|
Sx00000069838-74794
|
CDM
|
Jts Implant Set
|
31
|
14
|
$172,360.00
|
—
|
$31,024.80
|
$146,506.00
|
$86,180.00
|
2025-12-31
|
|
Sx00000069838
|
CDM
|
Jts Implant Set
|
32
|
16
|
$172,360.00
|
—
|
$310.25
|
$146,506.00
|
$84,887.30
|
2024-12-31
|
|
Sx00000066257
|
CDM
|
Controller Impella Packaged
|
32
|
16
|
$161,200.00
|
—
|
$290.16
|
$137,020.00
|
$79,391.00
|
2024-12-31
|
|
C1827
|
HCPCS
|
Generator Neurostimulator Vagal Nerve Stimulator Permanent Pulse
|
63
|
30
|
$136,290.00
|
—
|
$245.32
|
$115,846.50
|
$68,145.00
|
2025-12-31
|
|
A9543
|
HCPCS
|
Y-90 Yttrium Ibrit To 40 Mci Tx
|
101
|
37
|
$129,984.00
|
$56,824.55
56% off
|
$10,098.00
|
$129,984.00
|
$65,476.58
|
2025-12-31
|
|
C1605
|
HCPCS
|
System Leadless Pacemaker Aveir Dr
|
31
|
14
|
$118,965.00
|
—
|
$21,413.70
|
$101,120.25
|
$61,266.98
|
2025-12-31
|
|
Sx00000189430
|
CDM
|
Implant Gamma Tile 9 Count
|
32
|
16
|
$116,560.00
|
—
|
$209.81
|
$99,076.00
|
$57,405.80
|
2024-12-31
|
|
Sx00000102245-63191
|
CDM
|
Custom Pelvis IMPLaNT
|
31
|
14
|
$112,294.40
|
—
|
$20,212.99
|
$95,450.24
|
$56,147.20
|
2025-12-31
|
|
Sx00000102245
|
CDM
|
Custom Pelvis IMPLaNT
|
32
|
16
|
$112,294.40
|
—
|
$202.13
|
$95,450.24
|
$55,305.00
|
2024-12-31
|
|
Sx00000065138-76374
|
CDM
|
Carticel Cs1000
|
31
|
14
|
$108,087.82
|
—
|
$19,455.81
|
$91,874.65
|
$54,043.91
|
2025-12-31
|
|
Sx00000065138
|
CDM
|
Carticel Cs1000
|
32
|
16
|
$108,087.82
|
—
|
$194.56
|
$91,874.65
|
$53,233.25
|
2024-12-31
|
|
8010000021-108083
|
CDM
|
Cadaver Donor Kidney Acquisit
|
28
|
13
|
$93,500.00
|
—
|
$13,277.00
|
$90,994.20
|
$73,056.23
|
2025-12-31
|
|
128784
|
CDM
|
Cadaver Donor Kidney Acquisit
|
28
|
14
|
$93,500.00
|
—
|
$13,277.00
|
$87,890.00
|
$71,611.65
|
2024-12-31
|
|
8010000020-108084
|
CDM
|
Live Donor Kidney Acquisition
|
28
|
13
|
$88,000.00
|
—
|
$12,496.00
|
$85,641.60
|
$68,758.80
|
2025-12-31
|
|
128782
|
CDM
|
Live Donor Kidney Acquisition
|
28
|
14
|
$88,000.00
|
—
|
$12,496.00
|
$82,720.00
|
$67,399.20
|
2024-12-31
|
|
Sx00000075430
|
CDM
|
Ligasure Kit
|
27
|
14
|
$87,094.62
|
—
|
$12,367.44
|
$81,868.94
|
$68,090.57
|
2024-12-31
|
|
Sx00000075430-72847
|
CDM
|
Ligasure Kit
|
24
|
11
|
$87,094.62
|
—
|
$12,367.44
|
$84,760.48
|
$68,051.38
|
2025-12-31
|
|
8010000023-108081
|
CDM
|
Cadaver Kidney/pancreas Acquis
|
28
|
13
|
$80,453.00
|
—
|
$11,424.33
|
$78,296.86
|
$62,861.95
|
2025-12-31
|
|
128788
|
CDM
|
Cadaver Kidney/pancreas Acquis
|
28
|
14
|
$80,453.00
|
—
|
$11,424.33
|
$75,625.82
|
$61,618.96
|
2024-12-31
|
|
Sx00000076504
|
CDM
|
Ligasure Kit Lf1744/gen
|
27
|
14
|
$79,401.17
|
—
|
$11,274.97
|
$74,637.10
|
$62,075.83
|
2024-12-31
|
|
Sx00000076504-72657
|
CDM
|
Ligasure Kit Lf1744/gen
|
24
|
11
|
$79,401.17
|
—
|
$11,274.97
|
$77,273.22
|
$62,040.10
|
2025-12-31
|
|
33231
|
HCPCS
|
Ins Pacng Cvdfb Pls Gen Only W/exist Multi Leads
|
73
|
37
|
$75,878.00
|
$34,655.87
54% off
|
$781.25
|
$133,120.00
|
$54,844.62
|
2025-12-31
|
|
Sx00000046460
|
CDM
|
Kit Starter Stapler Endowrist 45
|
27
|
14
|
$72,354.00
|
—
|
$10,274.27
|
$68,012.76
|
$56,566.36
|
2024-12-31
|
|
Sx00000046460-81141
|
CDM
|
Kit Starter Stapler Endowrist 45
|
24
|
11
|
$72,354.00
|
—
|
$10,274.27
|
$70,414.91
|
$56,533.79
|
2025-12-31
|
|
J3391
|
HCPCS
|
Inj, Atidarsagene Autotemcel
|
6
|
5
|
—
|
$4,377,500.00
|
$4,377,500.00
|
$4,771,475.00
|
$4,377,500.00
|
2025-12-31
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
14
|
11
|
—
|
$3,685,266.67
|
$3,685,266.67
|
$4,422,320.00
|
$3,710,000.00
|
2025-12-31
|
|
J1414
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
7
|
6
|
—
|
$3,710,000.00
|
$3,710,000.00
|
$4,452,000.00
|
$3,710,000.00
|
2025-12-31
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
14
|
11
|
—
|
$3,324,571.90
|
$3,324,571.90
|
$3,989,486.28
|
$3,327,159.88
|
2025-12-31
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
14
|
11
|
—
|
$3,261,355.00
|
$3,261,355.00
|
$3,913,626.00
|
$3,286,000.00
|
2025-12-31
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
14
|
11
|
—
|
$2,950,686.67
|
$2,950,686.67
|
$3,540,824.00
|
$2,968,000.00
|
2025-12-31
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
14
|
11
|
—
|
$2,452,115.60
|
$2,354,513.02
|
$2,942,538.72
|
$2,452,115.60
|
2025-12-31
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
7
|
6
|
—
|
$2,332,000.00
|
$2,332,000.00
|
$2,798,400.00
|
$2,332,000.00
|
2025-12-31
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
8
|
7
|
—
|
$770,620.00
|
$655,027.00
|
$924,744.00
|
$770,620.00
|
2025-12-31
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel Car-pos T
|
21
|
16
|
—
|
$578,324.58
|
$491,575.89
|
$922,082.02
|
$578,324.58
|
2025-12-31
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
16
|
13
|
—
|
$553,378.83
|
$470,372.01
|
$664,054.60
|
$553,378.83
|
2025-12-31
|
|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
21
|
16
|
—
|
$541,635.66
|
$460,390.31
|
$933,986.41
|
$541,635.66
|
2025-12-31
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel Car
|
21
|
16
|
—
|
$541,260.45
|
$460,071.38
|
$954,928.83
|
$541,260.45
|
2025-12-31
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Car+
|
20
|
15
|
—
|
$533,076.48
|
$453,115.01
|
$884,589.61
|
$533,076.48
|
2025-12-31
|
|
Q2053
|
HCPCS
|
Brexucabtagene Car Pos T
|
20
|
15
|
—
|
$489,720.00
|
$416,262.00
|
$878,671.10
|
$489,720.00
|
2025-12-31
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
39
|
24
|
—
|
$304,088.96
|
$9,963.00
|
$1,266,961.52
|
$353,576.67
|
2025-12-31
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
53
|
28
|
—
|
$223,663.99
|
$15,110.00
|
$1,078,874.06
|
$282,363.13
|
2025-12-31
|
|
Q2058
|
HCPCS
|
Obecbtge Autol Up To 400 Mil
|
7
|
6
|
—
|
$270,375.00
|
$270,375.00
|
$324,450.00
|
$270,375.00
|
2025-12-31
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
55
|
29
|
—
|
$195,801.11
|
$15,110.00
|
$933,045.26
|
$265,008.34
|
2025-12-31
|
|
'583-4
|
OTHER
|
Neonate W Ecmo
|
1
|
1
|
—
|
—
|
$263,700.81
|
$263,700.81
|
$263,700.81
|
2024-12-31
|
|
'588-4
|
OTHER
|
Neonate Bwt <1500g W Major Procedure
|
1
|
1
|
—
|
—
|
$252,297.48
|
$252,297.48
|
$252,297.48
|
2024-12-31
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
55
|
29
|
—
|
$175,971.57
|
$15,110.00
|
$820,851.71
|
$218,739.53
|
2025-12-31
|
|
'002-4
|
OTHER
|
Heart &/or Lung Transplant
|
1
|
1
|
—
|
—
|
$217,484.20
|
$217,484.20
|
$217,484.20
|
2024-12-31
|
|
'591-4
|
OTHER
|
Neonate Birthwt 500-749g Without Major Procedure
|
1
|
1
|
—
|
—
|
$211,881.29
|
$211,881.29
|
$211,881.29
|
2024-12-31
|
|
'161-4
|
OTHER
|
Cardiac Defibrillator & Heart Assist Implant
|
1
|
1
|
—
|
—
|
$206,769.43
|
$206,769.43
|
$206,769.43
|
2024-12-31
|
|
'841-4
|
OTHER
|
Extensive 3rd Degree Burns W Skin Graft
|
1
|
1
|
—
|
—
|
$200,628.89
|
$200,628.89
|
$200,628.89
|
2024-12-31
|
|
'003-4
|
OTHER
|
Bone Marrow Transplant
|
1
|
1
|
—
|
—
|
$193,574.88
|
$193,574.88
|
$193,574.88
|
2024-12-31
|
|
Q0480
|
HCPCS
|
Driver Pneumatic Vad, Rep
|
3
|
3
|
—
|
—
|
$130,249.99
|
$270,421.41
|
$189,497.10
|
2025-12-31
|
|
'588-3
|
OTHER
|
Neonate Bwt <1500g W Major Procedure
|
1
|
1
|
—
|
—
|
$188,495.69
|
$188,495.69
|
$188,495.69
|
2024-12-31
|
|
'583-3
|
OTHER
|
Neonate W Ecmo
|
1
|
1
|
—
|
—
|
$176,349.22
|
$176,349.22
|
$176,349.22
|
2024-12-31
|
|
'593-4
|
OTHER
|
Neonate Birthwt 750-999g Without Major Procedure
|
1
|
1
|
—
|
—
|
$174,064.66
|
$174,064.66
|
$174,064.66
|
2024-12-31
|
|
'001-4
|
OTHER
|
Liver Transplant &/or Intestinal Transplant
|
1
|
1
|
—
|
—
|
$162,740.13
|
$162,740.13
|
$162,740.13
|
2024-12-31
|
|
'591-3
|
OTHER
|
Neonate Birthwt 500-749g Without Major Procedure
|
1
|
1
|
—
|
—
|
$150,089.36
|
$150,089.36
|
$150,089.36
|
2024-12-31
|
|
'006-4
|
OTHER
|
Pancreas Transplant
|
1
|
1
|
—
|
—
|
$149,325.21
|
$149,325.21
|
$149,325.21
|
2024-12-31
|
|
'004-4
|
OTHER
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
1
|
1
|
—
|
—
|
$148,223.13
|
$148,223.13
|
$148,223.13
|
2024-12-31
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
55
|
29
|
—
|
$121,329.54
|
$15,110.00
|
$541,193.13
|
$147,792.67
|
2025-12-31
|
|
'609-4
|
OTHER
|
Neonate Bwt 1500-2499g W Major Procedure
|
1
|
1
|
—
|
—
|
$146,310.46
|
$146,310.46
|
$146,310.46
|
2024-12-31
|
|
'589-1
|
OTHER
|
Neonate Bwt <500g Or Ga <24 Weeks
|
1
|
1
|
—
|
—
|
$145,878.54
|
$145,878.54
|
$145,878.54
|
2024-12-31
|
|
'002-3
|
OTHER
|
Heart &/or Lung Transplant
|
1
|
1
|
—
|
—
|
$137,941.74
|
$137,941.74
|
$137,941.74
|
2024-12-31
|
|
'603-4
|
OTHER
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
1
|
1
|
—
|
—
|
$137,867.36
|
$137,867.36
|
$137,867.36
|
2024-12-31
|
|
'602-4
|
OTHER
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
1
|
1
|
—
|
—
|
$134,052.13
|
$134,052.13
|
$134,052.13
|
2024-12-31
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
51
|
27
|
—
|
$94,594.94
|
$9,963.00
|
$440,154.97
|
$131,334.34
|
2025-12-31
|
|
7
|
MS_DRG
|
Lung Transplant
|
51
|
27
|
—
|
$101,243.31
|
$15,110.00
|
$439,046.34
|
$129,812.60
|
2025-12-31
|
|
'593-3
|
OTHER
|
Neonate Birthwt 750-999g Without Major Procedure
|
1
|
1
|
—
|
—
|
$121,880.62
|
$121,880.62
|
$121,880.62
|
2024-12-31
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
53
|
28
|
—
|
$101,059.25
|
$15,110.00
|
$456,412.07
|
$121,271.08
|
2025-12-31
|
|
'591-2
|
OTHER
|
Neonate Birthwt 500-749g Without Major Procedure
|
1
|
1
|
—
|
—
|
$120,867.52
|
$120,867.52
|
$120,867.52
|
2024-12-31
|
|
'160-4
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
1
|
1
|
—
|
—
|
$120,599.67
|
$120,599.67
|
$120,599.67
|
2024-12-31
|
|
'003-3
|
OTHER
|
Bone Marrow Transplant
|
1
|
1
|
—
|
—
|
$117,474.67
|
$117,474.67
|
$117,474.67
|
2024-12-31
|
|
'002-2
|
OTHER
|
Heart &/or Lung Transplant
|
1
|
1
|
—
|
—
|
$114,790.35
|
$114,790.35
|
$114,790.35
|
2024-12-31
|
|
'630-4
|
OTHER
|
Neonate Birthwt >2499g W Major Cardiovascular Procedure
|
1
|
1
|
—
|
—
|
$112,312.06
|
$112,312.06
|
$112,312.06
|
2024-12-31
|
|
'303-4
|
OTHER
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
1
|
1
|
—
|
—
|
$111,181.99
|
$111,181.99
|
$111,181.99
|
2024-12-31
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve?procedures
|
36
|
24
|
—
|
$89,915.09
|
$15,110.00
|
$417,247.26
|
$108,287.78
|
2025-12-31
|
|
'607-4
|
OTHER
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
1
|
1
|
—
|
—
|
$107,049.45
|
$107,049.45
|
$107,049.45
|
2024-12-31
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
57
|
29
|
—
|
$87,446.41
|
$15,110.00
|
$438,166.06
|
$106,203.81
|
2025-12-31
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
51
|
27
|
—
|
$85,425.90
|
$15,110.00
|
$357,766.59
|
$105,780.66
|
2025-12-31
|
|
'842-4
|
OTHER
|
Burns With Skin Graft Except Extensive 3rd Degree Burns
|
1
|
1
|
—
|
—
|
$105,141.01
|
$105,141.01
|
$105,141.01
|
2024-12-31
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
19
|
13
|
—
|
$86,460.91
|
$15,110.00
|
$401,218.29
|
$105,006.92
|
2025-12-31
|
|
B0407
|
HCPCS
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
7
|
5
|
—
|
—
|
$87,546.54
|
$113,723.64
|
$103,385.13
|
2025-12-31
|
|
'004-3
|
OTHER
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
1
|
1
|
—
|
—
|
$103,021.79
|
$103,021.79
|
$103,021.79
|
2024-12-31
|
|
'162-4
|
OTHER
|
Cardiac Valve Procedures W Ami Or Complex Pdx
|
1
|
1
|
—
|
—
|
$102,733.00
|
$102,733.00
|
$102,733.00
|
2024-12-31
|
|
'589-2
|
OTHER
|
Neonate Bwt <500g Or Ga <24 Weeks
|
1
|
1
|
—
|
—
|
$102,326.58
|
$102,326.58
|
$102,326.58
|
2024-12-31
|
|
'910-4
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
1
|
1
|
—
|
—
|
$100,740.12
|
$100,740.12
|
$100,740.12
|
2024-12-31
|
|
'608-4
|
OTHER
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
1
|
1
|
—
|
—
|
$99,872.51
|
$99,872.51
|
$99,872.51
|
2024-12-31
|
|
'631-4
|
OTHER
|
Neonate Birthwt >2499g W Other Major Procedure
|
1
|
1
|
—
|
—
|
$99,707.29
|
$99,707.29
|
$99,707.29
|
2024-12-31
|
|
'005-4
|
OTHER
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
1
|
1
|
—
|
—
|
$99,581.27
|
$99,581.27
|
$99,581.27
|
2024-12-31
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
56
|
29
|
—
|
$79,881.05
|
$54,906.00
|
$369,646.78
|
$98,039.67
|
2025-12-31
|
|
B1904
|
HCPCS
|
Guillain-barr? M <38.50
|
7
|
5
|
—
|
—
|
$75,753.70
|
$107,655.71
|
$97,868.83
|
2025-12-31
|
|
'602-3
|
OTHER
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
1
|
1
|
—
|
—
|
$96,830.97
|
$96,830.97
|
$96,830.97
|
2024-12-31
|
|
'863-4
|
OTHER
|
Neonatal Aftercare
|
1
|
1
|
—
|
—
|
$95,498.84
|
$95,498.84
|
$95,498.84
|
2024-12-31
|
|
C1842
|
HCPCS
|
Retinal Prosth, Add-on
|
1
|
1
|
—
|
—
|
$94,381.74
|
$94,381.74
|
$94,381.74
|
2024-12-31
|
|
C1841
|
HCPCS
|
Retinal Prosth Int/ext Comp
|
1
|
1
|
—
|
—
|
$94,381.74
|
$94,381.74
|
$94,381.74
|
2024-12-31
|
|
'006-3
|
OTHER
|
Pancreas Transplant
|
1
|
1
|
—
|
—
|
$94,371.46
|
$94,371.46
|
$94,371.46
|
2024-12-31
|
|
'583-2
|
OTHER
|
Neonate W Ecmo
|
1
|
1
|
—
|
—
|
$94,063.12
|
$94,063.12
|
$94,063.12
|
2024-12-31
|
|
'440-4
|
OTHER
|
Kidney Transplant
|
1
|
1
|
—
|
—
|
$93,448.69
|
$93,448.69
|
$93,448.69
|
2024-12-31
|
|
222
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…
|
16
|
7
|
—
|
—
|
$54,906.00
|
$256,191.60
|
$93,042.00
|
2025-12-31
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
19
|
13
|
—
|
$76,032.35
|
$15,110.00
|
$352,824.98
|
$92,341.41
|
2025-12-31
|
|
'588-2
|
OTHER
|
Neonate Bwt <1500g W Major Procedure
|
1
|
1
|
—
|
—
|
$92,313.61
|
$92,313.61
|
$92,313.61
|
2024-12-31
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
50
|
27
|
—
|
$49,066.66
|
$9,963.00
|
$227,691.78
|
$92,066.74
|
2025-12-31
|
|
'001-3
|
OTHER
|
Liver Transplant &/or Intestinal Transplant
|
1
|
1
|
—
|
—
|
$91,727.50
|
$91,727.50
|
$91,727.50
|
2024-12-31
|
|
'593-2
|
OTHER
|
Neonate Birthwt 750-999g Without Major Procedure
|
1
|
1
|
—
|
—
|
$91,513.46
|
$91,513.46
|
$91,513.46
|
2024-12-31
|
|
453
|
MS_DRG
|
Combined Anterior And Posterior Spinal Fusion With Mcc
|
29
|
16
|
—
|
$73,139.43
|
$69,809.30
|
$313,675.83
|
$89,091.83
|
2025-12-31
|
|
'002-1
|
OTHER
|
Heart &/or Lung Transplant
|
1
|
1
|
—
|
—
|
$89,049.08
|
$89,049.08
|
$89,049.08
|
2024-12-31
|
|
223
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…
|
16
|
7
|
—
|
—
|
$47,170.03
|
$200,118.60
|
$87,155.00
|
2025-12-31
|
|
'591-1
|
OTHER
|
Neonate Birthwt 500-749g Without Major Procedure
|
1
|
1
|
—
|
—
|
$87,118.91
|
$87,118.91
|
$87,118.91
|
2024-12-31
|
|
'163-4
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Pdx
|
1
|
1
|
—
|
—
|
$87,115.71
|
$87,115.71
|
$87,115.71
|
2024-12-31
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
55
|
29
|
—
|
$69,763.66
|
$15,110.00
|
$354,491.48
|
$86,469.00
|
2025-12-31
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
55
|
29
|
—
|
$69,902.32
|
$15,110.00
|
$324,378.82
|
$86,440.05
|
2025-12-31
|
|
'611-4
|
OTHER
|
Neonate Birthwt 1500-1999g W Major Anomaly
|
1
|
1
|
—
|
—
|
$86,306.97
|
$86,306.97
|
$86,306.97
|
2024-12-31
|
|
'161-3
|
OTHER
|
Cardiac Defibrillator & Heart Assist Implant
|
1
|
1
|
—
|
—
|
$86,171.67
|
$86,171.67
|
$86,171.67
|
2024-12-31
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
56
|
29
|
—
|
$68,460.81
|
$54,906.00
|
$324,558.84
|
$85,715.81
|
2025-12-31
|
|
'304-4
|
OTHER
|
Dorsal & Lumbar Fusion Proc Except For Curvature Of Back
|
1
|
1
|
—
|
—
|
$84,775.16
|
$84,775.16
|
$84,775.16
|
2024-12-31
|
|
'583-1
|
OTHER
|
Neonate W Ecmo
|
1
|
1
|
—
|
—
|
$84,656.77
|
$84,656.77
|
$84,656.77
|
2024-12-31
|
|
'006-2
|
OTHER
|
Pancreas Transplant
|
1
|
1
|
—
|
—
|
$84,402.89
|
$84,402.89
|
$84,402.89
|
2024-12-31
|
|
'312-4
|
OTHER
|
Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses
|
1
|
1
|
—
|
—
|
$84,333.89
|
$84,333.89
|
$84,333.89
|
2024-12-31
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
19
|
13
|
—
|
$68,840.89
|
$15,110.00
|
$319,453.32
|
$83,607.38
|
2025-12-31
|
|
'588-1
|
OTHER
|
Neonate Bwt <1500g W Major Procedure
|
1
|
1
|
—
|
—
|
$83,082.22
|
$83,082.22
|
$83,082.22
|
2024-12-31
|
|
'612-4
|
OTHER
|
Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond
|
1
|
1
|
—
|
—
|
$82,929.75
|
$82,929.75
|
$82,929.75
|
2024-12-31
|
|
B1806
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
7
|
5
|
—
|
—
|
$71,258.14
|
$91,057.02
|
$82,779.11
|
2025-12-31
|
|
'303-3
|
OTHER
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
1
|
1
|
—
|
—
|
$81,846.38
|
$81,846.38
|
$81,846.38
|
2024-12-31
|
|
C0407
|
HCPCS
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
7
|
5
|
—
|
—
|
$77,853.43
|
$89,596.45
|
$81,451.32
|
2025-12-31
|
|
'167-4
|
OTHER
|
Other Cardiothoracic & Thoracic Vascular Procedures
|
1
|
1
|
—
|
—
|
$79,431.83
|
$79,431.83
|
$79,431.83
|
2024-12-31
|
|
'603-3
|
OTHER
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
1
|
1
|
—
|
—
|
$79,182.43
|
$79,182.43
|
$79,182.43
|
2024-12-31
|
|
D0407
|
HCPCS
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
7
|
5
|
—
|
—
|
$75,575.62
|
$87,020.18
|
$79,109.25
|
2025-12-31
|
|
'609-3
|
OTHER
|
Neonate Bwt 1500-2499g W Major Procedure
|
1
|
1
|
—
|
—
|
$78,903.37
|
$78,903.37
|
$78,903.37
|
2024-12-31
|
|
'690-4
|
OTHER
|
Acute Leukemia
|
1
|
1
|
—
|
—
|
$78,823.04
|
$78,823.04
|
$78,823.04
|
2024-12-31
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
57
|
29
|
—
|
$64,514.30
|
$15,110.00
|
$299,375.93
|
$78,416.57
|
2025-12-31
|
|
'165-4
|
OTHER
|
Coronary Bypass W Ami Or Complex Pdx
|
1
|
1
|
—
|
—
|
$78,201.62
|
$78,201.62
|
$78,201.62
|
2024-12-31
|
|
'001-2
|
OTHER
|
Liver Transplant &/or Intestinal Transplant
|
1
|
1
|
—
|
—
|
$78,039.67
|
$78,039.67
|
$78,039.67
|
2024-12-31
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
50
|
27
|
—
|
$39,730.06
|
$15,110.00
|
$267,852.94
|
$77,742.79
|
2025-12-31
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
42
|
26
|
—
|
$65,976.03
|
$15,110.00
|
$303,623.51
|
$77,727.51
|
2025-12-31
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
57
|
29
|
—
|
$63,863.08
|
$15,110.00
|
$296,353.98
|
$77,561.81
|
2025-12-31
|
|
'841-3
|
OTHER
|
Extensive 3rd Degree Burns W Skin Graft
|
1
|
1
|
—
|
—
|
$77,546.57
|
$77,546.57
|
$77,546.57
|
2024-12-31
|
|
B0406
|
HCPCS
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
7
|
5
|
—
|
—
|
$64,037.48
|
$84,740.59
|
$77,036.90
|
2025-12-31
|
|
'607-3
|
OTHER
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
1
|
1
|
—
|
—
|
$76,571.53
|
$76,571.53
|
$76,571.53
|
2024-12-31
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
55
|
29
|
—
|
$61,607.34
|
$15,110.00
|
$285,886.32
|
$76,182.62
|
2025-12-31
|
|
'090-4
|
OTHER
|
Major Larynx & Trachea Procedures
|
1
|
1
|
—
|
—
|
$75,795.15
|
$75,795.15
|
$75,795.15
|
2024-12-31
|
|
B0404
|
HCPCS
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
7
|
5
|
—
|
—
|
$63,107.72
|
$82,620.74
|
$75,109.76
|
2025-12-31
|
|
'021-4
|
OTHER
|
Craniotomy Except For Trauma
|
1
|
1
|
—
|
—
|
$74,949.77
|
$74,949.77
|
$74,949.77
|
2024-12-31
|
|
'911-4
|
OTHER
|
Extensive Abdominal/thoracic Procedures For Mult Significant Trauma
|
1
|
1
|
—
|
—
|
$73,781.77
|
$73,781.77
|
$73,781.77
|
2024-12-31
|
|
A0407
|
HCPCS
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
7
|
5
|
—
|
—
|
$68,671.79
|
$81,106.93
|
$73,733.57
|
2025-12-31
|
|
'613-4
|
OTHER
|
Neonate Birthwt 1500-1999g W Congenital/perinatal Infection
|
1
|
1
|
—
|
—
|
$73,712.19
|
$73,712.19
|
$73,712.19
|
2024-12-31
|
|
'001-1
|
OTHER
|
Liver Transplant &/or Intestinal Transplant
|
1
|
1
|
—
|
—
|
$73,702.97
|
$73,702.97
|
$73,702.97
|
2024-12-31
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
56
|
29
|
—
|
$57,416.93
|
$9,963.00
|
$266,440.90
|
$73,536.58
|
2025-12-31
|
|
'912-4
|
OTHER
|
Musculoskeletal & Other Procedures For Multiple Significant Trauma
|
1
|
1
|
—
|
—
|
$73,375.09
|
$73,375.09
|
$73,375.09
|
2024-12-31
|
|
'589-3
|
OTHER
|
Neonate Bwt <500g Or Ga <24 Weeks
|
1
|
1
|
—
|
—
|
$73,197.70
|
$73,197.70
|
$73,197.70
|
2024-12-31
|
|
'680-4
|
OTHER
|
Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms
|
1
|
1
|
—
|
—
|
$73,073.87
|
$73,073.87
|
$73,073.87
|
2024-12-31
|
|
'602-2
|
OTHER
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
1
|
1
|
—
|
—
|
$72,941.45
|
$72,941.45
|
$72,941.45
|
2024-12-31
|
|
'401-4
|
OTHER
|
Pituitary & Adrenal Procedures
|
1
|
1
|
—
|
—
|
$72,817.49
|
$72,817.49
|
$72,817.49
|
2024-12-31
|
|
'023-4
|
OTHER
|
Spinal Procedures
|
1
|
1
|
—
|
—
|
$71,718.22
|
$71,718.22
|
$71,718.22
|
2024-12-31
|
|
'003-2
|
OTHER
|
Bone Marrow Transplant
|
1
|
1
|
—
|
—
|
$71,432.12
|
$71,432.12
|
$71,432.12
|
2024-12-31
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
19
|
13
|
—
|
$58,623.63
|
$15,110.00
|
$272,040.51
|
$71,198.49
|
2025-12-31
|
|
'621-4
|
OTHER
|
Neonate Bwt 2000-2499g W Major Anomaly
|
1
|
1
|
—
|
—
|
$71,101.74
|
$71,101.74
|
$71,101.74
|
2024-12-31
|
|
'004-2
|
OTHER
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
1
|
1
|
—
|
—
|
$71,018.46
|
$71,018.46
|
$71,018.46
|
2024-12-31
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
36
|
24
|
—
|
$58,328.97
|
$15,110.00
|
$270,673.16
|
$70,737.38
|
2025-12-31
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
56
|
29
|
—
|
$53,378.39
|
$9,963.00
|
$247,700.22
|
$70,087.05
|
2025-12-31
|
|
C1904
|
HCPCS
|
Guillain-barr? M <38.50
|
7
|
5
|
—
|
—
|
$58,239.42
|
$76,879.91
|
$69,890.83
|
2025-12-31
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
55
|
29
|
—
|
$56,358.81
|
$15,110.00
|
$261,530.71
|
$69,692.37
|
2025-12-31
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
55
|
29
|
—
|
$55,125.70
|
$15,110.00
|
$255,808.54
|
$69,570.13
|
2025-12-31
|
|
B0505
|
HCPCS
|
Non-traumatic Spinal Cord Injury M <39.50
|
7
|
5
|
—
|
—
|
$62,459.58
|
$76,400.66
|
$69,455.15
|
2025-12-31
|
|
C1806
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
7
|
5
|
—
|
—
|
$56,845.82
|
$76,177.52
|
$69,252.29
|
2025-12-31
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
55
|
29
|
—
|
$52,198.94
|
$15,110.00
|
$243,276.29
|
$69,096.59
|
2025-12-31
|
|
'681-4
|
OTHER
|
Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms
|
1
|
1
|
—
|
—
|
$69,072.03
|
$69,072.03
|
$69,072.03
|
2024-12-31
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
56
|
29
|
—
|
$55,032.44
|
$15,110.00
|
$255,375.74
|
$68,916.62
|
2025-12-31
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
55
|
29
|
—
|
$50,650.54
|
$15,110.00
|
$241,361.26
|
$68,552.67
|
2025-12-31
|
|
'321-4
|
OTHER
|
Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp
|
1
|
1
|
—
|
—
|
$68,449.71
|
$68,449.71
|
$68,449.71
|
2024-12-31
|
|
'166-4
|
OTHER
|
Coronary Bypass Without Ami Or Complex Pdx
|
1
|
1
|
—
|
—
|
$68,426.46
|
$68,426.46
|
$68,426.46
|
2024-12-31
|
|
'005-3
|
OTHER
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
1
|
1
|
—
|
—
|
$68,179.05
|
$68,179.05
|
$68,179.05
|
2024-12-31
|
|
'608-3
|
OTHER
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
1
|
1
|
—
|
—
|
$68,126.13
|
$68,126.13
|
$68,126.13
|
2024-12-31
|
|
D1904
|
HCPCS
|
Guillain-barr? M <38.50
|
7
|
5
|
—
|
—
|
$54,344.37
|
$74,438.03
|
$67,670.94
|
2025-12-31
|
|
'260-4
|
OTHER
|
Major Pancreas, Liver & Shunt Procedures
|
1
|
1
|
—
|
—
|
$67,604.46
|
$67,604.46
|
$67,604.46
|
2024-12-31
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
19
|
13
|
—
|
$55,338.65
|
$15,110.00
|
$256,796.71
|
$67,208.88
|
2025-12-31
|
|
'020-4
|
OTHER
|
Craniotomy For Trauma
|
1
|
1
|
—
|
—
|
$67,081.58
|
$67,081.58
|
$67,081.58
|
2024-12-31
|
|
B0106
|
HCPCS
|
Stroke M <41.50 And A <84.50
|
7
|
5
|
—
|
—
|
$60,183.84
|
$73,591.11
|
$66,901.01
|
2025-12-31
|
|
459
|
MS_DRG
|
Spinal Fusion Except Cervical With Mcc
|
29
|
16
|
—
|
$54,741.08
|
$51,116.24
|
$234,770.15
|
$66,680.63
|
2025-12-31
|
|
'169-4
|
OTHER
|
Major Abdominal Vascular Procedures
|
1
|
1
|
—
|
—
|
$66,523.20
|
$66,523.20
|
$66,523.20
|
2024-12-31
|
|
'950-4
|
OTHER
|
Extensive Procedure Unrelated To Principal Diagnosis
|
1
|
1
|
—
|
—
|
$65,683.46
|
$65,683.46
|
$65,683.46
|
2024-12-31
|
|
'022-4
|
OTHER
|
Ventricular Shunt Procedures
|
1
|
1
|
—
|
—
|
$65,639.90
|
$65,639.90
|
$65,639.90
|
2024-12-31
|
|
'089-4
|
OTHER
|
Major Cranial/facial Bone Procedures
|
1
|
1
|
—
|
—
|
$65,617.60
|
$65,617.60
|
$65,617.60
|
2024-12-31
|
|
'695-4
|
OTHER
|
Chemotherapy For Acute Leukemia
|
1
|
1
|
—
|
—
|
$65,438.74
|
$65,438.74
|
$65,438.74
|
2024-12-31
|
|
L7181
|
HCPCS
|
Electronic Elbo Simultaneous
|
5
|
5
|
—
|
—
|
$37,355.19
|
$120,305.46
|
$65,394.88
|
2025-12-31
|
|
'510-4
|
OTHER
|
Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs
|
1
|
1
|
—
|
—
|
$65,389.67
|
$65,389.67
|
$65,389.67
|
2024-12-31
|
|
'162-3
|
OTHER
|
Cardiac Valve Procedures W Ami Or Complex Pdx
|
1
|
1
|
—
|
—
|
$65,316.51
|
$65,316.51
|
$65,316.51
|
2024-12-31
|
|
A1904
|
HCPCS
|
Guillain-barr? M <38.50
|
7
|
5
|
—
|
—
|
$53,404.26
|
$71,473.80
|
$64,976.18
|
2025-12-31
|
|
793
|
MS_DRG
|
Full Term Neonate With Major Problems
|
50
|
27
|
—
|
$34,422.10
|
$9,963.00
|
$159,734.32
|
$64,827.90
|
2025-12-31
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
57
|
29
|
—
|
$53,301.63
|
$15,110.00
|
$247,344.02
|
$64,734.92
|
2025-12-31
|
|
'220-4
|
OTHER
|
Major Stomach, Esophageal & Duodenal Procedures
|
1
|
1
|
—
|
—
|
$64,483.36
|
$64,483.36
|
$64,483.36
|
2024-12-31
|
|
D1806
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
7
|
5
|
—
|
—
|
$53,967.50
|
$70,287.09
|
$63,897.35
|
2025-12-31
|
|
'024-4
|
OTHER
|
Extracranial Vascular Procedures
|
1
|
1
|
—
|
—
|
$63,665.98
|
$63,665.98
|
$63,665.98
|
2024-12-31
|
|
J9029
|
HCPCS
|
Instill Adstiladrin, Tx Dose
|
15
|
12
|
—
|
$63,431.05
|
$53,916.39
|
$76,117.26
|
$63,499.33
|
2025-12-31
|
|
791
|
MS_DRG
|
Prematurity With Major Problems
|
50
|
27
|
—
|
$33,509.24
|
$9,963.00
|
$155,498.22
|
$63,131.40
|
2025-12-31
|
|
B0205
|
HCPCS
|
Traumatic Brain Injury M <35.50
|
7
|
5
|
—
|
—
|
$54,636.34
|
$69,290.56
|
$62,991.42
|
2025-12-31
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
55
|
29
|
—
|
$50,828.00
|
$15,110.00
|
$235,865.21
|
$62,853.06
|
2025-12-31
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
55
|
29
|
—
|
$49,446.33
|
$15,110.00
|
$244,532.57
|
$62,797.80
|
2025-12-31
|
|
'441-4
|
OTHER
|
Major Bladder Procedures
|
1
|
1
|
—
|
—
|
$62,422.19
|
$62,422.19
|
$62,422.19
|
2024-12-31
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc
|
36
|
24
|
—
|
$51,126.78
|
$15,110.00
|
$237,251.71
|
$62,265.21
|
2025-12-31
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
51
|
27
|
—
|
$50,983.17
|
$9,963.00
|
$202,776.06
|
$62,103.07
|
2025-12-31
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
51
|
27
|
—
|
$50,983.17
|
$9,963.00
|
$222,359.22
|
$62,103.07
|
2025-12-31
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
55
|
29
|
—
|
$49,737.68
|
$15,110.00
|
$232,850.92
|
$62,049.81
|
2025-12-31
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
19
|
13
|
—
|
$51,060.75
|
$15,110.00
|
$236,945.30
|
$62,013.37
|
2025-12-31
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
55
|
29
|
—
|
$50,689.33
|
$15,110.00
|
$268,814.12
|
$61,745.16
|
2025-12-31
|
|
'403-4
|
OTHER
|
Procedures For Obesity
|
1
|
1
|
—
|
—
|
$61,677.07
|
$61,677.07
|
$61,677.07
|
2024-12-31
|
|
454
|
MS_DRG
|
Combined Anterior And Posterior Spinal Fusion With Cc
|
29
|
16
|
—
|
$50,482.17
|
$46,304.40
|
$216,504.78
|
$61,492.81
|
2025-12-31
|
|
B0405
|
HCPCS
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
7
|
5
|
—
|
—
|
$50,186.33
|
$67,482.60
|
$61,347.82
|
2025-12-31
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
57
|
29
|
—
|
$50,419.44
|
$15,110.00
|
$233,969.31
|
$61,234.49
|
2025-12-31
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
55
|
29
|
—
|
$47,371.34
|
$15,110.00
|
$222,536.03
|
$61,080.59
|
2025-12-31
|
|
'483-4
|
OTHER
|
Testes & Scrotal Procedures
|
1
|
1
|
—
|
—
|
$61,065.84
|
$61,065.84
|
$61,065.84
|
2024-12-31
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
55
|
29
|
—
|
$48,055.58
|
$15,110.00
|
$222,999.91
|
$60,793.05
|
2025-12-31
|
|
C0406
|
HCPCS
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
7
|
5
|
—
|
—
|
$56,947.29
|
$66,762.46
|
$60,693.15
|
2025-12-31
|
|
'181-4
|
OTHER
|
Lower Extremity Arterial Procedures
|
1
|
1
|
—
|
—
|
$60,202.85
|
$60,202.85
|
$60,202.85
|
2024-12-31
|
|
'006-1
|
OTHER
|
Pancreas Transplant
|
1
|
1
|
—
|
—
|
$60,029.49
|
$60,029.49
|
$60,029.49
|
2024-12-31
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
57
|
29
|
—
|
$49,103.80
|
$15,110.00
|
$227,864.13
|
$59,636.64
|
2025-12-31
|
|
B1705
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
7
|
5
|
—
|
—
|
$54,294.67
|
$65,540.26
|
$59,582.05
|
2025-12-31
|
|
C0404
|
HCPCS
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
7
|
5
|
—
|
—
|
$56,121.06
|
$65,093.97
|
$59,176.34
|
2025-12-31
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
57
|
29
|
—
|
$48,566.48
|
$15,110.00
|
$225,370.74
|
$59,123.10
|
2025-12-31
|
|
'440-3
|
OTHER
|
Kidney Transplant
|
1
|
1
|
—
|
—
|
$59,027.41
|
$59,027.41
|
$59,027.41
|
2024-12-31
|
|
D0406
|
HCPCS
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
7
|
5
|
—
|
—
|
$55,280.34
|
$64,842.94
|
$58,948.13
|
2025-12-31
|
|
'091-4
|
OTHER
|
Other Major Head & Neck Procedures
|
1
|
1
|
—
|
—
|
$58,781.28
|
$58,781.28
|
$58,781.28
|
2024-12-31
|
|
B0105
|
HCPCS
|
Stroke M <41.50 And A >=84.50
|
7
|
5
|
—
|
—
|
$52,913.49
|
$64,406.80
|
$58,551.64
|
2025-12-31
|
|
Q2043
|
HCPCS
|
Sipuleucel-t Auto Cd54+
|
22
|
17
|
—
|
$54,788.17
|
$47,554.07
|
$112,575.34
|
$58,515.85
|
2025-12-31
|
|
834
|
MS_DRG
|
Acute Leukemia Without Major O.r. Procedures With Mcc
|
56
|
29
|
—
|
$45,620.73
|
$9,963.00
|
$211,701.11
|
$58,428.62
|
2025-12-31
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
55
|
29
|
—
|
$46,788.63
|
$15,110.00
|
$218,511.03
|
$58,228.54
|
2025-12-31
|
|
131
|
MS_DRG
|
Cranial/facial Procedures W Cc/mcc
|
7
|
3
|
—
|
—
|
$21,490.00
|
$82,752.54
|
$58,138.00
|
2024-12-31
|
|
A1806
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
7
|
5
|
—
|
—
|
$50,037.24
|
$63,618.19
|
$57,834.72
|
2025-12-31
|
|
'003-1
|
OTHER
|
Bone Marrow Transplant
|
1
|
1
|
—
|
—
|
$57,800.22
|
$57,800.22
|
$57,800.22
|
2024-12-31
|
|
'361-4
|
OTHER
|
Skin Graft For Skin & Subcutaneous Tissue Diagnoses
|
1
|
1
|
—
|
—
|
$57,798.17
|
$57,798.17
|
$57,798.17
|
2024-12-31
|
|
B1903
|
HCPCS
|
Guillain-barr? M >=38.50 And M <51.50
|
7
|
5
|
—
|
—
|
$52,004.44
|
$63,453.38
|
$57,684.89
|
2025-12-31
|
|
224
|
MS_DRG
|
Cardiac Defib Implant W Cardiac Cath Without Ami/hf/shock W Mcc
|
14
|
6
|
—
|
—
|
$54,906.00
|
$233,759.25
|
$57,502.51
|
2025-12-31
|
|
D0404
|
HCPCS
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
7
|
5
|
—
|
—
|
$54,478.97
|
$63,220.09
|
$57,472.81
|
2025-12-31
|
|
'221-4
|
OTHER
|
Major Small & Large Bowel Procedures
|
1
|
1
|
—
|
—
|
$57,372.14
|
$57,372.14
|
$57,372.14
|
2024-12-31
|
|
C0106
|
HCPCS
|
Stroke M <41.50 And A <84.50
|
7
|
5
|
—
|
—
|
$52,194.95
|
$62,925.95
|
$57,205.41
|
2025-12-31
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
55
|
29
|
—
|
$44,531.24
|
$15,110.00
|
$206,645.38
|
$57,137.44
|
2025-12-31
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
55
|
29
|
—
|
$44,578.29
|
$15,110.00
|
$206,863.70
|
$56,942.40
|
2025-12-31
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
55
|
29
|
—
|
$46,011.13
|
$15,110.00
|
$213,512.75
|
$56,896.60
|
2025-12-31
|
|
B0604
|
HCPCS
|
Neurological M <43.50
|
7
|
5
|
—
|
—
|
$51,569.59
|
$62,431.49
|
$56,755.90
|
2025-12-31
|
|
B2102
|
HCPCS
|
Burns M <52.50
|
7
|
5
|
—
|
—
|
$47,991.36
|
$62,256.52
|
$56,596.84
|
2025-12-31
|
|
'607-2
|
OTHER
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
1
|
1
|
—
|
—
|
$56,539.19
|
$56,539.19
|
$56,539.19
|
2024-12-31
|
|
B1805
|
HCPCS
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
7
|
5
|
—
|
—
|
$50,175.98
|
$61,939.56
|
$56,308.69
|
2025-12-31
|
|
'303-2
|
OTHER
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
1
|
1
|
—
|
—
|
$55,863.97
|
$55,863.97
|
$55,863.97
|
2024-12-31
|
|
'070-4
|
OTHER
|
Orbital Procedures
|
1
|
1
|
—
|
—
|
$55,816.05
|
$55,816.05
|
$55,816.05
|
2024-12-31
|
|
'120-4
|
OTHER
|
Major Respiratory & Chest Procedures
|
1
|
1
|
—
|
—
|
$55,710.28
|
$55,710.28
|
$55,710.28
|
2024-12-31
|
|
'005-2
|
OTHER
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
1
|
1
|
—
|
—
|
$55,709.77
|
$55,709.77
|
$55,709.77
|
2024-12-31
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
55
|
29
|
—
|
$44,806.92
|
$15,110.00
|
$207,924.63
|
$55,407.49
|
2025-12-31
|
|
'613-3
|
OTHER
|
Neonate Birthwt 1500-1999g W Congenital/perinatal Infection
|
1
|
1
|
—
|
—
|
$55,287.20
|
$55,287.20
|
$55,287.20
|
2024-12-31
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
19
|
13
|
—
|
$45,429.25
|
$15,110.00
|
$210,812.53
|
$55,173.89
|
2025-12-31
|
|
'622-4
|
OTHER
|
Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond
|
1
|
1
|
—
|
—
|
$55,135.69
|
$55,135.69
|
$55,135.69
|
2024-12-31
|
|
B0305
|
HCPCS
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
7
|
5
|
—
|
—
|
$49,376.68
|
$60,623.53
|
$55,112.30
|
2025-12-31
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
55
|
29
|
—
|
$42,558.60
|
$15,110.00
|
$206,668.36
|
$55,072.72
|
2025-12-31
|
|
C0505
|
HCPCS
|
Non-traumatic Spinal Cord Injury M <39.50
|
7
|
5
|
—
|
—
|
$48,591.87
|
$60,567.75
|
$55,061.59
|
2025-12-31
|
|
A0406
|
HCPCS
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
7
|
5
|
—
|
—
|
$50,231.89
|
$60,438.42
|
$54,944.02
|
2025-12-31
|
|
'611-3
|
OTHER
|
Neonate Birthwt 1500-1999g W Major Anomaly
|
1
|
1
|
—
|
—
|
$54,935.75
|
$54,935.75
|
$54,935.75
|
2024-12-31
|
|
'182-4
|
OTHER
|
Other Peripheral Vascular Procedures
|
1
|
1
|
—
|
—
|
$54,930.37
|
$54,930.37
|
$54,930.37
|
2024-12-31
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
57
|
29
|
—
|
$43,911.39
|
$15,110.00
|
$203,768.98
|
$54,906.00
|
2025-12-31
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
57
|
29
|
—
|
$43,717.43
|
$15,110.00
|
$202,868.90
|
$54,906.00
|
2025-12-31
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
19
|
13
|
—
|
$45,151.92
|
$15,110.00
|
$209,525.62
|
$54,837.08
|
2025-12-31
|
|
E0194NU
|
OTHER
|
Air Fluidized Bed
|
2
|
2
|
—
|
—
|
$51,609.55
|
$57,835.69
|
$54,722.62
|
2025-12-31
|
|
'651-4
|
OTHER
|
Other Procedures Of Blood & Blood-forming Organs
|
1
|
1
|
—
|
—
|
$54,682.96
|
$54,682.96
|
$54,682.96
|
2024-12-31
|
|
'264-4
|
OTHER
|
Other Hepatobiliary, Pancreas & Abdominal Procedures
|
1
|
1
|
—
|
—
|
$54,620.31
|
$54,620.31
|
$54,620.31
|
2024-12-31
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
57
|
29
|
—
|
$41,130.71
|
$15,110.00
|
$223,610.53
|
$54,494.53
|
2025-12-31
|
|
'623-4
|
OTHER
|
Neonate Bwt 2000-2499g W Congenital/perinatal Infection
|
1
|
1
|
—
|
—
|
$54,396.08
|
$54,396.08
|
$54,396.08
|
2024-12-31
|
|
'740-4
|
OTHER
|
Mental Illness Diagnosis W O.r. Procedure
|
1
|
1
|
—
|
—
|
$54,374.62
|
$54,374.62
|
$54,374.62
|
2024-12-31
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
50
|
27
|
—
|
$43,428.55
|
$15,110.00
|
$182,793.75
|
$54,294.45
|
2025-12-31
|
|
A5104
|
HCPCS
|
Expired, Not Orthopedic, Length Of Stay Is 16 Days Or More
|
7
|
5
|
—
|
—
|
$49,353.90
|
$59,713.21
|
$54,284.74
|
2025-12-31
|
|
'711-4
|
OTHER
|
Post-op, Post-trauma, Other Device Infections W O.r. Procedure
|
1
|
1
|
—
|
—
|
$54,186.53
|
$54,186.53
|
$54,186.53
|
2024-12-31
|
|
226
|
MS_DRG
|
Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc
|
14
|
6
|
—
|
—
|
$50,205.05
|
$214,664.20
|
$54,173.00
|
2025-12-31
|
|
'160-3
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
1
|
1
|
—
|
—
|
$54,152.64
|
$54,152.64
|
$54,152.64
|
2024-12-31
|
|
'405-4
|
OTHER
|
Other Procedures For Endocrine, Nutritional & Metabolic Disorders
|
1
|
1
|
—
|
—
|
$54,121.00
|
$54,121.00
|
$54,121.00
|
2024-12-31
|
|
'710-4
|
OTHER
|
Infectious & Parasitic Diseases Including HIV W O.r. Procedure
|
1
|
1
|
—
|
—
|
$54,099.41
|
$54,099.41
|
$54,099.41
|
2024-12-31
|
|
'163-3
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Pdx
|
1
|
1
|
—
|
—
|
$54,066.86
|
$54,066.86
|
$54,066.86
|
2024-12-31
|
|
'612-3
|
OTHER
|
Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond
|
1
|
1
|
—
|
—
|
$54,063.02
|
$54,063.02
|
$54,063.02
|
2024-12-31
|
|
'634-4
|
OTHER
|
Neonate, Birthwt >2499g W Resp Dist Synd/oth Maj Resp Cond
|
1
|
1
|
—
|
—
|
$53,865.45
|
$53,865.45
|
$53,865.45
|
2024-12-31
|
|
B1004
|
HCPCS
|
Amputation Lower Extremity M <47.50
|
7
|
5
|
—
|
—
|
$47,649.68
|
$59,236.51
|
$53,851.37
|
2025-12-31
|
|
129
|
MS_DRG
|
Major Head & Neck Procedures W Cc/mcc Or Major Device
|
7
|
3
|
—
|
—
|
$18,293.00
|
$76,537.60
|
$53,771.00
|
2024-12-31
|
|
'161-2
|
OTHER
|
Cardiac Defibrillator & Heart Assist Implant
|
1
|
1
|
—
|
—
|
$53,580.62
|
$53,580.62
|
$53,580.62
|
2024-12-31
|
|
A0404
|
HCPCS
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
7
|
5
|
—
|
—
|
$49,502.99
|
$58,927.15
|
$53,570.14
|
2025-12-31
|
|
'603-2
|
OTHER
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
1
|
1
|
—
|
—
|
$53,287.15
|
$53,287.15
|
$53,287.15
|
2024-12-31
|
|
'026-4
|
OTHER
|
Other Nervous System & Related Procedures
|
1
|
1
|
—
|
—
|
$53,013.60
|
$53,013.60
|
$53,013.60
|
2024-12-31
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
56
|
29
|
—
|
$41,327.98
|
$9,963.00
|
$191,780.76
|
$52,930.68
|
2025-12-31
|
|
D0106
|
HCPCS
|
Stroke M <41.50 And A <84.50
|
7
|
5
|
—
|
—
|
$47,697.31
|
$58,054.86
|
$52,777.15
|
2025-12-31
|
|
'130-4
|
OTHER
|
Respiratory System Diagnosis W Ventilator Support 96+ Hours
|
1
|
1
|
—
|
—
|
$52,723.65
|
$52,723.65
|
$52,723.65
|
2024-12-31
|
|
B0704
|
HCPCS
|
Fracture Of Lower Extremity M <41.50
|
7
|
5
|
—
|
—
|
$48,192.22
|
$57,826.66
|
$52,569.69
|
2025-12-31
|
|
'165-3
|
OTHER
|
Coronary Bypass W Ami Or Complex Pdx
|
1
|
1
|
—
|
—
|
$52,532.23
|
$52,532.23
|
$52,532.23
|
2024-12-31
|
|
'309-4
|
OTHER
|
Other Significant Hip & Femur Surgery
|
1
|
1
|
—
|
—
|
$52,525.18
|
$52,525.18
|
$52,525.18
|
2024-12-31
|
|
'440-2
|
OTHER
|
Kidney Transplant
|
1
|
1
|
—
|
—
|
$52,201.02
|
$52,201.02
|
$52,201.02
|
2024-12-31
|
|
'004-1
|
OTHER
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
1
|
1
|
—
|
—
|
$52,199.42
|
$52,199.42
|
$52,199.42
|
2024-12-31
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
55
|
29
|
—
|
$42,049.35
|
$15,110.00
|
$195,128.27
|
$52,145.68
|
2025-12-31
|
|
B1704
|
HCPCS
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
7
|
5
|
—
|
—
|
$46,266.43
|
$57,213.01
|
$52,011.83
|
2025-12-31
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
56
|
29
|
—
|
$42,366.29
|
$15,110.00
|
$196,599.03
|
$51,921.69
|
2025-12-31
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
55
|
29
|
—
|
$41,920.59
|
$15,110.00
|
$194,530.77
|
$51,838.32
|
2025-12-31
|
|
'222-4
|
OTHER
|
Other Stomach, Esophageal & Duodenal Procedures
|
1
|
1
|
—
|
—
|
$51,822.21
|
$51,822.21
|
$51,822.21
|
2024-12-31
|
|
'092-4
|
OTHER
|
Facial Bone Procedures Except Major Cranial/facial Bone Procedures
|
1
|
1
|
—
|
—
|
$51,793.13
|
$51,793.13
|
$51,793.13
|
2024-12-31
|
|
D0505
|
HCPCS
|
Non-traumatic Spinal Cord Injury M <39.50
|
7
|
5
|
—
|
—
|
$45,906.12
|
$56,956.91
|
$51,779.01
|
2025-12-31
|
|
'261-4
|
OTHER
|
Major Biliary Tract Procedures
|
1
|
1
|
—
|
—
|
$51,734.64
|
$51,734.64
|
$51,734.64
|
2024-12-31
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
19
|
13
|
—
|
$42,507.43
|
$15,110.00
|
$197,253.98
|
$51,625.34
|
2025-12-31
|
|
B2005
|
HCPCS
|
Miscellaneous M <46.50 And A <77.50
|
7
|
5
|
—
|
—
|
$45,995.17
|
$56,784.49
|
$51,622.26
|
2025-12-31
|
|
'229-4
|
OTHER
|
Other Digestive System & Abdominal Procedures
|
1
|
1
|
—
|
—
|
$51,611.19
|
$51,611.19
|
$51,611.19
|
2024-12-31
|
|
'511-4
|
OTHER
|
Uterine & Adnexa Procedures For Ovarian & Adnexal Malignancy
|
1
|
1
|
—
|
—
|
$51,572.49
|
$51,572.49
|
$51,572.49
|
2024-12-31
|