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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

LIVINGSTON HEALTHCARE

Livingston, MT · CCN 271317 · Rates published

4,572 distinct procedures filed
14 distinct payers
93,518 rate rows
2026-06-04 last MRF observed
Data quality

92,246 of 93,518 rate rows are consumer-grade (98.6%)

1,272 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
per-diem day rate — not a per-procedure price 644
template filing: same amount across many unrelated codes — excluded 560
percent-of-charges filed in the dollar field — excluded from medians 50
exceeds 10× this hospital's gross charge — excluded from medians 18
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbLivingstonHCMT&type=CDMWithoutLabel&fileType=CSV
Found on page https://www.livingstonhealthcare.org/cms-hpt.txt
Discovered viaDiscovered by HANK (automated)
Last fetch success · 2026-06-08
Content fingerprint bf9a371a44f5bc03… · 52,175,409 bytes · first seen 2026-06-08

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
455
MS_DRG 		Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 10 $133,092.80 $147,880.89 $140,486.84 nat. median
$48,483
outlier · 2.9×
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 10 $130,143.00 $144,603.33 $137,373.17 nat. median
$62,270
outlier · 2.2×
329
MS_DRG 		Major Small And Large Bowel Procedures With Mcc 10 $92,403.85 $102,670.95 $97,537.40 nat. median
$44,810
outlier · 2.2×
208
MS_DRG 		Respiratory System Diagnosis With Ventilator Support <=96 Hours 10 $91,130.17 $101,255.75 $96,192.96 nat. median
$26,748
outlier · 3.6×
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 $75,621.20 $84,023.55 $79,822.37 nat. median
$58,024
1.4× median
519
MS_DRG 		Back And Neck Procedures Except Spinal Fusion With Cc 10 $67,829.11 $75,365.68 $71,597.40 nat. median
$20,499
outlier · 3.5×
330
MS_DRG 		Major Small And Large Bowel Procedures With Cc 10 $66,625.34 $74,028.16 $70,326.75 nat. median
$24,346
outlier · 2.9×
473
MS_DRG 		Cervical Spinal Fusion Without Cc/mcc 10 $66,607.94 $74,008.82 $70,308.38 nat. median
$24,796
outlier · 2.8×
622
MS_DRG 		Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 10 $63,303.03 $70,336.70 $66,819.87 nat. median
$35,325
1.9× median
468
MS_DRG 		Revision Of Hip Or Knee Replacement Without Cc/mcc 10 $62,214.08 $69,126.75 $65,670.42 nat. median
$27,218
outlier · 2.4×
472
MS_DRG 		Cervical Spinal Fusion With Cc 10 $58,169.31 $64,632.57 $61,400.94 nat. median
$29,860
outlier · 2.1×
335
MS_DRG 		Peritoneal Adhesiolysis With Mcc 10 $56,693.84 $62,993.15 $59,843.49 nat. median
$35,058
1.7× median
460
MS_DRG 		Spinal Fusion Except Cervical Without Mcc 10 $55,961.19 $62,179.10 $59,070.15 nat. median
$39,075
1.5× median
539
MS_DRG 		Osteomyelitis With Mcc 10 $55,050.48 $61,167.20 $58,108.84 nat. median
$19,718
outlier · 2.9×
J2350
HCPCS 		Injection, Ocrelizumab, 1 Mg 14 $26,330.59 $49,680.35 $47,196.33 nat. median
$712
outlier · 66.3×
470
MS_DRG 		Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without… 10 $44,468.33 $49,409.25 $46,938.79 nat. median
$20,059
outlier · 2.3×
467
MS_DRG 		Revision Of Hip Or Knee Replacement With Cc 10 $44,044.45 $48,938.28 $46,491.37 nat. median
$34,721
1.3× median
637
MS_DRG 		Diabetes With Mcc 10 $43,288.22 $48,098.03 $45,693.12 nat. median
$14,789
outlier · 3.1×
418
MS_DRG 		Laparoscopic Cholecystectomy Without C.d.e. With Cc 10 $40,609.58 $45,121.75 $42,865.66 nat. median
$17,483
outlier · 2.5×
813
MS_DRG 		Coagulation Disorders 10 $40,546.15 $45,051.28 $42,798.71 nat. median
$15,711
outlier · 2.7×
J2507
HCPCS 		Injection, Pegloticase, 1 Mg 14 $23,704.59 $44,725.65 $42,489.37 nat. median
$8,558
outlier · 5.0×
949
MS_DRG 		Aftercare With Cc/mcc 10 $38,917.04 $43,241.15 $41,079.09 nat. median
$12,475
outlier · 3.3×
315
MS_DRG 		Other Circulatory System Diagnoses With Cc 10 $36,947.61 $41,052.90 $39,000.26 nat. median
$10,515
outlier · 3.7×
J9334
HCPCS 		Injection, Efgartigimod Alfa, 2 Mg And Hyaluronidase-qvfc 14 $21,066.44 $39,748.00 $37,760.60 nat. median
$73
outlier · 514.7×
488
MS_DRG 		Knee Procedures Without Principal Diagnosis Of Infection With Cc/mcc 10 $33,592.73 $37,325.25 $35,458.99 nat. median
$19,302
1.8× median
417
MS_DRG 		Laparoscopic Cholecystectomy Without C.d.e. With Mcc 10 $33,250.23 $36,944.70 $35,097.47 nat. median
$23,832
1.5× median
489
MS_DRG 		Knee Procedures Without Principal Diagnosis Of Infection Without Cc/mcc 10 $32,815.49 $36,461.65 $34,638.57 nat. median
$12,955
outlier · 2.7×
J9043
HCPCS 		Injection, Cabazitaxel, 1 Mg 14 $18,874.12 $35,611.55 $33,830.97 nat. median
$739
outlier · 45.8×
552
MS_DRG 		Medical Back Problems Without Mcc 10 $31,666.42 $35,184.91 $33,425.66 nat. median
$10,424
outlier · 3.2×
742
MS_DRG 		Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc 10 $31,098.29 $34,553.65 $32,825.97 nat. median
$18,902
1.7× median
264
MS_DRG 		Other Circulatory System O.r. Procedures 10 $30,975.53 $34,417.25 $32,696.39 nat. median
$33,061
1.0× median
J9228
HCPCS 		Injection, Ipilimumab, 1 Mg 14 $10,528.16 $79,457.45 $30,988.45 nat. median
$9,906
outlier · 3.1×
J3245
HCPCS 		Injection, Tildrakizumab, 1 Mg 14 $17,135.22 $32,330.60 $30,714.07 nat. median
$256
outlier · 119.9×
788
MS_DRG 		Cesarean Section Without Sterilization Without Cc/mcc 10 $28,390.22 $31,544.69 $29,967.45 nat. median
$10,164
outlier · 2.9×
308
MS_DRG 		Cardiac Arrhythmia And Conduction Disorders With Mcc 10 $26,243.15 $29,159.05 $27,701.10 nat. median
$12,751
outlier · 2.2×
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 10 $25,251.88 $28,057.64 $26,654.76 nat. median
$19,635
1.4× median
445
MS_DRG 		Disorders Of The Biliary Tract With Cc 10 $25,012.42 $27,791.58 $26,402.00 nat. median
$11,641
outlier · 2.3×
J9144
HCPCS 		Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj 14 $14,119.81 $26,641.15 $25,309.09 nat. median
$233
outlier · 108.6×
82
MS_DRG 		Traumatic Stupor And Coma >1 Hour With Mcc 10 $23,910.44 $26,567.15 $25,238.79 nat. median
$22,770
1.1× median
328
MS_DRG 		Stomach, Esophageal And Duodenal Procedures Without Cc/mcc 10 $23,835.83 $26,484.25 $25,160.04 nat. median
$16,642
1.5× median
958
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Cc 10 $23,615.73 $26,239.70 $24,927.72 nat. median
$41,228
0.6× median
J3590
HCPCS 		Unclassified Biologics 14 $13,853.80 $26,139.25 $24,832.29 nat. median
$682
outlier · 36.4×
784
MS_DRG 		Cesarean Section With Sterilization With Cc 10 $22,788.09 $25,320.10 $24,054.10 nat. median
$11,116
outlier · 2.2×
743
MS_DRG 		Uterine And Adnexa Procedures For Non-malignancy Without Cc/mcc 10 $20,870.48 $23,189.43 $22,029.95 nat. median
$13,187
1.7× median
543
MS_DRG 		Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 10 $20,523.33 $22,803.70 $21,663.52 nat. median
$11,222
1.9× median
638
MS_DRG 		Diabetes With Cc 10 $20,388.66 $22,654.07 $21,521.37 nat. median
$9,826
outlier · 2.2×
806
MS_DRG 		Vaginal Delivery Without Sterilization Or D&c With Cc 10 $20,301.63 $22,557.37 $21,429.50 nat. median
$8,000
outlier · 2.7×
377
MS_DRG 		Gastrointestinal Hemorrhage With Mcc 10 $19,970.51 $22,189.45 $21,079.98 nat. median
$18,249
1.2× median
178
MS_DRG 		Respiratory Infections And Inflammations With Cc 10 $19,925.69 $22,139.65 $21,032.67 nat. median
$10,875
1.9× median
768
MS_DRG 		Vaginal Delivery With O.r. Procedures Except Sterilization And/or D&c 10 $19,844.30 $22,049.23 $20,946.76 nat. median
$10,536
2.0× median

Other procedures at this hospital

Browse this hospital's 4,572 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 10 10 $147,880.89 $140,486.84 $133,092.80 $147,880.89 $140,486.84 2026-06-04
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 10 10 $144,603.33 $137,373.17 $130,143.00 $144,603.33 $137,373.17 2026-06-04
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 10 10 $102,670.95 $97,537.40 $92,403.85 $102,670.95 $97,537.40 2026-06-04
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 10 10 $101,255.75 $96,192.96 $91,130.17 $101,255.75 $96,192.96 2026-06-04
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 10 $84,023.55 $79,822.37 $75,621.20 $84,023.55 $79,822.37 2026-06-04
J9228 HCPCS Injection, Ipilimumab, 1 Mg 28 14 $49,660.95 $47,177.90 $10,528.16 $79,457.45 $30,988.45 2026-06-04
519 MS_DRG Back And Neck Procedures Except Spinal Fusion With Cc 10 10 $75,365.68 $71,597.40 $67,829.11 $75,365.68 $71,597.40 2026-06-04
330 MS_DRG Major Small And Large Bowel Procedures With Cc 10 10 $74,028.16 $70,326.75 $66,625.34 $74,028.16 $70,326.75 2026-06-04
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 10 10 $74,008.82 $70,308.38 $66,607.94 $74,008.82 $70,308.38 2026-06-04
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 10 10 $70,336.70 $66,819.87 $63,303.03 $70,336.70 $66,819.87 2026-06-04
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 10 10 $69,126.75 $65,670.42 $62,214.08 $69,126.75 $65,670.42 2026-06-04
472 MS_DRG Cervical Spinal Fusion With Cc 10 10 $64,632.57 $61,400.94 $58,169.31 $64,632.57 $61,400.94 2026-06-04
335 MS_DRG Peritoneal Adhesiolysis With Mcc 10 10 $62,993.15 $59,843.49 $56,693.84 $62,993.15 $59,843.49 2026-06-04
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 10 10 $62,179.10 $59,070.15 $55,961.19 $62,179.10 $59,070.15 2026-06-04
539 MS_DRG Osteomyelitis With Mcc 10 10 $61,167.20 $58,108.84 $55,050.48 $61,167.20 $58,108.84 2026-06-04
J2350 HCPCS Injection, Ocrelizumab, 1 Mg 14 14 $49,680.35 $47,196.33 $26,330.59 $49,680.35 $47,196.33 2026-06-04
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 10 10 $49,409.25 $46,938.79 $44,468.33 $49,409.25 $46,938.79 2026-06-04
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 10 10 $48,938.28 $46,491.37 $44,044.45 $48,938.28 $46,491.37 2026-06-04
637 MS_DRG Diabetes With Mcc 10 10 $48,098.03 $45,693.12 $43,288.22 $48,098.03 $45,693.12 2026-06-04
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 10 10 $45,121.75 $42,865.66 $40,609.58 $45,121.75 $42,865.66 2026-06-04
813 MS_DRG Coagulation Disorders 10 10 $45,051.28 $42,798.71 $40,546.15 $45,051.28 $42,798.71 2026-06-04
J2507 HCPCS Injection, Pegloticase, 1 Mg 14 14 $44,725.65 $42,489.37 $23,704.59 $44,725.65 $42,489.37 2026-06-04
949 MS_DRG Aftercare With Cc/mcc 10 10 $43,241.15 $41,079.09 $38,917.04 $43,241.15 $41,079.09 2026-06-04
315 MS_DRG Other Circulatory System Diagnoses With Cc 10 10 $41,052.90 $39,000.26 $36,947.61 $41,052.90 $39,000.26 2026-06-04
J9334 HCPCS Injection, Efgartigimod Alfa, 2 Mg And Hyaluronidase-qvfc 14 14 $39,748.00 $37,760.60 $21,066.44 $39,748.00 $37,760.60 2026-06-04
488 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection With Cc/mcc 10 10 $37,325.25 $35,458.99 $33,592.73 $37,325.25 $35,458.99 2026-06-04
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 10 10 $36,944.70 $35,097.47 $33,250.23 $36,944.70 $35,097.47 2026-06-04
489 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection Without Cc/mcc 10 10 $36,461.65 $34,638.57 $32,815.49 $36,461.65 $34,638.57 2026-06-04
J9043 HCPCS Injection, Cabazitaxel, 1 Mg 14 14 $35,611.55 $33,830.97 $18,874.12 $35,611.55 $33,830.97 2026-06-04
552 MS_DRG Medical Back Problems Without Mcc 10 10 $35,184.91 $33,425.66 $31,666.42 $35,184.91 $33,425.66 2026-06-04
742 MS_DRG Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc 10 10 $34,553.65 $32,825.97 $31,098.29 $34,553.65 $32,825.97 2026-06-04
264 MS_DRG Other Circulatory System O.r. Procedures 10 10 $34,417.25 $32,696.39 $30,975.53 $34,417.25 $32,696.39 2026-06-04
J3245 HCPCS Injection, Tildrakizumab, 1 Mg 14 14 $32,330.60 $30,714.07 $17,135.22 $32,330.60 $30,714.07 2026-06-04
788 MS_DRG Cesarean Section Without Sterilization Without Cc/mcc 10 10 $31,544.69 $29,967.45 $28,390.22 $31,544.69 $29,967.45 2026-06-04
J9022 HCPCS Injection, Atezolizumab, 10 Mg 28 14 $25,569.08 $24,290.62 $11,160.16 $30,081.25 $20,004.06 2026-06-04
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 10 10 $29,159.05 $27,701.10 $26,243.15 $29,159.05 $27,701.10 2026-06-04
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 10 10 $28,057.64 $26,654.76 $25,251.88 $28,057.64 $26,654.76 2026-06-04
445 MS_DRG Disorders Of The Biliary Tract With Cc 10 10 $27,791.58 $26,402.00 $25,012.42 $27,791.58 $26,402.00 2026-06-04
J9144 HCPCS Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj 14 14 $26,641.15 $25,309.09 $14,119.81 $26,641.15 $25,309.09 2026-06-04
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 10 10 $26,567.15 $25,238.79 $23,910.44 $26,567.15 $25,238.79 2026-06-04
328 MS_DRG Stomach, Esophageal And Duodenal Procedures Without Cc/mcc 10 10 $26,484.25 $25,160.04 $23,835.83 $26,484.25 $25,160.04 2026-06-04
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 10 10 $26,239.70 $24,927.72 $23,615.73 $26,239.70 $24,927.72 2026-06-04
J3590 HCPCS Unclassified Biologics 14 14 $26,139.25 $24,832.29 $13,853.80 $26,139.25 $24,832.29 2026-06-04
784 MS_DRG Cesarean Section With Sterilization With Cc 10 10 $25,320.10 $24,054.10 $22,788.09 $25,320.10 $24,054.10 2026-06-04
J9217 HCPCS Leuprolide Acetate (for Depot Suspension), 7.5 Mg 84 14 $10,716.48 $10,180.65 $1,809.84 $24,339.45 $7,284.68 2026-06-04
743 MS_DRG Uterine And Adnexa Procedures For Non-malignancy Without Cc/mcc 10 10 $23,189.43 $22,029.95 $20,870.48 $23,189.43 $22,029.95 2026-06-04
543 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 10 10 $22,803.70 $21,663.52 $20,523.33 $22,803.70 $21,663.52 2026-06-04
638 MS_DRG Diabetes With Cc 10 10 $22,654.07 $21,521.37 $20,388.66 $22,654.07 $21,521.37 2026-06-04
806 MS_DRG Vaginal Delivery Without Sterilization Or D&c With Cc 10 10 $22,557.37 $21,429.50 $20,301.63 $22,557.37 $21,429.50 2026-06-04
J2427 HCPCS Injection, Paliperidone Palmitate Extended Release (invega Hafyera, Or Invega Tr… 28 14 $18,522.25 $17,596.14 $7,853.54 $22,226.50 $14,077.10 2026-06-04
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 10 10 $22,189.45 $21,079.98 $19,970.51 $22,189.45 $21,079.98 2026-06-04
178 MS_DRG Respiratory Infections And Inflammations With Cc 10 10 $22,139.65 $21,032.67 $19,925.69 $22,139.65 $21,032.67 2026-06-04
768 MS_DRG Vaginal Delivery With O.r. Procedures Except Sterilization And/or D&c 10 10 $22,049.23 $20,946.76 $19,844.30 $22,049.23 $20,946.76 2026-06-04
373 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/mcc 10 10 $21,870.67 $20,777.13 $19,683.60 $21,870.67 $20,777.13 2026-06-04
384 MS_DRG Uncomplicated Peptic Ulcer Without Mcc 10 10 $21,589.45 $20,509.98 $19,430.51 $21,589.45 $20,509.98 2026-06-04
J9301 HCPCS Injection, Obinutuzumab, 10 Mg 14 14 $21,539.05 $20,462.10 $11,415.70 $21,539.05 $20,462.10 2026-06-04
J2323 HCPCS Injection, Natalizumab, 1 Mg 14 14 $21,515.15 $20,439.39 $11,403.03 $21,515.15 $20,439.39 2026-06-04
292 MS_DRG Heart Failure And Shock With Cc 10 10 $21,495.67 $20,420.89 $19,346.10 $21,495.67 $20,420.89 2026-06-04
376 MS_DRG Digestive Malignancy Without Cc/mcc 10 10 $21,410.20 $20,339.69 $19,269.18 $21,410.20 $20,339.69 2026-06-04
908 MS_DRG Other O.r. Procedures For Injuries With Cc 10 10 $21,064.60 $20,011.37 $18,958.14 $21,064.60 $20,011.37 2026-06-04
787 MS_DRG Cesarean Section Without Sterilization With Cc 10 10 $20,906.28 $19,860.97 $18,815.65 $20,906.28 $19,860.97 2026-06-04
J1569 HCPCS Injection, Immune Globulin, (gammagard Liquid), Non-lyophilized, (e.g., Liquid),… 70 14 $6,929.60 $6,583.12 $924.16 $20,758.70 $6,583.12 2026-06-04
858 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures Without Cc/mcc 10 10 $20,653.65 $19,620.97 $18,588.29 $20,653.65 $19,620.97 2026-06-04
J9299 HCPCS Injection, Nivolumab, 1 Mg 56 14 $9,257.65 $8,794.77 $1,803.51 $20,417.05 $8,081.75 2026-06-04
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 10 10 $20,124.65 $19,118.42 $18,112.19 $20,124.65 $19,118.42 2026-06-04
J0896 HCPCS Injection, Luspatercept-aamt, 0.25 Mg 28 14 $14,752.55 $14,014.92 $4,975.64 $20,117.10 $10,025.03 2026-06-04
291 MS_DRG Heart Failure And Shock With Mcc 10 10 $20,087.49 $19,083.12 $18,078.74 $20,087.49 $19,083.12 2026-06-04
J1299 HCPCS Injection, Eculizumab, 2 Mg 14 14 $19,725.60 $18,739.32 $10,454.57 $19,725.60 $18,739.32 2026-06-04
J9308 HCPCS Injection, Ramucirumab, 5 Mg 28 14 $11,738.92 $11,151.98 $2,073.89 $19,564.85 $7,141.19 2026-06-04
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 10 10 $19,403.58 $18,433.40 $17,463.22 $19,403.58 $18,433.40 2026-06-04
189 MS_DRG Pulmonary Edema And Respiratory Failure 10 10 $19,360.76 $18,392.72 $17,424.68 $19,360.76 $18,392.72 2026-06-04
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 10 10 $19,028.50 $18,077.08 $17,125.65 $19,028.50 $18,077.08 2026-06-04
346 MS_DRG Minor Small And Large Bowel Procedures Without Cc/mcc 10 10 $18,793.00 $17,853.35 $16,913.70 $18,793.00 $17,853.35 2026-06-04
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 10 10 $18,634.28 $17,702.56 $16,770.85 $18,634.28 $17,702.56 2026-06-04
125 MS_DRG Other Disorders Of The Eye Without Mcc 10 10 $18,619.75 $17,688.76 $16,757.78 $18,619.75 $17,688.76 2026-06-04
J3380 HCPCS Injection, Vedolizumab, Intravenous, 1 Mg 14 14 $18,195.70 $17,285.92 $9,643.72 $18,195.70 $17,285.92 2026-06-04
181 MS_DRG Respiratory Neoplasms With Cc 10 10 $18,097.15 $17,192.29 $16,287.44 $18,097.15 $17,192.29 2026-06-04
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 10 10 $18,002.53 $17,102.40 $16,202.27 $18,002.53 $17,102.40 2026-06-04
J1930 HCPCS Injection, Lanreotide, 1 Mg 14 14 $18,000.00 $17,100.00 $9,540.00 $18,000.00 $17,100.00 2026-06-04
J9042 HCPCS Injection, Brentuximab Vedotin, 1 Mg 14 14 $18,000.00 $17,100.00 $9,540.00 $18,000.00 $17,100.00 2026-06-04
J1932 HCPCS Injection, Lanreotide, (cipla), 1 Mg 14 14 $18,000.00 $17,100.00 $9,540.00 $18,000.00 $17,100.00 2026-06-04
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 28 14 $17,086.67 $16,232.34 $8,571.88 $18,000.00 $15,364.68 2026-06-04
J9999 HCPCS Not Otherwise Classified, Antineoplastic Drugs 28 14 $12,113.47 $11,507.80 $3,300.28 $18,000.00 $7,883.48 2026-06-04
375 MS_DRG Digestive Malignancy With Cc 10 10 $17,980.80 $17,081.76 $16,182.72 $17,980.80 $17,081.76 2026-06-04
J9306 HCPCS Injection, Pertuzumab, 1 Mg 14 14 $17,187.55 $16,328.17 $9,109.40 $17,187.55 $16,328.17 2026-06-04
399 MS_DRG Appendix Procedures Without Cc/mcc 10 10 $17,164.80 $16,306.56 $15,448.32 $17,164.80 $16,306.56 2026-06-04
187 MS_DRG Pleural Effusion With Cc 10 10 $17,100.15 $16,245.14 $15,390.14 $17,100.15 $16,245.14 2026-06-04
316 MS_DRG Other Circulatory System Diagnoses Without Cc/mcc 10 10 $17,091.50 $16,236.93 $15,382.35 $17,091.50 $16,236.93 2026-06-04
177 MS_DRG Respiratory Infections And Inflammations With Mcc 10 10 $17,089.30 $16,234.83 $15,380.37 $17,089.30 $16,234.83 2026-06-04
807 MS_DRG Vaginal Delivery Without Sterilization Or D&c Without Cc/mcc 10 10 $16,893.43 $16,048.76 $15,204.09 $16,893.43 $16,048.76 2026-06-04
645 MS_DRG Endocrine Disorders Without Cc/mcc 10 10 $16,705.35 $15,870.08 $15,034.82 $16,705.35 $15,870.08 2026-06-04
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 10 10 $16,679.68 $15,845.70 $15,011.71 $16,679.68 $15,845.70 2026-06-04
J9303 HCPCS Injection, Panitumumab, 10 Mg 28 14 $10,271.70 $9,758.12 $2,177.61 $16,434.70 $6,409.55 2026-06-04
556 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc 10 10 $16,143.40 $15,336.23 $14,529.06 $16,143.40 $15,336.23 2026-06-04
805 MS_DRG Vaginal Delivery Without Sterilization Or D&c With Mcc 10 10 $16,001.20 $15,201.14 $14,401.08 $16,001.20 $15,201.14 2026-06-04
J9332 HCPCS Injection, Efgartigimod Alfa-fcab, 2mg 14 14 $15,911.70 $15,116.12 $8,433.20 $15,911.70 $15,116.12 2026-06-04
442 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc 10 10 $15,689.06 $14,904.61 $14,120.15 $15,689.06 $14,904.61 2026-06-04
7334829_1 CDM Aeq Asc Flex Ptc Hum Std,7b__dwf607b 14 14 $15,663.00 $14,879.85 $8,301.39 $15,663.00 $14,879.85 2026-06-04
7364477_1 CDM Aeq Ascend Flex Sz 5b__dwf605b 14 14 $15,663.00 $14,879.85 $8,301.39 $15,663.00 $14,879.85 2026-06-04
7334826_1 CDM Aeq Ascend Flex Sz 6c__dwf606c 14 14 $15,663.00 $14,879.85 $8,301.39 $15,663.00 $14,879.85 2026-06-04
7334812_1 CDM Aeq Ascend Flex Std Sz 6b__dwf606b 14 14 $15,663.00 $14,879.85 $8,301.39 $15,663.00 $14,879.85 2026-06-04
7364468_1 CDM Aeq Ascend Flex Ptc 6a 127.5__dwf606a 14 14 $15,663.00 $14,879.85 $8,301.39 $15,663.00 $14,879.85 2026-06-04
7334823_1 CDM Aeq Ascend Flex Std Size 8b__dwf608b 14 14 $15,663.00 $14,879.85 $8,301.39 $15,663.00 $14,879.85 2026-06-04
91 MS_DRG Other Disorders Of Nervous System With Mcc 10 10 $15,661.35 $14,878.28 $14,095.22 $15,661.35 $14,878.28 2026-06-04
544 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 10 10 $15,561.55 $14,783.47 $14,005.40 $15,561.55 $14,783.47 2026-06-04
918 MS_DRG Poisoning And Toxic Effects Of Drugs Without Mcc 10 10 $15,469.50 $14,696.03 $13,922.55 $15,469.50 $14,696.03 2026-06-04
J9223 HCPCS Injection, Lurbinectedin, 0.1 Mg 14 14 $15,195.60 $14,435.82 $8,053.67 $15,195.60 $14,435.82 2026-06-04
66 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc 10 10 $15,154.55 $14,396.82 $13,639.10 $15,154.55 $14,396.82 2026-06-04
J3101 HCPCS Injection, Tenecteplase, 1 Mg 14 14 $14,935.10 $14,188.35 $7,915.60 $14,935.10 $14,188.35 2026-06-04
J2353 HCPCS Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg 56 14 $11,066.55 $10,513.23 $4,523.18 $14,931.15 $9,877.35 2026-06-04
J1459 HCPCS Injection, Immune Globulin (privigen), Intravenous, Non-lyophilized (e.g., Liqui… 14 14 $14,926.80 $14,180.46 $7,911.20 $14,926.80 $14,180.46 2026-06-04
537 MS_DRG Sprains, Strains, And Dislocations Of Hip, Pelvis And Thigh With Cc/mcc 10 10 $14,857.80 $14,114.91 $13,372.02 $14,857.80 $14,114.91 2026-06-04
884 MS_DRG Organic Disturbances And Intellectual Disability 10 10 $14,757.30 $14,019.44 $13,281.57 $14,757.30 $14,019.44 2026-06-04
J9271 HCPCS Injection, Pembrolizumab, 1 Mg 14 14 $14,570.90 $13,842.36 $7,722.58 $14,570.90 $13,842.36 2026-06-04
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 10 10 $14,261.90 $13,548.81 $12,835.71 $14,261.90 $13,548.81 2026-06-04
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/mcc 10 10 $14,124.80 $13,418.56 $12,712.32 $14,124.80 $13,418.56 2026-06-04
312 MS_DRG Syncope And Collapse 10 10 $14,090.45 $13,385.93 $12,681.41 $14,090.45 $13,385.93 2026-06-04
8948124_1 CDM Operating Room Services - General Classification 14 14 $14,000.00 $13,300.00 $7,420.00 $14,000.00 $13,300.00 2026-06-04
8920784_1 CDM Labor Room/delivery - Delivery Room 14 14 $13,997.00 $13,297.15 $7,418.41 $13,997.00 $13,297.15 2026-06-04
8024990_1 CDM Labor Room/delivery - Delivery Room 14 14 $13,779.00 $13,090.05 $7,302.87 $13,779.00 $13,090.05 2026-06-04
C1832 HCPCS Autograft Suspension, Including Cell Processing And Application, And All System … 14 14 $13,750.00 $13,062.50 $7,287.50 $13,750.00 $13,062.50 2026-06-04
176 MS_DRG Pulmonary Embolism Without Mcc 10 10 $13,672.05 $12,988.45 $12,304.85 $13,672.05 $12,988.45 2026-06-04
897 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 10 10 $13,560.31 $12,882.30 $12,204.28 $13,560.31 $12,882.30 2026-06-04
J2802 HCPCS Injection, Romiplostim, 1 Microgram 42 14 $6,607.25 $6,276.89 $1,750.96 $13,214.50 $6,276.89 2026-06-04
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 10 10 $13,116.49 $12,460.66 $11,804.84 $13,116.49 $12,460.66 2026-06-04
441 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc 10 10 $13,093.97 $12,439.27 $11,784.57 $13,093.97 $12,439.27 2026-06-04
639 MS_DRG Diabetes Without Cc/mcc 10 10 $12,802.40 $12,162.28 $11,522.16 $12,802.40 $12,162.28 2026-06-04
7367952_1 CDM Integra Matrix Wound Dress__54051 14 14 $12,598.50 $11,968.58 $6,677.21 $12,598.50 $11,968.58 2026-06-04
8410219_1 CDM Operating Room Services - General Classification 14 14 $12,580.00 $11,951.00 $6,667.40 $12,580.00 $11,951.00 2026-06-04
379 MS_DRG Gastrointestinal Hemorrhage Without Cc/mcc 10 10 $12,298.05 $11,683.15 $11,068.25 $12,298.05 $11,683.15 2026-06-04
7334825_1 CDM Flex Shoulder Sys Head 52x23__dwf153 14 14 $12,171.60 $11,563.02 $6,450.95 $12,171.60 $11,563.02 2026-06-04
7364462_1 CDM Aequalis Hum Head Shoulder__dwf146 14 14 $12,171.60 $11,563.02 $6,450.95 $12,171.60 $11,563.02 2026-06-04
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 10 10 $12,170.95 $11,562.40 $10,953.85 $12,170.95 $11,562.40 2026-06-04
7334810_1 CDM Aeq Rev Ii Glenoid 36x35__dwd182 14 14 $12,053.90 $11,451.21 $6,388.57 $12,053.90 $11,451.21 2026-06-04
J9354 HCPCS Injection, Ado-trastuzumab Emtansine, 1 Mg 28 14 $10,293.03 $9,778.38 $4,600.85 $11,905.20 $8,246.81 2026-06-04
921 MS_DRG Complications Of Treatment Without Cc/mcc 10 10 $11,864.95 $11,271.70 $10,678.46 $11,864.95 $11,271.70 2026-06-04
J1162 HCPCS Injection, Digoxin Immune Fab (ovine), Per Vial 14 14 $11,793.60 $11,203.92 $6,250.61 $11,793.60 $11,203.92 2026-06-04
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 10 10 $11,740.30 $11,153.29 $10,566.27 $11,740.30 $11,153.29 2026-06-04
7334821_1 CDM Aeq Rev Ctr Glen Sz 42__dwd193 14 14 $11,699.70 $11,114.72 $6,200.84 $11,699.70 $11,114.72 2026-06-04
7364474_1 CDM Aeq Rev Ii Glenoid Bp 36__dwd180 14 14 $11,699.70 $11,114.72 $6,200.84 $11,699.70 $11,114.72 2026-06-04
700 MS_DRG Other Kidney And Urinary Tract Diagnoses Without Cc/mcc 10 10 $11,679.20 $11,095.24 $10,511.28 $11,679.20 $11,095.24 2026-06-04
186 MS_DRG Pleural Effusion With Mcc 10 10 $11,633.10 $11,051.45 $10,469.79 $11,633.10 $11,051.45 2026-06-04
J0517 HCPCS Injection, Benralizumab, 1 Mg 14 14 $11,557.95 $10,980.05 $6,125.71 $11,557.95 $10,980.05 2026-06-04
7422079_1 CDM Aequalis Hum Head 46mmx17mm__dwf046 14 14 $11,525.80 $10,949.51 $6,108.67 $11,525.80 $10,949.51 2026-06-04
683 MS_DRG Renal Failure With Cc 10 10 $11,428.13 $10,856.72 $10,285.32 $11,428.13 $10,856.72 2026-06-04
443 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis Without C… 10 10 $11,376.12 $10,807.31 $10,238.50 $11,376.12 $10,807.31 2026-06-04
389 MS_DRG Gastrointestinal Obstruction With Cc 10 10 $11,259.99 $10,696.99 $10,133.99 $11,259.99 $10,696.99 2026-06-04
93 MS_DRG Other Disorders Of Nervous System Without Cc/mcc 10 10 $11,209.48 $10,649.00 $10,088.53 $11,209.48 $10,649.00 2026-06-04
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 10 10 $11,131.36 $10,574.80 $10,018.23 $11,131.36 $10,574.80 2026-06-04
C1763 HCPCS Connective Tissue, Non-human (includes Synthetic) 14 14 $11,100.00 $10,545.00 $5,883.00 $11,100.00 $10,545.00 2026-06-04
603 MS_DRG Cellulitis Without Mcc 10 10 $11,082.63 $10,528.50 $9,974.37 $11,082.63 $10,528.50 2026-06-04
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 10 10 $11,020.85 $10,469.81 $9,918.77 $11,020.85 $10,469.81 2026-06-04
388 MS_DRG Gastrointestinal Obstruction With Mcc 10 10 $11,012.95 $10,462.30 $9,911.66 $11,012.95 $10,462.30 2026-06-04
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 10 10 $10,862.10 $10,318.99 $9,775.89 $10,862.10 $10,318.99 2026-06-04
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 10 10 $10,543.22 $10,016.06 $9,488.90 $10,543.22 $10,016.06 2026-06-04
Q5111 HCPCS Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg 28 14 $10,510.50 $9,984.98 $5,565.00 $10,521.00 $9,975.00 2026-06-04
7366128_1 CDM Polarstem Lateral 126deg Sz9__75100482 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400389_1 CDM Polrstm Stem Latti/ha 7 No-c__75100480 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400402_1 CDM Polarstem Collar Lat Ti/ha 9__75102209 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400398_1 CDM Polarstem Valgus Ti/ha 4__75102076 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400397_1 CDM Polarstem Valgus Ti/ha 3__75102075 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400391_1 CDM Polrstm Stem Latti/ha 10 No-c__75100483 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400390_1 CDM Polrstm Stem Latti/ha 8 No-c__75100481 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400386_1 CDM Polrstm Stem Latti/ha 4 No-c__75100477 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400387_1 CDM Polrstm Stem Latti/ha 5 No-c__75100478 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400383_1 CDM Polrstm Stem Std Ti/ha 10 No-c__75100473 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400392_1 CDM Polrstm Stem Std Ti/ha 11 No-c__75100509 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400384_1 CDM Polrstm Stem Latti/ha 1 No-c__75100474 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400401_1 CDM Polarstem Valgus Ti/ha 7__75102079 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400404_1 CDM Polarstem Collar Lat Ti/ha 11__75102211 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400385_1 CDM Polrstm Stem Latti/ha 2 No-c__75100475 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400393_1 CDM Polrstm Stem Latti/ha 11 No-c__75100510 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400394_1 CDM Polarstem Valgus Ti/ha 0__75102072 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400382_1 CDM Polrstm Stem Std Ti/ha 9 No-c__75100472 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400403_1 CDM Polarstem Collar Lat Ti/ha 10__75102210 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400372_1 CDM Polrstm Stem Std Ti/ha 01 No-c__75100462 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400380_1 CDM Polrstm Stem Std Ti/ha 7 No-c__75100470 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400381_1 CDM Polrstm Stem Std Ti/ha 8 No-c__75100471 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400378_1 CDM Polrstm Stem Std Ti/ha 5 No-c__75100468 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400399_1 CDM Polarstem Valgus Ti/ha 5__75102077 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7365886_1 CDM Polarstem Lateral Sz 5__75 100 478 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400377_1 CDM Polrstm Stem Std Ti/ha 4 No-c__75100467 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400396_1 CDM Polarstem Valgus Ti/ha 2__75102074 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7365893_1 CDM Polarstem Std Ti Ha Sz 3__75 100 466 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400376_1 CDM Polrstm Stem Std Ti/ha 3 No-c__75100466 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400374_1 CDM Polrstm Stem Std Ti/ha 1 No-c__75100464 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400375_1 CDM Polrstm Stem Std Ti/ha 2 No-c__75100465 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400373_1 CDM Polrstm Stem Std Ti/ha 0 No-c__75100463 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400379_1 CDM Polrstm Stem Std Ti/ha 6 No-c__75100469 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400370_1 CDM Polarstem Collar Lat Ti/ha 7__75018418 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400400_1 CDM Polarstem Valgus Ti/ha 6__75102078 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400371_1 CDM Polarstem Collar Lat Ti/ha 8__75018419 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400369_1 CDM Polarstem Collar Lat Ti/ha 6__75018417 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400395_1 CDM Polarstem Valgus Ti/ha 1__75102073 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
7400388_1 CDM Polrstm Stem Latti/ha 6 No-c__75100479 14 14 $10,474.20 $9,950.49 $5,551.33 $10,474.20 $9,950.49 2026-06-04
378 MS_DRG Gastrointestinal Hemorrhage With Cc 10 10 $10,345.55 $9,828.27 $9,311.00 $10,345.55 $9,828.27 2026-06-04
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 10 10 $10,278.93 $9,764.98 $9,251.04 $10,278.93 $9,764.98 2026-06-04
8929635_1 CDM Trinity Elite Extra Large 16cc__410004 14 14 $10,274.60 $9,760.87 $5,445.54 $10,274.60 $9,760.87 2026-06-04
7400081_1 CDM Jrny2 Bcs Fem Oxin R Sz 8__74022118 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400089_1 CDM Jrny2 Bcs Fem Oxin Lf Sz 8__74022128 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400099_1 CDM Journey Tibia Base Np Lf Sz 7__74022227 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400094_1 CDM Journey Tibia Base Np R Sz 8__74022218 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7365890_1 CDM Bi Cruciate Stab Jrny Bcs Sz 5__74022125 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400062_1 CDM Jrny2 Cr Fem Ox Np R Sz 2__74021152 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400075_1 CDM Jrny2 Cr Fem Ox Np Lf Sz 9__74021169 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400095_1 CDM Journey Tibia Base Np Lf Sz 1__74022221 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400077_1 CDM Jrny2 Bcs Fem Oxin R Sz 1__74022111 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400063_1 CDM Jrny2 Cr Fem Ox Np R Sz 3__74021153 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7365895_1 CDM Bi Cruciate Stab Jrny Sz 5__74022115 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400070_1 CDM Jrny2 Cr Fem Ox Np Lf Sz 2__74021162 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400090_1 CDM Jrny2 Bcs Fem Oxin Lf Sz 9__74022129 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400096_1 CDM Journey Tibia Base Np Lf Sz 2__74022222 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400067_1 CDM Jrny2 Cr Fem Ox Np R Sz 9__74021159 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400072_1 CDM Jrny2 Cr Fem Ox Np Lf Sz 5__74021165 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7365878_1 CDM Bi Cruciate Stab Jrny Bcs Sz 7__74022117 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7365869_1 CDM Cruciate Retain Journey Sz 6 L__74021166 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400068_1 CDM Jrny2 Cr Fem Ox Np Lf Sz 10__74021160 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400080_1 CDM Jrny2 Bcs Fem Oxin R Sz 6__74022116 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400085_1 CDM Jrny2 Bcs Fem Oxin Lf Sz 2__74022122 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400065_1 CDM Jrny2 Cr Fem Ox Np R Sz5__74021155 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400064_1 CDM Jrny2 Cr Fem Ox Np R Sz 4__74021154 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400086_1 CDM Jrny2 Bcs Fem Oxin Lf Sz 3__74022123 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400087_1 CDM Jrny2 Bcs Fem Oxin Lf Sz 4__74022124 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400098_1 CDM Journey Tibia Base Np Lf Sz 6__74022226 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7366124_1 CDM Journey Ii Bcs Femoral Oxi Sz7__74022127 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400060_1 CDM Jrny2 Cr Fem Ox Np R Sz 10__74021150 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400093_1 CDM Journey Tibia Base Np R Sz 7__74022217 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400061_1 CDM Jrny2 Cr Fem Ox Np R Sz 1__74021151 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400088_1 CDM Jrny2 Bcs Fem Oxin Lf Sz 6__74022126 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400071_1 CDM Jrny2 Cr Fem Ox Np Lf Sz 3__74021163 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7365874_1 CDM Bi Cruciate Stab Jrny Bcs Sz 4__74022114 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400091_1 CDM Journey Tibia Base Np R Sz 1__74022211 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7366122_1 CDM Journey Ii Cr Femoral Oxi Sz8__74021158 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400092_1 CDM Journey Tibia Base Np R Sz 2__74022212 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400084_1 CDM Jrny2 Bcs Fem Oxin Lf Sz 1__74022121 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400079_1 CDM Jrny2 Bcs Fem Oxin R Sz 3__74022113 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7365897_1 CDM Journey Ii Cr Oxi Fem Sz 4 L__74021164 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400083_1 CDM Jrny2 Bcs Fem Oxin Lf Sz 10__74022120 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7365877_1 CDM Cruciate Retain Journey Sz 6 R__74021156 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400078_1 CDM Jrny2 Bcs Fem Oxin R Sz 2__74022112 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400069_1 CDM Jrny2 Cr Fem Ox Np Lf Sz 1__74021161 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400074_1 CDM Jrny2 Cr Fem Ox Np Lf Sz 8__74021168 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400082_1 CDM Jrny2 Bcs Fem Oxin R Sz 9__74022119 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400066_1 CDM Jrny2 Cr Fem Ox Np R Sz 7__74021157 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400076_1 CDM Jrny2 Bcs Fem Oxin R Sz 10__74022110 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400097_1 CDM Journey Tibia Base Np Lf Sz 4__74022224 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
7400073_1 CDM Jrny2 Cr Fem Ox Np Lf Sz 7__74021167 14 14 $10,194.60 $9,684.87 $5,403.14 $10,194.60 $9,684.87 2026-06-04
444 MS_DRG Disorders Of The Biliary Tract With Mcc 10 10 $10,192.60 $9,682.97 $9,173.34 $10,192.60 $9,682.97 2026-06-04
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 10 $9,976.00 $9,477.20 $8,978.40 $9,976.00 $9,477.20 2026-06-04
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 10 10 $9,921.93 $9,425.84 $8,929.74 $9,921.93 $9,425.84 2026-06-04
7366133_1 CDM Polarstem Lateral Ccd 126dg S3__75100476 14 14 $9,760.00 $9,272.00 $5,172.80 $9,760.00 $9,272.00 2026-06-04
J9033 HCPCS Injection, Bendamustine Hydrochloride, 1 Mg 14 14 $9,733.15 $9,246.49 $5,158.57 $9,733.15 $9,246.49 2026-06-04
J2356 HCPCS Injection, Tezepelumab-ekko, 1 Mg 14 14 $9,695.35 $9,210.58 $5,138.54 $9,695.35 $9,210.58 2026-06-04
923 MS_DRG Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc 10 10 $9,469.45 $8,995.98 $8,522.51 $9,469.45 $8,995.98 2026-06-04
152 MS_DRG Otitis Media And Uri With Mcc 10 10 $9,462.00 $8,988.90 $8,515.80 $9,462.00 $8,988.90 2026-06-04
J1306 HCPCS Injection, Inclisiran, 1 Mg 14 14 $9,402.75 $8,932.61 $4,983.46 $9,402.75 $8,932.61 2026-06-04
8410218_1 CDM Operating Room Services - General Classification 14 14 $9,393.00 $8,923.35 $4,978.29 $9,393.00 $8,923.35 2026-06-04
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 10 10 $9,256.50 $8,793.68 $8,330.85 $9,256.50 $8,793.68 2026-06-04
950 MS_DRG Aftercare Without Cc/mcc 10 10 $9,011.15 $8,560.59 $8,110.04 $9,011.15 $8,560.59 2026-06-04
951 MS_DRG Other Factors Influencing Health Status 10 10 $8,967.21 $8,518.85 $8,070.49 $8,967.21 $8,518.85 2026-06-04
8028195_1 CDM Intensive Care Unit - Medical 10 10 $8,930.25 $8,483.74 $8,037.23 $8,930.25 $8,483.74 2026-06-04
8919460_1 CDM Labor Room/delivery - Delivery Room 14 14 $8,737.00 $8,300.15 $4,630.61 $8,737.00 $8,300.15 2026-06-04
7334828_1 CDM Aeq Rev Ii Thread Bp 29__dwe835 14 14 $8,321.40 $7,905.33 $4,410.34 $8,321.40 $7,905.33 2026-06-04
7364478_1 CDM Aeq Rev Ii Thread Bp 25__dwe730 14 14 $8,321.40 $7,905.33 $4,410.34 $8,321.40 $7,905.33 2026-06-04
7334820_1 CDM Aeq Rev Ii Thread Bp 29__dwe840 14 14 $8,321.40 $7,905.33 $4,410.34 $8,321.40 $7,905.33 2026-06-04
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 10 10 $8,295.10 $7,880.35 $7,465.59 $8,295.10 $7,880.34 2026-06-04
605 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc 10 10 $8,272.05 $7,858.45 $7,444.85 $8,272.05 $7,858.45 2026-06-04
722 MS_DRG Malignancy, Male Reproductive System With Mcc 10 10 $8,194.90 $7,785.16 $7,375.41 $8,194.90 $7,785.16 2026-06-04
8917770_1 CDM Labor Room/delivery - Delivery Room 14 14 $8,165.00 $7,756.75 $4,327.45 $8,165.00 $7,756.75 2026-06-04
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 10 10 $8,105.47 $7,700.20 $7,294.93 $8,105.47 $7,700.20 2026-06-04
7367953_1 CDM Primatrix 8x8__607-001-880 14 14 $8,087.80 $7,683.41 $4,286.53 $8,087.80 $7,683.41 2026-06-04
8402091_1 CDM Labor Room/delivery - Delivery Room 14 14 $8,038.00 $7,636.10 $4,260.14 $8,038.00 $7,636.10 2026-06-04
8024989_1 CDM Labor Room/delivery - Delivery Room 14 14 $8,038.00 $7,636.10 $4,260.14 $8,038.00 $7,636.10 2026-06-04
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 10 10 $7,996.77 $7,596.93 $7,197.09 $7,996.77 $7,596.93 2026-06-04
314 MS_DRG Other Circulatory System Diagnoses With Mcc 10 10 $7,951.37 $7,553.80 $7,156.23 $7,951.37 $7,553.80 2026-06-04
8929634_1 CDM Trinity Elite Large 10.6cc__410003 14 14 $7,899.20 $7,504.24 $4,186.58 $7,899.20 $7,504.24 2026-06-04
J0630 HCPCS Injection, Calcitonin Salmon, Up To 400 Units 14 14 $7,890.15 $7,495.64 $4,181.78 $7,890.15 $7,495.64 2026-06-04
7364460_1 CDM Affiniti Cort Glen Size 40__0020060 14 14 $7,795.20 $7,405.44 $4,131.46 $7,795.20 $7,405.44 2026-06-04
7334824_1 CDM Affiniti Cortiloc Glen Size 56__0020064 14 14 $7,795.20 $7,405.44 $4,131.46 $7,795.20 $7,405.44 2026-06-04
7422078_1 CDM Affiniti Cortiloc Pegged Glen__20062 14 14 $7,795.20 $7,405.44 $4,131.46 $7,795.20 $7,405.44 2026-06-04
7364467_1 CDM Affiniti Cortiloc Glen Size 52__0020063 14 14 $7,795.20 $7,405.44 $4,131.46 $7,795.20 $7,405.44 2026-06-04
812 MS_DRG Red Blood Cell Disorders Without Mcc 10 10 $7,574.60 $7,195.87 $6,817.14 $7,574.60 $7,195.87 2026-06-04
301 MS_DRG Peripheral Vascular Disorders Without Cc/mcc 10 10 $7,524.10 $7,147.90 $6,771.69 $7,524.10 $7,147.90 2026-06-04
J9034 HCPCS Injection, Bendamustine Hcl (bendeka), 1 Mg 14 14 $7,421.40 $7,050.33 $3,933.34 $7,421.40 $7,050.33 2026-06-04
J9317 HCPCS Injection, Sacituzumab Govitecan-hziy, 2.5 Mg 14 14 $7,226.80 $6,865.46 $3,830.20 $7,226.80 $6,865.46 2026-06-04
8339183_1 CDM Ryanodex 250 Mg Vial 14 14 $7,106.50 $6,751.18 $3,766.45 $7,106.50 $6,751.18 2026-06-04
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/mcc 10 10 $7,088.63 $6,734.19 $6,379.76 $7,088.63 $6,734.19 2026-06-04
880 MS_DRG Acute Adjustment Reaction And Psychosocial Dysfunction 10 10 $7,051.85 $6,699.26 $6,346.67 $7,051.85 $6,699.26 2026-06-04
8928709_1 CDM Strand Plus Fibers Large__02-7300-100 14 14 $7,042.50 $6,690.38 $3,732.53 $7,042.50 $6,690.38 2026-06-04
699 MS_DRG Other Kidney And Urinary Tract Diagnoses With Cc 10 10 $7,032.20 $6,680.59 $6,328.98 $7,032.20 $6,680.59 2026-06-04
7364476_1 CDM Flex Shoulder Sys Rev Tray__dwf520 14 14 $7,025.20 $6,673.94 $3,723.36 $7,025.20 $6,673.94 2026-06-04
7334811_1 CDM Flex Shoulder Sys Rev Tray 6__dwf521 14 14 $7,025.20 $6,673.94 $3,723.36 $7,025.20 $6,673.94 2026-06-04
776 MS_DRG Postpartum And Post Abortion Diagnoses Without O.r. Procedures 10 10 $6,930.25 $6,583.74 $6,237.23 $6,930.25 $6,583.74 2026-06-04
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 10 10 $6,912.45 $6,566.83 $6,221.21 $6,912.45 $6,566.83 2026-06-04
948 MS_DRG Signs And Symptoms Without Mcc 10 10 $6,889.43 $6,544.95 $6,200.48 $6,889.43 $6,544.95 2026-06-04
865 MS_DRG Viral Illness With Mcc 10 10 $6,873.75 $6,530.06 $6,186.38 $6,873.75 $6,530.06 2026-06-04
203 MS_DRG Bronchitis And Asthma Without Cc/mcc 10 10 $6,827.13 $6,485.78 $6,144.42 $6,827.13 $6,485.78 2026-06-04
J9358 HCPCS Injection, Fam-trastuzumab Deruxtecan-nxki, 1 Mg 14 14 $6,675.25 $6,341.49 $3,537.88 $6,675.25 $6,341.49 2026-06-04
303 MS_DRG Atherosclerosis Without Mcc 10 10 $6,673.50 $6,339.83 $6,006.15 $6,673.50 $6,339.83 2026-06-04
947 MS_DRG Signs And Symptoms With Mcc 10 10 $6,649.63 $6,317.14 $5,984.66 $6,649.63 $6,317.14 2026-06-04
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