Price Transparencybeta Hospital negotiated rates

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 HEART OF FLORIDA

Davenport, FL · CCN 100137 · Rates published

15,383 distinct procedures filed
43 distinct payers
1,067,677 rate rows
2024-12-15 last MRF observed · ⚠ 18 mo old
Data quality

1,060,195 of 1,067,677 rate rows are consumer-grade (99.3%)

7,482 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
exceeds 10× this hospital's gross charge — excluded from medians 4,752
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 2,357
per-diem day rate — not a per-procedure price 228
template filing: same amount across many unrelated codes — excluded 145

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 18 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://hospitalpricedisclosure.com/download.aspx?pi=URt8djdtH*__*GTsWWQK*__*ofUg*-*
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 — · 2026-05-17

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
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 22 $282,404.00 $1,711,256.00 $576,855.00 nat. median
$370,174
1.6× median
Q2042
HCPCS 		Tisagenlecleucel IV Infusion (wrapped) 29 $24,610.00 $4,980,487.00 $560,094.00 nat. median
$753,246
0.7× median
Q2055
HCPCS 		Idecabtagene Vicleucel 460000000 Cells IV Susp 29 $24,610.00 $4,680,626.00 $538,696.00 nat. median
$625,184
0.9× median
Q2054
HCPCS 		Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp 29 $24,610.00 $4,578,008.00 $531,138.00 nat. median
$673,137
0.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 22 $211,164.00 $1,278,165.00 $430,862.00 nat. median
$265,286
1.6× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 22 $177,983.00 $1,076,446.00 $362,864.00 nat. median
$206,474
1.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 22 $160,882.00 $972,480.00 $327,818.00 nat. median
$202,976
1.6× median
52427-273-75
NDC 		Naproxen Sodium ER 500 Mg Po Tb24 20 $129,370.00 $654,118.00 $285,632.00 nat. median
$111,860
outlier · 2.6×
58468-0132-2
NDC 		Sevelamer Carbonate 0.8 G Po Pack 20 $112,199.00 $567,297.00 $247,720.00 nat. median
$94,327
outlier · 2.6×
58468-0132-1
NDC 		Sevelamer Carbonate 0.8 G Po Pack 20 $112,199.00 $567,297.00 $247,720.00 nat. median
$92,408
outlier · 2.7×
68382-395-04
NDC 		Ribavirin 6 G In Solr 20 $104,760.00 $529,686.00 $231,296.00 nat. median
$88,073
outlier · 2.6×
68382-395-01
NDC 		Ribavirin 6 G In Solr 20 $104,760.00 $529,686.00 $231,296.00 nat. median
$88,073
outlier · 2.6×
59385-027-01
NDC 		Buprenorphine Hcl 900 Mcg Bu Film 20 $100,766.00 $509,492.00 $222,478.00 nat. median
$87,698
outlier · 2.5×
59385-027-60
NDC 		Buprenorphine Hcl 900 Mcg Bu Film 20 $100,766.00 $509,492.00 $222,478.00 nat. median
$87,698
outlier · 2.5×
5834
APR_DRG 		Neonate With Ecmo 8 $205,319.00 $246,383.00 $216,611.50 nat. median
$309,665
0.7× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 22 $106,383.00 $641,163.00 $216,132.00 nat. median
$133,161
1.6× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 22 $98,708.00 $594,507.00 $200,405.00 nat. median
$117,357
1.7× median
7
MS_DRG 		Lung Transplant 22 $98,462.00 $593,010.00 $199,900.00 nat. median
$122,708
1.6× median
0187-0007-14
NDC 		Ribavirin 6 G In Solr 20 $80,346.00 $406,245.00 $177,394.00 nat. median
$69,528
outlier · 2.6×
0781-5893-31
NDC 		Nevirapine ER 400 Mg Po Tb24 20 $78,773.00 $398,291.00 $173,920.00 nat. median
$68,166
outlier · 2.6×
13925-522-01
NDC 		Pentamidine Isethionate 300 Mg In Solr 20 $77,830.00 $393,523.00 $171,838.00 nat. median
$83,907
outlier · 2.0×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 22 $83,168.00 $500,030.00 $168,557.00 nat. median
$108,660
1.6× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 22 $82,229.00 $494,322.00 $166,633.00 nat. median
$102,358
1.6× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 22 $80,404.00 $483,227.00 $162,893.00 nat. median
$100,136
1.6× median
215
MS_DRG 		Other Heart Assist System Implant 22 $79,996.00 $480,750.00 $162,058.00 nat. median
$99,019
1.6× median
58914-501-56
NDC 		Mesalamine 1000 Mg Re Supp 20 $73,139.00 $369,805.00 $161,482.00 nat. median
$57,068
outlier · 2.8×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 22 $79,105.00 $475,332.00 $160,232.00 nat. median
$98,894
1.6× median
24338-050-08
NDC 		Carmustine In Polifeprosan 7.7 Mg Il Wafr 20 $69,851.00 $353,180.00 $154,222.00 nat. median
$49,264
outlier · 3.1×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 22 $72,952.00 $437,928.00 $147,623.00 nat. median
$93,672
1.6× median
C9089
HCPCS 		Bupivacaine Hcl (300 Mg Dose) 3 X 100 Mg Il Impl 38 $48,442.00 $251,789.00 $146,688.00 nat. median
$2
outlier · 92840.5×
47781-153-01
NDC 		Naproxen Sodium ER 375 Mg Po Tb24 20 $65,334.00 $330,343.00 $144,250.00 nat. median
$56,537
outlier · 2.6×
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 8 $133,948.00 $160,737.00 $141,315.00 nat. median
$246,434
0.6× median
850
MS_DRG 		Acute Leukemia With Other Procedures 22 $69,674.00 $417,999.00 $140,905.00 nat. median
$83,470
1.7× median
5833
APR_DRG 		Neonate With Ecmo 8 $133,012.00 $159,615.00 $140,328.00 nat. median
$244,017
0.6× median
63323-877-15
NDC 		Pentamidine Isethionate 300 Mg In Solr 20 $61,043.00 $308,646.00 $134,776.00 nat. median
$65,809
outlier · 2.0×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 22 $64,166.00 $384,512.00 $129,617.00 nat. median
$79,312
1.6× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 22 $64,131.00 $384,298.00 $129,545.00 nat. median
$81,118
1.6× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 22 $63,171.00 $378,463.00 $127,578.00 nat. median
$82,711
1.5× median
24
APR_DRG 		Heart And/or Lung Transplant 8 $118,623.00 $142,347.00 $125,147.00 nat. median
$234,729
0.5× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 22 $61,085.00 $365,780.00 $123,303.00 nat. median
$77,570
1.6× median
10
MS_DRG 		Pancreas Transplant 22 $60,427.00 $361,783.00 $121,955.00 nat. median
$68,884
1.8× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 22 $60,086.00 $359,709.00 $121,256.00 nat. median
$71,271
1.7× median
J2326
HCPCS 		Nusinersen 12 Mg/5ml It Soln 38 $1,211.00 $606,662.00 $119,984.00 nat. median
$2,675
outlier · 44.8×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 22 $59,258.00 $354,677.00 $119,560.00 nat. median
$73,807
1.6× median
0187-3013-30
NDC 		Pyridostigmine Bromide ER 180 Mg Po Tbcr 20 $53,951.00 $272,786.00 $119,117.00 nat. median
$46,687
outlier · 2.6×
J1950
HCPCS 		Leuprolide Acetate (3 Month) 11.25 Mg IM Kit 38 $614.00 $601,408.00 $118,945.00 nat. median
$4,344
outlier · 27.4×
51167-331-01
NDC 		Elexacaf-tezacaf-ivacaf&ivacaf 100-50-75 (trikafta Kit Morning Dose) 20 $53,693.00 $271,484.00 $118,548.00 nat. median
$47,016
outlier · 2.5×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 22 $58,669.00 $351,097.00 $118,353.00 nat. median
$74,915
1.6× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 22 $56,630.00 $338,696.00 $114,172.00 nat. median
$72,135
1.6× median
J7311
HCPCS 		Fluocinolone Acetonide 0.59 Mg Iz Impl 38 $316.00 $561,286.00 $111,010.00 nat. median
$490
outlier · 226.4×

Other procedures at this hospital

Browse this hospital's 15,383 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 35 22 $0.01 — $282,404.00 $1,711,256.00 $576,855.00 2024-12-15
Q2042 HCPCS Tisagenlecleucel IV Infusion (wrapped) 47 29 — $3,730,701.85 $24,610.00 $4,980,487.00 $560,094.00 2024-12-15
Q2055 HCPCS Idecabtagene Vicleucel 460000000 Cells IV Susp 46 29 — $4,354,070.48 $24,610.00 $4,680,626.00 $538,696.00 2024-12-15
Q2054 HCPCS Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp 46 29 — $4,258,612.21 $24,610.00 $4,578,008.00 $531,138.00 2024-12-15
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 35 22 $0.01 — $211,164.00 $1,278,165.00 $430,862.00 2024-12-15
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 35 22 $0.01 — $177,983.00 $1,076,446.00 $362,864.00 2024-12-15
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 35 22 $0.01 — $160,882.00 $972,480.00 $327,818.00 2024-12-15
52427-273-75 NDC Naproxen Sodium ER 500 Mg Po Tb24 31 20 $726,797.82 $290,719.13 60% off $129,370.00 $654,118.00 $285,632.00 2024-12-15
58468-0132-2 NDC Sevelamer Carbonate 0.8 G Po Pack 31 20 $630,330.07 $252,132.03 60% off $112,199.00 $567,297.00 $247,720.00 2024-12-15
58468-0132-1 NDC Sevelamer Carbonate 0.8 G Po Pack 31 20 $630,330.07 $252,132.03 60% off $112,199.00 $567,297.00 $247,720.00 2024-12-15
68382-395-04 NDC Ribavirin 6 G In Solr 31 20 $588,539.74 $235,415.90 60% off $104,760.00 $529,686.00 $231,296.00 2024-12-15
68382-395-01 NDC Ribavirin 6 G In Solr 31 20 $588,539.74 $235,415.90 60% off $104,760.00 $529,686.00 $231,296.00 2024-12-15
59385-027-60 NDC Buprenorphine Hcl 900 Mcg Bu Film 31 20 $566,101.69 $226,440.67 60% off $100,766.00 $509,492.00 $222,478.00 2024-12-15
59385-027-01 NDC Buprenorphine Hcl 900 Mcg Bu Film 31 20 $566,101.69 $226,440.67 60% off $100,766.00 $509,492.00 $222,478.00 2024-12-15
5834 APR_DRG Neonate With Ecmo 10 8 $0.01 — $205,319.00 $246,383.00 $216,611.50 2024-12-15
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 35 22 $0.01 — $106,383.00 $641,163.00 $216,132.00 2024-12-15
14 MS_DRG Allogeneic Bone Marrow Transplant 35 22 $0.01 — $98,708.00 $594,507.00 $200,405.00 2024-12-15
7 MS_DRG Lung Transplant 35 22 $0.01 — $98,462.00 $593,010.00 $199,900.00 2024-12-15
0187-0007-14 NDC Ribavirin 6 G In Solr 31 20 $451,383.58 $180,553.43 60% off $80,346.00 $406,245.00 $177,394.00 2024-12-15
0781-5893-31 NDC Nevirapine ER 400 Mg Po Tb24 31 20 $442,545.56 $177,018.22 60% off $78,773.00 $398,291.00 $173,920.00 2024-12-15
13925-522-01 NDC Pentamidine Isethionate 300 Mg In Solr 31 20 $437,248.06 $174,899.22 60% off $77,830.00 $393,523.00 $171,838.00 2024-12-15
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 35 22 $0.01 — $83,168.00 $500,030.00 $168,557.00 2024-12-15
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 35 22 $0.01 — $82,229.00 $494,322.00 $166,633.00 2024-12-15
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 35 22 $0.01 — $80,404.00 $483,227.00 $162,893.00 2024-12-15
215 MS_DRG Other Heart Assist System Implant 35 22 $0.01 — $79,996.00 $480,750.00 $162,058.00 2024-12-15
58914-501-56 NDC Mesalamine 1000 Mg Re Supp 31 20 $410,894.48 $164,357.79 60% off $73,139.00 $369,805.00 $161,482.00 2024-12-15
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 35 22 $0.01 — $79,105.00 $475,332.00 $160,232.00 2024-12-15
24338-050-08 NDC Carmustine In Polifeprosan 7.7 Mg Il Wafr 31 20 $392,422.48 $156,968.99 60% off $69,851.00 $353,180.00 $154,222.00 2024-12-15
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 35 22 $0.01 — $72,952.00 $437,928.00 $147,623.00 2024-12-15
C9089 HCPCS Bupivacaine Hcl (300 Mg Dose) 3 X 100 Mg Il Impl 90 38 $272,148.58 $108,859.43 60% off $48,442.00 $251,789.00 $146,688.00 2024-12-15
47781-153-01 NDC Naproxen Sodium ER 375 Mg Po Tb24 31 20 $367,047.60 $146,819.04 60% off $65,334.00 $330,343.00 $144,250.00 2024-12-15
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 10 8 $0.01 — $133,948.00 $160,737.00 $141,315.00 2024-12-15
850 MS_DRG Acute Leukemia With Other Procedures 35 22 $0.01 — $69,674.00 $417,999.00 $140,905.00 2024-12-15
5833 APR_DRG Neonate With Ecmo 10 8 $0.01 — $133,012.00 $159,615.00 $140,328.00 2024-12-15
63323-877-15 NDC Pentamidine Isethionate 300 Mg In Solr 31 20 $342,940.39 $137,176.16 60% off $61,043.00 $308,646.00 $134,776.00 2024-12-15
231 MS_DRG Coronary Bypass With Ptca With Mcc 35 22 $0.01 — $64,166.00 $384,512.00 $129,617.00 2024-12-15
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 35 22 $0.01 — $64,131.00 $384,298.00 $129,545.00 2024-12-15
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 35 22 $0.01 — $63,171.00 $378,463.00 $127,578.00 2024-12-15
24 APR_DRG Heart And/or Lung Transplant 10 8 $0.01 — $118,623.00 $142,347.00 $125,147.00 2024-12-15
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 35 22 $0.01 — $61,085.00 $365,780.00 $123,303.00 2024-12-15
10 MS_DRG Pancreas Transplant 35 22 $0.01 — $60,427.00 $361,783.00 $121,955.00 2024-12-15
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 35 22 $0.01 — $60,086.00 $359,709.00 $121,256.00 2024-12-15
J2326 HCPCS Nusinersen 12 Mg/5ml It Soln 59 38 $674,068.62 $269,627.45 60% off $1,211.00 $606,662.00 $119,984.00 2024-12-15
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 35 22 $0.01 — $59,258.00 $354,677.00 $119,560.00 2024-12-15
0187-3013-30 NDC Pyridostigmine Bromide ER 180 Mg Po Tbcr 31 20 $303,095.54 $121,238.21 60% off $53,951.00 $272,786.00 $119,117.00 2024-12-15
J1950 HCPCS Leuprolide Acetate (3 Month) 11.25 Mg IM Kit 59 38 $668,231.18 $267,292.47 60% off $614.00 $601,408.00 $118,945.00 2024-12-15
51167-331-01 NDC Elexacaf-tezacaf-ivacaf&ivacaf 100-50-75 (trikafta Kit Morning Dose) 31 20 $301,648.45 $120,659.38 60% off $53,693.00 $271,484.00 $118,548.00 2024-12-15
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 35 22 $0.01 — $58,669.00 $351,097.00 $118,353.00 2024-12-15
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 35 22 $0.01 — $56,630.00 $338,696.00 $114,172.00 2024-12-15
J7311 HCPCS Fluocinolone Acetonide 0.59 Mg Iz Impl 59 38 $623,651.42 $249,460.57 60% off $316.00 $561,286.00 $111,010.00 2024-12-15
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 10 8 $0.01 — $104,305.00 $125,166.00 $110,042.00 2024-12-15
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 35 22 $0.01 — $53,931.00 $322,292.00 $108,643.00 2024-12-15
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 35 22 $0.01 — $53,665.00 $320,672.00 $108,097.00 2024-12-15
5832 APR_DRG Neonate With Ecmo 10 8 $0.01 — $102,129.00 $122,555.00 $107,746.50 2024-12-15
1614 APR_DRG Implantable Heart Assist Systems 10 8 $0.01 — $101,659.00 $121,991.00 $107,250.50 2024-12-15
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 35 22 $0.01 — $52,840.00 $315,658.00 $106,407.00 2024-12-15
0078-0697-61 NDC Eltrombopag Olamine 25 Mg Po Pack 31 20 $266,503.60 $106,601.44 60% off $47,438.00 $239,853.00 $104,736.00 2024-12-15
0078-0697-19 NDC Eltrombopag Olamine 25 Mg Po Pack 31 20 $266,503.60 $106,601.44 60% off $47,438.00 $239,853.00 $104,736.00 2024-12-15
955 MS_DRG Craniotomy For Multiple Significant Trauma 35 22 $0.01 — $51,883.00 $309,841.00 $104,446.00 2024-12-15
J3357 HCPCS Ustekinumab 45 Mg/0.5ml Sc Sosy 59 38 $583,799.90 $233,519.96 60% off $158.00 $525,420.00 $103,916.00 2024-12-15
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 10 8 $0.01 — $97,710.00 $117,252.00 $103,084.50 2024-12-15
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 35 22 $0.01 — $50,961.00 $304,232.00 $102,555.00 2024-12-15
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 35 22 $0.01 — $50,768.00 $303,062.00 $102,160.00 2024-12-15
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 35 22 $0.01 — $50,684.00 $302,549.00 $101,988.00 2024-12-15
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 10 8 $0.01 — $96,372.00 $115,646.00 $101,672.00 2024-12-15
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 35 22 $0.01 — $49,188.00 $293,456.00 $98,922.00 2024-12-15
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 35 22 $0.01 — $49,119.00 $293,034.00 $98,780.00 2024-12-15
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 35 22 $0.01 — $48,121.00 $286,971.00 $96,736.00 2024-12-15
0955-1052-01 NDC Sevelamer Carbonate 0.8 G Po Pack 31 20 $241,551.43 $96,620.57 60% off $42,996.00 $217,396.00 $94,930.00 2024-12-15
0955-1052-90 NDC Sevelamer Carbonate 0.8 G Po Pack 31 20 $241,551.43 $96,620.57 60% off $42,996.00 $217,396.00 $94,930.00 2024-12-15
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 35 22 $0.01 — $47,152.00 $281,077.00 $94,750.00 2024-12-15
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 35 22 $0.01 — $47,092.00 $280,714.00 $94,627.00 2024-12-15
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 35 22 $0.01 — $46,882.00 $279,434.00 $94,196.00 2024-12-15
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 35 22 $0.01 — $46,721.00 $278,459.00 $93,867.00 2024-12-15
232 MS_DRG Coronary Bypass With Ptca Without Mcc 35 22 $0.01 — $46,512.00 $277,188.00 $93,439.00 2024-12-15
28 MS_DRG Spinal Procedures With Mcc 35 22 $0.01 — $46,294.00 $275,863.00 $92,992.00 2024-12-15
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 10 8 $0.01 — $88,071.00 $105,685.00 $92,914.50 2024-12-15
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 35 22 $0.01 — $45,969.00 $273,885.00 $92,325.00 2024-12-15
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 35 22 $0.01 — $45,969.00 $273,885.00 $92,325.00 2024-12-15
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 10 8 $0.01 — $87,116.00 $104,539.00 $91,907.50 2024-12-15
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 35 22 $0.01 — $45,632.00 $271,839.00 $91,635.00 2024-12-15
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 10 8 $0.01 — $86,464.00 $103,757.00 $91,219.50 2024-12-15
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 35 22 $0.01 — $45,322.00 $269,955.00 $91,000.00 2024-12-15
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 35 22 $0.01 — $44,836.00 $267,001.00 $90,005.00 2024-12-15
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 10 8 $0.01 — $85,092.00 $102,110.00 $89,772.00 2024-12-15
J1324 HCPCS Enfuvirtide 90 Mg Sc Solr 59 38 $166,320.21 $66,528.08 60% off $29,605.00 $149,688.00 $89,646.50 2024-12-15
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 35 22 $0.01 — $44,374.00 $264,193.00 $89,058.00 2024-12-15
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 35 22 $0.01 — $43,756.00 $260,431.00 $87,790.00 2024-12-15
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 35 22 $0.01 — $43,500.00 $258,875.00 $87,265.00 2024-12-15
61958-1004-1 NDC Ranolazine ER 1000 Mg Po Tb12 31 20 $218,752.33 $87,500.93 60% off $38,938.00 $196,877.00 $85,970.00 2024-12-15
0008-0423-03 NDC Antivenin Micrurus Fulvius IV Solr 31 20 $217,092.14 $86,836.85 60% off $38,642.00 $195,383.00 $85,317.00 2024-12-15
0008-0423-01 NDC Antivenin Micrurus Fulvius IV Solr 31 20 $217,092.14 $86,836.85 60% off $38,642.00 $195,383.00 $85,317.00 2024-12-15
653 MS_DRG Major Bladder Procedures With Mcc 35 22 $0.01 — $42,526.00 $252,953.00 $85,269.00 2024-12-15
74 APR_DRG Allogeneic Bone Marrow Transplant 10 8 $0.01 — $80,769.00 $96,923.00 $85,212.00 2024-12-15
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 10 8 $0.01 — $80,365.00 $96,438.00 $84,785.00 2024-12-15
834 MS_DRG Acute Leukemia With Mcc 35 22 $0.01 — $42,173.00 $250,807.00 $84,546.00 2024-12-15
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 35 22 $0.01 — $42,173.00 $250,807.00 $84,546.00 2024-12-15
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 35 22 $0.01 — $41,999.00 $249,754.00 $84,191.00 2024-12-15
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 35 22 $0.01 — $41,749.00 $248,229.00 $83,677.00 2024-12-15
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 10 8 $0.01 — $78,902.00 $94,682.00 $83,241.50 2024-12-15
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 35 22 $0.01 — $41,529.00 $246,895.00 $83,227.00 2024-12-15
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 35 22 $0.01 — $41,437.00 $246,333.00 $83,037.00 2024-12-15
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 35 22 $0.01 — $41,230.00 $245,076.00 $82,614.00 2024-12-15
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 35 22 $0.01 — $41,192.00 $244,844.00 $82,536.00 2024-12-15
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 35 22 $0.01 — $41,187.00 $244,817.00 $82,527.00 2024-12-15
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 35 22 $0.01 — $40,627.00 $241,409.00 $81,378.00 2024-12-15
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 35 22 $0.01 — $40,451.00 $240,343.00 $81,018.00 2024-12-15
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 10 8 $0.01 — $76,443.00 $91,731.00 $80,647.00 2024-12-15
69468-151-04 NDC Uridine Triacetate 10 G Po Pack 31 20 $202,866.13 $81,146.45 60% off $36,110.00 $182,580.00 $79,726.00 2024-12-15
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 35 22 $0.01 — $39,357.00 $233,691.00 $78,776.00 2024-12-15
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 35 22 $0.01 — $39,230.00 $232,915.00 $78,514.00 2024-12-15
5831 APR_DRG Neonate With Ecmo 10 8 $0.01 — $74,234.00 $89,081.00 $78,317.00 2024-12-15
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 35 22 $0.01 — $38,943.00 $231,173.00 $77,927.00 2024-12-15
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 35 22 $0.01 — $38,826.00 $230,465.00 $77,688.00 2024-12-15
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 35 22 $0.01 — $38,512.00 $228,554.00 $77,044.00 2024-12-15
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 10 8 $0.01 — $72,982.00 $87,578.00 $76,996.00 2024-12-15
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 35 22 $0.01 — $38,291.00 $227,207.00 $76,590.00 2024-12-15
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 35 22 $0.01 — $38,261.00 $227,030.00 $76,530.00 2024-12-15
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 35 22 $0.01 — $38,247.00 $226,939.00 $76,500.00 2024-12-15
228 MS_DRG Other Cardiothoracic Procedures With Mcc 35 22 $0.01 — $38,112.00 $226,122.00 $76,225.00 2024-12-15
14 APR_DRG Liver Transplant And/or Intestinal Transplant 10 8 $0.01 — $71,830.00 $86,196.00 $75,780.50 2024-12-15
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 10 8 $0.01 — $71,338.00 $85,605.00 $75,261.50 2024-12-15
67546-212-21 NDC Nitazoxanide 100 Mg/5ml Po Susr Bulk 31 20 $191,240.32 $76,496.13 60% off $34,041.00 $172,116.00 $75,157.00 2024-12-15
245 MS_DRG Aicd Generator Procedures 35 22 $0.01 — $37,392.00 $221,743.00 $74,748.00 2024-12-15
471 MS_DRG Cervical Spinal Fusion With Mcc 35 22 $0.01 — $37,172.00 $220,405.00 $74,297.00 2024-12-15
J2353 HCPCS Octreotide Acetate 10 Mg IM Kit 121 38 $392,205.85 $156,882.34 60% off $215.00 $995,344.00 $74,221.00 2024-12-15
6 MS_DRG Liver Transplant Without Mcc 35 22 $0.01 — $37,111.00 $220,037.00 $74,173.00 2024-12-15
0310-0283-60 NDC Quetiapine Fumarate ER 300 Mg Po Tb24 31 20 $187,114.72 $74,845.89 60% off $33,306.00 $168,403.00 $73,536.00 2024-12-15
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 35 22 $0.01 — $36,561.00 $216,693.00 $73,046.00 2024-12-15
799 MS_DRG Splenic Procedures With Mcc 35 22 $0.01 — $36,407.00 $215,754.00 $72,729.00 2024-12-15
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 35 22 $0.01 — $36,400.00 $215,713.00 $72,716.00 2024-12-15
1613 APR_DRG Implantable Heart Assist Systems 10 8 $0.01 — $68,785.00 $82,542.00 $72,568.00 2024-12-15
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 35 22 $0.01 — $36,033.00 $213,480.00 $71,963.00 2024-12-15
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 35 22 $0.01 — $35,845.00 $212,337.00 $71,578.00 2024-12-15
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 35 22 $0.01 — $35,639.00 $211,085.00 $71,155.00 2024-12-15
163 MS_DRG Major Chest Procedures With Mcc 35 22 $0.01 — $35,320.00 $209,147.00 $70,502.00 2024-12-15
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 35 22 $0.01 — $35,306.00 $209,061.00 $70,473.00 2024-12-15
23 APR_DRG Heart And/or Lung Transplant 10 8 $0.01 — $66,606.00 $79,927.00 $70,269.00 2024-12-15
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 35 22 $0.01 — $35,196.00 $208,394.00 $70,248.00 2024-12-15
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 35 22 $0.01 — $35,191.00 $208,362.00 $70,238.00 2024-12-15
47335-625-60 NDC Ranolazine ER 1000 Mg Po Pack 31 20 $176,340.99 $70,536.40 60% off $31,389.00 $158,707.00 $69,302.00 2024-12-15
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 10 8 $0.01 — $65,522.00 $78,627.00 $69,126.00 2024-12-15
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 35 22 $0.01 — $34,591.00 $204,718.00 $69,009.00 2024-12-15
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 35 22 $0.01 — $34,391.00 $203,498.00 $68,598.00 2024-12-15
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 35 22 $0.01 — $34,298.00 $202,935.00 $68,408.00 2024-12-15
J9302 HCPCS Ofatumumab 100 Mg/5ml IV Conc 59 38 $382,647.30 $153,058.92 60% off $64.00 $344,383.00 $68,111.00 2024-12-15
901 MS_DRG Wound Debridements For Injuries With Mcc 35 22 $0.01 — $33,986.00 $201,038.00 $67,769.00 2024-12-15
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 35 22 $0.01 — $33,705.00 $199,328.00 $67,192.00 2024-12-15
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 10 8 $0.01 — $63,159.00 $75,790.00 $66,632.00 2024-12-15
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 35 22 $0.01 — $33,213.00 $196,337.00 $66,184.00 2024-12-15
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 35 22 $0.01 — $33,146.00 $195,934.00 $66,048.00 2024-12-15
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 35 22 $0.01 — $32,756.00 $193,560.00 $65,248.00 2024-12-15
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 35 22 $0.01 — $32,709.00 $193,275.00 $65,152.00 2024-12-15
J0571 HCPCS Buprenorphine Hcl 300 Mcg Bu Film 59 38 $120,233.82 $48,093.53 60% off $21,402.00 $108,210.00 $64,806.00 2024-12-15
140 MS_DRG Major Head And Neck Procedures With Mcc 35 22 $0.01 — $32,484.00 $191,904.00 $64,690.00 2024-12-15
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 10 8 $0.01 — $60,831.00 $72,997.00 $64,176.50 2024-12-15
31 MS_DRG Ventricular Shunt Procedures With Mcc 35 22 $0.01 — $32,195.00 $190,153.00 $64,099.00 2024-12-15
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 35 22 $0.01 — $32,188.00 $190,107.00 $64,084.00 2024-12-15
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 35 22 $0.01 — $31,972.00 $188,796.00 $63,642.00 2024-12-15
A9520 HCPCS Technetium-99 (tc-99) Tilmanocept (lymphoseek) Radio-isotope Injection 49 34 $242,855.70 $97,142.28 60% off $10.00 $218,570.00 $63,628.00 2024-12-15
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 35 22 $0.01 — $31,610.00 $186,591.00 $62,899.00 2024-12-15
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 35 22 $0.01 — $31,592.00 $186,486.00 $62,864.00 2024-12-15
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 35 22 $0.01 — $31,547.00 $186,209.00 $62,770.00 2024-12-15
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 10 8 $0.01 — $59,311.00 $71,174.00 $62,573.50 2024-12-15
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 35 22 $0.01 — $31,396.00 $185,293.00 $62,461.00 2024-12-15
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 35 22 $0.01 — $31,276.00 $184,562.00 $62,215.00 2024-12-15
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 10 8 $0.01 — $58,591.00 $70,309.00 $61,813.50 2024-12-15
C1831 HCPCS Kit Imp Aprevo Spine Lvl 1 248 38 $178,220.00 $71,288.00 60% off $14,633.00 $211,050.00 $61,619.00 2024-12-15
0591-2720-60 NDC Metformin Hcl ER (osm) 1000 Mg Po Tb24 31 20 $156,314.75 $62,525.90 60% off $27,824.00 $140,683.00 $61,432.00 2024-12-15
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 35 22 $0.01 — $30,651.00 $180,764.00 $60,935.00 2024-12-15
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 35 22 $0.01 — $30,630.00 $180,637.00 $60,892.00 2024-12-15
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 35 22 $0.01 — $30,368.00 $179,040.00 $60,353.00 2024-12-15
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 35 22 $0.01 — $30,307.00 $178,673.00 $60,230.00 2024-12-15
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 35 22 $0.01 — $30,247.00 $178,310.00 $60,107.00 2024-12-15
C2624 HCPCS System Cardiomems Hrt Failure Ptnt 72 38 $111,321.00 $44,528.40 60% off $13,359.00 $100,189.00 $60,002.00 2024-12-15
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 35 22 $0.01 — $30,117.00 $177,520.00 $59,841.00 2024-12-15
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 35 22 $0.01 — $30,103.00 $177,434.00 $59,812.00 2024-12-15
34 MS_DRG Carotid Artery Stent Procedures With Mcc 35 22 $0.01 — $29,942.00 $176,454.00 $59,482.00 2024-12-15
61958-1003-1 NDC Ranolazine ER 500 Mg Po Tb12 31 20 $150,634.23 $60,253.69 60% off $26,813.00 $135,571.00 $59,199.00 2024-12-15
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 35 22 $0.01 — $29,765.00 $175,378.00 $59,119.00 2024-12-15
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 35 22 $0.01 — $29,736.00 $175,201.00 $59,059.00 2024-12-15
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 35 22 $0.01 — $29,655.00 $174,711.00 $58,894.00 2024-12-15
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 35 22 $0.01 — $29,447.00 $173,445.00 $58,467.00 2024-12-15
1612 APR_DRG Implantable Heart Assist Systems 10 8 $0.01 — $55,215.00 $66,258.00 $58,252.00 2024-12-15
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 35 22 $0.01 — $29,293.00 $172,506.00 $58,151.00 2024-12-15
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 10 8 $0.01 — $54,722.00 $65,666.00 $57,731.50 2024-12-15
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 35 22 $0.01 — $29,072.00 $171,163.00 $57,698.00 2024-12-15
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 35 22 $0.01 — $28,847.00 $169,797.00 $57,238.00 2024-12-15
C1825 HCPCS System Neo Barostim Includes 2102 Ipg 1036 Csl Kit 116 38 $156,240.00 $62,496.00 60% off $15,758.00 $140,616.00 $56,279.00 2024-12-15
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 35 22 $0.01 — $28,151.00 $165,563.00 $55,811.00 2024-12-15
59676-565-01 NDC Darunavir 100 Mg/ml Po Susp Bulk 31 20 $141,535.77 $56,614.31 60% off $25,193.00 $127,382.00 $55,624.00 2024-12-15
1611 APR_DRG Implantable Heart Assist Systems 10 8 $0.01 — $52,607.00 $63,128.00 $55,500.00 2024-12-15
335 MS_DRG Peritoneal Adhesiolysis With Mcc 35 22 $0.01 — $27,962.00 $164,415.00 $55,424.00 2024-12-15
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 10 8 $0.01 — $52,325.00 $62,790.00 $55,203.50 2024-12-15
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 10 8 $0.01 — $52,231.00 $62,678.00 $55,104.00 2024-12-15
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 35 22 $0.01 — $27,674.00 $162,664.00 $54,833.00 2024-12-15
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 35 22 $0.01 — $27,672.00 $162,655.00 $54,830.00 2024-12-15
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 35 22 $0.01 — $27,668.00 $162,628.00 $54,821.00 2024-12-15
265 MS_DRG Aicd Lead Procedures 35 22 $0.01 — $27,542.00 $161,865.00 $54,564.00 2024-12-15
64 APR_DRG Pancreas Transplant 10 8 $0.01 — $51,673.00 $62,007.00 $54,514.50 2024-12-15
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 35 22 $0.01 — $27,423.00 $161,139.00 $54,319.00 2024-12-15
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 35 22 $0.01 — $27,268.00 $160,195.00 $54,001.00 2024-12-15
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 35 22 $0.01 — $27,261.00 $160,155.00 $53,987.00 2024-12-15
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 35 22 $0.01 — $27,195.00 $159,751.00 $53,851.00 2024-12-15
38240 CPT Hc Trnsplj Allogeneic Hematopoietic Cells Per Donor 59 38 $149,282.89 $59,713.16 60% off $2,682.00 $217,637.00 $53,628.00 2024-12-15
J2430 HCPCS Pamidronate Disodium 90 Mg IV Solr 90 38 $148,878.86 $59,551.54 60% off $650.00 $133,991.00 $53,626.00 2024-12-15
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 35 22 $0.01 — $27,069.00 $158,988.00 $53,594.00 2024-12-15
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 35 22 $0.01 — $27,061.00 $158,939.00 $53,577.00 2024-12-15
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 10 8 $0.01 — $50,782.00 $60,938.00 $53,575.00 2024-12-15
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 35 22 $0.01 — $27,051.00 $158,875.00 $53,556.00 2024-12-15
264 MS_DRG Other Circulatory System O.r. Procedures 35 22 $0.01 — $27,004.00 $158,594.00 $53,461.00 2024-12-15
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 35 22 $0.01 — $26,836.00 $157,568.00 $53,115.00 2024-12-15
332 MS_DRG Rectal Resection With Mcc 35 22 $0.01 — $26,807.00 $157,396.00 $53,057.00 2024-12-15
54092-252-45 NDC Lanthanum Carbonate 500 Mg Po Chew 31 20 $134,880.42 $53,952.17 60% off $24,009.00 $121,392.00 $53,008.00 2024-12-15
54092-252-90 NDC Lanthanum Carbonate 500 Mg Po Chew 31 20 $134,880.42 $53,952.17 60% off $24,009.00 $121,392.00 $53,008.00 2024-12-15
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 35 22 $0.01 — $26,779.00 $157,223.00 $52,999.00 2024-12-15
8514 APR_DRG Gender Related Procedures 10 8 $0.01 — $50,103.00 $60,123.00 $52,858.50 2024-12-15
271 MS_DRG Other Major Cardiovascular Procedures With Cc 35 22 $0.01 — $26,626.00 $156,293.00 $52,686.00 2024-12-15
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 35 22 $0.01 — $26,586.00 $156,048.00 $52,603.00 2024-12-15
665 MS_DRG Prostatectomy With Mcc 35 22 $0.01 — $26,545.00 $155,803.00 $52,520.00 2024-12-15
252 MS_DRG Other Vascular Procedures With Mcc 35 22 $0.01 — $26,521.00 $155,658.00 $52,471.00 2024-12-15
54092-191-12 NDC Mesalamine ER 500 Mg Po Cpcr 31 20 $133,448.25 $53,379.30 60% off $23,754.00 $120,103.00 $52,445.00 2024-12-15
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 10 8 $0.01 — $49,700.00 $59,640.00 $52,433.50 2024-12-15
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 35 22 $0.01 — $26,483.00 $155,422.00 $52,392.00 2024-12-15
C1824 HCPCS Generator Pul Implantable Optimizer Smt F/hrt Fail 116 38 $121,940.00 $48,776.00 60% off $14,633.00 $130,572.00 $52,259.00 2024-12-15
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 35 22 $0.01 — $26,341.00 $154,560.00 $52,101.00 2024-12-15
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 10 8 $0.01 — $49,355.00 $59,226.00 $52,070.00 2024-12-15
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 35 22 $0.01 — $26,235.00 $153,915.00 $51,884.00 2024-12-15
50474-598-66 NDC Levetiracetam ER 500 Mg Po Tb24 31 20 $130,920.90 $52,368.36 60% off $23,304.00 $117,829.00 $51,452.00 2024-12-15
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 35 22 $0.01 — $25,971.00 $152,314.00 $51,344.00 2024-12-15
22 APR_DRG Heart And/or Lung Transplant 10 8 $0.01 — $48,472.00 $58,167.00 $51,138.50 2024-12-15
37 MS_DRG Extracranial Procedures With Mcc 35 22 $0.01 — $25,704.00 $150,689.00 $50,796.00 2024-12-15
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 10 8 $0.01 — $47,894.00 $57,473.00 $50,528.50 2024-12-15
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 35 22 $0.01 — $25,562.00 $149,827.00 $50,506.00 2024-12-15
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 35 22 $0.01 — $25,314.00 $148,321.00 $49,998.00 2024-12-15
54092-253-90 NDC Lanthanum Carbonate 750 Mg Po Chew 31 20 $126,877.14 $50,750.86 60% off $22,584.00 $114,189.00 $49,863.00 2024-12-15
54092-254-90 NDC Lanthanum Carbonate 1000 Mg Po Chew 31 20 $126,877.14 $50,750.86 60% off $22,584.00 $114,189.00 $49,863.00 2024-12-15
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 35 22 $0.01 — $25,245.00 $147,899.00 $49,856.00 2024-12-15
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 35 22 $0.01 — $25,235.00 $147,835.00 $49,834.00 2024-12-15
34701 CPT Hc Ccl Evasc Rpr A-ao Non-ruptre 59 38 $99,625.81 $39,850.32 60% off $9,941.00 $89,663.00 $49,802.00 2024-12-15
34707 CPT Hc Evasc Rpr Dplmnt Ilio-iliac Ndgft 88 38 $99,625.81 $39,850.32 60% off $9,941.00 $179,326.00 $49,802.00 2024-12-15
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 35 22 $0.01 — $24,946.00 $146,079.00 $49,242.00 2024-12-15
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 10 8 $0.01 — $46,657.00 $55,988.00 $49,222.50 2024-12-15
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 10 8 $0.01 — $46,532.00 $55,838.00 $49,091.00 2024-12-15
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 35 22 $0.01 — $24,834.00 $145,403.00 $49,015.00 2024-12-15
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 35 22 $0.01 — $24,765.00 $144,981.00 $48,872.00 2024-12-15
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 35 22 $0.01 — $24,720.00 $144,704.00 $48,779.00 2024-12-15
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 35 22 $0.01 — $24,655.00 $144,314.00 $48,647.00 2024-12-15
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 35 22 $0.01 — $24,608.00 $144,023.00 $48,550.00 2024-12-15
500 MS_DRG Soft Tissue Procedures With Mcc 35 22 $0.01 — $24,568.00 $143,783.00 $48,468.00 2024-12-15
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 33 22 $0.01 — $4,055.00 $269,751.00 $48,395.00 2024-12-15
67457-187-50 NDC Allopurinol Sodium 500 Mg IV Solr 31 20 $122,037.90 $48,815.16 60% off $21,723.00 $109,834.00 $47,961.00 2024-12-15
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 35 22 $0.01 — $24,212.00 $141,618.00 $47,739.00 2024-12-15
662 MS_DRG Minor Bladder Procedures With Mcc 35 22 $0.01 — $24,202.00 $141,555.00 $47,717.00 2024-12-15
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 35 22 $0.01 — $24,102.00 $140,951.00 $47,514.00 2024-12-15
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 10 8 $0.01 — $44,903.00 $53,883.00 $47,372.50 2024-12-15
0085-1328-01 NDC Posaconazole 40 Mg/ml Po Susp Bulk 31 20 $120,460.08 $48,184.03 60% off $21,442.00 $108,414.00 $47,341.00 2024-12-15
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 35 22 $0.01 — $23,999.00 $140,321.00 $47,301.00 2024-12-15
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 10 8 $0.01 — $44,820.00 $53,783.00 $47,285.00 2024-12-15
63304-089-13 NDC Mesalamine ER 500 Mg Po Cpcr 31 20 $120,137.54 $48,055.02 60% off $21,384.00 $108,124.00 $47,214.00 2024-12-15
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 35 22 $0.01 — $23,951.00 $140,030.00 $47,203.00 2024-12-15
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 10 8 $0.01 — $44,733.00 $53,680.00 $47,193.50 2024-12-15
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 35 22 $0.01 — $23,934.00 $139,931.00 $47,170.00 2024-12-15
21 APR_DRG Heart And/or Lung Transplant 10 8 $0.01 — $44,578.00 $53,493.00 $47,029.50 2024-12-15
652 MS_DRG Kidney Transplant 35 22 $0.01 — $23,842.00 $139,368.00 $46,980.00 2024-12-15
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 35 22 $0.01 — $23,821.00 $139,241.00 $46,937.00 2024-12-15
33264 CPT Hc Rmvl Impltbl Dfb Pls Gen W/rplcmt Pls Gen Mlt Ld 90 38 $158,054.66 $63,221.86 60% off $14,380.00 $142,249.00 $46,805.00 2024-12-15
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 35 22 $0.01 — $23,746.00 $138,787.00 $46,784.00 2024-12-15
13811-715-30 NDC Venlafaxine Hcl ER 225 Mg Po Tb24 31 20 $117,861.72 $47,144.69 60% off $20,979.00 $106,076.00 $46,320.00 2024-12-15
C9047 HCPCS Caplacizumab-yhdp 11 Mg Ij Kit 59 38 $259,805.63 $103,922.25 60% off $768.00 $233,825.00 $46,245.00 2024-12-15
570 MS_DRG Skin Debridement With Mcc 35 22 $0.01 — $23,385.00 $136,591.00 $46,044.00 2024-12-15
974 MS_DRG HIV With Major Related Condition With Mcc 35 22 $0.01 — $23,206.00 $135,502.00 $45,677.00 2024-12-15
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 35 22 $0.01 — $22,925.00 $133,796.00 $45,102.00 2024-12-15
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 35 22 $0.01 — $22,868.00 $133,451.00 $44,986.00 2024-12-15
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 10 8 $0.01 — $42,599.00 $51,119.00 $44,942.00 2024-12-15
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 35 22 $0.01 — $22,809.00 $133,088.00 $44,863.00 2024-12-15
668 MS_DRG Transurethral Procedures With Mcc 35 22 $0.01 — $22,684.00 $132,330.00 $44,608.00 2024-12-15
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 35 22 $0.01 — $22,672.00 $132,257.00 $44,583.00 2024-12-15
800 MS_DRG Splenic Procedures With Cc 35 22 $0.01 — $22,665.00 $132,217.00 $44,569.00 2024-12-15
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 35 22 $0.01 — $22,654.00 $132,144.00 $44,545.00 2024-12-15
68180-354-07 NDC Ranolazine ER 500 Mg Po Tb12 31 20 $113,181.31 $45,272.52 60% off $20,146.00 $101,863.00 $44,480.00 2024-12-15
472 MS_DRG Cervical Spinal Fusion With Cc 35 22 $0.01 — $22,542.00 $131,463.00 $44,316.00 2024-12-15
55111-284-48 NDC Fluoxetine Hcl 90 Mg Po Cpdr 31 20 $112,166.52 $44,866.61 60% off $19,966.00 $100,950.00 $44,081.00 2024-12-15
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 35 22 $0.01 — $22,317.00 $130,098.00 $43,855.00 2024-12-15
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 10 8 $0.01 — $41,561.00 $49,873.00 $43,846.50 2024-12-15
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 35 22 $0.01 — $22,292.00 $129,948.00 $43,805.00 2024-12-15
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 35 22 $0.01 — $22,280.00 $129,871.00 $43,779.00 2024-12-15
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 35 22 $0.01 — $22,250.00 $129,689.00 $43,717.00 2024-12-15
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 35 22 $0.01 — $22,165.00 $129,176.00 $43,545.00 2024-12-15
654 MS_DRG Major Bladder Procedures With Cc 35 22 $0.01 — $21,981.00 $128,056.00 $43,167.00 2024-12-15
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 35 22 $0.01 — $21,879.00 $127,434.00 $42,957.00 2024-12-15
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 35 22 $0.01 — $21,857.00 $127,302.00 $42,913.00 2024-12-15
0037-0442-67 NDC Felbamate 600 Mg/5ml Po Susp Bulk 31 20 $108,935.36 $43,574.14 60% off $19,390.00 $98,042.00 $42,812.00 2024-12-15
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 10 8 $0.01 — $40,490.00 $48,589.00 $42,717.50 2024-12-15
33365 CPT Hc Cath Replace Aortic Valve Open Transaortic Approach 59 38 $84,521.05 $33,808.42 60% off $9,361.00 $76,069.00 $42,715.00 2024-12-15
47335-624-60 NDC Ranolazine ER 500 Mg Po Pack 31 20 $107,597.07 $43,038.83 60% off $19,152.00 $96,837.00 $42,286.00 2024-12-15
84 APR_DRG Autologous Bone Marrow Transplant 10 8 $0.01 — $40,033.00 $48,039.00 $42,234.50 2024-12-15
Q5111 HCPCS Pegfilgrastim-cbqv 6 Mg/0.6ml Sc Soaj 90 38 $174,885.67 $69,954.27 60% off $166.00 $157,397.00 $42,190.50 2024-12-15
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 35 22 $0.01 — $21,341.00 $124,167.00 $41,856.00 2024-12-15
288 MS_DRG Acute And Subacute Endocarditis With Mcc 35 22 $0.01 — $21,305.00 $123,945.00 $41,781.00 2024-12-15
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