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

ELY - BLOOMENSON COMMUNITY HOSPITAL

Ely, MN · CCN 241318 · Rates published

4,514 distinct procedures filed
34 distinct payers
127,140 rate rows
2026-08-04 last MRF observed
Data quality

105,306 of 127,140 rate rows are consumer-grade (82.8%)

21,834 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
exceeds 10× this hospital's gross charge — excluded from medians 8,475
professional (physician) fee — not the facility price 8,034
per-diem day rate — not a per-procedure price 3,554
template filing: same amount across many unrelated codes — excluded 1,423
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 148
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 115
percent-of-charges filed in the dollar field — excluded from medians 49
placeholder amount (≤ $0.02) — excluded from medians 36
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbECHELYMN&type=CDMWithoutLabel&fileType=CSV
Found on page https://www.ebch.org/patients-visitor-info/billing-insurance/#price-transparency
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-18
Content fingerprint b3e0310f564b44b3… · 17,280,773 bytes · first seen 2026-08-12

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
J2507
HCPCS 		Pegloticase 8 Mg/ml Solution 1 Ml Vial 8 $3,090.93 $47,400.03 $23,820.93 nat. median
$9,200
outlier · 2.6×
J2350
HCPCS 		Ocrelizumab 300 Mg/10ml Solution 10 Ml Vial 8 $49.47 $32,487.00 $16,243.50 nat. median
$414
outlier · 39.2×
405
MS_DRG 		Pancreas, Liver And Shunt Procedures With Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$50,825
outlier · 0.2×
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$55,188
outlier · 0.2×
423
MS_DRG 		Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$38,579
outlier · 0.3×
414
MS_DRG 		Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$33,327
outlier · 0.3×
273
MS_DRG 		Percutaneous And Other Intracardiac Procedures With Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$38,116
outlier · 0.3×
236
MS_DRG 		Coronary Bypass Without Cardiac Catheterization Without Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$40,341
outlier · 0.3×
458
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$40,320
outlier · 0.3×
500
MS_DRG 		Soft Tissue Procedures With Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$29,700
outlier · 0.3×
653
MS_DRG 		Major Bladder Procedures With Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$49,999
outlier · 0.2×
469
MS_DRG 		Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$29,492
outlier · 0.3×
143
MS_DRG 		Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$32,977
outlier · 0.3×
510
MS_DRG 		Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$27,749
outlier · 0.4×
166
MS_DRG 		Other Respiratory System O.r. Procedures With Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$35,721
outlier · 0.3×
221
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$46,557
outlier · 0.2×
267
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$45,888
outlier · 0.2×
271
MS_DRG 		Other Major Cardiovascular Procedures With Cc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$34,048
outlier · 0.3×
329
MS_DRG 		Major Small And Large Bowel Procedures With Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$42,662
outlier · 0.2×
495
MS_DRG 		Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$33,786
outlier · 0.3×
492
MS_DRG 		Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$33,682
outlier · 0.3×
471
MS_DRG 		Cervical Spinal Fusion With Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$44,860
outlier · 0.2×
518
MS_DRG 		Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$34,464
outlier · 0.3×
515
MS_DRG 		Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$30,223
outlier · 0.3×
574
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Cc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$32,338
outlier · 0.3×
579
MS_DRG 		Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$30,215
outlier · 0.3×
656
MS_DRG 		Kidney And Ureter Procedures For Neoplasm With Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$30,376
outlier · 0.3×
799
MS_DRG 		Splenic Procedures With Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$43,294
outlier · 0.2×
800
MS_DRG 		Splenic Procedures With Cc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$26,970
outlier · 0.4×
242
MS_DRG 		Permanent Cardiac Pacemaker Implant With Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$30,994
outlier · 0.3×
274
MS_DRG 		Percutaneous And Other Intracardiac Procedures Without Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$30,851
outlier · 0.3×
220
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$50,679
outlier · 0.2×
234
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$51,613
outlier · 0.2×
235
MS_DRG 		Coronary Bypass Without Cardiac Catheterization With Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$55,491
outlier · 0.2×
326
MS_DRG 		Stomach, Esophageal And Duodenal Procedures With Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$46,224
outlier · 0.2×
252
MS_DRG 		Other Vascular Procedures With Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$32,714
outlier · 0.3×
269
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$40,092
outlier · 0.3×
270
MS_DRG 		Other Major Cardiovascular Procedures With Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$49,396
outlier · 0.2×
277
MS_DRG 		Cardiac Defibrillator Implant Without Mcc 1 $10,200.00 $10,200.00 $10,200.00 nat. median
$44,167
outlier · 0.2×
J9119
HCPCS 		Cemiplimab-rwlc 350 Mg/7ml Solution 7 Ml Vial 8 $23.75 $18,834.93 $9,465.51 nat. median
$91
outlier · 104.0×
662
MS_DRG 		Minor Bladder Procedures With Mcc 2 $5,356.00 $10,200.00 $7,778.00 nat. median
$28,447
outlier · 0.3×
625
MS_DRG 		Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 2 $5,356.00 $10,200.00 $7,778.00 nat. median
$27,818
outlier · 0.3×
96377
HCPCS 		Application Of On-body Injector For Under Skin Injection 20 $4,566.07 $13,355.00 $7,381.98 nat. median
$83
outlier · 88.4×
96377
CPT 		Appl On-body Injector For Timed Subq Injection 8 $41.50 $12,831.14 $6,448.30 nat. median
$83
outlier · 77.2×
J2506
HCPCS 		Pegfilgrastim 6 Mg/0.6ml Prefilled Syringe Kit 0.6 Ml Syringe 8 $46.46 $12,830.85 $6,415.42 nat. median
$1,659
outlier · 3.9×
Q4180
HCPCS 		Revita Placental Membrane 2x3cm 6sqcm 27 $1,027.70 $19,396.16 $6,009.87 nat. median
$761
outlier · 7.9×
100
OTHER 		Anesth Salivary Gland 6 $32.04 $5,740.93 $5,740.93 nat. median
$14,202
outlier · 0.4×
102
OTHER 		Anesth Repair Of Cleft Lip 6 $32.04 $5,740.93 $5,740.93 nat. median
$8,790
0.7× median
103
OTHER 		Anesth Blepharoplasty 6 $32.04 $5,740.93 $5,740.93 nat. median
$6,553
0.9× median
104
OTHER 		Anesth Electroshock 6 $32.04 $5,740.93 $5,740.93 nat. median
$1,688
outlier · 3.4×

Other procedures at this hospital

Browse this hospital's 4,514 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
             
100 OTHER Anesth Salivary Gland 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
102 OTHER Anesth Repair Of Cleft Lip 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
103 OTHER Anesth Blepharoplasty 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
104 OTHER Anesth Electroshock 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1112 OTHER Anesth Bone Aspirate/Bx 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1120 OTHER Anesth Pelvis Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1130 OTHER Anesth Body Cast Procedure 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1140 OTHER Anesth Amputation At Pelvis 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1150 OTHER Anesth Pelvic Tumor Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1160 OTHER Anesth Pelvis Procedure 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1170 OTHER Anesth Pelvis Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1173 OTHER Anesth Fx Repair Pelvis 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1180 OTHER Anesth Pelvis Nerve Removal 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1190 OTHER Anesth Pelvis Nerve Removal 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
120 OTHER Anesth Ear Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1200 OTHER Anesth Hip Joint Procedure 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1202 OTHER Anesth Arthroscopy Of Hip 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1210 OTHER Anesth Hip Joint Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1212 OTHER Anesth Hip Disarticulation 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1214 OTHER Anesth Hip Arthroplasty 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1215 OTHER Anesth Revise Hip Repair 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1220 OTHER Anesth Procedure On Femur 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1230 OTHER Anesth Surgery Of Femur 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1232 OTHER Anesth Amputation Of Femur 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1234 OTHER Anesth Radical Femur Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
124 OTHER Anesth Ear Exam 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1250 OTHER Anesth Upper Leg Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
126 OTHER Anesth Tympanotomy 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1260 OTHER Anesth Upper Leg Veins Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1270 OTHER Anesth Thigh Arteries Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1272 OTHER Anesth Femoral Artery Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1274 OTHER Anesth Femoral Embolectomy 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1320 OTHER Anesth Knee Area Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1340 OTHER Anesth Knee Area Procedure 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1360 OTHER Anesth Knee Area Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1380 OTHER Anesth Knee Joint Procedure 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1382 OTHER Anesth Dx Knee Arthroscopy 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1390 OTHER Anesth Knee Area Procedure 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1392 OTHER Anesth Knee Area Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
140 OTHER Anesth Procedures On Eye 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1400 OTHER Anesth Knee Joint Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1402 OTHER Anesth Knee Arthroplasty 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1404 OTHER Anesth Amputation At Knee 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
142 OTHER Anesth Lens Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1420 OTHER Anesth Knee Joint Casting 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
1430 OTHER Anesth Knee Veins Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1432 OTHER Anesth Knee Vessel Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
144 OTHER Anesth Corneal Transplant 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1440 OTHER Anesth Knee Arteries Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1442 OTHER Anesth Knee Artery Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1444 OTHER Anesth Knee Artery Repair 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
145 OTHER Anesth Vitreoretinal Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1462 OTHER Anesth Lower Leg Procedure 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1464 OTHER Anesth Ankle/Ft Arthroscopy 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
147 OTHER Anesth Iridectomy 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1470 OTHER Anesth Lower Leg Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1472 OTHER Anesth Achilles Tendon Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1474 OTHER Anesth Lower Leg Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
148 OTHER Anesth Eye Exam 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1480 OTHER Anesth Lower Leg Bone Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1482 OTHER Anesth Radical Leg Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1484 OTHER Anesth Lower Leg Revision 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1486 OTHER Anesth Ankle Replacement 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1490 OTHER Anesth Lower Leg Casting 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1500 OTHER Anesth Leg Arteries Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1502 OTHER Anesth Lwr Leg Embolectomy 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1520 OTHER Anesth Lower Leg Vein Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1522 OTHER Anesth Lower Leg Vein Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
160 OTHER Anesth Nose/Sinus Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1610 OTHER Anesth Surgery Of Shoulder 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
162 OTHER Anesth Nose/Sinus Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1620 OTHER Anesth Shoulder Procedure 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1622 OTHER Anes Dx Shoulder Arthroscopy 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1630 OTHER Anesth Surgery Of Shoulder 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1634 OTHER Anesth Shoulder Joint Amput 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1636 OTHER Anesth Forequarter Amput 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1638 OTHER Anesth Shoulder Replacement 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
164 OTHER Anesth Biopsy Of Nose 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1650 OTHER Anesth Shoulder Artery Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1652 OTHER Anesth Shoulder Vessel Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1654 OTHER Anesth Shoulder Vessel Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1656 OTHER Anesth Arm-leg Vessel Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
1670 OTHER Anesth Shoulder Vein Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1680 OTHER Anesth Shoulder Casting 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1682 OTHER Anesth Airplane Cast 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
170 OTHER Anesth Procedure On Mouth 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1710 OTHER Anesth Elbow Area Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1712 OTHER Anesth Uppr Arm Tendon Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1714 OTHER Anesth Uppr Arm Tendon Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1716 OTHER Anesth Biceps Tendon Repair 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
172 OTHER Anesth Cleft Palate Repair 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1730 OTHER Anesth Uppr Arm Procedure 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1732 OTHER Anesth Dx Elbow Arthroscopy 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
174 OTHER Anesth Pharyngeal Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1740 OTHER Anesth Upper Arm Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1742 OTHER Anesth Humerus Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1744 OTHER Anesth Humerus Repair 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1756 OTHER Anesth Radical Humerus Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1758 OTHER Anesth Humeral Lesion Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
176 OTHER Anesth Pharyngeal Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1760 OTHER Anesth Elbow Replacement 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1770 OTHER Anesth Uppr Arm Artery Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1772 OTHER Anesth Uppr Arm Embolectomy 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1780 OTHER Anesth Upper Arm Vein Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1782 OTHER Anesth Uppr Arm Vein Repair 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1810 OTHER Anesth Lower Arm Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1820 OTHER Anesth Lower Arm Procedure 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1829 OTHER Anesth Dx Wrist Arthroscopy 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1830 OTHER Anesth Lower Arm Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1832 OTHER Anesth Wrist Replacement 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1840 OTHER Anesth Lwr Arm Artery Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1842 OTHER Anesth Lwr Arm Embolectomy 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1844 OTHER Anesth Vascular Shunt Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1850 OTHER Anesth Lower Arm Vein Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1852 OTHER Anesth Lwr Arm Vein Repair 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1860 OTHER Anesth Lower Arm Casting 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
190 OTHER Anesth Face/Skull Bone Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1916 OTHER Anesth Dx Arteriography 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
192 OTHER Anesth Facial Bone Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1920 OTHER Anesth Catheterize Heart 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1922 OTHER Anesth Cat Or MRI Scan 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1924 OTHER Anes Ther Interven Rad Art 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1925 OTHER Anes Ther Interven Rad Car 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1926 OTHER Anes Tx Interv Rad Hrt/Cran 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1930 OTHER Anes Ther Interven Rad Vei 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1931 OTHER Anes Ther Interven Rad Tip 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1932 OTHER Anes Tx Interv Rad Th Vein 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1933 OTHER Anes Tx Interv Rad Cran V 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1935 OTHER Anesth Perc Img Dx Sp Proc 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1936 OTHER Anesth Perc Img Tx Sp Proc 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1951 OTHER Anesth Burn Less 4 Percent 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1952 OTHER Anesth Burn 4-9 Percent 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1953 OTHER Anesth Burn Each 9 Percent 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1958 OTHER Anesth Antepartum Manipul 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1960 OTHER Anesth Vaginal Delivery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1961 OTHER Anesth Cs Delivery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1962 OTHER Anesth Emer Hysterectomy 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1963 OTHER Anesth Cs Hysterectomy 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1965 OTHER Anesth Inc/Missed Ab Proc 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1966 OTHER Anesth Induced Ab Procedure 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1967 OTHER Anesth/Analg Vag Delivery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1968 OTHER Anes/Analg Cs Deliver Add-on 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1969 OTHER Anesth/Analg Cs Hyst Add-on 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1990 OTHER Support For Organ Donor 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1991 OTHER Anesth Nerve Block/Inj 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1992 OTHER Anesth N Block/Inj Prone 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1996 OTHER Hosp Manage Cont Drug Admin 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
1999 OTHER Unlisted Anesth Procedure 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
210 OTHER Anesth Cranial Surg Nos 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
211 OTHER Anesth Cran Surg Hemotoma 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
212 OTHER Anesth Skull Drainage 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
214 OTHER Anesth Skull Drainage 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
215 OTHER Anesth Skull Repair/Fract 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
216 OTHER Anesth Head Vessel Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
218 OTHER Anesth Special Head Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
220 OTHER Anesth Intrcrn Nerve 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
222 OTHER Anesth Head Nerve Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
252 MS_DRG Other Vascular Procedures With Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
300 OTHER Anesth Head/Neck/Ptrunk 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
320 OTHER Anesth Neck Organ 1 & Over 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
322 OTHER Anesth Biopsy Of Thyroid 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
326 OTHER Anesth Larynx/Trach < 1 Yr 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
350 OTHER Anesth Neck Vessel Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
352 OTHER Anesth Neck Vessel Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
400 OTHER Anesth Skin Ext/per/Atrunk 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
402 OTHER Anesth Surgery Of Breast 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
404 OTHER Anesth Surgery Of Breast 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
406 OTHER Anesth Surgery Of Breast 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
410 OTHER Anesth Correct Heart Rhythm 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
450 OTHER Anesth Surgery Of Shoulder 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
452 OTHER Anesth Surgery Of Shoulder 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
454 OTHER Anesth Collar Bone Biopsy 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
470 OTHER Anesth Removal Of Rib 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
471 MS_DRG Cervical Spinal Fusion With Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
472 OTHER Anesth Chest Wall Repair 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
474 OTHER Anesth Surgery Of Rib(S) 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
500 MS_DRG Soft Tissue Procedures With Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
500 OTHER Anesth Esophageal Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
520 OTHER Anesth Chest Procedure 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
522 OTHER Anesth Chest Lining Biopsy 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
524 OTHER Anesth Chest Drainage 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
528 OTHER Anesth Chest Partition View 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
529 OTHER Anesth Chest Partition View 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
530 OTHER Anesth Pacemaker Insertion 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
532 OTHER Anesth Vascular Access 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
534 OTHER Anesth Cardioverter/Defib 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
537 OTHER Anesth Cardiac Electrophys 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
539 OTHER Anesth Trach-bronch Reconst 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
540 OTHER Anesth Chest Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
541 OTHER Anesth One Lung Ventilation 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
542 OTHER Anesth Release Of Lung 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
546 OTHER Anesth Lung Chest Wall Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
548 OTHER Anesth Trachea Bronchi Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
550 OTHER Anesth Sternal Debridement 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
560 OTHER Anesth Heart Surg Without Pump 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
561 OTHER Anesth Heart Surg < 1 Yr 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
562 OTHER Anesth Hrt Surg W/Pmp Age 1+ 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
563 OTHER Anesth Heart Surg W/Arrest 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
566 OTHER Anesth Cabg Without Pump 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
567 OTHER Anesth Cabg W/Pump 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
580 OTHER Anesth Heart/Lung Transplnt 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
600 OTHER Anesth Spine Cord Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
604 OTHER Anesth Sitting Procedure 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
620 OTHER Anesth Spine Cord Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
622 OTHER Anesth Removal Of Nerves 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 2 2 — — $5,356.00 $10,200.00 $7,778.00 2024-07-01
625 OTHER Anes Spine Tranthor Without Vent 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
626 OTHER Anes Spine Transthor W/Vent 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
630 OTHER Anesth Spine Cord Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
632 OTHER Anesth Removal Of Nerves 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
634 OTHER Anesth For Chemonucleolysis 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
635 OTHER Anesth Lumbar Puncture 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
640 OTHER Anesth Spine Manipulation 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
653 MS_DRG Major Bladder Procedures With Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
662 MS_DRG Minor Bladder Procedures With Mcc 2 2 — — $5,356.00 $10,200.00 $7,778.00 2024-07-01
670 OTHER Anesth Spine Cord Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
700 OTHER Anesth Abdominal Wall Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
702 OTHER Anesth For Liver Biopsy 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
730 OTHER Anesth Abdominal Wall Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
731 OTHER Anes Upper Gi Endoscopic Px Nos 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
732 OTHER Anes Upper Gi Endoscopic Px Ercp 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
740 OTHER Anesth Upper Gi Visualize 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
750 OTHER Anesth Repair Of Hernia 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
752 OTHER Anesth Repair Of Hernia 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
754 OTHER Anesth Repair Of Hernia 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
756 OTHER Anesth Repair Of Hernia 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
770 OTHER Anesth Blood Vessel Repair 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
790 OTHER Anesth Surg Upper Abdomen 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
792 OTHER Anesth Hemorr/Excise Liver 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
794 OTHER Anesth Pancreas Removal 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
796 OTHER Anesth For Liver Transplant 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
797 OTHER Anesth Surgery For Obesity 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
799 MS_DRG Splenic Procedures With Mcc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
800 MS_DRG Splenic Procedures With Cc 1 1 — — $10,200.00 $10,200.00 $10,200.00 2024-07-01
800 OTHER Anesth Abdominal Wall Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
802 OTHER Anesth Fat Layer Removal 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
810 OTHER Anesth Low Intestine Scope 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
811 OTHER Anes Lower Intestinal Endoscopic Px Nos 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
812 OTHER Anes Lower Intestinal Screening Colonoscopy 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
813 OTHER Anes Upper/Lower Gi Endoscopic Px 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
820 OTHER Anesth Abdominal Wall Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
830 OTHER Anesth Repair Of Hernia 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
832 OTHER Anesth Repair Of Hernia 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
834 OTHER Anesth Hernia Repair < 1 Yr 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
836 OTHER Anesth Hernia Repair Preemie 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
840 OTHER Anesth Surg Lower Abdomen 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
842 OTHER Anesth Amniocentesis 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
844 OTHER Anesth Pelvis Surgery 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
846 OTHER Anesth Hysterectomy 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
848 OTHER Anesth Pelvic Organ Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
851 OTHER Anesth Tubal Ligation 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
860 OTHER Anesth Surgery Of Abdomen 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
862 OTHER Anesth Kidney/Ureter Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
864 OTHER Anesth Removal Of Bladder 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
865 OTHER Anesth Removal Of Prostate 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
866 OTHER Anesth Removal Of Adrenal 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
868 OTHER Anesth Kidney Transplant 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
870 OTHER Anesth Bladder Stone Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
872 OTHER Anesth Kidney Stone Destruct 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
873 OTHER Anesth Kidney Stone Destruct 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
880 OTHER Anesth Abdomen Vessel Surg 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
882 OTHER Anesth Major Vein Ligation 9 6 $36.00 — $32.04 $5,740.93 $5,740.93 2024-07-01
96377 HCPCS Application Of On-body Injector For Under Skin Injection 20 20 $13,355.00 $10,817.55 $4,566.07 $13,355.00 $7,381.98 2026-08-04
96377 CPT Appl On-body Injector For Timed Subq Injection 16 8 $13,093.00 — $41.50 $12,831.14 $6,448.30 2024-07-01
J2350 HCPCS Ocrelizumab 300 Mg/10ml Solution 10 Ml Vial 16 8 $33,150.00 — $49.47 $32,487.00 $16,243.50 2024-07-01
J2506 HCPCS Pegfilgrastim 6 Mg/0.6ml Prefilled Syringe Kit 0.6 Ml Syringe 31 8 $13,092.70 — $46.46 $12,830.85 $6,415.42 2024-07-01
J2507 HCPCS Pegloticase 8 Mg/ml Solution 1 Ml Vial 16 8 $48,367.38 — $3,090.93 $47,400.03 $23,820.93 2024-07-01
J9119 HCPCS Cemiplimab-rwlc 350 Mg/7ml Solution 7 Ml Vial 16 8 $19,219.32 — $23.75 $18,834.93 $9,465.51 2024-07-01
Q4180 HCPCS Revita Placental Membrane 2x3cm 6sqcm 95 27 $9,896.00 $8,015.76 $1,027.70 $19,396.16 $6,009.87 2026-08-04
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