|
845
|
OTHER
|
Inj, Atidarsagene Autotem
|
14
|
9
|
$17,854.42
|
—
|
$5,444.91
|
$4,820,350.00
|
$4,505,000.00
|
2026-07-17
|
|
00845
|
OTHER
|
Inj, Atidarsagene Autotem
|
1
|
1
|
—
|
—
|
$4,505,000.00
|
$4,505,000.00
|
$4,505,000.00
|
2026-03-01
|
|
J3392
|
HCPCS
|
Injection, Exagamglogene Autotemcel, Per Treatment
|
1
|
1
|
—
|
—
|
$3,847,800.00
|
$3,847,800.00
|
$3,847,800.00
|
2026-03-01
|
|
9138
|
OTHER
|
Inj, Hemgenix, Per Tx Dos
|
13
|
9
|
—
|
—
|
$3,648,414.33
|
$3,943,235.69
|
$3,685,267.00
|
2026-03-01
|
|
09138
|
OTHER
|
Inj, Hemgenix, Per Tx Dos
|
1
|
1
|
—
|
—
|
$3,685,267.00
|
$3,685,267.00
|
$3,685,267.00
|
2026-03-01
|
|
908
|
OTHER
|
Topi Adm Prad Zami Per Tr
|
14
|
9
|
$43,427.11
|
—
|
$9,858.79
|
$3,569,327.40
|
$3,335,820.00
|
2026-07-17
|
|
00908
|
OTHER
|
Topi Adm Prad Zami Per Tr
|
1
|
1
|
—
|
—
|
$3,335,820.00
|
$3,335,820.00
|
$3,335,820.00
|
2026-03-01
|
|
714
|
OTHER
|
Inj Delandistrogene Mox R
|
14
|
9
|
$20,234.31
|
—
|
$6,403.95
|
$3,560,810.20
|
$3,327,860.00
|
2026-07-17
|
|
00714
|
OTHER
|
Inj Delandistrogene Mox R
|
1
|
1
|
—
|
—
|
$3,327,860.00
|
$3,327,860.00
|
$3,327,860.00
|
2026-03-01
|
|
00748
|
OTHER
|
Inj, Lovotibeglogene Auto
|
1
|
1
|
—
|
—
|
$3,252,508.00
|
$3,252,508.00
|
$3,252,508.00
|
2026-03-01
|
|
748
|
OTHER
|
Inj, Lovotibeglogene Auto
|
14
|
9
|
$29,927.01
|
—
|
$12,189.86
|
$3,480,183.56
|
$3,252,508.00
|
2026-07-17
|
|
00906
|
OTHER
|
Inj Elivaldogene Autoteme
|
1
|
1
|
—
|
—
|
$3,180,000.00
|
$3,180,000.00
|
$3,180,000.00
|
2026-03-01
|
|
906
|
OTHER
|
Inj Elivaldogene Autoteme
|
14
|
9
|
$37,752.97
|
—
|
$8,711.40
|
$3,402,600.00
|
$3,180,000.00
|
2026-07-17
|
|
J3393
|
HCPCS
|
Injection, Betibeglogene Autotemcel, Per Treatment
|
7
|
6
|
—
|
—
|
$2,968,000.00
|
$4,850,948.67
|
$3,086,720.00
|
2026-03-01
|
|
00746
|
OTHER
|
Inj, Betibeglogene Autote
|
1
|
1
|
—
|
—
|
$2,939,969.00
|
$2,939,969.00
|
$2,939,969.00
|
2026-03-01
|
|
746
|
OTHER
|
Inj, Betibeglogene Autote
|
14
|
9
|
$33,014.32
|
—
|
$11,275.75
|
$3,145,766.83
|
$2,939,969.00
|
2026-07-17
|
|
9141
|
OTHER
|
Inj Onase Abepar-xioi Tre
|
13
|
9
|
—
|
—
|
$2,563,091.19
|
$2,770,209.67
|
$2,588,981.00
|
2026-03-01
|
|
09141
|
OTHER
|
Inj Onase Abepar-xioi Tre
|
1
|
1
|
—
|
—
|
$2,588,981.00
|
$2,588,981.00
|
$2,588,981.00
|
2026-03-01
|
|
824
|
OTHER
|
Inj, Exagamglogene Autote
|
14
|
9
|
$48,364.27
|
—
|
$13,203.62
|
$2,495,240.00
|
$2,332,000.00
|
2026-07-17
|
|
00824
|
OTHER
|
Inj, Exagamglogene Autote
|
1
|
1
|
—
|
—
|
$2,332,000.00
|
$2,332,000.00
|
$2,332,000.00
|
2026-03-01
|
|
J3399
|
HCPCS
|
Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge…
|
8
|
6
|
$4,463,735.93
|
—
|
$2,222,890.60
|
$4,271,819.03
|
$2,311,806.22
|
2026-07-17
|
|
5834
|
APR_DRG
|
Neonate With Ecmo
|
3
|
3
|
—
|
—
|
$868,320.28
|
$1,267,747.61
|
$1,007,251.52
|
2026-03-01
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure…
|
8
|
6
|
—
|
—
|
$770,620.00
|
$1,310,054.00
|
$801,444.80
|
2026-03-01
|
|
2067
|
OTHER
|
Afamitresgene Autoleucel
|
13
|
9
|
—
|
—
|
$762,913.80
|
$824,563.40
|
$770,620.00
|
2026-03-01
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige…
|
10
|
8
|
$813,285.00
|
—
|
$553,169.00
|
$969,621.79
|
$608,217.31
|
2026-07-17
|
|
5833
|
APR_DRG
|
Neonate With Ecmo
|
3
|
3
|
—
|
—
|
$524,269.45
|
$765,433.40
|
$608,152.56
|
2026-03-01
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka…
|
10
|
8
|
$772,928.48
|
—
|
$566,531.30
|
$983,910.90
|
$589,192.55
|
2026-07-17
|
|
09498
|
OTHER
|
Ciltacabtagene Car-pos T
|
1
|
1
|
—
|
—
|
$587,649.60
|
$587,649.60
|
$587,649.60
|
2026-03-01
|
|
9498
|
OTHER
|
Ciltacabtagene Car-pos T
|
13
|
9
|
$512,476.50
|
—
|
$581,773.10
|
$628,785.07
|
$587,649.60
|
2026-07-17
|
|
Q2054
|
HCPCS
|
Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi…
|
10
|
8
|
$717,614.70
|
—
|
$516,442.00
|
$927,632.05
|
$581,878.29
|
2026-07-17
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (…
|
9
|
7
|
$733,705.50
|
—
|
$527,622.00
|
$920,834.85
|
$574,824.18
|
2026-07-17
|
|
09194
|
OTHER
|
Tisagenlecleucel Car-pos
|
1
|
1
|
—
|
—
|
$566,531.30
|
$566,531.30
|
$566,531.30
|
2026-03-01
|
|
9194
|
OTHER
|
Tisagenlecleucel Car-pos
|
13
|
9
|
$485,626.56
|
—
|
$560,865.99
|
$606,188.49
|
$566,531.30
|
2026-07-17
|
|
09413
|
OTHER
|
Lisocabtagene Car Pos T
|
1
|
1
|
—
|
—
|
$562,201.20
|
$562,201.20
|
$562,201.20
|
2026-03-01
|
|
9413
|
OTHER
|
Lisocabtagene Car Pos T
|
13
|
9
|
$465,362.26
|
—
|
$556,579.19
|
$601,555.28
|
$562,201.20
|
2026-07-17
|
|
09422
|
OTHER
|
Idecabtagene Vicleucel Ca
|
1
|
1
|
—
|
—
|
$558,081.80
|
$558,081.80
|
$558,081.80
|
2026-03-01
|
|
9422
|
OTHER
|
Idecabtagene Vicleucel Ca
|
13
|
9
|
$475,796.90
|
—
|
$552,500.98
|
$597,147.53
|
$558,081.80
|
2026-07-17
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via…
|
10
|
8
|
$741,255.67
|
—
|
$502,841.00
|
$878,117.20
|
$550,818.97
|
2026-07-17
|
|
09035
|
OTHER
|
Axicabtagene Ciloleucel C
|
1
|
1
|
—
|
—
|
$532,192.20
|
$532,192.20
|
$532,192.20
|
2026-03-01
|
|
9035
|
OTHER
|
Axicabtagene Ciloleucel C
|
13
|
9
|
$452,486.70
|
—
|
$526,870.28
|
$569,445.65
|
$532,192.20
|
2026-07-17
|
|
Q2053
|
HCPCS
|
Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V…
|
9
|
7
|
$740,441.46
|
—
|
$489,399.00
|
$831,978.57
|
$509,028.21
|
2026-07-17
|
|
09391
|
OTHER
|
Brexucabtagene Car Pos T
|
1
|
1
|
—
|
—
|
$489,450.20
|
$489,450.20
|
$489,450.20
|
2026-03-01
|
|
9391
|
OTHER
|
Brexucabtagene Car Pos T
|
13
|
9
|
$452,545.80
|
—
|
$484,555.70
|
$523,711.71
|
$489,450.20
|
2026-07-17
|
|
Q2058
|
HCPCS
|
Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, …
|
1
|
1
|
—
|
—
|
$459,112.50
|
$459,112.50
|
$459,112.50
|
2026-03-01
|
|
6094
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
3
|
3
|
—
|
—
|
$385,925.99
|
$563,451.95
|
$447,674.15
|
2026-03-01
|
|
114
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
3
|
3
|
—
|
—
|
$378,956.13
|
$553,275.95
|
$439,589.11
|
2026-03-01
|
|
113
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
3
|
3
|
—
|
—
|
$378,956.13
|
$553,275.95
|
$439,589.11
|
2026-03-01
|
|
5914
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
3
|
3
|
—
|
—
|
$370,065.92
|
$540,296.24
|
$429,276.47
|
2026-03-01
|
|
5832
|
APR_DRG
|
Neonate With Ecmo
|
3
|
3
|
—
|
—
|
$328,990.69
|
$480,326.41
|
$381,629.20
|
2026-03-01
|
|
6314
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
3
|
3
|
—
|
—
|
$308,489.28
|
$450,394.35
|
$357,847.56
|
2026-03-01
|
|
112
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
3
|
3
|
—
|
—
|
$297,184.87
|
$433,889.91
|
$344,734.45
|
2026-03-01
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
30
|
18
|
—
|
—
|
$127,712.10
|
$961,594.59
|
$333,093.23
|
2026-03-01
|
|
5884
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
3
|
3
|
—
|
—
|
$278,454.89
|
$406,544.14
|
$323,007.67
|
2026-03-01
|
|
5883
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
3
|
3
|
—
|
—
|
$278,454.89
|
$406,544.14
|
$323,007.67
|
2026-03-01
|
|
5882
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
3
|
3
|
—
|
—
|
$278,454.89
|
$406,544.14
|
$323,007.67
|
2026-03-01
|
|
5934
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
3
|
3
|
—
|
—
|
$265,622.79
|
$387,809.27
|
$308,122.44
|
2026-03-01
|
|
5913
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
3
|
3
|
—
|
—
|
$252,258.22
|
$368,297.00
|
$292,619.54
|
2026-03-01
|
|
6304
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
3
|
3
|
—
|
—
|
$249,721.00
|
$364,592.66
|
$289,676.36
|
2026-03-01
|
|
5831
|
APR_DRG
|
Neonate With Ecmo
|
3
|
3
|
—
|
—
|
$240,319.30
|
$350,866.18
|
$278,770.39
|
2026-03-01
|
|
831
|
OTHER
|
Obecbtge Autol Up To 400
|
14
|
9
|
$15,519.26
|
—
|
$3,728.44
|
$297,727.50
|
$278,250.00
|
2026-07-17
|
|
00831
|
OTHER
|
Obecbtge Autol Up To 400
|
1
|
1
|
—
|
—
|
$278,250.00
|
$278,250.00
|
$278,250.00
|
2026-03-01
|
|
J3403
|
HCPCS
|
Revakinagene Taroretcel-lwey, Per Implant
|
5
|
5
|
—
|
—
|
$265,000.00
|
$275,600.00
|
$272,950.00
|
2026-03-01
|
|
5912
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
3
|
3
|
—
|
—
|
$232,975.11
|
$340,143.66
|
$270,251.13
|
2026-03-01
|
|
00897
|
OTHER
|
Revakinagene, Per Implant
|
1
|
1
|
—
|
—
|
$265,000.00
|
$265,000.00
|
$265,000.00
|
2026-03-01
|
|
897
|
OTHER
|
Revakinagene, Per Implant
|
13
|
9
|
$17,976.90
|
—
|
$262,350.00
|
$283,550.00
|
$265,000.00
|
2026-07-17
|
|
5881
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
3
|
3
|
—
|
—
|
$227,888.40
|
$332,717.06
|
$264,350.54
|
2026-03-01
|
|
1614
|
APR_DRG
|
Implantable Heart Assist Systems
|
3
|
3
|
—
|
—
|
$218,437.13
|
$318,918.21
|
$253,387.07
|
2026-03-01
|
|
94
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
3
|
3
|
—
|
—
|
$199,620.16
|
$291,445.43
|
$231,559.39
|
2026-03-01
|
|
1613
|
APR_DRG
|
Implantable Heart Assist Systems
|
3
|
3
|
—
|
—
|
$189,983.98
|
$277,376.61
|
$220,381.42
|
2026-03-01
|
|
6024
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
3
|
3
|
—
|
—
|
$189,895.14
|
$277,246.90
|
$220,278.36
|
2026-03-01
|
|
018
|
OTHER
|
$115,100.72
|
1
|
1
|
$763,278.19
|
—
|
$219,836.80
|
$219,836.80
|
$219,836.80
|
2026-07-17
|
|
8414
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
3
|
3
|
—
|
—
|
$186,872.72
|
$272,834.17
|
$216,772.36
|
2026-03-01
|
|
6074
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
3
|
3
|
—
|
—
|
$181,636.91
|
$265,189.89
|
$210,698.82
|
2026-03-01
|
|
J3402
|
HCPCS
|
Injection, Remestemcel-l-rknd, Per Therapeutic Dose
|
6
|
5
|
—
|
—
|
$201,669.02
|
$332,753.88
|
$208,727.43
|
2026-03-01
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
31
|
19
|
—
|
—
|
$81,258.66
|
$542,682.82
|
$207,532.77
|
2026-03-01
|
|
6034
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
3
|
3
|
—
|
—
|
$176,081.53
|
$257,079.03
|
$204,254.57
|
2026-03-01
|
|
5892
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational
|
3
|
3
|
—
|
—
|
$174,682.87
|
$255,036.99
|
$202,632.13
|
2026-03-01
|
|
5893
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational
|
3
|
3
|
—
|
—
|
$174,682.87
|
$255,036.99
|
$202,632.13
|
2026-03-01
|
|
5891
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational
|
3
|
3
|
—
|
—
|
$174,682.87
|
$255,036.99
|
$202,632.13
|
2026-03-01
|
|
00886
|
OTHER
|
Inj. Remestemcel-l-rknd/
|
1
|
1
|
—
|
—
|
$201,669.00
|
$201,669.00
|
$201,669.00
|
2026-03-01
|
|
886
|
OTHER
|
Inj. Remestemcel-l-rknd/
|
14
|
9
|
$28,824.70
|
—
|
$8,158.44
|
$215,785.83
|
$201,669.00
|
2026-07-17
|
|
6023
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
3
|
3
|
—
|
—
|
$170,881.95
|
$249,487.65
|
$198,223.06
|
2026-03-01
|
|
5933
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
3
|
3
|
—
|
—
|
$166,949.75
|
$243,746.63
|
$193,661.71
|
2026-03-01
|
|
001
|
OTHER
|
$107,461.81
|
1
|
1
|
$453,292.94
|
—
|
$193,240.00
|
$193,240.00
|
$193,240.00
|
2026-07-17
|
|
5932
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
3
|
3
|
—
|
—
|
$165,755.98
|
$242,003.73
|
$192,276.94
|
2026-03-01
|
|
6334
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
3
|
3
|
—
|
—
|
$157,393.46
|
$229,794.45
|
$182,576.41
|
2026-03-01
|
|
6093
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
3
|
3
|
—
|
—
|
$153,069.89
|
$223,482.04
|
$177,561.07
|
2026-03-01
|
|
6114
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
3
|
3
|
—
|
—
|
$152,711.63
|
$222,958.98
|
$177,145.49
|
2026-03-01
|
|
44
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
3
|
3
|
—
|
—
|
$150,096.90
|
$219,141.47
|
$174,112.40
|
2026-03-01
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
3
|
3
|
—
|
—
|
$145,701.15
|
$212,723.68
|
$169,013.33
|
2026-03-01
|
|
121165
|
CDM
|
Ins/repl Ccm System
|
32
|
17
|
$411,588.18
|
$411,588.18
|
$53,506.46
|
$370,429.36
|
$163,606.30
|
2026-03-01
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
28
|
20
|
—
|
—
|
$15,163.00
|
$413,452.43
|
$155,346.40
|
2026-03-01
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
28
|
20
|
—
|
—
|
$57,937.32
|
$421,173.00
|
$154,443.00
|
2026-03-01
|
|
6073
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
3
|
3
|
—
|
—
|
$132,891.14
|
$194,021.06
|
$154,153.72
|
2026-03-01
|
|
6124
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
3
|
3
|
—
|
—
|
$132,483.81
|
$193,426.36
|
$153,681.22
|
2026-03-01
|
|
955637
|
CDM
|
Rmv Icd W Rplc Mult Ld
|
32
|
17
|
$377,102.80
|
$377,102.80
|
$49,023.36
|
$339,392.52
|
$149,898.36
|
2026-03-01
|
|
955647
|
CDM
|
Rmv Icd W Rplc Mult Ld
|
32
|
17
|
$377,102.80
|
$377,102.80
|
$49,023.36
|
$339,392.52
|
$149,898.36
|
2026-03-01
|
|
1908
|
OTHER
|
New Technology - Level 52
|
13
|
9
|
$154,256.36
|
—
|
$148,013.32
|
$159,973.99
|
$149,508.40
|
2026-07-17
|
|
1907
|
OTHER
|
New Technology - Level 52
|
13
|
9
|
$154,256.36
|
—
|
$148,013.32
|
$159,973.99
|
$149,508.40
|
2026-07-17
|
|
943363
|
CDM
|
Inst/rp Gen Sg/dl Icd
|
32
|
17
|
$370,201.05
|
$370,201.05
|
$48,126.14
|
$333,180.95
|
$147,154.92
|
2026-03-01
|
|
01908
|
OTHER
|
New Technology - Level 52
|
1
|
1
|
—
|
—
|
$143,460.30
|
$143,460.30
|
$143,460.30
|
2026-03-01
|
|
01907
|
OTHER
|
New Technology - Level 52
|
1
|
1
|
—
|
—
|
$143,460.30
|
$143,460.30
|
$143,460.30
|
2026-03-01
|
|
J7330
|
HCPCS
|
$103,458.96
|
1
|
1
|
$103,458.96
|
—
|
$138,148.31
|
$138,148.31
|
$138,148.31
|
2026-07-17
|
|
1611
|
APR_DRG
|
Implantable Heart Assist Systems
|
3
|
3
|
—
|
—
|
$118,799.53
|
$173,447.31
|
$137,807.45
|
2026-03-01
|
|
1612
|
APR_DRG
|
Implantable Heart Assist Systems
|
3
|
3
|
—
|
—
|
$118,799.53
|
$173,447.31
|
$137,807.45
|
2026-03-01
|
|
955644
|
CDM
|
Ins Icd Gen W Mult Lead
|
32
|
17
|
$343,045.04
|
$343,045.04
|
$44,595.86
|
$308,740.54
|
$136,360.40
|
2026-03-01
|
|
955634
|
CDM
|
Ins Icd Gen W Mult Lead
|
32
|
17
|
$343,045.04
|
$343,045.04
|
$44,595.86
|
$308,740.54
|
$136,360.40
|
2026-03-01
|
|
003
|
OTHER
|
$77,265.25
|
1
|
1
|
$399,898.00
|
—
|
$136,199.50
|
$136,199.50
|
$136,199.50
|
2026-07-17
|
|
883402
|
CDM
|
Ins/repl Subq Imp Icd Sy
|
38
|
18
|
$377,102.80
|
$377,102.80
|
$49,023.36
|
$339,392.52
|
$135,568.46
|
2026-03-01
|
|
883401
|
CDM
|
Ins/repl Subq Imp Icd Sy
|
38
|
18
|
$377,102.80
|
$377,102.80
|
$49,023.36
|
$339,392.52
|
$135,568.46
|
2026-03-01
|
|
1905
|
OTHER
|
New Technology - Level 51
|
13
|
9
|
$139,083.65
|
—
|
$133,454.67
|
$144,238.89
|
$134,802.70
|
2026-07-17
|
|
1906
|
OTHER
|
New Technology - Level 51
|
13
|
9
|
$139,083.65
|
—
|
$133,454.67
|
$144,238.89
|
$134,802.70
|
2026-07-17
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
3
|
3
|
—
|
—
|
$115,488.36
|
$168,613.01
|
$133,966.50
|
2026-03-01
|
|
93
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
3
|
3
|
—
|
—
|
$113,723.79
|
$166,036.73
|
$131,919.60
|
2026-03-01
|
|
955633
|
CDM
|
Ins Icd Gen W Dual Lead
|
32
|
17
|
$329,870.72
|
$329,870.72
|
$42,883.19
|
$296,883.65
|
$131,123.61
|
2026-03-01
|
|
955643
|
CDM
|
Ins Icd Gen W Dual Lead
|
32
|
17
|
$329,870.72
|
$329,870.72
|
$42,883.19
|
$296,883.65
|
$131,123.61
|
2026-03-01
|
|
01906
|
OTHER
|
New Technology - Level 51
|
1
|
1
|
—
|
—
|
$129,349.50
|
$129,349.50
|
$129,349.50
|
2026-03-01
|
|
01905
|
OTHER
|
New Technology - Level 51
|
1
|
1
|
—
|
—
|
$129,349.50
|
$129,349.50
|
$129,349.50
|
2026-03-01
|
|
6022
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
3
|
3
|
—
|
—
|
$110,912.54
|
$161,932.31
|
$128,658.55
|
2026-03-01
|
|
901108
|
CDM
|
Insrt Pace Lead Prev Gen
|
32
|
17
|
$316,159.55
|
$316,159.55
|
$41,100.74
|
$284,543.59
|
$125,673.42
|
2026-03-01
|
|
111
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
3
|
3
|
—
|
—
|
$105,588.56
|
$154,159.30
|
$122,482.73
|
2026-03-01
|
|
6214
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
3
|
3
|
—
|
—
|
$104,556.00
|
$152,651.76
|
$121,284.96
|
2026-03-01
|
|
1904
|
OTHER
|
New Technology - Level 50
|
13
|
9
|
$123,910.95
|
—
|
$118,896.03
|
$128,503.79
|
$120,097.00
|
2026-07-17
|
|
1903
|
OTHER
|
New Technology - Level 50
|
13
|
9
|
$123,910.95
|
—
|
$118,896.03
|
$128,503.79
|
$120,097.00
|
2026-07-17
|
|
54
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
3
|
3
|
—
|
—
|
$102,382.95
|
$149,479.11
|
$118,764.22
|
2026-03-01
|
|
6303
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
3
|
3
|
—
|
—
|
$100,560.00
|
$146,817.60
|
$116,649.60
|
2026-03-01
|
|
8424
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
3
|
3
|
—
|
—
|
$99,933.49
|
$145,902.90
|
$115,922.85
|
2026-03-01
|
|
01903
|
OTHER
|
New Technology - Level 50
|
1
|
1
|
—
|
—
|
$115,238.70
|
$115,238.70
|
$115,238.70
|
2026-03-01
|
|
01904
|
OTHER
|
New Technology - Level 50
|
1
|
1
|
—
|
—
|
$115,238.70
|
$115,238.70
|
$115,238.70
|
2026-03-01
|
|
6134
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
3
|
3
|
—
|
—
|
$97,469.45
|
$142,305.40
|
$113,064.56
|
2026-03-01
|
|
955635
|
CDM
|
Rmv Icd W Rplc Sgl Ld
|
32
|
17
|
$280,413.74
|
$280,413.74
|
$36,453.79
|
$252,372.37
|
$111,464.46
|
2026-03-01
|
|
955646
|
CDM
|
Rmv Icd W Rplc Dual Ld
|
32
|
17
|
$280,413.74
|
$280,413.74
|
$36,453.79
|
$252,372.37
|
$111,464.46
|
2026-03-01
|
|
955645
|
CDM
|
Rmv Icd W Rplc Sgl Ld
|
32
|
17
|
$280,413.74
|
$280,413.74
|
$36,453.79
|
$252,372.37
|
$111,464.46
|
2026-03-01
|
|
955636
|
CDM
|
Rmv Icd W Rplc Dual Ld
|
32
|
17
|
$280,413.74
|
$280,413.74
|
$36,453.79
|
$252,372.37
|
$111,464.46
|
2026-03-01
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
3
|
3
|
—
|
—
|
$96,031.24
|
$140,205.61
|
$111,396.24
|
2026-03-01
|
|
Q0480
|
HCPCS
|
Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only
|
14
|
9
|
$101,369.26
|
—
|
$109,253.43
|
$118,081.99
|
$110,357.00
|
2026-07-17
|
|
943361
|
CDM
|
Ins Imp Icd Gen Sng Lead
|
32
|
17
|
$276,064.79
|
$276,064.79
|
$35,888.42
|
$248,458.31
|
$109,735.76
|
2026-03-01
|
|
943425
|
CDM
|
Ins Imp Icd Gen Sng Lead
|
32
|
17
|
$276,064.79
|
$276,064.79
|
$35,888.42
|
$248,458.31
|
$109,735.76
|
2026-03-01
|
|
888493
|
CDM
|
Ins Ecmo Perc Periph=>6y
|
32
|
17
|
$272,120.85
|
$272,120.85
|
$35,375.71
|
$244,908.76
|
$108,168.04
|
2026-03-01
|
|
6021
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
3
|
3
|
—
|
—
|
$92,833.02
|
$135,536.21
|
$107,686.30
|
2026-03-01
|
|
43
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
3
|
3
|
—
|
—
|
$92,007.03
|
$134,330.26
|
$106,728.15
|
2026-03-01
|
|
5931
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
3
|
3
|
—
|
—
|
$91,779.11
|
$133,997.50
|
$106,463.77
|
2026-03-01
|
|
004
|
OTHER
|
$43,916.42
|
1
|
1
|
$221,149.03
|
—
|
$106,361.00
|
$106,361.00
|
$106,361.00
|
2026-07-17
|
|
1901
|
OTHER
|
New Technology - Level 49
|
13
|
9
|
$108,738.24
|
—
|
$104,337.39
|
$112,768.69
|
$105,391.30
|
2026-07-17
|
|
1902
|
OTHER
|
New Technology - Level 49
|
13
|
9
|
$108,738.24
|
—
|
$104,337.39
|
$112,768.69
|
$105,391.30
|
2026-07-17
|
|
6083
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
3
|
3
|
—
|
—
|
$88,742.55
|
$129,564.12
|
$102,941.36
|
2026-03-01
|
|
6084
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
3
|
3
|
—
|
—
|
$88,742.55
|
$129,564.12
|
$102,941.36
|
2026-03-01
|
|
6113
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
3
|
3
|
—
|
—
|
$88,298.41
|
$128,915.68
|
$102,426.16
|
2026-03-01
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
28
|
20
|
—
|
—
|
$43,017.24
|
$268,232.36
|
$101,275.80
|
2026-03-01
|
|
01901
|
OTHER
|
New Technology - Level 49
|
1
|
1
|
—
|
—
|
$101,127.90
|
$101,127.90
|
$101,127.90
|
2026-03-01
|
|
01902
|
OTHER
|
New Technology - Level 49
|
1
|
1
|
—
|
—
|
$101,127.90
|
$101,127.90
|
$101,127.90
|
2026-03-01
|
|
214
|
APR_DRG
|
Open Craniotomy Except Trauma
|
3
|
3
|
—
|
—
|
$85,473.45
|
$124,791.24
|
$99,149.20
|
2026-03-01
|
|
6032
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
3
|
3
|
—
|
—
|
$84,778.45
|
$123,776.54
|
$98,343.00
|
2026-03-01
|
|
6033
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
3
|
3
|
—
|
—
|
$84,778.45
|
$123,776.54
|
$98,343.00
|
2026-03-01
|
|
7
|
MS_DRG
|
Lung Transplant
|
29
|
20
|
—
|
—
|
$38,295.10
|
$250,780.62
|
$96,673.40
|
2026-03-01
|
|
651
|
OTHER
|
$13,539.39
|
1
|
1
|
$57,111.55
|
—
|
$95,321.42
|
$95,321.42
|
$95,321.42
|
2026-07-17
|
|
K1007
|
HCPCS
|
Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin…
|
14
|
9
|
—
|
—
|
$94,130.19
|
$101,736.67
|
$95,081.00
|
2026-03-01
|
|
900987
|
CDM
|
Pmaker Sng To Dual Chmbr
|
32
|
17
|
$236,812.20
|
$236,812.20
|
$30,785.59
|
$213,130.98
|
$94,132.85
|
2026-03-01
|
|
900982
|
CDM
|
Ins Perm Pcmakr Atr Vent
|
32
|
17
|
$236,812.20
|
$236,812.20
|
$30,785.59
|
$213,130.98
|
$94,132.85
|
2026-03-01
|
|
900950
|
CDM
|
Ins Perm Pcmakr Atr Vent
|
32
|
17
|
$236,812.20
|
$236,812.20
|
$30,785.59
|
$213,130.98
|
$94,132.85
|
2026-03-01
|
|
A9543
|
HCPCS
|
$108,036.36
|
1
|
1
|
$108,036.36
|
—
|
$93,760.51
|
$93,760.51
|
$93,760.51
|
2026-07-17
|
|
1599
|
OTHER
|
New Technology - Level 48
|
13
|
9
|
$96,094.32
|
—
|
$92,205.22
|
$99,656.15
|
$93,136.59
|
2026-07-17
|
|
1585
|
OTHER
|
New Technology - Level 48
|
13
|
9
|
$96,094.32
|
—
|
$92,205.22
|
$99,656.15
|
$93,136.59
|
2026-07-17
|
|
3034
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
3
|
3
|
—
|
—
|
$79,564.87
|
$116,164.71
|
$92,295.25
|
2026-03-01
|
|
6123
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
3
|
3
|
—
|
—
|
$78,369.15
|
$114,418.96
|
$90,908.21
|
2026-03-01
|
|
6213
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
3
|
3
|
—
|
—
|
$78,045.25
|
$113,946.07
|
$90,532.49
|
2026-03-01
|
|
6072
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
3
|
3
|
—
|
—
|
$77,824.41
|
$113,623.64
|
$90,276.32
|
2026-03-01
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
31
|
19
|
—
|
—
|
$32,872.98
|
$292,256.00
|
$90,257.50
|
2026-03-01
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
31
|
20
|
—
|
—
|
$39,707.20
|
$232,726.63
|
$89,816.81
|
2026-03-01
|
|
01585
|
OTHER
|
New Technology - Level 48
|
1
|
1
|
—
|
—
|
$89,368.87
|
$89,368.87
|
$89,368.87
|
2026-03-01
|
|
01599
|
OTHER
|
New Technology - Level 48
|
1
|
1
|
—
|
—
|
$89,368.87
|
$89,368.87
|
$89,368.87
|
2026-03-01
|
|
6092
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
3
|
3
|
—
|
—
|
$75,889.60
|
$110,798.82
|
$88,031.94
|
2026-03-01
|
|
1634
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
3
|
3
|
—
|
—
|
$75,717.47
|
$110,547.51
|
$87,832.27
|
2026-03-01
|
|
6344
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…
|
3
|
3
|
—
|
—
|
$75,324.00
|
$109,973.04
|
$87,375.84
|
2026-03-01
|
|
6814
|
APR_DRG
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
3
|
3
|
—
|
—
|
$75,192.07
|
$109,780.42
|
$87,222.80
|
2026-03-01
|
|
8514
|
APR_DRG
|
Gender Related Procedures
|
3
|
3
|
—
|
—
|
$75,178.36
|
$109,760.41
|
$87,206.90
|
2026-03-01
|
|
953004
|
CDM
|
Revasc Tib Stnt/ath Init
|
32
|
17
|
$217,882.12
|
$217,882.12
|
$28,324.68
|
$196,093.91
|
$86,608.14
|
2026-03-01
|
|
953038
|
CDM
|
Revasc Tib Stnt/ath Init
|
32
|
17
|
$217,882.12
|
$217,882.12
|
$28,324.68
|
$196,093.91
|
$86,608.14
|
2026-03-01
|
|
1304
|
APR_DRG
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
3
|
3
|
—
|
—
|
$74,465.92
|
$108,720.24
|
$86,380.47
|
2026-03-01
|
|
209
|
MS_DRG
|
Complex Aortic Arch Procedures
|
35
|
18
|
—
|
—
|
$44,516.22
|
$252,047.04
|
$86,335.58
|
2026-03-01
|
|
6144
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition…
|
3
|
3
|
—
|
—
|
$73,780.56
|
$107,719.62
|
$85,585.45
|
2026-03-01
|
|
900948
|
CDM
|
Ins Perm Pacemakr Atrial
|
32
|
17
|
$214,818.20
|
$214,818.20
|
$27,926.37
|
$193,336.38
|
$85,390.24
|
2026-03-01
|
|
900981
|
CDM
|
Ins Perm Pacemakr Atrial
|
32
|
17
|
$214,818.20
|
$214,818.20
|
$27,926.37
|
$193,336.38
|
$85,390.24
|
2026-03-01
|
|
6313
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
3
|
3
|
—
|
—
|
$73,186.75
|
$106,852.65
|
$84,896.63
|
2026-03-01
|
|
2994
|
APR_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
3
|
3
|
—
|
—
|
$72,356.50
|
$105,640.49
|
$83,933.54
|
2026-03-01
|
|
6133
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
3
|
3
|
—
|
—
|
$71,875.20
|
$104,937.79
|
$83,375.23
|
2026-03-01
|
|
1584
|
OTHER
|
New Technology - Level 47
|
13
|
9
|
$85,979.18
|
—
|
$82,499.46
|
$89,166.09
|
$83,332.79
|
2026-07-17
|
|
1598
|
OTHER
|
New Technology - Level 47
|
13
|
9
|
$85,979.18
|
—
|
$82,499.46
|
$89,166.09
|
$83,332.79
|
2026-07-17
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
35
|
18
|
—
|
—
|
$45,771.18
|
$245,420.08
|
$83,295.28
|
2026-03-01
|
|
3044
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
3
|
3
|
—
|
—
|
$71,214.77
|
$103,973.56
|
$82,609.13
|
2026-03-01
|
|
1784
|
APR_DRG
|
External Heart Assist Devices
|
3
|
3
|
—
|
—
|
$70,682.87
|
$103,196.99
|
$81,992.13
|
2026-03-01
|
|
007
|
OTHER
|
$46,607.47
|
1
|
1
|
$196,598.57
|
—
|
$81,745.71
|
$81,745.71
|
$81,745.71
|
2026-07-17
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
41
|
19
|
—
|
—
|
$15,163.00
|
$242,144.46
|
$81,404.74
|
2026-03-01
|
|
900983
|
CDM
|
Ep Ppm Gen/lead Ins/rp V
|
32
|
17
|
$202,551.21
|
$202,551.21
|
$26,331.66
|
$182,296.09
|
$80,514.11
|
2026-03-01
|
|
7524
|
APR_DRG
|
Personality Disorders
|
3
|
3
|
—
|
—
|
$69,082.57
|
$100,860.55
|
$80,135.78
|
2026-03-01
|
|
01598
|
OTHER
|
New Technology - Level 47
|
1
|
1
|
—
|
—
|
$79,961.67
|
$79,961.67
|
$79,961.67
|
2026-03-01
|
|
01584
|
OTHER
|
New Technology - Level 47
|
1
|
1
|
—
|
—
|
$79,961.67
|
$79,961.67
|
$79,961.67
|
2026-03-01
|
|
9114
|
APR_DRG
|
Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma
|
3
|
3
|
—
|
—
|
$68,667.15
|
$100,254.04
|
$79,653.89
|
2026-03-01
|
|
953034
|
CDM
|
Revasc Fem/pop Stnt/ath
|
32
|
17
|
$199,891.84
|
$199,891.84
|
$25,985.94
|
$179,902.66
|
$79,457.01
|
2026-03-01
|
|
953000
|
CDM
|
Revasc Fem/pop Stnt/ath
|
32
|
17
|
$199,891.84
|
$199,891.84
|
$25,985.94
|
$179,902.66
|
$79,457.01
|
2026-03-01
|
|
6091
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
3
|
3
|
—
|
—
|
$68,146.66
|
$99,494.12
|
$79,050.13
|
2026-03-01
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
40
|
22
|
—
|
—
|
$39,147.78
|
$334,366.00
|
$78,400.67
|
2026-03-01
|
|
8633
|
APR_DRG
|
Neonatal Aftercare
|
3
|
3
|
—
|
—
|
$67,447.33
|
$98,473.10
|
$78,238.90
|
2026-03-01
|
|
6224
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…
|
3
|
3
|
—
|
—
|
$67,345.50
|
$98,324.43
|
$78,120.78
|
2026-03-01
|
|
6223
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…
|
3
|
3
|
—
|
—
|
$67,345.50
|
$98,324.43
|
$78,120.78
|
2026-03-01
|
|
6333
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
3
|
3
|
—
|
—
|
$67,233.85
|
$98,161.42
|
$77,991.27
|
2026-03-01
|
|
6143
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition…
|
3
|
3
|
—
|
—
|
$67,066.99
|
$97,917.81
|
$77,797.71
|
2026-03-01
|
|
4284
|
APR_DRG
|
Genetic Disorders
|
3
|
3
|
—
|
—
|
$66,936.94
|
$97,727.93
|
$77,646.85
|
2026-03-01
|
|
53
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
3
|
3
|
—
|
—
|
$66,807.33
|
$97,538.70
|
$77,496.50
|
2026-03-01
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
29
|
20
|
—
|
—
|
$30,508.08
|
$199,662.83
|
$77,259.75
|
2026-03-01
|
|
900979
|
CDM
|
Ins Pm Gen Exst Dual Ld
|
32
|
17
|
$193,866.08
|
$193,866.08
|
$25,202.59
|
$174,479.47
|
$77,061.76
|
2026-03-01
|
|
A9699
|
HCPCS
|
$78,168.72
|
1
|
1
|
$78,168.72
|
—
|
$77,046.96
|
$77,046.96
|
$77,046.96
|
2026-07-17
|
|
42
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
3
|
3
|
—
|
—
|
$66,390.90
|
$96,930.71
|
$77,013.44
|
2026-03-01
|
|
6071
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
3
|
3
|
—
|
—
|
$66,300.18
|
$96,798.26
|
$76,908.21
|
2026-03-01
|
|
789344
|
CDM
|
Insrt Perm Pcmkr Ldless
|
32
|
17
|
$192,670.42
|
$192,670.42
|
$25,047.15
|
$173,403.38
|
$76,586.49
|
2026-03-01
|
|
789349
|
CDM
|
Cath Rh W Wirls Sens Plc
|
32
|
17
|
$192,165.56
|
$192,165.56
|
$24,981.52
|
$172,949.00
|
$76,385.82
|
2026-03-01
|
|
92
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
3
|
3
|
—
|
—
|
$65,262.16
|
$95,282.75
|
$75,704.11
|
2026-03-01
|
|
1834
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
3
|
3
|
—
|
—
|
$63,988.35
|
$93,422.99
|
$74,226.49
|
2026-03-01
|
|
1597
|
OTHER
|
New Technology - Level 46
|
13
|
9
|
$75,864.04
|
—
|
$72,793.70
|
$78,676.02
|
$73,528.99
|
2026-07-17
|
|
1583
|
OTHER
|
New Technology - Level 46
|
13
|
9
|
$75,864.04
|
—
|
$72,793.70
|
$78,676.02
|
$73,528.99
|
2026-07-17
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
45
|
22
|
—
|
—
|
$38,485.44
|
$217,843.39
|
$73,378.78
|
2026-03-01
|
|
6804
|
APR_DRG
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
3
|
3
|
—
|
—
|
$63,155.51
|
$92,207.04
|
$73,260.39
|
2026-03-01
|
|
6904
|
APR_DRG
|
Acute Leukemia
|
3
|
3
|
—
|
—
|
$63,011.17
|
$91,996.31
|
$73,092.96
|
2026-03-01
|
|
2W19X7Z
|
OTHER
|
Compression Of Left Upper Extremity Using Intermittent Pressure Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3AXYZ
|
OTHER
|
Immobilization Of Right Upper Arm Using Other Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3CX3Z
|
OTHER
|
Immobilization Of Right Lower Arm Using Brace
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3AX3Z
|
OTHER
|
Immobilization Of Right Upper Arm Using Brace
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3EXYZ
|
OTHER
|
Immobilization Of Right Hand Using Other Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3MX3Z
|
OTHER
|
Immobilization Of Left Lower Extremity Using Brace
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W30X3Z
|
OTHER
|
Immobilization Of Head Using Brace
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W4QX5Z
|
OTHER
|
Packing Of Right Lower Leg Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2Y40X5Z
|
OTHER
|
Packing Of Mouth And Pharynx Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3LXYZ
|
OTHER
|
Immobilization Of Right Lower Extremity Using Other Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W4AX5Z
|
OTHER
|
Packing Of Right Upper Arm Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3PX3Z
|
OTHER
|
Immobilization Of Left Upper Leg Using Brace
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W44X5Z
|
OTHER
|
Packing Of Chest Wall Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W4FX5Z
|
OTHER
|
Packing Of Left Hand Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W4GX5Z
|
OTHER
|
Packing Of Right Thumb Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3SX3Z
|
OTHER
|
Immobilization Of Right Foot Using Brace
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3UXYZ
|
OTHER
|
Immobilization Of Right Toe Using Other Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W4LX5Z
|
OTHER
|
Packing Of Right Lower Extremity Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3HXYZ
|
OTHER
|
Immobilization Of Left Thumb Using Other Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W46X5Z
|
OTHER
|
Packing Of Right Inguinal Region Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W47X5Z
|
OTHER
|
Packing Of Left Inguinal Region Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3EX3Z
|
OTHER
|
Immobilization Of Right Hand Using Brace
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W42X5Z
|
OTHER
|
Packing Of Neck Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
0NH005Z
|
OTHER
|
Insertion Of External Fixation Device Into Skull, Open Approach
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W4VX5Z
|
OTHER
|
Packing Of Left Toe Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3RXYZ
|
OTHER
|
Immobilization Of Left Lower Leg Using Other Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3TXYZ
|
OTHER
|
Immobilization Of Left Foot Using Other Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3JX3Z
|
OTHER
|
Immobilization Of Right Finger Using Brace
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3QXYZ
|
OTHER
|
Immobilization Of Right Lower Leg Using Other Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3TX3Z
|
OTHER
|
Immobilization Of Left Foot Using Brace
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W40X5Z
|
OTHER
|
Packing Of Head Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W39XYZ
|
OTHER
|
Immobilization Of Left Upper Extremity Using Other Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3HX3Z
|
OTHER
|
Immobilization Of Left Thumb Using Brace
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3PXYZ
|
OTHER
|
Immobilization Of Left Upper Leg Using Other Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3FXYZ
|
OTHER
|
Immobilization Of Left Hand Using Other Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3UX3Z
|
OTHER
|
Immobilization Of Right Toe Using Brace
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3VX3Z
|
OTHER
|
Immobilization Of Left Toe Using Brace
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3KXYZ
|
OTHER
|
Immobilization Of Left Finger Using Other Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3GX3Z
|
OTHER
|
Immobilization Of Right Thumb Using Brace
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W1VX7Z
|
OTHER
|
Compression Of Left Toe Using Intermittent Pressure Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W45X5Z
|
OTHER
|
Packing Of Back Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W4HX5Z
|
OTHER
|
Packing Of Left Thumb Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W4NX5Z
|
OTHER
|
Packing Of Right Upper Leg Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3GXYZ
|
OTHER
|
Immobilization Of Right Thumb Using Other Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3VXYZ
|
OTHER
|
Immobilization Of Left Toe Using Other Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W49X5Z
|
OTHER
|
Packing Of Left Upper Extremity Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W4CX5Z
|
OTHER
|
Packing Of Right Lower Arm Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3BXYZ
|
OTHER
|
Immobilization Of Left Upper Arm Using Other Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W4DX5Z
|
OTHER
|
Packing Of Left Lower Arm Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W4KX5Z
|
OTHER
|
Packing Of Left Finger Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W4MX5Z
|
OTHER
|
Packing Of Left Lower Extremity Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3JXYZ
|
OTHER
|
Immobilization Of Right Finger Using Other Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3LX3Z
|
OTHER
|
Immobilization Of Right Lower Extremity Using Brace
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W43X5Z
|
OTHER
|
Packing Of Abdominal Wall Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3BX3Z
|
OTHER
|
Immobilization Of Left Upper Arm Using Brace
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3FX3Z
|
OTHER
|
Immobilization Of Left Hand Using Brace
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W4BX5Z
|
OTHER
|
Packing Of Left Upper Arm Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W10X7Z
|
OTHER
|
Compression Of Head Using Intermittent Pressure Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3RX3Z
|
OTHER
|
Immobilization Of Left Lower Leg Using Brace
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W48X5Z
|
OTHER
|
Packing Of Right Upper Extremity Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W4EX5Z
|
OTHER
|
Packing Of Right Hand Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3KX3Z
|
OTHER
|
Immobilization Of Left Finger Using Brace
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3CXYZ
|
OTHER
|
Immobilization Of Right Lower Arm Using Other Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3SXYZ
|
OTHER
|
Immobilization Of Right Foot Using Other Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3QX3Z
|
OTHER
|
Immobilization Of Right Lower Leg Using Brace
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3NXYZ
|
OTHER
|
Immobilization Of Right Upper Leg Using Other Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W4RX5Z
|
OTHER
|
Packing Of Left Lower Leg Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W4TX5Z
|
OTHER
|
Packing Of Left Foot Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2Y45X5Z
|
OTHER
|
Packing Of Urethra Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
0NH045Z
|
OTHER
|
Insertion Of External Fixation Device Into Skull, Percutaneous Endoscopic Approa…
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3DXYZ
|
OTHER
|
Immobilization Of Left Lower Arm Using Other Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W4JX5Z
|
OTHER
|
Packing Of Right Finger Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W4SX5Z
|
OTHER
|
Packing Of Right Foot Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3DX3Z
|
OTHER
|
Immobilization Of Left Lower Arm Using Brace
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3NX3Z
|
OTHER
|
Immobilization Of Right Upper Leg Using Brace
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W4PX5Z
|
OTHER
|
Packing Of Left Upper Leg Using Packing Material
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|
|
2W3MXYZ
|
OTHER
|
Immobilization Of Left Lower Extremity Using Other Device
|
1
|
1
|
—
|
—
|
$72,905.50
|
$72,905.50
|
$72,905.50
|
2026-03-01
|