Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

SAINT ROSE DOMINICAN HOSPITALS - SAN MARTIN CAMPUS

Las Vegas, NV · CCN 290053 · Rates published

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You selected 93306 (CPT)

TTE COMP W SPEC/CF W CON

This hospital’s price: $623 across 9 payers · range $204-$6,818

Source: https://www.dignityhealth.org/content/dam/dignity-health/documents/mrf-json/southwest/json/941196203_st-rose-dominican-hospital-san-martin_standardcharges.json?target=%22_blank%22 · 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.

10,049 distinct procedures filed
14 distinct payers
328,948 rate rows
2026-02-28 last MRF observed
Data quality

306,872 of 328,948 rate rows are consumer-grade (93.3%)

22,076 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 13,050
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 6,312
template filing: same amount across many unrelated codes — excluded 1,744
per-diem day rate — not a per-procedure price 658
exceeds 10× this hospital's gross charge — excluded from medians 250
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 28
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 22
placeholder amount (≤ $0.02) — excluded from medians 12
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.commonspirit.org/content/dam/commonspiritorg/en/dhnev/celv/finance/price-transparency/941196203_st-rose-dominican-hospital-san-martin_standardcharges.json
Found on page https://www.commonspirit.org/patient-resources/dignity-health-nevada-price-transparency
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-12
Content fingerprint 142c90674a0b6f6d… · 47,307,050 bytes · first seen 2026-07-06

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
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 $298,828.47 $1,081,528.00 $298,828.47 nat. median
$359,358
0.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 6 $223,425.68 $807,811.00 $223,425.68 nat. median
$249,124
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 6 $188,305.65 $680,322.00 $188,305.65 nat. median
$198,433
0.9× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face Mouth… 8 $4,139.00 $690,698.00 $170,204.87 nat. median
$190,557
0.9× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face Mouth And Neck… 8 $4,139.00 $455,382.00 $112,521.28 nat. median
$126,722
0.9× median
230
MS_DRG 		No Active Code Description 1 $64,648.00 $109,568.00 $109,568.00 nat. median
$12,593
outlier · 8.7×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 6 $104,398.37 $375,733.00 $104,398.37 nat. median
$110,192
0.9× median
7
MS_DRG 		Lung Transplant 6 $104,137.66 $374,787.00 $104,137.66 nat. median
$117,894
0.9× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 6 $87,949.51 $316,023.00 $87,949.51 nat. median
$103,967
0.8× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 6 $86,955.67 $312,415.00 $86,955.67 nat. median
$97,414
0.9× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 6 $85,024.09 $305,403.00 $85,024.09 nat. median
$94,964
0.9× median
61799
CPT 		Srs Cran Les Complex Addl 3 $286.69 $96,332.00 $84,724.00 nat. median
$1,954
outlier · 43.4×
215
MS_DRG 		Other Heart Assist System Implant 6 $64,648.00 $303,838.00 $84,592.74 nat. median
$93,917
0.9× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 7 $4,139.00 $300,414.00 $83,649.47 nat. median
$93,270
0.9× median
61800
CPT 		Apply Srs Headframe Add-on 4 $145.56 $96,332.00 $77,208.50 nat. median
$1,440
outlier · 53.6×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 $64,648.00 $276,774.00 $77,137.39 nat. median
$90,581
0.9× median
850
MS_DRG 		Acute Leukemia With Other Procedures 6 $73,667.65 $264,179.00 $73,667.65 nat. median
$78,262
0.9× median
J7330
HCPCS 		Maci Imp 42112x-46323 10 $29,353.10 $173,430.44 $72,118.90 nat. median
$75,037
1.0× median
63621
CPT 		Srs Spinal Lesion Addl 4 $238.35 $96,332.00 $69,693.00 nat. median
$2,300
outlier · 30.3×
63620
CPT 		Srs Spinal Lesion 4 $1,056.67 $96,332.00 $69,693.00 nat. median
$3,813
outlier · 18.3×
61798
CPT 		Srs Cranial Lesion Complex 4 $1,308.68 $96,332.00 $69,693.00 nat. median
$3,873
outlier · 18.0×
61797
CPT 		Srs Cran Les Simple Addl 4 $208.05 $96,332.00 $69,693.00 nat. median
$1,495
outlier · 46.6×
61796
CPT 		Srs Cranial Lesion Simple 4 $958.35 $96,332.00 $69,693.00 nat. median
$3,757
outlier · 18.5×
DB20JZZ
OTHER 		Gamma Knife - Ip 5 $46,280.00 $91,773.00 $69,026.50 nat. median
$51,212
1.3× median
DB20HZZ
OTHER 		Cyber Knife Radiosurgery Ip 5 $46,280.00 $91,773.00 $69,026.50 nat. median
$52,036
1.3× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 6 $64,648.00 $243,015.00 $67,837.36 nat. median
$77,043
0.9× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature Malignancy Infection Or Exte… 6 $16,657.00 $242,880.00 $67,800.22 nat. median
$77,696
0.9× median
D021JZZ
OTHER 		Gamma Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median
D723HZZ
OTHER 		Cyber Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median
D725JZZ
OTHER 		Gamma Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median
D720JZZ
OTHER 		Gamma Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median
D721JZZ
OTHER 		Gamma Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median
D721HZZ
OTHER 		Cyber Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median
D722JZZ
OTHER 		Gamma Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median
D726HZZ
OTHER 		Cyber Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median
D727JZZ
OTHER 		Gamma Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median
D724JZZ
OTHER 		Gamma Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median
D725HZZ
OTHER 		Cyber Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median
D020HZZ
OTHER 		Cyber Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median
D724HZZ
OTHER 		Cyber Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median
D726JZZ
OTHER 		Gamma Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median
D020JZZ
OTHER 		Gamma Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median
D026HZZ
OTHER 		Cyber Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median
D723JZZ
OTHER 		Gamma Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median
D027HZZ
OTHER 		Cyber Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median
D021HZZ
OTHER 		Cyber Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median
D026JZZ
OTHER 		Gamma Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median
D027JZZ
OTHER 		Gamma Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median
D720HZZ
OTHER 		Cyber Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median
D722HZZ
OTHER 		Cyber Knife - Ip 5 $46,280.00 $91,773.00 $66,894.00 nat. median
$46,280
1.4× median

Other procedures at this hospital

Browse this hospital's 10,049 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 14 6 — — $298,828.47 $1,081,528.00 $298,828.47 2026-02-28
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 14 6 — — $223,425.68 $807,811.00 $223,425.68 2026-02-28
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 14 6 — — $188,305.65 $680,322.00 $188,305.65 2026-02-28
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face Mouth … 18 8 — — $4,139.00 $690,698.00 $170,204.87 2026-02-28
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face Mouth And Neck… 18 8 — — $4,139.00 $455,382.00 $112,521.28 2026-02-28
230 MS_DRG No Active Code Description 6 1 — — $64,648.00 $109,568.00 $109,568.00 2026-02-28
14 MS_DRG Allogeneic Bone Marrow Transplant 14 6 — — $104,398.37 $375,733.00 $104,398.37 2026-02-28
7 MS_DRG Lung Transplant 14 6 — — $104,137.66 $374,787.00 $104,137.66 2026-02-28
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 14 6 — — $87,949.51 $316,023.00 $87,949.51 2026-02-28
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 14 6 — — $86,955.67 $312,415.00 $86,955.67 2026-02-28
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 14 6 — — $85,024.09 $305,403.00 $85,024.09 2026-02-28
61799 CPT Srs Cran Les Complex Addl 10 3 — — $286.69 $96,332.00 $84,724.00 2026-02-28
215 MS_DRG Other Heart Assist System Implant 20 6 — — $64,648.00 $303,838.00 $84,592.74 2026-02-28
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 16 7 — — $4,139.00 $300,414.00 $83,649.47 2026-02-28
61800 CPT Apply Srs Headframe Add-on 12 4 — — $145.56 $96,332.00 $77,208.50 2026-02-28
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 6 — — $64,648.00 $276,774.00 $77,137.39 2026-02-28
850 MS_DRG Acute Leukemia With Other Procedures 14 6 — — $73,667.65 $264,179.00 $73,667.65 2026-02-28
J7330 HCPCS Maci Imp 42112x-46323 46 10 $206,054.00 $42,241.07 80% off $29,353.10 $173,430.44 $72,118.90 2026-02-28
61798 CPT Srs Cranial Lesion Complex 14 4 — — $1,308.68 $96,332.00 $69,693.00 2026-02-28
61796 CPT Srs Cranial Lesion Simple 14 4 — — $958.35 $96,332.00 $69,693.00 2026-02-28
63620 CPT Srs Spinal Lesion 14 4 — — $1,056.67 $96,332.00 $69,693.00 2026-02-28
63621 CPT Srs Spinal Lesion Addl 14 4 — — $238.35 $96,332.00 $69,693.00 2026-02-28
61797 CPT Srs Cran Les Simple Addl 14 4 — — $208.05 $96,332.00 $69,693.00 2026-02-28
DB20HZZ OTHER Cyber Knife Radiosurgery Ip 18 5 — — $46,280.00 $91,773.00 $69,026.50 2026-02-28
DB20JZZ OTHER Gamma Knife - Ip 18 5 — — $46,280.00 $91,773.00 $69,026.50 2026-02-28
231 MS_DRG Coronary Bypass With Ptca With Mcc 20 6 — — $64,648.00 $243,015.00 $67,837.36 2026-02-28
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature Malignancy Infection Or Exte… 18 6 — — $16,657.00 $242,880.00 $67,800.22 2026-02-28
DD22HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D927JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D92CJZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D728JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D725JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D926JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DD23JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D726HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DB27HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DT20JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DD24HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DV20HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DD23HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D92DJZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DB28HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DD24JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DG24JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D928JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DB21JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DT21JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D927HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DW26HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D723JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DF21JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D92CHZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DU20JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DW26JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D026JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DG21JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DD20JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DW23JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DF22HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DB25HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D721HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DD25JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D027JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D020JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D820HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DT22JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DG21HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DD27JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DM20HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D020HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D021HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DT20HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DU21JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DV20JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DW22HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D021JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D920HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D928HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D724JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DW21JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DF23HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D820JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D929JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D920JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DU21HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D92BJZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D725HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D722JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DM20JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D925HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DT22HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DU22HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D723HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D929HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DG25JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D720JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DM21JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DG22HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D726JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DF23JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DD22JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DG20JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DD21HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DB22JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D924HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DB25JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DU22JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DT21HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DT23JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D92DHZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D722HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DD27HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DB28JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D727HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D720HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D724HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D026HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D921HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D721JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DD21JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D921JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DF21HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DT23HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D727JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DV21HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DB26HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DG25HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DB21HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DD20HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DD25HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DB27JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D926HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DW21HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D925JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DG20HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DF22JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DW23HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D92BHZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DW22JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DU20HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DG22JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DF20HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DV21JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DM21HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DB26JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DF20JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D728HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D924JZZ OTHER Gamma Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DB22HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
D027HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
DG24HZZ OTHER Cyber Knife - Ip 26 5 — — $46,280.00 $91,773.00 $66,894.00 2026-02-28
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 16 7 — — $4,139.00 $239,192.00 $66,784.27 2026-02-28
38240 CPT Transplt Allo Hct/donor 18 7 — — $212.54 $66,670.18 $65,362.92 2026-02-28
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 14 6 — — $64,576.18 $259,793.00 $64,576.18 2026-02-28
10 MS_DRG Pancreas Transplant 14 6 — — $63,880.18 $228,650.00 $63,880.18 2026-02-28
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 14 6 — — $63,519.14 $227,339.00 $63,519.14 2026-02-28
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 20 6 — — $62,643.02 $224,159.00 $63,269.46 2026-02-28
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 6 — — $62,019.70 $221,896.00 $62,639.90 2026-02-28
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 14 6 — — $59,860.59 $240,556.00 $59,860.59 2026-02-28
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 20 6 — — $56,722.66 $202,667.00 $57,289.89 2026-02-28
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 16 7 — — $4,139.00 $203,691.00 $57,004.70 2026-02-28
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 14 6 — — $55,849.70 $199,499.00 $55,849.70 2026-02-28
955 MS_DRG Craniotomy For Multiple Significant Trauma 14 6 — — $54,836.90 $220,062.00 $54,836.90 2026-02-28
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 14 6 — — $53,860.44 $192,277.00 $53,860.44 2026-02-28
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 14 6 — — $53,656.62 $191,537.00 $53,656.62 2026-02-28
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 14 6 — — $53,567.35 $191,213.00 $53,567.35 2026-02-28
C1825 HCPCS Nrstm Crsn Br26149x-28764 64 10 $134,344.00 $27,540.53 79% off $38,384.10 $101,333.52 $53,033.90 2026-02-28
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 6 — — $51,910.69 $185,200.00 $52,429.80 2026-02-28
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 18 8 — — $4,139.00 $185,466.00 $51,984.16 2026-02-28
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 14 6 — — $50,855.24 $181,368.00 $50,855.24 2026-02-28
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 22 7 — — $12,048.00 $177,643.00 $49,829.01 2026-02-28
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 14 6 — — $49,765.81 $177,414.00 $49,765.81 2026-02-28
232 MS_DRG Coronary Bypass With Ptca Without Mcc 20 6 — — $49,151.97 $175,185.00 $49,643.49 2026-02-28
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 14 6 — — $49,543.02 $176,605.00 $49,543.02 2026-02-28
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 14 6 — — $49,373.17 $175,988.00 $49,373.17 2026-02-28
28 MS_DRG Spinal Procedures With Mcc 14 6 — — $48,921.28 $195,930.00 $48,921.28 2026-02-28
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 14 6 — — $48,576.84 $173,098.00 $48,576.84 2026-02-28
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 14 6 — — $48,576.84 $173,098.00 $48,576.84 2026-02-28
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 6 — — $47,892.69 $170,614.00 $48,371.62 2026-02-28
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 14 6 — — $48,220.54 $171,804.00 $48,220.54 2026-02-28
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome Neonate 14 6 — — $47,857.14 $170,485.00 $47,857.14 2026-02-28
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 20 6 — — $47,378.39 $168,747.00 $47,852.18 2026-02-28
32701 CPT Thorax Stereo Rad Targetw/tx 8 3 — — $212.09 $91,924.00 $47,339.50 2026-02-28
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 14 6 — — $46,889.37 $166,972.00 $46,889.37 2026-02-28
C9293 HCPCS Glucarpidase 1000unit Inj 36 10 $147,346.00 $30,205.93 80% off $622.41 $106,089.12 $46,413.99 2026-02-28
DU20DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DT20DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D726DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DU22DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DW21DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D927DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D721DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D723DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DT22DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DB28DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DB21DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D92DDZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DF21DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DV21DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DB22DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D925DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DG22DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D724DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D928DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DD25DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D727DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D926DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DB25DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D920DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D929DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DT23DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DD20DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DG24DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D728DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D026DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DD22DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DG25DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DT21DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D725DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DW26DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DB20DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DM21DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DW23DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DB26DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DF23DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D720DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D820DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DF20DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D021DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D027DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DW22DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DD21DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DB27DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D92CDZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D924DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DD27DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DF22DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DV20DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DD24DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D020DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D92BDZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DU21DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DG20DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DG21DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D921DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DD23DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D722DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DM20DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature Malignancy Infection Or Exte… 18 6 — — $16,657.00 $164,595.00 $46,234.45 2026-02-28
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 14 6 — — $45,963.47 $183,864.00 $45,963.47 2026-02-28
C1605 HCPCS Pace Dl Ldles23772x-26149 32 10 $116,316.00 $23,844.78 80% off $34,894.80 $83,747.52 $45,944.82 2026-02-28
C1824 HCPCS Gener Ccm 23772x-26149 32 10 $116,316.00 $23,844.78 80% off $34,894.80 $83,747.52 $45,944.82 2026-02-28
653 MS_DRG Major Bladder Procedures With Mcc 14 6 — — $44,932.51 $159,868.00 $44,932.51 2026-02-28
834 MS_DRG Acute Leukemia With Mcc 14 6 — — $44,558.83 $158,512.00 $44,558.83 2026-02-28
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 14 6 — — $44,558.83 $178,134.00 $44,558.83 2026-02-28
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 16 7 — — $4,139.00 $157,847.00 $44,375.55 2026-02-28
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 16 7 — — $4,139.00 $156,883.00 $44,110.10 2026-02-28
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 14 6 — — $43,877.84 $156,040.00 $43,877.84 2026-02-28
405 MS_DRG Pancreas Liver And Shunt Procedures With Mcc 14 6 — — $43,779.88 $155,684.00 $43,779.88 2026-02-28
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 14 6 — — $43,561.05 $154,890.00 $43,561.05 2026-02-28
11 MS_DRG Tracheostomy For Face Mouth And Neck Diagnoses Or Laryngectomy With Mcc 14 6 — — $43,520.75 $154,744.00 $43,520.75 2026-02-28
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 14 6 — — $43,516.01 $154,726.00 $43,516.01 2026-02-28
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 20 6 — — $42,922.71 $152,573.00 $43,351.94 2026-02-28
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 6 — — $42,737.06 $151,899.00 $43,164.43 2026-02-28
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 14 6 — — $41,578.90 $147,695.00 $41,578.90 2026-02-28
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 14 6 — — $41,443.81 $147,204.00 $41,443.81 2026-02-28
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 18 8 — — $4,139.00 $146,103.00 $41,140.45 2026-02-28
326 MS_DRG Stomach Esophageal And Duodenal Procedures With Mcc 14 6 — — $41,017.20 $145,656.00 $41,017.20 2026-02-28
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 14 6 — — $40,684.61 $144,448.00 $40,684.61 2026-02-28
228 MS_DRG Other Cardiothoracic Procedures With Mcc 20 6 — — $40,261.16 $142,911.00 $40,663.78 2026-02-28
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 14 6 — — $40,449.97 $143,596.00 $40,449.97 2026-02-28
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 14 6 — — $40,419.16 $143,485.00 $40,419.16 2026-02-28
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 14 6 — — $40,403.36 $143,427.00 $40,403.36 2026-02-28
C2624 HCPCS Wrless Sens 19647x-21611 64 10 $100,936.50 $20,691.99 79% off $28,839.30 $76,134.24 $39,845.89 2026-02-28
245 MS_DRG Aicd Generator Procedures 18 8 — — $4,139.00 $140,144.00 $39,498.80 2026-02-28
471 MS_DRG Cervical Spinal Fusion With Mcc 18 6 — — $16,657.00 $156,541.00 $39,265.74 2026-02-28
6 MS_DRG Liver Transplant Without Mcc 14 6 — — $39,201.75 $139,065.00 $39,201.75 2026-02-28
32136293 CDM Inst/supp Ste13419x-14761 8 3 $65,659.00 $13,460.10 79% off $19,697.70 $47,274.48 $39,067.10 2026-02-28
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 14 6 — — $38,619.51 $136,952.00 $38,619.51 2026-02-28
799 MS_DRG Splenic Procedures With Mcc 14 6 — — $38,455.98 $136,358.00 $38,455.98 2026-02-28
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 14 6 — — $38,448.87 $136,332.00 $38,448.87 2026-02-28
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 14 6 — — $38,060.18 $134,921.00 $38,060.18 2026-02-28
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 14 6 — — $37,861.10 $134,199.00 $37,861.10 2026-02-28
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 22 7 — — $12,295.00 $133,407.00 $37,643.06 2026-02-28
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 6 — — $37,174.58 $131,707.00 $37,546.33 2026-02-28
C1822 HCPCS Nurstm Hf Rc 17861x-19647 224 10 $96,131.00 $19,706.86 79% off $1,171.20 $92,121.84 $37,491.09 2026-02-28
163 MS_DRG Major Chest Procedures With Mcc 14 6 — — $37,305.72 $132,183.00 $37,305.72 2026-02-28
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 14 6 — — $37,290.71 $132,128.00 $37,290.71 2026-02-28
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 14 6 — — $37,169.05 $131,687.00 $37,169.05 2026-02-28
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 14 6 — — $36,534.67 $129,384.00 $36,534.67 2026-02-28
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 14 6 — — $36,322.16 $128,612.00 $36,322.16 2026-02-28
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 14 6 — — $36,224.19 $144,133.00 $36,224.19 2026-02-28
C1767 HCPCS Neurstm Nrec 10082x-11090 512 10 $83,421.00 $17,101.31 80% off $9,590.40 $122,612.40 $35,952.28 2026-02-28
901 MS_DRG Wound Debridements For Injuries With Mcc 14 6 — — $35,893.97 $127,058.00 $35,893.97 2026-02-28
41024381 CDM Carmustine Polife 7.7mg 12 4 $57,648.00 $11,817.84 80% off $17,294.40 $41,506.56 $35,741.76 2026-02-28
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 14 6 — — $35,596.13 $125,977.00 $35,596.13 2026-02-28
32126245 CDM Inst/supp Ste12199x-13419 8 3 $59,690.00 $12,236.45 80% off $17,907.00 $42,976.80 $35,515.55 2026-02-28
33270 CPT Defib Subq Ins/rep W Lead 28 9 $75,893.00 $15,558.07 79% off $6,888.00 $54,642.96 $35,433.82 2026-02-28
69930 CPT Implant Cochlear Device 18 7 — — $1,174.14 $35,856.44 $35,153.37 2026-02-28
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 14 6 — — $35,075.52 $124,087.00 $35,075.52 2026-02-28
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