34,561.97
|
$86,952.43
|
$58,739.95
|
2026-05-17
|
|
MS-457
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…
|
33
|
19
|
—
|
—
|
$38,181.94
|
$194,433.65
|
$58,299.73
|
2026-05-17
|
|
MS-646
|
OTHER
|
Neonate- Birthwt 1500-1999g- W Signif O.r. Proc- Without Mult Major Prob
|
1
|
1
|
—
|
—
|
$58,162.92
|
$58,162.92
|
$58,162.92
|
2026-05-17
|
|
2424577
|
OTHER
|
C1822 Gen Neu Rchg Hf 36001-37000
|
33
|
16
|
$109,501.00
|
$65,700.60
40% off
|
$19,710.18
|
$109,501.00
|
$57,707.03
|
2026-05-17
|
|
2424369
|
OTHER
|
Impl-totl Knee 36001-37000
|
33
|
16
|
$109,501.00
|
$65,700.60
40% off
|
$19,710.18
|
$109,501.00
|
$57,707.03
|
2026-05-17
|
|
2423364
|
OTHER
|
L8614 Cochlear Imp 36001-37000
|
33
|
16
|
$109,501.00
|
$65,700.60
40% off
|
$19,710.18
|
$109,501.00
|
$57,707.03
|
2026-05-17
|
|
2424206
|
OTHER
|
Cardiovasc Supply 36001-37000
|
33
|
16
|
$109,501.00
|
$65,700.60
40% off
|
$19,710.18
|
$109,501.00
|
$57,707.03
|
2026-05-17
|
|
2423379
|
OTHER
|
Impl-heart 36001-37000
|
33
|
16
|
$109,501.00
|
$65,700.60
40% off
|
$19,710.18
|
$109,501.00
|
$57,707.03
|
2026-05-17
|
|
2424009
|
OTHER
|
C1767 Neurostm Gen 36001-37000
|
33
|
16
|
$109,501.00
|
$65,700.60
40% off
|
$19,710.18
|
$109,501.00
|
$57,707.03
|
2026-05-17
|
|
2422932
|
OTHER
|
Impl-spine 36001-37000
|
33
|
16
|
$109,501.00
|
$65,700.60
40% off
|
$19,710.18
|
$109,501.00
|
$57,707.03
|
2026-05-17
|
|
2424828
|
OTHER
|
C1889 Implantable Device Nos 36001-37000
|
33
|
16
|
$109,501.00
|
$65,700.60
40% off
|
$19,710.18
|
$109,501.00
|
$57,707.03
|
2026-05-17
|
|
MS-573
|
OTHER
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
33
|
19
|
—
|
—
|
$40,968.05
|
$208,621.34
|
$57,355.27
|
2026-05-17
|
|
MS-461
|
OTHER
|
Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc
|
33
|
19
|
—
|
—
|
$40,825.02
|
$207,892.99
|
$57,155.03
|
2026-05-17
|
|
MS-447
|
OTHER
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
30
|
18
|
—
|
—
|
$44,603.70
|
$227,135.12
|
$56,869.72
|
2026-05-17
|
|
MS-028
|
OTHER
|
Spinal Procedures With Mcc
|
33
|
19
|
—
|
—
|
$40,444.49
|
$205,955.22
|
$56,622.29
|
2026-05-17
|
|
MS-268
|
OTHER
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
34
|
19
|
—
|
—
|
$70.90
|
$225,878.29
|
$56,555.03
|
2026-05-17
|
|
MS-248
|
OTHER
|
Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4…
|
9
|
5
|
—
|
—
|
$83.30
|
$101,962.99
|
$56,433.75
|
2026-05-17
|
|
MS-016
|
OTHER
|
Autolous Bone Marrow Transplant With Cc/mcc
|
33
|
19
|
—
|
—
|
$40,154.44
|
$204,478.18
|
$56,216.22
|
2026-05-17
|
|
MS-017
|
OTHER
|
Autolous Bone Marrow Transplant Without Cc/mcc
|
33
|
19
|
—
|
—
|
$40,154.44
|
$204,478.18
|
$56,216.22
|
2026-05-17
|
|
MS-341
|
OTHER
|
Appendectomy Without Complicated Principal Diagnosis With Mcc
|
4
|
2
|
—
|
—
|
$27,115.86
|
$67,304.65
|
$56,206.18
|
2026-05-17
|
|
MS-246
|
OTHER
|
Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar…
|
9
|
5
|
—
|
—
|
$83.30
|
$101,475.17
|
$56,163.75
|
2026-05-17
|
|
2423817
|
OTHER
|
C1822 Gen Neu Rchg Hf 35001-36000
|
33
|
16
|
$106,501.00
|
$63,900.60
40% off
|
$19,170.18
|
$106,501.00
|
$56,126.03
|
2026-05-17
|
|
2423363
|
OTHER
|
L8614 Cochlear Imp 35001-36000
|
33
|
16
|
$106,501.00
|
$63,900.60
40% off
|
$19,170.18
|
$106,501.00
|
$56,126.03
|
2026-05-17
|
|
2424368
|
OTHER
|
Impl-totl Knee 35001-36000
|
33
|
16
|
$106,501.00
|
$63,900.60
40% off
|
$19,170.18
|
$106,501.00
|
$56,126.03
|
2026-05-17
|
|
2423378
|
OTHER
|
Impl-heart 35001-36000
|
33
|
16
|
$106,501.00
|
$63,900.60
40% off
|
$19,170.18
|
$106,501.00
|
$56,126.03
|
2026-05-17
|
|
2423079
|
OTHER
|
Cardiovasc Supply 35001-36000
|
33
|
16
|
$106,501.00
|
$63,900.60
40% off
|
$19,170.18
|
$106,501.00
|
$56,126.03
|
2026-05-17
|
|
2424008
|
OTHER
|
C1767 Neurostm Gen 35001-36000
|
33
|
16
|
$106,501.00
|
$63,900.60
40% off
|
$19,170.18
|
$106,501.00
|
$56,126.03
|
2026-05-17
|
|
2424827
|
OTHER
|
C1889 Implantable Device Nos 35001-36000
|
33
|
16
|
$106,501.00
|
$63,900.60
40% off
|
$19,170.18
|
$106,501.00
|
$56,126.03
|
2026-05-17
|
|
2422931
|
OTHER
|
Impl-spine 35001-36000
|
33
|
16
|
$106,501.00
|
$63,900.60
40% off
|
$19,170.18
|
$106,501.00
|
$56,126.03
|
2026-05-17
|
|
2994
|
OTHER
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
18
|
9
|
—
|
—
|
$32,975.86
|
$82,962.04
|
$56,044.27
|
2026-05-17
|
|
6073
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
18
|
9
|
—
|
—
|
$32,917.04
|
$82,814.06
|
$55,944.30
|
2026-05-17
|
|
MS-266
|
OTHER
|
Endovascular Cardiac Valve Replacement W Mcc
|
33
|
19
|
—
|
—
|
$38,568.69
|
$202,950.33
|
$55,796.17
|
2026-05-17
|
|
Q2043
|
OTHER
|
Sipuleucel-t Auto Cd54+
|
21
|
16
|
—
|
—
|
$15,363.65
|
$141,618.08
|
$55,536.50
|
2026-05-17
|
|
MS-008
|
OTHER
|
Simultaneous Pancreas/kidney Transplant
|
33
|
19
|
—
|
—
|
$36,197.47
|
$184,328.14
|
$55,455.17
|
2026-05-17
|
|
MS-235
|
OTHER
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
38
|
19
|
—
|
—
|
$65.55
|
$199,339.04
|
$55,165.07
|
2026-05-17
|
|
3560705
|
OTHER
|
Cl Insert/repl Ss Icd & Lead (s)
|
33
|
16
|
$103,975.00
|
$62,385.00
40% off
|
$18,715.50
|
$103,975.00
|
$54,794.82
|
2026-05-17
|
|
3570705
|
OTHER
|
Cl Insert/repl Ss Icd & Lead (s)
|
33
|
16
|
$103,975.00
|
$62,385.00
40% off
|
$18,715.50
|
$103,975.00
|
$54,794.82
|
2026-05-17
|
|
3550705
|
OTHER
|
Cl Insert/repl Ss Icd & Lead (s)
|
33
|
16
|
$103,975.00
|
$62,385.00
40% off
|
$18,715.50
|
$103,975.00
|
$54,794.82
|
2026-05-17
|
|
L7181
|
OTHER
|
Electronic Elbo Simultaneous
|
12
|
10
|
—
|
—
|
$47,173.81
|
$124,013.61
|
$54,711.89
|
2026-05-17
|
|
2424576
|
OTHER
|
C1822 Gen Neu Rchg Hf 34001-35000
|
33
|
16
|
$103,501.00
|
$62,100.60
40% off
|
$18,630.18
|
$103,501.00
|
$54,545.03
|
2026-05-17
|
|
2423362
|
OTHER
|
L8614 Cochlear Imp 34001-35000
|
33
|
16
|
$103,501.00
|
$62,100.60
40% off
|
$18,630.18
|
$103,501.00
|
$54,545.03
|
2026-05-17
|
|
2422860
|
OTHER
|
Impl-totl Knee 34001-35000
|
33
|
16
|
$103,501.00
|
$62,100.60
40% off
|
$18,630.18
|
$103,501.00
|
$54,545.03
|
2026-05-17
|
|
2423670
|
OTHER
|
C1767 Neurostm Gen 34001-35000
|
33
|
16
|
$103,501.00
|
$62,100.60
40% off
|
$18,630.18
|
$103,501.00
|
$54,545.03
|
2026-05-17
|
|
2422739
|
OTHER
|
Impl-spine 34001-35000
|
33
|
16
|
$103,501.00
|
$62,100.60
40% off
|
$18,630.18
|
$103,501.00
|
$54,545.03
|
2026-05-17
|
|
2423377
|
OTHER
|
Impl-heart 34001-35000
|
33
|
16
|
$103,501.00
|
$62,100.60
40% off
|
$18,630.18
|
$103,501.00
|
$54,545.03
|
2026-05-17
|
|
2423078
|
OTHER
|
Cardiovasc Supply 34001-35000
|
33
|
16
|
$103,501.00
|
$62,100.60
40% off
|
$18,630.18
|
$103,501.00
|
$54,545.03
|
2026-05-17
|
|
2424826
|
OTHER
|
C1889 Implantable Device Nos 34001-35000
|
33
|
16
|
$103,501.00
|
$62,100.60
40% off
|
$18,630.18
|
$103,501.00
|
$54,545.03
|
2026-05-17
|
|
2424618
|
OTHER
|
C1781 Surg Mesh 34001-35000
|
33
|
16
|
$103,501.00
|
$62,100.60
40% off
|
$18,630.18
|
$103,501.00
|
$54,545.03
|
2026-05-17
|
|
1784
|
OTHER
|
External Heart Assist Systems
|
18
|
9
|
—
|
—
|
$32,002.92
|
$80,514.29
|
$54,390.71
|
2026-05-17
|
|
MS-820
|
OTHER
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
33
|
19
|
—
|
—
|
$38,733.44
|
$197,242.06
|
$54,226.82
|
2026-05-17
|
|
MS-463
|
OTHER
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
33
|
19
|
—
|
—
|
$35,930.70
|
$182,969.68
|
$53,625.21
|
2026-05-17
|
|
6124
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
18
|
9
|
—
|
—
|
$31,455.02
|
$79,135.85
|
$53,459.52
|
2026-05-17
|
|
6334
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
18
|
9
|
—
|
—
|
$31,372.43
|
$78,928.07
|
$53,319.15
|
2026-05-17
|
|
MS-427
|
OTHER
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
30
|
18
|
—
|
—
|
$13,977.65
|
$240,618.17
|
$53,157.87
|
2026-05-17
|
|
3560355
|
OTHER
|
Cl Insert Defib Pulse Gen Only W/mult Leads
|
33
|
16
|
$100,849.00
|
$60,509.40
40% off
|
$18,152.82
|
$100,849.00
|
$53,147.42
|
2026-05-17
|
|
3570355
|
OTHER
|
Cl Insert Defib Pulse Gen Only W/mult Leads
|
33
|
16
|
$100,849.00
|
$60,509.40
40% off
|
$18,152.82
|
$100,849.00
|
$53,147.42
|
2026-05-17
|
|
3550355
|
OTHER
|
Cl Insert Defib Pulse Gen Only W/mult Leads
|
33
|
16
|
$100,849.00
|
$60,509.40
40% off
|
$18,152.82
|
$100,849.00
|
$53,147.42
|
2026-05-17
|
|
2423376
|
OTHER
|
Impl-heart 33001-34000
|
33
|
16
|
$100,501.00
|
$60,300.60
40% off
|
$18,090.18
|
$100,501.00
|
$52,964.03
|
2026-05-17
|
|
2424736
|
OTHER
|
C1827 Gen Neuro Imp Led Ex Cntr 33001-34000
|
33
|
16
|
$100,501.00
|
$60,300.60
40% off
|
$18,090.18
|
$100,501.00
|
$52,964.03
|
2026-05-17
|
|
2422738
|
OTHER
|
Impl-spine 33001-34000
|
33
|
16
|
$100,501.00
|
$60,300.60
40% off
|
$18,090.18
|
$100,501.00
|
$52,964.03
|
2026-05-17
|
|
2422859
|
OTHER
|
Impl-totl Knee 33001-34000
|
33
|
16
|
$100,501.00
|
$60,300.60
40% off
|
$18,090.18
|
$100,501.00
|
$52,964.03
|
2026-05-17
|
|
2424575
|
OTHER
|
C1822 Gen Neu Rchg Hf 33001-34000
|
33
|
16
|
$100,501.00
|
$60,300.60
40% off
|
$18,090.18
|
$100,501.00
|
$52,964.03
|
2026-05-17
|
|
2424413
|
OTHER
|
C1825 Gen Neuro Carot Sinus Baro 33001-34000
|
33
|
16
|
$100,501.00
|
$60,300.60
40% off
|
$18,090.18
|
$100,501.00
|
$52,964.03
|
2026-05-17
|
|
2423263
|
OTHER
|
L8614 Cochlear Imp 33001-34000
|
33
|
16
|
$100,501.00
|
$60,300.60
40% off
|
$18,090.18
|
$100,501.00
|
$52,964.03
|
2026-05-17
|
|
2423669
|
OTHER
|
C1767 Neurostm Gen 33001-34000
|
33
|
16
|
$100,501.00
|
$60,300.60
40% off
|
$18,090.18
|
$100,501.00
|
$52,964.03
|
2026-05-17
|
|
2423077
|
OTHER
|
Cardiovasc Supply 33001-34000
|
33
|
16
|
$100,501.00
|
$60,300.60
40% off
|
$18,090.18
|
$100,501.00
|
$52,964.03
|
2026-05-17
|
|
2424617
|
OTHER
|
C1781 Surg Mesh 33001-34000
|
33
|
16
|
$100,501.00
|
$60,300.60
40% off
|
$18,090.18
|
$100,501.00
|
$52,964.03
|
2026-05-17
|
|
2424825
|
OTHER
|
C1889 Implantable Device Nos 33001-34000
|
33
|
16
|
$100,501.00
|
$60,300.60
40% off
|
$18,090.18
|
$100,501.00
|
$52,964.03
|
2026-05-17
|
|
3550480
|
OTHER
|
Cl Ins/replac Sq Impltbl Defib
|
33
|
16
|
$100,354.00
|
$60,212.40
40% off
|
$18,063.72
|
$100,354.00
|
$52,886.56
|
2026-05-17
|
|
3570480
|
OTHER
|
Cl Ins/replac Sq Impltbl Defib
|
33
|
16
|
$100,354.00
|
$60,212.40
40% off
|
$18,063.72
|
$100,354.00
|
$52,886.56
|
2026-05-17
|
|
3560480
|
OTHER
|
Cl Ins/replac Sq Impltbl Defib
|
33
|
16
|
$100,354.00
|
$60,212.40
40% off
|
$18,063.72
|
$100,354.00
|
$52,886.56
|
2026-05-17
|
|
MS-228
|
OTHER
|
Other Cardiothoracic Procedures With Mcc
|
38
|
19
|
—
|
—
|
$65.55
|
$293,041.63
|
$52,871.31
|
2026-05-17
|
|
6214
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
18
|
9
|
—
|
—
|
$30,847.49
|
$77,607.39
|
$52,426.99
|
2026-05-17
|
|
MS-011
|
OTHER
|
Tracheostomy For Facemouth & Neck Diagnoses W Mcc
|
33
|
19
|
—
|
—
|
$35,896.77
|
$182,796.90
|
$52,404.28
|
2026-05-17
|
|
MS-234
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
38
|
19
|
—
|
—
|
$65.55
|
$328,997.91
|
$52,368.61
|
2026-05-17
|
|
MS-653
|
OTHER
|
Major Bladder Procedures With Mcc
|
33
|
19
|
—
|
—
|
$33,543.42
|
$188,850.72
|
$51,919.83
|
2026-05-17
|
|
MS-006
|
OTHER
|
Liver Transplant Without Mcc
|
33
|
19
|
—
|
—
|
$32,259.80
|
$164,276.35
|
$51,642.14
|
2026-05-17
|
|
MS-021
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
33
|
19
|
—
|
—
|
$36,770.93
|
$187,248.34
|
$51,479.30
|
2026-05-17
|
|
MS-576
|
OTHER
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
33
|
19
|
—
|
—
|
$35,892.78
|
$182,776.58
|
$51,401.52
|
2026-05-17
|
|
2422858
|
OTHER
|
Impl-totl Knee 32001-33000
|
33
|
16
|
$97,501.00
|
$58,500.60
40% off
|
$17,550.18
|
$97,501.00
|
$51,383.03
|
2026-05-17
|
|
2423361
|
OTHER
|
L8614 Cochlear Imp 32001-33000
|
33
|
16
|
$97,501.00
|
$58,500.60
40% off
|
$17,550.18
|
$97,501.00
|
$51,383.03
|
2026-05-17
|
|
2424574
|
OTHER
|
C1822 Gen Neu Rchg Hf 32001-33000
|
33
|
16
|
$97,501.00
|
$58,500.60
40% off
|
$17,550.18
|
$97,501.00
|
$51,383.03
|
2026-05-17
|
|
2424735
|
OTHER
|
C1827 Gen Neuro Imp Led Ex Cntr 32001-33000
|
33
|
16
|
$97,501.00
|
$58,500.60
40% off
|
$17,550.18
|
$97,501.00
|
$51,383.03
|
2026-05-17
|
|
2424412
|
OTHER
|
C1825 Gen Neuro Carot Sinus Baro 32001-33000
|
33
|
16
|
$97,501.00
|
$58,500.60
40% off
|
$17,550.18
|
$97,501.00
|
$51,383.03
|
2026-05-17
|
|
2423076
|
OTHER
|
Cardiovasc Supply 32001-33000
|
33
|
16
|
$97,501.00
|
$58,500.60
40% off
|
$17,550.18
|
$97,501.00
|
$51,383.03
|
2026-05-17
|
|
2423187
|
OTHER
|
Impl-heart 32001-33000
|
33
|
16
|
$97,501.00
|
$58,500.60
40% off
|
$17,550.18
|
$97,501.00
|
$51,383.03
|
2026-05-17
|
|
2422737
|
OTHER
|
Impl-spine 32001-33000
|
33
|
16
|
$97,501.00
|
$58,500.60
40% off
|
$17,550.18
|
$97,501.00
|
$51,383.03
|
2026-05-17
|