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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

MOSAIC MEDICAL CENTER - MARYVILLE

Maryville, MO · CCN 261340 · Rates published

13,002 distinct procedures filed
20 distinct payers
464,458 rate rows
2025-09-26 last MRF observed
Data quality

253,076 of 464,458 rate rows are consumer-grade (54.5%)

211,382 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 204,801
placeholder amount (≤ $0.02) — excluded from medians 5,898
percent-of-charges filed in the dollar field — excluded from medians 607
per-diem day rate — not a per-procedure price 28
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 25
exceeds 10× this hospital's gross charge — excluded from medians 23
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/12746/832249459-1265906663_heartland-regional-medical-center_standardcharges.csv
Found on page https://mymlc.com/cms-hpt.txt
Discovered viaDiscovered by HANK (automated)
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-19
Content fingerprint 8a00142c8355a3b2… · 356,076,935 bytes · first seen 2026-05-15

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 7 $35,448.00 $3,672,900.00 $3,672,900.00 nat. median
$3,710,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 4 $3,605,000.00 $3,605,000.00 $3,605,000.00 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 4 $3,325,454.76 $3,325,454.76 $3,325,454.76 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 4 $3,286,000.00 $3,286,000.00 $3,286,000.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 4 $2,968,000.00 $2,968,000.00 $2,968,000.00 nat. median
$3,004,655
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 4 $2,388,614.23 $2,388,614.23 $2,388,614.23 nat. median
$2,468,984
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 4 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 4 $529,192.86 $529,192.86 $529,192.86 nat. median
$753,246
0.7× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 4 $527,123.43 $527,123.43 $527,123.43 nat. median
$674,867
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 4 $526,587.59 $526,587.59 $526,587.59 nat. median
$625,184
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 4 $516,726.08 $516,726.08 $516,726.08 nat. median
$673,137
0.8× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $489,455.96 $489,455.96 $489,455.96 nat. median
$634,303
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 4 $460,530.40 $460,530.40 $460,530.40 nat. median
$619,808
0.7× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 $229,570.41 $229,570.41 $229,570.41 nat. median
$370,174
0.6× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 3 $180,413.81 $180,413.81 $180,413.81 nat. median
$265,286
0.7× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 3 $129,338.32 $129,338.32 $129,338.32 nat. median
$206,474
0.6× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 4 $111,860.00 $111,860.00 $111,860.00 nat. median
$96,983
1.2× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 6 $90,900.76 $99,999.99 $99,999.99 nat. median
$111,989
0.9× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 3 $99,220.68 $99,220.68 $99,220.68 nat. median
$100,136
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 3 $95,176.30 $95,176.30 $95,176.30 nat. median
$202,976
outlier · 0.5×
7
MS_DRG 		Lung Transplant 3 $94,702.27 $94,702.27 $94,702.27 nat. median
$122,708
0.8× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 $89,682.76 $89,682.76 $89,682.76 nat. median
$108,660
0.8× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 3 $86,116.72 $86,116.72 $86,116.72 nat. median
$117,357
0.7× median
8
MS_DRG 		Simultaneous Pancreas And Kidney Transplant 3 $84,449.91 $84,449.91 $84,449.91 nat. median
$53,167
1.6× median
652
MS_DRG 		Kidney Transplant 3 $83,758.84 $83,758.84 $83,758.84 nat. median
$31,494
outlier · 2.7×
L8702
HCPCS 		Ewhf S/d Uprt Micro Sensor 4 $80,943.19 $80,943.19 $80,943.19 nat. median
$70,825
1.1× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 $68,670.81 $68,670.81 $68,670.81 nat. median
$93,672
0.7× median
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 6 $60,768.00 $63,354.77 $63,354.77 nat. median
$69,774
0.9× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And… 3 $62,389.05 $62,389.05 $62,389.05 nat. median
$133,161
outlier · 0.5×
650
MS_DRG 		Kidney Transplant With Hemodialysis With Mcc 3 $59,648.74 $59,648.74 $59,648.74 nat. median
$45,278
1.3× median
L7181
HCPCS 		Electronic Elbo Simultaneous 7 $33,054.59 $57,614.51 $57,614.51 nat. median
$50,598
1.1× median
38240
CPT 		Transplt Allo Hct/donor 4 $57,370.87 $57,370.87 $57,370.87 nat. median
$15,979
outlier · 3.6×
6
MS_DRG 		Liver Transplant Without Mcc 3 $55,812.79 $55,812.79 $55,812.79 nat. median
$46,260
1.2× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 4 $55,015.23 $55,015.23 $55,015.23 nat. median
$66,682
0.8× median
J0202
HCPCS 		Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution 20 $2,337.69 $100,708.26 $52,790.62 nat. median
$4,053
outlier · 13.0×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 $52,448.41 $52,448.41 $52,448.41 nat. median
$77,570
0.7× median
L7180
HCPCS 		Electronic Elbow Sequential 7 $29,785.66 $52,277.90 $52,277.90 nat. median
$49,027
1.1× median
215
MS_DRG 		Other Heart Assist System Implant 3 $50,601.45 $50,601.45 $50,601.45 nat. median
$99,019
0.5× median
224
MS_DRG 		Inpatient Ms-DRG 3 $49,560.54 $49,560.54 $49,560.54 nat. median
$54,196
0.9× median
222
MS_DRG 		Inpatient Ms-DRG 3 $45,748.57 $45,748.57 $45,748.57 nat. median
$63,570
0.7× median
J9226
HCPCS 		Supprelin La Implant 6 $45,350.22 $47,999.60 $45,350.22 nat. median
$60,368
0.8× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 $44,486.31 $44,486.31 $44,486.31 nat. median
$81,118
0.5× median
0266T
CPT 		Outpatient Services 4 $43,652.62 $43,652.62 $43,652.62 nat. median
$42,941
1.0× median
33276
CPT 		Insj Phrnc Nrv Stim Sys 4 $43,652.62 $43,652.62 $43,652.62 nat. median
$43,787
1.0× median
21
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 3 $41,303.93 $41,303.93 $41,303.93 nat. median
$54,045
0.8× median
L8701
HCPCS 		Ewh S/d Uprt Micro Sensor 4 $41,141.33 $41,141.33 $41,141.33 nat. median
$35,999
1.1× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 3 $40,970.08 $40,970.08 $40,970.08 nat. median
$71,271
0.6× median
C1827
HCPCS 		Generator Vivistim Pair Vns 20 $20,060.00 $62,186.00 $40,120.00 nat. median
$28,413
1.4× median
453
MS_DRG 		Inpatient Ms-DRG 3 $39,779.14 $39,779.14 $39,779.14 nat. median
$87,428
outlier · 0.5×
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/mcc 3 $39,772.38 $39,772.38 $39,772.38 nat. median
$56,918
0.7× median

Other procedures at this hospital

Browse this hospital's 13,002 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
             
835 MS_DRG Acute Leukemia With Cc 3 3 — — $16,865.51 $16,865.51 $16,865.51 2025-09-26
19357 CPT Pr Tissue Expander Placement Breast Reconstruction 4 4 — — $16,877.23 $16,877.23 $16,877.23 2025-09-26
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 3 3 — — $16,895.02 $16,895.02 $16,895.02 2025-09-26
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 3 3 — — $16,930.07 $16,930.07 $16,930.07 2025-09-26
C9782 HCPCS Blind Myocar Trpl Bon Marrow 4 4 — — $16,976.32 $16,976.32 $16,976.32 2025-09-26
C9758 HCPCS Blind Interatrial Shunt Ide 4 4 — — $16,976.32 $16,976.32 $16,976.32 2025-09-26
0888T CPT Histotripsy Mal Renal Tissue 4 4 — — $16,976.32 $16,976.32 $16,976.32 2025-09-26
0686T CPT Histotripsy Mal Hepatcel Tis 4 4 — — $16,976.32 $16,976.32 $16,976.32 2025-09-26
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 3 3 — — $16,978.03 $16,978.03 $16,978.03 2025-09-26
62362 CPT Pr Impltj/rplcmt Ithcl/edrl Drug Nfs Prgrbl Pump 4 4 — — $17,144.74 $17,144.74 $17,144.74 2025-09-26
62360 CPT Insert Spine Infusion Device 4 4 — — $17,144.74 $17,144.74 $17,144.74 2025-09-26
62361 CPT Implant Spine Infusion Pump 4 4 — — $17,144.74 $17,144.74 $17,144.74 2025-09-26
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 3 3 — — $17,156.94 $17,156.94 $17,156.94 2025-09-26
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 3 3 — — $17,156.94 $17,156.94 $17,156.94 2025-09-26
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 3 3 — — $17,225.19 $17,225.19 $17,225.19 2025-09-26
Q0479 HCPCS Power Module Combo Vad, Rep 7 7 — — $10,451.37 $17,236.36 $17,236.36 2025-09-26
335 MS_DRG Peritoneal Adhesiolysis With Mcc 3 3 — — $17,388.12 $17,388.12 $17,388.12 2025-09-26
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 3 3 — — $17,405.95 $17,405.95 $17,405.95 2025-09-26
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 3 3 — — $17,405.95 $17,405.95 $17,405.95 2025-09-26
C9797 HCPCS Vasc Emb/occ W/prs Cath 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
0238T CPT Pr Trluml Peripheral Atherectomy Iliac Artery Ea 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
93581 CPT Pr Prq Tcat Clsr Cgen Ventr Septal Dfct W/implt 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
92933 CPT Pr Prq Trluml Coronry Stent/ath/angio One Art/brnch 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
C9775 HCPCS Revasc Lith-sten-ath Tib/per 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
C9766 HCPCS Revasc Intra Lithotrip-ather 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
C9767 HCPCS Revasc Lithotrip-stent-ather 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
C9765 HCPCS Revasc Intra Lithotrip-stent 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
C9602 HCPCS Perc D-e Cor Stent Ather S 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
C9773 HCPCS Revasc Lithotr-stent Tib/per 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
C9607 HCPCS Perc D-e Cor Revasc Chro Sin 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
93582 CPT Pr Percutan Transcath Closure Pat Duct Arteriosus 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
93591 CPT Perq Transcath Cls Aortic 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
93590 CPT Perq Transcath Cls Mitral 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
C9774 HCPCS Revasc Lithotr-ather Tib/per 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
37242 CPT Pr Vascular Embolization Or Occlusion Arterial Rs&i 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
37230 CPT Pr Revsc Opn/prq Tib/pero W/stnt/angiop Sm Vsl 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
0793T CPT Prq Tcat Thrm Ablt Nrv P-art 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
37231 CPT Pr Revsc Opn/prq Tib/pero W/stnt/athr/angiop Sm Vsl 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
37229 CPT Pr Revsc Opn/prq Tib/pero W/athrc/angiop Sm Vsl 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
37227 CPT Pr Revsc Opn/prq Fem/pop W/stnt/athrc/angiop Sm Vsl 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
37225 CPT Pr Revsc Opn/prq Fem/pop W/athrc/angiop Sm Vsl 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
0645T CPT Tcat Impltj C Sins Rdctj Dev 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
36906 CPT Pr Perq Thrmbc/nfs Dial Circuit Tcat Plmt IV Stent 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
37184 CPT Pr Prim Prq Trluml Mchnl Thrmbc N-cor N-icra 1st 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
33902 CPT Perq P-art Revsc 1 Abnor Uni 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
36836 CPT Prq Av Fstl Crtj Uxtr 1 Acs 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
36837 CPT Prq Av Fstl Crt Uxtr Sep Acs 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
0632T CPT Perq Tcat US Abltj Nrv P-art 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
93580 CPT Pr Prq Tcat Clsr Cgen Intratrl Comunicaj W/implt 4 4 — — $17,418.87 $17,418.87 $17,418.87 2025-09-26
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 3 3 — — $17,472.97 $17,472.97 $17,472.97 2025-09-26
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 3 3 — — $17,815.43 $17,815.43 $17,815.43 2025-09-26
24361 CPT Reconstruct Elbow Joint 4 4 — — $17,839.22 $17,839.22 $17,839.22 2025-09-26
23616 CPT Optx Prx Hmrl Fx Fix Rpr Rpl 4 4 — — $17,839.22 $17,839.22 $17,839.22 2025-09-26
C8003 HCPCS Imp Extar Knee Shck Absrb 4 4 — — $17,839.22 $17,839.22 $17,839.22 2025-09-26
22867 CPT Insj Stablj Dev W/dcmprn 4 4 — — $17,839.22 $17,839.22 $17,839.22 2025-09-26
20696 CPT App Mltpln Uni Xtrnl Fix 1st 4 4 — — $17,839.22 $17,839.22 $17,839.22 2025-09-26
25446 CPT Arthrp W/prostc Dst Rds&crps 4 4 — — $17,839.22 $17,839.22 $17,839.22 2025-09-26
24371 CPT Revise Reconst Elbow Joint 4 4 — — $17,839.22 $17,839.22 $17,839.22 2025-09-26
22856 CPT Pr Total Disc Arthrp Ant Single Interspace Cervical 4 4 — — $17,839.22 $17,839.22 $17,839.22 2025-09-26
27278 CPT Pr Arthrd Si Jt Prq W/plmt Iartic Implt Wo Tfxj Dev 4 4 — — $17,839.22 $17,839.22 $17,839.22 2025-09-26
22633 CPT Pr Arthrodesis Combined Tq 1ntrspc Lumbar 4 4 — — $17,839.22 $17,839.22 $17,839.22 2025-09-26
22612 CPT Pr Arthrodesis Posterior/pstlat Tq 1ntrspc Lumbar 4 4 — — $17,839.22 $17,839.22 $17,839.22 2025-09-26
21243 CPT Reconstruction Of Jaw Joint 4 4 — — $17,839.22 $17,839.22 $17,839.22 2025-09-26
24363 CPT Replace Elbow Joint 4 4 — — $17,839.22 $17,839.22 $17,839.22 2025-09-26
28705 CPT Arthrodesis Pantalar 4 4 — — $17,839.22 $17,839.22 $17,839.22 2025-09-26
22630 CPT Pr Arthrodesis Posterior Interbody 1 Ntrspc Lumbar 4 4 — — $17,839.22 $17,839.22 $17,839.22 2025-09-26
27702 CPT Reconstruct Ankle Joint 4 4 — — $17,839.22 $17,839.22 $17,839.22 2025-09-26
23472 CPT Pr Arthroplasty Glenohumeral Joint Total Shoulder 4 4 — — $17,839.22 $17,839.22 $17,839.22 2025-09-26
27279 CPT Pr Arthrodesis Si Joint Percutaneous/min Invasive 4 4 — — $17,839.22 $17,839.22 $17,839.22 2025-09-26
25442 CPT Arthrp W/prostc Dstl Ulna 4 4 — — $17,839.22 $17,839.22 $17,839.22 2025-09-26
662 MS_DRG Minor Bladder Procedures With Mcc 3 3 — — $18,018.33 $18,018.33 $18,018.33 2025-09-26
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 3 3 — — $18,032.47 $18,032.47 $18,032.47 2025-09-26
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 3 3 — — $18,107.48 $18,107.48 $18,107.48 2025-09-26
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 3 3 — — $18,132.07 $18,132.07 $18,132.07 2025-09-26
248 MS_DRG Inpatient Ms-DRG 3 3 — — $18,206.46 $18,206.46 $18,206.46 2025-09-26
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 3 3 — — $18,257.50 $18,257.50 $18,257.50 2025-09-26
0825T CPT Pr Tcat Rmvl&rplcmt Perm 1chmbr Ldls Pm R Atrial 4 4 — — $18,499.93 $18,499.93 $18,499.93 2025-09-26
0803T CPT Pr Tcat Rmvl&rplcmt Prm 2chmbr Ldls Pm R Vntr Cmpnt 4 4 — — $18,499.93 $18,499.93 $18,499.93 2025-09-26
0801T CPT Pr Tcat Rmvl&rplcmt Perm 2chmbr Ldls Pm 2chmbr Sys 4 4 — — $18,499.93 $18,499.93 $18,499.93 2025-09-26
0802T CPT Pr Tcat Rmvl&rplcmt Perm 2chmbr Ldls Pm R Atr Cmpnt 4 4 — — $18,499.93 $18,499.93 $18,499.93 2025-09-26
0823T CPT Pr Tcat Insj Perm 1chmbr Ldls Pacemaker R Atrial 4 4 — — $18,499.93 $18,499.93 $18,499.93 2025-09-26
0797T CPT Pr Tcat Insj Perm 2chmbr Ldls Pm R Ventr Pm Compnt 4 4 — — $18,499.93 $18,499.93 $18,499.93 2025-09-26
0525T CPT Insj/rplcmt Compl Iims 4 4 — — $18,499.93 $18,499.93 $18,499.93 2025-09-26
0795T CPT Pr Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys 4 4 — — $18,499.93 $18,499.93 $18,499.93 2025-09-26
0796T CPT Pr Tcat Insj Perm 2chmbr Ldls Pm R Atr Pm Compnt 4 4 — — $18,499.93 $18,499.93 $18,499.93 2025-09-26
33274 CPT Pr Tcat Insj/rpl Perm Leadless Pacemaker Rv W/img 4 4 — — $18,499.93 $18,499.93 $18,499.93 2025-09-26
33229 CPT Pr Remvl Perm Pm Pls Gen W/repl Plse Gen Mult Lead 4 4 — — $18,499.93 $18,499.93 $18,499.93 2025-09-26
33221 CPT Pr Ins Pacemaker Pulse Gen Only W/exist Mult Leads 4 4 — — $18,499.93 $18,499.93 $18,499.93 2025-09-26
265 MS_DRG Aicd Lead Procedures 3 3 — — $18,598.11 $18,598.11 $18,598.11 2025-09-26
665 MS_DRG Prostatectomy With Mcc 3 3 — — $18,675.58 $18,675.58 $18,675.58 2025-09-26
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 3 3 — — $18,904.92 $18,904.92 $18,904.92 2025-09-26
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 3 3 — — $18,952.26 $18,952.26 $18,952.26 2025-09-26
L6955 HCPCS Above Elbow Myoelectronic CT 7 7 — — $9,844.39 $19,113.49 $19,113.49 2025-09-26
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 3 3 — — $19,113.96 $19,113.96 $19,113.96 2025-09-26
L6960 HCPCS Shldr Disartic Switch Contro 7 7 — — $10,219.99 $19,277.39 $19,277.39 2025-09-26
460 MS_DRG Inpatient Ms-DRG 3 3 — — $19,301.48 $19,301.48 $19,301.48 2025-09-26
54416 CPT Remv/repl Penis Contain Pros 4 4 — — $19,525.66 $19,525.66 $19,525.66 2025-09-26
54405 CPT Insert Multi-comp Penis Pros 4 4 — — $19,525.66 $19,525.66 $19,525.66 2025-09-26
54410 CPT Remove/replace Penis Prosth 4 4 — — $19,525.66 $19,525.66 $19,525.66 2025-09-26
54401 CPT Insert Self-contd Prosthesis 4 4 — — $19,525.66 $19,525.66 $19,525.66 2025-09-26
53447 CPT Remove/replace Ur Sphincter 4 4 — — $19,525.66 $19,525.66 $19,525.66 2025-09-26
53444 CPT Insert Tandem Cuff 4 4 — — $19,525.66 $19,525.66 $19,525.66 2025-09-26
53445 CPT Insert Uro/ves Nck Sphincter 4 4 — — $19,525.66 $19,525.66 $19,525.66 2025-09-26
54411 CPT Remov/replc Penis Pros Comp 4 4 — — $19,525.66 $19,525.66 $19,525.66 2025-09-26
140 MS_DRG Major Head And Neck Procedures With Mcc 3 3 — — $19,641.49 $19,641.49 $19,641.49 2025-09-26
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 3 3 — — $19,646.41 $19,646.41 $19,646.41 2025-09-26
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 3 3 — — $19,687.60 $19,687.60 $19,687.60 2025-09-26
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 3 3 — — $19,974.11 $19,974.11 $19,974.11 2025-09-26
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 3 3 — — $20,048.51 $20,048.51 $20,048.51 2025-09-26
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 3 3 — — $20,283.37 $20,283.37 $20,283.37 2025-09-26
252 MS_DRG Other Vascular Procedures With Mcc 3 3 — — $20,404.50 $20,404.50 $20,404.50 2025-09-26
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 3 3 — — $20,600.63 $20,600.63 $20,600.63 2025-09-26
799 MS_DRG Splenic Procedures With Mcc 3 3 — — $20,604.32 $20,604.32 $20,604.32 2025-09-26
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 3 3 — — $20,616.61 $20,616.61 $20,616.61 2025-09-26
653 MS_DRG Major Bladder Procedures With Mcc 3 3 — — $20,675.02 $20,675.02 $20,675.02 2025-09-26
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 3 3 — — $20,747.57 $20,747.57 $20,747.57 2025-09-26
0816T CPT Opn Insj/rplcmt Ins Ptn Subq 4 4 — — $20,802.08 $20,802.08 $20,802.08 2025-09-26
64590 CPT Pr Ins/rplc Perph Sac/gstrc Npg/rcvr Pckt Crtj&conn 4 4 — — $20,802.08 $20,802.08 $20,802.08 2025-09-26
61885 CPT Pr Insj/rplcmt Cranial Neurostim Pulse Generator 4 4 — — $20,802.08 $20,802.08 $20,802.08 2025-09-26
0817T CPT Opn Insj/rplcmt Ins Ptn Subf 4 4 — — $20,802.08 $20,802.08 $20,802.08 2025-09-26
64580 CPT Opn Impltj Nea Neuromuscular 4 4 — — $20,802.08 $20,802.08 $20,802.08 2025-09-26
0680T CPT Insj/rplcmt Pg Only Isdss 4 4 — — $20,802.08 $20,802.08 $20,802.08 2025-09-26
63655 CPT Pr Lam Impltj Nstim Eltrds Plate/paddle Edrl 4 4 — — $20,802.08 $20,802.08 $20,802.08 2025-09-26
61891 CPT Pr Revj/rplcmt Skull-mntd Cranial Nstim Pg/receiver 4 4 — — $20,802.08 $20,802.08 $20,802.08 2025-09-26
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 3 3 — — $20,825.04 $20,825.04 $20,825.04 2025-09-26
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 3 3 — — $20,869.93 $20,869.93 $20,869.93 2025-09-26
Q0481 HCPCS Microprcsr Cu Elec Vad, Rep 7 7 — — $14,665.80 $20,899.38 $20,899.38 2025-09-26
271 MS_DRG Other Major Cardiovascular Procedures With Cc 3 3 — — $20,930.18 $20,930.18 $20,930.18 2025-09-26
L5859 HCPCS Knee-shin Pro Flex/ext Cont 4 4 — — $20,938.16 $20,938.16 $20,938.16 2025-09-26
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 3 — — $21,069.13 $21,069.13 $21,069.13 2025-09-26
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 3 3 — — $21,315.68 $21,315.68 $21,315.68 2025-09-26
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 3 3 — — $21,611.42 $21,611.42 $21,611.42 2025-09-26
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 3 3 — — $21,686.42 $21,686.42 $21,686.42 2025-09-26
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 3 3 — — $21,694.42 $21,694.42 $21,694.42 2025-09-26
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 3 3 — — $21,717.17 $21,717.17 $21,717.17 2025-09-26
0614T CPT Pr Rmvl&rplcmt Substernal Impltbl Defibrillator Pg 4 4 — — $21,773.87 $21,773.87 $21,773.87 2025-09-26
0916T CPT Insj Perm Ccm-d Sys Pg Only 4 4 — — $21,773.87 $21,773.87 $21,773.87 2025-09-26
0923T CPT Rmvl&rplcmt Perm Ccm-d Pg 4 4 — — $21,773.87 $21,773.87 $21,773.87 2025-09-26
0409T CPT Insj/rplc Car Modulj Pls Gn 4 4 — — $21,773.87 $21,773.87 $21,773.87 2025-09-26
33240 CPT Pr Insj Implntbl Defib Pulse Gen W/1 Existing Ld 4 4 — — $21,773.87 $21,773.87 $21,773.87 2025-09-26
33230 CPT Insrt Pulse Gen W/dual Leads 4 4 — — $21,773.87 $21,773.87 $21,773.87 2025-09-26
33262 CPT Pr Rmvl Impltbl Dfb Plse Gen W/repl Plse Gen 1 Lead 4 4 — — $21,773.87 $21,773.87 $21,773.87 2025-09-26
0414T CPT Rmvl & Rpl Car Modulj Pls Gn 4 4 — — $21,773.87 $21,773.87 $21,773.87 2025-09-26
0515T CPT Insj Wcs Lv Compl Sys 4 4 — — $21,773.87 $21,773.87 $21,773.87 2025-09-26
33263 CPT Pr Rmvl Impltbl Dfb Plse Gen W/rplcmt Plse Gen 2 Ld 4 4 — — $21,773.87 $21,773.87 $21,773.87 2025-09-26
455 MS_DRG Inpatient Ms-DRG 3 3 — — $21,843.21 $21,843.21 $21,843.21 2025-09-26
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 3 3 — — $22,218.26 $22,218.26 $22,218.26 2025-09-26
10 MS_DRG Pancreas Transplant 3 3 — — $22,248.38 $22,248.38 $22,248.38 2025-09-26
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 3 3 — — $22,253.30 $22,253.30 $22,253.30 2025-09-26
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 3 3 — — $22,349.83 $22,349.83 $22,349.83 2025-09-26
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 3 3 — — $22,598.22 $22,598.22 $22,598.22 2025-09-26
L6965 HCPCS Shldr Disartic Myoelectronic 7 7 — — $11,839.36 $22,680.77 $22,680.77 2025-09-26
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 3 3 — — $22,709.51 $22,709.51 $22,709.51 2025-09-26
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 3 3 — — $22,729.18 $22,729.18 $22,729.18 2025-09-26
28 MS_DRG Spinal Procedures With Mcc 3 3 — — $22,761.15 $22,761.15 $22,761.15 2025-09-26
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 3 3 — — $22,808.50 $22,808.50 $22,808.50 2025-09-26
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 3 3 — — $23,077.18 $23,077.18 $23,077.18 2025-09-26
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 3 3 — — $23,163.87 $23,163.87 $23,163.87 2025-09-26
L6970 HCPCS Interscapular-thor Switch CT 7 7 — — $12,443.65 $23,340.59 $23,340.59 2025-09-26
Q0489 HCPCS Pwr Pck Base Combo Vad, Rep 6 6 — — $16,405.71 $23,378.84 $23,378.84 2025-09-26
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 3 3 — — $23,503.26 $23,503.26 $23,503.26 2025-09-26
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 3 3 — — $23,641.60 $23,641.60 $23,641.60 2025-09-26
93653 CPT Pr Compre Ep Eval Abltj 3d Mapg Tx Svt 4 4 — — $23,797.50 $23,797.50 $23,797.50 2025-09-26
93654 CPT Pr Compre Ep Eval Abltj 3d Mapg Tx Vt 4 4 — — $23,797.50 $23,797.50 $23,797.50 2025-09-26
93656 CPT Pr Compre Ep Eval Abltj Atr Fib Pulm Vein Isolation 4 4 — — $23,797.50 $23,797.50 $23,797.50 2025-09-26
J9600 HCPCS Porfimer Sodium Injection 6 6 — — $22,590.50 $23,870.14 $23,870.14 2025-09-26
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 3 3 — — $24,260.12 $24,260.12 $24,260.12 2025-09-26
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 3 — — $24,829.46 $24,829.46 $24,829.46 2025-09-26
163 MS_DRG Major Chest Procedures With Mcc 3 3 — — $25,059.40 $25,059.40 $25,059.40 2025-09-26
471 MS_DRG Cervical Spinal Fusion With Mcc 3 3 — — $25,080.31 $25,080.31 $25,080.31 2025-09-26
L5973 HCPCS Ank-foot Sys Dors-plant Flex 6 6 — — $15,227.49 $25,092.86 $25,092.86 2025-09-26
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 3 3 — — $25,160.24 $25,160.24 $25,160.24 2025-09-26
227 MS_DRG Inpatient Ms-DRG 3 3 — — $25,409.24 $25,409.24 $25,409.24 2025-09-26
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 3 — — $25,499.01 $25,499.01 $25,499.01 2025-09-26
L6975 HCPCS Interscap-thor Myoelectronic 7 7 — — $14,029.61 $25,573.88 $25,573.88 2025-09-26
332 MS_DRG Rectal Resection With Mcc 3 3 — — $25,582.01 $25,582.01 $25,582.01 2025-09-26
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 3 3 — — $25,617.06 $25,617.06 $25,617.06 2025-09-26
C1605 HCPCS Pacemaker Aveir 19.5f 32.2mm 32 20 $21,080.00 $17,918.00 $8,432.00 $26,139.20 $16,864.00 2025-09-26
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 3 3 — — $26,187.62 $26,187.62 $26,187.62 2025-09-26
901 MS_DRG Wound Debridements For Injuries With Mcc 3 3 — — $26,212.22 $26,212.22 $26,212.22 2025-09-26
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 3 3 — — $26,541.77 $26,541.77 $26,541.77 2025-09-26
C9760 HCPCS Non-blind Interatrial Shunt 4 4 — — $26,676.79 $26,676.79 $26,676.79 2025-09-26
454 MS_DRG Inpatient Ms-DRG 3 3 — — $26,720.07 $26,720.07 $26,720.07 2025-09-26
L5858 HCPCS Stance Phase Only 6 6 — — $15,332.09 $26,723.96 $26,723.96 2025-09-26
Q0483 HCPCS Monitor Elec Vad, Rep 5 5 — — $18,923.59 $26,966.90 $26,966.90 2025-09-26
J9266 HCPCS Pegaspargase Injection 6 6 — — $24,633.46 $27,070.53 $27,070.53 2025-09-26
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 3 3 — — $27,500.91 $27,500.91 $27,500.91 2025-09-26
33289 CPT Tcat Impl Wrls P-art Prs Snr 4 4 — — $27,576.83 $27,576.83 $27,576.83 2025-09-26
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 3 3 — — $27,642.94 $27,642.94 $27,642.94 2025-09-26
245 MS_DRG Aicd Generator Procedures 3 3 — — $27,643.55 $27,643.55 $27,643.55 2025-09-26
L8614 HCPCS Cochlear Device 4 4 — — $27,812.64 $27,812.64 $27,812.64 2025-09-26
223 MS_DRG Inpatient Ms-DRG 3 3 — — $28,547.97 $28,547.97 $28,547.97 2025-09-26
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 3 — — $29,079.19 $29,079.19 $29,079.19 2025-09-26
459 MS_DRG Inpatient Ms-DRG 3 3 — — $29,085.95 $29,085.95 $29,085.95 2025-09-26
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 3 3 — — $29,189.24 $29,189.24 $29,189.24 2025-09-26
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 3 3 — — $29,286.39 $29,286.39 $29,286.39 2025-09-26
61886 CPT Pr Insj/rplcmt Cranial Neurostim Gener 2/> Eltrds 4 4 — — $29,560.83 $29,560.83 $29,560.83 2025-09-26
0268T CPT Outpatient Services 4 4 — — $29,560.83 $29,560.83 $29,560.83 2025-09-26
64582 CPT Opn Mpltj Hpglsl Nstm Ary Pg 4 4 — — $29,560.83 $29,560.83 $29,560.83 2025-09-26
33287 CPT Rmv&rplcmt Phrnc Nrv Stim Pg 4 4 — — $29,560.83 $29,560.83 $29,560.83 2025-09-26
0674T CPT Laps Insj Nw/rpcmt Prm Isdss 4 4 — — $29,560.83 $29,560.83 $29,560.83 2025-09-26
64568 CPT Pr Open Implantation Cranial Nerve Nea & Pulse Gen 4 4 — — $29,560.83 $29,560.83 $29,560.83 2025-09-26
63685 CPT Pr Insj/rplcmt Spinal Npg/rcvr Pocket Crtj&connj 4 4 — — $29,560.83 $29,560.83 $29,560.83 2025-09-26
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 3 3 — — $29,886.47 $29,886.47 $29,886.47 2025-09-26
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 3 3 — — $29,889.54 $29,889.54 $29,889.54 2025-09-26
69930 CPT Implant Cochlear Device 4 4 — — $30,855.10 $30,855.10 $30,855.10 2025-09-26
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 3 3 — — $30,975.95 $30,975.95 $30,975.95 2025-09-26
225 MS_DRG Inpatient Ms-DRG 3 3 — — $31,022.68 $31,022.68 $31,022.68 2025-09-26
0571T CPT Pr Insj/rplcmt Icds W/substernal Electrode 4 4 — — $31,101.26 $31,101.26 $31,101.26 2025-09-26
33231 CPT Insrt Pulse Gen W/mult Leads 4 4 — — $31,101.26 $31,101.26 $31,101.26 2025-09-26
33264 CPT Pr Rmvl Impltbl Dfb Pls Gen W/rplcmt Pls Gen Mlt Ld 4 4 — — $31,101.26 $31,101.26 $31,101.26 2025-09-26
0408T CPT Insj/rplc Cardiac Modulj Sys 4 4 — — $31,101.26 $31,101.26 $31,101.26 2025-09-26
33249 CPT Pr Insj/rplcmt Perm Dfb W/trnsvns Lds 1/dual Chmbr 4 4 — — $31,101.26 $31,101.26 $31,101.26 2025-09-26
33270 CPT Pr Ins/rplcmnt Perm Subq Impltbl Dfb W/subq Eltrd 4 4 — — $31,101.26 $31,101.26 $31,101.26 2025-09-26
0915T CPT Insj Perm Ccm-d Sys Pg&eltrd 4 4 — — $31,101.26 $31,101.26 $31,101.26 2025-09-26
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 3 3 — — $31,119.21 $31,119.21 $31,119.21 2025-09-26
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 3 3 — — $32,049.45 $32,049.45 $32,049.45 2025-09-26
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 3 3 — — $32,090.65 $32,090.65 $32,090.65 2025-09-26
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 3 — — $32,240.67 $32,240.67 $32,240.67 2025-09-26
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 3 — — $32,307.68 $32,307.68 $32,307.68 2025-09-26
228 MS_DRG Other Cardiothoracic Procedures With Mcc 3 3 — — $32,497.67 $32,497.67 $32,497.67 2025-09-26
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 3 — — $32,867.18 $32,867.18 $32,867.18 2025-09-26
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 3 — — $33,015.97 $33,015.97 $33,015.97 2025-09-26
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 3 3 — — $33,268.05 $33,268.05 $33,268.05 2025-09-26
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 3 3 — — $33,735.94 $33,735.94 $33,735.94 2025-09-26
0620T CPT Evasc Ven Artlz Tibl/prnl Vn 4 4 — — $33,952.15 $33,952.15 $33,952.15 2025-09-26
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 3 3 — — $34,053.81 $34,053.81 $34,053.81 2025-09-26
955 MS_DRG Craniotomy For Multiple Significant Trauma 3 3 — — $34,190.92 $34,190.92 $34,190.92 2025-09-26
L6880 HCPCS Elec Hand Ind Art Digits 7 7 — — $26,212.28 $34,363.97 $34,363.97 2025-09-26
L5856 HCPCS Elec Knee-shin Swing/stance 7 7 — — $19,799.35 $34,568.35 $34,568.35 2025-09-26
C2616 HCPCS Microsphere Sir Y-90 32 20 $28,050.00 $23,842.50 $11,220.00 $34,782.00 $19,382.55 2025-09-26
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 3 3 — — $34,976.68 $34,976.68 $34,976.68 2025-09-26
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 3 — — $35,494.98 $35,494.98 $35,494.98 2025-09-26
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 3 3 — — $35,592.13 $35,592.13 $35,592.13 2025-09-26
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 3 — — $36,068.01 $36,068.01 $36,068.01 2025-09-26
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 3 3 — — $36,393.87 $36,393.87 $36,393.87 2025-09-26
226 MS_DRG Inpatient Ms-DRG 3 3 — — $36,755.39 $36,755.39 $36,755.39 2025-09-26
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 3 3 — — $37,358.54 $37,358.54 $37,358.54 2025-09-26
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 3 3 — — $38,116.63 $38,116.63 $38,116.63 2025-09-26
232 MS_DRG Coronary Bypass With Ptca Without Mcc 3 3 — — $38,117.25 $38,117.25 $38,117.25 2025-09-26
834 MS_DRG Acute Leukemia With Mcc 3 3 — — $38,298.62 $38,298.62 $38,298.62 2025-09-26
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 3 3 — — $38,585.75 $38,585.75 $38,585.75 2025-09-26
231 MS_DRG Coronary Bypass With Ptca With Mcc 3 3 — — $39,111.44 $39,111.44 $39,111.44 2025-09-26
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 3 3 — — $39,772.38 $39,772.38 $39,772.38 2025-09-26
453 MS_DRG Inpatient Ms-DRG 3 3 — — $39,779.14 $39,779.14 $39,779.14 2025-09-26
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 3 3 — — $40,970.08 $40,970.08 $40,970.08 2025-09-26
L8701 HCPCS Ewh S/d Uprt Micro Sensor 4 4 — — $41,141.33 $41,141.33 $41,141.33 2025-09-26
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 3 3 — — $41,303.93 $41,303.93 $41,303.93 2025-09-26
33276 CPT Insj Phrnc Nrv Stim Sys 4 4 — — $43,652.62 $43,652.62 $43,652.62 2025-09-26
0266T CPT Outpatient Services 4 4 — — $43,652.62 $43,652.62 $43,652.62 2025-09-26
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 3 — — $44,486.31 $44,486.31 $44,486.31 2025-09-26
222 MS_DRG Inpatient Ms-DRG 3 3 — — $45,748.57 $45,748.57 $45,748.57 2025-09-26
C1826 HCPCS Neurostimultr Inceptiv 977119 32 20 $37,400.00 $31,790.00 $14,960.00 $46,376.00 $29,920.00 2025-09-26
C1820 HCPCS Battery Activa Rc Model 37612 186 20 $26,775.00 $22,758.75 $214.83 $46,376.00 $23,375.85 2025-09-26
J9226 HCPCS Supprelin La Implant 6 6 — — $45,350.22 $47,999.60 $45,350.22 2025-09-26
C1722 HCPCS Icd Energen E141 648 20 $22,276.80 $18,935.28 $5,848.00 $49,538.00 $18,700.00 2025-09-26
224 MS_DRG Inpatient Ms-DRG 3 3 — — $49,560.54 $49,560.54 $49,560.54 2025-09-26
C1721 HCPCS Biv Icd Energen E142 604 20 $21,816.10 $18,543.69 $1,222.64 $50,554.09 $18,749.10 2025-09-26
215 MS_DRG Other Heart Assist System Implant 3 3 — — $50,601.45 $50,601.45 $50,601.45 2025-09-26
L7180 HCPCS Electronic Elbow Sequential 7 7 — — $29,785.66 $52,277.90 $52,277.90 2025-09-26
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 3 — — $52,448.41 $52,448.41 $52,448.41 2025-09-26
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 4 4 — — $55,015.23 $55,015.23 $55,015.23 2025-09-26
6 MS_DRG Liver Transplant Without Mcc 3 3 — — $55,812.79 $55,812.79 $55,812.79 2025-09-26
C1822 HCPCS Kit Omnia Ipg2500 120 20 $41,650.00 $35,402.50 $680.00 $56,916.00 $32,517.60 2025-09-26
38240 CPT Transplt Allo Hct/donor 4 4 — — $57,370.87 $57,370.87 $57,370.87 2025-09-26
L7181 HCPCS Electronic Elbo Simultaneous 7 7 — — $33,054.59 $57,614.51 $57,614.51 2025-09-26
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 3 3 — — $59,648.74 $59,648.74 $59,648.74 2025-09-26
C1827 HCPCS Generator Vivistim Pair Vns 32 20 $50,150.00 $42,627.50 $20,060.00 $62,186.00 $40,120.00 2025-09-26
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And … 3 3 — — $62,389.05 $62,389.05 $62,389.05 2025-09-26
J9029 HCPCS Instill Adstiladrin, Tx Dose 6 6 — — $60,768.00 $63,354.77 $63,354.77 2025-09-26
C1882 HCPCS Biv Icd Itrevia 393014 714 20 $28,730.00 $24,420.50 $7,453.48 $67,466.54 $24,854.00 2025-09-26
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 3 — — $68,670.81 $68,670.81 $68,670.81 2025-09-26
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 4 4 — — $80,943.19 $80,943.19 $80,943.19 2025-09-26
652 MS_DRG Kidney Transplant 3 3 — — $83,758.84 $83,758.84 $83,758.84 2025-09-26
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 3 3 — — $84,449.91 $84,449.91 $84,449.91 2025-09-26
C1767 HCPCS Patient Ipg DRG Proclaim Ctrl 296 20 $32,300.00 $27,455.00 $227.50 $84,579.28 $27,412.50 2025-09-26
14 MS_DRG Allogeneic Bone Marrow Transplant 3 3 — — $86,116.72 $86,116.72 $86,116.72 2025-09-26
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 3 — — $89,682.76 $89,682.76 $89,682.76 2025-09-26
7 MS_DRG Lung Transplant 3 3 — — $94,702.27 $94,702.27 $94,702.27 2025-09-26
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 3 3 — — $95,176.30 $95,176.30 $95,176.30 2025-09-26
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 3 3 — — $99,220.68 $99,220.68 $99,220.68 2025-09-26
Q0480 HCPCS Driver Pneumatic Vad, Rep 6 6 — — $90,900.76 $99,999.99 $99,999.99 2025-09-26
J0202 HCPCS Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution 35 20 $81,216.34 $69,033.89 $2,337.69 $100,708.26 $52,790.62 2025-09-26
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 4 4 — — $111,860.00 $111,860.00 $111,860.00 2025-09-26
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 3 3 — — $129,338.32 $129,338.32 $129,338.32 2025-09-26
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 3 3 — — $180,413.81 $180,413.81 $180,413.81 2025-09-26
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 3 — — $229,570.41 $229,570.41 $229,570.41 2025-09-26
Q2053 HCPCS Brexucabtagene Car Pos T 4 4 — — $460,530.40 $460,530.40 $460,530.40 2025-09-26
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 4 4 — — $489,455.96 $489,455.96 $489,455.96 2025-09-26
Q2054 HCPCS Lisocabtagene Mara Car Pos T 4 4 — — $516,726.08 $516,726.08 $516,726.08 2025-09-26
Q2055 HCPCS Idecabtagene Vicleucel Car 4 4 — — $526,587.59 $526,587.59 $526,587.59 2025-09-26
Q2056 HCPCS Ciltacabtagene Car-pos T 4 4 — — $527,123.43 $527,123.43 $527,123.43 2025-09-26
Q2042 HCPCS Tisagenlecleucel Car-pos T 4 4 — — $529,192.86 $529,192.86 $529,192.86 2025-09-26
J3392 HCPCS Inj, Exagamglogene Autotem 4 4 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2025-09-26
J3399 HCPCS Inj Onase Abepar-xioi Treat 4 4 — — $2,388,614.23 $2,388,614.23 $2,388,614.23 2025-09-26
J3393 HCPCS Inj, Betibeglogene Autotemce 4 4 — — $2,968,000.00 $2,968,000.00 $2,968,000.00 2025-09-26
J3394 HCPCS Inj, Lovotibeglogene Autotem 4 4 — — $3,286,000.00 $3,286,000.00 $3,286,000.00 2025-09-26
J1413 HCPCS Inj Delandistrogene Mox Rokl 4 4 — — $3,325,454.76 $3,325,454.76 $3,325,454.76 2025-09-26
J1414 HCPCS Inj, Beqvez, Per Tx Dose 4 4 — — $3,605,000.00 $3,605,000.00 $3,605,000.00 2025-09-26
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 7 7 — — $35,448.00 $3,672,900.00 $3,672,900.00 2025-09-26
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