|
56552177
|
CDM
|
Delandistrogene Moxeparvovec Inj
|
33
|
20
|
—
|
$1,303,638.34
|
$0.03
|
$4,694,976.00
|
$3,597,916.61
|
2026-03-25
|
|
56508781
|
CDM
|
Lovotibeglogene Autotemcel Inj
|
26
|
17
|
$4,650,000.00
|
$1,162,035.00
75% off
|
$0.03
|
$4,185,000.00
|
$3,285,225.00
|
2026-03-25
|
|
56501190
|
CDM
|
Betibeglogene Autotemcel Inj
|
26
|
17
|
$4,564,560.00
|
$1,140,683.54
75% off
|
$0.03
|
$4,108,104.00
|
$3,224,861.64
|
2026-03-25
|
|
56507668
|
CDM
|
Exagamglogene Autotemcel Inj
|
35
|
18
|
$3,448,500.00
|
$861,780.15
75% off
|
$861,780.15
|
$3,103,650.00
|
$2,458,780.50
|
2026-03-25
|
|
56504608
|
CDM
|
Afamitresgene Autoleucel Inj
|
42
|
21
|
$1,817,500.00
|
$454,193.25
75% off
|
$454,193.25
|
$1,635,750.00
|
$1,263,162.50
|
2026-03-25
|
|
56507262
|
CDM
|
Lifileucel Inj
|
34
|
18
|
$1,614,525.00
|
$403,469.80
75% off
|
$306,759.75
|
$1,453,072.50
|
$1,122,094.88
|
2026-03-25
|
|
56504582
|
CDM
|
Obecabtagene Autoleucel Inj
|
42
|
21
|
$945,000.00
|
$236,155.50
75% off
|
$236,155.50
|
$850,500.00
|
$656,775.00
|
2026-03-25
|
|
114
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
7
|
4
|
—
|
—
|
$647,979.12
|
$647,979.12
|
$647,979.12
|
2026-03-25
|
|
52590841
|
CDM
|
Tisagenlecleucel Inj (iv)(all)
|
26
|
17
|
$912,121.10
|
$227,939.06
75% off
|
$0.03
|
$820,908.99
|
$644,413.55
|
2026-03-25
|
|
5834
|
APR_DRG
|
Neonate W Ecmo
|
7
|
4
|
—
|
—
|
$588,944.20
|
$588,944.20
|
$588,944.20
|
2026-03-25
|
|
5833
|
APR_DRG
|
Neonate W Ecmo
|
7
|
4
|
—
|
—
|
$588,944.20
|
$588,944.20
|
$588,944.20
|
2026-03-25
|
|
52599552
|
CDM
|
Ciltacabtagene Autoleucel Inj
|
33
|
20
|
$832,965.70
|
$208,158.13
75% off
|
$0.03
|
$749,669.13
|
$583,075.96
|
2026-03-25
|
|
52597630
|
CDM
|
Lisocabtagene Maraleucel Inj
|
33
|
20
|
$797,025.60
|
$199,176.70
75% off
|
$0.03
|
$717,323.04
|
$574,655.46
|
2026-03-25
|
|
52598240
|
CDM
|
Idecabtagene Vicleucel Inj
|
33
|
20
|
$792,468.65
|
$198,037.92
75% off
|
$0.03
|
$713,221.79
|
$571,369.89
|
2026-03-25
|
|
5831
|
APR_DRG
|
Neonate W Ecmo
|
7
|
4
|
—
|
—
|
$558,502.30
|
$558,502.30
|
$558,502.30
|
2026-03-25
|
|
5832
|
APR_DRG
|
Neonate W Ecmo
|
7
|
4
|
—
|
—
|
$558,502.30
|
$558,502.30
|
$558,502.30
|
2026-03-25
|
|
52594413
|
CDM
|
Tisagenlecleucel Inj (iv)(dlbcl)
|
26
|
17
|
$784,727.70
|
$196,103.45
75% off
|
$0.03
|
$706,254.93
|
$554,410.12
|
2026-03-25
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
30
|
16
|
—
|
—
|
$326,291.98
|
$1,824,646.03
|
$539,785.00
|
2026-03-25
|
|
24
|
APR_DRG
|
Heart &/or Lung Transplant
|
7
|
4
|
—
|
—
|
$537,458.68
|
$537,458.68
|
$537,458.68
|
2026-03-25
|
|
52590668
|
CDM
|
Axicabtagene Ciloleucel Inj (iv)
|
33
|
20
|
$755,370.00
|
$188,766.96
75% off
|
$0.03
|
$679,833.00
|
$528,759.00
|
2026-03-25
|
|
5884
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
7
|
4
|
—
|
—
|
$503,124.62
|
$503,124.62
|
$503,124.62
|
2026-03-25
|
|
52596608
|
CDM
|
Brexucabtagene Autoleucel Inj (iv)
|
33
|
20
|
$693,000.00
|
$173,180.70
75% off
|
$0.03
|
$623,700.00
|
$485,100.00
|
2026-03-25
|
|
1614
|
APR_DRG
|
Cardiac Defibrillator & Heart Assist Implant
|
7
|
4
|
—
|
—
|
$469,930.95
|
$469,930.95
|
$469,930.95
|
2026-03-25
|
|
6314
|
APR_DRG
|
Neonate Birthwt >2499g W Other Major Procedure
|
7
|
4
|
—
|
—
|
$469,136.53
|
$469,136.53
|
$469,136.53
|
2026-03-25
|
|
5883
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
7
|
4
|
—
|
—
|
$396,403.43
|
$396,403.43
|
$396,403.43
|
2026-03-25
|
|
44
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure
|
7
|
4
|
—
|
—
|
$393,435.20
|
$393,435.20
|
$393,435.20
|
2026-03-25
|
|
113
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
7
|
4
|
—
|
—
|
$378,177.99
|
$378,177.99
|
$378,177.99
|
2026-03-25
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
30
|
16
|
—
|
—
|
$212,010.64
|
$1,184,121.87
|
$350,298.75
|
2026-03-25
|
|
74
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
7
|
4
|
—
|
—
|
$333,375.47
|
$333,375.47
|
$333,375.47
|
2026-03-25
|
|
5914
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
7
|
4
|
—
|
—
|
$332,614.53
|
$332,614.53
|
$332,614.53
|
2026-03-25
|
|
14
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
7
|
4
|
—
|
—
|
$328,688.97
|
$328,688.97
|
$328,688.97
|
2026-03-25
|
|
5934
|
APR_DRG
|
Neonate Birthwt 750-999g Without Major Procedure
|
7
|
4
|
—
|
—
|
$317,330.38
|
$317,330.38
|
$317,330.38
|
2026-03-25
|
|
112
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
7
|
4
|
—
|
—
|
$304,837.81
|
$304,837.81
|
$304,837.81
|
2026-03-25
|
|
1613
|
APR_DRG
|
Cardiac Defibrillator & Heart Assist Implant
|
7
|
4
|
—
|
—
|
$303,870.59
|
$303,870.59
|
$303,870.59
|
2026-03-25
|
|
1612
|
APR_DRG
|
Cardiac Defibrillator & Heart Assist Implant
|
7
|
4
|
—
|
—
|
$303,851.24
|
$303,851.24
|
$303,851.24
|
2026-03-25
|
|
1611
|
APR_DRG
|
Cardiac Defibrillator & Heart Assist Implant
|
7
|
4
|
—
|
—
|
$302,838.59
|
$302,838.59
|
$302,838.59
|
2026-03-25
|
|
23
|
APR_DRG
|
Heart &/or Lung Transplant
|
7
|
4
|
—
|
—
|
$295,712.02
|
$295,712.02
|
$295,712.02
|
2026-03-25
|
|
5881
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
7
|
4
|
—
|
—
|
$294,207.35
|
$294,207.35
|
$294,207.35
|
2026-03-25
|
|
5882
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
7
|
4
|
—
|
—
|
$294,207.35
|
$294,207.35
|
$294,207.35
|
2026-03-25
|
|
52780152
|
CDM
|
Heartmate
|
46
|
21
|
$428,478.00
|
$107,076.65
75% off
|
$524.16
|
$385,630.20
|
$291,729.25
|
2026-03-25
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
30
|
16
|
—
|
—
|
$161,700.59
|
$902,144.03
|
$266,881.25
|
2026-03-25
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
30
|
16
|
—
|
—
|
$160,755.96
|
$896,849.60
|
$265,315.00
|
2026-03-25
|
|
6094
|
APR_DRG
|
Neonate Bwt 1500-2499g W Major Procedure
|
7
|
4
|
—
|
—
|
$250,369.68
|
$250,369.68
|
$250,369.68
|
2026-03-25
|
|
6024
|
APR_DRG
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
7
|
4
|
—
|
—
|
$245,243.37
|
$245,243.37
|
$245,243.37
|
2026-03-25
|
|
22
|
APR_DRG
|
Heart &/or Lung Transplant
|
7
|
4
|
—
|
—
|
$243,586.70
|
$243,586.70
|
$243,586.70
|
2026-03-25
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
7
|
4
|
—
|
—
|
$242,358.25
|
$242,358.25
|
$242,358.25
|
2026-03-25
|
|
6304
|
APR_DRG
|
Neonate Birthwt >2499g W Major Cardiovascular Procedure
|
7
|
4
|
—
|
—
|
$235,523.02
|
$235,523.02
|
$235,523.02
|
2026-03-25
|
|
54
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
7
|
4
|
—
|
—
|
$228,748.68
|
$228,748.68
|
$228,748.68
|
2026-03-25
|
|
94
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
7
|
4
|
—
|
—
|
$227,390.60
|
$227,390.60
|
$227,390.60
|
2026-03-25
|
|
73
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
7
|
4
|
—
|
—
|
$220,943.88
|
$220,943.88
|
$220,943.88
|
2026-03-25
|
|
6074
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
7
|
4
|
—
|
—
|
$219,132.78
|
$219,132.78
|
$219,132.78
|
2026-03-25
|
|
21
|
APR_DRG
|
Heart &/or Lung Transplant
|
7
|
4
|
—
|
—
|
$217,018.03
|
$217,018.03
|
$217,018.03
|
2026-03-25
|
|
43
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure
|
7
|
4
|
—
|
—
|
$199,957.70
|
$199,957.70
|
$199,957.70
|
2026-03-25
|
|
72
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
7
|
4
|
—
|
—
|
$198,437.33
|
$198,437.33
|
$198,437.33
|
2026-03-25
|
|
5933
|
APR_DRG
|
Neonate Birthwt 750-999g Without Major Procedure
|
7
|
4
|
—
|
—
|
$191,842.30
|
$191,842.30
|
$191,842.30
|
2026-03-25
|
|
55729339
|
CDM
|
Heartmate
|
46
|
21
|
$276,183.00
|
$69,018.13
75% off
|
$524.16
|
$248,564.70
|
$188,039.20
|
2026-03-25
|
|
8504
|
APR_DRG
|
Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service
|
7
|
4
|
—
|
—
|
$186,758.52
|
$186,758.52
|
$186,758.52
|
2026-03-25
|
|
55727275
|
CDM
|
Implant Hvad Pump
|
46
|
21
|
$273,585.00
|
$68,368.89
75% off
|
$524.16
|
$246,226.50
|
$186,270.35
|
2026-03-25
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures W Ami Or Complex Pdx
|
7
|
4
|
—
|
—
|
$181,159.91
|
$181,159.91
|
$181,159.91
|
2026-03-25
|
|
55747844
|
CDM
|
Gammatile Therapy Device
|
46
|
21
|
$266,044.00
|
$66,484.40
75% off
|
$524.16
|
$239,439.60
|
$181,136.06
|
2026-03-25
|
|
13
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
7
|
4
|
—
|
—
|
$180,772.13
|
$180,772.13
|
$180,772.13
|
2026-03-25
|
|
8514
|
APR_DRG
|
Gender Related Procedures
|
7
|
4
|
—
|
—
|
$180,152.55
|
$180,152.55
|
$180,152.55
|
2026-03-25
|
|
3034
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
7
|
4
|
—
|
—
|
$180,120.92
|
$180,120.92
|
$180,120.92
|
2026-03-25
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
30
|
16
|
—
|
—
|
$105,165.67
|
$585,277.06
|
$173,142.50
|
2026-03-25
|
|
6023
|
APR_DRG
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
7
|
4
|
—
|
—
|
$172,990.93
|
$172,990.93
|
$172,990.93
|
2026-03-25
|
|
62
|
APR_DRG
|
Pancreas Transplant
|
7
|
4
|
—
|
—
|
$171,455.28
|
$171,455.28
|
$171,455.28
|
2026-03-25
|
|
63
|
APR_DRG
|
Pancreas Transplant
|
7
|
4
|
—
|
—
|
$171,455.28
|
$171,455.28
|
$171,455.28
|
2026-03-25
|
|
64
|
APR_DRG
|
Pancreas Transplant
|
7
|
4
|
—
|
—
|
$171,455.28
|
$171,455.28
|
$171,455.28
|
2026-03-25
|
|
6334
|
APR_DRG
|
Neonate Birthwt >2499g W Major Anomaly
|
7
|
4
|
—
|
—
|
$169,641.18
|
$169,641.18
|
$169,641.18
|
2026-03-25
|
|
5932
|
APR_DRG
|
Neonate Birthwt 750-999g Without Major Procedure
|
7
|
4
|
—
|
—
|
$167,555.65
|
$167,555.65
|
$167,555.65
|
2026-03-25
|
|
53
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
7
|
4
|
—
|
—
|
$166,227.07
|
$166,227.07
|
$166,227.07
|
2026-03-25
|
|
84
|
APR_DRG
|
Autologous Bone Marrow Transplant
|
7
|
4
|
—
|
—
|
$166,222.61
|
$166,222.61
|
$166,222.61
|
2026-03-25
|
|
83
|
APR_DRG
|
Autologous Bone Marrow Transplant
|
7
|
4
|
—
|
—
|
$166,061.36
|
$166,061.36
|
$166,061.36
|
2026-03-25
|
|
7
|
MS_DRG
|
Lung Transplant
|
30
|
16
|
—
|
—
|
$98,371.62
|
$547,197.75
|
$161,877.50
|
2026-03-25
|
|
6093
|
APR_DRG
|
Neonate Bwt 1500-2499g W Major Procedure
|
7
|
4
|
—
|
—
|
$157,422.04
|
$157,422.04
|
$157,422.04
|
2026-03-25
|
|
6124
|
APR_DRG
|
Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond
|
7
|
4
|
—
|
—
|
$153,859.46
|
$153,859.46
|
$153,859.46
|
2026-03-25
|
|
6114
|
APR_DRG
|
Neonate Birthwt 1500-1999g W Major Anomaly
|
7
|
4
|
—
|
—
|
$152,229.56
|
$152,229.56
|
$152,229.56
|
2026-03-25
|
|
6092
|
APR_DRG
|
Neonate Bwt 1500-2499g W Major Procedure
|
7
|
4
|
—
|
—
|
$151,921.76
|
$151,921.76
|
$151,921.76
|
2026-03-25
|
|
55747836
|
CDM
|
Gammatile Therapy Device
|
46
|
21
|
$222,668.00
|
$55,644.73
75% off
|
$524.16
|
$200,401.20
|
$151,603.51
|
2026-03-25
|
|
6091
|
APR_DRG
|
Neonate Bwt 1500-2499g W Major Procedure
|
7
|
4
|
—
|
—
|
$150,780.11
|
$150,780.11
|
$150,780.11
|
2026-03-25
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
30
|
16
|
—
|
—
|
$91,343.10
|
$507,804.35
|
$150,223.75
|
2026-03-25
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
7
|
4
|
—
|
—
|
$150,117.29
|
$150,117.29
|
$150,117.29
|
2026-03-25
|
|
6214
|
APR_DRG
|
Neonate Bwt 2000-2499g W Major Anomaly
|
7
|
4
|
—
|
—
|
$149,016.91
|
$149,016.91
|
$149,016.91
|
2026-03-25
|
|
5913
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
7
|
4
|
—
|
—
|
$147,993.49
|
$147,993.49
|
$147,993.49
|
2026-03-25
|
|
52760881
|
CDM
|
Lung Acquisition-double
|
39
|
19
|
$210,810.00
|
$52,681.42
75% off
|
$40,053.90
|
$189,729.00
|
$147,567.00
|
2026-03-25
|
|
914
|
APR_DRG
|
Other Major Head & Neck Procedures
|
7
|
4
|
—
|
—
|
$143,859.47
|
$143,859.47
|
$143,859.47
|
2026-03-25
|
|
58100025
|
CDM
|
Kidney Acquisition-lrd
|
39
|
19
|
$204,309.00
|
$51,056.82
75% off
|
$38,818.71
|
$183,878.10
|
$143,016.30
|
2026-03-25
|
|
3033
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
7
|
4
|
—
|
—
|
$142,378.87
|
$142,378.87
|
$142,378.87
|
2026-03-25
|
|
56329485
|
CDM
|
Gemcitabine Ives Sys 225mg
|
43
|
20
|
$216,315.00
|
$54,057.12
75% off
|
$37.28
|
$194,683.50
|
$141,945.90
|
2026-03-25
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
30
|
16
|
—
|
—
|
$86,170.67
|
$478,813.88
|
$141,647.50
|
2026-03-25
|
|
209
|
MS_DRG
|
Complex Aortic Arch Procedures
|
30
|
16
|
—
|
—
|
$86,072.66
|
$478,264.58
|
$141,485.00
|
2026-03-25
|
|
9504
|
APR_DRG
|
Extensive Procedure Unrelated To Principal Diagnosis
|
7
|
4
|
—
|
—
|
$141,031.91
|
$141,031.91
|
$141,031.91
|
2026-03-25
|
|
4404
|
APR_DRG
|
Kidney Transplant
|
7
|
4
|
—
|
—
|
$140,057.84
|
$140,057.84
|
$140,057.84
|
2026-03-25
|
|
4403
|
APR_DRG
|
Kidney Transplant
|
7
|
4
|
—
|
—
|
$138,967.79
|
$138,967.79
|
$138,967.79
|
2026-03-25
|
|
4402
|
APR_DRG
|
Kidney Transplant
|
7
|
4
|
—
|
—
|
$138,883.94
|
$138,883.94
|
$138,883.94
|
2026-03-25
|
|
4401
|
APR_DRG
|
Kidney Transplant
|
7
|
4
|
—
|
—
|
$138,825.89
|
$138,825.89
|
$138,825.89
|
2026-03-25
|
|
214
|
APR_DRG
|
Craniotomy Except For Trauma
|
7
|
4
|
—
|
—
|
$138,009.22
|
$138,009.22
|
$138,009.22
|
2026-03-25
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
30
|
16
|
—
|
—
|
$83,829.09
|
$465,689.78
|
$137,765.00
|
2026-03-25
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
30
|
16
|
—
|
—
|
$82,720.12
|
$459,474.22
|
$135,926.25
|
2026-03-25
|
|
6022
|
APR_DRG
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
7
|
4
|
—
|
—
|
$135,568.66
|
$135,568.66
|
$135,568.66
|
2026-03-25
|
|
52573912
|
CDM
|
Sipuleucel-t 250 Ml
|
46
|
21
|
$196,489.65
|
$49,102.76
75% off
|
$49,102.76
|
$176,840.69
|
$135,548.39
|
2026-03-25
|
|
6073
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
7
|
4
|
—
|
—
|
$134,562.75
|
$134,562.75
|
$134,562.75
|
2026-03-25
|
|
5894
|
APR_DRG
|
Neonate Bwt <500g Or Ga <24 Weeks
|
7
|
4
|
—
|
—
|
$134,367.74
|
$134,367.74
|
$134,367.74
|
2026-03-25
|
|
5893
|
APR_DRG
|
Neonate Bwt <500g Or Ga <24 Weeks
|
7
|
4
|
—
|
—
|
$134,367.74
|
$134,367.74
|
$134,367.74
|
2026-03-25
|
|
1634
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Pdx
|
7
|
4
|
—
|
—
|
$133,236.70
|
$133,236.70
|
$133,236.70
|
2026-03-25
|
|
50730332
|
CDM
|
Aicd Other Than Sing/dual
|
46
|
21
|
$195,559.00
|
$48,870.19
75% off
|
$82.84
|
$176,003.10
|
$133,146.35
|
2026-03-25
|
|
9124
|
APR_DRG
|
Musculoskeletal & Other Procedures For Multiple Significant Trauma
|
7
|
4
|
—
|
—
|
$132,125.87
|
$132,125.87
|
$132,125.87
|
2026-03-25
|
|
55747828
|
CDM
|
Gammatile Therapy Device
|
46
|
21
|
$193,750.00
|
$48,418.13
75% off
|
$524.16
|
$174,375.00
|
$131,914.69
|
2026-03-25
|
|
1674
|
APR_DRG
|
Other Cardiothoracic & Thoracic Vascular Procedures
|
7
|
4
|
—
|
—
|
$131,273.94
|
$131,273.94
|
$131,273.94
|
2026-03-25
|
|
9114
|
APR_DRG
|
Extensive Abdominal/thoracic Procedures For Mult Significant Trauma
|
7
|
4
|
—
|
—
|
$131,271.86
|
$131,271.86
|
$131,271.86
|
2026-03-25
|
|
56507742
|
CDM
|
Nadofaragene Firadenovec Inj
|
46
|
21
|
$182,700.00
|
$45,656.73
75% off
|
$45,656.73
|
$174,225.62
|
$130,265.10
|
2026-03-25
|
|
3004
|
APR_DRG
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
7
|
4
|
—
|
—
|
$129,752.55
|
$129,752.55
|
$129,752.55
|
2026-03-25
|
|
52799806
|
CDM
|
Aicd Other Than Sing/dual
|
46
|
21
|
$189,768.00
|
$47,423.02
75% off
|
$82.84
|
$170,791.20
|
$129,203.55
|
2026-03-25
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
30
|
16
|
—
|
—
|
$78,471.20
|
$435,659.87
|
$128,881.25
|
2026-03-25
|
|
55748990
|
CDM
|
Cultured Chondrocyter Implnt
|
38
|
18
|
$148,357.00
|
$37,074.41
75% off
|
$37,074.41
|
$170,165.33
|
$128,328.81
|
2026-03-25
|
|
5891
|
APR_DRG
|
Neonate Bwt <500g Or Ga <24 Weeks
|
7
|
4
|
—
|
—
|
$127,924.41
|
$127,924.41
|
$127,924.41
|
2026-03-25
|
|
5892
|
APR_DRG
|
Neonate Bwt <500g Or Ga <24 Weeks
|
7
|
4
|
—
|
—
|
$127,924.41
|
$127,924.41
|
$127,924.41
|
2026-03-25
|
|
9104
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
7
|
4
|
—
|
—
|
$127,441.76
|
$127,441.76
|
$127,441.76
|
2026-03-25
|
|
1654
|
APR_DRG
|
Coronary Bypass W Ami Or Complex Pdx
|
7
|
4
|
—
|
—
|
$125,385.71
|
$125,385.71
|
$125,385.71
|
2026-03-25
|
|
224
|
APR_DRG
|
Ventricular Shunt Procedures
|
7
|
4
|
—
|
—
|
$124,923.91
|
$124,923.91
|
$124,923.91
|
2026-03-25
|
|
56300825
|
CDM
|
Y-90 Zevalin, Per Dose
|
46
|
21
|
$153,485.10
|
$38,355.93
75% off
|
$38,355.93
|
$173,265.87
|
$124,629.90
|
2026-03-25
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
30
|
16
|
—
|
—
|
$75,806.20
|
$420,723.08
|
$124,462.50
|
2026-03-25
|
|
52596475
|
CDM
|
Botulism Immune Globulin Inj 50 mg/mL (iv)
|
34
|
18
|
$178,162.85
|
$44,522.90
75% off
|
$33,850.94
|
$160,346.57
|
$123,823.18
|
2026-03-25
|
|
52797297
|
CDM
|
Aicd Dual Chamber
|
46
|
21
|
$181,549.00
|
$45,369.10
75% off
|
$82.84
|
$163,394.10
|
$123,607.64
|
2026-03-25
|
|
55700751
|
CDM
|
Aicd Other Than Sing/dual
|
46
|
21
|
$180,610.00
|
$45,134.44
75% off
|
$82.84
|
$162,549.00
|
$122,968.32
|
2026-03-25
|
|
71
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
7
|
4
|
—
|
—
|
$122,893.92
|
$122,893.92
|
$122,893.92
|
2026-03-25
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
30
|
16
|
—
|
—
|
$74,492.92
|
$413,362.43
|
$122,285.00
|
2026-03-25
|
|
111
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
7
|
4
|
—
|
—
|
$122,184.42
|
$122,184.42
|
$122,184.42
|
2026-03-25
|
|
50721950
|
CDM
|
Bmt Allogeneic Unrelated
|
39
|
19
|
$172,363.00
|
$43,073.51
75% off
|
$32,748.97
|
$155,126.70
|
$120,654.10
|
2026-03-25
|
|
12
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
7
|
4
|
—
|
—
|
$120,077.11
|
$120,077.11
|
$120,077.11
|
2026-03-25
|
|
93
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
7
|
4
|
—
|
—
|
$119,929.30
|
$119,929.30
|
$119,929.30
|
2026-03-25
|
|
52797313
|
CDM
|
Aicd Dual Chamber
|
46
|
21
|
$175,811.00
|
$43,935.17
75% off
|
$82.84
|
$158,229.90
|
$119,700.92
|
2026-03-25
|
|
56209950
|
CDM
|
Aicd Other Than Sing/dual
|
46
|
21
|
$175,116.00
|
$43,761.49
75% off
|
$82.84
|
$157,604.40
|
$119,227.73
|
2026-03-25
|
|
1784
|
APR_DRG
|
External Heart Assist Devices
|
7
|
4
|
—
|
—
|
$118,390.37
|
$118,390.37
|
$118,390.37
|
2026-03-25
|
|
6814
|
APR_DRG
|
Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms
|
7
|
4
|
—
|
—
|
$116,133.18
|
$116,133.18
|
$116,133.18
|
2026-03-25
|
|
6034
|
APR_DRG
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
7
|
4
|
—
|
—
|
$115,963.34
|
$115,963.34
|
$115,963.34
|
2026-03-25
|
|
6033
|
APR_DRG
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
7
|
4
|
—
|
—
|
$115,169.99
|
$115,169.99
|
$115,169.99
|
2026-03-25
|
|
2994
|
APR_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
7
|
4
|
—
|
—
|
$115,017.12
|
$115,017.12
|
$115,017.12
|
2026-03-25
|
|
2993
|
APR_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
7
|
4
|
—
|
—
|
$114,901.02
|
$114,901.02
|
$114,901.02
|
2026-03-25
|
|
42
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure
|
7
|
4
|
—
|
—
|
$114,623.02
|
$114,623.02
|
$114,623.02
|
2026-03-25
|
|
52797305
|
CDM
|
Aicd Other Than Sing/dual
|
46
|
21
|
$167,818.00
|
$41,937.72
75% off
|
$82.84
|
$151,036.20
|
$114,258.89
|
2026-03-25
|
|
8633
|
APR_DRG
|
Neonatal Aftercare
|
7
|
4
|
—
|
—
|
$113,807.97
|
$113,807.97
|
$113,807.97
|
2026-03-25
|
|
1834
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
7
|
4
|
—
|
—
|
$113,743.82
|
$113,743.82
|
$113,743.82
|
2026-03-25
|
|
5931
|
APR_DRG
|
Neonate Birthwt 750-999g Without Major Procedure
|
7
|
4
|
—
|
—
|
$112,777.42
|
$112,777.42
|
$112,777.42
|
2026-03-25
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
30
|
16
|
—
|
—
|
$68,663.85
|
$380,691.64
|
$112,620.00
|
2026-03-25
|
|
55747810
|
CDM
|
Gammatile Therapy Device
|
46
|
21
|
$164,831.00
|
$41,191.27
75% off
|
$524.16
|
$148,347.90
|
$112,225.18
|
2026-03-25
|
|
5912
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
7
|
4
|
—
|
—
|
$112,195.05
|
$112,195.05
|
$112,195.05
|
2026-03-25
|
|
52799947
|
CDM
|
Aicd Other Than Sing/dual
|
46
|
21
|
$164,467.00
|
$41,100.30
75% off
|
$82.84
|
$148,020.30
|
$111,977.36
|
2026-03-25
|
|
6344
|
APR_DRG
|
Neonate, Birthwt >2499g W Resp Dist Synd/oth Maj Resp Cond
|
7
|
4
|
—
|
—
|
$111,911.47
|
$111,911.47
|
$111,911.47
|
2026-03-25
|
|
204
|
APR_DRG
|
Craniotomy For Trauma
|
7
|
4
|
—
|
—
|
$111,739.26
|
$111,739.26
|
$111,739.26
|
2026-03-25
|
|
6954
|
APR_DRG
|
Chemotherapy For Acute Leukemia
|
7
|
4
|
—
|
—
|
$111,363.86
|
$111,363.86
|
$111,363.86
|
2026-03-25
|
|
6804
|
APR_DRG
|
Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms
|
7
|
4
|
—
|
—
|
$111,276.39
|
$111,276.39
|
$111,276.39
|
2026-03-25
|
|
3044
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc Except For Curvature Of Back
|
7
|
4
|
—
|
—
|
$111,053.89
|
$111,053.89
|
$111,053.89
|
2026-03-25
|
|
2604
|
APR_DRG
|
Major Pancreas, Liver & Shunt Procedures
|
7
|
4
|
—
|
—
|
$110,819.19
|
$110,819.19
|
$110,819.19
|
2026-03-25
|
|
58100033
|
CDM
|
Heart Acquisition
|
39
|
19
|
$157,985.00
|
$39,480.45
75% off
|
$30,017.15
|
$142,186.50
|
$110,589.50
|
2026-03-25
|
|
6123
|
APR_DRG
|
Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond
|
7
|
4
|
—
|
—
|
$109,899.76
|
$109,899.76
|
$109,899.76
|
2026-03-25
|
|
5911
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
7
|
4
|
—
|
—
|
$109,627.95
|
$109,627.95
|
$109,627.95
|
2026-03-25
|
|
50738376
|
CDM
|
Aicd Other Than Sing/dual
|
46
|
21
|
$160,522.00
|
$40,114.45
75% off
|
$82.84
|
$144,469.80
|
$109,291.40
|
2026-03-25
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
30
|
16
|
—
|
—
|
$66,024.48
|
$365,898.51
|
$108,243.75
|
2026-03-25
|
|
58142126
|
CDM
|
Liver Acquisition Living Donor
|
39
|
19
|
$154,411.00
|
$38,587.31
75% off
|
$29,338.09
|
$138,969.90
|
$108,087.70
|
2026-03-25
|
|
58100058
|
CDM
|
Liver Acquisition Cadaveric
|
39
|
19
|
$154,411.00
|
$38,587.31
75% off
|
$29,338.09
|
$138,969.90
|
$108,087.70
|
2026-03-25
|
|
58142134
|
CDM
|
Liver Acquistion Domino
|
39
|
19
|
$154,411.00
|
$38,587.31
75% off
|
$29,338.09
|
$138,969.90
|
$108,087.70
|
2026-03-25
|
|
2004
|
APR_DRG
|
Cardiac Structural & Valvular Disorders
|
7
|
4
|
—
|
—
|
$107,954.58
|
$107,954.58
|
$107,954.58
|
2026-03-25
|
|
55700744
|
CDM
|
Aicd Other Than Sing/dual
|
46
|
21
|
$157,265.00
|
$39,300.52
75% off
|
$82.84
|
$141,538.50
|
$107,073.88
|
2026-03-25
|
|
53300687
|
CDM
|
Srs,(cerebral)1 Ses Multi Co60
|
46
|
21
|
$157,077.00
|
$39,253.54
75% off
|
$29,078.36
|
$149,223.15
|
$106,969.43
|
2026-03-25
|
|
58100074
|
CDM
|
Pancreas Acquisition
|
39
|
19
|
$152,460.00
|
$38,099.75
75% off
|
$28,967.40
|
$137,214.00
|
$106,722.00
|
2026-03-25
|
|
55704142
|
CDM
|
Generator Neuro Non-recharg
|
47
|
21
|
$158,625.00
|
$39,640.39
75% off
|
$524.16
|
$142,762.50
|
$106,596.00
|
2026-03-25
|
|
52799780
|
CDM
|
Aicd Dual Chamber
|
46
|
21
|
$155,189.00
|
$38,781.73
75% off
|
$82.84
|
$139,670.10
|
$105,660.43
|
2026-03-25
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
30
|
16
|
—
|
—
|
$64,293.55
|
$356,196.99
|
$105,373.75
|
2026-03-25
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
30
|
16
|
—
|
—
|
$64,093.77
|
$355,077.26
|
$105,042.50
|
2026-03-25
|
|
57601171
|
CDM
|
Intestine Acquisition
|
39
|
19
|
$149,697.00
|
$37,409.28
75% off
|
$28,442.43
|
$134,727.30
|
$104,787.90
|
2026-03-25
|
|
6072
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
7
|
4
|
—
|
—
|
$104,674.53
|
$104,674.53
|
$104,674.53
|
2026-03-25
|
|
1694
|
APR_DRG
|
Major Abdominal Vascular Procedures
|
7
|
4
|
—
|
—
|
$104,651.81
|
$104,651.81
|
$104,651.81
|
2026-03-25
|
|
50751577
|
CDM
|
Aicd Other Than Sing/dual
|
46
|
21
|
$153,226.00
|
$38,291.18
75% off
|
$82.84
|
$137,903.40
|
$104,323.92
|
2026-03-25
|
|
1814
|
APR_DRG
|
Lower Extremity Arterial Procedures
|
7
|
4
|
—
|
—
|
$103,777.96
|
$103,777.96
|
$103,777.96
|
2026-03-25
|
|
56208754
|
CDM
|
Aicd Dual Chamber
|
46
|
21
|
$151,037.00
|
$37,744.15
75% off
|
$82.84
|
$135,933.30
|
$102,833.54
|
2026-03-25
|
|
58100017
|
CDM
|
Lung Acquisition-single
|
39
|
19
|
$146,611.00
|
$36,638.09
75% off
|
$27,856.09
|
$131,949.90
|
$102,627.70
|
2026-03-25
|
|
50736792
|
CDM
|
Aicd Dual Chamber
|
46
|
21
|
$150,462.00
|
$37,600.45
75% off
|
$82.84
|
$135,415.80
|
$102,442.05
|
2026-03-25
|
|
55747802
|
CDM
|
Gammatile Therapy Device
|
46
|
21
|
$150,373.00
|
$37,578.21
75% off
|
$524.16
|
$135,335.70
|
$102,381.46
|
2026-03-25
|
|
52798253
|
CDM
|
Aicd Dual Chamber
|
46
|
21
|
$150,270.00
|
$37,552.47
75% off
|
$82.84
|
$135,243.00
|
$102,311.33
|
2026-03-25
|
|
1304
|
APR_DRG
|
Respiratory System Diagnosis W Ventilator Support 96+ Hours
|
7
|
4
|
—
|
—
|
$102,054.57
|
$102,054.57
|
$102,054.57
|
2026-03-25
|
|
7104
|
APR_DRG
|
Infectious & Parasitic Diseases Including HIV W O.r. Procedure
|
7
|
4
|
—
|
—
|
$101,277.72
|
$101,277.72
|
$101,277.72
|
2026-03-25
|
|
3032
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
7
|
4
|
—
|
—
|
$101,038.94
|
$101,038.94
|
$101,038.94
|
2026-03-25
|
|
52794633
|
CDM
|
Aicd Dual Chamber
|
46
|
21
|
$148,184.00
|
$37,031.18
75% off
|
$82.84
|
$133,365.60
|
$100,891.07
|
2026-03-25
|
|
2304
|
APR_DRG
|
Major Small Bowel Procedures
|
7
|
4
|
—
|
—
|
$100,576.91
|
$100,576.91
|
$100,576.91
|
2026-03-25
|
|
50751544
|
CDM
|
Aicd Dual Chamber
|
46
|
21
|
$146,622.00
|
$36,640.84
75% off
|
$82.84
|
$131,959.80
|
$99,827.58
|
2026-03-25
|
|
50755347
|
CDM
|
Aicd Dual Chamber
|
46
|
21
|
$146,622.00
|
$36,640.84
75% off
|
$82.84
|
$131,959.80
|
$99,827.58
|
2026-03-25
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
30
|
16
|
—
|
—
|
$60,063.48
|
$332,488.28
|
$98,360.00
|
2026-03-25
|
|
6224
|
APR_DRG
|
Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond
|
7
|
4
|
—
|
—
|
$98,064.99
|
$98,064.99
|
$98,064.99
|
2026-03-25
|
|
55737928
|
CDM
|
Aicd Dual Chamber
|
46
|
21
|
$143,732.00
|
$35,918.63
75% off
|
$82.84
|
$129,358.80
|
$97,859.93
|
2026-03-25
|
|
1664
|
APR_DRG
|
Coronary Bypass Without Ami Or Complex Pdx
|
7
|
4
|
—
|
—
|
$97,549.52
|
$97,549.52
|
$97,549.52
|
2026-03-25
|
|
6084
|
APR_DRG
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
7
|
4
|
—
|
—
|
$97,374.00
|
$97,374.00
|
$97,374.00
|
2026-03-25
|
|
2204
|
APR_DRG
|
Major Stomach, Esophageal & Duodenal Procedures
|
7
|
4
|
—
|
—
|
$97,069.40
|
$97,069.40
|
$97,069.40
|
2026-03-25
|
|
3214
|
APR_DRG
|
Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp
|
7
|
4
|
—
|
—
|
$97,040.10
|
$97,040.10
|
$97,040.10
|
2026-03-25
|
|
6083
|
APR_DRG
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
7
|
4
|
—
|
—
|
$96,948.30
|
$96,948.30
|
$96,948.30
|
2026-03-25
|
|
3213
|
APR_DRG
|
Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp
|
7
|
4
|
—
|
—
|
$96,872.40
|
$96,872.40
|
$96,872.40
|
2026-03-25
|
|
6303
|
APR_DRG
|
Neonate Birthwt >2499g W Major Cardiovascular Procedure
|
7
|
4
|
—
|
—
|
$96,758.04
|
$96,758.04
|
$96,758.04
|
2026-03-25
|
|
6301
|
APR_DRG
|
Neonate Birthwt >2499g W Major Cardiovascular Procedure
|
7
|
4
|
—
|
—
|
$96,758.04
|
$96,758.04
|
$96,758.04
|
2026-03-25
|
|
6302
|
APR_DRG
|
Neonate Birthwt >2499g W Major Cardiovascular Procedure
|
7
|
4
|
—
|
—
|
$96,758.04
|
$96,758.04
|
$96,758.04
|
2026-03-25
|
|
58100041
|
CDM
|
Kidney Acquisition-cadaveric
|
39
|
19
|
$137,181.00
|
$34,281.53
75% off
|
$26,064.39
|
$123,462.90
|
$96,026.70
|
2026-03-25
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
30
|
16
|
—
|
—
|
$58,627.32
|
$324,438.89
|
$95,978.75
|
2026-03-25
|
|
6903
|
APR_DRG
|
Acute Leukemia
|
7
|
4
|
—
|
—
|
$95,802.54
|
$95,802.54
|
$95,802.54
|
2026-03-25
|
|
6904
|
APR_DRG
|
Acute Leukemia
|
7
|
4
|
—
|
—
|
$95,802.54
|
$95,802.54
|
$95,802.54
|
2026-03-25
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
30
|
16
|
—
|
—
|
$58,377.78
|
$323,040.28
|
$95,565.00
|
2026-03-25
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
30
|
16
|
—
|
—
|
$58,187.05
|
$321,971.25
|
$95,248.75
|
2026-03-25
|
|
6113
|
APR_DRG
|
Neonate Birthwt 1500-1999g W Major Anomaly
|
7
|
4
|
—
|
—
|
$94,985.80
|
$94,985.80
|
$94,985.80
|
2026-03-25
|
|
52749710
|
CDM
|
Aicd Dual Chamber
|
46
|
21
|
$139,326.00
|
$34,817.57
75% off
|
$82.84
|
$125,393.40
|
$94,860.11
|
2026-03-25
|
|
52534120
|
CDM
|
Sod Benzo-sod Phenylac Inj 100mg/mL
|
34
|
18
|
$136,187.30
|
$34,033.21
75% off
|
$25,875.59
|
$122,568.57
|
$94,650.18
|
2026-03-25
|
|
3043
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc Except For Curvature Of Back
|
7
|
4
|
—
|
—
|
$94,520.97
|
$94,520.97
|
$94,520.97
|
2026-03-25
|
|
50736800
|
CDM
|
Aicd Single Chamber
|
46
|
21
|
$138,633.00
|
$34,644.39
75% off
|
$82.84
|
$124,769.70
|
$94,388.28
|
2026-03-25
|
|
55737936
|
CDM
|
Aicd Single Chamber
|
46
|
21
|
$137,983.00
|
$34,481.95
75% off
|
$82.84
|
$124,184.70
|
$93,945.73
|
2026-03-25
|
|
55720247
|
CDM
|
Pmkr Other Than Sing/dual
|
46
|
21
|
$137,883.00
|
$34,456.96
75% off
|
$82.84
|
$124,094.70
|
$93,877.65
|
2026-03-25
|
|
55700736
|
CDM
|
Aicd Dual Chamber
|
46
|
21
|
$137,666.00
|
$34,402.73
75% off
|
$82.84
|
$123,899.40
|
$93,729.90
|
2026-03-25
|
|
6021
|
APR_DRG
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
7
|
4
|
—
|
—
|
$93,687.08
|
$93,687.08
|
$93,687.08
|
2026-03-25
|
|
7114
|
APR_DRG
|
Post-op, Post-trauma, Other Device Infections W O.r. Procedure
|
7
|
4
|
—
|
—
|
$93,332.37
|
$93,332.37
|
$93,332.37
|
2026-03-25
|
|
55729305
|
CDM
|
Generator Neuro Non-recharg
|
47
|
21
|
$138,541.00
|
$34,621.40
75% off
|
$524.16
|
$124,686.90
|
$93,099.55
|
2026-03-25
|
|
9514
|
APR_DRG
|
Moderately Extensive Procedure Unrelated To Principal Diagnosis
|
7
|
4
|
—
|
—
|
$93,047.62
|
$93,047.62
|
$93,047.62
|
2026-03-25
|
|
55747794
|
CDM
|
Gammatile Therapy Device
|
46
|
21
|
$135,915.00
|
$33,965.16
75% off
|
$524.16
|
$122,323.50
|
$92,537.73
|
2026-03-25
|
|
52794617
|
CDM
|
Aicd Dual Chamber
|
46
|
21
|
$135,882.00
|
$33,956.91
75% off
|
$82.84
|
$122,293.80
|
$92,515.26
|
2026-03-25
|
|
52
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
7
|
4
|
—
|
—
|
$92,323.37
|
$92,323.37
|
$92,323.37
|
2026-03-25
|
|
52799913
|
CDM
|
Aicd Dual Chamber
|
46
|
21
|
$135,516.00
|
$33,865.45
75% off
|
$82.84
|
$121,964.40
|
$92,266.07
|
2026-03-25
|
|
1204
|
APR_DRG
|
Major Respiratory & Chest Procedures
|
7
|
4
|
—
|
—
|
$92,232.30
|
$92,232.30
|
$92,232.30
|
2026-03-25
|
|
52730017
|
CDM
|
Aicd Dual Chamber
|
46
|
21
|
$134,984.00
|
$33,732.50
75% off
|
$82.84
|
$121,485.60
|
$91,903.86
|
2026-03-25
|
|
3031
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
7
|
4
|
—
|
—
|
$90,448.37
|
$90,448.37
|
$90,448.37
|
2026-03-25
|
|
1783
|
APR_DRG
|
External Heart Assist Devices
|
7
|
4
|
—
|
—
|
$90,339.64
|
$90,339.64
|
$90,339.64
|
2026-03-25
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
30
|
16
|
—
|
—
|
$55,161.69
|
$305,014.72
|
$90,232.50
|
2026-03-25
|
|
2992
|
APR_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
7
|
4
|
—
|
—
|
$90,231.60
|
$90,231.60
|
$90,231.60
|
2026-03-25
|
|
234
|
APR_DRG
|
Spinal Procedures
|
7
|
4
|
—
|
—
|
$90,204.57
|
$90,204.57
|
$90,204.57
|
2026-03-25
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
30
|
16
|
—
|
—
|
$54,838.27
|
$303,202.03
|
$89,696.25
|
2026-03-25
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
30
|
16
|
—
|
—
|
$54,815.66
|
$303,075.27
|
$89,658.75
|
2026-03-25
|
|
52550092
|
CDM
|
Histrelin Inj 50 Mg (Supprelin La)
|
46
|
21
|
$125,577.35
|
$31,381.78
75% off
|
$31,381.78
|
$124,713.11
|
$89,536.65
|
2026-03-25
|
|
55737332
|
CDM
|
Anchor/screw Bn/bntis/bn
|
46
|
21
|
$131,399.00
|
$32,836.61
75% off
|
$524.16
|
$118,259.10
|
$89,463.01
|
2026-03-25
|
|
52794377
|
CDM
|
Aicd Single Chamber
|
46
|
21
|
$131,301.00
|
$32,812.12
75% off
|
$82.84
|
$118,170.90
|
$89,396.29
|
2026-03-25
|
|
1623
|
APR_DRG
|
Cardiac Valve Procedures W Ami Or Complex Pdx
|
7
|
4
|
—
|
—
|
$89,298.56
|
$89,298.56
|
$89,298.56
|
2026-03-25
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
30
|
16
|
—
|
—
|
$54,528.42
|
$301,465.39
|
$89,182.50
|
2026-03-25
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
30
|
16
|
—
|
—
|
$54,496.76
|
$301,287.92
|
$89,130.00
|
2026-03-25
|
|
92
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
7
|
4
|
—
|
—
|
$88,620.13
|
$88,620.13
|
$88,620.13
|
2026-03-25
|
|
55748008
|
CDM
|
System Circulatory Assist
|
46
|
21
|
$130,130.00
|
$32,519.49
75% off
|
$524.16
|
$117,117.00
|
$88,599.01
|
2026-03-25
|
|
91
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
7
|
4
|
—
|
—
|
$88,491.13
|
$88,491.13
|
$88,491.13
|
2026-03-25
|
|
58100066
|
CDM
|
Pancreas Acq-combined W/kidney
|
39
|
19
|
$125,917.00
|
$31,466.66
75% off
|
$23,924.23
|
$113,325.30
|
$88,141.90
|
2026-03-25
|
|
1653
|
APR_DRG
|
Coronary Bypass W Ami Or Complex Pdx
|
7
|
4
|
—
|
—
|
$87,793.50
|
$87,793.50
|
$87,793.50
|
2026-03-25
|
|
304
|
APR_DRG
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
7
|
4
|
—
|
—
|
$87,568.42
|
$87,568.42
|
$87,568.42
|
2026-03-25
|
|
55751507
|
CDM
|
Device Ventricular Assist
|
46
|
21
|
$127,767.00
|
$31,928.97
75% off
|
$121.68
|
$114,990.30
|
$86,990.16
|
2026-03-25
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
30
|
16
|
—
|
—
|
$52,848.76
|
$292,051.20
|
$86,397.50
|
2026-03-25
|
|
53403796
|
CDM
|
Lu-177 Psma Pluvicto 200 Mci
|
39
|
19
|
$122,902.00
|
$30,713.21
75% off
|
$23,351.38
|
$110,611.80
|
$86,031.40
|
2026-03-25
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
30
|
16
|
—
|
—
|
$52,593.19
|
$290,618.79
|
$85,973.75
|
2026-03-25
|
|
9304
|
APR_DRG
|
Multiple Significant Trauma Without O.r. Procedure
|
7
|
4
|
—
|
—
|
$85,912.30
|
$85,912.30
|
$85,912.30
|
2026-03-25
|
|
1794
|
APR_DRG
|
Defibrillator Implants
|
7
|
4
|
—
|
—
|
$85,673.79
|
$85,673.79
|
$85,673.79
|
2026-03-25
|
|
52738143
|
CDM
|
Cochlear Device
|
39
|
19
|
$122,280.00
|
$30,557.77
75% off
|
$23,233.20
|
$110,052.00
|
$85,596.00
|
2026-03-25
|
|
894
|
APR_DRG
|
Major Cranial/facial Bone Procedures
|
7
|
4
|
—
|
—
|
$85,568.88
|
$85,568.88
|
$85,568.88
|
2026-03-25
|
|
54899992
|
CDM
|
Tis Cgen Car Anomal 1st Shnt
|
46
|
21
|
$127,110.00
|
$31,764.79
75% off
|
$1,854.49
|
$114,399.00
|
$85,417.92
|
2026-03-25
|
|
55718399
|
CDM
|
Generator Neuro Rechg Bat Sy
|
46
|
21
|
$125,124.00
|
$31,268.49
75% off
|
$524.16
|
$112,611.60
|
$85,190.68
|
2026-03-25
|
|
50743699
|
CDM
|
Generator Neuro Non-recharg
|
47
|
21
|
$126,739.00
|
$31,672.08
75% off
|
$524.16
|
$114,065.10
|
$85,168.61
|
2026-03-25
|
|
52794609
|
CDM
|
Aicd Single Chamber
|
46
|
21
|
$124,112.00
|
$31,015.59
75% off
|
$82.84
|
$111,700.80
|
$84,501.65
|
2026-03-25
|
|
274
|
APR_DRG
|
Other Open Craniotomy
|
7
|
4
|
—
|
—
|
$84,403.30
|
$84,403.30
|
$84,403.30
|
2026-03-25
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
30
|
16
|
—
|
—
|
$51,486.48
|
$284,415.90
|
$84,138.75
|
2026-03-25
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
30
|
16
|
—
|
—
|
$51,150.24
|
$282,531.37
|
$83,581.25
|
2026-03-25
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
30
|
16
|
—
|
—
|
$51,113.30
|
$282,324.33
|
$83,520.00
|
2026-03-25
|
|
55737894
|
CDM
|
Cochlear System
|
46
|
21
|
$122,652.00
|
$30,650.73
75% off
|
$524.16
|
$110,386.80
|
$83,507.61
|
2026-03-25
|
|
55729362
|
CDM
|
Berlin Heart
|
46
|
21
|
$122,434.00
|
$30,596.26
75% off
|
$524.16
|
$110,190.60
|
$83,359.19
|
2026-03-25
|
|
7924
|
APR_DRG
|
Extensive Or Procedures For Other Complications Of Treatment
|
7
|
4
|
—
|
—
|
$83,239.52
|
$83,239.52
|
$83,239.52
|
2026-03-25
|
|
55709984
|
CDM
|
Aicd Dual Chamber
|
46
|
21
|
$121,901.00
|
$30,463.06
75% off
|
$82.84
|
$109,710.90
|
$82,996.29
|
2026-03-25
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
30
|
16
|
—
|
—
|
$50,311.92
|
$277,832.73
|
$82,191.25
|
2026-03-25
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
30
|
16
|
—
|
—
|
$50,311.92
|
$277,832.73
|
$82,191.25
|
2026-03-25
|
|
52738135
|
CDM
|
Cochlear Device
|
39
|
19
|
$117,220.00
|
$29,293.28
75% off
|
$22,271.80
|
$105,498.00
|
$82,054.00
|
2026-03-25
|
|
50751635
|
CDM
|
Aicd Single Chamber
|
46
|
21
|
$120,391.00
|
$30,085.71
75% off
|
$82.84
|
$108,351.90
|
$81,968.21
|
2026-03-25
|
|
294
|
APR_DRG
|
Other Percutaneous Intracranial Procedures
|
7
|
4
|
—
|
—
|
$81,963.38
|
$81,963.38
|
$81,963.38
|
2026-03-25
|
|
50734425
|
CDM
|
Aicd Single Chamber
|
46
|
21
|
$120,357.00
|
$30,077.21
75% off
|
$82.84
|
$108,321.30
|
$81,945.06
|
2026-03-25
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
30
|
16
|
—
|
—
|
$50,131.74
|
$276,822.86
|
$81,892.50
|
2026-03-25
|
|
55748479
|
CDM
|
Implant Cardiovascular Anytype
|
46
|
21
|
$120,009.00
|
$29,990.25
75% off
|
$524.16
|
$108,008.10
|
$81,708.13
|
2026-03-25
|
|
4054
|
APR_DRG
|
Other Procedures For Endocrine, Nutritional & Metabolic Disorders
|
7
|
4
|
—
|
—
|
$80,814.58
|
$80,814.58
|
$80,814.58
|
2026-03-25
|
|
82
|
APR_DRG
|
Autologous Bone Marrow Transplant
|
7
|
4
|
—
|
—
|
$80,603.23
|
$80,603.23
|
$80,603.23
|
2026-03-25
|
|
81
|
APR_DRG
|
Autologous Bone Marrow Transplant
|
7
|
4
|
—
|
—
|
$80,551.63
|
$80,551.63
|
$80,551.63
|
2026-03-25
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
30
|
16
|
—
|
—
|
$49,251.95
|
$271,891.81
|
$80,433.75
|
2026-03-25
|
|
52738085
|
CDM
|
Cochlear Device
|
39
|
19
|
$114,882.00
|
$28,709.01
75% off
|
$21,827.58
|
$103,393.80
|
$80,417.40
|
2026-03-25
|
|
6313
|
APR_DRG
|
Neonate Birthwt >2499g W Other Major Procedure
|
7
|
4
|
—
|
—
|
$79,950.34
|
$79,950.34
|
$79,950.34
|
2026-03-25
|
|
52545092
|
CDM
|
Carmustine Wafer
|
39
|
19
|
$113,749.00
|
$28,425.88
75% off
|
$21,612.31
|
$102,374.10
|
$79,624.30
|
2026-03-25
|
|
56304686
|
CDM
|
Brachytx Non-stryttrium-90
|
46
|
21
|
$116,646.00
|
$29,149.84
75% off
|
$524.16
|
$104,981.40
|
$79,418.43
|
2026-03-25
|
|
6902
|
APR_DRG
|
Acute Leukemia
|
7
|
4
|
—
|
—
|
$79,314.45
|
$79,314.45
|
$79,314.45
|
2026-03-25
|
|
4414
|
APR_DRG
|
Major Bladder Procedures
|
7
|
4
|
—
|
—
|
$79,252.26
|
$79,252.26
|
$79,252.26
|
2026-03-25
|
|
6144
|
APR_DRG
|
Neonate Bwt 1500-1999g W Or Without Other Significant Condition
|
7
|
4
|
—
|
—
|
$78,591.47
|
$78,591.47
|
$78,591.47
|
2026-03-25
|
|
1214
|
APR_DRG
|
Other Respiratory & Chest Procedures
|
7
|
4
|
—
|
—
|
$78,448.14
|
$78,448.14
|
$78,448.14
|
2026-03-25
|
|
213
|
APR_DRG
|
Craniotomy Except For Trauma
|
7
|
4
|
—
|
—
|
$78,298.23
|
$78,298.23
|
$78,298.23
|
2026-03-25
|
|
4284
|
APR_DRG
|
Genetic Disorders
|
7
|
4
|
—
|
—
|
$78,294.40
|
$78,294.40
|
$78,294.40
|
2026-03-25
|
|
41
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure
|
7
|
4
|
—
|
—
|
$78,058.12
|
$78,058.12
|
$78,058.12
|
2026-03-25
|
|
52749603
|
CDM
|
Aicd Single Chamber
|
46
|
21
|
$114,556.00
|
$28,627.54
75% off
|
$524.16
|
$103,100.40
|
$77,995.45
|
2026-03-25
|
|
4474
|
APR_DRG
|
Other Kidney, Urinary Tract & Related Procedures
|
7
|
4
|
—
|
—
|
$77,900.70
|
$77,900.70
|
$77,900.70
|
2026-03-25
|
|
55756027
|
CDM
|
Anchor/screw Bn/bntis/bn
|
46
|
21
|
$113,458.00
|
$28,353.15
75% off
|
$524.16
|
$102,112.20
|
$77,247.88
|
2026-03-25
|
|
554
|
APR_DRG
|
Head Trauma W Coma >1 Hr Or Hemorrhage
|
7
|
4
|
—
|
—
|
$77,121.40
|
$77,121.40
|
$77,121.40
|
2026-03-25
|
|
6143
|
APR_DRG
|
Neonate Bwt 1500-1999g W Or Without Other Significant Condition
|
7
|
4
|
—
|
—
|
$76,940.27
|
$76,940.27
|
$76,940.27
|
2026-03-25
|
|
1633
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Pdx
|
7
|
4
|
—
|
—
|
$76,935.52
|
$76,935.52
|
$76,935.52
|
2026-03-25
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
30
|
16
|
—
|
—
|
$46,942.79
|
$258,949.41
|
$76,605.00
|
2026-03-25
|
|
2644
|
APR_DRG
|
Other Hepatobiliary, Pancreas & Abdominal Procedures
|
7
|
4
|
—
|
—
|
$76,544.35
|
$76,544.35
|
$76,544.35
|
2026-03-25
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
30
|
16
|
—
|
—
|
$46,889.26
|
$258,649.41
|
$76,516.25
|
2026-03-25
|
|
55756548
|
CDM
|
Valve Aortic
|
46
|
21
|
$112,338.00
|
$28,073.27
75% off
|
$524.16
|
$101,104.20
|
$76,485.33
|
2026-03-25
|
|
3124
|
APR_DRG
|
Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses
|
7
|
4
|
—
|
—
|
$76,239.22
|
$76,239.22
|
$76,239.22
|
2026-03-25
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
30
|
16
|
—
|
—
|
$46,446.73
|
$256,169.10
|
$75,782.50
|
2026-03-25
|
|
55725543
|
CDM
|
Conn Tiss Non-human
|
46
|
21
|
$111,123.00
|
$27,769.64
75% off
|
$524.16
|
$100,010.70
|
$75,658.10
|
2026-03-25
|
|
6223
|
APR_DRG
|
Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond
|
7
|
4
|
—
|
—
|
$75,527.18
|
$75,527.18
|
$75,527.18
|
2026-03-25
|
|
3134
|
APR_DRG
|
Knee & Lower Leg Procedures Except Foot
|
7
|
4
|
—
|
—
|
$75,266.96
|
$75,266.96
|
$75,266.96
|
2026-03-25
|