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

HENRY FORD ALLEGIANCE HEALTH

Jackson, MI · CCN 230092 · Rates published

17,422 distinct procedures filed
46 distinct payers
698,758 rate rows
2025-06-28 last MRF observed · ⚠ 14 mo old
Data quality

244,912 of 698,758 rate rows are consumer-grade (35.0%)

453,846 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
professional (physician) fee — not the facility price 298,597
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 149,006
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 5,972
placeholder amount (≤ $0.02) — excluded from medians 150
exceeds 10× this hospital's gross charge — excluded from medians 53
percent-of-charges filed in the dollar field — excluded from medians 33
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 31
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 4

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 14 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.henryford.com/-/media/files/henry-ford/patients-visitors/price-transparency-2026/382027689_henry-ford-health_standardcharges.csv
Found on page https://www.henryford.com/visitors/billing/cost-of-care/hospital-standard-charges
Discovered viaCMS hospital list
Last fetch not_modified · 2026-08-17
Content fingerprint 1d2e13a91df28010… · 487,328,925 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 20 $1,988,560.00 $4,958,415.00 $3,672,900.00 nat. median
$3,710,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 17 $1,988,560.00 $4,866,750.00 $3,605,000.00 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 19 $1,780,474.89 $4,489,363.93 $3,325,454.76 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 17 $1,711,448.00 $4,436,100.00 $3,239,500.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 17 $1,590,848.00 $4,006,800.00 $2,968,000.00 nat. median
$2,997,086
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 20 $1,288,253.89 $3,224,629.21 $2,388,614.23 nat. median
$2,460,273
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 17 $1,249,952.00 $3,148,200.00 $2,332,000.00 nat. median
$2,405,851
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 22 $303,174.38 $1,501,447.92 $529,192.86 nat. median
$691,418
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 22 $295,506.63 $1,495,576.46 $527,123.43 nat. median
$631,793
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 22 $283,175.46 $1,494,056.16 $526,587.59 nat. median
$610,161
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 22 $276,836.48 $1,479,651.46 $516,606.03 nat. median
$624,417
0.8× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 22 $262,381.19 $1,388,704.74 $489,455.96 nat. median
$588,565
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 22 $261,595.61 $1,306,635.96 $460,530.40 nat. median
$577,541
0.8× median
C9073
HCPCS 		Brexucabtagene Autoleucel Ca 1 $413,145.63 $413,145.63 $413,145.63 nat. median
$27,071
outlier · 15.3×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 18 $196,180.96 $756,292.49 $266,875.44 nat. median
$370,165
0.7× median
K0606
HCPCS 		Aed Garment W Elec Analysis 1 $201,031.88 $201,031.88 $201,031.88 nat. median
$3,697
outlier · 54.4×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 18 $167,223.55 $484,703.51 $177,256.96 nat. median
$205,166
0.9× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 18 $150,536.37 $544,869.23 $153,387.41 nat. median
$199,832
0.8× median
651
MS_DRG 		Neonate, Birth Weight 2000-2499 Grams, With Significant O.r. Procedures, With Mu… 1 $126,100.28 $126,100.28 $126,100.28 nat. median
$35,222
outlier · 3.6×
E0194
HCPCS 		Air Fluidized Bed 2 $12,533.34 $218,003.26 $115,268.30 nat. median
$4,438
outlier · 26.0×
K0743
HCPCS 		Portable Home Suction Pump 1 $104,160.00 $104,160.00 $104,160.00 nat. median
$795
outlier · 131.0×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 18 $99,803.68 $283,363.02 $102,871.52 nat. median
$132,706
0.8× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 14 $53,599.97 $495,999.75 $94,999.95 nat. median
$111,503
0.9× median
75987015003
NDC 		Inebilizumab-cdon 10 Mg/ml Intravenous Solution 14 $41,143.59 $123,430.76 $92,573.07 nat. median
$86,701
1.1× median
K0880
HCPCS 		Pwc Gp4 Vhd Sing Pow Opt S/b 1 $91,565.27 $91,565.27 $91,565.27 nat. median
$1,946
outlier · 47.1×
90288
HCPCS 		Botulism Ig IV 2 $48,705.00 $129,068.25 $88,886.62 nat. median
$52,716
1.7× median
G0448
HCPCS 		Place Perm Pacing Cardiovert 1 $85,168.29 $85,168.29 $85,168.29 nat. median
$8,162
outlier · 10.4×
00310453530
NDC 		Tremelimumab-actl 20 Mg/ml Intravenous Solution 14 $35,817.00 $107,451.00 $80,588.25 nat. median
$41,769
1.9× median
E0764
HCPCS 		Functional Neuromuscularstim 1 $78,639.76 $78,639.76 $78,639.76 nat. median
$1,656
outlier · 47.5×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 18 $76,289.24 $275,219.98 $78,215.71 nat. median
$100,978
0.8× median
E0469
HCPCS 		Lung Expans High Oscil Neb 1 $78,046.05 $78,046.05 $78,046.05 nat. median
$1,626
outlier · 48.0×
215
MS_DRG 		Other Heart Assist System Implant 18 $72,376.86 $217,380.48 $76,082.04 nat. median
$98,002
0.8× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 15 $18,921.75 $210,073.67 $74,489.12 nat. median
$96,835
0.8× median
00003232822
NDC 		Ipilimumab 200 Mg/40 Ml (5 Mg/ml) Intravenous Solution 14 $31,346.23 $94,038.70 $70,529.02 nat. median
$44,609
1.6× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 18 $68,325.19 $237,722.51 $69,350.07 nat. median
$92,900
0.7× median
50242093001
NDC 		Emicizumab-kxwh 300 Mg/2 Ml (150 Mg/ml) Subcutaneous Solution 14 $30,227.60 $90,682.81 $68,012.11 nat. median
$68,012
1.0× median
L5969
HCPCS 		Ak/ft Power Asst Incl Motors 1 $67,997.33 $67,997.33 $67,997.33 nat. median
$19,551
outlier · 3.5×
J7330
HCPCS 		Cultured Chondrocytes Implnt 3 $61,878.30 $154,331.76 $66,859.44 nat. median
$75,807
0.9× median
850
MS_DRG 		Acute Leukemia With Other Procedures 15 $65,238.42 $187,652.49 $66,216.99 nat. median
$81,364
0.8× median
72187040101
NDC 		Tagraxofusp-erzs 1 000 Mcg/ml Intravenous Solution 14 $28,949.27 $86,847.81 $65,135.86 nat. median
$64,653
1.0× median
K0871
HCPCS 		Pwc Gp 4 Vhd Seat/back 1 $64,502.22 $64,502.22 $64,502.22 nat. median
$260
outlier · 247.8×
K0879
HCPCS 		Pwc Gp4 Hd Sing Pow Opt S/b 1 $64,093.52 $64,093.52 $64,093.52 nat. median
$1,243
outlier · 51.6×
K0886
HCPCS 		Pwc Gp4 Hd Mult Pow S/b 1 $64,093.52 $64,093.52 $64,093.52 nat. median
$1,283
outlier · 50.0×
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 21 $33,983.49 $179,752.77 $63,354.77 nat. median
$69,291
0.9× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 18 $59,811.38 $169,841.33 $60,918.88 nat. median
$80,459
0.8× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 18 $55,201.72 $180,088.69 $60,351.89 nat. median
$79,040
0.8× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 15 $59,114.77 $167,262.39 $60,001.49 nat. median
$81,124
0.7× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 18 $57,150.40 $212,745.44 $59,133.33 nat. median
$77,385
0.8× median
58468020001
NDC 		Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution 14 $26,257.35 $78,772.04 $59,079.03 nat. median
$52,077
1.1× median
K0864
HCPCS 		Pwc Gp3 Xhd Mult Pow Opt S/b 2 $6,319.36 $109,917.47 $58,118.42 nat. median
$2,315
outlier · 25.1×

Other procedures at this hospital

Browse this hospital's 17,422 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
             
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 24 20 — — $1,988,560.00 $4,958,415.00 $3,672,900.00 2025-06-28
J1414 HCPCS Inj, Beqvez, Per Tx Dose 20 17 — — $1,988,560.00 $4,866,750.00 $3,605,000.00 2025-06-28
J1413 HCPCS Inj Delandistrogene Mox Rokl 23 19 — — $1,780,474.89 $4,489,363.93 $3,325,454.76 2025-06-28
J3394 HCPCS Inj, Lovotibeglogene Autotem 20 17 — — $1,711,448.00 $4,436,100.00 $3,239,500.00 2025-06-28
J3393 HCPCS Inj, Betibeglogene Autotemce 20 17 — — $1,590,848.00 $4,006,800.00 $2,968,000.00 2025-06-28
J3399 HCPCS Inj Onase Abepar-xioi Treat 24 20 — — $1,288,253.89 $3,224,629.21 $2,388,614.23 2025-06-28
J3392 HCPCS Inj, Exagamglogene Autotem 20 17 — — $1,249,952.00 $3,148,200.00 $2,332,000.00 2025-06-28
Q2042 HCPCS Tisagenlecleucel Car-pos T 26 22 — — $303,174.38 $1,501,447.92 $529,192.86 2025-06-28
Q2056 HCPCS Ciltacabtagene Car-pos T 26 22 — — $295,506.63 $1,495,576.46 $527,123.43 2025-06-28
Q2055 HCPCS Idecabtagene Vicleucel Car 26 22 — — $283,175.46 $1,494,056.16 $526,587.59 2025-06-28
Q2054 HCPCS Lisocabtagene Mara Car Pos T 26 22 — — $276,836.48 $1,479,651.46 $516,606.03 2025-06-28
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 27 22 — — $262,381.19 $1,388,704.74 $489,455.96 2025-06-28
Q2053 HCPCS Brexucabtagene Car Pos T 26 22 — — $261,595.61 $1,306,635.96 $460,530.40 2025-06-28
C9073 HCPCS Brexucabtagene Autoleucel Ca 1 1 — — $413,145.63 $413,145.63 $413,145.63 2025-06-28
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 22 18 — — $196,180.96 $756,292.49 $266,875.44 2025-06-28
K0606 HCPCS Aed Garment W Elec Analysis 1 1 — — $201,031.88 $201,031.88 $201,031.88 2025-06-28
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 22 18 — — $167,223.55 $484,703.51 $177,256.96 2025-06-28
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 22 18 — — $150,536.37 $544,869.23 $153,387.41 2025-06-28
651 MS_DRG Neonate, Birth Weight 2000-2499 Grams, With Significant O.r. Procedures, With Mu… 1 1 — — $126,100.28 $126,100.28 $126,100.28 2025-06-28
E0194 HCPCS Air Fluidized Bed 2 2 — — $12,533.34 $218,003.26 $115,268.30 2025-06-28
K0743 HCPCS Portable Home Suction Pump 1 1 — — $104,160.00 $104,160.00 $104,160.00 2025-06-28
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 22 18 — — $99,803.68 $283,363.02 $102,871.52 2025-06-28
Q0480 HCPCS Driver Pneumatic Vad, Rep 15 14 — — $53,599.97 $495,999.75 $94,999.95 2025-06-28
75987015003 NDC Inebilizumab-cdon 10 Mg/ml Intravenous Solution 14 14 $137,145.29 — $41,143.59 $123,430.76 $92,573.07 2025-06-28
K0880 HCPCS Pwc Gp4 Vhd Sing Pow Opt S/b 1 1 — — $91,565.27 $91,565.27 $91,565.27 2025-06-28
90288 HCPCS Botulism Ig IV 2 2 — — $48,705.00 $129,068.25 $88,886.62 2025-06-28
G0448 HCPCS Place Perm Pacing Cardiovert 1 1 — — $85,168.29 $85,168.29 $85,168.29 2025-06-28
00310453530 NDC Tremelimumab-actl 20 Mg/ml Intravenous Solution 14 14 $119,390.00 — $35,817.00 $107,451.00 $80,588.25 2025-06-28
E0764 HCPCS Functional Neuromuscularstim 1 1 — — $78,639.76 $78,639.76 $78,639.76 2025-06-28
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 22 18 — — $76,289.24 $275,219.98 $78,215.71 2025-06-28
E0469 HCPCS Lung Expans High Oscil Neb 1 1 — — $78,046.05 $78,046.05 $78,046.05 2025-06-28
215 MS_DRG Other Heart Assist System Implant 22 18 — — $72,376.86 $217,380.48 $76,082.04 2025-06-28
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 15 — — $18,921.75 $210,073.67 $74,489.12 2025-06-28
00003232822 NDC Ipilimumab 200 Mg/40 Ml (5 Mg/ml) Intravenous Solution 14 14 $104,487.44 — $31,346.23 $94,038.70 $70,529.02 2025-06-28
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 22 18 — — $68,325.19 $237,722.51 $69,350.07 2025-06-28
50242093001 NDC Emicizumab-kxwh 300 Mg/2 Ml (150 Mg/ml) Subcutaneous Solution 14 14 $100,758.68 — $30,227.60 $90,682.81 $68,012.11 2025-06-28
L5969 HCPCS Ak/ft Power Asst Incl Motors 1 1 — — $67,997.33 $67,997.33 $67,997.33 2025-06-28
J7330 HCPCS Cultured Chondrocytes Implnt 3 3 — — $61,878.30 $154,331.76 $66,859.44 2025-06-28
850 MS_DRG Acute Leukemia With Other Procedures 18 15 — — $65,238.42 $187,652.49 $66,216.99 2025-06-28
72187040101 NDC Tagraxofusp-erzs 1 000 Mcg/ml Intravenous Solution 14 14 $96,497.57 — $28,949.27 $86,847.81 $65,135.86 2025-06-28
K0871 HCPCS Pwc Gp 4 Vhd Seat/back 1 1 — — $64,502.22 $64,502.22 $64,502.22 2025-06-28
K0879 HCPCS Pwc Gp4 Hd Sing Pow Opt S/b 1 1 — — $64,093.52 $64,093.52 $64,093.52 2025-06-28
K0886 HCPCS Pwc Gp4 Hd Mult Pow S/b 1 1 — — $64,093.52 $64,093.52 $64,093.52 2025-06-28
J9029 HCPCS Instill Adstiladrin, Tx Dose 26 21 — — $33,983.49 $179,752.77 $63,354.77 2025-06-28
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 22 18 — — $59,811.38 $169,841.33 $60,918.88 2025-06-28
231 MS_DRG Coronary Bypass With Ptca With Mcc 22 18 — — $55,201.72 $180,088.69 $60,351.89 2025-06-28
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 18 15 — — $59,114.77 $167,262.39 $60,001.49 2025-06-28
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 22 18 — — $57,150.40 $212,745.44 $59,133.33 2025-06-28
58468020001 NDC Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution 14 14 $87,524.49 — $26,257.35 $78,772.04 $59,079.03 2025-06-28
K0864 HCPCS Pwc Gp3 Xhd Mult Pow Opt S/b 2 2 — — $6,319.36 $109,917.47 $58,118.42 2025-06-28
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 22 18 — — $55,378.90 $156,750.08 $56,262.06 2025-06-28
79952011001 NDC Loncastuximab Tesirine-lpyl 10 Mg Intravenous Solution 14 14 $83,349.20 — $25,004.76 $75,014.28 $56,260.71 2025-06-28
K0870 HCPCS Pwc Gp 4 Hd Seat/back 1 1 — — $55,825.00 $55,825.00 $55,825.00 2025-06-28
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 22 18 — — $54,756.75 $172,588.61 $55,699.22 2025-06-28
K0884 HCPCS Pwc Gp4 Std Mult Pow Opt S/b 1 1 — — $55,573.82 $55,573.82 $55,573.82 2025-06-28
K0885 HCPCS Pwc Gp4 Std Mult Pow Opt Cap 1 1 — — $55,573.82 $55,573.82 $55,573.82 2025-06-28
E0783 HCPCS Programmable Infusion Pump 1 1 — — $55,406.13 $55,406.13 $55,406.13 2025-06-28
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 28 22 — — $29,767.56 $180,587.80 $55,015.23 2025-06-28
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 22 18 — — $51,387.70 $184,729.52 $53,749.61 2025-06-28
K0878 HCPCS Pwc Gp4 Std Sing Pow Opt Cap 1 1 — — $52,694.10 $52,694.10 $52,694.10 2025-06-28
K0877 HCPCS Pwc Gp4 Std Sing Pow Opt S/b 1 1 — — $51,658.25 $51,658.25 $51,658.25 2025-06-28
L5859 HCPCS Knee-shin Pro Flex/ext Cont 1 1 — — $51,216.05 $51,216.05 $51,216.05 2025-06-28
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 22 18 — — $50,003.35 $165,520.18 $50,916.15 2025-06-28
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 15 — — $14,184.56 $142,437.54 $50,666.68 2025-06-28
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 22 18 — — $49,387.08 $155,456.34 $50,127.88 2025-06-28
955 MS_DRG Craniotomy For Multiple Significant Trauma 22 18 — — $43,348.30 $218,799.96 $49,213.36 2025-06-28
K0860 HCPCS Pwc Gp3 Vhd Sing Pow Opt S/b 2 2 — — $5,310.38 $92,367.55 $48,838.96 2025-06-28
K0863 HCPCS Pwc Gp3 Vhd Mult Pow Opt S/b 2 2 — — $5,310.38 $92,367.55 $48,838.96 2025-06-28
25682002801 NDC Ravulizumab-cwvz 100 Mg/ml Intravenous Solution 14 14 $71,857.88 — $21,557.36 $64,672.09 $48,504.07 2025-06-28
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 18 15 — — $47,617.38 $134,456.05 $48,331.64 2025-06-28
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 22 18 — — $32,057.12 $133,938.66 $48,147.60 2025-06-28
K0868 HCPCS Pwc Gp 4 Std Seat/back 1 1 — — $48,126.78 $48,126.78 $48,126.78 2025-06-28
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 22 18 — — $14,059.70 $133,712.05 $48,066.99 2025-06-28
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 22 18 — — $45,948.19 $159,804.59 $47,985.53 2025-06-28
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 22 18 — — $44,943.87 $163,115.75 $47,348.76 2025-06-28
K0854 HCPCS Pwc Gp 3 Xhd Seat/back 2 2 — — $5,090.84 $88,549.54 $46,820.19 2025-06-28
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 22 18 — — $45,284.43 $159,286.05 $46,571.07 2025-06-28
K0869 HCPCS Pwc Gp 4 Std Cap Chair 1 1 — — $46,270.85 $46,270.85 $46,270.85 2025-06-28
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 22 18 — — $43,625.38 $128,468.82 $46,242.90 2025-06-28
L7181 HCPCS Electronic Elbo Simultaneous 15 14 — — $25,926.73 $234,295.87 $45,952.22 2025-06-28
J9226 HCPCS Supprelin La Implant 27 21 — — $24,260.32 $128,669.51 $45,350.22 2025-06-28
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 18 15 — — $43,974.68 $124,062.06 $44,634.30 2025-06-28
L7180 HCPCS Electronic Elbow Sequential 15 14 — — $25,181.48 $227,561.23 $44,631.36 2025-06-28
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 22 18 — — $43,776.49 $149,807.39 $44,450.24 2025-06-28
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 22 18 — — $35,104.99 $163,153.41 $44,332.04 2025-06-28
K0855 HCPCS Pwc Gp 3 Xhd Cap Chair 2 2 — — $4,809.06 $83,647.77 $44,228.42 2025-06-28
232 MS_DRG Coronary Bypass With Ptca Without Mcc 22 18 — — $42,351.73 $158,834.13 $44,080.02 2025-06-28
28 MS_DRG Spinal Procedures With Mcc 22 18 — — $41,421.56 $121,918.29 $43,439.49 2025-06-28
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 22 18 — — $39,139.62 $142,921.46 $43,238.97 2025-06-28
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 22 18 — — $40,578.88 $128,109.61 $42,942.93 2025-06-28
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 22 18 — — $6,843.96 $176,273.47 $42,706.81 2025-06-28
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 22 18 — — $41,415.72 $130,302.56 $42,643.09 2025-06-28
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 22 18 — — $41,850.77 $120,580.57 $42,478.54 2025-06-28
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 22 18 — — $40,833.09 $127,434.63 $42,446.59 2025-06-28
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 22 18 — — $39,342.41 $155,502.70 $41,702.96 2025-06-28
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 22 18 — — $40,382.52 $130,508.24 $41,200.90 2025-06-28
S2068 HCPCS Breast Diep Or Siea Flap 2 2 — — $15,306.34 $66,393.46 $40,849.90 2025-06-28
834 MS_DRG Acute Leukemia With Mcc 22 18 — — $39,342.41 $213,765.15 $40,010.27 2025-06-28
50242015001 NDC Ocrelizumab 30 Mg/ml Intravenous Solution 14 14 $59,193.14 — $17,757.94 $53,273.83 $39,955.37 2025-06-28
E0483 HCPCS Hi Freq Chest Wall Oscil Sys 2 2 — — $4,343.32 $75,547.25 $39,945.28 2025-06-28
653 MS_DRG Major Bladder Procedures With Mcc 22 18 — — $34,039.96 $111,793.02 $39,873.21 2025-06-28
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 22 18 — — $38,414.69 $131,979.87 $39,833.07 2025-06-28
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 22 18 — — $38,454.75 $125,963.01 $39,785.24 2025-06-28
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 18 15 — — $38,943.21 $115,849.93 $39,527.35 2025-06-28
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 15 — — $10,777.95 $110,379.22 $39,375.26 2025-06-28
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 22 18 — — $38,649.43 $109,160.99 $39,326.77 2025-06-28
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 22 18 — — $36,775.60 $119,865.03 $38,995.19 2025-06-28
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 22 18 — — $37,068.37 $114,627.44 $38,455.18 2025-06-28
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 22 18 — — $37,397.04 $128,842.52 $38,287.54 2025-06-28
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 18 15 — — $36,691.38 $103,280.10 $37,241.75 2025-06-28
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 22 18 — — $36,301.32 $102,167.10 $37,008.10 2025-06-28
E0465 HCPCS Home Vent Invasive Interface 2 2 — — $3,899.60 $69,684.03 $36,791.81 2025-06-28
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 22 18 — — $3,402.88 $120,919.50 $36,754.06 2025-06-28
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 22 18 — — $36,191.68 $104,856.19 $36,734.56 2025-06-28
E2510 HCPCS Sgd W Multi Methods Msg/accs 2 2 — — $27,650.89 $45,805.20 $36,728.04 2025-06-28
K0898 HCPCS Power Wheelchair Noc 1 1 — — $36,705.69 $36,705.69 $36,705.69 2025-06-28
50242010501 NDC Polatuzumab Vedotin-piiq 140 Mg Intravenous Solution 14 14 $54,257.99 — $16,277.40 $48,832.19 $36,624.14 2025-06-28
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 22 18 — — $34,315.85 $101,009.99 $36,434.23 2025-06-28
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 22 18 — — $33,962.54 $117,257.82 $36,222.37 2025-06-28
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 22 18 — — $35,645.59 $100,296.07 $36,180.28 2025-06-28
228 MS_DRG Other Cardiothoracic Procedures With Mcc 22 18 — — $35,519.08 $147,747.69 $36,088.70 2025-06-28
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 22 18 — — $30,406.93 $114,053.85 $35,837.95 2025-06-28
245 MS_DRG Aicd Generator Procedures 22 18 — — $32,377.61 $106,064.20 $35,363.49 2025-06-28
K0853 HCPCS Pwc Gp 3 Vhd Cap Chair 2 2 — — $3,842.79 $66,841.06 $35,341.92 2025-06-28
471 MS_DRG Cervical Spinal Fusion With Mcc 22 18 — — $34,633.53 $97,408.29 $35,215.85 2025-06-28
799 MS_DRG Splenic Procedures With Mcc 22 18 — — $33,913.15 $95,352.75 $34,973.73 2025-06-28
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 22 18 — — $31,374.00 $95,767.87 $34,569.51 2025-06-28
C7564 HCPCS Vein Mech Throm W/intrvas US 1 1 — — $34,511.03 $34,511.03 $34,511.03 2025-06-28
75987013015 NDC Teprotumumab-trbw 500 Mg Intravenous Solution 14 14 $51,102.86 — $15,330.86 $45,992.57 $34,494.43 2025-06-28
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 22 18 — — $33,848.53 $127,579.48 $34,415.43 2025-06-28
K0852 HCPCS Pwc Gp 3 Vhd Seat/back 2 2 — — $3,740.82 $65,067.21 $34,404.01 2025-06-28
E0466 HCPCS Home Vent Non-invasive Inter 2 2 — — $3,899.60 $64,599.04 $34,249.32 2025-06-28
K0862 HCPCS Pwc Gp3 Hd Mult Pow Opt S/b 2 2 — — $3,717.11 $64,654.74 $34,185.92 2025-06-28
K0858 HCPCS Pwc Gp3 Hd Sing Pow Opt S/b 2 2 — — $3,717.11 $64,654.74 $34,185.92 2025-06-28
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 22 18 — — $3,770.93 $119,943.25 $34,064.44 2025-06-28
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 22 18 — — $33,189.95 $130,476.38 $33,998.93 2025-06-28
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 22 18 — — $32,169.99 $110,502.25 $33,884.68 2025-06-28
163 MS_DRG Major Chest Procedures With Mcc 23 18 — — $32,889.84 $92,432.89 $33,659.91 2025-06-28
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 22 18 — — $32,773.18 $114,526.04 $33,315.54 2025-06-28
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 22 18 — — $32,274.85 $92,085.96 $33,259.79 2025-06-28
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 22 18 — — $31,652.70 $94,172.43 $32,686.95 2025-06-28
K0859 HCPCS Pwc Gp3 Hd Sing Pow Opt Cap 2 2 — — $3,545.00 $61,660.64 $32,602.82 2025-06-28
L8687 HCPCS Implt Nrostm Pls Gen Dua Rec 1 1 — — $32,535.45 $32,535.45 $32,535.45 2025-06-28
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 22 18 — — $30,768.74 $92,779.02 $32,495.07 2025-06-28
C7539 HCPCS Insrt A & V Pm W/l Vent Lead 1 1 — — $32,486.26 $32,486.26 $32,486.26 2025-06-28
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 22 18 — — $31,565.43 $112,083.96 $32,406.61 2025-06-28
69930 HCPCS Implant Cochlear Device 27 22 — — $605.96 $107,952.31 $32,136.08 2025-06-28
901 MS_DRG Wound Debridements For Injuries With Mcc 22 18 — — $30,944.69 $88,849.24 $32,108.42 2025-06-28
C7537 HCPCS Insrt Atril Pm W/l Vent Lead 1 1 — — $31,964.90 $31,964.90 $31,964.90 2025-06-28
C7540 HCPCS Rmv&rplc Pm Dul W/l Vnt Lead 1 1 — — $31,933.63 $31,933.63 $31,933.63 2025-06-28
C7534 HCPCS Fem/pop Revasc W/arthr & US 1 1 — — $31,931.14 $31,931.14 $31,931.14 2025-06-28
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 22 18 — — $30,843.24 $120,516.83 $31,917.44 2025-06-28
C7538 HCPCS Insrt Vent Pm W/l Vent Lead 1 1 — — $31,876.81 $31,876.81 $31,876.81 2025-06-28
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 22 18 — — $31,184.68 $88,093.21 $31,839.49 2025-06-28
C7535 HCPCS Fem/pop Revasc W/stent & US 1 1 — — $31,653.59 $31,653.59 $31,653.59 2025-06-28
C9754 HCPCS Perc Av Fistula, Direct 1 1 — — $31,162.99 $31,162.99 $31,162.99 2025-06-28
C9755 HCPCS Rf Magnetic-guide Av Fistula 1 1 — — $31,162.99 $31,162.99 $31,162.99 2025-06-28
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 22 18 — — $21,824.96 $86,771.65 $30,905.79 2025-06-28
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 22 18 — — $29,622.97 $118,601.98 $30,887.86 2025-06-28
61886 HCPCS Implant Neurostim Arrays 27 22 — — $459.07 $82,858.34 $30,788.08 2025-06-28
64568 HCPCS Pr Open Implant Cranial Neuroelec Array+pulse Gen 27 22 — — $308.45 $84,213.28 $30,788.08 2025-06-28
63685 HCPCS Pr Implant Spinal Neurostim/receiver 27 22 — — $172.90 $82,528.40 $30,788.08 2025-06-28
64582 HCPCS Pr Open Implt Hypogloss Nstim Pulse Generator 27 22 — — $423.05 $82,532.55 $30,788.08 2025-06-28
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 22 18 — — $30,313.75 $85,544.34 $30,689.78 2025-06-28
A9543 HCPCS Y90 Ibritumomab, Rx 28 22 — — $14,774.74 $165,001.00 $30,457.96 2025-06-28
55513006901 NDC Tarlatamab-dlle 10 Mg Intravenous Solution 14 14 $45,050.00 — $13,515.00 $40,545.00 $30,408.75 2025-06-28
55513007701 NDC Tarlatamab-dlle 10 Mg Intravenous Solution 14 14 $45,050.00 — $13,515.00 $40,545.00 $30,408.75 2025-06-28
140 MS_DRG Major Head And Neck Procedures With Mcc 22 18 — — $4,857.39 $97,080.91 $30,370.24 2025-06-28
31 MS_DRG Ventricular Shunt Procedures With Mcc 22 18 — — $23,044.90 $114,775.18 $30,097.59 2025-06-28
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 22 18 — — $26,512.21 $84,018.23 $30,087.92 2025-06-28
00003712511 NDC Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solutio 14 14 $44,519.36 — $13,355.81 $40,067.42 $30,050.57 2025-06-28
793 MS_DRG Full Term Neonate With Major Problems 22 18 — — $12,035.48 $83,635.20 $29,955.62 2025-06-28
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 22 18 — — $6,391.11 $86,043.72 $29,894.48 2025-06-28
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 22 18 — — $28,927.62 $95,365.95 $29,837.08 2025-06-28
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 22 18 — — $28,952.96 $87,796.35 $29,820.67 2025-06-28
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 22 18 — — $28,672.15 $119,749.16 $29,777.15 2025-06-28
K0850 HCPCS Pwc Gp 3 Hd Seat/back 2 2 — — $3,237.55 $56,313.61 $29,775.58 2025-06-28
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 18 15 — — $29,195.13 $81,890.50 $29,633.06 2025-06-28
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 22 18 — — $28,010.58 $94,459.22 $29,518.21 2025-06-28
791 MS_DRG Prematurity With Major Problems 22 18 — — $2,702.18 $81,417.23 $29,322.41 2025-06-28
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 22 18 — — $25,937.21 $79,832.96 $28,901.15 2025-06-28
E0652 HCPCS Pneum Compres W/cal Pressure 2 2 — — $21,658.46 $35,878.46 $28,768.46 2025-06-28
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 22 18 — — $28,226.65 $79,127.06 $28,765.44 2025-06-28
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 22 18 — — $26,663.53 $79,889.11 $28,743.47 2025-06-28
K0851 HCPCS Pwc Gp 3 Hd Cap Chair 2 2 — — $3,112.96 $54,146.53 $28,629.74 2025-06-28
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 22 18 — — $27,843.78 $87,063.43 $28,592.26 2025-06-28
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 22 18 — — $27,556.16 $78,784.09 $28,575.86 2025-06-28
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 22 18 — — $26,747.98 $78,804.19 $28,535.21 2025-06-28
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 22 18 — — $27,912.76 $80,472.99 $28,397.52 2025-06-28
34 MS_DRG Carotid Artery Stent Procedures With Mcc 22 18 — — $27,826.05 $77,983.98 $28,243.44 2025-06-28
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 18 15 — — $11,493.56 $78,455.25 $28,131.17 2025-06-28
K0857 HCPCS Pwc Gp3 Std Sing Pow Opt Cap 2 2 — — $3,055.99 $53,155.48 $28,105.74 2025-06-28
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 22 18 — — $22,878.11 $77,508.71 $28,074.37 2025-06-28
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 22 18 — — $27,360.08 $135,065.07 $27,843.86 2025-06-28
C9760 HCPCS Non-blind Interatrial Shunt 25 21 — — $14,740.27 $105,067.48 $27,784.31 2025-06-28
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 22 18 — — $23,402.86 $77,430.49 $27,770.23 2025-06-28
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 22 18 — — $27,151.25 $100,267.50 $27,622.81 2025-06-28
K0861 HCPCS Pwc Gp3 Std Mult Pow Opt S/b 2 2 — — $3,000.72 $52,194.58 $27,597.65 2025-06-28
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 22 18 — — $27,006.56 $75,645.69 $27,566.09 2025-06-28
K0856 HCPCS Pwc Gp3 Std Sing Pow Opt S/b 2 2 — — $2,995.94 $52,110.75 $27,553.34 2025-06-28
L5856 HCPCS Elec Knee-shin Swing/stance 15 14 — — $15,533.38 $140,372.76 $27,531.17 2025-06-28
L6880 HCPCS Elec Hand Ind Art Digits 15 14 — — $15,460.03 $139,709.91 $27,401.17 2025-06-28
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 22 18 — — $26,795.01 $75,042.06 $27,370.58 2025-06-28
J9266 HCPCS Pegaspargase Injection 28 22 — — $14,509.80 $76,805.62 $27,070.53 2025-06-28
42747030401 NDC Burosumab-twza 30 Mg/ml Subcutaneous Solution 14 14 $40,068.08 — $12,020.42 $36,061.27 $27,045.96 2025-06-28
50242024501 NDC Pertuzumab 1 200 Mg-trastuzumab 600 Mg-hyaluron-zzxf/15 Ml Subcu 14 14 $40,001.77 — $12,000.53 $36,001.59 $27,001.19 2025-06-28
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 22 18 — — $25,982.26 $84,699.56 $26,531.37 2025-06-28
335 MS_DRG Peritoneal Adhesiolysis With Mcc 22 18 — — $25,646.55 $72,663.66 $26,350.89 2025-06-28
E0748 HCPCS Elec Osteogen Stim Spinal 1 1 — — $26,331.00 $26,331.00 $26,331.00 2025-06-28
50881002311 NDC Axatilimab-csfr 50 Mg/ml Intravenous Solution 14 14 $38,986.25 — $11,695.88 $35,087.63 $26,315.72 2025-06-28
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 22 18 — — $25,684.56 $71,873.53 $26,192.65 2025-06-28
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 22 18 — — $25,103.33 $111,600.18 $26,143.97 2025-06-28
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 22 18 — — $24,346.65 $71,889.57 $26,075.53 2025-06-28
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 22 18 — — $24,549.73 $71,885.56 $26,013.93 2025-06-28
265 MS_DRG Aicd Lead Procedures 22 18 — — $25,358.70 $87,764.48 $25,949.99 2025-06-28
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 22 18 — — $24,851.97 $71,215.76 $25,835.85 2025-06-28
332 MS_DRG Rectal Resection With Mcc 22 18 — — $24,874.21 $71,289.81 $25,694.22 2025-06-28
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 22 18 — — $24,954.72 $100,481.87 $25,687.47 2025-06-28
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 22 18 — — $23,012.96 $96,959.24 $25,681.04 2025-06-28
K0848 HCPCS Pwc Gp 3 Std Seat/back 2 2 — — $2,791.16 $48,548.98 $25,670.07 2025-06-28
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 22 18 — — $20,842.16 $105,377.63 $25,590.77 2025-06-28
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 22 18 — — $25,120.90 $78,219.20 $25,497.72 2025-06-28
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 22 18 — — $24,250.93 $95,988.78 $25,489.86 2025-06-28
264 MS_DRG Other Circulatory System O.r. Procedures 22 18 — — $21,414.28 $70,090.73 $25,185.06 2025-06-28
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 22 18 — — $24,568.49 $68,688.96 $25,041.08 2025-06-28
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 22 18 — — $24,196.74 $68,965.70 $25,035.46 2025-06-28
L8685 HCPCS Implt Nrostm Pls Gen Sng Rec 1 1 — — $24,999.76 $24,999.76 $24,999.76 2025-06-28
665 MS_DRG Prostatectomy With Mcc 22 18 — — $22,226.83 $68,857.41 $24,996.93 2025-06-28
252 MS_DRG Other Vascular Procedures With Mcc 22 18 — — $24,089.76 $107,165.02 $24,974.11 2025-06-28
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 22 18 — — $21,117.04 $69,485.10 $24,971.74 2025-06-28
271 MS_DRG Other Major Cardiovascular Procedures With Cc 22 18 — — $4,267.57 $77,190.80 $24,880.45 2025-06-28
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 22 18 — — $24,335.15 $85,412.20 $24,812.28 2025-06-28
E0747 HCPCS Elec Osteogen Stim Not Spine 1 1 — — $24,803.12 $24,803.12 $24,803.12 2025-06-28
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 22 18 — — $23,818.10 $95,913.46 $24,801.47 2025-06-28
S1034 HCPCS Art Pancreas System 1 1 — — $24,800.00 $24,800.00 $24,800.00 2025-06-28
E0782 HCPCS Non-programble Infusion Pump 1 1 — — $24,697.97 $24,697.97 $24,697.97 2025-06-28
K0849 HCPCS Pwc Gp 3 Std Cap Chair 2 2 — — $2,683.49 $46,676.18 $24,679.83 2025-06-28
650 MS_DRG Neonate, Birth Weight 1500-1999 Grams, Without Significant O.r. Procedures, With… 1 1 — — $24,655.95 $24,655.95 $24,655.95 2025-06-28
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 22 18 — — $24,087.06 $74,206.99 $24,591.09 2025-06-28
37 MS_DRG Extracranial Procedures With Mcc 22 18 — — $23,835.45 $66,597.32 $24,277.67 2025-06-28
59572077501 NDC Luspatercept-aamt 75 Mg Subcutaneous Solution 14 14 $35,630.66 — $10,689.20 $32,067.59 $24,050.69 2025-06-28
E0694 HCPCS Uvl Md Cabinet Sys 6 Ft 2 2 — — $18,087.38 $29,962.76 $24,025.07 2025-06-28
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 22 18 — — $23,403.22 $65,364.00 $23,939.70 2025-06-28
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 22 18 — — $23,468.58 $81,938.82 $23,929.40 2025-06-28
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 22 18 — — $23,566.70 $89,832.87 $23,915.11 2025-06-28
J9600 HCPCS Porfimer Sodium Injection 28 22 — — $12,986.43 $64,337.04 $23,870.14 2025-06-28
51144005001_3 NDC Brentuximab Vedotin 50 Mg IV Solution For 1.2 Mg/kg Dose 14 14 $35,276.00 — $10,582.80 $31,748.40 $23,811.30 2025-06-28
51144005001 NDC Brentuximab Vedotin 50 Mg Intravenous Solution 14 14 $35,276.00 — $10,582.80 $31,748.40 $23,811.30 2025-06-28
51144005001_2 NDC Brentuximab Vedotin 50 Mg IV Solution For 0.9 Mg/kg Dose 14 14 $35,276.00 — $10,582.80 $31,748.40 $23,811.30 2025-06-28
50242092201 NDC Emicizumab-kxwh 105 Mg/0.7 Ml Subcutaneous Solution 14 14 $35,268.81 — $10,580.64 $31,741.93 $23,806.45 2025-06-28
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 22 18 — — $22,568.17 $83,164.21 $23,744.28 2025-06-28
S2067 HCPCS Breast "stacked"" Diep/gap" 1 1 — — $23,693.25 $23,693.25 $23,693.25 2025-06-28
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 22 18 — — $23,121.39 $64,559.84 $23,626.36 2025-06-28
00173089803 NDC Dostarlimab-gxly 50 Mg/ml Intravenous Solution 14 14 $34,739.36 — $10,421.81 $31,265.42 $23,449.07 2025-06-28
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 22 18 — — $23,011.55 $64,583.49 $23,361.92 2025-06-28
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 22 18 — — $21,378.76 $79,566.26 $23,295.57 2025-06-28
500 MS_DRG Soft Tissue Procedures With Mcc 22 18 — — $22,765.76 $84,795.16 $23,264.82 2025-06-28
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 22 18 — — $22,480.90 $88,610.38 $23,252.06 2025-06-28
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 22 18 — — $22,803.01 $70,710.43 $23,187.04 2025-06-28
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 22 18 — — $16,234.48 $63,779.74 $23,096.44 2025-06-28
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 22 18 — — $22,430.52 $70,432.33 $23,086.81 2025-06-28
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 22 18 — — $22,327.20 $90,626.62 $22,818.75 2025-06-28
E0770 HCPCS Functional Electric Stim Nos 1 1 — — $22,816.00 $22,816.00 $22,816.00 2025-06-28
662 MS_DRG Minor Bladder Procedures With Mcc 22 18 — — $21,576.53 $63,862.16 $22,756.99 2025-06-28
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 22 18 — — $22,229.51 $108,694.58 $22,705.24 2025-06-28
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 22 18 — — $22,169.07 $94,053.65 $22,647.32 2025-06-28
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 18 15 — — $22,184.53 $64,890.56 $22,517.30 2025-06-28
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 13 13 — — $20,776.77 $50,391.42 $22,438.91 2025-06-28
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 22 18 — — $22,062.24 $62,512.21 $22,393.17 2025-06-28
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 22 18 — — $21,269.67 $83,503.14 $22,321.84 2025-06-28
50242091701 NDC Atezolizumab 1 200 Mg/20 Ml (60 Mg/ml) Intravenous Solution 14 14 $32,822.30 — $9,846.69 $29,540.07 $22,155.06 2025-06-28
E0676 HCPCS Inter Limb Compress Dev Nos 1 1 — — $22,079.44 $22,079.44 $22,079.44 2025-06-28
570 MS_DRG Skin Debridement With Mcc 22 18 — — $21,052.20 $60,366.55 $21,976.57 2025-06-28
E0760 HCPCS Osteogen Ultrasound Stimltor 1 1 — — $21,880.54 $21,880.54 $21,880.54 2025-06-28
974 MS_DRG HIV With Major Related Condition With Mcc 22 18 — — $21,012.08 $62,836.66 $21,805.36 2025-06-28
61891 HCPCS Pr Rev/rplcmt Skull-mntd Cranial Nstim Pg/receiver 26 21 — — $300.97 $48,324.79 $21,665.70 2025-06-28
61885 HCPCS Pr Insert/replace Neurostim Pulse Gen/receiver W/1 Array 27 22 — — $275.09 $60,864.18 $21,665.70 2025-06-28
63655 HCPCS Pr Implant Neuroelec Surg Epidural 27 22 — — $437.04 $56,067.38 $21,665.70 2025-06-28
64590 HCPCS Pr Insert/replace Periph/gastric Neuroelectrode 27 22 — — $148.98 $60,812.45 $21,665.70 2025-06-28
64580 HCPCS Opn Impltj Nea Neuromuscular 27 22 — — $161.14 $59,920.33 $21,665.70 2025-06-28
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 22 18 — — $21,218.86 $69,038.92 $21,626.42 2025-06-28
00024582411 NDC Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution 14 14 $31,950.16 — $9,585.05 $28,755.14 $21,566.35 2025-06-28
61755000801 NDC Cemiplimab-rwlc 50 Mg/ml Intravenous Solution 14 14 $31,870.28 — $9,561.08 $28,683.25 $21,512.44 2025-06-28
Q0483 HCPCS Monitor Elec Vad, Rep 15 14 — — $12,132.16 $109,636.48 $21,502.90 2025-06-28
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 22 18 — — $21,165.44 $79,783.52 $21,482.92 2025-06-28
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 22 18 — — $20,980.60 $94,004.41 $21,479.57 2025-06-28
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 22 18 — — $21,066.98 $72,891.80 $21,425.86 2025-06-28
E2513 HCPCS Sgd Accessory, EMG Sensor 1 1 — — $21,326.76 $21,326.76 $21,326.76 2025-06-28
L5858 HCPCS Stance Phase Only 15 14 — — $12,025.87 $108,675.93 $21,314.50 2025-06-28
668 MS_DRG Transurethral Procedures With Mcc 22 18 — — $20,318.85 $58,483.48 $21,306.73 2025-06-28
800 MS_DRG Splenic Procedures With Cc 22 18 — — $20,316.74 $58,433.34 $21,288.90 2025-06-28
472 MS_DRG Cervical Spinal Fusion With Cc 22 18 — — $20,857.61 $58,100.44 $21,280.31 2025-06-28
73150015006 NDC Ublituximab-xiiy 25 Mg/ml Intravenous Solution 14 14 $31,467.51 — $9,440.25 $28,320.76 $21,240.57 2025-06-28
68727074501 NDC Daunorubicin 44 Mg And Cytarabine 100 Mg In Liposome IV Solution 14 14 $31,415.00 — $9,424.50 $28,273.50 $21,205.12 2025-06-28
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 22 18 — — $19,418.39 $58,401.25 $21,067.85 2025-06-28
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 22 18 — — $20,646.06 $57,496.82 $21,052.07 2025-06-28
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 22 18 — — $20,518.02 $69,204.04 $20,932.22 2025-06-28
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 22 18 — — $19,096.37 $57,396.55 $20,920.08 2025-06-28
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 22 18 — — $19,633.36 $57,316.33 $20,891.56 2025-06-28
E0329 HCPCS Ped Hospital Bed Semi/elect 1 1 — — $20,839.09 $20,839.09 $20,839.09 2025-06-28
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