Hospital

PINEVILLE COMMUNITY HEALTH CENTER, INC

Pineville, KY · CCN 180154 · Rates published

10,056 distinct procedures filed

18 distinct payers

122,249 rate rows

2026-01-24 last MRF observed

Data quality

121,054 of 122,249 rate rows are consumer-grade (99.0%)

1,195 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 — reason	Rows
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	976
per-diem day rate — not a per-procedure price	91
exceeds 3× this hospital's gross charge for a DRG stay — excluded	69
percent-of-charges filed in the dollar field — excluded from medians	22
exceeds 10× this hospital's gross charge — excluded from medians	21
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	10
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings	6

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbPCHCPINEVILLEKY&type=CDMWithoutLabel&fileType=CSV
Found on page	https://yourhometownhospital.org/
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-08-18
Content fingerprint	f02ba5450153ee46… · 39,473,690 bytes · first seen 2026-05-13

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
09000155 CDM	Philips Affiniti 70 - Ultrasound Machine	11	$20,299.13	$51,994.25	$35,612.50	nat. median $35,612 1.0× median
01103445 CDM	Operating Room Services - General Classification	11	$18,450.26	$47,258.56	$32,368.88	nat. median $32,369 1.0× median
01103451 CDM	Operating Room Services - General Classification	11	$17,477.63	$44,767.25	$30,662.50	nat. median $30,662 1.0× median
01103440 CDM	Operating Room Services - General Classification	11	$16,052.77	$41,117.62	$28,162.75	nat. median $28,163 1.0× median
01103450 CDM	Operating Room Services - General Classification	11	$15,675.00	$40,150.00	$27,500.00	nat. median $27,500 1.0× median
01103435 CDM	Operating Room Services - General Classification	11	$13,655.28	$34,976.67	$23,956.63	nat. median $23,957 1.0× median
570 MS_DRG	Skin Debridement With Mcc	11	$18,078.77	$29,291.35	$20,087.51	nat. median $29,069 0.7× median
480 MS_DRG	Hip And Femur Procedures Except Major Joint With Mcc	11	$17,901.73	$27,257.05	$19,890.81	nat. median $29,103 0.7× median
521 MS_DRG	Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc	11	$17,642.95	$81,786.93	$19,603.27	nat. median $28,835 0.7× median
01103430 CDM	Operating Room Services - General Classification	11	$11,049.31	$28,301.74	$19,384.75	nat. median $19,385 1.0× median
483 MS_DRG	Major Joint Or Limb Reattachment Procedures Of Upper Extremities	11	$17,038.70	$46,083.99	$18,931.88	nat. median $26,451 0.7× median
478 MS_DRG	Biopsies Of Musculoskeletal System And Connective Tissue With Cc	11	$15,116.55	$29,411.20	$16,796.16	nat. median $23,808 0.7× median
982 MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc	11	$15,112.25	$20,600.21	$16,791.38	nat. median $24,391 0.7× median
01103425 CDM	Operating Room Services - General Classification	11	$8,860.29	$22,694.79	$15,544.38	nat. median $15,544 1.0× median
475 MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc	11	$13,988.59	$50,038.63	$15,542.87	nat. median $22,178 0.7× median
C1813 HCPCS	Prosthesis, Penile, Inflatable	10	$10,580.63	$27,101.25	$15,507.11	nat. median $10,408 1.5× median
857 MS_DRG	Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc	11	$13,163.67	$32,382.48	$14,626.30	nat. median $21,203 0.7× median
522 MS_DRG	Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc	11	$13,017.37	$58,030.42	$14,463.74	nat. median $21,659 0.7× median
516 MS_DRG	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc	11	$12,773.96	$30,126.36	$14,193.28	nat. median $20,941 0.7× median
871 MS_DRG	Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc	11	$11,940.43	$15,143.07	$13,267.14	nat. median $19,136 0.7× median
01103410 CDM	Operating Room Services - General Classification	11	$7,537.32	$19,306.13	$13,223.38	nat. median $13,223 1.0× median
592 MS_DRG	Skin Ulcers With Mcc	11	$11,896.17	$18,894.49	$13,217.96	nat. median $19,351 0.7× median
30 MS_DRG	Spinal Procedures Without Cc/mcc	11	$8,602.96	$14,993.06	$13,094.31	nat. median $22,255 0.6× median
J2997 HCPCS	Injection, Alteplase Recombinant, 1 Mg	16	$85.00	$87,009.20	$13,051.38	nat. median $488 outlier · 26.8×
617 MS_DRG	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	11	$11,496.62	$57,897.96	$12,774.02	nat. median $19,257 0.7× median
623 MS_DRG	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	11	$10,939.95	$12,252.21	$12,252.21	nat. median $18,576 0.7× median
505 MS_DRG	Foot Procedures Without Cc/mcc	11	$11,020.23	$13,975.19	$12,244.70	nat. median $17,839 0.7× median
62 MS_DRG	Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…	11	$10,801.40	$79,868.60	$12,001.55	nat. median $18,311 0.7× median
580 MS_DRG	Other Skin, Subcutaneous Tissue And Breast Procedures With Cc	11	$10,394.04	$11,802.12	$11,802.12	nat. median $17,681 0.7× median
01103405 CDM	Operating Room Services - General Classification	11	$6,505.13	$16,662.25	$11,412.50	nat. median $11,412 1.0× median
444 MS_DRG	Disorders Of The Biliary Tract With Mcc	11	$10,270.92	$36,380.99	$11,412.13	nat. median $16,694 0.7× median
01103420 CDM	Operating Room Services - General Classification	11	$6,462.80	$16,553.85	$11,338.25	nat. median $11,338 1.0× median
512 MS_DRG	Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures Without Cc/…	11	$10,175.64	$19,532.22	$11,306.27	nat. median $16,773 0.7× median
299 MS_DRG	Peripheral Vascular Disorders With Mcc	11	$9,008.97	$11,151.23	$11,151.23	nat. median $16,228 0.7× median
482 MS_DRG	Hip And Femur Procedures Except Major Joint Without Cc/mcc	11	$10,025.66	$31,722.09	$11,139.62	nat. median $16,898 0.7× median
C1889 HCPCS	Implantable/insertable Device, Not Otherwise Classified	10	$7,524.00	$19,272.00	$11,027.28	nat. median $2,377 outlier · 4.6×
884 MS_DRG	Organic Disturbances And Intellectual Disability	11	$6,829.93	$14,206.99	$10,988.67	nat. median $14,657 0.7× median
280 MS_DRG	Acute Myocardial Infarction, Discharged Alive With Mcc	11	$9,112.33	$10,955.89	$10,955.89	nat. median $16,417 0.7× median
177 MS_DRG	Respiratory Infections And Inflammations With Mcc	11	$7,775.93	$10,673.13	$10,673.13	nat. median $16,167 0.7× median
964 MS_DRG	Other Multiple Significant Trauma With Cc	11	$7,241.58	$10,467.55	$10,467.55	nat. median $15,586 0.7× median
54 MS_DRG	Nervous System Neoplasms With Mcc	11	$7,729.93	$10,428.62	$10,428.62	nat. median $15,277 0.7× median
682 MS_DRG	Renal Failure With Mcc	11	$9,103.62	$13,065.32	$10,115.13	nat. median $15,088 0.7× median
637 MS_DRG	Diabetes With Mcc	11	$8,831.31	$14,825.63	$9,812.56	nat. median $14,602 0.7× median
91 MS_DRG	Other Disorders Of Nervous System With Mcc	11	$6,433.73	$11,994.72	$9,792.59	nat. median $17,843 0.5× median
49109175 CDM	Stelara 45 Mg/0.5 Ml Vial	11	$5,543.08	$14,198.08	$9,724.71	nat. median $9,725 1.0× median
377 MS_DRG	Gastrointestinal Hemorrhage With Mcc	11	$6,306.63	$12,485.11	$9,599.14	nat. median $18,028 0.5× median
885 MS_DRG	Psychoses	11	$6,829.93	$15,692.43	$9,540.05	nat. median $12,669 0.8× median
100 MS_DRG	Seizures With Mcc	11	$6,190.52	$13,228.21	$9,422.41	nat. median $19,081 outlier · 0.5×
180 MS_DRG	Respiratory Neoplasms With Mcc	11	$6,167.22	$12,061.66	$9,386.94	nat. median $17,700 0.5× median
01103400 CDM	Operating Room Services - General Classification	11	$5,329.50	$13,651.00	$9,350.00	nat. median $9,350 1.0× median

Other procedures at this hospital

Browse this hospital's 10,056 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

535	MS_DRG	Fractures Of Hip And Pelvis With Mcc	11	11	$154,730.97	$154,730.97	$7,880.38	$112,953.61	$8,755.97	2026-01-24
521	MS_DRG	Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc	11	11	$112,036.89	$112,036.89	$17,642.95	$81,786.93	$19,603.27	2026-01-24
62	MS_DRG	Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…	11	11	$109,409.04	$109,409.04	$10,801.40	$79,868.60	$12,001.55	2026-01-24
522	MS_DRG	Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc	11	11	$79,493.73	$79,493.73	$13,017.37	$58,030.42	$14,463.74	2026-01-24
617	MS_DRG	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	11	11	$79,312.27	$79,312.27	$11,496.62	$57,897.96	$12,774.02	2026-01-24
09000155	CDM	Philips Affiniti 70 - Ultrasound Machine	11	11	$71,225.00	$71,225.00	$20,299.13	$51,994.25	$35,612.50	2026-01-24
475	MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc	11	11	$68,546.07	$68,546.07	$13,988.59	$50,038.63	$15,542.87	2026-01-24
01103445	CDM	Operating Room Services - General Classification	11	11	$64,737.75	$64,737.75	$18,450.26	$47,258.56	$32,368.88	2026-01-24
483	MS_DRG	Major Joint Or Limb Reattachment Procedures Of Upper Extremities	11	11	$63,128.75	$63,128.75	$17,038.70	$46,083.99	$18,931.88	2026-01-24
01103451	CDM	Operating Room Services - General Classification	11	11	$61,325.00	$61,325.00	$17,477.63	$44,767.25	$30,662.50	2026-01-24
01103440	CDM	Operating Room Services - General Classification	11	11	$56,325.50	$56,325.50	$16,052.77	$41,117.62	$28,162.75	2026-01-24
01103450	CDM	Operating Room Services - General Classification	11	11	$55,000.00	$55,000.00	$15,675.00	$40,150.00	$27,500.00	2026-01-24
444	MS_DRG	Disorders Of The Biliary Tract With Mcc	11	11	$49,836.98	$49,836.98	$10,270.92	$36,380.99	$11,412.13	2026-01-24
01103435	CDM	Operating Room Services - General Classification	11	11	$47,913.25	$47,913.25	$13,655.28	$34,976.67	$23,956.63	2026-01-24
502	MS_DRG	Soft Tissue Procedures Without Cc/mcc	11	11	$47,411.70	$47,411.70	$8,273.17	$34,610.54	$9,192.40	2026-01-24
857	MS_DRG	Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc	11	11	$44,359.56	$44,359.56	$13,163.67	$32,382.48	$14,626.30	2026-01-24
J2997	HCPCS	Injection, Alteplase Recombinant, 1 Mg	36	16	$43,504.60	$43,504.60	$85.00	$87,009.20	$13,051.38	2026-01-24
482	MS_DRG	Hip And Femur Procedures Except Major Joint Without Cc/mcc	11	11	$43,454.92	$43,454.92	$10,025.66	$31,722.09	$11,139.62	2026-01-24
516	MS_DRG	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc	11	11	$41,268.98	$41,268.98	$12,773.96	$30,126.36	$14,193.28	2026-01-24
478	MS_DRG	Biopsies Of Musculoskeletal System And Connective Tissue With Cc	11	11	$40,289.31	$40,289.31	$15,116.55	$29,411.20	$16,796.16	2026-01-24
570	MS_DRG	Skin Debridement With Mcc	11	11	$40,125.14	$40,125.14	$18,078.77	$29,291.35	$20,087.51	2026-01-24
01103430	CDM	Operating Room Services - General Classification	11	11	$38,769.50	$38,769.50	$11,049.31	$28,301.74	$19,384.75	2026-01-24
480	MS_DRG	Hip And Femur Procedures Except Major Joint With Mcc	11	11	$37,338.42	$37,338.42	$17,901.73	$27,257.05	$19,890.81	2026-01-24
C1813	HCPCS	Prosthesis, Penile, Inflatable	10	10	$37,125.00	$37,125.00	$10,580.63	$27,101.25	$15,507.11	2026-01-24
308	MS_DRG	Cardiac Arrhythmia And Conduction Disorders With Mcc	11	11	$31,717.04	$31,717.04	$7,400.92	$23,153.44	$8,223.24	2026-01-24
01103425	CDM	Operating Room Services - General Classification	11	11	$31,088.75	$31,088.75	$8,860.29	$22,694.79	$15,544.38	2026-01-24
54406	HCPCS	Removal Of All Components Of Inflatable Penile Implant	16	16	$29,007.00	$29,007.00	$2,976.71	$21,175.11	$8,702.10	2026-01-24
982	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc	11	11	$28,219.46	$28,219.46	$15,112.25	$20,600.21	$16,791.38	2026-01-24
348	MS_DRG	Anal And Stomal Procedures With Cc	11	11	$27,073.13	$27,073.13	$8,045.12	$19,763.38	$8,939.01	2026-01-24
512	MS_DRG	Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures Without Cc/…	11	11	$26,756.47	$26,756.47	$10,175.64	$19,532.22	$11,306.27	2026-01-24
01103410	CDM	Operating Room Services - General Classification	11	11	$26,446.75	$26,446.75	$7,537.32	$19,306.13	$13,223.38	2026-01-24
C1889	HCPCS	Implantable/insertable Device, Not Otherwise Classified	10	10	$26,400.00	$26,400.00	$7,524.00	$19,272.00	$11,027.28	2026-01-24
592	MS_DRG	Skin Ulcers With Mcc	11	11	$25,882.86	$25,882.86	$11,896.17	$18,894.49	$13,217.96	2026-01-24
544	MS_DRG	Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With…	11	11	$23,208.90	$23,208.90	$4,638.48	$16,942.49	$5,153.87	2026-01-24
01103405	CDM	Operating Room Services - General Classification	11	11	$22,825.00	$22,825.00	$6,505.13	$16,662.25	$11,412.50	2026-01-24
01103420	CDM	Operating Room Services - General Classification	11	11	$22,676.50	$22,676.50	$6,462.80	$16,553.85	$11,338.25	2026-01-24
193	MS_DRG	Simple Pneumonia And Pleurisy With Mcc	11	11	$21,796.28	$21,796.28	$8,079.54	$15,911.28	$8,977.26	2026-01-24
885	MS_DRG	Psychoses	11	11	$21,496.48	$21,496.48	$6,829.93	$15,692.43	$9,540.05	2026-01-24
871	MS_DRG	Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc	11	11	$20,743.93	$20,743.93	$11,940.43	$15,143.07	$13,267.14	2026-01-24
637	MS_DRG	Diabetes With Mcc	11	11	$20,309.08	$20,309.08	$8,831.31	$14,825.63	$9,812.56	2026-01-24
624	MS_DRG	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	11	11	$20,099.72	$20,099.72	$7,695.35	$14,672.80	$8,550.39	2026-01-24
884	MS_DRG	Organic Disturbances And Intellectual Disability	11	11	$19,461.63	$19,461.63	$6,829.93	$14,206.99	$10,988.67	2026-01-24
49109175	CDM	Stelara 45 Mg/0.5 Ml Vial	11	11	$19,449.42	$19,449.42	$5,543.08	$14,198.08	$9,724.71	2026-01-24
505	MS_DRG	Foot Procedures Without Cc/mcc	11	11	$19,144.09	$19,144.09	$11,020.23	$13,975.19	$12,244.70	2026-01-24
01103400	CDM	Operating Room Services - General Classification	11	11	$18,700.00	$18,700.00	$5,329.50	$13,651.00	$9,350.00	2026-01-24
49109523	CDM	Nystatin 10 Billion Unit Powd	11	11	$18,617.00	$18,617.00	$5,305.85	$13,590.41	$9,308.50	2026-01-24
194	MS_DRG	Simple Pneumonia And Pleurisy With Cc	11	11	$18,064.59	$18,064.59	$4,953.82	$13,187.15	$5,504.24	2026-01-24
682	MS_DRG	Renal Failure With Mcc	11	11	$17,897.69	$17,897.69	$9,103.62	$13,065.32	$10,115.13	2026-01-24
297	MS_DRG	Cardiac Arrest, Unexplained With Cc	11	11	$17,434.82	$17,434.82	$3,832.62	$12,727.42	$4,258.46	2026-01-24
623	MS_DRG	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	11	11	$16,651.37	$16,651.37	$10,939.95	$12,252.21	$12,252.21	2026-01-24
57	MS_DRG	Degenerative Nervous System Disorders Without Mcc	11	11	$16,405.33	$16,405.33	$7,963.98	$11,975.89	$8,848.86	2026-01-24
291	MS_DRG	Heart Failure And Shock With Mcc	11	11	$16,123.32	$16,123.32	$7,891.44	$11,770.03	$8,768.26	2026-01-24
00250100	CDM	Endoprosthesis 7mm	11	11	$15,888.40	$15,888.40	$4,528.19	$11,598.53	$7,944.20	2026-01-24
00250101	CDM	Endoprosthesis 9mm	11	11	$15,888.40	$15,888.40	$4,528.19	$11,598.53	$7,944.20	2026-01-24
C1874	HCPCS	Stent, Coated/covered, With Delivery System	10	10	$15,888.40	$15,888.40	$4,528.19	$11,598.53	$6,636.59	2026-01-24
580	MS_DRG	Other Skin, Subcutaneous Tissue And Breast Procedures With Cc	11	11	$15,820.46	$15,820.46	$10,394.04	$11,802.12	$11,802.12	2026-01-24
543	MS_DRG	Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With…	11	11	$15,782.26	$15,782.26	$6,319.05	$11,521.05	$7,021.17	2026-01-24
190	MS_DRG	Chronic Obstructive Pulmonary Disease With Mcc	11	11	$15,712.15	$15,712.15	$6,808.97	$11,469.87	$7,565.51	2026-01-24
01103395	CDM	Operating Room Services - General Classification	11	11	$15,125.00	$15,125.00	$4,310.63	$11,041.25	$7,562.50	2026-01-24
01103390	CDM	Operating Room Services - General Classification	11	11	$14,995.75	$14,995.75	$4,273.79	$10,946.90	$7,497.88	2026-01-24
11000196	CDM	Penile Prosthesis	11	11	$14,685.00	$14,685.00	$4,185.23	$10,720.05	$7,342.50	2026-01-24
537	MS_DRG	Sprains, Strains, And Dislocations Of Hip, Pelvis And Thigh With Cc/mcc	11	11	$14,456.46	$14,456.46	$5,866.02	$10,553.22	$6,517.80	2026-01-24
01103415	CDM	Operating Room Services - General Classification	11	11	$14,264.25	$14,264.25	$4,065.31	$10,412.90	$7,132.13	2026-01-24
49109301	CDM	Tezspire 210 Mg/1.91 Ml Syring	11	11	$13,990.40	$13,990.40	$3,987.26	$10,212.99	$6,995.20	2026-01-24
280	MS_DRG	Acute Myocardial Infarction, Discharged Alive With Mcc	11	11	$13,869.61	$13,869.61	$9,112.33	$10,955.89	$10,955.89	2026-01-24
191	MS_DRG	Chronic Obstructive Pulmonary Disease With Cc	11	11	$13,826.14	$13,826.14	$5,181.87	$10,093.08	$5,757.63	2026-01-24
299	MS_DRG	Peripheral Vascular Disorders With Mcc	11	11	$13,712.28	$13,712.28	$9,008.97	$11,151.23	$11,151.23	2026-01-24
30	MS_DRG	Spinal Procedures Without Cc/mcc	11	11	$13,094.31	$13,094.31	$8,602.96	$14,993.06	$13,094.31	2026-01-24
66	MS_DRG	Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc	11	11	$12,743.97	$12,743.97	$4,206.97	$9,303.10	$4,674.40	2026-01-24
389	MS_DRG	Gastrointestinal Obstruction With Cc	11	11	$12,551.66	$12,551.66	$4,854.85	$9,162.71	$5,394.28	2026-01-24
292	MS_DRG	Heart Failure And Shock With Cc	11	11	$12,345.00	$12,345.00	$5,218.75	$9,011.85	$5,798.61	2026-01-24
178	MS_DRG	Respiratory Infections And Inflammations With Cc	11	11	$12,093.14	$12,093.14	$5,999.41	$8,827.99	$6,666.01	2026-01-24
540	MS_DRG	Osteomyelitis With Cc	11	11	$11,972.08	$11,972.08	$7,865.65	$8,853.64	$8,853.64	2026-01-24
81	MS_DRG	Nontraumatic Stupor And Coma Without Mcc	11	11	$11,931.26	$11,931.26	$5,505.20	$8,709.82	$6,116.89	2026-01-24
69	MS_DRG	Transient Ischemia Without Thrombolytic	11	11	$11,852.06	$11,852.06	$4,910.18	$8,652.00	$5,455.75	2026-01-24
177	MS_DRG	Respiratory Infections And Inflammations With Mcc	11	11	$11,835.51	$11,835.51	$7,775.93	$10,673.13	$10,673.13	2026-01-24
J3110	HCPCS	Injection, Teriparatide, 10 Mcg	10	10	$11,797.90	$11,797.90	$3,362.40	$11,797.90	$5,645.30	2026-01-24
54	MS_DRG	Nervous System Neoplasms With Mcc	11	11	$11,765.49	$11,765.49	$7,729.93	$10,428.62	$10,428.62	2026-01-24
560	MS_DRG	Aftercare, Musculoskeletal System And Connective Tissue With Cc	11	11	$11,227.16	$11,227.16	$6,922.07	$8,195.83	$7,691.18	2026-01-24
11000120	CDM	Esophyx Kit	11	11	$11,220.00	$11,220.00	$3,197.70	$8,190.60	$5,610.00	2026-01-24
11000189	CDM	Esophyx 2 Link	11	11	$11,220.00	$11,220.00	$3,197.70	$8,190.60	$5,610.00	2026-01-24
47531	HCPCS	Injection Of Bile Duct For X-ray Through Already Existing Skin Access Using Imag…	17	17	$11,028.16	$11,028.16	$63.00	$8,050.56	$3,359.46	2026-01-24
964	MS_DRG	Other Multiple Significant Trauma With Cc	11	11	$11,022.20	$11,022.20	$7,241.58	$10,467.55	$10,467.55	2026-01-24
J2506	HCPCS	Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg	16	16	$10,946.70	$10,946.70	$80.41	$10,946.70	$3,284.01	2026-01-24
43262	HCPCS	Incision Of Pancreatic Outlet Using A Flexible Endoscope	16	16	$10,880.68	$10,880.68	$3,100.99	$7,942.90	$3,617.56	2026-01-24
43260	HCPCS	Diagnostic Exam Of Gallbladder And Pancreatic, Liver, And Bile Ducts Using An En…	16	16	$10,880.68	$10,880.68	$3,100.99	$7,942.90	$3,617.56	2026-01-24
572	MS_DRG	Skin Debridement Without Cc/mcc	11	11	$10,851.86	$10,851.86	$7,046.24	$7,921.86	$7,829.15	2026-01-24
00099911	CDM	Misc Item Surgery	11	11	$10,731.37	$10,731.37	$3,058.44	$7,833.90	$5,365.69	2026-01-24
11000042	CDM	Lap-band B-2245	11	11	$10,678.80	$10,678.80	$3,043.46	$7,795.52	$5,339.40	2026-01-24
34000050	CDM	Cpsi Timeclock	11	11	$10,609.50	$10,609.50	$3,023.71	$7,744.94	$5,304.75	2026-01-24
01103380	CDM	Operating Room Services - General Classification	11	11	$10,587.50	$10,587.50	$3,017.44	$7,728.88	$5,293.75	2026-01-24
J0840	HCPCS	Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram	16	16	$10,563.10	$10,563.10	$1,645.84	$10,563.10	$3,168.93	2026-01-24
11000041	CDM	Lap-band B-2240	11	11	$10,381.80	$10,381.80	$2,958.81	$7,578.71	$5,190.90	2026-01-24
00025056	CDM	Carboflo Straight Vascular Graft 6x70CM	11	11	$9,983.60	$9,983.60	$2,845.33	$7,288.03	$4,991.80	2026-01-24
378	MS_DRG	Gastrointestinal Hemorrhage With Cc	11	11	$9,859.31	$9,859.31	$6,028.30	$7,197.29	$6,698.11	2026-01-24
J1162	HCPCS	Injection, Digoxin Immune Fab (ovine), Per Vial	16	16	$9,799.36	$9,799.36	$2,792.82	$9,799.36	$5,168.23	2026-01-24
91	MS_DRG	Other Disorders Of Nervous System With Mcc	11	11	$9,792.59	$9,792.59	$6,433.73	$11,994.72	$9,792.59	2026-01-24
693	MS_DRG	Urinary Stones With Mcc	11	11	$9,653.26	$9,653.26	$6,342.19	$9,182.84	$9,182.84	2026-01-24
01103375	CDM	Operating Room Services - General Classification	11	11	$9,625.00	$9,625.00	$2,743.13	$7,026.25	$4,812.50	2026-01-24
377	MS_DRG	Gastrointestinal Hemorrhage With Mcc	11	11	$9,599.14	$9,599.14	$6,306.63	$12,485.11	$9,599.14	2026-01-24
14900143	CDM	Roche Probnp Ii Stat	11	11	$9,475.75	$9,475.75	$2,700.59	$6,917.30	$4,737.88	2026-01-24
100	MS_DRG	Seizures With Mcc	11	11	$9,422.41	$9,422.41	$6,190.52	$13,228.21	$9,422.41	2026-01-24
180	MS_DRG	Respiratory Neoplasms With Mcc	11	11	$9,386.94	$9,386.94	$6,167.22	$12,061.66	$9,386.94	2026-01-24
439	MS_DRG	Disorders Of Pancreas Except Malignancy With Cc	11	11	$9,151.74	$9,151.74	$5,170.81	$6,680.77	$5,745.34	2026-01-24
896	MS_DRG	Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc	11	11	$9,098.08	$9,098.08	$5,977.44	$11,918.91	$9,098.08	2026-01-24
J9217	HCPCS	Leuprolide Acetate (for Depot Suspension), 7.5 Mg	56	16	$8,967.30	$8,967.30	$158.80	$18,967.69	$3,793.49	2026-01-24
184	MS_DRG	Major Chest Trauma With Cc	11	11	$8,944.38	$8,944.38	$5,876.46	$7,267.73	$7,267.73	2026-01-24
391	MS_DRG	Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc	11	11	$8,866.55	$8,866.55	$5,825.33	$8,662.40	$8,662.40	2026-01-24
872	MS_DRG	Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc	11	11	$8,852.10	$8,852.10	$5,815.83	$6,989.07	$6,989.07	2026-01-24
36556	HCPCS	Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older)	16	16	$8,811.88	$8,811.88	$2,511.39	$6,432.67	$2,962.64	2026-01-24
64	MS_DRG	Intracranial Hemorrhage Or Cerebral Infarction With Mcc	11	11	$8,668.56	$8,668.56	$5,695.25	$13,734.99	$8,668.56	2026-01-24
698	MS_DRG	Other Kidney And Urinary Tract Diagnoses With Mcc	11	11	$8,666.55	$8,666.55	$5,693.92	$11,299.44	$8,666.55	2026-01-24
189	MS_DRG	Pulmonary Edema And Respiratory Failure	11	11	$8,655.58	$8,655.58	$5,686.72	$8,437.70	$8,437.70	2026-01-24
699	MS_DRG	Other Kidney And Urinary Tract Diagnoses With Cc	11	11	$8,455.79	$8,455.79	$5,555.45	$6,932.38	$6,932.38	2026-01-24
947	MS_DRG	Signs And Symptoms With Mcc	11	11	$8,286.36	$8,286.36	$5,444.14	$8,669.91	$8,286.36	2026-01-24
01103370	CDM	Operating Room Services - General Classification	11	11	$8,250.00	$8,250.00	$2,351.25	$6,022.50	$4,125.00	2026-01-24
282	MS_DRG	Acute Myocardial Infarction, Discharged Alive Without Cc/mcc	11	11	$8,237.24	$8,237.24	$4,444.85	$6,013.18	$4,938.72	2026-01-24
89	MS_DRG	Concussion With Cc	11	11	$8,169.53	$8,169.53	$5,367.38	$7,503.36	$7,503.36	2026-01-24
388	MS_DRG	Gastrointestinal Obstruction With Mcc	11	11	$8,155.07	$8,155.07	$5,357.88	$10,086.44	$8,155.07	2026-01-24
01103385	CDM	Operating Room Services - General Classification	11	11	$8,046.50	$8,046.50	$2,293.25	$5,873.95	$4,023.25	2026-01-24
49106602	CDM	Abilify Maintena ER 400 Mg Syr	11	11	$8,008.35	$8,008.35	$2,282.38	$5,846.10	$4,004.18	2026-01-24
J2993	HCPCS	Injection, Reteplase, 18.1 Mg	26	16	$7,896.75	$7,896.75	$2,250.57	$22,374.20	$5,764.63	2026-01-24
302	MS_DRG	Atherosclerosis With Mcc	11	11	$7,676.58	$7,676.58	$5,043.51	$8,172.69	$7,676.58	2026-01-24
45388	HCPCS	Destruction Of Polyp Or Growth Of Large Bowel Using A Flexible Endoscope	16	16	$7,606.54	$7,606.54	$1,010.52	$5,552.77	$2,281.96	2026-01-24
45385	HCPCS	Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope With Mechanical S…	16	16	$7,606.54	$7,606.54	$1,010.52	$5,552.77	$2,281.96	2026-01-24
44389	HCPCS	Biopsy Of Large Bowel Using An Endoscope Inserted Through Surgically Created Ope…	16	16	$7,606.54	$7,606.54	$1,010.52	$5,552.77	$2,281.96	2026-01-24
309	MS_DRG	Cardiac Arrhythmia And Conduction Disorders With Cc	11	11	$7,599.81	$7,599.81	$4,522.30	$5,547.86	$5,024.78	2026-01-24
83	MS_DRG	Traumatic Stupor And Coma >1 Hour With Cc	11	11	$7,532.99	$7,532.99	$4,949.17	$9,533.22	$7,532.99	2026-01-24
281	MS_DRG	Acute Myocardial Infarction, Discharged Alive With Cc	11	11	$7,409.55	$7,409.55	$4,868.07	$6,277.39	$6,277.39	2026-01-24
919	MS_DRG	Complications Of Treatment With Mcc	11	11	$7,400.00	$7,400.00	$4,861.80	$12,504.24	$7,400.00	2026-01-24
534	MS_DRG	Fractures Of Femur Without Mcc	11	11	$7,386.59	$7,386.59	$4,852.99	$5,505.61	$5,505.61	2026-01-24
547	MS_DRG	Connective Tissue Disorders Without Cc/mcc	11	11	$7,381.76	$7,381.76	$4,849.82	$5,711.19	$5,711.19	2026-01-24
01103360	CDM	Operating Room Services - General Classification	11	11	$7,315.00	$7,315.00	$2,084.78	$5,339.95	$3,657.50	2026-01-24
917	MS_DRG	Poisoning And Toxic Effects Of Drugs With Mcc	11	11	$7,295.55	$7,295.55	$4,793.18	$10,712.06	$7,295.55	2026-01-24
729	MS_DRG	Other Male Reproductive System Diagnoses With Cc/mcc	11	11	$7,232.54	$7,232.54	$4,751.78	$7,230.85	$7,230.85	2026-01-24
442	MS_DRG	Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc	11	11	$7,106.89	$7,106.89	$4,669.22	$6,592.93	$6,592.93	2026-01-24
01103365	CDM	Operating Room Services - General Classification	11	11	$6,875.00	$6,875.00	$1,959.38	$5,018.75	$3,437.50	2026-01-24
445	MS_DRG	Disorders Of The Biliary Tract With Cc	11	11	$6,869.26	$6,869.26	$4,513.10	$7,474.68	$6,869.26	2026-01-24
183	MS_DRG	Major Chest Trauma With Mcc	11	11	$6,849.72	$6,849.72	$4,500.27	$10,449.11	$6,849.72	2026-01-24
546	MS_DRG	Connective Tissue Disorders With Cc	11	11	$6,825.96	$6,825.96	$4,484.66	$7,877.64	$6,825.96	2026-01-24
441	MS_DRG	Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc	11	11	$6,797.94	$6,797.94	$4,466.25	$12,257.68	$6,797.94	2026-01-24
300	MS_DRG	Peripheral Vascular Disorders With Cc	11	11	$6,646.43	$6,646.43	$4,366.71	$7,290.95	$6,646.43	2026-01-24
375	MS_DRG	Digestive Malignancy With Cc	11	11	$6,482.60	$6,482.60	$4,259.07	$8,261.48	$6,482.60	2026-01-24
314	MS_DRG	Other Circulatory System Diagnoses With Mcc	11	11	$6,445.72	$6,445.72	$4,234.84	$14,241.77	$6,445.72	2026-01-24
00900778	CDM	Operating Room Services - Other Or Services	11	11	$6,435.00	$6,435.00	$1,833.98	$4,697.55	$3,217.50	2026-01-24
683	MS_DRG	Renal Failure With Cc	11	11	$6,394.62	$6,394.62	$4,201.27	$5,981.65	$5,981.65	2026-01-24
840	MS_DRG	Lymphoma And Non-acute Leukemia With Mcc	10	10	$6,384.95	$6,384.95	$4,194.91	$6,384.95	$6,384.95	2026-01-24
00800604	CDM	Werewolf Fastseal 6.0	11	11	$6,279.32	$6,279.32	$1,789.61	$4,583.90	$3,139.66	2026-01-24
315	MS_DRG	Other Circulatory System Diagnoses With Cc	11	11	$6,199.45	$6,199.45	$4,073.04	$6,579.27	$6,199.45	2026-01-24
602	MS_DRG	Cellulitis With Mcc	11	11	$6,192.01	$6,192.01	$4,068.15	$9,707.38	$6,192.01	2026-01-24
11000008	CDM	Essure System Ess305	11	11	$6,105.00	$6,105.00	$1,739.93	$4,456.65	$3,052.50	2026-01-24
09000004	CDM	Operating Room Services - Other Or Services	11	11	$5,940.00	$5,940.00	$1,692.90	$4,336.20	$2,970.00	2026-01-24
390	MS_DRG	Gastrointestinal Obstruction Without Cc/mcc	11	11	$5,915.26	$5,915.26	$3,343.94	$4,318.14	$3,715.48	2026-01-24
87	MS_DRG	Traumatic Stupor And Coma <1 Hour Without Cc/mcc	11	11	$5,907.21	$5,907.21	$3,881.04	$6,247.34	$5,907.21	2026-01-24
02600142	CDM	Bioinductive Implant W/arth Del Lrg	11	11	$5,890.00	$5,890.00	$1,678.65	$4,299.70	$2,945.00	2026-01-24
638	MS_DRG	Diabetes With Cc	11	11	$5,852.60	$5,852.60	$3,845.16	$6,120.98	$5,852.60	2026-01-24
00099996	CDM	Misc Item Administration	11	11	$5,804.24	$5,804.24	$1,654.21	$4,237.10	$2,902.12	2026-01-24
43270	HCPCS	Destruction Of Polyp Or Growth Of Esophagus, Stomach, And/or Upper Small Bowel U…	16	16	$5,784.79	$5,784.79	$1,620.45	$4,222.90	$1,800.50	2026-01-24
43255	HCPCS	Control Of Bleeding Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flex…	16	16	$5,784.79	$5,784.79	$1,620.45	$4,222.90	$1,800.50	2026-01-24
43251	HCPCS	Removal Of Polyps Or Growths Of Esophagus, Stomach, And/or Upper Small Bowel Usi…	16	16	$5,784.79	$5,784.79	$1,620.45	$4,222.90	$1,800.50	2026-01-24
43250	HCPCS	Removal Of Polyps Or Growths Of Esophagus, Stomach, And/or Upper Small Bowel Usi…	16	16	$5,784.79	$5,784.79	$1,620.45	$4,222.90	$1,800.50	2026-01-24
43249	HCPCS	Balloon Dilation Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexibl…	16	16	$5,784.79	$5,784.79	$1,620.45	$4,222.90	$1,800.50	2026-01-24
43245	HCPCS	Dilation Of Stomach Outlet Using A Flexible Endoscope	16	16	$5,784.79	$5,784.79	$1,620.45	$4,222.90	$1,800.50	2026-01-24
43244	HCPCS	Tying Of Dilated Veins Of Stomach And/or Esophagus Using A Flexible Endoscope	16	16	$5,784.79	$5,784.79	$1,620.45	$4,222.90	$1,800.50	2026-01-24
43233	HCPCS	Balloon Dilation Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexibl…	16	16	$5,784.79	$5,784.79	$1,620.45	$4,222.90	$1,800.50	2026-01-24
43205	HCPCS	Tying Of Dilated Veins Of Esophagus With Bands Using A Flexible Endoscope	16	16	$5,784.79	$5,784.79	$1,620.45	$4,222.90	$1,800.50	2026-01-24
J2426	HCPCS	Injection, Paliperidone Palmitate Extended Release (invega Sustenna), 1 Mg	36	16	$5,667.55	$5,667.55	$13.60	$8,501.10	$2,550.33	2026-01-24
00025053	CDM	Flixene 6mm X40cm Vas Graft	11	11	$5,535.46	$5,535.46	$1,577.61	$4,040.89	$2,767.73	2026-01-24
01103355	CDM	Operating Room Services - General Classification	11	11	$5,486.25	$5,486.25	$1,563.58	$4,004.96	$2,743.13	2026-01-24
176	MS_DRG	Pulmonary Embolism Without Mcc	11	11	$5,451.16	$5,451.16	$3,581.41	$5,498.09	$5,451.16	2026-01-24
192	MS_DRG	Chronic Obstructive Pulmonary Disease Without Cc/mcc	11	11	$5,444.36	$5,444.36	$3,576.94	$4,384.82	$4,384.82	2026-01-24
756	MS_DRG	Malignancy, Female Reproductive System Without Cc/mcc	11	11	$5,425.20	$5,425.20	$3,564.36	$6,560.15	$5,425.20	2026-01-24
49101498	CDM	Isoproterenol 1 Mg/5 Ml Vial	11	11	$5,424.60	$5,424.60	$1,546.01	$3,959.96	$2,712.30	2026-01-24
551	MS_DRG	Medical Back Problems With Mcc	11	11	$5,405.20	$5,405.20	$3,551.22	$11,447.65	$5,405.20	2026-01-24
536	MS_DRG	Fractures Of Hip And Pelvis Without Mcc	11	11	$5,393.98	$5,393.98	$3,543.84	$5,515.85	$5,393.98	2026-01-24
J1670	HCPCS	Injection, Tetanus Immune Globulin, Human, Up To 250 Units	16	16	$5,359.90	$5,359.90	$533.70	$5,359.90	$1,607.97	2026-01-24
65	MS_DRG	Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours	11	11	$5,347.93	$5,347.93	$3,513.59	$6,900.28	$5,347.93	2026-01-24
16000004	CDM	CT Syringe Kit Single	11	11	$5,340.50	$5,340.50	$1,522.04	$3,898.57	$2,670.25	2026-01-24
16000001	CDM	CT Syringe Kit Dual	11	11	$5,340.50	$5,340.50	$1,522.04	$3,898.57	$2,670.25	2026-01-24
16000005	CDM	CT Empower CTA Tubing Single	11	11	$5,340.50	$5,340.50	$1,522.04	$3,898.57	$2,670.25	2026-01-24
15260	HCPCS	Full Thickness Skin Graft To Nose, Ears, Eyelids, Or Lips, 20.0 Sq Cm Or Less	16	16	$5,282.20	$5,282.20	$1,505.43	$3,856.01	$1,935.96	2026-01-24
841	MS_DRG	Lymphoma And Non-acute Leukemia With Cc	11	11	$5,241.88	$5,241.88	$3,443.92	$11,142.35	$5,241.88	2026-01-24
00900627	CDM	Operating Room Services - Other Or Services	11	11	$5,225.00	$5,225.00	$1,489.13	$3,814.25	$2,612.50	2026-01-24
01122903	CDM	Operating Room Services - General Classification	11	11	$5,214.00	$5,214.00	$1,485.99	$3,806.22	$2,607.00	2026-01-24
312	MS_DRG	Syncope And Collapse	11	11	$5,163.18	$5,163.18	$3,392.21	$5,952.97	$5,163.18	2026-01-24
J0630	HCPCS	Injection, Calcitonin Salmon, Up To 400 Units	20	10	$5,135.15	$5,135.15	$112.35	$9,876.10	$1,604.45	2026-01-24
01105103	CDM	Core-tex Soft Tissue Patch	11	11	$5,011.60	$5,011.60	$1,428.31	$3,658.47	$2,505.80	2026-01-24
34000044	CDM	Lenovo Thinkpad X201 Tablet	11	11	$4,987.26	$4,987.26	$1,421.37	$3,640.70	$2,493.63	2026-01-24
446	MS_DRG	Disorders Of The Biliary Tract Without Cc/mcc	11	11	$4,894.82	$4,894.82	$3,215.90	$5,650.40	$4,894.82	2026-01-24
386	MS_DRG	Inflammatory Bowel Disease With Cc	11	11	$4,872.94	$4,872.94	$3,201.52	$6,668.06	$4,872.94	2026-01-24
00026071	CDM	Av Flixene Av Graft	11	11	$4,840.00	$4,840.00	$1,379.40	$3,533.20	$2,420.00	2026-01-24
00025052	CDM	Av Flixene Vas Graft 6mm X50cm	11	11	$4,803.15	$4,803.15	$1,368.90	$3,506.30	$2,401.58	2026-01-24
395	MS_DRG	Other Digestive System Diagnoses Without Cc/mcc	11	11	$4,789.39	$4,789.39	$3,146.63	$4,432.62	$4,432.62	2026-01-24
565	MS_DRG	Other Musculoskeletal System And Connective Tissue Diagnoses With Cc	11	11	$4,786.26	$4,786.26	$3,144.57	$6,655.08	$4,786.26	2026-01-24
11000057	CDM	Lithotripsy Service	11	11	$4,785.00	$4,785.00	$1,363.73	$3,493.05	$2,392.50	2026-01-24
00900001	CDM	Eswl	11	11	$4,785.00	$4,785.00	$1,363.73	$3,493.05	$2,392.50	2026-01-24
440	MS_DRG	Disorders Of Pancreas Except Malignancy Without Cc/mcc	11	11	$4,597.36	$4,597.36	$3,020.46	$4,244.12	$4,244.12	2026-01-24
00800600	CDM	Werewolf Flow 50 Coblation Wand	11	11	$4,573.72	$4,573.72	$1,303.51	$3,338.82	$2,286.86	2026-01-24
49106191	CDM	Premarin Vaginal Cream-appl	11	11	$4,556.50	$4,556.50	$1,298.60	$3,326.25	$2,278.25	2026-01-24
202	MS_DRG	Bronchitis And Asthma With Cc/mcc	11	11	$4,534.73	$4,534.73	$2,979.32	$6,633.23	$4,534.73	2026-01-24
776	MS_DRG	Postpartum And Post Abortion Diagnoses Without O.r. Procedures	11	11	$4,493.98	$4,493.98	$2,952.54	$4,471.56	$4,471.56	2026-01-24
186	MS_DRG	Pleural Effusion With Mcc	11	11	$4,427.99	$4,427.99	$2,909.19	$10,644.45	$4,427.99	2026-01-24
11000269	CDM	Myosure	11	11	$4,399.99	$4,399.99	$1,254.00	$3,211.99	$2,200.00	2026-01-24
894	MS_DRG	Alcohol, Drug Abuse Or Dependence, Left Ama	11	11	$4,357.29	$4,357.29	$2,862.74	$4,213.38	$4,213.38	2026-01-24
49108195	CDM	Nf- Animas Insulin Pump : R1000	11	11	$4,355.00	$4,355.00	$1,241.18	$3,179.15	$2,177.50	2026-01-24
11000114	CDM	Harmonic Ace 5mm Har36	11	11	$4,339.10	$4,339.10	$1,236.64	$3,167.54	$2,169.55	2026-01-24
11000033	CDM	Sparc Sling 72403656	11	11	$4,194.30	$4,194.30	$1,195.38	$3,061.84	$2,097.15	2026-01-24
90	MS_DRG	Concussion Without Cc/mcc	11	11	$4,151.10	$4,151.10	$2,727.27	$5,622.40	$4,151.10	2026-01-24
84	MS_DRG	Traumatic Stupor And Coma >1 Hour Without Cc/mcc	11	11	$4,088.70	$4,088.70	$2,686.28	$6,528.05	$4,088.70	2026-01-24
14900233	CDM	Roche Probe Sample	11	11	$4,079.33	$4,079.33	$1,162.61	$2,977.91	$2,039.67	2026-01-24
376	MS_DRG	Digestive Malignancy Without Cc/mcc	11	11	$4,026.04	$4,026.04	$2,645.11	$6,312.90	$4,026.04	2026-01-24
11000236	CDM	Novasure Device	11	11	$4,019.40	$4,019.40	$1,145.53	$2,934.16	$2,009.70	2026-01-24
49105980	CDM	Potassium Iodide 1 Gm/ml Sol	11	11	$4,016.30	$4,016.30	$1,144.65	$2,931.90	$2,008.15	2026-01-24
640	MS_DRG	Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M…	11	11	$4,010.38	$4,010.38	$2,634.82	$9,122.05	$4,010.38	2026-01-24
558	MS_DRG	Tendonitis, Myositis And Bursitis Without Mcc	11	11	$3,987.61	$3,987.61	$2,619.86	$6,100.49	$3,987.62	2026-01-24
09004592	CDM	Desara Blue Sling System/ T-sling	11	11	$3,956.70	$3,956.70	$1,127.66	$2,888.39	$1,978.35	2026-01-24
694	MS_DRG	Urinary Stones Without Mcc	11	11	$3,935.86	$3,935.86	$2,585.86	$5,338.96	$3,935.86	2026-01-24
49108735	CDM	Nystatin 2 Billion Unit Powder	11	11	$3,919.00	$3,919.00	$1,116.92	$2,860.87	$1,959.50	2026-01-24
09000901	CDM	G21 15mm Balloon Kit 900016b	11	11	$3,850.00	$3,850.00	$1,097.25	$2,810.50	$1,925.00	2026-01-24
34000035	CDM	Admin Misc Item	11	11	$3,842.09	$3,842.09	$1,095.00	$2,804.73	$1,921.05	2026-01-24
101	MS_DRG	Seizures Without Mcc	11	11	$3,825.46	$3,825.46	$2,513.33	$6,164.69	$3,825.46	2026-01-24
09000003	CDM	Operating Room Services - Other Or Services	11	11	$3,795.00	$3,795.00	$1,081.58	$2,770.35	$1,897.50	2026-01-24
155	MS_DRG	Other Ear, Nose, Mouth And Throat Diagnoses With Cc	11	11	$3,740.75	$3,740.75	$2,457.67	$6,259.63	$3,740.75	2026-01-24
C1771	HCPCS	Repair Device, Urinary, Incontinence, With Sling Graft	30	10	$3,738.74	$3,738.74	$691.50	$11,310.26	$1,886.47	2026-01-24
49100214	CDM	--donnatal Liq :473ml	11	11	$3,723.15	$3,723.15	$1,061.10	$2,717.90	$1,861.58	2026-01-24
283	MS_DRG	Acute Myocardial Infarction, Expired With Mcc	10	10	$3,664.48	$3,664.48	$2,407.56	$3,664.48	$3,664.48	2026-01-24
93	MS_DRG	Other Disorders Of Nervous System Without Cc/mcc	11	11	$3,638.13	$3,638.13	$2,390.25	$5,438.67	$3,638.13	2026-01-24
00900509	CDM	Rapidport Ez Standard	11	11	$3,630.00	$3,630.00	$1,034.55	$2,649.90	$1,815.00	2026-01-24
49109107	CDM	Breztri Aerosphere Inhaler	11	11	$3,610.40	$3,610.40	$1,028.96	$2,635.59	$1,805.20	2026-01-24
311	MS_DRG	Angina Pectoris	11	11	$3,608.26	$3,608.26	$2,370.63	$4,793.93	$3,608.26	2026-01-24
49106897	CDM	Cipro Hc Otic Suspension	11	11	$3,598.70	$3,598.70	$1,025.63	$2,627.05	$1,799.35	2026-01-24
01490271	CDM	Alere Binax Influenza A & B Case	11	11	$3,539.25	$3,539.25	$1,008.69	$2,583.65	$1,769.63	2026-01-24
11000115	CDM	Mesh 10 X 15 Atrium 31538	11	11	$3,531.00	$3,531.00	$1,006.34	$2,577.63	$1,765.50	2026-01-24
49109470	CDM	Ozempic 2 Mg/dose (8 Mg/3 Ml)	11	11	$3,521.90	$3,521.90	$1,003.74	$2,570.99	$1,760.95	2026-01-24
26000408	CDM	Cannon Ii Plus Hemodialysis	11	11	$3,516.22	$3,516.22	$1,002.12	$2,566.84	$1,758.11	2026-01-24
379	MS_DRG	Gastrointestinal Hemorrhage Without Cc/mcc	11	11	$3,509.47	$3,509.47	$2,305.72	$4,305.59	$3,509.47	2026-01-24
J2325	HCPCS	Injection, Nesiritide, 0.1 Mg	10	10	$3,502.39	$3,502.39	$998.18	$3,502.39	$1,675.89	2026-01-24
103	MS_DRG	Headaches Without Mcc	11	11	$3,476.28	$3,476.28	$2,283.91	$5,711.87	$3,476.28	2026-01-24
00900099	CDM	Suture 813h	11	11	$3,471.78	$3,471.78	$989.46	$2,534.40	$1,735.89	2026-01-24
55	MS_DRG	Nervous System Neoplasms Without Mcc	11	11	$3,467.01	$3,467.01	$2,277.82	$6,963.80	$3,467.01	2026-01-24
304	MS_DRG	Hypertension With Mcc	11	11	$3,465.03	$3,465.03	$2,276.52	$8,127.62	$3,465.03	2026-01-24
11000255	CDM	Cyclesure Bio Indicator	11	11	$3,458.40	$3,458.40	$985.64	$2,524.63	$1,729.20	2026-01-24
00900485	CDM	Ets Flex Articng Lnr Cutter 45mm Ats45	11	11	$3,421.00	$3,421.00	$974.99	$2,497.33	$1,710.50	2026-01-24
49108778	CDM	Ozempic 0.25-0.5 Mg/dose Pen	11	11	$3,402.80	$3,402.80	$969.80	$2,484.04	$1,701.40	2026-01-24
00001268	CDM	Nf-animas Insulin Pump R1000	11	11	$3,380.00	$3,380.00	$963.30	$2,467.40	$1,690.00	2026-01-24
14900106	CDM	Roche Ldl3	11	11	$3,345.31	$3,345.31	$953.41	$2,442.08	$1,672.66	2026-01-24
181	MS_DRG	Respiratory Neoplasms With Cc	11	11	$3,344.07	$3,344.07	$2,197.06	$7,314.86	$3,344.07	2026-01-24
00900374	CDM	Stapler Circular Ecs33	11	11	$3,313.53	$3,313.53	$944.36	$2,418.88	$1,656.77	2026-01-24
00900777	CDM	Operating Room Services - Other Or Services	11	11	$3,217.50	$3,217.50	$916.99	$2,348.78	$1,608.75	2026-01-24
34000051	CDM	Zebra S4m Thermal Printer	11	11	$3,200.97	$3,200.97	$912.28	$2,336.71	$1,600.49	2026-01-24
689	MS_DRG	Kidney And Urinary Tract Infections With Mcc	11	11	$3,187.76	$3,187.76	$2,094.36	$7,924.77	$3,187.76	2026-01-24
394	MS_DRG	Other Digestive System Diagnoses With Cc	11	11	$3,134.45	$3,134.45	$2,059.33	$6,390.77	$3,134.45	2026-01-24
43246	HCPCS	Insertion Of Stomach Tube Using A Flexible Endoscope	16	16	$3,032.70	$3,032.70	$864.32	$2,213.87	$1,755.49	2026-01-24
384	MS_DRG	Uncomplicated Peptic Ulcer Without Mcc	11	11	$2,993.95	$2,993.95	$1,967.03	$5,838.22	$2,993.95	2026-01-24
923	MS_DRG	Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc	11	11	$2,989.22	$2,989.22	$1,963.92	$6,950.82	$2,989.22	2026-01-24
182	MS_DRG	Respiratory Neoplasms Without Cc/mcc	11	11	$2,952.37	$2,952.37	$1,939.71	$5,081.47	$2,952.37	2026-01-24
757	MS_DRG	Infections, Female Reproductive System With Mcc	10	10	$2,931.43	$2,931.43	$1,925.95	$2,931.43	$2,931.43	2026-01-24
154	MS_DRG	Other Ear, Nose, Mouth And Throat Diagnoses With Mcc	10	10	$2,886.28	$2,886.28	$1,896.29	$2,886.28	$2,886.28	2026-01-24
811	MS_DRG	Red Blood Cell Disorders With Mcc	10	10	$2,849.14	$2,849.14	$1,871.88	$2,849.14	$2,849.14	2026-01-24
149	MS_DRG	Dysequilibrium	11	11	$2,843.07	$2,843.07	$1,867.90	$5,133.38	$2,843.07	2026-01-24
599	MS_DRG	Malignant Breast Disorders Without Cc/mcc	11	11	$2,785.35	$2,785.35	$1,829.97	$5,007.70	$2,785.35	2026-01-24
554	MS_DRG	Bone Diseases And Arthropathies Without Mcc	11	11	$2,751.77	$2,751.77	$1,807.91	$5,669.52	$2,751.77	2026-01-24
433	MS_DRG	Cirrhosis And Alcoholic Hepatitis With Cc	11	11	$2,677.21	$2,677.21	$1,758.92	$7,213.77	$2,677.21	2026-01-24
644	MS_DRG	Endocrine Disorders With Cc	11	11	$2,667.35	$2,667.35	$1,752.45	$7,000.68	$2,667.35	2026-01-24
200	MS_DRG	Pneumothorax With Cc	11	11	$2,655.63	$2,655.63	$1,744.75	$7,508.14	$2,655.63	2026-01-24
123	MS_DRG	Neurological Eye Disorders	11	11	$2,627.12	$2,627.12	$1,726.02	$5,454.38	$2,627.12	2026-01-24
596	MS_DRG	Major Skin Disorders Without Mcc	11	11	$2,571.55	$2,571.55	$1,689.51	$7,393.40	$2,571.55	2026-01-24
687	MS_DRG	Kidney And Urinary Tract Neoplasms With Cc	11	11	$2,526.32	$2,526.32	$1,659.79	$7,156.40	$2,526.32	2026-01-24
74	MS_DRG	Cranial And Peripheral Nerve Disorders Without Mcc	11	11	$2,496.83	$2,496.83	$1,640.42	$7,040.29	$2,496.83	2026-01-24
313	MS_DRG	Chest Pain	12	12	$2,404.15	$2,404.15	$1,579.53	$6,710.15	$2,404.15	2026-01-24
566	MS_DRG	Other Musculoskeletal System And Connective Tissue Diagnoses Without Cc/mcc	11	11	$2,367.39	$2,367.39	$1,555.38	$5,117.67	$2,367.39	2026-01-24
690	MS_DRG	Kidney And Urinary Tract Infections Without Mcc	12	12	$2,312.54	$2,312.54	$1,519.34	$5,528.83	$2,312.54	2026-01-24
641	MS_DRG	Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou…	11	11	$2,283.37	$2,283.37	$1,500.17	$5,315.05	$2,283.37	2026-01-24
688	MS_DRG	Kidney And Urinary Tract Neoplasms Without Cc/mcc	11	11	$2,281.14	$2,281.14	$1,498.71	$5,397.69	$2,281.14	2026-01-24
IC	CDM	Intensive Care Unit - General Classification	4	4	$2,256.00	$2,256.00	$1,482.19	$1,646.88	$1,646.88	2026-01-24
552	MS_DRG	Medical Back Problems Without Mcc	11	11	$2,215.14	$2,215.14	$1,455.35	$6,565.61	$2,215.14	2026-01-24
205	MS_DRG	Other Respiratory System Diagnoses With Mcc	10	10	$2,211.30	$2,211.30	$1,452.82	$2,211.30	$2,211.30	2026-01-24
392	MS_DRG	Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc	12	12	$2,199.35	$2,199.35	$1,444.97	$5,324.61	$2,198.94	2026-01-24
605	MS_DRG	Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc	10	10	$2,067.19	$2,067.19	$1,358.14	$2,067.19	$2,067.19	2026-01-24
152	MS_DRG	Otitis Media And Uri With Mcc	10	10	$2,017.53	$2,017.53	$1,325.52	$2,017.53	$2,017.53	2026-01-24
897	MS_DRG	Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc	10	10	$2,006.12	$2,006.12	$1,318.02	$2,006.12	$2,006.12	2026-01-24
303	MS_DRG	Atherosclerosis Without Mcc	11	11	$1,930.26	$1,930.26	$1,268.18	$4,597.91	$1,930.26	2026-01-24
563	MS_DRG	Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit…	10	10	$1,881.65	$1,881.65	$1,236.24	$1,881.65	$1,881.65	2026-01-24
948	MS_DRG	Signs And Symptoms Without Mcc	12	12	$1,880.72	$1,880.72	$1,235.63	$5,467.36	$1,880.72	2026-01-24
603	MS_DRG	Cellulitis Without Mcc	10	10	$1,815.68	$1,815.68	$1,192.90	$1,815.68	$1,815.68	2026-01-24
179	MS_DRG	Respiratory Infections And Inflammations Without Cc/mcc	11	11	$1,803.93	$1,803.93	$1,185.18	$5,156.60	$1,803.93	2026-01-24
918	MS_DRG	Poisoning And Toxic Effects Of Drugs Without Mcc	10	10	$1,769.88	$1,769.88	$1,162.81	$1,769.88	$1,769.88	2026-01-24
606	MS_DRG	Minor Skin Disorders With Mcc	10	10	$1,761.81	$1,761.81	$1,157.51	$1,761.81	$1,761.81	2026-01-24
880	MS_DRG	Acute Adjustment Reaction And Psychosocial Dysfunction	10	10	$1,755.90	$1,755.90	$1,153.63	$1,755.90	$1,755.90	2026-01-24
914	MS_DRG	Traumatic Injury Without Mcc	10	10	$1,738.17	$1,738.17	$1,141.98	$1,738.17	$1,738.17	2026-01-24
881	MS_DRG	Depressive Neuroses	10	10	$1,722.87	$1,722.87	$1,131.93	$1,722.87	$1,722.87	2026-01-24
726	MS_DRG	Benign Prostatic Hypertrophy Without Mcc	11	11	$1,716.59	$1,716.59	$1,127.80	$4,931.21	$1,716.59	2026-01-24
432	MS_DRG	Cirrhosis And Alcoholic Hepatitis With Mcc	10	10	$1,689.58	$1,689.58	$1,110.05	$1,689.58	$1,689.58	2026-01-24
553	MS_DRG	Bone Diseases And Arthropathies With Mcc	10	10	$1,638.94	$1,638.94	$1,076.78	$1,638.94	$1,638.94	2026-01-24
316	MS_DRG	Other Circulatory System Diagnoses Without Cc/mcc	11	11	$1,620.24	$1,620.24	$1,064.50	$4,658.70	$1,620.24	2026-01-24
203	MS_DRG	Bronchitis And Asthma Without Cc/mcc	11	11	$1,599.90	$1,599.90	$1,051.13	$4,576.05	$1,599.90	2026-01-24
310	MS_DRG	Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc	12	12	$1,563.95	$1,563.95	$1,027.52	$4,542.95	$1,563.95	2026-01-24
185	MS_DRG	Major Chest Trauma Without Cc/mcc	10	10	$1,560.23	$1,560.23	$1,025.07	$1,560.23	$1,560.23	2026-01-24
37246	HCPCS	Balloon Dilation Of Artery With Review By Radiologist, Initial Artery	26	16	$1,540.00	$1,540.00	$438.90	$7,959.34	$3,270.96	2026-01-24
36831	HCPCS	Removal Of Blood Clot From Hemodialysis Graft	26	16	$1,100.00	$1,100.00	$313.50	$7,660.62	$3,148.20	2026-01-24

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