Price Transparencybeta 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

KANSAS CITY ORTHOPAEDIC INSTITUTE

Leawood, KS · CCN 170188 · Rates published

Your selected procedure

You selected 93306 (HCPCS)

TTE W/DOPPLER COMPLETE

This hospital’s price: $1,273 across 4 payers · range $490-$1,273

Source: https://kcoi.pt.panaceainc.com/MRFDownload/kcoi/kcoi · observed 2025-12-05

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

29,895 distinct procedures filed
12 distinct payers
469,284 rate rows
2026-05-22 last MRF observed
Data quality

254,151 of 469,284 rate rows are consumer-grade (54.2%)

215,133 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 194,565
per-diem day rate — not a per-procedure price 18,926
template filing: same amount across many unrelated codes — excluded 1,156
placeholder amount (≤ $0.02) — excluded from medians 406
percent-of-charges filed in the dollar field — excluded from medians 62
exceeds 10× this hospital's gross charge — excluded from medians 17
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://kcoi.pt.panaceainc.com/MRFDownload/kcoi/kcoi
Found on page https://www.kcoi.com/patient-information/pricing/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-19
Content fingerprint 366eecd0d8041485… · 231,145,698 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 1 $4,377,500.00 $4,377,500.00 $4,377,500.00 nat. median
$4,505,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 1 $3,710,000.00 $3,710,000.00 $3,710,000.00 nat. median
$3,710,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 3 $3,685,266.67 $3,710,000.00 $3,710,000.00 nat. median
$3,703,693
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 3 $3,324,571.90 $3,327,159.88 $3,327,159.88 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 3 $3,261,355.00 $3,286,000.00 $3,286,000.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 3 $2,950,686.67 $2,968,000.00 $2,968,000.00 nat. median
$2,994,107
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 3 $2,354,513.02 $2,452,115.60 $2,354,513.02 nat. median
$2,466,282
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 1 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,401,960
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 4 $523,452.56 $1,375,901.44 $1,375,901.44 nat. median
$738,272
1.9× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 4 $507,687.00 $1,370,520.92 $1,370,520.92 nat. median
$646,415
outlier · 2.1×
Q2055
HCPCS 		Idecabtagene Vicleucel Car 4 $503,454.53 $1,369,127.73 $1,369,127.73 nat. median
$622,245
outlier · 2.2×
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 4 $496,390.21 $1,343,487.81 $1,343,487.81 nat. median
$640,950
outlier · 2.1×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $489,136.91 $1,272,585.50 $1,272,585.50 nat. median
$608,101
outlier · 2.1×
Q2053
HCPCS 		Brexucabtagene Car Pos T 4 $449,440.00 $1,197,379.04 $1,197,379.04 nat. median
$591,650
outlier · 2.0×
Q2057
HCPCS 		Afamitresgene Autoleucel 1 $770,620.00 $770,620.00 $770,620.00 nat. median
$809,217
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 5 $252,506.29 $431,057.30 $278,075.33 nat. median
$359,358
0.8× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 1 $270,375.00 $270,375.00 $270,375.00 nat. median
$319,951
0.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 5 $188,601.03 $321,963.67 $210,360.86 nat. median
$249,124
0.8× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 5 $158,836.16 $271,151.60 $177,161.87 nat. median
$198,433
0.9× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 4 $56,824.55 $170,239.11 $170,239.11 nat. median
$63,643
outlier · 2.7×
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 4 $63,431.05 $164,722.40 $164,722.40 nat. median
$68,423
outlier · 2.4×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 5 $143,495.41 $244,963.19 $160,051.19 nat. median
$190,557
0.8× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 4 $55,512.78 $143,039.60 $143,039.60 nat. median
$65,720
outlier · 2.2×
38240
HCPCS 		Transplt Allo Hct/donor 4 $48,498.60 $126,096.35 $126,096.35 nat. median
$12,855
outlier · 9.8×
J9226
HCPCS 		Supprelin La Implant 4 $44,158.25 $117,910.57 $117,910.57 nat. median
$55,159
outlier · 2.1×
0266T
OTHER 		Implt/rpl Crtd Sns Dev Total 4 $41,917.07 $108,984.37 $108,984.37 nat. median
$39,035
outlier · 2.8×
33276
HCPCS 		Insj Phrnc Nrv Stim Sys 4 $41,917.07 $108,984.37 $108,984.37 nat. median
$43,332
outlier · 2.5×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 5 $94,607.50 $161,505.90 $105,522.84 nat. median
$126,722
0.8× median
1603907
CDM 		Proclaim Elite 5 4 $821.60 $131,614.00 $101,120.00 nat. median
$101,120
1.0× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 5 $87,723.18 $149,753.57 $97,844.24 nat. median
$110,192
0.9× median
7
MS_DRG 		Lung Transplant 5 $87,502.23 $149,376.38 $97,597.80 nat. median
$117,894
0.8× median
453
MS_DRG 		Combined Anterior/posterior Spinal Fusion W Mcc 1 $84,030.18 $84,030.18 $84,030.18 nat. median
$71,201
1.2× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 5 $73,782.47 $125,955.17 $82,295.12 nat. median
$103,967
0.8× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 5 $72,940.17 $124,517.28 $81,355.65 nat. median
$97,414
0.8× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 5 $71,303.12 $121,722.64 $79,529.72 nat. median
$94,964
0.8× median
215
MS_DRG 		Other Heart Assist System Implant 5 $70,937.55 $121,098.56 $79,121.97 nat. median
$93,917
0.8× median
69930
HCPCS 		Implant Cochlear Device 4 $29,762.09 $77,381.43 $77,381.43 nat. median
$29,205
outlier · 2.6×
33270
HCPCS 		Ins/rep Subq Defibrillator 4 $29,198.15 $75,915.20 $75,915.20 nat. median
$32,113
outlier · 2.4×
33264
HCPCS 		Rmvl & Rplcmt Dfb Gen Mlt Ld 4 $29,198.15 $75,915.20 $75,915.20 nat. median
$31,564
outlier · 2.4×
0408T
OTHER 		Insj/rplc Cardiac Modulj Sys 4 $29,198.15 $75,915.20 $75,915.20 nat. median
$31,346
outlier · 2.4×
33231
HCPCS 		Insrt Pulse Gen W/mult Leads 4 $29,198.15 $75,915.20 $75,915.20 nat. median
$30,121
outlier · 2.5×
0571T
OTHER 		Insj/rplcmt Icds Ss Eltrd 4 $29,198.15 $75,915.20 $75,915.20 nat. median
$32,779
outlier · 2.3×
33249
HCPCS 		Insj/rplcmt Defib W/lead(s) 4 $29,198.15 $75,915.20 $75,915.20 nat. median
$31,584
outlier · 2.4×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 5 $64,619.00 $110,312.07 $72,074.41 nat. median
$90,581
0.8× median
1607381
CDM 		Membrane Maci 4 $584.18 $93,580.89 $71,898.88 nat. median
$1,975
outlier · 36.4×
61886
HCPCS 		Implant Neurostim Arrays 4 $27,559.04 $71,653.50 $71,653.50 nat. median
$27,176
outlier · 2.6×
64568
HCPCS 		Opn Impltj Crnl Nrv Nea&pg 4 $27,559.04 $71,653.50 $71,653.50 nat. median
$27,679
outlier · 2.6×
64582
HCPCS 		Opn Mpltj Hpglsl Nstm Ary Pg 4 $27,559.04 $71,653.50 $71,653.50 nat. median
$28,157
outlier · 2.5×
33287
HCPCS 		Rmv&rplcmt Phrnc Nrv Stim Pg 4 $27,559.04 $71,653.50 $71,653.50 nat. median
$28,973
outlier · 2.5×
0268T
OTHER 		Implt/rpl Crtd Sns Dev Gen 4 $27,559.04 $71,653.50 $71,653.50 nat. median
$28,036
outlier · 2.6×

Other procedures at this hospital

Browse this hospital's 29,895 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J3391 HCPCS Inj, Atidarsagene Autotemcel 1 1 — — $4,377,500.00 $4,377,500.00 $4,377,500.00 2025-12-05
J1414 HCPCS Inj, Beqvez, Per Tx Dose 1 1 — — $3,710,000.00 $3,710,000.00 $3,710,000.00 2025-12-05
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 3 3 — — $3,685,266.67 $3,710,000.00 $3,710,000.00 2025-12-05
J1413 HCPCS Inj Delandistrogene Mox Rokl 3 3 — — $3,324,571.90 $3,327,159.88 $3,327,159.88 2025-12-05
J3394 HCPCS Inj, Lovotibeglogene Autotem 3 3 — — $3,261,355.00 $3,286,000.00 $3,286,000.00 2025-12-05
J3393 HCPCS Inj, Betibeglogene Autotemce 3 3 — — $2,950,686.67 $2,968,000.00 $2,968,000.00 2025-12-05
J3399 HCPCS Inj Onase Abepar-xioi Treat 3 3 — — $2,354,513.02 $2,452,115.60 $2,354,513.02 2025-12-05
J3392 HCPCS Inj, Exagamglogene Autotem 1 1 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2025-12-05
Q2042 HCPCS Tisagenlecleucel Car-pos T 8 4 — — $523,452.56 $1,375,901.44 $1,375,901.44 2025-12-05
Q2056 HCPCS Ciltacabtagene Car-pos T 8 4 — — $507,687.00 $1,370,520.92 $1,370,520.92 2025-12-05
Q2055 HCPCS Idecabtagene Vicleucel Car 8 4 — — $503,454.53 $1,369,127.73 $1,369,127.73 2025-12-05
Q2054 HCPCS Lisocabtagene Mara Car Pos T 8 4 — — $496,390.21 $1,343,487.81 $1,343,487.81 2025-12-05
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 8 4 — — $489,136.91 $1,272,585.50 $1,272,585.50 2025-12-05
Q2053 HCPCS Brexucabtagene Car Pos T 8 4 — — $449,440.00 $1,197,379.04 $1,197,379.04 2025-12-05
Q2057 HCPCS Afamitresgene Autoleucel 1 1 — — $770,620.00 $770,620.00 $770,620.00 2025-12-05
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 10 5 — — $252,506.29 $431,057.30 $278,075.33 2025-12-05
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 1 1 — — $270,375.00 $270,375.00 $270,375.00 2025-12-05
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 11 5 — — $188,601.03 $321,963.67 $210,360.86 2025-12-05
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 11 5 — — $158,836.16 $271,151.60 $177,161.87 2025-12-05
A9543 HCPCS Y90 Ibritumomab, Rx 8 4 — — $56,824.55 $170,239.11 $170,239.11 2025-12-05
J9029 HCPCS Instill Adstiladrin, Tx Dose 8 4 — — $63,431.05 $164,722.40 $164,722.40 2025-12-05
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 11 5 — — $143,495.41 $244,963.19 $160,051.19 2025-12-05
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 8 4 — — $55,512.78 $143,039.60 $143,039.60 2025-12-05
38240 HCPCS Transplt Allo Hct/donor 8 4 — — $48,498.60 $126,096.35 $126,096.35 2025-12-05
J9226 HCPCS Supprelin La Implant 8 4 — — $44,158.25 $117,910.57 $117,910.57 2025-12-05
33276 HCPCS Insj Phrnc Nrv Stim Sys 8 4 — — $41,917.07 $108,984.37 $108,984.37 2025-12-05
0266T OTHER Implt/rpl Crtd Sns Dev Total 8 4 — — $41,917.07 $108,984.37 $108,984.37 2025-12-05
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 11 5 — — $94,607.50 $161,505.90 $105,522.84 2025-12-05
1603907 CDM Proclaim Elite 5 9 4 $158,000.00 — $821.60 $131,614.00 $101,120.00 2025-12-05
14 MS_DRG Allogeneic Bone Marrow Transplant 11 5 — — $87,723.18 $149,753.57 $97,844.24 2025-12-05
7 MS_DRG Lung Transplant 11 5 — — $87,502.23 $149,376.38 $97,597.80 2025-12-05
453 MS_DRG Combined Anterior/posterior Spinal Fusion W Mcc 1 1 — — $84,030.18 $84,030.18 $84,030.18 2025-12-05
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 11 5 — — $73,782.47 $125,955.17 $82,295.12 2025-12-05
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 11 5 — — $72,940.17 $124,517.28 $81,355.65 2025-12-05
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 11 5 — — $71,303.12 $121,722.64 $79,529.72 2025-12-05
215 MS_DRG Other Heart Assist System Implant 11 5 — — $70,937.55 $121,098.56 $79,121.97 2025-12-05
69930 HCPCS Implant Cochlear Device 8 4 — — $29,762.09 $77,381.43 $77,381.43 2025-12-05
33231 HCPCS Insrt Pulse Gen W/mult Leads 8 4 — — $29,198.15 $75,915.20 $75,915.20 2025-12-05
33249 HCPCS Insj/rplcmt Defib W/lead(s) 8 4 — — $29,198.15 $75,915.20 $75,915.20 2025-12-05
33270 HCPCS Ins/rep Subq Defibrillator 8 4 — — $29,198.15 $75,915.20 $75,915.20 2025-12-05
0408T OTHER Insj/rplc Cardiac Modulj Sys 8 4 — — $29,198.15 $75,915.20 $75,915.20 2025-12-05
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 8 4 — — $29,198.15 $75,915.20 $75,915.20 2025-12-05
0571T OTHER Insj/rplcmt Icds Ss Eltrd 8 4 — — $29,198.15 $75,915.20 $75,915.20 2025-12-05
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 11 5 — — $64,619.00 $110,312.07 $72,074.41 2025-12-05
1607381 CDM Membrane Maci 9 4 $112,342.00 — $584.18 $93,580.89 $71,898.88 2025-12-05
61886 HCPCS Implant Neurostim Arrays 8 4 — — $27,559.04 $71,653.50 $71,653.50 2025-12-05
64568 HCPCS Opn Impltj Crnl Nrv Nea&pg 8 4 — — $27,559.04 $71,653.50 $71,653.50 2025-12-05
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 8 4 — — $27,559.04 $71,653.50 $71,653.50 2025-12-05
0268T OTHER Implt/rpl Crtd Sns Dev Gen 8 4 — — $27,559.04 $71,653.50 $71,653.50 2025-12-05
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 8 4 — — $27,559.04 $71,653.50 $71,653.50 2025-12-05
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 4 — — $70,138.10 $78,230.29 $70,486.38 2025-12-05
J9266 HCPCS Pegaspargase Injection 8 4 — — $27,014.86 $70,383.38 $70,383.38 2025-12-05
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 8 4 — — $25,794.98 $67,066.95 $67,066.95 2025-12-05
C9760 HCPCS Non-blind Interatrial Shunt 8 4 — — $25,616.17 $66,602.03 $66,602.03 2025-12-05
0620T OTHER Evasc Ven Artlz Tibl/prnl Vn 8 4 — — $25,616.17 $66,602.03 $66,602.03 2025-12-05
231 MS_DRG Coronary Bypass With Ptca With Mcc 11 5 — — $56,737.05 $96,856.68 $63,283.09 2025-12-05
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 11 5 — — $56,705.58 $96,802.96 $63,247.99 2025-12-05
459 MS_DRG Spinal Fusion Except Cervical With Mcc 1 1 — — $62,892.24 $62,892.24 $62,892.24 2025-12-05
J9600 HCPCS Porfimer Sodium Injection 8 4 — — $23,517.16 $62,062.36 $62,062.36 2025-12-05
850 MS_DRG Acute Leukemia With Other Procedures 6 4 — — $61,678.33 $68,794.47 $61,984.60 2025-12-05
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 11 5 — — $53,973.14 $92,138.37 $60,200.29 2025-12-05
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 11 5 — — $53,077.28 $90,609.04 $59,201.08 2025-12-05
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 11 5 — — $52,334.75 $89,341.45 $58,372.88 2025-12-05
10 MS_DRG Pancreas Transplant 11 5 — — $45,646.02 $91,131.39 $58,035.47 2025-12-05
454 MS_DRG Combined Anterior/posterior Spinal Fusion W Cc 1 1 — — $57,999.16 $57,999.16 $57,999.16 2025-12-05
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 11 5 — — $51,806.48 $88,439.63 $57,783.65 2025-12-05
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 6 4 — — $55,844.54 $62,287.60 $56,121.84 2025-12-05
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 11 5 — — $49,976.59 $85,315.81 $55,742.65 2025-12-05
93653 HCPCS Compre Ep Eval Tx Svt 8 4 — — $21,078.64 $54,804.46 $54,804.46 2025-12-05
93656 HCPCS Compre Ep Eval Abltj Atr Fib 8 4 — — $21,078.64 $54,804.46 $54,804.46 2025-12-05
93654 HCPCS Compre Ep Eval Tx Vt 8 4 — — $21,078.64 $54,804.46 $54,804.46 2025-12-05
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 8 4 — — $20,919.78 $54,391.44 $54,391.44 2025-12-05
0515T OTHER Insj Wcs Lv Compl Sys 8 4 — — $20,919.78 $54,391.44 $54,391.44 2025-12-05
33240 HCPCS Insrt Pulse Gen W/singl Lead 8 4 — — $20,919.78 $54,391.44 $54,391.44 2025-12-05
33230 HCPCS Insrt Pulse Gen W/dual Leads 8 4 — — $20,919.78 $54,391.44 $54,391.44 2025-12-05
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 8 4 — — $20,919.78 $54,391.44 $54,391.44 2025-12-05
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 8 4 — — $20,919.78 $54,391.44 $54,391.44 2025-12-05
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 8 4 — — $20,919.78 $54,391.44 $54,391.44 2025-12-05
0409T OTHER Insj/rplc Car Modulj Pls Gn 8 4 — — $20,919.78 $54,391.44 $54,391.44 2025-12-05
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 11 5 — — $47,317.14 $80,775.81 $52,776.36 2025-12-05
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 11 5 — — $46,577.29 $79,512.80 $51,951.14 2025-12-05
955 MS_DRG Craniotomy For Multiple Significant Trauma 11 5 — — $45,718.92 $78,047.47 $50,993.74 2025-12-05
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 8 4 — — $19,414.69 $50,478.19 $50,478.19 2025-12-05
0817T OTHER Opn Insj/rplcmt Ins Ptn Subf 8 4 — — $19,414.69 $50,478.19 $50,478.19 2025-12-05
64580 HCPCS Opn Impltj Nea Neuromuscular 8 4 — — $19,414.69 $50,478.19 $50,478.19 2025-12-05
63655 HCPCS Implant Neuroelectrodes 8 4 — — $19,414.69 $50,478.19 $50,478.19 2025-12-05
0816T OTHER Opn Insj/rplcmt Ins Ptn Subq 8 4 — — $19,414.69 $50,478.19 $50,478.19 2025-12-05
61885 HCPCS Insrt/redo Neurostim 1 Array 8 4 — — $19,414.69 $50,478.19 $50,478.19 2025-12-05
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 11 5 — — $44,718.61 $76,339.83 $49,878.03 2025-12-05
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 11 5 — — $44,642.95 $76,210.67 $49,793.64 2025-12-05
J7330 HCPCS Cultured Chondrocytes Implnt 5 1 — — $41,988.60 $52,907.83 $49,202.31 2025-12-05
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 11 5 — — $43,301.17 $73,920.10 $48,297.05 2025-12-05
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 11 5 — — $43,238.91 $73,813.80 $48,227.60 2025-12-05
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 4 — — $47,556.17 $53,042.96 $47,792.32 2025-12-05
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 11 5 — — $42,344.39 $72,286.75 $47,229.87 2025-12-05
53447 HCPCS Remove/replace Ur Sphincter 8 4 — — $17,902.58 $46,546.71 $46,546.71 2025-12-05
54405 HCPCS Insert Multi-comp Penis Pros 8 4 — — $17,902.58 $46,546.71 $46,546.71 2025-12-05
54411 HCPCS Remov/replc Penis Pros Comp 8 4 — — $17,902.58 $46,546.71 $46,546.71 2025-12-05
53445 HCPCS Insert Uro/ves Nck Sphincter 8 4 — — $17,902.58 $46,546.71 $46,546.71 2025-12-05
54416 HCPCS Remv/repl Penis Contain Pros 8 4 — — $17,902.58 $46,546.71 $46,546.71 2025-12-05
54401 HCPCS Insert Self-contd Prosthesis 8 4 — — $17,902.58 $46,546.71 $46,546.71 2025-12-05
54410 HCPCS Remove/replace Penis Prosth 8 4 — — $17,902.58 $46,546.71 $46,546.71 2025-12-05
53444 HCPCS Insert Tandem Cuff 8 4 — — $17,902.58 $46,546.71 $46,546.71 2025-12-05
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 11 5 — — $33,083.00 $64,657.93 $46,350.00 2025-12-05
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 11 5 — — $41,474.64 $70,801.99 $46,259.78 2025-12-05
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 11 5 — — $41,232.26 $70,388.23 $45,989.44 2025-12-05
232 MS_DRG Coronary Bypass With Ptca Without Mcc 11 5 — — $40,900.84 $69,822.44 $45,619.77 2025-12-05
28 MS_DRG Spinal Procedures With Mcc 11 5 — — $40,705.33 $69,488.69 $45,401.71 2025-12-05
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 6 4 — — $44,891.36 $50,070.70 $45,114.27 2025-12-05
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 11 5 — — $40,413.40 $68,990.34 $45,076.10 2025-12-05
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 11 5 — — $40,413.40 $68,990.34 $45,076.10 2025-12-05
0795T OTHER Tcat Ins 2chmbr Ldls Pm Cmpl 8 4 — — $17,293.25 $44,962.46 $44,962.46 2025-12-05
0823T OTHER Tcat Ins 1chmbr Ldls Pm Ra 8 4 — — $17,293.25 $44,962.46 $44,962.46 2025-12-05
0825T OTHER Tcat Rmv&rpl1chmb Ldls Pm Ra 8 4 — — $17,293.25 $44,962.46 $44,962.46 2025-12-05
33274 HCPCS Tcat Insj/rpl Perm Ldls Pm 8 4 — — $17,293.25 $44,962.46 $44,962.46 2025-12-05
33221 HCPCS Insert Pulse Gen Mult Leads 8 4 — — $17,293.25 $44,962.46 $44,962.46 2025-12-05
33229 HCPCS Remv&replc Pm Gen Mult Leads 8 4 — — $17,293.25 $44,962.46 $44,962.46 2025-12-05
0796T OTHER Tcat Ins 2chmbr Ldls Pm Ra 8 4 — — $17,293.25 $44,962.46 $44,962.46 2025-12-05
0801T OTHER Tcat Rmv&rpl 2chmbr Ldls Pm 8 4 — — $17,293.25 $44,962.46 $44,962.46 2025-12-05
0803T OTHER Tcat Rmv&rpl2chmb Ldls Pm Rv 8 4 — — $17,293.25 $44,962.46 $44,962.46 2025-12-05
0802T OTHER Tcat Rmv&rpl2chmb Ldls Pm Ra 8 4 — — $17,293.25 $44,962.46 $44,962.46 2025-12-05
0797T OTHER Tcat Ins 2chmbr Ldls Pm Rv 8 4 — — $17,293.25 $44,962.46 $44,962.46 2025-12-05
A9604 HCPCS Sm 153 Lexidronam 8 4 — — $4,314.91 $44,875.61 $44,875.61 2025-12-05
266 MS_DRG Endovascular Cardiac Valve Replacement W Mcc 11 5 — — $40,111.44 $68,474.84 $44,739.29 2025-12-05
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 11 5 — — $39,833.57 $68,000.50 $44,429.37 2025-12-05
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 11 5 — — $39,397.69 $67,256.41 $43,943.21 2025-12-05
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 10 5 — — $39,803.44 $67,949.06 $43,833.99 2025-12-05
455 MS_DRG Combined Anterior/posterior Spinal Fusion Without Cc/mcc 1 1 — — $43,673.62 $43,673.62 $43,673.62 2025-12-05
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 11 5 — — $38,983.24 $66,548.89 $43,480.94 2025-12-05
27278 HCPCS Arthrd Si Jt Plmt Iartic Dev 8 4 — — $16,539.62 $43,003.01 $43,003.01 2025-12-05
22867 HCPCS Insj Stablj Dev W/dcmprn 8 4 — — $16,539.62 $43,003.01 $43,003.01 2025-12-05
25446 HCPCS Arthrp W/prostc Dst Rds&crps 8 4 — — $16,539.62 $43,003.01 $43,003.01 2025-12-05
25442 HCPCS Arthrp W/prostc Dstl Ulna 8 4 — — $16,539.62 $43,003.01 $43,003.01 2025-12-05
22630 HCPCS Arthrd Pst Tq 1ntrspc Lum 8 4 — — $16,539.62 $43,003.01 $43,003.01 2025-12-05
20696 HCPCS App Mltpln Uni Xtrnl Fix 1st 8 4 — — $16,539.62 $43,003.01 $43,003.01 2025-12-05
21243 HCPCS Reconstruction Of Jaw Joint 8 4 — — $16,539.62 $43,003.01 $43,003.01 2025-12-05
24371 HCPCS Revise Reconst Elbow Joint 8 4 — — $16,539.62 $43,003.01 $43,003.01 2025-12-05
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 11 5 — — $38,428.19 $65,601.34 $42,861.84 2025-12-05
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 11 5 — — $38,198.53 $65,209.29 $42,605.69 2025-12-05
C9782 HCPCS Blind Myocar Trpl Bon Marrow 8 4 — — $16,301.37 $42,383.55 $42,383.55 2025-12-05
C9758 HCPCS Blind Interatrial Shunt Ide 8 4 — — $16,301.37 $42,383.55 $42,383.55 2025-12-05
0888T OTHER Histotripsy Mal Renal Tissue 8 4 — — $16,301.37 $42,383.55 $42,383.55 2025-12-05
0686T OTHER Histotripsy Mal Hepatcel Tis 8 4 — — $16,301.37 $42,383.55 $42,383.55 2025-12-05
653 MS_DRG Major Bladder Procedures With Mcc 11 5 — — $37,324.77 $63,717.68 $41,631.11 2025-12-05
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 6 4 — — $41,421.08 $46,200.04 $41,626.76 2025-12-05
C2616 HCPCS Brachytx, Non-str,yttrium-90 8 4 — — $16,000.04 $41,600.11 $41,600.11 2025-12-05
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 11 5 — — $37,008.07 $63,177.04 $41,277.88 2025-12-05
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 11 5 — — $37,008.07 $63,177.04 $41,277.88 2025-12-05
62360 HCPCS Insert Spine Infusion Device 8 4 — — $15,828.06 $41,152.96 $41,152.96 2025-12-05
62361 HCPCS Implant Spine Infusion Pump 8 4 — — $15,828.06 $41,152.96 $41,152.96 2025-12-05
62362 HCPCS Implant Spine Infusion Pump 8 4 — — $15,828.06 $41,152.96 $41,152.96 2025-12-05
19357 HCPCS Tiss Xpndr Plmt Brst Rcnstj 8 4 — — $15,639.56 $40,662.85 $40,662.85 2025-12-05
8 MS_DRG Simultaneous Pancreas/kidney Transplant 11 5 — — $36,430.92 $62,191.77 $40,634.13 2025-12-05
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 11 5 — — $36,347.89 $62,050.04 $40,541.53 2025-12-05
37242 HCPCS Vasc Embolize/occlude Artery 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
C9797 HCPCS Vasc Emb/occ W/prs Cath 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
93582 HCPCS Perq Transcath Closure Pda 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
37231 HCPCS Tib/per Revasc Stent & Ather 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
C9774 HCPCS Revasc Lithotr-ather Tib/per 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
C9775 HCPCS Revasc Lith-sten-ath Tib/per 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
C9767 HCPCS Revasc Lithotrip-stent-ather 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
37227 HCPCS Fem/popl Revasc Stnt & Ather 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
37225 HCPCS Fem/popl Revas W/ather 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
36837 HCPCS Prq Av Fstl Crt Uxtr Sep Acs 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
C9607 HCPCS Perc D-e Cor Revasc Chro Sin 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
33902 HCPCS Perq P-art Revsc 1 Abnor Uni 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
C9765 HCPCS Revasc Intra Lithotrip-stent 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
37184 HCPCS Prim Art M-thrmbc 1st Vsl 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
36906 HCPCS Thrmbc/nfs Dialysis Circuit 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
93591 HCPCS Perq Transcath Cls Aortic 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
93581 HCPCS Transcath Closure Of Vsd 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
92933 HCPCS Prq Trlml C Athrc St Angiop1 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
93580 HCPCS Transcath Closure Of Asd 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
37229 HCPCS Tib/per Revasc W/ather 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
0793T OTHER Prq Tcat Thrm Ablt Nrv P-art 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
37230 HCPCS Tib/per Revasc W/stent 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
0632T OTHER Perq Tcat US Abltj Nrv P-art 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
93590 HCPCS Perq Transcath Cls Mitral 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
C9766 HCPCS Revasc Intra Lithotrip-ather 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
C9602 HCPCS Perc D-e Cor Stent Ather S 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
0238T OTHER Trluml Perip Athrc Iliac Art 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
0645T OTHER Tcat Impltj C Sins Rdctj Dev 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
36836 HCPCS Prq Av Fstl Crtj Uxtr 1 Acs 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
C9773 HCPCS Revasc Lithotr-stent Tib/per 8 4 — — $15,562.53 $40,462.57 $40,462.57 2025-12-05
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 11 5 — — $36,162.43 $61,733.43 $40,334.67 2025-12-05
11 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Mcc 11 5 — — $36,128.28 $61,675.14 $40,296.58 2025-12-05
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 11 5 — — $36,124.26 $61,668.28 $40,292.10 2025-12-05
0618T OTHER Insj Iris Prosth Sec Io Lens 7 3 — — $15,397.73 $40,034.09 $40,034.09 2025-12-05
0617T OTHER Insj Iris Prosth W/rmvl&insj 7 3 — — $15,397.73 $40,034.09 $40,034.09 2025-12-05
0308T OTHER Insj Ocular Telescope Prosth 8 4 — — $15,397.73 $40,034.09 $40,034.09 2025-12-05
0616T OTHER Insertion Of Iris Prosthesis 7 3 — — $15,397.73 $40,034.09 $40,034.09 2025-12-05
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 11 5 — — $35,621.43 $60,809.89 $39,731.25 2025-12-05
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 11 5 — — $35,464.08 $60,541.28 $39,555.76 2025-12-05
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 11 5 — — $34,368.03 $58,670.19 $38,333.24 2025-12-05
J7310 HCPCS Ganciclovir Long Act Implant 5 1 — — $32,478.40 $40,924.48 $38,058.24 2025-12-05
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 11 5 — — $34,110.92 $58,231.28 $38,046.47 2025-12-05
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 11 5 — — $34,006.47 $58,052.97 $37,929.97 2025-12-05
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 11 5 — — $33,724.59 $57,571.77 $37,615.57 2025-12-05
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 11 5 — — $33,525.74 $57,232.30 $37,393.77 2025-12-05
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 11 5 — — $33,499.62 $57,187.72 $37,364.64 2025-12-05
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 11 5 — — $33,486.23 $57,164.86 $37,349.71 2025-12-05
228 MS_DRG Other Cardiothoracic Procedures With Mcc 11 5 — — $33,365.71 $56,959.12 $37,215.28 2025-12-05
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 4 — — $36,852.73 $41,104.62 $37,035.73 2025-12-05
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 6 4 — — $36,627.76 $40,853.69 $36,809.64 2025-12-05
245 MS_DRG Aicd Generator Procedures 11 5 — — $32,719.60 $55,856.12 $36,494.62 2025-12-05
67027 HCPCS Implant Eye Drug System 8 4 — — $14,007.99 $36,420.77 $36,420.77 2025-12-05
471 MS_DRG Cervical Spinal Fusion With Mcc 11 5 — — $32,522.08 $55,518.94 $36,274.32 2025-12-05
6 MS_DRG Liver Transplant Without Mcc 11 5 — — $32,467.85 $55,426.36 $36,213.83 2025-12-05
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 11 5 — — $31,974.39 $54,583.97 $35,663.43 2025-12-05
799 MS_DRG Splenic Procedures With Mcc 11 5 — — $31,835.79 $54,347.36 $35,508.85 2025-12-05
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 11 5 — — $31,829.76 $54,337.08 $35,502.13 2025-12-05
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 11 5 — — $31,500.34 $53,774.72 $35,134.70 2025-12-05
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 11 5 — — $31,331.62 $53,486.69 $34,946.51 2025-12-05
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 11 5 — — $31,146.82 $53,171.22 $34,740.39 2025-12-05
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 1 1 — — $34,686.84 $34,686.84 $34,686.84 2025-12-05
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 6 4 — — $34,482.52 $38,460.95 $34,653.75 2025-12-05
163 MS_DRG Major Chest Procedures With Mcc 11 5 — — $30,860.92 $52,683.16 $34,421.51 2025-12-05
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 11 5 — — $30,848.20 $52,661.44 $34,407.32 2025-12-05
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 11 5 — — $30,749.78 $52,493.42 $34,297.54 2025-12-05
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 11 5 — — $30,745.09 $52,485.42 $34,292.31 2025-12-05
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 11 5 — — $30,207.44 $51,567.59 $33,692.63 2025-12-05
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 11 5 — — $30,027.33 $51,260.12 $33,491.74 2025-12-05
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 11 5 — — $29,944.31 $51,118.39 $33,399.14 2025-12-05
901 MS_DRG Wound Debridements For Injuries With Mcc 11 5 — — $29,664.44 $50,640.62 $33,086.97 2025-12-05
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 11 5 — — $29,412.02 $50,209.70 $32,805.43 2025-12-05
1606642 CDM DRG Proclaim 2 Lead System 9 4 $50,500.00 — $262.60 $42,066.50 $32,320.00 2025-12-05
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 11 5 — — $28,911.19 $49,354.74 $32,246.82 2025-12-05
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 11 5 — — $28,561.02 $48,756.95 $31,856.25 2025-12-05
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 11 5 — — $28,518.84 $48,684.94 $31,809.20 2025-12-05
140 MS_DRG Major Head And Neck Procedures With Mcc 11 5 — — $28,316.63 $48,339.76 $31,583.67 2025-12-05
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 11 5 — — $28,751.61 $49,456.47 $31,495.51 2025-12-05
0786T OTHER Insj/rplcmt Prq Ra Sac Nstim 7 3 — — $12,089.63 $31,433.04 $31,433.04 2025-12-05
33288 HCPCS Rmv&rplcmt Phrnc Nrv Stim Ld 8 4 — — $11,731.07 $31,433.04 $31,433.04 2025-12-05
64583 HCPCS Rev/rplct Hpglsl Nstm Ary Pg 8 4 — — $11,731.07 $31,433.04 $31,433.04 2025-12-05
64569 HCPCS Revise/repl Vagus N Eltrd 8 4 — — $11,731.07 $31,433.04 $31,433.04 2025-12-05
64575 HCPCS Opn Impltj Nea Perph Nerve 8 4 — — $11,731.07 $31,433.04 $31,433.04 2025-12-05
63664 HCPCS Revise Spine Eltrd Plate 8 4 — — $11,731.07 $31,433.04 $31,433.04 2025-12-05
64553 HCPCS Implant Neuroelectrodes 8 4 — — $11,731.07 $31,433.04 $31,433.04 2025-12-05
61888 HCPCS Revise/remove Neuroreceiver 8 4 — — $11,731.07 $31,433.04 $31,433.04 2025-12-05
0398T OTHER Mrgfus Strtctc Les Abltj 7 3 — — $12,089.63 $31,433.04 $31,433.04 2025-12-05
43647 HCPCS Lap Impl Electrode Antrum 8 4 — — $11,731.07 $31,433.04 $31,433.04 2025-12-05
0784T OTHER Ins/rplmt Eltrd Ra Spi Nstim 8 4 — — $11,731.07 $31,433.04 $31,433.04 2025-12-05
31 MS_DRG Ventricular Shunt Procedures With Mcc 11 5 — — $28,058.18 $47,898.56 $31,295.40 2025-12-05
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 11 5 — — $28,051.49 $47,887.13 $31,287.93 2025-12-05
J1412 HCPCS Inj Roctavian Ml 2x10^13vc G 8 4 — — $12,007.81 $31,220.31 $31,220.31 2025-12-05
81416 HCPCS Exome Sequence Analysis 8 4 — — $12,000.00 $31,200.00 $31,200.00 2025-12-05
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 11 5 — — $27,857.99 $47,556.80 $31,072.11 2025-12-05
793 MS_DRG Full Term Neonate With Major Problems 10 5 — — $27,923.61 $47,668.82 $30,751.18 2025-12-05
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 11 5 — — $27,532.59 $47,001.30 $30,709.16 2025-12-05
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 11 5 — — $27,517.19 $46,975.01 $30,691.99 2025-12-05
12 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Cc 11 5 — — $27,476.35 $46,905.29 $30,646.43 2025-12-05
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 11 5 — — $27,233.30 $46,490.38 $30,375.34 2025-12-05
20982 HCPCS Ablate Bone Tumor(s) Perq 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
25491 HCPCS Prophylactic Tx Ulna 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
29907 HCPCS Subtalar Arthro W/fusion 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
24587 HCPCS Optx Partclr Fx&/dslc Elbw W 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
C9781 HCPCS Arthro/shoul Surg; W/spacer 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
23802 HCPCS Arthrd Glenohumeral Jt W/grf 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
23680 HCPCS Optx Sho Dislc Neck Fx Fixj 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
0737T OTHER Xenograft Impltj Artclr Surf 6 2 — — $12,104.07 $30,369.54 $30,369.54 2025-12-05
C9734 HCPCS U/s Trtmt, Not Leiomyomata 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
C9757 HCPCS Spine Device Implant Surgery 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
0629T OTHER Perq Njx Algc CT Lmbr 1st 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
27709 HCPCS Osteotomy Tibia & Fibula 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
28420 HCPCS Optx Calcaneal Fx W/bone Grf 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
24546 HCPCS Optx Hum Fx W/ntrcndylr Xtn 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
25444 HCPCS Arthrp W/prostc Lunate 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
29856 HCPCS Tibial Arthroscopy/surgery 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
24802 HCPCS Arthrd Elbow Jt Autog Graft 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
27441 HCPCS Revision Of Knee Joint 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
69730 HCPCS Rplc Oi Implt Sk Tc Esp>=100 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
69729 HCPCS Impl Oi Implt Sk Tc Esp>=100 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
69714 HCPCS Impl Oi Implt Skull Perq Esp 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
69716 HCPCS Impl Oi Implt Sk Tc Esp<100 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
25441 HCPCS Arthrp W/prostc Dstl Rds 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
69719 HCPCS Rplcm Oi Implt Sk Tc Esp<100 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
23491 HCPCS Reinforce Shoulder Bones 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
0627T OTHER Perq Njx Algc Fluor Lmbr 1st 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
27440 HCPCS Revision Of Knee Joint 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
24498 HCPCS Proph Tx W/wo Mthylmthcrylt 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
24410 HCPCS Mlt Osteot Rlgnm Imed Rd Hum 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
24430 HCPCS Rpr Non/mal Humerus Wo Graft 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
24435 HCPCS Rpr Non/mal Hum With Agrft 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
24370 HCPCS Revise Reconst Elbow Joint 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
25365 HCPCS Revise Radius & Ulna 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
24362 HCPCS Reconstruct Elbow Joint 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
27356 HCPCS Remove Femur Lesion/graft 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
24365 HCPCS Reconstruct Head Of Radius 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
27443 HCPCS Revision Of Knee Joint 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
25391 HCPCS Lengthen Radius Or Ulna 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
24545 HCPCS Optx Hum Fx Wo Ntrcndylr Xtn 8 4 — — $11,680.59 $30,369.54 $30,369.54 2025-12-05
0915T OTHER Insj Perm Ccm-d Sys Pg&eltrd 1 1 — — $30,160.97 $30,160.97 $30,160.97 2025-12-05
1606298 CDM Kit Senza Omnia -nevro Non Construct 9 4 $47,000.00 — $244.40 $39,151.00 $30,080.00 2025-12-05
791 MS_DRG Prematurity With Major Problems 10 5 — — $27,183.08 $46,404.66 $29,935.67 2025-12-05
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 11 5 — — $26,672.88 $45,533.69 $29,750.27 2025-12-05
739 MS_DRG Uterine,adnexa Proc For Non-ovarian/adnexal Malig W Mcc 11 5 — — $26,654.14 $45,501.69 $29,729.36 2025-12-05
54417 HCPCS Remv/replc Penis Pros Compl 8 4 — — $11,392.77 $29,621.21 $29,621.21 2025-12-05
53451 HCPCS Tprnl Balo Cntnc Dev Bi 8 4 — — $11,392.77 $29,621.21 $29,621.21 2025-12-05
54400 HCPCS Insert Semi-rigid Prosthesis 8 4 — — $11,392.77 $29,621.21 $29,621.21 2025-12-05
53440 HCPCS Male Sling Procedure 8 4 — — $11,392.77 $29,621.21 $29,621.21 2025-12-05
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