|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
4
|
4
|
—
|
—
|
$129,317.70
|
$129,317.70
|
$129,317.70
|
2025-09-11
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
4
|
4
|
—
|
—
|
$115,670.72
|
$115,670.72
|
$115,670.72
|
2025-09-11
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
4
|
4
|
—
|
—
|
$106,701.60
|
$106,701.60
|
$106,701.60
|
2025-09-11
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
4
|
4
|
—
|
—
|
$83,930.86
|
$83,930.86
|
$83,930.86
|
2025-09-11
|
|
B0407
|
HCPCS
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
14
|
10
|
—
|
—
|
$78,424.33
|
$117,636.50
|
$78,424.33
|
2025-09-11
|
|
C0407
|
HCPCS
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
14
|
10
|
—
|
—
|
$69,741.23
|
$104,611.85
|
$69,741.23
|
2025-09-11
|
|
B1904
|
HCPCS
|
Guillain-barré M <38.50
|
14
|
10
|
—
|
—
|
$67,860.29
|
$101,790.44
|
$67,860.29
|
2025-09-11
|
|
D0407
|
HCPCS
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
14
|
10
|
—
|
—
|
$67,700.76
|
$101,551.14
|
$67,700.76
|
2025-09-11
|
|
B1806
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
14
|
10
|
—
|
—
|
$63,833.15
|
$95,749.73
|
$63,833.15
|
2025-09-11
|
|
A0407
|
HCPCS
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
14
|
10
|
—
|
—
|
$61,516.30
|
$92,274.45
|
$61,516.30
|
2025-09-11
|
|
993
|
MS_DRG
|
Birth Weight < 1000 Grams
|
4
|
4
|
—
|
—
|
$60,773.52
|
$60,773.52
|
$60,773.52
|
2025-09-11
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
4
|
4
|
—
|
—
|
$57,874.02
|
$57,874.02
|
$57,874.02
|
2025-09-11
|
|
B0406
|
HCPCS
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
14
|
10
|
—
|
—
|
$57,364.88
|
$86,047.32
|
$57,364.88
|
2025-09-11
|
|
B0404
|
HCPCS
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
14
|
10
|
—
|
—
|
$56,532.00
|
$84,798.00
|
$56,532.00
|
2025-09-11
|
|
B0505
|
HCPCS
|
Non-traumatic Spinal Cord Injury M <39.50
|
14
|
10
|
—
|
—
|
$55,951.40
|
$83,927.10
|
$55,951.40
|
2025-09-11
|
|
B0106
|
HCPCS
|
Stroke M <41.50 And A <84.50
|
14
|
10
|
—
|
—
|
$53,912.79
|
$80,869.19
|
$53,912.79
|
2025-09-11
|
|
C1904
|
HCPCS
|
Guillain-barré M <38.50
|
14
|
10
|
—
|
—
|
$52,170.97
|
$78,256.46
|
$52,170.97
|
2025-09-11
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
4
|
4
|
—
|
—
|
$52,113.68
|
$52,113.68
|
$52,113.68
|
2025-09-11
|
|
C0406
|
HCPCS
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
14
|
10
|
—
|
—
|
$51,013.47
|
$76,520.21
|
$51,013.47
|
2025-09-11
|
|
C1806
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
14
|
10
|
—
|
—
|
$50,922.58
|
$76,383.87
|
$50,922.58
|
2025-09-11
|
|
C0404
|
HCPCS
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
14
|
10
|
—
|
—
|
$50,273.34
|
$75,410.01
|
$50,273.34
|
2025-09-11
|
|
D0406
|
HCPCS
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
14
|
10
|
—
|
—
|
$49,520.22
|
$74,280.33
|
$49,520.22
|
2025-09-11
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
4
|
4
|
—
|
—
|
$49,446.14
|
$49,446.14
|
$49,446.14
|
2025-09-11
|
|
B0205
|
HCPCS
|
Traumatic Brain Injury M <35.50
|
14
|
10
|
—
|
—
|
$48,943.33
|
$73,415.00
|
$48,943.33
|
2025-09-11
|
|
D0404
|
HCPCS
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
14
|
10
|
—
|
—
|
$48,802.35
|
$73,203.53
|
$48,802.35
|
2025-09-11
|
|
D1904
|
HCPCS
|
Guillain-barré M <38.50
|
14
|
10
|
—
|
—
|
$48,681.78
|
$73,022.67
|
$48,681.78
|
2025-09-11
|
|
B1705
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
14
|
10
|
—
|
—
|
$48,637.26
|
$72,955.89
|
$48,637.26
|
2025-09-11
|
|
D1806
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
14
|
10
|
—
|
—
|
$48,344.17
|
$72,516.26
|
$48,344.17
|
2025-09-11
|
|
7
|
MS_DRG
|
Lung Transplant
|
4
|
4
|
—
|
—
|
$48,286.34
|
$48,286.34
|
$48,286.34
|
2025-09-11
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
4
|
4
|
—
|
—
|
$48,209.02
|
$48,209.02
|
$48,209.02
|
2025-09-11
|
|
A1904
|
HCPCS
|
Guillain-barré M <38.50
|
14
|
10
|
—
|
—
|
$47,839.62
|
$71,759.43
|
$47,839.62
|
2025-09-11
|
|
B0105
|
HCPCS
|
Stroke M <41.50 And A >=84.50
|
14
|
10
|
—
|
—
|
$47,399.99
|
$71,099.99
|
$47,399.99
|
2025-09-11
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
4
|
4
|
—
|
—
|
$46,971.90
|
$46,971.90
|
$46,971.90
|
2025-09-11
|
|
C0106
|
HCPCS
|
Stroke M <41.50 And A <84.50
|
14
|
10
|
—
|
—
|
$46,756.32
|
$70,134.48
|
$46,756.32
|
2025-09-11
|
|
B1903
|
HCPCS
|
Guillain-barré M >=38.50 And M <51.50
|
14
|
10
|
—
|
—
|
$46,585.66
|
$69,878.49
|
$46,585.66
|
2025-09-11
|
|
B0604
|
HCPCS
|
Neurological M <43.50
|
14
|
10
|
—
|
—
|
$46,196.12
|
$69,294.18
|
$46,196.12
|
2025-09-11
|
|
A0406
|
HCPCS
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
14
|
10
|
—
|
—
|
$44,997.81
|
$67,496.72
|
$44,997.81
|
2025-09-11
|
|
B0405
|
HCPCS
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
14
|
10
|
—
|
—
|
$44,957.00
|
$67,435.50
|
$44,957.00
|
2025-09-11
|
|
B1805
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
14
|
10
|
—
|
—
|
$44,947.73
|
$67,421.60
|
$44,947.73
|
2025-09-11
|
|
A1806
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
14
|
10
|
—
|
—
|
$44,823.44
|
$67,235.16
|
$44,823.44
|
2025-09-11
|
|
A0404
|
HCPCS
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
14
|
10
|
—
|
—
|
$44,344.86
|
$66,517.29
|
$44,344.86
|
2025-09-11
|
|
B0305
|
HCPCS
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
14
|
10
|
—
|
—
|
$44,231.71
|
$66,347.57
|
$44,231.71
|
2025-09-11
|
|
A5104
|
HCPCS
|
Expired, Not Orthopedic, Length Of Stay Is 16 Days Or More
|
14
|
10
|
—
|
—
|
$44,211.30
|
$66,316.95
|
$44,211.30
|
2025-09-11
|
|
B1604
|
HCPCS
|
Pain Syndrome M <43.50
|
14
|
10
|
—
|
—
|
$43,545.37
|
$65,318.06
|
$43,545.37
|
2025-09-11
|
|
C0505
|
HCPCS
|
Non-traumatic Spinal Cord Injury M <39.50
|
14
|
10
|
—
|
—
|
$43,528.68
|
$65,293.02
|
$43,528.68
|
2025-09-11
|
|
B0704
|
HCPCS
|
Fracture Of Lower Extremity M <41.50
|
14
|
10
|
—
|
—
|
$43,170.67
|
$64,756.01
|
$43,170.67
|
2025-09-11
|
|
B2102
|
HCPCS
|
Burns M <52.50
|
14
|
10
|
—
|
—
|
$42,990.73
|
$64,486.10
|
$42,990.73
|
2025-09-11
|
|
D0106
|
HCPCS
|
Stroke M <41.50 And A <84.50
|
14
|
10
|
—
|
—
|
$42,727.33
|
$64,091.00
|
$42,727.33
|
2025-09-11
|
|
B1004
|
HCPCS
|
Amputation Lower Extremity M <47.50
|
14
|
10
|
—
|
—
|
$42,684.67
|
$64,027.01
|
$42,684.67
|
2025-09-11
|
|
B1504
|
HCPCS
|
Pulmonary M <45.50
|
14
|
10
|
—
|
—
|
$42,189.39
|
$63,284.09
|
$42,189.39
|
2025-09-11
|
|
B1704
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
14
|
10
|
—
|
—
|
$41,445.55
|
$62,168.33
|
$41,445.55
|
2025-09-11
|
|
B2005
|
HCPCS
|
Miscellaneous M <46.50 And A <77.50
|
14
|
10
|
—
|
—
|
$41,202.55
|
$61,803.83
|
$41,202.55
|
2025-09-11
|
|
D0505
|
HCPCS
|
Non-traumatic Spinal Cord Injury M <39.50
|
14
|
10
|
—
|
—
|
$41,122.78
|
$61,684.17
|
$41,122.78
|
2025-09-11
|
|
C0105
|
HCPCS
|
Stroke M <41.50 And A >=84.50
|
14
|
10
|
—
|
—
|
$41,107.94
|
$61,661.91
|
$41,107.94
|
2025-09-11
|
|
453
|
MS_DRG
|
Combined Anterior And Posterior Spinal Fusion With Mcc
|
4
|
4
|
—
|
—
|
$40,786.30
|
$40,786.30
|
$40,786.30
|
2025-09-11
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
4
|
4
|
—
|
—
|
$40,747.64
|
$40,747.64
|
$40,747.64
|
2025-09-11
|
|
A0106
|
HCPCS
|
Stroke M <41.50 And A <84.50
|
14
|
10
|
—
|
—
|
$40,718.40
|
$61,077.60
|
$40,718.40
|
2025-09-11
|
|
B1204
|
HCPCS
|
Osteoarthritis M <49.50 And A <74.50
|
14
|
10
|
—
|
—
|
$40,506.93
|
$60,760.40
|
$40,506.93
|
2025-09-11
|
|
C0205
|
HCPCS
|
Traumatic Brain Injury M <35.50
|
14
|
10
|
—
|
—
|
$40,310.31
|
$60,465.47
|
$40,310.31
|
2025-09-11
|
|
B0504
|
HCPCS
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
14
|
10
|
—
|
—
|
$40,265.79
|
$60,398.69
|
$40,265.79
|
2025-09-11
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
4
|
4
|
—
|
—
|
$40,206.40
|
$40,206.40
|
$40,206.40
|
2025-09-11
|
|
B0304
|
HCPCS
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
14
|
10
|
—
|
—
|
$40,106.26
|
$60,159.39
|
$40,106.26
|
2025-09-11
|
|
C0405
|
HCPCS
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
14
|
10
|
—
|
—
|
$39,980.12
|
$59,970.18
|
$39,980.12
|
2025-09-11
|
|
B1404
|
HCPCS
|
Cardiac M <45.50
|
14
|
10
|
—
|
—
|
$39,803.90
|
$59,705.85
|
$39,803.90
|
2025-09-11
|
|
B0904
|
HCPCS
|
Other Orthopedic M <44.5
|
14
|
10
|
—
|
—
|
$39,725.99
|
$59,588.99
|
$39,725.99
|
2025-09-11
|
|
B1304
|
HCPCS
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
14
|
10
|
—
|
—
|
$39,725.99
|
$59,588.99
|
$39,725.99
|
2025-09-11
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
4
|
4
|
—
|
—
|
$39,278.56
|
$39,278.56
|
$39,278.56
|
2025-09-11
|
|
B2004
|
HCPCS
|
Miscellaneous M <46.50 And A >=77.50
|
14
|
10
|
—
|
—
|
$39,089.74
|
$58,634.61
|
$39,089.74
|
2025-09-11
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
4
|
4
|
—
|
—
|
$39,046.60
|
$39,046.60
|
$39,046.60
|
2025-09-11
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
4
|
4
|
—
|
—
|
$38,814.64
|
$38,814.64
|
$38,814.64
|
2025-09-11
|
|
D0405
|
HCPCS
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
14
|
10
|
—
|
—
|
$38,809.64
|
$58,214.46
|
$38,809.64
|
2025-09-11
|
|
B1203
|
HCPCS
|
Osteoarthritis M <49.50 And A >=74.50
|
14
|
10
|
—
|
—
|
$38,627.85
|
$57,941.78
|
$38,627.85
|
2025-09-11
|
|
B0805
|
HCPCS
|
Replacement Of Lower-extremity Joint M <42.50
|
14
|
10
|
—
|
—
|
$38,236.45
|
$57,354.68
|
$38,236.45
|
2025-09-11
|
|
B0204
|
HCPCS
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
14
|
10
|
—
|
—
|
$38,208.63
|
$57,312.95
|
$38,208.63
|
2025-09-11
|
|
B1305
|
HCPCS
|
Rheumatoid Other Arthritis M <51.50 And A <64.50
|
14
|
10
|
—
|
—
|
$38,043.54
|
$57,065.31
|
$38,043.54
|
2025-09-11
|
|
B0104
|
HCPCS
|
Stroke M >=41.50 And M <50.50
|
14
|
10
|
—
|
—
|
$37,906.27
|
$56,859.41
|
$37,906.27
|
2025-09-11
|
|
A0505
|
HCPCS
|
Non-traumatic Spinal Cord Injury M <39.50
|
14
|
10
|
—
|
—
|
$37,895.14
|
$56,842.71
|
$37,895.14
|
2025-09-11
|
|
C1705
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
14
|
10
|
—
|
—
|
$37,806.10
|
$56,709.15
|
$37,806.10
|
2025-09-11
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
4
|
4
|
—
|
—
|
$37,732.16
|
$37,732.16
|
$37,732.16
|
2025-09-11
|
|
D0105
|
HCPCS
|
Stroke M <41.50 And A >=84.50
|
14
|
10
|
—
|
—
|
$37,564.95
|
$56,347.43
|
$37,564.95
|
2025-09-11
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
4
|
4
|
—
|
—
|
$37,306.90
|
$37,306.90
|
$37,306.90
|
2025-09-11
|
|
B1103
|
HCPCS
|
Amputation Non-lower Extremity M <52.50
|
14
|
10
|
—
|
—
|
$37,203.24
|
$55,804.86
|
$37,203.24
|
2025-09-11
|
|
B1804
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50
|
14
|
10
|
—
|
—
|
$37,073.39
|
$55,610.09
|
$37,073.39
|
2025-09-11
|
|
B0603
|
HCPCS
|
Neurological M >=43.50 And M <52.50
|
14
|
10
|
—
|
—
|
$36,835.95
|
$55,253.93
|
$36,835.95
|
2025-09-11
|
|
B1703
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50
|
14
|
10
|
—
|
—
|
$36,617.07
|
$54,925.61
|
$36,617.07
|
2025-09-11
|
|
D0205
|
HCPCS
|
Traumatic Brain Injury M <35.50
|
14
|
10
|
—
|
—
|
$36,613.36
|
$54,920.04
|
$36,613.36
|
2025-09-11
|
|
B0403
|
HCPCS
|
Traumatic Spinal Cord Injury M >=41.50 And M <47.50
|
14
|
10
|
—
|
—
|
$36,207.12
|
$54,310.68
|
$36,207.12
|
2025-09-11
|
|
C1805
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
14
|
10
|
—
|
—
|
$35,856.53
|
$53,784.80
|
$35,856.53
|
2025-09-11
|
|
C1903
|
HCPCS
|
Guillain-barré M >=38.50 And M <51.50
|
14
|
10
|
—
|
—
|
$35,813.86
|
$53,720.79
|
$35,813.86
|
2025-09-11
|
|
A0105
|
HCPCS
|
Stroke M <41.50 And A >=84.50
|
14
|
10
|
—
|
—
|
$35,800.88
|
$53,701.32
|
$35,800.88
|
2025-09-11
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
4
|
4
|
—
|
—
|
$35,721.84
|
$35,721.84
|
$35,721.84
|
2025-09-11
|
|
C0305
|
HCPCS
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
14
|
10
|
—
|
—
|
$35,387.22
|
$53,080.83
|
$35,387.22
|
2025-09-11
|
|
B0703
|
HCPCS
|
Fracture Of Lower Extremity M >=41.50 And M <52.50
|
14
|
10
|
—
|
—
|
$35,338.99
|
$53,008.49
|
$35,338.99
|
2025-09-11
|
|
C1004
|
HCPCS
|
Amputation Lower Extremity M <47.50
|
14
|
10
|
—
|
—
|
$35,301.89
|
$52,952.84
|
$35,301.89
|
2025-09-11
|
|
A0405
|
HCPCS
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
14
|
10
|
—
|
—
|
$35,264.79
|
$52,897.19
|
$35,264.79
|
2025-09-11
|
|
B1603
|
HCPCS
|
Pain Syndrome M >=43.50 And M <58.50
|
14
|
10
|
—
|
—
|
$35,146.08
|
$52,719.12
|
$35,146.08
|
2025-09-11
|
|
994
|
MS_DRG
|
Birth Weight 1000 - 1499 Grams
|
4
|
4
|
—
|
—
|
$35,025.96
|
$35,025.96
|
$35,025.96
|
2025-09-11
|
|
D1705
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
14
|
10
|
—
|
—
|
$35,012.52
|
$52,518.78
|
$35,012.52
|
2025-09-11
|
|
B0303
|
HCPCS
|
Non-traumatic Brain Injury M >=42.50 And M <52.50
|
14
|
10
|
—
|
—
|
$34,591.44
|
$51,887.16
|
$34,591.44
|
2025-09-11
|
|
C0604
|
HCPCS
|
Neurological M <43.50
|
14
|
10
|
—
|
—
|
$34,585.88
|
$51,878.82
|
$34,585.88
|
2025-09-11
|
|
A0205
|
HCPCS
|
Traumatic Brain Injury M <35.50
|
14
|
10
|
—
|
—
|
$34,470.87
|
$51,706.31
|
$34,470.87
|
2025-09-11
|
|
C1504
|
HCPCS
|
Pulmonary M <45.50
|
14
|
10
|
—
|
—
|
$34,242.71
|
$51,364.07
|
$34,242.71
|
2025-09-11
|
|
B1503
|
HCPCS
|
Pulmonary M >=45.50 And M <56.50
|
14
|
10
|
—
|
—
|
$34,068.34
|
$51,102.51
|
$34,068.34
|
2025-09-11
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
4
|
4
|
—
|
—
|
$34,059.46
|
$34,059.46
|
$34,059.46
|
2025-09-11
|
|
D1805
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
14
|
10
|
—
|
—
|
$34,040.52
|
$51,060.78
|
$34,040.52
|
2025-09-11
|
|
B1803
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50
|
14
|
10
|
—
|
—
|
$33,901.39
|
$50,852.09
|
$33,901.39
|
2025-09-11
|
|
B0503
|
HCPCS
|
Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50
|
14
|
10
|
—
|
—
|
$33,873.57
|
$50,810.36
|
$33,873.57
|
2025-09-11
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
4
|
4
|
—
|
—
|
$33,479.56
|
$33,479.56
|
$33,479.56
|
2025-09-11
|
|
D1903
|
HCPCS
|
Guillain-barré M >=38.50 And M <51.50
|
14
|
10
|
—
|
—
|
$33,419.10
|
$50,128.65
|
$33,419.10
|
2025-09-11
|
|
C0704
|
HCPCS
|
Fracture Of Lower Extremity M <41.50
|
14
|
10
|
—
|
—
|
$33,394.99
|
$50,092.49
|
$33,394.99
|
2025-09-11
|
|
B1003
|
HCPCS
|
Amputation Lower Extremity M >=47.50 And M <55.50
|
14
|
10
|
—
|
—
|
$33,341.19
|
$50,011.79
|
$33,341.19
|
2025-09-11
|
|
A5102
|
HCPCS
|
Expired, Orthopedic, Length Of Stay Is 14 Days Or More
|
14
|
10
|
—
|
—
|
$33,252.15
|
$49,878.23
|
$33,252.15
|
2025-09-11
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
4
|
4
|
—
|
—
|
$33,170.28
|
$33,170.28
|
$33,170.28
|
2025-09-11
|
|
B0903
|
HCPCS
|
Other Orthopedic M >=44.50 And M <51.50
|
14
|
10
|
—
|
—
|
$33,153.84
|
$49,730.76
|
$33,153.84
|
2025-09-11
|
|
C2005
|
HCPCS
|
Miscellaneous M <46.50 And A <77.50
|
14
|
10
|
—
|
—
|
$32,910.84
|
$49,366.26
|
$32,910.84
|
2025-09-11
|
|
C0104
|
HCPCS
|
Stroke M >=41.50 And M <50.50
|
14
|
10
|
—
|
—
|
$32,873.74
|
$49,310.61
|
$32,873.74
|
2025-09-11
|
|
C1304
|
HCPCS
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
14
|
10
|
—
|
—
|
$32,845.92
|
$49,268.88
|
$32,845.92
|
2025-09-11
|
|
A1903
|
HCPCS
|
Guillain-barré M >=38.50 And M <51.50
|
14
|
10
|
—
|
—
|
$32,840.35
|
$49,260.53
|
$32,840.35
|
2025-09-11
|
|
B2003
|
HCPCS
|
Miscellaneous M >=46.50 And M <55.50
|
14
|
10
|
—
|
—
|
$32,693.81
|
$49,040.72
|
$32,693.81
|
2025-09-11
|
|
C2102
|
HCPCS
|
Burns M <52.50
|
14
|
10
|
—
|
—
|
$32,667.84
|
$49,001.76
|
$32,667.84
|
2025-09-11
|
|
D2102
|
HCPCS
|
Burns M <52.50
|
14
|
10
|
—
|
—
|
$32,667.84
|
$49,001.76
|
$32,667.84
|
2025-09-11
|
|
D0305
|
HCPCS
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
14
|
10
|
—
|
—
|
$32,506.46
|
$48,759.69
|
$32,506.46
|
2025-09-11
|
|
B1403
|
HCPCS
|
Cardiac M >=45.50 And M <55.50
|
14
|
10
|
—
|
—
|
$32,484.20
|
$48,726.30
|
$32,484.20
|
2025-09-11
|
|
C1604
|
HCPCS
|
Pain Syndrome M <43.50
|
14
|
10
|
—
|
—
|
$32,343.22
|
$48,514.83
|
$32,343.22
|
2025-09-11
|
|
D0604
|
HCPCS
|
Neurological M <43.50
|
14
|
10
|
—
|
—
|
$32,287.57
|
$48,431.36
|
$32,287.57
|
2025-09-11
|
|
D1004
|
HCPCS
|
Amputation Lower Extremity M <47.50
|
14
|
10
|
—
|
—
|
$32,246.76
|
$48,370.14
|
$32,246.76
|
2025-09-11
|
|
C1704
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
14
|
10
|
—
|
—
|
$32,215.23
|
$48,322.85
|
$32,215.23
|
2025-09-11
|
|
D1504
|
HCPCS
|
Pulmonary M <45.50
|
14
|
10
|
—
|
—
|
$32,204.10
|
$48,306.15
|
$32,204.10
|
2025-09-11
|
|
C0403
|
HCPCS
|
Traumatic Spinal Cord Injury M >=41.50 And M <47.50
|
14
|
10
|
—
|
—
|
$32,198.53
|
$48,297.80
|
$32,198.53
|
2025-09-11
|
|
C0304
|
HCPCS
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
14
|
10
|
—
|
—
|
$32,087.23
|
$48,130.85
|
$32,087.23
|
2025-09-11
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
4
|
4
|
—
|
—
|
$31,894.50
|
$31,894.50
|
$31,894.50
|
2025-09-11
|
|
B0804
|
HCPCS
|
Replacement Of Lower-extremity Joint M >=42.50 And M <51.50
|
14
|
10
|
—
|
—
|
$31,881.33
|
$47,822.00
|
$31,881.33
|
2025-09-11
|
|
C0904
|
HCPCS
|
Other Orthopedic M <44.5
|
14
|
10
|
—
|
—
|
$31,818.26
|
$47,727.39
|
$31,818.26
|
2025-09-11
|
|
A1705
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
14
|
10
|
—
|
—
|
$31,764.47
|
$47,646.71
|
$31,764.47
|
2025-09-11
|
|
D0704
|
HCPCS
|
Fracture Of Lower Extremity M <41.50
|
14
|
10
|
—
|
—
|
$31,634.62
|
$47,451.93
|
$31,634.62
|
2025-09-11
|
|
A1805
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
14
|
10
|
—
|
—
|
$31,562.28
|
$47,343.42
|
$31,562.28
|
2025-09-11
|
|
C0204
|
HCPCS
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
14
|
10
|
—
|
—
|
$31,471.38
|
$47,207.07
|
$31,471.38
|
2025-09-11
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
4
|
4
|
—
|
—
|
$31,469.24
|
$31,469.24
|
$31,469.24
|
2025-09-11
|
|
B1303
|
HCPCS
|
Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50
|
14
|
10
|
—
|
—
|
$31,456.54
|
$47,184.81
|
$31,456.54
|
2025-09-11
|
|
C1305
|
HCPCS
|
Rheumatoid Other Arthritis M <51.50 And A <64.50
|
14
|
10
|
—
|
—
|
$31,454.69
|
$47,182.04
|
$31,454.69
|
2025-09-11
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
4
|
4
|
—
|
—
|
$31,391.92
|
$31,391.92
|
$31,391.92
|
2025-09-11
|
|
C1404
|
HCPCS
|
Cardiac M <45.50
|
14
|
10
|
—
|
—
|
$31,356.38
|
$47,034.57
|
$31,356.38
|
2025-09-11
|
|
D1304
|
HCPCS
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
14
|
10
|
—
|
—
|
$31,352.67
|
$47,029.01
|
$31,352.67
|
2025-09-11
|
|
C0504
|
HCPCS
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
14
|
10
|
—
|
—
|
$31,324.84
|
$46,987.26
|
$31,324.84
|
2025-09-11
|
|
B0602
|
HCPCS
|
Neurological M >=52.50 And M <64.50
|
14
|
10
|
—
|
—
|
$31,261.77
|
$46,892.66
|
$31,261.77
|
2025-09-11
|
|
D0403
|
HCPCS
|
Traumatic Spinal Cord Injury M >=41.50 And M <47.50
|
14
|
10
|
—
|
—
|
$31,256.21
|
$46,884.32
|
$31,256.21
|
2025-09-11
|
|
C2004
|
HCPCS
|
Miscellaneous M <46.50 And A >=77.50
|
14
|
10
|
—
|
—
|
$31,222.82
|
$46,834.23
|
$31,222.82
|
2025-09-11
|
|
B1902
|
HCPCS
|
Guillain-barré M >=51.50 And M <66.50
|
14
|
10
|
—
|
—
|
$30,875.94
|
$46,313.91
|
$30,875.94
|
2025-09-11
|
|
B1702
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50
|
14
|
10
|
—
|
—
|
$30,814.73
|
$46,222.10
|
$30,814.73
|
2025-09-11
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
4
|
4
|
—
|
—
|
$30,812.02
|
$30,812.02
|
$30,812.02
|
2025-09-11
|
|
B0203
|
HCPCS
|
Traumatic Brain Injury M >=49.50 And M <61.50
|
14
|
10
|
—
|
—
|
$30,807.31
|
$46,210.97
|
$30,807.31
|
2025-09-11
|
|
C1204
|
HCPCS
|
Osteoarthritis M <49.50 And A <74.50
|
14
|
10
|
—
|
—
|
$30,796.18
|
$46,194.27
|
$30,796.18
|
2025-09-11
|
|
D2005
|
HCPCS
|
Miscellaneous M <46.50 And A <77.50
|
14
|
10
|
—
|
—
|
$30,744.24
|
$46,116.36
|
$30,744.24
|
2025-09-11
|
|
C0805
|
HCPCS
|
Replacement Of Lower-extremity Joint M <42.50
|
14
|
10
|
—
|
—
|
$30,681.17
|
$46,021.76
|
$30,681.17
|
2025-09-11
|
|
A0305
|
HCPCS
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
14
|
10
|
—
|
—
|
$30,638.50
|
$45,957.75
|
$30,638.50
|
2025-09-11
|
|
459
|
MS_DRG
|
Spinal Fusion Except Cervical With Mcc
|
4
|
4
|
—
|
—
|
$30,541.40
|
$30,541.40
|
$30,541.40
|
2025-09-11
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
4
|
4
|
—
|
—
|
$30,386.76
|
$30,386.76
|
$30,386.76
|
2025-09-11
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
4
|
4
|
—
|
—
|
$30,154.80
|
$30,154.80
|
$30,154.80
|
2025-09-11
|
|
A1504
|
HCPCS
|
Pulmonary M <45.50
|
14
|
10
|
—
|
—
|
$30,124.68
|
$45,187.02
|
$30,124.68
|
2025-09-11
|
|
D0104
|
HCPCS
|
Stroke M >=41.50 And M <50.50
|
14
|
10
|
—
|
—
|
$30,041.20
|
$45,061.80
|
$30,041.20
|
2025-09-11
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc
|
4
|
4
|
—
|
—
|
$30,038.82
|
$30,038.82
|
$30,038.82
|
2025-09-11
|
|
D1305
|
HCPCS
|
Rheumatoid Other Arthritis M <51.50 And A <64.50
|
14
|
10
|
—
|
—
|
$30,024.51
|
$45,036.77
|
$30,024.51
|
2025-09-11
|
|
B1502
|
HCPCS
|
Pulmonary M >=56.50 And M <68.50
|
14
|
10
|
—
|
—
|
$29,976.28
|
$44,964.42
|
$29,976.28
|
2025-09-11
|
|
C1103
|
HCPCS
|
Amputation Non-lower Extremity M <52.50
|
14
|
10
|
—
|
—
|
$29,905.79
|
$44,858.69
|
$29,905.79
|
2025-09-11
|
|
D1103
|
HCPCS
|
Amputation Non-lower Extremity M <52.50
|
14
|
10
|
—
|
—
|
$29,905.79
|
$44,858.69
|
$29,905.79
|
2025-09-11
|
|
D1704
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
14
|
10
|
—
|
—
|
$29,835.30
|
$44,752.95
|
$29,835.30
|
2025-09-11
|
|
B1102
|
HCPCS
|
Amputation Non-lower Extremity M >=52.50 And M <58.50
|
14
|
10
|
—
|
—
|
$29,833.45
|
$44,750.18
|
$29,833.45
|
2025-09-11
|
|
B1202
|
HCPCS
|
Osteoarthritis M >=49.50 And M <61.50
|
14
|
10
|
—
|
—
|
$29,816.75
|
$44,725.13
|
$29,816.75
|
2025-09-11
|
|
B0103
|
HCPCS
|
Stroke M >=50.50 And M <63.50
|
14
|
10
|
—
|
—
|
$29,701.75
|
$44,552.63
|
$29,701.75
|
2025-09-11
|
|
D0904
|
HCPCS
|
Other Orthopedic M <44.5
|
14
|
10
|
—
|
—
|
$29,657.23
|
$44,485.85
|
$29,657.23
|
2025-09-11
|
|
D0504
|
HCPCS
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
14
|
10
|
—
|
—
|
$29,594.16
|
$44,391.24
|
$29,594.16
|
2025-09-11
|
|
C1804
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50
|
14
|
10
|
—
|
—
|
$29,575.61
|
$44,363.42
|
$29,575.61
|
2025-09-11
|
|
B0502
|
HCPCS
|
Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50
|
14
|
10
|
—
|
—
|
$29,551.49
|
$44,327.24
|
$29,551.49
|
2025-09-11
|
|
D0304
|
HCPCS
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
14
|
10
|
—
|
—
|
$29,475.44
|
$44,213.16
|
$29,475.44
|
2025-09-11
|
|
C1203
|
HCPCS
|
Osteoarthritis M <49.50 And A >=74.50
|
14
|
10
|
—
|
—
|
$29,366.00
|
$44,049.00
|
$29,366.00
|
2025-09-11
|
|
A1103
|
HCPCS
|
Amputation Non-lower Extremity M <52.50
|
14
|
10
|
—
|
—
|
$29,301.07
|
$43,951.61
|
$29,301.07
|
2025-09-11
|
|
D1604
|
HCPCS
|
Pain Syndrome M <43.50
|
14
|
10
|
—
|
—
|
$29,234.29
|
$43,851.44
|
$29,234.29
|
2025-09-11
|
|
A0704
|
HCPCS
|
Fracture Of Lower Extremity M <41.50
|
14
|
10
|
—
|
—
|
$29,226.87
|
$43,840.31
|
$29,226.87
|
2025-09-11
|
|
D2004
|
HCPCS
|
Miscellaneous M <46.50 And A >=77.50
|
14
|
10
|
—
|
—
|
$29,167.51
|
$43,751.27
|
$29,167.51
|
2025-09-11
|
|
A1304
|
HCPCS
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
14
|
10
|
—
|
—
|
$29,167.51
|
$43,751.27
|
$29,167.51
|
2025-09-11
|
|
D1404
|
HCPCS
|
Cardiac M <45.50
|
14
|
10
|
—
|
—
|
$29,154.53
|
$43,731.80
|
$29,154.53
|
2025-09-11
|
|
A0604
|
HCPCS
|
Neurological M <43.50
|
14
|
10
|
—
|
—
|
$29,119.29
|
$43,678.94
|
$29,119.29
|
2025-09-11
|
|
A1004
|
HCPCS
|
Amputation Lower Extremity M <47.50
|
14
|
10
|
—
|
—
|
$28,891.12
|
$43,336.68
|
$28,891.12
|
2025-09-11
|
|
D1204
|
HCPCS
|
Osteoarthritis M <49.50 And A <74.50
|
14
|
10
|
—
|
—
|
$28,874.43
|
$43,311.65
|
$28,874.43
|
2025-09-11
|
|
B0402
|
HCPCS
|
Traumatic Spinal Cord Injury M >=47.50 And M <56.50
|
14
|
10
|
—
|
—
|
$28,852.17
|
$43,278.26
|
$28,852.17
|
2025-09-11
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
4
|
4
|
—
|
—
|
$28,801.70
|
$28,801.70
|
$28,801.70
|
2025-09-11
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
4
|
4
|
—
|
—
|
$28,801.70
|
$28,801.70
|
$28,801.70
|
2025-09-11
|
|
B0302
|
HCPCS
|
Non-traumatic Brain Injury M >=52.50 And M <65.50
|
14
|
10
|
—
|
—
|
$28,748.29
|
$43,122.44
|
$28,748.29
|
2025-09-11
|
|
B0702
|
HCPCS
|
Fracture Of Lower Extremity M >=52.50 And M <61.50
|
14
|
10
|
—
|
—
|
$28,737.16
|
$43,105.74
|
$28,737.16
|
2025-09-11
|
|
A0104
|
HCPCS
|
Stroke M >=41.50 And M <50.50
|
14
|
10
|
—
|
—
|
$28,629.57
|
$42,944.36
|
$28,629.57
|
2025-09-11
|
|
D0204
|
HCPCS
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
14
|
10
|
—
|
—
|
$28,583.20
|
$42,874.80
|
$28,583.20
|
2025-09-11
|
|
C1703
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50
|
14
|
10
|
—
|
—
|
$28,462.63
|
$42,693.95
|
$28,462.63
|
2025-09-11
|
|
B0803
|
HCPCS
|
Replacement Of Lower-extremity Joint M >=51.50 And M <57.50
|
14
|
10
|
—
|
—
|
$28,457.06
|
$42,685.59
|
$28,457.06
|
2025-09-11
|
|
B1002
|
HCPCS
|
Amputation Lower Extremity M >=55.50 And M <64.50
|
14
|
10
|
—
|
—
|
$28,457.06
|
$42,685.59
|
$28,457.06
|
2025-09-11
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
4
|
4
|
—
|
—
|
$28,453.76
|
$28,453.76
|
$28,453.76
|
2025-09-11
|
|
A0403
|
HCPCS
|
Traumatic Spinal Cord Injury M >=41.50 And M <47.50
|
14
|
10
|
—
|
—
|
$28,401.41
|
$42,602.12
|
$28,401.41
|
2025-09-11
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
4
|
4
|
—
|
—
|
$28,376.44
|
$28,376.44
|
$28,376.44
|
2025-09-11
|
|
454
|
MS_DRG
|
Combined Anterior And Posterior Spinal Fusion With Cc
|
4
|
4
|
—
|
—
|
$28,144.48
|
$28,144.48
|
$28,144.48
|
2025-09-11
|
|
D1804
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50
|
14
|
10
|
—
|
—
|
$28,076.79
|
$42,115.19
|
$28,076.79
|
2025-09-11
|
|
A2005
|
HCPCS
|
Miscellaneous M <46.50 And A <77.50
|
14
|
10
|
—
|
—
|
$27,984.05
|
$41,976.08
|
$27,984.05
|
2025-09-11
|
|
D0805
|
HCPCS
|
Replacement Of Lower-extremity Joint M <42.50
|
14
|
10
|
—
|
—
|
$27,972.92
|
$41,959.38
|
$27,972.92
|
2025-09-11
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
4
|
4
|
—
|
—
|
$27,951.18
|
$27,951.18
|
$27,951.18
|
2025-09-11
|
|
A1305
|
HCPCS
|
Rheumatoid Other Arthritis M <51.50 And A <64.50
|
14
|
10
|
—
|
—
|
$27,932.11
|
$41,898.17
|
$27,932.11
|
2025-09-11
|
|
B2101
|
HCPCS
|
Burns M >=52.50
|
14
|
10
|
—
|
—
|
$27,915.41
|
$41,873.12
|
$27,915.41
|
2025-09-11
|
|
A2102
|
HCPCS
|
Burns M <52.50
|
14
|
10
|
—
|
—
|
$27,898.72
|
$41,848.08
|
$27,898.72
|
2025-09-11
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
4
|
4
|
—
|
—
|
$27,835.20
|
$27,835.20
|
$27,835.20
|
2025-09-11
|
|
B1602
|
HCPCS
|
Pain Syndrome M >=58.50 And M <65.50
|
14
|
10
|
—
|
—
|
$27,830.08
|
$41,745.12
|
$27,830.08
|
2025-09-11
|
|
A0304
|
HCPCS
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
14
|
10
|
—
|
—
|
$27,781.85
|
$41,672.78
|
$27,781.85
|
2025-09-11
|
|
B0902
|
HCPCS
|
Other Orthopedic M >=51.50 And M <63.50
|
14
|
10
|
—
|
—
|
$27,763.30
|
$41,644.95
|
$27,763.30
|
2025-09-11
|
|
C0303
|
HCPCS
|
Non-traumatic Brain Injury M >=42.50 And M <52.50
|
14
|
10
|
—
|
—
|
$27,674.27
|
$41,511.41
|
$27,674.27
|
2025-09-11
|
|
C1503
|
HCPCS
|
Pulmonary M >=45.50 And M <56.50
|
14
|
10
|
—
|
—
|
$27,650.15
|
$41,475.23
|
$27,650.15
|
2025-09-11
|
|
B1302
|
HCPCS
|
Rheumatoid Other Arthritis M >=51.50 And M <62.50
|
14
|
10
|
—
|
—
|
$27,650.15
|
$41,475.23
|
$27,650.15
|
2025-09-11
|
|
C0603
|
HCPCS
|
Neurological M >=43.50 And M <52.50
|
14
|
10
|
—
|
—
|
$27,577.81
|
$41,366.72
|
$27,577.81
|
2025-09-11
|
|
C1003
|
HCPCS
|
Amputation Lower Extremity M >=47.50 And M <55.50
|
14
|
10
|
—
|
—
|
$27,574.10
|
$41,361.15
|
$27,574.10
|
2025-09-11
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
4
|
4
|
—
|
—
|
$27,564.58
|
$27,564.58
|
$27,564.58
|
2025-09-11
|
|
D1203
|
HCPCS
|
Osteoarthritis M <49.50 And A >=74.50
|
14
|
10
|
—
|
—
|
$27,535.14
|
$41,302.71
|
$27,535.14
|
2025-09-11
|
|
C0703
|
HCPCS
|
Fracture Of Lower Extremity M >=41.50 And M <52.50
|
14
|
10
|
—
|
—
|
$27,336.66
|
$41,004.99
|
$27,336.66
|
2025-09-11
|
|
B2002
|
HCPCS
|
Miscellaneous M >=55.50 And M <66.50
|
14
|
10
|
—
|
—
|
$27,301.42
|
$40,952.13
|
$27,301.42
|
2025-09-11
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
4
|
4
|
—
|
—
|
$27,293.96
|
$27,293.96
|
$27,293.96
|
2025-09-11
|
|
A0504
|
HCPCS
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
14
|
10
|
—
|
—
|
$27,271.74
|
$40,907.61
|
$27,271.74
|
2025-09-11
|
|
A0904
|
HCPCS
|
Other Orthopedic M <44.5
|
14
|
10
|
—
|
—
|
$27,134.47
|
$40,701.71
|
$27,134.47
|
2025-09-11
|
|
A1704
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
14
|
10
|
—
|
—
|
$27,067.69
|
$40,601.54
|
$27,067.69
|
2025-09-11
|
|
A1604
|
HCPCS
|
Pain Syndrome M <43.50
|
14
|
10
|
—
|
—
|
$27,062.13
|
$40,593.20
|
$27,062.13
|
2025-09-11
|
|
C1803
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50
|
14
|
10
|
—
|
—
|
$27,045.43
|
$40,568.15
|
$27,045.43
|
2025-09-11
|
|
A0204
|
HCPCS
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
14
|
10
|
—
|
—
|
$26,911.87
|
$40,367.81
|
$26,911.87
|
2025-09-11
|
|
A1404
|
HCPCS
|
Cardiac M <45.50
|
14
|
10
|
—
|
—
|
$26,826.55
|
$40,239.83
|
$26,826.55
|
2025-09-11
|
|
C0903
|
HCPCS
|
Other Orthopedic M >=44.50 And M <51.50
|
14
|
10
|
—
|
—
|
$26,553.86
|
$39,830.79
|
$26,553.86
|
2025-09-11
|
|
B1402
|
HCPCS
|
Cardiac M >=55.50 And M <68.50
|
14
|
10
|
—
|
—
|
$26,548.30
|
$39,822.45
|
$26,548.30
|
2025-09-11
|
|
A2004
|
HCPCS
|
Miscellaneous M <46.50 And A >=77.50
|
14
|
10
|
—
|
—
|
$26,548.30
|
$39,822.45
|
$26,548.30
|
2025-09-11
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
4
|
4
|
—
|
—
|
$26,520.76
|
$26,520.76
|
$26,520.76
|
2025-09-11
|
|
A1204
|
HCPCS
|
Osteoarthritis M <49.50 And A <74.50
|
14
|
10
|
—
|
—
|
$26,398.05
|
$39,597.08
|
$26,398.05
|
2025-09-11
|
|
B1802
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=55.50 And M <67.50
|
14
|
10
|
—
|
—
|
$26,386.92
|
$39,580.38
|
$26,386.92
|
2025-09-11
|
|
D1703
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50
|
14
|
10
|
—
|
—
|
$26,360.95
|
$39,541.43
|
$26,360.95
|
2025-09-11
|
|
C0503
|
HCPCS
|
Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50
|
14
|
10
|
—
|
—
|
$26,351.67
|
$39,527.51
|
$26,351.67
|
2025-09-11
|
|
C2003
|
HCPCS
|
Miscellaneous M >=46.50 And M <55.50
|
14
|
10
|
—
|
—
|
$26,114.24
|
$39,171.36
|
$26,114.24
|
2025-09-11
|
|
C1603
|
HCPCS
|
Pain Syndrome M >=43.50 And M <58.50
|
14
|
10
|
—
|
—
|
$26,104.96
|
$39,157.44
|
$26,104.96
|
2025-09-11
|
|
A0805
|
HCPCS
|
Replacement Of Lower-extremity Joint M <42.50
|
14
|
10
|
—
|
—
|
$26,090.12
|
$39,135.18
|
$26,090.12
|
2025-09-11
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
4
|
4
|
—
|
—
|
$26,056.84
|
$26,056.84
|
$26,056.84
|
2025-09-11
|
|
A1804
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50
|
14
|
10
|
—
|
—
|
$26,032.62
|
$39,048.93
|
$26,032.62
|
2025-09-11
|
|
C1303
|
HCPCS
|
Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50
|
14
|
10
|
—
|
—
|
$26,010.36
|
$39,015.54
|
$26,010.36
|
2025-09-11
|
|
D1503
|
HCPCS
|
Pulmonary M >=45.50 And M <56.50
|
14
|
10
|
—
|
—
|
$26,004.79
|
$39,007.19
|
$26,004.79
|
2025-09-11
|
|
D0703
|
HCPCS
|
Fracture Of Lower Extremity M >=41.50 And M <52.50
|
14
|
10
|
—
|
—
|
$25,895.35
|
$38,843.03
|
$25,895.35
|
2025-09-11
|
|
C0103
|
HCPCS
|
Stroke M >=50.50 And M <63.50
|
14
|
10
|
—
|
—
|
$25,759.94
|
$38,639.91
|
$25,759.94
|
2025-09-11
|
|
D0603
|
HCPCS
|
Neurological M >=43.50 And M <52.50
|
14
|
10
|
—
|
—
|
$25,745.10
|
$38,617.65
|
$25,745.10
|
2025-09-11
|
|
D1803
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50
|
14
|
10
|
—
|
—
|
$25,676.47
|
$38,514.71
|
$25,676.47
|
2025-09-11
|
|
C0402
|
HCPCS
|
Traumatic Spinal Cord Injury M >=47.50 And M <56.50
|
14
|
10
|
—
|
—
|
$25,657.92
|
$38,486.88
|
$25,657.92
|
2025-09-11
|
|
C1403
|
HCPCS
|
Cardiac M >=45.50 And M <55.50
|
14
|
10
|
—
|
—
|
$25,591.14
|
$38,386.71
|
$25,591.14
|
2025-09-11
|
|
C0804
|
HCPCS
|
Replacement Of Lower-extremity Joint M >=42.50 And M <51.50
|
14
|
10
|
—
|
—
|
$25,581.86
|
$38,372.79
|
$25,581.86
|
2025-09-11
|
|
B0802
|
HCPCS
|
Replacement Of Lower-extremity Joint M >=57.50 And M <63.50
|
14
|
10
|
—
|
—
|
$25,567.02
|
$38,350.53
|
$25,567.02
|
2025-09-11
|
|
D0303
|
HCPCS
|
Non-traumatic Brain Injury M >=42.50 And M <52.50
|
14
|
10
|
—
|
—
|
$25,422.33
|
$38,133.50
|
$25,422.33
|
2025-09-11
|
|
C0203
|
HCPCS
|
Traumatic Brain Injury M >=49.50 And M <61.50
|
14
|
10
|
—
|
—
|
$25,374.11
|
$38,061.17
|
$25,374.11
|
2025-09-11
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
4
|
4
|
—
|
—
|
$25,360.96
|
$25,360.96
|
$25,360.96
|
2025-09-11
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
4
|
4
|
—
|
—
|
$25,360.96
|
$25,360.96
|
$25,360.96
|
2025-09-11
|
|
D1003
|
HCPCS
|
Amputation Lower Extremity M >=47.50 And M <55.50
|
14
|
10
|
—
|
—
|
$25,188.61
|
$37,782.92
|
$25,188.61
|
2025-09-11
|
|
A1203
|
HCPCS
|
Osteoarthritis M <49.50 And A >=74.50
|
14
|
10
|
—
|
—
|
$25,171.91
|
$37,757.87
|
$25,171.91
|
2025-09-11
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
4
|
4
|
—
|
—
|
$25,167.66
|
$25,167.66
|
$25,167.66
|
2025-09-11
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
4
|
4
|
—
|
—
|
$25,167.66
|
$25,167.66
|
$25,167.66
|
2025-09-11
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
4
|
4
|
—
|
—
|
$24,935.70
|
$24,935.70
|
$24,935.70
|
2025-09-11
|
|
D0402
|
HCPCS
|
Traumatic Spinal Cord Injury M >=47.50 And M <56.50
|
14
|
10
|
—
|
—
|
$24,906.65
|
$37,359.98
|
$24,906.65
|
2025-09-11
|
|
D0503
|
HCPCS
|
Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50
|
14
|
10
|
—
|
—
|
$24,895.52
|
$37,343.28
|
$24,895.52
|
2025-09-11
|
|
D1303
|
HCPCS
|
Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50
|
14
|
10
|
—
|
—
|
$24,826.89
|
$37,240.34
|
$24,826.89
|
2025-09-11
|
|
B1701
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=57.50
|
14
|
10
|
—
|
—
|
$24,802.78
|
$37,204.17
|
$24,802.78
|
2025-09-11
|
|
D0903
|
HCPCS
|
Other Orthopedic M >=44.50 And M <51.50
|
14
|
10
|
—
|
—
|
$24,750.84
|
$37,126.26
|
$24,750.84
|
2025-09-11
|
|
B0202
|
HCPCS
|
Traumatic Brain Injury M >=61.50 And M <73.50
|
14
|
10
|
—
|
—
|
$24,737.85
|
$37,106.78
|
$24,737.85
|
2025-09-11
|
|
B0601
|
HCPCS
|
Neurological M >=64.50
|
14
|
10
|
—
|
—
|
$24,646.96
|
$36,970.44
|
$24,646.96
|
2025-09-11
|
|
B1201
|
HCPCS
|
Osteoarthritis M >=61.50
|
14
|
10
|
—
|
—
|
$24,628.41
|
$36,942.62
|
$24,628.41
|
2025-09-11
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
4
|
4
|
—
|
—
|
$24,471.78
|
$24,471.78
|
$24,471.78
|
2025-09-11
|
|
D2003
|
HCPCS
|
Miscellaneous M >=46.50 And M <55.50
|
14
|
10
|
—
|
—
|
$24,394.68
|
$36,592.02
|
$24,394.68
|
2025-09-11
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
4
|
4
|
—
|
—
|
$24,394.46
|
$24,394.46
|
$24,394.46
|
2025-09-11
|
|
C1502
|
HCPCS
|
Pulmonary M >=56.50 And M <68.50
|
14
|
10
|
—
|
—
|
$24,329.76
|
$36,494.64
|
$24,329.76
|
2025-09-11
|
|
A1503
|
HCPCS
|
Pulmonary M >=45.50 And M <56.50
|
14
|
10
|
—
|
—
|
$24,326.05
|
$36,489.08
|
$24,326.05
|
2025-09-11
|
|
B1601
|
HCPCS
|
Pain Syndrome M >=65.50
|
14
|
10
|
—
|
—
|
$24,285.24
|
$36,427.86
|
$24,285.24
|
2025-09-11
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
4
|
4
|
—
|
—
|
$24,278.48
|
$24,278.48
|
$24,278.48
|
2025-09-11
|
|
C1102
|
HCPCS
|
Amputation Non-lower Extremity M >=52.50 And M <58.50
|
14
|
10
|
—
|
—
|
$23,981.02
|
$35,971.53
|
$23,981.02
|
2025-09-11
|
|
D1102
|
HCPCS
|
Amputation Non-lower Extremity M >=52.50 And M <58.50
|
14
|
10
|
—
|
—
|
$23,981.02
|
$35,971.53
|
$23,981.02
|
2025-09-11
|
|
A0303
|
HCPCS
|
Non-traumatic Brain Injury M >=42.50 And M <52.50
|
14
|
10
|
—
|
—
|
$23,960.62
|
$35,940.93
|
$23,960.62
|
2025-09-11
|
|
C1702
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50
|
14
|
10
|
—
|
—
|
$23,953.20
|
$35,929.80
|
$23,953.20
|
2025-09-11
|
|
A0703
|
HCPCS
|
Fracture Of Lower Extremity M >=41.50 And M <52.50
|
14
|
10
|
—
|
—
|
$23,925.38
|
$35,888.07
|
$23,925.38
|
2025-09-11
|
|
A1703
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50
|
14
|
10
|
—
|
—
|
$23,916.10
|
$35,874.15
|
$23,916.10
|
2025-09-11
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
4
|
4
|
—
|
—
|
$23,853.22
|
$23,853.22
|
$23,853.22
|
2025-09-11
|
|
A1803
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50
|
14
|
10
|
—
|
—
|
$23,806.66
|
$35,709.99
|
$23,806.66
|
2025-09-11
|
|
D1403
|
HCPCS
|
Cardiac M >=45.50 And M <55.50
|
14
|
10
|
—
|
—
|
$23,793.67
|
$35,690.51
|
$23,793.67
|
2025-09-11
|
|
C1902
|
HCPCS
|
Guillain-barré M >=51.50 And M <66.50
|
14
|
10
|
—
|
—
|
$23,738.02
|
$35,607.03
|
$23,738.02
|
2025-09-11
|
|
B1501
|
HCPCS
|
Pulmonary M >=68.50
|
14
|
10
|
—
|
—
|
$23,630.44
|
$35,445.66
|
$23,630.44
|
2025-09-11
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
4
|
4
|
—
|
—
|
$23,621.26
|
$23,621.26
|
$23,621.26
|
2025-09-11
|
|
D1603
|
HCPCS
|
Pain Syndrome M >=43.50 And M <58.50
|
14
|
10
|
—
|
—
|
$23,595.19
|
$35,392.79
|
$23,595.19
|
2025-09-11
|
|
B0501
|
HCPCS
|
Non-traumatic Spinal Cord Injury M >=60.50
|
14
|
10
|
—
|
—
|
$23,556.24
|
$35,334.36
|
$23,556.24
|
2025-09-11
|
|
D0103
|
HCPCS
|
Stroke M >=50.50 And M <63.50
|
14
|
10
|
—
|
—
|
$23,539.54
|
$35,309.31
|
$23,539.54
|
2025-09-11
|
|
C1002
|
HCPCS
|
Amputation Lower Extremity M >=55.50 And M <64.50
|
14
|
10
|
—
|
—
|
$23,533.98
|
$35,300.97
|
$23,533.98
|
2025-09-11
|
|
A1102
|
HCPCS
|
Amputation Non-lower Extremity M >=52.50 And M <58.50
|
14
|
10
|
—
|
—
|
$23,496.88
|
$35,245.32
|
$23,496.88
|
2025-09-11
|
|
B1101
|
HCPCS
|
Amputation Non-lower Extremity M >=58.50
|
14
|
10
|
—
|
—
|
$23,465.34
|
$35,198.01
|
$23,465.34
|
2025-09-11
|
|
C0602
|
HCPCS
|
Neurological M >=52.50 And M <64.50
|
14
|
10
|
—
|
—
|
$23,405.98
|
$35,108.97
|
$23,405.98
|
2025-09-11
|
|
D0804
|
HCPCS
|
Replacement Of Lower-extremity Joint M >=42.50 And M <51.50
|
14
|
10
|
—
|
—
|
$23,324.37
|
$34,986.56
|
$23,324.37
|
2025-09-11
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
4
|
4
|
—
|
—
|
$23,273.32
|
$23,273.32
|
$23,273.32
|
2025-09-11
|
|
B0701
|
HCPCS
|
Fracture Of Lower Extremity M >=61.50
|
14
|
10
|
—
|
—
|
$23,265.01
|
$34,897.52
|
$23,265.01
|
2025-09-11
|
|
A0603
|
HCPCS
|
Neurological M >=43.50 And M <52.50
|
14
|
10
|
—
|
—
|
$23,218.63
|
$34,827.95
|
$23,218.63
|
2025-09-11
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
4
|
4
|
—
|
—
|
$23,157.34
|
$23,157.34
|
$23,157.34
|
2025-09-11
|
|
A1303
|
HCPCS
|
Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50
|
14
|
10
|
—
|
—
|
$23,096.20
|
$34,644.30
|
$23,096.20
|
2025-09-11
|
|
D0203
|
HCPCS
|
Traumatic Brain Injury M >=49.50 And M <61.50
|
14
|
10
|
—
|
—
|
$23,046.12
|
$34,569.18
|
$23,046.12
|
2025-09-11
|
|
B0102
|
HCPCS
|
Stroke M >=63.50 And M <72.50
|
14
|
10
|
—
|
—
|
$23,044.27
|
$34,566.41
|
$23,044.27
|
2025-09-11
|