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

UMASS MEMORIAL HEALTH - HARRINGTON HOSPITAL

Southbridge, MA · CCN 220019 · Rates published

15,213 distinct procedures filed
45 distinct payers
616,743 rate rows
2026-04-03 last MRF observed
Data quality

574,863 of 616,743 rate rows are consumer-grade (93.2%)

41,880 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
per-diem day rate — not a per-procedure price 21,019
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 17,095
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 2,497
template filing: same amount across many unrelated codes — excluded 378
exceeds 10× this hospital's gross charge — excluded from medians 337
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 285
placeholder amount (≤ $0.02) — excluded from medians 264
exceeds 3× this hospital's gross charge for a DRG stay — excluded 5
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://d1477x5i4cdpk9.cloudfront.net/042103577_umass-memorial-health-harrington-hospital-inc._standardcharges.csv
Found on page https://www.ummhealth.org/patients-visitors/price-transparency
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-09-21

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
SUP-106524US
CDM 		Kit Implant Lvad W/controller Heartmate 3 20 $155,296.52 $318,361.05 $255,325.56 —
SUP-1103
CDM 		Kit Implant Pump Hvad 20 $107,422.10 $220,217.50 $176,614.43 —
SUP-1000100
CDM 		Pump Heart With Smartassist Impella 5.5 20 $64,755.45 $132,750.00 $106,465.50 nat. median
$51,981
outlier · 2.0×
405
MS_DRG 		Other Procedures For Endocrine, Nutritional And Metabolic Disorders,extreme 1 $61,914.80 $153,798.00 $102,469.50 nat. median
$38,859
outlier · 2.6×
SUP-D0146
CDM 		Device Liver Perfusion Disposable Sterile Single-use Metra 20 $54,682.38 $112,100.00 $89,904.20 —
SUP-TCG50100
CDM 		System Transcatheter Edge To Edge Repair G5 Steerable Guide Catheter With Up To… 20 $51,804.36 $106,200.00 $85,172.40 —
681
MS_DRG 		Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms,major 1 $76,038.40 $87,444.20 $81,741.30 nat. median
$35,768
outlier · 2.3×
SUP-S3URCM26A
CDM 		Valve Heart Transcatheter With Commander System 26mm Edwards Sapien 3 Ultra Resi… 20 $48,926.34 $100,300.00 $80,440.60 —
SUP-S3URCM29A
CDM 		Valve Heart Transcatheter With Commander System 29mm Edwards Sapien 3 Ultra Resi… 20 $48,926.34 $100,300.00 $80,440.60 —
SUP-S3URCM20A
CDM 		Valve Heart Transcatheter With Commander System 20mm Edwards Sapien 3 Ultra Resi… 20 $48,926.34 $100,300.00 $80,440.60 —
SUP-S3URCM23A
CDM 		Valve Heart Transcatheter With Commander System 23mm Edwards Sapien 3 Ultra Resi… 20 $48,926.34 $100,300.00 $80,440.60 —
SUP-MCG50100
CDM 		System Transcatheter Edge To Edge Repair G5 Steerable Guide Catheter With Up To… 20 $47,487.33 $97,350.00 $78,074.70 —
SUP-9600CM29A
CDM 		Valve Heart Transcatheter With Commander 29mm Sapien 3 20 $46,767.83 $95,875.00 $76,891.75 —
SUP-9355ASP23A
CDM 		Valve Heart Aortic Transcatheter Sapien Xt 23mm Ascendra Plus 20 $46,767.83 $95,875.00 $76,891.75 —
SUP-9600CM26A
CDM 		Valve Heart Transcatheter With Commander 26mm Sapien 3 20 $46,767.83 $95,875.00 $76,891.75 —
SUP-9600CT26A
CDM 		Valve Heart Transcatheter With Certitude Sheath 26mm Sapien 3 20 $46,767.83 $95,875.00 $76,891.75 —
SUP-9120AS326A
CDM 		Heart Valve Sapien Transcather With Ascendra 2 Transapical System 25mm 20 $46,767.83 $95,875.00 $76,891.75 —
SUP-9120AS323A
CDM 		Heart Valve Sapien Transcather With Ascendra 2 Transapical System 23mm 20 $46,767.83 $95,875.00 $76,891.75 —
SUP-9600CT29A
CDM 		Valve Heart Transcatheter With Certitude Sheath 29mm Sapien 3 20 $46,767.83 $95,875.00 $76,891.75 —
SUP-9355NF26A
CDM 		Valve Heart Aortic Transcatheter Sapien 26mm Novaflex Plus 20 $46,767.83 $95,875.00 $76,891.75 —
SUP-S3UCM223A
CDM 		System Valve Heart Transcatheter 3 Ultra 23mm With Commander System Edwards Sapi… 20 $46,767.83 $95,875.00 $76,891.75 nat. median
$62,294
1.2× median
SUP-S3UCM220A
CDM 		System Valve Heart Transcatheter 3 Ultra 20mm With Commander System Edwards Sapi… 20 $46,767.83 $95,875.00 $76,891.75 —
SUP-S3USTA126A
CDM 		System Valve Heart Transcatheter 3 Ultra 26mm With Certitude System Edwards Sapi… 20 $46,767.83 $95,875.00 $76,891.75 —
SUP-9600CT20A
CDM 		Valve Heart Transcatheter With Certitude Sheath 20mm Sapien 3 20 $46,767.83 $95,875.00 $76,891.75 —
SUP-9100RF326A
CDM 		Heart Valve Sapien Transcather With Retroflex 3 Tranfemoral System 26mm 20 $46,767.83 $95,875.00 $76,891.75 —
SUP-9600CM20A
CDM 		Valve Heart Transcatheter With Commander 20mm Sapien 3 20 $46,767.83 $95,875.00 $76,891.75 —
SUP-S3UCM226A
CDM 		System Valve Heart Transcatheter 3 Ultra 26mm With Commander System Edwards Sapi… 20 $46,767.83 $95,875.00 $76,891.75 nat. median
$62,294
1.2× median
SUP-9355NF23A
CDM 		Valve Heart Aortic Transcatheter Sapien 23mm Novaflex Plus 20 $46,767.83 $95,875.00 $76,891.75 —
SUP-9100RF323A
CDM 		Heart Valve Sapien Transcather With Retroflex 3 Tranfemoral System 23mm 20 $46,767.83 $95,875.00 $76,891.75 —
SUP-9355ASP29A
CDM 		Valve Heart Aortic Transcatheter Sapien Xt 29mm Ascendra Plus 20 $46,767.83 $95,875.00 $76,891.75 —
SUP-S3USTA129A
CDM 		System Valve Heart Transcatheter 3 Ultra 29mm With Certitude System Edwards Sapi… 20 $46,767.83 $95,875.00 $76,891.75 —
SUP-9600CM23A
CDM 		Valve Heart Transcatheter With Commander 23mm Sapien 3 20 $46,767.83 $95,875.00 $76,891.75 —
SUP-9355NF29A
CDM 		Valve Heart Aortic Transcatheter Sapien 29mm Novaflex Plus 20 $46,767.83 $95,875.00 $76,891.75 —
SUP-9355ASP26A
CDM 		Valve Heart Aortic Transcatheter Sapien Xt 26mm Ascendra Plus 20 $46,767.83 $95,875.00 $76,891.75 —
SUP-S3USTA120A
CDM 		System Valve Heart Transcatheter 3 Ultra 20mm With Certitude System Edwards Sapi… 20 $46,767.83 $95,875.00 $76,891.75 nat. median
$62,294
1.2× median
SUP-9600CT23A
CDM 		Valve Heart Transcatheter With Certitude Sheath 23mm Sapien 3 20 $46,767.83 $95,875.00 $76,891.75 —
SUP-S3USTA123A
CDM 		System Valve Heart Transcatheter 3 Ultra 23mm With Certitude System Edwards Sapi… 20 $46,767.83 $95,875.00 $76,891.75 —
SUP-EVFXPLUS-29
CDM 		Valve Aortic Transcatheter 29mm Annulus 23-26mm Tavr Evolut Fx Plus 20 $43,170.30 $88,500.00 $70,977.00 —
SUP-MCS-P3-26-AOA-US
CDM 		Valve Aortic Corevalve Transcatheter 26mm 20 $43,170.30 $88,500.00 $70,977.00 —
SUP-MCS-P3-29-AOA-US
CDM 		Valve Aortic Corevalve Transcatheter 29mm 20 $43,170.30 $88,500.00 $70,977.00 —
SUP-EVOLUTFX-34
CDM 		Transcatheter Aortic Valve 34mm Evolut Fx 20 $43,170.30 $88,500.00 $70,977.00 —
SUP-EVOLUTR-34-US
CDM 		Valve Aortic Transcatheter 34mm Evolut R 20 $43,170.30 $88,500.00 $70,977.00 —
SUP-EVOLUTPRO-29-US
CDM 		Valve Aortic Transcatheter Replacement 29mm Evolut Pro 20 $43,170.30 $88,500.00 $70,977.00 —
SUP-EVOLUTR-29-US
CDM 		Valve Aortic Transcatheter 29mm Evolut R 20 $43,170.30 $88,500.00 $70,977.00 —
SUP-EVOLUTPRO-26-US
CDM 		Valve Aortic Transcatheter Replacement 26mm Evolut Pro 20 $43,170.30 $88,500.00 $70,977.00 —
SUP-MCS-P3-31-AOA-US
CDM 		Valve Aortic Corevalve Transcatheter 31mm 20 $43,170.30 $88,500.00 $70,977.00 —
SUP-EVPROPLUS-29US
CDM 		Valve Aortic Transcatheter Sterile 29mm Evolut Pro Plus 20 $43,170.30 $88,500.00 $70,977.00 nat. median
$57,502
1.2× median
SUP-EVFXPLUS-34
CDM 		Valve Aortic Transcatheter 34mm Annulus 26-30mm Tavr Evolut Fx Plus 20 $43,170.30 $88,500.00 $70,977.00 —
SUP-EVFXPLUS-26
CDM 		Valve Aortic Transcatheter 26mm Annulus 20-23mm Tavr Evolut Fx Plus 20 $43,170.30 $88,500.00 $70,977.00 —
SUP-EVOLUTPRO-23-US
CDM 		Valve Aortic Transcatheter Replacement 23mm Evolut Pro 20 $43,170.30 $88,500.00 $70,977.00 —

Other procedures at this hospital

Browse this hospital's 15,213 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
             
SUP-106524US CDM Kit Implant Lvad W/controller Heartmate 3 22 20 $318,361.05 $318,361.05 $155,296.52 $318,361.05 $255,325.56 2026-04-03
SUP-1103 CDM Kit Implant Pump Hvad 22 20 $220,217.50 $220,217.50 $107,422.10 $220,217.50 $176,614.43 2026-04-03
SUP-1000100 CDM Pump Heart With Smartassist Impella 5.5 22 20 $132,750.00 $132,750.00 $64,755.45 $132,750.00 $106,465.50 2026-04-03
405 MS_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders,extreme 4 1 $113,327.96 $113,327.96 $61,914.80 $153,798.00 $102,469.50 2026-04-03
SUP-D0146 CDM Device Liver Perfusion Disposable Sterile Single-use Metra 22 20 $112,100.00 $112,100.00 $54,682.38 $112,100.00 $89,904.20 2026-04-03
SUP-TCG50100 CDM System Transcatheter Edge To Edge Repair G5 Steerable Guide Catheter With Up To … 22 20 $106,200.00 $106,200.00 $51,804.36 $106,200.00 $85,172.40 2026-04-03
681 MS_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms,major 2 1 $52,975.89 $52,975.89 $76,038.40 $87,444.20 $81,741.30 2026-04-03
SUP-S3URCM26A CDM Valve Heart Transcatheter With Commander System 26mm Edwards Sapien 3 Ultra Resi… 22 20 $100,300.00 $100,300.00 $48,926.34 $100,300.00 $80,440.60 2026-04-03
SUP-S3URCM20A CDM Valve Heart Transcatheter With Commander System 20mm Edwards Sapien 3 Ultra Resi… 22 20 $100,300.00 $100,300.00 $48,926.34 $100,300.00 $80,440.60 2026-04-03
SUP-S3URCM29A CDM Valve Heart Transcatheter With Commander System 29mm Edwards Sapien 3 Ultra Resi… 22 20 $100,300.00 $100,300.00 $48,926.34 $100,300.00 $80,440.60 2026-04-03
SUP-S3URCM23A CDM Valve Heart Transcatheter With Commander System 23mm Edwards Sapien 3 Ultra Resi… 22 20 $100,300.00 $100,300.00 $48,926.34 $100,300.00 $80,440.60 2026-04-03
SUP-MCG50100 CDM System Transcatheter Edge To Edge Repair G5 Steerable Guide Catheter With Up To … 22 20 $97,350.00 $97,350.00 $47,487.33 $97,350.00 $78,074.70 2026-04-03
SUP-9600CM23A CDM Valve Heart Transcatheter With Commander 23mm Sapien 3 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-9355ASP29A CDM Valve Heart Aortic Transcatheter Sapien Xt 29mm Ascendra Plus 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-9355ASP26A CDM Valve Heart Aortic Transcatheter Sapien Xt 26mm Ascendra Plus 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-9600CM26A CDM Valve Heart Transcatheter With Commander 26mm Sapien 3 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-9600CT26A CDM Valve Heart Transcatheter With Certitude Sheath 26mm Sapien 3 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-9600CT29A CDM Valve Heart Transcatheter With Certitude Sheath 29mm Sapien 3 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-9600CT20A CDM Valve Heart Transcatheter With Certitude Sheath 20mm Sapien 3 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-9355NF23A CDM Valve Heart Aortic Transcatheter Sapien 23mm Novaflex Plus 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-S3USTA129A CDM System Valve Heart Transcatheter 3 Ultra 29mm With Certitude System Edwards Sapi… 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-9600CT23A CDM Valve Heart Transcatheter With Certitude Sheath 23mm Sapien 3 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-S3UCM223A CDM System Valve Heart Transcatheter 3 Ultra 23mm With Commander System Edwards Sapi… 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-9120AS323A CDM Heart Valve Sapien Transcather With Ascendra 2 Transapical System 23mm 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-9600CM29A CDM Valve Heart Transcatheter With Commander 29mm Sapien 3 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-9355ASP23A CDM Valve Heart Aortic Transcatheter Sapien Xt 23mm Ascendra Plus 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-S3UCM220A CDM System Valve Heart Transcatheter 3 Ultra 20mm With Commander System Edwards Sapi… 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-S3UCM226A CDM System Valve Heart Transcatheter 3 Ultra 26mm With Commander System Edwards Sapi… 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-S3USTA123A CDM System Valve Heart Transcatheter 3 Ultra 23mm With Certitude System Edwards Sapi… 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-9100RF323A CDM Heart Valve Sapien Transcather With Retroflex 3 Tranfemoral System 23mm 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-9600CM20A CDM Valve Heart Transcatheter With Commander 20mm Sapien 3 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-S3USTA120A CDM System Valve Heart Transcatheter 3 Ultra 20mm With Certitude System Edwards Sapi… 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-9355NF26A CDM Valve Heart Aortic Transcatheter Sapien 26mm Novaflex Plus 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-9100RF326A CDM Heart Valve Sapien Transcather With Retroflex 3 Tranfemoral System 26mm 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-9355NF29A CDM Valve Heart Aortic Transcatheter Sapien 29mm Novaflex Plus 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-9120AS326A CDM Heart Valve Sapien Transcather With Ascendra 2 Transapical System 25mm 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-S3USTA126A CDM System Valve Heart Transcatheter 3 Ultra 26mm With Certitude System Edwards Sapi… 22 20 $95,875.00 $95,875.00 $46,767.83 $95,875.00 $76,891.75 2026-04-03
SUP-MCS-P3-26-AOA-US CDM Valve Aortic Corevalve Transcatheter 26mm 22 20 $88,500.00 $88,500.00 $43,170.30 $88,500.00 $70,977.00 2026-04-03
SUP-EVOLUTFX-26 CDM Transcatheter Aortic Valve 26mm Evolut Fx 22 20 $88,500.00 $88,500.00 $43,170.30 $88,500.00 $70,977.00 2026-04-03
SUP-EVOLUTPRO-26-US CDM Valve Aortic Transcatheter Replacement 26mm Evolut Pro 22 20 $88,500.00 $88,500.00 $43,170.30 $88,500.00 $70,977.00 2026-04-03
SUP-MCS-P3-31-AOA-US CDM Valve Aortic Corevalve Transcatheter 31mm 22 20 $88,500.00 $88,500.00 $43,170.30 $88,500.00 $70,977.00 2026-04-03
SUP-EVOLUTR-23-US CDM Aortic Valve Transcatheter Evolut R 23mm 22 20 $88,500.00 $88,500.00 $43,170.30 $88,500.00 $70,977.00 2026-04-03
SUP-EVOLUTR-29-US CDM Valve Aortic Transcatheter 29mm Evolut R 22 20 $88,500.00 $88,500.00 $43,170.30 $88,500.00 $70,977.00 2026-04-03
SUP-EVOLUTPRO-23-US CDM Valve Aortic Transcatheter Replacement 23mm Evolut Pro 22 20 $88,500.00 $88,500.00 $43,170.30 $88,500.00 $70,977.00 2026-04-03
SUP-EVFXPLUS-34 CDM Valve Aortic Transcatheter 34mm Annulus 26-30mm Tavr Evolut Fx Plus 22 20 $88,500.00 $88,500.00 $43,170.30 $88,500.00 $70,977.00 2026-04-03
SUP-EVPROPLUS-29US CDM Valve Aortic Transcatheter Sterile 29mm Evolut Pro Plus 22 20 $88,500.00 $88,500.00 $43,170.30 $88,500.00 $70,977.00 2026-04-03
SUP-EVOLUTPRO-29-US CDM Valve Aortic Transcatheter Replacement 29mm Evolut Pro 22 20 $88,500.00 $88,500.00 $43,170.30 $88,500.00 $70,977.00 2026-04-03
SUP-EVFXPLUS-23 CDM Valve Aortic Transcatheter 23mm Annulus 17/18-20mm Tavr Evolut Fx Plus 22 20 $88,500.00 $88,500.00 $43,170.30 $88,500.00 $70,977.00 2026-04-03
SUP-EVOLUTFX-23 CDM Transcatheter Aortic Valve 23mm Evolut Fx 22 20 $88,500.00 $88,500.00 $43,170.30 $88,500.00 $70,977.00 2026-04-03
SUP-EVPROPLUS-26US CDM Valve Aortic Transcatheter Sterile 26mm Evolut Pro Plus 22 20 $88,500.00 $88,500.00 $43,170.30 $88,500.00 $70,977.00 2026-04-03
SUP-EVFXPLUS-29 CDM Valve Aortic Transcatheter 29mm Annulus 23-26mm Tavr Evolut Fx Plus 22 20 $88,500.00 $88,500.00 $43,170.30 $88,500.00 $70,977.00 2026-04-03
SUP-EVOLUTR-34-US CDM Valve Aortic Transcatheter 34mm Evolut R 22 20 $88,500.00 $88,500.00 $43,170.30 $88,500.00 $70,977.00 2026-04-03
SUP-MCS-P3-29-AOA-US CDM Valve Aortic Corevalve Transcatheter 29mm 22 20 $88,500.00 $88,500.00 $43,170.30 $88,500.00 $70,977.00 2026-04-03
SUP-EVFXPLUS-26 CDM Valve Aortic Transcatheter 26mm Annulus 20-23mm Tavr Evolut Fx Plus 22 20 $88,500.00 $88,500.00 $43,170.30 $88,500.00 $70,977.00 2026-04-03
SUP-EVOLUTR-26-US CDM Valve Aortic Transcatheter 26mm Evolut R 22 20 $88,500.00 $88,500.00 $43,170.30 $88,500.00 $70,977.00 2026-04-03
SUP-EVOLUTFX-29 CDM Transcatheter Aortic Valve 29mm Evolut Fx 22 20 $88,500.00 $88,500.00 $43,170.30 $88,500.00 $70,977.00 2026-04-03
SUP-EVOLUTFX-34 CDM Transcatheter Aortic Valve 34mm Evolut Fx 22 20 $88,500.00 $88,500.00 $43,170.30 $88,500.00 $70,977.00 2026-04-03
710 MS_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure,extreme 6 1 $86,756.25 $86,756.25 $39,677.80 $140,924.00 $68,760.35 2026-04-03
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 14 14 $111,711.91 $111,711.91 $60,924.20 $88,962.05 $67,056.82 2026-04-03
SUP-4000021 CDM Set Pump With Smart Assist Plus 7fr Companion Sheath Bundle Impella Cp 22 20 $79,650.00 $79,650.00 $38,853.27 $79,650.00 $63,879.30 2026-04-03
325 MS_DRG Non-elective Or Complex Knee Joint Replacement,moderate 2 1 $86,795.73 $86,795.73 $58,506.80 $67,282.90 $62,894.85 2026-04-03
SUP-NIPG3000 CDM Kit Implantable Pulse Generator Neurostimulator 8.5x15.5 Hfx Iq Senza 18 17 $73,750.00 $73,750.00 $35,975.25 $73,750.00 $62,628.50 2026-04-03
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 14 14 $211,207.16 $211,207.16 $56,718.79 $82,858.22 $62,455.94 2026-04-03
SUP-NVRO-27 CDM Valve Aortic Transcatheter With Radiopaque Markers 27mm Navitor 22 20 $77,437.50 $77,437.50 $37,774.01 $77,437.50 $62,104.88 2026-04-03
SUP-NVRO-29 CDM Valve Aortic Transcatheter With Radiopaque Markers 29mm Navitor 22 20 $77,437.50 $77,437.50 $37,774.01 $77,437.50 $62,104.88 2026-04-03
SUP-NVRO-25 CDM Valve Aortic Transcatheter With Radiopaque Markers 25mm Navitor 22 20 $77,437.50 $77,437.50 $37,774.01 $77,437.50 $62,104.88 2026-04-03
SUP-NVRO-23 CDM Valve Aortic Transcatheter With Radiopaque Markers 23mm Navitor 22 20 $77,437.50 $77,437.50 $37,774.01 $77,437.50 $62,104.88 2026-04-03
SUP-NVRO-35 CDM Valve Aortic Transcatheter With Radiopaque Markers 35mm Navitor 22 20 $77,437.50 $77,437.50 $37,774.01 $77,437.50 $62,104.88 2026-04-03
424 MS_DRG Other Endocrine Disorders,extreme 2 1 $42,745.85 $42,745.85 $56,282.40 $64,724.70 $60,503.55 2026-04-03
SUP-PLVAD06796 CDM Set Pump Percutaneous Left Ventricular Assist Device Elevate 22 20 $73,920.00 $73,920.00 $36,058.18 $73,920.00 $59,283.84 2026-04-03
SUP-1000323 CDM Pump Heart With Smart Assist Impella Rp 22 20 $73,750.00 $73,750.00 $35,975.25 $73,750.00 $59,147.50 2026-04-03
SUP-0048-0003 CDM Set Pump Ventricular Assist Device Impella Cp 22 20 $73,750.00 $73,750.00 $35,975.25 $73,750.00 $59,147.50 2026-04-03
SUP-005062 CDM Pump Ventricular Assist Device Impella 5.0 22 20 $73,750.00 $73,750.00 $35,975.25 $73,750.00 $59,147.50 2026-04-03
SUP-004334 CDM Set Pump Ventricular Assist Device Impella Rp 22 20 $73,750.00 $73,750.00 $35,975.25 $73,750.00 $59,147.50 2026-04-03
C2624 HCPCS Sensor Implantable Cardiomems 18 17 $66,220.00 $66,220.00 $32,302.12 $66,220.00 $56,234.02 2026-04-03
SUP-SYM-SV25-006-C CDM Valve Aortic Clinical Medium 25mm Acurate Neo 22 20 $68,992.00 $68,992.00 $33,654.30 $68,992.00 $55,331.58 2026-04-03
SUP-SYM-SV27-006-C CDM Valve Aortic Clinical Large 27mm Acurate Neo 22 20 $68,992.00 $68,992.00 $33,654.30 $68,992.00 $55,331.58 2026-04-03
SUP-SYM-SV23-006-C CDM Valve Aortic Clinical Small 23mm Acurate Neo 22 20 $68,992.00 $68,992.00 $33,654.30 $68,992.00 $55,331.58 2026-04-03
461 MS_DRG Kidney And Urinary Tract Malignancy,extreme 2 1 $55,752.70 $55,752.70 $51,367.30 $59,072.40 $55,219.85 2026-04-03
C1767 HCPCS Generator Neurostimulator Implantable Non Rechargeable 16 Channel Eonc Ipg Mini 362 19 $60,060.00 $60,060.00 $188.29 $112,660.50 $52,560.00 2026-04-03
SUP-W4-4-3 CDM System Aneurysm Embolization 3mmx4mm Via 21 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W4-6-3 CDM System Aneurysm Embolization 3mmx6mm Via 21 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W4-7-S CDM System Aneurysm Embolization 5.6mmx7mm Via 21 Web Sls 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W4-5-3 CDM System Aneurysm Embolization 3mmx5mm Via 21 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W2-10-7 CDM System Aneurysm Embolization 7mmx10mm Via 33 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W4-5-4 CDM System Aneurysm Embolization 4mmx5mm Via 21 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W2-10-5 CDM System Aneurysm Embolization 5mmx10mm Via 33 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W2-10-S CDM System Aneurysm Embolization 8.6mmx10mm Via 33 Web Sls 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W4-5-S CDM System Aneurysm Embolization 3.6mmx5mm Via 21 Web Sls 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W4-7-3 CDM System Aneurysm Embolization 3mmx7mm Via 21 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W2-9-5 CDM System Aneurysm Embolization 5mmx9mm Via 27 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W4-6-5 CDM System Aneurysm Embolization 5mmx6mm Via 21 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W2-11-S CDM System Aneurysm Embolization 9.6mmx11mm Via 33 Web Sls 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W2-11-6 CDM System Aneurysm Embolization 6mmx11mm Via 33 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W2-9-6 CDM System Aneurysm Embolization 6mmx9mm Via 27 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W2-8-5 CDM System Aneurysm Embolization 5mmx8mm Via 27 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W2-11-7 CDM System Aneurysm Embolization 7mmx11mm Via 33 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W2-11-9 CDM System Aneurysm Embolization 9mmx11mm Via 33 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W2-8-4 CDM System Aneurysm Embolization 4mmx8mm Via 27 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W2-8-3 CDM System Aneurysm Embolization 3mmx8mm Via 27 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W2-8-6 CDM System Aneurysm Embolization 6mmx8mm Via 27 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W4-7-4 CDM System Aneurysm Embolization 4mmx7mm Via 21 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W2-9-S CDM System Aneurysm Embolization 7.6mmx9mm Via 27 Web Sls 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W4-7-5 CDM System Aneurysm Embolization 5mmx7mm Via 21 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W4-6-4 CDM System Aneurysm Embolization 4mmx6mm Via 21 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W2-8-S CDM System Aneurysm Embolization 6.6mmx8mm Via 27 Web Sls 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W2-9-4 CDM System Aneurysm Embolization 4mmx9mm Via 27 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W4-4-S CDM System Aneurysm Embolization 2.6mmx4mm Via 21 Web Sls 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W4-6-S CDM System Aneurysm Embolization 4.6mmx6mm Via 21 Web Sls 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W2-11-8 CDM System Aneurysm Embolization 8mmx11mm Via 33 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W2-10-8 CDM System Aneurysm Embolization 8mmx10mm Via 33 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W2-10-6 CDM System Aneurysm Embolization 6mmx10mm Via 33 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-W2-9-7 CDM System Aneurysm Embolization 7mmx9mm Via 27 Web Sl 22 20 $65,481.00 $65,481.00 $31,941.63 $65,481.00 $52,515.76 2026-04-03
SUP-SGPV00 CDM Valve Pulmonary Sg And Conduit 6mm-32mm Cryovalve 22 20 $65,262.00 $65,262.00 $31,834.80 $65,262.00 $52,340.12 2026-04-03
SUP-5444-01-410 CDM Implant Customized Craniofacial Large Extra Medpor 22 20 $65,157.40 $65,157.40 $31,783.78 $65,157.40 $52,256.24 2026-04-03
C1820 HCPCS Microstimulator Interstim Rechargeable Battery 144 17 $63,756.00 $63,756.00 $22,933.88 $88,485.25 $52,117.91 2026-04-03
SUP-PED-350-35 CDM Coil Embolization Device 3.50mmx35mm Pipeline Flex 22 20 $64,964.16 $64,964.16 $31,689.52 $64,964.16 $52,101.26 2026-04-03
SUP-PED-400-35 CDM Device Emobilization 4 Flex Technology 4.00mmx35mm Pipeline 22 20 $64,964.16 $64,964.16 $31,689.52 $64,964.16 $52,101.26 2026-04-03
SUP-PED-475-25 CDM Coil Embolization Aneurysm Intracranial Sterile Latex Free 4.75mmx25mm Pipeline … 22 20 $64,964.16 $64,964.16 $31,689.52 $64,964.16 $52,101.26 2026-04-03
SUP-PED-350-25 CDM Coil Pipeline Flex Embolization Device 3.5mmx25mm 22 20 $64,964.16 $64,964.16 $31,689.52 $64,964.16 $52,101.26 2026-04-03
SUP-PED-425-25 CDM Device Emobilization 4 Flex Technology 4.25mmx25mm Pipeline 22 20 $64,964.16 $64,964.16 $31,689.52 $64,964.16 $52,101.26 2026-04-03
SUP-PED-425-35 CDM Device Emobilization 4 Flex Technology 4.25mmx35mm Pipeline 22 20 $64,964.16 $64,964.16 $31,689.52 $64,964.16 $52,101.26 2026-04-03
SUP-PED-475-35 CDM Device Emobilization 4 Flex Technology 4.75mmx35mm Pipeline 22 20 $64,964.16 $64,964.16 $31,689.52 $64,964.16 $52,101.26 2026-04-03
SUP-PED-400-25 CDM Device Emobilization 4 Flex Technology 4.00mmx25mm Pipeline 22 20 $64,964.16 $64,964.16 $31,689.52 $64,964.16 $52,101.26 2026-04-03
SUP-PED-500-25 CDM Coil Neurovascular Embolization 5.0mmx25mm Sterile Latex Free Pipeline Flex 22 20 $64,964.16 $64,964.16 $31,689.52 $64,964.16 $52,101.26 2026-04-03
SUP-PED-500-35 CDM Coil Flex Embolization Device Sterile Latex Free 5.00mmx35mm Pipeline 22 20 $64,964.16 $64,964.16 $31,689.52 $64,964.16 $52,101.26 2026-04-03
SUP-PED-375-25 CDM Device Emobilization 4 Flex Technology 3.75mmx25mm Pipeline 22 20 $64,964.16 $64,964.16 $31,689.52 $64,964.16 $52,101.26 2026-04-03
SUP-PED-500-30 CDM Coil Embolization Neurovascular 5.0x30mm Pipeline Flex 22 20 $64,964.16 $64,964.16 $31,689.52 $64,964.16 $52,101.26 2026-04-03
120 MS_DRG Major Respiratory And Chest Procedures,minor 4 1 $95,240.65 $95,240.65 $43,054.70 $61,037.90 $51,294.65 2026-04-03
SUP-TR1-2929 CDM System Lateral Interbody Fusion Veo 22 20 $63,926.10 $63,926.10 $31,183.15 $63,926.10 $51,268.73 2026-04-03
SUP-25-9029 CDM Kit Contains 2 Cages Cat 22-0467-03 And 22-0489-03 2l Veo 22 20 $63,926.10 $63,926.10 $31,183.15 $63,926.10 $51,268.73 2026-04-03
SUP-3670 CDM Implant Spine Generator Proclaim Plus 5 18 17 $60,060.00 $60,060.00 $29,297.27 $60,060.00 $51,002.95 2026-04-03
SUP-405 011 000US2 CDM Monitor Advance Hd Aview 22 20 $63,488.10 $63,488.10 $30,969.50 $63,488.10 $50,917.46 2026-04-03
SUP-5444-0-510 CDM Kit Implant Midface Customized Medpor 22 20 $63,434.66 $63,434.66 $30,943.43 $63,434.66 $50,874.60 2026-04-03
SUP-M003SFD040200 CDM System Neurovascular Flow Diverter Delivery 4mmx20mm Surpass Streamline 22 20 $63,081.11 $63,081.11 $30,770.97 $63,081.11 $50,591.05 2026-04-03
SUP-M003SFD030150 CDM System Neurovascular Flow Diverter Delivery 3mmx15mm Surpass Streamline 22 20 $63,081.11 $63,081.11 $30,770.97 $63,081.11 $50,591.05 2026-04-03
SUP-M003SFD050200 CDM System Neurovascular Flow Diverter Delivery 5mmx20mm Surpass Streamline 22 20 $63,081.11 $63,081.11 $30,770.97 $63,081.11 $50,591.05 2026-04-03
SUP-M003SFD050250 CDM System Neurovascular Flow Diverter Delivery 5mmx25mm Surpass Streamline 22 20 $63,081.11 $63,081.11 $30,770.97 $63,081.11 $50,591.05 2026-04-03
SUP-M003SFD050300 CDM System Neurovascular Flow Diverter Delivery 5mmx30mm Surpass Streamline 22 20 $63,081.11 $63,081.11 $30,770.97 $63,081.11 $50,591.05 2026-04-03
SUP-M003SFD040250 CDM System Neurovascular Flow Diverter Delivery 4mmx25mm Surpass Streamline 22 20 $63,081.11 $63,081.11 $30,770.97 $63,081.11 $50,591.05 2026-04-03
SUP-M003SFD040300 CDM System Neurovascular Flow Diverter Delivery 4mmx30mm Surpass Streamline 22 20 $63,081.11 $63,081.11 $30,770.97 $63,081.11 $50,591.05 2026-04-03
SUP-M003SFD030250 CDM System Neurovascular Flow Diverter Delivery 3mmx25mm Surpass Streamline 22 20 $63,081.11 $63,081.11 $30,770.97 $63,081.11 $50,591.05 2026-04-03
SUP-M003SFD030200 CDM System Neurovascular Flow Diverter Delivery 3mmx20mm Surpass Streamline 22 20 $63,081.11 $63,081.11 $30,770.97 $63,081.11 $50,591.05 2026-04-03
SUP-M003SFD040150 CDM System Neurovascular Flow Diverter Delivery 4mmx15mm Surpass Streamline 22 20 $63,081.11 $63,081.11 $30,770.97 $63,081.11 $50,591.05 2026-04-03
SUP-PED2-400-18 CDM Device Embolization With Shield Technology 4mmx18mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-400-20 CDM Device Embolization With Shield Technology 4mmx20mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-400-16 CDM Device Embolization With Shield Technology 4mmx16mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-275-20 CDM Device Embolization With Shield Technology 2.75mmx20mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-350-12 CDM Device Embolization With Shield Technology 3.50mmx12mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-250-10 CDM Device Embolization With Shield Technology 2.5mmx10mm Pipeline Flex 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-275-14 CDM Device Embolization With Shield Technology 2.75mmx14mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-275-12 CDM Device Embolization With Shield Technology 2.75mmx12mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-300-12 CDM Device Embolization With Shield Technology 3mmx12mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-400-14 CDM Device Embolization With Shield Technology 4mmx14mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-425-18 CDM Device Embolization With Shield Technology 4.25mmx18mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-325-12 CDM Device Embolization With Shield Technology 3.25mmx12mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-400-10 CDM Device Embolization With Shield Technology 4mmx10mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-425-14 CDM Device Embolization With Shield Technology 4.25mmx14mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-425-10 CDM Device Embolization With Shield Technology 4.25mmx10mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-375-16 CDM Device Embolization With Shield Technology 3.75mmx16mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-300-10 CDM Device Embolization With Shield Technology 3mmx10mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-250-16 CDM Device Embolization With Shield Technology 2.5mmx16mm Pipeline Flex 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-400-12 CDM Device Embolization With Shield Technology 4mmx12mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-375-18 CDM Device Embolization With Shield Technology 3.75mmx18mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-375-20 CDM Device Embolization With Shield Technology 3.75mmx20mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-350-10 CDM Device Embolization With Shield Technology 3.50mmx10mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-250-12 CDM Device Embolization With Shield Technology 2.5mmx12mm Pipeline Flex 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-300-18 CDM Device Embolization With Shield Technology 3mmx18mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-350-14 CDM Device Embolization With Shield Technology 3.50mmx14mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-425-12 CDM Device Embolization With Shield Technology 4.25mmx12mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-450-12 CDM Device Embolization With Shield Technology 4.5mmx12mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-275-10 CDM Device Embolization With Shield Technology 2.75mmx10mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-375-10 CDM Device Embolization With Shield Technology 3.75mmx10mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-325-16 CDM Device Embolization With Shield Technology 3.25mmx16mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-450-10 CDM Device Embolization With Shield Technology 4.5mmx10mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-500-14 CDM Device Embolization With Shield Technology 5mmx14mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-325-18 CDM Device Embolization With Shield Technology 3.25mmx18mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-375-14 CDM Device Embolization With Shield Technology 3.75mmx14mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-325-20 CDM Device Embolization With Shield Technology 3.25mmx20mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-475-14 CDM Device Embolization With Shield Technology 4.75mmx14mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-425-20 CDM Device Embolization With Shield Technology 4.25mmx20mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-450-20 CDM Device Embolization With Shield Technology 4.5mmx20mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-275-16 CDM Device Embolization With Shield Technology 2.75mmx16mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-275-18 CDM Device Embolization With Shield Technology 3.50mmx25mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-350-18 CDM Device Embolization With Shield Technology 3.50mmx18mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-350-20 CDM Device Embolization With Shield Technology 3.50mmx20mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-350-16 CDM Device Embolization With Shield Technology 3.50mmx16mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-450-16 CDM Device Embolization With Shield Technology 4.5mmx16mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-250-14 CDM Device Embolization With Shield Technology 2.5mmx14mm Pipeline Flex 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-375-12 CDM Device Embolization With Shield Technology 3.75mmx12mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-300-14 CDM Device Embolization With Shield Technology 3mmx14mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-450-18 CDM Device Embolization With Shield Technology 4.5mmx18mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-475-12 CDM Device Embolization With Shield Technology 4.75mmx12mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-475-20 CDM Device Embolization With Shield Technology 4.75mmx20mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-475-16 CDM Device Embolization With Shield Technology 4.75mmx16mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-450-14 CDM Device Embolization With Shield Technology 4.5mmx14mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-500-20 CDM Device Embolization With Shield Technology 5mmx20mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-325-10 CDM Device Embolization With Shield Technology 3.25mmx10mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-500-10 CDM Device Embolization With Shield Technology 5mmx10mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-325-14 CDM Device Embolization With Shield Technology 3.25mmx14mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-500-16 CDM Device Embolization With Shield Technology 5mmx16mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-425-16 CDM Device Embolization With Shield Technology 4.25mmx16mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-475-18 CDM Device Embolization With Shield Technology 4.75mmx18mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-475-10 CDM Device Embolization With Shield Technology 4.75mmx10mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-300-20 CDM Device Embolization With Shield Technology 3mmx20mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-250-18 CDM Device Embolization With Shield Technology 2.5mmx18mm Pipeline Flex 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-500-18 CDM Device Embolization With Shield Technology 5mmx18mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-300-16 CDM Device Embolization With Shield Technology 3mmx16mm Pipeline 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
SUP-PED2-250-20 CDM Device Embolization With Shield Technology 2.5mmx20mm Pipeline Flex 22 20 $62,655.90 $62,655.90 $30,563.55 $62,655.90 $50,250.03 2026-04-03
323 MS_DRG Non-elective Or Complex Hip Joint Replacement,major 4 1 $62,014.89 $62,014.89 $37,225.50 $64,763.40 $49,562.65 2026-04-03
SUP-005042 CDM Set Pump Ventricular Assist Device Impella 2.5 22 20 $61,600.00 $61,600.00 $30,048.48 $61,600.00 $49,403.20 2026-04-03
230 MS_DRG Major Small Bowel Procedures,moderate 2 1 $121,375.37 $121,375.37 $45,336.10 $52,136.60 $48,736.35 2026-04-03
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 14 14 $110,189.84 $110,189.84 $43,961.54 $64,341.99 $48,498.99 2026-04-03
SUP-FA-71450-25 CDM Coil Embolization 4.50mmx25mm Pipeline 22 20 $60,281.94 $60,281.94 $29,405.53 $60,281.94 $48,346.12 2026-04-03
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 15 15 $75,206.30 $75,206.30 $43,222.63 $63,717.67 $48,028.40 2026-04-03
SUP-PED-250-12 CDM Coil Pipeline Flex Embolization Device 2.50mm X 12mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-350-14 CDM Device Flex Embolization 3.5mmx14mm Pipeline 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-500-14 CDM Device Embolization 4.75mmx14mm Pipeline Flex 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-500-20 CDM Coil Embolization Neurovascular 5.0x20mm Pipeline Flex 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-375-14 CDM Coil Pipeline Flex Embolization Device Sterile Latex Free 3.75mmx14mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-350-16 CDM Coil Pipeline Flex Embolization Device 3.5mm X 16mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-400-16 CDM Coil Pipeline Flex Embolization Device 4.00mm X 16mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-275-14 CDM Coil Pipeline Flex Embolization Device 2.75mm X 14mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-350-12 CDM Device Embolization Flex 3.50mmx12mm Pipeline 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-475-16 CDM Coil Pipeline Flex Embolization Device 4.75mm X 16mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-475-18 CDM Coil Pipeline Flex Embolization Device 4.75mm X 18mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-325-20 CDM Device Emobilization 4 Flex Technology 3.25mmx20mm Pipeline 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-475-20 CDM Coil Pipeline Flex Embolization Device 4.75mmx20mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-375-18 CDM Coil Pipeline Flex Embolization Device 3.75mm X 18mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-400-18 CDM Coil Pipeline Flex Embolization Device 4.00mm X 18mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-450-20 CDM Coil Pipeline Flex Embolization Device 4.5mmx20mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-250-20 CDM Device Embolization Flow Diverter Sterile Latex Free 2.5mmx20mm Pipeline Flex 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-325-12 CDM Coil Flex Embolization Device 3.25mmx12mm Pipeline 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-475-14 CDM Device Emobilization 4 Flex Technology 4.75mmx14mm Pipeline 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-450-12 CDM Device Embolization Flex Sterile Latex Free 4.5mmx12mm Pipeline 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-425-20 CDM Coil Pipeline Flex Embolization Device 4.25mm X 20mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-425-18 CDM Coil Pipeline Flex Embolization Device 4.25mm X 18mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-450-14 CDM Coil Pipeline Flex Embolization Device 4.50mm X 14mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-450-16 CDM Coil Pipeline Flex Embolization Device 4.50mm X 16mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-425-14 CDM Coil Pipeline Flex Embolization Device 4.25mm X 14mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-300-14 CDM Coil Pipeline Flex Embolization Device 3.00mm X 14mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-325-16 CDM Coil Pipeline Flex Embolization Device Sterile Latex Free 3.25mmx16mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-400-12 CDM Coil Pipeline Flex Embolization Device 4mm X 12mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-425-12 CDM Device Emobilization 4 Flex Technology 4.25mmx12mm Pipeline 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-425-16 CDM Coil Pipeline Flex Embolization Device 4.25mm X 16mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-350-18 CDM Coil Pipeline Flex Embolization Device 3.5mm X 18mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-400-20 CDM Coil Pipeline Flex Embolization Device 4.00mmx20mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-250-14 CDM Device Emobilization 4 Flex Technology 2.50mmx14mm Pipeline 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-300-18 CDM Device Emobilization 4 Flex Technology 3.00mmx18mm Pipeline 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-325-14 CDM Device Emobilization 4 Flex Technology 3.25mmx14mm Pipeline 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-400-14 CDM Coil Pipeline Flex Embolization Device 4.00mm X 14mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-PED-450-18 CDM Coil Pipeline Flex Embolization Device 4.50mm X 18mm 22 20 $59,673.12 $59,673.12 $29,108.55 $59,673.12 $47,857.85 2026-04-03
SUP-23VAVGJ-515 CDM Graft Aortic Valved Mechanical With Gelweave Valsalva 23mm 22 20 $59,243.88 $59,243.88 $28,899.16 $59,243.88 $47,513.59 2026-04-03
SUP-25VAVGJ-515 CDM Graft Aortic Valved Mechanical With Gelweave Valsalva 25mm 22 20 $59,243.88 $59,243.88 $28,899.16 $59,243.88 $47,513.59 2026-04-03
SUP-27VAVGJ-515 CDM Graft Aortic Valved Mechanical With Gelweave Valsalva 27mm 22 20 $59,243.88 $59,243.88 $28,899.16 $59,243.88 $47,513.59 2026-04-03
SUP-G38067 CDM Graft Endovascular Custom 22 20 $59,130.00 $59,130.00 $28,843.61 $59,130.00 $47,422.26 2026-04-03
SUP-G38186 CDM Graft Endovascular Aaa Reinforced Fenestrated Proximal Custom 34mmx30mmx111mm 22 20 $59,130.00 $59,130.00 $28,843.61 $59,130.00 $47,422.26 2026-04-03
SUP-G38035 CDM Graft Endovascular Aaa Reinforced Fenestrated Priximal Custom 22 20 $59,130.00 $59,130.00 $28,843.61 $59,130.00 $47,422.26 2026-04-03
SUP-G50416 CDM Graft Aortic Aneurysm Body Proximal Fenestrated Pre Loaded 32mmx22mmx196mm Zenit… 22 20 $59,130.00 $59,130.00 $28,843.61 $59,130.00 $47,422.26 2026-04-03
SUP-G38013 CDM Graft Endovascular Aaa Reinforced Fenestrated Proximal Custom 22 20 $59,130.00 $59,130.00 $28,843.61 $59,130.00 $47,422.26 2026-04-03
SUP-TR1-2907 CDM Rod Stabilization System 2l Plus Axialif 22 20 $59,108.10 $59,108.10 $28,832.93 $59,108.10 $47,404.70 2026-04-03
C1772 HCPCS Pump Infusion Reservoir 20ml Synchmed Ii 18 17 $55,472.70 $55,472.70 $27,059.58 $55,472.70 $47,107.42 2026-04-03
171 MS_DRG Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock,moderate 2 1 $55,232.98 $55,232.98 $43,533.80 $50,063.80 $46,798.80 2026-04-03
SUP-5444-0-210 CDM Kit Implant Cranial Custom Medium Medpor 22 20 $57,825.55 $57,825.55 $28,207.30 $57,825.55 $46,376.09 2026-04-03
231 MS_DRG Major Large Bowel Procedures,major 6 1 $46,437.73 $46,437.73 $33,255.60 $76,723.20 $46,228.10 2026-04-03
C1882 HCPCS Icd Resynchronization Dual Chamber Df4 Connector 73mmx51mm Viva Xt 360 17 $54,093.00 $54,093.00 $11,751.10 $94,414.75 $46,200.00 2026-04-03
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 15 15 $61,675.62 $61,675.62 $41,062.63 $60,560.22 $45,648.40 2026-04-03
SUP-SG-HBB-24-96-80-20-A CDM Stent Flexible Graft System Aorfix Aaa Main Body 24mm X 96mm X 80mm X 20mm 22 20 $56,918.10 $56,918.10 $27,764.65 $56,918.10 $45,648.32 2026-04-03
L8614 HCPCS Kit Implant Bci 602 Bonebridge 321 20 $57,334.20 $57,334.20 $2,558.67 $86,140.00 $45,591.42 2026-04-03
SUP-G32535 CDM Graft Stent Endovascular Fenestrated Proximal Body Aaa 24mmx109mm Zenith 22 20 $56,839.26 $56,839.26 $27,726.19 $56,839.26 $45,585.09 2026-04-03
SUP-G32543 CDM Graft Stent Endovascular Fenestrated Proximal Body Aaa 30mmx124mm Zenith 22 20 $56,839.26 $56,839.26 $27,726.19 $56,839.26 $45,585.09 2026-04-03
121 MS_DRG Other Respiratory And Chest Procedures,moderate 2 1 $57,453.11 $57,453.11 $42,254.50 $48,592.70 $45,423.60 2026-04-03
SUP-FA-77475-18 CDM Coil Embolization 4.75mmx18mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-FA-77475-16 CDM Coil Embolization 4.75mmx16mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-FA-77500-16 CDM Coil Embolization 50.00mmx16mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-FA-77475-20 CDM Coil Embolization 4.75mmx20mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-FA-77500-20 CDM Coil Embolization 50.00mmx20mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-FA-77450-20 CDM Coil Embolization 4.50mmx20mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-FA-77450-14 CDM Coil Embolization 4.50mmx14mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-FA-77450-16 CDM Coil Embolization 4.50mmx16mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-FA-77450-18 CDM Coil Embolization 4.50mmx18mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-FA-77425-18 CDM Coil Embolization 4.25mmx18mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-FA-77400-18 CDM Coil Embolization 40.00mmx18mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-FA-77400-20 CDM Coil Embolization 40.00mmx20mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-FA-77375-18 CDM Coil Embolization 3.75mmx18mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-FA-77425-14 CDM Coil Embolization 4.25mmx14mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-FA-77375-20 CDM Coil Embolization 3.75mmx20mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-FA-77400-16 CDM Coil Embolization 40.00mmx16mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-FA-77375-16 CDM Coil Embolization 3.75mmx16mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-FA-77425-16 CDM Coil Embolization 4.25mmx16mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-FA-77325-16 CDM Coil Embolization 3.25mmx16mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-FA-77300-20 CDM Coil Embolization 30.00mmx20mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-FA-77250-16 CDM Device Embolization Pipeline Sterile Latex Free 2.50mmx16mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-FA-77350-18 CDM Coil Embolization 3.50mmx18mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-FA-77350-20 CDM Coil Embolization 3.50mmx20mm Pipeline 22 20 $56,396.88 $56,396.88 $27,510.40 $56,396.88 $45,230.29 2026-04-03
SUP-TGT3420 CDM Graft Endoprosthesis Thoracic Aortic Aneurysm 34mmx20cm Tag 22 20 $55,845.00 $55,845.00 $27,241.19 $55,845.00 $44,787.69 2026-04-03
SUP-TGT2610 CDM Graft Endoprosthesis Thoracic Aortic Aneurysm 26mmx10cm Tag 22 20 $55,845.00 $55,845.00 $27,241.19 $55,845.00 $44,787.69 2026-04-03
SUP-TGT3115 CDM Graft Endoprosthesis Thoracic Aortic Aneurysm 31mmx15cm Tag 22 20 $55,845.00 $55,845.00 $27,241.19 $55,845.00 $44,787.69 2026-04-03
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 14 14 $107,348.81 $107,348.81 $40,515.94 $59,340.98 $44,729.38 2026-04-03
SUP-60-000-23-09 CDM Implant Cranial Peek 00023 Ips 22 20 $55,747.19 $55,747.19 $27,193.48 $55,747.19 $44,709.24 2026-04-03
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