|
1
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant,major
|
2
|
1
|
$815,961.00
|
$815,961.00
|
$197,635.81
|
$197,635.81
|
$197,635.81
|
2026-04-23
|
|
120
|
APR_DRG
|
Major Respiratory And Chest Procedures,major
|
10
|
3
|
$389,577.00
|
$389,577.00
|
$26,747.66
|
$54,759.33
|
$52,263.30
|
2026-04-23
|
|
121
|
APR_DRG
|
Other Respiratory And Chest Procedures,extreme
|
16
|
3
|
$202,727.50
|
$202,727.50
|
$23,596.29
|
$83,030.68
|
$42,365.83
|
2026-04-23
|
|
130
|
APR_DRG
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours,extreme
|
10
|
3
|
$305,701.00
|
$305,701.00
|
$97,089.12
|
$131,150.60
|
$125,172.54
|
2026-04-23
|
|
131
|
APR_DRG
|
Cystic Fibrosis - Pulmonary Disease,moderate
|
8
|
3
|
$53,974.00
|
$53,974.00
|
$15,991.21
|
$49,313.96
|
$47,363.50
|
2026-04-23
|
|
133
|
APR_DRG
|
Respiratory Failure,major
|
14
|
3
|
$27,824.00
|
$27,824.00
|
$6,388.57
|
$33,405.90
|
$19,260.88
|
2026-04-23
|
|
136
|
APR_DRG
|
Respiratory Malignancy,extreme
|
12
|
3
|
$91,514.50
|
$91,514.50
|
$17,475.13
|
$38,603.28
|
$27,576.70
|
2026-04-23
|
|
137
|
APR_DRG
|
Major Respiratory Infections And Inflammations,extreme
|
6
|
1
|
$30,418.00
|
$30,418.00
|
$7,658.36
|
$31,238.02
|
$16,200.97
|
2026-04-23
|
|
140
|
APR_DRG
|
Chronic Obstructive Pulmonary Disease,major
|
8
|
3
|
$66,468.00
|
$66,468.00
|
$13,180.92
|
$17,548.80
|
$16,854.72
|
2026-04-23
|
|
142
|
APR_DRG
|
Interstitial And Alveolar Lung Diseases,extreme
|
8
|
3
|
$33,238.00
|
$33,238.00
|
$11,543.64
|
$22,358.92
|
$21,474.58
|
2026-04-23
|
|
160
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly,major
|
16
|
3
|
$335,356.00
|
$335,356.00
|
$47,163.36
|
$179,384.36
|
$90,873.92
|
2026-04-23
|
|
162
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis,extreme
|
2
|
1
|
$677,033.00
|
$677,033.00
|
$186,437.64
|
$186,437.64
|
$186,437.64
|
2026-04-23
|
|
163
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis,major
|
14
|
3
|
$363,804.00
|
$363,804.00
|
$76,757.59
|
$180,810.73
|
$112,591.42
|
2026-04-23
|
|
167
|
APR_DRG
|
Other Cardiothoracic And Thoracic Circulatory Procedures,extreme
|
20
|
3
|
$256,305.00
|
$256,305.00
|
$49,398.82
|
$118,039.96
|
$62,584.05
|
2026-04-23
|
|
169
|
APR_DRG
|
Major Abdominal Vascular Procedures,major
|
2
|
1
|
$192,771.00
|
$192,771.00
|
$79,641.55
|
$79,641.55
|
$79,641.55
|
2026-04-23
|
|
171
|
APR_DRG
|
Permanent Cardiac Pacemaker Implant Without Ami Heart Failure Or Shock,minor
|
8
|
3
|
$129,985.00
|
$129,985.00
|
$32,974.18
|
$37,738.48
|
$33,969.91
|
2026-04-23
|
|
175
|
APR_DRG
|
Percutaneous Cardiac Intervention Without Ami,major
|
16
|
3
|
$145,614.00
|
$145,614.00
|
$37,239.18
|
$60,109.28
|
$47,487.18
|
2026-04-23
|
|
176
|
APR_DRG
|
Insertion Revision And Replacements Of Pacemaker And Other Cardiac Devices,major
|
6
|
3
|
$478,832.00
|
$478,832.00
|
$40,426.20
|
$42,356.95
|
$40,937.04
|
2026-04-23
|
|
180
|
APR_DRG
|
Other Circulatory System Procedures,moderate
|
8
|
3
|
$209,245.00
|
$209,245.00
|
$19,681.41
|
$23,082.48
|
$22,169.51
|
2026-04-23
|
|
182
|
APR_DRG
|
Other Peripheral Vascular And Related Procedures,minor
|
14
|
3
|
$149,253.00
|
$149,253.00
|
$34,734.67
|
$58,253.15
|
$35,723.46
|
2026-04-23
|
|
192
|
APR_DRG
|
Cardiac Catheterization For Other Non-coronary Conditions,extreme
|
8
|
1
|
$118,406.00
|
$118,406.00
|
$17,724.77
|
$58,225.59
|
$29,333.25
|
2026-04-23
|
|
193
|
APR_DRG
|
Acute And Subacute Endocarditis,extreme
|
18
|
3
|
$154,337.00
|
$154,337.00
|
$14,926.79
|
$31,794.03
|
$20,077.83
|
2026-04-23
|
|
194
|
APR_DRG
|
Heart Failure,extreme
|
6
|
1
|
$62,287.00
|
$62,287.00
|
$14,066.02
|
$39,951.27
|
$20,722.14
|
2026-04-23
|
|
196
|
APR_DRG
|
Cardiac Arrest And Shock,major
|
10
|
3
|
$33,345.00
|
$33,345.00
|
$7,797.34
|
$25,115.24
|
$17,241.23
|
2026-04-23
|
|
2
|
APR_DRG
|
Heart And/or Lung Transplant,extreme
|
2
|
1
|
$2,361,376.00
|
$2,361,376.00
|
$299,151.97
|
$299,151.97
|
$299,151.97
|
2026-04-23
|
|
20
|
APR_DRG
|
Open Craniotomy For Trauma,moderate
|
2
|
1
|
$165,787.00
|
$165,787.00
|
$34,225.61
|
$39,359.45
|
$36,792.53
|
2026-04-23
|
|
201
|
APR_DRG
|
Cardiac Arrhythmia And Conduction Disorders,major
|
16
|
3
|
$50,474.00
|
$50,474.00
|
$9,846.38
|
$32,316.00
|
$16,953.95
|
2026-04-23
|
|
206
|
APR_DRG
|
Malfunction Reaction Complication Of Cardiac Or Vascular Device Or Procedure,ext…
|
10
|
3
|
$164,793.00
|
$164,793.00
|
$18,849.80
|
$31,688.73
|
$30,244.30
|
2026-04-23
|
|
21
|
APR_DRG
|
Open Craniotomy Except Trauma,minor
|
10
|
3
|
$143,747.00
|
$143,747.00
|
$36,091.50
|
$97,115.88
|
$42,758.56
|
2026-04-23
|
|
220
|
APR_DRG
|
Major Stomach Esophageal And Duodenal Procedures,major
|
14
|
3
|
$79,112.00
|
$79,112.00
|
$24,666.20
|
$68,223.25
|
$35,078.33
|
2026-04-23
|
|
222
|
APR_DRG
|
Other Stomach Esophageal And Duodenal Procedures,minor
|
14
|
3
|
$99,440.00
|
$99,440.00
|
$10,592.07
|
$57,037.35
|
$32,967.70
|
2026-04-23
|
|
223
|
APR_DRG
|
Other Small And Large Bowel Procedures,moderate
|
10
|
3
|
$89,656.00
|
$89,656.00
|
$13,506.01
|
$30,077.30
|
$25,948.03
|
2026-04-23
|
|
224
|
APR_DRG
|
Peritoneal Adhesiolysis,minor
|
4
|
1
|
$51,813.00
|
$51,813.00
|
$18,485.29
|
$23,226.69
|
$20,855.99
|
2026-04-23
|
|
226
|
APR_DRG
|
Anal And Perineal Procedures,major
|
12
|
3
|
$107,557.00
|
$107,557.00
|
$18,742.81
|
$27,129.98
|
$22,765.64
|
2026-04-23
|
|
227
|
APR_DRG
|
Hernia Procedures Except Inguinal Femoral And Umbilical,major
|
8
|
3
|
$63,189.00
|
$63,189.00
|
$18,172.18
|
$40,964.18
|
$39,343.98
|
2026-04-23
|
|
228
|
APR_DRG
|
Inguinal Femoral And Umbilical Hernia Procedures,minor
|
14
|
3
|
$36,579.00
|
$36,579.00
|
$11,211.30
|
$53,318.61
|
$18,872.50
|
2026-04-23
|
|
229
|
APR_DRG
|
Other Digestive System And Abdominal Procedures,minor
|
4
|
1
|
$80,427.50
|
$80,427.50
|
$23,340.17
|
$24,419.80
|
$23,879.99
|
2026-04-23
|
|
23
|
APR_DRG
|
Spinal Procedures,major
|
6
|
1
|
$70,935.00
|
$70,935.00
|
$18,617.99
|
$56,129.55
|
$36,096.37
|
2026-04-23
|
|
230
|
APR_DRG
|
Major Small Bowel Procedures,minor
|
16
|
3
|
$107,794.00
|
$107,794.00
|
$29,817.96
|
$89,510.53
|
$36,882.32
|
2026-04-23
|
|
231
|
APR_DRG
|
Major Large Bowel Procedures,moderate
|
8
|
3
|
$106,607.00
|
$106,607.00
|
$26,728.20
|
$36,780.80
|
$35,326.05
|
2026-04-23
|
|
232
|
APR_DRG
|
Gastric Fundoplication,extreme
|
2
|
1
|
$368,632.00
|
$368,632.00
|
$67,243.60
|
$67,243.60
|
$67,243.60
|
2026-04-23
|
|
233
|
APR_DRG
|
Appendectomy With Complex Principal Diagnosis,extreme
|
18
|
3
|
$105,607.00
|
$105,607.00
|
$25,189.81
|
$49,774.25
|
$29,872.98
|
2026-04-23
|
|
242
|
APR_DRG
|
Major Esophageal Disorders,major
|
4
|
1
|
$50,690.50
|
$50,690.50
|
$12,955.59
|
$24,455.46
|
$18,705.53
|
2026-04-23
|
|
252
|
APR_DRG
|
Malfunction Reaction And Complication Of Gastrointestinal Device Or Procedure,ma…
|
10
|
3
|
$46,507.00
|
$46,507.00
|
$9,992.98
|
$31,388.78
|
$24,209.62
|
2026-04-23
|
|
25575
|
CPT
|
Open Treatment Of Broken Forearm Bones
|
53
|
23
|
$24,641.00
|
$24,641.00
|
$512.28
|
$24,641.00
|
$17,002.29
|
2026-05-14
|
|
26
|
APR_DRG
|
Other Nervous System And Related Procedures,major
|
16
|
3
|
$115,506.00
|
$115,506.00
|
$12,888.50
|
$71,323.84
|
$30,115.85
|
2026-04-23
|
|
260
|
APR_DRG
|
Major Pancreas Liver And Shunt Procedures,moderate
|
10
|
3
|
$239,959.00
|
$239,959.00
|
$43,053.95
|
$92,546.89
|
$45,110.20
|
2026-04-23
|
|
261
|
APR_DRG
|
Major Biliary Tract Procedures,major
|
4
|
1
|
$163,919.50
|
$163,919.50
|
$33,732.85
|
$33,932.24
|
$33,832.54
|
2026-04-23
|
|
263
|
APR_DRG
|
Cholecystectomy,major
|
12
|
3
|
$115,326.00
|
$115,326.00
|
$16,896.40
|
$46,954.25
|
$30,999.81
|
2026-04-23
|
|
264
|
APR_DRG
|
Other Hepatobiliary Pancreas And Abdominal Procedures,minor
|
4
|
1
|
$100,275.50
|
$100,275.50
|
$20,098.03
|
$24,696.97
|
$22,397.50
|
2026-04-23
|
|
279
|
APR_DRG
|
Hepatic Coma And Other Major Acute Liver Disorders,extreme
|
12
|
3
|
$163,818.50
|
$163,818.50
|
$5,340.39
|
$31,092.56
|
$25,446.85
|
2026-04-23
|
|
281
|
APR_DRG
|
Malignancy Of Hepatobiliary System And Pancreas,major
|
4
|
1
|
$123,136.00
|
$123,136.00
|
$15,896.20
|
$21,829.31
|
$18,862.76
|
2026-04-23
|
|
282
|
APR_DRG
|
Disorders Of Pancreas Except Malignancy,extreme
|
8
|
1
|
$89,916.50
|
$89,916.50
|
$8,950.73
|
$37,333.24
|
$17,737.74
|
2026-04-23
|
|
29
|
APR_DRG
|
Other Percutaneous Intracranial Procedures,major
|
6
|
1
|
$298,662.00
|
$298,662.00
|
$29,647.72
|
$46,011.09
|
$35,081.06
|
2026-04-23
|
|
30
|
APR_DRG
|
Percutaneous Intracranial And Extracranial Vascular Procedures,moderate
|
2
|
1
|
$101,160.00
|
$101,160.00
|
$58,267.74
|
$58,267.74
|
$58,267.74
|
2026-04-23
|
|
303
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back,minor
|
8
|
3
|
$317,507.00
|
$317,507.00
|
$112,406.61
|
$160,473.00
|
$130,084.27
|
2026-04-23
|
|
304
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back,moderate
|
8
|
3
|
$186,462.00
|
$186,462.00
|
$64,935.14
|
$98,058.55
|
$75,147.21
|
2026-04-23
|
|
308
|
APR_DRG
|
Hip And Femur Fracture Repair,major
|
6
|
1
|
$62,435.00
|
$62,435.00
|
$24,275.52
|
$52,571.30
|
$36,568.10
|
2026-04-23
|
|
309
|
APR_DRG
|
Other Significant Hip And Femur Surgery,minor
|
10
|
3
|
$56,980.00
|
$56,980.00
|
$20,296.75
|
$35,561.41
|
$21,168.53
|
2026-04-23
|
|
310
|
APR_DRG
|
Vertebral And Intervertebral Spinal Procedures Including Disc Procedures,minor
|
14
|
3
|
$93,344.00
|
$93,344.00
|
$23,098.60
|
$54,628.44
|
$27,838.61
|
2026-04-23
|
|
312
|
APR_DRG
|
Skin Graft For Musculoskeletal And Connective Tissue Diagnoses,major
|
4
|
1
|
$166,217.00
|
$166,217.00
|
$36,840.44
|
$49,024.40
|
$42,932.42
|
2026-04-23
|
|
313
|
APR_DRG
|
Knee And Lower Leg Procedures Except Foot,minor
|
12
|
3
|
$72,135.00
|
$72,135.00
|
$24,880.15
|
$34,199.10
|
$29,177.08
|
2026-04-23
|
|
314
|
APR_DRG
|
Foot And Toe Procedures,major
|
14
|
3
|
$87,130.00
|
$87,130.00
|
$19,005.42
|
$36,322.21
|
$21,845.54
|
2026-04-23
|
|
317
|
APR_DRG
|
Tendon Muscle And Other Soft Tissue Procedures,minor
|
12
|
3
|
$59,620.00
|
$59,620.00
|
$18,520.72
|
$54,698.14
|
$22,617.69
|
2026-04-23
|
|
320
|
APR_DRG
|
Other Musculoskeletal System And Connective Tissue Procedures,major
|
14
|
3
|
$102,838.00
|
$102,838.00
|
$24,389.00
|
$35,445.79
|
$27,760.12
|
2026-04-23
|
|
321
|
APR_DRG
|
Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures,mode…
|
8
|
3
|
$245,384.00
|
$245,384.00
|
$34,536.90
|
$46,258.39
|
$44,428.74
|
2026-04-23
|
|
324
|
APR_DRG
|
Elective Hip Joint Replacement,minor
|
8
|
3
|
$95,693.00
|
$95,693.00
|
$21,107.02
|
$30,990.66
|
$29,764.89
|
2026-04-23
|
|
325
|
APR_DRG
|
Non-elective Or Complex Knee Joint Replacement,extreme
|
12
|
3
|
$328,405.00
|
$328,405.00
|
$46,380.39
|
$67,593.11
|
$56,553.81
|
2026-04-23
|
|
326
|
APR_DRG
|
Elective Knee Joint Replacement,major
|
2
|
1
|
$337,562.00
|
$337,562.00
|
$32,328.97
|
$32,328.97
|
$32,328.97
|
2026-04-23
|
|
33207
|
CPT
|
Pacemaker Insertion, Ventricular
|
53
|
23
|
$24,367.00
|
$24,367.00
|
$764.00
|
$24,367.00
|
$16,813.23
|
2026-05-14
|
|
33208
|
CPT
|
Pacemaker Insertion
|
53
|
23
|
$24,683.00
|
$24,683.00
|
$764.00
|
$24,683.00
|
$17,031.27
|
2026-05-14
|
|
33214
|
CPT
|
Pacemaker Conversion To Two Chamber System
|
53
|
23
|
$24,313.00
|
$24,313.00
|
$764.00
|
$24,313.00
|
$16,775.97
|
2026-05-14
|
|
33235
|
CPT
|
Removal Of Electrodes From Right Heart
|
53
|
23
|
$30,667.00
|
$30,667.00
|
$764.00
|
$30,667.00
|
$21,160.23
|
2026-05-14
|
|
33249
|
CPT
|
Insertion Or Replacement Of Single Or Dual Chamber Pacing Defibrillator Leads
|
53
|
23
|
$42,952.00
|
$42,952.00
|
$764.00
|
$42,952.00
|
$29,636.88
|
2026-05-14
|
|
33477
|
CPT
|
Transcatheter Valve Implantation
|
53
|
23
|
$81,742.00
|
$81,742.00
|
$764.00
|
$81,742.00
|
$56,401.98
|
2026-05-14
|
|
33741
|
CPT
|
Tas Congen Card Anomalies
|
53
|
23
|
$28,195.00
|
$28,195.00
|
$764.00
|
$28,195.00
|
$19,454.55
|
2026-05-14
|
|
33745
|
CPT
|
Tis Cgen Crd Anm 1st Shnt
|
53
|
23
|
$28,064.00
|
$28,064.00
|
$764.00
|
$28,064.00
|
$19,364.16
|
2026-05-14
|
|
33895
|
CPT
|
Evasc St Rpr Coarcj Thrc/Aa Xcrsg Maj Side Brnch
|
53
|
23
|
$32,464.00
|
$32,464.00
|
$764.00
|
$32,464.00
|
$22,400.16
|
2026-05-14
|
|
344
|
APR_DRG
|
Osteomyelitis Septic Arthritis And Other Musculoskeletal Infections,major
|
14
|
3
|
$29,233.00
|
$29,233.00
|
$10,703.92
|
$31,311.66
|
$17,583.75
|
2026-04-23
|
|
346
|
APR_DRG
|
Connective Tissue Disorders,moderate
|
10
|
3
|
$52,128.00
|
$52,128.00
|
$14,981.93
|
$25,210.88
|
$21,647.16
|
2026-04-23
|
|
351
|
APR_DRG
|
Other Musculoskeletal System And Connective Tissue Diagnoses,extreme
|
8
|
1
|
$45,957.50
|
$45,957.50
|
$5,781.05
|
$25,763.67
|
$19,107.83
|
2026-04-23
|
|
361
|
APR_DRG
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses,extreme
|
10
|
3
|
$687,334.00
|
$687,334.00
|
$31,100.20
|
$88,076.90
|
$84,062.21
|
2026-04-23
|
|
36254
|
CPT
|
Insertion Of Catheters Into Main And Accessory Arteries Of Both Kidneys For Imag…
|
53
|
23
|
$23,710.00
|
$23,710.00
|
$764.00
|
$23,710.00
|
$16,359.90
|
2026-05-14
|
|
364
|
APR_DRG
|
Other Skin Subcutaneous Tissue And Related Procedures,major
|
14
|
3
|
$58,023.00
|
$58,023.00
|
$12,539.23
|
$48,011.23
|
$31,617.35
|
2026-04-23
|
|
37187
|
CPT
|
Removal Of Blood Clot And Injections (Accessed Through The Skin) To Dissolve Blo…
|
53
|
23
|
$71,578.00
|
$71,578.00
|
$764.00
|
$71,578.00
|
$49,388.82
|
2026-05-14
|
|
37236
|
CPT
|
Open/Perq Placement Intravascular Stent Initial
|
53
|
23
|
$33,468.00
|
$33,468.00
|
$764.00
|
$33,468.00
|
$23,092.92
|
2026-05-14
|
|
37246
|
CPT
|
Balloon Dilation Of Artery W/Imaging
|
53
|
23
|
$23,714.00
|
$23,714.00
|
$764.00
|
$23,714.00
|
$16,362.66
|
2026-05-14
|
|
37258
|
CPT
|
Insertion Of Stent Of Artery In Abdomen/pelvis, Straightforward Lesion In Initia…
|
53
|
23
|
$30,941.00
|
$30,941.00
|
$764.00
|
$30,941.00
|
$21,349.29
|
2026-05-14
|
|
37260
|
CPT
|
Insertion Of Stent Artery Of Abdomen/pelvis, Complex Lesion In Initial Vessel
|
53
|
23
|
$30,941.00
|
$30,941.00
|
$764.00
|
$30,941.00
|
$21,349.29
|
2026-05-14
|
|
37262
|
CPT
|
Intravascular Shockwave Treatment Artery In Abdomen/pelvis
|
53
|
23
|
$30,941.00
|
$30,941.00
|
$764.00
|
$30,941.00
|
$21,349.29
|
2026-05-14
|
|
37267
|
CPT
|
Stent Placement In Artery In Thigh/behind Knee, Straightforward Lesion In Initia…
|
53
|
23
|
$32,584.00
|
$32,584.00
|
$764.00
|
$32,584.00
|
$22,482.96
|
2026-05-14
|
|
37268
|
CPT
|
Stent Placement In Artery In Thigh/behind Knee, Straightforward Lesion In Each A…
|
53
|
23
|
$49,861.00
|
$49,861.00
|
$764.00
|
$49,861.00
|
$34,404.09
|
2026-05-14
|
|
37269
|
CPT
|
Stent Placement In Artery In Thigh/behind Knee, Complex Lesion In Initial Vessel
|
53
|
23
|
$49,861.00
|
$49,861.00
|
$764.00
|
$49,861.00
|
$34,404.09
|
2026-05-14
|
|
37270
|
CPT
|
Stent Placement In Artery In Thigh/behind Knee, Complex Lesion In Each Additiona…
|
53
|
23
|
$32,584.00
|
$32,584.00
|
$764.00
|
$32,584.00
|
$22,482.96
|
2026-05-14
|
|
37271
|
CPT
|
Removal Of Plaque With Balloon Dilation Artery In Thigh/behind Knee, Straightfor…
|
53
|
23
|
$32,849.00
|
$32,849.00
|
$764.00
|
$32,849.00
|
$22,665.81
|
2026-05-14
|
|
37272
|
CPT
|
Removal Of Plaque With Balloon Dilation Artery In Thigh/behind Knee, Straightfor…
|
53
|
23
|
$49,861.00
|
$49,861.00
|
$764.00
|
$49,861.00
|
$34,404.09
|
2026-05-14
|
|
37273
|
CPT
|
Removal Of Plaque With Balloon Dilation Artery In Thigh/behind Knee, Complex Les…
|
53
|
23
|
$32,849.00
|
$32,849.00
|
$764.00
|
$32,849.00
|
$22,665.81
|
2026-05-14
|
|
37274
|
CPT
|
Removal Of Plaque With Balloon Dilation Artery In Thigh/behind Knee, Complex Les…
|
53
|
23
|
$32,849.00
|
$32,849.00
|
$764.00
|
$32,849.00
|
$22,665.81
|
2026-05-14
|
|
37275
|
CPT
|
Stent Placement In Artery In Thigh/behind Knee With Removal Of Plaque, Straightf…
|
53
|
23
|
$49,861.00
|
$49,861.00
|
$764.00
|
$49,861.00
|
$34,404.09
|
2026-05-14
|
|
37276
|
CPT
|
Stent Placement In Artery In Thigh/behind Knee With Removal Of Plaque, Straightf…
|
53
|
23
|
$49,861.00
|
$49,861.00
|
$764.00
|
$49,861.00
|
$34,404.09
|
2026-05-14
|
|
37277
|
CPT
|
Stent Placement In Artery In Thigh/behind Knee With Removal Of Plaque, Complex L…
|
53
|
23
|
$49,861.00
|
$49,861.00
|
$764.00
|
$49,861.00
|
$34,404.09
|
2026-05-14
|
|
37278
|
CPT
|
Stent Placement In Artery In Thigh/behind Knee With Removal Of Plaque, Complex L…
|
53
|
23
|
$49,861.00
|
$49,861.00
|
$764.00
|
$49,861.00
|
$34,404.09
|
2026-05-14
|
|
37279
|
CPT
|
Intravascular Shockwave Treatment Artery In Thigh/back Of Knee
|
53
|
23
|
$49,861.00
|
$49,861.00
|
$764.00
|
$49,861.00
|
$34,404.09
|
2026-05-14
|
|
37284
|
CPT
|
Stent Placement In Artery In Lower Leg, Straightforward Lesion In Initial Vessel
|
53
|
23
|
$31,838.00
|
$31,838.00
|
$764.00
|
$31,838.00
|
$21,968.22
|
2026-05-14
|
|
37285
|
CPT
|
Stent Placement In Artery In Lower Leg, Straightforward Lesion In Each Additiona…
|
53
|
23
|
$31,838.00
|
$31,838.00
|
$764.00
|
$31,838.00
|
$21,968.22
|
2026-05-14
|
|
37286
|
CPT
|
Stent Placement In Artery In Lower Leg, Complex Lesion In Initial Vessel
|
53
|
23
|
$31,838.00
|
$31,838.00
|
$764.00
|
$31,838.00
|
$21,968.22
|
2026-05-14
|
|
37287
|
CPT
|
Stent Placement In Artery In Lower Leg, Complex Lesion In Each Additional Vessel
|
53
|
23
|
$31,838.00
|
$31,838.00
|
$764.00
|
$31,838.00
|
$21,968.22
|
2026-05-14
|
|
37288
|
CPT
|
Removal Of Plaque With Balloon Dilation In Artery In Lower Leg, Straightforward …
|
53
|
23
|
$33,848.00
|
$33,848.00
|
$764.00
|
$33,848.00
|
$23,355.12
|
2026-05-14
|
|
37289
|
CPT
|
Removal Of Plaque With Balloon Dilation In Artery In Lower Leg, Straightforward …
|
53
|
23
|
$33,848.00
|
$33,848.00
|
$764.00
|
$33,848.00
|
$23,355.12
|
2026-05-14
|
|
37290
|
CPT
|
Removal Of Plaque With Balloon Dilation In Artery In Lower Leg, Complex Lesion I…
|
53
|
23
|
$33,848.00
|
$33,848.00
|
$764.00
|
$33,848.00
|
$23,355.12
|
2026-05-14
|
|
37291
|
CPT
|
Removal Of Plaque With Balloon Dilation In Artery In Lower Leg, Complex Lesion I…
|
53
|
23
|
$33,848.00
|
$33,848.00
|
$764.00
|
$33,848.00
|
$23,355.12
|
2026-05-14
|
|
37292
|
CPT
|
Stent Placement In Artery In Lower Leg With Removal Of Plaque, Straightforward L…
|
53
|
23
|
$45,130.00
|
$45,130.00
|
$764.00
|
$45,130.00
|
$31,139.70
|
2026-05-14
|
|
37293
|
CPT
|
Stent Placement In Artery In Lower Leg With Removal Of Plaque, Straightforward L…
|
53
|
23
|
$45,130.00
|
$45,130.00
|
$764.00
|
$45,130.00
|
$31,139.70
|
2026-05-14
|
|
37294
|
CPT
|
Stent Placement In Artery In Lower Leg With Removal Of Plaque, Complex Lesion In…
|
53
|
23
|
$45,130.00
|
$45,130.00
|
$764.00
|
$45,130.00
|
$31,139.70
|
2026-05-14
|
|
37295
|
CPT
|
Stent Placement In Artery In Lower Leg With Removal Of Plaque, Complex Lesion In…
|
53
|
23
|
$45,130.00
|
$45,130.00
|
$764.00
|
$45,130.00
|
$31,139.70
|
2026-05-14
|
|
38210
|
CPT
|
Prep Stem Cells For Transplant W/Removal Of T Cells
|
100
|
23
|
$64,507.50
|
$64,507.50
|
$25,425.45
|
$68,197.00
|
$45,674.94
|
2026-05-14
|
|
4
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure,extreme
|
2
|
1
|
$2,489,760.00
|
$2,489,760.00
|
$379,725.56
|
$379,725.56
|
$379,725.56
|
2026-04-23
|
|
401
|
APR_DRG
|
Adrenal Procedures,minor
|
6
|
3
|
$96,437.00
|
$96,437.00
|
$38,339.93
|
$40,170.99
|
$38,824.37
|
2026-04-23
|
|
403
|
APR_DRG
|
Procedures For Obesity,minor
|
12
|
3
|
$50,966.00
|
$50,966.00
|
$17,699.07
|
$20,686.25
|
$19,153.81
|
2026-04-23
|
|
404
|
APR_DRG
|
Thyroid Parathyroid And Thyroglossal Procedures,minor
|
8
|
3
|
$76,288.00
|
$76,288.00
|
$19,783.54
|
$22,985.13
|
$20,380.94
|
2026-04-23
|
|
405
|
APR_DRG
|
Other Procedures For Endocrine Nutritional And Metabolic Disorders,extreme
|
6
|
3
|
$851,168.00
|
$851,168.00
|
$58,943.68
|
$61,758.80
|
$59,688.49
|
2026-04-23
|
|
42
|
APR_DRG
|
Degenerative Nervous System Disorders Except Multiple Sclerosis,major
|
10
|
3
|
$52,241.00
|
$52,241.00
|
$7,760.48
|
$20,125.41
|
$19,208.06
|
2026-04-23
|
|
43
|
APR_DRG
|
Multiple Sclerosis Other Demyelinating Disease And Inflammatory Neuropathies,mod…
|
12
|
3
|
$71,007.00
|
$71,007.00
|
$15,439.07
|
$50,415.28
|
$22,540.28
|
2026-04-23
|
|
44
|
APR_DRG
|
Intracranial Hemorrhage,extreme
|
16
|
3
|
$99,071.00
|
$99,071.00
|
$11,775.45
|
$58,725.30
|
$30,729.77
|
2026-04-23
|
|
440
|
APR_DRG
|
Kidney Transplant,major
|
2
|
1
|
$412,334.00
|
$412,334.00
|
$109,376.73
|
$109,376.73
|
$109,376.73
|
2026-04-23
|
|
441
|
APR_DRG
|
Major Bladder Procedures,major
|
8
|
3
|
$135,151.00
|
$135,151.00
|
$32,140.95
|
$58,383.90
|
$56,074.70
|
2026-04-23
|
|
442
|
APR_DRG
|
Kidney And Urinary Tract Procedures For Malignancy,major
|
2
|
1
|
$125,773.00
|
$125,773.00
|
$35,454.42
|
$35,454.42
|
$35,454.42
|
2026-04-23
|
|
443
|
APR_DRG
|
Kidney And Urinary Tract Procedures For Non-malignancy,minor
|
14
|
3
|
$60,863.00
|
$60,863.00
|
$18,572.58
|
$48,803.93
|
$22,518.52
|
2026-04-23
|
|
444
|
APR_DRG
|
Renal Dialysis Access Device Procedures,major
|
2
|
1
|
$88,249.00
|
$88,249.00
|
$51,344.15
|
$51,344.15
|
$51,344.15
|
2026-04-23
|
|
445
|
APR_DRG
|
Other Bladder Procedures,extreme
|
14
|
3
|
$73,577.00
|
$73,577.00
|
$19,919.69
|
$47,156.88
|
$25,426.48
|
2026-04-23
|
|
446
|
APR_DRG
|
Urethral And Transurethral Procedures,major
|
6
|
3
|
$94,475.00
|
$94,475.00
|
$28,624.82
|
$29,991.94
|
$28,986.53
|
2026-04-23
|
|
447
|
APR_DRG
|
Other Kidney Urinary Tract And Related Non-percutaneous Procedures,moderate
|
8
|
3
|
$149,180.00
|
$149,180.00
|
$21,412.69
|
$29,176.02
|
$22,059.32
|
2026-04-23
|
|
45
|
APR_DRG
|
Cva And Precerebral Occlusion With Infarction,major
|
2
|
1
|
$98,052.00
|
$98,052.00
|
$32,520.29
|
$32,520.29
|
$32,520.29
|
2026-04-23
|
|
461
|
APR_DRG
|
Kidney And Urinary Tract Malignancy,extreme
|
4
|
1
|
$33,840.00
|
$33,840.00
|
$11,657.10
|
$23,144.02
|
$17,400.56
|
2026-04-23
|
|
465
|
APR_DRG
|
Urinary Stones And Acquired Upper Urinary Tract Obstruction,major
|
8
|
3
|
$30,328.00
|
$30,328.00
|
$12,067.25
|
$16,886.39
|
$16,218.50
|
2026-04-23
|
|
469
|
APR_DRG
|
Acute Kidney Injury,extreme
|
6
|
1
|
$85,913.00
|
$85,913.00
|
$9,886.79
|
$60,273.00
|
$24,551.11
|
2026-04-23
|
|
49
|
APR_DRG
|
Bacterial And Tuberculous Infections Of Nervous System,extreme
|
8
|
3
|
$308,672.00
|
$308,672.00
|
$28,157.99
|
$52,084.20
|
$50,024.17
|
2026-04-23
|
|
51
|
APR_DRG
|
Viral Meningitis,major
|
10
|
3
|
$39,318.00
|
$39,318.00
|
$7,214.38
|
$20,544.94
|
$19,608.46
|
2026-04-23
|
|
511
|
APR_DRG
|
Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy,minor
|
2
|
1
|
$71,250.00
|
$71,250.00
|
$21,242.50
|
$21,242.50
|
$21,242.50
|
2026-04-23
|
|
514
|
APR_DRG
|
Female Reproductive System Reconstructive Procedures,moderate
|
2
|
1
|
$89,504.00
|
$89,504.00
|
$25,692.34
|
$25,692.34
|
$25,692.34
|
2026-04-23
|
|
517
|
APR_DRG
|
Dilation And Curettage For Non-obstetric Diagnoses,major
|
2
|
1
|
$121,357.00
|
$121,357.00
|
$19,224.27
|
$19,224.27
|
$19,224.27
|
2026-04-23
|
|
518
|
APR_DRG
|
Other Female Reproductive System And Related Procedures,major
|
2
|
1
|
$106,815.00
|
$106,815.00
|
$35,900.22
|
$35,900.22
|
$35,900.22
|
2026-04-23
|
|
53
|
APR_DRG
|
Seizure,major
|
16
|
3
|
$32,791.50
|
$32,791.50
|
$8,001.59
|
$58,190.11
|
$17,631.49
|
2026-04-23
|
|
55
|
APR_DRG
|
Head Trauma With Coma > 1 Hour Or Hemorrhage,moderate
|
12
|
3
|
$28,607.00
|
$28,607.00
|
$9,872.32
|
$39,443.88
|
$19,587.68
|
2026-04-23
|
|
58
|
APR_DRG
|
Other Disorders Of Nervous System,extreme
|
20
|
3
|
$73,908.00
|
$73,908.00
|
$13,811.52
|
$48,502.08
|
$28,645.83
|
2026-04-23
|
|
583
|
APR_DRG
|
Neonate With Ecmo,moderate
|
8
|
3
|
$180,283.00
|
$180,283.00
|
$293,859.46
|
$503,150.95
|
$302,733.15
|
2026-04-23
|
|
589
|
APR_DRG
|
Neonate Birth Weight < 500 Grams Or Birth Weight 500-999 Grams And Gestational A…
|
8
|
3
|
$102,989.00
|
$102,989.00
|
$53,245.67
|
$80,635.18
|
$54,853.52
|
2026-04-23
|
|
593
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure,major
|
6
|
3
|
$118,034.00
|
$118,034.00
|
$194,842.89
|
$204,148.31
|
$197,304.82
|
2026-04-23
|
|
607
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
2
|
1
|
$1,846,642.00
|
$1,846,642.00
|
$112,981.98
|
$112,981.98
|
$112,981.98
|
2026-04-23
|
|
609
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure,major
|
2
|
1
|
$256,899.00
|
$256,899.00
|
$111,088.68
|
$111,088.68
|
$111,088.68
|
2026-04-23
|
|
611
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly,extreme
|
4
|
1
|
$218,456.00
|
$218,456.00
|
$35,357.16
|
$112,618.98
|
$73,988.07
|
2026-04-23
|
|
612
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
2
|
1
|
$177,804.00
|
$177,804.00
|
$84,926.24
|
$84,926.24
|
$84,926.24
|
2026-04-23
|
|
61624
|
CPT
|
Occlusion Or Embolization Of Abnormal Artery, Accessed Through The Skin
|
53
|
23
|
$26,395.00
|
$26,395.00
|
$764.00
|
$26,395.00
|
$18,212.55
|
2026-05-14
|
|
621
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly,extreme
|
10
|
3
|
$32,708.00
|
$32,708.00
|
$29,808.24
|
$92,569.40
|
$88,349.94
|
2026-04-23
|
|
622
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…
|
12
|
3
|
$156,100.50
|
$156,100.50
|
$43,318.23
|
$73,065.64
|
$57,561.12
|
2026-04-23
|
|
625
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition,moderate
|
2
|
1
|
$42,110.00
|
$42,110.00
|
$29,031.74
|
$29,031.74
|
$29,031.74
|
2026-04-23
|
|
630
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure,moderate
|
10
|
3
|
$350,419.00
|
$350,419.00
|
$55,393.53
|
$379,333.62
|
$58,039.11
|
2026-04-23
|
|
631
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure,extreme
|
12
|
3
|
$243,517.50
|
$243,517.50
|
$48,930.38
|
$178,519.79
|
$110,824.89
|
2026-04-23
|
|
633
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Anomaly,minor
|
16
|
3
|
$46,905.00
|
$46,905.00
|
$5,949.32
|
$169,453.69
|
$16,642.64
|
2026-04-23
|
|
634
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…
|
16
|
3
|
$49,960.00
|
$49,960.00
|
$12,085.08
|
$165,272.95
|
$26,791.03
|
2026-04-23
|
|
636
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection,extreme
|
20
|
3
|
$67,342.00
|
$67,342.00
|
$5,284.52
|
$40,724.69
|
$21,187.47
|
2026-04-23
|
|
650
|
APR_DRG
|
Splenic Procedures,minor
|
8
|
3
|
$59,033.00
|
$59,033.00
|
$21,841.44
|
$24,126.36
|
$22,252.90
|
2026-04-23
|
|
651
|
APR_DRG
|
Other Procedures Of Blood And Blood-forming Organs,major
|
8
|
3
|
$44,235.00
|
$44,235.00
|
$18,204.62
|
$36,323.91
|
$34,887.22
|
2026-04-23
|
|
660
|
APR_DRG
|
Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula…
|
12
|
3
|
$29,044.50
|
$29,044.50
|
$12,266.64
|
$44,769.09
|
$17,162.58
|
2026-04-23
|
|
661
|
APR_DRG
|
Coagulation And Platelet Disorders,moderate
|
10
|
3
|
$44,234.00
|
$44,234.00
|
$8,400.55
|
$22,780.15
|
$21,741.79
|
2026-04-23
|
|
662
|
APR_DRG
|
Sickle Cell Anemia Crisis,major
|
16
|
3
|
$48,580.50
|
$48,580.50
|
$13,510.00
|
$51,594.46
|
$22,008.10
|
2026-04-23
|
|
680
|
APR_DRG
|
Major O.r. Procedures For Lymphatic Hematopoietic Or Other Neoplasms,major
|
20
|
3
|
$199,779.00
|
$199,779.00
|
$39,083.96
|
$96,554.08
|
$40,950.60
|
2026-04-23
|
|
681
|
APR_DRG
|
Other O.r. Procedures For Lymphatic Hematopoietic Or Other Neoplasms,major
|
8
|
3
|
$350,800.00
|
$350,800.00
|
$21,847.16
|
$51,769.98
|
$49,722.38
|
2026-04-23
|
|
690
|
APR_DRG
|
Acute Leukemia,major
|
18
|
3
|
$248,872.00
|
$248,872.00
|
$8,272.54
|
$104,985.37
|
$31,570.35
|
2026-04-23
|
|
691
|
APR_DRG
|
Lymphoma Myeloma And Non-acute Leukemia,major
|
16
|
3
|
$160,278.00
|
$160,278.00
|
$6,736.72
|
$54,816.48
|
$23,569.47
|
2026-04-23
|
|
692
|
APR_DRG
|
Radiotherapy,moderate
|
8
|
3
|
$68,772.00
|
$68,772.00
|
$17,050.41
|
$23,696.80
|
$17,565.28
|
2026-04-23
|
|
695
|
APR_DRG
|
Chemotherapy For Acute Leukemia,extreme
|
14
|
3
|
$157,893.00
|
$157,893.00
|
$16,314.45
|
$87,339.75
|
$46,246.49
|
2026-04-23
|
|
696
|
APR_DRG
|
Other Chemotherapy,major
|
16
|
3
|
$43,142.00
|
$43,142.00
|
$10,143.03
|
$59,226.62
|
$20,068.40
|
2026-04-23
|
|
7
|
APR_DRG
|
Allogeneic Bone Marrow Transplant,extreme
|
4
|
1
|
$1,168,501.00
|
$1,168,501.00
|
$131,585.37
|
$239,566.59
|
$185,575.98
|
2026-04-23
|
|
710
|
APR_DRG
|
Infectious And Parasitic Diseases Including HIV With O.r. Procedure,moderate
|
10
|
3
|
$83,609.00
|
$83,609.00
|
$26,877.34
|
$104,312.61
|
$28,160.96
|
2026-04-23
|
|
711
|
APR_DRG
|
Post-operative Post-trauma Other Device Infections With O.r. Procedure,major
|
10
|
3
|
$106,336.00
|
$106,336.00
|
$25,807.43
|
$136,169.88
|
$55,392.56
|
2026-04-23
|
|
720
|
APR_DRG
|
Septicemia And Disseminated Infections,extreme
|
12
|
3
|
$105,199.00
|
$105,199.00
|
$9,371.41
|
$53,424.30
|
$37,334.86
|
2026-04-23
|
|
721
|
APR_DRG
|
Post-operative Post-traumatic Other Device Infections,major
|
10
|
3
|
$48,955.00
|
$48,955.00
|
$16,635.42
|
$58,329.34
|
$32,550.35
|
2026-04-23
|
|
724
|
APR_DRG
|
Other Infectious And Parasitic Diseases,extreme
|
20
|
3
|
$33,001.00
|
$33,001.00
|
$10,321.35
|
$33,490.83
|
$23,885.67
|
2026-04-23
|
|
792
|
APR_DRG
|
Extensive O.r. Procedures For Other Complications Of Treatment,extreme
|
6
|
1
|
$64,102.00
|
$64,102.00
|
$17,247.31
|
$75,444.60
|
$25,812.30
|
2026-04-23
|
|
793
|
APR_DRG
|
Moderately Extensive O.r. Procedures For Other Complications Of Treatment,extrem…
|
18
|
3
|
$136,768.00
|
$136,768.00
|
$15,025.54
|
$66,045.78
|
$33,400.68
|
2026-04-23
|
|
8
|
APR_DRG
|
Autologous Bone Marrow Transplant,extreme
|
8
|
3
|
$435,917.00
|
$435,917.00
|
$128,220.03
|
$134,343.78
|
$129,030.20
|
2026-04-23
|
|
813
|
APR_DRG
|
Other Complications Of Treatment,major
|
8
|
3
|
$35,482.00
|
$35,482.00
|
$11,633.87
|
$24,696.04
|
$23,719.27
|
2026-04-23
|
|
815
|
APR_DRG
|
Other Injury Poisoning And Toxic Effect Diagnoses,major
|
16
|
3
|
$69,368.00
|
$69,368.00
|
$6,704.75
|
$32,120.70
|
$19,981.06
|
2026-04-23
|
|
844
|
APR_DRG
|
Partial Thickness Burns Without Skin Graft,major
|
6
|
3
|
$39,534.00
|
$39,534.00
|
$16,025.90
|
$16,791.27
|
$16,228.39
|
2026-04-23
|
|
850
|
APR_DRG
|
Procedure With Diagnosis Of Rehabilitation Aftercare Or Other Contact With Healt…
|
4
|
1
|
$360,984.50
|
$360,984.50
|
$39,743.77
|
$63,768.03
|
$51,755.90
|
2026-04-23
|
|
860
|
APR_DRG
|
Rehabilitation,minor
|
16
|
3
|
$101,821.00
|
$101,821.00
|
$17,846.36
|
$35,528.99
|
$23,339.18
|
2026-04-23
|
|
89
|
APR_DRG
|
Major Cranial Or Facial Bone Procedures,minor
|
14
|
3
|
$150,093.00
|
$150,093.00
|
$36,738.31
|
$101,923.16
|
$39,030.50
|
2026-04-23
|
|
893
|
APR_DRG
|
HIV With Multiple Significant HIV Related Conditions,major
|
6
|
3
|
$74,122.00
|
$74,122.00
|
$26,392.64
|
$27,653.12
|
$26,726.12
|
2026-04-23
|
|
9
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo),extreme
|
8
|
3
|
$1,295,595.00
|
$1,295,595.00
|
$111,581.49
|
$475,254.49
|
$456,457.27
|
2026-04-23
|
|
91
|
APR_DRG
|
Other Major Head And Neck Procedures,minor
|
14
|
3
|
$86,243.00
|
$86,243.00
|
$20,597.32
|
$53,067.62
|
$35,086.98
|
2026-04-23
|
|
910
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma,extreme
|
6
|
3
|
$449,729.00
|
$449,729.00
|
$153,667.71
|
$161,006.66
|
$155,609.38
|
2026-04-23
|
|
911
|
APR_DRG
|
Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma,extre…
|
2
|
1
|
$225,513.00
|
$225,513.00
|
$91,032.81
|
$91,032.81
|
$91,032.81
|
2026-04-23
|
|
912
|
APR_DRG
|
Musculoskeletal And Other Procedures For Multiple Significant Trauma,major
|
10
|
3
|
$168,513.00
|
$168,513.00
|
$45,508.30
|
$122,753.90
|
$60,128.44
|
2026-04-23
|
|
92
|
APR_DRG
|
Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures,extreme
|
20
|
3
|
$156,523.00
|
$156,523.00
|
$37,940.32
|
$84,578.01
|
$45,179.17
|
2026-04-23
|
|
92986
|
CPT
|
Cath Repair Of Aortic Valve
|
50
|
23
|
$29,247.00
|
$29,247.00
|
$12,226.94
|
$29,247.00
|
$20,472.90
|
2026-05-14
|
|
92990
|
CPT
|
Cath Repair Of Pulmonary Valve
|
50
|
23
|
$24,630.00
|
$24,630.00
|
$10,296.77
|
$24,630.00
|
$17,241.00
|
2026-05-14
|
|
930
|
APR_DRG
|
Multiple Significant Trauma Without O.r. Procedure,major
|
12
|
3
|
$42,892.00
|
$42,892.00
|
$16,701.88
|
$17,798.70
|
$17,256.07
|
2026-04-23
|
|
93453
|
CPT
|
Cath Insertion Into Right And Left Heart For Diagnosis
|
50
|
23
|
$31,718.00
|
$31,718.00
|
$13,259.96
|
$31,718.00
|
$22,202.60
|
2026-05-14
|
|
93458
|
CPT
|
Cath Insertion For Coronary Angiography
|
50
|
23
|
$28,810.00
|
$28,810.00
|
$12,044.25
|
$28,810.00
|
$20,167.00
|
2026-05-14
|
|
93460
|
CPT
|
Cath Insertion For Coronary Angiography
|
50
|
23
|
$37,838.00
|
$37,838.00
|
$15,818.48
|
$37,838.00
|
$26,486.60
|
2026-05-14
|
|
93580
|
CPT
|
Percutaneous Repair, Atrial Septal Defect
|
50
|
23
|
$45,135.00
|
$45,135.00
|
$18,869.05
|
$45,135.00
|
$31,594.50
|
2026-05-14
|
|
93591
|
CPT
|
Perq Transcath Cls Aortic
|
50
|
23
|
$55,089.00
|
$55,089.00
|
$23,030.40
|
$55,089.00
|
$38,562.30
|
2026-05-14
|
|
93596
|
CPT
|
R&l Hrt Cath Chd Nml Nt Cnj
|
50
|
23
|
$25,332.00
|
$25,332.00
|
$10,590.25
|
$25,332.00
|
$17,732.40
|
2026-05-14
|
|
93597
|
CPT
|
R&l Hrt Cath Chd Abnl Nt Cnj
|
50
|
23
|
$25,332.00
|
$25,332.00
|
$10,590.25
|
$25,332.00
|
$17,732.40
|
2026-05-14
|
|
93653
|
CPT
|
Comp Electrophysiologic (Ep) Evaluation With Ablation
|
50
|
23
|
$49,493.00
|
$49,493.00
|
$20,690.94
|
$49,493.00
|
$34,645.10
|
2026-05-14
|
|
93654
|
CPT
|
Comp Electrophysiologic (Ep) Evaluation With Ablation
|
50
|
23
|
$49,493.00
|
$49,493.00
|
$20,690.94
|
$49,493.00
|
$34,645.10
|
2026-05-14
|
|
950
|
APR_DRG
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis,major
|
14
|
3
|
$119,899.00
|
$119,899.00
|
$18,242.21
|
$166,564.94
|
$68,694.46
|
2026-04-23
|
|
951
|
APR_DRG
|
Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis,major
|
6
|
1
|
$88,731.00
|
$88,731.00
|
$14,714.45
|
$54,362.58
|
$32,093.94
|
2026-04-23
|
|
952
|
APR_DRG
|
Non-extensive O.r. Procedure Unrelated To Principal Diagnosis,extreme
|
24
|
3
|
$98,509.50
|
$98,509.50
|
$14,751.72
|
$59,307.87
|
$35,183.65
|
2026-04-23
|
|
98
|
APR_DRG
|
Other Ear Nose Mouth Throat Craniofacial And Neck Procedures,extreme
|
6
|
1
|
$74,306.00
|
$74,306.00
|
$20,947.45
|
$52,759.34
|
$27,399.33
|
2026-04-23
|
|
C1721
|
HCPCS
|
Pacemaker Evera Xt Dr
|
184
|
23
|
$52,901.00
|
$52,901.00
|
$20,933.84
|
$53,950.00
|
$36,734.56
|
2026-05-14
|
|
C1722
|
HCPCS
|
Defibrillator Icd Vr Df-4
|
262
|
23
|
$64,101.00
|
$64,101.00
|
$17,902.92
|
$109,360.00
|
$45,128.02
|
2026-05-14
|
|
C1767
|
HCPCS
|
Gen Sentiva Mod 1000
|
300
|
23
|
$79,764.00
|
$79,764.00
|
$15,272.08
|
$110,257.00
|
$53,715.24
|
2026-05-14
|
|
C1772
|
HCPCS
|
Balcofen Pump 2.0ml
|
150
|
23
|
$37,945.00
|
$37,945.00
|
$15,290.05
|
$40,483.00
|
$27,123.61
|
2026-05-14
|
|
C1786
|
HCPCS
|
Micra Transcatheter Pacing System
|
334
|
23
|
$27,625.00
|
$27,625.00
|
$4,050.56
|
$41,448.00
|
$18,508.75
|
2026-05-14
|
|
C1816
|
HCPCS
|
Receiver I-110a Std Mark IV
|
28
|
23
|
$25,346.00
|
$25,346.00
|
$10,596.10
|
$25,346.00
|
$17,373.42
|
2026-04-23
|
|
C1875
|
HCPCS
|
Hchg Stent Cp Cov Mtd 26mmx5.5cm
|
200
|
23
|
$26,096.50
|
$26,096.50
|
$9,297.19
|
$29,436.00
|
$18,686.00
|
2026-05-14
|
|
C1899
|
HCPCS
|
Implant Heartware Hvad Et
|
50
|
23
|
$271,888.00
|
$271,888.00
|
$113,664.95
|
$271,888.00
|
$190,321.60
|
2026-05-14
|
|
C2616
|
HCPCS
|
Nm Isotope Yttrium, Mci
|
50
|
23
|
$66,224.00
|
$66,224.00
|
$27,685.47
|
$66,224.00
|
$46,356.80
|
2026-05-14
|
|
C9047
|
HCPCS
|
Caplacizumab-yhdp 11 Mg Injection Kit
|
28
|
23
|
$38,899.00
|
$38,899.00
|
$16,262.04
|
$38,899.00
|
$26,663.32
|
2026-04-23
|
|
C9293
|
HCPCS
|
Glucarpidase 1,000 Unit Intravenous Solution
|
28
|
23
|
$180,456.00
|
$180,456.00
|
$75,441.07
|
$180,456.00
|
$123,693.57
|
2026-04-23
|
|
J0391
|
HCPCS
|
Artesunate 110 Mg/11 Ml Solution For Injection
|
28
|
23
|
$47,824.00
|
$47,824.00
|
$12,036.05
|
$47,824.00
|
$32,780.96
|
2026-04-23
|
|
J0491
|
HCPCS
|
Anifrolumab-fnia 300 Mg/2 Ml (150 Mg/ml) Intravenous Solution
|
28
|
23
|
$26,112.00
|
$26,112.00
|
$6,155.64
|
$26,112.00
|
$17,898.47
|
2026-04-23
|
|
J0567
|
HCPCS
|
Cerliponase Alfa 300 Mg/10 Ml(150 Mg/5ml X2) Intraventricular Kit
|
31
|
23
|
$147,531.00
|
$147,531.00
|
$34,755.00
|
$147,531.00
|
$100,247.31
|
2026-04-23
|
|
J0600
|
HCPCS
|
Edetate Calcium Disodium 200 Mg/ml Injection Solution
|
28
|
23
|
$27,730.00
|
$27,730.00
|
$11,592.75
|
$27,730.00
|
$19,007.53
|
2026-04-23
|
|
J0802
|
HCPCS
|
Corticotropin 80 Unit/ml Injection Gel
|
28
|
23
|
$146,036.00
|
$146,036.00
|
$61,051.52
|
$146,036.00
|
$100,100.38
|
2026-04-23
|
|
J1246
|
HCPCS
|
Dinutuximab 3.5 Mg/ml Intravenous Solution
|
28
|
23
|
$74,674.00
|
$74,674.00
|
$31,218.06
|
$74,674.00
|
$51,185.29
|
2026-04-23
|
|
J1299
|
HCPCS
|
Eculizumab 300 Mg/30 Ml Intravenous Solution
|
28
|
23
|
$30,532.00
|
$30,532.00
|
$7,556.93
|
$30,532.00
|
$20,928.16
|
2026-04-23
|
|
J1303
|
HCPCS
|
Ravulizumab-cwvz 100 Mg/ml Intravenous Solution
|
28
|
23
|
$30,570.00
|
$30,570.00
|
$7,545.19
|
$30,570.00
|
$20,954.21
|
2026-04-23
|
|
J1413
|
HCPCS
|
Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp
|
31
|
23
|
$2,962,567.00
|
$2,962,567.00
|
$1,958,256.79
|
$3,580,800.00
|
$2,518,181.95
|
2026-04-23
|
|
J1930
|
HCPCS
|
Lanreotide 60 Mg/0.2 Ml Subcutaneous Syringe
|
28
|
23
|
$28,756.00
|
$28,756.00
|
$2,375.66
|
$28,756.00
|
$19,710.80
|
2026-04-23
|
|
J1950
|
HCPCS
|
Leuprolide 15 Mg Intramuscular Kit
|
84
|
23
|
$24,501.00
|
$24,501.00
|
$5,920.25
|
$53,466.00
|
$16,853.80
|
2026-04-23
|
|
J2323
|
HCPCS
|
Natalizumab 300 Mg/15 Ml Intravenous Solution
|
28
|
23
|
$40,155.00
|
$40,155.00
|
$8,226.54
|
$40,155.00
|
$27,524.25
|
2026-04-23
|
|
J2327
|
HCPCS
|
Risankizumab-rzaa 60 Mg/ml Intravenous Solution
|
28
|
23
|
$47,314.00
|
$47,314.00
|
$10,022.21
|
$47,314.00
|
$32,431.38
|
2026-04-23
|
|
J2350
|
HCPCS
|
Ocrelizumab 30 Mg/ml Intravenous Solution
|
28
|
23
|
$88,190.00
|
$88,190.00
|
$19,910.16
|
$88,190.00
|
$60,449.83
|
2026-04-23
|
|
J3380
|
HCPCS
|
Vedolizumab 300 Mg Intravenous Solution
|
28
|
23
|
$42,118.00
|
$42,118.00
|
$7,172.63
|
$42,118.00
|
$28,869.78
|
2026-04-23
|
|
J7330
|
HCPCS
|
1 Membrane Implant Autologus Chondrocytes
|
50
|
23
|
$159,854.00
|
$159,854.00
|
$66,828.24
|
$159,854.00
|
$111,897.80
|
2026-05-14
|
|
J9015
|
HCPCS
|
Aldesleukin 22 Million Unit Intravenous Solution
|
3
|
3
|
$26,565.00
|
$26,565.00
|
$23,908.50
|
$26,565.00
|
$26,033.70
|
2026-04-23
|
|
J9021
|
HCPCS
|
Asparaginase Erwinia Chrysanthemi-rywn 10 Mg/0.5 Ml IM Solution
|
28
|
23
|
$25,579.00
|
$25,579.00
|
$6,285.42
|
$25,579.00
|
$17,533.12
|
2026-04-23
|
|
J9039
|
HCPCS
|
Blinatumomab 35 Mcg Intravenous Kit
|
28
|
23
|
$26,584.00
|
$26,584.00
|
$6,409.38
|
$26,584.00
|
$18,222.00
|
2026-04-23
|
|
J9042
|
HCPCS
|
Brentuximab Vedotin 50 Mg Intravenous Solution
|
28
|
23
|
$55,660.00
|
$55,660.00
|
$15,017.09
|
$55,660.00
|
$38,152.15
|
2026-04-23
|
|
J9118
|
HCPCS
|
Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution
|
28
|
23
|
$122,476.00
|
$122,476.00
|
$34,436.66
|
$122,476.00
|
$83,951.18
|
2026-04-23
|
|
J9153
|
HCPCS
|
Daunorubicin 44 Mg And Cytarabine 100 Mg In Liposome IV Solution
|
28
|
23
|
$47,867.00
|
$47,867.00
|
$12,823.19
|
$47,867.00
|
$32,810.43
|
2026-04-23
|
|
J9203
|
HCPCS
|
Gemtuzumab Ozogamicin 4.5 Mg (1 Mg/ml Initial Concentration) IV Soln
|
28
|
23
|
$45,532.00
|
$45,532.00
|
$12,091.60
|
$45,532.00
|
$31,209.91
|
2026-04-23
|
|
J9226
|
HCPCS
|
Supprelin La 50 Mg (65 Mcg/day) Implant Kit
|
28
|
23
|
$208,834.00
|
$208,834.00
|
$48,315.76
|
$208,834.00
|
$143,145.27
|
2026-04-23
|
|
J9228
|
HCPCS
|
Ipilimumab 50 Mg/10 Ml (5 Mg/ml) Intravenous Solution
|
28
|
23
|
$40,872.00
|
$40,872.00
|
$10,455.75
|
$40,872.00
|
$28,015.71
|
2026-04-23
|
|
J9229
|
HCPCS
|
Inotuzumab Ozogamicin 0.9 Mg(0.25 Mg/ml Initial Concentration) IV Soln
|
28
|
23
|
$101,565.00
|
$101,565.00
|
$28,362.62
|
$101,565.00
|
$69,617.73
|
2026-04-23
|
|
J9266
|
HCPCS
|
Pegaspargase 750 Unit/ml Injection Solution
|
28
|
23
|
$113,406.00
|
$113,406.00
|
$31,800.84
|
$113,406.00
|
$77,734.14
|
2026-04-23
|
|
J9271
|
HCPCS
|
Pembrolizumab 25 Mg/ml Intravenous Solution
|
28
|
23
|
$27,979.00
|
$27,979.00
|
$6,682.59
|
$27,979.00
|
$19,178.21
|
2026-04-23
|
|
J9309
|
HCPCS
|
Polatuzumab Vedotin-piiq 140 Mg Intravenous Solution
|
28
|
23
|
$79,901.00
|
$79,901.00
|
$21,422.56
|
$79,901.00
|
$54,768.14
|
2026-04-23
|
|
J9331
|
HCPCS
|
Sirolimus-protein Bound 100 Mg Intravenous Suspension
|
28
|
23
|
$37,454.00
|
$37,454.00
|
$9,745.87
|
$37,454.00
|
$25,672.85
|
2026-04-23
|
|
J9348
|
HCPCS
|
Naxitamab-gqgk 4 Mg/ml Intravenous Solution
|
28
|
23
|
$110,346.00
|
$110,346.00
|
$30,703.45
|
$110,346.00
|
$75,636.67
|
2026-04-23
|
|
L5321
|
HCPCS
|
Above-knee-endoskeletal-system L5321
|
28
|
23
|
$25,327.00
|
$25,327.00
|
$2,668.10
|
$25,327.00
|
$17,360.39
|
2026-04-23
|
|
L5331
|
HCPCS
|
Hip Disarticulation-endoskeletal-system L5331
|
24
|
21
|
$30,240.00
|
$30,240.00
|
$4,385.55
|
$30,240.00
|
$21,168.00
|
2026-04-23
|
|
L5341
|
HCPCS
|
Hemipelvectomy-endoskeletal-system L5341
|
29
|
23
|
$30,240.00
|
$30,240.00
|
$3,539.10
|
$30,240.00
|
$20,590.42
|
2026-04-23
|
|
L5856
|
HCPCS
|
Microprocessor Swing&Stance With Sensor L5856
|
28
|
23
|
$62,369.00
|
$62,369.00
|
$16,244.68
|
$62,369.00
|
$42,750.83
|
2026-04-23
|
|
L5858
|
HCPCS
|
Microprocessor Stance Only L5858
|
24
|
21
|
$48,951.00
|
$48,951.00
|
$16,223.49
|
$48,951.00
|
$34,265.70
|
2026-04-23
|
|
L5961
|
HCPCS
|
Addition, Endo, Polycentric Hip Joint
|
44
|
20
|
$61,659.00
|
$61,659.00
|
$40,756.60
|
$61,659.00
|
$43,216.79
|
2026-05-14
|
|
L5973
|
HCPCS
|
Endo Microproc Ankle
|
22
|
20
|
$27,827.00
|
$27,827.00
|
$18,393.65
|
$27,827.00
|
$19,503.94
|
2026-04-23
|
|
L6880
|
HCPCS
|
Electric Hand Independently Articulating Fingers L6880
|
28
|
23
|
$81,991.00
|
$81,991.00
|
$24,597.30
|
$81,991.00
|
$56,200.73
|
2026-04-23
|
|
L6920
|
HCPCS
|
Wrist-disarticulation-external Power L6920
|
24
|
21
|
$27,433.00
|
$27,433.00
|
$5,760.81
|
$27,433.00
|
$19,203.10
|
2026-04-23
|
|
L6925
|
HCPCS
|
Wrist-disarticulation-external Power Myoelectric L6925
|
24
|
21
|
$30,378.00
|
$30,378.00
|
$7,755.02
|
$30,378.00
|
$21,264.60
|
2026-04-23
|
|
L6930
|
HCPCS
|
Below Elbow External Power Switch Control L6930
|
24
|
21
|
$30,378.00
|
$30,378.00
|
$5,796.53
|
$30,378.00
|
$21,264.60
|
2026-04-23
|
|
L6935
|
HCPCS
|
Below Elbow External Power Myoelectric Control L6935
|
28
|
23
|
$25,514.00
|
$25,514.00
|
$6,105.04
|
$25,514.00
|
$17,488.57
|
2026-04-23
|
|
L6940
|
HCPCS
|
Elbow Disarticulation-outside Hinges Switch L6940
|
24
|
21
|
$32,360.00
|
$32,360.00
|
$7,573.54
|
$32,360.00
|
$22,652.00
|
2026-04-23
|
|
L6945
|
HCPCS
|
Elbow Disarticulation-outside Hinges Myoelectric Control L6945
|
24
|
21
|
$33,724.00
|
$33,724.00
|
$9,253.97
|
$33,724.00
|
$23,606.80
|
2026-04-23
|
|
L6950
|
HCPCS
|
Above Elbow External Power Internal Elbow Switch L6950
|
24
|
21
|
$30,233.00
|
$30,233.00
|
$8,608.94
|
$30,233.00
|
$21,163.10
|
2026-04-23
|
|
L6955
|
HCPCS
|
Above Elbow External Power Myoelectric Control L6955
|
28
|
23
|
$50,774.00
|
$50,774.00
|
$7,992.16
|
$50,774.00
|
$34,803.04
|
2026-04-23
|
|
L6960
|
HCPCS
|
Shoulder Disarticulation External Power Switch L6960
|
24
|
21
|
$38,283.00
|
$38,283.00
|
$11,678.34
|
$38,283.00
|
$26,798.10
|
2026-04-23
|
|
L6965
|
HCPCS
|
Shoulder Disarticulation External Power Myoelectric L6965
|
24
|
21
|
$46,489.00
|
$46,489.00
|
$12,455.38
|
$46,489.00
|
$32,542.30
|
2026-04-23
|
|
L6970
|
HCPCS
|
Interscapular External Power Switch L6970
|
22
|
20
|
$44,861.00
|
$44,861.00
|
$29,653.12
|
$44,861.00
|
$31,443.08
|
2026-04-23
|
|
L6975
|
HCPCS
|
Interscapular External Power Myoelectric L6975
|
24
|
21
|
$56,822.00
|
$56,822.00
|
$14,194.54
|
$56,822.00
|
$39,775.40
|
2026-04-23
|
|
L7170
|
HCPCS
|
Electric Elbow Boston Switch L7170
|
46
|
21
|
$61,300.00
|
$61,300.00
|
$6,424.13
|
$61,300.00
|
$29,355.48
|
2026-04-23
|
|
L7180
|
HCPCS
|
Electric Elbow Utah Myoelectric Control L7180
|
46
|
21
|
$130,152.00
|
$130,152.00
|
$28,198.45
|
$130,152.00
|
$62,824.41
|
2026-04-23
|
|
L7185
|
HCPCS
|
Electric Elbow Variety Village Switch L7185
|
24
|
21
|
$29,287.00
|
$29,287.00
|
$6,343.93
|
$29,287.00
|
$20,500.90
|
2026-04-23
|
|
L7186
|
HCPCS
|
Electric Elbow Child Variety Village L7186
|
24
|
21
|
$35,250.00
|
$35,250.00
|
$7,635.53
|
$35,250.00
|
$24,675.00
|
2026-04-23
|
|
L7190
|
HCPCS
|
Electric Elbow Variety Village Myoelectric L7190
|
24
|
21
|
$33,782.00
|
$33,782.00
|
$6,663.29
|
$33,782.00
|
$23,647.40
|
2026-04-23
|
|
L7191
|
HCPCS
|
Electric Elbow Child Variety Village L7191
|
24
|
21
|
$36,832.00
|
$36,832.00
|
$7,978.68
|
$36,832.00
|
$25,782.40
|
2026-04-23
|
|
L8614
|
HCPCS
|
Impl Coch Nucleus Slm Modiolar
|
946
|
23
|
$37,297.00
|
$37,297.00
|
$994.98
|
$72,034.00
|
$27,104.00
|
2026-05-14
|
|
L8619
|
HCPCS
|
Naida Ci Sky M90 Patient Kit
|
56
|
23
|
$32,530.50
|
$32,530.50
|
$11,178.87
|
$38,321.00
|
$22,729.00
|
2026-04-23
|
|
L8699
|
HCPCS
|
Bar Darter Pre Bent
|
150
|
23
|
$33,851.00
|
$33,851.00
|
$2,359.94
|
$35,249.00
|
$23,001.75
|
2026-05-14
|
|
PX-36001592
|
CDM
|
Or Time Level E, First 15 Min
|
50
|
23
|
$28,242.00
|
$28,242.00
|
$11,806.79
|
$28,242.00
|
$19,769.40
|
2026-05-14
|
|
PX-36001594
|
CDM
|
Or Time Level P, First 15 Min
|
50
|
23
|
$37,610.00
|
$37,610.00
|
$15,723.16
|
$37,610.00
|
$26,327.00
|
2026-05-14
|
|
PX-36001596
|
CDM
|
Or Time Level I, First 15 Min
|
50
|
23
|
$60,705.00
|
$60,705.00
|
$25,378.21
|
$60,705.00
|
$42,493.50
|
2026-05-14
|
|
PX-41001004
|
CDM
|
Ecmo Initiation And Management, Each Day
|
50
|
23
|
$26,305.00
|
$26,305.00
|
$10,997.02
|
$26,305.00
|
$18,413.50
|
2026-05-14
|
|
PX-48011066
|
CDM
|
Cath Lab Time, First 15 Min
|
50
|
23
|
$25,489.00
|
$25,489.00
|
$10,655.88
|
$25,489.00
|
$17,842.30
|
2026-05-14
|
|
PX-48014890
|
CDM
|
Hybrid or/Cath, First 15 Min
|
50
|
23
|
$36,190.00
|
$36,190.00
|
$15,129.52
|
$36,190.00
|
$25,333.00
|
2026-05-14
|
|
PX-81011000
|
CDM
|
Organ Acquisition, Kidney, Living Donor
|
50
|
23
|
$85,206.00
|
$85,206.00
|
$35,621.05
|
$85,206.00
|
$59,644.20
|
2026-05-14
|
|
PX-81011001
|
CDM
|
Organ Acquisition, Liver, Living Donor
|
50
|
23
|
$100,541.00
|
$100,541.00
|
$42,031.97
|
$100,541.00
|
$70,378.70
|
2026-05-14
|
|
PX-81021000
|
CDM
|
Organ Acquisition, Kidney, Cadaveric Donor
|
50
|
23
|
$106,287.00
|
$106,287.00
|
$44,434.13
|
$106,287.00
|
$74,400.90
|
2026-05-14
|
|
PX-81021005
|
CDM
|
Organ Acquisition, Heart, Without Transportation
|
50
|
23
|
$207,553.00
|
$207,553.00
|
$86,769.19
|
$207,553.00
|
$145,287.10
|
2026-05-14
|
|
PX-81021006
|
CDM
|
Organ Acquisition, Heart, With Transportation
|
50
|
23
|
$228,127.00
|
$228,127.00
|
$95,370.32
|
$228,127.00
|
$159,688.90
|
2026-05-14
|
|
PX-81021007
|
CDM
|
Organ Acquisition, Liver, Cadaveric Donor Without Transportation
|
50
|
23
|
$100,541.00
|
$100,541.00
|
$42,031.97
|
$100,541.00
|
$70,378.70
|
2026-05-14
|
|
PX-81021009
|
CDM
|
Organ Acquisition, Liver, Cadaveric Donor With Transportation
|
50
|
23
|
$123,615.00
|
$123,615.00
|
$51,678.24
|
$123,615.00
|
$86,530.50
|
2026-05-14
|
|
Q0481
|
HCPCS
|
Kit Heartware Controller
|
50
|
23
|
$48,647.00
|
$48,647.00
|
$20,337.27
|
$48,647.00
|
$34,052.90
|
2026-05-14
|
|
Q4130
|
HCPCS
|
Mesh Firm Strattice 20x25cm
|
302
|
23
|
$41,510.00
|
$41,510.00
|
$4,373.30
|
$81,992.00
|
$25,447.65
|
2026-05-14
|
|
Q5151
|
HCPCS
|
Eculizumab-aagh 300 Mg/30 Ml Intravenous Solution
|
4
|
4
|
$22,057.00
|
$22,057.00
|
$19,851.30
|
$22,057.00
|
$21,573.95
|
2026-04-23
|
|
SUP-14452
|
CDM
|
Processor Single Rondo
|
50
|
23
|
$30,209.00
|
$30,209.00
|
$12,629.11
|
$30,209.00
|
$21,146.30
|
2026-05-14
|
|
SUP-64403
|
CDM
|
Electrode Cochlear Arr Flex28
|
50
|
23
|
$121,949.00
|
$121,949.00
|
$50,981.76
|
$121,949.00
|
$85,364.30
|
2026-05-14
|