|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
21
|
9
|
—
|
—
|
$3,672,900.00
|
$3,895,500.00
|
$3,710,000.00
|
2024-12-31
|
|
C9172
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
1
|
1
|
—
|
—
|
$3,605,000.00
|
$3,605,000.00
|
$3,605,000.00
|
2024-12-31
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
21
|
9
|
—
|
—
|
$3,325,454.76
|
$3,493,517.87
|
$3,327,159.88
|
2024-12-31
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
21
|
9
|
—
|
—
|
$3,286,000.00
|
$3,450,300.00
|
$3,286,000.00
|
2024-12-31
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
21
|
9
|
—
|
—
|
$2,968,000.00
|
$3,116,400.00
|
$2,968,000.00
|
2024-12-31
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
21
|
9
|
—
|
—
|
$2,354,513.02
|
$2,472,238.67
|
$2,354,513.02
|
2024-12-31
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel Car-pos T
|
25
|
10
|
—
|
$468,441.50
|
$523,452.56
|
$851,535.77
|
$523,452.56
|
2024-12-31
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
21
|
9
|
—
|
$492,900.00
|
$507,687.00
|
$533,071.35
|
$507,687.00
|
2024-12-31
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel Car
|
25
|
10
|
—
|
$444,670.00
|
$503,454.53
|
$881,869.54
|
$503,454.53
|
2024-12-31
|
|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
25
|
10
|
—
|
$434,918.00
|
$496,390.21
|
$862,529.38
|
$496,390.21
|
2024-12-31
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Car+
|
25
|
10
|
—
|
$449,245.86
|
$489,136.91
|
$816,911.81
|
$489,136.91
|
2024-12-31
|
|
Q2053
|
HCPCS
|
Brexucabtagene Car Pos T
|
25
|
10
|
—
|
$448,752.40
|
$449,440.00
|
$811,446.11
|
$449,440.00
|
2024-12-31
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
31
|
12
|
—
|
$321,657.03
|
$235,340.85
|
$1,083,064.85
|
$321,657.03
|
2024-12-31
|
|
'583-4
|
APR_DRG
|
Neonate W Ecmo
|
5
|
3
|
—
|
—
|
$262,934.78
|
$280,804.14
|
$263,700.81
|
2024-12-31
|
|
'588-4
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
5
|
3
|
—
|
—
|
$251,564.57
|
$268,661.20
|
$252,297.48
|
2024-12-31
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
39
|
14
|
—
|
$236,585.68
|
$143,947.00
|
$924,265.36
|
$236,585.68
|
2024-12-31
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
41
|
15
|
—
|
$230,125.95
|
$103,887.00
|
$981,149.89
|
$230,125.95
|
2024-12-31
|
|
'002-4
|
APR_DRG
|
Heart &/or Lung Transplant
|
5
|
3
|
—
|
—
|
$216,852.43
|
$231,589.97
|
$217,484.20
|
2024-12-31
|
|
'591-4
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
5
|
3
|
—
|
—
|
$211,265.79
|
$225,623.66
|
$211,881.29
|
2024-12-31
|
|
'161-4
|
APR_DRG
|
Cardiac Defibrillator & Heart Assist Implant
|
5
|
3
|
—
|
—
|
$206,168.78
|
$220,180.25
|
$206,769.43
|
2024-12-31
|
|
'841-4
|
APR_DRG
|
Extensive 3rd Degree Burns W Skin Graft
|
5
|
3
|
—
|
—
|
$200,046.08
|
$213,641.45
|
$200,628.89
|
2024-12-31
|
|
'003-4
|
APR_DRG
|
Bone Marrow Transplant
|
5
|
3
|
—
|
—
|
$193,012.57
|
$206,129.92
|
$193,574.88
|
2024-12-31
|
|
Q0480
|
HCPCS
|
Driver Pneumatic Vad, Rep
|
3
|
2
|
—
|
—
|
$96,561.52
|
$191,689.93
|
$191,689.93
|
2024-12-31
|
|
'588-3
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
5
|
3
|
—
|
—
|
$187,948.13
|
$200,721.30
|
$188,495.69
|
2024-12-31
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
41
|
15
|
—
|
$186,137.95
|
$98,732.00
|
$793,605.52
|
$186,137.95
|
2024-12-31
|
|
'583-3
|
APR_DRG
|
Neonate W Ecmo
|
5
|
3
|
—
|
—
|
$175,836.94
|
$187,787.03
|
$176,349.22
|
2024-12-31
|
|
'593-4
|
APR_DRG
|
Neonate Birthwt 750-999g Without Major Procedure
|
5
|
3
|
—
|
—
|
$173,559.02
|
$185,354.29
|
$174,064.66
|
2024-12-31
|
|
'001-4
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
5
|
3
|
—
|
—
|
$162,267.38
|
$173,295.27
|
$162,740.13
|
2024-12-31
|
|
'591-3
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
5
|
3
|
—
|
—
|
$149,653.36
|
$159,823.97
|
$150,089.36
|
2024-12-31
|
|
'006-4
|
APR_DRG
|
Pancreas Transplant
|
5
|
3
|
—
|
—
|
$148,891.43
|
$159,010.27
|
$149,325.21
|
2024-12-31
|
|
'004-4
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
5
|
3
|
—
|
—
|
$147,792.55
|
$157,836.70
|
$148,223.13
|
2024-12-31
|
|
'609-4
|
APR_DRG
|
Neonate Bwt 1500-2499g W Major Procedure
|
5
|
3
|
—
|
—
|
$145,885.43
|
$155,799.97
|
$146,310.46
|
2024-12-31
|
|
'589-1
|
APR_DRG
|
Neonate Bwt <500g Or Ga <24 Weeks
|
5
|
3
|
—
|
—
|
$145,454.78
|
$155,340.05
|
$145,878.54
|
2024-12-31
|
|
'002-3
|
APR_DRG
|
Heart &/or Lung Transplant
|
5
|
3
|
—
|
—
|
$137,541.03
|
$146,888.48
|
$137,941.74
|
2024-12-31
|
|
'603-4
|
APR_DRG
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
5
|
3
|
—
|
—
|
$137,466.87
|
$146,809.28
|
$137,867.36
|
2024-12-31
|
|
222
|
MS_DRG
|
Cardiac Defib Implant W Cardiac Cath W Ami/hf/shock W Mcc
|
12
|
4
|
—
|
—
|
$43,468.00
|
$284,769.45
|
$134,264.12
|
2024-12-31
|
|
'602-4
|
APR_DRG
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
5
|
3
|
—
|
—
|
$133,662.72
|
$142,746.59
|
$134,052.13
|
2024-12-31
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
41
|
15
|
—
|
$128,339.09
|
$60,132.00
|
$547,178.10
|
$128,339.09
|
2024-12-31
|
|
'593-3
|
APR_DRG
|
Neonate Birthwt 750-999g Without Major Procedure
|
5
|
3
|
—
|
—
|
$121,526.57
|
$129,785.66
|
$121,880.62
|
2024-12-31
|
|
224
|
MS_DRG
|
Cardiac Defib Implant W Cardiac Cath Without Ami/hf/shock W Mcc
|
12
|
4
|
—
|
—
|
$38,527.00
|
$259,834.80
|
$121,270.20
|
2024-12-31
|
|
'591-2
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
5
|
3
|
—
|
—
|
$120,516.42
|
$128,706.85
|
$120,867.52
|
2024-12-31
|
|
'160-4
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
5
|
3
|
—
|
—
|
$120,249.34
|
$128,421.62
|
$120,599.67
|
2024-12-31
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
39
|
14
|
—
|
$106,897.73
|
$72,998.00
|
$469,740.81
|
$119,725.50
|
2024-12-31
|
|
'003-3
|
APR_DRG
|
Bone Marrow Transplant
|
5
|
3
|
—
|
—
|
$117,133.41
|
$125,093.94
|
$117,474.67
|
2024-12-31
|
|
'002-2
|
APR_DRG
|
Heart &/or Lung Transplant
|
5
|
3
|
—
|
—
|
$114,456.90
|
$122,235.52
|
$114,790.35
|
2024-12-31
|
|
'630-4
|
APR_DRG
|
Neonate Birthwt >2499g W Major Cardiovascular Procedure
|
5
|
3
|
—
|
—
|
$111,985.80
|
$119,596.49
|
$112,312.06
|
2024-12-31
|
|
'303-4
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
5
|
3
|
—
|
—
|
$110,859.01
|
$118,393.12
|
$111,181.99
|
2024-12-31
|
|
226
|
MS_DRG
|
Cardiac Defibrillator Implant Without Cardiac Cath W Mcc
|
12
|
4
|
—
|
—
|
$34,837.00
|
$238,609.73
|
$110,790.60
|
2024-12-31
|
|
7
|
MS_DRG
|
Lung Transplant
|
39
|
14
|
—
|
$107,092.42
|
$56,186.00
|
$372,742.40
|
$107,092.42
|
2024-12-31
|
|
'607-4
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
5
|
3
|
—
|
—
|
$106,738.49
|
$113,992.56
|
$107,049.45
|
2024-12-31
|
|
'842-4
|
APR_DRG
|
Burns With Skin Graft Except Extensive 3rd Degree Burns
|
5
|
3
|
—
|
—
|
$104,835.58
|
$111,960.33
|
$105,141.01
|
2024-12-31
|
|
223
|
MS_DRG
|
Cardiac Defib Implant W Cardiac Cath W Ami/hf/shock Without Mcc
|
12
|
4
|
—
|
—
|
$31,269.00
|
$222,441.58
|
$103,469.26
|
2024-12-31
|
|
B0407
|
OTHER
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
6
|
3
|
—
|
—
|
$103,385.13
|
$103,385.13
|
$103,385.13
|
2024-12-31
|
|
'004-3
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
5
|
3
|
—
|
—
|
$102,722.53
|
$109,703.67
|
$103,021.79
|
2024-12-31
|
|
'162-4
|
APR_DRG
|
Cardiac Valve Procedures W Ami Or Complex Pdx
|
5
|
3
|
—
|
—
|
$102,434.56
|
$109,396.13
|
$102,733.00
|
2024-12-31
|
|
'589-2
|
APR_DRG
|
Neonate Bwt <500g Or Ga <24 Weeks
|
5
|
3
|
—
|
—
|
$102,029.33
|
$108,963.36
|
$102,326.58
|
2024-12-31
|
|
'910-4
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
5
|
3
|
—
|
—
|
$100,447.47
|
$107,274.00
|
$100,740.12
|
2024-12-31
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
37
|
14
|
—
|
$100,059.96
|
$73,209.02
|
$418,212.70
|
$100,059.96
|
2024-12-31
|
|
'608-4
|
APR_DRG
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
5
|
3
|
—
|
—
|
$99,582.39
|
$106,350.12
|
$99,872.51
|
2024-12-31
|
|
'631-4
|
APR_DRG
|
Neonate Birthwt >2499g W Other Major Procedure
|
5
|
3
|
—
|
—
|
$99,417.65
|
$106,174.19
|
$99,707.29
|
2024-12-31
|
|
'005-4
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
5
|
3
|
—
|
—
|
$99,292.00
|
$106,040.00
|
$99,581.27
|
2024-12-31
|
|
B1904
|
OTHER
|
Guillain-barr? M <38.50
|
6
|
3
|
—
|
—
|
$97,868.83
|
$97,868.83
|
$97,868.83
|
2024-12-31
|
|
'602-3
|
APR_DRG
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
5
|
3
|
—
|
—
|
$96,549.69
|
$103,111.32
|
$96,830.97
|
2024-12-31
|
|
'863-4
|
APR_DRG
|
Neonatal Aftercare
|
5
|
3
|
—
|
—
|
$95,221.42
|
$101,692.78
|
$95,498.84
|
2024-12-31
|
|
C1842
|
HCPCS
|
Retinal Prosth, Add-on
|
2
|
1
|
—
|
—
|
$95,473.91
|
$95,473.91
|
$95,473.91
|
2024-12-31
|
|
C1841
|
HCPCS
|
Retinal Prosth Int/ext Comp
|
2
|
1
|
—
|
—
|
$95,473.91
|
$95,473.91
|
$95,473.91
|
2024-12-31
|
|
'006-3
|
APR_DRG
|
Pancreas Transplant
|
5
|
3
|
—
|
—
|
$94,097.31
|
$100,492.27
|
$94,371.46
|
2024-12-31
|
|
'583-2
|
APR_DRG
|
Neonate W Ecmo
|
5
|
3
|
—
|
—
|
$93,789.87
|
$100,163.94
|
$94,063.12
|
2024-12-31
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
27
|
11
|
—
|
$94,034.13
|
$68,800.22
|
$400,917.76
|
$94,034.13
|
2024-12-31
|
|
'440-4
|
APR_DRG
|
Kidney Transplant
|
5
|
3
|
—
|
—
|
$93,177.23
|
$99,509.66
|
$93,448.69
|
2024-12-31
|
|
225
|
MS_DRG
|
Cardiac Defib Implant W Cardiac Cath Without Ami/hf/shock Without Mcc
|
12
|
4
|
—
|
—
|
$29,425.00
|
$200,156.12
|
$93,245.59
|
2024-12-31
|
|
'588-2
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
5
|
3
|
—
|
—
|
$92,045.45
|
$98,300.96
|
$92,313.61
|
2024-12-31
|
|
'001-3
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
5
|
3
|
—
|
—
|
$91,461.03
|
$97,676.83
|
$91,727.50
|
2024-12-31
|
|
'593-2
|
APR_DRG
|
Neonate Birthwt 750-999g Without Major Procedure
|
5
|
3
|
—
|
—
|
$91,247.63
|
$97,448.92
|
$91,513.46
|
2024-12-31
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
39
|
14
|
—
|
$90,361.19
|
$53,719.00
|
$358,866.48
|
$90,361.19
|
2024-12-31
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
41
|
15
|
—
|
$89,180.82
|
$65,249.28
|
$450,961.96
|
$89,180.82
|
2024-12-31
|
|
'002-1
|
APR_DRG
|
Heart &/or Lung Transplant
|
5
|
3
|
—
|
—
|
$88,790.40
|
$94,824.70
|
$89,049.08
|
2024-12-31
|
|
'591-1
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
5
|
3
|
—
|
—
|
$86,865.84
|
$92,769.35
|
$87,118.91
|
2024-12-31
|
|
'163-4
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Pdx
|
5
|
3
|
—
|
—
|
$86,862.65
|
$92,765.94
|
$87,115.71
|
2024-12-31
|
|
227
|
MS_DRG
|
Cardiac Defibrillator Implant Without Cardiac Cath Without Mcc
|
12
|
4
|
—
|
—
|
$27,239.00
|
$186,063.23
|
$86,762.20
|
2024-12-31
|
|
'611-4
|
APR_DRG
|
Neonate Birthwt 1500-1999g W Major Anomaly
|
5
|
3
|
—
|
—
|
$86,056.26
|
$91,904.75
|
$86,306.97
|
2024-12-31
|
|
'161-3
|
APR_DRG
|
Cardiac Defibrillator & Heart Assist Implant
|
5
|
3
|
—
|
—
|
$85,921.35
|
$91,760.67
|
$86,171.67
|
2024-12-31
|
|
'304-4
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc Except For Curvature Of Back
|
5
|
3
|
—
|
—
|
$84,528.90
|
$90,273.58
|
$84,775.16
|
2024-12-31
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
41
|
15
|
—
|
$84,732.61
|
$52,311.00
|
$361,260.38
|
$84,732.61
|
2024-12-31
|
|
'583-1
|
APR_DRG
|
Neonate W Ecmo
|
5
|
3
|
—
|
—
|
$84,410.85
|
$90,147.51
|
$84,656.77
|
2024-12-31
|
|
'006-2
|
APR_DRG
|
Pancreas Transplant
|
5
|
3
|
—
|
—
|
$84,157.71
|
$89,877.16
|
$84,402.89
|
2024-12-31
|
|
'312-4
|
APR_DRG
|
Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses
|
5
|
3
|
—
|
—
|
$84,088.90
|
$89,803.68
|
$84,333.89
|
2024-12-31
|
|
'588-1
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
5
|
3
|
—
|
—
|
$82,840.87
|
$88,470.83
|
$83,082.22
|
2024-12-31
|
|
Sx00000069838
|
CDM
|
Jts Implant Set
|
59
|
18
|
$172,360.00
|
—
|
$27,749.96
|
$167,189.20
|
$83,077.52
|
2024-12-31
|
|
'612-4
|
APR_DRG
|
Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond
|
5
|
3
|
—
|
—
|
$82,688.84
|
$88,308.47
|
$82,929.75
|
2024-12-31
|
|
B1806
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
6
|
3
|
—
|
—
|
$82,779.11
|
$82,779.11
|
$82,779.11
|
2024-12-31
|
|
'303-3
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
5
|
3
|
—
|
—
|
$81,608.62
|
$87,154.84
|
$81,846.38
|
2024-12-31
|
|
C0407
|
OTHER
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
6
|
3
|
—
|
—
|
$81,451.32
|
$81,451.32
|
$81,451.32
|
2024-12-31
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
41
|
15
|
—
|
$73,794.10
|
$53,991.56
|
$364,843.80
|
$79,438.76
|
2024-12-31
|
|
'167-4
|
APR_DRG
|
Other Cardiothoracic & Thoracic Vascular Procedures
|
5
|
3
|
—
|
—
|
$79,201.09
|
$84,583.69
|
$79,431.83
|
2024-12-31
|
|
'603-3
|
APR_DRG
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
5
|
3
|
—
|
—
|
$78,952.41
|
$84,318.11
|
$79,182.43
|
2024-12-31
|
|
D0407
|
OTHER
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
6
|
3
|
—
|
—
|
$79,109.25
|
$79,109.25
|
$79,109.25
|
2024-12-31
|
|
'609-3
|
APR_DRG
|
Neonate Bwt 1500-2499g W Major Procedure
|
5
|
3
|
—
|
—
|
$78,674.16
|
$84,020.95
|
$78,903.37
|
2024-12-31
|
|
'690-4
|
APR_DRG
|
Acute Leukemia
|
5
|
3
|
—
|
—
|
$78,594.06
|
$83,935.40
|
$78,823.04
|
2024-12-31
|
|
'165-4
|
APR_DRG
|
Coronary Bypass W Ami Or Complex Pdx
|
5
|
3
|
—
|
—
|
$77,974.45
|
$83,273.68
|
$78,201.62
|
2024-12-31
|
|
'001-2
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
5
|
3
|
—
|
—
|
$77,812.97
|
$83,101.23
|
$78,039.67
|
2024-12-31
|
|
Sx00000066257
|
CDM
|
Controller Impella Packaged
|
59
|
18
|
$161,200.00
|
—
|
$25,953.20
|
$156,364.00
|
$77,698.40
|
2024-12-31
|
|
'841-3
|
APR_DRG
|
Extensive 3rd Degree Burns W Skin Graft
|
5
|
3
|
—
|
—
|
$77,321.31
|
$82,576.15
|
$77,546.57
|
2024-12-31
|
|
453
|
MS_DRG
|
Combined Anterior/posterior Spinal Fusion W Mcc
|
41
|
15
|
—
|
$77,364.90
|
$49,002.00
|
$332,353.51
|
$77,364.90
|
2024-12-31
|
|
B0406
|
OTHER
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
6
|
3
|
—
|
—
|
$77,036.90
|
$77,036.90
|
$77,036.90
|
2024-12-31
|
|
'607-3
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
5
|
3
|
—
|
—
|
$76,349.10
|
$81,537.87
|
$76,571.53
|
2024-12-31
|
|
'090-4
|
APR_DRG
|
Major Larynx & Trachea Procedures
|
5
|
3
|
—
|
—
|
$75,574.97
|
$80,711.14
|
$75,795.15
|
2024-12-31
|
|
128784
|
CDM
|
Cadaver Donor Kidney Acquisit
|
54
|
17
|
$93,500.00
|
—
|
$15,053.50
|
$90,695.00
|
$75,389.05
|
2024-12-31
|
|
B0404
|
OTHER
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
6
|
3
|
—
|
—
|
$75,109.76
|
$75,109.76
|
$75,109.76
|
2024-12-31
|
|
'021-4
|
APR_DRG
|
Craniotomy Except For Trauma
|
5
|
3
|
—
|
—
|
$74,732.04
|
$79,810.92
|
$74,949.77
|
2024-12-31
|
|
'911-4
|
APR_DRG
|
Extensive Abdominal/thoracic Procedures For Mult Significant Trauma
|
5
|
3
|
—
|
—
|
$73,567.44
|
$78,567.17
|
$73,781.77
|
2024-12-31
|
|
A0407
|
OTHER
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
6
|
3
|
—
|
—
|
$73,733.57
|
$73,733.57
|
$73,733.57
|
2024-12-31
|
|
'613-4
|
APR_DRG
|
Neonate Birthwt 1500-1999g W Congenital/perinatal Infection
|
5
|
3
|
—
|
—
|
$73,498.07
|
$78,493.09
|
$73,712.19
|
2024-12-31
|
|
'001-1
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
5
|
3
|
—
|
—
|
$73,488.86
|
$78,483.25
|
$73,702.97
|
2024-12-31
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
41
|
15
|
—
|
$73,593.30
|
$47,305.00
|
$319,345.50
|
$73,593.30
|
2024-12-31
|
|
'912-4
|
APR_DRG
|
Musculoskeletal & Other Procedures For Multiple Significant Trauma
|
5
|
3
|
—
|
—
|
$73,161.94
|
$78,134.11
|
$73,375.09
|
2024-12-31
|
|
'589-3
|
APR_DRG
|
Neonate Bwt <500g Or Ga <24 Weeks
|
5
|
3
|
—
|
—
|
$72,985.07
|
$77,945.22
|
$73,197.70
|
2024-12-31
|
|
'680-4
|
APR_DRG
|
Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms
|
5
|
3
|
—
|
—
|
$72,861.59
|
$77,813.35
|
$73,073.87
|
2024-12-31
|
|
'602-2
|
APR_DRG
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
5
|
3
|
—
|
—
|
$72,729.56
|
$77,672.34
|
$72,941.45
|
2024-12-31
|
|
'401-4
|
APR_DRG
|
Pituitary & Adrenal Procedures
|
5
|
3
|
—
|
—
|
$72,605.96
|
$77,540.34
|
$72,817.49
|
2024-12-31
|
|
'023-4
|
APR_DRG
|
Spinal Procedures
|
5
|
3
|
—
|
—
|
$71,509.89
|
$76,369.79
|
$71,718.22
|
2024-12-31
|
|
'003-2
|
APR_DRG
|
Bone Marrow Transplant
|
5
|
3
|
—
|
—
|
$71,224.61
|
$76,065.12
|
$71,432.12
|
2024-12-31
|
|
'621-4
|
APR_DRG
|
Neonate Bwt 2000-2499g W Major Anomaly
|
5
|
3
|
—
|
—
|
$70,895.20
|
$75,713.32
|
$71,101.74
|
2024-12-31
|
|
'004-2
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
5
|
3
|
—
|
—
|
$70,812.16
|
$75,624.64
|
$71,018.46
|
2024-12-31
|
|
128782
|
CDM
|
Live Donor Kidney Acquisition
|
54
|
17
|
$88,000.00
|
—
|
$14,168.00
|
$85,360.00
|
$70,954.40
|
2024-12-31
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
41
|
15
|
—
|
$70,850.16
|
$42,774.00
|
$302,072.08
|
$70,850.16
|
2024-12-31
|
|
C1904
|
OTHER
|
Guillain-barr? M <38.50
|
6
|
3
|
—
|
—
|
$69,890.83
|
$69,890.83
|
$69,890.83
|
2024-12-31
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
33
|
13
|
—
|
$69,787.65
|
$51,060.24
|
$297,542.05
|
$69,787.65
|
2024-12-31
|
|
B0505
|
OTHER
|
Non-traumatic Spinal Cord Injury M <39.50
|
6
|
3
|
—
|
—
|
$69,455.15
|
$69,455.15
|
$69,455.15
|
2024-12-31
|
|
C1806
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
6
|
3
|
—
|
—
|
$69,252.29
|
$69,252.29
|
$69,252.29
|
2024-12-31
|
|
'681-4
|
APR_DRG
|
Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms
|
5
|
3
|
—
|
—
|
$68,871.37
|
$73,551.95
|
$69,072.03
|
2024-12-31
|
|
'321-4
|
APR_DRG
|
Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp
|
5
|
3
|
—
|
—
|
$68,250.87
|
$72,889.28
|
$68,449.71
|
2024-12-31
|
|
'166-4
|
APR_DRG
|
Coronary Bypass Without Ami Or Complex Pdx
|
5
|
3
|
—
|
—
|
$68,227.68
|
$72,864.52
|
$68,426.46
|
2024-12-31
|
|
'005-3
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
5
|
3
|
—
|
—
|
$67,980.99
|
$72,601.06
|
$68,179.05
|
2024-12-31
|
|
'608-3
|
APR_DRG
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
5
|
3
|
—
|
—
|
$67,928.23
|
$72,544.71
|
$68,126.13
|
2024-12-31
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization With Mcc
|
41
|
15
|
—
|
$68,094.80
|
$40,469.00
|
$290,324.51
|
$68,094.80
|
2024-12-31
|
|
D1904
|
OTHER
|
Guillain-barr? M <38.50
|
6
|
3
|
—
|
—
|
$67,670.94
|
$67,670.94
|
$67,670.94
|
2024-12-31
|
|
'260-4
|
APR_DRG
|
Major Pancreas, Liver & Shunt Procedures
|
5
|
3
|
—
|
—
|
$67,408.08
|
$71,989.21
|
$67,604.46
|
2024-12-31
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
41
|
15
|
—
|
$67,323.02
|
$40,840.00
|
$287,033.99
|
$67,323.02
|
2024-12-31
|
|
131
|
MS_DRG
|
Cranial/facial Procedures W Cc/mcc
|
7
|
3
|
—
|
—
|
$14,009.00
|
$91,983.49
|
$67,108.00
|
2024-12-31
|
|
'020-4
|
APR_DRG
|
Craniotomy For Trauma
|
5
|
3
|
—
|
—
|
$66,886.71
|
$71,432.40
|
$67,081.58
|
2024-12-31
|
|
B0106
|
OTHER
|
Stroke M <41.50 And A <84.50
|
6
|
3
|
—
|
—
|
$66,901.01
|
$66,901.01
|
$66,901.01
|
2024-12-31
|
|
'169-4
|
APR_DRG
|
Major Abdominal Vascular Procedures
|
5
|
3
|
—
|
—
|
$66,329.96
|
$70,837.82
|
$66,523.20
|
2024-12-31
|
|
'950-4
|
APR_DRG
|
Extensive Procedure Unrelated To Principal Diagnosis
|
5
|
3
|
—
|
—
|
$65,492.65
|
$69,943.61
|
$65,683.46
|
2024-12-31
|
|
'022-4
|
APR_DRG
|
Ventricular Shunt Procedures
|
5
|
3
|
—
|
—
|
$65,449.22
|
$69,897.22
|
$65,639.90
|
2024-12-31
|
|
'089-4
|
APR_DRG
|
Major Cranial/facial Bone Procedures
|
5
|
3
|
—
|
—
|
$65,426.99
|
$69,873.49
|
$65,617.60
|
2024-12-31
|
|
A9543
|
HCPCS
|
Y-90 Yttrium Ibrit To 40 Mci Tx
|
107
|
21
|
$129,984.00
|
$65,476.58
50% off
|
$9,032.10
|
$126,084.48
|
$65,476.58
|
2024-12-31
|
|
'695-4
|
APR_DRG
|
Chemotherapy For Acute Leukemia
|
5
|
3
|
—
|
—
|
$65,248.65
|
$69,683.02
|
$65,438.74
|
2024-12-31
|
|
'510-4
|
APR_DRG
|
Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs
|
5
|
3
|
—
|
—
|
$65,199.71
|
$69,630.76
|
$65,389.67
|
2024-12-31
|
|
'162-3
|
APR_DRG
|
Cardiac Valve Procedures W Ami Or Complex Pdx
|
5
|
3
|
—
|
—
|
$65,126.77
|
$69,552.86
|
$65,316.51
|
2024-12-31
|
|
A1904
|
OTHER
|
Guillain-barr? M <38.50
|
6
|
3
|
—
|
—
|
$64,976.18
|
$64,976.18
|
$64,976.18
|
2024-12-31
|
|
128788
|
CDM
|
Cadaver Kidney/pancreas Acquis
|
54
|
17
|
$80,453.00
|
—
|
$12,952.93
|
$78,039.41
|
$64,869.26
|
2024-12-31
|
|
'220-4
|
APR_DRG
|
Major Stomach, Esophageal & Duodenal Procedures
|
5
|
3
|
—
|
—
|
$64,296.04
|
$68,665.67
|
$64,483.36
|
2024-12-31
|
|
D1806
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
6
|
3
|
—
|
—
|
$63,897.35
|
$63,897.35
|
$63,897.35
|
2024-12-31
|
|
Sx00000075430
|
CDM
|
Ligasure Kit
|
53
|
18
|
$87,094.62
|
—
|
$14,022.23
|
$84,481.78
|
$63,666.17
|
2024-12-31
|
|
'024-4
|
APR_DRG
|
Extracranial Vascular Procedures
|
5
|
3
|
—
|
—
|
$63,481.03
|
$67,795.28
|
$63,665.98
|
2024-12-31
|
|
C1827
|
HCPCS
|
Generator Neurostimulator Vagal Nerve Stimulator Permanent Pulse
|
62
|
18
|
$136,290.00
|
—
|
$21,942.69
|
$132,201.30
|
$63,511.14
|
2024-12-31
|
|
J9029
|
HCPCS
|
Instill Adstiladrin, Tx Dose
|
21
|
9
|
—
|
—
|
$63,354.77
|
$66,674.30
|
$63,499.33
|
2024-12-31
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
41
|
15
|
—
|
$63,143.70
|
$39,243.00
|
$269,215.34
|
$63,143.70
|
2024-12-31
|
|
B0205
|
OTHER
|
Traumatic Brain Injury M <35.50
|
6
|
3
|
—
|
—
|
$62,991.42
|
$62,991.42
|
$62,991.42
|
2024-12-31
|
|
'441-4
|
APR_DRG
|
Major Bladder Procedures
|
5
|
3
|
—
|
—
|
$62,240.86
|
$66,470.82
|
$62,422.19
|
2024-12-31
|
|
129
|
MS_DRG
|
Major Head & Neck Procedures W Cc/mcc Or Major Device
|
7
|
3
|
—
|
—
|
$11,925.00
|
$85,075.28
|
$62,068.00
|
2024-12-31
|
|
'403-4
|
APR_DRG
|
Procedures For Obesity
|
5
|
3
|
—
|
—
|
$61,497.90
|
$65,677.37
|
$61,677.07
|
2024-12-31
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
27
|
11
|
—
|
$61,426.40
|
$44,942.72
|
$261,893.58
|
$61,426.40
|
2024-12-31
|
|
B0405
|
OTHER
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
6
|
3
|
—
|
—
|
$61,347.82
|
$61,347.82
|
$61,347.82
|
2024-12-31
|
|
'483-4
|
APR_DRG
|
Testes & Scrotal Procedures
|
5
|
3
|
—
|
—
|
$60,888.45
|
$65,026.50
|
$61,065.84
|
2024-12-31
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
41
|
15
|
—
|
$60,807.41
|
$32,944.00
|
$259,254.47
|
$60,807.41
|
2024-12-31
|
|
C0406
|
OTHER
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
6
|
3
|
—
|
—
|
$60,693.15
|
$60,693.15
|
$60,693.15
|
2024-12-31
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
41
|
15
|
—
|
$60,412.79
|
$32,270.00
|
$257,571.99
|
$60,412.79
|
2024-12-31
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
41
|
15
|
—
|
$60,310.64
|
$29,877.00
|
$257,136.48
|
$60,310.64
|
2024-12-31
|
|
'181-4
|
APR_DRG
|
Lower Extremity Arterial Procedures
|
5
|
3
|
—
|
—
|
$60,027.96
|
$64,107.53
|
$60,202.85
|
2024-12-31
|
|
'006-1
|
APR_DRG
|
Pancreas Transplant
|
5
|
3
|
—
|
—
|
$59,855.11
|
$63,922.94
|
$60,029.49
|
2024-12-31
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
41
|
15
|
—
|
$60,001.58
|
$30,227.00
|
$255,818.78
|
$60,001.58
|
2024-12-31
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
41
|
15
|
—
|
$59,845.30
|
$35,331.00
|
$255,152.49
|
$59,845.30
|
2024-12-31
|
|
B1705
|
OTHER
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
6
|
3
|
—
|
—
|
$59,582.05
|
$59,582.05
|
$59,582.05
|
2024-12-31
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc
|
41
|
15
|
—
|
$59,529.26
|
$28,018.00
|
$253,805.02
|
$59,529.26
|
2024-12-31
|
|
C0404
|
OTHER
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
6
|
3
|
—
|
—
|
$59,176.34
|
$59,176.34
|
$59,176.34
|
2024-12-31
|
|
'440-3
|
APR_DRG
|
Kidney Transplant
|
5
|
3
|
—
|
—
|
$58,855.94
|
$62,855.86
|
$59,027.41
|
2024-12-31
|
|
D0406
|
OTHER
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
6
|
3
|
—
|
—
|
$58,948.13
|
$58,948.13
|
$58,948.13
|
2024-12-31
|
|
'091-4
|
APR_DRG
|
Other Major Head & Neck Procedures
|
5
|
3
|
—
|
—
|
$58,610.52
|
$62,593.76
|
$58,781.28
|
2024-12-31
|
|
B0105
|
OTHER
|
Stroke M <41.50 And A >=84.50
|
6
|
3
|
—
|
—
|
$58,551.64
|
$58,551.64
|
$58,551.64
|
2024-12-31
|
|
Sx00000076504
|
CDM
|
Ligasure Kit Lf1744/gen
|
53
|
18
|
$79,401.17
|
—
|
$12,783.59
|
$77,019.13
|
$58,042.26
|
2024-12-31
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
41
|
15
|
—
|
$53,617.80
|
$39,229.54
|
$276,664.38
|
$57,974.34
|
2024-12-31
|
|
459
|
MS_DRG
|
Spinal Fusion Except Cervical With Mcc
|
41
|
15
|
—
|
$57,903.63
|
$35,692.00
|
$246,874.10
|
$57,903.63
|
2024-12-31
|
|
A1806
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
6
|
3
|
—
|
—
|
$57,834.72
|
$57,834.72
|
$57,834.72
|
2024-12-31
|
|
'003-1
|
APR_DRG
|
Bone Marrow Transplant
|
5
|
3
|
—
|
—
|
$57,632.31
|
$61,549.07
|
$57,800.22
|
2024-12-31
|
|
'361-4
|
APR_DRG
|
Skin Graft For Skin & Subcutaneous Tissue Diagnoses
|
5
|
3
|
—
|
—
|
$57,630.26
|
$61,546.88
|
$57,798.17
|
2024-12-31
|
|
B1903
|
OTHER
|
Guillain-barr? M >=38.50 And M <51.50
|
6
|
3
|
—
|
—
|
$57,684.89
|
$57,684.89
|
$57,684.89
|
2024-12-31
|
|
D0404
|
OTHER
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
6
|
3
|
—
|
—
|
$57,472.81
|
$57,472.81
|
$57,472.81
|
2024-12-31
|
|
'221-4
|
APR_DRG
|
Major Small & Large Bowel Procedures
|
5
|
3
|
—
|
—
|
$57,205.48
|
$61,093.23
|
$57,372.14
|
2024-12-31
|
|
C0106
|
OTHER
|
Stroke M <41.50 And A <84.50
|
6
|
3
|
—
|
—
|
$57,205.41
|
$57,205.41
|
$57,205.41
|
2024-12-31
|
|
B0604
|
OTHER
|
Neurological M <43.50
|
6
|
3
|
—
|
—
|
$56,755.90
|
$56,755.90
|
$56,755.90
|
2024-12-31
|
|
B2102
|
OTHER
|
Burns M <52.50
|
6
|
3
|
—
|
—
|
$56,596.84
|
$56,596.84
|
$56,596.84
|
2024-12-31
|
|
'607-2
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
5
|
3
|
—
|
—
|
$56,374.95
|
$60,206.26
|
$56,539.19
|
2024-12-31
|
|
B1805
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
6
|
3
|
—
|
—
|
$56,308.69
|
$56,308.69
|
$56,308.69
|
2024-12-31
|
|
Sx00000189430
|
CDM
|
Implant Gamma Tile 9 Count
|
59
|
18
|
$116,560.00
|
—
|
$18,766.16
|
$113,063.20
|
$56,181.92
|
2024-12-31
|
|
'303-2
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
5
|
3
|
—
|
—
|
$55,701.69
|
$59,487.24
|
$55,863.97
|
2024-12-31
|
|
'070-4
|
APR_DRG
|
Orbital Procedures
|
5
|
3
|
—
|
—
|
$55,653.91
|
$59,436.21
|
$55,816.05
|
2024-12-31
|
|
'120-4
|
APR_DRG
|
Major Respiratory & Chest Procedures
|
5
|
3
|
—
|
—
|
$55,548.45
|
$59,323.58
|
$55,710.28
|
2024-12-31
|
|
'005-2
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
5
|
3
|
—
|
—
|
$55,547.93
|
$59,323.03
|
$55,709.77
|
2024-12-31
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
41
|
15
|
—
|
$55,572.57
|
$34,649.00
|
$236,935.56
|
$55,572.57
|
2024-12-31
|
|
Q2043
|
HCPCS
|
Sipuleucel-t Auto Cd54+
|
31
|
12
|
—
|
$53,630.37
|
$55,015.23
|
$103,962.48
|
$55,512.78
|
2024-12-31
|
|
'613-3
|
APR_DRG
|
Neonate Birthwt 1500-1999g W Congenital/perinatal Infection
|
5
|
3
|
—
|
—
|
$55,126.60
|
$58,873.07
|
$55,287.20
|
2024-12-31
|
|
'622-4
|
APR_DRG
|
Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond
|
5
|
3
|
—
|
—
|
$54,975.53
|
$58,711.73
|
$55,135.69
|
2024-12-31
|
|
B0305
|
OTHER
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
6
|
3
|
—
|
—
|
$55,112.30
|
$55,112.30
|
$55,112.30
|
2024-12-31
|
|
C0505
|
OTHER
|
Non-traumatic Spinal Cord Injury M <39.50
|
6
|
3
|
—
|
—
|
$55,061.59
|
$55,061.59
|
$55,061.59
|
2024-12-31
|
|
A0406
|
OTHER
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
6
|
3
|
—
|
—
|
$54,944.02
|
$54,944.02
|
$54,944.02
|
2024-12-31
|
|
'611-3
|
APR_DRG
|
Neonate Birthwt 1500-1999g W Major Anomaly
|
5
|
3
|
—
|
—
|
$54,776.17
|
$58,498.82
|
$54,935.75
|
2024-12-31
|
|
'182-4
|
APR_DRG
|
Other Peripheral Vascular Procedures
|
5
|
3
|
—
|
—
|
$54,770.81
|
$58,493.09
|
$54,930.37
|
2024-12-31
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
37
|
14
|
—
|
$52,384.17
|
$29,030.00
|
$223,341.72
|
$54,882.44
|
2024-12-31
|
|
'651-4
|
APR_DRG
|
Other Procedures Of Blood & Blood-forming Organs
|
5
|
3
|
—
|
—
|
$54,524.11
|
$58,229.63
|
$54,682.96
|
2024-12-31
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement W Mcc
|
41
|
15
|
—
|
$54,531.89
|
$37,096.00
|
$251,673.73
|
$54,630.56
|
2024-12-31
|
|
'264-4
|
APR_DRG
|
Other Hepatobiliary, Pancreas & Abdominal Procedures
|
5
|
3
|
—
|
—
|
$54,461.64
|
$58,162.92
|
$54,620.31
|
2024-12-31
|
|
'623-4
|
APR_DRG
|
Neonate Bwt 2000-2499g W Congenital/perinatal Infection
|
5
|
3
|
—
|
—
|
$54,238.07
|
$57,924.15
|
$54,396.08
|
2024-12-31
|
|
'740-4
|
APR_DRG
|
Mental Illness Diagnosis W O.r. Procedure
|
5
|
3
|
—
|
—
|
$54,216.67
|
$57,901.29
|
$54,374.62
|
2024-12-31
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
41
|
15
|
—
|
$54,287.43
|
$27,688.00
|
$231,456.33
|
$54,287.43
|
2024-12-31
|
|
A5104
|
OTHER
|
Expired, Not Orthopedic, Length Of Stay Is 16 Days Or More
|
6
|
3
|
—
|
—
|
$54,284.74
|
$54,284.74
|
$54,284.74
|
2024-12-31
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc
|
27
|
11
|
—
|
$54,218.46
|
$39,669.02
|
$231,162.27
|
$54,218.46
|
2024-12-31
|
|
'711-4
|
APR_DRG
|
Post-op, Post-trauma, Other Device Infections W O.r. Procedure
|
5
|
3
|
—
|
—
|
$54,029.12
|
$57,701.01
|
$54,186.53
|
2024-12-31
|
|
'160-3
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
5
|
3
|
—
|
—
|
$53,995.33
|
$57,664.92
|
$54,152.64
|
2024-12-31
|
|
Sx00000102245
|
CDM
|
Custom Pelvis IMPLaNT
|
59
|
18
|
$112,294.40
|
—
|
$18,079.40
|
$108,925.57
|
$54,125.90
|
2024-12-31
|
|
'405-4
|
APR_DRG
|
Other Procedures For Endocrine, Nutritional & Metabolic Disorders
|
5
|
3
|
—
|
—
|
$53,963.78
|
$57,631.22
|
$54,121.00
|
2024-12-31
|
|
'710-4
|
APR_DRG
|
Infectious & Parasitic Diseases Including HIV W O.r. Procedure
|
5
|
3
|
—
|
—
|
$53,942.25
|
$57,608.23
|
$54,099.41
|
2024-12-31
|
|
'163-3
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Pdx
|
5
|
3
|
—
|
—
|
$53,909.80
|
$57,573.57
|
$54,066.86
|
2024-12-31
|
|
'612-3
|
APR_DRG
|
Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond
|
5
|
3
|
—
|
—
|
$53,905.97
|
$57,569.48
|
$54,063.02
|
2024-12-31
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
37
|
14
|
—
|
$53,928.61
|
$39,456.95
|
$228,852.84
|
$53,928.61
|
2024-12-31
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
37
|
14
|
—
|
$53,928.61
|
$37,180.37
|
$181,585.26
|
$53,928.61
|
2024-12-31
|
|
'634-4
|
APR_DRG
|
Neonate, Birthwt >2499g W Resp Dist Synd/oth Maj Resp Cond
|
5
|
3
|
—
|
—
|
$53,708.97
|
$57,359.09
|
$53,865.45
|
2024-12-31
|
|
B1004
|
OTHER
|
Amputation Lower Extremity M <47.50
|
6
|
3
|
—
|
—
|
$53,851.37
|
$53,851.37
|
$53,851.37
|
2024-12-31
|
|
133
|
MS_DRG
|
Other Ear, Nose, Mouth & Throat O.r. Procedures W Cc/mcc
|
7
|
3
|
—
|
—
|
$11,183.00
|
$73,442.61
|
$53,581.00
|
2024-12-31
|
|
'161-2
|
APR_DRG
|
Cardiac Defibrillator & Heart Assist Implant
|
5
|
3
|
—
|
—
|
$53,424.98
|
$57,055.80
|
$53,580.62
|
2024-12-31
|
|
A0404
|
OTHER
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
6
|
3
|
—
|
—
|
$53,570.14
|
$53,570.14
|
$53,570.14
|
2024-12-31
|
|
454
|
MS_DRG
|
Combined Anterior/posterior Spinal Fusion W Cc
|
41
|
15
|
—
|
$53,398.66
|
$31,905.00
|
$227,667.03
|
$53,398.66
|
2024-12-31
|
|
'603-2
|
APR_DRG
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
5
|
3
|
—
|
—
|
$53,132.35
|
$56,743.29
|
$53,287.15
|
2024-12-31
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
41
|
15
|
—
|
$53,170.80
|
$31,674.00
|
$226,695.51
|
$53,170.80
|
2024-12-31
|
|
33231
|
HCPCS
|
Ins Pacng Cvdfb Pls Gen Only W/exist Multi Leads
|
79
|
21
|
$75,878.00
|
$35,217.24
54% off
|
$104.00
|
$132,228.00
|
$53,114.60
|
2024-12-31
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
41
|
15
|
—
|
$53,040.71
|
$33,928.00
|
$229,034.82
|
$53,040.71
|
2024-12-31
|
|
'026-4
|
APR_DRG
|
Other Nervous System & Related Procedures
|
5
|
3
|
—
|
—
|
$52,859.60
|
$56,452.00
|
$53,013.60
|
2024-12-31
|
|
Sx00000046460
|
CDM
|
Kit Starter Stapler Endowrist 45
|
53
|
18
|
$72,354.00
|
—
|
$11,648.99
|
$70,183.38
|
$52,890.77
|
2024-12-31
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
41
|
15
|
—
|
$52,791.02
|
$29,779.00
|
$225,076.31
|
$52,791.02
|
2024-12-31
|
|
D0106
|
OTHER
|
Stroke M <41.50 And A <84.50
|
6
|
3
|
—
|
—
|
$52,777.15
|
$52,777.15
|
$52,777.15
|
2024-12-31
|
|
'130-4
|
APR_DRG
|
Respiratory System Diagnosis W Ventilator Support 96+ Hours
|
5
|
3
|
—
|
—
|
$52,570.49
|
$56,143.24
|
$52,723.65
|
2024-12-31
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
41
|
15
|
—
|
$52,611.17
|
$29,121.00
|
$224,309.52
|
$52,611.17
|
2024-12-31
|
|
B0704
|
OTHER
|
Fracture Of Lower Extremity M <41.50
|
6
|
3
|
—
|
—
|
$52,569.69
|
$52,569.69
|
$52,569.69
|
2024-12-31
|
|
'165-3
|
APR_DRG
|
Coronary Bypass W Ami Or Complex Pdx
|
5
|
3
|
—
|
—
|
$52,379.62
|
$55,939.40
|
$52,532.23
|
2024-12-31
|
|
'309-4
|
APR_DRG
|
Other Significant Hip & Femur Surgery
|
5
|
3
|
—
|
—
|
$52,372.60
|
$55,931.90
|
$52,525.18
|
2024-12-31
|
|
J7330
|
HCPCS
|
Graft Cartilage Membrane Collagen Maci 3x5cm 81073
|
123
|
19
|
$139,304.08
|
—
|
$10,549.38
|
$135,124.96
|
$52,419.26
|
2024-12-31
|
|
E0194NU
|
HCPCS
|
Air Fluidized Bed
|
2
|
1
|
—
|
—
|
$52,206.76
|
$52,206.76
|
$52,206.76
|
2024-12-31
|
|
'440-2
|
APR_DRG
|
Kidney Transplant
|
5
|
3
|
—
|
—
|
$52,049.38
|
$55,586.72
|
$52,201.02
|
2024-12-31
|
|
'004-1
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
5
|
3
|
—
|
—
|
$52,047.78
|
$55,585.01
|
$52,199.42
|
2024-12-31
|
|
Sx00000065138
|
CDM
|
Carticel Cs1000
|
59
|
18
|
$108,087.82
|
—
|
$17,402.14
|
$104,845.19
|
$52,098.33
|
2024-12-31
|
|
B1704
|
OTHER
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
6
|
3
|
—
|
—
|
$52,011.83
|
$52,011.83
|
$52,011.83
|
2024-12-31
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
41
|
15
|
—
|
$51,934.55
|
$31,184.00
|
$221,424.73
|
$51,934.55
|
2024-12-31
|
|
'222-4
|
APR_DRG
|
Other Stomach, Esophageal & Duodenal Procedures
|
5
|
3
|
—
|
—
|
$51,671.67
|
$55,183.34
|
$51,822.21
|
2024-12-31
|
|
'092-4
|
APR_DRG
|
Facial Bone Procedures Except Major Cranial/facial Bone Procedures
|
5
|
3
|
—
|
—
|
$51,642.68
|
$55,152.37
|
$51,793.13
|
2024-12-31
|
|
D0505
|
OTHER
|
Non-traumatic Spinal Cord Injury M <39.50
|
6
|
3
|
—
|
—
|
$51,779.01
|
$51,779.01
|
$51,779.01
|
2024-12-31
|
|
'261-4
|
APR_DRG
|
Major Biliary Tract Procedures
|
5
|
3
|
—
|
—
|
$51,584.36
|
$55,090.09
|
$51,734.64
|
2024-12-31
|
|
B2005
|
OTHER
|
Miscellaneous M <46.50 And A <77.50
|
6
|
3
|
—
|
—
|
$51,622.26
|
$51,622.26
|
$51,622.26
|
2024-12-31
|
|
'229-4
|
APR_DRG
|
Other Digestive System & Abdominal Procedures
|
5
|
3
|
—
|
—
|
$51,461.26
|
$54,958.63
|
$51,611.19
|
2024-12-31
|
|
'511-4
|
APR_DRG
|
Uterine & Adnexa Procedures For Ovarian & Adnexal Malignancy
|
5
|
3
|
—
|
—
|
$51,422.68
|
$54,917.42
|
$51,572.49
|
2024-12-31
|
|
B1504
|
OTHER
|
Pulmonary M <45.50
|
6
|
3
|
—
|
—
|
$51,511.61
|
$51,511.61
|
$51,511.61
|
2024-12-31
|
|
'843-4
|
APR_DRG
|
Extensive 3rd Degree Or Full Thickness Burns Without Skin Graft
|
5
|
3
|
—
|
—
|
$51,314.48
|
$54,801.87
|
$51,463.97
|
2024-12-31
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
41
|
15
|
—
|
$51,340.87
|
$30,653.00
|
$218,893.57
|
$51,340.87
|
2024-12-31
|
|
'317-4
|
APR_DRG
|
Tendon, Muscle & Other Soft Tissue Procedures
|
5
|
3
|
—
|
—
|
$50,858.84
|
$54,315.26
|
$51,007.01
|
2024-12-31
|
|
'633-4
|
APR_DRG
|
Neonate Birthwt >2499g W Major Anomaly
|
5
|
3
|
—
|
—
|
$50,816.30
|
$54,269.83
|
$50,964.34
|
2024-12-31
|
|
'304-3
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc Except For Curvature Of Back
|
5
|
3
|
—
|
—
|
$50,752.80
|
$54,202.02
|
$50,900.66
|
2024-12-31
|
|
B1305
|
OTHER
|
Rheumatoid Other Arthritis M <51.50 And A <64.50
|
6
|
3
|
—
|
—
|
$50,863.85
|
$50,863.85
|
$50,863.85
|
2024-12-31
|
|
B1204
|
OTHER
|
Osteoarthritis M <49.50 And A <74.50
|
6
|
3
|
—
|
—
|
$50,743.98
|
$50,743.98
|
$50,743.98
|
2024-12-31
|
|
'404-4
|
APR_DRG
|
Thyroid, Parathyroid & Thyroglossal Procedures
|
5
|
3
|
—
|
—
|
$50,484.01
|
$53,914.96
|
$50,631.08
|
2024-12-31
|
|
B1304
|
OTHER
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
6
|
3
|
—
|
—
|
$50,607.98
|
$50,607.98
|
$50,607.98
|
2024-12-31
|
|
B0904
|
OTHER
|
Other Orthopedic M <44.5
|
6
|
3
|
—
|
—
|
$50,605.67
|
$50,605.67
|
$50,605.67
|
2024-12-31
|
|
B0304
|
OTHER
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
6
|
3
|
—
|
—
|
$50,524.99
|
$50,524.99
|
$50,524.99
|
2024-12-31
|
|
'650-4
|
APR_DRG
|
Splenectomy
|
5
|
3
|
—
|
—
|
$50,369.03
|
$53,792.17
|
$50,515.77
|
2024-12-31
|
|
'175-4
|
APR_DRG
|
Percutaneous Coronary Intervention Without Ami
|
5
|
3
|
—
|
—
|
$50,361.87
|
$53,784.52
|
$50,508.59
|
2024-12-31
|
|
'480-4
|
APR_DRG
|
Major Male Pelvic Procedures
|
5
|
3
|
—
|
—
|
$50,323.42
|
$53,743.46
|
$50,470.03
|
2024-12-31
|
|
'791-4
|
APR_DRG
|
O.r. Procedure For Other Complications Of Treatment
|
5
|
3
|
—
|
—
|
$50,317.10
|
$53,736.71
|
$50,463.69
|
2024-12-31
|
|
'223-4
|
APR_DRG
|
Other Small & Large Bowel Procedures
|
5
|
3
|
—
|
—
|
$50,281.01
|
$53,698.16
|
$50,427.49
|
2024-12-31
|
|
'841-2
|
APR_DRG
|
Extensive 3rd Degree Burns W Skin Graft
|
5
|
3
|
—
|
—
|
$50,246.45
|
$53,661.26
|
$50,392.83
|
2024-12-31
|
|
'447-4
|
APR_DRG
|
Other Kidney, Urinary Tract & Related Procedures
|
5
|
3
|
—
|
—
|
$50,207.41
|
$53,619.57
|
$50,353.69
|
2024-12-31
|
|
'305-4
|
APR_DRG
|
Amputation Of Lower Limb Except Toes
|
5
|
3
|
—
|
—
|
$49,997.38
|
$53,395.26
|
$50,143.05
|
2024-12-31
|
|
'005-1
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
5
|
3
|
—
|
—
|
$49,993.11
|
$53,390.70
|
$50,138.76
|
2024-12-31
|
|
C0205
|
OTHER
|
Traumatic Brain Injury M <35.50
|
6
|
3
|
—
|
—
|
$50,091.61
|
$50,091.61
|
$50,091.61
|
2024-12-31
|
|
'514-4
|
APR_DRG
|
Female Reproductive System Reconstructive Procedures
|
5
|
3
|
—
|
—
|
$49,930.00
|
$53,323.30
|
$50,075.46
|
2024-12-31
|
|
C0105
|
OTHER
|
Stroke M <41.50 And A >=84.50
|
6
|
3
|
—
|
—
|
$50,063.95
|
$50,063.95
|
$50,063.95
|
2024-12-31
|
|
A0106
|
OTHER
|
Stroke M <41.50 And A <84.50
|
6
|
3
|
—
|
—
|
$49,955.61
|
$49,955.61
|
$49,955.61
|
2024-12-31
|
|
'440-1
|
APR_DRG
|
Kidney Transplant
|
5
|
3
|
—
|
—
|
$49,743.35
|
$53,123.96
|
$49,888.27
|
2024-12-31
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
41
|
15
|
—
|
$49,735.32
|
$28,136.00
|
$212,048.26
|
$49,735.32
|
2024-12-31
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
41
|
15
|
—
|
$49,616.59
|
$25,260.00
|
$211,542.03
|
$49,616.59
|
2024-12-31
|
|
'841-1
|
APR_DRG
|
Extensive 3rd Degree Burns W Skin Graft
|
5
|
3
|
—
|
—
|
$49,393.11
|
$52,749.93
|
$49,537.01
|
2024-12-31
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
41
|
15
|
—
|
$49,491.74
|
$29,260.00
|
$211,009.74
|
$49,491.74
|
2024-12-31
|
|
'609-2
|
APR_DRG
|
Neonate Bwt 1500-2499g W Major Procedure
|
5
|
3
|
—
|
—
|
$49,314.79
|
$52,666.28
|
$49,458.47
|
2024-12-31
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
41
|
15
|
—
|
$49,447.22
|
$27,232.00
|
$210,819.90
|
$49,447.22
|
2024-12-31
|
|
'614-4
|
APR_DRG
|
Neonate Bwt 1500-1999g W Or Without Other Significant Condition
|
5
|
3
|
—
|
—
|
$49,234.50
|
$52,580.54
|
$49,377.94
|
2024-12-31
|
|
B0504
|
OTHER
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
6
|
3
|
—
|
—
|
$49,360.87
|
$49,360.87
|
$49,360.87
|
2024-12-31
|
|
B1604
|
OTHER
|
Pain Syndrome M <43.50
|
6
|
3
|
—
|
—
|
$49,358.57
|
$49,358.57
|
$49,358.57
|
2024-12-31
|
|
'162-2
|
APR_DRG
|
Cardiac Valve Procedures W Ami Or Complex Pdx
|
5
|
3
|
—
|
—
|
$49,210.55
|
$52,554.95
|
$49,353.92
|
2024-12-31
|
|
B0204
|
OTHER
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
6
|
3
|
—
|
—
|
$49,282.50
|
$49,282.50
|
$49,282.50
|
2024-12-31
|
|
'850-4
|
APR_DRG
|
Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service
|
5
|
3
|
—
|
—
|
$49,120.67
|
$52,458.97
|
$49,263.78
|
2024-12-31
|
|
'519-4
|
APR_DRG
|
Uterine & Adnexa Procedures For Leiomyoma
|
5
|
3
|
—
|
—
|
$48,880.56
|
$52,202.54
|
$49,022.97
|
2024-12-31
|
|
'170-4
|
APR_DRG
|
Permanent Cardiac Pacemaker Implant W Ami, Heart Failure Or Shock
|
5
|
3
|
—
|
—
|
$48,847.15
|
$52,166.86
|
$48,989.46
|
2024-12-31
|