|
27000000004-1176
|
CDM
|
Drape Surg W/17 5/8x11.75in Towl Ster
|
61
|
36
|
$66,068.70
|
—
|
$58,173.49
|
$65,408.01
|
$62,302.78
|
2025-01-01
|
|
27000000004-1177
|
CDM
|
Drape Surg W/17 5/8x11.75in Towl Ster
|
61
|
36
|
$53,078.20
|
—
|
$46,735.36
|
$52,547.42
|
$50,052.74
|
2025-01-01
|
|
27000000004-1301
|
CDM
|
Marker Skin 1.5mm Arrow D Spot Lead Sm 99/bx
|
61
|
36
|
$46,865.70
|
—
|
$41,265.25
|
$46,397.04
|
$44,194.36
|
2025-01-01
|
|
27000000004-2122
|
CDM
|
Tube Insufl Std Filt 10ft Ster
|
61
|
36
|
$46,865.70
|
—
|
$41,265.25
|
$46,397.04
|
$44,194.36
|
2025-01-01
|
|
27100000002-663
|
CDM
|
Glv Exam Pow Ltx Sm
|
61
|
36
|
$43,692.98
|
—
|
$38,471.67
|
$43,256.05
|
$41,202.48
|
2025-01-01
|
|
27100000002-796
|
CDM
|
Processor Kanso Cp950 Slate Grey
|
61
|
36
|
$36,750.00
|
—
|
$32,358.38
|
$36,382.50
|
$34,655.25
|
2025-01-01
|
|
27100000002-816
|
CDM
|
Glove Vinyl Powder Free Lg
|
61
|
36
|
$166,479.51
|
—
|
$146,585.21
|
$164,814.71
|
$156,990.18
|
2025-01-01
|
|
27200000002-17550
|
CDM
|
Cannula Angiovac 20d Dilator P
|
61
|
36
|
$32,500.00
|
—
|
$28,616.25
|
$32,175.00
|
$30,647.50
|
2025-01-01
|
|
27200000002-17551
|
CDM
|
Cannula Angiovac 180d Dilator
|
61
|
36
|
$32,500.00
|
—
|
$28,616.25
|
$32,175.00
|
$30,647.50
|
2025-01-01
|
|
27200000002-17552
|
CDM
|
Cannula Angiovac 180d Dilator
|
61
|
36
|
$45,500.00
|
—
|
$40,062.75
|
$45,045.00
|
$42,906.50
|
2025-01-01
|
|
27200000002-17624
|
CDM
|
Set Circuit Adv Hls Beq-hls 7050 7.0
|
61
|
36
|
$30,385.00
|
—
|
$26,753.99
|
$30,081.15
|
$28,653.06
|
2025-01-01
|
|
27200000002-17625
|
CDM
|
Set Circuit Adv Hls Beq-hls 7050 7.0
|
61
|
36
|
$30,385.00
|
—
|
$26,753.99
|
$30,081.15
|
$28,653.06
|
2025-01-01
|
|
27200000002-17626
|
CDM
|
Set Circuit Adv Hls Beq-hls 7050 7.0
|
61
|
36
|
$30,385.00
|
—
|
$26,753.99
|
$30,081.15
|
$28,653.06
|
2025-01-01
|
|
27200000002-17627
|
CDM
|
Set Circuit Adv Hls Beq-hls 7050 7.0
|
61
|
36
|
$41,300.00
|
—
|
$36,364.65
|
$40,887.00
|
$38,945.90
|
2025-01-01
|
|
27200000002-17628
|
CDM
|
Set Circuit Adv Hls Beq-hls 7050 7.0
|
61
|
36
|
$41,795.60
|
—
|
$36,801.03
|
$41,377.64
|
$39,413.25
|
2025-01-01
|
|
27200000002-17629
|
CDM
|
Set Circuit Adv Hls Beq-hls 7050 7.0
|
61
|
36
|
$41,300.00
|
—
|
$36,364.65
|
$40,887.00
|
$38,945.90
|
2025-01-01
|
|
27200000002-18300
|
CDM
|
Set Tubing Cardiovasc Proc Kit Bld Syst Vein 50-70cm
|
61
|
36
|
$46,838.16
|
—
|
$41,241.00
|
$46,369.78
|
$44,168.38
|
2025-01-01
|
|
27200000002-18301
|
CDM
|
Set Tubing Cardiovasc Proc Kit Bld Syst Vein 50-70cm
|
61
|
36
|
$46,371.50
|
—
|
$40,830.11
|
$45,907.79
|
$43,728.32
|
2025-01-01
|
|
27200000002-18316
|
CDM
|
Cath Pulsed Fld Ablation Farawave 31mm
|
61
|
36
|
$29,575.00
|
—
|
$26,040.79
|
$29,279.25
|
$27,889.23
|
2025-01-01
|
|
27200000002-18317
|
CDM
|
Cath Pulsed Fld Ablation Farawave 35mm
|
61
|
36
|
$29,575.00
|
—
|
$26,040.79
|
$29,279.25
|
$27,889.23
|
2025-01-01
|
|
27200000002-21145
|
CDM
|
Glv Surg Orth Ltx Maxxus 8.5
|
61
|
36
|
$74,258.59
|
—
|
$65,384.69
|
$73,516.00
|
$70,025.85
|
2025-01-01
|
|
27200000002-21552
|
CDM
|
Hemostat D Stat Flowable 0330
|
61
|
36
|
$87,500.00
|
—
|
$77,043.75
|
$86,625.00
|
$82,512.50
|
2025-01-01
|
|
27200000002-28034
|
CDM
|
Clip Lig Ti Horizon Sm 6/cq
|
61
|
36
|
$71,250.00
|
—
|
$62,735.63
|
$70,537.50
|
$67,188.75
|
2025-01-01
|
|
27200000002-30479
|
CDM
|
Stylet Steerable 30cm
|
61
|
36
|
$138,979.55
|
—
|
$122,371.49
|
$137,589.75
|
$131,057.72
|
2025-01-01
|
|
27200000002-30508
|
CDM
|
Cath Drn 22fr Angiovac Venous 20deg Cannula Coil Reinforced
|
61
|
36
|
$28,750.00
|
—
|
$25,314.38
|
$28,462.50
|
$27,111.25
|
2025-01-01
|
|
27200000002-31348
|
CDM
|
Electrd Lapscp Lwire 33cm Ez Cln Disp
|
61
|
36
|
$43,692.98
|
—
|
$38,471.67
|
$43,256.05
|
$41,202.48
|
2025-01-01
|
|
27800000002-88909
|
CDM
|
Device Ifd Nanolock 7d Std 10mm
|
61
|
36
|
$28,125.00
|
—
|
$24,764.06
|
$27,843.75
|
$26,521.88
|
2025-01-01
|
|
27800000002-88914
|
CDM
|
Device Ifd Nanolock 12d Std 12mm
|
61
|
36
|
$28,125.00
|
—
|
$24,764.06
|
$27,843.75
|
$26,521.88
|
2025-01-01
|
|
27800000002-88920
|
CDM
|
Device Clsur Watchman Flx Laa 20mm
|
61
|
36
|
$42,500.00
|
—
|
$37,421.25
|
$42,075.00
|
$40,077.50
|
2025-01-01
|
|
27800000002-88950
|
CDM
|
Valve Heart Sutrlss Sm
|
61
|
36
|
$33,375.00
|
—
|
$29,386.69
|
$33,041.25
|
$31,472.63
|
2025-01-01
|
|
27800000002-88967
|
CDM
|
Device Impella 5.5 Smartassist
|
61
|
36
|
$146,250.00
|
—
|
$128,773.13
|
$144,787.50
|
$137,913.75
|
2025-01-01
|
|
27800000002-88968
|
CDM
|
Device Impella 5.5 Smartassist
|
61
|
36
|
$146,250.00
|
—
|
$128,773.13
|
$144,787.50
|
$137,913.75
|
2025-01-01
|
|
27800000002-88975
|
CDM
|
Plug Cardiac Amulet Amplatzer 22mm
|
61
|
36
|
$60,424.00
|
—
|
$53,203.33
|
$59,819.76
|
$56,979.83
|
2025-01-01
|
|
27800000002-88976
|
CDM
|
Plug Cardiac Amulet Amplatzer 18mm
|
61
|
36
|
$60,424.00
|
—
|
$53,203.33
|
$59,819.76
|
$56,979.83
|
2025-01-01
|
|
27800000002-88977
|
CDM
|
Plug Cardiac Amulet Amplatzer 18mm
|
61
|
36
|
$60,424.00
|
—
|
$53,203.33
|
$59,819.76
|
$56,979.83
|
2025-01-01
|
|
27800000002-88987
|
CDM
|
Valve Hrt Sapien 3 Ultra 23mm
|
61
|
36
|
$105,625.00
|
—
|
$93,002.81
|
$104,568.75
|
$99,604.38
|
2025-01-01
|
|
27800000002-88988
|
CDM
|
Valve Hrt Sapien 3 Ultra 26mm
|
61
|
36
|
$105,625.00
|
—
|
$93,002.81
|
$104,568.75
|
$99,604.38
|
2025-01-01
|
|
27800000002-88989
|
CDM
|
Device Embol Pipeline Flex 4.5x18mm
|
61
|
36
|
$48,234.38
|
—
|
$42,470.37
|
$47,752.04
|
$45,485.02
|
2025-01-01
|
|
27800000002-88994
|
CDM
|
Device Embol Pipeline Flex 4.25x14mm
|
61
|
36
|
$48,234.38
|
—
|
$42,470.37
|
$47,752.04
|
$45,485.02
|
2025-01-01
|
|
27800000002-88995
|
CDM
|
Device Embol Pipeline Flex 3x16mm
|
61
|
36
|
$48,234.38
|
—
|
$42,470.37
|
$47,752.04
|
$45,485.02
|
2025-01-01
|
|
27800000002-88996
|
CDM
|
Device Embol Pipeline Flex 4.25x25mm
|
61
|
36
|
$51,707.25
|
—
|
$45,528.23
|
$51,190.18
|
$48,759.94
|
2025-01-01
|
|
27800000002-88997
|
CDM
|
Device Embol Pipeline Flex 4.5x12mm
|
61
|
36
|
$48,234.38
|
—
|
$42,470.37
|
$47,752.04
|
$45,485.02
|
2025-01-01
|
|
27800000002-89000
|
CDM
|
Device Embol Pipeline Flex 4x10mm
|
61
|
36
|
$48,234.38
|
—
|
$42,470.37
|
$47,752.04
|
$45,485.02
|
2025-01-01
|
|
27800000002-89002
|
CDM
|
Device Embol Pipeline Flex 4x12mm
|
61
|
36
|
$48,234.38
|
—
|
$42,470.37
|
$47,752.04
|
$45,485.02
|
2025-01-01
|
|
27800000002-89003
|
CDM
|
Device Embol Pipeline Flex 5x30mm
|
61
|
36
|
$26,740.04
|
—
|
$23,544.61
|
$26,472.64
|
$25,215.86
|
2025-01-01
|
|
27800000002-89004
|
CDM
|
Device Embol Pipeline Flex 5x30mm
|
61
|
36
|
$26,740.04
|
—
|
$23,544.61
|
$26,472.64
|
$25,215.86
|
2025-01-01
|
|
27800000002-89010
|
CDM
|
Device Embol Pipeline Flex 4x16mm
|
61
|
36
|
$48,234.38
|
—
|
$42,470.37
|
$47,752.04
|
$45,485.02
|
2025-01-01
|
|
27800000002-89014
|
CDM
|
Device Embol Pipeline Flex 4.5x25mm
|
61
|
36
|
$26,740.04
|
—
|
$23,544.61
|
$26,472.64
|
$25,215.86
|
2025-01-01
|
|
27800000002-89019
|
CDM
|
Device Embol Pipeline Flex 4.25x20mm
|
61
|
36
|
$48,234.38
|
—
|
$42,470.37
|
$47,752.04
|
$45,485.02
|
2025-01-01
|
|
27800000002-89037
|
CDM
|
Stent Graft Confrm Thor 40x40x20 22f
|
61
|
36
|
$45,725.00
|
—
|
$40,260.86
|
$45,267.75
|
$43,118.68
|
2025-01-01
|
|
27800000002-89038
|
CDM
|
Stent Graft Confrm Thor 40x40x20 22f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-89042
|
CDM
|
Plug Cardiac Amulet Amplatzer 20mm
|
61
|
36
|
$60,424.00
|
—
|
$53,203.33
|
$59,819.76
|
$56,979.83
|
2025-01-01
|
|
27800000002-89043
|
CDM
|
Plug Cardiac Amulet Amplatzer 20mm
|
61
|
36
|
$60,424.00
|
—
|
$53,203.33
|
$59,819.76
|
$56,979.83
|
2025-01-01
|
|
27800000002-89062
|
CDM
|
Conduit Konect Resilia Aortic Vlv 23mm
|
61
|
36
|
$52,500.00
|
—
|
$46,226.25
|
$51,975.00
|
$49,507.50
|
2025-01-01
|
|
27800000002-89067
|
CDM
|
Watchman Flx Procedure - Device
|
61
|
36
|
$42,500.00
|
—
|
$37,421.25
|
$42,075.00
|
$40,077.50
|
2025-01-01
|
|
27800000002-89068
|
CDM
|
Watchman Flx Procedure - Device
|
61
|
36
|
$42,500.00
|
—
|
$37,421.25
|
$42,075.00
|
$40,077.50
|
2025-01-01
|
|
27800000002-89069
|
CDM
|
Watchman Flx Procedure - Device
|
61
|
36
|
$65,100.00
|
—
|
$57,320.55
|
$64,449.00
|
$61,389.30
|
2025-01-01
|
|
27800000002-89070
|
CDM
|
Valve Mitral Mitris Resilia Sz 29
|
61
|
36
|
$29,231.25
|
—
|
$25,738.12
|
$28,938.94
|
$27,565.07
|
2025-01-01
|
|
27800000002-89071
|
CDM
|
Valve Mitral Mitris Resilia Sz 33
|
61
|
36
|
$29,231.25
|
—
|
$25,738.12
|
$28,938.94
|
$27,565.07
|
2025-01-01
|
|
27800000002-89072
|
CDM
|
Valve Mitral Mitris Resilia Sz 31
|
61
|
36
|
$29,231.25
|
—
|
$25,738.12
|
$28,938.94
|
$27,565.07
|
2025-01-01
|
|
27800000002-89075
|
CDM
|
Valve Aortic 26mm Evolut Fx
|
61
|
36
|
$97,500.00
|
—
|
$85,848.75
|
$96,525.00
|
$91,942.50
|
2025-01-01
|
|
27800000002-89076
|
CDM
|
Valve Aortic 29mm Evolut Fx
|
61
|
36
|
$97,500.00
|
—
|
$85,848.75
|
$96,525.00
|
$91,942.50
|
2025-01-01
|
|
27800000002-89077
|
CDM
|
Valve Aortic 34mm Evolut Fx
|
61
|
36
|
$75,000.00
|
—
|
$66,037.50
|
$74,250.00
|
$70,725.00
|
2025-01-01
|
|
27800000002-89078
|
CDM
|
Valve Aortic 34mm Evolut Fx
|
61
|
36
|
$97,987.50
|
—
|
$86,277.99
|
$97,007.63
|
$92,402.21
|
2025-01-01
|
|
27800000002-89079
|
CDM
|
Valve Aortic 23mm Evolut Fx
|
61
|
36
|
$75,000.00
|
—
|
$66,037.50
|
$74,250.00
|
$70,725.00
|
2025-01-01
|
|
27800000002-89080
|
CDM
|
Valve Aortic 23mm Evolut Fx
|
61
|
36
|
$97,500.00
|
—
|
$85,848.75
|
$96,525.00
|
$91,942.50
|
2025-01-01
|
|
27800000002-89096
|
CDM
|
Valve Sapien Thv Edwards Resilia 23mm
|
61
|
36
|
$110,500.00
|
—
|
$97,295.25
|
$109,395.00
|
$104,201.50
|
2025-01-01
|
|
27800000002-89097
|
CDM
|
Valve Sapien Thv Edwards Resilia 29mm
|
61
|
36
|
$110,500.00
|
—
|
$97,295.25
|
$109,395.00
|
$104,201.50
|
2025-01-01
|
|
27800000002-89098
|
CDM
|
Valve Sapien Thv Edwards Resilia 26mm
|
61
|
36
|
$110,500.00
|
—
|
$97,295.25
|
$109,395.00
|
$104,201.50
|
2025-01-01
|
|
27800000002-89099
|
CDM
|
Valve Sapien Thv Edwards Resilia 20mm
|
61
|
36
|
$110,500.00
|
—
|
$97,295.25
|
$109,395.00
|
$104,201.50
|
2025-01-01
|
|
27800000002-89194
|
CDM
|
Device Watchman Flx Pro Procedure
|
61
|
36
|
$42,500.00
|
—
|
$37,421.25
|
$42,075.00
|
$40,077.50
|
2025-01-01
|
|
27800000002-89196
|
CDM
|
Conduit Konect Resilia Aortic Vlv 27mm
|
61
|
36
|
$52,500.00
|
—
|
$46,226.25
|
$51,975.00
|
$49,507.50
|
2025-01-01
|
|
27800000002-89197
|
CDM
|
Kit Ipg Pulse Senza Sys
|
61
|
36
|
$47,229.00
|
—
|
$41,585.13
|
$46,756.71
|
$44,536.95
|
2025-01-01
|
|
27800000002-89213
|
CDM
|
Coil Web Sgl Layer 6x2mm
|
61
|
36
|
$54,845.88
|
—
|
$48,291.80
|
$54,297.42
|
$51,719.66
|
2025-01-01
|
|
27800000002-89224
|
CDM
|
Vein Saphns 85cm Or Greater A B Ab O Bld Type
|
61
|
36
|
$46,838.16
|
—
|
$41,241.00
|
$46,369.78
|
$44,168.38
|
2025-01-01
|
|
27800000002-89225
|
CDM
|
Vein Saphns 85cm Or Greater A B Ab O Bld Type
|
61
|
36
|
$46,371.50
|
—
|
$40,830.11
|
$45,907.79
|
$43,728.32
|
2025-01-01
|
|
27800000002-89709
|
CDM
|
Coil Web Sngl Layer 10x5
|
61
|
36
|
$49,708.75
|
—
|
$43,768.55
|
$49,211.66
|
$46,875.35
|
2025-01-01
|
|
27800000002-89710
|
CDM
|
Coil Web Sngl Layer 11x6
|
61
|
36
|
$49,708.75
|
—
|
$43,768.55
|
$49,211.66
|
$46,875.35
|
2025-01-01
|
|
27800000002-89711
|
CDM
|
Coil Web Sngl Layer 5x4
|
61
|
36
|
$52,325.00
|
—
|
$46,072.16
|
$51,801.75
|
$49,342.48
|
2025-01-01
|
|
27800000002-89712
|
CDM
|
Coil Web Sngl Layer 9x5
|
61
|
36
|
$52,325.00
|
—
|
$46,072.16
|
$51,801.75
|
$49,342.48
|
2025-01-01
|
|
27800000002-89743
|
CDM
|
Device Embol 3.75x12 Pipeline
|
61
|
36
|
$45,937.50
|
—
|
$40,447.97
|
$45,478.13
|
$43,319.06
|
2025-01-01
|
|
27800000002-89752
|
CDM
|
Device Embol 4x14mm Pipeline
|
61
|
36
|
$45,937.50
|
—
|
$40,447.97
|
$45,478.13
|
$43,319.06
|
2025-01-01
|
|
27800000002-89960
|
CDM
|
Excluder Aort C3 23x12x16cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-89964
|
CDM
|
Excluder Aort C3 23x14.5x12cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-89965
|
CDM
|
Excluder Aort C3 23x14.5x12cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-89967
|
CDM
|
Excluder Aort C3 23x14.5x14cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-89969
|
CDM
|
Excluder Aort C3 23x14.5x14cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-89971
|
CDM
|
Excluder Aort C3 23x14.5x16cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-89972
|
CDM
|
Excluder Aort C3 23x14.5x16cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-89973
|
CDM
|
Excluder Aort C3 23x14.5x16cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-89974
|
CDM
|
Excluder Aort C3 23x14.5x16cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-89976
|
CDM
|
Excluder Aort C3 26x12x14cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-89978
|
CDM
|
Excluder Aort C3 26x12x16cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-89981
|
CDM
|
Excluder Aort C3 26x14.5x12cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-89984
|
CDM
|
Excluder Aort C3 26x14.5x12cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-89985
|
CDM
|
Excluder Aort C3 26x14.5x12cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-89988
|
CDM
|
Excluder Aort C3 26x14.5x14cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-89989
|
CDM
|
Excluder Aort C3 26x14.5x16cm
|
61
|
36
|
$25,625.00
|
—
|
$22,562.81
|
$25,368.75
|
$24,164.38
|
2025-01-01
|
|
27800000002-89991
|
CDM
|
Excluder Aort C3 26x14.5x16cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-89992
|
CDM
|
Excluder Aort C3 28x12x16cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-89994
|
CDM
|
Excluder Aort C3 28x14.5x12cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-89995
|
CDM
|
Excluder Aort C3 28x14.5x12cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-89997
|
CDM
|
Excluder Aort C3 28x14.5x12cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90000
|
CDM
|
Excluder Aort C3 28x14.5x14cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90001
|
CDM
|
Excluder Aort C3 28x14.5x14cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90003
|
CDM
|
Excluder Aort C3 28x14.5x16cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90005
|
CDM
|
Excluder Aort C3 28x14.5x16cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90007
|
CDM
|
Excluder Aort C3 31x14.5x13cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90009
|
CDM
|
Excluder Aort C3 31x14.5x13cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90013
|
CDM
|
Excluder Aort C3 31x14.5x15cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90015
|
CDM
|
Excluder Aort C3 31x14.5x15cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90016
|
CDM
|
Excluder Aort C3 31x14.5x17cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90017
|
CDM
|
Excluder Aort C3 31x14.5x17cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90018
|
CDM
|
Excluder Aort C3 35x14.5x14cm
|
61
|
36
|
$25,625.00
|
—
|
$22,562.81
|
$25,368.75
|
$24,164.38
|
2025-01-01
|
|
27800000002-90019
|
CDM
|
Excluder Aort C3 35x14.5x14cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90020
|
CDM
|
Excluder Aort C3 35x14.5x14cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90021
|
CDM
|
Excluder Aort C3 35x14.5x16cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90023
|
CDM
|
Excluder Aort C3 35x14.5x16cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90042
|
CDM
|
Excluder Aort Ibc 23x10x10 Fa
|
61
|
36
|
$37,481.25
|
—
|
$33,002.24
|
$37,106.44
|
$35,344.82
|
2025-01-01
|
|
27800000002-90044
|
CDM
|
Excluder Aort Ibc 23x10x10 Fa
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90046
|
CDM
|
Excluder Aort Ibc 23x12x10 Fa
|
61
|
36
|
$37,481.25
|
—
|
$33,002.24
|
$37,106.44
|
$35,344.82
|
2025-01-01
|
|
27800000002-90047
|
CDM
|
Excluder Aort Ibc 23x12x10 Fa
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90050
|
CDM
|
Excluder Aort Ibc 23x12x10 Fa
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90051
|
CDM
|
Excluder Aort Ibc 23x14x10 Fa
|
61
|
36
|
$37,481.25
|
—
|
$33,002.24
|
$37,106.44
|
$35,344.82
|
2025-01-01
|
|
27800000002-90052
|
CDM
|
Excluder Aort Ibc 23x14x10 Fa
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90055
|
CDM
|
Excluder Aort Ibc 23x14x10 Fa
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90056
|
CDM
|
Excluder Aort Ibc 23x14x10 Fa
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90151
|
CDM
|
Kit Mitraclip 1 Mbr0101
|
61
|
36
|
$97,500.00
|
—
|
$85,848.75
|
$96,525.00
|
$91,942.50
|
2025-01-01
|
|
27800000002-90152
|
CDM
|
Kit Mitraclip 1 Mbr0201
|
61
|
36
|
$97,500.00
|
—
|
$85,848.75
|
$96,525.00
|
$91,942.50
|
2025-01-01
|
|
27800000002-90153
|
CDM
|
Kit Mitraclip 1 Mbr0301
|
61
|
36
|
$97,500.00
|
—
|
$85,848.75
|
$96,525.00
|
$91,942.50
|
2025-01-01
|
|
27800000002-90154
|
CDM
|
Kit Mitraclip 1 Mbr0301
|
61
|
36
|
$97,500.00
|
—
|
$85,848.75
|
$96,525.00
|
$91,942.50
|
2025-01-01
|
|
27800000002-90155
|
CDM
|
Kit Mitraclip 3 Mbr0203
|
61
|
36
|
$97,500.00
|
—
|
$85,848.75
|
$96,525.00
|
$91,942.50
|
2025-01-01
|
|
27800000002-90156
|
CDM
|
Kit Mitraclp 1 Sgc0301 Cds0501
|
61
|
36
|
$97,500.00
|
—
|
$85,848.75
|
$96,525.00
|
$91,942.50
|
2025-01-01
|
|
27800000002-90157
|
CDM
|
Kit Mitraclp 2 Sgc0301 Cds0501
|
61
|
36
|
$97,500.00
|
—
|
$85,848.75
|
$96,525.00
|
$91,942.50
|
2025-01-01
|
|
27800000002-90158
|
CDM
|
Kit Mitraclp 3 Sgc0301 Cds0501
|
61
|
36
|
$97,500.00
|
—
|
$85,848.75
|
$96,525.00
|
$91,942.50
|
2025-01-01
|
|
27800000002-90265
|
CDM
|
Set Pump Impella Cp
|
61
|
36
|
$62,500.00
|
—
|
$55,031.25
|
$61,875.00
|
$58,937.50
|
2025-01-01
|
|
27800000002-90266
|
CDM
|
Set Pump Impella Cp
|
61
|
36
|
$62,500.00
|
—
|
$55,031.25
|
$61,875.00
|
$58,937.50
|
2025-01-01
|
|
27800000002-90267
|
CDM
|
Set Pump Impella Cp
|
61
|
36
|
$81,250.00
|
—
|
$71,540.63
|
$80,437.50
|
$76,618.75
|
2025-01-01
|
|
27800000002-90268
|
CDM
|
Set Pump Impella Cp
|
61
|
36
|
$81,250.00
|
—
|
$71,540.63
|
$80,437.50
|
$76,618.75
|
2025-01-01
|
|
27800000002-90269
|
CDM
|
Set Pump Impella Cp
|
61
|
36
|
$81,250.00
|
—
|
$71,540.63
|
$80,437.50
|
$76,618.75
|
2025-01-01
|
|
27800000002-90270
|
CDM
|
Set Pump Impella Cp
|
61
|
36
|
$81,250.00
|
—
|
$71,540.63
|
$80,437.50
|
$76,618.75
|
2025-01-01
|
|
27800000002-90271
|
CDM
|
Set Pump Impella Cp
|
61
|
36
|
$81,250.00
|
—
|
$71,540.63
|
$80,437.50
|
$76,618.75
|
2025-01-01
|
|
27800000002-90305
|
CDM
|
Stent Endur Aaa Bif 23x14x103
|
61
|
36
|
$33,463.65
|
—
|
$29,464.74
|
$33,129.01
|
$31,556.22
|
2025-01-01
|
|
27800000002-90308
|
CDM
|
Stent Endur Aaa Bif 25x14x103
|
61
|
36
|
$33,362.63
|
—
|
$29,375.80
|
$33,029.00
|
$31,460.96
|
2025-01-01
|
|
27800000002-90315
|
CDM
|
Stent Endur Aaa Bif 28x14x103
|
61
|
36
|
$33,665.63
|
—
|
$29,642.59
|
$33,328.97
|
$31,746.69
|
2025-01-01
|
|
27800000002-90319
|
CDM
|
Stent Endur Aaa Bif 32x14x103
|
61
|
36
|
$33,429.98
|
—
|
$29,435.10
|
$33,095.68
|
$31,524.47
|
2025-01-01
|
|
27800000002-90324
|
CDM
|
Stent Endur Aaa Bif 36x14x103
|
61
|
36
|
$33,362.63
|
—
|
$29,375.80
|
$33,029.00
|
$31,460.96
|
2025-01-01
|
|
27800000002-90386
|
CDM
|
Stent Graft 22-40-13-40mm Afx2 Bifurcated
|
61
|
36
|
$27,375.00
|
—
|
$24,103.69
|
$27,101.25
|
$25,814.63
|
2025-01-01
|
|
27800000002-90387
|
CDM
|
Stent Graft 22-40-13-40mm Afx2 Bifurcated
|
61
|
36
|
$38,325.00
|
—
|
$33,745.16
|
$37,941.75
|
$36,140.48
|
2025-01-01
|
|
27800000002-90388
|
CDM
|
Stent Graft 22-60-13-40mm Afx2 Bifurcated
|
61
|
36
|
$27,375.00
|
—
|
$24,103.69
|
$27,101.25
|
$25,814.63
|
2025-01-01
|
|
27800000002-90389
|
CDM
|
Stent Graft 22-60-13-40mm Afx2 Bifurcated
|
61
|
36
|
$38,325.00
|
—
|
$33,745.16
|
$37,941.75
|
$36,140.48
|
2025-01-01
|
|
27800000002-90390
|
CDM
|
Stent Graft 22-60-13-40mm Afx2 Bifurcated
|
61
|
36
|
$38,325.00
|
—
|
$33,745.16
|
$37,941.75
|
$36,140.48
|
2025-01-01
|
|
27800000002-90391
|
CDM
|
Stent Graft 22-70-16-30mm Afx2 Bifurcated
|
61
|
36
|
$38,325.00
|
—
|
$33,745.16
|
$37,941.75
|
$36,140.48
|
2025-01-01
|
|
27800000002-90392
|
CDM
|
Stent Graft 22-70-16-30mm Afx2 Bifurcated
|
61
|
36
|
$38,325.00
|
—
|
$33,745.16
|
$37,941.75
|
$36,140.48
|
2025-01-01
|
|
27800000002-90393
|
CDM
|
Stent Graft 22-80-20-40mm Afx2 Bifurcated
|
61
|
36
|
$38,325.00
|
—
|
$33,745.16
|
$37,941.75
|
$36,140.48
|
2025-01-01
|
|
27800000002-90395
|
CDM
|
Stent Graft 22-80-20-40mm Afx2 Bifurcated
|
61
|
36
|
$38,325.00
|
—
|
$33,745.16
|
$37,941.75
|
$36,140.48
|
2025-01-01
|
|
27800000002-90396
|
CDM
|
Stent Graft 25-100-16-40mm Afx2 Bifurcated
|
61
|
36
|
$38,325.00
|
—
|
$33,745.16
|
$37,941.75
|
$36,140.48
|
2025-01-01
|
|
27800000002-90397
|
CDM
|
Stent Graft 25-70-16-30mm Afx2 Bifurcated
|
61
|
36
|
$38,325.00
|
—
|
$33,745.16
|
$37,941.75
|
$36,140.48
|
2025-01-01
|
|
27800000002-90398
|
CDM
|
Stent Graft 25-80-13-40mm Afx2 Bifurcated
|
61
|
36
|
$27,375.00
|
—
|
$24,103.69
|
$27,101.25
|
$25,814.63
|
2025-01-01
|
|
27800000002-90399
|
CDM
|
Stent Graft 25-80-16-40mm Afx2 Bifurcated
|
61
|
36
|
$38,325.00
|
—
|
$33,745.16
|
$37,941.75
|
$36,140.48
|
2025-01-01
|
|
27800000002-90400
|
CDM
|
Stent Graft 28-110-16-30mm Afx2 Bifurcated
|
61
|
36
|
$27,375.00
|
—
|
$24,103.69
|
$27,101.25
|
$25,814.63
|
2025-01-01
|
|
27800000002-90402
|
CDM
|
Stent Graft 28-60-16-40mm Afx2 Bifurcated
|
61
|
36
|
$38,325.00
|
—
|
$33,745.16
|
$37,941.75
|
$36,140.48
|
2025-01-01
|
|
27800000002-90403
|
CDM
|
Stent Graft 28-70-16-30mm Afx2 Bifurcated
|
61
|
36
|
$38,325.00
|
—
|
$33,745.16
|
$37,941.75
|
$36,140.48
|
2025-01-01
|
|
27800000002-90404
|
CDM
|
Stent Graft 28-80-16-40mm Afx2 Bifurcated
|
61
|
36
|
$27,375.00
|
—
|
$24,103.69
|
$27,101.25
|
$25,814.63
|
2025-01-01
|
|
27800000002-90555
|
CDM
|
Valve Aort 26mm Evolutr
|
61
|
36
|
$107,250.00
|
—
|
$94,433.63
|
$106,177.50
|
$101,136.75
|
2025-01-01
|
|
27800000002-90556
|
CDM
|
Valve Aort 26mm Pro Perc
|
61
|
36
|
$97,500.00
|
—
|
$85,848.75
|
$96,525.00
|
$91,942.50
|
2025-01-01
|
|
27800000002-90558
|
CDM
|
Valve Aort 29mm Pro Perc
|
61
|
36
|
$97,500.00
|
—
|
$85,848.75
|
$96,525.00
|
$91,942.50
|
2025-01-01
|
|
27800000002-90559
|
CDM
|
Valve Aort 34mm Evolutr
|
61
|
36
|
$97,500.00
|
—
|
$85,848.75
|
$96,525.00
|
$91,942.50
|
2025-01-01
|
|
27800000002-90581
|
CDM
|
Valve Aortic Inspiris 19 19mm
|
61
|
36
|
$29,231.25
|
—
|
$25,738.12
|
$28,938.94
|
$27,565.07
|
2025-01-01
|
|
27800000002-90583
|
CDM
|
Valve Aortic Inspiris 19 19mm
|
61
|
36
|
$29,231.25
|
—
|
$25,738.12
|
$28,938.94
|
$27,565.07
|
2025-01-01
|
|
27800000002-90587
|
CDM
|
Valve Aortic Inspiris 21 21mm
|
61
|
36
|
$29,231.25
|
—
|
$25,738.12
|
$28,938.94
|
$27,565.07
|
2025-01-01
|
|
27800000002-90589
|
CDM
|
Valve Aortic Inspiris 21 21mm
|
61
|
36
|
$29,231.25
|
—
|
$25,738.12
|
$28,938.94
|
$27,565.07
|
2025-01-01
|
|
27800000002-90593
|
CDM
|
Valve Aortic Inspiris 23 23mm
|
61
|
36
|
$29,231.25
|
—
|
$25,738.12
|
$28,938.94
|
$27,565.07
|
2025-01-01
|
|
27800000002-90595
|
CDM
|
Valve Aortic Inspiris 23 23mm
|
61
|
36
|
$33,037.50
|
—
|
$29,089.52
|
$32,707.13
|
$31,154.36
|
2025-01-01
|
|
27800000002-90596
|
CDM
|
Valve Aortic Inspiris 23 23mm
|
61
|
36
|
$29,231.25
|
—
|
$25,738.12
|
$28,938.94
|
$27,565.07
|
2025-01-01
|
|
27800000002-90600
|
CDM
|
Valve Aortic Inspiris 25 25mm
|
61
|
36
|
$29,231.25
|
—
|
$25,738.12
|
$28,938.94
|
$27,565.07
|
2025-01-01
|
|
27800000002-90601
|
CDM
|
Valve Aortic Inspiris 25 25mm
|
61
|
36
|
$33,037.50
|
—
|
$29,089.52
|
$32,707.13
|
$31,154.36
|
2025-01-01
|
|
27800000002-90602
|
CDM
|
Valve Aortic Inspiris 25 25mm
|
61
|
36
|
$29,231.25
|
—
|
$25,738.12
|
$28,938.94
|
$27,565.07
|
2025-01-01
|
|
27800000002-90605
|
CDM
|
Valve Aortic Inspiris 27 27mm
|
61
|
36
|
$29,231.25
|
—
|
$25,738.12
|
$28,938.94
|
$27,565.07
|
2025-01-01
|
|
27800000002-90607
|
CDM
|
Valve Aortic Inspiris 27 27mm
|
61
|
36
|
$33,037.50
|
—
|
$29,089.52
|
$32,707.13
|
$31,154.36
|
2025-01-01
|
|
27800000002-90610
|
CDM
|
Valve Aortic Inspiris 29 29mm
|
61
|
36
|
$29,231.25
|
—
|
$25,738.12
|
$28,938.94
|
$27,565.07
|
2025-01-01
|
|
27800000002-90611
|
CDM
|
Valve Aortic Inspiris 29 29mm
|
61
|
36
|
$29,231.25
|
—
|
$25,738.12
|
$28,938.94
|
$27,565.07
|
2025-01-01
|
|
27800000002-90653
|
CDM
|
Valve Sapien 3 Thv 20mm W/command System
|
61
|
36
|
$105,625.00
|
—
|
$93,002.81
|
$104,568.75
|
$99,604.38
|
2025-01-01
|
|
27800000002-90654
|
CDM
|
Valve Sapien 3 Thv 23mm W/command System
|
61
|
36
|
$81,250.00
|
—
|
$71,540.63
|
$80,437.50
|
$76,618.75
|
2025-01-01
|
|
27800000002-90655
|
CDM
|
Valve Sapien 3 Thv 23mm W/command System
|
61
|
36
|
$105,625.00
|
—
|
$93,002.81
|
$104,568.75
|
$99,604.38
|
2025-01-01
|
|
27800000002-90656
|
CDM
|
Valve Sapien 3 Thv 26mm W/command System
|
61
|
36
|
$81,250.00
|
—
|
$71,540.63
|
$80,437.50
|
$76,618.75
|
2025-01-01
|
|
27800000002-90657
|
CDM
|
Valve Sapien 3 Thv 26mm W/command System
|
61
|
36
|
$105,625.00
|
—
|
$93,002.81
|
$104,568.75
|
$99,604.38
|
2025-01-01
|
|
27800000002-90658
|
CDM
|
Valve Sapien 3 Thv 29mm W/command System
|
61
|
36
|
$81,250.00
|
—
|
$71,540.63
|
$80,437.50
|
$76,618.75
|
2025-01-01
|
|
27800000002-90659
|
CDM
|
Valve Sapien 3 Thv 29mm W/command System
|
61
|
36
|
$105,625.00
|
—
|
$93,002.81
|
$104,568.75
|
$99,604.38
|
2025-01-01
|
|
27800000002-90719
|
CDM
|
Device Epi-sense 3cm Guide
|
61
|
36
|
$37,800.00
|
—
|
$33,282.90
|
$37,422.00
|
$35,645.40
|
2025-01-01
|
|
27800000002-90720
|
CDM
|
Device Epi-sense 3cm Guide
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90721
|
CDM
|
Excluder Aort C3 35x14.5x18cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90722
|
CDM
|
Excluder Aort C3 35x14.5x18cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90723
|
CDM
|
Excluder Aort C3 35x14.5x18cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90796
|
CDM
|
Excluder Aort C3 28x14.5x18cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90797
|
CDM
|
Excluder Aort C3 28x14.5x18cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-90836
|
CDM
|
Valve Aortic Evolut Tm Pro 26mm
|
61
|
36
|
$75,000.00
|
—
|
$66,037.50
|
$74,250.00
|
$70,725.00
|
2025-01-01
|
|
27800000002-90837
|
CDM
|
Valve Aortic Evolut Tm Pro 29mm
|
61
|
36
|
$97,500.00
|
—
|
$85,848.75
|
$96,525.00
|
$91,942.50
|
2025-01-01
|
|
27800000002-90838
|
CDM
|
Valve Aortic Evolut Tm Pro 34mm
|
61
|
36
|
$75,000.00
|
—
|
$66,037.50
|
$74,250.00
|
$70,725.00
|
2025-01-01
|
|
27800000002-90902
|
CDM
|
Coil Web Sngl Layer 9x4
|
61
|
36
|
$52,325.00
|
—
|
$46,072.16
|
$51,801.75
|
$49,342.48
|
2025-01-01
|
|
27800000002-90903
|
CDM
|
Coil Web Sngl Layer 9x4
|
61
|
36
|
$25,706.53
|
—
|
$22,634.60
|
$25,449.46
|
$24,241.26
|
2025-01-01
|
|
27800000002-91146
|
CDM
|
Excluder Aort C3 26x12x18cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-91147
|
CDM
|
Excluder Aort C3 26x12x18cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-91231
|
CDM
|
Valve Sapien 3 Ultra Thv 20mm W/command System
|
61
|
36
|
$105,625.00
|
—
|
$93,002.81
|
$104,568.75
|
$99,604.38
|
2025-01-01
|
|
27800000002-91232
|
CDM
|
Valve Sapien 3 Ultra Thv 23mm W/command System
|
61
|
36
|
$81,250.00
|
—
|
$71,540.63
|
$80,437.50
|
$76,618.75
|
2025-01-01
|
|
27800000002-91233
|
CDM
|
Valve Sapien 3 Ultra Thv 23mm W/command System
|
61
|
36
|
$105,625.00
|
—
|
$93,002.81
|
$104,568.75
|
$99,604.38
|
2025-01-01
|
|
27800000002-91234
|
CDM
|
Valve Sapien 3 Ultra Thv 23mm W/command System
|
61
|
36
|
$105,625.00
|
—
|
$93,002.81
|
$104,568.75
|
$99,604.38
|
2025-01-01
|
|
27800000002-91235
|
CDM
|
Valve Sapien 3 Ultra Thv 26mm W/command System
|
61
|
36
|
$81,250.00
|
—
|
$71,540.63
|
$80,437.50
|
$76,618.75
|
2025-01-01
|
|
27800000002-91236
|
CDM
|
Valve Sapien 3 Ultra Thv 26mm W/command System
|
61
|
36
|
$105,625.00
|
—
|
$93,002.81
|
$104,568.75
|
$99,604.38
|
2025-01-01
|
|
27800000002-91237
|
CDM
|
Valve Sapien 3 Ultra Thv 26mm W/command System
|
61
|
36
|
$105,625.00
|
—
|
$93,002.81
|
$104,568.75
|
$99,604.38
|
2025-01-01
|
|
27800000002-91247
|
CDM
|
Kit Mitraclip G4 Syst Cds0701nt/ntw/xt/xtw
|
61
|
36
|
$97,500.00
|
—
|
$85,848.75
|
$96,525.00
|
$91,942.50
|
2025-01-01
|
|
27800000002-91269
|
CDM
|
Excluder Aort C3 28x12x18cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-91270
|
CDM
|
Excluder Aort C3 28x12x18cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-91271
|
CDM
|
Excluder Aort C3 28x12x18cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-91327
|
CDM
|
Stent Endur Ii Bif 23x13x124
|
61
|
36
|
$33,665.63
|
—
|
$29,642.59
|
$33,328.97
|
$31,746.69
|
2025-01-01
|
|
27800000002-91332
|
CDM
|
Stent Endur Ii Aui 32x14x102
|
61
|
36
|
$33,665.63
|
—
|
$29,642.59
|
$33,328.97
|
$31,746.69
|
2025-01-01
|
|
27800000002-91429
|
CDM
|
Graft Stent Body Aortic Alto Pma 29mm
|
61
|
36
|
$28,747.50
|
—
|
$25,312.17
|
$28,460.03
|
$27,108.89
|
2025-01-01
|
|
27800000002-91430
|
CDM
|
Graft Stent Body Aortic Alto Pma 29mm
|
61
|
36
|
$40,246.50
|
—
|
$35,437.04
|
$39,844.04
|
$37,952.45
|
2025-01-01
|
|
27800000002-91431
|
CDM
|
Graft Stent Body Aortic Alto Pma 29mm
|
61
|
36
|
$40,246.50
|
—
|
$35,437.04
|
$39,844.04
|
$37,952.45
|
2025-01-01
|
|
27800000002-91432
|
CDM
|
Stent Graft Confrm Thor 34x34x15 22f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91433
|
CDM
|
Stent Graft Confrm Thor 34x34x15 22f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91435
|
CDM
|
Kit Mitraclip 1 Mbr0303
|
61
|
36
|
$97,500.00
|
—
|
$85,848.75
|
$96,525.00
|
$91,942.50
|
2025-01-01
|
|
27800000002-91443
|
CDM
|
Stent Graft Confrm Thor 40x40x15 22f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91444
|
CDM
|
Stent Graft Confrm Thor 40x40x15 22f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91446
|
CDM
|
Stent Graft Confrm Thor 40x40x10 22f
|
61
|
36
|
$45,725.00
|
—
|
$40,260.86
|
$45,267.75
|
$43,118.68
|
2025-01-01
|
|
27800000002-91447
|
CDM
|
Stent Graft Confrm Thor 40x40x10 22f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91448
|
CDM
|
Stent Graft Confrm Thor 40x40x10 22f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91455
|
CDM
|
Stent Endur Ii Aui 23x14x102
|
61
|
36
|
$33,665.63
|
—
|
$29,642.59
|
$33,328.97
|
$31,746.69
|
2025-01-01
|
|
27800000002-91464
|
CDM
|
Stent Graft Confrm Thor 31x31x10 20f
|
61
|
36
|
$45,725.00
|
—
|
$40,260.86
|
$45,267.75
|
$43,118.68
|
2025-01-01
|
|
27800000002-91465
|
CDM
|
Stent Graft Confrm Thor 31x31x10 20f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91466
|
CDM
|
Stent Graft Confrm Thor 21x21x10 18f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91484
|
CDM
|
Stent Graft Confrm Thor 45x45x15 24f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91485
|
CDM
|
Stent Graft Confrm Thor 45x45x15 24f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91486
|
CDM
|
Stent Graft Confrm Thor 45x45x15 24f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91487
|
CDM
|
Stent Graft Confrm Thor 37x37x10 22f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91490
|
CDM
|
Stent Graft Confrm Thor 45x45x10 24f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91491
|
CDM
|
Stent Graft Confrm Thor 28x28x10 20f
|
61
|
36
|
$45,725.00
|
—
|
$40,260.86
|
$45,267.75
|
$43,118.68
|
2025-01-01
|
|
27800000002-91492
|
CDM
|
Stent Graft Confrm Thor 28x28x10 20f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91494
|
CDM
|
Stent Graft Confrm Thor 34x34x10 22f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91495
|
CDM
|
Stent Graft Confrm Thor 34x34x10 22f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91502
|
CDM
|
Stent Graft Confrm Thor 28x28x15 20f
|
61
|
36
|
$45,725.00
|
—
|
$40,260.86
|
$45,267.75
|
$43,118.68
|
2025-01-01
|
|
27800000002-91503
|
CDM
|
Stent Graft Confrm Thor 28x28x15 20f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91511
|
CDM
|
Kit Mitraclip G4 Delivery Sys Xtw
|
61
|
36
|
$97,500.00
|
—
|
$85,848.75
|
$96,525.00
|
$91,942.50
|
2025-01-01
|
|
27800000002-91517
|
CDM
|
Kit Mitraclip G4 Delivery Sys Nt
|
61
|
36
|
$97,500.00
|
—
|
$85,848.75
|
$96,525.00
|
$91,942.50
|
2025-01-01
|
|
27800000002-91518
|
CDM
|
Stent Graft Confrm Thor 26x26x10 20f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91547
|
CDM
|
Graft Bn Canc Crsh Frzdr 30ml
|
61
|
36
|
$138,385.00
|
—
|
$121,847.99
|
$137,001.15
|
$130,497.06
|
2025-01-01
|
|
27800000002-91555
|
CDM
|
Kit Mitraclip 2 Mbr0202
|
61
|
36
|
$97,500.00
|
—
|
$85,848.75
|
$96,525.00
|
$91,942.50
|
2025-01-01
|
|
27800000002-91556
|
CDM
|
Kit Mitraclip 2 Mbr0202
|
61
|
36
|
$97,500.00
|
—
|
$85,848.75
|
$96,525.00
|
$91,942.50
|
2025-01-01
|
|
27800000002-91560
|
CDM
|
Stent Valiant Navion Vnmf4343c183tu Freeflo 175mm
|
61
|
36
|
$62,984.25
|
—
|
$55,457.63
|
$62,354.41
|
$59,394.15
|
2025-01-01
|
|
27800000002-91561
|
CDM
|
Stent Graft Confrm Thor 37x37x20 22f
|
61
|
36
|
$45,725.00
|
—
|
$40,260.86
|
$45,267.75
|
$43,118.68
|
2025-01-01
|
|
27800000002-91562
|
CDM
|
Stent Graft Confrm Thor 37x37x20 22f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91563
|
CDM
|
Stent Graft Confrm Thor 37x37x20 22f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91564
|
CDM
|
Stent Graft Confrm Thor 34x34x20 22f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91565
|
CDM
|
Stent Graft Confrm Thor 34x34x20 22f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91577
|
CDM
|
Implant Gammatile Therapy Device 4pk
|
61
|
36
|
$84,500.00
|
—
|
$74,402.25
|
$83,655.00
|
$79,683.50
|
2025-01-01
|
|
27800000002-91607
|
CDM
|
Stent Graft Confrm Thor 45x45x20 24f
|
61
|
36
|
$64,015.00
|
—
|
$56,365.21
|
$63,374.85
|
$60,366.15
|
2025-01-01
|
|
27800000002-91621
|
CDM
|
System Mntr Heartmate Ii
|
61
|
36
|
$34,323.75
|
—
|
$30,222.06
|
$33,980.51
|
$32,367.30
|
2025-01-01
|
|
27800000002-91675
|
CDM
|
Stent Graft Confrm Thor 26x21x10 20f
|
61
|
36
|
$33,104.90
|
—
|
$29,148.86
|
$32,773.85
|
$31,217.92
|
2025-01-01
|
|
27800000002-91695
|
CDM
|
Vale Heart Intuity Elite 19mm
|
61
|
36
|
$30,000.00
|
—
|
$26,415.00
|
$29,700.00
|
$28,290.00
|
2025-01-01
|
|
27800000002-91699
|
CDM
|
Excluder Aort C3 26x14.5x18cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-91786
|
CDM
|
Vale Heart Intuity Elite 23mm
|
61
|
36
|
$30,000.00
|
—
|
$26,415.00
|
$29,700.00
|
$28,290.00
|
2025-01-01
|
|
27800000002-91787
|
CDM
|
Vale Heart Intuity Elite 23mm
|
61
|
36
|
$30,000.00
|
—
|
$26,415.00
|
$29,700.00
|
$28,290.00
|
2025-01-01
|
|
27800000002-91808
|
CDM
|
Stent Endur Ii Bif 28x16x166 Bifurcated
|
61
|
36
|
$33,665.63
|
—
|
$29,642.59
|
$33,328.97
|
$31,746.69
|
2025-01-01
|
|
27800000002-91817
|
CDM
|
Stent Endur Ii Bif 28x13x145 Bifurcated
|
61
|
36
|
$33,665.63
|
—
|
$29,642.59
|
$33,328.97
|
$31,746.69
|
2025-01-01
|
|
27800000002-91872
|
CDM
|
Stent Endur Ii Bif 32x16x166 Bifurcated
|
61
|
36
|
$33,665.63
|
—
|
$29,642.59
|
$33,328.97
|
$31,746.69
|
2025-01-01
|
|
27800000002-91877
|
CDM
|
Excluder Aort C3 23x14.5x18cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-91901
|
CDM
|
Stent Endur Ii Bif 32x16x124 Bifurcated
|
61
|
36
|
$33,665.63
|
—
|
$29,642.59
|
$33,328.97
|
$31,746.69
|
2025-01-01
|
|
27800000002-91954
|
CDM
|
Stent Endur Ii Bif 28x13x166 Bifurcated
|
61
|
36
|
$33,665.63
|
—
|
$29,642.59
|
$33,328.97
|
$31,746.69
|
2025-01-01
|
|
27800000002-91955
|
CDM
|
Stent Endur Ii Bif 28x13x166 Bifurcated
|
61
|
36
|
$33,665.63
|
—
|
$29,642.59
|
$33,328.97
|
$31,746.69
|
2025-01-01
|
|
27800000002-91958
|
CDM
|
Valve Aortic Perceval Med
|
61
|
36
|
$31,856.25
|
—
|
$28,049.43
|
$31,537.69
|
$30,040.44
|
2025-01-01
|
|
27800000002-91975
|
CDM
|
Excluder Aort C3 23x12x18cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-91976
|
CDM
|
Excluder Aort C3 23x12x18cm
|
61
|
36
|
$37,500.00
|
—
|
$33,018.75
|
$37,125.00
|
$35,362.50
|
2025-01-01
|
|
27800000002-91990
|
CDM
|
Set Pump Aic Impella 5.0
|
61
|
36
|
$81,250.00
|
—
|
$71,540.63
|
$80,437.50
|
$76,618.75
|
2025-01-01
|
|
27800000002-91991
|
CDM
|
Set Pump Aic Impella 5.0
|
61
|
36
|
$81,250.00
|
—
|
$71,540.63
|
$80,437.50
|
$76,618.75
|
2025-01-01
|
|
27800000002-92065
|
CDM
|
Device Ifd Nanolock 7d Xlrg 11mm
|
61
|
36
|
$28,125.00
|
—
|
$24,764.06
|
$27,843.75
|
$26,521.88
|
2025-01-01
|
|
27800000002-92066
|
CDM
|
Device Ifd Nanolock 7d Xlrg 11mm
|
61
|
36
|
$28,125.00
|
—
|
$24,764.06
|
$27,843.75
|
$26,521.88
|
2025-01-01
|
|
7011434001
|
NDC
|
Toripalimab-tpzi 240 Mg/6 Ml (40 mg/mL) Solution 6 Ml Vial
|
61
|
36
|
$34,856.76
|
—
|
$30,691.38
|
$34,508.19
|
$32,869.92
|
2025-01-01
|
|
7315015006
|
NDC
|
Injection Ublituximab-xiiy 1 Mg
|
61
|
36
|
$26,914.33
|
—
|
$23,698.07
|
$26,645.19
|
$25,380.21
|
2025-01-01
|
|
A9504
|
HCPCS
|
Technetium Tc-99m Apcitide Diagnostic Per Study Dose Up To 20 Millicuries
|
61
|
36
|
$34,966.40
|
—
|
$30,787.92
|
$34,616.74
|
$32,973.32
|
2025-01-01
|
|
A9542
|
HCPCS
|
Indium In-111 Ibritumomab Tiuxetan Diagnostic Per Study Dose Up To 5 Millicuries
|
61
|
36
|
$83,782.00
|
—
|
$73,770.05
|
$82,944.18
|
$79,006.43
|
2025-01-01
|
|
A9543
|
HCPCS
|
Yttrium Y-90 Ibritumomab Tiuxetan Therapeutic Per Treatment Dose Up To 40 Millic…
|
61
|
36
|
$47,146.65
|
—
|
$41,512.63
|
$46,675.18
|
$44,459.29
|
2025-01-01
|
|
A9604
|
HCPCS
|
Samarium Sm-153 Lexidronam Therapeutic Per 150 Millicuries
|
61
|
36
|
$75,075.84
|
—
|
$66,104.28
|
$74,325.08
|
$70,796.52
|
2025-01-01
|
|
A9606
|
HCPCS
|
Radium Ra-223 Dichloride Therapeutic Per Microcurie
|
61
|
36
|
$72,882.53
|
—
|
$64,173.07
|
$72,153.70
|
$68,728.23
|
2025-01-01
|
|
C1721
|
HCPCS
|
Icd Cobalt Xt Dr MRI Is1 Df4
|
1,586
|
36
|
$27,497.50
|
—
|
$17,259.83
|
$44,487.14
|
$25,076.43
|
2025-01-01
|
|
C1817
|
HCPCS
|
Cath Septl Occl Amplatzer 22mm 9f 45deg Crv
|
671
|
36
|
$27,750.00
|
—
|
$2,852.82
|
$37,106.44
|
$25,382.93
|
2025-01-01
|
|
C1820
|
HCPCS
|
Adaptive Stim Implantable Neurostimulator
|
1,525
|
36
|
$29,085.23
|
—
|
$633.96
|
$81,248.31
|
$28,312.02
|
2025-01-01
|
|
C1822
|
HCPCS
|
Kit Ipg Omnia
|
305
|
36
|
$65,000.00
|
—
|
$12,861.90
|
$83,655.00
|
$61,295.00
|
2025-01-01
|
|
C1824
|
HCPCS
|
Kit Ipg Optimizer Smart Mini
|
61
|
36
|
$84,500.00
|
—
|
$74,402.25
|
$83,655.00
|
$79,683.50
|
2025-01-01
|
|
C1882
|
HCPCS
|
Icd Crtd Cobalt Xt Hf Quad MRI Is4 Df4
|
2,013
|
36
|
$35,512.00
|
—
|
$22,410.68
|
$57,505.14
|
$32,333.68
|
2025-01-01
|
|
C2616
|
HCPCS
|
Brachytherapy Source Non-stranded Yttrium-90 Per Source
|
61
|
36
|
$44,461.00
|
—
|
$39,147.91
|
$44,016.39
|
$41,926.72
|
2025-01-01
|
|
J1747
|
HCPCS
|
Injection Spesolimab-sbzo 1 Mg
|
61
|
36
|
$134,040.05
|
—
|
$118,022.26
|
$132,699.65
|
$126,399.77
|
2025-01-01
|
|
J2326
|
HCPCS
|
Inj Nusinersen 0.1mg
|
61
|
36
|
$354,405.08
|
—
|
$312,053.67
|
$350,861.03
|
$334,203.99
|
2025-01-01
|
|
J7330
|
HCPCS
|
Membrane Collgn Porcine Maci W/autologous Cult Chondrocytes
|
61
|
36
|
$114,240.00
|
—
|
$100,588.32
|
$113,097.60
|
$107,728.32
|
2025-01-01
|
|
J9042
|
HCPCS
|
Brentuximab Vedotin Per 1 Mg
|
61
|
36
|
$29,046.14
|
—
|
$25,575.13
|
$28,755.68
|
$27,390.51
|
2025-01-01
|
|
J9272
|
HCPCS
|
Inj Dostarlimab-gxly 100 Mg
|
61
|
36
|
$29,134.52
|
—
|
$25,652.94
|
$28,843.17
|
$27,473.85
|
2025-01-01
|
|
J9298
|
HCPCS
|
Opdualag Per 1 Each
|
61
|
36
|
$74,696.95
|
—
|
$65,770.66
|
$73,949.98
|
$70,439.22
|
2025-01-01
|
|
J9325
|
HCPCS
|
Talimogene Laherparepvec Per 1 Million Pfu
|
122
|
36
|
$684.03
|
—
|
$602.29
|
$67,710.24
|
$30,449.13
|
2025-01-01
|
|
J9359
|
HCPCS
|
Loncastuximab-lpyl 0.1 Mg
|
61
|
36
|
$67,591.03
|
—
|
$59,513.90
|
$66,915.12
|
$63,738.34
|
2025-01-01
|
|
J9600
|
HCPCS
|
Porfimer Per 75 Mg
|
61
|
36
|
$82,476.76
|
—
|
$72,620.79
|
$81,651.99
|
$77,775.58
|
2025-01-01
|
|
L8614
|
HCPCS
|
Dornhoffer Fixed Part W/window
|
427
|
36
|
$48,329.75
|
—
|
$115.62
|
$63,970.83
|
$45,574.95
|
2025-01-01
|