Price Transparency 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

NORTHSIDE HOSPITAL FORSYTH

Cumming, GA · CCN 110005 · Rates published

15,724 distinct procedures filed
67 distinct payers
1,747,332 rate rows
2026-02-15 last MRF observed
Data quality

1,563,590 of 1,747,332 rate rows are consumer-grade (89.5%)

183,742 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 86,075
template filing: same amount across many unrelated codes — excluded 54,249
per-diem day rate — not a per-procedure price 41,710
exceeds 10× this hospital's gross charge — excluded from medians 1,091
placeholder amount (≤ $0.02) — excluded from medians 617
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://assets.northside.com/price-transparency/581954432-1376574277_northside-hospital-inc_standardcharges.json
Found on page https://www.northside.com/patients-visitors/billing-and-insurance/price-transparency-information
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint 893675dbb770cc9b… · 947,037,362 bytes · first seen 2026-05-05

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
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 47 $278,250.00 $3,465,000.00 $2,182,950.00 nat. median
$324,450
outlier · 6.7×
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 55 $422,564.64 $3,506,913.00 $1,960,364.37 nat. median
$674,188
outlier · 2.9×
Q2055
HCPCS 		Idecabtagene Vicleucel Car T 55 $420,148.66 $3,486,862.50 $1,949,156.14 nat. median
$625,184
outlier · 3.1×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 55 $415,172.71 $3,445,566.50 $1,926,071.67 nat. median
$675,122
outlier · 2.9×
Q2053
HCPCS 		Brexucabtagene Tecartus T-cell 55 $367,412.62 $3,049,200.00 $1,704,502.80 nat. median
$620,080
outlier · 2.7×
Q2042
HCPCS 		Kymriah T-cell Susp For Infusion 55 $363,389.43 $3,015,811.00 $1,685,838.35 nat. median
$754,974
outlier · 2.2×
Q2041
HCPCS 		Yescarta T-cell Susp For Infusion 55 $296,634.00 $2,461,800.00 $1,376,146.20 nat. median
$634,511
outlier · 2.2×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 33 $297,174.15 $2,860,061.00 $500,228.01 nat. median
$370,174
1.4× median
J2326
HCPCS 		Spinraza(nusinersen)12mg/5ml Soln 55 $6,149.45 $816,348.50 $360,744.41 nat. median
$2,677
outlier · 134.7×
7
MS_DRG 		Lung Transplant 33 $102,981.20 $2,162,847.20 $342,503.59 nat. median
$122,708
outlier · 2.8×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 33 $196,224.27 $846,592.03 $206,035.49 nat. median
$265,286
0.8× median
1614
APR_DRG 		3 $189,765.67 $195,458.64 $189,765.67 nat. median
$207,730
0.9× median
Q2043
HCPCS 		Provenge(sipuleucel-t) Auto Cd54 55 $37,532.07 $311,483.00 $169,740.82 nat. median
$66,682
outlier · 2.5×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 34 $10,000.00 $465,667.50 $156,980.44 nat. median
$206,368
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 33 $148,627.97 $645,099.41 $156,059.37 nat. median
$202,986
0.8× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 33 $111,343.38 $949,211.27 $143,914.10 nat. median
$133,176
1.1× median
6304
APR_DRG 		3 $116,448.07 $119,941.52 $116,448.07 nat. median
$150,721
0.8× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 33 $86,834.44 $752,886.92 $108,543.05 nat. median
$108,660
1.0× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 33 $49,835.04 $740,885.64 $98,636.00 nat. median
$60,185
1.6× median
J9266
HCPCS 		Oncaspar 3750u/5ml Sd Vial 55 $18,029.51 $390,830.85 $97,258.85 nat. median
$34,109
outlier · 2.9×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 33 $15,552.82 $226,879.83 $86,694.65 nat. median
$117,303
0.7× median
1604
APR_DRG 		3 $85,209.95 $87,766.25 $85,209.95 nat. median
$97,957
0.9× median
6314
APR_DRG 		3 $80,933.98 $83,362.00 $80,933.98 nat. median
$122,924
0.7× median
212
MS_DRG 		Hip & Femur Procedures Except Major Joint Age 0-17 33 $59,547.22 $148,868.05 $79,970.15 nat. median
$102,358
0.8× median
9504
APR_DRG 		3 $79,120.56 $81,494.17 $79,120.56 nat. median
$53,715
1.5× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 33 $72,216.40 $473,562.45 $75,827.22 nat. median
$100,136
0.8× median
J9600
HCPCS 		Photofrin 75mg Vial 46 $13,734.35 $908,565.75 $75,798.70 nat. median
$31,644
outlier · 2.4×
6
MS_DRG 		Liver Transplant Without Mcc 33 $38,211.34 $613,006.45 $75,469.77 nat. median
$46,260
1.6× median
J9269
HCPCS 		Elzonris 1000mcg/1ml Soln 55 $356.93 $188,362.50 $75,345.00 nat. median
$509
outlier · 148.0×
C9293
HCPCS 		Voraxaze 1000units/ml Soln 30 $691.73 $117,450.00 $73,993.50 nat. median
$21,340
outlier · 3.5×
8
MS_DRG 		Simultaneous Pancreas And Kidney Transplant 33 $42,875.48 $591,940.40 $73,373.62 nat. median
$53,171
1.4× median
215
MS_DRG 		Other Heart Assist System Implant 33 $69,741.62 $335,128.60 $73,228.70 nat. median
$99,019
0.7× median
5884
APR_DRG 		3 $72,198.40 $74,364.35 $72,198.40 nat. median
$246,434
outlier · 0.3×
5833
APR_DRG 		3 $72,198.40 $74,364.35 $72,198.40 nat. median
$244,017
outlier · 0.3×
5834
APR_DRG 		3 $72,198.40 $74,364.35 $72,198.40 nat. median
$309,665
outlier · 0.2×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 35 $59,050.71 $312,560.30 $72,151.75 nat. median
$79,312
0.9× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 35 $26,794.00 $303,808.65 $71,948.19 nat. median
$93,672
0.8× median
0024
APR_DRG 		3 $71,871.71 $74,027.86 $71,871.71 nat. median
$372,987
outlier · 0.2×
5832
APR_DRG 		3 $71,545.02 $73,691.37 $71,545.02 nat. median
$156,126
outlier · 0.5×
5831
APR_DRG 		3 $71,545.02 $73,691.37 $71,545.02 nat. median
$145,122
outlier · 0.5×
6344
APR_DRG 		3 $71,492.75 $73,637.53 $71,492.75 nat. median
$37,344
1.9× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 33 $50,961.07 $557,980.25 $68,958.87 nat. median
$62,134
1.1× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 34 $62,071.54 $273,655.62 $67,404.15 nat. median
$87,411
0.8× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 34 $52,540.21 $540,754.16 $67,398.99 nat. median
$65,950
1.0× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 35 $53,788.93 $302,432.06 $66,089.04 nat. median
$74,915
0.9× median
0074
APR_DRG 		3 $65,337.92 $67,298.06 $65,337.92 nat. median
$178,275
outlier · 0.4×
1613
APR_DRG 		3 $65,337.92 $67,298.06 $65,337.92 nat. median
$119,796
0.5× median
C1605
HCPCS 		05932602_aveir Dr 52 $15,656.84 $129,938.00 $64,969.00 nat. median
$22,209
outlier · 2.9×
570
MS_DRG 		Skin Debridement With Mcc 33 $23,720.16 $561,768.89 $64,625.01 nat. median
$29,069
outlier · 2.2×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 34 $58,865.20 $325,502.69 $63,921.34 nat. median
$81,118
0.8× median

Other procedures at this hospital

Browse this hospital's 15,724 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
C2616 HCPCS Nm Ns Yttrium-90 Per Source 119 56 $71,433.00 $53,574.75 25% off $8,607.30 $71,433.00 $35,716.50 2026-02-15
Q2054 HCPCS Lisocabtagene Mara Car Pos T 111 55 $3,506,913.00 $2,630,184.75 25% off $422,564.64 $3,506,913.00 $1,960,364.37 2026-02-15
Q2055 HCPCS Idecabtagene Vicleucel Car T 111 55 $3,486,862.50 $2,615,146.88 25% off $420,148.66 $3,486,862.50 $1,949,156.14 2026-02-15
Q2056 HCPCS Ciltacabtagene Car-pos T 111 55 $3,445,566.50 $2,584,174.88 25% off $415,172.71 $3,445,566.50 $1,926,071.67 2026-02-15
Q2053 HCPCS Brexucabtagene Tecartus T-cell 111 55 $3,049,200.00 $2,286,900.00 25% off $367,412.62 $3,049,200.00 $1,704,502.80 2026-02-15
Q2042 HCPCS Kymriah T-cell Susp For Infusion 111 55 $3,015,811.00 $2,261,858.25 25% off $363,389.43 $3,015,811.00 $1,685,838.35 2026-02-15
Q2041 HCPCS Yescarta T-cell Susp For Infusion 111 55 $2,461,800.00 $1,846,350.00 25% off $296,634.00 $2,461,800.00 $1,376,146.20 2026-02-15
J2326 HCPCS Spinraza(nusinersen)12mg/5ml Soln 126 55 $816,348.50 $612,261.38 25% off $6,149.45 $816,348.50 $360,744.41 2026-02-15
Q2043 HCPCS Provenge(sipuleucel-t) Auto Cd54 145 55 $311,483.00 $233,612.25 25% off $37,532.07 $311,483.00 $169,740.82 2026-02-15
J9266 HCPCS Oncaspar 3750u/5ml Sd Vial 181 55 $149,629.00 $112,221.75 25% off $18,029.51 $390,830.85 $97,258.85 2026-02-15
J9269 HCPCS Elzonris 1000mcg/1ml Soln 129 55 $188,362.50 $141,271.88 25% off $356.93 $188,362.50 $75,345.00 2026-02-15
C9760 HCPCS Non-blind Interatrial Shunt 107 53 — — $6,024.74 $72,037.56 $39,031.15 2026-02-15
C1605 HCPCS 05932602_aveir Dr 115 52 $129,938.00 $97,453.50 25% off $15,656.84 $129,938.00 $64,969.00 2026-02-15
C1735 HCPCS Cath Renal Denerv Radiofreq 115 52 $80,000.00 $60,000.00 25% off $9,639.58 $80,000.00 $40,000.00 2026-02-15
C1736 HCPCS Cath Renal Denerv Ultrasnd 115 52 $80,000.00 $60,000.00 25% off $9,639.58 $80,000.00 $40,000.00 2026-02-15
0266T CPT Implt/rpl Crtd Sns Dev Total 109 48 $94,500.00 $70,875.00 25% off $5,305.00 $96,184.51 $35,154.00 2026-02-15
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 103 47 $3,465,000.00 $2,598,750.00 25% off $278,250.00 $3,465,000.00 $2,182,950.00 2026-02-15
J9600 HCPCS Photofrin 75mg Vial 112 46 $113,983.00 $85,487.25 25% off $13,734.35 $908,565.75 $75,798.70 2026-02-15
J3357 HCPCS Stelara 45mg Syrg 245 39 $81,333.00 $60,999.75 25% off $163.31 $162,665.50 $50,426.46 2026-02-15
J1744 HCPCS Firazyr 30mg/3ml Syr 93 39 $59,093.00 $44,319.75 25% off $224.02 $59,093.00 $38,410.45 2026-02-15
C1721 HCPCS Cardiovert Defib Dual Chamber 92 36 $108,296.00 $81,222.00 25% off $13,049.10 $108,296.00 $54,148.00 2026-02-15
C1822 HCPCS Gen Neurostimulator High Freq 92 36 $100,065.00 $75,048.75 25% off $12,057.30 $100,065.00 $50,032.50 2026-02-15
C1722 HCPCS Cardiovert Defib Single Chamber 92 36 $92,020.00 $69,015.00 25% off $11,087.92 $92,020.00 $46,010.00 2026-02-15
C1882 HCPCS Aicd Other Than Sing/dual 92 36 $91,645.00 $68,733.75 25% off $11,042.74 $91,645.00 $45,822.50 2026-02-15
L8614 HCPCS Cochlear Implant Dev/sys Lvl 1 183 36 $60,486.00 $45,364.50 25% off $7,288.24 $105,246.00 $42,098.40 2026-02-15
C1823 HCPCS Gen Neuro Trans Sen/stim 92 36 $78,750.00 $59,062.50 25% off $9,488.96 $78,750.00 $39,375.00 2026-02-15
C1825 HCPCS Gen Neuro Carot Sinus Baro 92 36 $77,175.00 $57,881.25 25% off $9,299.18 $77,175.00 $38,587.50 2026-02-15
C2624 HCPCS Wireless Pressure Sensor 92 36 $69,670.00 $52,252.50 25% off $8,394.87 $69,670.00 $34,835.00 2026-02-15
231 MS_DRG Coronary Bypass With Ptca With Mcc 42 35 — — $59,050.71 $312,560.30 $72,151.75 2026-02-15
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 50 35 — — $26,794.00 $303,808.65 $71,948.19 2026-02-15
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 42 35 — — $53,788.93 $302,432.06 $66,089.04 2026-02-15
J7330 HCPCS Cultured Chondrocytes 69866103005 91 35 $123,857.00 $92,892.75 25% off $14,924.11 $123,857.00 $61,928.50 2026-02-15
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 50 35 — — $21,737.00 $215,419.13 $57,537.00 2026-02-15
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 50 35 — — $26,794.00 $162,028.05 $56,807.43 2026-02-15
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 50 35 — — $20,990.36 $114,991.56 $52,072.42 2026-02-15
232 MS_DRG Coronary Bypass With Ptca Without Mcc 42 35 — — $36,648.00 $194,247.61 $50,053.57 2026-02-15
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 50 35 — — $21,737.00 $120,412.94 $49,236.58 2026-02-15
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 50 35 — — $21,737.00 $151,346.44 $46,995.80 2026-02-15
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 42 35 — — $37,368.56 $111,085.61 $45,074.57 2026-02-15
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 37 35 — — $38,700.09 $373,981.41 $43,399.91 2026-02-15
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 43 35 — — $35,320.13 $129,859.38 $42,974.87 2026-02-15
228 MS_DRG Other Cardiothoracic Procedures With Mcc 42 35 — — $34,670.45 $150,959.34 $41,197.26 2026-02-15
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 50 35 — — $21,737.00 $99,681.47 $37,399.00 2026-02-15
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 36 34 — — $10,000.00 $465,667.50 $156,980.44 2026-02-15
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 36 34 — — $62,071.54 $273,655.62 $67,404.15 2026-02-15
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 40 34 — — $52,540.21 $540,754.16 $67,398.99 2026-02-15
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 36 34 — — $58,865.20 $325,502.69 $63,921.34 2026-02-15
459 MS_DRG Spinal Fusion Except Cervical With Mcc 36 34 — — $46,466.08 $176,973.88 $50,453.11 2026-02-15
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 36 34 — — $42,938.39 $187,383.61 $46,146.19 2026-02-15
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 36 34 — — $35,838.64 $165,559.11 $44,996.36 2026-02-15
28 MS_DRG Spinal Procedures With Mcc 36 34 — — $30,773.79 $111,429.89 $44,202.47 2026-02-15
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 36 34 — — $29,523.14 $142,619.85 $43,870.22 2026-02-15
471 MS_DRG Cervical Spinal Fusion With Mcc 36 34 — — $38,108.78 $389,336.94 $40,014.22 2026-02-15
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 36 34 — — $10,000.00 $381,082.36 $39,000.88 2026-02-15
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 35 34 — — $36,973.01 $97,783.91 $38,821.66 2026-02-15
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 65 34 — — $10,000.00 $157,405.59 $38,676.00 2026-02-15
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 37 34 — — $33,846.06 $580,351.53 $36,339.29 2026-02-15
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 36 34 — — $33,364.10 $166,713.80 $36,052.50 2026-02-15
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 36 34 — — $32,277.58 $146,158.35 $35,041.21 2026-02-15
245 MS_DRG Aicd Generator Procedures 36 34 — — $31,975.15 $97,360.51 $34,712.71 2026-02-15
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 40 34 — — $29,600.48 $209,018.27 $34,694.51 2026-02-15
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 34 33 — — $297,174.15 $2,860,061.00 $500,228.01 2026-02-15
7 MS_DRG Lung Transplant 35 33 — — $102,981.20 $2,162,847.20 $342,503.59 2026-02-15
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 35 33 — — $196,224.27 $846,592.03 $206,035.49 2026-02-15
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 35 33 — — $148,627.97 $645,099.41 $156,059.37 2026-02-15
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 35 33 — — $111,343.38 $949,211.27 $143,914.10 2026-02-15
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 35 33 — — $86,834.44 $752,886.92 $108,543.05 2026-02-15
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 35 33 — — $49,835.04 $740,885.64 $98,636.00 2026-02-15
14 MS_DRG Allogeneic Bone Marrow Transplant 35 33 — — $15,552.82 $226,879.83 $86,694.65 2026-02-15
212 MS_DRG Hip & Femur Procedures Except Major Joint Age 0-17 34 33 — — $59,547.22 $148,868.05 $79,970.15 2026-02-15
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 35 33 — — $72,216.40 $473,562.45 $75,827.22 2026-02-15
6 MS_DRG Liver Transplant Without Mcc 35 33 — — $38,211.34 $613,006.45 $75,469.77 2026-02-15
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 35 33 — — $42,875.48 $591,940.40 $73,373.62 2026-02-15
215 MS_DRG Other Heart Assist System Implant 35 33 — — $69,741.62 $335,128.60 $73,228.70 2026-02-15
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 35 33 — — $50,961.07 $557,980.25 $68,958.87 2026-02-15
570 MS_DRG Skin Debridement With Mcc 35 33 — — $23,720.16 $561,768.89 $64,625.01 2026-02-15
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 35 33 — — $55,122.57 $387,183.73 $57,878.70 2026-02-15
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 35 33 — — $53,380.07 $179,465.74 $56,049.07 2026-02-15
10 MS_DRG Pancreas Transplant 35 33 — — $50,270.31 $363,908.35 $52,783.83 2026-02-15
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 35 33 — — $23,322.42 $111,124.31 $52,761.78 2026-02-15
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 42 33 — — $22,328.00 $149,021.59 $52,450.83 2026-02-15
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 35 33 — — $39,456.38 $468,312.38 $51,878.14 2026-02-15
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 34 33 — — $6,547.56 $78,083.19 $51,482.06 2026-02-15
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 35 33 — — $48,422.82 $205,349.01 $50,843.96 2026-02-15
163 MS_DRG Major Chest Procedures With Mcc 35 33 — — $36,320.17 $460,004.33 $50,052.27 2026-02-15
955 MS_DRG Craniotomy For Multiple Significant Trauma 35 33 — — $47,157.77 $203,377.17 $49,515.65 2026-02-15
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 35 33 — — $23,868.21 $76,548.17 $48,194.71 2026-02-15
653 MS_DRG Major Bladder Procedures With Mcc 35 33 — — $43,927.45 $432,627.77 $47,585.50 2026-02-15
276 MS_DRG Non-maligant Breast Disorders 42 33 — — $22,328.00 $70,317.29 $44,189.98 2026-02-15
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 35 33 — — $41,547.32 $176,947.00 $43,624.69 2026-02-15
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 35 33 — — $41,092.98 $159,643.33 $43,147.63 2026-02-15
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 37 33 — — $2,050.02 $105,855.09 $42,893.25 2026-02-15
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 35 33 — — $40,151.36 $286,913.55 $42,158.93 2026-02-15
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 35 33 — — $39,935.74 $126,655.08 $41,932.53 2026-02-15
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 35 33 — — $38,217.75 $225,144.85 $40,128.64 2026-02-15
278 MS_DRG Cellulitis Age >17 Without Cc 34 33 — — $5,772.38 $54,248.88 $39,977.59 2026-02-15
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 35 33 — — $15,926.24 $108,884.06 $39,815.60 2026-02-15
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 35 33 — — $7,559.25 $85,899.38 $39,207.07 2026-02-15
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 35 33 — — $37,095.52 $369,444.80 $38,950.29 2026-02-15
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 35 33 — — $28,283.34 $106,360.95 $38,300.48 2026-02-15
277 MS_DRG Cellulitis Age >17 W Cc 42 33 — — $22,328.00 $232,912.00 $36,474.49 2026-02-15
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 35 33 — — $34,490.54 $195,923.00 $36,215.07 2026-02-15
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 35 33 — — $5,092.18 $85,527.73 $35,377.42 2026-02-15
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 36 33 — — $32,881.05 $315,500.62 $34,929.53 2026-02-15
C9293 HCPCS Voraxaze 1000units/ml Soln 90 30 $117,450.00 $88,087.50 25% off $691.73 $117,450.00 $73,993.50 2026-02-15
1614 APR_DRG — 3 3 — — $189,765.67 $195,458.64 $189,765.67 2026-02-15
6304 APR_DRG — 3 3 — — $116,448.07 $119,941.52 $116,448.07 2026-02-15
1604 APR_DRG — 3 3 — — $85,209.95 $87,766.25 $85,209.95 2026-02-15
6314 APR_DRG — 3 3 — — $80,933.98 $83,362.00 $80,933.98 2026-02-15
9504 APR_DRG — 3 3 — — $79,120.56 $81,494.17 $79,120.56 2026-02-15
5884 APR_DRG — 3 3 — — $72,198.40 $74,364.35 $72,198.40 2026-02-15
5834 APR_DRG — 3 3 — — $72,198.40 $74,364.35 $72,198.40 2026-02-15
5833 APR_DRG — 3 3 — — $72,198.40 $74,364.35 $72,198.40 2026-02-15
0024 APR_DRG — 3 3 — — $71,871.71 $74,027.86 $71,871.71 2026-02-15
5831 APR_DRG — 3 3 — — $71,545.02 $73,691.37 $71,545.02 2026-02-15
5832 APR_DRG — 3 3 — — $71,545.02 $73,691.37 $71,545.02 2026-02-15
6344 APR_DRG — 3 3 — — $71,492.75 $73,637.53 $71,492.75 2026-02-15
0074 APR_DRG — 3 3 — — $65,337.92 $67,298.06 $65,337.92 2026-02-15
1613 APR_DRG — 3 3 — — $65,337.92 $67,298.06 $65,337.92 2026-02-15
8414 APR_DRG — 3 3 — — $62,071.02 $63,933.15 $62,071.02 2026-02-15
1634 APR_DRG — 3 3 — — $61,473.95 $63,318.16 $61,473.95 2026-02-15
0083 APR_DRG — 3 3 — — $60,906.27 $62,733.46 $60,906.27 2026-02-15
0113 APR_DRG — 3 3 — — $60,697.60 $62,518.52 $60,697.60 2026-02-15
6334 APR_DRG — 3 3 — — $58,699.26 $60,460.24 $58,699.26 2026-02-15
1784 APR_DRG — 3 3 — — $58,084.89 $59,827.43 $58,084.89 2026-02-15
1612 APR_DRG — 3 3 — — $57,776.61 $59,509.91 $57,776.61 2026-02-15
1303 APR_DRG — 3 3 — — $56,256.83 $57,944.54 $56,256.83 2026-02-15
1664 APR_DRG — 3 3 — — $55,425.97 $57,088.75 $55,425.97 2026-02-15
9124 APR_DRG — 3 3 — — $54,798.89 $56,442.86 $54,798.89 2026-02-15
7114 APR_DRG — 3 3 — — $54,751.40 $56,393.94 $54,751.40 2026-02-15
6094 APR_DRG — 3 3 — — $53,903.78 $55,520.90 $53,903.78 2026-02-15
1674 APR_DRG — 3 3 — — $53,514.76 $55,120.20 $53,514.76 2026-02-15
3033 APR_DRG — 3 3 — — $53,394.63 $54,996.47 $53,394.63 2026-02-15
6093 APR_DRG — 3 3 — — $52,768.60 $54,351.66 $52,768.60 2026-02-15
0093 APR_DRG — 3 3 — — $52,701.86 $54,282.92 $52,701.86 2026-02-15
4403 APR_DRG — 3 3 — — $51,955.45 $53,514.11 $51,955.45 2026-02-15
0304 APR_DRG — 3 3 — — $51,635.89 $53,184.96 $51,635.89 2026-02-15
0914 APR_DRG — 3 3 — — $50,999.84 $52,529.84 $50,999.84 2026-02-15
9104 APR_DRG — 3 3 — — $50,914.46 $52,441.89 $50,914.46 2026-02-15
8634 APR_DRG — 3 3 — — $49,690.14 $51,180.85 $49,690.14 2026-02-15
7104 APR_DRG — 3 3 — — $49,549.88 $51,036.37 $49,549.88 2026-02-15
0071 APR_DRG — 3 3 — — $48,676.66 $50,136.96 $48,676.66 2026-02-15
1833 APR_DRG — 3 3 — — $48,646.63 $50,106.03 $48,646.63 2026-02-15
8413 APR_DRG — 3 3 — — $48,511.11 $49,966.44 $48,511.11 2026-02-15
1783 APR_DRG — 3 3 — — $47,419.97 $48,842.57 $47,419.97 2026-02-15
3032 APR_DRG — 3 3 — — $47,273.50 $48,691.70 $47,273.50 2026-02-15
1653 APR_DRG — 3 3 — — $46,616.06 $48,014.54 $46,616.06 2026-02-15
0023 APR_DRG — 3 3 — — $45,736.54 $47,108.64 $45,736.54 2026-02-15
0094 APR_DRG — 3 3 — — $45,409.85 $46,772.15 $45,409.85 2026-02-15
0022 APR_DRG — 3 3 — — $45,083.16 $46,435.66 $45,083.16 2026-02-15
1794 APR_DRG — 3 3 — — $44,417.55 $45,750.08 $44,417.55 2026-02-15
2604 APR_DRG — 3 3 — — $43,961.00 $45,279.83 $43,961.00 2026-02-15
9114 APR_DRG — 3 3 — — $43,241.79 $44,539.05 $43,241.79 2026-02-15
5883 APR_DRG — 3 3 — — $43,123.03 $44,416.72 $43,123.03 2026-02-15
0073 APR_DRG — 3 3 — — $43,123.03 $44,416.72 $43,123.03 2026-02-15
1654 APR_DRG — 3 3 — — $43,044.76 $44,336.10 $43,044.76 2026-02-15
5882 APR_DRG — 3 3 — — $42,469.65 $43,743.74 $42,469.65 2026-02-15
0274 APR_DRG — 3 3 — — $40,369.58 $41,580.67 $40,369.58 2026-02-15
2614 APR_DRG — 3 3 — — $39,744.32 $40,936.65 $39,744.32 2026-02-15
2314 APR_DRG — 3 3 — — $39,678.86 $40,869.23 $39,678.86 2026-02-15
5934 APR_DRG — 3 3 — — $39,529.44 $40,715.32 $39,529.44 2026-02-15
3031 APR_DRG — 3 3 — — $39,521.22 $40,706.85 $39,521.22 2026-02-15
3034 APR_DRG — 3 3 — — $39,202.75 $40,378.83 $39,202.75 2026-02-15
5914 APR_DRG — 3 3 — — $39,202.75 $40,378.83 $39,202.75 2026-02-15
0084 APR_DRG — 3 3 — — $39,202.75 $40,378.83 $39,202.75 2026-02-15
0072 APR_DRG — 3 3 — — $39,202.75 $40,378.83 $39,202.75 2026-02-15
0014 APR_DRG — 3 3 — — $39,202.75 $40,378.83 $39,202.75 2026-02-15
8424 APR_DRG — 3 3 — — $39,202.75 $40,378.83 $39,202.75 2026-02-15
0213 APR_DRG — 3 3 — — $39,058.22 $40,229.97 $39,058.22 2026-02-15
0204 APR_DRG — 3 3 — — $39,017.41 $40,187.93 $39,017.41 2026-02-15
5104 APR_DRG — 3 3 — — $38,867.25 $40,033.27 $38,867.25 2026-02-15
0214 APR_DRG — 3 3 — — $38,734.85 $39,896.90 $38,734.85 2026-02-15
0234 APR_DRG — 3 3 — — $38,593.12 $39,750.92 $38,593.12 2026-02-15
1611 APR_DRG — 3 3 — — $38,545.46 $39,701.82 $38,545.46 2026-02-15
5891 APR_DRG — 3 3 — — $38,302.82 $39,451.91 $38,302.82 2026-02-15
0924 APR_DRG — 3 3 — — $38,289.95 $39,438.64 $38,289.95 2026-02-15
1204 APR_DRG — 3 3 — — $38,245.84 $39,393.21 $38,245.84 2026-02-15
0303 APR_DRG — 3 3 — — $38,049.48 $39,190.97 $38,049.48 2026-02-15
1792 APR_DRG — 3 3 — — $37,933.98 $39,072.00 $37,933.98 2026-02-15
1214 APR_DRG — 3 3 — — $37,642.90 $38,772.19 $37,642.90 2026-02-15
1834 APR_DRG — 3 3 — — $37,569.30 $38,696.38 $37,569.30 2026-02-15
6904 APR_DRG — 3 3 — — $37,569.30 $38,696.38 $37,569.30 2026-02-15
1632 APR_DRG — 3 3 — — $37,520.47 $38,646.08 $37,520.47 2026-02-15
1633 APR_DRG — 3 3 — — $36,965.26 $38,074.22 $36,965.26 2026-02-15
3124 APR_DRG — 3 3 — — $36,386.73 $37,478.34 $36,386.73 2026-02-15
6814 APR_DRG — 3 3 — — $35,935.86 $37,013.93 $35,935.86 2026-02-15
1624 APR_DRG — 3 3 — — $35,935.86 $37,013.93 $35,935.86 2026-02-15
0044 APR_DRG — 3 3 — — $35,935.86 $37,013.93 $35,935.86 2026-02-15
3154 APR_DRG — 3 3 — — $35,775.58 $36,848.85 $35,775.58 2026-02-15
1814 APR_DRG — 3 3 — — $35,432.92 $36,495.91 $35,432.92 2026-02-15
1631 APR_DRG — 3 3 — — $35,417.74 $36,480.27 $35,417.74 2026-02-15
5114 APR_DRG — 3 3 — — $35,086.41 $36,139.00 $35,086.41 2026-02-15
1663 APR_DRG — 3 3 — — $35,056.37 $36,108.07 $35,056.37 2026-02-15
4014 APR_DRG — 3 3 — — $35,055.61 $36,107.28 $35,055.61 2026-02-15
0224 APR_DRG — 3 3 — — $34,998.62 $36,048.58 $34,998.62 2026-02-15
7924 APR_DRG — 3 3 — — $34,942.10 $35,990.36 $34,942.10 2026-02-15
0D160KL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168KL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D767ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DQ63ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164J9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168J9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168KB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160JB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D767DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU647Z OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DN68ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160JA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DP643Z OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164Z9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DQ67ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164KL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DQ68ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV64DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168JA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160JL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168K9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D1687A OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160KA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160ZA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D16879 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DN67ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DQ60ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168Z9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D764DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168KA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DF63ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D1687L OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU687Z OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV63CZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164JA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168ZL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DM64ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D1647L OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DN60ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160Z9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168ZB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164ZL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160KB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DF60ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU64JZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV60ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV64CZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV67DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160J9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DN63ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D16479 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DN64ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D763ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DP64CZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU60JZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D768DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DF67ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D1647A OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU67JZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV60DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160ZL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D764ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D1607A OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D768ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DQ64ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D1607L OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D760ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DP67DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU607Z OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV63ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164K9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164ZA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160ZB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D1687B OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168JL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164KB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D760DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DP68DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU64KZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU68KZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DM60ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU60KZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164JB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164JL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU68JZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160K9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D1647B OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D1607B OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D763DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D16079 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164KA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168JB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV60CZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV63DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DF68ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164ZB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU677Z OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168ZA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DF64ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU67KZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV64ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV67ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV68DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV68ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
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