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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

Atrium Health Navicent Rehabilitation Hospital

Macon, GA · CCN 113029 · Rates published

14,774 distinct procedures filed
19 distinct payers
833,729 rate rows
2025-11-19 last MRF observed
Data quality

634,580 of 833,729 rate rows are consumer-grade (76.1%)

199,149 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
professional (physician) fee — not the facility price 197,905
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 460
percent-of-charges filed in the dollar field — excluded from medians 397
per-diem day rate — not a per-procedure price 164
placeholder amount (≤ $0.02) — excluded from medians 80
exceeds 10× this hospital's gross charge — excluded from medians 75
template filing: same amount across many unrelated codes — excluded 68
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/11183/300371539_central-georgia-rehabilitation-llc_standardcharges.csv
Found on page https://navicenthealth.org/for-patients-and-visitors/pt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint 218c9149d7665796… · 1,388,812,786 bytes · first seen 2026-05-09

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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 9 $4,505,000.00 $4,595,100.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 10 $3,685,266.67 $4,422,320.00 $3,685,266.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 10 $3,316,462.59 $3,979,755.11 $3,316,462.59 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 10 $3,248,445.72 $3,898,134.86 $3,248,445.72 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 10 $2,945,740.00 $3,534,888.00 $2,945,740.00 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 10 $2,455,110.61 $2,946,132.73 $2,455,110.61 nat. median
$2,469,189
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 10 $2,332,000.00 $2,798,400.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
J2326
HCPCS 		Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution 19 $1,280.25 $1,378,686.64 $941,361.31 nat. median
$2,677
outlier · 351.6×
Q2057
HCPCS 		Afamitresgene Autoleucel 10 $770,620.00 $924,744.00 $770,620.00 nat. median
$824,563
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 11 $518,240.68 $710,071.44 $591,726.20 nat. median
$754,974
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 11 $507,495.55 $679,042.73 $565,868.95 nat. median
$675,122
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 11 $474,060.62 $675,045.82 $562,538.19 nat. median
$674,188
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 11 $484,690.30 $668,781.52 $557,317.93 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 11 $459,381.45 $639,876.21 $533,230.17 nat. median
$634,511
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 11 $449,440.00 $587,165.53 $489,304.61 nat. median
$620,080
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 14 $293,336.99 $866,036.74 $440,108.38 nat. median
$370,174
1.2× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 14 $219,776.98 $646,856.84 $328,724.06 nat. median
$265,286
1.2× median
J0801
HCPCS 		Corticotropin 80 Unit/ml Injection Gel 18 $3,370.39 $431,860.38 $294,872.41 nat. median
$5,814
outlier · 50.7×
C9293
HCPCS 		Glucarpidase 1,000 Unit Intravenous Solution 18 $516.74 $411,660.32 $281,079.90 nat. median
$21,340
outlier · 13.2×
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 10 $278,250.00 $333,900.00 $278,250.00 nat. median
$324,450
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 14 $185,515.25 $544,770.38 $276,845.08 nat. median
$206,368
1.3× median
J3403
HCPCS 		Revakinagene, Per Implant 10 $257,500.00 $309,000.00 $257,500.00 nat. median
$265,000
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 14 $167,856.82 $492,155.26 $250,106.77 nat. median
$202,986
1.2× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 10 $205,640.00 $246,768.00 $205,640.00 nat. median
$209,753
1.0× median
J9269
HCPCS 		Tagraxofusp-erzs 1,000 Mcg/ml Intravenous Solution 19 $321.67 $290,438.12 $198,309.90 nat. median
$509
outlier · 389.4×
J9348
HCPCS 		Naxitamab-gqgk 4 Mg/ml Intravenous Solution 19 $610.03 $260,617.11 $177,948.24 nat. median
$887
outlier · 200.6×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And… 14 $111,582.97 $324,481.32 $164,897.10 nat. median
$133,176
1.2× median
J9347
HCPCS 		Tremelimumab-actl 20 Mg/ml Intravenous Solution 19 $135.75 $349,098.10 $157,375.67 nat. median
$3,461
outlier · 45.5×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 14 $103,658.58 $300,869.74 $152,898.01 nat. median
$117,303
1.3× median
7
MS_DRG 		Lung Transplant 14 $103,404.24 $300,111.92 $152,512.90 nat. median
$122,708
1.2× median
J9210
HCPCS 		Emapalumab-lzsg 5 Mg/ml Intravenous Solution 19 $364.87 $337,639.85 $152,210.22 nat. median
$756
outlier · 201.4×
J2350
HCPCS 		Ocrelizumab 30 Mg/ml Intravenous Solution 19 $58.76 $206,381.28 $140,916.25 nat. median
$712
outlier · 197.9×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 14 $87,611.71 $253,056.39 $128,599.90 nat. median
$108,660
1.2× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 14 $86,642.16 $250,167.52 $127,131.81 nat. median
$102,358
1.2× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 14 $84,757.78 $244,552.82 $124,278.50 nat. median
$100,136
1.2× median
215
MS_DRG 		Other Heart Assist System Implant 14 $84,336.98 $243,298.99 $123,641.32 nat. median
$99,019
1.2× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 $83,416.75 $240,557.09 $122,247.92 nat. median
$98,905
1.2× median
J9274
HCPCS 		Tebentafusp-tebn 100 Mcg/0.5 Ml Intravenous Solution 19 $208.93 $176,225.70 $120,326.15 nat. median
$418
outlier · 287.6×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 14 $77,063.83 $221,627.86 $112,628.34 nat. median
$93,672
1.2× median
J9334
HCPCS 		Efgartigimod Alfa 1008 Mg-hyaluron-qvfc 11,200 Unit/5.6 Ml Subcut Soln 19 $33.17 $160,844.38 $109,823.85 nat. median
$73
outlier · 1497.1×
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 10 $109,316.28 $131,179.54 $109,316.28 nat. median
$111,989
1.0× median
J9266
HCPCS 		Pegaspargase 750 Unit/ml Injection Solution 19 $25,781.46 $160,064.90 $109,291.62 nat. median
$34,109
outlier · 3.2×
850
MS_DRG 		Acute Leukemia With Other Procedures 14 $73,678.88 $211,542.07 $107,502.87 nat. median
$83,442
1.3× median
J0202
HCPCS 		Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution 19 $2,347.58 $151,777.40 $103,632.96 nat. median
$4,053
outlier · 25.6×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 14 $67,991.10 $194,594.64 $98,890.41 nat. median
$79,312
1.2× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 14 $67,954.85 $194,486.71 $98,835.56 nat. median
$81,118
1.2× median
J1304
HCPCS 		Tofersen 100 Mg/15 Ml (6.7 Mg/ml) Intrathecal Solution 19 $150.84 $142,975.78 $97,623.25 nat. median
$195
outlier · 501.2×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 14 $66,963.73 $191,533.54 $97,334.80 nat. median
$82,712
1.2× median
J3357
HCPCS 		Ustekinumab 45 Mg/0.5 Ml Subcutaneous Syringe 19 $149.40 $282,698.52 $96,512.76 nat. median
$14,306
outlier · 6.7×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 14 $64,809.59 $185,115.10 $94,073.04 nat. median
$77,576
1.2× median

Other procedures at this hospital

Browse this hospital's 14,774 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
             
J3391 HCPCS Inj, Atidarsagene Autotemcel 9 9 — — $4,505,000.00 $4,595,100.00 $4,505,000.00 2025-11-19
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 10 10 — — $3,685,266.67 $4,422,320.00 $3,685,266.67 2025-11-19
J1413 HCPCS Inj Delandistrogene Mox Rokl 10 10 — — $3,316,462.59 $3,979,755.11 $3,316,462.59 2025-11-19
J3394 HCPCS Inj, Lovotibeglogene Autotem 10 10 — — $3,248,445.72 $3,898,134.86 $3,248,445.72 2025-11-19
J3393 HCPCS Inj, Betibeglogene Autotemce 10 10 — — $2,945,740.00 $3,534,888.00 $2,945,740.00 2025-11-19
J3399 HCPCS Inj Onase Abepar-xioi Treat 10 10 — — $2,455,110.61 $2,946,132.73 $2,455,110.61 2025-11-19
J3392 HCPCS Inj, Exagamglogene Autotem 10 10 — — $2,332,000.00 $2,798,400.00 $2,332,000.00 2025-11-19
J2326 HCPCS Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution 48 19 $1,482,458.75 $741,229.38 50% off $1,280.25 $1,378,686.64 $941,361.31 2025-11-19
Q2057 HCPCS Afamitresgene Autoleucel 10 10 — — $770,620.00 $924,744.00 $770,620.00 2025-11-19
Q2042 HCPCS Tisagenlecleucel Car-pos T 11 11 — — $518,240.68 $710,071.44 $591,726.20 2025-11-19
Q2056 HCPCS Ciltacabtagene Car-pos T 11 11 — — $507,495.55 $679,042.73 $565,868.95 2025-11-19
Q2054 HCPCS Lisocabtagene Mara Car Pos T 11 11 — — $474,060.62 $675,045.82 $562,538.19 2025-11-19
Q2055 HCPCS Idecabtagene Vicleucel Car 11 11 — — $484,690.30 $668,781.52 $557,317.93 2025-11-19
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 11 11 — — $459,381.45 $639,876.21 $533,230.17 2025-11-19
Q2053 HCPCS Brexucabtagene Car Pos T 11 11 — — $449,440.00 $587,165.53 $489,304.61 2025-11-19
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 21 14 — — $293,336.99 $866,036.74 $440,108.38 2025-11-19
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 21 14 — — $219,776.98 $646,856.84 $328,724.06 2025-11-19
J0801 HCPCS Corticotropin 80 Unit/ml Injection Gel 36 18 $464,366.00 $232,183.00 50% off $3,370.39 $431,860.38 $294,872.41 2025-11-19
C9293 HCPCS Glucarpidase 1,000 Unit Intravenous Solution 36 18 $442,645.50 $221,322.75 50% off $516.74 $411,660.32 $281,079.90 2025-11-19
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 10 10 — — $278,250.00 $333,900.00 $278,250.00 2025-11-19
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 21 14 — — $185,515.25 $544,770.38 $276,845.08 2025-11-19
J3403 HCPCS Revakinagene, Per Implant 10 10 — — $257,500.00 $309,000.00 $257,500.00 2025-11-19
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 21 14 — — $167,856.82 $492,155.26 $250,106.77 2025-11-19
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 10 10 — — $205,640.00 $246,768.00 $205,640.00 2025-11-19
J9269 HCPCS Tagraxofusp-erzs 1,000 Mcg/ml Intravenous Solution 48 19 $312,299.05 $156,149.53 50% off $321.67 $290,438.12 $198,309.90 2025-11-19
J9348 HCPCS Naxitamab-gqgk 4 Mg/ml Intravenous Solution 48 19 $280,233.45 $140,116.73 50% off $610.03 $260,617.11 $177,948.24 2025-11-19
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And … 21 14 — — $111,582.97 $324,481.32 $164,897.10 2025-11-19
J9347 HCPCS Tremelimumab-actl 20 Mg/ml Intravenous Solution 66 19 $375,374.30 $187,687.15 50% off $135.75 $349,098.10 $157,375.67 2025-11-19
14 MS_DRG Allogeneic Bone Marrow Transplant 21 14 — — $103,658.58 $300,869.74 $152,898.01 2025-11-19
7 MS_DRG Lung Transplant 21 14 — — $103,404.24 $300,111.92 $152,512.90 2025-11-19
J9210 HCPCS Emapalumab-lzsg 5 Mg/ml Intravenous Solution 66 19 $363,053.60 $181,526.80 50% off $364.87 $337,639.85 $152,210.22 2025-11-19
J2350 HCPCS Ocrelizumab 30 Mg/ml Intravenous Solution 48 19 $221,915.35 $110,957.68 50% off $58.76 $206,381.28 $140,916.25 2025-11-19
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 21 14 — — $87,611.71 $253,056.39 $128,599.90 2025-11-19
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 21 14 — — $86,642.16 $250,167.52 $127,131.81 2025-11-19
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 21 14 — — $84,757.78 $244,552.82 $124,278.50 2025-11-19
215 MS_DRG Other Heart Assist System Implant 21 14 — — $84,336.98 $243,298.99 $123,641.32 2025-11-19
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 21 14 — — $83,416.75 $240,557.09 $122,247.92 2025-11-19
J9274 HCPCS Tebentafusp-tebn 100 Mcg/0.5 Ml Intravenous Solution 48 19 $189,490.00 $94,745.00 50% off $208.93 $176,225.70 $120,326.15 2025-11-19
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 21 14 — — $77,063.83 $221,627.86 $112,628.34 2025-11-19
J9334 HCPCS Efgartigimod Alfa 1008 Mg-hyaluron-qvfc 11,200 Unit/5.6 Ml Subcut Soln 48 19 $172,950.95 $86,475.48 50% off $33.17 $160,844.38 $109,823.85 2025-11-19
Q0480 HCPCS Driver Pneumatic Vad, Rep 10 10 — — $109,316.28 $131,179.54 $109,316.28 2025-11-19
J9266 HCPCS Pegaspargase 750 Unit/ml Injection Solution 48 19 $172,112.80 $86,056.40 50% off $25,781.46 $160,064.90 $109,291.62 2025-11-19
850 MS_DRG Acute Leukemia With Other Procedures 21 14 — — $73,678.88 $211,542.07 $107,502.87 2025-11-19
J0202 HCPCS Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution 48 19 $163,201.50 $81,600.75 50% off $2,347.58 $151,777.40 $103,632.96 2025-11-19
231 MS_DRG Coronary Bypass With Ptca With Mcc 21 14 — — $67,991.10 $194,594.64 $98,890.41 2025-11-19
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 21 14 — — $67,954.85 $194,486.71 $98,835.56 2025-11-19
J1304 HCPCS Tofersen 100 Mg/15 Ml (6.7 Mg/ml) Intrathecal Solution 48 19 $153,737.40 $76,868.70 50% off $150.84 $142,975.78 $97,623.25 2025-11-19
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 21 14 — — $66,963.73 $191,533.54 $97,334.80 2025-11-19
J3357 HCPCS Ustekinumab 45 Mg/0.5 Ml Subcutaneous Syringe 66 19 $151,988.60 $75,994.30 50% off $149.40 $282,698.52 $96,512.76 2025-11-19
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 21 14 — — $64,809.59 $185,115.10 $94,073.04 2025-11-19
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 10 10 — — $93,216.70 $111,860.04 $93,216.70 2025-11-19
10 MS_DRG Pancreas Transplant 21 14 — — $64,130.61 $183,091.97 $93,044.91 2025-11-19
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 21 14 — — $63,778.40 $182,042.52 $92,511.59 2025-11-19
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 21 14 — — $62,923.69 $179,495.81 $91,217.39 2025-11-19
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 21 14 — — $62,315.61 $177,683.95 $90,296.63 2025-11-19
J9298 HCPCS Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution 48 19 $139,906.15 $69,953.08 50% off $187.00 $130,112.72 $88,840.40 2025-11-19
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 21 14 — — $60,209.28 $171,407.89 $87,107.21 2025-11-19
J9043 HCPCS Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution 51 19 $132,868.30 $66,434.15 50% off $211.76 $123,567.52 $84,371.37 2025-11-19
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 21 14 — — $57,423.17 $163,106.40 $82,888.51 2025-11-19
J1305 HCPCS Evinacumab-dgnb 150 Mg/ml Intravenous Solution 66 19 $130,395.00 $65,197.50 50% off $179.14 $421,741.79 $82,800.82 2025-11-19
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 21 14 — — $57,148.03 $162,286.59 $82,471.89 2025-11-19
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 21 14 — — $56,296.39 $159,749.07 $81,182.36 2025-11-19
955 MS_DRG Craniotomy For Multiple Significant Trauma 21 14 — — $55,308.34 $156,805.08 $79,686.26 2025-11-19
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 21 14 — — $54,355.75 $153,966.73 $78,243.85 2025-11-19
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 21 14 — — $54,156.91 $153,374.26 $77,942.76 2025-11-19
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 21 14 — — $54,069.82 $153,114.77 $77,810.89 2025-11-19
J2329 HCPCS Ublituximab-xiiy 25 Mg/ml Intravenous Solution 48 19 $119,457.55 $59,728.78 50% off $67.23 $111,095.52 $75,855.54 2025-11-19
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 21 14 — — $52,525.34 $148,512.78 $75,472.22 2025-11-19
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 21 14 — — $52,453.65 $148,299.22 $75,363.69 2025-11-19
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 21 14 — — $51,423.98 $145,231.23 $73,804.58 2025-11-19
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 21 14 — — $50,422.83 $142,248.20 $72,288.65 2025-11-19
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 21 14 — — $50,361.19 $142,064.49 $72,195.29 2025-11-19
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 21 14 — — $50,143.85 $141,416.90 $71,866.19 2025-11-19
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 21 14 — — $49,978.16 $140,923.18 $71,615.29 2025-11-19
232 MS_DRG Coronary Bypass With Ptca Without Mcc 21 14 — — $49,762.34 $140,280.19 $71,288.53 2025-11-19
28 MS_DRG Spinal Procedures With Mcc 21 14 — — $49,537.29 $139,609.64 $70,947.77 2025-11-19
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 21 14 — — $49,201.28 $138,608.41 $70,438.95 2025-11-19
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 21 14 — — $49,201.28 $138,608.41 $70,438.95 2025-11-19
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 21 14 — — $48,853.68 $137,572.73 $69,912.64 2025-11-19
J9382 HCPCS Zenocutuzumab-zbco 375 Mg/18.75 Ml (20 Mg/ml) Intravenous Solution 68 19 $109,893.70 $54,946.85 50% off $32.91 $204,355.97 $69,782.50 2025-11-19
J2840 HCPCS Sebelipase Alfa 2 Mg/ml Intravenous Solution 48 19 $109,782.50 $54,891.25 50% off $539.91 $102,097.73 $69,711.89 2025-11-19
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 21 14 — — $48,533.85 $136,619.73 $69,428.33 2025-11-19
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 21 14 — — $48,499.16 $136,516.39 $69,375.82 2025-11-19
J9272 HCPCS Dostarlimab-gxly 50 Mg/ml Intravenous Solution 48 19 $109,148.05 $54,574.03 50% off $232.55 $101,507.69 $69,309.01 2025-11-19
J1303 HCPCS Ravulizumab-cwvz 100 Mg/ml Intravenous Solution 66 19 $185,644.95 $92,822.48 50% off $221.74 $172,649.80 $68,781.45 2025-11-19
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 21 14 — — $48,032.11 $135,124.77 $68,668.61 2025-11-19
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 21 14 — — $47,555.05 $133,703.30 $67,946.24 2025-11-19
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 10 10 — — $67,452.66 $80,943.19 $67,452.66 2025-11-19
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 21 14 — — $46,916.12 $131,799.58 $66,978.80 2025-11-19
J0222 HCPCS Patisiran (lipid Complex) 2 Mg/ml Intravenous Solution 48 19 $105,213.75 $52,606.88 50% off $99.20 $97,848.79 $66,810.74 2025-11-19
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 21 14 — — $46,651.78 $131,011.92 $66,578.52 2025-11-19
653 MS_DRG Major Bladder Procedures With Mcc 21 14 — — $45,646.00 $128,015.11 $65,055.58 2025-11-19
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 21 14 — — $45,281.48 $126,928.92 $64,503.59 2025-11-19
834 MS_DRG Acute Leukemia With Mcc 21 14 — — $45,281.48 $126,928.92 $64,503.59 2025-11-19
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 21 14 — — $45,102.66 $126,396.15 $64,232.85 2025-11-19
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 21 14 — — $44,843.71 $125,624.56 $63,840.74 2025-11-19
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 21 14 — — $44,617.12 $124,949.42 $63,497.64 2025-11-19
J3263 HCPCS Toripalimab-tpzi 240 Mg/6 Ml (40 Mg/ml) Intravenous Solution 48 19 $99,929.55 $49,964.78 50% off $39.41 $92,934.48 $63,455.26 2025-11-19
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 21 14 — — $44,521.55 $124,664.67 $63,352.93 2025-11-19
J9029 HCPCS Instill Adstiladrin, Tx Dose 11 11 — — $63,342.28 $76,010.74 $63,342.28 2025-11-19
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 21 14 — — $44,308.06 $124,028.56 $63,029.67 2025-11-19
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 21 14 — — $44,268.77 $123,911.45 $62,970.15 2025-11-19
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 21 14 — — $44,264.15 $123,897.67 $62,963.15 2025-11-19
J9119 HCPCS Cemiplimab-rwlc 50 Mg/ml Intravenous Solution 48 19 $98,162.55 $49,081.28 50% off $27.58 $91,291.17 $62,333.22 2025-11-19
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 21 14 — — $43,685.34 $122,173.07 $62,086.73 2025-11-19
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 21 14 — — $43,504.21 $121,633.42 $61,812.49 2025-11-19
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 21 14 — — $42,374.36 $118,266.90 $60,101.67 2025-11-19
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 21 14 — — $42,242.57 $117,874.21 $59,902.11 2025-11-19
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 21 14 — — $41,946.61 $116,992.39 $59,453.98 2025-11-19
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 21 14 — — $41,826.40 $116,634.16 $59,271.93 2025-11-19
38240 CPT Transplt Allo Hct/donor 14 11 — — $3,109.22 $60,325.18 $59,142.33 2025-11-19
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 21 14 — — $41,501.93 $115,667.37 $58,780.62 2025-11-19
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 21 14 — — $41,273.02 $114,985.34 $58,434.02 2025-11-19
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 21 14 — — $41,242.96 $114,895.78 $58,388.51 2025-11-19
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 21 14 — — $41,227.56 $114,849.85 $58,365.17 2025-11-19
J2323 HCPCS Natalizumab 300 Mg/15 Ml Intravenous Solution 48 19 $91,805.45 $45,902.73 50% off $24.00 $85,379.07 $58,296.46 2025-11-19
228 MS_DRG Other Cardiothoracic Procedures With Mcc 21 14 — — $41,088.84 $114,436.50 $58,155.11 2025-11-19
245 MS_DRG Aicd Generator Procedures 21 14 — — $40,345.09 $112,220.48 $57,028.96 2025-11-19
A9543 HCPCS Y90 Ibritumomab, Rx 10 10 — — $56,824.55 $68,189.46 $56,824.55 2025-11-19
471 MS_DRG Cervical Spinal Fusion With Mcc 21 14 — — $40,117.75 $111,543.04 $56,684.69 2025-11-19
6 MS_DRG Liver Transplant Without Mcc 21 14 — — $40,055.32 $111,357.03 $56,590.16 2025-11-19
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 21 14 — — $39,487.30 $109,664.58 $55,730.09 2025-11-19
799 MS_DRG Splenic Procedures With Mcc 21 14 — — $39,327.76 $109,189.23 $55,488.52 2025-11-19
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 21 14 — — $39,320.83 $109,168.56 $55,478.01 2025-11-19
J1930 HCPCS Lanreotide 90 Mg/0.3 Ml Subcutaneous Syringe 84 19 $87,161.05 $43,580.53 50% off $34.05 $95,596.10 $55,347.27 2025-11-19
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 11 11 — — $55,272.32 $66,326.79 $55,272.32 2025-11-19
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 21 14 — — $38,941.65 $108,038.73 $54,903.85 2025-11-19
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 21 14 — — $38,747.44 $107,460.04 $54,609.77 2025-11-19
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 21 14 — — $38,534.72 $106,826.23 $54,287.67 2025-11-19
163 MS_DRG Major Chest Procedures With Mcc 21 14 — — $38,205.61 $105,845.67 $53,789.36 2025-11-19
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 21 14 — — $38,190.98 $105,802.04 $53,767.19 2025-11-19
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 21 14 — — $38,077.68 $105,464.47 $53,595.64 2025-11-19
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 21 14 — — $38,072.29 $105,448.39 $53,587.47 2025-11-19
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 21 14 — — $37,453.42 $103,604.38 $52,650.37 2025-11-19
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 21 14 — — $37,246.07 $102,986.65 $52,336.45 2025-11-19
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 21 14 — — $37,150.52 $102,701.90 $52,191.74 2025-11-19
J9228 HCPCS Ipilimumab 50 Mg/10 Ml (5 Mg/ml) Intravenous Solution 63 19 $82,164.10 $41,082.05 50% off $172.71 $305,510.30 $52,174.20 2025-11-19
J9307 HCPCS Pralatrexate 40 Mg/2 Ml (20 Mg/ml) Intravenous Solution 102 19 $108,839.65 $54,419.83 50% off $234.32 $126,269.82 $51,838.54 2025-11-19
901 MS_DRG Wound Debridements For Injuries With Mcc 21 14 — — $36,828.36 $101,742.00 $51,703.94 2025-11-19
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 21 14 — — $36,537.81 $100,876.26 $51,263.98 2025-11-19
J9301 HCPCS Obinutuzumab 1,000 Mg/40 Ml Intravenous Solution 48 19 $79,717.70 $39,858.85 50% off $70.22 $74,137.46 $50,620.74 2025-11-19
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 21 14 — — $36,029.94 $99,362.93 $50,494.92 2025-11-19
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 21 14 — — $35,961.31 $99,158.55 $50,391.06 2025-11-19
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 21 14 — — $35,558.23 $97,957.53 $49,780.72 2025-11-19
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 21 14 — — $35,509.68 $97,812.86 $49,707.20 2025-11-19
140 MS_DRG Major Head And Neck Procedures With Mcc 21 14 — — $35,276.93 $97,119.35 $49,354.76 2025-11-19
31 MS_DRG Ventricular Shunt Procedures With Mcc 21 14 — — $34,979.44 $96,232.94 $48,904.30 2025-11-19
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 21 14 — — $34,971.74 $96,209.97 $48,892.63 2025-11-19
793 MS_DRG Full Term Neonate With Major Problems 21 14 — — $34,824.53 $95,771.36 $48,669.74 2025-11-19
L7181 HCPCS Electronic Elbo Simultaneous 10 10 — — $48,632.79 $58,359.35 $48,632.79 2025-11-19
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 21 14 — — $34,749.00 $95,546.31 $48,555.37 2025-11-19
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 21 14 — — $34,374.44 $94,430.26 $47,988.21 2025-11-19
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 21 14 — — $34,356.73 $94,377.45 $47,961.37 2025-11-19
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 21 14 — — $34,309.70 $94,237.37 $47,890.18 2025-11-19
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 21 14 — — $34,154.02 $93,773.49 $47,654.45 2025-11-19
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 21 14 — — $34,029.92 $93,403.77 $47,466.56 2025-11-19
791 MS_DRG Prematurity With Major Problems 21 14 — — $33,972.12 $93,231.54 $47,379.03 2025-11-19
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 21 14 — — $33,384.84 $91,481.69 $46,489.78 2025-11-19
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 21 14 — — $33,363.27 $91,417.39 $46,457.10 2025-11-19
J9022 HCPCS Atezolizumab 840 Mg/14 Ml (60 Mg/ml) Intravenous Solution 63 19 $72,905.55 $36,452.78 50% off $83.94 $96,840.30 $46,295.03 2025-11-19
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 21 14 — — $33,091.98 $90,609.05 $46,046.32 2025-11-19
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 21 14 — — $33,029.55 $90,423.05 $45,951.79 2025-11-19
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 19 13 — — $32,967.89 $90,239.33 $45,858.43 2025-11-19
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 21 14 — — $32,833.79 $89,839.76 $45,655.37 2025-11-19
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 21 14 — — $32,819.15 $89,796.13 $45,633.20 2025-11-19
34 MS_DRG Carotid Artery Stent Procedures With Mcc 21 14 — — $32,652.68 $89,300.11 $45,381.13 2025-11-19
J9063 HCPCS Mirvetuximab Soravtansine-gynx 5 Mg/ml Intravenous Solution 48 19 $71,331.05 $35,665.53 50% off $65.68 $66,337.88 $45,295.22 2025-11-19
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 21 14 — — $32,470.03 $88,755.86 $45,104.55 2025-11-19
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 21 14 — — $32,439.97 $88,666.30 $45,059.04 2025-11-19
J9226 HCPCS Supprelin La Implant 11 11 — — $44,578.75 $54,024.78 $45,020.65 2025-11-19
0266T CPT Fee Schedule 11 10 — — $6,829.20 $54,000.60 $45,000.50 2025-11-19
33276 CPT Insj Phrnc Nrv Stim Sys 12 10 — — $4,453.06 $45,900.51 $45,000.50 2025-11-19
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 21 14 — — $32,356.73 $88,418.29 $44,933.00 2025-11-19
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 21 14 — — $32,141.70 $87,777.59 $44,607.41 2025-11-19
J1323 HCPCS Elranatamab-bcmm 40 Mg/ml Subcutaneous Solution 67 19 $69,940.05 $34,970.03 50% off $181.67 $112,315.36 $44,411.93 2025-11-19
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 21 14 — — $31,982.16 $87,302.24 $44,365.84 2025-11-19
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 21 14 — — $31,754.05 $86,622.50 $44,020.41 2025-11-19
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 21 14 — — $31,522.04 $85,931.29 $43,669.14 2025-11-19
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 21 14 — — $30,802.99 $83,788.75 $42,580.33 2025-11-19
335 MS_DRG Peritoneal Adhesiolysis With Mcc 21 14 — — $30,607.98 $83,207.76 $42,285.08 2025-11-19
J9332 HCPCS Efgartigimod Alfa-fcab 20 Mg/ml Intravenous Solution 48 19 $66,571.60 $33,285.80 50% off $32.07 $61,911.59 $42,272.96 2025-11-19
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 21 14 — — $30,310.50 $82,321.35 $41,834.62 2025-11-19
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 21 14 — — $30,308.95 $82,316.75 $41,832.28 2025-11-19
J9333 HCPCS Rozanolixizumab-noli 140 Mg/ml Subcutaneous Solution 67 19 $65,875.55 $32,937.78 50% off $22.85 $183,746.10 $41,830.97 2025-11-19
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 21 14 — — $30,304.33 $82,302.98 $41,825.28 2025-11-19
265 MS_DRG Aicd Lead Procedures 21 14 — — $30,174.86 $81,917.18 $41,629.22 2025-11-19
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 21 14 — — $30,051.55 $81,549.76 $41,442.50 2025-11-19
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 21 14 — — $29,891.24 $81,072.11 $41,199.77 2025-11-19
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 21 14 — — $29,884.28 $81,051.44 $41,189.27 2025-11-19
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 21 14 — — $29,815.74 $80,847.06 $41,085.40 2025-11-19
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 21 14 — — $29,686.23 $80,461.26 $40,889.35 2025-11-19
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 21 14 — — $29,677.76 $80,436.00 $40,876.51 2025-11-19
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 21 14 — — $29,666.97 $80,403.85 $40,860.17 2025-11-19
J2427 HCPCS Paliperidone Palmitate (3 Month) 819 Mg/2.63 Ml Intramuscular Syringe 102 19 $72,947.70 $36,473.85 50% off $12.18 $101,759.58 $40,822.62 2025-11-19
264 MS_DRG Other Circulatory System O.r. Procedures 21 14 — — $29,619.17 $80,261.48 $40,787.82 2025-11-19
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 21 14 — — $29,445.01 $79,742.49 $40,524.08 2025-11-19
332 MS_DRG Rectal Resection With Mcc 21 14 — — $29,415.71 $79,655.23 $40,479.73 2025-11-19
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 21 14 — — $29,386.43 $79,567.96 $40,435.38 2025-11-19
271 MS_DRG Other Major Cardiovascular Procedures With Cc 21 14 — — $29,228.42 $79,097.20 $40,196.15 2025-11-19
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 21 14 — — $29,186.83 $78,973.20 $40,133.13 2025-11-19
J9306 HCPCS Pertuzumab 420 Mg/14 Ml (30 Mg/ml) Intravenous Solution 48 19 $63,139.60 $31,569.80 50% off $15.42 $58,719.83 $40,093.64 2025-11-19
665 MS_DRG Prostatectomy With Mcc 21 14 — — $29,145.18 $78,849.19 $40,070.11 2025-11-19
252 MS_DRG Other Vascular Procedures With Mcc 21 14 — — $29,120.52 $78,775.71 $40,032.77 2025-11-19
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 21 14 — — $29,080.46 $78,656.29 $39,972.08 2025-11-19
J1932 HCPCS Lanreotide 120 Mg/0.5 Ml Subcutaneous Syringe 48 19 $62,611.80 $31,305.90 50% off $29.84 $58,228.97 $39,758.49 2025-11-19
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 21 14 — — $28,934.01 $78,219.98 $39,750.35 2025-11-19
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 21 14 — — $28,824.58 $77,893.89 $39,584.64 2025-11-19
L7180 HCPCS Electronic Elbow Sequential 10 10 — — $39,208.42 $47,050.10 $39,208.42 2025-11-19
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 21 14 — — $28,552.52 $77,083.26 $39,172.69 2025-11-19
37 MS_DRG Extracranial Procedures With Mcc 21 14 — — $28,276.61 $76,261.15 $38,754.90 2025-11-19
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 10 10 — — $38,606.32 $46,327.58 $38,606.32 2025-11-19
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 21 14 — — $28,130.19 $75,824.83 $38,533.17 2025-11-19
J1299 HCPCS Eculizumab 300 Mg/30 Ml Intravenous Solution 48 19 $60,387.70 $30,193.85 50% off $44.82 $56,160.56 $38,346.19 2025-11-19
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 21 14 — — $27,874.31 $75,062.43 $38,145.73 2025-11-19
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 21 14 — — $27,802.62 $74,848.86 $38,037.20 2025-11-19
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 21 14 — — $27,791.85 $74,816.71 $38,020.86 2025-11-19
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 21 14 — — $27,493.57 $73,928.01 $37,569.23 2025-11-19
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 21 14 — — $27,378.74 $73,585.84 $37,395.35 2025-11-19
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 21 14 — — $27,307.07 $73,372.28 $37,286.82 2025-11-19
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 21 14 — — $27,260.04 $73,232.20 $37,215.63 2025-11-19
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 21 14 — — $27,193.76 $73,034.71 $37,115.27 2025-11-19
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 21 14 — — $27,144.46 $72,887.74 $37,040.58 2025-11-19
500 MS_DRG Soft Tissue Procedures With Mcc 21 14 — — $27,103.61 $72,766.03 $36,978.73 2025-11-19
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 21 14 — — $26,735.97 $71,670.64 $36,422.07 2025-11-19
662 MS_DRG Minor Bladder Procedures With Mcc 21 14 — — $26,725.18 $71,638.49 $36,405.73 2025-11-19
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 21 14 — — $26,622.68 $71,333.07 $36,250.52 2025-11-19
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 21 14 — — $26,515.55 $71,013.87 $36,088.31 2025-11-19
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 21 14 — — $26,466.23 $70,866.90 $36,013.62 2025-11-19
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 21 14 — — $26,449.27 $70,816.38 $35,987.95 2025-11-19
652 MS_DRG Kidney Transplant 21 14 — — $26,353.71 $70,531.63 $35,843.24 2025-11-19
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 21 14 — — $26,332.12 $70,467.33 $35,810.56 2025-11-19
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 21 14 — — $26,255.04 $70,237.69 $35,693.86 2025-11-19
J0517 HCPCS Benralizumab 30 Mg/ml Subcutaneous Syringe 48 19 $55,627.40 $27,813.70 50% off $164.59 $51,733.48 $35,323.40 2025-11-19
570 MS_DRG Skin Debridement With Mcc 21 14 — — $25,882.04 $69,126.23 $35,129.03 2025-11-19
0620T CPT Evasc Ven Artlz Tibl/prnl Vn 11 10 — — $6,829.20 $42,000.60 $35,000.50 2025-11-19
974 MS_DRG HIV With Major Related Condition With Mcc 21 14 — — $25,697.05 $68,575.10 $34,848.95 2025-11-19
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 21 14 — — $25,407.28 $67,711.65 $34,410.16 2025-11-19
J2267 HCPCS Mirikizumab-mrkz 100 Mg/ml Subcutaneous Pen Injector 68 19 $54,058.35 $27,029.18 50% off $43.05 $95,931.50 $34,327.06 2025-11-19
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 21 14 — — $25,348.70 $67,537.12 $34,321.47 2025-11-19
L8701 HCPCS Ewh S/d Uprt Micro Sensor 10 10 — — $34,284.44 $41,141.33 $34,284.44 2025-11-19
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 21 14 — — $25,287.04 $67,353.41 $34,228.11 2025-11-19
668 MS_DRG Transurethral Procedures With Mcc 21 14 — — $25,158.34 $66,969.91 $34,033.22 2025-11-19
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 21 14 — — $25,146.01 $66,933.17 $34,014.55 2025-11-19
800 MS_DRG Splenic Procedures With Cc 21 14 — — $25,139.07 $66,912.50 $34,004.05 2025-11-19
J9271 HCPCS Pembrolizumab 25 Mg/ml Intravenous Solution 51 19 $53,534.25 $26,767.13 50% off $57.31 $49,786.85 $33,994.25 2025-11-19
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 21 14 — — $25,126.74 $66,875.76 $33,985.37 2025-11-19
472 MS_DRG Cervical Spinal Fusion With Cc 21 14 — — $25,011.13 $66,531.30 $33,810.32 2025-11-19
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 21 14 — — $24,779.15 $65,840.08 $33,459.06 2025-11-19
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 21 14 — — $24,753.71 $65,764.30 $33,420.55 2025-11-19
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 21 14 — — $24,740.62 $65,725.26 $33,400.71 2025-11-19
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 21 14 — — $24,709.78 $65,633.41 $33,354.03 2025-11-19
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 21 14 — — $24,622.69 $65,373.92 $33,222.16 2025-11-19
654 MS_DRG Major Bladder Procedures With Cc 21 14 — — $24,432.33 $64,806.70 $32,933.91 2025-11-19
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 21 14 — — $24,326.74 $64,492.10 $32,774.03 2025-11-19
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 21 14 — — $24,304.40 $64,425.50 $32,740.19 2025-11-19
J9038 HCPCS Axatilimab-csfr 50 Mg/ml Intravenous Solution 68 19 $50,818.75 $25,409.38 50% off $55.65 $115,494.38 $32,269.91 2025-11-19
0571T CPT Insj/rplcmt Icds Ss Eltrd 11 10 — — $6,829.20 $38,473.90 $32,061.58 2025-11-19
33264 CPT Rmvl & Rplcmt Dfb Gen Mlt Ld 13 10 — — $4,453.06 $32,702.81 $32,061.58 2025-11-19
33270 CPT Ins/rep Subq Defibrillator 13 10 — — $4,453.06 $32,702.81 $32,061.58 2025-11-19
33249 CPT Insj/rplcmt Defib W/lead(s) 13 10 — — $4,453.06 $32,702.81 $32,061.58 2025-11-19
33231 CPT Insrt Pulse Gen W/mult Leads 13 10 — — $4,453.06 $32,702.81 $32,061.58 2025-11-19
0915T CPT Insj Perm Ccm-d Sys Pg&eltrd 10 10 — — $32,061.58 $38,473.90 $32,061.58 2025-11-19
0408T CPT Insj/rplc Cardiac Modulj Sys 11 10 — — $6,362.56 $32,702.81 $32,061.58 2025-11-19
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 21 14 — — $23,771.85 $62,838.69 $31,933.79 2025-11-19
288 MS_DRG Acute And Subacute Endocarditis With Mcc 21 14 — — $23,734.07 $62,726.17 $31,876.61 2025-11-19
619 MS_DRG O.r. Procedures For Obesity With Mcc 21 14 — — $23,695.55 $62,611.35 $31,818.26 2025-11-19
69930 CPT Implant Cochlear Device 17 11 — — $3,621.00 $32,443.98 $31,807.82 2025-11-19
963 MS_DRG Other Multiple Significant Trauma With Mcc 21 14 — — $23,620.02 $62,386.30 $31,703.89 2025-11-19
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 21 14 — — $23,517.50 $62,080.88 $31,548.68 2025-11-19
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 21 14 — — $23,448.91 $61,876.50 $31,444.82 2025-11-19
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 21 14 — — $23,366.44 $61,630.78 $31,319.95 2025-11-19
263 MS_DRG Vein Ligation And Stripping 21 14 — — $23,353.35 $61,591.74 $31,300.11 2025-11-19
849 MS_DRG Radiotherapy 21 14 — — $23,268.56 $61,339.14 $31,171.74 2025-11-19
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 21 14 — — $23,204.59 $61,148.54 $31,074.88 2025-11-19
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 21 14 — — $23,131.36 $60,930.38 $30,964.01 2025-11-19
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 21 14 — — $23,105.93 $60,854.60 $30,925.50 2025-11-19
503 MS_DRG Foot Procedures With Mcc 21 14 — — $23,079.76 $60,776.52 $30,885.82 2025-11-19
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 21 14 — — $23,058.93 $60,714.52 $30,854.31 2025-11-19
J2506 HCPCS Pegfilgrastim 6 Mg/0.6 Ml Subcutaneous Syringe 48 19 $48,331.50 $24,165.75 50% off $89.34 $44,948.30 $30,690.51 2025-11-19
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 21 14 — — $22,900.16 $60,241.46 $30,613.91 2025-11-19
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 21 14 — — $22,847.76 $60,085.31 $30,534.56 2025-11-19
61886 CPT Implant Neurostim Arrays 17 11 — — $1,747.00 $31,083.06 $30,473.59 2025-11-19
33287 CPT Rmv&rplcmt Phrnc Nrv Stim Pg 12 10 — — $4,453.06 $31,083.06 $30,473.59 2025-11-19
64582 CPT Opn Mpltj Hpglsl Nstm Ary Pg 12 10 — — $4,453.06 $31,083.06 $30,473.59 2025-11-19
0268T CPT Apc 11 10 — — $4,849.65 $31,083.06 $30,473.59 2025-11-19
63685 CPT Ins/rplc Spi Npg/rcvr Pocket 17 11 — — $1,456.00 $31,083.06 $30,473.59 2025-11-19
0674T CPT Laps Insj Nw/rpcmt Prm Isdss 10 10 — — $30,473.59 $36,568.31 $30,473.59 2025-11-19
64568 CPT Opn Impltj Crnl Nrv Nea&pg 13 10 — — $4,453.06 $31,083.06 $30,473.59 2025-11-19
A9517 HCPCS Sodium Iodide-131 (i-131) 500 Mci/0.5 Ml Oral Kit (therapeutic) 49 19 $42,187.50 $21,093.75 50% off $23.13 $39,234.38 $30,375.01 2025-11-19
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 21 14 — — $22,632.72 $59,444.61 $30,208.96 2025-11-19
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 21 14 — — $22,599.59 $59,345.87 $30,158.78 2025-11-19
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 21 14 — — $22,364.52 $58,645.46 $29,802.85 2025-11-19
253 MS_DRG Other Vascular Procedures With Cc 21 14 — — $22,358.36 $58,627.09 $29,793.51 2025-11-19
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 21 14 — — $22,321.36 $58,516.86 $29,737.49 2025-11-19
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 21 14 — — $22,220.42 $58,216.04 $29,584.62 2025-11-19
545 MS_DRG Connective Tissue Disorders With Mcc 21 14 — — $22,157.21 $58,027.73 $29,488.92 2025-11-19
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 21 14 — — $22,141.79 $57,981.80 $29,465.58 2025-11-19
164 MS_DRG Major Chest Procedures With Cc 21 14 — — $22,080.91 $57,800.39 $29,373.39 2025-11-19
56 MS_DRG Degenerative Nervous System Disorders With Mcc 21 14 — — $21,981.48 $57,504.15 $29,222.85 2025-11-19
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 21 14 — — $21,966.84 $57,460.52 $29,200.67 2025-11-19
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