Price Transparency Hospital negotiated rates

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

SAINT JOSEPH REGIONAL MEDICAL CENTER

Mishawaka, IN · CCN 150012 · Rates published

25,636 distinct procedures filed
37 distinct payers
1,845,196 rate rows
2025-01-01 last MRF observed · ⚠ 17 mo old
Data quality

1,096,399 of 1,845,196 rate rows are consumer-grade (59.4%)

748,797 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 719,577
template filing: same amount across many unrelated codes — excluded 20,313
exceeds 10× this hospital's gross charge — excluded from medians 8,292
percent-of-charges filed in the dollar field — excluded from medians 581
placeholder amount (≤ $0.02) — excluded from medians 34

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 17 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://trinityhealth.pt.panaceainc.com/MRFDownload/trinityhealth/mishawakamedicalcenter
Found on page https://www.sjmed.com/patients-visitors/billing-and-assistance/request-price-estimate
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-16
Content fingerprint 97a4810e2b06e970… · 37,027,068 bytes · first seen 2026-05-08

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
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 19 $13,201.00 $905,519.88 $428,144.16 nat. median
$370,174
1.2× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 20 $187,915.16 $666,029.39 $315,223.52 nat. median
$265,286
1.2× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 20 $114,318.77 $647,844.13 $306,649.10 nat. median
$206,368
1.5× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 20 $126,416.34 $524,010.33 $248,261.02 nat. median
$202,986
1.2× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 20 $78,367.55 $361,296.60 $171,540.90 nat. median
$133,176
1.3× median
7
MS_DRG 		Lung Transplant 19 $69,453.13 $301,483.58 $143,338.84 nat. median
$122,708
1.2× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 20 $92,309.94 $300,935.49 $143,080.41 nat. median
$108,660
1.3× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 19 $13,201.00 $281,686.00 $134,004.21 nat. median
$117,303
1.1× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve?procedures 19 $81,294.03 $264,722.26 $126,005.75 nat. median
$102,358
1.2× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 19 $76,796.02 $254,382.30 $121,130.41 nat. median
$100,136
1.2× median
215
MS_DRG 		Other Heart Assist System Implant 20 $77,137.83 $251,059.35 $119,563.64 nat. median
$99,019
1.2× median
'588-4
APR_DRG 		Neonate Bwt <1500g W Major Procedure 5 $115,628.23 $115,628.23 $115,628.23 —
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 $67,759.89 $238,536.86 $113,659.24 nat. median
$93,672
1.2× median
27100000002-816
CDM 		Glove Vinyl Powder Free Lg 18 $55,604.16 $166,479.51 $104,882.09 nat. median
$81,142
1.3× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 20 $67,019.10 $217,795.49 $103,879.61 nat. median
$87,411
1.2× median
'002-4
APR_DRG 		Heart &/or Lung Transplant 5 $101,004.57 $101,004.57 $101,004.57 —
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 20 $63,961.20 $207,743.09 $99,139.86 nat. median
$77,576
1.3× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 20 $63,789.24 $207,177.79 $98,873.32 nat. median
$81,118
1.2× median
'161-4
APR_DRG 		Cardiac Defibrillator & Heart Assist Implant 5 $96,953.83 $96,953.83 $96,953.83 —
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 20 $55,884.97 $199,455.39 $95,232.17 nat. median
$79,312
1.2× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 19 $60,530.22 $196,464.24 $93,821.84 nat. median
$71,240
1.3× median
27800000002-88967
CDM 		Device Impella 5.5 Smartassist 18 $48,847.50 $146,250.00 $92,137.50 nat. median
$71,282
1.3× median
27800000002-88968
CDM 		Device Impella 5.5 Smartassist 18 $48,847.50 $146,250.00 $92,137.50 nat. median
$71,282
1.3× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 20 $52,681.05 $191,698.57 $91,574.81 nat. median
$73,807
1.2× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 $54,119.42 $189,525.87 $90,550.36 nat. median
$74,915
1.2× median
27200000002-30479
CDM 		Stylet Steerable 30cm 18 $46,419.17 $138,979.55 $87,557.12 nat. median
$202
outlier · 433.2×
27800000002-91547
CDM 		Graft Bn Canc Crsh Frzdr 30ml 18 $46,220.59 $138,385.00 $87,182.55 nat. median
$67,449
1.3× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 20 $46,898.24 $177,760.39 $85,002.90 nat. median
$72,138
1.2× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 19 $53,369.95 $172,925.89 $82,723.42 nat. median
$68,887
1.2× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 20 $13,201.00 $171,183.31 $81,901.78 nat. median
$66,526
1.2× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 20 $41,095.39 $170,072.39 $81,377.98 nat. median
$64,027
1.3× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 20 $13,201.00 $169,784.82 $81,242.40 nat. median
$62,134
1.3× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 20 $36,006.34 $168,914.76 $80,832.16 nat. median
$60,185
1.3× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 20 $44,967.30 $168,474.82 $80,624.72 nat. median
$65,950
1.2× median
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 20 $46,863.16 $163,008.67 $78,047.41 nat. median
$65,381
1.2× median
461
MS_DRG 		Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 20 $36,497.49 $167,585.09 $77,617.95 nat. median
$55,736
1.4× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 $44,801.91 $156,446.34 $74,953.26 nat. median
$64,510
1.2× median
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 20 $47,465.74 $153,516.65 $73,571.90 nat. median
$60,726
1.2× median
'001-4
APR_DRG 		Liver Transplant &/or Intestinal Transplant 5 $73,501.84 $73,501.84 $73,501.84 —
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 20 $28,015.51 $152,828.46 $73,247.40 nat. median
$59,793
1.2× median
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc 19 $47,197.33 $152,634.30 $73,155.86 nat. median
$59,099
1.2× median
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/mcc 19 $13,201.00 $151,818.31 $72,771.12 nat. median
$56,920
1.3× median
17
MS_DRG 		Autologous Bone Marrow Transplant Without Cc/mcc 19 $13,201.00 $151,818.31 $72,771.12 nat. median
$53,805
1.4× median
21
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 20 $46,682.94 $150,943.33 $72,358.56 nat. median
$54,066
1.3× median
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 20 $46,495.28 $150,326.42 $72,067.68 nat. median
$62,270
1.2× median
J7330
HCPCS 		Membrane Collgn Porcine Maci W/autologous Cult Chondrocytes 18 $38,156.16 $114,240.00 $71,971.20 nat. median
$76,377
0.9× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 20 $40,647.20 $149,684.94 $71,765.22 nat. median
$64,732
1.1× median
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 20 $46,188.74 $149,318.72 $71,592.55 nat. median
$58,024
1.2× median
820
MS_DRG 		Lymphoma And Leukemia With Major O.r. Procedures With Mcc 20 $42,351.18 $148,615.79 $71,261.13 nat. median
$56,697
1.3× median
28
MS_DRG 		Spinal Procedures With Mcc 20 $38,443.47 $148,109.49 $71,022.40 nat. median
$57,823
1.2× median

Other procedures at this hospital

Browse this hospital's 25,636 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
             
C1822 HCPCS Kit Ipg Omnia 115 18 $44,980.00 $37,333.40 $4,878.91 $84,500.00 $39,065.00 2025-01-01
33264 HCPCS Hc Removal/replacement Implantable Defibrillator W/lead(s) Multi 55 36 $76,754.00 $63,705.82 $367.53 $112,466.99 $47,854.56 2025-01-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan Therapeutic Per Treatment Dose Up To 40 Millic… 50 34 $55,035.00 $45,679.05 $17,678.68 $188,572.55 $65,476.58 2025-01-01
J9600 HCPCS Porfimer Per 75 Mg 50 34 $105,199.95 $87,315.96 $6,256.05 $105,199.95 $48,451.49 2025-01-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 33 20 — — $13,201.00 $171,183.31 $81,901.78 2025-01-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 33 20 — — $13,201.00 $169,784.82 $81,242.40 2025-01-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 33 20 — — $36,497.49 $167,585.09 $77,617.95 2025-01-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 33 20 — — $13,201.00 $147,470.46 $70,721.09 2025-01-01
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 33 20 — — $13,201.00 $137,612.22 $66,072.89 2025-01-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 33 20 — — $36,080.09 $127,476.25 $59,316.53 2025-01-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 33 20 — — $13,201.00 $119,055.83 $56,310.65 2025-01-01
793 MS_DRG Full Term Neonate With Major Problems 33 20 — — $13,201.00 $103,456.18 $49,968.19 2025-01-01
791 MS_DRG Prematurity With Major Problems 33 20 — — $13,201.00 $100,713.27 $48,674.90 2025-01-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 33 20 — — $13,201.00 $89,387.73 $43,334.87 2025-01-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 33 20 — — $13,201.00 $89,038.72 $43,170.31 2025-01-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 33 20 — — $24,611.84 $85,686.28 $40,248.03 2025-01-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 33 20 — — $21,513.00 $81,839.82 $38,492.91 2025-01-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 32 19 — — $13,201.00 $905,519.88 $428,144.16 2025-01-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 32 20 — — $187,915.16 $666,029.39 $315,223.52 2025-01-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 32 20 — — $114,318.77 $647,844.13 $306,649.10 2025-01-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 32 20 — — $126,416.34 $524,010.33 $248,261.02 2025-01-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 32 20 — — $78,367.55 $361,296.60 $171,540.90 2025-01-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 32 20 — — $92,309.94 $300,935.49 $143,080.41 2025-01-01
14 MS_DRG Allogeneic Bone Marrow Transplant 32 19 — — $13,201.00 $281,686.00 $134,004.21 2025-01-01
215 MS_DRG Other Heart Assist System Implant 32 20 — — $77,137.83 $251,059.35 $119,563.64 2025-01-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 32 20 — — $67,759.89 $238,536.86 $113,659.24 2025-01-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 32 20 — — $67,019.10 $217,795.49 $103,879.61 2025-01-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 32 20 — — $63,961.20 $207,743.09 $99,139.86 2025-01-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 32 20 — — $63,789.24 $207,177.79 $98,873.32 2025-01-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 32 20 — — $55,884.97 $199,455.39 $95,232.17 2025-01-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 32 20 — — $52,681.05 $191,698.57 $91,574.81 2025-01-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 32 20 — — $54,119.42 $189,525.87 $90,550.36 2025-01-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 32 20 — — $46,898.24 $177,760.39 $85,002.90 2025-01-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 32 20 — — $41,095.39 $170,072.39 $81,377.98 2025-01-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 32 20 — — $36,006.34 $168,914.76 $80,832.16 2025-01-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 32 20 — — $44,967.30 $168,474.82 $80,624.72 2025-01-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 32 20 — — $46,863.16 $163,008.67 $78,047.41 2025-01-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 32 20 — — $44,801.91 $156,446.34 $74,953.26 2025-01-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 32 20 — — $47,465.74 $153,516.65 $73,571.90 2025-01-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 32 20 — — $28,015.51 $152,828.46 $73,247.40 2025-01-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 32 19 — — $13,201.00 $151,818.31 $72,771.12 2025-01-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 32 19 — — $13,201.00 $151,818.31 $72,771.12 2025-01-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 32 20 — — $46,682.94 $150,943.33 $72,358.56 2025-01-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 32 20 — — $46,495.28 $150,326.42 $72,067.68 2025-01-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 32 20 — — $40,647.20 $149,684.94 $71,765.22 2025-01-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 32 20 — — $46,188.74 $149,318.72 $71,592.55 2025-01-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 32 20 — — $42,351.18 $148,615.79 $71,261.13 2025-01-01
28 MS_DRG Spinal Procedures With Mcc 32 20 — — $38,443.47 $148,109.49 $71,022.40 2025-01-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 32 20 — — $41,367.45 $146,204.69 $70,124.28 2025-01-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 32 20 — — $41,599.42 $144,533.39 $69,336.24 2025-01-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 32 20 — — $39,245.35 $140,013.49 $67,205.10 2025-01-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 32 20 — — $38,298.85 $139,679.23 $67,047.50 2025-01-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 32 20 — — $38,293.84 $139,327.77 $66,881.79 2025-01-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 32 20 — — $36,534.01 $139,202.42 $66,822.69 2025-01-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 32 20 — — $40,013.57 $135,306.81 $64,985.89 2025-01-01
653 MS_DRG Major Bladder Procedures With Mcc 32 20 — — $41,241.53 $133,055.46 $63,924.37 2025-01-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 32 20 — — $36,566.94 $128,901.78 $61,965.88 2025-01-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 32 20 — — $35,136.45 $127,753.99 $61,424.70 2025-01-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 32 20 — — $34,008.82 $126,731.54 $60,942.62 2025-01-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 32 20 — — $38,739.88 $124,831.66 $60,046.81 2025-01-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 32 20 — — $33,899.99 $124,288.49 $59,790.71 2025-01-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 32 20 — — $38,438.58 $123,841.17 $59,579.80 2025-01-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 32 20 — — $36,753.09 $122,872.80 $59,123.20 2025-01-01
799 MS_DRG Splenic Procedures With Mcc 32 20 — — $34,057.50 $121,774.16 $58,605.19 2025-01-01
471 MS_DRG Cervical Spinal Fusion With Mcc 32 20 — — $35,105.67 $120,899.18 $58,192.64 2025-01-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 32 20 — — $37,253.55 $119,945.56 $57,743.00 2025-01-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 32 20 — — $34,638.14 $118,141.53 $56,892.39 2025-01-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 32 20 — — $34,746.97 $116,509.55 $56,122.91 2025-01-01
163 MS_DRG Major Chest Procedures With Mcc 32 20 — — $35,809.46 $115,850.86 $55,812.34 2025-01-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 32 20 — — $32,508.88 $114,253.29 $55,059.07 2025-01-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 32 20 — — $35,200.49 $113,196.44 $54,560.76 2025-01-01
245 MS_DRG Aicd Generator Procedures 32 20 — — $33,552.75 $111,372.75 $53,700.88 2025-01-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 32 20 — — $34,642.74 $111,362.92 $53,696.25 2025-01-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 32 20 — — $34,536.58 $111,013.91 $53,531.70 2025-01-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 32 20 — — $31,885.99 $110,647.70 $53,359.03 2025-01-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 32 20 — — $33,341.54 $108,841.22 $52,507.26 2025-01-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 32 20 — — $30,761.22 $108,536.45 $52,363.56 2025-01-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 32 20 — — $33,579.58 $113,739.61 $52,048.35 2025-01-01
901 MS_DRG Wound Debridements For Injuries With Mcc 32 20 — — $28,187.35 $106,368.67 $51,341.44 2025-01-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 32 20 — — $25,960.71 $105,754.22 $51,051.73 2025-01-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 32 20 — — $26,911.50 $105,161.89 $50,772.45 2025-01-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 32 20 — — $27,951.79 $102,210.07 $49,380.64 2025-01-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 32 20 — — $27,087.63 $101,177.79 $48,893.93 2025-01-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 32 20 — — $26,344.46 $99,732.61 $48,212.52 2025-01-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 32 20 — — $27,611.00 $99,413.09 $48,061.87 2025-01-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 32 20 — — $27,215.79 $99,324.61 $48,020.15 2025-01-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 32 20 — — $24,638.33 $98,668.38 $47,710.74 2025-01-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 32 20 — — $24,376.29 $98,432.43 $47,599.48 2025-01-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 32 20 — — $28,677.06 $97,272.35 $47,052.50 2025-01-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 32 20 — — $30,006.55 $96,122.10 $46,510.15 2025-01-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 32 20 — — $26,383.84 $95,888.61 $46,400.06 2025-01-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 32 20 — — $25,415.86 $95,780.47 $46,349.08 2025-01-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 32 20 — — $29,829.36 $95,539.60 $46,235.51 2025-01-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 32 20 — — $26,573.57 $95,318.40 $46,131.21 2025-01-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 32 20 — — $27,237.98 $94,637.59 $45,810.20 2025-01-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 32 20 — — $25,229.71 $94,025.60 $45,521.64 2025-01-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 32 20 — — $27,189.30 $93,121.13 $45,095.19 2025-01-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 32 20 — — $22,080.92 $91,712.81 $44,431.15 2025-01-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 32 20 — — $26,115.36 $91,484.23 $44,323.38 2025-01-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 32 20 — — $27,258.75 $91,417.87 $44,292.09 2025-01-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 32 20 — — $24,026.90 $90,889.44 $44,042.94 2025-01-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 32 20 — — $28,114.99 $89,903.87 $43,578.23 2025-01-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 32 20 — — $20,941.11 $89,753.94 $43,507.54 2025-01-01
332 MS_DRG Rectal Resection With Mcc 32 20 — — $27,888.45 $89,815.39 $43,227.10 2025-01-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 32 20 — — $24,401.35 $88,881.42 $43,096.14 2025-01-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 32 20 — — $21,586.91 $88,018.73 $42,689.39 2025-01-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 32 20 — — $27,495.18 $87,866.35 $42,617.53 2025-01-01
265 MS_DRG Aicd Lead Procedures 32 20 — — $21,250.41 $86,861.11 $42,143.55 2025-01-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 32 20 — — $25,261.22 $86,642.37 $42,040.42 2025-01-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 32 20 — — $26,760.24 $96,412.12 $41,478.37 2025-01-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 32 20 — — $22,613.60 $85,091.49 $41,309.17 2025-01-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 32 20 — — $22,499.76 $84,946.48 $41,240.80 2025-01-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 32 20 — — $26,598.75 $84,919.45 $41,228.06 2025-01-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 32 20 — — $21,871.15 $84,258.30 $40,916.33 2025-01-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 32 20 — — $20,354.74 $83,707.75 $40,656.75 2025-01-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 32 20 — — $24,256.72 $84,322.20 $40,477.12 2025-01-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 32 20 — — $22,998.78 $82,992.53 $40,319.51 2025-01-01
37 MS_DRG Extracranial Procedures With Mcc 32 20 — — $22,114.57 $82,965.50 $40,306.76 2025-01-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 32 20 — — $22,345.83 $82,803.28 $40,230.28 2025-01-01
252 MS_DRG Other Vascular Procedures With Mcc 32 20 — — $23,535.04 $82,429.70 $40,054.14 2025-01-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 32 20 — — $19,222.09 $82,144.59 $39,919.71 2025-01-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 32 20 — — $25,552.78 $81,480.99 $39,606.81 2025-01-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 32 20 — — $23,005.23 $80,959.93 $39,361.13 2025-01-01
264 MS_DRG Other Circulatory System O.r. Procedures 32 20 — — $20,104.16 $80,271.75 $39,036.66 2025-01-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 32 20 — — $23,010.95 $80,030.88 $38,923.09 2025-01-01
500 MS_DRG Soft Tissue Procedures With Mcc 32 20 — — $22,927.90 $79,701.54 $38,767.79 2025-01-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 32 20 — — $17,324.08 $79,652.38 $38,744.62 2025-01-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 32 20 — — $17,656.29 $79,030.56 $38,451.42 2025-01-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 32 20 — — $21,382.86 $79,025.64 $38,449.11 2025-01-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 32 20 — — $24,697.47 $78,669.26 $38,281.08 2025-01-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 32 20 — — $24,538.97 $78,148.21 $38,035.40 2025-01-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 32 20 — — $22,811.92 $77,703.35 $37,825.64 2025-01-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 32 20 — — $23,799.23 $77,514.10 $37,736.41 2025-01-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 32 20 — — $24,224.95 $77,115.93 $37,548.67 2025-01-01
7 MS_DRG Lung Transplant 31 19 — — $69,453.13 $301,483.58 $143,338.84 2025-01-01
212 MS_DRG Concomitant Aortic And Mitral Valve?procedures 31 19 — — $81,294.03 $264,722.26 $126,005.75 2025-01-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 31 19 — — $76,796.02 $254,382.30 $121,130.41 2025-01-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 31 19 — — $60,530.22 $196,464.24 $93,821.84 2025-01-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 31 19 — — $53,369.95 $172,925.89 $82,723.42 2025-01-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc 31 19 — — $47,197.33 $152,634.30 $73,155.86 2025-01-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 31 19 — — $38,903.83 $129,322.06 $62,164.05 2025-01-01
6 MS_DRG Liver Transplant Without Mcc 31 19 — — $34,602.35 $118,881.33 $57,241.21 2025-01-01
10 MS_DRG Pancreas Transplant 31 19 — — $30,814.20 $118,308.66 $56,971.20 2025-01-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 31 19 — — $36,522.34 $117,541.83 $56,609.63 2025-01-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 31 19 — — $34,392.28 $110,539.56 $53,308.03 2025-01-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 31 19 — — $34,114.90 $109,627.71 $52,878.10 2025-01-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 31 19 — — $33,378.46 $107,206.78 $51,736.61 2025-01-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 31 19 — — $31,719.42 $101,752.92 $49,165.10 2025-01-01
140 MS_DRG Major Head And Neck Procedures With Mcc 31 19 — — $29,013.67 $92,858.14 $44,971.19 2025-01-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 31 19 — — $26,623.42 $85,000.56 $41,266.30 2025-01-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 31 19 — — $25,630.54 $81,736.60 $39,727.34 2025-01-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 31 19 — — $24,695.97 $78,664.35 $38,278.75 2025-01-01
33990 HCPCS Hc Insert Vad Percutaneous Left Heart Arterial Access With S&i 28 22 $68,083.00 $56,508.89 $323.43 $68,083.00 $41,905.08 2025-01-01
27100000002-816 CDM Glove Vinyl Powder Free Lg 23 18 $166,479.51 $138,177.99 $55,604.16 $166,479.51 $104,882.09 2025-01-01
27800000002-88968 CDM Device Impella 5.5 Smartassist 23 18 $146,250.00 $121,387.50 $48,847.50 $146,250.00 $92,137.50 2025-01-01
27800000002-88967 CDM Device Impella 5.5 Smartassist 23 18 $146,250.00 $121,387.50 $48,847.50 $146,250.00 $92,137.50 2025-01-01
27200000002-30479 CDM Stylet Steerable 30cm 23 18 $138,979.55 $115,353.03 $46,419.17 $138,979.55 $87,557.12 2025-01-01
27800000002-91547 CDM Graft Bn Canc Crsh Frzdr 30ml 23 18 $138,385.00 $114,859.55 $46,220.59 $138,385.00 $87,182.55 2025-01-01
J7330 HCPCS Membrane Collgn Porcine Maci W/autologous Cult Chondrocytes 23 18 $114,240.00 $94,819.20 $38,156.16 $114,240.00 $71,971.20 2025-01-01
27800000002-89096 CDM Valve Sapien Thv Edwards Resilia 23mm 23 18 $110,500.00 $91,715.00 $36,907.00 $110,500.00 $69,615.00 2025-01-01
27800000002-89098 CDM Valve Sapien Thv Edwards Resilia 26mm 23 18 $110,500.00 $91,715.00 $36,907.00 $110,500.00 $69,615.00 2025-01-01
27800000002-89099 CDM Valve Sapien Thv Edwards Resilia 20mm 23 18 $110,500.00 $91,715.00 $36,907.00 $110,500.00 $69,615.00 2025-01-01
27800000002-89097 CDM Valve Sapien Thv Edwards Resilia 29mm 23 18 $110,500.00 $91,715.00 $36,907.00 $110,500.00 $69,615.00 2025-01-01
27800000002-90555 CDM Valve Aort 26mm Evolutr 23 18 $107,250.00 $89,017.50 $35,821.50 $107,250.00 $67,567.50 2025-01-01
27800000002-90653 CDM Valve Sapien 3 Thv 20mm W/command System 23 18 $105,625.00 $87,668.75 $35,278.75 $105,625.00 $66,543.75 2025-01-01
27800000002-91231 CDM Valve Sapien 3 Ultra Thv 20mm W/command System 23 18 $105,625.00 $87,668.75 $35,278.75 $105,625.00 $66,543.75 2025-01-01
27800000002-88988 CDM Valve Hrt Sapien 3 Ultra 26mm 23 18 $105,625.00 $87,668.75 $35,278.75 $105,625.00 $66,543.75 2025-01-01
27800000002-91234 CDM Valve Sapien 3 Ultra Thv 23mm W/command System 23 18 $105,625.00 $87,668.75 $35,278.75 $105,625.00 $66,543.75 2025-01-01
27800000002-91233 CDM Valve Sapien 3 Ultra Thv 23mm W/command System 23 18 $105,625.00 $87,668.75 $35,278.75 $105,625.00 $66,543.75 2025-01-01
27800000002-91236 CDM Valve Sapien 3 Ultra Thv 26mm W/command System 23 18 $105,625.00 $87,668.75 $35,278.75 $105,625.00 $66,543.75 2025-01-01
27800000002-88987 CDM Valve Hrt Sapien 3 Ultra 23mm 23 18 $105,625.00 $87,668.75 $35,278.75 $105,625.00 $66,543.75 2025-01-01
27800000002-90659 CDM Valve Sapien 3 Thv 29mm W/command System 23 18 $105,625.00 $87,668.75 $35,278.75 $105,625.00 $66,543.75 2025-01-01
27800000002-90657 CDM Valve Sapien 3 Thv 26mm W/command System 23 18 $105,625.00 $87,668.75 $35,278.75 $105,625.00 $66,543.75 2025-01-01
27800000002-91237 CDM Valve Sapien 3 Ultra Thv 26mm W/command System 23 18 $105,625.00 $87,668.75 $35,278.75 $105,625.00 $66,543.75 2025-01-01
27800000002-90655 CDM Valve Sapien 3 Thv 23mm W/command System 23 18 $105,625.00 $87,668.75 $35,278.75 $105,625.00 $66,543.75 2025-01-01
27800000002-89078 CDM Valve Aortic 34mm Evolut Fx 23 18 $97,987.50 $81,329.63 $32,727.83 $97,987.50 $61,732.13 2025-01-01
A9542 HCPCS Indium In-111 Ibritumomab Tiuxetan Diagnostic Per Study Dose Up To 5 Millicuries 23 18 $97,800.00 $81,174.00 $32,665.20 $97,800.00 $61,614.00 2025-01-01
27800000002-91511 CDM Kit Mitraclip G4 Delivery Sys Xtw 23 18 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $61,425.00 2025-01-01
27800000002-90154 CDM Kit Mitraclip 1 Mbr0301 23 18 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $61,425.00 2025-01-01
27800000002-90156 CDM Kit Mitraclp 1 Sgc0301 Cds0501 23 18 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $61,425.00 2025-01-01
27800000002-91555 CDM Kit Mitraclip 2 Mbr0202 23 18 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $61,425.00 2025-01-01
27800000002-90559 CDM Valve Aort 34mm Evolutr 23 18 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $61,425.00 2025-01-01
27800000002-90152 CDM Kit Mitraclip 1 Mbr0201 23 18 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $61,425.00 2025-01-01
27800000002-91556 CDM Kit Mitraclip 2 Mbr0202 23 18 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $61,425.00 2025-01-01
27800000002-91435 CDM Kit Mitraclip 1 Mbr0303 23 18 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $61,425.00 2025-01-01
27800000002-91247 CDM Kit Mitraclip G4 Syst Cds0701nt/ntw/xt/xtw 23 18 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $61,425.00 2025-01-01
27800000002-90151 CDM Kit Mitraclip 1 Mbr0101 23 18 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $61,425.00 2025-01-01
27800000002-90157 CDM Kit Mitraclp 2 Sgc0301 Cds0501 23 18 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $61,425.00 2025-01-01
27800000002-90556 CDM Valve Aort 26mm Pro Perc 23 18 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $61,425.00 2025-01-01
27800000002-90153 CDM Kit Mitraclip 1 Mbr0301 23 18 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $61,425.00 2025-01-01
27800000002-89075 CDM Valve Aortic 26mm Evolut Fx 23 18 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $61,425.00 2025-01-01
27800000002-89080 CDM Valve Aortic 23mm Evolut Fx 23 18 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $61,425.00 2025-01-01
27800000002-91517 CDM Kit Mitraclip G4 Delivery Sys Nt 23 18 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $61,425.00 2025-01-01
27800000002-89076 CDM Valve Aortic 29mm Evolut Fx 23 18 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $61,425.00 2025-01-01
27800000002-90837 CDM Valve Aortic Evolut Tm Pro 29mm 23 18 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $61,425.00 2025-01-01
27800000002-90558 CDM Valve Aort 29mm Pro Perc 23 18 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $61,425.00 2025-01-01
27800000002-90155 CDM Kit Mitraclip 3 Mbr0203 23 18 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $61,425.00 2025-01-01
27800000002-90158 CDM Kit Mitraclp 3 Sgc0301 Cds0501 23 18 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $61,425.00 2025-01-01
27200000002-21552 CDM Hemostat D Stat Flowable 0330 23 18 $87,500.00 $72,625.00 $29,225.00 $87,500.00 $55,125.00 2025-01-01
27800000002-91577 CDM Implant Gammatile Therapy Device 4pk 23 18 $84,500.00 $70,135.00 $28,223.00 $84,500.00 $53,235.00 2025-01-01
C1824 HCPCS Kit Ipg Optimizer Smart Mini 23 18 $84,500.00 $70,135.00 $28,223.00 $84,500.00 $53,235.00 2025-01-01
27800000002-90271 CDM Set Pump Impella Cp 23 18 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $51,187.50 2025-01-01
27800000002-90269 CDM Set Pump Impella Cp 23 18 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $51,187.50 2025-01-01
27800000002-90656 CDM Valve Sapien 3 Thv 26mm W/command System 23 18 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $51,187.50 2025-01-01
27800000002-90658 CDM Valve Sapien 3 Thv 29mm W/command System 23 18 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $51,187.50 2025-01-01
27800000002-90267 CDM Set Pump Impella Cp 23 18 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $51,187.50 2025-01-01
27800000002-90268 CDM Set Pump Impella Cp 23 18 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $51,187.50 2025-01-01
27800000002-90270 CDM Set Pump Impella Cp 23 18 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $51,187.50 2025-01-01
27800000002-90654 CDM Valve Sapien 3 Thv 23mm W/command System 23 18 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $51,187.50 2025-01-01
27800000002-91991 CDM Set Pump Aic Impella 5.0 23 18 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $51,187.50 2025-01-01
27800000002-91235 CDM Valve Sapien 3 Ultra Thv 26mm W/command System 23 18 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $51,187.50 2025-01-01
27800000002-91990 CDM Set Pump Aic Impella 5.0 23 18 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $51,187.50 2025-01-01
27800000002-91232 CDM Valve Sapien 3 Ultra Thv 23mm W/command System 23 18 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $51,187.50 2025-01-01
27800000002-90836 CDM Valve Aortic Evolut Tm Pro 26mm 23 18 $75,000.00 $62,250.00 $25,050.00 $75,000.00 $47,250.00 2025-01-01
27800000002-90838 CDM Valve Aortic Evolut Tm Pro 34mm 23 18 $75,000.00 $62,250.00 $25,050.00 $75,000.00 $47,250.00 2025-01-01
27800000002-89077 CDM Valve Aortic 34mm Evolut Fx 23 18 $75,000.00 $62,250.00 $25,050.00 $75,000.00 $47,250.00 2025-01-01
27800000002-89079 CDM Valve Aortic 23mm Evolut Fx 23 18 $75,000.00 $62,250.00 $25,050.00 $75,000.00 $47,250.00 2025-01-01
27200000002-21145 CDM Glv Surg Orth Ltx Maxxus 8.5 23 18 $74,258.59 $61,634.63 $24,802.37 $74,258.59 $46,782.91 2025-01-01
27200000002-28034 CDM Clip Lig Ti Horizon Sm 6/cq 23 18 $71,250.00 $59,137.50 $23,797.50 $71,250.00 $44,887.50 2025-01-01
27000000004-1176 CDM Drape Surg W/17 5/8x11.75in Towl Ster 23 18 $66,068.70 $54,837.02 $22,066.95 $66,068.70 $41,623.28 2025-01-01
27800000002-89069 CDM Watchman Flx Procedure - Device 23 18 $65,100.00 $54,033.00 $21,743.40 $65,100.00 $41,013.00 2025-01-01
27800000002-91490 CDM Stent Graft Confrm Thor 45x45x10 24f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91494 CDM Stent Graft Confrm Thor 34x34x10 22f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91495 CDM Stent Graft Confrm Thor 34x34x10 22f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91562 CDM Stent Graft Confrm Thor 37x37x20 22f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91432 CDM Stent Graft Confrm Thor 34x34x15 22f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91466 CDM Stent Graft Confrm Thor 21x21x10 18f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-89038 CDM Stent Graft Confrm Thor 40x40x20 22f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91447 CDM Stent Graft Confrm Thor 40x40x10 22f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91448 CDM Stent Graft Confrm Thor 40x40x10 22f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91465 CDM Stent Graft Confrm Thor 31x31x10 20f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91485 CDM Stent Graft Confrm Thor 45x45x15 24f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91484 CDM Stent Graft Confrm Thor 45x45x15 24f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91607 CDM Stent Graft Confrm Thor 45x45x20 24f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91433 CDM Stent Graft Confrm Thor 34x34x15 22f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91565 CDM Stent Graft Confrm Thor 34x34x20 22f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91503 CDM Stent Graft Confrm Thor 28x28x15 20f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91518 CDM Stent Graft Confrm Thor 26x26x10 20f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91564 CDM Stent Graft Confrm Thor 34x34x20 22f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91443 CDM Stent Graft Confrm Thor 40x40x15 22f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91444 CDM Stent Graft Confrm Thor 40x40x15 22f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91492 CDM Stent Graft Confrm Thor 28x28x10 20f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91487 CDM Stent Graft Confrm Thor 37x37x10 22f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91563 CDM Stent Graft Confrm Thor 37x37x20 22f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91486 CDM Stent Graft Confrm Thor 45x45x15 24f 23 18 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $40,329.45 2025-01-01
27800000002-91560 CDM Stent Valiant Navion Vnmf4343c183tu Freeflo 175mm 23 18 $62,984.25 $52,276.93 $21,036.74 $62,984.25 $39,680.08 2025-01-01
27800000002-90265 CDM Set Pump Impella Cp 23 18 $62,500.00 $51,875.00 $20,875.00 $62,500.00 $39,375.00 2025-01-01
27800000002-90266 CDM Set Pump Impella Cp 23 18 $62,500.00 $51,875.00 $20,875.00 $62,500.00 $39,375.00 2025-01-01
7772694881 NDC Nitroprusside 25 Mcg/ml Solution 1000 Ml Bag 23 18 $62,500.00 $51,875.00 $20,875.00 $62,500.00 $39,375.00 2025-01-01
27800000002-89042 CDM Plug Cardiac Amulet Amplatzer 20mm 23 18 $60,424.00 $50,151.92 $20,181.62 $60,424.00 $38,067.12 2025-01-01
27800000002-88976 CDM Plug Cardiac Amulet Amplatzer 18mm 23 18 $60,424.00 $50,151.92 $20,181.62 $60,424.00 $38,067.12 2025-01-01
27800000002-88977 CDM Plug Cardiac Amulet Amplatzer 18mm 23 18 $60,424.00 $50,151.92 $20,181.62 $60,424.00 $38,067.12 2025-01-01
27800000002-89043 CDM Plug Cardiac Amulet Amplatzer 20mm 23 18 $60,424.00 $50,151.92 $20,181.62 $60,424.00 $38,067.12 2025-01-01
27800000002-88975 CDM Plug Cardiac Amulet Amplatzer 22mm 23 18 $60,424.00 $50,151.92 $20,181.62 $60,424.00 $38,067.12 2025-01-01
'588-4 APR_DRG Neonate Bwt <1500g W Major Procedure 5 5 — — $115,628.23 $115,628.23 $115,628.23 2025-01-01
'002-4 APR_DRG Heart &/or Lung Transplant 5 5 — — $101,004.57 $101,004.57 $101,004.57 2025-01-01
'161-4 APR_DRG Cardiac Defibrillator & Heart Assist Implant 5 5 — — $96,953.83 $96,953.83 $96,953.83 2025-01-01
'001-4 APR_DRG Liver Transplant &/or Intestinal Transplant 5 5 — — $73,501.84 $73,501.84 $73,501.84 2025-01-01
'007-4 APR_DRG Allogeneic Bone Marrow Transplant 5 5 — — $69,192.08 $69,192.08 $69,192.08 2025-01-01
'004-4 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure 5 5 — — $68,020.03 $68,020.03 $68,020.03 2025-01-01
'591-4 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 5 5 — — $66,694.21 $66,694.21 $66,694.21 2025-01-01
'009-4 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $65,781.90 $65,781.90 $65,781.90 2025-01-01
'609-4 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 5 5 — — $63,710.81 $63,710.81 $63,710.81 2025-01-01
'593-4 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 5 5 — — $60,752.94 $60,752.94 $60,752.94 2025-01-01
'002-3 APR_DRG Heart &/or Lung Transplant 5 5 — — $58,449.60 $58,449.60 $58,449.60 2025-01-01
'002-2 APR_DRG Heart &/or Lung Transplant 5 5 — — $57,965.85 $57,965.85 $57,965.85 2025-01-01
'002-1 APR_DRG Heart &/or Lung Transplant 5 5 — — $57,798.15 $57,798.15 $57,798.15 2025-01-01
'583-3 APR_DRG Neonate W Ecmo 5 5 — — $56,336.76 $56,336.76 $56,336.76 2025-01-01
'583-4 APR_DRG Neonate W Ecmo 5 5 — — $56,336.76 $56,336.76 $56,336.76 2025-01-01
'583-2 APR_DRG Neonate W Ecmo 5 5 — — $56,336.76 $56,336.76 $56,336.76 2025-01-01
'583-1 APR_DRG Neonate W Ecmo 5 5 — — $54,795.21 $54,795.21 $54,795.21 2025-01-01
'631-4 APR_DRG Neonate Birthwt >2499g W Other Major Procedure 5 5 — — $53,626.40 $53,626.40 $53,626.40 2025-01-01
'630-4 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 5 5 — — $52,530.42 $52,530.42 $52,530.42 2025-01-01
'588-3 APR_DRG Neonate Bwt <1500g W Major Procedure 5 5 — — $52,192.62 $52,192.62 $52,192.62 2025-01-01
'588-2 APR_DRG Neonate Bwt <1500g W Major Procedure 5 5 — — $51,470.22 $51,470.22 $51,470.22 2025-01-01
'588-1 APR_DRG Neonate Bwt <1500g W Major Procedure 5 5 — — $51,470.22 $51,470.22 $51,470.22 2025-01-01
'611-4 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 5 5 — — $48,981.26 $48,981.26 $48,981.26 2025-01-01
'593-3 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 5 5 — — $48,568.14 $48,568.14 $48,568.14 2025-01-01
'006-4 APR_DRG Pancreas Transplant 5 5 — — $46,792.88 $46,792.88 $46,792.88 2025-01-01
'005-4 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 5 5 — — $44,535.51 $44,535.51 $44,535.51 2025-01-01
'602-4 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 5 5 — — $44,334.47 $44,334.47 $44,334.47 2025-01-01
'607-4 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 5 5 — — $43,134.82 $43,134.82 $43,134.82 2025-01-01
'007-1 APR_DRG Allogeneic Bone Marrow Transplant 5 5 — — $41,926.75 $41,926.75 $41,926.75 2025-01-01
'007-3 APR_DRG Allogeneic Bone Marrow Transplant 5 5 — — $41,926.75 $41,926.75 $41,926.75 2025-01-01
'007-2 APR_DRG Allogeneic Bone Marrow Transplant 5 5 — — $41,926.75 $41,926.75 $41,926.75 2025-01-01
'602-3 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 5 5 — — $41,246.26 $41,246.26 $41,246.26 2025-01-01
'621-4 APR_DRG Neonate Bwt 2000-2499g W Major Anomaly 5 5 — — $39,919.32 $39,919.32 $39,919.32 2025-01-01
'009-2 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $38,289.60 $38,289.60 $38,289.60 2025-01-01
'009-1 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $38,289.60 $38,289.60 $38,289.60 2025-01-01
'009-3 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $38,289.60 $38,289.60 $38,289.60 2025-01-01
23472 HCPCS Reconstruct Shoulder Joint 4 3 — — $17,756.28 $63,708.20 $40,936.43 2025-01-01
28715 HCPCS Arthrodesis Triple 3 2 — — $12,539.82 $44,991.94 $44,991.94 2025-01-01
27279 HCPCS Arthrd Si Jt Perq/min Nvas 2 1 — — $63,708.20 $63,708.20 $63,708.20 2025-01-01
27446 HCPCS Revision Of Knee Joint 2 1 — — $44,991.94 $44,991.94 $44,991.94 2025-01-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 1 — — $60,991.20 $60,991.20 $60,991.20 2025-01-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 1 — — $54,513.19 $54,513.19 $54,513.19 2025-01-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 1 1 — — $49,928.90 $49,928.90 $49,928.90 2025-01-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 1 — — $45,840.05 $45,840.05 $45,840.05 2025-01-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 1 — — $41,927.33 $41,927.33 $41,927.33 2025-01-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 1 1 — — $39,246.06 $39,246.06 $39,246.06 2025-01-01
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