Hospital

BOZEMAN HEALTH BIG SKY MEDICAL CENTER

Big Sky, MT · CCN 271389 · Rates published

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You selected 93306 (CPT)

HC ECHO (2D) COMPLETE W DOPPLER & COLOR

This hospital’s price: $563 across 13 payers · range $189-$563

Source: https://bozemanhealth.org/wp-content/uploads/2025/01/01/474718253_big-sky-medical-center_standardcharges.json · observed 2024-11-19

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

19,178 distinct procedures filed

20 distinct payers

381,938 rate rows

2024-11-19 last MRF observed · ⚠ 23 mo old

Data quality

274,678 of 381,938 rate rows are consumer-grade (71.9%)

107,260 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 — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	97,219
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	9,960
placeholder amount (≤ $0.02) — excluded from medians	42
exceeds 10× this hospital's gross charge — excluded from medians	24
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	11
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings	4

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 23 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://bozemanhealth.org/wp-content/uploads/2025/01/01/474718253_big-sky-medical-center_standardcharges.json
Discovered via	Discovered by HANK (automated)
Last fetch	not_modified · 2026-10-01
Content fingerprint	5d34a9ea589d30ee… · 122,862,244 bytes · first seen 2026-05-30

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	Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose	20	$3,973,410.00	$3,973,410.00	$3,973,410.00	nat. median $3,705,478 1.1× median
J1413 HCPCS	Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose	20	$3,530,016.00	$3,530,016.00	$3,530,016.00	nat. median $3,324,572 1.1× median
J3399 HCPCS	Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10^15 Vector Ge…	20	$2,466,282.38	$2,466,282.38	$2,466,282.38	nat. median $2,467,386 1.0× median
Q2042 HCPCS	Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka…	20	$485,518.88	$547,358.64	$516,438.76	nat. median $739,258 0.7× median
Q2056 HCPCS	Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige…	20	$481,836.12	$543,206.83	$512,521.47	nat. median $646,415 0.8× median
Q2055 HCPCS	Idecabtagene Vicleucel, Up To 460 Million Autologous B-cell Maturation Antigen (…	20	$460,455.79	$519,103.31	$489,779.55	nat. median $622,450 0.8× median
Q2054 HCPCS	Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi…	20	$450,160.84	$507,497.12	$478,828.98	nat. median $640,950 0.7× median
Q2053 HCPCS	Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V…	20	$426,968.00	$481,350.24	$454,159.12	nat. median $591,721 0.8× median
Q2041 HCPCS	Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via…	20	$426,968.00	$481,350.24	$454,159.12	nat. median $608,239 0.7× median
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell Immunotherapy	13	$241,757.74	$279,681.28	$279,681.28	nat. median $359,454 0.8× median
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	13	$205,711.61	$292,987.34	$205,711.61	nat. median $249,036 0.8× median
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	13	$200,094.86	$237,710.88	$200,094.86	nat. median $198,418 1.0× median
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	13	$161,847.23	$196,242.97	$161,847.23	nat. median $190,559 0.8× median
4 MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	13	$111,591.03	$137,983.16	$111,591.03	nat. median $126,695 0.9× median
7 MS_DRG	Lung Transplant	13	$93,117.02	$110,621.98	$93,117.02	nat. median $117,974 0.8× median
2 MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	13	$92,947.74	$110,421.30	$92,947.74	nat. median $104,013 0.9× median
14 MS_DRG	Allogeneic Bone Marrow Transplant	13	$87,002.29	$128,210.09	$87,002.29	nat. median $110,307 0.8× median
212 MS_DRG	Concomitant Aortic And Mitral Valve�procedures	13	$7,455.94	$81,762.82	$81,762.82	nat. median $97,323 0.8× median
5 MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	13	$78,569.20	$90,766.29	$78,569.20	nat. median $95,038 0.8× median
215 MS_DRG	Other Heart Assist System Implant	13	$77,542.86	$84,223.56	$77,542.86	nat. median $93,901 0.8× median
216 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	13	$73,675.13	$81,527.82	$73,675.13	nat. median $90,551 0.8× median
A9543 HCPCS	Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil…	20	$70,125.42	$70,125.42	$70,125.42	nat. median $63,528 1.1× median
453 MS_DRG	Combined Anterior And Posterior Spinal Fusion With Mcc	13	$67,268.90	$90,559.12	$67,268.90	nat. median $70,732 1.0× median
J9029 HCPCS	Injection, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose	20	$66,187.80	$66,187.80	$66,187.80	nat. median $68,423 1.0× median
20 MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	13	$64,164.08	$94,185.12	$64,164.08	nat. median $74,370 0.9× median
456 MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	13	$49,726.55	$63,989.49	$63,989.49	nat. median $77,632 0.8× median
231 MS_DRG	Coronary Bypass With Ptca With Mcc	13	$61,604.32	$73,185.49	$61,604.32	nat. median $77,028 0.8× median
19 MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	13	$60,680.47	$72,087.86	$60,680.47	nat. median $66,715 0.9× median
233 MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	13	$59,208.53	$61,185.47	$59,208.53	nat. median $71,748 0.8× median
219 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	13	$58,537.47	$62,118.99	$58,537.47	nat. median $72,398 0.8× median
38240 CPT	Transplantation Of Donor Stem Cells, Per Donor	13	$227.42	$55,762.87	$55,762.87	nat. median $12,842 outlier · 4.3×
957 MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	13	$54,903.55	$70,103.84	$54,903.55	nat. median $67,976 0.8× median
Q2043 HCPCS	Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm…	20	$50,755.33	$57,219.95	$53,987.64	nat. median $65,720 0.8× median
275 MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	13	$42,353.49	$53,410.35	$53,410.35	nat. median $66,649 0.8× median
870 MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	13	$52,872.13	$60,970.99	$52,872.13	nat. median $62,655 0.8× median
928 MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	13	$38,504.87	$52,529.01	$52,529.01	nat. median $61,308 0.9× median
207 MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	13	$52,440.19	$53,699.48	$52,440.19	nat. median $59,371 0.9× median
969 MS_DRG	HIV With Extensive O.r. Procedures With Mcc	13	$52,171.46	$61,979.25	$52,171.46	nat. median $58,251 0.9× median
268 MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	13	$13,528.25	$52,035.58	$52,035.58	nat. median $63,873 0.8× median
461 MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	13	$51,760.78	$61,490.96	$51,760.78	nat. median $53,342 1.0× median
459 MS_DRG	Spinal Fusion Except Cervical With Mcc	13	$41,439.47	$50,347.29	$50,347.29	nat. median $52,712 1.0× median
217 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	13	$48,320.43	$81,074.47	$48,320.43	nat. median $62,031 0.8× median
0266T CPT	Insertion Or Replacement Of Carotid Sinus Baroreflex Activation Device	20	$48,195.54	$48,195.54	$48,195.54	nat. median $42,739 1.1× median
33276 CPT	Insertion Of Phrenic Nerve Stimulator System (pulse Generator And Stimulating Le…	13	$517.85	$48,195.54	$48,195.54	nat. median $43,278 1.1× median
266 MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	13	$42,052.07	$47,415.56	$47,415.56	nat. median $58,280 0.8× median
573 MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	13	$47,203.01	$56,076.73	$47,203.01	nat. median $58,135 0.8× median
276 MS_DRG	Cardiac Defibrillator Implant With Mcc	13	$32,538.98	$47,143.04	$47,143.04	nat. median $56,687 0.8× median
17 MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	13	$46,891.01	$55,706.25	$46,891.01	nat. median $50,904 0.9× median
16 MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	13	$43,705.42	$46,891.01	$46,891.01	nat. median $53,927 0.9× median
21 MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	13	$46,620.76	$73,903.71	$46,620.76	nat. median $51,514 0.9× median

Other procedures at this hospital

Browse this hospital's 19,178 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

J1411	HCPCS	Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose	26	20	—	—	$3,973,410.00	$3,973,410.00	$3,973,410.00	2024-11-19
J1413	HCPCS	Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose	26	20	—	—	$3,530,016.00	$3,530,016.00	$3,530,016.00	2024-11-19
J3399	HCPCS	Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10^15 Vector Ge…	26	20	—	—	$2,466,282.38	$2,466,282.38	$2,466,282.38	2024-11-19
Q2042	HCPCS	Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka…	26	20	—	—	$485,518.88	$547,358.64	$516,438.76	2024-11-19
Q2056	HCPCS	Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige…	26	20	—	—	$481,836.12	$543,206.83	$512,521.47	2024-11-19
Q2055	HCPCS	Idecabtagene Vicleucel, Up To 460 Million Autologous B-cell Maturation Antigen (…	26	20	—	—	$460,455.79	$519,103.31	$489,779.55	2024-11-19
Q2054	HCPCS	Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi…	26	20	—	—	$450,160.84	$507,497.12	$478,828.98	2024-11-19
Q2041	HCPCS	Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via…	26	20	—	—	$426,968.00	$481,350.24	$454,159.12	2024-11-19
Q2053	HCPCS	Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V…	26	20	—	—	$426,968.00	$481,350.24	$454,159.12	2024-11-19
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell Immunotherapy	13	13	—	—	$241,757.74	$279,681.28	$279,681.28	2024-11-19
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	13	13	—	—	$205,711.61	$292,987.34	$205,711.61	2024-11-19
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	13	13	—	—	$200,094.86	$237,710.88	$200,094.86	2024-11-19
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	13	13	—	—	$161,847.23	$196,242.97	$161,847.23	2024-11-19
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	13	13	—	—	$111,591.03	$137,983.16	$111,591.03	2024-11-19
7	MS_DRG	Lung Transplant	13	13	—	—	$93,117.02	$110,621.98	$93,117.02	2024-11-19
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	13	13	—	—	$92,947.74	$110,421.30	$92,947.74	2024-11-19
14	MS_DRG	Allogeneic Bone Marrow Transplant	13	13	—	—	$87,002.29	$128,210.09	$87,002.29	2024-11-19
212	MS_DRG	Concomitant Aortic And Mitral Valve�procedures	13	13	—	—	$7,455.94	$81,762.82	$81,762.82	2024-11-19
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	13	13	—	—	$78,569.20	$90,766.29	$78,569.20	2024-11-19
215	MS_DRG	Other Heart Assist System Implant	13	13	—	—	$77,542.86	$84,223.56	$77,542.86	2024-11-19
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	13	13	—	—	$73,675.13	$81,527.82	$73,675.13	2024-11-19
A9543	HCPCS	Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil…	26	20	—	—	$70,125.42	$70,125.42	$70,125.42	2024-11-19
453	MS_DRG	Combined Anterior And Posterior Spinal Fusion With Mcc	13	13	—	—	$67,268.90	$90,559.12	$67,268.90	2024-11-19
J9029	HCPCS	Injection, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose	26	20	—	—	$66,187.80	$66,187.80	$66,187.80	2024-11-19
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	13	13	—	—	$64,164.08	$94,185.12	$64,164.08	2024-11-19
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	13	13	—	—	$49,726.55	$63,989.49	$63,989.49	2024-11-19
231	MS_DRG	Coronary Bypass With Ptca With Mcc	13	13	—	—	$61,604.32	$73,185.49	$61,604.32	2024-11-19
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	13	13	—	—	$60,680.47	$72,087.86	$60,680.47	2024-11-19
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	13	13	—	—	$59,208.53	$61,185.47	$59,208.53	2024-11-19
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	13	13	—	—	$58,537.47	$62,118.99	$58,537.47	2024-11-19
38240	CPT	Transplantation Of Donor Stem Cells, Per Donor	13	13	—	—	$227.42	$55,762.87	$55,762.87	2024-11-19
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	13	13	—	—	$54,903.55	$70,103.84	$54,903.55	2024-11-19
Q2043	HCPCS	Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm…	26	20	—	—	$50,755.33	$57,219.95	$53,987.64	2024-11-19
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	13	13	—	—	$42,353.49	$53,410.35	$53,410.35	2024-11-19
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	13	13	—	—	$52,872.13	$60,970.99	$52,872.13	2024-11-19
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	13	13	—	—	$38,504.87	$52,529.01	$52,529.01	2024-11-19
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	13	13	—	—	$52,440.19	$53,699.48	$52,440.19	2024-11-19
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	13	13	—	—	$52,171.46	$61,979.25	$52,171.46	2024-11-19
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	13	13	—	—	$13,528.25	$52,035.58	$52,035.58	2024-11-19
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	13	13	—	—	$51,760.78	$61,490.96	$51,760.78	2024-11-19
459	MS_DRG	Spinal Fusion Except Cervical With Mcc	13	13	—	—	$41,439.47	$50,347.29	$50,347.29	2024-11-19
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	13	13	—	—	$48,320.43	$81,074.47	$48,320.43	2024-11-19
33276	CPT	Insertion Of Phrenic Nerve Stimulator System (pulse Generator And Stimulating Le…	13	13	—	—	$517.85	$48,195.54	$48,195.54	2024-11-19
0266T	CPT	Insertion Or Replacement Of Carotid Sinus Baroreflex Activation Device	26	20	—	—	$48,195.54	$48,195.54	$48,195.54	2024-11-19
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	13	13	—	—	$42,052.07	$47,415.56	$47,415.56	2024-11-19
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	13	13	—	—	$47,203.01	$56,076.73	$47,203.01	2024-11-19
276	MS_DRG	Cardiac Defibrillator Implant With Mcc	13	13	—	—	$32,538.98	$47,143.04	$47,143.04	2024-11-19
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	13	13	—	—	$46,891.01	$55,706.25	$46,891.01	2024-11-19
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	13	13	—	—	$43,705.42	$46,891.01	$46,891.01	2024-11-19
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	13	13	—	—	$46,620.76	$73,903.71	$46,620.76	2024-11-19
454	MS_DRG	Combined Anterior And Posterior Spinal Fusion With Cc	13	13	—	—	$46,430.22	$49,573.00	$46,430.22	2024-11-19
955	MS_DRG	Craniotomy For Multiple Significant Trauma	13	13	—	—	$46,232.09	$102,193.53	$46,232.09	2024-11-19
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	13	13	—	—	$46,118.98	$52,556.35	$46,118.98	2024-11-19
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	13	13	—	—	$45,901.87	$50,946.05	$45,901.87	2024-11-19
28	MS_DRG	Spinal Procedures With Mcc	13	13	—	—	$34,631.06	$45,745.49	$45,745.49	2024-11-19
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	13	13	—	—	$5,664.46	$45,548.12	$45,548.12	2024-11-19
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	13	13	—	—	$45,157.17	$62,124.68	$45,157.17	2024-11-19
J9226	HCPCS	Histrelin Implant (supprelin La), 50 Mg	26	20	—	—	$42,347.14	$47,740.83	$45,043.99	2024-11-19
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	13	13	—	—	$44,640.97	$50,213.22	$44,640.97	2024-11-19
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	13	13	—	—	$43,244.94	$51,374.22	$43,244.94	2024-11-19
576	MS_DRG	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	13	13	—	—	$43,141.70	$51,251.54	$43,141.70	2024-11-19
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	13	13	—	—	$43,033.15	$50,489.45	$43,033.15	2024-11-19
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	13	13	—	—	$42,994.43	$44,638.12	$42,994.43	2024-11-19
834	MS_DRG	Acute Leukemia Without Major O.r. Procedures With Mcc	13	13	—	—	$42,503.28	$68,834.78	$42,503.28	2024-11-19
405	MS_DRG	Pancreas, Liver And Shunt Procedures With Mcc	13	13	—	—	$41,791.22	$55,618.51	$41,791.22	2024-11-19
653	MS_DRG	Major Bladder Procedures With Mcc	13	13	—	—	$41,095.86	$48,821.47	$41,095.86	2024-11-19
8	MS_DRG	Simultaneous Pancreas And Kidney Transplant	13	13	—	—	$39,942.76	$47,451.67	$39,942.76	2024-11-19
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	13	13	—	—	$39,812.95	$43,035.14	$39,812.95	2024-11-19
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	13	13	—	—	$39,458.44	$49,563.25	$39,458.44	2024-11-19
466	MS_DRG	Revision Of Hip Or Knee Replacement With Mcc	13	13	—	—	$39,372.66	$61,878.50	$39,372.66	2024-11-19
11	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	13	13	—	—	$39,142.64	$47,434.61	$39,142.64	2024-11-19
326	MS_DRG	Stomach, Esophageal And Duodenal Procedures With Mcc	13	13	—	—	$34,486.45	$38,555.84	$38,555.84	2024-11-19
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	12	12	—	—	$38,388.07	$38,388.07	$38,388.07	2024-11-19
228	MS_DRG	Other Cardiothoracic Procedures With Mcc	13	13	—	—	$38,249.91	$52,172.05	$38,249.91	2024-11-19
853	MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	13	13	—	—	$37,950.82	$40,807.38	$37,950.82	2024-11-19
799	MS_DRG	Splenectomy With Mcc	13	13	—	—	$37,611.49	$40,789.50	$37,611.49	2024-11-19
471	MS_DRG	Cervical Spinal Fusion With Mcc	13	13	—	—	$33,901.48	$37,341.24	$37,341.24	2024-11-19
267	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	12	12	—	—	$37,046.70	$37,046.70	$37,046.70	2024-11-19
6	MS_DRG	Liver Transplant Without Mcc	13	13	—	—	$36,718.00	$59,221.76	$36,718.00	2024-11-19
10	MS_DRG	Pancreas Transplant	13	13	—	—	$36,541.13	$43,410.50	$36,541.13	2024-11-19
239	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	13	13	—	—	$35,103.92	$36,489.51	$36,489.51	2024-11-19
277	MS_DRG	Cardiac Defibrillator Implant Without Mcc	13	13	—	—	$36,304.28	$38,243.26	$36,304.28	2024-11-19
837	MS_DRG	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	13	13	—	—	$36,108.43	$37,578.67	$36,108.43	2024-11-19
981	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	13	13	—	—	$35,985.45	$42,322.61	$35,985.45	2024-11-19
163	MS_DRG	Major Chest Procedures With Mcc	13	13	—	—	$30,377.84	$35,782.01	$35,782.01	2024-11-19
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	13	13	—	—	$32,972.02	$35,288.58	$35,288.58	2024-11-19
455	MS_DRG	Combined Anterior And Posterior Spinal Fusion Without Cc/mcc	13	13	—	—	$34,962.15	$36,083.74	$34,962.15	2024-11-19
245	MS_DRG	Aicd Generator Procedures	13	13	—	—	$34,398.88	$40,865.88	$34,398.88	2024-11-19
458	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	13	13	—	—	$34,395.85	$39,762.56	$34,395.85	2024-11-19
329	MS_DRG	Major Small And Large Bowel Procedures With Mcc	13	13	—	—	$34,288.05	$36,951.45	$34,288.05	2024-11-19
69930	CPT	Implantation Of Cochlear Device	13	13	—	—	$1,176.47	$34,219.95	$34,219.95	2024-11-19
823	MS_DRG	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	13	13	—	—	$34,174.94	$38,273.32	$34,174.94	2024-11-19
650	MS_DRG	Kidney Transplant With Hemodialysis With Mcc	13	13	—	—	$17,363.06	$34,141.54	$34,141.54	2024-11-19
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	13	13	—	—	$30,428.21	$33,859.91	$33,859.91	2024-11-19
856	MS_DRG	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	13	13	—	—	$25,775.26	$33,616.99	$33,616.99	2024-11-19
0571T	CPT	Insertion Or Replacement Of Implantable Cardioverter-defibrillator System With E…	26	20	—	—	$33,571.54	$33,571.54	$33,571.54	2024-11-19
33231	CPT	Insertion Of Pacing Defibrillator Pulse Generator With Existing Multiple Leads	13	13	—	—	$379.55	$33,571.54	$33,571.54	2024-11-19
33264	CPT	Removal And Replacement Of Defibrillator Pulse Generator, Multiple Wires (leads)	13	13	—	—	$383.71	$33,571.54	$33,571.54	2024-11-19
0408T	CPT	Insertion Or Replacement Of Pulse Generator And Electrodes Of Heart Contractilit…	26	20	—	—	$33,571.54	$33,571.54	$33,571.54	2024-11-19
33249	CPT	Insertion Or Replacement Of Single Or Dual Chamber Pacing Defibrillator Leads	13	13	—	—	$866.86	$33,571.54	$33,571.54	2024-11-19
33270	CPT	Insertion Or Replacement Of Defibrillator With Electrode	13	13	—	—	$533.62	$33,571.54	$33,571.54	2024-11-19
25	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Mcc	13	13	—	—	$33,522.86	$37,255.31	$33,522.86	2024-11-19
826	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	13	13	—	—	$33,316.38	$43,830.54	$33,316.38	2024-11-19
319	MS_DRG	Other Endovascular Cardiac Valve Procedures With Mcc	13	13	—	—	$33,112.17	$39,336.83	$33,112.17	2024-11-19
901	MS_DRG	Wound Debridements For Injuries With Mcc	13	13	—	—	$32,853.31	$39,029.72	$32,853.31	2024-11-19
474	MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	13	13	—	—	$32,663.53	$38,803.85	$32,663.53	2024-11-19
356	MS_DRG	Other Digestive System O.r. Procedures With Mcc	13	13	—	—	$30,881.57	$32,480.58	$32,480.58	2024-11-19
793	MS_DRG	Full Term Neonate With Major Problems	13	13	—	—	$31,953.75	$37,960.52	$31,953.75	2024-11-19
0268T	CPT	Implantation Or Replacement Of Carotid Sinus Baroreflex Activation Device Pulse …	26	20	—	—	$31,686.92	$31,686.92	$31,686.92	2024-11-19
33287	CPT	Removal And Replacement Of Phrenic Nerve Stimulator, Including Vessel Catheteriz…	13	13	—	—	$347.88	$31,686.92	$31,686.92	2024-11-19
64582	CPT	Insertion Of Hypoglossal Nerve Neurostimulator Electrode And Generator And Breat…	13	13	—	—	$827.06	$31,686.92	$31,686.92	2024-11-19
61886	CPT	Insertion Or Replacement Of Brain Neurostimulator Generator Or Receiver With Con…	13	13	—	—	$854.15	$31,686.92	$31,686.92	2024-11-19
63685	CPT	Insertion Of Spinal Neurostimulator Pulse Generator Or Receiver	13	13	—	—	$348.18	$31,686.92	$31,686.92	2024-11-19
64568	CPT	Implantation Of Cranial Nerve Neurostimulator Electrodes And Generator	13	13	—	—	$578.19	$31,686.92	$31,686.92	2024-11-19
269	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	12	12	—	—	$31,568.87	$31,568.87	$31,568.87	2024-11-19
323	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	13	13	—	—	$31,427.68	$52,132.24	$31,427.68	2024-11-19
31	MS_DRG	Ventricular Shunt Procedures With Mcc	13	13	—	—	$19,663.95	$31,250.04	$31,250.04	2024-11-19
791	MS_DRG	Prematurity With Major Problems	13	13	—	—	$2,456.88	$31,106.57	$31,106.57	2024-11-19
166	MS_DRG	Other Respiratory System O.r. Procedures With Mcc	13	13	—	—	$30,803.68	$43,885.79	$30,803.68	2024-11-19
958	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Cc	13	13	—	—	$30,704.99	$37,423.49	$30,704.99	2024-11-19
236	MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	13	13	—	—	$30,677.66	$38,516.24	$30,677.66	2024-11-19
628	MS_DRG	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	13	13	—	—	$30,474.98	$36,203.99	$30,474.98	2024-11-19
12	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	13	13	—	—	$28,801.67	$30,402.10	$30,402.10	2024-11-19
616	MS_DRG	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	13	13	—	—	$30,043.80	$42,794.65	$30,043.80	2024-11-19
423	MS_DRG	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	13	13	—	—	$29,688.53	$67,262.67	$29,688.53	2024-11-19
33289	CPT	Insertion Of Wireless Pressure Sensor Into Lung Artery Through Tube With Review …	13	13	—	—	$313.27	$29,658.64	$29,658.64	2024-11-19
34	MS_DRG	Carotid Artery Stent Procedures With Mcc	13	13	—	—	$27,331.93	$29,616.41	$29,616.41	2024-11-19
273	MS_DRG	Percutaneous And Other Intracardiac Procedures With Mcc	13	13	—	—	$29,583.01	$37,808.59	$29,583.01	2024-11-19
736	MS_DRG	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	13	13	—	—	$29,508.62	$35,055.98	$29,508.62	2024-11-19
C9760	HCPCS	Non-randomized, Non-blinded Procedure For Nyha Class Ii, Iii, IV Heart Failure; …	26	20	—	—	$29,453.04	$29,453.04	$29,453.04	2024-11-19
0620T	CPT	Insertion Of Stent To Shunt Arterial Blood To Deep Vein Of Lower Leg Via Cathete…	26	20	—	—	$29,453.04	$29,453.04	$29,453.04	2024-11-19
956	MS_DRG	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	13	13	—	—	$29,440.29	$70,942.29	$29,440.29	2024-11-19
40	MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	13	13	—	—	$28,055.83	$29,230.02	$29,230.02	2024-11-19
622	MS_DRG	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	13	13	—	—	$29,041.00	$34,500.26	$29,041.00	2024-11-19
24	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	13	13	—	—	$28,761.64	$37,045.69	$28,761.64	2024-11-19
140	MS_DRG	Major Head And Neck Procedures With Mcc	13	13	—	—	$4,166.29	$28,680.41	$28,680.41	2024-11-19
876	MS_DRG	O.r. Procedures With Principal Diagnosis Of Mental Illness	13	13	—	—	$28,326.66	$29,971.61	$28,326.66	2024-11-19
408	MS_DRG	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	13	13	—	—	$28,256.06	$47,935.89	$28,256.06	2024-11-19
907	MS_DRG	Other O.r. Procedures For Injuries With Mcc	13	13	—	—	$28,235.57	$30,485.90	$28,235.57	2024-11-19
673	MS_DRG	Other Kidney And Urinary Tract Procedures With Mcc	13	13	—	—	$28,072.36	$30,307.16	$28,072.36	2024-11-19
460	MS_DRG	Spinal Fusion Except Cervical Without Mcc	13	13	—	—	$27,767.95	$29,303.77	$27,767.95	2024-11-19
518	MS_DRG	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	13	13	—	—	$27,721.64	$29,187.59	$27,721.64	2024-11-19
97	MS_DRG	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	13	13	—	—	$27,608.53	$30,758.07	$27,608.53	2024-11-19
332	MS_DRG	Rectal Resection With Mcc	13	13	—	—	$27,537.93	$32,955.77	$27,537.93	2024-11-19
94	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System With Mcc	13	13	—	—	$26,131.93	$27,500.74	$27,500.74	2024-11-19
739	MS_DRG	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	13	13	—	—	$27,452.15	$32,612.92	$27,452.15	2024-11-19
495	MS_DRG	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	13	13	—	—	$27,185.70	$32,296.06	$27,185.70	2024-11-19
335	MS_DRG	Peritoneal Adhesiolysis With Mcc	13	13	—	—	$22,961.72	$27,138.64	$27,138.64	2024-11-19
265	MS_DRG	Aicd Lead Procedures	13	13	—	—	$26,828.15	$31,871.95	$26,828.15	2024-11-19
414	MS_DRG	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	13	13	—	—	$26,760.59	$31,791.52	$26,760.59	2024-11-19
467	MS_DRG	Revision Of Hip Or Knee Replacement With Cc	13	13	—	—	$26,465.29	$30,470.46	$26,465.29	2024-11-19
22	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	13	13	—	—	$26,392.42	$35,844.88	$26,392.42	2024-11-19
492	MS_DRG	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc	13	13	—	—	$26,281.59	$30,164.98	$26,281.59	2024-11-19
651	MS_DRG	Kidney Transplant With Hemodialysis Without Mcc	13	13	—	—	$26,253.50	$124,857.89	$26,253.50	2024-11-19
271	MS_DRG	Other Major Cardiovascular Procedures With Cc	12	12	—	—	$26,236.80	$26,236.80	$26,236.80	2024-11-19
242	MS_DRG	Permanent Cardiac Pacemaker Implant With Mcc	13	13	—	—	$26,228.45	$29,460.58	$26,228.45	2024-11-19
J9266	HCPCS	Injection, Pegaspargase, Per Single Dose Vial	26	20	—	—	$24,492.39	$27,611.94	$26,052.17	2024-11-19
29	MS_DRG	Spinal Procedures With Cc Or Spinal Neurostimulators	13	13	—	—	$21,809.65	$26,024.24	$26,024.24	2024-11-19
574	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Cc	13	13	—	—	$15,114.99	$25,854.20	$25,854.20	2024-11-19
802	MS_DRG	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	13	13	—	—	$25,736.54	$45,211.72	$25,736.54	2024-11-19
987	MS_DRG	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	13	13	—	—	$25,633.29	$32,300.12	$25,633.29	2024-11-19
37	MS_DRG	Extracranial Procedures With Mcc	13	13	—	—	$25,624.94	$30,442.03	$25,624.94	2024-11-19
477	MS_DRG	Biopsies Of Musculoskeletal System And Connective Tissue With Mcc	13	13	—	—	$25,574.84	$26,002.75	$25,574.84	2024-11-19
252	MS_DRG	Other Vascular Procedures With Mcc	13	13	—	—	$25,459.46	$38,706.36	$25,459.46	2024-11-19
579	MS_DRG	Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc	13	13	—	—	$22,253.25	$25,371.40	$25,371.40	2024-11-19
469	MS_DRG	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…	13	13	—	—	$25,277.27	$26,834.71	$25,277.27	2024-11-19
143	MS_DRG	Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc	13	13	—	—	$11,151.81	$25,245.38	$25,245.38	2024-11-19
260	MS_DRG	Cardiac Pacemaker Revision Except Device Replacement With Mcc	13	13	—	—	$25,166.43	$25,964.56	$25,166.43	2024-11-19
485	MS_DRG	Knee Procedures With Principal Diagnosis Of Infection With Mcc	13	13	—	—	$25,005.50	$29,705.94	$25,005.50	2024-11-19
264	MS_DRG	Other Circulatory System O.r. Procedures	13	13	—	—	$24,792.95	$32,613.73	$24,792.95	2024-11-19
904	MS_DRG	Skin Grafts For Injuries With Cc/mcc	13	13	—	—	$24,718.55	$28,464.50	$24,718.55	2024-11-19
500	MS_DRG	Soft Tissue Procedures With Mcc	13	13	—	—	$22,434.43	$24,616.83	$24,616.83	2024-11-19
274	MS_DRG	Percutaneous And Other Intracardiac Procedures Without Mcc	13	13	—	—	$24,601.65	$29,082.78	$24,601.65	2024-11-19
J9600	HCPCS	Injection, Porfimer Sodium, 75 Mg	26	20	—	—	$24,448.96	$24,448.96	$24,448.96	2024-11-19
929	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc	13	13	—	—	$17,742.48	$24,409.59	$24,409.59	2024-11-19
939	MS_DRG	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	13	13	—	—	$24,408.07	$28,996.66	$24,408.07	2024-11-19
420	MS_DRG	Hepatobiliary Diagnostic Procedures With Mcc	13	13	—	—	$24,298.00	$26,071.81	$24,298.00	2024-11-19
279	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	13	13	—	—	$21,349.80	$24,296.48	$24,296.48	2024-11-19
93656	CPT	Comprehensive Electrophysiologic Evaluation With Catheter Destruction Of Abnorma…	13	13	—	—	$899.04	$24,235.86	$24,235.86	2024-11-19
93653	CPT	Comprehensive Electrophysiologic Evaluation With Catheter Destruction Of Abnorma…	13	13	—	—	$792.80	$24,235.86	$24,235.86	2024-11-19
93654	CPT	Comprehensive Electrophysiologic Evaluation With Catheter Destruction Of Abnorma…	13	13	—	—	$955.53	$24,235.86	$24,235.86	2024-11-19
229	MS_DRG	Other Cardiothoracic Procedures Without Mcc	13	13	—	—	$24,137.06	$34,670.06	$24,137.06	2024-11-19
33263	CPT	Removal And Replacement Of Defibrillator Pulse Generator, Two Wires (leads)	13	13	—	—	$367.98	$24,053.21	$24,053.21	2024-11-19
0414T	CPT	Replacement Of Pulse Generator Of Heart Contractility Modulator System	26	20	—	—	$24,053.21	$24,053.21	$24,053.21	2024-11-19
0614T	CPT	Removal And Replacement Of Substernal Implantable Defibrillator Pulse Generator	26	20	—	—	$24,053.21	$24,053.21	$24,053.21	2024-11-19
33240	CPT	Insertion Of Pacing Defibrillator Pulse Generator With Existing Single Lead	13	13	—	—	$347.73	$24,053.21	$24,053.21	2024-11-19
33262	CPT	Removal And Replacement Of Defibrillator Pulse Generator, Single Wire (lead)	13	13	—	—	$354.49	$24,053.21	$24,053.21	2024-11-19
0409T	CPT	Insertion Or Replacement Of Pulse Generator Of Heart Contractility Modulator Sys…	26	20	—	—	$24,053.21	$24,053.21	$24,053.21	2024-11-19
33230	CPT	Insertion Of Pacing Defibrillator Pulse Generator With Existing Dual Leads	13	13	—	—	$364.14	$24,053.21	$24,053.21	2024-11-19
0515T	CPT	Insertion Of Complete Wireless Heart Stimulator System For Pacing Of Lower Left …	26	20	—	—	$24,053.21	$24,053.21	$24,053.21	2024-11-19
515	MS_DRG	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc	13	13	—	—	$23,999.66	$27,012.64	$23,999.66	2024-11-19
829	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…	13	13	—	—	$21,980.27	$23,941.21	$23,941.21	2024-11-19
656	MS_DRG	Kidney And Ureter Procedures For Neoplasm With Mcc	13	13	—	—	$17,445.93	$23,818.23	$23,818.23	2024-11-19
840	MS_DRG	Lymphoma And Non-acute Leukemia With Mcc	13	13	—	—	$23,724.10	$33,931.54	$23,724.10	2024-11-19
665	MS_DRG	Prostatectomy With Mcc	13	13	—	—	$23,450.06	$27,858.41	$23,450.06	2024-11-19
173	MS_DRG	Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…	13	13	—	—	$23,343.02	$27,731.66	$23,343.02	2024-11-19
933	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	13	13	—	—	$23,016.60	$27,343.31	$23,016.60	2024-11-19
652	MS_DRG	Kidney Transplant	13	13	—	—	$22,807.08	$31,850.83	$22,807.08	2024-11-19
464	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	13	13	—	—	$22,784.31	$30,115.42	$22,784.31	2024-11-19
662	MS_DRG	Minor Bladder Procedures With Mcc	13	13	—	—	$22,748.63	$27,024.82	$22,748.63	2024-11-19
521	MS_DRG	Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc	13	13	—	—	$22,729.65	$27,515.55	$22,729.65	2024-11-19
324	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc	13	13	—	—	$22,535.32	$27,405.05	$22,535.32	2024-11-19
472	MS_DRG	Cervical Spinal Fusion With Cc	13	13	—	—	$22,435.11	$23,752.24	$22,435.11	2024-11-19
26	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Cc	13	13	—	—	$22,417.65	$23,643.37	$22,417.65	2024-11-19
480	MS_DRG	Hip And Femur Procedures Except Major Joint With Mcc	13	13	—	—	$22,385.77	$33,087.39	$22,385.77	2024-11-19
63655	CPT	Removal Of Spine Bone For Insertion Of Neurostimulator Electrode Plate In Spine	13	13	—	—	$812.48	$22,322.68	$22,322.68	2024-11-19
0816T	CPT	Open Insertion Or Replacement Of Integrated Neurostimulation System For Bladder …	26	20	—	—	$22,322.68	$22,322.68	$22,322.68	2024-11-19
64590	CPT	Insertion Or Replacement Of Peripheral Or Gastric Neurostimulator Generator	13	13	—	—	$153.96	$22,322.68	$22,322.68	2024-11-19
0817T	CPT	Open Insertion Or Replacement Of Integrated Neurostimulation System For Bladder …	26	20	—	—	$22,322.68	$22,322.68	$22,322.68	2024-11-19
61891	CPT	Revision Or Replacement Of Skull-mounted Cranial Neurostimulator Pulse Generator…	13	13	—	—	$545.62	$22,322.68	$22,322.68	2024-11-19
61885	CPT	Insertion Or Replacement Of Brain Neurostimulator Generator Or Receiver With Con…	13	13	—	—	$513.10	$22,322.68	$22,322.68	2024-11-19
64580	CPT	Incision To Implant Muscle Neurostimulator Electrodes	13	13	—	—	$303.79	$22,322.68	$22,322.68	2024-11-19
353	MS_DRG	Hernia Procedures Except Inguinal And Femoral With Mcc	13	13	—	—	$22,199.02	$26,726.65	$22,199.02	2024-11-19
570	MS_DRG	Skin Debridement With Mcc	13	13	—	—	$22,183.08	$26,352.92	$22,183.08	2024-11-19
625	MS_DRG	Thyroid, Parathyroid And Thyroglossal Procedures With Mcc	13	13	—	—	$19,403.96	$22,175.49	$22,175.49	2024-11-19
974	MS_DRG	HIV With Major Related Condition With Mcc	13	13	—	—	$22,139.81	$24,574.45	$22,139.81	2024-11-19
406	MS_DRG	Pancreas, Liver And Shunt Procedures With Cc	13	13	—	—	$21,918.91	$23,555.62	$21,918.91	2024-11-19
411	MS_DRG	Cholecystectomy With C.d.e. With Mcc	13	13	—	—	$21,866.53	$27,418.87	$21,866.53	2024-11-19
321	MS_DRG	Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A…	13	13	—	—	$21,822.50	$27,799.10	$21,822.50	2024-11-19
462	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc	13	13	—	—	$21,606.91	$23,929.35	$21,606.91	2024-11-19
263	MS_DRG	Vein Ligation And Stripping	13	13	—	—	$21,446.73	$25,478.71	$21,446.73	2024-11-19
668	MS_DRG	Transurethral Procedures With Mcc	13	13	—	—	$21,392.08	$25,413.72	$21,392.08	2024-11-19
800	MS_DRG	Splenectomy With Cc	13	13	—	—	$21,389.80	$21,629.28	$21,389.80	2024-11-19
240	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc	13	13	—	—	$21,325.27	$29,616.57	$21,325.27	2024-11-19
61	MS_DRG	Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…	13	13	—	—	$21,276.69	$22,172.01	$21,276.69	2024-11-19
255	MS_DRG	Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc	13	13	—	—	$20,856.14	$24,776.75	$20,856.14	2024-11-19
344	MS_DRG	Minor Small And Large Bowel Procedures With Mcc	13	13	—	—	$19,289.40	$20,803.00	$20,803.00	2024-11-19
654	MS_DRG	Major Bladder Procedures With Cc	13	13	—	—	$17,940.72	$20,780.98	$20,780.98	2024-11-19
963	MS_DRG	Other Multiple Significant Trauma With Mcc	13	13	—	—	$20,679.52	$20,756.69	$20,756.69	2024-11-19
510	MS_DRG	Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc	13	13	—	—	$20,652.69	$24,535.45	$20,652.69	2024-11-19
54410	CPT	Removal And Replacement Of All Components Of A Multi-component Inflatable Penile…	13	13	—	—	$818.68	$20,584.08	$20,584.08	2024-11-19
54401	CPT	Insertion Of Inflatable Penile Prosthesis	13	13	—	—	$632.67	$20,584.08	$20,584.08	2024-11-19
54416	CPT	Removal And Replacement Of Non-inflatable Penile Prosthesis	13	13	—	—	$680.49	$20,584.08	$20,584.08	2024-11-19
53447	CPT	Removal And Replacement Of Inflatable Bladder Canal (urethra) Or Bladder Neck Sp…	13	13	—	—	$764.67	$20,584.08	$20,584.08	2024-11-19
53444	CPT	Insertion Of Tandem Cuff Artificial Urinary Sphincter	13	13	—	—	$751.80	$20,584.08	$20,584.08	2024-11-19
54405	CPT	Insertion Of Multi-component Inflatable Penile Prosthesis	13	13	—	—	$766.57	$20,584.08	$20,584.08	2024-11-19
54411	CPT	Removal And Replacement Of Infected Components Of Inflatable Penile Prosthesis	13	13	—	—	$976.44	$20,584.08	$20,584.08	2024-11-19
53445	CPT	Insertion Of Inflatable Bladder Canal (urethra) Or Bladder Neck Sphincter	13	13	—	—	$718.73	$20,584.08	$20,584.08	2024-11-19
258	MS_DRG	Cardiac Pacemaker Device Replacement With Mcc	13	13	—	—	$20,561.60	$24,426.58	$20,561.60	2024-11-19
208	MS_DRG	Respiratory System Diagnosis With Ventilator Support <=96 Hours	13	13	—	—	$17,817.23	$20,525.16	$20,525.16	2024-11-19
849	MS_DRG	Radiotherapy	13	13	—	—	$20,431.03	$24,272.21	$20,431.03	2024-11-19
13	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc	13	13	—	—	$20,387.76	$24,220.22	$20,387.76	2024-11-19
503	MS_DRG	Foot Procedures With Mcc	13	13	—	—	$20,358.91	$24,186.09	$20,358.91	2024-11-19
468	MS_DRG	Revision Of Hip Or Knee Replacement Without Cc/mcc	13	13	—	—	$20,265.54	$22,925.97	$20,265.54	2024-11-19
135	MS_DRG	Sinus And Mastoid Procedures With Cc/mcc	13	13	—	—	$20,132.69	$23,917.17	$20,132.69	2024-11-19
577	MS_DRG	Skin Graft Except For Skin Ulcer Or Cellulitis With Cc	13	13	—	—	$20,109.92	$26,447.17	$20,109.92	2024-11-19
325	MS_DRG	Coronary Intravascular Lithotripsy Without Intraluminal Device	13	13	—	—	$20,073.48	$23,847.30	$20,073.48	2024-11-19
0823T	CPT	Transcatheter Insertion Of Permanent Single-chamber Leadless Pacemaker, Right At…	26	20	—	—	$19,883.49	$19,883.49	$19,883.49	2024-11-19
0802T	CPT	Transcatheter Removal And Replacement Of Permanent Dual-chamber Leadless Pacemak…	26	20	—	—	$19,883.49	$19,883.49	$19,883.49	2024-11-19
33221	CPT	Insertion Of Pacemaker Pulse Generator With Existing Multiple Leads	13	13	—	—	$341.68	$19,883.49	$19,883.49	2024-11-19
0801T	CPT	Transcatheter Removal And Replacement Of Permanent Dual-chamber Leadless Pacemak…	26	20	—	—	$19,883.49	$19,883.49	$19,883.49	2024-11-19
0825T	CPT	Transcatheter Removal And Replacement Of Permanent Single-chamber Leadless Pacem…	26	20	—	—	$19,883.49	$19,883.49	$19,883.49	2024-11-19
0796T	CPT	Transcatheter Insertion Of Permanent Dual-chamber Leadless Pacemaker, Including …	26	20	—	—	$19,883.49	$19,883.49	$19,883.49	2024-11-19
0803T	CPT	Transcatheter Removal And Replacement Of Permanent Dual-chamber Leadless Pacemak…	26	20	—	—	$19,883.49	$19,883.49	$19,883.49	2024-11-19
0795T	CPT	Transcatheter Insertion Of Permanent Dual-chamber Leadless Pacemaker, Including …	26	20	—	—	$19,883.49	$19,883.49	$19,883.49	2024-11-19
33274	CPT	Insertion Or Replacement Of Permanent Leadless Pacemaker Into Lower Right Chambe…	13	13	—	—	$455.27	$19,883.49	$19,883.49	2024-11-19
33229	CPT	Removal And Replacement Of Multiple Lead Permanent Pacemaker Pulse Generator	13	13	—	—	$355.79	$19,883.49	$19,883.49	2024-11-19
0797T	CPT	Transcatheter Insertion Of Permanent Dual-chamber Leadless Pacemaker, Including …	26	20	—	—	$19,883.49	$19,883.49	$19,883.49	2024-11-19
498	MS_DRG	Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…	13	13	—	—	$19,820.69	$23,546.69	$19,820.69	2024-11-19
288	MS_DRG	Acute And Subacute Endocarditis With Mcc	13	13	—	—	$19,684.05	$23,384.19	$19,684.05	2024-11-19
659	MS_DRG	Kidney And Ureter Procedures For Non-neoplasm With Mcc	13	13	—	—	$15,613.84	$19,652.93	$19,652.93	2024-11-19
619	MS_DRG	O.r. Procedures For Obesity With Mcc	13	13	—	—	$19,649.89	$28,969.04	$19,649.89	2024-11-19
253	MS_DRG	Other Vascular Procedures With Cc	13	13	—	—	$19,365.98	$23,823.74	$19,365.98	2024-11-19
164	MS_DRG	Major Chest Procedures With Cc	13	13	—	—	$19,360.66	$20,985.82	$19,360.66	2024-11-19
347	MS_DRG	Anal And Stomal Procedures With Mcc	13	13	—	—	$15,371.72	$19,350.80	$19,350.80	2024-11-19
959	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc	13	13	—	—	$19,224.02	$28,843.92	$19,224.02	2024-11-19
749	MS_DRG	Other Female Reproductive System O.r. Procedures With Cc/mcc	13	13	—	—	$15,084.93	$19,108.64	$19,108.64	2024-11-19
113	MS_DRG	Orbital Procedures With Cc/mcc	13	13	—	—	$15,877.07	$19,033.48	$19,033.48	2024-11-19
27278	CPT	Arthrodesis, Sacroiliac Joint, Percutaneous, With Image Guidance, Including Plac…	13	13	—	—	$426.75	$19,016.98	$19,016.98	2024-11-19
27702	CPT	Reconstruction Of Ankle Joint With Prosthesis	13	13	—	—	$925.34	$19,016.98	$19,016.98	2024-11-19
27279	CPT	Fusion Sacroiliac Joint Through The Skin Or Minimally Invasive Using Image Guida…	13	13	—	—	$783.69	$19,016.98	$19,016.98	2024-11-19
25442	CPT	Arthroplasty Or Replacement Of The End Of The Forearm Bone On The Small Finger S…	13	13	—	—	$784.04	$19,016.98	$19,016.98	2024-11-19
327	MS_DRG	Stomach, Esophageal And Duodenal Procedures With Cc	13	13	—	—	$18,958.33	$22,137.88	$18,958.33	2024-11-19
545	MS_DRG	Connective Tissue Disorders With Mcc	13	13	—	—	$18,926.45	$23,385.82	$18,926.45	2024-11-19
982	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc	13	13	—	—	$18,871.79	$21,615.47	$18,871.79	2024-11-19
483	MS_DRG	Major Joint Or Limb Reattachment Procedures Of Upper Extremities	13	13	—	—	$18,858.13	$19,020.48	$18,858.13	2024-11-19
792	MS_DRG	Prematurity Without Major Problems	13	13	—	—	$1,672.85	$18,769.31	$18,769.31	2024-11-19
0686T	CPT	Acoustic Energy Destruction Of Malignant Liver Tissue Using Imaging Guidance	26	20	—	—	$18,743.04	$18,743.04	$18,743.04	2024-11-19
C9758	HCPCS	Blinded Procedure For Nyha Class Iii/iv Heart Failure; Transcatheter Implantatio…	26	20	—	—	$18,743.04	$18,743.04	$18,743.04	2024-11-19
C9782	HCPCS	Blinded Procedure For New York Heart Association (nyha) Class Ii Or Iii Heart Fa…	26	20	—	—	$18,743.04	$18,743.04	$18,743.04	2024-11-19
473	MS_DRG	Cervical Spinal Fusion Without Cc/mcc	13	13	—	—	$18,678.97	$18,805.18	$18,678.97	2024-11-19
846	MS_DRG	Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc	13	13	—	—	$14,589.33	$18,552.96	$18,552.96	2024-11-19
272	MS_DRG	Other Major Cardiovascular Procedures Without Cc/mcc	13	13	—	—	$18,518.80	$21,093.06	$18,518.80	2024-11-19
A9604	HCPCS	Samarium Sm-153 Lexidronam, Therapeutic, Per Treatment Dose, Up To 150 Millicuri…	26	20	—	—	$18,485.30	$18,485.30	$18,485.30	2024-11-19
27	MS_DRG	Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc	13	13	—	—	$18,468.70	$22,021.70	$18,468.70	2024-11-19
C2616	HCPCS	Brachytherapy Source, Non-stranded, Yttrium-90, Per Source	26	20	—	—	$18,396.58	$18,396.58	$18,396.58	2024-11-19
970	MS_DRG	HIV With Extensive O.r. Procedures Without Mcc	13	13	—	—	$18,252.35	$25,067.61	$18,252.35	2024-11-19
493	MS_DRG	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc	13	13	—	—	$18,231.85	$24,420.89	$18,231.85	2024-11-19
350	MS_DRG	Inguinal And Femoral Hernia Procedures With Mcc	13	13	—	—	$18,218.94	$21,643.91	$18,218.94	2024-11-19
62362	CPT	Implantation Or Replacement Of Programmable Spinal Canal Drug Infusion Pump	13	13	—	—	$370.93	$18,198.84	$18,198.84	2024-11-19
62361	CPT	Implantation Or Replacement Of Spinal Canal Drug Infusion Pump	13	13	—	—	$422.54	$18,198.84	$18,198.84	2024-11-19
62360	CPT	Implantation Or Replacement Of Spinal Canal Drug Infusion Device Beneath Skin	13	13	—	—	$307.04	$18,198.84	$18,198.84	2024-11-19
56	MS_DRG	Degenerative Nervous System Disorders With Mcc	13	13	—	—	$18,173.40	$21,120.68	$18,173.40	2024-11-19
95	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System With Cc	13	13	—	—	$17,943.97	$18,099.00	$18,099.00	2024-11-19
478	MS_DRG	Biopsies Of Musculoskeletal System And Connective Tissue With Cc	13	13	—	—	$18,095.21	$20,443.09	$18,095.21	2024-11-19
674	MS_DRG	Other Kidney And Urinary Tract Procedures With Cc	13	13	—	—	$18,083.82	$20,174.98	$18,083.82	2024-11-19
330	MS_DRG	Major Small And Large Bowel Procedures With Cc	13	13	—	—	$18,007.15	$18,682.49	$18,007.15	2024-11-19
C9774	HCPCS	Revascularization, Endovascular, Open Or Percutaneous, Tibial/peroneal Artery(ie…	26	20	—	—	$17,893.53	$17,893.53	$17,893.53	2024-11-19
33902	CPT	Percutaneous Pulmonary Artery Revascularization By Stent Placement, Initial; Abn…	13	13	—	—	$697.90	$17,893.53	$17,893.53	2024-11-19
C9607	HCPCS	Percutaneous Transluminal Revascularization Of Chronic Total Occlusion, Coronary…	26	20	—	—	$17,893.53	$17,893.53	$17,893.53	2024-11-19

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