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

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Hospital

ADVENTHEALTH GORDON

Calhoun, GA · CCN 110023 · Rates published

25,240 distinct procedures filed
28 distinct payers
586,940 rate rows
2026-04-01 last MRF observed
Data quality

566,848 of 586,940 rate rows are consumer-grade (96.6%)

20,092 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 13,114
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 2,667
template filing: same amount across many unrelated codes — excluded 2,234
exceeds 10× this hospital's gross charge — excluded from medians 1,627
per-diem day rate — not a per-procedure price 275
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 175
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://hospitalpricedisclosure.com/download.aspx?pi=lsLQxz40KGrFBqX94nBW*__*A*-*
Found on page https://urldefense.com/v3/__https://HospitalPriceDisclosure.com/Default.aspx?ci=RsbcVwMa5jfnDZuYpIqAxQ*-*__;Kio!!OwHQNGuS!NNxzc3gzcCDbWC_3aBKJU3Bm28st5mdzWI_DoAkJmDmhsUhsHjB8niD15jvlGIrs7b_d4aR0fJBjowy6rVbgBT5sJPyOLA$
Discovered viaCMS hospital list
Last fetch not_modified · 2026-08-12
Content fingerprint bd8884e685e3b6b9… · 21,887,793 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
Q2042
HCPCS 		Tisagenlecleucel IV Infusion (wrapped) 15 $523,453.00 $4,759,031.00 $1,039,053.00 nat. median
$691,418
1.5× median
Q2055
HCPCS 		Idecabtagene Vicleucel 460000000 Cells IV Susp 13 $503,455.00 $4,919,457.00 $896,239.50 nat. median
$610,161
1.5× median
Q2054
HCPCS 		Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp 13 $496,390.00 $4,811,603.00 $880,265.50 nat. median
$624,417
1.4× median
A9520
HCPCS 		Technetium-99 (tc-99) Tilmanocept (lymphoseek) Radio-isotope Injection 18 $10.00 $699,951.00 $381,862.00 nat. median
$1,032
outlier · 369.9×
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 10 $317,710.49 $676,113.10 $332,299.24 nat. median
$370,165
0.9× median
A9595
HCPCS 		Piflufolastat F 18 9 Mci IV Sosy 18 $615.00 $431,661.00 $235,495.00 nat. median
$896
outlier · 262.7×
A9588
HCPCS 		Fluciclovine F 18 9-221 Mci/ml IV Soln 18 $82.00 $418,044.00 $228,066.00 nat. median
$741
outlier · 307.7×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 10 $206,952.15 $438,770.20 $216,455.05 nat. median
$261,939
0.8× median
A9572
HCPCS 		Indium In-111 Pentetreotide IV Kit 18 $58.00 $351,327.00 $191,669.00 nat. median
$4,658
outlier · 41.2×
C1831
HCPCS 		Kit Imp Aprevo Spine Lvl 1 18 $24,717.00 $394,200.00 $182,208.00 nat. median
$7,752
outlier · 23.5×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 10 $158,193.02 $334,284.78 $165,456.98 nat. median
$205,166
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 10 $157,277.52 $332,322.96 $164,499.46 nat. median
$199,832
0.8× median
A9569
HCPCS 		Technetium-99 (tc-99) Exametazime White Blood Cells Radio-isotope Injection 18 $56.00 $288,353.00 $157,313.00 nat. median
$1,956
outlier · 80.4×
C1827
HCPCS 		Generator Imp Vivistim Vns Ipg 1001 18 $6,179.00 $232,578.00 $128,597.75 nat. median
$26,771
outlier · 4.8×
13925-522-01
NDC 		Pentamidine Isethionate 300 Mg In Solr 18 $27,296.00 $226,369.00 $126,832.50 nat. median
$83,907
1.5× median
J2326
HCPCS 		Nusinersen 12 Mg/5ml It Soln 18 $1,211.00 $230,869.00 $125,952.00 nat. median
$2,353
outlier · 53.5×
C1825
HCPCS 		System Neo Barostim Includes 2102 Ipg 1036 Csl Kit 18 $26,619.00 $220,752.00 $123,685.50 nat. median
$53,130
outlier · 2.3×
A9591
HCPCS 		Fluoroestradiol F 18 4-100 Mci/ml IV Soln 18 $68.00 $221,462.00 $120,820.00 nat. median
$1,106
outlier · 109.2×
58914-501-56
NDC 		Mesalamine 1000 Mg Re Supp 18 $25,651.00 $212,725.00 $119,188.00 nat. median
$45,242
outlier · 2.6×
C1824
HCPCS 		Generator Pul Implantable Optimizer Smt F/hrt Fail 18 $24,717.00 $204,984.00 $114,850.50 nat. median
$35,282
outlier · 3.3×
C1822
HCPCS 		Construct Neuromod Nevro Pain Mgmt Omnia With Ipg Rm 18 $19,489.00 $204,984.00 $111,830.00 nat. median
$32,176
outlier · 3.5×
C1823
HCPCS 		Generator Implantable Remede Pul Cent Sleep Apnea 18 $8,556.00 $201,042.00 $111,161.00 nat. median
$33,398
outlier · 3.3×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 10 $103,400.93 $216,871.37 $108,148.92 nat. median
$132,706
0.8× median
7
MS_DRG 		Lung Transplant 10 $96,816.33 $202,761.28 $101,261.98 nat. median
$122,690
0.8× median
63323-877-15
NDC 		Pentamidine Isethionate 300 Mg In Solr 18 $21,409.00 $177,545.00 $99,477.00 nat. median
$64,153
1.6× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 10 $90,004.48 $188,164.26 $94,137.35 nat. median
$114,305
0.8× median
C1816
HCPCS 		System Stim Nerv Stimq-4 8 Elect Dl Transm Kt 18 $1,901.00 $161,622.00 $90,555.50 nat. median
$9,949
outlier · 9.1×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 10 $84,991.50 $177,421.99 $88,894.17 nat. median
$108,240
0.8× median
209
MS_DRG 		Complex Aortic Arch Procedures 10 $84,896.52 $177,218.45 $88,794.82 nat. median
$96,134
0.9× median
C2624
HCPCS 		System Cardiomems Hrt Failure Ptnt 18 $18,966.00 $157,286.00 $88,126.00 nat. median
$32,499
outlier · 2.7×
C1767
HCPCS 		Generator Pul Sentiva Vns Therapy Prgmbl Mdl 1.8x1 18 $9,749.00 $308,619.00 $87,718.50 nat. median
$23,668
outlier · 3.7×
C1882
HCPCS 		Defibrillator Lumax 740 Hf-t Ti Bi Ventr Hm Mble 18 $19.00 $256,947.00 $86,958.50 nat. median
$27,675
outlier · 3.1×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 10 $82,722.10 $172,558.93 $86,520.57 nat. median
$96,835
0.9× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 10 $81,647.32 $170,255.78 $85,396.43 nat. median
$100,978
0.8× median
A9592
HCPCS 		Copper Cu 64 Dotatate 1 Mci/ml IV Soln 18 $255.00 $154,549.00 $84,315.00 nat. median
$1,673
outlier · 50.4×
C9089
HCPCS 		Bupivacaine Hcl (300 Mg Dose) 3 X 100 Mg Il Impl 18 $16,989.00 $144,838.00 $83,443.00 nat. median
$2
outlier · 55260.3×
C2616
HCPCS 		Sphere Embol Sir Msphre 90 18 $17,107.00 $144,632.00 $82,365.00 nat. median
$26,606
outlier · 3.1×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 10 $77,529.39 $161,431.50 $81,089.41 nat. median
$99,646
0.8× median
215
MS_DRG 		Other Heart Assist System Implant 10 $74,946.54 $155,896.75 $78,387.96 nat. median
$98,002
0.8× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 $73,673.75 $153,169.30 $77,056.74 nat. median
$92,900
0.8× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 10 $68,024.37 $141,063.31 $71,147.93 nat. median
$81,124
0.9× median
C1721
HCPCS 		Defibrillator Secura Dr 2chb Is1 Df1 Av 35jl 37ml 18 $9.00 $162,544.00 $69,350.50 nat. median
$22,566
outlier · 3.1×
850
MS_DRG 		Acute Leukemia With Other Procedures 10 $65,466.37 $135,581.79 $68,472.48 nat. median
$81,364
0.8× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 10 $63,788.80 $131,986.94 $66,717.88 nat. median
$79,040
0.8× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 $63,595.18 $131,572.03 $66,515.36 nat. median
$80,459
0.8× median
C1820
HCPCS 		Stimulator Nerv Activa Sc 60x55x11mm 27ml 44gm 18 $898.00 $201,476.00 $65,917.00 nat. median
$22,838
outlier · 2.9×
C1722
HCPCS 		Defibrillator Lumax 740 Vr-t Ti 1chb 18 $4,649.00 $175,813.00 $63,993.50 nat. median
$21,054
outlier · 3.0×
38240
HCPCS 		Transplt Allo Hct/donor 6 $3,327.00 $126,629.00 $63,889.51 nat. median
$13,835
outlier · 4.6×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 10 $59,689.12 $123,201.80 $62,429.96 nat. median
$77,385
0.8× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 10 $58,297.24 $120,219.14 $60,974.15 nat. median
$74,472
0.8× median

Other procedures at this hospital

Browse this hospital's 25,240 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
             
0008-0423-01 NDC Antivenin Micrurus Fulvius IV Solr 21 18 $98,393.34 $49,196.67 50% off $10,678.00 $88,554.00 $49,616.00 2024-12-15
0008-0423-03 NDC Antivenin Micrurus Fulvius IV Solr 21 18 $98,393.34 $49,196.67 50% off $10,678.00 $88,554.00 $49,616.00 2024-12-15
0187-0007-14 NDC Ribavirin 6 G In Solr 21 18 $53,072.85 $26,536.42 50% off $5,760.00 $47,766.00 $26,763.00 2024-12-15
0408T CPT Hc Ins/repl Ccm System, Pulse Gen With Tv Electrodes 21 18 $57,043.55 $28,521.78 50% off $2,439.00 $66,453.00 $31,973.00 2024-12-15
0408T OTHER Insj/rplc Cardiac Modulj Sys 9 6 — — $3,327.00 $63,190.30 $31,882.09 2026-04-01
0571T OTHER Insj/rplcmt Icds Ss Eltrd 8 6 — — $3,327.00 $63,190.30 $32,200.91 2026-04-01
0620T OTHER Evasc Ven Artlz Tibl/prnl Vn 8 6 — — $3,327.00 $88,671.90 $45,185.99 2026-04-01
0674T OTHER Laps Insj Nw/rpcmt Prm Isdss 8 6 — — $1,266.00 $62,120.99 $31,656.01 2026-04-01
0686T OTHER Histotripsy Mal Hepatcel Tis 8 6 — — $1,665.00 $68,967.25 $35,144.76 2026-04-01
0781-5893-31 NDC Nevirapine ER 400 Mg Po Tb24 21 18 $52,033.73 $26,016.86 50% off $5,647.00 $46,830.00 $26,238.50 2024-12-15
0908T OTHER Opn Imp Int Nstm Sys Vgs Nrv 9 6 — — $3,327.00 $62,120.99 $31,342.58 2026-04-01
0909T OTHER Rplcmt Int Nstim Sys Vgs Nrv 9 6 — — $2,452.00 $62,120.99 $31,342.58 2026-04-01
0915T OTHER Insj Perm Ccm-d Sys Pg&eltrd 9 6 — — $3,327.00 $63,190.30 $31,882.09 2026-04-01
0956T OTHER Prt Crn Ch Cr&tun Elt S-sclp 7 6 — — $5,063.00 $54,624.69 $28,111.60 2026-04-01
0960T OTHER Rpl S-sclp Eltr Ra Rcvr&tlmt 7 6 — — $5,063.00 $54,624.69 $28,111.60 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 12 10 — — $206,952.15 $438,770.20 $216,455.05 2026-04-01
10 MS_DRG Pancreas Transplant 12 10 — — $54,625.00 $112,349.93 $57,133.29 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 12 10 — — $42,046.15 $85,394.84 $43,976.83 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 12 10 — — $32,999.98 $66,740.78 $34,515.29 2026-04-01
13925-522-01 NDC Pentamidine Isethionate 300 Mg In Solr 21 18 $251,521.01 $125,760.50 50% off $27,296.00 $226,369.00 $126,832.50 2024-12-15
14 MS_DRG Allogeneic Bone Marrow Transplant 12 10 — — $90,004.48 $188,164.26 $94,137.35 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 12 10 — — $33,360.20 $67,469.30 $34,892.04 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 12 10 — — $29,570.32 $59,804.47 $30,928.14 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 12 10 — — $45,521.12 $92,841.31 $47,611.37 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 12 10 — — $34,942.05 $70,668.51 $36,546.53 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 12 10 — — $29,505.29 $59,672.95 $30,860.12 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 12 10 — — $41,886.87 $85,053.52 $43,810.24 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 12 10 — — $317,710.49 $676,113.10 $332,299.24 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 12 10 — — $54,324.70 $111,706.43 $56,819.21 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 12 10 — — $84,991.50 $177,421.99 $88,894.17 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 12 10 — — $59,689.12 $123,201.80 $62,429.96 2026-04-01
20696 HCPCS Comp Multiplane Ext Fixation 9 6 — — $3,108.00 $54,624.69 $27,560.39 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 12 10 — — $49,210.90 $100,748.10 $51,470.58 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 12 10 — — $84,896.52 $177,218.45 $88,794.82 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 12 10 — — $40,874.92 $82,885.03 $42,751.82 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 12 10 — — $81,647.32 $170,255.78 $85,396.43 2026-04-01
21243 HCPCS Reconstruction Of Jaw Joint 9 6 — — $1,665.00 $54,624.69 $27,560.39 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 12 10 — — $43,893.23 $89,352.93 $45,908.74 2026-04-01
215 MS_DRG Other Heart Assist System Implant 12 10 — — $74,946.54 $155,896.75 $78,387.96 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 10 — — $73,673.75 $153,169.30 $77,056.74 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 10 — — $50,238.18 $102,949.47 $52,545.04 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 10 — — $50,238.18 $102,949.47 $52,545.04 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 10 — — $58,297.24 $120,219.14 $60,974.15 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 12 10 — — $25,411.47 $51,393.40 $26,578.32 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 10 — — $41,159.87 $83,495.65 $43,049.87 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 10 — — $39,021.99 $78,919.99 $40,813.82 2026-04-01
22558 HCPCS Lumbar Spine Fusion 9 6 — — $1,266.00 $54,624.69 $27,560.39 2026-04-01
22630 HCPCS Lumbar Spine Fusion 9 6 — — $2,452.00 $54,624.69 $27,560.39 2026-04-01
22633 HCPCS Lumbar Spine Fusion Combined 9 6 — — $2,452.00 $54,624.69 $27,560.39 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 12 10 — — $38,343.95 $77,548.68 $40,104.64 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 13 10 — — $25,207.62 $50,981.12 $26,493.72 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 12 10 — — $44,064.20 $89,719.31 $46,087.56 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 12 10 — — $63,788.80 $131,986.94 $66,717.88 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 12 10 — — $46,492.15 $94,922.13 $48,626.99 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 12 10 — — $58,055.40 $119,700.90 $60,721.21 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 12 10 — — $42,108.98 $85,529.49 $44,042.56 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 12 10 — — $45,074.69 $91,884.67 $47,144.44 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 12 10 — — $32,801.25 $66,338.85 $34,307.43 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 12 10 — — $38,156.17 $77,168.91 $39,908.24 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 12 10 — — $30,778.09 $62,247.11 $32,191.37 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 12 10 — — $25,523.98 $51,620.95 $26,696.00 2026-04-01
24338-050-08 NDC Carmustine In Polifeprosan 7.7 Mg Il Wafr 21 18 $61,005.05 $30,502.53 50% off $6,620.00 $54,905.00 $30,762.50 2024-12-15
245 MS_DRG Aicd Generator Procedures 12 10 — — $35,530.95 $71,859.53 $37,162.47 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 12 10 — — $35,416.24 $71,627.54 $37,042.50 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 12 10 — — $27,683.05 $55,987.56 $28,954.21 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 12 10 — — $25,153.54 $50,871.76 $26,308.56 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 12 10 — — $24,913.17 $50,385.61 $26,057.14 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 12 10 — — $25,962.38 $52,507.58 $27,154.53 2026-04-01
263 MS_DRG Vein Ligation And Stripping 12 10 — — $24,534.69 $49,620.16 $25,661.28 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 13 10 — — $11,495.42 $53,805.00 $27,689.76 2026-04-01
265 MS_DRG Aicd Lead Procedures 12 10 — — $28,632.17 $57,907.10 $29,946.92 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 12 10 — — $46,972.92 $95,952.36 $49,129.84 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 12 10 — — $36,980.56 $74,791.31 $38,678.65 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 12 10 — — $52,449.13 $107,687.28 $54,857.51 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 12 10 — — $33,052.60 $66,847.19 $34,570.32 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 13 10 — — $9,956.26 $82,611.03 $42,410.20 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 12 10 — — $28,179.89 $56,992.39 $29,473.86 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 12 10 — — $32,338.75 $65,403.46 $33,823.68 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 12 10 — — $26,246.60 $53,082.40 $27,451.79 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 12 10 — — $54,294.02 $111,640.67 $56,787.11 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 12 10 — — $46,082.98 $94,045.34 $48,199.04 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 12 10 — — $35,940.84 $72,688.52 $37,591.19 2026-04-01
27702 HCPCS Reconstruct Ankle Joint 9 6 — — $1,266.00 $54,624.69 $27,560.39 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 12 10 — — $42,865.21 $87,149.99 $44,833.51 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 12 10 — — $28,545.95 $57,732.73 $29,856.74 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 12 10 — — $46,095.41 $94,071.95 $48,212.03 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 12 10 — — $27,122.65 $54,854.17 $28,368.07 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 12 10 — — $157,277.52 $332,322.96 $164,499.46 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 12 10 — — $34,932.55 $70,649.30 $36,536.60 2026-04-01
31253 CPT Hc Nasal/sinus Endo Total With Tiss Rem 31 18 $58,900.10 $29,450.05 50% off $1,621.00 $106,020.00 $28,920.00 2024-12-15
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 12 10 — — $51,050.67 $104,690.53 $53,394.84 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 12 10 — — $34,803.96 $70,389.22 $36,402.10 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 13 10 — — $33,474.13 $68,386.95 $35,194.09 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 12 10 — — $25,218.58 $51,003.28 $26,376.57 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 12 10 — — $25,652.58 $51,881.03 $26,830.50 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 12 10 — — $38,636.22 $78,139.78 $40,410.32 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 13 10 — — $35,410.12 $72,363.43 $37,240.52 2026-04-01
332 MS_DRG Rectal Resection With Mcc 12 10 — — $28,650.44 $57,944.05 $29,966.01 2026-04-01
33221 CPT Hc Ep Ins Pacemaker Pulse Gen Only W/exist Mult Leads 21 18 $57,771.07 $28,885.54 50% off $2,439.00 $51,994.00 $27,848.00 2024-12-15
33230 CPT Hc Ep Insj Implntbl Defib Pulse Gen W/exist Dual Leads 21 18 $74,130.39 $37,065.20 50% off $2,439.00 $66,717.00 $33,688.00 2024-12-15
33231 CPT Hc Ep Insj Implntbl Defib Pulse Gen W/exist Multileads 21 18 $50,477.03 $25,238.52 50% off $2,439.00 $66,453.00 $31,973.00 2024-12-15
33231 HCPCS Insrt Pulse Gen W/mult Leads 9 6 — — $3,327.00 $63,190.30 $31,882.09 2026-04-01
33240 CPT Hc Insj Implntbl Defib Pulse Gen W/1 Existing Ld 30 18 $80,085.22 $40,042.61 50% off $2,439.00 $72,077.00 $37,658.00 2024-12-15
33249 CPT Hc Insj/rplcmt Perm Dfb W/trnsvns Lds 1/dual Chmbr 30 18 $100,954.06 $50,477.03 50% off $2,439.00 $90,859.00 $47,019.00 2024-12-15
33249 HCPCS Insj/rplcmt Defib W/lead(s) 9 6 — — $3,327.00 $63,190.30 $31,882.09 2026-04-01
33262 CPT Hc Rmvl Impltbl Dfb Plse Gen W/repl Plse Gen 1 Lead 30 18 $85,073.45 $42,536.72 50% off $2,439.00 $80,818.00 $41,660.00 2024-12-15
33263 CPT Hc Rmvl Impltbl Dfb Plse Gen W/rplcmt Plse Gen 2 Ld 30 18 $77,499.95 $38,749.98 50% off $2,439.00 $70,773.00 $38,331.00 2024-12-15
33264 CPT Hc Rmvl Impltbl Dfb Pls Gen W/rplcmt Pls Gen Mlt Ld 30 18 $100,954.06 $50,477.03 50% off $2,439.00 $90,859.00 $47,019.00 2024-12-15
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 9 6 — — $3,327.00 $63,190.30 $31,882.09 2026-04-01
33270 CPT Hc Ins/rplcmnt Perm Subq Impltbl Dfb W/subq Eltrd 21 18 $66,640.11 $33,320.06 50% off $2,439.00 $66,453.00 $32,913.00 2024-12-15
33270 HCPCS Ins/rep Subq Defibrillator 9 6 — — $3,327.00 $63,190.30 $31,882.09 2026-04-01
33274 CPT Hc Tcat Insj/rpl Perm Leadless Pacemaker Rv W/img 21 18 $59,550.81 $29,775.40 50% off $2,439.00 $53,596.00 $27,848.00 2024-12-15
33276 HCPCS Insj Phrnc Nrv Stim Sys 9 6 — — $3,327.00 $88,671.90 $44,738.60 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 9 6 — — $3,327.00 $62,120.99 $31,342.58 2026-04-01
33289 CPT Hc Rhc W/plc Pressure Sensor 21 18 $77,382.17 $38,691.08 50% off $2,439.00 $69,644.00 $40,626.00 2024-12-15
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 9 6 — — $3,327.00 $57,743.72 $29,134.07 2026-04-01
33363 CPT Hc Replace Aortic Valve Open Axillry Artry Approach 23 12 $69,164.28 $34,582.14 50% off $1,798.00 $62,248.00 $41,499.00 2024-12-15
33365 CPT Hc Cath Replace Aortic Valve Open Transaortic Approach 13 12 $54,869.49 $27,434.74 50% off $1,798.00 $49,383.00 $28,806.00 2024-12-15
33477 CPT Hc Cath Tcat Pulmonary Valve Implantation Prq Approach 13 12 $47,741.90 $23,870.95 50% off $1,621.00 $42,968.00 $25,064.00 2024-12-15
335 MS_DRG Peritoneal Adhesiolysis With Mcc 12 10 — — $28,286.57 $57,208.15 $29,585.45 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 12 10 — — $30,477.06 $61,638.30 $31,876.51 2026-04-01
34708 CPT Hc Evasc Rpr Dplmnt Ilio-iliac Ndgft Rpt 23 12 $41,956.92 $20,978.46 50% off $1,621.00 $75,522.00 $29,370.00 2024-12-15
35355 CPT Hc Thromboendarterectomy With Without Patch Graft Iliofemoral 23 12 $40,639.16 $20,319.58 50% off $1,028.00 $73,150.00 $28,447.00 2024-12-15
35371 CPT Hc Thromboendartectmy Femoral Common 23 12 $37,940.07 $18,970.04 50% off $899.00 $68,292.00 $26,558.00 2024-12-15
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 12 10 — — $34,291.77 $69,353.35 $35,866.39 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 12 10 — — $27,319.92 $55,253.15 $28,574.40 2026-04-01
36906 CPT Hc Perq Thrmbc/nfs Dial Circuit Tcat Plmt IV Stent 21 18 $53,368.25 $26,684.12 50% off $440.00 $48,031.00 $25,061.00 2024-12-15
37 MS_DRG Extracranial Procedures With Mcc 12 10 — — $26,249.52 $53,088.31 $27,454.85 2026-04-01
37227 CPT Hc Revascularize Fem/pop Artery,angioplasty/stent/atherectomy 29 18 $62,733.60 $31,366.80 50% off $656.00 $112,920.00 $30,909.00 2024-12-15
37230 CPT Hc Revascularize Tibial/peron Artery,angioplasty/stent Initial 29 18 $59,008.08 $29,504.04 50% off $614.00 $106,215.00 $30,909.00 2024-12-15
37231 CPT Hc Revascularize Tibial/peron Artery,angioplasty/stent/atherectomy Init 29 18 $85,896.21 $42,948.10 50% off $667.00 $154,613.00 $35,419.00 2024-12-15
38240 HCPCS Transplt Allo Hct/donor 9 6 — — $3,327.00 $126,629.00 $63,889.51 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 12 10 — — $103,400.93 $216,871.37 $108,148.92 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 12 10 — — $30,407.65 $61,497.91 $31,803.92 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 12 10 — — $31,571.56 $63,851.87 $33,021.28 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 12 10 — — $42,165.98 $85,651.62 $44,102.18 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 12 10 — — $28,247.84 $57,129.82 $29,544.94 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 12 10 — — $26,331.36 $53,253.82 $27,540.44 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 12 10 — — $28,225.92 $57,085.48 $29,522.01 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 12 10 — — $27,089.77 $54,787.67 $28,333.69 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 12 10 — — $32,539.68 $65,809.83 $34,033.84 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 10 — — $82,722.10 $172,558.93 $86,520.57 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 10 — — $54,938.45 $113,021.62 $57,461.13 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 10 — — $43,272.91 $88,023.65 $45,259.93 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 12 10 — — $68,024.37 $141,063.31 $71,147.93 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 12 10 — — $44,333.08 $90,295.48 $46,368.79 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 12 10 — — $51,014.87 $104,613.81 $53,357.39 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 12 10 — — $33,181.18 $67,107.25 $34,704.81 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 12 10 — — $41,136.49 $83,445.55 $43,025.41 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 12 10 — — $25,798.71 $52,176.57 $26,983.34 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 10 — — $63,595.18 $131,572.03 $66,515.36 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 10 — — $45,765.16 $93,364.26 $47,866.62 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 10 — — $32,682.88 $66,099.46 $34,183.63 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 12 10 — — $42,549.57 $86,473.61 $44,503.38 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 12 10 — — $43,839.16 $89,237.07 $45,852.19 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 12 10 — — $24,953.35 $50,466.87 $26,099.17 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 12 10 — — $40,229.03 $81,500.95 $42,076.28 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 12 10 — — $27,962.89 $56,553.52 $29,246.90 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 12 10 — — $24,357.87 $49,262.55 $25,476.35 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 12 10 — — $37,476.67 $75,794.65 $39,197.54 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 12 10 — — $33,561.85 $67,877.14 $35,102.96 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 13 10 — — $27,436.82 $55,489.58 $28,556.70 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 12 10 — — $25,774.60 $52,127.81 $26,958.12 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 12 10 — — $29,022.34 $58,696.20 $30,354.99 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 12 10 — — $28,686.96 $58,017.92 $30,004.22 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 12 10 — — $24,238.05 $49,020.21 $25,351.01 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 12 10 — — $77,529.39 $161,431.50 $81,089.41 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 12 10 — — $25,319.41 $51,207.21 $26,482.03 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 12 10 — — $24,265.07 $49,074.87 $25,379.29 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 12 10 — — $25,480.88 $51,533.78 $26,650.92 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 12 10 — — $29,502.37 $59,667.04 $30,857.07 2026-04-01
52427-273-75 NDC Naproxen Sodium ER 500 Mg Po Tb24 21 18 $85,454.33 $42,727.16 50% off $9,274.00 $76,909.00 $43,091.50 2024-12-15
55566-9800-0 NDC Fecal Microbiota, Live-jslm 150 Ml Re Susp 21 18 $60,213.77 $30,106.88 50% off $6,535.00 $54,192.00 $30,363.50 2024-12-15
55566-9800-2 NDC Fecal Microbiota, Live-jslm 150 Ml Re Susp 21 18 $60,213.77 $30,106.88 50% off $6,535.00 $54,192.00 $30,363.50 2024-12-15
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 12 10 — — $50,063.56 $102,575.27 $52,362.40 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 12 10 — — $27,559.57 $55,737.82 $28,825.06 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 12 10 — — $38,006.39 $76,865.98 $39,751.58 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 12 10 — — $25,857.89 $52,296.26 $27,045.24 2026-04-01
58468-0132-1 NDC Sevelamer Carbonate 0.8 G Po Pack 21 18 $74,112.26 $37,056.13 50% off $8,043.00 $66,701.00 $37,372.00 2024-12-15
58468-0132-2 NDC Sevelamer Carbonate 0.8 G Po Pack 21 18 $74,112.26 $37,056.13 50% off $8,043.00 $66,701.00 $37,372.00 2024-12-15
58914-501-56 NDC Mesalamine 1000 Mg Re Supp 21 18 $236,361.47 $118,180.74 50% off $25,651.00 $212,725.00 $119,188.00 2024-12-15
59385-027-01 NDC Buprenorphine Hcl 900 Mcg Bu Film 21 18 $66,560.68 $33,280.34 50% off $7,223.00 $59,905.00 $33,564.00 2024-12-15
59385-027-60 NDC Buprenorphine Hcl 900 Mcg Bu Film 21 18 $66,560.68 $33,280.34 50% off $7,223.00 $59,905.00 $33,564.00 2024-12-15
6 MS_DRG Liver Transplant Without Mcc 12 10 — — $36,076.01 $72,961.90 $37,732.57 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 12 10 — — $27,676.47 $55,974.26 $28,947.33 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 11 8 — — $964.00 $62,120.99 $30,715.73 2026-04-01
61886 HCPCS Implant Neurostim Arrays 11 8 — — $1,266.00 $62,120.99 $30,715.73 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 9 6 — — $3,327.00 $62,120.99 $31,342.58 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 12 10 — — $28,201.09 $57,035.26 $29,496.03 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 12 10 — — $24,262.15 $49,068.97 $25,376.24 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 12 10 — — $29,425.65 $59,511.87 $30,776.82 2026-04-01
63323-877-15 NDC Pentamidine Isethionate 300 Mg In Solr 21 18 $197,271.80 $98,635.90 50% off $21,409.00 $177,545.00 $99,477.00 2024-12-15
63685 HCPCS Insrt/redo Spine N Generator 11 8 — — $964.00 $62,120.99 $30,715.73 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 9 6 — — $3,327.00 $88,671.90 $44,738.60 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 9 6 — — $3,327.00 $62,120.99 $31,342.58 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 12 10 — — $36,546.55 $73,913.54 $38,224.71 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 12 10 — — $29,272.22 $59,201.57 $30,616.35 2026-04-01
652 MS_DRG Kidney Transplant 12 10 — — $25,792.13 $52,163.27 $26,976.47 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 12 10 — — $40,163.27 $81,360.03 $42,007.50 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 12 10 — — $25,458.22 $51,487.96 $26,627.22 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 12 10 — — $24,564.64 $49,680.73 $25,692.61 2026-04-01
665 MS_DRG Prostatectomy With Mcc 12 10 — — $25,000.84 $50,562.92 $26,148.83 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 12 10 — — $32,894.77 $66,527.99 $34,405.24 2026-04-01
68382-395-01 NDC Ribavirin 6 G In Solr 21 18 $69,198.81 $34,599.40 50% off $7,510.00 $62,279.00 $34,894.50 2024-12-15
68382-395-04 NDC Ribavirin 6 G In Solr 21 18 $69,198.81 $34,599.40 50% off $7,510.00 $62,279.00 $34,894.50 2024-12-15
69930 HCPCS Implant Cochlear Device 9 6 — — $2,424.00 $66,377.63 $33,490.23 2026-04-01
7 MS_DRG Lung Transplant 12 10 — — $96,816.33 $202,761.28 $101,261.98 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 12 10 — — $28,312.88 $57,261.35 $29,612.96 2026-04-01
73702-140-71 NDC Indomethacin 100 Mg Re Supp 21 18 $50,178.77 $25,089.38 50% off $5,446.00 $45,161.00 $25,303.50 2024-12-15
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 12 10 — — $28,373.52 $57,383.99 $29,676.39 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 12 10 — — $45,621.95 $93,057.38 $47,716.83 2026-04-01
791 MS_DRG Prematurity With Major Problems 12 10 — — $31,852.87 $64,420.81 $33,315.50 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 13 10 — — $2,896.49 $66,055.12 $33,994.06 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 12 10 — — $35,286.18 $71,364.51 $36,906.47 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 12 10 — — $43,145.77 $87,751.22 $45,126.96 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 12 10 — — $31,305.61 $63,314.00 $32,743.11 2026-04-01
81416 CPT Hc Exome Sequence Analysis Each Comparator Exome 21 18 $93,492.00 $46,746.00 50% off $10,146.00 $84,143.00 $30,000.00 2024-12-15
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 12 10 — — $45,046.92 $91,825.17 $47,115.41 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 12 10 — — $35,694.62 $72,190.54 $37,333.65 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 12 10 — — $36,374.12 $73,564.80 $38,044.36 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 12 10 — — $25,284.33 $51,136.27 $26,445.35 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 12 10 — — $42,307.73 $85,955.36 $44,250.43 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 12 10 — — $37,298.39 $75,434.09 $39,011.07 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 12 10 — — $25,831.58 $52,243.06 $27,017.73 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 12 10 — — $65,466.37 $135,581.79 $68,472.48 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 16 10 — — $37,917.14 $163,445.97 $49,412.00 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 12 10 — — $35,430.85 $71,657.09 $37,057.78 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 12 10 — — $52,696.81 $108,218.05 $55,116.57 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 12 10 — — $30,434.67 $61,552.58 $31,832.18 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 12 10 — — $32,858.24 $66,454.12 $34,367.04 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 12 10 — — $29,033.29 $58,718.36 $30,366.46 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 12 10 — — $30,247.63 $61,174.29 $31,636.56 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 12 10 — — $158,193.02 $334,284.78 $165,456.98 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 12 10 — — $54,603.08 $112,302.96 $57,110.36 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 12 10 — — $25,728.57 $52,034.71 $26,909.98 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 12 10 — — $30,648.76 $61,985.54 $32,056.10 2026-04-01
93582 CPT Hc Cath Percutan Transcath Closure Pat Duct Arteriosus 21 18 $73,023.08 $36,511.54 50% off $2,439.00 $65,721.00 $25,061.00 2024-12-15
93653 CPT Hc Ephys Eval W/ablation Supravent Arrhythmia 21 18 $64,074.94 $32,037.47 50% off $2,439.00 $57,667.00 $33,639.00 2024-12-15
93653 HCPCS Ep & Ablate Supravent Arrhyt 8 6 — — $3,327.00 $52,619.27 $26,814.06 2026-04-01
93654 CPT Hc Ephys Eval W/ablation Ventricular Tachycardia 21 18 $73,072.23 $36,536.12 50% off $2,439.00 $65,765.00 $33,944.00 2024-12-15
93654 HCPCS Ep & Ablate Ventric Tachy 8 6 — — $3,327.00 $52,619.27 $26,814.06 2026-04-01
93656 CPT Hc Ephys Evl Trnsptl Tx Atrial Fib Isolat Pulm Vein 21 18 $76,404.56 $38,202.28 50% off $2,439.00 $68,764.00 $33,944.00 2024-12-15
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 8 6 — — $3,327.00 $52,619.27 $26,814.06 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 12 10 — — $28,707.42 $58,059.30 $30,025.62 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 12 10 — — $27,910.28 $56,447.12 $29,191.88 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 12 10 — — $51,376.54 $105,388.83 $53,735.67 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 12 10 — — $29,690.15 $60,046.81 $31,053.47 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 12 10 — — $57,870.55 $119,304.77 $60,527.87 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 12 10 — — $32,984.64 $66,709.76 $34,499.24 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 12 10 — — $46,921.04 $95,841.19 $49,075.57 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 12 10 — — $28,585.40 $57,812.52 $29,898.00 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 12 10 — — $36,476.41 $73,771.69 $38,151.35 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 12 10 — — $27,245.39 $55,102.41 $28,496.46 2026-04-01
A9520 HCPCS Technetium-99 (tc-99) Tilmanocept (lymphoseek) Radio-isotope Injection 21 18 $777,723.00 $388,861.50 50% off $10.00 $699,951.00 $381,862.00 2024-12-15
A9555 HCPCS Rubidium-82 (rb-82) Radio-isotope Injection 21 18 $84,801.00 $42,400.50 50% off $77.00 $76,321.00 $41,637.00 2024-12-15
A9569 HCPCS Technetium-99 (tc-99) Exametazime White Blood Cells Radio-isotope Injection 21 18 $320,392.36 $160,196.18 50% off $56.00 $288,353.00 $157,313.00 2024-12-15
A9572 HCPCS Indium In-111 Pentetreotide IV Kit 21 18 $390,363.81 $195,181.90 50% off $58.00 $351,327.00 $191,669.00 2024-12-15
A9584 HCPCS Ioflupane I 123 185 Mbq/2.5ml IV Soln 21 18 $57,241.00 $28,620.50 50% off $112.00 $51,517.00 $28,105.00 2024-12-15
A9588 HCPCS Fluciclovine F 18 9-221 Mci/ml IV Soln 21 18 $464,493.00 $232,246.50 50% off $82.00 $418,044.00 $228,066.00 2024-12-15
A9591 HCPCS Fluoroestradiol F 18 4-100 Mci/ml IV Soln 21 18 $246,069.40 $123,034.70 50% off $68.00 $221,462.00 $120,820.00 2024-12-15
A9592 HCPCS Copper Cu 64 Dotatate 1 Mci/ml IV Soln 21 18 $171,721.00 $85,860.50 50% off $255.00 $154,549.00 $84,315.00 2024-12-15
A9595 HCPCS Piflufolastat F 18 9 Mci IV Sosy 21 18 $479,623.55 $239,811.77 50% off $615.00 $431,661.00 $235,495.00 2024-12-15
C1721 HCPCS Defibrillator Secura Dr 2chb Is1 Df1 Av 35jl 37ml 654 18 $117,296.40 $58,648.20 50% off $9.00 $162,544.00 $69,350.50 2024-12-15
C1722 HCPCS Defibrillator Lumax 740 Vr-t Ti 1chb 632 18 $109,500.00 $54,750.00 50% off $4,649.00 $175,813.00 $63,993.50 2024-12-15
C1767 HCPCS Generator Pul Sentiva Vns Therapy Prgmbl Mdl 1.8x1 346 18 $148,920.00 $74,460.00 50% off $9,749.00 $308,619.00 $87,718.50 2024-12-15
C1772 HCPCS Pump Inf Synchromed Ii Ti 3.4x0.78x0.78in 20ml 34 18 $100,740.00 $50,370.00 50% off $9,412.00 $90,666.00 $50,799.50 2024-12-15
C1816 HCPCS System Stim Nerv Stimq-4 8 Elect Dl Transm Kt 47 18 $157,680.00 $78,840.00 50% off $1,901.00 $161,622.00 $90,555.50 2024-12-15
C1817 HCPCS Occluder Dct Amplatzer Ii 90deg 3x4mm 4fr 112 18 $71,849.52 $35,924.76 50% off $5,069.00 $81,954.00 $41,234.50 2024-12-15
C1820 HCPCS Stimulator Nerv Activa Sc 60x55x11mm 27ml 44gm 242 18 $114,580.80 $57,290.40 50% off $898.00 $201,476.00 $65,917.00 2024-12-15
C1822 HCPCS Construct Neuromod Nevro Pain Mgmt Omnia With Ipg Rm 47 18 $194,691.00 $97,345.50 50% off $19,489.00 $204,984.00 $111,830.00 2024-12-15
C1823 HCPCS Generator Implantable Remede Pul Cent Sleep Apnea 34 18 $223,380.00 $111,690.00 50% off $8,556.00 $201,042.00 $111,161.00 2024-12-15
C1824 HCPCS Generator Pul Implantable Optimizer Smt F/hrt Fail 21 18 $227,760.00 $113,880.00 50% off $24,717.00 $204,984.00 $114,850.50 2024-12-15
C1825 HCPCS System Neo Barostim Includes 2102 Ipg 1036 Csl Kit 21 18 $245,280.00 $122,640.00 50% off $26,619.00 $220,752.00 $123,685.50 2024-12-15
C1827 HCPCS Generator Imp Vivistim Vns Ipg 1001 34 18 $258,420.00 $129,210.00 50% off $6,179.00 $232,578.00 $128,597.75 2024-12-15
C1831 HCPCS Kit Imp Aprevo Spine Lvl 1 73 18 $332,880.00 $166,440.00 50% off $24,717.00 $394,200.00 $182,208.00 2024-12-15
C1833 HCPCS Monitor Crdc The Guardian Amsg3-e 21 18 $89,790.00 $44,895.00 50% off $9,744.00 $80,811.00 $45,277.50 2024-12-15
C1875 HCPCS Stent Cov Cp 8zigs 5.5cm 164 18 $63,439.92 $31,719.96 50% off $6,036.00 $70,840.00 $37,261.50 2024-12-15
C1882 HCPCS Defibrillator Lumax 740 Hf-t Ti Bi Ventr Hm Mble 786 18 $140,598.00 $70,299.00 50% off $19.00 $256,947.00 $86,958.50 2024-12-15
C2616 HCPCS Sphere Embol Sir Msphre 90 34 18 $160,702.20 $80,351.10 50% off $17,107.00 $144,632.00 $82,365.00 2024-12-15
C2621 HCPCS Pacemaker Consulta Bip Is1 Av 15ml 26gm 294 18 $51,684.00 $25,842.00 50% off $2,471.00 $87,108.00 $32,681.50 2024-12-15
C2622 HCPCS Prosthesis Penile Genisis Kt Semi Rgd Malle 9.5x23 47 18 $71,954.64 $35,977.32 50% off $1,495.00 $76,604.00 $36,284.00 2024-12-15
C2624 HCPCS System Cardiomems Hrt Failure Ptnt 21 18 $174,762.00 $87,381.00 50% off $18,966.00 $157,286.00 $88,126.00 2024-12-15
C9047 HCPCS Caplacizumab-yhdp 11 Mg Ij Kit 21 18 $98,873.24 $49,436.62 50% off $768.00 $88,986.00 $48,547.00 2024-12-15
C9089 HCPCS Bupivacaine Hcl (300 Mg Dose) 3 X 100 Mg Il Impl 34 18 $156,549.77 $78,274.88 50% off $16,989.00 $144,838.00 $83,443.00 2024-12-15
C9760 HCPCS Non-blind Interatrial Shunt 9 6 — — $2,452.00 $54,188.77 $27,340.45 2026-04-01
J0841 HCPCS Crotalidae Immune Fab (equine) IV Solr 21 18 $69,372.80 $34,686.40 50% off $1,056.00 $62,436.00 $34,062.00 2024-12-15
J1324 HCPCS Enfuvirtide 90 Mg Sc Solr 21 18 $63,297.39 $31,648.70 50% off $6,869.00 $56,968.00 $31,918.50 2024-12-15
J2326 HCPCS Nusinersen 12 Mg/5ml It Soln 21 18 $256,520.89 $128,260.44 50% off $1,211.00 $230,869.00 $125,952.00 2024-12-15
J2506 HCPCS Pegfilgrastim 6 Mg/0.6ml Sc Pskt 21 18 $80,420.12 $40,210.06 50% off $55.00 $72,378.00 $39,486.00 2024-12-15
L8614 HCPCS Electrode Hires Ultra 3d Ci Hifocus Slimj Cochlear 162 18 $117,438.75 $58,719.38 50% off $230.00 $165,564.00 $60,646.50 2024-12-15
L8619 HCPCS Abutment Cochlear Dermalock 3mmx8mm Strl 189 18 $100,740.00 $50,370.00 50% off $275.00 $165,564.00 $54,652.00 2024-12-15
Q0138 HCPCS Ferumoxytol 510 Mg/17ml IV Soln 21 18 $105,014.28 $52,507.14 50% off $117.00 $94,513.00 $51,562.00 2024-12-15
Q0479 HCPCS Module Pwr Heartmate Ii Cntrlr Tethered Operation 21 18 $75,427.20 $37,713.60 50% off $8,186.00 $67,884.00 $30,111.00 2024-12-15
Q0481 HCPCS Controller Heartware Hvad 47 18 $51,288.75 $25,644.38 50% off $947.00 $46,671.00 $25,461.00 2024-12-15
Q0495 HCPCS Charger Batt Heartmate Univ 34 18 $67,884.48 $33,942.24 50% off $4,951.00 $61,096.00 $30,644.50 2024-12-15
Q2042 HCPCS Tisagenlecleucel IV Infusion (wrapped) 18 15 — $3,399,308.09 $523,453.00 $4,759,031.00 $1,039,053.00 2024-12-15
Q2054 HCPCS Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp 14 13 — $3,880,325.32 $496,390.00 $4,811,603.00 $880,265.50 2024-12-15
Q2055 HCPCS Idecabtagene Vicleucel 460000000 Cells IV Susp 14 13 — $3,967,304.24 $503,455.00 $4,919,457.00 $896,239.50 2024-12-15
Q5111 HCPCS Pegfilgrastim-cbqv 6 Mg/0.6ml Sc Soaj 34 18 $66,556.97 $33,278.49 50% off $166.00 $59,901.00 $30,222.50 2024-12-15
Q5127 HCPCS Pegfilgrastim-fpgk 6 Mg/0.6ml Sc Sosy 21 18 $84,471.65 $42,235.83 50% off $335.00 $76,024.00 $41,476.00 2024-12-15
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