|
Q2042
|
HCPCS
|
Tisagenlecleucel IV Infusion (wrapped)
|
18
|
14
|
—
|
$3,399,308.09
|
$523,453.00
|
$4,755,632.00
|
$1,039,053.00
|
2024-12-15
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel 460000000 Cells IV Susp
|
15
|
13
|
—
|
$3,967,304.24
|
$503,455.00
|
$4,165,669.00
|
$977,409.00
|
2024-12-15
|
|
Q2054
|
HCPCS
|
Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp
|
15
|
13
|
—
|
$3,880,325.32
|
$496,390.00
|
$4,074,342.00
|
$955,980.00
|
2024-12-15
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies
|
18
|
14
|
$0.01
|
—
|
$244,353.00
|
$676,113.10
|
$365,558.00
|
2026-04-01
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
18
|
14
|
$0.01
|
—
|
$183,003.00
|
$438,770.20
|
$273,533.00
|
2026-04-01
|
|
1614
|
APR_DRG
|
Implantable Heart Assist Systems
|
3
|
3
|
$0.01
|
—
|
$238,859.00
|
$250,802.00
|
$250,802.00
|
2024-12-15
|
|
5834
|
APR_DRG
|
Neonate With Ecmo
|
3
|
3
|
$0.01
|
—
|
$228,083.00
|
$239,487.00
|
$239,487.00
|
2024-12-15
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
18
|
14
|
$0.01
|
—
|
$145,926.62
|
$334,284.78
|
$218,889.93
|
2026-04-01
|
|
94
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
3
|
3
|
$0.01
|
—
|
$205,618.00
|
$215,898.00
|
$215,898.00
|
2024-12-15
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
18
|
14
|
$0.01
|
—
|
$139,701.00
|
$332,322.96
|
$208,580.00
|
2026-04-01
|
|
5833
|
APR_DRG
|
Neonate With Ecmo
|
3
|
3
|
$0.01
|
—
|
$180,646.00
|
$189,678.00
|
$189,678.00
|
2024-12-15
|
|
1613
|
APR_DRG
|
Implantable Heart Assist Systems
|
3
|
3
|
$0.01
|
—
|
$174,866.00
|
$183,610.00
|
$183,610.00
|
2024-12-15
|
|
44
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
3
|
3
|
$0.01
|
—
|
$172,134.00
|
$180,740.00
|
$180,740.00
|
2024-12-15
|
|
6304
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
3
|
3
|
$0.01
|
—
|
$171,956.00
|
$180,553.00
|
$180,553.00
|
2024-12-15
|
|
5884
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
3
|
3
|
$0.01
|
—
|
$168,551.00
|
$176,979.00
|
$176,979.00
|
2024-12-15
|
|
C1831
|
HCPCS
|
Kit Imp Aprevo Spine Lvl 1
|
72
|
15
|
$332,880.00
|
$166,440.00
50% off
|
$24,717.00
|
$359,160.00
|
$146,747.50
|
2024-12-15
|
|
24
|
APR_DRG
|
Heart And/or Lung Transplant
|
3
|
3
|
$0.01
|
—
|
$135,609.00
|
$142,389.00
|
$142,389.00
|
2024-12-15
|
|
5832
|
APR_DRG
|
Neonate With Ecmo
|
3
|
3
|
$0.01
|
—
|
$133,209.00
|
$139,870.00
|
$139,870.00
|
2024-12-15
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
18
|
14
|
$0.01
|
—
|
$92,768.00
|
$216,871.37
|
$138,180.00
|
2026-04-01
|
|
8414
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
3
|
3
|
$0.01
|
—
|
$126,148.00
|
$132,455.00
|
$132,455.00
|
2024-12-15
|
|
5914
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
3
|
3
|
$0.01
|
—
|
$123,507.00
|
$129,683.00
|
$129,683.00
|
2024-12-15
|
|
7
|
MS_DRG
|
Lung Transplant
|
18
|
14
|
$0.01
|
—
|
$85,947.00
|
$202,761.28
|
$127,948.00
|
2026-04-01
|
|
5883
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
3
|
3
|
$0.01
|
—
|
$120,530.00
|
$126,557.00
|
$126,557.00
|
2024-12-15
|
|
54
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
3
|
3
|
$0.01
|
—
|
$119,304.00
|
$125,269.00
|
$125,269.00
|
2024-12-15
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
18
|
14
|
$0.01
|
—
|
$83,367.70
|
$188,164.26
|
$125,051.55
|
2026-04-01
|
|
5882
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
3
|
3
|
$0.01
|
—
|
$118,022.00
|
$123,923.00
|
$123,923.00
|
2024-12-15
|
|
114
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
3
|
3
|
$0.01
|
—
|
$117,678.00
|
$123,562.00
|
$123,562.00
|
2024-12-15
|
|
6094
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
3
|
3
|
$0.01
|
—
|
$117,077.00
|
$122,930.00
|
$122,930.00
|
2024-12-15
|
|
5831
|
APR_DRG
|
Neonate With Ecmo
|
3
|
3
|
$0.01
|
—
|
$115,117.00
|
$120,873.00
|
$120,873.00
|
2024-12-15
|
|
13925-522-01
|
NDC
|
Pentamidine Isethionate 300 Mg In Solr
|
19
|
15
|
$251,521.01
|
$125,760.50
50% off
|
$27,296.00
|
$206,247.00
|
$116,771.50
|
2024-12-15
|
|
1612
|
APR_DRG
|
Implantable Heart Assist Systems
|
3
|
3
|
$0.01
|
—
|
$110,032.00
|
$115,533.00
|
$115,533.00
|
2024-12-15
|
|
74
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
3
|
3
|
$0.01
|
—
|
$108,598.00
|
$114,028.00
|
$114,028.00
|
2024-12-15
|
|
C1825
|
HCPCS
|
System Neo Barostim Includes 2102 Ipg 1036 Csl Kit
|
20
|
15
|
$245,280.00
|
$122,640.00
50% off
|
$26,619.00
|
$201,130.00
|
$113,874.50
|
2024-12-15
|
|
1611
|
APR_DRG
|
Implantable Heart Assist Systems
|
3
|
3
|
$0.01
|
—
|
$104,530.00
|
$109,756.00
|
$109,756.00
|
2024-12-15
|
|
58914-501-56
|
NDC
|
Mesalamine 1000 Mg Re Supp
|
19
|
15
|
$236,361.47
|
$118,180.74
50% off
|
$25,651.00
|
$193,816.00
|
$109,733.50
|
2024-12-15
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
18
|
14
|
$0.01
|
—
|
$72,776.00
|
$177,421.99
|
$108,192.00
|
2026-04-01
|
|
5934
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
3
|
3
|
$0.01
|
—
|
$102,283.00
|
$107,398.00
|
$107,398.00
|
2024-12-15
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
18
|
14
|
$0.01
|
—
|
$71,967.00
|
$170,255.78
|
$106,979.00
|
2026-04-01
|
|
C1824
|
HCPCS
|
Generator Pul Implantable Optimizer Smt F/hrt Fail
|
20
|
15
|
$227,760.00
|
$113,880.00
50% off
|
$24,717.00
|
$186,763.00
|
$105,740.00
|
2024-12-15
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
18
|
14
|
$0.01
|
—
|
$70,395.00
|
$161,431.50
|
$104,621.00
|
2026-04-01
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
18
|
14
|
$0.01
|
—
|
$69,552.94
|
$155,896.75
|
$104,095.00
|
2026-04-01
|
|
6034
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
3
|
3
|
$0.01
|
—
|
$98,082.00
|
$102,986.00
|
$102,986.00
|
2024-12-15
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
18
|
14
|
$0.01
|
—
|
$69,277.00
|
$172,558.93
|
$102,944.00
|
2026-04-01
|
|
64
|
APR_DRG
|
Pancreas Transplant
|
3
|
3
|
$0.01
|
—
|
$97,454.00
|
$102,327.00
|
$102,327.00
|
2024-12-15
|
|
A9520
|
HCPCS
|
Technetium-99 (tc-99) Tilmanocept (lymphoseek) Radio-isotope Injection
|
19
|
15
|
$777,723.00
|
$388,861.50
50% off
|
$10.00
|
$637,733.00
|
$101,804.00
|
2024-12-15
|
|
209
|
MS_DRG
|
Complex Aortic Arch Procedures
|
10
|
8
|
—
|
—
|
$78,681.45
|
$177,218.45
|
$99,532.03
|
2026-04-01
|
|
53
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
3
|
3
|
$0.01
|
—
|
$93,147.00
|
$97,804.00
|
$97,804.00
|
2024-12-15
|
|
6303
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
3
|
3
|
$0.01
|
—
|
$90,810.00
|
$95,351.00
|
$95,351.00
|
2024-12-15
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
18
|
14
|
$0.01
|
—
|
$63,979.00
|
$153,169.30
|
$94,996.00
|
2026-04-01
|
|
14
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
3
|
3
|
$0.01
|
—
|
$89,590.00
|
$94,070.00
|
$94,070.00
|
2024-12-15
|
|
13
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
3
|
3
|
$0.01
|
—
|
$89,590.00
|
$94,070.00
|
$94,070.00
|
2024-12-15
|
|
12
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
3
|
3
|
$0.01
|
—
|
$89,590.00
|
$94,070.00
|
$94,070.00
|
2024-12-15
|
|
C1822
|
HCPCS
|
Construct Neuromod Nevro Pain Mgmt Omnia With Ipg Rm
|
46
|
15
|
$194,691.00
|
$97,345.50
50% off
|
$19,489.00
|
$186,763.00
|
$94,010.50
|
2024-12-15
|
|
5933
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
3
|
3
|
$0.01
|
—
|
$88,324.00
|
$92,740.00
|
$92,740.00
|
2024-12-15
|
|
63323-877-15
|
NDC
|
Pentamidine Isethionate 300 Mg In Solr
|
19
|
15
|
$197,271.80
|
$98,635.90
50% off
|
$21,409.00
|
$161,763.00
|
$91,586.00
|
2024-12-15
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
18
|
14
|
$0.01
|
—
|
$60,855.45
|
$135,581.79
|
$90,762.00
|
2026-04-01
|
|
23
|
APR_DRG
|
Heart And/or Lung Transplant
|
3
|
3
|
$0.01
|
—
|
$84,769.00
|
$89,007.00
|
$89,007.00
|
2024-12-15
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
3
|
3
|
$0.01
|
—
|
$84,514.00
|
$88,740.00
|
$88,740.00
|
2024-12-15
|
|
1634
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
3
|
3
|
$0.01
|
—
|
$81,963.00
|
$86,062.00
|
$86,062.00
|
2024-12-15
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
3
|
3
|
$0.01
|
—
|
$81,317.00
|
$85,383.00
|
$85,383.00
|
2024-12-15
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
18
|
14
|
$0.01
|
—
|
$56,412.00
|
$131,986.94
|
$83,646.00
|
2026-04-01
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
18
|
14
|
$0.01
|
—
|
$56,382.00
|
$131,572.03
|
$83,601.00
|
2026-04-01
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
18
|
14
|
$0.01
|
—
|
$55,555.00
|
$141,063.31
|
$82,361.00
|
2026-04-01
|
|
5881
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
3
|
3
|
$0.01
|
—
|
$77,687.00
|
$81,572.00
|
$81,572.00
|
2024-12-15
|
|
C1816
|
HCPCS
|
System Stim Nerv Stimq-4 8 Elect Dl Transm Kt
|
46
|
15
|
$157,680.00
|
$78,840.00
50% off
|
$1,901.00
|
$147,256.00
|
$81,363.00
|
2024-12-15
|
|
C2624
|
HCPCS
|
System Cardiomems Hrt Failure Ptnt
|
20
|
15
|
$174,762.00
|
$87,381.00
50% off
|
$18,966.00
|
$143,305.00
|
$81,135.50
|
2024-12-15
|
|
6314
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
3
|
3
|
$0.01
|
—
|
$77,236.00
|
$81,098.00
|
$81,098.00
|
2024-12-15
|
|
6334
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
3
|
3
|
$0.01
|
—
|
$76,815.00
|
$80,656.00
|
$80,656.00
|
2024-12-15
|
|
C9089
|
HCPCS
|
Bupivacaine Hcl (300 Mg Dose) 3 X 100 Mg Il Impl
|
31
|
15
|
$156,549.77
|
$78,274.88
50% off
|
$16,989.00
|
$131,963.00
|
$80,153.00
|
2024-12-15
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
18
|
14
|
$0.01
|
—
|
$53,758.00
|
$123,201.80
|
$79,666.00
|
2026-04-01
|
|
9504
|
APR_DRG
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
3
|
3
|
$0.01
|
—
|
$75,506.00
|
$79,281.00
|
$79,281.00
|
2024-12-15
|
|
C2616
|
HCPCS
|
Microsphere Gl Therasphere Y-90 3 Gbq
|
33
|
15
|
$160,702.20
|
$80,351.10
50% off
|
$17,107.00
|
$131,776.00
|
$78,905.00
|
2024-12-15
|
|
6344
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…
|
3
|
3
|
$0.01
|
—
|
$74,920.00
|
$78,666.00
|
$78,666.00
|
2024-12-15
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
18
|
14
|
$0.01
|
—
|
$52,186.00
|
$119,700.90
|
$77,307.00
|
2026-04-01
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
18
|
14
|
$0.01
|
—
|
$51,678.00
|
$120,219.14
|
$76,546.00
|
2026-04-01
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
18
|
14
|
$0.01
|
—
|
$50,909.14
|
$112,349.93
|
$76,363.71
|
2026-04-01
|
|
6024
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
3
|
3
|
$0.01
|
—
|
$72,386.00
|
$76,005.00
|
$76,005.00
|
2024-12-15
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
18
|
14
|
$0.01
|
—
|
$50,633.63
|
$111,706.43
|
$75,950.44
|
2026-04-01
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
18
|
14
|
$0.01
|
—
|
$49,922.00
|
$119,304.77
|
$73,911.00
|
2026-04-01
|
|
43
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
3
|
3
|
$0.01
|
—
|
$70,348.00
|
$73,865.00
|
$73,865.00
|
2024-12-15
|
|
9104
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
3
|
3
|
$0.01
|
—
|
$69,659.00
|
$73,142.00
|
$73,142.00
|
2024-12-15
|
|
5913
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
3
|
3
|
$0.01
|
—
|
$69,030.00
|
$72,482.00
|
$72,482.00
|
2024-12-15
|
|
C1767
|
HCPCS
|
Stimulator Proclaim Elite 5 W/ptnt Cntrl
|
345
|
15
|
$144,540.00
|
$72,270.00
50% off
|
$9,749.00
|
$281,186.00
|
$70,926.00
|
2024-12-15
|
|
C1882
|
HCPCS
|
Defibrillator Crdc Amplia MRI Quad Crt-d Surescan
|
785
|
15
|
$140,598.00
|
$70,299.00
50% off
|
$5.00
|
$234,108.00
|
$70,865.00
|
2024-12-15
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
18
|
14
|
$0.01
|
—
|
$47,598.00
|
$113,021.62
|
$70,425.00
|
2026-04-01
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
18
|
14
|
$0.01
|
—
|
$47,369.00
|
$111,640.67
|
$70,081.00
|
2026-04-01
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
18
|
14
|
$0.01
|
—
|
$46,658.00
|
$108,218.05
|
$69,016.00
|
2026-04-01
|
|
1654
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
3
|
3
|
$0.01
|
—
|
$65,441.00
|
$68,713.00
|
$68,713.00
|
2024-12-15
|
|
6023
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
3
|
3
|
$0.01
|
—
|
$65,146.00
|
$68,403.00
|
$68,403.00
|
2024-12-15
|
|
22
|
APR_DRG
|
Heart And/or Lung Transplant
|
3
|
3
|
$0.01
|
—
|
$64,811.00
|
$68,051.00
|
$68,051.00
|
2024-12-15
|
|
21
|
APR_DRG
|
Heart And/or Lung Transplant
|
3
|
3
|
$0.01
|
—
|
$64,811.00
|
$68,051.00
|
$68,051.00
|
2024-12-15
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
18
|
14
|
$0.01
|
—
|
$45,834.00
|
$105,388.83
|
$67,780.00
|
2026-04-01
|
|
5932
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
3
|
3
|
$0.01
|
—
|
$64,115.00
|
$67,321.00
|
$67,321.00
|
2024-12-15
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
18
|
14
|
$0.01
|
—
|
$45,040.00
|
$104,613.81
|
$66,588.00
|
2026-04-01
|
|
3034
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
3
|
3
|
$0.01
|
—
|
$63,256.00
|
$66,418.00
|
$66,418.00
|
2024-12-15
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc
|
18
|
14
|
$0.01
|
—
|
$44,874.00
|
$112,302.96
|
$66,339.00
|
2026-04-01
|
|
8424
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
3
|
3
|
$0.01
|
—
|
$63,093.00
|
$66,248.00
|
$66,248.00
|
2024-12-15
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
18
|
14
|
$0.01
|
—
|
$44,801.00
|
$107,687.28
|
$66,230.00
|
2026-04-01
|
|
7114
|
APR_DRG
|
Post-operative, Post-trauma, Other Device Infections With O.r. Procedure
|
3
|
3
|
$0.01
|
—
|
$61,727.00
|
$64,814.00
|
$64,814.00
|
2024-12-15
|
|
C1823
|
HCPCS
|
Generator Implantable Remede Pul Cent Sleep Apnea
|
33
|
15
|
$223,380.00
|
$111,690.00
50% off
|
$8,556.00
|
$183,172.00
|
$64,649.00
|
2024-12-15
|
|
214
|
APR_DRG
|
Open Craniotomy Except Trauma
|
3
|
3
|
$0.01
|
—
|
$61,519.00
|
$64,595.00
|
$64,595.00
|
2024-12-15
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
18
|
14
|
$0.01
|
—
|
$43,513.00
|
$100,748.10
|
$64,298.00
|
2026-04-01
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
18
|
14
|
$0.01
|
—
|
$43,453.00
|
$102,949.47
|
$64,208.00
|
2026-04-01
|
|
6022
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
3
|
3
|
$0.01
|
—
|
$59,987.00
|
$62,986.00
|
$62,986.00
|
2024-12-15
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$42,595.00
|
$95,841.19
|
$62,920.00
|
2026-04-01
|
|
A9595
|
HCPCS
|
Piflufolastat F 18 9 Mci IV Sosy
|
19
|
15
|
$479,623.55
|
$239,811.77
50% off
|
$615.00
|
$393,291.00
|
$62,783.00
|
2024-12-15
|
|
73
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
3
|
3
|
$0.01
|
—
|
$59,649.00
|
$62,631.00
|
$62,631.00
|
2024-12-15
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
18
|
14
|
$0.01
|
—
|
$41,760.00
|
$94,045.34
|
$61,668.00
|
2026-04-01
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
18
|
14
|
$0.01
|
—
|
$41,708.00
|
$104,690.53
|
$61,591.00
|
2026-04-01
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
18
|
14
|
$0.01
|
—
|
$41,527.00
|
$102,575.27
|
$61,319.00
|
2026-04-01
|
|
83
|
APR_DRG
|
Autologous Bone Marrow Transplant
|
3
|
3
|
$0.01
|
—
|
$58,123.00
|
$61,030.00
|
$61,030.00
|
2024-12-15
|
|
84
|
APR_DRG
|
Autologous Bone Marrow Transplant
|
3
|
3
|
$0.01
|
—
|
$58,123.00
|
$61,030.00
|
$61,030.00
|
2024-12-15
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
18
|
14
|
$0.01
|
—
|
$41,209.00
|
$94,922.13
|
$60,841.00
|
2026-04-01
|
|
113
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
3
|
3
|
$0.01
|
—
|
$57,924.00
|
$60,821.00
|
$60,821.00
|
2024-12-15
|
|
A9588
|
HCPCS
|
Fluciclovine F 18 9-221 Mci/ml IV Soln
|
19
|
15
|
$464,493.00
|
$232,246.50
50% off
|
$82.00
|
$380,884.00
|
$60,802.00
|
2024-12-15
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$41,021.00
|
$94,071.95
|
$60,560.00
|
2026-04-01
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/Mcc
|
18
|
14
|
$0.01
|
—
|
$40,741.00
|
$92,841.31
|
$60,140.00
|
2026-04-01
|
|
38240
|
HCPCS
|
Transplt Allo Hct/donor
|
6
|
5
|
—
|
—
|
$3,567.00
|
$116,075.10
|
$60,028.74
|
2026-04-01
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
18
|
14
|
$0.01
|
—
|
$39,830.65
|
$86,473.61
|
$59,745.98
|
2026-04-01
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$40,451.00
|
$95,952.36
|
$59,705.00
|
2026-04-01
|
|
1304
|
APR_DRG
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
3
|
3
|
$0.01
|
—
|
$56,742.00
|
$59,579.00
|
$59,579.00
|
2024-12-15
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
18
|
14
|
$0.01
|
—
|
$40,184.00
|
$102,949.47
|
$59,305.00
|
2026-04-01
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
18
|
14
|
$0.01
|
—
|
$40,155.00
|
$93,057.38
|
$59,261.00
|
2026-04-01
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/Mcc
|
18
|
14
|
$0.01
|
—
|
$39,222.66
|
$85,053.52
|
$58,833.99
|
2026-04-01
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
18
|
14
|
$0.01
|
—
|
$39,766.00
|
$91,884.67
|
$58,677.00
|
2026-04-01
|
|
9124
|
APR_DRG
|
Musculoskeletal And Other Procedures For Multiple Significant Trauma
|
3
|
3
|
$0.01
|
—
|
$55,646.00
|
$58,428.00
|
$58,428.00
|
2024-12-15
|
|
1784
|
APR_DRG
|
External Heart Assist Systems
|
3
|
3
|
$0.01
|
—
|
$55,431.00
|
$58,203.00
|
$58,203.00
|
2024-12-15
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$39,368.00
|
$91,825.17
|
$58,080.00
|
2026-04-01
|
|
C1721
|
HCPCS
|
Defibrillator Maximo Ii Dr 2chb Is1 Df1 Av 35jl 37
|
655
|
15
|
$117,296.40
|
$58,648.20
50% off
|
$8.00
|
$148,096.00
|
$57,958.00
|
2024-12-15
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
18
|
14
|
$0.01
|
—
|
$38,835.00
|
$93,364.26
|
$57,281.00
|
2026-04-01
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
18
|
14
|
$0.01
|
—
|
$38,615.00
|
$89,719.31
|
$56,950.00
|
2026-04-01
|
|
1303
|
APR_DRG
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
3
|
3
|
$0.01
|
—
|
$53,686.00
|
$56,371.00
|
$56,371.00
|
2024-12-15
|
|
C1820
|
HCPCS
|
Stimulator Neurostim Prodigy MRI Ipg W/burstdr
|
241
|
15
|
$125,268.00
|
$62,634.00
50% off
|
$898.00
|
$183,567.00
|
$56,259.00
|
2024-12-15
|
|
42
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
3
|
3
|
$0.01
|
—
|
$53,187.00
|
$55,847.00
|
$55,847.00
|
2024-12-15
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$37,641.36
|
$81,360.03
|
$55,692.00
|
2026-04-01
|
|
1664
|
APR_DRG
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
3
|
3
|
$0.01
|
—
|
$52,894.00
|
$55,538.00
|
$55,538.00
|
2024-12-15
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
18
|
14
|
$0.01
|
—
|
$37,472.00
|
$85,955.36
|
$55,236.00
|
2026-04-01
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
18
|
14
|
$0.01
|
—
|
$37,472.00
|
$82,885.03
|
$55,236.00
|
2026-04-01
|
|
2204
|
APR_DRG
|
Major Stomach, Esophageal And Duodenal Procedures
|
3
|
3
|
$0.01
|
—
|
$52,492.00
|
$55,116.00
|
$55,116.00
|
2024-12-15
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
18
|
14
|
$0.01
|
—
|
$37,323.00
|
$88,023.65
|
$55,012.00
|
2026-04-01
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
18
|
14
|
$0.01
|
—
|
$37,107.00
|
$90,295.48
|
$54,688.00
|
2026-04-01
|
|
4404
|
APR_DRG
|
Kidney Transplant
|
3
|
3
|
$0.01
|
—
|
$51,910.00
|
$54,506.00
|
$54,506.00
|
2024-12-15
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
18
|
14
|
$0.01
|
—
|
$36,918.00
|
$87,751.22
|
$54,405.00
|
2026-04-01
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$36,838.00
|
$85,651.62
|
$54,285.00
|
2026-04-01
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
18
|
14
|
$0.01
|
—
|
$36,660.00
|
$89,237.07
|
$54,018.00
|
2026-04-01
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
18
|
14
|
$0.01
|
—
|
$36,627.00
|
$85,394.84
|
$53,969.00
|
2026-04-01
|
|
6074
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
3
|
3
|
$0.01
|
—
|
$51,216.00
|
$53,777.00
|
$53,777.00
|
2024-12-15
|
|
1674
|
APR_DRG
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
3
|
3
|
$0.01
|
—
|
$51,070.00
|
$53,623.00
|
$53,623.00
|
2024-12-15
|
|
6114
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
3
|
3
|
$0.01
|
—
|
$51,051.00
|
$53,604.00
|
$53,604.00
|
2024-12-15
|
|
1633
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
3
|
3
|
$0.01
|
—
|
$51,039.00
|
$53,591.00
|
$53,591.00
|
2024-12-15
|
|
3031
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
3
|
3
|
$0.01
|
—
|
$50,955.00
|
$53,503.00
|
$53,503.00
|
2024-12-15
|
|
3032
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
3
|
3
|
$0.01
|
—
|
$50,955.00
|
$53,503.00
|
$53,503.00
|
2024-12-15
|
|
3033
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
3
|
3
|
$0.01
|
—
|
$50,955.00
|
$53,503.00
|
$53,503.00
|
2024-12-15
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
18
|
14
|
$0.01
|
—
|
$35,662.56
|
$76,738.09
|
$53,493.84
|
2026-04-01
|
|
63
|
APR_DRG
|
Pancreas Transplant
|
3
|
3
|
$0.01
|
—
|
$50,717.00
|
$53,253.00
|
$53,253.00
|
2024-12-15
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
18
|
14
|
$0.01
|
—
|
$36,140.00
|
$85,529.49
|
$53,239.00
|
2026-04-01
|
|
93
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
3
|
3
|
$0.01
|
—
|
$50,581.00
|
$53,110.00
|
$53,110.00
|
2024-12-15
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
18
|
14
|
$0.01
|
—
|
$35,989.00
|
$83,495.65
|
$53,012.00
|
2026-04-01
|
|
6093
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
3
|
3
|
$0.01
|
—
|
$50,358.00
|
$52,875.00
|
$52,875.00
|
2024-12-15
|
|
C1722
|
HCPCS
|
Defibrillator Crdc Ilesto Vr-t Df4 1chb
|
631
|
15
|
$109,500.00
|
$54,750.00
50% off
|
$4,649.00
|
$160,185.00
|
$52,655.00
|
2024-12-15
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
3
|
3
|
$0.01
|
—
|
$50,049.00
|
$52,551.00
|
$52,551.00
|
2024-12-15
|
|
1603
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
3
|
3
|
$0.01
|
—
|
$49,743.00
|
$52,230.00
|
$52,230.00
|
2024-12-15
|
|
1794
|
APR_DRG
|
Defibrillator Implants
|
3
|
3
|
$0.01
|
—
|
$49,671.00
|
$52,155.00
|
$52,155.00
|
2024-12-15
|
|
4403
|
APR_DRG
|
Kidney Transplant
|
3
|
3
|
$0.01
|
—
|
$49,582.00
|
$52,061.00
|
$52,061.00
|
2024-12-15
|
|
213
|
MS_DRG
|
Endovascular Abdominal Aorta With Iliac Branch Procedures
|
10
|
8
|
—
|
—
|
$41,063.38
|
$89,352.93
|
$51,945.18
|
2026-04-01
|
|
1824
|
APR_DRG
|
Other Peripheral Vascular And Related Procedures
|
3
|
3
|
$0.01
|
—
|
$49,443.00
|
$51,915.00
|
$51,915.00
|
2024-12-15
|
|
304
|
APR_DRG
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
3
|
3
|
$0.01
|
—
|
$49,277.00
|
$51,740.00
|
$51,740.00
|
2024-12-15
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
18
|
14
|
$0.01
|
—
|
$35,047.00
|
$83,445.55
|
$51,599.00
|
2026-04-01
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$34,937.00
|
$82,611.03
|
$51,434.00
|
2026-04-01
|
|
72
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
3
|
3
|
$0.01
|
—
|
$48,881.00
|
$51,325.00
|
$51,325.00
|
2024-12-15
|
|
914
|
APR_DRG
|
Other Major Head And Neck Procedures
|
3
|
3
|
$0.01
|
—
|
$48,670.00
|
$51,103.00
|
$51,103.00
|
2024-12-15
|
|
A9572
|
HCPCS
|
Indium In-111 Pentetreotide IV Kit
|
19
|
15
|
$390,363.81
|
$195,181.90
50% off
|
$58.00
|
$320,098.00
|
$51,099.00
|
2024-12-15
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
18
|
14
|
$0.01
|
—
|
$34,690.00
|
$81,500.95
|
$51,064.00
|
2026-04-01
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$34,590.00
|
$78,087.72
|
$50,913.00
|
2026-04-01
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
18
|
14
|
$0.01
|
—
|
$34,319.00
|
$77,059.06
|
$50,508.00
|
2026-04-01
|
|
913
|
APR_DRG
|
Other Major Head And Neck Procedures
|
3
|
3
|
$0.01
|
—
|
$48,033.00
|
$50,434.00
|
$50,434.00
|
2024-12-15
|
|
6134
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
3
|
3
|
$0.01
|
—
|
$47,897.00
|
$50,291.00
|
$50,291.00
|
2024-12-15
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
18
|
14
|
$0.01
|
—
|
$34,129.00
|
$75,220.93
|
$50,221.00
|
2026-04-01
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
18
|
14
|
$0.01
|
—
|
$34,104.00
|
$87,149.99
|
$50,184.00
|
2026-04-01
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$34,091.00
|
$77,323.66
|
$50,164.00
|
2026-04-01
|
|
6033
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
3
|
3
|
$0.01
|
—
|
$47,731.00
|
$50,117.00
|
$50,117.00
|
2024-12-15
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$33,975.00
|
$77,461.44
|
$49,991.00
|
2026-04-01
|
|
11
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
3
|
3
|
$0.01
|
—
|
$47,475.00
|
$49,849.00
|
$49,849.00
|
2024-12-15
|
|
1834
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
3
|
3
|
$0.01
|
—
|
$47,412.00
|
$49,782.00
|
$49,782.00
|
2024-12-15
|
|
7104
|
APR_DRG
|
Infectious And Parasitic Diseases Including HIV With O.r. Procedure
|
3
|
3
|
$0.01
|
—
|
$47,286.00
|
$49,650.00
|
$49,650.00
|
2024-12-15
|
|
6073
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
3
|
3
|
$0.01
|
—
|
$46,821.00
|
$49,162.00
|
$49,162.00
|
2024-12-15
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
18
|
14
|
$0.01
|
—
|
$33,355.00
|
$71,433.50
|
$49,060.00
|
2026-04-01
|
|
3124
|
APR_DRG
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
3
|
3
|
$0.01
|
—
|
$46,500.00
|
$48,825.00
|
$48,825.00
|
2024-12-15
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
18
|
14
|
$0.01
|
—
|
$33,165.00
|
$75,602.96
|
$48,776.00
|
2026-04-01
|
|
71
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
3
|
3
|
$0.01
|
—
|
$46,453.00
|
$48,775.00
|
$48,775.00
|
2024-12-15
|
|
1833
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
3
|
3
|
$0.01
|
—
|
$46,424.00
|
$48,745.00
|
$48,745.00
|
2024-12-15
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
18
|
14
|
$0.01
|
—
|
$33,113.00
|
$72,601.51
|
$48,698.00
|
2026-04-01
|
|
8413
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
3
|
3
|
$0.01
|
—
|
$46,295.00
|
$48,609.00
|
$48,609.00
|
2024-12-15
|
|
893
|
APR_DRG
|
Major Cranial Or Facial Bone Procedures
|
3
|
3
|
$0.01
|
—
|
$46,203.00
|
$48,513.00
|
$48,513.00
|
2024-12-15
|
|
894
|
APR_DRG
|
Major Cranial Or Facial Bone Procedures
|
3
|
3
|
$0.01
|
—
|
$46,203.00
|
$48,513.00
|
$48,513.00
|
2024-12-15
|
|
L8614
|
HCPCS
|
Kit Sound Nucleus 7 Procsr 2 Units
|
162
|
15
|
$116,070.00
|
$58,035.00
50% off
|
$230.00
|
$150,847.00
|
$48,162.00
|
2024-12-15
|
|
3044
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
3
|
3
|
$0.01
|
—
|
$45,710.00
|
$47,995.00
|
$47,995.00
|
2024-12-15
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
18
|
14
|
$0.01
|
—
|
$32,639.00
|
$73,240.31
|
$47,987.00
|
2026-04-01
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$32,506.00
|
$70,908.99
|
$47,788.00
|
2026-04-01
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
18
|
14
|
$0.01
|
—
|
$32,500.00
|
$73,459.51
|
$47,779.00
|
2026-04-01
|
|
6903
|
APR_DRG
|
Acute Leukemia
|
3
|
3
|
$0.01
|
—
|
$45,422.00
|
$47,693.00
|
$47,693.00
|
2024-12-15
|
|
6904
|
APR_DRG
|
Acute Leukemia
|
3
|
3
|
$0.01
|
—
|
$45,422.00
|
$47,693.00
|
$47,693.00
|
2024-12-15
|
|
1783
|
APR_DRG
|
External Heart Assist Systems
|
3
|
3
|
$0.01
|
—
|
$45,253.00
|
$47,516.00
|
$47,516.00
|
2024-12-15
|
|
1623
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
3
|
3
|
$0.01
|
—
|
$45,194.00
|
$47,454.00
|
$47,454.00
|
2024-12-15
|
|
62
|
APR_DRG
|
Pancreas Transplant
|
3
|
3
|
$0.01
|
—
|
$45,060.00
|
$47,313.00
|
$47,313.00
|
2024-12-15
|
|
61
|
APR_DRG
|
Pancreas Transplant
|
3
|
3
|
$0.01
|
—
|
$45,060.00
|
$47,313.00
|
$47,313.00
|
2024-12-15
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
18
|
14
|
$0.01
|
—
|
$32,184.00
|
$74,539.85
|
$47,305.00
|
2026-04-01
|
|
6032
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
3
|
3
|
$0.01
|
—
|
$44,936.00
|
$47,183.00
|
$47,183.00
|
2024-12-15
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$32,022.00
|
$71,784.21
|
$47,062.00
|
2026-04-01
|
|
33249
|
CPT
|
Hc Insj/rplcmt Perm Dfb W/trnsvns Lds 1/dual Chmbr
|
31
|
15
|
$100,954.06
|
$50,477.03
50% off
|
$9,101.00
|
$82,782.00
|
$47,019.00
|
2024-12-15
|
|
33264
|
CPT
|
Hc Rmvl Impltbl Dfb Pls Gen W/rplcmt Pls Gen Mlt Ld
|
31
|
15
|
$100,954.06
|
$50,477.03
50% off
|
$8,635.00
|
$82,782.00
|
$47,019.00
|
2024-12-15
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
18
|
14
|
$0.01
|
—
|
$31,845.00
|
$72,311.85
|
$46,795.00
|
2026-04-01
|
|
C1772
|
HCPCS
|
Pump Inf Synchromed Ii Ti 3.4x1x1in 40ml
|
33
|
15
|
$100,740.00
|
$50,370.00
50% off
|
$9,412.00
|
$82,607.00
|
$46,770.00
|
2024-12-15
|
|
1653
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
3
|
3
|
$0.01
|
—
|
$44,486.00
|
$46,710.00
|
$46,710.00
|
2024-12-15
|
|
C1827
|
HCPCS
|
Generator Imp Vivistim Vns Ipg 1001
|
33
|
15
|
$258,420.00
|
$129,210.00
50% off
|
$6,179.00
|
$211,904.00
|
$46,691.00
|
2024-12-15
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$31,570.00
|
$70,171.54
|
$46,384.00
|
2026-04-01
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
18
|
14
|
$0.01
|
—
|
$31,558.00
|
$73,609.82
|
$46,365.00
|
2026-04-01
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
18
|
14
|
$0.01
|
—
|
$31,464.00
|
$78,914.41
|
$46,224.00
|
2026-04-01
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$31,459.00
|
$71,967.40
|
$46,217.00
|
2026-04-01
|
|
1302
|
APR_DRG
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
3
|
3
|
$0.01
|
—
|
$44,011.00
|
$46,212.00
|
$46,212.00
|
2024-12-15
|
|
6804
|
APR_DRG
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
3
|
3
|
$0.01
|
—
|
$43,769.00
|
$45,957.00
|
$45,957.00
|
2024-12-15
|
|
0008-0423-03
|
NDC
|
Antivenin Micrurus Fulvius IV Solr
|
19
|
15
|
$98,393.34
|
$49,196.67
50% off
|
$10,678.00
|
$80,683.00
|
$45,680.50
|
2024-12-15
|
|
0008-0423-01
|
NDC
|
Antivenin Micrurus Fulvius IV Solr
|
19
|
15
|
$98,393.34
|
$49,196.67
50% off
|
$10,678.00
|
$80,683.00
|
$45,680.50
|
2024-12-15
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$30,943.00
|
$71,219.00
|
$45,443.00
|
2026-04-01
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
18
|
14
|
$0.01
|
—
|
$30,770.00
|
$67,213.94
|
$45,183.00
|
2026-04-01
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$30,690.00
|
$71,187.68
|
$45,064.00
|
2026-04-01
|
|
7404
|
APR_DRG
|
Mental Illness Diagnosis With O.r. Procedure
|
3
|
3
|
$0.01
|
—
|
$42,598.00
|
$44,728.00
|
$44,728.00
|
2024-12-15
|
|
6084
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
3
|
3
|
$0.01
|
—
|
$42,536.00
|
$44,663.00
|
$44,663.00
|
2024-12-15
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
18
|
14
|
$0.01
|
—
|
$30,422.00
|
$65,706.17
|
$44,661.00
|
2026-04-01
|
|
37231
|
CPT
|
Hc Revascularize Tibial/peron Artery,angioplasty/stent/atherectomy Init
|
28
|
15
|
$85,896.21
|
$42,948.10
50% off
|
$667.00
|
$140,870.00
|
$44,322.50
|
2024-12-15
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$30,179.00
|
$69,875.63
|
$44,297.00
|
2026-04-01
|
|
33262
|
CPT
|
Hc Rmvl Impltbl Dfb Plse Gen W/repl Plse Gen 1 Lead
|
31
|
15
|
$85,073.45
|
$42,536.72
50% off
|
$9,232.00
|
$73,634.00
|
$44,238.00
|
2024-12-15
|
|
2604
|
APR_DRG
|
Major Pancreas, Liver And Shunt Procedures
|
3
|
3
|
$0.01
|
—
|
$41,952.00
|
$44,050.00
|
$44,050.00
|
2024-12-15
|
|
458
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
18
|
14
|
$0.01
|
—
|
$29,699.00
|
$65,330.40
|
$43,576.00
|
2026-04-01
|
|
933
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
18
|
14
|
$0.01
|
—
|
$28,912.37
|
$60,971.49
|
$43,368.56
|
2026-04-01
|
|
6072
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
3
|
3
|
$0.01
|
—
|
$41,276.00
|
$43,340.00
|
$43,340.00
|
2024-12-15
|
|
9114
|
APR_DRG
|
Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma
|
3
|
3
|
$0.01
|
—
|
$41,266.00
|
$43,329.00
|
$43,329.00
|
2024-12-15
|
|
6814
|
APR_DRG
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
3
|
3
|
$0.01
|
—
|
$41,240.00
|
$43,302.00
|
$43,302.00
|
2024-12-15
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$29,362.00
|
$68,778.07
|
$43,072.00
|
2026-04-01
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
18
|
14
|
$0.01
|
—
|
$29,322.00
|
$67,754.10
|
$43,011.00
|
2026-04-01
|
|
1782
|
APR_DRG
|
External Heart Assist Systems
|
3
|
3
|
$0.01
|
—
|
$40,784.00
|
$42,823.00
|
$42,823.00
|
2024-12-15
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$29,128.00
|
$66,781.80
|
$42,720.00
|
2026-04-01
|
|
2304
|
APR_DRG
|
Major Small Bowel Procedures
|
3
|
3
|
$0.01
|
—
|
$40,576.00
|
$42,605.00
|
$42,605.00
|
2024-12-15
|
|
6083
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
3
|
3
|
$0.01
|
—
|
$40,509.00
|
$42,535.00
|
$42,535.00
|
2024-12-15
|
|
31
|
MS_DRG
|
Ventricular Shunt Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$28,880.00
|
$70,151.19
|
$42,348.00
|
2026-04-01
|
|
673
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$28,873.00
|
$65,784.45
|
$42,338.00
|
2026-04-01
|
|
793
|
MS_DRG
|
Full Term Neonate With Major Problems
|
18
|
14
|
$0.01
|
—
|
$28,750.00
|
$65,283.43
|
$42,154.00
|
2026-04-01
|
|
269
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
18
|
14
|
$0.01
|
—
|
$28,687.00
|
$66,122.64
|
$42,060.00
|
2026-04-01
|
|
6214
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
3
|
3
|
$0.01
|
—
|
$40,050.00
|
$42,052.00
|
$42,052.00
|
2024-12-15
|
|
33276
|
HCPCS
|
Insj Phrnc Nrv Stim Sys
|
6
|
5
|
—
|
—
|
$5,063.00
|
$81,281.53
|
$42,035.10
|
2026-04-01
|
|
64568
|
HCPCS
|
Inc For Vagus N Elect Impl
|
6
|
5
|
—
|
—
|
$6,215.00
|
$81,281.53
|
$42,035.10
|
2026-04-01
|
|
A9569
|
HCPCS
|
Technetium-99 (tc-99) Exametazime White Blood Cells Radio-isotope Injection
|
19
|
15
|
$320,392.36
|
$160,196.18
50% off
|
$56.00
|
$262,722.00
|
$41,939.00
|
2024-12-15
|
|
7594
|
APR_DRG
|
Eating Disorders
|
3
|
3
|
$0.01
|
—
|
$39,861.00
|
$41,854.00
|
$41,854.00
|
2024-12-15
|
|
C1833
|
HCPCS
|
Monitor Crdc The Guardian Amsg3-e
|
20
|
15
|
$89,790.00
|
$44,895.00
50% off
|
$9,744.00
|
$73,628.00
|
$41,686.00
|
2024-12-15
|
|
236
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
18
|
14
|
$0.01
|
—
|
$28,375.00
|
$65,584.04
|
$41,591.00
|
2026-04-01
|
|
958
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
18
|
14
|
$0.01
|
—
|
$28,360.00
|
$65,977.03
|
$41,569.00
|
2026-04-01
|
|
12
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
18
|
14
|
$0.01
|
—
|
$28,321.00
|
$66,009.91
|
$41,510.00
|
2026-04-01
|
|
L8619
|
HCPCS
|
Clip Phn Wrels Cochlear Baha 4 Sys
|
189
|
15
|
$100,740.00
|
$50,370.00
50% off
|
$275.00
|
$150,847.00
|
$41,364.00
|
2024-12-15
|
|
448
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical Without Mcc
|
18
|
14
|
$0.01
|
—
|
$28,191.00
|
$66,398.21
|
$41,315.00
|
2026-04-01
|
|
423
|
MS_DRG
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$28,088.00
|
$65,023.52
|
$41,160.00
|
2026-04-01
|
|
791
|
MS_DRG
|
Prematurity With Major Problems
|
18
|
14
|
$0.01
|
—
|
$28,040.00
|
$63,551.76
|
$41,088.00
|
2026-04-01
|
|
1673
|
APR_DRG
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
3
|
3
|
$0.01
|
—
|
$39,036.00
|
$40,988.00
|
$40,988.00
|
2024-12-15
|
|
1694
|
APR_DRG
|
Major Abdominal Vascular Procedures
|
3
|
3
|
$0.01
|
—
|
$38,928.00
|
$40,874.00
|
$40,874.00
|
2024-12-15
|
|
3043
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
3
|
3
|
$0.01
|
—
|
$38,653.00
|
$40,586.00
|
$40,586.00
|
2024-12-15
|
|
274
|
APR_DRG
|
Other Open Craniotomy
|
3
|
3
|
$0.01
|
—
|
$38,525.00
|
$40,451.00
|
$40,451.00
|
2024-12-15
|
|
6124
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
3
|
3
|
$0.01
|
—
|
$38,498.00
|
$40,423.00
|
$40,423.00
|
2024-12-15
|
|
6144
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
3
|
3
|
$0.01
|
—
|
$38,490.00
|
$40,414.00
|
$40,414.00
|
2024-12-15
|
|
33289
|
CPT
|
Hc Rhc W/plc Pressure Sensor
|
19
|
15
|
$77,382.17
|
$38,691.08
50% off
|
$8,398.00
|
$63,453.00
|
$40,393.00
|
2024-12-15
|
|
52
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
3
|
3
|
$0.01
|
—
|
$38,466.00
|
$40,389.00
|
$40,389.00
|
2024-12-15
|
|
907
|
MS_DRG
|
Other O.r. Procedures For Injuries With Mcc
|
18
|
14
|
$0.01
|
—
|
$27,550.00
|
$60,111.92
|
$40,353.00
|
2026-04-01
|
|
33263
|
CPT
|
Hc Rmvl Impltbl Dfb Plse Gen W/rplcmt Plse Gen 2 Ld
|
31
|
15
|
$77,499.95
|
$38,749.98
50% off
|
$8,411.00
|
$64,482.00
|
$40,300.00
|
2024-12-15
|
|
739
|
MS_DRG
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…
|
18
|
14
|
$0.01
|
—
|
$26,824.97
|
$56,191.00
|
$40,237.46
|
2026-04-01
|
|
3614
|
APR_DRG
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
3
|
3
|
$0.01
|
—
|
$38,106.00
|
$40,012.00
|
$40,012.00
|
2024-12-15
|
|
628
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$27,306.00
|
$58,350.51
|
$39,987.00
|
2026-04-01
|
|
736
|
MS_DRG
|
Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc
|
18
|
14
|
$0.01
|
—
|
$26,769.33
|
$55,965.95
|
$39,908.00
|
2026-04-01
|
|
876
|
MS_DRG
|
O.r. Procedures With Principal Diagnosis Of Mental Illness
|
18
|
14
|
$0.01
|
—
|
$27,202.00
|
$60,512.74
|
$39,831.00
|
2026-04-01
|
|
2614
|
APR_DRG
|
Major Biliary Tract Procedures
|
3
|
3
|
$0.01
|
—
|
$37,928.00
|
$39,825.00
|
$39,825.00
|
2024-12-15
|
|
1764
|
APR_DRG
|
Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices
|
3
|
3
|
$0.01
|
—
|
$37,925.00
|
$39,821.00
|
$39,821.00
|
2024-12-15
|
|
2314
|
APR_DRG
|
Major Large Bowel Procedures
|
3
|
3
|
$0.01
|
—
|
$37,866.00
|
$39,759.00
|
$39,759.00
|
2024-12-15
|
|
6954
|
APR_DRG
|
Chemotherapy For Acute Leukemia
|
3
|
3
|
$0.01
|
—
|
$37,787.00
|
$39,677.00
|
$39,677.00
|
2024-12-15
|
|
52427-273-75
|
NDC
|
Naproxen Sodium ER 500 Mg Po Tb24
|
19
|
15
|
$85,454.33
|
$42,727.16
50% off
|
$9,274.00
|
$70,073.00
|
$39,673.50
|
2024-12-15
|
|
402
|
MS_DRG
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
18
|
14
|
$0.01
|
—
|
$27,090.00
|
$62,948.97
|
$39,664.00
|
2026-04-01
|
|
273
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$27,078.00
|
$64,592.95
|
$39,645.00
|
2026-04-01
|
|
34
|
MS_DRG
|
Carotid Artery Stent Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$26,939.00
|
$60,603.55
|
$39,437.00
|
2026-04-01
|
|
616
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
18
|
14
|
$0.01
|
—
|
$26,185.48
|
$54,611.00
|
$39,208.00
|
2026-04-01
|
|
904
|
MS_DRG
|
Skin Grafts For Injuries With Cc/Mcc
|
18
|
14
|
$0.01
|
—
|
$26,762.00
|
$57,509.73
|
$39,171.00
|
2026-04-01
|
|
213
|
APR_DRG
|
Open Craniotomy Except Trauma
|
3
|
3
|
$0.01
|
—
|
$37,274.00
|
$39,137.00
|
$39,137.00
|
2024-12-15
|
|
93656
|
CPT
|
Hc Ephys Evl Trnsptl Tx Atrial Fib Isolat Pulm Vein
|
19
|
15
|
$76,404.56
|
$38,202.28
50% off
|
$8,292.00
|
$62,652.00
|
$39,119.00
|
2024-12-15
|
|
204
|
APR_DRG
|
Open Craniotomy For Trauma
|
3
|
3
|
$0.01
|
—
|
$37,235.00
|
$39,096.00
|
$39,096.00
|
2024-12-15
|
|
166
|
MS_DRG
|
Other Respiratory System O.r. Procedures With Mcc
|
18
|
14
|
$0.01
|
—
|
$26,692.00
|
$58,521.17
|
$39,067.00
|
2026-04-01
|
|
5104
|
APR_DRG
|
Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…
|
3
|
3
|
$0.01
|
—
|
$37,091.00
|
$38,946.00
|
$38,946.00
|
2024-12-15
|
|
1781
|
APR_DRG
|
External Heart Assist Systems
|
3
|
3
|
$0.01
|
—
|
$37,069.00
|
$38,923.00
|
$38,923.00
|
2024-12-15
|
|
33240
|
CPT
|
Hc Insj Implntbl Defib Pulse Gen W/1 Existing Ld
|
31
|
15
|
$80,085.22
|
$40,042.61
50% off
|
$8,045.00
|
$65,670.00
|
$38,918.00
|
2024-12-15
|
|
956
|
MS_DRG
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
18
|
14
|
$0.01
|
—
|
$26,513.00
|
$58,917.29
|
$38,798.00
|
2026-04-01
|
|
92
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
3
|
3
|
$0.01
|
—
|
$36,892.00
|
$38,736.00
|
$38,736.00
|
2024-12-15
|
|
234
|
APR_DRG
|
Spinal Procedures
|
3
|
3
|
$0.01
|
—
|
$36,830.00
|
$38,671.00
|
$38,671.00
|
2024-12-15
|
|
24
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
18
|
14
|
$0.01
|
—
|
$26,380.00
|
$61,248.62
|
$38,598.00
|
2026-04-01
|
|
5912
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
3
|
3
|
$0.01
|
—
|
$36,732.00
|
$38,569.00
|
$38,569.00
|
2024-12-15
|
|
924
|
APR_DRG
|
Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures
|
3
|
3
|
$0.01
|
—
|
$36,592.00
|
$38,422.00
|
$38,422.00
|
2024-12-15
|
|
5891
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
3
|
3
|
$0.01
|
—
|
$36,553.00
|
$38,380.00
|
$38,380.00
|
2024-12-15
|