Hospital

CHI HEALTH SCHUYLER

Schuyler, NE · CCN 281323 · Rates published

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HC ECHO W PW CW CF DOPPLER

This hospital’s price: $544 across 18 payers · range $103-$3,030

Source: https://www.chihealth.com/content/dam/chihealthcom/documents/patients-and-visitors/financial-assistance/price-transparency-standard-charges/470399853_chi-health-schuyler_standardcharges.json · observed 2026-02-28

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.

5,833 distinct procedures filed

18 distinct payers

2,029,380 rate rows

2026-02-28 last MRF observed

Data quality

1,978,078 of 2,029,380 rate rows are consumer-grade (97.5%)

51,302 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
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	29,070
per-diem day rate — not a per-procedure price	17,002
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	2,888
template filing: same amount across many unrelated codes — excluded	1,436
placeholder amount (≤ $0.02) — excluded from medians	662
exceeds 10× this hospital's gross charge — excluded from medians	180
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	64

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

Source MRF file	https://www.chihealth.com/content/dam/chihealthcom/documents/patients-and-visitors/financial-assistance/price-transparency-standard-charges/470399853_chi-health-schuyler_standardcharges.json
Found on page	https://www.chihealth.com/patients-visitors/financial-assistance
Discovered via	CMS hospital list
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-10-20
Content fingerprint	3a04f3aafc9d4fd8… · 222,376,119 bytes · first seen 2026-05-04

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
J0225 HCPCS	Vutrisiran 25 Mg/0.5 Ml Subcutaneous Syringe	18	$127,824.93	$675,646.02	$569,901.03	nat. median $8,223 outlier · 69.3×
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	2	$234,161.40	$238,752.80	$236,457.10	nat. median $359,454 0.7× median
A9513 HCPCS	Lutetium Lu 177 Dotatate 10 Mci/ml (370 Mbq/ml) Intravenous Solution	18	$50,872.50	$268,897.50	$226,812.50	nat. median $479 outlier · 473.3×
J1823 HCPCS	Inebilizumab-cdon 10 Mg/ml Intravenous Solution	18	$46,766.93	$247,196.63	$208,508.02	nat. median $818 outlier · 255.0×
J2351 HCPCS	Ocrelizumab 920 Mg-hyaluronidase-ocsq 23000 Unit/23 Ml Subcut Soln	18	$44,212.94	$233,696.94	$197,121.16	nat. median $78 outlier · 2528.8×
C9293 HCPCS	Glucarpidase 1000 Unit Intravenous Solution	18	$44,097.36	$233,086.02	$196,605.85	nat. median $30,297 outlier · 6.5×
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	2	$184,022.28	$187,630.56	$185,826.42	nat. median $249,036 0.7× median
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	2	$131,924.76	$134,511.52	$133,218.14	nat. median $198,418 0.7× median
J1747 HCPCS	Spesolimab-sbzo 60 Mg/ml Intravenous Solution	18	$27,381.73	$144,731.98	$122,080.06	nat. median $92 outlier · 1326.5×
5 MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	2	$101,205.42	$103,189.84	$102,197.63	nat. median $95,038 1.1× median
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face Mouth…	2	$97,079.52	$98,983.04	$98,031.28	nat. median $190,559 0.5× median
7 MS_DRG	Lung Transplant	2	$96,596.04	$98,490.08	$97,543.06	nat. median $117,974 0.8× median
J2350 HCPCS	Ocrelizumab 30 Mg/ml Intravenous Solution	18	$21,114.02	$111,602.66	$94,135.79	nat. median $470 outlier · 200.4×
2 MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	2	$91,476.66	$93,270.32	$92,373.49	nat. median $104,013 0.9× median
14 MS_DRG	Allogeneic Bone Marrow Transplant	2	$87,839.34	$89,561.68	$88,700.51	nat. median $110,307 0.8× median
8 MS_DRG	Simultaneous Pancreas And Kidney Transplant	2	$86,139.00	$87,828.00	$86,983.50	nat. median $50,831 1.7× median
652 MS_DRG	Kidney Transplant	2	$85,434.18	$87,109.36	$86,271.77	nat. median $29,925 outlier · 2.9×
J0638 HCPCS	Canakinumab (pf) 150 Mg/ml Subcutaneous Solution	18	$18,339.51	$96,937.38	$81,765.76	nat. median $253 outlier · 323.5×
J9334 HCPCS	Efgartigimod Alfa 1008 Mg-hyaluron-qvfc 11200 Unit/5.6 Ml Subcut Soln	18	$16,892.89	$89,290.96	$75,316.07	nat. median $83 outlier · 909.3×
J3241 HCPCS	Teprotumumab-trbw 500 Mg Intravenous Solution	18	$16,570.09	$87,584.73	$73,876.89	nat. median $729 outlier · 101.3×
J2507 HCPCS	Pegloticase 8 Mg/ml Intravenous Solution	18	$16,478.41	$127,949.93	$73,852.80	nat. median $9,200 outlier · 8.0×
216 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	2	$70,044.42	$71,417.84	$70,731.13	nat. median $90,551 0.8× median
J9298 HCPCS	Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution	18	$15,564.29	$82,268.37	$69,392.60	nat. median $561 outlier · 123.7×
J1628 HCPCS	Guselkumab 200 Mg/20 Ml (10 Mg/ml) Intravenous Solution	18	$14,857.77	$79,574.47	$66,589.44	nat. median $228 outlier · 291.7×
4 MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face Mouth And Neck…	2	$63,636.78	$64,884.56	$64,260.67	nat. median $126,695 0.5× median
J3245 HCPCS	Tildrakizumab-asmn 100 Mg/ml Subcutaneous Syringe	18	$14,263.37	$75,392.07	$63,592.50	nat. median $256 outlier · 248.3×
650 MS_DRG	Kidney Transplant With Hemodialysis With Mcc	2	$60,841.98	$62,034.96	$61,438.47	nat. median $42,881 1.4× median
J3357 HCPCS	Ustekinumab 45 Mg/0.5 Ml Subcutaneous Solution	18	$12,954.19	$79,625.31	$58,057.97	nat. median $14,744 outlier · 3.9×
6 MS_DRG	Liver Transplant Without Mcc	2	$56,929.26	$58,045.52	$57,487.39	nat. median $44,153 1.3× median
J9042 HCPCS	Brentuximab Vedotin 50 Mg Intravenous Solution	18	$12,575.69	$66,471.47	$56,068.05	nat. median $951 outlier · 58.9×
J9272 HCPCS	Dostarlimab-gxly 50 Mg/ml Intravenous Solution	18	$12,141.28	$64,175.31	$54,131.27	nat. median $786 outlier · 68.9×
20 MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	2	$53,496.96	$54,545.92	$54,021.44	nat. median $74,370 0.7× median
J9043 HCPCS	Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution	18	$12,092.98	$64,057.28	$53,973.53	nat. median $735 outlier · 73.5×
J1640 HCPCS	Hemin 350 Mg Intravenous Powder For Solution	18	$11,717.27	$61,934.12	$52,240.85	nat. median $80 outlier · 653.7×
215 MS_DRG	Other Heart Assist System Implant	2	$51,613.02	$52,625.04	$52,119.03	nat. median $93,901 0.6× median
224 MS_DRG	No Active Code Description	2	$50,552.22	$51,543.44	$51,047.83	nat. median $39,452 1.3× median
J9144 HCPCS	Daratumumab 1800 Mg-hyaluronidase-fihj 30000 Unit/15 Ml Subcut Soln	18	$11,265.86	$59,548.10	$50,228.26	nat. median $211 outlier · 237.6×
J2329 HCPCS	Ublituximab-xiiy 25 Mg/ml Intravenous Solution	18	$11,216.05	$59,284.84	$50,006.20	nat. median $177 outlier · 282.4×
J9381 HCPCS	Teplizumab-mzwv 1 Mg/ml Intravenous Solution	18	$11,022.02	$61,316.16	$49,398.39	nat. median $55 outlier · 891.5×
J9119 HCPCS	Cemiplimab-rwlc 50 Mg/ml Intravenous Solution	18	$11,028.97	$58,295.96	$49,172.10	nat. median $91 outlier · 540.1×
J2327 HCPCS	Risankizumab-rzaa 150 Mg/ml Subcutaneous Syringe	18	$10,720.35	$122,278.00	$49,047.34	nat. median $2,076 outlier · 23.6×
222 MS_DRG	No Active Code Description	2	$46,663.98	$47,578.96	$47,121.47	nat. median $47,543 1.0× median
456 MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature Malignancy Infection Or Exte…	2	$45,375.72	$46,265.44	$45,820.58	nat. median $77,632 0.6× median
J2267 HCPCS	Mirikizumab-mrkz 300 Mg/15 Ml (20 Mg/ml) Intravenous Solution	18	$10,274.34	$54,307.22	$45,807.63	nat. median $90 outlier · 509.7×
J0222 HCPCS	Patisiran (lipid Complex) 2 Mg/ml Intravenous Solution	18	$10,174.50	$53,779.50	$45,362.50	nat. median $156 outlier · 290.5×
J3380 HCPCS	Vedolizumab 300 Mg Intravenous Solution	18	$10,024.47	$52,986.46	$44,693.57	nat. median $162 outlier · 275.8×
J9228 HCPCS	Ipilimumab 200 Mg/40 Ml (5 Mg/ml) Intravenous Solution	18	$9,507.49	$201,014.87	$43,498.28	nat. median $9,003 outlier · 4.8×
21 MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	2	$42,130.08	$42,956.16	$42,543.12	nat. median $51,514 0.8× median
19 MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	2	$41,789.40	$42,608.80	$42,199.10	nat. median $66,715 0.6× median
J9301 HCPCS	Obinutuzumab 1000 Mg/40 Ml Intravenous Solution	18	$9,224.23	$48,756.61	$41,125.74	nat. median $287 outlier · 143.3×

Other procedures at this hospital

Browse this hospital's 5,833 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

J0225	HCPCS	Vutrisiran 25 Mg/0.5 Ml Subcutaneous Syringe	64	18	$596,755.00	$507,241.75	$127,824.93	$675,646.02	$569,901.03	2026-02-28
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	4	2	—	—	$234,161.40	$238,752.80	$236,457.10	2026-02-28
A9513	HCPCS	Lutetium Lu 177 Dotatate 10 Mci/ml (370 Mbq/ml) Intravenous Solution	64	18	$237,500.00	$201,875.00	$50,872.50	$268,897.50	$226,812.50	2026-02-28
J1823	HCPCS	Inebilizumab-cdon 10 Mg/ml Intravenous Solution	64	18	$218,333.00	$185,583.05	$46,766.93	$247,196.63	$208,508.02	2026-02-28
J2351	HCPCS	Ocrelizumab 920 Mg-hyaluronidase-ocsq 23000 Unit/23 Ml Subcut Soln	64	18	$206,409.59	$175,448.16	$44,212.94	$233,696.94	$197,121.16	2026-02-28
C9293	HCPCS	Glucarpidase 1000 Unit Intravenous Solution	64	18	$205,870.00	$174,989.50	$44,097.36	$233,086.02	$196,605.85	2026-02-28
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	4	2	—	—	$184,022.28	$187,630.56	$185,826.42	2026-02-28
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	4	2	—	—	$131,924.76	$134,511.52	$133,218.14	2026-02-28
J1747	HCPCS	Spesolimab-sbzo 60 Mg/ml Intravenous Solution	64	18	$127,832.52	$108,657.65	$27,381.73	$144,731.98	$122,080.06	2026-02-28
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	4	2	—	—	$101,205.42	$103,189.84	$102,197.63	2026-02-28
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face Mouth …	4	2	—	—	$97,079.52	$98,983.04	$98,031.28	2026-02-28
7	MS_DRG	Lung Transplant	4	2	—	—	$96,596.04	$98,490.08	$97,543.06	2026-02-28
J2350	HCPCS	Ocrelizumab 30 Mg/ml Intravenous Solution	64	18	$98,571.50	$83,785.78	$21,114.02	$111,602.66	$94,135.79	2026-02-28
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	4	2	—	—	$91,476.66	$93,270.32	$92,373.49	2026-02-28
14	MS_DRG	Allogeneic Bone Marrow Transplant	4	2	—	—	$87,839.34	$89,561.68	$88,700.51	2026-02-28
8	MS_DRG	Simultaneous Pancreas And Kidney Transplant	4	2	—	—	$86,139.00	$87,828.00	$86,983.50	2026-02-28
652	MS_DRG	Kidney Transplant	4	2	—	—	$85,434.18	$87,109.36	$86,271.77	2026-02-28
J0638	HCPCS	Canakinumab (pf) 150 Mg/ml Subcutaneous Solution	64	18	$85,618.60	$72,775.81	$18,339.51	$96,937.38	$81,765.76	2026-02-28
J9334	HCPCS	Efgartigimod Alfa 1008 Mg-hyaluron-qvfc 11200 Unit/5.6 Ml Subcut Soln	64	18	$78,865.00	$67,035.25	$16,892.89	$89,290.96	$75,316.07	2026-02-28
J3241	HCPCS	Teprotumumab-trbw 500 Mg Intravenous Solution	64	18	$77,358.00	$65,754.30	$16,570.09	$87,584.73	$73,876.89	2026-02-28
J2507	HCPCS	Pegloticase 8 Mg/ml Intravenous Solution	128	18	$94,970.00	$80,724.50	$16,478.41	$127,949.93	$73,852.80	2026-02-28
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	4	2	—	—	$70,044.42	$71,417.84	$70,731.13	2026-02-28
J9298	HCPCS	Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution	64	18	$72,662.40	$61,763.04	$15,564.29	$82,268.37	$69,392.60	2026-02-28
J1628	HCPCS	Guselkumab 200 Mg/20 Ml (10 Mg/ml) Intravenous Solution	128	18	$69,823.52	$59,350.00	$14,857.77	$79,574.47	$66,589.44	2026-02-28
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face Mouth And Neck…	4	2	—	—	$63,636.78	$64,884.56	$64,260.67	2026-02-28
J3245	HCPCS	Tildrakizumab-asmn 100 Mg/ml Subcutaneous Syringe	64	18	$66,589.00	$56,600.65	$14,263.37	$75,392.07	$63,592.50	2026-02-28
650	MS_DRG	Kidney Transplant With Hemodialysis With Mcc	4	2	—	—	$60,841.98	$62,034.96	$61,438.47	2026-02-28
J3357	HCPCS	Ustekinumab 45 Mg/0.5 Ml Subcutaneous Solution	128	18	$65,402.50	$55,592.13	$12,954.19	$79,625.31	$58,057.97	2026-02-28
6	MS_DRG	Liver Transplant Without Mcc	4	2	—	—	$56,929.26	$58,045.52	$57,487.39	2026-02-28
J9042	HCPCS	Brentuximab Vedotin 50 Mg Intravenous Solution	64	18	$58,710.00	$49,903.50	$12,575.69	$66,471.47	$56,068.05	2026-02-28
J9272	HCPCS	Dostarlimab-gxly 50 Mg/ml Intravenous Solution	64	18	$56,681.95	$48,179.66	$12,141.28	$64,175.31	$54,131.27	2026-02-28
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	4	2	—	—	$53,496.96	$54,545.92	$54,021.44	2026-02-28
J9043	HCPCS	Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution	128	18	$56,517.09	$48,039.53	$12,092.98	$64,057.28	$53,973.53	2026-02-28
J1640	HCPCS	Hemin 350 Mg Intravenous Powder For Solution	64	18	$54,702.45	$46,497.09	$11,717.27	$61,934.12	$52,240.85	2026-02-28
215	MS_DRG	Other Heart Assist System Implant	4	2	—	—	$51,613.02	$52,625.04	$52,119.03	2026-02-28
224	MS_DRG	No Active Code Description	4	2	—	—	$50,552.22	$51,543.44	$51,047.83	2026-02-28
J9144	HCPCS	Daratumumab 1800 Mg-hyaluronidase-fihj 30000 Unit/15 Ml Subcut Soln	64	18	$52,595.03	$44,705.78	$11,265.86	$59,548.10	$50,228.26	2026-02-28
J2329	HCPCS	Ublituximab-xiiy 25 Mg/ml Intravenous Solution	64	18	$52,362.51	$44,508.14	$11,216.05	$59,284.84	$50,006.20	2026-02-28
J9381	HCPCS	Teplizumab-mzwv 1 Mg/ml Intravenous Solution	128	18	$52,806.65	$44,885.66	$11,022.02	$61,316.16	$49,398.39	2026-02-28
J9119	HCPCS	Cemiplimab-rwlc 50 Mg/ml Intravenous Solution	64	18	$51,489.10	$43,765.74	$11,028.97	$58,295.96	$49,172.10	2026-02-28
J2327	HCPCS	Risankizumab-rzaa 150 Mg/ml Subcutaneous Syringe	128	18	$79,024.33	$67,170.68	$10,720.35	$122,278.00	$49,047.34	2026-02-28
222	MS_DRG	No Active Code Description	4	2	—	—	$46,663.98	$47,578.96	$47,121.47	2026-02-28
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature Malignancy Infection Or Exte…	4	2	—	—	$45,375.72	$46,265.44	$45,820.58	2026-02-28
J2267	HCPCS	Mirikizumab-mrkz 300 Mg/15 Ml (20 Mg/ml) Intravenous Solution	64	18	$47,966.10	$40,771.19	$10,274.34	$54,307.22	$45,807.63	2026-02-28
J0222	HCPCS	Patisiran (lipid Complex) 2 Mg/ml Intravenous Solution	64	18	$47,500.00	$40,375.00	$10,174.50	$53,779.50	$45,362.50	2026-02-28
J3380	HCPCS	Vedolizumab 300 Mg Intravenous Solution	64	18	$46,799.55	$39,779.62	$10,024.47	$52,986.46	$44,693.57	2026-02-28
J9228	HCPCS	Ipilimumab 200 Mg/40 Ml (5 Mg/ml) Intravenous Solution	128	18	$110,964.80	$94,320.08	$9,507.49	$201,014.87	$43,498.28	2026-02-28
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	4	2	—	—	$42,130.08	$42,956.16	$42,543.12	2026-02-28
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	4	2	—	—	$41,789.40	$42,608.80	$42,199.10	2026-02-28
J9301	HCPCS	Obinutuzumab 1000 Mg/40 Ml Intravenous Solution	64	18	$43,063.60	$36,604.06	$9,224.23	$48,756.61	$41,125.74	2026-02-28
453	MS_DRG	No Active Code Description	4	2	—	—	$40,574.58	$41,370.16	$40,972.37	2026-02-28
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	4	2	—	—	$40,567.44	$41,362.88	$40,965.16	2026-02-28
A9604	HCPCS	Hc Rp Sm 153 Tx Ds Upto 150mci	64	18	$42,326.00	$35,977.10	$9,066.23	$47,921.50	$40,421.33	2026-02-28
231	MS_DRG	Coronary Bypass With Ptca With Mcc	4	2	—	—	$39,893.22	$40,675.44	$40,284.33	2026-02-28
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	4	2	—	—	$39,357.72	$40,129.44	$39,743.58	2026-02-28
834	MS_DRG	Acute Leukemia With Mcc	4	2	—	—	$39,064.98	$39,830.96	$39,447.97	2026-02-28
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	4	2	—	—	$38,879.34	$39,641.68	$39,260.51	2026-02-28
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	4	2	—	—	$38,879.34	$39,641.68	$39,260.51	2026-02-28
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	4	2	—	—	$38,106.18	$38,853.36	$38,479.77	2026-02-28
226	MS_DRG	No Active Code Description	4	2	—	—	$37,490.10	$38,225.20	$37,857.65	2026-02-28
C9047	HCPCS	Caplacizumab-yhdp 11 Mg Injection Kit	64	18	$39,625.00	$33,681.25	$8,487.68	$44,863.43	$37,841.88	2026-02-28
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	4	2	—	—	$37,121.88	$37,849.76	$37,485.82	2026-02-28
J0584	HCPCS	Burosumab-twza 20 Mg/ml Subcutaneous Solution	320	18	$42,394.80	$36,035.58	$3,732.44	$71,998.87	$37,254.24	2026-02-28
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	4	2	—	—	$36,789.36	$37,510.72	$37,150.04	2026-02-28
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	4	2	—	—	$36,303.84	$37,015.68	$36,659.76	2026-02-28
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	4	2	—	—	$36,204.90	$36,914.80	$36,559.85	2026-02-28
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	4	2	—	—	$35,676.54	$36,376.08	$36,026.31	2026-02-28
C2624	HCPCS	Sys Del Pa Sens Cardiomems Cm2000	128	18	$39,165.00	$33,290.25	$7,871.85	$47,076.88	$35,280.00	2026-02-28
955	MS_DRG	Craniotomy For Multiple Significant Trauma	4	2	—	—	$34,874.82	$35,558.64	$35,216.73	2026-02-28
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	4	2	—	—	$34,735.08	$35,416.16	$35,075.62	2026-02-28
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	4	2	—	—	$34,410.72	$35,085.44	$34,748.08	2026-02-28
J1440	HCPCS	Fecal Microbiota Live-jslm 150 Ml Rectal Suspension Enema	64	18	$36,000.00	$30,600.00	$7,711.20	$40,759.20	$34,380.00	2026-02-28
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	4	2	—	—	$33,933.36	$34,598.72	$34,266.04	2026-02-28
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	4	2	—	—	$33,676.32	$34,336.64	$34,006.48	2026-02-28
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature Malignancy Infection Or Exte…	4	2	—	—	$33,524.34	$34,181.68	$33,853.01	2026-02-28
228	MS_DRG	Other Cardiothoracic Procedures With Mcc	4	2	—	—	$33,147.96	$33,797.92	$33,472.94	2026-02-28
458	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature Malignancy Infection Or Exte…	4	2	—	—	$32,954.16	$33,600.32	$33,277.24	2026-02-28
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	4	2	—	—	$32,885.82	$33,530.64	$33,208.23	2026-02-28
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	4	2	—	—	$32,732.82	$33,374.64	$33,053.73	2026-02-28
267	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	4	2	—	—	$32,689.98	$33,330.96	$33,010.47	2026-02-28
J9223	HCPCS	Lurbinectedin 4 Mg Intravenous Solution	64	18	$34,491.60	$29,317.86	$7,388.11	$39,051.39	$32,939.48	2026-02-28
J1932	HCPCS	Lanreotide 120 Mg/0.5 Ml Subcutaneous Syringe	64	18	$34,068.85	$28,958.53	$7,297.55	$38,572.76	$32,535.75	2026-02-28
J9306	HCPCS	Pertuzumab 420 Mg/14 Ml (30 Mg/ml) Intravenous Solution	64	18	$33,983.11	$28,885.65	$7,279.19	$38,475.68	$32,453.88	2026-02-28
576	MS_DRG	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	4	2	—	—	$31,741.38	$32,363.76	$32,052.57	2026-02-28
225	MS_DRG	No Active Code Description	4	2	—	—	$31,643.46	$32,263.92	$31,953.69	2026-02-28
826	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	4	2	—	—	$31,595.52	$32,215.04	$31,905.28	2026-02-28
J1303	HCPCS	Ravulizumab-cwvz 100 Mg/ml Intravenous Solution	128	18	$75,887.40	$64,504.29	$6,858.69	$135,586.39	$31,379.61	2026-02-28
J9063	HCPCS	Mirvetuximab Soravtansine-gynx 5 Mg/ml Intravenous Solution	64	18	$32,435.80	$27,570.43	$6,947.75	$36,723.82	$30,976.19	2026-02-28
956	MS_DRG	Limb Reattachment Hip And Femur Procedures For Multiple Significant Trauma	4	2	—	—	$30,487.80	$31,085.60	$30,786.70	2026-02-28
22	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	4	2	—	—	$30,483.72	$31,081.44	$30,782.58	2026-02-28
J0741	HCPCS	Cabotegravir ER 600 Mg/3 Ml-rilpivirine ER 900 Mg/3ml IM Suspensioner	64	18	$32,146.71	$27,324.71	$6,885.83	$36,396.51	$30,700.11	2026-02-28
J9273	HCPCS	Tisotumab Vedotin-tftv 40 Mg Intravenous Solution	64	18	$31,760.00	$26,996.00	$6,803.00	$35,958.68	$30,330.80	2026-02-28
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	4	2	—	—	$29,871.72	$30,457.44	$30,164.58	2026-02-28
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	4	2	—	—	$29,772.78	$30,356.56	$30,064.67	2026-02-28
459	MS_DRG	No Active Code Description	4	2	—	—	$29,667.72	$30,249.44	$29,958.58	2026-02-28
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	4	2	—	—	$29,660.58	$30,242.16	$29,951.37	2026-02-28
J9022	HCPCS	Atezolizumab 1200 Mg/20 Ml (60 Mg/ml) Intravenous Solution	128	18	$43,596.96	$37,057.42	$6,626.24	$63,696.56	$29,697.43	2026-02-28
J9332	HCPCS	Efgartigimod Alfa-fcab 20 Mg/ml Intravenous Solution	64	18	$30,951.90	$26,309.12	$6,629.90	$35,043.75	$29,559.07	2026-02-28
223	MS_DRG	No Active Code Description	4	2	—	—	$29,118.96	$29,689.92	$29,404.44	2026-02-28
J3101	HCPCS	Tenecteplase 50 Mg Intravenous Kit	128	18	$35,175.62	$29,899.29	$6,493.90	$45,326.84	$29,104.28	2026-02-28
245	MS_DRG	Aicd Generator Procedures	4	2	—	—	$28,196.88	$28,749.76	$28,473.32	2026-02-28
239	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	4	2	—	—	$28,195.86	$28,748.72	$28,472.29	2026-02-28
63685	CPT	Hc Insrt Redo Spine N Generator	64	18	$29,769.00	$25,303.65	$6,376.52	$33,704.47	$28,429.40	2026-02-28
L8687	HCPCS	Genrtr Imp Pulse MRI Prodigy 3772 Controlsys	64	18	$29,750.00	$25,287.50	$6,372.45	$33,682.95	$28,411.25	2026-02-28
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	4	2	—	—	$28,051.02	$28,601.04	$28,326.03	2026-02-28
J9271	HCPCS	Pembrolizumab 25 Mg/ml Intravenous Solution	64	18	$29,488.60	$25,065.31	$6,316.46	$33,387.00	$28,161.61	2026-02-28
J9207	HCPCS	Ixabepilone 45 Mg Intravenous Solution	64	18	$29,044.90	$24,688.17	$6,221.42	$32,884.64	$27,737.89	2026-02-28
454	MS_DRG	No Active Code Description	4	2	—	—	$27,254.40	$27,788.80	$27,521.60	2026-02-28
J0717	HCPCS	Certolizumab Pegol 400 Mg (200 Mg X 2 Vials) Subcutaneous Kit	128	18	$29,202.60	$24,822.22	$6,107.50	$33,843.90	$27,372.53	2026-02-28
319	MS_DRG	Other Endovascular Cardiac Valve Procedures With Mcc	4	2	—	—	$27,072.84	$27,603.68	$27,338.26	2026-02-28
901	MS_DRG	Wound Debridements For Injuries With Mcc	4	2	—	—	$26,736.24	$27,260.48	$26,998.36	2026-02-28
736	MS_DRG	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	4	2	—	—	$26,711.76	$27,235.52	$26,973.64	2026-02-28
C2642	HCPCS	Dev Gammatile Therapy 10pk Gt-10	896	18	$37,000.00	$31,450.00	$1,132.20	$93,123.45	$26,457.60	2026-02-28
823	MS_DRG	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	4	2	—	—	$26,129.34	$26,641.68	$26,385.51	2026-02-28
J0391	HCPCS	Artesunate 110 Mg Intravenous Solution	128	18	$40,338.75	$34,287.94	$5,760.38	$60,895.38	$26,354.65	2026-02-28
332	MS_DRG	Rectal Resection With Mcc	4	2	—	—	$26,093.64	$26,605.28	$26,349.46	2026-02-28
981	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	4	2	—	—	$26,008.98	$26,518.96	$26,263.97	2026-02-28
227	MS_DRG	No Active Code Description	4	2	—	—	$25,917.18	$26,425.36	$26,171.27	2026-02-28
405	MS_DRG	Pancreas Liver And Shunt Procedures With Mcc	4	2	—	—	$25,663.20	$26,166.40	$25,914.80	2026-02-28
471	MS_DRG	Cervical Spinal Fusion With Mcc	4	2	—	—	$25,581.60	$26,083.20	$25,832.40	2026-02-28
163	MS_DRG	Major Chest Procedures With Mcc	4	2	—	—	$25,560.18	$26,061.36	$25,810.77	2026-02-28
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	4	2	—	—	$25,325.58	$25,822.16	$25,573.87	2026-02-28
J0775	HCPCS	Collagenase Clostridium Histolyticum 0.9 Mg Solution For Injection	64	18	$26,169.45	$22,244.04	$5,605.50	$29,629.06	$24,991.83	2026-02-28
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	4	2	—	—	$24,745.20	$25,230.40	$24,987.80	2026-02-28
J0491	HCPCS	Anifrolumab-fnia 300 Mg/2 Ml (150 Mg/ml) Intravenous Solution	64	18	$26,146.85	$22,224.83	$5,600.66	$29,603.47	$24,970.24	2026-02-28
J0517	HCPCS	Benralizumab 30 Mg/ml Subcutaneous Auto-injector	128	18	$27,083.20	$23,020.72	$5,522.65	$32,136.09	$24,751.35	2026-02-28
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome Neonate	4	2	—	—	$24,114.84	$24,587.68	$24,351.26	2026-02-28
739	MS_DRG	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	4	2	—	—	$23,973.06	$24,443.12	$24,208.09	2026-02-28
25	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Mcc	4	2	—	—	$23,627.28	$24,090.56	$23,858.92	2026-02-28
J9021	HCPCS	Asparaginase Erwinia Chrysanthemi-rywn 10 Mg/0.5 Ml IM Solution	64	18	$24,900.00	$21,165.00	$5,333.58	$28,191.78	$23,779.50	2026-02-28
411	MS_DRG	Cholecystectomy With C.d.e. With Mcc	4	2	—	—	$23,538.54	$24,000.08	$23,769.31	2026-02-28
802	MS_DRG	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	4	2	—	—	$23,264.16	$23,720.32	$23,492.24	2026-02-28
28	MS_DRG	Spinal Procedures With Mcc	4	2	—	—	$23,216.22	$23,671.44	$23,443.83	2026-02-28
236	MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	4	2	—	—	$23,183.58	$23,638.16	$23,410.87	2026-02-28
651	MS_DRG	Kidney Transplant With Hemodialysis Without Mcc	4	2	—	—	$23,164.20	$23,618.40	$23,391.30	2026-02-28
J1930	HCPCS	Lanreotide 120 Mg/0.5 Ml Subcutaneous Syringe	192	18	$38,795.00	$32,975.75	$3,094.60	$51,798.15	$23,332.50	2026-02-28
853	MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	4	2	—	—	$23,049.96	$23,501.92	$23,275.94	2026-02-28
495	MS_DRG	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	4	2	—	—	$22,797.00	$23,244.00	$23,020.50	2026-02-28
492	MS_DRG	Lower Extremity And Humerus Procedures Except Hip Foot And Femur With Mcc	4	2	—	—	$22,698.06	$23,143.12	$22,920.59	2026-02-28
J1162	HCPCS	Digoxin Immune Fab 40 Mg Intravenous Solution	64	18	$23,999.55	$20,399.62	$5,140.71	$27,172.30	$22,919.58	2026-02-28
10	MS_DRG	Pancreas Transplant	4	2	—	—	$22,692.96	$23,137.92	$22,915.44	2026-02-28
622	MS_DRG	Skin Grafts And Wound Debridement For Endocrine Nutritional And Metabolic Disord…	4	2	—	—	$22,662.36	$23,106.72	$22,884.54	2026-02-28
455	MS_DRG	No Active Code Description	4	2	—	—	$22,279.86	$22,716.72	$22,498.29	2026-02-28
94	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System With Mcc	4	2	—	—	$22,151.34	$22,585.68	$22,368.51	2026-02-28
11	MS_DRG	Tracheostomy For Face Mouth And Neck Diagnoses Or Laryngectomy With Mcc	4	2	—	—	$22,127.88	$22,561.76	$22,344.82	2026-02-28
423	MS_DRG	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	4	2	—	—	$22,119.72	$22,553.44	$22,336.58	2026-02-28
C1882	HCPCS	Biv Aice Unify Assura Cd3357-40c	2,112	18	$28,875.00	$24,543.75	$1,228.98	$72,517.41	$22,312.17	2026-02-28
420	MS_DRG	Hepatobiliary Diagnostic Procedures With Mcc	4	2	—	—	$22,043.22	$22,475.44	$22,259.33	2026-02-28
J7504	HCPCS	Lymphocyteanti-thymo Immune Globulin 50 Mg/ml Intravenous Solution	64	18	$23,257.70	$19,769.05	$4,981.80	$26,332.37	$22,211.11	2026-02-28
J1575	HCPCS	Igg 30 Gram/300 Ml (10 %)-hyaluronidaserecomb. Subcutaneous Solution	64	18	$23,171.40	$19,695.69	$4,963.32	$26,234.66	$22,128.69	2026-02-28
466	MS_DRG	Revision Of Hip Or Knee Replacement With Mcc	4	2	—	—	$21,742.32	$22,168.64	$21,955.48	2026-02-28
24	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	4	2	—	—	$21,490.38	$21,911.76	$21,701.07	2026-02-28
271	MS_DRG	Other Major Cardiovascular Procedures With Cc	4	2	—	—	$21,348.60	$21,767.20	$21,557.90	2026-02-28
467	MS_DRG	Revision Of Hip Or Knee Replacement With Cc	4	2	—	—	$21,287.40	$21,704.80	$21,496.10	2026-02-28
939	MS_DRG	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	4	2	—	—	$21,241.50	$21,658.00	$21,449.75	2026-02-28
329	MS_DRG	Major Small And Large Bowel Procedures With Mcc	4	2	—	—	$21,162.96	$21,577.92	$21,370.44	2026-02-28
J2506	HCPCS	Pegfilgrastim 6 Mg/0.6 Ml (deliverable) Wearable Subcutaneous Injector	64	18	$22,363.90	$19,009.32	$4,790.35	$25,320.41	$21,357.53	2026-02-28
653	MS_DRG	Major Bladder Procedures With Mcc	4	2	—	—	$21,088.50	$21,502.00	$21,295.25	2026-02-28
36905	CPT	Hc Perq Thrmbc/nfs Dial Circuit Trluml Balo Angiop	64	18	$22,290.00	$18,946.50	$4,774.52	$25,236.74	$21,286.95	2026-02-28
326	MS_DRG	Stomach Esophageal And Duodenal Procedures With Mcc	4	2	—	—	$21,029.34	$21,441.68	$21,235.51	2026-02-28
799	MS_DRG	Splenic Procedures With Mcc	4	2	—	—	$21,016.08	$21,428.16	$21,222.12	2026-02-28
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	4	2	—	—	$21,013.02	$21,425.04	$21,219.03	2026-02-28
252	MS_DRG	Other Vascular Procedures With Mcc	4	2	—	—	$20,812.08	$21,220.16	$21,016.12	2026-02-28
462	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc	4	2	—	—	$20,688.66	$21,094.32	$20,891.49	2026-02-28
J9295	HCPCS	Necitumumab 800 Mg/50 Ml (16 Mg/ml) Intravenous Solution	64	18	$21,648.75	$18,401.44	$4,637.17	$24,510.72	$20,674.56	2026-02-28
958	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Cc	4	2	—	—	$20,449.98	$20,850.96	$20,650.47	2026-02-28
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	4	2	—	—	$20,373.48	$20,772.96	$20,573.22	2026-02-28
258	MS_DRG	Cardiac Pacemaker Device Replacement With Mcc	4	2	—	—	$20,081.76	$20,475.52	$20,278.64	2026-02-28
J9039	HCPCS	Blinatumomab 35 Mcg Intravenous Solution	64	18	$21,210.50	$18,028.93	$4,543.29	$24,014.53	$20,256.03	2026-02-28
356	MS_DRG	Other Digestive System O.r. Procedures With Mcc	4	2	—	—	$20,038.92	$20,431.84	$20,235.38	2026-02-28
140	MS_DRG	Major Head And Neck Procedures With Mcc	4	2	—	—	$20,033.82	$20,426.64	$20,230.23	2026-02-28
J2353	HCPCS	Octreotidemicrospheres ER 20 Mg Intramuscular Susp Extended Release	128	18	$26,097.12	$22,182.56	$4,476.62	$35,432.20	$20,063.28	2026-02-28
460	MS_DRG	No Active Code Description	4	2	—	—	$19,687.02	$20,073.04	$19,880.03	2026-02-28
J2356	HCPCS	Tezepelumab-ekko 210 Mg/1.91 Ml (110 Mg/ml) Subcutaneous Syringe	64	18	$20,804.56	$17,683.88	$4,456.34	$23,554.93	$19,868.36	2026-02-28
J2323	HCPCS	Natalizumab 300 Mg/15 Ml Intravenous Solution	128	18	$31,455.79	$26,737.43	$4,331.77	$48,332.02	$19,818.54	2026-02-28
J0185	HCPCS	Aprepitant 130 Mg/18 Ml (7.2 Mg/ml) Intravenous Emulsion	64	18	$20,640.60	$17,544.51	$4,421.22	$23,369.29	$19,711.78	2026-02-28
166	MS_DRG	Other Respiratory System O.r. Procedures With Mcc	4	2	—	—	$19,496.28	$19,878.56	$19,687.42	2026-02-28
C1721	HCPCS	Defib Current Dr 36j 2207-36	2,176	18	$23,362.50	$19,858.12	$12.77	$91,164.75	$19,603.92	2026-02-28
J9309	HCPCS	Polatuzumab Vedotin-piiq 140 Mg Intravenous Solution	128	18	$54,853.35	$46,625.35	$4,146.93	$102,290.48	$19,541.99	2026-02-28
229	MS_DRG	Other Cardiothoracic Procedures Without Mcc	4	2	—	—	$19,331.04	$19,710.08	$19,520.56	2026-02-28
837	MS_DRG	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	4	2	—	—	$19,283.10	$19,661.20	$19,472.15	2026-02-28
J0896	HCPCS	Luspatercept-aamt 25 Mg Subcutaneous Solution	128	18	$39,534.10	$33,603.99	$4,234.12	$67,140.71	$19,371.76	2026-02-28
34718	CPT	Hc Evasc Rpr N/a A-iliac Ndgft	64	18	$20,149.00	$17,126.65	$4,315.92	$22,812.70	$19,242.29	2026-02-28
665	MS_DRG	Prostatectomy With Mcc	4	2	—	—	$19,049.52	$19,423.04	$19,236.28	2026-02-28
265	MS_DRG	Aicd Lead Procedures	4	2	—	—	$18,969.96	$19,341.92	$19,155.94	2026-02-28
34717	CPT	Hc Evasc Rpr A-iliac Ndgft	64	18	$19,821.00	$16,847.85	$4,245.66	$22,441.34	$18,929.06	2026-02-28
269	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	4	2	—	—	$18,623.16	$18,988.32	$18,805.74	2026-02-28
248	MS_DRG	No Active Code Description	4	2	—	—	$18,570.12	$18,934.24	$18,752.18	2026-02-28
J9354	HCPCS	Ado-trastuzumab Emtansine 100 Mg Intravenous Solution	128	18	$25,296.35	$21,501.90	$4,168.07	$35,249.86	$18,680.40	2026-02-28
521	MS_DRG	Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc	4	2	—	—	$18,494.64	$18,857.28	$18,675.96	2026-02-28
970	MS_DRG	HIV With Extensive O.r. Procedures Without Mcc	4	2	—	—	$18,469.14	$18,831.28	$18,650.21	2026-02-28
242	MS_DRG	Permanent Cardiac Pacemaker Implant With Mcc	4	2	—	—	$18,392.64	$18,753.28	$18,572.96	2026-02-28
662	MS_DRG	Minor Bladder Procedures With Mcc	4	2	—	—	$18,378.36	$18,738.72	$18,558.54	2026-02-28
J0402	HCPCS	Aripiprazole ER (2 Month) 720 Mg/2.4 Ml Susp Extended Rel IM Syringe	128	18	$22,313.73	$18,966.67	$4,096.79	$28,872.76	$18,360.96	2026-02-28
907	MS_DRG	Other O.r. Procedures For Injuries With Mcc	4	2	—	—	$18,171.30	$18,527.60	$18,349.45	2026-02-28
J0739	HCPCS	Cabotegravir ER 600 Mg/3 Ml (200 Mg/ml) IM Suspensionextended Release	128	18	$19,202.10	$16,321.79	$4,082.47	$21,902.47	$18,296.79	2026-02-28
C1722	HCPCS	Defib Momen El Icd Vr D120	2,368	18	$24,500.00	$20,825.00	$2,061.68	$84,948.97	$18,296.25	2026-02-28
J7189	HCPCS	Coagulation Factor Viia Recomb 1 Mg (1000 Mcg) Intravenous Solution	192	18	$20,065.50	$17,055.68	$2,570.40	$62,203.07	$18,259.61	2026-02-28
C1772	HCPCS	Defibrillator Emblem MRI S-icd	512	18	$21,523.25	$18,294.76	$2,399.04	$78,733.19	$18,240.00	2026-02-28
J9061	HCPCS	Amivantamab-vmjw 50 Mg/ml Intravenous Solution	64	18	$19,033.39	$16,178.39	$4,076.96	$21,549.61	$18,176.90	2026-02-28
J0565	HCPCS	Bezlotoxumab 25 Mg/ml Intravenous Solution	64	18	$19,000.00	$16,150.00	$4,069.80	$21,511.80	$18,145.00	2026-02-28
625	MS_DRG	Thyroid Parathyroid And Thyroglossal Procedures With Mcc	4	2	—	—	$17,822.46	$18,171.92	$17,997.19	2026-02-28
409	MS_DRG	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	4	2	—	—	$17,754.12	$18,102.24	$17,928.18	2026-02-28
408	MS_DRG	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	4	2	—	—	$17,754.12	$18,102.24	$17,928.18	2026-02-28
335	MS_DRG	Peritoneal Adhesiolysis With Mcc	4	2	—	—	$17,735.76	$18,083.52	$17,909.64	2026-02-28
J7686	HCPCS	Treprostinil 1.74 Mg/2.9 Ml (0.6 Mg/ml) Solution For Nebulization	192	18	$19,536.00	$16,605.60	$1,992.06	$92,132.30	$17,777.76	2026-02-28
344	MS_DRG	Minor Small And Large Bowel Procedures With Mcc	4	2	—	—	$17,569.50	$17,914.00	$17,741.75	2026-02-28
J3285	HCPCS	Treprostinil Sodium 10 Mg/ml Injection Solution	256	18	$27,632.85	$23,487.92	$1,578.40	$90,100.48	$17,685.03	2026-02-28
260	MS_DRG	Cardiac Pacemaker Revision Except Device Replacement With Mcc	4	2	—	—	$17,500.14	$17,843.28	$17,671.71	2026-02-28
480	MS_DRG	Hip And Femur Procedures Except Major Joint With Mcc	4	2	—	—	$17,500.14	$17,843.28	$17,671.71	2026-02-28
J9304	HCPCS	Pemetrexed 25 Mg/ml Intravenous Solution	64	18	$18,325.20	$15,576.42	$3,925.26	$20,747.80	$17,500.57	2026-02-28
468	MS_DRG	Revision Of Hip Or Knee Replacement Without Cc/mcc	4	2	—	—	$17,317.56	$17,657.12	$17,487.34	2026-02-28
26	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Cc	4	2	—	—	$17,268.60	$17,607.20	$17,437.90	2026-02-28
904	MS_DRG	Skin Grafts For Injuries With Cc/mcc	4	2	—	—	$17,232.90	$17,570.80	$17,401.85	2026-02-28
835	MS_DRG	Acute Leukemia With Cc	4	2	—	—	$17,203.32	$17,540.64	$17,371.98	2026-02-28
40	MS_DRG	Peripheral Cranial Nerve And Other Nervous System Procedures With Mcc	4	2	—	—	$17,078.88	$17,413.76	$17,246.32	2026-02-28
C1767	HCPCS	Generator Pk Access 502	3,648	18	$21,600.00	$18,360.00	$153.91	$100,301.94	$16,954.00	2026-02-28
515	MS_DRG	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc	4	2	—	—	$16,567.86	$16,892.72	$16,730.29	2026-02-28
503	MS_DRG	Foot Procedures With Mcc	4	2	—	—	$16,489.32	$16,812.64	$16,650.98	2026-02-28
240	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc	4	2	—	—	$16,486.26	$16,809.52	$16,647.89	2026-02-28
J0597	HCPCS	C1 Esterase Inhibitor 500 Unit (10 Ml) Intravenous Kit	64	18	$17,390.60	$14,782.01	$3,725.07	$19,689.64	$16,608.03	2026-02-28
12	MS_DRG	Tracheostomy For Face Mouth And Neck Diagnoses Or Laryngectomy With Cc	4	2	—	—	$16,363.86	$16,684.72	$16,524.29	2026-02-28
469	MS_DRG	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…	4	2	—	—	$16,283.28	$16,602.56	$16,442.92	2026-02-28
498	MS_DRG	Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…	4	2	—	—	$16,210.86	$16,528.72	$16,369.79	2026-02-28
614	MS_DRG	Adrenal And Pituitary Procedures With Cc/mcc	4	2	—	—	$16,108.86	$16,424.72	$16,266.79	2026-02-28
246	MS_DRG	No Active Code Description	4	2	—	—	$16,066.02	$16,381.04	$16,223.53	2026-02-28
856	MS_DRG	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	4	2	—	—	$16,004.82	$16,318.64	$16,161.73	2026-02-28
J1306	HCPCS	Inclisiran 284 Mg/1.5 Ml Subcutaneous Syringe	64	18	$16,907.10	$14,371.04	$3,621.51	$19,142.22	$16,146.28	2026-02-28
673	MS_DRG	Other Kidney And Urinary Tract Procedures With Mcc	4	2	—	—	$15,986.46	$16,299.92	$16,143.19	2026-02-28
273	MS_DRG	Percutaneous And Other Intracardiac Procedures With Mcc	4	2	—	—	$15,965.04	$16,278.08	$16,121.56	2026-02-28
274	MS_DRG	Percutaneous And Other Intracardiac Procedures Without Mcc	4	2	—	—	$15,965.04	$16,278.08	$16,121.56	2026-02-28
619	MS_DRG	O.r. Procedures For Obesity With Mcc	4	2	—	—	$15,817.14	$16,127.28	$15,972.21	2026-02-28
849	MS_DRG	Radiotherapy	4	2	—	—	$15,603.96	$15,909.92	$15,756.94	2026-02-28
406	MS_DRG	Pancreas Liver And Shunt Procedures With Cc	4	2	—	—	$15,574.38	$15,879.76	$15,727.07	2026-02-28
464	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	4	2	—	—	$15,567.24	$15,872.48	$15,719.86	2026-02-28
143	MS_DRG	Other Ear Nose Mouth And Throat O.r. Procedures With Mcc	4	2	—	—	$15,541.74	$15,846.48	$15,694.11	2026-02-28
474	MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	4	2	—	—	$15,473.40	$15,776.80	$15,625.10	2026-02-28
347	MS_DRG	Anal And Stomal Procedures With Mcc	4	2	—	—	$15,440.76	$15,743.52	$15,592.14	2026-02-28
253	MS_DRG	Other Vascular Procedures With Cc	4	2	—	—	$15,405.06	$15,707.12	$15,556.09	2026-02-28
656	MS_DRG	Kidney And Ureter Procedures For Neoplasm With Mcc	4	2	—	—	$15,397.92	$15,699.84	$15,548.88	2026-02-28
34	MS_DRG	Carotid Artery Stent Procedures With Mcc	4	2	—	—	$15,377.52	$15,679.04	$15,528.28	2026-02-28
320	MS_DRG	Other Endovascular Cardiac Valve Procedures Without Mcc	4	2	—	—	$15,328.56	$15,629.12	$15,478.84	2026-02-28
264	MS_DRG	Other Circulatory System O.r. Procedures	4	2	—	—	$15,296.94	$15,596.88	$15,446.91	2026-02-28
61	MS_DRG	Ischemic Stroke Precerebral Occlusion Or Transient Ischemia With Thrombolytic Ag…	4	2	—	—	$15,284.70	$15,584.40	$15,434.55	2026-02-28
C1820	HCPCS	Ipg Rechargeable 3788	1,728	18	$18,710.00	$15,903.50	$289.17	$77,531.48	$15,350.40	2026-02-28
485	MS_DRG	Knee Procedures With Principal Diagnosis Of Infection With Mcc	4	2	—	—	$15,159.24	$15,456.48	$15,307.86	2026-02-28
82	MS_DRG	Traumatic Stupor And Coma >1 Hour With Mcc	4	2	—	—	$15,020.52	$15,315.04	$15,167.78	2026-02-28
472	MS_DRG	Cervical Spinal Fusion With Cc	4	2	—	—	$15,019.50	$15,314.00	$15,166.75	2026-02-28
987	MS_DRG	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	4	2	—	—	$14,874.66	$15,166.32	$15,020.49	2026-02-28
31	MS_DRG	Ventricular Shunt Procedures With Mcc	4	2	—	—	$14,839.98	$15,130.96	$14,985.47	2026-02-28
13	MS_DRG	Tracheostomy For Face Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc	4	2	—	—	$14,833.86	$15,124.72	$14,979.29	2026-02-28
J1743	HCPCS	Idursulfase 6 Mg/3 Ml Intravenous Solution	64	18	$15,679.16	$13,327.29	$3,358.48	$17,751.95	$14,973.60	2026-02-28
J9299	HCPCS	Nivolumab 100 Mg/10 Ml Intravenous Solution	256	18	$16,270.99	$13,830.34	$1,210.12	$43,219.70	$14,969.86	2026-02-28
J9352	HCPCS	Trabectedin 1 Mg Intravenous Solution	64	18	$15,486.40	$13,163.44	$3,317.19	$17,533.71	$14,789.51	2026-02-28
243	MS_DRG	Permanent Cardiac Pacemaker Implant With Cc	4	2	—	—	$14,640.06	$14,927.12	$14,783.59	2026-02-28
483	MS_DRG	Major Joint Or Limb Reattachment Procedures Of Upper Extremities	4	2	—	—	$14,576.82	$14,862.64	$14,719.73	2026-02-28
J2182	HCPCS	Mepolizumab 100 Mg/ml Subcutaneous Auto-injector	128	18	$16,860.43	$14,331.37	$3,272.27	$20,882.47	$14,665.64	2026-02-28
709	MS_DRG	Penis Procedures With Cc/mcc	4	2	—	—	$14,502.36	$14,786.72	$14,644.54	2026-02-28
Q5111	HCPCS	Pegfilgrastim-cbqv 6 Mg/0.6 Ml (deliverable) Wearable Subcut Injector	128	18	$15,557.26	$13,223.67	$3,261.02	$17,991.06	$14,615.20	2026-02-28
522	MS_DRG	Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc	4	2	—	—	$14,464.62	$14,748.24	$14,606.43	2026-02-28
263	MS_DRG	Vein Ligation And Stripping	4	2	—	—	$14,457.48	$14,740.96	$14,599.22	2026-02-28
510	MS_DRG	Shoulder Elbow Or Forearm Procedures Except Major Joint Procedures With Mcc	4	2	—	—	$14,449.32	$14,732.64	$14,590.98	2026-02-28
424	MS_DRG	Other Hepatobiliary Or Pancreas O.r. Procedures With Cc	4	2	—	—	$14,312.64	$14,593.28	$14,452.96	2026-02-28
412	MS_DRG	Cholecystectomy With C.d.e. With Cc	4	2	—	—	$14,274.90	$14,554.80	$14,414.85	2026-02-28
J1437	HCPCS	Ferric Derisomaltose 100 Mg Iron/ml Intravenous Solution	64	18	$15,073.30	$12,812.31	$3,228.71	$17,066.00	$14,395.01	2026-02-28
L8614	HCPCS	Elctrd Profle Nucmodiolar Slim P783831	256	18	$20,627.29	$17,533.21	$3,129.63	$31,079.04	$14,318.53	2026-02-28
933	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	4	2	—	—	$14,161.68	$14,439.36	$14,300.52	2026-02-28
840	MS_DRG	Lymphoma And Non-acute Leukemia With Mcc	4	2	—	—	$14,135.16	$14,412.32	$14,273.74	2026-02-28
Q5120	HCPCS	Pegfilgrastim-bmez 6 Mg/0.6 Ml Subcutaneous Syringe	64	18	$14,927.80	$12,688.63	$3,197.54	$16,901.26	$14,256.05	2026-02-28
164	MS_DRG	Major Chest Procedures With Cc	4	2	—	—	$14,069.88	$14,345.76	$14,207.82	2026-02-28
945	MS_DRG	Rehabilitation With Cc/mcc	4	2	—	—	$14,044.38	$14,319.76	$14,182.07	2026-02-28
272	MS_DRG	Other Major Cardiovascular Procedures Without Cc/mcc	4	2	—	—	$14,020.92	$14,295.84	$14,158.38	2026-02-28
414	MS_DRG	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	4	2	—	—	$13,940.34	$14,213.68	$14,077.01	2026-02-28
959	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc	4	2	—	—	$13,897.50	$14,170.00	$14,033.75	2026-02-28
949	MS_DRG	Aftercare With Cc/mcc	4	2	—	—	$13,839.36	$14,110.72	$13,975.04	2026-02-28
674	MS_DRG	Other Kidney And Urinary Tract Procedures With Cc	4	2	—	—	$13,834.26	$14,105.52	$13,969.89	2026-02-28
J9358	HCPCS	Fam-trastuzumab Deruxtecan-nxki 100 Mg Intravenous Solution	64	18	$14,622.40	$12,429.04	$3,132.12	$16,555.49	$13,964.40	2026-02-28
36902	CPT	Hc Intro Cath Dialysis Circuit W/trluml Balo Angiop	64	18	$14,558.00	$12,374.30	$3,118.33	$16,482.57	$13,902.89	2026-02-28
36904	CPT	Hc Perq Thrmbc/nfs Dialysis Circuit Img Dx Angrph	64	18	$14,558.00	$12,374.30	$3,118.33	$16,482.57	$13,902.89	2026-02-28
113	MS_DRG	Orbital Procedures With Cc/mcc	4	2	—	—	$13,749.60	$14,019.20	$13,884.40	2026-02-28
29	MS_DRG	Spinal Procedures With Cc Or Spinal Neurostimulators	4	2	—	—	$13,698.60	$13,967.20	$13,832.90	2026-02-28
749	MS_DRG	Other Female Reproductive System O.r. Procedures With Cc/mcc	4	2	—	—	$13,690.44	$13,958.88	$13,824.66	2026-02-28
J0598	HCPCS	C1 Esterase Inhibitor 500 Unit (5 Ml) Intravenous Solution	64	18	$14,345.70	$12,193.85	$3,072.85	$16,242.21	$13,700.15	2026-02-28
493	MS_DRG	Lower Extremity And Humerus Procedures Except Hip Foot And Femur With Cc	4	2	—	—	$13,524.18	$13,789.36	$13,656.77	2026-02-28
135	MS_DRG	Sinus And Mastoid Procedures With Cc/mcc	4	2	—	—	$13,428.30	$13,691.60	$13,559.95	2026-02-28
711	MS_DRG	Testes Procedures With Cc/mcc	4	2	—	—	$13,363.02	$13,625.04	$13,494.03	2026-02-28
J9177	HCPCS	Enfortumab Vedotin-ejfv 20 Mg Intravenous Solution	128	18	$17,350.00	$14,747.50	$3,008.44	$23,385.60	$13,483.20	2026-02-28
333	MS_DRG	Rectal Resection With Cc	4	2	—	—	$13,345.68	$13,607.36	$13,476.52	2026-02-28
J2425	HCPCS	Palifermin 6.25 Mg Intravenous Solution	64	18	$14,109.89	$11,993.41	$3,022.34	$15,975.22	$13,474.95	2026-02-28
655	MS_DRG	Major Bladder Procedures Without Cc/mcc	4	2	—	—	$13,293.66	$13,554.32	$13,423.99	2026-02-28
654	MS_DRG	Major Bladder Procedures With Cc	4	2	—	—	$13,293.66	$13,554.32	$13,423.99	2026-02-28
475	MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc	4	2	—	—	$13,220.22	$13,479.44	$13,349.83	2026-02-28
574	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Cc	4	2	—	—	$13,202.88	$13,461.76	$13,332.32	2026-02-28
628	MS_DRG	Other Endocrine Nutritional And Metabolic O.r. Procedures With Mcc	4	2	—	—	$13,140.66	$13,398.32	$13,269.49	2026-02-28
97	MS_DRG	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	4	2	—	—	$13,129.44	$13,386.88	$13,258.16	2026-02-28
80	MS_DRG	Nontraumatic Stupor And Coma With Mcc	4	2	—	—	$13,122.30	$13,379.60	$13,250.95	2026-02-28
827	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	4	2	—	—	$13,118.22	$13,375.44	$13,246.83	2026-02-28
56	MS_DRG	Degenerative Nervous System Disorders With Mcc	4	2	—	—	$13,082.52	$13,339.04	$13,210.78	2026-02-28
357	MS_DRG	Other Digestive System O.r. Procedures With Cc	4	2	—	—	$13,067.22	$13,323.44	$13,195.33	2026-02-28
37	MS_DRG	Extracranial Procedures With Mcc	4	2	—	—	$13,062.12	$13,318.24	$13,190.18	2026-02-28

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