|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
114
|
58
|
$3,506,913.00
|
$2,630,184.75
25% off
|
$527,558.67
|
$3,506,913.00
|
$2,139,216.93
|
2026-02-15
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel Car T
|
114
|
58
|
$3,486,862.50
|
$2,615,146.88
25% off
|
$524,542.39
|
$3,486,862.50
|
$2,126,986.12
|
2026-02-15
|
|
Q2058
|
HCPCS
|
Obecbtge Autol Up To 400 Mil
|
106
|
50
|
$3,465,000.00
|
$2,598,750.00
25% off
|
$278,250.00
|
$3,465,000.00
|
$2,182,950.00
|
2026-02-15
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
114
|
58
|
$3,445,566.50
|
$2,584,174.88
25% off
|
$518,330.08
|
$3,445,566.50
|
$2,101,795.56
|
2026-02-15
|
|
Q2053
|
HCPCS
|
Brexucabtagene Tecartus T-cell
|
114
|
58
|
$3,049,200.00
|
$2,286,900.00
25% off
|
$458,703.11
|
$3,049,200.00
|
$1,860,012.00
|
2026-02-15
|
|
Q2042
|
HCPCS
|
Kymriah T-cell Susp For Infusion
|
114
|
58
|
$3,015,811.00
|
$2,261,858.25
25% off
|
$453,680.27
|
$3,015,811.00
|
$1,839,644.71
|
2026-02-15
|
|
Q2041
|
HCPCS
|
Yescarta T-cell Susp For Infusion
|
114
|
58
|
$2,461,800.00
|
$1,846,350.00
25% off
|
$370,338.22
|
$2,461,800.00
|
$1,501,698.00
|
2026-02-15
|
|
J2326
|
HCPCS
|
Spinraza(nusinersen)12mg/5ml Soln
|
130
|
59
|
$816,348.50
|
$612,261.38
25% off
|
$6,149.45
|
$816,348.50
|
$367,356.83
|
2026-02-15
|
|
Q2043
|
HCPCS
|
Provenge(sipuleucel-t) Auto Cd54
|
150
|
59
|
$311,483.00
|
$233,612.25
25% off
|
$46,857.61
|
$311,483.00
|
$170,528.23
|
2026-02-15
|
|
J9269
|
HCPCS
|
Elzonris 1000mcg/1ml Soln
|
132
|
58
|
$188,362.50
|
$141,271.88
25% off
|
$356.93
|
$188,362.50
|
$81,711.65
|
2026-02-15
|
|
J9266
|
HCPCS
|
Oncaspar 3750u/5ml Sd Vial
|
186
|
59
|
$149,629.00
|
$112,221.75
25% off
|
$17,391.60
|
$390,830.85
|
$97,258.85
|
2026-02-15
|
|
C1605
|
HCPCS
|
05932602_aveir Dr
|
118
|
55
|
$129,938.00
|
$97,453.50
25% off
|
$19,547.08
|
$129,938.00
|
$64,969.00
|
2026-02-15
|
|
J7330
|
HCPCS
|
Cultured Chondrocytes 69866103005
|
96
|
40
|
$123,857.00
|
$92,892.75
25% off
|
$18,632.29
|
$123,857.00
|
$61,928.50
|
2026-02-15
|
|
C9293
|
HCPCS
|
Voraxaze 1000units/ml Soln
|
95
|
35
|
$117,450.00
|
$88,087.50
25% off
|
$355.34
|
$117,450.00
|
$73,993.50
|
2026-02-15
|
|
J9600
|
HCPCS
|
Photofrin 75mg Vial
|
116
|
50
|
$113,983.00
|
$85,487.25
25% off
|
$17,146.91
|
$872,223.12
|
$78,477.29
|
2026-02-15
|
|
C1721
|
HCPCS
|
Cardiovert Defib Dual Chamber
|
96
|
40
|
$108,296.00
|
$81,222.00
25% off
|
$16,291.39
|
$108,296.00
|
$54,148.00
|
2026-02-15
|
|
C1822
|
HCPCS
|
Gen Neurostimulator High Freq
|
97
|
41
|
$100,065.00
|
$75,048.75
25% off
|
$15,053.17
|
$100,065.00
|
$50,032.50
|
2026-02-15
|
|
0266T
|
CPT
|
Implt/rpl Crtd Sns Dev Total
|
112
|
51
|
$94,500.00
|
$70,875.00
25% off
|
$5,305.00
|
$96,184.51
|
$36,477.00
|
2026-02-15
|
|
C1722
|
HCPCS
|
Cardiovert Defib Single Chamber
|
96
|
40
|
$92,020.00
|
$69,015.00
25% off
|
$13,842.93
|
$92,020.00
|
$46,010.00
|
2026-02-15
|
|
C1882
|
HCPCS
|
Aicd Other Than Sing/dual
|
96
|
40
|
$91,645.00
|
$68,733.75
25% off
|
$13,786.52
|
$91,645.00
|
$45,822.50
|
2026-02-15
|
|
J3357
|
HCPCS
|
Stelara 45mg Syrg
|
257
|
44
|
$81,333.00
|
$60,999.75
25% off
|
$108.24
|
$162,665.50
|
$50,426.46
|
2026-02-15
|
|
C1735
|
HCPCS
|
Cath Renal Denerv Radiofreq
|
118
|
55
|
$80,000.00
|
$60,000.00
25% off
|
$12,034.71
|
$80,000.00
|
$40,000.00
|
2026-02-15
|
|
C1736
|
HCPCS
|
Cath Renal Denerv Ultrasnd
|
118
|
55
|
$80,000.00
|
$60,000.00
25% off
|
$12,034.71
|
$80,000.00
|
$40,000.00
|
2026-02-15
|
|
C1823
|
HCPCS
|
Gen Neuro Trans Sen/stim
|
96
|
40
|
$78,750.00
|
$59,062.50
25% off
|
$11,846.67
|
$78,750.00
|
$39,375.00
|
2026-02-15
|
|
C1825
|
HCPCS
|
Gen Neuro Carot Sinus Baro
|
96
|
40
|
$77,175.00
|
$57,881.25
25% off
|
$11,609.74
|
$77,175.00
|
$38,587.50
|
2026-02-15
|
|
C2616
|
HCPCS
|
Nm Ns Yttrium-90 Per Source
|
123
|
60
|
$71,433.00
|
$53,574.75
25% off
|
$10,745.95
|
$71,433.00
|
$35,716.50
|
2026-02-15
|
|
C2624
|
HCPCS
|
Wireless Pressure Sensor
|
96
|
40
|
$69,670.00
|
$52,252.50
25% off
|
$10,480.73
|
$69,670.00
|
$34,835.00
|
2026-02-15
|
|
L8614
|
HCPCS
|
Cochlear Implant Dev/sys Lvl 1
|
192
|
41
|
$60,486.00
|
$45,364.50
25% off
|
$9,099.15
|
$105,246.00
|
$42,249.47
|
2026-02-15
|
|
J1744
|
HCPCS
|
Firazyr 30mg/3ml Syr
|
98
|
44
|
$59,093.00
|
$44,319.75
25% off
|
$224.02
|
$59,093.00
|
$38,410.45
|
2026-02-15
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
33
|
32
|
—
|
—
|
$297,174.15
|
$2,860,061.00
|
$515,466.43
|
2026-02-15
|
|
7
|
MS_DRG
|
Lung Transplant
|
34
|
32
|
—
|
—
|
$102,981.20
|
$2,162,847.20
|
$355,151.91
|
2026-02-15
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
34
|
32
|
—
|
—
|
$202,655.78
|
$846,592.03
|
$222,442.77
|
2026-02-15
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
35
|
33
|
—
|
—
|
$10,000.00
|
$465,667.50
|
$170,912.88
|
2026-02-15
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
34
|
32
|
—
|
—
|
$154,487.60
|
$645,099.41
|
$169,407.91
|
2026-02-15
|
|
1614
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$154,022.14
|
$158,642.80
|
$154,022.14
|
2026-02-15
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
34
|
32
|
—
|
—
|
$111,343.38
|
$949,211.27
|
$150,039.18
|
2026-02-15
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
34
|
32
|
—
|
—
|
$86,834.44
|
$752,886.92
|
$113,024.05
|
2026-02-15
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
34
|
32
|
—
|
—
|
$49,835.04
|
$740,885.64
|
$103,677.45
|
2026-02-15
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
34
|
32
|
—
|
—
|
$15,552.82
|
$226,879.83
|
$94,702.28
|
2026-02-15
|
|
6304
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$94,514.36
|
$97,349.79
|
$94,514.36
|
2026-02-15
|
|
212
|
MS_DRG
|
Hip & Femur Procedures Except Major Joint Age 0-17
|
33
|
32
|
—
|
—
|
$59,547.22
|
$148,868.05
|
$86,971.20
|
2026-02-15
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
34
|
32
|
—
|
—
|
$77,157.92
|
$473,562.45
|
$85,565.45
|
2026-02-15
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
34
|
32
|
—
|
—
|
$74,653.43
|
$335,128.60
|
$83,535.41
|
2026-02-15
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
50
|
35
|
—
|
—
|
$26,794.00
|
$683,022.22
|
$81,514.34
|
2026-02-15
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
34
|
32
|
—
|
—
|
$38,211.34
|
$613,006.45
|
$79,936.20
|
2026-02-15
|
|
1604
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$79,428.67
|
$81,811.53
|
$79,428.67
|
2026-02-15
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
34
|
32
|
—
|
—
|
$42,875.48
|
$591,940.40
|
$77,810.30
|
2026-02-15
|
|
6314
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$75,442.81
|
$77,706.09
|
$75,442.81
|
2026-02-15
|
|
453
|
MS_DRG
|
Combined Anterior And Posterior Spinal Fusion With Mcc
|
35
|
33
|
—
|
—
|
$66,891.19
|
$273,655.62
|
$75,215.84
|
2026-02-15
|
|
9504
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$73,752.43
|
$75,965.00
|
$73,752.43
|
2026-02-15
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
34
|
32
|
—
|
—
|
$50,961.07
|
$557,980.25
|
$73,308.48
|
2026-02-15
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
41
|
34
|
—
|
—
|
$63,834.03
|
$312,560.30
|
$72,039.02
|
2026-02-15
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
35
|
33
|
—
|
—
|
$63,646.31
|
$325,502.69
|
$71,551.32
|
2026-02-15
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
39
|
33
|
—
|
—
|
$52,540.21
|
$540,754.16
|
$71,057.56
|
2026-02-15
|
|
570
|
MS_DRG
|
Skin Debridement With Mcc
|
34
|
32
|
—
|
—
|
$23,720.16
|
$561,768.89
|
$69,023.36
|
2026-02-15
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
34
|
32
|
—
|
—
|
$59,858.70
|
$387,183.73
|
$66,559.23
|
2026-02-15
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
41
|
34
|
—
|
—
|
$58,509.03
|
$302,432.06
|
$66,356.61
|
2026-02-15
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
51
|
34
|
—
|
—
|
$21,737.00
|
$215,419.13
|
$65,484.82
|
2026-02-15
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
34
|
32
|
—
|
—
|
$58,095.26
|
$179,465.74
|
$64,593.59
|
2026-02-15
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
34
|
32
|
—
|
—
|
$54,948.15
|
$363,908.35
|
$61,728.29
|
2026-02-15
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
35
|
32
|
—
|
—
|
$53,078.43
|
$205,349.01
|
$59,616.77
|
2026-02-15
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
42
|
32
|
—
|
—
|
$22,328.00
|
$155,140.74
|
$59,100.00
|
2026-02-15
|
|
5833
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$58,599.39
|
$60,357.37
|
$58,599.39
|
2026-02-15
|
|
5884
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$58,599.39
|
$60,357.37
|
$58,599.39
|
2026-02-15
|
|
5834
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$58,599.39
|
$60,357.37
|
$58,599.39
|
2026-02-15
|
|
0024
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$58,334.23
|
$60,084.26
|
$58,334.23
|
2026-02-15
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
34
|
32
|
—
|
—
|
$23,322.42
|
$111,124.31
|
$58,306.05
|
2026-02-15
|
|
5831
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$58,069.08
|
$59,811.15
|
$58,069.08
|
2026-02-15
|
|
5832
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$58,069.08
|
$59,811.15
|
$58,069.08
|
2026-02-15
|
|
6344
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$58,026.65
|
$59,767.45
|
$58,026.65
|
2026-02-15
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
34
|
32
|
—
|
—
|
$51,798.18
|
$203,377.17
|
$57,574.47
|
2026-02-15
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
33
|
32
|
—
|
—
|
$6,547.56
|
$78,083.19
|
$57,389.80
|
2026-02-15
|
|
459
|
MS_DRG
|
Spinal Fusion Except Cervical With Mcc
|
35
|
33
|
—
|
—
|
$51,098.20
|
$176,973.88
|
$57,380.46
|
2026-02-15
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
49
|
34
|
—
|
—
|
$26,794.00
|
$162,028.05
|
$57,248.76
|
2026-02-15
|
|
0083
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$56,773.93
|
$58,477.15
|
$56,773.93
|
2026-02-15
|
|
0113
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$56,579.42
|
$58,276.80
|
$56,579.42
|
2026-02-15
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
34
|
32
|
—
|
—
|
$39,456.38
|
$468,312.38
|
$55,792.94
|
2026-02-15
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
34
|
32
|
—
|
—
|
$23,868.21
|
$76,548.17
|
$54,311.77
|
2026-02-15
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
49
|
34
|
—
|
—
|
$20,990.36
|
$114,991.56
|
$54,213.71
|
2026-02-15
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
34
|
32
|
—
|
—
|
$36,320.17
|
$460,004.33
|
$53,917.59
|
2026-02-15
|
|
454
|
MS_DRG
|
Combined Anterior And Posterior Spinal Fusion With Cc
|
35
|
33
|
—
|
—
|
$35,838.64
|
$165,559.11
|
$53,251.88
|
2026-02-15
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
35
|
33
|
—
|
—
|
$47,207.07
|
$187,383.61
|
$53,107.96
|
2026-02-15
|
|
1613
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$53,031.12
|
$54,622.05
|
$53,031.12
|
2026-02-15
|
|
0074
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$53,031.12
|
$54,622.05
|
$53,031.12
|
2026-02-15
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
41
|
34
|
—
|
—
|
$36,648.00
|
$194,247.61
|
$52,822.21
|
2026-02-15
|
|
1784
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$52,652.11
|
$54,231.67
|
$52,652.11
|
2026-02-15
|
|
1303
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$52,439.95
|
$54,013.15
|
$52,439.95
|
2026-02-15
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
50
|
34
|
—
|
—
|
$21,737.00
|
$120,412.94
|
$51,716.46
|
2026-02-15
|
|
1664
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$51,665.46
|
$53,215.42
|
$51,665.46
|
2026-02-15
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
35
|
33
|
—
|
—
|
$30,773.79
|
$111,429.89
|
$51,344.95
|
2026-02-15
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
34
|
32
|
—
|
—
|
$46,120.34
|
$176,947.00
|
$51,245.61
|
2026-02-15
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
35
|
33
|
—
|
—
|
$29,523.14
|
$142,619.85
|
$50,879.31
|
2026-02-15
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
34
|
32
|
—
|
—
|
$43,927.45
|
$432,627.77
|
$50,816.94
|
2026-02-15
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
34
|
32
|
—
|
—
|
$45,660.53
|
$159,643.33
|
$50,733.08
|
2026-02-15
|
|
8414
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$50,379.56
|
$51,890.95
|
$50,379.56
|
2026-02-15
|
|
1634
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$49,894.95
|
$51,391.80
|
$49,894.95
|
2026-02-15
|
|
1674
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$49,883.92
|
$51,380.43
|
$49,883.92
|
2026-02-15
|
|
276
|
MS_DRG
|
Non-maligant Breast Disorders
|
41
|
32
|
—
|
—
|
$22,328.00
|
$70,317.29
|
$49,880.13
|
2026-02-15
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
34
|
32
|
—
|
—
|
$44,707.62
|
$286,913.55
|
$49,670.90
|
2026-02-15
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
51
|
35
|
—
|
—
|
$21,737.00
|
$173,429.85
|
$49,605.72
|
2026-02-15
|
|
6093
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$49,188.38
|
$50,664.03
|
$49,188.38
|
2026-02-15
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
34
|
32
|
—
|
—
|
$2,050.02
|
$105,855.09
|
$48,529.04
|
2026-02-15
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
36
|
34
|
—
|
—
|
$43,238.91
|
$373,981.41
|
$48,430.76
|
2026-02-15
|
|
4403
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$48,430.40
|
$49,883.31
|
$48,430.40
|
2026-02-15
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
34
|
32
|
—
|
—
|
$42,559.48
|
$126,655.08
|
$48,408.90
|
2026-02-15
|
|
0304
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$48,132.52
|
$49,576.50
|
$48,132.52
|
2026-02-15
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
35
|
32
|
—
|
—
|
$42,519.30
|
$225,144.85
|
$47,834.22
|
2026-02-15
|
|
6334
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$47,642.89
|
$49,072.18
|
$47,642.89
|
2026-02-15
|
|
0914
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$47,539.63
|
$48,965.82
|
$47,539.63
|
2026-02-15
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
41
|
34
|
—
|
—
|
$41,737.61
|
$111,085.61
|
$46,982.97
|
2026-02-15
|
|
1612
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$46,894.03
|
$48,300.85
|
$46,894.03
|
2026-02-15
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
34
|
32
|
—
|
—
|
$41,615.05
|
$369,444.80
|
$46,223.74
|
2026-02-15
|
|
7104
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$46,188.04
|
$47,573.68
|
$46,188.04
|
2026-02-15
|
|
1833
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$45,346.08
|
$46,706.46
|
$45,346.08
|
2026-02-15
|
|
8413
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$45,219.75
|
$46,576.34
|
$45,219.75
|
2026-02-15
|
|
834
|
MS_DRG
|
Acute Leukemia Without Major O.r. Procedures With Mcc
|
34
|
32
|
—
|
—
|
$15,926.24
|
$108,884.06
|
$45,154.64
|
2026-02-15
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
34
|
32
|
—
|
—
|
$7,559.25
|
$85,899.38
|
$45,115.00
|
2026-02-15
|
|
278
|
MS_DRG
|
Cellulitis Age >17 Without Cc
|
33
|
32
|
—
|
—
|
$5,772.38
|
$52,253.98
|
$44,851.33
|
2026-02-15
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
41
|
34
|
—
|
—
|
$36,189.36
|
$129,859.38
|
$44,641.82
|
2026-02-15
|
|
9124
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$44,477.18
|
$45,811.50
|
$44,477.18
|
2026-02-15
|
|
7114
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$44,438.63
|
$45,771.79
|
$44,438.63
|
2026-02-15
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
34
|
32
|
—
|
—
|
$28,283.34
|
$106,360.95
|
$44,431.25
|
2026-02-15
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
34
|
33
|
—
|
—
|
$39,113.56
|
$97,783.91
|
$44,315.14
|
2026-02-15
|
|
1783
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$44,202.65
|
$45,528.73
|
$44,202.65
|
2026-02-15
|
|
3033
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$44,182.52
|
$45,508.00
|
$44,182.52
|
2026-02-15
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
35
|
33
|
—
|
—
|
$38,275.18
|
$389,336.94
|
$44,113.45
|
2026-02-15
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
41
|
34
|
—
|
—
|
$39,160.84
|
$150,959.34
|
$43,899.31
|
2026-02-15
|
|
6094
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$43,750.67
|
$45,063.19
|
$43,750.67
|
2026-02-15
|
|
1653
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$43,453.28
|
$44,756.88
|
$43,453.28
|
2026-02-15
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
35
|
33
|
—
|
—
|
$10,000.00
|
$381,082.36
|
$43,388.66
|
2026-02-15
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
34
|
32
|
—
|
—
|
$38,978.75
|
$195,923.00
|
$43,285.15
|
2026-02-15
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
64
|
33
|
—
|
—
|
$10,000.00
|
$157,405.59
|
$42,866.96
|
2026-02-15
|
|
0093
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$42,775.14
|
$44,058.40
|
$42,775.14
|
2026-02-15
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
34
|
32
|
—
|
—
|
$33,846.06
|
$107,506.88
|
$42,375.07
|
2026-02-15
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
35
|
33
|
—
|
—
|
$37,072.69
|
$166,713.80
|
$41,706.78
|
2026-02-15
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
34
|
32
|
—
|
—
|
$37,250.75
|
$149,954.58
|
$41,359.02
|
2026-02-15
|
|
9104
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$41,324.41
|
$42,564.14
|
$41,324.41
|
2026-02-15
|
|
455
|
MS_DRG
|
Combined Anterior And Posterior Spinal Fusion Without Cc/mcc
|
35
|
33
|
—
|
—
|
$36,739.21
|
$146,158.35
|
$41,164.51
|
2026-02-15
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
34
|
32
|
—
|
—
|
$5,092.18
|
$85,527.73
|
$41,116.01
|
2026-02-15
|
|
2604
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$40,978.35
|
$42,207.71
|
$40,978.35
|
2026-02-15
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
33
|
32
|
—
|
—
|
$36,305.19
|
$236,647.50
|
$40,843.34
|
2026-02-15
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
35
|
32
|
—
|
—
|
$36,183.84
|
$162,067.99
|
$40,706.82
|
2026-02-15
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
34
|
32
|
—
|
—
|
$36,591.84
|
$170,430.30
|
$40,624.56
|
2026-02-15
|
|
277
|
MS_DRG
|
Cellulitis Age >17 W Cc
|
41
|
32
|
—
|
—
|
$22,328.00
|
$232,912.00
|
$40,513.68
|
2026-02-15
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
34
|
32
|
—
|
—
|
$35,333.96
|
$103,170.93
|
$40,473.04
|
2026-02-15
|
|
8634
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$40,330.70
|
$41,540.62
|
$40,330.70
|
2026-02-15
|
|
9114
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$40,307.94
|
$41,517.18
|
$40,307.94
|
2026-02-15
|
|
799
|
MS_DRG
|
Splenectomy With Mcc
|
34
|
32
|
—
|
—
|
$36,195.80
|
$103,507.48
|
$40,183.10
|
2026-02-15
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
35
|
33
|
—
|
—
|
$36,433.16
|
$97,360.51
|
$40,076.47
|
2026-02-15
|
|
0071
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$39,919.36
|
$41,116.94
|
$39,919.36
|
2026-02-15
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
35
|
32
|
—
|
—
|
$35,241.40
|
$91,615.14
|
$39,646.58
|
2026-02-15
|
|
C9760
|
HCPCS
|
Non-blind Interatrial Shunt
|
107
|
53
|
—
|
—
|
$6,858.00
|
$72,037.56
|
$39,447.78
|
2026-02-15
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
33
|
32
|
—
|
—
|
$34,614.94
|
$124,093.30
|
$38,941.81
|
2026-02-15
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
35
|
32
|
—
|
—
|
$20,520.08
|
$99,472.98
|
$38,770.72
|
2026-02-15
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
35
|
32
|
—
|
—
|
$33,613.41
|
$388,049.48
|
$38,754.70
|
2026-02-15
|
|
31
|
MS_DRG
|
Ventricular Shunt Procedures With Mcc
|
34
|
32
|
—
|
—
|
$33,021.63
|
$123,249.83
|
$38,732.10
|
2026-02-15
|
|
3032
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$38,369.24
|
$39,520.32
|
$38,369.24
|
2026-02-15
|
|
236
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
50
|
35
|
—
|
—
|
$21,737.00
|
$103,114.88
|
$38,154.13
|
2026-02-15
|
|
269
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
40
|
33
|
—
|
—
|
$32,786.02
|
$209,018.27
|
$38,104.89
|
2026-02-15
|
|
458
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
35
|
33
|
—
|
—
|
$33,671.46
|
$108,681.72
|
$37,700.03
|
2026-02-15
|
|
0274
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$37,630.60
|
$38,759.52
|
$37,630.60
|
2026-02-15
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
33
|
32
|
—
|
—
|
$33,325.79
|
$184,620.42
|
$37,491.51
|
2026-02-15
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
34
|
32
|
—
|
—
|
$26,958.36
|
$74,212.95
|
$37,398.82
|
2026-02-15
|
|
673
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Mcc
|
34
|
32
|
—
|
—
|
$33,013.74
|
$174,696.12
|
$37,202.53
|
2026-02-15
|
|
0023
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$37,121.78
|
$38,235.44
|
$37,121.78
|
2026-02-15
|
|
323
|
MS_DRG
|
Urinary Stones W Cc, &/or Esw Lithotripsy
|
33
|
32
|
—
|
—
|
$21,264.56
|
$53,161.41
|
$37,084.36
|
2026-02-15
|
|
423
|
MS_DRG
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
35
|
32
|
—
|
—
|
$32,050.81
|
$129,419.50
|
$36,885.85
|
2026-02-15
|
|
12
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
34
|
32
|
—
|
—
|
$32,336.86
|
$170,114.57
|
$36,877.91
|
2026-02-15
|
|
0094
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$36,856.63
|
$37,962.33
|
$36,856.63
|
2026-02-15
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
34
|
32
|
—
|
—
|
$33,841.49
|
$89,423.75
|
$36,656.65
|
2026-02-15
|
|
0022
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$36,591.47
|
$37,689.22
|
$36,591.47
|
2026-02-15
|
|
0204
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$36,370.17
|
$37,461.28
|
$36,370.17
|
2026-02-15
|
|
958
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
34
|
32
|
—
|
—
|
$29,256.10
|
$79,703.09
|
$36,326.27
|
2026-02-15
|
|
5104
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$36,230.21
|
$37,317.11
|
$36,230.21
|
2026-02-15
|
|
273
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures With Mcc
|
34
|
33
|
—
|
—
|
$30,812.88
|
$117,267.40
|
$36,068.08
|
2026-02-15
|
|
1794
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$36,051.23
|
$37,132.77
|
$36,051.23
|
2026-02-15
|
|
0234
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$35,974.67
|
$37,053.91
|
$35,974.67
|
2026-02-15
|
|
5891
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$35,704.07
|
$36,775.19
|
$35,704.07
|
2026-02-15
|
|
2314
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$35,573.67
|
$36,640.88
|
$35,573.67
|
2026-02-15
|
|
1792
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$35,360.25
|
$36,421.06
|
$35,360.25
|
2026-02-15
|
|
793
|
MS_DRG
|
Full Term Neonate With Major Problems
|
35
|
32
|
—
|
—
|
$3,415.28
|
$74,264.57
|
$35,332.70
|
2026-02-15
|
|
933
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
34
|
32
|
—
|
—
|
$31,699.01
|
$138,107.65
|
$35,170.71
|
2026-02-15
|
|
5883
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$35,000.54
|
$36,050.56
|
$35,000.54
|
2026-02-15
|
|
0073
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$35,000.54
|
$36,050.56
|
$35,000.54
|
2026-02-15
|
|
1654
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$34,937.01
|
$35,985.12
|
$34,937.01
|
2026-02-15
|
|
1214
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$34,812.87
|
$35,857.25
|
$34,812.87
|
2026-02-15
|
|
22
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…
|
34
|
32
|
—
|
—
|
$27,819.30
|
$357,603.65
|
$34,735.95
|
2026-02-15
|
|
0213
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$34,718.67
|
$35,760.23
|
$34,718.67
|
2026-02-15
|
|
34
|
MS_DRG
|
Carotid Artery Stent Procedures With Mcc
|
35
|
33
|
—
|
—
|
$30,642.68
|
$94,876.96
|
$34,685.77
|
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
|
|
0D168KA
|
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
|
|
0DV63DZ
|
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
|
|
0D168K9
|
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
|
|
0D1607B
|
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
|
|
0DN68ZZ
|
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
|
|
0DP643Z
|
OTHER
|
Bariatric Surgery
|
1
|
1
|
—
|
—
|
$34,622.00
|
$34,622.00
|
$34,622.00
|
2026-02-15
|
|
0DW643Z
|
OTHER
|
Bariatric Surgery
|
1
|
1
|
—
|
—
|
$34,622.00
|
$34,622.00
|
$34,622.00
|
2026-02-15
|
|
0DW64CZ
|
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
|
|
0DP67DZ
|
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
|
|
0DU677Z
|
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
|
|
0D168ZA
|
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
|
|
0DU68KZ
|
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
|
|
0DW04UZ
|
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
|
|
0D1607L
|
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
|
|
0D1607A
|
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
|
|
0DF60ZZ
|
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
|
|
0DU687Z
|
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
|
|
0D16079
|
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
|
|
0D164JA
|
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
|
|
0DQ63ZZ
|
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
|
|
0DW08UZ
|
OTHER
|
Bariatric Surgery
|
1
|
1
|
—
|
—
|
$34,622.00
|
$34,622.00
|
$34,622.00
|
2026-02-15
|
|
3E0G3GC
|
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
|
|
0D164KA
|
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
|
|
0D160KA
|
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
|
|
0DU60KZ
|
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
|
|
0D164ZL
|
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
|
|
0D768ZZ
|
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
|
|
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
|
|
0D1647A
|
OTHER
|
Bariatric Surgery
|
1
|
1
|
—
|
—
|
$34,622.00
|
$34,622.00
|
$34,622.00
|
2026-02-15
|
|
0D160KL
|
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
|
|
0D160J9
|
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
|
|
0D1687B
|
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
|
|
0DM60ZZ
|
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
|
|
0DV64CZ
|
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
|
|
0DF63ZZ
|
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
|
|
0DU647Z
|
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
|
|
0DF67ZZ
|
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
|
|
0DN60ZZ
|
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
|
|
0DN63ZZ
|
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
|
|
0D763DZ
|
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
|
|
0DU607Z
|
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
|
|
0DV63CZ
|
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
|
|
0D168ZL
|
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
|
|
0D160JB
|
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
|
|
0D767DZ
|
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
|
|
0D164JB
|
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
|
|
0D768DZ
|
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
|
|
0DV60ZZ
|
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
|
|
0D764ZZ
|
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
|
|
0D160KB
|
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
|
|
0DU64KZ
|
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
|
|
0D1647B
|
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
|
|
0D168J9
|
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
|
|
0DV63ZZ
|
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
|
|
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
|
|
876
|
MS_DRG
|
O.r. Procedures With Principal Diagnosis Of Mental Illness
|
34
|
32
|
—
|
—
|
$30,964.97
|
$86,300.43
|
$34,580.37
|
2026-02-15
|
|
5882
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$34,470.23
|
$35,504.33
|
$34,470.23
|
2026-02-15
|