|
J3391
|
HCPCS
|
Inj, Atidarsagene Autotemcel
|
5
|
5
|
—
|
—
|
$4,158,625.00
|
$4,815,250.00
|
$4,377,500.00
|
2025-12-31
|
|
J1414
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
5
|
5
|
—
|
—
|
$3,524,500.00
|
$4,081,000.00
|
$3,710,000.00
|
2025-12-31
|
|
C9172
|
HCPCS
|
Inj- Beqvez- Per Tx Dose
|
7
|
7
|
—
|
—
|
$3,424,750.00
|
$4,001,550.00
|
$3,605,000.00
|
2026-07-18
|
|
J1411
|
HCPCS
|
Inj- Hemgenix- Per Tx Dose
|
24
|
12
|
—
|
—
|
$10.56
|
$4,076,919.00
|
$3,495,129.17
|
2026-07-18
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
16
|
12
|
—
|
—
|
$3,158,343.31
|
$4,887,120.69
|
$3,491,264.00
|
2026-07-18
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
15
|
12
|
—
|
—
|
$3,098,287.25
|
$4,794,191.85
|
$3,424,422.75
|
2026-07-18
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
15
|
12
|
—
|
—
|
$2,803,152.34
|
$4,337,509.40
|
$3,098,221.00
|
2026-07-18
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
9
|
6
|
—
|
—
|
$2,215,400.00
|
$3,987,720.00
|
$2,565,200.00
|
2025-12-31
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
18
|
12
|
—
|
—
|
$2,269,183.52
|
$4,193,117.68
|
$2,554,964.71
|
2026-07-18
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
12
|
8
|
—
|
—
|
$732,089.00
|
$1,905,914.65
|
$1,001,806.00
|
2025-12-31
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
28
|
15
|
—
|
—
|
$500,767.26
|
$1,368,628.92
|
$644,179.62
|
2026-07-18
|
|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
29
|
15
|
—
|
—
|
$490,889.78
|
$1,339,585.45
|
$634,963.72
|
2026-07-18
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel Car
|
28
|
15
|
—
|
—
|
$500,258.21
|
$1,338,657.47
|
$622,435.75
|
2026-07-18
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel Car-pos T
|
28
|
15
|
—
|
—
|
$502,733.22
|
$1,430,325.31
|
$621,698.93
|
2026-07-18
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Car+
|
30
|
15
|
—
|
—
|
$411,083.30
|
$1,318,416.69
|
$594,316.86
|
2026-07-18
|
|
Q2053
|
HCPCS
|
Brexucabtagene Car Pos T
|
28
|
15
|
—
|
—
|
$437,503.88
|
$1,211,186.47
|
$568,690.76
|
2026-07-18
|
|
C9098
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
1
|
1
|
—
|
—
|
$530,100.00
|
$530,100.00
|
$530,100.00
|
2026-07-18
|
|
24
|
APR_DRG
|
Heart &/or Lung Transplant
|
17
|
7
|
—
|
—
|
$215,493.86
|
$1,245,031.41
|
$484,861.18
|
2026-07-18
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell Immunotherapy
|
33
|
17
|
—
|
—
|
$287,145.26
|
$1,706,843.62
|
$374,926.13
|
2026-07-18
|
|
5834
|
APR_DRG
|
Neonate W Ecmo
|
17
|
7
|
—
|
—
|
$158,824.61
|
$916,491.46
|
$357,355.38
|
2026-07-18
|
|
5884
|
APR_DRG
|
Poisoning Of Medicinal Agents
|
17
|
7
|
—
|
—
|
$156,045.83
|
$900,381.49
|
$351,103.12
|
2026-07-18
|
|
5883
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
17
|
7
|
—
|
—
|
$156,045.83
|
$900,381.49
|
$351,103.12
|
2026-07-18
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
37
|
19
|
—
|
—
|
$172,107.00
|
$1,274,869.09
|
$344,418.29
|
2026-07-18
|
|
Q2058
|
HCPCS
|
Obecbtge Autol Up To 400 Mil
|
10
|
7
|
—
|
—
|
$256,856.25
|
$668,697.51
|
$332,561.25
|
2025-12-31
|
|
1614
|
APR_DRG
|
Disorders Of Gallbladder & Biliary Tract
|
17
|
7
|
—
|
—
|
$142,792.63
|
$823,546.02
|
$321,283.41
|
2026-07-18
|
|
5914
|
APR_DRG
|
Other Injury Poisoning & Toxic Effect Diagnoses
|
17
|
7
|
—
|
—
|
$119,982.02
|
$691,301.53
|
$269,959.54
|
2026-07-18
|
|
5882
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
17
|
7
|
—
|
—
|
$119,551.20
|
$688,803.86
|
$268,990.20
|
2026-07-18
|
|
5881
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
17
|
7
|
—
|
—
|
$119,551.20
|
$688,803.86
|
$268,990.20
|
2026-07-18
|
|
J3402
|
HCPCS
|
Inj. Remestemcel-l-rknd/ Td
|
2
|
1
|
—
|
—
|
$267,332.00
|
$267,332.00
|
$267,332.00
|
2025-12-31
|
|
8414
|
APR_DRG
|
Extensive 3rd Degree Burns W Skin Graft
|
17
|
7
|
—
|
—
|
$116,067.11
|
$668,604.85
|
$261,151.00
|
2026-07-18
|
|
44
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure
|
17
|
7
|
—
|
—
|
$111,966.33
|
$644,830.60
|
$251,924.25
|
2026-07-18
|
|
14
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
17
|
7
|
—
|
—
|
$108,478.55
|
$624,610.18
|
$244,076.74
|
2026-07-18
|
|
5934
|
APR_DRG
|
Toxic Effects Of Non-medicinal Substances
|
17
|
7
|
—
|
—
|
$108,050.81
|
$622,130.35
|
$243,114.32
|
2026-07-18
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
33
|
17
|
—
|
—
|
$180,625.40
|
$1,073,670.21
|
$235,941.99
|
2026-07-18
|
|
6094
|
APR_DRG
|
Procedure W Diag Of Rehab Aftercare Or Oth Contact W Health Service
|
17
|
7
|
—
|
—
|
$98,993.16
|
$569,618.62
|
$222,734.61
|
2026-07-18
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
33
|
17
|
—
|
—
|
$163,180.20
|
$969,972.78
|
$213,179.99
|
2026-07-18
|
|
6024
|
APR_DRG
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
17
|
7
|
—
|
—
|
$93,807.34
|
$539,553.81
|
$211,066.51
|
2026-07-18
|
|
23
|
APR_DRG
|
Heart &/or Lung Transplant
|
17
|
7
|
—
|
—
|
$93,482.38
|
$537,669.85
|
$210,335.34
|
2026-07-18
|
|
8413
|
APR_DRG
|
Extensive 3rd Degree Burns W Skin Graft
|
17
|
7
|
—
|
—
|
$90,861.15
|
$522,473.31
|
$204,437.59
|
2026-07-18
|
|
222
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization With Ami- Hf Or Shock…
|
6
|
4
|
—
|
—
|
$187,177.00
|
$218,672.50
|
$204,005.50
|
2026-07-18
|
|
5833
|
APR_DRG
|
O.r. Procedure For Other Complications Of Treatment
|
17
|
7
|
—
|
—
|
$90,550.35
|
$520,671.42
|
$203,738.28
|
2026-07-18
|
|
224
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami- Hf Or Sh…
|
6
|
4
|
—
|
—
|
$187,177.00
|
$207,974.00
|
$201,252.27
|
2026-07-18
|
|
226
|
MS_DRG
|
Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc
|
3
|
2
|
—
|
—
|
$182,809.70
|
$200,037.00
|
$200,037.00
|
2026-07-18
|
|
223
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization With Ami- Hf Or Shock…
|
3
|
2
|
—
|
—
|
$149,046.07
|
$200,037.00
|
$200,037.00
|
2026-07-18
|
|
225
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami- Hf Or Sh…
|
3
|
2
|
—
|
—
|
$144,447.91
|
$200,037.00
|
$200,037.00
|
2026-07-18
|
|
227
|
MS_DRG
|
Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc
|
6
|
4
|
—
|
—
|
$143,391.19
|
$207,974.00
|
$200,037.00
|
2026-07-18
|
|
5832
|
APR_DRG
|
O.r. Procedure For Other Complications Of Treatment
|
17
|
7
|
—
|
—
|
$88,870.77
|
$510,934.08
|
$199,959.24
|
2026-07-18
|
|
5831
|
APR_DRG
|
O.r. Procedure For Other Complications Of Treatment
|
17
|
7
|
—
|
—
|
$88,870.77
|
$510,934.08
|
$199,959.24
|
2026-07-18
|
|
6034
|
APR_DRG
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
17
|
7
|
—
|
—
|
$86,472.34
|
$497,029.19
|
$194,562.77
|
2026-07-18
|
|
54
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
17
|
7
|
—
|
—
|
$85,608.86
|
$492,023.15
|
$192,619.94
|
2026-07-18
|
|
5933
|
APR_DRG
|
Other Injury Poisoning & Toxic Effect Diagnoses
|
17
|
7
|
—
|
—
|
$84,553.36
|
$485,903.86
|
$190,245.05
|
2026-07-18
|
|
22
|
APR_DRG
|
Heart &/or Lung Transplant
|
17
|
7
|
—
|
—
|
$79,800.81
|
$458,350.99
|
$179,551.83
|
2026-07-18
|
|
453
|
MS_DRG
|
Combined Anterior/posterior Spinal Fusion W Mcc
|
3
|
2
|
—
|
—
|
$177,396.37
|
$253,081.58
|
$177,396.37
|
2026-07-18
|
|
J2326
|
HCPCS
|
Nusinersen 12 Mg/5ml It Soln
|
90
|
25
|
$365,748.40
|
$182,874.20
50% off
|
$250.00
|
$943,630.44
|
$175,559.15
|
2026-07-18
|
|
6074
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
17
|
7
|
—
|
—
|
$76,722.31
|
$440,503.35
|
$172,625.19
|
2026-07-18
|
|
6304
|
APR_DRG
|
Neonate Birthwt >2499g W Major Cardiovascular Procedure
|
17
|
7
|
—
|
—
|
$76,007.76
|
$436,360.79
|
$171,017.47
|
2026-07-18
|
|
5891
|
APR_DRG
|
Poisoning Of Medicinal Agents
|
17
|
7
|
—
|
—
|
$75,450.16
|
$433,128.09
|
$169,762.86
|
2026-07-18
|
|
5892
|
APR_DRG
|
Poisoning Of Medicinal Agents
|
17
|
7
|
—
|
—
|
$75,450.16
|
$433,128.09
|
$169,762.86
|
2026-07-18
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
37
|
19
|
—
|
—
|
$83,904.00
|
$1,038,855.00
|
$169,665.74
|
2026-07-18
|
|
21
|
APR_DRG
|
Heart &/or Lung Transplant
|
17
|
7
|
—
|
—
|
$75,211.36
|
$431,743.67
|
$169,225.57
|
2026-07-18
|
|
5913
|
APR_DRG
|
Other Complications Of Treatment
|
17
|
7
|
—
|
—
|
$73,455.47
|
$421,563.88
|
$165,274.81
|
2026-07-18
|
|
6023
|
APR_DRG
|
Toxic Effects Of Non-medicinal Substances
|
17
|
7
|
—
|
—
|
$69,438.40
|
$398,274.89
|
$156,236.39
|
2026-07-18
|
|
5932
|
APR_DRG
|
Other Injury Poisoning & Toxic Effect Diagnoses
|
17
|
7
|
—
|
—
|
$69,315.31
|
$397,561.27
|
$155,959.44
|
2026-07-18
|
|
5912
|
APR_DRG
|
Other Complications Of Treatment
|
17
|
7
|
—
|
—
|
$68,575.53
|
$393,272.41
|
$154,294.94
|
2026-07-18
|
|
3034
|
APR_DRG
|
Male Reproductive System Diagnoses Except Malignancy
|
17
|
7
|
—
|
—
|
$67,791.44
|
$388,726.65
|
$152,530.74
|
2026-07-18
|
|
5931
|
APR_DRG
|
Other Injury Poisoning & Toxic Effect Diagnoses
|
17
|
7
|
—
|
—
|
$67,227.07
|
$385,454.71
|
$151,260.90
|
2026-07-18
|
|
34
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Pdx
|
11
|
5
|
—
|
—
|
$138,666.00
|
$371,623.47
|
$148,372.62
|
2026-07-18
|
|
6314
|
APR_DRG
|
Neonate Birthwt >2499g W Other Major Procedure
|
17
|
7
|
—
|
—
|
$65,445.94
|
$375,128.63
|
$147,253.37
|
2026-07-18
|
|
4404
|
APR_DRG
|
Neonate Bwt 2000-2499g Normal Newborn Or Neonate W Other Problem
|
17
|
7
|
—
|
—
|
$64,650.16
|
$292,156.65
|
$145,462.85
|
2026-07-18
|
|
43
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure
|
17
|
7
|
—
|
—
|
$62,720.71
|
$359,329.08
|
$141,121.59
|
2026-07-18
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
33
|
17
|
—
|
—
|
$107,585.82
|
$639,509.67
|
$140,641.99
|
2026-07-18
|
|
1604
|
APR_DRG
|
Other Disorders Of The Liver
|
17
|
7
|
—
|
—
|
$61,940.92
|
$354,808.30
|
$139,367.08
|
2026-07-18
|
|
1613
|
APR_DRG
|
Other Disorders Of The Liver
|
17
|
7
|
—
|
—
|
$61,299.01
|
$351,086.77
|
$137,922.76
|
2026-07-18
|
|
3614
|
APR_DRG
|
Skin Graft For Skin & Subcutaneous Tissue Diagnoses
|
17
|
7
|
—
|
—
|
$59,827.45
|
$342,555.44
|
$134,611.77
|
2026-07-18
|
|
6022
|
APR_DRG
|
Toxic Effects Of Non-medicinal Substances
|
17
|
7
|
—
|
—
|
$59,110.45
|
$338,398.60
|
$132,998.51
|
2026-07-18
|
|
459
|
MS_DRG
|
Spinal Fusion Except Cervical With Mcc
|
3
|
2
|
—
|
—
|
$132,772.01
|
$189,418.49
|
$132,772.01
|
2026-07-18
|
|
1624
|
APR_DRG
|
Hip Joint Replacement
|
17
|
7
|
—
|
—
|
$58,499.30
|
$334,855.48
|
$131,623.43
|
2026-07-18
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
33
|
18
|
—
|
—
|
$99,757.11
|
$592,974.37
|
$130,892.51
|
2026-07-18
|
|
7
|
MS_DRG
|
Lung Transplant
|
33
|
18
|
—
|
—
|
$99,505.84
|
$591,480.82
|
$130,563.51
|
2026-07-18
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
37
|
18
|
—
|
—
|
$80,668.81
|
$479,510.05
|
$129,748.45
|
2026-07-18
|
|
53
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
17
|
7
|
—
|
—
|
$57,563.81
|
$329,431.97
|
$129,518.57
|
2026-07-18
|
|
3044
|
APR_DRG
|
Pelvic Evisceration Radical Hysterectomy & Other Radical GYN Procs
|
17
|
7
|
—
|
—
|
$57,253.00
|
$327,630.08
|
$128,819.26
|
2026-07-18
|
|
6073
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
17
|
7
|
—
|
—
|
$57,049.29
|
$326,449.04
|
$128,360.90
|
2026-07-18
|
|
3124
|
APR_DRG
|
Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses
|
17
|
7
|
—
|
—
|
$56,145.80
|
$321,211.07
|
$126,328.05
|
2026-07-18
|
|
6033
|
APR_DRG
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
17
|
7
|
—
|
—
|
$55,999.32
|
$320,361.86
|
$125,998.48
|
2026-07-18
|
|
6814
|
APR_DRG
|
Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms
|
17
|
7
|
—
|
—
|
$55,954.39
|
$320,101.39
|
$125,897.39
|
2026-07-18
|
|
6804
|
APR_DRG
|
Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms
|
17
|
7
|
—
|
—
|
$55,801.15
|
$319,212.93
|
$125,552.58
|
2026-07-18
|
|
5911
|
APR_DRG
|
Other Complications Of Treatment
|
17
|
7
|
—
|
—
|
$55,450.95
|
$317,182.68
|
$124,764.64
|
2026-07-18
|
|
6904
|
APR_DRG
|
Acute Leukemia
|
17
|
7
|
—
|
—
|
$54,612.09
|
$312,319.36
|
$122,877.20
|
2026-07-18
|
|
454
|
MS_DRG
|
Combined Anterior/posterior Spinal Fusion W Cc
|
3
|
2
|
—
|
—
|
$122,442.21
|
$174,681.53
|
$122,442.21
|
2026-07-18
|
|
8424
|
APR_DRG
|
Burns With Skin Graft Except Extensive 3rd Degree Burns
|
17
|
7
|
—
|
—
|
$53,901.85
|
$308,201.77
|
$121,279.17
|
2026-07-18
|
|
6124
|
APR_DRG
|
Signs Symptoms & Other Factors Influencing Health Status
|
17
|
7
|
—
|
—
|
$52,891.89
|
$302,346.52
|
$119,006.75
|
2026-07-18
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
37
|
18
|
—
|
—
|
$73,483.48
|
$436,799.13
|
$118,220.64
|
2026-07-18
|
|
4054
|
APR_DRG
|
Other Procedures For Endocrine, Nutritional & Metabolic Disorders
|
17
|
7
|
—
|
—
|
$52,365.68
|
$299,295.80
|
$117,822.77
|
2026-07-18
|
|
13
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
17
|
7
|
—
|
—
|
$52,232.74
|
$298,525.09
|
$117,523.66
|
2026-07-18
|
|
J0225
|
HCPCS
|
Vutrisiran Sodium 25 Mg/0.5ml Sc Sosy
|
94
|
27
|
$292,585.18
|
$146,292.59
50% off
|
$10.56
|
$769,816.10
|
$117,034.07
|
2026-07-18
|
|
6114
|
APR_DRG
|
Rehabilitation
|
17
|
7
|
—
|
—
|
$51,292.32
|
$293,073.03
|
$115,407.73
|
2026-07-18
|
|
9504
|
APR_DRG
|
Extensive Procedure Unrelated To Principal Diagnosis
|
17
|
7
|
—
|
—
|
$50,680.56
|
$289,526.34
|
$114,031.26
|
2026-07-18
|
|
234
|
APR_DRG
|
Spinal Procedures
|
17
|
7
|
—
|
—
|
$50,482.38
|
$288,377.41
|
$113,585.37
|
2026-07-18
|
|
64
|
APR_DRG
|
Pancreas Transplant
|
17
|
7
|
—
|
—
|
$47,754.69
|
$214,920.45
|
$107,448.05
|
2026-07-18
|
|
4474
|
APR_DRG
|
Other Kidney, Urinary Tract & Related Procedures
|
17
|
7
|
—
|
—
|
$47,703.61
|
$272,267.44
|
$107,333.11
|
2026-07-18
|
|
8504
|
APR_DRG
|
Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service
|
17
|
7
|
—
|
—
|
$47,679.60
|
$272,128.28
|
$107,279.11
|
2026-07-18
|
|
9124
|
APR_DRG
|
Musculoskeletal & Other Procedures For Multiple Significant Trauma
|
17
|
7
|
—
|
—
|
$47,371.26
|
$270,340.66
|
$106,585.33
|
2026-07-18
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
33
|
18
|
—
|
—
|
$81,084.53
|
$481,981.19
|
$106,442.00
|
2026-07-18
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve?procedures
|
31
|
17
|
—
|
—
|
$82,946.15
|
$344,127.41
|
$105,936.97
|
2026-07-18
|
|
5124
|
APR_DRG
|
Uterine & Adnexa Procedures For Non-ovarian & Non-adnexal Malig
|
17
|
7
|
—
|
—
|
$46,920.75
|
$267,728.82
|
$105,571.68
|
2026-07-18
|
|
6072
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
17
|
7
|
—
|
—
|
$46,766.88
|
$266,836.79
|
$105,225.49
|
2026-07-18
|
|
2604
|
APR_DRG
|
Nephritis & Nephrosis
|
17
|
7
|
—
|
—
|
$46,447.46
|
$264,984.95
|
$104,506.79
|
2026-07-18
|
|
6954
|
APR_DRG
|
Chemotherapy For Acute Leukemia
|
17
|
7
|
—
|
—
|
$46,203.13
|
$263,568.41
|
$103,957.03
|
2026-07-18
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
37
|
18
|
—
|
—
|
$64,520.27
|
$383,520.24
|
$103,840.50
|
2026-07-18
|
|
924
|
APR_DRG
|
Facial Bone Procedures Except Major Cranial/facial Bone Procedures
|
17
|
7
|
—
|
—
|
$45,997.56
|
$262,376.67
|
$103,494.52
|
2026-07-18
|
|
63
|
APR_DRG
|
Pancreas Transplant
|
17
|
7
|
—
|
—
|
$45,756.31
|
$205,785.02
|
$102,951.69
|
2026-07-18
|
|
6093
|
APR_DRG
|
Partial Thickness Burns Without Skin Graft
|
17
|
7
|
—
|
—
|
$45,564.90
|
$259,868.29
|
$102,521.02
|
2026-07-18
|
|
Q0480
|
HCPCS
|
Driver Pneumatic Vad- Rep
|
16
|
10
|
—
|
—
|
$54,670.85
|
$161,541.01
|
$102,499.91
|
2026-07-18
|
|
214
|
APR_DRG
|
Permanent Cardiac Pacemaker Implant W Ami Heart Failure Or Shock
|
17
|
7
|
—
|
—
|
$45,308.25
|
$258,380.39
|
$101,943.57
|
2026-07-18
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
31
|
17
|
—
|
—
|
$79,759.70
|
$330,907.41
|
$101,877.27
|
2026-07-18
|
|
42
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure
|
17
|
7
|
—
|
—
|
$44,983.29
|
$256,496.44
|
$101,212.41
|
2026-07-18
|
|
41
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure
|
17
|
7
|
—
|
—
|
$44,983.29
|
$256,496.44
|
$101,212.41
|
2026-07-18
|
|
1694
|
APR_DRG
|
Major Abdominal Vascular Procedures
|
17
|
7
|
—
|
—
|
$44,948.21
|
$256,293.05
|
$101,133.48
|
2026-07-18
|
|
9104
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
17
|
7
|
—
|
—
|
$44,945.75
|
$256,278.78
|
$101,127.94
|
2026-07-18
|
|
6084
|
APR_DRG
|
Partial Thickness Burns Without Skin Graft
|
17
|
7
|
—
|
—
|
$44,945.14
|
$256,275.21
|
$101,126.56
|
2026-07-18
|
|
A9513
|
HCPCS
|
Lutetium Lu 177 Dotatate 370 Mbq/ml IV Soln
|
57
|
24
|
$152,512.23
|
$76,256.12
50% off
|
$258.80
|
$393,481.56
|
$100,658.07
|
2026-07-18
|
|
2204
|
APR_DRG
|
Major Stomach, Esophageal & Duodenal Procedures
|
17
|
7
|
—
|
—
|
$44,362.30
|
$252,896.22
|
$99,815.18
|
2026-07-18
|
|
8412
|
APR_DRG
|
Extensive 3rd Degree Burns W Skin Graft
|
17
|
7
|
—
|
—
|
$44,326.60
|
$252,689.27
|
$99,734.86
|
2026-07-18
|
|
1654
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
17
|
7
|
—
|
—
|
$44,293.98
|
$252,500.16
|
$99,661.47
|
2026-07-18
|
|
3214
|
APR_DRG
|
Vaginal Delivery W Sterilization &/or D&c
|
17
|
7
|
—
|
—
|
$44,217.67
|
$252,057.72
|
$99,489.75
|
2026-07-18
|
|
1634
|
APR_DRG
|
Knee Joint Replacement
|
17
|
7
|
—
|
—
|
$44,111.81
|
$251,444.01
|
$99,251.57
|
2026-07-18
|
|
3033
|
APR_DRG
|
Malignancy Male Reproductive System
|
17
|
7
|
—
|
—
|
$43,748.69
|
$249,338.83
|
$98,434.56
|
2026-07-18
|
|
4014
|
APR_DRG
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
17
|
7
|
—
|
—
|
$43,746.85
|
$249,328.12
|
$98,430.40
|
2026-07-18
|
|
6032
|
APR_DRG
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
17
|
7
|
—
|
—
|
$43,197.86
|
$246,145.38
|
$97,195.18
|
2026-07-18
|
|
3104
|
APR_DRG
|
Intervertebral Disc Excision & Decompression
|
17
|
7
|
—
|
—
|
$42,851.36
|
$244,136.54
|
$96,415.56
|
2026-07-18
|
|
6083
|
APR_DRG
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
17
|
7
|
—
|
—
|
$42,736.88
|
$243,472.87
|
$96,157.99
|
2026-07-18
|
|
894
|
APR_DRG
|
Other Small & Large Bowel Procedures
|
17
|
7
|
—
|
—
|
$42,706.11
|
$243,294.47
|
$96,088.75
|
2026-07-18
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization With Mcc
|
37
|
18
|
—
|
—
|
$59,514.07
|
$353,762.45
|
$95,808.78
|
2026-07-18
|
|
244
|
APR_DRG
|
Percutaneous Coronary Intervention Without Ami
|
17
|
7
|
—
|
—
|
$42,552.25
|
$242,402.44
|
$95,742.56
|
2026-07-18
|
|
6214
|
APR_DRG
|
Neonate Bwt 2000-2499g W Major Anomaly
|
17
|
7
|
—
|
—
|
$42,543.02
|
$242,348.92
|
$95,721.79
|
2026-07-18
|
|
4414
|
APR_DRG
|
Neonate Birthwt >2499g W Major Cardiovascular Procedure
|
17
|
7
|
—
|
—
|
$42,365.76
|
$241,321.31
|
$95,322.97
|
2026-07-18
|
|
204
|
APR_DRG
|
Major Abdominal Vascular Procedures
|
17
|
7
|
—
|
—
|
$41,914.64
|
$238,705.89
|
$94,307.93
|
2026-07-18
|
|
1674
|
APR_DRG
|
Other Cardiothoracic & Thoracic Vascular Procedures
|
17
|
7
|
—
|
—
|
$41,552.75
|
$236,607.85
|
$93,493.68
|
2026-07-18
|
|
1814
|
APR_DRG
|
Tendon Muscle & Other Soft Tissue Procedures
|
17
|
7
|
—
|
—
|
$41,462.28
|
$236,083.34
|
$93,290.12
|
2026-07-18
|
|
K1007
|
HCPCS
|
Bil Hkaf Pc S/d Micro Sensor
|
3
|
3
|
—
|
—
|
$93,216.70
|
$103,470.54
|
$93,216.70
|
2025-12-31
|
|
4034
|
APR_DRG
|
Procedures For Obesity
|
19
|
7
|
—
|
—
|
$33,546.00
|
$234,663.23
|
$92,738.98
|
2026-07-18
|
|
455
|
MS_DRG
|
Combined Anterior/posterior Spinal Fusion Without Cc/mcc
|
3
|
2
|
—
|
—
|
$92,199.51
|
$131,535.94
|
$92,199.51
|
2026-07-18
|
|
6021
|
APR_DRG
|
Toxic Effects Of Non-medicinal Substances
|
17
|
7
|
—
|
—
|
$40,700.34
|
$231,666.03
|
$91,575.77
|
2026-07-18
|
|
9114
|
APR_DRG
|
Extensive Abdominal/thoracic Procedures For Mult Significant Trauma
|
17
|
7
|
—
|
—
|
$40,685.57
|
$231,580.39
|
$91,542.54
|
2026-07-18
|
|
3134
|
APR_DRG
|
Other Female Reproductive System & Related Procedures
|
17
|
7
|
—
|
—
|
$40,568.64
|
$230,902.46
|
$91,279.43
|
2026-07-18
|
|
5104
|
APR_DRG
|
Post-op Post-trauma Other Device Infections W O.r. Procedure
|
17
|
7
|
—
|
—
|
$40,187.05
|
$228,690.23
|
$90,420.87
|
2026-07-18
|
|
4424
|
APR_DRG
|
Neonate Birthwt >2499g W Other Major Procedure
|
17
|
7
|
—
|
—
|
$39,981.49
|
$227,498.49
|
$89,958.36
|
2026-07-18
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
31
|
17
|
—
|
—
|
$70,139.41
|
$290,994.71
|
$89,620.60
|
2026-07-18
|
|
6123
|
APR_DRG
|
Rehabilitation
|
17
|
7
|
—
|
—
|
$39,779.01
|
$226,324.58
|
$89,502.77
|
2026-07-18
|
|
1774
|
APR_DRG
|
Shoulder Upper Arm & Forearm Procedures Except Joint Replacement
|
17
|
7
|
—
|
—
|
$39,727.31
|
$226,024.86
|
$89,386.45
|
2026-07-18
|
|
6914
|
APR_DRG
|
Lymphoma, Myeloma & Non-acute Leukemia
|
17
|
7
|
—
|
—
|
$39,716.23
|
$225,960.64
|
$89,361.52
|
2026-07-18
|
|
7104
|
APR_DRG
|
Infectious & Parasitic Diseases Including HIV W O.r. Procedure
|
17
|
7
|
—
|
—
|
$39,639.91
|
$225,518.19
|
$89,189.81
|
2026-07-18
|
|
3174
|
APR_DRG
|
Tendon, Muscle & Other Soft Tissue Procedures
|
17
|
7
|
—
|
—
|
$39,625.14
|
$225,432.56
|
$89,156.57
|
2026-07-18
|
|
3054
|
APR_DRG
|
Uterine & Adnexa Procedures For Ovarian & Adnexal Malignancy
|
17
|
7
|
—
|
—
|
$39,525.44
|
$224,854.53
|
$88,932.24
|
2026-07-18
|
|
264
|
APR_DRG
|
Other Nervous System & Related Procedures
|
17
|
7
|
—
|
—
|
$39,366.04
|
$223,930.39
|
$88,573.58
|
2026-07-18
|
|
9514
|
APR_DRG
|
Moderately Extensive Procedure Unrelated To Principal Diagnosis
|
17
|
7
|
—
|
—
|
$39,361.11
|
$223,901.84
|
$88,562.51
|
2026-07-18
|
|
1824
|
APR_DRG
|
Other Peripheral Vascular Procedures
|
17
|
7
|
—
|
—
|
$39,342.03
|
$223,791.23
|
$88,519.58
|
2026-07-18
|
|
6113
|
APR_DRG
|
Procedure W Diag Of Rehab Aftercare Or Oth Contact W Health Service
|
17
|
7
|
—
|
—
|
$39,303.88
|
$223,570.01
|
$88,433.72
|
2026-07-18
|
|
1664
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc Except For Curvature Of Back
|
17
|
7
|
—
|
—
|
$39,090.93
|
$222,335.45
|
$87,954.59
|
2026-07-18
|
|
5114
|
APR_DRG
|
Uterine & Adnexa Procedures For Ovarian & Adnexal Malignancy
|
17
|
7
|
—
|
—
|
$39,061.39
|
$222,164.18
|
$87,888.12
|
2026-07-18
|
|
4444
|
APR_DRG
|
Renal Dialysis Access Device And Vessel Repair
|
17
|
7
|
—
|
—
|
$38,812.13
|
$220,719.10
|
$87,327.29
|
2026-07-18
|
|
12
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
17
|
7
|
—
|
—
|
$38,673.03
|
$219,912.71
|
$87,014.33
|
2026-07-18
|
|
11
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
17
|
7
|
—
|
—
|
$38,673.03
|
$219,912.71
|
$87,014.33
|
2026-07-18
|
|
2644
|
APR_DRG
|
Other Kidney & Urinary Tract Diagnoses Signs & Symptoms
|
17
|
7
|
—
|
—
|
$38,619.49
|
$219,602.28
|
$86,893.85
|
2026-07-18
|
|
2614
|
APR_DRG
|
Major Biliary Tract Procedures
|
17
|
7
|
—
|
—
|
$38,533.33
|
$219,102.75
|
$86,699.98
|
2026-07-18
|
|
1612
|
APR_DRG
|
Other Disorders Of The Liver
|
17
|
7
|
—
|
—
|
$38,453.32
|
$218,638.90
|
$86,519.96
|
2026-07-18
|
|
1204
|
APR_DRG
|
Major Respiratory & Chest Procedures
|
17
|
7
|
—
|
—
|
$38,226.83
|
$217,325.83
|
$86,010.37
|
2026-07-18
|
|
1304
|
APR_DRG
|
Respiratory System Diagnosis W Ventilator Support 96+ Hours
|
17
|
7
|
—
|
—
|
$38,116.05
|
$216,683.58
|
$85,761.11
|
2026-07-18
|
|
6903
|
APR_DRG
|
Acute Leukemia
|
17
|
7
|
—
|
—
|
$38,055.12
|
$216,330.33
|
$85,624.02
|
2026-07-18
|
|
1214
|
APR_DRG
|
Other Respiratory & Chest Procedures
|
17
|
7
|
—
|
—
|
$38,019.42
|
$216,123.39
|
$85,543.70
|
2026-07-18
|
|
3014
|
APR_DRG
|
Other Male Reproductive System & Related Procedures
|
17
|
7
|
—
|
—
|
$37,998.50
|
$216,002.07
|
$85,496.62
|
2026-07-18
|
|
5194
|
APR_DRG
|
Uterine & Adnexa Procedures For Leiomyoma
|
17
|
7
|
—
|
—
|
$37,968.34
|
$215,827.23
|
$85,428.76
|
2026-07-18
|
|
6071
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
17
|
7
|
—
|
—
|
$37,921.56
|
$215,556.06
|
$85,323.52
|
2026-07-18
|
|
7114
|
APR_DRG
|
Post-op, Post-trauma, Other Device Infections W O.r. Procedure
|
17
|
7
|
—
|
—
|
$37,888.95
|
$215,366.95
|
$85,250.13
|
2026-07-18
|
|
5184
|
APR_DRG
|
Other Female Reproductive System & Related Procedures
|
17
|
7
|
—
|
—
|
$37,531.98
|
$213,297.45
|
$84,446.96
|
2026-07-18
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
33
|
17
|
—
|
—
|
$64,484.49
|
$383,307.52
|
$84,404.58
|
2026-07-18
|
|
494
|
APR_DRG
|
Cardiac Arrest And Shock
|
17
|
7
|
—
|
—
|
$37,467.97
|
$212,926.37
|
$84,302.94
|
2026-07-18
|
|
1714
|
APR_DRG
|
Perm Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock
|
17
|
7
|
—
|
—
|
$37,445.20
|
$212,794.35
|
$84,251.71
|
2026-07-18
|
|
8
|
MS_DRG
|
Simultaneous Pancreas/kidney Transplant
|
37
|
19
|
—
|
—
|
$41,428.54
|
$604,661.00
|
$83,982.63
|
2026-07-18
|
|
9524
|
APR_DRG
|
Nonextensive Procedure Unrelated To Principal Diagnosis
|
17
|
7
|
—
|
—
|
$37,247.03
|
$211,645.42
|
$83,805.81
|
2026-07-18
|
|
6303
|
APR_DRG
|
Neonate Birthwt >2499g W Major Cardiovascular Procedure
|
17
|
7
|
—
|
—
|
$37,209.48
|
$211,427.77
|
$83,721.34
|
2026-07-18
|
|
434
|
APR_DRG
|
Other Peripheral Vascular Procedures #
|
17
|
7
|
—
|
—
|
$37,161.48
|
$211,149.45
|
$83,613.32
|
2026-07-18
|
|
3814
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
17
|
7
|
—
|
—
|
$37,069.77
|
$210,617.81
|
$83,406.99
|
2026-07-18
|
|
52
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
17
|
7
|
—
|
—
|
$36,705.43
|
$208,505.49
|
$82,587.21
|
2026-07-18
|
|
2294
|
APR_DRG
|
Other Digestive System & Abdominal Procedures
|
17
|
7
|
—
|
—
|
$36,355.85
|
$206,478.81
|
$81,800.66
|
2026-07-18
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
37
|
18
|
—
|
—
|
$50,767.11
|
$301,768.91
|
$81,775.56
|
2026-07-18
|
|
3084
|
APR_DRG
|
Uterine & Adnexa Procedures For Non-ovarian & Non-adnexal Malig
|
17
|
7
|
—
|
—
|
$36,245.07
|
$205,836.55
|
$81,551.40
|
2026-07-18
|
|
3094
|
APR_DRG
|
Uterine & Adnexa Procedures For Non-malignancy Except Leiomyoma
|
17
|
7
|
—
|
—
|
$36,099.20
|
$204,990.91
|
$81,223.21
|
2026-07-18
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
31
|
17
|
—
|
—
|
$63,505.33
|
$263,471.21
|
$81,168.49
|
2026-07-18
|
|
1623
|
APR_DRG
|
Disorders Of Gallbladder & Biliary Tract
|
17
|
7
|
—
|
—
|
$36,047.50
|
$204,691.19
|
$81,106.88
|
2026-07-18
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
37
|
18
|
—
|
—
|
$58,913.33
|
$350,191.51
|
$80,687.00
|
2026-07-18
|
|
6504
|
APR_DRG
|
Splenectomy
|
17
|
7
|
—
|
—
|
$35,840.10
|
$203,488.74
|
$80,640.22
|
2026-07-18
|
|
51
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
17
|
7
|
—
|
—
|
$35,797.63
|
$203,242.54
|
$80,544.67
|
2026-07-18
|
|
6082
|
APR_DRG
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
17
|
7
|
—
|
—
|
$35,735.47
|
$202,882.17
|
$80,404.80
|
2026-07-18
|
|
4403
|
APR_DRG
|
Neonate Bwt 2000-2499g W Other Significant Condition
|
17
|
7
|
—
|
—
|
$35,651.77
|
$163,524.00
|
$80,216.47
|
2026-07-18
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
33
|
18
|
—
|
—
|
$60,706.42
|
$360,850.01
|
$79,758.18
|
2026-07-18
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
37
|
18
|
—
|
—
|
$49,170.45
|
$292,278.10
|
$79,213.96
|
2026-07-18
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
34
|
18
|
—
|
—
|
$60,358.46
|
$358,781.67
|
$79,161.80
|
2026-07-18
|
|
2234
|
APR_DRG
|
Other Small & Large Bowel Procedures
|
17
|
7
|
—
|
—
|
$35,073.85
|
$199,046.46
|
$78,916.17
|
2026-07-18
|
|
2244
|
APR_DRG
|
Peritoneal Adhesiolysis
|
17
|
7
|
—
|
—
|
$35,012.92
|
$198,693.22
|
$78,779.08
|
2026-07-18
|
|
33
|
APR_DRG
|
Cardiac Valve Procedures W Ami Or Complex Pdx
|
11
|
5
|
—
|
—
|
$73,506.55
|
$198,053.35
|
$78,652.01
|
2026-07-18
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
33
|
17
|
—
|
—
|
$61,377.22
|
$364,837.32
|
$78,457.17
|
2026-07-18
|
|
2224
|
APR_DRG
|
Other Stomach, Esophageal & Duodenal Procedures
|
17
|
7
|
—
|
—
|
$34,799.98
|
$197,458.65
|
$78,299.95
|
2026-07-18
|
|
A9607
|
HCPCS
|
Lutetium Lu 177 Vipivotide Tet 1000 Mbq/ml IV Soln
|
48
|
20
|
$124,194.50
|
$62,097.25
50% off
|
$229.18
|
$320,421.81
|
$78,242.54
|
2026-07-18
|
|
3024
|
APR_DRG
|
Malignancy Male Reproductive System
|
17
|
7
|
—
|
—
|
$34,238.68
|
$194,204.55
|
$77,037.03
|
2026-07-18
|
|
4234
|
APR_DRG
|
Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond
|
17
|
7
|
—
|
—
|
$34,210.99
|
$194,043.98
|
$76,974.72
|
2026-07-18
|
|
224
|
APR_DRG
|
Ventricular Shunt Procedures
|
17
|
7
|
—
|
—
|
$33,898.34
|
$192,231.39
|
$76,271.25
|
2026-07-18
|
|
8411
|
APR_DRG
|
Extensive 3rd Degree Burns W Skin Graft
|
17
|
7
|
—
|
—
|
$33,770.94
|
$191,492.79
|
$75,984.61
|
2026-07-18
|
|
338
|
MS_DRG
|
Appendectomy With Complicated Principal Diagnosis With Mcc
|
1
|
1
|
—
|
—
|
$75,869.64
|
$75,869.64
|
$75,869.64
|
2026-07-18
|
|
6334
|
APR_DRG
|
Neonate Birthwt >2499g W Major Anomaly
|
17
|
7
|
—
|
—
|
$33,691.54
|
$191,032.51
|
$75,805.97
|
2026-07-18
|
|
504
|
APR_DRG
|
Peripheral & Other Vascular Disorders
|
17
|
7
|
—
|
—
|
$33,646.00
|
$190,768.47
|
$75,703.50
|
2026-07-18
|
|
3043
|
APR_DRG
|
Male Reproductive System Diagnoses Except Malignancy
|
17
|
7
|
—
|
—
|
$33,529.68
|
$190,094.10
|
$75,441.78
|
2026-07-18
|
|
3644
|
APR_DRG
|
Other Skin, Subcutaneous Tissue & Related Procedures
|
17
|
7
|
—
|
—
|
$33,417.05
|
$189,441.13
|
$75,188.36
|
2026-07-18
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
17
|
7
|
—
|
—
|
$33,353.66
|
$189,073.62
|
$75,045.73
|
2026-07-18
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
37
|
18
|
—
|
—
|
$46,511.64
|
$276,473.65
|
$74,948.29
|
2026-07-18
|
|
3032
|
APR_DRG
|
Malignancy Male Reproductive System
|
17
|
7
|
—
|
—
|
$33,288.42
|
$188,695.40
|
$74,898.94
|
2026-07-18
|
|
904
|
APR_DRG
|
Peritoneal Adhesiolysis
|
11
|
5
|
—
|
—
|
$69,858.75
|
$188,336.43
|
$74,748.87
|
2026-07-18
|
|
2274
|
APR_DRG
|
Thyroid Parathyroid & Thyroglossal Procedures
|
17
|
7
|
—
|
—
|
$33,197.95
|
$188,170.89
|
$74,695.38
|
2026-07-18
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
33
|
17
|
—
|
—
|
$56,832.42
|
$337,822.23
|
$74,420.37
|
2026-07-18
|
|
6134
|
APR_DRG
|
Other Aftercare & Convalescence
|
17
|
7
|
—
|
—
|
$32,609.57
|
$184,759.79
|
$73,371.54
|
2026-07-18
|
|
6031
|
APR_DRG
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
17
|
7
|
—
|
—
|
$32,585.57
|
$184,620.63
|
$73,317.53
|
2026-07-18
|
|
6224
|
APR_DRG
|
Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond
|
17
|
7
|
—
|
—
|
$32,553.57
|
$184,435.09
|
$73,245.52
|
2026-07-18
|
|
460
|
MS_DRG
|
Spinal Fusion Except Cervical Without Mcc
|
3
|
2
|
—
|
—
|
$73,227.50
|
$104,469.62
|
$73,227.50
|
2026-07-18
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
37
|
18
|
—
|
—
|
$45,297.97
|
$269,259.37
|
$73,001.14
|
2026-07-18
|
|
3154
|
APR_DRG
|
Shoulder, Upper Arm & Forearm Procedures Except Joint Replacement
|
17
|
7
|
—
|
—
|
$32,334.46
|
$183,164.85
|
$72,752.54
|
2026-07-18
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
37
|
18
|
—
|
—
|
$44,802.30
|
$266,313.01
|
$72,205.91
|
2026-07-18
|
|
8444
|
APR_DRG
|
Partial Thickness Burns Without Skin Graft
|
17
|
7
|
—
|
—
|
$32,003.97
|
$181,248.78
|
$72,008.92
|
2026-07-18
|
|
4434
|
APR_DRG
|
Neonate Birthwt >2499g W Major Anomaly
|
17
|
7
|
—
|
—
|
$31,930.73
|
$180,824.17
|
$71,844.13
|
2026-07-18
|
|
62
|
APR_DRG
|
Pancreas Transplant
|
17
|
7
|
—
|
—
|
$31,854.41
|
$156,324.00
|
$71,672.42
|
2026-07-18
|
|
61
|
APR_DRG
|
Pancreas Transplant
|
17
|
7
|
—
|
—
|
$31,854.41
|
$156,324.00
|
$71,672.42
|
2026-07-18
|
|
6133
|
APR_DRG
|
Signs Symptoms & Other Factors Influencing Health Status
|
17
|
7
|
—
|
—
|
$31,807.02
|
$180,106.98
|
$71,565.79
|
2026-07-18
|
|
6144
|
APR_DRG
|
Neonate Bwt 1500-1999g W Or Without Other Significant Condition
|
17
|
7
|
—
|
—
|
$31,735.63
|
$179,693.08
|
$71,405.16
|
2026-07-18
|
|
6143
|
APR_DRG
|
Other Aftercare & Convalescence
|
17
|
7
|
—
|
—
|
$31,735.63
|
$179,693.08
|
$71,405.16
|
2026-07-18
|
|
3204
|
APR_DRG
|
Other Musculoskeletal System & Connective Tissue Procedures
|
17
|
7
|
—
|
—
|
$31,535.60
|
$178,533.45
|
$70,955.11
|
2026-07-18
|
|
248
|
MS_DRG
|
Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4…
|
4
|
3
|
—
|
—
|
$63,650.00
|
$85,959.89
|
$70,721.00
|
2026-07-18
|
|
93651
|
CPT
|
Ablate Heart Dysrhythm Focus
|
3
|
2
|
—
|
—
|
$60,266.00
|
$70,652.00
|
$70,652.00
|
2026-07-18
|
|
93607
|
CPT
|
Right Ventricular Recording
|
3
|
2
|
—
|
—
|
$60,266.00
|
$70,652.00
|
$70,652.00
|
2026-07-18
|
|
93652
|
CPT
|
Ablate Heart Dysrhythm Focus
|
3
|
2
|
—
|
—
|
$60,266.00
|
$70,652.00
|
$70,652.00
|
2026-07-18
|
|
6604
|
APR_DRG
|
Major Hematologic/immunologic Diag Exc Sickle Cell Crisis & Coagul
|
17
|
7
|
—
|
—
|
$31,378.05
|
$177,620.02
|
$70,600.61
|
2026-07-18
|
|
1754
|
APR_DRG
|
Percutaneous Coronary Intervention Without Ami
|
17
|
7
|
—
|
—
|
$30,963.85
|
$175,218.69
|
$69,668.65
|
2026-07-18
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
33
|
17
|
—
|
—
|
$52,966.79
|
$314,844.23
|
$69,376.61
|
2026-07-18
|
|
6313
|
APR_DRG
|
Neonate Birthwt >2499g W Other Major Procedure
|
17
|
7
|
—
|
—
|
$30,750.28
|
$173,980.56
|
$69,188.14
|
2026-07-18
|
|
3464
|
APR_DRG
|
Preterm Labor
|
17
|
7
|
—
|
—
|
$30,741.05
|
$173,927.03
|
$69,167.37
|
2026-07-18
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
31
|
17
|
—
|
—
|
$54,079.96
|
$224,367.19
|
$69,160.14
|
2026-07-18
|
|
0810
|
RC
|
Hc Acquisition Of Kidney Other Than From Amc C.t.d.
|
6
|
5
|
$81,268.00
|
$40,634.00
50% off
|
$60,951.00
|
$69,077.80
|
$69,077.80
|
2026-07-18
|
|
0811
|
RC
|
Hc Kidney Living Donor Excludes Surgeons Fees
|
6
|
5
|
$81,268.00
|
$40,634.00
50% off
|
$60,951.00
|
$69,077.80
|
$69,077.80
|
2026-07-18
|
|
1653
|
APR_DRG
|
Knee Joint Replacement
|
17
|
7
|
—
|
—
|
$30,660.43
|
$173,459.61
|
$68,985.96
|
2026-07-18
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
31
|
17
|
—
|
—
|
$53,808.14
|
$225,486.00
|
$68,813.83
|
2026-07-18
|
|
1804
|
APR_DRG
|
Other Circulatory System Procedures
|
17
|
7
|
—
|
—
|
$30,400.09
|
$171,950.31
|
$68,400.20
|
2026-07-18
|
|
1704
|
APR_DRG
|
Permanent Cardiac Pacemaker Implant W Ami, Heart Failure Or Shock
|
17
|
7
|
—
|
—
|
$30,359.47
|
$171,714.81
|
$68,308.81
|
2026-07-18
|
|
5134
|
APR_DRG
|
Uterine & Adnexa Procedures For Non-malignancy Except Leiomyoma
|
17
|
7
|
—
|
—
|
$30,292.38
|
$171,325.89
|
$68,157.87
|
2026-07-18
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
33
|
17
|
—
|
—
|
$51,990.68
|
$309,042.03
|
$68,103.00
|
2026-07-18
|
|
1603
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
17
|
7
|
—
|
—
|
$30,160.06
|
$170,558.75
|
$67,860.14
|
2026-07-18
|
|
L8702
|
HCPCS
|
Ewhf S/d Uprt Micro Sensor
|
12
|
10
|
—
|
—
|
$3,094.36
|
$74,872.45
|
$66,662.20
|
2026-07-18
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
33
|
17
|
—
|
—
|
$50,853.14
|
$302,280.34
|
$66,618.78
|
2026-07-18
|
|
0812
|
RC
|
Hc Cadaver Kidney From Amc C.t.d.
|
12
|
5
|
$79,795.50
|
$39,897.75
50% off
|
$58,742.25
|
$69,077.80
|
$66,574.55
|
2026-07-18
|
|
4402
|
APR_DRG
|
Neonate Bwt 2000-2499g W Other Significant Condition
|
17
|
7
|
—
|
—
|
$29,331.04
|
$163,524.00
|
$65,994.85
|
2026-07-18
|
|
77310
|
CPT
|
Hc Telether Isodose Plan Interm
|
6
|
5
|
$77,301.00
|
$38,650.50
50% off
|
$57,975.75
|
$65,705.85
|
$65,705.85
|
2026-07-18
|
|
A9543
|
HCPCS
|
Y90 Ibritumomab- Rx
|
15
|
7
|
—
|
—
|
$40.00
|
$114,571.66
|
$65,476.58
|
2026-07-18
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Without Mcc
|
37
|
18
|
—
|
—
|
$40,508.00
|
$240,786.93
|
$65,316.34
|
2026-07-18
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
31
|
17
|
—
|
—
|
$51,049.59
|
$211,794.77
|
$65,299.31
|
2026-07-18
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
37
|
18
|
—
|
—
|
$40,329.07
|
$239,723.35
|
$65,029.27
|
2026-07-18
|
|
6614
|
APR_DRG
|
Coagulation & Platelet Disorders
|
17
|
7
|
—
|
—
|
$28,842.99
|
$162,923.01
|
$64,896.72
|
2026-07-18
|
|
6122
|
APR_DRG
|
Rehabilitation
|
17
|
7
|
—
|
—
|
$28,744.52
|
$162,352.12
|
$64,675.16
|
2026-07-18
|
|
1633
|
APR_DRG
|
Hip Joint Replacement
|
17
|
7
|
—
|
—
|
$28,716.82
|
$162,191.55
|
$64,612.85
|
2026-07-18
|
|
341
|
MS_DRG
|
Appendectomy Without Complicated Principal Diagnosis With Mcc
|
1
|
1
|
—
|
—
|
$64,517.04
|
$64,517.04
|
$64,517.04
|
2026-07-18
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
33
|
17
|
—
|
—
|
$49,241.26
|
$292,699.00
|
$64,515.64
|
2026-07-18
|
|
3123
|
APR_DRG
|
Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses
|
17
|
7
|
—
|
—
|
$28,606.65
|
$161,552.86
|
$64,364.97
|
2026-07-18
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
38
|
19
|
—
|
—
|
$35,079.98
|
$333,815.00
|
$63,891.98
|
2026-07-18
|
|
1622
|
APR_DRG
|
Disorders Of Gallbladder & Biliary Tract
|
17
|
7
|
—
|
—
|
$28,326.01
|
$159,925.81
|
$63,733.51
|
2026-07-18
|
|
7514
|
APR_DRG
|
Major Depressive Disorders & Other/unspecified Psychoses
|
8
|
4
|
—
|
—
|
$14,945.40
|
$82,351.75
|
$63,498.85
|
2026-07-18
|
|
1934
|
APR_DRG
|
Fracture Of Pelvis Or Dislocation Of Hip
|
17
|
7
|
—
|
—
|
$28,215.84
|
$159,287.12
|
$63,485.64
|
2026-07-18
|
|
2284
|
APR_DRG
|
Other Procedures For Endocrine Nutritional & Metabolic Disorders
|
17
|
7
|
—
|
—
|
$28,164.14
|
$158,987.40
|
$63,369.32
|
2026-07-18
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
33
|
17
|
—
|
—
|
$48,153.22
|
$286,231.49
|
$63,096.00
|
2026-07-18
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
37
|
18
|
—
|
—
|
$39,082.66
|
$232,314.45
|
$63,029.59
|
2026-07-18
|
|
3031
|
APR_DRG
|
Malignancy Male Reproductive System
|
17
|
7
|
—
|
—
|
$27,942.58
|
$157,702.88
|
$62,870.80
|
2026-07-18
|
|
5893
|
APR_DRG
|
Poisoning Of Medicinal Agents
|
17
|
7
|
—
|
—
|
$27,820.10
|
$156,992.83
|
$62,595.23
|
2026-07-18
|
|
6964
|
APR_DRG
|
Other Chemotherapy
|
17
|
7
|
—
|
—
|
$27,786.25
|
$156,796.59
|
$62,519.07
|
2026-07-18
|
|
G0251
|
HCPCS
|
Linear Acc Based Stero Radio
|
2
|
1
|
—
|
—
|
$62,212.00
|
$62,212.00
|
$62,212.00
|
2026-07-18
|
|
G0173
|
HCPCS
|
Linear Acc Stereo Radsur Com
|
2
|
1
|
—
|
—
|
$62,212.00
|
$62,212.00
|
$62,212.00
|
2026-07-18
|
|
8423
|
APR_DRG
|
Burns With Skin Graft Except Extensive 3rd Degree Burns
|
17
|
7
|
—
|
—
|
$27,596.08
|
$155,694.04
|
$62,091.17
|
2026-07-18
|
|
213
|
APR_DRG
|
Major Abdominal Vascular Procedures
|
17
|
7
|
—
|
—
|
$27,401.59
|
$154,566.52
|
$61,653.58
|
2026-07-18
|
|
Q2043
|
HCPCS
|
Sipuleucel-t Auto Cd54+
|
31
|
15
|
—
|
—
|
$45,599.43
|
$138,366.83
|
$61,540.57
|
2026-07-18
|
|
652
|
MS_DRG
|
Kidney Transplant
|
37
|
19
|
—
|
—
|
$23,385.64
|
$333,815.00
|
$61,486.36
|
2026-07-18
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
33
|
17
|
—
|
—
|
$46,888.53
|
$278,713.97
|
$61,445.87
|
2026-07-18
|
|
5464
|
APR_DRG
|
Other O.r. Proc For Obstetric Diagnoses Except Delivery Diagnoses
|
17
|
7
|
—
|
—
|
$27,252.65
|
$153,703.04
|
$61,318.47
|
2026-07-18
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc
|
33
|
17
|
—
|
—
|
$46,724.83
|
$277,740.91
|
$61,232.28
|
2026-07-18
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
37
|
18
|
—
|
—
|
$37,942.85
|
$255,500.00
|
$61,200.92
|
2026-07-18
|
|
233
|
APR_DRG
|
Spinal Procedures
|
17
|
7
|
—
|
—
|
$27,183.11
|
$153,299.85
|
$61,161.99
|
2026-07-18
|
|
247
|
MS_DRG
|
Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc
|
4
|
3
|
—
|
—
|
$54,535.32
|
$64,369.00
|
$61,150.50
|
2026-07-18
|
|
1303
|
APR_DRG
|
Respiratory System Diagnosis W Ventilator Support 96+ Hours
|
17
|
7
|
—
|
—
|
$27,078.48
|
$152,693.27
|
$60,926.58
|
2026-07-18
|
|
4834
|
APR_DRG
|
Penis, Testes & Scrotal Procedures
|
17
|
7
|
—
|
—
|
$27,069.86
|
$152,643.32
|
$60,907.19
|
2026-07-18
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
33
|
17
|
—
|
—
|
$46,289.31
|
$275,152.09
|
$60,664.02
|
2026-07-18
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
33
|
18
|
—
|
—
|
$45,957.34
|
$583,246.00
|
$60,445.22
|
2026-07-18
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
33
|
18
|
—
|
—
|
$45,957.34
|
$583,246.00
|
$60,445.22
|
2026-07-18
|
|
6081
|
APR_DRG
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
17
|
7
|
—
|
—
|
$26,863.07
|
$151,444.44
|
$60,441.91
|
2026-07-18
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
31
|
17
|
—
|
—
|
$47,164.16
|
$225,486.00
|
$60,349.10
|
2026-07-18
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
31
|
17
|
—
|
—
|
$47,103.25
|
$195,422.19
|
$60,271.50
|
2026-07-18
|
|
J9226
|
HCPCS
|
Histrelin Acetate (cpp) 50 Mg Sc Kit
|
89
|
27
|
$118,482.43
|
$59,241.22
50% off
|
$34,094.73
|
$323,671.43
|
$60,217.94
|
2026-07-18
|