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

SAVOY MEDICAL CENTER

Mamou, LA · CCN 190025 · Rates published

17,247 distinct procedures filed
10 distinct payers
321,348 rate rows
2026-03-15 last MRF observed
Data quality

247,508 of 321,348 rate rows are consumer-grade (77.0%)

73,840 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 65,142
per-diem day rate — not a per-procedure price 5,613
template filing: same amount across many unrelated codes — excluded 2,130
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 779
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 114
placeholder amount (≤ $0.02) — excluded from medians 44
exceeds 10× this hospital's gross charge — excluded from medians 18
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://savoymedical.com/pricing/80-0202027_SavoyMedicalCenter_standardcharges.csv
Found on page https://savoymedical.com/price-transparency/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-09-21
Content fingerprint c267dcd55f159e5f… · 610,354 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
J1414
HCPCS 		Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose 10 $3,611,511.82 $9,931,657.51 $4,254,360.92 nat. median
$3,508,750
1.2× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 10 $3,611,511.82 $9,931,657.51 $4,183,614.78 nat. median
$3,685,267
1.1× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 10 $3,233,599.24 $8,892,397.91 $3,741,400.95 nat. median
$3,325,455
1.1× median
J3394
HCPCS 		Injection, Lovotibeglogene Autotemcel, Per Treatment 10 $3,108,236.45 $8,547,650.24 $3,661,502.54 nat. median
$3,248,446
1.1× median
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 10 $2,889,209.45 $7,945,325.99 $3,403,488.73 nat. median
$2,968,000
1.1× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 10 $2,339,654.90 $6,434,050.98 $2,692,960.61 nat. median
$2,455,111
1.1× median
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 10 $2,270,093.14 $6,242,756.14 $2,674,169.72 nat. median
$2,332,000
1.1× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 10 $527,587.17 $1,514,173.10 $628,445.11 nat. median
$621,313
1.0× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 10 $6,875.00 $1,475,877.34 $527,360.18 nat. median
$599,737
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 10 $91,323.63 $1,382,631.20 $505,976.25 nat. median
$579,571
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 10 $98.13 $1,414,290.60 $504,229.13 nat. median
$574,037
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 10 $71,000.00 $1,306,512.24 $476,182.11 nat. median
$513,770
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 10 $32,480.00 $1,310,435.75 $471,879.74 nat. median
$562,501
0.8× median
100T
OTHER 		Prosth Retina Receive&gen 6 $7,420.00 $411,515.93 $310,491.95 nat. median
$2,520
outlier · 123.2×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 10 $975.00 $576,689.74 $175,859.50 nat. median
$168,055
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 10 $975.00 $362,760.00 $111,001.55 nat. median
$131,925
0.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 9 $975.00 $430,738.90 $109,171.96 nat. median
$186,516
0.6× median
Q0480
HCPCS 		Dme Pos 6 $99,999.96 $102,680.21 $101,340.09 nat. median
$108,243
0.9× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 10 $975.00 $327,723.84 $100,359.24 nat. median
$145,435
0.7× median
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 10 $61,718.93 $169,727.06 $78,127.16 nat. median
$66,211
1.2× median
33276
CPT 		Insj Phrnc Nrv Stim Sys 10 $4,328.00 $151,170.18 $66,673.82 nat. median
$44,163
1.5× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 10 $975.00 $216,070.56 $66,444.34 nat. median
$97,418
0.7× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 10 $47,948.60 $148,671.02 $65,576.78 nat. median
$63,499
1.0× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 10 $55,316.05 $152,119.14 $65,567.32 nat. median
$65,477
1.0× median
38240
CPT 		Transplt Allo Hct/donor 10 $145.39 $158,323.83 $60,951.30 nat. median
$28,331
outlier · 2.2×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 10 $975.00 $200,347.73 $57,432.36 nat. median
$72,715
0.8× median
J9226
HCPCS 		Supprelin La Implant 10 $43,324.60 $121,165.69 $54,049.04 nat. median
$57,036
0.9× median
J9347
HCPCS 		Imjudo IV Soln 300mg 10 $134.76 $197,199.49 $52,650.21 nat. median
$355
outlier · 148.5×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 10 $975.00 $166,585.37 $51,413.11 nat. median
$74,509
0.7× median
7
MS_DRG 		Lung Transplant 9 $975.00 $199,843.10 $51,241.85 nat. median
$70,649
0.7× median
215
MS_DRG 		Other Heart Assist System Implant 10 $975.00 $162,011.64 $50,023.83 nat. median
$73,023
0.7× median
915T
OTHER 		Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 10 $4,328.00 $107,704.47 $49,650.04 nat. median
$48,103
1.0× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 10 $975.00 $160,185.82 $49,469.24 nat. median
$2,736
outlier · 18.1×
266T
OTHER 		Implt/rpl Crtd Sns Dev Total 10 $4,328.00 $120,466.20 $47,174.67 nat. median
$7,159
outlier · 6.6×
L7180
HCPCS 		Dme Pos 6 $46,054.76 $47,877.56 $46,966.16 nat. median
$42,745
1.1× median
33231
CPT 		Insrt Pulse Gen W/mult Leads 10 $4,328.00 $104,011.08 $46,796.13 nat. median
$31,377
1.5× median
33264
CPT 		Rmvl & Rplcmt Dfb Gen Mlt Ld 10 $4,328.00 $104,011.08 $46,796.13 nat. median
$32,779
1.4× median
L7181
HCPCS 		Dme Pos 6 $45,680.56 $47,488.54 $46,584.55 nat. median
$48,410
1.0× median
33270
CPT 		Ins/rep Subq Defibrillator 10 $4,328.00 $101,930.87 $46,406.09 nat. median
$32,475
1.4× median
571T
OTHER 		Insj/rplcmt Icds Ss Eltrd 10 $4,328.00 $101,930.87 $46,406.09 nat. median
$48,103
1.0× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 $975.00 $147,580.94 $45,640.48 nat. median
$69,822
0.7× median
64582
CPT 		Opn Mpltj Hpglsl Nstm Ary Pg 10 $4,328.00 $100,992.25 $44,864.92 nat. median
$29,815
1.5× median
33287
CPT 		Rmv&rplcmt Phrnc Nrv Stim Pg 10 $4,328.00 $99,389.22 $44,564.35 nat. median
$27,599
1.6× median
850
MS_DRG 		Acute Leukemia With Other Procedures 10 $975.00 $140,864.86 $43,600.45 nat. median
$2,633
outlier · 16.6×
64568
CPT 		Opn Impltj Crnl Nrv Nea&pg 10 $4,328.00 $93,696.89 $43,497.04 nat. median
$27,905
1.6× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 9 $975.00 $168,509.04 $43,380.36 nat. median
$65,418
0.7× median
69930
CPT 		Implant Cochlear Device 10 $1,358.78 $109,513.11 $42,744.10 nat. median
$23,645
1.8× median
33289
CPT 		Tcat Impl Wrls P-art Prs Snr 10 $4,328.00 $98,564.31 $42,699.45 nat. median
$28,889
1.5× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 9 $975.00 $162,846.55 $41,959.68 nat. median
$69,922
0.6× median
33249
CPT 		Insj/rplcmt Defib W/lead(s) 10 $1,091.28 $101,930.87 $41,371.11 nat. median
$32,069
1.3× median

Other procedures at this hospital

Browse this hospital's 17,247 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J1414 HCPCS Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose 18 10 — — $3,611,511.82 $9,931,657.51 $4,254,360.92 2026-03-15
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 20 10 — — $3,611,511.82 $9,931,657.51 $4,183,614.78 2026-03-15
J1413 HCPCS Inj Delandistrogene Mox Rokl 20 10 — — $3,233,599.24 $8,892,397.91 $3,741,400.95 2026-03-15
J3394 HCPCS Injection, Lovotibeglogene Autotemcel, Per Treatment 18 10 — — $3,108,236.45 $8,547,650.24 $3,661,502.54 2026-03-15
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 18 10 — — $2,889,209.45 $7,945,325.99 $3,403,488.73 2026-03-15
J3399 HCPCS Inj Onase Abepar-xioi Treat 20 10 — — $2,339,654.90 $6,434,050.98 $2,692,960.61 2026-03-15
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 18 10 — — $2,270,093.14 $6,242,756.14 $2,674,169.72 2026-03-15
Q2042 HCPCS Tisagenlecleucel Car-pos T 20 10 — — $527,587.17 $1,514,173.10 $628,445.11 2026-03-15
Q2056 HCPCS Ciltacabtagene Car-pos T 20 10 — — $6,875.00 $1,475,877.34 $527,360.18 2026-03-15
Q2054 HCPCS Lisocabtagene Mara Car Pos T 20 10 — — $91,323.63 $1,382,631.20 $505,976.25 2026-03-15
Q2055 HCPCS Idecabtagene Vicleucel Car 20 10 — — $98.13 $1,414,290.60 $504,229.13 2026-03-15
Q2053 HCPCS Brexucabtagene Car Pos T 20 10 — — $71,000.00 $1,306,512.24 $476,182.11 2026-03-15
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 20 10 — — $32,480.00 $1,310,435.75 $471,879.74 2026-03-15
100T OTHER Prosth Retina Receive&gen 11 6 — — $7,420.00 $411,515.93 $310,491.95 2026-03-15
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 20 10 — — $975.00 $576,689.74 $175,859.50 2026-03-15
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 20 10 — — $975.00 $362,760.00 $111,001.55 2026-03-15
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 15 9 — — $975.00 $430,738.90 $109,171.96 2026-03-15
Q0480 HCPCS Dme Pos 13 6 — — $99,999.96 $102,680.21 $101,340.09 2026-03-15
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 20 10 — — $975.00 $327,723.84 $100,359.24 2026-03-15
J9029 HCPCS Instill Adstiladrin, Tx Dose 20 10 — — $61,718.93 $169,727.06 $78,127.16 2026-03-15
33276 CPT Insj Phrnc Nrv Stim Sys 20 10 — — $4,328.00 $151,170.18 $66,673.82 2026-03-15
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 20 10 — — $975.00 $216,070.56 $66,444.34 2026-03-15
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 20 10 — — $47,948.60 $148,671.02 $65,576.78 2026-03-15
A9543 HCPCS Y90 Ibritumomab, Rx 20 10 — — $55,316.05 $152,119.14 $65,567.32 2026-03-15
38240 CPT Transplt Allo Hct/donor 20 10 — — $145.39 $158,323.83 $60,951.30 2026-03-15
14 MS_DRG Allogeneic Bone Marrow Transplant 17 10 — — $975.00 $200,347.73 $57,432.36 2026-03-15
J9226 HCPCS Supprelin La Implant 20 10 — — $43,324.60 $121,165.69 $54,049.04 2026-03-15
J9347 HCPCS Imjudo IV Soln 300mg 20 10 $281,713.57 $169,028.14 40% off $134.76 $197,199.49 $52,650.21 2026-03-15
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 20 10 — — $975.00 $166,585.37 $51,413.11 2026-03-15
7 MS_DRG Lung Transplant 15 9 — — $975.00 $199,843.10 $51,241.85 2026-03-15
215 MS_DRG Other Heart Assist System Implant 20 10 — — $975.00 $162,011.64 $50,023.83 2026-03-15
915T OTHER Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 18 10 — — $4,328.00 $107,704.47 $49,650.04 2026-03-15
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 20 10 — — $975.00 $160,185.82 $49,469.24 2026-03-15
266T OTHER Implt/rpl Crtd Sns Dev Total 20 10 — — $4,328.00 $120,466.20 $47,174.67 2026-03-15
L7180 HCPCS Dme Pos 13 6 — — $46,054.76 $47,877.56 $46,966.16 2026-03-15
33231 CPT Insrt Pulse Gen W/mult Leads 20 10 — — $4,328.00 $104,011.08 $46,796.13 2026-03-15
33264 CPT Rmvl & Rplcmt Dfb Gen Mlt Ld 20 10 — — $4,328.00 $104,011.08 $46,796.13 2026-03-15
L7181 HCPCS Dme Pos 13 6 — — $45,680.56 $47,488.54 $46,584.55 2026-03-15
571T OTHER Insj/rplcmt Icds Ss Eltrd 20 10 — — $4,328.00 $101,930.87 $46,406.09 2026-03-15
33270 CPT Ins/rep Subq Defibrillator 20 10 — — $4,328.00 $101,930.87 $46,406.09 2026-03-15
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 10 — — $975.00 $147,580.94 $45,640.48 2026-03-15
64582 CPT Opn Mpltj Hpglsl Nstm Ary Pg 20 10 — — $4,328.00 $100,992.25 $44,864.92 2026-03-15
33287 CPT Rmv&rplcmt Phrnc Nrv Stim Pg 20 10 — — $4,328.00 $99,389.22 $44,564.35 2026-03-15
850 MS_DRG Acute Leukemia With Other Procedures 20 10 — — $975.00 $140,864.86 $43,600.45 2026-03-15
64568 CPT Opn Impltj Crnl Nrv Nea&pg 20 10 — — $4,328.00 $93,696.89 $43,497.04 2026-03-15
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 15 9 — — $975.00 $168,509.04 $43,380.36 2026-03-15
69930 CPT Implant Cochlear Device 20 10 — — $1,358.78 $109,513.11 $42,744.10 2026-03-15
33289 CPT Tcat Impl Wrls P-art Prs Snr 20 10 — — $4,328.00 $98,564.31 $42,699.45 2026-03-15
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 15 9 — — $975.00 $162,846.55 $41,959.68 2026-03-15
33249 CPT Insj/rplcmt Defib W/lead(s) 20 10 — — $1,091.28 $101,930.87 $41,371.11 2026-03-15
408T OTHER Insj/rplc Cardiac Modulj Sys 20 10 — — $4,328.00 $85,828.74 $41,220.78 2026-03-15
C9760 HCPCS Non-blind Interatrial Shunt 20 10 — — $4,328.00 $92,382.43 $40,850.59 2026-03-15
C9606 HCPCS Perc D-e Cor Revasc W Ami S 11 6 — — $10,611.51 $50,588.27 $40,594.08 2026-03-15
231 MS_DRG Coronary Bypass With Ptca With Mcc 20 10 — — $975.00 $129,579.65 $40,172.55 2026-03-15
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 20 10 — — $975.00 $129,507.77 $40,150.72 2026-03-15
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 20 10 — — $975.00 $127,541.28 $39,553.39 2026-03-15
620T OTHER Evasc Ven Artlz Tibl/prnl Vn 20 10 — — $4,328.00 $93,696.21 $39,022.39 2026-03-15
61886 CPT Implant Neurostim Arrays 20 10 — — $844.44 $91,822.94 $38,445.53 2026-03-15
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 20 10 — — $975.00 $123,267.26 $38,255.15 2026-03-15
L2006 HCPCS Dme Pos 13 6 — — $37,842.37 $37,842.37 $37,842.37 2026-03-15
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 20 10 — — $975.00 $121,221.24 $37,633.67 2026-03-15
268T OTHER Implt/rpl Crtd Sns Dev Gen 20 10 — — $4,328.00 $81,577.71 $37,498.86 2026-03-15
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 20 10 — — $975.00 $119,525.40 $37,118.55 2026-03-15
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 10 — — $975.00 $118,318.90 $36,752.08 2026-03-15
J7330 HCPCS Cultured Chondrocytes Implnt 11 6 — — $33,406.63 $43,088.81 $36,634.02 2026-03-15
63685 CPT Ins/rplc Spi Npg/rcvr Pocket 20 10 — — $440.19 $81,577.71 $36,267.52 2026-03-15
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 20 10 — — $975.00 $114,139.70 $35,482.64 2026-03-15
34707 CPT Evasc Rpr Ilio-iliac Ndgft 11 6 — — $4,328.00 $45,557.52 $35,250.14 2026-03-15
916T OTHER Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 18 10 — — $4,328.00 $75,403.49 $34,852.52 2026-03-15
923T OTHER Removal And Replacement Of Permanent Cardiac Contractility Modulation-defibrilla… 18 10 — — $4,328.00 $75,403.49 $34,852.52 2026-03-15
93653 CPT Compre Ep Eval Tx Svt 20 10 — — $23,360.42 $65,672.89 $34,309.56 2026-03-15
93656 CPT Compre Ep Eval Abltj Atr Fib 20 10 — — $23,360.42 $65,672.89 $34,309.56 2026-03-15
93654 CPT Compre Ep Eval Tx Vt 20 10 — — $23,360.42 $65,672.89 $34,060.75 2026-03-15
55881 CPT Ablation Of Prostate Tissue, Transurethral, Using Thermal Ultrasound, Including … 11 6 — — $4,328.00 $43,645.44 $33,816.08 2026-03-15
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 20 10 — — $975.00 $108,611.78 $33,803.52 2026-03-15
614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 20 10 — — $4,328.00 $77,398.81 $33,768.12 2026-03-15
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 20 10 — — $975.00 $108,065.86 $33,637.69 2026-03-15
92941 CPT Prq Card Revasc Mi 1 Vsl 11 6 — — $33,189.31 $33,189.31 $33,189.31 2026-03-15
33262 CPT Rmvl& Replc Pulse Gen 1 Lead 20 10 — — $4,328.00 $74,275.87 $33,182.57 2026-03-15
33230 CPT Insrt Pulse Gen W/dual Leads 20 10 — — $4,328.00 $74,275.87 $33,182.57 2026-03-15
414T OTHER Rmvl & Rpl Car Modulj Pls Gn 20 10 — — $4,328.00 $74,275.87 $33,182.57 2026-03-15
409T OTHER Insj/rplc Car Modulj Pls Gn 20 10 — — $4,328.00 $74,275.87 $33,182.57 2026-03-15
33263 CPT Rmvl & Rplcmt Dfb Gen 2 Lead 20 10 — — $4,328.00 $74,275.87 $33,182.57 2026-03-15
515T OTHER Insj Wcs Lv Compl Sys 20 10 — — $4,328.00 $73,892.71 $33,110.73 2026-03-15
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 20 10 — — $975.00 $106,376.14 $33,000.81 2026-03-15
955 MS_DRG Craniotomy For Multiple Significant Trauma 20 10 — — $975.00 $104,415.74 $32,528.97 2026-03-15
674T OTHER Laps Insj Nw/rpcmt Prm Isdss 18 10 — — $4,328.00 $81,577.71 $32,161.57 2026-03-15
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 20 10 — — $975.00 $102,525.72 $31,954.87 2026-03-15
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 20 10 — — $975.00 $102,131.18 $31,835.03 2026-03-15
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 20 10 — — $975.00 $101,958.38 $31,782.54 2026-03-15
J9266 HCPCS Pegaspargase Injection 20 10 — — $23,577.01 $72,467.73 $31,744.95 2026-03-15
10 MS_DRG Pancreas Transplant 15 9 — — $975.00 $121,920.07 $31,691.52 2026-03-15
817T OTHER Opn Insj/rplcmt Ins Ptn Subf 20 10 — — $4,328.00 $70,017.35 $31,457.60 2026-03-15
61891 CPT Rev/rplcmt Sk-mnt Crnl Nstm 20 10 — — $4,328.00 $70,017.35 $31,457.60 2026-03-15
816T OTHER Opn Insj/rplcmt Ins Ptn Subq 20 10 — — $4,328.00 $70,017.35 $31,457.60 2026-03-15
23474 CPT Revis Reconst Shoulder Joint 11 6 — — $4,328.00 $39,978.06 $31,065.54 2026-03-15
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 10 — — $975.00 $98,751.74 $30,808.51 2026-03-15
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 20 10 — — $975.00 $98,893.94 $30,728.07 2026-03-15
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 20 10 — — $975.00 $96,708.79 $30,187.96 2026-03-15
398T OTHER Mrgfus Strtctc Les Abltj 13 6 — — $1,500.63 $58,789.43 $29,856.23 2026-03-15
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 20 10 — — $975.00 $94,722.41 $29,584.59 2026-03-15
33240 CPT Insrt Pulse Gen W/singl Lead 20 10 — — $560.65 $74,275.87 $29,557.91 2026-03-15
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 20 10 — — $975.00 $94,600.06 $29,547.43 2026-03-15
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 20 10 — — $975.00 $94,168.85 $29,416.45 2026-03-15
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 20 10 — — $975.00 $93,840.07 $29,316.58 2026-03-15
232 MS_DRG Coronary Bypass With Ptca Without Mcc 20 10 — — $975.00 $93,411.91 $29,186.53 2026-03-15
28 MS_DRG Spinal Procedures With Mcc 20 10 — — $975.00 $92,965.39 $29,050.90 2026-03-15
888T OTHER Histotripsy (ie, Non-thermal Ablation Via Acoustic Energy Delivery) Of Malignant… 18 10 — — $17,035.92 $58,789.43 $29,003.96 2026-03-15
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 20 10 — — $975.00 $91,609.03 $28,638.90 2026-03-15
C8003 HCPCS Implantation Of Medial Knee Extraarticular Implantable Shock Absorber Spanning T… 18 10 — — $4,328.00 $61,777.69 $28,610.36 2026-03-15
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 10 — — $975.00 $90,974.42 $28,446.14 2026-03-15
C2616 HCPCS Brachytx, Non-str,yttrium-90 20 10 — — $17,020.93 $56,159.40 $28,383.44 2026-03-15
C7515 HCPCS Cath/angio Dial Cir W/embol 11 6 — — $7,420.00 $35,307.79 $28,335.84 2026-03-15
L6880 HCPCS Dme Pos 13 6 — — $28,317.29 $28,317.29 $28,317.29 2026-03-15
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 20 10 — — $975.00 $89,978.93 $28,143.75 2026-03-15
825T OTHER Tcat Rmv&rpl1chmb Ldls Pm Ra 20 10 — — $4,328.00 $62,366.58 $28,028.29 2026-03-15
795T OTHER Tcat Ins 2chmbr Ldls Pm Cmpl 20 10 — — $4,328.00 $62,366.58 $28,028.29 2026-03-15
823T OTHER Tcat Ins 1chmbr Ldls Pm Ra 20 10 — — $4,328.00 $62,366.58 $28,028.29 2026-03-15
796T OTHER Tcat Ins 2chmbr Ldls Pm Ra 20 10 — — $4,328.00 $62,366.58 $28,028.29 2026-03-15
801T OTHER Tcat Rmv&rpl 2chmbr Ldls Pm 20 10 — — $4,328.00 $62,366.58 $28,028.29 2026-03-15
797T OTHER Tcat Ins 2chmbr Ldls Pm Rv 20 10 — — $4,328.00 $62,366.58 $28,028.29 2026-03-15
803T OTHER Tcat Rmv&rpl2chmb Ldls Pm Rv 20 10 — — $4,328.00 $62,366.58 $28,028.29 2026-03-15
802T OTHER Tcat Rmv&rpl2chmb Ldls Pm Ra 20 10 — — $4,328.00 $62,366.58 $28,028.29 2026-03-15
S2067 HCPCS Breast ""stacked"" Diep/gap 11 6 — — $27,945.79 $27,945.79 $27,945.79 2026-03-15
C9797 HCPCS Vasc Emb/occ W/prs Cath 18 10 — — $4,328.00 $60,322.01 $27,943.48 2026-03-15
L5856 HCPCS Dme Pos 13 6 — — $27,368.44 $28,451.67 $27,910.06 2026-03-15
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 20 10 — — $975.00 $89,032.39 $27,856.24 2026-03-15
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 20 10 — — $975.00 $87,764.71 $27,471.18 2026-03-15
33221 CPT Insert Pulse Gen Mult Leads 20 10 — — $4,328.00 $59,075.10 $27,411.13 2026-03-15
33229 CPT Remv&replc Pm Gen Mult Leads 20 10 — — $4,328.00 $59,075.10 $27,411.13 2026-03-15
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 20 10 — — $975.00 $87,240.22 $27,311.86 2026-03-15
786T OTHER Insj/rplcmt Prq Ra Sac Nstim 13 6 — — $4,328.00 $43,600.19 $26,987.54 2026-03-15
27278 CPT Arthrd Si Jt Prq Wo Tfxj Dev 20 10 — — $4,328.00 $59,648.67 $26,926.13 2026-03-15
27280 CPT Arthr Si Jt Opn B1grf Instrm 11 6 — — $1,136.19 $51,635.80 $26,917.96 2026-03-15
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 17 10 — — $975.00 $92,298.67 $26,899.81 2026-03-15
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 17 10 — — $975.00 $92,298.67 $26,899.81 2026-03-15
93590 CPT Perq Transcath Cls Mitral 20 10 — — $17,247.19 $53,817.30 $26,790.74 2026-03-15
93591 CPT Perq Transcath Cls Aortic 20 10 — — $17,247.19 $53,817.30 $26,790.74 2026-03-15
653 MS_DRG Major Bladder Procedures With Mcc 20 10 — — $975.00 $85,244.66 $26,705.71 2026-03-15
92933 CPT Prq Card Stent/ath/angio 20 10 — — $17,247.19 $52,740.94 $26,575.46 2026-03-15
93582 CPT Perq Transcath Closure Pda 20 10 — — $17,247.19 $52,740.94 $26,575.46 2026-03-15
61885 CPT Insrt/redo Neurostim 1 Array 20 10 — — $668.14 $61,706.61 $26,548.42 2026-03-15
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 20 10 — — $975.00 $84,521.35 $26,486.00 2026-03-15
J1300 HCPCS Eculizumab Injection 20 10 — — $218.21 $600.08 $26,448.75 2026-03-15
64580 CPT Opn Impltj Nea Neuromuscular 20 10 — — $321.06 $61,706.61 $26,441.08 2026-03-15
J9600 HCPCS Porfimer Sodium Injection 20 10 — — $22,191.25 $64,859.41 $26,382.02 2026-03-15
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 20 10 — — $975.00 $84,166.58 $26,378.24 2026-03-15
834 MS_DRG Acute Leukemia With Mcc 20 10 — — $975.00 $84,521.35 $26,362.37 2026-03-15
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 20 10 — — $975.00 $83,652.79 $26,222.18 2026-03-15
C9607 HCPCS Perc D-e Cor Revasc Chro Sin 20 10 — — $17,247.19 $50,588.27 $26,144.93 2026-03-15
33902 CPT Perq P-art Revsc 1 Abnor Uni 20 10 — — $4,328.00 $57,704.71 $26,115.70 2026-03-15
36836 CPT Prq Av Fstl Crtj Uxtr 1 Acs 20 10 — — $4,328.00 $57,704.71 $26,115.70 2026-03-15
36837 CPT Prq Av Fstl Crt Uxtr Sep Acs 20 10 — — $4,328.00 $57,704.71 $26,115.70 2026-03-15
C9782 HCPCS Blind Myocar Trpl Bon Marrow 20 10 — — $4,328.00 $58,789.43 $26,094.46 2026-03-15
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 20 10 — — $975.00 $83,013.60 $26,028.02 2026-03-15
33274 CPT Tcat Insj/rpl Perm Ldls Pm 20 10 — — $4,328.00 $51,580.37 $26,005.87 2026-03-15
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 20 10 — — $975.00 $82,590.02 $25,899.36 2026-03-15
64590 CPT Ins/rpl Prph Sac/gstr Npg/r 20 10 — — $332.08 $58,004.23 $25,894.02 2026-03-15
C1882 HCPCS Aicd, Other Than Sing/dual 8 6 — — $25,888.24 $25,888.24 $25,888.24 2026-03-15
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 20 10 — — $975.00 $82,512.05 $25,875.67 2026-03-15
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 20 10 — — $975.00 $82,502.86 $25,872.88 2026-03-15
793T OTHER Prq Tcat Thrm Ablt Nrv P-art 20 10 — — $4,328.00 $56,124.87 $25,819.48 2026-03-15
C1822 HCPCS Gen, Neuro, Hf, Rechg Bat 8 6 — — $25,745.02 $25,745.02 $25,745.02 2026-03-15
C7540 HCPCS Rmv&rplc Pm Dul W/l Vnt Lead 11 6 — — $4,328.00 $32,746.42 $25,641.81 2026-03-15
66683 CPT Implantation Of Iris Prosthesis, Including Suture Fixation And Repair Or Removal… 18 10 — — $4,328.00 $55,147.75 $25,573.08 2026-03-15
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 20 10 — — $975.00 $81,354.46 $25,524.05 2026-03-15
308T OTHER Insj Ocular Telescope Prosth 20 10 — — $7,420.00 $58,993.64 $25,423.87 2026-03-15
24371 CPT Revise Reconst Elbow Joint 20 10 — — $4,328.00 $51,635.80 $25,423.71 2026-03-15
22867 CPT Insj Stablj Dev W/dcmprn 20 10 — — $4,328.00 $51,635.80 $25,423.71 2026-03-15
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 10 — — $975.00 $80,995.10 $25,414.90 2026-03-15
C9774 HCPCS Revasc Lithotr-ather Tib/per 20 10 — — $4,328.00 $53,963.80 $25,414.28 2026-03-15
C9767 HCPCS Revasc Lithotrip-stent-ather 20 10 — — $4,328.00 $53,963.80 $25,414.28 2026-03-15
C9775 HCPCS Revasc Lith-sten-ath Tib/per 20 10 — — $4,328.00 $53,963.80 $25,414.28 2026-03-15
C9773 HCPCS Revasc Lithotr-stent Tib/per 20 10 — — $4,328.00 $53,963.80 $25,414.28 2026-03-15
36906 CPT Thrmbc/nfs Dialysis Circuit 20 10 — — $4,328.00 $53,817.30 $25,386.81 2026-03-15
238T OTHER Trluml Perip Athrc Iliac Art 20 10 — — $4,328.00 $53,817.30 $25,386.81 2026-03-15
37231 CPT Tib/per Revasc Stent & Ather 20 10 — — $4,328.00 $53,817.30 $25,386.81 2026-03-15
27279 CPT Arthrd Si Jt Perq/min Nvas 20 10 — — $4,328.00 $50,603.08 $25,230.08 2026-03-15
C9602 HCPCS Perc D-e Cor Stent Ather S 20 10 — — $17,247.19 $48,070.08 $25,176.22 2026-03-15
C7539 HCPCS Insrt A & V Pm W/l Vent Lead 11 6 — — $4,328.00 $32,091.49 $25,150.62 2026-03-15
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 20 10 — — $975.00 $78,753.36 $24,733.96 2026-03-15
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 20 10 — — $975.00 $78,491.88 $24,654.54 2026-03-15
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 20 10 — — $975.00 $77,904.67 $24,476.17 2026-03-15
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 20 10 — — $975.00 $77,666.14 $24,403.72 2026-03-15
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 20 10 — — $975.00 $77,022.36 $24,208.17 2026-03-15
54411 CPT Remov/replc Penis Pros Comp 20 10 — — $1,260.28 $53,884.08 $24,197.25 2026-03-15
54410 CPT Remove/replace Penis Prosth 20 10 — — $1,065.65 $53,884.08 $24,175.63 2026-03-15
C7538 HCPCS Insrt Vent Pm W/l Vent Lead 11 6 — — $4,328.00 $30,781.64 $24,168.23 2026-03-15
54416 CPT Remv/repl Penis Contain Pros 20 10 — — $864.95 $53,884.08 $24,153.33 2026-03-15
53444 CPT Insert Tandem Cuff 20 10 — — $982.00 $53,884.08 $24,063.33 2026-03-15
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 20 10 — — $975.00 $76,508.54 $24,052.10 2026-03-15
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 20 10 — — $975.00 $76,477.97 $24,042.81 2026-03-15
53445 CPT Insert Uro/ves Nck Sphincter 20 10 — — $1,082.18 $53,884.08 $24,005.69 2026-03-15
54405 CPT Insert Multi-comp Penis Pros 20 10 — — $1,000.85 $53,884.08 $23,992.64 2026-03-15
54401 CPT Insert Self-contd Prosthesis 20 10 — — $798.68 $53,884.08 $23,970.18 2026-03-15
228 MS_DRG Other Cardiothoracic Procedures With Mcc 20 10 — — $975.00 $76,202.71 $23,959.20 2026-03-15
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 20 10 — — $975.00 $76,568.18 $23,946.58 2026-03-15
37229 CPT Tib/per Revasc W/ather 20 10 — — $4,328.00 $48,070.08 $23,873.20 2026-03-15
37227 CPT Fem/popl Revasc Stnt & Ather 20 10 — — $4,328.00 $48,070.08 $23,873.20 2026-03-15
37230 CPT Tib/per Revasc W/stent 20 10 — — $4,328.00 $48,070.08 $23,873.20 2026-03-15
93581 CPT Transcath Closure Of Vsd 20 10 — — $1,599.81 $53,817.30 $23,827.10 2026-03-15
53447 CPT Remove/replace Ur Sphincter 20 10 — — $1,001.50 $53,884.08 $23,820.94 2026-03-15
93580 CPT Transcath Closure Of Asd 20 10 — — $1,217.85 $53,817.30 $23,782.16 2026-03-15
553T OTHER Perq Tcat Iliac Anast Implt 11 6 — — $4,328.00 $30,011.62 $23,590.72 2026-03-15
C7535 HCPCS Fem/pop Revasc W/stent & US 11 6 — — $4,328.00 $30,011.62 $23,590.72 2026-03-15
C7534 HCPCS Fem/pop Revasc W/arthr & US 11 6 — — $4,328.00 $30,011.62 $23,590.72 2026-03-15
245 MS_DRG Aicd Generator Procedures 20 10 — — $975.00 $74,727.07 $23,510.97 2026-03-15
33967 CPT Insert I-aort Percut Device 13 6 — — $323.71 $53,547.14 $23,482.04 2026-03-15
63655 CPT Implant Neuroelectrodes 20 10 — — $913.46 $57,406.55 $23,456.60 2026-03-15
471 MS_DRG Cervical Spinal Fusion With Mcc 20 10 — — $975.00 $74,275.97 $23,373.95 2026-03-15
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 20 10 — — $975.00 $73,025.11 $22,994.00 2026-03-15
686T OTHER Histotripsy Mal Hepatcel Tis 20 10 — — $4,328.00 $46,848.78 $22,945.12 2026-03-15
C9758 HCPCS Blind Interatrial Shunt Ide 20 10 — — $4,328.00 $46,848.78 $22,945.12 2026-03-15
520T OTHER Rmv&rplcmt Pg Wcs Lv Battery 20 10 — — $4,328.00 $73,892.71 $22,938.80 2026-03-15
20696 CPT App Mltpln Uni Xtrnl Fix 1st 20 10 — — $1,210.94 $51,635.80 $22,905.18 2026-03-15
21243 CPT Reconstruction Of Jaw Joint 20 10 — — $1,826.01 $51,635.80 $22,904.75 2026-03-15
799 MS_DRG Splenic Procedures With Mcc 20 10 — — $975.00 $72,708.58 $22,897.85 2026-03-15
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 20 10 — — $975.00 $72,694.82 $22,893.67 2026-03-15
23616 CPT Optx Prx Hmrl Fx Fix Rpr Rpl 20 10 — — $1,432.78 $51,635.80 $22,792.39 2026-03-15
24363 CPT Replace Elbow Joint 20 10 — — $1,648.65 $51,635.80 $22,782.04 2026-03-15
680T OTHER Insj/rplcmt Pg Only Isdss 18 10 — — $4,328.00 $57,406.55 $22,748.80 2026-03-15
25446 CPT Wrist Replacement 20 10 — — $1,299.28 $51,635.80 $22,743.22 2026-03-15
24361 CPT Reconstruct Elbow Joint 20 10 — — $1,108.64 $51,635.80 $22,722.04 2026-03-15
25442 CPT Reconstruct Wrist Joint 20 10 — — $875.19 $51,635.80 $22,696.10 2026-03-15
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 20 10 — — $975.00 $71,942.47 $22,665.14 2026-03-15
63664 CPT Revise Spine Eltrd Plate 20 10 — — $7,420.00 $61,706.61 $22,646.06 2026-03-15
62360 CPT Insert Spine Infusion Device 20 10 — — $307.56 $55,229.58 $22,585.27 2026-03-15
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 20 10 — — $975.00 $71,557.13 $22,548.09 2026-03-15
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 20 10 — — $975.00 $71,135.09 $22,419.90 2026-03-15
22856 CPT Tot Disc Arthrp 1ntrspc Crv 20 10 — — $1,843.01 $49,230.12 $22,287.28 2026-03-15
L8614 HCPCS Dme Pos 13 6 — — $21,822.64 $22,686.36 $22,254.50 2026-03-15
163 MS_DRG Major Chest Procedures With Mcc 20 10 — — $975.00 $70,482.12 $22,221.56 2026-03-15
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 20 10 — — $975.00 $70,453.08 $22,212.74 2026-03-15
L6975 HCPCS Dme Pos 13 6 — — $21,772.25 $22,633.97 $22,203.11 2026-03-15
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 10 — — $975.00 $70,228.30 $22,144.46 2026-03-15
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 20 10 — — $975.00 $70,217.59 $22,141.21 2026-03-15
27284 CPT Arthrodesis Hip Joint 11 6 — — $1,745.38 $41,615.51 $22,110.88 2026-03-15
L6970 HCPCS Dme Pos 13 6 — — $21,656.01 $22,513.14 $22,084.58 2026-03-15
62362 CPT Implant Spine Infusion Pump 20 10 — — $455.98 $51,915.80 $22,049.47 2026-03-15
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 15 9 — — $975.00 $83,203.22 $21,977.74 2026-03-15
Q0483 HCPCS Dme Pos 13 6 — — $21,375.79 $22,221.81 $21,798.80 2026-03-15
37242 CPT Vasc Embolize/occlude Artery 20 10 — — $4,328.00 $48,070.08 $21,783.88 2026-03-15
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 20 10 — — $975.00 $68,989.66 $21,768.22 2026-03-15
L6965 HCPCS Dme Pos 13 6 — — $21,305.91 $22,149.18 $21,727.54 2026-03-15
C1820 HCPCS Generator Neuro Rechg Bat Sy 8 6 — — $21,721.59 $21,721.59 $21,721.59 2026-03-15
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 20 10 — — $975.00 $68,578.32 $21,643.28 2026-03-15
C9765 HCPCS Revasc Intra Lithotrip-stent 20 10 — — $4,328.00 $48,070.08 $21,621.81 2026-03-15
C9766 HCPCS Revasc Intra Lithotrip-ather 20 10 — — $4,328.00 $48,070.08 $21,621.81 2026-03-15
L5858 HCPCS Dme Pos 13 6 — — $21,188.51 $22,027.14 $21,607.83 2026-03-15
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 20 10 — — $975.00 $68,388.70 $21,585.68 2026-03-15
28705 CPT Fusion Of Foot Bones 20 10 — — $1,480.21 $49,230.12 $21,506.76 2026-03-15
525T OTHER Insj/rplcmt Compl Iims 20 10 — — $4,328.00 $51,053.42 $21,474.45 2026-03-15
901 MS_DRG Wound Debridements For Injuries With Mcc 20 10 — — $975.00 $67,749.50 $21,391.52 2026-03-15
C1721 HCPCS Aicd, Dual Chamber 8 6 — — $21,358.44 $21,358.44 $21,358.44 2026-03-15
62361 CPT Implant Spine Infusion Pump 20 10 — — $427.14 $47,313.56 $21,217.82 2026-03-15
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 20 10 — — $975.00 $67,173.02 $21,216.41 2026-03-15
22633 CPT Arthrd Cmbn 1ntrspc Lumbar 20 10 — — $4,328.00 $49,230.12 $21,161.69 2026-03-15
C1722 HCPCS Aicd, Single Chamber 8 6 — — $21,056.15 $21,056.15 $21,056.15 2026-03-15
37225 CPT Fem/popl Revas W/ather 20 10 — — $4,328.00 $48,070.08 $20,923.25 2026-03-15
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 20 10 — — $975.00 $66,029.21 $20,868.98 2026-03-15
S2068 HCPCS Breast Diep Or Siea Flap 11 6 — — $20,812.15 $20,812.15 $20,812.15 2026-03-15
22869 CPT Insj Stablj Dev Without Dcmprn 20 10 — — $4,328.00 $51,635.80 $20,792.06 2026-03-15
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 20 10 — — $975.00 $66,165.31 $20,786.69 2026-03-15
49188 CPT Excision Or Destruction, Open, Intra-abdominal (ie, Peritoneal, Mesenteric, Retr… 11 6 — — $4,328.00 $26,244.80 $20,765.60 2026-03-15
49189 CPT Excision Or Destruction, Open, Intra-abdominal (ie, Peritoneal, Mesenteric, Retr… 11 6 — — $4,328.00 $26,244.80 $20,765.60 2026-03-15
49190 CPT Excision Or Destruction, Open, Intra-abdominal (ie, Peritoneal, Mesenteric, Retr… 11 6 — — $4,328.00 $26,244.80 $20,765.60 2026-03-15
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 20 10 — — $975.00 $65,229.46 $20,626.05 2026-03-15
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 20 10 — — $975.00 $65,133.12 $20,596.79 2026-03-15
140 MS_DRG Major Head And Neck Procedures With Mcc 20 10 — — $975.00 $64,671.31 $20,456.51 2026-03-15
L5973 HCPCS Dme Pos 13 6 — — $20,390.96 $20,390.96 $20,390.96 2026-03-15
55882 CPT Ablation Of Prostate Tissue, Transurethral, Using Thermal Ultrasound, Including … 18 10 — — $4,328.00 $43,645.44 $20,303.71 2026-03-15
31 MS_DRG Ventricular Shunt Procedures With Mcc 20 10 — — $975.00 $64,081.06 $20,277.22 2026-03-15
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 20 10 — — $975.00 $64,065.77 $20,272.58 2026-03-15
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 20 10 — — $975.00 $63,623.83 $20,138.34 2026-03-15
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 20 10 — — $975.00 $62,880.67 $19,912.60 2026-03-15
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 20 10 — — $975.00 $62,845.49 $19,901.92 2026-03-15
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 20 10 — — $975.00 $62,752.22 $19,873.59 2026-03-15
23472 CPT Reconstruct Shoulder Joint 20 10 — — $1,681.13 $49,230.12 $19,847.34 2026-03-15
64575 CPT Opn Impltj Nea Perph Nerve 20 10 — — $315.75 $61,706.61 $19,821.36 2026-03-15
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 20 10 — — $975.00 $62,443.32 $19,779.76 2026-03-15
G0340 HCPCS Robt Lin-radsurg Fractx 2-5 11 6 — — $4,328.00 $24,907.13 $19,762.35 2026-03-15
G0339 HCPCS Robot Lin-radsurg Com, First 11 6 — — $4,328.00 $24,907.13 $19,762.35 2026-03-15
81416 CPT Exome Sequence Analysis 20 10 — — $12,000.00 $40,311.60 $19,755.42 2026-03-15
C7537 HCPCS Insrt Atril Pm W/l Vent Lead 11 6 — — $4,328.00 $24,887.27 $19,747.45 2026-03-15
6 MS_DRG Liver Transplant Without Mcc 15 9 — — $975.00 $74,152.10 $19,706.88 2026-03-15
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 20 10 — — $975.00 $62,197.13 $19,704.98 2026-03-15
Q0488 HCPCS Pwr Pack Base Elec Vad, Rep 11 6 — — $19,661.13 $19,661.13 $19,661.13 2026-03-15
61715 CPT Magnetic Resonance Image Guided High Intensity Focused Ultrasound (MRgFUS), Ster… 18 10 — — $4,328.00 $41,891.51 $19,500.22 2026-03-15
L8687 HCPCS Implt Nrostm Pls Gen Dua Rec 11 6 — — $19,401.95 $19,401.95 $19,401.95 2026-03-15
69730 CPT Rplc Oi Implt Sk Tc Esp>=100 20 10 — — $4,328.00 $43,832.42 $19,328.92 2026-03-15
C9781 HCPCS Arthro/shoul Surg; W/spacer 20 10 — — $4,328.00 $43,832.42 $19,328.92 2026-03-15
69729 CPT Impl Oi Implt Sk Tc Esp>=100 20 10 — — $4,328.00 $43,832.42 $19,328.92 2026-03-15
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 20 10 — — $975.00 $60,917.21 $19,316.20 2026-03-15
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 20 10 — — $975.00 $60,874.39 $19,303.19 2026-03-15
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 20 10 — — $975.00 $60,336.14 $19,139.70 2026-03-15
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 20 10 — — $1,600.00 $39,013.66 $19,114.23 2026-03-15
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 20 10 — — $975.00 $60,212.28 $19,102.07 2026-03-15
64596 CPT Ins/rplcmt Prq Eltrd Ra Pn 1 20 10 — — $4,328.00 $43,600.19 $19,057.86 2026-03-15
33288 CPT Rmv&rplcmt Phrnc Nrv Stim Ld 20 10 — — $4,328.00 $43,600.19 $19,057.86 2026-03-15
784T OTHER Ins/rplmt Eltrd Ra Spi Nstim 20 10 — — $4,328.00 $43,600.19 $19,057.86 2026-03-15
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